Item hierarchy-based analysis of the Rivermead Mobility Index resulted in improved interpretation and enabled faster scoring in patients undergoing rehabilitation after stroke.

Science.gov (United States)

Roorda, Leo D; Green, John R; Houwink, Annemieke; Bagley, Pam J; Smith, Jane; Molenaar, Ivo W; Geurts, Alexander C

2012-06-01

To enable improved interpretation of the total score and faster scoring of the Rivermead Mobility Index (RMI) by studying item ordering or hierarchy and formulating start-and-stop rules in patients after stroke. Cohort study. Rehabilitation center in the Netherlands; stroke rehabilitation units and the community in the United Kingdom. Item hierarchy of the RMI was studied in an initial group of patients (n=620; mean age ± SD, 69.2±12.5y; 297 [48%] men; 304 [49%] left hemisphere lesion, and 269 [43%] right hemisphere lesion), and the adequacy of the item hierarchy-based start-and-stop rules was checked in a second group of patients (n=237; mean age ± SD, 60.0±11.3y; 139 [59%] men; 103 [44%] left hemisphere lesion, and 93 [39%] right hemisphere lesion) undergoing rehabilitation after stroke. Not applicable. Mokken scale analysis was used to investigate the fit of the double monotonicity model, indicating hierarchical item ordering. The percentages of patients with a difference between the RMI total score and the scores based on the start-and-stop rules were calculated to check the adequacy of these rules. The RMI had good fit of the double monotonicity model (coefficient H(T)=.87). The interpretation of the total score improved. Item hierarchy-based start-and-stop rules were formulated. The percentages of patients with a difference between the RMI total score and the score based on the recommended start-and-stop rules were 3% and 5%, respectively. Ten of the original 15 items had to be scored after applying the start-and-stop rules. Item hierarchy was established, enabling improved interpretation and faster scoring of the RMI. Copyright © 2012 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

The effects of a novel hostile interpretation bias modification paradigm on hostile interpretations, mood, and aggressive behavior.

Science.gov (United States)

AlMoghrabi, Nouran; Huijding, Jorg; Franken, Ingmar H A

2018-03-01

Cognitive theories of aggression propose that biased information processing is causally related to aggression. To test these ideas, the current study investigated the effects of a novel cognitive bias modification paradigm (CBM-I) designed to target interpretations associated with aggressive behavior. Participants aged 18-33 years old were randomly assigned to either a single session of positive training (n = 40) aimed at increasing prosocial interpretations or negative training (n = 40) aimed at increasing hostile interpretations. The results revealed that the positive training resulted in an increase in prosocial interpretations while the negative training seemed to have no effect on interpretations. Importantly, in the positive condition, a positive change in interpretations was related to lower anger and verbal aggression scores after the training. In this condition, participants also reported an increase in happiness. In the negative training no such effects were found. However, the better participants performed on the negative training, the more their interpretations were changed in a negative direction and the more aggression they showed on the behavioral aggression task. Participants were healthy university students. Therefore, results should be confirmed within a clinical population. These findings provide support for the idea that this novel CBM-I paradigm can be used to modify interpretations, and suggests that these interpretations are related to mood and aggressive behavior. Copyright © 2017 Elsevier Ltd. All rights reserved.

Comparing the use and interpretation of PGMI scoring to assess the technical quality of screening mammograms in the UK and Norway

International Nuclear Information System (INIS)

Boyce, M.; Gullien, R.; Parashar, D.; Taylor, K.

2015-01-01

Objectives: To compare PGMI systems used in the UK and Norway, determine levels of agreement in its interpretation for radiographers within and between centres, informing further research towards developing a more quantitative, uniform system. Methods: Mammograms from 112 women consecutively screened in the UK and Norway were anonymised, numbered and enriched to include all four PGMI categories. Cases were scored by five mammographers from each centre using local PGMI. Sets were exchanged and the process repeated. Distribution of categories was recorded and faults documented for images scored less than perfect. These were compared within and between centres and agreement analysed using non-weighted kappa statistic. Results: Norway uses 38 assessment criteria, the UK uses 15. Best agreement was between Norway raters scoring MLO views from both UK(RMLO k = 0.57, LMLO k = 0.490) and Norway (RMLO k = 0.48, LMLO k = 0.470). Least agreement was between UK raters scoring CC views from both UK(RCC k = 0.007, LCC k = 0.01) and Norway(RCC k = −0.04, LCC k = −0.003). There were no other apparent trends in inter-rater assessment. Most frequent faults in both test sets were on MLO views. Two out of three most common faults were the same for UK and Norway raters. Conclusions: Use of PGMI varied between centres in both number and interpretation of criteria employed. We identified the most common mammographic faults highlighting possible training needs. We suggest further work to provide a consensus list of visual criteria with accurate descriptors for each classification category. A validated way of applying them could help to standardise the process. - Highlights: • No previous published work comparing PGMI use between different countries. • Variation in number of assessment criteria used and their interpretation. • Best agreement was Norway scoring MLO views from both centres-moderate. • Least agreement was UK raters scoring CC views from both

What's in a word? Conflicting interpretations of vulnerability in climate change research

International Nuclear Information System (INIS)

O'Brien, Karen; Eriksen, Siri; Schjolden, Ane; Nygaard, Lynn

2004-01-01

In this paper, we discuss two competing interpretations of vulnerability in the climate change literature and consider the implications for both research and policy. The first interpretation, which can be referred to as the ''end point'' approach, views vulnerability as a residual of climate change impacts minus adaptation. The second interpretation, which takes vulnerability as a ''starting point'', views vulnerability as a general characteristic generated by multiple factors and processes. Viewing vulnerability as an end point considers that adaptations and adaptive capacity determine vulnerability, whereas viewing vulnerability as a starting point holds that vulnerability determines adaptive capacity. The practical consequences of these two interpretations are illustrated through the examples of Norway and Mozambique. We show that, if the underlying causes and contexts of vulnerability are not taken into account, there is a danger of underestimating the magnitude (large), scope (social arid environmental) and urgency (high) of climate change. (author)

Reliable Change Indices and Standardized Regression-Based Change Score Norms for Evaluating Neuropsychological Change in Children with Epilepsy

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Busch, Robyn M.; Lineweaver, Tara T.; Ferguson, Lisa; Haut, Jennifer S.

2015-01-01

Reliable change index scores (RCIs) and standardized regression-based change score norms (SRBs) permit evaluation of meaningful changes in test scores following treatment interventions, like epilepsy surgery, while accounting for test-retest reliability, practice effects, score fluctuations due to error, and relevant clinical and demographic factors. Although these methods are frequently used to assess cognitive change after epilepsy surgery in adults, they have not been widely applied to examine cognitive change in children with epilepsy. The goal of the current study was to develop RCIs and SRBs for use in children with epilepsy. Sixty-three children with epilepsy (age range 6–16; M=10.19, SD=2.58) underwent comprehensive neuropsychological evaluations at two time points an average of 12 months apart. Practice adjusted RCIs and SRBs were calculated for all cognitive measures in the battery. Practice effects were quite variable across the neuropsychological measures, with the greatest differences observed among older children, particularly on the Children’s Memory Scale and Wisconsin Card Sorting Test. There was also notable variability in test-retest reliabilities across measures in the battery, with coefficients ranging from 0.14 to 0.92. RCIs and SRBs for use in assessing meaningful cognitive change in children following epilepsy surgery are provided for measures with reliability coefficients above 0.50. This is the first study to provide RCIs and SRBs for a comprehensive neuropsychological battery based on a large sample of children with epilepsy. Tables to aid in evaluating cognitive changes in children who have undergone epilepsy surgery are provided for clinical use. An excel sheet to perform all relevant calculations is also available to interested clinicians or researchers. PMID:26043163

Building Capacity: The National Network for Ocean and Climate Change Interpretation

Science.gov (United States)

Spitzer, W.

2014-12-01

In the US, more than 1,500 informal science venues (science centers, museums, aquariums, zoos, nature centers, national parks) are visited annually by 61% of the population. Research shows that these visitors are receptive to learning about climate change, and expect these institutions to provide reliable information about environmental issues and solutions. These informal science venues play a critical role in shaping public understanding. Since 2007, the New England Aquarium has led a national effort to increase the capacity of informal science venues to effectively communicate about climate change. We are now leading the NSF-funded National Network for Ocean and Climate Change Interpretation (NNOCCI), partnering with the Association of Zoos and Aquariums, FrameWorks Institute, Woods Hole Oceanographic Institution, Monterey Bay Aquarium, and National Aquarium, with evaluation conducted by the New Knowledge Organization, Pennsylvania State University, and Ohio State University. After two years of project implementation, key findings include: 1. Importance of adaptive management - We continue to make ongoing changes in training format, content, and roles of facilitators and participants. 2. Impacts on interpreters - We have multiple lines of evidence for changes in knowledge, skills, attitudes, and behaviors. 3. Social radiation - Trained interpreters have a significant influence on their friends, family and colleagues. 4. Visitor impacts - "Exposure to "strategically framed" interpretation does change visitors' perceptions about climate change. 5. Community of practice - We are seeing evidence of growing participation, leadership, and sustainability. 6. Diffusion of innovation - Peer networks are facilitating dissemination throughout the informal science education community. Over the next five years, NNOCCI will achieve a systemic national impact across the ISE community, embed its work within multiple ongoing regional and national climate change education

Facilitating the Interpretation of English Language Proficiency Scores: Combining Scale Anchoring and Test Score Mapping Methodologies

Science.gov (United States)

Powers, Donald; Schedl, Mary; Papageorgiou, Spiros

2017-01-01

The aim of this study was to develop, for the benefit of both test takers and test score users, enhanced "TOEFL ITP"® test score reports that go beyond the simple numerical scores that are currently reported. To do so, we applied traditional scale anchoring (proficiency scaling) to item difficulty data in order to develop performance…

Evaluating Transcription Factor Activity Changes by Scoring Unexplained Target Genes in Expression Data.

Directory of Open Access Journals (Sweden)

Evi Berchtold

Full Text Available Several methods predict activity changes of transcription factors (TFs from a given regulatory network and measured expression data. But available gene regulatory networks are incomplete and contain many condition-dependent regulations that are not relevant for the specific expression measurement. It is not known which combination of active TFs is needed to cause a change in the expression of a target gene. A method to systematically evaluate the inferred activity changes is missing. We present such an evaluation strategy that indicates for how many target genes the observed expression changes can be explained by a given set of active TFs. To overcome the problem that the exact combination of active TFs needed to activate a gene is typically not known, we assume a gene to be explained if there exists any combination for which the predicted active TFs can possibly explain the observed change of the gene. We introduce the i-score (inconsistency score, which quantifies how many genes could not be explained by the set of activity changes of TFs. We observe that, even for these minimal requirements, published methods yield many unexplained target genes, i.e. large i-scores. This holds for all methods and all expression datasets we evaluated. We provide new optimization methods to calculate the best possible (minimal i-score given the network and measured expression data. The evaluation of this optimized i-score on a large data compendium yields many unexplained target genes for almost every case. This indicates that currently available regulatory networks are still far from being complete. Both the presented Act-SAT and Act-A* methods produce optimal sets of TF activity changes, which can be used to investigate the difficult interplay of expression and network data. A web server and a command line tool to calculate our i-score and to find the active TFs associated with the minimal i-score is available from https://services.bio.ifi.lmu.de/i-score.

Have Nursing Home Compare quality measure scores changed over time in response to competition?

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Castle, Nicholas G; Engberg, John; Liu, Darren

2007-06-01

Currently, the Centers for Medicare and Medicaid Services report on 15 Quality Measures (QMs) on the Nursing Home Compare (NHC) website. It is assumed that nursing homes are able to make improvements on these QMs, and in doing so they will attract more residents. In this investigation, we examine changes in QM scores, and whether competition and/or excess demand have influenced these change scores over a period of 1 year. Data come from NHC and the On-line Survey Certification And Recording (OSCAR) system. QM change scores are calculated using values from January 2003 to January 2004. A series of regression analyses are used to examine the association of competition and excess demand on QM scores. Eight QMs show an average decrease in scores (ie, better quality) and six QMs show an average increase in scores (ie, worse quality). However, for 13 of the 14 QMs these average changes averaged less than 1%. The regression analyses show an association between higher competition and improving QM scores and an association between lower occupancy and improving QM scores. As would be predicted based on the market-driven mechanism underlying quality improvements using report cards, we show that it is in the most competitive markets and those with the lowest average occupancy rates that improvements in the QM scores are more likely.

Radiology Residents' Performance in Screening Mammography Interpretation

International Nuclear Information System (INIS)

Lee, Eun Hye; Lyou, Chae Yeon

2013-01-01

To evaluate radiology residents' performance in screening mammography interpretation and to analyze the factors affecting performance. We enrolled 203 residents from 21 institutions and performed mammography interpretation tests. Between the trainee and non-trainee groups, we compared the interpretation score, recall rate, sensitivity, positive predictive value (PPV) and false-positive rate (FPR). We estimated the training effect using the score differences between trainee and non-trainee groups. We analyzed the factors affecting performance between training-effective and non-effective groups. Trainees were superior to non-trainees regarding interpretation score (43.1 vs. 37.1), recall rate (11.0 vs. 15.5%), sensitivity (83.6 vs. 72.0%), PPV (53.0 vs. 32.4%) and FPR (13.5 vs. 25.5). The longer the training period, the better were the interpretation score, recall rate, sensitivity, PPV and FPR (rho = 0.486, -0.375, 0.343, 0.504, -0.446, respectively). The training affected an increase by an average of 6 points; however, 31.6% of institutions showed no effect. A difference was noted in the volume of mammography interpretation during a month (594.0 vs. 476.9) and dedication of breast staff (61.5 vs. 0%) between training-effective and non-effective groups. Trainees showed better performance in mammography interpretation compared to non-trainees. Moreover, performance was correlated with the training period. The factors affecting performance were the volume of mammography interpretation and the dedication of the breast staff.

The characteristics and interpretability of land surface change and implications for project design

Science.gov (United States)

Sohl, Terry L.; Gallant, Alisa L.; Loveland, Thomas R.

2004-01-01

The need for comprehensive, accurate information on land-cover change has never been greater. While remotely sensed imagery affords the opportunity to provide information on land-cover change over large geographic expanses at a relatively low cost, the characteristics of land-surface change bring into question the suitability of many commonly used methodologies. Algorithm-based methodologies to detect change generally cannot provide the same level of accuracy as the analyses done by human interpreters. Results from the Land Cover Trends project, a cooperative venture that includes the U.S. Geological Survey, Environmental Protection Agency, and National Aeronautics and Space Administration, have shown that land-cover conversion is a relatively rare event, occurs locally in small patches, varies geographically and temporally, and is spectrally ambiguous. Based on these characteristics of change and the type of information required, manual interpretation was selected as the primary means of detecting change in the Land Cover Trends project. Mixtures of algorithm-based detection and manual interpretation may often prove to be the most feasible and appropriate design for change-detection applications. Serious examination of the expected characteristics and measurability of change must be considered during the design and implementation phase of any change analysis project.

Agents of Change: Interpreters as Witnesses of Transition

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Kristina Mullamaa

2014-08-01

Full Text Available In this article we would like to share the preliminary results of our on-going research on the memories of interpreters. From 2011-2012 we have carried out in-depth interviews with representatives of two different samples: experienced dialogue interpreters a in Estonia and  b in Sweden, most of whom have worked from the 1960s till today. This article sums up the preliminary results on the sample from Estonia. The focus is on the development of the interpreter´s role as reflecting the changes in society, cultural and social practices. As for the theoretical background, we view the processes within the framework of Transition Studies (cf. Lauristin, Vihalemm 2010;  Kennedy 2002. The methodological framework is ethnographic research. More specifically:  we combine narrative studies and memory research ( Kõresaar, Kirss 2004; Riessman 1993, Middleton, Brown 2005, Gilbert 2008; method:  semi-structured interviews (cf. Nunan 1992, Van Maanen 1983, Gilbert 2008. The analysis of our on-going research also enables us to test and share with our readers the pros and cons of the chosen methodology and methods.

Methods of scoring induced chromosome structural changes in barley

International Nuclear Information System (INIS)

Nicoleff, H.; Gecheff, K.

1976-01-01

In barley, a material widely used in mutation and chromosomal aberration studies, the method most frequently used for scoring induced chromosomal changes is still anaphase analysis. In this paper, data obtained after treatment of barley with gamma-rays and ethyleneimine (EI) and comparative scoring of aberrations in metaphase and anaphase are reported and discussed. It is evident that the metaphase aberrations induced by gamma-rays and ethyleneimine, due probably to their specific location, showed a differential manifestation during anaphase. Thus, after treatment with ethyleneimine a great portion of the induced aberrations, being located preferentially at the centromere regions, gave no scorable bridges, and an apparent excess of fragments was observed at anaphase. After gamma-irradiation the differences between metaphase and anaphase scoring were mainly due to a large portion of fragments escaping detection

Examining the Impact of Unscorable Item Responses on the Validity and Interpretability of MMPI-2/MMPI-2-RF Restructured Clinical (RC) Scale Scores

Science.gov (United States)

Dragon, Wendy R.; Ben-Porath, Yossef S.; Handel, Richard W.

2012-01-01

This article examined the impact of unscorable item responses on the psychometric validity and practical interpretability of scores on the Restructured Clinical (RC) Scales of the Minnesota Multiphasic Personality Inventory-2/Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2/MMPI-2-RF). In analyses conducted with five…

Interpretation bias and anxiety in childhood: stability, specificity and longitudinal associations.

Science.gov (United States)

Creswell, Cathy; O'Connor, Thomas G

2011-03-01

Biases in the interpretation of ambiguous material are central to cognitive models of anxiety; however, understanding of the association between interpretation and anxiety in childhood is limited. To address this, a prospective investigation of the stability and specificity of anxious cognitions and anxiety and the relationship between these factors was conducted. Sixty-five children (10-11 years) from a community sample completed measures of self-reported anxiety, depression, and conduct problems, and responded to ambiguous stories at three time points over one-year. Individual differences in biases in interpretation of ambiguity (specifically "anticipated distress" and "threat interpretation") were stable over time. Furthermore, anticipated distress and threat interpretation were specifically associated with anxiety symptoms. Distress anticipation predicted change in anxiety symptoms over time. In contrast, anxiety scores predicted change in threat interpretation over time. The results suggest that different cognitive constructs may show different longitudinal links with anxiety. These preliminary findings extend research and theory on anxious cognitions and their link with anxiety in children, and suggest that these cognitive processes may be valuable targets for assessment and intervention.

Interobserver agreement in interpretation of radiographic pulmonary changes in dogs in relation to radiology training

Directory of Open Access Journals (Sweden)

Tilde Rodrigues Froes

2014-09-01

Full Text Available Interpretation of pulmonary radiographs is one of the most difficult aspects of radiology and interobserver variability is high. The aim of this study was to assess variations in interpretation of pulmonary pathology amongst Brazilian veterinarians with different levels of training and experience, using the interpretation by American board-certified radiologists as a reference. We identified areas where interpretation is particularly challenging. Sixty digital canine thoracic radiographic examinations were interpreted by four groups of three Brazilian observers, each group being defined by different levels of training and experience. The radiographic findings of the 4 groups of observers in the study were compared to a reference interpretation established from the findings of three ACVR board-certified radiologists. The degree of discrepancy for each list between each group and the reference interpretation was assessed according to a three-level scoring system: no discrepancy, minor discrepancy, or major discrepancy. Data was analyzed using a Kappa and Cochran-Mantel-Haenszel tests. Brazilian veterinarians with the most training and experience showed the least interobserver variation and best performance when compared to the reference interpretation, followed by those with practical training, but with little work experience in professional practice. The radiographic patterns that were associated with the highest interobserver variability were the vascular, unstructured interstitial and bronchial patterns. Interobserver major discrepancies occurred in all groups, but is more evident in groups with the least training (44.4% and the general practitioners (26.7% group. It can be concluded that training positively influences the accuracy of radiographic interpretation and is recommended to reduce erroneous diagnoses.

RENZI SCORE FOR OBSTRUCTED DEFECATION SYNDROME - VALIDATION OF THE PORTUGUESE VERSION ACCORDING TO THE COSMIN CHECKLIST.

Science.gov (United States)

Caetano, Ana Celia; Dias, Sara; Santa-Cruz, André; Rolanda, Carla

2018-01-01

Recently, the Obstructed Defecation Syndrome score (ODS score) was developed and validated by Renzi to assess clinical staging and to allow evaluation and comparison of the efficacy of treatment of this disorder. Our goal is to validate the Portuguese version of Renzi ODS score, according to the Consensus based Standards for the selection of the Health Measurement Instruments (COSMIN) checklist. Following guidelines for cross-cultural validity, Renzi ODS score was translated into the Portuguese language. Then, a group of patients and healthy controls were invited to fill in the Renzi ODS score at baseline, after 2 weeks and 3 months, respectively. We assessed internal consistency, reliability and measurement error, content and construct validity, responsiveness and interpretability. A total of 113 individuals (77 patients; 36 healthy controls) completed the questionnaire. Seventy and 30 patients repeated the Renzi ODS score after 2 weeks and 3 months respectively. Factor analysis confirmed the unidimensionality of the scale. Cronbach's α coefficient of 0.77 supported item's homogeneity. Weighted quadratic kappa of 0.89 established test-retest reliability. The smallest detectable change at the individual level was 2.66 and at the group level was 0.30. Renzi ODS score and the total (-0.32) and physical (-0.43) SF-36 scores correlated negatively. Patient and control's groups significantly differed (11 points). The change score of Renzi ODS score between baseline and 3 months correlated negatively with the clinical evolution (-0.86). ROC analysis showed minimal important change of 2.00 with AUC 0.97. Neither floor nor ceiling effects were observed. This work validated the Portuguese version of Renzi ODS score. We can now use this reliable, responsive, and interpretable (at the group level) tool to evaluate Portuguese ODS patients.

"It Takes a Network": Building National Capacity for Climate Change Interpretation

Science.gov (United States)

Spitzer, W.

2014-12-01

Since 2007, the New England Aquarium has led a national effort to increase the capacity of informal science venues to effectively communicate about climate change. We are now leading the NSF-funded National Network for Ocean and Climate Change Interpretation (NNOCCI), partnering with the Association of Zoos and Aquariums, FrameWorks Institute, Woods Hole Oceanographic Institution, Monterey Bay Aquarium, and National Aquarium, with evaluation conducted by the New Knowledge Organization, Pennsylvania State University, and Ohio State University. More than 1,500 informal science venues (science centers, museums, aquariums, zoos, nature centers, national parks) are visited annually by 61% of the U.S. population. These visitors expect reliable information about environmental issues and solutions. NNOCCI enables teams of informal science interpreters across the country to serve as "communication strategists" - beyond merely conveying information they can influence public perceptions, given their high level of commitment, knowledge, public trust, social networks, and visitor contact. Beyond providing in-depth training, we have found that our "alumni network" is assuming an increasingly important role in achieving our goals: 1. Ongoing learning - Training must be ongoing given continuous advances in climate and social science research. 2. Implementation support - Social support is critical as interpreters move from learning to practice, given complex and potentially contentious subject matter. 3. Leadership development - We rely on a national cadre of interpretive leaders to conduct workshops, facilitate study circle trainings, and support alumni. 4. Coalition building - A peer network helps to build and maintain connections with colleagues, and supports further dissemination through the informal science community. We are experimenting with a variety of online and face to face strategies to support the growing alumni network. Our goals are to achieve a systemic national

Anthropometric adjustments are helpful in the interpretation of BMD and BMC Z-scores of pediatric patients with Prader-Willi syndrome.

Science.gov (United States)

Hangartner, T N; Short, D F; Eldar-Geva, T; Hirsch, H J; Tiomkin, M; Zimran, A; Gross-Tsur, V

2016-12-01

Anthropometric adjustments of bone measurements are necessary in Prader-Willi syndrome patients to correctly assess the bone status of these patients. This enables physicians to get a more accurate diagnosis of normal versus abnormal bone, allow for early and effective intervention, and achieve better therapeutic results. Bone mineral density (BMD) is decreased in patients with Prader-Willi syndrome (PWS). Because of largely abnormal body height and weight, traditional BMD Z-scores may not provide accurate information in this patient group. The goal of the study was to assess a cohort of individuals with PWS and characterize the development of low bone density based on two adjustment models applied to a dataset of BMD and bone mineral content (BMC) from dual-energy X-ray absorptiometry (DXA) measurements. Fifty-four individuals, aged 5-20 years with genetically confirmed PWS, underwent DXA scans of spine and hip. Thirty-one of them also underwent total body scans. Standard Z-scores were calculated for BMD and BMC of spine and total hip based on race, sex, and age for all patients, as well as of whole body and whole-body less head for those patients with total-body scans. Additional Z-scores were generated based on anthropometric adjustments using weight, height, and percentage body fat and a second model using only weight and height in addition to race, sex, and age. As many PWS patients have abnormal anthropometrics, addition of explanatory variables weight, height, and fat resulted in different bone classifications for many patients. Thus, 25-70 % of overweight patients, previously diagnosed as normal, were subsequently diagnosed as below normal, and 40-60 % of patients with below-normal body height changed from below normal to normal depending on bone parameter. This is the first study to include anthropometric adjustments into the interpretation of BMD and BMC in children and adolescents with PWS. This enables physicians to get a more accurate diagnosis of

Can Linear Regression Modeling Help Clinicians in the Interpretation of Genotypic Resistance Data? An Application to Derive a Lopinavir-Score

DEFF Research Database (Denmark)

Cozzi-Lepri, Alessandro; Prosperi, Mattia C F; Kjær, Jesper

2011-01-01

explored the potential of linear regression to construct a simple predictive model for lopinavir/r-based TCE. Although, the performance of our proposed score was similar to that of already existing IS, previously unrecognized lopinavir/r-associated mutations were identified. The analysis illustrates......BACKGROUND: The question of whether a score for a specific antiretroviral (e.g. lopinavir/r in this analysis) that improves prediction of viral load response given by existing expert-based interpretation systems (IS) could be derived from analyzing the correlation between genotypic data......). Our analysis identified mutations V82A, I54V, K20I and I62V, which were associated with reduced viral response and mutations I15V and V91S which determined lopinavir/r hypersensitivity. All models performed equally well (ASE on test ranging between 1.1 and 1.3, p¿=¿0.34). CONCLUSIONS: We fully...

Correlation of Head Impacts to Change in Balance Error Scoring System Scores in Division I Men's Lacrosse Players.

Science.gov (United States)

Miyashita, Theresa L; Diakogeorgiou, Eleni; Marrie, Kaitlyn

Investigation into the effect of cumulative subconcussive head impacts has yielded various results in the literature, with many supporting a link to neurological deficits. Little research has been conducted on men's lacrosse and associated balance deficits from head impacts. (1) Athletes will commit more errors on the postseason Balance Error Scoring System (BESS) test. (2) There will be a positive correlation to change in BESS scores and head impact exposure data. Prospective longitudinal study. Level 3. Thirty-four Division I men's lacrosse players (age, 19.59 ± 1.42 years) wore helmets instrumented with a sensor to collect head impact exposure data over the course of a competitive season. Players completed a BESS test at the start and end of the competitive season. The number of errors from pre- to postseason increased during the double-leg stance on foam ( P impacts sustained over the course of 1 lacrosse season, as measured by average linear acceleration, head injury criteria, and Gadd Severity Index scores. If there is microtrauma to the vestibular system due to repetitive subconcussive impacts, only an assessment that highly stresses the vestibular system may be able to detect these changes. Cumulative subconcussive impacts may result in neurocognitive dysfunction, including balance deficits, which are associated with an increased risk for injury. The development of a strategy to reduce total number of head impacts may curb the associated sequelae. Incorporation of a modified BESS test, firm surface only, may not be recommended as it may not detect changes due to repetitive impacts over the course of a competitive season.

A simple scoring system for breast MRI interpretation: does it compensate for reader experience?

International Nuclear Information System (INIS)

Marino, Maria Adele; Clauser, Paola; Woitek, Ramona; Wengert, Georg J.; Kapetas, Panagiotis; Bernathova, Maria; Pinker-Domenig, Katja; Helbich, Thomas H.; Baltzer, Pascal A.T.; Preidler, Klaus

2016-01-01

To investigate the impact of a scoring system (Tree) on inter-reader agreement and diagnostic performance in breast MRI reading. This IRB-approved, single-centre study included 100 patients with 121 consecutive histopathologically verified lesions (52 malignant, 68 benign). Four breast radiologists with different levels of MRI experience and blinded to histopathology retrospectively evaluated all examinations. Readers independently applied two methods to classify breast lesions: BI-RADS and Tree. BI-RADS provides a reporting lexicon that is empirically translated into likelihoods of malignancy; Tree is a scoring system that results in a diagnostic category. Readings were compared by ROC analysis and kappa statistics. Inter-reader agreement was substantial to almost perfect (kappa: 0.643-0.896) for Tree and moderate (kappa: 0.455-0.657) for BI-RADS. Diagnostic performance using Tree (AUC: 0.889-0.943) was similar to BI-RADS (AUC: 0.872-0.953). Less experienced radiologists achieved AUC: improvements up to 4.7 % using Tree (P-values: 0.042-0.698); an expert's performance did not change (P = 0.526). The least experienced reader improved in specificity using Tree (16 %, P = 0.001). No further sensitivity and specificity differences were found (P > 0.1). The Tree scoring system improves inter-reader agreement and achieves a diagnostic performance similar to that of BI-RADS. Less experienced radiologists, in particular, benefit from Tree. (orig.)

Defining the minimal detectable change in scores on the eight-item Morisky Medication Adherence Scale.

Science.gov (United States)

Muntner, Paul; Joyce, Cara; Holt, Elizabeth; He, Jiang; Morisky, Donald; Webber, Larry S; Krousel-Wood, Marie

2011-05-01

Self-report scales are used to assess medication adherence. Data on how to discriminate change in self-reported adherence over time from random variability are limited. To determine the minimal detectable change for scores on the 8-item Morisky Medication Adherence Scale (MMAS-8). The MMAS-8 was administered twice, using a standard telephone script, with administration separated by 14-22 days, to 210 participants taking antihypertensive medication in the CoSMO (Cohort Study of Medication Adherence among Older Adults). MMAS-8 scores were calculated and participants were grouped into previously defined categories (<6, 6 to <8, and 8 for low, medium, and high adherence). The mean (SD) age of participants was 78.1 (5.8) years, 43.8% were black, and 68.1% were women. Overall, 8.1% (17/210), 16.2% (34/210), and 51.0% (107/210) of participants had low, medium, and high MMAS-8 scores, respectively, at both survey administrations (overall agreement 75.2%; 158/210). The weighted κ statistic was 0.63 (95% CI 0.53 to 0.72). The intraclass correlation coefficient was 0.78. The within-person standard error of the mean for change in MMAS-8 scores was 0.81, which equated to a minimal detectable change of 1.98 points. Only 4.3% (9/210) of the participants had a change in MMAS-8 of 2 or more points between survey administrations. Within-person changes in MMAS-8 scores of 2 or more points over time may represent a real change in antihypertensive medication adherence.

What Do Test Scores Really Mean? A Latent Class Analysis of Danish Test Score Performance

DEFF Research Database (Denmark)

Munk, Martin D.; McIntosh, James

2014-01-01

Latent class Poisson count models are used to analyze a sample of Danish test score results from a cohort of individuals born in 1954-55, tested in 1968, and followed until 2011. The procedure takes account of unobservable effects as well as excessive zeros in the data. We show that the test scores...... of intelligence explain a significant proportion of the variation in test scores. This adds to the complexity of interpreting test scores and suggests that school culture and possible incentive problems make it more di¢ cult to understand what the tests measure....

Changes in metamorphopsia in daily life after successful epiretinal membrane surgery and correlation with M-CHARTS score

Directory of Open Access Journals (Sweden)

Kinoshita T

2015-02-01

Full Text Available Takamasa Kinoshita,1,2 Hiroko Imaizumi,1 Hirotomo Miyamoto,1 Utako Okushiba,1 Yuki Hayashi,2 Takashi Katome,2 Yoshinori Mitamura2 1Department of Ophthalmology, Sapporo City General Hospital, Sapporo, Japan; 2Department of Ophthalmology, Institute of Health Biosciences, The University of Tokushima Graduate School, Tokushima, Japan Purpose: To determine the correlation between the changes in metamorphopsia in daily life environment and the M-CHARTS scores after epiretinal membrane (ERM removal, and to determine the criterion for determining whether clinically significant changes in the metamorphopsia score have occurred in M-CHARTS. Methods: We studied 65 eyes undergoing vitrectomy for unilateral ERM. Self-administered questionnaires were used to examine the metamorphopsia in their daily life. The degree of metamorphopsia was determined by M-CHARTS. The receiver operating characteristic curve was used to determine the best predictor of the changes in metamorphopsia in daily life. To determine the reproducibility of the M-CHARTS score, another set of 56 eyes with ERM was tested twice on two different days. Results: The postoperative changes in the logarithm of the M-CHARTS score was defined as M2-value. The area under the receiver operating characteristic curve for the M2-value as a predictor of the changes in metamorphopsia in daily life was larger than area under the receiver operating characteristic curve obtained for any other parameter. The optimal cutoff value was -0.4. The 95% limits of agreement between test and retest measurements had a reproducibility of ±0.3 logarithm of the M-CHARTS score. Taking into account not only the reproducibility but also the consistency with the subjective changes, we determined the criterion for clinically significant changes in the M-CHARTS scores as a change of the M2-value by ≥0.4. Conclusion: Evaluating the changes in the M-CHARTS scores in logarithmic form is favorable not only theoretically but also

[Propensity score matching in SPSS].

Science.gov (United States)

Huang, Fuqiang; DU, Chunlin; Sun, Menghui; Ning, Bing; Luo, Ying; An, Shengli

2015-11-01

To realize propensity score matching in PS Matching module of SPSS and interpret the analysis results. The R software and plug-in that could link with the corresponding versions of SPSS and propensity score matching package were installed. A PS matching module was added in the SPSS interface, and its use was demonstrated with test data. Score estimation and nearest neighbor matching was achieved with the PS matching module, and the results of qualitative and quantitative statistical description and evaluation were presented in the form of a graph matching. Propensity score matching can be accomplished conveniently using SPSS software.

Reliability, validity and sensitivity to change of neurogenic bowel dysfunction score in patients with spinal cord injury

DEFF Research Database (Denmark)

Erdem, D.; Hava, D.; Keskinoglu, P.

2017-01-01

cord injury (SCI). The reliability of NBD score was assessed by test-retest reliability and internal consistency. Cronbach's alpha coefficient was calculated to determine internal consistency. The construct validity was evaluated by exploring correlations between the NBD score and SF-36 scales, patient...... assessment of impact of NBD on quality of life (QoL) and the physician global assessment (PGA). The Global Rating of Change (GRC) scale was used to assess the change of NBD to investigate the sensitivity of the score to change. Results: Cronbach's alpha coefficient was 0.547. In test-retest reliability...

Building A National Network for Ocean and Climate Change Interpretation (Invited)

Science.gov (United States)

Spitzer, W.; Anderson, J.

2013-12-01

In the US, more than 1,500 informal science venues (science centers, museums, aquariums, zoos, nature centers, national parks) are visited annually by 61% of the population. Research shows that these visitors are receptive to learning about climate change, and expect these institutions to provide reliable information about environmental issues and solutions. Given that we spend less than 5% of our lifetime in a classroom, informal science venues play a critical role in shaping public understanding. Since 2007, the New England Aquarium (NEAq) has led a national effort to increase the capacity of informal science education institutions (ISEIs) to effectively communicate about the impacts of climate change on the oceans. NEAq is now leading the NSF-funded National Network for Ocean and Climate Change Interpretation (NNOCCI), partnering with the Association of Zoos and Aquariums, FrameWorks Institute, Woods Hole Oceanographic Institution, Monterey Bay Aquarium, and National Aquarium, with evaluation conducted by the New Knowledge Organization, Pennsylvania State University, and Ohio State University. NNOCCI's design is based on best practices in informal science learning, cognitive/social psychology, community and network building: Interpreters as Communication Strategists - Interpreters can serve not merely as educators disseminating information, but can also be leaders in influencing public perceptions, given their high level of commitment, knowledge, public trust, social networks, and visitor contact. Communities of Practice - Learning is a social activity that is created through engagement in a supportive community context. Social support is particularly important in addressing a complex, contentious and distressing subject. Diffusion of Innovation - Peer networks are of primary importance in spreading innovations. Leaders serve as 'early adopters' and influence others to achieve a critical mass of implementation. Over the next five years, NNOCCI will achieve a

Association of metabolic syndrome and change in Unified Parkinson's Disease Rating Scale scores.

Science.gov (United States)

Leehey, Maureen; Luo, Sheng; Sharma, Saloni; Wills, Anne-Marie A; Bainbridge, Jacquelyn L; Wong, Pei Shieen; Simon, David K; Schneider, Jay; Zhang, Yunxi; Pérez, Adriana; Dhall, Rohit; Christine, Chadwick W; Singer, Carlos; Cambi, Franca; Boyd, James T

2017-10-24

To explore the association between metabolic syndrome and the Unified Parkinson's Disease Rating Scale (UPDRS) scores and, secondarily, the Symbol Digit Modalities Test (SDMT). This is a secondary analysis of data from 1,022 of 1,741 participants of the National Institute of Neurological Disorders and Stroke Exploratory Clinical Trials in Parkinson Disease Long-Term Study 1, a randomized, placebo-controlled trial of creatine. Participants were categorized as having or not having metabolic syndrome on the basis of modified criteria from the National Cholesterol Education Program Adult Treatment Panel III. Those who had the same metabolic syndrome status at consecutive annual visits were included. The change in UPDRS and SDMT scores from randomization to 3 years was compared in participants with and without metabolic syndrome. Participants with metabolic syndrome (n = 396) compared to those without (n = 626) were older (mean [SD] 63.9 [8.1] vs 59.9 [9.4] years; p metabolic syndrome experienced an additional 0.6- (0.2) unit annual increase in total UPDRS ( p = 0.02) and 0.5- (0.2) unit increase in motor UPDRS ( p = 0.01) scores compared with participants without metabolic syndrome. There was no difference in the change in SDMT scores. Persons with Parkinson disease meeting modified criteria for metabolic syndrome experienced a greater increase in total UPDRS scores over time, mainly as a result of increases in motor scores, compared to those who did not. Further studies are needed to confirm this finding. NCT00449865. © 2017 American Academy of Neurology.

Change in fibrosis score as a predictor of mortality among HIV-infected patients with viral hepatitis.

Science.gov (United States)

Jain, Mamta K; Seremba, Emmanuel; Bhore, Rafia; Dao, Doan; Joshi, Reeti; Attar, Nahid; Yuan, He-Jun; Lee, William M

2012-02-01

Noninvasive markers of liver fibrosis, measured at baseline, have been shown to predict liver-related mortality. It remains unknown if a change in the value of the scores over time predicts mortality in patients with HIV and viral hepatitis. In this retrospective study, survival in HIV/hepatitis B virus (HBV; n = 67), HIV/hepatitis C virus (HCV; n = 43), and HIV/HBV/HCV (n = 41) patients was examined using Kaplan-Meier life table analysis. Aspartate aminotransferase (AST)-to-platelet ratio index (APRI) and FIB-4 scores, two noninvasive markers of liver fibrosis, were calculated at baseline and at last available clinical follow-up to determine the change in fibrosis score. Factors associated with mortality were assessed by Cox proportional hazards, including the change in the noninvasive marker score between the two time points. All-cause mortality was determined by Social Security Death Index and chart review. Sixty-seven were coinfected with HIV/HBV, 43 with HIV/HCV, and 41 were triply infected (HIV/HBV/HCV). Kaplan-Meier analysis showed similar survival for the three groups at 7 years of follow-up (p = 0.10). However, median length of follow-up was lower in HIV/HCV (60.5; range 0-102) compared to HIV/HBV (75.7; 12.3-126.5) and HIV/HBV/HCV (80.0; 2.7-123) months, respectively, p = 0.02. Baseline fibrosis score (p = 0.002), an increase in the value for noninvasive measurements for fibrosis (p < 0.001), and the presence of HIV/HCV coinfection (p = 0.041) were each associated with higher risk for mortality. Baseline fibrosis score (p = 0.03) and an increase in FIB-4 score (p = 0.05) were independent predictors of all-cause mortality, but liver-related mortality was not evaluated. In this study, baseline fibrosis score was predictive of 7-year all-cause mortality. Further studies are needed in a prospective cohort to evaluate the predictive value of monitoring changes in fibrosis scores over time to predict mortality in patients with viral hepatitis.

Scoring an Abstract Contemporary Silent Film

OpenAIRE

Frost, Crystal

2014-01-01

I composed an original digital audio film score with full sound design for a contemporary silent film called Apple Tree. The film is highly conceptual and interpretive and required a very involved, intricate score to successfully tell the story. In the process of scoring this film, I learned new ways to convey an array of contrasting emotions through music and sound. After analyzing the film's emotional journey, I determined that six defining emotions were the foundation on which to build an ...

Utility of proverb interpretation measures with cardiac transplant candidates.

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Dugbartey, A T

1998-12-01

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

Perception and Interpretation of Climate Change among Quechua Farmers of Bolivia: Indigenous Knowledge as a Resource for Adaptive Capacity

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Sébastien Boillat

2013-12-01

Full Text Available We aim to explore how indigenous peoples observe and ascribe meaning to change. The case study involves two Quechua-speaking farmer communities from mountainous areas near Cochabamba, Bolivia. Taking climate change as a starting point, we found that, first, farmers often associate their observations of climate change with other social and environmental changes, such as value change in the community, population growth, out-migration, urbanization, and land degradation. Second, some of the people interpret change as part of a cycle, which includes a belief in the return of some characteristics of ancient or mythological times. Third, environmental change is also perceived as the expression of "extra-human intentionalities," a reaction of natural or spiritual entities that people consider living beings. On the basis of these interpretations of change and their adaptive strategies, we discuss the importance of indigenous knowledge as a component of adaptive capacity. Even in the context of living with modern science and mass media, indigenous patterns of interpreting phenomena tend to be persistent. Our results support the view that indigenous knowledge must be acknowledged as process, emphasizing ways of observing, discussing, and interpreting new information. In this case, indigenous knowledge can help address complex relationships between phenomena, and help design adaptation strategies based on experimentation and knowledge coproduction.

Changing interpretations of Plotinus

DEFF Research Database (Denmark)

Catana, Leo

2013-01-01

about method point in other directions. Eduard Zeller (active in the second half of the 19th century) is typically regarded as the first who gave a satisfying account of Plotinus’ philosophy as a whole. In this article, on the other hand, Zeller is seen as the one who finalised a tradition initiated...... in the 18th century. Very few Plotinus scholars have examined the interpretative development prior to Zeller. Schiavone (1952) and Bonetti (1971), for instance, have given little attention to Brucker’s introduction of the concept system of philosophy. The present analysis, then, has value...

Reliability and sensitivity to change of the OMERACT rheumatoid arthritis magnetic resonance imaging score in a multireader, longitudinal setting

DEFF Research Database (Denmark)

Haavardsholm, ea; Østergaard, Mikkel; Kvan, NP

2005-01-01

, erosion, and bone marrow edema status and for change scores. RESULTS: Intrareader ICCs were generally very high, both for status scores (median baseline and followup 0.89 and 0.90 for synovitis, 0.91 and 0.90 for erosion, and 0.90 and 0.98 for edema) and for change scores (median 0.80 for synovitis, 0...

The Effects of the Clock and Kickoff Rule Changes on Actual and Market-Based Expected Scoring in NCAA Football

Directory of Open Access Journals (Sweden)

Kenneth Linna

2014-04-01

Full Text Available Clock rule changes were introduced in the 2006 season with the goal of reducing the average duration of the game; these changes were reversed in 2007. In addition, in 2007 the kickoff rule was changed to create more excitement and potentially more scoring. We examine what happened to actual and expected scoring during these National Collegiate Athletic Association (NCAA football seasons. The clock rule change in 2006 led to lower scoring which was not fully encompassed in the betting market, leading to significant returns to betting the under. Multiple rule changes in 2007 led to volatility in the betting market that subsided by season’s end.

Disciplinary reporting affects the interpretation of climate change impacts in global oceans.

Science.gov (United States)

Hauser, Donna D W; Tobin, Elizabeth D; Feifel, Kirsten M; Shah, Vega; Pietri, Diana M

2016-01-01

Climate change is affecting marine ecosystems, but different investigative approaches in physical, chemical, and biological disciplines may influence interpretations of climate-driven changes in the ocean. Here, we review the ocean change literature from 2007 to 2012 based on 461 of the most highly cited studies in physical and chemical oceanography and three biological subdisciplines. Using highly cited studies, we focus on research that has shaped recent discourse on climate-driven ocean change. Our review identified significant differences in spatial and temporal scales of investigation among disciplines. Physical/chemical studies had a median duration of 29 years (n = 150) and covered the greatest study areas (median 1.41 × 10(7) km(2) , n = 148). Few biological studies were conducted over similar spatial and temporal scales (median 8 years, n = 215; median 302 km(2) , n = 196), suggesting a more limited ability to separate climate-related responses from natural variability. We linked physical/chemical and biological disciplines by tracking studies examining biological responses to changing ocean conditions. Of the 545 biological responses recorded, a single physical or chemical stressor was usually implicated as the cause (59%), with temperature as the most common primary stressor (44%). The most frequently studied biological responses were changes in physiology (31%) and population abundance (30%). Differences in disciplinary studies, as identified in this review, can ultimately influence how researchers interpret climate-related impacts in marine systems. We identified research gaps and the need for more discourse in (1) the Indian and other Southern Hemisphere ocean basins; (2) research themes such as archaea, bacteria, viruses, mangroves, turtles, and ocean acidification; (3) physical and chemical stressors such as dissolved oxygen, salinity, and upwelling; and (4) adaptive responses of marine organisms to climate-driven ocean change. Our findings reveal

Conceptual Change in Understanding the Nature of Science Learning: An Interpretive Phenomenological Analysis

Science.gov (United States)

DiBenedetto, Christina M.

This study is the first of its kind to explore the thoughts, beliefs, attitudes and values of secondary educators as they experience conceptual change in their understanding of the nature of science learning vis a vis the Framework for K-12 Science Education published by the National Research Council. The study takes aim at the existing gap between the vision for science learning as an active process of inquiry and current pedagogical practices in K-12 science classrooms. For students to understand and explain everyday science ideas and succeed in science studies and careers, the means by which they learn science must change. Focusing on this change, the study explores the significance of educator attitudes, beliefs and values to science learning through interpretive phenomenological analysis around the central question, "In what ways do educators understand and articulate attitudes and beliefs toward the nature of science learning?" The study further explores the questions, "How do educators experience changes in their understanding of the nature of science learning?" and "How do educators believe these changes influence their pedagogical practice?" Study findings converge on four conceptions that science learning: is the action of inquiry; is a visible process initiated by both teacher and learner; values student voice and changing conceptions is science learning. These findings have implications for the primacy of educator beliefs, attitudes and values in reform efforts, science teacher leadership and the explicit instruction of both Nature of Science and conceptual change in educator preparation programs. This study supports the understanding that the nature of science learning is cognitive and affective conceptual change. Keywords: conceptual change, educator attitudes and beliefs, framework for K-12 science education, interpretive phenomenological analysis, nature of science learning, next generation science standards, science professional development

Abdominal and pelvic computed tomography (CT) interpretation: discrepancy rates among experienced radiologists

Energy Technology Data Exchange (ETDEWEB)

Abujudeh, Hani H.; Boland, Giles W.; Kaewlai, Rathachai; Rabiner, Pavel; Thrall, James H. [Massachusetts General Hospital and Harvard Medical School, Department of Radiology, Boston, MA (United States); Halpern, Elkarn F.; Gazelle, G.S. [Massachusetts General Hospital and Harvard Medical School, Department of Radiology, Boston, MA (United States); Massachusetts General Hospital and Harvard Medical School, Institute for Technology Assessment, Boston, MA (United States)

2010-08-15

To assess the discrepancy rate for the interpretation of abdominal and pelvic computed tomography (CT) examinations among experienced radiologists. Ninety abdominal and pelvic CT examinations reported by three experienced radiologists who specialize in abdominal imaging were randomly selected from the radiological database. The same radiologists, blinded to previous interpretation, were asked to re-interpret 60 examinations: 30 of their previous interpretations and 30 interpreted by others. All reports were assessed for the degree of discrepancy between initial and repeat interpretations according to a three-level scoring system: no discrepancy, minor, or major discrepancy. Inter- and intrareader discrepancy rates and causes were evaluated. CT examinations included in the investigation were performed on 90 patients (43 men, mean age 59 years, SD 14, range 19-88) for the following indications: follow-up/evaluation of malignancy (69/90, 77%), pancreatitis (5/90, 6%), urinary tract stone (4/90, 4%) or other (12/90, 13%). Interobserver and intraobserver major discrepancy rates were 26 and 32%, respectively. Major discrepancies were due to missed findings, different opinions regarding interval change of clinically significant findings, and the presence of recommendation. Major discrepancy of between 26 and 32% was observed in the interpretation of abdominal and pelvic CT examinations. (orig.)

Abdominal and pelvic computed tomography (CT) interpretation: discrepancy rates among experienced radiologists

International Nuclear Information System (INIS)

Abujudeh, Hani H.; Boland, Giles W.; Kaewlai, Rathachai; Rabiner, Pavel; Thrall, James H.; Halpern, Elkarn F.; Gazelle, G.S.

2010-01-01

To assess the discrepancy rate for the interpretation of abdominal and pelvic computed tomography (CT) examinations among experienced radiologists. Ninety abdominal and pelvic CT examinations reported by three experienced radiologists who specialize in abdominal imaging were randomly selected from the radiological database. The same radiologists, blinded to previous interpretation, were asked to re-interpret 60 examinations: 30 of their previous interpretations and 30 interpreted by others. All reports were assessed for the degree of discrepancy between initial and repeat interpretations according to a three-level scoring system: no discrepancy, minor, or major discrepancy. Inter- and intrareader discrepancy rates and causes were evaluated. CT examinations included in the investigation were performed on 90 patients (43 men, mean age 59 years, SD 14, range 19-88) for the following indications: follow-up/evaluation of malignancy (69/90, 77%), pancreatitis (5/90, 6%), urinary tract stone (4/90, 4%) or other (12/90, 13%). Interobserver and intraobserver major discrepancy rates were 26 and 32%, respectively. Major discrepancies were due to missed findings, different opinions regarding interval change of clinically significant findings, and the presence of recommendation. Major discrepancy of between 26 and 32% was observed in the interpretation of abdominal and pelvic CT examinations. (orig.)

Predictors of Knowledge and Image Interpretation Skill Development in Radiology Residents.

Science.gov (United States)

Ravesloot, Cécile J; van der Schaaf, Marieke F; Kruitwagen, Cas L J J; van der Gijp, Anouk; Rutgers, Dirk R; Haaring, Cees; Ten Cate, Olle; van Schaik, Jan P J

2017-09-01

Purpose To investigate knowledge and image interpretation skill development in residency by studying scores on knowledge and image questions on radiology tests, mediated by the training environment. Materials and Methods Ethical approval for the study was obtained from the ethical review board of the Netherlands Association for Medical Education. Longitudinal test data of 577 of 2884 radiology residents who took semiannual progress tests during 5 years were retrospectively analyzed by using a nonlinear mixed-effects model taking training length as input variable. Tests included nonimage and image questions that assessed knowledge and image interpretation skill. Hypothesized predictors were hospital type (academic or nonacademic), training hospital, enrollment age, sex, and test date. Results Scores showed a curvilinear growth during residency. Image scores increased faster during the first 3 years of residency and reached a higher maximum than knowledge scores (55.8% vs 45.1%). The slope of image score development versus knowledge question scores of 1st-year residents was 16.8% versus 12.4%, respectively. Training hospital environment appeared to be an important predictor in both knowledge and image interpretation skill development (maximum score difference between training hospitals was 23.2%; P radiology residency and leveled off in the 3rd and 4th training year. The shape of the curve was mainly influenced by the specific training hospital. © RSNA, 2017 Online supplemental material is available for this article.

Interpreter-mediated dentistry.

Science.gov (United States)

Bridges, Susan; Drew, Paul; Zayts, Olga; McGrath, Colman; Yiu, Cynthia K Y; Wong, H M; Au, T K F

2015-05-01

The global movements of healthcare professionals and patient populations have increased the complexities of medical interactions at the point of service. This study examines interpreter mediated talk in cross-cultural general dentistry in Hong Kong where assisting para-professionals, in this case bilingual or multilingual Dental Surgery Assistants (DSAs), perform the dual capabilities of clinical assistant and interpreter. An initial language use survey was conducted with Polyclinic DSAs (n = 41) using a logbook approach to provide self-report data on language use in clinics. Frequencies of mean scores using a 10-point visual analogue scale (VAS) indicated that the majority of DSAs spoke mainly Cantonese in clinics and interpreted for postgraduates and professors. Conversation Analysis (CA) examined recipient design across a corpus (n = 23) of video-recorded review consultations between non-Cantonese speaking expatriate dentists and their Cantonese L1 patients. Three patterns of mediated interpreting indicated were: dentist designated expansions; dentist initiated interpretations; and assistant initiated interpretations to both the dentist and patient. The third, rather than being perceived as negative, was found to be framed either in response to patient difficulties or within the specific task routines of general dentistry. The findings illustrate trends in dentistry towards personalized care and patient empowerment as a reaction to product delivery approaches to patient management. Implications are indicated for both treatment adherence and the education of dental professionals. Copyright © 2015 Elsevier Ltd. All rights reserved.

Pain flare following external beam radiotherapy and meaningful change in pain scores in the treatment of bone metastases

International Nuclear Information System (INIS)

Chow, Edward; Ling, Alison; Davis, Lori; Panzarella, Tony; Danjoux, Cyril

2005-01-01

Background and purpose: To examine the incidence of pain flare following external beam radiotherapy and to determine what constitutes a meaningful change in pain scores in the treatment of bone metastases. Patients and methods: Patients with bone metastases treated with external beam radiotherapy were asked to score their pain on a scale of 0-10 before the treatment (baseline), daily during the treatment and for 10 days after completion of external beam radiation. Pain flare was defined as a two-point increase from baseline pain in the pain scale of 0-10 with no decrease in analgesic intake or a 25% increase in analgesic intake employing daily oral morphine equivalent with no decrease in pain score. To distinguish pain flare from progression of pain, we required the pain score and analgesic intake to return back to baseline levels after the increase/flare. They were also asked to indicate if their pain changed during that time compared to pre-treatment level. The change in pain score was compared with patient perception. Results: Eighty-eight patients were evaluated in this study. There were 49 male and 39 female patients with the median age of 70 years. Twelve of 88 patients (14%) had pain flare on day 1. The overall incidence of pain flare during the study period ranged from 2 to 16%. A total of 797 pain scorings were obtained. Patients perceived an improvement in pain when their self-reported pain score decreased by at least two points. Conclusions: Our study confirms the occurrence of pain flare following the external beam radiotherapy in the treatment of bone metastases. Further studies are required to predict who are at risk for flare. Appropriate measures can be taken to alleviate the pain flare. The finding in the meaningful change in pain scores supports the investigator-defined partial response used in some clinical trials

Patient-perceived satisfactory improvement (PPSI): interpreting meaningful change in pain from the patient's perspective

NARCIS (Netherlands)

ten Klooster, Peter M.; Drossaers-Bakker, K.W.; Taal, Erik; van de Laar, Mart A F J

2006-01-01

The assessment of clinically meaningful changes in patient-reported pain has become increasingly important when interpreting results of clinical studies. However, proposed response criteria, such as the minimal clinically important difference, do not correspond with the growing need for information

MMPI-2 and MMPI-A Computerized Interpretation: An Adjunct to Quality Mental Health Service.

Science.gov (United States)

Phelps, LeAdelle

1994-01-01

Provides reviews of computerized scoring and interpretive systems for the Minnesota Multiphasic Personality Inventory (MMPI-2 and MMPI-A): Caldwell Report, the Psychological Assessment Resources MMPI-2 Interpretive System, and the National Computer Systems Programs. Concludes that when used appropriately, such scoring systems enhance a counselor's…

Changes in Student Populations and Average Test Scores of Dutch Primary Schools

Science.gov (United States)

Luyten, Hans; de Wolf, Inge

2011-01-01

This article focuses on the relation between student population characteristics and average test scores per school in the final grade of primary education from a dynamic perspective. Aggregated data of over 5,000 Dutch primary schools covering a 6-year period were used to study the relation between changes in school populations and shifts in mean…

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

DEFF Research Database (Denmark)

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

2016-01-01

OBJECTIVES: The aim was to evaluate the metric properties of the semi-quantitative OMERACT US scoring system vs a novel quantitative US scoring system for tenosynovitis, by testing its intra- and inter-reader reliability, sensitivity to change and comparison with clinical tenosynovitis scoring...... in a 6-month follow-up study. METHODS: US and clinical assessments of the tendon sheaths of the clinically most affected hand and foot were performed at baseline, 3 and 6 months in 51 patients with RA. Tenosynovitis was assessed using the semi-quantitative scoring system (0-3) proposed by the OMERACT US...... tenosynovitis score was performed, calculating a sum score per patient. RESULTS: The intra- and inter-observer agreements for US tenosynovitis assessments were very good at baseline and for change for GS and CD, but less good for PI. The smallest detectable change was 0.97 for GS, 0.93 for CD and 30.1 for PI...

Similar predictions of etravirine sensitivity regardless of genotypic testing method used: comparison of available scoring systems.

Science.gov (United States)

Vingerhoets, Johan; Nijs, Steven; Tambuyzer, Lotke; Hoogstoel, Annemie; Anderson, David; Picchio, Gaston

2012-01-01

The aims of this study were to compare various genotypic scoring systems commonly used to predict virological outcome to etravirine, and examine their concordance with etravirine phenotypic susceptibility. Six etravirine genotypic scoring systems were assessed: Tibotec 2010 (based on 20 mutations; TBT 20), Monogram, Stanford HIVdb, ANRS, Rega (based on 37, 30, 27 and 49 mutations, respectively) and virco(®)TYPE HIV-1 (predicted fold change based on genotype). Samples from treatment-experienced patients who participated in the DUET trials and with both genotypic and phenotypic data (n=403) were assessed using each scoring system. Results were retrospectively correlated with virological response in DUET. κ coefficients were calculated to estimate the degree of correlation between the different scoring systems. Correlation between the five scoring systems and the TBT 20 system was approximately 90%. Virological response by etravirine susceptibility was comparable regardless of which scoring system was utilized, with 70-74% of DUET patients determined as susceptible to etravirine by the different scoring systems achieving plasma viral load <50 HIV-1 RNA copies/ml. In samples classed as phenotypically susceptible to etravirine (fold change in 50% effective concentration ≤3), correlations with genotypic score were consistently high across scoring systems (≥70%). In general, the etravirine genotypic scoring systems produced similar results, and genotype-phenotype concordance was high. As such, phenotypic interpretations, and in their absence all genotypic scoring systems investigated, may be used to reliably predict the activity of etravirine.

Electrocardiogram interpretation skills among ambulance nurses.

