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Sample records for scar assessment scale

  1. Values of a Patient and Observer Scar Assessment Scale to Evaluate the Facial Skin Graft Scar.

    Science.gov (United States)

    Chae, Jin Kyung; Kim, Jeong Hee; Kim, Eun Jung; Park, Kun

    2016-10-01

    The patient and observer scar assessment scale (POSAS) recently emerged as a promising method, reflecting both observer's and patient's opinions in evaluating scar. This tool was shown to be consistent and reliable in burn scar assessment, but it has not been tested in the setting of skin graft scar in skin cancer patients. To evaluate facial skin graft scar applied to POSAS and to compare with objective scar assessment tools. Twenty three patients, who diagnosed with facial cutaneous malignancy and transplanted skin after Mohs micrographic surgery, were recruited. Observer assessment was performed by three independent rates using the observer component of the POSAS and Vancouver scar scale (VSS). Patient self-assessment was performed using the patient component of the POSAS. To quantify scar color and scar thickness more objectively, spectrophotometer and ultrasonography was applied. Inter-observer reliability was substantial with both VSS and the observer component of the POSAS (average measure intraclass coefficient correlation, 0.76 and 0.80, respectively). The observer component consistently showed significant correlations with patients' ratings for the parameters of the POSAS (all p -valuesskin graft scar assessment in skin cancer patients, the POSAS showed acceptable inter-observer reliability. This tool was more comprehensive and had higher correlation with patient's opinion.

  2. Assessment of scar quality after cleft lip closure

    NARCIS (Netherlands)

    Frans, Franceline A.; van Zuijlen, Paul P. M.; Griot, J. P. W. Don; van der Horst, Chantal M. A. M.

    2012-01-01

    To assess scar quality after cleft lip repair. The linear scars of patients with cleft lip with or without cleft palate were evaluated in a prospective study using the Patient and Observer Scar Assessment Scale. Linear regression was performed to identify which scar characteristics were important

  3. Reliability and Validity of the Turkish Version of Patient and Observer Scar Assessment Scale in Patients with Burns

    Directory of Open Access Journals (Sweden)

    Ayşe Kabuk

    2017-12-01

    Full Text Available Objective: To evaluation reliability and validity of the Turkish version of Patient and Observer Scar Assessment Scale (POSAS in patients with burns. Methods: This is a methodologically study. Data were collected using POSAS, survey form and plexiglas. Patient Scar Assessment Scale (PSAS was completed by patients (n=53 and Observer Scar Assessment Scale (OSAS was completed by two observers separately. The test-retest was measured applying the scales in 25 patients after two weeks. Data were analyzed by Kruskal-Wallis and Mann-Whitney U test. Content validity was determined using Kaiser-Meyer-Olkin, Barlett’s test and structure validity was performed by explanatory factor analysis (EFA and confirmatory factor analysis (CFA; reliability was evaluated using internal consistency, Cronbach’s alpha and intraclass correlation coefficient (ICC. Results: Factor weights were in appropriate range according to EFA, 6 items single factor structure of the original scale was valid and had high consistency index according to CFA, ICC between the 7th item and the total points was proportional, inner consistency was highly reliable (PSAS a=0.992, OSAS a=0.993, consistency between the observers was high (a=0.952, r=0.909. It was determined OSAS scores increased as the burn degree increased (p<0.05. Conclusion: POSAS was determined to be a valid and reliable scale in patients with burns in the Turkish society.

  4. Reliable scar scoring system to assess photographs of burn patients.

    Science.gov (United States)

    Mecott, Gabriel A; Finnerty, Celeste C; Herndon, David N; Al-Mousawi, Ahmed M; Branski, Ludwik K; Hegde, Sachin; Kraft, Robert; Williams, Felicia N; Maldonado, Susana A; Rivero, Haidy G; Rodriguez-Escobar, Noe; Jeschke, Marc G

    2015-12-01

    Several scar-scoring scales exist to clinically monitor burn scar development and maturation. Although scoring scars through direct clinical examination is ideal, scars must sometimes be scored from photographs. No scar scale currently exists for the latter purpose. We modified a previously described scar scale (Yeong et al., J Burn Care Rehabil 1997) and tested the reliability of this new scale in assessing burn scars from photographs. The new scale consisted of three parameters as follows: scar height, surface appearance, and color mismatch. Each parameter was assigned a score of 1 (best) to 4 (worst), generating a total score of 3-12. Five physicians with burns training scored 120 representative photographs using the original and modified scales. Reliability was analyzed using coefficient of agreement, Cronbach alpha, intraclass correlation coefficient, variance, and coefficient of variance. Analysis of variance was performed using the Kruskal-Wallis test. Color mismatch and scar height scores were validated by analyzing actual height and color differences. The intraclass correlation coefficient, the coefficient of agreement, and Cronbach alpha were higher for the modified scale than those of the original scale. The original scale produced more variance than that in the modified scale. Subanalysis demonstrated that, for all categories, the modified scale had greater correlation and reliability than the original scale. The correlation between color mismatch scores and actual color differences was 0.84 and between scar height scores and actual height was 0.81. The modified scar scale is a simple, reliable, and useful scale for evaluating photographs of burn patients. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Patient reported facial scar assessment: directions for the professional

    NARCIS (Netherlands)

    Hoogewerf, C.J.; van Baar, M.E.; Middelkoop, E.; van Loey, N.E.

    2014-01-01

    Background The face is central to our identity and provides our most expressive means of communication. Currently, the role of facial scarring in relation to self-esteem is unclear and the value of self-reported scar assessment is insufficiently understood. The aim of this study was twofold: (1) to

  6. Patient reported facial scar assessment : directions for the professional

    NARCIS (Netherlands)

    Hoogewerf, Cornelis J; van Baar, Margriet E; Middelkoop, Esther; Van Loey, N.E.E.

    BACKGROUND: The face is central to our identity and provides our most expressive means of communication. Currently, the role of facial scarring in relation to self-esteem is unclear and the value of self-reported scar assessment is insufficiently understood. The aim of this study was twofold: (1) to

  7. Assessing the effectiveness of massage therapy for bilateral cleft lip reconstruction scars.

    Science.gov (United States)

    McKay, Emilie

    2014-06-01

    Bilateral cleft lips occur when the bones that form the upper lip fail to fuse at birth. Surgical reconstruction creates scars, which may lead to the following impairments: adhesions, decreased oral range of motion, decreased strength of orbicularis oris muscle, and asymmetry of oral region leading to poor self-esteem. The purpose of this case study is to determine the effectiveness of massage therapy in its ability to improve these impairments. A five-week treatment plan consisting of fascial release, kneading, and intraoral techniques. Subjective information was assessed on two scales: restriction of scar and clients attitudes and acceptance of scar. Objective information was cataloged through photographs, a palpatory chart, and a self-created "Pen Test". Results included increase range of motion and strength, decrease restrictions (palpable and subjective), and increase of symmetry. Client's perceived confidence of scar and its appearance increased. The evidence suggests that massage therapy helped with the impairments associated with scars formed by bilateral cleft lip reconstruction.

  8. The challenge of objective scar colour assessment in a clinical setting: using digital photography.

    Science.gov (United States)

    Anderson, J C; Hallam, M-J; Nduka, C; Osorio, D

    2015-08-01

    Scar assessment in the clinical setting is typically impeded by a lack of quantitative data and most systems rely on subjective rating scales which are user dependant and show considerable variability between raters. The growing use of digital photography in medicine suggests a more objective approach to scar evaluation. Our objective was to determine if cameras could be of practical use for measuring colour in a clinical setting. The measurement of colour and reflectance spectra in photographs faces two difficulties: firstly the effects of variable illumination spectra, and secondly to recover accurate colour and spectral information from the sparse red, green and blue (RGB) camera signals. As a result the colour rendition is often inaccurate, and spectral information is lost. To deal with variable illumination and other factors that systematically affect all reflectance spectra ColourWorker (a method for image-based colour measurement implemented in software) calibrates the spectral responses of the camera's RGB sensors using a colour standard in the image. To make best use of the calibrated signals, it takes advantage of the fact that although a given RGB signal can be caused by an infinite number of spectra, most natural reflectance spectra vary smoothly and have predictable forms. This means given a set of examples of spectra produced by the materials of interest, it is possible to estimate the specific spectrum that produced a given RGB signal once corrected for the illumination. We describe a method for recovering spectral and chromatic information relating to surface reflectance from ordinary digital images and apply this to analyse photographs of surgical scars, taken as part of a clinical trial, in an attempt to better quantify clinical scar assessment. It should be noted the pre-existing trial protocol did not allow for a comprehensive evaluation of the accuracy of the method which would require the spectrophotometric measurement of skin regions

  9. New Atrophic Acne Scar Classification: Reliability of Assessments Based on Size, Shape, and Number.

    Science.gov (United States)

    Kang, Sewon; Lozada, Vicente Torres; Bettoli, Vincenzo; Tan, Jerry; Rueda, Maria Jose; Layton, Alison; Petit, Lauren; Dréno, Brigitte

    2016-06-01

    Post-acne atrophic scarring is a major concern for which standardized outcome measures are needed. Traditionally, this type of scar has been classified based on shape; but survey of practicing dermatologists has shown that atrophic scar morphology has not been well enough defined to allow good agreement in clinical classification. Reliance on clinical assessment is still needed at the current time, since objective tools are not yet available in routine practice. Evaluate classification for atrophic acne scars by shape, size, and facial location and establish reliability in assessments. We conducted a non-interventional study with dermatologists performing live clinical assessments of atrophic acne scars. To objectively compare identification of lesions, individual lesions were marked on a high-resolution photo of the patient that was displayed on a computer during the clinical evaluation. The Jacob clinical classification system was used to define three primary shapes of scars 1) icepick, 2) boxcar, and 3) rolling. To determine agreement for classification by size, independent technicians assessed the investigators' markings on digital images. Identical localization of scars was denoted if the maximal distance between their centers was ≤ 60 pixels (approximately 3 mm). Raters assessed scars on the same patients twice (morning/afternoon). Aggregate models of rater assessments were created and analyzed for agreement. Raters counted a mean scar count per subject ranging from 15.75 to 40.25 scars. Approximately 50% of scars were identified by all raters and ~75% of scars were identified by at least 2 of 3 raters (weak agreement, Kappa pairwise agreement 0.30). Agreement between consecutive counts was moderate, with Kappa index ranging from 0.26 to 0.47 (after exclusion of one outlier investigator who had significantly higher counts than all others). Shape classifications of icepick, boxcar, and rolling differed significantly between raters and even for same raters at

  10. ASSESSMENT OF MICRONEEDLING THERAPY IN THE MANAGEMENT OF ATROPHIC FACIAL ACNE SCARS

    Directory of Open Access Journals (Sweden)

    Ajay

    2015-12-01

    Full Text Available STUDY BACKGROUND Post acne scars are always a challenge to treat, especially the ones which are deep seated. There are many treatment options like laser resurfacing, dermabrasion, microdermabrasion and non-ablative laser resurfacing but with considerable morbidity and interference with the daily activities of the patient in the post-treatment period. Microneedling or dermaroller therapy is one of the new treatment options in the management of acne scars with satisfactory improvement and no significant side effect. The aim of the present study is to perform an objective evaluation the efficacy of microneedling in the treatment of atrophic acne scars. MATERIALS AND METHODS Thirty patients of skin type III-V having atrophic facial acne scars presenting to our dermatology OPD. were received multiple sittings of microneedling (dermaroller treatment with an interval of 6 weeks between each session. Goodman & Baron’s acne scar grading system was used for assessment of their scars and was evaluated clinically by serial photography at the start as well as at two months after the conclusion of the treatment. Patients on anticoagulant therapy, of keloidal tendency, with bleeding disorders, vitiligo patients, pregnant and lactating mothers and patients with active acne lesions were excluded from the study. The duration of this study was for ten months-from January 2014 to October 2014. RESULTS Any change in the grading of scars after the end of treatment and follow-up period was noted down. The efficacy and improvement of dermaroller treatment was assessed by Goodman and Baron’s Global Acne Scarring System. Out of 30 patients, 26(80.64% patients achieved a reduction in the severity of their scarring by one or two grades. Quantitative assessment showed that 13.3% of patients had minimal, 16.6% had good and 70% showed very good improvement. Adverse effects were limited to transient pain, erythema and edema. CONCLUSION Microneedling therapy seems to be

  11. Ultrasound assessed thickness of burn scars in association with laser Doppler imaging determined depth of burns in paediatric patients.

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    Wang, Xue-Qing; Mill, Julie; Kravchuk, Olena; Kimble, Roy M

    2010-12-01

    This study describes the ultrasound assessment of burn scars in paediatric patients and the association of these scar thickness with laser Doppler imaging (LDI) determined burn depth. A total of 60 ultrasound scar assessments were conducted on 33 scars from 21 paediatric burn patients at 3, 6 and 9 months after-burn. The mean of peak scar thickness was 0.39±0.032 cm, with the thickest at 6 months (0.40±0.036 cm). There were 17 scald burn scars (0.34±0.045 cm), 4 contact burn scars (0.61±0.092 cm), and 10 flame burn scars (0.42±0.058 cm). Each group of scars followed normal distributions. Twenty-three scars had original burns successfully scanned by LDI and various depths of burns were presented by different colours according to blood perfusion units (PU), with dark blue burns, with the thinnest scars for green coloured burns and the thickest for dark blue coloured burns. Within light blue burns, grafted burns healed with significantly thinner scars than non-grafted burns. This study indicates that LDI can be used for predicting the risk of hypertrophic scarring and for guiding burn care. To our knowledge, this is the first study to correlate the thickness of burns scars by ultrasound scan with burn depth determined by LDI. Copyright © 2010 Elsevier Ltd and ISBI. All rights reserved.

  12. Quality of life and mediating role of patient scar assessment in burn patients.

    Science.gov (United States)

    Oh, Hyunjin; Boo, Sunjoo

    2017-09-01

    In this study, we examined the plausibility of the mediating effect of the levels of patient scar assessment on the relationship between burn severity measured with total body surface area and burn-specific health-related quality of life (HRQL) among patients with burns in South Korea. In this cross sectional descriptive study, we collected data from 100 burn patients in three burn centers specializing in burn care in South Korea. Patient scar assessment, burn specific HRQL, and burn-related characteristics were self-reported with anonymous, paper-based surveys. The findings showed a positive correlation between burn severity, patient scar assessment, and HRQL in burn patients. The evidence of this paper is that quality of life after burns more determined by scar characteristics than burn severity. In the light of the poor HRQL in burn patients, the results of this study support that improving scar status could improve patients' HRQL. Health care providers should keep in mind that patients' perspectives of their scars would be a great indicator of their HRQL, so the providers' focus should be on intensive scar management intervention in their care. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

  13. The role of massage in scar management: a literature review.

    Science.gov (United States)

    Shin, Thuzar M; Bordeaux, Jeremy S

    2012-03-01

    Many surgeons recommend postoperative scar massage to improve aesthetic outcome, although scar massage regimens vary greatly. To review the regimens and efficacy of scar massage. PubMed was searched using the following key words: "massage" in combination with "scar," or "linear," "hypertrophic," "keloid," "diasta*," "atrophic." Information on study type, scar type, number of patients, scar location, time to onset of massage therapy, treatment protocol, treatment duration, outcomes measured, and response to treatment was tabulated. Ten publications including 144 patients who received scar massage were examined in this review. Time to treatment onset ranged from after suture removal to longer than 2 years. Treatment protocols ranged from 10 minutes twice daily to 30 minutes twice weekly. Treatment duration varied from one treatment to 6 months. Overall, 65 patients (45.7%) experienced clinical improvement based on Patient Observer Scar Assessment Scale score, Vancouver Scar Scale score, range of motion, pruritus, pain, mood, depression, or anxiety. Of 30 surgical scars treated with massage, 27 (90%) had improved appearance or Patient Observer Scar Assessment Scale score. The evidence for the use of scar massage is weak, regimens used are varied, and outcomes measured are neither standardized nor reliably objective, although its efficacy appears to be greater in postsurgical scars than traumatic or postburn scars. Although scar massage is anecdotally effective, there is scarce scientific data in the literature to support it. © 2011 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.

  14. Outcome after burns: an observational study on burn scar maturation and predictors for severe scarring.

    Science.gov (United States)

    van der Wal, Martijn B A; Vloemans, Jos F P M; Tuinebreijer, Wim E; van de Ven, Peter; van Unen, Ella; van Zuijlen, Paul P M; Middelkoop, Esther

    2012-01-01

    Long-term outcome of burn scars as well as the relation with clinically relevant parameters has not been studied quantitatively. Therefore, we conducted a detailed analysis on the clinical changes of burn scars in a longitudinal setup. In addition, we focused on the differences in scar quality in relation to the depth, etiology of the burn wound and age of the patient. Burn scars of 474 patients were subjected to a scar assessment protocol 3, 6, and 12 months postburn. Three different age groups were defined (≤5, 5-18, and ≥18 years). The observer part of the patient and observer scar assessment scale revealed a significant (p burned (p  0.230) have no significant influence on scar quality when corrected for sex, total body surface area burned, time, and age or etiology, respectively. © 2012 by the Wound Healing Society.

  15. Assessment of left ventricular myocardial scar with three-dimensional MRI

    International Nuclear Information System (INIS)

    Yin Gang; Zhao Shihua; Lu Minjie

    2011-01-01

    Objective: To assess the value of free-breathing 3D phase sensitive inversion recovery (PSIR) turbo FLASH for demonstrating the left ventricular myocardial scar in patients with myocardial infarction. Methods: Twenty-three patients with myocardial infarction underwent 2D and 3D phase sensitive inversion recovery (PSIR) Turbo FLASH sequences 10-15 minutes after injection of dimeglumine gadopentetate. The image quality, the area, location and volume of hyperenhanced scar were independently assessed by two experienced radiologists. Student's t test or rank sum test and Pearson linear correlation were used for the statistics. Results: There were no significant differences in the overall image quality (2.57± 0.59 vs 2.39±0.66, Z=-0.93, P=0.35), the area (24.48±10.83 vs 29.00±11.56, Z=-1.41, P=0.16) and location (16.78±6.51 vs 18.87±6.76, Z=-1.17, P=0.24) of hyperenhanced scar between 2D and 3D PSIR sequences. The mean volume of hyperenhanced scar was significantly greater in 3D PSIR sequence than that in 2D PSIR sequence [(23.46±10.61) vs (31.65±13.86) cm 3 , t=-2.25, P= 0.03]. There was a good correlation in the volume of hyperenhanced scar between 2D PSIR and 3D PSIR sequences (r=0.940, P 2 =0.883). Conclusion: Free-breathing 3D PSIR Turbo FLASH is a promising new imaging technique for accurate assessment of myocardial scar. (authors)

  16. Assessment of burn-specific health-related quality of life and patient scar status following burn.

    Science.gov (United States)

    Oh, Hyunjin; Boo, Sunjoo

    2017-11-01

    This study assessed patient-perceived levels of scar assessment and burn-specific quality of life (QOL) in Korean burn patients admitted to burn care centers and identified differences in scar assessment and QOL based on various patient characteristics. A cross-sectional descriptive study using anonymous paper-based survey methods was conducted with 100 burn patients from three burn centers specializing in burn care in South Korea. Mean subject age was 44.5 years old, and 69% of the subjects were men. The overall mean QOL was 2.91 out of 5. QOL was lowest for the work subdomain (2.25±1.45) followed by the treatment regimen subdomain (2.32±1.16). The subjects' mean total scar assessment score was 35.51 out of 60, and subjects were most unsatisfied with scar color. Subjects with low income, flame-source burns, severe burns, visible scars, and scars on face or hand reported significantly lower QOL. Subjects with severe burn degree and burn range perceived their burn scar condition to be worse than that of others. The results show that burn subjects experience the most difficulties with their work and the treatment regimen. Subjects with severe burn and visible scarring have a reduced QOL and a poor scar status. Scar management intervention may improve QOL of burn patients especially those with severe burn and visible scars. Further studies are warranted to evaluate the relationship between scar assessment and QOL. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

  17. Differences in quantitative assessment of myocardial scar and gray zone by LGE-CMR imaging using established gray zone protocols.

    Science.gov (United States)

    Mesubi, Olurotimi; Ego-Osuala, Kelechi; Jeudy, Jean; Purtilo, James; Synowski, Stephen; Abutaleb, Ameer; Niekoop, Michelle; Abdulghani, Mohammed; Asoglu, Ramazan; See, Vincent; Saliaris, Anastasios; Shorofsky, Stephen; Dickfeld, Timm

    2015-02-01

    Late gadolinium enhancement cardiac magnetic resonance (LGE-CMR) imaging is the gold standard for myocardial scar evaluation. Heterogeneous areas of scar ('gray zone'), may serve as arrhythmogenic substrate. Various gray zone protocols have been correlated to clinical outcomes and ventricular tachycardia channels. This study assessed the quantitative differences in gray zone and scar core sizes as defined by previously validated signal intensity (SI) threshold algorithms. High quality LGE-CMR images performed in 41 cardiomyopathy patients [ischemic (33) or non-ischemic (8)] were analyzed using previously validated SI threshold methods [Full Width at Half Maximum (FWHM), n-standard deviation (NSD) and modified-FWHM]. Myocardial scar was defined as scar core and gray zone using SI thresholds based on these methods. Scar core, gray zone and total scar sizes were then computed and compared among these models. The median gray zone mass was 2-3 times larger with FWHM (15 g, IQR: 8-26 g) compared to NSD or modified-FWHM (5 g, IQR: 3-9 g; and 8 g. IQR: 6-12 g respectively, p zone extent (percentage of total scar that was gray zone) also varied significantly among the three methods, 51 % (IQR: 42-61 %), 17 % (IQR: 11-21 %) versus 38 % (IQR: 33-43 %) for FWHM, NSD and modified-FWHM respectively (p zone and scar core. Infarct core and total myocardial scar mass also differ using these methods. Further evaluation of the most accurate quantification method is needed.

