WorldWideScience

Sample records for outcome variable conclusions

  1. Conclusion

    Indian Academy of Sciences (India)

    First page Back Continue Last page Overview Graphics. Conclusion. Problems of an Under-developed Economy. Geographical Location. Terrain. Change in attitude of mainstream India required. Using Technology to overcome problems.

  2. Conclusion

    NARCIS (Netherlands)

    Grignon, F.; Mazrui, A.; Rutten, M.M.E.M.; Rutten, M.M.E.M.; Mazrui, A.; Grignon, F.

    2001-01-01

    The outcome of a three-day conference held at the African Studies Centre, Leiden, The Netherlands, in September 1998, this book on the 1997 Kenya general elections is organized in four parts: the direct pre-electoral background; technical and national analysis of the general elections, including the

  3. Conclusions

    Indian Academy of Sciences (India)

    First page Back Continue Last page Overview Graphics. Conclusions. Be it 2G or 4G, networks are vulnerable to unwanted access and thus should be protected. 4G networks would be more sensitive as its core network will be TCP/IP based. Accordingly, resource and security management schemes with seamless ...

  4. Conclusions:

    Indian Academy of Sciences (India)

    First page Back Continue Last page Overview Graphics. Conclusions: Extended objects – “D-branes” – appear naturally in theories of strings. They manifest themselves as new types of physical particles in string models. They provide a powerful handle on the symmetries and dynamics of strings. Branes will play a key role ...

  5. Conclusions :

    Indian Academy of Sciences (India)

    First page Back Continue Last page Overview Graphics. Conclusions : No dramatic difference in the dynamics of anion-water and water-water hydrogen bonds are found for Cl- and Br- ions. Solvation shells of these ions are not rigid. For OH- in water, HB dynamics in the hydration shell determines the rate of proton transfer.

  6. Conclusion

    DEFF Research Database (Denmark)

    Sandøy, Helge; Kristiansen, Tore

    2010-01-01

    1. Comparing empirical findings with the “mountain peak model” In the introduction to this volume, we presented a “mountain peak model” of Nordic purism based on evidence showing that language scholars and lay people are very much in agreement as to where we find the more purist languages......-speaking Finland to Finnish-speaking Finland. In this conclusion to the volume, we will summarize the empirical findings presented in the volume, findings for use and attitudes alike, and compare them with the mountain peak model. That way, we may be able to estimate the nature of the cross-national ideological...

  7. Conclusion

    International Nuclear Information System (INIS)

    Ainul Hayati Daud; Hazmimi Kasim

    2010-01-01

    In Asia, Japan and the Republic of Korea have conducted similar studies but relying on statistical data and used inputs and outputs (I-O) methodology, utilizing on general macro-level data. In contrast, this study captures data directly through surveys using questionnaires, face-to-face interviews, case studies and focus group discussions. The impact of nuclear technology applications in Malaysia were evaluated both quantitatively and qualitatively. These impacts are then linked to a broader objective associated with technological development, namely wealth generation, knowledge generation and societal well-being. In the process of the study, users and practitioners of the technology highlighted issues and challenges faced by them. To cap the study, the level of activities of nuclear technology in Malaysia was benchmarked against those in Japan and the Republic of Korea. This chapter highlights the results of the study, the outcome of the study, followed by recommendations as response to issues and challenges raised by respondents, and finally the way forward for monitoring and charting further progress of nuclear technology in the country. (author)

  8. Investigation of the role of the jumping-to-conclusions bias for short-term functional outcome in schizophrenia.

    Science.gov (United States)

    Andreou, Christina; Treszl, András; Roesch-Ely, Daniela; Köther, Ulf; Veckenstedt, Ruth; Moritz, Steffen

    2014-08-30

    Symptom severity and neuropsychological deficits negatively influence functional outcomes in patients with schizophrenia. Recent research implicates specific types of biased thinking styles (e.g. jumping-to-conclusions) in the pathogenesis of schizophrenia. This is the first study to test the impact of jumping-to-conclusions on functional outcome in schizophrenia. The aim of the study was to investigate the association of psychopathology, neuropsychology and JTC with subjective quality of life, vocational outcome and housing status in schizophrenia. Analyses were carried out both cross-sectionally at baseline, and longitudinally over the course of symptomatic improvement in the immediate aftermath of a psychotic exacerbation. Seventy-nine patients with schizophrenia were included in the study. Data concerning the variables of interest were collected at baseline, after one month, and after six months. Positive symptomatology was the most significant predictor of subjective and vocational outcome and changes across time. Verbal memory deficits were associated with functional status cross-sectionally, whereas general cognitive capacity significantly predicted functional changes over time. Improvement of the jumping-to-conclusions bias positively affected vocational outcome. Though limited, the observed effect of this bias on real-world functioning highlights the possible usefulness of interventions aimed at improving (meta)cognitive deficits in schizophrenia. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  9. Epidemiological analysis of demographic characteristics and type of injuries in patients with multiple trauma with respect to conclusive treatment outcome

    Directory of Open Access Journals (Sweden)

    Zagorac Slaviša

    2008-01-01

    Full Text Available Introduction Multiple trauma is one of the leading causes of mortality and morbidity in the population of people under 45 years of age. The consequences of multiple trauma have huge epidemiological, social and economic significance. Objective The aim of the paper was to analyze the conclusive treatment outcome of multiply traumatized patients with respect to their sex, age, injury mechanism and type. METHOD This retrospective study included 100 patients with multiple injuries (ISS>16 treated in the Emergency Room of the Clinical Centre of Serbia in the course of 2004. Clinical, X-ray, laboratory and numerical presentation methods - scores (ISS and GCS were used to show the injury severity. Results Most of the injured were males (80%, and the average age was 40±20 (5-83. Out of the total number of patients who died, 23 (82% were males, and 5 (18% were females. The average age of the patients with fatal outcomes was 48±21 (8-86. Traffic accidents were the leading cause of injury (59%. The median GCS was 10±3 (3-15. The average ISS was 30 (20-66 in the surviving patients, and 53 (27-77 in those who died. Conclusion With respect to sex, in most cases multiple trauma affects males (p<0.01, with the average age of about 40. With respect to injury mechanism, the main cause of the occurrence of multiple trauma is traffic accidents (p<0.01. There is a statistically significant difference in the values of GCS and ISS relative to the definitive outcome (p<0.01. Statistical data processing indicated that there was a statistically significant correlation between mortality and type of injury in a given organic system (p<0.01, but that there was no statistically significant correlation between mortality and age. .

  10. Sweet Conclusion

    Science.gov (United States)

    Shirley, Britt M.; Wooldridge, Barbara Ross; Camp, Kerri M.

    2012-01-01

    Jen Harrington is the owner and pastry chef of Sweet Conclusion, a bakery in Tampa, Florida. Most of Harrington's business comes from baking wedding cakes, but she has been attempting to attract customers to her retail bakery, where she sells cupcakes, pies, ice cream, and coffee. Nearly four years she opened Sweet Conclusion, the retail part of…

  11. Conclusion; Zaklyuchenie

    Energy Technology Data Exchange (ETDEWEB)

    Nikitin, V I

    1961-07-01

    In this chapter of book are present conclusions about work done by author, in particular that he found comparatively simple and available ways of synthesis of glycerin of acetylene line and glycerin of ethylen line which before was unknown or almost unknown in the chemical literature.

  12. General conclusions

    International Nuclear Information System (INIS)

    Tubiana, M.

    1993-01-01

    In conclusion, a general consensus of a number of points which the author endeavours to summarize in this article: -doctors are an excellent channel for passing on information to the public -doctors feel that they do not know enough about the subject and a training on radiobiology and radiation protection is a necessity for them -communication between doctors and the general public is poor in this field -research should be encouraged in numerous areas such as: carcinogenic effect of low doses of radiation, pedagogy and risk perception

  13. Research on injury compensation and health outcomes: ignoring the problem of reverse causality led to a biased conclusion.

    Science.gov (United States)

    Spearing, Natalie M; Connelly, Luke B; Nghiem, Hong S; Pobereskin, Louis

    2012-11-01

    This study highlights the serious consequences of ignoring reverse causality bias in studies on compensation-related factors and health outcomes and demonstrates a technique for resolving this problem of observational data. Data from an English longitudinal study on factors, including claims for compensation, associated with recovery from neck pain (whiplash) after rear-end collisions are used to demonstrate the potential for reverse causality bias. Although it is commonly believed that claiming compensation leads to worse recovery, it is also possible that poor recovery may lead to compensation claims--a point that is seldom considered and never addressed empirically. This pedagogical study compares the association between compensation claiming and recovery when reverse causality bias is ignored and when it is addressed, controlling for the same observable factors. When reverse causality is ignored, claimants appear to have a worse recovery than nonclaimants; however, when reverse causality bias is addressed, claiming compensation appears to have a beneficial effect on recovery, ceteris paribus. To avert biased policy and judicial decisions that might inadvertently disadvantage people with compensable injuries, there is an urgent need for researchers to address reverse causality bias in studies on compensation-related factors and health. Copyright © 2012 Elsevier Inc. All rights reserved.

  14. Econometrics in outcomes research: the use of instrumental variables.

    Science.gov (United States)

    Newhouse, J P; McClellan, M

    1998-01-01

    We describe an econometric technique, instrumental variables, that can be useful in estimating the effectiveness of clinical treatments in situations when a controlled trial has not or cannot be done. This technique relies upon the existence of one or more variables that induce substantial variation in the treatment variable but have no direct effect on the outcome variable of interest. We illustrate the use of the technique with an application to aggressive treatment of acute myocardial infarction in the elderly.

  15. Blood Pressure Variability and Outcome in Patients with Acute Nonlobar Intracerebral Hemorrhage following Intensive Antihypertensive Treatment

    Directory of Open Access Journals (Sweden)

    Jin Pyeong Jeon

    2018-01-01

    Conclusions: The MAC of SBP is associated with hematoma growth, and SD and COV are correlated with 3-month poor outcome in patients with supratentorial nonlobar ICH. Therefore, sustained SBP control, with a reduction in SBP variability is essential to reinforce the beneficial effect of intensive antihypertensive treatment.

  16. High Intrapatient Variability of Tacrolimus Levels and Outpatient Clinic Nonattendance Are Associated With Inferior Outcomes in Renal Transplant Patients

    Directory of Open Access Journals (Sweden)

    Dawn L. Goodall, MSc

    2017-08-01

    Conclusions. This study shows that high tacrolimus IPV and clinic nonattendance are associated with inferior allograft survival. Interventions to minimize the causes of high variability, particularly nonadherence are essential to improve long-term allograft outcomes.

  17. Combining clinical variables to optimize prediction of antidepressant treatment outcomes.

    Science.gov (United States)

    Iniesta, Raquel; Malki, Karim; Maier, Wolfgang; Rietschel, Marcella; Mors, Ole; Hauser, Joanna; Henigsberg, Neven; Dernovsek, Mojca Zvezdana; Souery, Daniel; Stahl, Daniel; Dobson, Richard; Aitchison, Katherine J; Farmer, Anne; Lewis, Cathryn M; McGuffin, Peter; Uher, Rudolf

    2016-07-01

    The outcome of treatment with antidepressants varies markedly across people with the same diagnosis. A clinically significant prediction of outcomes could spare the frustration of trial and error approach and improve the outcomes of major depressive disorder through individualized treatment selection. It is likely that a combination of multiple predictors is needed to achieve such prediction. We used elastic net regularized regression to optimize prediction of symptom improvement and remission during treatment with escitalopram or nortriptyline and to identify contributing predictors from a range of demographic and clinical variables in 793 adults with major depressive disorder. A combination of demographic and clinical variables, with strong contributions from symptoms of depressed mood, reduced interest, decreased activity, indecisiveness, pessimism and anxiety significantly predicted treatment outcomes, explaining 5-10% of variance in symptom improvement with escitalopram. Similar combinations of variables predicted remission with area under the curve 0.72, explaining approximately 15% of variance (pseudo R(2)) in who achieves remission, with strong contributions from body mass index, appetite, interest-activity symptom dimension and anxious-somatizing depression subtype. Escitalopram-specific outcome prediction was more accurate than generic outcome prediction, and reached effect sizes that were near or above a previously established benchmark for clinical significance. Outcome prediction on the nortriptyline arm did not significantly differ from chance. These results suggest that easily obtained demographic and clinical variables can predict therapeutic response to escitalopram with clinically meaningful accuracy, suggesting a potential for individualized prescription of this antidepressant drug. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

  18. Instrumental variable estimation of treatment effects for duration outcomes

    NARCIS (Netherlands)

    G.E. Bijwaard (Govert)

    2007-01-01

    textabstractIn this article we propose and implement an instrumental variable estimation procedure to obtain treatment effects on duration outcomes. The method can handle the typical complications that arise with duration data of time-varying treatment and censoring. The treatment effect we

  19. Variability in the Initial Costs of Care and One-Year Outcomes of Observation Services

    Directory of Open Access Journals (Sweden)

    Abbass, Ibrahim

    2015-05-01

    Full Text Available Introduction: The use of observation units (OUs following emergency departments (ED visits as a model of care has increased exponentially in the last decade. About one-third of U.S. hospitals now have OUs within their facilities. While their use is associated with lower costs and comparable level of care compared to inpatient units, there is a wide variation in OUs characteristics and operational procedures. The objective of this research was to explore the variability in the initial costs of care of placing patients with non-specific chest pain in observation units (OUs and the one-year outcomes. Methods: The author retrospectively investigated medical insurance claims of 22,962 privately insured patients (2009-2011 admitted to 41 OUs. Outcomes included the one-year chest pain/cardiovascular related costs and primary and secondary outcomes. Primary outcomes included myocardial infarction, congestive heart failure, stroke or cardiac arrest, while secondary outcomes included revascularization procedures, ED revisits for angina pectoris or chest pain and hospitalization due to cardiovascular diseases. The author aggregated the adjusted costs and prevalence rates of outcomes for patients over OUs, and computed the weighted coefficients of variation (WCV to compare variations across OUs. Results: There was minimal variability in the initial costs of care (WCV=2.2%, while the author noticed greater variability in the outcomes. Greater variability were associated with the adjusted cardiovascular-related costs of medical services (WCV=17.6% followed by the adjusted prevalence odds ratio of patients experiencing primary outcomes (WCV=16.3% and secondary outcomes (WCV=10%. Conclusion: Higher variability in the outcomes suggests the need for more standardization of the observation services for chest pain patients. [West J Emerg Med. 2015;16(3:395–400.

  20. Nurse dose: linking staffing variables to adverse patient outcomes.

    Science.gov (United States)

    Manojlovich, Milisa; Sidani, Souraya; Covell, Christine L; Antonakos, Cathy L

    2011-01-01

    Inconsistent findings in more than 100 studies have made it difficult to explain how variation in nurse staffing affects patient outcomes. Nurse dose, defined as the level of nurses required to provide patient care in hospital settings, draws on variables used in staffing studies to describe the influence of many staffing variables on outcomes. The aim of this study was to examine the construct validity of nurse dose by determining its association with methicillin-resistant Staphylococcus aureus (MRSA) infections and reported patient falls on a sample of inpatient adult acute care units. Staffing data came from 26 units in Ontario, Canada, and Michigan. Financial and human resource data were data sources for staffing variables. Sources of data for MRSA came from infection control departments. Incident reports were the data source for patient falls. Data analysis consisted of bivariate correlations and Poisson regression. Bivariate correlations revealed that nurse dose attributes (active ingredient and intensity) were associated significantly with both outcomes. Active ingredient (education, experience, skill mix) and intensity (full-time employees, registered nurse [RN]:patient ratio, RN hours per patient day) were significant predictors of MRSA. Coefficients for both attributes were negative and almost identical. Both attributes were significant predictors of reported patient falls, and coefficients were again negative, but coefficient sizes differed. By conceptualizing nurse and staffing variables (education, experience, skill mix, full-time employees, RN:patient ratio, RN hours per patient day) as attributes of nurse dose and by including these in the same analysis, it is possible to determine their relative influence on MRSA infections and reported patient falls.

  1. The Moderating Role of Power Distance on the Relationship between Employee Participation and Outcome Variables

    Science.gov (United States)

    Rafiei, Sima; Pourreza, Abolghasem

    2013-01-01

    Background: Many organisations have realised the importance of human resource for their competitive advantage. Empowering employees is therefore essential for organisational effectiveness. This study aimed to investigate the relationship between employee participation with outcome variables such as organisational commitment, job satisfaction, perception of justice in an organisation and readiness to accept job responsibilities. It further examined the impact of power distance on the relationship between participation and four outcome variables. Methods: This was a cross sectional study with a descriptive research design conducted among employees and managers of hospitals affiliated with Tehran University of Medical Sciences, Tehran, Iran. A questionnaire as a main procedure to gather data was developed, distributed and collected. Descriptive statistics, Pearson correlation coefficient and moderated multiple regression were used to analyse the study data. Results: Findings of the study showed that the level of power distance perceived by employees had a significant relationship with employee participation, organisational commitment, job satisfaction, perception of justice and readiness to accept job responsibilities. There was also a significant relationship between employee participation and four outcome variables. The moderated multiple regression results supported the hypothesis that power distance had a significant effect on the relationship between employee participation and four outcome variables. Conclusion: Organisations in which employee empowerment is practiced through diverse means such as participating them in decision making related to their field of work, appear to have more committed and satisfied employees with positive perception toward justice in the organisational interactions and readiness to accept job responsibilities. PMID:24596840

  2. The Moderating Role of Power Distance on the Relationship between Employee Participation and Outcome Variables

    Directory of Open Access Journals (Sweden)

    Abolghasem Pourreza

    2013-05-01

    Full Text Available Background Many organisations have realised the importance of human resource for their competitive advantage. Empowering employees is therefore essential for organisational effectiveness. This study aimed to investigate the relationship between employee participation with outcome variables such as organisational commitment, job satisfaction, perception of justice in an organisation and readiness to accept job responsibilities. It further examined the impact of power distance on the relationship between participation and four outcome variables. Methods This was a cross sectional study with a descriptive research design conducted among employees and managers of hospitals affiliated with Tehran University of Medical Sciences, Tehran, Iran. A questionnaire as a main procedure to gather data was developed, distributed and collected. Descriptive statistics, Pearson correlation coefficient and moderated multiple regression were used to analyse the study data. Results Findings of the study showed that the level of power distance perceived by employees had a significant relationship with employee participation, organisational commitment, job satisfaction, perception of justice and readiness to accept job responsibilities. There was also a significant relationship between employee participation and four outcome variables. The moderated multiple regression results supported the hypothesis that power distance had a significant effect on the relationship between employee participation and four outcome variables. Conclusion Organisations in which employee empowerment is practiced through diverse means such as participating them in decision making related to their field of work, appear to have more committed and satisfied employees with positive perception toward justice in the organisational interactions and readiness to accept job responsibilities.

  3. What Variables are Associated with Successful Weight Loss Outcomes for Bariatric Surgery After One Year?

    Science.gov (United States)

    Robinson, Athena H.; Adler, Sarah; Stevens, Helen B.; Darcy, Alison M.; Morton, John M.; Safer, Debra L.

    2014-01-01

    Background Prior evidence indicates that predictors of weight loss outcomes after gastric bypass surgery fall within 5 domains: 1) presurgical factors; 2) postsurgical psychosocial variables (e.g., support group attendance); 3) postsurgical eating patterns; 4) postsurgical physical activity; and 5) follow-up at postsurgical clinic. However, little data exist on which specific behavioral predictors are most associated with successful outcomes (e.g., ≥50% excess weight loss) when considering the 5 domains simultaneously. Objectives Specify the behavioral variables, and their respective cutoff points, most associated with successful weight loss outcomes. Setting On-line survey. Methods Signal Detection Analysis evaluated associations between 84 pre-and postsurgical behavioral variables (within the 5 domains) and successful weight loss at ≥1 year in 274 post-gastric bypass surgery patients. Results Successful weight loss was highest (92.6%) among those reporting dietary adherence of >3 on a 9 point scale (median=5) who grazed no more than once-per-day. Among participants reporting dietary adherence <3 and grazing daily or less, success rates more than doubled when highest lifetime Body Mass Index was <53.7 kg/m2. Success rates also doubled for participants with dietary adherence =3 if attending support groups. No variables from the physical activity or postsurgical follow-up domains were significant, nor were years since surgery. The overall model’s sensitivity =.62, specificity =.92. Conclusions To our knowledge, this is the first study to simultaneously consider the relative contribution of behavioral variables within 5 domains and offer clinicians an assessment algorithm identifying cut-off points for behaviors most associated with successful postsurgical weight loss. Such data may inform prospective study designs and postsurgical interventions. PMID:24913590

  4. Measuring Networking as an Outcome Variable in Undergraduate Research Experiences.

    Science.gov (United States)

    Hanauer, David I; Hatfull, Graham

    2015-01-01

    The aim of this paper is to propose, present, and validate a simple survey instrument to measure student conversational networking. The tool consists of five items that cover personal and professional social networks, and its basic principle is the self-reporting of degrees of conversation, with a range of specific discussion partners. The networking instrument was validated in three studies. The basic psychometric characteristics of the scales were established by conducting a factor analysis and evaluating internal consistency using Cronbach's alpha. The second study used a known-groups comparison and involved comparing outcomes for networking scales between two different undergraduate laboratory courses (one involving a specific effort to enhance networking). The final study looked at potential relationships between specific networking items and the established psychosocial variable of project ownership through a series of binary logistic regressions. Overall, the data from the three studies indicate that the networking scales have high internal consistency (α = 0.88), consist of a unitary dimension, can significantly differentiate between research experiences with low and high networking designs, and are related to project ownership scales. The ramifications of the networking instrument for student retention, the enhancement of public scientific literacy, and the differentiation of laboratory courses are discussed. © 2015 D. I. Hanauer and G. Hatfull. CBE—Life Sciences Education © 2015 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

  5. General conclusions on workshop

    International Nuclear Information System (INIS)

    Rustand, H.

    2006-01-01

    The author proposes a general conclusion on the second workshop on the indemnification of damage in the event of a nuclear accident, organized in Bratislava, the 18-20 May 2005. He pointed out the most important discussions and the results revealed during these two days. (A.L.B.)

  6. Conclusions and recommendations

    International Nuclear Information System (INIS)

    1984-01-01

    The FAO/IAEA/GSF/SIDA Co-ordinated Research Programme on Cereal Grain Protein Improvement by Nuclear Techniques was a follow-up to the FAO/IAEA/GSF Co-ordinated Research Programme on the Use of Nuclear Techniques for Seed Protein Improvement. It was initiated in 1969 and ended in 1981. The objectives of the meeting were to review and evaluate the achievements of the current and previous programmes in order to draw conclusions on the possibility of genetic improvement of cereal grain protein using nuclear techniques, to identify unsolved problems and to discuss and propose possible approaches for their solution. Through reviews and discussions, conclusions and recommendations were made by the participants

  7. 7. Conclusions and reflections

    OpenAIRE

    Nettle, Daniel

    2016-01-01

    But now your eyes sing the sad, sad song,Of how you lived so fast and died so young. Introduction We’ve now finished the data chapters of this book, and some conclusions are in order. In this chapter, I summarise what strike me as the main things we have learned, and suggest what their implications might be. I then devote a more extended discussion to the issue of causes of patterns of social behaviour, and how our data might bear on it. From this follows a brief consideration of what kinds o...

  8. Conclusions and recommendations

    International Nuclear Information System (INIS)

    Carrette, M.

    1997-01-01

    The paper presents conclusions and recommendations at the closing session of the NEA/OECD Workshop held at Fontenay-aux-Roses on 12-14 June 1995. The conclusions refer to issues like: public reaction to foodstuffs containing radioisotope concentrations under the danger standards, possible non-adherence of manufacturers, processors, distributors, et al, to the instructions and guidance from radiation protection specialists, integration of all the food chain factors in the elaboration of the emergency intervention programs, etc. Among the most significant recommendations the following may be mentioned: 1. Differences between different intervention levels and the maximum admissible levels agreed upon by national, regional or international nutrition authorities should be further studied; 2. Problems created by the Chernobyl accident (as for instance, the methods of treatment of food chain products containing unacceptable radioactivity concentrations) are still present and must be solved; 3. Further studies should be done on the socio-cultural aspects of the communication, particularly on the information in rural environment; 4. The preventive measures in agriculture should be implemented as rapidly as possible; 5. In elaborating programmes of agriculture countermeasures, the management of contaminated media, particularly, of forests and their effect on agriculture

  9. Clinical Operations Variables are Associated With Blood Pressure Outcomes.

    Science.gov (United States)

    Kressin, Nancy R; Lasser, Karen E; Paasche-Orlow, Michael; Allison, Jeroan; Ash, Arlene S; Adams, William G; Shanahan, Christopher W; Legler, Aaron; Pizer, Steven D

    2015-06-01

    Uncontrolled blood pressure (BP), among patients diagnosed and treated for the condition, remains an important clinical challenge; aspects of clinical operations could potentially be adjusted if they were associated with better outcomes. To assess clinical operations factors' effects on normalization of uncontrolled BP. Observational cohort study. Patients diagnosed with hypertension from a large urban clinical practice (2005-2009). We obtained clinical data on BP, organized by person-month, and administrative data on primary care provider (PCP) staffing. We assessed the resolution of an episode of uncontrolled BP as a function of time-varying covariates including practice-level appointment volume, individual clinicians' appointment volume, overall practice-level PCP staffing, and number of unique PCPs. Among the 7409 unique patients representing 50,403 person-months, normalization was less likely for the patients in whom the episode starts during months when the number of unique PCPs were high [the top quintile of unique PCPs was associated with a 9 percentage point lower probability of normalization (Ppercentage point reduction in the probability of normalization (P=0.01)]. Neither clinician appointment volume nor practice clinician staffing levels were significantly associated with the probability of normalization. Findings suggest that clinical operations factors can affect clinical outcomes like BP normalization, and point to the importance of considering outcome effects when organizing clinical care.

  10. Summary and Conclusions

    International Nuclear Information System (INIS)

    2013-01-01

    This section summarizes the presentations and Panel discussions of the 4 technical sessions of the workshop: 1 - Regulatory cooperation on generic and design specific issues, MDEP working groups (EPR, AP1000), vendor inspection co-operation, digital I and C, and codes and standards (7 presentations); 2 - Regulatory positions on siting practices and enhancements as a result of lessons learned from Fukushima accident (5 presentations); 3 - Construction experience and regulatory oversight of new reactor construction activities (6 presentations); 4 - Lessons learned from regulatory licensing reviews of new reactor designs (6 presentations). The main workshop conclusions are listed as follows: - Harmonization is a long term goal and significant progress has been made. However, this long term objective needs to be associated with short term measurable steps; - MDEP approach to tackle on one side with specific technical subjects, and to strive harmonisation on generic topics was considered appropriate; - Convergence on technical requirements is more realistic than harmonization of codes and standard; - Beneficial early engagement of different stakeholders specially at the siting stage has been acknowledged; - Need to characterise the hazards and to keep updated the safety assessment (PSR); - Land use issues are important particularly after Fukushima; - Commissioning aspects (e.g. training aspects for inspectors) should be addressed by WGRNR taking into account MDEP interaction; - Importance of WGRNR ConEx Programme: construction experience sharing is a leverage for quality and so for a future safe operation of NPPs; - Capability of licensee to follow the responsibility of design changes (could be an issue for small utilities); - Importance of Periodic Safety Reviews to review and account for the design. Finally, the WGRNR has convened that a third conference should be held in about two years time (2014- 2015)

  11. Summary and conclusions

    International Nuclear Information System (INIS)

    2011-01-01

    authorities, reactor designers, and operators/ licensees perspectives on the various practices used in the regulation of nuclear power plant siting (selection, evaluation and site preparation). This session was also aimed to address issues on sites where a mixture of activities are taking place (e.g., operating units, new construction, decommissioning, etc.) including organisation of the regulators and licensee/engineering organisation, methods, systems, etc. Conclusions: In general workshop participants agreed on the need to regularly have these kind of forums to discuss relevant regulatory issues for new builds. One important aspect of this workshop was the participation of 'New Entrants'. The interaction between NEA member countries with mature nuclear power plants and newcomers was quite important since it gave newcomers the possibility to benefit of mature international practices in order to focus their regulatory oversight and control. NEA members could also benefit from insights the New Entrants discover as they develop or enhance their regulatory controls. In addition technical exchanges associated with construction experience of New Entrants as they begin to license, build and operate NPP could benefit NEA members

  12. Conclusions

    Indian Academy of Sciences (India)

    In long-term better adapted varieties are needed to adapt to multiple stresses linked with climate change. ... and water management are available which can help minimize negative impacts. ... Adaptation practices take time to become effective.

  13. Conclusion

    OpenAIRE

    Rainhorn, Jean-Daniel; Boudamoussi, Samira El

    2017-01-01

    “Science without conscience is but the ruin of the soul.”—François Rabelais, 1542 A special feature of this book is to bring together the work of researchers coming from different disciplines and having various themes of reflection or practices in the field of biomedicine. While the general trend of science goes towards increasing specialization, the project of this book is to look at the use of medical advances in a transversal perspective. In other words, it intends to highlight what unregu...

  14. Conclusions

    International Nuclear Information System (INIS)

    Mandil, C.

    1994-01-01

    The renewable energies and the nuclear one are complementary. They belong to the french energy policy, which has three aims: strategic, economic and environmental. They contribute to the diversification of the energy balance and to the energy competitiveness. Energy savings might be achieved and renewable energies might be developed for the future

  15. Conclusions

    Indian Academy of Sciences (India)

    Confounding effect of obesity and associated co-morbidities (especially on metabolic abnormalities, cardiovascular and cerebrovascular morbidity) should be clearly dissected out in future studies ...

  16. Conclusion

    OpenAIRE

    Houmed Soulé, Aramis

    2018-01-01

    Au cours de son règne qui a duré plus d’une quarantaine d’années, en une période cruciale de l’histoire de la Corne de l’Afrique, Maḥammad Ḥanfaré parvient à préserver son sultanat, à défaut de l’ensemble du pays ‘Afar, des visées impérialistes d’où qu’elles viennent. Malheureusement, l’indépendance de cette entité politique ‘Afar ne lui survit pas, du moins sur le plan international. Des luttes fratricides pour sa succession qui opposent ses nombreux héritiers et dont les prémices apparaisse...

  17. Conclusion

    DEFF Research Database (Denmark)

    Fahnøe, Kristian Relsted; Warming, Hanne

    2017-01-01

    analysis approach reveal how clients’ struggles in intimate and societal life, and in public and private spaces, are intertwined with geo-politics and global flows of governance strategies, e.g. neoliberalism and managerialism, which also condition social work practices. Indeed, social work constitutes......Fahnøe and Warming provide a cogent overview of how a lived citizenship approach enables critical analyses of social work and social policies by addressing challenges related to rights, recognition, participation, belonging and identity. The sub-concept of intimate citizenship and a spatial...... a kind of sociological magnifying glass through which broader social changes can be studied, including dynamics of inclusion and exclusion, new conflicts and modes of resistance, and new social pathologies....

  18. Conclusion

    DEFF Research Database (Denmark)

    Warming, Hanne; Fahnøe, Kristian

    2017-01-01

    analysis approach reveal how clients’ struggles in intimate and societal life, and in public and private spaces, are intertwined with geo-politics and global flows of governance strategies, e.g. neoliberalism and managerialism, which also condition social work practices. Indeed, social work constitutes......Warming and Fahnøe provide a cogent overview of how a lived citizenship approach enables critical analyses of social work and social policies by addressing challenges related to rights, recognition, participation, belonging and identity. The sub-concept of intimate citizenship and a spatial...... a kind of sociological magnifying glass through which broader social changes can be studied, including dynamics of inclusion and exclusion, new conflicts and modes of resistance, and new social pathologies....

  19. Conclusion

    DEFF Research Database (Denmark)

    de Vreese, Claes; Reinemann, Carsten; Esser, Frank

    2017-01-01

    At the outset, we asked if there is any good news about the news and, if so, where the good news is. In academic research and public discussions about news and democracy, one fi nds different interpretations of the state of current news provision. A tendency towards pessimism about current news...... is seen as having a negative impact on the quality of political life and democracy. Set against the pessimism and caution in the public debate and literature on news quality and the performance of political journalism, we were not optimistic that we would fi nd good-quality news or that we would be able...... to offer some good news as a positive antidote, so to speak, to the pervasive pessimism in the literature....

  20. Conclusions

    International Nuclear Information System (INIS)

    Brookes, L.G.; Motamen, H.

    1984-01-01

    The paper covers the following: economics of nuclear power; nuclear or fossil-fuel plants; power systems; methods of capital investment appraisal; size factor; nuclear industry; uranium demand; fuel cycle; fast reactors; choice of reactors; case studies from France; power plants in USA and West Germany; electricity tariffs; nuclear energy in Middle Eastern states; energy growth and economic growth; nuclear energy as macroeconomic influence; future energy options. (U.K.)

  1. Conclusion

    DEFF Research Database (Denmark)

    Jørgensen, Christian Helms; Wallo, Andreas; Toiviainen, Hanna

    2015-01-01

    Work in times of globalisation and uncertainty is undergoing considerable changes, which has strengthened the importance of work as a site of learning. New trends in production, such as digitalisation, challenge traditional modes of producing goods and services. Emerging forms of flexible...... production and knowledge-work offer growing learning opportunities to people throughout their active working life. In contrast to the stable and standardised modes of Fordist production, modern working life is characterised by rapid changes and employees interacting across globally distributed professional...... explores the challenges of working and learning on the boundaries between education and working life. Globalisation affects the transition patterns from vocational education to the labour market in many ways (Schoon & Silbereisen, 2009), even though the specific challenges to national-level policies vary...

  2. Conclusions

    Science.gov (United States)

    Ahonen, Pasi; Alahuhta, Petteri; Daskala, Barbara; Delaitre, Sabine; Hert, Paul De; Lindner, Ralf; Maghiros, Ioannis; Moscibroda, Anna; Schreurs, Wim; Verlinden, Michiel

    Some say that an increase in security does not necessarily mean a further encroachment on privacy - indeed, security is necessary to protect personal data and our privacy. Networks must be secure, our personal devices, reliable, dependable and trustworthy. But security is a multifaceted term, with many dimensions. We are of the view that an increase in security most likely will encroach upon our privacy in an ambient intelligence world. Surveillance cameras will continue to proliferate. We assume that, whatever the law is, whatever privacy protections government and business say they honour, our telecommunications, e-mails and Internet usage will be monitored to an increasing degree. The same will be true of our interfaces with the world of ambient intelligence.

  3. Conclusions

    Indian Academy of Sciences (India)

    First page Back Continue Last page Overview Graphics. First study on fHSC. First study on fHSC. fHSC exhibit embryonic stem cell like properties. fHSC therapy results in myocardial regeneration in rat model of MI. fHSC may be a novel stem cell type for cardiovascular regeneration.

  4. Conclusion

    International Nuclear Information System (INIS)

    2000-01-01

    In the monograph peculiarities of radioinduced sexual dysfunctions of Chernobyl accident liquidators are described. It is shown, that ones of principal clinical manifestations of stochastic radio-genetic effects are sexual dysfunctions. Assessment in point of view of stages and components of copulative cycle is carried out. Authors made attempt to take in account all involved in sexual dysfunctions systems for examined contingent. It is noted, that genesis of radioinduced sexual dysfunctions is complex and it includes both the influence of vegetative nervous system damage and the direct damage of gonads. During clinical examination with patients it is revealed that both vegetative-vascular dysfunctions and asteno-neurotic dysfunctions are dominating. Authors noting that mentioned sexual dysfunctions are caused by low dose irradiation, and they have certain distinctions. Measures for comprehensive rehabilitation of suffered contingent in late period after irradiation are developed

  5. Conclusions

    Indian Academy of Sciences (India)

    Microbial organisms play a major role in assimilation of P from the water column and also from the interstitial waters. Mineralisation of microbial bodies is a very rapid process and autophosphatization may occur within few hours or days after death. Geo-microbiology is an important subject and needs to be developed.

  6. Conclusion

    International Nuclear Information System (INIS)

    Timofeev, Yu.M.; Zikiryakhodjaev, D.Z.

    1997-01-01

    In this chapter of book authors made following summary: the cancerous growths of anal canal is rare form of growths; extension of anal canal depends from sex, age, weight and growth of patient; the developed schemes of classification and staging of cancerous growths of anal canal have important role for growths systematization; typical symptoms are blood in excrement, pains in anus, presence of swelling in anus, the treatment of the cancerous growths of anal canal must be varied

  7. Glucose variability negatively impacts long-term functional outcome in patients with traumatic brain injury.

    Science.gov (United States)

    Matsushima, Kazuhide; Peng, Monica; Velasco, Carlos; Schaefer, Eric; Diaz-Arrastia, Ramon; Frankel, Heidi

    2012-04-01

    Significant glycemic excursions (so-called glucose variability) affect the outcome of generic critically ill patients but has not been well studied in patients with traumatic brain injury (TBI). The purpose of this study was to evaluate the impact of glucose variability on long-term functional outcome of patients with TBI. A noncomputerized tight glucose control protocol was used in our intensivist model surgical intensive care unit. The relationship between the glucose variability and long-term (a median of 6 months after injury) functional outcome defined by extended Glasgow Outcome Scale (GOSE) was analyzed using ordinal logistic regression models. Glucose variability was defined by SD and percentage of excursion (POE) from the preset range glucose level. A total of 109 patients with TBI under tight glucose control had long-term GOSE evaluated. In univariable analysis, there was a significant association between lower GOSE score and higher mean glucose, higher SD, POE more than 60, POE 80 to 150, and single episode of glucose less than 60 mg/dL but not POE 80 to 110. After adjusting for possible confounding variables in multivariable ordinal logistic regression models, higher SD, POE more than 60, POE 80 to 150, and single episode of glucose less than 60 mg/dL were significantly associated with lower GOSE score. Glucose variability was significantly associated with poorer long-term functional outcome in patients with TBI as measured by the GOSE score. Well-designed protocols to minimize glucose variability may be key in improving long-term functional outcome. Copyright © 2012 Elsevier Inc. All rights reserved.

  8. The Effects of Job Autonomy on Work Outcomes: Self Efficacy as an Intervening Variable

    OpenAIRE

    Susanti Saragih

    2011-01-01

    The purpose of this research was to examine the relationship between job autonomy and work outcomes (job performance, job satisfaction and job stress), self efficacy as a mediating variable. This research also investigated the impact of job satisfaction on job performance and job stress on job performance. Va-riables in this research were measured via a survey of 190 banking salespersons in D.I. Yogyakarta and Solo. Structural Equation Modeling (SEM) were used to examine the effects of job au...

  9. Variable reporting of functional outcomes and return to play in superior labrum anterior and posterior tear.

    Science.gov (United States)

    Steinhaus, Michael E; Makhni, Eric C; Lieber, Adam C; Kahlenberg, Cynthia A; Gulotta, Lawrence V; Romeo, Anthony A; Verma, Nikhil N

    2016-11-01

    Outcomes assessments after superior labrum anterior and posterior (SLAP) tear/repair are highly varied, making it difficult to draw comparisons across the literature. This study examined the inconsistency in outcomes reporting in the SLAP tear literature. We hypothesize that there is significant variability in outcomes reporting and that although most studies may report return to play, time to return reporting will be highly variable. The PubMed, Medline, Scopus, and Embase databases were systematically reviewed for studies from January 2000 to December 2014 reporting outcomes after SLAP tear/repair. Two reviewers assessed each study, and those meeting inclusion criteria were examined for pertinent data. Outcomes included objective (range of motion, strength, clinical examinations, and imaging) and subjective (patient-reported outcomes, satisfaction, activities of daily living, and return to play) measures. Of the 56 included studies, 43% documented range of motion, 14% reported strength, and 16% noted postoperative imaging. There was significant variation in use of patient-reported outcomes measures, with the 3 most commonly noted measures reported in 20% to 55% of studies. Return to play was noted in 75% of studies, and 23% reported time to return, with greater rates in elite athletes. Eleven studies (20%) did not report follow-up or noted data with <12 months of follow-up. The SLAP literature is characterized by substantial variability in outcomes reporting, with time to return to play noted in few studies. Efforts to standardize outcomes reporting would facilitate comparisons across the literature and improve our understanding of the prognosis of this injury. Copyright © 2016 Journal of Shoulder and Elbow Surgery Board of Trustees. Published by Elsevier Inc. All rights reserved.

  10. High Variability in Outcome Reporting Patterns in High-Impact ACL Literature.

    Science.gov (United States)

    Makhni, Eric C; Padaki, Ajay S; Petridis, Petros D; Steinhaus, Michael E; Ahmad, Christopher S; Cole, Brian J; Bach, Bernard R

    2015-09-16

    ACL (anterior cruciate ligament) reconstruction is one of the most commonly performed and studied procedures in modern sports medicine. A multitude of objective and subjective patient outcome measures exists; however, nonstandardized reporting patterns of these metrics may create challenges in objectively analyzing pooled results from different studies. The goal of this study was to document the variability in outcome reporting patterns in high-impact orthopaedic studies of ACL reconstruction. All clinical studies pertaining to ACL reconstruction in four high-impact-factor orthopaedic journals over a five-year period were reviewed. Biomechanical, basic science, and imaging studies were excluded, as were studies with fewer than fifty patients, yielding 119 studies for review. Incorporation of various objective and subjective outcomes was noted for each study. Substantial variability in reporting of both objective and subjective measures was noted in the study cohort. Although a majority of studies reported instrumented laxity findings, there was substantial variability in the type and method of laxity reporting. Most other objective outcomes, including range of motion, strength, and complications, were reported in <50% of all studies. Return to pre-injury level of activity was infrequently reported (24% of studies), as were patient satisfaction and pain assessment following surgery (8% and 13%, respectively). Of the patient-reported outcomes, the International Knee Documentation Committee (IKDC), Lysholm, and Tegner scores were most often reported (71%, 63%, and 42%, respectively). Substantial variability in outcome reporting patterns exists among high-impact studies of ACL reconstruction. Such variability may create challenges in interpreting results and pooling them across different studies. Copyright © 2015 by The Journal of Bone and Joint Surgery, Incorporated.

  11. Education and Health Matters: School Nurse Interventions, Student Outcomes, and School Variables

    Science.gov (United States)

    Wolfe, Linda C.

    2013-01-01

    This paper presents findings from a quantitative, correlational study that examined selected school nursing services, student academic outcomes, and school demographics. Ex post facto data from the 2011-2012 school year of Delaware public schools were used in the research. The selected variables were school nurse interventions provided to students…

  12. The Moderating Role of Power Distance on the Relationship between Employee Participation and Outcome Variables.

    Science.gov (United States)

    Rafiei, Sima; Pourreza, Abolghasem

    2013-06-01

    Many organisations have realised the importance of human resource for their competitive advantage. Empowering employees is therefore essential for organisational effectiveness. This study aimed to investigate the relationship between employee participation with outcome variables such as organisational commitment, job satisfaction, perception of justice in an organisation and readiness to accept job responsibilities. It further examined the impact of power distance on the relationship between participation and four outcome variables. This was a cross sectional study with a descriptive research design conducted among employees and managers of hospitals affiliated with Tehran University of Medical Sciences, Tehran, Iran. A questionnaire as a main procedure to gather data was developed, distributed and collected. Descriptive statistics, Pearson correlation coefficient and moderated multiple regression were used to analyse the study data. Findings of the study showed that the level of power distance perceived by employees had a significant relationship with employee participation, organisational commitment, job satisfaction, perception of justice and readiness to accept job responsibilities. There was also a significant relationship between employee participation and four outcome variables. The moderated multiple regression results supported the hypothesis that power distance had a significant effect on the relationship between employee participation and four outcome variables. Organisations in which employee empowerment is practiced through diverse means such as participating them in decision making related to their field of work, appear to have more committed and satisfied employees with positive perception toward justice in the organisational interactions and readiness to accept job responsibilities.

  13. Assessing the Impact of Socioeconomic Variables on Small Area Variations in Suicide Outcomes in England

    Directory of Open Access Journals (Sweden)

    Peter Congdon

    2012-12-01

    Full Text Available Ecological studies of suicide and self-harm have established the importance of area variables (e.g., deprivation, social fragmentation in explaining variations in suicide risk. However, there are likely to be unobserved influences on risk, typically spatially clustered, which can be modeled as random effects. Regression impacts may be biased if no account is taken of spatially structured influences on risk. Furthermore a default assumption of linear effects of area variables may also misstate or understate their impact. This paper considers variations in suicide outcomes for small areas across England, and investigates the impact on them of area socio-economic variables, while also investigating potential nonlinearity in their impact and allowing for spatially clustered unobserved factors. The outcomes are self-harm hospitalisations and suicide mortality over 6,781 Middle Level Super Output Areas.

  14. High glucose variability is associated with poor neurodevelopmental outcomes in neonatal hypoxic ischemic encephalopathy.

    Science.gov (United States)

    Al Shafouri, N; Narvey, M; Srinivasan, G; Vallance, J; Hansen, G

    2015-01-01

    In neonatal hypoxic ischemic encephalopathy (HIE), hypo- and hyperglycemia have been associated with poor outcomes. However, glucose variability has not been reported in this population. To examine the association between serum glucose variability within the first 24 hours and two-year neurodevelopmental outcomes in neonates cooled for HIE. In this retrospective cohort study, glucose, clinical and demographic data were documented from 23 term newborns treated with whole body therapeutic hypothermia. Severe neurodevelopmental outcomes from planned two-year assessments were defined as the presence of any one of the following: Gross Motor Function Classification System levels 3 to 5, Bayley III Motor Standard Score neurodevelopmental outcomes from 8 of 23 patients were considered severe, and this group demonstrated a significant increase of mean absolute glucose (MAG) change (-0.28 to -0.03, 95% CI, p = 0.032). There were no significant differences between outcome groups with regards to number of patients with hyperglycemic means, one or multiple hypo- or hyperglycemic measurement(s). There were also no differences between both groups with mean glucose, although mean glucose standard deviation was approaching significance. Poor neurodevelopmental outcomes in whole body cooled HIE neonates are significantly associated with MAG changes. This information may be relevant for prognostication and potential management strategies.

  15. Leg pain and psychological variables predict outcome 2-3 years after lumbar fusion surgery.

    Science.gov (United States)

    Abbott, Allan D; Tyni-Lenné, Raija; Hedlund, Rune

    2011-10-01

    Prediction studies testing a thorough range of psychological variables in addition to demographic, work-related and clinical variables are lacking in lumbar fusion surgery research. This prospective cohort study aimed at examining predictions of functional disability, back pain and health-related quality of life (HRQOL) 2-3 years after lumbar fusion by regressing nonlinear relations in a multivariate predictive model of pre-surgical variables. Before and 2-3 years after lumbar fusion surgery, patients completed measures investigating demographics, work-related variables, clinical variables, functional self-efficacy, outcome expectancy, fear of movement/(re)injury, mental health and pain coping. Categorical regression with optimal scaling transformation, elastic net regularization and bootstrapping were used to investigate predictor variables and address predictive model validity. The most parsimonious and stable subset of pre-surgical predictor variables explained 41.6, 36.0 and 25.6% of the variance in functional disability, back pain intensity and HRQOL 2-3 years after lumbar fusion. Pre-surgical control over pain significantly predicted functional disability and HRQOL. Pre-surgical catastrophizing and leg pain intensity significantly predicted functional disability and back pain while the pre-surgical straight leg raise significantly predicted back pain. Post-operative psychomotor therapy also significantly predicted functional disability while pre-surgical outcome expectations significantly predicted HRQOL. For the median dichotomised classification of functional disability, back pain intensity and HRQOL levels 2-3 years post-surgery, the discriminative ability of the prediction models was of good quality. The results demonstrate the importance of pre-surgical psychological factors, leg pain intensity, straight leg raise and post-operative psychomotor therapy in the predictions of functional disability, back pain and HRQOL-related outcomes.

  16. Sensitivity of adaptive enrichment trial designs to accrual rates, time to outcome measurement, and prognostic variables

    Directory of Open Access Journals (Sweden)

    Tianchen Qian

    2017-12-01

    Full Text Available Adaptive enrichment designs involve rules for restricting enrollment to a subset of the population during the course of an ongoing trial. This can be used to target those who benefit from the experimental treatment. Trial characteristics such as the accrual rate and the prognostic value of baseline variables are typically unknown when a trial is being planned; these values are typically assumed based on information available before the trial starts. Because of the added complexity in adaptive enrichment designs compared to standard designs, it may be of special concern how sensitive the trial performance is to deviations from assumptions. Through simulation studies, we evaluate the sensitivity of Type I error, power, expected sample size, and trial duration to different design characteristics. Our simulation distributions mimic features of data from the Alzheimer's Disease Neuroimaging Initiative cohort study, and involve two subpopulations based on a genetic marker. We investigate the impact of the following design characteristics: the accrual rate, the time from enrollment to measurement of a short-term outcome and the primary outcome, and the prognostic value of baseline variables and short-term outcomes. To leverage prognostic information in baseline variables and short-term outcomes, we use a semiparametric, locally efficient estimator, and investigate its strengths and limitations compared to standard estimators. We apply information-based monitoring, and evaluate how accurately information can be estimated in an ongoing trial.

  17. Heart rate variability measured early in patients with evolving acute coronary syndrome and 1-year outcomes of rehospitalization and mortality

    Directory of Open Access Journals (Sweden)

    Harris PR

    2014-08-01

    power. A model with ultra low frequency power <8 ms2 (HR =3.8; 95% CI =1.5–10.1; P=0.007 and troponin >0.3 ng/mL (HR =4.0; 95% CI =1.3–12.1; P=0.016 revealed that each contributed independently in predicting mortality. Nonlinear HRV variables were significant predictors of both outcomes. Conclusion: HRV measured close to the ACS onset may assist in risk stratification. HRV cut-points may provide additional, incremental prognostic information to established assessment guidelines, and may be worthy of additional study. Keywords: autonomic cardiac function, coronary artery disease, outcomes research, risk assessment, hospital readmittance, mortality 

  18. Visit-to-visit cholesterol variability correlates with coronary atheroma progression and clinical outcomes.

    Science.gov (United States)

    Clark, Donald; Nicholls, Stephen J; St John, Julie; Elshazly, Mohamed B; Kapadia, Samir R; Tuzcu, E Murat; Nissen, Steven E; Puri, Rishi

    2018-04-21

    Utilizing serial intravascular ultrasonography (IVUS), we aimed to exam the association of intra-individual lipid variability, coronary atheroma progression, and clinical outcomes. We performed a post hoc patient-level analysis of nine clinical trials involving 4976 patients with coronary artery disease who underwent serial coronary IVUS in the setting of a range of medical therapies. We assessed the associations between progression in percent atheroma volume (ΔPAV), clinical outcomes, and visit-to-visit lipid variability including low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), non-HDL-C, total cholesterol (TC)/HDL-C, and apolipoprotein B (ApoB). Variability of lipid parameters was measured using intra-individual standard deviation over 3, 6, 12, 18, and 24 months. Atherogenic lipoprotein variability significantly associated with ΔPAV [odds ratio (95% confidence interval; P-value), LDL-C: 1.09 (1.02, 1.17, P = 0.01); non-HDL-C: 1.10 (1.02, 1.18, P = 0.01); TC/HDL-C: 1.14 (1.06, 1.24, P = 0.001); ApoB: 1.13 (1.03, 1.24, P = 0.01)]. Survival curves revealed significant stepwise relationships between cumulative major adverse cardiovascular events and increasing quartiles of atherogenic lipoprotein variability at 24-months follow-up (log-rank P C). Stronger associations were noted between achieved lipoprotein levels and ΔPAV [LDL-C: 1.27 (1.17, 1.39; P C: 1.32 (1.21, 1.45; P C: 1.31 (1.19, 1.45; P < 0.001); ApoB: 1.20 (1.07, 1.35; P = 0.003)]. Greater visit-to-visit variability in atherogenic lipoprotein levels significantly associates with coronary atheroma progression and clinical outcomes, although the association between achieved atherogenic lipoproteins and atheroma progression appears stronger. These data highlight the importance of achieving low and consistent atherogenic lipoprotein levels to promote plaque regression and improve clinical outcomes.

  19. Evaluation of standardized and applied variables in predicting treatment outcomes of polytrauma patients.

    Science.gov (United States)

    Aksamija, Goran; Mulabdic, Adi; Rasic, Ismar; Muhovic, Samir; Gavric, Igor

    2011-01-01

    Polytrauma is defined as an injury where they are affected by at least two different organ systems or body, with at least one life-threatening injuries. Given the multilevel model care of polytrauma patients within KCUS are inevitable weaknesses in the management of this category of patients. To determine the dynamics of existing procedures in treatment of polytrauma patients on admission to KCUS, and based on statistical analysis of variables applied to determine and define the factors that influence the final outcome of treatment, and determine their mutual relationship, which may result in eliminating the flaws in the approach to the problem. The study was based on 263 polytrauma patients. Parametric and non-parametric statistical methods were used. Basic statistics were calculated, based on the calculated parameters for the final achievement of research objectives, multicoleration analysis, image analysis, discriminant analysis and multifactorial analysis were used. From the universe of variables for this study we selected sample of n = 25 variables, of which the first two modular, others belong to the common measurement space (n = 23) and in this paper defined as a system variable methods, procedures and assessments of polytrauma patients. After the multicoleration analysis, since the image analysis gave a reliable measurement results, we started the analysis of eigenvalues, that is defining the factors upon which they obtain information about the system solve the problem of the existing model and its correlation with treatment outcome. The study singled out the essential factors that determine the current organizational model of care, which may affect the treatment and better outcome of polytrauma patients. This analysis has shown the maximum correlative relationships between these practices and contributed to development guidelines that are defined by isolated factors.

  20. Long-term outcome of major depressive disorder in psychiatric patients is variable.

    Science.gov (United States)

    Holma, K Mikael; Holma, Irina A K; Melartin, Tarja K; Rytsälä, Heikki J; Isometsä, Erkki T

    2008-02-01

    The prevailing view of outcome of major depressive disorder (MDD), based on mostly inpatient cohorts sampled from tertiary centers, emphasizes chronicity and frequent recurrences. We investigated the long-term outcome of a regionally representative psychiatric MDD cohort comprising mainly outpatients. The Vantaa Depression Study included 163 patients with DSM-IV MDD (71.5% of those eligible) diagnosed using structured and semistructured interviews and followed up at 6 months, 18 months, and 5 years with a life chart between February 1, 1997, and April 30, 2004. The effects of comorbid disorders and other predictors on outcome were comprehensively investigated. Over the 5-year follow-up, 98.8% of patients achieved a symptom state below major depressive episode (MDE) criteria, and 88.4% reached full remission, with the median time to full remission being 11.0 months. Nearly one third (29.3%) had no recurrences, whereas 30.0% experienced 1, 12.9% experienced 2, and 27.9% experienced 3 or more recurrences. Preceding dysthymic disorder (p = .028), cluster C personality disorder (p = .041), and longer MDE duration prior to entry (p = .011) were the most significant predictors of longer time in achieving full remission. Severity of MDD and comorbidity, especially social phobia, predicted probability of, shorter time to, and number of recurrences. Previous literature on mostly inpatient MDD may have, by generalizing from patients with the most severe psychopathology, overemphasized chronicity of MDD. The long-term outcome of MDD in psychiatric care is variable, with about one tenth of patients having poor, one third having intermediate, and one half having favorable outcomes. In addition to known predictors, cluster C personality disorders and social phobia warrant further attention as predictors of MDD outcome among outpatients.

  1. CONCLUSIONS Urban Children and Adolescents

    Indian Academy of Sciences (India)

    CONCLUSIONS Urban Children and Adolescents. Increasing prevalence of overweight and obesity and measures of regional (central) adiposity. High prevalence of markers of dysmetabolic state in urban adolescents. ~10% prevalence of dysglycemia in overweight / obese school children.

  2. Chapter 6: Conclusions and recommendations

    International Nuclear Information System (INIS)

    1995-01-01

    This chapter provides a brief summary of conclusions with respect to project implementation issues. Furthermore, the chapter contains recommendations on future applications of the modelling system and on water resources management in the project area

  3. Summary and conclusions [Chapter 11

    Science.gov (United States)

    Daniel G. Neary; John N. Rinne; Alvin L.. Medina

    2012-01-01

    Summaries and conclusions of each chapter are compiled here to provide a “Quick Reference” guide of major results and recommendations for the UVR. More detail can be obtained from individual chapters.

  4. Perceived match or mismatch on the Gottman conflict styles: associations with relationship outcome variables.

    Science.gov (United States)

    Busby, Dean M; Holman, Thomas B

    2009-12-01

    Gottman has proposed that there are 3 functional styles of conflict management in couple relationships, labeled Avoidant, Validating, and Volatile, and 1 dysfunctional style, labeled Hostile. Using a sample of 1,983 couples in a committed relationship, we test the association of perceived matches or mismatches on these conflict styles with relationship outcome variables. The results indicate that 32% of the participants perceive there is a mismatch with their conflict style and that of their partner. The Volatile-Avoidant mismatch was particularly problematic and was associated with more stonewalling, relationship problems, and lower levels of relationship satisfaction and stability than the Validating matched style and than other mismatched styles. The most problematic style was the Hostile style. Contrary to existing assumptions by Gottman, the 3 matched functional styles were not equivalent, as the Validating Style was associated with substantially better results on relationship outcome measures than the Volatile and Avoidant styles.

  5. CONCLUSIONS New Delhi Birth Cohort

    Indian Academy of Sciences (India)

    CONCLUSIONS New Delhi Birth Cohort. Crossing BMI centiles and early adiposity rebound associated with adult metabolic syndrome. BMI gain in infancy and early childhood – associated more with adult lean mass. BMI gain in later childhood / adolescence – associated more with adult fat mass and constituents of ...

  6. Diastolic blood pressure variability in 24 hour-ABPM and outcomes of chronic kidney disease
.

    Science.gov (United States)

    Sahutoglu, Tuncay; Sakaci, Tamer

    2018-04-10

    Blood pressure variability (BPV) has been associated with increased morbidity and mortality. There are a few studies that reported worse outcomes of chronic kidney disease (CKD) with greater visit-to-visit BPV (VVV), but data with ambulatory blood pressure monitoring (ABPM) is scarce. Ambulatory hypertensive CKD (stage 2 - 4) patients (> 18 years old) with complete 24 hours of ABPM study (SpaceLabs), who were followed up between January 2012 and December 2016, were retrospectively analyzed for the baseline characteristics and outcomes of CKD. Coefficient of variation (CV) in diastolic blood pressure (DBP) was used as an index of BPV. Data of 191 patients (mean age 59.7 ± 12.4 years, 54.9% males, 42.1% diabetic, mean eGFR-EPI (Chronic Kidney Disease Epidemiology Collaboration) 51.7 ± 22.0 mL/min/1.73m2, mean follow-up 26.2 ± 10.4 months) were available for the analysis. On multivariate linear regression analysis, greater DBP-CV was associated with slower decline in eGFR-EPI per year (B -0.648, p = 0.000). Likewise, the hazard ratio (HR) for dialysis inception (occurred in 9.4%) was found significantly lower with increasing DBP-CV in unadjusted and fully adjusted Cox models (HR 0.730, 95% CI 0.618 - 0.861, p = 0.000, and HR 0.678, 95% CI 0.526 - 0.874, p = 0.003, respectively). These findings suggest that DBP variability in 24-hour ABPM may be a good prognostic factor for the outcomes of CKD. Further studies are needed to determine the impact of 24-hour ABPM BPV on CKD progression and its differences from VVV.
.

  7. Scrub typhus in South India: clinical and laboratory manifestations, genetic variability, and outcome.

    Science.gov (United States)

    Varghese, George M; Janardhanan, Jeshina; Trowbridge, Paul; Peter, John V; Prakash, John A J; Sathyendra, Sowmya; Thomas, Kurien; David, Thambu S; Kavitha, M L; Abraham, Ooriapadickal C; Mathai, Dilip

    2013-11-01

    This study sought to document the clinical and laboratory manifestations, genetic variability, and outcomes of scrub typhus, an often severe infection caused by Orientia tsutsugamushi, in South India. Patients admitted to a large teaching hospital with IgM ELISA-confirmed scrub typhus were evaluated. Clinical examination with a thorough search for an eschar, laboratory testing, chest X-ray, and outcome were documented and analyzed. Additionally, a 410-bp region of the 56-kDa type-specific antigen gene of O. tsutsugamushi was sequenced and compared with isolates from other regions of Asia. Most of the 154 patients evaluated presented with fever and non-specific symptoms. An eschar was found in 86 (55%) patients. Mild hepatic involvement was seen in most, with other organ involvement including respiratory, cardiovascular, and renal. Multi-organ dysfunction was noted in 59 (38.3%), and the fatality rate was 7.8%. Hypotension requiring vasoactive agents was found to be an independent predictor of mortality (p<0.001). The phylogeny of 26 samples showed 17 (65%) clustering with the Kato-like group and eight (31%) with the Karp-like group. The presentation of scrub typhus can be variable, often non-specific, but with potentially severe multi-organ dysfunction. Prompt recognition is key to specific treatment and good outcomes. Further study of the circulating strains is essential for the development of a successful vaccine and sensitive point-of-care testing. Copyright © 2013 International Society for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

  8. Intraindividual variability in reaction time predicts cognitive outcomes 5 years later.

    Science.gov (United States)

    Bielak, Allison A M; Hultsch, David F; Strauss, Esther; Macdonald, Stuart W S; Hunter, Michael A

    2010-11-01

    Building on results suggesting that intraindividual variability in reaction time (inconsistency) is highly sensitive to even subtle changes in cognitive ability, this study addressed the capacity of inconsistency to predict change in cognitive status (i.e., cognitive impairment, no dementia [CIND] classification) and attrition 5 years later. Two hundred twelve community-dwelling older adults, initially aged 64-92 years, remained in the study after 5 years. Inconsistency was calculated from baseline reaction time performance. Participants were assigned to groups on the basis of their fluctuations in CIND classification over time. Logistic and Cox regressions were used. Baseline inconsistency significantly distinguished among those who remained or transitioned into CIND over the 5 years and those who were consistently intact (e.g., stable intact vs. stable CIND, Wald (1) = 7.91, p < .01, Exp(β) = 1.49). Average level of inconsistency over time was also predictive of study attrition, for example, Wald (1) = 11.31, p < .01, Exp(β) = 1.24. For both outcomes, greater inconsistency was associated with a greater likelihood of being in a maladaptive group 5 years later. Variability based on moderately cognitively challenging tasks appeared to be particularly sensitive to longitudinal changes in cognitive ability. Mean rate of responding was a comparable predictor of change in most instances, but individuals were at greater relative risk of being in a maladaptive outcome group if they were more inconsistent rather than if they were slower in responding. Implications for the potential utility of intraindividual variability in reaction time as an early marker of cognitive decline are discussed. (c) 2010 APA, all rights reserved

  9. Modelling variable dropout in randomised controlled trials with longitudinal outcomes: application to the MAGNETIC study.

    Science.gov (United States)

    Kolamunnage-Dona, Ruwanthi; Powell, Colin; Williamson, Paula Ruth

    2016-04-28

    Clinical trials with longitudinally measured outcomes are often plagued by missing data due to patients withdrawing or dropping out from the trial before completing the measurement schedule. The reasons for dropout are sometimes clearly known and recorded during the trial, but in many instances these reasons are unknown or unclear. Often such reasons for dropout are non-ignorable. However, the standard methods for analysing longitudinal outcome data assume that missingness is non-informative and ignore the reasons for dropout, which could result in a biased comparison between the treatment groups. In this article, as a post hoc analysis, we explore the impact of informative dropout due to competing reasons on the evaluation of treatment effect in the MAGNETIC trial, the largest randomised placebo-controlled study to date comparing the addition of nebulised magnesium sulphate to standard treatment in acute severe asthma in children. We jointly model longitudinal outcome and informative dropout process to incorporate the information regarding the reasons for dropout by treatment group. The effect of nebulised magnesium sulphate compared with standard treatment is evaluated more accurately using a joint longitudinal-competing risk model by taking account of such complexities. The corresponding estimates indicate that the rate of dropout due to good prognosis is about twice as high in the magnesium group compared with standard treatment. We emphasise the importance of identifying reasons for dropout and undertaking an appropriate statistical analysis accounting for such dropout. The joint modelling approach accounting for competing reasons for dropout is proposed as a general approach for evaluating the sensitivity of conclusions to assumptions regarding missing data in clinical trials with longitudinal outcomes. EudraCT number 2007-006227-12 . Registration date 18 Mar 2008.

  10. Variable sleep schedules and outcomes in children with psychopathological problems: preliminary observations

    Directory of Open Access Journals (Sweden)

    Spruyt K

    2012-02-01

    Full Text Available Karen Spruyt1, Danielle L Raubuck2, Katie Grogan2, David Gozal1, Mark A Stein21Department of Pediatrics and Comer Children’s Hospital, Pritzker School of Medicine, University of Chicago, Chicago, IL; 2Institute for Juvenile Research, Hyperactivity and Learning Problems Clinic, University of Illinois at Chicago, Chicago, ILBackground: Night-to-night variability in sleep of children with attention deficit hyperactivity disorder (ADHD may be a mediator of behavioral phenotype. We examined the potential association between alertness, sleep, and eating behaviors in children with ADHD and comorbid problems.Methods: Sleep was monitored by actigraphy for 7 days. Questionnaires were used to assess sleep complaints, habits and food patterns by parental report, and sleep complaints and sleepiness by child report.Results: The group comprised 18 children, including 15 boys, aged 9.4 ± 1.7 years, 88.9% Caucasian, who took one or multiple medications. Children slept on average for 6 hours and 58 minutes with a variability of 1 hour 3 minutes relative to the mean, and their sleepiness scores were highly variable from day to day. Most children had a normal body mass index (BMI. Sleepiness and BMI were associated with sleep schedules and food patterns, such that they accounted for 76% of variance, predominantly by the association of BMI with mean wake after sleep onset and by bedtime sleepiness, with wake after sleep onset variability. Similarly, 97% of variance was shared with eating behaviors, such as desserts and snacks, and fast food meals were associated with morning sleepiness.Conclusion: Disrupted sleep and sleepiness appears to favor unhealthy food patterns and may place children with ADHD at increased risk for obesity.Keywords: sleep, child, attention deficit hyperactivity disorder, actigraphy

  11. The television, school, and family smoking prevention and cessation project. VIII. Student outcomes and mediating variables.

    Science.gov (United States)

    Flay, B R; Miller, T Q; Hedeker, D; Siddiqui, O; Britton, C F; Brannon, B R; Johnson, C A; Hansen, W B; Sussman, S; Dent, C

    1995-01-01

    This paper presents the student outcomes of a large-scale, social-influences-based, school and media-based tobacco use prevention and cessation project in Southern California. The study provided an experimental comparison of classroom delivery with television delivery and the combination of the two in a 2 x 2 plus 1 design. Schools were randomly assigned to conditions. Control groups included "treatment as usual" and an "attention control" with the same outcome expectancies as the treatment conditions. Students were surveyed twice in grade 7 and once in each of grades 8 and 9. The interventions occurred during grade 7. We observed significant effects on mediating variables such as knowledge and prevalence estimates, and coping effort. The knowledge and prevalence estimates effects decayed partially but remained significant up to a 2-year follow-up. The coping effort effect did not persist at follow-ups. There were significant main effects of both classroom training and TV programming on knowledge and prevalence estimates and significant interactions of classroom and TV programming on knowledge (negative), disapproval of parental smoking, and coping effort. There were no consistent program effects on refusal/self-efficacy, smoking intentions, or behavior. Previous reports demonstrated successful development and pilot testing of program components and measures and high acceptance of the program by students and parents. The lack of behavioral effects may have been the result of imperfect program implementation or low base rates of intentions and behavior.