Science.gov (United States)

Werner, Kristoffer; Kander, Kristofer; Axelsson, Christer

2016-06-01

To describe ambulance nurses' practical electrocardiogram (ECG) interpretation skills and to measure the correlation between these skills and factors that may impact on the level of knowledge. This study was conducted using a prospective quantitative survey with questionnaires and a knowledge test. A convenience sample collection was conducted among ambulance nurses in three different districts in western Sweden. The knowledge test consisted of nine different ECGs. The score of the ECG test were correlated against the questions in the questionnaire regarding both general ECG interpretation skill and ability to identify acute myocardial infarction using Mann-Whitney U test, Kruskal-Wallis test and Spearman's rank correlation. On average, the respondents had 54% correct answers on the test and identified 46% of the ECGs indicating acute myocardial infarction. The median total score was 9 of 16 (interquartile range 7-11) and 1 of 3 (IQR 1-2) in infarction points. No correlation between ECG interpretation skill and factors such as education and professional experience was found, except that coronary care unit experience was associated with better results on the ECG test. Ambulance nurses have deficiencies in their ECG interpretation skills. This also applies to conditions where the ambulance crew has great potential to improve the outcome of the patient's health, such as myocardial infarction and cardiac arrest. Neither education, extensive experience in ambulance service nor in nursing contributed to an improved result. The only factor of importance for higher ECG interpretation knowledge was prior experience of working in a coronary care unit. © The European Society of Cardiology 2014.

Measurement of osteogenic exercise – How to interpret accelerometric data?

Directory of Open Access Journals (Sweden)

Timo eJämsä

2011-10-01

Full Text Available Bone tissue adapts to its mechanical loading environment. We review here the accelerometric measurements with special emphasis on osteogenic exercise. The accelerometric method offers a unique opportunity to assess the intensity of mechanical loadings. We present methods to interpret accelerometric data, reducing it to the daily distributions of magnitude, slope, area and energy of signal. These features represent the intensity level of physical activities, and were associated with the changes in bone density, bone geometry, physical performance and metabolism in healthy premenopausal women. Bone adaptations presented a dose- and intensity dependent relationship with impact loading. Changes in hip were threshold dependent, indicating the importance of high impacts exceeding acceleration of 4 g or slope of 100 g/s as an osteogenic stimulus. The number of impacts needed was 60 per day. We also present the Daily Impact Score to describe the osteogenic potential of daily mechanical loading with a single score. The methodology presented here can be used to study musculoskeletal adaptation to exercise in other target groups as well.

Summary scores captured changes in subjects' QoL as measured by the multiple scales of the EORTC QLQ-C30.

Science.gov (United States)

Phillips, Rachel; Gandhi, Mihir; Cheung, Yin Bun; Findlay, Michael P; Win, Khin Maung; Hai, Hoang Hoa; Yang, Jin Mo; Lobo, Rolley Rey; Soo, Khee Chee; Chow, Pierce K H

2015-08-01

To examine the performance of the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) global health status/quality of life (QoL) scale and two summary scores to detect changes in the QoL profile over time, according to changes in the individual scales. Data came from 167 clinical trial patients with unresectable (advanced) hepatocellular carcinoma. The global health status/QoL scale of the questionnaire contained two items: overall health and overall QoL. Nordin and Hinz proposed summary scores for the questionnaire. A mixed-effect model was fitted to estimate trends in scores over time. Predominantly the individual scale scores declined over time; however, the global health status/QoL score was stable [rate of change = -0.3 per month; 95% confidence interval (CI): -1.2, 0.6]. Nordin's summary score, which gave equal weight to the 15 questionnaire scales, and Hinz's summary score, which gave equal weight to the 30 questionnaire items, showed a statistically significant decline over time, 3.4 (95% CI: -4.5, -2.4) and 4.2 (95% CI: -5.3, -3.0) points per month, respectively. In contrast to the global health status/QoL scale, the summary scores proposed by Nordin and Hinz detected changes in subjects' QoL profile described by the EORTC QLQ-C30 individual scales. Copyright © 2015 Elsevier Inc. All rights reserved.

Does PACS improve diagnostic accuracy in chest radiograph interpretations in clinical practice?

International Nuclear Information System (INIS)

Hurlen, Petter; Borthne, Arne; Dahl, Fredrik A.; Østbye, Truls; Gulbrandsen, Pål

2012-01-01

Objectives: To assess the impact of a Picture Archiving and Communication System (PACS) on the diagnostic accuracy of the interpretation of chest radiology examinations in a “real life” radiology setting. Materials and methods: During a period before PACS was introduced to radiologists, when images were still interpreted on film and reported on paper, images and reports were also digitally stored in an image database. The same database was used after the PACS introduction. This provided a unique opportunity to conduct a blinded retrospective study, comparing sensitivity (the main outcome parameter) in the pre and post-PACS periods. We selected 56 digitally stored chest radiograph examinations that were originally read and reported on film, and 66 examinations that were read and reported on screen 2 years after the PACS introduction. Each examination was assigned a random number, and both reports and images were scored independently for pathological findings. The blinded retrospective score for the original reports were then compared with the score for the images (the gold standard). Results: Sensitivity was improved after the PACS introduction. When both certain and uncertain findings were included, this improvement was statistically significant. There were no other statistically significant changes. Conclusion: The result is consistent with prospective studies concluding that diagnostic accuracy is at least not reduced after PACS introduction. The sensitivity may even be improved.

Quantification of maceration changes using post mortem MRI in fetuses

International Nuclear Information System (INIS)

Montaldo, P.; Addison, S.; Oliveira, V.; Lally, P. J.; Taylor, A. M.; Sebire, N. J.; Thayyil, S.; Arthurs, O. J.

2016-01-01

Post mortem imaging is playing an increasingly important role in perinatal autopsy, and correct interpretation of imaging changes is paramount. This is particularly important following intra-uterine fetal death, where there may be fetal maceration. The aim of this study was to investigate whether any changes seen on a whole body fetal post mortem magnetic resonance imaging (PMMR) correspond to maceration at conventional autopsy. We performed pre-autopsy PMMR in 75 fetuses using a 1.5 Tesla Siemens Avanto MR scanner (Erlangen, Germany). PMMR images were reported blinded to the clinical history and autopsy data using a numerical severity scale (0 = no maceration changes to 2 = severe maceration changes) for 6 different visceral organs (total 12). The degree of maceration at autopsy was categorized according to severity on a numerical scale (1 = no maceration to 4 = severe maceration). We also generated quantitative maps to measure the liver and lung T 2 . The mean PMMR maceration score correlated well with the autopsy maceration score (R 2 = 0.93). A PMMR score of ≥4.5 had a sensitivity of 91 %, specificity of 64 %, for detecting moderate or severe maceration at autopsy. Liver and lung T 2 were increased in fetuses with maceration scores of 3–4 in comparison to those with 1–2 (liver p = 0.03, lung p = 0.02). There was a good correlation between PMMR maceration score and the extent of maceration seen at conventional autopsy. This score may be useful in interpretation of fetal PMMR

Intention stability assessed using residual change scores moderates the intention-behaviour association: a prospective cohort study.

Science.gov (United States)

Rowan, Alicia A; McDermott, Máirtín S; Allen, Mark S

2017-12-01

Intention stability is considered to be one of the key pre-requisites for a strong association between intention and behaviour. It has been claimed, however, that studies examining the moderating impact of intention stability may be invalid, as they have relied on statistically inferior methods. Residual change scores have been suggested as a more appropriate method of measuring change (or lack thereof) in constructs. The aim of the current study, therefore, is to test whether intention stability, calculated using residual change scores, moderates the intention-physical activity behaviour association. A total of 163 participants (124 women, 39 men) completed questionnaires online at three time points separated by 14 day intervals. The moderating impact of intention stability was assessed using multiple linear regression followed up using simple slope analyses to identify the direction of any effect. The interaction of intention and intention stability was found to significantly improve the overall model fit. Intentions had a stronger positive association with behaviour when intentions were more stable than when they were more unstable. However, sensitivity analyses revealed that the association was not robust and reduced to non-significant with the removal of potential multivariate outliers. Future research should use residual change scores as the preferred method of assessing intention stability.

You changed your mind! Infants interpret a change in word as signaling a change in an agent's goals.

Science.gov (United States)

Jin, Kyong-Sun; Song, Hyun-Joo

2017-10-01

Language provides information about our psychological states. For instance, adults can use language to convey information about their goals or preferences. The current research examined whether 14- and 12-month-old infants could interpret a change in an agent's word as signaling a change in her goals. In two experiments, 14-month-olds (Experiment 1) and 12-month-olds (Experiment 2) were first familiarized to an event in which an agent uttered a novel word and then reached for one of two novel objects. During the test trials, the agent uttered a different novel word (different-word condition) or the same word (same-word condition) and then reached for the same object or the other object. Both 14- and 12-month-olds in the different-word condition expected the agent to change her goal and reach for the other object. In contrast, the infants in the same-word condition expected the agent to maintain her goal. In Experiment 3, 12-month-olds who heard two distinct sounds instead of the agent's novel words expected the agent to maintain her goal regardless of the change in the nonlinguistic sounds. Together, these results indicate that by 12months of age infants can use an agent's verbal information to detect a change in her goals. Copyright © 2017 Elsevier Inc. All rights reserved.

Chest radiograph interpretation by medical students

International Nuclear Information System (INIS)

Jeffrey, D.R.; Goddard, P.R.; Callaway, M.P.; Greenwood, R.

2003-01-01

AIM: To assess the ability of final year medical students to interpret conventional chest radiographs. MATERIALS AND METHODS: Ten conventional chest radiographs were selected from a teaching hospital radiology department library that were good radiological examples of common conditions. All were conditions that a medical student should be expected to recognize by the end of their training. One normal radiograph was included. The radiographs were shown to 52 final year medical students who were asked to describe their findings. RESULTS: The median score achieved was 12.5 out of 20 (range 6-18). There was no difference between the median scores of male and female students (12.5 and 12.3, respectively, p=0.82) but male students were more likely to be certain of their answers than female students (median certainty scores 23.0 and 14.0, respectively). The overall degree of certainty was low. On no radiograph were more than 25% of students definite about their answer. Students had received little formal radiology teaching (2-42 h, median 21) and few expressed an interest in radiology as a career. Only two (3.8%) students thought they were good at interpreting chest radiographs, 17 (32.7%) thought they were bad or awful. CONCLUSION: Medical students reaching the end of their training do not perform well at interpreting simple chest radiographs. They lack confidence and have received little formal radiological tuition. Perhaps as a result, few are interested in radiology as a career, which is a matter for concern in view of the current shortage of radiologists in the UK

Association between Mediterranean and Nordic diet scores and changes in weight and waist circumference

DEFF Research Database (Denmark)

Roswall, Nina; Ängquist, Lars; Ahluwalia, Tarun Veer Singh

2014-01-01

BACKGROUND: Several studies have shown that adherence to the Mediterranean Diet measured by using the Mediterranean diet score (MDS) is associated with lower obesity risk. The newly proposed Nordic Diet could hold similar beneficial effects. Because of the increasing focus on the interaction...... between diet and genetic predisposition to adiposity, studies should consider both diet and genetics. OBJECTIVE: We investigated whether FTO rs9939609 and TCF7L2 rs7903146 modified the association between the MDS and Nordic diet score (NDS) and changes in weight (Δweight), waist circumference (ΔWC...

Relationships between Participants' International Prostate Symptom Score and BPH Impact Index Changes and Global Ratings of Change in a Trial of Phytotherapy for Men with Lower Urinary Tract Symptoms

Science.gov (United States)

Barry, Michael J.; Cantor, Alan; Roehrborn, Claus G.

2014-01-01

Purpose To relate changes in AUA Symptom Index (AUASI) scores with bother measures and global ratings of change among men with lower urinary tract symptoms enrolled in a trial of saw palmetto. Materials and Methods To be eligible, men were ≥45 years old, had ajpeak uroflow ≥4 ml/sec, and an AUASI score ≥ 8 and ≤ 24. Participants self-administered the AUASI, IPSS quality of life item (IPSS QoL), BPH Impact Index (BII) and two global change questions at baseline and 24, 48, and 72 weeks. Results Among 357 participants, global ratings of “a little better” were associated with mean decreases in AUASI scores from 2.8 to 4.1 points, across three time points. The analogous range for mean decreases in BII scores was 1.0 to 1.7 points, and for the IPSS QoL item 0.5 to 0.8 points. At 72 weeks, for the first global change question, each change measure could discriminate between participants rating themselves at least a little better versus unchanged or worse 70-72% of the time. A multivariable model increased discrimination to 77%. For the second global change question, each change measure correctly discriminated ratings of at least a little better versus unchanged or worse 69-74% of the time, and a multivariable model increased discrimination to 79%. Conclusions Changes in AUASI scores could discriminate between participants rating themselves at least a little better versus unchanged or worse. Our findings support the practice of powering studies to detect group mean differences in AUASI scores of at least 3 points. PMID:23017510

Two-Way Interpretation about Climate Change: Preliminary Results from a Study in Select Units of the United States National Park System

Science.gov (United States)

Forist, B. E.; Knapp, D.

2014-12-01

Much interpretation in units of the National Park System, conducted by National Park Service (NPS) rangers and partners today is done in a didactic, lecture style. This "one-way" communication runs counter to research suggesting that long-term impacts of park interpretive experiences must be established through direct connections with the visitor. Previous research in interpretation has suggested that interpretive experiences utilizing a "two-way" dialogue approach are more successful at facilitating long-term memories than "one-way" approaches where visitors have few, if any, opportunities to ask questions, offer opinions, or share interests and experiences. Long-term memories are indicators of connections to places and resources. Global anthropogenic change poses critical threats to NPS sites, resources, and visitor experiences. As climate change plays an ever-expanding role in public, political, social, economic, and environmental discourse it stands to reason that park visitors may also be interested in engaging in this discourse. Indeed, NPS Director Jonathan Jarvis stated in the agency's Climate Change Action Plan 2012 - 2014 that, "We now know through social science conducted in parks that our visitors are looking to NPS staff for honest dialogue about this critical issue." Researchers from Indiana University will present preliminary findings from a multiple park study that assessed basic visitor knowledge and the impact of two-way interpretation related to climate change. Observations from park interpretive program addressing climate change will be presented. Basic visitor knowledge of climate change impacts in the select parks as well as immediate and long-term visitor recollections will be presented. Select units of the National Park System in this research included Cape Cod National Seashore, Cape Hatteras National Seashore, North Cascades National Park, Shenandoah National Park, and Zion National Park.

Does Changing Examiner Stations During UK Postgraduate Surgery Objective Structured Clinical Examinations Influence Examination Reliability and Candidates' Scores?

Science.gov (United States)

Brennan, Peter A; Croke, David T; Reed, Malcolm; Smith, Lee; Munro, Euan; Foulkes, John; Arnett, Richard

2016-01-01

Objective structured clinical examinations (OSCE) are widely used for summative assessment in surgery. Despite standardizing these as much as possible, variation, including examiner scoring, can occur which may affect reliability. In study of a high-stakes UK postgraduate surgical OSCE, we investigated whether examiners changing stations once during a long examining day affected marking, reliability, and overall candidates' scores compared with examiners who examined the same scenario all day. An observational study of 18,262 examiner-candidate interactions from the UK Membership of the Royal College of Surgeons examination was carried at 3 Surgical Colleges across the United Kingdom. Scores between examiners were compared using analysis of variance. Examination reliability was assessed with Cronbach's alpha, and the comparative distribution of total candidates' scores for each day was evaluated using t-tests of unit-weighted z scores. A significant difference was found in absolute scores differences awarded in the morning and afternoon sessions between examiners who changed stations at lunchtime and those who did not (p design and examiner experience in surgical OSCEs and beyond. Copyright © 2016 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

Relationships among participant international prostate symptom score, benign prostatic hyperplasia impact index changes and global ratings of change in a trial of phytotherapy in men with lower urinary tract symptoms.

Science.gov (United States)

Barry, Michael J; Cantor, Alan; Roehrborn, Claus G

2013-03-01

We related changes in American Urological Association symptom index scores with bother measures and global ratings of change in men with lower urinary tract symptoms who were enrolled in a saw palmetto trial. To be eligible for study men were 45 years old or older, and had a peak uroflow of 4 ml per second or greater and an American Urological Association symptom index score of 8 to 24. Participants self-administered the American Urological Association symptom index, International Prostate Symptom Score quality of life item, Benign Prostatic Hyperplasia Impact Index and 2 global change questions at baseline, and at 24, 48 and 72 weeks. In 357 participants global ratings of a little better were associated with a mean decrease in American Urological Association symptom index scores from 2.8 to 4.1 points across 3 time points. The analogous range for mean decreases in Benign Prostatic Hyperplasia Impact Index scores was 1.0 to 1.7 points and for the International Prostate Symptom Score quality of life item it was 0.5 to 0.8 points. At 72 weeks for the first global change question each change measure discriminated between participants who rated themselves at least a little better vs unchanged or worse 70% to 72% of the time. A multivariate model increased discrimination to 77%. For the second global change question each change measure correctly discriminated ratings of at least a little better vs unchanged or worse 69% to 74% of the time and a multivariate model increased discrimination to 79%. Changes in American Urological Association symptom index scores could discriminate between participants rating themselves at least a little better vs unchanged or worse. Our findings support the practice of powering studies to detect group mean differences in American Urological Association symptom index scores of at least 3 points. Copyright © 2013 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Can energy fluxes be used to interpret glacial/interglacial precipitation changes in the tropics?

Science.gov (United States)

Roberts, W. H. G.; Valdes, P. J.; Singarayer, J. S.

2017-06-01

Recent theoretical advances in the relationship between heat transport and the position of the Intertropical Convergence Zone (ITCZ) present an elegant framework through which to interpret past changes in tropical precipitation patterns. Using a very large ensemble of climate model simulations, we investigate whether it is possible to use this framework to interpret changes in the position of the ITCZ in response to glacial and interglacial boundary conditions. We find that the centroid of tropical precipitation, which represents the evolution of precipitation in the whole tropics, is best correlated with heat transport changes. We find that the response of the annual mean ITCZ to glacial and interglacial boundary conditions is quite different to the response of the climatological annual cycle of the ITCZ to the seasonal cycle of insolation. We show that the reason for this is that while the Hadley Circulation plays a dominant role in transporting heat over the seasonal cycle, in the annual mean response to forcing, the Hadley Circulation is not dominant. When we look regionally, rather than at the zonal mean, we find that local precipitation is poorly related either to the zonal mean ITCZ or to meridional heat transport. We demonstrate that precipitation is spatially highly variable even when the zonal mean ITCZ is in the same location. This suggests only limited use for heat transport in explaining local precipitation records; thus, there is limited scope for using heat transport changes to explain individual paleoprecipitation records.

Interpreting patient decisional conflict scores: behavior and emotions in decisions about treatment

NARCIS (Netherlands)

Knops, Anouk M.; Goossens, Astrid; Ubbink, Dirk T.; Legemate, Dink A.; Stalpers, Lukas J.; Bossuyt, Patrick M.

2013-01-01

Patient decision aids facilitate treatment decisions. They are often evaluated in terms of their effect on decisional conflict, as measured by the Decisional Conflict Scale (DCS). It is unclear to what extent lower DCS scores are accompanied by observable patient behavior or emotions. To help

Assessing working memory in children with ADHD: Minor administration and scoring changes may improve digit span backward's construct validity.

Science.gov (United States)

Wells, Erica L; Kofler, Michael J; Soto, Elia F; Schaefer, Hillary S; Sarver, Dustin E

2018-01-01

Pediatric ADHD is associated with impairments in working memory, but these deficits often go undetected when using clinic-based tests such as digit span backward. The current study pilot-tested minor administration/scoring modifications to improve digit span backward's construct and predictive validities in a well-characterized sample of children with ADHD. WISC-IV digit span was modified to administer all trials (i.e., ignore discontinue rule) and count digits rather than trials correct. Traditional and modified scores were compared to a battery of criterion working memory (construct validity) and academic achievement tests (predictive validity) for 34 children with ADHD ages 8-13 (M=10.41; 11 girls). Traditional digit span backward scores failed to predict working memory or KTEA-2 achievement (allns). Alternate administration/scoring of digit span backward significantly improved its associations with working memory reordering (r=.58), working memory dual-processing (r=.53), working memory updating (r=.28), and KTEA-2 achievement (r=.49). Consistent with prior work, these findings urge caution when interpreting digit span performance. Minor test modifications may address test validity concerns, and should be considered in future test revisions. Digit span backward becomes a valid measure of working memory at exactly the point that testing is traditionally discontinued. Copyright © 2017 Elsevier Ltd. All rights reserved.

Effects of nutrient profiling and price changes based on NuVal® scores on food purchasing in an online experimental supermarket.

Science.gov (United States)

Epstein, Leonard H; Finkelstein, Eric A; Katz, David L; Jankowiak, Noelle; Pudlewski, Corrin; Paluch, Rocco A

2016-08-01

The goal of the present study was to apply experimental economic methods in an online supermarket to examine the effects of nutrient profiling, and differential pricing based on the nutrient profile, on the overall diet quality, energy and macronutrients of the foods purchased, and diet cost. Participants were provided nutrient profiling scores or price adjustments based on nutrient profile scores while completing a hypothetical grocery shopping task. Prices of foods in the top 20 % of nutrient profiling scores were reduced (subsidized) by 25 % while those in the bottom 20 % of scores were increased (taxed) by 25 %. We evaluated the independent and interactive effects of nutrient profiling or price adjustments on overall diet quality of foods purchased as assessed by the NuVal® score, energy and macronutrients purchased and diet cost in a 2×2 factorial design. A large (>10 000 food items) online experimental supermarket in the USA. Seven hundred and eighty-one women. Providing nutrient profiling scores improved overall diet quality of foods purchased. Price changes were associated with an increase in protein purchased, an increase in energy cost, and reduced carbohydrate and protein costs. Price changes and nutrient profiling combined were associated with no unique benefits beyond price changes or nutrient profiling alone. Providing nutrient profile score increased overall NuVal® score without a reduction in energy purchased. Combining nutrient profiling and price changes did not show an overall benefit to diet quality and may be less useful than nutrient profiling alone to consumers who want to increase overall diet quality of foods purchased.

Coordinated analysis of age, sex, and education effects on change in MMSE scores.

Science.gov (United States)

Piccinin, Andrea M; Muniz-Terrera, Graciela; Clouston, Sean; Reynolds, Chandra A; Thorvaldsson, Valgeir; Deary, Ian J; Deeg, Dorly J H; Johansson, Boo; Mackinnon, Andrew; Spiro, Avron; Starr, John M; Skoog, Ingmar; Hofer, Scott M

2013-05-01

We describe and compare the expected performance trajectories of older adults on the Mini-Mental Status Examination (MMSE) across six independent studies from four countries in the context of a collaborative network of longitudinal studies of aging. A coordinated analysis approach is used to compare patterns of change conditional on sample composition differences related to age, sex, and education. Such coordination accelerates evaluation of particular hypotheses. In particular, we focus on the effect of educational attainment on cognitive decline. Regular and Tobit mixed models were fit to MMSE scores from each study separately. The effects of age, sex, and education were examined based on more than one centering point. Findings were relatively consistent across studies. On average, MMSE scores were lower for older individuals and declined over time. Education predicted MMSE score, but, with two exceptions, was not associated with decline in MMSE over time. A straightforward association between educational attainment and rate of cognitive decline was not supported. Thoughtful consideration is needed when synthesizing evidence across studies, as methodologies adopted and sample characteristics, such as educational attainment, invariably differ.

Text-interpreter language for flexible generation of patient notes and instructions.

Science.gov (United States)

Forker, T S

1992-01-01

An interpreted computer language has been developed along with a windowed user interface and multi-printer-support formatter to allow preparation of documentation of patient visits, including progress notes, prescriptions, excuses for work/school, outpatient laboratory requisitions, and patient instructions. Input is by trackball or mouse with little or no keyboard skill required. For clinical problems with specific protocols, the clinician can be prompted with problem-specific items of history, exam, and lab data to be gathered and documented. The language implements a number of text-related commands as well as branching logic and arithmetic commands. In addition to generating text, it is simple to implement arithmetic calculations such as weight-specific drug dosages; multiple branching decision-support protocols for paramedical personnel (or physicians); and calculation of clinical scores (e.g., coma or trauma scores) while simultaneously documenting the status of each component of the score. ASCII text files produced by the interpreter are available for computerized quality audit. Interpreter instructions are contained in text files users can customize with any text editor.

Gray-Matter Volume Estimate Score: A Novel Semi-Automatic Method Measuring Early Ischemic Change on CT

OpenAIRE

Song, Dongbeom; Lee, Kijeong; Kim, Eun Hye; Kim, Young Dae; Lee, Hye Sun; Kim, Jinkwon; Song, Tae-Jin; Ahn, Sung Soo; Nam, Hyo Suk; Heo, Ji Hoe

2015-01-01

Background and Purpose We developed a novel method named Gray-matter Volume Estimate Score (GRAVES), measuring early ischemic changes on Computed Tomography (CT) semi-automatically by computer software. This study aimed to compare GRAVES and Alberta Stroke Program Early CT Score (ASPECTS) with regards to outcome prediction and inter-rater agreement. Methods This was a retrospective cohort study. Among consecutive patients with ischemic stroke in the anterior circulation who received intra-art...

Evaluation of the Dutch version of the Foot and Ankle Outcome Score (FAOS): Responsiveness and Minimally Important Change

NARCIS (Netherlands)

Sierevelt, I. N.; van Eekeren, I. C. M.; Haverkamp, D.; Reilingh, M. L.; Terwee, C. B.; Kerkhoffs, G. M. M. J.

2016-01-01

The aim of this study was to evaluate the responsiveness of the Foot and Ankle Outcome Score (FAOS) and provide data on the Minimally Important Change (MIC) in patients 1 year after hindfoot and ankle surgery. Prospective pre-operative and 1 year post-operative FAOS scores were collected from 145

Development of a valid and reliable test to assess trauma radiograph interpretation performance

International Nuclear Information System (INIS)

Neep, M.J.; Steffens, T.; Riley, V.; Eastgate, P.; McPhail, S.M.

2017-01-01

Objectives: The purpose of this investigation was to develop and examine the preliminary validity and reliability among radiographers of a test to assess trauma radiograph interpretation performance suitable for use among health professionals. Methods: Stage 1 examined 14,159 consecutive appendicular and axial examinations from a hospital emergency department over a 12 month period to quantify a typical anatomical region case-mix of trauma radiographs. A sample of radiographic cases representative of affected anatomical regions was then developed into the Image Interpretation Test (IIT). Stage 2 involved prospective investigations of the IIT's reliability (inter-rater, intra-rater, internal consistency) and validity (concurrent) among 41 radiographers. Results: The IIT included 60 cases. The median (interquartile range) clinical experience of participants was 5 (2–10) years. Case scores were internally consistent (Cronbach's alpha = 0.90). Favourable inter-rater reliability (kappa > 0.70 for 58/60 cases, Intra-class correlation coefficient (ICC) > 0.99 for total score) and intra-rater reliability (kappa > 0.90 for 60/60 cases, ICC > 0.99 for total score) was observed. There was a positive association between radiographers' confidence in image interpretation and IIT score (coefficient = 1.52, r-squared = 0.60, p < 0.001). Conclusions: The IIT developed during this investigation included a selection of radiographic cases consistent with anatomical regions represented in an adult trauma case-mix. This study has also provided foundational preliminary evidence to support the reliability and validity of the IIT among radiographers. The findings suggest that it is possible to assess image interpretation performance of adult trauma radiographs with this test. - Highlights: • Development of an Image Interpretation Test (IIT). • Cases consistent with anatomical regions represented in a typical adult trauma case-mix. • Development of a

Reaffirming normal: the high risk of pathologizing healthy adults when interpreting the MMPI-2-RF.

Science.gov (United States)

Odland, Anthony P; Lammy, Andrew B; Perle, Jonathan G; Martin, Phillip K; Grote, Christopher L

2015-01-01

Monte Carlo simulations were utilized to determine the proportion of the normal population expected to have scale elevations on the MMPI-2-RF when multiple scores are interpreted. Results showed that when all 40 MMPI-2-RF scales are simultaneously considered, approximately 70% of normal adults are likely to have at least one scale elevation at or above 65 T, and as many as 20% will have five or more elevated scales. When the Restructured Clinical (RC) Scales are under consideration, 34% of normal adults have at least one elevated score. Interpretation of the Specific Problem Scales and Personality Psychopathology Five Scales--Revised also yielded higher than expected rates of significant scores, with as many as one in four normal adults possibly being miscategorized as having features of a personality disorder by the latter scales. These findings are consistent with the growing literature on rates of apparently abnormal scores in the normal population due to multiple score interpretation. Findings are discussed in relation to clinical assessment, as well as in response to recent work suggesting that the MMPI-2-RF's multiscale composition does not contribute to high rates of elevated scores.

Regional Distribution Shifts Help Explain Local Changes in Wintering Raptor Abundance: Implications for Interpreting Population Trends

OpenAIRE

Paprocki, Neil; Heath, Julie A.; Novak, Stephen J.

2014-01-01

Studies of multiple taxa across broad-scales suggest that species distributions are shifting poleward in response to global climate change. Recognizing the influence of distribution shifts on population indices will be an important part of interpreting trends within management units because current practice often assumes that changes in local populations reflect local habitat conditions. However, the individual- and population-level processes that drive distribution shifts may occur across a ...

Adequate proverb interpretation is associated with performance on the independent living scales.

Science.gov (United States)

Ahmed, Fayeza S; Miller, L Stephen

2015-01-01

The purpose of this study was to examine proverb interpretation performance and functional independence in older adults. From the limited literature on proverb interpretation in aging and its conceptualization as an executive function, it was hypothesized that proverb interpretation would be related to functional independence similar to other executive functions. Tests of proverb interpretation, additional executive functions, and functional ability were administered to nondemented older adults. Results showed that proverb interpretation accounted for a significant amount of unique variance of functional ability scores. This supports including a measure of proverb interpretation to the assessment of older adults.

Divorce and Child Behavior Problems: Applying Latent Change Score Models to Life Event Data

Science.gov (United States)

Malone, Patrick S.; Lansford, Jennifer E.; Castellino, Domini R.; Berlin, Lisa J.; Dodge, Kenneth A.; Bates, John E.; Pettit, Gregory S.

2004-01-01

Effects of parents' divorce on children's adjustment have been studied extensively. This article applies new advances in trajectory modeling to the problem of disentangling the effects of divorce on children's adjustment from related factors such as the child's age at the time of divorce and the child's gender. Latent change score models were used…

Psychometric Properties of Raw and Scale Scores on Mixed-Format Tests

Science.gov (United States)

Kolen, Michael J.; Lee, Won-Chan

2011-01-01

This paper illustrates that the psychometric properties of scores and scales that are used with mixed-format educational tests can impact the use and interpretation of the scores that are reported to examinees. Psychometric properties that include reliability and conditional standard errors of measurement are considered in this paper. The focus is…

18 CFR 385.1901 - Interpretations and interpretative rules under the NGPA (Rule 1901).

Science.gov (United States)

2010-04-01

... to requests for interpretations to prospective, existing or completed facts, acts, or transactions..., knowledge, and belief there is no untrue statement of a material or relevant fact and there is no omission... misrepresented or omitted or if any material or relevant fact changes after an interpretation is issued or if the...

Normal Variability of Weekly Musculoskeletal Screening Scores and the Influence of Training Load across an Australian Football League Season.

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Esmaeili, Alireza; Stewart, Andrew M; Hopkins, William G; Elias, George P; Lazarus, Brendan H; Rowell, Amber E; Aughey, Robert J

2018-01-01

Aim: The sit and reach test (S&R), dorsiflexion lunge test (DLT), and adductor squeeze test (AST) are commonly used in weekly musculoskeletal screening for athlete monitoring and injury prevention purposes. The aim of this study was to determine the normal week to week variability of the test scores, individual differences in variability, and the effects of training load on the scores. Methods: Forty-four elite Australian rules footballers from one club completed the weekly screening tests on day 2 or 3 post-main training (pre-season) or post-match (in-season) over a 10 month season. Ratings of perceived exertion and session duration for all training sessions were used to derive various measures of training load via both simple summations and exponentially weighted moving averages. Data were analyzed via linear and quadratic mixed modeling and interpreted using magnitude-based inference. Results: Substantial small to moderate variability was found for the tests at both season phases; for example over the in-season, the normal variability ±90% confidence limits were as follows: S&R ±1.01 cm, ±0.12; DLT ±0.48 cm, ±0.06; AST ±7.4%, ±0.6%. Small individual differences in variability existed for the S&R and AST (factor standard deviations between 1.31 and 1.66). All measures of training load had trivial effects on the screening scores. Conclusion: A change in a test score larger than the normal variability is required to be considered a true change. Athlete monitoring and flagging systems need to account for the individual differences in variability. The tests are not sensitive to internal training load when conducted 2 or 3 days post-training or post-match, and the scores should be interpreted cautiously when used as measures of recovery.

A mathematical model for interpretable clinical decision support with applications in gynecology.

Directory of Open Access Journals (Sweden)

Vanya M C A Van Belle

Full Text Available Over time, methods for the development of clinical decision support (CDS systems have evolved from interpretable and easy-to-use scoring systems to very complex and non-interpretable mathematical models. In order to accomplish effective decision support, CDS systems should provide information on how the model arrives at a certain decision. To address the issue of incompatibility between performance, interpretability and applicability of CDS systems, this paper proposes an innovative model structure, automatically leading to interpretable and easily applicable models. The resulting models can be used to guide clinicians when deciding upon the appropriate treatment, estimating patient-specific risks and to improve communication with patients.We propose the interval coded scoring (ICS system, which imposes that the effect of each variable on the estimated risk is constant within consecutive intervals. The number and position of the intervals are automatically obtained by solving an optimization problem, which additionally performs variable selection. The resulting model can be visualised by means of appealing scoring tables and color bars. ICS models can be used within software packages, in smartphone applications, or on paper, which is particularly useful for bedside medicine and home-monitoring. The ICS approach is illustrated on two gynecological problems: diagnosis of malignancy of ovarian tumors using a dataset containing 3,511 patients, and prediction of first trimester viability of pregnancies using a dataset of 1,435 women. Comparison of the performance of the ICS approach with a range of prediction models proposed in the literature illustrates the ability of ICS to combine optimal performance with the interpretability of simple scoring systems.The ICS approach can improve patient-clinician communication and will provide additional insights in the importance and influence of available variables. Future challenges include extensions of the

Apparently abnormal Wechsler Memory Scale index score patterns in the normal population.

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Carrasco, Roman Marcus; Grups, Josefine; Evans, Brittney; Simco, Edward; Mittenberg, Wiley

2015-01-01

Interpretation of the Wechsler Memory Scale-Fourth Edition may involve examination of multiple memory index score contrasts and similar comparisons with Wechsler Adult Intelligence Scale-Fourth Edition ability indexes. Standardization sample data suggest that 15-point differences between any specific pair of index scores are relatively uncommon in normal individuals, but these base rates refer to a comparison between a single pair of indexes rather than multiple simultaneous comparisons among indexes. This study provides normative data for the occurrence of multiple index score differences calculated by using Monte Carlo simulations and validated against standardization data. Differences of 15 points between any two memory indexes or between memory and ability indexes occurred in 60% and 48% of the normative sample, respectively. Wechsler index score discrepancies are normally common and therefore not clinically meaningful when numerous such comparisons are made. Explicit prior interpretive hypotheses are necessary to reduce the number of index comparisons and associated false-positive conclusions. Monte Carlo simulation accurately predicts these false-positive rates.

Validating Automated Essay Scoring: A (Modest) Refinement of the "Gold Standard"

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Powers, Donald E.; Escoffery, David S.; Duchnowski, Matthew P.

2015-01-01

By far, the most frequently used method of validating (the interpretation and use of) automated essay scores has been to compare them with scores awarded by human raters. Although this practice is questionable, human-machine agreement is still often regarded as the "gold standard." Our objective was to refine this model and apply it to…

[Interpretation of proverbs and Alzheimer's disease].

Science.gov (United States)

Báez, S; Mendoza, L; Reyes, P; Matallana, D; Montañés, P

To evaluate the performance of patients with Alzheimer's disease (AD) in the mild-moderate stage in a verbal material abstraction task that involves interpreting the implicit meaning of proverbs and sayings. A qualitative-quantitative analysis was carried out of the performance of 30 patients with AD and 30 controls, paired by age, gender and level of education. Patients had significantly greater difficulties than the controls when it came to interpreting proverbs. A high correlation was found between subjects' years of schooling and the overall score on the proverb interpretation test. Results suggest that the processes that may be predominantly affected in patients with AD are the investigation of the conditions of the problem, together with selecting an alternative and formulating a cognitive plan to resolve the task. The results help to further our knowledge of the characteristics of performance of patients with AD in a test involving the interpretation of the implicit meaning of proverbs and also provide information about the processes that may be predominantly affected. Further research is needed, however, on this subject area in order to obtain more conclusive explanations.

Variation in dietary intake and physical activity pattern as predictors of change in body mass index (BMI) Z-score among Brazilian adolescents.

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Enes, Carla C; Slater, Betzabeth

2013-06-01

To assess whether changes in dietary intake and physical activity pattern are associated with the annual body mass index (BMI) z-score change among adolescents. The study was conducted in public schools in the city of Piracicaba, Sao Paulo, Brazil, with a probabilistic sample of 431 adolescents participating in wave I (2004) (hereafter, baseline) and 299 in wave II (2005) (hereafter, follow-up). BMI, usual food intake, physical activity, screen time, sexual maturation and demographic variables were assessed twice. The association between annual change in food intake, physical activity, screen time, and annual BMI z-score changes were assessed by multiple regression. The study showed a positive variation in BMI z-score over one-year. Among variables related to physical activity pattern only playing videogame and using computer increased over the year. The intake of fruits and vegetables and sugar-sweetened beverages increased over one year, while the others variables showed a reduction. An increased consumption of fatty foods (β = 0.04, p = 0.04) and sweetened natural fruit juices (β = 0.05, p = 0.03) was positively associated with the rise in BMI z-score. Unhealthy dietary habits can predict the BMI z-score gain more than the physical activity pattern. The intake of fatty foods and sweetened fruit juices is associated with the BMI z-score over one year.

Variation in dietary intake and physical activity pattern as predictors of change in body mass index (BMI Z-score among Brazilian adolescents*

Directory of Open Access Journals (Sweden)

Carla C. Enes

2013-06-01

Full Text Available Objective: To assess whether changes in dietary intake and physical activity pattern are associated with the annual body mass index (BMI z-score change among adolescents. Methods: The study was conducted in public schools in the city of Piracicaba, Sao Paulo, Brazil, with a probabilistic sample of 431 adolescents participating in wave I (2004 (hereafter, baseline and 299 in wave II (2005 (hereafter, follow-up. BMI, usual food intake, physical activity, screen time, sexual maturation and demographic variables were assessed twice. The association between annual change in food intake, physical activity, screen time, and annual BMI z-score changes were assessed by multiple regression. Results: The study showed a positive variation in BMI z-score over one-year. Among variables related to physical activity pattern only playing videogame and using computer increased over the year. The intake of fruits and vegetables and sugar-sweetened beverages increased over one year, while the others variables showed a reduction. An increased consumption of fatty foods (β = 0.04, p = 0.04 and sweetened natural fruit juices (β = 0.05, p = 0.03 was positively associated with the rise in BMI z-score. Conclusions: Unhealthy dietary habits can predict the BMI z-score gain more than the physical activity pattern. The intake of fatty foods and sweetened fruit juices is associated with the BMI z-score over one year.

Age, education, and changes in the Mini-Mental State Exam scores of older women: findings from the Nun Study.

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Butler, S M; Ashford, J W; Snowdon, D A

1996-06-01

To describe the relationship of Mini-Mental State Exam (MMSE) scores and changes over time in MMSE scores to age and education in a population of older women. A prospective study of a defined population. Various motherhouses and church-run health care facilities in the Eastern, Midwestern, and Southern regions of the United States. Catholic sisters (nuns) participating in the Nun Study, a study of aging and Alzheimer's Disease. The 678 participants were 75 to 102 years old (mean 83.3, standard deviation 5.5, median 82.3) at the time of the first functional assessment. Second assessments were obtained an average of 1.6 years later on 575 survivors. The outcome variables were MMSE scores at the first assessment (Time-one), and MMSE scores at the second assessment (Time-two). The independent variables were age at Time-one, and education (bachelor's degree or no bachelor's degree). Time-one MMSE scores decreased with age at Time-one. The decrease in MMSE scores with age was less in sisters with bachelor's degrees than in sisters without bachelor's degrees. The changes in MMSE scores had a "U-shaped" relationship with Time-one score, where the greatest declines occurred in sisters with intermediate Time-one scores. Stratified analysis by age, education, and Time-one MMSE scores of 20 or greater because of the small numbers of sisters with Time-one scores less than 20. In sisters with Time-one MMSE scores in the categories 20 to 23, 24 to 26, or 27 to 30, older ages at Time-one were associated with greater decline in those with bachelor's degrees, but not in those without bachelor's degrees. Also, lower education was associated with greater decline in sisters aged 75 to 84 years at Time-one, but this education effect disappeared or reversed in sisters who were 85 years of age or older at Time-one. Cognitive function as measured by the MMSE decreased with age at Time-one, most steeply as a function of age in those without bachelor's degrees. Cognitive function declined

Surprising Ripple Effects: How Changing the SAT Score-Sending Policy for Low-Income Students Impacts College Access and Success

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Hurwitz, Michael; Mbekeani, Preeya P.; Nipson, Margaret M.; Page, Lindsay C.

2017-01-01

Subtle policy adjustments can induce relatively large "ripple effects." We evaluate a College Board initiative that increased the number of free SAT score reports available to low-income students and changed the time horizon for using these score reports. Using a difference-in-differences analytic strategy, we estimate that targeted…

Measuring Primary Students' Graph Interpretation Skills Via a Performance Assessment: A case study in instrument development

Science.gov (United States)

Peterman, Karen; Cranston, Kayla A.; Pryor, Marie; Kermish-Allen, Ruth

2015-11-01

This case study was conducted within the context of a place-based education project that was implemented with primary school students in the USA. The authors and participating teachers created a performance assessment of standards-aligned tasks to examine 6-10-year-old students' graph interpretation skills as part of an exploratory research project. Fifty-five students participated in a performance assessment interview at the beginning and end of a place-based investigation. Two forms of the assessment were created and counterbalanced within class at pre and post. In situ scoring was conducted such that responses were scored as correct versus incorrect during the assessment's administration. Criterion validity analysis demonstrated an age-level progression in student scores. Tests of discriminant validity showed that the instrument detected variability in interpretation skills across each of three graph types (line, bar, dot plot). Convergent validity was established by correlating in situ scores with those from the Graph Interpretation Scoring Rubric. Students' proficiency with interpreting different types of graphs matched expectations based on age and the standards-based progression of graphs across primary school grades. The assessment tasks were also effective at detecting pre-post gains in students' interpretation of line graphs and dot plots after the place-based project. The results of the case study are discussed in relation to the common challenges associated with performance assessment. Implications are presented in relation to the need for authentic and performance-based instructional and assessment tasks to respond to the Common Core State Standards and the Next Generation Science Standards.

Changes in Allergy Symptoms and Depression Scores Are Positively Correlated In Patients With Recurrent Mood Disorders Exposed to Seasonal Peaks in Aeroallergens

Directory of Open Access Journals (Sweden)

Teodor T. Postolache

2007-01-01

Full Text Available Although growing evidence supports an association between allergy, allergens and depression, it remains unknown if this relationship is between “states” (possible triggers or “traits” (possible vulnerabilities. We hypothesized that patients with recurrent mood disorders who are sensitized to tree pollen (as determined by allergen specific IgE antibodies, in comparison to those who are not sensitized, would report larger negative changes in mood during exposure to tree pollen in spring. We also hypothesized that differences between high and low tree pollen periods in self reported allergy symptoms would correlate positively with differences in self reported depression scores. We present 1-year preliminary data on the first 51 patients with unipolar or bipolar disorder (age: 19-63 years, 65% female, twelve patients were tree-pollen IgE positive. Ratings of mood and allergic disease status were performed once during the peak airborne pollen counts and once during the period of low airborne pollen counts, as reported by two local pollen counting stations. Linear regression models were developed to examine associations of changes in depression scores (dependent variable with tree pollen sensitization, changes in the allergy symptom severity score, adjusted for gender and order of testing. We did not confirm the hypothesized relationship between a specific tree pollen sensitization and changes in mood during tree pollen exposure. We did confirm the hypothesized positive relationship between the changes in allergy symptoms and changes in subjects' depression scores (adjusted p<0.05. This result is consistent with previous epidemiological evidence connecting allergy with depression, as well as our recent reports of increased expression of cytokines in the prefrontal cortex in victims of suicide and in experimental animals sensitized and exposed to tree pollen. A relationship between changes in allergy symptom scores and changes in depression

Do Multidimensional Pain Inventory scale score changes indicate risk of receiving sick leave benefits 1 year after a pain rehabilitation programme?

DEFF Research Database (Denmark)

Nyberg, Vanja E; Novo, Mehmed; Sjölund, Bengt H

2011-01-01

To study whether scale score changes in the Multidimensional Pain Inventory (MPI) can predict which persons disabled by pain will receive sick leave benefits 1 year after completing a pain rehabilitation programme.......To study whether scale score changes in the Multidimensional Pain Inventory (MPI) can predict which persons disabled by pain will receive sick leave benefits 1 year after completing a pain rehabilitation programme....

The OMERACT Psoriatic Arthritis Magnetic Resonance Imaging Score (PsAMRIS) is reliable and sensitive to change: results from an OMERACT workshop

DEFF Research Database (Denmark)

Bøyesen, Pernille; McQueen, Fiona M; Gandjbakhch, Frédérique

2011-01-01

The aim of this multireader exercise was to assess the reliability and sensitivity to change of the psoriatic arthritis magnetic resonance imaging score (PsAMRIS) in PsA patients followed for 1 year.......The aim of this multireader exercise was to assess the reliability and sensitivity to change of the psoriatic arthritis magnetic resonance imaging score (PsAMRIS) in PsA patients followed for 1 year....

Predictive Accuracy of Violence Risk Scale-Sexual Offender Version Risk and Change Scores in Treated Canadian Aboriginal and Non-Aboriginal Sexual Offenders.

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Olver, Mark E; Sowden, Justina N; Kingston, Drew A; Nicholaichuk, Terry P; Gordon, Audrey; Beggs Christofferson, Sarah M; Wong, Stephen C P

2018-04-01

The present study examined the predictive properties of Violence Risk Scale-Sexual Offender version (VRS-SO) risk and change scores among Aboriginal and non-Aboriginal sexual offenders in a combined sample of 1,063 Canadian federally incarcerated men. All men participated in sexual offender treatment programming through the Correctional Service of Canada (CSC) at sites across its five regions. The Static-99R was also examined for comparison purposes. In total, 393 of the men were identified as Aboriginal (i.e., First Nations, Métis, Circumpolar) while 670 were non-Aboriginal and primarily White. Aboriginal men scored significantly higher on the Static-99R and VRS-SO and had higher rates of sexual and violent recidivism; however, there were no significant differences between Aboriginal and non-Aboriginal groups on treatment change with both groups demonstrating close to a half-standard deviation of change pre and post treatment. VRS-SO risk and change scores significantly predicted sexual and violent recidivism over fixed 5- and 10-year follow-ups for both racial/ancestral groups. Cox regression survival analyses also demonstrated positive treatment changes to be significantly associated with reductions in sexual and violent recidivism among Aboriginal and non-Aboriginal men after controlling baseline risk. A series of follow-up Cox regression analyses demonstrated that risk and change score information accounted for much of the observed differences between Aboriginal and non-Aboriginal men in rates of sexual recidivism; however, marked group differences persisted in rates of general violent recidivism even after controlling for these covariates. The results support the predictive properties of VRS-SO risk and change scores with treated Canadian Aboriginal sexual offenders.

The MMPI Assistant: A Microcomputer Based Expert System to Assist in Interpreting MMPI Profiles

Science.gov (United States)

Tanner, Barry A.

1989-01-01

The Assistant is an MS DOS program to aid clinical psychologists in interpreting the results of the Minnesota Multiphasic Personality Inventory (MMPI). Interpretive hypotheses are based on the professional literature and the author's experience. After scores are entered manually, the Assistant produces a hard copy which is intended for use by a psychologist knowledgeable about the MMPI. The rules for each hypothesis appear first on the monitor, and then in the printed output, followed by the patient's scores on the relevant scales, and narrative hypotheses for the scores. The data base includes hypotheses for 23 validity configurations, 45 two-point clinical codes, 10 high scoring single-point clinical scales, and 10 low scoring single-point clinical scales. The program can accelerate the production of test reports, while insuring that actuarial rules are not overlooked. It has been especially useful as a teaching tool with graduate students. The Assistant requires an IBM PC compatible with 128k available memory, DOS 2.x or higher, and a printer.

A robust interpretation of duration calculus

DEFF Research Database (Denmark)

Franzle, M.; Hansen, Michael Reichhardt

2005-01-01

We transfer the concept of robust interpretation from arithmetic first-order theories to metric-time temporal logics. The idea is that the interpretation of a formula is robust iff its truth value does not change under small variation of the constants in the formula. Exemplifying this on Duration...... Calculus (DC), our findings are that the robust interpretation of DC is equivalent to a multi-valued interpretation that uses the real numbers as semantic domain and assigns Lipschitz-continuous interpretations to all operators of DC. Furthermore, this continuity permits approximation between discrete...

The assessment of changes in cognitive functioning: age-, education-, and gender-specific reliable change indices for older adults tested on the CERAD-NP battery: results of the German Study on Ageing, Cognition, and Dementia in Primary Care Patients (AgeCoDe).

Science.gov (United States)

Stein, Janine; Luppa, Melanie; Luck, Tobias; Maier, Wolfgang; Wagner, Michael; Daerr, Moritz; van den Bussche, Hendrik; Zimmermann, Thomas; Köhler, Mirjam; Bickel, Horst; Mösch, Edelgard; Weyerer, Siegfried; Kaufeler, Teresa; Pentzek, Michael; Wiese, Birgitt; Wollny, Anja; König, Hans-Helmut; Riedel-Heller, Steffi G

2012-01-01

The Consortium to Establish a Registry for Alzheimer's Disease-Neuropsychological (CERAD-NP) battery represents a commonly used neuropsychological instrument to measure cognitive functioning in the elderly. This study provides normative data for changes in cognitive function that normally occur in cognitively healthy individuals to interpret changes in CERAD-NP test scores over longer time periods. Longitudinal cohort study with three assessments at 1.5-year intervals over a period of 3 years. : Primary care medical record registry sample. As part of the German Study on Ageing, Cognition, and Dementia in Primary Care Patients, a sample of 1,450 cognitively healthy general practitioner patients, age 75 years and older, was assessed. Age-, education-, and gender-specific Reliable Change Indices (RCIs) were computed for a 90% confidence interval for selected subtests of the CERAD-NP battery. Across different age, education, and gender subgroups, changes from at least six to nine points in Verbal Fluency, four to eight points in Word List Memory, two to four points in Word List Recall, and one to four points in Word List Recognition indicated significant (i.e. reliable) changes in CERAD-NP test scores at the 90% confidence level. Furthermore, the calculation of RCIs for individual patients is demonstrated. Smaller changes in CERAD-NP test scores can be interpreted with only high uncertainty because of probable measurement error, practice effects, and normal age-related cognitive decline. This study, for the first time, provides age-, education-, and gender-specific CERAD-NP reference values on the basis of RCI methods for the interpretation of cognitive changes in older-age groups.

Keeping Your Audience in Mind: Applying Audience Analysis to the Design of Interactive Score Reports

Science.gov (United States)

Zapata-Rivera, Juan Diego; Katz, Irvin R.

2014-01-01

Score reports have one or more intended audiences: the people who use the reports to make decisions about test takers, including teachers, administrators, parents and test takers. Attention to audience when designing a score report supports assessment validity by increasing the likelihood that score users will interpret and use assessment results…

Noninvasive assessment of extracellular and intracellular dehydration in healthy humans using the resistance-reactance-score graph method.

Science.gov (United States)

Heavens, Kristen R; Charkoudian, Nisha; O'Brien, Catherine; Kenefick, Robert W; Cheuvront, Samuel N

2016-03-01

Few dehydration assessment measures provide accurate information; most are based on reference change values and very few are diagnostically accurate from a single observation or measure. Bioelectrical impedance may lack the precision to detect common forms of dehydration in healthy individuals. Limitations in bioimpedance may be addressed by a unique resistance-reactance (RXc)-score graph method, which transforms vector components into z scores for use with any impedance analyzer in any population. We tested whether the RXc-score graph method provides accurate single or serial assessments of dehydration when compared with gold-standard measures of total body water by using stable isotope dilution (deuterium oxide) combined with body-weight changes. We retrospectively analyzed data from a previous study in which 9 healthy young men participated in 3 trials: euhydration (EUH), extracellular dehydration (ED; via a diuretic), and intracellular dehydration (ID; via exercise in the heat). Participants lost 4-5% of their body weight during the dehydration trials; volume loss was similar between trials (ID compared with ED group: 3.5 ± 0.8 compared with 3.0 ± 0.6 L; P > 0.05). Despite significant losses of body water, most RXc vector scores for ED and ID groups were classified as "normal" (within the 75% population tolerance ellipse). However, directional displacement of vectors was consistent with loss of volume in both ED and ID conditions compared with the EUH condition and tended to be longer in ED than in ID conditions (P = 0.054). We conclude that, whereas individual RXc-score graph values do not provide accurate detection of dehydration from single measurements, directional changes in vector values from serial measurements are consistent with fluid loss for both ED and ID conditions. The RXc-score graph method may therefore alert clinicians to changes in hydration state, which may bolster the interpretation of other recognized change measures of hydration. © 2016

Validation of a Novel Scoring System for Changes in Skeletal Manifestations of Hypophosphatasia in Newborns, Infants, and Children: The Radiographic Global Impression of Change Scale.

Science.gov (United States)

Whyte, Michael P; Fujita, Kenji P; Moseley, Scott; Thompson, David D; McAlister, William H

2018-05-01

Hypophosphatasia (HPP) is the heritable metabolic disease characterized by impaired skeletal mineralization due to low activity of the tissue-nonspecific isoenzyme of alkaline phosphatase. Although HPP during growth often manifests with distinctive radiographic skeletal features, no validated method was available to quantify them, including changes over time. We created the Radiographic Global Impression of Change (RGI-C) scale to assess changes in the skeletal burden of pediatric HPP. Site-specific pairs of radiographs of newborns, infants, and children with HPP from three clinical studies of asfotase alfa, an enzyme replacement therapy for HPP, were obtained at baseline and during treatment. Each pair was scored by three pediatric radiologists ("raters"), with nine raters across the three studies. Intrarater and interrater agreement was determined by weighted Kappa coefficients. Interrater reliability was assessed using intraclass correlation coefficients (ICCs) and by two-way random effects analysis of variance (ANOVA) and a mixed-model repeated measures ANOVA. Pearson correlation coefficients evaluated relationships of the RGI-C to the Rickets Severity Scale (RSS), Pediatric Outcomes Data Collection Instrument Global Function Parent Normative Score, Childhood Health Assessment Questionnaire Disability Index, 6-Minute Walk Test percent predicted, and Z-score for height in patients aged 6 to 12 years at baseline. Eighty-nine percent (8/9) of raters showed substantial or almost perfect intrarater agreement of sequential RGI-C scores (weighted Kappa coefficients, 0.72 to 0.93) and moderate or substantial interrater agreement (weighted Kappa coefficients, 0.53 to 0.71) in patients aged 0 to 12 years at baseline. Moderate-to-good interrater reliability was observed (ICC, 0.57 to 0.65). RGI-C scores were significantly (p ≤ 0.0065) correlated with the RSS and with measures of global function, disability, endurance, and growth in the patients aged 6 to 12 years at

[Using a modified remote sensing imagery for interpreting changes in cultivated saline-alkali land].

Science.gov (United States)

Gao, Hui; Liu, Hui-tao; Liu, Hong-juan; Liu, Jin-tong

2015-04-01

This paper developed a new interpretation symbol system for grading and classifying saline-alkali land, using Huanghua, a cosatal city in Hebei Province as a case. The system was developed by inverting remote sensing images from 1992 to 2011 based on site investigation, plant cover characteristics and features of remote sensing images. Combining this interpretation symbol system with supervising classification method, the information on arable land was obtained for the coastal saline-alkali ecosystem of Huanghua City, and the saline-alkali land area, changes in intensity of salinity-alkalinity and spatial distribution from 1992 to 2011 were analyzed. The results showed that salinization of arable land in Huanghua City alleviated from 1992 to 2011. The severely and moderately saline-alkali land area decreased in 2011 compared with 1992, while the non/slightly saline land area increased. The moderately saline-alkali land in southeast transformed to non/slightly saline-alkaline, while the severely saline-alkali land in west of the city far from the coastal zone became moderately saline-alkaline. The center of gravity (CG) of severely and non/slightly saline-alkali land moved closer the coastline, while that of the moderately saline-alkali land moved from southwest coastal line to northwest. Factors influencing changes in arable land within the saline-alkali ecosystem of Huanghua City were climate, hydrology and human activities.

Changes in medical treatment six months after risk stratification with HeartScore and coronary artery calcification scanning of healthy middle-aged subjects

DEFF Research Database (Denmark)

Sørensen, Mette Hjortdal; Gerke, Oke; Lambrechtsen, Jess

2012-01-01

Objectives: The aim was to examine and compare the impact of HeartScore and coronary artery calcification (CAC) score on subsequent changes in the use of medication. Methods: A total of 1156 healthy men and women, aged 50 or 60, had a baseline medical examination and a coronary artery CT-scan as ......Objectives: The aim was to examine and compare the impact of HeartScore and coronary artery calcification (CAC) score on subsequent changes in the use of medication. Methods: A total of 1156 healthy men and women, aged 50 or 60, had a baseline medical examination and a coronary artery CT......-up questionnaires addressing current medication were mailed to the participants. Results: A completed questionnaire was returned by 1075 (93%) subjects. At follow up, the overall use of prophylactic medication was significantly increased. Of those with CAC (n = 462) or high HeartScore (n = 233), 21 and 19...

A Human Capital Model of Educational Test Scores

DEFF Research Database (Denmark)

McIntosh, James; D. Munk, Martin

Latent class Poisson count models are used to analyze a sample of Danish test score results from a cohort of individuals born in 1954-55 and tested in 1968. The procedure takes account of unobservable effects as well as excessive zeros in the data. The bulk of unobservable effects are uncorrelated...... with observable parental attributes and, thus, are environmental rather than genetic in origin. We show that the test scores measure manifest or measured ability as it has evolved over the life of the respondent and is, thus, more a product of the human capital formation process than some latent or fundamental...... measure of pure cognitive ability. We find that variables which are not closely associated with traditional notions of intelligence explain a significant proportion of the variation in test scores. This adds to the complexity of interpreting test scores and suggests that school culture, attitudes...

Interpretation and consequences of Meyer-Neldel rule for conductivity of phase change alloys

Energy Technology Data Exchange (ETDEWEB)

Savransky, S.D. [The TRIZ Experts, 6015 Peppertree Court, Newark, CA 94560 (United States); Yelon, A. [Department of Engineering Physics and Reseau Quebecois de Materiaux de Pointe, Ecole Polytechnique, P.O. Box 6079, Station C-V Montreal, Quebec (Canada)

2010-03-15

Measurements of conductivity as a function of temperature were performed on a large number of memory cells of a GeSbTe phase change memory alloy, in both the set and reset states. Conductivity obeys the Meyer-Neldel rule in both states, with the same Meyer-Neldel, or isokinetic, temperature, but with conductivity prefactors about six orders of magnitude larger in the set than in the reset state. These observations are interpreted in terms of the multiexcitation entropy model, and conduction mechanisms are suggested. Their effect on the expected behavior of memories is considered. (Abstract Copyright [2010], Wiley Periodicals, Inc.)