  18. Elastin Is Differentially Regulated by Pressure Therapy in a Porcine Model of Hypertrophic Scar.

    Science.gov (United States)

    Carney, Bonnie C; Liu, Zekun; Alkhalil, Abdulnaser; Travis, Taryn E; Ramella-Roman, Jessica; Moffatt, Lauren T; Shupp, Jeffrey W

    Beneficial effects of pressure therapy for hypertrophic scars have been reported, but the mechanisms of action are not fully understood. This study evaluated elastin and its contribution to scar pliability. The relationship between changes in Vancouver Scar Scale (VSS) scores of pressure-treated scars and differential regulation of elastin was assessed. Hypertrophic scars were created and assessed weekly using VSS and biopsy procurement. Pressure treatment began on day 70 postinjury. Treated scars were compared with untreated shams. Treatment lasted 2 weeks, through day 84, and scars were assessed weekly through day 126. Transcript and protein levels of elastin were quantified. Pressure treatment resulted in lower VSS scores compared with sham-treated scars. Pliability (VSSP) was a key contributor to this difference. At day 70 pretreatment, VSSP = 2. Without treatment, sham-treated scars became less pliable, while pressure-treated scars became more pliable. The percentage of elastin in scars at day 70 was higher than in uninjured skin. Following treatment, the percentage of elastin increased and continued to increase through day 126. Untreated sham scars did not show a similar increase. Quantification of Verhoeff-Van Gieson staining corroborated the findings and immunofluorescence revealed the alignment of elastin fibers. Pressure treatment results in increased protein level expression of elastin compared with sham-untreated scars. These findings further characterize the extracellular matrix's response to the application of pressure as a scar treatment, which will contribute to the refinement of rehabilitation practices and ultimately improvements in functional and psychosocial outcomes for patients.

  19. Assessment of propeller and off-road vehicle scarring in seagrass beds and wind-tidal flats of the southwestern Gulf of Mexico

    Science.gov (United States)

    Martin, S.R.; Onuf, C.P.; Dunton, K.H.

    2008-01-01

    We used aerial photography and GIS to establish a quantitative baseline of propeller and off-road vehicle (ORV) scarring in seagrass and wind-tidal flats of the upper Laguna Madre in the Padre Island National Seashore (Texas, USA). We also examined scar recovery through comparison of recent (2002, 2005) and historical (1967) aerial photographs of the study area. Scarring intensity was calculated using two different methods. In the first, polygons were visually drawn around groups of scars on digital images. Scarring intensity was estimated as light (20%), based on the total coverage of scars within each polygon (taking into account the length, width, and density of scars). We developed a more objective method that employed creation of vector grid cells and buffers that incorporated the localized ecological impact of scars. Results of spatial and temporal analysis revealed that the polygon approach greatly underestimated the magnitude of scarring. For example, in a single photograph, 7% of seagrass area was lightly scarred according to the polygon method; but light scarring increased to 51% according to grid analysis of the same image. Our results also indicated that propeller scars in Halodule wrightii beds appear to recover in less than three years and ORV tracks have persisted in the wind-tidal flats for at least 38 years. Our approach provides resource managers with procedures for a more objective and efficient assessment of physical disturbances to seagrass and wind-tidal flats caused by boats and ORVs. ?? 2008 by Walter de Gruyter.

  20. Acne Scars

    Science.gov (United States)

    ... or scrubbing scarred areas can further reduce skin elasticity and heighten the appearance of the scar. Pick ... technique or procedure is appropriate for my skin type? Did the doctor show me before-and-after ...

  1. Fractional CO2 laser treatment of caesarean section scars

    DEFF Research Database (Denmark)

    Karmisholt, Katrine E; Taudorf, Elisabeth H; Wulff, Camilla B

    2017-01-01

    BACKGROUND AND OBJECTIVES: Caesarean section (c-section) scars can be pose functional and cosmetic challenges and ablative fractional laser (AFXL) treatment may offer benefit to patients. We evaluated textural and color changes over time in AFXL-treated versus untreated control scars. MATERIALS...... AND METHODS: A randomized, controlled, intra-individual split-scar trial with three sessions of AFXL-treatments for mature c-section scars. Settings of AFXL were adjusted to each individual scar. End-points were blinded on-site clinical evaluations at 1, 3, and 6 months follow-up (Patient and Observer Scar...... Assessment Scale [POSAS] and Vancouver Scar Scale [VSS]), blinded photo-evaluations, reflectance measurements, tissue histology, and patients satisfaction. RESULTS: Eleven of 12 patients completed the study. At 1 month follow-up, AFXL-treated scars were significantly improved in pliability (POSAS P = 0...

  2. Outcome measures and scar aesthetics in minimally invasive video-assisted parathyroidectomy.

    LENUS (Irish Health Repository)

    Casserly, Paula

    2012-02-01

    OBJECTIVES: To compare the scar outcome of video-assisted parathyroidectomy (VAP) with traditional bilateral cervical exploration (BCE) using previously validated scar assessment scales, and to examine the feasibility of introducing VAP into a general otolaryngology-head and neck practice. DESIGN: A retrospective review of medical records from a prospectively obtained database of patients and long-term follow-up of scar analysis. PATIENTS: The records of 60 patients undergoing parathyroidectomy were reviewed: 29 patients underwent VAP and 31 patients underwent an open procedure with BCE. The groups were matched for age and sex. A total of 46 patients were followed up to assess scar outcome. MAIN OUTCOME MEASURES: The primary outcome was a comparison of patient and observer scar satisfaction between VAP and traditional BCE using validated scar assessment tools: the Patient Scar Assessment Scale and the Manchester Scar Scale. The secondary outcomes were to retrospectively evaluate our results with VAP and to assess the suitability of introducing this technique into a general otolaryngology-head and neck practice. RESULTS: The average scar length in the VAP group was 1.7 cm, and the average scar length in the BCE group was 4.3 cm. The patients in the BCE group scored higher than the patients in the VAP group on the Manchester Scar Scale (P < .01) and on the Patient and Observer Scar Scales (P = .02), indicating a worse scar outcome. The mean operative time in the VAP group was 41 minutes compared with 115 minutes in the open procedure BCE group. There was no difference between the 2 groups in terms of postoperative complications. CONCLUSIONS: Video-assisted parathyroidectomy is a safe and feasible procedure in the setting of a general otolaryngology-head and neck practice, with outcomes and complication rates that are comparable to those of traditional bilateral neck exploration. Both patient and observer analysis demonstrated that VAP was associated with a more

  3. A new argon gas-based device for the treatment of keloid scars with the use of intralesional cryotherapy.

    Science.gov (United States)

    van Leeuwen, Michiel C E; Bulstra, Anne-Eva J; van Leeuwen, Paul A M; Niessen, Frank B

    2014-12-01

    Intralesional (IL) cryotherapy is a new promising technique for the treatment of keloid scars, in which the scar is frozen from inside. Multiple devices are available, mostly based on a simple liquid nitrogen Dewar system, which have a limited freezing capacity. Argon gas-based systems ensure accurate and highly controlled freezing and have shown to be effective within the field of oncologic surgery. However, this technique has never been used for the treatment of keloid scars. This prospective study evaluates an argon gas-based system for the treatment of keloids in a patient population including all Fitzpatrick skin types with a 1-year follow-up. Twenty-five patients with 30 keloid scars were included and treated with a device called Seednet (Galil Medical, Yokneam, Israel). Scar quality and possible scar recurrence were assessed before treatment and post treatment (6 and 12 months) with objective devices determining scar color, scar elasticity, scar volume, and patient's skin type. In addition, scars were evaluated using the Patient and Observer Scar Assessment Scale. After 12 months, a significant volume reduction of 62% was obtained, p = 0.05. Moreover, complaints of pain and itching were alleviated and scar quality had improved according to the Patient and Observer Scar Assessment Scale. Scar pigmentation recovered in 62% of all keloid scars within 12 months. Five out of 30 (17%) scars recurred within 12 months, three of which had previously been treated with liquid nitrogen-based IL cryotherapy. Both recurrent and persistent hypopigmentation were mainly seen in Afro-American patients. IL cryotherapy with the use of an argon gas-based system proves to be effective in the treatment of keloid scars, yielding volume reduction and low recurrence rates. Although hypopigmentation recovered in most cases, it is strongly related to non-Caucasian patients. Finally, additional treatment of keloid scars previously unresponsive to IL cryotherapy is predisposed to a high

  4. Validation of prediction model for successful vaginal birth after Cesarean delivery based on sonographic assessment of hysterotomy scar.

    Science.gov (United States)

    Baranov, A; Salvesen, K Å; Vikhareva, O

    2018-02-01

    To validate a prediction model for successful vaginal birth after Cesarean delivery (VBAC) based on sonographic assessment of the hysterotomy scar, in a Swedish population. Data were collected from a prospective cohort study. We recruited non-pregnant women aged 18-35 years who had undergone one previous low-transverse Cesarean delivery at ≥ 37 gestational weeks and had had no other uterine surgery. Participants who subsequently became pregnant underwent transvaginal ultrasound examination of the Cesarean hysterotomy scar at 11 + 0 to 13 + 6 and at 19 + 0 to 21 + 6 gestational weeks. Thickness of the myometrium at the thinnest part of the scar area was measured. After delivery, information on pregnancy outcome was retrieved from hospital records. Individual probabilities of successful VBAC were calculated using a previously published model. Predicted individual probabilities were divided into deciles. For each decile, observed VBAC rates were calculated. To assess the accuracy of the prediction model, receiver-operating characteristics curves were constructed and the areas under the curves (AUC) were calculated. Complete sonographic data were available for 120 women. Eighty (67%) women underwent trial of labor after Cesarean delivery (TOLAC) with VBAC occurring in 70 (88%) cases. The scar was visible in all 80 women at the first-trimester scan and in 54 (68%) women at the second-trimester scan. AUC was 0.44 (95% CI, 0.28-0.60) among all women who underwent TOLAC and 0.51 (95% CI, 0.32-0.71) among those with the scar visible sonographically at both ultrasound examinations. The prediction model demonstrated poor accuracy for prediction of successful VBAC in our Swedish population. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd. Copyright © 2017 ISUOG. Published by John Wiley & Sons Ltd.

  5. The effect of burn rehabilitation massage therapy on hypertrophic scar after burn: a randomized controlled trial.

    Science.gov (United States)

    Cho, Yoon Soo; Jeon, Jong Hyun; Hong, Aram; Yang, Hyeong Tae; Yim, Haejun; Cho, Yong Suk; Kim, Do-Hern; Hur, Jun; Kim, Jong Hyun; Chun, Wook; Lee, Boung Chul; Seo, Cheong Hoon

    2014-12-01

    To evaluate the effect of burn rehabilitation massage therapy on hypertrophic scar after burn. One hundred and forty-six burn patients with hypertrophic scar(s) were randomly divided into an experimental group and a control group. All patients received standard rehabilitation therapy for hypertrophic scars and 76 patients (massage group) additionally received burn scar rehabilitation massage therapy. Both before and after the treatment, we determined the scores of visual analog scale (VAS) and itching scale and assessed the scar characteristics of thickness, melanin, erythema, transepidermal water loss (TEWL), sebum, and elasticity by using ultrasonography, Mexameter(®), Tewameter(®), Sebumeter(®), and Cutometer(®), respectively. The scores of both VAS and itching scale decreased significantly in both groups, indicating a significant intragroup difference. With regard to the scar characteristics, the massage group showed a significant decrease after treatment in scar thickness, melanin, erythema, TEWL and a significant intergroup difference. In terms of scar elasticity, a significant intergroup difference was noted in immediate distension and gross skin elasticity, while the massage group significant improvement in skin distensibility, immediate distension, immediate retraction, and delayed distension. Our results suggest that burn rehabilitation massage therapy is effective in improving pain, pruritus, and scar characteristics in hypertrophic scars after burn. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

  6. Fully automatic segmentation of left atrium and pulmonary veins in late gadolinium-enhanced MRI: Towards objective atrial scar assessment.

    Science.gov (United States)

    Tao, Qian; Ipek, Esra Gucuk; Shahzad, Rahil; Berendsen, Floris F; Nazarian, Saman; van der Geest, Rob J

    2016-08-01

    To realize objective atrial scar assessment, this study aimed to develop a fully automatic method to segment the left atrium (LA) and pulmonary veins (PV) from late gadolinium-enhanced (LGE) magnetic resonance imaging (MRI). The extent and distribution of atrial scar, visualized by LGE-MRI, provides important information for clinical treatment of atrial fibrillation (AF) patients. Forty-six AF patients (age 62 ± 8, 14 female) who underwent cardiac MRI prior to RF ablation were included. A contrast-enhanced MR angiography (MRA) sequence was acquired for anatomy assessment followed by an LGE sequence for LA scar assessment. A fully automatic segmentation method was proposed consisting of two stages: 1) global segmentation by multiatlas registration; and 2) local refinement by 3D level-set. These automatic segmentation results were compared with manual segmentation. The LA and PVs were automatically segmented in all subjects. Compared with manual segmentation, the method yielded a surface-to-surface distance of 1.49 ± 0.65 mm in the LA region when using both MRA and LGE, and 1.80 ± 0.93 mm when using LGE alone (P automatic and manual segmentation was comparable to the interobserver difference (P = 0.8 in LA region and P = 0.7 in PV region). We developed a fully automatic method for LA and PV segmentation from LGE-MRI, with comparable performance to a human observer. Inclusion of an MRA sequence further improves the segmentation accuracy. The method leads to automatic generation of a patient-specific model, and potentially enables objective atrial scar assessment for AF patients. J. Magn. Reson. Imaging 2016;44:346-354. © 2016 Wiley Periodicals, Inc.

  7. Role of sonography in the recognition, assessment, and treatment of cesarean scar ectopic pregnancies.

    Science.gov (United States)

    McKenna, David A; Poder, Liina; Goldman, Mindy; Goldstein, Ruth B

    2008-05-01

    Cesarean scar ectopic pregnancies (CSEPs) are rare but may have serious adverse consequences and are therefore important to promptly recognize on sonography. We aim to describe the typical sonographic appearances. Potential treatments are discussed, including sonographic guidance for transcervical injection of methotrexate (MTX) into the gestational sac. Two patients with CSEPs were treated with systemic and intra-amniotic administration of MTX under sonographic guidance. Both patients were followed clinically after medical treatment, resulting in low maternal morbidity and mortality. Considering the increasing rate of cesarean delivery and the increased risk of CSEPs, sonologists should be familiar with the sonographic appearances of a pregnancy implanted into the cesarean scar. We show how to correctly diagnose scar implantation and describe how to perform sonographically guided transcervical injection of MTX.

  8. Colour evaluation in scars: tristimulus colorimeter, narrow-band simple reflectance meter or subjective evaluation?

    Science.gov (United States)

    Draaijers, Lieneke J; Tempelman, Fenike R H; Botman, Yvonne A M; Kreis, Robert W; Middelkoop, Esther; van Zuijlen, Paul P M

    2004-03-01

    The evaluation of scar colour is, at present, usually limited to an assessment according to a scar assessment scale. Although useful, these assessment scales only evaluate subjectively the degree of scar colour. In this study, the reliability of the subjective assessment of scar colour by observers is compared to the reliability of the measurements of two objective colour measurement instruments. Four independent observers subjectively assessed the vascularisation and pigmentation of 49 scar areas in 20 patients. The degree of vascularisation and pigmentation was scored according to a scale ranging from '1', when it appeared to be like healthy skin, to '10', which corresponds to the worst imaginable outcome of vascularisation or pigmentation. The observers also scored the pigmentation categories of the scar (hypopigmention, hyperpigmention or mixed pigmentation). Finally, each observer measured the scar areas with a tristimulus colorimeter (Minolta Chromameter) and a narrow-band simple reflectance meter (DermaSpectrometer). A single observer could reliably carry out measurements of the DermaSpectrometer and the Minolta Chromameter for the evaluation of scar colour (r = 0.72). The vascularisation of scars could also be assessed reliably with a single observer (r = 0.76) whereas for a reliable assessment of pigmentation at least three observers were necessary (r > or = 0.77). The agreement between the observers for the pigmentation categories also turned out to be unacceptably low (k = 0.349). This study shows that an overall evaluation of scar colour with the DermaSpectrometer and the Minolta Chromameter is more reliable than the evaluation of scar colour with observers. Of both instruments for measuring scar colour, we prefer, because of its feasibility, the DermaSpectrometer.

  9. A comparison between laser-doppler imaging and colorimetry in the assessment of scarring: "a pilot study".

    Science.gov (United States)

    Peeters, Wouter; Anthonissen, Mieke; Deliaert, An; Van der Hulst, Rene; Van den Kerckhove, Eric

    2012-05-01

    This cross-sectional pilot-study investigated the reproducibility of the LDI (Moor-LDI-B2; Moor Instruments) and the chromameter (Minolta chromameter CR-300) when used in scar assessment. Twenty-seven scars in 14 subjects were included between January and June 2003. One observer performed two times both measurements with 10 min apart. The intra-observer agreement is quantified by means of the intra-class correlations (ICC) and the standard errors of measurement (SEM) for both the LDI and the chromameter. Ignoring one outlier, the ICC of the LDI = 0.856 and the SEM = 34.56. The chromameter shows a better reproducibility with an ICC of 0.93 and a SEM of 0.79. This pilot-study with a limited number of measurements shows a moderate reproducibility of the LDI compared to the chromameter measurements, in the assessment of respectively flux and redness in scars. © 2011 John Wiley & Sons A/S.

  10. Assessing blood flow, microvasculature, erythema and redness in hypertrophic scars: A cross sectional study showing different features that require precise definitions.

    Science.gov (United States)

    Jaspers, M E H; Stekelenburg, C M; Simons, J M; Brouwer, K M; Vlig, M; van den Kerckhove, E; Middelkoop, E; van Zuijlen, P P M

    2017-08-01

    In hypertrophic scar assessment, laser Doppler imaging (LDI), colorimetry and subjective assessment (POSAS) can be used to evaluate blood flow, erythema and redness, respectively. In addition, the microvasculature (i.e. presence of microvessels) can be determined by immunohistochemistry. These measurement techniques are frequently used in clinical practice and/or in research to evaluate treatment response and monitor scar development. However, until now it has not been tested to what extent the outcomes of these techniques are associated, whilst the outcome terms are frequently used interchangeably or replaced by the umbrella term 'vascularization'. This is confusing, as every technique seems to measure a specific feature. Therefore, we evaluated the correlations of the four measurement techniques. We included 32 consecutive patients, aged ≥18 years, who underwent elective resection of a hypertrophic scar. Pre-operatively, we performed LDI (measuring blood flow), colorimetry (measuring erythema) and the POSAS (subjective redness) within the predefined scar area of interest (∼1.5cm). Subsequently, the scar was excised and the area of interest was sent for immunohistochemistry, to determine the presence of microvessels. Only a statistically significant correlation was found between erythema values (colorimetry) and subjective redness assessment (POSAS) (r=0.403, p=0.030). We found no correlations between the outcomes of LDI, immunohistochemistry and colorimetry. Blood flow, the presence of microvessels and erythema appear to be different hypertrophic scar features because they show an absence of correlation. Therefore, in the field of scar assessment, these outcome terms cannot be used interchangeably. In addition, we conclude that the term 'vascularization' does not seem appropriate to serve as an umbrella term. The use of precise definitions in research as well as in clinical practice is recommended. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

  11. A prospective study of time to healing and hypertrophic scarring in paediatric burns: every day counts.

    Science.gov (United States)

    Chipp, Elizabeth; Charles, Lisa; Thomas, Clare; Whiting, Kate; Moiemen, Naiem; Wilson, Yvonne

    2017-01-01

    It is commonly accepted that burns taking longer than 3 weeks to heal have a much higher rate of hypertrophic scarring than those which heal more quickly. However, some of our patients develop hypertrophic scars despite healing within this 3-week period. We performed a prospective study of 383 paediatric burns treated non-operatively at a regional burns centre over a 2-year period from May 2011 to April 2013. Scar assessment was performed by a senior burns therapist using the Vancouver Scar Scale. Overall rates of hypertrophic scarring were 17.2%. Time to healing was the strongest predictor of developing hypertrophic scarring, and the earliest hypertrophic scar developed in a patient who was healed after 8 days. The risk of hypertrophic scarring was multiplied by 1.138 for every additional day taken for the burn wound to heal. There was a trend towards higher rates of hypertrophic scarring in non-white skin types but this did not reach statistical significance. The risk of hypertrophic scarring increases with every day and, therefore, every effort should be made to get the wound healed as quickly as possible, even within the traditional 3-week period usually allowed for healing. We believe that the traditional dogma of aiming for healing within 3 weeks is overly simplistic and should be abandoned: in paediatric burns, every day counts. Not applicable.

  12. An assessment of the efficacy and safety of cross technique with 100% TCA in the management of ice pick acne scars

    Directory of Open Access Journals (Sweden)

    Deepali Bhardwaj

    2010-01-01

    Full Text Available Background : Chemical reconstruction of skin scars (CROSS is a technique using high concentrations of trichloroacetic acid (TCA focally on atrophic acne scars to induce inflammation followed by collagenisation. This can lead to reduction in the appearance of scars and cosmetic improvement. Aims : The aim of this pilot study is to investigate the safety of the CROSS technique, using 100% TCA, for atrophic ice pick acne scars. Settings and Design : Open prospective study. Materials and Methods : Twelve patients with predominant atrophic ice pick post acne scars were treated with the CROSS technique, using 100% TCA, applied with a wooden toothpick, at two weekly intervals for four sittings. Efficacy was assessed on the basis of the physician′s clinical assessment, photographic evaluation at each sitting and patient′s feedback after the fourth treatment, and at the three-month and six-month follow-up period, after the last treatment. Results : More than 70% improvement was seen in eight out of ten patients evaluated and good results (50 - 70% improvement were observed in the remaining two patients. No significant side effects were noted. Transient hypopigmentation and hyperpigmentation was observed in one patient each. Physician′s findings were in conformity with the patient′s assessment. Three months after the last treatment, one patient noted a decrease in improvement with no further improvement even at the six-month follow-up period. Conclusion : The CROSS technique with 100% TCA is a safe, efficacious, cost-effective and minimally invasive technique for the management of ice pick acne scars that are otherwise generally difficult to treat. In few patients the improvement may not be sustained, probably due to inadequate or delayed collagenisation.

  13. Impact of facial burns: relationship between depressive symptoms, self-esteem and scar severity.

    Science.gov (United States)

    Hoogewerf, Cornelis Johannes; van Baar, Margriet Elisabeth; Middelkoop, Esther; van Loey, Nancy Elisa

    2014-01-01

    This study assessed the role of self-reported facial scar severity as a possible influencing factor on self-esteem and depressive symptoms in patients with facial burns. A prospective multicentre cohort study with a 6 months follow-up was conducted including 132 patients with facial burns. Patients completed the Patient and Observer Scar Assessment Scale, the Rosenberg Self-esteem Scale and the Hospital Anxiety and Depression Scale. Structural Equation Modeling was used to assess the relations between depressive symptoms, self-esteem and scar severity. The model showed that patient-rated facial scar severity was not predictive for self-esteem and depressive symptoms six months post-burn. There was, however, a significant relationship between early depressive symptoms and both patient-rated facial scar severity and subsequent self-esteem. The variables in the model accounted for 37% of the variance in depressive symptoms six months post-burn and the model provided a moderately well-fitting representation of the data. The study suggests that self-esteem and depressive symptoms were not affected by self-reported facial scar severity but that earlier depressive symptoms were indicative for a more severe self-reported facial scar rating. Therefore, routine psychological screening during hospitalisation is recommended in order to identify patients at risk and to optimise their treatment. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. Treatment of hypertrophic scars and keloids using intense pulsed light (IPL).

