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Sample records for outcomes inconsistent results

  1. The Interpretability of Inconsistency: Feferman's Theorem and Related Results

    NARCIS (Netherlands)

    Visser, Albert

    This paper is an exposition of Feferman's Theorem concerning the interpretability of inconsistency and of further insights directly connected to this result. Feferman's Theorem is a strengthening of the Second Incompleteness Theorem. It says, in metaphorical paraphrase, that it is not just the case

  2. The Interpretability of Inconsistency: Feferman's Theorem and Related Results

    NARCIS (Netherlands)

    Visser, Albert

    2014-01-01

    This paper is an exposition of Feferman's Theorem concerning the interpretability of inconsistency and of further insights directly connected to this result. Feferman's Theorem is a strengthening of the Second Incompleteness Theorem. It says, in metaphorical paraphrase, that it is not just the case

  3. Status inconsistency in groups : How discrepancies between instrumental and expressive status result in symptoms of stress

    NARCIS (Netherlands)

    van de Brake, Hendrik; Grow, André; Dijkstra, Jan Kornelis

    This study examines whether a mismatch between the positions that individuals hold in different status hierarchies results in symptoms of stress. Prior research has focused on inconsistencies between socioeconomic status dimensions (e.g., education and income) and did not find a significant relation

  4. WACC Calculations in Practice : Incorrect Results due to Inconsistent Assumptions - Status Quo and Improvements

    OpenAIRE

    Grüninger, Matthias C.; Kind, Axel H.

    2013-01-01

    This paper argues that in practical applications the weighted average cost of capital (WACC) is often incorrectly estimated due to the simultaneous use of two inconsistent input parameters: (i) a beta of debt equal to zero when transforming asset betas into equity betas (beta levering) and (ii) a cost of debt above the risk-free interest rate when calculating the WACC. The paper discusses and quantifies the consequences of this inconsistency and offers viable solutions. By replacing the cost ...

  5. Inconsistencies between Academic E-Book Platforms: A Comparison of Metadata and Search Results

    Science.gov (United States)

    Wiersma, Gabrielle; Tovstiadi, Esta

    2017-01-01

    This article presents the results of a study of academic e-books that compared the metadata and search results from major academic e-book platforms. The authors collected data and performed a series of test searches designed to produce the same result regardless of platform. Testing, however, revealed metadata-related errors and significant…

  6. Measuring Competition: Inconsistent Definitions, Inconsistent Results

    Science.gov (United States)

    Linick, Matthew Allen

    2014-01-01

    There is a developing literature examining how charter schools, through the effects of competition, impact performance in public school districts and district-run public schools, also known as the second-level effects of competition. What follows is an examination of how competition is measured in this literature that offers a critique of existing…

  7. On the statistical evaluation of inconsistent measurement results illustrated on the example of the 90Sr half-life

    International Nuclear Information System (INIS)

    Zijp, W.L.

    1985-12-01

    The problem how to make an objective evaluation of inconsistent numerical observations made by different authors or laboratories on the same physical quantity is dealt with. The problem is treated in a practical way in the light of the example on the half-life of 90 Sr, and it is to some extent a response to a document by Gray (1985) on the same topic

  8. Inconsistencies between alcohol screening results based on AUDIT-C scores and reported drinking on the AUDIT-C questions: prevalence in two US national samples

    Science.gov (United States)

    2014-01-01

    Background The AUDIT-C is an extensively validated screen for unhealthy alcohol use (i.e. drinking above recommended limits or alcohol use disorder), which consists of three questions about alcohol consumption. AUDIT-C scores ≥4 points for men and ≥3 for women are considered positive screens based on US validation studies that compared the AUDIT-C to “gold standard” measures of unhealthy alcohol use from independent, detailed interviews. However, results of screening—positive or negative based on AUDIT-C scores—can be inconsistent with reported drinking on the AUDIT-C questions. For example, individuals can screen positive based on the AUDIT-C score while reporting drinking below US recommended limits on the same AUDIT-C. Alternatively, they can screen negative based on the AUDIT-C score while reporting drinking above US recommended limits. Such inconsistencies could complicate interpretation of screening results, but it is unclear how often they occur in practice. Methods This study used AUDIT-C data from respondents who reported past-year drinking on one of two national US surveys: a general population survey (N = 26,610) and a Veterans Health Administration (VA) outpatient survey (N = 467,416). Gender-stratified analyses estimated the prevalence of AUDIT-C screen results—positive or negative screens based on the AUDIT-C score—that were inconsistent with reported drinking (above or below US recommended limits) on the same AUDIT-C. Results Among men who reported drinking, 13.8% and 21.1% of US general population and VA samples, respectively, had screening results based on AUDIT-C scores (positive or negative) that were inconsistent with reported drinking on the AUDIT-C questions (above or below US recommended limits). Among women who reported drinking, 18.3% and 20.7% of US general population and VA samples, respectively, had screening results that were inconsistent with reported drinking. Limitations This study did not include an

  9. Inconsistent definitions for intention-to-treat in relation to missing outcome data: systematic review of the methods literature.

    Science.gov (United States)

    Alshurafa, Mohamad; Briel, Matthias; Akl, Elie A; Haines, Ted; Moayyedi, Paul; Gentles, Stephen J; Rios, Lorena; Tran, Chau; Bhatnagar, Neera; Lamontagne, Francois; Walter, Stephen D; Guyatt, Gordon H

    2012-01-01

    Authors of randomized trial reports seem to hold a variety of views regarding the relationship between missing outcome data (MOD) and intention to treat (ITT). The objectives of this study were to systematically investigate how authors of methodology articles define ITT in the presence of MOD, how they recommend handling MOD under ITT, and to make a proposal for potential improvement in the definition and use of ITT in relation to MOD. We systematically searched MEDLINE in February 2009 for methodological articles written in English that devoted at least one paragraph to ITT and two other paragraphs to either ITT or MOD. We excluded original trial reports, observational studies, and clinical systematic reviews. Working in teams of two, we independently extracted relevant information from each eligible article. Of 1007 titles and abstracts reviewed, 66 articles met eligibility criteria. Five (8%) did not provide a definition of ITT; 25 (38%) mentioned MOD but did not discuss its relationship to ITT; and 36 (55%) discussed the relationship of MOD with ITT. These 36 articles described one or more of three statements: complete follow-up is required for ITT (58%); ITT and MOD are separate issues (17%); and ITT requires a specific strategy for handling MOD (78%); 17 (47%) endorsed more than one relationship. The most frequently mentioned strategies for handling MOD within ITT were: using the last outcome carried forward (50%); sensitivity analysis (50%); and use of available data to impute missing data (46%). We found that there is no consensus on the definition of ITT in relation to MOD. For conceptual clarity, we suggest that both reports of randomized trials and systematic reviews separately consider and describe how they deal with participants with complete data and those with MOD.

  10. A commercially available immunoglobulin E-based test for food allergy gives inconsistent results in healthy ponies.

    Science.gov (United States)

    Dupont, S; De Spiegeleer, A; Liu, D J X; Lefère, L; van Doorn, D A; Hesta, M

    2016-01-01

    Commercial immunoglobulin E (IgE)-based tests are available for diagnosis of food allergies and are commonly used in equine practice. However, these tests have been proven unreliable as a screening method in man and other species, but not critically evaluated in equids. Therefore, a commercially available IgE-based test for horses was evaluated. To evaluate the consistency of the results obtained with a commercially available IgE-based test for food allergy diagnosis in ponies (Phase I) and to subject ponies to a provocation trial with the presumed allergens (Phase II). Allergen screening followed by experimental food provocation trials in healthy ponies. Blood samples of 17 healthy Shetland ponies were taken at 2 different time points, sent blinded to a commercial laboratory for screening of common food allergens and the results were evaluated for consistency (Phase I). Ponies that were positive for food allergens were consecutively challenged orally with each allergen separately for 14 days (Phase II). A washout period of one week was applied in ponies with multiple positive results. Clinical parameters and serum amyloid A were monitored during the provocation trial. Only 7/17 ponies were negative on the IgE-based test at the 2 time points, 3 had positive results twice but only one tested positive twice for the same food allergen. No abnormalities were noted during the provocation trials. This study demonstrated that this IgE-based test is not a reliable screening tool for food allergy in healthy equids. © 2015 EVJ Ltd.

  11. Differences in delineation guidelines for head and neck cancer result in inconsistent reported dose and corresponding NTCP

    International Nuclear Information System (INIS)

    Brouwer, Charlotte L.; Steenbakkers, Roel J.H.M.; Gort, Elske; Kamphuis, Marije E.; Laan, Hans Paul van der; Veld, Aart A. van’t; Sijtsema, Nanna M.; Langendijk, Johannes A.

    2014-01-01

    Purpose: To test the hypothesis that delineation of swallowing organs at risk (SWOARs) based on different guidelines results in differences in dose–volume parameters and subsequent normal tissue complication probability (NTCP) values for dysphagia-related endpoints. Materials and methods: Nine different SWOARs were delineated according to five different delineation guidelines in 29 patients. Reference delineation was performed according to the guidelines and NTCP-models of Christianen et al. Concordance Index (CI), dosimetric consequences, as well as differences in the subsequent NTCPs were calculated. Results: The median CI of the different delineation guidelines with the reference guidelines was 0.54 for the pharyngeal constrictor muscles, 0.56 for the laryngeal structures and 0.07 for the cricopharyngeal muscle and esophageal inlet muscle. The average difference in mean dose to the SWOARs between the guidelines with the largest difference (maxΔD) was 3.5 ± 3.2 Gy. A mean ΔNTCP of 2.3 ± 2.7% was found. For two patients, ΔNTCP exceeded 10%. Conclusions: The majority of the patients showed little differences in NTCPs between the different delineation guidelines. However, large NTCP differences >10% were found in 7% of the patients. For correct use of NTCP models in individual patients, uniform delineation guidelines are of great importance

  12. Learning from moral inconsistency.

    Science.gov (United States)

    Campbell, Richmond

    2017-10-01

    Moral inconsistency is an understudied phenomenon in cognitive moral psychology and deserves in depth empirical study. Moral inconsistency, as understood here, is not formal inconsistency but inconsistency in moral emotion and belief in response to particular cases. It occurs when persons treat cases as morally different that are really morally the same, even from their moral perspective. Learning to recognize and avoid such moral inconsistency in non-trivial but is a form of moral learning that complements and enhances other psychological and social mechanisms through which persons learn how to apply shared moral norms when their applications are uncertain and threaten to lapse into moral inconsistency. The same psychological process also can function to revise current moral norms when their straightforward applications are morally inconsistent with more basic moral commitments. Through this moral learning and related kinds, people can learn how to identify issues of moral priority when moral norms conflict and, when necessary, how to revise their moral norms. The recent revolution in dominant moral norms around gay sex and gay marriage in Europe and North America provides a possible illustration. When coupled with other modes of moral learning in the context of ambiguous but deeply rooted moral norms, such as those of sanctity and authority, reflection on moral inconsistency can help to justify this large-scale moral change, even among those who find gay sex, by its nature, morally repugnant. Copyright © 2017 Elsevier B.V. All rights reserved.

  13. Classification for Inconsistent Decision Tables

    KAUST Repository

    Azad, Mohammad; Moshkov, Mikhail

    2016-01-01

    Decision trees have been used widely to discover patterns from consistent data set. But if the data set is inconsistent, where there are groups of examples with equal values of conditional attributes but different labels, then to discover the essential patterns or knowledge from the data set is challenging. Three approaches (generalized, most common and many-valued decision) have been considered to handle such inconsistency. The decision tree model has been used to compare the classification results among three approaches. Many-valued decision approach outperforms other approaches, and M_ws_entM greedy algorithm gives faster and better prediction accuracy.

  14. Classification for Inconsistent Decision Tables

    KAUST Repository

    Azad, Mohammad

    2016-09-28

    Decision trees have been used widely to discover patterns from consistent data set. But if the data set is inconsistent, where there are groups of examples with equal values of conditional attributes but different labels, then to discover the essential patterns or knowledge from the data set is challenging. Three approaches (generalized, most common and many-valued decision) have been considered to handle such inconsistency. The decision tree model has been used to compare the classification results among three approaches. Many-valued decision approach outperforms other approaches, and M_ws_entM greedy algorithm gives faster and better prediction accuracy.

  15. Patterns and risk factors of inconsistent condom use among men who have sex with men in Viet Nam: Results from an Internet-based cross-sectional survey.

    Science.gov (United States)

    García, Macarena C; Duong, Quyen L; Mercer, Licelot C Eralte; Meyer, Samantha B; Koppenhaver, Todd; Ward, Paul R

    2014-01-01

    Survey data from men who have sex with men (MSM) in Asian cities indicate drastic increases in HIV prevalence. It is unknown which factors are most important in driving these epidemics. The objective of this study was to identify patterns of condom use among MSM Internet users living in Viet Nam, as well as risk factors associated with inconsistent condom use and non-condom use. A national Internet-based survey of sexual behaviours was administered in 2011. Results showed that 44.9% of MSM reported not using a condom during their last anal sex encounter with a male partner. MSM were less likely to report condom use during anal sex with long-term partners than with casual partners. Twenty-three and a half per cent of MSM surveyed had ever taken an HIV test and received the results. Study findings highlight the urgent need for targeted strategies focused on increasing the rate of consistent condom use during anal sex with male partners among MSM in Viet Nam.

  16. The Inconsistent Vegetarian

    NARCIS (Netherlands)

    van der Kooi, Merle E.

    2010-01-01

    Vegetarians are often charged with inconsistency. They are told that, if they refrain from meat consumption, they should also refrain from the consumption of all animal products. The central question this paper addresses is whether the requirement of consistency means that vegetarians should become

  17. Gradient phonological inconsistency affects vocabulary learning.

    Science.gov (United States)

    Muench, Kristin L; Creel, Sarah C

    2013-09-01

    Learners frequently experience phonologically inconsistent input, such as exposure to multiple accents. Yet, little is known about the consequences of phonological inconsistency for language learning. The current study examines vocabulary acquisition with different degrees of phonological inconsistency, ranging from no inconsistency (e.g., both talkers call a picture /vig/) to mild but detectable inconsistency (e.g., one talker calls a picture a /vig/, and the other calls it a /vIg/), up to extreme inconsistency (e.g., the same picture is both a /vig/ and a /dIdʒ/). Previous studies suggest that learners readily extract consistent phonological patterns, given variable input. However, in Experiment 1, adults acquired phonologically inconsistent vocabularies more slowly than phonologically consistent ones. Experiment 2 examined whether word-form inconsistency alone, without phonological competition, was a source of learning difficulty. Even without phonological competition, listeners learned faster in 1 accent than in 2 accents, but they also learned faster in 2 accents (/vig/ = /vIg/) than with completely different labels (/vig/ = /dIdʒ/). Overall, results suggest that learners exposed to multiple accents may experience difficulty learning when 2 forms mismatch by more than 1 phonological feature, plus increased phonological competition due to a greater number of word forms. Implications for learning from variable input are discussed. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  18. A misfit function tolerating inconsistent data

    KAUST Repository

    Huang, Yunsong

    2014-01-01

    Inversion methods that do not model all of the physical events in the observed data lead to inconsistent sets of equations. This often results in serious artifacts in the inverted model. To mitigate this problem, I propose a misfit function

  19. Was Newtonian cosmology really inconsistent?

    Science.gov (United States)

    Vickers, Peter

    This paper follows up a debate as to the consistency of Newtonian cosmology. Whereas Malament [(1995). Is Newtonian cosmology really inconsistent? Philosophy of Science 62, 489-510] has shown that Newtonian cosmology is not inconsistent, to date there has been no analysis of Norton's claim [(1995). The force of Newtonian cosmology: Acceleration is relative. Philosophy of Science 62, 511-522.] that Newtonian cosmology was inconsistent prior to certain advances in the 1930s, and in particular prior to Seeliger's seminal paper of Seeliger [(1895). Über das Newton'sche Gravitationsgesetz. Astronomische Nachrichten 137 (3273), 129-136.] In this paper I agree that there are assumptions, Newtonian and cosmological in character, and relevant to the real history of science, which are inconsistent. But there are some important corrections to make to Norton's account. Here I display for the first time the inconsistencies-four in total-in all their detail. Although this extra detail shows there to be several different inconsistencies, it also goes some way towards explaining why they went unnoticed for 200 years.

  20. Statistical reporting inconsistencies in experimental philosophy.

    Science.gov (United States)

    Colombo, Matteo; Duev, Georgi; Nuijten, Michèle B; Sprenger, Jan

    2018-01-01

    Experimental philosophy (x-phi) is a young field of research in the intersection of philosophy and psychology. It aims to make progress on philosophical questions by using experimental methods traditionally associated with the psychological and behavioral sciences, such as null hypothesis significance testing (NHST). Motivated by recent discussions about a methodological crisis in the behavioral sciences, questions have been raised about the methodological standards of x-phi. Here, we focus on one aspect of this question, namely the rate of inconsistencies in statistical reporting. Previous research has examined the extent to which published articles in psychology and other behavioral sciences present statistical inconsistencies in reporting the results of NHST. In this study, we used the R package statcheck to detect statistical inconsistencies in x-phi, and compared rates of inconsistencies in psychology and philosophy. We found that rates of inconsistencies in x-phi are lower than in the psychological and behavioral sciences. From the point of view of statistical reporting consistency, x-phi seems to do no worse, and perhaps even better, than psychological science.

  1. Statistical reporting inconsistencies in experimental philosophy

    Science.gov (United States)

    Colombo, Matteo; Duev, Georgi; Nuijten, Michèle B.; Sprenger, Jan

    2018-01-01

    Experimental philosophy (x-phi) is a young field of research in the intersection of philosophy and psychology. It aims to make progress on philosophical questions by using experimental methods traditionally associated with the psychological and behavioral sciences, such as null hypothesis significance testing (NHST). Motivated by recent discussions about a methodological crisis in the behavioral sciences, questions have been raised about the methodological standards of x-phi. Here, we focus on one aspect of this question, namely the rate of inconsistencies in statistical reporting. Previous research has examined the extent to which published articles in psychology and other behavioral sciences present statistical inconsistencies in reporting the results of NHST. In this study, we used the R package statcheck to detect statistical inconsistencies in x-phi, and compared rates of inconsistencies in psychology and philosophy. We found that rates of inconsistencies in x-phi are lower than in the psychological and behavioral sciences. From the point of view of statistical reporting consistency, x-phi seems to do no worse, and perhaps even better, than psychological science. PMID:29649220

  2. Inconsistency in large pharmacogenomic studies

    DEFF Research Database (Denmark)

    Haibe-Kains, Benjamin; El-Hachem, Nehme; Birkbak, Nicolai Juul

    2013-01-01

    Two large-scale pharmacogenomic studies were published recently in this journal. Genomic data are well correlated between studies; however, the measured drug response data are highly discordant. Although the source of inconsistencies remains uncertain, it has potential implications for using...

  3. Measuring inconsistency in research ethics committee review.

    Science.gov (United States)

    Trace, Samantha; Kolstoe, Simon Erik

    2017-11-28

    The review of human participant research by Research Ethics Committees (RECs) or Institutional Review Boards (IRBs) is a complex multi-faceted process that cannot be reduced to an algorithm. However, this does not give RECs/ IRBs permission to be inconsistent in their specific requirements to researchers or in their final opinions. In England the Health Research Authority (HRA) coordinates 67 committees, and has adopted a consistency improvement plan including a process called "Shared Ethical Debate" (ShED) where multiple committees review the same project. Committee reviews are compared for consistency by analysing the resulting minutes. We present a description of the ShED process. We report an analysis of minutes created by research ethics committees participating in two ShED exercises, and compare them to minutes produced in a published "mystery shopper" exercise. We propose a consistency score by defining top themes for each exercise, and calculating the ratio between top themes and total themes identified by each committee for each ShED exercise. Our analysis highlights qualitative differences between the ShED 19, ShED 20 and "mystery shopper" exercises. The quantitative measure of consistency showed only one committee across the three exercises with more than half its total themes as top themes (ratio of 0.6). The average consistency scores for the three exercises were 0.23 (ShED19), 0.35 (ShED20) and 0.32 (mystery shopper). There is a statistically significant difference between the ShED 19 exercise, and the ShED 20 and mystery shopper exercises. ShED exercises are effective in identifying inconsistency between ethics committees and we describe a scoring method that could be used to quantify this. However, whilst a level of inconsistency is probably inevitable in research ethics committee reviews, studies must move beyond the ShED methodology to understand why inconsistency occurs, and what an acceptable level of inconsistency might be.

  4. Cantor, God, and Inconsistent Multiplicities*

    Directory of Open Access Journals (Sweden)

    Thomas-Bolduc Aaron R.

    2016-03-01

    Full Text Available The importance of Georg Cantor’s religious convictions is often neglected in discussions of his mathematics and metaphysics. Herein I argue, pace Jané (1995, that due to the importance of Christianity to Cantor, he would have never thought of absolutely infinite collections/inconsistent multiplicities, as being merely potential, or as being purely mathematical entities. I begin by considering and rejecting two arguments due to Ignacio Jané based on letters to Hilbert and the generating principles for ordinals, respectively, showing that my reading of Cantor is consistent with that evidence. I then argue that evidence from Cantor’s later writings shows that he was still very religious later in his career, and thus would not have given up on the reality of the absolute, as that would imply an imperfection on the part of God.

  5. Day-to-Day Inconsistency in Parent Knowledge: Links with Youth Health and Parents’ Stress

    Science.gov (United States)

    Lippold, Melissa A.; McHale, Susan M.; Davis, Kelly D.; Kossek, Ellen Ernst

    2015-01-01

    Purpose Considerable evidence documents the linkages between higher levels of parental knowledge about youth activities and positive youth outcomes. This study investigated how day-to-day inconsistency in parental knowledge of youth activities was linked to youth behavioral, psychological, and physical health as well as parents’ stress. Methods Participants were employees in the Information Technology division of a Fortune 500 company and their children (N =129, Mean age youth = 13.39 years, 55% female). Data were collected from parents and youth via separate workplace and in-home surveys as well as telephone diary surveys on 8 consecutive evenings. We assessed day-to-day inconsistency in parental knowledge across these eight calls. Results Parents differed in their knowledge from day to day almost as much as their average knowledge scores differed from those of other parents. Controlling for mean levels of knowledge, youth whose parents exhibited more knowledge inconsistency reported more physical health symptoms (e.g., colds, flu). Knowledge inconsistency was also associated with more risky behavior for girls but greater psychological well-being for older adolescents. Parents who reported more stressors also had higher knowledge inconsistency. Conclusions Assessing only average levels of parental knowledge does not fully capture how this parenting dimension is associated with youth health. Consistent knowledge may promote youth physical health and less risky behavior for girls. Yet knowledge inconsistency also may reflect normative increases in autonomy as it was positively associated with psychological well-being for older adolescents. Given the linkages between parental stress and knowledge inconsistency, parent interventions should include stress-management components. PMID:25703318

  6. Does Status Inconsistency Matter for Marital Quality?

    Science.gov (United States)

    Gong, Min

    2007-01-01

    This study tests status inconsistency theory by examining the associations between wives' and husbands' relative statuses--that is, earnings, work-time, occupational, and educational inconsistencies--and marital quality and global happiness. The author asks three questions: (a) Is status inconsistency associated with marital quality and overall…

  7. A general framework for reasoning on inconsistency

    CERN Document Server

    Martinez, Maria Vanina; Subrahmanian, VS; Amgoud, Leila

    2013-01-01

    This SpringerBrief proposes a general framework for reasoning about inconsistency in a wide variety of logics, including inconsistency resolution methods that have not yet been studied.  The proposed framework allows users to specify preferences on how to resolve inconsistency when there are multiple ways to do so. This empowers users to resolve inconsistency in data leveraging both their detailed knowledge of the data as well as their application needs. The brief shows that the framework is well-suited to handle inconsistency in several logics, and provides algorithms to compute preferred opt

  8. Clinical outcomes resulting from telemedicine interventions: a systematic review

    Directory of Open Access Journals (Sweden)

    Kraemer Dale

    2001-11-01

    Full Text Available Abstract Background The use of telemedicine is growing, but its efficacy for achieving comparable or improved clinical outcomes has not been established in many medical specialties. The objective of this systematic review was to evaluate the efficacy of telemedicine interventions for health outcomes in two classes of application: home-based and office/hospital-based. Methods Data sources for the study included deports of studies from the MEDLINE, EMBASE, CINAHL, and HealthSTAR databases; searching of bibliographies of review and other articles; and consultation of printed resources as well as investigators in the field. We included studies that were relevant to at least one of the two classes of telemedicine and addressed the assessment of efficacy for clinical outcomes with data of reported results. We excluded studies where the service did not historically require face-to-face encounters (e.g., radiology or pathology diagnosis. All included articles were abstracted and graded for quality and direction of the evidence. Results A total of 25 articles met inclusion criteria and were assessed. The strongest evidence for the efficacy of telemedicine in clinical outcomes comes from home-based telemedicine in the areas of chronic disease management, hypertension, and AIDS. The value of home glucose monitoring in diabetes mellitus is conflicting. There is also reasonable evidence that telemedicine is comparable to face-to-face care in emergency medicine and is beneficial in surgical and neonatal intensive care units as well as patient transfer in neurosurgery. Conclusions Despite the widespread use of telemedicine in virtually all major areas of health care, evidence concerning the benefits of its use exists in only a small number of them. Further randomized controlled trials must be done to determine where its use is most effective.

  9. A misfit function tolerating inconsistent data

    KAUST Repository

    Huang, Yunsong

    2014-08-05

    Inversion methods that do not model all of the physical events in the observed data lead to inconsistent sets of equations. This often results in serious artifacts in the inverted model. To mitigate this problem, I propose a misfit function that partly ignores the unexplainable arrivals in the data due to modeling limitation. This is tested on least squares migration of synthetic P–P arrivals, albeit P–S reflections exist in the observed data in addition, to demonstrate that in this case the new misfit is more robust than the standard L2 misfit.

  10. Clinical outcomes of pars plicata anterior vitrectomy: 2-year results

    Directory of Open Access Journals (Sweden)

    Priya Narang

    2015-01-01

    Full Text Available Purpose: To demonstrate the safety and outcome of a surgical approach that uses pars plicata site for anterior vitrectomy during phacoemulsification procedure complicated by posterior capsule rupture and residual cortical matter. Design: Single center, retrospective, interventional, noncomparative study. Materials and Methods: Medical records of a consecutive series of 35 eyes of 35 patients who underwent pars plicata anterior vitrectomy (PPAV were reviewed. The main outcome measures were corrected and uncorrected distance visual acuity (CDVA, UDVA, early and late postoperative complications and intraocular pressure (IOP. Ultrasound biomicroscopic (UBM evaluation of sclerotomy site and spectral domain optical coherence tomography analysis for central macular thickness (CMT was performed. The final visual outcome at 2 years was evaluated. Results: At 2 years follow-up, the mean postoperative UDVA (logarithm of the minimum angle of resolution [logMAR] and CDVA (logMAR was 0.49 ± 0.26 and 0.19 ± 0.14, respectively. There was no significant change in the IOP (P = 0.061 and the mean CMT at 2 years was 192.5 ± 5.54 mm. The postoperative UBM image of the sclerotomy site at 8 weeks demonstrated a clear wound without any vitreous adhesion or incarceration. Intraoperative hyphema was seen in 1 (2.8% case and postoperative uveitis was seen in 2 (5.7% cases, which resolved with medications. No case of an iatrogenic retinal break or retinal detachment was reported. Conclusions: PPAV enables a closed chamber approach, allows thorough cleanup of vitreous in the pupillary plane and anterior chamber and affords better access to the subincisional and retropupillary cortical remnant with a significant visual outcome and an acceptable complication rate.

  11. Global cue inconsistency diminishes learning of cue validity

    Directory of Open Access Journals (Sweden)

    Tony Wang

    2016-11-01

    Full Text Available We present a novel two-stage probabilistic learning task that examines the participants’ ability to learn and utilize valid cues across several levels of probabilistic feedback. In the first stage, participants sample from one of three cues that gives predictive information about the outcome of the second stage. Participants are rewarded for correct prediction of the outcome in stage two. Only one of the three cues gives valid predictive information and thus participants can maximise their reward by learning to sample from the valid cue. The validity of this predictive information, however, is reinforced across several levels of probabilistic feedback. A second manipulation involved changing the consistency of the predictive information in stage one and the outcome in stage two. The results show that participants, with higher probabilistic feedback, learned to utilise the valid cue. In inconsistent task conditions, however, participants were significantly less successful in utilising higher validity cues. We interpret this result as implying that learning in probabilistic categorization is based on developing a representation of the task that allows for goal-directed action.

  12. Empirical evidence about inconsistency among studies in a pair‐wise meta‐analysis

    Science.gov (United States)

    Turner, Rebecca M.; Higgins, Julian P. T.

    2015-01-01

    This paper investigates how inconsistency (as measured by the I2 statistic) among studies in a meta‐analysis may differ, according to the type of outcome data and effect measure. We used hierarchical models to analyse data from 3873 binary, 5132 continuous and 880 mixed outcome meta‐analyses within the Cochrane Database of Systematic Reviews. Predictive distributions for inconsistency expected in future meta‐analyses were obtained, which can inform priors for between‐study variance. Inconsistency estimates were highest on average for binary outcome meta‐analyses of risk differences and continuous outcome meta‐analyses. For a planned binary outcome meta‐analysis in a general research setting, the predictive distribution for inconsistency among log odds ratios had median 22% and 95% CI: 12% to 39%. For a continuous outcome meta‐analysis, the predictive distribution for inconsistency among standardized mean differences had median 40% and 95% CI: 15% to 73%. Levels of inconsistency were similar for binary data measured by log odds ratios and log relative risks. Fitted distributions for inconsistency expected in continuous outcome meta‐analyses using mean differences were almost identical to those using standardized mean differences. The empirical evidence on inconsistency gives guidance on which outcome measures are most likely to be consistent in particular circumstances and facilitates Bayesian meta‐analysis with an informative prior for heterogeneity. © 2015 The Authors. Research Synthesis Methods published by John Wiley & Sons, Ltd. © 2015 The Authors. Research Synthesis Methods published by John Wiley & Sons, Ltd. PMID:26679486

  13. Node-Splitting Generalized Linear Mixed Models for Evaluation of Inconsistency in Network Meta-Analysis.

    Science.gov (United States)

    Yu-Kang, Tu

    2016-12-01

    Network meta-analysis for multiple treatment comparisons has been a major development in evidence synthesis methodology. The validity of a network meta-analysis, however, can be threatened by inconsistency in evidence within the network. One particular issue of inconsistency is how to directly evaluate the inconsistency between direct and indirect evidence with regard to the effects difference between two treatments. A Bayesian node-splitting model was first proposed and a similar frequentist side-splitting model has been put forward recently. Yet, assigning the inconsistency parameter to one or the other of the two treatments or splitting the parameter symmetrically between the two treatments can yield different results when multi-arm trials are involved in the evaluation. We aimed to show that a side-splitting model can be viewed as a special case of design-by-treatment interaction model, and different parameterizations correspond to different design-by-treatment interactions. We demonstrated how to evaluate the side-splitting model using the arm-based generalized linear mixed model, and an example data set was used to compare results from the arm-based models with those from the contrast-based models. The three parameterizations of side-splitting make slightly different assumptions: the symmetrical method assumes that both treatments in a treatment contrast contribute to inconsistency between direct and indirect evidence, whereas the other two parameterizations assume that only one of the two treatments contributes to this inconsistency. With this understanding in mind, meta-analysts can then make a choice about how to implement the side-splitting method for their analysis. Copyright © 2016 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  14. Surgery of petroclival meningiomas. Recent surgical results and outcomes

    Directory of Open Access Journals (Sweden)

    Radoi Mugurel

    2015-03-01

    Full Text Available Petroclival meningiomas represent only 10% of all meningiomas located in the posterior fossa, but are some of the most formidable challenges in skull base surgery. We described our recent experience (2005-September2014 regarding the surgery of these tumors. We retrospectively analyzed surgical results and outcome in 11 cases of petroclival meningiomas. Most common symptoms in our series were headache and gait disturbance, while cranial nerves palsies represented the most common presenting signs. There were 8 females and 3 males, and the mean age was 52 years. Surgical approaches chosen for petroclival meningiomas in our series were retrosigmoid (9 patients and subtemporal transtentorial (2 patients. We achieved total tumor resection in 5 cases (45% and subtotal resection in 6 cases (55%. Overall outcome (total/subtotal resection was good in 6 cases, fair in 3 cases and poor in one case. One postoperative death occurred due to hemorrhagic midbrain infarction (9%. Complications were usually related to cranial nerve deficits: loss of hearing (2 patients, paresis of trochlear nerve (1 patient, trigeminal nerve (3 patients and facial nerve (1 patient. In 4 patients these cranial nerves deficits were transient. In one case, a patient developed postoperative hydrocephalus and needed shunt placement. Despite the fact that complications can be disastrous, we considered that an appropriate approach, combined with microsurgical techniques and a better understanding of the anatomy, greatly decrease the incidence and severity of complications and make feasible a total tumor resection.

  15. Computing autocatalytic sets to unravel inconsistencies in metabolic network reconstructions

    DEFF Research Database (Denmark)

    Schmidt, R.; Waschina, S.; Boettger-Schmidt, D.

    2015-01-01

    , the method we report represents a powerful tool to identify inconsistencies in large-scale metabolic networks. AVAILABILITY AND IMPLEMENTATION: The method is available as source code on http://users.minet.uni-jena.de/ approximately m3kach/ASBIG/ASBIG.zip. CONTACT: christoph.kaleta@uni-jena.de SUPPLEMENTARY...... by inherent inconsistencies and gaps. RESULTS: Here we present a novel method to validate metabolic network reconstructions based on the concept of autocatalytic sets. Autocatalytic sets correspond to collections of metabolites that, besides enzymes and a growth medium, are required to produce all biomass...... components in a metabolic model. These autocatalytic sets are well-conserved across all domains of life, and their identification in specific genome-scale reconstructions allows us to draw conclusions about potential inconsistencies in these models. The method is capable of detecting inconsistencies, which...

  16. Dialogue Games for Inconsistent and Biased Information

    NARCIS (Netherlands)

    Lebbink, H.J.; Witteman, C.L.M.; Meyer, J.J.C.

    2003-01-01

    In this article, a dialogue game is presented in which coherent conversational sequences with inconsistent and biased information are described at the speech act level. Inconsistent and biased information is represented with bilattice structures, and based on these bilattice structures, a

  17. Inconsistencies in Models for RHIC and LHC

    CERN Document Server

    Werner, K; Ostapchenko, S; Pierog, T

    2002-01-01

    The interpretation of experimental results at RHIC and in the future also at LHC requires very reliable and realistic models. Considerable effort has been devoted to the development of such models during the past decade, many of them being heavily used in order to analyze data. It is the purpose of this paper to point out serious inconsistencies in the above-mentioned approaches. We will demonstrate that requiring theoretical self-consistency reduces the freedom in modeling high energy nuclear scattering enormously. We will introduce a fully self-consistent formulation of the multiple-scattering scheme in the framework of a Gribov-Regge type effective theory. In addition, we develop new computational techniques which allow for the first time a satisfactory solution of the problem in the sense that calculations of observable quantities can be done strictly within a self-consistent formalism.

  18. FUNCTIONAL ABILITIES AS PREDICTORS OF PREADOSLESCENT STUDENTS’ ATHLETIC RESULTS OUTCOME

    Directory of Open Access Journals (Sweden)

    Miroljub Ivanović

    2011-09-01

    Full Text Available Aim of this research has been directed to the functional abilities relation testing (as predictors and athletic results (as criterion of students, who are VII and VIII grade of primary school (Χ= 13, 9 years; SD = 1, 17. The research has been conducted in Valjevo during November 2010. on the sample of 108 examinees. Variables’ sample has been assembled from 3 tests for functional abilities (maximal oxygen consumption, pulse frequency and vital lungs capacity evaluation and 4 athletic disciplines (high jump, long jump, shot put and 60 meters low start sprint from current physical education curriculum. Crombah-alfa coefficient values indicate to satisfactory reliability of applied instruments. In data processing canonical correlation analysis and multiple regression analysis have been used. Achieved canonical correlation analysis results showed that functional abilities set is statistically and significantly related to criterion variables set (R=.67, manifesting one canonical factor on the level p<.03. Achieved determination coefficient (R² = .43 indicates to functional abilities prognostic significance of explained variance 46% criterion. Using hierarchy regression model following statistically significant beta coefficient of functional abilities as partial predictors of athletics outcome have been determined: I for vital lungs capacity- high jump (β = .67, p < .01, II for vital lungs capacity- long jump (β = .55, p < .01, III for vital lungs capacity and pulse frequency- shot put (β =.-.34, p < .01; β =.42, p < .02 and IV for vital lungs capacity- 60 meters sprint (β = .-.39. Regression equation calculation of other applied functional abilities preadolescents’ predictor variables has not statistically and significantly contributed to univariance prediction of criterion variable variance

  19. Minimally inconsistent reasoning in Semantic Web.

    Science.gov (United States)

    Zhang, Xiaowang

    2017-01-01

    Reasoning with inconsistencies is an important issue for Semantic Web as imperfect information is unavoidable in real applications. For this, different paraconsistent approaches, due to their capacity to draw as nontrivial conclusions by tolerating inconsistencies, have been proposed to reason with inconsistent description logic knowledge bases. However, existing paraconsistent approaches are often criticized for being too skeptical. To this end, this paper presents a non-monotonic paraconsistent version of description logic reasoning, called minimally inconsistent reasoning, where inconsistencies tolerated in the reasoning are minimized so that more reasonable conclusions can be inferred. Some desirable properties are studied, which shows that the new semantics inherits advantages of both non-monotonic reasoning and paraconsistent reasoning. A complete and sound tableau-based algorithm, called multi-valued tableaux, is developed to capture the minimally inconsistent reasoning. In fact, the tableaux algorithm is designed, as a framework for multi-valued DL, to allow for different underlying paraconsistent semantics, with the mere difference in the clash conditions. Finally, the complexity of minimally inconsistent description logic reasoning is shown on the same level as the (classical) description logic reasoning.

  20. Minimally inconsistent reasoning in Semantic Web.

    Directory of Open Access Journals (Sweden)

    Xiaowang Zhang

    Full Text Available Reasoning with inconsistencies is an important issue for Semantic Web as imperfect information is unavoidable in real applications. For this, different paraconsistent approaches, due to their capacity to draw as nontrivial conclusions by tolerating inconsistencies, have been proposed to reason with inconsistent description logic knowledge bases. However, existing paraconsistent approaches are often criticized for being too skeptical. To this end, this paper presents a non-monotonic paraconsistent version of description logic reasoning, called minimally inconsistent reasoning, where inconsistencies tolerated in the reasoning are minimized so that more reasonable conclusions can be inferred. Some desirable properties are studied, which shows that the new semantics inherits advantages of both non-monotonic reasoning and paraconsistent reasoning. A complete and sound tableau-based algorithm, called multi-valued tableaux, is developed to capture the minimally inconsistent reasoning. In fact, the tableaux algorithm is designed, as a framework for multi-valued DL, to allow for different underlying paraconsistent semantics, with the mere difference in the clash conditions. Finally, the complexity of minimally inconsistent description logic reasoning is shown on the same level as the (classical description logic reasoning.

  1. Is special relativity logically inconsistent

    International Nuclear Information System (INIS)

    Prokhovnik, S.J.

    1980-01-01

    The author gives his view that Special Relativity is logically and mathematically consistent, as well as physically comprehensible if, and only if, it is firmly based on the single assumption of a unique fundamental reference frame for light propagation. The theory and all its results are derivable from this assumption; the Relativity and Light Principles become intelligible consequences of this assumption; the physical significance and source of time dilation and length contraction are made manifest thereby. (Auth.)

  2. Inside Quality Reform: Early Results on Using Outcomes for Improvement

    Science.gov (United States)

    El-Khawas, Elaine

    2014-01-01

    This article offers evidence on ways in which assessment of student learning outcomes made a difference for some academic institutions in the United States. It offers perspectives on the internal changes that took place, especially within academic programmes. Even after the capacity for assessment was developed, challenges remained in evaluating…

  3. Outcomes of Asthma Education: Results of a Multisite Evaluation

    Directory of Open Access Journals (Sweden)

    Wilma M Hopman

    2004-01-01

    Full Text Available BACKGROUND: This observational study compared the effectiveness of a standardized adult asthma education program administered in a variety of sites and practice settings on health care utilization, absenteeism, amount of leisure time missed and quality of life (using the Medical Outcomes Study 36-Item Short Form 1.0 [SF-36].

  4. Kinematic Origins of Motor Inconsistency in Expert Pianists.

    Directory of Open Access Journals (Sweden)

    Kenta Tominaga

    Full Text Available For top performers, including athletes and musicians, even subtle inconsistencies in rhythm and force during movement production decrease the quality of performance. However, extensive training over many years beginning in childhood is unable to perfect dexterous motor performance so that it is without any error. To gain insight into the biological mechanisms underlying the subtle defects of motor actions, the present study sought to identify the kinematic origins of inconsistency of dexterous finger movements in musical performance. Seven highly-skilled pianists who have won prizes at international piano competitions played a short sequence of tones with the right hand at a predetermined tempo. Time-varying joint angles of the fingers were recorded using a custom-made data glove, and the timing and velocity of the individual keystrokes were recorded from a digital piano. Both ridge and stepwise multiple regression analyses demonstrated an association of the inter-trial variability of the inter-keystroke interval (i.e., rhythmic inconsistency with both the rotational velocity of joints of the finger used for a keystroke (i.e., striking finger and the movement independence between the striking and non-striking fingers. This indicates a relationship between rhythmic inconsistency in musical performance and the dynamic features of movements in not only the striking finger but also the non-striking fingers. In contrast, the inter-trial variability of the key-descending velocity (i.e., loudness inconsistency was associated mostly with the kinematic features of the striking finger at the moment of the keystroke. Furthermore, there was no correlation between the rhythmic and loudness inconsistencies. The results suggest distinct kinematic origins of inconsistencies in rhythm and loudness in expert musical performance.

  5. Kinematic Origins of Motor Inconsistency in Expert Pianists.

    Science.gov (United States)

    Tominaga, Kenta; Lee, André; Altenmüller, Eckart; Miyazaki, Fumio; Furuya, Shinichi

    2016-01-01

    For top performers, including athletes and musicians, even subtle inconsistencies in rhythm and force during movement production decrease the quality of performance. However, extensive training over many years beginning in childhood is unable to perfect dexterous motor performance so that it is without any error. To gain insight into the biological mechanisms underlying the subtle defects of motor actions, the present study sought to identify the kinematic origins of inconsistency of dexterous finger movements in musical performance. Seven highly-skilled pianists who have won prizes at international piano competitions played a short sequence of tones with the right hand at a predetermined tempo. Time-varying joint angles of the fingers were recorded using a custom-made data glove, and the timing and velocity of the individual keystrokes were recorded from a digital piano. Both ridge and stepwise multiple regression analyses demonstrated an association of the inter-trial variability of the inter-keystroke interval (i.e., rhythmic inconsistency) with both the rotational velocity of joints of the finger used for a keystroke (i.e., striking finger) and the movement independence between the striking and non-striking fingers. This indicates a relationship between rhythmic inconsistency in musical performance and the dynamic features of movements in not only the striking finger but also the non-striking fingers. In contrast, the inter-trial variability of the key-descending velocity (i.e., loudness inconsistency) was associated mostly with the kinematic features of the striking finger at the moment of the keystroke. Furthermore, there was no correlation between the rhythmic and loudness inconsistencies. The results suggest distinct kinematic origins of inconsistencies in rhythm and loudness in expert musical performance.

  6. Social inequalities in patient-reported outcomes among older multimorbid patients--results of the MultiCare cohort study.

    Science.gov (United States)

    von dem Knesebeck, Olaf; Bickel, Horst; Fuchs, Angela; Gensichen, Jochen; Höfels, Susanne; Riedel-Heller, Steffi G; König, Hans-Helmut; Mergenthal, Karola; Schön, Gerhard; Wegscheider, Karl; Weyerer, Siegfried; Wiese, Birgitt; Scherer, Martin; van den Bussche, Hendrik; Schäfer, Ingmar

    2015-02-07

    In this article three research questions are addressed: (1) Is there an association between socioeconomic status (SES) and patient-reported outcomes in a cohort of multimorbid patients? (2) Does the association vary according to SES indicator used (income, education, occupational position)? (3) Can the association between SES and patient-reported outcomes (self-rated health, health-related quality of life and functional status) be (partly) explained by burden of disease? Analyses are based on the MultiCare Cohort Study, a German multicentre, prospective, observational cohort study of multimorbid patients from general practice. We analysed baseline data and data from the first follow-up after 15 months (N = 2,729). To assess burden of disease we used the patients' morbidity data from standardized general practitioner (GP) interviews based on a list of 46 groups of chronic conditions including the GP's severity rating of each chronic condition ranging from marginal to very severe. In the cross-sectional analyses SES was significantly associated with the patient-reported outcomes at baseline. Associations with income were more consistent and stronger than with education and occupational position. Associations were partly explained (17% to 44%) by burden of disease. In the longitudinal analyses only income (but not education and occupational position) was significantly related to the patient-reported outcomes at follow-up. Associations between income and the outcomes were reduced by 18% to 27% after adjustment for burden of disease. Results indicate social inequalities in self-rated health, functional status and health related quality of life among older multimorbid patients. As associations with education and occupational position were inconsistent, these inequalities were mainly due to income. Inequalities were partly explained by burden of disease. However, even among patients with a similar disease burden, those with a low income were worse off in terms of the

  7. Expressive Dissonance: When Emotional Inconsistency Arouses Dissonance

    Directory of Open Access Journals (Sweden)

    Audrey Pelt

    2018-05-01

    Full Text Available The aim of the two studies was to explore a new dissonance paradigm–expressive dissonance–based on the inconsistency between what people feel and what people express behaviorally. Expressive dissonance was aroused by asking participants to watch a film with a high emotional content, either positive (joy or negative (sadness. In the no-dissonance condition, they received the instruction to naturally watch the film. In the expressive dissonance condition, they received the instruction to facially express emotions that were the opposite of what they felt. We expected that the expressive dissonance situation would: 1 require cognitive resources leading to a decrease in cognitive performance (studies 1 and 2; 2 be accompanied by emotional regulation strategies (study 1; 3 be accompanied by an increase in dissonance-related affects (study 2. Although our results (studies 1 and 2 corroborated those obtained previously in terms of performance, they also showed that participants in the expressive dissonance situation use emotional regulation strategies: exaggeration and suppression (study 1, and that they felt self-directed negative affects (study 2, just like the participants in a cognitive dissonance situation. These first results allowed us to establish a theoretical bridge between the theories of emotions–particularly those related to the emotional regulation processes–and to widen the scope of relevance of the dissonance theory.

  8. Cataract Surgery Outcomes in Glaucomatous Eyes: Results From the Veterans Affairs Ophthalmic Surgery Outcomes Data Project.

    Science.gov (United States)

    Turalba, Angela; Payal, Abhishek R; Gonzalez-Gonzalez, Luis A; Cakiner-Egilmez, Tulay; Chomsky, Amy S; Vollman, David E; Baze, Elizabeth F; Lawrence, Mary; Daly, Mary K

    2015-10-01

    To compare visual acuity outcomes, vision-related quality of life, and complications related to cataract surgery in eyes with and without glaucoma. Retrospective cohort study. Cataract surgery outcomes in cases with and without glaucoma from the Veterans Affairs Ophthalmic Surgical Outcomes Data Project were compared. We identified 608 glaucoma cases and 4306 controls undergoing planned cataract surgery alone. After adjusting for age, pseudoexfoliation, small pupil, prior ocular surgery, and anterior chamber depth, we found that glaucoma cases were more likely to have posterior capsular tear with vitrectomy (odds ratio [OR] 1.8, P = .03) and sulcus intraocular lens placement (OR 1.65, P = .03) during cataract surgery. Glaucoma cases were more likely to have postoperative inflammation (OR 1.73, P < .0001), prolonged elevated intraocular pressure (OR 2.96, P = .0003), and additional surgery within 30 days (OR 1.92, P = .03). Mean best-corrected visual acuity (BCVA) and Visual Function Questionnaire (VFQ) scores significantly improved after cataract surgery in both groups (P < .0001), but there were larger improvements in BCVA (P = .01) and VFQ composite scores (P < .0001) in the nonglaucoma vs the glaucoma group. A total of 3621 nonglaucoma cases (94.1%) had postoperative BCVA 20/40 or better, compared to 466 glaucoma cases (89.6%) (P = .0003). Eyes with glaucoma are at increased risk for complications and have more modest visual outcomes after cataract surgery compared to eyes without glaucoma. Despite this, glaucoma patients still experience significant improvement in vision-related outcomes after cataract extraction. Further study is needed to explore potential factors that influence cataract surgery outcomes in glaucomatous eyes. Published by Elsevier Inc.

  9. Mathematics Placement Test: Typical Results with Unexpected Outcomes

    Science.gov (United States)

    Ingalls, Victoria

    2011-01-01

    Based on the results of a prior case-study analysis of mathematics placement at one university, the mathematics department developed and piloted a mathematics placement test. This article describes the implementation process for a mathematics placement test and further analyzes the test results for the pilot group. As an unexpected result, the…

  10. Maintained intentional weight loss reduces cardiovascular outcomes: results from the Sibutramine Cardiovascular OUTcomes (SCOUT) trial.

    Science.gov (United States)

    Caterson, I D; Finer, N; Coutinho, W; Van Gaal, L F; Maggioni, A P; Torp-Pedersen, C; Sharma, A M; Legler, U F; Shepherd, G M; Rode, R A; Perdok, R J; Renz, C L; James, W P T

    2012-06-01

    The Sibutramine Cardiovascular OUTcomes trial showed that sibutramine produced greater mean weight loss than placebo but increased cardiovascular morbidity but not mortality. The relationship between 12-month weight loss and subsequent cardiovascular outcomes is explored. Overweight/obese subjects (N = 10 744), ≥55 years with cardiovascular disease and/or type 2 diabetes mellitus, received sibutramine plus weight management during a 6-week Lead-in Period before randomization to continue sibutramine (N = 4906) or to receive placebo (N = 4898). The primary endpoint was the time from randomization to first occurrence of a primary outcome event (non-fatal myocardial infarction, non-fatal stroke, resuscitated cardiac arrest or cardiovascular death). For the total population, mean weight change during Lead-in Period (sibutramine) was -2.54 kg. Post-randomization, mean total weight change to Month 12 was -4.18 kg (sibutramine) or -1.87 kg (placebo). Degree of weight loss during Lead-in Period or through Month 12 was associated with a progressive reduction in risk for the total population in primary outcome events and cardiovascular mortality over the 5-year assessment. Although more events occurred in the randomized sibutramine group, on an average, a modest weight loss of approximately 3 kg achieved in the Lead-in Period appeared to offset this increased event rate. Moderate weight loss (3-10 kg) reduced cardiovascular deaths in those with severe, moderate or mild cardiovascular disease. Modest weight loss over short-term (6 weeks) and longer-term (6-12 months) periods is associated with reduction in subsequent cardiovascular mortality for the following 4-5 years even in those with pre-existing cardiovascular disease. While the sibutramine group experienced more primary outcome events than the placebo group, greater weight loss reduced overall risk of these occurring in both groups. © 2011 Blackwell Publishing Ltd.

  11. Framing and time-inconsistent preferences

    NARCIS (Netherlands)

    Roelofsma, P.; Keren, G.; Caverni, J.-P.; Bar-Hillel, M.; Hutton Barron, F.; Jungermann, H.

    1995-01-01

    Recent research on intertemporal choice (e.g., Ainslie, 1991; Herrnstein, 1990; Loewenstein & Elster, 1992) exhibits several pervasive effects that are Incompatible with the basic tenets of the "rational’ or "normative" economic theory. In particular, people show time-inconsistent preferences when

  12. Measuring inconsistency in research ethics committee review

    OpenAIRE

    Trace, Samantha; Kolstoe, Simon Erik

    2017-01-01

    Background The review of human participant research by Research Ethics Committees (RECs) or Institutional Review Boards (IRBs) is a complex multi-faceted process that cannot be reduced to an algorithm. However, this does not give RECs/ IRBs permission to be inconsistent in their specific requirements to researchers or in their final opinions. In England the Health Research Authority (HRA) coordinates 67 committees, and has adopted a consistency improvement plan including a process called “Sha...

  13. How students deal with inconsistencies in health knowledge.

    Science.gov (United States)

    Bientzle, Martina; Cress, Ulrike; Kimmerle, Joachim

    2013-07-01

    In their work, health care professionals have to deal daily with inconsistent health information and are confronted with differing therapeutic health concepts. Medical education should prepare students to handle these challenges adequately. The aim of this study was to contribute to a better understanding of how students deal with inconsistencies in health knowledge when they are presented with either a therapeutic concept they accept or one they reject. Seventy-six students of physiotherapy participated in this 2 × 2 experiment with health information (consistent versus inconsistent information) and therapeutic concept (congruent versus contradictory therapeutic concept) as between-group factors. The participants' task was to improve the quality of a text about the effectiveness of stretching; participants were randomly assigned to one of four texts. Knowledge acquisition and text modification were measured as dependent variables. Students acquired more knowledge when they worked with a text containing inconsistent information. Medical information that was presented in agreement with a student's therapeutic concept was also more readily acquired than the same information presented posing a contradictory therapeutic concept. Participants modified the contradictory text in order to adapt it to their own point of view. Disagreement resulted in a disregard or devaluation of the information itself, which in turn was detrimental to learning. It is a problem when prospective health care professionals turn a blind eye to discrepancies that do not fit their view of the world. It may be useful for educational purposes to include a knowledge conflict caused by a combination of conviction and inconsistent information to facilitate learning processes. © 2013 John Wiley & Sons Ltd.

  14. Detection of Tampering Inconsistencies on Mobile Photos

    Science.gov (United States)

    Cao, Hong; Kot, Alex C.

    Fast proliferation of mobile cameras and the deteriorating trust on digital images have created needs in determining the integrity of photos captured by mobile devices. As tampering often creates some inconsistencies, we propose in this paper a novel framework to statistically detect the image tampering inconsistency using accurately detected demosaicing weights features. By first cropping four non-overlapping blocks, each from one of the four quadrants in the mobile photo, we extract a set of demosaicing weights features from each block based on a partial derivative correlation model. Through regularizing the eigenspectrum of the within-photo covariance matrix and performing eigenfeature transformation, we further derive a compact set of eigen demosaicing weights features, which are sensitive to image signal mixing from different photo sources. A metric is then proposed to quantify the inconsistency based on the eigen weights features among the blocks cropped from different regions of the mobile photo. Through comparison, we show our eigen weights features perform better than the eigen features extracted from several other conventional sets of statistical forensics features in detecting the presence of tampering. Experimentally, our method shows a good confidence in tampering detection especially when one of the four cropped blocks is from a different camera model or brand with different demosaicing process.

  15. Age and inconsistency in driving performance.

    Science.gov (United States)

    Bunce, David; Young, Mark S; Blane, Alison; Khugputh, Priya

    2012-11-01

    Research in cognitive neuropsychology suggests that investigation of the within-person variability, or inconsistency, of cognitive performance may provide valuable insights into ageing mental processes. It is rare though, for this interest in intraindividual variability to extend to everyday activities. As this may provide important information about driving behaviour, we therefore assessed age differences in driving inconsistency in younger (n=24, M age=21.29 years) and older (n=21, M age=71.24 years) persons who drove in residential, urban and motorway conditions in a fully immersive driving simulator. In measures of headway (maintaining a safe distance to a preceding vehicle) and lateral lane position, older drivers exhibited significantly greater performance inconsistency, and this was particularly marked in the faster motorway condition. Older drivers also recorded greater perceived mental demands associated with driving, and greater within-person variability across a range of cognitive measures. The findings suggest that age-related deficits in attentional and executive control may affect the consistency of driving performance in older persons. Discussion considers interventions to introduce in-vehicle systems to help maintain attention in older drivers, and to intervene when safety-critical boundaries are exceeded. Copyright © 2012 Elsevier Ltd. All rights reserved.

  16. Documenting Penicillin Allergy: The Impact of Inconsistency

    Science.gov (United States)

    Shah, Nirav S.; Ridgway, Jessica P.; Pettit, Natasha; Fahrenbach, John; Robicsek, Ari

    2016-01-01

    Background Allergy documentation is frequently inconsistent and incomplete. The impact of this variability on subsequent treatment is not well described. Objective To determine how allergy documentation affects subsequent antibiotic choice. Design Retrospective, cohort study. Participants 232,616 adult patients seen by 199 primary care providers (PCPs) between January 1, 2009 and January 1, 2014 at an academic medical system. Main Measures Inter-physician variation in beta-lactam allergy documentation; antibiotic treatment following beta-lactam allergy documentation. Key Results 15.6% of patients had a reported beta-lactam allergy. Of those patients, 39.8% had a specific allergen identified and 22.7% had allergic reaction characteristics documented. Variation between PCPs was greater than would be expected by chance (all ppenicillins”) (24.0% to 58.2%) and documentation of the reaction characteristics (5.4% to 51.9%). After beta-lactam allergy documentation, patients were less likely to receive penicillins (Relative Risk [RR] 0.16 [95% Confidence Interval: 0.15–0.17]) and cephalosporins (RR 0.28 [95% CI 0.27–0.30]) and more likely to receive fluoroquinolones (RR 1.5 [95% CI 1.5–1.6]), clindamycin (RR 3.8 [95% CI 3.6–4.0]) and vancomycin (RR 5.0 [95% CI 4.3–5.8]). Among patients with beta-lactam allergy, rechallenge was more likely when a specific allergen was identified (RR 1.6 [95% CI 1.5–1.8]) and when reaction characteristics were documented (RR 2.0 [95% CI 1.8–2.2]). Conclusions Provider documentation of beta-lactam allergy is highly variable, and details of the allergy are infrequently documented. Classification of a patient as beta-lactam allergic and incomplete documentation regarding the details of the allergy lead to beta-lactam avoidance and use of other antimicrobial agents, behaviors that may adversely impact care quality and cost. PMID:26981866

  17. Inconsistent selection and definition of local and regional endpoints in breast cancer research.

    Science.gov (United States)

    Moossdorff, M; van Roozendaal, L M; Schipper, R-J; Strobbe, L J A; Voogd, A C; Tjan-Heijnen, V C G; Smidt, M L

    2014-12-01

    Results in breast cancer research are reported using study endpoints. Most are composite endpoints (such as locoregional recurrence), consisting of several components (for example local recurrence) that are in turn composed of specific events (such as skin recurrence). Inconsistent endpoint selection and definition might lead to unjustified conclusions when comparing study outcomes. This study aimed to determine which locoregional endpoints are used in breast cancer studies, and how these endpoints and their components are defined. PubMed was searched for breast cancer studies published in nine leading journals in 2011. Articles using endpoints with a local or regional component were included and definitions were compared. Twenty-three different endpoints with a local or regional component were extracted from 44 articles. Most frequently used were disease-free survival (25 articles), recurrence-free survival (7), local control (4), locoregional recurrence-free survival (3) and event-free survival (3). Different endpoints were used for similar outcomes. Of 23 endpoints, five were not defined and 18 were defined only partially. Of these, 16 contained a local and 13 a regional component. Included events were not specified in 33 of 57 (local) and 27 of 50 (regional) cases. Definitions of local components inconsistently included carcinoma in situ and skin and chest wall recurrences. Regional components inconsistently included specific nodal sites and skin and chest wall recurrences. Breast cancer studies use many different endpoints with a locoregional component. Definitions of endpoints and events are either not provided or vary between trials. To improve transparency, facilitate trial comparison and avoid unjustified conclusions, authors should report detailed definitions of all endpoints. © 2014 BJS Society Ltd. Published by John Wiley & Sons Ltd.

  18. The Time-Inconsistency of Alternative Energy Policy

    OpenAIRE

    D'ARTIGUES, Agnès; PERCEBOIS, Jacques; VIGNOLO, Thierry

    2007-01-01

    Time-inconsistency can arise when a government attempts to convince private sector to use a particular alternative energy (gas, green electricity...) rather than petroleum products. By introducing taxes and feed-in prices, a government would encourage firms and households to switch to an alternative energy rather than use petroleum products. However, even if a government is in favor of increasing alternative energy consumption, it can benefit from considerable financial resources resulting fr...

  19. Parental Inconsistency versus Parental Authoritarianism: Associations with Symptoms of Psychological Disorders

    Science.gov (United States)

    Dwairy, Marwan Adeeb

    2008-01-01

    While in western countries, such as the US and Europe, authoritarian parenting is associated with negative psycho-social outcomes. Studies have indicated that this is not the case in collective/authoritarian cultures. It has been hypothesized that inconsistency in parenting style and culture contributes to these negative outcomes. In this study a…

  20. Experimental economics' inconsistent ban on deception.

    Science.gov (United States)

    Hersch, Gil

    2015-08-01

    According to what I call the 'argument from public bads', if a researcher deceived subjects in the past, there is a chance that subjects will discount the information that a subsequent researcher provides, thus compromising the validity of the subsequent researcher's experiment. While this argument is taken to justify an existing informal ban on explicit deception in experimental economics, it can also apply to implicit deception, yet implicit deception is not banned and is sometimes used in experimental economics. Thus, experimental economists are being inconsistent when they appeal to the argument from public bads to justify banning explicit deception but not implicit deception. Copyright © 2015 Elsevier Ltd. All rights reserved.

  1. Using noise inconsistencies for blind image forensics

    Czech Academy of Sciences Publication Activity Database

    Saic, Stanislav; Mahdian, Babak

    2009-01-01

    Roč. 27, č. 10 (2009), s. 1497-1503 ISSN 0262-8856 R&D Projects: GA ČR GA102/08/0470 Institutional research plan: CEZ:AV0Z10750506 Keywords : Image forensics * Digital forgery * Image tampering * Image segmentation Subject RIV: IN - Informatics, Computer Science Impact factor: 1.474, year: 2009 http://library.utia.cas.cz/separaty/2009/ZOI/saic-using%20noise%20inconsistencies%20for%20blind%20image%20forensics.pdf

  2. Risk of bias and brand explain the observed inconsistency in trials on glucosamine for symptomatic relief of osteoarthritis

    DEFF Research Database (Denmark)

    Eriksen, Patrick; Bartels, Else M; Altman, Roy D

    2014-01-01

    placebo-controlled trials was performed, and random-effects models were applied with inconsistency (I(2) ) and heterogeneity (tau(2) ) estimated using Review Manager and SAS, respectively. The major outcome was reduction of pain; the standardized mean difference (SMD [95% confidence interval (95% CI......)]) served as effect size. RESULTS: The inclusion criteria yielded 25 trials (3,458 patients). Glucosamine moderately reduced pain (SMD -0.51 [95% CI -0.72, -0.30]), although a high level of between-trial inconsistency was observed (I(2) = 88%). The single most important explanation (i.e., covariate......) was brand, reducing heterogeneity by 41% (P = 0.00032). Twelve trials (1,437 patients) using the Rottapharm/Madaus product resulted in significant pain reduction (SMD -1.07 [95% CI -1.47, -0.67]), although a sensitivity analysis of 3 low risk of bias trials using the Rottapharm/Madaus product showed less...

  3. Uso inconsistente del condón entre trabajadoras sexuales en Ecuador: resultados de una encuesta de comportamientos Inconsistent condom use among sexual workers in Ecuador: results from a behavior survey

    Directory of Open Access Journals (Sweden)

    Juan Pablo Gutiérrez

    2006-04-01

    el uso consistente del condón en esta población.OBJECTIVE: Whilst existing data suggests that the HIV epidemic in Ecuador is concentrated amongst men who have sex with men (MSM, there is very little available information on the situation of key populations, i.e. those most at risk of HIV infection and/or transmitting the infection. In particular, there is very little known about sex workers (SWs, their rate of condom use and other behaviors and characteristics with respect to the risk of acquiring sexually transmitted infections (STIs. This study presents findings from a survey carried out with SWs in eight cities in Ecuador. MATERIAL AND METHODS: Using a cross-sectional design, a questionnaire focusing on behaviours, attitudes and socio-economic and demographic characteristics was administered to SWs in eight cities in Ecuador. These eight cities together account for the majority of the population in the country, and they were also identified as the locations with high reported levels of HIV. RESULTS: Information from a total of 2867 SWs was obtained, the majority were captured in their workplaces. Most of SWs interviewed carry out their activities in closed settings dedicated to sex work (i.e. not in the street. The average age of respondents was 28 (95%CI 27-29, and around half of them live with a male partner (married or not. The rate of condom use with the last client was 88% (82% consistently with the last three, whilst with regular partners it was 6%. A high index of life-skills, high socio-economic status and having an official document that allows them to work, were positively associated with condom use with clients (PR [CI 95%] 1.40 [1.40-1.40], 1.37 [1.36-1.37], y 7.26 [6.87-7.46], respectively. CONCLUSIONS: Whilst condom use with clients amongst Ecuadorian SWs is high, this diminishes if one analyzes consistent condom use and is notably low with respect to regular partners. Condom use appears to be related to variables that can be linked to

  4. Integrative Bioethics: A Conceptually Inconsistent Project.

    Science.gov (United States)

    Ivanković, Viktor; Savić, Lovro

    2016-06-01

    This article provides a critical evaluation of the central components of Integrative Bioethics, a project aiming at a bioethical framework reconceptualization. Its proponents claim that this new system of thought has developed a better bioethical methodology than mainstream Western bioethics, a claim that we criticize here. We deal especially with the buzz words of Integrative Bioethics - pluriperspectivism, integrativity, orientational knowledge, as well as with its underlying theory of moral truth. The first part of the paper looks at what the claims of a superior methodology consist in. The second reveals pluriperspectivism and integrativity to be underdeveloped, hazy terms, but which seem to be underpinned by two theses - the incommensurability and the inclusiveness theses. These theses we critically scrutinize. We then consider strategies the project's proponents might apply to curb these theses in order to acquire minimal consistency for their framework. This part of the article also deals with the conception of moral truth that drives the theory, a position equally burdened with inconsistencies. In the last part of the article, we observe the concept of orientational knowledge, and develop two interpretations of its possible meaning. We claim that, following the first interpretation, Integrative Bioethics is completely descriptive, in which case it is informative and important, but hardly bioethics; if it is normative, following the second interpretation, it is bioethics as we already know it, but merely clad in rhetorical embellishments. We conclude that there is nothing new about this project, and that its inconsistencies are reason enough for its abandonment. © 2015 John Wiley & Sons Ltd.

  5. The Inconsistency Of Assessing Agricultural Zakat

    Directory of Open Access Journals (Sweden)

    Muhamad Firdaus Abdul Rahman

    2014-06-01

    Full Text Available The management of agricultural zakat in Malaysia is under the jurisdiction of States ReligiousCouncil. The objective of this paper is to analyze the nisab, rate and to assess the deduction ofcost before zakat is imposed. A qualitative methodology was used to analyze the data through descriptive and comparative methods. The researchers used five states as samples, namely Selangor, Penang, Perlis, Terengganu, and Sarawak. The findings showed the inconsistency indeciding the nisab for the bushel (sa` metric weight. In addition, the variability of rates was applied in all states and the deduction of cost is allowed only in the state of Perlis. It can be summarized that the occurrence of the diversity is due to inconsistency of bushel (sa’ weight in every state and there are various rates of agriculturazakat, specifically 5%, 7.5% and 10% which is set by State Islamic Religious Authority. It can be implied that fatwa issued by the State Mufti Department and Baitulmal are required to be reassessed from time to time. It is recommended that digital modern metric measurement is to be used and all costs should be deducted beforethey imposed agricultural zakat.

  6. Inconsistency of Minkowski higher-derivative theories

    Energy Technology Data Exchange (ETDEWEB)

    Aglietti, Ugo G. [Universita di Roma ' ' La Sapienza' ' , Dipartimento di Fisica, Rome (Italy); Anselmi, Damiano [Universita di Pisa, Dipartimento di Fisica ' ' Enrico Fermi' ' , Pisa (Italy); INFN, Sezione di Pisa, Pisa (Italy)

    2017-02-15

    We show that Minkowski higher-derivative quantum field theories are generically inconsistent, because they generate nonlocal, non-hermitian ultraviolet divergences, which cannot be removed by means of standard renormalization procedures. By ''Minkowski theories'' we mean theories that are defined directly in Minkowski spacetime. The problems occur when the propagators have complex poles, so that the correlation functions cannot be obtained as the analytic continuations of their Euclidean versions. The usual power counting rules fail and are replaced by much weaker ones. Self-energies generate complex divergences proportional to inverse powers of D'Alembertians. Three-point functions give more involved nonlocal divergences, which couple to infrared effects. We illustrate the violations of the locality and hermiticity of counterterms in scalar models and higher-derivative gravity. (orig.)

  7. Content-Related Repairing of Inconsistencies in Distributed Data

    Institute of Scientific and Technical Information of China (English)

    Yue-Feng Du; De-Rong Shen; Tie-Zheng Nie; Yue Kou; Ge Yu

    2016-01-01

    Conditional functional dependencies (CFDs) are a critical technique for detecting inconsistencies while they may ignore some potential inconsistencies without considering the content relationship of data. Content-related conditional functional dependencies (CCFDs) are a type of special CFDs, which combine content-related CFDs and detect potential inconsistencies by putting content-related data together. In the process of cleaning inconsistencies, detection and repairing are interactive: 1) detection catches inconsistencies, 2) repairing corrects caught inconsistencies while may bring new incon-sistencies. Besides, data are often fragmented and distributed into multiple sites. It consequently costs expensive shipment for inconsistencies cleaning. In this paper, our aim is to repair inconsistencies in distributed content-related data. We propose a framework consisting of an inconsistencies detection method and an inconsistencies repairing method, which work iteratively. The detection method marks the violated CCFDs for computing the inconsistencies which should be repaired preferentially. Based on the repairing-cost model presented in this paper, we prove that the minimum-cost repairing using CCFDs is NP-complete. Therefore, the repairing method heuristically repairs the inconsistencies with minimum cost. To improve the efficiency and accuracy of repairing, we propose distinct values and rules sequences. Distinct values make less data shipments than real data for communication. Rules sequences determine appropriate repairing sequences to avoid some incorrect repairs. Our solution is proved to be more effective than CFDs by empirical evaluation on two real-life datasets.

  8. Reliability and validity of the Parenting Scale of Inconsistency.

    Science.gov (United States)

    Yoshizumi, Takahiro; Murase, Satomi; Murakami, Takashi; Takai, Jiro

    2006-08-01

    The purposes of the present study were to develop a Parenting Scale of Inconsistency and to evaluate its initial reliability and validity. The 12 items assess the inconsistency among parents' moods, behaviors, and attitudes toward children. In the primary study, 517 participants completed three measures: the new Parenting Scale of Inconsistency, the Parental Bonding Instrument, and the Depression Scale of the General Health Questionnaire. The Parenting Scale of Inconsistency had good test-retest reliability of .85 and internal consistency of .88 (Cronbach coefficient alpha). Construct validity was good as Inconsistency scores were significantly correlated with the Care and Overprotection scores of the Parental Bonding Instrument and with the Depression scores. Moreover, Inconsistency scores' relation with a dimension of parenting style distinct from Care and Overprotection suggested that the Parenting Scale of Inconsistency had factorial validity. This scale seems a potential measure for examining the relationships between inconsistent parenting and the mental health of children.

  9. Effects of Inconsistent Behaviors on Person Impressions: A Multidimensional Study.

    Science.gov (United States)

    Vonk, Roos

    1995-01-01

    Examined effects of unexpected behavioral information on person impressions. Inconsistency was manipulated with respect to Implicit Personality Theory. Found that behaviors with inconsistent evaluation implications did not affect impressions and that effects of inconsistent information depended on dimension of contrast, valence of initial…

  10. 19 CFR 177.13 - Inconsistent customs decisions.

    Science.gov (United States)

    2010-04-01

    ... inconsistent with decisions being made by Customs officials at another location may be brought to the attention...) Inconsistent decisions subject to petition. The decisions which may be the subject of a petition include: (i... 19 Customs Duties 2 2010-04-01 2010-04-01 false Inconsistent customs decisions. 177.13 Section 177...

  11. Environmental catastrophes under time-inconsistent preference

    Energy Technology Data Exchange (ETDEWEB)

    Michielsen, T.

    2013-02-15

    I analyze optimal natural resource use in an intergenerational model with the risk of a catastrophe. Each generation maximizes a weighted sum of discounted utility (positive) and the probability that a catastrophe will occur at any point in the future (negative). The model generates time inconsistency as generations disagree on the relative weights on utility and catastrophe prevention. As a consequence, future generations emit too much from the current generation's perspective and a dynamic game ensues. I consider a sequence of models. When the environmental problem is related to a scarce exhaustible resource, early generations have an incentive to reduce emissions in Markov equilibrium in order to enhance the ecosystem's resilience to future emissions. When the pollutant is expected to become obsolete in the near future, early generations may however increase their emissions if this reduces future emissions. When polluting inputs are abundant and expected to remain essential, the catastrophe becomes a self-fulfilling prophecy and the degree of concern for catastrophe prevention has limited or even no effect on equilibrium behaviour.

  12. Inconsistency between direct and indirect comparisons of competing interventions: meta-epidemiological study.

    Science.gov (United States)

    Song, Fujian; Xiong, Tengbin; Parekh-Bhurke, Sheetal; Loke, Yoon K; Sutton, Alex J; Eastwood, Alison J; Holland, Richard; Chen, Yen-Fu; Glenny, Anne-Marie; Deeks, Jonathan J; Altman, Doug G

    2011-08-16

    To investigate the agreement between direct and indirect comparisons of competing healthcare interventions. Meta-epidemiological study based on sample of meta-analyses of randomised controlled trials. Data sources Cochrane Database of Systematic Reviews and PubMed. Inclusion criteria Systematic reviews that provided sufficient data for both direct comparison and independent indirect comparisons of two interventions on the basis of a common comparator and in which the odds ratio could be used as the outcome statistic. Inconsistency measured by the difference in the log odds ratio between the direct and indirect methods. The study included 112 independent trial networks (including 1552 trials with 478,775 patients in total) that allowed both direct and indirect comparison of two interventions. Indirect comparison had already been explicitly done in only 13 of the 85 Cochrane reviews included. The inconsistency between the direct and indirect comparison was statistically significant in 16 cases (14%, 95% confidence interval 9% to 22%). The statistically significant inconsistency was associated with fewer trials, subjectively assessed outcomes, and statistically significant effects of treatment in either direct or indirect comparisons. Owing to considerable inconsistency, many (14/39) of the statistically significant effects by direct comparison became non-significant when the direct and indirect estimates were combined. Significant inconsistency between direct and indirect comparisons may be more prevalent than previously observed. Direct and indirect estimates should be combined in mixed treatment comparisons only after adequate assessment of the consistency of the evidence.