Causal Indicators Can Help to Interpret Factors

Science.gov (United States)

Bentler, Peter M.

2016-01-01

The latent factor in a causal indicator model is no more than the latent factor of the factor part of the model. However, if the causal indicator variables are well-understood and help to improve the prediction of individuals' factor scores, they can help to interpret the meaning of the latent factor. Aguirre-Urreta, Rönkkö, and Marakas (2016)…

Interpretation of scenario results in terms of described and mapped land change trajectories and archetypes

DEFF Research Database (Denmark)

Kuemmerle, Tobias; Stürck, Julia; Levers, Christian

Module VISIONS seeks to identify critical pathways to reach desired futures for land systems (i.e., visions). In order to do so, work package (WP) 11 links the model-based scenarios (module ASSESSMENT) to the visions formulated derived in a transdisciplinary process together with stakeholders...... of future developments of current land change archetypes; and (3) an interpretation of future land change in light of long-term land system trajectories. Synthesizing across these analyses, six key insights emerged. First, future land change was relatively similar across marker scenarios and different...... policy alternatives, for many regions in Europe, suggesting strong path dependency. Second, the impact of policy options can differ (a) between regions in Europe and (b) among marker scenarios, highlighting the need for contextualized, regionalized policy making. Third, the expansion and intensification...

Labtracker+, a medical smartphone app for the interpretation of consecutive laboratory results: an external validation study.

Science.gov (United States)

Hilderink, Judith M; Rennenberg, Roger J M W; Vanmolkot, Floris H M; Bekers, Otto; Koopmans, Richard P; Meex, Steven J R

2017-09-01

When monitoring patients over time, clinicians may struggle to distinguish 'real changes' in consecutive blood parameters from so-called natural fluctuations. In practice, they have to do so by relying on their clinical experience and intuition. We developed Labtracker+ , a medical app that calculates the probability that an increase or decrease over time in a specific blood parameter is real, given the time between measurements. We presented patient cases to 135 participants to examine whether there is a difference between medical students, residents and experienced clinicians when it comes to interpreting changes between consecutive laboratory results. Participants were asked to interpret if changes in consecutive laboratory values were likely to be 'real' or rather due to natural fluctuations. The answers of the study participants were compared with the calculated probabilities by the app Labtracker+ and the concordance rates were assessed. Medical students (n=92), medical residents from the department of internal medicine (n=19) and internists (n=24) at a Dutch University Medical Centre. Concordance rates between the study participants and the calculated probabilities by the app Labtracker+ were compared. Besides, we tested whether physicians with clinical experience scored better concordance rates with the app Labtracker+ than inexperienced clinicians. Medical residents and internists showed significantly better concordance rates with the calculated probabilities by the app Labtracker+ than medical students, regarding their interpretation of differences between consecutive laboratory results (p=0.009 and p<0.001, respectively). The app Labtracker+ could serve as a clinical decision tool in the interpretation of consecutive laboratory test results and could contribute to rapid recognition of parameter changes by physicians. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial

A simple approximation of productivity scores of fuzzy production plans

DEFF Research Database (Denmark)

Hougaard, Jens Leth

2005-01-01

This paper suggests a simple approximation procedure for the assessment of productivity scores with respect to fuzzy production plans. The procedure has a clear economic interpretation and all the necessary calculations can be performed in a spreadsheet making it highly operational...

Evaluation of airway protection: Quantitative timing measures versus penetration/aspiration score.

Science.gov (United States)

Kendall, Katherine A

2017-10-01

Quantitative measures of swallowing function may improve the reliability and accuracy of modified barium swallow (MBS) study interpretation. Quantitative study analysis has not been widely instituted, however, secondary to concerns about the time required to make measures and a lack of research demonstrating impact on MBS interpretation. This study compares the accuracy of the penetration/aspiration (PEN/ASP) scale (an observational visual-perceptual assessment tool) to quantitative measures of airway closure timing relative to the arrival of the bolus at the upper esophageal sphincter in identifying a failure of airway protection during deglutition. Retrospective review of clinical swallowing data from a university-based outpatient clinic. Swallowing data from 426 patients were reviewed. Patients with normal PEN/ASP scores were identified, and the results of quantitative airway closure timing measures for three liquid bolus sizes were evaluated. The incidence of significant airway closure delay with and without a normal PEN/ASP score was determined. Inter-rater reliability for the quantitative measures was calculated. In patients with a normal PEN/ASP score, 33% demonstrated a delay in airway closure on at least one swallow during the MBS study. There was no correlation between PEN/ASP score and airway closure delay. Inter-rater reliability for the quantitative measure of airway closure timing was nearly perfect (intraclass correlation coefficient = 0.973). The use of quantitative measures of swallowing function, in conjunction with traditional visual perceptual methods of MBS study interpretation, improves the identification of airway closure delay, and hence, potential aspiration risk, even when no penetration or aspiration is apparent on the MBS study. 4. Laryngoscope, 127:2314-2318, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

Building National Capacity for Climate Change Interpretation: The Role of Leaders, Partnerships, and Networks

Science.gov (United States)

Spitzer, W.

2015-12-01

Since 2007, the New England Aquarium has led a national effort to increase the capacity of informal science venues to effectively communicate about climate change. We are now leading the NSF-funded National Network for Ocean and Climate Change Interpretation (NNOCCI), partnering with the Association of Zoos and Aquariums, FrameWorks Institute, Woods Hole Oceanographic Institution, Monterey Bay Aquarium, and National Aquarium, with evaluation conducted by the New Knowledge Organization, Pennsylvania State University, and Ohio State University. NNOCCI enables teams of informal science interpreters across the country to serve as "communication strategists" - beyond merely conveying information they can influence public perceptions, given their high level of commitment, knowledge, public trust, social networks, and visitor contact. We provide in-depth training as well as an alumni network for ongoing learning, implementation support, leadership development, and coalition building. Our goals are to achieve a systemic national impact, embed our work within multiple ongoing regional and national climate change education networks, and leave an enduring legacy. Our project represents a cross-disciplinary partnership among climate scientists, social and cognitive scientists, and informal education practitioners. We have built a growing national network of more than 250 alumni, including approximately 15-20 peer leaders who co-lead both in-depth training programs and introductory workshops. We have found that this alumni network has been assuming increasing importance in providing for ongoing learning, support for implementation, leadership development, and coalition building. As we look toward the future, we are exploring potential partnerships with other existing networks, both to sustain our impact and to expand our reach. This presentation will address what we have learned in terms of network impacts, best practices, factors for success, and future directions.

Changes in life satisfaction in persons with spinal cord injury during and after inpatient rehabilitation : adaptation or measurement bias?

NARCIS (Netherlands)

van Leeuwen, Christel M. C.; Post, Marcel W. M.; van der Woude, Lucas H. V.; de Groot, Sonja; Smit, Christof; van Kuppevelt, Dirk; Lindeman, Eline

2012-01-01

Purpose To analyze changes in life satisfaction (LS) scores over time in persons with spinal cord injury (SCI) and to interpret what these changes mean. Methods Multicenter, prospective cohort study of persons with SCI (n = 96) classified into 3 life satisfaction trajectories identified earlier.

Interpreting the Customary Rules on Interpretation

NARCIS (Netherlands)

Merkouris, Panos

2017-01-01

International courts have at times interpreted the customary rules on interpretation. This is interesting because what is being interpreted is: i) rules of interpretation, which sounds dangerously tautological, and ii) customary law, the interpretation of which has not been the object of critical

Comparing IM Residents with EM Resident for Their Skills of ECG Interpretation and Outlining Management Plan Accordingly

Directory of Open Access Journals (Sweden)

Hamid Reza Karimpoor Tari

2009-06-01

Full Text Available Background and Purpose: Electrocardiogram (ECG is one of the most commonly performed investigations in cardiac diseases and ECG abnormalities can reveal the early manifestations of cardiac ischemia, metabolic disorders, or life-threatening disrhythmias. Misinterpretation of ECG and its consequent mistreatment or performing inessential  interventions may cause life-threatening cardiac events. Since EM residents and internal medicine (IM residents are usually the first to visit at bedside and start treatments based on patient’s ECG, we intended to evaluate the ability of EM residents to interpret ECGs and to compare it with that of IM residents using various ECG samples.Method: 63 participants including 33 IM residents and 30 EM residents from two education hospitals of Shahid Beheshti University of Medical Sciences were enrolled in our study. A diagnosis test consisting of 15 ECG samples associated with a questionnaire containing questions about gender, academic year and proficiency in ECG interpretation was taken from all participants. This study was conducted under the supervision of a cardiologist and an emergency specialist who supervised the ECG selection, answers and scoring of each ECG. The maximum score for each ECG was 6 which were given to a completely correct diagnosis and -0.25 negative point was given if the answer was wrong or any differential diagnosis was mentioned. After the test, the answer sheets were collected and wereanalyzed with SPSS program, by two of study authors who were kept blind to the real identities of participants.Results: After classification of groups, the overall mean score was 45.5/100 (38-60. The mean score of IM and EM residents was 56.0/100 (44.9-72 and 38.9/100 (31.5-45.5, respectively (p< 0.001.No significant correlation was found between the diagnosis scores and participant’s self-judgment on her/his ECG interpretation skills (p=0.897, r=0.017. Five ECGs were considered as the most important and

Changes in parent motivation predicts changes in body mass index z-score (zBMI) and dietary intake among preschoolers enrolled in a family-based obesity intervention.

Science.gov (United States)

Van Allen, Jason; Kuhl, Elizabeth S; Filigno, Stephanie S; Clifford, Lisa M; Connor, Jared M; Stark, Lori J

2014-10-01

To examine whether changes in parent motivation over the course of a pediatric obesity intervention are significantly associated with long-term changes in treatment outcomes.   Study hypotheses were tested with a secondary data analysis of a randomized controlled trial (N = 42). Study analyses tested whether baseline to posttreatment change in total score for a self-report parent motivation measure (Parent Motivation Inventory [PMI]) was significantly associated with baseline to 6-month follow-up changes in body mass index z-score (zBMI), dietary variables, and physical activity.   Increases in PMI were significantly associated with decreased zBMI, decreased consumption of sugar-sweetened beverages and sweets, and increased consumption of artificially sweetened beverages.   Given that increases in parent motivation were associated with some treatment benefits, future research should evaluate the impact of directly assessing and targeting parent motivation on weight outcomes for preschoolers participating in a weight management program. © The Author 2014. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Characterizing neuropathic pain profiles: enriching interpretation of painDETECT

Directory of Open Access Journals (Sweden)

Cappelleri JC

2016-07-01

. Conclusion: painDETECT differentiates pain profiles across the range of scores such that, for a particular score, the probability of experiencing at least a moderate sensation of each symptom was determined and compared. These results can help characterize NeP symptomatology, enrich interpretation of painDETECT scores, and provide a basis for individualizing NeP management. Keywords: neuropathic pain, painDETECT, sensory symptoms, pain profile, interpretation, patient-reported outcomes

The influence of a continuing education program on the image interpretation accuracy of rural radiographers.

Science.gov (United States)

Smith, Tony N; Traise, Peter; Cook, Aiden

2009-01-01

In regional, rural and remote clinical practice, radiographers work closely with medical members of the acute care team in the interpretation of radiographic images, particularly when no radiologist is available. However, the misreading of radiographs by non-radiologist physicians has been shown to be the most common type of clinical error in the emergency department. Further, in Australia few rural radiographers are specifically trained to interpret and report on images. This study aimed to evaluate the accuracy of a group of rural radiographers in interpreting musculoskeletal plain radiographs, and to assess the effectiveness of continuing education (CE) in improving their accuracy within a short time frame. Following ethics approval, 16 rural radiographers were recruited to the study. At inception a purpose-designed 'test-object' of 25 cases compiled by a radiologist was used to assess image interpretation accuracy. The cases were categorised into three grades of complexity. The radiographers entered their answers on a structured radiographer opinion form (ROF) that had three levels of response - 'general opinion', 'observations' and 'open comment'. Subsequent to base-line testing, the radiographers participated in a CE program aimed at improving their image interpretation skills. After a 4 month period they were re-tested using the same methodology. The ROFs were scored by the radiologist and the pooled results analysed for statistically significant changes at all ROF levels and grades of complexity. While for the small number of less complex grade 1 cases there was no change in image interpretation accuracy, for the more numerous and more complex grade 2 and grade 3 cases there was a statistically significant improvement at the 'general opinion' and 'observation' levels (paired t-test, p radiologist. However, radiographers' ability to use radiological vocabulary needs improvement. The complementary role that exists between radiographers and other members of

Development of a standardized method of assessment of radiographs and radiographic change in juvenile idiopathic arthritis - Introduction of the Dijkstra composite score

NARCIS (Netherlands)

van Rossum, MAJ; Zwinderman, AH; van Soesbergen, RM; Wieringa, H; Fiselier, TJW; Franssen, MJAM; ten Cate, R; van Suijlekom-Smit, LWA; Wulffraat, NM; van Luijk, WHJ; Oostveen, JCM; Kuis, W; Dijkmans, BAC

Objective. To evaluate the sensitivity to change of a newly developed radiologic assessment tool, the Dijkstra score, and to develop a numeric composite score and progressor classification scheme to apply in juvenile idiopathic arthritis (JIA) trials. Methods. A placebo-controlled trial of

The Changes of Students’ Toefl Score After One Year Learning

Directory of Open Access Journals (Sweden)

Ienneke Indra Dewi

2015-10-01

Full Text Available BINUS students are supposed to increase their English competence indicated by their TOEFL scores. This paper aims to observe the differences between studens TOEFL scores obtained when they entered BINUS and the scores after they joined TOEFL courses at BINUS for one year. The participants were 121 students. The data for the entrance test were taken from the BINUS data center and the final test data were taken from their final test at English class. The data were analysed using statistics especially the descriptive statistics, comparing means, and correlation. To support the quantative data, a set of questionnaires was distributed to those 121 students. The results show that the students’ TOEFL scores have increased significantly in the final test compared to those in the entrance test. The low achiever students showed a better performance than the higher ones. Students’ motivation and background support their English study. Students proved to have the most problem in listening. The results of the research are expected to be the input for English lecturers to improve their teaching especially the existence of SALLC (Self Access Language Learning Center. 

Serial automated quantitative CT analysis in idiopathic pulmonary fibrosis. Functional correlations and comparison with changes in visual CT scores

International Nuclear Information System (INIS)

Jacob, Joseph; Bartholmai, Brian J.; Rajagopalan, Srinivasan; Kokosi, Maria; Wells, Athol U.; Egashira, Ryoko; Brun, Anne Laure; Nair, Arjun; Walsh, Simon L.F.; Karwoski, Ronald

2018-01-01

To determine whether computer-based CT quantitation of change can improve on visual change quantification of parenchymal features in IPF. Sixty-six IPF patients with serial CT imaging (6-24 months apart) had CT features scored visually and with a computer software tool: ground glass opacity, reticulation and honeycombing (all three variables summed as interstitial lung disease extent [ILD]) and emphysema. Pulmonary vessel volume (PVV) was estimated by computer only. Relationships between changes in CT features and forced vital capacity (FVC) were examined using univariate and multivariate linear regression analyses. On univariate analysis, changes in computer variables demonstrated stronger linkages to FVC change than changes in visual scores (CALIPER ILD:R 2 =0.53, p<0.0001; Visual ILD:R 2 =0.16, p=0.001). PVV increase correlated most strongly with relative FVC change (R 2 =0.57). When PVV constituents (vessel size and location) were examined, an increase in middle zone vessels linked most strongly to FVC decline (R 2 =0.57) and was independent of baseline disease severity (characterised by CT fibrosis extent, FVC, or DLco). An increase in PVV, specifically an increase in middle zone lung vessels, was the strongest CT determinant of FVC decline in IPF and was independent of baseline disease severity. (orig.)

Serial automated quantitative CT analysis in idiopathic pulmonary fibrosis. Functional correlations and comparison with changes in visual CT scores

Energy Technology Data Exchange (ETDEWEB)

Jacob, Joseph; Bartholmai, Brian J.; Rajagopalan, Srinivasan [Mayo Clinic Rochester, Division of Radiology, Rochester, MN (United States); Kokosi, Maria; Wells, Athol U. [Royal Brompton and Harefield NHS Foundation Trust, Interstitial Lung Disease Unit, Royal Brompton Hospital, London (United Kingdom); Egashira, Ryoko [Saga Daigaku, Department of Radiology, Saga (Japan); Brun, Anne Laure [Whittington Hospital, Department of Radiology, London (United Kingdom); Nair, Arjun [Guys and St Thomas' NHS Foundation Trust, Department of Radiology, London (United Kingdom); Walsh, Simon L.F. [Kings College Hospital NHS Foundation Trust, Department of Radiology, London (United Kingdom); Karwoski, Ronald [Mayo Clinic Rochester, Department of Physiology and Biomedical Engineering, Rochester, MN (United States)

2018-03-15

To determine whether computer-based CT quantitation of change can improve on visual change quantification of parenchymal features in IPF. Sixty-six IPF patients with serial CT imaging (6-24 months apart) had CT features scored visually and with a computer software tool: ground glass opacity, reticulation and honeycombing (all three variables summed as interstitial lung disease extent [ILD]) and emphysema. Pulmonary vessel volume (PVV) was estimated by computer only. Relationships between changes in CT features and forced vital capacity (FVC) were examined using univariate and multivariate linear regression analyses. On univariate analysis, changes in computer variables demonstrated stronger linkages to FVC change than changes in visual scores (CALIPER ILD:R{sup 2}=0.53, p<0.0001; Visual ILD:R{sup 2}=0.16, p=0.001). PVV increase correlated most strongly with relative FVC change (R{sup 2}=0.57). When PVV constituents (vessel size and location) were examined, an increase in middle zone vessels linked most strongly to FVC decline (R{sup 2}=0.57) and was independent of baseline disease severity (characterised by CT fibrosis extent, FVC, or DLco). An increase in PVV, specifically an increase in middle zone lung vessels, was the strongest CT determinant of FVC decline in IPF and was independent of baseline disease severity. (orig.)

The evaluation of an open source online training system for teaching 12 lead electrocardiographic interpretation.

Science.gov (United States)

Breen, Cathal; Zhu, Tingting; Bond, Raymond; Finlay, Dewar; Clifford, Gari

2016-01-01

The aim of this study is to present and evaluate the integration of a low resource JavaScript based ECG training interface (CrowdLabel) and a standardised curriculum for self-guided tuition in ECG interpretation. Participants practiced interpreting ECGs weekly using the CrowdLabel interface to assist with the learning of the traditional didactic taught course material during a 6 week training period. To determine competency students were tested during week 7. A total of 245 unique ECG cases were submitted by each student. Accuracy scores during the training period ranged from 0-59.5% (median = 33.3%). Conversely accuracy scores during the test ranged from 30 - 70% (median = 37.5%) (p < 0.05). There was no correlation between students who interpreted high numbers of ECGs during the training period and their marks obtained. CrowdLabel is shown to be a readily accessible dedicated learning platform to support ECG interpretation competency. Copyright © 2016 Elsevier Inc. All rights reserved.

Changes of the liver volume and the Child-Pugh score after high dose hypofractionated radiotherapy in patients with small hepatocellular carcinoma

International Nuclear Information System (INIS)

Kim, Young Il; Park, Hee Chul; Lim, Do Hoon; Park, Hyo Jung; Park, Su Yeon; Kim, Jin Sung; Han, Young Yih; Kang, Sang Won; Paik, Seung Woon

2012-01-01

To investigate the safety of high dose hypofractionated radiotherapy (RT) in patients with small hepatocellular carcinoma (HCC) in terms of liver volumetric changes and clinical liver function. We retrospectively reviewed 16 patients with small HCC who were treated with high dose hypofractionated RT between 2006 and 2009. The serial changes of the liver volumetric parameter were analyzed from pre-RT and follow-up (FU) computed tomography (CT) scans. We estimated linear time trends of whole liver volume using a linear mixed model. The serial changes of the Child-Pugh (CP) scores were also analyzed in relation to the volumetric changes. Mean pre-RT volume of entire liver was 1,192.2 mL (range, 502.6 to 1,310.2 mL) and mean clinical target volume was 14.7 mL (range, 1.56 to 70.07 mL). Fourteen (87.5%) patients had 4 FU CT sets and 2 (12.5%) patients had 3 FU CT sets. Mean interval between FU CT acquisition was 2.5 months. After considering age, gender and the irradiated liver volume as a fixed effects, the mixed model analysis confirmed that the change in liver volume is not significant throughout the time course of FU periods. Majority of patients had a CP score change less than 2 except in 1 patient who had CP score change more than 3. The high dose hypofractionated RT for small HCC is relatively safe and feasible in terms of liver volumetric changes and clinical liver function.

Cytological artifacts masquerading interpretation

Directory of Open Access Journals (Sweden)

Khushboo Sahay

2013-01-01

Conclusions: In order to justify a cytosmear interpretation, a cytologist must be well acquainted with delayed fixation-induced cellular changes and microscopic appearances of common contaminants so as to implicate better prognosis and therapy.

Myocardial perfusion imaging and coronary calcium scoring with a two-slice SPECT/CT system: can the attenuation map be calculated from the calcium scoring CT scan?

Energy Technology Data Exchange (ETDEWEB)

Wenning, Christian; Rahbar, Kambiz; Schober, Otmar; Stegger, Lars [University of Muenster, Department of Nuclear Medicine, Muenster (Germany); Vrachimis, Alexis; Schaefers, Michael [University of Muenster, Department of Nuclear Medicine, Muenster (Germany); University of Muenster, European Institute for Molecular Imaging, Muenster (Germany)

2013-07-15

Coronary artery calcium scoring can complement myocardial perfusion imaging (MPI). The purpose of this study was to evaluate the feasibility and accuracy of using the CalciumScore-CT derived from a combined SPECT/CT device also for SPECT attenuation correction (AC). The study group comprised 99 patients who underwent both post-stress and rest MPI using a two-slice SPECT/CT system. For AC, one of the two scans was accompanied by a CalciumScore-CT scan (CalciumScore-CTAC) and the other by a conventional spiral CT (AttenCorr-CT) scan (AttenCorr-CTAC). In 48 patients the CalciumScore-CT scan was acquired with the post-stress scan and the AttenCorr-CT scan with the rest scan, and in 51 patients the order was reversed. The accuracy of the images based on AC was determined qualitatively by consensus reading with respect to the clinical diagnoses as well as quantitatively by comparing the perfusion summed stress scores (SSS) and the summed rest scores (SRS) between attenuation-corrected and uncorrected images. In comparison to the uncorrected images CalciumScore-CTAC led to regional inaccuracies in 14 of 51 of studies (27.5 %) versus 12 of 48 studies (25 %) with AttenCorr-CTAC for the stress studies and in 5 of 48 (10 %) versus 1 of 51 (2 %) for the rest studies, respectively. This led to intermediate and definite changes in the final diagnosis (ischaemia and/or scarring) in 12 % of the studies (12 of 99) and in 7 % of the studies (7 of 99) with CalciumScore-CTAC and in 9 % of the studies (9 of 99) and 4 % of the studies (4 of 99) with AttenCorr-CTAC. Differences in SSS and SRS with respect to the uncorrected images were greater for the CalciumScore-CTAC images than for the AttenCorr-CTAC images ({Delta}SSS 4.5 {+-} 5.6 and 2.1 {+-} 4.4, p = 0.023; {Delta}SRS 4.2 {+-} 4.9 and 1.6 {+-} 3.2, p = 0.004, respectively). Using the same CT scan for calcium scoring and SPECT AC is feasible. Image interpretation must, however, include uncorrected images since CT-based AC relatively

Ordinal convolutional neural networks for predicting RDoC positive valence psychiatric symptom severity scores.

Science.gov (United States)

Rios, Anthony; Kavuluru, Ramakanth

2017-11-01

The CEGS N-GRID 2016 Shared Task in Clinical Natural Language Processing (NLP) provided a set of 1000 neuropsychiatric notes to participants as part of a competition to predict psychiatric symptom severity scores. This paper summarizes our methods, results, and experiences based on our participation in the second track of the shared task. Classical methods of text classification usually fall into one of three problem types: binary, multi-class, and multi-label classification. In this effort, we study ordinal regression problems with text data where misclassifications are penalized differently based on how far apart the ground truth and model predictions are on the ordinal scale. Specifically, we present our entries (methods and results) in the N-GRID shared task in predicting research domain criteria (RDoC) positive valence ordinal symptom severity scores (absent, mild, moderate, and severe) from psychiatric notes. We propose a novel convolutional neural network (CNN) model designed to handle ordinal regression tasks on psychiatric notes. Broadly speaking, our model combines an ordinal loss function, a CNN, and conventional feature engineering (wide features) into a single model which is learned end-to-end. Given interpretability is an important concern with nonlinear models, we apply a recent approach called locally interpretable model-agnostic explanation (LIME) to identify important words that lead to instance specific predictions. Our best model entered into the shared task placed third among 24 teams and scored a macro mean absolute error (MMAE) based normalized score (100·(1-MMAE)) of 83.86. Since the competition, we improved our score (using basic ensembling) to 85.55, comparable with the winning shared task entry. Applying LIME to model predictions, we demonstrate the feasibility of instance specific prediction interpretation by identifying words that led to a particular decision. In this paper, we present a method that successfully uses wide features and

Cumulative response curves to enhance interpretation of treatment differences on the Self-Esteem And Relationship questionnaire for men with erectile dysfunction.

Science.gov (United States)

Cappelleri, Joseph C; Zou, Kelly H; Bushmakin, Andrew G; Carlsson, Martin O; Symonds, Tara

2013-03-01

What's known on the subject? and What does the study add? Studies on erectile dysfunction (ED) therapies rely heavily on patient-reported outcomes (PROs) to measure efficacy on treatment response. A challenge when using PROs is interpretation of the clinical meaning of changes in scores. A responder analysis provides a threshold score to indicate whether a change in score qualifies a patient as a responder. However, a major consideration with responder analysis is the sometimes arbitrary nature of defining the threshold for a response. By contrast, cumulative response curves (CRCs) display patient response rates over a continuum of possible thresholds, thus eliminating problems with a rigid threshold definition, allowing for a variety of response thresholds to be examined simultaneously, and encompassing all data. With respect to the psychosocial factors addressed in the Self-Esteem And Relationship questionnaire in ED, CRCs clearly, distinctly, and meaningfully highlighted the favourable profiles of responses to sildenafil compared with placebo. CRCs for PROs in urology can provide a clear, transparent and meaningful visual depiction of efficacy data that can supplement and complement other analyses. To use cumulative response curves (CRCs) to enrich meaning and enhance interpretation of scores on the Self-Esteem And Relationship (SEAR) questionnaire with respect to treatment differences for men with erectile dysfunction (ED). This post hoc analysis used data from all patients who took at least one dose of study drug and had at least one post-baseline efficacy evaluation in a previously published 12-week, multicentre, randomized, double-blind, placebo-controlled trial of flexible-dose (25, 50, or 100 mg) sildenafil citrate (Viagra) in adult men with ED who had scored ≤ 75 out of 100 on the Self-Esteem subscale of the SEAR questionnaire. CRCs were used on the numeric change in transformed SEAR scores from baseline to end-of-study for each SEAR component. The

Interpretive medicine: Supporting generalism in a changing primary care world.

Science.gov (United States)

Reeve, Joanne

2010-01-01

Patient-centredness is a core value of general practice; it is defined as the interpersonal processes that support the holistic care of individuals. To date, efforts to demonstrate their relationship to patient outcomes have been disappointing, whilst some studies suggest values may be more rhetoric than reality. Contextual issues influence the quality of patient-centred consultations, impacting on outcomes. The legitimate use of knowledge, or evidence, is a defining aspect of modern practice, and has implications for patient-centredness. Based on a critical review of the literature, on my own empirical research, and on reflections from my clinical practice, I critique current models of the use of knowledge in supporting individualised care. Evidence-Based Medicine (EBM), and its implementation within health policy as Scientific Bureaucratic Medicine (SBM), define best evidence in terms of an epistemological emphasis on scientific knowledge over clinical experience. It provides objective knowledge of disease, including quantitative estimates of the certainty of that knowledge. Whilst arguably appropriate for secondary care, involving episodic care of selected populations referred in for specialist diagnosis and treatment of disease, application to general practice can be questioned given the complex, dynamic and uncertain nature of much of the illness that is treated. I propose that general practice is better described by a model of Interpretive Medicine (IM): the critical, thoughtful, professional use of an appropriate range of knowledges in the dynamic, shared exploration and interpretation of individual illness experience, in order to support the creative capacity of individuals in maintaining their daily lives. Whilst the generation of interpreted knowledge is an essential part of daily general practice, the profession does not have an adequate framework by which this activity can be externally judged to have been done well. Drawing on theory related to the

Determination of difficult concepts in the interpretation of musculoskeletal radiographs using a web-based learning/teaching tool

International Nuclear Information System (INIS)

Nunn, Heidi; Nunn, David L.

2011-01-01

Aim: To identify which aspects of musculoskeletal radiograph image interpretation users of a web-based learning resource found to be most difficult. Method: The resource provides modular online training, based on twelve musculoskeletal anatomical and pathological areas. At the end of each module is a multiple choice self-test, which users can utilize to consolidate their learning. There are 217 questions within the tests. The results for all questions answered on or before 1st February 2011 were analyzed, and the lowest scoring 25% of questions subsequently reviewed. A low-scoring question implies that the subject was difficult. Results: Users provided a total of 117,097 answers. The range of scores provided by the test questions varied significantly (P < 0.0001), from 15.8% to 93.8%. Topics appearing in the lowest quartile were analyzed in detail. They included interpretation of paediatric radiographs, the Salter-Harris classification, soft-tissue signs and the identification of multiple injuries. The lowest scoring modules were the shoulder and ankle. Conclusion: The results of this study will help to guide educators both within radiography and other health professions in providing more targeted teaching in musculoskeletal image interpretation.

Educational principles and techniques for interpreters.

Science.gov (United States)

F. David Boulanger; John P. Smith

1973-01-01

Interpretation is in large part education, since it attempts to convey information, concepts, and principles while creating attitude changes and such emotional states as wonder, delight, and appreciation. Although interpreters might profit greatly by formal training in the principles and techniques of teaching, many have not had such training. Some means of making the...

Clinically meaningful scores on pain catastrophizing before and after multidisciplinary rehabilitation: a prospective study of individuals with subacute pain after whiplash injury.

Science.gov (United States)

Scott, Whitney; Wideman, Timothy H; Sullivan, Michael J L

2014-03-01

Pain catastrophizing has emerged as a significant risk factor for problematic recovery after musculoskeletal injury. As such, there has been an increased focus on interventions that target patients' levels of catastrophizing. However, it is not presently clear how clinicians might best interpret scores on catastrophizing before and after treatment. Thus, the purpose of this study was to provide preliminary guidelines for the clinical interpretation of scores on pain catastrophizing among individuals with subacute pain after musculoskeletal injury. A sample of 166 occupationally disabled individuals with subacute pain due to a whiplash injury participated in this study. Participants completed a 7-week standardized multidisciplinary rehabilitation program aimed at fostering functional recovery. Participants completed the Pain Catastrophizing Scale (PCS) upon program commencement and completion. One year later, participants indicated their pain severity and involvement in employment activities. Separate receiver operating characteristic curve analyses were conducted to determine absolute pretreatment and posttreatment and percent change scores on the PCS that were best associated with clinically important levels of pain and employment status at the follow-up. An absolute pretreatment PCS score of 24 best identified patients according to follow-up clinical outcomes. Posttreatment PCS scores of 14 and 15 best identified patients with high follow-up pain intensity ratings and those who did not return to work, respectively. PCS reductions of approximately 38% to 44% were best associated with return to work and low pain intensity ratings at follow-up. The results indicate scores on catastrophizing before and after treatment that are clinically meaningful. These results may serve as preliminary guidelines to assess the clinical significance of interventions targeting pain catastrophizing in patients with subacute pain after musculoskeletal injury.

Interpretation, compilation and field verification procedures in the CARETS project

Science.gov (United States)

Alexander, Robert H.; De Forth, Peter W.; Fitzpatrick, Katherine A.; Lins, Harry F.; McGinty, Herbert K.

1975-01-01

The production of the CARETS map data base involved the development of a series of procedures for interpreting, compiling, and verifying data obtained from remote sensor sources. Level II land use mapping from high-altitude aircraft photography at a scale of 1:100,000 required production of a photomosaic mapping base for each of the 48, 50 x 50 km sheets, and the interpretation and coding of land use polygons on drafting film overlays. CARETS researchers also produced a series of 1970 to 1972 land use change overlays, using the 1970 land use maps and 1972 high-altitude aircraft photography. To enhance the value of the land use sheets, researchers compiled series of overlays showing cultural features, county boundaries and census tracts, surface geology, and drainage basins. In producing Level I land use maps from Landsat imagery, at a scale of 1:250,000, interpreters overlaid drafting film directly on Landsat color composite transparencies and interpreted on the film. They found that such interpretation involves pattern and spectral signature recognition. In studies using Landsat imagery, interpreters identified numerous areas of change but also identified extensive areas of "false change," where Landsat spectral signatures but not land use had changed.

Interactive or static reports to guide clinical interpretation of cancer genomics.

Science.gov (United States)

Gray, Stacy W; Gagan, Jeffrey; Cerami, Ethan; Cronin, Angel M; Uno, Hajime; Oliver, Nelly; Lowenstein, Carol; Lederman, Ruth; Revette, Anna; Suarez, Aaron; Lee, Charlotte; Bryan, Jordan; Sholl, Lynette; Van Allen, Eliezer M

2018-05-01

Misinterpretation of complex genomic data presents a major challenge in the implementation of precision oncology. We sought to determine whether interactive genomic reports with embedded clinician education and optimized data visualization improved genomic data interpretation. We conducted a randomized, vignette-based survey study to determine whether exposure to interactive reports for a somatic gene panel, as compared to static reports, improves physicians' genomic comprehension and report-related satisfaction (overall scores calculated across 3 vignettes, range 0-18 and 1-4, respectively, higher score corresponding with improved endpoints). One hundred and five physicians at a tertiary cancer center participated (29% participation rate): 67% medical, 20% pediatric, 7% radiation, and 7% surgical oncology; 37% female. Prior to viewing the case-based vignettes, 34% of the physicians reported difficulty making treatment recommendations based on the standard static report. After vignette/report exposure, physicians' overall comprehension scores did not differ by report type (mean score: interactive 11.6 vs static 10.5, difference = 1.1, 95% CI, -0.3, 2.5, P = .13). However, physicians exposed to the interactive report were more likely to correctly assess sequencing quality (P < .001) and understand when reports needed to be interpreted with caution (eg, low tumor purity; P = .02). Overall satisfaction scores were higher in the interactive group (mean score 2.5 vs 2.1, difference = 0.4, 95% CI, 0.2-0.7, P = .001). Interactive genomic reports may improve physicians' ability to accurately assess genomic data and increase report-related satisfaction. Additional research in users' genomic needs and efforts to integrate interactive reports into electronic health records may facilitate the implementation of precision oncology.

The Human Behaviour-Change Project: harnessing the power of artificial intelligence and machine learning for evidence synthesis and interpretation.

Science.gov (United States)

Michie, Susan; Thomas, James; Johnston, Marie; Aonghusa, Pol Mac; Shawe-Taylor, John; Kelly, Michael P; Deleris, Léa A; Finnerty, Ailbhe N; Marques, Marta M; Norris, Emma; O'Mara-Eves, Alison; West, Robert

2017-10-18

Behaviour change is key to addressing both the challenges facing human health and wellbeing and to promoting the uptake of research findings in health policy and practice. We need to make better use of the vast amount of accumulating evidence from behaviour change intervention (BCI) evaluations and promote the uptake of that evidence into a wide range of contexts. The scale and complexity of the task of synthesising and interpreting this evidence, and increasing evidence timeliness and accessibility, will require increased computer support. The Human Behaviour-Change Project (HBCP) will use Artificial Intelligence and Machine Learning to (i) develop and evaluate a 'Knowledge System' that automatically extracts, synthesises and interprets findings from BCI evaluation reports to generate new insights about behaviour change and improve prediction of intervention effectiveness and (ii) allow users, such as practitioners, policy makers and researchers, to easily and efficiently query the system to get answers to variants of the question 'What works, compared with what, how well, with what exposure, with what behaviours (for how long), for whom, in what settings and why?'. The HBCP will: a) develop an ontology of BCI evaluations and their reports linking effect sizes for given target behaviours with intervention content and delivery and mechanisms of action, as moderated by exposure, populations and settings; b) develop and train an automated feature extraction system to annotate BCI evaluation reports using this ontology; c) develop and train machine learning and reasoning algorithms to use the annotated BCI evaluation reports to predict effect sizes for particular combinations of behaviours, interventions, populations and settings; d) build user and machine interfaces for interrogating and updating the knowledge base; and e) evaluate all the above in terms of performance and utility. The HBCP aims to revolutionise our ability to synthesise, interpret and deliver

Meteorological interpretation of transient LOD changes

Science.gov (United States)

Masaki, Y.

2008-04-01

The Earth’s spin rate is mainly changed by zonal winds. For example, seasonal changes in global atmospheric circulation and episodic changes accompanied with El Nĩ os are clearly detected n in the Length-of-day (LOD). Sub-global to regional meteorological phenomena can also change the wind field, however, their effects on the LOD are uncertain because such LOD signals are expected to be subtle and transient. In our previous study (Masaki, 2006), we introduced atmospheric pressure gradients in the upper atmosphere in order to obtain a rough picture of the meteorological features that can change the LOD. In this presentation, we compare one-year LOD data with meteorological elements (winds, temperature, pressure, etc.) and make an attempt to link transient LOD changes with sub-global meteorological phenomena.

Automated, computer interpreted radioimmunoassay results

International Nuclear Information System (INIS)

Hill, J.C.; Nagle, C.E.; Dworkin, H.J.; Fink-Bennett, D.; Freitas, J.E.; Wetzel, R.; Sawyer, N.; Ferry, D.; Hershberger, D.

1984-01-01

90,000 Radioimmunoassay results have been interpreted and transcribed automatically using software developed for use on a Hewlett Packard Model 1000 mini-computer system with conventional dot matrix printers. The computer program correlates the results of a combination of assays, interprets them and prints a report ready for physician review and signature within minutes of completion of the assay. The authors designed and wrote a computer program to query their patient data base for radioassay laboratory results and to produce a computer generated interpretation of these results using an algorithm that produces normal and abnormal interpretives. Their laboratory assays 50,000 patient samples each year using 28 different radioassays. Of these 85% have been interpreted using our computer program. Allowances are made for drug and patient history and individualized reports are generated with regard to the patients age and sex. Finalization of reports is still subject to change by the nuclear physician at the time of final review. Automated, computerized interpretations have realized cost savings through reduced personnel and personnel time and provided uniformity of the interpretations among the five physicians. Prior to computerization of interpretations, all radioassay results had to be dictated and reviewed for signing by one of the resident or staff physicians. Turn around times for reports prior to the automated computer program generally were two to three days. Whereas, the computerized interpret system allows reports to generally be issued the day assays are completed

Objective interpretation as conforming interpretation

Directory of Open Access Journals (Sweden)

Lidka Rodak

2011-12-01

Full Text Available The practical discourse willingly uses the formula of “objective interpretation”, with no regards to its controversial nature that has been discussed in literature.The main aim of the article is to investigate what “objective interpretation” could mean and how it could be understood in the practical discourse, focusing on the understanding offered by judicature.The thesis of the article is that objective interpretation, as identified with textualists’ position, is not possible to uphold, and should be rather linked with conforming interpretation. And what this actually implies is that it is not the virtue of certainty and predictability – which are usually associated with objectivity- but coherence that makes the foundation of applicability of objectivity in law.What could be observed from the analyses, is that both the phenomenon of conforming interpretation and objective interpretation play the role of arguments in the interpretive discourse, arguments that provide justification that interpretation is not arbitrary or subjective. With regards to the important part of the ideology of legal application which is the conviction that decisions should be taken on the basis of law in order to exclude arbitrariness, objective interpretation could be read as a question “what kind of authority “supports” certain interpretation”? that is almost never free of judicial creativity and judicial activism.One can say that, objective and conforming interpretation are just another arguments used in legal discourse.

Detection and validation of unscalable item score patterns using item response theory: an illustration with Harter's Self-Perception Profile for Children.

Science.gov (United States)

Meijer, Rob R; Egberink, Iris J L; Emons, Wilco H M; Sijtsma, Klaas

2008-05-01

We illustrate the usefulness of person-fit methodology for personality assessment. For this purpose, we use person-fit methods from item response theory. First, we give a nontechnical introduction to existing person-fit statistics. Second, we analyze data from Harter's (1985) Self-Perception Profile for Children (Harter, 1985) in a sample of children ranging from 8 to 12 years of age (N = 611) and argue that for some children, the scale scores should be interpreted with care and caution. Combined information from person-fit indexes and from observation, interviews, and self-concept theory showed that similar score profiles may have a different interpretation. For some children in the sample, item scores did not adequately reflect their trait level. Based on teacher interviews, this was found to be due most likely to a less developed self-concept and/or problems understanding the meaning of the questions. We recommend investigating the scalability of score patterns when using self-report inventories to help the researcher interpret respondents' behavior correctly.

High-throughput interpretation of gene structure changes in human and nonhuman resequencing data, using ACE.

Science.gov (United States)

Majoros, William H; Campbell, Michael S; Holt, Carson; DeNardo, Erin K; Ware, Doreen; Allen, Andrew S; Yandell, Mark; Reddy, Timothy E

2017-05-15

The accurate interpretation of genetic variants is critical for characterizing genotype-phenotype associations. Because the effects of genetic variants can depend strongly on their local genomic context, accurate genome annotations are essential. Furthermore, as some variants have the potential to disrupt or alter gene structure, variant interpretation efforts stand to gain from the use of individualized annotations that account for differences in gene structure between individuals or strains. We describe a suite of software tools for identifying possible functional changes in gene structure that may result from sequence variants. ACE ('Assessing Changes to Exons') converts phased genotype calls to a collection of explicit haplotype sequences, maps transcript annotations onto them, detects gene-structure changes and their possible repercussions, and identifies several classes of possible loss of function. Novel transcripts predicted by ACE are commonly supported by spliced RNA-seq reads, and can be used to improve read alignment and transcript quantification when an individual-specific genome sequence is available. Using publicly available RNA-seq data, we show that ACE predictions confirm earlier results regarding the quantitative effects of nonsense-mediated decay, and we show that predicted loss-of-function events are highly concordant with patterns of intolerance to mutations across the human population. ACE can be readily applied to diverse species including animals and plants, making it a broadly useful tool for use in eukaryotic population-based resequencing projects, particularly for assessing the joint impact of all variants at a locus. ACE is written in open-source C ++ and Perl and is available from geneprediction.org/ACE. myandell@genetics.utah.edu or tim.reddy@duke.edu. Supplementary information is available at Bioinformatics online. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please e

Puzzle based teaching versus traditional instruction in electrocardiogram interpretation for medical students--a pilot study.

Science.gov (United States)

Rubinstein, Jack; Dhoble, Abhijeet; Ferenchick, Gary

2009-01-13

Most medical professionals are expected to possess basic electrocardiogram (EKG) interpretation skills. But, published data suggests that residents' and physicians' EKG interpretation skills are suboptimal. Learning styles differ among medical students; individualization of teaching methods has been shown to be viable and may result in improved learning. Puzzles have been shown to facilitate learning in a relaxed environment. The objective of this study was to assess efficacy of teaching puzzle in EKG interpretation skills among medical students. This is a reader blinded crossover trial. Third year medical students from College of Human Medicine, Michigan State University participated in this study. Two groups (n = 9) received two traditional EKG interpretation skills lectures followed by a standardized exam and two extra sessions with the teaching puzzle and a different exam. Two other groups (n = 6) received identical courses and exams with the puzzle session first followed by the traditional teaching. EKG interpretation scores on final test were used as main outcome measure. The average score after only traditional teaching was 4.07 +/- 2.08 while after only the puzzle session was 4.04 +/- 2.36 (p = 0.97). The average improvement after the traditional session was followed up with a puzzle session was 2.53 +/- 1.94 while the average improvement after the puzzle session was followed with the traditional session was 2.08 +/- 1.73 (p = 0.67). The final EKG exam score for this cohort (n = 15) was 84.1 compared to 86.6 (p = 0.22) for a comparable sample of medical students (n = 15) at a different campus. Teaching EKG interpretation with puzzles is comparable to traditional teaching and may be particularly useful for certain subgroups of students. Puzzle session are more interactive and relaxing, and warrant further investigations on larger scale.

Electrocardiographic interpretation skills of cardiology residents: are they competent?

Science.gov (United States)

Sibbald, Matthew; Davies, Edward G; Dorian, Paul; Yu, Eric H C

2014-12-01

Achieving competency at electrocardiogram (ECG) interpretation among cardiology subspecialty residents has traditionally focused on interpreting a target number of ECGs during training. However, there is little evidence to support this approach. Further, there are no data documenting the competency of ECG interpretation skills among cardiology residents, who become de facto the gold standard in their practice communities. We tested 29 Cardiology residents from all 3 years in a large training program using a set of 20 ECGs collected from a community cardiology practice over a 1-month period. Residents interpreted half of the ECGs using a standard analytic framework, and half using their own approach. Residents were scored on the number of correct and incorrect diagnoses listed. Overall diagnostic accuracy was 58%. Of 6 potentially life-threatening diagnoses, residents missed 36% (123 of 348) including hyperkalemia (81%), long QT (52%), complete heart block (35%), and ventricular tachycardia (19%). Residents provided additional inappropriate diagnoses on 238 ECGs (41%). Diagnostic accuracy was similar between ECGs interpreted using an analytic framework vs ECGs interpreted without an analytic framework (59% vs 58%; F(1,1333) = 0.26; P = 0.61). Cardiology resident proficiency at ECG interpretation is suboptimal. Despite the use of an analytic framework, there remain significant deficiencies in ECG interpretation among Cardiology residents. A more systematic method of addressing these important learning gaps is urgently needed. Copyright © 2014 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

Interpreting the change detection error matrix

NARCIS (Netherlands)

Oort, van P.A.J.

2007-01-01

Two different matrices are commonly reported in assessment of change detection accuracy: (1) single date error matrices and (2) binary change/no change error matrices. The third, less common form of reporting, is the transition error matrix. This paper discuses the relation between these matrices.

ECG interpretation in Emergency Department residents: an update and e-learning as a resource to improve skills.

Science.gov (United States)

Barthelemy, Francois X; Segard, Julien; Fradin, Philippe; Hourdin, Nicolas; Batard, Eric; Pottier, Pierre; Potel, Gilles; Montassier, Emmanuel

2017-04-01

ECG interpretation is a pivotal skill to acquire during residency, especially for Emergency Department (ED) residents. Previous studies reported that ECG interpretation competency among residents was rather low. However, the optimal resource to improve ECG interpretation skills remains unclear. The aim of our study was to compare two teaching modalities to improve the ECG interpretation skills of ED residents: e-learning and lecture-based courses. The participants were first-year and second-year ED residents, assigned randomly to the two groups. The ED residents were evaluated by means of a precourse test at the beginning of the study and a postcourse test after the e-learning and lecture-based courses. These evaluations consisted of the interpretation of 10 different ECGs. We included 39 ED residents from four different hospitals. The precourse test showed that the overall average score of ECG interpretation was 40%. Nineteen participants were then assigned to the e-learning course and 20 to the lecture-based course. Globally, there was a significant improvement in ECG interpretation skills (accuracy score=55%, P=0.0002). However, this difference was not significant between the two groups (P=0.14). Our findings showed that the ECG interpretation was not optimal and that our e-learning program may be an effective tool for enhancing ECG interpretation skills among ED residents. A large European study should be carried out to evaluate ECG interpretation skills among ED residents before the implementation of ECG learning, including e-learning strategies, during ED residency.

Vocational students' learning preferences: the interpretability of ipsative data.

Science.gov (United States)

Smith, P J

2000-02-01

A number of researchers have argued that ipsative data are not suitable for statistical procedures designed for normative data. Others have argued that the interpretability of such analyses of ipsative data are little affected where the number of variables and the sample size are sufficiently large. The research reported here represents a factor analysis of the scores on the Canfield Learning Styles Inventory for 1,252 students in vocational education. The results of the factor analysis of these ipsative data were examined in a context of existing theory and research on vocational students and lend support to the argument that the factor analysis of ipsative data can provide sensibly interpretable results.

PI-RADS version 2: quantitative analysis aids reliable interpretation of diffusion-weighted imaging for prostate cancer

Energy Technology Data Exchange (ETDEWEB)

Park, Sung Yoon; Jung, Dae Chul; Oh, Young Taik [Yonsei University College of Medicine, Department of Radiology and Research Institute of Radiological Science, Severance Hospital, Seoul (Korea, Republic of); Shin, Su-Jin [Yonsei University College of Medicine, Department of Pathology, Seoul (Korea, Republic of); Hanyang University College of Medicine, Department of Pathology, Seoul (Korea, Republic of); Cho, Nam Hoon [Yonsei University College of Medicine, Department of Pathology, Seoul (Korea, Republic of); Choi, Young Deuk; Rha, Koon Ho; Hong, Sung Joon [Yonsei University College of Medicine, Department of Urology, Seoul (Korea, Republic of)

2017-07-15

To determine whether apparent diffusion coefficient (ADC) ratio aids reliable interpretation of diffusion-weighted imaging (DWI) for prostate cancer (PCa). Seventy-six consecutive patients with PCa who underwent DWI and surgery were included. Based on pathologic tumour location, two readers independently performed DWI scoring according to the revised Prostate Imaging Reporting and Data System (PI-RADSv2). ADC ratios of benign to cancerous prostatic tissue were then measured independently and compared between cases showing concordant and discordant DWI scores ≥4. Area under the curve (AUC) and threshold of ADC ratio were analyzed for DWI scores ≥4. The rate of inter-reader disagreement for DWI score ≥4 was 11.8% (9/76). ADC ratios were higher in concordant vs. discordant DWI scores ≥4 (median, 1.7 vs. 1.1-1.2; p < 0.001). For DWI scores ≥4, the AUCs of ADC ratios were 0.970 for reader 1 and 0.959 for reader 2. In patients with an ADC ratio >1.3, the rate of inter-reader disagreement for DWI score ≥4 decreased to 5.9-6.0%. An ADC ratio >1.3 yielded 100% (reader 1, 54/54; reader 2, 51/51) positive predictive value for clinically significant cancer. ADC ratios may be useful for reliable interpretation of DWI score ≥4 in PI-RADSv2. (orig.)

Discriminant Validity of the WISC-IV Culture-Language Interpretive Matrix

Science.gov (United States)

Styck, Kara M.; Watkins, Marley W.

2014-01-01

The Culture-Language Interpretive Matrix (C-LIM) was developed to help practitioners determine the validity of test scores obtained from students who are culturally and linguistically different from the normative group of a test. The present study used an idiographic approach to investigate the diagnostic utility of the C-LIM for the Wechsler…

Cognitive bias modification of interpretation in children with social anxiety disorder.

Science.gov (United States)

Orchard, Faith; Apetroaia, Adela; Clarke, Kiri; Creswell, Cathy

2017-01-01

Negative (or a lack of positive) interpretation of ambiguous social situations has been hypothesised to maintain social anxiety disorder in children, yet there is currently limited evidence to support this. Cognitive Bias Modification of Interpretation (CBM-I) provides a means to explore the causal influence of interpretation bias on social anxiety disorder, and has been associated with a reduction in social anxiety symptoms in adults. Seven to twelve year old children with a diagnosis of social anxiety disorder completed CBM-I training, adapted from materials designed for socially anxious children in the community, or no training. Effects on interpretation bias and social anxiety were assessed. The adapted CBM-I training was not associated with significant changes in benign or negative interpretation. Unsurprisingly given the lack of successful interpretation training, there were no significant changes in child or parent reported social anxiety symptoms, clinician-rated severity or diagnoses and change in interpretation was not significantly associated with change in social anxiety. These findings contrast with some studies with community populations although it is possible that more intensive CBM-I training is required to fully test this hypothesis among clinical groups. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

Assessing Trust and Effectiveness in Virtual Teams: Latent Growth Curve and Latent Change Score Models

Directory of Open Access Journals (Sweden)

Michael D. Coovert

2017-08-01

Full Text Available Trust plays a central role in the effectiveness of work groups and teams. This is the case for both face-to-face and virtual teams. Yet little is known about the development of trust in virtual teams. We examined cognitive and affective trust and their relationship to team effectiveness as reflected through satisfaction with one’s team and task performance. Latent growth curve analysis reveals both trust types start at a significant level with individual differences in that initial level. Cognitive trust follows a linear growth pattern while affective trust is overall non-linear, but becomes linear once established. Latent change score models are utilized to examine change in trust and also its relationship with satisfaction with the team and team performance. In examining only change in trust and its relationship to satisfaction there appears to be a straightforward influence of trust on satisfaction and satisfaction on trust. However, when incorporated into a bivariate coupling latent change model the dynamics of the relationship are revealed. A similar pattern holds for trust and task performance; however, in the bivariate coupling change model a more parsimonious representation is preferred.

The role of internal climate variability for interpreting climate change scenarios

Science.gov (United States)

Maraun, Douglas

2013-04-01

When communicating information on climate change, the use of multi-model ensembles has been advocated to sample uncertainties over a range as wide as possible. To meet the demand for easily accessible results, the ensemble is often summarised by its multi-model mean signal. In rare cases, additional uncertainty measures are given to avoid loosing all information on the ensemble spread, e.g., the highest and lowest projected values. Such approaches, however, disregard the fundamentally different nature of the different types of uncertainties and might cause wrong interpretations and subsequently wrong decisions for adaptation. Whereas scenario and climate model uncertainties are of epistemic nature, i.e., caused by an in principle reducible lack of knowledge, uncertainties due to internal climate variability are aleatory, i.e., inherently stochastic and irreducible. As wisely stated in the proverb "climate is what you expect, weather is what you get", a specific region will experience one stochastic realisation of the climate system, but never exactly the expected climate change signal as given by a multi model mean. Depending on the meteorological variable, region and lead time, the signal might be strong or weak compared to the stochastic component. In cases of a low signal-to-noise ratio, even if the climate change signal is a well defined trend, no trends or even opposite trends might be experienced. Here I propose to use the time of emergence (TOE) to quantify and communicate when climate change trends will exceed the internal variability. The TOE provides a useful measure for end users to assess the time horizon for implementing adaptation measures. Furthermore, internal variability is scale dependent - the more local the scale, the stronger the influence of internal climate variability. Thus investigating the TOE as a function of spatial scale could help to assess the required spatial scale for implementing adaptation measures. I exemplify this proposal with

A randomized control trial comparing use of a novel electrocardiogram simulator with traditional teaching in the acquisition of electrocardiogram interpretation skill.

Science.gov (United States)

Fent, Graham; Gosai, Jivendra; Purva, Makani

2016-01-01

Accurate interpretation of the electrocardiogram (ECG) remains an essential skill for medical students and junior doctors. While many techniques for teaching ECG interpretation are described, no single method has been shown to be superior. This randomized control trial is the first to investigate whether teaching ECG interpretation using a computer simulator program or traditional teaching leads to improved scores in a test of ECG interpretation among medical students and postgraduate doctors immediately after and 3months following teaching. Participants' opinions of the program were assessed using a questionnaire. There were no differences in ECG interpretation test scores immediately after or 3months after teaching in the lecture or simulator groups. At present therefore, there is insufficient evidence to suggest that ECG simulator programs are superior to traditional teaching. Copyright © 2016 Elsevier Inc. All rights reserved.

Myth of the Master Detective: Reliability of Interpretations for Kaufman's "Intelligent Testing" Approach to the WISC-III.

Science.gov (United States)

Macmann, Gregg M.; Barnett, David W.

1997-01-01

Used computer simulation to examine the reliability of interpretations for Kaufman's "intelligent testing" approach to the Wechsler Intelligence Scale for Children (3rd ed.) (WISC-III). Findings indicate that factor index-score differences and other measures could not be interpreted with confidence. Argues that limitations of IQ testing…

Reliability and sensitivity to change of the OMERACT rheumatoid arthritis magnetic resonance imaging score in a multireader, longitudinal setting

DEFF Research Database (Denmark)

Haavardsholm, ea; Østergaard, Mikkel; Kvan, NP

2005-01-01

OBJECTIVE: To assess the intra- and interreader reliability and the sensitivity to change of the Outcome Measures in Rheumatology Clinical Trials (OMERACT) Rheumatoid Arthritis Magnetic Resonance Imaging Score (RAMRIS) system on digital images of the wrist joints of patients with early or establi...

Puzzle based teaching versus traditional instruction in electrocardiogram interpretation for medical students – a pilot study

Science.gov (United States)

Rubinstein, Jack; Dhoble, Abhijeet; Ferenchick, Gary

2009-01-01

Background Most medical professionals are expected to possess basic electrocardiogram (EKG) interpretation skills. But, published data suggests that residents' and physicians' EKG interpretation skills are suboptimal. Learning styles differ among medical students; individualization of teaching methods has been shown to be viable and may result in improved learning. Puzzles have been shown to facilitate learning in a relaxed environment. The objective of this study was to assess efficacy of teaching puzzle in EKG interpretation skills among medical students. Methods This is a reader blinded crossover trial. Third year medical students from College of Human Medicine, Michigan State University participated in this study. Two groups (n = 9) received two traditional EKG interpretation skills lectures followed by a standardized exam and two extra sessions with the teaching puzzle and a different exam. Two other groups (n = 6) received identical courses and exams with the puzzle session first followed by the traditional teaching. EKG interpretation scores on final test were used as main outcome measure. Results The average score after only traditional teaching was 4.07 ± 2.08 while after only the puzzle session was 4.04 ± 2.36 (p = 0.97). The average improvement after the traditional session was followed up with a puzzle session was 2.53 ± 1.94 while the average improvement after the puzzle session was followed with the traditional session was 2.08 ± 1.73 (p = 0.67). The final EKG exam score for this cohort (n = 15) was 84.1 compared to 86.6 (p = 0.22) for a comparable sample of medical students (n = 15) at a different campus. Conclusion Teaching EKG interpretation with puzzles is comparable to traditional teaching and may be particularly useful for certain subgroups of students. Puzzle session are more interactive and relaxing, and warrant further investigations on larger scale. PMID:19144134

Puzzle based teaching versus traditional instruction in electrocardiogram interpretation for medical students – a pilot study

Directory of Open Access Journals (Sweden)

Dhoble Abhijeet

2009-01-01

Full Text Available Abstract Background Most medical professionals are expected to possess basic electrocardiogram (EKG interpretation skills. But, published data suggests that residents' and physicians' EKG interpretation skills are suboptimal. Learning styles differ among medical students; individualization of teaching methods has been shown to be viable and may result in improved learning. Puzzles have been shown to facilitate learning in a relaxed environment. The objective of this study was to assess efficacy of teaching puzzle in EKG interpretation skills among medical students. Methods This is a reader blinded crossover trial. Third year medical students from College of Human Medicine, Michigan State University participated in this study. Two groups (n = 9 received two traditional EKG interpretation skills lectures followed by a standardized exam and two extra sessions with the teaching puzzle and a different exam. Two other groups (n = 6 received identical courses and exams with the puzzle session first followed by the traditional teaching. EKG interpretation scores on final test were used as main outcome measure. Results The average score after only traditional teaching was 4.07 ± 2.08 while after only the puzzle session was 4.04 ± 2.36 (p = 0.97. The average improvement after the traditional session was followed up with a puzzle session was 2.53 ± 1.94 while the average improvement after the puzzle session was followed with the traditional session was 2.08 ± 1.73 (p = 0.67. The final EKG exam score for this cohort (n = 15 was 84.1 compared to 86.6 (p = 0.22 for a comparable sample of medical students (n = 15 at a different campus. Conclusion Teaching EKG interpretation with puzzles is comparable to traditional teaching and may be particularly useful for certain subgroups of students. Puzzle session are more interactive and relaxing, and warrant further investigations on larger scale.