    Science.gov (United States)

    Erol, O Onur; Gurlek, Ali; Agaoglu, Galip; Topcuoglu, Ela; Oz, Hayat

    2008-11-01

    Keloids and hypertrophic scars are extremely disturbing to patients, both physically and psychologically. This study prospectively assessed the safety and efficacy of intense pulsed light (IPL) on scars originating from burns, trauma, surgery, and acne. Hypertrophic scars in 109 patients, originating from surgical incisions (n = 55), traumatic cuts (traffic accidents) (n = 24), acne scars (n = 6), keloids (n = 5), and burns (n = 19), were treated using an IPL Quantum device. Treatment was administered at 2-4-week intervals, and patients received an average of 8 treatments (range = 6-24). Using digital photographs, Changes in scar appearance were assessed by two physicians who were blinded to the study patients and treatments. The photographs were graded on a scale of 0 to 4 (none, minimal, moderate, good, excellent) for improvement in overall clinical appearance and reduction in height, erythema, and hardness. An overall clinical improvement in the appearance of scars and reductions in height, erythema, and hardness were seen in the majority of the patients (92.5%). Improvement was excellent in 31.2% of the patients, good in 25.7%, moderate in 34%, and minimal in 9.1%. Over half the patients had good or excellent improvement. In the preventive IPL treatment group, 65% had good to excellent improvement in clinical appearance. Patient satisfaction was very high. This study suggests that IPL is effective not only in improving the appearance of hypertrophic scars and keloids regardless of their origin, but also in reducing the height, redness, and hardness of scars.

  15. Comparison of the Effectiveness of Ablative and Non-Ablative Fractional Laser Treatments for Early Stage Thyroidectomy Scars

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    Jin-Uk Jang

    2016-11-01

    Full Text Available BackgroundOpen thyroidectomy is conventionally performed at the anterior side of neck, which is a body part with a comparatively great degree of open exposure; due to this, postoperative scarring may cause distress in patients. We aimed to compare the effects of ablative and nonablative fractional laser treatments on thyroidectomy scars. We examined medical records in a retrospective manner and analyzed scars based on their digital images by using the modified Manchester Scar Scale (mMSS.MethodsBetween February 2012 and May 2013, 55 patients with thyroidectomy scars were treated with ablative (34 patients or nonablative (21 patients fractional laser. Each patient underwent 4 laser treatment sessions in 3–4 week intervals, 1–2 months postoperatively. Scar improvement was assessed using patient images and the mMSS scale.ResultsThe mean decrease in scar score was 3.91 and 3.47 in the ablative and nonablative groups, respectively; the reduction between 2 groups did not exhibit any significant difference (P=0.16. We used the scale once again to individually evaluate scar attributes. The nonablative group accounted for a considerably higher color score value (P=0.03; the ablative group accounted for a considerably higher contour score value (P<0.01. Patient satisfaction was high and no complications occurred.ConclusionsBoth types of fractional laser treatments can be used successfully for thyroidectomy scar treatment with minimal complications; however, results indicate that higher effectiveness may be obtained from the use of ablative and nonablative lasers for hypertrophic scars and early erythematous scars, respectively. Therefore, the appropriate laser for scar treatment should be selected according to its specific characteristics.

  16. Effectiveness of Onion Extract Gel on Surgical Scars in Asians

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    Kumutnart Chanprapaph

    2012-01-01

    Full Text Available Background. Onion extracts have been shown in vitro to accelerate wound healing. Results from clinical studies on surgical scars in Caucasians were disappointing. The aim of this study is to evaluate the effectiveness of onion extract gel in improving the cosmetic and symptoms of surgical scars in Asians. Patients/Methods. Twenty Asians who had new Pfannenstiel’s cesarean section scars were recruited in this prospective double-blinded, split-scar study. Each side was randomly assigned treatment with onion extract gel or placebo at 7 days after surgery. The product was applied three times daily for 12 weeks. Subjects were evaluated at baseline and 4th and 12th weeks. Scar redness was assessed by calorimeter, scar height and pliability were assessed by blinded investigators, and scar symptoms and overall cosmetic improvement were assessed by subjects. Results. Sixteen subjects completed the study. A statistically significant difference between two sides of scar in terms of scar height and scar symptoms was found. There was no statistically significant difference in scar redness, scar pliability, and overall cosmetic appearance between two sides. Conclusions. The early use of topical 12% onion extract gel on Pfannenstiel’s cesarean section scar in Asians resulted in the improvement of scar height and scar symptoms.

  17. Fractional CO 2 laser resurfacing as monotherapy in the treatment of atrophic facial acne scars

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    Imran Majid

    2014-01-01

    Full Text Available Background: While laser resurfacing remains the most effective treatment option for atrophic acne scars, the high incidence of post-treatment adverse effects limits its use. Fractional laser photothermolysis attempts to overcome these limitations of laser resurfacing by creating microscopic zones of injury to the dermis with skip areas in between. Aim: The aim of the present study is to assess the efficacy and safety of fractional CO 2 laser resurfacing in atrophic facial acne scars. Materials and Methods: Sixty patients with moderate to severe atrophic facial acne scars were treated with 3-4 sessions of fractional CO 2 laser resurfacing at 6-week intervals. The therapeutic response to treatment was assessed at each follow up visit and then finally 6 months after the last laser session using a quartile grading scale. Response to treatment was labelled as ′excellent′ if there was >50% improvement in scar appearance and texture of skin on the grading scale while 25-50% response and <25% improvement were labelled as ′good′ and ′poor′ response, respectively. The overall satisfaction of the patients and any adverse reactions to the treatment were also noted. Results: Most of the patients showed a combination of different morphological types of acne scars. At the time of final assessment 6 months after the last laser session, an excellent response was observed in 26 patients (43.3% while 15 (25% and 19 patients (31.7% demonstrated a good and poor response respectively. Rolling and superficial boxcar scars responded the best while pitted scars responded the least to fractional laser monotherapy. The commonest reported adverse effect was transient erythema and crusting lasting for an average of 3-4 and 4-6 days, respectively while three patients developed post-inflammatory pigmentation lasting for 8-12 weeks. Conclusions: Fractional laser resurfacing as monotherapy is effective in treating acne scars especially rolling and superficial boxcar

  18. Post-burn scars and scar contractures

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    Goel Arun

    2010-10-01

    Full Text Available The mortality and morbidity from burns have diminished tremendously over the last six to seven decades. However, these do not truly reflect whether the victim could go back to society as a useful person or not and lead a normal life because of the inevitable post-burn scars, contractures and other deformities which collectively have aesthetic and functional considerations. This article gives an overview of the post-burn scars and scar contractures, especially their prevention, minimisation and principles of management.

  19. Orthodontic scars

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    Vinay Reddy

    2012-01-01

    Full Text Available Orthodontic therapy apart from its benefits also has potential risks and limitations in terms of tissue damage. Fortunately, in orthodontics, risks are minimal and infrequent However, all potential risks and limitations should be considered and addressed when making the decision to undergo orthodontic treatment. Orthodontic treatment carries with it the risk of various types of soft and hard tissue damages (e.g. decalcification of enamel, lacerations, ulcerations, temporomandibular joint disorders, etc-, apart from treatment failure in itself. If correcting a malocclusion is to be of benefit, the advantages offered should outweigh any possible damage- All preventive procedures should be considered during and after orthodontic treatment to restore the normal health of soft and hard tissues. Hence, the orthodontist should be vigilant and prudent enough in assessing and monitoring every aspect of these tissues at any given stage and time in order to achieve a healthy and successful final result.

  20. Assessment of SCAR markers to design real-time PCR primers for rhizosphere quantification of Azospirillum brasilense phytostimulatory inoculants of maize.

    Science.gov (United States)

    Couillerot, O; Poirier, M-A; Prigent-Combaret, C; Mavingui, P; Caballero-Mellado, J; Moënne-Loccoz, Y

    2010-08-01

    To assess the applicability of sequence characterized amplified region (SCAR) markers obtained from BOX, ERIC and RAPD fragments to design primers for real-time PCR quantification of the phytostimulatory maize inoculants Azospirillum brasilense UAP-154 and CFN-535 in the rhizosphere. Primers were designed based on strain-specific SCAR markers and were screened for successful amplification of target strain and absence of cross-reaction with other Azospirillum strains. The specificity of primers thus selected was verified under real-time PCR conditions using genomic DNA from strain collection and DNA from rhizosphere samples. The detection limit was 60 fg DNA with pure cultures and 4 x 10(3) (for UAP-154) and 4 x 10(4) CFU g(-1) (for CFN-535) in the maize rhizosphere. Inoculant quantification was effective from 10(4) to 10(8) CFU g(-1) soil. BOX-based SCAR markers were useful to find primers for strain-specific real-time PCR quantification of each A. brasilense inoculant in the maize rhizosphere. Effective root colonization is a prerequisite for successful Azospirillum phytostimulation, but cultivation-independent monitoring methods were lacking. The real-time PCR methods developed here will help understand the effect of environmental conditions on root colonization and phytostimulation by A. brasilense UAP-154 and CFN-535.

  1. Microplasma radiofrequency technology combined with triamcinolone improved the therapeutic effect on Chinese patients with hypertrophic scar and reduced the risk of tissue atrophy.

    Science.gov (United States)

    Yu, Shui; Li, Hengjin

    2016-01-01

    The current study aimed to assess the value of microplasma radiofrequency technology combined with triamcinolone for the therapy of Chinese patients with hypertrophic scar. A total of 120 participants with hypertrophic scars were enrolled in the current study. Participants were divided into two groups based on sex, and then randomly and evenly divided into four groups (Groups A, B, C, and D). Participants in Group A received microplasma radiofrequency technology combined with triamcinolone. Participants in Group B received microplasma radiofrequency technology combined with normal saline. Participants in Groups C and D received triamcinolone (40 and 10 mg/mL) injected directly into scar. Experienced physicians evaluated the condition of scars according to the Vancouver Scar Scale 1 month before and after the therapy. There was no difference in age, sex, area, height and location of scars, and Vancouver Scar Scale scores before the therapy between any groups (P>0.05 for all). Vancouver Scar Scale scores after the therapy were significantly lower than those before the therapy in all groups (P0.05 for all). Incidences of tissue atrophy after the therapy were significantly lower in Groups A and B than in Group C (P0.05 for all). Microplasma radiofrequency technology combined with triamcinolone improved the therapeutic effect on Chinese patients with hypertrophic scar and reduced the risk of tissue atrophy compared with the use of either microplasma radiofrequency technology or triamcinolone injection alone.

  2. DIEP flap customization using Fluobeam® indocyanine green tissue perfusion assessment with large previous abdominal scar

    Directory of Open Access Journals (Sweden)

    Michael A. Fallucco

    2017-06-01

    Full Text Available The Fluobeam® is a portable, near-infrared camera that is held and controlled by the surgeon to visualize tissue perfusion using indocyanine green (ICG fluorescence imaging. This case report describes how data obtained from ICG imaging allows intraoperative customization in a previously surgically scarred abdomen during autologous Deep Inferior Epigastric Artery Perforator (DIEP flap bilateral breast reconstruction. The outcome was successful breast mound recreation without fat necrosis.

  3. Fractional CO2 Laser Resurfacing as Monotherapy in the Treatment of Atrophic Facial Acne Scars.

    Science.gov (United States)

    Majid, Imran; Imran, Saher

    2014-04-01

    While laser resurfacing remains the most effective treatment option for atrophic acne scars, the high incidence of post-treatment adverse effects limits its use. Fractional laser photothermolysis attempts to overcome these limitations of laser resurfacing by creating microscopic zones of injury to the dermis with skip areas in between. The aim of the present study is to assess the efficacy and safety of fractional CO2 laser resurfacing in atrophic facial acne scars. Sixty patients with moderate to severe atrophic facial acne scars were treated with 3-4 sessions of fractional CO2 laser resurfacing at 6-week intervals. The therapeutic response to treatment was assessed at each follow up visit and then finally 6 months after the last laser session using a quartile grading scale. Response to treatment was labelled as 'excellent' if there was >50% improvement in scar appearance and texture of skin on the grading scale while 25-50% response and resurfacing as monotherapy is effective in treating acne scars especially rolling and superficial boxcar scars with minimal adverse effects.

  4. [Physical therapy for scars].

    Science.gov (United States)

    Masanovic, Marguerite Guillot

    2013-01-01

    Physical therapy consists notably of hand or mechanical massages, pressure therapy using various fabrics or splints, cryotherapy, laser therapy, etc. It forms part of the range of therapies used to treat pathological scars, including medical and surgical treatment. While the results are often satisfactory for hypertrophic scars, they remain uncertain for major keloids.

  5. Combination therapy in the management of atrophic acne scars

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    Shilpa Garg

    2014-01-01

    Full Text Available Background: Atrophic acne scars are difficult to treat. The demand for less invasive but highly effective treatment for scars is growing. Objective: To assess the efficacy of combination therapy using subcision, microneedling and 15% trichloroacetic acid (TCA peel in the management of atrophic scars. Materials and Methods: Fifty patients with atrophic acne scars were graded using Goodman and Baron Qualitative grading. After subcision, dermaroller and 15% TCA peel were performed alternatively at 2-weeks interval for a total of 6 sessions of each. Grading of acne scar photographs was done pretreatment and 1 month after last procedure. Patients own evaluation of improvement was assessed. Results: Out of 16 patients with Grade 4 scars, 10 (62.5% patients improved to Grade 2 and 6 (37.5% patients improved to Grade 3 scars. Out of 22 patients with Grade 3 scars, 5 (22.7% patients were left with no scars, 2 (9.1% patients improved to Grade 1and 15 (68.2% patients improved to Grade 2. All 11 (100% patients with Grade 2 scars were left with no scars. There was high level of patient satisfaction. Conclusion: This combination has shown good results in treating not only Grade 2 but also severe Grade 4 and 3 scars.

  6. Facial Scar Revision: Understanding Facial Scar Treatment

    Science.gov (United States)

    ... keep the head elevated when lying down, to use cold compresses to reduce swelling, and to avoid any activity that places undue stress on the area of the incision. Depending on the surgery performed and the site of the scar, the facial plastic surgeon will explain the types of activities to ...

  7. Efficacy of the fractional photothermolysis system with dynamic operating mode on acne scars and enlarged facial pores.

    Science.gov (United States)

    Cho, Sung Bin; Lee, Ju Hee; Choi, Moon Jung; Lee, Kyu-Yeop; Oh, Sang Ho

    2009-01-01

    Current treatments for acne scars and enlarged facial pores have shown limited efficacy. To evaluate the efficacy and safety of the fractional photothermolysis system (FPS) with dynamic operating mode on acne scars and enlarged pores. Twelve patients with mild to moderate atrophic acne scars and enlarged pores were included in this study. Three sessions of FPS treatment were performed for acne scars and facial pores monthly. Two blinded dermatologists who compared before and after photos based on a quartile grading scale conducted objective clinical assessments of acne scar- and facial pore-treated areas. We took a biopsy immediately after one treatment with the laser from one of the authors to assess the histologic effects of the laser on facial pores. Follow-up results at 4 months after the last treatment revealed that, of the 12 patients, for acne scars, five demonstrated clinical improvements of 51% to 75% and three demonstrated improvements of 76% to 100%, and for facial pores, five demonstrated moderate clinical improvements of 26% to 50% and three demonstrated improvements of 76% to 100%. Side effects, including pain, post-treatment erythema, and edema, were resolved within 1 week. We suggest that the FPS may provide a new treatment algorithm in some cases with acne scars and enlarged pores. Considering the lack of placebo-controlled, split-face design of our study, optimized, prospective studies should be conducted to fully assess the efficacy of FPS with dynamic operating mode.

  8. Forensic analysis of rockfall scars

    Science.gov (United States)

    de Vilder, Saskia J.; Rosser, Nick J.; Brain, Matthew J.

    2017-10-01

    We characterise and analyse the detachment (scar) surfaces of rockfalls to understand the mechanisms that underpin their failure. Rockfall scars are variously weathered and comprised of both discontinuity release surfaces and surfaces indicative of fracturing through zones of previously intact rock, known as rock bridges. The presence of rock bridges and pre-existing discontinuities is challenging to quantify due to the difficulty in determining discontinuity persistence below the surface of a rock slope. Rock bridges form an important control in holding blocks onto rockslopes, with their frequency, extent and location commonly modelled from the surface exposure of daylighting discontinuities. We explore an alternative approach to assessing their role, by characterising failure scars. We analyse a database of multiple rockfall scar surfaces detailing the areal extent, shape, and location of broken rock bridges and weathered surfaces. Terrestrial laser scanning and gigapixel imagery were combined to record the detailed texture and surface morphology. From this, scar surfaces were mapped via automated classification based on RGB pixel values. Our analysis of the resulting data from scars on the North Yorkshire coast (UK) indicates a wide variation in both weathering and rock bridge properties, controlled by lithology and associated rock mass structure. Importantly, the proportion of rock bridges in a rockfall failure surface does not increase with failure size. Rather larger failures display fracturing through multiple rock bridges, and in contrast smaller failures fracture occurs only through a single critical rock bridge. This holds implications for how failure mechanisms change with rockfall size and shape. Additionally, the location of rock bridges with respect to the geometry of an incipient rockfall is shown to determine failure mode. Weathering can occur both along discontinuity surfaces and previously broken rock bridges, indicating the sequential stages of

  9. Keloids and Hypertrophic Scars

    Science.gov (United States)

    ... to the skin both skin cells and connective tissue cells (fibroblasts) begin multiplying to repair the damage. A scar is made up of 'connective tissue', gristle-like fibers deposited in the skin by ...

  10. Radiation scars on mammograms

    International Nuclear Information System (INIS)

    Otto, H.; Breining, H.; Knappschafts-Krankenhaus Essen

    1985-01-01

    Six patients with radiation scars are described. In each case the diagnosis was confirmed histologically in five cases corresponding mammograms were available. The histological appearances of radiation scars are described and the radiological features are presented. These lesions can be diagnosed mammographically in vivo. Macroscopically differentiation from a scirrhous carcinoma is not possible and therefore a radiation scar must always be excised; this also leads to definitive cure. On mammographic screening the incidence is 0.5 to 0.9 per thousand. The significance of radiation scars depends on the fact that they are pre-cancerous and therefore are equivalent to the early diagnosis of a carcinoma with the possibility of a complete cure. (orig.) [de

  11. The Efficacy of a Silicone Sheet in Postoperative Scar Management.

    Science.gov (United States)

    Kim, Jin Sam; Hong, Joon Pio; Choi, Jong Woo; Seo, Dong Kyo; Lee, Eun Sook; Lee, Ho Seong

    2016-09-01

    Silicone gel sheeting has been introduced to prevent scarring, but objective evidence for its usefulness in scar healing is limited. Therefore, the authors' objective was to examine the effectiveness of silicone gel sheeting by randomly applying it to only unilateral scars from a bilateral hallux valgus surgery with symmetrical closure. In a prospective randomized, blinded, intraindividual comparison study, the silicone gel sheeting was applied to 1 foot of a hallux valgus incision scar (an experiment group) for 12 weeks upon removal of the stitches, whereas the symmetrical scar from the other foot was left untreated (a control group). The scars were evaluated at 4 and 12 weeks after the silicon sheet application. The Vancouver Scar Scale was used to measure the vascularity, pigmentation, pliability, height, and length of the scars. Adverse effects were also evaluated, and they included pain, itchiness, rash, erythema, and skin softening. At weeks 4 and 12, the experiment group scored significantly better on the Vancouver Scar Scale in all items, except length (P sheet does not cause adverse effects (P sheet application did show a significant improvement in prevention of postoperative scarring.

  12. Autologous fat graft as treatment of post short stature surgical correction scars.

    Science.gov (United States)

    Maione, Luca; Memeo, Antonio; Pedretti, Leopoldo; Verdoni, Fabio; Lisa, Andrea; Bandi, Valeria; Giannasi, Silvia; Vinci, Valeriano; Mambretti, Andrea; Klinger, Marco

    2014-12-01

    Surgical limb lengthening is undertaken to correct pathological short stature. Among the possible complications related to this procedure, painful and retractile scars are a cause for both functional and cosmetic concern. Our team has already shown the efficacy of autologous fat grafting in the treatment of scars with varying aetiology, so we decided to apply this technique to scars related to surgical correction of dwarfism. A prospective study was conducted to evaluate the efficacy of autologous fat grafting in the treatment of post-surgical scars in patients with short-limb dwarfism using durometer measurements and a modified patient and observer scar assessment scale (POSAS), to which was added a parameter to evaluate movement impairment. Between January 2009 and September 2012, 36 children (28 female and 8 male) who presented retractile and painful post-surgical scars came to our unit and were treated with autologous fat grafting. Preoperative and postoperative mean durometer measurements were analysed using the analysis of variance (ANOVA) test and POSAS parameters were studied using the Wilcoxon rank sum test. There was a statistically significant reduction in all durometer measurements (p-value treatment with autologous fat grafting. Surgical procedures to camouflage scars on lower limbs are not often used as a first approach and non-surgical treatments often lead to unsatisfactory results. In contrast, our autologous fat grafting technique in the treatment of post-surgical scars has been shown to be a valuable option in patients with short-limb dwarfism. There was a reduction of skin hardness and a clinical improvement of all POSAS parameters in all patients treated. Moreover, the newly introduced POSAS parameter appears to be reliable and we recommend that it is included to give a more complete evaluation of patient perception. Copyright © 2014 Elsevier Ltd. All rights reserved.

  13. A study on scar revision

    Directory of Open Access Journals (Sweden)

    Ashutosh Talwar

    2016-04-01

    Full Text Available Introduction: Scars are psychologically distressing for the patients and have an impact on the quality of life and self esteem of the patients. Scar revision is an aesthetic skill which is mastered by plastic surgeons and encroached now by dermatosurgeons. Scars on the face are aesthetically unacceptable and various techniques have been improvised for making a scar aesthetically acceptable. Various types of techniques are used for scar revision like W plasty, Z plasty and VY plasty. Aims: To see the efficacy of various scar revision techniques including Z plasty, VY plasty and W plasty in 30 patients with disfiguring scars. Methods: We selected twenty patients of disfiguring scars for the study. The scars from various causes including trauma and burns were included in our study. Various techniques of scar revision include Z plasty, W plasty and VY plasty were performed according to the type and site of scar. Results: Male: female was 1.5: 1. The scar revision surgery yielded excellent results with minimal complications including haematoma formation, secondary infection and delayed healing seen in 5% patients each. Regarding the efficacy of scar revision, excellent improvement was seen in 60% patients, moderate improvement was seen in 30% patients and mild improvement was seen in 10% patients. Conclusions: Dermatologists can employ a number of surgical scar revision techniques. While some are better suited to treat specific types of scars, they can be used in combination with each other or with adjunctive therapies to achieve optimal results.