  13. Self-reported cognitive inconsistency in older adults.

    Science.gov (United States)

    Vanderhill, Susan; Hultsch, David F; Hunter, Michael A; Strauss, Esther

    2010-01-01

    Insight into one's own cognitive abilities, or metacognition, has been widely studied in developmental psychology. Relevance to the clinician is high, as memory complaints in older adults show an association with impending dementia, even after controlling for likely confounds. Another candidate marker of impending dementia under study is inconsistency in cognitive performance over short time intervals. Although there has been a recent proliferation of studies of cognitive inconsistency in older adults, to date, no one has examined adults' self-perceptions of cognitive inconsistency. Ninety-four community-dwelling older adults (aged 70-91) were randomly selected from a parent longitudinal study of short-term inconsistency and long-term cognitive change in aging. Participants completed a novel 40-item self-report measure of everyday cognitive inconsistency, including parallel scales indexing perceived inconsistency 5 years ago and at present, yielding measures of past, present, and 5-year change in inconsistency. The questionnaire showed acceptable psychometric characteristics. The sample reported an increase in perceived inconsistency over time. Higher reported present inconsistency and greater 5-year increase in inconsistency were associated with noncognitive (e.g., older age, poorer ADLs, poorer health, higher depression), metacognitive (e.g., poorer self-rated memory) and neuropsychological (e.g., poorer performance and greater 5-year decline in global cognitive status, vocabulary, and memory) measures. Correlations between self-reported inconsistency and neuropsychological performance were attenuated, but largely persisted when self-rated memory and age were controlled. Observed relationships between self-reported inconsistency and measures of neuropsychological (including memory) status and decline suggest that self-perceived inconsistency may be an area of relevance in evaluating older adults for memory disorders.

  14. The delay effect on outcome evaluation: results from an Event-related Potential study

    Directory of Open Access Journals (Sweden)

    Chen eQu

    2013-11-01

    Full Text Available Behavioral studies demonstrate that the timing of receiving gains or losses affects decision-making, a phenomenon known as temporal discounting, as participants are inclined to prefer immediate rewards over delayed ones and vice versa for losses. The present study used the event-related potential (ERP technique with a simple gambling task to investigate how delayed rewards and losses affected the brain activity in outcome evaluations made by 20 young adults. Statistical analysis revealed a larger feedback related negativity (FRN effect between loss and gain following immediate outcomes than following future outcomes. In addition, delay impacted FRN only in gain conditions, with delayed winning eliciting a more negative FRN than immediatewinning. These results suggest that temporal discounting and sign effect could be encoded in the FRN in the early stage of outcome evaluation.

  15. Minimal solution for inconsistent singular fuzzy matrix equations

    Directory of Open Access Journals (Sweden)

    M. Nikuie

    2013-10-01

    Full Text Available The fuzzy matrix equations $Ailde{X}=ilde{Y}$ is called a singular fuzzy matrix equations while the coefficients matrix of its equivalent crisp matrix equations be a singular matrix. The singular fuzzy matrix equations are divided into two parts: consistent singular matrix equations and inconsistent fuzzy matrix equations. In this paper, the inconsistent singular fuzzy matrix equations is studied and the effect of generalized inverses in finding minimal solution of an inconsistent singular fuzzy matrix equations are investigated.

  16. Misleading Children: Causal Attributions of Inconsistency under Repeated Questioning.

    Science.gov (United States)

    Siegal, Michael; And Others

    1988-01-01

    Four studies investigated whether inconsistency of children aged four to six on developmental tasks may reflect a misinterpretation of the experimenter's intent in communication under repeated questioning. (SKC)

  17. Inconsistency of residents' communication performance in challenging consultations.

    Science.gov (United States)

    Wouda, Jan C; van de Wiel, Harry B M

    2013-12-01

    Communication performance inconsistency between consultations is usually regarded as a measurement error that jeopardizes the reliability of assessments. However, inconsistency is an important phenomenon, since it indicates that physicians' communication may be below standard in some consultations. Fifty residents performed two challenging consultations. Residents' communication competency was assessed with the CELI instrument. Residents' background in communication skills training (CST) was also established. We used multilevel analysis to explore communication performance inconsistency between the two consultations. We also established the relationships between inconsistency and average performance quality, the type of consultation, and CST background. Inconsistency accounted for 45.5% of variance in residents' communication performance. Inconsistency was dependent on the type of consultation. The effect of CST background training on performance quality was case specific. Inconsistency and average performance quality were related for those consultation combinations dissimilar in goals, structure, and required skills. CST background had no effect on inconsistency. Physician communication performance should be of high quality, but also consistent regardless of the type and complexity of the consultation. In order to improve performance quality and reduce performance inconsistency, communication education should offer ample opportunities to practice a wide variety of challenging consultations. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  18. Day-to-day inconsistency in parent knowledge: links with youth health and parents' stress.

    Science.gov (United States)

    Lippold, Melissa A; McHale, Susan M; Davis, Kelly D; Kossek, Ellen Ernst

    2015-03-01

    Considerable evidence documents the linkages between higher levels of parental knowledge about youth activities and positive youth outcomes. This study investigated how day-to-day inconsistency in parental knowledge of youth activities was linked to youth behavioral, psychological, and physical health and parents' stress. Participants were employees in the Information Technology Division of a Fortune 500 company and their children (N = 129, mean age of youth = 13.39 years, 55% female). Data were collected from parents and youth via separate workplace and in-home surveys as well as telephone diary surveys on eight consecutive evenings. We assessed day-to-day inconsistency in parental knowledge across these eight calls. Parents differed in their knowledge from day to day almost as much as their average knowledge scores differed from those of other parents. Controlling for mean levels of knowledge, youth whose parents exhibited more knowledge inconsistency reported more physical health symptoms (e.g., colds and flu). Knowledge inconsistency was also associated with more risky behavior for girls but greater psychological well-being for older adolescents. Parents who reported more stressors also had higher knowledge inconsistency. Assessing only average levels of parental knowledge does not fully capture how this parenting dimension is associated with youth health. Consistent knowledge may promote youth physical health and less risky behavior for girls. Yet knowledge inconsistency also may reflect normative increases in autonomy as it was positively associated with psychological well-being for older adolescents. Given the linkages between parental stress and knowledge inconsistency, parent interventions should include stress management components. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  19. Disentangling the effects of spatial inconsistency of targets and distractors when searching in realistic scenes.

    Science.gov (United States)

    Spotorno, Sara; Malcolm, George L; Tatler, Benjamin W

    2015-02-10

    Previous research has suggested that correctly placed objects facilitate eye guidance, but also that objects violating spatial associations within scenes may be prioritized for selection and subsequent inspection. We analyzed the respective eye guidance of spatial expectations and target template (precise picture or verbal label) in visual search, while taking into account any impact of object spatial inconsistency on extrafoveal or foveal processing. Moreover, we isolated search disruption due to misleading spatial expectations about the target from the influence of spatial inconsistency within the scene upon search behavior. Reliable spatial expectations and precise target template improved oculomotor efficiency across all search phases. Spatial inconsistency resulted in preferential saccadic selection when guidance by template was insufficient to ensure effective search from the outset and the misplaced object was bigger than the objects consistently placed in the same scene region. This prioritization emerged principally during early inspection of the region, but the inconsistent object also tended to be preferentially fixated overall across region viewing. These results suggest that objects are first selected covertly on the basis of their relative size and that subsequent overt selection is made considering object-context associations processed in extrafoveal vision. Once the object was fixated, inconsistency resulted in longer first fixation duration and longer total dwell time. As a whole, our findings indicate that observed impairment of oculomotor behavior when searching for an implausibly placed target is the combined product of disruption due to unreliable spatial expectations and prioritization of inconsistent objects before and during object fixation. © 2015 ARVO.

  20. Female College Students’ Media Use and Academic Outcomes: Results from a Longitudinal Cohort Study

    Science.gov (United States)

    Walsh, Jennifer L.; Fielder, Robyn L.; Carey, Kate B.; Carey, Michael P.

    2013-01-01

    This longitudinal study describes women’s media use during their first year of college and examines associations between media use and academic outcomes. Female students (N = 483, Mage = 18.1 years) reported on their use of 11 media forms and their grade point average, academic behaviors, academic confidence, and problems affecting schoolwork. Allowing for multi-tasking, women reported nearly 12 hours of media use per day; use of texting, music, the Internet, and social networking was heaviest. In general, media use was negatively associated with academic outcomes after controlling for prior academics and demographics. Exceptions were newspaper reading and music listening, which were positively associated with academic outcomes. There were significant indirect effects of magazine reading and social networking on GPA via academic behaviors, confidence, and problems. Results show that female college students are heavy users of new media, and that some forms of media use may adversely impact academic performance. PMID:24505554

  1. Female College Students' Media Use and Academic Outcomes: Results from a Longitudinal Cohort Study.

    Science.gov (United States)

    Walsh, Jennifer L; Fielder, Robyn L; Carey, Kate B; Carey, Michael P

    2013-09-01

    This longitudinal study describes women's media use during their first year of college and examines associations between media use and academic outcomes. Female students ( N = 483, M age = 18.1 years) reported on their use of 11 media forms and their grade point average, academic behaviors, academic confidence, and problems affecting schoolwork. Allowing for multi-tasking, women reported nearly 12 hours of media use per day; use of texting, music, the Internet, and social networking was heaviest. In general, media use was negatively associated with academic outcomes after controlling for prior academics and demographics. Exceptions were newspaper reading and music listening, which were positively associated with academic outcomes. There were significant indirect effects of magazine reading and social networking on GPA via academic behaviors, confidence, and problems. Results show that female college students are heavy users of new media, and that some forms of media use may adversely impact academic performance.

  2. Comparison of ASSESS neutralization module results with actual small force engagement outcomes

    International Nuclear Information System (INIS)

    Gardner, B.H.; Snell, M.K.; Paulus, W.K.

    1991-01-01

    The ASSESS Neutralization module (Neutralization) is part of the Analytic System and Software for Evaluation of Safeguards and Security (ASSESS), a vulnerability assessment tool. Neutralization models a fire fight between security inspectors (SIs) and adversaries. This paper reports that a comparison has been made between actual outcomes of police and small military engagements and the results predicted by the Neutralization module for similar scenarios. The results of this comparison show a surprising correlation between predicted outcomes (based on numbers of combatants, weapon types, and exposures, etc.) and the actual outcomes of the engagements analyzed. The importance of this analysis is that given the defenders have intelligence on actual adversary characteristics or are protecting against a design basis threat, defense capabilities can be evaluated before an engagement. Results could then be used to develop a favorable probability of a desired outcome. For example, law enforcement agencies are frequently able to compile the number of criminals, types of weaponry, willingness to use force, etc., from analysis of crime scenes

  3. Do Declining Discount Rates lead to Time Inconsistent Economic Advice?

    DEFF Research Database (Denmark)

    Hansen, Anders Chr.

    2006-01-01

    This paper addresses the risk of time inconsistency in economic appraisals related to the use of hyperbolic discounting (declining discount rates) instead of exponential discounting (constant discount rate). Many economists are uneasy about the prospects of potential time inconsistency. The paper...

  4. 17 CFR 250.28 - Inconsistent financial statements.

    Science.gov (United States)

    2010-04-01

    ... Accounts § 250.28 Inconsistent financial statements. Except as otherwise authorized or required by the..., financial statements which are inconsistent with the book accounts of such company or financial statements... prevent the distribution or publication of reasonable condensations or of unaudited financial statements...

  5. Using semantic distances for reasoning with inconsistent ontologies

    NARCIS (Netherlands)

    Huang, Zhisheng; van Harmelen, Frank

    2009-01-01

    Re-using and combining multiple ontologies on the Web is bound to lead to inconsistencies between the combined vocabularies. Even many of the ontologies that are in use today turn out to be inconsistent once some of their implicit knowledge is made explicit. However, robust and efficient methods to

  6. Inconsistency in reaction time across the life span.

    Science.gov (United States)

    Williams, Benjamin R; Hultsch, David F; Strauss, Esther H; Hunter, Michael A; Tannock, Rosemary

    2005-01-01

    Inconsistency in latency across trials of 2-choice reaction time data was analyzed in 273 participants ranging in age from 6 to 81 years. A U-shaped curve defined the relationship between age and inconsistency, with increases in age associated with lower inconsistency throughout childhood and higher inconsistency throughout adulthood. Differences in inconsistency were independent of practice, fatigue, and age-related differences in mean level of performance. Evidence for general and specific variability-producing processes was found in those aged less than 21 years, whereas only a specific process, such as attentional blocks, was evident for those 21 years and older. The findings highlight the importance of considering moment-to-moment changes in performance in psychological research. 2005 APA

  7. Compensating Injury to Autonomy in English Negligence Law: Inconsistent Recognition.

    Science.gov (United States)

    Keren-Paz, Tsachi

    2018-04-10

    Recently in Shaw v Kovac, the Court of Appeal seemed to have rejected a standalone injury to autonomy (ITA) as actionable in negligence, in an informed consent case. In this article, I argue that Shaw can be explained away, and that English law recognizes ITA as actionable in a series of cases, some of which-Bhamra, Tracey, and Yearworth-were not hitherto understood to do so. However, the under-theorization in the cases leads to inconsistencies. Like cases (Rees/Yearworth; Chester/Tracey) are not treated alike; ITA is misunderstood to be about 'religious offence' (Bhamra) and property loss (Yearworth) and worse still, the more serious type 2 ITA (Rees) gives rise to a weaker remedy (of exceptional nature aside) than the less serious type 1 injury (Chester). A better understanding of the different manifestations of ITA will lead to results which are both more consistent and more justified on the merit.

  8. Identification of Mendelian inconsistencies between SNP and pedigree information of sibs

    Directory of Open Access Journals (Sweden)

    Calus Mario PL

    2011-10-01

    Full Text Available Abstract Background Using SNP genotypes to apply genomic selection in breeding programs is becoming common practice. Tools to edit and check the quality of genotype data are required. Checking for Mendelian inconsistencies makes it possible to identify animals for which pedigree information and genotype information are not in agreement. Methods Straightforward tests to detect Mendelian inconsistencies exist that count the number of opposing homozygous marker (e.g. SNP genotypes between parent and offspring (PAR-OFF. Here, we develop two tests to identify Mendelian inconsistencies between sibs. The first test counts SNP with opposing homozygous genotypes between sib pairs (SIBCOUNT. The second test compares pedigree and SNP-based relationships (SIBREL. All tests iteratively remove animals based on decreasing numbers of inconsistent parents and offspring or sibs. The PAR-OFF test, followed by either SIB test, was applied to a dataset comprising 2,078 genotyped cows and 211 genotyped sires. Theoretical expectations for distributions of test statistics of all three tests were calculated and compared to empirically derived values. Type I and II error rates were calculated after applying the tests to the edited data, while Mendelian inconsistencies were introduced by permuting pedigree against genotype data for various proportions of animals. Results Both SIB tests identified animal pairs for which pedigree and genomic relationships could be considered as inconsistent by visual inspection of a scatter plot of pairwise pedigree and SNP-based relationships. After removal of 235 animals with the PAR-OFF test, SIBCOUNT (SIBREL identified 18 (22 additional inconsistent animals. Seventeen animals were identified by both methods. The numbers of incorrectly deleted animals (Type I error, were equally low for both methods, while the numbers of incorrectly non-deleted animals (Type II error, were considerably higher for SIBREL compared to SIBCOUNT. Conclusions

  9. Inconsistent Knowledge as a Natural Phenomenon : The Ranking of Reasonable Inferences as a Computational Approach to Naturally Inconsistent (Legal) Theories

    NARCIS (Netherlands)

    Vey Mestdagh, C.N.J. de; Hoepman, J.H.

    2011-01-01

    The perspective-bound character of information and information processing gives rise to natural inconsistency. Natural inconsistency poses a problem if a common perspective is needed, for example when a shared (consistent) decision has to be made (by humans, within logics or by computers). There are

  10. The Relation between Nonverbal IQ and Postoperative CI Outcomes in Cochlear Implant Users: Preliminary Result

    Directory of Open Access Journals (Sweden)

    Mina Park

    2015-01-01

    Full Text Available Objectives. This study assessed the correlation between performance intelligence and the postoperative cochlear implant (CI outcome in Korean-speaking children. In addition, the relationship between the performance intelligence subscales and the post-CI speech outcome was evaluated. Materials and Methods. Thirteen pediatric CI users (five males, eight females; median age at implantation 6.2 (range 1.3–14.2 years; median age at intelligence test 9.3 (range 5–16 years who were tested using the Korean Educational Development Institute-Wechsler Intelligence Scale for children were studied. The correlations between the intelligence scores and 1-2 years postoperative Categories of Auditory Performance (CAP scores and between subscales of performance and 1-2 years postoperative CAP scores were analyzed. Results. There was no correlation between the categories of verbal intelligence quotient (IQ and performance IQ for “mentally retarded” and “average,” respectively (Spearman’s rho = 0.42, P=0.15. There was a strong correlation between performance IQ and the postoperative CAP scale (Spearman’s rho = 0.8977, P=0.0008. “Picture arrangement” and “picture completion,” reflecting social cognition, were strongly correlated with the postoperative CAP scales. Conclusion. Performance intelligence, especially social cognition, was strongly related to the postoperative CI outcome of cochlear implant users. Therefore, auditory rehabilitation, including social rehabilitation, should maximize the postoperative CI outcomes.

  11. Clinical results and functional outcomes after direct intralaminar screw repair of spondylolysis.

    Science.gov (United States)

    Menga, Emmanuel N; Kebaish, Khaled M; Jain, Amit; Carrino, John A; Sponseller, Paul D

    2014-01-01

    Prospective analysis. Our objective was to analyze clinical and functional results of patients with spondylolysis treated via direct intralaminar screw fixation and autograft, a minimally invasive and motion-preserving surgery. Spondylolysis is usually treated nonoperatively; multiple surgical techniques are available when nonoperative measures fail. No studies evaluate the clinical and functional outcomes and their correlation with pars defect size and disc morphology on magnetic resonance imaging. We reviewed patients with spondylolysis treated with intralaminar screw fixation and bone grafting from 2000 through 2010. Of the 31 patients (mean age, 16 yr; range, 10-37 yr), 25 (81%) were competitive athletes. Preoperative computed tomographic scans were used to measure the pars defect size, and preoperative magnetic resonance images were graded using Pfirrmann classification for correlation with postoperative outcomes. Student t test was used for analysis (significance, P spondylolysis repair for persistent pain starting 18 months after intralaminar screw fixation, 2 patients sustained unilateral intralaminar screw fractures at L5, and 1 patient required irrigation and debridement for a superficial postoperative infection. There was no correlation among preoperative magnetic resonance imaging disc morphology, defect size on computed tomography, patient age, and clinical outcomes. Direct repair of spondylolysis with intralaminar screws offers a low profile, reliable treatment with good functional outcome and a low complication rate in active patients. 4.

  12. Microsurgical clipping of ophthalmic artery aneurysms: surgical results and visual outcomes with 208 aneurysms.

    Science.gov (United States)

    Kamide, Tomoya; Tabani, Halima; Safaee, Michael M; Burkhardt, Jan-Karl; Lawton, Michael T

    2018-01-26

    OBJECTIVE While most paraclinoid aneurysms can be clipped with excellent results, new postoperative visual deficits are a concern. New technology, including flow diverters, has increased the popularity of endovascular therapy. However, endovascular treatment of paraclinoid aneurysms is not without procedural risks, is associated with higher rates of incomplete aneurysm occlusion and recurrence, and may not address optic nerve compression symptoms that surgical debulking can. The increasing endovascular management of paraclinoid aneurysms should be justified by comparisons to surgical benchmarks. The authors, therefore, undertook this study to define patient, visual, and aneurysm outcomes in the most common type of paraclinoid aneurysm: ophthalmic artery (OphA) aneurysms. METHODS Results from microsurgical clipping of 208 OphA aneurysms in 198 patients were retrospectively reviewed. Patient demographics, aneurysm morphology (size, calcification, etc.), clinical characteristics, and patient outcomes were recorded and analyzed. RESULTS Despite 20% of these aneurysms being large or giant in size, complete aneurysm occlusion was accomplished in 91% of 208 cases, with OphA patency preserved in 99.5%. The aneurysm recurrence rate was 3.1% and the retreatment rate was 0%. Good outcomes (modified Rankin Scale score 0-2) were observed in 96.2% of patients overall and in all 156 patients with unruptured aneurysms. New visual field defects (hemianopsia or quadrantanopsia) were observed in 8 patients (3.8%), decreased visual acuity in 5 (2.4%), and monocular blindness in 9 (4.3%). Vision improved in 9 (52.9%) of the 17 patients with preoperative visual deficits. CONCLUSIONS The most important risk associated with clipping OphA aneurysms is a new visual deficit. Meticulous microsurgical technique is necessary during anterior clinoidectomy, aneurysm dissection, and clip application to optimize visual outcomes, and aggressive medical management postoperatively might potentially

  13. Word production inconsistency of Singaporean-English-speaking adolescents with Down Syndrome.

    Science.gov (United States)

    Wong, Betty; Brebner, Chris; McCormack, Paul; Butcher, Andy

    2015-01-01

    The nature of speech disorders in individuals with Down Syndrome (DS) remains controversial despite various explanations put forth in the literature to account for the observed speech profiles. A high level of word production inconsistency in children with DS has led researchers to query whether the inconsistency continues into adolescence, and if the inconsistency stems from inconsistent phonological disorder (IPD) or childhood apraxia of speech (CAS). Of the studies that have been published, most suggest that the speech profile of individuals with DS is delayed, while a few recent studies suggest a combination of delayed and disordered patterns. However, no studies have explored the nature of word production inconsistency in this population, and the relationship between word production inconsistency, receptive vocabulary and severity of speech disorder. To investigate in a pilot study the extent of word production inconsistency in adolescents with DS and to examine the correlations between word production inconsistency, measures of receptive vocabulary, severity of speech disorder and oromotor skills in adolescents with DS. The participants were 32 native speakers of Singaporean-English adolescents, comprising 16 participants with DS and 16 typically developing (TD) participants. The participants completed a battery of standardized speech and language assessments, including The Diagnostic Evaluation of Articulation and Phonology (DEAP) assessment. Results from each test were correlated to determine relationships. Qualitative analyses were also carried out on all the data collected. In this study, seven out of 16 participants with DS scored above 40% on word production inconsistency, a diagnostic criterion for IPD. In addition, all participants with DS performed poorly on the oromotor assessment of DEAP. The overall speech profile observed did not exactly correspond with the cluster symptoms observed in children with IPD or CAS. Word production inconsistency is a

  14. Evidence of inconsistency among laboratory technicians collecting ...

    African Journals Online (AJOL)

    The unsupervised samples yielded 37.50% (15/40) of visible bands, and 62.50% (25/40) of no visible bands (Binomial test p= 0.15). The overall difference between supervised and unsupervised samples was significant (x2= 21.33, df= 1, p< 0.001). These results reveal that without some form of supervision, some laboratory ...

  15. A General Theory of Markovian Time Inconsistent Stochastic Control Problems

    DEFF Research Database (Denmark)

    Björk, Tomas; Murgochi, Agatha

    We develop a theory for stochastic control problems which, in various ways, are time inconsistent in the sense that they do not admit a Bellman optimality principle. We attach these problems by viewing them within a game theoretic framework, and we look for Nash subgame perfect equilibrium points...... examples of time inconsistency in the literature are easily seen to be special cases of the present theory. We also prove that for every time inconsistent problem, there exists an associated time consistent problem such that the optimal control and the optimal value function for the consistent problem...

  16. Optimizing time management after perforation by colonoscopy results in better outcome for the patients.

    Science.gov (United States)

    Rumstadt, Bernhard; Schilling, Dieter

    2008-01-01

    Perforation during colonoscopy is a rare but severe complication. The aim of this study was to assess the time management and laparoscopic therapy of this complication and to evaluate patient outcomes. A retrospective analysis was done on 15 patients operated for a perforation from colonoscopy between January 2000 and December 2006. Three perforations occurred during diagnostic and 12 perforations during interventional colonoscopy. Two perforations occurred as transmural thermal injury to the colon wall. Peritonitis was found in 4 cases and significantly correlated with the mean time between perforation and operation. Twelve perforations were oversewn laparoscopically and 3 perforations were oversewn by laparotomy. After laparoscopic treatment, hospital stay was significantly shorter than after laparotomy. One patient had a postoperative wound infection, mortality was 0%. Laparoscopic oversewing is a safe and effective method in the treatment of perforation from colonoscopy. Optimizing the time range between perforation and laparoscopic therapy results in a better outcome for the patients.

  17. One-stage Revision ACL reconstruction with hamstring autograft results in satisfactory outcome

    Science.gov (United States)

    Kejriwal, Ritwik; Buelow, Jens

    2017-01-01

    Objectives: Revision anterior cruciate ligament (ACL) reconstruction is associated with poorer outcomes and higher rerupture rates when compared to primary ACL reconstruction. There is also a significant heterogeneity in surgical technique, number of stages, and graft options. We report a large single surgeon case series with hamstring autograft as a graft option. Methods: Observational series of revision ACL reconstructions performed by the senior author between 2005 and 2015 was carried out. Chart reviews and clinic follow-ups were performed with the following recorded – re-rupture rate, radiographic grading of osteoarthritis, KT-1000 arthrometer test, IKDC outcome scores and knee range of motion. All patients underwent single bundle four-strand hamstring autograft performed in one stage with use of new tunnels in majority of the cases. Results: 66 patients underwent hamstring autograft one-stage revision ACL reconstruction by Dr Jens Buelow. Chart review was carried out on all patients, and 26 (39%) were followed up in clinic and/or by phone with a mean follow up of 4.7 years. Outcomes included re-rupture rate of 4.5%, reoperation rate of 12%, mean visual analogue scale score of 7.6, mean side-to-side difference of 2.6 mm for KT-1000 arthrometer test, and mean IKDC score of 79. Of the 17 patients with radiographs, 40% had moderate osteoarthritis (grade 2 or 3) at follow-up. Conclusion: Revision ACL reconstruction can result in a satisfactory outcome when performed with a hamstring autograft in one stage.

  18. On inconsistency in frictional granular systems

    Science.gov (United States)

    Alart, Pierre; Renouf, Mathieu

    2018-04-01

    Numerical simulation of granular systems is often based on a discrete element method. The nonsmooth contact dynamics approach can be used to solve a broad range of granular problems, especially involving rigid bodies. However, difficulties could be encountered and hamper successful completion of some simulations. The slow convergence of the nonsmooth solver may sometimes be attributed to an ill-conditioned system, but the convergence may also fail. The prime aim of the present study was to identify situations that hamper the consistency of the mathematical problem to solve. Some simple granular systems were investigated in detail while reviewing and applying the related theoretical results. A practical alternative is briefly analyzed and tested.

  19. Decisional Outcomes of Maternal Disclosure of BRCA1/2 Genetic Test Results to Children

    Science.gov (United States)

    Tercyak, Kenneth P.; Mays, Darren; DeMarco, Tiffani A.; Peshkin, Beth N.; Valdimarsdottir, Heiddis B.; Schneider, Katherine A.; Garber, Judy E.; Patenaude, Andrea Farkas

    2013-01-01

    Background Although BRCA1/2 genetic testing is discouraged in minors, mothers may disclose their own results to their children. Factors affecting patients’ disclosure decisions and patient outcomes of disclosure are largely unknown. Methods Mothers (N = 221) of children ages 8-21 enrolled in this prospective study of family communication about cancer genetic testing. Patients underwent BRCA1/2 genetic counseling and testing, and completed standardized behavioral assessments prior to and 1-month following receipt of their results. Results Most patients (62.4%) disclosed BRCA1/2 test results to their child. Patients were more likely to disclose if they received negative or uninformative vs. positive results (OR = 3.11; 95% CI = 1.11 - 8.71; P = .03), their child was ≥ 13 years of age vs. younger (OR = 5.43; 95% CI = 2.18 - 13.53; P Post-decision satisfaction about disclosure was lowest among nondisclosing patients (P information is perceived as beneficial. Satisfaction with disclosure decision-making remains lowest among nondisclosing and conflicted patients. Family communication decision support adjuncts to genetic counseling are needed to help ameliorate these effects. Impact This study describes the prevalence of family communication about maternal BRCA1/2 genetic testing with minor children, and decisions and outcomes of disclosure. PMID:23825307

  20. Is the special theory of relativity logically inconsistent

    International Nuclear Information System (INIS)

    Honig, W.

    1980-01-01

    The author's aim is to illustrate that the controversial subject of the logical inconsistency of STR is capable of two interpretations. If one retains a fidelity to the Einstein operational assumptions and methods then one may conclude that logical inconsistencies cannot be derived. If however, one wishes to base a theory upon a single world view with a single set of consistent assumptions, then STR is logically inconsistent. This inconsistency is at the present time not operationally evident. The usefulness of this second view is in its heuristic and future usefulness in the elucidation of natural phenomena. It is hoped that this discussion may somewhat reduce the contention and emotion in this field. (Auth.)

  1. Inconsistency of residents' communication performance in challenging consultations

    NARCIS (Netherlands)

    Wouda, Jan C.; van de Wiel, Harry B. M.

    2013-01-01

    Objective: Communication performance inaonsistency between consultations is usually regarded as a measurement error that jeopardizes the reliability of assessments. However, inconsistency is an important phenomenon, since it indicates that physicians' communication may be below standard in some

  2. Counterfactual Reasoning: resolving inconsistency before your eyes

    Directory of Open Access Journals (Sweden)

    Russell Revlin

    2005-03-01

    Full Text Available Belief revision has invariably been studied with abstract relationships using paper-and-pencil tasks. The present study asks whether people employ the same procedures in revising their beliefs when they concern concrete situations rather than arbitrary, abstract ones. Students listened to a narrative and then verified that selected statements from it were true and consistent. They then needed to revise their beliefs as a result of confronting a belief-contravening assumption that they had to accept as true even though it was false of the narrative. There are two main findings. First, when the artificial beliefs were part of an integrated, narrative structure, participants treated them as they do natural semantic categories and not as arbitrary relations. Second, when reasoning about concrete situations in front of them, reasoners readily changed the properties of the objects in order to retain the belief structure of the narrative. This suggests that college students act as if they were Platonists who view the observable world as fallible reflections of the idealized world.

  3. Association between thymic function and allogeneic hematopoietic stem cell transplantation outcome: results of a pediatric study.

    Science.gov (United States)

    Saglio, Francesco; Cena, Silvia; Berger, Massimo; Quarello, Paola; Boccasavia, Viola; Ferrando, Federica; Pittana, Laura; Bruno, Benedetto; Fagioli, Franca

    2015-06-01

    Robust T cell function recovery has been shown to be crucial in determining allogeneic hematopoietic stem cell transplantation (HSCT) outcome, and there is growing evidence that the thymus plays a central role in regulating this process. We performed a long-term analysis of the role of thymic activity recovery in a population of pediatric patients undergoing allogeneic HSCT by signal joint T cell receptor excision circle (sjTREC) quantification. In this study, characterized by a long-term follow-up (median, 72 months), we found patients with higher levels of sjTRECs before transplantation had a statistically significant reduced risk of death compared with patients with lower values (relative risk, .31; 95% confidence interval, .30 to .32; P = .02), showing this different outcome was mainly related to a reduction of relapse incidence (14% versus 43%, P = .02). Unlike previous reports, we observed no correlation between sjTREC levels and lymphocyte recovery. Moreover, we confirmed that only graft-versus-host disease influenced thymic activity after transplantation. In conclusion, our results suggest an association between pretransplantation thymic activity and the long-term outcome of pediatric patients undergoing HSCT, mainly through a reduction of relapse opportunities. Copyright © 2015 American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

  4. Spontaneous subarachnoid haemorrhage and outcome--results from Tan Tock Seng Hospital, Singapore.

    Science.gov (United States)

    Wong, S H; Yeo, T T; Seow, W T; Tan, K K; Ong, P L

    1999-07-01

    To ascertain the number of cases of spontaneous (aneurysmal) subarachnoid haemorrhage presenting to Tan Tock Seng Hospital, Singapore, over a one year period, the demographics of the patients involved, their treatment and their eventual outcome. A retrospective study from June 1995 to June 1996. There were 62 patients admitted over this period with an average of 5 patients per month. Their ages ranged from 9 to 85 years with a mean of 54 years. All 62 patients underwent 4-vessel cerebral angiograms. Forty-three patients (69%) underwent clipping of their aneurysms. Twelve patients (19%) had negative angiograms. Four patients (6%) underwent coiling of their aneurysms via interventional neuroradiology techniques. Patients with subarachnoid haemorrhage of Grades 1 to 3 on the WFNS (World Federation of Neurological Surgeons) grading had a favourable outcome (Glasgow Outcome Score of 4 and 5) in 85% of the cases. The overall mortality rate for the operated group (all grades) was 11%. However for the group with good WFNS grading, namely the Grade 1 to 2 groups, there were no deaths. Twenty-four percent of patients developed clinically symptomatic vasospasm. Eighteen percent of patients required ventriculo-peritoneal shunting for hydrocephalus secondary to the subarachnoid haemorrhage. The overall management mortality (operated and non-operated cases) was 14% for proven aneurysmal and angiographically-negative spontaneous subarachnoid haemorrhage. These results are comparable to that of other reputable centers reported in the literature.

  5. Inconsistent condom use among Ugandan university students from a gender perspective: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Devika Mehra

    2014-04-01

    Full Text Available Background: Feminization of the HIV/AIDS epidemic has been a prominent phenomenon in sub-Saharan Africa. Inconsistent condom use among young people is one of the major risk factors in the continued propagation of the epidemic. Therefore, it is of importance to increase knowledge of gender aspects of condom use among young people. Objective: To investigate whether gender differences regarding individual and social factors determine the association between condom efficacy and inconsistent condom use with a new sex partner, among Ugandan university students. Design: In 2010, 1954 Ugandan students participated in a cross-sectional survey, conducted at Mbarara University of Science and Technology in southwestern Uganda. A self-administered questionnaire assessed socio-demographic factors, alcohol consumption, sexual behaviors (including condom use and condom efficacy, and peer norms. The data were stratified by sex and examined by multivariate logistic regression analysis. Results: A total of 1,179 (60.3% students reported having had their sexual debut. Of these, 231 (37.4% males and 209 (49.2% females reported inconsistent condom use with a new sex partner. Students with low condom efficacy had a higher risk of inconsistent condom use with a new sex partner, even after adjusting for the potential confounders. A synergistic effect was observed between being a female and low condom efficacy with inconsistent condom use. Conclusion: The association between inconsistent condom use and low condom efficacy was found among both males and females, but females were found to be at a higher risk of inconsistent condom use compared to their male counterparts. Therefore, gender power relations should be addressed in policies and interventions aiming at increasing condom use among young people in sub-Saharan settings. Programs could be designed with intervention strategies that focus on interactive and participatory educational activities and youth

  6. Language model: Extension to solve inconsistency, incompleteness, and short query in cultural heritage collection

    Science.gov (United States)

    Tan, Kian Lam; Lim, Chen Kim

    2017-10-01

    With the explosive growth of online information such as email messages, news articles, and scientific literature, many institutions and museums are converting their cultural collections from physical data to digital format. However, this conversion resulted in the issues of inconsistency and incompleteness. Besides, the usage of inaccurate keywords also resulted in short query problem. Most of the time, the inconsistency and incompleteness are caused by the aggregation fault in annotating a document itself while the short query problem is caused by naive user who has prior knowledge and experience in cultural heritage domain. In this paper, we presented an approach to solve the problem of inconsistency, incompleteness and short query by incorporating the Term Similarity Matrix into the Language Model. Our approach is tested on the Cultural Heritage in CLEF (CHiC) collection which consists of short queries and documents. The results show that the proposed approach is effective and has improved the accuracy in retrieval time.

  7. Journal Data Sharing Policies and Statistical Reporting Inconsistencies in Psychology

    Directory of Open Access Journals (Sweden)

    Michèle B. Nuijten

    2017-12-01

    Full Text Available In this paper, we present three retrospective observational studies that investigate the relation between data sharing and statistical reporting inconsistencies. Previous research found that reluctance to share data was related to a higher prevalence of statistical errors, often in the direction of statistical significance (Wicherts, Bakker, & Molenaar, 2011. We therefore hypothesized that journal policies about data sharing and data sharing itself would reduce these inconsistencies. In Study 1, we compared the prevalence of reporting inconsistencies in two similar journals on decision making with different data sharing policies. In Study 2, we compared reporting inconsistencies in psychology articles published in PLOS journals (with a data sharing policy and Frontiers in Psychology (without a stipulated data sharing policy. In Study 3, we looked at papers published in the journal Psychological Science to check whether papers with or without an Open Practice Badge differed in the prevalence of reporting errors. Overall, we found no relationship between data sharing and reporting inconsistencies. We did find that journal policies on data sharing seem extremely effective in promoting data sharing. We argue that open data is essential in improving the quality of psychological science, and we discuss ways to detect and reduce reporting inconsistencies in the literature.

  8. Do continuous assessment results affect final exam outcomes? Evidence from a microeconomics course

    Directory of Open Access Journals (Sweden)

    Juan Carlos Reboredo

    2017-04-01

    Full Text Available Continuous assessment aims to enhance student learning and understanding of a subject and so achieve better educational outcomes. We investigated how continuous assessment grades affected final exam grades. Using a dataset for six academic post-Bologna Process years (2009-2015 for a first-year undergraduate microeconomics course offered at a Spanish public university, we examined conditional dependence between continuous assessment and final exam grades. Our results would indicate a limited contribution of continuous assessment results to final exam results: the probability of the final exam performance improving on the continuous assessment grade was lower than the probability of the opposite occurring. A consistent exception, however, was students who obtained an A grade for continuous assessment. Our results would cast some doubt on the beneficial effects of continuous assessment advocated by the Bologna Process.

  9. [Gene method for inconsistent hydrological frequency calculation. 2: Diagnosis system of hydrological genes and method of hydrological moment genes with inconsistent characters].

    Science.gov (United States)

    Xie, Ping; Zhao, Jiang Yan; Wu, Zi Yi; Sang, Yan Fang; Chen, Jie; Li, Bin Bin; Gu, Hai Ting

    2018-04-01

    The analysis of inconsistent hydrological series is one of the major problems that should be solved for engineering hydrological calculation in changing environment. In this study, the diffe-rences of non-consistency and non-stationarity were analyzed from the perspective of composition of hydrological series. The inconsistent hydrological phenomena were generalized into hydrological processes with inheritance, variability and evolution characteristics or regulations. Furthermore, the hydrological genes were identified following the theory of biological genes, while their inheritance bases and variability bases were determined based on composition of hydrological series under diffe-rent time scales. To identify and test the components of hydrological genes, we constructed a diagnosis system of hydrological genes. With the P-3 distribution as an example, we described the process of construction and expression of the moment genes to illustrate the inheritance, variability and evolution principles of hydrological genes. With the annual minimum 1-month runoff series of Yunjinghong station in Lancangjiang River basin as an example, we verified the feasibility and practicability of hydrological gene theory for the calculation of inconsistent hydrological frequency. The results showed that the method could be used to reveal the evolution of inconsistent hydrological series. Therefore, it provided a new research pathway for engineering hydrological calculation in changing environment and an essential reference for the assessment of water security.

  10. Estimating nonrigid motion from inconsistent intensity with robust shape features

    International Nuclear Information System (INIS)

    Liu, Wenyang; Ruan, Dan

    2013-01-01

    Purpose: To develop a nonrigid motion estimation method that is robust to heterogeneous intensity inconsistencies amongst the image pairs or image sequence. Methods: Intensity and contrast variations, as in dynamic contrast enhanced magnetic resonance imaging, present a considerable challenge to registration methods based on general discrepancy metrics. In this study, the authors propose and validate a novel method that is robust to such variations by utilizing shape features. The geometry of interest (GOI) is represented with a flexible zero level set, segmented via well-behaved regularized optimization. The optimization energy drives the zero level set to high image gradient regions, and regularizes it with area and curvature priors. The resulting shape exhibits high consistency even in the presence of intensity or contrast variations. Subsequently, a multiscale nonrigid registration is performed to seek a regular deformation field that minimizes shape discrepancy in the vicinity of GOIs. Results: To establish the working principle, realistic 2D and 3D images were subject to simulated nonrigid motion and synthetic intensity variations, so as to enable quantitative evaluation of registration performance. The proposed method was benchmarked against three alternative registration approaches, specifically, optical flow, B-spline based mutual information, and multimodality demons. When intensity consistency was satisfied, all methods had comparable registration accuracy for the GOIs. When intensities among registration pairs were inconsistent, however, the proposed method yielded pronounced improvement in registration accuracy, with an approximate fivefold reduction in mean absolute error (MAE = 2.25 mm, SD = 0.98 mm), compared to optical flow (MAE = 9.23 mm, SD = 5.36 mm), B-spline based mutual information (MAE = 9.57 mm, SD = 8.74 mm) and mutimodality demons (MAE = 10.07 mm, SD = 4.03 mm). Applying the proposed method on a real MR image sequence also provided

  11. Surrogacy: outcomes for surrogate mothers, children and the resulting families-a systematic review.

    Science.gov (United States)

    Söderström-Anttila, Viveca; Wennerholm, Ulla-Britt; Loft, Anne; Pinborg, Anja; Aittomäki, Kristiina; Romundstad, Liv Bente; Bergh, Christina

    2016-01-01

    Surrogacy is a highly debated method mainly used for treating women with infertility caused by uterine factors. This systematic review summarizes current levels of knowledge of the obstetric, medical and psychological outcomes for the surrogate mothers, the intended parents and children born as a result of surrogacy. PubMed, Cochrane and Embase databases up to February 2015 were searched. Cohort studies and case series were included. Original studies published in English and the Scandinavian languages were included. In case of double publications, the latest study was included. Abstracts only and case reports were excluded. Studies with a control group and case series (more than three cases) were included. Cohort studies, but not case series, were assessed for methodological quality, in terms of risk of bias. We examined a variety of main outcomes for the surrogate mothers, children and intended mothers, including obstetric outcome, relationship between surrogate mother and intended couple, surrogate's experiences after relinquishing the child, preterm birth, low birthweight, birth defects, perinatal mortality, child psychological development, parent-child relationship, and disclosure to the child. The search returned 1795 articles of which 55 met the inclusion criteria. The medical outcome for the children was satisfactory and comparable to previous results for children conceived after fresh IVF and oocyte donation. The rate of multiple pregnancies was 2.6-75.0%. Preterm birth rate in singletons varied between 0 and 11.5% and low birthweight occurred in between 0 and 11.1% of cases. At the age of 10 years there were no major psychological differences between children born after surrogacy and children born after other types of assisted reproductive technology (ART) or after natural conception. The obstetric outcomes for the surrogate mothers were mainly reported from case series. Hypertensive disorders in pregnancy were reported in between 3.2 and 10% of cases and

  12. Profiles of inconsistent knowledge in children's pathways of conceptual change.

    Science.gov (United States)

    Schneider, Michael; Hardy, Ilonca

    2013-09-01

    Conceptual change requires learners to restructure parts of their conceptual knowledge base. Prior research has identified the fragmentation and the integration of knowledge as 2 important component processes of knowledge restructuring but remains unclear as to their relative importance and the time of their occurrence during development. Previous studies mostly were based on the categorization of answers in interview studies and led to mixed empirical results, suggesting that methodological improvements might be helpful. We assessed 161 third-graders' knowledge about floating and sinking of objects in liquids at 3 measurement points by means of multiple-choice tests. The tests assessed how strongly the children agreed with commonly found but mutually incompatible statements about floating and sinking. A latent profile transition analysis of the test scores revealed 5 profiles, some of which indicated the coexistence of inconsistent pieces of knowledge in learners. The majority of students (63%) were on 1 of 7 developmental pathways between these profiles. Thus, a child's knowledge profile at a point in time can be used to predict further development. The degree of knowledge integration decreased on some individual developmental paths, increased on others, and remained stable on still others. The study demonstrates the usefulness of explicit quantitative models of conceptual change. The results support a constructivist perspective on conceptual development, in which developmental changes of a learner's knowledge base result from idiosyncratic, yet systematic knowledge-construction processes. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  13. Neuroimaging studies of word and pseudoword reading: consistencies, inconsistencies, and limitations.

    Science.gov (United States)

    Mechelli, Andrea; Gorno-Tempini, Maria Luisa; Price, Cathy J

    2003-02-15

    Several functional neuroimaging studies have compared words and pseudowords to test different cognitive models of reading. There are difficulties with this approach, however, because cognitive models do not make clear-cut predictions at the neural level. Therefore, results can only be interpreted on the basis of prior knowledge of cognitive anatomy. Furthermore, studies comparing words and pseudowords have produced inconsistent results. The inconsistencies could reflect false-positive results due to the low statistical thresholds applied or confounds from nonlexical aspects of the stimuli. Alternatively, they may reflect true effects that are inconsistent across subjects; dependent on experimental parameters such as stimulus rate or duration; or not replicated across studies because of insufficient statistical power. In this fMRI study, we investigate consistent and inconsistent differences between word and pseudoword reading in 20 subjects, and distinguish between effects associated with increases and decreases in activity relative to fixation. In addition, the interaction of word type with stimulus duration is explored. We find that words and pseudowords activate the same set of regions relative to fixation, and within this system, there is greater activation for pseudowords than words in the left frontal operculum, left posterior inferior temporal gyrus, and the right cerebellum. The only effects of words relative to pseudowords consistent over subjects are due to decreases in activity for pseudowords relative to fixation; and there are no significant interactions between word type and stimulus duration. Finally, we observe inconsistent but highly significant effects of word type at the individual subject level. These results (i) illustrate that pseudowords place increased demands on areas that have previously been linked to lexical retrieval, and (ii) highlight the importance of including one or more baselines to qualify word type effects. Furthermore, (iii

  14. Neurocognitive markers of cognitive impairment: exploring the roles of speed and inconsistency.

    Science.gov (United States)

    Dixon, Roger A; Garrett, Douglas D; Lentz, Tanya L; MacDonald, Stuart W S; Strauss, Esther; Hultsch, David F

    2007-05-01

    A well-known challenge for research in the cognitive neuropsychology of aging is to distinguish between the deficits and changes associated with normal aging and those indicative of early cognitive impairment. In a series of 2 studies, the authors explored whether 2 neurocognitive markers, speed (mean level) and inconsistency (intraindividual variability), distinguished between age groups (64-73 and 74-90+ years) and cognitive status groups (nonimpaired, mildly impaired, and moderately impaired). Study 1 (n = 416) showed that both level and inconsistency distinguished between the age and 2 cognitive status (not impaired, mildly impaired) groups, with a modest tendency for inconsistency to predict group membership over and above mean level. Study 2 (n = 304) replicated these results but extended them because of the qualifying effects associated with the unique moderately impaired oldest group. Specifically, not only were the groups more firmly distinguished by both indicators of speed, but evidence for the differential contribution of performance inconsistency was stronger. Neurocognitive markers of speed and inconsistency may be leading indicators of emerging cognitive impairment. (c) 2007 APA, all rights reserved

  15. Critical care admission of South African (SA surgical patients: Results of the SA Surgical Outcomes Study

    Directory of Open Access Journals (Sweden)

    David Lee Skinner

    2017-05-01

    Full Text Available Background. Appropriate critical care admissions are an important component of surgical care. However, there are few data describing postoperative critical care admission in resource-limited low- and middle-income countries. Objective. To describe the demographics, organ failures, organ support and outcomes of non-cardiac surgical patients admitted to critical care units in South Africa (SA. Methods. The SA Surgical Outcomes Study (SASOS was a 7-day national, multicentre, prospective, observational cohort study of all patients ≥16 years of age undergoing inpatient non-cardiac surgery between 19 and 26 May 2014 at 50 government-funded hospitals. All patients admitted to critical care units during this study were included for analysis. Results. Of the 3 927 SASOS patients, 255 (6.5% were admitted to critical care units; of these admissions, 144 (56.5% were planned, and 111 (43.5% unplanned. The incidence of confirmed or strongly suspected infection at the time of admission was 35.4%, with a significantly higher incidence in unplanned admissions (49.1 v. 24.8%, p<0.001. Unplanned admission cases were more frequently hypovolaemic, had septic shock, and required significantly more inotropic, ventilatory and renal support in the first 48 hours after admission. Overall mortality was 22.4%, with unplanned admissions having a significantly longer critical care length of stay and overall mortality (33.3 v. 13.9%, p<0.001. Conclusion. The outcome of patients admitted to public sector critical care units in SA is strongly associated with unplanned admissions. Adequate ‘high care-dependency units’ for postoperative care of elective surgical patients could potentially decrease the burden on critical care resources in SA by 23%. This study was registered on ClinicalTrials.gov (NCT02141867.

  16. The Effect of Inconsistency Appeals on the Influence of Direct-to-Consumer Prescription Drug Advertisements: An Application of Goal Disruption Theory.

    Science.gov (United States)

    Rosenberg, Benjamin D; Siegel, Jason T

    2016-01-01

    Scholars across multiple domains have identified the presence of inconsistency-arousing information in direct-to-consumer prescription drug advertisements and have suggested that these appeals, which highlight differences between people's actual and desired lives, may create psychological disequilibrium. However, experimental assessment of the distinct influence of inconsistency-arousing information in this domain is rare. Guided by goal disruption theory-a framework that outlines people's reactions to goal expectation violations-we created direct-to-consumer advertisements designed to make people's life inconsistencies salient. The influence of these ads on people's perceptions of, and intentions to use, prescription drugs was then assessed. Results from a structural equation modeling analysis supported the proposed model, indicating that compared to a control ad, an ad containing a goal expectation violation manipulation resulted in higher levels of psychological disequilibrium; in turn, psychological disequilibrium led to positive evaluations of the ad and the drug, positive outcome expectations of the drug, increased purposive harm endurance, and increased usage intentions. The current results suggest a psychological pathway that begins with a negative goal expectation violation and ends with increased usage intentions and a greater willingness to endure harm to make use possible.

  17. Consumer Preferences for Health and Nonhealth Outcomes of Health Promotion: Results from a Discrete Choice Experiment

    NARCIS (Netherlands)

    Alayli-Goebbels, A.F.G.; Dellaert, B.G.C.; Knox, S.A.; Ament, A.J.H.A.; Lakerveld, J.; Bot, S.D.M.; Nijpels, G.; Severens, J.L.

    2013-01-01

    Objective: Health promotion (HP) interventions have outcomes that go beyond health. Such broader nonhealth outcomes are usually neglected in economic evaluation studies. To allow for their consideration, insights are needed into the types of nonhealth outcomes that HP interventions produce and their

  18. Towards global consensus on outcome measures for atopic eczema research: results of the HOME II meeting

    NARCIS (Netherlands)

    Schmitt, Jochen; Spuls, Phyllis; Boers, Maarten; Thomas, Kim; Chalmers, Joanne; Roekevisch, Evelien; Schram, Mandy; Allsopp, Richard; Aoki, Valeria; Apfelbacher, Christian; Bruijnzeel-Koomen, Carla; Bruin-Weller, Marjolein; Charman, Carolyn; Cohen, Arnon; Dohil, Magdalene; Flohr, Carsten; Furue, Masutaka; Gieler, Uwe; Hooft, Lotty; Humphreys, Rosemary; Ishii, Henrique Akira; Katayama, Ichiro; Kouwenhoven, Willem; Langan, Sinéad; Lewis-Jones, Sue; Merhand, Stephanie; Murota, Hiroyuki; Murrell, Dedee F.; Nankervis, Helen; Ohya, Yukihiro; Oranje, Arnold; Otsuka, Hiromi; Paul, Carle; Rosenbluth, Yael; Saeki, Hidehisa; Schuttelaar, Marie-Louise; Stalder, Jean-Francois; Svensson, Ake; Takaoka, Roberto; Wahlgren, Carl-Fredrik; Weidinger, Stephan; Wollenberg, Andreas; Williams, Hywel

    2012-01-01

    The use of nonstandardized and inadequately validated outcome measures in atopic eczema trials is a major obstacle to practising evidence-based dermatology. The Harmonising Outcome Measures for Eczema (HOME) initiative is an international multiprofessional group dedicated to atopic eczema outcomes

  19. Towards global consensus on outcome measures for atopic eczema research : Results of the HOME II meeting

    NARCIS (Netherlands)

    Schmitt, Jochen; Spuls, Phyllis; Boers, Maarten; Thomas, Kim; Chalmers, Joanne; Roekevisch, Evelien; Schram, Mandy; Allsopp, Richard; Aoki, Valeria; Apfelbacher, Christian; Bruijnzeel-Koomen, Carla; Bruin-Weller, Marjolein; Charman, Carolyn; Cohen, Arnon; Dohil, Magdalene; Flohr, Carsten; Furue, Masutaka; Gieler, Uwe; Hooft, Lotty; Humphreys, Rosemary; Ishii, Henrique Akira; Katayama, Ichiro; Kouwenhoven, Willem; Langan, Sinéad; Lewis-Jones, Sue; Merhand, Stephanie; Murota, Hiroyuki; Murrell, Dedee F; Nankervis, Helen; Ohya, Yukihiro; Oranje, Arnold; Otsuka, Hiromi; Paul, Carle; Rosenbluth, Yael; Saeki, Hidehisa; Schuttelaar, Marie-Louise; Stalder, Jean-Francois; Svensson, Ake; Takaoka, Roberto; Wahlgren, Carl-Fredrik; Weidinger, Stephan; Wollenberg, Andreas; Williams, Hywel

    The use of nonstandardized and inadequately validated outcome measures in atopic eczema trials is a major obstacle to practising evidence-based dermatology. The Harmonising Outcome Measures for Eczema (HOME) initiative is an international multiprofessional group dedicated to atopic eczema outcomes

  20. An iterative approach to case study analysis: insights from qualitative analysis of quantitative inconsistencies

    Directory of Open Access Journals (Sweden)

    Allain J Barnett

    2016-09-01

    Full Text Available Large-N comparative studies have helped common pool resource scholars gain general insights into the factors that influence collective action and governance outcomes. However, these studies are often limited by missing data, and suffer from the methodological limitation that important information is lost when we reduce textual information to quantitative data. This study was motivated by nine case studies that appeared to be inconsistent with the expectation that the presence of Ostrom’s Design Principles increases the likelihood of successful common pool resource governance. These cases highlight the limitations of coding and analysing Large-N case studies. We examine two issues: 1 the challenge of missing data and 2 potential approaches that rely on context (which is often lost in the coding process to address inconsistencies between empirical observations theoretical predictions.  For the latter, we conduct a post-hoc qualitative analysis of a large-N comparative study to explore 2 types of inconsistencies: 1 cases where evidence for nearly all design principles was found, but available evidence led to the assessment that the CPR system was unsuccessful and 2 cases where the CPR system was deemed successful despite finding limited or no evidence for design principles.  We describe inherent challenges to large-N comparative analysis to coding complex and dynamically changing common pool resource systems for the presence or absence of design principles and the determination of “success”.  Finally, we illustrate how, in some cases, our qualitative analysis revealed that the identity of absent design principles explained inconsistencies hence de-facto reconciling such apparent inconsistencies with theoretical predictions.  This analysis demonstrates the value of combining quantitative and qualitative analysis, and using mixed-methods approaches iteratively to build comprehensive methodological and theoretical approaches to understanding

  1. Valence instabilities as a source of actinide system inconsistencies

    International Nuclear Information System (INIS)

    Sandenaw, T.A.

    1979-01-01

    Light actinide elements alone, and in some of their alloys, may exist as a static or dynamic mixture of two configurations. Such a state can explain both a resistivity maximum and lack of magnetic order observed in so many actinide materials, and still be compatible with the existence of f-electrons in narrow bands. Impurity elements may stabilize slightly different intermediate valence states in U, Np, and Pu, thus contributing to inconsistencies in published results. The physical property behavior of mixed-valence, rare-earth compounds is very much like that observed in development of antiphase (martensitic) structures. Martensitic transformations in U, Np, and Pu, from high-temperature b. c. c. to alpha phase, may be a way of ordering an alloy-like metal of mixed or intermediate valence. The relative stability of each phase structure may depend upon its electron-valence ratio. A Hubbard model for electron correlations in a narrow energy band has been invoked in most recent theories for explaining light actinide behavior. Such a model may also be applicable to crystal symmetry changes in martensitic transformations in actinides

  2. Sexual outcomes after partial penectomy for penile cancer: results from a multi-institutional study

    Directory of Open Access Journals (Sweden)

    Salvatore Sansalone

    2017-01-01

    Full Text Available Penile cancer is an uncommon malignancy. Surgical treatment is inevitably mutilating. Considering the strong impact on patients′ sexual life we want to evaluate sexual function and satisfaction after partial penectomy. The patients in this study (n = 25 represented all those who attended our institutions and were diagnosed and treated for penile cancer from October 2011 to November 2013. All patients underwent partial penectomy and followed-up (mean: 14 months; range: 12-25. Sexual presurgical baseline was estimated using the International Index of Erectile Dysfunction 15 (IIEF-15. Sexual outcomes of each patient were estimated considering four standardized and validated questionnaires. We analyzed the means and ranges of IIEF-15 including erectile function (IIEF-1-5 and -15, orgasmic function (IIEF-9 and -10, sexual desire (IIEF-11 and -12, intercourse satisfaction (IIEF-6-8, and overall satisfaction (IIEF-13 and -14. Then, we also used Quality of Erection Questionnaire (QEQ, Erectile Dysfunction Inventory of Treatment Satisfaction (EDITS and Self-Esteem and Relationship (SEAR to evaluate the sexual function and satisfaction of our patients. The final results showed that penile cancer leads to several sexual and psychosexual dysfunctions. Nevertheless, patients who undergo partial penectomy for penile cancer can maintain the sexual outcomes at levels slightly lower to those that existed in the period before surgery.

  3. Results after laparoscopic partial splenectomy for children with hereditary spherocytosis: Are outcomes influenced by genetic mutation?

    Science.gov (United States)

    Pugi, Jakob; Carcao, Manuel; Drury, Luke J; Langer, Jacob C

    2018-05-01

    Laparoscopic partial splenectomy (LPS) theoretically maintains long-term splenic immune function for children with hereditary spherocytosis (HS). Our goal was to review our results after LPS and to determine if specific genetic mutations influence outcome. All children with HS undergoing LPS between 2005 and 2016 were reviewed. Thirty-one children underwent LPS (16 male) at a median age of 9 (range 2-18) years. All experienced an increase in hemoglobin and decrease in reticulocyte count early after LPS and at last follow-up. Twenty-two were sent for genetic analysis. Mutations in α-spectrin, β-spectrin, and Ankyrin were identified in 6, 5, and 11 patients, respectively. Gene mutation was not correlated with complications, perioperative transfusion, length of hospital stay, or median hemoglobin, platelet, or reticulocyte counts. Three children required completion splenectomy at 10.9, 6.9, and 3.2years post-LPS, each with a different gene mutation. LPS is effective in reversing anemia and reducing reticulocytosis. So far less than 10% have required completion splenectomy, and those children did benefit from delaying the risks of asplenia. In this preliminary analysis, genetic mutation did not influence outcome after LPS. A larger multicenter study is necessary to further investigate potential correlations with specific genetic mutations. Prognosis Study. IV. Copyright © 2018. Published by Elsevier Inc.

  4. Inconsistency effects in source memory and compensatory schema-consistent guessing.

    Science.gov (United States)

    Küppers, Viviane; Bayen, Ute J

    2014-10-01

    The attention-elaboration hypothesis of memory for schematically unexpected information predicts better source memory for unexpected than expected sources. In three source-monitoring experiments, the authors tested the occurrence of an inconsistency effect in source memory. Participants were presented with items that were schematically either very expected or very unexpected for their source. Multinomial processing tree models were used to separate source memory, item memory, and guessing bias. Results show an inconsistency effect in source memory accompanied by a compensatory schema-consistent guessing bias when expectancy strength is high, that is, when items are very expected or very unexpected for their source.

  5. How Teachers' Beliefs About Climate Change Influence Their Instruction and Resulting Student Outcomes

    Science.gov (United States)

    Nation, M.; Feldman, A.; Smith, G.

    2017-12-01

    The purpose of the study was to understand the relationship between teachers' beliefs and understandings of climate change and their instructional practices to determine if and how they impact student outcomes. Limited research has been done in the area of teacher beliefs on climate change, their instruction, and resulting student outcomes. This study contributes to the greater understanding of teachers' beliefs and impact on climate change curriculum implementation. The study utilized a mixed methods approach to data collection and analysis. Data were collected in the form of classroom observations, surveys, and interviews from teachers and students participating in the study over a four-month period. Qualitative and quantitative findings were analyzed through thematic coding and descriptive analysis and compared in an effort to triangulate findings. The results of the study suggest teachers and students believe climate change is occurring and humans are largely to blame. Personal beliefs are important when teaching controversial topics, such as climate change, but participants maintained neutrality within their instruction of the topic, as not to appear biased or influence students' decisions about climate change, and avoid political controversy in the classroom. Overall, the study found teachers' level of understandings and beliefs about climate change had little impact on their instruction and resulting student outcomes. Based on the findings, simply adding climate change to the existing science curriculum is not sufficient for teachers or students. Teachers need to be better prepared about effective pedagogical practices of the content in order to effectively teach a climate-centered curriculum. The barriers that exist for the inclusion of teachers' personal beliefs need to be removed in order for teachers to assert their own personal beliefs about climate change within their classroom instruction. Administrators and stakeholders need to support science

  6. Towards global consensus on outcome measures for atopic eczema research: results of the HOME II meeting.

    Science.gov (United States)

    Schmitt, Jochen; Spuls, Phyllis; Boers, Maarten; Thomas, Kim; Chalmers, Joanne; Roekevisch, Evelien; Schram, Mandy; Allsopp, Richard; Aoki, Valeria; Apfelbacher, Christian; Bruijnzeel-Koomen, Carla; Bruin-Weller, Marjolein; Charman, Carolyn; Cohen, Arnon; Dohil, Magdalene; Flohr, Carsten; Furue, Masutaka; Gieler, Uwe; Hooft, Lotty; Humphreys, Rosemary; Ishii, Henrique Akira; Katayama, Ichiro; Kouwenhoven, Willem; Langan, Sinéad; Lewis-Jones, Sue; Merhand, Stephanie; Murota, Hiroyuki; Murrell, Dedee F; Nankervis, Helen; Ohya, Yukihiro; Oranje, Arnold; Otsuka, Hiromi; Paul, Carle; Rosenbluth, Yael; Saeki, Hidehisa; Schuttelaar, Marie-Louise; Stalder, Jean-Francois; Svensson, Ake; Takaoka, Roberto; Wahlgren, Carl-Fredrik; Weidinger, Stephan; Wollenberg, Andreas; Williams, Hywel

    2012-09-01

    The use of nonstandardized and inadequately validated outcome measures in atopic eczema trials is a major obstacle to practising evidence-based dermatology. The Harmonising Outcome Measures for Eczema (HOME) initiative is an international multiprofessional group dedicated to atopic eczema outcomes research. In June 2011, the HOME initiative conducted a consensus study involving 43 individuals from 10 countries, representing different stakeholders (patients, clinicians, methodologists, pharmaceutical industry) to determine core outcome domains for atopic eczema trials, to define quality criteria for atopic eczema outcome measures and to prioritize topics for atopic eczema outcomes research. Delegates were given evidence-based information, followed by structured group discussion and anonymous consensus voting. Consensus was achieved to include clinical signs, symptoms, long-term control of flares and quality of life into the core set of outcome domains for atopic eczema trials. The HOME initiative strongly recommends including and reporting these core outcome domains as primary or secondary endpoints in all future atopic eczema trials. Measures of these core outcome domains need to be valid, sensitive to change and feasible. Prioritized topics of the HOME initiative are the identification/development of the most appropriate instruments for the four core outcome domains. HOME is open to anyone with an interest in atopic eczema outcomes research. © 2012 John Wiley & Sons A/S.

  7. Outcomes after cataract surgery in eyes with pseudoexfoliation: Results from the Veterans Affairs Ophthalmic Surgery Outcomes Data Project.

    Science.gov (United States)

    Turalba, Angela; Cakiner-Egilmez, Tulay; Payal, Abhishek R; Gonzalez-Gonzalez, Luis A; Chomsky, Amy S; Vollman, David E; Baze, Elizabeth F; Lawrence, Mary G; Daly, Mary K

    2017-02-01

    To compare clinical outcomes of cataract surgery in eyes with and without pseudoexfoliation (PXF). Retrospective deidentified data analysis. A total of 123 PXF and 4776 non-PXF eyes of patients who underwent cataract surgery. We compared data on visual acuity, Visual Function Questionnaire (VFQ)-based quality of life, and complications in PXF and non-PXF eyes from the Veterans Affairs (VA) Ophthalmic Surgery Outcomes Data Project across 5 VA medical centres. Pupillary expansion devices were used in 31 (25.2%) PXF cases and 398 (8.4%) non-PXF cases (p < 0.0001). Capsular tension rings were used in 6 (4.9%) PXF cases and 55 (1.2%) non-PXF cases (p < 0.004). The following complications occurred more frequently in PXF cases: zonular dehiscence without vitrectomy (4 [3.3%] PXF cases vs 40 [0.8%] non-PXF cases p = 0.02), persistent inflammation (28 [24.1%] vs 668 [14.5%]; p = 0.007), and persistent intraocular pressure elevation (5 [4.3%] vs 68 [1.5%]; p = 0.03). Best corrected visual acuity (BCVA) improved in both groups after 1 month, but 87 (83.7%) PXF cases achieved postoperative BCVA better than or equal to 20/40 compared to 3991 (93.8%) non-PXF cases (p = 0.0003). There was no significant difference in the postoperative composite VFQ scores between PXF (82.1 ± 16.9) and non-PXF cases (84.2 ± 16.8, p = 0.09). Several complications occurred more frequently in the PXF group compared to the non-PXF group, and fewer PXF cases achieved BCVA better than or equal to 20/40. Despite this, both groups experienced similar improvement in vision-related quality of life after cataract surgery. Published by Elsevier Inc.

  8. Auditing hierarchical cycles to locate other inconsistencies in the UMLS.

    Science.gov (United States)

    Halper, Michael; Morrey, C Paul; Chen, Yan; Elhanan, Gai; Hripcsak, George; Perl, Yehoshua

    2011-01-01

    A cycle in the parent relationship hierarchy of the UMLS is a configuration that effectively makes some concept(s) an ancestor of itself. Such a structural inconsistency can easily be found automatically. A previous strategy for disconnecting cycles is to break them with the deletion of one or more parent relationships-irrespective of the correctness of the deleted relationships. A methodology is introduced for auditing of cycles that seeks to discover and delete erroneous relationships only. Cycles involving three concepts are the primary consideration. Hypotheses about the high probability of locating an erroneous parent relationship in a cycle are proposed and confirmed with statistical confidence and lend credence to the auditing approach. A cycle may serve as an indicator of other non-structural inconsistencies that are otherwise difficult to detect automatically. An extensive auditing example shows how a cycle can indicate further inconsistencies.

  9. Auditing Hierarchical Cycles to Locate Other Inconsistencies in the UMLS

    Science.gov (United States)

    Halper, Michael; Morrey, C. Paul; Chen, Yan; Elhanan, Gai; Hripcsak, George; Perl, Yehoshua

    2011-01-01

    A cycle in the parent relationship hierarchy of the UMLS is a configuration that effectively makes some concept(s) an ancestor of itself. Such a structural inconsistency can easily be found automatically. A previous strategy for disconnecting cycles is to break them with the deletion of one or more parent relationships—irrespective of the correctness of the deleted relationships. A methodology is introduced for auditing of cycles that seeks to discover and delete erroneous relationships only. Cycles involving three concepts are the primary consideration. Hypotheses about the high probability of locating an erroneous parent relationship in a cycle are proposed and confirmed with statistical confidence and lend credence to the auditing approach. A cycle may serve as an indicator of other non-structural inconsistencies that are otherwise difficult to detect automatically. An extensive auditing example shows how a cycle can indicate further inconsistencies. PMID:22195107

  10. TOWARDS A PHILOSOPHICAL UNDERSTANDING OF THE LOGICS OF FORMAL INCONSISTENCY

    Directory of Open Access Journals (Sweden)

    WALTER CARNIELLI

    2015-01-01

    Full Text Available AbstractIn this paper we present a philosophical motivation for the logics of formal inconsistency, a family of paraconsistent logics whose distinctive feature is that of having resources for expressing the notion of consistency within the object language in such a way that consistency may be logically independent of non-contradiction. We defend the view according to which logics of formal inconsistency may be interpreted as theories of logical consequence of an epistemological character. We also argue that in order to philosophically justify paraconsistency there is no need to endorse dialetheism, the thesis that there are true contradictions. Furthermore, we show that mbC, a logic of formal inconsistency based on classical logic, may be enhanced in order to express the basic ideas of an intuitive interpretation of contradictions as conflicting evidence.

  11. Endoscopic Therapy for Achalasia Before Heller Myotomy Results in Worse Outcomes Than Heller Myotomy Alone

    Science.gov (United States)

    Smith, C Daniel; Stival, Alessandro; Howell, D Lee; Swafford, Vickie

    2006-01-01

    Objective: Heller myotomy has been shown to be an effective primary treatment of achalasia. However, many physicians treating patients with achalasia continue to offer endoscopic therapies before recommending operative myotomy. Herein we report outcomes in 209 patients undergoing Heller myotomy with the majority (74%) undergoing myotomy as secondary treatment of achalasia. Methods: Data on all patients undergoing operative management of achalasia are collected prospectively. Over a 9-year period (1994–2003), 209 patients underwent Heller myotomy for achalasia. Of these, 154 had undergone either Botox injection and/or pneumatic dilation preoperatively. Preoperative, operative, and long-term outcome data were analyzed. Statistical analysis was performed with multiple χ2 and Mann-Whitney U analyses, as well as ANOVA. Results: Among the 209 patients undergoing Heller myotomy for achalasia, 154 received endoscopic therapy before being referred for surgery (100 dilation only, 33 Botox only, 21 both). The groups were matched for preoperative demographics and symptom scores for dysphagia, regurgitation, and chest pain. Intraoperative complications were more common in the endoscopically treated group with GI perforations being the most common complication (9.7% versus 3.6%). Postoperative complications, primarily severe dysphagia, and pulmonary complications were more common after endoscopic treatment (10.4% versus 5.4%). Failure of myotomy as defined by persistent or recurrent severe symptoms, or need for additionally therapy including redo myotomy or esophagectomy was higher in the endoscopically treated group (19.5% versus 10.1%). Conclusion: Use of preoperative endoscopic therapy remains common and has resulted in more intraoperative complications, primarily perforation, more postoperative complications, and a higher rate of failure than when no preoperative therapy was used. Endoscopic therapy for achalasia should not be used unless patients are not candidates for

  12. Dimensions of poverty and inconsistent condom use among youth in urban Kenya.

    Science.gov (United States)

    Davidoff-Gore, Alena; Luke, Nancy; Wawire, Salome

    2011-10-01

    To date, research on the link between poverty and unsafe sexual behaviors has utilized limited measures of socioeconomic status and has overlooked key dimensions of poverty at the individual level. This study explored how various dimensions of socioeconomic status are associated with inconsistent condom use and how these associations vary by gender. We analyzed unique life history survey data from 261 young men and women in Kisumu, Kenya, and conducted analyses based on 959 person-months in which respondents had been sexually active in nonmarital relationships. Dependent variables were inconsistent condom use (not always using a condom) and never use of condoms. Condoms were used inconsistently in 57% of months and were never used in 31%. Corroborating existing literature, lower household wealth and lower educational attainment were associated with inconsistent condom use. Lower individual economic status (lower earned income, food insufficiency, and larger material transfers from partners) were also important determinants of inconsistent condom use. There were no significant differences in these associations by gender, with the exception of food insufficiency, which increased the risk of inconsistent condom use for young women but not for young men. None of these individual measures of socioeconomic status were associated with never use of a condom. The findings suggest that both household- and individual-level measures of socioeconomic status are important correlates of condom use and that individual economic resources play a crucial role in negotiations over the highest level of usage. The results highlight the importance of poverty in shaping sexual behavior, and, in particular, that increasing individual access to resources beyond the household, including ensuring access to food and providing educational and work opportunities, could prove to be effective strategies for decreasing the risk of HIV among youth.

  13. Developing a workflow to identify inconsistencies in volunteered geographic information: a phenological case study

    Science.gov (United States)

    Mehdipoor, Hamed; Zurita-Milla, Raul; Rosemartin, Alyssa; Gerst, Katharine L.; Weltzin, Jake F.

    2015-01-01

    Recent improvements in online information communication and mobile location-aware technologies have led to the production of large volumes of volunteered geographic information. Widespread, large-scale efforts by volunteers to collect data can inform and drive scientific advances in diverse fields, including ecology and climatology. Traditional workflows to check the quality of such volunteered information can be costly and time consuming as they heavily rely on human interventions. However, identifying factors that can influence data quality, such as inconsistency, is crucial when these data are used in modeling and decision-making frameworks. Recently developed workflows use simple statistical approaches that assume that the majority of the information is consistent. However, this assumption is not generalizable, and ignores underlying geographic and environmental contextual variability that may explain apparent inconsistencies. Here we describe an automated workflow to check inconsistency based on the availability of contextual environmental information for sampling locations. The workflow consists of three steps: (1) dimensionality reduction to facilitate further analysis and interpretation of results, (2) model-based clustering to group observations according to their contextual conditions, and (3) identification of inconsistent observations within each cluster. The workflow was applied to volunteered observations of flowering in common and cloned lilac plants (Syringa vulgaris and Syringa x chinensis) in the United States for the period 1980 to 2013. About 97% of the observations for both common and cloned lilacs were flagged as consistent, indicating that volunteers provided reliable information for this case study. Relative to the original dataset, the exclusion of inconsistent observations changed the apparent rate of change in lilac bloom dates by two days per decade, indicating the importance of inconsistency checking as a key step in data quality

  14. Developing a Workflow to Identify Inconsistencies in Volunteered Geographic Information: A Phenological Case Study.

    Science.gov (United States)

    Mehdipoor, Hamed; Zurita-Milla, Raul; Rosemartin, Alyssa; Gerst, Katharine L; Weltzin, Jake F

    2015-01-01

    Recent improvements in online information communication and mobile location-aware technologies have led to the production of large volumes of volunteered geographic information. Widespread, large-scale efforts by volunteers to collect data can inform and drive scientific advances in diverse fields, including ecology and climatology. Traditional workflows to check the quality of such volunteered information can be costly and time consuming as they heavily rely on human interventions. However, identifying factors that can influence data quality, such as inconsistency, is crucial when these data are used in modeling and decision-making frameworks. Recently developed workflows use simple statistical approaches that assume that the majority of the information is consistent. However, this assumption is not generalizable, and ignores underlying geographic and environmental contextual variability that may explain apparent inconsistencies. Here we describe an automated workflow to check inconsistency based on the availability of contextual environmental information for sampling locations. The workflow consists of three steps: (1) dimensionality reduction to facilitate further analysis and interpretation of results, (2) model-based clustering to group observations according to their contextual conditions, and (3) identification of inconsistent observations within each cluster. The workflow was applied to volunteered observations of flowering in common and cloned lilac plants (Syringa vulgaris and Syringa x chinensis) in the United States for the period 1980 to 2013. About 97% of the observations for both common and cloned lilacs were flagged as consistent, indicating that volunteers provided reliable information for this case study. Relative to the original dataset, the exclusion of inconsistent observations changed the apparent rate of change in lilac bloom dates by two days per decade, indicating the importance of inconsistency checking as a key step in data quality

  15. WE-F-304-00: Outcomes of Hypofractionated Treatments - Results of the WGSBRT

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2015-06-15

    Stereotactic Body Radiation Therapy (SBRT) was introduced clinically more than twenty years ago, and many subsequent publications have reported safety and efficacy data. The AAPM Working Group on Biological Effects of Hypofractionated Radiotherapy/SBRT (WGSBRT) extracted published treatment outcomes data from extensive literature searches to summarize and construct tumor control probability (TCP) and normal tissue complication probability (NTCP) models for six anatomical regions: Cranial, Head and Neck, Thoracic, Abdominal, Pelvic, and Spinal. In this session, we present the WGSBRT’s work for cranial sites, and recurrent head and neck cancer. From literature-based data and associated models, guidelines to aid with safe and effective hypofractionated radiotherapy treatment are being determined. Further, the ability of existing and proposed radiobiological models to fit these data is considered as to the ability to distinguish between the linear-quadratic and alternative radiobiological models such as secondary cell death from vascular damage, immunogenic, or bystander effects. Where appropriate, specific model parameters are estimated. As described in “The lessons of QUANTEC,” (1), lack of adequate reporting standards continues to limit the amount of useful quantitative information that can be extracted from peer-reviewed publications. Recommendations regarding reporting standards are considered, to enable such reviews to achieve more complete characterization of clinical outcomes. 1 Jackson A, Marks LB, Bentzen SM, Eisbruch A, Yorke ED, Ten Haken RK, Constine LS, Deasy JO. The lessons of QUANTEC: recommendations for reporting and gathering data on dose-volume dependencies of treatment outcome. Int J Radiat Oncol Biol Phys. 2010 Mar 1;76(3 Suppl):S155–60. Learning Objectives: Describe the techniques, types of cancer and dose schedules used in treating recurrent H&N cancers with SBRT List the radiobiological models that compete with the linear-quadratic model

  16. WE-F-304-00: Outcomes of Hypofractionated Treatments - Results of the WGSBRT

    International Nuclear Information System (INIS)

    2015-01-01

    Stereotactic Body Radiation Therapy (SBRT) was introduced clinically more than twenty years ago, and many subsequent publications have reported safety and efficacy data. The AAPM Working Group on Biological Effects of Hypofractionated Radiotherapy/SBRT (WGSBRT) extracted published treatment outcomes data from extensive literature searches to summarize and construct tumor control probability (TCP) and normal tissue complication probability (NTCP) models for six anatomical regions: Cranial, Head and Neck, Thoracic, Abdominal, Pelvic, and Spinal. In this session, we present the WGSBRT’s work for cranial sites, and recurrent head and neck cancer. From literature-based data and associated models, guidelines to aid with safe and effective hypofractionated radiotherapy treatment are being determined. Further, the ability of existing and proposed radiobiological models to fit these data is considered as to the ability to distinguish between the linear-quadratic and alternative radiobiological models such as secondary cell death from vascular damage, immunogenic, or bystander effects. Where appropriate, specific model parameters are estimated. As described in “The lessons of QUANTEC,” (1), lack of adequate reporting standards continues to limit the amount of useful quantitative information that can be extracted from peer-reviewed publications. Recommendations regarding reporting standards are considered, to enable such reviews to achieve more complete characterization of clinical outcomes. 1 Jackson A, Marks LB, Bentzen SM, Eisbruch A, Yorke ED, Ten Haken RK, Constine LS, Deasy JO. The lessons of QUANTEC: recommendations for reporting and gathering data on dose-volume dependencies of treatment outcome. Int J Radiat Oncol Biol Phys. 2010 Mar 1;76(3 Suppl):S155–60. Learning Objectives: Describe the techniques, types of cancer and dose schedules used in treating recurrent H&N cancers with SBRT List the radiobiological models that compete with the linear-quadratic model

  17. Trochleoplasty as a Solitary Treatment for Recurrent Patellar Dislocation Results in Good Clinical Outcome in Adolescents.