  12. Metacognition as a Mediating Variable Between Neurocognition and Functional Outcome in First Episode Psychosis.

    Science.gov (United States)

    Davies, Geoff; Fowler, David; Greenwood, Kathryn

    2017-07-01

    Neurocognitive and functional outcome deficits have long been acknowledged in schizophrenia and neurocognition has been found to account for functional disability to a greater extent than psychopathology. Much of the variance in functional outcome however still remains unexplained and metacognition may mediate the relationship between neurocognition, functional capacity, and self-reported social and occupational function. Eighty first episode psychosis participants were recruited and completed measures of neurocognition (memory, executive function, and intelligence quotient), metacognition (Beck Cognitive Insight Scale, Metacognitive Awareness Interview), psychopathology (PANSS), and both functional capacity (UPSA) and real-life social and occupational function (The Time Use Survey). Path analyses investigated the relationships between variables through structural equation modeling. A series of path models demonstrated that metacognition partially mediates the relationship between neurocognition and functional capacity, and fully mediates the relationship between functional capacity and social and occupational function. The present study findings identify that metacognition may be critical to translating cognitive and functional skills into real-world contexts, and this relationship is found at early stages of illness. Understanding how individuals translate cognitive and functional skills into the real-world (the competence-performance gap) may offer valuable guidance to intervention programs. This finding is important to models of recovery as it suggests that intervention programs that focus on enhancing metacognition abilities may have a greater impact than traditional rehabilitation programs focusing on cognitive abilities, on social and occupational outcomes. © The Author 2016. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com

  13. Parental Decisional Regret after Primary Distal Hypospadias Repair: Family and Surgery Variables, and Repair Outcomes.

    Science.gov (United States)

    Ghidini, Filippo; Sekulovic, Sasa; Castagnetti, Marco

    2016-03-01

    Decisional regret is defined as distress after making a health care choice and can be an issue for parents electing distal hypospadias repair for their sons. We assessed the influence on decisional regret of variables related to the family, surgery and outcomes. Charts for 372 patients undergoing primary distal hypospadias repair between 2005 and 2012 were reviewed, and validated questionnaires, including the Decisional Regret Scale, Pediatric Penile Perception Score and Dysfunctional Voiding and Incontinence Scoring System, were administered to parents. Data were available for 172 of 372 families (response rate 46.2%). Of 323 parents 128 (39.6%) presented with moderately strong decisional regret, with good agreement within couples. Predictors of decisional regret included intermediate parental educational level (OR 3.19, 95% CI 1.52-6.69), patient not being the first born (OR 2.01, 95% CI 1.07-3.78), family history of hypospadias (OR 4.42, 95% CI 1.96-9.97), initial desire to avoid surgery (OR 2.07, 95% CI 1.04-4.12), younger age at followup (OR 0.81, 95% CI 0.72-0.91), presence of lower urinary tract symptoms (OR 4.92, 95% CI 1.53-15.81) and lower Pediatric Penile Perception Score (OR 0.86, 95% CI 0.75-0.99). Decisional regret was unrelated to parental desire to avoid circumcision, surgical variables, development of complications and duration of followup. Decisional regret is a problem in a significant proportion of parents electing distal hypospadias repair for their sons. In our experience family variables seemed to be predictors of decisional regret, while surgical variables did not. Predictors of decisional regret included worse parental perception of penile appearance and the presence of lower urinary tract symptoms. However, the latter could be unrelated to surgery. Irrespective of the duration of followup, decisional regret seems decreased in parents of older patients. Copyright © 2016 American Urological Association Education and Research, Inc

  14. Sleep quality, the neglected outcome variable in clinical studies focusing on locomotor system; a construct validation study

    Directory of Open Access Journals (Sweden)

    Röder Christoph

    2010-09-01

    Full Text Available Abstract Background In addition to general health and pain, sleep is highly relevant to judging the well-being of an individual. Of these three important outcome variables, however, sleep is neglected in most outcome studies. Sleep is a very important resource for recovery from daily stresses and strains, and any alteration of sleep will likely affect mental and physical health, especially during disease. Sleep assessment therefore should be standard in all population-based or clinical studies focusing on the locomotor system. Yet current sleep assessment tools are either too long or too specific for general use. Methods Based on a literature review and subsequent patient-based rating of items, an expert panel designed a four-item questionnaire about sleep. Construct validation of the questionnaire in a random sample of the German-speaking Swiss population was performed in 2003. Reliability, correlation, and tests for internal consistency and validity were analyzed. Results Overall, 16,634 (70% out of 23,763 eligible individuals participated in the study. Test-retest reliability coefficients ranged from 0.72 to 0.87, and a Cronbach's alpha of 0.83 indicates good internal consistency. Results show a moderate to good correlation between sleep disturbances and health perception, and between sleep disturbances and overall pain. Conclusions The Sleep Standard Evaluation Questionnaire (SEQ-Sleep is a reliable and short tool with confirmed construct validity for sleep assessment in population-based observational studies. It is easy to administer and therefore suitable for postal surveys of the general population. Criterion validity remains to be determined.

  15. Outcomes of splenectomy in patients with common variable immunodeficiency (CVID): a survey of 45 patients

    Science.gov (United States)

    Wong, G K; Goldacker, S; Winterhalter, C; Grimbacher, B; Chapel, H; Lucas, M; Alecsandru, D; McEwen, D; Quinti, I; Martini, H; Schmidt, R E; Ernst, D; Espanol, T; Vidaller, A; Carbone, J; Fernandez-Cruz, E; Lougaris, V; Plebani, A; Kutukculer, N; Gonzalez-Granado, L I; Contreras, R; Kiani-Alikhan, S; Ibrahim, M A A; Litzman, J; Jones, A; Gaspar, H B; Hammarstrom, L; Baumann, U; Warnatz, K; Huissoon, A P

    2013-01-01

    Splenectomy has been used in patients with common variable immunodeficiency disorders (CVID), mainly in the context of refractory autoimmune cytopenia and suspected lymphoma, but there are understandable concerns about the potential of compounding an existing immunodeficiency. With increasing use of rituximab as an alternative treatment for refractory autoimmune cytopenia, the role of splenectomy in CVID needs to be re-examined. This retrospective study provides the largest cohesive data set to date describing the outcome of splenectomy in 45 CVID patients in the past 40 years. Splenectomy proved to be an effective long-term treatment in 75% of CVID patients with autoimmune cytopenia, even in some cases when rituximab had failed. Splenectomy does not worsen mortality in CVID and adequate immunoglobulin replacement therapy appears to play a protective role in overwhelming post-splenectomy infections. Future trials comparing the effectiveness and safety of rituximab and splenectomy are needed to provide clearer guidance on the second-line management of autoimmune cytopenia in CVID. PMID:23480186

  16. The Effect of Latent Binary Variables on the Uncertainty of the Prediction of a Dichotomous Outcome Using Logistic Regression Based Propensity Score Matching.

    Science.gov (United States)

    Szekér, Szabolcs; Vathy-Fogarassy, Ágnes

    2018-01-01

    Logistic regression based propensity score matching is a widely used method in case-control studies to select the individuals of the control group. This method creates a suitable control group if all factors affecting the output variable are known. However, if relevant latent variables exist as well, which are not taken into account during the calculations, the quality of the control group is uncertain. In this paper, we present a statistics-based research in which we try to determine the relationship between the accuracy of the logistic regression model and the uncertainty of the dependent variable of the control group defined by propensity score matching. Our analyses show that there is a linear correlation between the fit of the logistic regression model and the uncertainty of the output variable. In certain cases, a latent binary explanatory variable can result in a relative error of up to 70% in the prediction of the outcome variable. The observed phenomenon calls the attention of analysts to an important point, which must be taken into account when deducting conclusions.

  17. Language and speech outcomes of children with hearing loss and additional disabilities: Identifying the variables that influence performance at 5 years of age

    Science.gov (United States)

    Cupples, Linda; Ching, Teresa Y.C.; Button, Laura; Leigh, Greg; Marnane, Vivienne; Whitfield, Jessica; Gunnourie, Miriam; Martin, Louise

    2016-01-01

    Objective This study examined language and speech outcomes in young children with hearing loss and additional disabilities. Design Receptive and expressive language skills and speech output accuracy were evaluated using direct assessment and caregiver report. Results were analysed first for the entire participant cohort, and then to compare results for children with hearing aids (HAs) versus cochlear implants (CIs). Study sample A population-based cohort of 146 5-year-old children with hearing loss and additional disabilities took part. Results Across all participants, multiple regressions showed that better language outcomes were associated with milder hearing loss, use of oral communication, higher levels of cognitive ability and maternal education, and earlier device fitting. Speech output accuracy was associated with use of oral communication only. Average outcomes were similar for children with HAs versus CIs, but their associations with demographic variables differed. For HA users, results resembled those for the whole cohort. For CI users, only use of oral communication and higher cognitive ability levels were significantly associated with better language outcomes. Conclusions The results underscore the importance of early device fitting for children with additional disabilities. Strong conclusions cannot be drawn for CI users given the small number of participants with complete data. PMID:27630013

  18. Blood pressure variability in relation to outcome in the International Database of Ambulatory blood pressure in relation to Cardiovascular Outcome

    DEFF Research Database (Denmark)

    Stolarz-Skrzypek, Katarzyna; Thijs, Lutgarde; Richart, Tom

    2010-01-01

    Ambulatory blood pressure (BP) monitoring provides information not only on the BP level but also on the diurnal changes in BP. In the present review, we summarized the main findings of the International Database on Ambulatory BP in relation to Cardiovascular Outcome (IDACO) with regard to risk...

  19. Assessing the variability of outcome for patients treated with localized prostate irradiation using different definitions of biochemical control

    International Nuclear Information System (INIS)

    Horwitz, Eric; Ziaja, Ellen; Vicini, Frank; Dmuchowski, Carl; Gonzalez, Jose; Stromberg, Jannifer; Brabbins, Donald; Hollander, Jay; Chen, Peter; Martinez, Alvaro

    1995-01-01

    Purpose: Biochemical control is rapidly becoming the standard to assess treatment outcome of clinically localized prostate cancer. However, no standardized definition of biochemical control has been established. We reviewed our experience treating patients with localized prostate cancer and applied 3 different commonly used definitions to estimate the variability in rates of biochemical control. Materials and Methods: Between (1(87)) and (12(91)), 480 patients with clinically localized prostate cancer received uniform treatment with external beam irradiation (RT) using localized prostate fields at William Beaumont Hospital. The median dose to the prostate was 66.6 Gy (range 58 to 70.4 Gy) through a 4 field technique. A total of 14 patients received pelvic nodal RT (median dose 45 Gy). Four hundred seventy patients had post-treatment (posttx) PSA values and 414 patients had pre-treatment (pretx) PSA values. Three different definitions of biochemical control were used: 1) Biochemical control was defined as posttx PSA nadir < 1 ng/ml within 1 year. After achieving nadir, if there were 2 consecutive increases, the patient was scored a failure at the time of the first increase; 2) Biochemical control was defined as posttx PSA nadir < 1.5 ng/ml within 1 year. After achieving nadir, if there were 2 consecutive increases, the patient was scored a failure at the time of the first increase; 3) Posttx PSA nadir < 4 ng/ml without a time limit. Once the nadir was achieved, and it did not rise above normal, the patient was considered controlled. Clinical local control was defined as no palpable prostate nodularity beyond 18 months, no new prostate nodularity, or a negative biopsy. If hormonal therapy was started, the patient was censored for biochemical failure at that time. Results: Median follow-up is 48 months (range 3 to 112 months). Pre-treatment PSA values were correlated with biochemical response using the 3 definitions of biochemical control as well as clinical local

  20. Effect of an office worksite-based yoga program on heart rate variability: outcomes of a randomized controlled trial

    Science.gov (United States)

    2013-01-01

    Background Chronic work-related stress is an independent risk factor for cardiometabolic diseases and associated mortality, particularly when compounded by a sedentary work environment. The purpose of this study was to determine if an office worksite-based hatha yoga program could improve physiological stress, evaluated via heart rate variability (HRV), and associated health-related outcomes in a cohort of office workers. Methods Thirty-seven adults employed in university-based office positions were randomized upon the completion of baseline testing to an experimental or control group. The experimental group completed a 10-week yoga program prescribed three sessions per week during lunch hour (50 min per session). An experienced instructor led the sessions, which emphasized asanas (postures) and vinyasa (exercises). The primary outcome was the high frequency (HF) power component of HRV. Secondary outcomes included additional HRV parameters, musculoskeletal fitness (i.e. push-up, side-bridge, and sit & reach tests) and psychological indices (i.e. state and trait anxiety, quality of life and job satisfaction). Results All measures of HRV failed to change in the experimental group versus the control group, except that the experimental group significantly increased LF:HF (p = 0.04) and reduced pNN50 (p = 0.04) versus control, contrary to our hypotheses. Flexibility, evaluated via sit & reach test increased in the experimental group versus the control group (p yoga sessions (n = 11) to control (n = 19) yielded the same findings, except that the high adherers also reduced state anxiety (p = 0.02) and RMSSD (p = 0.05), and tended to improve the push-up test (p = 0.07) versus control. Conclusions A 10-week hatha yoga intervention delivered at the office worksite during lunch hour did not improve HF power or other HRV parameters. However, improvements in flexibility, state anxiety and musculoskeletal fitness were noted with high adherence

  1. Soft Tissue Sarcoma: A Prognostic Variables and Treatment Outcomes after Chemo - Radiotherapy and Conservative Surgery

    International Nuclear Information System (INIS)

    Abaza, A.; El-Shanshoury, H.

    2015-01-01

    Soft tissue sarcomas (STS) constitute a group of rare and heterogeneous cancers, that diverse a wide spectrum of histology and varied clinical behavior. The aim was to study, retrospectively the clinico-epidemiologic manifestation, response to therapy and prognostic factors of retroperitoneal (RPS), extremity and other STS patients treated with conservative surgery plus chemo - radiotherapy (CRT) attending the Pediatric Oncology Clinic, National Cancer Institute (NCI), Cairo University during 6 years period (inclusive). Files of 66 STS patients were revised for history, staging, investigations, treatment modalities and outcome of therapy. Their ages ranged from 6 months to 21 years. The male to female ratio was 1.87:1. Most of the patients belong to stage 3 and 1. Radiotherapy (RTH) and surgery remains the backbone of the multi - modality treatment plan. Complete remission (CR) was obtained in 80.3% of STS patients. Meanwhile, 6% of cases had disease progression and 6% died. The 2 - years overall survival rate (OS) and Disease - free survivals (DFS) we re 74.2% and 57.6% respectively. However, 20.8% of patients develop relapse>2 years after the end of treatment. Age at diagnosis, stage of the disease, tumor mass, pathological subtype and the RTH used were statistically significant prognostic variables affecting survival. Finally, the use of RTH in the treatment of STS gives positive impact on the survival of patients. Recommendation regarding further studies would be required to identify methods of increasing the radiation dose selectively. Also, using the newly developed radiation technologies to make dose escalation and sparing normal tissue

  2. Neutropenia in Patients with Common Variable Immunodeficiency: a Rare Event Associated with Severe Outcome.

    Science.gov (United States)

    Guffroy, Aurélien; Mourot-Cottet, Rachel; Gérard, Laurence; Gies, Vincent; Lagresle, Chantal; Pouliet, Aurore; Nitschké, Patrick; Hanein, Sylvain; Bienvenu, Boris; Chanet, Valérie; Donadieu, Jean; Gardembas, Martine; Karmochkine, Marina; Nove-Josserand, Raphaele; Martin, Thierry; Poindron, Vincent; Soulas-Sprauel, Pauline; Rieux-Laucat, Fréderic; Fieschi, Claire; Oksenhendler, Eric; André-Schmutz, Isabelle; Korganow, Anne-Sophie

    2017-10-01

    Common variable immunodeficiency (CVID) is characterized by infections and hypogammaglobulinemia. Neutropenia is rare during CVID. The French DEFI study enrolled patients with primary hypogammaglobulinemia. Patients with CVID and neutropenia were retrospectively analyzed. Among 473 patients with CVID, 16 patients displayed neutropenia (lowest count [0-1400]*10 6 /L). Sex ratio (M/F) was 10/6. Five patients died during the follow-up (11 years) with an increased percentage of deaths compared to the whole DEFI group (31.3 vs 3.4%, P < 0.05). Neutropenia was diagnosed for 10 patients before 22 years old. The most frequent symptoms, except infections, were autoimmune cytopenia, i.e., thrombopenia or anemia (11/16). Ten patients were affected with lymphoproliferative diseases. Two patients were in the infection only group and the others belonged to one or several other CVID groups. The median level of IgG was 2.6 g/L [0.35-4.4]. Most patients presented increased numbers of CD21 low CD38 low B cell, as already described in CVID autoimmune cytopenia group. Neutropenia was considered autoimmune in 11 cases. NGS for 52 genes of interest was performed on 8 patients. No deleterious mutations were found in LRBA, CTLA4, and PIK3. More than one potentially damaging variant in other genes associated with CVID were present in most patients arguing for a multigene process. Neutropenia is generally associated with another cytopenia and presumably of autoimmune origin during CVID. In the DEFI study, neutropenia is coupled with more severe clinical outcomes. It appears as an "alarm bell" considering patients' presentation and the high rate of deaths. Whole exome sequencing diagnosis should improve management.

  3. Regulating task-monitoring systems in response to variable reward contingencies and outcomes in cocaine addicts.

    Science.gov (United States)

    Morie, Kristen P; De Sanctis, Pierfilippo; Garavan, Hugh; Foxe, John J

    2016-03-01

    We investigated anticipatory and consummatory reward processing in cocaine addiction. In addition, we set out to assess whether task-monitoring systems were appropriately recalibrated in light of variable reward schedules. We also examined neural measures of task-monitoring and reward processing as a function of hedonic tone, since anhedonia is a vulnerability marker for addiction that is obviously germane in the context of reward processing. High-density event-related potentials were recorded while participants performed a speeded response task that systematically varied anticipated probabilities of reward receipt. The paradigm dissociated feedback regarding task success (or failure) from feedback regarding the value of reward (or loss), so that task-monitoring and reward processing could be examined in partial isolation. Twenty-three active cocaine abusers and 23 age-matched healthy controls participated. Cocaine abusers showed amplified anticipatory responses to reward predictive cues, but crucially, these responses were not as strongly modulated by reward probability as in controls. Cocaine users also showed blunted responses to feedback about task success or failure and did not use this information to update predictions about reward. In turn, they showed clearly blunted responses to reward feedback. In controls and users, measures of anhedonia were associated with reward motivation. In cocaine users, anhedonia was also associated with diminished monitoring and reward feedback responses. Findings imply that reward anticipation and monitoring deficiencies in addiction are associated with increased responsiveness to reward cues but impaired ability to predict reward in light of task contingencies, compounded by deficits in responding to actual reward outcomes.

  4. Inferior outcomes for black children with high risk acute lymphoblastic leukemia and the impact of socioeconomic variables.

    Science.gov (United States)

    Walsh, Alexandra; Chewning, Joseph; Li, Xuelin; Dai, Chen; Whelan, Kimberly; Madan-Swain, Avi; Waterbor, John; Baskin, Monica L; Goldman, Frederick D

    2017-02-01

    While significant improvements have been made for children with acute lymphoblastic leukemia (ALL) in the United States over the past 20 years, black patients continue to have inferior outcomes. The full impact of socioeconomic variables on outcomes in this minority population is not entirely understood. Disease characteristics, demographic, and socioeconomic status (SES) variables were collected on black (n = 44) and white (n = 178) patients diagnosed at the University of Alabama at Birmingham. Cox proportional hazard regression was used to evaluate the influence of SES and insurance status on survival. As a cohort, 5-year overall survival (OS) was 87% (82-91%), with a median follow-up of 99 months. In univariable analysis, black race was not significantly associated with a higher risk of death or relapse and death. White and black patients with standard-risk leukemia had excellent outcomes, with 97% (91-99%) and 96% (75-99%) 5-year OS, respectively. In contrast, for high-risk disease, white patients had a statistically significant improved 5-year OS rates compared with black patients (79% [68-87%] vs. 52% [28-72%]). Black children were more likely to have public insurance, and, in multivariable analysis, this was associated with a trend toward an improved outcome. Black patients also had poorer census tract-level SES parameters, but these variables were not associated with survival. Our study demonstrates significantly inferior outcomes for black children with high-risk leukemia. These outcome disparities were not related to SES variables, including poverty or private insurance coverage, suggesting the involvement of other factors and highlighting the need for a prospective investigative analysis. © 2016 Wiley Periodicals, Inc.

  5. Cerebrovascular accidents after percutaneous coronary interventions from 2002 to 2014: Incidence, outcomes, and associated variables.

    Science.gov (United States)

    Didier, Romain; Gaglia, Michael A; Koifman, Edward; Kiramijyan, Sarkis; Negi, Smita I; Omar, Al Fazir; Gai, Jiaxing; Torguson, Rebecca; Pichard, Augusto D; Waksman, Ron

    2016-02-01

    Cerebrovascular accident (CVA) and transient ischemic attack (TIA) related to percutaneous coronary intervention (PCI) are relatively rare complications, but they are associated with high morbidity and mortality. Given the evolution of both CVA risk and PCI techniques over time, this study was conducted to evaluate trends in CVA and TIA associated with PCI and to identify variables associated with neurologic events. Consecutive patients undergoing PCI at the Washington Hospital Center between January 2002 and June 2015 were included. Prespecified data were prospectively collected, including baseline and procedural characteristics, in-hospital outcomes, and 1-year mortality. The subjects who had a CVA or TIA during or immediately after PCI were compared with those without procedure-associated CVA or TIA. Overall, 25,626 patients were included in the study. The mean age was 65.0 ± 12.4 years, 16,949 (65.2%) were male, and 7,436 (28.6%) were African American. From 2002 to 2015, 110 neurologic events post-PCI were diagnosed (0.43%); this included 86 CVAs (0.34%) and 24 TIAs (0.09%). The annual rate of postprocedural neurologic events was 0.42% ± 0.12%. There were significant changes in baseline risk factors over time, with increasing age, incidence of insulin-dependent diabetes, and chronic kidney disease. Patients with neurologic events were more often African American (43.6% vs 28.6%, P < .001) with prior history of CVA (24.5% vs 7.8%, P < .001), chronic renal insufficiency (26.6% vs 15.2%, P < .001), and insulin-dependent diabetes (19.1% vs 12.4%, P = .03). Acute myocardial infarction (56% vs 30.4%, P < .001) and cardiogenic shock (20.2% vs 3%, P < .001) were also more common among patients with neurologic events post-PCI. After multivariable adjustment, use of an intraaortic balloon pump was strongly associated with neurologic events (odds ratio [OR] 4.9, 95% CI 2.7-8.8, P < .001), as was prior CVA (OR 2.4, 95% CI 1.4-4.4, P = .002) and African American race (OR

  6. A Correlational Study on Critical Thinking in Nursing as an Outcome Variable for Success

    Science.gov (United States)

    Porter, Rebecca Jean

    2018-01-01

    Critical thinking is a required curricular outcome for nursing education; however, the literature shows a gap related to valid and reliable tools to measure critical thinking specific to nursing and relating that critical thinking measurement to meaningful outcomes. This study examined critical thinking scores, as measured by Assessment…

  7. Does psychotherapy work with school-aged youth? A meta-analytic examination of moderator variables that influence therapeutic outcomes.

    Science.gov (United States)

    Fedewa, Alicia L; Ahn, Soyeon; Reese, Robert J; Suarez, Marietta M; Macquoid, Ahjane; Davis, Matthew C; Prout, H Thompson

    2016-06-01

    The present study is a quantitative synthesis of the available literature to investigate the efficacy of psychotherapy for children's mental health outcomes. In particular, this study focuses on potential moderating variables-study design, treatment, client, and therapist characteristics-that may influence therapeutic outcomes for youth but have not been thoroughly accounted for in prior meta-analytic studies. An electronic search of relevant databases resulted in 190 unpublished and published studies that met criteria for inclusion in the analysis. Effect sizes differed by study design. Pre-post-test designs resulted in absolute magnitudes of treatment effects ranging from |-0.02| to |-0.76| while treatment versus control group comparison designs resulted in absolute magnitudes of treatment effects ranging from |-0.14| to |-2.39|. Changes in youth outcomes larger than 20% were found, irrespective of study design, for outcomes focused on psychosomatization (29% reduction), school attendance (25% increase), and stress (48% reduction). The magnitude of changes after psychotherapy ranged from 6% (externalizing problems) to 48% (stress). Several moderator variables significantly influenced psychotherapy treatment effect sizes, including frequency and length of treatment as well as treatment format. However, results did not support the superiority of a single type of intervention for most outcomes. Implications for therapy with school-aged youth and future research are discussed. Copyright © 2016 Society for the Study of School Psychology. Published by Elsevier Ltd. All rights reserved.

  8. LB01.06: VISIT-TO-VISIT BLOOD PRESSURE VARIABILITY AND CARDIOVASCULAR OUTCOMES IN FELODIPINE EVENT REDUCTION STUDY.

    Science.gov (United States)

    Zhang, Y; Zhang, X; Liu, L; Zanchetti, A

    2015-06-01

    Many antihypertensive outcome trials have shown that visit-to-visit blood pressure variability is correlated closely with clinical outcomes in hypertensive patients. The objective of the study was to investigate the relationship between visit-to-visit blood pressure variability (BPV) and the major cardiovascular outcomes in the Chinese hypertensive patients. Felodipine Event Reduction (FEVER) study was a double-blind, randomized trial on 9711 Chinese hypertensive patients, in whom cardiovascular outcomes were significantly reduced by more intense therapy achieving a mean of 138 mmHg SBP compared with less-intense therapy achieving a mean of 142 mmHg. Visit-to-visit BPV during the follow-up period [defined as standard deviation (SD), coefficient of variation (CV), and average real variability(ARV)] was derived from casual cuff BP measures after six months follow-up until the end of the study. Hazard ratios (HRs), for the incidence of CVD associated with SD, CV, and ARV of SBP and DBP were calculated using Cox proportional hazard models. Overall predictive power [area under receiver operating characteristic (AUC ROC) curve] of the level of blood pressure, blood pressure variability and other baseline characteristics was calculated. In FEVER study, visit-to-visit variability in SBP were significant predictors of subsequent stroke [eg, hazard ratios [HR] for ARV, SD and CV was 1.071 (95% CI: 1.025-1.118), 1.373 (95% CI: 1.159-1.626) and 0.572 (95% CI: 0.451-0,726)]. Visit-to-visit variability in DBP were also showed similar trend [eg, HR for ARV, SD and CV was 1.066 (95% CI: 0.992-1.145), 1.931 (95% CI: 1.435-2.598) and 0.558 (95% CI: 0.438-0,710)]. However, using the analysis of AUC ROC analysis, the risk importance sequence of the stroke events in this cohort was level of SBP, age, level of DBP ARV, SD, sex, CV and treatment. Visit-to-visit blood pressure variability has some effects on the cardiovascular outcomes in the Chinese hypertensive patents in the cohort in

  9. Patient-Therapist Identification in Relation to Both Patient and Therapist Variables and Therapy Outcome

    Science.gov (United States)

    Melnick, Barry

    1972-01-01

    The results of the study confirmed the hypothesis that greater patient identification with the therapist, as defined by increased similarity between the patient's and therapist's semantic differential ratings, moderately correlated with more successful therapy outcome. (Author)

  10. Reciprocal Interaction of 24-Hour Blood Pressure Variability and Systolic Blood Pressure on Outcome in Stroke Thrombolysis.

    Science.gov (United States)

    Kellert, Lars; Hametner, Christian; Ahmed, Niaz; Rauch, Geraldine; MacLeod, Mary J; Perini, Francesco; Lees, Kennedy R; Ringleb, Peter A

    2017-07-01

    Significance and management of blood pressure (BP) changes in acute stroke care are unclear. Here, we aimed to investigate the impact of 24-hour BP variability (BPV) on outcome in patients with acute ischemic stroke treated with intravenous thrombolysis. From the Safe Implementation of Treatment in Stroke International Stroke Thrombolysis registry, 28 976 patients with documented pre-treatment systolic BP at 2 and 24 hours were analyzed. The primary measure of BP variability was successive variability. Data were preprocessed using coarsened exact matching. We assessed early neurological improvement, symptomatic intracerebral hemorrhage (SICH), and long-term functional outcome (modified Rankin Scale [mRS] at 90 days) by binary and ordinal regression analyses. Attempts to explain successive variation for analysis of BPV with patients characteristics at admission found systolic BP (5.5% variance) to be most influential, yet 92% of BPV variance remained unexplained. Independently from systolic BP, successive variation for analysis of BPV was associated with poor functional outcome mRS score of 0 to 2 (odds ratio [OR], 0.94; 95% confidence interval [CI], 0.90-0.98), disadvantage across the shift of mRS (OR, 1.04; 95% CI, 1.01-1.08), mortality (OR, 1.10; 95% CI, 1.01-1.08), SICH SITS (OR, 1.14; 95% CI, 1.06-1.23), and SICH ECASS (OR, 1.24; 95% CI, 1.10-1.40; ECASS [European Cooperative Acute Stroke Study 2]). Analyzing successive variation for analysis of BPV as a function of pre-treatment, systolic BP significantly improved the prediction of functional outcome (mRS score of 0-1, mRS score of 0-2, neurological improvement, mRS-shift: all P interaction accounting for pre-treatment BP and the acute BP course (ie, BPV) to achieve best possible outcome for the patient. © 2017 American Heart Association, Inc.

  11. Dynamics of melanoma tumor therapy with vesicular stomatitis virus: explaining the variability in outcomes using mathematical modeling.

    Science.gov (United States)

    Rommelfanger, D M; Offord, C P; Dev, J; Bajzer, Z; Vile, R G; Dingli, D

    2012-05-01

    Tumor selective, replication competent viruses are being tested for cancer gene therapy. This approach introduces a new therapeutic paradigm due to potential replication of the therapeutic agent and induction of a tumor-specific immune response. However, the experimental outcomes are quite variable, even when studies utilize highly inbred strains of mice and the same cell line and virus. Recognizing that virotherapy is an exercise in population dynamics, we utilize mathematical modeling to understand the variable outcomes observed when B16ova malignant melanoma tumors are treated with vesicular stomatitis virus in syngeneic, fully immunocompetent mice. We show how variability in the initial tumor size and the actual amount of virus delivered to the tumor have critical roles on the outcome of therapy. Virotherapy works best when tumors are small, and a robust innate immune response can lead to superior tumor control. Strategies that reduce tumor burden without suppressing the immune response and methods that maximize the amount of virus delivered to the tumor should optimize tumor control in this model system.

  12. Case-Mix Variables and Predictors for Outcomes of Laparoscopic Hysterectomy: A Systematic Review.

    Science.gov (United States)

    Driessen, Sara R C; Sandberg, Evelien M; la Chapelle, Claire F; Twijnstra, Andries R H; Rhemrev, Johann P T; Jansen, Frank Willem

    2016-01-01

    The assessment of surgical quality is complex, and an adequate case-mix correction is missing in currently applied quality indicators. The purpose of this study is to give an overview of all studies mentioning statistically significant associations between patient characteristics and surgical outcomes for laparoscopic hysterectomy (LH). Additionally, we identified a set of potential case-mix characteristics for LH. This systematic review was conducted according to the Meta-Analysis of Observational Studies in Epidemiology guidelines. We searched PubMed and EMBASE from January 1, 2000 to August 1, 2015. All articles describing statistically significant associations between patient characteristics and adverse outcomes of LH for benign indications were included. Primary outcomes were blood loss, operative time, conversion, and complications. The methodologic quality of the included studies was assessed using the Newcastle-Ottawa Quality Assessment Scale. The included articles were summed per predictor and surgical outcome. Three sets of case-mix characteristics were determined, stratified by different levels of evidence. Eighty-five of 1549 identified studies were considered eligible. Uterine weight and body mass index (BMI) were the most mentioned predictors (described, respectively, 83 and 45 times) in high quality studies. For longer operative time and higher blood loss, uterine weight ≥ 250 to 300 g and ≥500 g and BMI ≥ 30 kg/m(2) dominated as predictors. Previous operations, adhesions, and higher age were also considered as predictors for longer operative time. For complications and conversions, the patient characteristics varied widely, and uterine weight, BMI, previous operations, adhesions, and age predominated. Studies of high methodologic quality indicated uterine weight and BMI as relevant case-mix characteristics for all surgical outcomes. For future development of quality indicators of LH and to compare surgical outcomes adequately, a case

  13. Effects of surgeon variability on oncologic and functional outcomes in a population-based setting.

    Science.gov (United States)

    Carlsson, Sigrid; Berglund, Anders; Sjoberg, Daniel; Khatami, Ali; Stranne, Johan; Bergdahl, Svante; Lodding, Pär; Aus, Gunnar; Vickers, Andrew; Hugosson, Jonas

    2014-03-06

    Oncologic and functional outcomes after radical prostatectomy (RP) can vary between surgeons to a greater extent than is expected by chance. We sought to examine the effects of surgeon variation on functional and oncologic outcomes for patients undergoing RP for prostate cancer in a European center. The study comprised 1,280 men who underwent open retropubic RP performed by one of nine surgeons at an academic institution in Sweden between 2001 and 2008. Potency and continence outcomes were measured preoperatively and 18 months postoperatively by patient-administered questionnaires. Biochemical recurrence (BCR) was defined as a prostate-specific antigen (PSA) value > 0.2 ng/mL with at least one confirmatory rise. Multivariable random effect models were used to evaluate heterogeneity between surgeons, adjusting for case mix (age, PSA, pathological stage and grade), year of surgery, and surgical experience. Of 679 men potent at baseline, 647 provided data at 18 months with 122 (19%) reporting potency. We found no evidence for heterogeneity of potency outcomes between surgeons (P = 1). The continence rate for patients at 18 months was 85%, with 836 of the 979 patients who provided data reporting continence. There was statistically significant heterogeneity between surgeons (P = 0.001). We did not find evidence of an association between surgeons' adjusted probabilities of functional recovery and 5-year probability of freedom from BCR. Our data support previous studies regarding a large heterogeneity among surgeons in continence outcomes for patients undergoing RP. This indicates that some patients are receiving sub-optimal care. Quality assurance measures involving performance feedback, should be considered. When surgeons are aware of their outcomes, they can improve them to provide better care to patients.

  14. Age at disease onset and peak ammonium level rather than interventional variables predict the neurological outcome in urea cycle disorders.

    Science.gov (United States)

    Posset, Roland; Garcia-Cazorla, Angeles; Valayannopoulos, Vassili; Teles, Elisa Leão; Dionisi-Vici, Carlo; Brassier, Anaïs; Burlina, Alberto B; Burgard, Peter; Cortès-Saladelafont, Elisenda; Dobbelaere, Dries; Couce, Maria L; Sykut-Cegielska, Jolanta; Häberle, Johannes; Lund, Allan M; Chakrapani, Anupam; Schiff, Manuel; Walter, John H; Zeman, Jiri; Vara, Roshni; Kölker, Stefan

    2016-09-01

    Patients with urea cycle disorders (UCDs) have an increased risk of neurological disease manifestation. Determining the effect of diagnostic and therapeutic interventions on the neurological outcome. Evaluation of baseline, regular follow-up and emergency visits of 456 UCD patients prospectively followed between 2011 and 2015 by the E-IMD patient registry. About two-thirds of UCD patients remained asymptomatic until age 12 days [i.e. the median age at diagnosis of patients identified by newborn screening (NBS)] suggesting a potential benefit of NBS. In fact, NBS lowered the age at diagnosis in patients with late onset of symptoms (>28 days), and a trend towards improved long-term neurological outcome was found for patients with argininosuccinate synthetase and lyase deficiency as well as argininemia identified by NBS. Three to 17 different drug combinations were used for maintenance therapy, but superiority of any single drug or specific drug combination above other combinations was not demonstrated. Importantly, non-interventional variables of disease severity, such as age at disease onset and peak ammonium level of the initial hyperammonemic crisis (cut-off level: 500 μmol/L) best predicted the neurological outcome. Promising results of NBS for late onset UCD patients are reported and should be re-evaluated in a larger and more advanced age group. However, non-interventional variables affect the neurological outcome of UCD patients. Available evidence-based guideline recommendations are currently heterogeneously implemented into practice, leading to a high variability of drug combinations that hamper our understanding of optimised long-term and emergency treatment.

  15. Semiparametric methods for estimation of a nonlinear exposure‐outcome relationship using instrumental variables with application to Mendelian randomization

    Science.gov (United States)

    Staley, James R.

    2017-01-01

    ABSTRACT Mendelian randomization, the use of genetic variants as instrumental variables (IV), can test for and estimate the causal effect of an exposure on an outcome. Most IV methods assume that the function relating the exposure to the expected value of the outcome (the exposure‐outcome relationship) is linear. However, in practice, this assumption may not hold. Indeed, often the primary question of interest is to assess the shape of this relationship. We present two novel IV methods for investigating the shape of the exposure‐outcome relationship: a fractional polynomial method and a piecewise linear method. We divide the population into strata using the exposure distribution, and estimate a causal effect, referred to as a localized average causal effect (LACE), in each stratum of population. The fractional polynomial method performs metaregression on these LACE estimates. The piecewise linear method estimates a continuous piecewise linear function, the gradient of which is the LACE estimate in each stratum. Both methods were demonstrated in a simulation study to estimate the true exposure‐outcome relationship well, particularly when the relationship was a fractional polynomial (for the fractional polynomial method) or was piecewise linear (for the piecewise linear method). The methods were used to investigate the shape of relationship of body mass index with systolic blood pressure and diastolic blood pressure. PMID:28317167

  16. Heart rate variability measured early in patients with evolving acute coronary syndrome and 1-year outcomes of rehospitalization and mortality.

    Science.gov (United States)

    Harris, Patricia R E; Stein, Phyllis K; Fung, Gordon L; Drew, Barbara J

    2014-01-01

    This study sought to examine the prognostic value of heart rate variability (HRV) measurement initiated immediately after emergency department presentation for patients with acute coronary syndrome (ACS). Altered HRV has been associated with adverse outcomes in heart disease, but the value of HRV measured during the earliest phases of ACS related to risk of 1-year rehospitalization and death has not been established. Twenty-four-hour Holter recordings of 279 patients with ACS were initiated within 45 minutes of emergency department arrival; recordings with ≥18 hours of sinus rhythm were selected for HRV analysis (number [N] =193). Time domain, frequency domain, and nonlinear HRV were examined. Survival analysis was performed. During the 1-year follow-up, 94 patients were event-free, 82 were readmitted, and 17 died. HRV was altered in relation to outcomes. Predictors of rehospitalization included increased normalized high frequency power, decreased normalized low frequency power, and decreased low/high frequency ratio. Normalized high frequency >42 ms(2) predicted rehospitalization while controlling for clinical variables (hazard ratio [HR] =2.3; 95% confidence interval [CI] =1.4-3.8, P=0.001). Variables significantly associated with death included natural logs of total power and ultra low frequency power. A model with ultra low frequency power 0.3 ng/mL (HR =4.0; 95% CI =1.3-12.1; P=0.016) revealed that each contributed independently in predicting mortality. Nonlinear HRV variables were significant predictors of both outcomes. HRV measured close to the ACS onset may assist in risk stratification. HRV cut-points may provide additional, incremental prognostic information to established assessment guidelines, and may be worthy of additional study.

  17. Analysis of biopsy outcome after three-dimensional conformal radiation therapy of prostate cancer using dose-distribution variables and tumor control probability models

    International Nuclear Information System (INIS)

    Levegruen, Sabine; Jackson, Andrew; Zelefsky, Michael J.; Venkatraman, Ennapadam S.; Skwarchuk, Mark W.; Schlegel, Wolfgang; Fuks, Zvi; Leibel, Steven A.; Ling, C. Clifton

    2000-01-01

    standardized CTV definition, substantial target motion and small dose inhomogeneities, Dmean (or any variable that downplays the effect of cold spots) is a very good predictor of biopsy outcome. While our findings may indicate a general problem in the application of current TCP models to clinical data, these conclusions should not be extrapolated to other disease sites without careful analysis

  18. Influence of Flow Sequencing Attributed to Climate Change and Climate Variability on the Assessment of Water-dependent Ecosystem Outcomes

    Science.gov (United States)

    Wang, J.; Nathan, R.; Horne, A.

    2017-12-01

    Traditional approaches to characterize water-dependent ecosystem outcomes in response to flow have been based on time-averaged hydrological indicators, however there is increasing recognition for the need to characterize ecological processes that are highly dependent on the sequencing of flow conditions (i.e. floods and droughts). This study considers the representation of flow regimes when considering assessment of ecological outcomes, and in particular, the need to account for sequencing and variability of flow. We conducted two case studies - one in the largely unregulated Ovens River catchment and one in the highly regulated Murray River catchment (both located in south-eastern Australia) - to explore the importance of flow sequencing to the condition of a typical long-lived ecological asset in Australia, the River Red Gum forests. In the first, the Ovens River case study, the implications of representing climate change using different downscaling methods (annual scaling, monthly scaling, quantile mapping, and weather generator method) on the sequencing of flows and resulting ecological outcomes were considered. In the second, the Murray River catchment, sequencing within a historic drought period was considered by systematically making modest adjustments on an annual basis to the hydrological records. In both cases, the condition of River Red Gum forests was assessed using an ecological model that incorporates transitions between ecological conditions in response to sequences of required flow components. The results of both studies show the importance of considering how hydrological alterations are represented when assessing ecological outcomes. The Ovens case study showed that there is significant variation in the predicted ecological outcomes when different downscaling techniques are applied. Similarly, the analysis in the Murray case study showed that the drought as it historically occurred provided one of the best possible outcomes for River Red Gum

  19. Teachers' and Students' Work-Culture Variables Associated with Positive School Outcome.

    Science.gov (United States)

    Goldwater, Orna D.; Nutt, Roberta L.

    1999-01-01

    Investigates whether goodness of fit between teachers' and students' backgrounds is associated with subjective grading and objective achievement at school. One hundred one seventh graders and twenty of their teachers completed the Self-Report Family Inventory. Similarity between teachers' and students' work-culture variables was associated with…

  20. Variables predictive of outcome in patients with acute hypercapneic respiratory failure treated with noninvasive ventilation

    International Nuclear Information System (INIS)

    Salahuddin, N.; Irfan, M.; Khan, S.; Naeem, M.; Haque, A.S.

    2010-01-01

    To assess results with NIV in acute hypercapneic respiratory failure and to identify outcome predictors. This was a retrospective observational study on consecutive patients presenting with acute type II respiratory failure and meeting criteria for NIV use over a 5 year period. Patients presenting with haemodynamic instability, inability to protect their airway, malignant arrhythmias and recent oesophageal surgery were excluded. Univariate and Multivariate regression analysis was used to determine the impact on survival. A p value of 35 Meq/L (adjusted Odds ratio 0.9; 95% CI 0.83, 0.98, p < 0.015) identified those less at risk for intubation. NIV was found to be both safe and effective in the management of acute hypercapneic respiratory failure. Sepsis and serum HCO/sub 3/ at admission identified patients having poor outcomes (JPMA 60:13; 2010). (author)

  1. Alpha male replacements in nonhuman primates: Variability in processes, outcomes, and terminology.

    Science.gov (United States)

    Teichroeb, Julie A; Jack, Katharine M

    2017-07-01

    Alpha male replacements occur in all primates displaying a dominance hierarchy but the process can be extremely variable. Here, we review the primate literature to document differences in patterns of alpha male replacements, showing that group composition and dispersal patterns account for a large proportion of this variability. We also examine the consequences of alpha male replacements in terms of sexual selection theory, infanticide, and group compositions. Though alpha male replacements are often called takeovers in the literature, this term masks much of the variation that is present in these processes. We argue for more concise terminology and provide a list of terms that we suggest more accurately define these events. Finally, we introduce the papers in this special issue on alpha male replacements in the American Journal of Primatology and discuss areas where data are still lacking. © 2017 Wiley Periodicals, Inc.

  2. Longitudinal assessment of maternal parenting capacity variables and child adjustment outcomes in pediatric cancer.

    Science.gov (United States)

    Fedele, David A; Mullins, Larry L; Wolfe-Christensen, Cortney; Carpentier, Melissa Y

    2011-04-01

    This preliminary investigation aimed to longitudinally examine parenting capacity variables, namely parental overprotection, perceived child vulnerability, and parenting stress and their relation to child adjustment in mothers of children on treatment for cancer. As part of a larger study, biological mothers (N=22) completed measures of parental overprotection, perceived child vulnerability, parenting stress, and child adjustment at Time 1 and a follow-up time point. Analyses were conducted to determine whether (1) levels of parental overprotection, perceived child vulnerability, and parenting stress declined from Time 1 to follow-up and (2) if Time 1 parenting capacity variables were associated with child adjustment at follow-up. Results revealed that parental overprotection, perceived child vulnerability, and parenting stress declined from Time 1 to follow-up, and levels of parental overprotection, perceived child vulnerability, and parenting stress at Time 1 were significantly related to child adjustment at follow-up. Collectively, the preliminary findings of this study indicate that mothers of children with cancer evidence improved parenting capacity over time. Furthermore, it seems that Time 1 parenting capacity variables are significantly related to later child adjustment.

  3. Discrete factor approximations in simultaneous equation models: estimating the impact of a dummy endogenous variable on a continuous outcome.

    Science.gov (United States)

    Mroz, T A

    1999-10-01

    This paper contains a Monte Carlo evaluation of estimators used to control for endogeneity of dummy explanatory variables in continuous outcome regression models. When the true model has bivariate normal disturbances, estimators using discrete factor approximations compare favorably to efficient estimators in terms of precision and bias; these approximation estimators dominate all the other estimators examined when the disturbances are non-normal. The experiments also indicate that one should liberally add points of support to the discrete factor distribution. The paper concludes with an application of the discrete factor approximation to the estimation of the impact of marriage on wages.

  4. Meta-modeling of occupancy variables and analysis of their impact on energy outcomes of office buildings

    International Nuclear Information System (INIS)

    Wang, Qinpeng; Augenbroe, Godfried; Kim, Ji-Hyun; Gu, Li

    2016-01-01

    Highlights: • A meta-analysis framework for a stochastic characterization of occupancy variables. • Sensitivity ranking of occupancy variability against all other sources of uncertainty. • Sensitivity of occupant presence for building energy consumption is low. • Accurate mean knowledge is sufficient for predicting building energy consumption. • Prediction of peak demand behavior requires stochastic occupancy modeling. - Abstract: Occupants interact with buildings in various ways via their presence (passive effects) and control actions (active effects). Therefore, understanding the influence of occupants is essential if we are to evaluate the performance of a building. In this paper, we model the mean profiles and variability of occupancy variables (presence and actions) separately. We will use a multi-variate Gaussian distribution to generate mean profiles of occupancy variables, while the variability will be represented by a multi-dimensional time series model, within a framework for a meta-analysis that synthesizes occupancy data gathered from a pool of buildings. We then discuss variants of occupancy models with respect to various outcomes of interest such as HVAC energy consumption and peak demand behavior via a sensitivity analysis. Results show that our approach is able to generate stochastic occupancy profiles, requiring minimum additional input from the energy modeler other than standard diversity profiles. Along with the meta-analysis, we enable the generalization of previous research results and statistical inferences to choose occupancy variables for future buildings. The sensitivity analysis shows that for aggregated building energy consumption, occupant presence has a smaller impact compared to lighting and appliance usage. Specifically, being accumulatively 55% wrong with regard to presence, only translates to 2% error in aggregated cooling energy in July and 3.6% error in heating energy in January. Such a finding redirects focus to the

  5. Association between competing interests and authors' conclusions

    DEFF Research Database (Denmark)

    Kjaergard, Lise L; Als-Nielsen, Bodil

    2002-01-01

    To assess the association between competing interests and authors' conclusions in randomised clinical trials.......To assess the association between competing interests and authors' conclusions in randomised clinical trials....

  6. Hypothetical Outcome Plots Outperform Error Bars and Violin Plots for Inferences about Reliability of Variable Ordering.

    Science.gov (United States)

    Hullman, Jessica; Resnick, Paul; Adar, Eytan

    2015-01-01

    Many visual depictions of probability distributions, such as error bars, are difficult for users to accurately interpret. We present and study an alternative representation, Hypothetical Outcome Plots (HOPs), that animates a finite set of individual draws. In contrast to the statistical background required to interpret many static representations of distributions, HOPs require relatively little background knowledge to interpret. Instead, HOPs enables viewers to infer properties of the distribution using mental processes like counting and integration. We conducted an experiment comparing HOPs to error bars and violin plots. With HOPs, people made much more accurate judgments about plots of two and three quantities. Accuracy was similar with all three representations for most questions about distributions of a single quantity.

  7. Hypothetical Outcome Plots Outperform Error Bars and Violin Plots for Inferences about Reliability of Variable Ordering.

    Directory of Open Access Journals (Sweden)

    Jessica Hullman

    Full Text Available Many visual depictions of probability distributions, such as error bars, are difficult for users to accurately interpret. We present and study an alternative representation, Hypothetical Outcome Plots (HOPs, that animates a finite set of individual draws. In contrast to the statistical background required to interpret many static representations of distributions, HOPs require relatively little background knowledge to interpret. Instead, HOPs enables viewers to infer properties of the distribution using mental processes like counting and integration. We conducted an experiment comparing HOPs to error bars and violin plots. With HOPs, people made much more accurate judgments about plots of two and three quantities. Accuracy was similar with all three representations for most questions about distributions of a single quantity.

  8. Penalized regression procedures for variable selection in the potential outcomes framework.

    Science.gov (United States)

    Ghosh, Debashis; Zhu, Yeying; Coffman, Donna L

    2015-05-10

    A recent topic of much interest in causal inference is model selection. In this article, we describe a framework in which to consider penalized regression approaches to variable selection for causal effects. The framework leads to a simple 'impute, then select' class of procedures that is agnostic to the type of imputation algorithm as well as penalized regression used. It also clarifies how model selection involves a multivariate regression model for causal inference problems and that these methods can be applied for identifying subgroups in which treatment effects are homogeneous. Analogies and links with the literature on machine learning methods, missing data, and imputation are drawn. A difference least absolute shrinkage and selection operator algorithm is defined, along with its multiple imputation analogs. The procedures are illustrated using a well-known right-heart catheterization dataset. Copyright © 2015 John Wiley & Sons, Ltd.

  9. Relapse May Serve as a Mediator Variable in Longitudinal Outcomes in Multiple Sclerosis.

    Science.gov (United States)

    Stone, Lael Anne; Cutter, Gary Raymond; Fisher, Elizabeth; Richert, Nancy; McCartin, Jennifer; Ohayon, Joan; Bash, Craig; McFarland, Henry

    2016-05-01

    Contrast-enhancing lesions (CEL) on magnetic resonance imaging (MRI) are believed to represent inflammatory disease activity in multiple sclerosis (MS), but their relationship to subsequent long-term disability and progression is unclear, particularly at longer time periods such as 8-10 years. Between 1989 and 1994, 111 MS patients were seen at the National Institutes of Health for clinical evaluations and 3 monthly contrast-enhanced MRI scans. Of these, 94 patients were re-evaluated a mean of 8 years later (range 6.1-10.5 years) with a single MRI scan and clinical evaluation. CEL number and volume were determined at baseline and follow-up. The number of relapses was ascertained over the follow-up period and annualized relapse rates were calculated. Other MRI parameters, such as T2 hyperintensity volume, T1 volume, and brain parenchymal fraction, were also calculated. While there was no direct correlation between CEL number or volume at baseline and disability status at follow-up, CEL measures at baseline did correlate with number of relapses observed in the subsequent years, and the number of relapses in turn correlated with subsequent disability as well as transition to progressive MS. While number and volume of CEL at baseline do not directly correlate with disability in the longer term in MS, our data suggest that 1 route to disability involves relapses as a mediator variable in the causal sequence of MS progression from CEL to disability. Further studies using relapse as a mediator variable in a larger data set may be warranted. Copyright © 2015 by the American Society of Neuroimaging.

  10. A Two Year Longitudinal Outcome Study of Addicted Health Care Professionals: An Investigation of the Role of Personality Variables

    Directory of Open Access Journals (Sweden)

    Daniel Angres

    2013-01-01

    Full Text Available The co-morbidity of personality disorders (PDs and other dysregulatory personality patterns with addiction have been well-established, although few studies have examined this interplay on long-term sobriety outcome. In addition, health care professionals suffering from addiction have both a significant public health impact and a unique set of treatment and recovery challenges. The aim of this study was to investigate if personality variables differentiated sobriety outcome in this population over a two year interval. A clinical sample of health care professionals participated in a substance abuse hospital treatment program individually tailored with respect to personality. Participants took the Temperament and Character Inventory and the Millon Clinical Multiaxial Inventory at intake, and were tracked two years post-discharge to determine sobriety status. Univariate analyses showed antisocial personality, female gender, and alcohol dependence were independent predictors of relapse, however a significant relationship between personality and substance use did not exist in multivariate analysis when controlling for demographic variables The lack of multivariate relationships demonstrates the heterogeneity in self-report measures of personality, which suggests the interplay of personality and addiction is complex and individualized.

  11. Effectiveness of Splanchnic Nerve Neurolysis for Targeting Location of Cancer Pain: Using the Pain Drawing as an Outcome Variable.

    Science.gov (United States)

    Novy, Diane M; Engle, Mitchell P; Lai, Emily A; Cook, Christina; Martin, Emily C; Trahan, Lisa; Yu, Jun; Koyyalagunta, Dhanalakshmi

    2016-07-01

    The effectiveness of splanchnic nerve neurolysis (SNN) for cancer-related abdominal pain has been investigated using numeric pain intensity rating as an outcome variable. The outcome variable in this study used the grid method for obtaining a targeted pain drawing score on 60 patients with pain from pancreatic or gastro-intestinal primary cancers or metastatic disease to the abdominal region. Results demonstrate excellent inter-rater agreement (intra-class correlation [ICC] coefficient at pre-SNN = 0.97 and ICC at within one month post-SNN = 0.98) for the grid method of scoring the pain drawing and demonstrate psychometric generalizability among patients with cancer-related pain. Using the Wilcoxon signed rank test and associated effect sizes, results show significant improvement in dispersion of pain following SNN. Effect sizes for the difference in pre-SNN to 2 post-SNN time points were higher for the pain drawing than for pain intensity rating. Specifically, the effect size difference from pre- to within one month post-SNN was r = 0.42 for pain drawing versus r = 0.23 for pain intensity rating. Based on a smaller subset of patients who were seen within 1 - 6 months following SNN, the effect size difference from pre-SNN was r = 0.46 for pain drawing versus r = 0.00 for pain intensity rating. Collectively, these data support the use of the pain drawing as a reliable outcome measure among patients with cancer pain for procedures such as SNN that target specific location and dispersion of pain.

  12. Tongue motion variability with changes of upper airway stimulation electrode configuration and effects on treatment outcomes.

    Science.gov (United States)

    Steffen, Armin; Kilic, Ayse; König, Inke R; Suurna, Maria V; Hofauer, Benedikt; Heiser, Clemens

    2017-12-27

    Upper airway stimulation (UAS) is an effective treatment for obstructive sleep apnea (OSA). Previous data have demonstrated a correlation between the phenotype of tongue motion and therapy response. Closed loop hypoglossal nerve stimulation implant offers five different electrode configuration settings which may result in different tongue motion. Two-center, prospective consecutive trial in a university hospital setting. Clinical outcomes of 35 patients were analyzed after at least 12 months of device use. Tongue motion was assessed at various electrode configuration settings. Correlation between the tongue motion and treatment response was evaluated. OSA severity was significantly reduced with the use of UAS therapy (P < .001). Changes in tongue motion patterns were frequently observed (58.8%) with different electrode configuration settings. Most of the patients alternated between right and bilateral protrusion (73.5%), which are considered to be the optimal phenotypes for selective UAS responses. Different voltage settings were required to achieve functional stimulation levels when changing between the electrode settings. UAS is highly effective for OSA treatment in selected patients with an apnea-hypopnea index between 15 and 65 events per hour and higher body mass index. Attention should be given to patients with shifting tongue movement in response to change of electrode configuration. The intraoperative cuff placement should be reassessed when tongue movement shifting is observed. 4 Laryngoscope, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  13. Visit-to-Visit Variability in Blood Pressure and Kidney and Cardiovascular Outcomes in Patients With Type 2 Diabetes and Nephropathy

    DEFF Research Database (Denmark)

    McMullan, Ciaran J; Lambers Heerspink, Hiddo J; Parving, Hans-Henrik

    2014-01-01

    -to-visit variability was calculated from the SD of the systolic blood pressure from 4 visits occurring 3-12 months postrandomization. OUTCOMES: The kidney disease outcome was defined as time to confirmed doubling of serum creatinine level, end-stage renal disease, or death; the cardiovascular outcome was defined......BACKGROUND: Increased systolic blood pressure variability between outpatient visits is associated with increased incidence of cardiovascular end points. However, few studies have examined the association of visit-to-visit variability in systolic blood pressure with clinically relevant kidney...... disease outcomes. We analyzed the association of systolic blood pressure visit-to-visit variability with renal and cardiovascular morbidity and mortality among individuals with diabetes and nephropathy. STUDY DESIGN: Observational analysis of IDNT (Irbesartan Diabetic Nephropathy Trial) and the RENAAL...

  14. Social variables affecting mate preferences, copulation and reproductive outcome in a pack of free-ranging dogs.

    Directory of Open Access Journals (Sweden)

    Simona Cafazzo

    Full Text Available Mating and reproductive outcome is often determined by the simultaneous operation of different mechanisms like intra-sexual competition, mating preferences and sexual coercion. The present study investigated how social variables affected mating outcome in a pack of free-ranging dogs, a species supposed to have lost most features of the social system of wolves during domestication. We found that, although the pack comprised multiple breeding individuals, both male copulation success and female reproductive success were positively influenced by a linear combination of dominance rank, age and leadership. Our results also suggest that mate preferences affect mating outcome by reinforcing the success of most dominant individuals. In particular, during their oestrous period bitches clearly searched for the proximity of high-ranking males who displayed affiliative behaviour towards them, while they were more likely to reject the males who intimidated them. At the same time, male courting effort and male-male competition for receptive females appeared to be stronger in the presence of higher-ranking females, suggesting a male preference for dominant females. To our knowledge, these results provide the first clear evidence of social regulation of reproductive activities in domestic dogs, and suggest that some common organizing mechanisms may contribute to shape the social organization of both dogs and wolves.

  15. Hemodynamic variables predict outcome of emergency thoracotomy in the pediatric trauma population.

    Science.gov (United States)

    Wyrick, Deidre L; Dassinger, Melvin S; Bozeman, Andrew P; Porter, Austin; Maxson, R Todd

    2014-09-01

    Limited data exist regarding indications for resuscitative emergency thoracotomy (ETR) in the pediatric population. We attempt to define the presenting hemodynamic parameters that predict survival for pediatric patients undergoing ETR. We reviewed all pediatric patients (age <18years), entered into the National Trauma Data Bank from 2007 to 2010, who underwent ETR within one hour of ED arrival. Mechanism of injury and hemodynamics were analyzed using Chi squared and Wilcoxon tests. 316 children (70 blunt, 240 penetrating) underwent ETR, 31% (98/316) survived to discharge. Less than 5% of patients survived when presenting SBP was ≤50mmHg or heart rate was ≤70bpm. For blunt injuries there were no survivors with a pulse ≤80bpm or SBP ≤60mmHg. When survivors were compared to nonsurvivors, blood pressure, pulse, and injury type were statistically significant when treated as independent variables and in a logistic regression model. When ETR was performed for SBP ≤50mmHg or for heart rate ≤70bpm less than 5% of patients survived. There were no survivors of blunt trauma when SBP was ≤60mmHg or pulse was ≤80bpm. This review suggests that ETR may have limited benefit in these patients. Copyright © 2014 Elsevier Inc. All rights reserved.

  16. Variable gene dispersal conditions and spatial deforestation patterns can interact to affect tropical tree conservation outcomes.

    Directory of Open Access Journals (Sweden)

    Yamini Kashimshetty

    dispersal regimens will be a likely outcome of fragmentation. Conservation implications include possible manual interventions (manual manipulations of offspring dispersers and/or pollinators in forest fragments to increase population recovery and genetic diversity retention.

  17. Variable gene dispersal conditions and spatial deforestation patterns can interact to affect tropical tree conservation outcomes.

    Science.gov (United States)

    Kashimshetty, Yamini; Pelikan, Stephan; Rogstad, Steven H

    2015-01-01

    regimens will be a likely outcome of fragmentation. Conservation implications include possible manual interventions (manual manipulations of offspring dispersers and/or pollinators) in forest fragments to increase population recovery and genetic diversity retention.

  18. Cerebral venous thrombosis in Saudi Arabia. Clinical variables, response to treatment, and outcome

    International Nuclear Information System (INIS)

    Kajtazi, Naim I; Arulneyam, Jayanthi C; AlSenani, Fahmi M; Zimmerman, Valerie A; AlShami, Sadiq Y

    2009-01-01

    To investigate cerebral venous thrombosis (CVTR) clinical presentations, risk factors, and response to treatment in Saudi Arabia. Retrospective analysis of the King Farad Medical City, Riyadh, acute stroke database from April 2005 through February 2008 revealed 22 patients with CVTR. Hyper coagulable work-up and neuroimaging were performed. Sixteen patients were female (72.7%), and the median age was 35 years. Clinical presentations included: headache (77.3%), seizures (54.5%), focal neurological signs (54.5%), and decreased level of consciousness (50%). Over two-thirds (n=11; 69%) of female patients had a history of oral contraceptive use, which was the most common risk factor. Protein S deficiency (n=3), anti phospholipid antibody syndrome secondary to systemic lupus erythematosus (SLE) (n=1), rhinocerebral mucormycosis (n=1), leukemia (n=1), non-Hodgkin's lymphoma (n=1), sepsis (n=1), and unknown (n=6) were causes. Affected areas included superior sagittal (n=13), transverse (n=16), sigmoid (n=14), straight (n=6), and cavernous sinus (n=1); internal cerebral vein (n=2); vein of Galen (n=3); cortical veins (n=10); and internal jugular vein (n=12). Two patients had quadriparesis, and 2 patients died. The remainder (n=18, 81.8%) improved. Bilateral hemorrhagic presentation or venous infarction, deep venous system thrombosis, and underlying malignancy had less favorable results. Presentations in our series were similar to those in other reports, although altered consciousness and seizures were more common. Cortical vein involvement was also higher than commonly reported. Oral contraceptive use was a primary risk factor in female patients. Outcomes were favorable in 81.8% of patients. (author)

  19. Outcomes and Prognostic Variables in Adenoid Cystic Carcinoma of the Head and Neck: A Recent Experience

    International Nuclear Information System (INIS)

    Gomez, Daniel R.; Hoppe, Bradford S.; Wolden, Suzanne L.; Zhung, Joanne E.; Patel, Snehal G.; Kraus, Dennis H.; Shah, Jatin P.; Ghossein, Ronald A.; Lee, Nancy Y.

    2008-01-01

    Purpose: To analyze the recent experience of patients with adenoid cystic carcinoma treated with radiation therapy at Memorial Sloan-Kettering Cancer Center. Methods and Materials: From 1990 to 2004, a total of 59 patients with a diagnosis of primary adenoid cystic carcinoma of the head and neck received radiation therapy at our institution. The subsite distribution was oral cavity, 28% (n = 17); paranasal sinuses, 22% (n = 13); parotid, 14% (n = 8); submandibular, 14% (n = 8); oropharynx, 10% (n = 6); sublingual, 3% (n = 2); nasopharynx, 3% (n = 2); and other, 5% (n = 3). T Stage distribution was T1, 34% (n = 20); T2, 19% (n = 11); T3, 14% (n = 8); and T4, 34% (n = 20). Twenty-nine percent of patients (n = 17) were treated with intensity-modulated radiation therapy; 25% (n =15), with three-dimensional conformal therapy, and the remainder, with conventional techniques. Ninety percent (n = 53) of patients received treatment including the base of skull. Results: Median follow-up for surviving patients was 5.9 years. Five-year and 10-year rates of local control and distant metastases-free survival were 91%/81% and 81%/49%, respectively. Five-year and 10-year rates of disease-free and overall survival were 76%/40% and 87%/65%, respectively. On univariate analysis, stage T4 (p = 0.004) and gross/clinical nerve involvement (p = 0.002) were associated with decreased progression free survival, whereas stage T4 and lymph node involvement were associated with decreased overall survival (p = 0.046 and p < 0.001, respectively). Conclusions: Radiation therapy in combination with surgery produces excellent rates of local control, although distant metastases account for a high proportion of failures. Routine treatment to the base of skull reduces the significance of histologic perineural invasion, but major nerve involvement remains an adverse prognostic factor

  20. Measuring the Impact of Gastrointestinal Variables on the Systemic Outcome of Two Suspensions of Posaconazole by a PBPK Model.

    Science.gov (United States)

    Hens, Bart; Talattof, Arjang; Paixão, Paulo; Bermejo, Marival; Tsume, Yasuhiro; Löbenberg, Raimar; Amidon, Gordon L

    2018-03-29

    For the last two decades, the application of physiologically based pharmacokinetic (PBPK) models has grown exponentially in the field of oral absorption and in a regulatory context. Although these models are widely used, their predictive power should be validated and optimized in order to rely on these models and to know exactly what is going on "under the hood". In this study, an automated sensitivity analysis (ASA) was performed for 11 gastrointestinal (GI) variables that are integrated into the PBPK software program Simcyp®. The model of interest was a previously validated workspace that was able to predict the intraluminal and systemic behavior of two different suspensions of posaconazole in the Simcyp® Simulator. The sensitivity of the following GI parameters was evaluated in this model: gastric and duodenal pH, gastric and duodenal bicarbonate concentrations (reflecting buffer capacity), duodenal bile salts concentration, gastric emptying, the interdigestive migrating motor complex (IMMC), small intestinal transit time (SITT), gastric and jejunal volumes, and permeability. The most sensitive parameters were gastric/duodenal pH and gastric emptying, for both suspensions. The outcome of the sensitivity analyses highlights the important GI variables that must be integrated into an in vivo predictive dissolution test to help and create a rational and scientific framework/design for product development of novel and generic drug products.

  1. Differential Responding by Rhesus Monkeys (Macaca mulatta and Humans (Homo sapiens to Variable Outcomes in the Assurance Game

    Directory of Open Access Journals (Sweden)

    Audrey E. Parrish

    2014-08-01

    Full Text Available Behavioral flexibility in how one responds to variable partner play can be examined using economic coordination games in which subjects play against a variety of partners and therefore may need to alter their behavior to produce the highest payoff. But how do we study this behavioral flexibility once players have settled on a response? Here, we investigated how responding by rhesus monkeys (Macaca mulatta and humans (Homo sapiens playing a computerized single-player version of a coordination game, the Assurance game, changed as a function of the variable responses (Stag/Hare generated by multiple simulations (SIMs. We were interested in whether individuals could track and differentially respond to changing frequencies of Stag and Hare play by the SIMs, especially with regard to the payoff dominant (Stag-Stag outcome, something that could not be done with real partners as they quickly settled on the Stag response. For both monkeys and humans, there was a linear relationship between proportion of Stag play by the subject and the likelihood of the Stag choice by the SIM such that both species increased their use of Stag as the SIM increased its use of the Stag response. However, humans more closely matched their proportion of Stag responses to that of the SIM, whereas monkeys adopted a different, but equally effective, strategy of exploiting the higher-paying Stag alternative. These results suggest that monkeys and humans demonstrate sensitivity to a dynamic game environment in which they encounter variable contingencies for the same response options, although they may employ different strategies to maximize reward.