  14. A Comparative Study on the Formation Mechanism of Wear Scars during the Partial and Full Scale Fretting Wear Tests of Spacer Grids

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Young Ho; Shin, Chang Hwan; Oh, Dong Seok; Kang, Heung Seok [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2012-05-15

    traces without considering flow field effects. So, in this study, fretting wear tests of nuclear fuel rod with partial and full scale spacer girds have been performed to compare the morphology of wear scars at each test condition and to verify the flow field effect on the variation of fretting wear mechanism

  15. A Comparative Study on the Formation Mechanism of Wear Scars during the Partial and Full Scale Fretting Wear Tests of Spacer Grids

    International Nuclear Information System (INIS)

    Lee, Young Ho; Shin, Chang Hwan; Oh, Dong Seok; Kang, Heung Seok

    2012-01-01

    traces without considering flow field effects. So, in this study, fretting wear tests of nuclear fuel rod with partial and full scale spacer girds have been performed to compare the morphology of wear scars at each test condition and to verify the flow field effect on the variation of fretting wear mechanism

  16. Sonographic evaluation of surgical repair of uterine cesarean scar defects.

    Science.gov (United States)

    Pomorski, Michal; Fuchs, Tomasz; Rosner-Tenerowicz, Anna; Zimmer, Mariusz

    2017-10-01

    The aim of the study was to assess the clinical outcomes of surgical repair of uterine cesarean scar defects with sonography (US). Seven nonpregnant women with history of cesarean section and a large uterine scar defect were enrolled. The surgical repair was performed by minilaparotomy. The US assessment of the uterine scar was performed using a standardized approach at baseline, then at a first visit 2-3 days following the surgical intervention (V1) and at a follow-up visit 3 months later (V2). Residual myometrial thickness (RMT), width, and depth of the scar defect were measured. The mean RMT increased significantly from 1.9 mm at baseline to 8.8 mm at V1 and 8.0 mm at V2. No intraoperative complications were observed. Postmenstrual spotting and abdominal pain reported preoperatively resolved after the operation. A surgical repair procedure for an incompletely healed uterine cesarean scar is effective in increasing RMT thickness, decreasing the depth of the scar, and reducing symptoms related to the cesarean section scar defect. Further studies on post-repair pregnancy outcomes are required to evaluate whether the procedure affects the rate of cesarean scar pregnancy, morbidly adherent placenta, and/or uterine scar dehiscence and rupture. The repair of a cesarean scar defect is recommended only for symptomatic women. © 2017 Wiley Periodicals, Inc. J Clin Ultrasound 45:455-460, 2017. © 2017 Wiley Periodicals, Inc.

  17. Spatial and temporal corroboration of a fire-scar-based fire history in a frequently burned ponderosa pine forest.

    Science.gov (United States)

    Farris, Calvin A; Baisan, Christopher H; Falk, Donald A; Yool, Stephen R; Swetnam, Thomas W

    2010-09-01

    Fire scars are used widely to reconstruct historical fire regime parameters in forests around the world. Because fire scars provide incomplete records of past fire occurrence at discrete points in space, inferences must be made to reconstruct fire frequency and extent across landscapes using spatial networks of fire-scar samples. Assessing the relative accuracy of fire-scar fire history reconstructions has been hampered due to a lack of empirical comparisons with independent fire history data sources. We carried out such a comparison in a 2780-ha ponderosa pine forest on Mica Mountain in southern Arizona (USA) for the time period 1937-2000. Using documentary records of fire perimeter maps and ignition locations, we compared reconstructions of key spatial and temporal fire regime parameters developed from documentary fire maps and independently collected fire-scar data (n = 60 plots). We found that fire-scar data provided spatially representative and complete inventories of all major fire years (> 100 ha) in the study area but failed to detect most small fires. There was a strong linear relationship between the percentage of samples recording fire scars in a given year (i.e., fire-scar synchrony) and total area burned for that year (y = 0.0003x + 0.0087, r2 = 0.96). There was also strong spatial coherence between cumulative fire frequency maps interpolated from fire-scar data and ground-mapped fire perimeters. Widely reported fire frequency summary statistics varied little between fire history data sets: fire-scar natural fire rotations (NFR) differed by or = 25% of study area burned) were identical between data sets (25.5 yr); fire-scar MFIs for all fire years differed by 1.2 yr from documentary records. The known seasonal timing of past fires based on documentary records was furthermore reconstructed accurately by observing intra-annual ring position of fire scars and using knowledge of tree-ring growth phenology in the Southwest. Our results demonstrate clearly

  18. Scaling up: Assessing social impacts at the macro-scale

    International Nuclear Information System (INIS)

    Schirmer, Jacki

    2011-01-01

    Social impacts occur at various scales, from the micro-scale of the individual to the macro-scale of the community. Identifying the macro-scale social changes that results from an impacting event is a common goal of social impact assessment (SIA), but is challenging as multiple factors simultaneously influence social trends at any given time, and there are usually only a small number of cases available for examination. While some methods have been proposed for establishing the contribution of an impacting event to macro-scale social change, they remain relatively untested. This paper critically reviews methods recommended to assess macro-scale social impacts, and proposes and demonstrates a new approach. The 'scaling up' method involves developing a chain of logic linking change at the individual/site scale to the community scale. It enables a more problematised assessment of the likely contribution of an impacting event to macro-scale social change than previous approaches. The use of this approach in a recent study of change in dairy farming in south east Australia is described.

  19. Cesarean scar pregnancy

    DEFF Research Database (Denmark)

    Petersen, Kathrine Birch; Hoffmann, Elise; Rifbjerg Larsen, Christian

    2016-01-01

    OBJECTIVE: To study treatment modalities for cesarean scar pregnancies (CSPs), focusing on efficacy and complications in relation to study quality. DESIGN: Systematic review. SETTING: Not applicable. PATIENT(S): A total of 2,037 women with CSP. INTERVENTION(S): Review of MEDLINE, EMBASE, and Coch......OBJECTIVE: To study treatment modalities for cesarean scar pregnancies (CSPs), focusing on efficacy and complications in relation to study quality. DESIGN: Systematic review. SETTING: Not applicable. PATIENT(S): A total of 2,037 women with CSP. INTERVENTION(S): Review of MEDLINE, EMBASE...

  20. Psychological status as a function of residual scarring and facial asymmetry after surgical repair of cleft lip and palate.

    Science.gov (United States)

    Millar, Keith; Bell, Aileen; Bowman, Adrian; Brown, Denise; Lo, Tsz-Wai; Siebert, Paul; Simmons, David; Ayoub, Ashraf

    2013-03-01

    Objective : Objective measure of scarring and three-dimensional (3D) facial asymmetry after surgical correction of unilateral cleft lip (UCL) and unilateral cleft lip (UCLP). It was hypothesized that the degree of scarring or asymmetry would be correlated with poorer psychological function. Design : In a cross-sectional design, children underwent 3D imaging of the face and completed standardized assessments of self-esteem, depression, and state and trait anxiety. Parents rated children's adjustment with a standard scale. Setting : Glasgow Dental School, School of Medicine, College of Medical, Veterinary and Life Sciences. Patients : Fifty-one children aged 10 years with UCLP and 43 with UCL were recruited from the cohort treated with the surgical protocol of the CLEFTSIS managed clinical network in Scotland. Methods : Objective assessment to determine the luminance and redness of the scar and facial asymmetry. Depression, anxiety, and a self-esteem assessment battery were used for the psychological analysis. Results : Cleft cases showed superior psychological adjustment when compared with normative data. Prevalence of depression matched the population norm. The visibility of the scar (luminance ratio) was significantly correlated with lower self-esteem and higher trait anxiety in UCLP children (P  =  .004). Similar but nonsignificant trends were seen in the UCL group. Parental ratings of poorer adjustment also correlated with greater luminance of the scar. Conclusions : The objectively defined degree of postoperative cleft scarring was associated with subclinical symptoms of anxiety, depression, and low self-esteem.

  1. Evaluation of a constipation risk assessment scale.

    Science.gov (United States)

    Zernike, W; Henderson, A

    1999-06-01

    This project was undertaken in order to evaluate the utility of a constipation risk assessment scale and the accompanying bowel management protocol. The risk assessment scale was primarily introduced to teach and guide staff in managing constipation when caring for patients. The intention of the project was to reduce the incidence of constipation in patients during their admission to hospital.

  2. Comparative Study of the Use of Trichloroacetic Acid and Phenolic Acid in the Treatment of Atrophic-Type Acne Scars.

    Science.gov (United States)

    Dalpizzol, Mariana; Weber, Magda B; Mattiazzi, Anna Paula F; Manzoni, Ana Paula D

    2016-03-01

    Many therapies involving varying degrees of complexity have been used to treat acne scars, but none is considered the gold standard treatment. A comparative evaluation of 88% phenol and 90% trichloroacetic acid (TCA) applied using the chemical reconstruction of skin scars (CROSS) technique. A nonrandomized, single-blinded self-controlled clinical trial was conducted among patients with ice pick-type and boxcar-type atrophic acne scars. Using 88% phenol on the left hemiface and 90% TCA on the right hemiface was adopted as the standard practice of the CROSS technique. The dermatological quality of life index (DLQI) questionnaire, acne scar grading scale Échelle d´Evaluation Clinique des Cicatrices d'Acne (ECCA), and evaluation of improvement were performed pretreatment and post-treatment. Regarding ECCA, significant differences were found in pretreatment and post-treatment (p < .001). Regarding tolerance to pain, it was found that the discomfort felt with 90% TCA was significantly less than that felt with 88% phenol (p = .020). Regarding the quality of life measured with the DLQI, the results showed that the mean score in post-treatment assessment was significantly lower than that in the pretreatment assessment (p < .05). Hypochromia and enlargement scar were only seen after the use of 90% TCA. This study confirmed the efficacy of both TCA and phenol for treating such scars, with less severe complications from the use of phenol.

  3. Scar evaluation of split thickness skin graft donor site

    Directory of Open Access Journals (Sweden)

    Jani Muha

    2014-12-01

    Full Text Available BACKGROUND. Split thickness skin graft harvesting causes a certain degree of scaring on the donor site. Donor site scar can cause aesthetic and functional sequelae on the patient's body. Our goal was to study the process of donor site selection, and then evaluate donor site scars and their impact on patients. PATIENTS AND METHODS. This retrospective study included 45 patients aged 5 to 61 years (in average 36, who have been treated with STSG in the 2004–2010 period. 57.8% of them were men. On a follow-up visit, we photographed healed skin defects and donor sites. We then determined and compared the surface areas of skin defect and the donor site using the Adobe® Illustrator® CS5 computer program. Donor site scars were assessed according to the Vancouver scar scale (VSS. We examined scar’s light touch sensitivity with monofilaments and skin colouring compared to adjacent healthy skin using colorimeter. Patients were also interviewed about their treatment course in a form of a standardized questionnaire. RESULTS. Our research has revealed that 20.0% of patients participated in the decision making process of choosing the donor site, while in 80.0% the donor site was chosen by the surgeon himself. 6.7% of patients were not satisfied with their donor site. Most of the patients (37/45 had donor sites on their thighs. In average, the donor site surface area was 94% bigger than the skin defect area. We found statistically significant differences in VSS values, light touch sensitivity and skin colouring between donor site scaring and adjacent healthy skin. CONCLUSIONS. Donor site scar can represent a lasting aesthetic and functional disability for patients. Our research has shown that most of the patients do not participate in the donor site selection process, but are satisfied with their donor site. In most cases, STGSs are harvested from the thigh, other anatomical regions, where scarring would be aesthetically less obtrusive, are underused

  4. An objective device for measuring surface roughness of skin and scars

    NARCIS (Netherlands)

    Bloemen, Monica C. T.; van Gerven, Maaike S.; van der Wal, Martijn B. A.; Verhaegen, Pauline D. H. M.; Middelkoop, Esther

    2011-01-01

    Scar formation remains a major clinical problem; therefore, various therapies have been developed to improve scar quality. To evaluate the effectiveness of these therapies, objective measurement tools are necessary. An appropriate, objective measuring instrument for assessment of surface roughness

  5. An objective device for measuring surface roughness of skin and scars

    NARCIS (Netherlands)

    Bloemen, M.C.T.; van Gerven, M.S.; van der Wal, M.B.A.; Verhaegen, P.D.H.M.; Middelkoop, E.

    2011-01-01

    Background: Scar formation remains a major clinical problem; therefore, various therapies have been developed to improve scar quality. To evaluate the effectiveness of these therapies, objective measurement tools are necessary. An appropriate, objective measuring instrument for assessment of surface

  6. Intralesional triamcinolone alone and in combination with 5-fluorouracil for the treatment of Keloid and Hypertrophic scars

    International Nuclear Information System (INIS)

    Khan, M. A.; Bashir, M. M.; Khan, F. A.

    2014-01-01

    Objective: To compare the use of intralesional triamcinolone acetonide and its combination with 5 flourouracil in the treatment of keloid and hypertrophic scars in terms of reduction in initial height of the scar. Methods: The randomised controlled trial was conducted at the Department of Plastic Surgery, King Edward Medical University, Lahore, from March 2011 to December 2012. It comprised patients of both genders having keloids or hypertrophic scars (1 cm to 5 cm in size) having no history of treatment for the scars in preceding 6 months. Those who were pregnant, planning pregnancy or lactating were excluded. The subjects were divided into two groups: Group A received intralesional triamcinolone acetonide alone; and Group B received triamcinolone acetonide + 5 flourouracil. Eight injections were given at weekly interval. Scars were assessed 4 weeks after the completion of treatment on a five-point scale. SPSS 16 was used for statistical analysis. Results: The 150 subjects in the study were divided into two equal groups of 75(50%) each. Good to excellent results were seen in 51(68%) cases in Group A compared to 63(84%) in Group B. Frequency of complications was 18(24%) and 6(8%) in Group A and Group B respectively. Conclusion: Combination of triamcinolone acetonide and 5 flourouracil is superior to triamcinolone acetonide therapy in the treatment of keloids and hypertrophic scars. (author)

  7. Acne Scar Treatment: A Multimodality Approach Tailored to Scar Type.

    Science.gov (United States)

    Zaleski-Larsen, Lisa A; Fabi, Sabrina G; McGraw, Timothy; Taylor, Mark

    2016-05-01

    Acne scarring can be classified into atrophic icepick, boxcar, and rolling scars in addition to keloidal and hypertrophic scars. Additionally, these scars can be erythematous, hyperpigmented, and/or hypopigmented. Each scar type has a different structural cause warranting a customized approach. Many cosmetic options exist to address these changes individually, but little literature exists about the safety and efficacy of combining such procedures and devices. A Medline search was performed on combination treatments because it relates to facial acne scarring, and results are summarized. Practical applications for these combinations of procedures are also discussed. Studies examining the efficacy and safety of ablative, nonablative, fractionated, and nonfractionated lasers, dermabrasion, chemical peels, needling, subcision, radiofrequency, stem cell therapy, fat transplantation, platelet-rich plasma, and hyaluronic acid dermal fillers for acne scars were found. The authors review their experience in combining these techniques. Review of the literature revealed multiple single options for facial acne scarring treatment with minimal evidence in the literature found on the safety and efficacy of combining such procedures and devices. The authors' experience is that combining acne scar treatment techniques can be performed safely and synergistically with optimal patient outcomes.

  8. Validated assessment scales for the lower face.

    Science.gov (United States)

    Narins, Rhoda S; Carruthers, Jean; Flynn, Timothy C; Geister, Thorin L; Görtelmeyer, Roman; Hardas, Bhushan; Himmrich, Silvia; Jones, Derek; Kerscher, Martina; de Maio, Maurício; Mohrmann, Cornelia; Pooth, Rainer; Rzany, Berthold; Sattler, Gerhard; Buchner, Larry; Benter, Ursula; Breitscheidel, Lusine; Carruthers, Alastair

    2012-02-01

    Aging in the lower face leads to lines, wrinkles, depression of the corners of the mouth, and changes in lip volume and lip shape, with increased sagging of the skin of the jawline. Refined, easy-to-use, validated, objective standards assessing the severity of these changes are required in clinical research and practice. To establish the reliability of eight lower face scales assessing nasolabial folds, marionette lines, upper and lower lip fullness, lip wrinkles (at rest and dynamic), the oral commissure and jawline, aesthetic areas, and the lower face unit. Four 5-point rating scales were developed to objectively assess upper and lower lip wrinkles, oral commissures, and the jawline. Twelve experts rated identical lower face photographs of 50 subjects in two separate rating cycles using eight 5-point scales. Inter- and intrarater reliability of responses was assessed. Interrater reliability was substantial or almost perfect for all lower face scales, aesthetic areas, and the lower face unit. Intrarater reliability was high for all scales, areas and the lower face unit. Our rating scales are reliable tools for valid and reproducible assessment of the aging process in lower face areas. © 2012 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.

  9. Clinical Music Study Quality Assessment Scale (MUSIQUAS)

    NARCIS (Netherlands)

    Jaschke, A.C.; Eggermont, L.H.P.; Scherder, E.J.A.; Shippton, M.; Hiomonides, I.

    2013-01-01

    AIMS Quality assessment of studies is essential for the understanding and application of these in systematic reviews and meta analyses, the two “gold standards” of medical sciences. Publications in scientific journals have extensively used assessment scales to address poor methodological quality,

  10. Roentgenodiagnosis of stomach postulcer scar

    International Nuclear Information System (INIS)

    Strunin, A.E.

    1985-01-01

    A study was made of the X-ray picture of the stomach postulcer scar in correlation with fibrogastroscopy in 39 patients. The X-ray picture was characterized by considerable polymorphism and at the same time it was difficult to single out pathognomonic features. For specified diagnosis and differentiation the detection of the postulcer scar must become a multifaceted roentgenoendoscopic problem. Stomach ulcers may scar, sometimes with the complete regeneration of the mucosa relief, however their recurrences can develop in the zone of the postulcer scar

  11. Mokken scaling of the Myocardial Infarction Dimensional Assessment Scale (MIDAS).

    Science.gov (United States)

    Thompson, David R; Watson, Roger

    2011-02-01

    The purpose of this study was to examine the hierarchical and cumulative nature of the 35 items of the Myocardial Infarction Dimensional Assessment Scale (MIDAS), a disease-specific health-related quality of life measure. Data from 668 participants who completed the MIDAS were analysed using the Mokken Scaling Procedure, which is a computer program that searches polychotomous data for hierarchical and cumulative scales on the basis of a range of diagnostic criteria. Fourteen MIDAS items were retained in a Mokken scale and these items included physical activity, insecurity, emotional reaction and dependency items but excluded items related to diet, medication or side-effects. Item difficulty, in item response theory terms, ran from physical activity items (low difficulty) to insecurity, suggesting that the most severe quality of life effect of myocardial infarction is loneliness and isolation. Items from the MIDAS form a strong and reliable Mokken scale, which provides new insight into the relationship between items in the MIDAS and the measurement of quality of life after myocardial infarction. © 2010 Blackwell Publishing Ltd.

  12. Can Acne Scars Be Removed?

    Science.gov (United States)

    ... Safe Videos for Educators Search English Español Can Acne Scars Be Removed? KidsHealth / For Teens / Can Acne ... eliminar las cicatrices del acné? Different Types of Acne Scars from acne can seem like double punishment — ...

  13. Perioperative interstitial brachytherapy for recurrent keloid scars

    International Nuclear Information System (INIS)

    Rio, E.; Bardet, E.; Peuvrel, P.; Martinet, L.; Perrot, P.; Baraer, F.; Loirat, Y.; Sartre, J.Y.; Malard, O.; Ferron, C.; Dreno, B.

    2010-01-01

    Purpose: Evaluation of the results of perioperative interstitial brachytherapy with low dose-rate (L.D.R.) Ir-192 in the treatment of keloid scars. Patients and methods: We performed a retrospective analysis of 73 histologically confirmed keloids (from 58 patients) resistant to medico surgical treated by surgical excision plus early perioperative brachytherapy. All lesions were initially symptomatic. Local control was evaluated by clinical evaluation. Functional and cosmetic results were assessed in terms of patient responses to a self-administered questionnaire. Results: Median age was 28 years (range 13-71 years). Scars were located as follows: 37% on the face, 32% on the trunk or abdomen, 16% on the neck, and 15% on the arms or legs. The mean delay before loading was four hours (range, 1-6 h). The median dose was 20 Gy (range, 15-40 Gy). Sixty-four scars (from 53 patients) were evaluated. Local control was 86% (follow-up, 44.5 months; range, 14-150 months). All relapses occurred early within 2 years posttreatment. At 20 months, survival without recurrence was significantly lower when treated lengths were more than 6 cm long. The rate was 100% for treated scars below 4.5 cm in length, 95% (95% CI: 55-96) for those 4.5-6 cm long, and 75% (95% CI: 56-88) beyond 6 cm (p = 0.038). Of the 35 scars (28 patients) whose results were reassessed, six remained symptomatic and the esthetic results were considered to be good in 51% (18/35) and average in 37% (13/35) (median follow-up, 70 months; range, 16-181 months). Conclusion: Early perioperative L.D.R. brachytherapy delivering 20 Gy at 5 mm reduced the rate of recurrent keloids resistant to other treatments and gave good functional results. (authors)

  14. Cumulative effects assessment: Does scale matter?

    International Nuclear Information System (INIS)

    Therivel, Riki; Ross, Bill

    2007-01-01

    Cumulative effects assessment (CEA) is (or should be) an integral part of environmental assessment at both the project and the more strategic level. CEA helps to link the different scales of environmental assessment in that it focuses on how a given receptor is affected by the totality of plans, projects and activities, rather than on the effects of a particular plan or project. This article reviews how CEAs consider, and could consider, scale issues: spatial extent, level of detail, and temporal issues. It is based on an analysis of Canadian project-level CEAs and UK strategic-level CEAs. Based on a review of literature and, especially, case studies with which the authors are familiar, it concludes that scale issues are poorly considered at both levels, with particular problems being unclear or non-existing cumulative effects scoping methodologies; poor consideration of past or likely future human activities beyond the plan or project in question; attempts to apportion 'blame' for cumulative effects; and, at the plan level, limited management of cumulative effects caused particularly by the absence of consent regimes. Scale issues are important in most of these problems. However both strategic-level and project-level CEA have much potential for managing cumulative effects through better siting and phasing of development, demand reduction and other behavioural changes, and particularly through setting development consent rules for projects. The lack of strategic resource-based thresholds constrains the robust management of strategic-level cumulative effects

  15. Nonablative Fractional Laser Resurfacing for Acne Scarring in Patients With Fitzpatrick Skin Phototypes IV-VI.

    Science.gov (United States)

    Alexis, Andrew F; Coley, Marcelyn K; Nijhawan, Rajiv I; Luke, Janiene D; Shah, Sejal K; Argobi, Yahya A; Nodzenski, Michael; Veledar, Emir; Alam, Murad

    2016-03-01

    There is a paucity of studies investigating laser resurfacing in Fitzpatrick skin phototypes (SPT) IV to VI. To assess the efficacy and safety of fractional nonablative laser resurfacing in the treatment of acne scarring in patients with SPT IV to VI. The authors conducted a randomized, investigator-blinded and rater-blinded, split-face comparative study of adults with SPT IV to VI and facial acne scars treated with 2 different density settings and the same fluence. Quantitative global scarring grading system (QGSGS) scores were significantly improved from baseline at 16 and 24 weeks (p = .0277). Improvements in QGSGS scores after higher and lower density treatments were statistically similar (p = .96). The live-blinded dermatologist, the blinded dermatologist photoraters, and the patients rated scars as being significantly more improved by visual analog scale at weeks 16 and 24 compared with baseline (p skin types IV to VI. Self-limited postinflammatory hyperpigmentation was a common occurrence, especially with higher treatment densities.