    Science.gov (United States)

    Camathias, Carlo; Studer, Katrin; Kiapour, Ata; Rutz, Erich; Vavken, Patrick

    2016-11-01

    The essential static patellar stabilizer is a normal-shaped trochlear groove. A dysplastic groove destabilizes the patella. Trochleoplasty approaches this underlying condition and reshapes the trochlea. However, studies have reported on trochleoplasty for revision cases or as accompanied by other interventions. The effect of trochleoplasty alone remains unexplained. To introduce trochleoplasty as a stand-alone treatment for recurrent patellar dislocation and to compare its pre- to postoperative functional and clinical variables. Case series; Level of evidence, 4. A trochleoplasty was performed in 50 knees (27 right) in 44 patients (30 females; mean ± SD age, 15.6 ± 2.0 years). The indication for surgery was recurrent patellar dislocation not responding to nonoperative treatment (>6 months), with types B through D dysplasia and closed or closing physes in adolescents aged 10 to 20 years. Assessment included J-sign and apprehension test, Kujala and Lysholm scores, patients' subjective assessment and activity level according to the International Knee Documentation Committee questionnaire, and patients' overall satisfaction. The Caton-Deschamps ratio and the lateral condyle index were measured. Pre- versus postoperative values were compared with a paired Wilcoxon signed-rank test. The minimum follow-up was 24 months (33 ± 10.6 months). The Kujala score improved from 71 preoperatively to 92 postoperatively (P debridement. In this study, trochleoplasty as a solitary treatment for recurrent patellofemoral dislocations in patients with trochlear dysplasia resulted in good clinical outcomes if severe torsional and axial malalignment was excluded. Kujala and Lysholm scores increased postoperatively, as well as subjective International Knee Documentation Committee assessment of outcomes, activity level, and overall satisfaction. © 2016 The Author(s).

  18. Outcomes of Concurrent Operations: Results From the American College of Surgeons' National Surgical Quality Improvement Program.

    Science.gov (United States)

    Liu, Jason B; Berian, Julia R; Ban, Kristen A; Liu, Yaoming; Cohen, Mark E; Angelos, Peter; Matthews, Jeffrey B; Hoyt, David B; Hall, Bruce L; Ko, Clifford Y

    2017-09-01

    To determine whether concurrently performed operations are associated with an increased risk for adverse events. Concurrent operations occur when a surgeon is simultaneously responsible for critical portions of 2 or more operations. How this practice affects patient outcomes is unknown. Using American College of Surgeons' National Surgical Quality Improvement Program data from 2014 to 2015, operations were considered concurrent if they overlapped by ≥60 minutes or in their entirety. Propensity-score-matched cohorts were constructed to compare death or serious morbidity (DSM), unplanned reoperation, and unplanned readmission in concurrent versus non-concurrent operations. Multilevel hierarchical regression was used to account for the clustered nature of the data while controlling for procedure and case mix. There were 1430 (32.3%) surgeons from 390 (77.7%) hospitals who performed 12,010 (2.3%) concurrent operations. Plastic surgery (n = 393 [13.7%]), otolaryngology (n = 470 [11.2%]), and neurosurgery (n = 2067 [8.4%]) were specialties with the highest proportion of concurrent operations. Spine procedures were the most frequent concurrent procedures overall (n = 2059/12,010 [17.1%]). Unadjusted rates of DSM (9.0% vs 7.1%; P < 0.001), reoperation (3.6% vs 2.7%; P < 0.001), and readmission (6.9% vs 5.1%; P < 0.001) were greater in the concurrent operation cohort versus the non-concurrent. After propensity score matching and risk-adjustment, there was no significant association of concurrence with DSM (odds ratio [OR] 1.08; 95% confidence interval [CI] 0.96-1.21), reoperation (OR 1.16; 95% CI 0.96-1.40), or readmission (OR 1.14; 95% CI 0.99-1.29). In these analyses, concurrent operations were not detected to increase the risk for adverse outcomes. These results do not lessen the need for further studies, continuous self-regulation and proactive disclosure to patients.

  19. [Results of two treatment regimens for pyelonephritis during pregnancy and correlation with pregnancy outcome].

    Science.gov (United States)

    Calegari, Saron Souza; Konopka, Cristine Kolling; Balestrin, Bruna; Hoffmann, Maurício Scopel; de Souza, Floriano Soeiro; Resener, Elaine Verena

    2012-08-01

    To determine the epidemiological profile of women admitted for urinary tract infection as well as to verify the most prevalent agents and response to antibiotic therapy. A retrospective study of 106 pregnant women admitted to a university hospital for urinary tract infection treatment during the period between January 2007 to December 2010. The evaluation was based on analysis of the medical records of these pregnant women, with the observation of hospitalization and pregnancy data, as well as its outcome. Statistical analysis was performed using Statistical Package for the Social Science, version 15.0. The bilateral Fisher exact test and Student's t test were used for data analysis, as well as descriptive statistical methods. Positive urine cultures were observed in 60.5% of pregnant women admitted due to urinary tract infection. The most frequent infectious agent was Escherichia coli and no difference in resistance, recurrence or complications was observed between the most frequent etiologic agents. Pregnant women with previous UTI had a higher recurrence risk (OR=10.8; p<0.05). The antibiotics most commonly used during hospitalization were ampicillin and cefazolin. Change of therapeutic agent due to bacterial resistance occurred in 11.9% of patients who took cefazolin and in 20% of patients who took ampicillin (OR=5.5; p<0.05). The rate of gestational complications was the same for both treatments. There was no difference in mean number of days of hospitalization between the treatments. In the studied population ampicillin showed a higher rate of bacterial resistance than cefazolin, requiring a larger number of treatment regimen exchanges, without resulting in differences in clinical outcome or time of hospitalization.

  20. Spelling and Phonetic Inconsistencies in English: A Problem for ...

    African Journals Online (AJOL)

    But it is not the case in English. English spelling is defective. It is a poor reflection of English pronunciation as we have not enough symbols to represent all the sounds of English. The problems of these inconsistencies to foreign and second language learners can not be overemphasized. This study will look at the historical ...

  1. Journal data sharing policies and statistical reporting inconsistencies in psychology.

    NARCIS (Netherlands)

    Nuijten, M.B.; Borghuis, J.; Veldkamp, C.L.S.; Dominguez Alvarez, L.; van Assen, M.A.L.M.; Wicherts, J.M.

    2018-01-01

    In this paper, we present three retrospective observational studies that investigate the relation between data sharing and statistical reporting inconsistencies. Previous research found that reluctance to share data was related to a higher prevalence of statistical errors, often in the direction of

  2. Inconsistencies in quality of life data collection in clinical trials: a potential source of bias? Interviews with research nurses and trialists.

    Science.gov (United States)

    Kyte, Derek; Ives, Jonathan; Draper, Heather; Keeley, Thomas; Calvert, Melanie

    2013-01-01

    Patient-reported outcomes (PROs), such as health-related quality of life (HRQL) are increasingly used to evaluate treatment effectiveness in clinical trials, are valued by patients, and may inform important decisions in the clinical setting. It is of concern, therefore, that preliminary evidence, gained from group discussions at UK-wide Medical Research Council (MRC) quality of life training days, suggests there are inconsistent standards of HRQL data collection in trials and appropriate training and education is often lacking. Our objective was to investigate these reports, to determine if they represented isolated experiences, or were indicative of a potentially wider problem. We undertook a qualitative study, conducting 26 semi-structured interviews with research nurses, data managers, trial coordinators and research facilitators involved in the collection and entry of HRQL data in clinical trials, across one primary care NHS trust, two secondary care NHS trusts and two clinical trials units in the UK. We used conventional content analysis to analyze and interpret our data. Our study participants reported (1) inconsistent standards in HRQL measurement, both between, and within, trials, which appeared to risk the introduction of bias; (2), difficulties in dealing with HRQL data that raised concern for the well-being of the trial participant, which in some instances led to the delivery of non-protocol driven co-interventions, (3), a frequent lack of HRQL protocol content and appropriate training and education of trial staff, and (4) that HRQL data collection could be associated with emotional and/or ethical burden. Our findings suggest there are inconsistencies in the standards of HRQL data collection in some trials resulting from a general lack of HRQL-specific protocol content, training and education. These inconsistencies could lead to biased HRQL trial results. Future research should aim to develop HRQL guidelines and training programmes aimed at supporting

  3. SPECIFIC COURSE OF PREGNANCY, PERINATAL OUTCOMES AND TREATMENT RESULTS IN HIV NEGATIVE FEMALE PATIENTS

    Directory of Open Access Journals (Sweden)

    A. V. Nesterenko

    2017-01-01

    Full Text Available The objective of the study is to investigate the specific course of pregnancy, perinatal outcomes and treatment results in HIV negative female patients.Subjects and Methods. Medical files of 109 pregnant tuberculosis patients were analyzed who were followed up in Krasnoyarsk Regional TB Dispensary no. 1 from 2010 to 2014.Results. The part of children prematurely born by mothers ill with tuberculosis was practically compatible with the overall national cohort of live-born children (6.8% in the analyzed group versus 5.7% in the national cohort for 2014. The part of children with congenital abnormalities born by mothers suffering from tuberculosis turned out to be twice lower versus the overall national cohort of live-born children (1.4% versus 3.0% in 2010 and 2.9% in 2014.The efficiency of the main treatment course in pregnant women without multiple drug resistant tuberculosis, of which 3.8 ± 0.3 months of tuberculosis treatment coincided with pregnancy was practically the same as treatment efficiency for the overall cohort of patients in Krasnoyarsky Kray (66.2% in the analyzed cohort versus 60.3-72.7% in the regional cohort for 2010-2014. In the pregnant with multiple drug resistant forms of tuberculosis, treatment efficiency was lower versus the regional cohort (30.4% in the analyzed cohort versus 41.1-60.2% in the regional cohort for 2010-2014. 

  4. Risk of Performance Decrements and Adverse Health Outcomes Resulting from Sleep Loss, Circadian Desynchronization, and Work Overload

    Science.gov (United States)

    Flynn-Evans, Erin; Gregory, Kevin; Arsintescu, Lucia; Whitmire, Alexandra

    2016-01-01

    needed to evaluate fitness-for-duty during spaceflight. Although ground-based evidence supports the notion that sleep loss, circadian desynchronization and work overload lead to performance impairment, inconsistency in the measures used to evaluate performance during spaceflight make it difficult to evaluate the magnitude of performance impairment during spaceflight. Work is underway to standardize measures of performance evaluation during spaceflight. Once established, such performance indicators need to be correlated with operational performance. Individual differences in sleep need and circadian preference, phase shifting ability and period have been documented in ground-based studies. Individual differences in response to sleep loss and circadian misalignment have also been documented and are presumed to be associated with genetic polymorphisms. No studies have systematically reported individual differences in sleep or circadian-related outcomes during spaceflight. More work is needed in this area in order to identify genetic or phenotypic biomarkers that predict resilience or vulnerability to sleep loss in order to personalize countermeasure strategies and mitigate performance impairment during spaceflight. Two laboratory and field investigations specific to this topic are currently ongoing; additional efforts, including an effort to mine existing biological data from spaceflight relative to sleep and circadian outcomes, are planned. Sex differences in sleep need and circadian period and phase have been reported in ground-based studies. The impact of these sex differences on performance is unclear. Sex differences in sleep need and circadian rhythms have not been systematically studied during spaceflight, presumably due to the small number of women that have flown in space. More research is needed in this area to evaluate whether any of the observed sex differences in physiology lead to altered performance in spaceflight and on the ground.

  5. Consumer preferences for health and nonhealth outcomes of health promotion: results from a discrete choice experiment.

    Science.gov (United States)

    Alayli-Goebbels, Adrienne F G; Dellaert, Benedict G C; Knox, Stephanie A; Ament, André J H A; Lakerveld, Jeroen; Bot, Sandra D M; Nijpels, G; Severens, J L

    2013-01-01

    Health promotion (HP) interventions have outcomes that go beyond health. Such broader nonhealth outcomes are usually neglected in economic evaluation studies. To allow for their consideration, insights are needed into the types of nonhealth outcomes that HP interventions produce and their relative importance compared with health outcomes. This study explored consumer preferences for health and nonhealth outcomes of HP in the context of lifestyle behavior change. A discrete choice experiment was conducted among participants in a lifestyle intervention (n = 132) and controls (n = 141). Respondents made 16 binary choices between situations that can be experienced after lifestyle behavior change. The situations were described by 10 attributes: future health state value, start point of future health state, life expectancy, clothing size above ideal, days with sufficient relaxation, endurance, experienced control over lifestyle choices, lifestyle improvement of partner and/or children, monetary cost per month, and time cost per week. With the exception of "time cost per week" and "start point of future health state," all attributes significantly determined consumer choices. Thus, both health and nonhealth outcomes affected consumer choice. Marginal rates of substitution between the price attribute and the other attributes revealed that the attributes "endurance," "days with sufficient relaxation," and "future health state value" had the greatest impact on consumer choices. The "life expectancy" attribute had a relatively low impact and for increases of less than 3 years, respondents were not willing to trade. Health outcomes and nonhealth outcomes of lifestyle behavior change were both important to consumers in this study. Decision makers should respond to consumer preferences and consider nonhealth outcomes when deciding about HP interventions. Copyright © 2013 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All

  6. Predicting impending death: inconsistency in speed is a selective and early marker.

    Science.gov (United States)

    Macdonald, Stuart W S; Hultsch, David F; Dixon, Roger A

    2008-09-01

    Among older adults, deficits in both level and variability of speeded performance are linked to neurological impairment. This study examined whether and when speed (rate), speed (inconsistency), and traditional accuracy-based markers of cognitive performance foreshadow terminal decline and impending death. Victoria Longitudinal Study data spanning 12 years (5 waves) of measurement were assembled for 707 adults aged 59 to 95 years. Whereas 442 survivors completed all waves and relevant measures, 265 decedents participated on at least 1 occasion and subsequently died. Four main results were observed. First, Cox regressions evaluating the 3 cognitive predictors of mortality replicated previous results for cognitive accuracy predictors. Second, level (rate) of speeded performance predicted survival independent of demographic indicators, cardiovascular health, and cognitive performance level. Third, inconsistency in speed predicted survival independent of all influences combined. Fourth, follow-up random-effects models revealed increases in inconsistency in speed per year closer to death, with advancing age further moderating the accelerated growth. Hierarchical prediction patterns support the view that inconsistency in speed is an early behavioral marker of neurological dysfunction associated with impending death. (c) 2008 APA, all rights reserved

  7. The Advanced Glaucoma Intervention Study (AGIS): 13. Comparison of treatment outcomes within race: 10-year results.

    Science.gov (United States)

    Ederer, Fred; Gaasterland, Douglas A; Dally, Leonard G; Kim, Jonghyeon; VanVeldhuisen, Paul C; Blackwell, Beth; Prum, Bruce; Shafranov, George; Allen, Robert C; Beck, Allen

    2004-04-01

    To present for black and white patients with medically uncontrolled glaucoma 10-year results of treatment with 1 of 2 randomly assigned surgical intervention sequences. Randomized clinical trial. Three hundred thirty-two black patients (451 eyes) and 249 white patients (325 eyes). Eyes had glaucoma that could not be controlled with medications alone. Eyes were randomly assigned to 1 of 2 sequences: argon laser trabeculoplasty (ALT)-trabeculectomy-trabeculectomy (ATT) or trabeculectomy-ALT-trabeculectomy (TAT). Second and third interventions were offered after failure of the preceding intervention. Minimum required intraocular pressure (IOP) for intervention failure ranged upward from 18 mmHg, the value depending on whether recent optic disc or visual field (VF) deterioration occurred, and on the magnitude of the field defect. Patients were observed every 6 months, with total potential follow-up ranging from 8 years, 4 months to 13 years. The averages over follow-up of (1) the percentage of eyes having moderate loss of VF and (2) the percentage of eyes having moderate loss of visual acuity (VA). Race-treatment interactions in VF and VA loss are significant for the 2 main outcome measures; therefore, results of treatment sequence differences are presented by race. In black patients the average percent of eyes with VF loss was less in the ATT sequence than in the TAT sequence, a difference that is not statistically significant at any visit. In white patients, conversely, after 18 months the average percent of eyes with VF loss was less in the TAT sequence, a difference that increases and is statistically significant in years 8 to 10. In both black and white patients, the average percent of eyes with VA loss was less in the ATT sequence; this difference is statistically significant throughout 10 follow-up years in black patients and is statistically significant only for the first year in white patients. In both black and white patients, average IOP reductions were

  8. Mercury in fish and adverse reproductive outcomes: results from South Carolina

    Science.gov (United States)

    2014-01-01

    Background Mercury is a metal with widespread distribution in aquatic ecosystems and significant neurodevelopmental toxicity in humans. Fish biomonitoring for total mercury has been conducted in South Carolina (SC) since 1976, and consumption advisories have been posted for many SC waterways. However, there is limited information on the potential reproductive impacts of mercury due to recreational or subsistence fish consumption. Methods To address this issue, geocoded residential locations for live births from the Vital Statistics Registry (1995–2005, N = 362,625) were linked with spatially interpolated total mercury concentrations in fish to estimate potential mercury exposure from consumption of locally caught fish. Generalized estimating equations were used to test the hypothesis that risk of low birth weight (LBW, mercury in fish, after adjustment for confounding. Separate analyses estimated term LBW and PTB risks using residential proximity to rivers with fish consumption advisories to characterize exposure. Results Term LBW was more likely among women residing in areas in the upper quartile of predicted total mercury in fish (odds ratio [OR] = 1.04; 95% confidence interval [CI]: 1.00-1.09) or within 8 kilometers of a river with a ‘do not eat’ fish advisory (1.05; 1.00-1.11) compared to the lowest quartile, or rivers without fish consumption restrictions, respectively. When stratified by race, risks for term LBW or PTB were 10-18% more likely among African-American (AA) mothers living in areas with the highest total fish mercury concentrations. Conclusions To our knowledge, this is the first study to examine the relationship between fish total mercury concentrations and adverse reproductive outcomes in a large population-based sample that included AA women. The ecologic nature of exposure assessment in this study precludes causal inference. However, the results suggest a need for more detailed investigations to characterize patterns of local

  9. Inconsistencies in authoritative national paediatric workforce data sources.

    Science.gov (United States)

    Allen, Amy R; Doherty, Richard; Hilton, Andrew M; Freed, Gary L

    2017-12-01

    Objective National health workforce data are used in workforce projections, policy and planning. If data to measure the current effective clinical medical workforce are not consistent, accurate and reliable, policy options pursued may not be aligned with Australia's actual needs. The aim of the present study was to identify any inconsistencies and contradictions in the numerical count of paediatric specialists in Australia, and discuss issues related to the accuracy of collection and analysis of medical workforce data. Methods This study compared respected national data sources regarding the number of medical practitioners in eight fields of paediatric speciality medical (non-surgical) practice. It also counted the number of doctors listed on the websites of speciality paediatric hospitals and clinics as practicing in these eight fields. Results Counts of medical practitioners varied markedly for all specialties across the data sources examined. In some fields examined, the range of variability across data sources exceeded 450%. Conclusions The national datasets currently available from federal and speciality sources do not provide consistent or reliable counts of the number of medical practitioners. The lack of an adequate baseline for the workforce prevents accurate predictions of future needs to provide the best possible care of children in Australia. What is known about the topic? Various national data sources contain counts of the number of medical practitioners in Australia. These data are used in health workforce projections, policy and planning. What does this paper add? The present study found that the current data sources do not provide consistent or reliable counts of the number of practitioners in eight selected fields of paediatric speciality practice. There are several potential issues in the way workforce data are collected or analysed that cause the variation between sources to occur. What are the implications for practitioners? Without accurate

  10. Outcome measurements in major trauma--results of a consensus meeting.

    Science.gov (United States)

    Ardolino, A; Sleat, G; Willett, K

    2012-10-01

    The NHS Outcomes Framework for England has identified recovery from major injury as an important clinical area. At present, there are no established outcome indicators. As more patients survive major trauma, outcomes will need to be measured in terms of morbidity and not mortality alone. To make recommendations for a selection of outcome measures that could be integrated into National Clinical Audit data collection and form part of clinical governance requirements for Regional Trauma Networks (RTNs) and measures by which RTNs are held to account by government. Specific focus was given to acute care and rehabilitation for both adults and children. A Multiprofessional, multidisciplinary expert group reviewed the current evidence on outcome measures for major trauma in the adult and children's populations, informed by a systematic review carried out jointly by the Trauma Audit and Research Network (TARN) and the Cochrane Injuries Group. A structured discussion covered functional and quality of life outcome measures as well as patient experience and indicators such as return to work, education and social dependency. For the adult population the group agreed with the in-hospital performance and hospital discharge measures recommended in the TARN and Cochrane systematic review. Concerning longer-term outcome indicators, the group suggested the use of the Glasgow Outcome Scale - Extended (GOS-E) and European Quality of Life 5D (EQ-5D) with consideration to be given to the World Health Organisation Quality of Life survey (WHO-QoL). For patients who had ongoing inpatient rehabilitation needs the group thought the measurement of the Rehabilitation Complexity Scale (RCS) and Functional Independence Measure (FIM) were important in total brain injury and, the American Spinal Injury Association Impairment Scale (ASIA) and Spinal Cord Independence Measure (SCIM) in spinal cord injury. For children the group recommended the use of the King's Outcome Scale for Childhood Head Injury

  11. CT-Guided Lumbar Sympathectomy: Results and Analysis of Factors Influencing the Outcome

    International Nuclear Information System (INIS)

    Heindel, Walter; Ernst, Stefan; Manshausen, Gudrun; Gawenda, Michael; Siemens, Peter; Krahe, Thomas; Walter, Michael; Lackner, Klaus

    1998-01-01

    Purpose: To prospectively analyze the effectiveness of computed tomography-guided percutaneous lumbar sympathectomy (CTLS) in patients with peripheral arterial occlusive disease in relation to angiographic findings and vascular risk factors. Methods: Eighty-three patients were treated by CTLS. After clinical evaluation of the risk profile and diagnostic intraarterial digital subtraction arteriography, 14 patients underwent unilateral, and 69 bilateral one-level treatment. Follow-up studies took place on the day following the intervention, after 3 weeks, and after 3 months. Results: A total of 152 interventions were performed in 83 patients. After 3 months, clinical examination of 54 patients (5 patients had died, 24 were lost to follow-up) revealed improvement in 46% (25/54), no change in 39% (21/54), and worsening (amputation) in 15% (8/54). There was no significant statistical correlation among any of the analyzed factors (diabetes mellitus, arterial hypertension, smoking, hyperlipidemia, obesity, hyperuricemia, number of risk factors, ankle-arm index, and angiography score) and the outcome after CTLS. Three major complications occurred: one diabetic patient developed a retroperitoneal abscess 2 weeks after CTLS, and in two other patients ureteral strictures were detected 3 months and 2 years after CTLS, respectively. Conclusion: As no predictive criteria for clinical improvement in an individual patient could be identified, CTLS, as a safe procedure, should be employed on a large scale in patients who are unsuitable for treatment by angioplasty or revascularization

  12. DISEASE MODIFYING THERAPY AND OUTCOME OF RHEUMATOID ARTHRITIS: RETROSPECTIVE ASSESSMENT OF LONG-TERM RESULTS

    Directory of Open Access Journals (Sweden)

    D. E. Karateyev

    2000-01-01

    Full Text Available Aim of study: To investigate the relation between patterns of basic treatment and the outcome of disease in patients with rheumatoid arthritis (RA. Material and methods: We studied retrospectively two groups of patients with RA (1987 ACR criteria: 1 main group - died (72 patients, mean duration of disease from the onset to death 12.8±0.9 years; 2 control group - alive to 1999 with duration of disease at least 15 years (90 patients, mean follow-up period 19.4±0.47 years. Results: Some patterns of basic treatment were observed: 1 "passive ” strategy - only hydroxychloroquine or sulphasalazine during many years; 2 "inteirupted " treatment - early treatment gold or cytotoxics, but when improvement occurred, therapy with DMARD was interrupted for 1-2 years or more, after that re-started etc.; 3 “emergency” strategy’ - 7-10years of "passive" treatment, after that se\\>ere destruction and/or amyloidosis appeared, and cytotoxics started; 4 typical "pyramid " strategy; 5 "active " strategy - early start of treatment with active DMARD (melotrexate, gold with consecutive change of DMARDs without interruption of basic treatment (very close to "sawtooth ” strategy. The most of died patients were treated with "passive ” and "interrupted" strategies, but the most of patients in control group were treated with "pyramid” and "active" strategies. Conclusion: active strategy of basic treatment has a positive influence on the survival ofpatients with R.A.

  13. Tracking How Science Resources Result in Educator- and Community-Level Outcomes

    Science.gov (United States)

    Dusenbery, P.; Harold, J. B.; Fitzhugh, G.; LaConte, K.; Holland, A.

    2017-12-01

    Learners frequently need to access increasingly complex information to help them understand our changing world. More and more libraries are transforming themselves into places where learners not only access STEM information, but interact with professionals and undertake hands-on learning. Libraries are beginning to position themselves as part of learning ecosystems that contribute to a collective impact on the community. Traveling STEM exhibits are catalyzing these partnerships and engaging students, families, and adults in repeat visits through an accessible venue: their public library. This talk will explore impacts from two STAR Library Network's (STAR_Net) exhibitions (Discover Earth and Discover Tech) on partnerships, the circulation of STEM resources, and the engagement of learners. The STAR_Net project's summative evaluation utilized mixed methods to investigate project implementation and its outcomes. Methods included pre- and post-exhibit surveys administered to staff from each library that hosted the exhibits; interviews with staff from host libraries; patron surveys; exhibit-related circulation records; web metrics regarding the online STAR_Net community of practice; and site visits. The latter provides a more complete view of impacts on the community, including underserved audiences. NASA@ My Library is a new STAR_Net initiative, which provides STEM facilitation kits, training, and other resources to 75 libraries nationwide. Initial results will be presented that show high levels of engagement by librarians and strong response rate from patrons on surveys.

  14. Postoperative Adverse Events Inconsistently Improved by the World Health Organization Surgical Safety Checklist: A Systematic Literature Review of 25 Studies.

    Science.gov (United States)

    de Jager, Elzerie; McKenna, Chloe; Bartlett, Lynne; Gunnarsson, Ronny; Ho, Yik-Hong

    2016-08-01

    The World Health Organization Surgical Safety Checklist (SSC) has been widely implemented in an effort to decrease surgical adverse events. This systematic literature review examined the effects of the SSC on postoperative outcomes. The review included 25 studies: two randomised controlled trials, 13 prospective and ten retrospective cohort trials. A meta-analysis was not conducted as combining observational studies of heterogeneous quality may be highly biased. The quality of the studies was largely suboptimal; only four studies had a concurrent control group, many studies were underpowered to examine specific postoperative outcomes and teamwork-training initiatives were often combined with the implementation of the checklist, confounding the results. The effects of the checklist were largely inconsistent. Postoperative complications were examined in 20 studies; complication rates significantly decreased in ten and increased in one. Eighteen studies examined postoperative mortality. Rates significantly decreased in four and increased in one. Postoperative mortality rates were not significantly decreased in any studies in developed nations, whereas they were significantly decreased in 75 % of studies conducted in developing nations. The checklist may be associated with a decrease in surgical adverse events and this effect seems to be greater in developing nations. With the observed incongruence between specific postoperative outcomes and the overall poor study designs, it is possible that many of the positive changes associated with the use of the checklist were due to temporal changes, confounding factors and publication bias.

  15. Arthroscopic treatment for intratendinous rotator cuff tear results in satisfactory clinical outcomes and structural integrity.

    Science.gov (United States)

    Cheon, Sang Jin; Lee, Hyo Yeol; Jeon, Woong Ki

    2018-04-20

    This study aimed to evaluate the clinical outcomes and structural integrity of arthroscopic repair of intratendinous rotator cuff tear. Patients who were diagnosed with an intratendinous tear but in whom conservative treatment failed were selected and underwent arthroscopic repair. Between 2008 and 2014, a total of 30 patients (6 men, 24 women; mean age, 59 ± 3.7 years) met the inclusion criteria and were followed up. The mean follow-up period was 26.3 ± 0.7 months. The results were evaluated using the University of California at Los Angeles (UCLA) score, the Society of the American Shoulder and Elbow Surgeons rating scale (ASES) questionnaire, and the visual analog scale (VAS) and range of motion (ROM) were measured preoperatively and at final follow-up. Magnetic resonance imaging (MRI) was performed preoperatively and at 6.7 ± 0.2 months postoperatively. Postoperative MRI was performed on 27 out of 30 patients and analysed using the Sugaya classification. Corresponding to the preoperative MRI findings, arthroscopic findings of intratendinous tears were observed in all 30 patients. The mean active forward elevation ROM was 137.3° ± 15.4° before surgery and 168.8° ± 15.2° at the final follow-up. The internal and external rotations at abduction were 31.7° ± 5.1° and 63.0° ± 11.6° before surgery, respectively, and 60.5° ± 8.0° and 75.2° ± 10.8° after surgery, respectively. The UCLA score improved from of 20.1 ± 7.4 points preoperative to 28.4 ± 5.5 points at the final follow-up. The ASES score improved from 55.7 ± 15.3 points preoperative to 82.6 ± 9.7 points postoperatively. The VAS for pain score decreased from 6.4 ± 1.2 points preoperative to 1.6 ± 0.9 points postoperative. Satisfactory outcomes (excellent/good) in terms of UCLA and ASES scores were observed in 29 of 30 patients. Based on Sugaya classification, grades I, II, and III structural integrities were observed in 9

  16. Shunting outcomes in posthemorrhagic hydrocephalus: results of a Hydrocephalus Clinical Research Network prospective cohort study.

    Science.gov (United States)

    Wellons, John C; Shannon, Chevis N; Holubkov, Richard; Riva-Cambrin, Jay; Kulkarni, Abhaya V; Limbrick, David D; Whitehead, William; Browd, Samuel; Rozzelle, Curtis; Simon, Tamara D; Tamber, Mandeep S; Oakes, W Jerry; Drake, James; Luerssen, Thomas G; Kestle, John

    2017-07-01

    OBJECTIVE Previous Hydrocephalus Clinical Research Network (HCRN) retrospective studies have shown a 15% difference in rates of conversion to permanent shunts with the use of ventriculosubgaleal shunts (VSGSs) versus ventricular reservoirs (VRs) as temporization procedures in the treatment of hydrocephalus due to high-grade intraventricular hemorrhage (IVH) of prematurity. Further research in the same study line revealed a strong influence of center-specific decision-making on shunt outcomes. The primary goal of this prospective study was to standardize decision-making across centers to determine true procedural superiority, if any, of VSGS versus VR as a temporization procedure in high-grade IVH of prematurity. METHODS The HCRN conducted a prospective cohort study across 6 centers with an approximate 1.5- to 3-year accrual period (depending on center) followed by 6 months of follow-up. Infants with premature birth, who weighed less than 1500 g, had Grade 3 or 4 IVH of prematurity, and had more than 72 hours of life expectancy were included in the study. Based on a priori consensus, decisions were standardized regarding the timing of initial surgical treatment, upfront shunt versus temporization procedure (VR or VSGS), and when to convert a VR or VSGS to a permanent shunt. Physical examination assessment and surgical technique were also standardized. The primary outcome was the proportion of infants who underwent conversion to a permanent shunt. The major secondary outcomes of interest included infection and other complication rates. RESULTS One hundred forty-five premature infants were enrolled and met criteria for analysis. Using the standardized decision rubrics, 28 infants never reached the threshold for treatment, 11 initially received permanent shunts, 4 were initially treated with endoscopic third ventriculostomy (ETV), and 102 underwent a temporization procedure (36 with VSGSs and 66 with VRs). The 2 temporization cohorts were similar in terms of sex, race

  17. Automated generation of node-splitting models for assessment of inconsistency in network meta-analysis.

    Science.gov (United States)

    van Valkenhoef, Gert; Dias, Sofia; Ades, A E; Welton, Nicky J

    2016-03-01

    Network meta-analysis enables the simultaneous synthesis of a network of clinical trials comparing any number of treatments. Potential inconsistencies between estimates of relative treatment effects are an important concern, and several methods to detect inconsistency have been proposed. This paper is concerned with the node-splitting approach, which is particularly attractive because of its straightforward interpretation, contrasting estimates from both direct and indirect evidence. However, node-splitting analyses are labour-intensive because each comparison of interest requires a separate model. It would be advantageous if node-splitting models could be estimated automatically for all comparisons of interest. We present an unambiguous decision rule to choose which comparisons to split, and prove that it selects only comparisons in potentially inconsistent loops in the network, and that all potentially inconsistent loops in the network are investigated. Moreover, the decision rule circumvents problems with the parameterisation of multi-arm trials, ensuring that model generation is trivial in all cases. Thus, our methods eliminate most of the manual work involved in using the node-splitting approach, enabling the analyst to focus on interpreting the results. © 2015 The Authors Research Synthesis Methods Published by John Wiley & Sons Ltd.

  18. Clinical outcome and radiographic results after operative treatment of Scheuermann's disease

    NARCIS (Netherlands)

    Poolman, R. W.; Been, H. D.; Ubags, L. H.

    2002-01-01

    The aim of this prospective study was to evaluate radiographic findings, patient satisfaction and clinical outcome, and to report complications and instrumentation failure after operative treatment of Scheuermann's disease using a combined anterior and posterior spondylodesis. The loss of sagittal

  19. Birth outcome racial disparities: A result of intersecting social and environmental factors.

    Science.gov (United States)

    Burris, Heather H; Hacker, Michele R

    2017-10-01

    Adverse birth outcomes such as preterm birth, low-birth weight, and infant mortality continue to disproportionately affect black and poor infants in the United States. Improvements in healthcare quality and access have not eliminated these disparities. The objective of this review was to consider societal factors, including suboptimal education, income inequality, and residential segregation, that together lead to toxic environmental exposures and psychosocial stress. Many toxic chemicals, as well as psychosocial stress, contribute to the risk of adverse birth outcomes and black women often are more highly exposed than white women. The extent to which environmental exposures combine with stress and culminate in racial disparities in birth outcomes has not been quantified but is likely substantial. Primary prevention of adverse birth outcomes and elimination of disparities will require a societal approach to improve education quality, income equity, and neighborhoods. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Development of an Inconsistent Responding Scale for the Triarchic Psychopathy Measure.

    Science.gov (United States)

    Mowle, Elyse N; Kelley, Shannon E; Edens, John F; Donnellan, M Brent; Smith, Shannon Toney; Wygant, Dustin B; Sellbom, Martin

    2017-08-01

    Inconsistent or careless responding to self-report measures is estimated to occur in approximately 10% of university research participants and may be even more common among offender populations. Inconsistent responding may be a result of a number of factors including inattentiveness, reading or comprehension difficulties, and cognitive impairment. Many stand-alone personality scales used in applied and research settings, however, do not include validity indicators to help identify inattentive response patterns. Using multiple archival samples, the current study describes the development of an inconsistent responding scale for the Triarchic Psychopathy Measure (TriPM; Patrick, 2010), a widely used self-report measure of psychopathy. We first identified pairs of correlated TriPM items in a derivation sample (N = 2,138) and then created a total score based on the sum of the absolute value of the differences for each item pair. The resulting scale, the Triarchic Assessment Procedure for Inconsistent Responding (TAPIR), strongly differentiated between genuine TriPM protocols and randomly generated TriPM data (N = 1,000), as well as between genuine protocols and those in which 50% of the original data were replaced with random item responses. TAPIR scores demonstrated fairly consistent patterns of association with some theoretically relevant correlates (e.g., inconsistency scales embedded in other personality inventories), although not others (e.g., measures of conscientiousness) across our cross-validation samples. Tentative TAPIR cut scores that may discriminate between attentively and carelessly completed protocols are presented. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  1. Postoperative outcomes and functional results after Deloyer's procedure – a retrospective cohort study

    Directory of Open Access Journals (Sweden)

    Noel Salgado-Nesme

    2017-04-01

    Full Text Available Introduction: The objective of our study was to describe surgical outcomes of Deloyers procedure in our referral center, and to compare the results of patients with and without protective ileostomy. Methods: Patients undergoing a Deloyers procedure from 2013 to 2016 were prospectively included. General characteristics, intraoperative variables, postoperative course, and functional outcomes were analyzed. Patients were compared into two groups: group (1 patients undergoing Deloyers procedure without ileostomy, and group (2 Deloyers procedure with protective ileostomy. Results: Sixteen patients undergoing isoperistaltic transposition of the right colon remnant were included, of which 9 (63% were males with a median age of 47 (range 22–76 years. The main surgical indication was the restoration of bowel transit (62.5%. There was higher major morbidity rate in the Deloyers procedure with protective ileostomy group, but without statistical significance (20% vs. 9%, p = 0.92. No leaks or deaths were reported. The length of hospital stay was 7 days. The mean number of bowel movements per day was 4 at 18 months of follow up. Only four (25% patients used irregularly loperamide. Conclusions: The Deloyers procedure has satisfactory results and is reproducible with low morbidity. The major and minor morbidity rates were similar between groups, suggesting that the costs and risks of a second procedure can be avoided by providing a safe primary anastomosis. Resumo: Introdução: O objetivo de nosso estudo foi descrever os resultados cirúrgicos do procedimento de Deloyer em nosso centro de referência e comparar os resultados de pacientes com e sem ileostomia de proteção. Métodos: Pacientes submetidos ao procedimento de Deloyer de 2013 a 2016 foram incluídos prospectivamente. Foram analisadas as características gerais, as variáveis intraoperatórias, o curso pós-operatório e os desfechos funcionais. Os pacientes foram comparados em dois grupos

  2. Improved Outcome Prediction Using CT Angiography in Addition to Standard Ischemic Stroke Assessment: Results from the STOPStroke Study

    Science.gov (United States)

    González, R. Gilberto; Lev, Michael H.; Goldmacher, Gregory V.; Smith, Wade S.; Payabvash, Seyedmehdi; Harris, Gordon J.; Halpern, Elkan F.; Koroshetz, Walter J.; Camargo, Erica C. S.; Dillon, William P.; Furie, Karen L.

    2012-01-01

    Purpose To improve ischemic stroke outcome prediction using imaging information from a prospective cohort who received admission CT angiography (CTA). Methods In a prospectively designed study, 649 stroke patients diagnosed with acute ischemic stroke had admission NIH stroke scale scores, noncontrast CT (NCCT), CTA, and 6-month outcome assessed using the modified Rankin scale (mRS) scores. Poor outcome was defined as mRS>2. Strokes were classified as “major” by the (1) Alberta Stroke Program Early CT Score (ASPECTS+) if NCCT ASPECTS was≤7; (2) Boston Acute Stroke Imaging Scale (BASIS+) if they were ASPECTS+ or CTA showed occlusion of the distal internal carotid, proximal middle cerebral, or basilar arteries; and (3) NIHSS for scores>10. Results Of 649 patients, 253 (39.0%) had poor outcomes. NIHSS, BASIS, and age, but not ASPECTS, were independent predictors of outcome. BASIS and NIHSS had similar sensitivities, both superior to ASPECTS (p10/BASIS+ had poor outcomes, versus 21.5% (77/358) with NIHSS≤10/BASIS− (p10/BASIS+ compared to patients who are NIHSS≤10/BASIS−; the odds ratio is 5.4 (95% CI: 3.5 to 8.5) when compared to patients who are only NIHSS>10 or BASIS+. Conclusions BASIS and NIHSS are independent outcome predictors. Their combination is stronger than either instrument alone in predicting outcomes. The findings suggest that CTA is a significant clinical tool in routine acute stroke assessment. PMID:22276182

  3. Fractional flow reserve guided percutaneous coronary intervention results in reduced ischemic myocardium and improved outcomes.

    Science.gov (United States)

    Sawant, Abhishek C; Bhardwaj, Aishwarya; Banerjee, Kinjal; Jobanputra, Yash; Kumar, Arnav; Parikh, Parth; Kandregula, Krishna C; Poddar, Kanhaiya; Ellis, Stephen G; Nair, Ravi; Corbelli, John; Kapadia, Samir

    2018-02-06

    To determine if fractional flow reserve guided percutaneous coronary intervention (FFR-guided PCI) is associated with reduced ischemic myocardium compared with angiography-guided PCI. Although FFR-guided PCI has been shown to improve outcomes, it remains unclear if it reduces the extent of ischemic myocardium at risk compared with angiography-guided PCI. We evaluated 380 patients (190 FFR-guided PCI cases and 190 propensity-matched controls) who underwent PCI from 2009 to 2014. Clinical, laboratory, angiographic, stress testing, and major adverse cardiac events [MACE] (all-cause mortality, recurrence of MI requiring PCI, stroke) data were collected. Mean age was 63 ± 11 years; the majority of patients were males (76%) and Caucasian (77%). Median duration of follow up was 3.4 [Range: 1.9, 5.0] years. Procedural complications including coronary dissection (2% vs. 0%, P = .12) and perforation (0% vs. 0%, P = 1.00) were similar between FFR-guided and angiography-guided PCI patients. FFR-guided PCI patients had lower unadjusted (14.7% vs. 23.2%, P = .04) and adjusted [OR = 0.58 (95% CI: 0.34-0.98)] risk of repeat revascularization at one year. FFR-guided PCI patients were less likely (23% vs. 32%, P = .02) to have ischemia and had lower (5.9% vs. 21.1%, P guided PCI, FFR-guided PCI results in less repeat revascularization and a lower incidence of post PCI ischemia translating into improved survival, without an increase in complications. © 2018 Wiley Periodicals, Inc.

  4. Functional Outcomes After Rectal Resection for Deep Infiltrating Pelvic Endometriosis: Long-term Results.

    Science.gov (United States)

    Erdem, Suna; Imboden, Sara; Papadia, Andrea; Lanz, Susanne; Mueller, Michael D; Gloor, Beat; Worni, Mathias

    2018-06-01

    Curative management of deep infiltrating endometriosis requires complete removal of all endometriotic implants. Surgical approach to rectal involvement has become a topic of debate given potential postoperative bowel dysfunction and complications. This study aims to assess long-term postoperative evacuation and incontinence outcomes after laparoscopic segmental rectal resection for deep infiltrating endometriosis involving the rectal wall. This is a retrospective study of prospectively collected data. This single-center study was conducted at the University Hospital of Bern, Switzerland. Patients with deep infiltrating endometriosis involving the rectum undergoing rectal resection from June 2002 to May 2011 with at least 24 months follow-up were included. Aside from endometriosis-related symptoms, detailed symptoms on evacuation (points: 0 (best) to 21 (worst)) and incontinence (0-24) were evaluated by using a standardized questionnaire before and at least 24 months after surgery. Of 66 women who underwent rectal resection, 51 were available for analyses with a median follow-up period of 86 months (range: 26-168). Forty-eight patients (94%) underwent laparoscopic resection (4% converted, 2% primary open), with end-to-end anastomosis in 41 patients (82%). Two patients (4%) had an anastomotic insufficiency; 1 case was complicated by rectovaginal fistula. Dysmenorrhea, nonmenstrual pain, and dyspareunia substantially improved (p endometriosis including the rectal wall is associated with good results in endometriotic-related symptoms, although patients should be informed about possible postoperative impairments in evacuation and incontinence. However, its clinical impact does not outweigh the benefit that can be achieved through this approach. See Video Abstract at http://links.lww.com/DCR/A547.

  5. Food away from home and body mass outcomes: taking heterogeneity into account enhances quality of results.

    Science.gov (United States)

    Kim, Tae Hyun; Lee, Eui-Kyung; Han, Euna

    2014-09-01

    The aim of this study was to explore the heterogeneous association of consumption of food away from home (FAFH) with individual body mass outcomes including body mass index and waist circumference over the entire conditional distribution of each outcome. Information on 16,403 adults obtained from nationally representative data on nutrition and behavior in Korea was used. A quantile regression model captured the variability of the association of FAFH with body mass outcomes across the entire conditional distribution of each outcome measure. Heavy FAFH consumption was defined as obtaining ≥1400 kcal from FAFH on a single day. Heavy FAFH consumption, specifically at full-service restaurants, was significantly associated with higher body mass index (+0.46 kg/m2 at the 50th quantile, 0.55 at the 75th, 0.66 at the 90th, and 0.44 at the 95th) and waist circumference (+0.96 cm at the 25th quantile, 1.06 cm at the 50th, 1.35 cm at the 75th, and 0.96 cm at the 90th quantiles) with overall larger associations at higher quantiles. Findings of the study indicate that conventional regression methods may mask important heterogeneity in the association between heavy FAFH consumption and body mass outcomes. Further public health efforts are needed to improve the nutritional quality of affordable FAFH choices and nutrition education and to establish a healthy food consumption environment. Copyright © 2014 Elsevier Inc. All rights reserved.

  6. Thermodynamic inconsistency of the modified Saha equation at high pressures

    International Nuclear Information System (INIS)

    Sweeney, M.A.

    1978-01-01

    The inclusion of a pressure ionization term in the Saha equation violates the thermodynamic Maxwell identities if corresponding changes are not made to the expressions for entropy and pressure. It is demonstrated that the usual application of the Rouse and Stewart-Pyatt modesl suffers from this limitation. Negative values of the adiabatic gradient in the degenerate dwarf models of Boehm and Straka are explained in terms of this thermodynamic inconsistency

  7. Avoiding inconsistencies over time and tracking difficulties in Applied Biosystems AB1700™/Panther™ probe-to-gene annotations

    Directory of Open Access Journals (Sweden)

    Benecke Arndt

    2005-12-01

    Full Text Available Abstract Background Significant inconsistencies between probe-to-gene annotations between different releases of probe set identifiers by commercial microarray platform solutions have been reported. Such inconsistencies lead to misleading or ambiguous interpretation of published gene expression results. Results We report here similar inconsistencies in the probe-to-gene annotation of Applied Biosystems AB1700 data, demonstrating that this is not an isolated concern. Moreover, the online information source PANTHER does not provide information required to track such inconsistencies, hence, even correctly annotated datasets, when resubmitted after PANTHER was updated to a new probe-to-gene annotation release, will generate differing results without any feedback on the origin of the change. Conclusion The importance of unequivocal annotation of microarray experiments can not be underestimated. Inconsistencies greatly diminish the usefulness of the technology. Novel methods in the analysis of transcriptome profiles often rely on large disparate datasets stemming from multiple sources. The predictive and analytic power of such approaches rapidly diminishes if only least-common subsets can be used for analysis. We present here the information that needs to be provided together with the raw AB1700 data, and the information required together with the biologic interpretation of such data to avoid inconsistencies and tracking difficulties.

  8. Accelerating deep neural network training with inconsistent stochastic gradient descent.

    Science.gov (United States)

    Wang, Linnan; Yang, Yi; Min, Renqiang; Chakradhar, Srimat

    2017-09-01

    Stochastic Gradient Descent (SGD) updates Convolutional Neural Network (CNN) with a noisy gradient computed from a random batch, and each batch evenly updates the network once in an epoch. This model applies the same training effort to each batch, but it overlooks the fact that the gradient variance, induced by Sampling Bias and Intrinsic Image Difference, renders different training dynamics on batches. In this paper, we develop a new training strategy for SGD, referred to as Inconsistent Stochastic Gradient Descent (ISGD) to address this problem. The core concept of ISGD is the inconsistent training, which dynamically adjusts the training effort w.r.t the loss. ISGD models the training as a stochastic process that gradually reduces down the mean of batch's loss, and it utilizes a dynamic upper control limit to identify a large loss batch on the fly. ISGD stays on the identified batch to accelerate the training with additional gradient updates, and it also has a constraint to penalize drastic parameter changes. ISGD is straightforward, computationally efficient and without requiring auxiliary memories. A series of empirical evaluations on real world datasets and networks demonstrate the promising performance of inconsistent training. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. Neurosurgical outcomes after intracerebral hemorrhage: results of the Factor Seven for Acute Hemorrhagic Stroke Trial (FAST).

    Science.gov (United States)

    Steiner, Thorsten; Vincent, Catherine; Morris, Stephen; Davis, Stephen; Vallejo-Torres, Laura; Christensen, Michael C

    2011-01-01

    The value of neurosurgical interventions after spontaneous intracerebral hemorrhage (SICH) is uncertain. We evaluated clinical outcomes in patients diagnosed with SICH within 3 hours of symptom onset who underwent hematoma evacuation or external ventricular drainage (EVD) of the hematoma in the Factor Seven for Acute Hemorrhagic Stroke Trial (FAST). FAST was a randomized, multicenter, double-blind, placebo-controlled trial conducted between May 2005 and February 2007 at 122 sites in 22 countries. Neurosurgical procedures (hematoma evacuation and external ventricular drainage) performed at any point after hospital admission were prospectively recorded. Clinical outcomes evaluated were post-SICH disability, as assessed by the modified Rankin Scale; neurologic impairment, as assessed by the National Institutes of Health Stroke Scale; and mortality at 90 days after SICH onset. The impact of neurosurgical procedures on clinical outcomes was evaluated using multivariate logistic regression analysis, controlling for relevant baseline characteristics. Fifty-five of 821 patients underwent neurosurgery. Patients who underwent hematoma evacuation or EVD were on average younger, had greater baseline neurologic impairment, and lower levels of consciousness compared with patients who did not undergo neurosurgery. After adjusting for these differences and other relevant baseline characteristics, we found that neurosurgery was generally associated with unfavorable outcomes at day 90. Among the patients who underwent hematoma evacuation, those with lobar ICH had less ICH expansion than those with deep gray matter ICH, and the smaller expansion was associated with lower mortality. ICH volume was substantially decreased in patients who underwent hematoma evacuation between 24 and 72 hours after hospital admission, and this was associated with better clinical outcome. In conclusion, a small number of patients who underwent neurosurgery in FAST exhibited no overall clinical benefit

  10. Modeling the Offensive-Defensive Interaction and Resulting Outcomes in Basketball.

    Directory of Open Access Journals (Sweden)

    Leonardo Lamas

    Full Text Available We analyzed the interaction between offensive (i.e. space creation dynamics--SCDs and defensive (i.e. space protection dynamics--SPDs actions in six play outcomes (free shot, contested shot, new SCD, reset, foul, and turnover in Spanish professional basketball games.Data consisted of 1548 SCD-SPD-outcome triples obtained from six play-off games. We used Bayesian methods to compute marginal probabilities of six outcomes following five different SCDs. We also computed probabilities of the six outcomes following the 16 most frequent SCD-SPD combinations.The pick action (e.g. pick and roll, pop and pop was the most prevalent SCD (33%. However, this SCD did not produce the highest probability of a free shot (0.235. The highest probability of a free shot followed the SCD without ball (0.409. The pick was performed not only to attempt scoring but also to initiate offenses, as it produced the highest probability leading to a new SCD (0.403. Additionally, the SPD performed influenced the outcome of the SCD. This reinforces the notion that the opposition (offensive-defensive interaction should be considered. To the best of our knowledge, in team sports, this is the first study to successfully model the tactical features involved in offense-defense interactions. Our analyses revealed that the high frequency of occurrence of some SCDs may be justified not only by an associated high probability of free shots but also by the possibility of progressively create more space in the defense (i.e. a new SCD as outcome. In the second case, it evidences offensive strategic features of progressive disruption of the defensive system through the concatenation of subsequent offensive actions.

  11. Modeling the Offensive-Defensive Interaction and Resulting Outcomes in Basketball.

    Science.gov (United States)

    Lamas, Leonardo; Santana, Felipe; Heiner, Matthew; Ugrinowitsch, Carlos; Fellingham, Gilbert

    2015-01-01

    We analyzed the interaction between offensive (i.e. space creation dynamics--SCDs) and defensive (i.e. space protection dynamics--SPDs) actions in six play outcomes (free shot, contested shot, new SCD, reset, foul, and turnover) in Spanish professional basketball games. Data consisted of 1548 SCD-SPD-outcome triples obtained from six play-off games. We used Bayesian methods to compute marginal probabilities of six outcomes following five different SCDs. We also computed probabilities of the six outcomes following the 16 most frequent SCD-SPD combinations. The pick action (e.g. pick and roll, pop and pop) was the most prevalent SCD (33%). However, this SCD did not produce the highest probability of a free shot (0.235). The highest probability of a free shot followed the SCD without ball (0.409). The pick was performed not only to attempt scoring but also to initiate offenses, as it produced the highest probability leading to a new SCD (0.403). Additionally, the SPD performed influenced the outcome of the SCD. This reinforces the notion that the opposition (offensive-defensive interaction) should be considered. To the best of our knowledge, in team sports, this is the first study to successfully model the tactical features involved in offense-defense interactions. Our analyses revealed that the high frequency of occurrence of some SCDs may be justified not only by an associated high probability of free shots but also by the possibility of progressively create more space in the defense (i.e. a new SCD as outcome). In the second case, it evidences offensive strategic features of progressive disruption of the defensive system through the concatenation of subsequent offensive actions.

  12. Communicating patient-reported outcome scores using graphic formats: results from a mixed-methods evaluation.

    Science.gov (United States)

    Brundage, Michael D; Smith, Katherine C; Little, Emily A; Bantug, Elissa T; Snyder, Claire F

    2015-10-01

    Patient-reported outcomes (PROs) promote patient-centered care by using PRO research results ("group-level data") to inform decision making and by monitoring individual patient's PROs ("individual-level data") to inform care. We investigated the interpretability of current PRO data presentation formats. This cross-sectional mixed-methods study randomized purposively sampled cancer patients and clinicians to evaluate six group-data or four individual-data formats. A self-directed exercise assessed participants' interpretation accuracy and ratings of ease-of-understanding and usefulness (0 = least to 10 = most) of each format. Semi-structured qualitative interviews explored helpful and confusing format attributes. We reached thematic saturation with 50 patients (44 % < college graduate) and 20 clinicians. For group-level data, patients rated simple line graphs highest for ease-of-understanding and usefulness (median 8.0; 33 % selected for easiest to understand/most useful) and clinicians rated simple line graphs highest for ease-of-understanding and usefulness (median 9.0, 8.5) but most often selected line graphs with confidence limits or norms (30 % for each format for easiest to understand/most useful). Qualitative results support that clinicians value confidence intervals, norms, and p values, but patients find them confusing. For individual-level data, both patients and clinicians rated line graphs highest for ease-of-understanding (median 8.0 patients, 8.5 clinicians) and usefulness (median 8.0, 9.0) and selected them as easiest to understand (50, 70 %) and most useful (62, 80 %). The qualitative interviews supported highlighting scores requiring clinical attention and providing reference values. This study has identified preferences and opportunities for improving on current formats for PRO presentation and will inform development of best practices for PRO presentation. Both patients and clinicians prefer line graphs across group-level data and individual

  13. Goals, Motivation for, and Outcomes of Personal Learning through Networks: Results of a Tweetstorm

    Science.gov (United States)

    Sie, Rory L. L.; Pataraia, Nino; Boursinou, Eleni; Rajagopal, Kamakshi; Margaryan, Anoush; Falconer, Isobel; Bitter-Rijpkema, Marlies; Littlejohn, Allison; Sloep, Peter B.

    2013-01-01

    Recent developments in the use of social media for learning have posed serious challenges for learners. The information overload that these online social tools create has changed the way learners learn and from whom they learn. An investigation of learners' goals, motivations and expected outcomes when using a personal learning network is…

  14. Peripheral glucose levels and cognitive outcome after ischemic stroke : Results from the Munich Stroke Cohort

    NARCIS (Netherlands)

    Zietemann, Vera; Wollenweber, Frank Arne; Bayer-Karpinska, Anna; Biessels, Geert Jan; Dichgans, Martin

    2016-01-01

    Introduction: The relationship between glucose metabolism and stroke outcome is likely to be complex. We examined whether there is a linear or non-linear relationship between glucose measures in the acute phase of stroke and post-stroke cognition, and whether altered glucose metabolism at different

  15. Improved quality of nursing documentation: results of a nursing diagnoses, interventions, and outcomes implementation study.

    NARCIS (Netherlands)

    Muller-Staub, M.; Needham, I.; Odenbreit, M.; Lavin, M.A.; Achterberg, T. van

    2007-01-01

    PURPOSE: To evaluate the impact of the quality of nursing diagnoses, interventions, and outcomes in an acute care hospital following the implementation of an educational program. METHOD: In a pretest-posttest experimental design study, nurses from 12 wards of a Swiss hospital received an educational

  16. Predictors of outcomes in outpatients with anorexia nervosa - Results from the ANTOP study.

    Science.gov (United States)

    Wild, Beate; Friederich, Hans-Christoph; Zipfel, Stephan; Resmark, Gaby; Giel, Katrin; Teufel, Martin; Schellberg, Dieter; Löwe, Bernd; de Zwaan, Martina; Zeeck, Almut; Herpertz, Stephan; Burgmer, Markus; von Wietersheim, Jörn; Tagay, Sefik; Dinkel, Andreas; Herzog, Wolfgang

    2016-10-30

    This study aimed to determine predictors of BMI and recovery for outpatients with anorexia nervosa (AN). Patients were participants of the ANTOP (Anorexia Nervosa Treatment of Out-Patients) trial and randomized to focal psychodynamic therapy (FPT), enhanced cognitive behavior therapy (CBT-E), or optimized treatment as usual (TAU-O). N=169 patients participated in the one-year follow-up (T4). Outcomes were the BMI and global outcome (recovery/partial syndrome/full syndrome) at T4. We examined the following baseline variables as possible predictors: age, BMI, duration of illness, subtype of AN, various axis I diagnoses, quality of life, self-esteem, and psychological characteristics relevant to AN. Linear and logistic regression analyses were conducted to identify the predictors of the BMI and global outcome. The strongest positive predictor for BMI and recovery at T4 was a higher baseline BMI of the patients. Negative predictors for BMI and recovery were a duration of illness >6 years and a lifetime depression diagnosis at baseline. Additionally, higher bodily pain was significantly associated with a lower BMI and self-esteem was a positive predictor for recovery at T4. A higher baseline BMI and shorter illness duration led to a better outcome. Further research is necessary to investigate whether or not AN patients with lifetime depression, higher bodily pain, and lower self-esteem may benefit from specific treatment approaches. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  17. Clinical and radiographic outcome of revision surgery of radial head prostheses: midterm results in 16 patients

    NARCIS (Netherlands)

    Viveen, Jetske; Kodde, Izaäk F.; Koenraadt, Koen L. M.; Beumer, Annechien; The, Bertram; Eygendaal, Denise

    2017-01-01

    Little is known about revision surgery of radial head arthroplasty. The aim of this study was to report on the clinical and radiographic outcome of revision arthroplasty of the elbow with a bipolar metallic radial head prosthesis. Between 2006 and 2013, we used either a press-fit or cemented RHS

  18. PBL-GIS in Secondary Geography Education: Does It Result in Higher-Order Learning Outcomes?

    Science.gov (United States)

    Liu, Yan; Bui, Elisabeth N.; Chang, Chew-Hung; Lossman, Hans G.

    2010-01-01

    This article presents research on evaluating problem-based learning using GIS technology in a Singapore secondary school. A quasi-experimental research design was carried to test the PBL pedagogy (PBL-GIS) with an experimental group of students and compare their learning outcomes with a control group who were exposed to PBL but not GIS. The…

  19. Predicting Postsecondary Education and Employment Outcomes Using Results from the Transition Assessment and Goal Generator

    Science.gov (United States)

    Burnes, Jennifer J.; Martin, James E.; Terry, Robert; McConnell, Amber E.; Hennessey, Maeghan N.

    2018-01-01

    We conducted an exploratory study to investigate the relation between nonacademic behavior constructs measured by the "Transition Assessment and Goal Generator" (TAGG) and postsecondary education and employment outcomes for 297 high school leavers who completed the TAGG during their high school years. Four of eight TAGG constructs…

  20. Goals, Motivation for, and Outcomes of Personal Learning through Networks: Results of a Tweetstorm

    NARCIS (Netherlands)

    Sie, Rory; Pataraia, Nino; Boursinou, Eleni; Rajagopal, Kamakshi; Margaryan, Anoush; Falconer, Isobel; Bitter-Rijpkema, Marlies; Littlejohn, Allison; Sloep, Peter

    2018-01-01

    Recent developments in the use of social media for learning have posed serious challenges for learners. The information overload that these online social tools create has changed the way learners learn and from whom they learn. An investigation of learners' goals, motivations and expected outcomes

  1. Outcomes of cataract surgery in diabetic patients: results of the Pan American Collaborative Retina Study Group

    Directory of Open Access Journals (Sweden)

    Roberto Gallego-Pinazo

    2014-12-01

    Full Text Available Purpose: This study was designed to evaluate the visual and anatomical outcomes after cataract surgery in diabetic patients with different intraoperative therapeutic strategies. Methods: The research design comprised of a multicentric, retrospective, interventional study conducted at 6 centers in Argentina, Brazil, Costa Rica, Puerto Rico, Spain, and Venezuela. We included 138 diabetic patients with at least 6-month follow-up following phacoemulsification and intraocular lens implantation. Best-corrected visual acuity (BCVA and central subfield thickness were collected at baseline and at 1-, 2-, 3-, and 6-month follow-up. Of these, 42 cases were not treated with any intraoperative coadjuvant medication (Group 1, 59 patients received intraoperative bevacizumab (Group 2 and 37 patients received intraoperative triamcinolone (4 mg/0.1 ml (Group 3. Results: The mean logMAR [± standard deviation (SD] BCVA improved from 0.82 (± 0.43 at baseline, to 0.14 (± 0.23 at 6-month follow-up (p<0.001 in Group 1; from 0.80 (± 0.48 to 0.54 (± 0.45 (p<0.001 in Group 2; and from 1.0 (± 0.40 to 0.46 (± 0.34 (p<0.001 in Group 3. The mean central subfield thickness increased from 263.57 µm (± 35.7 at baseline to 274.57 µm (± 48.7 at 6-month follow-up (p=0.088 in Group 1; from 316.02 µm (± 100.4 to 339.56 µm (± 145.3 (p=0.184 in Group 2; and from 259.18 µm (± 97.9 to 282.21 µm (± 87.24 (p=0.044 in Group 3. Conclusion: Diabetic patients may significantly benefit from cataract surgery. This study provides evidence to support the use of intravitreal triamcinolone or bevacizumab at the time of cataract surgery in cases with pre-existent diabetic macular edema or moderate-severe non-proliferative diabetic retinopathy.

  2. Adult age differences in memory for schema-consistent and schema-inconsistent objects in a real-world setting.

    Science.gov (United States)

    Prull, Matthew W

    2015-01-01

    The present study examined age-related differences in the inconsistency effect, in which memory is enhanced for schema-inconsistent information compared to schema-consistent information. Young and older adults studied schema-consistent and schema-inconsistent objects in an academic office under either intentional or incidental encoding instructions, and were given two recognition tests either immediately or after 48 hr: A yes/no item recognition test that included modified remember/know judgments and a token recognition test that required determining whether an original object was replaced with a different object with the same name. Young and older adults showed equivalent inconsistency effects in both item and token recognition tests, although older adults reported phenomenologically less rich memories of schema-inconsistent objects relative to young adults. These findings run counter to previous reports suggesting that aging is associated with processing declines at encoding that impair memory for details of schema-inconsistent or distinctive events. The results are consistent with a retrieval-based account in which age-related difficulties in retrieving contextual details can be offset by environmental support.

  3. Nuclear data and the effects of its inconsistency on instrumental neutron activation analysis

    International Nuclear Information System (INIS)

    Ahmed, Y.A.; Ewa, I.O.B.; Umar, I.M.

    2006-04-01

    In this study, we examine the role of nuclear data in Instrumental Neutron Activation Analysis (INAA) particularly as it affects determination of reactor flux parameters and application of comparator methods. The work reviewed the available sources of nuclear data, the variations that exist from one source to the other and the effects of such variations on INAA. Measurement of Neutron flux parameters in inner and outer irradiation channel of a miniature neutron source reactor was carried out using two independent nuclear data sources to investigate the effects of inconsistency of nuclear data on the precision of analytical result. The result obtained shows a slight variation of flux parameters with nuclear data source. It was also observed that modification of the earlier compiled basic nuclear data lead to inconsistencies in the secondary data that applies it. (author)

  4. Female College Students’ Media Use and Academic Outcomes: Results from a Longitudinal Cohort Study

    OpenAIRE

    Walsh, Jennifer L.; Fielder, Robyn L.; Carey, Kate B.; Carey, Michael P.

    2013-01-01

    This longitudinal study describes women’s media use during their first year of college and examines associations between media use and academic outcomes. Female students (N = 483, Mage = 18.1 years) reported on their use of 11 media forms and their grade point average, academic behaviors, academic confidence, and problems affecting schoolwork. Allowing for multi-tasking, women reported nearly 12 hours of media use per day; use of texting, music, the Internet, and social networking was heavies...

  5. Patient-Reported Outcomes and Total Health Care Expenditure in Prediction of Patient Satisfaction: Results From a National Study

    Science.gov (United States)

    Zhang, Weiping; Chen, Wei; Bounsanga, Jerry; Cheng, Christine; Franklin, Jeremy D; Crum, Anthony B; Voss, Maren W; Hon, Shirley D

    2015-01-01

    Background Health care quality is often linked to patient satisfaction. Yet, there is a lack of national studies examining the relationship between patient satisfaction, patient-reported outcomes, and medical expenditure. Objective The aim of this study is to examine the contribution of physical health, mental health, general health, and total health care expenditures to patient satisfaction using a longitudinal, nationally representative sample. Methods Using data from the 2010-2011 Medical Expenditure Panel Survey, analyses were conducted to predict patient satisfaction from patient-reported outcomes and total health care expenditures. The study sample consisted of adult participants (N=10,157), with sampling weights representative of 233.26 million people in the United States. Results The results indicated that patient-reported outcomes and total health care expenditure were associated with patient satisfaction such that higher physical and mental function, higher general health status, and higher total health care expenditure were associated with higher patient satisfaction. Conclusions We found that patient-reported outcomes and total health care expenditure had a significant relationship with patient satisfaction. As more emphasis is placed on health care value and quality, this area of research will become increasingly needed and critical questions should be asked about what we value in health care and whether we can find a balance between patient satisfaction, outcomes, and expenditures. Future research should apply big data analytics to investigate whether there is a differential effect of patient-reported outcomes and medical expenditures on patient satisfaction across different medical specialties. PMID:27227131

  6. Does Excision of Heterotopic Ossification of the Elbow Result in Satisfactory Patient-Rated Outcomes?

    Science.gov (United States)

    Sandeep, K N; Suresh, G; Gopisankar, B; Abhishek, N; Sujiv, A

    2017-03-01

    Treatment of heterotopic ossification (HO) of the elbow is challenging and fraught with complications. Patients who sustain direct trauma to the elbow joint, the central nervous system, and thermal burns are at increased risk for development of HO. There is a paucity of studies and reports on patient's self-evaluation after the excision of the heterotopic ossification. This retrospective study assessed outcomes after excision of heterotopic ossification around the elbow in a cohort of ten patients operated from 2012 to 2015. The outcome assessment was done by the Mayo Elbow Performance index (MEPI) and the American Shoulder and Elbow Surgeons-Elbow score (ASES-E scores). The mean follow-up was 18.11 months after the operation. The Mayo Elbow Performance Score was excellent in two elbows, good in six and fair in two. The mean gain in flexion-extension arc after excision of HO was 80 degrees. All of the patients had residual flexion deformity postoperatively. Eight of the nine patients were able to do activities requiring flexion at final follow-up. Excision of HO around the elbow is associated with satisfactory patient-rated outcomes in spite of failure to regain full range of motion.

  7. 18- and 24-month-olds' discrimination of gender-consistent and inconsistent activities.

    Science.gov (United States)

    Hill, Sara E; Flom, Ross

    2007-02-01

    18- and 24-month-olds' ability to discriminate gender-stereotyped activities was assessed. Using a preferential looking paradigm, toddlers viewed male and female actors performing masculine and feminine-stereotyped activities. Consistent with our predictions, and previous research, 24-month-olds, but not 18-month-olds, looked longer at the gender-inconsistent activities than the gender-consistent activities. Results are discussed in terms of toddlers emerging gender stereotypes and perception of everyday events.

  8. Examining the Effects of Displaying Clicker Voting Results on High School Students' Voting Behaviors, Discussion Processes, and Learning Outcomes

    Science.gov (United States)

    Chien, Yu-Ta; Lee, Yu-Hsien; Li, Tsung-Yen; Chang, Chun-Yen

    2015-01-01

    This study explores the relationship between students' clicking behaviors, discussion processes, learning outcomes, and a prominent feature of clicker systems--the whole class' response results aggregated by clickers in real time. The results indicate that, while teaching Newton's laws of motion, displaying the real-time responses of the whole…

  9. Planned versus actual outcomes as a result of animal feeding operation decisions for managing phosphorus.

    Science.gov (United States)

    Cabot, Perry E; Nowak, Pete

    2005-01-01

    The paper explores how decisions made on animal feeding operations (AFOs) influence the management of manure and phosphorus. Variability among these decisions from operation to operation and from field to field can influence the validity of nutrient loss risk assessments. These assessments are based on assumptions that the decision outcomes regarding manure distribution will occur as they are planned. The discrepancy between planned versus actual outcomes in phosphorus management was explored on nine AFOs managing a contiguous set of 210 fields in south-central Wisconsin. A total of 2611 soil samples were collected and multiple interviews conducted to assign phosphorus index (PI) ratings to the fields. Spearman's rank correlation coefficients (r(S)) indicated that PI ratings were less sensitive to soil test phosphorus (STP) levels (r(S) = 0.378), universal soil loss equation (USLE) (r(S) = 0.261), ratings for chemical fertilizer application (r(S) = 0.185), and runoff class (r(S) = -0.089), and more sensitive to ratings for manure application (r(S) = 0.854). One-way ANOVA indicated that mean field STP levels were more homogenous than field PI ratings between AFOs. Kolmogorov-Smirnov (K-S) tests displayed several nonsignificant comparisons for cumulative distribution functions, S(x), of mean STP levels on AFO fields. On the other hand, the K-S tests of S(x) for PI ratings indicated that the majority of these S(x) functions were significantly different between AFOs at or greater than the 0.05 significance level. Interviews suggested multiple reasons for divergence between planned and actual outcomes in managing phosphorus, and that this divergence arises at the strategic, tactical, and operational levels of decision-making.

  10. Outcomes one year after a road accident: Results from the ESPARR cohort.

    Science.gov (United States)

    Hours, Martine; Chossegros, Laetitia; Charnay, Pierrette; Tardy, Hélène; Nhac-Vu, Hoang-Thy; Boisson, Dominique; Luauté, Jacques; Laumon, Bernard

    2013-01-01

    Reducing the rates of death, trauma and sequelae associated with road accidents is the prime goal of road safety authorities, and success requires having data on victims' outcomes in the long term. The present study examined the outcome of adult road accident victims one year after their accident. A follow-up study. The cohort comprised 886 injured road-accident victims, aged ≥16 years, and living in the Rhône administrative Département, France (taken from the ESPARR Cohort). Data were collected on victim characteristics at the time of crash, and self-reported outcomes one year later. The population of respondents at the one-year questionnaire follow-up was divided into two categories according to injury severity, as mild-to-moderate (M.AISaccident, 45% of the mild-to-moderate injury group versus only 20% of severely injured subjects reported full recovery of health (paccident had had an impact on the everyday life of their family; this was twice as many as in the mild-to-moderate injury group (55% vs. 22%). Most of the severely injured reported impact on leisure, projects and emotional life: 20% reported relational difficulties in the couple, 16% reported impaired sexual life, and the rate of separation was significantly higher than in the mild-to-moderate injury group (5% vs. 1%; proad accident, the consequences for victims remain significant. In terms of physical impact, pain frequently persists, impairing daily life for many. There is an elevated rate of chronic PTSD (post-traumatic stress disorder) and a non-negligible impact on affective and occupational life. Copyright © 2012 Elsevier Ltd. All rights reserved.

  11. Patient-Reported Outcomes and Total Health Care Expenditure in Prediction of Patient Satisfaction: Results From a National Study.