  2. What Variables Are Associated With the Outcome of Arthroscopic Lysis and Lavage Surgery for Internal Derangement of the Temporomandibular Joint?

    Science.gov (United States)

    Haeffs, Tyler H; D'Amato, Lindsay N; Khawaja, Shehryar N; Keith, David A; Scrivani, Steven J

    2018-04-26

    Arthroscopic lysis and lavage surgery (AS) is an effective modality that can decrease pain and increase maximum interincisal opening (MIO) in patients with internal derangement (ID) of the temporomandibular joint (TMJ). However, some patients remain in pain or have limited mandibular range of motion despite AS. The purpose of this study was to determine the effectiveness, prevalence of adverse effects, and predictors of response to TMJ AS in patients with TMJ arthralgia and ID. A retrospective cohort study was conducted using data of patients who had undergone AS by a single surgeon (D.A.K.) from September 2010 to April 2015 in the Department of Oral and Maxillofacial Surgery at Massachusetts General Hospital (Boston, MA). Variables, including demographic data, medical history, and clinical presentation, were extracted and analyzed. Criteria for surgical success were defined as a postoperative MIO of at least 35 mm and a postoperative pain level no higher than 3 on an 11-point Likert-type numeric verbal pain rating scale. Appropriate descriptive and analytic statistics were computed and significance was set at a P value less than .05. Of the 247 participants, 226 (91.5%) were women. The mean age of the sample was 38 ± 15.4 years. Successful surgical outcome was achieved in 62.3% of patients. Based on logistic regression analysis, higher initial mean pain score and concurrent use of benzodiazepines were the only variables that predicted an unsuccessful surgical outcome (P < .001; P = .005). Adverse effects were reported by 13.4% of patients, the most common being postoperative increase in pain (13.4%), temporary malocclusion (1.2%), and temporary paresthesia in the preauricular region (0.4%). The results from this study indicate that in patients with ID of the TMJ unresponsive to noninvasive treatments, high initial pain scores and concurrent use of benzodiazepines are correlated with an unsuccessful outcome after AS. Copyright © 2018. Published by

  3. Data, Model, Conclusions, Doing It Again.

    Science.gov (United States)

    Molenaar, Ivo W.

    1998-01-01

    Explores the robustness of conclusions from a statistical model against variations in model choice with an illustration from G. Box and G. Tiao (1973). Suggests that simultaneous consideration of a class of models for the same data is sometimes superior to analyzing the data under one model and demonstrates advantages to Adaptive Bayesian…

  4. Premature conclusions about psychotherapy for dysthymia

    NARCIS (Netherlands)

    Cuijpers, P.

    2009-01-01

    Dr Cuijpers and Colleagues Reply To the Editor: We thank Dr Gaudiano and colleagues for their contribution to the discussion about psychotherapy for dysthymia. We agree very much with Gaudiano et al that we should be careful about drawing definite conclusions about the comparative efficacy of

  5. Data, model, conclusion, doing it again

    NARCIS (Netherlands)

    Molenaar, W.

    1998-01-01

    This paper explores the robustness of conclusions from a statistical model against variations in model choice (rather than variations in random sampling and random assignment to treatments, which are the usual variations covered by inferential statistics). After the problem formulation in section 1,

  6. Results and conclusion; Resultados e conclusoes

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2009-10-15

    This chapter shows the results and conclusions of the ordered studies by the Science and Technology Ministry from Brazil to the Center of Management and Strategic Studies (CGEE), executed by a multidisciplinary team, most of UNICAMP - State University of Campinas, SP - for evaluation of Brazilian capacity and potential in the production of fuel bioethanol.

  7. Assessing the variability of outcome for patients treated with localized prostate irradiation using different definitions of biochemical control

    International Nuclear Information System (INIS)

    Horwitz, Eric M.; Vicini, Frank A.; Ziaja, Ellen L.; Gonzalez, Jose; Dmuchowski, Carl F.; Stromberg, Jannifer S.; Brabbins, Donald S.; Hollander, Jay; Chen, Peter Y.; Martinez, Alvaro A.

    1996-01-01

    .001). Conclusion: When different definitions of biochemical control are used in assessing treatment outcome, significantly different rates of success are noted. Until a standardized definition of biochemical control is adopted, differences in treatment outcome cannot be meaningfully compared

  8. Power and Democracy in Denmark. Conclusions

    DEFF Research Database (Denmark)

    Andersen, Jørgen Goul; Christiansen, Peter Munk; Beck Jørgensen, Torben

    In 1997, the Danish Parliament decided to launch a power study, officially An Analysis of Democracy and Power in Denmark. A steering committee consisting of five independent researchers was assigned responsibility for the project. The Steering Committee has gathered the overall conclusions from...... the numerous projects under the Power Study, and this book is a short presentation of these conclusions.The main focus of the book is the state of democracy in Denmark at the dawn of the 21st century. How has democracy fared, has the development made things better or worse, and to which extent does......, and the political institutions show considerable democratic robustness. However, not everything has gone or is going well. There are still pronounced social divisions in Danish society, although their nature has changed somewhat. The ideal of an informed public debate does not always enjoy the best conditions...

  9. Hierarchy of treatment variables affecting outcome of 131I therapy in thyroid cancer patients with lung metastases.

    Science.gov (United States)

    Kozak, Oksana V; Sukach, Georgiy G; Korchinskaya, Oksana I; Trembach, Alexander M; Turicina, Viktoria L; Voit, Natalia U

    2005-06-01

    To assess the correlations between the first 131I activity value, time interval between the courses of radioiodine treatment and the overall number of courses required for total destruction of lung metastases in patients with differentiated thyroid cancer with metastatic lesions in lungs. 27 patients with differentiated thyroid cancer with metastases in lungs have been treated with radioiodine after surgical intervention. Activities administered amounted from 1600 to 7980 MBq. The number of radioiodine courses before total ablation of all metastatic lesions amounted from 1 to 10. Time interval between the 1st and the 2nd courses amounted from 3.5 to 11.5 months (6 months in average). The regression analysis of the data has been made. The exponential model fits the actual number of courses as a function of the first-second activity value and time interval between the courses. The first activity has a decisive influence on the number of courses required for total metastases ablation. The greater was the first activity value, the lesser was the overall number of courses. Increasing time interval between 1st and 2nd courses to 10 months seems to result in reducing the number of courses. Nevertheless even in the case of high activities the probability to undergone less then 3 courses is low. According to the proposed model in thyroid cancer patients with metastases in lungs the first activity should be not lesser than 6000 MBq, time interval between treatments--approximately 10 months. The results of our study suggest that individual factors such as histology, the number and the size of metastases in lymph nodes could not contribute more to the final outcome than the treatment variables, namely the first-second activity and time interval, nor could they affect the hierarchy of the effects revealed for the treatment variables.

  10. Dysglycemia, Glycemic Variability, and Outcome After Cardiac Arrest and Temperature Management at 33°C and 36°C

    DEFF Research Database (Denmark)

    Borgquist, Ola; Wise, Matt P; Nielsen, Niklas

    2017-01-01

    OBJECTIVES: Dysglycemia and glycemic variability are associated with poor outcomes in critically ill patients. Targeted temperature management alters blood glucose homeostasis. We investigated the association between blood glucose concentrations and glycemic variability and the neurologic outcomes...... of patients randomized to targeted temperature management at 33°C or 36°C after cardiac arrest. DESIGN: Post hoc analysis of the multicenter TTM-trial. Primary outcome of this analysis was neurologic outcome after 6 months, referred to as "Cerebral Performance Category." SETTING: Thirty-six sites in Europe...... and Australia. PATIENTS: All 939 patients with out-of-hospital cardiac arrest of presumed cardiac cause that had been included in the TTM-trial. INTERVENTIONS: Targeted temperature management at 33°C or 36°C. MEASUREMENTS AND MAIN RESULTS: Nonparametric tests as well as multiple logistic regression and mixed...

  11. Accelerated partial breast irradiation: An analysis of variables associated with late toxicity and long-term cosmetic outcome after high-dose-rate interstitial brachytherapy

    International Nuclear Information System (INIS)

    Wazer, David E.; Kaufman, Seth; Cuttino, Laurie; Di Petrillo, Thomas; Arthur, Douglas W.

    2006-01-01

    . Suboptimal cosmetic outcome was significantly associated with the number of source dwell positions, V150, and V200 and inversely associated with DHI (0.77 vs. 0.73; p = 0.05). Late skin toxicity was rated as Grade 0, 1, or 2 in 77%, 19%, and 4% of patients, respectively. The risk of Grade 1/2 skin toxicity was significantly associated with V150 and V200 and inversely associated with DHI (0.77 vs. 0.71; p = 0.009). Late subcutaneous toxicity was rated as Grade 0, 1, 2, 3, or 4 in 55%, 15%, 12%, 5%, and 13% of patients, respectively. The risk of Grade 0/1 vs. Grade 2-4 subcutaneous toxicity was significantly associated only with a lower value of DHI (0.77 vs. 0.73; p = 0.02). To further explore factors that might contribute to the risk of fat necrosis (symptomatic or asymptomatic), a separate analysis showed that only dose hotspots as reflected in V150 and V200 were significantly associated with elevated risk. The use of adriamycin-based chemotherapy after APBI was found to be associated with a significant increase in the incidence of higher-grade skin toxicity and a higher risk of fat necrosis and suboptimal cosmetic outcome. Patient age, volume of resection, extent of axillary surgery, a history of diabetes or hypertension, and the use of tamoxifen were not found to be significantly associated with cosmetic outcome or late normal tissue complications. Conclusions: Long-term cosmetic results and the risk of late skin and subcutaneous toxicity after APBI with interstitial HDR brachytherapy can be correlated with specific treatment-related variables. These data provide dosimetric parameters that might be used to minimize the risk of normal tissue injury after APBI interstitial brachytherapy

  12. Superiority in value and the repugnant conclusion

    DEFF Research Database (Denmark)

    Jensen, Karsten Klint

    2007-01-01

    superiority does not amount to a radical value difference at all. I then spell out the consequences of these results for different interpretations of Griffin's suggestion regarding population ethics. None of them comes out very successful, but perhaps they nevertheless retain some interest.......James Griffin has considered a weak form of superiority in value a possible remedy to the Repugnant Conclusion. In this paper, I demonstrate that, in a context where value is additive, this weaker form collapses into a stronger form of superiority. And in a context where value is non-additive, weak...

  13. High Intrapatient Variability of Tacrolimus Exposure in the Early Period After Liver Transplantation Is Associated With Poorer Outcomes.

    Science.gov (United States)

    Rayar, Michel; Tron, Camille; Jézéquel, Caroline; Beaurepaire, Jean Marie; Petitcollin, Antoine; Houssel-Debry, Pauline; Camus, Christophe; Verdier, Marie Clémence; Dehlawi, Ammar; Lakéhal, Mohamed; Desfourneaux, Véronique; Meunier, Bernard; Sulpice, Laurent; Bellissant, Eric; Boudjema, Karim; Lemaitre, Florian

    2018-03-01

    Tacrolimus (TAC) is the cornerstone of immunosuppressive regimen in liver transplantation (LT). Its pharmacokinetics is characterized by a high interpatient and intrapatient variability (IPV) leading to an unpredictable dose-response relationship. The aim of our study was to evaluate the impact of TAC IPV (IPV) on graft and patient outcomes after LT. We retrospectively analyzed 812 LT recipients treated with TAC. The IPV of TAC concentrations was estimated by calculating the coefficient of variation (CV) of whole blood trough concentrations. Patients were categorized in 2 groups: low IPV (CV < 40%) and high IPV (CV ≥ 40%). There were significantly more neurologic complications (31.2% vs 16.6%, P < 0.001), cardiovascular complications (19.7% vs 9.7%, P < 0.001), and acute renal failure requiring dialysis (8.5% vs 2.2%, P < 0.001) in the high CV group than in the low CV group. Moreover, graft survival was significantly poorer in the high CV group (hazard ratio, 1.42; 95% confidence interval, 1.04-1.95; P = 0.03). A pretransplantation elevated Model for End-Stage Liver Disease score (P < 0.001) and Child-Pugh grade (P < 0.001) were identified as risk factors for presenting a high CV. A high CV of TAC concentrations was found to be predictive of TAC-related toxicity and poorer survival.

  14. Characteristics of patients in routine psycho-oncological care, and changes in outcome variables during and after their treatment.

    Science.gov (United States)

    Garssen, Bert; Van der Lee, Marije; Van der Poll, Amber; Ranchor, Adelita V; Sanderman, Robbert; Schroevers, Maya J

    2016-10-01

    The primary aim of this study was to determine the characteristics of clients and interventions in routine psycho-oncological care. The secondary aim was to determine the course of symptomatology during and after the psychological interventions. During a period of nine months, all clients who sought help in one of the seven psycho-oncological care institutes in the Netherlands were approached to participate in the present study (N = 483). Information was gathered with respect to demographic and medical characteristics, and type and duration of the interventions. In addition, depression, anxiety, well-being, quality of life, fatigue and daily function were determined before interventions and three and nine months later. Compared to the Dutch cancer population, patients in psycho-oncological care were more often young and female. Compared to the general Dutch population, they were highly educated and were more likely to have a partner. Clinical levels of depression, anxiety and/or fatigue were found among 83% of the patients. After three months, only 23% had completed their intervention; this figure was 62% after nine months. Symptoms decreased significantly for all outcome variables. An importance difference with randomised controlled trials is the low session frequency and the long intervention time of patients in clinical care.

  15. Conclusions: environmental change, wildlife conservation and reproduction.

    Science.gov (United States)

    Holt, William V; Brown, Janine L; Comizzoli, Pierre

    2014-01-01

    Our intention when planning this book was to explore the diverse ways that reproductive science is inextricably tied to many aspects of biodiversity conservation, using the opportunity to present a vast amount of specialised information in a way that forms a coherent and important body of work. Some of the chapters were therefore concerned with understanding how taxonomic groups and species are being affected by globally important environmental changes, mostly caused through anthropogenic influences. Others were more focused on monitoring and understanding the physiology of wild species, with the aim of better understanding mechanisms underlying responses to captive conditions and environmental change, in both wild and captive animals. We also wanted to review advances in technological measures that are being actively developed to support the breeding and management of wildlife. In a few cases we have presented specific case studies that highlight the amount of effort required for the successful development of assisted reproductive technologies for wild species. Viewed overall, the outcome is spectacular; the last decade has seen enormous progress in many aspects of the sciences and technologies relevant to the topic. It is also clear that the boundaries between different scientific disciplines are becoming ever more blurred, and it is no longer easy or even possible to remain focused on a highly specialized topic in reproduction or conservation, without having at least some understanding of allied subjects. Here we present a few concluding comments about what we have learnt, and how the various topics interact with each other. We also emphasize that, as far as we know, no similarly comprehensive consideration of the contribution of reproductive science to wildlife conservation has been published within the last decade.

  16. Surgical outcomes of laparoscopic hysterectomy with concomitant endometriosis without bowel or bladder dissection : A cohort analysis to define a case-mix variable

    NARCIS (Netherlands)

    Sandberg, Evelien M.; Driessen, Sara R C; Bak, Evelien A.T.; van Geloven, Nan; Berger, Judith P.; Smeets, Mathilde J.G.H.; Rhemrev, Johann P T; Jansen, F.W.

    2018-01-01

    Background: Pelvic endometriosis is often mentioned as one of the variables influencing surgical outcomes of laparoscopic hysterectomy (LH). However, its additional surgical risks have not been well established. The aim of this study was to analyze to what extent concomitant endometriosis

  17. Executive Summary of the NHLBI Workshop Report: Leveraging Current Scientific Advancements to Understand Sarcoidosis Variability and Improve Outcomes.

    Science.gov (United States)

    Maier, Lisa A; Crouser, Elliott D; Martin, William J; Eu, Jerry

    2017-12-01

    Sarcoidosis is a systemic granulomatous disease that primarily affects the lung; it is associated with significant disparities, more commonly impacting those in the prime of their lives (age 20-50 yr, with a second peak after age 60 yr), black individuals, and women. However, the burden of disease, the ability to diagnose and prognose organ involvement and course, as well as specific treatment options, management options, and disease pathogenesis remain poorly understood. As a result, the National Heart, Lung, and Blood Institute undertook a sarcoidosis workshop, "Leveraging Current Scientific Advancements to Understand Sarcoidosis Variability and Improve Outcomes," to help address these issues by defining the scientific and clinical priorities to improve sarcoidosis care. The overarching recommendations from this workshop are outlined in the following summary and detailed in the accompanying articles. The recommendations included establishing collaborations and networks to conduct research based on consensus definitions of disease phenotypes and standards of care, and to provide clinical outreach to areas with a burden of disease to improve care. These collaborative networks would also serve as the hub to conduct clinical trials of devastating phenotypes (e.g., cardiac, neurologic, and fibrotic disease) not only for treatment but to enhance our understanding of the burden of disease. In addition, the networks would be used to leverage state-of-the-art "omics" and systems biology research, as well as other studies to advance understanding of disease pathogenesis, and development of biomarkers and therapeutic targets, with a goal to translate this information to improve care of individuals with sarcoidosis.

  18. Combining biological and psychosocial baseline variables did not improve prediction of outcome of a very-low-energy diet in a clinic referral population.

    Science.gov (United States)

    Sumithran, P; Purcell, K; Kuyruk, S; Proietto, J; Prendergast, L A

    2018-02-01

    Consistent, strong predictors of obesity treatment outcomes have not been identified. It has been suggested that broadening the range of predictor variables examined may be valuable. We explored methods to predict outcomes of a very-low-energy diet (VLED)-based programme in a clinically comparable setting, using a wide array of pre-intervention biological and psychosocial participant data. A total of 61 women and 39 men (mean ± standard deviation [SD] body mass index: 39.8 ± 7.3 kg/m 2 ) underwent an 8-week VLED and 12-month follow-up. At baseline, participants underwent a blood test and assessment of psychological, social and behavioural factors previously associated with treatment outcomes. Logistic regression, linear discriminant analysis, decision trees and random forests were used to model outcomes from baseline variables. Of the 100 participants, 88 completed the VLED and 42 attended the Week 60 visit. Overall prediction rates for weight loss of ≥10% at weeks 8 and 60, and attrition at Week 60, using combined data were between 77.8 and 87.6% for logistic regression, and lower for other methods. When logistic regression analyses included only baseline demographic and anthropometric variables, prediction rates were 76.2-86.1%. In this population, considering a wide range of biological and psychosocial data did not improve outcome prediction compared to simply-obtained baseline characteristics. © 2017 World Obesity Federation.

  19. Only one simple conclusion about the climate

    Energy Technology Data Exchange (ETDEWEB)

    Jaremko, G.

    2000-07-24

    Findings concerning climate change, by a three-man team of scientists from the North Dakota Geological Survey, which were presented in a paper read at the Eight International Williston Basin Horizontal Well Workshop, are discussed. The survey by the three scientists covered more than 6,000 scholarly publications. It reported that while the rise in the Earth's temperature is beyond argument, there is anything but agreement as to the causes, or whether the trend is unusual enough to justify concerted and costly actions to change lifestyles. It is shown by direct instrumental measurements that the average temperature at the Earth's surface increased about 0.8 degree Celsius between 1866 and 1998. During that time the concentration of carbon dioxide in the atmosphere increased from 280 to 353 parts per million. While it is generally assumed that the global warming was caused by human activities, new techniques of measurement such as glacier ice coring, dendrochronology (tree-growth rings), lichenometry (measuring the diameter of lichens) and counting concentrations of oxygen 18 and 16 (isotopes whose presence in marine fossils varies depending on temperature) suggest that most of the global warming took place before the increase in carbon dioxide concentration occurred, raising the possibility that the increase in average temperature had causes other than the increase in greenhouse gases. Some of the studies reviewed by the group show that in Europe between ice ages during the Eemian period, some 135,000 to 110,000 years ago, temperature variations of seven degrees Celsius took place; they dropped from two degree Celsius warmer than today to five degree Celsius colder than today. Based on these findings the group's only firm conclusion was that climate is in a continual flux.

  20. Surgical outcomes of laparoscopic hysterectomy with concomitant endometriosis without bowel or bladder dissection: a cohort analysis to define a case-mix variable.

    Science.gov (United States)

    Sandberg, Evelien M; Driessen, Sara R C; Bak, Evelien A T; van Geloven, Nan; Berger, Judith P; Smeets, Mathilde J G H; Rhemrev, Johann P T; Jansen, Frank Willem

    2018-01-01

    Pelvic endometriosis is often mentioned as one of the variables influencing surgical outcomes of laparoscopic hysterectomy (LH). However, its additional surgical risks have not been well established. The aim of this study was to analyze to what extent concomitant endometriosis influences surgical outcomes of LH and to determine if it should be considered as case-mix variable. A total of 2655 LH's were analyzed, of which 397 (15.0%) with concomitant endometriosis. For blood loss and operative time, no measurable association was found for stages I ( n  = 106) and II ( n  = 103) endometriosis compared to LH without endometriosis. LH with stages III ( n  = 93) and IV ( n  = 95) endometriosis were associated with more intra-operative blood loss ( p  = case-mix variables in future quality measurement tools.

  1. Treatment of malignant gastric outlet obstruction with stents: An evaluation of the reported variables for clinical outcome

    Directory of Open Access Journals (Sweden)

    Medhus Asle W

    2009-06-01

    Full Text Available Abstract Background Malignant gastric outlet obstruction (GOO is commonly seen in patients with advanced gastric-, pancreatic-, duodenal, hepatobiliary or metastatic malignancies. Ten to 25% of patients with pancreatic cancer will develop duodenal obstruction during the course of the disease. Duodenal stenting with self-expandable metal stents is an alternative treatment to surgical bypass procedures. Our aim was to review the published literature regarding treatment of malignant GOO with stents to reveal whether the information provided is sufficient to evaluate the clinical effects of this treatment Methods A literature search from 2000 – 2007 was conducted in Pub Med, Embase, and Cochrane library, combining the following search terms: duodenal stent, malignant duodenal obstruction, gastric outlet obstruction, SEMS, and gastroenteroanastomosis. All publications presenting data with ≥ 15 patients and only articles written in English were included and a review focusing on the following parameters were conducted: 1 The use of graded scoring systems evaluating clinical success; 2 Assessment of Quality of life (QoL before and after treatment; 3 Information on stent-patency; 4 The use of objective criteria to evaluate the stent effect. Results 41 original papers in English were found; no RCT's. 16 out of 41 studies used some sort of graded scoring system. No studies had objectively evaluated QoL before or after stent treatment, using standardized QoL-questionnaires, 32/41 studies reported on stent patency and 9/41 performed an oral contrast examination after stent placement. Objective quantitative tests of gastric emptying had not been performed. Conclusion Available reports do not provide sufficient relevant information of the clinical outcome of duodenal stenting. In future studies, these relevant issues should be addressed to allow improved evaluation of the effect of stent treatment.

  2. Global Advisory Group: conclusions and recommendations.

    Science.gov (United States)

    1986-02-01

    The conclusions and recommendations formulated for the global program by the 8th meeting of the Expanded Program on Immunization (EPI) Global Advisory Group, which took place during November 1985, are summarized. The Global Advisory Group recommends that, in furtherance of the Five-Point Action Program endorsed by the World Health Assembly in 1983, 3 general and 4 specific actions be taken by national immunization programs with the support of the World Health Organization (WHO) to accelerate EPI progress. These recommendations reflect optimism that the 1990 goal of reducing morbidity and mortality by providing immunization for all children of the world can be realized but also acknowledge that many fundamental problems of national program management remain to be resolved. The general actions are: to promote the achievement of the 1990 immunization goal at national and international levels through collaboration among ministries, organizations, and individuals in both the public and private sectors; to adopt a mix of complementary strategies for program acceleration; and to ensure that rapid increases in coverage can be sustained through mechanisms which strengthen th delivery of other primary health care interventions. The specific actions are as follows: to provide immunization at every contact point; to reduce dropout rates between 1st and last immunizations; to improve immunization services to the disadvantaged in urban areas; and to increase priority for the control of measles, poliomyelitis, and neonatal tetanus. The WHO and the UN International Children's Emergency Fund (UNICEF) have collaborated in support of the EPI since the early days of the program. The acceleration of national efforts heightens the importance of this collaboration, particularly at the national level. It may be further facilitated by the provision of policy guidance from global and regional levels, by WHO and UNICEF collaborative agreements at the regional level, and by country agreements

  3. Assessment of leg muscles mechanical capacities: Which jump, loading, and variable type provide the most reliable outcomes?

    Science.gov (United States)

    García-Ramos, Amador; Feriche, Belén; Pérez-Castilla, Alejandro; Padial, Paulino; Jaric, Slobodan

    2017-07-01

    This study aimed to explore the strength of the force-velocity (F-V) relationship of lower limb muscles and the reliability of its parameters (maximum force [F 0 ], slope [a], maximum velocity [V 0 ], and maximum power [P 0 ]). Twenty-three men were tested in two different jump types (squat and countermovement jump: SJ and CMJ), performed under two different loading conditions (free weight and Smith machine: Free and Smith) with 0, 17, 30, 45, 60, and 75 kg loads. The maximum and averaged values of F and V were obtained for the F-V relationship modelling. All F-V relationships were strong and linear independently whether observed from the averaged across the participants (r ≥ 0.98) or individual data (r = 0.94-0.98), while their parameters were generally highly reliable (F 0 [CV: 4.85%, ICC: 0.87], V 0 [CV: 6.10%, ICC: 0.82], a [CV: 10.5%, ICC: 0.81], and P 0 [CV: 3.5%, ICC: 0.93]). Both the strength of the F-V relationships and the reliability of their parameters were significantly higher for (1) the CMJ over the SJ, (2) the Free over the Smith loading type, and (3) the maximum over the averaged F and V variables. In conclusion, although the F-V relationships obtained from all the jumps tested were linear and generally highly reliable, the less appropriate choice for testing the F-V relationship could be through the averaged F and V data obtained from the SJ performed either in a Free weight or in a Smith machine. Insubstantial differences exist among the other combinations tested.

  4. Moderation of effects of AAC based on setting and types of aided AAC on outcome variables: an aggregate study of single-case research with individuals with ASD.

    Science.gov (United States)

    Ganz, Jennifer B; Rispoli, Mandy J; Mason, Rose Ann; Hong, Ee Rea

    2014-06-01

    The purpose of this meta-analysis was to evaluate the potential moderating effects of intervention setting and type of aided augmentative and alternative communication (AAC) on outcome variables for students with autism spectrum disorders. Improvement rate difference, an effect size measure, was used to calculate aggregate effects across 35 single-case research studies. Results indicated that the largest effects for aided AAC were observed in general education settings. With respect to communication outcomes, both speech generating devices (SGDs) and the Picture Exchange Communication System (PECS) were associated with larger effects than other picture-based systems. With respect to challenging behaviour outcomes, SGDs produced larger effects than PECS. This aggregate study highlights the importance of considering intervention setting, choice of AAC system and target outcomes when designing and planning an aided AAC intervention.

  5. The mediation proportion: a structural equation approach for estimating the proportion of exposure effect on outcome explained by an intermediate variable

    DEFF Research Database (Denmark)

    Ditlevsen, Susanne; Christensen, Ulla; Lynch, John

    2005-01-01

    It is often of interest to assess how much of the effect of an exposure on a response is mediated through an intermediate variable. However, systematic approaches are lacking, other than assessment of a surrogate marker for the endpoint of a clinical trial. We review a measure of "proportion...... of several intermediate variables. Binary or categorical variables can be included directly through threshold models. We call this measure the mediation proportion, that is, the part of an exposure effect on outcome explained by a third, intermediate variable. Two examples illustrate the approach. The first...... example is a randomized clinical trial of the effects of interferon-alpha on visual acuity in patients with age-related macular degeneration. In this example, the exposure, mediator and response are all binary. The second example is a common problem in social epidemiology-to find the proportion...

  6. Outcome prediction in mild traumatic brain injury: age and clinical variables are stronger predictors than CT abnormalities.

    NARCIS (Netherlands)

    Jacobs, B.; Beems, T.; Stulemeijer, M.; Vugt, A.B. van; Vliet, A.M. van der; Borm, G.F.; Vos, P.E.

    2010-01-01

    Mild traumatic brain injury (mTBI) is a common heterogeneous neurological disorder with a wide range of possible clinical outcomes. Accurate prediction of outcome is desirable for optimal treatment. This study aimed both to identify the demographic, clinical, and computed tomographic (CT)

  7. Monitoring the quality of cardiac surgery based on three or more surgical outcomes using a new variable life-adjusted display.

    Science.gov (United States)

    Gan, Fah Fatt; Tang, Xu; Zhu, Yexin; Lim, Puay Weng

    2017-06-01

    The traditional variable life-adjusted display (VLAD) is a graphical display of the difference between expected and actual cumulative deaths. The VLAD assumes binary outcomes: death within 30 days of an operation or survival beyond 30 days. Full recovery and bedridden for life, for example, are considered the same outcome. This binary classification results in a great loss of information. Although there are many grades of survival, the binary outcomes are commonly used to classify surgical outcomes. Consequently, quality monitoring procedures are developed based on binary outcomes. With a more refined set of outcomes, the sensitivities of these procedures can be expected to improve. A likelihood ratio method is used to define a penalty-reward scoring system based on three or more surgical outcomes for the new VLAD. The likelihood ratio statistic W is based on testing the odds ratio of cumulative probabilities of recovery R. Two methods of implementing the new VLAD are proposed. We accumulate the statistic W-W¯R to estimate the performance of a surgeon where W¯R is the average of the W's of a historical data set. The accumulated sum will be zero based on the historical data set. This ensures that if a new VLAD is plotted for a future surgeon of performance similar to this average performance, the plot will exhibit a horizontal trend. For illustration of the new VLAD, we consider 3-outcome surgical results: death within 30 days, partial and full recoveries. In our first illustration, we show the effect of partial recoveries on surgical results of a surgeon. In our second and third illustrations, the surgical results of two surgeons are compared using both the traditional VLAD based on binary-outcome data and the new VLAD based on 3-outcome data. A reversal in relative performance of surgeons is observed when the new VLAD is used. In our final illustration, we display the surgical results of four surgeons using the new VLAD based completely on 3-outcome data. Full

  8. Variability in Management of Acute Osteoarticular Infections at a Children’s Hospital and Favorable Outcomes with Increasing Early Transition to Oral Therapy

    OpenAIRE

    Biary, Nora; Wrotniak, Brian; Islam, Shamim

    2017-01-01

    Abstract Background To date, there is no established guideline for the treatment of acute pediatric osteoarticular infections (OAI), and considerable variability in management exists amongst providers and across institutions. This study analyzed the recent management and clinical outcomes of OAI at a children’s hospital. Methods Patients admitted with acute osteomyelitis and septic arthritis [OAI] aged 2 months to 18 years at the Women & Children’s Hospital of Buffalo, between 1/1/2013 and 12...

  9. Ensemble survival tree models to reveal pairwise interactions of variables with time-to-events outcomes in low-dimensional setting

    Science.gov (United States)

    Dazard, Jean-Eudes; Ishwaran, Hemant; Mehlotra, Rajeev; Weinberg, Aaron; Zimmerman, Peter

    2018-01-01

    Unraveling interactions among variables such as genetic, clinical, demographic and environmental factors is essential to understand the development of common and complex diseases. To increase the power to detect such variables interactions associated with clinical time-to-events outcomes, we borrowed established concepts from random survival forest (RSF) models. We introduce a novel RSF-based pairwise interaction estimator and derive a randomization method with bootstrap confidence intervals for inferring interaction significance. Using various linear and nonlinear time-to-events survival models in simulation studies, we first show the efficiency of our approach: true pairwise interaction-effects between variables are uncovered, while they may not be accompanied with their corresponding main-effects, and may not be detected by standard semi-parametric regression modeling and test statistics used in survival analysis. Moreover, using a RSF-based cross-validation scheme for generating prediction estimators, we show that informative predictors may be inferred. We applied our approach to an HIV cohort study recording key host gene polymorphisms and their association with HIV change of tropism or AIDS progression. Altogether, this shows how linear or nonlinear pairwise statistical interactions of variables may be efficiently detected with a predictive value in observational studies with time-to-event outcomes. PMID:29453930

  10. Magnetic resonance observation of cartilage repair tissue (MOCART) for the evaluation of autologous chondrocyte transplantation: Determination of interobserver variability and correlation to clinical outcome after 2 years

    International Nuclear Information System (INIS)

    Marlovits, Stefan; Singer, Philipp; Zeller, Philip; Mandl, Irena; Haller, Joerg; Trattnig, Siegfried

    2006-01-01

    In an observational study, the validity and reliability of magnetic resonance imaging (MRI) for the assessment of autologous chondrocyte transplantation (ACT) in the knee joint was determined. Two years after implantation, high-resolution MRI was used to analyze the repair tissue with nine pertinent variables. A complete filling of the defect was found in 61.5%, and a complete integration of the border zone to the adjacent cartilage in 76.9%. An intact subchondral lamina was present in 84.6% and an intact subchondral bone was present in 61.5%. Isointense signal intensities of the repair tissue compared to the adjacent native cartilage were seen in 92.3%. To evaluate interobserver variability, a reliability analysis with the determination of the intraclass correlation coefficient (ICC) was calculated. An 'almost perfect' agreement, with an ICC value >0.81, was calculated in 8 of 9 variables. The clinical outcome after 2 years showed the visual analog score (VAS) at 2.62 (S.D. ±0.65). The values for the knee injury and osteoarthritis outcome score (KOOS) subgroups were 68.29 (±23.90) for pain, 62.09 (±14.62) for symptoms, 75.45 (±21.91) for ADL function, 52.69 (±28.77) for sport and 70.19 (±22.41) for knee-related quality of life. The clinical scores were correlated with the MRI variables. A statistically significant correlation was found for the variables 'filling of the defect,' 'structure of the repair tissue,' 'changes in the subchondral bone,' and 'signal intensities of the repair issue'. High resolution MRI and well-defined MRI variables are a reliable, reproducible and accurate tool for assessing cartilage repair tissue

  11. Magnetic resonance observation of cartilage repair tissue (MOCART) for the evaluation of autologous chondrocyte transplantation: Determination of interobserver variability and correlation to clinical outcome after 2 years

    Energy Technology Data Exchange (ETDEWEB)

    Marlovits, Stefan [Department of Traumatology, Center for Joint and Cartilage, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria)]. E-mail: stefan.marlovits@meduniwien.ac.at; Singer, Philipp [Department of Traumatology, Center for Joint and Cartilage, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Zeller, Philip [Department of Traumatology, Center for Joint and Cartilage, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Mandl, Irena [Department of Traumatology, Center for Joint and Cartilage, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria); Haller, Joerg [Department of Radiology, Hanusch Hospital, Heinrich-Collin-Strasse, A-1140 Vienna (Austria); Trattnig, Siegfried [Department of Radiology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna (Austria)

    2006-01-15

    In an observational study, the validity and reliability of magnetic resonance imaging (MRI) for the assessment of autologous chondrocyte transplantation (ACT) in the knee joint was determined. Two years after implantation, high-resolution MRI was used to analyze the repair tissue with nine pertinent variables. A complete filling of the defect was found in 61.5%, and a complete integration of the border zone to the adjacent cartilage in 76.9%. An intact subchondral lamina was present in 84.6% and an intact subchondral bone was present in 61.5%. Isointense signal intensities of the repair tissue compared to the adjacent native cartilage were seen in 92.3%. To evaluate interobserver variability, a reliability analysis with the determination of the intraclass correlation coefficient (ICC) was calculated. An 'almost perfect' agreement, with an ICC value >0.81, was calculated in 8 of 9 variables. The clinical outcome after 2 years showed the visual analog score (VAS) at 2.62 (S.D. {+-}0.65). The values for the knee injury and osteoarthritis outcome score (KOOS) subgroups were 68.29 ({+-}23.90) for pain, 62.09 ({+-}14.62) for symptoms, 75.45 ({+-}21.91) for ADL function, 52.69 ({+-}28.77) for sport and 70.19 ({+-}22.41) for knee-related quality of life. The clinical scores were correlated with the MRI variables. A statistically significant correlation was found for the variables 'filling of the defect,' 'structure of the repair tissue,' 'changes in the subchondral bone,' and 'signal intensities of the repair issue'. High resolution MRI and well-defined MRI variables are a reliable, reproducible and accurate tool for assessing cartilage repair tissue.

  12. Association of heart rate variability with clinical outcome in Parkinsonian patients after subthalamic deep brain stimulation: A retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Shin-Yuan Chen

    2011-09-01

    Conclusion: Our study showed an improvement in autonomic cardiovascular regulation in Parkinsonian patients with >50% improvement in rating scale after STN-DBS, which implied morbidity reduction in nonmotor symptoms among such patients.

  13. Perfiles de organizaciones positivas. Análisis de características percibidas según variables individuales, organizacionales y de resultado (Positive organization profiles. Analysis of perceived characteristics according to individual, organizational, and outcome variables

    Directory of Open Access Journals (Sweden)

    María Laura Lupano Perugini

    2016-08-01

    Full Text Available This study analysed the profiles of organizations based on employee perceptions of their workplace. The sample consisted of 459 Argentinian employees (232 men; average age, 36.3 years (SD = 11.7. The participants worked for public companies (17.2%, n = 79 or private companies (82.6%, n = 379. Most of them lived in Buenos Aires and surrounding areas (96.5%, n = 443. A protocol was used for data collection, in which the participants were asked to report positive and negative characteristics associated with their organization. A content analysis of the answers given by the participants was performed, from which different categories of characteristics were derived (e.g., work climate, commitment, values. Several multiple correspondence analyses were conducted to generate profiles according to individual variables (i.e., gender, age, and position, organizational variables (i.e., size, typology, and type, and outcome variables (i.e., performance and job satisfaction. One of the most significant profiles showed associations between the perception of positive characteristics, such as values and outcomes, and high levels of satisfaction and individual/organizational performance.

  14. Identifying the independent effect of HbA1c variability on adverse health outcomes in patients with Type 2 diabetes.

    Science.gov (United States)

    Prentice, J C; Pizer, S D; Conlin, P R

    2016-12-01

    To characterize the relationship between HbA 1c variability and adverse health outcomes among US military veterans with Type 2 diabetes. This retrospective cohort study used Veterans Affairs and Medicare claims for veterans with Type 2 diabetes taking metformin who initiated a second diabetes medication (n = 50 861). The main exposure of interest was HbA 1c variability during a 3-year baseline period. HbA 1c variability, categorized into quartiles, was defined as standard deviation, coefficient of variation and adjusted standard deviation, which accounted for the number and mean number of days between HbA 1c tests. Cox proportional hazard models predicted mortality, hospitalization for ambulatory care-sensitive conditions, and myocardial infarction or stroke and were controlled for mean HbA 1c levels and the direction of change in HbA 1c levels during the baseline period. Over a mean 3.3 years of follow-up, all HbA 1c variability measures significantly predicted each outcome. Using the adjusted standard deviation measure for HbA 1c variability, the hazard ratios for the third and fourth quartile predicting mortality were 1.14 (95% CI 1.04, 1.25) and 1.42 (95% CI 1.28, 1.58), for myocardial infarction and stroke they were 1.25 (95% CI 1.10, 1.41) and 1.23 (95% CI 1.07, 1.42) and for ambulatory-care sensitive condition hospitalization they were 1.10 (95% CI 1.03, 1.18) and 1.11 (95% CI 1.03, 1.20). Higher baseline HbA 1c levels independently predicted the likelihood of each outcome. In veterans with Type 2 diabetes, greater HbA 1c variability was associated with an increased risk of adverse long-term outcomes, independently of HbA 1c levels and direction of change. Limiting HbA 1c fluctuations over time may reduce complications. © 2016 Diabetes UK.

  15. The validity of the variable "NICU admission" as an outcome measure for neonatal morbidity: a retrospective study

    NARCIS (Netherlands)

    Wiegerinck, Melanie M. J.; Danhof, Nora A.; van Kaam, Anton H.; Tamminga, Pieter; Mol, Ben Willem J.

    2014-01-01

    To determine whether "neonatal intensive care unit (NICU) admission" is a valid surrogate outcome measure to assess neonatal condition in clinical studies. Retrospective study. Tertiary hospital in the Netherlands. Neonates admitted to NICU during a 10-year period. Inclusion was restricted to

  16. Fetal MR imaging of posterior intracranial dural sinus thrombosis: a report of three cases with variable outcomes

    International Nuclear Information System (INIS)

    Byrd, Sharon E.; Elias, Dean; Abramowicz, Jacques S.; Kent, Paul; Kimura, Robert E.; Heydeman, Peter T.

    2012-01-01

    Thrombosis of fetal intracranial dural sinuses is a rare entity. A specific type of midline dural sinus thrombosis (DST) at the torcular Herophili with extension into the superior sagittal sinus (SSS) was initially seen on fetal US and was referred to fetal MRI for definite diagnosis and better delineation. Retrospective comparison to medical literature of three cases, diagnosed at our institution, of midline fetal DST with MR imaging findings and clinical outcomes. We reviewed MRI findings on T2-weighted images of our three cases of fetal midline DST and clinical outcomes of these fetuses and compared our findings to medical literature. The MR imaging and clinical findings of our cases extend over 6 years. They consist of three pregnant women, 31-39 years of age each with a single fetus, with fetal MR imaging performed at different gestational ages (GA). Case 1 the MR imaging was performed at 21 5/7 weeks' GA, case 2 at 24 and 33 4/7 weeks' GA, and case 3 at 22 and 25 weeks' GA. Postnatal MRI was performed in case 2 at 6 months of life and case 3 at 1 day of life. Clinical follow-up occurred during the last 6 years. In all of our cases, T2-W MR imaging demonstrated ballooned midline torcular Herophili with iso- to hypointense mass with or without focal eccentric area of greater hypointensity occupying the torcular Herophili with extension into the SSS. Case 3 had associated leptomeningeal dural vascular malformation overlying the left cerebral hemisphere with development of migrational disorder in the left cerebral hemisphere. Clinical outcome consisted of fetal demise in case 1, normal postnatal outcome in case 2 and severe brain damage with poor postnatal outcome in case 3. Our findings of large iso-hypointense thrombus with or without a focal eccentric area more hypointense to thrombus in a dilated torcular Herophili with extension into the SSS on T2-W images corresponds to the majority of cases of this rare type of DST in the medical literature. (orig.)

  17. Fetal MR imaging of posterior intracranial dural sinus thrombosis: a report of three cases with variable outcomes

    Energy Technology Data Exchange (ETDEWEB)

    Byrd, Sharon E.; Elias, Dean [Rush Medical College and Rush University Medical Center, Department of Diagnostic Radiology and Nuclear Medicine Section of Neuroradiology, Chicago, IL (United States); Abramowicz, Jacques S. [Rush Medical College and Rush University Medical Center, Department of Obstetrics and Gynecology, Rush Fetal and Neonatal Medicine Center, Chicago, IL (United States); Kent, Paul [Rush Medical College and Rush University Medical Center, Department of Pediatrics, Division of Hematology and Oncology, Chicago, IL (United States); Kimura, Robert E. [Rush Medical College and Rush University Medical Center, Department of Pediatrics, Division of Neonatology, Chicago, IL (United States); Heydeman, Peter T. [Rush Medical College and Rush University Medical Center, Department of Pediatrics, Division of Pediatric Neurology, Chicago, IL (United States)

    2012-05-15

    Thrombosis of fetal intracranial dural sinuses is a rare entity. A specific type of midline dural sinus thrombosis (DST) at the torcular Herophili with extension into the superior sagittal sinus (SSS) was initially seen on fetal US and was referred to fetal MRI for definite diagnosis and better delineation. Retrospective comparison to medical literature of three cases, diagnosed at our institution, of midline fetal DST with MR imaging findings and clinical outcomes. We reviewed MRI findings on T2-weighted images of our three cases of fetal midline DST and clinical outcomes of these fetuses and compared our findings to medical literature. The MR imaging and clinical findings of our cases extend over 6 years. They consist of three pregnant women, 31-39 years of age each with a single fetus, with fetal MR imaging performed at different gestational ages (GA). Case 1 the MR imaging was performed at 21 5/7 weeks' GA, case 2 at 24 and 33 4/7 weeks' GA, and case 3 at 22 and 25 weeks' GA. Postnatal MRI was performed in case 2 at 6 months of life and case 3 at 1 day of life. Clinical follow-up occurred during the last 6 years. In all of our cases, T2-W MR imaging demonstrated ballooned midline torcular Herophili with iso- to hypointense mass with or without focal eccentric area of greater hypointensity occupying the torcular Herophili with extension into the SSS. Case 3 had associated leptomeningeal dural vascular malformation overlying the left cerebral hemisphere with development of migrational disorder in the left cerebral hemisphere. Clinical outcome consisted of fetal demise in case 1, normal postnatal outcome in case 2 and severe brain damage with poor postnatal outcome in case 3. Our findings of large iso-hypointense thrombus with or without a focal eccentric area more hypointense to thrombus in a dilated torcular Herophili with extension into the SSS on T2-W images corresponds to the majority of cases of this rare type of DST in the medical literature

  18. It pays to be green. A premature conclusion?

    International Nuclear Information System (INIS)

    Telle, K.

    2006-01-01

    It has been claimed that good environmental performance can improve firms' economic performance. However, because of e.g. data limitations, the methods applied in most previous quantitative empirical studies on effects of environmental performance on economic performance of firms suffer from several shortcomings. We discuss these shortcomings and conclude that previously applied methods are unsatisfactory as support for a conclusion that it pays for firms to be green. Then we illustrate the consequences of these shortcomings by performing several regression analyses of the effect of environmental performance on economic performance using a panel data set of Norwegian plants. A pooled regression where observable firm characteristics like e.g. size or industry are controlled for, confirms a positive effect of environmental performance on economic performance. However, the estimated positive effect could be due to omitted unobserved variables like management or technology. When the regression model controls for unobserved plant heterogeneity, the effect is generally no longer statistically significant. Hence, although greener plants tend to perform economically better, the analysis provides little support for the claim that it is because they are greener. These empirical findings further indicate that a conclusion that it pays to be green is premature

  19. Do resettlement variables predict psychiatric treatment outcomes in a sample of asylum-seeking survivors of torture?

    Science.gov (United States)

    Whitsett, David; Sherman, Martin F

    2017-12-01

    Mental health clinicians who work with asylum seekers provide services to patients who face stressful everyday living conditions. However, little is known about how these problems potentially impact psychiatric treatment within these populations. The purpose of this study was thus to examine whether resettlement factors predict outcomes of a mental health intervention for a sample of asylum-seeking survivors of torture. The study included data from a US outpatient clinic that specialized in treating asylum-seeking survivors of torture. Patients (primarily from Iraq, Afghanistan and African Countries) were evaluated on demographic factors at intake and psychiatric symptoms throughout the course of treatment. Patients experienced significant reductions in depression, anxiety and trauma symptoms, although symptoms still remained near or above clinical thresholds. Stable, uncrowded housing conditions significantly predicted lower depression, anxiety and trauma symptoms at follow-up. These findings support the hypotheses that individuals seeking asylum within the United States who have survived torture can benefit from psychiatric treatment and emphasize the importance of stable living conditions in improving treatment effectiveness. This suggests the need for further research on social predictors of treatment outcomes, as well as the need for clinicians and policymakers to target improved housing as a potentially important tool to reduce psychiatric problems related to torture and forced migration.

  20. Psoriasis and associated variables in classification and outcome of juvenile idiopathic arthritis - an eight-year follow-up study

    DEFF Research Database (Denmark)

    Ekelund, Maria; Aalto, Kristiina; Fasth, Anders

    2017-01-01

    BACKGROUND: To study the impact of psoriasis and features associated with psoriasis on classification and outcome in a population-based follow-up cohort of children with juvenile idiopathic arthritis (JIA). METHODS: In all, 440 children with JIA were followed for a median of 8 years...... in a prospective Nordic population-based cohort study. Data for remission was available for 427 of these children. The presence of psoriasis, psoriasis-like rash, dactylitis, nail pitting, enthesitis, tenosynovitis and heredity was assessed in relation to ILAR classification and remission. RESULTS: Clinical...... findings associated with psoriasis developed consecutively during the 8-year period. Six of 14 children with psoriasis were not classified as juvenile psoriatic arthritis according to the ILAR criteria at 8 year follow-up. Dactylitis was more common in children with early onset of JIA. After 8 years we...

  1. Rothmund-Thomson Syndrome: Insights from New Patients on the Genetic Variability Underpinning Clinical Presentation and Cancer Outcome

    Directory of Open Access Journals (Sweden)

    Elisa A. Colombo

    2018-04-01

    Full Text Available Biallelic mutations in RECQL4 gene, a caretaker of the genome, cause Rothmund-Thomson type-II syndrome (RTS-II and confer increased cancer risk if they damage the helicase domain. We describe five families exemplifying clinical and allelic heterogeneity of RTS-II, and report the effect of pathogenic RECQL4 variants by in silico predictions and transcripts analyses. Complete phenotype of patients #39 and #42 whose affected siblings developed osteosarcoma correlates with their c.[1048_1049del], c.[1878+32_1878+55del] and c.[1568G>C;1573delT], c.[3021_3022del] variants which damage the helicase domain. Literature survey highlights enrichment of these variants affecting the helicase domain in patients with cancer outcome raising the issue of strict oncological surveillance. Conversely, patients #29 and #19 have a mild phenotype and carry, respectively, the unreported homozygous c.3265G>T and c.3054A>G variants, both sparing the helicase domain. Finally, despite matching several criteria for RTS clinical diagnosis, patient #38 is heterozygous for c.2412_2414del; no pathogenic CNVs out of those evidenced by high-resolution CGH-array, emerged as contributors to her phenotype.

  2. Treatment outcome and prognostic variables for local control and survival in patients receiving radical radiotherapy for urinary bladder cancer

    Energy Technology Data Exchange (ETDEWEB)

    Fokdal, Lars; Hoeyer, Morten; Maase, Hans von der [Aarhus Univ. Hospital (Denmark). Dept. of Oncology

    2004-12-01

    The aim of this retrospective study was to analyze the outcome of radical radiotherapy in 292 patients with bladder cancer and to identify prognostic factors for local control and survival. Median age was 72.3 years (range 45-83 years). Median follow up was 66 months (range 18-121 months). All patients were treated by use of a standard 3-field technique with 60 Gy in 30 fractions to the tumor and the bladder. The elective lymph nodes were treated with doses in the range from 46 Gy to 60 Gy. Complete response was obtained in 52% of the patients at 3-month control. However, 41% of all patients with an initial CR developed recurrence during follow-up. The 3-year and 5-year overall survival rate was 31% and 21%, respectively. Performance status, T-stage, macroscopic complete TURB, hydronephrosis, and serum creatinine were independent prognostic factors for overall survival and, thus, important for the selection of patients for curative intended radiotherapy. During radiotherapy acute transient side effects were recorded in 78% of the patients; severe bowel complications were recorded in 9 patients (3%). Following radiotherapy, 10 patients (3%) developed intestinal reactions requiring surgery. Three patients (1%) were cystectomized because of severe radiation reactions in the bladder. At 5-year follow-up, the actuarial risk of complications requiring surgery was 15%. Treatment-related mortality was 2%.

  3. Effects of central nervous system drugs on driving: speed variability versus standard deviation of lateral position as outcome measure of the on-the-road driving test.

    Science.gov (United States)

    Verster, Joris C; Roth, Thomas

    2014-01-01

    The on-the-road driving test in normal traffic is used to examine the impact of drugs on driving performance. This paper compares the sensitivity of standard deviation of lateral position (SDLP) and SD speed in detecting driving impairment. A literature search was conducted to identify studies applying the on-the-road driving test, examining the effects of anxiolytics, antidepressants, antihistamines, and hypnotics. The proportion of comparisons (treatment versus placebo) where a significant impairment was detected with SDLP and SD speed was compared. About 40% of 53 relevant papers did not report data on SD speed and/or SDLP. After placebo administration, the correlation between SDLP and SD speed was significant but did not explain much variance (r = 0.253, p = 0.0001). A significant correlation was found between ΔSDLP and ΔSD speed (treatment-placebo), explaining 48% of variance. When using SDLP as outcome measure, 67 significant treatment-placebo comparisons were found. Only 17 (25.4%) were significant when SD speed was used as outcome measure. Alternatively, for five treatment-placebo comparisons, a significant difference was found for SD speed but not for SDLP. Standard deviation of lateral position is a more sensitive outcome measure to detect driving impairment than speed variability.

  4. Unintended outcomes of farmers' adaptation to climate variability: deforestation and conservation in Calakmul and Maya biosphere reserves

    Directory of Open Access Journals (Sweden)

    Claudia Rodriguez-Solorzano

    2014-06-01

    Full Text Available Minimizing the impact of climate change on farmer livelihoods is crucial, but adaptation efforts may have unintended consequences for ecosystems, with potential impacts on farmers' welfare. Unintended outcomes of climate adaptation strategies have been widely discussed, however, empirical exploration has been neglected. Grounded in scholarship on climate adaptation, environmental governance, social-ecological systems, and land-use change, this paper studies whether farmers' climate adaptation contributes to deforestation or forest conservation. The paper draws on interviews with 353 farmers from 46 communities in Calakmul Biosphere Reserve in Mexico and Maya Biosphere Reserve in Guatemala. Farmers in the area of study have implemented adaptation strategies that people around the world have used for centuries, including migration, diversification, savings, and pooling. The findings show that climate adaptation can increase deforestation or support forest conservation depending on the type of adaptation strategy farmers implement. Saving, based on cattle ranching, is a deforestation-driving strategy. The choice of this strategy is influenced by distance to the commercial and administrative center and cash benefits from the forest. Deforestation can have a negative impact on farmers' welfare, as well as harm biodiversity and contribute to increased climate change. Thus, deforestation-driving adaptation strategies may be ineffective. However, diversification, based on off-farm jobs and operating provision shops, is a conservation-driving strategy influenced by distance as well as by family size. Farmers who choose diversification to adapt may contribute to a virtuous circle in which livelihood improvement in the short term leads to enhanced social-ecological resilience in the longer term. The need for farmers to implement adaptation strategies thus represents great risk but also opportunities.

  5. Experience by children and adolescents of more than one type of maltreatment: Association of different classes of maltreatment profiles with clinical outcome variables.

    Science.gov (United States)

    Witt, Andreas; Münzer, Annika; Ganser, Helene G; Fegert, Jörg M; Goldbeck, Lutz; Plener, Paul L

    2016-07-01

    Most victims of child abuse have experienced more than one type of maltreatment, yet there is a lack of understanding of the impact of specific combinations of types of maltreatment. This study aimed to identify meaningful classes of maltreatment profiles and to associate them with short-term clinical outcomes. A total of 358 German children and adolescents aged 4-17 with a known history of child maltreatment were included in the study. Through interviews and questionnaires, information was obtained from participants and their primary caregivers on history of maltreatment, sociodemographics, psychopathology, level of psychosocial functioning, and health-related quality of life. Types of abuse were categorized into six major groups: sexual abuse in general, sexual abuse with penetration, physical abuse, emotional abuse, neglect, and exposure to domestic violence. A latent class analysis (LCA) was performed to determine distinct multi-type maltreatment profiles, which were then assessed for their associations with the sociodemographic and clinical outcome variables. The LCA revealed that participants could be categorized into three meaningful classes according to history of maltreatment: (1) experience of multiple types of maltreatment excluding sexual abuse (63.1%), (2) experience of multiple types of maltreatment including sexual abuse (26.5%), and (3) experience of predominantly sexual abuse (10.3%). Members of Class 2 showed significantly worse short-term outcomes on psychopathology, level of functioning, and quality of life compared to the other classes. Three distinct profiles of multiple types of maltreatment were empirically identified in this sample. Exposure to multiple types of abuse was associated with poorer outcomes. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. An exploratory, large-scale study of pain and quality of life outcomes in cancer patients with moderate or severe pain, and variables predicting improvement.

    Science.gov (United States)

    Maximiano, Constanza; López, Iker; Martín, Cristina; Zugazabeitia, Luis; Martí-Ciriquián, Juan L; Núñez, Miguel A; Contreras, Jorge; Herdman, Michael; Traseira, Susana; Provencio, Mariano

    2018-01-01

    There have been few large-scale, real world studies in Spain to assess change in pain and quality of life (QOL) outcomes in cancer patients with moderate to severe pain. This study aimed to assess changes on both outcomes after 3 months of usual care and to investigate factors associated with change in QoL. Large, multi-centre, observational study in patients with lung, head and neck, colorectal or breast cancer experiencing a first episode of moderate to severe pain while attending one of the participating centres. QoL was assessed using the EuroQol-5D questionnaire and pain using the Brief Pain Inventory (BPI). Instruments were administered at baseline and after 3 months of follow up. Multivariate analyses were used to assess the impact of treatment factors, demographic and clinical variables, pain and other symptoms on QoL scores. 1711 patients were included for analysis. After 3 months of usual care, a significant improvement was observed in pain and QoL in all four cancer groups (pbreast cancer patients showed the largest gains. Poorer baseline performance status (ECOG) and the presence of anxiety/depression were associated with significantly poorer QOL outcomes. Improvements in BPI pain scores were associated with improved QoL. In the four cancer types studied, pain and QoL outcomes improved considerably after 3 months of usual care. Improvements in pain made a substantial contribution to QoL gains whilst the presence of anxiety and depression and poor baseline performance status significantly constrained improvement.

  7. Escaping the repugnant conclusion: rank-discounted utilitarianism with variable population

    OpenAIRE

    Asheim, Geir Bjarne; Zuber, Stéphane

    2014-01-01

    We contribute to population ethics by proposing and axiomatizing rank-discounted critical-level generalized utilitarianism (RDCLU). Population ethics is needed for evaluation of policies, e.g., concerning climate change, where population size depends on the chosen policy. We show that critical-level generalized utilitarianism and (a version of) critical-level leximin are the limits of RDCLU for extreme values of the rank utility discount factor. Moreover, we establish how RDCLU avoids serious...

  8. Surgeons and suture zones: Hybridization among four surgeonfish species in the Indo-Pacific with variable evolutionary outcomes

    KAUST Repository

    DiBattista, Joseph; Whitney, Jonathan; Craig, Matthew T.; Hobbs, Jean-Paul A.; Rocha, Luiz A.; Feldheim, Kevin A.; Berumen, Michael L.; Bowen, Brian W.

    2016-01-01

    DNA lineage and species identification based on external morphology, indicating that species integrity may not be eroding. The A. nigricans complex demonstrates a range of outcomes from incomplete speciation to secondary contact to decreasing hybridization with increasing evolutionary depth.

  9. Surgeons and suture zones: Hybridization among four surgeonfish species in the Indo-Pacific with variable evolutionary outcomes.

    Science.gov (United States)

    DiBattista, Joseph D; Whitney, Jonathan; Craig, Matthew T; Hobbs, Jean-Paul A; Rocha, Luiz A; Feldheim, Kevin A; Berumen, Michael L; Bowen, Brian W

    2016-08-01

    species identification based on external morphology, indicating that species integrity may not be eroding. The A. nigricans complex demonstrates a range of outcomes from incomplete speciation to secondary contact to decreasing hybridization with increasing evolutionary depth. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Surgeons and suture zones: Hybridization among four surgeonfish species in the Indo-Pacific with variable evolutionary outcomes

    KAUST Repository

    DiBattista, Joseph

    2016-04-30

    DNA lineage and species identification based on external morphology, indicating that species integrity may not be eroding. The A. nigricans complex demonstrates a range of outcomes from incomplete speciation to secondary contact to decreasing hybridization with increasing evolutionary depth.

  11. New Frontiers in Heart Rate Variability and Social Coherence Research: Techniques, Technologies, and Implications for Improving Group Dynamics and Outcomes

    Directory of Open Access Journals (Sweden)

    Rollin McCraty

    2017-10-01

    Full Text Available Concepts embraced by the term coherence have been identified as central to fields such as quantum physics, physiology, and social science. There are different types of coherence, although the term always implies a harmonious relationship, correlations and connections between the various parts of a system. A specific measure derived from heart rate variability (HRV provides a measure of physiological coherence. Another type of coherence, social coherence, relates to the harmonious alignment between couples or pairs, family units, small groups, or larger organizations in which a network of relationships exists among individuals who share common interests and objectives. A high degree of social coherence is reflected by stable and harmonious relationships, which allows for the efficient flow and utilization of energy and communication required for optimal collective cohesion and action. Social coherence requires that group members are attuned and are emotionally connected with each other, and that the group’s emotional energy is organized and regulated by the group as a whole. A number of studies are reviewed which have explored various types of synchronization in infants, pairs and groups, indicating that feelings of cooperation, trust, compassion and increased prosocial behaviors depends largely on the establishment of a spontaneous synchronization of various physiological rhythms between individuals. This article discusses a new application using HRV monitoring in social coherence research and the importance of physiological synchronization in group developmental processes and dynamics. Building on the extensive body of research showing that providing feedback of HRV coherence level at the individual level can improve self-regulation, we suggest the following hypotheses: (1 providing feedback of individual and collective HRV coherence and the degree of heart rhythm synchronization will increase group coherence, and heart rhythm synchronization

  12. Variable effects of high-dose adrenaline relative to standard-dose adrenaline on resuscitation outcomes according to cardiac arrest duration.

    Science.gov (United States)

    Jeung, Kyung Woon; Ryu, Hyun Ho; Song, Kyung Hwan; Lee, Byung Kook; Lee, Hyoung Youn; Heo, Tag; Min, Yong Il

    2011-07-01

    Adjustment of adrenaline (epinephrine) dosage according to cardiac arrest (CA) duration, rather than administering the same dose, may theoretically improve resuscitation outcomes. We evaluated variable effects of high-dose adrenaline (HDA) relative to standard-dose adrenaline (SDA) on resuscitation outcomes according to CA duration. Twenty-eight male domestic pigs were randomised to the following 4 groups according to the dosage of adrenaline (SDA 0.02 mg/kg vs. HDA 0.2mg/kg) and duration of CA before beginning cardiopulmonary resuscitation (CPR): 6 min SDA, 6 min HDA, 13 min SDA, or 13 min HDA. After the predetermined duration of untreated ventricular fibrillation, CPR was provided. All animals in the 6 min SDA, 6 min HDA, and 13 min HDA groups were successfully resuscitated, while only 4 of 7 pigs in the 13 min SDA group were successfully resuscitated (p=0.043). HDA groups showed higher right atrial pressure, more frequent ventricular ectopic beats, higher blood glucose, higher troponin-I, and more severe metabolic acidosis than SDA groups. Animals of 13 min groups showed more severe metabolic acidosis and higher troponin-I than animals of 6 min groups. All successfully resuscitated animals, except two animals in the 13 min HDA group, survived for 7 days (p=0.121). Neurologic deficit score was not affected by the dose of adrenaline. HDA showed benefit in achieving restoration of spontaneous circulation in 13 min CA, when compared with 6 min CA. However, this benefit did not translate into improved long-term survival or neurologic outcome. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  13. 2015 Army Science Planning and Strategy Meeting Series: Outcomes and Conclusions

    Science.gov (United States)

    2017-12-21

    drawn was the need for a control architecture that simultaneously deals with both global and localized control of single agents, multiagent teams, and...environment. Similarly, liquid infiltration into voids within percolating porous systems (e.g., opal and inverse opal systems) is another broad approach... simultaneously to produce a composite or hybrid structure that has increased functionality. This functionality could be structural, mechanical

  14. Number of objectives and conclusions in dissertations and thesis

    Directory of Open Access Journals (Sweden)

    Liebano Richard Eloin

    2005-01-01

    Full Text Available PURPOSE: To analyze the number of objectives and conclusions presented in dissertations and thesis defended at Federal University of São Paulo - Paulista School of Medicine (UNIFESP - EPM. METHODS: It was realized a search in the master degree dissertations and doctor degree thesis defended at Federal University of São Paulo - Paulista School of Medicine in the years 2002 and 2003 that were found available in the central library of this university. RESULTS: From 723 master dissertations analyzed, 62 (8,57% presented only one objective and one conclusion, 134 (18,53% presented one objective and more than one conclusion and 527 (72,89% had more than one objective and more than one conclusion. From 502 doctor thesis analyzed, 23 (4,58% presented only one objective and one conclusion, 123 (24,50% presented one objective and more than one conclusion and 376 (74,90% had more than one objective and more than one conclusion.. CONCLUSIONS: It wasn't found in researched literature the number of objectives and conclusions a scientific work must have. A highest number of thesis and dissertations presented more than one objective and more than one conclusion.

  15. [Effects of blood glucose control on glucose variability and clinical outcomes in patients with severe acute pancreatitis in intensive care unit].

    Science.gov (United States)

    Wu, Jing; Sun, Qiuhong; Yang, Hua

    2015-05-19

    To explore the effects of blood glucose control on glucose variability and clinical outcomes in patients with severe acute pancreatitis in intensive care unit (ICU). A total of 72 ICU patients with severe acute pancreatitis were recruited and divided randomly into observation and control groups (n = 36 each). Both groups were treated conventionally. And the observation group achieved stable blood glucose at 6.1-8.3 mmol/L with intensive glucose control. The length of ICU and hospital stays, ICU mortality rate, transit operative rate, concurrent infection rate, admission blood glucose, glycosylated hemoglobin, mean insulin dose, mean blood glucose, blood glucose value standard deviation (GLUSD), glycemic liability index (GLUGLI) and mean amplitude of glycemic excursion (GLUMAGE) of two groups were compared. At the same time, the relationship between blood glucose variability, ICU mortality rate and its predictive value were analyzed by correlation analysis and receiver operating characteristic curve (ROC). The lengths of ICU and hospital stays of observation group were all significantly less than those of the control group [(11.7 ± 9.9) vs (15.9 ± 8.02) days, (21.8 ± 10.8) vs (28.2 ± 12.7) days, P blood glucose value and GLUSD of observation group were significantly lower than those of control group [(7.4 ± 1.1) vs (9.6 ± 1.2), (1.8 ± 1.0) vs (2.5 ± 1.3) mmol/L]. The differences were statistically significant (P curve analysis showed that, AUC of GLUGLI was 0.748 and 95% CI 0.551-0.965 (P glucose control in patients with severe acute pancreatitis helps reduce the blood sugar fluctuations, lower the risks of infectious complications and promote the patient rehabilitation. And GLUGLI is positively correlated with ICU mortality rate. It has good predictive values.

  16. Claimed Effects, Outcome Variables and Methods of Measurement for Health Claims on Foods Related to Vision Proposed Under Regulation (EC) 1924/2006

    Science.gov (United States)

    Bedogni, Giorgio; Biasini, Beatrice; Zavaroni, Ivana; Ventura, Marco; Galli, Daniela; Mirandola, Prisco; Vitale, Marco; Bonadonna, Riccardo C.; Passeri, Giovanni

    2018-01-01

    Adequate visual function has a strong impact on the quality of life of people. Several foods and food components have been hypothesized to play a role in the maintenance of normal visual function and in the prevention of eye diseases. Some of these foods/food components have been the object of a request of authorization for use of health claims under Articles 13(5) or 14 of the Regulation (EC) 1924/2006. Most of these requests have received a negative opinion from the European Food Safety Authority (EFSA) due to the choice of inappropriate outcome variables (OVs) and/or methods of measurement (MMs) applied in the studies used to substantiate the claims. This manuscript refers to the collection, collation and critical analysis of OVs and MMs related to vision. Guidance document and requests for authorization of health claims were used to collect OVs and MMs related to vision. A literature review was performed to critically analyse OVs and MMs, with the aim of defining their appropriateness in the context of a specific claimed effect related to vision. The results highlight the importance of adequate choices of OVs and MMs for an effective substantiation of claims related to visual function. PMID:29443929

  17. Quality of life as an outcome variable and a risk factor for total mortality and cardiovascular disease: a study of men born in 1913.