  16. Tuberculin reaction and BCG scar

    DEFF Research Database (Denmark)

    Timmermann, Clara Amalie Gade; Biering-Sørensen, Sofie; Aaby, Peter

    2015-01-01

    rate ratio (MRR) comparing children with a BCG scar with those without was 0.42 (95% CI = 0.19; 0.93). There was a similar tendency for TST positivity: MRR = 0.47 (95% CI = 0.14; 1.54). For LBW children who had both a positive TST reaction and a scar, the MRR was 0.22 (95% CI = 0.05; 0.87). For NBW...

  17. Symptom rating scale for assessing hyperthyroidism.

    Science.gov (United States)

    Klein, I; Trzepacz, P T; Roberts, M; Levey, G S

    1988-02-01

    A hyperthyroid symptom scale (HSS) was designed and administered to ten subjects with untreated Graves' disease. All subjects had clinical and chemical evidence of hyperthyroidism and reproducible HSS scores of 20 or more points. During sequential treatments with propranolol hydrochloride (phase 2) followed by propylthiouracil (phase 3) there was a significant decline in the HSS scores at each phase. Accompanying the decrease in HSS scores was a decrease in heart rate, but there was no change in thyroid function test results at phase 2 and a decrease in heart rate, thyroid function test results, and goiter size at phase 3. This new scale includes ten categories of symptoms, it is sensitive to changes in both the adrenergic and metabolic components of hyperthyroidism, and it is useful in the clinical assessment and management of patients with thyrotoxicosis.

  18. Predictors of renal scar in children with urinary infection and vesicoureteral reflux.

    Science.gov (United States)

    Soylu, Alper; Demir, Belde Kasap; Türkmen, Mehmet; Bekem, Ozlem; Saygi, Murat; Cakmakçi, Handan; Kavukçu, Salih

    2008-12-01

    We evaluated the predictors of renal scar in children with urinary tract infections (UTIs) having primary vesicoureteral reflux (VUR). Data of patients who were examined by dimercaptosuccinic acid (DMSA) scintigraphy between 1995 and 2005 were evaluated retrospectively. Gender, age, reflux grade, presence/development of scarring, breakthrough UTIs, and resolution of reflux, were recorded. The relation of gender, age and VUR grade to preformed scarring and the relation of gender, age, VUR grade, presence of preformed scarring, number of breakthrough UTIs and reflux resolution to new scarring were assessed. There were 138 patients [male/female (M/F) 53/85]. Multivariate analysis showed that male gender [odds ratio (OR) 2.5], age > or = 27 months in girls (OR 4.2) and grades IV-V reflux (OR 12.4) were independent indicators of renal scarring. On the other hand, only the presence of previous renal scarring was found to be an independent indicator for the development of new renal scar (OR 13.4). In conclusion, while the most predictive variables for the presence of renal scarring among children presenting with a UTI were male gender, age > or = 27 months in girls, and grades IV-V reflux, the best predictor of new scar formation was presence of previous renal scarring.

  19. Quantitative measurement of hypertrophic scar: interrater reliability and concurrent validity.

    Science.gov (United States)

    Nedelec, Bernadette; Correa, José A; Rachelska, Grazyna; Armour, Alexis; LaSalle, Léo

    2008-01-01

    Research into the pathophysiology and treatment of hypertrophic scar (HSc) remains limited by the heterogeneity of scar and the imprecision with which its severity is measured. The objective of this study was to test the interrater reliability and concurrent validity of the Cutometer measurement of elasticity, the Mexameter measurement of erythema and pigmentation, and total thickness measure of the DermaScan C relative to the modified Vancouver Scar Scale (mVSS) in patient-matched normal skin, normal scar, and HSc. Three independent investigators evaluated 128 sites (severe HSc, moderate or mild HSc, donor site, and normal skin) on 32 burn survivors using all of the above measurement tools. The intraclass correlation coefficient, which was used to measure interrater reliability, reflects the inherent amount of error in the measure and is considered acceptable when it is >0.75. Interrater reliability of the totals of the height, pliability, and vascularity subscales of the mVSS fell below the acceptable limit ( congruent with0.50). The individual subscales of the mVSS fell well below the acceptable level (0.89) for each study site with the exception of severe scar. Mexameter and DermaScan C reliability measurements were acceptable for all sites (>0.82). Concurrent validity correlations with the mVSS were significant except for the comparison of the mVSS pliability subscale and the Cutometer maximum deformation measure comparison in severe scar. In conclusion, the Mexameter and DermaScan C measurements of scar color and thickness of all sites, as well as the Cutometer measurement of elasticity in all but the most severe scars shows high interrater reliability. Their significant concurrent validity with the mVSS confirms that these tools are measuring the same traits as the mVSS, and in a more objective way.

  20. Spatial and temporal corroboration of a fire-scar-based fire history in a frequently burned ponderosa pine forest

    Science.gov (United States)

    Calvin A. Farris; Christopher H. Baisan; Donald A. Falk; Stephen R. Yool; Thomas W. Swetnam

    2010-01-01

    Fire scars are used widely to reconstruct historical fire regime parameters in forests around the world. Because fire scars provide incomplete records of past fire occurrence at discrete points in space, inferences must be made to reconstruct fire frequency and extent across landscapes using spatial networks of fire-scar samples. Assessing the relative accuracy of fire...

  1. Usefulness of parametric renal clearance images in the assessment of basic risk factors for renalnal clearance images in the assessment of basic risk factors for renal scarring in children with recurrent urinary tract infections.

    Science.gov (United States)

    Pietrzak-Stelasiak, Ewa; Bieńkiewicz, Małgorzata; Woźnicki, Wojciech; Bubińska, Krystyna; Kowalewska-Pietrzak, Magdalena; Płachcińska, Anna; Kuśmierek, Jacek

    2017-01-01

    Clinically confirmed incidents of acute pyelonephritis (APN) following recurrent infections of urinary tract (UTI) form basic risk factors for renal scarring in children. Vesico-uretheral reflux (VUR) of higher grade is additional risk factor for this scarring. Opinions on diagnostic value of summed sequential images of renal uptake phase (SUM) of dynamic renal scintigraphy in detection of renal scars are diverse. However, several publications point to higher diagnostic efficacy of clearance parametric images (PAR) generated from this study. To establish a clinical value of parametric renal clearance images in detection of renal scarring. A prospective study was performed in a group of 91 children at the age of 4 to 18 years with recurrent UTI. Clinically documented incidents of APN were noted in 32 children: in 8 cases - one and in the remaining 24 - 2 to 5 (mean 3) incidents. In the remaining 59 patients only infections of the lower part of urinary tract were diagnosed. Static renal 99mTc-DMSA SPECT study and after 2-4 days dynamic renal studies (99mTc-EC) were performed in every patient not earlier than 6 months after the last documented incident of UTI. PAR images generated from a dynamic study by in-house developed software and SUM images were compared with a gold standard SPECT study. Percentages of children with detected renal scar(s) with SPECT and PAR methods amounted to 55% and 54%, respectively and were statistically significantly higher (p children with history of APN detected with SPECT and PAR methods were significantly more frequent than with infections of only lower part of urinary tract (72% vs. 46%; p = 0.017 and 69% vs. 46%; p = 0.036, respectively). A SUM method did not reveal statistically significant differences between frequencies of detection of scars in groups specified above - 38% vs. 27% (p = 0.31). Both SPECT and PAR methods showed also that frequencies of occurrence of renal scars in children with higher grades of VUR were higher than

  2. Extensive scarring induced by chronic intrathecal tubing augmented cord tissue damage and worsened functional recovery after rat spinal cord injury.

    Science.gov (United States)

    Zhang, Shu-xin; Huang, Fengfa; Gates, Mary; White, Jason; Holmberg, Eric G

    2010-08-30

    Intrathecal infusion has been widely used to directly deliver drugs or neurotrophins to a lesion site following spinal cord injury. Evidence shows that intrathecal infusion is efficient for 7 days but is markedly reduced after 14 days, due to time dependent occlusion. In addition, extensive fibrotic scarring is commonly observed with intrathecal infusion. These anomalies need to be clearly elucidated in histology. In the present study, all adult Long-Evans rats received a 25 mm contusion injury on spinal cord T10 produced using the NYU impactor device. Immediately after injury, catheter tubing with an outer diameter of 0.38 mm was inserted through a small dural opening at L3 into the subdural space with the tubing tip positioned near the injury site. The tubing was connected to an Alzet mini pump, which was filled with saline solution and was placed subcutaneously. Injured rats without tubing served as control. Rats were behaviorally tested for 6 weeks using the BBB locomotor rating scale and histologically assessed for tissue scarring. Six weeks later, we found that the intrathecal tubing caused extensive scarring and inflammation, related to neutrophils, macrophages and plasma cells. The tubing's tip was occluded by scar tissue and inflammatory cells. The scar tissue surrounding the tubing consists of 20-70 layers of fibroblasts and densely compacted collagen fibers, seriously compressing and damaging the cord tissue. BBB scores of rats with intrathecal tubing were significantly lower than control rats (p<0.01) from 2 weeks after injury, implying serious impairment of functional recovery caused by the scarring. Copyright (c) 2010 Elsevier B.V. All rights reserved.

  3. Rare complications of cesarean scar

    International Nuclear Information System (INIS)

    Mahajan, Divyesh; Kang, Mandeep; Sandhu, Manavjit Singh; Jain, Vanita; Kalra, Naveen; Khandelwal, Niranjan

    2013-01-01

    Cesarean scar pregnancy (CSP) and cesarean scar dehiscence (CSD) are the most dreaded complications of cesarean scar (CS). As the incidence of CS is increasing worldwide, so is the incidence of CSP, especially in cases with assisted reproduction techniques. It is of utmost importance to diagnose CSP in the early first trimester, as it can lead to myometrial rupture with fatal outcome. On the other hand, CSD may be encountered during pregnancy or in the postpartum period. CSD in the postpartum period is very rare and can cause secondary postpartum hemorrhage (PPH) leading to increased maternal morbidity or even death if not diagnosed and managed promptly. Both complications can be diagnosed on ultrasonography (USG) and confirmed on magnetic resonance imaging (MRI). These two conditions carry high morbidity and mortality. In this article, we highlight the role of imaging in the early diagnosis and management of these conditions

  4. Rare complications of cesarean scar

    Directory of Open Access Journals (Sweden)

    Divyesh Mahajan

    2013-01-01

    Full Text Available Cesarean scar pregnancy (CSP and cesarean scar dehiscence (CSD are the most dreaded complications of cesarean scar (CS. As the incidence of CS is increasing worldwide, so is the incidence of CSP, especially in cases with assisted reproduction techniques. It is of utmost importance to diagnose CSP in the early first trimester, as it can lead to myometrial rupture with fatal outcome. On the other hand, CSD may be encountered during pregnancy or in the postpartum period. CSD in the postpartum period is very rare and can cause secondary postpartum hemorrhage (PPH leading to increased maternal morbidity or even death if not diagnosed and managed promptly. Both complications can be diagnosed on ultrasonography (USG and confirmed on magnetic resonance imaging (MRI. These two conditions carry high morbidity and mortality. In this article, we highlight the role of imaging in the early diagnosis and management of these conditions.

  5. Scars of the Wigner Function.

    Science.gov (United States)

    Toscano; de Aguiar MA; Ozorio De Almeida AM

    2001-01-01

    We propose a picture of Wigner function scars as a sequence of concentric rings along a two-dimensional surface inside a periodic orbit. This is verified for a two-dimensional plane that contains a classical hyperbolic orbit of a Hamiltonian system with 2 degrees of freedom. The stationary wave functions are the familiar mixture of scarred and random waves, but the spectral average of the Wigner functions in part of the plane is nearly that of a harmonic oscillator and individual states are also remarkably regular. These results are interpreted in terms of the semiclassical picture of chords and centers.

  6. Classical resonances and quantum scarring

    International Nuclear Information System (INIS)

    Manderfeld, Christopher

    2003-01-01

    We study the correspondence between phase-space localization of quantum (quasi-)energy eigenstates and classical correlation decay, given by Ruelle-Pollicott resonances of the Frobenius-Perron operator. It will be shown that scarred (quasi-)energy eigenstates are correlated: pairs of eigenstates strongly overlap in phase space (scar in same phase-space regions) if the difference of their eigenenergies is close to the phase of a leading classical resonance. Phase-space localization of quantum states will be measured by L 2 norms of their Husimi functions

  7. Fractional ablative CO2 laser treatment versus scar subcision and autologous fat transfer in the treatment of atrophic acne scars: New technique

    Directory of Open Access Journals (Sweden)

    Laila Mohammad

    2016-04-01

    Full Text Available There are different modalities for management of atrophic acne scars which include lasers. Ablative fractional CO2 laser was developed to address the shortcomings of traditional ablative lasers, with superior results to non-ablative fractional lasers. Autologous fat transfer has been utilized for nearly a decade in tissue augmentation and reconstruction.Present studies were designed to compare ablative fractional CO2 laser treatment with scar subcision and autologous fat transfer in the treatment of atrophic acne scars. 20 patients with atrophic acne scars were recruited: 10 patients were treated by three sessions of ablative fractional CO2 laser therapy, and 10 patients treated by subcision and autologous fat transfer. All patients were followed up for three months, and were assessed by digital photograph before and after treatment through the application of Goodman and Baron quantitative and qualitative grading systems, in addition to reports by three physicians committees and reports of patients’ satisfaction. Analysis of both groups showed significant improvements in all types of atrophic acne scars. The mean percentage of total quantitative improvement was more significant in the case of autologous fat transfer with regard to ice-pick and total number of scars. Therefore, scar subcision with autologous fat transfer proved to be as effective as, or even more effective than, ablative fractional CO2 laser in the treatment of atrophic acne scars with regard to the total number of scars as well as ice-pick type.

  8. Efficacy of IPL device combined with intralesional corticosteroid injection for the treatment of keloids and hypertrophic scars with regards to the recovery of skin barrier function: A pilot study.

    Science.gov (United States)

    Kim, Dong Young; Park, Hyun Sun; Yoon, Hyun-Sun; Cho, Soyun

    2015-10-01

    Keloids and hypertrophic scars are prevalent and psychologically distressful dermatologic conditions. Various treatment modalities have been tried but without complete success by any one method. We evaluated the efficacy of a combination of intense pulsed light (IPL) device and intralesional corticosteroid injection for the treatment of keloids and hypertrophic scars with respect to the recovery of skin barrier function. Totally 52 Korean patients were treated by the combined treatment at 4-8-week intervals. Using digital photographs, changes in scar appearance were assessed with modified Vancouver Scar Scale (MVSS), physicians' global assessment (PGA) and patient's satisfaction score. In 12 patients, the stratum corneum (SC) barrier function was assessed by measuring transepidermal water loss (TEWL) and SC capacitance. Most scars demonstrated significant clinical improvement in MVSS, PGA and patient's satisfaction score after the combined therapy. A significant decrease of TEWL and elevation of SC capacitance were also documented after the treatment. The combination therapy (IPL + corticosteroid injection) not only improves the appearance of keloids and hypertrophic scars but also increases the recovery level of skin hydration status in terms of the skin barrier function.

  9. Interrupted or continuous-intradermal suturing? Statistical analysis of postoperative scars

    Directory of Open Access Journals (Sweden)

    Elif Sarı

    2014-12-01

    Full Text Available Background and Design: Postoperative scar development is an important problem for patients treated in plastic surgery clinics. Most patients think that continuous intradermal suturing is superior to interrupted suturing because they assume that it creates less scarring. We evaluated scars that form following intradermal and interrupted suturing. This article presents our controlled study that objectively compared the scars on patients' faces using a wound evaluation scale. Materials and Methods: Thirty-five patients, who had undergone operations on the bilateral cheeks, were included in this study. Thirty patients were female; five patients were male. Their mean age was 40.05 years. The average scar evaluation time after surgery was 9.05 months. Elliptical excisions were made on the lesions under local anesthesia. The incisions on the right cheeks were sutured with 6/0 monofilament nonabsorbable sutures using the continuous intradermal suturing technique. The left cheek incisions were sutured with same sutures using the interrupted suturing method. Results: The patients were evaluated 7–11 months after operation (mean: 9.05 months using the Stony Brook Scar Evaluation Scale. A Related Samples T-test was used for statistical evaluation of the differences between the suturing techniques. No significant differences were noted in scar formation between the two suturing methods (p>0.05. Conclusion: We found no differences in scar formation between the two frequently used suturing techniques studied here. We believe that the suturing technique is a less important determinant of scar formation than are other factors.

  10. Quantitative measurement of hypertrophic scar: intrarater reliability, sensitivity, and specificity.

    Science.gov (United States)

    Nedelec, Bernadette; Correa, José A; Rachelska, Grazyna; Armour, Alexis; LaSalle, Léo

    2008-01-01

    The comparison of scar evaluation over time requires measurement tools with acceptable intrarater reliability and the ability to discriminate skin characteristics of interest. The objective of this study was to evaluate the intrarater reliability and sensitivity and specificity of the Cutometer, the Mexameter, and the DermaScan C relative to the modified Vancouver Scar Scale (mVSS) in patient-matched normal skin, normal scar (donor sites), and hypertrophic scar (HSc). A single investigator evaluated four tissue types (severe HSc, less severe HSc, donor site, and normal skin) in 30 burn survivors with all four measurement tools. The intraclass correlation coefficient (ICC) for the Cutometer was acceptable (> or =0.75) for the maximum deformation measure for the donor site and normal skin (>0.78) but was below the acceptable range for the HSc sites and all other parameters. The ICC for the Mexameter erythema (>0.75) and melanin index (>0.89) and the DermaScan C total thickness measurement (>0.82) were acceptable for all sites. The ICC for the total of the height, pliability, and vascularity subscales of the mVSS was acceptable (0.81) for normal scar but below the acceptable range for the scar sites. The DermaScan C was clearly able to discriminate HSc from normal scar and normal skin based on the total thickness measure. The Cutometer was less discriminating but was still able to discriminate HSc from normal scar and normal skin. The Mexameter erythema index was not a good discriminator of HSc and normal scar. Receiver operating characteristic curves were generated to establish the best cutoff point for the DermaScan C total thickness and the Cutometer maximum deformation, which were 2.034 and 0.387 mm, respectively. This study showed that although the Cutometer, the DermaScan C, and the Mexameter have measurement properties that make them attractive substitutes for the mVSS, caution must be used when interpreting results since the Cutometer has a ceiling effect when

  11. Endometriosis in an episiotomy scar

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    Mine islimye Taskin

    2016-03-01

    Full Text Available Endometriosis that is defined as the presence of functional endometrial tissue outside the uterine cavity is seen 5-10% of reproductive age women. Endometriosis can be seen any other site of the body; but the most frequently affected areas are ovaries, pelvic peritoneum, uterosacral ligament and Douglas pouche. Several teories exist for the development of endometriosis including retrograde menstruation, venous or lymphatic metastasis and immun dysfunction. Endometriosis of the perineum and vulva are extremely rare with the most common sites being episiotomy scars. Scar endometriosis is likely to be caused by mechanical transplantation of endometrium from the uterine cavity into the wound at the time of the surgery. The primary treatment for scar endometriosis is total surgical excision of the lesion. It is important not to leave residual tissue during surgery to prevent the recurrence. Here we present a patient who had her vaginal delivery 5 years ago, have a complaint of painful vulvar lump at the right mediolateral episiotomy scar since 1 year during her every menstruation period and whose final diagnosis was endometriosis after surgical removal and histopathologic examination. Althought vulvar endometrosis is rare, it should be considered in the patients who had a vaginal delivery and complaining painful vulvar lump with swelling in her mestrual cycle. [Cukurova Med J 2016; 41(1.000: 164-166

  12. Time course of epidural scar enhancement with Gd-DTPA in an animal model

    International Nuclear Information System (INIS)

    Blaser, S.I.; Ross, J.S.; Berridge, M.; Emery, S.; Bolesta, M.J.; Modic, M.T.; Masaryk, T.J.; Bohlman, H.