    Science.gov (United States)

    Hung, Man; Zhang, Weiping; Chen, Wei; Bounsanga, Jerry; Cheng, Christine; Franklin, Jeremy D; Crum, Anthony B; Voss, Maren W; Hon, Shirley D

    2015-01-01

    Health care quality is often linked to patient satisfaction. Yet, there is a lack of national studies examining the relationship between patient satisfaction, patient-reported outcomes, and medical expenditure. The aim of this study is to examine the contribution of physical health, mental health, general health, and total health care expenditures to patient satisfaction using a longitudinal, nationally representative sample. Using data from the 2010-2011 Medical Expenditure Panel Survey, analyses were conducted to predict patient satisfaction from patient-reported outcomes and total health care expenditures. The study sample consisted of adult participants (N=10,157), with sampling weights representative of 233.26 million people in the United States. The results indicated that patient-reported outcomes and total health care expenditure were associated with patient satisfaction such that higher physical and mental function, higher general health status, and higher total health care expenditure were associated with higher patient satisfaction. We found that patient-reported outcomes and total health care expenditure had a significant relationship with patient satisfaction. As more emphasis is placed on health care value and quality, this area of research will become increasingly needed and critical questions should be asked about what we value in health care and whether we can find a balance between patient satisfaction, outcomes, and expenditures. Future research should apply big data analytics to investigate whether there is a differential effect of patient-reported outcomes and medical expenditures on patient satisfaction across different medical specialties.

  12. Transportation safety aspects of ore and related material - inconsistencies in current exemption values

    International Nuclear Information System (INIS)

    Rawl, R.R.; Leggett, R.W.; Eckerman, K.F.; Cook, J.R.

    2004-01-01

    The IAEA's system for exemption of material from the transport regulations is based on the fundamental principle that exemption values should be commensurate with the risk posed by the material, as represented by effective dose and skin dose. Important departures from that principle as well as inconsistencies between exemption values for different radionuclides have resulted from special provisions for natural materials that depend on their intended use, and from exposure scenarios and other assumptions and rules used in the derivation of exemption values. This paper examines the sources and extent of inconsistencies in exemption values for transport, particularly as they relate to naturally occurring radionuclides, and suggests ways to achieve greater internal consistency in exemption values as well as greater consistency with the fundamental principle underlying the current system

  13. The Belief that Alcohol Use is Inconsistent with Personal Autonomy: A Promotive Factor for Younger Adolescents

    Science.gov (United States)

    Henry, Kimberly L.; Shtivelband, Annette; Comello, Maria Leonora G.; Slater, Michael D.

    2011-01-01

    This study explored an understudied promotive factor, a belief that alcohol use is inconsistent with personal autonomy, which may reduce adolescent intention to drink and subsequent alcohol use. Autonomy was examined as an attitudinal construct within the Theory of Reasoned Action. Longitudinal data from 2,493 seventh grade students nested in 40 schools were analyzed using a structural equation model. Autonomy was negatively correlated with intention to use alcohol and subsequent alcohol use at a later wave, and intention to use fully mediated the effect of autonomy on subsequent alcohol use. These results are consistent with the proposition that when personal autonomy is perceived as inconsistent with alcohol use among younger adolescents, students indicate a lower intention to use alcohol and use less alcohol during the following school year. PMID:23519434

  14. The Belief that Alcohol Use is Inconsistent with Personal Autonomy: A Promotive Factor for Younger Adolescents.

    Science.gov (United States)

    Henry, Kimberly L; Shtivelband, Annette; Comello, Maria Leonora G; Slater, Michael D

    2011-08-01

    This study explored an understudied promotive factor, a belief that alcohol use is inconsistent with personal autonomy, which may reduce adolescent intention to drink and subsequent alcohol use. Autonomy was examined as an attitudinal construct within the Theory of Reasoned Action. Longitudinal data from 2,493 seventh grade students nested in 40 schools were analyzed using a structural equation model. Autonomy was negatively correlated with intention to use alcohol and subsequent alcohol use at a later wave, and intention to use fully mediated the effect of autonomy on subsequent alcohol use. These results are consistent with the proposition that when personal autonomy is perceived as inconsistent with alcohol use among younger adolescents, students indicate a lower intention to use alcohol and use less alcohol during the following school year.

  15. Analysis of inconsistent source sampling in monte carlo weight-window variance reduction methods

    Directory of Open Access Journals (Sweden)

    David P. Griesheimer

    2017-09-01

    Full Text Available The application of Monte Carlo (MC to large-scale fixed-source problems has recently become possible with new hybrid methods that automate generation of parameters for variance reduction techniques. Two common variance reduction techniques, weight windows and source biasing, have been automated and popularized by the consistent adjoint-driven importance sampling (CADIS method. This method uses the adjoint solution from an inexpensive deterministic calculation to define a consistent set of weight windows and source particles for a subsequent MC calculation. One of the motivations for source consistency is to avoid the splitting or rouletting of particles at birth, which requires computational resources. However, it is not always possible or desirable to implement such consistency, which results in inconsistent source biasing. This paper develops an original framework that mathematically expresses the coupling of the weight window and source biasing techniques, allowing the authors to explore the impact of inconsistent source sampling on the variance of MC results. A numerical experiment supports this new framework and suggests that certain classes of problems may be relatively insensitive to inconsistent source sampling schemes with moderate levels of splitting and rouletting.

  16. Intensive glucose regulation in hyperglycemic acute coronary syndrome: Results of the randomized BIOMarker study to identify the acute risk of a coronary syndrome-2 (BIOMArCS-2) glucose trial

    NARCIS (Netherlands)

    M. de Mulder (Maarten); V.A.W.M. Umans (Victor); J.H. Cornel (Jan); F.M. van der Zant (F.); F. Stam (Frank); R.M. Oemrawsingh (Rohit); K.M. Akkerhuis (Martijn); H. Boersma (Eric)

    2013-01-01

    textabstractIMPORTANCE: Elevated plasma glucose levels in patients with acute coronary syndrome (ACS) on hospital admission are associated with increased mortality. Clinical trials of glucose regulation have provided inconsistent results with respect to cardiovascular outcomes, perhaps because

  17. Analysis of characteristics associated with reinjection of icatibant: Results from the icatibant outcome survey.

    Science.gov (United States)

    Longhurst, Hilary J; Aberer, Werner; Bouillet, Laurence; Caballero, Teresa; Fabien, Vincent; Zanichelli, Andrea; Maurer, Marcus

    2015-01-01

    Phase 3 icatibant trials showed that most hereditary angioedema (HAE) (C1 inhibitor deficiency) acute attacks were treated successfully with one injection of icatibant, a selective bradykinin B2 receptor antagonist. We conducted a post hoc analysis of icatibant reinjection for HAE type I and II attacks in a real-world setting by using data from the Icatibant Outcome Survey, an ongoing observational study that monitors the safety and effectiveness of icatibant treatment. Descriptive retrospective analyses of icatibant reinjection were performed on Icatibant Outcome Survey data (February 2008 to December 2012). New attacks were defined as the onset of new symptoms after full resolution of the previous attack. Potential associations between the patient and attack characteristics and reinjection were explored by using logistic regression analysis. Icatibant was administered for 652 attacks in 170 patients with HAE type I or II. Most attacks (89.1%) were treated with a single icatibant injection. For attacks that required two or three injections, the second injection was given a median of 11.0 hours after the first injection, with 90.4% of second injections administered ≥6 hours after the first injection. Time to resolution and attack duration were significantly longer for two or three injections versus one icatibant injection (p < 0.0001 and p < 0.05, respectively). Multivariate logistic regression analysis identified sex, attack severity, and laryngeal attacks as significantly correlated with reinjection (all p ≤ 0.05). These factors did not remain predictors for reinjection when two outlier patients with distinct patterns of icatibant use were excluded. In this real-world setting, most HAE attacks resolved with one icatibant injection. There was no distinct profile for patients or attacks that required reinjection when outliers with substantially different patterns of use were excluded. Because new attacks were not distinguished from the recurrence of symptoms

  18. Intraoperative floppy iris and prevalence of intraoperative complications: results from ophthalmic surgery outcomes database.

    Science.gov (United States)

    Vollman, David E; Gonzalez-Gonzalez, Luis A; Chomsky, Amy; Daly, Mary K; Baze, Elizabeth; Lawrence, Mary

    2014-06-01

    To estimate the prevalence of untoward events during cataract surgery with the use of pupillary expansion devices and intraoperative floppy iris (IFIS). Retrospective analysis of 4923 cataract surgery cases from the Veterans Affairs Ophthalmic Surgical Outcomes Data Project. Outcomes from 5 Veterans Affairs medical centers were analyzed, including use of alpha-blockers (both selective and nonselective), IFIS, intraoperative iris trauma, intraoperative iris prolapse, posterior capsular tear, anterior capsule tear, intraoperative vitreous prolapse, and use of pupillary expansion devices. P values were calculated using the χ(2) test. A total of 1254 patients (25.5%) took alpha-blockers preoperatively (selective, 587; nonselective, 627; both, 40). Of these 1254 patients, 428 patients (34.1%) had documented IFIS. However, 75.2% of patients with IFIS (428/569) had taken alpha-blockers preoperatively (P < .00001). A total of 430 patients (8.7%) had a pupillary expansion device used during their cataract surgery, of which 186 patients (43.4%) had IFIS (P < .0001). Eighty-six patients with IFIS had at least 1 intraoperative complication and 39 patients with IFIS had more than 1 intraoperative complication (P < .001). The use of either selective or nonselective alpha-antagonists preoperatively demonstrated a significant risk of IFIS. Nonselective alpha-antagonists caused IFIS at a higher prevalence than previously reported. This study did demonstrate statistically significant increased odds of surgical complications in patients with IFIS vs those without IFIS in all groups (those taking selective and nonselective alpha-antagonists and also those not taking medications). Published by Elsevier Inc.

  19. Neighborhood characteristics and lifestyle intervention outcomes: Results from the Special Diabetes Program for Indians.

    Science.gov (United States)

    Jiang, Luohua; Chang, Jenny; Beals, Janette; Bullock, Ann; Manson, Spero M

    2018-06-01

    Growing evidence reveals various neighborhood conditions are associated with the risk of developing type 2 diabetes. It is unknown, however, whether the effectiveness of diabetes prevention interventions is also influenced by neighborhood characteristics. The purpose of the current study is to examine the impact of neighborhood characteristics on the outcomes of a lifestyle intervention to prevent diabetes in American Indians and Alaska Natives (AI/ANs). Year 2000 US Census Tract data were linked with those from the Special Diabetes Program for Indians Diabetes Prevention Program (SDPI-DP), an evidence-based lifestyle intervention implemented in 36 AI/AN grantee sites across the US. A total of 3394 participants started the intervention between 01/01/2006 and 07/31/2009 and were followed by 07/31/2016. In 2016-2017, data analyses were conducted to evaluate the relationships of neighborhood characteristics with intervention outcomes, controlling for individual level socioeconomic status. AI/ANs from sites located in neighborhoods with higher median household income had 38% lower risk of developing diabetes than those from sites with lower neighborhood income (adjusted hazard ratio = 0.65, 95% CI: 0.47-0.90). Further, those from sites with higher neighborhood concentrations of AI/ANs achieved less BMI reduction and physical activity increase. Meanwhile, participants from sites with higher neighborhood level of vehicle occupancy made more improvement in BMI and diet. Lifestyle intervention effectiveness was not optimal when the intervention was implemented at sites with disadvantaged neighborhood characteristics. Meaningful improvements in socioeconomic and other neighborhood disadvantages of vulnerable populations could be important in stemming the global epidemic of diabetes. Copyright © 2018 Elsevier Inc. All rights reserved.

  20. Tape functionality: position, change in shape, and outcome after TVT procedure--mid-term results.

    Science.gov (United States)

    Kociszewski, Jacek; Rautenberg, Oliver; Kolben, Sebastian; Eberhard, Jakob; Hilgers, Reinhard; Viereck, Volker

    2010-07-01

    This study evaluates the relevance of the tape position and change in shape (tape functionality) under in vivo conditions for mid-term outcome. Changes in the sonographic tension-free vaginal tape (TVT) position relative to the percentage urethral length and the tape-urethra distance were determined after 6 and 48 months in 41 women with stress urinary incontinence. At 48 months, 76% (31/41) of women were cured, 17% (7/41) were improved, and 7% (3/41) were failures. Disturbed bladder voiding was present in 12% (5/41), de novo urge incontinence in 7% (3/41). The median TVT position was at 63% of urethral length. Median tape-urethra distance was 2.7 mm, ranging from 2.9 mm in continent patients without complications to 1.1 mm in those with obstructive complications. Patients with postoperative urine loss had a median distance of 3.9 mm. The tape was stretched at rest and C-shaped during straining in 15 of 41 women (37%) at 48 months (all continent). Patients with this tape functionality at 6 months were also cured at 48 months in 86% of cases (19/22), and only 14% (3/22) showed recurrent incontinence. Mid-term data suggest an optimal outcome if the tape is positioned at least 2 mm from the urethra at the junction of the middle and distal thirds. Patients with optimal tape functionality at 6 months are likely to show mid-term therapeutic success.

  1. Homocysteine-Lowering and Cardiovascular Disease Outcomes in Kidney Transplant Recipients: Primary Results from the Folic Acid for Vascular Outcome Reduction in Transplantation (FAVORIT) Trial

    Science.gov (United States)

    Bostom, Andrew G.; Carpenter, Myra A.; Kusek, John W.; Levey, Andrew S.; Hunsicker, Lawrence; Pfeffer, Marc A.; Selhub, Jacob; Jacques, Paul F.; Cole, Edward; Gravens-Mueller, Lisa; House, Andrew A.; Kew, Clifton; McKenney, Joyce L.; Pacheco-Silva, Alvaro; Pesavento, Todd; Pirsch, John; Smith, Stephen; Solomon, Scott; Weir, Matthew

    2015-01-01

    Background Kidney transplant recipients, like other patients with chronic kidney disease (CKD), experience excess risk of cardiovascular disease (CVD) and elevated total homocysteine (tHcy) concentrations. Observational studies of patients with CKD suggest increased homocysteine is a risk factor for CVD. The impact of lowering total homocysteine (tHcy) levels in kidney transplant recipients is unknown. Methods and Results In a double-blind controlled trial, we randomized 4110 stable kidney transplant recipients to a multivitamin that included either a high dose (n=2056) or low dose (n=2054) of folic acid, vitamin B6, and vitamin B12 to determine whether decreasing tHcy concentrations reduced the rate of the primary composite arteriosclerotic CVD outcome (myocardial infarction, stroke, CVD death, resuscitated sudden death, coronary artery or renal artery revascularization, lower extremity arterial disease, carotid endarterectomy or angioplasty, or abdominal aortic aneurysm repair). Mean follow-up was 4.0 years. Treatment with the high dose multivitamin reduced homocysteine but did not reduce the rates of the primary outcome (n= 547 total events; hazards ratio [95% confidence interval] = 0.99 [0.84–1.17]), or secondary outcomes of all-cause mortality (n=431 deaths; 1.04 [0.86–1.26]) or dialysis-dependent kidney failure (n=343 events; 1.15 [0.93–1.43]) compared to the low dose multivitamin. Conclusions Treatment with a high dose folic acid, B6, and B12 multivitamin in kidney transplant recipients did not reduce a composite cardiovascular disease outcome, all-cause mortality, or dialysis-dependent kidney failure despite significant reduction in homocysteine level. PMID:21482964

  2. Financial Health of the Higher Education Sector: Financial Results and TRAC Outcomes 2013-14. Issues Paper 2015/07

    Science.gov (United States)

    Higher Education Funding Council for England, 2015

    2015-01-01

    This report provides an overview of the financial health of the Higher Education Funding Council for England (HEFCE)-funded higher education sector in England. The analysis covers financial results for the academic year 2013-14, as submitted to HEFCE in December 2014, as well as the outcomes from the sector's Transparent Approach to Costing (TRAC)…

  3. Confidence in Science and Achievement Outcomes of Fourth-Grade Students in Korea: Results from the TIMSS 2011 Assessment

    Science.gov (United States)

    House, J. Daniel; Telese, James A.

    2017-01-01

    Findings from assessments of fourth-grade science have indicated that students in Korea scored higher than international averages. Research results have also shown that attitudes toward science were related to achievement outcomes for Korean students. The purpose of this study was to examine the relationship between confidence in science and…

  4. Do Syrian refugees have increased risk for worser pregnancy outcomes? Results of a tertiary center in İstanbul.

    Science.gov (United States)

    Güngör, Emre Sinan; Seval, Olcay; İlhan, Gülşah; Verit, Fatma Ferda

    2018-03-01

    To compare obstetric and perinatal outcomes of Syrian refugee pregnants and Turkish counterparts who gave birth at a tertiary center in İstanbul. A retrospective study including the birth records of 704 Syrian refugees and 744 Turkish pregnant women between January 2016 and May 2017 were analyzed. Demographic data, obstetric and neonatal outcomes were compared. The primary aims of this study were to evaluate the pregnancy outcomes and cesarean rates between the groups. The secondary outcomes were the use of antenatal vitamin supplementation, hemoglobin-hematocrit values, and maternal complications. Our results showed that the use of folic acid and iron supplementation rates during pregnancy were similar between the groups (folic acid supplementation 8.1% vs 6.5%, p=0.264; iron supplementation 20.7% vs 19.6%, p=0.125; respectively for Turkish women and Syrian refugees). Cesarean rates were significantly higher for Turkish patients than in Syrian refugees (42.7% vs 32.7%; pyrian refugees (37.7±2.3 vs 36.4±2.3 weeks, pyrian refugees, respectively, p=0.105). Although obstetric complications were seen more often in Syrian refugees, it did not reach statistical difference (9.7% vs 8.1%, respectively, p=0.285). Syrian refugees use antenatal vitamin supplementations at similar rates to Turkish citizens and obstetric and perinatal outcomes are similar between the groups.

  5. Postoperative Outcomes in Graves' Disease Patients: Results from the Nationwide Inpatient Sample Database.

    Science.gov (United States)

    Rubio, Gustavo A; Koru-Sengul, Tulay; Vaghaiwalla, Tanaz M; Parikh, Punam P; Farra, Josefina C; Lew, John I

    2017-06-01

    Current surgical indications for Graves' disease include intractability to medical and/or radioablative therapy, compressive symptoms, and worsening ophthalmopathy. Total thyroidectomy for Graves' disease may be technically challenging and lead to untoward perioperative outcomes. This study examines outcomes in patients with Graves' disease who underwent total thyroidectomy and assesses its safety for this patient population. A retrospective cross-sectional analysis was performed using the Nationwide Inpatient Sample database from 2006 to 2011. Total thyroidectomy performed in patients with Graves' disease, benign multinodular goiter (MNG), and thyroid cancer was identified. Demographic factors, comorbidities, and postoperative complications were evaluated. Chi-square, one-way analysis of variance, and risk-adjusted multivariable logistic regression were performed. Of 215,068 patients who underwent total thyroidectomy during the study period, 11,205 (5.2%) had Graves' disease, 110,124 (51.2%) MNG, and 93,739 (43.6%) thyroid malignancy. Patients with Graves' disease were younger than MNG and thyroid cancer patients (M age  = 42.8 years vs. 55.5 and 51.0 years; p Graves' disease group included a higher proportion of women (p Graves' disease was independently associated with a higher risk of vocal-cord paralysis (odds ratio [OR] = 1.36 [confidence interval (CI) 1.08-1.69]), tracheostomy (OR = 1.35 [CI 1.1-1.67]), postoperative hypocalcemia (OR = 1.65 [CI 1.54-1.77]), and hematoma requiring reoperation (OR = 2.79 [CI 2.16-3.62]) compared to MNG patients. High-volume centers for total thyroidectomy were independently associated with lower risk of postoperative complications, including in patients with Graves' disease. Despite low overall morbidity following total thyroidectomy, Graves' disease patients are at increased risk of postoperative complications, including bleeding, vocal-cord paralysis, tracheostomy, and hypocalcemia. These risks appear

  6. Post-stroke rehabilitation in Italy: inconsistencies across regional strategies.

    Science.gov (United States)

    Guidetti, D; Spallazzi, M; Baldereschi, M; Di Carlo, A; Ferro, S; Rota E Morelli, N; Immovilli, P; Toni, D; Polizzi, B M; Inzitari, D

    2014-06-01

    Remarkable differences among European countries have been found in stroke rehabilitation models, owing to the fact that stroke rehabilitation services are embedded in health care systems. Comprehensive data on service utilization by stroke survivors in Italy are lacking, but would be instrumental in improving efficiency and effectiveness of post-acute stroke care, and consequently, in containing costs and improving outcomes. The purpose of the present study was to survey the Italian regional legislations in order to examine the provision of rehabilitation services for stroke survivors in Italy. This is a cross-sectional, observational study. Post-stroke intra- and extra-hospital rehabilitation. All decrees and resolutions as to post-acute stroke rehabilitation were collected from each Italian region. All decrees and resolutions were examined by the means of a check list including quantitative and qualitative characteristics, selected in accordance with national official recommendations. Each completed check list was then sent to each regional reference person, who filled in the section on the implementation of the indications and compliance. The study was carried out from November 2009 to September 2010. The documents were collected from 19 out of the 20 Italian regions. The results of the study indicate that there are many, remarkable regional variations in health policies concerning post-stroke care. Instruments for evaluation and criteria for allocating stroke patients to proper rehabilitation setting vary across regions, but data on the potential impact of these variations on clinical outcomes are still lacking. The study highlights the issue that, in Italy, delivery of post-stroke rehabilitation services is not uniform nation-wide and varies substantially across regions. The lack of a comprehensive post-acute stroke strategy is a major obstacle to service availability. The study results advocate the need for a consistent and comprehensive strategic planning of

  7. High-precision radiotherapy for meningiomas. Long-term results and patient-reported outcome (PRO)

    Energy Technology Data Exchange (ETDEWEB)

    Kessel, Kerstin A.; Fischer, Hanna; Combs, Stephanie E. [Technical University of Munich (TUM), Department of Radiation Oncology, Munich (Germany); Helmholtz Zentrum Muenchen (HMGU), Institute for Innovative Radiotherapy (iRT), Department of Radiation Sciences DRS, Neuherberg (Germany); Oechnser, Markus [Technical University of Munich (TUM), Department of Radiation Oncology, Munich (Germany); Zimmer, Claus [Technical University of Munich (TUM), Department of Neuroradiology, Munich (Germany); Meyer, Bernhard [Technical University of Munich (TUM), Department of Neurosurgery, Munich (Germany)

    2017-11-15

    To evaluate long-term outcome after high-precision radiotherapy (RT) of meningioma patients in terms of survival and side effects. We analyzed 275 meningioma cases: 147 low-grade and 43 high-grade meningiomas (WHO II: n = 40, III: n = 3). In all, 85 patients had no pathologically confirmed histology but were determined as low-grade based on multimodal imaging. Surgery was performed in 183 cases. RT was delivered as either radiosurgery (RS, n = 16), fractionated stereotactic radiotherapy (FSRT, n = 241), or intensity-modulated radiation therapy (IMRT, n = 18). Of 218 patients contacted for patient-reported-outcome (PRO), 207 responded (95%). Median follow-up was 7.2 years. For low-grade meningioma the survival rate (OS) was 97% at 3 years, 85% at 10 years, and 64% at 15 years, for atypical meningioma 91% at 3 years, 62% at 10 years, and 50% at 15 years. Local control rate (PFS) for low-grade meningioma was 91% at 3 years, 87% at 5 years, and 86% at 10 years, for atypical cases 67% at 3 years and 55% at 5 years. Of all, 3.0% of patients reported worsened or new symptoms grade ≥3 during RT and the first 6 months thereafter; 17.5% reported a deterioration after more than 2 years. We found the prognostic factors tumor volume and age significantly influencing OS and PFS. Complemented by PRO, we found long-term low toxicity rates in addition to excellent local control. Thus, due to the beneficial risk-benefit profile of benign and high-risk meningiomas, RT should be performed as adjuvant treatment and should not be postponed until tumor progression. (orig.) [German] Langzeitergebnisse nach Hochpraezisionsstrahlentherapie (RT) von Patienten mit Meningeomen hinsichtlich Ueberleben und Nebenwirkungen. Es wurden 275 Meningeomfaelle untersucht: 145 benigne (WHO I), 40 atypische (WHO II) und 3 anaplastische (WHO III) Meningeome; bei 85 Patienten bestand keine histologische Sicherung. Voroperiert waren 183 Faelle (67 %). Bei 16 Patienten wurde eine Radiochirurgie (RS

  8. PROSPECT Eligibility and Clinical Outcomes: Results From the Pan-Canadian Rectal Cancer Consortium.

    Science.gov (United States)

    Bossé, Dominick; Mercer, Jamison; Raissouni, Soundouss; Dennis, Kristopher; Goodwin, Rachel; Jiang, Di; Powell, Erin; Kumar, Aalok; Lee-Ying, Richard; Price-Hiller, Julie; Heng, Daniel Y C; Tang, Patricia A; MacLean, Anthony; Cheung, Winson Y; Vickers, Michael M

    2016-09-01

    The PROSPECT trial (N1048) is evaluating the selective use of chemoradiation in patients with cT2N1 and cT3N0-1 rectal cancer undergoing sphincter-sparing low anterior resection. We evaluated outcomes of PROSPECT-eligible and -ineligible patients from a multi-institutional database. Data from patients with locally advanced rectal cancer who received chemoradiation and low anterior resection from 2005 to 2014 were retrospectively collected from 5 Canadian centers. Overall survival, disease-free survival (DFS), recurrence-free survival (RFS), and time to local recurrence (LR) were estimated using the Kaplan-Meier method, and a multivariate analysis was performed adjusting for prognostic factors. A total of 566 (37%) of 1531 patients met the PROSPECT eligibility criteria. Eligible patients were more likely to have better PS (P = .0003) and negative circumferential resection margin (P PROSPECT eligibility was associated with improved DFS (hazard ratio [HR], 0.75; 95% confidence interval [CI], 0.61-0.91), overall survival (HR, 0.73; 95% CI, 0.57-0.95), and RFS (HR, 0.68; 95% CI, 0.54-0.86) in univariate analyses. In multivariate analysis, only RFS remained significantly improved for PROSPECT-eligible patients (HR, 0.75; 95% CI, 0.57-1.00, P = .0499). The 3-year DFS and freedom from LR for PROSPECT-eligible patients were 79.1% and 97.4%, respectively, compared to 71.1% and 96.8% for PROSPECT-ineligible patients. Real-world data corroborate the eligibility criteria used in the PROSPECT study; the criteria identify a subgroup of patients in whom risk of recurrence is lower and in whom selective use of chemoradiation should be actively examined. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. Predictors of a favourable outcome in patients with fibromyalgia: results of 1-year follow-up.

    Science.gov (United States)

    Kim, Ji-Eun; Park, Dong-Jin; Choi, Sung-Eun; Kang, Ji-Hyoun; Yim, Yi-Rang; Lee, Jeong-Won; Lee, Kyung-Eun; Wen, Lihui; Kim, Seong-Kyu; Choe, Jung-Yoon; Lee, Shin-Seok

    2016-01-01

    To determine the outcomes of Korean patients with fibromyalgia (FM) and to identify prognostic factors associated with improvement at 1-year follow-up. Forty-eight patients with FM were enrolled and examined every 3 months for 1 year. At the time of enrollment, we interviewed all patients using a structured questionnaire that recorded socio-demographic data, current or past FM symptoms, and current use of relevant medications. Tender point counts and scores were assessed by thumb palpation. Patients were asked to complete the Korean versions of the Fibromyalgia Impact Questionnaire (FIQ), the Brief Fatigue Inventory, the SF-36, the Beck Depression Inventory, the State-Trait Anxiety Inventory (STAI), the Self-Efficacy Scale, and the Social Support Scale. Tender points, FIQ scores, and the use of relevant medications were recorded during one year of follow-up. Of the 48 patients, 32 (66.7%) had improved FIQ scores 1 year after enrollment. Improved patients had higher baseline FIQ scores (68.4±13.9 vs. 48.4±20.8, p=0.001) and STAI-II scores (55.8±10.9 vs. 11.5±11.5, p=0.022). Patients treated with pregabalin were more likely to improve after 1 year, based on the FIQ scores (71.9% vs. 37.5%, p=0.031). On multivariate logistic regression analysis, a higher STAI-II score at the time of enrollment and pregabalin treatment during one year of follow-up were the predictors of improvement. Two-thirds of our Korean FM patients experienced some clinical improvement by 1-year follow-up. A high baseline STAI-II score and treatment with pregabalin were the important predictor of improved FM.

  10. Re: Factors Predicting Outcomes of Micropercutaneous Nephrolithotomy: Results from a Large Single-Centre Experience

    Directory of Open Access Journals (Sweden)

    Yakup Bostancı

    2016-09-01

    Full Text Available The recently developed micropercutaneous nephrolithotomy (microperc is the miniaturized version of mini-percutaneous nephrolithotomy (PCNL and standard-PCNL that allows for safe access and stone disintegration under direct vision. In this single-centre study, the authors aimed to define the role of microperc in the management of renal calculi and analyse factors predicting outcomes. A total of 139 patients, who underwent microperc between June 2010 and November 2014, were enrolled in this study. Microperc was successful in 119 (91.53% patients, while in 11 patients (8.46% some residual fragments were seen on imaging. Of the total study group, conversion to mini- or standard PCNL was required in nine patients (6.47%. Overall complication rate of 11.53%, primarily minor complications comprising renal colic and urinary tract infection. On multivariate analysis, stone density (HU, stone number and stone volume were significantly associated with the dependent variable stone clearance. Multivariate analysis showed that intra-operative complications and stone number were significantly associated with conversion to mini- or standard PCNL. Stone volume threshold of 1.000 mm3 was a significant predictor of stone clearance in univariate and multivariate analyses, regardless of the stone location. Some limitations of this study, relatively small sample size and particularly the retrospective and non-comparative design, should be highlighted. EAU guidelines recommend shockwave lithotripsy (SWL or retrograde intrarenal surgery as the primary treatment modality for stones <10 mm in size. Although microperc is presently being used for small to moderate stones, the very indication that holds for SWL as well, it is notable that SWL is influenced by stone location and pelvicalyceal anatomy, and may require multiple sessions. Nevertheless, microperc has an inherent limitation in that the stone fragments cannot be retrieved for analysis. It has been noted that the

  11. Diet matters, particularly in pregnancy – Results from MoBa studies of maternal diet and pregnancy outcomes

    Directory of Open Access Journals (Sweden)

    Anne Lise Brantsæter

    2014-12-01

    Full Text Available Awareness that maternal diet may influence the outcome of pregnancy as well as the long-term health of mother and child has increased in recent years. A new food frequency questionnaire (FFQ was developed and validated specifically for the Norwegian Mother and Child Cohort Study (MoBa. The MoBa FFQ is a semi-quantitative tool which covers the average intake of food, beverages and dietary supplements during the first 4 to 5 months of pregnancy. It includes questions about intakes of 255 foods and dishes and was used from 2002 onwards. Data assessed by the MoBa FFQ is available for 87,700 pregnancies. Numerous sub-studies have examined associations between dietary factors and health outcomes in MoBa. The aim of this paper is to summarize the results from 19 studies of maternal diet and pregnancy outcomes, which is the complete collection of studies based on the MoBa FFQ and published before September 2014. The overall research question is whether maternal diet – from single substances to dietary patterns – matters for pregnancy outcome. The pregnancy outcomes studied till now include birth size measures, infants being small and large for gestational age, pregnancy duration, preterm delivery, preeclampsia, as well as maternal gestational weight gain and postpartum weight retention. As a whole, the results from these studies corroborate that the current dietary recommendations to pregnant women are sound and that maternal diet during pregnancy is likely to contribute to reduce the risk of pregnancy complications including preterm birth, preeclampsia, and reduced foetal growth. The results provide supporting evidence for recommending pregnant women to consume vegetables, fruit, whole grain, fish, dairy, and water regularly and lower the intake of sugar sweetened beverages, processed meat products and salty snacks. The results showing negative impact of even low levels of environmental contaminants support the precautionary advice on consumption

  12. The inconsistent nature of symptomatic pancreatico-jejunostomy anastomotic strictures

    Science.gov (United States)

    Demirjian, Aram N; Kent, Tara S; Callery, Mark P; Vollmer, Charles M

    2010-01-01

    Background Pancreatico-jejunostomy strictures (PJS) after pancreatiocoduodenectomy (PD) are poorly understood. Methods Patients treated for PJS were identified from all PDs (n =357) performed for all indications in our practice (2002 to 2009). Technical aspects of the original operation, as well as the presentation, management and outcomes of the resultant stricture were assessed. Results Seven patients developed a symptomatic PJS for an incidence of 2%. ‘Soft’ glands and small ducts (≤3 mm) were each present in 3/7 of the original anastomoses. Pancreatic fistula occurred in 6/7. The latency period to stricture presentation averaged 41 months. Diagnosis of PJS was confirmed by secretin magnetic resonance cholangio-pancreatography (MRCP). Therapeutic endoscopic retrograde cholangiopancreatography (ERCP) was attempted – each unsuccessfully – in four patients. All patients required operative correction of their PJS by takedown/revision of the original pancreatico-jejunal anastomoses (PJA) (n =4) ± a modified Puestow (n =2). One patient's PJS was completely inaccessible due to dense adhesions. Another patient's stricture recurred and was successfully revised with a stricturoplasty. At a mean follow-up of 25 months, all are alive, but only 4/7 are pain free. Conclusion A symptomatic PJS appears to be independent of original pathological, glandular or technical features but pancreatic fistulae may contribute. Secretin MRCP is diagnostically useful, whereas ERCP has been proven to be therapeutically ineffective. Durable resolution of symptoms after surgical revision is unpredictable. PMID:20815857

  13. Including a range of outcome targets offers a broader view of fibromyalgia treatment outcome: results from a retrospective review of multidisciplinary treatment.

    Science.gov (United States)

    Marcus, Dawn A; Bernstein, Cheryl D; Haq, Adeel; Breuer, Paula

    2014-06-01

    Fibromyalgia is associated with substantial functional disability. Current drug and non-drug treatments result in statistically significant but numerically small improvements in typical numeric measures of pain severity and fibromyalgia impact. The aim of the present study was to evaluate additional measures of pain severity and functional outcome that might be affected by fibromyalgia treatment. This retrospective review evaluated outcomes from 274 adults with fibromyalgia who participated in a six-week, multidisciplinary treatment programme. Pain and function were evaluated on the first and final treatment visit. Pain was evaluated using an 11-point numerical scale to determine clinically meaningful pain reduction (decrease ≥ 2 points) and from a pain drawing. Function was evaluated by measuring active range of motion (ROM), walking distance and speed, upper extremity exercise repetitions, and self-reports of daily activities. Numerical rating scores for pain decreased by 10-13% (p Fibromyalgia Impact Questionnaire (FIQ) scores decreased by 20% (p fibromyalgia treatment effectiveness. © 2013 John Wiley & Sons, Ltd.

  14. Adult experience of mental health outcomes as a result of intimate partner violence victimisation: a systematic review

    Science.gov (United States)

    Lagdon, Susan; Armour, Cherie; Stringer, Maurice

    2014-01-01

    Background Intimate partner violence (IPV) has been known to adversely affect the mental health of victims. Research has tended to focus on the mental health impact of physical violence rather than considering other forms of violence. Objective To systematically review the literature in order to identify the impact of all types of IPV victimisation on various mental health outcomes. Method A systematic review of 11 electronic databases (2004–2014) was conducted. Fifty eight papers were identified and later described and reviewed in relation to the main objective. Results Main findings suggest that IPV can have increasing adverse effects on the mental health of victims in comparison with those who have never experienced IPV or those experiencing other traumatic events. The most significant outcomes were associations between IPV experiences with depression, posttraumatic stress disorder, and anxiety. Findings confirm previous observations that the severity and extent of IPV exposure can increase mental health symptoms. The effect of psychological violence on mental health is more prominent than originally thought. Individual differences such as gender and childhood experience of violence also increase IPV risk and affect mental health outcomes in diverse ways. Conclusions Psychological violence should be considered as a more serious form of IPV which can affect the mental health of victims. Experiencing more than one form of IPV can increase severity of outcomes. Researchers should look at IPV as a multi-dimensional experience. A uniformed definition and measure of IPV could help advance knowledge and understanding of this disparaging global issue. PMID:25279103

  15. Changes in Weight and Comorbidities among Adolescents Undergoing Bariatric Surgery: 1-Year Results from the Bariatric Outcomes Longitudinal Database

    Science.gov (United States)

    Messiah, Sarah E.; Lopez-Mitnik, Gabriela; Winegar, Deborah; Sherif, Bintu; Arheart, Kristopher L.; Reichard, Kirk W.; Michalsky, Marc P.; Lipshultz, Steven E.; Miller, Tracie L.; Livingstone, Alan S.; De La Cruz-Muñoz, Nestor

    2012-01-01

    Background Bariatric surgery is one of the few effective treatments for morbid obesity but the weight loss and other health related outcomes for this procedure in large, diverse adolescent patient populations are not well characterized. Objective To analyze the prospective Bariatric Outcomes Longitudinal Database (BOLD) to determine the weight loss and health related outcomes in adolescents. Setting BOLD data is collected from 423 surgeons at 360 facilities in the United States. Methods Main outcome measures included anthropometric and comorbidity status at baseline (n=890) and at 3 (n=786), 6 (n=541), and 12 (n=259) months after surgery. Adolescents (75% female; 68% non-Hispanic white, 14% Hispanic, 11% non-Hispanic black, and 6% other) age 11-to-19 years were included in the analyses. Results The overall one year mean weight loss for those who underwent gastric bypass surgery was more than twice that of those who underwent adjustable gastric band surgery (48.6 kg versus 20 kg, Psurgery types (Psurgery. There were a total of 45 readmissions among gastric bypass patients and 10 among adjustable gastric band patients with 29 and 8 reoperations required, respectively. Conclusions Weight loss at 3-, 6-, and 12-months after surgery is approximately double in adolescent males and females who underwent gastric bypass surgery versus those who underwent adjustable gastric band surgery. Bariatric surgery can safely and substantially reduce weight and related comorbidities in morbidly obese adolescents for at least 1 year. PMID:22542199

  16. Symptoms and Association with Health Outcomes in Relapsing-Remitting Multiple Sclerosis: Results of a US Patient Survey

    Directory of Open Access Journals (Sweden)

    Angela E. Williams

    2014-01-01

    Full Text Available Background. A variety of symptoms have been reported, but the prevalence of specific symptoms in relapsing-remitting multiple sclerosis (RRMS, how they are related to one another, and their impact on patient reported outcomes is not well understood. Objective. To describe how symptoms of RRMS cooccur and their impact on patient-reported outcomes. Methods. Individuals who reported a physician diagnosis of RRMS in a large general health survey in the United States indicated the symptoms they experience because of RRMS and completed validated scales, including the work productivity and activity impairment questionnaire and either the SF-12v2 or SF-36v2. Symptom clusters were identified through hierarchical cluster analysis, and the relationship between clusters and outcomes was assessed through regression. Results. Fatigue, difficulty walking, and numbness were the most commonly reported symptoms. Seven symptom clusters were identified, and several were significantly related to patient reported outcomes. Pain, muscle spasms, and stiffness formed a cluster strongly related to physical quality of life; depression was strongly related to mental quality of life and cognitive difficulty was associated with work impairment. Conclusions. Symptoms in RRMS show a strong relationship with quality of life and should be taken into consideration in treatment decisions and evaluation of treatment success.

  17. 26 CFR 1.1311(b)-1 - Maintenance of an inconsistent position.

    Science.gov (United States)

    2010-04-01

    ..., or nonrecognition, as the case may be, in the year of the error, and (ii) such inconsistent position... 26 Internal Revenue 11 2010-04-01 2010-04-01 true Maintenance of an inconsistent position. 1.1311....1311(b)-1 Maintenance of an inconsistent position. (a) In general. Under the circumstances stated in...

  18. Long-term outcome of sports injuries : results after inpatient treatment

    NARCIS (Netherlands)

    Dekker, R; van der Sluis, CK; Groothoff, JW; Eisma, WH; ten Duis, HJ

    Objective: To investigate whether sports injuries result in long-term disabilities and handicaps and to establish variables with a prognostic value for the occurrence of these long-term consequences. Materials and methods: All patients older than 17 years of age and admitted to the University

  19. Outcome measures in stapes surgery: postoperative results are independent from preoperative parameters.

    Science.gov (United States)

    Koopmann, Mario; Weiss, Daniel; Savvas, Eleftherios; Rudack, Claudia; Stenner, Markus

    2015-09-01

    The aim of this study was to compare audiometric results before and after stapes surgery and identify potential prognostic factors to appropriately select patients with otosclerosis who will most likely benefit from surgery. We enrolled 126 patients with otosclerosis (162 consecutive ears) in our study who underwent stapes surgery between 2007 and 2012 at our institution. Preoperative and postoperative data including pure-tone audiometry, speech audiometry, stapedial reflex audiometry and surgical data were analyzed. The average preoperative air-bone gap (ABG) was 28.9 ± 8.6 dB. Male patients and patients older than 45 years of age had greater preoperative ABGs in comparison to females and younger patients. Postoperative ABGs were 11.2 ± 7.4 dB. The average ABG gain was 17.7 ± 11.1 dB. Preoperative audiometric data, age, gender and type of surgery did not influence the postoperative results. Stapes surgery offers predictable results independent from disease progression or patient-related factors. While absolute values of hearing improvement are instrumental in reflecting audiometric results of a cohort, relative values better reflect individual's audiometric data resembling the patient's benefit.

  20. Distress among women receiving uninformative BRCA1/2 results: 12-month outcomes.

    Science.gov (United States)

    O'Neill, Suzanne C; Rini, Christine; Goldsmith, Rachel E; Valdimarsdottir, Heiddis; Cohen, Lawrence H; Schwartz, Marc D

    2009-10-01

    Few data are available regarding the long-term psychological impact of uninformative BRCA1/2 test results. This study examines change in distress from pretesting to 12-months post-disclosure, with medical, family history, and psychological variables, such as pretesting perceived risk of carrying a deleterious mutation prior to testing and primary and secondary appraisals, as predictors. Two hundred and nine women with uninformative BRCA1/2 test results completed questionnaires at pretesting and 1-, 6-, and 12-month post-disclosure, including measures of anxiety and depression, cancer-specific and genetic testing distress. We used a mixed models approach to predict change in post-disclosure distress. Distress declined from pretesting to 1-month post-disclosure, but remained stable thereafter. Primary appraisals predicted all types of distress at 1-month post-disclosure. Primary and secondary appraisals predicted genetic testing distress at 1-month as well as change over time. Receiving a variant of uncertain clinical significance and entering testing with a high expectation for carrying a deleterious mutation predicted genetic testing distress that persisted through the year after testing. As a whole, women receiving uninformative BRCA1/2 test results are a resilient group. For some women, distress experienced in the month after testing does not dissipate. Variables, such as heightened pretesting perceived risk and cognitive appraisals, predict greater likelihood for sustained distress in this group and could be amenable to intervention.

  1. Development and Validation of Culture-Specific Variable Response Inconsistency and True Response Inconsistency Scales for Use with the Korean MMPI-2

    Science.gov (United States)

    Ketterer, Holly L.; Han, Kyunghee; Hur, Jaehong; Moon, Kyungjoo

    2010-01-01

    In response to the concern that Minnesota Multiphasic Personality Inventory-2 (MMPI-2; J. N. Butcher, W. Dahlstrom, J. R. Graham, A. Tellegen, & B. Kaemmer, 1989; J. N. Butcher et al., 2001) Variable Response Inconsistency (VRIN) and True Response Inconsistency (TRIN) score invalidity criteria recommended for use with American samples results…

  2. Partial Breast Radiation Therapy With Proton Beam: 5-Year Results With Cosmetic Outcomes

    Energy Technology Data Exchange (ETDEWEB)

    Bush, David A., E-mail: dbush@llu.edu [Department of Radiation Oncology, Loma Linda University Medical Center, Loma Linda, California (United States); Do, Sharon [Department of Radiation Oncology, Loma Linda University Medical Center, Loma Linda, California (United States); Lum, Sharon; Garberoglio, Carlos [Department of Surgical Oncology, Loma Linda University Medical Center, Loma Linda, California (United States); Mirshahidi, Hamid [Department of Medical Oncology, Loma Linda University Medical Center, Loma Linda, California (United States); Patyal, Baldev; Grove, Roger; Slater, Jerry D. [Department of Radiation Oncology, Loma Linda University Medical Center, Loma Linda, California (United States)

    2014-11-01

    Purpose: We updated our previous report of a phase 2 trial using proton beam radiation therapy to deliver partial breast irradiation (PBI) in patients with early stage breast cancer. Methods and Materials: Eligible subjects had invasive nonlobular carcinoma with a maximal dimension of 3 cm. Patients underwent partial mastectomy with negative margins; axillary lymph nodes were negative on sampling. Subjects received postoperative proton beam radiation therapy to the surgical bed. The dose delivered was 40 Gy in 10 fractions, once daily over 2 weeks. Multiple fields were treated daily, and skin-sparing techniques were used. Following treatment, patients were evaluated with clinical assessments and annual mammograms to monitor toxicity, tumor recurrence, and cosmesis. Results: One hundred subjects were enrolled and treated. All patients completed the assigned treatment and were available for post-treatment analysis. The median follow-up was 60 months. Patients had a mean age of 63 years; 90% had ductal histology; the average tumor size was 1.3 cm. Actuarial data at 5 years included ipsilateral breast tumor recurrence-free survival of 97% (95% confidence interval: 100%-93%); disease-free survival of 94%; and overall survival of 95%. There were no cases of grade 3 or higher acute skin reactions, and late skin reactions included 7 cases of grade 1 telangiectasia. Patient- and physician-reported cosmesis was good to excellent in 90% of responses, was not changed from baseline measurements, and was well maintained throughout the entire 5-year follow-up period. Conclusions: Proton beam radiation therapy for PBI produced excellent ipsilateral breast recurrence-free survival with minimal toxicity. The treatment proved to be adaptable to all breast sizes and lumpectomy cavity configurations. Cosmetic results appear to be excellent and unchanged from baseline out to 5 years following treatment. Cosmetic results may be improved over those reported with photon

  3. Spontaneous indices are inconsistent with arterial baroreflex gain.

    Science.gov (United States)

    Lipman, Ruth D; Salisbury, Julie K; Taylor, J Andrew

    2003-10-01

    Spontaneously occurring, parallel fluctuations in arterial pressure and heart period are frequently used as indices of baroreflex function. Despite the convenience of spontaneous indices, their relation to the arterial baroreflex remains unclear. Therefore, in 97 volunteers, we derived 5 proposed indices (sequence method, alpha-index, transfer function, low-frequency transfer function, and impulse response function), compared them with arterial baroreflex gain (by the modified Oxford pharmacologic technique), and examined their relation to carotid distensibility and respiratory sinus arrhythmia. The subjects comprised men and women (n=41) aged 25 to 86 years, 30% of whom had established coronary artery disease. Generally, the indices were correlated with each other (except alpha-index and low-frequency transfer function) and with baroreflex gain. However, the Bland-Altman method demonstrated that the spontaneous indices had limits of agreement as large as the baroreflex gain itself. Even in individuals within the lowest tertile of baroreflex gain for whom baroreflex gain appears to be the most clinically relevant, spontaneous indices failed to relate to baroreflex gain. In fact, for these individuals, there was no correlation between any index and baroreflex gain. Forward stepwise linear regression showed that all spontaneous indices and baroreflex gain were related to respiratory sinus arrhythmia, but only baroreflex gain was related to carotid distensibility. Therefore, these data suggest that spontaneous indices are inadequate estimates of gain and are inconsistent with arterial baroreflex function.

  4. Firewalls as artefacts of inconsistent truncations of quantum geometries

    Energy Technology Data Exchange (ETDEWEB)

    Germani, Cristiano [Max-Planck-Institut fuer Physik, Muenchen (Germany); Arnold Sommerfeld Center, Ludwig-Maximilians-University, Muenchen (Germany); Institut de Ciencies del Cosmos, Universitat de Barcelona (Spain); Sarkar, Debajyoti [Max-Planck-Institut fuer Physik, Muenchen (Germany); Arnold Sommerfeld Center, Ludwig-Maximilians-University, Muenchen (Germany)

    2016-01-15

    In this paper we argue that a firewall is simply a manifestation of an inconsistent truncation of non-perturbative effects that unitarize the semiclassical black hole. Namely, we show that a naive truncation of quantum corrections to the Hawking spectrum at order O(e{sup -S}), inexorably leads to a ''localised'' divergent energy density near the black hole horizon. Nevertheless, in the same approximation, a distant observer only sees a discretised spectrum and concludes that unitarity is achieved by (e{sup -S}) effects. This is due to the fact that instead, the correct quantum corrections to the Hawking spectrum go like (g{sup tt}e{sup -S}). Therefore, while at a distance far away from the horizon, where g{sup tt} ∼ 1, quantum corrections are perturbative, they do diverge close to the horizon, where g{sup tt} → ∞. Nevertheless, these ''corrections'' nicely re-sum so that correlations functions are smooth at the would-be black hole horizon. Thus, we conclude that the appearance of firewalls is just a signal of the breaking of the semiclassical approximation at the Page time, even for large black holes. (copyright 2015 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim)

  5. Firewalls as artefacts of inconsistent truncations of quantum geometries

    Science.gov (United States)

    Germani, Cristiano; Sarkar, Debajyoti

    2016-01-01

    In this paper we argue that a firewall is simply a manifestation of an inconsistent truncation of non-perturbative effects that unitarize the semiclassical black hole. Namely, we show that a naive truncation of quantum corrections to the Hawking spectrum at order ${\\cal O}(e^{-S})$, inexorably leads to a "localised'' divergent energy density near the black hole horizon. Nevertheless, in the same approximation, a distant observer only sees a discretised spectrum and concludes that unitarity is achieved by ${\\cal O}(e^{-S})$ effects. This is due to the fact that instead, the correct quantum corrections to the Hawking spectrum go like ${\\cal O}( g^{tt} e^{-S})$. Therefore, while at a distance far away from the horizon, where $g^{tt}\\approx 1$, quantum corrections {\\it are} perturbative, they {\\it do} diverge close to the horizon, where $g^{tt}\\rightarrow \\infty$. Nevertheless, these "corrections" nicely re-sum so that correlations functions are smooth at the would-be black hole horizon. Thus, we conclude that the appearance of firewalls is just a signal of the breaking of the semiclassical approximation at the Page time, even for large black holes.

  6. Firewalls as artefacts of inconsistent truncations of quantum geometries

    International Nuclear Information System (INIS)

    Germani, Cristiano; Sarkar, Debajyoti

    2016-01-01

    In this paper we argue that a firewall is simply a manifestation of an inconsistent truncation of non-perturbative effects that unitarize the semiclassical black hole. Namely, we show that a naive truncation of quantum corrections to the Hawking spectrum at order O(e -S ), inexorably leads to a ''localised'' divergent energy density near the black hole horizon. Nevertheless, in the same approximation, a distant observer only sees a discretised spectrum and concludes that unitarity is achieved by (e -S ) effects. This is due to the fact that instead, the correct quantum corrections to the Hawking spectrum go like (g tt e -S ). Therefore, while at a distance far away from the horizon, where g tt ∼ 1, quantum corrections are perturbative, they do diverge close to the horizon, where g tt → ∞. Nevertheless, these ''corrections'' nicely re-sum so that correlations functions are smooth at the would-be black hole horizon. Thus, we conclude that the appearance of firewalls is just a signal of the breaking of the semiclassical approximation at the Page time, even for large black holes. (copyright 2015 WILEY-VCH Verlag GmbH and Co. KGaA, Weinheim)

  7. Inconsistency prevents the valuable synergism of explanatory and pragmatic trails.

    Science.gov (United States)

    Correia, Luis C L; Correia, Vitor C A; Souza, Thiago M B; Cerqueira, Antonio Maurício S; Alexandre, Felipe K B; Garcia, Guilherme; Ferreira, Felipe R M; Lopes, Fernanda O A

    2018-05-01

    To assess review articles on pragmatic trials in order to describe how authors define the aim of this type of study, how comprehensive methodological topics are covered, and which topics are most valued by authors. Review articles were selected from Medline Database, based on the expression "pragmatic trial" in the titles. Five trained medical students evaluated the articles, based on a list of 15 self-explanatory methodological topics. Each article was evaluated regarding topics covered. Baseline statements on the aim of pragmatic trials were derived. Among 22 articles identified, there was general agreement that the aim of a pragmatic trial is to evaluate if the intervention works under real-world conditions. The mean number of methodological topics addressed by each article was 7.6 ± 3.1. Only one article covered all 15 topics, three articles (14%) responded to at least 75% of topics and 13 articles (59%) mentioned at least 50% of the topics. The relative frequency each of the 15 topics was cited by articles had a mean of 50% ± 25%. No topic was addressed by all articles, only three (20%) were addressed by more than 75% of articles. There is agreement on the different aims of explanatory and pragmatic trials. But there is a large variation on methodological topics used to define a pragmatic trial, which led to inconsistency in defining the typical methodology of a pragmatic trial. © 2018 Chinese Cochrane Center, West China Hospital of Sichuan University and John Wiley & Sons Australia, Ltd.

  8. Limited Hiatal Dissection Without Fundoplication Results in Comparable Symptomatic Outcomes to Laparoscopic Heller Myotomy with Anterior Fundoplication.

    Science.gov (United States)

    DeHaan, Reece K; Frelich, Matthew J; Gould, Jon C

    2016-07-01

    Previous randomized controlled trials have demonstrated that partial fundoplication following Heller myotomy results in less pathologic acid exposure to the esophagus when compared to myotomy without fundoplication. Recent studies have questioned the necessity of a fundoplication, especially when a limited hiatal dissection (LHD) is performed and the angle of His is preserved. This is a retrospective review of prospectively maintained data. All patients underwent primary Heller myotomy for achalasia over a 30-month period. In select patients, an LHD was performed anteriorly. Symptomatic outcomes were assessed up to 2 years postoperation using the Achalasia Severity Questionnaire (ASQ), Gastrointestinal Quality of Life Index (GIQLI), and Gastroesophageal Reflux Disease-Health-Related Quality of Life (GERD-HRQL). A total of 31 patients underwent Heller myotomy during the study interval. The majority of patients underwent Heller myotomy with full hiatal dissection (FHD) (21, 68%). Intraoperative mucosal perforations occurred in 3 (14%) patients undergoing FHD. Patient demographics, surgery details, and baseline symptomatic outcomes did not differ significantly preoperatively. At greater than 1 year postoperation, there was no significant difference between the groups for ASQ, GERD-HRQL, and GIGLI (P = .76, .78, and .33, respectively). Heller myotomy with LHD and no fundoplication and Heller myotomy with FHD and partial fundoplication result in similar GERD-related quality of life outcomes. Further studies (including pH studies) are necessary to determine if fundoplication is a necessary step in selected patients in whom an LHD is possible.

  9. Long-Term Outcomes of Cultivated Limbal Epithelial Transplantation: Evaluation and Comparison of Results in Children and Adults

    Directory of Open Access Journals (Sweden)

    Anita Ganger

    2015-01-01

    Full Text Available Purpose. To compare the long-term clinical outcomes of cultivated limbal epithelial transplantation (CLET in children and adults with limbal stem cell deficiency. Design. Retrospective case series. Methods. Case records of patients with limbal stem cell deficiency (LSCD who underwent CLET from April 2004 to December 2014 were studied. Outcome measures were compared in terms of anatomical success and visual improvement. Parameters for total anatomical success were avascular, epithelized, and clinically stable corneal surface without conjunctivalization, whereas partial anatomical success was considered when mild vascularization (sparing centre of cornea and mild conjunctivalization were noted along with complete epithelization. Results. A total of 62 cases underwent the CLET procedure: 38 (61.3% were children and 24 (38.7% were adults. Patients with unilateral LSCD (33 children and 21 adults had autografts and those with bilateral LSCD (5 children and 3 adults had allografts. Amongst the 54 autografts partial and total anatomical success were noted in 21.2% and 66.6% children, respectively, and 19.0% and 80.9% in adults, respectively (p value 0.23. Visual improvement of 1 line and ≥2 lines was seen in 57.5% and 21.2% children, respectively, and 38% and 38% in adults, respectively (p value 0.31. Conclusion. Cultivated limbal epithelial transplantation gives good long-term results in patients with LSCD and the outcomes are comparable in children and adults.

  10. Diabetic peripheral arterial disease: lower limb angiography results and one year outcomes of interventional treatment

    International Nuclear Information System (INIS)

    Chen Guoping; Gu Jianping; Lou Wensheng; He Xu; Chen Liang; Su Haobo; Song Jinhua; Wang Tao; Xu Ke

    2010-01-01

    Objective: To demonstrate lower limb angiography results of peripheral arterial disease (PAD) in diabetics and evaluate one-year curative effect after interventional therapy. Methods: Lower limb angiography results and the efficiency of interventional therapy for 44 limbs with PAD in 38 diabetics were retrospectively analyzed. Post-treatment clinical manifestations, signs and ankle-brachial-index (ABI) at 1 week, 1 month, 3 months, 6 months and 12 months were compared with those before treatment. Clinical evaluation was divided into four grades: apparent, effective, ineffective and deterioration. Efficiency = (apparent + effective) / total cases × 100%. ABI was compared using analysis of variance. Results: Lower limb angiography revealed multi-branch lesions, with multi-segmental stenoses or obstructions. Lesions involved both above- and below-the-knee arteries in 25 limbs (56.8%), only above-the-knee arteries in 3 limbs (6.8%) and only below-the-knee arteries in 16 limbs (36.4%). In the limbs only with below-the-knee arterial lesions, the involved artery branches were one in one limb (2.3%), two in six limbs (13.6%) and three in nine limbs (20.5%), respectively. The technical success rate of percutaneous transluminal angioplasty (PTA) was 91.4% (53/58) for diseased below-the-knee arteries. Among the 12 cases with foot and ankle ulcers, ulcers healed within 3 months in 9 cases; however, the other three cases suffered below-the-ankle (in one case) or below-the-knee amputation (in two cases) within 6 months. Four cases with gangrene suffered below-the-knee amputation within one month after PTA. The amputation rate was 15.9% (7/44). At 1 week, 1, 3, 6 and 12 months after PTA, the effective rates were 79.6% (35/44), 83.3% (30/36), 85.7% (24/28), 85.0% (17/20) and 81.3% (13/16), respectively; ABI values were 0.86±0.10, 0.85±0.10, 0.83±0.11, 0.79±0.12 and 0.75±0.12, respectively. Compared with pie-PTA ABI value (0.53±0.20), post-PTA ABI value was significant

  11. Hypoxic Prostate/Muscle PO2 Ratio Predicts for Outcome in Patients With Localized Prostate Cancer: Long-Term Results

    International Nuclear Information System (INIS)

    Turaka, Aruna; Buyyounouski, Mark K.; Hanlon, Alexandra L.; Horwitz, Eric M.; Greenberg, Richard E.; Movsas, Benjamin

    2012-01-01

    Purpose: To correlate tumor oxygenation status with long-term biochemical outcome after prostate brachytherapy. Methods and Materials: Custom-made Eppendorf PO 2 microelectrodes were used to obtain PO 2 measurements from the prostate (P), focused on positive biopsy locations, and normal muscle tissue (M), as a control. A total of 11,516 measurements were obtained in 57 men with localized prostate cancer immediately before prostate brachytherapy was given. The Eppendorf histograms provided the median PO 2 , mean PO 2 , and % 2 ratio on BF. Results: With a median follow-up time of 8 years, 12 men had ASTRO BF and 8 had Phoenix BF. On multivariate analysis, P/M PO 2 ratio 2 ratio 2 ratio) significantly predicts for poor long-term biochemical outcome, suggesting that novel hypoxic strategies should be investigated.

  12. Is disclosure of childhood rape associated with mental health outcome? Results from the National Women's Study.

    Science.gov (United States)

    Ruggiero, Kenneth J; Smith, Daniel W; Hanson, Rochelle F; Resnick, Heidi S; Saunders, Benjamin E; Kilpatrick, Dean G; Best, Connie L

    2004-02-01

    Clinicians often assert that disclosure of childhood rape is beneficial to victims because it sets the occasion for protective action and can bring them into contact with professionals trained to address rape-related mental health needs. Consistent with this is the hypothesis that victims of childhood rape who disclose their victimization soon after it occurs are at lower risk for later psychosocial difficulties relative to those who delay disclosure or never disclose. We explored this issue with a nationally representative sample of 3,220 adult women; 288 (8.9%) endorsed at least one instance of forcible sexual penetration prior to age 18. Results revealed a significantly higher past-year prevalence of posttraumatic stress disorder (PTSD) and major depressive episodes among women who waited longer than 1 month to disclose their rape relative to nondisclosers and women who disclosed within 1 month of the rape. Delayed disclosure remained associated with PTSD after controlling for demographic and rape characteristics. Patterns of disclosure were not associated with past-year substance-use problems.

  13. Factors associated with inconsistent condom use with clients among female sex workers in Podgorica, Montenegro

    Directory of Open Access Journals (Sweden)

    Laušević Dragan

    2016-01-01

    Full Text Available Introduction. Female sex workers (FSWs are a group at increased risk for human immunodeficiency virus (HIV infection, and inconsistent condom use with clients is a known risk factor for infection in this group. Objective. The aim of the study was to determine factors associated with inconsistent condom use with clients among female sex workers in Podgorica, Montenegro. Methods. We conducted an HIV bio-behavioral cross-sectional study in a sample of female sex workers recruited by snowball sampling. Results. A total of 142 FSWs were recruited. Eighty-one (57.0% of them used condoms consistently with clients. HIV prevalence was 0.0%. In the multivariate analysis inconsistent condom use with clients in the previous month was associated with clients’ negative personal attitude [age-adjusted odds ratio (AOR = 22.7, 95% confidence interval (CI = 2.3-228.0] or client’s indifference (AOR = 13.0, 95% CI = 1.4-118.9 towards using condom during sex with sexual workers, decision making by clients or by mutual agreement with client about using a condom (AOR = 10.2, 95% CI = 3.7-28.0, and early age of first sex (AOR = 5.4, 95% CI = 1.6-18.5. Conclusion. Our results suggest not only the need for further promotion of condom use, information and education for FSW but also the need to strengthen negotiation skills of FSWs with clients on regular use of condoms, as well as the need to extend prevention programs to clients of FSWs.

  14. SCEGRAM: An image database for semantic and syntactic inconsistencies in scenes.

    Science.gov (United States)

    Öhlschläger, Sabine; Võ, Melissa Le-Hoa

    2017-10-01

    Our visual environment is not random, but follows compositional rules according to what objects are usually found where. Despite the growing interest in how such semantic and syntactic rules - a scene grammar - enable effective attentional guidance and object perception, no common image database containing highly-controlled object-scene modifications has been publically available. Such a database is essential in minimizing the risk that low-level features drive high-level effects of interest, which is being discussed as possible source of controversial study results. To generate the first database of this kind - SCEGRAM - we took photographs of 62 real-world indoor scenes in six consistency conditions that contain semantic and syntactic (both mild and extreme) violations as well as their combinations. Importantly, always two scenes were paired, so that an object was semantically consistent in one scene (e.g., ketchup in kitchen) and inconsistent in the other (e.g., ketchup in bathroom). Low-level salience did not differ between object-scene conditions and was generally moderate. Additionally, SCEGRAM contains consistency ratings for every object-scene condition, as well as object-absent scenes and object-only images. Finally, a cross-validation using eye-movements replicated previous results of longer dwell times for both semantic and syntactic inconsistencies compared to consistent controls. In sum, the SCEGRAM image database is the first to contain well-controlled semantic and syntactic object-scene inconsistencies that can be used in a broad range of cognitive paradigms (e.g., verbal and pictorial priming, change detection, object identification, etc.) including paradigms addressing developmental aspects of scene grammar. SCEGRAM can be retrieved for research purposes from http://www.scenegrammarlab.com/research/scegram-database/ .

  15. Tolerance and early outcome results of postprostatectomy three-dimensional conformal radiotherapy

    International Nuclear Information System (INIS)

    Zelefsky, Michael J.; Aschkenasy, Eric; Kelsen, Suzanne; Leibel, Steven A.

    1997-01-01

    Purpose: Three-dimensional conformal radiotherapy (3D-CRT) has been associated with a reduction in acute and late toxicity among patients treated for localized prostatic cancer. The purpose of this study is to assess the acute and late toxicity of 3D-CRT delivered to patients in the postprostatectomy setting and to analyze which factors predict for durable biochemical control in this group of patients. Methods and Materials: Between 1988 and 1994, 42 patients were treated after prostatectomy with three-dimensional conformal radiotherapy. The median time from prostatectomy to radiotherapy was 11 months. Indications for treatment included a rising serum PSA level in 28 patients (65%) and positive surgical margins without a rising PSA level in 14 (35%). Twenty-five patients (60%) had pathologic stage T3 disease, and 32 (74%) had tumor at or close to the surgical margins. The median dose was 64.8 Gy, and the median follow-up time was 2 years. Results: 3D-CRT in the postprostatectomy setting was well tolerated. Three patients (7%) experienced Grade II acute genitourinary toxicity and nine patients (21%) experienced Grade II acute gastrointestinal toxicity during treatment. No patient experienced Grade III or higher acute morbidity. The 2-year actuarial risk for Grade II late genitourinary and gastrointestinal late complications were 5 and 9%, respectively. In patients with existing incontinence, the incidence of worsening stress incontinence 6 months after treatment was 17%, which resolved within 12 months to its preradiotherapy level in four of six cases (66%). The overall 2-year postirradiation PSA relapse-free survival rate was 53%. The 2-year PSA relapse-free survival was 66% for patients with undetectable PSA levels in the immediate postoperative period compared to 26% for those with detectable levels of PSA after surgery (p 1.0 ng/ml (p 1 ng/ml (p < 0.002) was the most important covariate predicting for a rising PSA after radiotherapy. Conclusions: After

  16. The Key Role of Psychosocial Risk on Therapeutic Outcome in Obese Children and Adolescents. Results from a Longitudinal Multicenter Study

    Directory of Open Access Journals (Sweden)

    Markus Röbl

    2013-06-01

    Full Text Available Objective: Childhood obesity is high on the global public health agenda. Although risk factors are well known, the influence of social risk on the therapeutic outcome of lifestyle intervention is poorly examined. This study aims to investigate the influence of migration background, low education, and parental unemployment. Methods: 62,147 patients participated in multidimensional lifestyle intervention programs in 179 pediatric obesity centers. Data were collected using standardized software for longitudinal multicenter documentation. 12,305 (19.8% attended care for 6-24 months, undergoing an intensive therapy period and subsequent follow-ups for up to 3 years. A cumulative social risk score was calculated based on different risk indicators. Results: Migration background, low education, and parental employment significantly influenced the outcome of lifestyle intervention. The observed BMI-SDS reduction was significantly higher in the subgroup with low social risks factors (Δ BMI-SDS -0.19 compared to those presenting moderate (Δ BMI-SDS -0.14 and high social risk (Δ BMI-SDS -0.11. Conclusion: Our data underline the effect of children's social setting on the outcome of multidimensional lifestyle intervention. The presence of a high social risk burden is a negative predictor for successful weight loss. Specific therapeutic programs need to be developed for disadvantaged children and adolescents.

  17. Inconsistencies In Croatian Strategy Of Radioactive Waste Management

    International Nuclear Information System (INIS)

    Knapp, A.; Levanat, I.; Lokner, V.; Saponja-Milutinovic, D.

    2015-01-01

    The paper addresses inconsistencies appearing in the new Croatian Strategy of radioactive waste, spent sources and spent nuclear fuel management. These appear both at the conceptual level as well as at the level of justification: 1) New Croatian Strategy is planning unconditional and hasty establishment of a Croatian dry storage for the Croatian half of the spent fuel from the Krsko nuclear power plant (in about 10 years), although the plant itself is planning establishment of dry storage for its spent fuel on its own site in Slovenia by 2019 - which is noted in the same Strategy. 2) The Croatian Strategy provides false arguments for establishment of radioactive waste storage and repository in Croatia (based on invented 'interpretations' of the Bilateral agreement with Slovenia), although true arguments, legitimate and convincing, are obvious and sufficient for such strategic planning. One author of this paper communicated suggestions, based on above arguments, to the State Office for Radiological and Nuclear Safety, who had drafted the Strategy and was coordinating preparation of the final proposal during the document adoption procedure. Croatian Radiation Protection Association and Croatian Nuclear Society also provided comments aimed at improving the draft. The authors here suggest that only clear and honest arguments can maintain public confidence in the competence of the State, which is a prerequisite for establishing radioactive waste management facilities. The authors propose that the State office should engage Croatian professional associations and societies already in the process of strategic documents drafting, whereas they should most seriously focus on the conceptual aspects of such documents. (author).

  18. Outcomes following arthroscopic transosseous equivalent suture bridge double row rotator cuff repair: a prospective study and short-term results

    Directory of Open Access Journals (Sweden)

    Imam Mohamed Abdelnabi

    2016-01-01

    Full Text Available Background: The transosseous-equivalent cross bridge double row (TESBDR rotator cuff (RC repair technique has been developed to optimize healing biology at a repaired RC tendon insertion. It has been shown in the laboratory to improve pressurized contact area and mean foot print pressure when compared with a double row anchor technique. Pressure has been shown to influence healing between tendon and bone, and the tendon compression vector provided by the transosseous-equivalent suture bridges may enhance healing. The purpose was to prospectively evaluate the outcomes of arthroscopic TESBDR RC repair. Methods: Single center prospective case series study. Sixty-nine patients were selected to undergo arthroscopic TESBDR RC repair and were included in the current study. Primary outcome measures included the Oxford Shoulder Score (OSS, the University of California, Los Angeles (UCLA score, the Constant-Murley (CM Score and Range of motion (ROM. Secondary outcome measures included a Visual Analogue Scale (VAS for pain, another VAS for patient satisfaction from the operative procedure, EuroQoL 5-Dimensions Questionnaire (EQ-5D for quality of life assessment. Results: At 24 months post-operative, average OSS score was 44, average UCLA score was 31, average CM score was 88, average forward flexion was 145°, average internal rotation was 35°, average external rotation was 79°, average abduction was 150°, average EQ-5D score was 0.73, average VAS for pain was 2.3, and average VAS for patient satisfaction was 9.2. Conclusion: Arthroscopic TESBDR RC repair is a procedure with good post-operative functional outcome and low re-tear rate based on a short term follow-up.

  19. The closed-mindedness that wasn’t: Need for structure and expectancy-inconsistent information

    Directory of Open Access Journals (Sweden)

    Markus eKemmelmeier

    2015-07-01

    Full Text Available Social-cognitive researchers have typically assumed that individuals high in need for structure or need for closure tend to be closed-minded: they are motivated to resist or ignore information that is inconsistent with existing beliefs but instead they rely on category-based expectancies. The present paper argues that this conclusion is not necessarily warranted because previous studies did not allow individual differences in categorical processing to emerge and did not consider different distributions of category-relevant information. Using a person memory paradigm, Experiments 1 and 2 show that, when categorical processing is optional, high need-for-structure individuals are especially likely to use this type processing to reduce uncertainty, which results in superior recall for expectancy-inconsistent information. Experiment 2 demonstrates that such information is also more likely to be used in judgment making, leading to judgmental moderation among high need-for-structure individuals. Experiments 3 and 4 used a person memory paradigm which requires categorical processing regardless of levels of need for structure. Experiment 3 and 4 demonstrate that, whether expectancy-consistent or -inconsistent information is recalled better is a function of whether the majority of available information is compatible or incompatible with an initial category-based expectancy. Experiment 4 confirmed that the extent to which high need-for-structure individuals attend to different types of information varies with their distribution. The discussion highlights that task affordances have a critical influences on the consequences of categorical processing for memory and social judgment. Thus, high need for structure does not necessarily equate closed-mindedness.

  20. The closed-mindedness that wasn't: need for structure and expectancy-inconsistent information.

    Science.gov (United States)

    Kemmelmeier, Markus

    2015-01-01

    Social-cognitive researchers have typically assumed that individuals high in need for structure or need for closure tend to be closed-minded: they are motivated to resist or ignore information that is inconsistent with existing beliefs but instead they rely on category-based expectancies. The present paper argues that this conclusion is not necessarily warranted because previous studies did not allow individual differences in categorical processing to emerge and did not consider different distributions of category-relevant information. Using a person memory paradigm, Experiments 1 and 2 shows that, when categorical processing is optional, high need-for-structure individuals are especially likely to use this type processing to reduce uncertainty, which results in superior recall for expectancy-inconsistent information. Experiment 2 demonstrates that such information is also more likely to be used in judgment making, leading to judgmental moderation among high need-for-structure individuals. Experiments 3 and 4 used a person memory paradigm which requires categorical processing regardless of levels of need for structure. Experiments 3 and 4 demonstrate that, whether expectancy-consistent or -inconsistent information is recalled better is a function of whether the majority of available information is compatible or incompatible with an initial category-based expectancy. Experiment 4 confirmed that the extent to which high need-for-structure individuals attend to different types of information varies with their distribution. The discussion highlights that task affordances have a critical influence on the consequences of categorical processing for memory and social judgment. Thus, high need for structure does not necessarily equate closed-mindedness.

  1. Search for Expectancy-Inconsistent Information Reduces Uncertainty Better: The Role of Cognitive Capacity.

    Science.gov (United States)

    Strojny, Paweł; Kossowska, Małgorzata; Strojny, Agnieszka

    2016-01-01

    Motivation and cognitive capacity are key factors in people's everyday struggle with uncertainty. However, the exact nature of their interplay in various contexts still needs to be revealed. The presented paper reports on two experimental studies which aimed to examine the joint consequences of motivational and cognitive factors for preferences regarding incomplete information expansion. In Study 1 we demonstrate the interactional effect of motivation and cognitive capacity on information preference. High need for closure resulted in a stronger relative preference for expectancy-inconsistent information among non-depleted individuals, but the opposite among cognitively depleted ones. This effect was explained by the different informative value of questions in comparison to affirmative sentences and the potential possibility of assimilation of new information if it contradicts prior knowledge. In Study 2 we further investigated the obtained effect, showing that not only questions but also other kinds of incomplete information are subject to the same dependency. Our results support the expectation that, in face of incomplete information, motivation toward closure may be fulfilled efficiently by focusing on expectancy-inconsistent pieces of data. We discuss the obtained effect in the context of previous assumptions that high need for closure results in a simple processing style, advocating a more complex approach based on the character of the provided information.

  2. Avatar Web-Based Self-Report Survey System Technology for Public Health Research: Technical Outcome Results and Lessons Learned.

    Science.gov (United States)

    Savel, Craig; Mierzwa, Stan; Gorbach, Pamina M; Souidi, Samir; Lally, Michelle; Zimet, Gregory; Interventions, Aids

    2016-01-01

    This paper reports on a specific Web-based self-report data collection system that was developed for a public health research study in the United States. Our focus is on technical outcome results and lessons learned that may be useful to other projects requiring such a solution. The system was accessible from any device that had a browser that supported HTML5. Report findings include: which hardware devices, Web browsers, and operating systems were used; the rate of survey completion; and key considerations for employing Web-based surveys in a clinical trial setting.

  3. Bone Marrow Stem Cells Added to a Hydroxyapatite Scaffold Result in Better Outcomes after Surgical Treatment of Intertrochanteric Hip Fractures

    Directory of Open Access Journals (Sweden)

    Joao Torres

    2014-01-01

    Full Text Available Introduction. Intertrochanteric hip fractures occur in the proximal femur. They are very common in the elderly and are responsible for high rates of morbidity and mortality. The authors hypothesized that adding an autologous bone marrow stem cells concentrate (ABMC to a hydroxyapatite scaffold and placing it in the fracture site would improve the outcome after surgical fixation of intertrochanteric hip fractures. Material and Methods. 30 patients were randomly selected and divided into 2 groups of 15 patients, to receive either the scaffold enriched with the ABMC (Group A during the surgical procedure, or fracture fixation alone (Group B. Results. There was a statistically significant difference in favor of group A at days 30, 60, and 90 for Harris Hip Scores (HHS, at days 30 and 60 for VAS pain scales, for bedridden period and time taken to start partial and total weight bearing (P<0.05. Discussion. These results show a significant benefit of adding a bone marrow enriched scaffold to surgical fixation in intertrochanteric hip fractures, which can significantly reduce the associated morbidity and mortality rates. Conclusion. Bone marrow stem cells added to a hydroxyapatite scaffold result in better outcomes after surgical treatment of intertrochanteric hip fractures.