Interpretation of changes in water level accompanying fault creep and implications for earthquake prediction.

Science.gov (United States)

Wesson, R.L.

1981-01-01

Quantitative calculations for the effect of a fault creep event on observations of changes in water level in wells provide an approach to the tectonic interpretation of these phenomena. For the pore pressure field associated with an idealized creep event having an exponential displacement versus time curve, an analytic expression has been obtained in terms of exponential-integral functions. The pore pressure versus time curves for observation points near the fault are pulselike; a sharp pressure increase (or decrease, depending on the direction of propagation) is followed by more gradual decay to the normal level after the creep event. The time function of the water level change may be obtained by applying the filter - derived by A.G.Johnson and others to determine the influence of atmospheric pressure on water level - to the analytic pore pressure versus time curves. The resulting water level curves show a fairly rapid increase (or decrease) and then a very gradual return to normal. The results of this analytic model do not reproduce the steplike changes in water level observed by Johnson and others. If the procedure used to obtain the water level from the pore pressure is correct, these results suggest that steplike changes in water level are not produced by smoothly propagating creep events but by creep events that propagate discontinuously, by changes in the bulk properties of the region around the well, or by some other mechanism.-Author

Minimal Clinically Important Differences for American Orthopaedic Foot & Ankle Society Score in Hallux Valgus Surgery.

Science.gov (United States)

Chan, Hiok Yang; Chen, Jerry Yongqiang; Zainul-Abidin, Suraya; Ying, Hao; Koo, Kevin; Rikhraj, Inderjeet Singh

2017-05-01

< .001). There were no statistical differences between demographics or preoperative AOFAS scores of patients with good versus fair satisfaction levels. At 2 years, patients who had good satisfaction had higher AOFAS scores than fair satisfaction (83.9 vs 78.1, P < .001) and higher mean change (30.2 vs 22.3, P = .015). Mean change in AOFAS score in patients with good satisfaction was 30.2 (SD = 19.8). Mean difference in good versus fair satisfaction was 7.9. Using ROC analysis, the cut-off point is 29.0, with an area under the curve (AUC) of 0.62. Effect size method derived an MCID of 8.4 with a moderate effect size of 0.5. Multiple linear regression demonstrated increasing age (β = -0.129, CI = -0.245, -0.013, P = .030) and higher preoperative AOFAS score (β = -0.874, CI = -0.644, -0.081, P < .001) to significantly decrease the amount of change in the AOFAS score. The MCID of AOFAS score in hallux valgus surgery was 7.9 to 30.2. The MCID can ensure clinical improvement from a patient's perspective and also aid in interpreting results from clinical trials and other studies. Level III, retrospective comparative series.

Radiographic interpretation of the appendicular skeleton: A comparison between casualty officers, nurse practitioners and radiographers

International Nuclear Information System (INIS)

Coleman, Liz; Piper, Keith

2009-01-01

Aim: To assess how accurately and confidently casualty officers, nurse practitioners and radiographers, practicing within the emergency department (ED), recognize and describe radiographic trauma within an image test bank of 20 appendicular radiographs. Method: The participants consisted of 7 casualty officers, 13 nurse practitioners and 18 radiographers. All 20 radiographic examinations selected for the image test bank had been acquired following trauma and included some subtle, yet clinically significant abnormalities. The test bank score (maximum 40 marks), sensitivity and specificity percentages were calculated against an agreed radiological diagnosis (reference standard). Alternative Free-response Receiver Operating Characteristic (AFROC) analysis was used to assess the overall performance of the diagnostic accuracy of these professional groups. The variation in performance between each group was measured using the analysis of variance (ANOVA) test, to identify any statistical significant differences in the performance in interpretation between these groups. The relationship between the participants' perceived image interpretation accuracy during clinical practice and the actual accuracy of their image test bank score was examined using Pearson's Correlation Coefficient (r). Results: The results revealed that the radiographers gained the highest mean test bank score (28.5/40; 71%). This score was statistically higher than the mean test bank scores attained by the participating nurse practitioners (21/40; 53%) and casualty officers (21.5/40; 54%), with p < 0.01 and p = 0.02, respectively. When compared with each other, the scores from these latter groups showed no significant difference (p = 0.91). The mean 'area under the curve' (AUC) value achieved by the radiographers was also significantly higher (p < 0.01) in comparison to the AUC values demonstrated by the nurse practitioners and casualty officers, whose results, when compared, showed no significant

Stability and Change of Behavioral and Emotional Screening Scores

Science.gov (United States)

Dever, Bridget V.; Dowdy, Erin; Raines, Tara C.; Carnazzo, Katherine

2015-01-01

Universal screening for behavioral and emotional difficulties is integral to the identification of students needing early intervention and prevention efforts. However, unanswered questions regarding the stability of screening scores impede the ability to determine optimal strategies for subsequent screening. This study examined the 2-year…

An Interpreter's Interpretation: Sign Language Interpreters' View of Musculoskeletal Disorders

National Research Council Canada - National Science Library

Johnson, William L

2003-01-01

Sign language interpreters are at increased risk for musculoskeletal disorders. This study used content analysis to obtain detailed information about these disorders from the interpreters' point of view...

Linkage between company scores and stock returns

Directory of Open Access Journals (Sweden)

Saban Celik

2017-12-01

Full Text Available Previous studies on company scores conducted at firm-level, generally concluded that there exists a positive relation between company scores and stock returns. Motivated by these studies, this study examines the relationship between company scores (Corporate Governance Score, Economic Score, Environmental Score, and Social Score and stock returns, both at portfolio-level analysis and firm-level cross-sectional regressions. In portfolio-level analysis, stocks are sorted based on each company scores and quintile portfolio are formed with different levels of company scores. Then, existence and significance of raw returns and risk-adjusted returns difference between portfolios with the extreme company scores (portfolio 10 and portfolio 1 is tested. In addition, firm-level cross-sectional regression is performed to examine the significance of company scores effects with control variables. While portfolio-level analysis results indicate that there is no significant relation between company scores and stock returns; firm-level analysis indicates that economic, environmental, and social scores have effect on stock returns, however, significance and direction of these effects change, depending on the included control variables in the cross-sectional regression.

Interpreting the Relationships between TOEFL iBT Scores and GPA: Language Proficiency, Policy, and Profiles

Science.gov (United States)

Ginther, April; Yan, Xun

2018-01-01

This study examines the predictive validity of the TOEFL iBT with respect to academic achievement as measured by the first-year grade point average (GPA) of Chinese students at Purdue University, a large, public, Research I institution in Indiana, USA. Correlations between GPA, TOEFL iBT total and subsection scores were examined on 1990 mainland…

Training interpretation biases among individuals with body dysmorphic disorder symptoms.

Science.gov (United States)

Premo, Julie E; Sarfan, Laurel D; Clerkin, Elise M

2016-03-01

The current study provided an initial test of a Cognitive Bias Modification for Interpretations (CBM-I) training paradigm among a sample with elevated BDD symptoms (N=86). As expected, BDD-relevant interpretations were reduced among participants who completed a positive (vs. comparison) training program. Results also pointed to the intriguing possibility that modifying biased appearance-relevant interpretations is causally related to changes in biased, socially relevant interpretations. Further, providing support for cognitive behavioral models, residual change in interpretations was associated with some aspects of in vivo stressor responding. However, contrary to expectations there were no significant effects of condition on emotional vulnerability to a BDD stressor, potentially because participants in both training conditions experienced reductions in biased socially-threatening interpretations following training (suggesting that the "comparison" condition was not inert). These findings have meaningful theoretical and clinical implications, and fit with transdiagnostic conceptualizations of psychopathology. Copyright © 2015 Elsevier Ltd. All rights reserved.

What Does It Take to Change an Editor's Mind? Identifying Minimally Important Difference Thresholds for Peer Reviewer Rating Scores of Scientific Articles.

Science.gov (United States)

Callaham, Michael; John, Leslie K

2018-01-05

We define a minimally important difference for the Likert-type scores frequently used in scientific peer review (similar to existing minimally important differences for scores in clinical medicine). The magnitude of score change required to change editorial decisions has not been studied, to our knowledge. Experienced editors at a journal in the top 6% by impact factor were asked how large a change of rating in "overall desirability for publication" was required to trigger a change in their initial decision on an article. Minimally important differences were assessed twice for each editor: once assessing the rating change required to shift the editor away from an initial decision to accept, and the other assessing the magnitude required to shift away from an initial rejection decision. Forty-one editors completed the survey (89% response rate). In the acceptance frame, the median minimally important difference was 0.4 points on a scale of 1 to 5. Editors required a greater rating change to shift from an initial rejection decision; in the rejection frame, the median minimally important difference was 1.2 points. Within each frame, there was considerable heterogeneity: in the acceptance frame, 38% of editors did not change their decision within the maximum available range; in the rejection frame, 51% did not. To our knowledge, this is the first study to determine the minimally important difference for Likert-type ratings of research article quality, or in fact any nonclinical scientific assessment variable. Our findings may be useful for future research assessing whether changes to the peer review process produce clinically meaningful differences in editorial decisionmaking. Copyright © 2017 American College of Emergency Physicians. Published by Elsevier Inc. All rights reserved.

Quantitation of PET signal as an adjunct to visual interpretation of florbetapir imaging

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Pontecorvo, Michael J.; Arora, Anupa K.; Devine, Marybeth; Lu, Ming; Galante, Nick; Siderowf, Andrew; Devadanam, Catherine; Joshi, Abhinay D.; Heun, Stephen L.; Teske, Brian F.; Truocchio, Stephen P.; Krautkramer, Michael; Devous, Michael D.; Mintun, Mark A. [Avid Radiopharmaceuticals (a wholly owned subsidiary of Eli Lilly and Company), Philadelphia, PA (United States)

2017-05-15

This study examined the feasibility of using quantitation to augment interpretation of florbetapir PET amyloid imaging. A total of 80 physician readers were trained on quantitation of florbetapir PET images and the principles for using quantitation to augment a visual read. On day 1, the readers completed a visual read of 96 scans (46 autopsy-verified and 50 from patients seeking a diagnosis). On day 2, 69 of the readers reinterpreted the 96 scans augmenting their interpretation with quantitation (VisQ method) using one of three commercial software packages. A subset of 11 readers reinterpreted all scans on day 2 based on a visual read only (VisVis control). For the autopsy-verified scans, the neuropathologist's modified CERAD plaque score was used as the truth standard for interpretation accuracy. Because an autopsy truth standard was not available for scans from patients seeking a diagnosis, the majority VisQ interpretation of the three readers with the best accuracy in interpreting autopsy-verified scans was used as the reference standard. Day 1 visual read accuracy was high for both the autopsy-verified scans (90%) and the scans from patients seeking a diagnosis (87.3%). Accuracy improved from the visual read to the VisQ read (from 90.1% to 93.1%, p < 0.0001). Importantly, access to quantitative information did not decrease interpretation accuracy of the above-average readers (>90% on day 1). Accuracy in interpreting the autopsy-verified scans also increased from the first to the second visual read (VisVis group). However, agreement with the reference standard (best readers) for scans from patients seeking a diagnosis did not improve with a second visual read, and in this cohort the VisQ group was significantly improved relative to the VisVis group (change 5.4% vs. -1.1%, p < 0.0001). These results indicate that augmentation of visual interpretation of florbetapir PET amyloid images with quantitative information obtained using commercially available

Quantitation of PET signal as an adjunct to visual interpretation of florbetapir imaging

International Nuclear Information System (INIS)

Pontecorvo, Michael J.; Arora, Anupa K.; Devine, Marybeth; Lu, Ming; Galante, Nick; Siderowf, Andrew; Devadanam, Catherine; Joshi, Abhinay D.; Heun, Stephen L.; Teske, Brian F.; Truocchio, Stephen P.; Krautkramer, Michael; Devous, Michael D.; Mintun, Mark A.

2017-01-01

This study examined the feasibility of using quantitation to augment interpretation of florbetapir PET amyloid imaging. A total of 80 physician readers were trained on quantitation of florbetapir PET images and the principles for using quantitation to augment a visual read. On day 1, the readers completed a visual read of 96 scans (46 autopsy-verified and 50 from patients seeking a diagnosis). On day 2, 69 of the readers reinterpreted the 96 scans augmenting their interpretation with quantitation (VisQ method) using one of three commercial software packages. A subset of 11 readers reinterpreted all scans on day 2 based on a visual read only (VisVis control). For the autopsy-verified scans, the neuropathologist's modified CERAD plaque score was used as the truth standard for interpretation accuracy. Because an autopsy truth standard was not available for scans from patients seeking a diagnosis, the majority VisQ interpretation of the three readers with the best accuracy in interpreting autopsy-verified scans was used as the reference standard. Day 1 visual read accuracy was high for both the autopsy-verified scans (90%) and the scans from patients seeking a diagnosis (87.3%). Accuracy improved from the visual read to the VisQ read (from 90.1% to 93.1%, p < 0.0001). Importantly, access to quantitative information did not decrease interpretation accuracy of the above-average readers (>90% on day 1). Accuracy in interpreting the autopsy-verified scans also increased from the first to the second visual read (VisVis group). However, agreement with the reference standard (best readers) for scans from patients seeking a diagnosis did not improve with a second visual read, and in this cohort the VisQ group was significantly improved relative to the VisVis group (change 5.4% vs. -1.1%, p < 0.0001). These results indicate that augmentation of visual interpretation of florbetapir PET amyloid images with quantitative information obtained using commercially available

Change in Level of Service Inventory-Ontario Revised (LSI-OR) Risk Scores Over Time: An Examination of Overall Growth Curves and Subscale-Dependent Growth Curves.

Science.gov (United States)

Day, David M; Wilson, Holly A; Bodwin, Kelly; Monson, Candice M

2017-10-01

The dynamic nature of risk to re-offend is an important issue in the management of offenders and has stimulated extensive research into dynamic risk factors that can alter an individual's overall risk to re-offend if addressed. However, few studies have examined the relative importance of these dynamic risk factors, complicating the task of developing case management and treatment plans that will effect the most change. Using a large, high-risk sample and multi-wave data of a common risk assessment tool, the Level of Service Inventory-Ontario Revised (LSI-OR), the current study investigated the relationship among criminogenic risk factors and their role in influencing the overall risk score. Results indicated a diverse pattern of effects on the eight subscale scores, specifically suggesting that changes on Procriminal Attitude/Orientation, Criminal History, and Leisure/Recreation subscales resulted in a quicker rate of change to the overall risk score over time. These results suggest that some factors may be driving the change in overall risk and could potentially effect the most change if prioritized for intervention. Practical implications and implications for further research are discussed.

Minimal changes in health status questionnaires: distinction between minimally detectable change and minimally important change

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Knol Dirk L

2006-08-01

Full Text Available Abstract Changes in scores on health status questionnaires are difficult to interpret. Several methods to determine minimally important changes (MICs have been proposed which can broadly be divided in distribution-based and anchor-based methods. Comparisons of these methods have led to insight into essential differences between these approaches. Some authors have tried to come to a uniform measure for the MIC, such as 0.5 standard deviation and the value of one standard error of measurement (SEM. Others have emphasized the diversity of MIC values, depending on the type of anchor, the definition of minimal importance on the anchor, and characteristics of the disease under study. A closer look makes clear that some distribution-based methods have been merely focused on minimally detectable changes. For assessing minimally important changes, anchor-based methods are preferred, as they include a definition of what is minimally important. Acknowledging the distinction between minimally detectable and minimally important changes is useful, not only to avoid confusion among MIC methods, but also to gain information on two important benchmarks on the scale of a health status measurement instrument. Appreciating the distinction, it becomes possible to judge whether the minimally detectable change of a measurement instrument is sufficiently small to detect minimally important changes.

SIGI: score-based identification of genomic islands

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Merkl Rainer

2004-03-01

Full Text Available Abstract Background Genomic islands can be observed in many microbial genomes. These stretches of DNA have a conspicuous composition with regard to sequence or encoded functions. Genomic islands are assumed to be frequently acquired via horizontal gene transfer. For the analysis of genome structure and the study of horizontal gene transfer, it is necessary to reliably identify and characterize these islands. Results A scoring scheme on codon frequencies Score_G1G2(cdn = log(f_G2(cdn / f_G1(cdn was utilized. To analyse genes of a species G1 and to test their relatedness to species G2, scores were determined by applying the formula to log-odds derived from mean codon frequencies of the two genomes. A non-redundant set of nearly 400 codon usage tables comprising microbial species was derived; its members were used alternatively at position G2. Genes having at least one score value above a species-specific and dynamically determined cut-off value were analysed further. By means of cluster analysis, genes were identified that comprise clusters of statistically significant size. These clusters were predicted as genomic islands. Finally and individually for each of these genes, the taxonomical relation among those species responsible for significant scores was interpreted. The validity of the approach and its limitations were made plausible by an extensive analysis of natural genes and synthetic ones aimed at modelling the process of gene amelioration. Conclusions The method reliably allows to identify genomic island and the likely origin of alien genes.

Total Mini-Mental State Examination score and regional cerebral blood flow using Z score imaging and automated ROI analysis software in subjects with memory impairment

International Nuclear Information System (INIS)

Ikeda, Eiji; Shiozaki, Kazumasa; Takahashi, Nobukazu; Togo, Takashi; Odawara, Toshinari; Oka, Takashi; Inoue, Tomio; Hirayasu, Yoshio

2008-01-01

The Mini-Mental State Examination (MMSE) is considered a useful supplementary method to diagnose dementia and evaluate the severity of cognitive disturbance. However, the region of the cerebrum that correlates with the MMSE score is not clear. Recently, a new method was developed to analyze regional cerebral blood flow (rCBF) using a Z score imaging system (eZIS). This system shows changes of rCBF when compared with a normal database. In addition, a three-dimensional stereotaxic region of interest (ROI) template (3DSRT), fully automated ROI analysis software was developed. The objective of this study was to investigate the correlation between rCBF changes and total MMSE score using these new methods. The association between total MMSE score and rCBF changes was investigated in 24 patients (mean age±standard deviation (SD) 71.5±9.2 years; 6 men and 18 women) with memory impairment using eZIS and 3DSRT. Step-wise multiple regression analysis was used for multivariate analysis, with the total MMSE score as the dependent variable and rCBF change in 24 areas as the independent variable. Total MMSE score was significantly correlated only with the reduction of left hippocampal perfusion but not with right (P<0.01). Total MMSE score is an important indicator of left hippocampal function. (author)

Genic intolerance to functional variation and the interpretation of personal genomes.

Directory of Open Access Journals (Sweden)

Slavé Petrovski

Full Text Available A central challenge in interpreting personal genomes is determining which mutations most likely influence disease. Although progress has been made in scoring the functional impact of individual mutations, the characteristics of the genes in which those mutations are found remain largely unexplored. For example, genes known to carry few common functional variants in healthy individuals may be judged more likely to cause certain kinds of disease than genes known to carry many such variants. Until now, however, it has not been possible to develop a quantitative assessment of how well genes tolerate functional genetic variation on a genome-wide scale. Here we describe an effort that uses sequence data from 6503 whole exome sequences made available by the NHLBI Exome Sequencing Project (ESP. Specifically, we develop an intolerance scoring system that assesses whether genes have relatively more or less functional genetic variation than expected based on the apparently neutral variation found in the gene. To illustrate the utility of this intolerance score, we show that genes responsible for Mendelian diseases are significantly more intolerant to functional genetic variation than genes that do not cause any known disease, but with striking variation in intolerance among genes causing different classes of genetic disease. We conclude by showing that use of an intolerance ranking system can aid in interpreting personal genomes and identifying pathogenic mutations.

Interpretive Media Study and Interpretive Social Science.

Science.gov (United States)

Carragee, Kevin M.

1990-01-01

Defines the major theoretical influences on interpretive approaches in mass communication, examines the central concepts of these perspectives, and provides a critique of these approaches. States that the adoption of interpretive approaches in mass communication has ignored varied critiques of interpretive social science. Suggests that critical…

Interpreters, Interpreting, and the Study of Bilingualism.

Science.gov (United States)

Valdes, Guadalupe; Angelelli, Claudia

2003-01-01

Discusses research on interpreting focused specifically on issues raised by this literature about the nature of bilingualism. Suggests research carried out on interpreting--while primarily produced with a professional audience in mind and concerned with improving the practice of interpreting--provides valuable insights about complex aspects of…

Decolonizing Interpretive Research: A Critical Bicultural Methodology for Social Change

Science.gov (United States)

Darder, Antonia

2015-01-01

This paper introduces a discussion of decolonizing interpretive research in a way that gives greater salience to and understanding of the theoretical efforts of critical bicultural education researchers over the years. Grounded in educational principles that have been derived from critical social theory, a decolonizing approach to theory building,…

Dichotomous scoring of Trails B in patients referred for a dementia evaluation.

Science.gov (United States)

Schmitt, Andrew L; Livingston, Ronald B; Smernoff, Eric N; Waits, Bethany L; Harris, James B; Davis, Kent M

2010-04-01

The Trail Making Test is a popular neuropsychological test and its interpretation has traditionally used time-based scores. This study examined an alternative approach to scoring that is simply based on the examinees' ability to complete the test. If an examinee is able to complete Trails B successfully, they are coded as "completers"; if not, they are coded as "noncompleters." To assess this approach to scoring Trails B, the performance of 97 diagnostically heterogeneous individuals referred for a dementia evaluation was examined. In this sample, 55 individuals successfully completed Trails B and 42 individuals were unable to complete it. Point-biserial correlations indicated a moderate-to-strong association (r(pb)=.73) between the Trails B completion variable and the Total Scale score of the Repeatable Battery for the Assessment of Neurological Status (RBANS), which was larger than the correlation between the Trails B time-based score and the RBANS Total Scale score (r(pb)=.60). As a screen for dementia status, Trails B completion showed a sensitivity of 69% and a specificity of 100% in this sample. These results suggest that dichotomous scoring of Trails B might provide a brief and clinically useful measure of dementia status.

Sway Area and Velocity Correlated With MobileMat Balance Error Scoring System (BESS) Scores.

Science.gov (United States)

Caccese, Jaclyn B; Buckley, Thomas A; Kaminski, Thomas W

2016-08-01

The Balance Error Scoring System (BESS) is often used for sport-related concussion balance assessment. However, moderate intratester and intertester reliability may cause low initial sensitivity, suggesting that a more objective balance assessment method is needed. The MobileMat BESS was designed for objective BESS scoring, but the outcome measures must be validated with reliable balance measures. Thus, the purpose of this investigation was to compare MobileMat BESS scores to linear and nonlinear measures of balance. Eighty-eight healthy collegiate student-athletes (age: 20.0 ± 1.4 y, height: 177.7 ± 10.7 cm, mass: 74.8 ± 13.7 kg) completed the MobileMat BESS. MobileMat BESS scores were compared with 95% area, sway velocity, approximate entropy, and sample entropy. MobileMat BESS scores were significantly correlated with 95% area for single-leg (r = .332) and tandem firm (r = .474), and double-leg foam (r = .660); and with sway velocity for single-leg (r = .406) and tandem firm (r = .601), and double-leg (r = .575) and single-leg foam (r = .434). MobileMat BESS scores were not correlated with approximate or sample entropy. MobileMat BESS scores were low to moderately correlated with linear measures, suggesting the ability to identify changes in the center of mass-center of pressure relationship, but not higher-order processing associated with nonlinear measures. These results suggest that the MobileMat BESS may be a clinically-useful tool that provides objective linear balance measures.

A new CT-score as index of hemodynamic changes in patients with chronic thromboembolic pulmonary hypertension.

Science.gov (United States)

Leone, Maria Barbara; Giannotta, Marica; Palazzini, Massimiliano; Cefarelli, Mariano; Martìn Suàrez, Sofia; Gotti, Enrico; Bacchi Reggiani, Maria Letizia; Zompatori, Maurizio; Galiè, Nazzareno

2017-07-01

The aim of this study was to retrospectively assess the relationship between radiological and hemodynamic parameters in patients with chronic thromboembolic pulmonary hypertension (CTEPH). We introduced a new CT-score to evaluate hemodynamic changes, only employing CT-pulmonary angiography (CTPA). 145 patients affected by CTEPH underwent hemodynamic and CTPA evaluation. Among these 145 patients, 69 underwent pulmonary endarterectomy (PEA) and performed a CTPA evaluation even after surgery. Hemodynamic assessment considered the values of mean pulmonary artery pressure (mPAP) and pulmonary vascular resistance (PVR), obtained through right heart catheterization (RHC). Radiological evaluation included CTPA signs of pulmonary hypertension. A highly significant statistical correlation was observed between the new CT-score and both mPAP and PVR (p < 0.000) in the whole sample and also in the subgroup who underwent PEA. In addition, mPAP and PVR showed an important association with the severity of mosaic perfusion (p < 0.000). mPAP also correlated with main pulmonary artery diameter (p < 0.01); a significant association was found in both between PVR and tricuspid regurgitation(p < 0.000) and with PVR and presence of unilateral or bilateral pulmonary thromboembolic occlusion (p < 0.05). Our results confirm the diagnostic role of CTPA in evaluating patients with CTEPH and in addition open a new horizon in assessing hemodynamic changes in patients with CTEPH, only employing a CTPA, especially when RHC is contraindicated or not possible.

Comparison of two teaching methods for cardiac arrhythmia interpretation among nursing students.

Science.gov (United States)

Varvaroussis, Dimitrios P; Kalafati, Maria; Pliatsika, Paraskevi; Castrén, Maaret; Lott, Carsten; Xanthos, Theodoros

2014-02-01

The aim of this study was to compare the six-stage method (SSM) for instructing primary cardiac arrhythmias interpretation to students without basic electrocardiogram (ECG) knowledge with a descriptive teaching method in a single educational intervention. This is a randomized trial. Following a brief instructional session, undergraduate nursing students, assigned to group A (SSM) and group B (descriptive teaching method), undertook a written test in cardiac rhythm recognition, immediately after the educational intervention (initial exam). Participants were also examined with an unannounced retention test (final exam), one month after instruction. Altogether 134 students completed the study. Interpretation accuracy for each cardiac arrhythmia was assessed. Mean score at the initial exam was 8.71±1.285 for group A and 8.74±1.303 for group B. Mean score at the final exam was 8.25±1.46 for group A vs 7.84±1.44 for group B. Overall results showed that the SSM was equally effective with the descriptive teaching method. The study showed that in each group bradyarrhythmias were identified correctly by more students than tachyarrhythmias. No significant difference between the two teaching methods was seen for any specific cardiac arrhythmia. The SSM effectively develops staff competency for interpreting common cardiac arrhythmias in students without ECG knowledge. More research is needed to support this conclusion and the method's effectiveness must be evaluated if being implemented to trainee groups with preexisting basic ECG interpretation knowledge. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

ASSESSING STUDENT PERFORMANCE ON INTERPRETING THROUGH PEER-ASSESSMENT

Directory of Open Access Journals (Sweden)

Titik Ismailia

2017-12-01

Full Text Available As a part of translation interpreting is translating spoken discourse orally. It needs some requirements like ability to speak clearly, clarity, fluency, eye contact, and self-confidence. It also needs linguistic proficiency, analytical skill, listening and recall, interpersonal skills, ethical behaviour, speaking skills, cultural knowledge, and subject knowledge. Evaluating students performance on interpreting can be done through peer assessment. Peer- assessment is one of alternative assessment to grade the peers in group or individuals by commenting on and judging other students work. To do this process there is a join work between listening and speaking, and two students. The first student as a speaker and the second student as an interpreter. Both of them should do the same quality on speak clearly as a speaker and as an interpreter should able to listen and translating the spoken discourse orally. Evaluation can use analytical grade that allows teacher to set clear criteria for correction like fluency, grammar, terminology, general content, and mechanics. Students and teacher can give comment on every criteria based on their own competency. During the process on making criteria, students and teacher can discuss and give reasonable suggestion to make the assessment suitable to the students competency. At the end, a rubric of assessment with the score from 0 to 100 and criteria and also the comment included in the paper of assessment.

Communicating efficacy information based on composite scores in direct-to-consumer prescription drug advertising.

Science.gov (United States)

Williams, Pamela A; O'Donoghue, Amie C; Sullivan, Helen W; Willoughby, Jessica Fitts; Squire, Claudia; Parvanta, Sarah; Betts, Kevin R

2016-04-01

Drug efficacy can be measured by composite scores, which consist of two or more symptoms or other clinical components of a disease. We evaluated how individuals interpret composite scores in direct-to-consumer (DTC) prescription drug advertising. We conducted an experimental study of seasonal allergy sufferers (n=1967) who viewed a fictitious print DTC ad that varied by the type of information featured (general indication, list of symptoms, or definition of composite scores) and the presence or absence of an educational intervention about composite scores. We measured composite score recognition and comprehension, and perceived drug efficacy and risk. Ads that featured either (1) the composite score definition alone or (2) the list of symptoms or general indication information along with the educational intervention improved composite score comprehension. Ads that included the composite score definition or the educational intervention led to lower confidence in the drug's benefits. The composite score definition improved composite score recognition and lowered drug risk perceptions. Adding composite score information to DTC print ads may improve individuals' comprehension of composite scores and affect their perceptions of the drug. Providing composite score information may lead to more informed patient-provider prescription drug decisions. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

A combination of traditional learning and e-learning can be more effective on radiological interpretation skills in medical students: a pre- and post-intervention study.

Science.gov (United States)

Salajegheh, Ali; Jahangiri, Alborz; Dolan-Evans, Elliot; Pakneshan, Sahar

2016-02-03

The ability to interpret an X-Ray is a vital skill for graduating medical students which guides clinicians towards accurate diagnosis and treatment of the patient. However, research has suggested that radiological interpretation skills are less than satisfactory in not only medical students, but also in residents and consultants. This study investigated the effectiveness of e-learning for the development of X-ray interpretation skills in pre-clinical medical students. Competencies in clinical X-Ray interpretation were assessed by comparison of pre- and post-intervention scores and one year follow up assessment, where the e-learning course was the 'intervention'. Our results demonstrate improved knowledge and skills in X-ray interpretation in students. Assessment of the post training students showed significantly higher scores than the scores of control group of students undertaking the same assessment at the same time. The development of the Internet and advances in multimedia technologies has paved the way for computer-assisted education. As more rural clinical schools are established the electronic delivery of radiology teaching through websites will become a necessity. The use of e-learning to deliver radiology tuition to medical students represents an exciting alternative and is an effective method of developing competency in radiological interpretation for medical students.

Automatic interpretation of seismic micro facies using the fuzzy mathematics method

Energy Technology Data Exchange (ETDEWEB)

Dongrun, G.; Gardner, G.H.F.

1988-01-01

The interpretation of seismic micro facies concentrates on changes involving single reflection or several reflections, and endeavors to explain the relations between these changes and stratigraphic variation or hydrocarbon accumulation. In most cases, one can not determine the geological significance of reflection character anomalies on single or several seismic sections. But when one maps them on a plane, their distribution may on the whole indicate the geological significance. It is stated how the fuzzy method is used on a VAX computer to automatically construct a plane map of the reflection character changes in a time window. What an interpreter needs to do for whole interpretation is only to provide some parameters, such as time window, threshold, weight coefficients etc.

How to perform and interpret cine MR enterography.

Science.gov (United States)

Wnorowski, Amelia M; Guglielmo, Flavius F; Mitchell, Donald G

2015-11-01

Magnetic resonance (MR) enterography has become a fundamental tool for small bowel evaluation. Multiphasic cine imaging is a useful component of MR enterography evaluation because it provides functional information about bowel motility. Cine MR enterography can be used to evaluate for strictures and adhesions. Bowel motility evaluation has been shown to increase pathologic lesion detection in Crohn's disease and has been incorporated into disease activity scoring systems. Currently, cine MR enterography remains underutilized. The purpose of this article is to outline how to perform and interpret cine MR enterography. The authors describe how to perform a multiphasic balanced steady state free precession sequence using different MR systems and give practical advice on how to display and interpret the cine sequence. Sample cases illustrate how the cine sequence complements standard MR enterography evaluation with T2 -weighted, contrast-enhanced T1 -weighted, and diffusion-weighted imaging. © 2015 Wiley Periodicals, Inc.

MEASUREMENT OF THE STUDENTS’ ATTITUDE TOWARD A WHOLE-LANGUAGEAPPROACH-BASED LECTURE USING SCORE QUESTIONNAIRES

Directory of Open Access Journals (Sweden)

Nizamuddin Sadiq

2015-06-01

Full Text Available Abstract: The objective was to investigate students’ attitude toward the implementation of a whole language approach on Reading and Writing for Occupational Purposes Course in the academic year of 2013/2014. The approaches employed were phonological and phoneme awareness, phonic and word study, fluency, vocabulary, comprehension skills and strategies, and writing. The participants were 15 students of the English Language Education Department, Universitas Islam Indonesia. SCORE questionnaire using the Likert’s scale was the instrument. Calculation was to find out score index and categorization by following Riduwan’s (2007 score interpretation criteria. The findings showed that in the simple category, two of ten questions were agreed absolutely (100%, in the clear category, all questions were agreed for 80 %, in the original category, five of thirteen questions reached majority of agreement (100%, in the relevant category, one of five questions was agreed absolutely (100%, and in the enjoyable category, all questions were agreed by 93%. Keywords: a whole language approach, SCORE, score interpretation criteria PENGUKURAN SIKAP MAHASISWA TENTANG PERKULIAHAN BERBASIS A WHOLE LANGUAGE APPROACH DENGAN KUESIONER SCORE Abstrak: Tujuan penelitian ini adalah mengukur sikap mahasiswa terhadap pelaksanaan a whole language approach dalam perkuliahan Reading and Writing for Occupational Purposes Course tahun akademik 2013/2014. Pendekatan yang diterapkan adalah kesadaran fonetik dan fonemik, pelafalan dan kata, kelancaran, kosakata, keterampilan dan strategi membaca komprehensif, dan menulis. Responden penelitian ini adalah 15 maahsiswa Pendidikan Bahasa Inggris Universitas Islam Indonesia. Kuesioner SCOREs dengan skala Likert sebagai instrumen. Penghitungan ditujukan kepada skor indeks dan kategorisasi mengikuti criteria interpretasi skor Riduwan (2007. Hasilnya menunjukkan bahwa pada kategori simple, dua pertanyaan disetujui mutlak (100%, pada kategori

Time-dependent changes in mortality and transformation risk in MDS.

Science.gov (United States)

Pfeilstöcker, Michael; Tuechler, Heinz; Sanz, Guillermo; Schanz, Julie; Garcia-Manero, Guillermo; Solé, Francesc; Bennett, John M; Bowen, David; Fenaux, Pierre; Dreyfus, Francois; Kantarjian, Hagop; Kuendgen, Andrea; Malcovati, Luca; Cazzola, Mario; Cermak, Jaroslav; Fonatsch, Christa; Le Beau, Michelle M; Slovak, Marilyn L; Levis, Alessandro; Luebbert, Michael; Maciejewski, Jaroslaw; Machherndl-Spandl, Sigrid; Magalhaes, Silvia M M; Miyazaki, Yasushi; Sekeres, Mikkael A; Sperr, Wolfgang R; Stauder, Reinhard; Tauro, Sudhir; Valent, Peter; Vallespi, Teresa; van de Loosdrecht, Arjan A; Germing, Ulrich; Haase, Detlef; Greenberg, Peter L

2016-08-18

In myelodysplastic syndromes (MDSs), the evolution of risk for disease progression or death has not been systematically investigated despite being crucial for correct interpretation of prognostic risk scores. In a multicenter retrospective study, we described changes in risk over time, the consequences for basal prognostic scores, and their potential clinical implications. Major MDS prognostic risk scoring systems and their constituent individual predictors were analyzed in 7212 primary untreated MDS patients from the International Working Group for Prognosis in MDS database. Changes in risk of mortality and of leukemic transformation over time from diagnosis were described. Hazards regarding mortality and acute myeloid leukemia transformation diminished over time from diagnosis in higher-risk MDS patients, whereas they remained stable in lower-risk patients. After approximately 3.5 years, hazards in the separate risk groups became similar and were essentially equivalent after 5 years. This fact led to loss of prognostic power of different scoring systems considered, which was more pronounced for survival. Inclusion of age resulted in increased initial prognostic power for survival and less attenuation in hazards. If needed for practicability in clinical management, the differing development of risks suggested a reasonable division into lower- and higher-risk MDS based on the IPSS-R at a cutoff of 3.5 points. Our data regarding time-dependent performance of prognostic scores reflect the disparate change of risks in MDS subpopulations. Lower-risk patients at diagnosis remain lower risk whereas initially high-risk patients demonstrate decreasing risk over time. This change of risk should be considered in clinical decision making. © 2016 by The American Society of Hematology.

The use of hidden curriculum in the interpretation of climate change on infographics in higher education students

Directory of Open Access Journals (Sweden)

Abner Colón Ortiz

2016-12-01

Full Text Available The importance of environmental issues is evident deemed climate change to educate students. The main purpose of this study was to explore the interpretation of climate change on infographics in higher education students using the hidden curriculum. To achieve the purpose, a content analysis was performed to analyze the infographics that present students before (diagnostic and after (formative to use a hidden curriculum concepts of climate change in a course of General Biology. The study was conducted was a qualitative content analysis approach. The sample consisted of undergraduate students of an institution of higher education in Puerto Rico who took a course in General Biology.The results of the content analysis reflected that 81% of students had some misconceptions of climate change at the beginning of the course. Then offer the course General Biology and integrate concepts of climate change with a hidden curriculum, students downplayed their erroneous concepts to 9%. Therefore, we conclude that concepts should be integrated in climate change science courses for better environmental education. This explains why there is a need to educate students on climate change as recommended by the state and international agencies. So states to consider the potential of universities to develop environmental education and close collaboration between institutions of higher education as well as established the United Nations Educational, Scientific and Cultural Organization. 

College Students' Interpretation of Research Reports on Group Differences: The Tall-Tale Effect

Science.gov (United States)

Hogan, Thomas P.; Zaboski, Brian A.; Perry, Tiffany R.

2015-01-01

How does the student untrained in advanced statistics interpret results of research that reports a group difference? In two studies, statistically untrained college students were presented with abstracts or professional associations' reports and asked for estimates of scores obtained by the original participants in the studies. These estimates…

Does Year Round Schooling Affect the Outcome and Growth of California's API Scores?

Science.gov (United States)

Wu, Amery D.; Stone, Jake E.

2010-01-01

This paper examined whether year round schooling (YRS) in California had an effect upon the outcome and growth of schools' Academic Performance Index (API) scores. While many previous studies had examined the connection between YRS and academic achievement, most had lacked the statistical rigour required to provide reliable interpretations. As a…

Pediatric dual-energy X-ray absorptiometry: interpretation and clinical and research application

Directory of Open Access Journals (Sweden)

Jung Sub Lim

2010-03-01

Full Text Available Peak bone mass is established predominately during childhood and adolescence. It is an important determinant of future resistance to osteoporosis and fractures to gain bone mass during growth. The issue of low bone density in children and adolescents has recently attracted much attention and the use of pediatric dual-energy X-ray absorptiometry (DXA is increasing. The process of interpretation of pediatric DXA results is different from that of adults because normal bone mineral density (BMD of children varies by age, body size, pubertal stage, skeletal maturation, sex, and ethnicity. Thus, an appropriate normal BMD Z-score reference value with Z-score should be used to detect and manage low BMD. Z-scores below -2.0 are generally considered a low BMD to pediatrician even though diagnoses of osteoporosis in children and adolescents are usually only made in the presence of at least one fragility fracture. This article will review the basic knowledge and practical guidelines on pediatric DXA based on the International Society for Clinical Densitometry (ISCD Pediatric Official Positions. Also discussed are the characteristics of normal Korean children and adolescents with respect to BMD development. The objective of this review is to help pediatricians to understand when DXA will be useful and how to interpret pediatric DXA reports in the clinical practice for management of children with the potential to develop osteoporosis in adulthood.

Normative Data for Interpreting the BREAST-Q: Augmentation

Science.gov (United States)

Mundy, Lily R.; Homa, Karen; Klassen, Anne F.; Pusic, Andrea L.; Kerrigan, Carolyn L.

2016-01-01

Background The BREAST-Q is a rigorously developed, well-validated, patient-reported outcome (PRO) instrument with a module designed for evaluating breast augmentation outcomes. However, there are no published normative BREAST-Q scores, limiting interpretation. Methods Normative data were generated for the BREAST-Q Augmentation Module via the Army of Women (AOW), an online community of women (with and without breast cancer) engaged in breast-cancer related research. Members were recruited via email, with women 18 years or older without a history of breast cancer or breast surgery invited to participate. Descriptive statistics and a linear multivariate regression were performed. A separate analysis compared normative scores to findings from previously published BREAST-Q augmentation studies. Results The preoperative BREAST-Q Augmentation Module was completed by 1,211 women. Mean age was 54 ±24 years, mean body mass index (BMI) was 27 ±6, and 39% (n=467) had a bra cup size ≥D. Mean scores were Satisfaction with Breasts (54 ±19), Psychosocial Well-being (66 ±20), Sexual Well-being (49 ±20), and Physical Well-being (86 ±15). Women with a BMI of 30 or greater and bra cup size D or greater had lower scores. In comparison to AOW scores, published BREAST-Q augmentation scores were lower before and higher after surgery for all scales except Physical Well-being. Conclusions The AOW normative data represent breast-related satisfaction and well-being in woman not actively seeking breast augmentation. This data may be used as normative comparison values for those seeking and undergoing surgery as we did, demonstrating the value of breast augmentation in this patient population. PMID:28350657

Determination of minimal clinically important change in early and advanced Parkinson's disease.

Science.gov (United States)

Hauser, Robert A; Auinger, Peggy

2011-04-01

Two common primary efficacy outcome measures in Parkinson's disease (PD) are change in Unified Parkinson's Disease Rating Scale (UPDRS) scores in early PD and change in "off" time in patients with motor fluctuations. Defining the minimal clinically important change (MCIC) in these outcome measures is important to interpret the clinical relevance of changes observed in clinical trials and other situations. We analyzed data from 2 multicenter, placebo-controlled, randomized clinical trials of rasagiline; TEMPO studied 404 early PD subjects, and PRESTO studied 472 levodopa-treated subjects with motor fluctuations. An anchor-based approach using clinical global impression of improvement (CGI-I) was used to determine MCIC for UPDRS scores and daily "off" time. MCIC was defined as mean change in actively treated subjects rated minimally improved on CGI-I. Receiver operating characteristic (ROC) curves defined optimal cutoffs discriminating between changed and unchanged subjects. MCIC for improvement in total UPDRS score (parts I-III) in early PD was determined to be -3.5 points based on mean scores and -3.0 points based on ROC curves. In addition, we found an MCIC for reduction in "off" time of 1.0 hours as defined by mean reduction in "off" time in active treated subjects self-rated as minimally improved on CGI-I minus mean reduction in "off" time in placebo-treated subjects self-rated as unchanged (1.9-0.9 hours). We hypothesize that many methodological factors can influence determination of the MCIC, and a range of values is likely to emerge from multiple studies. Copyright © 2011 Movement Disorder Society.

Reliability and sensitivity to change of the Simple Erosion Narrowing Score compared with the Sharp-van der Heijde method for scoring radiographs in rheumatoid arthritis

NARCIS (Netherlands)

Dias, E. M.; Lukas, C.; Landewé, R.; Fatenejad, S.; van der Heijde, D.

2008-01-01

To compare the performance of a simplified scoring method for structural damage on radiographs of patients with rheumatoid arthritis (the Simple Erosion Narrowing Score or SENS) with the Sharp-van der Heijde Score (SHS) as reference. We used the radiographic data from the Trial of Etanercept and

[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.

Longitudinal Factor Score Estimation Using the Kalman Filter.

Science.gov (United States)

Oud, Johan H.; And Others

1990-01-01

How longitudinal factor score estimation--the estimation of the evolution of factor scores for individual examinees over time--can profit from the Kalman filter technique is described. The Kalman estimates change more cautiously over time, have lower estimation error variances, and reproduce the LISREL program latent state correlations more…

On the interpretation and relevance of the Fundamental Theorem of Natural Selection.

Science.gov (United States)

Ewens, Warren J; Lessard, Sabin

2015-09-01

The attempt to understand the statement, and then to find the interpretation, of Fisher's "Fundamental Theorem of Natural Selection" caused problems for generations of population geneticists. Price's (1972) paper was the first to lead to an understanding of the statement of the theorem. The theorem shows (in the discrete-time case) that the so-called "partial change" in mean fitness of a population between a parental generation and an offspring generation is the parental generation additive genetic variance in fitness divided by the parental generation mean fitness. In the continuous-time case the partial rate of change in mean fitness is equal to the parental generation additive genetic variance in fitness with no division by the mean fitness. This "partial change" has been interpreted by some as the change in mean fitness due to changes in gene frequency, and by others as the change in mean fitness due to natural selection. (Fisher variously used both interpretations.) In this paper we discuss these interpretations of the theorem. We indicate why we are unhappy with both. We also discuss the long-term relevance of the Fundamental Theorem of Natural Selection, again reaching a negative assessment. We introduce and discuss the concept of genic evolutionary potential. We finally review an optimizing theorem that involves changes in gene frequency, the additive genetic variance in fitness and the mean fitness itself, all of which are involved in the Fundamental Theorem of Natural Selection, and which is free of the difficulties in interpretation of the Fundamental Theorem of Natural Selection. Copyright © 2015 Elsevier Inc. All rights reserved.

An Automated, High-Throughput Method for Interpreting the Tandem Mass Spectra of Glycosaminoglycans

Science.gov (United States)

Duan, Jiana; Jonathan Amster, I.

2018-05-01

The biological interactions between glycosaminoglycans (GAGs) and other biomolecules are heavily influenced by structural features of the glycan. The structure of GAGs can be assigned using tandem mass spectrometry (MS2), but analysis of these data, to date, requires manually interpretation, a slow process that presents a bottleneck to the broader deployment of this approach to solving biologically relevant problems. Automated interpretation remains a challenge, as GAG biosynthesis is not template-driven, and therefore, one cannot predict structures from genomic data, as is done with proteins. The lack of a structure database, a consequence of the non-template biosynthesis, requires a de novo approach to interpretation of the mass spectral data. We propose a model for rapid, high-throughput GAG analysis by using an approach in which candidate structures are scored for the likelihood that they would produce the features observed in the mass spectrum. To make this approach tractable, a genetic algorithm is used to greatly reduce the search-space of isomeric structures that are considered. The time required for analysis is significantly reduced compared to an approach in which every possible isomer is considered and scored. The model is coded in a software package using the MATLAB environment. This approach was tested on tandem mass spectrometry data for long-chain, moderately sulfated chondroitin sulfate oligomers that were derived from the proteoglycan bikunin. The bikunin data was previously interpreted manually. Our approach examines glycosidic fragments to localize SO3 modifications to specific residues and yields the same structures reported in literature, only much more quickly.

Differences of wells scores accuracy, caprini scores and padua scores in deep vein thrombosis diagnosis

Science.gov (United States)

Gatot, D.; Mardia, A. I.

2018-03-01

Deep Vein Thrombosis (DVT) is the venous thrombus in lower limbs. Diagnosis is by using venography or ultrasound compression. However, these examinations are not available yet in some health facilities. Therefore many scoring systems are developed for the diagnosis of DVT. The scoring method is practical and safe to use in addition to efficacy, and effectiveness in terms of treatment and costs. The existing scoring systems are wells, caprini and padua score. There have been many studies comparing the accuracy of this score but not in Medan. Therefore, we are interested in comparative research of wells, capriniand padua score in Medan.An observational, analytical, case-control study was conducted to perform diagnostic tests on the wells, caprini and padua score to predict the risk of DVT. The study was at H. Adam Malik Hospital in Medan.From a total of 72 subjects, 39 people (54.2%) are men and the mean age are 53.14 years. Wells score, caprini score and padua score has a sensitivity of 80.6%; 61.1%, 50% respectively; specificity of 80.65; 66.7%; 75% respectively, and accuracy of 87.5%; 64.3%; 65.7% respectively.Wells score has better sensitivity, specificity and accuracy than caprini and padua score in diagnosing DVT.

New risk markers may change the HeartScore risk classification significantly in one-fifth of the population

DEFF Research Database (Denmark)

Olsen, M H; Hansen, T W; Christensen, M K

2008-01-01

subjects with estimated risk below 5%. During the following 9.5 years the composite end point of cardiovascular death, non-fatal myocardial infarction or stroke (CEP) occurred in 204 subjects. CEP was predicted in all three groups by UACR (HRs: 2.1, 2.1 and 2.3 per 10-fold increase, all P...CRP in subjects with low-moderate risk and UACR and Nt-proBNP in subjects with known diabetes of cardiovascular disease changed HeartScore risk classification significantly in 19% of the population....

An ultrasound score for knee osteoarthritis

DEFF Research Database (Denmark)

Riecke, B F; Christensen, R.; Torp-Pedersen, S

2014-01-01

OBJECTIVE: To develop standardized musculoskeletal ultrasound (MUS) procedures and scoring for detecting knee osteoarthritis (OA) and test the MUS score's ability to discern various degrees of knee OA, in comparison with plain radiography and the 'Knee injury and Osteoarthritis Outcome Score' (KOOS......) domains as comparators. METHOD: A cross-sectional study of MUS examinations in 45 patients with knee OA. Validity, reliability, and reproducibility were evaluated. RESULTS: MUS examination for knee OA consists of five separate domains assessing (1) predominantly morphological changes in the medial...... coefficients ranging from 0.75 to 0.97 for the five domains. Construct validity was confirmed with statistically significant correlation coefficients (0.47-0.81, P knee OA. In comparison with standing radiographs...

Characterization and scoring of skin changes in severe acute malnutrition in children between 6 months and 5 years of age

DEFF Research Database (Denmark)

Heilskov, S; Vestergaard, Christian; Babirekere, E

2015-01-01

BACKGROUND: Severe acute malnutrition is a life-threatening condition. It can be associated with severe skin changes, first properly described by Williams in 1933. The aetiology of these skin changes is still unknown and their character has never been systematically described in dermatological...... objective was to identify the skin changes characteristic of children with severe acute malnutrition and to develop a clinical score that describes the morphology and severity in dermatological terms. We also investigated if any of the different skin changes were connected to prognosis. MATERIALS...... AND METHODS: At Mulago Hospital, Mwanamugimu (Department of Paediatrics and Child Health), Uganda, 120 children were included over a period of six months and observed when treated for severe acute malnutrition. Skin changes were registered through clinical examination and photo documentation and associated...

76 FR 10050 - Changes to the Public Housing Assessment System (PHAS): Management Operations Scoring Notice

Science.gov (United States)

2011-02-23

... Housing Assessment System (PHAS): Management Operations Scoring Notice SUMMARY: This notice provides... issuing scores under the management operations indicator of the Public Housing Assessment System (PHAS... notice is to provide additional information about the scoring process for the PHAS management operations...

A comparison of the Shwachman, Chrispin-Norman and Brasfield methods for scoring of chest radiographs of patients with cystic fibrosis

International Nuclear Information System (INIS)

Meerman, G.J. te; Dankert-Roelse, J.; Rijksuniversiteit Groningen; Martijn, A.; Woerden, H.H. van

1985-01-01

Three systems are described for chest radiograph scoring in cystic fibrosis patients: the Shwachman-Kulczycki, the Chrispin-Norman and the Brasfield method. Sixty chest radiographs of 39 patients of different ages have been independently scored by two radiologists according to the three methods. No statistical differences between the methods could be demonstrated. The Chrispin-Norman method is recommended as the best choice because differences in scoring appeared better interpretable. A significant increase in precision could be achieved by combining the scores of the three methods. (orig.)

Correction to: CASPer, an online pre-interview screen for personal/professional characteristics: prediction of national licensure scores.

Science.gov (United States)

Dore, Kelly L; Reiter, Harold I; Kreuger, Sharyn; Norman, Geoffrey R

2017-12-01

In re-examining the paper "CASPer, an online pre-interview screen for personal/professional characteristics: prediction of national licensure scores" published in AHSE (22(2), 327-336), we recognized two errors of interpretation.

76 FR 20366 - Changes to the Public Housing Assessment System (PHAS): Management Operations Scoring Notice

Science.gov (United States)

2011-04-12

... Housing Assessment System (PHAS): Management Operations Scoring Notice AGENCY: Office of the Assistant... Management Operations interim scoring notice. The document inadvertently omitted a word with respect to the... INFORMATION: I. Background The proposed management operations scoring information was published on August 21...

Interpretive focus groups: a participatory method for interpreting and extending secondary analysis of qualitative data

Directory of Open Access Journals (Sweden)

Michelle Redman-MacLaren

2014-08-01

Full Text Available Background: Participatory approaches to qualitative research practice constantly change in response to evolving research environments. Researchers are increasingly encouraged to undertake secondary analysis of qualitative data, despite epistemological and ethical challenges. Interpretive focus groups can be described as a more participative method for groups to analyse qualitative data. Objective: To facilitate interpretive focus groups with women in Papua New Guinea to extend analysis of existing qualitative data and co-create new primary data. The purpose of this was to inform a transformational grounded theory and subsequent health promoting action. Design: A two-step approach was used in a grounded theory study about how women experience male circumcision in Papua New Guinea. Participants analysed portions or ‘chunks’ of existing qualitative data in story circles and built upon this analysis by using the visual research method of storyboarding. Results: New understandings of the data were evoked when women in interpretive focus groups analysed the data ‘chunks’. Interpretive focus groups encouraged women to share their personal experiences about male circumcision. The visual method of storyboarding enabled women to draw pictures to represent their experiences. This provided an additional focus for whole-of-group discussions about the research topic. Conclusions: Interpretive focus groups offer opportunity to enhance trustworthiness of findings when researchers undertake secondary analysis of qualitative data. The co-analysis of existing data and co-generation of new data between research participants and researchers informed an emergent transformational grounded theory and subsequent health promoting action.

Interpretive focus groups: a participatory method for interpreting and extending secondary analysis of qualitative data.

Science.gov (United States)

Redman-MacLaren, Michelle; Mills, Jane; Tommbe, Rachael

2014-01-01

Participatory approaches to qualitative research practice constantly change in response to evolving research environments. Researchers are increasingly encouraged to undertake secondary analysis of qualitative data, despite epistemological and ethical challenges. Interpretive focus groups can be described as a more participative method for groups to analyse qualitative data. To facilitate interpretive focus groups with women in Papua New Guinea to extend analysis of existing qualitative data and co-create new primary data. The purpose of this was to inform a transformational grounded theory and subsequent health promoting action. A two-step approach was used in a grounded theory study about how women experience male circumcision in Papua New Guinea. Participants analysed portions or 'chunks' of existing qualitative data in story circles and built upon this analysis by using the visual research method of storyboarding. New understandings of the data were evoked when women in interpretive focus groups analysed the data 'chunks'. Interpretive focus groups encouraged women to share their personal experiences about male circumcision. The visual method of storyboarding enabled women to draw pictures to represent their experiences. This provided an additional focus for whole-of-group discussions about the research topic. Interpretive focus groups offer opportunity to enhance trustworthiness of findings when researchers undertake secondary analysis of qualitative data. The co-analysis of existing data and co-generation of new data between research participants and researchers informed an emergent transformational grounded theory and subsequent health promoting action.

Origin of Disagreements in Tandem Mass Spectra Interpretation by Search Engines.

Science.gov (United States)

Tessier, Dominique; Lollier, Virginie; Larré, Colette; Rogniaux, Hélène

2016-10-07

Several proteomic database search engines that interpret LC-MS/MS data do not identify the same set of peptides. These disagreements occur even when the scores of the peptide-to-spectrum matches suggest good confidence in the interpretation. Our study shows that these disagreements observed for the interpretations of a given spectrum are almost exclusively due to the variation of what we call the "peptide space", i.e., the set of peptides that are actually compared to the experimental spectra. We discuss the potential difficulties of precisely defining the "peptide space." Indeed, although several parameters that are generally reported in publications can easily be set to the same values, many additional parameters-with much less straightforward user access-might impact the "peptide space" used by each program. Moreover, in a configuration where each search engine identifies the same candidates for each spectrum, the inference of the proteins may remain quite different depending on the false discovery rate selected.

Modifying scoring system at South African University rugby level ...

African Journals Online (AJOL)

Success in rugby is measured by winning the game and in order to do so, teams need to score more points ... if modifying the scoring system at South African University rugby level changes the game dynamics. ... AJOL African Journals Online.

19 CFR 102.18 - Rules of interpretation.

Science.gov (United States)

2010-04-01

... Interpretation (GRI) 2(a) is referred to in § 102.20 as an exception to an allowed change in tariff... manner as a complete or finished good pursuant to GRI 2(a). (b) (1) For purposes of identifying the... except from subheading 8607.19 when that change is pursuant to GRI 2(a)), the only materials that may be...

What Explains the Correlation between Growth in Vocabulary and Grammar? New Evidence from Latent Change Score Analyses of Simultaneous Bilingual Development

Science.gov (United States)

Hoff, Erika; Quinn, Jamie M.; Giguere, David

2018-01-01

A close relationship between children's vocabulary size and the grammatical complexity of their speech is well attested but not well understood. The present study used latent change score modeling to examine the dynamic relationships between vocabulary and grammar growth within and across languages in longitudinal data from 90 simultaneous…

Validity and reliability of Nintendo Wii Fit balance scores.

Science.gov (United States)

Wikstrom, Erik A

2012-01-01

Interactive gaming systems have the potential to help rehabilitate patients with musculoskeletal conditions. The Nintendo Wii Balance Board, which is part of the Wii Fit game, could be an effective tool to monitor progress during rehabilitation because the board and game can provide objective measures of balance. However, the validity and reliability of Wii Fit balance scores remain unknown. To determine the concurrent validity of balance scores produced by the Wii Fit game and the intrasession and intersession reliability of Wii Fit balance scores. Descriptive laboratory study. Sports medicine research laboratory. Forty-five recreationally active participants (age = 27.0 ± 9.8 years, height = 170.9 ± 9.2 cm, mass = 72.4 ± 11.8 kg) with a heterogeneous history of lower extremity injury. Participants completed a single-limb-stance task on a force plate and the Star Excursion Balance Test (SEBT) during the first test session. Twelve Wii Fit balance activities were completed during 2 test sessions separated by 1 week. Postural sway in the anteroposterior (AP) and mediolateral (ML) directions and the AP, ML, and resultant center-of-pressure (COP) excursions were calculated from the single-limb stance. The normalized reach distance was recorded for the anterior, posteromedial, and posterolateral directions of the SEBT. Wii Fit balance scores that the game software generated also were recorded. All 96 of the calculated correlation coefficients among Wii Fit activity outcomes and established balance outcomes were interpreted as poor (r Wii Fit balance activity scores ranged from good (intraclass correlation coefficient [ICC] = 0.80) to poor (ICC = 0.39), with 8 activities having poor intrasession reliability. Similarly, 11 of the 12 Wii Fit balance activity scores demonstrated poor intersession reliability, with scores ranging from fair (ICC = 0.74) to poor (ICC = 0.29). Wii Fit balance activity scores had poor concurrent validity relative to COP outcomes and SEBT

The interpretation and management of thyroid disorders

African Journals Online (AJOL)

population reference range, will induce very pronounced TSH changes. ... An overview of the management of ... The interpretation and management of thyroid disorders ..... Tietz textbook of clinical cemistry and molecular diagnostics. 4th ed.