    1988-01-01

    In eight beagles following laminectomies, dynamic contrast enhancement of posterior epidural scar was assessed sequentially over 4 months by means of FLASH sequence (20/10/50) following Gd-DTPA. A consistent pattern of enhancement was apparent in all dogs. Maximum enhancement occurred after 1 month (80%-130%), with peak enhancement at 7-10 minutes. There was decreased enhancement each succeeding month with a similar time to peak. Time curves were obtained for blood, muscle, and scar following injection of 40 μCi Gd-153 DTPA and correlated well with in vivo MR image intensities. Histology showed granulation tissue early following surgery, which matured to scar by 4 months. These findings are in contrast to reports of enhancement of anterior scar in humans irrespective of age. The difference may be secondary to location in that posterior scar does not receive the trauma and stress acting on anterior scar associated with a degenerative disk

  13. Risk factors for hypertrophic burn scar pain, pruritus, and paresthesia development.

    Science.gov (United States)

    Xiao, Yongqiang; Sun, Yu; Zhu, Banghui; Wang, Kangan; Liang, Pengfei; Liu, Wenjun; Fu, Jinfeng; Zheng, Shiqing; Xiao, Shichu; Xia, Zhaofan

    2018-05-02

    Hypertrophic scar pain, pruritus, and paresthesia symptoms are major and particular concerns for burn patients. However, because no effective and satisfactory methods exist for their alleviation, the clinical treatment for these symptoms is generally considered unsatisfactory. Therefore, their risk factors should be identified and prevented during management. We reviewed the medical records of 129 post-burn hypertrophy scar patients and divided them into two groups for each of three different symptoms based on the University of North Carolina "4P" Scar Scale: patients with scar pain requiring occasional or continuous pharmacological intervention (HSc pain, n=75) vs. patients without such scar pain (No HSc pain, n=54); patients with scar pruritus requiring occasional or continuous pharmacological intervention (HSc pruritus, n=63) vs. patients without such scar pruritus (No HSc pruritus, n=66); patients with scar paresthesia that influenced the patients' daily activities (HSc paresthesia, n=31) vs. patients without such scar paresthesia (No HSc paresthesia, n=98). Three multivariable logistic regression models were built, respectively, to identify the risk factors for hypertrophic burn scar pain, pruritus, and paresthesia development. Multivariable analysis showed that hypertrophic burn scar pain development requiring pharmacological intervention was associated with old age (odds ratio [OR]=1.046; 95% confidence interval [CI], 1.011-1.082, p=0.009), high body mass index(OR=1.242; 95%CI,1.068-1.445, p=0.005), 2-5-mm-thick post-burn hypertrophic scars (OR=3.997; 95%CI, 1.523-10.487; p=0.005), and 6-12-month post-burn hypertrophic scars (OR=4.686; 95%CI; 1.318-16.653; p=0.017). Hypertrophic burn scar pruritus development requiring pharmacological intervention was associated with smoking (OR=3.239; 95%CI, 1.380-7.603; p=0.007), having undergone surgical operation (OR=2.236; 95%CI, 1.001-4.998; p=0.049), and firm scars (OR=3.317; 95%CI, 1.237-8.894; p=0.017). Finally

  14. Skin cancer full-grown from scar

    International Nuclear Information System (INIS)

    Zikiryakhodjaev, D.Z.; Sanginov, D.R.

    2001-01-01

    In this chapter authors investigate the peculiarities of skin cancer full-grown from scar, the theory of it's descent, quote some statistical data on skin cancer full-grown from scar and variety clinical forms of skin cancer full-grown from scar was shown, quote some methods of treatment

  15. Techniques for Optimizing Surgical Scars, Part 2: Hypertrophic Scars and Keloids.

    Science.gov (United States)

    Potter, Kathryn; Konda, Sailesh; Ren, Vicky Zhen; Wang, Apphia Lihan; Srinivasan, Aditya; Chilukuri, Suneel

    2017-01-01

    Surgical management of benign or malignant cutaneous tumors may result in noticeable scars that are of great concern to patients, regardless of sex, age, or ethnicity. Techniques to optimize surgical scars are discussed in this three-part review. Part 2 focuses on scar revision for hypertrophic and keloids scars. Scar revision options for hypertrophic and keloid scars include corticosteroids, bleomycin, fluorouracil, verapamil, avotermin, hydrogel scaffold, nonablative fractional lasers, ablative and fractional ablative lasers, pulsed dye laser (PDL), flurandrenolide tape, imiquimod, onion extract, silicone, and scar massage.

  16. Hypertrophic scars and keloids in surgery: current concepts.

    Science.gov (United States)

    Song, Colin

    2014-09-01

    Hypertrophic scars and keloids remain a challenge in surgery. We appreciate that our understanding of the process at cellular and molecular level, profound as it is, when it comes to the clinical evidence much is left to be desired. Although the bench to bedside conundrum remains, the science of translational research calls for an even higher level of cooperation between the scientist and the clinician for the impetus to succeed.The clinicians alerted us to the possible theories in the pathogenesis of keloid formation, inter alia, the ischemia theory, mast cell theory, immune theory, transforming growth factor β interaction, mechanical theory, and the melanocyte stimulating hormone theory. All of the above presupposed a stimulus that would result in an uncontrolled upregulation of collagen and extracellular matrix expression in the pathogenesis of the keloid. This bedside to bench initiative, as in true science, realized more ponderables than possibilities.By the same token, research into the epidermal-mesenchymal signaling, molecular biology, genomics, and stem cell research holds much promise in the bench top arena. To assess efficacy, many scar assessment scores exist in the literature. The clinical measurement of scar maturity can aid in determining end points for therapeutics. Tissue oxygen tension and color assessment of scars by standardized photography proved to be useful.In surgery, the use of dermal substitutes holds some promise as we surmise that quality scars that arise from dermal elements, molecular and enzyme behavior, and balance. Although a systematic review shows some benefit for earlier closure and healing of wounds, no such review exists at this point in time for the use of dermal substitutes in scars.Adipose-derived stem cell, as it pertains to scars, will hopefully realize the potential of skin regeneration rather than by repair in which we are familiar with as well as the undesirable scarring as a result of healing through the inflammatory

  17. The Chinese version of the Myocardial Infarction Dimensional Assessment Scale (MIDAS: Mokken scaling

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    Watson Roger

    2012-01-01

    Full Text Available Abstract Background Hierarchical scales are very useful in clinical practice due to their ability to discriminate precisely between individuals, and the original English version of the Myocardial Infarction Dimensional Assessment Scale has been shown to contain a hierarchy of items. The purpose of this study was to analyse a Mandarin Chinese translation of the Myocardial Infarction Dimensional Assessment Scale for a hierarchy of items according to the criteria of Mokken scaling. Data from 180 Chinese participants who completed the Chinese translation of the Myocardial Infarction Dimensional Assessment Scale were analysed using the Mokken Scaling Procedure and the 'R' statistical programme using the diagnostics available in these programmes. Correlation between Mandarin Chinese items and a Chinese translation of the Short Form (36 Health Survey was also analysed. Findings Fifteen items from the Mandarin Chinese Myocardial Infarction Dimensional Assessment Scale were retained in a strong and reliable Mokken scale; invariant item ordering was not evident and the Mokken scaled items of the Chinese Myocardial Infarction Dimensional Assessment Scale correlated with the Short Form (36 Health Survey. Conclusions Items from the Mandarin Chinese Myocardial Infarction Dimensional Assessment Scale form a Mokken scale and this offers further insight into how the items of the Myocardial Infarction Dimensional Assessment Scale relate to the measurement of health-related quality of life people with a myocardial infarction.

  18. Comparative efficacy of intralesional verapamil hydrochloride and triamcinolone acetonide in hypertrophic scars and keloids.

    Science.gov (United States)

    Ahuja, Rajeev B; Chatterjee, Pallab

    2014-06-01

    There is not much level 1 evidence based literature to guide management of hypertrophic scars and keloids despite an array of therapeutic modalities at disposal. Intralesional (i/l) triamcinolone injections have remained a gold standard in non surgical management. Sporadic reports on use of i/l verapamil suggest its efficacy. Since verapamil has not found sufficient mention as an effective alternative modality, it was decided to undertake a randomized study which could also address some additional clinical parameters. A randomized, parallel group and observer blinded comparison with 40 patients (48 scars) was carried out to compare the effects of i/l triamcinolone (T) (22 scars) and verapamil injections (V) (26 scars). 1.5 ml was the maximum indicative volume decided in the study protocol for both the drugs (triamcinolone @40 mg/ml and verapamil @ 2.5 mg/ml). Patients included were aged between 15-60 years with scars ranging between 0.5-5 cm (but total area roughly scars under 2 years duration. Patients with keloidal diathesis were excluded. Injections were scheduled every three weeks until complete flattening of the scar or eight sessions, which ever came earlier. No concomitant therapies like massage, silicone gel or pressure garments were used. Scar evaluation at each stage was done by serial photographic records as well as by Vancouver Scar Scale (VSS). Comparative survival analysis between the two drugs was done using Kaplan Meier curves, and VSS scores were analyzed using Wilcoxon test and log rank test. Mean zero VSS scores were achieved with treatments in respect of scar height (T-12 weeks, V-21 weeks), vascularity (T-15 weeks, V-18 weeks) and pliability (T-15 weeks, V-21 weeks). The improvement in scar vascularity and pliability kept pace with decrease in scar height, in both the groups. There was not much difference in the rate of change of scar pigmentation with either drug but almost 60% patients in both the groups regained normal pigmentation. Our

  19. Descendants of Hardship: Prevalence, Drivers and Scarring Effects of Social Exclusion in Childhood

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    J. Cok Vrooman

    2015-07-01

    Full Text Available The social exclusion of children is problematic for two reasons. Young people typically inherit their marginal position from their family, and therefore cannot be held responsible for their hardship themselves; and social exclusion in childhood may affect their wellbeing and subsequent development, possibly leading to a “scarring effect” in later life. In this contribution we develop an instrument for measuring social exclusion among children. Social exclusion is regarded as a theoretical construct with four sub-dimensions: material deprivation, limited social participation, inadequate access to social rights, and a lack of normative integration. First we analyse data from a survey of 2,200 Dutch children, which contains a large set of social exclusion items. We applied nonlinear principal components analysis in order to construct a multidimensional scale. Measured in this way, the prevalence of social exclusion among children is 4.5%. Boys and children living in large families are more likely to experience social exclusion than girls and children with few siblings. The parental level of education and dependency on social security benefits are also important driving factors of childhood social exclusion. Subsequently we investigate the scarring effect. Longitudinal administrative income and household data covering 25 years were combined with a new survey of just under 1,000 Dutch adults, a third of whom were poor as a child. The survey assessed their past and current degree of social exclusion, and their health and psychosocial development, educational career, past family circumstances, etc. In an absolute sense scarring turns out to have been limited during this period: a very large majority of those who were poor or excluded as a child are above the threshold values in adult life. However, the “descendants of hardship” are still more likely to be socially excluded as adults than people who grew up in more favourable conditions. A

  20. Evaluation of microneedling fractional radiofrequency device for treatment of acne scars

    Directory of Open Access Journals (Sweden)

    Byalekere Shivanna Chandrashekar

    2014-01-01

    Full Text Available Background: Various treatment modalities including non-invasive methods such as chemical peels, topical retinoids, microdermabrasion, minimally invasive techniques such as microneedling, fractional lasers, microneedling radiofrequency devices and invasive procedures such as acne scar surgeries and ablative lasers are used for acne scars, each with its own unique advantages and disadvantages. This study is a retrospective assessment of efficacy and safety of microneedling fractional radiofrequency in the treatment of acne scars. Methods: Thirty one patients of skin types III-V with moderate and severe facial acne scarring received four sequential fractional radiofrequency treatments over a period of 6 months with an interval of 6 weeks between each session. Goodman & Baron′s acne scar grading system was used for assessment by a side by side comparison of preoperative and post- operative photographs taken at their first visit and at the end of 3 months after the last session. Results: Estimation of improvement with Goodman and Baron′s Global Acne Scarring System showed that by qualitative assessment of 31 patients with grade 3 and grade 4 acne scars, 80.64% showed improvement by 2 grades and 19.35% showed improvement by 1 grade. Quantitative assessment showed that 58% of the patients had moderate, 29% had minimal, 9% had good and 3% showed very good improvement. Adverse effects were limited to transient pain, erythema, edema and hyperpigmentation. Conclusion: Microneedling fractional radiofrequency is efficacious for the treatment of moderate and severe acne scars.

  1. Long-term scar quality after hydrosurgical versus conventional debridement of deep dermal burns (HyCon trial): study protocol for a randomized controlled trial.

    Science.gov (United States)

    Legemate, Catherine M; Goei, Harold; Middelkoop, Esther; Oen, Irma M M H; Nijhuis, Tim H J; Kwa, Kelly A A; van Zuijlen, Paul P M; Beerthuizen, Gerard I J M; Nieuwenhuis, Marianne K; van Baar, Margriet E; van der Vlies, Cornelis H

    2018-04-19

    Deep dermal burns require tangential excision of non-viable tissue and skin grafting to improve wound healing and burn-scar quality. Tangential excision is conventionally performed with a knife, but during the last decade hydrosurgery has become popular as a new tool for tangential excision. Hydrosurgery is generally thought to be a more precise and controlled manner of burn debridement leading to preservation of viable tissue and, therefore, better scar quality. Although scar quality is considered to be one of the most important outcomes in burn surgery today, no randomized controlled study has compared the effect of these two common treatment modalities with scar quality as a primary outcome. The aim of this study is, therefore, to compare long-term scar quality after hydrosurgical versus conventional tangential excision in deep dermal burns. A multicenter, randomized, intra-patient, controlled trial will be conducted in the Dutch burn centers of Rotterdam, Beverwijk, and Groningen. All patients with deep dermal burns that require excision and grafting are eligible. Exclusion criteria are: a burn wound burned > 30%, full-thickness burns, chemical or electrical burns, infected wounds (clinical symptoms in combination with positive wound swabs), insufficient knowledge of the Dutch or English language, patients that are unlikely to comply with requirements of the study protocol and follow-up, and patients who are (temporarily) incompetent because of sedation and/or intubation. A total of 137 patients will be included. Comparable wound areas A and B will be appointed, randomized and either excised conventionally with a knife or with the hydrosurgery system. The primary outcome is scar quality measured by the observer score of the Patient and Observer Scar Assessment Scale (POSAS); a subjective scar-assessment instrument, consisting of two separate six-item scales (observer and patient) that are both scored on a 10-point rating scale. This study will contribute to

  2. Two dimensional unstable scar statistics.

    Energy Technology Data Exchange (ETDEWEB)

    Warne, Larry Kevin; Jorgenson, Roy Eberhardt; Kotulski, Joseph Daniel; Lee, Kelvin S. H. (ITT Industries/AES Los Angeles, CA)

    2006-12-01

    This report examines the localization of time harmonic high frequency modal fields in two dimensional cavities along periodic paths between opposing sides of the cavity. The cases where these orbits lead to unstable localized modes are known as scars. This paper examines the enhancements for these unstable orbits when the opposing mirrors are both convex and concave. In the latter case the construction includes the treatment of interior foci.

  3. Relationship Between Scarring and Dog Aggression in Pit Bull-Type Dogs Involved in Organized Dogfighting

    Directory of Open Access Journals (Sweden)

    Katherine A. Miller

    2016-11-01

    Full Text Available When pit bull-type dogs are seized in an investigation of organized dogfighting, heavily scarred dogs are often assumed to be highly dog aggressive due to a history of fighting. These dogs may be deemed dangerous and euthanized based on scarring alone. We analyzed our existing data on dogs seized from four dogfighting investigations, examining the relationship between the dogs’ scars with aggression towards other dogs. Scar and wound data were tallied in three body zones where dogfighting injuries tend to be concentrated. Dog aggression was assessed using a model dog and a friendly stimulus dog in a standardized behavior evaluation. Scarring and dog aggression were significantly related, more strongly among male (Fisher’s Exact p < 0.001 than female dogs (Fisher’s Exact p = 0.05. Ten or more scars in the three body zones was a reasonable threshold with which to classify a dog as high risk for dog aggression: 82% of males and 60% of females with such scarring displayed dog aggression. However, because many unscarred dogs were dog aggressive while some highly scarred dogs were not, we recommend collecting behavioral information to supplement scar counts when making disposition decisions about dogs seized in dogfighting investigations.

  4. FACTORS INFLUENCING THE OCCURRENCE OF HYPERTROPHIC SCARS AMONG POSTOPERATIVE PATIENTS IN GARUT, INDONESIA

    Directory of Open Access Journals (Sweden)

    Andri Nugraha

    2017-02-01

    Full Text Available Background: Hypertrophic scar causes physical and psychological problems. Thus understanding the factors related to the occurrence of hypertrophic scar tissue is needed. Little is known about its influencing factors in Indonesia, especially in Garut. Objective: This study aims to examine the relationships between hypertrophic scar and its influencing factors, and identify the most dominant factor of the occurrence of hypertrophic scars. Methods: This was an observational case control study using retrospective approach in Polyclinic of Surgery of Regional Public Hospital of dr. Slamet of Garut Regency. There were 40 samples recruited in this study by purposive sampling, which was divided to be case group (20 patients and control group (20 patients. Data were collected using Stony Brook Scar Evaluation Scale by observation and documentation of the medical records of patients. Data were analyzed using logistic regression analysis Results: Findings indicated that there were significant relationships between the surgical wound infection (p = 0.02, family history (p = 0.026, and type of suture (p = 0.043 with the occurrence of hypertrophic scars. The most dominant factor on the occurrence of hypertrophic scars was type of suture, acid polyglactin 910. The variables that had no significant relationships with the occurrence of hypertrophic scar tissue were age (p = 0.34, area of surgical wound (p = 0.177, and smoking habit (p = 0.479. Conclusion: There were significant relationships between infection of surgical wound, genetic history, the type of suture, and the occurrence of hypertrophic scar tissue. The most dominant factor that influenced the occurrence of hypertrophic scar tissue was the type of suture. Therefore, it is suggested to health professionals to modify the using of acid polyglactin 910 sutures, and nurses particularly need to provide the information regarding the family history and genetic-related hypertrophic scar, and prevent the

  5. Usefulness of direct W-plasty application to wound debridement for minimizing scar formation in the ED.

    Science.gov (United States)

    Min, Jin Hong; Park, Kyung Hye; Choi, Hong Lak; Park, Jung Soo; Lee, Ji Han; Kim, Hoon; Lee, Byung Kook; Lee, Dong Hun; Lee, Taek Gu

    2017-12-01

    A suture line placed with the same direction as the relaxed skin tension line leads to good healing, but a suture line with over 30 degrees of angle from the relaxed skin tension line leads to longer healing time and more prominent scarring. W-plasty is widely used to change the direction of the scar or to divide it into several split scars. In this study, we applied W-plasty to patients with facial lacerations in the emergency department. From June 2012 to December 2014, 35 patients underwent simple repair or W-plasty for facial lacerations. Patients in the simple repair group underwent resection following a thermal margin, and the W-plasty group was resected within a pre-designed margin of W-shaped laceration. We assessed prognosis using the Stony Brook Scar Evaluation Scale (SBSES) after 10 days (short-term) and six months (long-term), respectively, following suture removal. Among 35 patients, 15 (42.9%) underwent simple debridement and 20 (57.1%) underwent W-plasty. In the W-plasty group, there was no difference between short-term and long-term follow-up showing high SBSES, but in the simple debridement group, long-term follow-up SBSES significantly decreased. W-plasty SBSES was higher than simple debridement at short-term as well as long-term follow-up. We experienced good results of direct W-plasty application at six-month long-term follow-up. Therefore, W-plasty application is more effective in reducing scar appearance than a simple debridement method for facial laceration patients with an angle of 30 degrees or more to the relaxed skin tension line. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Linking Large-Scale Reading Assessments: Comment

    Science.gov (United States)

    Hanushek, Eric A.

    2016-01-01

    E. A. Hanushek points out in this commentary that applied researchers in education have only recently begun to appreciate the value of international assessments, even though there are now 50 years of experience with these. Until recently, these assessments have been stand-alone surveys that have not been linked, and analysis has largely focused on…

  7. Vaccinia scars associated with improved survival among adults in rural Guinea-Bissau.

    Directory of Open Access Journals (Sweden)

    Mette Lundsby Jensen

    Full Text Available BACKGROUND: In urban Guinea-Bissau, adults with a vaccinia scar had better survival but also a higher prevalence of HIV-2 infection. We therefore investigated the association between vaccinia scar and survival and HIV infection in a rural area of Guinea-Bissau. METHODOLOGY/PRINCIPAL FINDINGS: In connection with a study of HIV in rural Guinea-Bissau, we assessed vaccinia and BCG scars in 193 HIV-1 or HIV-2 infected and 174 uninfected participants. Mortality was assessed after 2(1/2-3 years of follow-up. The analyses were adjusted for age, sex, village, and HIV status. The prevalence of vaccinia scar was associated with age, village, and HIV-2 status but not with sex and schooling. Compared with individuals without any scar, individuals with a vaccinia scar had better survival (mortality rate ratio (MR = 0.22 (95% CI 0.08-0.61, the MR being 0.19 (95% CI 0.06-0.57 for women and 0.40 (95% CI 0.04-3.74 for men. Estimates were similar for HIV-2 infected and HIV-1 and HIV-2 uninfected individuals. The HIV-2 prevalence was higher among individuals with a vaccinia scar compared to individuals without a vaccinia scar (RR = 1.57 (95% CI 1.02-2.36. CONCLUSION: The present study supports the hypothesis that vaccinia vaccination may have a non-specific beneficial effect on adult survival.

  8. Immunohistochemical Analysis of Scarring Trachoma Indicates Infiltration by Natural Killer and Undefined CD45 Negative Cells.

    Science.gov (United States)

    Hu, Victor H; Luthert, Philip J; Derrick, Tamsyn; Pullin, James; Weiss, Helen A; Massae, Patrick; Mtuy, Tara; Makupa, William; Essex, David; Mabey, David C W; Bailey, Robin L; Holland, Martin J; Burton, Matthew J

    2016-05-01

    The phenotype and function of immune cells infiltrating the conjunctiva in scarring trachoma have yet to be fully characterized. We assessed tissue morphology and immunophenotype of cellular infiltrates found in trachomatous scarring compared to control participants. Clinical assessments and conjunctival biopsy samples were obtained from 34 individuals with trachomatous scarring undergoing trichiasis surgery and 33 control subjects undergoing cataract or retinal detachment surgery. Biopsy samples were fixed in buffered formalin and embedded in paraffin wax. Hematoxylin and eosin (H&E) staining was performed for assessment of the inflammatory cell infiltrate. Immunohistochemical staining of single markers on individual sections was performed to identify cells expressing CD3 (T-cells), CD4 (helper T-cells), CD8 (suppressor/cytotoxic T-cells and Natural Killer, NK, cells), NCR1 (NK cells), CD20 (B-cells), CD45 (nucleated hematopoietic cells), CD56 (NK and T-cells), CD68 (macrophages/monocytes) and CD83 (mature dendritic cells). The degree of scarring was assessed histologically using cross-polarized light to visualize collagen fibres. Scarring, regardless of clinical inflammation, was associated with increased inflammatory cell infiltrates on H&E and CD45 staining. Scarring was also associated with increased CD8+ and CD56+ cells, but not CD3+ cells, suggestive of a NK cell infiltrate. This was supported by the presence of NCR1+ cells. There was some increase in CD20+ cells, but no evidence for increased CD4+, CD68+ or CD83+ cells. Numerous CD45 negative cells were also seen in the population of infiltrating inflammatory cells in scarred conjunctiva. Disorganization of the normal collagen architecture was strongly associated with clinical scarring. These data point to the infiltration of immune cells with a phenotype suggestive of NK cells in conjunctival trachomatous scarring. A large proportion of CD45 negative inflammatory cells were also present. Future work should

  9. Clinical and psychometric validation of the psychotic depression assessment scale

    DEFF Research Database (Denmark)

    Østergaard, Søren D; Pedersen, Christina H; Uggerby, Peter

    2015-01-01

    BACKGROUND: Recent studies have indicated that the 11-item Psychotic Depression Assessment Scale (PDAS), consisting of the 6-item melancholia subscale (HAM-D6) of the Hamilton Depression Rating Scale and 5 psychosis items from the Brief Psychiatric Rating Scale (BPRS), is a valid measure for the ...