    Science.gov (United States)

    Tibblin, G; Svärdsudd, K; Welin, L; Erikson, H; Larsson, B

    1993-06-01

    To construct a simple assessment of the quality of life that can be used to evaluate medical treatment in light of the need to conserve resources and limit costs. The Göteborg Quality of Life Assessment was constructed in 1973 from the responses of men who were 50 years old at the time of the initial survey (1963) and were re-evaluated 10 years later. The assessment covers 15 factors in the World Health Organization definition of health or well-being, and includes a symptom questionnaire of 30 items relating to the most common elements of physical, mental and social well-being. The assessment was validated by determining the variation in these three principle components of well-being as a function of age. The use of this assessment as an outcome variable for subjects with cardiovascular disease indicated significantly lower quality of life scores, especially with regard to the general well-being, fitness and energy of subjects with hypertension and congestive heart failure compared to subjects without these diseases. When the assessment was evaluated as a risk factor for cardiovascular disease and mortality, the results of univariate analysis showed that health, fitness and appetite were significantly correlated with total mortality, while multivariate analysis indicated that only health was a significant factor.

  18. CSNI/NEA Rasplav seminar 2000. Summary and conclusions

    International Nuclear Information System (INIS)

    2001-01-01

    various boundary conditions were investigated. The work involved a combination of integral and separate effect tests including molten-salt tests to investigate non-eutectic mixtures and the effects of stratification, extension of the material property database to allow interpretation and modelling of the experimental data. The CSNI decided to hold a seminar where the major outcome of the RASPLAV Project could be presented and discussed also in the context of other experienced activities on Severe Accidents. The objectives of the seminar are: - to review the experimental results of the RASPLAV Project; - to exchange information on complementary research; - to discuss the progress made on understanding severe accident progression; - to discuss the applicability to nuclear power plants and use of the results. The Seminar was intended to provide an in-depth review of the RASPLAV Project in terms of the technical capabilities, results and analyses produced during the project execution. The application of the results and their significance for power plant applications were addressed. Relevant results of the complementary research carried out at various laboratories were also presented. The seminar consisted of five sessions organised as follows: - Opening and overview; - Experimental results; - Theoretical Analyses; - Application and complementary research; - Conclusion

  19. CSNI/NEA Rasplav seminar 2000. Summary and conclusions

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2001-01-15

    various boundary conditions were investigated. The work involved a combination of integral and separate effect tests including molten-salt tests to investigate non-eutectic mixtures and the effects of stratification, extension of the material property database to allow interpretation and modelling of the experimental data. The CSNI decided to hold a seminar where the major outcome of the RASPLAV Project could be presented and discussed also in the context of other experienced activities on Severe Accidents. The objectives of the seminar are: - to review the experimental results of the RASPLAV Project; - to exchange information on complementary research; - to discuss the progress made on understanding severe accident progression; - to discuss the applicability to nuclear power plants and use of the results. The Seminar was intended to provide an in-depth review of the RASPLAV Project in terms of the technical capabilities, results and analyses produced during the project execution. The application of the results and their significance for power plant applications were addressed. Relevant results of the complementary research carried out at various laboratories were also presented. The seminar consisted of five sessions organised as follows: - Opening and overview; - Experimental results; - Theoretical Analyses; - Application and complementary research; - Conclusion.

  20. Impact of pretreatment variables on the outcome of 131I therapy with a standardized dose of 150 Gray in Graves' disease

    International Nuclear Information System (INIS)

    Pfeilschifter, J.; Elser, H.; Haufe, S.; Ziegler, R.; Georgi, P.

    1997-01-01

    Aim: We examined the impact of several pretreatment variables on thyroid size and function in 61 patients with Graves' disease one year after a standardized [131[I treatment with 150 Gray. Methods: FT3, FT4, and TSH serum concentrations were determined before and 1.5, 3, 6, and 12 months after therapy. Thyroid size was measured by ultrasound and scintigraphy before and one year after therapy. Results: One year after therapy, 30% of the patients had latent or manifest hyperthyroidism, 24% were euthyroid, and 46% had developed latent or manifest hypothyroidism. Age and initial thyroid volume were major predictors of posttherapeutical thyroid function. Thus, persistent hyperthyroidism was observed in 70% of the patients age 50 years and older with a thyroid size of more than 50 ml. With few exception, thyroid size markedly decreased after therapy. Initial thyroid size and age were also major predictors of posttherapeutical thyroid volume. Thyroid size normalized in all patients younger than 50 years of age, independent from initial thyroid size. Conclusion: Radioiodine treatment with 150 Gray causes a considerable decrease in thyroid size in most patients with Graves' disease. Age and initial thyroid volume are important determinants of thyroid function and size after therapy and should be considered in dose calculation. (orig.) [de

  1. Regret and Responsibility Resolved? Evaluation Ordonez and Connolly's Conclusions.

    NARCIS (Netherlands)

    Zeelenberg, M.; van Dijk, W.W.; Manstead, A.S.R.

    2000-01-01

    T. Connolly, L. D. Ordo;aan;atez, and R. Coughlan (1997, Organizational Behavior and Human Decision Processes, 70, 73-85) argued, on the basis of 5 experiments, that regret need not be related to a sense of responsibility for the regretted outcome. We (M. Zeelenberg, W. W. van Dijk, & A. S. R.

  2. General conclusions regarding the planetary–solar–terrestrial interaction

    Czech Academy of Sciences Publication Activity Database

    Mörner, N.-A.; Tattersall, R.; Solheim, J.-E.; Charvátová, Ivanka; Scafetta, N.; Jelbring, H.; Wilson, I. R.; Salvador, R.; Willson, R. C.; Hejda, Pavel; Soon, W.; Velasco Herrera, V. M.; Humlum, O.; Archibald, D.; Yndestad, H.; Easterbrook, D.; Casey, J.; Gregori, G.; Henriksson, G.

    2013-01-01

    Roč. 1, č. 1 (2013), s. 205-206 ISSN 2195-9242 R&D Projects: GA MŠk OC09070 Institutional support: RVO:67985530 Keywords : solar variability * solar inertial motion * climate change Subject RIV: DE - Earth Magnetism, Geodesy, Geography

  3. Twelve-Month Prostate-Specific Antigen Values and Perineural Invasion as Strong Independent Prognostic Variables of Long-Term Biochemical Outcome After Prostate Seed Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Ding, William, E-mail: billyding888@gmail.com [Department of Radiation Oncology, California Pacific Medical Center, San Francisco, California (United States); Lee, John [Department of Radiation Oncology, California Pacific Medical Center, San Francisco, California (United States); Chamberlain, David [Department of Radiation Oncology, St. Mary' s Regional Medical Center, Reno, Nevada (United States); Cunningham, James [Carson Urology, Carson City, Nevada (United States); Yang Lixi [Department of Radiation Oncology, California Pacific Medical Center, San Francisco, California (United States); Tay, Jonathan [Department of Radiation Oncology, St. Mary' s Regional Medical Center, Reno, Nevada (United States)

    2012-11-15

    Purpose: To determine whether post-treatment prostate-specific antigen (ptPSA) values at 12 months and other clinical parameters predict long-term PSA relapse-free survival (PRFS) following prostate seed brachytherapy. Methods and Materials: Records of 204 hormone-naieve patients with localized adenocarcinoma of the prostate treated at St. Mary's Regional Medical Center in Reno, NV, and at Carson Tahoe Regional Medical Center in Carson City, NV, between 1998 and 2003, using I-125 or Pd-103 seed brachytherapy, were retrospectively analyzed. Treatment planning was done using a preplanned, modified peripheral loading technique. A total of 185 of 204 patients had PSA records at 12 months after implant. Variables included were age, initial pretreatment PSA, Gleason score, T stage, National Comprehensive Cancer Network (NCCN) risk group (RG), perineural invasion (PNI), external beam boost, dose, and ptPSA levels at 12 months with cutpoints at {<=}1, 1.01 to 2.00, 2.01 to 3.00, and >3.00 ng/ml. Results: Median follow-up was 80 months, and median age was 69 years. The numbers of patients stratified by NCCN low, intermediate, and high RG were 110:65:10, respectively. Monotherapy and boost prescription doses were 145 Gy and 110 Gy for I-125, and 125 Gy and 100 Gy for Pd-103 seeds, respectively. The median dose (D90) was 95.4% of the prescribed dose. The 5-year PRFS at the 12-months ptPSA levels of {<=}1, 1.01 to 2.00, 2.01 to 3.00, and >3.00 ng/ml were 98.5%, 85.7%, 61.5%, and 22.2%, respectively. The 10-year PRFS at the 12-months ptPSA levels of {<=}1 and 1.01 to 2.00 ng/ml were 90.5% and 85.7%, respectively. In multivariate analysis, both ptPSA and PNI were significant independent predictors of PRFS. Hazard ratios (HR) for ptPSA levels at {<=}1, 1.01 to 2.00, 2.01 to 3.00, and >3.00 ng/ml at 12 months were 1, 4.96, 27.57, and 65.10, respectively. PNI had an HR of 6.1 (p = 0.009). Conclusions: Presence of PNI and ptPSA values at 12 months are strong prognostic

  4. Twelve-Month Prostate-Specific Antigen Values and Perineural Invasion as Strong Independent Prognostic Variables of Long-Term Biochemical Outcome After Prostate Seed Brachytherapy

    International Nuclear Information System (INIS)

    Ding, William; Lee, John; Chamberlain, David; Cunningham, James; Yang Lixi; Tay, Jonathan

    2012-01-01

    Purpose: To determine whether post-treatment prostate-specific antigen (ptPSA) values at 12 months and other clinical parameters predict long-term PSA relapse-free survival (PRFS) following prostate seed brachytherapy. Methods and Materials: Records of 204 hormone-naïve patients with localized adenocarcinoma of the prostate treated at St. Mary’s Regional Medical Center in Reno, NV, and at Carson Tahoe Regional Medical Center in Carson City, NV, between 1998 and 2003, using I-125 or Pd-103 seed brachytherapy, were retrospectively analyzed. Treatment planning was done using a preplanned, modified peripheral loading technique. A total of 185 of 204 patients had PSA records at 12 months after implant. Variables included were age, initial pretreatment PSA, Gleason score, T stage, National Comprehensive Cancer Network (NCCN) risk group (RG), perineural invasion (PNI), external beam boost, dose, and ptPSA levels at 12 months with cutpoints at ≤1, 1.01 to 2.00, 2.01 to 3.00, and >3.00 ng/ml. Results: Median follow-up was 80 months, and median age was 69 years. The numbers of patients stratified by NCCN low, intermediate, and high RG were 110:65:10, respectively. Monotherapy and boost prescription doses were 145 Gy and 110 Gy for I-125, and 125 Gy and 100 Gy for Pd-103 seeds, respectively. The median dose (D90) was 95.4% of the prescribed dose. The 5-year PRFS at the 12-months ptPSA levels of ≤1, 1.01 to 2.00, 2.01 to 3.00, and >3.00 ng/ml were 98.5%, 85.7%, 61.5%, and 22.2%, respectively. The 10-year PRFS at the 12-months ptPSA levels of ≤1 and 1.01 to 2.00 ng/ml were 90.5% and 85.7%, respectively. In multivariate analysis, both ptPSA and PNI were significant independent predictors of PRFS. Hazard ratios (HR) for ptPSA levels at ≤1, 1.01 to 2.00, 2.01 to 3.00, and >3.00 ng/ml at 12 months were 1, 4.96, 27.57, and 65.10, respectively. PNI had an HR of 6.1 (p = 0.009). Conclusions: Presence of PNI and ptPSA values at 12 months are strong prognostic variables for

  5. Real-world variability in ranibizumab treatment and associated clinical, quality of life, and safety outcomes over 24 months in patients with neovascular age-related macular degeneration: the HELIOS study

    Directory of Open Access Journals (Sweden)

    Rakic JM

    2013-09-01

    < 0.0001. The mean visual acuity increase over baseline at 12 months was not significant (P = 0.08; the decline over baseline at 24 months statistically significant (P = 0.02. Overall, 94.3% of patients showed stable or improved disease at 6 months and 81.5% of patients showed stable or improved disease at 24 months. At 6 months, improvements over baseline were significant for VFQ-25 (P = 0.03 and HUI3 (P = 0.02, but not at 12 months and 24 months. Improvements in VFQ-25 and HUI3 were maintained at 24 months in 38% and 34% of patients, respectively. In total 78 serious adverse events were reported in 40 patients and 77 nonserious adverse events in 34 patients. Nine serious adverse events and nine nonserious adverse events in 14 patients were suspected to be related to ranibizumab treatment. Conclusion: The "real-world" clinical effectiveness of ranibizumab was evidenced by the initial improvements over baseline in visual acuity and quality of life, as well as the maintenance of these outcomes at baseline levels at 24 months, and this was observed under variable treatment conditions. The findings underscore the need for individualized treatment with regular monitoring to achieve optimal vision and quality of life outcomes. Keywords: ranibizumab, age-related macular degeneration, neovascular macular degeneration, visual acuity, visual function, quality of life

  6. Hypothesis, Prediction, and Conclusion: Using Nature of Science Terminology Correctly

    Science.gov (United States)

    Eastwell, Peter

    2012-01-01

    This paper defines the terms "hypothesis," "prediction," and "conclusion" and shows how to use the terms correctly in scientific investigations in both the school and science education research contexts. The scientific method, or hypothetico-deductive (HD) approach, is described and it is argued that an understanding of the scientific method,…

  7. Conclusion Chapters in Doctoral Theses: Some International Findings

    Science.gov (United States)

    Trafford, Vernon; Leshem, Shosh; Bitzer, Eli

    2014-01-01

    This study investigated how candidates claimed to have made an original contribution to knowledge in the conclusion chapters of 100 PhD theses. Documentary analysis was used to discover how this was explained within theses at selected universities in three countries. No other documents were accessed and neither were candidates, supervisors or…

  8. Overview of human health in the Arctic: conclusions and recommendations.

    Science.gov (United States)

    Donaldson, Shawn; Adlard, Bryan; Odland, Jon Øyvind

    2016-01-01

    This article is intended to provide an overview of the key conclusions, knowledge gaps and key recommendations based on the recent 2015 Arctic human health assessment under the Arctic Monitoring and Assessment Program. This assessment was based primarily on data from human health monitoring and research studies and peer-reviewed literature published since the last assessment in 2009.

  9. 20 CFR 901.48 - Proposed findings and conclusions.

    Science.gov (United States)

    2010-04-01

    ... Law Judge, before making his/her decision, shall give the parties a reasonable opportunity to submit... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Proposed findings and conclusions. 901.48 Section 901.48 Employees' Benefits JOINT BOARD FOR THE ENROLLMENT OF ACTUARIES REGULATIONS GOVERNING THE...

  10. Actual Problems of Conclusion and Discharge of Urgent Labour Contracts

    Directory of Open Access Journals (Sweden)

    Shevelyova A. A.

    2013-05-01

    Full Text Available This article is devoted to the consideration of the questions connected with the conclusion and the termination of the urgent labour contract. The author, analyzing judicial practice, allocates the problems of separate regulation of the RF labour legislation enforcement.

  11. Astronaut Preflight Cardiovascular Variables Associated with Vascular Compliance are Highly Correlated with Post-Flight Eye Outcome Measures in the Visual Impairment Intracranial Pressure (VIIP) Syndrome Following Long Duration Spaceflight

    Science.gov (United States)

    Otto, Christian; Ploutz-Snyder, R.

    2015-01-01

    The detection of the first VIIP case occurred in 2005, and adequate eye outcome measures were available for 31 (67.4%) of the 46 long duration US crewmembers who had flown on the ISS since its first crewed mission in 2000. Therefore, this analysis is limited to a subgroup (22 males and 9 females). A "cardiovascular profile" for each astronaut was compiled by examining twelve individual parameters; eleven of these were preflight variables: systolic blood pressure, pulse pressure, body mass index, percentage body fat, LDL, HDL, triglycerides, use of anti-lipid medication, fasting serum glucose, and maximal oxygen uptake in ml/kg. Each of these variables was averaged across three preflight annual physical exams. Astronaut age prior to the long duration mission, and inflight salt intake was also included in the analysis. The group of cardiovascular variables for each crew member was compared with seven VIIP eye outcome variables collected during the immediate post-flight period: anterior-posterior axial length of the globe measured by ultrasound and optical biometry; optic nerve sheath diameter, optic nerve diameter, and optic nerve to sheath ratio- each measured by ultrasound and magnetic resonance imaging (MRI), intraocular pressure (IOP), change in manifest refraction, mean retinal nerve fiber layer (RNFL) on optical coherence tomography (OCT), and RNFL of the inferior and superior retinal quadrants. Since most of the VIIP eye outcome measures were added sequentially beginning in 2005, as knowledge of the syndrome improved, data were unavailable for 22.0% of the outcome measurements. To address the missing data, we employed multivariate multiple imputation techniques with predictive mean matching methods to accumulate 200 separate imputed datasets for analysis. We were able to impute data for the 22.0% of missing VIIP eye outcomes. We then applied Rubin's rules for collapsing the statistical results across our 200 multiply imputed data sets to assess the canonical

  12. Conclusion: imaging in strategy of endocrine diagnosis and therapeutics

    International Nuclear Information System (INIS)

    Mornex, R.

    1995-01-01

    Images in medicine have to help the doctor in a diagnostic or therapeutic aim. The choice must be made in function of pathology or organ as known (it is not necessary to ask for a computed tomography where we know that only an echography can give the answer to the question we ask ), the criteria must stay the best performance for the cheapest price, but the quality of interpretation is a more important thing. It is important to avoid a lot of examinations which do not give better informations but are heavy to endure for the patients. In conclusion, the aim of this kind of proceedings is to assure to the patients who come confidently to us, the best service at the less constraints price without forgetting that a conclusion depends on a given methodological situation and reminding of beside machines we have not to forget the men

  13. Conclusive identification of quantum channels via monogamy of quantum correlations

    International Nuclear Information System (INIS)

    Kumar, Asutosh; Singha Roy, Sudipto; Pal, Amit Kumar; Prabhu, R.; Sen, Aditi; Sen, Ujjwal

    2016-01-01

    We investigate the action of global noise and local channels, namely, amplitude-damping, phase-damping, and depolarizing channels, on monogamy of quantum correlations, such as negativity and quantum discord, in three-qubit systems. We discuss the monotonic and non-monotonic variation, and robustness of the monogamy scores. By using monogamy scores, we propose a two-step protocol to conclusively identify the noise applied to the quantum system, by using generalized Greenberger–Horne–Zeilinger and generalized W states as resource states. We discuss a possible generalization of the results to higher number of parties. - Highlights: • Monogamy score monotonically decays with noise for generalized GHZ state as input. • Non-monotonically decaying monogamy score with noise for generalized W state as input. • Characterizing the dynamics of monogamy score. • Dynamics terminal quantifying robustness of monogamy score against noise. • Conclusively identifying the type of noise using monogamy score.

  14. Conclusive identification of quantum channels via monogamy of quantum correlations

    Energy Technology Data Exchange (ETDEWEB)

    Kumar, Asutosh; Singha Roy, Sudipto; Pal, Amit Kumar [Harish-Chandra Research Institute, Chhatnag Road, Jhunsi, Allahabad 211019 (India); Homi Bhaba National Institute, Training School Complex, Anushaktinagar, Mumbai 400094 (India); Prabhu, R. [Harish-Chandra Research Institute, Chhatnag Road, Jhunsi, Allahabad 211019 (India); Homi Bhaba National Institute, Training School Complex, Anushaktinagar, Mumbai 400094 (India); Department of Physics, Indian Institute of Technology Patna, Bihta 801103, Bihar (India); Sen, Aditi, E-mail: aditi@hri.res.in [Harish-Chandra Research Institute, Chhatnag Road, Jhunsi, Allahabad 211019 (India); Homi Bhaba National Institute, Training School Complex, Anushaktinagar, Mumbai 400094 (India); Sen, Ujjwal [Harish-Chandra Research Institute, Chhatnag Road, Jhunsi, Allahabad 211019 (India); Homi Bhaba National Institute, Training School Complex, Anushaktinagar, Mumbai 400094 (India)

    2016-10-23

    We investigate the action of global noise and local channels, namely, amplitude-damping, phase-damping, and depolarizing channels, on monogamy of quantum correlations, such as negativity and quantum discord, in three-qubit systems. We discuss the monotonic and non-monotonic variation, and robustness of the monogamy scores. By using monogamy scores, we propose a two-step protocol to conclusively identify the noise applied to the quantum system, by using generalized Greenberger–Horne–Zeilinger and generalized W states as resource states. We discuss a possible generalization of the results to higher number of parties. - Highlights: • Monogamy score monotonically decays with noise for generalized GHZ state as input. • Non-monotonically decaying monogamy score with noise for generalized W state as input. • Characterizing the dynamics of monogamy score. • Dynamics terminal quantifying robustness of monogamy score against noise. • Conclusively identifying the type of noise using monogamy score.

  15. Do psychological variables affect early surgical recovery?

    Directory of Open Access Journals (Sweden)

    Michael N Mavros

    Full Text Available BACKGROUND: Numerous studies have examined the effect of psychological variables on surgical recovery, but no definite conclusion has been reached yet. We sought to examine whether psychological factors influence early surgical recovery. METHODS: We performed a systematic search in PubMed, Scopus and PsycINFO databases to identify studies examining the association of preoperative psychological variables or interventions with objectively measured, early surgical outcomes. RESULTS: We identified 16 eligible studies, 15 of which reported a significant association between at least one psychological variable or intervention and an early postoperative outcome. However, most studies also reported psychological factors not influencing surgical recovery and there was significant heterogeneity across the studies. Overall, trait and state anxiety, state anger, active coping, subclinical depression, and intramarital hostility appeared to complicate recovery, while dispositional optimism, religiousness, anger control, low pain expectations, and external locus of control seemed to promote healing. Psychological interventions (guided relaxation, couple support visit, and psychiatric interview also appeared to favor recovery. Psychological factors unrelated to surgical outcomes included loneliness, perceived social support, anger expression, and trait anger. CONCLUSION: Although the heterogeneity of the available evidence precludes any safe conclusions, psychological variables appear to be associated with early surgical recovery; this association could bear important implications for clinical practice. Large clinical trials and further analyses are needed to precisely evaluate the contribution of psychology in surgical recovery.

  16. Biogeochemistry of uranium mill wastes program overview and conclusions

    International Nuclear Information System (INIS)

    Dreesen, D.R.

    1981-05-01

    The major findings and conclusions are summarized for research on uranium mill tailings for the US Department of Energy and the US Nuclear Regulatory Commission. An overview of results and interpretations is presented for investigations of 222 Rn emissions, revegetation of tailings and mine spoils, and trace element enrichment, mobility, and bioavailability. A brief discussion addresses the implications of these findings in relation to tailings disposal technology and proposed uranium recovery processes

  17. Summary and Conclusions. Final chapter of Scholarly Communication for Librarians.

    OpenAIRE

    Morrison, Heather

    2008-01-01

    Summary and Conclusions of Scholarly Communication for Librarians, a book designed to provide librarians at all levels with the basics of how scholarly communication works, an understanding of the academic library as an essential support for scholarly communication, the impact of the decisions librarians make, and emerging roles for libraries and librarians in scholarly communication. Includes major points from all chapters, on: scholarship, scholarly journals, the scholarly publishing indus...

  18. Review conclusions by Ernst and Canter regarding spinal manipulation refuted

    Directory of Open Access Journals (Sweden)

    Evans Roni

    2006-08-01

    Full Text Available Abstract In the April 2006 issue of the Journal of Royal Society of Medicine, Ernst and Canter authored a review of the most recent systematic reviews on the effectiveness of spinal manipulation for any condition. The authors concluded that, except for back pain, spinal manipulation is not an effective intervention for any condition and, because of potential side effects, cannot be recommended for use at all in clinical practice. Based on a critical appraisal of their review, the authors of this commentary seriously challenge the conclusions by Ernst and Canter, who did not adhere to standard systematic review methodology, thus threatening the validity of their conclusions. There was no systematic assessment of the literature pertaining to the hazards of manipulation, including comparison to other therapies. Hence, their claim that the risks of manipulation outweigh the benefits, and thus spinal manipulation cannot be recommended as treatment for any condition, was not supported by the data analyzed. Their conclusions are misleading and not based on evidence that allow discrediting of a large body of professionals using spinal manipulation.

  19. Conclusion of the I.C.T. benchmark exercise

    International Nuclear Information System (INIS)

    Giacometti, A.

    1991-01-01

    The ICT Benchmark exercise made within the RIV working group of ESARDA on reprocessing data supplied by COGEMA for 53 routines reprocessing input batches made of 110 irradiated fuel assemblies from KWO Nuclear Power Plant was finally evaluated. The conclusions are: all seven different ICT methods applied verified the operator data on plutonium within about one percent; anomalies intentionally introduced to the operator data were detected in 90% of the cases; the nature of the introduced anomalies, which were unknown to the participants, was completely resolved for the safeguards relevant cases; the false alarm rate was in a few percent range. The ICT Benchmark results shows that this technique is capable of detecting and resolving anomalies in the reprocessing input data to the order of a percent

  20. The no conclusion intervention for couples in conflict.

    Science.gov (United States)

    Migerode, Lieven

    2014-07-01

    Dealing with difference is central to all couple therapy. This article presents an intervention designed to assist couples in handling conflict. Central to this approach is the acceptance that most conflicts cannot be solved. Couples are in need of a different understanding of couples conflict. This understanding is found in the analysis of love in context and in relational dialectics. Couples are guided through different steps: deciding on the valence of the issue as individuals, helping them decide which differences can be resolved and which issues demand new ways of living with the inevitable, and the introduction in the suggested no conclusion dialogue. This article briefly describes the five day intensive couple therapy program, in which the no intervention is embedded. The theoretical foundation of the intervention, followed by the step by step description of the intervention forms the major part of the article. A case vignette illustrates this approach. © 2012 American Association for Marriage and Family Therapy.

  1. The European Food Consumption Validation Project: conclusions and recommendations

    DEFF Research Database (Denmark)

    de Boer, E. J.; Slimani, N.; van 't Veer, P.

    2011-01-01

    Background/Objectives: To outline and discuss the main results and conclusions of the European Food Consumption Validation (EFCOVAL) Project. Subjects/Methods: The EFCOVAL Project was carried out within the EU Sixth Framework Program by researchers in 11 EU countries. The activities focused on (1...... showed that two non-consecutive EPIC-Soft 24-HDRs are suitable to estimate the usual intake distributions of protein and potassium of European adult populations. The 2-day non-consecutive 24-HDRs in combination with a food propensity questionnaire also appeared to be appropriate to rank individuals...... according to their fish and fruit and vegetable intake in a comparable way in five European centers. Dietary intake of (young) children can be assessed by the combination of EPIC-Soft 24-HDRs and food recording booklets. The EPIC-Soft-standardized method of describing foods is useful to estimate dietary...

  2. The accident at the Harrisburg nuclear reactor - Interim conclusions

    International Nuclear Information System (INIS)

    Yiftah, S.

    1979-07-01

    This work describes the first minutes, first day and first week following the Three Mile Island accident. It shows the failures that occurred and the lessons which should be derived. It is pointed out that the doses of radiation that escaped from the TMI plant were at no time large enough to have had any effect on the 2 million people living on a radius of 80 km from the plant. Although no casualties occurred the Harrisburg accident will create an impulse for a new study and understanding of the nuclear plant safety and might serve as a live safety laboratory. After the TMI accident nuclear plants are already safer, one of the conclusions being that a new planning of the operation room is required, with the operators acquiring a better understanding of what is going on during a nuclear reactor accident. (B.G.)

  3. Workshop on large molten pool heat transfer summary and conclusions

    International Nuclear Information System (INIS)

    1994-01-01

    The CSNI Workshop on Large Molten Heat Transfer held at Grenoble (France) in March 1994 was organised by CSNI's Principal Working Group on the Confinement of Accidental Radioactive Releases (PWG4) with the cooperation of the Principal Working Group on Coolant System Behaviour (FWG2) and in collaboration with the Grenoble Nuclear Research Centre of the French Commissariat a l'Energie Atomique (CEA). Conclusions and recommendations are given for each of the five sessions of the workshops: Feasibility of in-vessel core debris cooling through external cooling of the vessel; Experiments on molten pool heat transfer; Calculational efforts on molten pool convection; Heat transfer to the surrounding water - experimental techniques; Future experiments and ex-vessel studies (open forum discussion)

  4. Jumping to conclusions and the continuum of delusional beliefs.

    Science.gov (United States)

    Warman, Debbie M; Lysaker, Paul H; Martin, Joel M; Davis, Louanne; Haudenschield, Samantha L

    2007-06-01

    The present study examined the jumping to conclusions reasoning bias across the continuum of delusional ideation by investigating individuals with active delusions, delusion prone individuals, and non-delusion prone individuals. Neutral and highly self-referent probabilistic reasoning tasks were employed. Results indicated that individuals with delusions gathered significantly less information than delusion prone and non-delusion prone participants on both the neutral and self-referent tasks, (preferent task (p=.002). Those with delusions and those who were delusion prone reported higher confidence in their performance on the self-referent task than they did the neutral task (p=.02), indicating that high self-reference impacted information processing for individuals in both of these groups. The results are discussed in relation to previous research in the area of probabilistic reasoning and delusions.

  5. Snakebites in French Guiana: Conclusions of an international symposium.

    Science.gov (United States)

    Kallel, Hatem; Hommel, Didier; Mehdaoui, Hossein; Megarbane, Bruno; Resiere, Dabor

    2018-05-01

    A workshop on epidemiology and management of snakebites in French Guiana was performed at Cayenne, French Guiana from September 15 to September 16, 2017, under the auspices of the French Regional Health Agency (ARS) and the Pan American Health Organization (PAHO). The activity was attended by experts from France (Angers, Martinique, French Guiana, Guadeloupe, and Paris), Costa Rica, Brazil, Saint Lucia, and Surinam. The epidemiology, clinical manifestations, clinical grading and the management of snakebite in French Guiana were discussed. The conclusions of this symposium illustrated the urgent need to ensure accessibility of effective and safe polyvalent viperid antivenom in French Guiana. Finally, the results of this symposium have forged ties based on mutual goals and objectives. Copyright © 2018 Elsevier Ltd. All rights reserved.

  6. Conclusions regarding geotechnical acceptability of the WIPP site

    International Nuclear Information System (INIS)

    Weart, W.D.

    1983-01-01

    The Waste Isolation Pilot Plant (WIPP) was authorized by Congress in 1980 as an unlicensed research and development (R and D) facility to demonstrate the safe disposal of radioactive wastes arising from the defense activities and programs of the United States. WIPP is now being constructed in southeast New Mexico, using salt beds about 655 m below the surface of the ground. Construction of the full WIPP facility will not commence until a preliminary underground excavation phase, called Site and Preliminary Design Validation (SPDV), is satisfactorily concluded in the summer of 1983. This SPDV program permits confirmation of subsurface geology, in drifts at planned facility depth that extend for 1555 m in a north-south direction, and in the two vertical shafts that provide access to these drifts. The subsurface studies are nearing completion, and it is therefore appropriate to draw conclusions regarding the geotechnical acceptability of the WIPP site. Four geotechnical elements are discussed: dissolution, deformation, hydrologic regime, and natural resources

  7. Role of blood pressure and other variables in the differential cardiovascular event rates noted in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA)

    DEFF Research Database (Denmark)

    Poulter, Neil R; Wedel, Hans; Dahlöf, Björn

    2005-01-01

    Results of the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA) show significantly lower rates of coronary and stroke events in individuals allocated an amlodipine-based combination drug regimen than in those allocated an atenolol-based combination drug regimen (HR...... 0.86 and 0.77, respectively). Our aim was to assess to what extent these differences were due to significant differences in blood pressures and in other variables noted after randomisation....

  8. Regulatory aspects of management of change - Summary and conclusions

    International Nuclear Information System (INIS)

    2002-01-01

    Nuclear licensees are increasingly required to adapt to a more challenging commercial environment as moves to de-regulate electricity markets gather pace. One of the costs that is often perceived as being amenable to control is staffing, and hence there is significant exploration of new strategies for managing staffing levels. This report presents the outputs from a Workshop convened by the Special Experts' Group in Human and Organisational Factors (SEGHOF) of the Committee for the Safety of Nuclear Installations (CSNI) and organised by the UK Nuclear Installations Inspectorate (NII). The purpose of the workshop was to facilitate the exchange of views on, and approaches towards, the regulation of organisational change. The major risks associated with organisational change were discussed, and a range of regulatory challenges was identified for detailed discussion. There was agreement that the licensee must retain the responsibility to manage its own business but that organisational issues should be subject to regulatory scrutiny if they have the potential to impact on safety. The regulator should be able to demonstrate an approach to oversight of organisational change which is valid, transparent and consistent, and should inform the licensee of its expectations in terms of information supplied, communication and timing. The workshop confirmed that there is significant agreement between regulators concerning the need for licensees to put in place arrangements to manage organisational change. There was also broad consensus on what should constitute the elements of a licensee's management of change process. Differing views were evident about the balance between regulatory scrutiny of the process, as opposed to the outcomes of change, which largely represents differing regulatory regimes and philosophies. However, it was acknowledged that the regulator must be capable of taking an early view of the adequacy of proposed changes, rather than monitoring outcomes alone

  9. Physics conclusions in support of ITER W divertor monoblock shaping

    Directory of Open Access Journals (Sweden)

    R.A. Pitts

    2017-08-01

    Full Text Available The key remaining physics design issue for the ITER tungsten (W divertor is the question of monoblock (MB front surface shaping in the high heat flux target areas of the actively cooled targets. Engineering tolerance specifications impose a challenging maximum radial step between toroidally adjacent MBs of 0.3mm. Assuming optical projection of the parallel heat loads, magnetic shadowing of these edges is required if quasi-steady state melting is to be avoided under certain conditions during burning plasma operation and transiently during edge localized mode (ELM or disruption induced power loading. An experiment on JET in 2013 designed to investigate the consequences of transient W edge melting on ITER, found significant deficits in the edge power loads expected on the basis of simple geometric arguments, throwing doubt on the understanding of edge loading at glancing field line angles. As a result, a coordinated multi-experiment and simulation effort was initiated via the International Tokamak Physics Activity (ITPA and through ITER contracts, aimed at improving the physics basis supporting a MB shaping decision from the point of view both of edge power loading and melt dynamics. This paper reports on the outcome of this activity, concluding first that the geometrical approximation for leading edge power loading on radially misaligned poloidal leading edges is indeed valid. On this basis, the behaviour of shaped and unshaped monoblock surfaces under stationary and transient loads, with and without melting, is compared in order to examine the consequences of melting, or power overload in context of the benefit, or not, of shaping. The paper concludes that MB top surface shaping is recommended to shadow poloidal gap edges in the high heat flux areas of the ITER divertor targets.

  10. Summary of the discussion, Conclusion of the meeting

    International Nuclear Information System (INIS)

    Crutzen, S.

    1997-01-01

    The discussion was organised in three major periods corresponding to the main themes developed by the programme of the meeting: the qualification approaches, the qualification experience accumulated so far, one particular frame or motivation of the ISI qualification: the risk based (or informed) ISI. The qualification approaches presented by national representatives raised few questions. More discussion was induced on the qualification concepts, responsibilities, need and writing of the technical justification, motivation for the open trials, similitude between concepts, benefit deriving from the qualification of inspection procedures and further motivation. the conclusion could be as the following: the evolution of qualification applications, even if issued from harmonised concepts, appears to be nationalistically based. It is a thought that emulation and harmonisation could actually produce both savings and improvements in this area. 'The wheel does not have to be re-invented in each country' and it is the declared objective of ENIQ. There seems to be a need for some international agreement in the setting of standards for qualification. One area which seems to continue to be of underlying concern is in the characterisation of defects. There seems to be a need for appropriate 'defected blocks' satisfying the criteria of representativeness, quality, low cost, reproducibility, etc. More specific cases of Technical Justification development are needed to serve as examples and incentive for the case of this element of inspection qualification

  11. Medical irradiation of children. Beware of too fast conclusion

    International Nuclear Information System (INIS)

    Brisse, H.; Sirinelli, D.; Adamsbaum, C.; Chateil, J.F.; Claudon, M.; Geoffray, A.; Petit, P.; Rausin, L.; Panuel, M.

    2004-01-01

    The publication in january 2004 in the British medical journal of the article of P. Hall and coll. 'Effect of low doses of ionizing irradiation in infancy on cognitive function in adulthood: Swedish population based cohort study, has been noticed by the Radiation protection group of the French speaking society of pediatrics imaging. The authors evaluate the psycho-motor development of less eighteen months years old children and irradiated between 1930 and 1959 for a face angioma. They study for each dose of irradiation ( from 0 to 250 m Gy) the level of school attendance and their results to the psycho-motor tests made during conscription medical examination. They noticed a diminution of 50% of the access success rate to university for the children having received an irradiation dose of 250 mG. No effect is noticed under the irradiation dose of 100 mGy. In their conclusions the authors compare these irradiation doses to these ones delivered in brain scanner examination. These results seem overestimated compared with the work made on fetuses ( publication 84 of ICRP) then the fetus is considered as more sensitive to ionizing radiations than the infant. The dose of 120 mGy is found in the literature and now the dose delivered in pediatrics are in the area of 0 and 100 mGy where no effect has been revealed in the cohort of irradiated children. The article does not include the principle of justification that is used nowadays and the replacement by the trans fontanel echography has allowed to reduce the number of brain scanner, used only for limited cases where the benefit is superior the the risk of irradiation. (N.C.)

  12. Plurihormonal cells of normal anterior pituitary: Facts and conclusions

    Science.gov (United States)

    Mitrofanova, Lubov B.; Konovalov, Petr V.; Krylova, Julia S.; Polyakova, Victoria O.; Kvetnoy, Igor M.

    2017-01-01

    Introduction plurihormonality of pituitary adenomas is an ability of adenoma cells to produce more than one hormone. After the immunohistochemical analysis had become a routine part of the morphological study, a great number of adenomas appeared to be multihormonal in actual practice. We hypothesize that the same cells of a normal pituitary gland releases several hormones simultaneously. Objective To analyse a possible co-expression of hormones by the cells of the normal anterior pituitary of adult humans in autopsy material. Materials and methods We studied 10 pituitary glands of 4 women and 6 men with cardiovascular and oncological diseases. Double staining immunohistochemistry using 11 hormone combinations was performed in all the cases. These combinations were: prolactin/thyroid-stimulating hormone (TSH), prolactin/luteinizing hormone (LH), prolactin/follicle-stimulating hormone (FSH), prolactin/adrenocorticotropic hormone (ACTH), growth hormone (GH)/TSH, GH/LH, GH/FSH, GH/ACTH, TSH/LH, TSH/FSH, TSH/ACTH. Laser Confocal Scanning Microscopy with a mixture of primary antibodies was performed in 2 cases. These mixtures were ACTH/prolactin, FSH/prolactin, TSH/prolactin, ACTH/GH, and FSH/GH. Results We found that the same cells of the normal adenohypophysis can co-express prolactin with ACTH, TSH, FSH, LH; GH with ACTH, TSH, FSH, LH, and TSH with ACTH, FSH, LH. The comparison of the average co-expression coefficients of prolactin, GH and TSH with other hormones showed that the TSH co-expression coefficient was significantly the least (9,5±6,9%; 9,6±7,8%; 1,0±1,3% correspondingly). Conclusion Plurihormonality of normal adenohypophysis is an actually existing phenomenon. Identification of different hormones in pituitary adenomas enables to find new ways to improve both diagnostic process and targeted treatment. PMID:28418929

  13. Waste Handling Shaft concrete liner degradation conclusions and recommendations

    International Nuclear Information System (INIS)

    1992-10-01

    The primary function of the Waste Handling Shaft (WHS) at the Waste Isolation Pilot Plant (WIPP) is to permit the transfer of radioactive waste from the surface waste handling building to the underground storage area. It also serves as an intake shaft for small volumes of air during normal storage operations and as an emergency escape route. Part of the construction was the placement of a concrete liner and steel reinforced key in 1984. During a routine shaft inspection in May 1990, some degradation of the WHS concrete liner was observed between the depths of 800 and 900 feet below the ground surface. Detailed investigations of the liner had been carried out by Sandia National Laboratories and by Westinghouse Electric Corporation Waste Isolation Division (WID) through Lankard Materials Laboratory. Observations, reports, and data support the conclusion that the concrete degradation, resulting from attack by chemically aggressive brine, is a localized phenomena. It is the opinion of the WID that the degradation is not considered an immediate or near term concern; this is supported by technical experts. WID recommendations have been made which, when implemented, will ensure an extended liner life. Based on the current assessment of available data and the proposed shaft liner monitoring program described in this report, it is reasonable to assume that the operational life of the concrete shaft liner can safely support the 25-year life of the WIPP. Analysis of data indicates that degradation of the shaft's concrete liner is attributed to chemically aggressive brine seeping through construction joints and shrinkage cracks from behind the liner in and around the 834-foot depth. Chemical and mechanical components of concrete degradation have been identified. Chemical attack is comprised of several stages of concrete alteration. The other component, mechanical degradation, results from the expansive forces of crystals forming in the concrete pore space

  14. The Danish energy crop research and development project - main conclusions

    International Nuclear Information System (INIS)

    Gylling, Morten

    2003-01-01

    Production of energy crops in Denmark is more or less non-existent in Denmark at the time being. However, the need for biomass on the other side of year 2005 exceeds the existing biomass resources and a substantial amount of energy crops will be necessary in order to fulfil the goals in Energy 21. The targeted share of the use of renewable energy sources by year 2030 is approximately 30%. Energy crops are seen as the most important new resource in order to create a balanced input mix of renewable in the energy system. The energy crops are mainly seen as fuel in small and medium sized CHP plants and in the big power plants. The Danish energy crop project consists of three main parts: a demonstration part, a research and development part, and an overall assessment part. Based on the results from the project the following overall conclusions can be made: Seen from a strictly market and production economic point of view energy crops will not be competitive in a foreseeable future, neither as a production for farmers nor as a fuel at the utility companies; The costs per GJ of energy crops are still higher than a GJ of straw; The cost difference between annual and perennial energy crops are slightly in favour of perennials, however the conditions on the individual farms should govern the choice between annual and perennial energy crops; Energy crops must be seen as part of an overall environmental scheme covering both agriculture and the energy sector; Given the right production scheme energy crops can be grown on environmental sensitive areas and on most ground water protection areas; Adding the potential sustainability benefits like reduced nutrient leakage and reduced CO 2 emissions energy crops seem to be a sensible and sustainable solution; Due to different handling, storage and fuel characteristics an all year delivery scheme of energy crops should include a mix of different energy crops to keep overall cost down. (BA)

  15. Guidelines for the Investigation of Mediating Variables in Business Research

    OpenAIRE

    MacKinnon, David P.; Coxe, Stefany; Baraldi, Amanda N.

    2011-01-01

    Business theories often specify the mediating mechanisms by which a predictor variable affects an outcome variable. In the last 30 years, investigations of mediating processes have become more widespread with corresponding developments in statistical methods to conduct these tests. The purpose of this article is to provide guidelines for mediation studies by focusing on decisions made prior to the research study that affect the clarity of conclusions from a mediation study, the statistical mo...

  16. Implementation of severe accident management measures - Summary and conclusions

    International Nuclear Information System (INIS)

    2002-01-01

    implemented in various ways in many plants, but not yet in all plants. A systematic approach, which is based upon a clearly defined decision-making process, is one of the features implemented in many cases. Available means are determined and priorities are set. This approach is made up of strategies intended to become an optimum approach to prevent or mitigate the consequences of beyond-design basis accidents. It is based upon a prepared information package about plant-specific behaviour to be expected in beyond design scenarios. The approaches followed in the different countries do not fit one single pattern. Harmonization, to the extent it is desirable, does not seem feasible at this stage. As a rule, the responsibility of the plant owner for the safety of his plant remains untouched. Also, safety goals may vary between countries. This report presents the general conclusion and recommendations of the workshop and the summaries of the sessions

  17. [Conclusions. The precautionary principle: its advantages and risks].

    Science.gov (United States)

    Tubiana, M

    2000-01-01

    estimation of risks and benefits, the putting into proper perspective the possible risks that can be incurred from any given action, enables the main pitfalls of the precautionary principle to be avoided: the opposition to progress and the refusal of innovation, ever greater bureaucracy, and the waste of funds in the pursuit of an utopian "zero risk". Other drawbacks are more insidious: increased anxiety in the population, the manipulation of opinion by campaigns fomented by commercial or ideological interests, the influencing of practitioners and decision-makers to choose not the best solution but rather the one that will protect them from any future accusations. At the international level, efforts must be made to avoid that the precautionary principle be used for protectionist reasons. Nevertheless, the precautionary principle can have advantages, such as motivating decision-makers in the public or private sector to explain and quantify their reasoning, and to give objective information. However, the medical practitioner should not be tempted to ask that documents be signed as proof of the information given. This example underlines the possible dangers of the strict application of the law in certain cases and the importance of the role of jurisprudence. The precautionary principle will also impose new obligations on the State, which also must conform to the requirements of proportionality between risk and action, transparency and information in the field of care and health. The application of the precautionary principle will require good judgment because the way it is implemented will determine whether its outcome will be for the better or the worse. That is why it is indispensable that jurists, medical practitioners, and scientists work together so that the precautionary principle will be as precisely defined and codified as possible.

  18. Scientific imperatives, clinical implications, and theoretical underpinnings for the investigation of the relationship between genetic variables and patient-reported quality-of-life outcomes

    NARCIS (Netherlands)

    Sprangers, Mirjam A. G.; Sloan, Jeff A.; Barsevick, Andrea; Chauhan, Cynthia; Dueck, Amylou C.; Raat, Hein; Shi, Quiling; van Noorden, Cornelis J. F.; Abernethy, Amy P.; Baas, Frank; Barsevick, Andrea M.; Bartels, Meike; Boomsma, Dorret I.; Bottomley, Andrew; Brundage, Michael; Cella, David; Cleeland, Charles S.; Coens, Corneel; Frost, Marlene H.; Hall, Per; Halyard, Michele Y.; Klepstad, Pål; Martin, Nicholas G.; Miaskowski, Christine; Mosing, Miriam; Movsas, Benjamin; Oliveira, Joao R.; Ordoñana, Juan; Patrick, Donald L.; Pedersen, Nancy L.; Reeve, Bryce; Ropka, Mary E.; Shinozaki, Gen; Singh, Jasvinder A.; Swaab, Dick; Veenhoven, Ruut; Wagner, Gert; Yang, Ping; Zwinderman, Ailko H.

    2010-01-01

    Objectives There is emerging evidence for a genetic basis of patient-reported quality-of-life (QOL) outcomes that can ultimately be incorporated into clinical research and practice. Objectives are (1) to provide arguments for the timeliness of investigating the genetic basis of QOL given the

  19. Cosmological Gamma-Ray Bursts and Hypernovae Conclusively Linked

    Science.gov (United States)

    2003-06-01

    Clearest-Ever Evidence from VLT Spectra of Powerful Event Summary A very bright burst of gamma-rays was observed on March 29, 2003 by NASA's High Energy Transient Explorer (HETE-II) , in a sky region within the constellation Leo. Within 90 min, a new, very bright light source (the "optical afterglow") was detected in the same direction by means of a 40-inch telescope at the Siding Spring Observatory (Australia) and also in Japan. The gamma-ray burst was designated GRB 030329 , according to the date. And within 24 hours, a first, very detailed spectrum of this new object was obtained by the UVES high-dispersion spectrograph on the 8.2-m VLT KUEYEN telescope at the ESO Paranal Observatory (Chile). It allowed to determine the distance as about 2,650 million light-years (redshift 0.1685). Continued observations with the FORS1 and FORS2 multi-mode instruments on the VLT during the following month allowed an international team of astronomers [1] to document in unprecedented detail the changes in the spectrum of the optical afterglow of this gamma-ray burst . Their detailed report appears in the June 19 issue of the research journal "Nature". The spectra show the gradual and clear emergence of a supernova spectrum of the most energetic class known, a "hypernova" . This is caused by the explosion of a very heavy star - presumably over 25 times heavier than the Sun. The measured expansion velocity (in excess of 30,000 km/sec) and the total energy released were exceptionally high, even within the elect hypernova class. From a comparison with more nearby hypernovae, the astronomers are able to fix with good accuracy the moment of the stellar explosion. It turns out to be within an interval of plus/minus two days of the gamma-ray burst. This unique conclusion provides compelling evidence that the two events are directly connected. These observations therefore indicate a common physical process behind the hypernova explosion and the associated emission of strong gamma

  20. ASSOCIATION OF A LYMPHOTOXIN-α VARIABLE SITE rs1041981 WITH DEVELOPMENT OF LONG-TERM UNFAVORABLE OUTCOMES IN PATIENTS WITH ACUTE CORONARY SYNDROME WITHOUT ST-SEGMENT ELEVATION

    Directory of Open Access Journals (Sweden)

    E. A. Shmidt

    2018-01-01

    Full Text Available Lymphotoxin-α (LTA is a major pro-inflammatory cytokine produced at the early stages of vascular inflammation, taking part in the formation of arterial atherosclerosis and development of coronary heart disease. Functional changes in the gene encoding LTA production may influence the development of coronary heart disease with unfavorable progression. However, studies for associations between rs1041981 (C-804A LTA gene variant and development of acute cerebrovascular accidents, myocardial infarction, and severity of coronary atherosclerosis have yielded contradictory results. The purpose of our study was to investigate an association of rs1041981 gene LTA with risk of adverse events within five years of follow-up in the patients with acute coronary syndrome without ST elevation ST (nonST-ACS. 178 patients with nonST-ACS from the Kemerovo Cardiology Center Registry were included into the study. Genotyping of rs1041981 site variable LTA gene was performed by TaqMan technique using an “iCycler iQ” device (BIO-RAD, USA. Results: we have found that the A allele and A/A genotype polymorphism in LTA gene (rs1041981 have been associated with development of adverse cardiovascular events over five years of observation (respective p levels were 0.02 and 0.036. In patients with A/A genotype, the rs1041981 polymorphism in LTA gene was associated with 3.8-fold increase in adverse cardiovascular events, compared to patients having A/C or C/C genotype. Carriage of A allele in LTA gene (rs1041981 doubles the risk of adverse cardiovascular events in patients with nonST-ACS at long observation terms. By means of Kaplan-Meier method, we have determined that survival to the first endpoint occurred more often in carriers of the genotype A/A of LTA gene (rs1041981. The A/A genotype of LTA gene (rs1041981 proved to be more significant (p = 0.016 for development of adverse outcomes, when combining the patients with A/C and C/C genotypes. One may draw a conclusion

  1. OECD/SERENA Project Report. Summary and Conclusions

    International Nuclear Information System (INIS)

    2015-02-01

    The OECD/SERENA Project Integration Report summarises the outcome of a broad range of activities conducted in the framework of the Organisation for Economic Cooperation and Development (OECD) Steam Explosion Resolution for Nuclear Applications Project (OECD/SERENA) to address remaining issues on fuel-coolant interaction (FCI) mechanisms and their effect on ex-vessel steam explosion energetics. The scope the OECD/SERENA project was to resolve uncertainties in the remaining issues and to bring the code capabilities to an adequate level for use in reactor safety applications. This scope was accomplished with the completion of three major tasks: (1) an experimental programme consisting of two sets of steam explosion experiments in two different facilities; (2) an analytical programme consisting of pre-test calculations in support of test specifications and post-test calculations in support of data analysis and code assessment, and also a code benchmark exercise; and (3) a reactor calculation exercise repeating the one performed in the framework of the CSNI/WGAMA SERENA activity performed from 2001 to 2006 (also referred to as SERENA Phase I, published as CSNI/R(2007)/11). The objectives of the experimental programme were to provide data: (1) to clarify the explosion behaviour of prototypic corium melts and for validation of steam explosion models for prototypic materials; and (2) for steam explosion behaviour in two different geometries to verify the geometrical extrapolation capabilities of the codes. These objectives were to be accomplished by conducting complementary sets of six experiments each at two different facilities: KROTOS at the Commissariat l'Energie Atomique et aux Energies Alternatives (CEA) in Cadarache, France, representing one-dimensional FCI configuration involving nominally 5 kilograms of prototypic corium melt, and TROI at Korea Atomic Energy Research Institute (KAERI) in Daejeon, Korea, representing multi-dimensional FCI configuration

  2. Medical irradiation of children. Beware of too fast conclusion; Irradiation medicale de l'enfant. Attention aux conclusions hatives

    Energy Technology Data Exchange (ETDEWEB)

    Brisse, H. [Institut Curie, Dept. d' Imagerie, 75 - Paris (France); Sirinelli, D. [Hopital Clocheville, Service de Radiologie et Echographie, 37 - Tours (France); Adamsbaum, C. [Hopital Saint-Vincent-de-Paul, Service de Radiologie, 75 - Paris (France); Chateil, J.F. [Hopital Pellegrin, Unite de Radiopediatrie, 33 - Bordeaux (France); Claudon, M. [Centre Hospitalier Universitaire Nancy-Hopital Brabois Enfants, Service de Radiologie, 54 - Vandoeuvre-les-Nancy (France); Geoffray, A. [Fondation Lenval, Service de Radiologie, 06 - Nice (France); Petit, P. [Hopital de la Timone, Service de Radiologie, 13 - Marseille (France); Rausin, L. [Centre Hospitalier Regional de la Citadelle, Service de Radiologie, Liege (Belgium); Panuel, M. [Hopital Nord, Service de Radiologie, 13 - Marseille (France)

    2004-10-01

    The publication in january 2004 in the British medical journal of the article of P. Hall and coll. 'Effect of low doses of ionizing irradiation in infancy on cognitive function in adulthood: Swedish population based cohort study, has been noticed by the Radiation protection group of the French speaking society of pediatrics imaging. The authors evaluate the psycho-motor development of less eighteen months years old children and irradiated between 1930 and 1959 for a face angioma. They study for each dose of irradiation ( from 0 to 250 m Gy) the level of school attendance and their results to the psycho-motor tests made during conscription medical examination. They noticed a diminution of 50% of the access success rate to university for the children having received an irradiation dose of 250 mG. No effect is noticed under the irradiation dose of 100 mGy. In their conclusions the authors compare these irradiation doses to these ones delivered in brain scanner examination. These results seem overestimated compared with the work made on fetuses ( publication 84 of ICRP) then the fetus is considered as more sensitive to ionizing radiations than the infant. The dose of 120 mGy is found in the literature and now the dose delivered in pediatrics are in the area of 0 and 100 mGy where no effect has been revealed in the cohort of irradiated children. The article does not include the principle of justification that is used nowadays and the replacement by the trans fontanel echography has allowed to reduce the number of brain scanner, used only for limited cases where the benefit is superior the the risk of irradiation. (N.C.)

  3. Reduction in camera-specific variability in [(123)I]FP-CIT SPECT outcome measures by image reconstruction optimized for multisite settings

    DEFF Research Database (Denmark)

    Buchert, Ralph; Kluge, Andreas; Tossici-Bolt, Livia

    2016-01-01

    the Southampton method with binding in the whole brain, occipital cortex or cerebellum as the reference. The correlation between SBR and age was used as the primary quality measure. RESULTS: The fraction of SBR variability explained by age was highest (1) with QSPECT, independently of the reference region, and (2...... as the reference provides more stable quantitative estimates than occipital or cerebellar binding....

  4. Debris impact on emergency coolant recirculation - summary and conclusions

    International Nuclear Information System (INIS)

    Jain, Bhagwat; Hsia, Anthony; Armand, Yves; Mattei, Jean-Marie; Hyvaerinen, Juhani; Maqua, Michael; Puetter, Bernhard; Sandervaag, Oddbjoern; Vandewalle, Andre; Tombuyses, Beatrice; Pyy, Pekka; Royen, Jacques

    2004-01-01

    to two orders of magnitude because of strainer clogging. Consequently, the CSNI decided to continue its previous efforts in the area. The overall purpose of the 2004 Workshop was to discuss the impact of new information made available since 1996 and to promote consensus among member countries on identification of remaining technical issues important to safety, and on possible paths for their resolution. The specific purposes of the Workshop were: a. To review the knowledge base and in particular information developed after 1999, and to consider the validity of the conclusions drawn. b. To exchange information on the current status of research related to debris generation, debris transportation, and sump strainer clogging and penetration phenomena, in particular for PWRs, and to assess uncertainties. c. To exchange and disseminate information on recent and current activities and practices in these areas. d. To identify and discuss differences between approaches relevant to reactor safety. e. To identify technical issues and programs of interest for international collaborative research and develop an Action Plan outlining activities that CSNI should undertake in the area of strainer or sump screen clogging during the next few years. Summary of the main findings: a. The safety significance of the sump strainer clogging depends on the plant design (e.g. sump strainer, ECCS) and backfitting measures performed. b. The following are examples of PWR design features that could influence the debris impact on the ECCS sump performance: - Type of insulation (material, combination of materials, protection). - Break size to be postulated. - Transport in containment with or without containment spray system (CSS). - Degree of turbulence and flow velocities in the sump influenced by CSS, water level, break flow location and sump geometry. - Redundancy of sumps and residual heat removal system (RHRS). - Strainer design (area, mesh size). - Positioning of recirculation pumps and vortex

  5. The Alaska earthquake, March 27, 1964: lessons and conclusions

    Science.gov (United States)

    Eckel, Edwin B.

    1970-01-01

    local waves. Better earthquake-hazard maps, based on improved knowledge of regional geology, fault behavior, and earthquake mechanisms, are needed for the entire country. Their preparation will require the close collaboration of engineers, seismologists, and geologists. Geologic maps of all inhabited places in earthquake-prone parts of the country are also needed by city planners and others, because the direct relationship between local geology and potential earthquake damage is now well understood. Improved and enlarged nets of earthquake-sensing instruments, sited in relation to known geology, are needed, as are many more geodetic and hydrographic measurements. Every large earthquake, wherever located, should be regarded as a full-scale laboratory experiment whose study can give scientific and engineering information unobtainable from any other source. Plans must be made before the event to insure staffing, funding, and coordination of effort for the scientific and engineering study of future earthquakes. Advice of earth scientists and engineers should be used in the decision-making processes involved in reconstruction after any future disastrous earthquake, as was done after the Alaska earthquake. The volume closes with a selected bibliography and a comprehensive index to the entire series of U.S. Geological Survey Professional Papers 541-546. This is the last in a series of six reports that the U.S. Geological Survey published on the results of a comprehensive geologic study that began, as a reconnaissance survey, within 24 hours after the March 27, 1964, Magnitude 9.2 Great Alaska Earthquake and extended, as detailed investigations, through several field seasons. The 1964 Great Alaska earthquake was the largest earthquake in the U.S. since 1700. Professional Paper 546, in 1 part, describes Lessons and Conclusions.

  6. Regret and Responsibility Resolved? Evaluating Ordóñez and Connolly's (2000) Conclusions.

    Science.gov (United States)

    Zeelenberg; van Dijk WW; Manstead

    2000-01-01

    T. Connolly, L. D. Ordo;aan;atez, and R. Coughlan (1997, Organizational Behavior and Human Decision Processes, 70, 73-85) argued, on the basis of 5 experiments, that regret need not be related to a sense of responsibility for the regretted outcome. We (M. Zeelenberg, W. W. van Dijk, & A. S. R. Manstead, 1998, Organizational Behavior and Human Decision Processes, 74, 254-272) showed in 2 experiments that this conclusion was premature, because it was based on an indirect measure of regret (i.e., overall happiness with the decision outcome). When regret was directly measured, the predicted effects of responsibility were found. L. D. Ordo;aan;atez and T. Connolly (2000, Organizational Behavior and Human Decision Processes, 81, 132-142) replicated our findings in 2 experiments. Based on their findings they arrived at 4 conclusions. In this rejoinder we first discuss Ordóñez and Connolly's new studies and we then discuss the validity of their 4 conclusions. Copyright 2000 Academic Press.

  7. Evaluation of plasma lactate concentration and base excess at the time of hospital admission as predictors of gastric necrosis and outcome and correlation between those variables in dogs with gastric dilatation-volvulus: 78 cases (2004-2009).

    Science.gov (United States)

    Beer, Kari A Santoro; Syring, Rebecca S; Drobatz, Kenneth J

    2013-01-01

    To determine the correlation between plasma lactate concentration and base excess at the time of hospital admission and evaluate each variable as a predictor of gastric necrosis or outcome in dogs with gastric dilatation-volvulus (GDV). Retrospective case series. 78 dogs. For each dog, various data, including plasma lactate concentration and base excess at the time of hospital admission, surgical or necropsy findings, and outcome, were collected from medical records. Gastric necrosis was identified in 12 dogs at the time of surgery and in 4 dogs at necropsy. Sixty-five (83%) dogs survived to hospital discharge, whereas 13 (17%) dogs died or were euthanized. Of the 65 survivors and 8 nonsurvivors that underwent surgery, gastric necrosis was detected in 8 and 4 dogs, respectively. Via receiver operating characteristic curve analysis, an initial plasma lactate concentration cutoff of 7.4 mmol/L was 82% accurate for predicting gastric necrosis (sensitivity, 50%; specificity, 88%) and 88% accurate for predicting outcome (sensitivity, 75%; specificity, 89%). Among all dogs, the correlation between initial plasma lactate concentration and base excess was significant, although base excess was a poor discriminator for predicting gastric necrosis or outcome (area under the receiver operating characteristic curve, 0.571 and 0.565, respectively). In dogs with GDV, plasma lactate concentration at the time of hospital admission was a good predictor of gastric necrosis and outcome. However, despite the correlation between initial base excess and plasma lactate concentration, base excess should not be used for prediction of gastric necrosis or outcome in those patients.

  8. Reinforcing Saccadic Amplitude Variability

    Science.gov (United States)

    Paeye, Celine; Madelain, Laurent

    2011-01-01

    Saccadic endpoint variability is often viewed as the outcome of neural noise occurring during sensorimotor processing. However, part of this variability might result from operant learning. We tested this hypothesis by reinforcing dispersions of saccadic amplitude distributions, while maintaining constant their medians. In a first experiment we…

  9. 5. Conclusion

    OpenAIRE

    Beerli, Monique Jo

    2013-01-01

    Attracted by conflict and war, starvation and disease, natural disasters and underdevelopment, discrimination and injustice, solidarity organizations and their supporters engage themselves in struggles for the acquisition of benefits that they themselves will not receive. In the absence of political solutions addressing the demands of a given people, non-state actors are capable of appropriating functions and responsibilities upon themselves which the state is unwilling or unable to perform. ...

  10. Conclusion conference

    International Nuclear Information System (INIS)

    Tubiana, M.

    1997-01-01

    Radioactive isotopes are the basis of spectacular advancements in biology, but also in medicine, not only indirectly with progress in disease and human body understanding, but also directly through nuclear medicine and radiotherapy. The important role of the Cea in the development of French radiotherapy, dosimetry and radioactive isotopes (especially cobalt) is reviewed

  11. A Pilot Assessment of Ethnic Differences in Cosmetic Outcomes following Breast Conservation Therapy

    Directory of Open Access Journals (Sweden)

    Elliot M. Hirsch, MD

    2014-01-01

    Conclusions: Although generalizing the results of this study is limited by the small sample size, it seems that there is a difference in the perception of cosmetic outcomes between white and African American patients. The novel techniques of cosmetic evaluation used in this study show promise toward identifying variables that can affect cosmetic outcome following BCT.

  12. Genetic polymorphisms of antioxidant enzymes CAT and SOD affect the outcome of clinical, biochemical, and anthropometric variables in people with obesity under a dietary intervention.

    Science.gov (United States)

    Hernández-Guerrero, César; Parra-Carriedo, Alicia; Ruiz-de-Santiago, Diana; Galicia-Castillo, Oscar; Buenrostro-Jáuregui, Mario; Díaz-Gutiérrez, Carmen

    2018-01-01

    Genetic polymorphisms of antioxidant enzymes CAT, GPX, and SOD are involved in the etiology of obesity and its principal comorbidities. The aim of the present study was to analyze the effect of aforementioned SNPs over the output of several variables in people with obesity after a nutritional intervention. The study included 92 Mexican women, which received a dietary intervention by 3 months. Participants were genotyped and stratified into two groups: (1) carriers; mutated homozygous plus heterozygous (CR) and (2) homozygous wild type (WT). A comparison between CR and WT was done in clinical (CV), biochemical (BV), and anthropometric variables (AV), at the beginning and at the end of the intervention. Participants ( n  = 92) showed statistically significant differences ( p  T GPX1 (rs1050450), - 251A>G SOD1 (rs2070424), and - 262C>T CAT (rs1001179). (B) Only CR showed statistically changes ( p  T CAT (rs7943316) and 47C>T SOD2 (rs4880). The dietary intervention effect was statistically significantly between the polymorphisms of 47C>T SOD2 and BMI, SBP, TBARS, total cholesterol, and C-LCL ( p  T CAT (rs7943316) and SBP, DBP, total cholesterol, and atherogenic index ( p  CAT enzymes.

  13. Prognostic Predictors of Outcome in an Operative Series in Traumatic Brain Injury Patients

    Directory of Open Access Journals (Sweden)

    Jinn-Rung Kuo

    2011-04-01

    Conclusion: In our preliminary findings, five variables to predict poor outcomes 6 months after TBI were useful. These sensitive variables can be used as a referential guideline in our daily practice to decide whether or not to perform advanced management or avoid decompressive craniectomy.

  14. Total Knee Arthroplasty for Knee Osteoarthritis: Support for a Foregone Conclusion?

    Science.gov (United States)

    Steinhaus, Michael E; Christ, Alexander B; Cross, Michael B

    2017-07-01

    Total knee arthroplasty (TKA) is generally accepted as the definitive treatment for advanced knee arthritis after patients fail nonoperative treatments; however, the safety and efficacy of TKA compared to continued nonoperative treatment has never been proven in high-quality, randomized controlled trials. Recently, a 2015 Danish study published a 12-month follow-up on a cohort of patients randomized to either a TKA or continued nonsurgical management for advanced knee osteoarthritis (OA). The authors reported significantly greater improvement in the TKA group in functional outcome scores such as the overall Knee Injury and Osteoarthritis Outcome Score (KOOS 4 score), the KOOS subscales, EQ-5D descriptive index, and timed get up-and-go and 20-m walk tests; however, patients in the TKA did suffer significantly more serious adverse events (SAE). The authors concluded that TKA combined with additional nonoperative care postoperatively is more efficacious than nonsurgical treatment alone in terms of improving pain, function, and quality of life at 12 months but is associated with more SAE. The purpose of this review is to identify the strengths and weaknesses of this trial, interpret its outcomes within the context of prior literature, and evaluate the validity of its conclusions.

  15. Variables influencing wearable sensor outcome estimates in individuals with stroke and incomplete spinal cord injury: a pilot investigation validating two research grade sensors.