  4. Bone Marrow Stem Cells Added to a Hydroxyapatite Scaffold Result in Better Outcomes after Surgical Treatment of Intertrochanteric Hip Fractures

    Science.gov (United States)

    Gutierres, Manuel; Lopes, M. Ascenção; Santos, J. Domingos; Cabral, A. T.; Pinto, R.

    2014-01-01

    Introduction. Intertrochanteric hip fractures occur in the proximal femur. They are very common in the elderly and are responsible for high rates of morbidity and mortality. The authors hypothesized that adding an autologous bone marrow stem cells concentrate (ABMC) to a hydroxyapatite scaffold and placing it in the fracture site would improve the outcome after surgical fixation of intertrochanteric hip fractures. Material and Methods. 30 patients were randomly selected and divided into 2 groups of 15 patients, to receive either the scaffold enriched with the ABMC (Group A) during the surgical procedure, or fracture fixation alone (Group B). Results. There was a statistically significant difference in favor of group A at days 30, 60, and 90 for Harris Hip Scores (HHS), at days 30 and 60 for VAS pain scales, for bedridden period and time taken to start partial and total weight bearing (P < 0.05). Discussion. These results show a significant benefit of adding a bone marrow enriched scaffold to surgical fixation in intertrochanteric hip fractures, which can significantly reduce the associated morbidity and mortality rates. Conclusion. Bone marrow stem cells added to a hydroxyapatite scaffold result in better outcomes after surgical treatment of intertrochanteric hip fractures. PMID:24955356

  5. Positive outcomes influence the rate and time to publication, but not the impact factor of publications of clinical trial results.

    Directory of Open Access Journals (Sweden)

    Pilar Suñé

    Full Text Available OBJECTIVES: Publication bias may affect the validity of evidence based medical decisions. The aim of this study is to assess whether research outcomes affect the dissemination of clinical trial findings, in terms of rate, time to publication, and impact factor of journal publications. METHODS AND FINDINGS: All drug-evaluating clinical trials submitted to and approved by a general hospital ethics committee between 1997 and 2004 were prospectively followed to analyze their fate and publication. Published articles were identified by searching Pubmed and other electronic databases. Clinical study final reports submitted to the ethics committee, final reports synopses available online and meeting abstracts were also considered as sources of study results. Study outcomes were classified as positive (when statistical significance favoring experimental drug was achieved, negative (when no statistical significance was achieved or it favored control drug and descriptive (for non-controlled studies. Time to publication was defined as time from study closure to publication. A survival analysis was performed using a Cox regression model to analyze time to publication. Journal impact factors of identified publications were recorded. Publication rate was 48·4% (380/785. Study results were identified for 68·9% of all completed clinical trials (541/785. Publication rate was 84·9% (180/212 for studies with results classified as positive and 68·9% (128/186 for studies with results classified as negative (p<0·001. Median time to publication was 2·09 years (IC95 1·61-2·56 for studies with results classified as positive and 3·21 years (IC95 2·69-3·70 for studies with results classified as negative (hazard ratio 1·99 (IC95 1·55-2·55. No differences were found in publication impact factor between positive (median 6·308, interquartile range: 3·141-28·409 and negative result studies (median 8·266, interquartile range: 4·135-17·157. CONCLUSIONS

  6. Classification and Optimization of Decision Trees for Inconsistent Decision Tables Represented as MVD Tables

    KAUST Repository

    Azad, Mohammad

    2015-10-11

    Decision tree is a widely used technique to discover patterns from consistent data set. But if the data set is inconsistent, where there are groups of examples (objects) with equal values of conditional attributes but different decisions (values of the decision attribute), then to discover the essential patterns or knowledge from the data set is challenging. We consider three approaches (generalized, most common and many-valued decision) to handle such inconsistency. We created different greedy algorithms using various types of impurity and uncertainty measures to construct decision trees. We compared the three approaches based on the decision tree properties of the depth, average depth and number of nodes. Based on the result of the comparison, we choose to work with the many-valued decision approach. Now to determine which greedy algorithms are efficient, we compared them based on the optimization and classification results. It was found that some greedy algorithms Mult\\\\_ws\\\\_entSort, and Mult\\\\_ws\\\\_entML are good for both optimization and classification.

  7. The Ups and Downs of Cognitive Function: Neuroticism and Negative Affect Drive Performance Inconsistency.

    Science.gov (United States)

    Munoz, Elizabeth; Stawski, Robert S; Sliwinski, Martin J; Smyth, Joshua M; MacDonald, Stuart W S

    2018-03-26

    Response time inconsistency (RTI)-or trial-to-trial variability in speeded performance-is increasingly recognized as an indicator of transient lapses of attention, cognitive health status, and central nervous system integrity, as well as a potential early indicator of normal and pathological cognitive aging (Hultsch, Strauss, Hunter, & MacDonald, 2008; MacDonald, Li, & Bäckman, 2009). Comparatively, little research has examined personality predictors of RTI across adulthood. We evaluated the association between the personality trait neuroticism and RTI in a community-dwelling sample of 317 adults between the ages of 19 to 83 and tested for two indirect pathways through negative affect (NA) and cognitive interference (CI). The personality trait neuroticism predicted greater RTI independent of mean response time performance and demographic covariates; the results were age-invariant. Furthermore, NA (but not CI) accounted for this association and moderated mediation model results indicated that older adults were more vulnerable to the adverse effects of NA. Neuroticism predicts greater response time inconsistency irrespective of mean performance and this effect is driven largely by heightened negative emotionality that may be particularly detrimental for older adults.

  8. Classification and Optimization of Decision Trees for Inconsistent Decision Tables Represented as MVD Tables

    KAUST Repository

    Azad, Mohammad; Moshkov, Mikhail

    2015-01-01

    Decision tree is a widely used technique to discover patterns from consistent data set. But if the data set is inconsistent, where there are groups of examples (objects) with equal values of conditional attributes but different decisions (values of the decision attribute), then to discover the essential patterns or knowledge from the data set is challenging. We consider three approaches (generalized, most common and many-valued decision) to handle such inconsistency. We created different greedy algorithms using various types of impurity and uncertainty measures to construct decision trees. We compared the three approaches based on the decision tree properties of the depth, average depth and number of nodes. Based on the result of the comparison, we choose to work with the many-valued decision approach. Now to determine which greedy algorithms are efficient, we compared them based on the optimization and classification results. It was found that some greedy algorithms Mult\\_ws\\_entSort, and Mult\\_ws\\_entML are good for both optimization and classification.

  9. Reduction of image-based ADI-to-AEI overlay inconsistency with improved algorithm

    Science.gov (United States)

    Chen, Yen-Liang; Lin, Shu-Hong; Chen, Kai-Hsiung; Ke, Chih-Ming; Gau, Tsai-Sheng

    2013-04-01

    In image-based overlay (IBO) measurement, the measurement quality of various measurement spectra can be judged by quality indicators and also the ADI-to-AEI similarity to determine the optimum light spectrum. However we found some IBO measured results showing erroneous indication of wafer expansion from the difference between the ADI and the AEI maps, even after their measurement spectra were optimized. To reduce this inconsistency, an improved image calculation algorithm is proposed in this paper. Different gray levels composed of inner- and outer-box contours are extracted to calculate their ADI overlay errors. The symmetry of intensity distribution at the thresholds dictated by a range of gray levels is used to determine the particular gray level that can minimize the ADI-to-AEI overlay inconsistency. After this improvement, the ADI is more similar to AEI with less expansion difference. The same wafer was also checked by the diffraction-based overlay (DBO) tool to verify that there is no physical wafer expansion. When there is actual wafer expansion induced by large internal stress, both the IBO and the DBO measurements indicate similar expansion results. The scanning white-light interference microscope was used to check the variation of wafer warpage during the ADI and AEI stages. It predicts a similar trend with the overlay difference map, confirming the internal stress.

  10. Urinary Phthalate Metabolite Concentrations and Reproductive Outcomes among Women Undergoing in Vitro Fertilization: Results from the EARTH Study.

    Science.gov (United States)

    Hauser, Russ; Gaskins, Audrey J; Souter, Irene; Smith, Kristen W; Dodge, Laura E; Ehrlich, Shelley; Meeker, John D; Calafat, Antonia M; Williams, Paige L

    2016-06-01

    Evidence from both animal and human studies suggests that exposure to phthalates may be associated with adverse female reproductive outcomes. We evaluated the associations between urinary concentrations of phthalate metabolites and outcomes of assisted reproductive technologies (ART). This analysis included 256 women enrolled in the Environment and Reproductive Health (EARTH) prospective cohort study (2004-2012) who provided one to two urine samples per cycle before oocyte retrieval. We measured 11 urinary phthalate metabolites [mono(2-ethylhexyl) phthalate (MEHP), mono(2-ethyl-5-hydroxyhexyl) phthalate (MEHHP), mono(2-ethyl-5-oxohexyl) phthalate (MEOHP), mono(2-ethyl-5-carboxypentyl) phthalate (MECPP), mono-isobutyl phthalate (MiBP), mono-n-butyl phthalate (MBP), monobenzyl phthalate (MBzP), monoethyl phthalate (MEP), monocarboxyisooctyl phthalate (MCOP), monocarboxyisononyl phthalate (MCNP), and mono(3-carboxypropyl) phthalate (MCPP)]. We used generalized linear mixed models to evaluate the association of urinary phthalate metabolites with in vitro fertilization (IVF) outcomes, accounting for multiple IVF cycles per woman. In multivariate models, women in the highest as compared with lowest quartile of MEHP, MEHHP, MEOHP, MECPP, ΣDEHP (MEHP + MEHHP + MEOHP + MECPP), and MCNP had lower oocyte yield. Similarly, the number of mature (MII) oocytes retrieved was lower in the highest versus lowest quartile for these same phthalate metabolites. The adjusted differences (95% CI) in proportion of cycles resulting in clinical pregnancy and live birth between women in the fourth versus first quartile of ΣDEHP were -0.19 (-0.29, -0.08) and -0.19 (-0.28, -0.08), respectively, and there was also a lower proportion of cycles resulting in clinical pregnancy and live birth for individual DEHP metabolites. Urinary concentrations of DEHP metabolites were inversely associated with oocyte yield, clinical pregnancy, and live birth following ART. Hauser R, Gaskins AJ, Souter I, Smith

  11. Sphincter-sparing surgery after preoperative radiotherapy for low rectal cancers: feasibility, oncological results, and quality of life outcomes

    International Nuclear Information System (INIS)

    Allal, A.S.; Soravia, C.; Gertsch, P.; Bieri, S.; Sprangers, M.A.G.

    1999-01-01

    In cancers of the distal rectum, preoperative radiotherapy is often associated with low anterior resection. This study assesses the choice of surgical procedure, oncological results, and quality of life outcomes in a retrospective cohort of patients with low-lying rectal cancers. The results obtained reinforce the notion of the feasibility, in routine practice, of sphincter-sparing surgery after preoperative radiotherapy in a significant proportion of low rectal cancers. The oncological results seem to be unaffected by the choice of surgical procedure. However, with the possible exception of body image and sexual aspects in males, quality of life parameters were not necessarily better in the restorative surgery group. Prospective studies are mandatory to clarify the putative quality of life advantages of sphincter-conserving procedures in this context. (author)

  12. Lack of a standardised UK care pathway resulting in national variations in management and outcomes of paediatric small area scalds.

    Science.gov (United States)

    Trevatt, Alexander E J; Kirkham, Emily N; Allix, Bradley; Greenwood, Rosemary; Coy, Karen; Hollén, Linda I; Young, Amber E R

    2016-09-01

    There is a paucity of evidence guiding management of small area partial thickness paediatric scalds. This has prevented the development of national management guidelines for these injuries. This research aimed to investigate whether a lack of evidence for national guidelines has resulted in variations in both management and outcomes of paediatric small area scalds across England and Wales (E&W). A national survey of initial management of paediatric scalds ≤5% Total Body Surface Area (%TBSA) was sent to 14 burns services in E&W. Skin graft rates of anonymised burns services over seven years were collected from the international Burns Injury Database (iBID). Average skin grafting rates across services were compared. Length of stay and proportion of patients receiving general anaesthesia for dressing application at each service were also compared. All 14 burns services responded to the survey. Only 50% of services had a protocol in place for the management of small area burns. All protocols varied in how partial thickness paediatrics scalds ≤5% TBSA should be managed. There was no consensus as to which scalds should be treated using biosynthetic dressings. Data from iBID for 11,917 patients showed that the average reported skin grafting rate across all burns services was 2.3% (95% CI 2.1, 2.6) but varied from 0.3% to 7.1% (P<0.001). Service provider remained associated with likelihood of skin grafting when variations in the %TBSA case mix seen by each service were controlled for (χ(2)=87.3, P<0.001). The use of general anaesthetics across services varied between 0.6 and 35.5% (P<0.001). The median length of stay across services varied from 1 to 3 days (P<0.001). A lack of evidence guiding management of small-area paediatric scalds has resulted in variation in management of these injuries across E&W. There is also significant variation in outcomes for these injuries. Further research is indicated to determine if care pathways and outcomes are linked. An evidence

  13. Shifting management of a community volunteer system for improved child health outcomes: results from an operations research study in Burundi.

    Science.gov (United States)

    Weiss, Jennifer; Makonnen, Raphael; Sula, Delphin

    2015-01-01

    Community-based strategies that foster frequent contact between caregivers of children under five and provide credible sources of health information are essential to improve child survival. Care Groups are a community-based implementation strategy for the delivery of social and behavior change interventions. This study assessed if supervision of Care Group activities by Ministry of Health (MOH) personnel could achieve the same child health outcomes as supervision provided by specialized non-governmental organization (NGO) staff. The study was a pretest-posttest quasi-experimental design implemented in Burundi. A total of 45 MOH-led Care Groups with 478 Care Group Volunteers (CGVs) were established in the intervention area; and 50 NGO-led Care Groups with 509 CGVs were formed in the comparison area. Data were collected from 593 and 700 mothers of children 0-23 months at baseline and endline, respectively. Pearson's chi-squared test and difference-in-difference analysis assessed changes in 40 child health and nutrition outcomes. A qualitative process evaluation was also conducted midway through the study. The MOH-led Care Group model performed at least as well as the NGO-led model in achieving specific child health and nutrition outcomes. Mothers of children 0-23 months in the intervention and comparison sites reported similar levels of knowledge and practices for 38 of 40 dependent variables measured in the study, and these results remained unchanged after accounting for differences in the indicator values at baseline. Process monitoring data confirmed that the MOH-led Care Group model and the NGO-led Care Group model were implemented with similar intervention strength. The study demonstrated that behavior change interventions traditionally led by NGOs can be implemented through the existing MOH systems and achieve similar results, thereby increasing the potential for sustainable child health outcomes. Future research on the MOH-led Care Group model is required to

  14. Inconsistency and social decision making in patients with Borderline Personality Disorder.

    Science.gov (United States)

    Preuss, Nora; Brändle, Laura S; Hager, Oliver M; Haynes, Melanie; Fischbacher, Urs; Hasler, Gregor

    2016-09-30

    Inconsistent social behavior is a core psychopathological feature of borderline personality disorder. The goal of the present study was to examine inconsistency in social decision-making using simple economic social experiments. We investigated the decisions of 17 female patients with BPD, 24 patients with major depressive disorder (MDD), and 36 healthy controls in three single shot economic experiments measuring trust, cooperation, and punishment. BPD severity was assessed using the Zanarini Rating Scale for BPD. Investments across identical one-shot trust and punishment games were significantly more inconsistent in BPD patients than in controls. Such inconsistencies were only found in the social risk conditions of the trust and punishment conditions but not in the non-social control conditions. MDD patients did not show such inconsistencies. Furthermore, social support was negatively correlated with inconsistent decision-making in the trust and punishment game, which underscores the clinical relevance of this finding. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  15. Reaction time inconsistency in a spatial stroop task: age-related differences through childhood and adulthood.

    Science.gov (United States)

    Williams, Benjamin R; Strauss, Esther H; Hultsch, David F; Hunter, Michael A

    2007-07-01

    Age-related differences in inconsistency of reaction time (RT) across the life span were examined on a task with differing levels of demand on executive control. A total of 546 participants, aged 5 to 76 years, completed a spatial Stroop task that permitted observations under three conditions (congruent, incongruent, and neutral) according to the correspondence between the required response (based on stimulus direction) and stimulus location. An interference effect was observed across all ages. Analyses of neutral condition data replicated previous research demonstrating RT inconsistency follows a U-shaped developmental curve across the life span. The relationship between age and inconsistency, however, depended on condition: inconsistency in the congruent condition was higher than inconsistency in both the neutral and incongruent conditions across middle-aged groups. Reaction time inconsistency may reflect processing efficiency that is maximal in young adulthood and may also be sensitive to fluctuations in performance that reflect momentarily highly efficient responding.

  16. The relationship between everyday problem solving and inconsistency in reaction time in older adults.

    Science.gov (United States)

    Burton, Catherine L; Strauss, Esther; Hultsch, David F; Hunter, Michael A

    2009-09-01

    The purpose of the present study was to investigate whether inconsistency in reaction time (RT) is predictive of older adults' ability to solve everyday problems. A sample of 304 community dwelling non-demented older adults, ranging in age from 62 to 92, completed a measure of everyday problem solving, the Everyday Problems Test (EPT). Inconsistency in latencies across trials was assessed on four RT tasks. Performance on the EPT was found to vary according to age and cognitive status. Both mean latencies and inconsistency were significantly associated with EPT performance, such that slower and more inconsistent RTs were associated with poorer everyday problem solving abilities. Even after accounting for age, education, and mean level of performance, inconsistency in reaction time continued to account for a significant proportion of the variance in EPT scores. These findings suggest that indicators of inconsistency in RT may be of functional relevance.

  17. Bias field inconsistency correction of motion-scattered multislice MRI for improved 3D image reconstruction.

    Science.gov (United States)

    Kim, Kio; Habas, Piotr A; Rajagopalan, Vidya; Scott, Julia A; Corbett-Detig, James M; Rousseau, Francois; Barkovich, A James; Glenn, Orit A; Studholme, Colin

    2011-09-01

    A common solution to clinical MR imaging in the presence of large anatomical motion is to use fast multislice 2D studies to reduce slice acquisition time and provide clinically usable slice data. Recently, techniques have been developed which retrospectively correct large scale 3D motion between individual slices allowing the formation of a geometrically correct 3D volume from the multiple slice stacks. One challenge, however, in the final reconstruction process is the possibility of varying intensity bias in the slice data, typically due to the motion of the anatomy relative to imaging coils. As a result, slices which cover the same region of anatomy at different times may exhibit different sensitivity. This bias field inconsistency can induce artifacts in the final 3D reconstruction that can impact both clinical interpretation of key tissue boundaries and the automated analysis of the data. Here we describe a framework to estimate and correct the bias field inconsistency in each slice collectively across all motion corrupted image slices. Experiments using synthetic and clinical data show that the proposed method reduces intensity variability in tissues and improves the distinction between key tissue types.

  18. Inconsistency in the analysis of morphological deformities in chironomidae (Insecta: Diptera) larvae.

    Science.gov (United States)

    Salmelin, Johanna; Vuori, Kari-Matti; Hämäläinen, Heikki

    2015-08-01

    The incidence of morphological deformities of chironomid larvae as an indicator of sediment toxicity has been studied for decades. However, standards for deformity analysis are lacking. The authors evaluated whether 25 experts diagnosed larval deformities in a similar manner. Based on high-quality digital images, the experts rated 211 menta of Chironomus spp. larvae as normal or deformed. The larvae were from a site with polluted sediments or from a reference site. The authors revealed this to a random half of the experts, and the rest conducted the assessment blind. The authors quantified the interrater agreement by kappa coefficient, tested whether open and blind assessments differed in deformity incidence and in differentiation between the sites, and identified those deformity types rated most consistently or inconsistently. The total deformity incidence varied greatly, from 10.9% to 66.4% among experts. Kappa coefficient across rater pairs averaged 0.52, indicating insufficient agreement. The deformity types rated most consistently were those missing teeth or with extra teeth. The open and blind assessments did not differ, but differentiation between sites was clearest for raters who counted primarily absolute deformities such as missing and extra teeth and excluded apparent mechanical aberrations or deviations in tooth size or symmetry. The highly differing criteria in deformity assignment have likely led to inconsistent results in midge larval deformity studies and indicate an urgent need for standardization of the analysis. © 2015 SETAC.

  19. Are neurocognitive speed and inconsistency similarly affected in type 2 diabetes?

    Science.gov (United States)

    Whitehead, Bonnie P; Dixon, Roger A; Hultsch, David F; MacDonald, Stuart W S

    2011-07-01

    Type 2 diabetes (T2D) is a disease of aging with indirect but detectable and cumulative neurological implications. We systematically tested whether neurocognitive speed (mean rate) or inconsistency (intraindividual variability) was the more sensitive clinical marker of T2D. Three of four research questions used a cross-sectional wave of the Victoria Longitudinal Study (VLS) divided into T2D (age 55-81 years) and control (age = 53-91 years) groups. The fourth question addressed relative two-wave longitudinal changes. Each of four speeded tasks produced intraindividual mean rate (IM) and intraindividual standard deviation (ISD) scores. First, the T2D group performed more slowly than the controls. Second, this deficit extended to inconsistency, but less uniformly. Third, based on logistic regression analyses, IM was the more effective predictor of T2D status. Fourth, we observed similar longitudinal change patterns for IM and ISD. Results are linked to the theoretical location of T2D on an adjusted neural vulnerability continuum.

  20. Flexibility of Gender Stereotypes: Italian Study on Comparative Gender-consistent and Gender-inconsistent Information

    Directory of Open Access Journals (Sweden)

    Elisabetta Sagone

    2018-05-01

    Full Text Available The topic of this study is flexibility in gender stereotyping linked to attribution of toys, socio-cognitive traits, and occupations in 160 Italian children aged 6 to 12 years. We used the Gender Toys Choice, the Gender Traits Choice, and the Gender Jobs Choice, a selected set of colored cards containing masculine and feminine stimuli to assign to a male or female or both male and female silhouette (the flexible-choice technique. In order to verify the change of flexibility in gender stereotyping, we made use of four cartoon stories with male and female characters with typical or atypical traits and performing gender-consistent or gender-inconsistent activities. Results indicated that the exposure to cartoon stories with gender-inconsistent information rather than cartoon stories with gender-consistent information increased flexibility in gender stereotyping, showing age differences in favor of children aged 11-12. Implications in relation to the developmental-constructivist approach were noted.

  1. Inconsistent condom use among public primary care patients with tuberculosis in South Africa.

    Science.gov (United States)

    Matseke, Gladys; Peltzer, Karl; Louw, Julia; Naidoo, Pamela; McHunu, Gugu; Tutshana, Bomkazi

    2012-01-01

    The high rate of HIV infections among tuberculosis (TB) patients in South Africa calls for urgent HIV reduction interventions in this subpopulation. While correct and consistent condom use is one of the effective means of HIV prevention among sexually active people, there is insufficient research on condom use among TB patients in South Africa. The aim of this paper was to determine the prevalence of inconsistent condom use among public primary care TB patients and its associated factors using a sample of 4900 TB patients from a cross-sectional survey in three health districts in South Africa. Results indicated that when asked about their consistency of condom use in the past 3 months, 63.5% of the participants reported that they did not always use condoms. In the multivariable analysis, being married (OR = 1.66; 95% CI 1.25-2.20) or cohabitating or separated, divorced, or widowed (OR = 3.67; 1.85-7.29), lower educational level (OR = 0.66; 0.46-0.94), greater poverty (OR = 1.60; 1.25-2.20), not having HIV status disclosed (OR = 0.34; 0.25-0.48), sexual partner on antiretroviral treatment (OR = 0.38; 0.23-0.60), and partner alcohol use before sex (OR = 1.56; 1.30-1.90) were significantly associated with inconsistent condom use in the past 3 months. The low proportion of consistent condom use among TB patients needs to be improved.

  2. Formalization of taxon-based constraints to detect inconsistencies in annotation and ontology development

    Directory of Open Access Journals (Sweden)

    Mungall Christopher J

    2010-10-01

    Full Text Available Abstract Background The Gene Ontology project supports categorization of gene products according to their location of action, the molecular functions that they carry out, and the processes that they are involved in. Although the ontologies are intentionally developed to be taxon neutral, and to cover all species, there are inherent taxon specificities in some branches. For example, the process 'lactation' is specific to mammals and the location 'mitochondrion' is specific to eukaryotes. The lack of an explicit formalization of these constraints can lead to errors and inconsistencies in automated and manual annotation. Results We have formalized the taxonomic constraints implicit in some GO classes, and specified these at various levels in the ontology. We have also developed an inference system that can be used to check for violations of these constraints in annotations. Using the constraints in conjunction with the inference system, we have detected and removed errors in annotations and improved the structure of the ontology. Conclusions Detection of inconsistencies in taxon-specificity enables gradual improvement of the ontologies, the annotations, and the formalized constraints. This is progressively improving the quality of our data. The full system is available for download, and new constraints or proposed changes to constraints can be submitted online at https://sourceforge.net/tracker/?atid=605890&group_id=36855.

  3. Exploring reasons for the observed inconsistent trial reports on intra-articular injections with hyaluronic acid in the treatment of osteoarthritis: Meta-regression analyses of randomized trials.

    Science.gov (United States)

    Johansen, Mette; Bahrt, Henriette; Altman, Roy D; Bartels, Else M; Juhl, Carsten B; Bliddal, Henning; Lund, Hans; Christensen, Robin

    2016-08-01

    The aim was to identify factors explaining inconsistent observations concerning the efficacy of intra-articular hyaluronic acid compared to intra-articular sham/control, or non-intervention control, in patients with symptomatic osteoarthritis, based on randomized clinical trials (RCTs). A systematic review and meta-regression analyses of available randomized trials were conducted. The outcome, pain, was assessed according to a pre-specified hierarchy of potentially available outcomes. Hedges׳s standardized mean difference [SMD (95% CI)] served as effect size. REstricted Maximum Likelihood (REML) mixed-effects models were used to combine study results, and heterogeneity was calculated and interpreted as Tau-squared and I-squared, respectively. Overall, 99 studies (14,804 patients) met the inclusion criteria: Of these, only 71 studies (72%), including 85 comparisons (11,216 patients), had adequate data available for inclusion in the primary meta-analysis. Overall, compared with placebo, intra-articular hyaluronic acid reduced pain with an effect size of -0.39 [-0.47 to -0.31; P hyaluronic acid. Based on available trial data, intra-articular hyaluronic acid showed a better effect than intra-articular saline on pain reduction in osteoarthritis. Publication bias and the risk of selective outcome reporting suggest only small clinical effect compared to saline. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Religious variations in perceived infertility and inconsistent contraceptive use among unmarried young adults in the United States.

    Science.gov (United States)

    Burdette, Amy M; Haynes, Stacy H; Hill, Terrence D; Bartkowski, John P

    2014-06-01

    In this paper, we examine associations among personal religiosity, perceived infertility, and inconsistent contraceptive use among unmarried young adults (ages 18-29). The data for this investigation came from the National Survey of Reproductive and Contraceptive Knowledge (n = 1,695). We used multinomial logistic regression to model perceived infertility, adjusted probabilities to model rationales for perceived infertility, and binary logistic regression to model inconsistent contraceptive use. Evangelical Protestants were more likely than non-affiliates to believe that they were infertile. Among the young women who indicated some likelihood of infertility, evangelical Protestants were also more likely than their other Protestant or non-Christian faith counterparts to believe that they were infertile because they had unprotected sex without becoming pregnant. Although evangelical Protestants were more likely to exhibit inconsistent contraception use than non-affiliates, we were unable to attribute any portion of this difference to infertility perceptions. Whereas most studies of religion and health emphasize the salubrious role of personal religiosity, our results suggest that evangelical Protestants may be especially likely to hold misconceptions about their fertility. Because these misconceptions fail to explain higher rates of inconsistent contraception use among evangelical Protestants, additional research is needed to understand the principles and motives of this unique religious community. Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  5. Interesting association rule mining with consistent and inconsistent rule detection from big sales data in distributed environment

    Directory of Open Access Journals (Sweden)

    Dinesh J. Prajapati

    2017-06-01

    Full Text Available Nowadays, there is an increasing demand in mining interesting patterns from the big data. The process of analyzing such a huge amount of data is really computationally complex task when using traditional methods. The overall purpose of this paper is in twofold. First, this paper presents a novel approach to identify consistent and inconsistent association rules from sales data located in distributed environment. Secondly, the paper also overcomes the main memory bottleneck and computing time overhead of single computing system by applying computations to multi node cluster. The proposed method initially extracts frequent itemsets for each zone using existing distributed frequent pattern mining algorithms. The paper also compares the time efficiency of Mapreduce based frequent pattern mining algorithm with Count Distribution Algorithm (CDA and Fast Distributed Mining (FDM algorithms. The association generated from frequent itemsets are too large that it becomes complex to analyze it. Thus, Mapreduce based consistent and inconsistent rule detection (MR-CIRD algorithm is proposed to detect the consistent and inconsistent rules from big data and provide useful and actionable knowledge to the domain experts. These pruned interesting rules also give useful knowledge for better marketing strategy as well. The extracted consistent and inconsistent rules are evaluated and compared based on different interestingness measures presented together with experimental results that lead to the final conclusions.

  6. Inconsistent results in the analysis of ALK rearrangements in non-small cell lung cancer

    International Nuclear Information System (INIS)

    Mattsson, Johanna S. M.; Brunnström, Hans; Jabs, Verena; Edlund, Karolina; Jirström, Karin; Mindus, Stephanie; Fleur, Linnéa la; Pontén, Fredrik; Karlsson, Mats G.; Karlsson, Christina; Koyi, Hirsh; Brandén, Eva; Botling, Johan; Helenius, Gisela; Micke, Patrick; Svensson, Maria A.

    2016-01-01

    Identification of targetable EML4-ALK fusion proteins has revolutionized the treatment of a minor subgroup of non-small cell lung cancer (NSCLC) patients. Although fluorescence in situ hybridization (FISH) is regarded as the gold standard for detection of ALK rearrangements, ALK immunohistochemistry (IHC) is often used as screening tool in clinical practice. In order to unbiasedly analyze the diagnostic impact of such a screening strategy, we compared ALK IHC with ALK FISH in three large representative Swedish NSCLC cohorts incorporating clinical parameters and gene expression data. ALK rearrangements were detected using FISH on tissue microarrays (TMAs), including tissue from 851 NSCLC patients. In parallel, ALK protein expression was detected using IHC, applying the antibody clone D5F3 with two different protocols (the FDA approved Ventana CDx assay and our in house Dako IHC protocol). Gene expression microarray data (Affymetrix) was available for 194 patients. ALK rearrangements were detected in 1.7 % in the complete cohort and 2.0 % in the non-squamous cell carcinoma subgroup. ALK protein expression was observed in 1.8 and 1.4 % when applying the Ventana assay or the in house Dako protocol, respectively. The specificity and accuracy of IHC was high (> 98 %), while the sensitivity was between 69 % (Ventana) and 62 % (in house Dako protocol). Furthermore, only 67 % of the ALK IHC positive cases were positive with both IHC assays. Gene expression analysis revealed that 6/194 (3 %) tumors showed high ALK gene expression (≥ 6 AU) and of them only three were positive by either FISH or IHC. The overall frequency of ALK rearrangements based on FISH was lower than previously reported. The sensitivity of both IHC assays was low, and the concordance between the FISH and the IHC assays poor, questioning current strategies to screen with IHC prior to FISH or completely replace FISH by IHC. The online version of this article (doi:10.1186/s12885-016-2646-x) contains supplementary material, which is available to authorized users

  7. Predisposing factors for bacterial vaginosis, treatment efficacy and pregnancy outcome among term deliveries; results from a preterm delivery study

    Directory of Open Access Journals (Sweden)

    Jakobsson Tell

    2007-10-01

    Full Text Available Abstract Background Bacterial vaginosis (BV during pregnancy is associated with an increased risk of preterm delivery but little is known about factors that could predict BV. We have analyzed if it is possible to identify a category of pregnant women that should be screened for BV, and if BV would alter the pregnancy outcome at term; we have also studied the treatment efficacy of clindamycin. Methods Prospective BV screening and treatment study of 9025 women in a geographically defined region in southeast Sweden. BV was defined as a modified Nugent score of 6 and above. Data was collected from the Swedish Medical Birth Register. Women allocated to treatment were supplied with vaginal clindamycin cream. The main outcome goals were to identify factors that could predict BV. Results Vaginal smears were consistent with BV criteria in 9.3%. Logistic regression indicates a significant correlation between smoking and BV (p Conclusion BV is more than twice as common among smokers, and there is a higher prevalence in the younger age group. However these two markers for BV do not suffice as a tool for screening, and considering the lack of other risk factors associated with BV, screening of all pregnant women might be a strategy to follow in a program intended to reduce the number of preterm births.

  8. Effect of Young Maternal Age on Obstetric and Perinatal Outcomes: Results from the Tertiary Center in Turkey

    Directory of Open Access Journals (Sweden)

    Oya Demirci

    2016-06-01

    Full Text Available Background: Young maternal age is variously defined in studies of its effect on obstetrics and perinatal outcomes. Also, pregnancy has been reported as the leading cause of death in adolescent girls in low- and middle-income countries. Aims: The aim of the study was to evaluate whether young maternal age was associated with an increased risk of obstetrics and perinatal adverse outcomes. Study Design: Case-control study. Methods: This case-control study was derived from a database of the medical records between January 2008 and December 2012. In the present study, 1374 teenage pregnancy and 1294 adult pregnancy cases were included. After restriction of analyses to singleton primiparous women, 1282 teenage pregnancy and 735 adult pregnancy cases were analyzed. Maternal age was separated into three groups: 15 and less, 16-19, and 20-34 years. Adjusted odds ratios (ORs were derived through logistic regression models for the potential confounding factors. Results: Adolescents aged 15 years and younger had higher risks of preterm delivery, early preterm delivery, intrauterine fetal death and neonatal death compared with women aged 20 to 34 years after adjustment for confounding factors. In addition, both groups of adolescents had higher risks for anemia and episiotomy and lower risk of cesarean delivery. The rates of preeclampsia, gestational diabetes, chronic diseases, intrauterine growth restriction (IUGR were higher in the adult group. Conclusion: Younger maternal age was correlated with increased risks of preterm delivery, fetal and neonatal death and anemia.

  9. Outcomes of empirical eating disorder phenotypes in a clinical female sample: results from a latent class analysis.

    Science.gov (United States)

    Dechartres, Agnes; Huas, Caroline; Godart, Nathalie; Pousset, Maud; Pham, Alexandra; Divac, Snezana M; Rouillon, Frederic; Falissard, Bruno

    2011-01-01

    To empirically classify phenotypes of eating disorders (ED) using latent class analysis (LCA), and to validate this classification based on clinical outcomes. LCA was applied to 968 inpatients. The resultant classes were validated by clinical outcomes including mortality. A 5-class solution showed the best fit. The symptoms of latent class 1 (LC1; 26% of the sample) resembled anorexia nervosa (AN), bingeing-purging (AN-B/P) subtype; those of LC2 (23%) resembled bulimia nervosa; those of LC3 (11%) were close to AN-B/P without weight and body concerns; those of LC4 resembled restrictive anorexia nervosa (RAN) without weight and body concerns, and those of LC5 RAN. A history of hospitalization for ED was significantly more frequent for LC3 and LC4. The lowest BMI at admission were presented in LC4. LC1 showed the highest level of psychological disturbances and LC4 the lowest. LC3 and LC4 differed from LC1 and LC5 by higher percentages of treatment dropout (64.9 vs. 57.2 and 55.7 vs. 47.5%, respectively; overall p = 0.001). Survival rates tended to be different between the LC (p = 0.09). Subgroups of AN patients with low weight and body concerns seem more severe at hospitalization and more difficult to manage, with a higher rate of treatment dropout than the 'typical' AN patients. Copyright © 2010 S. Karger AG, Basel.

  10. The impact of employee assistance services on workplace outcomes: Results of a prospective, quasi-experimental study.

    Science.gov (United States)

    Richmond, Melissa K; Pampel, Fred C; Wood, Randi C; Nunes, Ana P

    2017-04-01

    Employee Assistance Programs (EAPs) are widely used to help employees experiencing personal or work-related difficulties that impact work productivity. However, rigorous research on the effectiveness of programs to improve work-related outcomes is lacking. The current study represents a major advance in EAP research by using a prospective, quasi-experimental design with a large and diverse employee base. Using propensity scores calculated from demographic, social, work-related, and psychological variables collected on baseline surveys, we matched 156 employees receiving EAP to 188 non-EAP employees. Follow-up surveys were collected from 2 to 12 months post-baseline (M = 6.0). At follow-up, EAP employees had significantly greater reductions in absenteeism (b = -.596, p = .001) and presenteeism (b = -.217, p = .038), but not workplace distress (b = -.079, p = .448), than did non-EAP employees. Tests of moderation of baseline alcohol use, depression, anxiety, and productivity indicate that for the most part, the program works equally well for all groups. However, EAP did more to reduce absenteeism for those who began with lower severity of depression and anxiety at baseline. Results provide the scientific rigor needed to demonstrate EAP impact on improved work outcomes. In the first study of its kind, findings confirm the value of EAPs to help employees address personal and work-related concerns that are affecting job performance. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  11. Status inconsistency and return to work among foreign-born and native Swedes

    Directory of Open Access Journals (Sweden)

    Vania Ranjbar

    2017-03-01

    Full Text Available We investigated potential differences in status inconsistency and time to return to work (RTW from sickness absence between foreign-born and native Swedes, whether inconsistency was associated with RTW, and if this association was stronger for foreign-borns than natives. Significantly fewer native than foreign-born Swedes reported negative status inconsistency, but RTW did not differ between the groups and inconsistency was not associated with RTW. A positive selection of individuals to the Swedish labour market might help explain the findings. This first study of status inconcistency and RTW requires follow-ups in different settings of labour markets and insurance regulations.

  12. Large volume unresectable locally advanced non-small cell lung cancer: acute toxicity and initial outcome results with rapid arc

    Directory of Open Access Journals (Sweden)

    Fogliata Antonella

    2010-10-01

    Full Text Available Abstract Background To report acute toxicity, initial outcome results and planning therapeutic parameters in radiation treatment of advanced lung cancer (stage III with volumetric modulated arcs using RapidArc (RA. Methods Twenty-four consecutive patients were treated with RA. All showed locally advanced non-small cell lung cancer with stage IIIA-IIIB and with large volumes (GTV:299 ± 175 cm3, PTV:818 ± 206 cm3. Dose prescription was 66Gy in 33 fractions to mean PTV. Delivery was performed with two partial arcs with a 6 MV photon beam. Results From a dosimetric point of view, RA allowed us to respect most planning objectives on target volumes and organs at risk. In particular: for GTV D1% = 105.6 ± 1.7%, D99% = 96.7 ± 1.8%, D5%-D95% = 6.3 ± 1.4%; contra-lateral lung mean dose resulted in 13.7 ± 3.9Gy, for spinal cord D1% = 39.5 ± 4.0Gy, for heart V45Gy = 9.0 ± 7.0Gy, for esophagus D1% = 67.4 ± 2.2Gy. Delivery time was 133 ± 7s. At three months partial remission > 50% was observed in 56% of patients. Acute toxicities at 3 months showed 91% with grade 1 and 9% with grade 2 esophageal toxicity; 18% presented grade 1 and 9% with grade 2 pneumonia; no grade 3 acute toxicity was observed. The short follow-up does not allow assessment of local control and progression free survival. Conclusions RA proved to be a safe and advantageous treatment modality for NSCLC with large volumes. Long term observation of patients is needed to assess outcome and late toxicity.

  13. Inconsistency in Reporting Abstention and Heavy Drinking Frequency: Associations with Sex and Socioeconomic Status, and Potential Impacts

    Science.gov (United States)

    Kydd, Robyn M.; Connor, Jennie

    2015-01-01

    Aims: To describe inconsistencies in reporting past-year drinking status and heavy drinking occasions (HDOs) on single questions from two different instruments, and to identify associated characteristics and impacts. Methods: We compared computer-presented Alcohol Use Disorder Identification Test-Consumption (AUDIT-C) with categorical response options, and mental health interview (MHI) with open-ended consumption questions, completed on the same day. Participants were 464 men and 459 women aged 38 (91.7% of surviving birth cohort members). Differences in dichotomous single-item measures of abstention and HDO frequency, associations of inconsistent reporting with sex, socioeconomic status (SES) and survey order, and impacts of instrument choice on associations of alcohol with sex and SES were examined. Results: The AUDIT-C drinking frequency question estimated higher past-year abstention prevalence (AUDIT = 7.6%, MHI = 5.4%), with one-third of AUDIT-C abstainers being MHI drinkers. Only AUDIT-C produced significant sex differences in abstainer prevalence. Inconsistencies in HDO classifications were bidirectional, but with fewer HDOs reported on the MHI than AUDIT-C question. Lower SES was associated with inconsistency in abstention and weekly+ HDOs. Abstention and higher HDO frequency were associated with lower SES overall, but sex-specific associations differed by instrument. Conclusions: In this context, data collection method affected findings, with inconsistencies in abstention reports having most impact. Future studies should: (a) confirm self-reported abstention; (b) consider piloting data collection methods in target populations; (c) expect impacts of sex and SES on measurements and analyses. PMID:25648932

  14. Results of total joint arthroplasty and joint preserving surgery in younger patients evaluated by alternative outcome measures

    DEFF Research Database (Denmark)

    Klit, Jakob

    2014-01-01

    , hip OA is associated with FAI covering three fundamentally different hip deformities, including acetabular dysplasia; all hypothesized to initiates OA development. Where PAO is used worldwide as a joint-preserving procedure in acetabular dysplasia, TKA and THA are the treatment of choice of end stage......BACKGROUND: Knee and hip OA is the clinical and pathological outcome of a functional and structural failure of the joint, resulting in pain and physical dysfunction. Despite the similarity in clinical presentation the pathogenesis seems to differ. Where knee OA is associated with obesity and trauma...... information prior to PAO, TKA and THA surgery. MATERIAL AND METHODS: This PhD thesis is based on three studies. Study I is a cross-sectional survey of preserved hip joints with a mean follow-up of ten years after PAO. One hundred patients (121 PAO's) were eligible for inclusion. An inquiry to the National...

  15. Reaction time performance in adolescents with attention deficit/hyperactivity disorder: evidence of inconsistency in the fast and slow portions of the RT distribution.

    Science.gov (United States)

    Williams, Benjamin R; Strauss, Esther H; Hultsch, David F; Hunter, Michael A; Tannock, Rosemary

    2007-04-01

    Inconsistency across trials of 2-choice reaction time (RT) data was analyzed in 72 adolescents (age 12-17 years) within 4 groups differentiated by the presence or absence of attention deficit/hyperactivity disorder (ADHD) and reading difficulties (RD). ADHD participants were more inconsistent (across all trials, and in the slow portion of the RT distribution) than controls, but only when RD was present. Within the fast portion of the RT distribution, ADHD participants were more inconsistent than controls regardless of RD. The results highlight the importance of fluctuations in cognitive performance in ADHD and suggest that there may be independent sources of variation in inconsistency affecting the fast and slow portions of the RT distribution.

  16. 'Misclassification error' greedy heuristic to construct decision trees for inconsistent decision tables

    KAUST Repository

    Azad, Mohammad; Moshkov, Mikhail

    2014-01-01

    A greedy algorithm has been presented in this paper to construct decision trees for three different approaches (many-valued decision, most common decision, and generalized decision) in order to handle the inconsistency of multiple decisions in a decision table. In this algorithm, a greedy heuristic ‘misclassification error’ is used which performs faster, and for some cost function, results are better than ‘number of boundary subtables’ heuristic in literature. Therefore, it can be used in the case of larger data sets and does not require huge amount of memory. Experimental results of depth, average depth and number of nodes of decision trees constructed by this algorithm are compared in the framework of each of the three approaches.

  17. results

    Directory of Open Access Journals (Sweden)

    Salabura Piotr

    2017-01-01

    Full Text Available HADES experiment at GSI is the only high precision experiment probing nuclear matter in the beam energy range of a few AGeV. Pion, proton and ion beams are used to study rare dielectron and strangeness probes to diagnose properties of strongly interacting matter in this energy regime. Selected results from p + A and A + A collisions are presented and discussed.

  18. Results of total joint arthroplasty and joint preserving surgery in younger patients evaluated by alternative outcome measures.

    Science.gov (United States)

    Klit, Jakob

    2014-04-01

    Knee and hip OA is the clinical and pathological outcome of a functional and structural failure of the joint, resulting in pain and physical dysfunction. Despite the similarity in clinical presentation the pathogenesis seems to differ. Where knee OA is associated with obesity and trauma, hip OA is associated with FAI covering three fundamentally different hip deformities, including acetabular dysplasia; all hypothesized to initiates OA development. Where PAO is used worldwide as a joint-preserving procedure in acetabular dysplasia, TKA and THA are the treatment of choice of end stage OA. Traditional main outcomes are clinically objective surgeon-reported endpoints. Patient perceived outcomes are known to differ from these and PROMs are now recommended as the core set of outcomes. When evaluating the outcome in younger patients, this high demanding group can show ceiling-effects of the scores. The overall aim of this thesis was to investigate the consequences of PAO, TKA, and THA in younger patients evaluated by alternative outcomes in relation to satisfaction, fulfillment of expectations, symptoms of depression, the socioeconomic effects, and abilities in sex-life; to improve patient information prior to PAO, TKA and THA surgery. This PhD thesis is based on three studies. Study I is a cross-sectional survey of preserved hip joints with a mean follow-up of ten years after PAO. One hundred patients (121 PAO's) were eligible for inclusion. An inquiry to the National Patient registry identified 36 of PAO's (in 35 patients) being converted to THA. The 61 remaining patients (80 preserved hip joints) were asked to participate in this questionnaire based follow-up. Fifty-five patients (70 preserved hip-joints) accepted and constituted the study population. All patients received a questionnaire concerning aspects of functional ability, patient satisfaction, expectations, and quality of life following PAO. Both Study II and Study III are prospective multicenter cohort

  19. Patient reported outcome measures (PROMs) following forward planned field-in field IMRT: Results from the Cambridge Breast IMRT trial

    International Nuclear Information System (INIS)

    Mukesh, Mukesh B.; Qian, Wendi; Wilkinson, Jennifer S.; Dorling, Leila; Barnett, Gillian C.; Moody, Anne M.; Wilson, Charles; Twyman, Nicola; Burnet, Neil G.; Wishart, Gordon C.; Coles, Charlotte E.

    2014-01-01

    Background: The use of intensity-modulated radiotherapy (IMRT) in breast cancer reduces clinician-assessed breast tissue toxicity including fibrosis, telangectasia and sub-optimal cosmesis. Patient reported outcome measures (PROMs) are also important as they provide the patient’s perspective. This longitudinal study reports on (a) the effect of forward planned field-in-field IMRT (∼simple IMRT) on PROMs compared to standard RT at 5 years after RT, (b) factors affecting PROMs at 5 years after RT and (c) the trend of PROMs over 5 years of follow up. Methods: PROMs were assessed at baseline (pre-RT), 6, 24 and 60 months after completion of RT using global health (EORTC QLQ C30) and 4 breast symptom questions (BR23). Also, 4 breast RT-specific questions were included at 6, 24 and 60 months: change in skin appearance, firmness to touch, reduction in breast size and overall change in breast appearance since RT. The benefits of simple IMRT over standard RT at 5 years after RT were assessed using standard t-test for global health and logistic regression analysis for breast symptom questions and breast RT-specific questions. Clinical factors affecting PROMs at 5 years were investigated using a multivariate analysis. A repeated mixed model was applied to explore the trend over time for each of PROMs. Results: (89%) 727/815, 84%, 81% and 61% patients completed questionnaires at baseline, 6, 24 and 60 months respectively. Patients reported worse toxicity for all four BR23 breast symptoms at 6 months, which then improved over time (p < 0.0001). They also reported improvement in skin appearance and breast hardness over time (p < 0.0001), with no significant change for breast shrinkage (p = 0.47) and overall breast appearance (p = 0.13). At 5 years, PROMs assessments did not demonstrate a benefit for simple IMRT over standard radiotherapy. Large breast volume, young age, baseline surgical cosmesis and post-operative infection were the most important variables to affect PROMs

  20. Intensive-phase treatment outcomes among hospitalized multidrug-resistant tuberculosis patients: results from a nationwide cohort in Nigeria.

    Directory of Open Access Journals (Sweden)

    Olanrewaju Oladimeji

    Full Text Available BACKGROUND: Nigeria is faced with a high burden of Human Immunodeficiency Virus (HIV infection and multidrug-resistant tuberculosis (MDR-TB. Treatment outcomes among MDR-TB patients registered across the globe have been poor, partly due to high loss-to-follow-up. To address this challenge, MDR-TB patients in Nigeria are hospitalized during the intensive-phase(IP of treatment (first 6-8 months and are provided with a package of care including standardized MDR-TB treatment regimen, antiretroviral therapy (ART and cotrimoxazole prophylaxis (CPT for HIV-infected patients, nutritional and psychosocial support. In this study, we report the end-IP treatment outcomes among them. METHODS: In this retrospective cohort study, we reviewed the patient records of all bacteriologically-confirmed MDR-TB patients admitted for treatment between July 2010 and October 2012. RESULTS: Of 162 patients, 105(65% were male, median age was 34 years and 28(17% were HIV-infected; all 28 received ART and CPT. Overall, 138(85% were alive and culture negative at the end of IP, 24(15% died and there was no loss-to-follow-up. Mortality was related to low CD4-counts at baseline among HIV-positive patients. The median increase in body mass index among those documented to be underweight was 2.6 kg/m2 (p<0.01 and CD4-counts improved by a median of 52 cells/microL among the HIV-infected patients (p<0.01. CONCLUSIONS: End-IP treatment outcomes were exceptional compared to previously published data from international cohorts, thus confirming the usefulness of a hospitalized model of care. However, less than five percent of all estimated 3600 MDR-TB patients in Nigeria were initiated on treatment during the study period. Given the expected scale-up of MDR-TB care, the hospitalized model is challenging to sustain and the national TB programme is contemplating to move to ambulatory care. Hence, we recommend using both ambulatory and hospitalized approaches, with the latter being reserved

  1. Effectiveness of psycho-educational intervention in improving outcome of unipolar depression: results from a randomised clinical trial.

    Science.gov (United States)

    Kumar, K; Gupta, M

    2015-03-01

    Depressive disorders are one of the leading components of the global burden of disease with a prevalence of up to 14% in the general population. Numerous studies have demonstrated that pharmacotherapy combined with non-pharmacological measures offer the best treatment approach. Psycho-education as an intervention has been studied mostly in disorders such as schizophrenia and dementia, less so in depressive disorders. The present study aimed to assess the impact of psycho-education of patients and their caregivers on the outcome of depression. A total of 80 eligible depressed subjects were recruited and randomised into 2 groups. The study group involved an eligible family member and all were offered individual structured psycho-educational modules. Another group (controls) received routine counselling. The subjects in both groups also received routine pharmacotherapy and counselling from the treating clinician and were assessed at baseline, 2, 4, 8, and 12 weeks using the Hamilton Depression Rating Scale (HDRS), Global Assessment of Functioning (GAF), and Psychological General Well-Being Index (PGWBI). Results from both groups were compared using statistical methods including Chi-square test, Fisher's exact test, Student's t test, Pearson's correlation coefficient, as well as univariate and multiple regression analyses. Baseline socio-demographic and assessment measures were similar in both groups. The study group had consistent improvement in terms of outcome measures with HDRS, GAF, and PGWBI scores showing respective mean change of -15.08, 22, and 60 over 12 weeks. The comparable respective changes in the controls were -8.77, 18.1, and 43.25. Structured psycho-education combined with pharmacotherapy is an effective intervention for people with depressive disorders. Psycho-education optimises the pharmacological treatment of depression in terms of faster recovery, reduction in severity of depression, and improvement in subjective wellbeing and social functioning.

  2. 48 CFR 52.225-14 - Inconsistency between English Version and Translation of Contract.

    Science.gov (United States)

    2010-10-01

    ... English Version and Translation of Contract. 52.225-14 Section 52.225-14 Federal Acquisition Regulations... CLAUSES Text of Provisions and Clauses 52.225-14 Inconsistency between English Version and Translation of... and Translation of Contract (FEB 2000) In the event of inconsistency between any terms of this...

  3. Timing of schema activation and memory: Inhibited access to inconsistent information

    NARCIS (Netherlands)

    Dijksterhuis, A.; Knippenberg, A. van

    1995-01-01

    In the present experiment, recognition of consistent and inconsistent information was measured as a function of time of schema activation. A schema was either activated before or after encoding, or not at all. Schema activation after encoding reduced recognition of inconsistent information while

  4. Trait Implications as a Moderator of Recall of Stereotype-Consistent and Stereotype-Inconsistent Behaviors.

    Science.gov (United States)

    Dijksterhuis, Ap; Knippenberg, Ad van

    1996-01-01

    Tests the assumption that organization in memory of behavior information and recall depends on the descriptive relatedness of consistent information with inconsistent information. Subjects read stereotype-consistent and stereotype-inconsistent behavioral descriptions implying the same trait dimension or different trait dimensions. Predictions were…

  5. Analyzing inconsistent cases in management fsQCA studies: A methodological manifesto

    NARCIS (Netherlands)

    Balachandran Nair, L.; Gibbert, Michael

    2016-01-01

    Cases inconsistent with theoretical expectations are by default indicators for a lack of theory-data fit, and as such are prime candidates for theory building. However, the conventional tendency is to ignore inconsistent cases in Management research. The current article focuses on the

  6. Multiple imputation using linked proxy outcome data resulted in important bias reduction and efficiency gains: a simulation study.

    Science.gov (United States)

    Cornish, R P; Macleod, J; Carpenter, J R; Tilling, K

    2017-01-01

    When an outcome variable is missing not at random (MNAR: probability of missingness depends on outcome values), estimates of the effect of an exposure on this outcome are often biased. We investigated the extent of this bias and examined whether the bias can be reduced through incorporating proxy outcomes obtained through linkage to administrative data as auxiliary variables in multiple imputation (MI). Using data from the Avon Longitudinal Study of Parents and Children (ALSPAC) we estimated the association between breastfeeding and IQ (continuous outcome), incorporating linked attainment data (proxies for IQ) as auxiliary variables in MI models. Simulation studies explored the impact of varying the proportion of missing data (from 20 to 80%), the correlation between the outcome and its proxy (0.1-0.9), the strength of the missing data mechanism, and having a proxy variable that was incomplete. Incorporating a linked proxy for the missing outcome as an auxiliary variable reduced bias and increased efficiency in all scenarios, even when 80% of the outcome was missing. Using an incomplete proxy was similarly beneficial. High correlations (> 0.5) between the outcome and its proxy substantially reduced the missing information. Consistent with this, ALSPAC analysis showed inclusion of a proxy reduced bias and improved efficiency. Gains with additional proxies were modest. In longitudinal studies with loss to follow-up, incorporating proxies for this study outcome obtained via linkage to external sources of data as auxiliary variables in MI models can give practically important bias reduction and efficiency gains when the study outcome is MNAR.

  7. Inconsistency in health care professional work: Employment in independent sector treatment centres.

    Science.gov (United States)

    Bishop, Simon; Waring, Justin

    2011-01-01

    The purpose of this paper is to investigate the impact of recent outsourcing and public-private partnership (PPPs) arrangements on the consistency of professional employment in health care. A case study methodology is applied. The paper finds that multiple arrangements for employment within the ISTC creates numerous sources for inconsistency in employment: across the workplace, within professional groups and with national frameworks for health care employment. These are identified as having implications for organisational outcomes, threatening the stability of current partnerships, and partially stymieing intended behavioural change. The study is a single case study of an independent sector treatment centre. Future research is required to investigate wider trends of employment in heterogeneous outsourcing and PPP arrangements. The paper informs both managers and clinical professionals of the unanticipated complexities and practical challenges that can arise in partnerships and outsourcing arrangements. The paper presents a unique in-depth investigation of employment within recently established ISTCs, and highlights important employment changes for the core health care workforce and high-status professionals in the evolving health care organisational landscape.

  8. Clinical outcome and cosmetic results of conservative surgery plus radiation therapy in early stage breast cancer patients

    International Nuclear Information System (INIS)

    Jin Yening; Wang Yajie; Zhang Xiaoqing; Meng Yan; Li Rongqing; Shi Junyi

    2005-01-01

    Objective: To evaluate the clinical outcome and cosmetic results in early stage breast cancer patients treated with conservative surgery plus radiation therapy. Methods: From May 1995 to December 2002, 109 such patients were so treated. The post-operative radiotherapy consisted of whole-breast 6 MV linear accelerator irradiation with two tangential half-fields to a total dose of 45-52 Gy (mean 48.6 Gy), followed by a boost irradiation to the tumor bed. Among them, 79 patients received 10-12 Gy (DB) boost by interstitial implantation brachytherapy ( 192 Ir HDR, Nucletron), with single plane implantation for T1 and double plane implantation for T2 tumor. Thirty patients received 15 Gy boost by electron beam. Adjuvant/concurrent chemotherapy (CMF or CEF) and hormonotherapy were also used according to the patients' clinical characteristics. The cosmetic results were scored by both the doctor and the patients. Results: The overall actuarial 5-year survival was 93.8%, with local recurrence of 6.5%. No radiation-induced ulcer was observed in the breast except for acute inflammation at skin pinholes in 5 patients treated by interstitial implant brachytherapy. Among the 75 patients who had had breast examination, cosmetic result scored as good by patient and doctor were 81% and 87%, respectively. The good rate assessed by doctor in brachytherapy boost group and electron beam boost group were 81.2% (39/48) and 85.2% (23/27), There was no significant difference between these two boost techniques (P>0.05). Conclusions: Tumor bed boost irradiation by either brachytherapy or electron beam technique can provide satisfactory local control in early breast cancer treated with conservative surgery plus radiotherapy without increasing the side effects. There is no significant difference in cosmetic result between these two boost techniques. (authors)

  9. Three approaches to deal with inconsistent decision tables - Comparison of decision tree complexity

    KAUST Repository

    Azad, Mohammad; Chikalov, Igor; Moshkov, Mikhail

    2013-01-01

    In inconsistent decision tables, there are groups of rows with equal values of conditional attributes and different decisions (values of the decision attribute). We study three approaches to deal with such tables. Instead of a group of equal rows, we consider one row given by values of conditional attributes and we attach to this row: (i) the set of all decisions for rows from the group (many-valued decision approach); (ii) the most common decision for rows from the group (most common decision approach); and (iii) the unique code of the set of all decisions for rows from the group (generalized decision approach). We present experimental results and compare the depth, average depth and number of nodes of decision trees constructed by a greedy algorithm in the framework of each of the three approaches. © 2013 Springer-Verlag.

  10. Prospective and Retrospective Studies of Substance Abuse Treatment Outcomes: Methods and Results of Four Large-Scale Follow-Up Studies.

    Science.gov (United States)

    Gerstein, Dean R.; Johnson, Robert A.

    This report compares the research methods, provider and patient characteristics, and outcome results from four large-scale followup studies of drug treatment during the 1990s: (1) the California Drug and Alcohol Treatment Assessment (CALDATA); (2) Services Research Outcomes Study (SROS); (3) National Treatment Improvement Evaluation Study (NTIES);…

  11. Can Research Design Explain Variation in Head Start Research Results? A Meta-Analysis of Cognitive and Achievement Outcomes

    Science.gov (United States)

    Shager, Hilary M.; Schindler, Holly S.; Magnuson, Katherine A.; Duncan, Greg J.; Yoshikawa, Hirokazu; Hart, Cassandra M. D.

    2013-01-01

    This study explores the extent to which differences in research design explain variation in Head Start program impacts. We employ meta-analytic techniques to predict effect sizes for cognitive and achievement outcomes as a function of the type and rigor of research design, quality and type of outcome measure, activity level of control group, and…

  12. 2008 Key Student Outcomes Indicators for BC Diploma, Associate Degree, and Certificate Programs: Survey Results by Institution

    Science.gov (United States)

    Ministry of Advanced Education and Labour Market Development, 2009

    2009-01-01

    The BC Diploma, Associate Degree, and Certificate Student Outcomes (DACSO) Survey (formerly the BC College and Institute Student Outcomes Survey) collects and disseminates information about former students' post-secondary experiences and their subsequent labour market and further education experiences. The survey is administered annually to former…

  13. Differences in outcome between twins and singletons born very preterm: results from a population-based European cohort

    DEFF Research Database (Denmark)

    Papiernik, Emile; Zeitlin, Jennifer; Delmas, Dominique

    2010-01-01

    About 10% of twins are born before 32 weeks of gestation and very preterm birth rates are increasing. Preterm twins tend to have more favourable outcomes than singletons of the same gestational age, but fewer data are available for very preterm infants. This study aims to determine whether outcom...

  14. Results of a Pilot Study to Ameliorate Psychological and Behavioral Outcomes of Minority Stress Among Young Gay and Bisexual Men.

    Science.gov (United States)

    Smith, Nathan Grant; Hart, Trevor A; Kidwai, Ammaar; Vernon, Julia R G; Blais, Martin; Adam, Barry

    2017-09-01

    Project PRIDE (Promoting Resilience In Discriminatory Environments) is an 8-session small group intervention aimed at reducing negative mental and behavioral health outcomes resulting from minority stress. This study reports the results of a one-armed pilot test of Project PRIDE, which aimed to examine the feasibility and potential for efficacy of the intervention in a sample of 33 gay and bisexual men aged 18 to 25. The intervention appeared feasible to administer in two different sites and all participants who completed posttreatment (n = 22) or follow-up (n = 19) assessments reported high satisfaction with the intervention. Small to large effect sizes were observed for increases in self-esteem; small effect sizes were found for decreases in loneliness and decreases in minority stress variables; and small and medium effect sizes were found for reductions in alcohol use and number of sex partners, respectively. Overall, Project PRIDE appears to be a feasible intervention with promise of efficacy. Copyright © 2017. Published by Elsevier Ltd.

  15. Virtual planning of complex head and neck reconstruction results in satisfactory match between real outcomes and virtual models.

    Science.gov (United States)

    Hanken, Henning; Schablowsky, Clemens; Smeets, Ralf; Heiland, Max; Sehner, Susanne; Riecke, Björn; Nourwali, Ibrahim; Vorwig, Oliver; Gröbe, Alexander; Al-Dam, Ahmed

    2015-04-01

    The reconstruction of large facial bony defects using microvascular transplants requires extensive surgery to achieve full rehabilitation of form and function. The purpose of this study is to measure the agreement between virtual plans and the actual results of maxillofacial reconstruction. This retrospective cohort study included 30 subjects receiving maxillofacial reconstruction with a preoperative virtual planning. Parameters including defect size, position, angle and volume of the transplanted segments were compared between the virtual plan and the real outcome using paired t test. A total of 63 bone segments were transplanted. The mean differences between the virtual planning and the postoperative situation were for the defect sizes 1.17 mm (95 % confidence interval (CI) (-.21 to 2.56 mm); p = 0.094), for the resection planes 1.69 mm (95 % CI (1.26-2.11); p = 0.033) and 10.16° (95 % CI (8.36°-11.96°); p satisfactory postoperative results are the basis for an optimal functional and aesthetic reconstruction in a single surgical procedure. The technique should be further investigated in larger study populations and should be further improved.

  16. Outcome of the 'Drip-and-Ship' Paradigm among Patients with Acute Ischemic Stroke: Results of a Statewide Study.

    Science.gov (United States)

    Qureshi, Adnan I; Chaudhry, Saqib A; Rodriguez, Gustavo J; Suri, M Fareed K; Lakshminarayan, Kamakshi; Ezzeddine, Mustapha A

    2012-01-01

    BACKGROUND: The 'drip-and-ship' paradigm denotes a treatment regimen in patients in whom intravenous (IV) recombinant tissue plasminogen activator (rt-PA) is initiated at the emergency department (ED) of a community hospital, followed by transfer within 24 h to a comprehensive stroke center. Although the drip-and-ship paradigm has the potential to increase the number of patients who receive IV rt-PA, comparative outcomes have not been assessed at a population-based level. METHODS: Statewide estimates of thrombolysis, associated in-hospital outcomes, and hospitalization charges were obtained from 2008-2009 Minnesota Hospital Association data for all patients hospitalized with a primary diagnosis of ischemic stroke. Patients who were assigned the drip-and-ship code [International Classification of Diseases, 9th revision, Clinical Modification (ICD-9-CM) V45.88] were classified under the drip-and-ship paradigm. Patients who underwent thrombolysis (ICD-9-CM code 99.10) without drip-and-ship code were classified as primary ED arrival. Patient outcomes were analyzed after stratification into patients treated with IV rt-PA through primary ED arrival or drip-and-ship paradigm. RESULTS: Of the 21,024 admissions, 602 (2.86%) received IV rt-PA either through primary ED arrival (n = 473) or the drip-and-ship paradigm (n = 129). IV rt-PA was administered in 30 hospitals, of which 13 hospitals used the drip-and-ship paradigm; the number of patients treated with the drip-and-ship paradigm varied from 1 to 40 between the 13 hospitals. The rates of secondary intracerebral or subarachnoid hemorrhage were higher in patients treated with IV rt-PA through primary ED arrival compared with those treated with the drip-and-ship paradigm (8.5 vs. 3.1%, respectively; p = 0.038). The in-hospital mortality rate was similar among ischemic stroke patients receiving IV rt-PA through primary ED arrival or the drip-and-ship paradigm (5.9 vs. 7.0%, respectively). The mean hospital charges were USD

  17. Inconsistent Condom Use among Public Primary Care Patients with Tuberculosis in South Africa

    Directory of Open Access Journals (Sweden)

    Gladys Matseke

    2012-01-01

    Full Text Available The high rate of HIV infections among tuberculosis (TB patients in South Africa calls for urgent HIV reduction interventions in this subpopulation. While correct and consistent condom use is one of the effective means of HIV prevention among sexually active people, there is insufficient research on condom use among TB patients in South Africa. The aim of this paper was to determine the prevalence of inconsistent condom use among public primary care TB patients and its associated factors using a sample of 4900 TB patients from a cross-sectional survey in three health districts in South Africa. Results indicated that when asked about their consistency of condom use in the past 3 months, 63.5% of the participants reported that they did not always use condoms. In the multivariable analysis, being married (OR=1.66; 95% CI 1.25–2.20 or cohabitating or separated, divorced, or widowed (OR=3.67; 1.85–7.29, lower educational level (OR=0.66; 0.46–0.94, greater poverty (OR=1.60; 1.25–2.20, not having HIV status disclosed (OR=0.34; 0.25–0.48, sexual partner on antiretroviral treatment (OR=0.38; 0.23–0.60, and partner alcohol use before sex (OR=1.56; 1.30–1.90 were significantly associated with inconsistent condom use in the past 3 months. The low proportion of consistent condom use among TB patients needs to be improved.

  18. Context Matters: Distinct Disease Outcomes as a Result of Crebbp Hemizygosity in Different Mouse Bone Marrow Compartments.

    Directory of Open Access Journals (Sweden)

    Ting Zhou

    Full Text Available Perturbations in CREB binding protein (CREBBP are associated with hematopoietic malignancies, including myelodysplastic syndrome (MDS. Mice hemizygous for Crebbp develop myelodysplasia with proliferative features, reminiscent of human MDS/myeloproliferative neoplasm-unclassifiable (MDS/MPN-U, and a proportion goes on to develop acute myeloid leukemia (AML. We have also shown that the Crebbp+/- non-hematopoietic bone marrow microenvironment induces excessive myeloproliferation of wild-type cells. We now report that transplantation of unfractionated Crebbp+/- bone marrow into wild-type recipients resulted in either early-onset AML or late-onset MDS and MDS/MPN-U. In contrast, purified Lin-Sca-1+c-Kit++ cells primarily gave rise to MDS with occasional transformation to AML. Furthermore, Crebbp+/- common myeloid progenitors and granulocyte/macrophage progenitors could trigger skewed myelopoiesis, myelodysplasia and late-onset AML. Surprisingly, the phenotypically abnormal cells were all of wild-type origin. MDS, MPN and AML can thus all be transferred from Crebbp+/- BM to wild-type hosts but fractionated bone marrow does not recapitulate the full disease spectrum of whole bone marrow, indicating that not only mutational status but also cellular context contribute to disease outcome. This has important consequences for structuring and interpreting future investigations into the underlying mechanisms of myeloid malignancies as well as for their treatment.

  19. Baseline Patient Characteristics Predicting Outcome and Attrition in Cognitive Therapy for Social Phobia: Results from a Large Multicentre Trial.

    Science.gov (United States)

    Hoyer, Juergen; Wiltink, Joerg; Hiller, Wolfgang; Miller, Robert; Salzer, Simone; Sarnowsky, Stephan; Stangier, Ulrich; Strauss, Bernhard; Willutzki, Ulrike; Leibing, Eric

    2016-01-01

    We examined the role of baseline patient characteristics as predictors of outcome (end-state functioning, response and remission) and attrition for cognitive therapy (CT) in social anxiety disorder (SAD). Beyond socio-demographic and clinical variables such as symptom severity and comorbidity status, previously neglected patient characteristics (e.g., personality, self-esteem, shame, interpersonal problems and attachment style) were analysed. Data came from the CT arm of a multicentre RCT with n = 244 patients having DSM-IV SAD. CT was conducted according to the manual by Clark and Wells. Severity of SAD was assessed at baseline and end of treatment with the Liebowitz Social Anxiety Scale (LSAS). Multiple linear regression analyses and logistic regression analyses were applied. Up to 37% of the post-treatment variance (LSAS) could be explained by all pre-treatment variables combined. Symptom severity (baseline LSAS) was consistently negatively associated with end-state functioning and remission, but not with response. Number of comorbid diagnoses was negatively associated with end-state functioning and response, but not with remission. Self-esteem was positively associated with higher end-state functioning and more shame with better response. Attrition could not be significantly predicted. The results indicate that the initial probability for treatment success mainly depends on severity of disorder and comorbid conditions while other psychological variables are of minor importance, at least on a nomothetic level. This stands in contrast with efforts to arrive at an empirical-based foundation for differential indication and argues to search for more potent moderators of therapeutic change rather on the process level. Personality, self-esteem, shame, attachment style and interpersonal problems do not or only marginally moderate the effects of interventions in CT of social phobia. Symptom severity and comorbid diagnoses might affect treatment outcome negatively

  20. Comparing outcomes in poorly-differentiated versus anaplastic thyroid cancers treated with radiation: A surveillance, epidemiology, and end results analysis

    Directory of Open Access Journals (Sweden)

    Shruthi Arora

    2014-01-01

    Conclusion: This is the first large population-based study evaluating PDTC and ATC outcomes in patients who received radiation treatment. Radioisotope use and timing of radiotherapy (postoperative vs. preoperative were associated with improved CSS in both histologies.

  1. Treatment Decision Regret Among Long-Term Survivors of Localized Prostate Cancer: Results From the Prostate Cancer Outcomes Study.

    Science.gov (United States)

    Hoffman, Richard M; Lo, Mary; Clark, Jack A; Albertsen, Peter C; Barry, Michael J; Goodman, Michael; Penson, David F; Stanford, Janet L; Stroup, Antoinette M; Hamilton, Ann S

    2017-07-10

    Purpose To determine the demographic, clinical, decision-making, and quality-of-life factors that are associated with treatment decision regret among long-term survivors of localized prostate cancer. Patients and Methods We evaluated men who were age ≤ 75 years when diagnosed with localized prostate cancer between October 1994 and October 1995 in one of six SEER tumor registries and who completed a 15-year follow-up survey. The survey obtained demographic, socioeconomic, and clinical data and measured treatment decision regret, informed decision making, general- and disease-specific quality of life, health worry, prostate-specific antigen (PSA) concern, and outlook on life. We used multivariable logistic regression analyses to identify factors associated with regret. Results We surveyed 934 participants, 69.3% of known survivors. Among the cohort, 59.1% had low-risk tumor characteristics (PSA decision regret: 8.2% of those whose disease was managed conservatively, 15.0% of those who received surgery, and 16.6% of those who underwent radiotherapy. Factors associated with regret on multivariable analysis included reporting moderate or big sexual function bother (reported by 39.0%; OR, 2.77; 95% CI, 1.51 to 5.0), moderate or big bowel function bother (reported by 7.7%; OR, 2.32; 95% CI, 1.04 to 5.15), and PSA concern (mean score 52.8; OR, 1.01 per point change; 95% CI, 1.00 to 1.02). Increasing age at diagnosis and report of having made an informed treatment decision were inversely associated with regret. Conclusion Regret was a relatively infrequently reported outcome among long-term survivors of localized prostate cancer; however, our results suggest that better informing men about treatment options, in particular, conservative treatment, might help mitigate long-term regret. These findings are timely for men with low-risk cancers who are being encouraged to consider active surveillance.

  2. Survival Outcomes in Resected Extrahepatic Cholangiocarcinoma: Effect of Adjuvant Radiotherapy in a Surveillance, Epidemiology, and End Results Analysis

    International Nuclear Information System (INIS)

    Vern-Gross, Tamara Z.; Shivnani, Anand T.; Chen, Ke; Lee, Christopher M.; Tward, Jonathan D.; MacDonald, O. Kenneth; Crane, Christopher H.; Talamonti, Mark S.; Munoz, Louis L.; Small, William

    2011-01-01

    Purpose: The benefit of adjuvant radiotherapy (RT) after surgical resection for extrahepatic cholangiocarcinoma has not been clearly established. We analyzed survival outcomes of patients with resected extrahepatic cholangiocarcinoma and examined the effect of adjuvant RT. Methods and Materials: Data were obtained from the Surveillance, Epidemiology, and End Results (SEER) program between 1973 and 2003. The primary endpoint was the overall survival time. Cox regression analysis was used to perform univariate and multivariate analyses of the following clinical variables: age, year of diagnosis, histologic grade, localized (Stage T1-T2) vs. regional (Stage T3 or greater and/or node positive) stage, gender, race, and the use of adjuvant RT after surgical resection. Results: The records for 2,332 patients were obtained. Patients with previous malignancy, distant disease, incomplete or conflicting records, atypical histologic features, and those treated with preoperative/intraoperative RT were excluded. Of the remaining 1,491 patients eligible for analysis, 473 (32%) had undergone adjuvant RT. After a median follow-up of 27 months (among surviving patients), the median overall survival time for the entire cohort was 20 months. Patients with localized and regional disease had a median survival time of 33 and 18 months, respectively (p < .001). The addition of adjuvant RT was not associated with an improvement in overall or cause-specific survival for patients with local or regional disease. Conclusion: Patients with localized disease had significantly better overall survival than those with regional disease. Adjuvant RT was not associated with an improvement in long-term overall survival in patients with resected extrahepatic bile duct cancer. Key data, including margin status and the use of combined chemotherapy, was not available through the SEER database.