  10. Subjective assessment of impairment in scale-space-coded images

    NARCIS (Netherlands)

    Ridder, de H.; Majoor, G.M.M.

    1988-01-01

    Direct category scaling and a scaling procedure in accordance with Functional Measurement Theory (Anderson, 1982) have been used to assess impairment in scale-space-coded illlages, displayed on a black-and-white TV monitor. The image of a complex scene was passed through a Gaussian filter of limited

  11. A Case of Multiple Spontaneous Keloid Scars

    Directory of Open Access Journals (Sweden)

    Abdulhadi Jfri

    2015-07-01

    Full Text Available Keloid scars result from an abnormal healing response to cutaneous injury or inflammation that extends beyond the borders of the original wound. Spontaneous keloid scars forming in the absence of any previous trauma or surgical procedure are rare. Certain syndromes have been associated with this phenomenon, and few reports have discussed the evidence of single spontaneous keloid scar, which raises the question whether they are really spontaneous. Here, we present a 27-year-old mentally retarded single female with orbital hypertelorism, broad nasal bridge, repaired cleft lip and high-arched palate who presented with progressive multiple spontaneous keloid scars in different parts of her body which were confirmed histologically by the presence of typical keloidal collagen. This report supports the fact that keloid scars can appear spontaneously and are possibly linked to a genetic factor. Furthermore, it describes a new presentation of spontaneous keloid scars in the form of multiple large lesions in different sites of the body.

  12. Effect of skin graft thickness on scar development in a porcine burn model.

    Science.gov (United States)

    DeBruler, Danielle M; Blackstone, Britani N; McFarland, Kevin L; Baumann, Molly E; Supp, Dorothy M; Bailey, J Kevin; Powell, Heather M

    2018-06-01

    Animal models provide a way to investigate scar therapies in a controlled environment. It is necessary to produce uniform, reproducible scars with high anatomic and biologic similarity to human scars to better evaluate the efficacy of treatment strategies and to develop new treatments. In this study, scar development and maturation were assessed in a porcine full-thickness burn model with immediate excision and split-thickness autograft coverage. Red Duroc pigs were treated with split-thickness autografts of varying thickness: 0.026in. ("thin") or 0.058in. ("thick"). Additionally, the thin skin grafts were meshed and expanded at 1:1.5 or 1:4 to evaluate the role of skin expansion in scar formation. Overall, the burn-excise-autograft model resulted in thick, raised scars. Treatment with thick split-thickness skin grafts resulted in less contraction and reduced scarring as well as improved biomechanics. Thin skin autograft expansion at a 1:4 ratio tended to result in scars that contracted more with increased scar height compared to the 1:1.5 expansion ratio. All treatment groups showed Matrix Metalloproteinase 2 (MMP2) and Transforming Growth Factor β1 (TGF-β1) expression that increased over time and peaked 4 weeks after grafting. Burns treated with thick split-thickness grafts showed decreased expression of pro-inflammatory genes 1 week after grafting, including insulin-like growth factor 1 (IGF-1) and TGF-β1, compared to wounds treated with thin split-thickness grafts. Overall, the burn-excise-autograft model using split-thickness autograft meshed and expanded to 1:1.5 or 1:4, resulted in thick, raised scars similar in appearance and structure to human hypertrophic scars. This model can be used in future studies to study burn treatment outcomes and new therapies. Copyright © 2017 Elsevier Ltd and ISBI. All rights reserved.

  13. Mammographic scar for stereotaxic biopsy

    International Nuclear Information System (INIS)

    Guzman Tattis; Hincapie U, Ana Lucia; Patino P, Jairo Hernando

    1997-01-01

    It is reported the case of 56 years old woman who underwent a stereotactic biopsy because of having a circumscribed breast nodule. The histologic diagnosis was benign. After six months, during the mammographic control, it was noticed that the nodule showed irregular contours, because of that a surgical biopsy was performed. The histopathology was reported as benign. it is considered then, that the mammographic changes observed in the mammographic control are due to scar phenomenon after stereotactic biopsy. This findings has not been reported previously

  14. Efficacy and Safety of Fractional CO2 Laser Resurfacing in Non-hypertrophic Traumatic and Burn Scars

    Science.gov (United States)

    Majid, Imran; Imran, Saher

    2015-01-01

    Background: Fractional photothermolysis is one of the most effective treatment options used to resurface scars of different aetiologies. Aim: To assess the efficacy and safety of fractional CO2 laser resurfacing treatment in the management of non-hypertrophic traumatic and burn scars. Materials and Methods: Twenty-five patients affected by non-hypertrophic traumatic and burn scars were treated with four sessions of fractional CO2 laser resurfacing treatment at 6-weekly intervals. Patients were photographed at each visit and finally, 3 months after the end of treatment schedule. Response to treatment was assessed clinically as well as by comparing the initial photograph of the patient with the one taken at the last follow-up visit 3-months after the final treatment session. Changes in skin texture, surface irregularity and pigmentation were assessed on a quartile grading scale and scored individually from 0 to 4. A mean of the three individual scores was calculated and the response was labelled as ‘excellent’ if the mean score achieved was >2. A score of 1-2 was labeled as good response while a score below 1 was labeled as ‘poor’ response. The subjective satisfaction of each patient with the treatment offered was also assessed at the last follow-up visit. Results: The commonest site of scarring treated was the face followed by hands. Response to treatment was rated as excellent in 60% (15/25) patients while 24% (6/25) and 16% (4/25) patients were labeled as good and poor responders, respectively. Skin texture showed better response than other variables with average score of 2.44. Linear post-traumatic scars were seen to respond less than other morphological types. Majority of the patients (19 out of 25) were highly satisfied with the treatment offered. No long-term adverse effects were noted in any patient. Conclusions: Fractional photothermolysis with a fractional CO2 laser gives excellent results in patients with post-burn scars with minimal adverse

  15. Efficacy and safety of fractional CO 2 laser resurfacing in non-hypertrophic traumatic and burn scars

    Directory of Open Access Journals (Sweden)

    Imran Majid

    2015-01-01

    Full Text Available Background: Fractional photothermolysis is one of the most effective treatment options used to resurface scars of different aetiologies. Aim: To assess the efficacy and safety of fractional CO 2 laser resurfacing treatment in the management of non-hypertrophic traumatic and burn scars. Materials and Methods: Twenty-five patients affected by non-hypertrophic traumatic and burn scars were treated with four sessions of fractional CO 2 laser resurfacing treatment at 6-weekly intervals. Patients were photographed at each visit and finally, 3 months after the end of treatment schedule. Response to treatment was assessed clinically as well as by comparing the initial photograph of the patient with the one taken at the last follow-up visit 3-months after the final treatment session. Changes in skin texture, surface irregularity and pigmentation were assessed on a quartile grading scale and scored individually from 0 to 4. A mean of the three individual scores was calculated and the response was labelled as ′excellent′ if the mean score achieved was >2. A score of 1-2 was labeled as good response while a score below 1 was labeled as ′poor′ response. The subjective satisfaction of each patient with the treatment offered was also assessed at the last follow-up visit. Results: The commonest site of scarring treated was the face followed by hands. Response to treatment was rated as excellent in 60% (15/25 patients while 24% (6/25 and 16% (4/25 patients were labeled as good and poor responders, respectively. Skin texture showed better response than other variables with average score of 2.44. Linear post-traumatic scars were seen to respond less than other morphological types. Majority of the patients (19 out of 25 were highly satisfied with the treatment offered. No long-term adverse effects were noted in any patient. Conclusions: Fractional photothermolysis with a fractional CO 2 laser gives excellent results in patients with post-burn scars with

  16. Cutaneous osteosarcoma arising from a burn scar

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Min A.; Yi, Jaehyuck [Kyungpook National University, Department of Radiology, College of Medicine, Daegu (Korea, Republic of); Kyungpook National University Hospital, Department of Radiology, Daegu (Korea, Republic of); Chae, Jong Min [Kyungpook National University, Department of Pathology, College of Medicine, Daegu (Korea, Republic of)

    2017-04-15

    Tumors that develop in old burn scars are usually squamous cell carcinomas. Sarcomas have also been reported, albeit rarely. To our knowledge, there has been only one case report of an extraskeletal osteosarcoma arising in a prior burn scar reported in the English-language literature, mainly discussing the clinicopathological features. Herein, we present a case of cutaneous osteosarcoma visualized as a mineralized soft-tissue mass arising from the scar associated with a previous skin burn over the back. This seems to be the first report describing the imaging features of a cutaneous osteosarcoma from an old burn scar. (orig.)

  17. Assessing carbon flow at the local scale

    Energy Technology Data Exchange (ETDEWEB)

    McEvoy, D.; Gibbs, D.C.; Longhurst, J.W.S. [University of Hull, Hull (United Kingdom). Dept. of Geography

    1997-12-31

    Greater Manchester, an urban conurbation in the UK, was the birth place of the industrial revolution. Recent restructing and the potential for increases in economic growth place a requirement on the city to consider its future energy strategies if it is to keep its CO{sub 2} emissions to responsible levels. Reducing the carbon intensity of economies is an essential element of combating the threat of global warming, and although the problem is global in nature, effective remedial action has to be instigated at a variety of spatial scales. Inventories that are based at the city level allow the intensity and distribution of local carbon flows to be calculated and therefore have considerable potential in many planning and decision making processes. The CO{sub 2} inventory constructed for this paper is the first stage of prioritising carbon reduction strategies for Greater Manchester, providing an indication of carbon flows specific to the region. The inventory has been developed from the knowledge and experience of other city-scale energy studies which have taken place to date, and although the methodology has been developed for application to the Greater Manchester region the approach can be replicated for other urban areas. Sources of emission included: coal-fired power plants; gas; other solid fuel consumption; and petroleum use by automobiles; and others. The quantity of CO{sub 2} emitted by each was analysed, with a view to increasing efficiency. 27 refs., 1 fig., 17 tabs.

  18. Outcome after burns: An observational study on burn scar maturation and predictors for severe scarring

    NARCIS (Netherlands)

    van der Wal, M.B.A.; Vloemans, J.F.P.M.; Tuinebreijer, W.E.; van de Ven, P.M.; van Unen, E.; van Zuijlen, P.P.M.; Middelkoop, E.

    2012-01-01

    Long-term outcome of burn scars as well as the relation with clinically relevant parameters has not been studied quantitatively. Therefore, we conducted a detailed analysis on the clinical changes of burn scars in a longitudinal setup. In addition, we focused on the differences in scar quality in

  19. An empirical assessment of the SERVQUAL scale

    Directory of Open Access Journals (Sweden)

    Mahla Zargar

    2015-11-01

    Full Text Available During the past few years, many people have used point of sales for purchasing goods and services. Point of sales tends to provide a reliable method for making purchases in stores. Implementation of point of sales may reduce depreciation cost of automated telling machines and helps banks increase their productivities. Therefore, for bank managers, it is important to provide high quality services. This paper presents an empirical investigation to measure quality service using SERVQUAL scale. The study first extracts six factors including Trust, Responsiveness, Reliability, Empathy, Tangibles and getting insight for future development through the implementation of structural equation modeling. Next, it has implemented structural equation modeling and realizes that all components had positive impacts on customer satisfaction.

  20. The efficacy of conditioned media of adipose-derived stem cells combined with ablative carbon dioxide fractional resurfacing for atrophic acne scars and skin rejuvenation.

    Science.gov (United States)

    Zhou, Bing-Rong; Zhang, Ting; Bin Jameel, Afzaal Ahmed; Xu, Yang; Xu, Yan; Guo, Shi-Lei; Wang, Ying; Permatasari, Felicia; Luo, Dan

    2016-06-01

    To evaluate the effects of conditioned medium of adipose-derived stem cells (ADSC-CM) on efficacy and side effects after fractional carbon dioxide laser resurfacing (FxCR) when treating subjects with facial atrophic acne scars or with skin rejuvenation needs. Twenty-two subjects were enrolled in the study and divided into two groups. Nine subjects were included in skin rejuvenation group and thirteen subjects were included in acne scar group, and all subjects underwent three sessions of FxCR. ADSC-CM was applied on FxCR site of one randomly selected face side. Evaluations were done at baseline, 1 week after first treatment, and 1 month after each treatment. The outcome assessments included subjective satisfaction scale; blinded clinical assessment; and the biophysical parameters of roughness, elasticity, skin hydration, transepidermal water loss (TEWL), and the erythema and melanin index. Biopsies taken from one subject in skin rejuvenation group were analyzed using hematoxylin and eosin, Masson's Trichrome, and Gomori's aldehyde fuchsin staining. ADSC-CM combined with FxCR increased subject satisfaction, elasticity, skin hydration, and skin elasticity and decreased TEWL, roughness, and the melanin index in both acne scars and skin rejuvenation groups. Histologic analysis showed that ADSC-CM increased dermal collagen density, elastin density, and arranged them in order. ADSC-CM with FxCR is a good combination therapy for treating atrophic acne scars and skin rejuvenation. JSPH2012-082 - Registered 14 Feb 2012.

  1. Efficacy of fractionated microneedle radiofrequency with and without adding subcision for the treatment of atrophic facial acne scars: A randomized split-face clinical study.

    Science.gov (United States)

    Faghihi, Gita; Poostiyan, Nazila; Asilian, Ali; Abtahi-Naeini, Bahareh; Shahbazi, Masoom; Iraji, Fariba; Fatemi Naeini, Farahnaz; Nilforoushzadeh, Mohammad Ali

    2017-06-01

    There is no gold standard treatment for facial acne scars, and overall, little literature exists about the combination therapy for treatment of acne scar. The aim of this study was to evaluate the efficacy of fractionated microneedle radiofrequency (FMR) vs FMR combined with subcision for the treatment of atrophic acne scars. This was a randomized, split-face clinical study of 25 patients with II-IV Fitzpatrick skin types with moderate to severe facial atrophic acne scars. Initially, standard subcision by Nokor needle was performed on one side. Two weeks after subcision, FMR treatment was performed on both cheeks of each participant. Second and third FMR treatment sessions were performed within 4-week intervals. Two-blinded dermatologists performed clinical assessments using a quartile grading scale, and patients were also asked to judge their satisfaction using a visual analog scale (VAS) scoring system. The age of the patients varied from 24 to 40 years (mean: 30.08±4.94 years). Only nine patients (36%) were males. Clinical assessment by two-blinded dermatologists showed statistically significant improvement in the combination (FMR+subcision) group (P=.009). Patient satisfaction was statistically significantly better in the combination group (P=.001). A darkening of skin phototype was associated with a decrease in patient's satisfaction VAS score (P=.07). The combination of subcision and FMR is a safe and effective modality for mixed type acne scars. Additional randomized clinical study with long-term follow-up is necessary for further evaluation of FMR in combination with other procedures. The full trial protocol can be accessed in: http://www.irct.ir/searchresult.php?keyword=%20%20IRCT2016103130597N1&id=30597&number=1&field=a&prt=1&total=1&m=1. The clinical trial registration number is IRCT2016103130597N1. © 2017 Wiley Periodicals, Inc.

  2. Formation of hypertrophic scars: Evolution and susceptibility

    NARCIS (Netherlands)

    Mahdavian Delavary, B.; van der Veer, W.M.; Ferreira, J.A.; Niessen, F.B.

    2012-01-01

    Formation of hypertrophic scars is a common complication of wound healing, and at present little is known about the incidence and risk factors. Our aim was to analyse the incidence, progression, and regression of postoperative hypertrophic scars over time and to identify risk factors of hypertrophic

  3. Cutaneous leiomyosarcoma arising in a smallpox scar

    NARCIS (Netherlands)

    Pol, Robert A.; Dannenberg, Hilde; Robertus, Jan-Lukas; van Ginkel, Robert J.

    2012-01-01

    Background: Cutaneous leiomyosarcoma (CLM) is a very rare smooth muscle tumour that accounts for about 2-3% of all superficial soft tissue sarcomas. Although the development of various malignancies in scar tissue is well known, we report the first case of a CLM developing in a small pox scar. Case

  4. Reproducibility of three-dimensional ultrasound for the measurement of a niche in a caesarean scar and assessment of its shape

    NARCIS (Netherlands)

    Bij de Vaate, A.J.M.; Linskens, I.H.; van der Voet, L.F.; Twisk, J.W.R.; Brölmann, H.A.M.; Huirne, J.A.F.

    2015-01-01

    Abstract Objective To evaluate the inter- and intraobserver agreement for measurement of the size and volume of a niche and assessment of the shape, with the use of three-dimensional (3D) ultrasound. Study design In this reproducibility study, 20 3D ultrasound volumes of uteri with a niche were

  5. SCAR/WAVE: A complex issue.

    Science.gov (United States)

    Davidson, Andrew J; Insall, Robert H

    2013-11-01

    The SCAR/WAVE complex drives the actin polymerisation that underlies protrusion of the front of the cell and thus drives migration. However, it is not understood how the activity of SCAR/WAVE is regulated to generate the infinite range of cellular shape changes observed during cell motility. What are the relative roles of the subunits of the SCAR/WAVE complex? What signaling molecules do they interact with? And how does the complex integrate all this information in order to control the temporal and spatial polymerisation of actin during protrusion formation? Unfortunately, the interdependence of SCAR complex members has made genetic dissection hard. In our recent paper,(1) we describe stabilization of the Dictyostelium SCAR complex by a small fragment of Abi. Here we summarize the main findings and discuss how this approach can help reveal the inner workings of this impenetrable complex.

  6. Strong quantum scarring by local impurities

    Science.gov (United States)

    Luukko, Perttu J. J.; Drury, Byron; Klales, Anna; Kaplan, Lev; Heller, Eric J.; Räsänen, Esa

    2016-11-01

    We discover and characterise strong quantum scars, or quantum eigenstates resembling classical periodic orbits, in two-dimensional quantum wells perturbed by local impurities. These scars are not explained by ordinary scar theory, which would require the existence of short, moderately unstable periodic orbits in the perturbed system. Instead, they are supported by classical resonances in the unperturbed system and the resulting quantum near-degeneracy. Even in the case of a large number of randomly scattered impurities, the scars prefer distinct orientations that extremise the overlap with the impurities. We demonstrate that these preferred orientations can be used for highly efficient transport of quantum wave packets across the perturbed potential landscape. Assisted by the scars, wave-packet recurrences are significantly stronger than in the unperturbed system. Together with the controllability of the preferred orientations, this property may be very useful for quantum transport applications.

  7. Prevention and curative management of hypertrophic scar formation

    NARCIS (Netherlands)

    Bloemen, M.C.; Veer, van der W.M.; Ulrich, M.; Zuijlen, van P.P.; Niessen, F.B.; Middelkoop, E.

    2009-01-01

    Although hypertrophic scarring commonly occurs following burns, many aspects such as incidence of and optimal treatment for scar hypertrophy remain unclear. This review will focus on hypertrophic scar formation after burn in particular, exploring multiple treatment options and describing their

  8. Regional scale ecological risk assessment: using the relative risk model

    National Research Council Canada - National Science Library

    Landis, Wayne G

    2005-01-01

    ...) in the performance of regional-scale ecological risk assessments. The initial chapters present the methodology and the critical nature of the interaction between risk assessors and decision makers...

  9. Trait Sources of Spirituality Scale: Assessing Trait Spirituality More Inclusively

    Science.gov (United States)

    Westbrook, Charles J.; Davis, Don E.; McElroy, Stacey E.; Brubaker, Kacy; Choe, Elise; Karaga, Sara; Dooley, Matt; O'Bryant, Brittany L.; Van Tongeren, Daryl R.; Hook, Joshua

    2018-01-01

    We develop the Trait Sources of Spirituality Scale (TSSS), which assesses experiences of closeness to the sacred, within and outside a religious tradition. After using factor analysis to finalize the scale, we examine evidence of construct validity, including latent profile analysis that reveals 5 patterns of how spirituality is experienced.

  10. The Efficacy and Safety of Ablative Fractional Resurfacing Using a 2,940-Nm Er:YAG Laser for Traumatic Scars in the Early Posttraumatic Period

    Directory of Open Access Journals (Sweden)

    Sun Goo Kim

    2012-05-01

    Full Text Available Background Skin injuries, such as lacerations due to trauma, are relatively common, andpatients are very concerned about the resulting scars. Recently, the use of ablative and nonablativelasers based on the fractional approach has been used to treat scars. In this study,the authors demonstrated the efficacy and safety of ablative fractional resurfacing (AFRfor traumatic scars using a 2,940-nm erbium: yttrium-aluminum-garnet (Er:YAG laser fortraumatic scars after primary repair during the early posttraumatic period.Methods Twelve patients with fifteen scars were enrolled. All had a history of faciallaceration and primary repair by suturing on the day of trauma. Laser therapy was initiatedat least 4 weeks after the primary repair. Each patient was treated four times at 1-monthintervals with a fractional ablative 2,940-nm Er:YAG laser using the same parameters. Posttreatmentevaluations were performed 1 month after the fourth treatment session.Results All 12 patients completed the study. After ablative fractional laser treatment, alltreated portions of the scars showed improvements, as demonstrated by the VancouverScar Scale and the overall cosmetic scale as evaluated by 10 independent physicians, 10independent non-physicians, and the patients themselves.Conclusions This study shows that ablative fractional Er:YAG laser treatment of scars reducesscars fairly according to both objective results and patient satisfaction rates. The authorssuggest that early scar treatment using AFR can be one adjuvant scar management methodfor improving the quality of life of patients with traumatic scars.

  11. Effect of intense pulsed light on immature burn scars: A clinical study

    Directory of Open Access Journals (Sweden)

    Arindam Sarkar

    2014-01-01

    Full Text Available Introduction: As intense pulsed light (IPL is widely used to treat cutaneous vascular malformations and also used as non-ablative skin rejunuvation to remodel the skin collagen. A study has been undertaken to gauze the effect of IPL on immature burn scars with regard to vascularity, pliability and height. Materials and Methods: This study was conducted between June 2013 and May 2014, among patients with immature burn scars that healed conservatively within 2 months. Photographic evidence of appearance of scars and grading and rating was done with Vancouver Scar Scale parameters. Ratings were done for both case and control scar after the completion of four IPL treatment sessions and were compared. Results: Out of the 19 cases, vascularity, pliability and height improved significantly (P < 0.05 in 13, 14 and 11 scars respectively following IPL treatment. Conclusions: Intense pulsed light was well-tolerated by patients, caused good improvement in terms of vascularity, pliability, and height of immature burn scar.