    Science.gov (United States)

    Jayaraman, Chandrasekaran; Mummidisetty, Chaithanya Krishna; Mannix-Slobig, Alannah; McGee Koch, Lori; Jayaraman, Arun

    2018-03-13

    Monitoring physical activity and leveraging wearable sensor technologies to facilitate active living in individuals with neurological impairment has been shown to yield benefits in terms of health and quality of living. In this context, accurate measurement of physical activity estimates from these sensors are vital. However, wearable sensor manufacturers generally only provide standard proprietary algorithms based off of healthy individuals to estimate physical activity metrics which may lead to inaccurate estimates in population with neurological impairment like stroke and incomplete spinal cord injury (iSCI). The main objective of this cross-sectional investigation was to evaluate the validity of physical activity estimates provided by standard proprietary algorithms for individuals with stroke and iSCI. Two research grade wearable sensors used in clinical settings were chosen and the outcome metrics estimated using standard proprietary algorithms were validated against designated golden standard measures (Cosmed K4B2 for energy expenditure and metabolic equivalent and manual tallying for step counts). The influence of sensor location, sensor type and activity characteristics were also studied. 28 participants (Healthy (n = 10); incomplete SCI (n = 8); stroke (n = 10)) performed a spectrum of activities in a laboratory setting using two wearable sensors (ActiGraph and Metria-IH1) at different body locations. Manufacturer provided standard proprietary algorithms estimated the step count, energy expenditure (EE) and metabolic equivalent (MET). These estimates were compared with the estimates from gold standard measures. For verifying validity, a series of Kruskal Wallis ANOVA tests (Games-Howell multiple comparison for post-hoc analyses) were conducted to compare the mean rank and absolute agreement of outcome metrics estimated by each of the devices in comparison with the designated gold standard measurements. The sensor type, sensor location

  16. Provider volume and outcomes for oncological procedures.

    LENUS (Irish Health Repository)

    Killeen, S D

    2012-02-03

    BACKGROUND: Oncological procedures may have better outcomes if performed by high-volume providers. METHODS: A review of the English language literature incorporating searches of the Medline, Embase and Cochrane collaboration databases was performed. Studies were included if they involved a patient cohort from 1984 onwards, were community or population based, and assessed health outcome as a dependent variable and volume as an independent variable. The studies were also scored quantifiably to assess generalizability with respect to any observed volume-outcome relationship and analysed according to organ system; numbers needed to treat were estimated where possible. RESULTS: Sixty-eight relevant studies were identified and a total of 41 were included, of which 13 were based on clinical data. All showed either an inverse relationship, of variable magnitude, between provider volume and mortality, or no volume-outcome effect. All but two clinical reports revealed a statistically significant positive relationship between volume and outcome; none demonstrated the opposite. CONCLUSION: High-volume providers have a significantly better outcome for complex cancer surgery, specifically for pancreatectomy, oesphagectomy, gastrectomy and rectal resection.

  17. Intermediate Term (3-6 Years Post Surgery) Outcome of ...

    African Journals Online (AJOL)

    Post-operatively, the 5 eyes had VA ranging from 6/60 to NLP, after a variable follow-up period of 3-6 years. Complications included development of tough vascularized retroprosthetic membrane (4 eyes) and infective endophthalmitis in one eye. Conclusion: The intermediate-term outcome of keratoprosthesis surgery in ...

  18. Variable mechanical ventilation.

    Science.gov (United States)

    Fontela, Paula Caitano; Prestes, Renata Bernardy; Forgiarini, Luiz Alberto; Friedman, Gilberto

    2017-01-01

    To review the literature on the use of variable mechanical ventilation and the main outcomes of this technique. Search, selection, and analysis of all original articles on variable ventilation, without restriction on the period of publication and language, available in the electronic databases LILACS, MEDLINE®, and PubMed, by searching the terms "variable ventilation" OR "noisy ventilation" OR "biologically variable ventilation". A total of 36 studies were selected. Of these, 24 were original studies, including 21 experimental studies and three clinical studies. Several experimental studies reported the beneficial effects of distinct variable ventilation strategies on lung function using different models of lung injury and healthy lungs. Variable ventilation seems to be a viable strategy for improving gas exchange and respiratory mechanics and preventing lung injury associated with mechanical ventilation. However, further clinical studies are necessary to assess the potential of variable ventilation strategies for the clinical improvement of patients undergoing mechanical ventilation.

  19. The 2015 Dietary Guidelines Advisory Committee Scientific Report: Development and Major Conclusions.

    Science.gov (United States)

    Millen, Barbara E; Abrams, Steve; Adams-Campbell, Lucile; Anderson, Cheryl Am; Brenna, J Thomas; Campbell, Wayne W; Clinton, Steven; Hu, Frank; Nelson, Miriam; Neuhouser, Marian L; Perez-Escamilla, Rafael; Siega-Riz, Anna Maria; Story, Mary; Lichtenstein, Alice H

    2016-05-01

    The Dietary Guidelines for Americans (DGA) is published every 5 y jointly by the Department of Health and Human Services (HHS) and the USDA and provides a framework for US-based food and nutrition programs, health promotion and disease prevention initiatives, and research priorities. Summarized in this report are the methods, major conclusions, and recommendations of the Scientific Report of the 2015 US Dietary Guidelines Advisory Committee (DGAC). Early in the process, the DGAC developed a conceptual model and formulated questions to examine nutritional risk and determinants and impact of dietary patterns in relation to numerous health outcomes among individuals aged ≥2 y. As detailed in the report, an expansive, transparent, and comprehensive process was used to address each question, with multiple opportunities for public input included. Consensus was reached on all DGAC's findings, including each conclusion and recommendation, and the entire report. When research questions were answered by original systematic literature reviews and/or with existing, high-quality expert reports, the quality and strength of the evidence was formally graded. The report was organized around the following 5 themes: 1) food and nutrient intakes and health: current status and trends; 2) dietary patterns, foods and nutrients, and health outcomes; 3) diet and physical activity behavior change; 4) food and physical activity environments; and 5) food sustainability and food safety. The following 3 cross-cutting topics were addressed: 1) sodium, 2) saturated fat, and 3) added sugars. Physical activity recommendations from recent expert reports were endorsed. The overall quality of the American diet was assessed to identify overconsumed and underconsumed nutrients of public health concern. Common food characteristics of healthy dietary patterns were determined. Features of effective interventions to change individual and population diet and physical activity behaviors in clinical, public

  20. Claimed effects, outcome variables and methods of measurement for health claims on foods proposed under European Community Regulation 1924/2006 in the area of appetite ratings and weight management.

    Science.gov (United States)

    Martini, Daniela; Biasini, Beatrice; Rossi, Stefano; Zavaroni, Ivana; Bedogni, Giorgio; Musci, Marilena; Pruneti, Carlo; Passeri, Giovanni; Ventura, Marco; Galli, Daniela; Mirandola, Prisco; Vitale, Marco; Dei Cas, Alessandra; Bonadonna, Riccardo C; Del Rio, Daniele

    2018-06-01

    All the requests for authorisation to bear health claims under Articles 13(5) and 14 in the context of appetite ratings and weight management have received a negative opinion by the European Food Safety Authority (EFSA), mainly because of the insufficient substantiation of the claimed effects (CEs). This manuscript results from an investigation aimed to collect, collate and critically analyse the information related to outcome variables (OVs) and methods of measurement (MMs) in the context of appetite ratings and weight management compliant with Regulation 1924/2006. Based on the literature review, the appropriateness of OVs and MMs was evaluated for specific CEs. This work might help EFSA in the development of updated guidance addressed to stakeholders interested in bearing health claims in the area of weight management. Moreover, it could drive the applicants during the design of randomised controlled trials aimed to substantiate such claims.

  1. Status of maintenance in the US nuclear power industry 1985. Volume 1. Findings and conclusions

    International Nuclear Information System (INIS)

    1986-06-01

    This report presents the findings, conclusions and recommendations derived from activities performed under Phase I of the NRC Maintenance and Surveillance Program (MSP). Findings are based on trends and patterns derived from operational data compiled by the NRC for the period 1980 through 1985, site surveys conducted at eight plants, and questionnaires administered to NRC Resident Inspectors to characterize nuclear power plant maintenance programs and practices. These activities have shown that plant maintenance programs and practices are highly variable from plant-to-plant and are currently undergoing major changes. While measured plant performance has improved overall since 1980, the maintenance-related contribution to reportable events and challenges to safety systems remains high and is increasing by some measures. The findings of Phase I of the MSP confirmed a number of problems in nuclear power plant maintenance which warrant further NRC and industry attention

  2. Controversies and research agenda in nephropathic cystinosis: conclusions from a "Kidney Disease: Improving Global Outcomes" (KDIGO) Controversies Conference

    NARCIS (Netherlands)

    Langman, C.B.; Barshop, B.A.; Deschenes, G.; Emma, F.; Goodyer, P.; Lipkin, G.; Midgley, J.P.; Ottolenghi, C.; Servais, A.; Soliman, N.A.; Thoene, J.G.; Levtchenko, E.N.; Janssen, M.C.H.; Heuvel, L.P.W.J. van den

    2016-01-01

    Nephropathic cystinosis is an autosomal recessive metabolic, lifelong disease characterized by lysosomal cystine accumulation throughout the body that commonly presents in infancy with a renal Fanconi syndrome and, if untreated, leads to end-stage kidney disease (ESKD) in the later childhood years.

  3. Variability Bugs:

    DEFF Research Database (Denmark)

    Melo, Jean

    . Although many researchers suggest that preprocessor-based variability amplifies maintenance problems, there is little to no hard evidence on how actually variability affects programs and programmers. Specifically, how does variability affect programmers during maintenance tasks (bug finding in particular......)? How much harder is it to debug a program as variability increases? How do developers debug programs with variability? In what ways does variability affect bugs? In this Ph.D. thesis, I set off to address such issues through different perspectives using empirical research (based on controlled...... experiments) in order to understand quantitatively and qualitatively the impact of variability on programmers at bug finding and on buggy programs. From the program (and bug) perspective, the results show that variability is ubiquitous. There appears to be no specific nature of variability bugs that could...

  4. We've looked at care from both sides now: the effects of alternative evaluation strategies on study conclusions.

    Science.gov (United States)

    Kane, Robert L; Kane, Rosalie A

    2009-01-01

    This study uses two studies about the role of managed-care programs in serving Medicaid long-term care clients in Florida to illustrate how different research designs can reach divergent conclusions. Two reports from different groups using essentially the same database to assess the impact of managed care on a group of older Medicaid clients served by a Nursing Home Diversion Program reached different conclusions. The report from Florida's Office of Program Policy Analysis and Government Accountability concluded that the Diversion program saved money, whereas the report from the Florida Policy Exchange Center on Aging at the University of South Florida reached basically the opposite conclusion. Both agreed that the capitation rate was too high. How the policy questions are framed and analyzed can affect the conclusions reached. A variety of factors can influence the apparent effects of programmatic interventions. Evaluations must take relevant confounding variables into account.

  5. Defining epidemics in computer simulation models: How do definitions influence conclusions?

    Directory of Open Access Journals (Sweden)

    Carolyn Orbann

    2017-06-01

    Full Text Available Computer models have proven to be useful tools in studying epidemic disease in human populations. Such models are being used by a broader base of researchers, and it has become more important to ensure that descriptions of model construction and data analyses are clear and communicate important features of model structure. Papers describing computer models of infectious disease often lack a clear description of how the data are aggregated and whether or not non-epidemic runs are excluded from analyses. Given that there is no concrete quantitative definition of what constitutes an epidemic within the public health literature, each modeler must decide on a strategy for identifying epidemics during simulation runs. Here, an SEIR model was used to test the effects of how varying the cutoff for considering a run an epidemic changes potential interpretations of simulation outcomes. Varying the cutoff from 0% to 15% of the model population ever infected with the illness generated significant differences in numbers of dead and timing variables. These results are important for those who use models to form public health policy, in which questions of timing or implementation of interventions might be answered using findings from computer simulation models.

  6. Guidelines for the Investigation of Mediating Variables in Business Research.

    Science.gov (United States)

    MacKinnon, David P; Coxe, Stefany; Baraldi, Amanda N

    2012-03-01

    Business theories often specify the mediating mechanisms by which a predictor variable affects an outcome variable. In the last 30 years, investigations of mediating processes have become more widespread with corresponding developments in statistical methods to conduct these tests. The purpose of this article is to provide guidelines for mediation studies by focusing on decisions made prior to the research study that affect the clarity of conclusions from a mediation study, the statistical models for mediation analysis, and methods to improve interpretation of mediation results after the research study. Throughout this article, the importance of a program of experimental and observational research for investigating mediating mechanisms is emphasized.

  7. Pulsating variables

    International Nuclear Information System (INIS)

    1989-01-01

    The study of stellar pulsations is a major route to the understanding of stellar structure and evolution. At the South African Astronomical Observatory (SAAO) the following stellar pulsation studies were undertaken: rapidly oscillating Ap stars; solar-like oscillations in stars; 8-Scuti type variability in a classical Am star; Beta Cephei variables; a pulsating white dwarf and its companion; RR Lyrae variables and galactic Cepheids. 4 figs

  8. Conclusions from some unusual events in the field of ionizing radiation in the German Democratic Republic

    International Nuclear Information System (INIS)

    Schuettmann, W.; Koenig, W.

    1977-01-01

    In the GDR all unusual events in the field of ionizing radiation have been recorded and analysed since 1963. This is done by a central governmental institution, the National Board of Nuclear Safety and Radiation Protection established in 1962, and responsible for all relevant measures throughout the country. An unusual event is defined by radiation protection legislation as an event which deviates from the planned operation programme whether the incident has caused injury or not. The obligation to report such events rests on all licensed users, from users of X-ray machines to operators of reactors in research and nuclear power production. The listed events are continually assessed by the Board. The results of the assessment are evaluated in summary. There has not been a single event with a fatal outcome arising from ionizing radiation. Over the same period there were only seventeen occurrences which resulted in permanent injury to persons, mainly effected by acute external irradiation of parts of the body, especially of hands and forearms. Among the detected causes of unusual events described in detail, human failure predominates by far. Finally, conclusions are drawn from these results. The measures suggested all aim to reduce the frequency of radiation accidents and to minimize their consequences. The main measures concern ways of reducing human error in all fields of radiation protection. Among these, the education and training and the medical examination of radiation workers are discussed in somewhat more detail. (author)

  9. Client Predictors of Short-term Psychotherapy Outcomes among Asian and White American Outpatients

    Science.gov (United States)

    Kim, Jin E.; Zane, Nolan W.; Blozis, Shelley A.

    2015-01-01

    Purpose To examine predictors of psychotherapy outcomes, focusing on client characteristics that are especially salient for culturally diverse clients. Method Sixty clients (31 women; 27 White Americans, 33 Asian Americans) participated in this treatment study. Client characteristics were measured at pre-treatment, and outcomes were measured post-fourth session via therapist ratings of functioning and symptomatology. Regression analyses were utilized to test for predictors of outcomes, and bootstrap analyses were utilized to test for mediators. Results Higher levels of somatic symptoms predicted lower psychosocial functioning at post-treatment. Avoidant coping style predicted more negative symptoms and more psychological discomfort. Non-English language preference predicted worse outcomes; this effect was mediated by an avoidant coping style. Conclusions Language preference, avoidant coping style, and somatic symptoms predicted treatment outcome in a culturally diverse sample. Findings suggest that race/ethnicity-related variables may function through mediating proximal variables to affect outcomes. PMID:22836681

  10. Cognitive Variability

    Science.gov (United States)

    Siegler, Robert S.

    2007-01-01

    Children's thinking is highly variable at every level of analysis, from neural and associative levels to the level of strategies, theories, and other aspects of high-level cognition. This variability exists within people as well as between them; individual children often rely on different strategies or representations on closely related problems…

  11. Administrative Databases Can Yield False Conclusions-An Example of Obesity in Total Joint Arthroplasty.

    Science.gov (United States)

    George, Jaiben; Newman, Jared M; Ramanathan, Deepak; Klika, Alison K; Higuera, Carlos A; Barsoum, Wael K

    2017-09-01

    Research using large administrative databases has substantially increased in recent years. Accuracy with which comorbidities are represented in these databases has been questioned. The purpose of this study was to evaluate the extent of errors in obesity coding and its impact on arthroplasty research. Eighteen thousand thirty primary total knee arthroplasties (TKAs) and 10,475 total hip arthroplasties (THAs) performed at a single healthcare system from 2004-2014 were included. Patients were classified as obese or nonobese using 2 methods: (1) body mass index (BMI) ≥30 kg/m 2 and (2) international classification of disease, 9th edition codes. Length of stay, operative time, and 90-day complications were collected. Effect of obesity on various outcomes was analyzed separately for both BMI- and coding-based obesity. From 2004 to 2014, the prevalence of BMI-based obesity increased from 54% to 63% and 40% to 45% in TKA and THA, respectively. The prevalence of coding-based obesity increased from 15% to 28% and 8% to 17% in TKA and THA, respectively. Coding overestimated the growth of obesity in TKA and THA by 5.6 and 8.4 times, respectively. When obesity was defined by coding, obesity was falsely shown to be a significant risk factor for deep vein thrombosis (TKA), pulmonary embolism (THA), and longer hospital stay (TKA and THA). The growth in obesity observed in administrative databases may be an artifact because of improvements in coding over the years. Obesity defined by coding can overestimate the actual effect of obesity on complications after arthroplasty. Therefore, studies using large databases should be interpreted with caution, especially when variables prone to coding errors are involved. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. The chooz a expert survey program and its main conclusions for plant life management

    International Nuclear Information System (INIS)

    Barthelet, B.; Heuze, A.; Hennart, J.C.; Havard, P.

    2001-01-01

    Because of the importance of PWR components life management represents for Electricity Companies, significant R and D programs are dedicated to identifying and analysing mechanisms and damage rates of the different degradation modes of these components, systems and structures. To assess R and D assumptions and to validate non destructive test results through reviews, expert survey programs on in-situ equipment may enhance the knowledge about most of the various phenomena involved. In this regard, an extensive program was launched after the Chooz A NPP was decommissioned in 1991, after 24 years in operation. This program gathered EDF, IPSN, FRAMATOME, ELECTRABEL and TRACTEBEL into partnership. The expert survey program was performed in various laboratories between 1995 and 1999 and includes: - on-site non destructive testing before sampling, - and metallurgical and mechanical tests performed on samples taken from the nuclear and non nuclear part of the unit. The expert survey program performed by Utilities in various laboratories involved the following equipment: - reactor vessel and internal equipment, - reactor coolant system (dissimilar metal welds, SS welds, cast austenitic ferritic steels), - feedwater plant piping (erosion-corrosion), - electric cables susceptible of temperature and irradiation induced ageing, - anchoring in civil engineering structures, - main primary circuit concerning activation measurement. In conclusion, the extensive Chooz A expert survey program yields numerous significant results. The main outcomes will contribute to validate non destructive tests and enhance our knowledge of some degradation mechanisms of often quite similar components present in units in operation. It is worthy to note that this program is of prime importance for operation feedback; the cost of the whole study amounts to approximately 10 Million Euros. (author)

  13. Gulf War Illnesses: DOD's Conclusions about U.S. Troops' Exposure Cannot Be Adequately Supported

    National Research Council Canada - National Science Library

    Rhodes, Keith

    2004-01-01

    ... (MOD) conclusions about troops' exposure. The GAO found that DoD's and MOD's conclusions about troops' exposure to CW agents, based on DoD and CIA plume modeling, cannot be adequately supported...

  14. Move Analysis of the Conclusion Sections of Research Papers in Persian and English

    Science.gov (United States)

    Zamani, Gerannaz; Ebadi, Saman

    2016-01-01

    The structure of the conclusion sections in Research Papers (RPs) is of significance in academic writing. The conclusion section in spite of providing an outline of the article, states other essential components, such as recommendations, implications and statements of possible lines of future research. This paper analyses the conclusion parts of…

  15. Use of Bayesian Networks to Analyze Port Variables in Order to Make Sustainable Planning and Management Decision

    Directory of Open Access Journals (Sweden)

    Beatriz Molina Serrano

    2018-01-01

    Full Text Available In the current economic, social and political environment, society demands a greater variety of outcomes from the public logistics sector, such as efficiency, efficiency of managed resources, greater transparency and business performance. All of them are an indispensable counterpart for its recognition and support. In case of port planning and management, many variables are included. Use of Bayesian Networks allows to classify, predict and diagnose these variables and even to estimate the subsequent probability of unknown variables, basing on the known ones. Research includes a data base with more than 40 variables, which have been classified as smart port studies in Spain. Then a network was generated using a non-cyclic conducted grafo, which shows port variable relationships. As conclusion, economic variables are cause of the rest of categories and they represent a parent role in the most of cases. Furthermore, if environmental variables are known, subsequent probability of social variables can be estimated.

  16. Complex variables

    CERN Document Server

    Fisher, Stephen D

    1999-01-01

    The most important topics in the theory and application of complex variables receive a thorough, coherent treatment in this introductory text. Intended for undergraduates or graduate students in science, mathematics, and engineering, this volume features hundreds of solved examples, exercises, and applications designed to foster a complete understanding of complex variables as well as an appreciation of their mathematical beauty and elegance. Prerequisites are minimal; a three-semester course in calculus will suffice to prepare students for discussions of these topics: the complex plane, basic

  17. Conclusiveness of the Cochrane reviews in gynaecological cancer: A systematic analysis.

    Science.gov (United States)

    Yin, Shande; Chuai, Yunhai; Wang, Aiming; Zhang, Lanmei

    2015-06-01

    To assess the conclusiveness of Cochrane reviews in the field of gynaecological cancer. The Cochrane Library was searched for reviews regarding gynaecological cancer published between 1 January 2000 and 1 November 2014. Data were extracted from each paper and the conclusiveness of each review was assessed. The study included 66 reviews, 41 (62.1%) of which were conclusive. Of these, 58 included randomized controlled trials (RCTs), 37 (63.8%) of which were conclusive. Conclusive reviews of RCTs included significantly more patients than inconclusive reviews, but there was no difference in the number of included studies. Of the eight reviews of nonrandomized studies, four (50.0%) were conclusive. The majority of reviews recognized the need for additional studies. In the field of gynaecological cancer, reviews are more likely to be conclusive when they include RCTs, as well as large numbers of patients. © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  18. Variable stars

    International Nuclear Information System (INIS)

    Feast, M.W.; Wenzel, W.; Fernie, J.D.; Percy, J.R.; Smak, J.; Gascoigne, S.C.B.; Grindley, J.E.; Lovell, B.; Sawyer Hogg, H.B.; Baker, N.; Fitch, W.S.; Rosino, L.; Gursky, H.

    1976-01-01

    A critical review of variable stars is presented. A fairly complete summary of major developments and discoveries during the period 1973-1975 is given. The broad developments and new trends are outlined. Essential problems for future research are identified. (B.R.H. )

  19. A critical assessment of adverse pregnancy outcome and periodontal disease.

    Science.gov (United States)

    Wimmer, Gernot; Pihlstrom, Bruce L

    2008-09-01

    Pre-term birth is a major cause of infant mortality and morbidity that has considerable societal, medical, and economic costs. The rate of pre-term birth appears to be increasing world-wide and efforts to prevent or reduce its prevalence have been largely unsuccessful. To review the literature for studies investigating periodontal disease as a possible risk factor for pre-term birth and adverse pregnancy outcomes. Variability among studies in definitions of periodontal disease and adverse pregnancy outcomes as well as widespread inadequate control for confounding factors and possible effect modification make it difficult to base meaningful conclusions on published data. However, while there are indications of an association between periodontal disease and increased risk of adverse pregnancy outcome in some populations, there is no conclusive evidence that treating periodontal disease improves birth outcome. Based on a critical qualitative review, available evidence from clinical trials indicates that, although non-surgical mechanical periodontal treatment in the second trimester of pregnancy is safe and effective in reducing signs of maternal periodontal disease, it does not reduce the rate of pre-term birth. Clinical trials currently underway will further clarify the potential role of periodontal therapy in preventing adverse birth outcomes. Regardless of the outcomes of these trials, it is recommended that large, prospective cohort studies be conducted to assess risk for adverse pregnancy outcome in populations with periodontal disease. It is critical that periodontal exposure and adverse birth outcomes be clearly defined and the many potential confounding factors and possible effect modifiers for adverse pregnancy outcome be controlled in these studies. If periodontal disease is associated with higher risk of adverse pregnancy outcome in these specific populations, large multicenter randomized-controlled trials will be needed to determine if prevention or

  20. Relationship between funding source and conclusion among nutrition-related scientific articles.

    Science.gov (United States)

    Lesser, Lenard I; Ebbeling, Cara B; Goozner, Merrill; Wypij, David; Ludwig, David S

    2007-01-01

    Industrial support of biomedical research may bias scientific conclusions, as demonstrated by recent analyses of pharmaceutical studies. However, this issue has not been systematically examined in the area of nutrition research. The purpose of this study is to characterize financial sponsorship of scientific articles addressing the health effects of three commonly consumed beverages, and to determine how sponsorship affects published conclusions. Medline searches of worldwide literature were used to identify three article types (interventional studies, observational studies, and scientific reviews) about soft drinks, juice, and milk published between 1 January, 1999 and 31 December, 2003. Financial sponsorship and article conclusions were classified by independent groups of coinvestigators. The relationship between sponsorship and conclusions was explored by exact tests and regression analyses, controlling for covariates. 206 articles were included in the study, of which 111 declared financial sponsorship. Of these, 22% had all industry funding, 47% had no industry funding, and 32% had mixed funding. Funding source was significantly related to conclusions when considering all article types (p = 0.037). For interventional studies, the proportion with unfavorable conclusions was 0% for all industry funding versus 37% for no industry funding (p = 0.009). The odds ratio of a favorable versus unfavorable conclusion was 7.61 (95% confidence interval 1.27 to 45.73), comparing articles with all industry funding to no industry funding. Industry funding of nutrition-related scientific articles may bias conclusions in favor of sponsors' products, with potentially significant implications for public health.

  1. Conclusiveness of fine needle aspiration in 2419 histologically confirmed benign and malignant breast lesions

    NARCIS (Netherlands)

    Kooistra, B.; Wauters, C.; Wobbes, T.; Strobbe, L.

    2011-01-01

    We aimed to retrospectively assess (1) the conclusiveness of breast fine needle aspiration (FNA) in a histologically confirmed population and (2) the clinical and radiologic determinants of a conclusive diagnosis. Aspirates were diagnosed as inadequate, benign, atypical, suspicious or malignant. We

  2. 20 CFR 410.471 - Conclusion by physician regarding miner's disability or death.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Conclusion by physician regarding miner's disability or death. 410.471 Section 410.471 Employees' Benefits SOCIAL SECURITY ADMINISTRATION FEDERAL COAL MINE HEALTH AND SAFETY ACT OF 1969, TITLE IV-BLACK LUNG BENEFITS (1969- ) Total Disability or Death Due to Pneumoconiosis § 410.471 Conclusion...

  3. Diffusion versus linear ballistic accumulation: different models but the same conclusions about psychological processes?

    NARCIS (Netherlands)

    Donkin, C.; Brown, S.; Heathcote, A.; Wagenmakers, E.-J.

    2011-01-01

    Quantitative models for response time and accuracy are increasingly used as tools to draw conclusions about psychological processes. Here we investigate the extent to which these substantive conclusions depend on whether researchers use the Ratcliff diffusion model or the Linear Ballistic

  4. Complex variables

    CERN Document Server

    Flanigan, Francis J

    2010-01-01

    A caution to mathematics professors: Complex Variables does not follow conventional outlines of course material. One reviewer noting its originality wrote: ""A standard text is often preferred [to a superior text like this] because the professor knows the order of topics and the problems, and doesn't really have to pay attention to the text. He can go to class without preparation."" Not so here-Dr. Flanigan treats this most important field of contemporary mathematics in a most unusual way. While all the material for an advanced undergraduate or first-year graduate course is covered, discussion

  5. Forensic scientists' conclusions: how readable are they for non-scientist report-users?

    Science.gov (United States)

    Howes, Loene M; Kirkbride, K Paul; Kelty, Sally F; Julian, Roberta; Kemp, Nenagh

    2013-09-10

    Scientists have an ethical responsibility to assist non-scientists to understand their findings and expert opinions before they are used as decision-aids within the criminal justice system. The communication of scientific expert opinion to non-scientist audiences (e.g., police, lawyers, and judges) through expert reports is an important but under-researched issue. Readability statistics were used to assess 111 conclusions from a proficiency test in forensic glass analysis. The conclusions were written using an average of 23 words per sentence, and approximately half of the conclusions were expressed using the active voice. At an average Flesch-Kincaid Grade level of university undergraduate (Grade 13), and Flesch Reading Ease score of difficult (42), the conclusions were written at a level suitable for people with some tertiary education in science, suggesting that the intended non-scientist readers would find them difficult to read. To further analyse the readability of conclusions, descriptive features of text were used: text structure; sentence structure; vocabulary; elaboration; and coherence and unity. Descriptive analysis supported the finding that texts were written at a level difficult for non-scientists to read. Specific aspects of conclusions that may pose difficulties for non-scientists were located. Suggestions are included to assist scientists to write conclusions with increased readability for non-scientist readers, while retaining scientific integrity. In the next stage of research, the readability of expert reports in their entirety is to be explored. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  6. Conclusions of the presidency. European council of Barcelona, March 15 and 16 2002; Conclusions de la presidence. Conseil europeen de Barcelone 15 et 16 mars 2002

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2002-07-01

    This document summarizes the conclusions of the European Council held in Barcelona (Spain) on March 15 and 16, 2002. Among the priority actions listed by the council figure the integration of energy, transportation and communication networks at the European scale. In particular, the council commits the Parliament and itself to start the final phase of opening of gas and electricity markets: free choice of a supplier, obligation of public utility, security of supplies, separation between transmission and distribution and between production and supply, non-discriminatory access of consumers and suppliers to networks with transparent tariffs, establishment of a regulatory agency in each member state, agreement for a tariffing system for the international electricity trades etc.. Concerning the sustainable development strategy of the European union, the council is pressing the member states for the completion of the national procedures of ratification of the Kyoto protocol. However, new measures need to be taken to develop technologies respectful for the environment, in particular in the domain of energy and transports. (J.S.)

  7. Three Mile Island unit 2 vessel investigation project. Conclusions and significance

    International Nuclear Information System (INIS)

    Beckjord, E.S.

    1994-01-01

    At the conclusion of the TMI-2 Vessel Investigation Project, additional insights about the accident have been gained, specifically in the area of reactor vessel integrity and the conditions of the lower head of the reactor vessel. This paper discusses three topics: the evolving views about the TMI-2 accident scenario over time, the technical conclusions of the TMI-2 VIP (recovery of samples from the vessel lower head), and the broad significance of these findings (accident management). 4 refs

  8. Funding source, conflict of interest and positive conclusions in neuro-oncology clinical trials.

    Science.gov (United States)

    Moraes, Fabio Y; Mendez, Lucas C; Taunk, Neil K; Raman, Srinivas; Suh, John H; Souhami, Luis; Slotman, Ben; Weltman, Eduardo; Spratt, Daniel E; Berlin, Alejandro; Marta, Gustavo N

    2018-02-01

    We aimed to test any association between authors' conclusions and self-reported COI or funding sources in central nervous system (CNS) studies. A review was performed for CNS malignancy clinical trials published in the last 5 years. Two investigators independently classified study conclusions according to authors' endorsement of the experimental therapy. Statistical models were used to test for associations between positive conclusions and trials characteristics. From February 2010 to February 2015, 1256 articles were retrieved; 319 were considered eligible trials. Positive conclusions were reported in 56.8% of trials with industry-only, 55.6% with academia-only, 44.1% with academia and industry, 77.8% with none, and 76.4% with not described funding source (p = 0.011). Positive conclusions were reported in 60.4% of trials with unrelated COI, 60% with related COI, and 60% with no COI reported (p = 0.997). Factors that were significantly associated with the presence of positive conclusion included trials design (phase 1) [OR 11.64 (95 CI 4.66-29.09), p source [OR 2.45 (95 CI 1.22-5.22), p = 0.011]. In a multivariable regression model, all these factors remained significantly associated with trial's positive conclusion. Funding source and self-reported COI did not appear to influence the CNS trials conclusion. Funding source information and COI disclosure were under-reported in 14.1 and 17.2% of the CNS trials. Continued efforts are needed to increase rates of both COI and funding source reporting.

  9. Application of Artificial Neural Networks in the Heart Electrical Axis Position Conclusion Modeling

    Science.gov (United States)

    Bakanovskaya, L. N.

    2016-08-01

    The article touches upon building of a heart electrical axis position conclusion model using an artificial neural network. The input signals of the neural network are the values of deflections Q, R and S; and the output signal is the value of the heart electrical axis position. Training of the network is carried out by the error propagation method. The test results allow concluding that the created neural network makes a conclusion with a high degree of accuracy.

  10. Personality disorder and alcohol treatment outcome: systematic review and meta-analysis.

    Science.gov (United States)

    Newton-Howes, Giles M; Foulds, James A; Guy, Nicola H; Boden, Joseph M; Mulder, Roger T

    2017-07-01

    Background Personality disorders commonly coexist with alcohol use disorders (AUDs), but there is conflicting evidence on their association with treatment outcomes. Aims To determine the size and direction of the association between personality disorder and the outcome of treatment for AUD. Method We conducted a systematic review and meta-analysis of randomised trials and longitudinal studies. Results Personality disorders were associated with more alcohol-related impairment at baseline and less retention in treatment. However, during follow-up people with a personality disorder showed a similar amount of improvement in alcohol outcomes to that of people without such disorder. Synthesis of evidence was hampered by variable outcome reporting and a low quality of evidence overall. Conclusions Current evidence suggests the pessimism about treatment outcomes for this group of patients may be unfounded. However, there is an urgent need for more consistent and better quality reporting of outcomes in future studies in this area. © The Royal College of Psychiatrists 2017.

  11. Conclusions from the HIV in Europe Copenhagen 2012 Conference and ways forward

    DEFF Research Database (Denmark)

    Raben, D.; Delpech, V.; de Wit, J.

    2013-01-01

    The objective of this article is to set the scene for this supplement by presenting and discussing the overall outcomes of the HIV in Europe Copenhagen 2012 Conference and how the HIV in Europe initiative intends to further address challenges and themes raised during the conference....

  12. Summary and conclusion : instructional leadership in schools as loosely coupled organizations

    NARCIS (Netherlands)

    Scheerens, Jaap; Scheerens, Jaap

    2012-01-01

    In this final chapter a summary of the main outcomes is given. The study has looked at the definition and concept formation of school leadership, analyzed modeling and theory foundation and presented results of meta-analyses of leadership effects. In the last section some implications for

  13. A fallacious jar? The peculiar relation between descriptive premises and normative conclusions in neuroethics.

    Science.gov (United States)

    Wagner, Nils-Frederic; Northoff, Georg

    2015-06-01

    Ethical questions have traditionally been approached through conceptual analysis. Inspired by the rapid advance of modern brain imaging techniques, however, some ethical questions appear in a new light. For example, hotly debated trolley dilemmas have recently been studied by psychologists and neuroscientists alike, arguing that their findings can support or debunk moral intuitions that underlie those dilemmas. Resulting from the wedding of philosophy and neuroscience, neuroethics has emerged as a novel interdisciplinary field that aims at drawing conclusive relationships between neuroscientific observations and normative ethics. A major goal of neuroethics is to derive normative ethical conclusions from the investigation of neural and psychological mechanisms underlying ethical theories, as well as moral judgments and intuitions. The focus of this article is to shed light on the structure and functioning of neuroethical arguments of this sort, and to reveal particular methodological challenges that lie concealed therein. We discuss the methodological problem of how one can--or, as the case may be, cannot--validly infer normative conclusions from neuroscientific observations. Moreover, we raise the issue of how preexisting normative ethical convictions threaten to invalidate the interpretation of neuroscientific data, and thus arrive at question-begging conclusions. Nonetheless, this is not to deny that current neuroethics rightly presumes that moral considerations about actual human lives demand empirically substantiated answers. Therefore, in conclusion, we offer some preliminary reflections on how the discussed methodological challenges can be met.

  14. Acceleration toward the conclusion negotiation of bilateral nuclear cooperation agreements indispensable for globalization

    International Nuclear Information System (INIS)

    Mitsumata, Hiroki; Hattori, Takuya; Ake, Yutaka

    2011-01-01

    According to Japan's basic policies of new growth strategy, it would be one option of the economic growth to increase exports of nuclear power plant system or its equipments. However, bilateral nuclear cooperation agreements are indispensable for business activities on nuclear power. Recently signature of agreement with Jordan, agreed conclusion negotiation with Vietnam and Korea, under negotiation with India and expected negotiation with Indonesia and Malaysia. Signed agreements with Russia and Kazakhstan will be coming into effect and contribute nuclear fuel supply at export of nuclear power system. This special article consists of four expert's papers titled as (1) necessity of conclusion negotiation of nuclear cooperation agreements with several countries simultaneously and in parallel, (2) Japan's nuclear cooperation in new era, (3) desirable acceleration of conclusion negotiation of nuclear cooperation agreements and (4) insurance of nuclear fuel supply fundamental for global business activities of Japan's nuclear industries-best choice to establish cooperative relations with US and Russia. (T. Tanaka)

  15. The grand leap of the whale up the Niagara Falls: converting philosophical conclusions into policy prescriptions.

    Science.gov (United States)

    Holm, Søren

    2015-04-01

    This article analyzes a neat conjuring trick employed in bioethics, that is, the immediate conversion of a philosophical conclusion into a policy prescription, and compares it to the "grand leap of the whale up the Niagara Falls" mentioned by Benjamin Franklin. It is shown that there is no simple and easy way to achieve the conversion, by considering arguments falling under four headings: (1) reasonable disagreement about values and theories, (2) general jurisprudential arguments, (3) the differences between policymaking and philosophy, and (4) the messy world of implementation. The particular issue used to illustrate the difficulties in moving from philosophical conclusion to policy description is infanticide of healthy infants, but the analysis is general, and the conclusion that the immediate move to policy is illegitimate is quite general.

  16. Treatments of Missing Values in Large National Data Affect Conclusions: The Impact of Multiple Imputation on Arthroplasty Research.

    Science.gov (United States)

    Ondeck, Nathaniel T; Fu, Michael C; Skrip, Laura A; McLynn, Ryan P; Su, Edwin P; Grauer, Jonathan N

    2018-03-01

    Despite the advantages of large, national datasets, one continuing concern is missing data values. Complete case analysis, where only cases with complete data are analyzed, is commonly used rather than more statistically rigorous approaches such as multiple imputation. This study characterizes the potential selection bias introduced using complete case analysis and compares the results of common regressions using both techniques following unicompartmental knee arthroplasty. Patients undergoing unicompartmental knee arthroplasty were extracted from the 2005 to 2015 National Surgical Quality Improvement Program. As examples, the demographics of patients with and without missing preoperative albumin and hematocrit values were compared. Missing data were then treated with both complete case analysis and multiple imputation (an approach that reproduces the variation and associations that would have been present in a full dataset) and the conclusions of common regressions for adverse outcomes were compared. A total of 6117 patients were included, of which 56.7% were missing at least one value. Younger, female, and healthier patients were more likely to have missing preoperative albumin and hematocrit values. The use of complete case analysis removed 3467 patients from the study in comparison with multiple imputation which included all 6117 patients. The 2 methods of handling missing values led to differing associations of low preoperative laboratory values with commonly studied adverse outcomes. The use of complete case analysis can introduce selection bias and may lead to different conclusions in comparison with the statistically rigorous multiple imputation approach. Joint surgeons should consider the methods of handling missing values when interpreting arthroplasty research. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. N Reactor Production Assurance Program blance of plant evaluation: report of findings and conclusions

    International Nuclear Information System (INIS)

    Hurd, E.N.; Bitten, E.J.

    1985-03-01

    Fourteen tasks were identified by UNC Nuclear Industries for evaluating the life expectancy of N Reactor structures, systems and components in the Balance of Plant portion of the Production Assurance Program. A Westinghouse Hanford Company (WHC) evaluation team was assigned to each of these fourteen tasks. A uniform set of criteria was used by all teams in evaluating the problems that may be encountered during the extended plant operating lifetime. The overall conclusion is that extended life to those Balance of Plant components and systems studied can be achieved. Problems with the potential for compromising that conclusion are identified, and feasible solutions are provided

  18. Optimal conclusive teleportation of a d-dimensional two-particle unknown quantum state

    Institute of Scientific and Technical Information of China (English)

    Yang Yu-Guang; Wen Qiao-Yan; Zhu Fu-Chen

    2006-01-01

    A conclusive teleportation protocol of a d-dimensional two-particle unknown quantum state using three ddimensional particles in an arbitrary pure state is proposed. A sender teleports the unknown state conclusively to a receiver by using the positive operator valued measure(POVM) and introducing an ancillary qudit to perform the generalized Bell basis measurement. We calculate the optimal teleportation fidelity. We also discuss and analyse the reason why the information on the teleported state is lost in the course of the protocol.

  19. Benchmark exercises on PWR level-1 PSA (step 3). Analyses of accident sequence and conclusions

    International Nuclear Information System (INIS)

    Niwa, Yuji; Takahashi, Hideaki.

    1996-01-01

    The results of level 1 PSA generate fluctuations due to the assumptions based on several engineering judgements set in the stages of PSA analysis. On the purpose of the investigation of uncertainties due to assumptions, three kinds of a standard problem, what we call benchmark exercise have been set. In this report, sensitivity studies (benchmark exercise) of sequence analyses are treated and conclusions are mentioned. The treatment of inter-system dependency would generate uncertainly of PSA. In addition, as a conclusion of the PSA benchmark exercise, several findings in the sequence analysis together with previous benchmark analyses in earlier INSS Journals are treated. (author)

  20. Extraction Methods, Variability Encountered in

    NARCIS (Netherlands)

    Bodelier, P.L.E.; Nelson, K.E.

    2014-01-01

    Synonyms Bias in DNA extractions methods; Variation in DNA extraction methods Definition The variability in extraction methods is defined as differences in quality and quantity of DNA observed using various extraction protocols, leading to differences in outcome of microbial community composition

  1. Negotiated forms of worker involvement in the European Company (SE): First empirical evidence and conclusions

    OpenAIRE

    Keller, Berndt; Werner, Frank

    2008-01-01

    This article analyses the negotiations on worker involvement in the first almost four years of the European Company SE and their outcomes. First, some basic institutional aspects of the SE itself and its current empirical situation are described and explained. Then, the focus is on questions of employee involvement in this new legal form. Again some main institutional provisions on employee involvement are assessed, before a detailed empirical analysis on specific issues is presented. A final...

  2. The Polokwane conference and South Africa’s second political transition: tentative conclusions on future perspectives

    Directory of Open Access Journals (Sweden)

    J.C.M. Venter

    2008-07-01

    Full Text Available In this phase of South Africa’s second political transition (manifesting characteristics of political decay it looks as if the ANC is becoming more dominant, hegemonic and ideological, with added neo-patrimonial tendencies that are becoming more overt in an oligarchic manner. This article analyses the ANC’s Polokwane conference (qualitatively and deductively as part of South Africa’s second political transition since 1994 and postulates potential outcomes (scenario perspectives.

  3. The medical eye: Conclusions from eye tracking research on expertise development in medicine

    NARCIS (Netherlands)

    Jarodzka, Halszka; Jaarsma, Thomas; Dewhurst, Richard; Boshuizen, Els

    2013-01-01

    Jarodzka, H., Jaarsma, T., Dewhurst, R., & Boshuizen, H. P. A. (2012, October). The medical eye: Conclusions from eye tracking research on expertise development in medicine. Paper presented at the New tools and practices for seeing and learning in medicine ’12, University of Turku, Turku, Finland.

  4. Jumping to the wrong conclusions? An investigation of the mechanisms of reasoning errors in delusions.

    Science.gov (United States)

    Jolley, Suzanne; Thompson, Claire; Hurley, James; Medin, Evelina; Butler, Lucy; Bebbington, Paul; Dunn, Graham; Freeman, Daniel; Fowler, David; Kuipers, Elizabeth; Garety, Philippa

    2014-10-30

    Understanding how people with delusions arrive at false conclusions is central to the refinement of cognitive behavioural interventions. Making hasty decisions based on limited data ('jumping to conclusions', JTC) is one potential causal mechanism, but reasoning errors may also result from other processes. In this study, we investigated the correlates of reasoning errors under differing task conditions in 204 participants with schizophrenia spectrum psychosis who completed three probabilistic reasoning tasks. Psychotic symptoms, affect, and IQ were also evaluated. We found that hasty decision makers were more likely to draw false conclusions, but only 37% of their reasoning errors were consistent with the limited data they had gathered. The remainder directly contradicted all the presented evidence. Reasoning errors showed task-dependent associations with IQ, affect, and psychotic symptoms. We conclude that limited data-gathering contributes to false conclusions but is not the only mechanism involved. Delusions may also be maintained by a tendency to disregard evidence. Low IQ and emotional biases may contribute to reasoning errors in more complex situations. Cognitive strategies to reduce reasoning errors should therefore extend beyond encouragement to gather more data, and incorporate interventions focused directly on these difficulties. Copyright © 2014 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  5. 19 CFR 210.63 - Proposed findings and conclusions and briefs.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 3 2010-04-01 2010-04-01 false Proposed findings and conclusions and briefs. 210.63 Section 210.63 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION INVESTIGATIONS OF UNFAIR PRACTICES IN IMPORT TRADE ADJUDICATION AND ENFORCEMENT Temporary Relief § 210.63 Proposed findings...

  6. 19 CFR 210.40 - Proposed findings and conclusions and briefs.

    Science.gov (United States)

    2010-04-01

    ... 19 Customs Duties 3 2010-04-01 2010-04-01 false Proposed findings and conclusions and briefs. 210.40 Section 210.40 Customs Duties UNITED STATES INTERNATIONAL TRADE COMMISSION INVESTIGATIONS OF UNFAIR PRACTICES IN IMPORT TRADE ADJUDICATION AND ENFORCEMENT Prehearing Conferences and Hearings § 210...

  7. Conclusions and recommendations. [for problems in energy situation, air transportation, and hydrogen fuel

    Science.gov (United States)

    1973-01-01

    Conclusions and recommendations are presented for an analysis of the total energy situation; the effect of the energy problem on air transportation; and hydrogen fuel for aircraft. Properties and production costs of fuels, future prediction for energy and transportation, and economic aspects of hydrogen production are appended.

  8. 20 CFR 220.112 - Conclusions by physicians concerning the claimant's disability.

    Science.gov (United States)

    2010-04-01

    ... medically determinable physical or mental impairment which can be expected to result in death or which has... may have to consider such factors as age, education and past work experience. Such vocational factors... opinion by a treating source will be conclusive as to the medical issues of the nature and severity of a...

  9. Oklo: The fossil nuclear reactors. Physics study - Translation of chapters 6, 13 and conclusions

    Energy Technology Data Exchange (ETDEWEB)

    Naudet, R [CEA, Paris (France)

    1996-09-01

    Three parts of the 1991 book `Oklo: reacteurs nucleaires fossiles. Etude physique` have been translated in this report. The chapters bear the titles `Study of criticality`(45 p.), `Some problems with the overall functioning of the reactor zones`(45 p.) and `Conclusions` (15 p.), respectively.

  10. Oklo: The fossil nuclear reactors. Physics study - Translation of chapters 6, 13 and conclusions

    International Nuclear Information System (INIS)

    Naudet, R.

    1996-09-01

    Three parts of the 1991 book 'Oklo: reacteurs nucleaires fossiles. Etude physique' have been translated in this report. The chapters bear the titles 'Study of criticality'(45 p.), 'Some problems with the overall functioning of the reactor zones'(45 p.) and 'Conclusions' (15 p.), respectively

  11. Tritium in precipitation of Vostok (Antarctica): conclusions on the tritium latitude effect.

    Science.gov (United States)

    Hebert, Detlef

    2011-09-01

    During the Antarctic summer of 1985 near the Soviet Antarctic station Vostok, firn samples for tritium measurements were obtained down to a depth of 2.40 m. The results of the tritium measurements are presented and discussed. Based on this and other data, conclusions regarding the tritium latitude effect are derived.

  12. Role of blood pressure and other variables in the differential cardiovascular event rates noted in the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA)

    DEFF Research Database (Denmark)

    Poulter, Neil R; Wedel, Hans; Dahlöf, Björn

    2005-01-01

    Results of the Anglo-Scandinavian Cardiac Outcomes Trial-Blood Pressure Lowering Arm (ASCOT-BPLA) show significantly lower rates of coronary and stroke events in individuals allocated an amlodipine-based combination drug regimen than in those allocated an atenolol-based combination drug regimen (HR...

  13. Variable collimator

    International Nuclear Information System (INIS)

    Richey, J.B.; McBride, T.R.; Covic, J.

    1979-01-01

    This invention describes an automatic variable collimator which controls the width and thickness of X-ray beams in X-ray diagnostic medical equipment, and which is particularly adapted for use with computerized axial tomographic scanners. A two-part collimator is provided which shapes an X-ray beam both prior to its entering an object subject to radiographic analysis and after the attenuated beam has passed through the object. Interposed between a source of radiation and the object subject to radiographic analysis is a first or source collimator. The source collimator causes the X-ray beam emitted by the source of radiation to be split into a plurality of generally rectangular shaped beams. Disposed within the source collimator is a movable aperture plate which may be used to selectively vary the thickness of the plurality of generally rectangular shaped beams transmitted through the source collimator. A second or receiver collimator is interposed between the object subject to radiographic analysis and a series of radiation detectors. The receiver collimator is disposed to receive the attenuated X-ray beams passing through the object subject to radiographic analysis. Located within the receiver collimator are a plurality of movable aperture plates adapted to be displaced relative to a plurality of fixed aperture plates for the purpose of varying the width and thickness of the attenuated X-ray beams transmitted through the object subject to radiographic analysis. The movable aperture plates of the source and receiver collimators are automatically controlled by circuitry which is provided to allow remote operation of the movable aperture plates

  14. Secondary Data Analyses of Conclusions Drawn by the Program Implementers of a Positive Youth Development Program in Hong Kong

    Directory of Open Access Journals (Sweden)

    Andrew M. H. Siu

    2010-01-01

    Full Text Available The Tier 2 Program of the Project P.A.T.H.S. (Positive Adolescent Training through Holistic Social Programmes is designed for adolescents with significant psychosocial needs, and its various programs are designed and implemented by social workers (program implementers for specific student groups in different schools. Using subjective outcome evaluation data collected from the program participants (Form C at 207 schools, the program implementers were asked to aggregate data and write down five conclusions (n = 1,035 in their evaluation reports. The conclusions stated in the evaluation reports were further analyzed via secondary data analyses in this study. Results showed that the participants regarded the Tier 2 Program as a success, and was effective in enhancing self-understanding, interpersonal skills, and self-management. They liked the experiential learning approach and activities that are novel, interesting, diversified, adventure-based, and outdoor in nature. They also liked instructors who were friendly, supportive, well-prepared, and able to bring challenges and give positive recognition. Most of the difficulties encountered in running the programs were related to time constraints, clashes with other activities, and motivation of participants. Consistent with the previous evaluation findings, the present study suggests that the Tier 2 Program was well received by the participants and that it was beneficial to the development of the program participants.

  15. Are we drawing the right conclusions from randomised placebo-controlled trials? A post-hoc analysis of data from a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Bone Kerry M

    2009-06-01

    Full Text Available Abstract Background Assumptions underlying placebo controlled trials include that the placebo effect impacts on all study arms equally, and that treatment effects are additional to the placebo effect. However, these assumptions have recently been challenged, and different mechanisms may potentially be operating in the placebo and treatment arms. The objective of the current study was to explore the nature of placebo versus pharmacological effects by comparing predictors of the placebo response with predictors of the treatment response in a randomised, placebo-controlled trial of a phytotherapeutic combination for the treatment of menopausal symptoms. A substantial placebo response was observed but no significant difference in efficacy between the two arms. Methods A post hoc analysis was conducted on data from 93 participants who completed this previously published study. Variables at baseline were investigated as potential predictors of the response on any of the endpoints of flushing, overall menopausal symptoms and depression. Focused tests were conducted using hierarchical linear regression analyses. Based on these findings, analyses were conducted for both groups separately. These findings are discussed in relation to existing literature on placebo effects. Results Distinct differences in predictors were observed between the placebo and active groups. A significant difference was found for study entry anxiety, and Greene Climacteric Scale (GCS scores, on all three endpoints. Attitude to menopause was found to differ significantly between the two groups for GCS scores. Examination of the individual arms found anxiety at study entry to predict placebo response on all three outcome measures individually. In contrast, low anxiety was significantly associated with improvement in the active treatment group. None of the variables found to predict the placebo response was relevant to the treatment arm. Conclusion This study was a post hoc analysis

  16. Spontaneous Intracerebral Hemorrhage: Computed Tomographic Characteristics and Outcome

    Directory of Open Access Journals (Sweden)

    Aimara de la Caridad Vergara Santos

    2015-12-01

    Full Text Available Background: strokes are the third leading cause of death among adults and 10-15 % of them are due to spontaneous intracerebral hemorrhage. Objective: to characterize spontaneous intracerebral hemorrhage through computed tomography scan and its outcome. Methods: a case series study was conducted comprising patients diagnosed with spontaneous intracerebral hemorrhage admitted to the Arnaldo Milián Castro Provincial University Hospital in Villa Clara from January 2009 to January 2010. Tomographic variables of interest were derived from evaluation of spontaneous intracerebral hematomas. Results: fifty-nine cases of spontaneous intracerebral hemorrhage were studied, 23 were located in lobar regions, 4 had severe midline shift, and 2 showed volume greater than 80 ml. Eight out of eleven with extension into the ventricular system had an unfavorable outcome. Among those with thalamic hemorrhage, patients with diameter larger than 4cm and extension into the ventricular system died. Patients with putaminal hemorrhage larger than 4 cm and posterior fossa hematoma with hydrocephalus had a poor outcome, as well as most individuals (55 with other mass effects. Most lobar hematomas (14 out of 23 had a satisfactory outcome, unlike cerebellar and brainstem hematomas. Conclusions: tomographic variables that had a negative impact on the outcome were: volume greater than 80 ml, severe midline shift, diameter larger than 4 cm, extension into the ventricular system, hydrocephalus, other signs of mass effect and brainstem location.

  17. Energy 2000: effects of the program and conclusions from its evaluation

    International Nuclear Information System (INIS)

    Balthasar, A.

    2000-01-01

    The action program Energy 2000 has been continually reviewed by independent experts in view of its effects. This resulted in around 50 scientific studies between 1991 and 1999, dealing with different aspects of the program. In the book 'Energy 2000: effects of the program and conclusions from its evaluation', the results of these evaluations are summarised, and conclusions for the design of the follow-up program are drawn. The organisational frame of the program is presented and the question answered whether the determining principles of the program proved practical. Besides, the effects of state intervention, of the conflict solving groups and the voluntary actions of Energy 2000 are appraised. A separate chapter is dedicated to the evaluation strategy of the program, its implementation and the benefits of the evaluations. Propositions for the evaluation of the follow-up program are formulated as well. Dr. Andreas Balthasar is President of the Swiss Evaluation Society. (author)

  18. The 1993 Finnish Interdisciplinary Seminar on SETI - A review of aims, approaches and conclusions

    Science.gov (United States)

    Seppanen, Jouko

    1993-10-01

    The communications of the International Interdisciplinary Seminar on SETI, held on March 6-7, 1993 in Vantaa, Finland, are reviewed and the contents and conclusions of papers summarized. The seminar was organized jointly by the Finnish Artificial Intelligence Society (FAIS), Finnish Astronomical Society, Ursa Astronomical Association and Heureka - The Finnish Science Centre. As the ninth in a series of intelligence-related seminars of FAIS, SETI was chosen as the topic for spring 1993, noting the new ten year NASA SETI program HRMS (High Resolution Micro-wave Survey), commenced on Columbus Day, October 12, 1992. The aims and the interdisciplinary format of the seminar are described, the main results and conclusions of papers are restated, and the seminar publications introduced. The summaries of papers are based on their abstracts and contain excerpts from texts.

  19. Conclusions on the two technical panels on HLW-disposal and waste treatment processes respectively

    International Nuclear Information System (INIS)

    Dinkespiller, J.A.; Dejonghe, P.; Feates, F.

    1986-01-01

    The paper reports the concluding panel session at the European Community Conference on radioactive waste management and disposal, Luxembourg 1985. The panel considered the conclusions of two preceeding technical panels on high level waste (HLW) disposal and waste treatment processes. Geological disposal of HLW, waste management, safety assessment of waste disposal, public opinion, public acceptance of the manageability of radioactive wastes, international cooperation, and waste management in the United States, are all discussed. (U.K.)

  20. "Jumping to conclusions" in delusion-prone participants: an experimental economics approach.

    Science.gov (United States)

    van der Leer, Leslie; McKay, Ryan

    2014-01-01

    That delusional and delusion-prone individuals "jump to conclusions" on probabilistic reasoning tasks is a key finding in cognitive neuropsychiatry. Here we focused on a less frequently investigated aspect of "jumping to conclusions" (JTC): certainty judgments. We incorporated rigorous procedures from experimental economics to eliminate potential confounds of miscomprehension and motivation and systematically investigated the effect of incentives on task performance. Low- and high-delusion-prone participants (n = 109) completed a series of computerised trials; on each trial, they were shown a black or a white fish, caught from one of the two lakes containing fish of both colours in complementary ratios. In the betting condition, participants were given £4 to distribute over the two lakes as they wished; in the control condition, participants simply provided an estimate of how probable each lake was. Deviations from Bayesian probabilities were investigated. Whereas high-delusion-prone participants in both the control and betting conditions underestimated the Bayesian probabilities (i.e. were conservative), low-delusion-prone participants in the control condition underestimated but those in the betting condition provided accurate estimates. In the control condition, there was a trend for high-delusion-prone participants to give higher estimates than low-delusion-prone participants, which is consistent with previous reports of "jumping to conclusions" in delusion-prone participants. However, our findings in the betting condition, where high-delusion-prone participants provided lower estimates than low-delusion-prone participants (who were accurate), are inconsistent with the jumping-to-conclusions effect in both a relative and an absolute sense. Our findings highlight the key role of task incentives and underscore the importance of comparing the responses of delusion-prone participants to an objective rational standard as well as to the responses of non

  1. Chernobyl accident: causes and consequences (expert conclusion). Part 3. Chernobyl accident effect on Belarus

    International Nuclear Information System (INIS)

    Nesterenko, V.B.

    1992-01-01

    Expert conclusion is presented on the Chernobyl accident effect on Belarus. Problems of ground and food contamination, medical and biological radiation effects on the population are considered. Attention is paid to the radiation monitoring and radiometric gages. Scale of the damage for forestry and agriculture is described and recommendations on the agriculture is described and recommendations on the agricultural production and forest utilization at contaminated areas are given. 24 refs.; 4 figs.; 24 tabs

  2. Cognitive control in belief-laden reasoning during conclusion processing: An ERP study

    OpenAIRE

    Junlong Luo, Xiumin Du , Edward J. N. Stupple, Xiao Xiao, Lei Jia , Qinglin Zhang ,

    2012-01-01

    Belief-bias is the tendency to accept conclusions that are compatible with existing beliefs more frequently than those that contradict beliefs. It is one of the most replicated behavioral findings in the reasoning literature. Recently, neuroimaging studies using functional magnetic resonance imaging (fMRI) and event-related potentials (ERPs) have provided a new perspective and have demonstrated neural correlates of belief bias that have been viewed as supportive of dual process theories of be...

  3. International senior expert symposium on electricity and the environment: Highlights and conclusions from Helsinki

    International Nuclear Information System (INIS)

    Bennett, L.L.

    1991-01-01

    This article summarizes briefly the Senior Expert Symposium on Electricity and the Environment, held in May 1991. Four Expert Groups considered key issues: the implications for the global environment of energy and electricity supply and demand; energy sources and technologies for electricity generation; comparative environmental and health effects of different energy sources for electricity generation; and the incorporation of environmental and health impacts into policy, planning and decision making for the electricity sector. The conclusions of these groups are presented

  4. ANCLI's conclusions and recommendations made after the ANCLI colloquium 'Tritium, discrete, but present everywhere'

    International Nuclear Information System (INIS)

    Sene, M.

    2009-01-01

    The authors briefly state the conclusions of the colloquium about the presence of tritium in the environment, its sanitary impact, the re-examination of a management based on release, the need to reduce tritium production. The recommendations are also indicated: to continue researches on organically bound tritium, not to allow any release increase as long as effects are not better known. The role of the ANCLI is outlined

  5. Definition of sampling units begets conclusions in ecology: the case of habitats for plant communities

    OpenAIRE

    M?rsdorf, Martin A.; Ravolainen, Virve T.; St?vern, Leif Einar; Yoccoz, Nigel G.; J?nsd?ttir, Ingibj?rg Svala; Br?then, Kari Anne

    2015-01-01

    In ecology, expert knowledge on habitat characteristics is often used to define sampling units such as study sites. Ecologists are especially prone to such approaches when prior sampling frames are not accessible. Here we ask to what extent can different approaches to the definition of sampling units influence the conclusions that are drawn from an ecological study? We do this by comparing a formal versus a subjective definition of sampling units within a study design which is ...

  6. Jumping to the wrong conclusions? An investigation of the mechanisms of reasoning errors in delusions

    Science.gov (United States)

    Jolley, Suzanne; Thompson, Claire; Hurley, James; Medin, Evelina; Butler, Lucy; Bebbington, Paul; Dunn, Graham; Freeman, Daniel; Fowler, David; Kuipers, Elizabeth; Garety, Philippa

    2014-01-01

    Understanding how people with delusions arrive at false conclusions is central to the refinement of cognitive behavioural interventions. Making hasty decisions based on limited data (‘jumping to conclusions’, JTC) is one potential causal mechanism, but reasoning errors may also result from other processes. In this study, we investigated the correlates of reasoning errors under differing task conditions in 204 participants with schizophrenia spectrum psychosis who completed three probabilistic reasoning tasks. Psychotic symptoms, affect, and IQ were also evaluated. We found that hasty decision makers were more likely to draw false conclusions, but only 37% of their reasoning errors were consistent with the limited data they had gathered. The remainder directly contradicted all the presented evidence. Reasoning errors showed task-dependent associations with IQ, affect, and psychotic symptoms. We conclude that limited data-gathering contributes to false conclusions but is not the only mechanism involved. Delusions may also be maintained by a tendency to disregard evidence. Low IQ and emotional biases may contribute to reasoning errors in more complex situations. Cognitive strategies to reduce reasoning errors should therefore extend beyond encouragement to gather more data, and incorporate interventions focused directly on these difficulties. PMID:24958065

  7. Interrater variability of EEG interpretation in comatose cardiac arrest patients

    DEFF Research Database (Denmark)

    Westhall, Erik; Rosén, Ingmar; Rossetti, Andrea O

    2015-01-01

    OBJECTIVE: EEG is widely used to predict outcome in comatose cardiac arrest patients, but its value has been limited by lack of a uniform classification. We used the EEG terminology proposed by the American Clinical Neurophysiology Society (ACNS) to assess interrater variability in a cohort...... who were blinded for patient outcome. Percent agreement and kappa (κ) for the categories in the ACNS EEG terminology and for prespecified malignant EEG-patterns were calculated. RESULTS: There was substantial interrater agreement (κ 0.71) for highly malignant patterns and moderate agreement (κ 0.......42) for malignant patterns. Substantial agreement was found for malignant periodic or rhythmic patterns (κ 0.72) while agreement for identifying an unreactive EEG was fair (κ 0.26). CONCLUSIONS: The ACNS EEG terminology can be used to identify highly malignant EEG-patterns in post cardiac arrest patients...

  8. How often do sensitivity analyses for economic parameters change cost-utility analysis conclusions?

    Science.gov (United States)

    Schackman, Bruce R; Gold, Heather Taffet; Stone, Patricia W; Neumann, Peter J

    2004-01-01

    There is limited evidence about the extent to which sensitivity analysis has been used in the cost-effectiveness literature. Sensitivity analyses for health-related QOL (HR-QOL), cost and discount rate economic parameters are of particular interest because they measure the effects of methodological and estimation uncertainties. To investigate the use of sensitivity analyses in the pharmaceutical cost-utility literature in order to test whether a change in economic parameters could result in a different conclusion regarding the cost effectiveness of the intervention analysed. Cost-utility analyses of pharmaceuticals identified in a prior comprehensive audit (70 articles) were reviewed and further audited. For each base case for which sensitivity analyses were reported (n = 122), up to two sensitivity analyses for HR-QOL (n = 133), cost (n = 99), and discount rate (n = 128) were examined. Article mentions of thresholds for acceptable cost-utility ratios were recorded (total 36). Cost-utility ratios were denominated in US dollars for the year reported in each of the original articles in order to determine whether a different conclusion would have been indicated at the time the article was published. Quality ratings from the original audit for articles where sensitivity analysis results crossed the cost-utility ratio threshold above the base-case result were compared with those that did not. The most frequently mentioned cost-utility thresholds were $US20,000/QALY, $US50,000/QALY, and $US100,000/QALY. The proportions of sensitivity analyses reporting quantitative results that crossed the threshold above the base-case results (or where the sensitivity analysis result was dominated) were 31% for HR-QOL sensitivity analyses, 20% for cost-sensitivity analyses, and 15% for discount-rate sensitivity analyses. Almost half of the discount-rate sensitivity analyses did not report quantitative results. Articles that reported sensitivity analyses where results crossed the cost

  9. The termination of the asymptotic giant branch phase imposed by helium shell flashes - description and conclusions

    International Nuclear Information System (INIS)

    Tuchman, Y.

    1984-01-01

    The increase in the surface luminosity associated with the well-known helium shell flashes might be a trigger for an early mass ejection process. This phenomenon has a significant influence on the global statistical features of the Mira variables as well as on the mass distribution of white dwarfs. The above situation is analysed by adopting the luminosity behaviour during helium shell flashes presented by previous authors to a dynamical picture for the asymptotic giant branch stars. The main observational implications are described and discussed. (author)

  10. Risk variables of external apical root resorption during orthodontic treatment

    Directory of Open Access Journals (Sweden)

    Maria Carolina Feio Barroso

    2012-04-01

    Full Text Available INTRODUCTION: External apical root resorption (EARR is an adverse outcome of the orthodontic treatment. So far, no single or associated factor has been identified as responsible for EARR due to tooth movement. OBJECTIVE: This study investigated the association of risk variables (age, gender, extraction for orthodontic treatment and Angle classification with EARR and orthodontic treatment. METHOD: The sample (n=72 was divided into two groups according to presence (n=32 or absence (n=40 of EARR in maxillary central and lateral incisors after orthodontic treatment. RESULTS: There were no statistically significant differences in EARR according to age, gender, extraction or type of malocclusion (p>0.05. CONCLUSION: The risk variables examined were not associated with EARR in the study population.