  3. Replication of Psycholinguistic Experiments and the Resolution of Inconsistencies

    Science.gov (United States)

    Rákosi, Csilla

    2017-01-01

    Non-exact replications are regarded as effective tools of problem solving in psycholinguistic research because they lead to more plausible experimental results; however, they are also ineffective tools of problem solving because they trigger cumulative contradictions among different replications of an experiment. This paper intends to resolve this…

  4. 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

  5. Outcome of childhood anorexia nervosa-The results of a five- to ten-year follow-up study.

    Science.gov (United States)

    Herpertz-Dahlmann, Beate; Dempfle, Astrid; Egberts, Karin Maria; Kappel, Viola; Konrad, Kerstin; Vloet, Jennifer Anne; Bühren, Katharina

    2018-04-01

    Although admissions of children with anorexia nervosa (AN) are increasing, there remains a dearth of up-to-date knowledge of the course and outcome of early-onset AN. The aim of the present study was to investigate the outcomes of patients with AN onset before the age of 14. Sixty-eight consecutive former patients who met the DSM-IV criteria for AN and who had been treated at one of three German university hospitals were asked to participate in a follow-up study. Body mass index, body height, outcome of the eating disorder (ED), psychiatric morbidity, and health related quality of life (HRQoL) were assessed through a personal examination after an average time span of 7.5 years (range: 4.5-11.5 years) after admission. One patient had died. Fifty-two subjects with a mean age of 12.5 (SD 1.0) years at admission and of 20.2 (SD 2.0) years at follow-up agreed to participate in the follow-up assessment, aggregating to 77.9% of the original sample. Approximately 41% of the participants had a good outcome, while 35% and 24% had intermediate and poor outcomes, respectively. Twenty-eight percent of the sample met the DSM-IV criteria for a current non-ED psychiatric disorder, and 64% met the criteria for a past non-ED psychiatric disorder. Mental HRQoL and ED-specific psychopathology was strongly associated with the outcome of AN. Average body height was below the normal range. A higher weight at admission was the only significant positive indicator of outcome. Childhood AN is a serious disorder with an unfavorable course in many patients and high rates of chronicity and psychiatric comorbidity in young adulthood. Early detection and intervention are urgently needed. © 2018 Wiley Periodicals, Inc.

  6. Sex differences in adult outcomes by changes in weight status from adolescence to adulthood: results from Add Health.

    Science.gov (United States)

    Chung, Arlene E; Skinner, Asheley Cockrell; Maslow, Gary R; Halpern, Carolyn T; Perrin, Eliana M

    2014-01-01

    Changes in weight status from adolescence to adulthood may be associated with varying social, vocational, economic, and educational outcomes, which may differ by sex. We studied whether there are differences in adult outcomes by sex for different weight status changes in the transition to adulthood. Using data from the National Longitudinal Study of Adolescent Health, participants were categorized by weight status from adolescence into adulthood. We examined self-reported outcomes in adulthood for living with parents, being married, being a parent, employment, receipt of public assistance, income, and college graduation by weight groupings (healthy-healthy, healthy-overweight/obese, overweight/obese-overweight/obese, overweight/obese-healthy). The effect of changes in weight status on the adult outcomes was modeled, controlling for sex, age, parental education, and race/ethnicity. There were differences by sex for many of the self-reported outcomes, especially educational and economic outcomes. Female subjects who became overweight/obese between adolescence and adulthood or remained so had worse economic and educational findings as adults compared to male subjects. Overall, for female subjects, becoming and remaining overweight/obese was associated with worse outcomes, while for male subjects, adolescent obesity was more important than isolated adult obesity. The relationship between obesity and life situations may be more negative for female subjects in the transition to adulthood. The findings emphasize that adolescent obesity, and not just obesity isolated in adulthood, is important for characteristics achieved in adulthood. Copyright © 2014 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  7. Use of and confidence in administering outcome measures among clinical prosthetists: Results from a national survey and mixed-methods training program.

    Science.gov (United States)

    Gaunaurd, Ignacio; Spaulding, Susan E; Amtmann, Dagmar; Salem, Rana; Gailey, Robert; Morgan, Sara J; Hafner, Brian J

    2015-08-01

    Outcome measures can be used in prosthetic practices to evaluate interventions, inform decision making, monitor progress, document outcomes, and justify services. Strategies to enhance prosthetists' ability to use outcome measures are needed to facilitate their adoption in routine practice. To assess prosthetists' use of outcome measures and evaluate the effects of training on their confidence in administering performance-based measures. Cross-sectional and single-group pretest-posttest survey. Seventy-nine certified prosthetists (mean of 16.0 years of clinical experience) were surveyed about their experiences with 20 standardized outcome measures. Prosthetists were formally trained by the investigators to administer the Timed Up and Go and Amputee Mobility Predictor. Prosthetists' confidence in administering the Timed Up and Go and Amputee Mobility Predictor was measured before and after training. The majority of prosthetists (62%) were classified as non-routine outcome measure users. Confidence administering the Timed Up and Go and Amputee Mobility Predictor prior to training was low-to-moderate across the study sample. Training significantly (p measures. Interactive training resulted in a statistically significant increase of prosthetists' confidence in administering the Timed Up and Go and Amputee Mobility Predictor and may facilitate use of outcome measures in clinical practice. Frequency of outcome measure use in the care of persons with limb loss has not been studied. Study results suggest that prosthetists may not regularly use standardized outcome measures and report limited confidence in administering them. Training enhances confidence and may encourage use of outcome measures in clinical practice. © The International Society for Prosthetics and Orthotics 2014.

  8. Adaptive Robotic Fabrication for Conditions of Material Inconsistency

    DEFF Research Database (Denmark)

    Nicholas, Paul; Zwierzycki, Mateusz; Clausen Nørgaard, Esben

    2017-01-01

    This paper describes research that addresses the variable behaviour of industrial quality metals and the extension of computational techniques into the fabrication process. It describes the context of robotic incremental sheet metal forming, a freeform method for imparting 3D form onto a 2D thin...... and the fabrication process? Here, two adaptive methods are presented that aim to increase forming accuracy with only a minimum increase in fabrication time, and that maintain ongoing input from the results of the fabrication process. The first method is an online sensor-based strategy and the second method...

  9. Long-term outcome of the adjustable transobturator male system (ATOMS): results of a European multicentre study.

    Science.gov (United States)

    Friedl, Alexander; Mühlstädt, Sandra; Zachoval, Roman; Giammò, Alessandro; Kivaranovic, Danijel; Rom, Maximilian; Fornara, Paolo; Brössner, Clemens

    2017-05-01

    To evaluate the long-term effectiveness and safety of the adjustable transobturator male system (ATOMS ® , Agency for Medical Innovations A.M.I., Feldkirch, Austria) in a European-wide multicentre setting. In all, 287 men with stress urinary incontinence (SUI) were treated with the ATOMS device between June 2009 and March 2016. Continence parameters (daily pad test/pad use), urodynamics (maximum urinary flow rate, voiding volume, residual urine), and pain/quality of life (QoL) ratings (visual analogue scale/Leeds Assessment of Neuropathic Symptoms and Signs, International Consultation on Incontinence Questionnaire-Short Form [ICIQ-SF]/Patient Global Impression of Improvement [PGI-I]) were compared preoperatively and after intermediate (12 months) as well as after individual maximum follow-up. Overall success rate, dry rate (ATOMS devices are still functioning; 56 (20%) were removed, the most common reason being local titanium intolerance (41%) and leak/dysfunction (30%). The operating time and continence outcome varied between port generations. In this regard the latest port generation (silicone-covered scrotal port) was superior to its predecessors. Primary implantation (P = 0.002), good physical health (P = 0.001), and no history of radiotherapy (P ATOMS device is safe and shows high treatment efficacy and patient satisfaction in the largest cohort study to date. The latest generation, with its pre-attached silicone-covered scrotal port, is superior to its predecessors. Significantly better results were achieved with primary implantation and in those without a history of radiotherapy. © 2016 The Authors BJU International © 2016 BJU International Published by John Wiley & Sons Ltd.

  10. One-year results of maxillary overdentures supported by 2 titanium-zirconium implants - implant survival rates and radiographic outcomes.

    Science.gov (United States)

    Zembic, Anja; Tahmaseb, Ali; Jung, Ronald E; Wismeijer, Daniel

    2017-07-01

    To assess implant survival rates and peri-implant bone loss of 2 titanium-zirconium implants supporting maxillary overdentures at 1 year of loading. Twenty maxillary edentulous patients (5 women and 15 men) being dissatisfied with their complete dentures were included. In total, 40 diameter-reduced titanium-zirconium implants were placed in the anterior maxilla. Local guided bone regeneration (GBR) was allowed if the treatment did not compromise implant stability. Following 3 to 5 months of healing, implant-supported overdentures were inserted on two ball anchors. Implants and overdentures were assessed at 1, 2, 4, and 8 weeks after implant insertion and 2, 4, and 12 months after insertion of overdentures (baseline). Standardized radiographs were taken at implant loading and 1 year. Implant survival rates and bone loss were the primary outcomes. Nineteen patients (1 dropout) with 38 implants were evaluated at a mean follow-up of 1.1 years (range 1.0-1.7 years). One implant failed resulting in an implant survival rate of 97.3%. There was a significant peri-implant bone loss of the implants at 1 year of function (mean, 0.7 mm, SD = 1.1 mm; median: 0.48 mm, IQR = 0.56 mm). There was a high 1-year implant survival rate for edentulous patients receiving 2 maxillary implants and ball anchors as overdenture support. However, several implants exhibited an increased amount of bone loss of more than 2 mm. Overdentures supported by 2 maxillary implants should thus be used with caution as minimally invasive treatment for specific patients encountering problems with their upper dentures until more long-term data is available. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  11. Long-Term Outcomes of Hypertrophic Cardiomyopathy Diagnosed During Childhood: Results from a National Population-Based Study.

    Science.gov (United States)

    Alexander, Peta M A; Nugent, Alan W; Daubeney, Piers E F; Lee, Katherine J; Sleeper, Lynn A; Schuster, Tibor; Turner, Christian; Davis, Andrew M; Semsarian, Chris; Colan, Steven D; Robertson, Terry; Ramsay, James; Justo, Robert; Sholler, Gary F; King, Ingrid; Weintraub, Robert G

    2018-02-28

    Background -Late survival and symptomatic status of children with hypertrophic cardiomyopathy (HCM) have not been well defined. We examined long-term outcomes for pediatric HCM. Methods -The National Australian Childhood Cardiomyopathy Study is a longitudinal population-based cohort study of children (0-10 years) diagnosed with cardiomyopathy between 1987 and 1996. The primary study end-point was time to death or cardiac transplantation. Results -There were 80 patients with HCM with median age at diagnosis of 0.48 (Inter-quartile range [IQR] 0.1, 2.5) years. Freedom from death/transplantation (95% confidence interval [CI]) was 86 (77-92)% one year after presentation, 80 (69-87)% at 10 years and 78 (67-86)% at 20 years. From multivariable analyses, risk factors for death/transplantation included symmetric left ventricular hypertrophy at the time of diagnosis (hazard ratio [HR] 4.20 95%CI 1.60, 11.05 p=0.004), Noonan syndrome (HR 2.88, 95%CI 1.02, 8.08, p=0.045), higher posterior wall thickness z-score (HR 1.45, 95%CI 1.22, 1.73, p<0.001) and lower fractional shortening z-score (HR 0.84, 95%CI 0.74, 0.95, p=0.005) during follow-up. Nineteen (23%) subjects underwent left ventricular myectomy. At median 15.7 years' follow-up, 27 (42%) of 63 survivors were treated with beta-blocker and 13 (21%) had an implantable cardioverter-defibrillator. Conclusions -The highest risk of death or transplantation for children with HCM is within one year post-diagnosis, with low attrition rates thereafter. Many subjects receive medical, surgical or device therapy.

  12. Measuring IBS patient reported outcomes with an abdominal pain numeric rating scale: results from the proof cohort

    Science.gov (United States)

    SPIEGEL, B.; BOLUS, R.; HARRIS, L. A.; LUCAK, S.; NALIBOFF, B.; ESRAILIAN, E.; CHEY, W. D.; LEMBO, A.; KARSAN, H.; TILLISCH, K.; TALLEY, J.; MAYER, E.; CHANG, L.

    2009-01-01

    Background Controversy exists about how to effectively measure patient reported outcomes in IBS clinical trials. Pain numeric rating scales (NRS) are widely used in the non-IBS pain literature. The FDA has proposed using the NRS in IBS. Aim To test the psychometrics of an abdominal pain NRS in IBS. Methods We analyzed data from a longitudinal cohort of Rome III IBS subjects. At entry, subjects completed a 10-point NRS, bowel symptoms, IBS severity measurements (IBSSS, FBDSI), health related quality of life indices (IBS-QOL, EQ5D), and the worker productivity activity index (WPAI). We repeated assessments at 3 months along with a response scale to calculate the minimal clinically important difference (MCID). Results There were 277 subjects (82% women; age=42±15) at baseline and 90 at 3 months. The NRS correlated cross-sectionally with IBSSS (r=0.60; p<0.0011), FBDSI (r=0.49; p<0.0001), IBS-QOL (r=0.43; p<0.0001), EQ5D (r=0.48; p<0.0001), presenteeism (r=0.39; p<0.0001), absenteeism (r=0.17; p=0.04), and distension (r=0.46; p<0.0001), but not stool frequency or form. The MCID was 2.2 points, correlating with a 29.5% reduction over time. Conclusions An abdominal pain NRS exhibits excellent validity and can be readily interpreted with an MCID in patients with IBS. These data support the use of the NRS in IBS clinical trials. PMID:19751360

  13. Why is electricity consumption inconsistent with economic growth in China?

    International Nuclear Information System (INIS)

    Lin, Boqiang; Liu, Chang

    2016-01-01

    Studies have indicated that there exists a relatively stable and positive correlation between electricity consumption and economic growth and there should not be a large deviation between them. However, the deviation between electricity consumption and economic growth in China during the Asian Financial Crisis and Global Economic Crisis sparks intense debates. We attempt to explain the deviation from the perspective of inventory investment adjustment in the business cycle using the SVAR model in this paper. The results show that the effects of inventory investment adjustment shock and electricity consumption structure shock on the deviation are positive but tend to be negative for electricity efficiency shock. The results of historical decomposition of these shocks also show that the inventory investment adjustment shock is the main factor that influences the deviation during the Global Economic Crisis. Economic fluctuation in the short term can not change the economic development pattern and the characteristics of electricity demand. Once the economy returns to stable growth, the deviation between electricity consumption and economic growth will shrink and disappear soon. - Highlights: • We analyze the deviation between GDP and electricity consumption in business cycle. • The inventory investment adjustment mainly impacts the deviation in China. • Concentrated electricity consumption of heavy industry magnifies the deviation.

  14. What is This Thing Called Sensemaking?: A Theoretical Framework for How Physics Students Resolve Inconsistencies in Understanding

    Science.gov (United States)

    Odden, Tor Ole B.

    Students often emerge from introductory physics courses with a feeling that the concepts they have learned do not make sense. In recent years, science education researchers have begun to attend to this type of problem by studying the ways in which students make sense of science concepts. However, although many researchers agree intuitively on what sensemaking looks like, the literature on sensemaking is both theoretically fragmented and provides few guidelines for how to encourage and support the process. In this dissertation, I address this challenge by proposing a theoretical framework to describe students' sensemaking processes. I base this framework both on the science education research literature on sensemaking and on a series of video-recorded cognitive, clinical interviews conducted with introductory physics students enrolled in a course on electricity and magnetism. Using the science education research literature on sensemaking as well as a cognitivist, dynamic network model of mind as a theoretical lens, I first propose a coherent definition of sensemaking. Then, using this definition I analyze the sensemaking processes of these introductory physics students during episodes when they work to articulate and resolve gaps or inconsistencies in their understanding. Based on the students' framing, gestures, and dialogue I argue that the process of sensemaking unfolds in a distinct way, which we can describe as an epistemic game in which students first build a framework of knowledge, then identify a gap or inconsistency in that framework, iteratively build an explanation to resolve the gap or inconsistency, and (sometimes) successfully resolve it. I further argue that their entry into the sensemaking frame is facilitated by a specific question, which is in turn motivated by a gap or inconsistency in knowledge that I call the vexation point. I also investigate the results of sensemaking, arguing that students may use the technique of conceptual blending to both

  15. Resolution of an apparent inconsistency in the electromagnetic Casimir effect

    International Nuclear Information System (INIS)

    Alnes, H; Olaussen, K; Ravndal, F; Wehus, I K

    2007-01-01

    The vacuum expectation value of the electromagnetic energy-momentum tensor between two parallel plates in spacetime dimensions D > 4 is calculated in the axial gauge. While the pressure between the plates agrees with the global Casimir force, the energy density is divergent at the plates and not compatible with the total energy which follows from the force. However, subtracting the divergent self-energies of the plates, the resulting energy is finite and consistent with the force. In analogy with the corresponding scalar case for spacetime dimensions D > 2, the divergent self-energy of a single plate can be related to the lack of conformal invariance of the electromagnetic Lagrangian for dimensions D > 4. (fast track communication)

  16. Characteristics of pregnant illicit drug users and associations between cannabis use and perinatal outcome in a population-based study.

    NARCIS (Netherlands)

    Gelder, M.M.H.J. van; Reefhuis, J.; Caton, A.R.; Werler, M.M.; Druschel, C.M.; Roeleveld, N.

    2010-01-01

    BACKGROUND: According to the 2004 National Survey on Drug Use and Health, 4.6% of American women reported use of an illicit drug during pregnancy. Previous studies on illicit drug use during pregnancy and perinatal outcomes showed inconsistent results. METHODS: This population-based study included

  17. "Good job, you're so smart": The effects of inconsistency of praise type on young children's motivation.

    Science.gov (United States)

    Zentall, Shannon R; Morris, Bradley J

    2010-10-01

    Previous research has demonstrated that generic praise ("good drawer") is related to children giving up after failure because failure implies the lack of a critical trait (e.g., drawing ability). Conversely, nongeneric praise ("good job drawing") is related to mastery motivation because it implies that success is related to effort. Yet children may receive a mixture of these praise types (i.e., inconsistent praise), the effects of which are unclear. We tested how inconsistent praise influenced two components of motivation: self-evaluation and persistence. Kindergarteners (N=135) were randomly assigned to one of five conditions in which consistency of praise type was varied. After two failure scenarios, children reported self-evaluations and persistence. Results indicated that more nongeneric praise related linearly to greater motivation, yet self-evaluation and persistence were impacted differently by inconsistent praise types. Hearing even a small amount of generic praise reduced persistence, whereas hearing a small amount of nongeneric praise preserved self-evaluation. Copyright 2010 Elsevier Inc. All rights reserved.

  18. Publication Rates and Inconsistencies of the Abstracts Presented at the National Anatomy Congresses in 2007 and 2008

    Directory of Open Access Journals (Sweden)

    İlke Ali Gürses

    2017-02-01

    Full Text Available Background: Despite significant efforts made for, most abstracts presented during a meeting do not proceed and publish as a manuscript in scientific journals. Aims: To investigate publication rates of national anatomy congresses. Study Design: Descriptive study. Methods: All abstracts presented at two annual meetings in 2007 and 2008 were extracted. PubMed and Google Scholar database search used for publication history. Presentation and study types, publication rates and mean publishing times were evaluated. Inconsistency rates between meeting abstract and final published article were also considered. Results: Among 342 abstracts, 195 (57% were followed by a full-text article. Publication rates for oral and poster presentations were 75% and 52.2%, respectively. The mean publication time was 23.7±23 months. Overall, 89.2% of the articles were published within 5 years. There were no inconsistencies in 50 (25.6% articles, while 145 (74.4% had inconsistencies compared to the abstracts presented at the congress. Getting adequate information for 45 (23.1% articles was not possible. There was no standard reporting format for the abstracts. Conclusion: Our study shows that, overall publication rates for abstracts presented at national anatomy meetings were higher than those presented at national meetings for clinical specialties

  19. Results of total joint arthroplasty and joint preserving surgery in younger patients evaluated by alternative outcome measures

    DEFF Research Database (Denmark)

    Klit, Jakob

    2013-01-01

    The utilization of alternative outcome measures in the evaluation of outcome after PAO, TKA, and THA in young adults seem warranted to better understand the patients perception of successful treatment. Due to the lack of focus in contemporary literature on alternative aspects of outcome measurement...... in younger PAO, TKA, and THA patients our aims were, to explore patient satisfaction, fulfillment of expectations, symptoms of depression, the effect on socioeconomic status, and abilities in sex-life in younger PAO, TKA, and THA patients using PROMs. These alternative endpoints were collected in addition...... the surgeon and patient with information, when deciding the right time for surgery. 3. To investigate functional and quality of life aspects after PAO surgery in relation to the effect on the patient’s sex-life, the patient’s ability to participate in sports, the patient’s ability to interact socially...

  20. Gender Differences in Emotional Response: Inconsistency between Experience and Expressivity

    Science.gov (United States)

    Deng, Yaling; Chang, Lei; Yang, Meng; Huo, Meng

    2016-01-01

    The present study investigated gender differences in both emotional experience and expressivity. Heart rate (HR) was recorded as an indicator of emotional experience while the participants watched 16 video clips that induced eight types of emotion (sadness, anger, horror, disgust, neutrality, amusement, surprise, and pleasure). We also asked the participants to report valence, arousal, and motivation as indicators of emotional expressivity. Overall, the results revealed gender differences in emotional experience and emotional expressivity. When watching videos that induced anger, amusement, and pleasure, men showed larger decreases in HR, whereas women reported higher levels of arousal. There was no gender difference in HR when the participants watched videos that induced horror and disgust, but women reported lower valence, higher arousal, and stronger avoidance motivation than did men. Finally, no gender difference was observed in sadness or surprise, although there was one exception—women reported higher arousal when watching videos that induced sadness. The findings suggest that, when watching videos that induce an emotional response, men often have more intense emotional experiences, whereas women have higher emotional expressivity, particularly for negative emotions. In addition, gender differences depend on the specific emotion type but not the valence. PMID:27362361

  1. Peer assessment of aviation performance: inconsistent for good reasons.

    Science.gov (United States)

    Roth, Wolff-Michael; Mavin, Timothy J

    2015-03-01

    Research into expertise is relatively common in cognitive science concerning expertise existing across many domains. However, much less research has examined how experts within the same domain assess the performance of their peer experts. We report the results of a modified think-aloud study conducted with 18 pilots (6 first officers, 6 captains, and 6 flight examiners). Pairs of same-ranked pilots were asked to rate the performance of a captain flying in a critical pre-recorded simulator scenario. Findings reveal (a) considerable variance within performance categories, (b) differences in the process used as evidence in support of a performance rating, (c) different numbers and types of facts (cues) identified, and (d) differences in how specific performance events affect choice of performance category and gravity of performance assessment. Such variance is consistent with low inter-rater reliability. Because raters exhibited good, albeit imprecise, reasons and facts, a fuzzy mathematical model of performance rating was developed. The model provides good agreement with observed variations. Copyright © 2014 Cognitive Science Society, Inc.

  2. Gender Differences in Emotional Response: Inconsistency between Experience and Expressivity.

    Science.gov (United States)

    Deng, Yaling; Chang, Lei; Yang, Meng; Huo, Meng; Zhou, Renlai

    2016-01-01

    The present study investigated gender differences in both emotional experience and expressivity. Heart rate (HR) was recorded as an indicator of emotional experience while the participants watched 16 video clips that induced eight types of emotion (sadness, anger, horror, disgust, neutrality, amusement, surprise, and pleasure). We also asked the participants to report valence, arousal, and motivation as indicators of emotional expressivity. Overall, the results revealed gender differences in emotional experience and emotional expressivity. When watching videos that induced anger, amusement, and pleasure, men showed larger decreases in HR, whereas women reported higher levels of arousal. There was no gender difference in HR when the participants watched videos that induced horror and disgust, but women reported lower valence, higher arousal, and stronger avoidance motivation than did men. Finally, no gender difference was observed in sadness or surprise, although there was one exception-women reported higher arousal when watching videos that induced sadness. The findings suggest that, when watching videos that induce an emotional response, men often have more intense emotional experiences, whereas women have higher emotional expressivity, particularly for negative emotions. In addition, gender differences depend on the specific emotion type but not the valence.

  3. Gender Differences in Emotional Response: Inconsistency between Experience and Expressivity.

    Directory of Open Access Journals (Sweden)

    Yaling Deng

    Full Text Available The present study investigated gender differences in both emotional experience and expressivity. Heart rate (HR was recorded as an indicator of emotional experience while the participants watched 16 video clips that induced eight types of emotion (sadness, anger, horror, disgust, neutrality, amusement, surprise, and pleasure. We also asked the participants to report valence, arousal, and motivation as indicators of emotional expressivity. Overall, the results revealed gender differences in emotional experience and emotional expressivity. When watching videos that induced anger, amusement, and pleasure, men showed larger decreases in HR, whereas women reported higher levels of arousal. There was no gender difference in HR when the participants watched videos that induced horror and disgust, but women reported lower valence, higher arousal, and stronger avoidance motivation than did men. Finally, no gender difference was observed in sadness or surprise, although there was one exception-women reported higher arousal when watching videos that induced sadness. The findings suggest that, when watching videos that induce an emotional response, men often have more intense emotional experiences, whereas women have higher emotional expressivity, particularly for negative emotions. In addition, gender differences depend on the specific emotion type but not the valence.

  4. Oligodendrogliomas in pediatric and adult patients: an outcome-based study from the Surveillance, Epidemiology, and End Result database

    Directory of Open Access Journals (Sweden)

    Lau CSM

    2017-05-01

    Full Text Available Christine SM Lau,1,2 Krishnaraj Mahendraraj,1 Ronald S Chamberlain1–4 1Department of Surgery, Saint Barnabas Medical Center, Livingston, NJ, USA; 2Saint George’s University School of Medicine, Grenada, West Indies; 3Department of Surgery, New Jersey Medical School, Rutgers University, Newark, NJ, 4Department of Surgery, Banner MD Anderson Cancer Center, Gilbert, AZ, USA Introduction: Oligodendrogliomas (OGs account for <20% of all intracranial tumors and 25% of gliomas. Despite improvements in imaging techniques allowing for earlier diagnosis, OG is rare among the pediatric population. This study examines a large cohort of OG patients in an effort to define the demographic, clinical, and pathologic factors associated with clinical and survival outcomes.Methods: Data on 7,001 OG patients were abstracted from the Surveillance, Epidemiology, and End Result (SEER database (1973–2013. Pediatric patients were defined as ≤19 years old, and adult patients were defined as age ≥20 years.Results: Among 7,001 OG patients, 6.5% were pediatric (mean age 12 ± 6 years, and 93.5% were adult (mean age 46 ± 15 years. Overall, OGs were more common among males, with a male-to-female ratio of 1.28:1. Overall, OGs were more common among Caucasians (76.9% and also among the African American (10.8% pediatric vs. 4.0% adult and Hispanic (12.8% pediatric vs. 11.8% adult. OGs occurred most commonly in the temporal lobe of pediatric patients and the frontal lobes of adults. Surgical resection was the primary treatment modality for both pediatric and adult populations (70.6% and 40.5%, followed by combined surgery and radiation (19.7% and 41.2%. Surgical resection was associated with significantly improved survival in both groups. Pediatric patients had a lower overall mortality (19.8% vs. 48.5% and lower cancer-specific mortality (17.6% vs. 36.8%.Conclusion: OGs most often present in Caucasian males in their fifth decade of life with tumors >4 cm in size

  5. Time inconsistency and reputation in monetary policy: a strategic model in continuous time

    OpenAIRE

    Li, Jingyuan; Tian, Guoqiang

    2005-01-01

    This article develops a model to examine the equilibrium behavior of the time inconsistency problem in a continuous time economy with stochastic and endogenized dis- tortion. First, the authors introduce the notion of sequentially rational equilibrium, and show that the time inconsistency problem may be solved with trigger reputation strategies for stochastic setting. The conditions for the existence of sequentially rational equilibrium are provided. Then, the concept of sequen...

  6. Human (InConsistencies in Ian McEwan’s Amsterdam

    Directory of Open Access Journals (Sweden)

    Anghel Florentina

    2016-12-01

    Full Text Available Ian McEwan’s Amsterdam has supplied its readers with psychological, moral and social topical issues presented in an easy flowing and exhilarating style. Starting from the assumption that life consists of a series of inconsistencies which are inherent and bring their contribution to the individual’s formation, the paper aims at demonstrating that the protagonists’ judgmental and moral inconsistencies, which are used as a plot generator and are environmentally determined, reveal features of their personality.

  7. Resolving inconsistencies in utility measurement under risk: Tests of generalizations of expected utility

    OpenAIRE

    Han Bleichrodt; José María Abellán-Perpiñan; JoséLuis Pinto; Ildefonso Méndez-Martínez

    2005-01-01

    This paper explores inconsistencies that occur in utility measurement under risk when expected utility theory is assumed and the contribution that prospect theory and some other generalizations of expected utility can make to the resolution of these inconsistencies. We used five methods to measure utilities under risk and found clear violations of expected utility. Of the theories studied, prospect theory was the most consistent with our data. The main improvement of prospect theory over expe...

  8. Perceived consequences of hypothetical identity-inconsistent sexual experiences: effects of perceiver's sex and sexual identity.

    Science.gov (United States)

    Preciado, Mariana A; Johnson, Kerri L

    2014-04-01

    Most people organize their sexual orientation under a single sexual identity label. However, people may have sexual experiences that are inconsistent with their categorical sexual identity label. A man might identify as heterosexual but still experience some attraction to men; a woman might identify as lesbian yet enter into a romantic relationship with a man. Identity-inconsistent experiences are likely to have consequences. In the present study, we examined lay perceptions of the consequences of identity-inconsistent sexual experiences for self-perceived sexuality and for social relationships among a sexually diverse sample (N = 283). We found that the perceived consequences of identity-inconsistent experiences for self-perception, for social stigmatization, and for social relationships varied as a function of participant sex, participant sexual identity (heterosexual, gay, lesbian), and experience type (fantasy, attraction, behavior, love). We conclude that not all identity-inconsistent sexual experiences are perceived as equally consequential and that the perceived consequences of such experiences vary predictably as a function of perceiver sex and sexual identity. We discuss the role lay perceptions of the consequences of identity-inconsistent sexual experiences may play in guiding attitudes and behavior.

  9. Preprocessing in Matlab Inconsistent Linear System for a Meaningful Least Squares Solution

    Science.gov (United States)

    Sen, Symal K.; Shaykhian, Gholam Ali

    2011-01-01

    Mathematical models of many physical/statistical problems are systems of linear equations Due to measurement and possible human errors/mistakes in modeling/data, as well as due to certain assumptions to reduce complexity, inconsistency (contradiction) is injected into the model, viz. the linear system. While any inconsistent system irrespective of the degree of inconsistency has always a least-squares solution, one needs to check whether an equation is too much inconsistent or, equivalently too much contradictory. Such an equation will affect/distort the least-squares solution to such an extent that renders it unacceptable/unfit to be used in a real-world application. We propose an algorithm which (i) prunes numerically redundant linear equations from the system as these do not add any new information to the model, (ii) detects contradictory linear equations along with their degree of contradiction (inconsistency index), (iii) removes those equations presumed to be too contradictory, and then (iv) obtain the . minimum norm least-squares solution of the acceptably inconsistent reduced linear system. The algorithm presented in Matlab reduces the computational and storage complexities and also improves the accuracy of the solution. It also provides the necessary warning about the existence of too much contradiction in the model. In addition, we suggest a thorough relook into the mathematical modeling to determine the reason why unacceptable contradiction has occurred thus prompting us to make necessary corrections/modifications to the models - both mathematical and, if necessary, physical.

  10. Superior episodic memory in inconsistent-handers: a replication and extension using fNIRS.

    Science.gov (United States)

    Propper, Ruth E; Patel, Neil; Christman, Stephen D; Carlei, Christophe

    2017-11-01

    A large body of evidence supports the existence of a robust handedness difference in episodic memory retrieval, with inconsistent-handedness being associated with superior memory across a wide variety of paradigms, including superior retrieval of lab-based and real world memories. Despite superior episidoc memory in inconsistent-handers, and despite neuroanatomical and neurophysiological differences in cortical regions between inconsistent- and consistent-handers, we are aware of no studies to date that have examined physiological activity in the brains of inconsistent- versus consistent-handers while engaged in memory tasks. The purpose of this paper, therefore, is to present a first look at this issue, using functional near-infrared spectroscopy (fNIRS) as a simple, non-invasive measure of frontal lobe activity during encoding and recall of list words in inconsistent- and consistent-handers. Behaviourally, we replicated prior studies, finding a significant inconsistent-handed advantage in free recall. Using fNIRS-derived oxygenated haemoglobin (O 2 Hb) as a measure of frontal lobe activity, we found the first evidence for handedness differences in brain activity that are associated with the handedness differences in episodic retrieval. Specifically, the primary finding was that increased O 2 Hb in the right hemisphere during recall was associated with better retrieval, but for consistent-handers only.

  11. Differences in outcome between twins and singletons born very preterm: results from a population-based European cohort.

    NARCIS (Netherlands)

    Papiernik, E.; Zeitlin, J.; Delmas, D.; Blondel, B.; Kunzel, W.; Cuttini, M.; Weber, T.; Petrou, S.; Gortner, L.; Kollee, L.A.A.; Draper, E.S.

    2010-01-01

    BACKGROUND: About 10% of twins are born before 32 weeks of gestation and very preterm birth rates are increasing. Preterm twins tend to have more favourable outcomes than singletons of the same gestational age, but fewer data are available for very preterm infants. This study aims to determine

  12. Teaching Note--Educating Public Health Social Work Professionals: Results from an MSW/MPH Program Outcomes Study

    Science.gov (United States)

    Ruth, Betty J.; Marshall, Jamie Wyatt; Velásquez, Esther E. M.; Bachman, Sara S.

    2015-01-01

    Dual-degree programs in public health and social work continue to proliferate, yet there has been little research on master's of social work (MSW)/master's of public health (MPH) graduates. The purpose of this study was to describe and better understand the self-reported professional experiences, identities, roles, and outcomes associated with 1…

  13. Coping and mental health outcomes among Sierra Leonean war-affected youth: Results from a longitudinal study.

    Science.gov (United States)

    Sharma, Manasi; Fine, Shoshanna L; Brennan, Robert T; Betancourt, Theresa S

    2017-02-01

    This study explored how coping with war-related traumatic events in Sierra Leone impacted mental health outcomes among 529 youth (aged 10-17 at baseline; 25% female) using longitudinal data from three time points (Time 1 in 2002, Time 2 in 2004, and Time 3 in 2008). We examined two types of coping items (approach and avoidance); used multiple regression models to test their relations with long-term mental health outcomes (internalizing behaviors, externalizing behaviors, adaptive/prosocial behaviors, and posttraumatic stress symptoms); and used mediation analyses to test whether coping explained the relation between previous war exposures (being raped, death of parent(s), or killing/injuring someone during the war) and those outcomes. We found that avoidance coping items were associated with lower internalizing and posttraumatic stress behaviors at Time 3, and provided some evidence of mediating the relation between death of parent(s) during the war and the two outcomes mentioned above. Approach coping was associated with higher Time 3 adaptive/prosocial behaviors, whereas avoidance coping was associated with lower Time 3 adaptive/prosocial behaviors. Avoidance coping may be a protective factor against mental illness, whereas approach coping may be a promotive factor for adaptive/prosocial behaviors in war-affected societies. This study has important implications for designing and implementing mental health interventions for youth in postconflict settings.

  14. Linear and nonlinear relations between psychosocial job characteristics, subjective outcomes, and sickness absence : baseline results from SMASH

    NARCIS (Netherlands)

    Jonge, J. de; Houtman, I.L.D.; Bongers, P.M.; Reuvers, M.M.E.N.; Kompier, M.A.J.

    2000-01-01

    This study investigates the demand-control-support (DCS) model by (a) using a more focused measure of job control, (b) testing for interactive and nonlinear relationships, and (c) further extending the model to the prediction of an objective outcome measure (i.e., company-administrated sickness

  15. Linear and non-linear relations between psychosocial job characteristics, subjective outcomes, and sickness absence: baseline results from SMASH

    NARCIS (Netherlands)

    Jonge, J. de; Reuvers, M.M.E.N.; Houtman, I.L.D.; Bongers, P.M.; Kompier, M.A.J.

    2000-01-01

    This study investigates the demand-control-support (DCS) model by (a) using a more focused measure of job control, (b) testing for interactive and nonlinear relationships, and (c) further extending the model to the prediction of an objective outcome measure (i.e., company-administrated sickness

  16. Early Neurological Outcome of Young Infants Exposed to Selective Serotonin Reuptake Inhibitors during Pregnancy : Results from the Observational SMOK Study

    NARCIS (Netherlands)

    de Vries, N.K.S.; van der Veere, C.N.; Reijneveld, S.A.; Bos, A.F.

    2013-01-01

    Background: Use of selective serotonin reuptake inhibitors (SSRI) during pregnancy is common while the effect on the infant's neurological outcome is unknown. Our objective was to determine the effects of prenatal SSRI-exposure on the infants' neurological functioning, adjusted for maternal mental

  17. Admission time is associated with outcome of upper gastrointestinal bleeding: results of a multicentre prospective cohort study

    NARCIS (Netherlands)

    de Groot, N. L.; Bosman, J. H.; Siersema, P. D.; van Oijen, M. G. H.; Bredenoord, A. J.

    2012-01-01

    Background It has been suggested that patients presenting with upper gastrointestinal bleeding (UGIB) during the weekend have a worse outcome compared with weekdays, with an increased risk of recurrent bleeding and mortality. Aim To investigate the association between timing of admission and adverse

  18. The Advanced Glaucoma Intervention Study (AGIS): 4. Comparison of treatment outcomes within race. Seven-year results.

    Science.gov (United States)

    1998-07-01

    The purpose of this report is to present separately for black and white patients with advanced glaucoma 7-year results of two alternative surgical intervention sequences. A randomized controlled trial. A total of 332 black patients (451 eyes), 249 white patients (325 eyes), and 10 patients of other races (13 eyes) participated. Potential follow-up ranged from 4 to 7 years. Eyes were randomly assigned to either an argon laser trabeculoplasty (ALT)-trabeculectomy-trabeculectomy (ATT) sequence or a trabeculectomy-ALT-trabeculectomy (TAT) sequence. The second and third interventions were offered after failure of the first and second interventions, respectively. Average percent of eyes with decrease of visual field (APDVF), average percent of eyes with decrease of visual acuity (APDVA), and average percent of eyes with decrease of vision (APDV) are the outcome measures. Decrease of visual field (DVF) is an increase from baseline of at least 4 points on a glaucoma visual field defect scale ranging from 0 to 20, decrease of visual acuity (DVA) is a decrease from baseline of at least 15 letters (3 lines), and decrease of vision (DV) is the occurrence of either DVF or DVA. The averages are of percent decreases observed at 6-month intervals from the first 6-month visit to the end of the specified observation period. In both black and white patients throughout 7-year follow-up, the mean decrease in intraocular pressure was greater in eyes assigned to TAT, and the cumulative probability of failure of the first intervention was greater in eyes assigned to ATT. In black patients, APDVF, APDVA, and APDV are less for the ATT sequence than for the TAT sequence throughout the 7 years. In white patients, APDVF also favors the ATT sequence but only for the first year, after which it favors the TAT sequence through the seventh year; APDVA also favors the ATT sequence, but the ATT-TAT difference progressively diminishes over 7 years; and APDV favors ATT over TAT initially, but after 4

  19. Severe malnutrition evaluated by patient-generated subjective global assessment results in poor outcome among adult patients with acute leukemia

    Science.gov (United States)

    Li, Ji; Wang, Chang; Liu, Xiaoliang; Liu, Qiuju; Lin, Hai; Liu, Chunshui; Jin, Fengyan; Yang, Yan; Bai, Ou; Tan, Yehui; Gao, Sujun; Li, Wei

    2018-01-01

    Abstract To evaluate nutritional status in adult patients with acute leukemia (AL) using patient-generated subjective global assessment (PG-SGA) and to investigate the influence of nutritional status on prognosis. We observationally investigated 68 adult patients with newly diagnosed AL who received PG-SGA at the First Hospital of Jilin University between May 2013 and July 2015. Clinical features, chemotherapy regimens, biochemical indexes, body composition, complete remission (CR) rate, minimal residual disease (MRD), survival time, and side-effects of chemotherapy were compared between patients with and without severe malnutrition. Mean PG-SGA scores of the total patients were 6.1 ± 4.0, and 19 of 68 (27.9%) patients had severe malnutrition (PG-SGA score ≥9). Patients with acute myeloid leukemia (AML) had higher scores than those with acute lymphocytic leukemia (ALL; P = .011) and high-risk patients had higher scores regardless of whether they had AML or ALL (AML, P = .012; ALL, P = .043). Univariate analysis showed that severe malnutrition was correlated with age (P = .041), transferrin (P = .042), Karnofsky Performance Status score (P = .006), and C-reactive protein (CRP) (P = .018). Multivariate analysis demonstrated that severe malnutrition was associated with CRP (hazard ratio [HR] = 1.020, 95% confidence interval [CI]: 1.002–1.039, P = .026). No difference was found in CR rate (P = .831) between patients with and without malnutrition, but those who were severely malnourished had higher MRD (P = .048 in AML patients, P = .036 in ALL patients) and more gastrointestinal side-effects (P = .014). Severe malnutrition was also associated with inferior overall survival (HR = 0.243, 95% CI: 0.063–0.945, P = .041) but not with event-free survival (HR = 0.808, 95% CI: 0.338–1.934, P = .663). Severe malnutrition defined by PG-SGA in adult patients with de novo AL may result in poor outcome

  20. Metabolic and cardiovascular outcomes of fatherhood: results from a cohort of study in subjects with sexual dysfunction.

    Science.gov (United States)

    Fisher, Alessandra D; Rastrelli, Giulia; Bandini, Elisa; Corona, Giovanni; Balzi, Daniela; Melani, Cecilia; Monami, Matteo; Matta, Vanessa; Mannucci, Edoardo; Maggi, Mario

    2012-11-01

    Previous cross-sectional and longitudinal studies reported a negative correlation between fatherhood and testosterone (T) levels, likely due to a centrally mediated downregulation of the hypothalamic-pituitary-gonadal axis. Moreover, epidemiological data indicate that fatherhood might affect metabolic and cardiovascular outcomes, although different results have been reported. Up to now, no studies have evaluated these associations in a population of men seeking treatment for sexual dysfunction (SD). To explore biological and clinical correlates of number of children (NoC) and its possible associations with forthcoming major cardiovascular events (MACE) in a sample of men with SD. A consecutive series of 4,045 subjects (mean age 52 ± 13.1 years old) attending the Outpatient Clinic for SD was retrospectively studied. A subset of the previous sample (N = 1,687) was enrolled in a longitudinal study. Information on MACE was obtained through the City of Florence Registry Office. Among patients studied, 31.6% had no children, while 26.3% reported having one child, 33.4% two, and 8.8% three or more children. Although fatherhood was negatively related with follicle-stimulating hormone levels and positively with testis volume, we found a NoC-dependent, stepwise decrease in T plasma levels, not compensated by a concomitant increase in luteinizing hormone. NoC was associated with a worse metabolic and cardiovascular profile, as well as worse penile blood flows and a higher prevalence of metabolic syndrome (MetS). In the longitudinal study, after adjusting for confounders, NoC was independently associated with a higher incidence of MACE. However, when the presence of MetS was introduced as a further covariate, the association was no longer significant. This study supports the hypothesis that bond maintenance contexts and fatherhood are associated with an adaptive downregulation of the gonadotropin-gonadal axis, even in a sample of men with SD. Moreover, our data suggest that

  1. Left ventricular mass in dialysis patients, determinants and relation with outcome. Results from the COnvective TRansport STudy (CONTRAST.

    Directory of Open Access Journals (Sweden)

    Ira M Mostovaya

    Full Text Available BACKGROUND AND OBJECTIVES: Left ventricular mass (LVM is known to be related to overall and cardiovascular mortality in end stage kidney disease (ESKD patients. The aims of the present study are 1 to determine whether LVM is associated with mortality and various cardiovascular events and 2 to identify determinants of LVM including biomarkers of inflammation and fibrosis. DESIGN SETTING PARTICIPANTS & MEASUREMENTS: Analysis was performed with data of 327 ESKD patients, a subset from the CONvective TRAnsport STudy (CONTRAST. Echocardiography was performed at baseline. Cox regression analysis was used to assess the relation of LVM tertiles with clinical events. Multivariable linear regression models were used to identify factors associated with LVM. RESULTS: Median age was 65 (IQR: 54-73 years, 203 (61% were male and median LVM was 227 (IQR: 183-279 grams. The risk of all-cause mortality (hazard ratio (HR = 1.73, 95% CI: 1.11-2.99, cardiovascular death (HR = 3.66, 95% CI: 1.35-10.05 and sudden death (HR = 13.06; 95% CI: 6.60-107 was increased in the highest tertile (>260 grams of LVM. In the multivariable analysis positive relations with LVM were found for male gender (B = 38.8±10.3, residual renal function (B = 17.9±8.0, phosphate binder therapy (B = 16.9±8.5, and an inverse relation for a previous kidney transplantation (B = -41.1±7.6 and albumin (B = -2.9±1.1. Interleukin-6 (Il-6, high-sensitivity C-reactive protein (hsCRP, hepcidin-25 and connective tissue growth factor (CTGF were not related to LVM. CONCLUSION: We confirm the relation between a high LVM and outcome and expand the evidence for increased risk of sudden death. No relationship was found between LVM and markers of inflammation and fibrosis. TRIAL REGISTRATION: Controlled-Trials.com ISRCTN38365125.

  2. Inconsistent Physics

    OpenAIRE

    Asenjo, F. G.

    2011-01-01

    Um certo número de trabalhos foi dedicado à viabilidade e interesse da matemática inconsistente, mas até hoje poucos esforços comparáveis foram feitos no que diz respeito à física. Alguns poucos tópicos de física são aqui descritos no qual a presença de contradições é indisputável e clama por um tratamento lógico diferenciado. O argumento baseia-se em dois fatos. Primeiro, antinomias não são necessariamente geradas por negação: a conjunção de dois enunciados opostos pode igualmente gerar uma ...

  3. Inconsistent Transduction

    DEFF Research Database (Denmark)

    Højlund, Marie Koldkjær; Riis, Morten S.

    2017-01-01

    The growing integration of sounding art as research practice in academia is a part of the “practice turn” in humanities and social sciences, where artistic practices and artefacts themselves become a form of academic inquiry. As the process of creating art represents a valid research method...... at “not-knowing” or “not-yet-knowing” within artistic research encompassing the unexpected, the spontaneous and involuntary. We argue that the implicit human-centred perspective present in these alternative understandings of knowledge production in artistic research prevents us from fully engaging...... with the objects in question on their own premises. Therefore, tuning into the “not-knowing” requires expanding the perspective to encompass non-human forms of knowledge incorporated through an object-oriented ontological line of thinking. By switching the focus from the human perspective to that of the objects...

  4. Risk-perception and dangerous driving among adolescents: Outcome- and behavior-focused questions yield opposite results.

    Science.gov (United States)

    O'Brien, Fearghal; Gormley, Michael

    2016-10-01

    While some studies have found that those who perceive a behavior to be more risky are less likely to engage in it, others have found that those who engage in more risky behaviors see themselves as being more at-risk. Using an online questionnaire we investigated whether such conflicting findings may be due to the types of risk-questions employed in past studies. We assessed risk-perception using outcome-focused questions (e.g. the likelihood of being in an accident) and a behavior-focused question (the riskiness of speeding). Participants who reported engaging in more risky driving gave higher estimates of their chances of experiencing a negative outcome. However, those same participants gave lower estimates of the general riskiness of risky driving. Drivers may think about the risks of risky driving in different ways depending on the focus of the questions. Published by Elsevier Ltd.

  5. The Effects of Travel Burden on Outcomes After Resection of Extrahepatic Biliary Malignancies: Results from the US Extrahepatic Biliary Consortium.

    Science.gov (United States)

    O'Connor, Sean C; Mogal, Harveshp; Russell, Gregory; Ethun, Cecilia; Fields, Ryan C; Jin, Linda; Hatzaras, Ioannis; Vitiello, Gerardo; Idrees, Kamran; Isom, Chelsea A; Martin, Robert; Scoggins, Charles; Pawlik, Timothy M; Schmidt, Carl; Poultsides, George; Tran, Thuy B; Weber, Sharon; Salem, Ahmed; Maithel, Shishir; Shen, Perry

    2017-12-01

    Surgical resection of extrahepatic biliary malignancies has been increasingly centralized at high-volume tertiary care centers. While this has improved outcomes overall, increased travel burden has been associated with worse survival for many other malignancies. We hypothesized that longer travel distances are associated with worse outcomes for these patients as well. Data was analyzed from the US Extrahepatic Biliary Consortium database, which retrospectively reviewed patients who received resection of extrahepatic biliary malignancies at 10 high-volume centers. Driving distance to the patient's treatment center was measured for 1025 patients. These were divided into four quartiles for analysis: travel distances were associated with decreased overall survival, especially in the 3rd quartile of our study. Patients traveling longer distances also had a lower household income, suggesting that these patients have significant barriers to care.

  6. Patient-Reported Allergies Predict Worse Outcomes After Hip and Knee Arthroplasty: Results From a Prospective Cohort Study.

    Science.gov (United States)

    Otero, Jesse E; Graves, Christopher M; Gao, Yubo; Olson, Tyler S; Dickinson, Christopher C; Chalus, Rhonda J; Vittetoe, David A; Goetz, Devon D; Callaghan, John J

    2016-12-01

    Retrospective analyses have demonstrated correlation between patient-reported allergies and negative outcomes after total joint arthroplasty. We sought to validate these observations in a prospective cohort. One hundred forty-four patients undergoing total hip arthroplasty and 302 patients undergoing total knee arthroplasty were prospectively enrolled. Preoperatively, patients listed their allergies and completed the Medical Outcomes Study Short Form 36 (SF-36) and the Charlson Comorbidity Index (CCI) Questionnaire. At a mean of 17 months (range 12-25 months) postoperatively, SF-36, CCI, and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) were obtained by telephone survey. Regression analysis was used to determine the strength of correlation between patient age, comorbidity burden, and number of allergies and outcome measurements. In 446 patients, 273 reported at least 1 allergy. The number of allergies reported ranged from 0 to 33. Penicillin or its derivative was the most frequently reported allergy followed by sulfa, environmental allergen, and narcotic pain medication. Patients reporting at least 1 allergy had a significantly lower postoperative SF-36 Physical Component Score compared to those reporting no allergies (51.3 vs 49.4, P = .01). The SF-36 postoperative Mental Component Score was no different between groups. Multivariate regression analysis showed that age and patient reported allergies, but not comorbidities, were independently associated with worse postoperative SF-36 Physical Component Summary (PCS) and WOMAC score. Patients with allergies experienced the same improvement in SF-36 PCS as those without an allergy. Comorbidities did not correlate with patient-reported function postoperatively. Patients who report allergies have lower postoperative outcome scores but may experience the same increment in improvement after total joint arthroplasty. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. The key role of psychosocial risk on therapeutic outcome in obese children and adolescents. Results from a longitudinal multicenter study.

    OpenAIRE

    Röbl, Markus; de Souza, Martin; Schiel, Ralf; Gellhaus, Ines; Zwiauer, Karl; Holl, Reinhard W.; Wiegand, Susanna

    2013-01-01

    Objective: Childhood obesity is high on the global public health agenda. Although risk factors are well known, the influence of social risk on the therapeutic outcome of lifestyle intervention is poorly examined. This study aims to investigate the influence of migration background, low education, and parental unemployment. Methods: 62,147 patients participated in multidimensional lifestyle intervention programs in 179 pediatric obesity centers. Data were collected using standardized software ...

  8. Less Is More: Results of a Statewide Analysis of the Impact of Blood Transfusion on Coronary Artery Bypass Grafting Outcomes.

    Science.gov (United States)

    Crawford, Todd C; Magruder, J Trent; Fraser, Charles; Suarez-Pierre, Alejandro; Alejo, Diane; Bobbitt, Jennifer; Fonner, Clifford E; Canner, Joseph K; Horvath, Keith; Wehberg, Kurt; Taylor, Bradley; Kwon, Christopher; Whitman, Glenn J; Conte, John V; Salenger, Rawn

    2018-01-01

    Debate persists over the association between blood transfusions, especially those considered discretionary, and outcomes after cardiac operations. Using data from the Maryland Cardiac Surgery Quality Initiative, we sought to determine whether outcomes differed among coronary artery bypass grafting (CABG) patients receiving 1 U of red blood cells (RBCs) vs none. We used a statewide database to review patients who underwent isolated CABG from July 1, 2011, to June 30, 2016, across 10 Maryland cardiac surgery centers. We included patients who received 1 U or fewer of RBCs from the time of the operation through discharge. Propensity scoring, using 20 variables to control for treatment effect, was performed among patients who did and did not receive a transfusion. These two groups were matched 1:1 to assess for differences in our primary outcomes: operative death, prolonged postoperative length of stay (>14 days), and a composite postoperative respiratory complication of pneumonia or reintubation, or both. Of 10,877 patients who underwent CABG, 6,124 (56%) received no RBCs (group 1) during their operative hospitalization, and 981 (9.0%) received 1 U of RBCs (group 2), including 345 of 981 patients (35%) who received a transfusion intraoperatively. Propensity score matching generated 937 well-matched pairs. Compared with group 2, propensity-matched analysis revealed significantly greater 30-day survival in group 1 (99% vs 98%, p = 0.02) and reduced incidence of prolonged length of stay (3.7% vs 4.0%, p < 0.01). Our collaborative statewide analysis demonstrated that even 1 unit of blood was associated with significantly worse survival and longer length of stay after CABG. Multiinstitutional quality initiatives may seek to address discretionary transfusions and possess the potential to improve patient outcomes. Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  9. The key role of psychosocial risk on therapeutic outcome in obese children and adolescents. Results from a longitudinal multicenter study.

    Science.gov (United States)

    Röbl, Markus; de Souza, Martin; Schiel, Ralf; Gellhaus, Ines; Zwiauer, Karl; Holl, Reinhard W; Wiegand, Susanna

    2013-01-01

    Childhood obesity is high on the global public health agenda. Although risk factors are well known, the influence of social risk on the therapeutic outcome of lifestyle intervention is poorly examined. This study aims to investigate the influence of migration background, low education, and parental unemployment. 62,147 patients participated in multidimensional lifestyle intervention programs in 179 pediatric obesity centers. Data were collected using standardized software for longitudinal multicenter documentation. 12,305 (19.8%) attended care for 6-24 months, undergoing an intensive therapy period and subsequent follow-ups for up to 3 years. A cumulative social risk score was calculated based on different risk indicators. Migration background, low education, and parental employment significantly influenced the outcome of lifestyle intervention. The observed BMI-SDS reduction was significantly higher in the subgroup with low social risks factors (Δ BMI-SDS -0.19) compared to those presenting moderate (Δ BMI-SDS -0.14) and high social risk (Δ BMI-SDS -0.11). Our data underline the effect of children's social setting on the outcome of multidimensional lifestyle intervention. The presence of a high social risk burden is a negative predictor for successful weight loss. Specific therapeutic programs need to be developed for disadvantaged children and adolescents. Copyright © 2013 S. Karger GmbH, Freiburg

  10. Costs and Benefits of Orthographic Inconsistency in Reading: Evidence from a Cross-Linguistic Comparison.

    Directory of Open Access Journals (Sweden)

    Chiara Valeria Marinelli

    Full Text Available We compared reading acquisition in English and Italian children up to late primary school analyzing RTs and errors as a function of various psycholinguistic variables and changes due to experience. Our results show that reading becomes progressively more reliant on larger processing units with age, but that this is modulated by consistency of the language. In English, an inconsistent orthography, reliance on larger units occurs earlier on and it is demonstrated by faster RTs, a stronger effect of lexical variables and lack of length effect (by fifth grade. However, not all English children are able to master this mode of processing yielding larger inter-individual variability. In Italian, a consistent orthography, reliance on larger units occurs later and it is less pronounced. This is demonstrated by larger length effects which remain significant even in older children and by larger effects of a global factor (related to speed of orthographic decoding explaining changes of performance across ages. Our results show the importance of considering not only overall performance, but inter-individual variability and variability between conditions when interpreting cross-linguistic differences.

  11. Inconsistent condom use among Ugandan university students from a gender perspective: a cross-sectional study.

    Science.gov (United States)

    Mehra, Devika; Östergren, Per-Olof; Ekman, Björn; Agardh, Anette

    2014-01-01

    Feminization of the HIV/AIDS epidemic has been a prominent phenomenon in sub-Saharan Africa. Inconsistent condom use among young people is one of the major risk factors in the continued propagation of the epidemic. Therefore, it is of importance to increase knowledge of gender aspects of condom use among young people. To investigate whether gender differences regarding individual and social factors determine the association between condom efficacy and inconsistent condom use with a new sex partner, among Ugandan university students. In 2010, 1954 Ugandan students participated in a cross-sectional survey, conducted at Mbarara University of Science and Technology in southwestern Uganda. A self-administered questionnaire assessed socio-demographic factors, alcohol consumption, sexual behaviors (including condom use and condom efficacy), and peer norms. The data were stratified by sex and examined by multivariate logistic regression analysis. A total of 1,179 (60.3%) students reported having had their sexual debut. Of these, 231 (37.4%) males and 209 (49.2%) females reported inconsistent condom use with a new sex partner. Students with low condom efficacy had a higher risk of inconsistent condom use with a new sex partner, even after adjusting for the potential confounders. A synergistic effect was observed between being a female and low condom efficacy with inconsistent condom use. The association between inconsistent condom use and low condom efficacy was found among both males and females, but females were found to be at a higher risk of inconsistent condom use compared to their male counterparts. Therefore, gender power relations should be addressed in policies and interventions aiming at increasing condom use among young people in sub-Saharan settings. Programs could be designed with intervention strategies that focus on interactive and participatory educational activities and youth-friendly counseling of young people, which in turn may improve their interpersonal

  12. American Society of Anesthesiologists classification in cataract surgery: Results from the Ophthalmic Surgery Outcomes Data Project.

    Science.gov (United States)

    Payal, Abhishek R; Sola-Del Valle, David; Gonzalez-Gonzalez, Luis A; Cakiner-Egilmez, Tulay; Chomsky, Amy S; Vollman, David E; Baze, Elizabeth F; Lawrence, Mary; Daly, Mary K

    2016-07-01

    To explore the association of American Society of Anesthesiologists (ASA) classification with cataract surgery outcomes. Five Veterans Affairs Medical Centers, United States. Retrospective observational cohort study. The study analyzed the outcomes of cataract surgery cases. Corrected distance visual acuity (CDVA), unanticipated events, and vision-related quality of life (VRQL) were assessed using the National Eye Institute Visual Function Questionnaire (NEI-VFQ), comparing ASA classes I through IV. For some analyses, ASA classes I and II were designated as Group A and ASA classes III and IV were designated Group B. Of the 4923 cases, 875 (17.8%) were in Group A, 4032 (81.9%) were in Group B, and 16 (0.3%) had missing data. The mean CDVA and mean composite NEI-VFQ score improved after cataract surgery in both groups (P < .0001); however, Group A had a better mean postoperative CDVA and postoperative VFQ composite scores than Group B (P < .0001, both outcomes). A higher ASA class was associated with an increased risk for 2 unanticipated events; that is, clinically significant macular edema (CSME) (Group A: 4 [0.47%] versus Group B: 50 [1.28%]; adjusted odds ratio [OR], 3.02; 95% confidence interval [CI], 1.02-13.05; P = 0.04) and readmission to the hospital within 30 days (2 [0.23%] versus 56 [1.41%]; OR, 8.26; 95% CI, 1.71-148.62; P = .004) CONCLUSIONS: Among United States veterans, the ASA classification could be an important predictor of VRQL and visual outcomes. In this cohort, it was associated with an increased risk for 2 serious unanticipated events-CSME and readmission to the hospital-both costly, unwanted outcomes. Dr. Vollman is a consultant to Forsight Vision5. None of the authors has a financial or proprietary interest in any material or method mentioned. Copyright © 2016 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  13. Perioperative outcomes of zero ischemia radiofrequency ablation-assisted tumor enucleation for renal cell carcinoma: results of 182 patients.

    Science.gov (United States)

    Zhang, Chengwei; Zhao, Xiaozhi; Guo, Suhan; Ji, Changwei; Wang, Wei; Guo, Hongqian

    2018-05-15

    To evaluate the perioperative outcomes of zero ischemia radiofrequency ablation-assisted tumor enucleation. Patients undergoing zero ischemia radiofrequency ablation-assisted tumor enucleation were retrospectively identified from July 2008 to March 2013. The tumor was enucleated after RFA treatment. R.E.N.A.L., PADUA and centrality index (C-index) score systems were used to assess each tumor case. We analyzed the correlation of perioperative outcomes with these scores. Postoperative complications were graded with Clavien-Dindo system. Multivariate logistic regression analyses were used to assess risk of complications. Among 182 patients assessed, median tumor size, estimated blood loss, hospital stay and operative time were 3.2 cm (IQR 2.8-3.4), 80 ml (IQR 50-120), 7 days (IQR 6-8) and 100 min (IQR 90-120), respectively. All three scoring systems were strongly correlated with estimated blood loss, hospital stay and operative time. We found 3 (1.6%) intraoperative and 23 (12.6%, 13 [7.1%] Grade 1 and 10 [5.5%] Grade 2 & 3a) postoperative complications. The median follow-up was 55.5 months (IQR 45-70). Additionally, the complexities of R.E.N.A.L., PADUA and C-index scores were significantly correlated with complication grades (P radiofrequency ablation-assisted tumor enucleation is considered an effective nephron-sparing treatment. Scoring systems could be useful for predicting perioperative outcomes of radiofrequency ablation-assisted tumor enucleation.

  14. Haemodialysis prescription, adherence and nutritional indicators in five European countries: results from the Dialysis Outcomes and Practice Patterns Study (DOPPS).

    Science.gov (United States)

    Hecking, Erwin; Bragg-Gresham, Jennifer L; Rayner, Hugh C; Pisoni, Ronald L; Andreucci, Vittorio E; Combe, Christian; Greenwood, Roger; McCullough, Keith; Feldman, Harold I; Young, Eric W; Held, Philip J; Port, Friedrich K

    2004-01-01

    The Dialysis Outcomes and Practice Patterns Study (DOPPS) is a prospective, observational study designed to evaluate practice patterns in random samples of haemodialysis facilities and patients across three continents. Participating countries include France, Germany, Italy, Spain and the UK (Euro-DOPPS), Japan and the USA. DOPPS data collection has used the same questionnaires and protocols across all participating countries to assess components of dialysis therapy and outcomes. This study focuses on dialysis prescription, adherence and nutrition among the Euro-DOPPS countries. In each Euro-DOPPS country, patients were selected randomly from 20-21 representative facilities. Simple means and frequencies were calculated to compare relevant data elements to gain insights into differences in therapeutic aspects among nationally representative patients. Participants entering the study within 90 days of beginning dialysis therapy were excluded from these analyses. Among the five countries, mean delivered dose as measured by normalized urea clearance (Kt/V) varied from 1.28 to 1.50 and was accompanied by differences in dialysis prescription components, including blood flow rates, treatment times, and dialyser membrane and flux characteristics. By country, a nearly 2-fold difference was observed in indicators of patient adherence and management (skipping and shortening dialysis, hyperkalaemia, hyperphosphataemia and high interdialytic weight gain). Indicators of malnutrition varied substantially. This study demonstrates differences in the management of haemodialysis patients across Euro-DOPPS and offers opportunities for improving dialysis dose, adherence and nutrition. Correlation of differences in practice patterns at the dialysis unit level with patient outcomes will offer new insights into improving dialysis therapy.

  15. Distribution and Outcomes of a Phenotype-Based Approach to Guide COPD Management: Results from the CHAIN Cohort.

    Directory of Open Access Journals (Sweden)

    Borja G Cosio

    Full Text Available The Spanish guideline for COPD (GesEPOC recommends COPD treatment according to four clinical phenotypes: non-exacerbator phenotype with either chronic bronchitis or emphysema (NE, asthma-COPD overlap syndrome (ACOS, frequent exacerbator phenotype with emphysema (FEE or frequent exacerbator phenotype with chronic bronchitis (FECB. However, little is known on the distribution and outcomes of the four suggested phenotypes.We aimed to determine the distribution of these COPD phenotypes, and their relation with one-year clinical outcomes.We followed a cohort of well-characterized patients with COPD up to one-year. Baseline characteristics, health status (CAT, BODE index, rate of exacerbations and mortality up to one year of follow-up were compared between the four phenotypes.Overall, 831 stable COPD patients were evaluated. They were distributed as NE, 550 (66.2%; ACOS, 125 (15.0%; FEE, 38 (4.6%; and FECB, 99 (11.9%; additionally 19 (2.3% COPD patients with frequent exacerbations did not fulfill the criteria for neither FEE nor FECB. At baseline, there were significant differences in symptoms, FEV1 and BODE index (all p<0.05. The FECB phenotype had the highest CAT score (17.1±8.2, p<0.05 compared to the other phenotypes. Frequent exacerbator groups (FEE and FECB were receiving more pharmacological treatment at baseline, and also experienced more exacerbations the year after (all p<0.05 with no differences in one-year mortality. Most of NE (93% and half of exacerbators were stable after one year.There is an uneven distribution of COPD phenotypes in stable COPD patients, with significant differences in demographics, patient-centered outcomes and health care resources use.

  16. Association between maternal dental periapical infections and pregnancy outcomes: results from a cross-sectional study in Malawi.

    Science.gov (United States)

    Harjunmaa, Ulla; Järnstedt, Jorma; Alho, Lotta; Dewey, Kathryn G; Cheung, Yin Bun; Deitchler, Megan; Ashorn, Ulla; Maleta, Kenneth; Klein, Nigel J; Ashorn, Per

    2015-11-01

    Maternal infections are associated with intrauterine growth restriction (IUGR) and preterm birth (PTB). Dental infections are common in low-income settings, but their contribution to adverse pregnancy outcomes is unknown. We studied the epidemiology of dental periapical infections among pregnant women and their association to foetal growth restriction and the duration of pregnancy in a rural sub-Saharan African population. This was a cross-sectional study on the association between maternal dental periapical infections and birth outcomes, in Malawi, Africa. We assessed oral health clinically and radiologically among recently delivered women with known duration of pregnancy and measured birthweight (BW), length and head circumference of their infants. Of 1024 analysed participants, 23.5% had periapical infections. Mean duration of pregnancy was 39.4 weeks, BW 2979 g and length 49.7 cm. Women with periapical infection had mean (95% CI) pregnancy duration 0.4 weeks (0.1-0.8) shorter and delivered infants with 79 g (13-145) lower BW and 0.5 cm (0.2-0.9) shorter neonatal length than women without periapical infection. The incidence of PTB was 10.0% among women with periapical infection and 7.3% among those without (adjusted difference 3.5%, 95% CI -1.1-8.1%). Corresponding prevalences for stunting were 20.9% and 14.2% (adjusted difference 9.0%, 95% CI 2.7%-15.2%). The population-attributable risk fraction attributable to periapical infection was 9.7% for PTB and 12.8% for stunting. Periapical infection was associated with shorter pregnancy duration and IUGR in the study area; interventions addressing this risk factor may improve birth outcomes in low-income settings. © 2015 John Wiley & Sons Ltd.

  17. Improving Work Outcome in Supported Employment for Serious Mental Illness: Results From 2 Independent Studies of Errorless Learning.

    Science.gov (United States)

    Kern, Robert S; Zarate, Roberto; Glynn, Shirley M; Turner, Luana R; Smith, Kellie M; Mitchell, Sharon S; Sugar, Catherine A; Bell, Morris D; Liberman, Robert P; Kopelowicz, Alex; Green, Michael F

    2018-01-13

    Heterogeneity in work outcomes is common among individuals with serious mental illness (SMI). In 2 studies, we sought to examine the efficacy of adding errorless learning, a behavioral training intervention, to evidence-based supported employment to improve SMI work outcomes. Work behavior problems were targeted for intervention. We also explored associations between early work behavior and job tenure. For both studies (VA: n = 71; community mental health center: n = 91), randomization occurred at the time of job obtainment with participants randomized (1:1) to either errorless learning plus ongoing supported employment or ongoing supported employment alone and then followed for 12 months. Dependent variables included job tenure, work behavior, and hours worked and wages earned per week. For the primary intent-to-treat analyses, data were combined across studies. Findings revealed that participants in the errorless learning plus supported employment group stayed on their jobs significantly longer than those in the supported employment alone group (32.8 vs 25.6 wk). In addition, differential treatment effects favoring errorless learning were found on targeted work behavior problems (50.5% vs 27.4% improvement from baseline to follow-up assessment). There were no other differential treatment effects. For the prediction analyses involving work behavior, social skills explained an additional 18.3% of the variance in job tenure beyond levels of cognition, symptom severity, and past work history. These data support errorless learning as an adjunctive intervention to enhance supported employment outcomes and implicate the relevance of workplace social difficulties as a key impediment to prolonged job tenure. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center 2017.

  18. Prolonged sedation and/or analgesia and 5-year neurodevelopment outcome in very preterm infants: results from the EPIPAGE cohort.

    Science.gov (United States)

    Rozé, Jean-Christophe; Denizot, Sophie; Carbajal, Ricardo; Ancel, Pierre-Yves; Kaminski, Monique; Arnaud, Catherine; Truffert, Patrick; Marret, Stéphane; Matis, Jaqueline; Thiriez, Gérard; Cambonie, Gilles; André, Monique; Larroque, Béatrice; Bréart, Gérard

    2008-08-01

    To describe the long-term outcome of very preterm infants receiving prolonged sedation and/or analgesia and examine the relationship between prolonged sedation and/or analgesia and this long-term outcome. A prospective population-based study (Etude EPIdémiologique sur les Petits Ages GEstationnels [EPIPAGE]). To reduce bias, the propensity score method was used. Nine regions of France. The study population included very preterm infants of fewer than 33 weeks' gestational age, born in 1997, who received mechanical ventilation and/or surgery. Main Exposure Prolonged exposure to sedative and/or analgesic drugs in the neonatal period, defined as exposure of more than 7 days to sedative and/or opioid drugs. Presence of moderate or severe disability at 5 years of age. The analysis concerns 1572 premature infants who received mechanical ventilation for whom information about exposure to prolonged sedation and/or analgesia in the neonatal period was available. A total of 115 were exposed and 1457 were not exposed. There was no significant difference between the number of patients lost to follow-up from the group of very preterm infants who were exposed to prolonged sedation and/or analgesia and the group who were not. Exposed very preterm infants had severe or moderate disability at 5 years (41/97; 42%) more often than those who were not exposed (324/1248; 26%). After adjustment for gestational age and propensity score, this association was no longer statistically significant (adjusted relative risk, 1.0; 95% confidence interval, 0.8-1.2). Prolonged sedation and/or analgesia is not associated with a poor 5-year neurological outcome after adjustment for the propensity score.

  19. Outcome of Patients With Metastatic Sarcomatoid Renal Cell Carcinoma: Results From the International Metastatic Renal Cell Carcinoma Database Consortium

    DEFF Research Database (Denmark)

    Kyriakopoulos, Christos E; Chittoria, Namita; Choueiri, Toni K

    2015-01-01

    BACKGROUND: Sarcomatoid renal cell carcinoma is associated with poor prognosis. Data regarding outcome in the targeted therapy era are lacking. PATIENTS AND METHODS: Clinical, prognostic, and treatment parameters in metastatic renal cell carcinoma patients with and without sarcomatoid histology......% intermediate risk, and 40% vs. 24% poor risk; P system metastases (6...... of second- (P = .018) and third-line (P systemic therapy. The median progression-free survival (PFS)/overall survival (OS) was 4.5/10.4 months in sRCC patients and 7.8/22.5 months in non-sRCC patients (P

  20. Arthroscopic Suture Anchor Fixation of Bony Bankart Lesions: Clinical Outcome, Magnetic Resonance Imaging Results, and Return to Sports.

    Science.gov (United States)

    Plath, Johannes E; Feucht, Matthias J; Bangoj, Robert; Martetschläger, Frank; Wörtler, Klaus; Seppel, Gernot; Aboalata, Mohamed; Tischer, Thomas; Imhoff, Andreas B; Vogt, Stephan

    2015-08-01

    The purpose of this study was to evaluate the outcome, return to sporting activity, and postoperative articular cartilage and bony morphology of shoulders that underwent arthroscopic suture anchor repair of bony Bankart lesions. The inclusion criteria for this retrospective study were anterior glenoid rim fractures after traumatic shoulder instability that were treated with arthroscopic suture anchor repair. Patients were surveyed by a questionnaire including sport-specific outcome, Rowe score, Western Ontario Shoulder Instability Index, and Oxford Instability Score. Three-tesla magnetic resonance imaging could be performed in 30 patients to assess osseous integration, glenoid reconstruction, and signs of osteoarthritis. From November 1999 to April 2010, 81 patients underwent an anterior bony Bankart repair in our department (50 arthroscopic suture anchor repairs, 5 arthroscopic screw fixations, and 26 open repairs). The 55 arthroscopic repairs comprised a consecutive cohort of patients treated by a single surgeon. Of the 50 patients in the suture anchor group, 45 (90%) were available for evaluation. At 82 ± 31 months postoperatively, the mean Rowe score was 85.9 ± 20.5 points, the mean Western Ontario Shoulder Instability Index score was 89.4% ± 14.7%, and the mean Oxford Instability Score was 13.6 ± 5.4 points. Compared with the contralateral shoulder, all scores showed a significantly reduced outcome (P sporting activity after surgery. The number of sports disciplines (P < .001), duration (P = .005), level (P = .02), and risk category (P = .013) showed a significant reduction compared with the pretrauma condition. However, only 19% of patients reported that shoulder complaints were the reason for the reduction in activity. Nonunion occurred in 16.6%, with a higher frequency in patients with chronic lesions (P = .031). Anatomic reduction was achieved in 72%, the medial step-off in patients with nonanatomic reduction averaged 1.8 ± 0.9 mm, and the

  1. The elephant in the room: Inconsistency in scene viewing and representation.

    Science.gov (United States)

    Spotorno, Sara; Tatler, Benjamin W

    2017-10-01

    We examined the extent to which semantic informativeness, consistency with expectations and perceptual salience contribute to object prioritization in scene viewing and representation. In scene viewing (Experiments 1-2), semantic guidance overshadowed perceptual guidance in determining fixation order, with the greatest prioritization for objects that were diagnostic of the scene's depicted event. Perceptual properties affected selection of consistent objects (regardless of their informativeness) but not of inconsistent objects. Semantic and perceptual properties also interacted in influencing foveal inspection, as inconsistent objects were fixated longer than low but not high salience diagnostic objects. While not studied in direct competition with each other (each studied in competition with diagnostic objects), we found that inconsistent objects were fixated earlier and for longer than consistent but marginally informative objects. In change detection (Experiment 3), perceptual guidance overshadowed semantic guidance, promoting detection of highly salient changes. A residual advantage for diagnosticity over inconsistency emerged only when selection prioritization could not be based on low-level features. Overall these findings show that semantic inconsistency is not prioritized within a scene when competing with other relevant information that is essential to scene understanding and respects observers' expectations. Moreover, they reveal that the relative dominance of semantic or perceptual properties during selection depends on ongoing task requirements. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  2. Governance implications of nanomaterials companies' inconsistent risk perceptions and safety practices

    Science.gov (United States)

    Engeman, Cassandra D.; Baumgartner, Lynn; Carr, Benjamin M.; Fish, Allison M.; Meyerhofer, John D.; Satterfield, Terre A.; Holden, Patricia A.; Harthorn, Barbara Herr

    2012-03-01

    Current research on the nanotechnology industry indicates its downstream expansion at a rapid pace, while toxicological research and best practices for environmental health and safety are still being developed. Companies that use and/or produce engineered nanomaterials (ENMs) have enormous potential to influence safe-handling practices for ENMs across the product life cycle. Knowledge of both industry practices and leaders' perceptions of risk is vital for understanding how companies will act to control potential environmental and health risks. This article reports results from a new international survey of nanomaterials companies in 14 countries. In this survey, company participants reported relatively high levels of uncertainty and/or perceived risk with regard to ENMs. However, these perspectives were not accompanied by expected risk-avoidant practices or preferences for regulatory oversight. A majority of companies indicated "lack of information" as a significant impediment to implementing nano-specific safety practices, but they also reported practices that were inconsistent with widely available guidance. Additionally, in the absence of safe-handling regulations, companies reported nano-specific health and safety programs that were narrow in scope. Taken together, these findings indicate that health and safety guidance is not reaching industry. While industry leaders' reluctance toward regulation might be expected, their own reported unsafe practices and recognition of possible risks suggest a more top-down approach from regulators is needed to protect workers and the environment.