Impact on house staff evaluation scores when changing from a Dreyfus- to a Milestone-based evaluation model: one internal medicine residency program's findings

Directory of Open Access Journals (Sweden)

Karen A. Friedman

2014-11-01

Full Text Available Purpose: As graduate medical education (GME moves into the Next Accreditation System (NAS, programs must take a critical look at their current models of evaluation and assess how well they align with reporting outcomes. Our objective was to assess the impact on house staff evaluation scores when transitioning from a Dreyfus-based model of evaluation to a Milestone-based model of evaluation. Milestones are a key component of the NAS. Method: We analyzed all end of rotation evaluations of house staff completed by faculty for academic years 2010–2011 (pre-Dreyfus model and 2011–2012 (post-Milestone model in one large university-based internal medicine residency training program. Main measures included change in PGY-level average score; slope, range, and separation of average scores across all six Accreditation Council for Graduate Medical Education (ACGME competencies. Results: Transitioning from a Dreyfus-based model to a Milestone-based model resulted in a larger separation in the scores between our three post-graduate year classes, a steeper progression of scores in the PGY-1 class, a wider use of the 5-point scale on our global end of rotation evaluation form, and a downward shift in the PGY-1 scores and an upward shift in the PGY-3 scores. Conclusions: For faculty trained in both models of assessment, the Milestone-based model had greater discriminatory ability as evidenced by the larger separation in the scores for all the classes, in particular the PGY-1 class.

Impact on house staff evaluation scores when changing from a Dreyfus- to a Milestone-based evaluation model: one internal medicine residency program's findings.

Science.gov (United States)

Friedman, Karen A; Balwan, Sandy; Cacace, Frank; Katona, Kyle; Sunday, Suzanne; Chaudhry, Saima

2014-01-01

As graduate medical education (GME) moves into the Next Accreditation System (NAS), programs must take a critical look at their current models of evaluation and assess how well they align with reporting outcomes. Our objective was to assess the impact on house staff evaluation scores when transitioning from a Dreyfus-based model of evaluation to a Milestone-based model of evaluation. Milestones are a key component of the NAS. We analyzed all end of rotation evaluations of house staff completed by faculty for academic years 2010-2011 (pre-Dreyfus model) and 2011-2012 (post-Milestone model) in one large university-based internal medicine residency training program. Main measures included change in PGY-level average score; slope, range, and separation of average scores across all six Accreditation Council for Graduate Medical Education (ACGME) competencies. Transitioning from a Dreyfus-based model to a Milestone-based model resulted in a larger separation in the scores between our three post-graduate year classes, a steeper progression of scores in the PGY-1 class, a wider use of the 5-point scale on our global end of rotation evaluation form, and a downward shift in the PGY-1 scores and an upward shift in the PGY-3 scores. For faculty trained in both models of assessment, the Milestone-based model had greater discriminatory ability as evidenced by the larger separation in the scores for all the classes, in particular the PGY-1 class.

The Effect of Improved School Climate over Time on Fifth-Grade Students' Achievement Assessment Scores and Teacher Administered Grade Scores

Science.gov (United States)

Marten, Dawn M.

2012-01-01

The purpose of the study was to determine the effect of improved school climate, as teachers' beliefs changed from negative to positive over time, on students' reading, math, and writing assessment scores and teacher administered grade scores in reading, math, and writing. Overall, findings indicate that lose, maintain, or improve…

Regional Distribution Shifts Help Explain Local Changes in Wintering Raptor Abundance: Implications for Interpreting Population Trends

Science.gov (United States)

Paprocki, Neil; Heath, Julie A.; Novak, Stephen J.

2014-01-01

Studies of multiple taxa across broad-scales suggest that species distributions are shifting poleward in response to global climate change. Recognizing the influence of distribution shifts on population indices will be an important part of interpreting trends within management units because current practice often assumes that changes in local populations reflect local habitat conditions. However, the individual- and population-level processes that drive distribution shifts may occur across a large, regional scale and have little to do with the habitats within the management unit. We examined the latitudinal center of abundance for the winter distributions of six western North America raptor species using Christmas Bird Counts from 1975–2011. Also, we considered whether population indices within western North America Bird Conservation Regions (BCRs) were explained by distribution shifts. All six raptors had significant poleward shifts in their wintering distributions over time. Rough-legged Hawks (Buteo lagopus) and Golden Eagles (Aquila chrysaetos) showed the fastest rate of change, with 8.41 km yr−1 and 7.74 km yr−1 shifts, respectively. Raptors may be particularly responsive to warming winters because of variable migration tendencies, intraspecific competition for nesting sites that drives males to winter farther north, or both. Overall, 40% of BCR population trend models were improved by incorporating information about wintering distributions; however, support for the effect of distribution on BCR indices varied by species with Rough-legged Hawks showing the most evidence. These results emphasize the importance of understanding how regional distribution shifts influence local-scale population indices. If global climate change is altering distribution patterns, then trends within some management units may not reflect changes in local habitat conditions. The methods used to monitor and manage bird populations within local BCRs will fundamentally change as

Regional distribution shifts help explain local changes in wintering raptor abundance: implications for interpreting population trends.

Directory of Open Access Journals (Sweden)

Neil Paprocki

Full Text Available Studies of multiple taxa across broad-scales suggest that species distributions are shifting poleward in response to global climate change. Recognizing the influence of distribution shifts on population indices will be an important part of interpreting trends within management units because current practice often assumes that changes in local populations reflect local habitat conditions. However, the individual- and population-level processes that drive distribution shifts may occur across a large, regional scale and have little to do with the habitats within the management unit. We examined the latitudinal center of abundance for the winter distributions of six western North America raptor species using Christmas Bird Counts from 1975-2011. Also, we considered whether population indices within western North America Bird Conservation Regions (BCRs were explained by distribution shifts. All six raptors had significant poleward shifts in their wintering distributions over time. Rough-legged Hawks (Buteo lagopus and Golden Eagles (Aquila chrysaetos showed the fastest rate of change, with 8.41 km yr(-1 and 7.74 km yr(-1 shifts, respectively. Raptors may be particularly responsive to warming winters because of variable migration tendencies, intraspecific competition for nesting sites that drives males to winter farther north, or both. Overall, 40% of BCR population trend models were improved by incorporating information about wintering distributions; however, support for the effect of distribution on BCR indices varied by species with Rough-legged Hawks showing the most evidence. These results emphasize the importance of understanding how regional distribution shifts influence local-scale population indices. If global climate change is altering distribution patterns, then trends within some management units may not reflect changes in local habitat conditions. The methods used to monitor and manage bird populations within local BCRs will fundamentally

Interpretation of ambiguities by schoolchildren with low birth weight from Embu das Artes, São Paulo state, Brazil.

Science.gov (United States)

Pessoa, Rebeca Rodrigues; Araújo, Sarah Cueva Cândido Soares de; Isotani, Selma Mie; Puccini, Rosana Fiorini; Perissinoto, Jacy

To assess the development of language regarding the ability to recognize and interpret lexical ambiguity in low-birth-weight schoolchildren enrolled at the school system in the municipality of Embu das Artes, Sao Paulo state, compared with that of schoolchildren with normal birth weight. A case-control, retrospective, cross-sectional study conducted with 378 schoolchildren, both genders, aged 5 to 9.9 years, from the municipal schools of Embu das Artes. Study Group (SG) comprising 210 schoolchildren with birth weight Control Group (CG) composed of 168 school children with birth weight ≥ 2500 g. Participants of both groups were compared with respect to the skills of recognition and verbal interpretation of sentences containing lexical ambiguity using the Test of Language Competence. Variables of interest: Age and gender of children; age and schooling of mothers. Statistical analysis: Descriptive analysis to characterize the sample and score per group; Student's t test for comparison between the total scores of each skill/subtest; Chi-square test to compare items within each subtest; multiple regression analysis for the intervening variables. Participants of the SG presented lower scores for ambiguous sentences compared with those of participants of the CG. Multiple regression analysis showed that child's current age was a predictor for all metalinguistic skills regarding interpretation of ambiguities in both groups. Participants of the SG presented lower specific and total scores than those of participants of the CG for ambiguity skills. The child's current age factor positively influenced the ambiguity skills in both groups.

An Objective Fluctuation Score for Parkinson's Disease

Science.gov (United States)

Horne, Malcolm K.; McGregor, Sarah; Bergquist, Filip

2015-01-01

Introduction Establishing the presence and severity of fluctuations is important in managing Parkinson’s Disease yet there is no reliable, objective means of doing this. In this study we have evaluated a Fluctuation Score derived from variations in dyskinesia and bradykinesia scores produced by an accelerometry based system. Methods The Fluctuation Score was produced by summing the interquartile range of bradykinesia scores and dyskinesia scores produced every 2 minutes between 0900-1800 for at least 6 days by the accelerometry based system and expressing it as an algorithm. Results This Score could distinguish between fluctuating and non-fluctuating patients with high sensitivity and selectivity and was significant lower following activation of deep brain stimulators. The scores following deep brain stimulation lay in a band just above the score separating fluctuators from non-fluctuators, suggesting a range representing adequate motor control. When compared with control subjects the score of newly diagnosed patients show a loss of fluctuation with onset of PD. The score was calculated in subjects whose duration of disease was known and this showed that newly diagnosed patients soon develop higher scores which either fall under or within the range representing adequate motor control or instead go on to develop more severe fluctuations. Conclusion The Fluctuation Score described here promises to be a useful tool for identifying patients whose fluctuations are progressing and may require therapeutic changes. It also shows promise as a useful research tool. Further studies are required to more accurately identify therapeutic targets and ranges. PMID:25928634

Comparison of L-system applications towards plant modelling, music rendering and score generation using visual language programming

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Lim, Chen Kim; Tan, Kian Lam; Yusran, Hazwanni; Suppramaniam, Vicknesh

2017-10-01

Visual language or visual representation has been used in the past few years in order to express the knowledge in graphic. One of the important graphical elements is fractal and L-Systems is a mathematic-based grammatical model for modelling cell development and plant topology. From the plant model, L-Systems can be interpreted as music sound and score. In this paper, LSound which is a Visual Language Programming (VLP) framework has been developed to model plant to music sound and generate music score and vice versa. The objectives of this research has three folds: (i) To expand the grammar dictionary of L-Systems music based on visual programming, (ii) To design and produce a user-friendly and icon based visual language framework typically for L-Systems musical score generation which helps the basic learners in musical field and (iii) To generate music score from plant models and vice versa using L-Systems method. This research undergoes a four phases methodology where the plant is first modelled, then the music is interpreted, followed by the output of music sound through MIDI and finally score is generated. LSound is technically compared to other existing applications in the aspects of the capability of modelling the plant, rendering the music and generating the sound. It has been found that LSound is a flexible framework in which the plant can be easily altered through arrow-based programming and the music score can be altered through the music symbols and notes. This work encourages non-experts to understand L-Systems and music hand-in-hand.

Change in KOOS and WOMAC Scores in a Young Athletic Population With and Without Anterior Cruciate Ligament Injury.

Science.gov (United States)

Antosh, Ivan J; Svoboda, Steven J; Peck, Karen Y; Garcia, E'Stephan J; Cameron, Kenneth L

2018-06-01

Several studies have examined changes in patient-reported outcome measures (PROMs) after anterior cruciate ligament (ACL) injury, but no studies to date have prospectively evaluated changes from preinjury baseline through injury and follow-up among ACL-injured patients compared to the baseline and follow-up changes of uninjured patients. To examine changes in PROMs over time from preinjury baseline to at least 2 years after ACL reconstruction and to compare these changes with those of an uninjured control group having similar physical activity requirements. Cohort study; Level of evidence, 2. The authors conducted a prospective cohort study with a nested case-control analysis at a US service academy. All incoming first year students were recruited to participate in this study. Consenting participants completed a baseline questionnaire that included the KOOS (Knee injury and Osteoarthritis Outcome Score), WOMAC (Western Ontario and McMaster Universities Osteoarthritis Index), and MARS (Marx Activity Rating Scale). Participants who sustained a subsequent ACL injury completed assessments at the time of surgery and at 6, 12, and 24 months after surgery. Healthy participants were recruited to repeat the baseline assessments within 1 year of graduation. Inter- and intragroup differences at these time points were evaluated with dependent and independent t tests, respectively. We also compared these results with established minimum clinically important difference (MCID) values. Of 1268 first year students entering the academy, 1005 with no previous injuries consented to participate in this study (82% male, mean ± SD age 19 ± 1 years). Of those enrolled, 30 suffered an ACL injury and met the inclusion criteria for this study. Ninety uninjured control students who met the inclusion criteria completed follow-up assessments. There were statistically significant differences across all KOOS and WOMAC subscales between ACL-injured group and uninjured group at the time of the

Initial image interpretation of appendicular skeletal radiographs: A comparison between nurses and radiographers

International Nuclear Information System (INIS)

Piper, Keith J.; Paterson, Audrey

2009-01-01

Purpose: To examine the effect of a short training programme on nurses and radiographers, exploring differences between their performance before and after training. Method: Twenty-two nurses and 18 radiographers interpreted 20 trauma radiographs of the appendicular skeleton before and after training. Normal and abnormal cases of a discriminatory nature were included. Total score, sensitivity and specificity values were calculated for each participant by comparison with an agreed expected answer. The area under the curve (AUC) was analysed using alternate free-response receiver operating characteristic (AFROC) methodology. Results: Significant differences were demonstrated between the total scores achieved by the two groups (pre-training: p = 0.007, post-training: p = 0.04). After training, the mean score increased significantly for both groups (p < 0.001). No significant difference was found between the radiographers mean pre-training scores and the nurses mean post-training scores (p = 0.66). Sensitivity for both groups increased following training, significantly so for the nurses (nurses: p < 0.001, radiographers: p = 0.06). Specificity reduced significantly after training for the nurses (p < 0.001), and increased for the radiographers but not significantly (p = 0.085). After training, there was no significant difference between the two groups in terms of sensitivity (p = 0.09) but specificity was significantly higher for the radiographers (p < 0.001). The radiographers achieved higher pre-training AUC values than the nurses (p = 0.04), although a difference remained after training this did not achieve statistical significance (p = 0.15). The AUC values increased significantly after training for both groups (nurses: p = 0.012, radiographers: p = 0.004) and again there was no significant difference between the radiographers pre-training performance and the nurses post-training performance (p = 0.62). Conclusion: Improvement after training was seen in both groups

A Growing Consensus for Change in Interpretation of Clinical Research Evidence.

Science.gov (United States)

Wilkerson, Gary B; Denegar, Craig R

2018-03-01

  The paradigm of evidence-based practice (EBP) is well established among the health care professions, but perspectives on the best methods for acquiring, analyzing, appraising, and using research evidence are evolving.   The EBP paradigm has shifted away from a hierarchy of research-evidence quality to recognize that multiple research methods can yield evidence to guide clinicians and patients through a decision-making process. Whereas the "frequentist" approach to data interpretation through hypothesis testing has been the dominant analytical method used by and taught to athletic training students and scholars, this approach is not optimal for integrating evidence into routine clinical practice. Moreover, the dichotomy of rejecting, or failing to reject, a null hypothesis is inconsistent with the Bayesian-like clinical decision-making process that skilled health care providers intuitively use. We propose that data derived from multiple research methods can be best interpreted by reporting a credible lower limit that represents the smallest treatment effect at a specified level of certainty, which should be judged in relation to the smallest effect considered to be clinically meaningful. Such an approach can provide a quantifiable estimate of certainty that an individual patient needs follow-up attention to prevent an adverse outcome or that a meaningful level of therapeutic benefit will be derived from a given intervention.   The practice of athletic training will be influenced by the evolution of the EBP paradigm. Contemporary practice will require clinicians to expand their critical-appraisal skills to effectively integrate the results derived from clinical research into the care of individual patients. Proper interpretation of a credible lower limit value for a magnitude ratio has the potential to increase the likelihood of favorable patient outcomes, thereby advancing the practice of evidence-based athletic training.

IMPACT OF SHOTS ON FINAL SCORE OF A FOOTBALL MATCH

Directory of Open Access Journals (Sweden)

Miroslav Radoman

2008-08-01

Full Text Available The research has been done on a sample of 64 played games on the World championship FIFA, World Cup Germany 2006 and 128 results of the games divided in three integrals according to the score (win, defeat and unresolved score . The analysis is done according to the total number of shots during the game. Considering the results that are got and their interpretations, we could conclude that the results of data analysis in which is used the multi-method of MANOVA analysis and discriminative analysis, has shown that there are significant difference in frequency of the games result (win, defeat or unresolved score in shots element during the game. Even thou the noticed difference in frequency are not equally expressed, the results that are got have insinuated that there are significant differences in followed elements of the football game. Implemented analysis (royev test i T-test have confirmed that in every analyzed elements of the shot there are statistically significant differences in the result of the game (win, defeat, unresolved score and that the differences in shot’s elements are consequence different selection of the tactics and techniques also the ability of their realization in the stage of at tack and defense.

Interpretative intra- and interobserver reproducibility of Stress/Rest 99m Tc-steamboat's myocardial perfusion SPECT using semi quantitative 20-segment model

International Nuclear Information System (INIS)

Fazeli, M.; Firoozi, F.

2002-01-01

It well established that myocardial perfusion SPECT with 201 T L or 99 mTc-se sta mi bi play an important role diagnosis and risk assessment in patients with known or suspected coronary artery disease. Both quantitative and qualitative methods are available for interpretation of images. The use of a semi quantitative scoring system in which each of 20 segments is scored according to a five-point scheme provides an approach to interpretation that is more systematic and reproducible than simple qualitative evaluation. Only a limited number of studies have dealt with the interpretive observer reproducibility of 99 mTc-steamboat's myocardial perfusion imaging. The aim of this study was to assess the intra-and inter observer variability of semi quantitative SPECT performed with this technique. Among 789 patients that underwent myocardial perfusion SPECT during last year 80 patients finally need to coronary angiography as gold standard. In this group of patients a semi quantitative visual interpretation was carried out using short axis and vertical long-axis myocardial tomograms and a 20-segments model. These segments we reassigned on six evenly spaced regions in the apical, mid-ventricular, and basal short-axis view and two apical segments on the mid-ventricular long-axis slice. Uptake in each segment was graded on a 5-point scale (0=normal, 1=equivocal, 2=moderate, 3=severe, 4=absence of uptake). The steamboat's images was interpreted separately w ice by two observers without knowledge of each other's findings or results of angiography. A SPECT study was judged abnormal if there were two or more segments with a stress score equal or more than 2. We con eluded that semi-quantitative visual analysis is a simple and reproducible method of interpretation

Who will be sicker in the morning? Changes in the Simple Clinical Score the day after admission and the subsequent outcomes of acutely ill unselected medical patients.

LENUS (Irish Health Repository)

Kellett, John

2011-08-01

All doctors are haunted by the possibility that a patient they reassured yesterday will return seriously ill tomorrow. We examined changes in the Simple Clinical Score (SCS) the day after admission, factors that might influence these changes and the relationship of these changes to subsequent clinical outcome.

Analyzing and Interpreting Historical Sources

DEFF Research Database (Denmark)

Kipping, Matthias; Wadhwani, Dan; Bucheli, Marcelo

2014-01-01

This chapter outlines a methodology for the interpretation of historical sources, helping to realize their full potential for the study of organization, while overcoming their challenges in terms of distortions created by time, changes in context, and selective production or preservation. Drawing....... The chapter contributes to the creation of a language for describing the use of historical sources in management research....

Diagnostic performance of a CT-based scoring system for diagnosis of anastomotic leakage after esophagectomy: comparison with subjective CT assessment

Energy Technology Data Exchange (ETDEWEB)

Goense, Lucas; Rossum, Peter S.N. van [University Medical Center Utrecht, Department of Surgery, Utrecht (Netherlands); University Medical Center Utrecht, Department of Radiation Oncology, Utrecht (Netherlands); Stassen, Pauline M.C.; Ruurda, Jelle P.; Hillegersberg, Richard van [University Medical Center Utrecht, Department of Surgery, Utrecht (Netherlands); Wessels, Frank J.; Leeuwen, Maarten S. van [University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands)

2017-10-15

To develop a CT-based prediction score for anastomotic leakage after esophagectomy and compare it to subjective CT interpretation. Consecutive patients who underwent a CT scan for a clinical suspicion of anastomotic leakage after esophagectomy with cervical anastomosis between 2003 and 2014 were analyzed. The CT scans were systematically re-evaluated by two radiologists for the presence of specific CT findings and presence of an anastomotic leak. Also, the original CT interpretations were acquired. These results were compared to patients with and without a clinical confirmed leak. Out of 122 patients that underwent CT for a clinical suspicion of anastomotic leakage; 54 had a confirmed leak. In multivariable analysis, anastomotic leakage was associated with mediastinal fluid (OR = 3.4), esophagogastric wall discontinuity (OR = 4.9), mediastinal air (OR = 6.6), and a fistula (OR = 7.2). Based on these criteria, a prediction score was developed resulting in an area-under-the-curve (AUC) of 0.86, sensitivity of 80%, and specificity of 84%. The original interpretation and the systematic subjective CT assessment by two radiologists resulted in AUCs of 0.68 and 0.75 with sensitivities of 52% and 69%, and specificities of 84% and 82%, respectively. This CT-based score may provide improved diagnostic performance for diagnosis of anastomotic leakage after esophagectomy. (orig.)

Change in CD3 positive T-cell expression in psoriatic arthritis synovium correlates with change in DAS28 and magnetic resonance imaging synovitis scores following initiation of biologic therapy--a single centre, open-label study.

LENUS (Irish Health Repository)

Pontifex, Eliza K

2011-01-01

With the development of increasing numbers of potential therapeutic agents in inflammatory disease comes the need for effective biomarkers to help screen for drug efficacy and optimal dosing regimens early in the clinical trial process. This need has been recognized by the Outcome Measures in Rheumatology Clinical Trials (OMERACT) group, which has established guidelines for biomarker validation. To seek a candidate synovial biomarker of treatment response in psoriatic arthritis (PsA), we determined whether changes in immunohistochemical markers of synovial inflammation correlate with changes in disease activity scores assessing 28 joints (ΔDAS28) or magnetic resonance imaging synovitis scores (ΔMRI) in patients with PsA treated with a biologic agent.

Interpretative commenting.

Science.gov (United States)

Vasikaran, Samuel

2008-08-01

* Clinical laboratories should be able to offer interpretation of the results they produce. * At a minimum, contact details for interpretative advice should be available on laboratory reports.Interpretative comments may be verbal or written and printed. * Printed comments on reports should be offered judiciously, only where they would add value; no comment preferred to inappropriate or dangerous comment. * Interpretation should be based on locally agreed or nationally recognised clinical guidelines where available. * Standard tied comments ("canned" comments) can have some limited use.Individualised narrative comments may be particularly useful in the case of tests that are new, complex or unfamiliar to the requesting clinicians and where clinical details are available. * Interpretative commenting should only be provided by appropriately trained and credentialed personnel. * Audit of comments and continued professional development of personnel providing them are important for quality assurance.

Psychometric properties of the Neck OutcOme Score, Neck Disability Index, and Short Form-36 were evaluated in patients with neck pain.

Science.gov (United States)

Juul, Tina; Søgaard, Karen; Davis, Aileen M; Roos, Ewa M

2016-11-01

To assess reliability, construct validity, responsiveness, and interpretability for Neck OutcOme Score (NOOS), Neck Disability Index (NDI), and Short Form-36 (SF-36) in neck pain patients. Internal consistency was assessed by Cronbach alpha. Test-retest reliability was evaluated by intraclass correlation coefficient (ICC), and measurement error was estimated from the standard error of measurement. Responsiveness was assessed as standardized response mean (SRM) and interpretability from the minimal important difference (MID). Construct validity was tested correlating subscale scores from NOOS and SF-36 and NDI items. At baseline, 196 neck pain patients were included. Cronbach α was adequate for most NOOS subscales, NDI, and SF-36 with few exceptions. Good to excellent reliability was found for NOOS subscales (ICC 0.88-0.95), for NDI, and for SF-36 with few exceptions. For NOOS, minimal detectable changes varied between 1.1 and 1.9, and construct validity was supported. SRMs were higher for NOOS subscales (0.19-0.42), compared to SF-36 and NDI. MID values varied between 15.0 and 24.1 for NOOS subscales. In conclusion, the NOOS is a reliable, valid, and responsive measure of self-reported disability in neck pain patients, performing at least as well or better than the commonly used SF-36 and NDI. Copyright © 2016 Elsevier Inc. All rights reserved.

Change in health-related quality of life over 1 month in cancer patients with high initial levels of symptoms and problems

DEFF Research Database (Denmark)

Lund Rasmussen, Charlotte; Johnsen, Anna Thit; Petersen, Morten Aagaard

2016-01-01

PURPOSE: To investigate the mean changes over time in health-related quality of life among advanced cancer patients who did not receive any intervention, comparing changes among all patients versus changes in subgroups of patients with high initial symptom scores. METHODS: Patients with advanced...... of change over a 1-month period in health-related quality of life in advanced cancer patients, and in subgroups selected according to certain initial symptom levels. This information may help the interpretation of longitudinal studies of patients selected via screening....... cancer answered two questionnaires, containing the EORTC QLQ-C30 (15 multi- or single-item scales), with approximately 1 month in between and received no known intervention in between. For each QLQ-C30 scale, we estimated the mean change among all patients and in subgroups of patients scoring at least 33...

Towards operational interpretations of generalized entropies

Science.gov (United States)

Topsøe, Flemming

2010-12-01

The driving force behind our study has been to overcome the difficulties you encounter when you try to extend the clear and convincing operational interpretations of classical Boltzmann-Gibbs-Shannon entropy to other notions, especially to generalized entropies as proposed by Tsallis. Our approach is philosophical, based on speculations regarding the interplay between truth, belief and knowledge. The main result demonstrates that, accepting philosophically motivated assumptions, the only possible measures of entropy are those suggested by Tsallis - which, as we know, include classical entropy. This result constitutes, so it seems, a more transparent interpretation of entropy than previously available. However, further research to clarify the assumptions is still needed. Our study points to the thesis that one should never consider the notion of entropy in isolation - in order to enable a rich and technically smooth study, further concepts, such as divergence, score functions and descriptors or controls should be included in the discussion. This will clarify the distinction between Nature and Observer and facilitate a game theoretical discussion. The usefulness of this distinction and the subsequent exploitation of game theoretical results - such as those connected with the notion of Nash equilibrium - is demonstrated by a discussion of the Maximum Entropy Principle.

Towards operational interpretations of generalized entropies

International Nuclear Information System (INIS)

Topsoee, Flemming

2010-01-01

The driving force behind our study has been to overcome the difficulties you encounter when you try to extend the clear and convincing operational interpretations of classical Boltzmann-Gibbs-Shannon entropy to other notions, especially to generalized entropies as proposed by Tsallis. Our approach is philosophical, based on speculations regarding the interplay between truth, belief and knowledge. The main result demonstrates that, accepting philosophically motivated assumptions, the only possible measures of entropy are those suggested by Tsallis - which, as we know, include classical entropy. This result constitutes, so it seems, a more transparent interpretation of entropy than previously available. However, further research to clarify the assumptions is still needed. Our study points to the thesis that one should never consider the notion of entropy in isolation - in order to enable a rich and technically smooth study, further concepts, such as divergence, score functions and descriptors or controls should be included in the discussion. This will clarify the distinction between Nature and Observer and facilitate a game theoretical discussion. The usefulness of this distinction and the subsequent exploitation of game theoretical results - such as those connected with the notion of Nash equilibrium - is demonstrated by a discussion of the Maximum Entropy Principle.

Protein flexibility: coordinate uncertainties and interpretation of structural differences

Energy Technology Data Exchange (ETDEWEB)

Rashin, Alexander A., E-mail: alexander-rashin@hotmail.com [BioChemComp Inc., 543 Sagamore Avenue, Teaneck, NJ 07666 (United States); LH Baker Center for Bioinformatics and Department of Biochemistry, Biophysics and Molecular Biology, 112 Office and Lab Building, Iowa State University, Ames, IA 50011-3020 (United States); Rashin, Abraham H. L. [BioChemComp Inc., 543 Sagamore Avenue, Teaneck, NJ 07666 (United States); Rutgers, The State University of New Jersey, 22371 BPO WAY, Piscataway, NJ 08854-8123 (United States); Jernigan, Robert L. [LH Baker Center for Bioinformatics and Department of Biochemistry, Biophysics and Molecular Biology, 112 Office and Lab Building, Iowa State University, Ames, IA 50011-3020 (United States); BioChemComp Inc., 543 Sagamore Avenue, Teaneck, NJ 07666 (United States)

2009-11-01

Criteria for the interpretability of coordinate differences and a new method for identifying rigid-body motions and nonrigid deformations in protein conformational changes are developed and applied to functionally induced and crystallization-induced conformational changes. Valid interpretations of conformational movements in protein structures determined by X-ray crystallography require that the movement magnitudes exceed their uncertainty threshold. Here, it is shown that such thresholds can be obtained from the distance difference matrices (DDMs) of 1014 pairs of independently determined structures of bovine ribonuclease A and sperm whale myoglobin, with no explanations provided for reportedly minor coordinate differences. The smallest magnitudes of reportedly functional motions are just above these thresholds. Uncertainty thresholds can provide objective criteria that distinguish between true conformational changes and apparent ‘noise’, showing that some previous interpretations of protein coordinate changes attributed to external conditions or mutations may be doubtful or erroneous. The use of uncertainty thresholds, DDMs, the newly introduced CDDMs (contact distance difference matrices) and a novel simple rotation algorithm allows a more meaningful classification and description of protein motions, distinguishing between various rigid-fragment motions and nonrigid conformational deformations. It is also shown that half of 75 pairs of identical molecules, each from the same asymmetric crystallographic cell, exhibit coordinate differences that range from just outside the coordinate uncertainty threshold to the full magnitude of large functional movements. Thus, crystallization might often induce protein conformational changes that are comparable to those related to or induced by the protein function.

Standardized Computer-based Organized Reporting of EEG: SCORE

Science.gov (United States)

Beniczky, Sándor; Aurlien, Harald; Brøgger, Jan C; Fuglsang-Frederiksen, Anders; Martins-da-Silva, António; Trinka, Eugen; Visser, Gerhard; Rubboli, Guido; Hjalgrim, Helle; Stefan, Hermann; Rosén, Ingmar; Zarubova, Jana; Dobesberger, Judith; Alving, Jørgen; Andersen, Kjeld V; Fabricius, Martin; Atkins, Mary D; Neufeld, Miri; Plouin, Perrine; Marusic, Petr; Pressler, Ronit; Mameniskiene, Ruta; Hopfengärtner, Rüdiger; Emde Boas, Walter; Wolf, Peter

2013-01-01

The electroencephalography (EEG) signal has a high complexity, and the process of extracting clinically relevant features is achieved by visual analysis of the recordings. The interobserver agreement in EEG interpretation is only moderate. This is partly due to the method of reporting the findings in free-text format. The purpose of our endeavor was to create a computer-based system for EEG assessment and reporting, where the physicians would construct the reports by choosing from predefined elements for each relevant EEG feature, as well as the clinical phenomena (for video-EEG recordings). A working group of EEG experts took part in consensus workshops in Dianalund, Denmark, in 2010 and 2011. The faculty was approved by the Commission on European Affairs of the International League Against Epilepsy (ILAE). The working group produced a consensus proposal that went through a pan-European review process, organized by the European Chapter of the International Federation of Clinical Neurophysiology. The Standardised Computer-based Organised Reporting of EEG (SCORE) software was constructed based on the terms and features of the consensus statement and it was tested in the clinical practice. The main elements of SCORE are the following: personal data of the patient, referral data, recording conditions, modulators, background activity, drowsiness and sleep, interictal findings, “episodes” (clinical or subclinical events), physiologic patterns, patterns of uncertain significance, artifacts, polygraphic channels, and diagnostic significance. The following specific aspects of the neonatal EEGs are scored: alertness, temporal organization, and spatial organization. For each EEG finding, relevant features are scored using predefined terms. Definitions are provided for all EEG terms and features. SCORE can potentially improve the quality of EEG assessment and reporting; it will help incorporate the results of computer-assisted analysis into the report, it will make

Construct validity of the reporter-interpreter-manager-educator structure for assessing students' patient encounter skills

DEFF Research Database (Denmark)

Tolsgaard, Martin G.; Arendrup, Henrick; Lindhardt, Bjarne O.

2012-01-01

PURPOSE: The aim of this study, done in Denmark, was to explore the construct validity of a Reporter-Interpreter-Manager-Educator (RIME)-structured scoring format for assessing patient encounter skills. METHOD: The authors developed a RIME-structured scoring form and explored its construct validity...... in a two-step procedure. The first step (implemented in 2009) was a randomized, controlled, experimental study in which the performance of three groups (16 fourth-year medical students, 16 sixth-year medical students, and 16 interns) was assessed in two simulated patient encounters. The second step...... (carried out during 2009-2010) was an observational study of patient encounter skills where clinician examiners used the scoring form in end-of-clerkship oral examinations of three consecutive cohorts of a total of 547 fourth-year medical students. RESULTS: In the experimental study, RIME scores showed...

Using Modified Remote Sensing Imagery to Interpret Changes in Cultivated Land under Saline-Alkali Conditions

Directory of Open Access Journals (Sweden)

Hui Gao

2016-07-01

Full Text Available Managing the rapidly changing saline-alkali land under cultivation in the coastal areas of China is important not only for mitigating the negative impacts of such land on the environment, but also for ensuring long-term sustainability of agriculture. In this light, setting up rapid monitoring systems to assist decision-making in developing sustainable management plans is therefore an absolute necessity. In this study, we developed a new interpretation system where symbols are used to grade and classify saline-alkali lands in space and time, based on the characteristics of plant cover and features of remote sensing images. The system was used in combination with the maximum likelihood supervised classification to analyze the changes in cultivated lands under saline-alkali conditions in Huanghua City. The analysis revealed changes in the area and spatial distribution of cultivated under saline-alkali conditions in the region. The total area of saline-alkali land was 139,588.8 ha in 1992 and 134,477.5 ha in 2011. Compared with 1992, severely and moderately saline-alkali land areas decreased in 2011. However, non/slightly saline land areas increased over that in 1992. The results showed that the salinization rate of arable lands in Huanghua City decreased from 1992 to 2011. The moderately saline-alkali land southeast of the city transformed into non/slightly saline-alkaline. Then, severely saline-alkali land far from the coastal zone west of the city became moderately saline-alkaline. Spatial changes in cultivated saline-alkali lands in Huanghua City were such that the centers of gravity (CG of severely and non/slightly saline-alkali land moved closer the coastline, while that of the moderately saline-alkali land moved from southwest coastal line to northwest. Factors influencing changes in cultivated lands in the saline-alkali ecosystem included climate, hydrology and human activity. Thus, studies are required to further explore these factors in

Correspondence between EQ-5D health state classifications and EQ VAS scores

Directory of Open Access Journals (Sweden)

Whynes David K

2008-11-01

Full Text Available Abstract Background The EQ-5D health-related quality of life instrument comprises a health state classification followed by a health evaluation using a visual analogue scale (VAS. The EQ-5D has been employed frequently in economic evaluations, yet the relationship between the two parts of the instrument remains ill-understood. In this paper, we examine the correspondence between VAS scores and health state classifications for a large sample, and identify variables which contribute to determining the VAS scores independently of the health states as classified. Methods A UK trial of management of low-grade abnormalities detected on screening for cervical pre-cancer (TOMBOLA provided EQ-5D data for over 3,000 women. Information on distress and multi-dimensional health locus of control had been collected using other instruments. A linear regression model was fitted, with VAS score as the dependent variable. Independent variables comprised EQ-5D health state classifications, distress, locus of control, and socio-demographic characteristics. Equivalent EQ-5D and distress data, collected at twelve months, were available for over 2,000 of the women, enabling us to predict changes in VAS score over time from changes in EQ-5D classification and distress. Results In addition to EQ-5D health state classification, VAS score was influenced by the subject's perceived locus of control, and by her age, educational attainment, ethnic origin and smoking behaviour. Although the EQ-5D classification includes a distress dimension, the independent measure of distress was an additional determinant of VAS score. Changes in VAS score over time were explained by changes in both EQ-5D severities and distress. Women allocated to the experimental management arm of the trial reported an increase in VAS score, independently of any changes in health state and distress. Conclusion In this sample, EQ VAS scores were predictable from the EQ-5D health state classification, although

Interpreting radiographs. 4. The carpus

International Nuclear Information System (INIS)

Burguez, P.N.

1984-01-01

The complexity of the carpus which has three major joints, seven or eight carpal bones and five adjacent bones, each of which articulates with one or more of the carpal elements, necessitates good quality radiographs for definitive radiographic interpretation may be extremely difficult because of the disparity between radiographic changes and obvious clinical signs and, therefore, must be discussed in the light of a thorough clinical assessment

Parametric analyses of summative scores may lead to conflicting inferences when comparing groups: A simulation study.

Science.gov (United States)

Khan, Asaduzzaman; Chien, Chi-Wen; Bagraith, Karl S

2015-04-01

To investigate whether using a parametric statistic in comparing groups leads to different conclusions when using summative scores from rating scales compared with using their corresponding Rasch-based measures. A Monte Carlo simulation study was designed to examine between-group differences in the change scores derived from summative scores from rating scales, and those derived from their corresponding Rasch-based measures, using 1-way analysis of variance. The degree of inconsistency between the 2 scoring approaches (i.e. summative and Rasch-based) was examined, using varying sample sizes, scale difficulties and person ability conditions. This simulation study revealed scaling artefacts that could arise from using summative scores rather than Rasch-based measures for determining the changes between groups. The group differences in the change scores were statistically significant for summative scores under all test conditions and sample size scenarios. However, none of the group differences in the change scores were significant when using the corresponding Rasch-based measures. This study raises questions about the validity of the inference on group differences of summative score changes in parametric analyses. Moreover, it provides a rationale for the use of Rasch-based measures, which can allow valid parametric analyses of rating scale data.

CERAD Neuropsychological Total Scores Reflect Cortical Thinning in Prodromal Alzheimer's Disease

Directory of Open Access Journals (Sweden)

T. Paajanen

2013-11-01

Full Text Available Background: Sensitive cognitive global scores are beneficial in screening and monitoring for prodromal Alzheimer's disease (AD. Early cortical changes provide a novel opportunity for validating established cognitive total scores against the biological disease markers. Methods: We examined how two different total scores of the Consortium to Establish a Registry for Alzheimer's Disease (CERAD battery and the Mini-Mental State Examination (MMSE are associated with cortical thickness (CTH in mild cognitive impairment (MCI and prodromal AD. Cognitive and magnetic resonance imaging (MRI data of 22 progressive MCI, 78 stable MCI, and 98 control subjects, and MRI data of 103 AD patients of the prospective multicenter study were analyzed. Results: CERAD total scores correlated with mean CTH more strongly (r = 0.34-0.38, p Conclusion: CERAD total scores are sensitive to the CTH signature of prodromal AD, which supports their biological validity in detecting early disease-related cognitive changes.

Validity and Reliability of Nintendo Wii Fit Balance Scores

Science.gov (United States)

Wikstrom, Erik A.

2012-01-01

Context: Interactive gaming systems have the potential to help rehabilitate patients with musculoskeletal conditions. The Nintendo Wii Balance Board, which is part of the Wii Fit game, could be an effective tool to monitor progress during rehabilitation because the board and game can provide objective measures of balance. However, the validity and reliability of Wii Fit balance scores remain unknown. Objective: To determine the concurrent validity of balance scores produced by the Wii Fit game and the intrasession and intersession reliability of Wii Fit balance scores. Design: Descriptive laboratory study. Setting: Sports medicine research laboratory. Patients or Other Participants: Forty-five recreationally active participants (age  =  27.0 ± 9.8 years, height  =  170.9 ± 9.2 cm, mass  =  72.4 ± 11.8 kg) with a heterogeneous history of lower extremity injury. Intervention(s): Participants completed a single-limb–stance task on a force plate and the Star Excursion Balance Test (SEBT) during the first test session. Twelve Wii Fit balance activities were completed during 2 test sessions separated by 1 week. Main Outcome Measure(s): Postural sway in the anteroposterior (AP) and mediolateral (ML) directions and the AP, ML, and resultant center-of-pressure (COP) excursions were calculated from the single-limb stance. The normalized reach distance was recorded for the anterior, posteromedial, and posterolateral directions of the SEBT. Wii Fit balance scores that the game software generated also were recorded. Results: All 96 of the calculated correlation coefficients among Wii Fit activity outcomes and established balance outcomes were interpreted as poor (r Wii Fit balance activity scores ranged from good (intraclass correlation coefficient [ICC]  =  0.80) to poor (ICC  =  0.39), with 8 activities having poor intrasession reliability. Similarly, 11 of the 12 Wii Fit balance activity scores demonstrated poor intersession reliability, with

Interpreting Impoliteness: Interpreters’ Voices

Directory of Open Access Journals (Sweden)

Tatjana Radanović Felberg

2017-11-01

Full Text Available Interpreters in the public sector in Norway interpret in a variety of institutional encounters, and the interpreters evaluate the majority of these encounters as polite. However, some encounters are evaluated as impolite, and they pose challenges when it comes to interpreting impoliteness. This issue raises the question of whether interpreters should take a stance on their own evaluation of impoliteness and whether they should interfere in communication. In order to find out more about how interpreters cope with this challenge, in 2014 a survey was sent to all interpreters registered in the Norwegian Register of Interpreters. The survey data were analyzed within the theoretical framework of impoliteness theory using the notion of moral order as an explanatory tool in a close reading of interpreters’ answers. The analysis shows that interpreters reported using a variety of strategies for interpreting impoliteness, including omissions and downtoning. However, the interpreters also gave examples of individual strategies for coping with impoliteness, such as interrupting and postponing interpreting. These strategies border behavioral strategies and conflict with the Norwegian ethical guidelines for interpreting. In light of the ethical guidelines and actual practice, mapping and discussing different strategies used by interpreters might heighten interpreters’ and interpreter-users’ awareness of the role impoliteness can play in institutional interpreter– mediated encounters. 

An analysis of the use of Pharmacy Curriculum Outcomes Assessment (PCOA) scores within one professional program.

Science.gov (United States)

Garavalia, Linda S; Prabhu, Sunil; Chung, Eunice; Robinson, Daniel C

The Pharmacy Curriculum Outcomes Assessment (PCOA) is a recent assessment requirement for US pharmacy professional programs. This study analyses PCOA scores for uses described in the 2016 Standards with data from one professional program. PCOA data were analyzed for two consecutive classes (n=215) of pharmacy students at the end of their didactic curriculum to explore relationships among PCOA scores, grade point average (GPA), and North American Pharmacist Licensure Examination (NAPLEX) scores utilizing regression analyses. Decisions about student learning based on PCOA scores and GPA indicated remediation would have been prescribed for approximately 7% of students. In comparison, NAPLEX scores revealed a 1% failure rate among the study sample. Relationships between PCOA scores and GPA (r=0.47) and NAPLEX (r=0.51) were moderate to large, respectively. GPA explained a larger portion of unique variance (14%) than PCOA (8%) in NAPLEX scores. In this sample of students, academic decisions would have varied depending upon the learning assessment, which is consistent with a moderate correlation between GPA and PCOA scores. Although PCOA scores correlate with GPA and NAPLEX, PCOA scores explained a smaller portion of unique variance in NAPLEX scores than GPA. The ongoing establishment of validity evidence of PCOA scores is important for meaningful interpretation of scores for the intended uses. Copyright © 2017 Elsevier Inc. All rights reserved.

Penultimate interpretation.

Science.gov (United States)

Neuman, Yair

2010-10-01

Interpretation is at the center of psychoanalytic activity. However, interpretation is always challenged by that which is beyond our grasp, the 'dark matter' of our mind, what Bion describes as ' O'. O is one of the most central and difficult concepts in Bion's thought. In this paper, I explain the enigmatic nature of O as a high-dimensional mental space and point to the price one should pay for substituting the pre-symbolic lexicon of the emotion-laden and high-dimensional unconscious for a low-dimensional symbolic representation. This price is reification--objectifying lived experience and draining it of vitality and complexity. In order to address the difficulty of approaching O through symbolization, I introduce the term 'Penultimate Interpretation'--a form of interpretation that seeks 'loopholes' through which the analyst and the analysand may reciprocally save themselves from the curse of reification. Three guidelines for 'Penultimate Interpretation' are proposed and illustrated through an imaginary dialogue. Copyright © 2010 Institute of Psychoanalysis.

Histologic scoring of gastritis and gastric cancer in mouse models.

Science.gov (United States)

Rogers, Arlin B

2012-01-01

Histopathology is a defining endpoint in mouse models of experimental gastritis and gastric adenocarcinoma. Presented here is an overview of the histology of gastritis and gastric cancer in mice experimentally infected with Helicobacter pylori or H. felis. A modular histopathologic scoring scheme is provided that incorporates relevant disease-associated changes. Whereas the guide uses Helicobacter infection as the prototype challenge, features may be applied to chemical and genetically engineered mouse models of stomach cancer as well. Specific criteria included in the combined gastric histologic activity index (HAI) include inflammation, epithelial defects, oxyntic atrophy, hyperplasia, pseudopyloric metaplasia, and dysplasia or neoplasia. Representative photomicrographs accompany descriptions for each lesion grade. Differentiation of genuine tumor invasion from pseudoinvasion is highlighted. A brief comparison of normal rodent versus human stomach anatomy and physiology is accompanied by an introduction to mouse-specific lesions including mucous metaplasia and eosinophilic droplets (hyalinosis). In conjunction with qualified pathology support, this guide is intended to assist research scientists, postdoctoral fellows, graduate students, and medical professionals from affiliated disciplines in the interpretation and histologic grading of chronic gastritis and gastric carcinoma in mouse models.

ClimateInterpreter.org: an online sharing platform with best practices and resources on effective climate change communication, climate change exhibits, and sustainability efforts at aquariums, zoos, and science museums

Science.gov (United States)

Miller, M. K.; MacKenzie, S.

2011-12-01

Many aquariums, zoos, museums, and other informal science education (ISE) centers across the country want to connect their visitors with the important issue of climate change. Communicating climate change and the science it embodies is no easy task though, and ISE institutions are seeking creative and collaborative ways to best interpret the issue with their audiences. Some of these institutions, particularly aquariums and zoos, have live specimens on exhibit that stand to be severely impacted by climate change. Others see it as an educational and moral imperative to address such an important issue affecting the world today, especially one so close to the core mission of their institution. Regardless, informal science educators have noticed that the public is increasingly coming to them with questions related to climate change, and they want to be able to respond as effectively as they can. The Monterey Bay Aquarium is one partner in a coalition of aquariums, zoos, museums and informal science education institutions that are working together to present climate change to its visitors. These institutions hold enormous public trust as sources of sound scientific information. Whether it is through exhibitions like the Aquarium's Hot Pink Flamingos: Stories of Hope in a Changing Sea, interpretive and communication techniques to navigate challenging climate change discussions, or with sustainability planning and operational greening efforts, there is a concerted movement to improve the capacity of these institutions to respond to the issue. Ultimately, their goal is to inspire visitors in a way that positively impacts the country's discourse surrounding climate change, and helps steer our dialog toward a focus on solutions. In addition to the Hot Pink Flamingos exhibit, the Aquarium is also working with the coalition to build a website, www.climateinterpreter.org, that can serve as an online platform for sharing the experiences of what different partners have learned at

Varying performance in mammographic interpretation across two countries: Do results indicate reader or population variances?

Science.gov (United States)

Soh, BaoLin P.; Lee, Warwick B.; Wong, Jill; Sim, Llewellyn; Hillis, Stephen L.; Tapia, Kriscia A.; Brennan, Patrick C.

2016-03-01

Aim: To compare the performance of Australian and Singapore breast readers interpreting a single test-set that consisted of mammographic examinations collected from the Australian population. Background: In the teleradiology era, breast readers are interpreting mammographic examinations from different populations. The question arises whether two groups of readers with similar training backgrounds, demonstrate the same level of performance when presented with a population familiar only to one of the groups. Methods: Fifty-three Australian and 15 Singaporean breast radiologists participated in this study. All radiologists were trained in mammogram interpretation and had a median of 9 and 15 years of experience in reading mammograms respectively. Each reader interpreted the same BREAST test-set consisting of sixty de-identified mammographic examinations arising from an Australian population. Performance parameters including JAFROC, ROC, case sensitivity as well as specificity were compared between Australian and Singaporean readers using a Mann Whitney U test. Results: A significant difference (P=0.036) was demonstrated between the JAFROC scores of the Australian and Singaporean breast radiologists. No other significant differences were observed. Conclusion: JAFROC scores for Australian radiologists were higher than those obtained by the Singaporean counterparts. Whilst it is tempting to suggest this is down to reader expertise, this may be a simplistic explanation considering the very similar training and audit backgrounds of the two populations of radiologists. The influence of reading images that are different from those that radiologists normally encounter cannot be ruled out and requires further investigation, particularly in the light of increasing international outsourcing of radiologic reporting.

D-score: a search engine independent MD-score.

Science.gov (United States)

Vaudel, Marc; Breiter, Daniela; Beck, Florian; Rahnenführer, Jörg; Martens, Lennart; Zahedi, René P

2013-03-01

While peptides carrying PTMs are routinely identified in gel-free MS, the localization of the PTMs onto the peptide sequences remains challenging. Search engine scores of secondary peptide matches have been used in different approaches in order to infer the quality of site inference, by penalizing the localization whenever the search engine similarly scored two candidate peptides with different site assignments. In the present work, we show how the estimation of posterior error probabilities for peptide candidates allows the estimation of a PTM score called the D-score, for multiple search engine studies. We demonstrate the applicability of this score to three popular search engines: Mascot, OMSSA, and X!Tandem, and evaluate its performance using an already published high resolution data set of synthetic phosphopeptides. For those peptides with phosphorylation site inference uncertainty, the number of spectrum matches with correctly localized phosphorylation increased by up to 25.7% when compared to using Mascot alone, although the actual increase depended on the fragmentation method used. Since this method relies only on search engine scores, it can be readily applied to the scoring of the localization of virtually any modification at no additional experimental or in silico cost. © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Description and validation of a scoring system for tomosynthesis in pulmonary cystic fibrosis.

Science.gov (United States)

Vult von Steyern, Kristina; Björkman-Burtscher, Isabella M; Höglund, Peter; Bozovic, Gracijela; Wiklund, Marie; Geijer, Mats

2012-12-01

To design and validate a scoring system for tomosynthesis (digital tomography) in pulmonary cystic fibrosis. A scoring system dedicated to tomosynthesis in pulmonary cystic fibrosis was designed. Three radiologists independently scored 88 pairs of radiographs and tomosynthesis examinations of the chest in 60 patients with cystic fibrosis and 7 oncology patients. Radiographs were scored according to the Brasfield scoring system and tomosynthesis examinations were scored using the new scoring system. Observer agreements for the tomosynthesis score were almost perfect for the total score with square-weighted kappa >0.90, and generally substantial to almost perfect for subscores. Correlation between the tomosynthesis score and the Brasfield score was good for the three observers (Kendall's rank correlation tau 0.68, 0.77 and 0.78). Tomosynthesis was generally scored higher as a percentage of the maximum score. Observer agreements for the total score for Brasfield score were almost perfect (square-weighted kappa 0.80, 0.81 and 0.85). The tomosynthesis scoring system seems robust and correlates well with the Brasfield score. Compared with radiography, tomosynthesis is more sensitive to cystic fibrosis changes, especially bronchiectasis and mucus plugging, and the new tomosynthesis scoring system offers the possibility of more detailed and accurate scoring of disease severity. Tomosynthesis is more sensitive than conventional radiography for pulmonary cystic fibrosis changes. The radiation dose from chest tomosynthesis is low compared with computed tomography. Tomosynthesis may become useful in the regular follow-up of patients with cystic fibrosis.

Are the MDS-UPDRS-based composite scores clinically applicable?

Science.gov (United States)

Makkos, Attila; Kovács, Márton; Aschermann, Zsuzsanna; Harmat, Márk; Janszky, József; Karádi, Kázmér; Kovács, Norbert

2018-02-28

The International Parkinson and Movement Disorder Society-sponsored UPDRS (MDS-UPDRS) is a powerful clinical outcome measure. To evaluate the feasibility of various MDS-UPDRS-based composite scores and determine their minimal clinically important difference threshold values. Overall, 1,113 paired investigations of 452 patients were reviewed implementing three different techniques simultaneously. Based on the ordinal regression modeling, the MDS-UPDRS II+III, MDS-UPDRS I+II+III, and the total score of MDS-UPDRS are clinically applicable outcome measures. Any improvement greater than 4.9 points or any worsening more than 4.2 points on MDS-UPDRS II+III represent a minimal, yet clinically meaningful, change. In reference to MDS-UPDRS I+II+III, the smallest changes considered clinically relevant were 6.7 and 5.2 points for improvement and deterioration, respectively. The thresholds for the total score of MDS-UPDRS were 7.1 points for improvement and 6.3 points for worsening. Our findings support the application of various MDS-UPDRS-based composite scores. © 2018 International Parkinson and Movement Disorder Society. © 2018 International Parkinson and Movement Disorder Society.

A study of the effect of a visual arts-based program on the scores of Jefferson Scale for Physician Empathy.

Science.gov (United States)

Yang, Kuang-Tao; Yang, Jen-Hung

2013-10-25

The effect of visual arts interventions on development of empathy has not been quantitatively investigated. A study was conducted on the effect of a visual arts-based program on the scores of the Jefferson Scale for Physician Empathy (JSPE). A total of 110 clerks (n = 92) and first-year postgraduate residents (PGY1s) (n = 18) participating in the program were recruited into this study. The 4-hr program covered the subjects of learning to interpret paintings, interpreting paintings relating to medicine, illness and human suffering, the related-topics of humanitarianism and the other humanities fields and values and meaning. The JSPE was completed at the beginning (pretest) and the end (posttest) of the program. There was no significant difference between the pretest and posttest JSPE scores. The average of the scores for the pretest was lower in the subgroup of PGY1s than the subgroup of clerks (p = 0.0358). An increased but not significantly mean posttest JESPE score was noted for the subgroup of PGY1s. Neither the females nor the males had higher posttest JSPE scores than the pretest scores. Although using a structured visual arts-based program as an intervention may be useful to enhance medical students' empathy, our results failed to show a positive effect on the JSPE Scores for a group of clerks and PGY1s. This suggests that further experimental studies are needed if quantitative evaluation of the effectiveness of visual-arts based programs on empathy is to be investigated.

A computer-aided detection system for rheumatoid arthritis MRI data interpretation and quantification of synovial activity

DEFF Research Database (Denmark)

Kubassove, Olga; Boesen, Mikael; Cimmino, Marco A

2009-01-01

and interpretation slow down development in this area. Existing scoring systems of especially synovitis are too rigid and insensitive to measure early treatment response and quantify inflammation. This study tested a novel automated, computer system for analysis of dynamic MRI data acquired from patients with RA...

Change in CD3 positive T-cell expression in psoriatic arthritis synovium correlates with change in DAS28 and magnetic resonance imaging synovitis scores following initiation of biologic therapy - a single centre, open-label study

LENUS (Irish Health Repository)

Pontifex, Eliza K

2011-01-27

Abstract Introduction With the development of increasing numbers of potential therapeutic agents in inflammatory disease comes the need for effective biomarkers to help screen for drug efficacy and optimal dosing regimens early in the clinical trial process. This need has been recognized by the Outcome Measures in Rheumatology Clinical Trials (OMERACT) group, which has established guidelines for biomarker validation. To seek a candidate synovial biomarker of treatment response in psoriatic arthritis (PsA), we determined whether changes in immunohistochemical markers of synovial inflammation correlate with changes in disease activity scores assessing 28 joints (ΔDAS28) or magnetic resonance imaging synovitis scores (ΔMRI) in patients with PsA treated with a biologic agent. Methods Twenty-five consecutive patients with PsA underwent arthroscopic synovial biopsies and MRI scans of an inflamed knee joint at baseline and 12 weeks after starting treatment with either anakinra (first 10 patients) or etanercept (subsequent 15 patients) in two sequential studies of identical design. DAS28 scores were measured at both time points. Immunohistochemical staining for CD3, CD68 and Factor VIII (FVIII) was performed on synovial samples and scored by digital image analysis (DIA). MRI scans performed at baseline and at 12 weeks were scored for synovitis semi-quantitatively. The ΔDAS28 of the European League Against Rheumatism good response definition (>1.2) was chosen to divide patients into responder and non-responder groups. Differences between groups (Mann Whitney U test) and correlations between ΔDAS28 with change in immunohistochemical and MRI synovitis scores (Spearman\\'s rho test) were calculated. Results Paired synovial samples and MRI scans were available for 21 patients (8 anakinra, 13 etanercept) and 23 patients (8 anakinra, 15 etanercept) respectively. Change in CD3 (ΔCD3) and CD68 expression in the synovial sublining layer (ΔCD68sl) was significantly greater in

Assessment of US score and CT number for diagnosis of fatty liver

International Nuclear Information System (INIS)

Ogasawara, Tetsuo; Tanda, Shigeru; Lim, Insu; Oota, Keisuke; Taima, Tadashi

1987-01-01

The author evaluates US and CT for diagnosis of fatty liver in 70 cases with fatty change of the liver. We tried to score the US findings of the fatty change, i.e., ''bright liver pattern'', ''liver-kidney contrast'', ''vascular blurring'', ''deep attenuation'', and the usefulness of the scoring was examined. Comparing with CT number, US score was more sensitive, but had no significant correlation with the amount of the fat in the liver and with the abnormality of the liver function tests. The results indicate that US should be used as a primary screening examination, and for the further evaluation of the fatty change of the liver, CT should be carried out. (author)

Augmenting Amyloid PET Interpretations With Quantitative Information Improves Consistency of Early Amyloid Detection.

Science.gov (United States)

Harn, Nicholas R; Hunt, Suzanne L; Hill, Jacqueline; Vidoni, Eric; Perry, Mark; Burns, Jeffrey M

2017-08-01

Establishing reliable methods for interpreting elevated cerebral amyloid-β plaque on PET scans is increasingly important for radiologists, as availability of PET imaging in clinical practice increases. We examined a 3-step method to detect plaque in cognitively normal older adults, focusing on the additive value of quantitative information during the PET scan interpretation process. Fifty-five F-florbetapir PET scans were evaluated by 3 experienced raters. Scans were first visually interpreted as having "elevated" or "nonelevated" plaque burden ("Visual Read"). Images were then processed using a standardized quantitative analysis software (MIMneuro) to generate whole brain and region of interest SUV ratios. This "Quantitative Read" was considered elevated if at least 2 of 6 regions of interest had an SUV ratio of more than 1.1. The final interpretation combined both visual and quantitative data together ("VisQ Read"). Cohen kappa values were assessed as a measure of interpretation agreement. Plaque was elevated in 25.5% to 29.1% of the 165 total Visual Reads. Interrater agreement was strong (kappa = 0.73-0.82) and consistent with reported values. Quantitative Reads were elevated in 45.5% of participants. Final VisQ Reads changed from initial Visual Reads in 16 interpretations (9.7%), with most changing from "nonelevated" Visual Reads to "elevated." These changed interpretations demonstrated lower plaque quantification than those initially read as "elevated" that remained unchanged. Interrater variability improved for VisQ Reads with the addition of quantitative information (kappa = 0.88-0.96). Inclusion of quantitative information increases consistency of PET scan interpretations for early detection of cerebral amyloid-β plaque accumulation.