  11. Workshop on iodine aspects of severe accident management. Summary and conclusions

    International Nuclear Information System (INIS)

    2000-03-01

    Following a recommendation of the OECD Workshop on the Chemistry of Iodine in Reactor Safety held in Wuerenlingen (Switzerland) in June 1996 [Summary and Conclusions of the Workshop, Report NEA/CSNI/R(96)7], the CSNI decided to sponsor a Workshop on Iodine Aspects of Severe Accident Management, and their planned or effective implementation. The starting point for this conclusion was the realization that the consolidation of the accumulated iodine chemistry knowledge into accident management guidelines and procedures remained, to a large extent, to be done. The purpose of the meeting was therefore to help build a bridge between iodine research and the application of its results in nuclear power plants, with particular emphasis on severe accident management. Specifically, the Workshop was expected to answer the following questions: - what is the role of iodine in severe accident management? - what are the needs of the utilities? - how can research fulfill these needs? The Workshop was organized in Vantaa (Helsinki), Finland, from 18 to 20 May 1999, in collaboration with Fortum Engineering Ltd. It was attended by forty-six specialists representing fifteen Member countries and the European Commission. Twenty-eight papers were presented. These included four utility papers, representing the views of Electricite de France (EDF), Teollisuuden Voima Oy and Fortum Engineering Ltd (Finland), the Nuclear Energy Institute (USA), and Japanese utilities. The papers were presented in five sessions: - iodine speciation; - organic compound control; - iodine control; - modeling; - iodine management; A sixth session was devoted to a general discussion on iodine management under severe accident conditions. This report summarizes the content of the papers and the conclusions of the workshop

  12. Specialist meeting on selected containment severe accident management strategies. Summary and conclusions

    International Nuclear Information System (INIS)

    1994-01-01

    The CSNI Specialist Meeting on Selected Containment Severe Accident Management Strategies held in Stockholm, Sweden in June 1994 was organised by the Task Group on Containment Aspects of Severe Accident Management (CAM) of CSNI's Principal Working Group on the Confinement of Accidental Radioactive Releases (PWG4) in collaboration with the Swedish Nuclear Power Inspectorate (SKI). Conclusions and recommendations are given for each of the sessions of the workshops: Containment accident management strategies (general aspects); hydrogen management techniques and other containment accident management techniques; surveillance and protection of containment function

  13. Some conclusions about the concrete strength of the bored piles of Angra 2 nuclear power plant

    International Nuclear Information System (INIS)

    Thomaz, E.C.S.; Joia, L.A.

    1984-01-01

    The concrete of the bored piles of Angra 2 was submitted to a deep control, so more than five thousand core samples were analyzed to verify the quality of the concrete. Based on these samples and using statistics regression theory some conclusions could be done. It was analyzed the dependence of the concrete strength upon the depth of the pile. Also based on these samples some probability distribution functions that could simulate the concrete strength were studied applying the Kolmogorov - Smirnov fitness test. Finally, a method for evaluating a confidence interval of one of the probability function (Weibull distribution) was developed adopting the Monte Carlo simulation technique. (Author) [pt

  14. One metric does not tell the whole story of scientific production. III. Management and conclusions

    Directory of Open Access Journals (Sweden)

    Nieves GONZÁLEZ-FERNÁNDEZ-VILLAVICENCIO

    2016-09-01

    Full Text Available Introduction: There are different strategies for scientific publication that can be addressed from the perspective of management, ahead of the assessment by national agencies. Rising of alternative metrics, services and suppliers. Method: Narrative review. Results: the characteristic features of the evaluation criteria of scientific publications by Spanish agencies evaluation are presented and described altmetrics services. Conclusions: The need for national evaluation systems of scientific production to avoid the current bias and ignorance of the publishing sector which suffer WoS and Scopus arises. And also the need for other altmetric systems, complementary to traditional, to expand the type of scientific products and evaluate the scientific social impact.

  15. The successful conclusion of the Deep Space 1 Mission: important results without a flashy title

    Science.gov (United States)

    Rayman, M. D.

    2002-01-01

    In September 2001, Deep Space 1 (DS1) completed a high-risk and flawless encounter with comet 19P/Borrelly. Its data provide a detailed view of this comet and offere surprising and exciting insights. With this successful conclusion of its extended mission, DS1 undertook a hyperextended mission. Following this period of extremely agressive testing, with no further technology or science objectives, the mission was terminated on December 18, 2001, with the powering off of the spacecraft's trnasmitter, although the receiver was left on. By the end of its mission, DS1 had returned a wealth of important science data and engineering data for future missions.

  16. Epidemiology, biology and therapy of Merkel cell carcinoma: conclusions from the EU project IMMOMEC

    DEFF Research Database (Denmark)

    Becker, Juergen C.; Stang, Andreas; zur Hausen, Axel

    2018-01-01

    Merkel cell carcinoma (MCC) is a highly aggressive, often lethal neuroendocrine cancer. Its carcinogenesis may be either caused by the clonal integration of the Merkel cell polyomavirus into the host genome or by UV-induced mutations. Notably, virally-encoded oncoproteins and UV-induced mutations...... knowledge on epidemiology, biology and therapy of MCC as conclusion of the project 'Immune Modulating strategies for treatment of Merkel Cell Carcinoma', which was funded over a 5-year period by the European Commission to investigate innovative immunotherapies for MCC....

  17. Farmer Health and Adaptive Capacity in the Face of Climate Change and Variability. Part 1: Health as a Contributor to Adaptive Capacity and as an Outcome from Pressures Coping with Climate Related Adversities

    Directory of Open Access Journals (Sweden)

    Anne Parkinson

    2011-10-01

    Full Text Available This paper examines the role farmers’ health plays as an element of adaptive capacity. The study examines which of twenty aspects of adaptation may be related to overall health outcomes, controlling for demographic and on-farm-factors in health problems. The analysis is based on 3,993 farmers’ responses to a national survey of climate risk and adaptation. Hierarchical linear regression modelling was used examine the extent to which, in a multivariate analysis, the use of adaptive practices was predictively associated with self-assessed health, taking into account the farmer’s rating of whether their health was a barrier to undertaking farm work. We present two models, one excluding pre-existing health (model 1 and one including pre-existing health (model 2. The first model accounted for 21% of the variance. In this model better health was most strongly predicted by an absence of on-farm risk, greater financial viability, greater debt pressures, younger age and a desire to continue farming. Social capital (trust and reciprocity was moderately associated with health as was the intention to adopt more sustainable practices. The second model (including the farmers’ health as a barrier to undertaking farm work accounted for 43% of the variance. Better health outcomes were most strongly explained, in order of magnitude, by the absence of pre-existing health problems, greater access to social support, greater financial viability, greater debt pressures, a desire to continue farming and the condition of on-farm resources. Model 2 was a more parsimonious model (only nine predictors, compared with 15 in model 1, and explained twice as much variance in health outcomes. These results suggest that (i pre-existing health problems are a very important factor to consider when designing adaptation programs and policies and (ii these problems may mediate or modify the relationship between adaptation and health.

  18. The prospects for nuclear power in the UK. Conclusions of the Government's nuclear review

    International Nuclear Information System (INIS)

    1995-05-01

    The conclusions of the United Kingdom government's review of the nuclear industry in Britain were presented to Parliament in May 1995. The provision of public sector support for a new nuclear power station is deemed unwarranted against the background of the current electricity market. In reaching this conclusion the government considered possible environmental and strategic advantages, the question of diversity of fuel sources, and wider economic benefits. It is intended to privatize parts of Nuclear Electric and Scottish Nuclear in 1996 as subsidiaries of a single holding company to take over the UK's AGR and PWR stations together with a significant level of their associated liabilities. A publicly owned company will continue to run the magnox stations and retain their liabilities. British Nuclear Fuels Ltd (BNFL) will continue to offer nuclear fuel services and to receive government support in developing business in overseas markets. Since their formation in 1990, Nuclear Electric and Scottish Nuclear have improved their financial performance significantly. At privatisation the nuclear component of the fossil fuel levy will cease to be paid to Nuclear Electric and Scottish Nuclear will no longer receive the current premium price paid under the Nuclear Energy Agreement. The current regulatory regime and rigorous safety standards for nuclear power will remain substantially unchanged. (UK)

  19. Comparative analysis of sustainable consumption and production in Visegrad region - conclusions for textile and clothing sector

    Science.gov (United States)

    Koszewska, M.; Militki, J.; Mizsey, P.; Benda-Prokeinova, R.

    2017-10-01

    Gradual environmental degradation, shrinking of non-renewable resources, and lower quality of life are directly or indirectly arising from snowballing consumption. These unfavorable processes concern increasingly textile and clothing sector and are increasingly being felt in Visegrad Region (V4). The objective of the article was to access current consumption patterns in V4 countries, identify the factors that influence those patterns and finally to draw the conclusions for more sustainable consumption and production models as well as to make a comparative analysis of the results across V4 countries. A consumer survey was conducted to examine V4 citizens’ attitudes and behaviors in the context of sustainable consumption. To ensure sample size and comparability across countries 2000 randomly-selected V4 citizens, aged 18 and over, were interviewed. To analyze the supply side of the market and legal framework, the desk research was used. The results allowed to give some guidelines for the joint V4 strategy for solving ecological and social problems of V4 countries as well as the conclusions for textile and clothing sector.

  20. [Sexual child abuse: correlation between medical certificates' conclusions and judiciary sanctions].

    Science.gov (United States)

    Soumah, M M; Bah, H; Mbaye, I; Fall, M C; Yetognon, C; Sow, M L

    2005-01-01

    Sexual child abuse, comprises of indecency attitudes and physical misbehaviours, directed towards children are dominated by rape. The objective of our study was to assess in sexual child abuse the relation between the conclusion of medical certificates and court decision. It is a retrospective study carried out from 1994 to 1998 on the clerk's office correctional repertories in Dakar regional court. An overall number of 79 cases of child abuse were collected in 5 years period. Children under 18 years old of of both sex, were concerned. Data found were correlated with a review of requisition cases received by the of gynaecology and obstetrics clinic of Aristide Dantec Hospital. This facilitates the establishement of the relationship between the offences and the pronounced sanctions, as well as the initial medical certificate and these sanctions. The sanctions were severe whenever rape had been retained. Some cases were disqualified in indecent assault and were judged as such. The judge decision, which follow the medical certificate conclusions in 11 cases out of 14 shows the importance and reliability of this medical document. All files reviewed at the medical and legal level were incomplete. The difficulty of the materiality of the rape and the psychological consequences in the long run and especially HIV infection should invite to a multidisciplinary, specialized and organized management of sexual child abuse. This study has shown the importance of a correct and complete drafting of the medical certificate, to enable the establishment by the judge the materiality of the facts.

  1. Attaining and Maintaining a Continuity of Knowledge to Draw Safeguards Conclusions with Confidence.

    Energy Technology Data Exchange (ETDEWEB)

    Bean, Robert [Purdue Univ., West Lafayette, IN (United States); Blair, Dianna S. [Sandia National Laboratories (SNL-NM), Albuquerque, NM (United States); Pickett, Chris [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

    2014-11-01

    As the 21st century progresses, new nuclear facilities and the expansion of nuclear activities into new countries will require the International Atomic Energy Agency (IAEA) to place a higher reliance on attaining and maintaining a Continuity of Knowledge (CoK) of its safeguards information than is currently practiced. Additionally, a conceptual view of where and how CoK can be applied will need to evolve to support improved efficiency and efficacy of drawing a safeguards conclusion for each Member State. The ability to draw a safeguards conclusion for a Member State will be predicated on the confidence that CoK has been attained and subsequently maintained with respect to the data and information streams used by the IAEA. This confidence can be described as a function of factors such as elapsed time since the measurement, surveillance of attributes, authentication of information, historic knowledge of potential system failures, and the number and type of data collections. A set of general scenarios are further described for determining what is required to attain CoK and whether CoK has been maintained. A high-level analysis of example scenarios is presented to identify failures or gaps that could cause a loss of CoK. Potential areas for technological research and development are discussed for the next generation of CoK tools.

  2. Analysing and exemplifying forensic conclusion criteria in terms of Bayesian decision theory.

    Science.gov (United States)

    Biedermann, A; Bozza, S; Taroni, F

    2018-03-01

    There is ongoing discussion in forensic science and the law about the nature of the conclusions reached based on scientific evidence, and on how such conclusions - and conclusion criteria - may be justified by rational argument. Examples, among others, are encountered in fields such as fingermarks (e.g., 'this fingermark comes from Mr. A's left thumb'), handwriting examinations (e.g., 'the questioned signature is that of Mr. A'), kinship analyses (e.g., 'Mr. A is the father of child C') or anthropology (e.g., 'these are human remains'). Considerable developments using formal methods of reasoning based on, for example (Bayesian) decision theory, are available in literature, but currently such reference principles are not explicitly used in operational forensic reporting and ensuing decision-making. Moreover, applied examples, illustrating the principles, are scarce. A potential consequence of this in practical proceedings, and hence a cause of concern, is that underlying ingredients of decision criteria (such as losses quantifying the undesirability of adverse decision consequences), are not properly dealt with. There is merit, thus, in pursuing the study and discussion of practical examples, demonstrating that formal decision-theoretic principles are not merely conceptual considerations. Actually, these principles can be shown to underpin practical decision-making procedures and existing legal decision criteria, though often not explicitly apparent as such. In this paper, we will present such examples and discuss their properties from a Bayesian decision-theoretic perspective. We will argue that these are essential concepts for an informed discourse on decision-making across forensic disciplines and the development of a coherent view on this topic. We will also emphasize that these principles are of normative nature in the sense that they provide standards against which actual judgment and decision-making may be compared. Most importantly, these standards are

  3. The international INTRAVAL project. Summary and conclusions by the TVO/VTT Team

    International Nuclear Information System (INIS)

    Hautojaervi, A.

    1994-12-01

    Teollisuuden Voima Oy (TVO) participated the international cooperation project INTRAVAL and VTT Energy acted as a project team. The Finnish participation focused on flow and transport in crystalline fractured rock and six test cases out of thirteen were tackled. The experimental results were evaluated mainly by means of analytical transport models. The report presents a short review of the experience obtained in the course of the project. It concentrates on the issues revealed in the discussions and analyses of the six test cases in which the TVO/VTT team actively participated but some of the conclusions are even more general in nature. Some suggestions are made for future experimental and theoretical work in the field of geosphere. (15 refs., 2 tabs.)

  4. The six most essential questions in psychiatric diagnosis: a pluralogue. Part 4: general conclusion

    Directory of Open Access Journals (Sweden)

    Phillips James

    2012-12-01

    Full Text Available Abstract In the conclusion to this multi-part article I first review the discussions carried out around the six essential questions in psychiatric diagnosis – the position taken by Allen Frances on each question, the commentaries on the respective question along with Frances’ responses to the commentaries, and my own view of the multiple discussions. In this review I emphasize that the core question is the first – what is the nature of psychiatric illness – and that in some manner all further questions follow from the first. Following this review I attempt to move the discussion forward, addressing the first question from the perspectives of natural kind analysis and complexity analysis. This reflection leads toward a view of psychiatric disorders – and future nosologies – as far more complex and uncertain than we have imagined.

  5. Conclusive evidence of abrupt coagulation inside the void during cyclic nanoparticle formation in reactive plasma

    International Nuclear Information System (INIS)

    Wetering, F. M. J. H. van de; Nijdam, S.; Beckers, J.

    2016-01-01

    In this letter, we present scanning electron microscopy (SEM) results that confirm in a direct way our earlier explanation of an abrupt coagulation event as the cause for the void hiccup. In a recent paper, we reported on the fast and interrupted expansion of voids in a reactive dusty argon–acetylene plasma. The voids appeared one after the other, each showing a peculiar, though reproducible, behavior of successive periods of fast expansion, abrupt contraction, and continued expansion. The abrupt contraction was termed “hiccup” and was related to collective coagulation of a new generation of nanoparticles growing in the void using relatively indirect methods: electron density measurements and optical emission spectroscopy. In this letter, we present conclusive evidence using SEM of particles collected at different moments in time spanning several growth cycles, which enables us to follow the nanoparticle formation process in great detail.

  6. Gasification of waste. Summary and conclusions of twenty-five years of development

    Energy Technology Data Exchange (ETDEWEB)

    Rensfelt, Erik [TPS Termiska Processer AB, Nykoeping (Sweden); Oestman, Anders [Kemiinformation AB, Stockholm (Sweden)

    2000-04-01

    An overview of nearly thirty years development of waste gasification and pyrolysis technology is given, and some major general conclusions are drawn. The aim has been to give new developers an overview of earlier major attempts to treat MSW/RDF with thermochemical processes, gasification or pyrolysis. Research work in general is not covered, only R and D efforts that have led to substantial testing in pilot scale or demonstration. For further details, especially related to ongoing R and D, readers are referred to other recent reviews. The authors' view is that gasification of RDF with appropriate gas cleaning can play an important role in the future, for environmentally acceptable and efficient energy production. A prerequisite is that some of the major mistakes can be avoided, such as: (1) too rapid scale-up without experimental base, (2) unsuitable pretreatment of MSW to RDF and poor integration with material recycling, and (3) too limited gas/flue gas cleaning.

  7. No Conclusive Evidence for Transits of Proxima b in MOST Photometry

    Energy Technology Data Exchange (ETDEWEB)

    Kipping, David M.; Chen, Jingjing; Sandford, Emily [Department of Astronomy, Columbia University, 550 W. 120th Street, New York, NY 10027 (United States); Cameron, Chris [Department of Mathematics, Physics and Geology, Cape Breton University, 1250 Grand Lake Road, Sydney, NS B1P 6L2 (Canada); Hartman, Joel D.; Bakos, Gáspár Á.; Penev, Kaloyan; Csubry, Zoltan [Department of Astrophysical Sciences, 4 Ivy Lane, Princeton, NJ 08544 (United States); Davenport, James R. A. [Department of Physics and Astronomy, Western Washington University, 516 High Street, Bellingham, WA 98225 (United States); Matthews, Jaymie M. [Department of Physics and Astronomy, University of British Columbia, 6224 Agricultural Road, Vancouver, BC V6T 1Z1 (Canada); Sasselov, Dimitar [Harvard-Smithsonian Center for Astrophysics, 60 Garden Street, Cambridge, MA 02138 (United States); Rowe, Jason [Observatoire Astronomque du Mont Mégantic, Départment de Physique, Université de Montréal C. P. 6128, Succursale, Centre-Ville, Montréal, QC H3C 3J7 (Canada); Siverd, Robert J. [Las Cumbres Observatory Global Telescope Network, 6740 Cortona Drive, Suite 102, Santa Barbara, CA 93117 (United States); Jordán, Andrés [Instituto de Astrofísica, Universidad Católica de Chile, Av. Vicuña Mackenna 4860, 7820436 Macul, Santiago (Chile); Bayliss, Daniel [Observatoire Astronomique de Universite de Genéve, 51 ch. des Maillettes, 1290 Versoix (Switzerland); Henning, Thomas; Mancini, Luigi [Max Plank Institute for Astronomy, Königstuhl 17, D-69117 Heidelberg (Germany); and others

    2017-03-01

    The analysis of Proxima Centauri’s radial velocities recently led Anglada-Escudé et al. to claim the presence of a low-mass planet orbiting the Sun’s nearest star once every 11.2 days. Although the a priori probability that Proxima b transits its parent star is just 1.5%, the potential impact of such a discovery would be considerable. Independent of recent radial velocity efforts, we observed Proxima Centauri for 12.5 days in 2014 and 31 days in 2015 with the Microwave and Oscillations of Stars space telescope. We report here that we cannot make a compelling case that Proxima b transits in our precise photometric time series. Imposing an informative prior on the period and phase, we do detect a candidate signal with the expected depth. However, perturbing the phase prior across 100 evenly spaced intervals reveals one strong false positive and one weaker instance. We estimate a false-positive rate of at least a few percent and a much higher false-negative rate of 20%–40%, likely caused by the very high flare rate of Proxima Centauri. Comparing our candidate signal to HATSouth ground-based photometry reveals that the signal is somewhat, but not conclusively, disfavored (1 σ –2 σ ), leading us to argue that the signal is most likely spurious. We expect that infrared photometric follow-up could more conclusively test the existence of this candidate signal, owing to the suppression of flare activity and the impressive infrared brightness of the parent star.

  8. Definition of sampling units begets conclusions in ecology: the case of habitats for plant communities.

    Science.gov (United States)

    Mörsdorf, Martin A; Ravolainen, Virve T; Støvern, Leif Einar; Yoccoz, Nigel G; Jónsdóttir, Ingibjörg Svala; Bråthen, Kari Anne

    2015-01-01

    In ecology, expert knowledge on habitat characteristics is often used to define sampling units such as study sites. Ecologists are especially prone to such approaches when prior sampling frames are not accessible. Here we ask to what extent can different approaches to the definition of sampling units influence the conclusions that are drawn from an ecological study? We do this by comparing a formal versus a subjective definition of sampling units within a study design which is based on well-articulated objectives and proper methodology. Both approaches are applied to tundra plant communities in mesic and snowbed habitats. For the formal approach, sampling units were first defined for each habitat in concave terrain of suitable slope using GIS. In the field, these units were only accepted as the targeted habitats if additional criteria for vegetation cover were fulfilled. For the subjective approach, sampling units were defined visually in the field, based on typical plant communities of mesic and snowbed habitats. For each approach, we collected information about plant community characteristics within a total of 11 mesic and seven snowbed units distributed between two herding districts of contrasting reindeer density. Results from the two approaches differed significantly in several plant community characteristics in both mesic and snowbed habitats. Furthermore, differences between the two approaches were not consistent because their magnitude and direction differed both between the two habitats and the two reindeer herding districts. Consequently, we could draw different conclusions on how plant diversity and relative abundance of functional groups are differentiated between the two habitats depending on the approach used. We therefore challenge ecologists to formalize the expert knowledge applied to define sampling units through a set of well-articulated rules, rather than applying it subjectively. We see this as instrumental for progress in ecology as only rules

  9. Definition of sampling units begets conclusions in ecology: the case of habitats for plant communities

    Directory of Open Access Journals (Sweden)

    Martin A. Mörsdorf

    2015-03-01

    Full Text Available In ecology, expert knowledge on habitat characteristics is often used to define sampling units such as study sites. Ecologists are especially prone to such approaches when prior sampling frames are not accessible. Here we ask to what extent can different approaches to the definition of sampling units influence the conclusions that are drawn from an ecological study? We do this by comparing a formal versus a subjective definition of sampling units within a study design which is based on well-articulated objectives and proper methodology. Both approaches are applied to tundra plant communities in mesic and snowbed habitats. For the formal approach, sampling units were first defined for each habitat in concave terrain of suitable slope using GIS. In the field, these units were only accepted as the targeted habitats if additional criteria for vegetation cover were fulfilled. For the subjective approach, sampling units were defined visually in the field, based on typical plant communities of mesic and snowbed habitats. For each approach, we collected information about plant community characteristics within a total of 11 mesic and seven snowbed units distributed between two herding districts of contrasting reindeer density. Results from the two approaches differed significantly in several plant community characteristics in both mesic and snowbed habitats. Furthermore, differences between the two approaches were not consistent because their magnitude and direction differed both between the two habitats and the two reindeer herding districts. Consequently, we could draw different conclusions on how plant diversity and relative abundance of functional groups are differentiated between the two habitats depending on the approach used. We therefore challenge ecologists to formalize the expert knowledge applied to define sampling units through a set of well-articulated rules, rather than applying it subjectively. We see this as instrumental for progress in

  10. Single-case synthesis tools II: Comparing quantitative outcome measures.

    Science.gov (United States)

    Zimmerman, Kathleen N; Pustejovsky, James E; Ledford, Jennifer R; Barton, Erin E; Severini, Katherine E; Lloyd, Blair P

    2018-03-07

    Varying methods for evaluating the outcomes of single case research designs (SCD) are currently used in reviews and meta-analyses of interventions. Quantitative effect size measures are often presented alongside visual analysis conclusions. Six measures across two classes-overlap measures (percentage non-overlapping data, improvement rate difference, and Tau) and parametric within-case effect sizes (standardized mean difference and log response ratio [increasing and decreasing])-were compared to determine if choice of synthesis method within and across classes impacts conclusions regarding effectiveness. The effectiveness of sensory-based interventions (SBI), a commonly used class of treatments for young children, was evaluated. Separately from evaluations of rigor and quality, authors evaluated behavior change between baseline and SBI conditions. SBI were unlikely to result in positive behavior change across all measures except IRD. However, subgroup analyses resulted in variable conclusions, indicating that the choice of measures for SCD meta-analyses can impact conclusions. Suggestions for using the log response ratio in SCD meta-analyses and considerations for understanding variability in SCD meta-analysis conclusions are discussed. Copyright © 2018 Elsevier Ltd. All rights reserved.

  11. Galvanizing action: conclusions and next steps for mainstreaming zinc interventions in public health programs.

    Science.gov (United States)

    Brown, Kenneth H; Baker, Shawn K

    2009-03-01

    This paper summarizes the results of the foregoing reviews of the impact of different intervention strategies designed to enhance zinc nutrition, including supplementation, fortification, and dietary diversification or modification. Current evidence indicates a beneficial impact of such interventions on zinc status and zinc-related functional outcomes. Preventive zinc supplementation reduces the incidence of diarrhea and acute lower respiratory tract infection among young children, decreases mortality of children over 12 months of age, and increases growth velocity. Therapeutic zinc supplementation during episodes of diarrhea reduces the duration and severity of illness. Zinc fortification increases zinc intake and total absorbed zinc, and recent studies are beginning to confirm a positive impact of zinc fortification on indicators of population zinc status. To assist with the development of zinc intervention programs, more information is needed on the prevalence of zinc deficiency in different countries, and rigorous evaluations of the effectiveness of large-scale zinc intervention programs should be planned. Recommended steps for scaling up zinc intervention programs, with or without other micronutrients, are described. In summary, there is now clear evidence of the benefit of selected interventions to reduce the risk of zinc deficiency, and a global commitment is urgently needed to conduct systematic assessments of population zinc status and to develop interventions to control zinc deficiency in the context of existing public health and nutrition programs.

  12. Determinants of physician empathy during medical education: hypothetical conclusions from an exploratory qualitative survey of practicing physicians

    Science.gov (United States)

    2014-01-01

    Background Empathy is an outcome-relevant physician characteristic and thus a crucial component of high-quality communication in health care. However, the factors that promote and inhibit the development of empathy during medical education have not been extensively researched. Also, currently there is no explicit research on the perspective of practicing physicians on the subject. Therefore the aim of our study was to explore physicians’ views of the positive and negative influences on the development of empathy during their medical education, as well as in their everyday work as physicians. Method We administered a written Qualitative Short Survey to 63 physicians in seven specialties. They were able to respond anonymously. Our open-ended question was: “What educational content in the course of your studies and/or your specialist training had a positive or negative effect on your empathy?” We analyzed the data using thematic content analysis following Mayring’s approach. Results Forty-two physicians took part in our survey. All together, they mentioned 68 specific factors (37 positive, 29 negative, 2 neutral) from which six themes emerged: 1. In general, medical education does not promote the development of empathy. 2. Recognizing the psycho-social dimensions of care fosters empathy. 3. Interactions with patients in medical practice promote empathy. 4. Physicians’ active self-development through reflective practice helps the development of empathy. 5. Interactions with colleagues can both promote and inhibit empathy through their role modeling of empathic and non-empathic behavior. 6. Stress, time pressure, and adverse working conditions are detrimental to empathy development. Conclusions Our results provide an overview of what might influence the development of clinical empathy, as well as hypothetical conclusions about how to promote it. Reflective practice seems to be lacking in current medical curricula and could be incorporated. Raising physicians

  13. A working group`s conclusion on site specific flow and transport modelling

    Energy Technology Data Exchange (ETDEWEB)

    Andersson, J. [Golder Associates AB (Sweden); Ahokas, H. [Fintact Oy, Helsinki (Finland); Koskinen, L.; Poteri, A. [VTT Energy, Espoo (Finland); Niemi, A. [Royal Inst. of Technology, Stockholm (Sweden). Hydraulic Engineering; Hautojaervi, A. [Posiva Oy, Helsinki (Finland)

    1998-03-01

    This document suggests a strategy plan for groundwater flow and transport modelling to be used in the site specific performance assessment analysis of spent nuclear fuel disposal to be used for the site selection planned by the year 2000. Considering suggested general regulations in Finland, as well as suggested regulations in Sweden and the approach taken in recent safety assessment exercises conducted in these countries, it is clear that in such an analysis, in addition to showing that the proposed repository is safe, there exist needs to strengthen the link between field data, groundwater flow modelling and derivation of safety assessment parameters, and needs to assess uncertainty and variability. The suggested strategy plan builds on an evaluation of different approaches to modelling the groundwater flow in crystalline basement rock, the abundance of data collected in the site investigation programme in Finland, and the modelling methodology developed in the programme so far. It is suggested to model the whole system using nested models, where larger scale models provide the boundary conditions for the smaller ones 62 refs.

  14. OECD/CSNI Workshop on In-Vessel Core Debris Retention and Coolability - Summary and Conclusions

    International Nuclear Information System (INIS)

    Behbahani, Ali-Reza; Drozd, Andrzej; Kim, Sang-Baik; Micaelli, Jean-Claude; Okkonen, Timo; Sugimoto, Jun; Trambauer, Klaus; Tuomisto, Harri

    1999-01-01

    In the spring of 1994 an OECD Workshop on Large Pool Heat transfer was held in Grenoble. The scope of this workshop was the investigation of (1) molten pool heat transfer, (2) heat transfer to the surrounding water, and (3) the feasibility of in-vessel core debris cooling through external cooling of the vessel. Since this time, experimental test series have been completed (e.g., COPO, ULPU, CORVIS) and new experimental programs (e.g., BALI, SONATA, RASPLAV, debris and gap heat transfer) have been established to consolidate and expand the data base for further model development and to improve the understanding of in-vessel debris retention and coolability in a nuclear power plant. Discussions within the CSNI's PWG-2 and the Task Group on Degraded Core Cooling (TG-DCC) have led to the conclusion that the time was ripe for organizing a new international Workshop with the objectives: - to review the results of experimental research that has been conducted in this area; - to exchange information on the results of member countries experiments and model development on in-vessel core debris retention and coolability; - to discuss areas where additional experimental research is needed in order to provide an adequate data base for analytical model development for core debris retention and coolability. The scope of this workshop was limited to the phenomena connected to in-vessel core debris retention and coolability and did not include steam explosion and fission product issues. The workshop was structured into the following sessions: Key note papers; Experiments and model development; Debris bed heat transfer; Corium properties, molten pool convection and crust formation; Gap formation and gap cooling; Creep behaviour of reactor pressure vessel lower head; Ex-vessel boiling and critical heat flux phenomena; Scaling to reactor severe accident conditions and reactor applications. Compared to the previous workshop held in Grenoble in 1994, large progress has been made in the

  15. Fourth Integrated Communications, Navigation, and Surveillance (ICNS) Conference and Workshop 2004: Conclusions and Recommendations

    Science.gov (United States)

    Phillips, Brent; Swanda, Ronald L.; Lewis, Michael S.; Kenagy, Randy; Donahue, George; Homans, Al; Kerczewski, Robert; Pozesky, Marty

    2004-01-01

    The NASA Glenn Research Center organized and hosted the Fourth Integrated Communications, Navigation, and Surveillance (ICNS) Technologies Conference and Workshop, which took place April 26-30, 2004 at the Hyatt Fair Lakes Hotel in Fairfax, Virginia. This fourth conference of the annual series followed the very successful first ICNS Conference (May 1-3, 2001 in Cleveland, Ohio), second ICNS conference (April 29-May 2, 2002 in Vienna, Virginia), and third ICNS conference (May 19-22, 2003 in Annapolis, Maryland). The purpose of the Fourth ICNS Conference was to assemble government, industry and academic communities performing research and development for advanced digital communications, surveillance and navigation systems and associated applications supporting the national and global air transportation systems to: 1) Understand current efforts and recent results in near- and far-term R&D and technology demonstration; 2) Identify integrated digital communications, navigation and surveillance R&D requirements necessary for a safe, secure and reliable, high-capacity, advanced air transportation system; 3) Provide a forum for fostering collaboration and coordination; and 4) Discuss critical issues and develop recommendations to achieve the future integrated CNS vision for national and global air transportation. The workshop attracted 316 attendees from government, industry and academia to address these purposes through technical presentations, breakout sessions, and individual and group discussions during the workshop and after-hours events, and included 16 international attendees. An Executive Committee consisting of representatives of several key segments of the aviation community concerned with CNS issues met on the day following the workshop to consider the primary outcomes and recommendations of the workshop. This report presents an overview of the conference, workshop breakout session results, and the findings of the Executive Committee.

  16. Financial conflicts of interest and conclusions about neuraminidase inhibitors for influenza: an analysis of systematic reviews.

    Science.gov (United States)

    Dunn, Adam G; Arachi, Diana; Hudgins, Joel; Tsafnat, Guy; Coiera, Enrico; Bourgeois, Florence T

    2014-10-07

    Industry funding and financial conflicts of interest may contribute to bias in the synthesis and interpretation of scientific evidence. To examine the association between financial conflicts of interest and characteristics of systematic reviews of neuraminidase inhibitors. Retrospective analysis. Reviews that examined the use of neuraminidase inhibitors in the prophylaxis or treatment of influenza, were published between January 2005 and May 2014, and used a systematic search protocol. Two investigators blinded to all information regarding the review authors independently assessed the presentation of evidence on the use of neuraminidase inhibitors as favorable or not favorable. Financial conflicts of interest were identified using the index reviews, other publications, and Web-based searches. Associations between financial conflicts of interest, favorability assessments, and presence of critical appraisals of evidence quality were analyzed. Twenty-six systematic reviews were identified, of which 13 examined prophylaxis and 24 examined treatment, accounting for 37 distinct assessments. Among assessments associated with a financial conflict of interest, 7 of 8 (88%) were classified as favorable, compared with 5 of 29 (17%) among those without a financial conflict of interest. Reviewers without financial conflicts of interest were more likely to include statements about the quality of the primary studies than those with financial conflicts of interest. The heterogeneity in populations and outcomes examined in the reviews precluded analysis of the contribution of selective inclusion of evidence on the discordance of the assessments made in the reviews. Many of the systematic reviews had overlapping authorship. Reviewers with financial conflicts of interest may be more likely to present evidence about neuraminidase inhibitors in a favorable manner and recommend the use of these drugs than reviewers without financial conflicts of interest. Australian National Health and

  17. On an experimental curiosity that if undetected may lead to erroneous far-reaching conclusions

    International Nuclear Information System (INIS)

    Noninski, V.C.; Ciottone, J.L.; White, P.J.

    1997-01-01

    This letter gives a brief discussion of the possibilities of inducing nuclear effects by carrying out only chemical reactions. Undoubtedly, this interest is a result of the still unresolved problem of 'cold fusion,' and some colleagues tend to see a clear connection, and even an extension of the studies, between cold fusion and the alleged chemical transmutation of elements. While we have already published thorough reports (negative so far) of our studies with regard to the claimed increase of gamma-ray emission and beta decay after burning of a mixture of chemicals, this letter informs the Fusion Technology readership of an experimental curiosity that is encountered during similar studies that initially led us to an erroneous conclusion. As in previous studies, we compared certain radiochemical properties of a mixture of chemicals before and after a chemical reaction (burning). Under discussion here is a peak that we observed in the range of 412 keV in the gamma spectrum in one of the burned samples after neutron activating it for 3 min at 1 kW. This peak was ostensibly not present in the same sample unburned. 4 refs., 2 figs

  18. Why do different criteria for 'cure' yield different conclusions in comparing two treatments for bacterial vaginosis?

    Science.gov (United States)

    Thomas, Katherine K; Sanchez, Sixto; Garcia, Patricia J; Holmes, King K

    2005-09-01

    The objective of this study was to determine why different criteria for response to treatment of bacterial vaginosis (BV) led to markedly different conclusions about treatment efficacy in a randomized trial comparing metronidazole gel versus metronidazole/nystatin ovules. We compared the impact of two treatment regimens on individual components of Amsel and Nugent criteria at follow-up visits 14, 42, and 104 days after initiating treatment. Compared with gel, ovules more effectively eliminated amines, clue cells, and Gardnerella, Prevotella, or Mobiluncus morphotypes from vaginal fluid, thus achieving cure based on "usual" criteria (absence of BV by Amsel or Nugent criteria), but did not more effectively restore Lactobacillus morphotypes or lower vaginal pH, thus not meeting Federal Drug Administration (FDA) criteria for cure. Because early vaginal recolonization by lactobacilli was poor after both gel and ovules, FDA draft criteria for cure missed marked differences in treatment efficacies against Gardnerella, clue cells, and amines. Cure defined more "usually" may give more useful information.

  19. Development integration via real and technological convergence. Experience of Poland and conclusions for Ukraine

    Directory of Open Access Journals (Sweden)

    Michał G. Woźniak

    2014-09-01

    Full Text Available The paper summarizes main achievements, losses and gains during the first decade of Poland's membership in the EU, while also aiming at development of suggestions for the Polish economic policy in the years to come, as well as draws conclusions for Ukraine, which has now elected the strategy of international economic cooperation. The first part of the paper presents an empirical analysis of Poland's both real and technological convergence with the developed EU countries. These data show that since 1994, as the process of Poland integration with the EU commenced, our country significantly reduced the income and technology gap as compared to the EU. During the financial crisis, Poland 'felt' better than most European countries. In the second part of the paper we attempt to answer the question as to the current conditions of Polish economy development. It is demonstrated that Poland's economic success was due to multiple factors such as endogenous and exogenous, historical and those derived from present events. However, it can be assumed that integration with the EU has been an important positive factor in development of Poland during recent 20 years. Great importance was also vested in the implementation of economic reforms in Poland as well as in policy of the government, although not faultless. The last section of the paper identifies problems now faced by the EU and individual member states, including Poland as regards future years till 2020

  20. Paradigm, experiment and conclusion: La Casa by Bernard Rudofsky in three acts

    Directory of Open Access Journals (Sweden)

    Héctor García-Diego Villarías

    2018-04-01

    Full Text Available La Casa –or in English, the house– that Bernard Rudofsky built on the Spanish Mediterranean coast in 1971 is a valuable case study on the operational possibilities of popular architecture in the practice of this contemporary discipline. It is a repository of theoretical references typical of the vernacular world; its author, known for the exhibition Architecture without Architects, is emblematic of this type of architecture to which he dedicated much of his efforts as a theorist and polemicist throughout the course of his life. Additionally, La Casa is a unique architectural feat as it involves the practical materialization of its implicated theoretical position. It is possible that a concrete conclusion can be drawn from this case, which may shed light on the possible operability of a type of architecture that presents more than a few difficulties for the current context of the discipline, despite being habitually admired and praised. Additionally, the text presented here brings to light unpublished information found in the personal diaries of the architect that allows for the recreation of the circumstances surrounding the ideation and construction of this piece of architecture.

  1. Permutation entropy based time series analysis: Equalities in the input signal can lead to false conclusions

    Energy Technology Data Exchange (ETDEWEB)

    Zunino, Luciano, E-mail: lucianoz@ciop.unlp.edu.ar [Centro de Investigaciones Ópticas (CONICET La Plata – CIC), C.C. 3, 1897 Gonnet (Argentina); Departamento de Ciencias Básicas, Facultad de Ingeniería, Universidad Nacional de La Plata (UNLP), 1900 La Plata (Argentina); Olivares, Felipe, E-mail: olivaresfe@gmail.com [Instituto de Física, Pontificia Universidad Católica de Valparaíso (PUCV), 23-40025 Valparaíso (Chile); Scholkmann, Felix, E-mail: Felix.Scholkmann@gmail.com [Research Office for Complex Physical and Biological Systems (ROCoS), Mutschellenstr. 179, 8038 Zurich (Switzerland); Biomedical Optics Research Laboratory, Department of Neonatology, University Hospital Zurich, University of Zurich, 8091 Zurich (Switzerland); Rosso, Osvaldo A., E-mail: oarosso@gmail.com [Instituto de Física, Universidade Federal de Alagoas (UFAL), BR 104 Norte km 97, 57072-970, Maceió, Alagoas (Brazil); Instituto Tecnológico de Buenos Aires (ITBA) and CONICET, C1106ACD, Av. Eduardo Madero 399, Ciudad Autónoma de Buenos Aires (Argentina); Complex Systems Group, Facultad de Ingeniería y Ciencias Aplicadas, Universidad de los Andes, Av. Mons. Álvaro del Portillo 12.455, Las Condes, Santiago (Chile)

    2017-06-15

    A symbolic encoding scheme, based on the ordinal relation between the amplitude of neighboring values of a given data sequence, should be implemented before estimating the permutation entropy. Consequently, equalities in the analyzed signal, i.e. repeated equal values, deserve special attention and treatment. In this work, we carefully study the effect that the presence of equalities has on permutation entropy estimated values when these ties are symbolized, as it is commonly done, according to their order of appearance. On the one hand, the analysis of computer-generated time series is initially developed to understand the incidence of repeated values on permutation entropy estimations in controlled scenarios. The presence of temporal correlations is erroneously concluded when true pseudorandom time series with low amplitude resolutions are considered. On the other hand, the analysis of real-world data is included to illustrate how the presence of a significant number of equal values can give rise to false conclusions regarding the underlying temporal structures in practical contexts. - Highlights: • Impact of repeated values in a signal when estimating permutation entropy is studied. • Numerical and experimental tests are included for characterizing this limitation. • Non-negligible temporal correlations can be spuriously concluded by repeated values. • Data digitized with low amplitude resolutions could be especially affected. • Analysis with shuffled realizations can help to overcome this limitation.

  2. Evaluating Behaviorally Oriented Aviation Maintenance Resource Management (MRM) Training and Programs: Methods, Results, and Conclusions

    Science.gov (United States)

    Taylor, James C.; Thomas, Robert L., III

    2003-01-01

    Assessment of the impact of Aviation Resource Management Programs on aviation culture and performance has compelled a considerable body of research (Taylor & Robertson, 1995; Taylor, 1998; Taylor & Patankar, 2001). In recent years new methods have been applied to the problem of maintenance error precipitated by factors such as the need for self-assessment of communication and trust. The present study - 2002 -- is an extension of that past work. This research project was designed as the conclusion of a larger effort to help understand, evaluate and validate the impact of Maintenance Resource Management (MRM) training programs, and other MRM interventions on participant attitudes, opinions, behaviors, and ultimately on enhanced safety performance. It includes research and development of evaluation methodology as well as examination of psychological constructs and correlates of maintainer performance. In particular, during 2002, three issues were addressed. First, the evaluation of two (independent & different) MRM programs for changing behaviors was undertaken. In one case we were able to further apply the approach to measuring written communication developed during 2001 (Taylor, 2002; Taylor & Thomas, 2003). Second, the MRM/TOQ surveys were made available for completion on the internet. The responses from these on-line surveys were automatically linked to a results calculator (like the one developed and described in Taylor, 2002) to aid industry users in analyzing and evaluating their local survey data on the internet. Third, the main trends and themes from our research about MRM programs over the past dozen years were reviewed.

  3. Pressure Measurement Techniques for Abdominal Hypertension: Conclusions from an Experimental Model.

    Science.gov (United States)

    Chopra, Sascha Santosh; Wolf, Stefan; Rohde, Veit; Freimann, Florian Baptist

    2015-01-01

    Introduction. Intra-abdominal pressure (IAP) measurement is an indispensable tool for the diagnosis of abdominal hypertension. Different techniques have been described in the literature and applied in the clinical setting. Methods. A porcine model was created to simulate an abdominal compartment syndrome ranging from baseline IAP to 30 mmHg. Three different measurement techniques were applied, comprising telemetric piezoresistive probes at two different sites (epigastric and pelvic) for direct pressure measurement and intragastric and intravesical probes for indirect measurement. Results. The mean difference between the invasive IAP measurements using telemetric pressure probes and the IVP measurements was -0.58 mmHg. The bias between the invasive IAP measurements and the IGP measurements was 3.8 mmHg. Compared to the realistic results of the intraperitoneal and intravesical measurements, the intragastric data showed a strong tendency towards decreased values. The hydrostatic character of the IAP was eliminated at high-pressure levels. Conclusion. We conclude that intragastric pressure measurement is potentially hazardous and might lead to inaccurately low intra-abdominal pressure values. This may result in missed diagnosis of elevated abdominal pressure or even ACS. The intravesical measurements showed the most accurate values during baseline pressure and both high-pressure plateaus.

  4. Micah 7:8-20: An apt conclusion to the book of Micah

    Directory of Open Access Journals (Sweden)

    W J Wessels

    2003-10-01

    Full Text Available It is argued in this article that Micah 7:8-20 forms an apt conclusion to the book of Micah. As was the case with Micah 1, the concluding section also focusses on Yahweh and his dealings with the people of the earth. There is a universal tendency to be detected in this section as well. An important aspect to notice� is� the liturgical nature of chapters six and seven, especially 7:8-20. There is a vagueness, almost a timelessness, imbuing this section. This could be intended allowing later generations of believers to apply these words to� their� own� circumstances. With Micah 7:8-20 as the concluding section of the book, one is left with a sense of well-roundedness, of completeness. The collection of oracles attributed� to Micah in general has a sombre tone. For this very reason Micah� 7:8-20� seems� to� change� the mood. It breathes hope into a negative atmosphere of judgment. It ends with a strong emphasis on the power of Yahweh, the power of forgiveness.

  5. A conclusive scalable model for the complete actuation response for IPMC transducers

    International Nuclear Information System (INIS)

    McDaid, A J; Aw, K C; Haemmerle, E; Xie, S Q

    2010-01-01

    This paper proposes a conclusive scalable model for the complete actuation response for ionic polymer metal composites (IPMC). This single model is proven to be able to accurately predict the free displacement/velocity and force actuation at varying displacements, with up to 3 V inputs. An accurate dynamic relationship between the force and displacement has been established which can be used to predict the complete actuation response of the IPMC transducer. The model is accurate at large displacements and can also predict the response when interacting with external mechanical systems and loads. This model equips engineers with a useful design tool which enables simple mechanical design, simulation and optimization when integrating IPMC actuators into an application. The response of the IPMC is modelled in three stages: (i) a nonlinear equivalent electrical circuit to predict the current drawn, (ii) an electromechanical coupling term and (iii) a segmented mechanical beam model which includes an electrically induced torque for the polymer. Model parameters are obtained using the dynamic time response and results are presented demonstrating the correspondence between the model and experimental results over a large operating range. This newly developed model is a large step forward, aiding in the progression of IPMCs towards wide acceptance as replacements to traditional actuators

  6. Results and Conclusions from the NASA Isokinetic Total Water Content Probe 2009 IRT Test

    Science.gov (United States)

    Reehorst, Andrew; Brinker, David

    2010-01-01

    The NASA Glenn Research Center has developed and tested a Total Water Content Isokinetic Sampling Probe. Since, by its nature, it is not sensitive to cloud water particle phase nor size, it is particularly attractive to support super-cooled large droplet and high ice water content aircraft icing studies. The instrument comprises the Sampling Probe, Sample Flow Control, and Water Vapor Measurement subsystems. Results and conclusions are presented from probe tests in the NASA Glenn Icing Research Tunnel (IRT) during January and February 2009. The use of reference probe heat and the control of air pressure in the water vapor measurement subsystem are discussed. Several run-time error sources were found to produce identifiable signatures that are presented and discussed. Some of the differences between measured Isokinetic Total Water Content Probe and IRT calibration seems to be caused by tunnel humidification and moisture/ice crystal blow around. Droplet size, airspeed, and liquid water content effects also appear to be present in the IRT calibration. Based upon test results, the authors provide recommendations for future Isokinetic Total Water Content Probe development.

  7. Conclusions from working group 2 - the analyses of the WIPP-2 experiments

    International Nuclear Information System (INIS)

    Jackson, C.P.

    1995-01-01

    The INTRAVAL WIPP-2 test case is based on data from site investigations carried out at the Waste Isolation Pilot Plant (WIPP) in New Mexico, USA. The site has been chosen as a potential location for a radioactive waste repository. Extensive investigations have been carried out, focused mainly on groundwater flow and transport in the Culebra Dolomite, the main pathway for transport of radionuclides off the site by groundwater in the case of an accidental borehole intrusion into the repository. Five teams studied the test case. Two teams addressed issues involved in the treatment of heterogeneity. Stochastic models and a Monte Carlo approach were used. One team quantified the increased uncertainty resulting from fewer data and explored the issues involved in validation of stochastic models. A second team developed a new method for conditioning stochastic models on head data. Two other teams examined issues relating to the choice of conceptual models. Two-dimensional vertical cross-section models were used to explore the importance of vertical flow. The fifth team advocate the use of a variety of models to highlight the most important processes and parameters. Conclusions from each team experiment are analysed. (J.S.). 4 refs., 11 figs

  8. A fine-grained analysis of the jumping-to-conclusions bias in schizophrenia

    Directory of Open Access Journals (Sweden)

    Steffen Moritz

    2009-12-01

    Full Text Available Impaired decision behavior has been repeatedly observed in schizophrenia patients. We investigated several cognitive mechanisms that might contribute to the jumping-to-conclusions bias (JTC seen in schizophrenia patients: biases in information-gathering, information weighting and integration, and overconfidence, using the process tracing paradigm Mouselab. Mouselab allows for an in-depth exploration of various decision-making processes in a structured information environment. A total of 37 schizophrenia patients and 30 healthy controls participated in the experiment. Although showing less focused and systematic information search, schizophrenia patients practically considered all pieces of information and showed no JTC in the sense of collecting less pieces of evidence. Choices of patients and controls both approximated a rational solution quite well, but patients showed more extreme confidence ratings. Both groups mainly used weighted additive decision strategies for information integration and only a small proportion relied on simple heuristics. Under high stress induced by affective valence plus time pressure, however, schizophrenia patients switched to equal weighting strategies: less valid cues and more valid ones were weighted equally.

  9. Methodology and conclusions of activation calculations of WWER-440 type nuclear power plants

    Energy Technology Data Exchange (ETDEWEB)

    Babcsány, Boglárka, E-mail: boglarka.babcsany@reak.bme.hu; Czifrus, Szabolcs; Fehér, Sándor

    2015-04-01

    Highlights: • Activation calculation of two WWER-440 type nuclear power plants. • Detailed description of the applied activation calculation methodology. • Graphical results for total activity and waste index categorization. • General conclusions for activation applicable in the case of PWR reactors. - Abstract: Activation calculations for two nuclear power plants of WWER-440 type have been performed by the authors in order to assist the decommissioning planning by assessing the radioactive inventory present at the time of and at different times after the final shutdown. According to related international literature and studies performed earlier by the authors, considering the activity more than 99% of this inventory is concentrated in the materials directly surrounding the reactor core, where the predominant evolution of radionuclides is generated by neutron induced nuclear reactions. In order to obtain the highest possible accuracy in modelling, three-dimensional Monte Carlo neutron transport calculations were performed. Besides the methods and models applied to these analyses, the paper also summarizes the results that can be generally applied to such nuclear power plant types. At the time of shutdown, the total activity of the stainless steel components is about 6 × 10{sup 16} Bq and 1.3 × 10{sup 17} Bq for the two NPPs considered. The biological shielding concrete constitutes approximately 7 × 10{sup 13} Bq and 1.1 × 10{sup 14} Bq.

  10. Iron deficiency anaemia: with the conclusion of a need for iron reader

    Science.gov (United States)

    Lim, Wai Feng; Yap, Boon Kar; Lai, Mei I.; Talik, Noorazrina; Nasser, Ammar Ahmed; Al-Haiqi, Ahmed Mubarak Ahmed; Sankar Krishnan, Prajindra

    2017-10-01

    In our bloodstream, there are plenty of red blood cells (RBC), which function as an important oxygen carrier in our bodies. Each RBC consists of millions of haemoglobin (Hb), which is made up from globin and iron. If any deficiency/malfunction of any globin, it will lead to anaemia as indicated in low Hb level while iron deficiency anaemia (IDA) is anaemic due to the lacking of iron as indicated in low Hb and ferritin levels. IDA affects almost two billion people globally while anaemia without iron deficiency, such as thalassaemia, affects almost 4.5% in Malaysian population. These anaemic conditions have similar clinical symptoms like fatigue, dizziness, in which disturb their cognitive development and productivity in workplace. In areas without proper medical access, many anaemic individuals were misdiagnosed and treated with iron tablets because they were thought to have iron deficiency anaemia due to low Hb content. But, excess iron is toxic to the body. Misdiagnosis can be avoided by iron status assessment. We hereby review the currently available iron status parameters in laboratory and field study with the conclusion of demonstrating the importance of a need for iron reader, in the effort to reduce the prevalence of IDA globally.

  11. Blast Testing Issues and TBI; Experimental Models that Lead to Wrong Conclusions

    Directory of Open Access Journals (Sweden)

    Charles E. Needham

    2015-04-01

    Full Text Available Over the past several years we have noticed an increase in the number of blast injury studies published in peer-reviewed biomedical journals that have utilized improperly conceived experiments. Data from these studies will lead to false conclusions and more confusion than advancement in the understanding of blast injury, particularly blast neurotrauma. Computational methods to properly characterize the blast environment have been available for decades. These methods, combined with a basic understanding of blast wave phenomena enable researchers to extract useful information from well documented experiments. This basic understanding must include the differences and interrelationships of static pressure, dynamic pressure, reflected pressure, and total or stagnation pressure in transient shockwave flows, how they relate to loading of objects, and how they are properly measured. However, it is critical that the research community effectively overcomes the confusion that has been compounded by a misunderstanding of the differences between the loading produced by a free field explosive blast and loading produced by a conventional shock tube. The principles of blast scaling have been well established for decades and when properly applied will do much to repair these problems.This paper provides guidance regarding proper experimental methods and offers insights into the implications of improperly designed and executed tests. Through application of computational methods, useful data can be extracted from well documented historical tests, and future work can be conducted in a way to maximize the effectiveness and use of valuable biological test data.

  12. Osiris and SOMBRERO inertial fusion power plant designs - summary, conclusions, and recommendations

    International Nuclear Information System (INIS)

    Meier, Wayne R.

    1994-01-01

    An 18 month study to evaluate the potential of inertial fusion energy (IFE) for electric power production has been completed. The primary objective of the study was to provide the US Department of Energy with an evaluation of the potential of inertial fusion for electric power production. The study included the conceptual design of two inertial fusion power plants. Osiris uses an induction linac heavy ion beam driver, and SOMBRERO uses a krypton fluoride laser driver. Conceptual designs were completed for the reactors, power conversion and plant facilities, and drivers. Environmental and safety aspects, technical issues, technology development needs, and economics of the final point designs were assessed and compared. This paper summarizes the results and conclusions of the conceptual designs and results of the assessment studies. We conclude that IFE has the potential of producing technically credible designs with environmental, safety, and economics characteristics that are just as attractive as magnetic fusion. Realizing this potential will require additional research and development on target physics, chamber design, target production and injection systems, and drivers. ((orig.))

  13. KiKK: An endless story or the long way to come to a conclusion?

    International Nuclear Information System (INIS)

    Michel, Rolf; Mueller, Wolfgang-Ulrich

    2009-01-01

    More than one year after the publication of the KiKK-Study (Epidemiological Study on Childhood Cancer in the Vicinity of Nuclear Power Plants), which reported a statistical correlation between the proximity of a person's residence to the nearest nuclear power plant, at the time of diagnosis, and the person's risk of contracting cancer (or leukaemia) prior to his or her fifth birthday, the SSK presented its assessment and the related scientific explanatory statement to the public on the occasion of an expert discussion in Bonn on February 26, 2009, This article describes the background of the SSK deliberations and gives a survey of its essential results and conclusions. In total, the results are unsatisfactory, since the SSK was not able to explain the findings of the KiKK-Study. However, this was not unexpected considering the international state of knowledge regarding the development of childhood cancer. Considering the fact, that the radiation exposure of members of the public, originating from the nuclear power plants even at the locations of the potentially highest exposures, is by orders of magnitude lower than the natural radiation exposures, the SSK was able to exclude the radiation from the nuclear power plants as cause of the observed increased relative risks. Any more far-reaching explanation attempts would be mere speculation. It is still a long way to know how childhood cancer develops and how the results of the KiKK-Study or other small-scale enhancements of the cancer risk can be explained. (orig.)

  14. Summary and conclusions of the specialist meeting on severe accident management programme development

    International Nuclear Information System (INIS)

    1992-01-01

    The CSNI Specialist meeting on severe accident management programme development was held in Rome and about seventy experts from thirteen countries attended the meeting. A total of 27 papers were presented in four sessions, covering specific aspects of accident management programme development. It purposely focused on the programmatic aspects of accident management rather than on some of the more complex technical issues associated with accident management strategies. Some of the major observations and conclusions from the meeting are that severe accident management is the ultimate part of the defense in depth concept within the plant. It is function and success oriented, not event oriented, as the aim is to prevent or minimize consequences of severe accidents. There is no guarantee it will always be successful but experts agree that it can reduce the risks significantly. It has to be exercised and the importance of emergency drills has been underlined. The basic structure and major elements of accident management programmes appear to be similar among OECD member countries. Dealing with significant phenomenological uncertainties in establishing accident management programmes continues to be an important issue, especially in confirming the appropriateness of specific accident management strategies

  15. FOETOMATERNAL OUTCOME OF OBSTETRIC CHOLESTASIS

    Directory of Open Access Journals (Sweden)

    Nina Mishra

    2017-07-01

    Full Text Available BACKGROUND Obstetric cholestasis is a disorder of liver function commonly occurring in the third trimester of pregnancy. Clinical characters of this disorder include unexplained maternal pruritus, most common site being palms and soles, altered liver functions (elevated serum transaminases and increased fasting serum bile acids (>10 micro mol/L in previously healthy pregnant women. The incidence is variable geographically from 0.1% to 15.6% all over the world. The aetiology of this condition is not fully understood. Its pathogenesis is related to increased sex hormone synthesis, environmental factors and genetic predisposition. Obstetric cholestasis can lead to increased foetal morbidity and mortality with regards to preterm delivery, neonatal respiratory distress syndrome, foetal distress and sudden intrauterine foetal death. Treatment of the disease focus on relieving symptoms and signs. The aim of the study is to evaluate the pregnancy and foetal outcome of pregnant women with obstetric cholestasis. MATERIALS AND METHODS A cross-sectional study was conducted in M.K.C.G. Medical College and Hospital, Berhampur from February 2015 to May 2017. Inclusion Criteria- All patients having pruritus during course of pregnancy with biochemical evidence of raised liver function tests attending antenatal clinic or labour room. Exclusion Criteria- 1 Pregnant women without pruritus; 2 Pregnant women having other liver diseases. RESULTS The incidence of obstetric cholestasis was 0.6%. Majority of cases were primigravida (72.9%. Positive family history was present in 11.4% of cases. Majority of cases (77.1% had normal vaginal delivery. 22.9% of cases had caesarean section. Primary postpartum haemorrhage occurred in only 2.9% of cases. CONCLUSION Obstetric cholestasis can be managed by improving the circulating bile acid level, targeting the cause of pruritus and optimising the time of delivery as a result of which we can reduce adverse pregnancy outcomes.

  16. Randomized trials, generalizability, and meta-analysis: Graphical insights for binary outcomes

    Directory of Open Access Journals (Sweden)

    Kramer Barnett S

    2003-06-01

    Full Text Available Abstract Background Randomized trials stochastically answer the question. "What would be the effect of treatment on outcome if one turned back the clock and switched treatments in the given population?" Generalizations to other subjects are reliable only if the particular trial is performed on a random sample of the target population. By considering an unobserved binary variable, we graphically investigate how randomized trials can also stochastically answer the question, "What would be the effect of treatment on outcome in a population with a possibly different distribution of an unobserved binary baseline variable that does not interact with treatment in its effect on outcome?" Method For three different outcome measures, absolute difference (DIF, relative risk (RR, and odds ratio (OR, we constructed a modified BK-Plot under the assumption that treatment has the same effect on outcome if either all or no subjects had a given level of the unobserved binary variable. (A BK-Plot shows the effect of an unobserved binary covariate on a binary outcome in two treatment groups; it was originally developed to explain Simpsons's paradox. Results For DIF and RR, but not OR, the BK-Plot shows that the estimated treatment effect is invariant to the fraction of subjects with an unobserved binary variable at a given level. Conclusion The BK-Plot provides a simple method to understand generalizability in randomized trials. Meta-analyses of randomized trials with a binary outcome that are based on DIF or RR, but not OR, will avoid bias from an unobserved covariate that does not interact with treatment in its effect on outcome.

  17. Twenty years of children’s health monitoring: organization, results, conclusions

    Directory of Open Access Journals (Sweden)

    Aleksandra Anatol’evna Shabunova

    2015-05-01

    Full Text Available Deep understanding of human potential reproduction, presenting it as a continuous cycle and reflecting the continuity of generations, is significant for the formation of health and development of children. Today’s children will determine the future of Russian society. It is they who in 10–15 years will be a major part of the labor and creative population, a demographic base of the country. The research into children’s problems through the prism of socio-economic development helps identify targets of the state many-sided policy. The article presents results of the long-term medical sociological monitoring on the formation of child health carried out by the Institute of Socio-Economic Development of Territories of RAS with the support of the Vologda Oblast Healthcare Department since 1995. The special monitoring study of health dynamics in real time is unique not only for the Vologda Oblast, but for Russia as well. It reveals the transformation of a personality and the dependence of these changes on direct and indirect factors. The work’s feature is that it addresses an extremely important and wide range of issues: whether man was born healthy or not, if he/she is unhealthy, then why and why he/she was born unhealthy; whether his/her health after the birth is improving or deteriorating; if health is changing, what causes the changes. The 15 year observations disclose the dynamics of child health in the conditions of transformation processes taking place in the country. If the official statistics only records certain health trends, the monitoring results allow us to talk about them at a qualitatively new level. They reveal the underlying causes of demographic processes. The conclusion is, on the one hand, obvious and, on the other hand, it can not be neglected: economic stability and orderly development of the social sphere are critical for family well-being and child health. The reverse situation leads to the destruction of the family

  18. [Domestic elder abuse and neglect--conclusions from the evaluation of a model project].

    Science.gov (United States)

    Görgen, T; Nägele, B

    2005-02-01

    The main task of a federally funded model project in the German city of Hannover was to develop approaches for prevention and intervention in the field of domestic elder abuse. Over a three year period (1998-2001), different approaches--like a telephone helpline for senior citizens, and social workers operating as counsellors for elderly people and their relatives--were tested at a local level. The paper presents results from the evaluation of the project and draws conclusions for future prevention and intervention in the field. The authors argue that the explicit use of the conceptual framework of "violence"/"abuse" creates potentials for scandalizing the issue and is therefore supportive for media appearance, whereas it can impede the approach to the main target groups (elderly people and their relatives) and reduce accessibility of counselling services for potential clients. In the light of evaluation results the focus of the project ("domestic elder abuse" or "violence against elderly people in close relationships") was too narrow for a local project. Counselling services were used in a relatively small number of cases; analyses of cases show that incidents of domestic elder abuse are often embedded in complex problem constellations. Cases brought to the attention of the model project were multifaceted and not limited to incidents of neglect and abuse of elderly care recipients caused by caregiver overload. Cases of intimate violence in partnerships and of intergenerational violence without any of the participants being dependent on care show the need to develop a broader concept of domestic elder abuse. Integration of the concepts of domestic violence, violence against women, elder abuse/neglect and abuse/neglect in caregiving relationships is necessary on a conceptual level as well as on the level of interagency cooperation of institutions dealing with cases of "elder abuse".

  19. On the challenges of drawing conclusions from p-values just below 0.05

    Science.gov (United States)

    2015-01-01

    In recent years, researchers have attempted to provide an indication of the prevalence of inflated Type 1 error rates by analyzing the distribution of p-values in the published literature. De Winter & Dodou (2015) analyzed the distribution (and its change over time) of a large number of p-values automatically extracted from abstracts in the scientific literature. They concluded there is a ‘surge of p-values between 0.041–0.049 in recent decades’ which ‘suggests (but does not prove) questionable research practices have increased over the past 25 years.’ I show the changes in the ratio of fractions of p-values between 0.041–0.049 over the years are better explained by assuming the average power has decreased over time. Furthermore, I propose that their observation that p-values just below 0.05 increase more strongly than p-values above 0.05 can be explained by an increase in publication bias (or the file drawer effect) over the years (cf. Fanelli, 2012; Pautasso, 2010, which has led to a relative decrease of ‘marginally significant’ p-values in abstracts in the literature (instead of an increase in p-values just below 0.05). I explain why researchers analyzing large numbers of p-values need to relate their assumptions to a model of p-value distributions that takes into account the average power of the performed studies, the ratio of true positives to false positives in the literature, the effects of publication bias, and the Type 1 error rate (and possible mechanisms through which it has inflated). Finally, I discuss why publication bias and underpowered studies might be a bigger problem for science than inflated Type 1 error rates, and explain the challenges when attempting to draw conclusions about inflated Type 1 error rates from a large heterogeneous set of p-values. PMID:26246976

  20. Beads task vs. box task: The specificity of the jumping to conclusions bias.

    Science.gov (United States)

    Balzan, Ryan P; Ephraums, Rachel; Delfabbro, Paul; Andreou, Christina

    2017-09-01

    Previous research involving the probabilistic reasoning 'beads task' has consistently demonstrated a jumping-to-conclusions (JTC) bias, where individuals with delusions make decisions based on limited evidence. However, recent studies have suggested that miscomprehension may be confounding the beads task. The current study aimed to test the conventional beads task against a conceptually simpler probabilistic reasoning "box task" METHODS: One hundred non-clinical participants completed both the beads task and the box task, and the Peters et al. Delusions Inventory (PDI) to assess for delusion-proneness. The number of 'draws to decision' was assessed for both tasks. Additionally, the total amount of on-screen evidence was manipulated for the box task, and two new box task measures were assessed (i.e., 'proportion of evidence requested' and 'deviation from optimal solution'). Despite being conceptually similar, the two tasks did not correlate, and participants requested significantly less information on the beads task relative to the box task. High-delusion-prone participants did not demonstrate hastier decisions on either task; in fact, for box task, this group was observed to be significantly more conservative than low-delusion-prone group. Neither task was incentivized; results need replication with a clinical sample. Participants, and particularly those identified as high-delusion-prone, displayed a more conservative style of responding on the novel box task, relative to the beads task. The two tasks, whilst conceptually similar, appear to be tapping different cognitive processes. The implications of these results are discussed in relation to the JTC bias and the theoretical mechanisms thought to underlie it. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Managing nuclear waste: a better idea (Excerpt of conclusions and recommendations)

    International Nuclear Information System (INIS)

    1984-12-01

    The panel concludes that an immediate effort must be made to improve the credibility, internal flexibility and cost-effectiveness of the Office of Civilian Radioactive Waste Management (OCRWM). However, in recognition that no modification to DOE/OCRWM organization would necessarily provide adequate stability and continuity, it is our principal recommendation that investigation of the specific steps necessary to implement, for example, a dedicated federally chartered corporation (the first choice of the Panel voting on organizational tests), should be undertaken immediately so that Congress can have a precise understanding of the legislative changes required to bring about such an organization. The main thrust of the Panel study has dealt with the structure and capabilities of various organizational alternatives for managing the high-level radioactive waste management program. The Panel also gave consideration to the financing processes of the Nuclear Waste Policy Act (NWPA), and to certain financing alternatives which might be substituted for the existing mechanisms. In doing so, the Panel encountered an array of financial uncertainties which confront the radioactive waste management program as it moves forward over the next two decades. At this juncture, it is extremely difficult to predict how future events, programmatic developments, and economic influences will affect the financing structure and cost level over the term of the program. It is the Panel's conclusion that the financing mechanism provided by Congress under the Nuclear Waste Policy Act appears to be fair, amenable to administrative implementation and cost controls, and sufficiently flexible to accommodate the full-recovery requirement of the legislation. Under NWPA, utilities are assessed a fee of 1 mill per kilowatthour of nuclear-generated electricity, plus a one-time fee for spent fuel accumulated prior to April 7, 1983

  2. Radioactive-waste ocean dumping will have negligible enviromental impact. Conclusion of draft assessment of NSB

    Energy Technology Data Exchange (ETDEWEB)

    1976-11-01

    This draft report is the result of extensive studies based on the best available information in the field of oceanography, marine radiobiology and health physics. On various basic considerations, assessment was undertaken, and the following conclusion was reached. The quantity of radioactivity to be dumped at one time is assumed to be 500 Ci in the case of test dumping, and 10/sup 5/ Ci/year in the case of full-scale dumping. The conditions required for the dumping sea area are that the bottom water flow and upwelling amount are limited, and that the sea bottom is flat. The horizontal dispersion coefficient of 10/sup 7/ cm/sup 2//sec and the vertical dispersion coefficient of 2 x 10/sup 2/ cm/sup 2//sec are assumed. It is assumed that the radionuclides in the disposed package would leached out as soon as it reaches the sea bottom, and would not show any physicochemical behavior. Typycal radionuclides are classified into 5 groups in terms of their half lives, and their estimated concentrations at 1 km depth are tabulated. The maximum level of individual dose and the magnitude of population dose were assessed on the fishermen working in the dumping sea area, and the adults, children and infants who were expected to receive higher dose on account of the larger intake of fish products than average. The dose level given with the dose assessment model and various panamentors under the dumping conditions is much lower than natural radiation and the permissible level recommended by ICRP.