  3. Governance implications of nanomaterials companies' inconsistent risk perceptions and safety practices

    Energy Technology Data Exchange (ETDEWEB)

    Engeman, Cassandra D. [University of California, Santa Barbara, Department of Sociology (United States); Baumgartner, Lynn; Carr, Benjamin M.; Fish, Allison M.; Meyerhofer, John D. [UC Center for the Environmental Implications of Nanotechnology (UC CEIN), University of California, Santa Barbara (United States); Satterfield, Terre A. [University of California, Santa Barbara, NSF Center for Nanotechnology and Society (United States); Holden, Patricia A. [UC Center for the Environmental Implications of Nanotechnology (UC CEIN), University of California, Santa Barbara (United States); Harthorn, Barbara Herr, E-mail: harthorn@cns.ucsb.edu [University of California, Santa Barbara, NSF Center for Nanotechnology and Society (United States)

    2012-03-15

    Current research on the nanotechnology industry indicates its downstream expansion at a rapid pace, while toxicological research and best practices for environmental health and safety are still being developed. Companies that use and/or produce engineered nanomaterials (ENMs) have enormous potential to influence safe-handling practices for ENMs across the product life cycle. Knowledge of both industry practices and leaders' perceptions of risk is vital for understanding how companies will act to control potential environmental and health risks. This article reports results from a new international survey of nanomaterials companies in 14 countries. In this survey, company participants reported relatively high levels of uncertainty and/or perceived risk with regard to ENMs. However, these perspectives were not accompanied by expected risk-avoidant practices or preferences for regulatory oversight. A majority of companies indicated 'lack of information' as a significant impediment to implementing nano-specific safety practices, but they also reported practices that were inconsistent with widely available guidance. Additionally, in the absence of safe-handling regulations, companies reported nano-specific health and safety programs that were narrow in scope. Taken together, these findings indicate that health and safety guidance is not reaching industry. While industry leaders' reluctance toward regulation might be expected, their own reported unsafe practices and recognition of possible risks suggest a more top-down approach from regulators is needed to protect workers and the environment.

  4. Governance implications of nanomaterials companies’ inconsistent risk perceptions and safety practices

    International Nuclear Information System (INIS)

    Engeman, Cassandra D.; Baumgartner, Lynn; Carr, Benjamin M.; Fish, Allison M.; Meyerhofer, John D.; Satterfield, Terre A.; Holden, Patricia A.; Harthorn, Barbara Herr

    2012-01-01

    Current research on the nanotechnology industry indicates its downstream expansion at a rapid pace, while toxicological research and best practices for environmental health and safety are still being developed. Companies that use and/or produce engineered nanomaterials (ENMs) have enormous potential to influence safe-handling practices for ENMs across the product life cycle. Knowledge of both industry practices and leaders’ perceptions of risk is vital for understanding how companies will act to control potential environmental and health risks. This article reports results from a new international survey of nanomaterials companies in 14 countries. In this survey, company participants reported relatively high levels of uncertainty and/or perceived risk with regard to ENMs. However, these perspectives were not accompanied by expected risk-avoidant practices or preferences for regulatory oversight. A majority of companies indicated “lack of information” as a significant impediment to implementing nano-specific safety practices, but they also reported practices that were inconsistent with widely available guidance. Additionally, in the absence of safe-handling regulations, companies reported nano-specific health and safety programs that were narrow in scope. Taken together, these findings indicate that health and safety guidance is not reaching industry. While industry leaders’ reluctance toward regulation might be expected, their own reported unsafe practices and recognition of possible risks suggest a more top-down approach from regulators is needed to protect workers and the environment.

  5. Equality Hypocrisy, Inconsistency, and Prejudice: The Unequal Application of the Universal Human Right to Equality

    Science.gov (United States)

    2015-01-01

    In Western culture, there appears to be widespread endorsement of Article 1 of the Universal Declaration of Human Rights (which stresses equality and freedom). But do people really apply their equality values equally, or are their principles and application systematically discrepant, resulting in equality hypocrisy? The present study, conducted with a representative national sample of adults in the United Kingdom (N = 2,895), provides the first societal test of whether people apply their value of “equality for all” similarly across multiple types of status minority (women, disabled people, people aged over 70, Blacks, Muslims, and gay people). Drawing on theories of intergroup relations and stereotyping we examined, relation to each of these groups, respondents’ judgments of how important it is to satisfy their particular wishes, whether there should be greater or reduced equality of employment opportunities, and feelings of social distance. The data revealed a clear gap between general equality values and responses to these specific measures. Respondents prioritized equality more for “paternalized” groups (targets of benevolent prejudice: women, disabled, over 70) than others (Black people, Muslims, and homosexual people), demonstrating significant inconsistency. Respondents who valued equality more, or who expressed higher internal or external motivation to control prejudice, showed greater consistency in applying equality. However, even respondents who valued equality highly showed significant divergence in their responses to paternalized versus nonpaternalized groups, revealing a degree of hypocrisy. Implications for strategies to promote equality and challenge prejudice are discussed. PMID:25914516

  6. The upper end of climate model temperature projections is inconsistent with past warming

    International Nuclear Information System (INIS)

    Stott, Peter; Good, Peter; Jones, Gareth; Gillett, Nathan; Hawkins, Ed

    2013-01-01

    Climate models predict a large range of possible future temperatures for a particular scenario of future emissions of greenhouse gases and other anthropogenic forcings of climate. Given that further warming in coming decades could threaten increasing risks of climatic disruption, it is important to determine whether model projections are consistent with temperature changes already observed. This can be achieved by quantifying the extent to which increases in well mixed greenhouse gases and changes in other anthropogenic and natural forcings have already altered temperature patterns around the globe. Here, for the first time, we combine multiple climate models into a single synthesized estimate of future warming rates consistent with past temperature changes. We show that the observed evolution of near-surface temperatures appears to indicate lower ranges (5–95%) for warming (0.35–0.82 K and 0.45–0.93 K by the 2020s (2020–9) relative to 1986–2005 under the RCP4.5 and 8.5 scenarios respectively) than the equivalent ranges projected by the CMIP5 climate models (0.48–1.00 K and 0.51–1.16 K respectively). Our results indicate that for each RCP the upper end of the range of CMIP5 climate model projections is inconsistent with past warming. (letter)

  7. Inconsistent food safety pressures complicate environmental conservation for California produce growers

    Directory of Open Access Journals (Sweden)

    Patrick Baur

    2016-08-01

    Full Text Available Controlling human pathogens on fresh vegetables, fruits and nuts is imperative for California growers. A range of rules and guidelines have been developed since 2006, when a widespread outbreak of E. coli O157:H7 was linked to bagged spinach grown in California. Growers face pressure from industry and government sources to adopt specific control measures on their farms, resulting in a complex, shifting set of demands, some of which conflict with environmental stewardship. We surveyed 588 California produce growers about on-farm practices related to food safety and conservation. Nearly all respondents considered both food safety and environmental protection to be important responsibilities for their farms. Responses indicate that clearing vegetation to create buffers around cropped fields, removing vegetation from ditches and ponds, and using poison bait and wildlife fences are commonly used practices intended to reduce wildlife movements onto farm fields. The survey also revealed that on-farm practices vary substantially even among farms with similar characteristics. This variability suggests inconsistencies in food safety requirements, auditors' interpretations or growers' perception of the demands of their buyers. Although site-specific considerations are important and practices should be tailored to local conditions, our findings suggest growers, natural resources and food safety would benefit from clearer, more consistent requirements.

  8. Equality Hypocrisy, Inconsistency, and Prejudice: The Unequal Application of the Universal Human Right to Equality.

    Science.gov (United States)

    Abrams, Dominic; Houston, Diane M; Van de Vyver, Julie; Vasiljevic, Milica

    2015-02-01

    In Western culture, there appears to be widespread endorsement of Article 1 of the Universal Declaration of Human Rights (which stresses equality and freedom). But do people really apply their equality values equally, or are their principles and application systematically discrepant, resulting in equality hypocrisy? The present study, conducted with a representative national sample of adults in the United Kingdom ( N = 2,895), provides the first societal test of whether people apply their value of "equality for all" similarly across multiple types of status minority (women, disabled people, people aged over 70, Blacks, Muslims, and gay people). Drawing on theories of intergroup relations and stereotyping we examined, relation to each of these groups, respondents' judgments of how important it is to satisfy their particular wishes, whether there should be greater or reduced equality of employment opportunities, and feelings of social distance. The data revealed a clear gap between general equality values and responses to these specific measures. Respondents prioritized equality more for "paternalized" groups (targets of benevolent prejudice: women, disabled, over 70) than others (Black people, Muslims, and homosexual people), demonstrating significant inconsistency. Respondents who valued equality more, or who expressed higher internal or external motivation to control prejudice, showed greater consistency in applying equality. However, even respondents who valued equality highly showed significant divergence in their responses to paternalized versus nonpaternalized groups, revealing a degree of hypocrisy. Implications for strategies to promote equality and challenge prejudice are discussed.

  9. Inconsistencies among secondary sources of Chukar Partridge (Alectoris chukar introductions to the United States

    Directory of Open Access Journals (Sweden)

    Michael P. Moulton

    2015-11-01

    Full Text Available The propagule pressure hypothesis asserts that the number of individuals released is the key determinant of whether an introduction will succeed or not. It remains to be shown whether propagule pressure is more important than either species-level or site-level factors in determining the fate of an introduction. Studies claiming to show that propagule pressure is the primary determinant of introduction success must assume that the historical record as reported by secondary sources is complete and accurate. Here, examine a widely introduced game bird, the Chukar (Alectoris chukar, to the USA. We compare the records reported by two secondary sources (Long, 1981; Lever, 1987 to those in a primary source (Christensen, 1970 and to a recent study by Sol et al. (2012. Numerous inconsistencies exist in the records reported by Sol et al. (2012, Long (1981 and Lever (1987 when compared to the primary record of Christensen (1970. As reported by Christensen (1970, very large numbers of Chukars were released unsuccessfully in some states. Our results strongly imply that factors other than sheer numbers are more important. Site-to-site differences are the most likely explanation for the variation in success.

  10. Globally inconsistent figure/ground relations induced by a negative part.

    Science.gov (United States)

    Kim, Sung-Ho; Feldman, Jacob

    2009-09-10

    Figure/ground interpretation is a dynamic and complex process involving the cooperation and competition of a number of perceptual factors. Most research has assumed that figure/ground assignment is globally consistent along the entire contour of a single figure, meaning that the one side of each boundary is interpreted as figure along the entire length of the boundary, and the other side interpreted as ground. We investigated a situation that challenges this assumption, because local cues to figure/ground conflict with global cues: a "negative part," a contour region that appears locally convex but that the global form requires be concave. To measure figure/ground assignment, we use a new task based on local contour motion attribution that allows us to measure border ownership locally at points along the contour. The results from two experiments showed that the more salient a negative part is, the more border ownership tended to locally reverse within it, creating an inconsistency in figure/ground assignments along the contour. This suggests that border ownership assignment is not an all-or-none process, but rather a locally autonomous process that is not strictly constrained by global cues.

  11. Impact on outcome of different types of carotid stent: results from the European Registry of Carotid Artery Stenting.

    Science.gov (United States)

    Stabile, Eugenio; Giugliano, Giuseppe; Cremonesi, Alberto; Bosiers, Marc; Reimers, Bernhard; Setacci, Carlo; Cao, Piergiorgio; Schmidt, Andrej; Sievert, Horst; Peeters, Patrick; Nikas, Dimitrios; Sannino, Anna; de Donato, Gianmarco; Parlani, Giambattista; Castriota, Fausto; Hornung, Marius; Rubino, Paolo; Esposito, Giovanni; Tesorio, Tullio

    2016-06-12

    Conflicting data exist on the impact on outcome of the use of different stent types during carotid artery stenting (CAS). The aim of this study was to evaluate clinical outcomes according to different carotid stent design among the population of the European Registry of Carotid Artery Stenting (ERCAS). The present study was conducted in 1,604 patients who underwent neuroprotected CAS in ERCAS. All types of commercially available carotid stent were used. Open-cell design stents were classified according to free cell area into 7.5 mm2. A total of 713 closed-cell, 456 hybrid-cell, 238 7.5 mm2 open-cell stents were implanted. Overall, the 30-day stroke and death rate was 1.37%. At 30 days, 19 strokes occurred (1.18%): eight in the group of patients treated with a closed-cell (1.12%), two in those with a hybrid-cell (0.44%), three in those with a 7.5 mm2 open-cell stent (3.05%) (p=0.045). Data of the present study suggest that, in the setting of neuroprotected CAS performed in high-volume centres by properly trained operators, the use of an open-cell design stent with a free cell area >7.5 mm2 may be associated with an increased 30-day stroke risk.

  12. Service provision and outcome for deliberate self-poisoning in adults--results from a six centre descriptive study.

    Science.gov (United States)

    Kapur, Navneet; House, Allan; May, Chris; Creed, Francis

    2003-07-01

    The aim of the study was to compare the hospital management and direct costs of self-poisoning in six United Kingdom hospitals and to investigate whether hospital management influences outcome. This was a prospective descriptive study carried out at three teaching hospitals and three district general hospitals in North West England on adults (aged 16 or over) presenting to the study centres with deliberate self-poisoning over a 5-month period. Data were based on demographic and clinical characteristics, management of the current episode, direct costs and repetition of self-poisoning within 12 weeks of index episode. There were 1778 episodes of self-poisoning during the study period. There were marked differences in management between centres. There was a fivefold difference in the rate of admission to a medical bed (16.5%-81.3%), and a twofold difference in the rate of psychosocial assessment (28.5%-57.7%). These differences remained after adjustment for demographic and clinical factors. Hospital costs per episode varied from pound 228 to pound 422 and repetition rate ranged from 10% to 16%. Psychosocial assessment was associated with a twofold reduction in the risk of repetition. The marked variability of services for self-poisoning continue. It seems likely that this is having a detrimental effect on patient outcomes. Large scale intervention studies are required to inform both clinical practice and service provision.

  13. A comprehensive picture of 4-year outcome of severe brain injuries. Results from the PariS-TBI study.

    Science.gov (United States)

    Jourdan, C; Bayen, E; Pradat-Diehl, P; Ghout, I; Darnoux, E; Azerad, S; Vallat-Azouvi, C; Charanton, J; Aegerter, P; Ruet, A; Azouvi, P

    2016-04-01

    Survivors of severe traumatic brain injury have a great variety of impairments and participation restrictions. Detailed descriptions of their long-term outcome are critical. We aimed to assess brain injury outcome for subjects with traumatic brain injury in terms of the International classification of functioning, disability and health. Four-year follow-up of an inception cohort of adults with severe traumatic brain injury by using face-to-face interviews with patients and proxies. Among 245 survivors at 4 years, 147 were evaluated (80% male, mean age: 32.5±14.2 years at injury); 46 (32%) presented severe disability, 58 (40%) moderate disability, and 40 (28%) good recovery. Most frequent somatic problems were fatigue, headaches, other pain, and balance. One quarter of subjects had motor impairments. Rates of cognitive complaints ranged from 25 to 68%, the most frequent being memory, irritability, slowness and concentration. With the Hospital Anxiety and Depression Scale, 43% had anxiety and 25% depression. Overall, 79% were independent in daily living activities and 40 to 50% needed help for outdoor or organizational activities on the BICRO-39. Most had regular contacts with relatives or close friends but few contacts with colleagues or new acquaintances. Subjects spent little time in productive activities such as working, studying, looking after children or voluntary work. Quality of life on the QOLIBRI scale was associated with disability level (Plife. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

  14. Effect of inborn versus outborn delivery on clinical outcomes in ventilated preterm neonates: secondary results from the NEOPAIN trial.

    Science.gov (United States)

    Palmer, Kristine G; Kronsberg, Shari S; Barton, Bruce A; Hobbs, Charlotte A; Hall, Richard W; Anand, K J S

    2005-04-01

    The objective of this study was to evaluate the effect of birth center (inborn versus outborn) on morbidity and mortality for preterm neonates (23 to 32 weeks) using data collected prospectively within a uniform protocol. Secondary analyses of data from the NEurologic Outcomes and Pre-emptive Analgesia In Neonates (NEOPAIN) trial (n=898) were performed to evaluate the effect of inborn versus outborn delivery on neonatal outcomes, including the occurrence of severe intraventricular hemorrhage (IVH), periventricular leukomalacia (PVL), chronic lung disease (CLD), and mortality. Outborn babies were more likely to have severe IVH (p=0.0005); this increased risk persisted after controlling for severity of illness. When adjustments for antenatal steroids were added, the effect of birth center was no longer significant. Neither the occurrences of PVL or CLD nor mortality were significantly different between the inborn and outborn infants. Outborn babies are more likely to have severe IVH than inborn babies, perhaps because their mothers are less likely to receive antenatal steroids. Improvements in antenatal steroid administration to high-risk women may substantially reduce neonatal morbidity.

  15. Contributing Factors and Mental Health Outcomes of First Suicide Attempt During Childhood and Adolescence: Results From a Nationally Representative Study.

    Science.gov (United States)

    Peyre, Hugo; Hoertel, Nicolas; Stordeur, Coline; Lebeau, Gaële; Blanco, Carlos; McMahon, Kibby; Basmaci, Romain; Lemogne, Cédric; Limosin, Frédéric; Delorme, Richard

    2017-06-01

    To investigate whether risk factors for suicide attempts differ in children and adolescents and to categorize adulthood mental health outcomes of child and adolescent suicide attempters in the general population. Using a large (N = 34,653), nationally representative US adult sample, the 2004-2005 National Epidemiologic Survey on Alcohol and Related Conditions, we examined whether individuals who first attempted suicide during childhood (under the age of 13 years) differ from those who first attempted suicide during adolescence (13 through 17 years) in (1) contributing factors for first suicide attempt, including mental disorders and traumatic experiences that occurred before the first suicide attempt, parental history of mental disorders, and family poverty and (2) adulthood mental health outcomes, including lifetime and current prevalence of DSM-IV psychiatric disorders and quality of life measures. Suicide attempts during childhood (n = 104) were more strongly related to childhood maltreatment, while suicide attempts during adolescence (n = 415) were more strongly associated with major depressive episode. Compared to first suicide attempts during adolescence, first attempts during childhood were associated with increased risk for multiple suicide attempts (61.3% vs 32.6%), several psychiatric disorders (mania, hypomania, and panic disorder), and poorer social functioning during adulthood (all P values childhood maltreatment and early intervention for psychiatric disorders may have broad benefits to reduce not only the suffering of these children and adolescents, but also the burden of suicide. © Copyright 2017 Physicians Postgraduate Press, Inc.

  16. The Outcome and Assessment Information Set (OASIS): A Review of Validity and Reliability

    Science.gov (United States)

    O’CONNOR, MELISSA; DAVITT, JOAN K.

    2015-01-01

    The Outcome and Assessment Information Set (OASIS) is the patient-specific, standardized assessment used in Medicare home health care to plan care, determine reimbursement, and measure quality. Since its inception in 1999, there has been debate over the reliability and validity of the OASIS as a research tool and outcome measure. A systematic literature review of English-language articles identified 12 studies published in the last 10 years examining the validity and reliability of the OASIS. Empirical findings indicate the validity and reliability of the OASIS range from low to moderate but vary depending on the item studied. Limitations in the existing research include: nonrepresentative samples; inconsistencies in methods used, items tested, measurement, and statistical procedures; and the changes to the OASIS itself over time. The inconsistencies suggest that these results are tentative at best; additional research is needed to confirm the value of the OASIS for measuring patient outcomes, research, and quality improvement. PMID:23216513

  17. Assessment of Outcomes of Treatment of Fractures of Distal Femur with a Locking Plate Taking into Account Factors Influencing the Result.

    Science.gov (United States)

    Pakuła, Grzegorz; Kwiatkowski, Krzysztof; Kuczmera, Piotr; Fudalej, Piotr

    2015-10-01

    The aim of this paper is to evaluate the results of treatment of distal femoral fractures (DFF) fixed with locking plates and analysis of factors that influence the final outcome. The patients were treated at the Department of Traumatology and Orthopedics, Military Medical Institute in Warsaw, and the Department of Orthopedics and Traumatology, 4th Military Research Hospital in Wroclaw. We analysed 39 patients with 42 fractures of the distal femur. Treatment results were analysed using the KOOS and KSS scales. Factors influencing the outcome were also investigated. Statistical analysis was performed using STATISTICA v. 10. Mean KOOS scores indicate a predominance of poor outcomes, while mean KSS scores indicate good outcomes. Treatment outcomes were significantly influenced by pain and limited mobility. 1. Subjective evaluation of treatment of fractures of the distal femur using the KOOS scale per form edworse than a clinical evaluation using the KSS. 2. Post-operative management should emphasise pain relief and restoration of the performance of the treated lower limb to ensure good mobility without crutches. 3. Despite the use of modern operational methods of fracture fixation, treatment of distal femur fractures is still a challenge.

  18. Correlates of HIV and Inconsistent Condom Use Among Female Sex Workers in Ukraine.

    Science.gov (United States)

    Iakunchykova, Olena P; Burlaka, Viktor

    2017-08-01

    While female sex workers (FSWs) carry one of the highest risks of HIV transmission, little is known about predictors of HIV and risky behavior of FSWs in Ukraine. In this study of 4806 Ukrainian FSWs, the prevalence of HIV was 5.6 %. FSWs had higher odds to be HIV infected if they had lower income, were older, injected drugs, experienced violence, and solicited clients on highways. Inconsistent condom use with clients was reported by 34.5 % of FSWs. FSWs who solicited clients at railway stations, via media, through previous clients and other FSWs, and on highways reported lower consistency of condom use. Furthermore, inconsistent condom use was related to younger age, alcohol use, having fewer clients, not being covered with HIV prevention, and experiences of violence. The present study expands on the rather limited knowledge of correlates of the HIV and inconsistent condom use among FSWs in Ukraine.

  19. Surgical outcome of patients with ischemic cardiomyopathy selected by the results of myocardial viability by preoperative F-18 FDG PET

    International Nuclear Information System (INIS)

    Kim, Jae Sung; Hong, Suk Keun; Lee, Young Tak; Kim, Youn Jung; Moon, Keon Sik; Won, Tae Kyoung; Hwang, Hweung Kon; Lee, Dong Soo; Kim, Yu Kyeong

    2000-01-01

    We investigated the operative outcome after bypass surgery in patients selected using viability criteria on F-18 FDG PET. Rest-24hr delay redistribution imaging of Tl-201 SPECT and F-18 FDG PET were performed in 11 patients. Seven of these 11 patients (6 men, 1 woman) were evaluated to have viable myocardium by F-18 FDG PET. Changes in symptoms and left ventricular ejection fraction (LVEF) after operation were evaluated. In seven of 11 patients, a significant amount of viable myocardium was found on F-18 FDG PET and Tl-201 SPECT. Severity of both chest pain and dyspnea improved markedly in all patients. Mean LVEF improved from 22% to 32%. F-18 FDG PET could be used to select the patients who will benefit from coronary artery bypass surgery.=20

  20. Outcome of cervix uteri cancer patients: Clinical treatment results and toxicity profile in a retrospective study from Saudi Arabia.

    Science.gov (United States)

    El Sayed, Mohamed E; Bahadur, Yasir A; Hassouna, Ashraf H; Fawzy, Ehab E; Nasr, Azza M; Sadiq, Bakr B; Dada, Reyad; Sait, Khalid H; Anfinan, Nisrin M

    2017-10-01

    This study evaluated the survival outcome, pattern of failure and prognostic factors in cervix uteri cancer patients. We reviewed the data of 60 patients with stages IB-IVA cancer who were treated between January 2004 and December 2010. Most patients (n = 50; 83%) had squamous cell carcinoma. Stage IIB was the most common presentation (n = 41; 68%). Forty-seven patients (78%) received Cisplatin concurrent with radiotherapy (CRT). The 2- and 4-year overall survival (OS) was 82% and 79%, respectively. Prolongation of the overall treatment time (OAT) for greater than 56 days, advanced stage and pretreatment hemoglobin (Hb) levels (cervix uteri cancer patients and the prognostic factors are comparable to those of previous reports. Orthogonal brachytherapy planning and vaginal infiltration negatively predicted relapse. © 2016 John Wiley & Sons Australia, Ltd.

  1. Parental Characteristics Associated With Outcomes in Youth With Type 2 Diabetes: Results From the TODAY Clinical Trial.

    Science.gov (United States)

    Weinstock, Ruth S; Trief, Paula M; El Ghormli, Laure; Goland, Robin; McKay, Siripoom; Milaszewski, Kerry; Preske, Jeff; Willi, Steven; Yasuda, Patrice M

    2015-05-01

    This study examined parental factors associated with outcomes of youth in the Treatment Options for type 2 Diabetes in Adolescents and Youth (TODAY) clinical trial. Of 699 youth with type 2 diabetes in the TODAY cohort, 623 (89.1%) had a parent participate and provide data at baseline, including weight, HbA1c, blood pressure, symptoms of depression, binge eating (BE), and medical history. Youth were followed 2-6.5 years. Data were analyzed using regression models and survival curve methods. Parental diabetes (43.6% of parents) was associated with higher baseline HbA1c (P parent, P = 0.0002). Parental hypertension (40.6% of parents) was associated with hypertension in youth during TODAY (40.4% vs. 27.4% of youth with and without parental hypertension had hypertension, P = 0.0008) and with higher youth baseline BMI z scores (P = 0.0038). Parents had a mean baseline BMI of 33.6 kg/m(2). Parental obesity (BMI >30 kg/m(2)) was associated with higher baseline BMI z scores in the youth (P parents (20.6% of parents) were related to youth depressive symptoms at baseline only (P = 0.0430); subclinical BE in parents was related to the presence of subclinical BE (P = 0.0354) and depressive symptoms (P = 0.0326) in youth throughout the study period. Parental diabetes and hypertension were associated with lack of glycemic control, hypertension, and higher BMI z scores in youth. Further research is needed to better understand and address parental biological and behavioral factors to improve youth health outcomes. © 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

  2. Vertebral artery ostial stent placement for atherosclerotic stenosis in 72 consecutive patients: clinical outcomes and follow-up results

    International Nuclear Information System (INIS)

    Taylor, Robert A.; Memon, Muhammad Zeeshan; Qureshi, Adnan I.; Vazquez, Gabriela; Siddiq, Farhan; Hayakawa, Minako; Chaloupka, John C.

    2009-01-01

    The study's purpose is to report the technical and clinical outcomes of a patient cohort that underwent vertebral artery ostium stent placement for atherosclerotic stenosis. We retrospectively analyzed a prospectively collected database of neurointerventional procedures performed at a single center from 1999 to 2005. Outcome measures included recurrent transient neurological deficits (TNDs), stroke, and death. Kaplan-Meier analysis was used to estimate stroke- and/or death-free survival at 12 months. Cox proportional hazard was used to identify risk factors for recurrent vertebrobasilar ischemic events. Seventy-two patients with 77 treated vertebral ostial lesions were included. The 30-day stroke and/or death rate was 5.2% (n = 4), although no event was directly related to the vertebral ostium stent placement. Three procedure-related strokes were secondary to attempted stent placement at other sites (one carotid artery and two basilar arteries), and the one death was secondary to the presenting stroke severity. The mean clinical follow-up time available for 66 patients was 9 months. There were 14 TNDs (21%), two strokes (3%), and two deaths (3%) recorded in the follow-up. Recurrent vertebrobasilar ischemic events occurred in nine patients (seven TNDs and two strokes). No recurrent stroke and/or deaths were related to the treated vertebral ostium. Stroke- and/or death-free survival rate (including periprocedural stroke and/or death) was 89 ± 5% at 12 months. No vascular risk factor was significantly associated with recurrent vertebrobasilar ischemic events. Vertebral artery ostium stent placement can be safely and effectively performed with a low rate of recurrent stroke in the territory of the treated vessel. Patients who also underwent attempted treatment of a tandem intracranial stenosis appeared to be at highest risk for periprocedure stroke. (orig.)

  3. The impact of cessation media messages on cessation-related outcomes: results from a national experiment of smokers.

    Science.gov (United States)

    Duke, Jennifer C; Nonnemaker, James M; Davis, Kevin C; Watson, Kimberly A; Farrelly, Matthew C

    2014-01-01

    Examine effects of exposure to two types of cessation advertisements on changes in cessation-related outcomes. Experimental data from a nationally representative, longitudinal sample of smokers, collected in three waves over 4 weeks. National. Subjects. Three thousand and two adult U.S. smokers aged 18+ completed baseline and follow-up interviews at 2 and 4 weeks, from December 2010 to February 2011. Six randomly assigned conditions consisting of repeated exposure to cessation advertisements: why-to-quit advertisements featuring emotional, personal testimonies (1: WTQ-T) or graphic images (2: WTQ-G); how-to-quit advertisements (3: HTQ), a combination of both (4: WTQ-T + HTQ; 5: WTQ-G + HTQ), and no-ad condition (6: control). Cessation-related beliefs, attitudes, intentions, and quitting behavior. Multivariable ordinary least squares and logistic regressions testing whether exposure to antitobacco television advertisements were associated with changes in tobacco-related outcomes. Exposure to WTQ-T or WTQ-G advertisements, both alone and combined with HTQ advertisements, elicited positive change in beliefs, attitudes, and intentions as compared to controls. Smokers in three of four WTQ conditions were substantially more likely to have quit smoking at 4 weeks than controls (odds ratios range from 5.9 to 10.1, p advertisements markedly increases the odds that a smoker will quit in the study period, suggesting positive movement toward successful, long-term cessation. HTQ advertisements did not enhance advertising effectiveness and may not be suitable as a primary message strategy.

  4. Implications of comorbid ADHD in ASD interventions and outcome: Results from a naturalistic follow up study from south India.

    Science.gov (United States)

    Manohar, Harshini; Kuppili, Pooja Patnaik; Kandasamy, Preeti; Chandrasekaran, Venkatesh; Rajkumar, Ravi Philip

    2018-03-01

    Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder commonly associated with Attention Deficit Hyperactivity Disorder (ADHD), the prevalence ranging from 14-70%. The current study attempted to assess the impact of comorbid ADHD in children with ASD, in terms of challenges in diagnosis, treatment, intervention outcomes and parental stress and coping through a naturalistic design. Fifty children aged 2-6 years with ASD were recruited, assessed and followed up for six months. Twenty children were found to have comorbid ADHD. Severity of ASD and ADHD was assessed by Childhood Autism rating scale and Connor's abbreviated rating scale respectively. Parental stress and coping was assessed by Family Interview for stress and coping. The diagnosis of ASD was apparently obscured by ADHD symptoms in about 22% of cases, as only diagnosis of ADHD was made at the time of referral to our centre. ADHD was the most common comorbidity followed by intellectual disability and seizure disorder. About 66% of children received combination of pharmacological and behavioral interventions. Clonidine was the most common medication to be used and was well tolerated. The improvement in ADHD symptomatology showed positive correlation with improvement with ASD-specific interventions as reflected by change in severity scores. Severity of ADHD significantly also predicted parental stress and coping, and thereby engagement in ASD-specific interventions. The current study highlights the need for screening and early diagnosis of comorbid ADHD in children with ASD and vice versa considering the management challenges. In case of multiple comorbid neurodevelopmental disorders, early interventions for one disorder can improve the outcome of the other. Copyright © 2018 Elsevier B.V. All rights reserved.

  5. Feminism, status inconsistency, and women's intimate partner victimization in heterosexual relationships.

    Science.gov (United States)

    Franklin, Cortney A; Menaker, Tasha A

    2014-07-01

    This study used a random community sample of 303 women in romantic relationships to investigate the role of educational and employment status inconsistency and patriarchal family ideology as risk factors for intimate partner violence (IPV) victimization, while considering demographic factors and relationship context variables. Sequential multivariate logistic regression models demonstrated a decrease in the odds of IPV victimization for Hispanic women and women who were older as compared with their counterparts. In addition, increased relationship distress, family-of-origin violence, and employment status inconsistency significantly increased the odds of IPV. Clinical intervention strategies and future research directions are discussed. © The Author(s) 2014.

  6. Institutions, credibility and crisis: the inconsistencies of Argentine exchange rate policy (1991-2006

    Directory of Open Access Journals (Sweden)

    NICOLÁS CHERNY

    2015-03-01

    Full Text Available The purpose of this article is twofold. The first is to explain the time inconsistencies of the convertibility regime that led to the 2001 crisis. The argument suggests that the credibility requirements for convertibility induced a dynamic of legal, fiscal, financial and external commitments that increased exit costs and time inconsistencies. The second objective is to explain the tensions of the floating regime that replaced convertibility in 2002. We describe the effects of a floating exchange rate on macroeconomic imbalance and the growing tension between competitiveness and inflation.

  7. Inconsistency in serial choice decision and motor reaction times dissociate in younger and older adults

    OpenAIRE

    Bunce, D; MacDonald, SWS; Hultsch, DF

    2004-01-01

    Intraindividual variability (inconsistency) in reaction time (RT) latencies was investigated in a group of younger (M = 25.46 years) and older (M = 69.29 years) men. Both groups performed 300 trials in 2-, 4-, and 8-choice RT conditions where RTs for decision and motor components of the task were recorded separately. A dissociation was evident in that inconsistency was greater in older adults for decision RTs when task demands relating to the number of choices and fatigue arising from time-on...

  8. Phonological inconsistency in word naming: Determinants of the interference effect between languages

    OpenAIRE

    Smits, E.M.G.; Sandra, D.M.J.; Martensen, H.E.; Dijkstra, A.F.J.

    2009-01-01

    Dutch-English participants named words and nonwords having a between-language phonologically inconsistent rime, e.g., GREED and PREED, and control words with a language-typical rime, e.g., GROAN, in a monolingual stimulus list or in a mixed list containing Dutch words. Inconsistent items had longer latencies and more errors than typical items in the mixed lists but not in the pure list. The consistency effect depended on word frequency, but not on language membership, lexicality, or instructi...

  9. Inconsistency of speech in children with childhood apraxia of speech, phonological disorders, and typical speech

    Science.gov (United States)

    Iuzzini, Jenya

    There is a lack of agreement on the features used to differentiate Childhood Apraxia of Speech (CAS) from Phonological Disorders (PD). One criterion which has gained consensus is lexical inconsistency of speech (ASHA, 2007); however, no accepted measure of this feature has been defined. Although lexical assessment provides information about consistency of an item across repeated trials, it may not capture the magnitude of inconsistency within an item. In contrast, segmental analysis provides more extensive information about consistency of phoneme usage across multiple contexts and word-positions. The current research compared segmental and lexical inconsistency metrics in preschool-aged children with PD, CAS, and typical development (TD) to determine how inconsistency varies with age in typical and disordered speakers, and whether CAS and PD were differentiated equally well by both assessment levels. Whereas lexical and segmental analyses may be influenced by listener characteristics or speaker intelligibility, the acoustic signal is less vulnerable to these factors. In addition, the acoustic signal may reveal information which is not evident in the perceptual signal. A second focus of the current research was motivated by Blumstein et al.'s (1980) classic study on voice onset time (VOT) in adults with acquired apraxia of speech (AOS) which demonstrated a motor impairment underlying AOS. In the current study, VOT analyses were conducted to determine the relationship between age and group with the voicing distribution for bilabial and alveolar plosives. Findings revealed that 3-year-olds evidenced significantly higher inconsistency than 5-year-olds; segmental inconsistency approached 0% in 5-year-olds with TD, whereas it persisted in children with PD and CAS suggesting that for child in this age-range, inconsistency is a feature of speech disorder rather than typical development (Holm et al., 2007). Likewise, whereas segmental and lexical inconsistency were

  10. Reassuring results on birth outcomes in children fathered by men treated with azathioprine/6-mercaptopurine within 3 months before conception

    DEFF Research Database (Denmark)

    Nørgård, B M; Magnussen, B; Larsen, M D

    2017-01-01

    not use AZA/6-MP 3 months prior to conception constituted the unexposed cohort (N=1 012 624). The outcomes were congenital abnormalities (CAs), preterm birth and small for gestational age (SGA). We adjusted for multiple covariates and performed a restricted analysis of men with IBD. RESULTS: There were...

  11. Fatal and non-fatal injury outcomes: results from a purposively sampled census of seven rural subdistricts in Bangladesh.

    Science.gov (United States)

    Alonge, Olakunle; Agrawal, Priyanka; Talab, Abu; Rahman, Qazi S; Rahman, Akm Fazlur; Arifeen, Shams El; Hyder, Adnan A

    2017-08-01

    90% of the global burden of injuries is borne by low-income and middle-income countries (LMICs). However, details of the injury burden in LMICs are less clear because of the scarcity of data and population-based studies. The Saving of Lives from Drowning project, implemented in rural Bangladesh, did a census on 1·2 million people to fill this gap. This Article describes the epidemiology of fatal and non-fatal injuries from the study. In this study, we used data from the baseline census conducted as part of the Saving of Lives from Drowning (SoLiD) project. The census was implemented in 51 unions from seven purposively sampled rural subdistricts of Bangladesh between June and November, 2013. Sociodemographic, injury mortality, and morbidity information were collected for the whole population in the study area. We analysed the data for descriptive measures of fatal and non-fatal injury outcomes. Age and gender distribution, socioeconomic characteristics, and injury characteristics such as external cause, intent, location, and body part affected were reported for all injury outcomes. The census covered a population of 1 169 593 from 270 387 households and 451 villages. The overall injury mortality rate was 38 deaths per 100 000 population per year, and 104 703 people sustained major non-fatal injuries over a 6-month recall period. Drowning was the leading external cause of injury death for all ages, and falls caused the most number of non-fatal injuries. Fatal injury rates were highest in children aged 1-4 years. Non-fatal injury rates were also highest in children aged 1-4 years and those aged 65 years and older. Males had more fatal and non-fatal injuries than females across all external causes except for burns. Suicide was the leading cause of injury deaths in individuals aged 15-24 years, and more than 50% of the suicides occurred in females. The home environment was the most common location for most injuries. The burden of fatal and non-fatal injuries

  12. The rank-heat plot is a novel way to present the results from a network meta-analysis including multiple outcomes.

    Science.gov (United States)

    Veroniki, Areti Angeliki; Straus, Sharon E; Fyraridis, Alexandros; Tricco, Andrea C

    2016-08-01

    To present a novel and simple graphical approach to improve the presentation of the treatment ranking in a network meta-analysis (NMA) including multiple outcomes. NMA simultaneously compares many relevant interventions for a clinical condition from a network of trials, and allows ranking of the effectiveness and/or safety of each intervention. There are numerous ways to present the NMA results, which can challenge their interpretation by research users. The rank-heat plot is a novel graph that can be used to quickly recognize which interventions are most likely the best or worst interventions with respect to their effectiveness and/or safety for a single or multiple outcome(s) and may increase interpretability. Using empirical NMAs, we show that the need for a concise and informative presentation of results is imperative, particularly as the number of competing treatments and outcomes in an NMA increases. The rank-heat plot is an efficient way to present the results of ranking statistics, particularly when a large amount of data is available, and it is targeted to users from various backgrounds. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Analysis on the capacity degradation mechanism of a series lithium-ion power battery pack based on inconsistency of capacity

    International Nuclear Information System (INIS)

    Wang Zhen-Po; Liu Peng; Wang Li-Fang

    2013-01-01

    The lithium-ion battery has been widely used as an energy source. Charge rate, discharge rate, and operating temperature are very important factors for the capacity degradations of power batteries and battery packs. Firstly, in this paper we make use of an accelerated life test and a statistical analysis method to establish the capacity accelerated degradation model under three constant stress parameters according to the degradation data, which are charge rate, discharge rate, and operating temperature, and then we propose a capacity degradation model according to the current residual capacity of a Li-ion cell under dynamic stress parameters. Secondly, we analyze the charge and discharge process of a series power battery pack and interpret the correlation between the capacity degradations of the battery pack and its charge/discharge rate. According to this cycling condition, we establish a capacity degradation model of a series power battery pack under inconsistent capacity of cells, and analyze the degradation mechanism with capacity variance and operating temperature difference. The comparative analysis of test results shows that the inconsistent operating temperatures of cells in the series power battery pack are the main cause of its degradation; when the difference between inconsistent temperatures is narrowed by 5 °C, the cycle life can be improved by more than 50%. Therefore, it effectively improves the cycle life of the series battery pack to reasonably assemble the batteries according to their capacities and to narrow the differences in operating temperature among cells. (interdisciplinary physics and related areas of science and technology)

  14. Clinical outcomes according to symptom presentation in patients with acute myocardial infarction: Results from the FAST-MI 2010 registry.

    Science.gov (United States)

    Puymirat, Etienne; Aissaoui, Nadia; Bonello, Laurent; Cayla, Guillaume; Labèque, Jean-Noel; Nallet, Olivier; Motreff, Pascal; Varenne, Olivier; Schiele, François; Ferrières, Jean; Simon, Tabassome; Danchin, Nicolas

    2017-12-01

    Atypical clinical presentation in acute myocardial infarction (AMI) patients is not uncommon; most studies suggest that it is associated with unfavorable prognosis. Long-term clinical impact differs according to predominant symptom presentation (typical chest pain, atypical chest pain, syncope, cardiac arrest, or dyspnea) in AMI patients. FAST-MI 2010, a nationwide French registry, included 4169 patients with AMI in 213 centers at the end of 2010 (76% of active centers). Demographics, medical history, hospital management, and outcomes were compared according to predominant symptom presentation. Typical chest pain with no other symptom was reported in 3020 patients (68% in STEMI patients, 76% in NSTEMI patients). Atypical chest pain, dyspnea, syncope, and cardiac arrest were reported in 11%, 11%, 5%, and 1%, respectively. Patients with atypical clinical presentation had a higher cardiovascular risk profile and received fewer medications and a less invasive strategy. Using Cox multivariate analysis, atypical chest pain was not associated with higher death rate at 3 years (HR: 0.96, 95% CI: 0.69-1.33, P = 0.78), whereas cardiac arrest (HR: 2.44, 95% CI: 1.00-5.97, P = 0.05), syncope (HR: 1.70, 95% CI: 1.18-2.46, P = 0.005), and dyspnea (HR: 1.66, 95% CI: 1.31-2.10, P clinical presentation is observed in about 20% of AMI patients. Cardiac arrest, dyspnea, and syncope represent independent predictors of long-term mortality in STEMI and NSTEMI populations. © 2017 Wiley Periodicals, Inc.

  15. Impact of Negative Quality Inconsistency on Brand Loyalty – Case of Croatian Food Market

    Directory of Open Access Journals (Sweden)

    Martina Ferenčić

    2015-03-01

    Full Text Available Attracting and keeping consumers’ loyalty in Fast Moving Consumer Goods segment became the main concern for all producing companies and retailers, too. Many marketing researchers argue that product or service quality perception is one of the key elements in brand loyalty building process. When talking about food market, one has to be aware that food consumption has direct impact on human health and, in that context, process of building brand loyalty for food brands is not possible, or it can be hard, if the product quality of food brands is not on the expected level and according to defined food quality standards. The goal of this paper was to understand aspects of connection between food product quality and brand loyalty process better and to explore how problems with negative quality inconsistency in different food categories can influence brand loyalty. An empirical research (on-line survey was conducted to prove and explain the connection between food product quality and food brand loyalty. The research results shows that the main reasons for being loyal to a certain food brand or product are related mostly to positive brand experience, high and stabile product quality, and recognizable taste. In the context of these research results, it can be concluded that long term consumer satisfaction as a factor in food brand loyalty process depends on stabile product quality, so food manufacturers or food brand owners should be focused on preventing or minimizing the aspect of negative quality issues. Regarding research limitations, the study was conducted only on users from Croatian market; so broadening the survey to other markets should give a clearer view on the connection between food product quality and brand loyalty process.

  16. The reliability of computer analysis of ultrasonographic prostate images: the influence of inconsistent histopathology

    NARCIS (Netherlands)

    Giesen, R. J.; Huynen, A. L.; de la Rosette, J. J.; Schaafsma, H. E.; van Iersel, M. P.; Aarnink, R. G.; Debruyne, F. M.; Wijkstra, H.

    1994-01-01

    This article describes a method to investigate the influence of inconsistent histopathology during the development of tissue discrimination algorithms. Review of the pathology is performed on the biopsies used as training set of a computer system for cancer detection in ultrasonographic prostate

  17. An investigation of inconsistent projections and artefacts in multi-pinhole SPECT with axially aligned pinholes

    International Nuclear Information System (INIS)

    Kench, P L; Meikle, S R; Lin, J; Gregoire, M C

    2011-01-01

    Multiple pinholes are advantageous for maximizing the use of the available field of view (FOV) of compact small animal single photon emission computed tomography (SPECT) detectors. However, when the pinholes are aligned axially to optimize imaging of extended objects, such as rodents, multiplexing of the pinhole projections can give rise to inconsistent data which leads to 'ghost point' artefacts in the reconstructed volume. A novel four pinhole collimator with a baffle was designed and implemented to eliminate these inconsistent projections. Simulation and physical phantom studies were performed to investigate artefacts from axially aligned pinholes and the efficacy of the baffle in removing inconsistent data and, thus, reducing reconstruction artefacts. SPECT was performed using a Defrise phantom to investigate the impact of collimator design on FOV utilization and axial blurring effects. Multiple pinhole SPECT acquired with a baffle had fewer artefacts and improved quantitative accuracy when compared to SPECT acquired without a baffle. The use of four pinholes positioned in a square maximized the available FOV, increased acquisition sensitivity and reduced axial blurring effects. These findings support the use of a baffle to eliminate inconsistent projection data arising from axially aligned pinholes and improve small animal SPECT reconstructions.

  18. Inconsistency of Bayesian Inference for Misspecified Linear Models, and a Proposal for Repairing It

    NARCIS (Netherlands)

    Grünwald, P.; van Ommen, T.

    2017-01-01

    We empirically show that Bayesian inference can be inconsistent under misspecification in simple linear regression problems, both in a model averaging/selection and in a Bayesian ridge regression setting. We use the standard linear model, which assumes homoskedasticity, whereas the data are

  19. Sociodemographic, behavioral, and clinical correlates of inconsistent condom use in HIV-serodiscordant heterosexual couples.

    Science.gov (United States)

    Buchacz, K; van der Straten, A; Saul, J; Shiboski, S C; Gomez, C A; Padian, N

    2001-11-01

    We examined sociodemographic, behavioral, and clinical characteristics associated with inconsistent condom use in a cross-sectional analysis of 145 sexually active HIV-serodiscordant heterosexual couples who participated in the California Partners Study II. All couples were aware of their HIV-serodiscordant status. Forty-five percent of couples reported having had unprotected vaginal or anal sex in the previous 6 months. In the multivariate couple-level analyses, factors independently associated with inconsistent (i.e., <100%) condom use in the previous 6 months included lower educational level, unemployment, African-American ethnicity, and practice of anal sex by the couple. Injection drug use was associated with inconsistent condom use among couples with younger HIV-infected partners. In addition, couples with HIV-infected partners who had higher CD4 cell counts and couples in which the HIV-infected male partner ever had sex with a man were more likely to use condoms inconsistently. Consistency of condom use did not depend on the gender of the HIV-infected partner or duration of sexual relationship. The findings suggest that many HIV-serodiscordant heterosexual couples remain at high risk of HIV transmission and may benefit not only from behavioral interventions but also from structural interventions aimed at improving their social and economic conditions.

  20. Trauma and dissociation in treatment-seeking alcoholics: Towards a resolution of inconsistent findings

    NARCIS (Netherlands)

    Langeland, Willie; Draijer, Nel; van den Brink, Wim

    2002-01-01

    There is consistent empirical evidence for a trauma-dissociation relation in general population samples and in psychiatric patients. However, contradictory findings have been reported on this relation among substance abusers. The present study attempts to resolve these inconsistencies by testing a

  1. Inconsistency in Serial Choice Decision and Motor Reaction Times Dissociate in Younger and Older Adults

    Science.gov (United States)

    Bunce, D.; MacDonald, S.W.S.; Hultsch, D.F.

    2004-01-01

    Intraindividual variability (inconsistency) in reaction time (RT) latencies was investigated in a group of younger (M=25.46 years) and older (M=69.29 years) men. Both groups performed 300 trials in 2-, 4-, and 8-choice RT conditions where RTs for decision and motor components of the task were recorded separately. A dissociation was evident in that…

  2. An Evaluation of the MMPI-2 and MMPI-A True Response Inconsistency (TRIN) Scales

    Science.gov (United States)

    Handel, Richard W.; Arnau, Randolph C.; Archer, Robert P.; Dandy, Kristina L.

    2006-01-01

    The Minnesota Multiphasic Personality Inventory--Adolescent (MMPI-A) and Minnesota Multiphasic Personality Inventory--2 (MMPI-2) True Response Inconsistency (TRIN) scales are measures of acquiescence and nonacquiescence included among the standard validity scales on these instruments. The goals of this study were to evaluate the effectiveness of…

  3. The Belief that Alcohol Use Is Inconsistent with Personal Autonomy: A Promotive Factor for Younger Adolescents

    Science.gov (United States)

    Henry, Kimberly L.; Shtivelband, Annette; Comello, Maria Leonora G.; Slater, Michael D.

    2011-01-01

    This study explored an understudied promotive factor, a belief that alcohol use is inconsistent with personal autonomy, which may reduce adolescent intention to drink and subsequent alcohol use. Autonomy was examined as an attitudinal construct within the Theory of Reasoned Action. Longitudinal data from 2,493 seventh grade students nested in 40…

  4. Memory for stereotype (in)consistent information : The role of in-group identification

    NARCIS (Netherlands)

    Doosje, Bertjan; Spears, Russell; de Redelijkheid, Hans; van Onna, Joost

    Effects of identification with one's group on memory of stereotype consistent and inconsistent information about one's group were examined in two studies. In the first study, we focused on supporters of a low status soccer team, and observed that diehard fans were more likely to remember

  5. Inconsistency of Bayesian inference for misspecified linear models, and a proposal for repairing it

    NARCIS (Netherlands)

    P.D. Grünwald (Peter); T. van Ommen (Thijs)

    2017-01-01

    textabstractWe empirically show that Bayesian inference can be inconsistent under misspecification in simple linear regression problems, both in a model averaging/selection and in a Bayesian ridge regression setting. We use the standard linear model, which assumes homoskedasticity, whereas the data

  6. A theory of Markovian time-inconsistent stochastic control in discrete time

    DEFF Research Database (Denmark)

    Bjork, Tomas; Murgoci, Agatha

    2014-01-01

    We develop a theory for a general class of discrete-time stochastic control problems that, in various ways, are time-inconsistent in the sense that they do not admit a Bellman optimality principle. We attack these problems by viewing them within a game theoretic framework, and we look for subgame...

  7. Setting standards and detecting intrajudge inconsistency using interdependent evaluation of response alternatives

    NARCIS (Netherlands)

    Chang, Lei; van der Linden, Willem J.; Vos, Hendrik J.

    2004-01-01

    This article introduces a new test-centered standard-setting method as well as a procedure to detect intrajudge inconsistency of the method. The standard-setting method that is based on interdependent evaluations of alternative responses has judges closely evaluate the process that examinees use to

  8. Inconsistent Discipline as a Mediator between Maternal Distress and Aggression in Boys

    Science.gov (United States)

    Barry, Tammy D.; Dunlap, Sarah T.; Lochman, John E.; Wells, Karen C.

    2009-01-01

    The current study examines inconsistent discipline as a mediator in the association between maternal distress and child aggression and attention problems. Participants were 215 boys, ranging in age from 9 to 12 years, and their mothers. Mothers provided self-report data on socioeconomic status (SES), parenting stress, maternal distress (depression…

  9. Identification of Mendelian inconsistencies between SNP and pedigree Information of Sibs

    NARCIS (Netherlands)

    Calus, M.P.L.; Mulder, H.A.; Bastiaansen, J.W.M.

    2011-01-01

    Background Using SNP genotypes to apply genomic selection in breeding programs is becoming common practice. Tools to edit and check the quality of genotype data are required. Checking for Mendelian inconsistencies makes it possible to identify animals for which pedigree information and genotype

  10. Does clinical management improve outcomes following self-harm? Results from the multicentre study of self-harm in England.

    Directory of Open Access Journals (Sweden)

    Nav Kapur

    Full Text Available Evidence to guide clinical management of self-harm is sparse, trials have recruited selected samples, and psychological treatments that are suggested in guidelines may not be available in routine practice.To examine how the management that patients receive in hospital relates to subsequent outcome.We identified episodes of self-harm presenting to three UK centres (Derby, Manchester, Oxford over a 10 year period (2000 to 2009. We used established data collection systems to investigate the relationship between four aspects of management (psychosocial assessment, medical admission, psychiatric admission, referral for specialist mental health follow up and repetition of self-harm within 12 months, adjusted for differences in baseline demographic and clinical characteristics.35,938 individuals presented with self-harm during the study period. In two of the three centres, receiving a psychosocial assessment was associated with a 40% lower risk of repetition, Hazard Ratios (95% CIs: Centre A 0.99 (0.90-1.09; Centre B 0.59 (0.48-0.74; Centre C 0.59 (0.52-0.68. There was little indication that the apparent protective effects were mediated through referral and follow up arrangements. The association between psychosocial assessment and a reduced risk of repetition appeared to be least evident in those from the most deprived areas.These findings add to the growing body of evidence that thorough assessment is central to the management of self-harm, but further work is needed to elucidate the possible mechanisms and explore the effects in different clinical subgroups.

  11. Endoscopic stenting for common bile duct stenoses in chronic pancreatitis: results and impact on long-term outcome.

    Science.gov (United States)

    Eickhoff, A; Jakobs, R; Leonhardt, A; Eickhoff, J C; Riemann, J F

    2001-10-01

    The overall incidence of common bile duct strictures due to chronic pancreatitis is reported to be approximately 10-30%. It remains a challenging problem for gastroenterologists and surgeons. The exact role of endoscopic stenting has not yet been clearly defined. Thirty-nine patients with chronic pancreatitis and symptomatic common bile duct stenoses underwent endoscopic stenting and were studied retrospectively. We were particularly interested in how many patients would achieve resolution of the stricture and tolerate removal of the stents in the long term. Indications for endoscopic stenting were symptomatic cholestasis, jaundice or cholangitis. The initial serum bilirubin was 8.3 mg/dl and the diameter of the common bile duct was 14.2 mm before stenting. Within 3-7 days of stenting, all patients presented improvement of jaundice and cholestasis. After a median stenting time of 9 months (range 1-144 months), 46% of the patients demonstrated regression of the stricture and clinical improvement, 26% required further stenting, and 28% were referred to surgery. Five patients received a self-expandable metal Wallstent. Thirty-one per cent demonstrated complete clinical recovery of the stricture as well as 10.2% a complete, radiologically verified stricture regression in a median follow-up of 58 months. There seems to be a therapeutic benefit for short-term endoscopic treatment but medium-term and long-term outcome remains questionable. Endoscopic stenting should be applied as an initial therapy before surgery, but it can be the definitive approach for older and morbid patients or cases with complete stricture regression after stent removal. Overall, it should not be considered as a routine procedure for symptomatic cases.

  12. The impact of obesity on pediatric procedural sedation-related outcomes: results from the Pediatric Sedation Research Consortium.

    Science.gov (United States)

    Scherrer, Patricia D; Mallory, Michael D; Cravero, Joseph P; Lowrie, Lia; Hertzog, James H; Berkenbosch, John W

    2015-07-01

    To evaluate the impact of obesity on adverse events and required interventions during pediatric procedural sedation. The Pediatric Sedation Research Consortium database of prospectively collected procedural sedation encounters was queried to identify patients for whom body mass index (BMI) could be calculated. Obesity was defined as BMI ≥95th percentile for age and gender. Sedation-related outcomes, adverse events, and therapeutic interventions were compared between obese and nonobese patients. For analysis, 28,792 records were eligible. A total of 5,153 patients (17.9%) were obese; they were predominantly male and older and had a higher median American Society of Anesthesiologists Physical Status classification (P obese patients (odds ratio [OR] 1.49, 95% confidence interval [1.31, 1.70]). Respiratory events (airway obstruction OR 1.94 [1.54, 2.44], oxygen desaturation OR 1.99 [1.50, 2.63], secretions OR 1.48 [1.01, 2.15], laryngospasm OR 2.30 [1.30, 4.05]), inability to complete the associated procedure (OR 1.96 [1.16, 3.30]), and prolonged recovery (OR 2.66 [1.26, 5.59]) were increased in obese patients. Obese patients more frequently required airway intervention including repositioning, suctioning, jaw thrust, airway adjuncts, and bag-valve-mask ventilation. Multivariate regression analysis demonstrated obesity to be independently associated with minor and moderate but not major adverse events. Obesity is an independent risk factor for adverse respiratory events during procedural sedation and is associated with an increased frequency of airway interventions, suggesting that additional vigilance and expertise are required when sedating these patients. © 2015 John Wiley & Sons Ltd.

  13. Neurodevelopmental Outcome of Young Children with Biliary Atresia and Native Liver: Results from the ChiLDReN Study.

    Science.gov (United States)

    Ng, Vicky L; Sorensen, Lisa G; Alonso, Estella M; Fredericks, Emily M; Ye, Wen; Moore, Jeff; Karpen, Saul J; Shneider, Benjamin L; Molleston, Jean P; Bezerra, Jorge A; Murray, Karen F; Loomes, Kathleen M; Rosenthal, Philip; Squires, Robert H; Wang, Kasper; Arnon, Ronen; Schwarz, Kathleen B; Turmelle, Yumirle P; Haber, Barbara H; Sherker, Averell H; Magee, John C; Sokol, Ronald J

    2018-05-01

    To assess neurodevelopmental outcomes among participants with biliary atresia with their native liver at ages 12 months (group 1) and 24 months (group 2), and to evaluate variables predictive of neurodevelopmental impairment. Participants enrolled in a prospective, longitudinal, multicenter study underwent neurodevelopmental testing with either the Bayley Scales of Infant Development, 2nd edition, or Bayley Scales of Infant and Toddler Development, 3rd edition. Scores (normative mean = 100 ± 15) were categorized as ≥100, 85-99, and Development, 2nd edition, or Bayley Scales of Infant and Toddler Development, 3rd edition, scales) was analyzed using logistic regression. There were 148 children who completed 217 Bayley Scales of Infant and Toddler Development, 3rd edition, examinations (group 1, n = 132; group 2, n = 85). Neurodevelopmental score distributions significantly shifted downward compared with test norms at 1 and 2 years of age. Multivariate analysis identified ascites (OR, 3.17; P = .01) and low length z-scores at time of testing (OR, 0.70; P cognitive/language impairment at 1 year of age. An unsuccessful hepatoportoenterostomy was predictive of both physical/motor (OR, 4.88; P cognitive/language impairment (OR, 4.76; P = .02) at 2 years of age. Participants with biliary atresia surviving with native livers after hepatoportoenterostomy are at increased risk for neurodevelopmental delays at 12 and 24 months of age. Those with unsuccessful hepatoportoenterostomy are >4 times more likely to have neurodevelopmental impairment compared with those with successful hepatoportoenterostomy. Growth delays and/or complications indicating advanced liver disease should alert clinicians to the risk for neurodevelopmental delays, and expedite appropriate interventions. Clinicaltrials.gov: NCT00061828 and NCT00294684. Copyright © 2018 Elsevier Inc. All rights reserved.

  14. Reconstruction of supracrestal alveolar bone lost as a result of severe chronic periodontitis. Five-year outcome: case report.

    Science.gov (United States)

    Kotschy, Peter; Laky, Markus

    2006-10-01

    This patient presented with generalized severe chronic periodontitis. Conventional periodontal therapy would have left her compromised esthetically and anatomically, with growing interdental "black triangles." This prompted the authors to try to reconstruct the maxillary alveolar bone that had been lost in the previous three decades because of untreated periodontitis. To maintain the level and quality of the gingival margin, open flap surgery was performed in the maxilla soon after scaling and root planing. To gain access to the roots and bone surfaces, a flap was raised by intrasulcular incisions and the modified and simplified papilla preservation technique. After debridement, the root surfaces were conditioned and enamel matrix proteins were applied. Bovine bone mineral was placed in the infrabony defects and supracrestally (buccally, lingually, and interdentally) to help regenerate the lost alveolar bone. In addition, the defects around the maxillary anterior teeth were covered with a membrane. To prevent shrinkage of the gingiva, suspensory sutures were placed on the right central incisor and both left incisors so that the anterior flap would be positioned approximately 3 mm coronally. After surgery, the patient was advised to apply 1% chlorhexidine gel twice a day and to avoid brushing the surgical site for 4 weeks. Professional maintenance care was administered twice a week for 2 months and the patient was instructed to maintain a liquid diet for 4 weeks. The treatment outcome was evaluated clinically and radiographically at regular intervals for 5 years postsurgically. Periodontal conditions were stable and fulfilled the patient's desire to eliminate the pockets without compromising esthetics, particularly in the maxillary anterior.

  15. Baseline results of the first healthy schools evaluation among a community of young, Irish, urban disadvantaged children and a comparison of outcomes with international norms.

    Science.gov (United States)

    Comiskey, Catherine M; O'Sullivan, Karin; Quirke, Mary B; Wynne, Ciara; Hollywood, Eleanor; MGillloway, Sinead

    2012-11-01

    In 2008, the Irish Government initiated a pilot Healthy Schools Programme based on the World Health Organization Health Promoting Schools Model among children attending schools officially designated as urban and disadvantaged. We present here the first results on physical and emotional health and the relationship between childhood depression and demographic and socioeconomic factors. The Healthy Schools Programme evaluation was a 3-year longitudinal outcome study among urban disadvantaged children aged 4 to 12 years. Physical and psychological health outcomes were measured using validated, international instruments at baseline. Outcomes at baseline were compared with international norms and where differences were found, results were statistically modeled to determine factors predicting poor outcomes. A total of 552 children responded at baseline, representing over 50% of all eligible children available to participate from 7 schools. Findings at baseline revealed that in general, children did not differ significantly from international norms. However, detailed analysis of the childhood depression scores revealed that in order of importance, psychological well-being, the school environment, social support, and peer relations and age were statistically significant predictors of increased childhood depression in children under 12 years of age. Future health and well-being studies in schools among urban disadvantaged children need to broaden their scope to include measures of depression in children under 12 years of age and be cognisant of the impact of the school environment on the mental and emotional health of the very young. © 2012, American School Health Association.

  16. Influence of the wording of evaluation items on outcome-based evaluation results for large-group teaching in anatomy, biochemistry and legal medicine.

    Science.gov (United States)

    Anders, Sven; Pyka, Katharina; Mueller, Tjark; von Streinbuechel, Nicole; Raupach, Tobias

    2016-11-01

    Student learning outcome is an important dimension of teaching quality in undergraduate medical education. Measuring an increase in knowledge during teaching requires repetitive objective testing which is usually not feasible. As an alternative, student learning outcome can be calculated from student self-ratings. Comparative self-assessment (CSA) gain reflects the performance difference before and after teaching, adjusted for initial knowledge. It has been shown to be a valid proxy measure of actual learning outcome derived from objective tests. However, student self-ratings are prone to a number of confounding factors. In the context of outcome-based evaluation, the wording of self-rating items is crucial to the validity of evaluation results. This randomized trial assessed whether including qualifiers in these statements impacts on student ratings and CSA gain. First-year medical students self-rated their initial (then-test) and final (post-test) knowledge for lectures in anatomy, biochemistry and legal medicine, respectively, and 659 questionnaires were retrieved. Six-point scales were used for self-ratings with 1 being the most positive option. Qualifier use did not affect then-test ratings but was associated with slightly less favorable post-test ratings. Consecutively, mean CSA gain was smaller for items containing qualifiers than for items lacking qualifiers (50.6±15.0% vs. 56.3±14.6%, p=0.079). The effect was more pronounced (Cohen's d=0.82) for items related to anatomy. In order to increase fairness of outcome-based evaluation and increase the comparability of CSA gain data across subjects, medical educators should agree on a consistent approach (qualifiers for all items or no qualifiers at all) when drafting self-rating statements for outcome-based evaluation. Copyright © 2016 Elsevier GmbH. All rights reserved.

  17. Comparing individual differences in inconsistency and plasticity as predictors of cognitive function in older adults.

    Science.gov (United States)

    Grand, Jacob H G; Stawski, Robert S; MacDonald, Stuart W S

    2016-01-01

    Recent theorizing differentiates key constraints on cognition, including one's current range of processing efficiency (i.e., flexibility or inconsistency) as well as the capacity to expand flexibility over time (i.e., plasticity). The present study uses intensive assessment of response time data to examine the interplay between markers of intraindividual variability (inconsistency) and gains across biweekly retest sessions (plasticity) in relation to age-related cognitive function. Participants included 304 adults (aged 64 to 92 years: M = 74.02, SD = 5.95) from Project MIND, a longitudinal burst design study assessing performance across micro and macro intervals (response latency trials, weekly bursts, annual retests). For two reaction time (RT) measures (choice RT and one-back choice RT), baseline measures of RT inconsistency (intraindividual standard deviation, ISD, across trials at the first testing session) and plasticity (within-person performance gains in average RT across the 5 biweekly burst sessions) were computed and were then employed in linear mixed models as predictors of individual differences in cognitive function and longitudinal (6-year) rates of cognitive change. Independent of chronological age and years of education, higher RT inconsistency was associated uniformly with poorer cognitive function at baseline and with increased cognitive decline for measures of episodic memory and crystallized verbal ability. In contrast, predictive associations for plasticity were more modest for baseline cognitive function and were absent for 6-year cognitive change. These findings underscore the potential utility of response times for articulating inconsistency and plasticity as dynamic predictors of cognitive function in older adults.

  18. Outcome of Treatment of Uveitic Macular Edema: The Multicenter Uveitis Steroid Treatment Trial 2-Year Results.

    Science.gov (United States)

    Tomkins-Netzer, Oren; Lightman, Susan; Drye, Lea; Kempen, John; Holland, Gary N; Rao, Narsing A; Stawell, Richard J; Vitale, Albert; Jabs, Douglas A

    2015-11-01

    To evaluate the 2-year outcomes of uveitic macular edema. Longitudinal follow-up of a randomized cohort. At baseline, 148 eyes of 117 patients enrolled in the Multicenter Uveitis Steroid Treatment (MUST) Trial had macular edema, and 134 eyes of 108 patients completed 2-year follow-up. Patients enrolled in the study were randomized to either systemic immunosuppression or intravitreal fluocinolone acetonide implant therapy. Macular edema was defined as thickening of the retina (center point thickness≥240 μm) on time-domain optical coherence tomography (OCT) of macula. Improvement in macular edema (≥20% reduction in central point thickness on OCT), resolution of macular edema (normalization of thickness on OCT), and best-corrected visual acuity (BCVA). Between randomization and 2-years' follow-up, 62% and 25% of eyes in the systemic and implant groups, respectively, received at least 1 supplemental regional corticosteroid injection. By 2-years' follow-up, macular edema improved in 71% of eyes and resolved in 60%. There were no differences between treatment groups in the proportion of eyes with macular edema improving (systemic therapy vs. implant, 65% vs. 77%; P=0.20) and resolving (52% vs. 68%; P=0.28), but eyes randomized to implant had more improvement in macular thickness (median decrease of 180 vs. 109 μm in the systemic therapy group; P=0.04). Eyes with baseline fluorescein angiographic leakage were more likely to improve than those without (76% vs. 58%; P=0.03). Overall, there was a mean 5-letter (1 line) improvement in BCVA at 2 years. Mean changes in BCVA from baseline at 2 years by macular edema response status were: resolution, +10 letters; improvement without resolution, +10 letters (P=0.92); little to no change, 6 letters (P=0.19); and worsening, -16 letters (worsening acuity; P=0.0003). About two thirds of eyes with uveitic macular edema were observed to experience improvement in the edema and visual acuity with implant or systemic treatment

  19. Pilot outcome results of culturally adapted evidence-based substance use disorder treatment with a Southwest Tribe

    Directory of Open Access Journals (Sweden)

    Kamilla L. Venner

    2016-06-01

    Conclusions: Results suggest that culturally adapted EBTs yield significant improvements in alcohol use, psychological distress, and legal problems among AI/ANs. Future research using RCT methodology is needed to examine efficacy and effectiveness.

  20. The predictive value of angiographic results for the outcome of percutaneous transluminal angioplasty in stenosed femoral bypass grafts

    International Nuclear Information System (INIS)

    Spijkerboer, Anje M.; Beek, Frederik J. A.; Graaf, Yolanda van der; Eikelboom, Bert C.; Mali, Willem P. T. M.

    1997-01-01

    Purpose. To assess the predictive value of immediate angiographic results after percutaneous transluminal angioplasty (PTA) for stenoses in femoral bypass grafts using duplex ultrasound (DUS) criteria. Methods. A 1-year follow-up with DUS was performed in 38 patients with 50 stenoses in 41 grafts, treated with PTA for a graft stenosis. The indication for PTA according to DUS criteria was a severe stenosis in 43 lesions, and a moderate stenosis in 7 lesions. In the moderate stenosis group 3 patients showed claudication and 1 patient had a nonhealing ulcer. For the purposes of statistical evaluation, primary patency was considered present if the graft was not occluded. The graft was considered to have failed when it was found to be occluded on DUS, or when secondary interventions (surgery, repeat PTA) were performed. Results. After 1 year the cumulative primary patency rate was 44$ [95% confidence interval (CI) 27.8-59.8]. Stenoses with initially good angiographic results after PTA (<30% residual stenosis) were 2.9 times more likely to be patent at 1 year than stenoses with initially poor or moderate angiographic results (hazard ratio 2.9, 95% CI 1.3-6.4,p=0.007). Conclusion. A poor or moderate angiographic result immediately following PTA was prognostic for poor long-term results and may indicate a requirement for earlier surgical intervention

  1. [Outcome mesurement: the case of the "Center of Results" of the public healthcare providers network in Catalonia, Spain].

    Science.gov (United States)

    Argenter-Giralt, Miquel; Barba-Albós, Genoveva; Román-Martínez, Anna

    2010-02-01

    The health information system in Catalonia has experienced an important evolution but obtaining integrated data to evaluate the health services is still difficult. At the end of 2008 the basis of the information system of the "Center of Results" and a first set of indicators has been approved by the health system stakeholders. The "Center of Results" is assigned to the Catalan Health Service. It has a Direction Board and a Technical Committee to regulate its operation. The "Center of Results" has the mission to measure, evaluate and disseminate the results obtained in health care by the members of the public health services, to facilitate decision making with shared responsibility at the service of the quality of the health care given to the citizens of Catalonia. The "Center of Results" is based on performance principles that determine their operation: to share and to coordinate the existing information, to stimulate the participation and the co-responsibility of the implied agents, continuous improvement of the health information, promotion of good practices in the use of information and its responsible use, efficient instrumentation of technologies and analytical capacity to transform data into information. A participative process has been made to select and prioritize indicators. This process has reached consensus on a set of indicators. These indicators must contribute to assess the impact of the interventions of the health system on the level of the population's health and how results, with an efficient use of the resources, are obtained. 2010 Elsevier España S.L. All rights reserved.

  2. Boosted classification trees result in minor to modest improvement in the accuracy in classifying cardiovascular outcomes compared to conventional classification trees

    Science.gov (United States)

    Austin, Peter C; Lee, Douglas S

    2011-01-01

    Purpose: Classification trees are increasingly being used to classifying patients according to the presence or absence of a disease or health outcome. A limitation of classification trees is their limited predictive accuracy. In the data-mining and machine learning literature, boosting has been developed to improve classification. Boosting with classification trees iteratively grows classification trees in a sequence of reweighted datasets. In a given iteration, subjects that were misclassified in the previous iteration are weighted more highly than subjects that were correctly classified. Classifications from each of the classification trees in the sequence are combined through a weighted majority vote to produce a final classification. The authors' objective was to examine whether boosting improved the accuracy of classification trees for predicting outcomes in cardiovascular patients. Methods: We examined the utility of boosting classification trees for classifying 30-day mortality outcomes in patients hospitalized with either acute myocardial infarction or congestive heart failure. Results: Improvements in the misclassification rate using boosted classification trees were at best minor compared to when conventional classification trees were used. Minor to modest improvements to sensitivity were observed, with only a negligible reduction in specificity. For predicting cardiovascular mortality, boosted classification trees had high specificity, but low sensitivity. Conclusions: Gains in predictive accuracy for predicting cardiovascular outcomes were less impressive than gains in performance observed in the data mining literature. PMID:22254181

  3. Does transfusion improve the outcome for HNSCC patients treated with radiotherapy? - Results from the randomized DAHANCA 5 and 7 trials

    DEFF Research Database (Denmark)

    Hoff, Camilla Molich; Lassen, Pernille; Eriksen, Jesper Grau

    2011-01-01

    of transfusion by the results from the randomized DAHANCA 5 trial, including 414 patients in the analysis. Aim of the current analysis was to gain additional power by adding patients from the continued subrandomization in the DAHANCA 7 trial, now including a total of almost 1200 patients. Material and methods...

  4. Clinical outcome scoring of intra-articular calcaneal fractures

    NARCIS (Netherlands)

    Schepers, Tim; Heetveld, Martin J.; Mulder, Paul G. H.; Patka, Peter

    2008-01-01

    Outcome reporting of intra-articular calcaneal fractures is inconsistent. This study aimed to identify the most cited outcome scores in the literature and to analyze their reliability and validity. A systematic literature search identified 34 different outcome scores. The most cited outcome score

  5. Relevance of positive cardiovascular outcome trial results in clinical practice: perspectives from the Academy for Cardiovascular Risk, Outcomes and Safety Studies in Type 2 Diabetes (ACROSS T2D

    Directory of Open Access Journals (Sweden)

    Schernthaner G

    2017-12-01

    Full Text Available Guntram Schernthaner,1 Kamlesh Khunti,2 Chaim Lotan,3 Michel Burnier,4 Heinz Drexel,5 Martin Prázný61Department of Medicine I, Rudolfstiftung Hospital, Vienna, Austria; 2Diabetes Research Centre, Leicester General Hospital, Leicester, UK; 3Cardiovascular Division, Hadassah Medical Centre, Jerusalem, Israel; 4Division of Nephrology and Hypertension Consultation, University Hospital of Lausanne, Lausanne, Switzerland; 5Vorarlberg Institute for Vascular Investigation and Treatment, Feldkirch, Austria; 6Charles University, Prague, Czech RepublicAbstract: Type 2 diabetes (T2D imposes a substantial disease burden, predominantly from cardiovascular disease (CVD, which accounts for >50% of deaths in this population and leads to a 12-year reduction in the life expectancy of a 60-year-old male patient with T2D and CVD compared with the general population. The results from mandatory cardiovascular outcome trials (CVOTs are therefore of great interest in the field. The Academy for Cardiovascular Risk, Outcomes and Safety Studies in Type 2 Diabetes meeting program aims to bring together experts from several associated disciplines to provide fair and balanced resources for those involved in the management of patients with T2D. This publication represents the opinions of the faculty on the key learnings from the meeting held in Vienna in the spring of 2017. In particular, we detail how data from the EMPA-REG OUTCOME® [cardiovascular outcomes trial of empagliflozin] and Liraglutide Effect and Action in Diabetes: Evaluation of Cardiovascular Outcome Results (LEADER® (liraglutide CVOTs can be practically interpreted across clinical specialities. It is hoped that this translation of CVOT data will achieve a dual treatment paradigm for the management of both raised glucose levels and CV risk in patients with T2D. Keywords: type 2 diabetes, cardiovascular disease, CVOT, SGLT2 inhibitors, GLP-1 agonists, DPP-4 inhibitors

  6. Effects of implicit theories of ability and stereotype-inconsistent information on handgrip strength in older adults: A regulatory fit perspective.