Extension of the lod score: the mod score.

Science.gov (United States)

Clerget-Darpoux, F

2001-01-01

In 1955 Morton proposed the lod score method both for testing linkage between loci and for estimating the recombination fraction between them. If a disease is controlled by a gene at one of these loci, the lod score computation requires the prior specification of an underlying model that assigns the probabilities of genotypes from the observed phenotypes. To address the case of linkage studies for diseases with unknown mode of inheritance, we suggested (Clerget-Darpoux et al., 1986) extending the lod score function to a so-called mod score function. In this function, the variables are both the recombination fraction and the disease model parameters. Maximizing the mod score function over all these parameters amounts to maximizing the probability of marker data conditional on the disease status. Under the absence of linkage, the mod score conforms to a chi-square distribution, with extra degrees of freedom in comparison to the lod score function (MacLean et al., 1993). The mod score is asymptotically maximum for the true disease model (Clerget-Darpoux and Bonaïti-Pellié, 1992; Hodge and Elston, 1994). Consequently, the power to detect linkage through mod score will be highest when the space of models where the maximization is performed includes the true model. On the other hand, one must avoid overparametrization of the model space. For example, when the approach is applied to affected sibpairs, only two constrained disease model parameters should be used (Knapp et al., 1994) for the mod score maximization. It is also important to emphasize the existence of a strong correlation between the disease gene location and the disease model. Consequently, there is poor resolution of the location of the susceptibility locus when the disease model at this locus is unknown. Of course, this is true regardless of the statistics used. The mod score may also be applied in a candidate gene strategy to model the potential effect of this gene in the disease. Since, however, it

A study of low scores in Canadian children and adolescents on the Wechsler Intelligence Scale For Children, Fourth Edition (WISC-IV).

Science.gov (United States)

Brooks, Brian L

2011-01-01

Knowing the prevalence of low neurocognitive scores for the WISC-IV Canadian normative sample (WISC-IV(CDN)) is an important supplement for clinical interpretation of test performance. On the WISC-IV(CDN), it is uncommon for children and adolescents to have 4 or more subtest scores or 2 or more Index scores ≤ 9th percentile when all scores on the battery are considered simultaneously. As the level of the child's intelligence increases or the number of years of parental education increases, the prevalence of low scores decreases. These results are consistent with existing studies of the base rates of low scores in children and adolescents on pediatric cognitive batteries, including the WISC-IV American normative sample. Tables provided are ready for clinical use.

Evaluating a grading change at UCSD school of medicine: pass/fail grading is associated with decreased performance on preclinical exams but unchanged performance on USMLE step 1 scores.

Science.gov (United States)

McDuff, Susan G R; McDuff, DeForest; Farace, Jennifer A; Kelly, Carolyn J; Savoia, Maria C; Mandel, Jess

2014-06-30

To assess the impact of a change in preclerkship grading system from Honors/Pass/Fail (H/P/F) to Pass/Fail (P/F) on University of California, San Diego (UCSD) medical students' academic performance. Academic performance of students in the classes of 2011 and 2012 (constant-grading classes) were collected and compared with performance of students in the class of 2013 (grading-change class) because the grading policy at UCSD SOM was changed for the class of 2013, from H/P/F during the first year (MS1) to P/F during the second year (MS2). For all students, data consisted of test scores from required preclinical courses from MS1 and MS2 years, and USMLE Step 1 scores. Linear regression analysis controlled for other factors that could be predictive of student performance (i.e., MCAT scores, undergraduate GPA, age, gender, etc.) in order to isolate the effect of the changed grading policy on academic performance. The change in grading policy in the MS2 year only, without any corresponding changes to the medical curriculum, presents a unique natural experiment with which to cleanly evaluate the effect of P/F grading on performance outcomes. After controlling for other factors, the grading policy change to P/F grading in the MS2 year had a negative impact on second-year grades relative to first-year grades (the constant-grading classes performed 1.65% points lower during their MS2 year compared to the MS1 year versus 3.25% points lower for the grading-change class, p < 0.0001), but had no observable impact on USMLE Step 1 scores. A change in grading from H/P/F grading to P/F grading was associated with decreased performance on preclinical examinations but no decrease in performance on the USMLE Step 1 examination. These results are discussed in the broader context of the multitude of factors that should be considered in assessing the merits of various grading systems, and ultimately the authors recommend the continuation of pass-fail grading at UCSD School of Medicine.

Surgical Apgar Score Predicts Post- Laparatomy Complications

African Journals Online (AJOL)

calculated Surgical Apgar Scores for 152 patients during a 6-month study ... major postoperative complications and/or death within. 30 days of ... respond to and control hemodynamic changes during a ... abdominal injury (18.42%). Intestinal ...

Ossification score is a better indicator of maturity related changes in eating quality than animal age.

Science.gov (United States)

Bonny, S P F; Pethick, D W; Legrand, I; Wierzbicki, J; Allen, P; Farmer, L J; Polkinghorne, R J; Hocquette, J-F; Gardner, G E

2016-04-01

Ossification score and animal age are both used as proxies for maturity-related collagen crosslinking and consequently decreases in beef tenderness. Ossification score is strongly influenced by the hormonal status of the animal and may therefore better reflect physiological maturity and consequently eating quality. As part of a broader cross-European study, local consumers scored 18 different muscle types cooked in three ways from 482 carcasses with ages ranging from 590 to 6135 days and ossification scores ranging from 110 to 590. The data were studied across three different maturity ranges; the complete range of maturities, a lesser range and a more mature range. The lesser maturity group consisted of carcasses having either an ossification score of 200 or less or an age of 987 days or less with the remainder in the greater maturity group. The three different maturity ranges were analysed separately with a linear mixed effects model. Across all the data, and for the greater maturity group, animal age had a greater magnitude of effect on eating quality than ossification score. This is likely due to a loss of sensitivity in mature carcasses where ossification approached and even reached the maximum value. In contrast, age had no relationship with eating quality for the lesser maturity group, leaving ossification score as the more appropriate measure. Therefore ossification score is more appropriate for most commercial beef carcasses, however it is inadequate for carcasses with greater maturity such as cull cows. Both measures may therefore be required in models to predict eating quality over populations with a wide range in maturity.

On court interpreters' visibility

DEFF Research Database (Denmark)

Dubslaff, Friedel; Martinsen, Bodil

of the service they receive. Ultimately, the findings will be used for training purposes. Future - and, for that matter, already practising - interpreters as well as the professional users of interpreters ought to take the reality of the interpreters' work in practice into account when assessing the quality...... on the interpreter's interpersonal role and, in particular, on signs of the interpreter's visibility, i.e. active co-participation. At first sight, the interpreting assignment in question seems to be a short and simple routine task which would not require the interpreter to deviate from the traditional picture...

A structured approach to control of Salmonella Dublin in 10 Danish dairy herds based on risk scoring and test-and-manage procedures

DEFF Research Database (Denmark)

Nielsen, Liza Rosenbaum; Nielsen, Søren Saxmose

2012-01-01

routes of infection; 4) interpretation of repeated testing of individual animals to detect high-risk animals for special hygienic management or culling; and 5) diagnostic testing of different age groups and bulk tank milk to evaluate progress of control over time. Serology, true prevalence estimates...... stock and adult cattle in 10 case herds that were followed for more than three years. The five steps in the structured approach were: 1) risk scoring to determine transmission routes within the herd and into the herd; 2) determining a plan of action; 3) performing management changes to close important...... and changes in herd classification in the Danish surveillance programme for Salmonella Dublin were used to assess the progress in the herds during and after the control period. Effective control of Salmonella Dublin was achieved in all participating herds through management that focused on closing infection...

Do Interpreters Indeed Have Superior Working Memory in Interpreting

Institute of Scientific and Technical Information of China (English)

于飞

2012-01-01

With the frequent communications between China and western countries in the field of economy,politics and culture,etc,Inter preting becomes more and more important to people in all walks of life.This paper aims to testify the author’s hypothesis "professional interpreters have similar short-term memory with unprofessional interpreters,but they have superior working memory." After the illustration of literatures concerning with consecutive interpreting,short-term memory and working memory,experiments are designed and analysis are described.

UNE INTERPRETATION DU TAUX DE CHANGE

Directory of Open Access Journals (Sweden)

Galina ULIAN

2015-03-01

Full Text Available Dans l’étude ci-dessous on a été réalisé une interprétation de l'impact des fluctuations des taux de change du leu moldave (MDL sur certaines variables économiques. La période considérée est Novembre-Décembre 2014 et le début de l'année 2015. Notamment au cours de cette période, le taux de la monnaie nationale par rapport aux principales devises de référence de change a commencé la voie de fortes dévaluations. Cette tendance, cependant, s’est placée dans le contexte des situations similaires dans la région, qui a ainsi permis sa dépréciation graduelle. Compte tenu que la dépréciation de la monnaie est un phénomène aux effets complexes et multilatérales, une fois arrivé dans un pays "X", celui-ci devrait, afin d'améliorer la situation, en premier lieu, augmenter leur présence sur d'autres marchés de ventes, plus stable et avec de plus grandes possibilités.

Genre and Interpretation

DEFF Research Database (Denmark)

Auken, Sune

2015-01-01

Despite the immensity of genre studies as well as studies in interpretation, our understanding of the relationship between genre and interpretation is sketchy at best. The article attempts to unravel some of intricacies of that relationship through an analysis of the generic interpretation carrie...

Aristotelian Presocratics A Look at Aristotle\\'s Interpretation of Presocratic Phiolosophers

Directory of Open Access Journals (Sweden)

Mehdi Qavam Safari

2015-03-01

Full Text Available Aristotle's understanding of Presocratic philosophers and his interpretation of their theses based on his own framework has always been a matter of dispute among scholars. His role of representing them as one of the main sources of Presocratic philosophy makes this is more. Here in this paper we try to investigate, analyzing Metaphysics, Physics and Generation and Destruction, how Aristotle interprets all the Presocratics in the same way and based on his own framework. He understands their arche as a simple element came out of nothing and constructing all other things and even considers it as substance while every other thing as accident which is obviously on the basis of his own distinction. He also interprets their change on the basis of his own distinction between change on the one hand and generation and destruction on the other that is itself based on the substance-accident distinction. All these show that he interprets them Aristotelian and this is what we should be aware of while we look at Presocratic philosophers through Aristotle.

Quantification of temporal changes in calcium score in active atherosclerotic plaque in major vessels by {sup 18}F-sodium fluoride PET/CT

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Ishiwata, Yoshinobu; Kaneta, Tomohiro; Nawata, Shintaro; Hino-Shishikura, Ayako; Yoshida, Keisuke; Inoue, Tomio [Yokohama City University, Graduate School of Medicine, Department of Radiology, Yokohama, Kanagawa (Japan)

2017-08-15

Our aim was to assess whether {sup 18}F-NaF PET/CT is able to predict progression of the CT calcium score. Between August 2007 and November 2015, 34 patients (18 women, 16 men; age, mean ± standard deviation, 57.5 ± 13.9 years; age range 19-78 years) with malignancy or orthopaedic disease were enrolled in this study, with approximately 1-year follow-up data. Baseline and follow-up CT images were retrospectively evaluated for the presence of calcification sites in major vessel walls. The maximum and mean CT values (CTmax and CTmean, in Hounsfield units), calcification volumetric score (CVS, in cubic millimetres) and Agatston units score (AU) were evaluated for each site. Subsequent changes in CTmax, CTmean, CVS and AU were calculated and expressed as ΔCTmax, ΔCTmean, ΔCVS and ΔAU, respectively. We then evaluated the relationship between {sup 18}F-NaF uptake (using the maximum target-to-background ratio, TBRmax, and the maximum blood-subtracted {sup 18}F-NaF activity, bsNaFmax, which was obtained by subtracting the SUVmax of each calcified plaque lesion and NaF-avid site from the SUVmean in the right atrium blood pool) and the change in calcified plaque volume and characteristics obtained after 1 year. We detected and analysed 182 calcified plaque sites and 96 hot spots on major vessel walls. {sup 18}F-NaF uptake showed very weak correlations with CTmax, CTmean, CVS, CVS after 1 year, AU and AU after 1 year on both baseline and follow-up PET/CT scans for each site. {sup 18}F-NaF uptake showed no correlation with ΔCTmax or ΔCTmean. However, there was a significant correlation between the intensity of {sup 18}F-NaF uptake and ΔCVS and ΔAU. {sup 18}F-NaF uptake has a strong correlation with calcium score progression which was a predictor of future cardiovascular disease risk. PET/CT using {sup 18}F-NaF may be able to predict calcium score progression which is known to be the major characteristic of atherosclerosis. (orig.)

Slit Lamp-Based Ocular Scoring Systems in Toxicology and Drug Development: A Literature Survey.

Science.gov (United States)

Eaton, Joshua Seth; Miller, Paul E; Bentley, Ellison; Thomasy, Sara M; Murphy, Christopher J

2017-12-01

To present a survey of the features of published slit lamp-based scoring systems and their applicability in the context of modern ocular toxicology and drug development. References describing original or modified slit lamp-based scoring systems for human or veterinary clinical patients or in investigative or toxicologic research were collected following a comprehensive literature review using textbooks and online publication searches. Each system's indications and features were compiled to facilitate comparison. Literature review identified 138 original or modified scoring systems. Most (48%) were published for evaluation of the ocular surface, 34% for the general anterior segment, and 18% for the lens. Most systems were described for assessment of human patients (50%) and small albino laboratory species such as rabbits (19%), rats (12%), and mice (8%). Systems described for pigmented laboratory species and for larger species such as dogs, cats, pigs, and nonhuman primates (NHPs) were comparatively underrepresented. No systems described a lens scoring scheme specific to the dog, cat, pig, or NHP. Scoring schemes for aqueous and vitreous cells were infrequently described for laboratory species. Many slit lamp-based scoring systems have been published, but the features of each differ and complicate translation of findings between different species. Use and interpretation of any scoring system in toxicology and drug development must be done with awareness of the limitations of the system being used.

Psychometric properties for the Balanced Inventory of Desirable Responding: dichotomous versus polytomous conventional and IRT scoring.

Science.gov (United States)

Vispoel, Walter P; Kim, Han Yi

2014-09-01

[Correction Notice: An Erratum for this article was reported in Vol 26(3) of Psychological Assessment (see record 2014-16017-001). The mean, standard deviation and alpha coefficient originally reported in Table 1 should be 74.317, 10.214 and .802, respectively. The validity coefficients in the last column of Table 4 are affected as well. Correcting this error did not change the substantive interpretations of the results, but did increase the mean, standard deviation, alpha coefficient, and validity coefficients reported for the Honesty subscale in the text and in Tables 1 and 4. The corrected versions of Tables 1 and Table 4 are shown in the erratum.] Item response theory (IRT) models were applied to dichotomous and polytomous scoring of the Self-Deceptive Enhancement and Impression Management subscales of the Balanced Inventory of Desirable Responding (Paulhus, 1991, 1999). Two dichotomous scoring methods reflecting exaggerated endorsement and exaggerated denial of socially desirable behaviors were examined. The 1- and 2-parameter logistic models (1PLM, 2PLM, respectively) were applied to dichotomous responses, and the partial credit model (PCM) and graded response model (GRM) were applied to polytomous responses. For both subscales, the 2PLM fit dichotomous responses better than did the 1PLM, and the GRM fit polytomous responses better than did the PCM. Polytomous GRM and raw scores for both subscales yielded higher test-retest and convergent validity coefficients than did PCM, 1PLM, 2PLM, and dichotomous raw scores. Information plots showed that the GRM provided consistently high measurement precision that was superior to that of all other IRT models over the full range of both construct continuums. Dichotomous scores reflecting exaggerated endorsement of socially desirable behaviors provided noticeably weak precision at low levels of the construct continuums, calling into question the use of such scores for detecting instances of "faking bad." Dichotomous

The Zhongshan Score

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Zhou, Lin; Guo, Jianming; Wang, Hang; Wang, Guomin

2015-01-01

Abstract In the zero ischemia era of nephron-sparing surgery (NSS), a new anatomic classification system (ACS) is needed to adjust to these new surgical techniques. We devised a novel and simple ACS, and compared it with the RENAL and PADUA scores to predict the risk of NSS outcomes. We retrospectively evaluated 789 patients who underwent NSS with available imaging between January 2007 and July 2014. Demographic and clinical data were assessed. The Zhongshan (ZS) score consisted of three parameters. RENAL, PADUA, and ZS scores are divided into three groups, that is, high, moderate, and low scores. For operative time (OT), significant differences were seen between any two groups of ZS score and PADUA score (all P RENAL showed no significant difference between moderate and high complexity in OT, WIT, estimated blood loss, and increase in SCr. Compared with patients with a low score of ZS, those with a high or moderate score had 8.1-fold or 3.3-fold higher risk of surgical complications, respectively (all P RENAL score, patients with a high or moderate score had 5.7-fold or 1.9-fold higher risk of surgical complications, respectively (all P RENAL and PADUA scores. ZS score could be used to reflect the surgical complexity and predict the risk of surgical complications in patients undergoing NSS. PMID:25654399

Primer on statistical interpretation or methods report card on propensity-score matching in the cardiology literature from 2004 to 2006: a systematic review.

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Austin, Peter C

2008-09-01

Propensity-score matching is frequently used in the cardiology literature. Recent systematic reviews have found that this method is, in general, poorly implemented in the medical literature. The study objective was to examine the quality of the implementation of propensity-score matching in the general cardiology literature. A total of 44 articles published in the American Heart Journal, the American Journal of Cardiology, Circulation, the European Heart Journal, Heart, the International Journal of Cardiology, and the Journal of the American College of Cardiology between January 1, 2004, and December 31, 2006, were examined. Twenty of the 44 studies did not provide adequate information on how the propensity-score-matched pairs were formed. Fourteen studies did not report whether matching on the propensity score balanced baseline characteristics between treated and untreated subjects in the matched sample. Only 4 studies explicitly used statistical methods appropriate for matched studies to compare baseline characteristics between treated and untreated subjects. Only 11 (25%) of the 44 studies explicitly used statistical methods appropriate for the analysis of matched data when estimating the effect of treatment on the outcomes. Only 2 studies described the matching method used, assessed balance in baseline covariates by appropriate methods, and used appropriate statistical methods to estimate the treatment effect and its significance. Application of propensity-score matching was poor in the cardiology literature. Suggestions for improving the reporting and analysis of studies that use propensity-score matching are provided.

Engineering Definitional Interpreters

DEFF Research Database (Denmark)

Midtgaard, Jan; Ramsay, Norman; Larsen, Bradford

2013-01-01

A definitional interpreter should be clear and easy to write, but it may run 4--10 times slower than a well-crafted bytecode interpreter. In a case study focused on implementation choices, we explore ways of making definitional interpreters faster without expending much programming effort. We imp...

What dementia reveals about proverb interpretation and its neuroanatomical correlates.

Science.gov (United States)

Kaiser, Natalie C; Lee, Grace J; Lu, Po H; Mather, Michelle J; Shapira, Jill; Jimenez, Elvira; Thompson, Paul M; Mendez, Mario F

2013-08-01

Neuropsychologists frequently include proverb interpretation as a measure of executive abilities. A concrete interpretation of proverbs, however, may reflect semantic impairments from anterior temporal lobes, rather than executive dysfunction from frontal lobes. The investigation of proverb interpretation among patients with different dementias with varying degrees of temporal and frontal dysfunction may clarify the underlying brain-behavior mechanisms for abstraction from proverbs. We propose that patients with behavioral variant frontotemporal dementia (bvFTD), who are characteristically more impaired on proverb interpretation than those with Alzheimer's disease (AD), are disproportionately impaired because of anterior temporal-mediated semantic deficits. Eleven patients with bvFTD and 10 with AD completed the Delis-Kaplan Executive Function System (D-KEFS) Proverbs Test and a series of neuropsychological measures of executive and semantic functions. The analysis included both raw and age-adjusted normed data for multiple choice responses on the D-KEFS Proverbs Test using independent samples t-tests. Tensor-based morphometry (TBM) applied to 3D T1-weighted MRI scans mapped the association between regional brain volume and proverb performance. Computations of mean Jacobian values within select regions of interest provided a numeric summary of regional volume, and voxel-wise regression yielded 3D statistical maps of the association between tissue volume and proverb scores. The patients with bvFTD were significantly worse than those with AD in proverb interpretation. The worse performance of the bvFTD patients involved a greater number of concrete responses to common, familiar proverbs, but not to uncommon, unfamiliar ones. These concrete responses to common proverbs correlated with semantic measures, whereas concrete responses to uncommon proverbs correlated with executive functions. After controlling for dementia diagnosis, TBM analyses indicated significant

Re-Scoring the Game’s Score

DEFF Research Database (Denmark)

Gasselseder, Hans-Peter

2014-01-01

This study explores immersive presence as well as emotional valence and arousal in the context of dynamic and non-dynamic music scores in the 3rd person action-adventure video game genre while also considering relevant personality traits of the player. 60 subjects answered self-report questionnai......This study explores immersive presence as well as emotional valence and arousal in the context of dynamic and non-dynamic music scores in the 3rd person action-adventure video game genre while also considering relevant personality traits of the player. 60 subjects answered self......-temporal alignment in the resulting emotional congruency of nondiegetic music. Whereas imaginary aspects of immersive presence are systemically affected by the presentation of dynamic music, sensory spatial aspects show higher sensitivity towards the arousal potential of the music score. It is argued...

Social Interpretation Bias in Children and Adolescents with Anxiety Disorders: Psychometric Examination of the Self-report of Ambiguous Social Situations for Youth (SASSY) Scale.

Science.gov (United States)

Gonzalez, Araceli; Rozenman, Michelle; Langley, Audra K; Kendall, Philip C; Ginsburg, Golda S; Compton, Scott; Walkup, John T; Birmaher, Boris; Albano, Anne Marie; Piacentini, John

2017-06-01

Anxiety disorders are among the most common mental health problems in youth, and faulty interpretation bias has been positively linked to anxiety severity, even within anxiety-disordered youth. Quick, reliable assessment of interpretation bias may be useful in identifying youth with certain types of anxiety or assessing changes on cognitive bias during intervention. This study examined the factor structure, reliability, and validity of the Self-report of Ambiguous Social Situations for Youth (SASSY) scale, a self-report measure developed to assess interpretation bias in youth. Participants (N=488, age 7 to 17) met diagnostic criteria for Social Phobia, Generalized Anxiety Disorder, and/or Separation Anxiety Disorder. An exploratory factor analysis was performed on baseline data from youth participating in a large randomized clinical trial. Exploratory factor analysis yielded two factors (Accusation/Blame, Social Rejection). The SASSY full scale and Social Rejection factor demonstrated adequate internal consistency, convergent validity with social anxiety, and discriminant validity as evidenced by non-significant correlations with measures of non-social anxiety. Further, the SASSY Social Rejection factor accurately distinguished children and adolescents with Social Phobia from those with other anxiety disorders, supporting its criterion validity, and revealed sensitivity to changes with treatment. Given the relevance to youth with social phobia, pre- and post-intervention data were examined for youth social phobia to test sensitivity to treatment effects; results suggested that SASSY scores reduced for treatment responders. Findings suggest the potential utility of the SASSY Social Rejection factor as a quick, reliable, and efficient way of assessing interpretation bias in anxious youth, particularly as related to social concerns, in research and clinical settings.

Distribution of coronary calcium score in healthy middle-aged Korean

International Nuclear Information System (INIS)

Choe, Kyu Ok; Kim, Min Jung; Choi, Byoung Wook; Kim, Jung Ho; Noh, Ki Suh; Kim, Si Yon; Ko, Heung Kyu; Suh, Il

1999-01-01

To determine the prevalence and degree of CAC (coronary artery calcification) in appearently healthy middle-aged Koreans, and the relation of CAC to risk factors for atherosclerosis. A total of 289 apparently healthy personnel at Yonsei University (male: 170, female:119, age: mean(SD=54.9±7.1 years) underwent EBT (electron bean tomography). The risk factors for athero-sclerosis, which included diabetes mellitus, hypertension, smoking, a family history of precocious onset, obesity, hyperlipidemia, and high intraperitoneal fat, were scrutinized. One hundred and sixty-eight subjects (58%) had at least one risk factor. The CAC score was calculated for all subjects and for each coronary artery separately and was then analyzed by age and sex and in relation to the risk factors. The prevalence of CAC was 40% in men and 18.5% in women (mean score:29.7 vs. 9.9). The number of individuals who had one, two, or more than two risk factors was 141,41, and 19, respectively. The number of risk factors and the prevalence and score of CAC were significantly correlated (p=0.01, 0.02 respectively). The number of individuals with no risk factor, with without CAC, was 58(20.1%) and 103(35.6%), respectively, while the number with some risk factor, with or without CAC, was 38(13.1%) and 90(31.1%), respectively. The CAC score was significantly higher in the presence of hypertension, low HDL, or obesity(p=0.001, 0.049, and 0.068, respectively). Smoking appeared to have a borderline effect on the calcium score(p=0.118). This study should provide useful information for interpreting CAC scores and establishing a treatment strategy for Koreans. The comparison of our results with other studies will enable a better understanding of the process and risk factors of atherosclerosis in Koreans

Distribution of coronary calcium score in healthy middle-aged Korean

Energy Technology Data Exchange (ETDEWEB)

Choe, Kyu Ok; Kim, Min Jung; Choi, Byoung Wook; Kim, Jung Ho; Noh, Ki Suh; Kim, Si Yon; Ko, Heung Kyu; Suh, Il [Yonsei Univ. College of Medicine, Seoul (Korea, Republic of)

1999-11-01

To determine the prevalence and degree of CAC (coronary artery calcification) in appearently healthy middle-aged Koreans, and the relation of CAC to risk factors for atherosclerosis. A total of 289 apparently healthy personnel at Yonsei University (male: 170, female:119, age: mean(SD=54.9{+-}7.1 years)) underwent EBT (electron bean tomography). The risk factors for athero-sclerosis, which included diabetes mellitus, hypertension, smoking, a family history of precocious onset, obesity, hyperlipidemia, and high intraperitoneal fat, were scrutinized. One hundred and sixty-eight subjects (58%) had at least one risk factor. The CAC score was calculated for all subjects and for each coronary artery separately and was then analyzed by age and sex and in relation to the risk factors. The prevalence of CAC was 40% in men and 18.5% in women (mean score:29.7 vs. 9.9). The number of individuals who had one, two, or more than two risk factors was 141,41, and 19, respectively. The number of risk factors and the prevalence and score of CAC were significantly correlated (p=0.01, 0.02 respectively). The number of individuals with no risk factor, with without CAC, was 58(20.1%) and 103(35.6%), respectively, while the number with some risk factor, with or without CAC, was 38(13.1%) and 90(31.1%), respectively. The CAC score was significantly higher in the presence of hypertension, low HDL, or obesity(p=0.001, 0.049, and 0.068, respectively). Smoking appeared to have a borderline effect on the calcium score(p=0.118). This study should provide useful information for interpreting CAC scores and establishing a treatment strategy for Koreans. The comparison of our results with other studies will enable a better understanding of the process and risk factors of atherosclerosis in Koreans.

Risk scoring for the primary prevention of cardiovascular disease.

Science.gov (United States)

Karmali, Kunal N; Persell, Stephen D; Perel, Pablo; Lloyd-Jones, Donald M; Berendsen, Mark A; Huffman, Mark D

2017-03-14

The current paradigm for cardiovascular disease (CVD) emphasises absolute risk assessment to guide treatment decisions in primary prevention. Although the derivation and validation of multivariable risk assessment tools, or CVD risk scores, have attracted considerable attention, their effect on clinical outcomes is uncertain. To assess the effects of evaluating and providing CVD risk scores in adults without prevalent CVD on cardiovascular outcomes, risk factor levels, preventive medication prescribing, and health behaviours. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) in the Cochrane Library (2016, Issue 2), MEDLINE Ovid (1946 to March week 1 2016), Embase (embase.com) (1974 to 15 March 2016), and Conference Proceedings Citation Index-Science (CPCI-S) (1990 to 15 March 2016). We imposed no language restrictions. We searched clinical trial registers in March 2016 and handsearched reference lists of primary studies to identify additional reports. We included randomised and quasi-randomised trials comparing the systematic provision of CVD risk scores by a clinician, healthcare professional, or healthcare system compared with usual care (i.e. no systematic provision of CVD risk scores) in adults without CVD. Three review authors independently selected studies, extracted data, and evaluated study quality. We used the Cochrane 'Risk of bias' tool to assess study limitations. The primary outcomes were: CVD events, change in CVD risk factor levels (total cholesterol, systolic blood pressure, and multivariable CVD risk), and adverse events. Secondary outcomes included: lipid-lowering and antihypertensive medication prescribing in higher-risk people. We calculated risk ratios (RR) for dichotomous data and mean differences (MD) or standardised mean differences (SMD) for continuous data using 95% confidence intervals. We used a fixed-effects model when heterogeneity (I²) was at least 50% and a random-effects model for substantial heterogeneity

Interpretation of the FGF8 morphogen gradient is regulated by endocytic trafficking.

Science.gov (United States)

Nowak, Matthias; Machate, Anja; Yu, Shuizi Rachel; Gupta, Mansi; Brand, Michael

2011-02-01

Forty years ago, it was proposed that during embryonic development and organogenesis, morphogen gradients provide positional information to the individual cells within a tissue leading to specific fate decisions. Recently, much insight has been gained into how such morphogen gradients are formed and maintained; however, which cellular mechanisms govern their interpretation within target tissues remains debated. Here we used in vivo fluorescence correlation spectroscopy and automated image analysis to assess the role of endocytic sorting dynamics on fibroblast growth factor 8 (Fgf8) morphogen gradient interpretation. By interfering with the function of the ubiquitin ligase Cbl, we found an expanded range of Fgf target gene expression and a delay of Fgf8 lysosomal transport. However, the extracellular Fgf8 morphogen gradient remained unchanged, indicating that the observed signalling changes are due to altered gradient interpretation. We propose that regulation of morphogen signalling activity through endocytic sorting allows fast feedback-induced changes in gradient interpretation during the establishment of complex patterns.

Assessment of reliability, validity, responsiveness and minimally important change of the German Hip dysfunction and osteoarthritis outcome score (HOOS) in patients with osteoarthritis of the hip.

Science.gov (United States)

Arbab, Dariusch; van Ochten, Johannes H M; Schnurr, Christoph; Bouillon, Bertil; König, Dietmar

2017-12-01

Patient-reported outcome measures are a critical tool in evaluating the efficacy of orthopedic procedures. The intention of this study was to evaluate reliability, validity, responsiveness and minimally important change of the German version of the Hip dysfunction and osteoarthritis outcome score (HOOS). The German HOOS was investigated in 251 consecutive patients before and 6 months after total hip arthroplasty. All patients completed HOOS, Oxford-Hip Score, Short-Form (SF-36) and numeric scales for pain and disability. Test-retest reliability, internal consistency, floor and ceiling effects, construct validity and minimal important change were analyzed. The German HOOS demonstrated excellent test-retest reliability with intraclass correlation coefficient values > 0.7. Cronbach´s alpha values demonstrated strong internal consistency. As hypothesized, HOOS subscales strongly correlated with corresponding OHS and SF-36 domains. All subscales showed excellent (effect size/standardized response means > 0.8) responsiveness between preoperative assessment and postoperative follow-up. The HOOS and all subdomains showed higher changes than the minimal detectable change which indicates true changes. The German version of the HOOS demonstrated good psychometric properties. It proved to be valid, reliable and responsive to the changes instrument for use in patients with hip osteoarthritis undergoing total hip replacement.

Mandatory early warning scoring-implementation evaluated with a mixed-methods approach

DEFF Research Database (Denmark)

Bunkenborg, Gitte; Poulsen, Ingrid; Samuelson, Karin

2016-01-01

to such interventions is required to correctly interpret interventional outcome. METHOD: Adherence was evaluated with a mixed-methods approach. Quantitative data, obtained pre-interventionally (2009) and postinterventionally (2010 and 2011), were used to calculate and compare time intervals between scorings of vital...... modified EWS levels of 0, 2 or 4. The theme Motivation by clinical relevance and meaningfulness was identified as crucial to the implementation process. CONCLUSION: High adherence to an intervention may be strongly related to nurses' perceived clinical relevance of the intervention....

Electromagnetic SAMPO monitoring soundings at OLKILUOTO in 2012 with updated interpretations

International Nuclear Information System (INIS)

Korhonen, K.

2013-11-01

The Geological Survey of Finland (GTK) has carried out electromagnetic depth soundings annually at fixed stations at Olkiluoto since 2004 as part of a monitoring programme. The goal of the programme is to detect and monitor changes in the electrical properties of the bedrock above and in the vicinity of the ONKALO tunnel which will serve as a part of the future underground nuclear waste disposal facility. A new Sampo monitoring survey was carried out during October 2012. The survey plan of 2011 was slightly modified and 36 soundings at 16 measurement stations were carried out. The nominal coil separations of 200, 400, 500, 600 and 800 meters were used. Interpretations at eight selected stations were updated with the new data. The interpretations indicate consistent statistically significant changes. Annual increases in resistivity were detected at stations to the East of ONKALO while annual decreases in resistivity were detected to the West of ONKALO. However, these changes need to be considered keeping in mind the high degree of uncertainty associated with the data and their interpretations. (orig.)

Elecromagnetic Sampo monitoring soundings at Olkiluoto in 2013 with updated interpretations

International Nuclear Information System (INIS)

Korhonen, K.

2014-10-01

The Geological Survey of Finland (GTK) has carried out electromagnetic depth soundings annually at fixed stations in Olkiluoto since 2004 as part of a monitoring program. The goal of the monitoring program is to detect and monitor changes in the electrical properties of the bedrock in the vicinity of the ONKALO underground research facility which will constitute a part of the final nuclear waste repository. A new Sampo monitoring survey was carried out by GTK in October 2013. The survey consists of 37 soundings performed at 17 measurement stations. The nominal coil separations of 200, 400, 500, 600 and 800 metres were used depending on the station. Layer-model interpretations of soundings at eight selected stations were updated with the new data. The interpretations indicate consistent annual changes. Resistivities be-low stations to the East of the ONKALO facility appear to increase annually. In contrast, resistivities below stations to the West of the ONKALO facility appear to decrease annually. However, these changes need to be considered keeping in mind the uncertainties associated with the data and their interpretations. (orig.)

Directionality effects in simultaneous language interpreting: the case of sign language interpreters in The Netherlands.

Science.gov (United States)

Van Dijk, Rick; Boers, Eveline; Christoffels, Ingrid; Hermans, Daan

2011-01-01

The quality of interpretations produced by sign language interpreters was investigated. Twenty-five experienced interpreters were instructed to interpret narratives from (a) spoken Dutch to Sign Language of The Netherlands (SLN), (b) spoken Dutch to Sign Supported Dutch (SSD), and (c) SLN to spoken Dutch. The quality of the interpreted narratives was assessed by 5 certified sign language interpreters who did not participate in the study. Two measures were used to assess interpreting quality: the propositional accuracy of the interpreters' interpretations and a subjective quality measure. The results showed that the interpreted narratives in the SLN-to-Dutch interpreting direction were of lower quality (on both measures) than the interpreted narratives in the Dutch-to-SLN and Dutch-to-SSD directions. Furthermore, interpreters who had begun acquiring SLN when they entered the interpreter training program performed as well in all 3 interpreting directions as interpreters who had acquired SLN from birth.

INTERPRETER TRAINING CURRICULUM IN TURKEY: THE CASE OF SAKARYA UNIVERSITY

Directory of Open Access Journals (Sweden)

Sibel OKUYAN

2017-04-01

Full Text Available In our globalizing and rapidly changing world thanks to the communication technologies, Turkey has a significant strategic position in terms of socio-cultural and economical aspects. Therefore, Turkey has a different commercial and political relationship with many countries comprising various cultures and languages. In order to maintain these relations healthfully, interpreting is of utmost importance. Turkey’s membership application for EU shows that Turkey is now an important political power. Besides, commercial contacts with other countries are on the rise and foreign people pay a visit to our country for health tourism. On the other hand, conflicts in neighboring countries increase. All of these factors raise the demand for interpreting in Turkey. In this respect, considering aforementioned explanations we believe that contents of the interpreting courses in academic translation institutions must be refreshed and updated, while doing so, market conditions must also be taken into account. This study deals with interpreting courses offered at Sakarya University taking the above-mentioned suggestions into consideration. In this study, we aim to evaluate interpreting courses in terms of the developments in academic interpreter training and interpreting profession. Hence, curricula of Translation & Interpreting (Studies Departments were compared to each other and the findings are discussed.

College Math Assessment: SAT Scores vs. College Math Placement Scores

Science.gov (United States)

Foley-Peres, Kathleen; Poirier, Dawn

2008-01-01

Many colleges and university's use SAT math scores or math placement tests to place students in the appropriate math course. This study compares the use of math placement scores and SAT scores for 188 freshman students. The student's grades and faculty observations were analyzed to determine if the SAT scores and/or college math assessment scores…

Constellation Map: Downstream visualization and interpretation of gene set enrichment results [version 1; referees: 2 approved

Directory of Open Access Journals (Sweden)

Yan Tan

2015-06-01

Full Text Available Summary: Gene set enrichment analysis (GSEA approaches are widely used to identify coordinately regulated genes associated with phenotypes of interest. Here, we present Constellation Map, a tool to visualize and interpret the results when enrichment analyses yield a long list of significantly enriched gene sets. Constellation Map identifies commonalities that explain the enrichment of multiple top-scoring gene sets and maps the relationships between them. Constellation Map can help investigators take full advantage of GSEA and facilitates the biological interpretation of enrichment results. Availability: Constellation Map is freely available as a GenePattern module at http://www.genepattern.org.

Overcoming Language Barriers in Health Care: Costs and Benefits of Interpreter Services

Science.gov (United States)

Jacobs, Elizabeth A.; Shepard, Donald S.; Suaya, Jose A.; Stone, Esta-Lee

2004-01-01

Objectives. We assessed the impact of interpreter services on the cost and the utilization of health care services among patients with limited English proficiency. Methods. We measured the change in delivery and cost of care provided to patients enrolled in a health maintenance organization before and after interpreter services were implemented. Results. Compared with English-speaking patients, patients who used the interpreter services received significantly more recommended preventive services, made more office visits, and had more prescriptions written and filled. The estimated cost of providing interpreter services was $279 per person per year. Conclusions. Providing interpreter services is a financially viable method for enhancing delivery of health care to patients with limited English proficiency. PMID:15117713

Agreement among graders on Heidelberg retina tomograph (HRT) topographic change analysis (TCA) glaucoma progression interpretation.

Science.gov (United States)

Iester, Michele M; Wollstein, Gadi; Bilonick, Richard A; Xu, Juan; Ishikawa, Hiroshi; Kagemann, Larry; Schuman, Joel S

2015-04-01

To evaluate agreement among experts of Heidelberg retina tomography's (HRT) topographic change analysis (TCA) printout interpretations of glaucoma progression and explore methods for improving agreement. 109 eyes of glaucoma, glaucoma suspect and healthy subjects with ≥5 visits and 2 good quality HRT scans acquired at each visit were enrolled. TCA printouts were graded as progression or non-progression. Each grader was presented with 2 sets of tests: a randomly selected single test from each visit and both tests from each visit. Furthermore, the TCA printouts were classified with grader's individual criteria and with predefined criteria (reproducible changes within the optic nerve head, disregarding changes along blood vessels or at steep rim locations and signs of image distortion). Agreement among graders was modelled using common latent factor measurement error structural equation models for ordinal data. Assessment of two scans per visit without using the predefined criteria reduced overall agreement, as indicated by a reduction in the slope, reflecting the correlation with the common factor, for all graders with no effect on reducing the range of the intercepts between the graders. Using the predefined criteria improved grader agreement, as indicated by the narrower range of intercepts among the graders compared with assessment using individual grader's criteria. A simple set of predefined common criteria improves agreement between graders in assessing TCA progression. The inclusion of additional scans from each visit does not improve the agreement. We, therefore, recommend setting standardised criteria for TCA progression evaluation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Therapeutic intervention scoring system-28 (TISS-28: diretrizes para aplicação Therapeutic intervention scoring system-28 (tiss-28: directrices para su aplicación Therapeutic intervention scoring system-28 (tiss-28: directions for application

Directory of Open Access Journals (Sweden)

Katia Grillo Padilha

2005-06-01

Full Text Available O Therapeutic Intervention Scoring System-28 (TISS-28 é um instrumento que permite dimensionar carga de trabalho de enfermagem em Unidade de Terapia Intensiva e estimar gravidade da doença. Apresenta-se nesta publicação as definições operacionais para sua aplicação, proposta por um grupo de especialistas na área, com vistas a uniformizar o significado de cada um dos itens e evitar vieses de interpretação.El Therapeutic Intervention Scoring System-28 (TISS-28 es un instrumento que permite dimensionar carga de trabajo de enfermería en una Unidad de Terapia Intensiva y estimar la gravedad de la enfermedad. Se presenta en esta publicación las definiciones operacionales para su aplicación, propuesta por un grupo de especialistas en el área, con vistas a uniformizar el significado de cada uno de los items y evitar sesgos de interpretación.Therapeutic Intervention Scoring System-28 (TISS-28 is a tool that enables the measurement of the nursing work load in Intensive Care Units and the estimate of how grave the disease is. In this study are presented the operational definitions for its application, proposed by a group of specialists in the area, with the aim of rendering uniform the meaning of each of the items and preventing interpretation biases.

Influences of Radiology Trainees on Screening Mammography Interpretation.

Science.gov (United States)

Hawley, Jeffrey R; Taylor, Clayton R; Cubbison, Alyssa M; Erdal, B Selnur; Yildiz, Vedat O; Carkaci, Selin

2016-05-01

Participation of radiology trainees in screening mammographic interpretation is a critical component of radiology residency and fellowship training. The aim of this study was to investigate and quantify the effects of trainee involvement on screening mammographic interpretation and diagnostic outcomes. Screening mammograms interpreted at an academic medical center by six dedicated breast imagers over a three-year period were identified, with cases interpreted by an attending radiologist alone or in conjunction with a trainee. Trainees included radiology residents, breast imaging fellows, and fellows from other radiology subspecialties during breast imaging rotations. Trainee participation, patient variables, results of diagnostic evaluations, and pathology were recorded. A total of 47,914 mammograms from 34,867 patients were included, with an overall recall rate for attending radiologists reading alone of 14.7% compared with 18.0% when involving a trainee (P radiology trainees, with no change in cancer detection rate. Radiology faculty members should be aware of this potentiality and mitigate tendencies toward greater false positives. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Diffusion-weighted MRI to assess response to chemoradiotherapy in rectal cancer: main interpretation pitfalls and their use for teaching

International Nuclear Information System (INIS)

Lambregts, Doenja M.J.; Lahaye, Max J.; Maas, Monique; Heeswijk, Miriam M. van; Delli Pizzi, Andrea; Elderen, Saskia G.C. van; Andrade, Luisa; Peters, Nicky H.G.M.; Osinga-de Jong, Margreet; Kint, Peter A.M.; Bipat, Shandra; Ooms, Rik; Beets, Geerard L.; Bakers, Frans C.H.; Beets-Tan, Regina G.H.

2017-01-01

To establish the most common image interpretation pitfalls for non-expert readers using diffusion-weighted imaging (DWI) to assess response to chemoradiotherapy in patients with rectal cancer and to explore the use of these pitfalls in an expert teaching setting. Two independent non-expert readers (R1 and R2) scored the restaging DW MRI scans (b1,000 DWI, in conjunction with ADC maps and T2-W MRI scans for anatomical reference) in 100 patients for the likelihood of a complete response versus residual tumour using a five-point confidence score. The readers received expert feedback and the final response outcome for each case. The supervising expert documented any potential interpretation errors/pitfalls discussed for each case to identify the most common pitfalls. The most common pitfalls were the interpretation of low signal on the ADC map, small susceptibility artefacts, T2 shine-through effects, suboptimal sequence angulation and collapsed rectal wall. Diagnostic performance (area under the ROC curve) was 0.78 (R1) and 0.77 (R2) in the first 50 patients and 0.85 (R1) and 0.85 (R2) in the final 50 patients. Five main image interpretation pitfalls were identified and used for teaching and feedback. Both readers achieved a good diagnostic performance with an AUC of 0.85. (orig.)

Emergency CT brain: preliminary interpretation with a tablet device: image quality and diagnostic performance of the Apple iPad.

LENUS (Irish Health Repository)

Mc Laughlin, Patrick

2012-04-01

Tablet devices have recently been used in radiological image interpretation because they have a display resolution comparable to desktop LCD monitors. We identified a need to examine tablet display performance prior to their use in preliminary interpretation of radiological images. We compared the spatial and contrast resolution of a commercially available tablet display with a diagnostic grade 2 megapixel monochrome LCD using a contrast detail phantom. We also recorded reporting discrepancies, using the ACR RADPEER system, between preliminary interpretation of 100 emergency CT brain examinations on the tablet display and formal review on a diagnostic LCD. The iPad display performed inferiorly to the diagnostic monochrome display without the ability to zoom. When the software zoom function was enabled on the tablet device, comparable contrast detail phantom scores of 163 vs 165 points were achieved. No reporting discrepancies were encountered during the interpretation of 43 normal examinations and five cases of acute intracranial hemorrhage. There were seven RADPEER2 (understandable) misses when using the iPad display and 12 with the diagnostic LCD. Use of software zoom in the tablet device improved its contrast detail phantom score. The tablet allowed satisfactory identification of acute CT brain findings, but additional research will be required to examine the cause of "understandable" reporting discrepancies that occur when using tablet devices.

Diffusion-weighted MRI to assess response to chemoradiotherapy in rectal cancer: main interpretation pitfalls and their use for teaching

Energy Technology Data Exchange (ETDEWEB)

Lambregts, Doenja M.J.; Lahaye, Max J.; Maas, Monique [The Netherlands Cancer Institute, Department of Radiology, Amsterdam (Netherlands); Heeswijk, Miriam M. van [The Netherlands Cancer Institute, Department of Radiology, Amsterdam (Netherlands); Maastricht University Medical Centre, Department of Radiology, Maastricht (Netherlands); Maastricht University Medical Centre, Department of Surgery, Maastricht (Netherlands); Maastricht University, GROW School for Oncology and Developmental Biology, Maastricht (Netherlands); Delli Pizzi, Andrea [Gabriele d' Annunzio University, SS. Annunziate Hospital, Department of Neuroscience and Imaging, Chieti (Italy); Elderen, Saskia G.C. van [Leiden University Medical Centre, Department of Radiology, Leiden (Netherlands); Andrade, Luisa [Hospitais da Universidade de Coimbra, Department of Radiology, Coimbra (Portugal); Peters, Nicky H.G.M.; Osinga-de Jong, Margreet [Zuyderland Medical Center, location Heerlen, Heerlen (Netherlands); Kint, Peter A.M. [Amphia Hospital, Department of Radiology, Breda (Netherlands); Bipat, Shandra [Academic Medical Centre, Department of Radiology, Amsterdam (Netherlands); Ooms, Rik [Maxima Medical Centre, Department of Radiology, Eindhoven-Veldhoven (Netherlands); Beets, Geerard L. [The Netherlands Cancer Institute, Department of Surgery, Amsterdam (Netherlands); Maastricht University, GROW School for Oncology and Developmental Biology, Maastricht (Netherlands); Bakers, Frans C.H. [Maastricht University Medical Centre, Department of Radiology, Maastricht (Netherlands); Beets-Tan, Regina G.H. [The Netherlands Cancer Institute, Department of Radiology, Amsterdam (Netherlands); Maastricht University, GROW School for Oncology and Developmental Biology, Maastricht (Netherlands)

2017-10-15

To establish the most common image interpretation pitfalls for non-expert readers using diffusion-weighted imaging (DWI) to assess response to chemoradiotherapy in patients with rectal cancer and to explore the use of these pitfalls in an expert teaching setting. Two independent non-expert readers (R1 and R2) scored the restaging DW MRI scans (b1,000 DWI, in conjunction with ADC maps and T2-W MRI scans for anatomical reference) in 100 patients for the likelihood of a complete response versus residual tumour using a five-point confidence score. The readers received expert feedback and the final response outcome for each case. The supervising expert documented any potential interpretation errors/pitfalls discussed for each case to identify the most common pitfalls. The most common pitfalls were the interpretation of low signal on the ADC map, small susceptibility artefacts, T2 shine-through effects, suboptimal sequence angulation and collapsed rectal wall. Diagnostic performance (area under the ROC curve) was 0.78 (R1) and 0.77 (R2) in the first 50 patients and 0.85 (R1) and 0.85 (R2) in the final 50 patients. Five main image interpretation pitfalls were identified and used for teaching and feedback. Both readers achieved a good diagnostic performance with an AUC of 0.85. (orig.)

Scoring sacroiliac joints by magnetic resonance imaging. A Multiple-reader reliability experiment

DEFF Research Database (Denmark)

Landewé, RB; Hermann, KG; van der Heijde, DM

2005-01-01

Magnetic resonance imaging (MRI) of the sacroiliac (SI) joints and the spine is increasingly important in the assessment of inflammatory activity and structural damage in clinical trials with patients with ankylosing spondylitis (AS). We investigated inter-reader reliability and sensitivity...... for 'depth' and 'intensity,' and the fifth method included the SPARCC slice with the maximum score. Inter-reader reliability was investigated by calculating intraclass correlation coefficients (ICC) for all readers together and for all possible reader pairs. Sensitivity to change was investigated...... values close to zero (no agreement) and highest observed values over 0.80 (excellent agreement). In general, agreement of status scores was somewhat better than agreement of change scores, and agreement of the comprehensive SPARCC scoring system was somewhat better than agreement of the more condensed...

MRI assessment of knee osteoarthritis: Knee Osteoarthritis Scoring System (KOSS) - inter-observer and intra-observer reproducibility of a compartment-based scoring system

International Nuclear Information System (INIS)

Kornaat, Peter R.; Ceulemans, Ruth Y.T.; Kroon, Herman M.; Bloem, Johan L.; Riyazi, Naghmeh; Kloppenburg, Margreet; Carter, Wayne O.; Woodworth, Thasia G.

2005-01-01

To develop a scoring system for quantifying osteoarthritic changes of the knee as identified by magnetic resonance (MR) imaging, and to determine its inter- and intra-observer reproducibility, in order to monitor medical therapy in research studies. Two independent observers evaluated 25 consecutive MR examinations of the knee in patients with previously defined clinical symptoms and radiological signs of osteoarthritis. We acquired on a 1.5 T system: coronal and sagittal proton density- and T2-weighted dual spin echo (SE) images, sagittal three-dimensional T1-weighted gradient echo (GE) images with fat suppression, and axial dual turbo SE images with fat suppression. Images were scored for the presence of cartilaginous lesions, osteophytes, subchondral cysts, bone marrow edema, and for meniscal abnormalities. Presence and size of effusion, synovitis and Baker's cyst were recorded. All parameters were ranked on a previously defined, semiquantitative scale, reflecting increasing severity of findings. Kappa, weighted kappa and intraclass correlation coefficient (ICC) were used to determine inter- and intra-observer variability. Inter-observer reproducibility was good (ICC value 0.77). Inter- and intra-observer reproducibility for individual parameters was good to very good (inter-observer ICC value 0.63-0.91; intra-observer ICC value 0.76-0.96). The presented comprehensive MR scoring system for osteoarthritic changes of the knee has a good to very good inter-observer and intra-observer reproducibility. Thus the score form with its definitions can be used for standardized assessment of osteoarthritic changes to monitor medical therapy in research studies. (orig.)

Preoperative differentiation between T1a and ≥T1b gallbladder cancer: combined interpretation of high-resolution ultrasound and multidetector-row computed tomography

International Nuclear Information System (INIS)

Joo, Ijin; Baek, Jee Hyun; Kim, Jung Hoon; Han, Joon Koo; Choi, Byung Ihn; Lee, Jae Young; Park, Hee Sun

2014-01-01

To determine the diagnostic value of combined interpretation of high-resolution ultrasound (HRUS) and multidetector-row computed tomography (MDCT) for preoperative differentiation between T1a and ≥T1b gallbladder (GB) cancer. Eighty-seven patients with pathologically confirmed GB cancers (T1a, n = 15; ≥T1b, n = 72), who preoperatively underwent both HRUS and MDCT, were included in this retrospective study. Two reviewers independently determined the T-stages of the GB cancers on HRUS and MDCT using a five-point confidence scale (5, definitely T1a; 1, definitely ≥T1b). For individual modality interpretation, the lesions with scores ≥4 were classified as T1a, and, for combined modality interpretation, the lesions with all scores ≥4 in both modalities were classified as T1a. The McNemar test was used to compare diagnostic performance. The diagnostic accuracy of differentiation between T1a and ≥T1b GB cancer was higher using combined interpretation (90.8 % and 88.5 % for reviewers 1 and 2, respectively) than individual interpretation of HRUS (82.8 % and 83.9 %) or MDCT (74.7 % and 82.8 %) (P < 0.05, reviewer 1). Combined interpretations demonstrated 100 % specificity for both reviewers, which was significantly higher than individual interpretations (P < 0.05, both reviewers). Combined HRUS and MDCT interpretation may improve the diagnostic accuracy and specificity for differentiating between T1a and ≥T1b GB cancers. circle Differentiating between T1a and ≥T1b gallbladder cancer can help surgical planning. (orig.)

Analysis of theories and interpretative criteria in fiscal or tax provisions

Directory of Open Access Journals (Sweden)

María Angélica Nava-Rodríguez

2010-06-01

Full Text Available This article focuses on the subject of the interpretation of Tax law, as it constitutes one of the fundamental legal problems in the area. The basic aim of tax law is to regulate the form by which taxpayers contribute to the public expense of the State within the limits established by the Constitution. This interpretation presents special characteristics because it regulates the relations between the government and tax payers and contains special arrangements in dealing between them in terms of accounting, economics and finance. Because tax liability changes frequently, it is difficult to control the large number of daily specific situations that occur, therefore, the interpreter must determine whether the conduct that creates an obligation falls within the tax provision. The article studies the schools of interpretation, the methods that are located in each of the categories and the criteria of doctrinal interpretation of tax laws, also the interpretation according to the federal tax law.

Reproducibility of scoring emphysema by HRCT

International Nuclear Information System (INIS)

Malinen, A.; Partanen, K.; Rytkoenen, H.; Vanninen, R.; Erkinjuntti-Pekkanen, R.

2002-01-01

Purpose: We evaluated the reproducibility of three visual scoring methods of emphysema and compared these methods with pulmonary function tests (VC, DLCO, FEV1 and FEV%) among farmer's lung patients and farmers. Material and Methods: Three radiologists examined high-resolution CT images of farmer's lung patients and their matched controls (n=70) for chronic interstitial lung diseases. Intraobserver reproducibility and interobserver variability were assessed for three methods: severity, Sanders' (extent) and Sakai. Pulmonary function tests as spirometry and diffusing capacity were measured. Results: Intraobserver -values for all three methods were good (0.51-0.74). Interobserver varied from 0.35 to 0.72. The Sanders' and the severity methods correlated strongly with pulmonary function tests, especially DLCO and FEV1. Conclusion: The Sanders' method proved to be reliable in evaluating emphysema, in terms of good consistency of interpretation and good correlation with pulmonary function tests

Localized Smart-Interpretation

Science.gov (United States)

Lundh Gulbrandsen, Mats; Mejer Hansen, Thomas; Bach, Torben; Pallesen, Tom

2014-05-01

The complex task of setting up a geological model consists not only of combining available geological information into a conceptual plausible model, but also requires consistency with availably data, e.g. geophysical data. However, in many cases the direct geological information, e.g borehole samples, are very sparse, so in order to create a geological model, the geologist needs to rely on the geophysical data. The problem is however, that the amount of geophysical data in many cases are so vast that it is practically impossible to integrate all of them in the manual interpretation process. This means that a lot of the information available from the geophysical surveys are unexploited, which is a problem, due to the fact that the resulting geological model does not fulfill its full potential and hence are less trustworthy. We suggest an approach to geological modeling that 1. allow all geophysical data to be considered when building the geological model 2. is fast 3. allow quantification of geological modeling. The method is constructed to build a statistical model, f(d,m), describing the relation between what the geologists interpret, d, and what the geologist knows, m. The para- meter m reflects any available information that can be quantified, such as geophysical data, the result of a geophysical inversion, elevation maps, etc... The parameter d reflects an actual interpretation, such as for example the depth to the base of a ground water reservoir. First we infer a statistical model f(d,m), by examining sets of actual interpretations made by a geological expert, [d1, d2, ...], and the information used to perform the interpretation; [m1, m2, ...]. This makes it possible to quantify how the geological expert performs interpolation through f(d,m). As the geological expert proceeds interpreting, the number of interpreted datapoints from which the statistical model is inferred increases, and therefore the accuracy of the statistical model increases. When a model f

Exploring a Source of Uneven Score Equity across the Test Score Range

Science.gov (United States)

Huggins-Manley, Anne Corinne; Qiu, Yuxi; Penfield, Randall D.

2018-01-01

Score equity assessment (SEA) refers to an examination of population invariance of equating across two or more subpopulations of test examinees. Previous SEA studies have shown that score equity may be present for examinees scoring at particular test score ranges but absent for examinees scoring at other score ranges. No studies to date have…

"I'm pretty sure that we will win!": The influence of score-related nonverbal behavioral changes on the confidence in winning a basketball game.

Science.gov (United States)

Furley, Philip; Schweizer, Geoffrey

2014-06-01

The goal of the present research was to test whether score-related changes in opponents' nonverbal behavior influence athletes' confidence in beating their opponents. In an experiment, 40 participants who were experienced basketball players watched brief video clips depicting athletes' nonverbal behavior. Video clips were not artificially created, but showed naturally occurring behavior. Participants indicated how confident they were in beating the presented athletes in a hypothetical scenario. Results indicated that participants' confidence estimations were influenced by opponents' score-related nonverbal behavior. Participants were less confident about beating a leading team and more confident about beating a trailing team, although they were unaware of the actual score during the depicted scenes. The present research is the first to show that in-game variations of naturally occurring nonverbal behavior can influence athletes' confidence. This finding highlights the importance of research into nonverbal behavior in sports, particularly in relation to athletes' confidence.

Life satisfaction and perceived stress among young offenders in a residential therapeutic community: Latent change score analysis.

Science.gov (United States)

Tang, Kristen N S; Chan, Christian S

2017-06-01

Recent rehabilitation frameworks underscore the importance of strength-based interventions for young offenders who may lack internal and external resources to manage their stress and plan for their life. This multi-wave longitudinal study investigated the dynamic relationship between perceived stress and life satisfaction among a group of young ex-offenders in a residential therapeutic community. Four waves of data were collected from 117 Hong Kong youths (24.0% female, mean age = 17.7) over one year. Latent change score analysis was employed to examine the univairate and bivariate changes of their perceived stress and life satisfaction. Results suggest a positive growth trajectory in life satisfaction over time. The results of perceived stress were less conclusive. Bivariate models indicated that the previous level of life satisfaction was negatively linked to the subsequent perceived stress level but not vice versa. The findings suggest that improvement in life satisfaction may reduce perceived stress in young ex-offenders. Copyright © 2017 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Focus is key: Panic-focused interpretations are associated with symptomatic improvement in panic-focused psychodynamic psychotherapy.