  3. Percutaneous nephrolithotomy; alarming variables for postoperative bleeding

    Directory of Open Access Journals (Sweden)

    Shakhawan H.A. Said

    2017-03-01

    Conclusion: According to our present results stone complexity (GSS grade 3 and 4, history of ipsilateral renal stone surgery, and occurrence of intraoperative pelvicalyceal perforation are alarming variables for post-PCNL bleeding.

  4. The variable phenotype of the p.A16V mutation of cationic trypsinogen (PRSS1) in pancreatitis families

    DEFF Research Database (Denmark)

    Grocock, Christopher J; Rebours, Vinciane; Delhaye, Myriam

    2010-01-01

    Pancreatitis (HP); idiopathic disease; or pancreatitis in a single generation. HP was defined as 2 cases in 2 generations. MAIN OUTCOME MEASURES: Onset of painful episodes of pancreatitis, death from pancreatic cancer, diagnosis of diabetes mellitus and exocrine pancreatic failure. RESULTS: Ten families with p...... or Mann-Whitney-U tests. CONCLUSIONS: Penetrance of p.A16V is highly variable and family dependent, suggesting it contributes to a multigenic inheritance of a predisposition to pancreatitis....

  5. Perioperative Variables Contributing to the Rupture of Intracranial Aneurysm: An Update

    Directory of Open Access Journals (Sweden)

    Tumul Chowdhury

    2013-01-01

    Full Text Available Background. Perioperative aneurysm rupture (PAR is one of the most dreaded complications of intracranial aneurysms, and approximately 80% of nontraumatic SAHs are related to such PAR aneurysms. The literature is currently scant and even controversial regarding the issues of various contributory factors on different phases of perioperative period. Thus this paper highlights the current understanding of various risk factors, variables, and outcomes in relation to PAR and try to summarize the current knowledge. Method. We have performed a PubMed search (1 January 1991–31 December 2012 using search terms including “cerebral aneurysm,” “intracranial aneurysm,” and “intraoperative/perioperative rupture.” Results. Various risk factors are summarized in relation to different phases of perioperative period and their relationship with outcome is also highlighted. There exist many well-known preoperative variables which are responsible for the highest percentage of PAR. The role of other variables in the intraoperative/postoperative period is not well known; however, these factors may have important contributory roles in aneurysm rupture. Preoperative variables mainly include natural course (age, gender, and familial history as well as the pathophysiological factors (size, type, location, comorbidities, and procedure. Previously ruptured aneurysm is associated with rupture in all the phases of perioperative period. On the other hand intraoperative/postoperative variables usually depend upon anesthesia and surgery related factors. Intraoperative rupture during predissection phase is associated with poor outcome while intraoperative rupture at any step during embolization procedure imposes poor outcome. Conclusion. We have tried to create such an initial categorization but know that we cannot scale according to its clinical importance. Thorough understanding of various risk factors and other variables associated with PAR will assist in better

  6. Sample Size and Statistical Conclusions from Tests of Fit to the Rasch Model According to the Rasch Unidimensional Measurement Model (Rumm) Program in Health Outcome Measurement.

    Science.gov (United States)

    Hagell, Peter; Westergren, Albert

    Sample size is a major factor in statistical null hypothesis testing, which is the basis for many approaches to testing Rasch model fit. Few sample size recommendations for testing fit to the Rasch model concern the Rasch Unidimensional Measurement Models (RUMM) software, which features chi-square and ANOVA/F-ratio based fit statistics, including Bonferroni and algebraic sample size adjustments. This paper explores the occurrence of Type I errors with RUMM fit statistics, and the effects of algebraic sample size adjustments. Data with simulated Rasch model fitting 25-item dichotomous scales and sample sizes ranging from N = 50 to N = 2500 were analysed with and without algebraically adjusted sample sizes. Results suggest the occurrence of Type I errors with N less then or equal to 500, and that Bonferroni correction as well as downward algebraic sample size adjustment are useful to avoid such errors, whereas upward adjustment of smaller samples falsely signal misfit. Our observations suggest that sample sizes around N = 250 to N = 500 may provide a good balance for the statistical interpretation of the RUMM fit statistics studied here with respect to Type I errors and under the assumption of Rasch model fit within the examined frame of reference (i.e., about 25 item parameters well targeted to the sample).

  7. Professionalisation of Teaching: The Outcomes of an ATEE Seminar. Debate and Conclusions: Report from the ATEE Seminar on the Professionalisation of Teachers.

    Science.gov (United States)

    Montane, Mireia

    1994-01-01

    The paper presents information from a debate on the professionalization of teaching. After defining professionalization, the paper discusses trends, advances, and problems with preservice or inservice training related to professionalization in various countries; teaching as a social activity; and professionalization involved in the training and…

  8. Antimicrobial breakpoint estimation accounting for variability in pharmacokinetics

    Directory of Open Access Journals (Sweden)

    Nekka Fahima

    2009-06-01

    Full Text Available Abstract Background Pharmacokinetic and pharmacodynamic (PK/PD indices are increasingly being used in the microbiological field to assess the efficacy of a dosing regimen. In contrast to methods using MIC, PK/PD-based methods reflect in vivo conditions and are more predictive of efficacy. Unfortunately, they entail the use of one PK-derived value such as AUC or Cmax and may thus lead to biased efficiency information when the variability is large. The aim of the present work was to evaluate the efficacy of a treatment by adjusting classical breakpoint estimation methods to the situation of variable PK profiles. Methods and results We propose a logical generalisation of the usual AUC methods by introducing the concept of "efficiency" for a PK profile, which involves the efficacy function as a weight. We formulated these methods for both classes of concentration- and time-dependent antibiotics. Using drug models and in silico approaches, we provide a theoretical basis for characterizing the efficiency of a PK profile under in vivo conditions. We also used the particular case of variable drug intake to assess the effect of the variable PK profiles generated and to analyse the implications for breakpoint estimation. Conclusion Compared to traditional methods, our weighted AUC approach gives a more powerful PK/PD link and reveals, through examples, interesting issues about the uniqueness of therapeutic outcome indices and antibiotic resistance problems.

  9. Advanced thermal-hydraulic and neutronic codes: current and future applications. Summary and conclusions

    International Nuclear Information System (INIS)

    2001-05-01

    An OECD Workshop on Advanced Thermal-Hydraulic and Neutronic Codes Applications was held from 10 to 13 April 2000, in Barcelona, Spain, sponsored by the Committee on the Safety of Nuclear Installations (CSNI) of the OECD Nuclear Energy Agency (NEA). It was organised in collaboration with the Spanish Nuclear Safety Council (CSN) and hosted by CSN and the Polytechnic University of Catalonia (UPC) in collaboration with the Spanish Electricity Association (UNESA). The objectives of the Workshop were to review the developments since the previous CSNI Workshop held in Annapolis [NEA/CSNI/ R(97)4; NUREG/CP-0159], to analyse the present status of maturity and remnant needs of thermal-hydraulic (TH) and neutronic system codes and methods, and finally to evaluate the role of these tools in the evolving regulatory environment. The Technical Sessions and Discussion Sessions covered the following topics: - Regulatory requirements for Best-Estimate (BE) code assessment; - Application of TH and neutronic codes for current safety issues; - Uncertainty analysis; - Needs for integral plant transient and accident analysis; - Simulators and fast running codes; - Advances in next generation TH and neutronic codes; - Future trends in physical modeling; - Long term plans for development of advanced codes. The focus of the Workshop was on system codes. An incursion was made, however, in the new field of applying Computational Fluid Dynamic (CFD) codes to nuclear safety analysis. As a general conclusion, the Barcelona Workshop can be considered representative of the progress towards the targets marked at Annapolis almost four years ago. The Annapolis Workshop had identified areas where further development and specific improvements were needed, among them: multi-field models, transport of interfacial area, 2D and 3D thermal-hydraulics, 3-D neutronics consistent with level of details of thermal-hydraulics. Recommendations issued at Annapolis included: developing small pilot/test codes for

  10. LEAping to conclusions: A computational reanalysis of late embryogenesis abundant proteins and their possible roles

    Directory of Open Access Journals (Sweden)

    Wise Michael J

    2003-10-01

    Full Text Available Abstract Background The late embryogenesis abundant (LEA proteins cover a number of loosely related groups of proteins, originally found in plants but now being found in non-plant species. Their precise function is unknown, though considerable evidence suggests that LEA proteins are involved in desiccation resistance. Using a number of statistically-based bioinformatics tools the classification of a large set of LEA proteins, covering all Groups, is reexamined together with some previous findings. Searches based on peptide composition return proteins with similar composition to different LEA Groups; keyword clustering is then applied to reveal keywords and phrases suggestive of the Groups' properties. Results Previous research has suggested that glycine is characteristic of LEA proteins, but it is only highly over-represented in Groups 1 and 2, while alanine, thought characteristic of Group 2, is over-represented in Group 3, 4 and 6 but under-represented in Groups 1 and 2. However, for LEA Groups 1 2 and 3 it is shown that glutamine is very significantly over-represented, while cysteine, phenylalanine, isoleucine, leucine and tryptophan are significantly under-represented. There is also evidence that the Group 4 LEA proteins are more appropriately redistributed to Group 2 and Group 3. Similarly, Group 5 is better found among the Group 3 LEA proteins. Conclusions There is evidence that Group 2 and Group 3 LEA proteins, though distinct, might be related. This relationship is also evident in the overlapping sets of keywords for the two Groups, emphasising alpha-helical structure and, at a larger scale, filaments, all of which fits well with experimental evidence that proteins from both Groups are natively unstructured, but become structured under stress conditions. The keywords support localisation of LEA proteins both in the nucleus and associated with the cytoskeleton, and a mode of action similar to chaperones, perhaps the cold shock chaperones

  11. Summary of the workshop robustness of electrical systems - Conclusions and recommendations

    International Nuclear Information System (INIS)

    2015-01-01

    The workshop included an opening session, seven sessions with participant presentations followed by short discussions, and a facilitated discussion session. The contributions presented were devoted to discussions of national post-Fukushima regulatory programme developments, methods to determine allowable coping time for electric power recovery, electric power system simulation methods development and benchmarking efforts, analysis of component capability, and approaches to facilitate electric power system recovery from extended loss of AC power. The following conclusions and recommendations are made based on workshop presentations, discussions during particular sessions, and facilitated discussions: - Based upon the panel discussions at the end of the workshop, a majority of the participants suggested the need for continuing efforts after the ROBELSYS workshop and particularly the importance of launching a more permanent international working group on modeling tools and methods related to nuclear power plant electrical power system studies. The working group would be modelled on WGRISK. (It is recognized that creating such a permanent working group would require a multi-year commitment of CSNI and the participants). - It will be very beneficial to continue international information sharing of the following items, eventually leading to development of suitable international electrical standards: System and component requirements for addressing beyond design basis external events; Recommended practice for incorporating diversity in the onsite electrical power system; Recommended practice for relaxing electric power protection features used in emergency situations (assuring margin against spurious electrical shutdowns); Recommended practice for qualification requirements for existing systems and portable components used to cope with AC station blackout. - There is a need for further development and improvements in the analysis and simulation of the following

  12. FUNMIG Integrated Project results and conclusions from a safety case perspective

    International Nuclear Information System (INIS)

    Schwyn, B.; Wersin, P.; Rüedi, J.; Schneider, J.; Altmann, S.; Missana, T.; Noseck, U.

    2012-01-01

    The scope of the FUNMIG Integrated Project (IP) was to improve the knowledge base on biogeochemical processes in the geosphere which are relevant for the safety of radioactive waste repositories. An important part of this project involved the interaction between data producers (research) and data users (radioactive waste management organisations in Europe). The aim thereof was to foster the benefits of the research work for performance assessment (PA), and in a broader sense, for the safety case of radioactive waste repositories. For this purpose a specifically adapted procedure was elaborated. Thus, relevant features, events and processes (FEPs) for the three host rock types, clay, crystalline and salt, were taken from internationally accepted catalogues and mapped onto each of the 108 research tasks conducted during the FUNMIG project by a standardised procedure. The main outcome thereof was a host-rock specific tool (Task Evaluation Table) in which the relevance and benefits of the research results were evaluated both from the PA and research perspective. Virtually all generated data within FUNMIG are related to the safety-relevant FEP-groups “transport mechanisms” and “retardation”. Generally speaking, much of the work within FUNMIG helped to support and to increase confidence in the simplified PA transport and retardation models used for calculating radionuclide (RN) transport through the host rock. Some of the studies on retardation processes (e.g. coupled sorption-redox processes at the mineral–water interface) yielded valuable data for all three rock types dealt within the IP. However, most of the studies provided improved insight regarding host-rock specific features and processes, the majority of this work being dedicated to clay-rich and crystalline host rocks. For both of these host rock types, FUNMIG has significantly contributed to improving understanding on a conceptual level, both by providing new experimental data at different spatial

  13. Chester 2, Summary and Way Forward, Plenary Session Outputs, Summary Presentation and Conclusions

    International Nuclear Information System (INIS)

    2012-01-01

    The workshop ended with a summary session. The Workshop Chair and Technical Reporter summarised the main findings, and provided the opportunity for further discussion and comment. There was a discussion on the way forward, including reporting, future meetings and other means of networking. Participants provided feedback on the workshop to assist with the planning and conduct of future events. The main conclusions arising from the workshop were as follows: - Licensees are generally positive about engaging with regulators to raise awareness about and support improvements in LMfS/SC. - More active and visible senior regulatory leadership increases the effectiveness of LMfS/SC interventions. Examples of practical actions that senior regulatory leaders can take include raising LMfS/SC matters at senior levels within licensee organisations and feeding back results of discussions to regulatory staff so that priorities and expectations are aligned. - A common 'language', and trust between regulators and licensees are fundamental factors for effective oversight of LMfS/SC. - The message from the previous workshop in 2007 on the importance of integrating LMfS/SC into normal regulatory business was reinforced. - A combination of integrated and targeted LMfS/SC interventions is considered to be effective to take account of the advantages and disadvantages of both approaches. - In line with the conclusions from the previous workshop, influence is preferred to 'enforcement'. Where enforcement action is required, this is likely to be associated with tangible manifestations of LMfS/SC safety culture issues, such as license condition violations. - A fundamental principle of regulatory oversight of LMfS/SC is to encourage licensees to understand and take ownership of issues and solutions. Strategies include: Discussion of regulatory perceptions to test for shared regulator/licensee understanding, - Working together with licensees to develop guidance and understanding (e.g., through

  14. Severe accident management (SAM), operator training and instrumentation capabilities - Summary and conclusions

    International Nuclear Information System (INIS)

    2002-01-01

    The Workshop on Operator Training for Severe Accident Management (SAM) and Instrumentation Capabilities During Severe Accidents was organised in collaboration with Electricite de France (Service Etudes et Projets Thermiques et Nucleaires). There were 34 participants, representing thirteen OECD Member countries, the Russian Federation and the OECD/NEA. Almost half the participants represented utilities. The second largest group was regulatory authorities and their technical support organisations. Basically, the Workshop was a follow-up to the 1997 Second Specialist Meeting on Operator Aids for Severe Accident Management (SAMOA-2) [Reports NEA/CSNI/R(97)10 and 27] and to the 1992 Specialist Meeting on Instrumentation to Manage Severe Accidents [Reports NEA/CSNI/R(92)11 and (93)3]. It was aimed at sharing and comparing progress made and experience gained from these two meetings, emphasizing practical lessons learnt during training or incidents as well as feedback from instrumentation capability assessment. The objectives of the Workshop were therefore: - to exchange information on recent and current activities in the area of operator training for SAM, and lessons learnt during the management of real incidents ('operator' is defined hear as all personnel involved in SAM); - to compare capabilities and use of instrumentation available during severe accidents; - to monitor progress made; - to identify and discuss differences between approaches relevant to reactor safety; - and to make recommendations to the Working Group on the Analysis and Management of Accidents and the CSNI (GAMA). The Workshop was organised into five sessions: - 1: Introduction; - 2: Tools and Methods; - 3: Training Programmes and Experience; - 4: SAM Organisation Efficiency; - 5: Instrumentation Capabilities. It was concluded by a Panel and General Discussion. This report presents the summary and conclusions: the meeting confirmed that only limited information is needed for making required decisions

  15. The Successful Conclusion of the Deep Space 1 Mission: Important Results without a Flashy Title

    Science.gov (United States)

    Rayman, Marc D.

    2002-01-01

    direct scientific return, the comet encounter is of engineering value to other missions planning comet encounters. With the successful conclusion of its extended mission, DS1 undertook a hyperextended mission. This phase of its flight was dedicated to final testing of the advanced technologies on board. With the mission at more than three times its planned lifetime, this offered an excellent opportunity to obtain unplanned data on the effects of long-term operation in space. All nine of the hardware technologies were used during the hyperextended mission, with a focus on the ion propulsion system. Following this period of extremely aggressive testing, with no further technology or science objectives, the mission was terminated on December 18, 2001, with the powering off of the spacecraft s transmitter, although the receiver was left on. By the end of its mission, DS1 had returned a wealth of important science data and engineering data for future missions. It did so following the shortest time from pre-phase A through launch of any NASA interplanetary mission in the modern era and the lowest cost of any NASA interplanetary mission ever conducted (measured in same year dollars, including the launch cost). This paper will describe the encounter with comet Borrelly, the hyperextended mission, and summarize the overall results of the Deep Space 1 project.

  16. Estudo sobre o melhoramento da laranja "Baía" III: Conclusão

    Directory of Open Access Journals (Sweden)

    F. G. Brieger

    1941-09-01

    published, that all species used as root stocks in this country are highly variable which is not astonishing since there has not yet been any selection for root stocks (fig. 8a to 10b. A-similar variation has been found by Webber for the Californian sour orange. 12. The existence of effects of root stocks on scion, besides the appearance of general incompatibilities, has been shown in the extensive studies of Hatton. Webber (12 demonstrated correlations between root stock and the trunk area, top volume and total yield of scion in Washington Navel budded on sour orange in California. Gurgel (3 found an influence of various root stocks on pollen fertility in the "Pera" orange and the grape fruit "March seedless". Further experiments, already under way, will show if our hypothesis about the effect of the root stock on number and diameter of the fruits of the scion is correct. 13. The variation of seedlings in Citrus cannot be due exclusively to the occurrence of sexual reproduction besides simple apogamy as supposed by Webber. This author assumed that all variants were due to the appearance of embryos from normally fertilized eggs. However histological complications seem to occur which cause variations also within the apogamous offspring. 14. The praticai value of the new type "Araras" in contrast to "Piracicaba" is illustrated in figures 4 and 5 and quadro XIII. The proportion of larger fruits of the commercial types of "126" to "80" is very small in "Araras". Under the pre-war conditions the type "126" was still exportable without loss while the larger fruits could not be exported at all. Thus it would be of great economic value to establish definitely the new type "Baianinha Araras".

  17. Brain signal variability differentially affects cognitive flexibility and cognitive stability

    NARCIS (Netherlands)

    Armbruster-Genç, D.J.N.; Ültzhöffer, K.; Fiebach, C.J.

    2016-01-01

    Recent research yielded the intriguing conclusion that, in healthy adults, higher levels of variability in neuronal processes are beneficial for cognitive functioning. Beneficial effects of variability in neuronal processing can also be inferred from neurocomputational theories of working memory,

  18. Wide Variability in Emergency Physician Admission Rates: A Target to Reduce Costs Without Compromising Quality

    Directory of Open Access Journals (Sweden)

    Jeffrey J. Guterman

    2016-09-01

    Full Text Available Introduction: Attending physician judgment is the traditional standard of care for emergency department (ED admission decisions. The extent to which variability in admission decisions affect cost and quality is not well understood. We sought to determine the impact of variability in admission decisions on cost and quality. Methods: We performed a retrospective observational study of patients presenting to a university-affiliated, urban ED from October 1, 2007, through September 30, 2008. The main outcome measures were admission rate, fiscal indicators (Medicaid-denied payment days, and quality indicators (15- and 30-day ED returns; delayed hospital admissions. We asked each Attending to estimate their inpatient admission rate and correlated their personal assessment with actual admission rates. Results: Admission rates, even after adjusting for known confounders, were highly variable (15.2%-32.0% and correlated with Medicaid denied-payment day rates (p=0.038. There was no correlation with quality outcome measures (30-day ED return or delayed hospital admission. There was no significant correlation between actual and self-described admission rate; the range of mis-estimation was 0% to 117%. Conclusion: Emergency medicine attending admission rates at this institution are highly variable, unexplained by known confounding variables, and unrelated to quality of care, as measured by 30-day ED return or delayed hospital admission. Admission optimization represents an important untapped potential for cost reduction through avoidable hospitalizations, with no apparent adverse effects on quality.

  19. 43 CFR 4.452-8 - Findings and conclusions; decision by administrative law judge; submission to Board for decision.

    Science.gov (United States)

    2010-10-01

    ... after the time allowed for presenting proposed findings and conclusions, the administrative law judge... 43 Public Lands: Interior 1 2010-10-01 2010-10-01 false Findings and conclusions; decision by... Findings and conclusions; decision by administrative law judge; submission to Board for decision. (a) At...

  20. Preoperative prediction model of outcome after cholecystectomy for symptomatic gallstones

    DEFF Research Database (Denmark)

    Borly, L; Anderson, I B; Bardram, L

    1999-01-01

    and sonography evaluated gallbladder motility, gallstones, and gallbladder volume. Preoperative variables in patients with or without postcholecystectomy pain were compared statistically, and significant variables were combined in a logistic regression model to predict the postoperative outcome. RESULTS: Eighty...... and by the absence of 'agonizing' pain and of symptoms coinciding with pain (P model 15 of 18 predicted patients had postoperative pain (PVpos = 0.83). Of 62 patients predicted as having no pain postoperatively, 56 were pain-free (PVneg = 0.90). Overall accuracy...... was 89%. CONCLUSION: From this prospective study a model based on preoperative symptoms was developed to predict postcholecystectomy pain. Since intrastudy reclassification may give too optimistic results, the model should be validated in future studies....

  1. Parametric methods outperformed non-parametric methods in comparisons of discrete numerical variables

    Directory of Open Access Journals (Sweden)

    Sandvik Leiv

    2011-04-01

    Full Text Available Abstract Background The number of events per individual is a widely reported variable in medical research papers. Such variables are the most common representation of the general variable type called discrete numerical. There is currently no consensus on how to compare and present such variables, and recommendations are lacking. The objective of this paper is to present recommendations for analysis and presentation of results for discrete numerical variables. Methods Two simulation studies were used to investigate the performance of hypothesis tests and confidence interval methods for variables with outcomes {0, 1, 2}, {0, 1, 2, 3}, {0, 1, 2, 3, 4}, and {0, 1, 2, 3, 4, 5}, using the difference between the means as an effect measure. Results The Welch U test (the T test with adjustment for unequal variances and its associated confidence interval performed well for almost all situations considered. The Brunner-Munzel test also performed well, except for small sample sizes (10 in each group. The ordinary T test, the Wilcoxon-Mann-Whitney test, the percentile bootstrap interval, and the bootstrap-t interval did not perform satisfactorily. Conclusions The difference between the means is an appropriate effect measure for comparing two independent discrete numerical variables that has both lower and upper bounds. To analyze this problem, we encourage more frequent use of parametric hypothesis tests and confidence intervals.

  2. Conventional heart rate variability analysis of ambulatory electrocardiographic recordings fails to predict imminent ventricular fibrillation

    Science.gov (United States)

    Vybiral, T.; Glaeser, D. H.; Goldberger, A. L.; Rigney, D. R.; Hess, K. R.; Mietus, J.; Skinner, J. E.; Francis, M.; Pratt, C. M.

    1993-01-01

    OBJECTIVES. The purpose of this report was to study heart rate variability in Holter recordings of patients who experienced ventricular fibrillation during the recording. BACKGROUND. Decreased heart rate variability is recognized as a long-term predictor of overall and arrhythmic death after myocardial infarction. It was therefore postulated that heart rate variability would be lowest when measured immediately before ventricular fibrillation. METHODS. Conventional indexes of heart rate variability were calculated from Holter recordings of 24 patients with structural heart disease who had ventricular fibrillation during monitoring. The control group consisted of 19 patients with coronary artery disease, of comparable age and left ventricular ejection fraction, who had nonsustained ventricular tachycardia but no ventricular fibrillation. RESULTS. Heart rate variability did not differ between the two groups, and no consistent trends in heart rate variability were observed before ventricular fibrillation occurred. CONCLUSIONS. Although conventional heart rate variability is an independent long-term predictor of adverse outcome after myocardial infarction, its clinical utility as a short-term predictor of life-threatening arrhythmias remains to be elucidated.

  3. Variable importance in latent variable regression models

    NARCIS (Netherlands)

    Kvalheim, O.M.; Arneberg, R.; Bleie, O.; Rajalahti, T.; Smilde, A.K.; Westerhuis, J.A.

    2014-01-01

    The quality and practical usefulness of a regression model are a function of both interpretability and prediction performance. This work presents some new graphical tools for improved interpretation of latent variable regression models that can also assist in improved algorithms for variable

  4. Predicting Battle Outcomes with Classification Trees

    National Research Council Canada - National Science Library

    Coban, Muzaffer

    2001-01-01

    ... from the actual battlefield, The models built by using classification trees reveal that the objective variables alone cannot explain the outcome of battles, Relative factors, such as leadership, have deep...

  5. Diverging Conclusions from the Same Meta-Analysis in Drug Safety: Source of Data (Primary Versus Secondary) Takes a Toll.

    Science.gov (United States)

    Prada-Ramallal, Guillermo; Takkouche, Bahi; Figueiras, Adolfo

    2017-04-01

    Meta-analyses of observational studies represent an important tool for assessing efficacy and safety in the pharmacoepidemiologic field. The data from the individual studies are either primary (i.e., collected through interviews or self-administered questionnaires) or secondary (i.e., collected from databases that were established for other purposes). So far, the origin of the data (primary vs. secondary) has not been systematically assessed as a source of heterogeneity in pharmacoepidemiologic meta-analyses. The aim was to assess the impact of considering the source of exposure data as a criterion in sensitivity and subgroup analysis on the conclusions of drug safety meta-analyses. We selected meta-analyses published between 2013 and 2015 in which the intake of frequently used over-the-counter medicines was either the main exposure or a concomitant treatment and the outcome had short latency and induction periods. We stratified the results by origin of data (primary vs. secondary) and compared the new results to those presented originally in the meta-analyses. We used four meta-analyses that fulfilled our criteria of inclusion. The results were selective serotonin reuptake inhibitors and upper gastrointestinal bleeding: original estimate odds ratio (OR) = 1.71 [95% confidence interval (CI) 1.44-2.04], OR primary data = 1.19 (95% CI 0.90-1.58), OR secondary data = 1.81 (95% CI 1.50-2.17); proton pump inhibitors and cardiac events: original estimate hazard ratio (HR) = 1.35 (95% CI 1.18-1.54), HR primary data = 1.05 (95% CI 0.87-1.26), HR secondary data = 1.43 (95% CI 1.23-1.66); non-aspirin non-steroidal anti-inflammatory drugs and myocardial infarction: original estimate risk ratio (RR) = 1.08 (95% CI 0.95-1.22), RR primary data = 0.57 (95% CI 0.34-0.96), RR secondary data = 1.15 (95% CI 1.03-1.28); paracetamol during pregnancy and childhood asthma: original estimate OR = 1.32 (95% CI 1.14-1.52), OR primary data = 1.23 (95% CI 1.06-1.42), OR

  6. Conclusion Dokter en digter

    African Journals Online (AJOL)

    1994-08-17

    Aug 17, 1994 ... Effects of srmvastatin and cholestyramine in familial and non-familial hypercholesterolaemia. .... in 1993, total and tobacco advertising expenditure, brand ..... luxury market, and through funding of accessories such as ...

  7. Summary and conclusions

    International Nuclear Information System (INIS)

    Bates, T.D.

    1980-01-01

    Various aspects of a clinical session on 'High dose-rate afterloading in the treatment of cancer of the uterus' at the International Workshop, London in April 1978 are discussed. The results of high dose-rate afterloading treatment were at least as good as those of conventional low dose-rate therapy. However, there is still a need to optimize dose fractionation and technique according to the type and stage of the disease to achieve the best results with the least distress for the patient. It would appear that, at the doses used, side effects with high dose-rate afterloading were few and probably related to the external rather than to the intracavitary therapy. High dose-rate afterloading therapy has obvious social and economic advantages and is thus of interest to all countries. (U.K.)

  8. Prospects and conclusion

    International Nuclear Information System (INIS)

    1994-01-01

    The present issue of 'Les Cahiers de COGEMAGAZINE', dedicated to role played by Cogema in the nuclear fuel cycling, ends with a short account on perspectives and concluding considerations. In the world nuclear fuel industry the most active zones appear to be France, Japan, China, Taiwan and Korea. A real expansion is to be expected in UO 2 market for PWRs. Also rapid development will be recorded by the production of MOF (mixed oxide fuels) especially due to the inception of British reprocessing plant at Thorp and the increase of number of MOF-fuelled reactors. The most significant lines of progress related to the new fuels are estimated to be: high burn-up (by increasing the resistance to fission gas pressure and irradiation), improvement of response to power excursions, fuel matrices of stronger retention, increase in the plutonium content of MOF, 100% MOF-fuelled reactors, optimizing the utilization of consumable poisons (for PWR) and very high burn-up and very long service lifetimes (for Breeders). In a nuclear environment, now in a rather low expansion rate, the French nuclear fuel industry enjoys the benefit of: an important national market, industrial experimented teams able to tackle all the steps from design to realization of a diversity of nuclear fuel types, fabrication facilities combining suppleness to clients' demands with requirements for high quality, a highly-rated worldwide position, and important capabilities of technological further development. An annex is added showing the percentage involvement of COGEMA and FRAMATOME in the fields of UO 2 -PuO 2 fuel production for PWR, fuels for Breeder, WER and experimental reactors and transport. Also participation of other European companies like PECHINEY, BELGONUCLEAIRE and SIEMENS is indicated

  9. Conclusions and recommendations

    International Nuclear Information System (INIS)

    Moore, A.

    1996-01-01

    This Air Concerted Action successfully developed a standard methodology to help integrate non-food crop production in rural areas with niche energy markets. The project developed and used a common methodology for comparing the costs of different energy crop production and conversion options across the six participating nations. The partners tested the methodology and ran examples in each of the two heat and one liquid biofuel niche markets. The examples demonstrated that at the current crop yields and with the current conversion technology, the delivered heat and liquid fuel from biomass were not competitive with that from fossil fuels, even in the three niche markets. It was confirmed, however, that biomass was important non only as a potential ''clean'' alternative fuel, but as an alternative crop for farmers which could additionally boost employment in rural communities. Following the inclusion of grants, subsidies and co-firing options, the partners tested the extended methodology and then ran another series of examples in the selected niche markets. (Author)

  10. Conclusion. Chapter 4

    International Nuclear Information System (INIS)

    1999-01-01

    Beginning 1992, January 1 Semipalatinsk test site was transforming into large research scientific center. The National Nuclear Center (NNC) was formed on the base of site's research enterprises. The principal problems of NNC are as follows: liquidation of nuclear tests consequences; liquidation of technological infrastructure for preparation and conducting of nuclear tests, creation of technology for radioactive wastes store; implementation of atomic energy development conception in Kazakhstan, etc. Program of site conversion constantly is expanding. In this chapter measures by rehabilitation of injured population are revealed. Taking into account radioecological situation, dose loadings, demographic indexes, sick rate and mortality of population on territories exposed to site's influence Government of Kazakhstan adopted Decree on declaration of these lands of zone of ecological catastrophe. Measures on improvement of radioecological situation are reduce to following ones: determination of irradiation doses received by population during testing period; study of existing radiation contamination; study of all possible sources for dose increasing and taking into account other ones; information of population about radioecological situation and about all consequences of nuclear tests. In 1992 Supreme Soviet of Republic of Kazakhstan worked out and adopted law On social defence of citizens suffered from consequences of nuclear tests on Semipalatinsk test site. It was distinguished four zones of radiation risk. The first zone is zone of extreme risk. It is part of territory subjected to radiation contamination with dose of influence on population above 100 rem during of total period of tests conducting. To this zone belong following inhabited settlements: Budene, Dolon', Cheremushki, Mostik, Sarzhal, Isa, Sarpan, Karakoryk, Zagotskot-2. Second zone is zone of maximal radiation risk. To this zone belong inhabited settlements of following districts: Abaj, Abraly, Beskargaj and Zana-Semej. Population of these districts have been exposed to ionizing radiation influence in doses from 35 up to 100 rem. Third zone is zone of increased risk. To this zone belong inhabited settlements of following districts of Semipalatinsk region: Chybartau, Novo-Shul'ba, Borodulikha, Charsk, Zharmy, Ayaguz. Effective equivalent doses for population during all these years made up from 7 to 35 rem. Forth zone is zone of minimal radiation risk. To this zone the inhabited settlements of Makanchi, Urdzhary, Taskesken, Kokpekty, Aksuat districts belongs. Effective equivalent doses of population irradiation made up from 0.1 to 7 rem. Measures on compensation payment for caused harm to suffered peoples health in result of nuclear weapon test have been carried out with taking into consideration of living duration in different zones

  11. Conclusion: The balanced company

    DEFF Research Database (Denmark)

    Scheuer, John Damm; Jensen, Inger

    2013-01-01

    This concluding chapter brings together the various research findings of the book "The balanced company - organizing for the 21st Century" and develops a general overview of their implications for our understanding of the balancing processes unfolding in companies and organizations....

  12. Conclusions [Chapter 15

    Science.gov (United States)

    Joanne J. Ho; David L. Peterson; Natalie J. Little

    2018-01-01

    The Intermountain Adaptation Partnership (IAP) provided significant contributions to assist climate change response in national forests and national parks of the region. The effort synthesized the best available scientific information to assess climate change vulnerability, develop adaptation options, and catalyze a collaboration of land management agencies and...

  13. Conclusions [Chapter 13

    Science.gov (United States)

    S. Karen Dante-Wood; Linh Hoang

    2018-01-01

    The Northern Rockies Adaptation Partnership (NRAP) provided significant contributions to assist climate change response in national forests and national parks of the Northern Rockies region. The effort synthesized the best available scientific information to assess climate change vulnerability, develop adaptation options, and catalyze a collaboration of land management...

  14. Instead of a Conclusion

    DEFF Research Database (Denmark)

    Dosenrode, Søren

    2009-01-01

    The findings of the book are summarised and commented upon. The concept of 'martyrdom' and the reluctance in the use of violence are discussed......The findings of the book are summarised and commented upon. The concept of 'martyrdom' and the reluctance in the use of violence are discussed...

  15. Geomagnetic field: Conclusions

    Digital Repository Service at National Institute of Oceanography (India)

    Gorodnitsky, A; Subrahmanyam, A

    stream_size 1 stream_content_type text/plain stream_name Mem_Geol_Soc_India_1998_39_38.pdf.txt stream_source_info Mem_Geol_Soc_India_1998_39_38.pdf.txt Content-Encoding ISO-8859-1 Content-Type text/plain; charset=ISO-8859-1 ...

  16. Chernobyl - consequences and conclusions

    International Nuclear Information System (INIS)

    1986-10-01

    The Chernobyl accident has taught mankind very plainly that nuclear energy bears a deadly potential and thus is to be ranked as a key problem of future decisions in the sector of power engineering. Decisions to be taken in future have to be seen in the context of the ecological, economic, and social needs. The statements given reflect the FEST's opinion on nuclear energy and the biological, economic, political, and ethical implications. (DG) [de

  17. Conclusions and Further Readings.

    Science.gov (United States)

    Lucas, John A.

    1979-01-01

    The components of a complete and effective marketing plan for higher education institutions are summarized. It is suggested that a marketing plan embrace all elements of the total marketing concept, and include curriculum evaluation, a retention program, and a scheme for evaluating the strategy's effectiveness. A bibliography is included.…

  18. Summary and conclusions

    Digital Repository Service at National Institute of Oceanography (India)

    Rao, D.G; Murthy, K.S; Neprochnov, Y.P; Subrahmanyam, C.

    stream_size 4 stream_content_type text/plain stream_name Mem_Geol_Soc_India_1998_39_233.pdf.txt stream_source_info Mem_Geol_Soc_India_1998_39_233.pdf.txt Content-Encoding ISO-8859-1 Content-Type text/plain; charset=ISO-8859-1 ...

  19. Chernobyl - facts and conclusions

    Energy Technology Data Exchange (ETDEWEB)

    Schlaefer, H

    1986-07-01

    The article summarizes and comments on the activities started in the FRG after the Chernobyl MCA, and tries to assess whether the legal provisions currently applicable, or emergency plans available, are apt to efficiently cope with such an emergency situation. The author discusses the Soviet Union's initial efforts towards minimizing the disastrous significance of events, the lack of preparedness of German authorities and provisions, the non-availability of persons responsible during weekends and night hours, the confounding mess of measured data and units published by the information media and authorities, and the lack of a suitable information scheme and infrastructure supported both by the Land governments and the Federal Government. (HSCH).

  20. Summary and conclusions

    International Nuclear Information System (INIS)

    2000-01-01

    The international workshop on 'Nuclear Power Plant Life Management in a Changing Business World' was held in Washington, DC, on 26-27 June 2000. This workshop was attended by more than 50 experts from 12 countries and three international organisations. The workshop included a series of presentations to a plenary session of all participants. A spectrum of experiences in plant life extension activities as well as experiences in operating a nuclear power plant (NPP) in a 'free-market' electricity environment were presented: The workshop also included three working groups in which major issues facing PLIM activities for NPPs were identified and discussed. The three working groups covered technology, regulation and business. The following sections of this report consist of summaries of the discussions that took place in each of the three working groups. (author)

  1. Different Teams, Same Conclusions?

    DEFF Research Database (Denmark)

    Fuller, Thomas E; Haider, Haula F; Kikidis, Dimitris

    2017-01-01

    Background: Though clinical guidelines for assessment and treatment of chronic subjective tinnitus do exist, a comprehensive review of those guidelines has not been performed. The objective of this review was to identify current clinical guidelines, and compare their recommendations for the asses......Background: Though clinical guidelines for assessment and treatment of chronic subjective tinnitus do exist, a comprehensive review of those guidelines has not been performed. The objective of this review was to identify current clinical guidelines, and compare their recommendations...... for the assessment and treatment of subjective tinnitus in adults. Method: We systematically searched a range of sources for clinical guidelines (as defined by the Institute of Medicine, United States) for the assessment and/or treatment of subjective tinnitus in adults. No restrictions on language or year......, use of a validated questionnaire(s) to assess tinnitus related distress, and referral to a psychologist when required. Cognitive behavioral treatment for tinnitus related distress, use of hearing aids in instances of hearing loss and recommendations against the use of medicines were consistent across...

  2. Conclusions and prospects

    International Nuclear Information System (INIS)

    2005-01-01

    This article presents general problems of countries Tajikistan, Uzbekistan, Kyrgyzstan-leakage of dangerous matters and industry pollutions, transboundary pollutions of environment, the problems of tailing pits, climate change, public health

  3. Conclusion du titre II

    OpenAIRE

    Nguyen, Minh Hang

    2013-01-01

    La qualification de la conciliation et de la médiation judiciaires en contrats de pourparlers judiciaires emporte d’importantes conséquences. 216. Consécration d’une nouvelle famille de contrats : les contrats de pourparlers judiciaires - Elle consacre tout d’abord une nouvelle famille de contrats : les contrats de pourparlers judiciaires. Ce faisant, elle apporte une pierre supplémentaire à l’édifice des figures hybrides qui mêlent le conventionnel et le judiciaire. 217. Les contrats de pour...

  4. The Cramster Conclusion

    Science.gov (United States)

    Grams, Michael

    2011-01-01

    In a recent "TPT" article, I wrote about a website called "Cramster" (www.cramster.com), which provides students with solutions to homework problems from many textbooks in math and science. I proposed the following question: Could giving students the answers to their assigned homework problems be an effective way of teaching them physics? This…

  5. Proposals, conclusions and recommendations

    OpenAIRE

    2014-01-01

    MISE EN PLACE OU CONSOLIDATION DES OUTILS DE GESTION Des modèles de simulation Les connaissances scientifiques doivent être mieux intégrées et plus accessibles aux décideurs. L’une des options possibles serait d’utiliser des modèles permettant de simuler des scénarios afin d’aider les décideurs dans leurs choix stratégiques. Trois types de modèles nous semblent particulièrement souhaitables : un modèle hydraulique simulant les écoulements et permettant notamment de faire des études d’impact d...

  6. Association of education level with dialysis outcome.

    Science.gov (United States)

    Khattak, Muhammad; Sandhu, Gurprataap S; Desilva, Ranil; Goldfarb-Rumyantzev, Alexander S

    2012-01-01

    The impact of education on health care outcome has been studied in the past, but its role in the dialysis population is unclear. In this report, we evaluated this association. We used the United States Renal Data System data of end-stage renal disease patients aged 18 years. Education level at the time of end-stage renal disease onset was the primary variable of interest. The outcome of the study was patient mortality. We used four categories of education level: 0 = less than 12 years of education; 1 = high school graduate; 2 = some college; 3 = college graduate. Subgroups based on age, race, sex, donor type, and diabetic status were also analyzed. After adjustments for covariates in the Cox model, using individuals with less than 12 years of education as a reference, patients with college education showed decreased mortality with hazard ratio of 0.81 (95% confidence interval 0.69–0.95), P = 0.010. In conclusion, we showed that higher education level is associated with improved survival of patients on dialysis.

  7. Variable and subset selection in PLS regression

    DEFF Research Database (Denmark)

    Høskuldsson, Agnar

    2001-01-01

    The purpose of this paper is to present some useful methods for introductory analysis of variables and subsets in relation to PLS regression. We present here methods that are efficient in finding the appropriate variables or subset to use in the PLS regression. The general conclusion...... is that variable selection is important for successful analysis of chemometric data. An important aspect of the results presented is that lack of variable selection can spoil the PLS regression, and that cross-validation measures using a test set can show larger variation, when we use different subsets of X, than...

  8. Evaluation of the Tier 1 Program of Project P.A.T.H.S.: Secondary Data Analyses of Conclusions Drawn by the Program Implementers

    Directory of Open Access Journals (Sweden)

    Daniel T. L. Shek

    2008-01-01

    Full Text Available The Tier 1 Program of the Project P.A.T.H.S. (Positive Adolescent Training through Holistic Social Programmes is a curricula-based positive youth development program. In the experimental implementation phase, 52 schools participated in the program. Based on subjective outcome evaluation data collected from the program participants (Form A and program implementers (Form B in each school, the program implementers were invited to write down five conclusions based on an integration of the evaluation findings (N = 52. The conclusions stated in the 52 evaluation reports were further analyzed via secondary data analyses in this paper. Results showed that most of the conclusions concerning perceptions of the Tier 1 Program, instructors, and effectiveness of the programs were positive in nature. There were also conclusions reflecting the respondents’ appreciation of the program. Finally, responses on the difficulties encountered and suggestions for improvements were observed. In conjunction with the previous evaluation findings, the present study suggests that the Tier 1 Program was well received by the stakeholders and the program was beneficial to the development of the program participants.

  9. Identified metabolic signature for assessing red blood cell unit quality is associated with endothelial damage markers and clinical outcomes

    DEFF Research Database (Denmark)

    Bordbar, Aarash; Johansson, Pär I.; Paglia, Giuseppe

    2016-01-01

    shown no difference of clinical outcome for patients receiving old or fresh RBCs. An overlooked but essential issue in assessing RBC unit quality and ultimately designing the necessary clinical trials is a metric for what constitutes an old or fresh RBC unit. STUDY DESIGN AND METHODS: Twenty RBC units...... years and endothelial damage markers in healthy volunteers undergoing autologous transfusions. CONCLUSION: The state of RBC metabolism may be a better indicator of cellular quality than traditional hematologic variables....

  10. Child sexual abuse and family outcomes

    NARCIS (Netherlands)

    de Jong, Rinke; Bijleveld, C.C.J.H.

    2015-01-01

    This study aimed to examine the association between different characteristics of sexual abuse and adverse family outcomes in later life. Through archived court files, a large sample of Dutch men and women who have been sexually abused as a child could be identified. Outcome variables were assessed

  11. Maternal nutrition and birth outcomes.

    Science.gov (United States)

    Abu-Saad, Kathleen; Fraser, Drora

    2010-01-01

    In this review, the authors summarize current knowledge on maternal nutritional requirements during pregnancy, with a focus on the nutrients that have been most commonly investigated in association with birth outcomes. Data sourcing and extraction included searches of the primary resources establishing maternal nutrient requirements during pregnancy (e.g., Dietary Reference Intakes), and searches of Medline for "maternal nutrition"/[specific nutrient of interest] and "birth/pregnancy outcomes," focusing mainly on the less extensively reviewed evidence from observational studies of maternal dietary intake and birth outcomes. The authors used a conceptual framework which took both primary and secondary factors (e.g., baseline maternal nutritional status, socioeconomic status of the study populations, timing and methods of assessing maternal nutritional variables) into account when interpreting study findings. The authors conclude that maternal nutrition is a modifiable risk factor of public health importance that can be integrated into efforts to prevent adverse birth outcomes, particularly among economically developing/low-income populations.

  12. 16 CFR 5.63 - Evidence; transcript; in camera orders; proposed findings of fact and conclusions of law.

    Science.gov (United States)

    2010-01-01

    ... 16 Commercial Practices 1 2010-01-01 2010-01-01 false Evidence; transcript; in camera orders; proposed findings of fact and conclusions of law. 5.63 Section 5.63 Commercial Practices FEDERAL TRADE... findings of fact and conclusions of law. Sections 3.43, 3.44, 3.45, and 3.46 of the Commission's Rules of...

  13. Predicting Inpatient Detoxification Outcome of Alcohol and Drug Dependent Patients: The Influence of Sociodemographic Environment, Motivation, Impulsivity, and Medical Comorbidities

    Directory of Open Access Journals (Sweden)

    Yvonne Sofin

    2017-01-01

    Full Text Available Aims. This prospective study aims to identify patient characteristics as predictors for treatment outcome during inpatient detoxification treatment for drug and alcohol dependent patients. Methods. A mixed gender sample of 832 consecutively admitted drug and alcohol dependent patients were interviewed by an experienced physician. The impact of a variety of factors concerning social environment, therapy motivation, impulsivity related variables, medical history, and addiction severity on treatment outcome was examined. Results. 525 (63.1% of the patients completed detoxification treatment whereas 307 (36.9% dropped out prematurely. Being female, living in a partnership, having children, being employed, and having good education were predictive for a positive outcome. Family, health, the fear of losing the job, prosecution, and emergency admission were significant motivational predictors for treatment outcome. Being younger, history of imprisonment, and the number of previous drop-outs were predictive for a negative outcome. Conclusions. Variables concerning social environment and the number of previous drop-outs have been identified as best predictors for treatment outcome. Socially stable patients benefit from the current treatment setting and treatment shall be adapted for patients with negative predictors. Treatment may consequently be tailored with respect to intervention type, duration, and intensity to improve the outcome for those patients that fulfil criteria with negative impact on treatment retention.

  14. Social Support Contributes to Outcomes following Distal Radius Fractures

    Directory of Open Access Journals (Sweden)

    Caitlin J. Symonette

    2013-01-01

    Full Text Available Background. Distal radius fractures are the most common fracture of the upper extremity and cause variable disability. This study examined the role of social support in patient-reported pain and disability at one year following distal radius fracture. Methods. The Medical Outcomes Study Social Support Survey was administered to a prospective cohort of 291 subjects with distal radius fractures at their baseline visit. Pearson correlations and stepwise linear regression models (F-to-remove 0.10 were used to identify whether social support contributes to wrist fracture outcomes. The primary outcome of pain and disability at one year was measured using the Patient Rated Wrist Evaluation. Results. Most injuries were low energy (67.5% and were treated nonoperatively (71.9%. Pearson correlation analysis revealed that higher reported social support correlated with improved Patient Rated Wrist Evaluation scores at 1 year, r(n=181=-0.22, P<0.05. Of the subscales within the Social Support Survey, emotional/informational support explained a significant proportion of the variance in 1-year Patient Rated Wrist Evaluation scores, R2=4.7%, F (1, 181 = 9.98, P<0.05. Conclusion. Lower emotional/informational social support at the time of distal radius fracture contributes a small but significant percentage to patient-reported pain and disability outcomes.

  15. Prediction of surgical outcome in compressive cervical myelopathy: A novel clinicoradiological prognostic score

    Directory of Open Access Journals (Sweden)

    Rishi Anil Aggarwal

    2016-01-01

    Full Text Available Context: Preoperative severity of myelopathy, age, and duration of symptoms have been shown to be highly predictive of the outcome in compressive cervical myelopathy (CCM. The role of radiological parameters is still controversial. Aims: Define the prognostic factors in CCM and formulate a prognostic score to predict the outcome following surgery in CCM. Settings and Design: Retrospective. Materials and Methods: This study included 78 consecutive patients with CCM treated surgically. The modified Japanese Orthopaedic Association (mJOA scale was used to quantify severity of myelopathy at admission and at 12-month follow-up. The outcome was defined as "good" if the patient had mJOA score ≥16 and "poor" if the score was <16. Age, sex, duration of symptoms, comorbidities, intrinsic hand muscle wasting (IHMW, diagnosis, surgical technique, Torg ratio, instability on dynamic radiographs, and magnetic resonance imaging (MRI signal intensity changes were assessed. Statistics: Statistical Package for the Social Sciences (SPSS (version 20.0 was used for statistical analysis. The association was assessed amongst variables using logistic regression analysis. Parameters having a statistically significant correlation with the outcome were included in formulating a prognostic score. Results: Severity of myelopathy, IHMW, age, duration, diabetes, and instability on radiographs were predictive of the outcome with a P value <0.01. Genders, diagnosis, surgical procedure, Torg ratio, and intensity changes on MRI were not significantly related to the outcome. A 8-point scoring system was devised incorporating the significant clinicoradiological parameters, and it was found that nearly all patients (97.82% with a score below 5 had good outcome and all patients (100% with a score above 5 had poor outcome. The outcome is difficult to predict with a score of 5. Conclusions: Clinical parameters are better predictors of the outcome as compared to radiological findings

  16. Clinicopathological features and outcomes of pythiosis

    Directory of Open Access Journals (Sweden)

    Maria Nina Chitasombat

    2018-06-01

    Conclusions: This study highlights new aspects of pythiosis, such as the unusual host, clinical presentation, serology as a marker for rapid diagnosis, histopathology, and outcomes. Early recognition of the disease with prompt multimodality treatment may improve survival.

  17. Obstetric outcomes and antenatal access among adolescent ...

    African Journals Online (AJOL)

    T Govender

    Conclusion: Adolescent pregnancy was associated with late booking and reduced ANC visits, which was a risk for adverse maternal health ..... Mkalipi M. The fight to stop teenage pregnancy [Internet]. .... outcomes and risk factors in Malaysia.

  18. Assessing Factors Related to Waist Circumference and Obesity: Application of a Latent Variable Model

    Directory of Open Access Journals (Sweden)

    Sahar Dalvand

    2015-01-01

    Full Text Available Background. Because the use of BMI (Body Mass Index alone as a measure of adiposity has been criticized, in the present study our aim was to fit a latent variable model to simultaneously examine the factors that affect waist circumference (continuous outcome and obesity (binary outcome among Iranian adults. Methods. Data included 18,990 Iranian individuals aged 20–65 years that are derived from the third National Survey of Noncommunicable Diseases Risk Factors in Iran. Using latent variable model, we estimated the relation of two correlated responses (waist circumference and obesity with independent variables including age, gender, PR (Place of Residence, PA (physical activity, smoking status, SBP (Systolic Blood Pressure, DBP (Diastolic Blood Pressure, CHOL (cholesterol, FBG (Fasting Blood Glucose, diabetes, and FHD (family history of diabetes. Results. All variables were related to both obesity and waist circumference (WC. Older age, female sex, being an urban resident, physical inactivity, nonsmoking, hypertension, hypercholesterolemia, hyperglycemia, diabetes, and having family history of diabetes were significant risk factors that increased WC and obesity. Conclusions. Findings from this study of Iranian adult settings offer more insights into factors associated with high WC and high prevalence of obesity in this population.

  19. Amplification factor variable amplifier

    NARCIS (Netherlands)

    Akitsugu, Oshita; Nauta, Bram

    2007-01-01

    PROBLEM TO BE SOLVED: To provide an amplification factor variable amplifier capable of achieving temperature compensation of an amplification factor over a wide variable amplification factor range. ; SOLUTION: A Gilbert type amplification factor variable amplifier 11 amplifies an input signal and

  20. Amplification factor variable amplifier

    NARCIS (Netherlands)

    Akitsugu, Oshita; Nauta, Bram

    2010-01-01

    PROBLEM TO BE SOLVED: To provide an amplification factor variable amplifier capable of achieving temperature compensation of an amplification factor over a wide variable amplification factor range. ;SOLUTION: A Gilbert type amplification factor variable amplifier 11 amplifies an input signal and can

  1. Can We Predict Functional Outcome in Neonates with Hypoxic Ischemic Encephalopathy by the Combination of Neuroimaging and Electroencephalography?

    Science.gov (United States)

    Nanavati, Tania; Seemaladinne, Nirupama; Regier, Michael; Yossuck, Panitan; Pergami, Paola

    2015-01-01

    Background Neonatal hypoxic ischemic encephalopathy (HIE) is a major cause of mortality, morbidity, and long-term neurological deficits. Despite the availability of neuroimaging and neurophysiological testing, tools for accurate early diagnosis and prediction of developmental outcome are still lacking. The goal of this study was to determine if combined use of magnetic resonance imaging (MRI) and electroencephalography (EEG) findings could support outcome prediction. Methods We retrospectively reviewed records of 17 HIE neonates, classified brain MRI and EEG findings based on severity, and assessed clinical outcome up to 48 months. We determined the relation between MRI/EEG findings and clinical outcome. Results We demonstrated a significant relationship between MRI findings and clinical outcome (Fisher’s exact test, p = 0.017). EEG provided no additional information about the outcome beyond that contained in the MRI score. The statistical model for outcome prediction based on random forests suggested that EEG readings at 24 hours and 72 hours could be important variables for outcome prediction, but this needs to be investigated further. Conclusion Caution should be used when discussing prognosis for neonates with mild-to-moderate HIE based on early MR imaging and EEG findings. A robust, quantitative marker of HIE severity that allows for accurate prediction of long-term outcome, particularly for mild-to-moderate cases, is still needed. PMID:25862075

  2. Pediatric hydrocephalus outcomes: a review

    Directory of Open Access Journals (Sweden)

    Vinchon Matthieu

    2012-08-01

    Full Text Available Abstract The outcome of pediatric hydrocephalus, including surgical complications, neurological sequelae and academic achievement, has been the matter of many studies. However, much uncertainty remains, regarding the very long-term and social outcome, and the determinants of complications and clinical outcome. In this paper, we review the different facets of outcome, including surgical outcome (shunt failure, infection and independence, and complications of endoscopy, clinical outcome (neurological, sensory, cognitive sequels, epilepsy, schooling and social integration. We then provide a brief review of the English-language literature and highlighting selected studies that provide information on the outcome and sequelae of pediatric hydrocephalus, and the impact of predictive variables on outcome. Mortality caused by hydrocephalus and its treatments is between 0 and 3%, depending on the duration of follow-up. Shunt event-free survival (EFS is about 70% at one year and 40% at ten years. The EFS after endoscopic third ventriculostomy (ETV appears better but likely benefits from selection bias and long-term figures are not available. Shunt infection affects between 5 and 8% of surgeries, and 15 to 30% of patients according to the duration of follow-up. Shunt independence can be achieved in 3 to 9% of patients, but the definition of this varies. Broad variations in the prevalence of cognitive sequelae, affecting 12 to 50% of children, and difficulties at school, affecting between 20 and 60%, attest of disparities among studies in their clinical evaluation. Epilepsy, affecting 6 to 30% of patients, has a serious impact on outcome. In adulthood, social integration is poor in a substantial number of patients but data are sparse. Few controlled prospective studies exist regarding hydrocephalus outcomes; in their absence, largely retrospective studies must be used to evaluate the long-term consequences of hydrocephalus and its treatments. This review

  3. Shareholders proposals, vote outcome, and board composition

    Directory of Open Access Journals (Sweden)

    Amani Khaled Bouresli

    2008-07-01

    Full Text Available This paper examines the variables that affect vote outcome in shareholder proposals. We found that sponsor identity, proposal type, and board composition play a significant role in determining vote outcome. Furthermore, we found that the interaction between the prior performance with board composition is significant and has a negative coefficient. We conducted nonparametric tests to investigate changes in board’s major characteristics before and after targeting. The results indicate that some changes in management and boards occur after shareholder proposals. These changes, however, are unrelated to variables that impact vote outcome. We conclude that shareholders proposals are not effective at changing company behavior or corporate governance

  4. The textbook as classroom context variable

    NARCIS (Netherlands)

    Krammer, H.P.M.

    1985-01-01

    To explore the role of the textbook as a context variable in process—product relationships, data on teaching practices and learning outcomes from the IEA Classroom Environment Study in The Netherlands were used. The sample consisted of 50 secondary school mathematics classes and their teachers.

  5. Travel time variability and rational inattention

    DEFF Research Database (Denmark)

    Fosgerau, Mogens; Jiang, Gege

    2017-01-01

    This paper sets up a rational inattention model for the choice of departure time for a traveler facing random travel time. The traveler chooses how much information to acquire about the travel time out-come before choosing departure time. This reduces the cost of travel time variability compared...

  6. Intraspecific chromosome variability

    Directory of Open Access Journals (Sweden)

    N Dubinin

    2010-12-01

    Full Text Available (Editorial preface. The publication is presented in order to remind us of one of dramatic pages of the history of genetics. It re-opens for the contemporary reader a comprehensive work marking the priority change from plant cytogenetics to animal cytogenetics led by wide population studies which were conducted on Drosophila polytene chromosomes. The year of the publication (1937 became the point of irretrievable branching between the directions of Old World and New World genetics connected with the problems of chromosome variability and its significance for the evolution of the species. The famous book of T. Dobzhansky (1937 was published by Columbia University in the US under the title “Genetics and the origin of species”, and in the shadow of this American ‘skybuilding’ all other works grew dim. It is remarkable that both Dobzhansky and Dubinin come to similar conclusions about the role of chromosomes in speciation. This is not surprising given that they both might be considered as representatives of the Russian genetic school, by their birth and education. Interestingly, Dobzhansky had never referred to the full paper of Dubinin et al. (1937, though a previous short communication in Nature (1936 was included together with all former papers on the related subject. In full, the volume of the original publication printed in the Biological Journal in Moscow comprised 47 pages, in that number 41 pages of the Russian text accompanied by 16 Figs, a table and reference list, and, above all, 6 pages of the English summary. This final part in English is now reproduced in the authors’ version with the only addition being the reference list in the originally printed form.

  7. Emergency medicine task shifting: Quick dash outcome scores of upper extremity injury management

    Directory of Open Access Journals (Sweden)

    D.S. Frank*

    2013-12-01

    Results and conclusions: There were a total of 25 initial candidates, of which only 17 were able to complete the survey. Using the Quick DASH Outcome Measure, our 17 patients had a mean score of 29.5 (range 5.0– 56.8. When compared to the standardized Quick DASH outcomes (no work limitation at 27.5 vs. work limited by injury at 52.6 the non-physician clinicians appear to be performing upper extremity repairs with good outcomes. The key variable to successful repair was the initial injury type. Although accommodations needed to be made to the standard Quick DASH protocol, the tool appears to be usable in non-traditional settings.

  8. Antenatal Deworming and Materno-Perinatal Outcomes in Calabar, Nigeria

    Directory of Open Access Journals (Sweden)

    Ubong Bassey Akpan

    2018-05-01

    CONCLUSION: Presumptive deworming during the antenatal period can significantly reduce the incidence of peripartum anaemia. However, more studies may be needed to prove any positive perinatal outcome.

  9. Erosion and variability in brand loyalty

    OpenAIRE

    Dekimpe, Marnik; Mellens, M; Steenkamp, J; Vanden Abeele, Pierre

    1996-01-01

    In this paper, we examine the over-time behavior of brand loyalty for a large set of brands drawn from many product categories. Using the brand-loyalty operationalization of Colombo and Morrison (1989), the following conclusions are obtained. First, little support is found for the often-heard contention that brand loyalty is gradually declining over time. Second, while the short-run variability around a brand's mean loyalty level is not negligible, no evidence is found that this variability...

  10. Misrepresentation of neuroscience data might give rise to misleading conclusions in the media: the case of attention deficit hyperactivity disorder.

    Directory of Open Access Journals (Sweden)

    Francois Gonon

    Full Text Available BACKGROUND: There is often a huge gap between neurobiological facts and firm conclusions stated by the media. Data misrepresentation in the conclusions and summaries of neuroscience articles might contribute to this gap. METHODOLOGY/PRINCIPAL FINDINGS: Using the case of attention deficit hyperactivity disorder (ADHD, we identified three types of misrepresentation. The first relies on prominent inconsistencies between results and claimed conclusions and was observed in two scientific reports dealing with ADHD. Only one out of the 61 media articles echoing both scientific reports adequately described the results and, thus questioned the claimed conclusion. The second type of misrepresentation consists in putting a firm conclusion in the summary while raw data that strongly limit the claim are only given in the results section. To quantify this misrepresentation we analyzed the summaries of all articles asserting that polymorphisms of the gene coding for the D4 dopaminergic receptor are associated with ADHD. Only 25 summaries out of 159 also mentioned that this association confers a small risk. This misrepresentation is also observed in most media articles reporting on ADHD and the D4 gene. The third misrepresentation consists in extrapolating basic and pre-clinical findings to new therapeutic prospects in inappropriate ways. Indeed, analysis of all ADHD-related studies in mice showed that 23% of the conclusions were overstated. The frequency of this overstatement was positively related with the impact factor of the journal. CONCLUSION/SIGNIFICANCE: Data misrepresentations are frequent in the scientific literature dealing with ADHD and may contribute to the appearance of misleading conclusions in the media. In synergy with citation distortions and publication biases they influence social representations and bias the scientific evidence in favor of the view that ADHD is primarily caused by biological factors. We discuss the social consequences and

  11. Uncertainties in model-based outcome predictions for treatment planning

    International Nuclear Information System (INIS)

    Deasy, Joseph O.; Chao, K.S. Clifford; Markman, Jerry

    2001-01-01

    plans can be ranked based on the probability that one plan is superior to another. Thus, reliability of plan ranking could also be assessed. Conclusions: A comprehensive framework for incorporating uncertainties into treatment-plan-specific outcome predictions is described. Uncertainty histograms for continuous variable endpoint models provide a straightforward method for visual review of the reliability of outcome predictions for each treatment plan

  12. Bias and Bias Correction in Multi-Site Instrumental Variables Analysis of Heterogeneous Mediator Effects

    Science.gov (United States)

    Reardon, Sean F.; Unlu, Faith; Zhu, Pei; Bloom, Howard

    2013-01-01

    We explore the use of instrumental variables (IV) analysis with a multi-site randomized trial to estimate the effect of a mediating variable on an outcome in cases where it can be assumed that the observed mediator is the only mechanism linking treatment assignment to outcomes, as assumption known in the instrumental variables literature as the…

  13. Psychosocial determinants of outcomes in knee replacement.

    Science.gov (United States)

    Lopez-Olivo, Maria A; Landon, Glenn C; Siff, Sherwin J; Edelstein, David; Pak, Chong; Kallen, Michael A; Stanley, Melinda; Zhang, Hong; Robinson, Kausha C; Suarez-Almazor, Maria E

    2011-10-01

    To identify potential psychosocial and educational barriers to clinical success following knee replacement. The authors evaluated 241 patients undergoing total knee replacement, preoperatively and 6 months after surgery. Outcomes included the Western Ontario McMaster (WOMAC) scale and the Knee Society rating system (KSRS). Independent variables included: the medical outcome study-social support scale; depression, anxiety and stress scale; brief COPE inventory; health locus of control; arthritis self-efficacy scale and the life orientation test-revised. Multiple regression models evaluated associations of baseline demographic and psychosocial variables with outcomes at 6 months, controlling for body mass index, comorbidities and baseline outcome scores. Patients' mean age was 65 ± 9 years; 65% were women. Most patients improved outcomes after surgery. Several psychosocial variables were associated with outcomes. Regression analyses indicated lower education, less tangible support, depression, less problem-solving coping, more dysfunctional coping, lower internal locus of control were associated with worse WOMAC scores (R(2) contribution of psychosocial variables for pain 0.07; for function, 0.14). Older age, lower education, depression and less problem-solving coping were associated with poorer total KSRS scores (R(2) contribution of psychosocial variables to total KSRS model 0.09). Psychosocial variables as a set contributed from 25% to 74% of total explained variance across the models tested. Patients' level of education, tangible support, depression, problem-solving coping, dysfunctional coping and internal locus of control were associated with pain and functional outcomes after knee replacement. The findings suggest that, in addition to medical management, perioperative psychosocial evaluation and intervention are crucial in enhancing knee replacement outcomes.

  14. EVALUATION OF ADJUSTABLE SUTURE TECHNIQUE IN OUTCOME OF PTOSIS SURGERY

    Directory of Open Access Journals (Sweden)

    Nagaraju

    2015-10-01

    Full Text Available AIM: To evaluate the outcome of adjustable suture technique in ptosis surgery. INTRODUCTION : Surgical management of blepharoptosis is indicated in multiple situations and the post - operative outcomes can be as variable as the indications for surgery. Adjustable suture techniques in ptosis repair have been introduced and variable efficacies have been reported. MATERIALS AND METHODS: A retrospective case review of medical records from June 2010 to May 2011 (12 months of 5 eyes of 5 consecutive patients operated by a single surgeon at a Tertiary Eye care center in South India were reviewed. The clinical profile of patients included was r ecorded and results of adjustable suture technique described by Borman and collegues for these patients was reported. RESULTS: 5 eyes of 5 patients underwent adjustable suture ptosis repair in the study duration. 4 patients with moderate and 1 with severe ptosis, all having good levator function were diagnosed to have c ongenital ptosis in 3 cases and a cquired involutional ptosis in 2 cases. All 5 cases had a satisfactory outcome at day 4 post - operative after adjustment of lid height in the out - patient clini c. 1 patient with acquired involutional ptosis, identified with levator dehiscence intra - operatively had overcorrection at 6 months warranting re - surgery while the other 4 patients had satisfactory cosmetic lid height and functional outcome at 6 months fol low up after the adjustable suture technique for ptosis repair. CONCLUSION: Use of adjustable sutures in ptosis surgery can eliminate the intraoperative lid factors that can lead to unpredictable results. The technique described is easy to adapt and perfor m and can give repeatable and well acceptable results in the properly selected cases

  15. Misrepresentation of neuroscience data might give rise to misleading conclusions in the media: the case of attention deficit hyperactivity disorder.