    Science.gov (United States)

    Emile, Mélanie; Chalabaev, Aina; Colson, Serge S; Vaulerin, Jerome; Falzon, Charlene; D'Arripe-Longueville, Fabienne

    2017-03-01

    This study examined whether stereotype-inconsistent information interacts with implicit theories of ability to affect handgrip strength in older adults. Eighty-two retired older adults (13 men and 69 women) from 61 to 89 years old (M age = 75.8 years; SD = 6.9) performed maximum voluntary contractions (MVC) during a handgrip task in a design manipulating implicit theories of ability and stereotype-inconsistent information related to physical decline with aging. Participants were randomly assigned to one of three groups: incremental condition, entity condition, or control group. The results showed that in the incremental condition the stereotype-inconsistent information improved the peak MVC, the average MVC, the peak rate of force development (RFD), and RFD in the initial 50 ms of the MVC. This study therefore demonstrated that individuals with an incremental mindset who are exposed to stereotype-inconsistent information can boost their physical performance. These findings are discussed from the perspective of regulatory fit (i.e., when task framing is congruent with the individual's goal). © 2016 The Authors. Psychophysiology published by Wiley Periodicals, Inc. on behalf of Society for Psychophysiological Research.

  7. Can GSTM1 and GSTT1 polymorphisms predict clinical outcomes of chemotherapy in gastric and colorectal cancers? A result based on the previous reports

    Directory of Open Access Journals (Sweden)

    Liu H

    2016-06-01

    Full Text Available Haixia Liu,1,* Wei Shi,2,* Lianli Zhao,3 Dianlu Dai,4 Jinghua Gao,5 Xiangjun Kong6 1Department of Ultrasound, 2Office of Medical Statistics, 3Human Resource Department, 4Department of Surgical Oncology, 5Department of Medical Oncology, 6Central Laboratory, Cangzhou Central Hospital, Yunhe District, Cangzhou, People’s Republic of China *These authors contributed equally to this study and should be considered cofirst authors Background: Gastric and colorectal cancers remain the major causes of cancer-related death. Although chemotherapy improves the prognosis of the patients with gastrointestinal cancers, some patients do not benefit from therapy and are exposed to the adverse effects. The polymorphisms in genes including GSTM1 and GSTT1 have been explored to predict therapeutic efficacy; however, the results were inconsistent and inconclusive. Materials and methods: A systematic review and meta-analysis was performed by searching relevant studies about the association between the GSTM1 and GSTT1 polymorphisms and chemotherapy efficacy in gastrointestinal cancers in databases such as PubMed, EMBASE, Web of Science, Chinese National Knowledge Infrastructure, and Wanfang database up to January 10, 2016. Subgroup analyses were also performed according to ethnicity, cancer type, evaluation criteria, study type, chemotherapy type, and age. Results: A total of 19 articles containing 3,217 cases were finally included. Overall analysis suggested that no significance was found between overall toxicity, neurotoxicity, neutropenia, gastrointestinal toxicity, tumor response, and progression-free survival, and the polymorphisms in GSTM1 and GSTT1, while GSTM1 polymorphism associated with overall survival (OS; hazard ratio =1.213, 95% confidence interval =1.060–1.388, P=0.005. Subgroup analyses suggested that neurotoxicity was associated with GSTM1 polymorphism in the Asian population, neutropenia was associated with GSTM1 polymorphism in palliative

  8. Evaluation of Outcome- Prenatal Diagnosis Indication and Results Suitability in Families Referred to our Laboratory For Prenatal Diagnosis

    Directory of Open Access Journals (Sweden)

    Ayşegül Türkyılmaz

    2007-01-01

    Full Text Available Since our aim is to establish the importance, necessity and concept of prenatal diagnosis in our region and supply routine service at a stage which we admit as a transitional period for application, all of the materials of amniocentesis, cordocentesis and corion villi sample referred to laboratories were evaluated without refusal.When we examined prenatal diagnoses of these specimens, we found Down Risk (according to triple test result in 164 specimens (%34, fetal anomaly risk in 122 (%25, advanced age in 69 (%14 poor-obstetric anamnesis in 27(%5, Down Syndrome- infant history in 20 (%4, family request in 17, and habitual abortus (%3 etc. in specimens. Lymphocyte Culture prepared in duplicate for each specimen and chromosome were obtained from total of ten slides for each specimen. Slides were stained with Giemsa Banding Technic (GTG Banding. Total (10x481 4810 slides were evaluated for diagnosis.There were no false positive and false negative results.

  9. Patient reported out-come in posttraumatic pituitary deficiency: results from The Danish National Study on Posttraumatic Hypopituitarism

    DEFF Research Database (Denmark)

    Klose, Marianne; Krag, Kirstine Stochholm; Janukonyté, Jurgita

    2015-01-01

    . RESULTS: Patients with TBI had significant detriments in QoL. Impairment (mainly physical scales) related to pituitary deficiency, although only partially confirmed after adjustment for demographic differences. Hypogonadotropic hypogonadism related to several QoL scores. Increasing impairments were...... observed with declining total testosterone concentrations (men), but not free testosterone concentrations or any other hormone concentrations. Total testosterone was not independently related to impaired QoL and fatigue, after adjustment for demographics, and treatment with antidiabetics, opioids...

  10. Comparison of Chemistry Learning Outcomes with Inquiry Learning Model and Learning Cycle 5E in Material Solubility and Solubility Multiplication Results

    Directory of Open Access Journals (Sweden)

    Nur Indah Firdausi

    2015-04-01

    Full Text Available Perbandingan Hasil Belajar Kimia dengan Model Pembelajaran Inquiry dan Learning Cycle 5E pada Materi Kelarutan dan Hasil Kali Kelarutan   Abstract: This research is aimed to compare the effectiveness between inquiry and LC 5E in solubility equilibria and the solubility product for students with different prior knowledge. The effectiveness of both learning models is measured from students learning outcome. This quasi experimental research uses factorial2x2 with posttest only design. Research samples are chosen using cluster random sampling. They are two classes of XI IPA SMAN 1 Kepanjen in the 2012/2013 academic year which consist of 31 students in each class. Cognitive learning outcome is measured by test items consist of four objective items and nine subjective items. Technique of data analysis in this research is two way ANOVA. Research results show that: (1 cognitive learning outcome and higher cognitive learning outcome of students in inquiry class is higher than students in LC 5E class; (2 cognitive learning outcome and higher cognitive learning outcome of students who have upper prior knowledge is higher than students who have lower prior knowledge in both inquiry and LC 5E. Key Words: learning outcome, inquiry, learning cycle 5E, solubility equilibria and the solubility product   Abstrak: Penelitian ini bertujuan membandingkan keefektifan model inquiry dan LC 5E pada materi kelarutan dan hasil kali kelarutan untuk siswa dengan kemampuan awal berbeda. Keefektifan model pembelajaran dilihat dari hasil belajar kognitif siswa. Penelitian ini menggunakan rancangan eksperimen semu dengan desain faktorial 2x2. Subjek penelitian dipilih secara cluster random sampling yaitu dua kelas XI IPA SMAN 1 Kepanjen dengan jumlah masing-masing kelas sebanyak 31 siswa. Instrumen perlakuan yang digunakan adalah silabus dan RPP sedangkan instrumen pengukuran berupa soal tes terdiri dari empat soal objektif dan sembilan soal subjektif. Teknik analisis data

  11. A points-based algorithm for prognosticating clinical outcome of Chiari malformation Type I with syringomyelia: results from a predictive model analysis of 82 surgically managed adult patients.

    Science.gov (United States)

    Thakar, Sumit; Sivaraju, Laxminadh; Jacob, Kuruthukulangara S; Arun, Aditya Atal; Aryan, Saritha; Mohan, Dilip; Sai Kiran, Narayanam Anantha; Hegde, Alangar S

    2018-01-01

    OBJECTIVE Although various predictors of postoperative outcome have been previously identified in patients with Chiari malformation Type I (CMI) with syringomyelia, there is no known algorithm for predicting a multifactorial outcome measure in this widely studied disorder. Using one of the largest preoperative variable arrays used so far in CMI research, the authors attempted to generate a formula for predicting postoperative outcome. METHODS Data from the clinical records of 82 symptomatic adult patients with CMI and altered hindbrain CSF flow who were managed with foramen magnum decompression, C-1 laminectomy, and duraplasty over an 8-year period were collected and analyzed. Various preoperative clinical and radiological variables in the 57 patients who formed the study cohort were assessed in a bivariate analysis to determine their ability to predict clinical outcome (as measured on the Chicago Chiari Outcome Scale [CCOS]) and the resolution of syrinx at the last follow-up. The variables that were significant in the bivariate analysis were further analyzed in a multiple linear regression analysis. Different regression models were tested, and the model with the best prediction of CCOS was identified and internally validated in a subcohort of 25 patients. RESULTS There was no correlation between CCOS score and syrinx resolution (p = 0.24) at a mean ± SD follow-up of 40.29 ± 10.36 months. Multiple linear regression analysis revealed that the presence of gait instability, obex position, and the M-line-fourth ventricle vertex (FVV) distance correlated with CCOS score, while the presence of motor deficits was associated with poor syrinx resolution (p ≤ 0.05). The algorithm generated from the regression model demonstrated good diagnostic accuracy (area under curve 0.81), with a score of more than 128 points demonstrating 100% specificity for clinical improvement (CCOS score of 11 or greater). The model had excellent reliability (κ = 0.85) and was validated with

  12. Does transfusion improve the outcome for HNSCC patients treated with radiotherapy? - results from the randomized DAHANCA 5 and 7 trials

    DEFF Research Database (Denmark)

    Hoff, Camilla; Lassen, Pernille; Eriksen, Jesper Grau

    2011-01-01

    Patients with head and neck squamous cell carcinoma (HNSCC) and a low level of hemoglobin often have a poor response to radiation that may be related to hypoxia-induced radioresistance. We have previously published the importance of hemoglobin level and the effect of transfusion by the results fr...... the randomized DAHANCA 5 trial, including 414 patients in the analysis. Aim of the current analysis was to gain additional power by adding patients from the continued subrandomization in the DAHANCA 7 trial, now including a total of almost 1200 patients....

  13. Estimating the Public Health Burden Associated With Adverse Pregnancy Outcomes Resulting From Syphilis Infection Across 43 Countries in Sub-Saharan Africa.

    Science.gov (United States)

    Kuznik, Andreas; Habib, Abdulrazaq G; Manabe, Yukari C; Lamorde, Mohammed

    2015-07-01

    Untreated syphilis in pregnancy is associated with adverse clinical outcomes to the infant. The study aimed to estimate the public health burden resulting from adverse pregnancy outcomes due to syphilis infection among pregnant women not screened for syphilis in 43 countries in sub-Saharan Africa. Estimated country-specific incidence of syphilis was generated from annual number of live births, the proportion of women with at least 1 antenatal care (ANC) visit, the syphilis prevalence rate, and the proportion of women screened for syphilis during ANC.Adverse pregnancy outcome data (stillbirth, neonatal death, low birth weight, and congenital syphilis) were obtained from published sources. Disability-adjusted life-year (DALY) estimates were calculated using undiscounted local life expectancy, the neonatal standard loss function, and relevant disability weights. The model assessed the potential impact of raising ANC coverage to at least 95% and syphilis screening to at least 95% (World Health Organization targets). For all 43 sub-Saharan Africa countries, the estimated incidence of adverse pregnancy outcomes was 205,901 (95% confidence interval [CI], 113,256-383,051) per year, including stillbirth (88,376 [95% CI, 60,854-121,713]), neonatal death (34,959 [95% CI, 23,330-50,076]), low birth weight (22,483 [95% CI, 0-98,847]), and congenital syphilis (60,084 [95% CI, 29,073-112,414]), resulting in approximately 12.5 million DALYs. Countries with the greatest burden are (in DALYs, millions) Democratic Republic of the Congo (1.809), Nigeria (1.598), Ethiopia (1.466), and Tanzania (0.961). Attaining World Health Organization targets could reduce the burden by 8.5 million DALYs. Substantial infant mortality and morbidity results from maternal syphilis infection concentrated in countries with low access to ANC or low rates of syphilis screening.

  14. A simple MRI protocol in patients with clinically suspected appendicitis: results in 138 patients and effect on outcome of appendectomy

    International Nuclear Information System (INIS)

    Cobben, Lodewijk; Groot, Ingrid; Kingma, Lucas; Coerkamp, Emile; Puylaert, Julien; Blickman, Johan

    2009-01-01

    To establish the value of breathhold magnetic resonance imaging (MRI) in the diagnosis of acute appendicitis. Over a 14-month period, 138 patients clinically suspected of having appendicitis were evaluated prospectively with MRI and comprised the study group. Fast turbo spin-echo breathhold T1, T2 and T2 fat suppression sequences were used in coronal and axial planes. The imaging results were recorded separately and subsequently correlated with clinical, radiological and histopathological follow-up. The effect of imaging strategies in patients suspected of appendicitis on hospital resources was calculated. Sixty-two of the 138 patients had a histopathologically proven appendicitis. MRI determined appendicitis in 63 patients, with one examination being false positive. The resulting sensitivity and specificity were 100% and 99%, respectively. MRI showed an alternative diagnosis in 41 of the 75 remaining patients. In 22 of the remaining 34 patients, a normal appendix was depicted with MRI. In two patients, where MRI showed no appendicitis, an alternative diagnosis or normal appendix, an unnecessary appendectomy was performed. The overall effect of using MRI in patients suspected of appendicitis on the use of hospital resources could have been a net saving between EUR 55,746 and EUR 72,534. MRI has a high accuracy in detecting and excluding appendicitis, an alternative diagnosis or showing the normal appendix, and can be a valuable and cost-effective tool in the workup of patients clinically suspected of having appendicitis. (orig.)

  15. A simple MRI protocol in patients with clinically suspected appendicitis: results in 138 patients and effect on outcome of appendectomy

    Energy Technology Data Exchange (ETDEWEB)

    Cobben, Lodewijk [Medisch Centrum Haaglanden, Department of Radiology, Leidschendam (Netherlands); Groot, Ingrid [Medisch Centrum Haaglanden, Department of Surgery, Leidschendam (Netherlands); Kingma, Lucas; Coerkamp, Emile; Puylaert, Julien [Medisch Centrum Haaglanden, Department of Radiology, Den Haag (Netherlands); Blickman, Johan [Universitair Medisch Centrum St Radboud, Department of Radiology, Geert Grooteplein 10, GA, Nijmegen (Netherlands)

    2009-05-15

    To establish the value of breathhold magnetic resonance imaging (MRI) in the diagnosis of acute appendicitis. Over a 14-month period, 138 patients clinically suspected of having appendicitis were evaluated prospectively with MRI and comprised the study group. Fast turbo spin-echo breathhold T1, T2 and T2 fat suppression sequences were used in coronal and axial planes. The imaging results were recorded separately and subsequently correlated with clinical, radiological and histopathological follow-up. The effect of imaging strategies in patients suspected of appendicitis on hospital resources was calculated. Sixty-two of the 138 patients had a histopathologically proven appendicitis. MRI determined appendicitis in 63 patients, with one examination being false positive. The resulting sensitivity and specificity were 100% and 99%, respectively. MRI showed an alternative diagnosis in 41 of the 75 remaining patients. In 22 of the remaining 34 patients, a normal appendix was depicted with MRI. In two patients, where MRI showed no appendicitis, an alternative diagnosis or normal appendix, an unnecessary appendectomy was performed. The overall effect of using MRI in patients suspected of appendicitis on the use of hospital resources could have been a net saving between EUR 55,746 and EUR 72,534. MRI has a high accuracy in detecting and excluding appendicitis, an alternative diagnosis or showing the normal appendix, and can be a valuable and cost-effective tool in the workup of patients clinically suspected of having appendicitis. (orig.)

  16. Alternate Directed Anthropogenic Shifts in Genotype Result in Different Ecological Outcomes in Coho Salmon Oncorhynchus kisutch Fry.

    Directory of Open Access Journals (Sweden)

    Rosalind A Leggatt

    Full Text Available Domesticated and growth hormone (GH transgenic salmon provide an interesting model to compare effects of selected versus engineered phenotypic change on relative fitness in an ecological context. Phenotype in domestication is altered via polygenic selection of traits over multiple generations, whereas in transgenesis is altered by a single locus in one generation. These established and emerging technologies both result in elevated growth rates in culture, and are associated with similar secondary effects such as increased foraging, decreased predator avoidance, and similar endocrine and gene expression profiles. As such, there is concern regarding ecological consequences should fish that have been genetically altered escape to natural ecosystems. To determine if the type of genetic change influences fitness components associated with ecological success outside of the culture environments they were produced for, we examined growth and survival of domesticated, transgenic, and wild-type coho salmon fry under different environmental conditions. In simple conditions (i.e. culture with unlimited food, transgenic fish had the greatest growth, while in naturalized stream tanks (limited natural food, with or without predators domesticated fish had greatest growth and survival of the three fish groups. As such, the largest growth in culture conditions may not translate to the greatest ecological effects in natural conditions, and shifts in phenotype over multiple rather than one loci may result in greater success in a wider range of conditions. These differences may arise from very different historical opportunities of transgenic and domesticated strains to select for multiple growth pathways or counter-select against negative secondary changes arising from elevated capacity for growth, with domesticated fish potentially obtaining or retaining adaptive responses to multiple environmental conditions not yet acquired in recently generated transgenic

  17. One-Year Outcomes Following Directional Atherectomy of Infrapopliteal Artery Lesions: Subgroup Results of the Prospective, Multicenter DEFINITIVE LE Trial.

    Science.gov (United States)

    Rastan, Aljoscha; McKinsey, James F; Garcia, Lawrence A; Rocha-Singh, Krishna J; Jaff, Michael R; Noory, Elias; Zeller, Thomas

    2015-12-01

    To report a subgroup analysis of the prospective, multicenter, single-arm DEFINITIVE LE trial to assess the effectiveness of directional atherectomy for the treatment of infrapopliteal artery lesions at 1 year. In the DEFINITIVE LE trial, follow-up assessments occurred up to 1 year postprocedure. Of the 800 patients enrolled, 145 subjects with 189 infrapopliteal lesions met the criteria for this analysis. Seventy (48.3%) and 75 (51.7%) patients were suffering critical limb ischemia (CLI) and intermittent claudication, respectively; 68.3% (99/145) had diabetes. The mean lesion length was 58±44 mm (all lesions); 20.2% were occluded. The primary endpoint for patients with claudication was duplex ultrasound-derived primary patency, while for subjects with CLI it was freedom from major amputation of the target limb at 1 year. Endpoints and adverse events were independently assessed. Procedure success (≤30% residual stenosis) was achieved in 84% of treated lesions. The 1-year primary patency rate was 84% (claudicants 89.6% and CLI patients 78%, p=0.11), and the freedom from major amputation rate was 97.1% (claudicants 100% and CLI 93.8%, p=0.03). In both claudication and CLI patients, significant improvements in Rutherford category and objective measures of walking distance and quality of life were seen at 1 year in comparison to baseline. This study demonstrates that directional atherectomy in infrapopliteal arteries results in promising technical and clinical results at 1 year for claudicant as well as CLI patients. © The Author(s) 2015.

  18. Inconsistent-handed advantage in episodic memory extends to paragraph-level materials.

    Science.gov (United States)

    Prichard, Eric C; Christman, Stephen D

    2017-09-01

    Past research using handedness as a proxy for functional access to the right hemisphere demonstrates that individuals who are mixed/inconsistently handed outperform strong/consistently handed individuals when performing episodic recall tasks. However, research has generally been restricted to stimuli presented in a list format. In the present paper, we present two studies in which participants were presented with paragraph-level material and then asked to recall material from the passages. The first study was based on a classic study looking at retroactive interference with prose materials. The second was modelled on a classic experiment looking at perspective taking and the content of memory. In both studies, the classic effects were replicated and the general finding that mixed/inconsistent-handers outperform strong/consistent-handers was replicated. This suggests that considering degree of handedness may be an empirically useful means of reducing error variance in paradigms looking at memory for prose level material.

  19. Reliability of self-reported childhood physical abuse by adults and factors predictive of inconsistent reporting.

    Science.gov (United States)

    McKinney, Christy M; Harris, T Robert; Caetano, Raul

    2009-01-01

    Little is known about the reliability of self-reported child physical abuse (CPA) or CPA reporting practices. We estimated reliability and prevalence of self-reported CPA and identified factors predictive of inconsistent CPA reporting among 2,256 participants using surveys administered in 1995 and 2000. Reliability of CPA was fair to moderate (kappa = 0.41). Using a positive report from either survey, the prevalence of moderate (61.8%) and severe (12.0%) CPA was higher than at either survey alone. Compared to consistent reporters of having experienced CPA, inconsistent reporters were less likely to be > or = 30 years old (vs. 18-29) or Black (vs. White) and more likely to have report one type (vs. > or = 2) of CPA. These findings may assist researchers conducting and interpreting studies of CPA.

  20. Causes of the armed conflict in Croatia 1991. Resolving conceptual and methodological inconsistencies

    Directory of Open Access Journals (Sweden)

    Kosta Nikolić

    2016-08-01

    Full Text Available This text is intended to identify, clarify and resolve the most frequent examples of methodological inconsistencies found in the current literature by Serbian and foreign researchers, and to point to their conceptual, methodological and factual inconsistencies. This work follows the basic line of conceptual delimitation concerning the phenomenon of the breakup of Yugoslavia, on one hand, and of the violent conflicts in certain Yugoslav republics, on the other. It is based on the interdisciplinary analysis of the findings in the field of international relations and historical analysis, while relying primarily on the fundamental sources of historical material. Henceforth, this paper will address the issues of correct determining of the main and secondary actors, temporal determination and elements for making a clear and unambiguous definition of the armed conflict in Croatia.

  1. Contemporary management of neonatal alloimmune thrombocytopenia: good outcomes in the intravenous immunoglobulin era: results from the Australian neonatal alloimmune thrombocytopenia registry.

    Science.gov (United States)

    Crighton, Gemma L; Scarborough, Ri; McQuilten, Zoe K; Phillips, Louise E; Savoia, Helen F; Williams, Bronwyn; Holdsworth, Rhonda; Henry, Amanda; Wood, Erica M; Cole, Stephen A

    2017-10-01

    To describe the natural history, antenatal and postnatal therapy, and clinical outcomes of Australian patients with fetomaternal/neonatal alloimmune thrombocytopenia (NAIT) recorded in the Australian NAIT registry. Analysis of registry data of Australian mothers treated antenatally for NAIT and any fetus/newborn with thrombocytopenia (TCP) and maternal human platelet antigen (HPA) antibodies. Ninety four potential cases (91 pregnancies; three twin pregnancies) were registered between December 2004 and September 2015 with 76 confirmed or treated as NAIT. NAIT was frequently unanticipated (44 cases, 58%), whilst 32 cases (42%) were anticipated due to personal or family history. In 70/76 cases, the diagnosis of NAIT was made based on HPA antibody results; anti-HPA-1a was most commonly detected (58/70, 82%), followed by anti-HPA-5b (5/70, 7%). Intracranial haemorrhage (ICH) was detected in seven cases (9%). Maternal antenatal therapy resulted in improved clinical outcomes. For antenatally treated cases, whilst 10/29 (34%) neonates had severe TCP, only one ICH was detected. This study provides data on contemporary "real world" management of Australian mothers and babies with NAIT. Antenatal IVIG therapy was associated with better neonatal outcomes. Maternal side-effects and treatment costs were substantial.

  2. Expressive writing intervention and self-reported physical health out-comes - Results from a nationwide randomized controlled trial with breast cancer patients

    DEFF Research Database (Denmark)

    Jensen-Johansen, Mikael B; O'Toole, Mia S; Christensen, Søren

    2018-01-01

    or a non-cancer topic) or a non-disclosing topic (control). Outcomes were self-reported physical symptoms and healthcare utilization (visits and telephone contacts with GP) 3 and 9 months post-intervention. Potential moderators were repressive coping, alexithymia, rumination, social constraints......The objective was to examine the effect of Expressive Writing Intervention (EWI) on self-reported physical symptoms and healthcare utilization in a nationwide randomized controlled trial with Danish women treated for primary breast cancer, and to explore participant characteristics related......, and writing topic. Results revealed no group by time interaction effects for any outcomes. Moderation analyses showed that 1) low alexithymic women in the EWI group showed larger decreases in GP telephone calls over time than both high alexithymic women and controls and 2) women in the EWI group writing about...

  3. Design description and validation results for the IFMIF High Flux Test Module as outcome of the EVEDA phase

    Directory of Open Access Journals (Sweden)

    F. Arbeiter

    2016-12-01

    Full Text Available During the Engineering Validation and Engineering Design Activities (EVEDA phase (2007-2014 of the International Fusion Materials Irradiation Facility (IFMIF, an advanced engineering design of the High Flux Test Module (HFTM has been developed with the objective to facilitate the controlled irradiation of steel samples in the high flux area directly behind the IFMIF neutron source. The development process addressed included manufacturing techniques, CAD, neutronic, thermal-hydraulic and mechanical analyses complemented by a series of validation activities. Validation included manufacturing of 1:1 parts and mockups, test of prototypes in the FLEX and HELOKA-LP helium loops of KIT for verification of the thermal and mechanical properties, and irradiation of specimen filled capsule prototypes in the BR2 test reactor. The prototyping activities were backed by several R&D studies addressing focused issues like handling of liquid NaK (as filling medium and insertion of Small Specimen Test Technique (SSTT specimens into the irradiation capsules. This paper provides an up-todate design description of the HFTM irradiation device, and reports on the achieved performance criteria related to the requirements. Results of the validation activities are accounted for and the most important issues for further development are identified.

  4. An inconclusive study comparing the effect of concrete and abstract descriptions of belief-inconsistent information.

    Science.gov (United States)

    Collins, Katherine A; Clément, Richard

    2018-01-01

    Linguistic bias is the differential use of linguistic abstraction (as defined by the Linguistic Category Model) to describe the same behaviour for members of different groups. Essentially, it is the tendency to use concrete language for belief-inconsistent behaviours and abstract language for belief-consistent behaviours. Having found that linguistic bias is produced without intention or awareness in many contexts, researchers argue that linguistic bias reflects, reinforces, and transmits pre-existing beliefs, thus playing a role in belief maintenance. Based on the Linguistic Category Model, this assumes that concrete descriptions reduce the impact of belief-inconsistent behaviours while abstract descriptions maximize the impact of belief-consistent behaviours. However, a key study by Geschke, Sassenberg, Ruhrmann, and Sommer [2007] found that concrete descriptions of belief-inconsistent behaviours actually had a greater impact than abstract descriptions, a finding that does not fit easily within the linguistic bias paradigm. Abstract descriptions (e.g. the elderly woman is athletic) are, by definition, more open to interpretation than concrete descriptions (e.g. the elderly woman works out regularly). It is thus possible that abstract descriptions are (1) perceived as having less evidentiary strength than concrete descriptions, and (2) understood in context (i.e. athletic for an elderly woman). In this study, the design of Geschke et al. [2007] was modified to address this possibility. We expected that the differences in the impact of concrete and abstract descriptions would be reduced or reversed, but instead we found that differences were largely absent. This study did not support the findings of Geschke et al. [2007] or the linguistic bias paradigm. We encourage further attempts to understand the strong effect of concrete descriptions for belief-inconsistent behaviour.

  5. VIPER:a visualisation tool for exploring inheritance inconsistencies in genotyped pedigrees

    OpenAIRE

    Paterson, Trevor; Graham, Martin; Kennedy, Jessie; Law, Andy

    2012-01-01

    Background Pedigree genotype datasets are used for analysing genetic inheritance and to map genetic markers and traits. Such datasets consist of hundreds of related animals genotyped for thousands of genetic markers and invariably contain multiple errors in both the pedigree structure and in the associated individual genotype data. These errors manifest as apparent inheritance inconsistencies in the pedigree, and invalidate analyses of marker inheritance patterns across the dataset. Cleaning ...

  6. Social, demographic and situational characteristics associated with inconsistent use of oral contraceptives: evidence from France.

    OpenAIRE

    Moreau, Caroline; BOUYER, Jean; Gilbert, Fabien; Group, Cocon; Bajos, Nathalie

    2006-01-01

    The COCON group includes : Beatrice Ducot, Michèle Ferrand, Danielle Hassoun, Nadine Job-Spira, Monique Kaminski, Nathalie Lelong, Henri Leridon, Nicolas Razafindratsima, Clementine Rossier and Josiane Warszawski.; CONTEXT: Oral contraceptives are the most popular form of reversible contraception used in developed countries. Their efficacy depends on how consistently and correctly they are used. METHODS: The incidence of inconsistent pill use was estimated from data from a random sample of 1,...

  7. An inconclusive study comparing the effect of concrete and abstract descriptions of belief-inconsistent information.

    Directory of Open Access Journals (Sweden)

    Katherine A Collins

    Full Text Available Linguistic bias is the differential use of linguistic abstraction (as defined by the Linguistic Category Model to describe the same behaviour for members of different groups. Essentially, it is the tendency to use concrete language for belief-inconsistent behaviours and abstract language for belief-consistent behaviours. Having found that linguistic bias is produced without intention or awareness in many contexts, researchers argue that linguistic bias reflects, reinforces, and transmits pre-existing beliefs, thus playing a role in belief maintenance. Based on the Linguistic Category Model, this assumes that concrete descriptions reduce the impact of belief-inconsistent behaviours while abstract descriptions maximize the impact of belief-consistent behaviours. However, a key study by Geschke, Sassenberg, Ruhrmann, and Sommer [2007] found that concrete descriptions of belief-inconsistent behaviours actually had a greater impact than abstract descriptions, a finding that does not fit easily within the linguistic bias paradigm. Abstract descriptions (e.g. the elderly woman is athletic are, by definition, more open to interpretation than concrete descriptions (e.g. the elderly woman works out regularly. It is thus possible that abstract descriptions are (1 perceived as having less evidentiary strength than concrete descriptions, and (2 understood in context (i.e. athletic for an elderly woman. In this study, the design of Geschke et al. [2007] was modified to address this possibility. We expected that the differences in the impact of concrete and abstract descriptions would be reduced or reversed, but instead we found that differences were largely absent. This study did not support the findings of Geschke et al. [2007] or the linguistic bias paradigm. We encourage further attempts to understand the strong effect of concrete descriptions for belief-inconsistent behaviour.

  8. Family-Specific Investments and Divorce: A Theory of Dynamically Inconsistent Household Behavior

    OpenAIRE

    Anderberg, Dan; Rainer, Helmut; Roeder, Kerstin

    2016-01-01

    This paper bridges two distinct areas of inquiry: the economic theory of the family and behavioral research on time-inconsistent preferences. In our model, hyperbolic discounting couples engage in household production activities, thereby accumulating family-specific capital over time. At any given point in time, the gains to continued marriage depend on the accumulated stock of this capital and a temporary random shock to match quality. Couples whose match quality deteriorates may choose to d...

  9. Importance of Local Control in Early-Stage Prostate Cancer: Outcomes of Patients With Positive Post-Radiation Therapy Biopsy Results Treated in RTOG 9408

    International Nuclear Information System (INIS)

    Krauss, Daniel J.; Hu, Chen; Bahary, Jean-Paul; Souhami, Luis; Gore, Elizabeth M.; Chafe, Susan Maria Jacinta; Leibenhaut, Mark H.; Narayan, Samir; Torres-Roca, Javier; Michalski, Jeff; Zeitzer, Kenneth L.; Donavanik, Viroon; Sandler, Howard; McGowan, David G.; Jones, Christopher U.; Shipley, William U.

    2015-01-01

    Purpose: The purpose of this study was to assess the association between positive post-radiation therapy (RT) biopsy results and subsequent clinical outcomes in males with localized prostate cancer. Methods and Materials: Radiation Therapy Oncology Group study 94-08 analyzed 1979 males with prostate cancer, stage T1b-T2b and prostate-specific antigen concentrations of ≤20 ng/dL, to investigate whether 4 months of total androgen suppression (TAS) added to RT improved survival compared to RT alone. Patients randomized to receive TAS received flutamide with luteinizing hormone releasing hormone (LHRH) agonist. According to protocol, patients without evidence of clinical recurrence or initiation of additional endocrine therapy underwent repeat prostate biopsy 2 years after RT completion. Statistical analysis was performed to evaluate the impact of positive post-RT biopsy results on clinical outcomes. Results: A total of 831 patients underwent post-RT biopsy, 398 were treated with RT alone and 433 with RT plus TAS. Patients with positive post-RT biopsy results had higher rates of biochemical failure (hazard ratio [HR] = 1.7; 95% confidence interval [CI] = 1.3-2.1) and distant metastasis (HR = 2.4; 95% CI = 1.3-4.4) and inferior disease-specific survival (HR = 3.8; 95% CI = 1.9-7.5). Positive biopsy results remained predictive of such outcomes after correction for potential confounders such as Gleason score, tumor stage, and TAS administration. Prior TAS therapy did not prevent elevated risk of adverse outcome in the setting of post-RT positive biopsy results. Patients with Gleason score ≥7 with a positive biopsy result additionally had inferior overall survival compared to those with a negative biopsy result (HR = 1.56; 95% CI = 1.04-2.35). Conclusions: Positive post-RT biopsy is associated with increased rates of distant metastases and inferior disease-specific survival in patients treated with definitive RT and was associated with inferior overall

  10. Does the World Health Organization histological classification predict outcomes after thymomectomy? Results of a multicentre study on 750 patients.

    Science.gov (United States)

    Guerrera, Francesco; Rendina, Erino Angelo; Venuta, Federico; Margaritora, Stefano; Ciccone, Anna Maria; Novellis, Pierluigi; Novero, Domenico; Anile, Marco; Bora, Giulia; Rena, Ottavio; Casadio, Caterina; Mussi, Alfredo; Evangelista, Andrea; Ruffini, Enrico; Lucchi, Marco; Filosso, Pier Luigi

    2015-07-01

    The World Health Organization (WHO) thymoma histological classification clinical value remains a controversy. In this study, we evaluated its prognostic significance in patients with thymoma treated with radical intent. Six high-volume Italian Thoracic Surgery Institutions collaborated with their own retrospective anonymized datasets. Demographic, clinical, pathological and treatment data were examined. A WHO histological classification (WHO-HC) collapsed scheme (A/AB and B1/B2 types merged) was proposed and compared with the traditional one. Predictors of survival were assessed using a Cox model with shared frailty. Competing-risk regression models were performed to identify the association between individual factors and freedom from recurrence. Between 1990 and 2011, 750 thymomas were operated on in participating centres. Myasthenia gravis was observed in 363 (48%) patients. A complete resection was achieved in 676 (91%) cases. One hundred and nine patients (15%) had a WHO-HC A type, 166 (22%) AB, 179 (24%) B1, 158 (21%) B2 and 135 (18%) B3. The rate of 5-year OS and cumulative incidence of recurrence for all cases was 91% and 0.11, respectively. Five-year survival rates by WHO-HC in the collapsed scheme were A/AB 93%, early-B 90% and advanced-B 85%. Masaoka stage only was demonstrated to be an independent predictor for survival and recurrence. The WHO-collapsed scheme showed a trend in influencing recurrence overall survival development (hazard ratio: 1.32; P = 0.16). Our results show evidence of lack of significance by WHO-HC in influencing prognosis, even though the proposed collapsed scheme revealed a fair stratification of risk to relapses and better correlation with patients' clinical characteristics. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  11. Different Mechanisms of Soil Microbial Response to Global Change Result in Different Outcomes in the MIMICS-CN Model

    Science.gov (United States)

    Kyker-Snowman, E.; Wieder, W. R.; Grandy, S.

    2017-12-01

    Microbial-explicit models of soil carbon (C) and nitrogen (N) cycling have improved upon simulations of C and N stocks and flows at site-to-global scales relative to traditional first-order linear models. However, the response of microbial-explicit soil models to global change factors depends upon which parameters and processes in a model are altered by those factors. We used the MIcrobial-MIneral Carbon Stabilization Model with coupled N cycling (MIMICS-CN) to compare modeled responses to changes in temperature and plant inputs at two previously-modeled sites (Harvard Forest and Kellogg Biological Station). We spun the model up to equilibrium, applied each perturbation, and evaluated 15 years of post-perturbation C and N pools and fluxes. To model the effect of increasing temperatures, we independently examined the impact of decreasing microbial C use efficiency (CUE), increasing the rate of microbial turnover, and increasing Michaelis-Menten kinetic rates of litter decomposition, plus several combinations of the three. For plant inputs, we ran simulations with stepwise increases in metabolic litter, structural litter, whole litter (structural and metabolic), or labile soil C. The cumulative change in soil C or N varied in both sign and magnitude across simulations. For example, increasing kinetic rates of litter decomposition resulted in net releases of both C and N from soil pools, while decreasing CUE produced short-term increases in respiration but long-term accumulation of C in litter pools and shifts in soil C:N as microbial demand for C increased and biomass declined. Given that soil N cycling constrains the response of plant productivity to global change and that soils generate a large amount of uncertainty in current earth system models, microbial-explicit models are a critical opportunity to advance the modeled representation of soils. However, microbial-explicit models must be improved by experiments to isolate the physiological and stoichiometric

  12. Health, Social, and Economic Outcomes Experienced by Families as a Result of Receiving Assistance from a Community-Based Diaper Bank.

    Science.gov (United States)

    Massengale, Kelley E C; Erausquin, Jennifer Toller; Old, Michelle

    2017-10-01

    Objectives This paper aims to describe low-income recipients of a community-based diaper bank and the multiple daily challenges they face. Our paper seeks to document the health, social, and financial outcomes recipients experienced after receiving assistance. Methods We surveyed families (n = 150) about their experiences receiving diapers from a diaper bank in the southeastern United States. Additionally, we conducted short, focused interviews with families (n = 15) about outcomes after receiving diapers. Results Families experience regularly a range of challenges meeting basic needs. These difficulties include high unmet needs for transportation, food, and nonfood essentials such as personal hygiene items. Families experiencing the greatest difficulty in paying utility or medical bills were significantly more likely to have a high level of diaper need compared to families facing these challenges less often (AORs ranging from 3.40 to 9.39). As a result of receiving diapers, families reported positive health, social, and economic outcomes. Families reported positive changes in parental mood; improved child health and happiness; increased opportunities for childcare, work, and school attendance; and the ability to divert household finances toward other basic needs, including utilities and medical care. Conclusions for Practice The monetary value of the supplemental provision of diapers is a small investment in affected families' economic, social, and health outcomes. The positive effects continue far longer than the diapers provided. We demonstrate the social value of such an operation, and recommend the expansion of federal, state, and local safety net programs to help low-income families secure a steady supply of diapers.

  13. Need for cognition moderates paranormal beliefs and magical ideation in inconsistent-handers.

    Science.gov (United States)

    Prichard, Eric C; Christman, Stephen D

    2016-01-01

    A growing literature suggests that degree of handedness predicts gullibility and magical ideation. Inconsistent-handers (people who use their non-dominant hand for at least one common manual activity) report more magical ideation and are more gullible. The current study tested whether this effect is moderated by need for cognition. One hundred eighteen university students completed questionnaires assessing handedness, self-reported paranormal beliefs, and self-reported need for cognition. Handedness (Inconsistent vs. Consistent Right) and Need for Cognition (High vs. Low) were treated as categorical predictors. Both paranormal beliefs and magical ideation served as dependent variable's in separate analyses. Neither set of tests yielded main effects for handedness or need for cognition. However, there were a significant handedness by need for cognition interactions. Post-hoc comparisons revealed that low, but not high, need for cognition inconsistent-handers reported relatively elevated levels of paranormal belief and magical ideation. A secondary set of tests treating the predictor variables as continuous instead of categorical obtained the same overall pattern.

  14. Inconsistency in the average hydraulic models used in nuclear reactor design and safety analysis

    Energy Technology Data Exchange (ETDEWEB)

    Park, Jee Won; Roh, Gyu Hong; Choi, Hang Bok [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of)

    1997-12-31

    One of important inconsistencies in the six-equation model predictions has been found to be the force experienced by a single bubble placed in a convergent stream of liquid. Various sets of governing equations yield different amount of forces to hold the bubble stationary in a convergent nozzle. By using the first order potential flow theory, it is found that the six-equation model can not be used to estimate the force experienced by a deformed bubble. The theoretical value of the particle stress of a bubble in a convergent nozzle flow has been found to be a function of the Weber number when bubble distortion is allowed. This force has been calculated by using different sets of governing equations and compared with the theoretical value. It is suggested in this study that the bubble size distribution function can be used to remove the presented inconsistency by relating the interfacial variables with different moments of the bubble size distribution function. This study also shows that the inconsistencies in the thermal-hydraulic governing equation can be removed by mechanistic modeling of the phasic interface. 11 refs., 3 figs. (Author)

  15. Inconsistency in the average hydraulic models used in nuclear reactor design and safety analysis

    Energy Technology Data Exchange (ETDEWEB)

    Park, Jee Won; Roh, Gyu Hong; Choi, Hang Bok [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of)

    1998-12-31

    One of important inconsistencies in the six-equation model predictions has been found to be the force experienced by a single bubble placed in a convergent stream of liquid. Various sets of governing equations yield different amount of forces to hold the bubble stationary in a convergent nozzle. By using the first order potential flow theory, it is found that the six-equation model can not be used to estimate the force experienced by a deformed bubble. The theoretical value of the particle stress of a bubble in a convergent nozzle flow has been found to be a function of the Weber number when bubble distortion is allowed. This force has been calculated by using different sets of governing equations and compared with the theoretical value. It is suggested in this study that the bubble size distribution function can be used to remove the presented inconsistency by relating the interfacial variables with different moments of the bubble size distribution function. This study also shows that the inconsistencies in the thermal-hydraulic governing equation can be removed by mechanistic modeling of the phasic interface. 11 refs., 3 figs. (Author)

  16. Mistakes and inconsistencies regarding adsorption of contaminants from aqueous solutions: A critical review.

    Science.gov (United States)

    Tran, Hai Nguyen; You, Sheng-Jie; Hosseini-Bandegharaei, Ahmad; Chao, Huan-Ping

    2017-09-01

    In recent years, adsorption science and technology for water and wastewater treatment has attracted substantial attention from the scientific community. However, the number of publications containing inconsistent concepts is increasing. Many publications either reiterate previously discussed mistakes or create new mistakes. The inconsistencies are reflected by the increasing publication of certain types of article in this field, including "short communications", "discussions", "critical reviews", "comments", "letters to the editor", and "correspondence (comment/rebuttal)". This article aims to discuss (1) the inaccurate use of technical terms, (2) the problem associated with quantities for measuring adsorption performance, (3) the important roles of the adsorbate and adsorbent pK a , (4) mistakes related to the study of adsorption kinetics, isotherms, and thermodynamics, (5) several problems related to adsorption mechanisms, (6) inconsistent data points in experimental data and model fitting, (7) mistakes in measuring the specific surface area of an adsorbent, and (8) other mistakes found in the literature. Furthermore, correct expressions and original citations of the relevant models (i.e., adsorption kinetics and isotherms) are provided. The authors hope that this work will be helpful for readers, researchers, reviewers, and editors who are interested in the field of adsorption studies. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Correlates of Inconsistent Refusal of Unprotected Sex among Armenian Female Sex Workers

    Directory of Open Access Journals (Sweden)

    Karine Markosyan

    2014-01-01

    Full Text Available This cross-sectional study assessed the prevalence and correlates of inconsistent refusal of unprotected sex among female sex workers (FSWs in Armenia. One hundred and eighteen street-based FSWs between the ages of 20 and 52 completed a questionnaire assessing FSWs’ demographic, psychosocial, and behavioral characteristics. A total of 52.5% (n=62 of FSWs reported inconsistent refusal of unprotected sex with clients in the past 3 months. Logistic regression analysis controlling for participants’ age and education revealed that perceiving more barriers toward condom use (AOR = 1.1; P<0.01, reporting more types of abuse (AOR = 2.1; P<0.01, and setting lower fees for service (AOR = 0.9; P=0.02 significantly predicted inconsistent refusal of unprotected sex. HIV-risk-reduction behavioral interventions tailored to FSWs working in Yerevan Armenia should address the factors identified in this study toward the goal of enhancing refusal of unprotected sex and ultimately preventing acquisition of sexually transmitted infections (STIs including HIV.

  18. Thyroglobulin (Tg) Testing Revisited: Tg Assays, TgAb Assays, and Correlation of Results With Clinical Outcomes.

    Science.gov (United States)

    Netzel, Brian C; Grebe, Stefan K G; Carranza Leon, B Gisella; Castro, M Regina; Clark, Penelope M; Hoofnagle, Andrew N; Spencer, Carole A; Turcu, Adina F; Algeciras-Schimnich, Alicia

    2015-08-01

    Measurement of thyroglobulin (Tg) by mass spectrometry (Tg-MS) is emerging as a tool for accurate Tg quantification in patients with anti-Tg autoantibodies (TgAbs). The objective of the study was to perform analytical and clinical evaluations of two Tg-MS assays in comparison with immunometric Tg assays (Tg-IAs) and Tg RIAs (Tg-RIAs) in a cohort of thyroid cancer patients. A total of 589 samples from 495 patients, 243 TgAb-/252 TgAb+, were tested by Beckman, Roche, Siemens-Immulite, and Thermo-Brahms Tg and TgAb assays, two Tg-RIAs, and two Tg-MS assays. The frequency of TgAb+ was 58%, 41%, 27%, and 39% for Roche, Beckman, Siemens-Immulite, and Thermo-Brahms, respectively. In TgAb- samples, clinical sensitivities and specificities of 100% and 74%-100%, respectively, were observed across all assays. In TgAb+ samples, all Tg-IAs demonstrated assay-dependent Tg underestimation, ranging from 41% to 86%. In TgAb+ samples, the use of a common cutoff (0.5 ng/mL) for the Tg-MS, three Tg-IAs, and the USC-RIA improved the sensitivity for the Tg-MSs and Tg-RIAs when compared with the Tg-IAs. In up to 20% of TgAb+ cases, Tg-IAs failed to detect Tg that was detectable by Tg-MS. In Tg-RIAs false-high biases were observed in TgAb+ samples containing low Tg concentrations. Tg-IAs remain the method of choice for Tg quantitation in TgAb- patients. In TgAb+ patients with undetectable Tg by immunometric assay, the Tg-MS will detect Tg in up to 20% additional cases. The Tg-RIA will detect Tg in approximately 35% cases, but a significant proportion of these will be clinical false-positive results. The undetectable Tg-MS seen in approximately 40% of TgAb+ cases in patients with disease need further evaluation.

  19. Experiences and outcomes of maternal Ramadan fasting during pregnancy: results from a sub-cohort of the Born in Bradford birth cohort study.

    Science.gov (United States)

    Petherick, Emily S; Tuffnell, Derek; Wright, John

    2014-09-26

    compared to their non-fasting peers. Fasting was not found to be associated with adverse birth outcomes in this sample although these results require confirmation using reported fasting data in a larger sample before the safety of fasting during pregnancy can be established.

  20. Surgery for the correction of hallux valgus: minimum five-year results with a validated patient-reported outcome tool and regression analysis.

    Science.gov (United States)

    Chong, A; Nazarian, N; Chandrananth, J; Tacey, M; Shepherd, D; Tran, P

    2015-02-01

    This study sought to determine the medium-term patient-reported and radiographic outcomes in patients undergoing surgery for hallux valgus. A total of 118 patients (162 feet) underwent surgery for hallux valgus between January 2008 and June 2009. The Manchester-Oxford Foot Questionnaire (MOXFQ), a validated tool for the assessment of outcome after surgery for hallux valgus, was used and patient satisfaction was sought. The medical records and radiographs were reviewed retrospectively. At a mean of 5.2 years (4.7 to 6.0) post-operatively, the median combined MOXFQ score was 7.8 (IQR:0 to 32.8). The median domain scores for pain, walking/standing, and social interaction were 10 (IQR: 0 to 45), 0 (IQR: 0 to 32.1) and 6.3 (IQR: 0 to 25) respectively. A total of 119 procedures (73.9%, in 90 patients) were reported as satisfactory but only 53 feet (32.7%, in 43 patients) were completely asymptomatic. The mean (SD) correction of hallux valgus, intermetatarsal, and distal metatarsal articular angles was 18.5° (8.8°), 5.7° (3.3°), and 16.6° (8.8°), respectively. Multivariable regression analysis identified that an American Association of Anesthesiologists grade of >1 (Incident Rate Ratio (IRR) = 1.67, p-value = 0.011) and recurrent deformity (IRR = 1.77, p-value = 0.003) were associated with significantly worse MOXFQ scores. No correlation was found between the severity of deformity, the type, or degree of surgical correction and the outcome. When using a validated outcome score for the assessment of outcome after surgery for hallux valgus, the long-term results are worse than expected when compared with the short- and mid-term outcomes, with 25.9% of patients dissatisfied at a mean follow-up of 5.2 years. ©2015 The British Editorial Society of Bone & Joint Surgery.

  1. Reconciling apparent inconsistencies in estimates of terrestrial CO2 sources and sinks

    International Nuclear Information System (INIS)

    House, J.I.; Prentice, I.C.; Heimann, M.; Ramankutty, N.

    2003-01-01

    The magnitude and location of terrestrial carbon sources and sinks remains subject to large uncertainties. Estimates of terrestrial CO 2 fluxes from ground-based inventory measurements typically find less carbon uptake than inverse model calculations based on atmospheric CO 2 measurements, while a wide range of results have been obtained using models of different types. However, when full account is taken of the processes, pools, time scales and geographic areas being measured, the different approaches can be understood as complementary rather than inconsistent, and can provide insight as to the contribution of various processes to the terrestrial carbon budget. For example, quantitative differences between atmospheric inversion model estimates and forest inventory estimates in northern extratropical regions suggest that carbon fluxes to soils (often not accounted for in inventories), and into non-forest vegetation, may account for about half of the terrestrial uptake. A consensus of inventory and inverse methods indicates that, in the 1980s, northern extratropical land regions were a large net sink of carbon, and the tropics were approximately neutral (albeit with high uncertainty around the central estimate of zero net flux). The terrestrial flux in southern extratropical regions was small. Book-keeping model studies of the impacts of land-use change indicated a large source in the tropics and almost zero net flux for most northern extratropical regions; similar land use change impacts were also recently obtained using process-based models. The difference between book-keeping land-use change model studies and inversions or inventories was previously interpreted as a 'missing' terrestrial carbon uptake. Land-use change studies do not account for environmental or many management effects (which are implicitly included in inventory and inversion methods). Process-based model studies have quantified the impacts of CO 2 fertilisation and climate change in addition to

  2. The effect of a health promotion intervention for construction workers on work-related outcomes: results from a randomized controlled trial.

    Science.gov (United States)

    Viester, Laura; Verhagen, Evert A L M; Bongers, Paulien M; van der Beek, Allard J

    2015-08-01

    The objective of the present study is to investigate the effects of a worksite health promotion intervention on musculoskeletal symptoms, physical functioning, work ability, work-related vitality, work performance, and sickness absence. In a randomized controlled design, 314 construction workers were randomized into an intervention group (n = 162) receiving personal coaching, tailored information, and materials, and a control group (n = 152) receiving usual care. Sickness absence was recorded continuously in company records, and questionnaires were completed before, directly after the 6-month intervention period, and 12 months after baseline measurements. Linear and logistic regression analyses were performed to determine intervention effects. No significant changes at 6 or 12 months of follow-up were observed in musculoskeletal symptoms, physical functioning, work ability, work-related vitality, work performance, and sickness absence as a result of the intervention. This study shows that the intervention was not statistically significantly effective on secondary outcomes. Although the intervention improved physical activity, dietary, and weight-related outcomes, it was not successful in decreasing musculoskeletal symptoms and improving other work-related measures. Presumably, more multifaceted interventions are required to establish significant change in these outcomes.

  3. Predicting sugar-sweetened behaviours with theory of planned behaviour constructs: Outcome and process results from the SIPsmartER behavioural intervention

    Science.gov (United States)

    Zoellner, Jamie M.; Porter, Kathleen J.; Chen, Yvonnes; Hedrick, Valisa E.; You, Wen; Hickman, Maja; Estabrooks, Paul A.

    2017-01-01

    Objective Guided by the theory of planned behaviour (TPB) and health literacy concepts, SIPsmartER is a six-month multicomponent intervention effective at improving SSB behaviours. Using SIPsmartER data, this study explores prediction of SSB behavioural intention (BI) and behaviour from TPB constructs using: (1) cross-sectional and prospective models and (2) 11 single-item assessments from interactive voice response (IVR) technology. Design Quasi-experimental design, including pre- and post-outcome data and repeated-measures process data of 155 intervention participants. Main Outcome Measures Validated multi-item TPB measures, single-item TPB measures, and self-reported SSB behaviours. Hypothesised relationships were investigated using correlation and multiple regression models. Results TPB constructs explained 32% of the variance cross sectionally and 20% prospectively in BI; and explained 13–20% of variance cross sectionally and 6% prospectively. Single-item scale models were significant, yet explained less variance. All IVR models predicting BI (average 21%, range 6–38%) and behaviour (average 30%, range 6–55%) were significant. Conclusion Findings are interpreted in the context of other cross-sectional, prospective and experimental TPB health and dietary studies. Findings advance experimental application of the TPB, including understanding constructs at outcome and process time points and applying theory in all intervention development, implementation and evaluation phases. PMID:28165771

  4. Continuous intra-arterial nimodipine infusion in patients with severe refractory cerebral vasospasm after aneurysmal subarachnoid hemorrhage: a feasibility study and outcome results.

    Science.gov (United States)

    Bele, Sylvia; Proescholdt, Martin A; Hochreiter, Andreas; Schuierer, Gerhard; Scheitzach, Judith; Wendl, Christina; Kieninger, Martin; Schneiker, Andre; Bründl, Elisabeth; Schödel, Petra; Schebesch, Karl-Michael; Brawanski, Alexander

    2015-12-01

    Severe cerebral vasospasm is a major cause of death and disability in patients with aneurysmal subarachnoid hemorrhage. No causative treatment is yet available and hypertensive hypervolemic therapy (HHT) is often insufficient to avoid delayed cerebral ischemia and neurological deficits. We compared patients receiving continuous intra-arterial infusion of the calcium-antagonist nimodipine with a historical group treated with HHT and oral nimodipine alone. Between 0.5 and 1.2 mg/h of nimodipine were continuously administered by intra-arterial infusion via microcatheters either into the internal carotid or vertebral artery or both, depending on the areas of vasospasm. The effect was controlled via multimodal neuromonitoring and transcranial Doppler sonography. Outcome was determined by means of the Glasgow Outcome Scale at discharge and 6 months after the hemorrhage and compared to a historical control group. Twenty-one patients received 28 intra-arterial nimodipine infusions. Six months after discharge, the occurrence of cerebral infarctions was significantly lower (42.6 %) in the nimodipine group than in the control group (75.0 %). This result was reflected by a significantly higher proportion (76.0 %) of patients with good outcome in the nimodipine-treated group, when compared to 10.0 % good outcome in the control group. Median GOS was 4 in the nimodipine group and 2 in the control group (p = 0.001). Continuous intra-arterial nimodipine infusion is an effective treatment for patients with severe cerebral vasospasm who fail to respond to HHT and oral nimodipine alone. Key to the effective administration of continuous intra-arterial nimodipine is multimodal neuromonitoring and the individual adaptation of dosage and time of infusion for each patient.

  5. Speech Inconsistency in Children with Childhood Apraxia of Speech, Language Impairment, and Speech Delay: Depends on the Stimuli

    Science.gov (United States)

    Iuzzini-Seigel, Jenya; Hogan, Tiffany P.; Green, Jordan R.

    2017-01-01

    Purpose: The current research sought to determine (a) if speech inconsistency is a core feature of childhood apraxia of speech (CAS) or if it is driven by comorbid language impairment that affects a large subset of children with CAS and (b) if speech inconsistency is a sensitive and specific diagnostic marker that can differentiate between CAS and…

  6. Response inconsistency of patient-reported symptoms as a predictor of discrepancy between patient and clinician reported depression severity

    NARCIS (Netherlands)

    Conijn, J.M.; Emons, W.H.M.; Page, B.F.; Sijtsma, K.; van der Does, W.; Carlier, I.V.; Giltay, E.J.

    2018-01-01

    The aim of this study was to assess the extent to which discrepancy between self-reported and clinician-rated severity of depression are due to inconsistent self-reports. Response inconsistency threatens the validity of the test score. We used data from a large sample of outpatients (N = 5,959) who

  7. 41 CFR 102-75.275 - Who determines whether the proposed disposal would create or maintain a situation inconsistent...

    Science.gov (United States)

    2010-07-01

    ... the proposed disposal would create or maintain a situation inconsistent with antitrust laws? 102-75... Real Property Disposal Applicability of Antitrust Laws § 102-75.275 Who determines whether the proposed disposal would create or maintain a situation inconsistent with antitrust laws? The Attorney General...

  8. Cognitively-Impaired-Not-Demented Status Moderates the Time-Varying Association between Finger Tapping Inconsistency and Executive Performance.

    Science.gov (United States)

    Halliday, Drew W R; Stawski, Robert S; MacDonald, Stuart W S

    2017-02-01

    Response time inconsistency (RTI) in cognitive performance predicts deleterious health outcomes in late-life; however, RTI estimates are often confounded by additional influences (e.g., individual differences in learning). Finger tapping is a basic sensorimotor measure largely independent of higher-order cognition that may circumvent such confounds of RTI estimates. We examined the within-person coupling of finger-tapping mean and RTI on working memory, and the moderation of these associations by cognitive status. A total of 262 older adults were recruited and classified as controls, cognitively-impaired-not-demented (CIND) unstable or CIND stable. Participants completed finger-tapping and working-memory tasks during multiple weekly assessments, repeated annually for 4 years. Within-person coupling estimates from multilevel models indicated that on occasions when RTI was greater, working-memory response latency was slower for the CIND-stable, but not for the CIND-unstable or control individuals. The finger-tapping task shows potential for minimizing confounds on RTI estimates, and for yielding RTI estimates sensitive to central nervous system function and cognitive status. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  9. Early predictors of the long-term outcome of low back pain - results of a 22-year prospective cohort study from general practice

    DEFF Research Database (Denmark)

    Lonnberg, F.; Pedersen, P.; Siersma, V.

    2010-01-01

    , use of painkillers for low back pain, use of health care providers, impairments due to low back pain and unfitness for work caused by low back pain. The influence of the predictors was assessed by relative risks. RESULTS: After 22 years, four out of five patients still experienced low back pain....... The perception of poor working conditions correlates with recurrent low back pain, intake of painkillers and limitations to daily life. CONCLUSION: Compared with pain history and clinical findings, the perception of workload is a better predictor of the long-term outcome of low back pain Udgivelsesdato: 2010/8/3...

  10. Reporting clinical outcomes of breast reconstruction: a systematic review.

    Science.gov (United States)

    Potter, S; Brigic, A; Whiting, P F; Cawthorn, S J; Avery, K N L; Donovan, J L; Blazeby, J M

    2011-01-05

    Breast reconstruction after mastectomy for cancer requires accurate evaluation to inform evidence-based participatory decision making, but the standards of outcome reporting after breast reconstruction have not previously been considered. We used extensive searches to identify articles reporting surgical outcomes of breast reconstruction. We extracted data using published criteria for complication reporting modified to reflect reconstructive practice. Study designs included randomized controlled trials, cohort studies, and case series. The Cochrane Risk of Bias tool was used to critically appraise all study designs. Other criteria used to assess the studies were selection and funding bias, statistical power calculations, and institutional review board approval. Wilcoxon signed rank tests were used to compare the breadth and frequency of study outcomes, and χ² tests were used to compare the number of studies in each group reporting each of the published criteria. All statistical tests were two-sided. Surgical complications following breast reconstruction in 42,146 women were evaluated in 134 studies. These included 11 (8.2%) randomized trials, 74 (55.2%) cohort studies, and 49 (36.6%) case series. Fifty-three percent of studies demonstrated a disparity between methods and results in the numbers of complications reported. Complications were defined by 87 (64.9%) studies and graded by 78 (58.2%). Details such as the duration of follow-up and risk factors for adverse outcomes were omitted from 47 (35.1%) and 58 (43.3%) studies, respectively. Overall, the studies defined fewer than 20% of the complications they reported, and the definitions were largely inconsistent. The results of this systematic review suggest that outcome reporting in breast reconstruction is inconsistent and lacks methodological rigor. The development of a standardized core outcome set is recommended to improve outcome reporting in breast reconstruction.

  11. The impact of perception of consistency and inconsistency in parenting style on pro-social motives of adolescents

    Directory of Open Access Journals (Sweden)

    Karmakar R.

    2017-07-01

    Full Text Available Adolescence is the most dynamic and eventful period of human development. During this crucial period of life, adolescents encounter challenges in life and constantly adapting to the relationship dynamics with friends, family, school and society. There is tendency of adolescents to engage in antisocial or pro-social behaviour. Adolescents’ relationship with parents and guardian significantly influence their antisocial and prosocial behavior. Pro-social behavior is defined as a behavior that is primarily aimed at benefiting others. Some pro-social behaviour is extrinsically motivated whereas some are intrinsically motivated. The present study investigated the nature of prosocial behaviour among adolescents and impact of consistency and inconsistency of parenting style on prosocial behaviour. A group of 610 adolescents (310 boys and 300 girls aged between 16—18 years (mean = 17.07 and standard deviation = 1.02 was selected for the present study. Pro-social Motivation Questionnaire and Parental Authority Questionnaire were used to measure pro-social motive and parenting style, respectively. The results indicate that adolescents generally show higher level of intrinsic pro-social motive. Adolescent girls prefer to display internalised and empathetic pro-social motives whereas adolescent boys tend to gain others’ approval by displaying heroic activities. Consistency in parenting style facilitates intrinsic pro-social motive only when both parents are authoritative in nature. The result interestingly reveals that inconsistent parenting style is not always bad. Authoritative and permissive dyad facilitates intrinsic pro-social motive among adolescents. Implications for parental socialisation in families and pro-social motive among adolescents are discussed.

  12. Expressive writing intervention and self-reported physical health out-comes - Results from a nationwide randomized controlled trial with breast cancer patients.

    Science.gov (United States)

    Jensen-Johansen, Mikael B; O'Toole, Mia S; Christensen, Søren; Valdimarsdottir, Heiddis; Zakowski, Sandra; Bovbjerg, Dana H; Jensen, Anders B; Zachariae, Robert

    2018-01-01

    The objective was to examine the effect of Expressive Writing Intervention (EWI) on self-reported physical symptoms and healthcare utilization in a nationwide randomized controlled trial with Danish women treated for primary breast cancer, and to explore participant characteristics related to emotion regulation as possible moderators of the effect. Women who had recently completed treatment for primary breast cancer (n = 507) were randomly assigned to three 20 min. home-based writing exercises, one week apart, focusing on emotional disclosure (EWI) of a distressing experience (their cancer or a non-cancer topic) or a non-disclosing topic (control). Outcomes were self-reported physical symptoms and healthcare utilization (visits and telephone contacts with GP) 3 and 9 months post-intervention. Potential moderators were repressive coping, alexithymia, rumination, social constraints, and writing topic. Results revealed no group by time interaction effects for any outcomes. Moderation analyses showed that 1) low alexithymic women in the EWI group showed larger decreases in GP telephone calls over time than both high alexithymic women and controls and 2) women in the EWI group writing about their own cancer, but not women writing about other topics, showed a larger decrease than controls. The results from this large randomized trial are concordant with previous findings showing that EWI is unlikely to be a generally applicable intervention to improve health-related outcomes in cancer patients and cancer survivors. However, written disclosure might have a beneficial impact for individuals who write about their own cancer, as well as for those low in alexithymia.

  13. Expressive writing intervention and self-reported physical health out-comesResults from a nationwide randomized controlled trial with breast cancer patients

    Science.gov (United States)

    Jensen-Johansen, Mikael B.; Christensen, Søren; Valdimarsdottir, Heiddis; Zakowski, Sandra; Bovbjerg, Dana H.; Jensen, Anders B.; Zachariae, Robert

    2018-01-01

    The objective was to examine the effect of Expressive Writing Intervention (EWI) on self-reported physical symptoms and healthcare utilization in a nationwide randomized controlled trial with Danish women treated for primary breast cancer, and to explore participant characteristics related to emotion regulation as possible moderators of the effect. Women who had recently completed treatment for primary breast cancer (n = 507) were randomly assigned to three 20 min. home-based writing exercises, one week apart, focusing on emotional disclosure (EWI) of a distressing experience (their cancer or a non-cancer topic) or a non-disclosing topic (control). Outcomes were self-reported physical symptoms and healthcare utilization (visits and telephone contacts with GP) 3 and 9 months post-intervention. Potential moderators were repressive coping, alexithymia, rumination, social constraints, and writing topic. Results revealed no group by time interaction effects for any outcomes. Moderation analyses showed that 1) low alexithymic women in the EWI group showed larger decreases in GP telephone calls over time than both high alexithymic women and controls and 2) women in the EWI group writing about their own cancer, but not women writing about other topics, showed a larger decrease than controls. The results from this large randomized trial are concordant with previous findings showing that EWI is unlikely to be a generally applicable intervention to improve health-related outcomes in cancer patients and cancer survivors. However, written disclosure might have a beneficial impact for individuals who write about their own cancer, as well as for those low in alexithymia. PMID:29474441

  14. Does restoration of focal lumbar lordosis for single level degenerative spondylolisthesis result in better patient-reported clinical outcomes? A systematic literature review.

    Science.gov (United States)

    Rhee, Chanseok; Visintini, Sarah; Dunning, Cynthia E; Oxner, William M; Glennie, R Andrew

    2017-10-01

    It is controversial whether the surgical restoration of sagittal balance and spinopelvic angulation in a single level lumbar degenerative spondylolisthesis results in clinical improvements. The purpose of this study to systematically review the available literature to determine whether the surgical correction of malalignment in lumbar degenerative spondylolisthesis correlates with improvements in patient-reported clinical outcomes. Literature searches were performed via Ovid Medline, Embase, CENTRAL and Web of Science using search terms "lumbar," "degenerative/spondylolisthesis" and "surgery/surgical/surgeries/fusion". This resulted in 844 articles and after reviewing the abstracts and full-texts, 13 articles were included for summary and final analysis. There were two Level II articles, four Level III articles and five Level IV articles. Most commonly used patient-reported outcome measures (PROMs) were Oswestery disability index (ODI) and visual analogue scale (VAS). Four articles were included for the final statistical analysis. There was no statistically significant difference between the patient groups who achieved successful surgical correction of malalignment and those who did not for either ODI (mean difference -0.94, CI -8.89-7.00) or VAS (mean difference 1.57, CI -3.16-6.30). Two studies assessed the efficacy of manual reduction of lumbar degenerative spondylolisthesis and their clinical outcomes after the operation, and there was no statistically significant improvement. Overall, the restoration of focal lumbar lordosis and restoration of sagittal balance for single-level lumbar degenerative spondylolisthesis does not seem to yield clinical improvements but well-powered studies on this specific topic is lacking in the current literature. Future well-powered studies are needed for a more definitive conclusion. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Stress Outcomes of Four Types of Perceived Interruptions.

    Science.gov (United States)

    Fletcher, Keaton A; Potter, Sean M; Telford, Britany N

    2018-03-01

    Objective We sought to define and measure four types of perceived interruptions and to examine their relationships with stress outcomes. Background Interruptions have been defined and measured in a variety of inconsistent ways. No study has simultaneously examined the subjective experience of all types of interruptions. Method First, we provide a synthesized definition and model of interruptions that aligns interruptions along two qualities: origin and degree of multitasking. Second, we create and validate a self-report measure of these four types of perceived interruptions within two samples (working undergraduate students and working engineers). Last, we correlate this measure with self-reported psychological and physical stress outcomes. Results Our results support the four-factor model of interruptions. Results further support the link between each of the four types of interruptions (intrusions, breaks, distractions, and a specific type of ruminations, discrepancies) and stress outcomes. Specifically, results suggest that distractions explain a unique portion of variance in stress outcomes above and beyond the shared variance explained by intrusions, breaks, and discrepancies. Conclusion The synthesized four-factor model of interruptions is an adequate representation of the overall construct of interruptions. Further, perceived interruptions can be measured and are significantly related to stress outcomes. Application Measuring interruptions by observation can be intrusive and resource intensive. Additionally, some types of interruptions may be internal and therefore unobservable. Our survey measure offers a practical alternative method for practitioners and researchers interested in the outcomes of interruptions, especially stress outcomes.

  16. CheShift-2 resolves a local inconsistency between two X-ray crystal structures

    International Nuclear Information System (INIS)

    Vila, Jorge A.; Sue, Shih-Che; Fraser, James S.; Scheraga, Harold A.; Dyson, H. Jane

    2012-01-01

    Since chemical shifts provide important and relatively accessible information about protein structure in solution, a Web server, CheShift-2, was developed for structure interrogation, based on a quantum mechanics database of 13 C α chemical shifts. We report the application of CheShift-2 to a local inconsistency between two X-ray crystal structures (PDB IDs 1IKN and 1NFI) of the complex between the p65/p50 heterodimer of NFκB and its inhibitor IκBα. The availability of NMR resonance assignments that included the region of the inconsistency provided an opportunity for independent validation of the CheShift-2 server. Application of the server showed that the 13 C α chemical shifts measured for the Gly270-Pro281 sequence close to the C-terminus of IκBα were unequivocally consistent with the backbone structure modeled in the 1IKN structure, and were inconsistent with the 1NFI structure. Previous NOE measurements had demonstrated that the position of a tryptophan ring in the region immediately N-terminal in this region was not consistent with either structure. Subsequent recalculation of the local structure in this region, based on the electron density of the deposited structure factors for 1IKN, confirmed that the local backbone structure was best modeled by 1IKN, but that the rotamer of Trp258 is consistent with the 1NFI structure, including the presence of a hydrogen bond between the ring NεH of Trp258 and the backbone carbonyl group of Gln278. The consensus between all of these measures suggests that the CheShift-2 server operates well under circumstances in which backbone chemical shifts are available but where local plasticity may render X-ray structural data ambiguous.

  17. Functional and oncologic outcomes after excision of the total femur in primary bone tumors: Results with a low cost total femur prosthesis

    Directory of Open Access Journals (Sweden)

    Ajay Puri

    2012-01-01

    Full Text Available Background: The extent of tumor may necessitate resection of the complete femur rarely to achieve adequate oncologic clearance in bone sarcomas. We present our experience with reconstruction in such cases using an indigenously manufactured, low-cost, total femoral prosthesis (TFP. We assessed the complications of the procedure, the oncologic and functional outcomes, and implant survival. Materials and Methods: Eight patients (four males and four females with a mean age of 32 years, operated between December 2003 and June 2009, had a TFP implanted. The diagnosis included osteogenic sarcoma (5, Ewing′s sarcoma (1, and chondrosarcoma (2. Mean followup was 33 months (9-72 months for all and 40 months (24-72 months in survivors. They were evaluated by Musculoskeletal Tumor Society score, implant survival as well as patient survival. Results: There was one local recurrence and five of seven patients are currently alive at the time of last followup. The Musculoskeletal Tumor Society score for patients ranged from 21 to 25 with a mean of 24 (80%. The implant survival was 88% at 5 years with only one TFP needing removal because of infection. Conclusions: A TFP in appropriately indicated patients with malignant bone tumors is oncologically safe. A locally manufactured, cost-effective implant provided consistent and predictable results after excision of the total femur with good functional outcomes.

  18. Diabetes Outcomes in the Indian Health System During the Era of the Special Diabetes Program for Indians and the Government Performance and Results Act

    Science.gov (United States)

    Wilson, Charlton; Gilliland, Susan; Cullen, Theresa; Moore, Kelly; Roubideaux, Yvette; Valdez, Lorraine; Vanderwagen, William; Acton, Kelly

    2005-01-01

    Objectives. We reviewed changes in blood glucose, blood pressure, and cholesterol levels among American Indians and Alaska Natives between 1995 and 2001 to estimate the quality of diabetes care in the Indian Health Service (IHS) health care delivery system. Methods. We conducted a cross-sectional analysis of data from the Indian Health Service Diabetes Care and Outcomes Audit. Results. Adjusted mean Hemoglobin A1c (HbA1c) levels (7.9% vs 8.9%) and mean diastolic blood pressure levels (76 vs 79 mm Hg) were lower in 2001 than in 1995, respectively. A similar pattern was observed for mean total cholesterol (193 vs 208 mg/dL) and triglyceride (235 vs 257 mg/dL) levels in 2001 and 1995, respectively. Conclusions. We identified changes in intermediate clinical outcomes over the period from 1995 to 2001 that may reflect the global impact of increased resource allocation and improvements in processes on the quality of diabetes care, and we describe the results that may be achieved when community, health program, and congressional initiatives focus on common goals. PMID:16051933

  19. A cognitive dissonance interpretation of consistencies and inconsistencies in environmentally responsible behavior

    DEFF Research Database (Denmark)

    Thøgersen, John

    2004-01-01

    The issue of consistency and inconsistency in environmentally responsible behavior (ERB), as reflected in the correlations between different ERBs, is discussed in the light of social psychological theories suggesting that most people desire to behave consistently. It is ar-gued that except in cases......" in this context) and measurement error and it is moderated by perceived dissimilarity between the behaviors and by the (moral) importance of behaving in a responsible way towards the environment. These propositions are tested (and confirmed) by means of a mall-intercept survey of ordinary Danish shop...

  20. Quality controls in integrative approaches to detect errors and inconsistencies in biological databases

    Directory of Open Access Journals (Sweden)

    Ghisalberti Giorgio

    2010-12-01

    Full Text Available Numerous biomolecular data are available, but they are scattered in many databases and only some of them are curated by experts. Most available data are computationally derived and include errors and inconsistencies. Effective use of available data in order to derive new knowledge hence requires data integration and quality improvement. Many approaches for data integration have been proposed. Data warehousing seams to be the most adequate when comprehensive analysis of integrated data is required. This makes it the most suitable also to implement comprehensive quality controls on integrated data. We previously developed GFINDer (http://www.bioinformatics.polimi.it/GFINDer/, a web system that supports scientists in effectively using available information. It allows comprehensive statistical analysis and mining of functional and phenotypic annotations of gene lists, such as those identified by high-throughput biomolecular experiments. GFINDer backend is composed of a multi-organism genomic and proteomic data warehouse (GPDW. Within the GPDW, several controlled terminologies and ontologies, which describe gene and gene product related biomolecular processes, functions and phenotypes, are imported and integrated, together with their associations with genes and proteins of several organisms. In order to ea