Science.gov (United States)

Keefe, John R; Solomonov, Nili; Derubeis, Robert J; Phillips, Alexander C; Busch, Fredric N; Barber, Jacques P; Chambless, Dianne L; Milrod, Barbara L

2018-04-18

This study examines whether, in panic-focused psychodynamic psychotherapy (PFPP), interpretations of conflicts that underlie anxiety (panic-focused or PF-interpretations) are specifically associated with subsequent panic disorder (PD) symptom improvement, over and above the provision of non-symptom-focused interpretations. Technique use in Sessions 2 and 10 of a 24-session PFPP protocol was assessed for the 65 patients with complete outcome data randomized to PFPP in a two-site trial of psychotherapies for PD. Sessions were rated in 15-min segments for therapists' use of PF-interpretations, non-PF-interpretations, and PF-clarifications. Robust regressions were conducted to examine the relationship between these interventions and symptom change subsequent to the sampled session. Interpersonal problems were examined as a moderator of the relationship of PF-interpretations to symptom change. At Session 10, but not at Session 2, patients who received a higher degree of PF-interpretations experienced greater subsequent improvement in panic symptoms. Non-PF-interpretations were not predictive. Patients with more interpersonal distress benefitted particularly from the use of PF-interpretations at Session 10. By the middle phase of PFPP, panic-focused interpretations may drive subsequent improvements in panic symptoms, especially among patients with higher interpersonal distress. Interpretations of conflict absent a panic focus may not be especially helpful.

A Unified Discussion on the Concept of Score Functions Used in the Context of Nonparametric Linkage Analysis

Directory of Open Access Journals (Sweden)

Lars Ängquist

2008-01-01

Full Text Available In this article we try to discuss nonparametric linkage (NPL score functions within a broad and quite general framework. The main focus of the paper is the structure, derivation principles and interpretations of the score function entity itself. We define and discuss several families of one-locus score function definitions, i.e. the implicit, explicit and optimal ones. Some generalizations and comments to the two-locus, unconditional and conditional, cases are included as well. Although this article mainly aims at serving as an overview, where the concept of score functions are put into a covering context, we generalize the noncentrality parameter (NCP optimal score functions in Ängquist et al. (2007 to facilitate—through weighting—for incorporation of several plausible distinct genetic models. Since the genetic model itself most oftenly is to some extent unknown this facilitates weaker prior assumptions with respect to plausible true disease models without loosing the property of NCP-optimality. Moreover, we discuss general assumptions and properties of score functions in the above sense. For instance, the concept of identical by descent (IBD sharing structures and score function equivalence are discussed in some detail.

Reassessing the "traditional background hypothesis" for elevated MMPI and MMPI-2 Lie-scale scores.

Science.gov (United States)

Rosen, Gerald M; Baldwin, Scott A; Smith, Ronald E

2016-10-01

The Lie (L) scale of the Minnesota Multiphasic Personality Inventory (MMPI) is widely regarded as a measure of conscious attempts to deny common human foibles and to present oneself in an unrealistically positive light. At the same time, the current MMPI-2 manual states that "traditional" and religious backgrounds can account for elevated L scale scores as high as 65T-79T, thereby tempering impression management interpretations for faith-based individuals. To assess the validity of the traditional background hypothesis, we reviewed 11 published studies that employed the original MMPI with religious samples and found that only 1 obtained an elevated mean L score. We then conducted a meta-analysis of 12 published MMPI-2 studies in which we compared L scores of religious samples to the test normative group. The meta-analysis revealed large between-study heterogeneity (I2 = 87.1), L scale scores for religious samples that were somewhat higher but did not approach the upper limits specified in the MMPI-2 manual, and an overall moderate effect size (d¯ = 0.54, p < .001; 95% confidence interval [0.37, 0.70]). Our analyses indicated that religious-group membership accounts, on average, for elevations on L of about 5 t-score points. Whether these scores reflect conscious "fake good" impression management or religious-based virtuousness remains unanswered. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Mediterranean and Nordic diet scores and long-term changes in body weight and waist circumference: results from a large cohort study.

Science.gov (United States)

Li, Yingjun; Roswall, Nina; Ström, Peter; Sandin, Sven; Adami, Hans-Olov; Weiderpass, Elisabete

2015-12-28

Dietary patterns, which represent a broader picture of food and nutrient consumption, have gained increasing interest over the last decades. In a cohort design, we followed 27 544 women aged 29-49 years from baseline in 1991-1992. We collected data from an FFQ at baseline and body weight (BW) and waist circumference (WC) data both at baseline and at follow-up in 2003. We calculated the Mediterranean diet score (MDS, ranging from 0 to 9) and the Nordic diet score (NDS, ranging from 0 to 6). We used linear regression to examine the association between MDS and NDS (exposures) with subsequent BW change (ΔBW) and WC change (ΔWC) (outcomes) both continuously and categorically. Higher adherence to the MDS or NDS was not associated with ΔBW. The multivariable population average increment in BW was 0·03 kg (95 % CI -0·03, 0·09) per 1-point increase in MDS and 0·04 kg (95 % CI -0·02, 0·10) per 1-point increase in NDS. In addition, higher adherence to the MDS was not associated with ΔWC, with the multivariable population average increment per 1-point increase in MDS being 0·05 cm (95 % CI -0·03, 0·13). Higher adherence to the NDS was not significantly associated with gain in WC when adjusted for concurrent ΔBW. In conclusion, a higher adherence to the MDS or NDS was not associated with changes in average BW or WC in the present cohort followed for 12 years.

The effect of rater training on scoring performance and scale-specific expertise amongst occupational therapists participating in a multicentre study

DEFF Research Database (Denmark)

Hansen, Tina; Elholm Madsen, Esben; Sørensen, Annette

2016-01-01

Gill Ingestive Skills Assessment (MISA) they observe, interpret and record occupational performance of dysphagic clients participating in a meal. This is a highly complex task, which might introduce unwanted variability in measurement scores. A 2-day rater training programme was developed and this builds...... of the training on scoring performance and scale-specific expertise amongst raters. METHOD: During 2 days of rater training, 81 occupational therapists (OTs) were qualified to observe and score dysphagic clients' mealtime performance according to the criteria of 36 MISA-items. The training effects were evaluated...... deficient mealtime performance appeared most difficult to score. The OTs scale-specific expertise improved significantly (knowledge: Z = -7.857, p performance when using the Danish MISA as well as their perceived...

Assessment of the level of agreement in the interpretation of plain radiographs of lumbar spondylosis among clinical physiotherapists in Ghana

International Nuclear Information System (INIS)

Bello, Ajediran I; Ofori, Eric K; Alabi, Oluwasegun J; Adjei, David N

2014-01-01

Objective physical assessment of patients with lumbar spondylosis involves plain film radiographs (PFR) viewing and interpretation by the radiologists. Physiotherapists also routinely assess PFR within the scope of their practice. However, studies appraising the level of agreement of physiotherapists’ PFR interpretation with radiologists are not common in Ghana. Forty-one (41) physiotherapists took part in the cross-sectional survey. An assessment guide was developed from findings of the interpretation of three PFR of patients with lumbar spondylosis by a radiologist. The three PFR were selected from a pool of different radiographs based on clarity, common visible pathological features, coverage body segments and short post production period. Physiotherapists were required to view the same PFR after which they were assessed with the assessment guide according to the number of features identified correctly or incorrectly. The score range on the assessment form was 0–24, interpreted as follow: 0–8 points (low), 9–16 points (moderate) and 17–24 points (high) levels of agreement. Data were analyzed using one sample t-test and fisher’s exact test at α = 0.05. The mean score of interpretation for the physiotherapists was 12.7 ± 2.6 points compared to the radiologist’s interpretation of 24 points (assessment guide). The physiotherapists’ levels were found to be significantly associated with their academic qualification (p = 0.006) and sex (p = 0.001). However, their levels of agreement were not significantly associated with their age group (p = 0.098), work settings (p = 0.171), experience (p = 0.666), preferred PFR view (p = 0.088) and continuing education (p = 0.069). The physiotherapists’ skills fall short of expectation for interpreting PFR of patients with lumbar spondylosis. The levels of agreement with radiologist’s interpretation have no link with year of clinial practice, age, work settings and continuing education. Thus, routine PFR viewing

Assessment of the level of agreement in the interpretation of plain radiographs of lumbar spondylosis among clinical physiotherapists in Ghana.

Science.gov (United States)

Bello, Ajediran I; Ofori, Eric K; Alabi, Oluwasegun J; Adjei, David N

2014-03-29

Objective physical assessment of patients with lumbar spondylosis involves plain film radiographs (PFR) viewing and interpretation by the radiologists. Physiotherapists also routinely assess PFR within the scope of their practice. However, studies appraising the level of agreement of physiotherapists' PFR interpretation with radiologists are not common in Ghana. Forty-one (41) physiotherapists took part in the cross-sectional survey. An assessment guide was developed from findings of the interpretation of three PFR of patients with lumbar spondylosis by a radiologist. The three PFR were selected from a pool of different radiographs based on clarity, common visible pathological features, coverage body segments and short post production period. Physiotherapists were required to view the same PFR after which they were assessed with the assessment guide according to the number of features identified correctly or incorrectly. The score range on the assessment form was 0-24, interpreted as follow: 0-8 points (low), 9-16 points (moderate) and 17-24 points (high) levels of agreement. Data were analyzed using one sample t-test and fisher's exact test at α = 0.05. The mean score of interpretation for the physiotherapists was 12.7 ± 2.6 points compared to the radiologist's interpretation of 24 points (assessment guide). The physiotherapists' levels were found to be significantly associated with their academic qualification (p = 0.006) and sex (p = 0.001). However, their levels of agreement were not significantly associated with their age group (p = 0.098), work settings (p = 0.171), experience (p = 0.666), preferred PFR view (p = 0.088) and continuing education (p = 0.069). The physiotherapists' skills fall short of expectation for interpreting PFR of patients with lumbar spondylosis. The levels of agreement with radiologist's interpretation have no link with year of clinial practice, age, work settings and continuing education. Thus

Optical music recognition on the International Music Score Library Project

Science.gov (United States)

Raphael, Christopher; Jin, Rong

2013-12-01

A system is presented for optical recognition of music scores. The system processes a document page in three main phases. First it performs a hierarchical decomposition of the page, identifying systems, staves and measures. The second phase, which forms the heart of the system, interprets each measure found in the previous phase as a collection of non-overlapping symbols including both primitive symbols (clefs, rests, etc.) with fixed templates, and composite symbols (chords, beamed groups, etc.) constructed through grammatical composition of primitives (note heads, ledger lines, beams, etc.). This phase proceeds by first building separate top-down recognizers for the symbols of interest. Then, it resolves the inevitable overlap between the recognized symbols by exploring the possible assignment of overlapping regions, seeking globally optimal and grammatically consistent explanations. The third phase interprets the recognized symbols in terms of pitch and rhythm, focusing on the main challenge of rhythm. We present results that compare our system to the leading commercial OMR system using MIDI ground truth for piano music.

The use of bone age for bone mineral density interpretation in a cohort of pediatric brain tumor patients

International Nuclear Information System (INIS)

Morris, E.B.; Shelso, John; Smeltzer, Matthew P.; Li, Chin-Shang; Thomas, Nicole A.; Karimova, E.J.; Merchant, Thomas; Gajjar, Amar; Kaste, Sue C.

2008-01-01

Skeletal bone accretion occurs throughout childhood. The integrity of this process can influence future adult bone health and the risk of osteoporosis. Although surveillance of children who are at risk of poor bone accretion is important, the most appropriate method to monitor childhood bone health has not been established. Previous investigators have proposed using bone age (BA) rather than chronological age (CA) when interpreting bone mineral density (BMD) values in children. To investigate the value of BA assessment for BMD measurement in a cohort of children at risk of poor accretion. A cohort of 163 children with brain tumors who completed both a BMD assessment (quantitative computed tomography, QCT) and who had a BA within a 6-month interval were identified. The difference in BMD Z-scores determined by CA and BA was determined. The impact of salient clinical features was assessed. No significant difference between CA and BA Z-scores was detected in the overall cohort (P 0.056). However, the scores in 18 children (all boys between the ages of 11 years and 15 years) were statistically determined to be outliers from the values in the rest of the cohort. Interpretation of BMD with BA measurement might be appropriate and affect treatment decisions in peripubertal males. (orig.)

Interpretive Management: What General Managers Can Learn from Design.

Science.gov (United States)

Lester, Richard K.; Piore, Michael J.; Malek, Kamal M.

1998-01-01

An analytical management approach reflects a traditional perspective and an interpretive approach involves a perspective suited to rapidly changing, unpredictable markets. Both approaches are valid, but each serves different purposes and calls for different strategies and skills. (JOW)

Accuracy of remote electrocardiogram interpretation with the use of Google Glass technology.

Science.gov (United States)

Jeroudi, Omar M; Christakopoulos, George; Christopoulos, George; Kotsia, Anna; Kypreos, Megan A; Rangan, Bavana V; Banerjee, Subhash; Brilakis, Emmanouil S

2015-02-01

We sought to investigate the accuracy of remote electrocardiogram (ECG) interpretation using Google Glass (Google, Mountain View, California). Google Glass is an optical head mounted display device with growing applications in medicine. We compared interpretation of 10 ECGs with 21 clinically important findings by faculty and fellow cardiologists by (1) viewing the electrocardiographic image at the Google Glass screen; (2) viewing a photograph of the ECG taken using Google Glass and interpreted on a mobile device; (3) viewing the original paper ECG; and (4) viewing a photograph of the ECG taken with a high-resolution camera and interpreted on a mobile device. One point was given for identification of each correct finding. Subjective rating of the user experience was also recorded. Twelve physicians (4 faculty and 8 fellow cardiologists) participated. The average electrocardiographic interpretation score (maximum 21 points) as viewed through the Google Glass, Google Glass photograph on a mobile device, on paper, and high-resolution photograph on a mobile device was 13.5 ± 1.8, 16.1 ± 2.6, 18.3 ± 1.7, and 18.6 ± 1.5, respectively (p = 0.0005 between Google Glass and mobile device, p = 0.0005 between Google Glass and paper, and p = 0.002 between mobile device and paper). Of the 12 physicians, 9 (75%) were dissatisfied with ECGs viewing on the prism display of Google Glass. In conclusion, further improvements are needed before Google Glass can be reliably used for remote electrocardiographic analysis. Published by Elsevier Inc.

Re-Interpreting the "Chinese miracle"

DEFF Research Database (Denmark)

Feng, Xingyuan; Ljungwall, Christer; Guo, Sujian

2011-01-01

The rapid economic development and transformation of Chinese society over the past three decades has, by a large mass of analysts, been called a "Miracle." This paper not only addresses the shortcomings of existing interpretations but also develops a new multi-dimensional framework based on North......'s theory of institutional change and Hayek's theory of institutional evolution to explain China's miraculous growth. Our analysis shows that both Hayekian spontaneous order and Popper's "piecemeal social engineering" played a major role in attaining China's miraculous growth....

Reproducibility of scoring emphysema by HRCT

Energy Technology Data Exchange (ETDEWEB)

Malinen, A.; Partanen, K.; Rytkoenen, H.; Vanninen, R. [Kuopio Univ. Hospital (Finland). Dept. of Clinical Radiology; Erkinjuntti-Pekkanen, R. [Kuopio Univ. Hospital (Finland). Dept. of Pulmonary Diseases

2002-04-01

Purpose: We evaluated the reproducibility of three visual scoring methods of emphysema and compared these methods with pulmonary function tests (VC, DLCO, FEV1 and FEV%) among farmer's lung patients and farmers. Material and Methods: Three radiologists examined high-resolution CT images of farmer's lung patients and their matched controls (n=70) for chronic interstitial lung diseases. Intraobserver reproducibility and interobserver variability were assessed for three methods: severity, Sanders' (extent) and Sakai. Pulmonary function tests as spirometry and diffusing capacity were measured. Results: Intraobserver -values for all three methods were good (0.51-0.74). Interobserver varied from 0.35 to 0.72. The Sanders' and the severity methods correlated strongly with pulmonary function tests, especially DLCO and FEV1. Conclusion: The Sanders' method proved to be reliable in evaluating emphysema, in terms of good consistency of interpretation and good correlation with pulmonary function tests.

Development and Validation of the OMERACT Rheumatoid Arthritis Magnetic Resonance Tenosynovitis Scoring System in a Multireader Exercise.

Science.gov (United States)

Glinatsi, Daniel; Bird, Paul; Gandjbakhch, Frédérique; Haavardsholm, Espen A; Peterfy, Charles G; Vital, Edward M; Emery, Paul; Conaghan, Philip G; Østergaard, Mikkel

2017-11-01

To develop and validate a magnetic resonance imaging (MRI) tenosynovitis (TS) score for tendons at the wrist and metacarpophalangeal (MCP) joint levels in patients with rheumatoid arthritis (RA). Axial T1-weighted precontrast and postcontrast fat-saturated MR image sets of the hands of 43 patients with RA initiating rituximab therapy were obtained at baseline and after 14, 26, 38, or 52 weeks. The MR images were scored twice by 4 readers. Nine tendon compartments of the wrist and 4 flexor tendon compartments at the MCP joints were assessed. Tenosynovitis was scored as follows: 0: No; 1: The overall PEA/PCA intrareader and interreader agreements for change scores in all tendons were 73.8%/97.6% and 47.9%/85.0%, respectively. Average SRM was moderate for total scores and 60.5% of the patients had a tenosynovitis change score ≥ SDC. The TS score showed high intrareader and interreader agreement for wrist and finger tendons, with moderate responsiveness, and the majority of the patients showed a change above the SDC. This scoring system may be included as a component of the RAMRIS.

WebScore: An Effective Page Scoring Approach for Uncertain Web Social Networks

Directory of Open Access Journals (Sweden)

Shaojie Qiao

2011-10-01

Full Text Available To effectively score pages with uncertainty in web social networks, we first proposed a new concept called transition probability matrix and formally defined the uncertainty in web social networks. Second, we proposed a hybrid page scoring algorithm, called WebScore, based on the PageRank algorithm and three centrality measures including degree, betweenness, and closeness. Particularly,WebScore takes into a full consideration of the uncertainty of web social networks by computing the transition probability from one page to another. The basic idea ofWebScore is to: (1 integrate uncertainty into PageRank in order to accurately rank pages, and (2 apply the centrality measures to calculate the importance of pages in web social networks. In order to verify the performance of WebScore, we developed a web social network analysis system which can partition web pages into distinct groups and score them in an effective fashion. Finally, we conducted extensive experiments on real data and the results show that WebScore is effective at scoring uncertain pages with less time deficiency than PageRank and centrality measures based page scoring algorithms.

Schrodinger's mechanics interpretation

CERN Document Server

Cook, David B

2018-01-01

The interpretation of quantum mechanics has been in dispute for nearly a century with no sign of a resolution. Using a careful examination of the relationship between the final form of classical particle mechanics (the Hamilton–Jacobi Equation) and Schrödinger's mechanics, this book presents a coherent way of addressing the problems and paradoxes that emerge through conventional interpretations.Schrödinger's Mechanics critiques the popular way of giving physical interpretation to the various terms in perturbation theory and other technologies and places an emphasis on development of the theory and not on an axiomatic approach. When this interpretation is made, the extension of Schrödinger's mechanics in relation to other areas, including spin, relativity and fields, is investigated and new conclusions are reached.

Factors affecting the student evaluation of teaching scores: evidence from panel data estimation

Directory of Open Access Journals (Sweden)

Eduardo de Carvalho Andrade

2012-03-01

Full Text Available We use a random-effects model to find the factors that affect the student evaluation of teaching (SET scores. Dataset covers 6 semesters, 496 undergraduate courses related to 101 instructors and 89 disciplines. Our empirical findings are: (i the class size affects negatively the SET score; (ii instructors with more experience are better evaluated, but these gains reduce over time; (iii participating in training programs, designed to improve the quality of teaching, did not increase the SET scores; (iv instructors seem to be able to marginally 'buy' a better evaluation by inflating students' grade. Finally, there are significant changes in the rankings when we adjust the SET score to eliminate the effects of variables beyond instructors' control. Despite these changes, they are not statistically significant.

Radiologic head CT interpretation errors in pediatric abusive and non-abusive head trauma patients

International Nuclear Information System (INIS)

Kralik, Stephen F.; Finke, Whitney; Wu, Isaac C.; Ho, Chang Y.; Hibbard, Roberta A.; Hicks, Ralph A.

2017-01-01

Pediatric head trauma, including abusive head trauma, is a significant cause of morbidity and mortality. The purpose of this research was to identify and evaluate radiologic interpretation errors of head CTs performed on abusive and non-abusive pediatric head trauma patients from a community setting referred for a secondary interpretation at a tertiary pediatric hospital. A retrospective search identified 184 patients <5 years of age with head CT for known or potential head trauma who had a primary interpretation performed at a referring community hospital by a board-certified radiologist. Two board-certified fellowship-trained neuroradiologists at an academic pediatric hospital independently interpreted the head CTs, compared their interpretations to determine inter-reader discrepancy rates, and resolved discrepancies to establish a consensus second interpretation. The primary interpretation was compared to the consensus second interpretation using the RADPEER trademark scoring system to determine the primary interpretation-second interpretation overall and major discrepancy rates. MRI and/or surgical findings were used to validate the primary interpretation or second interpretation when possible. The diagnosis of abusive head trauma was made using clinical and imaging data by a child abuse specialist to separate patients into abusive head trauma and non-abusive head trauma groups. Discrepancy rates were compared for both groups. Lastly, primary interpretations and second interpretations were evaluated for discussion of imaging findings concerning for abusive head trauma. There were statistically significant differences between primary interpretation-second interpretation versus inter-reader overall and major discrepancy rates (28% vs. 6%, P=0.0001; 16% vs. 1%, P=0.0001). There were significant differences in the primary interpretation-second interpretation overall and major discrepancy rates for abusive head trauma patients compared to non-abusive head trauma

Radiologic head CT interpretation errors in pediatric abusive and non-abusive head trauma patients

Energy Technology Data Exchange (ETDEWEB)

Kralik, Stephen F.; Finke, Whitney; Wu, Isaac C.; Ho, Chang Y. [Indiana University School of Medicine, Department of Radiology and Imaging Sciences, Indianapolis, IN (United States); Hibbard, Roberta A.; Hicks, Ralph A. [Indiana University School of Medicine, Department of Pediatrics, Section of Child Protection Programs, Indianapolis, IN (United States)

2017-07-15

Pediatric head trauma, including abusive head trauma, is a significant cause of morbidity and mortality. The purpose of this research was to identify and evaluate radiologic interpretation errors of head CTs performed on abusive and non-abusive pediatric head trauma patients from a community setting referred for a secondary interpretation at a tertiary pediatric hospital. A retrospective search identified 184 patients <5 years of age with head CT for known or potential head trauma who had a primary interpretation performed at a referring community hospital by a board-certified radiologist. Two board-certified fellowship-trained neuroradiologists at an academic pediatric hospital independently interpreted the head CTs, compared their interpretations to determine inter-reader discrepancy rates, and resolved discrepancies to establish a consensus second interpretation. The primary interpretation was compared to the consensus second interpretation using the RADPEER trademark scoring system to determine the primary interpretation-second interpretation overall and major discrepancy rates. MRI and/or surgical findings were used to validate the primary interpretation or second interpretation when possible. The diagnosis of abusive head trauma was made using clinical and imaging data by a child abuse specialist to separate patients into abusive head trauma and non-abusive head trauma groups. Discrepancy rates were compared for both groups. Lastly, primary interpretations and second interpretations were evaluated for discussion of imaging findings concerning for abusive head trauma. There were statistically significant differences between primary interpretation-second interpretation versus inter-reader overall and major discrepancy rates (28% vs. 6%, P=0.0001; 16% vs. 1%, P=0.0001). There were significant differences in the primary interpretation-second interpretation overall and major discrepancy rates for abusive head trauma patients compared to non-abusive head trauma

Ecg changes after dipyridamole infusion in patients undergoing myocardial perfusion imaging

International Nuclear Information System (INIS)

Taherpour, M.; Zakavi, R.; Ariana, K.

2002-01-01

Dipyridamole is used as the main pharmacological stress agent in patient referred for myocardial perfusion imaging. This vasodilator agent makes difference between normal and abnormal coronary perfusion. Some authors believe that post-Dipyridamole Ecg changes have low sensitivity and relatively high specificity for ischemic detection. This study tries to evaluate this issue. All patients who referred to nuclear medicine department for Myocardial Perfusion Imaging and were not suitable for treadmill E T T, and had no L BBB pattern in basal Ecg were included in the study. Basal and post Dipyridamole Ecg were interpreted with a cardiologist after infusion of 142 u g/kg/min of Dipyridamole and all changes as well as basal Ecg abnormalities were recorded. Also Q Tc were calculated in all Ecg records: M P Is were interpreted by a nuclear medicine specialist and summed stress and rest scores were determined. Two hundred patients including 89 female (44.5%) and 111 male (55.5%) with a mean age of 55.2 years and age range of 30-85 years were studied. Mean basal and post Dipyridamole heart rates were 72.2/min and 84.8/min and mean basal and post Dipyridamole Qt Cs were 419.6 msec and 435.7 msec respectively. New Ecg changes were noted in 22.5% of cases and consisted of 1% T-wave flattening, 1% T-wave inversion, 16.5% St depression and 4% Pseudo normalization. Horizontal pattern was the main type of St segment depression (83.%) among new S T changes. Mean St depression severity was 0.8 mm with a range of 0.5-2 mm. New St depression was noted in lateral leads (Excluding high lateral) in 62.5% of new S T changes. M P I was interpreted normal in 4% of cases and showed some degrees of ischemia in 42% of the cases. The mean post Dipyridamole heart rate increment, was 11.2/ min patients with abnormal scintigraphy (infarct and/or ischemia) compared to 14.5/ min in normal cases. (P=0.009). Also Qt c increment in patients with ischemia was significantly more than patients with simple

Pregabalin Improves Pain Scores in Patients with Fibromyalgia Irrespective of Comorbid Osteoarthritis.

Science.gov (United States)

Argoff, Charles E; Emir, Birol; Whalen, Ed; Ortiz, Marie; Pauer, Lynne; Clair, Andrew

2016-11-01

Fibromyalgia (FM) is a chronic pain disorder with patients frequently suffering from comorbid conditions, including osteoarthritis (OA). Data on how FM patients with comorbid OA respond to recommended therapies (such as pregabalin) could help their treatment. This was a pooled exploratory analysis of three randomized placebo-controlled clinical trials of pregabalin in FM patients to assess the impact of comorbid OA on the response to pregabalin. Patients were divided into those with and without comorbid OA. Difference in change in least squares (LS) mean pain score at endpoint (assessed by 0-10 numeric rating scale, controlled for baseline pain score) with pregabalin (300 mg/day and 450 mg/day) vs placebo was assessed. Changes in Patient Global Impression of Change (PGIC) responders and Fibromyalgia Impact Questionnaire (FIQ) total score were also assessed. There were 1665 patients in the analysis set (558, placebo; 552, pregabalin 300 mg/day; 555, pregabalin 450 mg/day), including 296 with comorbid OA. Pregabalin 450 mg/day significantly improved the LS mean (95% confidence interval) difference in pain score vs placebo in patients with (0.99 [0.44, 1.55], P FIQ total score were observed in patients with and without comorbid OA. FM patients with or without comorbid OA respond to treatment with pregabalin 450mg/day with significant improvements in pain intensity scores. These data could provide guidance to healthcare professionals treating these patients. © 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Evidence for age-associated cognitive decline from Internet game scores.

Science.gov (United States)

Geyer, Jason; Insel, Philip; Farzin, Faraz; Sternberg, Daniel; Hardy, Joseph L; Scanlon, Michael; Mungas, Dan; Kramer, Joel; Mackin, R Scott; Weiner, Michael W

2015-06-01

Lumosity's Memory Match (LMM) is an online game requiring visual working memory. Change in LMM scores may be associated with individual differences in age-related changes in working memory. Effects of age and time on LMM learning and forgetting rates were estimated using data from 1890 game sessions for users aged 40 to 79 years. There were significant effects of age on baseline LMM scores (β = -.31, standard error or SE = .02, P game performance. Online memory games have the potential to identify age-related decline in cognition and to identify subjects at risk for cognitive decline with smaller sample sizes and lower cost than traditional recruitment methods.

The scoring of arousal in sleep: reliability, validity, and alternatives.

Science.gov (United States)

Bonnet, Michael H; Doghramji, Karl; Roehrs, Timothy; Stepanski, Edward J; Sheldon, Stephen H; Walters, Arthur S; Wise, Merrill; Chesson, Andrew L

2007-03-15

The reliability and validity of EEG arousals and other types of arousal are reviewed. Brief arousals during sleep had been observed for many years, but the evolution of sleep medicine in the 1980s directed new attention to these events. Early studies at that time in animals and humans linked brief EEG arousals and associated fragmentation of sleep to daytime sleepiness and degraded performance. Increasing interest in scoring of EEG arousals led the ASDA to publish a scoring manual in 1992. The current review summarizes numerous studies that have examined scoring reliability for these EEG arousals. Validity of EEG arousals was explored by review of studies that empirically varied arousals and found deficits similar to those found after total sleep deprivation depending upon the rate and extent of sleep fragmentation. Additional data from patients with clinical sleep disorders prior to and after effective treatment has also shown a continuing relationship between reduction in pathology-related arousals and improved sleep and daytime function. Finally, many suggestions have been made to refine arousal scoring to include additional elements (e.g., CAP), change the time frame, or focus on other physiological responses such as heart rate or blood pressure changes. Evidence to support the reliability and validity of these measures is presented. It was concluded that the scoring of EEG arousals has added much to our understanding of the sleep process but that significant work on the neurophysiology of arousal needs to be done. Additional refinement of arousal scoring will provide improved insight into sleep pathology and recovery.

Heart valve surgery: EuroSCORE vs. EuroSCORE II vs. Society of Thoracic Surgeons score

Directory of Open Access Journals (Sweden)

Muhammad Sharoz Rabbani

2014-12-01

Full Text Available Background This is a validation study comparing the European System for Cardiac Operative Risk Evaluation (EuroSCORE II with the previous additive (AES and logistic EuroSCORE (LES and the Society of Thoracic Surgeons’ (STS risk prediction algorithm, for patients undergoing valve replacement with or without bypass in Pakistan. Patients and Methods Clinical data of 576 patients undergoing valve replacement surgery between 2006 and 2013 were retrospectively collected and individual expected risks of death were calculated by all four risk prediction algorithms. Performance of these risk algorithms was evaluated in terms of discrimination and calibration. Results There were 28 deaths (4.8% among 576 patients, which was lower than the predicted mortality of 5.16%, 6.96% and 4.94% by AES, LES and EuroSCORE II but was higher than 2.13% predicted by STS scoring system. For single and double valve replacement procedures, EuroSCORE II was the best predictor of mortality with highest Hosmer and Lemmeshow test (H-L p value (0.346 to 0.689 and area under the receiver operating characteristic (ROC curve (0.637 to 0.898. For valve plus concomitant coronary artery bypass grafting (CABG patients actual mortality was 1.88%. STS calculator came out to be the best predictor of mortality for this subgroup with H-L p value (0.480 to 0.884 and ROC (0.657 to 0.775. Conclusions For Pakistani population EuroSCORE II is an accurate predictor for individual operative risk in patients undergoing isolated valve surgery, whereas STS performs better in the valve plus CABG group.

Questionnaire Adapting: Little Changes Mean a Lot.

Science.gov (United States)

Sousa, Vanessa E C; Matson, Jeffrey; Dunn Lopez, Karen

2017-09-01

Questionnaire development involves rigorous testing to ensure reliability and validity. Due to time and cost constraints of developing new questionnaires, researchers often adapt existing questionnaires to better fit the purpose of their study. However, the effect of such adaptations is unclear. We conducted cognitive interviews as a method to evaluate the understanding of original and adapted questionnaire items to be applied in a future study. The findings revealed that all subjects (a) comprehended the original and adapted items differently, (b) changed their scores after comparing the original to the adapted items, and (c) were unanimous in stating that the adapted items were easier to understand. Cognitive interviewing allowed us to assess the interpretation of adapted items in a useful and efficient manner before use in data collection.

Interpretation of Chemical Pathology Test Results in Paediatrics ...

African Journals Online (AJOL)

At any time we interprete paediatric chemical pathology test results we must take into consideration a number of factors, which are related with and restricted to paediatric patients. Such factors include the paediatric patient's age that may change from prematurity to above 18 years, and the paediatric patient's body weight ...

The effect of clinical bias on the interpretation of myelography and spinal computed tomography

International Nuclear Information System (INIS)

Eldevik, O.P.; Dugstad, G.; Orrison, W.W.; Haughton, V.M.

1982-01-01

Spinal computed tomograms and myelograms of 107 patients with sciatica or low back pain were interpreted with and without knowledge of clinical history. A significant number of interpretations was changed by knowledge of the clinical history. More studies were interpreted correctly without the clinical history than with it. Knowledge of the clinical history increased the number of false-positive and decreased the number of false-negative diagnoses. This study suggest a tendency of observers to interpret questionable myelographic or computed tomograhic findings as positive when they correlate with clinical findings

Volumetric CT-images improve testing of radiological image interpretation skills

Energy Technology Data Exchange (ETDEWEB)

Ravesloot, Cécile J., E-mail: C.J.Ravesloot@umcutrecht.nl [Radiology Department at University Medical Center Utrecht, Heidelberglaan 100, 3508 GA Utrecht, Room E01.132 (Netherlands); Schaaf, Marieke F. van der, E-mail: M.F.vanderSchaaf@uu.nl [Department of Pedagogical and Educational Sciences at Utrecht University, Heidelberglaan 1, 3584 CS Utrecht (Netherlands); Schaik, Jan P.J. van, E-mail: J.P.J.vanSchaik@umcutrecht.nl [Radiology Department at University Medical Center Utrecht, Heidelberglaan 100, 3508 GA Utrecht, Room E01.132 (Netherlands); Cate, Olle Th.J. ten, E-mail: T.J.tenCate@umcutrecht.nl [Center for Research and Development of Education at University Medical Center Utrecht, Heidelberglaan 100, 3508 GA Utrecht (Netherlands); Gijp, Anouk van der, E-mail: A.vanderGijp-2@umcutrecht.nl [Radiology Department at University Medical Center Utrecht, Heidelberglaan 100, 3508 GA Utrecht, Room E01.132 (Netherlands); Mol, Christian P., E-mail: C.Mol@umcutrecht.nl [Image Sciences Institute at University Medical Center Utrecht, Heidelberglaan 100, 3508 GA Utrecht (Netherlands); Vincken, Koen L., E-mail: K.Vincken@umcutrecht.nl [Image Sciences Institute at University Medical Center Utrecht, Heidelberglaan 100, 3508 GA Utrecht (Netherlands)

2015-05-15

Rationale and objectives: Current radiology practice increasingly involves interpretation of volumetric data sets. In contrast, most radiology tests still contain only 2D images. We introduced a new testing tool that allows for stack viewing of volumetric images in our undergraduate radiology program. We hypothesized that tests with volumetric CT-images enhance test quality, in comparison with traditional completely 2D image-based tests, because they might better reflect required skills for clinical practice. Materials and methods: Two groups of medical students (n = 139; n = 143), trained with 2D and volumetric CT-images, took a digital radiology test in two versions (A and B), each containing both 2D and volumetric CT-image questions. In a questionnaire, they were asked to comment on the representativeness for clinical practice, difficulty and user-friendliness of the test questions and testing program. Students’ test scores and reliabilities, measured with Cronbach's alpha, of 2D and volumetric CT-image tests were compared. Results: Estimated reliabilities (Cronbach's alphas) were higher for volumetric CT-image scores (version A: .51 and version B: .54), than for 2D CT-image scores (version A: .24 and version B: .37). Participants found volumetric CT-image tests more representative of clinical practice, and considered them to be less difficult than volumetric CT-image questions. However, in one version (A), volumetric CT-image scores (M 80.9, SD 14.8) were significantly lower than 2D CT-image scores (M 88.4, SD 10.4) (p < .001). The volumetric CT-image testing program was considered user-friendly. Conclusion: This study shows that volumetric image questions can be successfully integrated in students’ radiology testing. Results suggests that the inclusion of volumetric CT-images might improve the quality of radiology tests by positively impacting perceived representativeness for clinical practice and increasing reliability of the test.

Interpreting land records

CERN Document Server

Wilson, Donald A

2014-01-01

Base retracement on solid research and historically accurate interpretation Interpreting Land Records is the industry's most complete guide to researching and understanding the historical records germane to land surveying. Coverage includes boundary retracement and the primary considerations during new boundary establishment, as well as an introduction to historical records and guidance on effective research and interpretation. This new edition includes a new chapter titled "Researching Land Records," and advice on overcoming common research problems and insight into alternative resources wh

The Interpretive Function

DEFF Research Database (Denmark)

Agerbo, Heidi

2017-01-01

Approximately a decade ago, it was suggested that a new function should be added to the lexicographical function theory: the interpretive function(1). However, hardly any research has been conducted into this function, and though it was only suggested that this new function was relevant...... to incorporate into lexicographical theory, some scholars have since then assumed that this function exists(2), including the author of this contribution. In Agerbo (2016), I present arguments supporting the incorporation of the interpretive function into the function theory and suggest how non-linguistic signs...... can be treated in specific dictionary articles. However, in the current article, due to the results of recent research, I argue that the interpretive function should not be considered an individual main function. The interpretive function, contrary to some of its definitions, is not connected...

Does the Consecutive Interpreting Approach enhance medical English communication skills of Japanese-speaking students?

Science.gov (United States)

Iizuka, Hideki; Lefor, Alan K

2018-04-19

To determine if the Consecutive Interpreting Approach enhances medical English communication skills of students in a Japanese medical university and to assess this method based on performance and student evaluations.  This is a three-phase study using a mixed-methods design, which starts with four language reproduction activities for 30 medical and 95 nursing students, followed by a quantitative analysis of perfect-match reproduction rates to assess changes over the duration of the study and qualitative error analysis of participants' language reproduction. The final stage included a scored course evaluation and free-form comments to evaluate this approach and to identify effective educational strategies to enhance medical English communication skills. Mean perfect-match reproduction rates of all participants over four reproduction activities differed statistically significantly (repeated measures ANOVA, pEnglish communication skills are enhanced using this approach. Participants expressed positive feedback regarding this instruction method. This approach may be effective to enhance the language skills of non-native English-speaking students seeking to practice medicine in English speaking countries.

A Comparison of Two Scoring Methods for an Automated Speech Scoring System

Science.gov (United States)

Xi, Xiaoming; Higgins, Derrick; Zechner, Klaus; Williamson, David

2012-01-01

This paper compares two alternative scoring methods--multiple regression and classification trees--for an automated speech scoring system used in a practice environment. The two methods were evaluated on two criteria: construct representation and empirical performance in predicting human scores. The empirical performance of the two scoring models…

Access to New Zealand Sign Language interpreters and quality of life for the deaf: a pilot study.

Science.gov (United States)

Henning, Marcus A; Krägeloh, Christian U; Sameshima, Shizue; Shepherd, Daniel; Shepherd, Gregory; Billington, Rex

2011-01-01

This paper aims to: (1) explore usage and accessibility of sign language interpreters, (2) appraise the levels of quality of life (QOL) of deaf adults residing in New Zealand, and (3) consider the impact of access to and usage of sign language interpreters on QOL. Sixty-eight deaf adults living in New Zealand participated in this study. Two questionnaires were employed: a 12-item instrument about access and use of New Zealand sign language interpreters and the abbreviated version of the World Health Organization Quality of Life questionnaire (WHOQOL-BREF). The results showed that 39% of this sample felt that they were unable to adequately access interpreting services. Moreover, this group scored significantly lower than a comparable hearing sample on all four WHOQOL-BREF domains. Finally, the findings revealed that access to good quality interpreters were associated with access to health services, transport issues, engagement in leisure activities, gaining more information, mobility and living in a healthy environment. These findings have consequences for policy makers and agencies interested in ensuring that there is an equitable distribution of essential services for all groups within New Zealand which inevitably has an impact on the health of the individual.

Cross cultural comparison of JTCI inventory of temperament and character scores of 11-13 year olds

Directory of Open Access Journals (Sweden)

Dukanac Vesna

2008-01-01

Full Text Available The study compares characteristics of Serbian and American children on the dimensions of temperament and character on the Junior TCI (JTCI for assessment of 9 to 13 year olds - based on Robert Cloninger’s Psychobiological model of temperament and character. Given the lack of assessment tools for this age group, the goal of the present study was to test the factor structure and main psychometric characteristics of the JTCI in order to determine the applicability of this questionnaire on Serbian children. The sample consisted of 222 boys and girls from the normal population, ages 11 to 13 and who attended grades 6 to 8. The results showed significant differences between Serbian and American sample. Namely, Serbian children had higher scores on the Novelty seeking and Harm Avoidance and lower scores on Reward Dependence and Persistency. As to the Character Dimensions, Serbian children had lower scores on Reward dependence and persistency, and significantly lower on Self-directedness and Cooperativeness. Scores on the Self-transcendence were higher among the Serbian children. The differences on Character dimensions between children from different cultures suppose to be primarily a result of the socialization process. They reflect a lower level of maturity, cooperation and probably compensatory reliance on the religion. Although it is a temperament dimension, being prone to negative emotions (higher scores on Danger avoidance may also be a result of a situational sensitivity. This result could be interpreted as a reflection of the negative effects that the general socio cultural milieu had on the children who grew up during the social crisis and transitional periods of our society. The result did not confirm a seven factor personality structure of children in this age group. It is likely that at the age of 11 to 13, dimensions of character and temperament did not yet clearly differentiate. Finally, poor reliability of the JTCI scales imposes

Increased correlation coefficient between the written test score and tutors' performance test scores after training of tutors for assessment of medical students during problem-based learning course in Malaysia.

Science.gov (United States)

Jaiprakash, Heethal; Min, Aung Ko Ko; Ghosh, Sarmishtha

2016-03-01

This paper is aimed at finding if there was a change of correlation between the written test score and tutors' performance test scores in the assessment of medical students during a problem-based learning (PBL) course in Malaysia. This is a cross-sectional observational study, conducted among 264 medical students in two groups from November 2010 to November 2012. The first group's tutors did not receive tutor training; while the second group's tutors were trained in the PBL process. Each group was divided into high, middle and low achievers based on their end-of-semester exam scores. PBL scores were taken which included written test scores and tutors' performance test scores. Pearson correlation coefficient was calculated between the two kinds of scores in each group. The correlation coefficient between the written scores and tutors' scores in group 1 was 0.099 (pcorrelation coefficient in the group where tutors received the PBL training reinforces the importance of tutor training before their participation in the PBL course.

NCACO-score: An effective main-chain dependent scoring function for structure modeling

Directory of Open Access Journals (Sweden)

Dong Xiaoxi

2011-05-01

Full Text Available Abstract Background Development of effective scoring functions is a critical component to the success of protein structure modeling. Previously, many efforts have been dedicated to the development of scoring functions. Despite these efforts, development of an effective scoring function that can achieve both good accuracy and fast speed still presents a grand challenge. Results Based on a coarse-grained representation of a protein structure by using only four main-chain atoms: N, Cα, C and O, we develop a knowledge-based scoring function, called NCACO-score, that integrates different structural information to rapidly model protein structure from sequence. In testing on the Decoys'R'Us sets, we found that NCACO-score can effectively recognize native conformers from their decoys. Furthermore, we demonstrate that NCACO-score can effectively guide fragment assembly for protein structure prediction, which has achieved a good performance in building the structure models for hard targets from CASP8 in terms of both accuracy and speed. Conclusions Although NCACO-score is developed based on a coarse-grained model, it is able to discriminate native conformers from decoy conformers with high accuracy. NCACO is a very effective scoring function for structure modeling.

Empirical validation of the S-Score algorithm in the analysis of gene expression data

Directory of Open Access Journals (Sweden)

Archer Kellie J

2006-03-01

Full Text Available Abstract Background Current methods of analyzing Affymetrix GeneChip® microarray data require the estimation of probe set expression summaries, followed by application of statistical tests to determine which genes are differentially expressed. The S-Score algorithm described by Zhang and colleagues is an alternative method that allows tests of hypotheses directly from probe level data. It is based on an error model in which the detected signal is proportional to the probe pair signal for highly expressed genes, but approaches a background level (rather than 0 for genes with low levels of expression. This model is used to calculate relative change in probe pair intensities that converts probe signals into multiple measurements with equalized errors, which are summed over a probe set to form the S-Score. Assuming no expression differences between chips, the S-Score follows a standard normal distribution, allowing direct tests of hypotheses to be made. Using spike-in and dilution datasets, we validated the S-Score method against comparisons of gene expression utilizing the more recently developed methods RMA, dChip, and MAS5. Results The S-score showed excellent sensitivity and specificity in detecting low-level gene expression changes. Rank ordering of S-Score values more accurately reflected known fold-change values compared to other algorithms. Conclusion The S-score method, utilizing probe level data directly, offers significant advantages over comparisons using only probe set expression summaries.

Interpretation bias in Cluster-C and borderline personality disorders.

Science.gov (United States)

Arntz, Arnoud; Weertman, Anoek; Salet, Sjoerd

2011-08-01

Cognitive therapy (CT) assumes that personality disorders (PDs) are characterized by interpretational biases that maintain the disorder. Changing interpretations is therefore a major aim of CT of PDs. This study tested whether Borderline PD (BPD), Avoidant and Dependent PD (AV/DEPD), and Obsessive-Compulsive PD (OCPD) are characterized by specific interpretations. Among the 122 participants there were 55 PD patients (17 BPD, 30 AV/DEPD, 29 OCPD diagnoses), 26 axis-1 patients, and 41 nonpatients. Participants put themselves into 10 scripts of negative events and noted feelings, thoughts and behaviors that came to mind. Next, they chose between hypothesized BPD-specific, AV/DEPD-specific, and OCPD-specific interpretations of each event (forced choice). Lastly, participants rated belief in each interpretation. Regression analyses revealed that forced choices and belief ratings supported the CT-model of BPD and AV/DEP: interpretations were specific. The alleged OCPD-beliefs were however not specifically related to OCPD, with relatively high popularity in axis-1 patients and nonpatients. The open responses were classified by judges blind for diagnoses, with the following results. BPD was characterized by low levels of solution-focused and healthy-flexible/accepting responses, and higher levels of criticizing others and malevolent interpretations of others. AV/DEPD was characterized by lower levels of solution-focused responses, and higher levels of self-criticism, negative emotions, guilt and fear of judgment, as well as lower levels of other-criticism. OCPD only showed trends for lower healthy responses, and higher compulsiveness and worry. It is concluded that the assumptions of CT are supported for BPD and AV/DEPD, but not - at least not on the explicit interpretational level - for OCPD. CT of OCPD might need a slightly different approach. Copyright © 2011 Elsevier Ltd. All rights reserved.

Extended Smoluchowski models for interpreting relaxation phenomena in liquids

International Nuclear Information System (INIS)

Polimeno, A.; Frezzato, D.; Saielli, G.; Moro, G.J.; Nordio, P.L.

1998-01-01

Interpretation of the dynamical behaviour of single molecules or collective modes in liquids has been increasingly centered, in the last decade, on complex liquid systems, including ionic solutions, polymeric liquids, supercooled fluids and liquid crystals. This has been made necessary by the need of interpreting dynamical data obtained by advanced experiments, like optical Kerr effect, time dependent fluorescence shift experiments, two-dimensional Fourier-transform and high field electron spin resonance and scattering experiments like quasi-elastic neutron scattering. This communication is centered on the definition, treatment and application of several extended stochastic models, which have proved to be very effective tools for interpreting and rationalizing complex relaxation phenomena in liquids structures. First, applications of standard Fokker-Planck equations for the orientational relaxation of molecules in isotropic and ordered liquid phase are reviewed. In particular attention will be focused on the interpretation of neutron scattering in nematics. Next, an extended stochastic model is used to interpret time-domain resolved fluorescence emission experiments. A two-body stochastic model allows the theoretical interpretation of dynamical Stokes shift effects in fluorescence emission spectra, performed on probes in isotropic and ordered polar phases. Finally, for the case of isotropic fluids made of small rigid molecules, a very detailed model is considered, which includes as basic ingredients a Fokker-Planck description of the molecular vibrational motion and the slow diffusive motion of a persistent cage structure together with the decay processes related to the changing structure of the cage. (author)

The Impact of Linking Distinct Achievement Test Scores on the Interpretation of Student Growth in Achievement

Science.gov (United States)

Airola, Denise Tobin

2011-01-01

Changes to state tests impact the ability of State Education Agencies (SEAs) to monitor change in performance over time. The purpose of this study was to evaluate the Standardized Performance Growth Index (PGIz), a proposed statistical model for measuring change in student and school performance, across transitions in tests. The PGIz is a…

Interpretation of Coronary Angiograms Recorded Using Google Glass: A Comparative Analysis.

Science.gov (United States)

Duong, Thao; Wosik, Jedrek; Christakopoulos, Georgios E; Martínez Parachini, José Roberto; Karatasakis, Aris; Tarar, Muhammad Nauman Javed; Resendes, Erica; Rangan, Bavana V; Roesle, Michele; Grodin, Jerrold; Abdullah, Shuaib M; Banerjee, Subhash; Brilakis, Emmanouil S

2015-10-01

Google Glass (Google, Inc) is a voice-activated, hands-free, optical head-mounted display device capable of taking pictures, recording videos, and transmitting data via wi-fi. In the present study, we examined the accuracy of coronary angiogram interpretation, recorded using Google Glass. Google Glass was used to record 15 angiograms with 17 major findings and the participants were asked to interpret those recordings on: (1) an iPad (Apple, Inc); or (2) a desktop computer. Interpretation was compared with the original angiograms viewed on a desktop. Ten physicians (2 interventional cardiologists and 8 cardiology fellows) participated. One point was assigned for each correct finding, for a maximum of 17 points. The mean angiogram interpretation score for Google Glass angiogram recordings viewed on an iPad or a desktop vs the original angiograms viewed on a desktop was 14.9 ± 1.1, 15.2 ± 1.8, and 15.9 ± 1.1, respectively (P=.06 between the iPad and the original angiograms, P=.51 between the iPad and recordings viewed on a desktop, and P=.43 between the recordings viewed on a desktop and the original angiograms). In a post-study survey, one of the 10 physicians (10%) was "neutral" with the quality of the recordings using Google Glass, 6 physicians (60%) were "somewhat satisfied," and 3 physicians (30%) were "very satisfied." This small pilot study suggests that the quality of coronary angiogram video recordings obtained using Google Glass may be adequate for recognition of major findings, supporting its expanding use in telemedicine.

An analysis of diversity in the cognitive performance of elderly community dwellers: individual differences in change scores as a function of age.

Science.gov (United States)

Christensen, H; Mackinnon, A J; Korten, A E; Jorm, A F; Henderson, A S; Jacomb, P; Rodgers, B

1999-09-01

This longitudinal study investigated whether age is associated with increases in interindividual variability across 4 ability domains using a sample of 426 elderly community dwellers followed over 3.5 years. Interindividual variability in change scores increased with age for memory, spatial functioning, and speed but not for crystallized intelligence for the full sample and in a subsample that excluded dementia or probable dementia cases. Hierarchical regression analyses indicated that being female, having weaker muscle strength, and having greater symptoms of illness and greater depression were associated with overall greater variability in cognitive scores. Having a higher level of education was associated with reduced variability. These findings are consistent with the view that there is a greater range of responses at older ages, that certain domains of intelligence are less susceptible to variation than others and that variables other than age affect cognitive performance in later life.

Digital Capture and Fabrication Tools for Interpretation of Historic Sites

Science.gov (United States)

Ackerman, A.; Glekas, E.

2017-08-01

Historic sites and the narratives they produce can have a lasting impact on the community through public engagement and education. However, when these sites are neglected and lost over time, opportunities to engage the public with the history of these places is lost with them. The interpretation of heritage that has been lost or forgotten is an emerging trend in humanities studies. This trend, in combination with technological advancements in digital media and representation, presents an innovative opportunity for historic preservation professionals to create new paths for public engagement. This paper discusses applications of photogrammetry, 3D modeling, and digital fabrication in digitally reconstructing interpretive models of the Larz Anderson Estate (now Larz Anderson Park). This site has changed dramatically through its transition from a private estate to a public park and recreation area, with few remnants of the original estate remaining extant. The above stated use of digital strategies aims to create digital and physical models of the estate's change over time, with the aim of interpreting the site's lost heritage for the public. Combining existing archival research and heritage documentation methods with these digital representation techniques tells the story of a place that no longer exists.

Scoring inflammatory activity of the spine by magnetic resonance imaging in ankylosing spondylitis: a multireader experiment

DEFF Research Database (Denmark)

Lukas, Cédric; Braun, Jürgen; van der Heijde, Désirée

2007-01-01

= 10) and selected to cover a wide range of activity at baseline and change in activity, were presented electronically in a partial latin-square design to 9 experienced readers from different countries (Europe, Canada). Readers scored each set of MRI 3 times, using 3 different methods including...... the Ankylosing Spondylitis spine Magnetic Resonance Imaging-activity [ASspiMRI-a, grading activity (0-6) per vertebral unit in 23 units]; the Berlin modification of the ASspiMRI-a; and the Spondyloarthritis Research Consortium of Canada (SPARCC) scoring system, which scores the 6 vertebral units considered......) assessed by Z-scores was good and comparable among methods. CONCLUSION: This experiment demonstrates the feasibility of multiple-reader MRI scoring exercises for method comparison, provides evidence for the feasibility, reliability, sensitivity to change, and discriminatory capacity of all 3 tested scoring...

Neutral vs positive oral contrast in diagnosing acute appendicitis with contrast-enhanced CT: sensitivity, specificity, reader confidence and interpretation time

Science.gov (United States)

Naeger, D M; Chang, S D; Kolli, P; Shah, V; Huang, W; Thoeni, R F

2011-01-01

Objective The study compared the sensitivity, specificity, confidence and interpretation time of readers of differing experience in diagnosing acute appendicitis with contrast-enhanced CT using neutral vs positive oral contrast agents. Methods Contrast-enhanced CT for right lower quadrant or right flank pain was performed in 200 patients with neutral and 200 with positive oral contrast including 199 with proven acute appendicitis and 201 with other diagnoses. Test set disease prevalence was 50%. Two experienced gastrointestinal radiologists, one fellow and two first-year residents blindly assessed all studies for appendicitis (2000 readings) and assigned confidence scores (1=poor to 4=excellent). Receiver operating characteristic (ROC) curves were generated. Total interpretation time was recorded. Each reader's interpretation with the two agents was compared using standard statistical methods. Results Average reader sensitivity was found to be 96% (range 91–99%) with positive and 95% (89–98%) with neutral oral contrast; specificity was 96% (92–98%) and 94% (90–97%). For each reader, no statistically significant difference was found between the two agents (sensitivities p-values >0.6; specificities p-values>0.08), in the area under the ROC curve (range 0.95–0.99) or in average interpretation times. In cases without appendicitis, positive oral contrast demonstrated improved appendix identification (average 90% vs 78%) and higher confidence scores for three readers. Average interpretation times showed no statistically significant differences between the agents. Conclusion Neutral vs positive oral contrast does not affect the accuracy of contrast-enhanced CT for diagnosing acute appendicitis. Although positive oral contrast might help to identify normal appendices, we continue to use neutral oral contrast given its other potential benefits. PMID:20959365

Stability and Change in the Cognitive and Adaptive Behaviour Scores of Preschoolers with Autism Spectrum Disorder

Science.gov (United States)

Flanagan, Helen E.; Smith, Isabel M.; Vaillancourt, Tracy; Duku, Eric; Szatmari, Peter; Bryson, Susan; Fombonne, Eric; Mirenda, Pat; Roberts, Wendy; Volden, Joanne; Waddell, Charlotte; Zwaigenbaum, Lonnie; Bennett, Teresa; Elsabbagh, Mayada; Georgiades, Stelios

2015-01-01

We examined the stability of cognitive and adaptive behaviour standard scores in children with autism spectrum disorder (ASD) between diagnosis and school entry approximately age 6. IQ increased 18 points in 2-year-olds, 12 points in 3-year-olds, and 9 points in 4-year-olds (N = 281). Adaptive behaviour scores increased 4 points across age groups…

Reformulation of the Children's Eating Attitudes Test (ChEAT): factor structure and scoring method in a non-clinical population.

Science.gov (United States)

Anton, S D; Han, H; Newton, R L; Martin, C K; York-Crowe, E; Stewart, T M; Williamson, D A

2006-12-01

The primary aims of this study were to empirically test the factor structure of the Children's Eating Attitudes Test (ChEAT) through both exploratory and confirmatory factor analyses and to interpret the factor structure of the ChEAT within the context of a new scoring method. The ChEAT was administered to 728 children in the 2nd through 6th grades (from five schools) at two different time points. Exactly half the students were male and half were female. To the best of our knowledge, this is the first study to empirically test the merits of an alternative 6-point scoring system as compared to the traditionally used 4-point scoring system. With the new scoring procedure, the skewness for all factor scores decreased, which resulted in increased variance in the item scores, as well as the total ChEAT score. Since the internal consistency of two factors in a recently proposed model was not acceptable (ChEAT reported by previous investigations. Intercorrelations among the factors suggested three higher order constructs. These findings indicate that the ChEAT subscales may be sufficiently stable to allow use in non-clinical samples of children.

Scoring function to predict solubility mutagenesis

Directory of Open Access Journals (Sweden)

Deutsch Christopher

2010-10-01

Full Text Available Abstract Background Mutagenesis is commonly used to engineer proteins with desirable properties not present in the wild type (WT protein, such as increased or decreased stability, reactivity, or solubility. Experimentalists often have to choose a small subset of mutations from a large number of candidates to obtain the desired change, and computational techniques are invaluable to make the choices. While several such methods have been proposed to predict stability and reactivity mutagenesis, solubility has not received much attention. Results We use concepts from computational geometry to define a three body scoring function that predicts the change in protein solubility due to mutations. The scoring function captures both sequence and structure information. By exploring the literature, we have assembled a substantial database of 137 single- and multiple-point solubility mutations. Our database is the largest such collection with structural information known so far. We optimize the scoring function using linear programming (LP methods to derive its weights based on training. Starting with default values of 1, we find weights in the range [0,2] so that predictions of increase or decrease in solubility are optimized. We compare the LP method to the standard machine learning techniques of support vector machines (SVM and the Lasso. Using statistics for leave-one-out (LOO, 10-fold, and 3-fold cross validations (CV for training and prediction, we demonstrate that the LP method performs the best overall. For the LOOCV, the LP method has an overall accuracy of 81%. Availability Executables of programs, tables of weights, and datasets of mutants are available from the following web page: http://www.wsu.edu/~kbala/OptSolMut.html.

An objective interpretation of Lagrangian quantum mechanics

International Nuclear Information System (INIS)

Roberts, K.V.