    Science.gov (United States)

    Gonon, Francois; Bezard, Erwan; Boraud, Thomas

    2011-01-31

    There is often a huge gap between neurobiological facts and firm conclusions stated by the media. Data misrepresentation in the conclusions and summaries of neuroscience articles might contribute to this gap. Using the case of attention deficit hyperactivity disorder (ADHD), we identified three types of misrepresentation. The first relies on prominent inconsistencies between results and claimed conclusions and was observed in two scientific reports dealing with ADHD. Only one out of the 61 media articles echoing both scientific reports adequately described the results and, thus questioned the claimed conclusion. The second type of misrepresentation consists in putting a firm conclusion in the summary while raw data that strongly limit the claim are only given in the results section. To quantify this misrepresentation we analyzed the summaries of all articles asserting that polymorphisms of the gene coding for the D4 dopaminergic receptor are associated with ADHD. Only 25 summaries out of 159 also mentioned that this association confers a small risk. This misrepresentation is also observed in most media articles reporting on ADHD and the D4 gene. The third misrepresentation consists in extrapolating basic and pre-clinical findings to new therapeutic prospects in inappropriate ways. Indeed, analysis of all ADHD-related studies in mice showed that 23% of the conclusions were overstated. The frequency of this overstatement was positively related with the impact factor of the journal. Data misrepresentations are frequent in the scientific literature dealing with ADHD and may contribute to the appearance of misleading conclusions in the media. In synergy with citation distortions and publication biases they influence social representations and bias the scientific evidence in favor of the view that ADHD is primarily caused by biological factors. We discuss the social consequences and the causes of data misrepresentations and suggest a few corrective actions.

  16. Development impacts of value chain interventions: how to collect practical evidence and draw valid conclusions in impact evaluation

    NARCIS (Netherlands)

    Ton, G.; Vellema, S.; Ruijter de Wildt, de M.J.M.

    2011-01-01

    In development policy and practice, support to or interventions in value chains are considered to be instrumental for achieving outcomes such as poverty alleviation. This paper reviews methodological discussions on how to show the effects and workings of value chain support in a context of donors

  17. Jumping to Conclusions--The PISA Knee-Jerk: Some Remarks on the Current Economic-Educational Discourse

    Science.gov (United States)

    Bittlingmayer, Uwe H.; Boutiuc, Alina Florentina; Heinemann, Lars; Kotthoff, Hans-Georg

    2016-01-01

    Ever since PISA studies have been constantly present in mainstream media, a close relation between academic achievement and economic outcome has been routinely presumed. This essay takes a closer look at some of the most common lines of argument, then goes on to outline a critique of the assumptions underlying the alleged causal relationship…

  18. Cataclysmic Variable Stars

    Science.gov (United States)

    Hellier, Coel

    2001-01-01

    Cataclysmic variable stars are the most variable stars in the night sky, fluctuating in brightness continually on timescales from seconds to hours to weeks to years. The changes can be recorded using amateur telescopes, yet are also the subject of intensive study by professional astronomers. That study has led to an understanding of cataclysmic variables as binary stars, orbiting so closely that material transfers from one star to the other. The resulting process of accretion is one of the most important in astrophysics. This book presents the first account of cataclysmic variables at an introductory level. Assuming no previous knowledge of the field, it explains the basic principles underlying the variability, while providing an extensive compilation of cataclysmic variable light curves. Aimed at amateur astronomers, undergraduates, and researchers, the main text is accessible to those with no mathematical background, while supplementary boxes present technical details and equations.

  19. Understanding Brown Dwarf Variability

    Science.gov (United States)

    Marley, Mark S.

    2013-01-01

    Surveys of brown dwarf variability continue to find that roughly half of all brown dwarfs are variable. While variability is observed amongst all types of brown dwarfs, amplitudes are typically greatest for L-T transition objects. In my talk I will discuss the possible physical mechanisms that are responsible for the observed variability. I will particularly focus on comparing and contrasting the effects of changes in atmospheric thermal profile and cloud opacity. The two different mechanisms will produce different variability signatures and I will discuss the extent to which the current datasets constrain both mechanisms. By combining constraints from studies of variability with existing spectral and photometric datasets we can begin to construct and test self-consistent models of brown dwarf atmospheres. These models not only aid in the interpretation of existing objects but also inform studies of directly imaged giant planets.

  20. Reward-dependent modulation of movement variability.

    Science.gov (United States)

    Pekny, Sarah E; Izawa, Jun; Shadmehr, Reza

    2015-03-04

    Movement variability is often considered an unwanted byproduct of a noisy nervous system. However, variability can signal a form of implicit exploration, indicating that the nervous system is intentionally varying the motor commands in search of actions that yield the greatest success. Here, we investigated the role of the human basal ganglia in controlling reward-dependent motor variability as measured by trial-to-trial changes in performance during a reaching task. We designed an experiment in which the only performance feedback was success or failure and quantified how reach variability was modulated as a function of the probability of reward. In healthy controls, reach variability increased as the probability of reward decreased. Control of variability depended on the history of past rewards, with the largest trial-to-trial changes occurring immediately after an unrewarded trial. In contrast, in participants with Parkinson's disease, a known example of basal ganglia dysfunction, reward was a poor modulator of variability; that is, the patients showed an impaired ability to increase variability in response to decreases in the probability of reward. This was despite the fact that, after rewarded trials, reach variability in the patients was comparable to healthy controls. In summary, we found that movement variability is partially a form of exploration driven by the recent history of rewards. When the function of the human basal ganglia is compromised, the reward-dependent control of movement variability is impaired, particularly affecting the ability to increase variability after unsuccessful outcomes. Copyright © 2015 the authors 0270-6474/15/354015-10$15.00/0.

  1. Provider volume and outcomes for abdominal aortic aneurysm repair, carotid endarterectomy, and lower extremity revascularization procedures.

    LENUS (Irish Health Repository)

    Killeen, Shane D

    2012-02-03

    BACKGROUND: Intuitively, vascular procedures performed by high-volume vascular subspecialists working at high-volume institutions should be associated with improved patient outcome. Although a large number of studies assess the relationship between volume and outcome, a single contemporary compilation of such studies is lacking. METHODS: A review of the English language literature was performed incorporating searches of the Medline, EMBASE, and Cochrane collaboration databases for abdominal aortic aneurysm repair (elective and emergent), carotid endarterectomy, and arterial lower limb procedures for any volume outcome relationship. Studies were included if they involved a patient cohort from 1980 onwards, were community or population based, and assessed health outcomes (mortality and morbidity) as a dependent variable and volume as an independent variable. RESULTS: We identified 74 relevant studies, and 54 were included. All showed either an inverse relationship of variable magnitude between provider volume and mortality, or no volume-outcome effect. The reduction in the risk-adjusted mortality rate (RAMR) for high-volume providers was 3% to 11% for elective abdominal aortic aneurysm (AAA) repair, 2.5 to 5% for emergent AAA repair, 0.7% to 4.7% carotid endarterectomy, and 0.3% to 0.9% for lower limb arterial bypass procedures. Subspeciality training also conferred a considerable morbidity and mortality benefit for emergent AAA repair, carotid endarterectomy, and lower limb arterial procedures. CONCLUSION: High-volume providers have significantly better outcomes for vascular procedures both in the elective and emergent setting. Subspeciality training also has a considerable impact. These data provide further evidence for the specialization of vascular services, whereby vascular procedures should generally be preformed by high-volume, speciality trained providers.

  2. Building prognostic models for breast cancer patients using clinical variables and hundreds of gene expression signatures

    Directory of Open Access Journals (Sweden)

    Liu Yufeng

    2011-01-01

    Full Text Available Abstract Background Multiple breast cancer gene expression profiles have been developed that appear to provide similar abilities to predict outcome and may outperform clinical-pathologic criteria; however, the extent to which seemingly disparate profiles provide additive prognostic information is not known, nor do we know whether prognostic profiles perform equally across clinically defined breast cancer subtypes. We evaluated whether combining the prognostic powers of standard breast cancer clinical variables with a large set of gene expression signatures could improve on our ability to predict patient outcomes. Methods Using clinical-pathological variables and a collection of 323 gene expression "modules", including 115 previously published signatures, we build multivariate Cox proportional hazards models using a dataset of 550 node-negative systemically untreated breast cancer patients. Models predictive of pathological complete response (pCR to neoadjuvant chemotherapy were also built using this approach. Results We identified statistically significant prognostic models for relapse-free survival (RFS at 7 years for the entire population, and for the subgroups of patients with ER-positive, or Luminal tumors. Furthermore, we found that combined models that included both clinical and genomic parameters improved prognostication compared with models with either clinical or genomic variables alone. Finally, we were able to build statistically significant combined models for pathological complete response (pCR predictions for the entire population. Conclusions Integration of gene expression signatures and clinical-pathological factors is an improved method over either variable type alone. Highly prognostic models could be created when using all patients, and for the subset of patients with lymph node-negative and ER-positive breast cancers. Other variables beyond gene expression and clinical-pathological variables, like gene mutation status or DNA

  3. The nebular variables

    CERN Document Server

    Glasby, John S

    1974-01-01

    The Nebular Variables focuses on the nebular variables and their characteristics. Discussions are organized by type of nebular variable, namely, RW Aurigae stars, T Orionis stars, T Tauri stars, and peculiar nebular objects. Topics range from light variations of the stars to their spectroscopic and physical characteristics, spatial distribution, interaction with nebulosity, and evolutionary features. This volume is divided into four sections and consists of 25 chapters, the first of which provides general information on nebular variables, including their stellar associations and their classifi

  4. Ultrasonic variables affecting inspection

    International Nuclear Information System (INIS)

    Lautzenheiser, C.E.; Whiting, A.R.; McElroy, J.T.

    1977-01-01

    There are many variables which affect the detection of the effects and reproducibility of results when utilizing ultrasonic techniques. The most important variable is the procedure, as this document specifies, to a great extent, the controls that are exercised over the other variables. The most important variable is personnel with regards to training, qualification, integrity, data recording, and data analysis. Although the data is very limited, these data indicate that, if the procedure is carefully controlled, reliability of defect detection and reproducibility of results are both approximately 90 percent for reliability of detection, this applies to relatively small defects as reliability increases substantially as defect size increases above the recording limit. (author)

  5. Evaluation of an IPCC climate report. An analysis of conclusions on the possible regional consequences of climate change

    International Nuclear Information System (INIS)

    2010-01-01

    This report contains the results of a study of the reliability of the regional chapters (H9-16) of the contribution of Working Group II to the Fourth Climate Report of the IPCC (the sub report on consequences, adaptation and vulnerability). Moreover an assessment was made of the possible consequences of errors for the conclusions in the high level summaries of that report. The Netherlands Environmental Assessment Agency did not detect any errors that may undermine the main conclusions of the scientific UN Climate Panel IPCC of 2007 on the possible future consequences of climate change. However, some of the substantiations of the conclusions lack clarity. To prevent lack of clarity and inaccuracies the IPCC needs to invest more in quality checks. [nl

  6. Alternative global goodness metrics and sensitivity analysis: heuristics to check the robustness of conclusions from studies comparing virtual screening methods.

    Science.gov (United States)

    Sheridan, Robert P

    2008-02-01

    We introduce two ways of testing the robustness of conclusions from studies comparing virtual screening methods: alternative "global goodness" metrics and sensitivity analysis. While the robustness tests cannot eliminate all biases in virtual screening comparisons, they are useful as a "reality check" for any given study. To illustrate this, we apply them to a set of enrichments published in McGaughey et al. (J. Chem. Inf. Model. 2007, 47, 1504-1519) where 11 target protein/ligand combinations are tested on 2D and 3D similarity methods, plus docking. The major conclusions in that paper, for instance, that ligand-based methods are better than docking methods, hold up. However, some minor conclusions, such as Glide being the best docking method, do not.

  7. Malignant Arrhythmia in Apical Ballooning Syndrome: Risk Factors and Outcomes

    Directory of Open Access Journals (Sweden)

    Samuel J. Asirvatham

    2008-08-01

    Full Text Available Objectives: We sought to determine the frequency and outcomes with symptomatic arrhythmia in patients with apical ballooning syndrome (ABS. Methods: A retrospective review of the Mayo Clinic Angiography database was conducted to identify patients who met the Mayo criteria for ABS. Patients with documented arrhythmias formed the study group, and 31 randomly selected patients with ABS but without arrhythmia formed the control group.Results: Out of 105 patients identified with ABS, 6 (5.7% women aged 69 +/- 9 years experienced significant arrhythmia (ventricular fibrillation, asystole, 2 patients died, and 1 required permanent pacemaker implantation. When compared with controls, the study group showed no significant difference with respect to ECG characteristics (QT, QRS duration or axis except for R-R interval variability (see comments below (30.6±6 vs 14.5±17 p = 0.0004, QTc, and P-R interval. Patients without arrhythmia were more likely to be on beta-blocker therapy than the study population (33% vs 80.6% p = 0.02. Conclusion: Life-threatening arrhythmia is uncommon (5.7% with ABS despite marked, structural abnormalities. When arrhythmias do occur, the outcome is poor. Prominent variability in R-R intervals appears to be predictive of significant arrhythmias in ABS. The role of beta-blocker therapy in preventing arrhythmia with ABS requires further investigation.

  8. Variables associated with active spondylolysis.

    Science.gov (United States)

    Gregg, Chris D; Dean, Sarah; Schneiders, Anthony G

    2009-11-01

    Retrospective non-experimental study. To investigate variables associated with active spondylolysis. A retrospective study audited clinical data over a two year period from patients with suspected spondylolysis that were referred for a SPECT bone scan. Six exploratory variables were identified and analysed using uni- and multi-variate regression from 82 patient records to determine the association between symptomatic, physical and demographic characteristics, and the presence of an active spondylolysis. Tertiary level multidisciplinary private practice sports medicine clinic. All patients with low back pain that required a SPECT bone scan to confirm suspected spondylolysis. 82 subjects were included in the final sample group. The six exploratory variables included Age, Gender, Injury duration, Injury onset, Sports participation and the result of the Single Leg Hyperextension Test. The dependent outcome variable was the result of the SPECT bone scan (scan-positive or scan-negative). Adolescent males had a higher incidence of spondylolysis detected by SPECT bone scan compared to other patients and a statistically significant association was demonstrated for both age (p=0.01) and gender (p=0.01). Subjects with an active spondylolysis were nearly five times more likely to be male and aged less than 20 years. Furthermore, the likelihood ratio indicated that adolescent males with suspected spondylolysis were three and a half times more likely to have a positive bone scan result. The Single Leg Hyperextension Test did not demonstrate a statistically significant association with spondylolysis (p=0.47). Clinicians assessing for a predisposition to the development of spondylolysis should consider the gender and age of the patient and not rely on the predictive ability of the Single Leg Hyperextension Test.

  9. NON-TRAUMATIC COMA- INCIDENCE, AETIOLOGY AND OUTCOME

    Directory of Open Access Journals (Sweden)

    Mallikarjun R. Patil

    2017-10-01

    %, intracranial bleed- 5% and others contributed-7% of cases. Survival was significantly better in CNS infections group (77.6% as compared to those with toxic and metabolic causes (57.1% and intracranial bleed (40%. 4. Low MGCS Score (3-5 was associated with high mortality and survival was better with increasing MGCS score (p<0.001. CONCLUSION Neuroinfections contribute majority of cases of non-traumatic coma in children followed by toxic metabolic group. The overall outcome of CNS infections was significantly better than toxic/metabolic group and among survivors most of them improved with intact neurological outcome. Clinical variables and MGCS score remain the most readily available tools for assessment of non-traumatic coma and also help in prediction of outcome.

  10. Neuron-Specific Enolase as a Predictor of Death or Poor Neurological Outcome After Out-of-Hospital Cardiac Arrest and Targeted Temperature Management at 33°C and 36°C

    DEFF Research Database (Denmark)

    Stammet, Pascal; Collignon, Olivier; Hassager, Christian

    2015-01-01

    levels were assessed in blood samples obtained 24, 48, and 72 h after return of spontaneous circulation. The primary outcome was neurological outcome at 6 months using the cerebral performance category score. RESULTS: NSE was a robust predictor of neurological outcome in a baseline variable......-adjusted model, and target temperature did not significantly affect NSE values. Median NSE values were 18 ng/ml versus 35 ng/ml, 15 ng/ml versus 61 ng/ml, and 12 ng/ml versus 54 ng/ml for good versus poor outcome at 24, 48, and 72 h, respectively (p ... with areas under the receiver-operating curve of 0.85 and 0.86, respectively. High NSE cutoff values with false positive rates ≤5% and tight 95% confidence intervals were able to reliably predict outcome. CONCLUSIONS: High, serial NSE values are strong predictors of poor outcome after OHCA. Targeted...

  11. Predicting outcome after appendicectomy.

    LENUS (Irish Health Repository)

    Kell, M R

    2012-02-03

    AIM: To validate an intraoperative appendicitis severity score (IASS) and examine outcome following emergency appendectomy. METHODS: A prospective study was undertaken, enrolling consecutive patients undergoing emergency appendicectomy. Data were obtained independently on preoperative Alvarado scores, IASS (0-3: 0 no inflammation, 1 engorged appendix\\/no peritonitis, 2 peritoneal reaction\\/exudate or 3 evidence of perforation\\/abscess) and postoperative outcome parameters. RESULTS: There were 149 patients identified with a mean age of 20.7 years. There was no association between Alvarado score and length of hospital stay, septic complication, patient sex or duration of symptoms (p>0.05). IASS was found to be an independent risk factor for septic complication, wound infection (p<0.05) and length of hospital stay (p<0.001). There was no correlation between preoperative duration of symptoms or time until surgery and intraoperative score. CONCLUSIONS: This simple scoring system can identify patients more likely to suffer morbidity following emergency appendicectomy. Specifically, this system identifies patients who have a high risk of sepsis and therefore could be of use when comparing healthcare performance.

  12. Sampling season affects conclusions on soil arthropod community structure responses to metal pollution in Mediterranean urban soils

    NARCIS (Netherlands)

    Santorufo, L.; van Gestel, C.A.M.; Maisto, G.

    2014-01-01

    This study aimed to assess if the period of sampling affected conclusions on the responses of arthropod community structure to metal pollution in urban soils in the Mediterranean area. Higher temperature and lower precipitation were detected in autumn than in spring. In both samplings, the most

  13. It Is Incorrect To Say "The Test Is Reliable": Bad Language Habits Can Contribute to Incorrect or Meaningless Research Conclusions.

    Science.gov (United States)

    Thompson, Bruce

    Researchers too frequently consider the reliability of the scores they analyze, and this may lead to incorrect conclusions. Practice in this regard may be negatively influenced by telegraphic habits of speech implying that tests possess reliability and other measurement characteristics. Styles of speaking in journal articles, in textbooks, and in…

  14. Variable volume combustor

    Science.gov (United States)

    Ostebee, Heath Michael; Ziminsky, Willy Steve; Johnson, Thomas Edward; Keener, Christopher Paul

    2017-01-17

    The present application provides a variable volume combustor for use with a gas turbine engine. The variable volume combustor may include a liner, a number of micro-mixer fuel nozzles positioned within the liner, and a linear actuator so as to maneuver the micro-mixer fuel nozzles axially along the liner.

  15. Collective variables and dissipation

    International Nuclear Information System (INIS)

    Balian, R.

    1984-09-01

    This is an introduction to some basic concepts of non-equilibrium statistical mechanics. We emphasize in particular the relevant entropy relative to a given set of collective variables, the meaning of the projection method in the Liouville space, its use to establish the generalized transport equations for these variables, and the interpretation of dissipation in the framework of information theory

  16. Variability: A Pernicious Hypothesis.

    Science.gov (United States)

    Noddings, Nel

    1992-01-01

    The hypothesis of greater male variability in test results is discussed in its historical context, and reasons feminists have objected to the hypothesis are considered. The hypothesis acquires political importance if it is considered that variability results from biological, rather than cultural, differences. (SLD)

  17. POVMs and hidden variables

    International Nuclear Information System (INIS)

    Stairs, Allen

    2007-01-01

    Recent results by Paul Busch and Adan Cabello claim to show that by appealing to POVMs, non-contextual hidden variables can be ruled out in two dimensions. While the results of Busch and Cabello are mathematically correct, interpretive problems render them problematic as no hidden variable proofs

  18. Interdependence Among Organizational Variables

    Science.gov (United States)

    Knowles, M. C.

    1975-01-01

    The interrelationship between a set of organizational variables was investigated at 14 work organizations within a company. The variables were production, quality, costs, job satisfaction of operatives, job satisfaction of supervisors, work anxiety, accidents, absence, labor turnover, and industrial unrest. (Author)

  19. The relationships between depression and other outcomes of chronic illness caregiving

    Directory of Open Access Journals (Sweden)

    Jirovec Mary M

    2005-02-01

    Full Text Available Abstract Background Many caregivers with chronically ill relatives suffer from depression. However, the relationship of depression to other outcomes of chronic caregiving remains unclear. This study tested a hypothesized model which proposed that hours of care, stressful life events, social support, age and gender would predict caregivers' outcomes through perceived caregiver stress. Depression was expected to mediate the relationship between perceived stress and outcomes of chronic caregiving (physical function, self-esteem, and marital satisfaction. Methods The sample for this secondary data analysis consisted of 236 and 271 subjects from the Americans' Changing Lives, Wave 1, 1986, and Wave 2, 1989, data sets. Measures were constructed from the original study. Structural equation modeling was used to test the hypothesized model, and an exploratory structural modeling method, specification search, was used to develop a data-derived model. Cross-validation was used to verify the paths among variables. Results Hours of care, age, and gender predicted caregivers' outcomes directly or through perceived caregiver stress (p Conclusion Depression predicted psychological outcomes. Whether depression predicts physical health outcomes needs to be further explored.

  20. Surgical Stabilization of Pelvic and Acetabular Fractures: A Review on the Determinants of Clinical Outcomes

    Directory of Open Access Journals (Sweden)

    SS Sathappan

    2010-03-01

    Full Text Available AIM: Pelvic and acetabular fractures are associated with high-energy trauma. The aim of this study was to identify factors that are associated with specific clinical outcomes following treatment for these fractures. METHODS: A consecutive series of 30 patients who had surgical intervention for either pelvic or acetabular fractures formed the sample for this study. Clinical variables reviewed were: age, associated injuries, number of surgical procedures, time to surgery and post-operative complications. Clinical outcomes were assessed using Matta’s grading of post- operative fracture reduction alignment, and functional outcomes were graded using D'Aubigne & Postel’s Hip scoring system. RESULTS: Study subjects included twelve pelvic fractures and eighteen acetabular fractures. Patients older than 50 years of age had poorer hip scores despite surgery. Earlier fracture fixation (within five days was associated with better hip scores. Patients with acetabular fractures generally had better functional outcomes than patients with pelvic fractures (mean hip score 15.0 vs. 13.5. Closer anatomical reduction of acetabular fractures was associated with better functional outcome. CONCLUSION: Improved clinical outcomes are associated with younger age, fewer concomitant injuries, shorter time interval to surgery and more closely approximated anatomical fracture reduction.

  1. Auditory Outcomes with Hearing Rehabilitation in Children with Unilateral Hearing Loss: A Systematic Review.

    Science.gov (United States)

    Appachi, Swathi; Specht, Jessica L; Raol, Nikhila; Lieu, Judith E C; Cohen, Michael S; Dedhia, Kavita; Anne, Samantha

    2017-10-01

    Objective Options for management of unilateral hearing loss (UHL) in children include conventional hearing aids, bone-conduction hearing devices, contralateral routing of signal (CROS) aids, and frequency-modulating (FM) systems. The objective of this study was to systematically review the current literature to characterize auditory outcomes of hearing rehabilitation options in UHL. Data Sources PubMed, EMBASE, Medline, CINAHL, and Cochrane Library were searched from inception to January 2016. Manual searches of bibliographies were also performed. Review Methods Studies analyzing auditory outcomes of hearing amplification in children with UHL were included. Outcome measures included functional and objective auditory results. Two independent reviewers evaluated each abstract and article. Results Of the 249 articles identified, 12 met inclusion criteria. Seven articles solely focused on outcomes with bone-conduction hearing devices. Outcomes favored improved pure-tone averages, speech recognition thresholds, and sound localization in implanted patients. Five studies focused on FM systems, conventional hearing aids, or CROS hearing aids. Limited data are available but suggest a trend toward improvement in speech perception with hearing aids. FM systems were shown to have the most benefit for speech recognition in noise. Studies evaluating CROS hearing aids demonstrated variable outcomes. Conclusions Data evaluating functional and objective auditory measures following hearing amplification in children with UHL are limited. Most studies do suggest improvement in speech perception, speech recognition in noise, and sound localization with a hearing rehabilitation device.

  2. Frequency of hepatitis C in pregnancy and pregnancy outcome

    International Nuclear Information System (INIS)

    Jaffery, T.; Tariq, N.; Ayub, R.; Yawar, A.

    2005-01-01

    Objective: To determine the frequency of HCV infections in pregnant women, to find out the risk factors of HCV infection in pregnant women and to compare pregnancy outcome of the sero-positive women with sero-negative women. Design: Case-control study. Place and Duration of Study: Shifa International Hospital, Islamabad, from June 2001 to May 2002. Patients and Methods: Study was conducted on 947 booked pregnant women who were screened for HCV antibodies during antenatal consultation and were admitted for delivery in labor room. At the time of admission in labor ward, medical records of all patients were reviewed for anti HCV antibody testing and the presence of risk factors for HCV infection. Previous vaginal deliveries with episiotomy, previous surgeries, blood transfusions, and D and C for abortion or dysfunctional uterine bleeding were taken as independent variables. The obstetric outcome variables studied were: completed weeks of gestation by mother, birth weight and apgar score of newborns. The risk factors under study and the outcome variables were compared among HCV positive and negative women through a case-control study and measures of association calculated. Results: The proportion of HCV sero-positively among pregnant woman in our study was 3.27%. Among all the risk factors under study, previous surgery was found to have a significant association with HCV positive status of women (p=0.001). Other variables did not have significant association with HCV positive status in our study. There was no statistical difference in the mean birth weight of newborns (p=0.94), mean Apgar score of newborns (p=0.73) and mean gestational period among HCV positive cases and controls (p=0.47). Conclusion: Prevalence of hepatitis C in pregnant women was 3.27%. Past history of surgical procedures was the most important factor for transmission of hepatitis C virus infection. No adverse effect on pregnancy outcome was observed in terms of gestational age, Apgar score and baby

  3. A review of instrumental variable estimators for Mendelian randomization.

    Science.gov (United States)

    Burgess, Stephen; Small, Dylan S; Thompson, Simon G

    2017-10-01

    Instrumental variable analysis is an approach for obtaining causal inferences on the effect of an exposure (risk factor) on an outcome from observational data. It has gained in popularity over the past decade with the use of genetic variants as instrumental variables, known as Mendelian randomization. An instrumental variable is associated with the exposure, but not associated with any confounder of the exposure-outcome association, nor is there any causal pathway from the instrumental variable to the outcome other than via the exposure. Under the assumption that a single instrumental variable or a set of instrumental variables for the exposure is available, the causal effect of the exposure on the outcome can be estimated. There are several methods available for instrumental variable estimation; we consider the ratio method, two-stage methods, likelihood-based methods, and semi-parametric methods. Techniques for obtaining statistical inferences and confidence intervals are presented. The statistical properties of estimates from these methods are compared, and practical advice is given about choosing a suitable analysis method. In particular, bias and coverage properties of estimators are considered, especially with weak instruments. Settings particularly relevant to Mendelian randomization are prioritized in the paper, notably the scenario of a continuous exposure and a continuous or binary outcome.

  4. Variable-bias coin tossing

    International Nuclear Information System (INIS)

    Colbeck, Roger; Kent, Adrian

    2006-01-01

    Alice is a charismatic quantum cryptographer who believes her parties are unmissable; Bob is a (relatively) glamorous string theorist who believes he is an indispensable guest. To prevent possibly traumatic collisions of self-perception and reality, their social code requires that decisions about invitation or acceptance be made via a cryptographically secure variable-bias coin toss (VBCT). This generates a shared random bit by the toss of a coin whose bias is secretly chosen, within a stipulated range, by one of the parties; the other party learns only the random bit. Thus one party can secretly influence the outcome, while both can save face by blaming any negative decisions on bad luck. We describe here some cryptographic VBCT protocols whose security is guaranteed by quantum theory and the impossibility of superluminal signaling, setting our results in the context of a general discussion of secure two-party computation. We also briefly discuss other cryptographic applications of VBCT

  5. Variable-bias coin tossing

    Science.gov (United States)

    Colbeck, Roger; Kent, Adrian

    2006-03-01

    Alice is a charismatic quantum cryptographer who believes her parties are unmissable; Bob is a (relatively) glamorous string theorist who believes he is an indispensable guest. To prevent possibly traumatic collisions of self-perception and reality, their social code requires that decisions about invitation or acceptance be made via a cryptographically secure variable-bias coin toss (VBCT). This generates a shared random bit by the toss of a coin whose bias is secretly chosen, within a stipulated range, by one of the parties; the other party learns only the random bit. Thus one party can secretly influence the outcome, while both can save face by blaming any negative decisions on bad luck. We describe here some cryptographic VBCT protocols whose security is guaranteed by quantum theory and the impossibility of superluminal signaling, setting our results in the context of a general discussion of secure two-party computation. We also briefly discuss other cryptographic applications of VBCT.

  6. Systematic review on adverse birth outcomes of climate change

    Directory of Open Access Journals (Sweden)

    Parinaz Poursafa

    2015-01-01

    Full Text Available Background: Climate change and global warming have significant effects on human health. This systematic review presents the effects of the climate changes on pregnancy outcomes. Materials and Methods: The search process was conducted in electronic databases including ISI Web of Knowledge, PubMed, Scopus, and Google Scholar using key words of "environmental temperature" "pregnancy" "low birth weight (LBW" "pregnancy outcome," "climate change," "preterm birth (PTB," and a combination of them. We did not consider any time limitation; English-language papers were included. The related papers were selected in three phases. After quality assessment, two reviewers extracted the data while the third reviewer checked their extracted data. Finally, 15 related articles were selected and included in the current study. Results: Approximately all studies have reported a significant relationship between exposure variable and intended outcomes including eclampsia, preeclampsia, cataract, LBW, PTB, hypertension, sex ratio and length of pregnancy. According to conducted studies, decrease in birth weight is more possible in cold months. Increase in temperature was followed by increase in PTB rate. According to most of the studies, eclampsia and preeclampsia were more prevalent in cold and humid seasons. Two spectrums of heat extent, different seasons of the year, sunlight intensity and season of fertilization were associated with higher rates of PTB, hypertension, eclampsia, preeclampsia, and cataract. Conclusion: Climate change has unfavorable effects on eclampsia, preeclampsia, PTB, and cataract. The findings of this review confirm the crucial importance of the adverse health effects of climate change especially in the perinatal period.

  7. Neurologic Outcomes in Very Preterm Infants Undergoing Surgery.

    LENUS (Irish Health Repository)

    2012-01-31

    OBJECTIVE: To investigate the relationship between surgery in very preterm infants and brain structure at term equivalent and 2-year neurodevelopmental outcome. STUDY DESIGN: A total of 227 infants born at <30 weeks gestation or at a birth weight of <1250 g were prospectively enrolled into a longitudinal observational cohort for magnetic resonance imaging and developmental follow-up. The infants were categorized retrospectively into either a nonsurgical group (n=178) or a surgical group (n=30). Nineteen infants were excluded because of incomplete or unsuitable data. The surgical and nonsurgical groups were compared in terms of clinical demographic data, white matter injury, and brain volume at term. Neurodevelopmental outcome was assessed at age 2 years. RESULTS: Compared with the nonsurgical group, the infants in the surgical group were smaller and more growth-restricted at birth, received more respiratory support and oxygen therapy, and had longer hospital stays. They also had smaller brain volumes, particularly smaller deep nuclear gray matter volumes. Infants who underwent bowel surgery had greater white matter injury. Mental Developmental Index scores were lower in the surgical group, whereas Psychomotor Developmental Index scores did not differ between the groups. The Mental Developmental Index difference became nonsignificant after adjustment for confounding variables. CONCLUSION: Preterm infants exposed to surgery and anesthesia had greater white matter injury and smaller total brain volumes, particularly smaller deep nuclear gray matter volumes. Surgical exposure in the preterm infant should alert the clinician to an increased risk for adverse cognitive outcome.

  8. Retrospective evaluation of the pregnancy outcomes of women with epilepsy

    Directory of Open Access Journals (Sweden)

    Mert Kazandı

    2010-09-01

    Full Text Available Objective: The purpose of this study was to investigate obstetric and neonatal outcomes and to discuss benefit effects of preconception counseling of women with epilepsy. Design: Retrospective evaluation of the pregnancy outcomes of women with epilepsy, which it was diagnosed by neurologist at Department of Obstetrics and Gynecology, Ege University School of Medicine, İzmir, between january 2004 and november 2009. Data according to demographic, obstetric and neonatal variables were collected retrospectively from the records of 66 pregnants with epilepsy. We also investigated the pregnancy outcomes related to AED using and preconception counseling. Setting: Department of Obstetrics and Gynecology, Ege University School of Medicine, İzmir Patients: 66 pregnants with epilepsy. Results: The mean maternal age was 28,3±6,3. the median gestational age and fetal weight was 38±0,7 weeks and 3027±341 gr at the time of birth, respectively. Fourteen pregnants (%23,1 were borned before 37. gestational weeks. There were no adverse fetal outcomes and major or minor congenital malformations. The preconception counseling ratio was % 57,57 (n: 38 in study group and all of these used antiepileptic drugs during pregnancy. 28 (%42,43 pregnants with epilepsy didn’t applied preconception counseling that 17 cases of them discontinued their medical terapy during first trimester. Epileptic seizures were commonly developed because of leaving AED. Conclusion: The pregnants with epilepsy have some risk according to disease and medical terapy. A good team work is required by experienced obstetrician and neurologist for management. Then, favorable pregnancy outcomes may be obtained as like as general population.

  9. Clinical audit of foetomaternal outcome in pregnancies with fibroid uterus

    International Nuclear Information System (INIS)

    Sarwar, I.; Habib, S.; Bibi, A.; Malik, N.; Parveen, Z.

    2012-01-01

    Background: Leiomyoma, myoma, leiomyoma or fibroids are synonymous terms. They may be present in as many as 1 in 5 women over age 35 years. If pregnancy is associated with fibroids, it leads to multiple complications. Objectives of this study were to evaluate the maternal and foetal outcome in women having pregnancy with fibroids in uterus and the complications associated with fibroids during the pregnancy. Methods: This descriptive study was conducted in the Department of Obstetrics and Gynaecology, Ayub Teaching Hospital Abbottabad from March 2009 to March 2010. Data were collected on proforma regarding demographic variables, obstetrical history, mode of delivery, maternal outcome, maternal complications, and foetal outcome. Mean and standard deviation was calculated for age, period of gestation, and obstetrical history. Frequency and percentages was calculated for booking status, maternal outcome, maternal complications and foetal outcome. Results: Thirty patients were included in this study who had pregnancy with fibroid. Normal delivery was achieved in 14 (46.66%) patients. Eight (26.67%) patients had caesarean section and eight (26.67%) had miscarriages. Seven (23.33%) patients had no complications while 8 (26.67%) had miscarriages, 8 (26.67%) had postpartum haemorrhage, 10 (33.33%) had preterm delivery, and 3 patients had ante-partum haemorrhage. Two (10%) patients had premature rupture off membranes and 1 patient (3.33%) had pain abdomen and technical difficulty during caesarean section. There were 12 (40%) healthy babies. Five (16.67%) babies delivered with morbidity but recovered. There were 4 (13.33%) intrauterine deaths and one early neonatal death. Conclusion: Fibroid in pregnancy, especially multiple intramural fibroids and fibroids larger than 10 Cm, cause miscarriage and preterm labour. (author)

  10. Quality of Life: Literature Review and Recommendations for Measurement of Military Outcomes (Computer Diskette).

    Science.gov (United States)

    Quality of Life (QOL) programs, meeting service member’s QOL need is of primary concern to the Navy. The purpose of this report is to review the literature in regards to the relationship of QOL and its impact on such military outcome variables as retention attrition performance readiness, and recruitment. Conclusions from the review were that (1) Intent to reenlist was found to be one of the most potent predictors of retention, with other factors such as pay, services, housing, and job satisfaction, also, exerting their influence; (2) certain demographics,

  11. Low Cerebral Blood Volume Identifies Poor Outcome in Stent Retriever Thrombectomy

    International Nuclear Information System (INIS)

    Protto, Sara; Pienimäki, Juha-Pekka; Seppänen, Janne; Numminen, Heikki; Sillanpää, Niko

    2017-01-01

    BackgroundMechanical thrombectomy (MT) is an efficient treatment of acute stroke caused by large-vessel occlusion. We evaluated the factors predicting poor clinical outcome (3-month modified Rankin Scale, mRS >2) although MT performed with modern stent retrievers.MethodsWe prospectively collected the clinical and imaging data of 105 consecutive anterior circulation stroke patients who underwent MT after multimodal CT imaging. Patients with occlusion of the internal carotid artery and/or middle cerebral artery up to the M2 segment were included. We recorded baseline clinical, procedural and imaging variables, technical outcome, 24-h imaging outcome and the clinical outcome. Differences between the groups were studied with appropriate statistical tests and binary logistic regression analysis.ResultsLow cerebral blood volume Alberta stroke program early CT score (CBV-ASPECTS) was associated with poor clinical outcome (median 7 vs. 9, p = 0.01). Lower collateral score (CS) significantly predicted poor outcome in regression modelling with CS = 0 increasing the odds of poor outcome 4.4-fold compared to CS = 3 (95% CI 1.27–15.5, p = 0.02). Lower CBV-ASPECTS significantly predicted poor clinical outcome among those with moderate or severe stroke (OR 0.82, 95% CI 0.68–1, p = 0.05) or poor collateral circulation (CS 0–1, OR 0.66, 95% CI 0.48–0.90, p = 0.009) but not among those with mild strokes or good collaterals.ConclusionsCBV-ASPECTS estimating infarct core is a significant predictor of poor clinical outcome among anterior circulation stroke patients treated with MT, especially in the setting of poor collateral circulation and/or moderate or severe stroke.

  12. Low Cerebral Blood Volume Identifies Poor Outcome in Stent Retriever Thrombectomy

    Energy Technology Data Exchange (ETDEWEB)

    Protto, Sara, E-mail: sara.protto@pshp.fi; Pienimäki, Juha-Pekka; Seppänen, Janne [Tampere University Hospital, Medical Imaging Center (Finland); Numminen, Heikki [Tampere University Hospital, Department of Neurology (Finland); Sillanpää, Niko [Tampere University Hospital, Medical Imaging Center (Finland)

    2017-04-15

    BackgroundMechanical thrombectomy (MT) is an efficient treatment of acute stroke caused by large-vessel occlusion. We evaluated the factors predicting poor clinical outcome (3-month modified Rankin Scale, mRS >2) although MT performed with modern stent retrievers.MethodsWe prospectively collected the clinical and imaging data of 105 consecutive anterior circulation stroke patients who underwent MT after multimodal CT imaging. Patients with occlusion of the internal carotid artery and/or middle cerebral artery up to the M2 segment were included. We recorded baseline clinical, procedural and imaging variables, technical outcome, 24-h imaging outcome and the clinical outcome. Differences between the groups were studied with appropriate statistical tests and binary logistic regression analysis.ResultsLow cerebral blood volume Alberta stroke program early CT score (CBV-ASPECTS) was associated with poor clinical outcome (median 7 vs. 9, p = 0.01). Lower collateral score (CS) significantly predicted poor outcome in regression modelling with CS = 0 increasing the odds of poor outcome 4.4-fold compared to CS = 3 (95% CI 1.27–15.5, p = 0.02). Lower CBV-ASPECTS significantly predicted poor clinical outcome among those with moderate or severe stroke (OR 0.82, 95% CI 0.68–1, p = 0.05) or poor collateral circulation (CS 0–1, OR 0.66, 95% CI 0.48–0.90, p = 0.009) but not among those with mild strokes or good collaterals.ConclusionsCBV-ASPECTS estimating infarct core is a significant predictor of poor clinical outcome among anterior circulation stroke patients treated with MT, especially in the setting of poor collateral circulation and/or moderate or severe stroke.

  13. Cartas de control para monitorear variables multinomiales

    Directory of Open Access Journals (Sweden)

    Luz Marcela Restrepo-Tamayo

    2014-07-01

    Full Text Available Background: The control as a tool for monitoring the quality of a product, allows to study the stability of processes over time, contrasting two hypothesis, which states that the process is in stable condition and the other denies it. Its use has been massive for continuous variables but not for categorical variables, why it is imperative to design such tools for such variables. Objective: To propose two (2 control charts for variables multinomial processes based on the p-value test result for homogeneity of proportions using the chi square test for uniform processing variables and approximation Wilson - Hilferty for variables chi square. Methods: The performance of proposed charts via simulation is estimated considering a Phase II process and considering the first category increments of 2%, 4% and 6% in the control stage. Results: The multinomial control chart using Wilson-Hilferty approximation for variables chi square, from the transformation of value-p, has poor performance compared to the control charts using p-value processing and using chi-square p-value, as they have less ability to detect small changes. Conclusion: We propose two control charts to monitor multinomial variables and once studied via simulation, based on the average run length (ARL and the probability of rejecting the null hypothesis of equal proportions, we recommend the control chart using value-p, or equivalently, the control chart processing using chi square p-value.

  14. Functional Outcome of Anorectal Malformations and Associated Anomalies in Era of Krickenbeck Classification

    International Nuclear Information System (INIS)

    Qazi, S. H.; Faruque, A. V.; Khan, M. A. M.

    2016-01-01

    Objective: To describe the management and functional outcome of anorectal malformations and associated anomalies according to Krickenbeck classification. Study Design: Case series. Place and Duration of Study: The Aga Khan University Hospital, Karachi, from January 2002 to December 2012. Methodology: Anorectal anomalies were classified according to Krickenbeck classification. Data was collected and proforma used regarding the primary disease associated anomalies, its management and functional outcome, according to Krickenbeck classification. Cases included were: all those children with imperforate anus managed during the study period. Qualitative variables like gender and functional outcome were reported as frequencies and percentages. Quantitative variables like age were reported as medians with interquartile ranges. Results: There were 84 children in study group. Most common associated anomaly was cardiac (38 percent), followed by urological anomaly (33 percent). All children were treated by Posterior Sagittal Anorectoplasty (PSARP). Fistula was present in 64 out of 84 (76 percent) cases. The most common fistula was rectourethral (33 percent), followed by recto vestibular (31 percent). According to Krickenbeck classification, continence was achieved in 62 percent children; however 27 percent children were constipated, followed by 12 percent children having fecal soiling. Conclusion: Functional outcome of anorectal malformation depends upon severity of disease. A thorough evaluation of all infants with ARM should be done with particular focus on cardiovascular (38 percent) and genitourinary abnormalities (33 percent). (author)

  15. Is there a relationship between service integration and differentiation and patient outcomes?

    Directory of Open Access Journals (Sweden)

    Robin P. Newhouse

    2003-11-01

    Full Text Available Objective: To examine the level of service integration within Maryland hospitals and service differentiation across the hospital system or network and its affect on heart failure patient clinical and economic outcomes. Data sources/Study setting: Maryland Health Services Cost Review Commission Inpatient Data for 1997 and 1998 were used for secondary data analysis. Study design: Retrospective cross sectional. Independent variables were the level of service integration and differentiation created from the 1998 American Hospital Association Annual Survey based on the work of Bazzoli et al. [1]. The primary dependent variables were readmission, in-hospital mortality, length of stay and costs. Data collection/Extraction methods: Patients discharged from Maryland hospitals with a diagnosis that grouped to DRG 127 (heart failure were extracted. Multivariate linear and logistic models clustered by hospital were used to analyse results at the patient level. Principal findings: A higher likelihood of readmission was found as the level of Community Differentiation increased. Although costs were higher as Total Differentiation increased in 1998, these results were not validated by 1997 data. No significant relationship was found between integration of services and outcomes. Conclusions: Similar outcomes were achieved regardless of the level of service integration or differentiation. Community hospitals produce similar patient outcomes at the same cost for this diagnosis.

  16. An Investigation of the "Jumping to Conclusions" Data-Gathering Bias and Paranoid Thoughts in Asperger Syndrome

    Science.gov (United States)

    Jänsch, Claire; Hare, Dougal Julian

    2014-01-01

    The existence of a data-gathering bias, in the form of jumping to conclusions, and links to paranoid ideation was investigated in Asperger syndrome (AS). People with AS (N = 30) were compared to a neurotypical control group (N = 30) on the Reading the Mind in the Eyes and the Beads tasks, with self-report measures of depression, general anxiety,…

  17. Rapidly variable relatvistic absorption

    Science.gov (United States)

    Parker, M.; Pinto, C.; Fabian, A.; Lohfink, A.; Buisson, D.; Alston, W.; Jiang, J.

    2017-10-01

    I will present results from the 1.5Ms XMM-Newton observing campaign on the most X-ray variable AGN, IRAS 13224-3809. We find a series of nine absorption lines with a velocity of 0.24c from an ultra-fast outflow. For the first time, we are able to see extremely rapid variability of the UFO features, and can link this to the X-ray variability from the inner accretion disk. We find a clear flux dependence of the outflow features, suggesting that the wind is ionized by increasing X-ray emission.

  18. Decision-making when data and inferences are not conclusive: risk-benefit and acceptable regret approach.

    Science.gov (United States)

    Hozo, Iztok; Schell, Michael J; Djulbegovic, Benjamin

    2008-07-01

    The absolute truth in research is unobtainable, as no evidence or research hypothesis is ever 100% conclusive. Therefore, all data and inferences can in principle be considered as "inconclusive." Scientific inference and decision-making need to take into account errors, which are unavoidable in the research enterprise. The errors can occur at the level of conclusions that aim to discern the truthfulness of research hypothesis based on the accuracy of research evidence and hypothesis, and decisions, the goal of which is to enable optimal decision-making under present and specific circumstances. To optimize the chance of both correct conclusions and correct decisions, the synthesis of all major statistical approaches to clinical research is needed. The integration of these approaches (frequentist, Bayesian, and decision-analytic) can be accomplished through formal risk:benefit (R:B) analysis. This chapter illustrates the rational choice of a research hypothesis using R:B analysis based on decision-theoretic expected utility theory framework and the concept of "acceptable regret" to calculate the threshold probability of the "truth" above which the benefit of accepting a research hypothesis outweighs its risks.

  19. Eternity Variables to Simulate Specifications

    NARCIS (Netherlands)

    Hesselink, WH; Boiten, EA; Moller, B

    2002-01-01

    Simulation of specifications is introduced as a unification and generalization of refinement mappings, history variables, forward simulations, prophecy variables, and backward simulations. Eternity variables are introduced as a more powerful alternative for prophecy variables and backward

  20. Functional outcomes in patients with chronic obstructive pulmonary disease: a multivariate analysis

    Directory of Open Access Journals (Sweden)

    Filipe T. S. Athayde

    2014-01-01

    Full Text Available Background: Multiple factors can influence the severity of chronic obstructive pulmonary disease (COPD and the functioning of patients with COPD, such as personal characteristics and systemic manifestations. Objective: To evaluate the different factors that can influence the activity and psychosocial impact domains of the Saint George's Respiratory Questionnaire (SGRQ in COPD patients. Method: Participants, recruited in a university-based hospital, responded to the SGRQ, and in addition, personal, anthropometric, and clinical data were collected. The study was approved by the Institutional Ethics Committee. Data were analyzed using multiple linear regression models, with the SGRQ activity and psychosocial impact scores as outcome variables, and 10 explanatory variables (age, gender, forced expiratory volume in the first second - FEV1, smoking load, body mass index, oxygen therapy, associated diseases, regular physical activity, participation in a formal rehabilitation program, and SGRQ symptoms score were considered. Results: The best regression model for predicting the SGRQ activity score (r2=0.477 included gender, FEV1, and SGRQ symptoms. In contrast, the predictive model with the highest proportion of explained variance in psychosocial impact score (r2=0.426 included the variables gender, oxygen therapy, and SGRQ symptoms. Conclusions: The results indicate that the outcomes, while based on functioning parameters in COPD patients, could be partly explained by the personal and clinical factors analyzed, especially by the symptoms assessed by the SGRQ. Thus, it appears that the health conditions of these patients cannot be described by isolated variables, including pulmonary function parameters.

  1. Variable Attitude Test Stand

    Data.gov (United States)

    Federal Laboratory Consortium — The Variable Attitude Test Stand designed and built for testing of the V-22 tilt rotor aircraft propulsion system, is used to evaluate the effect of aircraft flight...

  2. Several complex variables

    International Nuclear Information System (INIS)

    Field, M.J.

    1976-01-01

    Topics discussed include the elementary of holomorphic functions of several complex variables; the Weierstrass preparation theorem; meromorphic functions, holomorphic line bundles and divisors; elliptic operators on compact manifolds; hermitian connections; the Hodge decomposition theorem. ( author)

  3. Variable-Rate Premiums

    Data.gov (United States)

    Pension Benefit Guaranty Corporation — These interest rates are used to value vested benefits for variable rate premium purposes as described in PBGC's regulation on Premium Rates (29 CFR Part 4006) and...

  4. Variable Pricing Feasibility Assessment

    National Research Council Canada - National Science Library

    2004-01-01

    ...) and Willard Bishop Consulting (Barrington, IL) to evaluate the practicality of using a variable pricing system within DeCA to maintain an average of 30 percent customer savings and lower appropriated fund costs...

  5. Evolution of variable stars

    International Nuclear Information System (INIS)

    Becker, S.A.

    1986-08-01

    Throughout the domain of the H R diagram lie groupings of stars whose luminosity varies with time. These variable stars can be classified based on their observed properties into distinct types such as β Cephei stars, δ Cephei stars, and Miras, as well as many other categories. The underlying mechanism for the variability is generally felt to be due to four different causes: geometric effects, rotation, eruptive processes, and pulsation. In this review the focus will be on pulsation variables and how the theory of stellar evolution can be used to explain how the various regions of variability on the H R diagram are populated. To this end a generalized discussion of the evolutionary behavior of a massive star, an intermediate mass star, and a low mass star will be presented. 19 refs., 1 fig., 1 tab

  6. Calculus of one variable

    CERN Document Server

    Grossman, Stanley I

    1986-01-01

    Calculus of One Variable, Second Edition presents the essential topics in the study of the techniques and theorems of calculus.The book provides a comprehensive introduction to calculus. It contains examples, exercises, the history and development of calculus, and various applications. Some of the topics discussed in the text include the concept of limits, one-variable theory, the derivatives of all six trigonometric functions, exponential and logarithmic functions, and infinite series.This textbook is intended for use by college students.

  7. Software Testing Requires Variability

    DEFF Research Database (Denmark)

    Christensen, Henrik Bærbak

    2003-01-01

    Software variability is the ability of a software system or artefact to be changed, customized or configured for use in a particular context. Variability in software systems is important from a number of perspectives. Some perspectives rightly receive much attention due to their direct economic...... impact in software production. As is also apparent from the call for papers these perspectives focus on qualities such as reuse, adaptability, and maintainability....

  8. Suspended graphene variable capacitor

    OpenAIRE

    AbdelGhany, M.; Mahvash, F.; Mukhopadhyay, M.; Favron, A.; Martel, R.; Siaj, M.; Szkopek, T.

    2016-01-01

    The tuning of electrical circuit resonance with a variable capacitor, or varactor, finds wide application with the most important being wireless telecommunication. We demonstrate an electromechanical graphene varactor, a variable capacitor wherein the capacitance is tuned by voltage controlled deflection of a dense array of suspended graphene membranes. The low flexural rigidity of graphene monolayers is exploited to achieve low actuation voltage in an ultra-thin structure. Large arrays compr...

  9. Molecular Classification Substitutes for the Prognostic Variables Stage, Age, and MYCN Status in Neuroblastoma Risk Assessment

    Directory of Open Access Journals (Sweden)

    Carolina Rosswog

    2017-12-01

    Full Text Available BACKGROUND: Current risk stratification systems for neuroblastoma patients consider clinical, histopathological, and genetic variables, and additional prognostic markers have been proposed in recent years. We here sought to select highly informative covariates in a multistep strategy based on consecutive Cox regression models, resulting in a risk score that integrates hazard ratios of prognostic variables. METHODS: A cohort of 695 neuroblastoma patients was divided into a discovery set (n = 75 for multigene predictor generation, a training set (n = 411 for risk score development, and a validation set (n = 209. Relevant prognostic variables were identified by stepwise multivariable L1-penalized least absolute shrinkage and selection operator (LASSO Cox regression, followed by backward selection in multivariable Cox regression, and then integrated into a novel risk score. RESULTS: The variables stage, age, MYCN status, and two multigene predictors, NB-th24 and NB-th44, were selected as independent prognostic markers by LASSO Cox regression analysis. Following backward selection, only the multigene predictors were retained in the final model. Integration of these classifiers in a risk scoring system distinguished three patient subgroups that differed substantially in their outcome. The scoring system discriminated patients with diverging outcome in the validation cohort (5-year event-free survival, 84.9 ± 3.4 vs 63.6 ± 14.5 vs 31.0 ± 5.4; P < .001, and its prognostic value was validated by multivariable analysis. CONCLUSION: We here propose a translational strategy for developing risk assessment systems based on hazard ratios of relevant prognostic variables. Our final neuroblastoma risk score comprised two multigene predictors only, supporting the notion that molecular properties of the tumor cells strongly impact clinical courses of neuroblastoma patients.

  10. Risk factors and outcome in 100 patients with aneurysmal subarachnoid hemorrhage

    Directory of Open Access Journals (Sweden)

    Bonilha Leonardo

    2001-01-01

    Full Text Available OBJECTIVE: Clinical and surgical outcome of patients with subarachnoid hemorrhage (SAH due to ruptured aneurysm were assessed in comparison to pre-operative data and risk factors such as previous medical history, clinical presenting condition, CT findings and site of bleeding. METHODS: We evaluated 100 consecutive patients with aneurysmal SAH. Gender, color, history of hypertension, smoking habit, site and size of aneurysm, admittance and before surgery Hunt Hess scale, need for cerebro-spinal fluid shunt, presence of complications during the surgical procedure, Glasgow Outcome Scale, presence of vasospasm and of rebleeding were assessed and these data matched to outcome. For statistical analysis, we applied the chi-squared test or Fisher's test using the pondered kappa coeficient. Kruskal-Wallis test was used for comparison of continue variables. Tendency of proportion was analyzed through Cochran-Armitage test. Significance level adopted was 5%. RESULTS: Patients studied were mainly white, female, without previous history of hypertension and non-smokers. Upon hospital admittance, grade 2 of Hunt-Hess scale was most frequently observed (34%, while grade 3 of Fisher scale was the most prevalent. Single aneurysms were most frequent at anterior circulation, between 12 and 24 mm. The most frequent Glasgow Outcome Scale observed was 5 (60%. Hunt Hess upon the moment of surgery and presence of complications during surgical procedure showed positive correlation with clinical outcome (p=0.00002 and p=0.001, respectively. Other variables were not significantly correlated to prognosis. Tendency of proportion was observed between Hunt-Hess scale and Fisher scale. CONCLUSION: Among variables such as epidemiological data, previous medical history and presenting conditions of patients with ruptured aneurysms, the Hunt-Hess scale upon the moment of surgery and the presence of surgical adversities are statistically related to degree of disability.

  11. Farmacoeconomia e outcomes research

    Directory of Open Access Journals (Sweden)

    Ermanno Attanasio

    2004-09-01

    Full Text Available Pharmaceutical products are relevant for their contribution to the medicine progress and in health peoples improvement, altough this evidence goes back to the forthy years with the reduction in mortality, morbidity and hospitalisation rates. The ambivalence of drugs, both remedy and poison, needs a careful assessment of risks and benefits. Primitive estimates of health treatments evaluation occurred in the human history but the modern concept of evaluation in health care derived from cost-benefit analysis (welfare economics and technology assessment. Then a new discipline, pharmacoeconomics and outcomes research, developed with the contribution of health economics, clinical medicine, pharmacology, statistics and epidemiology. Pharmaceutical products are also relevant because of their responsability of health expenditure growth. From 1992, in Italy, several legislative actions were made to face up the pharmaceutical expenditure. The most important one (L. 537/1993 achieved the maximum decrease of 16,8%, in 1994, and modified radically the pharmaceutical policy. Nevertheless, in the following six years the pharmaceutical expenditure grew more than 93%. New actions were made fixing the pharmaceutical expenditure to 13% of health expenditure, any excess being charged to Regions. In the new version for the current year, the excesses will be paid-back by pharmaceutical companies (60% and Regions (40%. Furtherly, the creation of Agenzia Italiana del Farmaco increases the relevance of cost-effectiveness analyses for drugs reimbursement. However, pharmacoeconomic evaluations have still many methodological problems. Economic variables should be treated in the same manner of biomedical or epidemiological data, that is, by confidence intervals and sample sizes. There would be an “economic significance” besides to clinical and statistical ones. In this way, pharmacoeconomics and outcomes research would be able to add rationality to health care

  12. Standardization of SMP procedure and its impact on outcome

    Directory of Open Access Journals (Sweden)

    Rachita S Dhurat

    2017-01-01

    Full Text Available Background: Cosmetic deformities can result from various types of alopecia or even post hair transplantation procedures. Patients with such deformities seek aesthetically appealing longer-lasting options. Scalp concealers are commonly used by men and women to camouflage these deformities. Scalp micropigmentation (SMP is one of the concealers recently gaining popularity. Objectives: SMP is a novel technique wherein microdot tattoos are placed in a stippling pattern to mimic hair follicles that are cut close to the scalp and various variables affecting its outcome were evaluated. Methods: Forty-five subjects were recruited for the study. The various factors affecting outcome of SMP—angle of needle against the scalp, depth of needle into the scalp, time of the needle contact in scalp, speed of the rotor, resistance of scalp, color of pigment, viscosity of dye, needle number, needle thickness, and pattern of dot placement—were systematically studied in 15 patients through clinical photographs and trichoscopy. Ideal depth of pigment deposition was assessed through histopathological examination. After using these optimum variables, standardized SMP was performed in 30 patients with hair loss (3 patients with cicatricial and 27 patients with diffuse non-cicatricial alopecia. SMP was also used to create an aesthetically denser hairline. The outcome of the procedure was evaluated using standardized global photographs. Results: The ideal parameters were established to achieve standard reproducible results. There were great patient satisfaction and acceptance of the procedure. All the patients showed moderate to great improvement after the procedure with satisfactory scalp coverage. Adverse events were transient which were seen in the form of edema and redness. Conclusion: SMP offers a non-medical, tattoo-based cosmetically appealing and effective “cover-up” that hides the unsightly conditions. The cosmetic tattoo placement creates an illusion of

  13. Conclusions to the first Baxter-Senpe workshop on: ready-to-use (RTU) products for parenteral nutrition

    OpenAIRE

    García de Lorenzo Mateos, A.; Bermejo Vicedo, T.; Gómez Candela, C.; Planas Vila, M.

    2005-01-01

    Conclusiones de la Mesa de Trabajo sobre productos listos para su uso (RTU) en nutrición parenteral. Se efectúa una aproximación a la definición y a las ventajas en comparación con otros modelos de nutrición parenteral. Destacan los aspectos relacionados con la gestión, composición de la RTU e indicaciones tanto intrahospitalarias como domiciliarias.Conclusions to the workshop on ready-to use (RTU) products for parenteral nutrition. An approximation is done to the definition and advantages in...

  14. Legal Nature of the Investor’s Consent to the Conclusion of the Agreement with Sub-contractor

    OpenAIRE

    Sławomir Szejna

    2013-01-01

    Author of present article presents and comments on the divergent views of doctrine and judicature concerning the legal nature of the investor’s consent to the conclusion of the agreement for subcontracting, arose from the introduction of the provisions of Article 6471 § 2 and 3 to the Polish Civil Code with Act dated 14 February 2003 amending the Act – the Civil Code and other acts. Author refers also to the joint responsibility of the investor and the contractor towards further subcontractor...

  15. Electron attachment in F2 - Conclusive demonstration of nonresonant, s-wave coupling in the limit of zero electron energy

    Science.gov (United States)

    Chutjian, A.; Alajajian, S. H.

    1987-01-01

    Dissociative electron attachment to F2 has been observed in the energy range 0-140 meV, at a resolution of 6 meV (full width at half maximum). Results show conclusively a sharp, resolution-limited threshold behavior consistent with an s-wave cross section varying as sq rt of epsilon. Two accurate theoretical calculations predict only p-wave behavior varying as the sq rt of epsilon. Several nonadiabatic coupling effects leading to s-wave behavior are outlined.

  16. Bioenergy. The Impact of Indirect Land Use Change. Summary and Conclusions from the IEA Bioenergy ExCo63 Workshop

    International Nuclear Information System (INIS)

    Brown, A.; Tustin, J.

    2009-09-01

    This publication provides the summary and conclusions from the title workshop, held in conjunction with he meeting of the Executive Committee of IEA Bioenergy in Rotterdam, Netherlands, on 12 May 2009. The purpose of the workshop was to inform the Executive Committee on the rapidly evolving international debate on bioenergy and land use - particularly the thorny issue of indirect land use change. The aim was to stimulate discussion between the Executive Committee and invited experts and thereby enhance the new policy-oriented work within IEA Bioenergy.

  17. ModerateDrinking.com and Moderation Management: Outcomes of a randomized clinical trial with non-dependent problem drinkers1

    Science.gov (United States)

    Hester, Reid K.; Delaney, Harold D.; Campbell, William

    2011-01-01

    Objective To evaluate the effectiveness of a web-based protocol, Moderate Drinking (MD) (www.moderatedrinking.com) combined with use of the online resources of Moderation Management (MM) (www.moderation.org) as opposed to the use of the online resources of MM alone. Method We randomly assigned 80 problem drinkers to either the experimental or control group with follow-ups at 3, 6, and 12 months. Results Seventy-five participants (94%) had outcome data at one or more follow-up points and 59 (73%) were assessed at all three follow-ups. Comparing baseline measures to the average outcomes at follow-ups indicated a significant overall reduction in both groups in alcohol-related problems and consumption variables. Compared to the control group, the experimental group had better outcomes on percent days abstinent (PDA). There was an interaction between intensity of drinking at baseline and treatment in determining outcomes assessing drinking. Less heavy drinkers in the experimental group had better outcomes on log Mean BAC per drinking day compared to the control group. Heavier drinkers did not differentially benefit from the MD program on this measure. Mixed model analyses in general corroborated these outcomes. Conclusion The outcome data provide partial evidence for the effectiveness of the MD web application combined with MM, compared to the effectiveness of the resources available online at MM by themselves. PMID:21319896

  18. Test-retest variability of multifocal electroretinography in normal volunteers and short-term variability in hydroxychloroquine users

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    Browning DJ

    2014-08-01

    Full Text Available David J Browning,1 Chong Lee2 1Charlotte Eye, Ear, Nose and Throat Associates, 2University of North Carolina – Charlotte, Charlotte, NC, USA Purpose: To determine measurement variability of N1P1 amplitudes and the R1/R2 ratio in normal subjects and hydroxychloroquine users without retinopathy. Design: Retrospective, observational study. Subjects: Normal subjects (n=21 and 44 patients taking hydroxychloroquine (n=44 without retinopathy. Methods: Multifocal electroretinography (mfERG was performed twice in one session in the 21 normal subjects and twice within 1 year in the hydroxychloroquine users, during which time no clinical change in macular status occurred. Main outcome measures: N1P1 amplitudes of rings R1–R5, the R1/R2 ratio, and coefficients of repeatability (COR for these measurements. Results: Values for N1P1 amplitudes in hydroxychloroquine users were reduced compared with normal subjects by the known effect of age, but R1/R2 was not affected by age. The COR for R1–R5 ranged from 43% to 52% for normal subjects and from 43% to 59% for hydroxychloroquine users; for R1/R2 the COR was 29% in normal subjects and 45% in hydroxychloroquine users. Conclusion: mfERG measurements show high test-retest variability, limiting the ability of a single mfERG test to influence a decision to stop hydroxychloroquine; corroborative evidence with a different ancillary test is recommended in a suspicious case. Keywords: multifocal electroretinography, hydroxychloroquine, test-retest variability 

  19. Do recent data from the Seychelles Islands alter the conclusions of the NRC Report on the toxicological effects of methylmercury?

    Directory of Open Access Journals (Sweden)

    Jacobson Joseph L

    2004-01-01

    Full Text Available Abstract In 2000, the National Research Council (NRC, an arm of the National Academy of Sciences, released a report entitled, "Toxicological Effects of Methylmercury." The overall conclusion of that report was that, at levels of exposure in some fish- and marine mammal-consuming communities (including those in the Faroe Islands and New Zealand, subtle but significant adverse effects on neuropsychological development were occurring as a result of in utero exposure. Since the release of that report, there has been continuing discussion of the public health relevance of current levels of exposure to Methylmercury. Much of this discussion has been linked to the release of the most recent longitudinal update of the Seychelles Island study. It has recently been posited that these findings supercede those of the NRC committee, and that based on the Seychelles findings, there is little or no risk of adverse neurodevelopmental effects at current levels of exposure. In this commentary, members of the NRC committee address the conclusions from the NRC report in light of the recent Seychelles data. We conclude that no evidence has emerged since the publication of the NRC report that alters the findings of that report.

  20. Conclusions drawn from actions implemented within the first stage of the Cracow program of energy conservation and clean fossil fuels

    Energy Technology Data Exchange (ETDEWEB)

    Bieda, J.; Bardel, J.; Pierce, B.

    1995-12-31

    Since 1992 Brookhaven National Laboratory (BNL) and Pacific Northwest Laboratory (PNL), acting on behalf of the U.S. Department of Energy, executed the first stage of the Cracow Program of Energy Conservation and Clean Fossil Fuels, called also American-Polish Program of Actions for Elimination of Low Emission Sources in Cracow. The main contractor for BNL and PNL was the Cracow Development Office (BRK). The interest in improving the condition of Cracow air results from the fact that the standard for permissible air pollution was exceeded several times in Cracow and especially within the central part of the town. Therefore, air pollution appeared one of the most important problems that faced the municipal authorities. It followed from monitoring investigations that the high level of air pollutant concentration is caused by in-home coal-fired tile stoves operated in winter seasons and by coal- and coke-fired boiler houses simulated mainly in the central part of the town. The results obtained in first stage are presented. This paper is an attempt to formulate conclusions drawn from these works and recommendations with regard to the future policy of the town authorities; selected results are presented to clarify or illustrate the conclusions.