1978-01-01

Unlike classical mechanics, the Copenhagen interpretation of quantum mechanics does not provide an objective space-time picture of the actual history of a physical system. This paper suggests how the conceptual foundations of quantum mechanics can be reformulated, without changing the mathematical content of the theory or its detailed agreement with experiment and without introducing any hidden variables, in order to provide an objective, covariant, Lagrangian description of reality which is deterministic and time-symmetric on the microscopic scale. The basis of this description can be expressed either as an action functional or as a summation over Feynman diagrams or paths. The probability laws associated with the quantum-mechanical measurement process, and the asymmetry in time of the principles of macroscopic causality and of the laws of statistical mechanics, are interpreted as consequences of the particular boundary conditions that apply to the actual universe. The objective interpretation does not include the observer and the measurement process among the fundamental concepts of the theory, but it does not entail a revision of the ideas of determinism and of time, since in a Lagrangian theory both initial and final boundary conditions on the action functional are required. (author)

What does my patient's coronary artery calcium score mean? Combining information from the coronary artery calcium score with information from conventional risk factors to estimate coronary heart disease risk

Directory of Open Access Journals (Sweden)

Pletcher Mark J

2004-08-01

Full Text Available Abstract Background The coronary artery calcium (CAC score is an independent predictor of coronary heart disease. We sought to combine information from the CAC score with information from conventional cardiac risk factors to produce post-test risk estimates, and to determine whether the score may add clinically useful information. Methods We measured the independent cross-sectional associations between conventional cardiac risk factors and the CAC score among asymptomatic persons referred for non-contrast electron beam computed tomography. Using the resulting multivariable models and published CAC score-specific relative risk estimates, we estimated post-test coronary heart disease risk in a number of different scenarios. Results Among 9341 asymptomatic study participants (age 35–88 years, 40% female, we found that conventional coronary heart disease risk factors including age, male sex, self-reported hypertension, diabetes and high cholesterol were independent predictors of the CAC score, and we used the resulting multivariable models for predicting post-test risk in a variety of scenarios. Our models predicted, for example, that a 60-year-old non-smoking non-diabetic women with hypertension and high cholesterol would have a 47% chance of having a CAC score of zero, reducing her 10-year risk estimate from 15% (per Framingham to 6–9%; if her score were over 100, however (a 17% chance, her risk estimate would be markedly higher (25–51% in 10 years. In low risk scenarios, the CAC score is very likely to be zero or low, and unlikely to change management. Conclusion Combining information from the CAC score with information from conventional risk factors can change assessment of coronary heart disease risk to an extent that may be clinically important, especially when the pre-test 10-year risk estimate is intermediate. The attached spreadsheet makes these calculations easy.

Intercept Centering and Time Coding in Latent Difference Score Models

Science.gov (United States)

Grimm, Kevin J.

2012-01-01

Latent difference score (LDS) models combine benefits derived from autoregressive and latent growth curve models allowing for time-dependent influences and systematic change. The specification and descriptions of LDS models include an initial level of ability or trait plus an accumulation of changes. A limitation of this specification is that the…

Interpretations of Resilience and Change and The Catalytic Roles of Media: A Case of Canadian Daily Newspaper Discourse on Natural Disasters

Science.gov (United States)

Choudhury, Mahed-Ul-Islam; Emdad Haque, C.

2018-02-01

The varied interpretations of the concept of resilience in natural hazards research literature has attracted numerous criticisms. A common criticism centers around a poor understanding of the changes caused by natural disasters by the research stream. Considering resilience as a metaphor of change, and newspaper as a catalyst that often highlights post-disaster opportunities for "forward looking" (rather than bouncing back) changes, we examined some specific aspects of change in Canadian communities by analyzing coverage of natural disasters in daily newspapers. We posit that post-disaster newspaper discourse on resilience and change can not only assist enhancing academic inquiries on resilience but also contribute to improving practices for transformative changes in post-disaster contexts. We adopted a social constructivist approach to analyzing newspaper discourse, using the ProQuest database to find articles from the 1996-2017 period. The findings exhibited a trend of the increased use of narratives on resilience in Canadian newspapers since the 1990s that substantiates the hypothesis that transformative change in the personal and practical spheres requires alteration of peoples' attitude, behavior, and thinking toward environmental risks. The discourse emphasized incremental changes at the policy level: (i) to improve response and recovery, and (ii) to address the needs of vulnerable and disaster-affected population. Our findings overall underscore the importance of documentation and efforts towards streamlining learning; application of learning at multiple interconnected levels for progressive changes to enhance community resilience, and the need for building consensus among academicians, practitioners and policy makers regarding the meaning and use of the concept of resilience.

Interpretations of Resilience and Change and The Catalytic Roles of Media: A Case of Canadian Daily Newspaper Discourse on Natural Disasters.

Science.gov (United States)

Choudhury, Mahed-Ul-Islam; Emdad Haque, C

2018-02-01

The varied interpretations of the concept of resilience in natural hazards research literature has attracted numerous criticisms. A common criticism centers around a poor understanding of the changes caused by natural disasters by the research stream. Considering resilience as a metaphor of change, and newspaper as a catalyst that often highlights post-disaster opportunities for "forward looking" (rather than bouncing back) changes, we examined some specific aspects of change in Canadian communities by analyzing coverage of natural disasters in daily newspapers. We posit that post-disaster newspaper discourse on resilience and change can not only assist enhancing academic inquiries on resilience but also contribute to improving practices for transformative changes in post-disaster contexts. We adopted a social constructivist approach to analyzing newspaper discourse, using the ProQuest database to find articles from the 1996-2017 period. The findings exhibited a trend of the increased use of narratives on resilience in Canadian newspapers since the 1990s that substantiates the hypothesis that transformative change in the personal and practical spheres requires alteration of peoples' attitude, behavior, and thinking toward environmental risks. The discourse emphasized incremental changes at the policy level: (i) to improve response and recovery, and (ii) to address the needs of vulnerable and disaster-affected population. Our findings overall underscore the importance of documentation and efforts towards streamlining learning; application of learning at multiple interconnected levels for progressive changes to enhance community resilience, and the need for building consensus among academicians, practitioners and policy makers regarding the meaning and use of the concept of resilience.

Interactive dedicated training curriculum improves accuracy in the interpretation of MR imaging of prostate cancer

International Nuclear Information System (INIS)

Akin, Oguz; Zhang, Jingbo; Hricak, Hedvig; Riedl, Christopher C.; Ishill, Nicole M.; Moskowitz, Chaya S.

2010-01-01

To assess the effect of interactive dedicated training on radiology fellows' accuracy in assessing prostate cancer on MRI. Eleven radiology fellows, blinded to clinical and pathological data, independently interpreted preoperative prostate MRI studies, scoring the likelihood of tumour in the peripheral and transition zones and extracapsular extension. Each fellow interpreted 15 studies before dedicated training (to supply baseline interpretation accuracy) and 200 studies (10/week) after attending didactic lectures. Expert radiologists led weekly interactive tutorials comparing fellows' interpretations to pathological tumour maps. To assess interpretation accuracy, receiver operating characteristic (ROC) analysis was conducted, using pathological findings as the reference standard. In identifying peripheral zone tumour, fellows' average area under the ROC curve (AUC) increased from 0.52 to 0.66 (after didactic lectures; p < 0.0001) and remained at 0.66 (end of training; p < 0.0001); in the transition zone, their average AUC increased from 0.49 to 0.64 (after didactic lectures; p = 0.01) and to 0.68 (end of training; p = 0.001). In detecting extracapsular extension, their average AUC increased from 0.50 to 0.67 (after didactic lectures; p = 0.003) and to 0.81 (end of training; p < 0.0001). Interactive dedicated training significantly improved accuracy in tumour localization and especially in detecting extracapsular extension on prostate MRI. (orig.)

Interactive dedicated training curriculum improves accuracy in the interpretation of MR imaging of prostate cancer

Energy Technology Data Exchange (ETDEWEB)

Akin, Oguz; Zhang, Jingbo; Hricak, Hedvig [Memorial Sloan-Kettering Cancer Center, Department of Radiology, New York, NY (United States); Riedl, Christopher C. [Memorial Sloan-Kettering Cancer Center, Department of Radiology, New York, NY (United States); Medical University of Vienna, Department of Radiology, Vienna (Austria); Ishill, Nicole M.; Moskowitz, Chaya S. [Memorial Sloan-Kettering Cancer Center, Epidemiology and Biostatistics, New York, NY (United States)

2010-04-15

To assess the effect of interactive dedicated training on radiology fellows' accuracy in assessing prostate cancer on MRI. Eleven radiology fellows, blinded to clinical and pathological data, independently interpreted preoperative prostate MRI studies, scoring the likelihood of tumour in the peripheral and transition zones and extracapsular extension. Each fellow interpreted 15 studies before dedicated training (to supply baseline interpretation accuracy) and 200 studies (10/week) after attending didactic lectures. Expert radiologists led weekly interactive tutorials comparing fellows' interpretations to pathological tumour maps. To assess interpretation accuracy, receiver operating characteristic (ROC) analysis was conducted, using pathological findings as the reference standard. In identifying peripheral zone tumour, fellows' average area under the ROC curve (AUC) increased from 0.52 to 0.66 (after didactic lectures; p < 0.0001) and remained at 0.66 (end of training; p < 0.0001); in the transition zone, their average AUC increased from 0.49 to 0.64 (after didactic lectures; p = 0.01) and to 0.68 (end of training; p = 0.001). In detecting extracapsular extension, their average AUC increased from 0.50 to 0.67 (after didactic lectures; p = 0.003) and to 0.81 (end of training; p < 0.0001). Interactive dedicated training significantly improved accuracy in tumour localization and especially in detecting extracapsular extension on prostate MRI. (orig.)

Description and validation of a scoring system for tomosynthesis in pulmonary cystic fibrosis

Energy Technology Data Exchange (ETDEWEB)

Vult von Steyern, Kristina; Bjoerkman-Burtscher, Isabella M.; Bozovic, Gracijela; Wiklund, Marie; Geijer, Mats [Skaane University Hospital, Lund University, Centre for Medical Imaging and Physiology, Lund (Sweden); Hoeglund, Peter [Skaane University Hospital, Competence Centre for Clinical Research, Lund (Sweden)

2012-12-15

To design and validate a scoring system for tomosynthesis (digital tomography) in pulmonary cystic fibrosis. A scoring system dedicated to tomosynthesis in pulmonary cystic fibrosis was designed. Three radiologists independently scored 88 pairs of radiographs and tomosynthesis examinations of the chest in 60 patients with cystic fibrosis and 7 oncology patients. Radiographs were scored according to the Brasfield scoring system and tomosynthesis examinations were scored using the new scoring system. Observer agreements for the tomosynthesis score were almost perfect for the total score with square-weighted kappa >0.90, and generally substantial to almost perfect for subscores. Correlation between the tomosynthesis score and the Brasfield score was good for the three observers (Kendall's rank correlation tau 0.68, 0.77 and 0.78). Tomosynthesis was generally scored higher as a percentage of the maximum score. Observer agreements for the total score for Brasfield score were almost perfect (square-weighted kappa 0.80, 0.81 and 0.85). The tomosynthesis scoring system seems robust and correlates well with the Brasfield score. Compared with radiography, tomosynthesis is more sensitive to cystic fibrosis changes, especially bronchiectasis and mucus plugging, and the new tomosynthesis scoring system offers the possibility of more detailed and accurate scoring of disease severity. (orig.)

Description and validation of a scoring system for tomosynthesis in pulmonary cystic fibrosis

International Nuclear Information System (INIS)

Vult von Steyern, Kristina; Bjoerkman-Burtscher, Isabella M.; Bozovic, Gracijela; Wiklund, Marie; Geijer, Mats; Hoeglund, Peter

2012-01-01

To design and validate a scoring system for tomosynthesis (digital tomography) in pulmonary cystic fibrosis. A scoring system dedicated to tomosynthesis in pulmonary cystic fibrosis was designed. Three radiologists independently scored 88 pairs of radiographs and tomosynthesis examinations of the chest in 60 patients with cystic fibrosis and 7 oncology patients. Radiographs were scored according to the Brasfield scoring system and tomosynthesis examinations were scored using the new scoring system. Observer agreements for the tomosynthesis score were almost perfect for the total score with square-weighted kappa >0.90, and generally substantial to almost perfect for subscores. Correlation between the tomosynthesis score and the Brasfield score was good for the three observers (Kendall's rank correlation tau 0.68, 0.77 and 0.78). Tomosynthesis was generally scored higher as a percentage of the maximum score. Observer agreements for the total score for Brasfield score were almost perfect (square-weighted kappa 0.80, 0.81 and 0.85). The tomosynthesis scoring system seems robust and correlates well with the Brasfield score. Compared with radiography, tomosynthesis is more sensitive to cystic fibrosis changes, especially bronchiectasis and mucus plugging, and the new tomosynthesis scoring system offers the possibility of more detailed and accurate scoring of disease severity. (orig.)

Functional MRI experiments : acquisition, analysis and interpretation of data

NARCIS (Netherlands)

Ramsey, NF; Hoogduin, H; Jansma, JM

2002-01-01

Functional MRI is widely used to address basic and clinical neuroscience questions. In the key domains of fMRI experiments, i.e. acquisition, processing and analysis, and interpretation of data, developments are ongoing. The main issues are sensitivity for changes in fMRI signal that are associated

Divorce and Child Behavior Problems: Applying Latent Change Score Models to Life Event Data

Science.gov (United States)

Malone, Patrick S.; Lansford, Jennifer E.; Castellino, Domini R.; Berlin, Lisa J.; Dodge, Kenneth A.; Bates, John E.; Pettit, Gregory S.

2009-01-01

Effects of parents' divorce on children's adjustment have been studied extensively. This article applies new advances in trajectory modeling to the problem of disentangling the effects of divorce on children's adjustment from related factors such as the child's age at the time of divorce and the child's gender. Latent change score models were used to examine trajectories of externalizing behavior problems in relation to children's experience of their parents' divorce. Participants included 356 boys and girls whose biological parents were married at kindergarten entry. The children were assessed annually through Grade 9. Mothers reported whether they had divorced or separated in each 12-month period, and teachers reported children's externalizing behavior problems each year. Girls' externalizing behavior problem trajectories were not affected by experiencing their parents' divorce, regardless of the timing of the divorce. In contrast, boys who were in elementary school when their parents divorced showed an increase in externalizing behavior problems in the year of the divorce. This increase persisted in the years following the divorce. Boys who were in middle school when their parents divorced showed an increase in externalizing behavior problems in the year of the divorce followed by a decrease to below baseline levels in the year after the divorce. This decrease persisted in the following years. PMID:20209039

[Skin biopsy in diagnosis of chronic graft-versus-host disease in patients after allogeneic haematopoietic stem cell transplantation: pathologist's point of view on quantitative scoring system].

Science.gov (United States)

Grzanka, Dariusz; Styczyński, Jan; Debski, Robert; Krenska, Anna; Pacholska, Małgorzata; Prokurat, Andrzej I; Wysocki, Mariusz; Marszałek, Andrzej

2008-01-01

Pathology diagnosis of chronic graft-versus-host-disease (GVHD) after allogeneic haematopoietic stem cell transplantation (allo-HSCT) is an important issue in clinical follow-up, in spite of frequent difficulties in interpretation., related to dynamic changes occurring in the skin during the disease, as well as to sequelae of basic disease and immunosuppressive therapy. Recently presented Consensus NIH (National Health Institute, Bethesda, USA) of histopathologic (HP) analysis is still complex and intrinsically divergent, thus clinically difficult to implement. Analysis of clinical value of histological evaluation results of skin biopsy in children after allo-HSCT and its correlation with clinical status. Ten skin biopsies were taken from 7 patients (4 boys, 3 girls, age 3-15 years) after allo-HSCT (6 MFD, 1 MMUD) and analyzed after hematoxylin/eosine and immunohistochemical (CD3, CD45T, CD20) staining. Pathology analysis was based on commonly accepted criteria enabling simple and unambiguous interpretation. Results were compared with clinical data and indications for immunosuppressive therapy. It was found that reliable and coherent interpretation can be made when following parameters were taken into account: 1. in epithelium: the presence of apoptosis, archetypical changes and vacuolar degeneration in the basilar layer, presence of CD3/CD45 in the epidermis; 2. in the dermis: the extent of collagenization, presence of melanophages and lymphocyte infiltrations; 3. in the eccrine glands epithelium: eccrine glands atrophy and presence of lymphocytes. A new scoring system of skin biopsy analysis in patients with chronic GVHD based on the modified NIH Consensus was proposed. The preliminary clinical value of histological results was assessed. Skin biopsy evaluation based on limited qualitative and quantitative analysis of lymphocyte infiltrates together with studies on intensity of apoptosis, collagenization and archetypical changes is a valuable diagnostic method

The Role of Interpretation in the Internationalization of Smaller Brazilian Firms

Directory of Open Access Journals (Sweden)

Rene Eugenio Seifert

2012-10-01

Full Text Available This study considers how decision-makers in smaller firms interpret the means and conditions of internationalization, and how different modes of interpretation are likely to inform action choices in this process. Drawing on 58 qualitative interviews with the leaders of Brazilian small and medium-sized enterprises (SMEsin the clothing industry located in the state of Paraná, the results support the contention that different understandings given to the means/conditions of internationalization are associated with different action choices. More specifically, the results indicate that: (a interpretation changes the criteria and parameters by which rational choices on internationalization are made; (b a comprehensive explanation of internationalization on the basis of situational characteristics is likely to be inconclusive without taking into account decision-makers’ interpretations; (c particular meanings given to internationalization are likely to inform choice in different ways, (d managers act on the basis of their inter-subjectively negotiated, shared and sustained reality; and (e investigative proximity with practitioners is pivotal in order to comprehensively account for their interpretations.

Soetomo score: score model in early identification of acute haemorrhagic stroke

Directory of Open Access Journals (Sweden)

Moh Hasan Machfoed

2016-06-01

Full Text Available Aim of the study: On financial or facility constraints of brain imaging, score model is used to predict the occurrence of acute haemorrhagic stroke. Accordingly, this study attempts to develop a new score model, called Soetomo score. Material and methods: The researchers performed a cross-sectional study of 176 acute stroke patients with onset of ≤24 hours who visited emergency unit of Dr. Soetomo Hospital from July 14th to December 14th, 2014. The diagnosis of haemorrhagic stroke was confirmed by head computed tomography scan. There were seven predictors of haemorrhagic stroke which were analysed by using bivariate and multivariate analyses. Furthermore, a multiple discriminant analysis resulted in an equation of Soetomo score model. The receiver operating characteristic procedure resulted in the values of area under curve and intersection point identifying haemorrhagic stroke. Afterward, the diagnostic test value was determined. Results: The equation of Soetomo score model was (3 × loss of consciousness + (3.5 × headache + (4 × vomiting − 4.5. Area under curve value of this score was 88.5% (95% confidence interval = 83.3–93.7%. In the Soetomo score model value of ≥−0.75, the score reached the sensitivity of 82.9%, specificity of 83%, positive predictive value of 78.8%, negative predictive value of 86.5%, positive likelihood ratio of 4.88, negative likelihood ratio of 0.21, false negative of 17.1%, false positive of 17%, and accuracy of 83%. Conclusions: The Soetomo score model value of ≥−0.75 can identify acute haemorrhagic stroke properly on the financial or facility constrains of brain imaging.

Hope, Interpreter Self-efficacy, and Social Impacts: Assessment of the NNOCCI Training

Science.gov (United States)

Fraser, J.; Swim, J.

2012-12-01

Conservation educators at informal science learning centers are well-positioned to teach climate science and motivate action but have resisted the topic. Our research demonstrates their resist is due to self-doubt about climate science facts and the belief they will encounter negative audience feedback. Further, this self-doubt and self-silencing is emotional taxing. As a result we have developed a National Network for Ocean Climate Change Interpretation's (NNOCCI) program that addresses educators' needs for technical training and emotional scaffolding to help them fully engage with this work. The evaluation of this program sought to understand how to support educators interested in promoting public literacy on climate change through engagement with a structured training program aimed at increased the efficacy of interpreters through teaching strategic framing strategies. The program engaged educator dyads from informal science learning sites to attend an online and in-person program that initiated a new community of practice focused on sharing techniques and tools for ocean climate change interpretation. The presentation will summarize a model for embedded assessment across all aspects of a program and how social vectors, based upon educators' interpersonal and professional relationships, impact the understanding of an educator's work across their life-world. This summary will be followed by results from qualitative front-end research that demonstrated the psychologically complex emotional conditions that describe the experience of being an environmental educator. The project evaluators will then present results from their focus groups and social network analysis to demonstrate how training impacted in-group relationships, skill development, and the layered social education strategies that help communities engage with the content. Results demonstrated that skill training increased educator's hope--in the form of increased perceived agency and plans for educational

Further Simplification of the Simple Erosion Narrowing Score With Item Response Theory Methodology.

Science.gov (United States)

Oude Voshaar, Martijn A H; Schenk, Olga; Ten Klooster, Peter M; Vonkeman, Harald E; Bernelot Moens, Hein J; Boers, Maarten; van de Laar, Mart A F J

2016-08-01

To further simplify the simple erosion narrowing score (SENS) by removing scored areas that contribute the least to its measurement precision according to analysis based on item response theory (IRT) and to compare the measurement performance of the simplified version to the original. Baseline and 18-month data of the Combinatietherapie Bij Reumatoide Artritis (COBRA) trial were modeled using longitudinal IRT methodology. Measurement precision was evaluated across different levels of structural damage. SENS was further simplified by omitting the least reliably scored areas. Discriminant validity of SENS and its simplification were studied by comparing their ability to differentiate between the COBRA and sulfasalazine arms. Responsiveness was studied by comparing standardized change scores between versions. SENS data showed good fit to the IRT model. Carpal and feet joints contributed the least statistical information to both erosion and joint space narrowing scores. Omitting the joints of the foot reduced measurement precision for the erosion score in cases with below-average levels of structural damage (relative efficiency compared with the original version ranged 35-59%). Omitting the carpal joints had minimal effect on precision (relative efficiency range 77-88%). Responsiveness of a simplified SENS without carpal joints closely approximated the original version (i.e., all Δ standardized change scores were ≤0.06). Discriminant validity was also similar between versions for both the erosion score (relative efficiency = 97%) and the SENS total score (relative efficiency = 84%). Our results show that the carpal joints may be omitted from the SENS without notable repercussion for its measurement performance. © 2016, American College of Rheumatology.

Ranking of microRNA target prediction scores by Pareto front analysis.

Science.gov (United States)

Sahoo, Sudhakar; Albrecht, Andreas A

2010-12-01

Over the past ten years, a variety of microRNA target prediction methods has been developed, and many of the methods are constantly improved and adapted to recent insights into miRNA-mRNA interactions. In a typical scenario, different methods return different rankings of putative targets, even if the ranking is reduced to selected mRNAs that are related to a specific disease or cell type. For the experimental validation it is then difficult to decide in which order to process the predicted miRNA-mRNA bindings, since each validation is a laborious task and therefore only a limited number of mRNAs can be analysed. We propose a new ranking scheme that combines ranked predictions from several methods and - unlike standard thresholding methods - utilises the concept of Pareto fronts as defined in multi-objective optimisation. In the present study, we attempt a proof of concept by applying the new ranking scheme to hsa-miR-21, hsa-miR-125b, and hsa-miR-373 and prediction scores supplied by PITA and RNAhybrid. The scores are interpreted as a two-objective optimisation problem, and the elements of the Pareto front are ranked by the STarMir score with a subsequent re-calculation of the Pareto front after removal of the top-ranked mRNA from the basic set of prediction scores. The method is evaluated on validated targets of the three miRNA, and the ranking is compared to scores from DIANA-microT and TargetScan. We observed that the new ranking method performs well and consistent, and the first validated targets are elements of Pareto fronts at a relatively early stage of the recurrent procedure, which encourages further research towards a higher-dimensional analysis of Pareto fronts. Copyright © 2010 Elsevier Ltd. All rights reserved.

Workplace-based assessments of junior doctors: do scores predict training difficulties?

Science.gov (United States)

Mitchell, Colin; Bhat, Sarita; Herbert, Anne; Baker, Paul

2011-12-01

scores is, however, not a valid way of screening for trainees in difficulty. Workplace-based assessments have value as formative assessments that prompt supervision, feedback and reflection. They should not be relied upon to certify competence and their use for such ends may reduce their effectiveness in training. Their results should be interpreted in the context of multiple other methods of assessment, with the aim of achieving a genuinely holistic and representative assessment of professional competence. © Blackwell Publishing Ltd 2011.

Medical interpreters as tools: dangers and challenges in the utilitarian approach to interpreters' roles and functions.

Science.gov (United States)

Hsieh, Elaine; Kramer, Eric Mark

2012-10-01

This study explores the tensions, challenges, and dangers when a utilitarian view of interpreter is constructed, imposed, and/or reinforced in health care settings. We conducted in-depth interviews and focus groups with 26 medical interpreters from 17 different languages and cultures and 39 providers of five specialties. Grounded theory was used for data analysis. The utilitarian view to interpreters' roles and functions influences providers in the following areas: (a) hierarchical structure and unidirectional communication, (b) the interpreter seen as information gatekeeper, (c) the interpreter seen as provider proxy, and (d) interpreter's emotional support perceived as tools. When interpreters are viewed as passive instruments, a utilitarian approach may compromise the quality of care by silencing patients' and interpreters' voice, objectifying interpreters' emotional work, and exploiting patients' needs. Providers need to recognize that a utilitarian approach to the interpreter's role and functions may create interpersonal and ethical dilemmas that compromise the quality of care. By viewing interpreters as smart technology (rather than passive instruments), both providers and interpreters can learn from and co-evolve with each other, allowing them to maintain control over their expertise and to work as collaborators in providing quality care. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Interpretive versus noninterpretive content in top-selling radiology textbooks: what are we teaching medical students?

Science.gov (United States)

Webb, Emily M; Vella, Maya; Straus, Christopher M; Phelps, Andrew; Naeger, David M

2015-04-01

There are little data as to whether appropriate, cost effective, and safe ordering of imaging examinations are adequately taught in US medical school curricula. We sought to determine the proportion of noninterpretive content (such as appropriate ordering) versus interpretive content (such as reading a chest x-ray) in the top-selling medical student radiology textbooks. We performed an online search to identify a ranked list of the six top-selling general radiology textbooks for medical students. Each textbook was reviewed including content in the text, tables, images, figures, appendices, practice questions, question explanations, and glossaries. Individual pages of text and individual images were semiquantitatively scored on a six-level scale as to the percentage of material that was interpretive versus noninterpretive. The predominant imaging modality addressed in each was also recorded. Descriptive statistical analysis was performed. All six books had more interpretive content. On average, 1.4 pages of text focused on interpretation for every one page focused on noninterpretive content. Seventeen images/figures were dedicated to interpretive skills for every one focused on noninterpretive skills. In all books, the largest proportion of text and image content was dedicated to plain films (51.2%), with computed tomography (CT) a distant second (16%). The content on radiographs (3.1:1) and CT (1.6:1) was more interpretive than not. The current six top-selling medical student radiology textbooks contain a preponderance of material teaching image interpretation compared to material teaching noninterpretive skills, such as appropriate imaging examination selection, rational utilization, and patient safety. Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.

[Circadian rhythm : Influence on Epworth Sleepiness Scale score].

Science.gov (United States)

Herzog, M; Bedorf, A; Rohrmeier, C; Kühnel, T; Herzog, B; Bremert, T; Plontke, S; Plößl, S

2017-02-01

The Epworth Sleepiness Scale (ESS) is frequently used to determine daytime sleepiness in patients with sleep-disordered breathing. It is still unclear whether different levels of alertness induced by the circadian rhythm influence ESS score. The aim of this study is to investigate the influence of circadian rhythm-dependent alertness on ESS performance. In a monocentric prospective noninterventional observation study, 97 patients with suspected sleep-disordered breathing were investigated with respect to daytime sleepiness in temporal relationship to polysomnographic examination and treatment. The Karolinska Sleepiness Scale (KSS) and the Stanford Sleepiness Scale (SSS) served as references for the detection of present sleepiness at three different measurement times (morning, noon, evening), prior to and following a diagnostic polysomnography night as well as after a continuous positive airway pressure (CPAP) titration night (9 measurements in total). The KSS, SSS, and ESS were performed at these times in a randomized order. The KSS and SSS scores revealed a circadian rhythm-dependent curve with increased sleepiness at noon and in the evening. Following a diagnostic polysomnography night, the scores were increased compared to the measurements prior to the night. After the CPAP titration night, sleepiness in the morning was reduced. KSS and SSS reflect the changes in alertness induced by the circadian rhythm. The ESS score war neither altered by the intra-daily nor by the inter-daily changes in the level of alertness. According to the present data, the ESS serves as a reliable instrument to detect the level of daytime sleepiness independently of the circadian rhythm-dependent level of alertness.

Algorithm improvement program nuclide identification algorithm scoring criteria and scoring application.

Energy Technology Data Exchange (ETDEWEB)

Enghauser, Michael [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

2016-02-01

The goal of the Domestic Nuclear Detection Office (DNDO) Algorithm Improvement Program (AIP) is to facilitate gamma-radiation detector nuclide identification algorithm development, improvement, and validation. Accordingly, scoring criteria have been developed to objectively assess the performance of nuclide identification algorithms. In addition, a Microsoft Excel spreadsheet application for automated nuclide identification scoring has been developed. This report provides an overview of the equations, nuclide weighting factors, nuclide equivalencies, and configuration weighting factors used by the application for scoring nuclide identification algorithm performance. Furthermore, this report presents a general overview of the nuclide identification algorithm scoring application including illustrative examples.

Psychometric properties of the Neck OutcOme Score, Neck Disability Index, and Short Form-36 were evaluated in patients with neck pain

DEFF Research Database (Denmark)

Juul, Tina; Søgaard, Karen; Davis, Aileen M.

2016-01-01

Objective:To assess reliability, construct validity, responsiveness, and interpretability for Neck OutcOme Score (NOOS), Neck Disability Index (NDI), and Short Form–36 (SF-36) in neck pain patients. Study Design and Setting: Internal consistency was assessed by Cronbach alpha. Test-retest reliabi...

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.

Interpreting Ex-Dividend Evidence: The Citizens Utilities Case Reconsidered

OpenAIRE

James M. Poterba

1983-01-01

Numerous empirical studies have attempted to measure the effect of changes in dividend policy on corporate equity values. One of the most popular study methodologies has been an examination of share price changes around ex-dividend days. Comparing the movement in a stock's price with its nominal dividend payment leads to estimates of the stock market's relative valuation of dividends and capital gains. Ex-day price studies are often interpreted as showing that investors recognize their tax li...

Derivation and Cross-Validation of Cutoff Scores for Patients With Schizophrenia Spectrum Disorders on WAIS-IV Digit Span-Based Performance Validity Measures.

Science.gov (United States)

Glassmire, David M; Toofanian Ross, Parnian; Kinney, Dominique I; Nitch, Stephen R

2016-06-01

Two studies were conducted to identify and cross-validate cutoff scores on the Wechsler Adult Intelligence Scale-Fourth Edition Digit Span-based embedded performance validity (PV) measures for individuals with schizophrenia spectrum disorders. In Study 1, normative scores were identified on Digit Span-embedded PV measures among a sample of patients (n = 84) with schizophrenia spectrum diagnoses who had no known incentive to perform poorly and who put forth valid effort on external PV tests. Previously identified cutoff scores resulted in unacceptable false positive rates and lower cutoff scores were adopted to maintain specificity levels ≥90%. In Study 2, the revised cutoff scores were cross-validated within a sample of schizophrenia spectrum patients (n = 96) committed as incompetent to stand trial. Performance on Digit Span PV measures was significantly related to Full Scale IQ in both studies, indicating the need to consider the intellectual functioning of examinees with psychotic spectrum disorders when interpreting scores on Digit Span PV measures. © The Author(s) 2015.

The impact of a revised EQ-5D population scoring on preference-based utility scores in an inflammatory arthritis cohort.

LENUS (Irish Health Repository)

Adams, Roisin

2012-02-01

BACKGROUND AND OBJECTIVE: It is well established that there are problems with the EQ-5D. This is due to the original scoring methods used and how negative time trade-off (TTO) values were treated. A revised scoring method has been published. This article applies this to an inflammatory arthritis cohort. The objective is to examine the impact of a revised scoring system for the EQ-5D (UK) TTO on the utility estimates and in the case of rheumatoid arthritis, to explore the impact of using different utility metrics on the incremental cost-effectiveness ratio (ICER) results of an economic model. METHODS: A total of 504 patients with inflammatory arthritis were rescored using revised EQ-5D scoring, which uses an episodic random utility model to deal with negative TTO values. Differences in utility scores were compared and the new mapping coefficients were obtained. These were then used in an economic model to examine the impact on the ICER. RESULTS: In rheumatoid arthritis, the overall change is less for the revised EQ-5D scoring than with the original EQ-5D (TTO) but greater than the SF-6D: EQ-5D UK -0.22 (95% confidence interval [CI] -0.30 to -0.15), revised EQ-5D UK -0.16 (95% CI -0.21 to -0.10) and SF-6D -0.08 (95% CI -0.11 to -0.05). A similar trend is seen in the psoriatic arthritis group. The economic model produced different ICERs, when different utility measures were used; EQ-5D (TTO) euro42,402, SF-6D euro111,788, and revised EQ-5D (TTO) euro57,747. CONCLUSION: In the context of inflammatory arthritis, this article demonstrates that a revised scoring for EQ-5D may have a significant impact on utility estimates and on the output of the economic model.

Holocene Paleohydrological Changes in Northern Michigan: Interpretations of Biomarker Distributions and Compound Specific Stable Isotope Analysis from Peatlands

Science.gov (United States)

Nichols, J. E.; Booth, R. K.; Jackson, S. T.; Pendall, E. G.; Huang, Y.

2006-12-01

Sediments of ombrotrophic peatlands are excellent archives for reconstructing past changes in precipitation/evaporation (P/E) balance. Multiproxy analysis of these sediments is critical for better understanding of climatic events experienced by these highly sensitive systems, as each proxy may respond to different climate parameters. In this study, we use distributions of n-alkanes and δD of Sphagnum biomarkers to interpret paleohydrology from sediments of Irwin Smith Bog, northern Michigan. We then integrate these data with pollen data and testate amoebae-inferred water table depth. Sphagnum moss is the dominant peat former in ombrotrophic bogs, but vascular plants become abundant when water tables are drawn down. Thus, the abundance of Sphagnum relative to vascular plants is indicative of peatland hydrology. The n-alkanes produced by Sphagnum differ from vascular plants in the relative abundance of the different homologues, with the former having excess amounts of shorter chain C23 n-alkane. We use several measures (compound ratios, PCA) to show changes in then-alkane distributions in the sediments, and thus changes in the peatland plant community. Our data provide high- resolution, quantitative paleohydrological records for the study region that are consistent with other records. We also show that the relative abundance of a newly identified Sphagnum biomarker, 2-heptacosanone, can be used to reconstruct changing plant communities. Because ombrotrophic systems lose water by evaporation, drier/warmer conditions cause hydrogen isotopic enrichment of bog water and Sphagnum biomarkers. We measured the δD of C23 n-alkane and 2-heptacosanone to provide additional paleoclimate information. Our multiproxy approach allows us to better understand the climate changes during key intervals of the Holocene. For example, a sharp decrease in the abundance of Tsuga canadensis (hemlock) pollen has been previously identified in records from many places throughout eastern North

Scoring inflammatory activity of the spine by magnetic resonance imaging in ankylosing spondylitis: a multireader experiment

DEFF Research Database (Denmark)

Lukas, Cédric; Braun, Jürgen; van der Heijde, Désirée

2007-01-01

ability was assessed using Z-scores (Mann-Whitney test) comparing change in score between patients treated with TNF-blocking drug and placebo. RESULTS: The mean time to score one set of MRI was shortest for the Berlin method. SDC was lowest for the Berlin method and highest for SPARCC. Overall inter...... of 3 different scoring methods for MRI activity and change in activity of the spine in patients with AS. METHODS: Thirty sets of spinal MRI at baseline and after 24 weeks of followup, derived from a randomized clinical trial comparing a tumor necrosis factor (TNF)-blocking drug (n = 20) with placebo (n...... the Ankylosing Spondylitis spine Magnetic Resonance Imaging-activity [ASspiMRI-a, grading activity (0-6) per vertebral unit in 23 units]; the Berlin modification of the ASspiMRI-a; and the Spondyloarthritis Research Consortium of Canada (SPARCC) scoring system, which scores the 6 vertebral units considered...

Associations between television viewing and love styles: an interpretation using cultivation theory.

Science.gov (United States)

Hetsroni, Amir

2012-02-01

This study evaluated the associations between television viewing and love styles. The Love Attitudes Scale (LAS), based on Lee's love style taxonomy, was administered to a sample of 338 unmarried Israeli students along with questions about TV viewing habits, current involvement in a serious romantic relationship, and marital intentions. A confirmatory factor analysis of the LAS indicated that the expected six-factor solution adequately fit the data. Correlations between individual love styles and TV viewing were small to moderate, ranging from .12 to .29. Scores for Ludus love style correlated positively with viewing of news and general programming. Those for Pragma love style correlated positively with news viewing and negatively with viewing genres frequently including love themes such as soap operas and family drama, while scores for Eros love style positively correlated with watching these love abundant genres. No significant association was found for TV viewing with Storge, Mania, and Agape love styles. Hierarchical regression using demographic variables, love status, and viewing habits mirrored these results, with the unique R2 for Ludus, Pragma, and Eros ranging from 1.8% to 8%, while the total variance accounted for by the models ranged from 12% to 21%. The findings can be interpreted as support for a weak cultivation effect, in which habits in long-term TV viewing among young adults correspond to small to moderate tendencies for particular love styles that thematically relate them. However, because they are correlational, the findings could equally be interpreted in terms of tendencies that exist due to modeling within families and socialization during development.

Good validity and reliability of the forgotten joint score in evaluating the outcome of total knee arthroplasty

DEFF Research Database (Denmark)

Thomsen, Morten G; Latifi, Roshan; Kallemose, Thomas

2016-01-01

. We investigated the validity and reliability of the FJS. Patients and methods - A Danish version of the FJS questionnaire was created according to internationally accepted standards. 360 participants who underwent primary TKA were invited to participate in the study. Of these, 315 were included...... in a validity study and 150 in a reliability study. Correlation between the Oxford knee score (OKS) and the FJS was examined and test-retest evaluation was performed. A ceiling effect was defined as participants reaching a score within 15% of the maximum achievable score. Results - The validity study revealed...... of the FJS (ICC? 0.79). We found a high level of internal consistency (Cronbach's? = 0.96). The ceiling effect for the FJS was 16%, as compared to 37% for the OKS. Interpretation - The FJS showed good construct validity and test-retest reliability. It had a lower ceiling effect than the OKS. The FJS appears...

Modeling Bivariate Change in Individual Differences: Prospective Associations Between Personality and Life Satisfaction.

Science.gov (United States)

Hounkpatin, Hilda Osafo; Boyce, Christopher J; Dunn, Graham; Wood, Alex M

2017-09-18

A number of structural equation models have been developed to examine change in 1 variable or the longitudinal association between 2 variables. The most common of these are the latent growth model, the autoregressive cross-lagged model, the autoregressive latent trajectory model, and the latent change score model. The authors first overview each of these models through evaluating their different assumptions surrounding the nature of change and how these assumptions may result in different data interpretations. They then, to elucidate these issues in an empirical example, examine the longitudinal association between personality traits and life satisfaction. In a representative Dutch sample (N = 8,320), with participants providing data on both personality and life satisfaction measures every 2 years over an 8-year period, the authors reproduce findings from previous research. However, some of the structural equation models overviewed have not previously been applied to the personality-life satisfaction relation. The extended empirical examination suggests intraindividual changes in life satisfaction predict subsequent intraindividual changes in personality traits. The availability of data sets with 3 or more assessment waves allows the application of more advanced structural equation models such as the autoregressive latent trajectory or the extended latent change score model, which accounts for the complex dynamic nature of change processes and allows stronger inferences on the nature of the association between variables. However, the choice of model should be determined by theories of change processes in the variables being studied. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

High resolution esophageal manometry--the switch from "intuitive" visual interpretation to Chicago classification.

Science.gov (United States)

Srinivas, M; Balakumaran, T A; Palaniappan, S; Srinivasan, Vijaya; Batcha, M; Venkataraman, Jayanthi

2014-03-01

High resolution esophageal manometry (HREM) has been interpreted all along by visual interpretation of color plots until the recent introduction of Chicago classification which categorises HREM using objective measurements. It compares HREM diagnosis of esophageal motor disorders by visual interpretation and Chicago classification. Using software Trace 1.2v, 77 consecutive tracings diagnosed by visual interpretation were re-analyzed by Chicago classification and findings compared for concordance between the two systems of interpretation. Kappa agreement rate between the two observations was determined. There were 57 males (74 %) and cohort median age was 41 years (range: 14-83 years). Majority of the referrals were for gastroesophageal reflux disease, dysphagia and achalasia. By "intuitive" visual interpretation, the tracing were reported as normal in 45 (58.4 %), achalasia 14 (18.2 %), ineffective esophageal motility 3 (3.9 %), nutcracker esophagus 11 (14.3 %) and nonspecific motility changes 4 (5.2 %). By Chicago classification, there was 100 % agreement (Kappa 1) for achalasia (type 1: 9; type 2: 5) and ineffective esophageal motility ("failed peristalsis" on visual interpretation). Normal esophageal motility, nutcracker esophagus and nonspecific motility disorder on visual interpretation were reclassified as rapid contraction and esophagogastric junction (EGJ) outflow obstruction by Chicago classification. Chicago classification identified distinct clinical phenotypes including EGJ outflow obstruction not identified by visual interpretation. A significant number of unclassified HREM by visual interpretation were also classified by it.

Association Between Change in Body Mass Index, Unified Parkinson's Disease Rating Scale Scores, and Survival Among Persons With Parkinson Disease: Secondary Analysis of Longitudinal Data From NINDS Exploratory Trials in Parkinson Disease Long-term Study 1.

Science.gov (United States)

Wills, Anne-Marie A; Pérez, Adriana; Wang, Jue; Su, Xiao; Morgan, John; Rajan, Suja S; Leehey, Maureen A; Pontone, Gregory M; Chou, Kelvin L; Umeh, Chizoba; Mari, Zoltan; Boyd, James

2016-03-01

Greater body mass index (BMI, calculated as weight in kilograms divided by height in meters squared) is associated with improved survival among persons with Huntington disease or amyotrophic lateral sclerosis. Weight loss is common among persons with Parkinson disease (PD) and is associated with worse quality of life. To explore the association between change in BMI, Unified Parkinson's Disease Rating Scale (UPDRS) motor and total scores, and survival among persons with PD and to test whether there is a positive association between BMI at randomization and survival. Secondary analysis (from May 27, 2014, to October 13, 2015) of longitudinal data (3-6 years) from 1673 participants who started the National Institute of Neurological Disorders and Stroke Exploratory Trials in PD Long-term Study-1 (NET-PD LS-1). This was a double-blind randomized placebo-controlled clinical trial of creatine monohydrate (10 g/d) that was performed at 45 sites throughout the United States and Canada. Participants with early (within 5 years of diagnosis) and treated (receiving dopaminergic therapy) PD were enrolled from March 2007 to May 2010 and followed up until September 2013. Change across time in motor UPDRS score, change across time in total UPDRS score, and time to death. Generalized linear mixed models were used to estimate the effect of BMI on the change in motor and total UPDRS scores after controlling for covariates. Survival was analyzed using Cox proportional hazards models of time to death. A participant's BMI was measured at randomization, and BMI trajectory groups were classified according to whether participants experienced weight loss ("decreasing BMI"), weight stability ("stable BMI"), or weight gain ("increasing BMI") during the study. Of the 1673 participants (mean [SD] age, 61.7 [9.6] years; 1074 [64.2%] were male), 158 (9.4%) experienced weight loss (decreasing BMI), whereas 233 (13.9%) experienced weight gain (increasing BMI). After adjusting for covariates, we

REQUIREMENTS FOR A GENERAL INTERPRETATION THEORY

Directory of Open Access Journals (Sweden)

Anda Laura Lungu Petruescu

2013-06-01

Full Text Available Time has proved that Economic Analysis is not enough as to ensure all the needs of the economic field. The present study wishes to propose a new approach method of the economic phenomena and processes based on the researches made outside the economic space- a new general interpretation theory- which is centered on the human being as the basic actor of economy. A general interpretation theory must assure the interpretation of the causalities among the economic phenomena and processes- causal interpretation; the interpretation of the correlations and dependencies among indicators- normative interpretation; the interpretation of social and communicational processes in economic organizations- social and communicational interpretation; the interpretation of the community status of companies- transsocial interpretation; the interpretation of the purposes of human activities and their coherency – teleological interpretation; the interpretation of equilibrium/ disequilibrium from inside the economic systems- optimality interpretation. In order to respond to such demands, rigor, pragmatism, praxiology and contextual connectors are required. In order to progress, the economic science must improve its language, both its syntax and its semantics. The clarity of exposure requires a language clarity and the scientific theory progress asks for the need of hypotheses in the building of the theories. The switch from the common language to the symbolic one means the switch from ambiguity to rigor and rationality, that is order in thinking. But order implies structure, which implies formalization. Our paper should be a plea for these requirements, requirements which should be fulfilled by a modern interpretation theory.

The longitudinal reliability and responsiveness of the OMERACT Hand Osteoarthritis Magnetic Resonance Imaging Scoring System (HOAMRIS)

DEFF Research Database (Denmark)

Haugen, Ida K.; Eshed, Iris; Gandjbakhch, Frederique

2015-01-01

Objective. To evaluate the interreader reliability of change scores and the responsiveness of the OMERACT Hand Osteoarthritis (OA) Magnetic Resonance Image (MRI) Scoring System (HOAMRIS). Methods. Paired MRI (baseline and 5-yr followup) from 20 patients with hand OA were scored with known time se...

Interpreting Physics

CERN Document Server

MacKinnon, Edward

2012-01-01

This book is the first to offer a systematic account of the role of language in the development and interpretation of physics. An historical-conceptual analysis of the co-evolution of mathematical and physical concepts leads to the classical/quatum interface. Bohrian orthodoxy stresses the indispensability of classical concepts and the functional role of mathematics. This book analyses ways of extending, and then going beyond this orthodoxy orthodoxy. Finally, the book analyzes how a revised interpretation of physics impacts on basic philosophical issues: conceptual revolutions, realism, and r

[Adolescence, sexuality, and reproduction: cultural constructions, normative controversies, and interpretative alternatives].

Science.gov (United States)

Ventura, Miriam; Corrêa, Sonia

2006-07-01

This research note discusses the cultural and legal constructs referring to the sexual and reproductive rights of adolescents. Beginning with the expansion of human rights to include the prerogatives of children and adolescents, a veritable change occurred in the way families, society, and communities are expected to deal with these stages in life. Despite recent positive and progressive changes in legislation and healthcare for this age group, Brazil and other countries still experience difficulties in enforcing and interpreting the specific legislation, especially in dealing with teenage sexuality and reproduction. This article discusses possible alternatives and attempts to demonstrate that such legal reforms are not indispensable, since it is possible to weigh ethical and legal principles and then develop an interpretation that ensures the exercise of sexual and reproductive rights by adolescents.

Medical students' cognitive load in volumetric image interpretation : Insights from human-computer interaction and eye movements

NARCIS (Netherlands)

Stuijfzand, Bobby G.; Van Der Schaaf, Marieke F.; Kirschner, Femke C.; Ravesloot, Cécile J.; Van Der Gijp, Anouk; Vincken, Koen L.

2016-01-01

Medical image interpretation is moving from using 2D- to volumetric images, thereby changing the cognitive and perceptual processes involved. This is expected to affect medical students' experienced cognitive load, while learning image interpretation skills. With two studies this explorative

A score for measuring health risk perception in environmental surveys.

Science.gov (United States)

Marcon, Alessandro; Nguyen, Giang; Rava, Marta; Braggion, Marco; Grassi, Mario; Zanolin, Maria Elisabetta

2015-09-15

In environmental surveys, risk perception may be a source of bias when information on health outcomes is reported using questionnaires. Using the data from a survey carried out in the largest chipboard industrial district in Italy (Viadana, Mantova), we devised a score of health risk perception and described its determinants in an adult population. In 2006, 3697 parents of children were administered a questionnaire that included ratings on 7 environmental issues. Items dimensionality was studied by factor analysis. After testing equidistance across response options by homogeneity analysis, a risk perception score was devised by summing up item ratings. Factor analysis identified one latent factor, which we interpreted as health risk perception, that explained 65.4% of the variance of five items retained after scaling. The scale (range 0-10, mean ± SD 9.3 ± 1.9) had a good internal consistency (Cronbach's alpha 0.87). Most subjects (80.6%) expressed maximum risk perception (score = 10). Italian mothers showed significantly higher risk perception than foreign fathers. Risk perception was higher for parents of young children, and for older parents with a higher education, than for their counterparts. Actual distance to major roads was not associated with the score, while self-reported intense traffic and frequent air refreshing at home predicted higher risk perception. When investigating health effects of environmental hazards using questionnaires, care should be taken to reduce the possibility of awareness bias at the stage of study planning and data analysis. Including appropriate items in study questionnaires can be useful to derive a measure of health risk perception, which can help to identify confounding of association estimates by risk perception. Copyright © 2015 Elsevier B.V. All rights reserved.

Analysis of the Scoliosis Research Society-22 Questionnaire Scores: Is There a Difference Between a Child and Parent and Does Physician Review Change That?

Science.gov (United States)

Brewer, Paul; Berryman, Fiona; Baker, De; Pynsent, Paul; Gardner, Adrian

2014-01-01

Prospective sequential patient series. To investigate whether at initial assessment information imparted by a physician changed the Scoliosis Research Society (SRS) score for a patient or a parent scoring independently of the child; to investigate whether the SRS score should be assessed before or after consultation to achieve the most accurate representation of the patient; and to investigate the differences between the patient and parent assessment of the scoliosis using the SRS questionnaire. A total of 52 children with adolescent idiopathic scoliosis and their parents were given the SRS-22 questionnaire at first consultation before and after meeting the physician. Parents and patients completed the questionnaires in isolation. Assessment and discussion with a physician made no statistical difference for the SRS-22 scores for both the patients and the parents when comparing SRS-22 scores before and after consultation in most domains. Significant differences were found in a few cases. This was the case for the patient group before and after consultation for the function domain (p = .023), the patient and parent groups before and after consultation for the pain domain (p = .025 and .022 for patient and parent groups respectively), the patient and parent groups after consultation for self-image domain (p = .024), and the parent group before and after consultation for mental health domain (p = .018). However, the differences in all these cases were low and not considered clinically important. The SRS-22 questionnaire is robust and a true reflection of patients' assessment of their symptoms not influenced by meeting a physician. Assessment of the child by the parent is not statistically different from the child's self-assessment using the SRS-22 instrument. It makes no difference to the total SRS-22 score as to when it is measured in the initial clinic visit. Copyright © 2014 Scoliosis Research Society. Published by Elsevier Inc. All rights reserved.

GalaxyDock BP2 score: a hybrid scoring function for accurate protein-ligand docking

Science.gov (United States)

Baek, Minkyung; Shin, Woong-Hee; Chung, Hwan Won; Seok, Chaok

2017-07-01

Protein-ligand docking is a useful tool for providing atomic-level understanding of protein functions in nature and design principles for artificial ligands or proteins with desired properties. The ability to identify the true binding pose of a ligand to a target protein among numerous possible candidate poses is an essential requirement for successful protein-ligand docking. Many previously developed docking scoring functions were trained to reproduce experimental binding affinities and were also used for scoring binding poses. However, in this study, we developed a new docking scoring function, called GalaxyDock BP2 Score, by directly training the scoring power of binding poses. This function is a hybrid of physics-based, empirical, and knowledge-based score terms that are balanced to strengthen the advantages of each component. The performance of the new scoring function exhibits significant improvement over existing scoring functions in decoy pose discrimination tests. In addition, when the score is used with the GalaxyDock2 protein-ligand docking program, it outperformed other state-of-the-art docking programs in docking tests on the Astex diverse set, the Cross2009 benchmark set, and the Astex non-native set. GalaxyDock BP2 Score and GalaxyDock2 with this score are freely available at http://galaxy.seoklab.org/softwares/galaxydock.html.

Predictive value of semi-quantitative MRI-based scoring systems for future knee replacement: data from the osteoarthritis initiative

International Nuclear Information System (INIS)

Hafezi-Nejad, Nima; Eng, John; Demehri, Shadpour; Zikria, Bashir; Carrino, John A.

2015-01-01

To evaluate, in a confirmatory fashion, whether baseline and change from baseline to 24-month follow-up in cartilage damage, bone marrow lesions and meniscal damage are predictors of knee replacement (KR) in subjects with a high risk of osteoarthritis (OA), independent of the level of physical activity, symptom severity and radiographic abnormalities. Data from the Osteoarthritis Initiative's (OAI) baseline and 24-month follow-up knee MRIs of 115 patients (age range: 45-78 years; 48 % female; BMI: 20.9-48.7) were analyzed. Cartilage, bone marrow and menisci were semi-quantitatively scored according to the Whole-Organ Magnetic Resonance Imaging Score (WORMS) and Boston-Leeds Osteoarthritis Knee Score (BLOKS) systems in all compartments. Baseline and 24-month interval changes in structural tissue damage assessed by BLOKS and WORMS were used as predictors of KR independent of clinical and radiographic parameters using Cox hazard analysis. Adjustments were performed for age, gender, BMI and physical activity (Physical Activity Scale for the Elderly: PASE), Western Ontario and McMaster Questionnaire (WOMAC) total score and radiographic Kellgren-Lawrence (KL) score. BLOKS and WORMS baseline cartilage scores were predictors of KR independent of the PASE, WOMAC and KL score. One score increase in the average baseline BLOKS full-thickness cartilage defect score was associated with a [hazard ratio (95 % CI)] 13.55 (3.61-50.89) times greater risk of KR independent of the PASE, WOMAC and KL score. Net reclassification improvements (NRIs) of the additional evaluation of 24-month follow-up MRI scores and assessment of changes were not significant for prediction of KR (NRI range: - 7.23 - 24.8 %). The BLOKS cartilage score for full-thickness cartilage defects had the highest hazard for KR. Follow-up MRI changes in structural tissue damage, detected by BLOKS and WORMS cartilage, bone marrow or meniscus scores (up to 24 months) had no significant predictive value in addition

Predictive value of semi-quantitative MRI-based scoring systems for future knee replacement: data from the osteoarthritis initiative

Energy Technology Data Exchange (ETDEWEB)

Hafezi-Nejad, Nima; Eng, John; Demehri, Shadpour [Johns Hopkins University School of Medicine, Musculoskeletal Radiology, Russell H. Morgan Department of Radiology and Radiological Science, Baltimore, MD (United States); Zikria, Bashir [Johns Hopkins University, Department of Orthopedic Surgery, Baltimore, MD (United States); Carrino, John A. [Hospital for Special Surgery, Department of Radiology and Imaging, New York, NY (United States)

2015-11-15

To evaluate, in a confirmatory fashion, whether baseline and change from baseline to 24-month follow-up in cartilage damage, bone marrow lesions and meniscal damage are predictors of knee replacement (KR) in subjects with a high risk of osteoarthritis (OA), independent of the level of physical activity, symptom severity and radiographic abnormalities. Data from the Osteoarthritis Initiative's (OAI) baseline and 24-month follow-up knee MRIs of 115 patients (age range: 45-78 years; 48 % female; BMI: 20.9-48.7) were analyzed. Cartilage, bone marrow and menisci were semi-quantitatively scored according to the Whole-Organ Magnetic Resonance Imaging Score (WORMS) and Boston-Leeds Osteoarthritis Knee Score (BLOKS) systems in all compartments. Baseline and 24-month interval changes in structural tissue damage assessed by BLOKS and WORMS were used as predictors of KR independent of clinical and radiographic parameters using Cox hazard analysis. Adjustments were performed for age, gender, BMI and physical activity (Physical Activity Scale for the Elderly: PASE), Western Ontario and McMaster Questionnaire (WOMAC) total score and radiographic Kellgren-Lawrence (KL) score. BLOKS and WORMS baseline cartilage scores were predictors of KR independent of the PASE, WOMAC and KL score. One score increase in the average baseline BLOKS full-thickness cartilage defect score was associated with a [hazard ratio (95 % CI)] 13.55 (3.61-50.89) times greater risk of KR independent of the PASE, WOMAC and KL score. Net reclassification improvements (NRIs) of the additional evaluation of 24-month follow-up MRI scores and assessment of changes were not significant for prediction of KR (NRI range: - 7.23 - 24.8 %). The BLOKS cartilage score for full-thickness cartilage defects had the highest hazard for KR. Follow-up MRI changes in structural tissue damage, detected by BLOKS and WORMS cartilage, bone marrow or meniscus scores (up to 24 months) had no significant predictive value in addition

Increased correlation coefficient between the written test score and tutors’ performance test scores after training of tutors for assessment of medical students during problem-based learning course in Malaysia

Directory of Open Access Journals (Sweden)

Heethal Jaiprakash

2016-03-01

Full Text Available This paper is aimed at finding if there was a change of correlation between the written test score and tutors’ performance test scores in the assessment of medical students during a problem-based learning (PBL course in Malaysia. This is a cross-sectional observational study, conducted among 264 medical students in two groups from November 2010 to November 2012. The first group’s tutors did not receive tutor training; while the second group’s tutors were trained in the PBL process. Each group was divided into high, middle and low achievers based on their end-of-semester exam scores. PBL scores were taken which included written test scores and tutors’ performance test scores. Pearson correlation coefficient was calculated between the two kinds of scores in each group. The correlation coefficient between the written scores and tutors’ scores in group 1 was 0.099 (p<0.001 and for group 2 was 0.305 (p<0.001. The higher correlation coefficient in the group where tutors received the PBL training reinforces the importance of tutor training before their participation in the PBL course.

Catastrophic misinterpretations as a predictor of symptom change during treatment for panic disorder.

Science.gov (United States)

Teachman, Bethany A; Marker, Craig D; Clerkin, Elise M

2010-12-01

Cognitive models of panic disorder suggest that change in catastrophic misinterpretations of bodily sensations will predict symptom reduction. To examine change processes, we used a repeated measures design to evaluate whether the trajectory of change in misinterpretations over the course of 12-week cognitive behavior therapy is related to the trajectory of change in a variety of panic-relevant outcomes. Participants had a primary diagnosis of panic disorder (N = 43; 70% female; mean age = 40.14 years). Race or ethnicity was reported as 91% Caucasian, 5% African American, 2.3% biracial, and 2.3% "other." Change in catastrophic misinterpretations (assessed with the Brief Body Sensations Interpretation Questionnaire; Clark et al., 1997) was used to predict a variety of treatment outcomes, including overall panic symptom severity (assessed with the Panic Disorder Severity Scale [PDSS]; Shear et al., 1997), panic attack frequency (assessed with the relevant PDSS item), panic-related distress/apprehension (assessed by a latent factor, including peak anxiety in response to a panic-relevant stressor-a straw breathing task), and avoidance (assessed by a latent factor, which included the Fear Questionnaire-Agoraphobic Avoidance subscale; Marks & Mathews, 1979). Bivariate latent difference score modeling indicated that, as expected, change in catastrophic misinterpretations predicted subsequent reductions in overall symptom severity, panic attack frequency, distress/apprehension, and avoidance behavior. However, change in the various symptom domains was not typically a significant predictor of later interpretation change (except for the distress/apprehension factor). These results provide considerable support for the cognitive model of panic and speak to the temporal sequence of change processes during therapy. (c) 2010 APA, all rights reserved.