  12. Development and external validation of a new PTA assessment scale

    Directory of Open Access Journals (Sweden)

    Jacobs Bram

    2012-08-01

    Full Text Available Abstract Background Post-traumatic amnesia (PTA is a key symptom of traumatic brain injury (TBI. Accurate assessment of PTA is imperative in guiding clinical decision making. Our aim was to develop and externally validate a short, examiner independent and practical PTA scale, by selecting the most discriminative items from existing scales and using a three-word memory test. Methods Mild, moderate and severe TBI patients and control subjects were assessed in two separate cohorts, one for derivation and one for validation, using a questionnaire comprised of items from existing PTA scales. We tested which individual items best discriminated between TBI patients and controls, represented by sensitivity and specificity. We then created our PTA scale based on these results. This new scale was externally evaluated for its discriminative value using Receiver Operating Characteristic (ROC analysis and compared to existing PTA scales. Results The derivation cohort included 126 TBI patients and 31 control subjects; the validation cohort consisted of 132 patients and 30 controls. A set of seven items was eventually selected to comprise the new PTA scale: age, name of hospital, time, day of week, month, mode of transport and recall of three words. This scale demonstrated adequate discriminative values compared to existing PTA scales on three consecutive administrations in the validation cohort. Conclusion We introduce a valid, practical and examiner independent PTA scale, which is suitable for mild TBI patients at the emergency department and yet still valuable for the follow-up of more severely injured TBI patients.

  13. Ecosystem assessment methods for cumulative effects at the regional scale

    International Nuclear Information System (INIS)

    Hunsaker, C.T.

    1989-01-01

    Environmental issues such as nonpoint-source pollution, acid rain, reduced biodiversity, land use change, and climate change have widespread ecological impacts and require an integrated assessment approach. Since 1978, the implementing regulations for the National Environmental Policy Act (NEPA) have required assessment of potential cumulative environmental impacts. Current environmental issues have encouraged ecologists to improve their understanding of ecosystem process and function at several spatial scales. However, management activities usually occur at the local scale, and there is little consideration of the potential impacts to the environmental quality of a region. This paper proposes that regional ecological risk assessment provides a useful approach for assisting scientists in accomplishing the task of assessing cumulative impacts. Critical issues such as spatial heterogeneity, boundary definition, and data aggregation are discussed. Examples from an assessment of acidic deposition effects on fish in Adirondack lakes illustrate the importance of integrated data bases, associated modeling efforts, and boundary definition at the regional scale

  14. Radial scars detected mammographically in a breast cancer screening programme

    International Nuclear Information System (INIS)

    Azavedo, E.; Svane, G.

    1992-01-01

    Radial scars are getting more and more common since implementation of mammography as diagnostic tool in screening women for breast cancer. At Karolinska Hospital, 18987 asymptomatic women, aged 50-69, were screened for breast cancer through mammography during August 1989-May 1991. A total of 735 (3.87%) were recalled for additional views after initial mammograms and 463 (2.44%) were assessed with help of cytology. In all 175 women (0.92%) were selected for surgery and 146 (0.77%) had histologically verified cancers. The remaining 29 (0.15%) had non- malignant lesions of which 11 (0.06%) were radial scars. All radial scars were diagnosed on mammograms and later confirmed with histology. The radiologic characteristics were found to be a) rather thick and long radiating structures accompanied by radiolucent linear structures parallel to some of the spicules, b) absence of calcifications, c) radiolucent areas in the body of the lesion, d) an average mean size of 6 mm and e) changing image in different views. Most of the lesions, 73% (8/11), were in moderately dense breasts and there was no specific relation to the right or left breast. A majority of radial scars, 64% (7/11), were found in the upper outer quadrants, 3/11 in the lower outer quadrants and 1/11 in the lower inner quadrant. Literature shows that histology uses many synonyms for radial scars and therefore team work between radiologists and pathologists is suggested for better conformity of the diagnosis. (author). 32 refs.; 1 fig

  15. Assessment of Commonly Used Pediatric Stool Scales: A pilot study

    OpenAIRE

    Saps, M.; Nichols-Vinueza, D.; Dhroove, G.; Adams, P.; Chogle, A.

    2013-01-01

    Background: The Bristol Stool Form Scale (BSFS) and a modified child-friendly version (M-BSFS) are frequently used in clinical practice and research. These scales have not been validated in children. 3-D stool scale models may be better adapted to the child's development. Aims: To assess the usefulness of the BSFS, M-BSFS, and a newly developed 3-D stool scale in children. Methods: Fifty children were asked to rank the picture cards of the BSFS and 3-D models from hardest to softest and...

  16. A phase I/II exploratory clinical trial for intracordal injection of recombinant hepatocyte growth factor for vocal fold scar and sulcus.

    Science.gov (United States)

    Hirano, Shigeru; Kawamoto, Atsuhiko; Tateya, Ichiro; Mizuta, Masanobu; Kishimoto, Yo; Hiwatashi, Nao; Kawai, Yoshitaka; Tsuji, Takuya; Suzuki, Ryo; Kaneko, Mami; Naito, Yasushi; Kagimura, Tatsuo; Nakamura, Tatsuo; Kanemaru, Shin-Ichi

    2018-04-01

    Vocal fold scar and sulcus are intractable diseases with no effective established treatments. Hepatocyte growth factor (HGF) has preclinically proven to have potent antifibrotic and regenerative effects on vocal fold scar. The current Phase I/II clinical trial aims to examine the safety and effectiveness of intracordal injection of a recombinant human HGF drug for patients with vocal fold scar or sulcus. This is an open-label, dose-escalating, first-in-human clinical trial. Eighteen patients with bilateral vocal fold scar or sulcus were enrolled and divided into three groups: Step I received 1 μg of HGF per vocal fold; Step II received 3 μg of HGF; and Step III received 10 μg of HGF. Injections were administered once weekly for 4 weeks. The protocol treatment was performed starting with Step I and escalating to Step III. Patients were followed for 6 months post-treatment. Local and systemic safety aspects were examined as primary endpoints, and therapeutic effects were assessed as secondary endpoints using voice handicap index-10; maximum phonation time; vocal fold vibratory amplitude; grade, rough, breathy, asthenic, strained scale; and jitter. The results indicated no serious drug-related adverse events in either the systemic or local examinations. In whole-subject analysis, voice handicap index-10, vocal fold vibratory amplitude, and grade, rough, breathy, asthenic, strained scale were significantly improved at 6 months, whereas maximum phonation time and jitter varied. There were no significant differences in phonatory data between the step groups. In conclusion, intracordal injection of a recombinant human HGF drug was safe, feasible, and potentially effective for human patients with vocal fold scar or sulcus. Copyright © 2017 John Wiley & Sons, Ltd.

  17. Cutaneous leiomyosarcoma arising in a smallpox scar.

    Science.gov (United States)

    Pol, Robert A; Dannenberg, Hilde; Robertus, Jan-Lukas; van Ginkel, Robert J

    2012-07-16

    Cutaneous leiomyosarcoma (CLM) is a very rare smooth muscle tumour that accounts for about 2-3% of all superficial soft tissue sarcomas. Although the development of various malignancies in scar tissue is well known, we report the first case of a CLM developing in a small pox scar. A 66-year-old man presented with a painless, slow-growing lump in a small pox scar on his left shoulder. Histological biopsies showed the lesion to be a primary, well-differentiated cutaneous leiomyosarcoma. A CT scan of the thorax was conducted, which showed no signs of metastases. The complete lesion was then surgically excised, and histopathological examination revealed a radically excised cutaneous type leiomyosarcoma After 13 months' review the patient was doing well with no evidence of tumour recurrence. This is the first report of a CLM arising in a small pox scar. Although the extended time interval between scarring and malignant changes makes it difficult to advise strict follow-up for patients with small pox scars, one should be aware that atypical changes and/or symptoms occurring in a small pox scar could potentially mean malignant transformation.

  18. Cutaneous leiomyosarcoma arising in a smallpox scar

    Directory of Open Access Journals (Sweden)

    Pol Robert A

    2012-07-01

    Full Text Available Abstract Background Cutaneous leiomyosarcoma (CLM is a very rare smooth muscle tumour that accounts for about 2–3% of all superficial soft tissue sarcomas. Although the development of various malignancies in scar tissue is well known, we report the first case of a CLM developing in a small pox scar. Case presentation A 66-year-old man presented with a painless, slow-growing lump in a small pox scar on his left shoulder. Histological biopsies showed the lesion to be a primary, well-differentiated cutaneous leiomyosarcoma. A CT scan of the thorax was conducted, which showed no signs of metastases. The complete lesion was then surgically excised, and histopathological examination revealed a radically excised cutaneous type leiomyosarcoma After 13 months’ review the patient was doing well with no evidence of tumour recurrence. Conclusions This is the first report of a CLM arising in a small pox scar. Although the extended time interval between scarring and malignant changes makes it difficult to advise strict follow-up for patients with small pox scars, one should be aware that atypical changes and/or symptoms occurring in a small pox scar could potentially mean malignant transformation.

  19. High spatial resolution free-breathing 3D late gadolinium enhancement cardiac magnetic resonance imaging in ischaemic and non-ischaemic cardiomyopathy: quantitative assessment of scar mass and image quality.

    Science.gov (United States)

    Bizino, Maurice B; Tao, Qian; Amersfoort, Jacob; Siebelink, Hans-Marc J; van den Bogaard, Pieter J; van der Geest, Rob J; Lamb, Hildo J

    2018-04-06

    To compare breath-hold (BH) with navigated free-breathing (FB) 3D late gadolinium enhancement cardiac MRI (LGE-CMR) MATERIALS AND METHODS: Fifty-one patients were retrospectively included (34 ischaemic cardiomyopathy, 14 non-ischaemic cardiomyopathy, three discarded). BH and FB 3D phase sensitive inversion recovery sequences were performed at 3T. FB datasets were reformatted into normal resolution (FB-NR, 1.46x1.46x10mm) and high resolution (FB-HR, isotropic 0.91-mm voxels). Scar mass, scar edge sharpness (SES), SNR and CNR were compared using paired-samples t-test, Pearson correlation and Bland-Altman analysis. Scar mass was similar in BH and FB-NR (mean ± SD: 15.5±18.0 g vs. 15.5±16.9 g, p=0.997), with good correlation (r=0.953), and no bias (mean difference ± SD: 0.00±5.47 g). FB-NR significantly overestimated scar mass compared with FB-HR (15.5±16.9 g vs 14.4±15.6 g; p=0.007). FB-NR and FB-HR correlated well (r=0.988), but Bland-Altman demonstrated systematic bias (1.15±2.84 g). SES was similar in BH and FB-NR (p=0.947), but significantly higher in FB-HR than FB-NR (pFB-NR (pFB-HR than FB-NR (p<0.01). Navigated free-breathing 3D LGE-CMR allows reliable scar mass quantification comparable to breath-hold. During free-breathing, spatial resolution can be increased resulting in improved sharpness and reduced scar mass. • Navigated free-breathing 3D late gadolinium enhancement is reliable for myocardial scar quantification. • High-resolution 3D late gadolinium enhancement increases scar sharpness • Ischaemic and non-ischaemic cardiomyopathy patients can be imaged using free-breathing LGE CMR.

  20. Do pressure ulcer risk assessment scales improve clinical practice?

    Directory of Open Access Journals (Sweden)

    Jan Kottner

    2010-07-01

    Full Text Available Jan Kottner1, Katrin Balzer21Department of Nursing Science, Charité-Universitätsmedizin Berlin, Germany; 2Nursing Research Group, Institute for Social Medicine, Universitätsklinikum Schleswig-Holstein, Lübeck, GermanyAbstract: Standardized assessment instruments are deemed important for estimating pressure ulcer risk. Today, more than 40 so-called pressure ulcer risk assessment scales are available but still there is an ongoing debate about their usefulness. From a measurement point of view pressure ulcer (PU risk assessment scales have serious limitations. Empirical evidence supporting the validity of PU risk assessment scale scores is weak and obtained scores contain varying amounts of measurement error. The concept of pressure ulcer risk is strongly related to the general health status and severity of illness. A clinical impact due do the application of these scales could also not be demonstrated. It is questionable whether completion of standardized pressure ulcer risk scales in clinical practice is really needed.Keywords: Braden pressure ulcer, prevention, risk assessment, nursing assessment, predictive value, clinical effectiveness, review

  1. SONOGRAPHIC PREDICTION OF SCAR DEHISCENCE IN WOMEN WITH PREVIOUS CAESAREAN SECTION

    Directory of Open Access Journals (Sweden)

    Shubhada Suhas Jajoo

    2018-01-01

    Full Text Available BACKGROUND Caesarean section (Sectio Caesarea is a surgical method for the completion of delivery. After various historical modifications of operative techniques, modern approach consists in the transverse dissection of the anterior wall of the uterus. The rate of vaginal birth after caesarean section was significantly reduced from year to year and the rate of repeated caesarean section is increased during the past 10 years. Evaluation of scar thickness is done by ultrasound, but it is still debatable size of thick scar that would be guiding “cut-off value” for the completion of the delivery method. To better assess the risk of uterine rupture, some authors have proposed sonographic measurement of lower uterine segment thickness near term assuming that there is an inverse correlation between LUS thickness and the risk of uterine scar defect. Therefore, this assessment for the management of women with prior CS may increase safety during labour by selecting women with the lowest risk of uterine rupture. The aim of the study is to study the diagnostic accuracy of sonographic measurements of the Lower Uterine Segment (LUS thickness near term in predicting uterine scar defects in women with prior Caesarean Section (CS. We aim to ascertain the best cut-off values for predicting uterine rupture. MATERIALS AND METHODS 100 antenatal women with history of previous one LSCS who come to attend antenatal clinic will be assessed for scar thickness by transabdominal ultrasonography and its correlation with intraoperative findings. This prospective longitudinal study was conducted for 1 year after IEC approval with inclusion criteria previous one LSCS. Exclusion criteria- 1 Previous myomectomy scar; 2 Previous 2 LSCS; 3 Previous hysterotomy scar. RESULTS Our findings indicate that there is a strong association between degree of LUS thinning measured near term and the risk of uterine scar defect at birth. In our study, optimal cut-off value for predicting

  2. [Clinical study of influential factors on renal scarring after ESWL monotherapy for renal stone disease].

    Science.gov (United States)

    Ishito, Noritaka; Takamoto, Hitoshi; Kunitomi, Kimito; Satoh, Eiichi; Ishii, Ayano; Shiotuka, Youichi; Sako, Shinichi; Ohta, Naoki; Araki, Tohru

    2002-11-01

    ESWL is now widely used for the treatment of renal stone disease. Although ESWL has many advantages for patients' quality of life, few reports have demonstrated the long-term outcomes of the alterations of renal morphology after ESWL. We reported renal scarring after ESWL monotherapy in patients with renal calyceal stones. In this study, we evaluated a large series of patients' cohort treated at our institution, and assessed the causal effect of ESWL on the late occurrence of renal scar formation. ESWL was performed with EDAP (LT-01,02) that generates shock wave energy by piezoelectric discharge. We analyzed the records of 285 kidneys treated between Dec. 1986 and Nov. 1998. Renal scarring was noted in 44 kidneys and not in 241 kidneys with periodical ultrasonography. We compared the backgrounds of the two groups using chi-square or non-parametric analysis. The Kaplan-Meier method and Cox regression model determined the analysis of renal scar formation. Univariate and multiple regression analysis revealed that the total amount of ESWL emission and hyperuricemia independently affected the probability of renal scar formation. Over-emission of ESWL (over 10,000 shots) must be care for the prevention of renal scarring in patients with renal calyceal calculi, especially when associated with hyperuricemia. After ESWL, periodical checkups with ultrasonography will provide useful information for the clinical diagnosis of renal scarring.

  3. Incidence of stunned, hibernating and scarred myocardium in ischaemic cardiomyopathy

    International Nuclear Information System (INIS)

    Hernandez-Pampaloni, Miguel; Morita, Koichi; Dutka, David P.; Camici, Paolo G.; Bax, Jeroen J.

    2005-01-01

    Different criteria to identify residual viability in chronically dysfunctioning myocardium in patients with coronary artery disease (CAD) can be derived by the combined assessment of myocardial blood flow (MBF) and glucose utilisation (MRG) using positron emission tomography (PET). The aim of this study was to evaluate, in a large number of patients, the prevalence of these different patterns by purely quantitative means. One hundred and sixteen consecutive patients with ischaemic cardiomyopathy (LVEF ≤40%) underwent resting 2D echocardiography to assess regional contractile function (16-segment model). PET with 15 O-labelled water (H 2 15 O) and 18 F-fluorodeoxyglucose (FDG) was used to quantify MBF and MRG during hyperinsulinaemic euglycaemic clamp. Dysfunctional segments with normal MBF (≥0.6 ml min -1 g -1 ) were classified as stunned, and segments with reduced MBF ( -1 g -1 ) as hibernating if MRG was ≥0.25 μmol min -1 g -1 . Segments with reduced MBF and MRG -1 g -1 were classified as transmural scars and segments with reduced MBF and MRG between 0.20 and 0.25 μmol min -1 g -1 as non-transmural scars. Eight hundred and thirty-four (46%) segments were dysfunctional. Of these, 601 (72%) were chronically stunned, with 368 (61%) having normal MRG (0.47±0.20 μmol min -1 g -1 ) and 233 (39%) reduced MRG (0.16±0.05 μmol min -1 g -1 ). Seventy-four (9%) segments with reduced MBF had preserved MRG (0.40±0.18 μmol min -1 g -1 ) and were classified as hibernating myocardium. In addition, 15% of segments were classified as transmural and 4% as non-transmural scar. The mean MBF was highest in stunned myocardium (0.95±0.32 ml min -1 g -1 ), intermediate in hibernating myocardium and non-transmural scars (0.47±0.09 ml min -1 g -1 and 0.48±0.08 ml min -1 g -1 , respectively), and lowest in transmural scars (0.40±0.14 ml min -1 g -1 , P -1 g -1 vs 0.46±0.20 μmol min -1 g -1 , NS), and lowest in stunned myocardium with reduced MRG and transmural scars

  4. Medical makeup for concealing facial scars.

    Science.gov (United States)

    Mee, Donna; Wong, Brian J F

    2012-10-01

    Surgical, laser, and pharmacological therapies are all used to correct scars and surgical incisions, though have limits with respect to how well facial skin can be restored or enhanced. The use of cosmetics has long been a relevant adjunct to all scar treatment modalities. In recent years, technical advancements in the chemistry and composition of cosmetic products have provided the patient with a broader range of products to employ for concealing scars. This review will provide an overview of contemporary methods for concealing facial scars, birthmarks, and pigmentary changes without the use of traditional/dated, heavy appearing camouflage products. Additionally, general guidelines and information will be provided with respect to identifying competent makeup artists for care of the medical patient. The article by no means is meant to be a tutorial, but rather serves as a starting point in this allied field of medicine. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  5. Relationship Between Scarring and Dog Aggression in Pit Bull-Type Dogs Involved in Organized Dogfighting

    Science.gov (United States)

    Miller, Katherine A.; Touroo, Rachel; Spain, C. Victor; Jones, Kelly; Reid, Pamela; Lockwood, Randall

    2016-01-01

    Simple Summary Organizations responsible for placing dogs seized from dogfighting investigations often must determine if a particular dog should be euthanized because it is too dangerous or if it is safe to place the dog in an adoptive home. In this study, we examine whether the extent of scarring from dog fighting is a reliable predictor of aggression towards other dogs and therefore could be used to help make that decision. We found that dogs with 10 or more scars in the three body zones where dogfighting injuries tend to be concentrated were more likely, on average, to show aggression to other dogs. The relationship is imperfect, however. Many unscarred dogs were dog aggressive while some highly scarred dogs were not. Therefore, we recommend also assessing a dog’s behavior before making decisions about its disposition. Abstract When pit bull-type dogs are seized in an investigation of organized dogfighting, heavily scarred dogs are often assumed to be highly dog aggressive due to a history of fighting. These dogs may be deemed dangerous and euthanized based on scarring alone. We analyzed our existing data on dogs seized from four dogfighting investigations, examining the relationship between the dogs’ scars with aggression towards other dogs. Scar and wound data were tallied in three body zones where dogfighting injuries tend to be concentrated. Dog aggression was assessed using a model dog and a friendly stimulus dog in a standardized behavior evaluation. Scarring and dog aggression were significantly related, more strongly among male (Fisher’s Exact p < 0.001) than female dogs (Fisher’s Exact p = 0.05). Ten or more scars in the three body zones was a reasonable threshold with which to classify a dog as high risk for dog aggression: 82% of males and 60% of females with such scarring displayed dog aggression. However, because many unscarred dogs were dog aggressive while some highly scarred dogs were not, we recommend collecting behavioral information to

  6. Reconstructive Surgery of Extensive Face and Neck Burn Scars Using Tissue Expanders

    OpenAIRE

    Ashab Yamin, Mohammad Reza; Mozafari, Naser; Mozafari, Mohadase; Razi, Zahra

    2015-01-01

    BACKGROUND Neck reconstruction is considered as one of the most important surgeries in cosmetic and reconstructive surgery.?The present study aimed to assess the results of reconstructive surgery of extensive face and neck burning scars using tissue expanders. METHODS This descriptive prospective study was conducted on 36 patients with extensive burning scars on the neck and face. Operation for tissue expander insertion was performed and tissue distension started two or three weeks later, dep...

  7. [Development of the Heterosexual Love Assessment Scale for Alcoholics].

    Science.gov (United States)

    Sugawarai, Tazuko; Morita, Noriaki; Nakatani, Youji

    2013-10-01

    The purpose of this study was to develop a scale for assessing the attributes of the heterosexual love of alcoholics. Using the characteristics and categories related to the heterosexual love of alcoholics found in previous research, we created a "Heterosexual Love Assessment Scale for Alcoholics" and conducted a survey among 110 alcoholics (80 men and 30 women). The following three factors were extracted from the results: "mutual respect", "superficial intimacy", and "fear of being disliked", A high level of reliability was obtained on the scales indicated below (alpha = 63-82), and concurrent validity was confirmed between these and the Adult Attachment Scale (ECR: Experiences in Close Relationships inventory). Further, correlations were found between "mutual respect" and the benefit of heterosexual love in recovery, and between the other two factors and the impediment of heterosexual love, and between the Denial & Awareness Scale (for alcoholic). As this scale can be used to assess the type of heterosexual love of alcoholics, we predict that it will be useful in examining the effects of heterosexual love on recovery and as a tool for offering advice.

  8. Assessing the Psychometric Properties of Two Food Addiction Scales

    Science.gov (United States)

    Lemeshow, Adina; Gearhardt, Ashley; Genkinger, Jeanine; Corbin, William R.

    2016-01-01

    Background While food addiction is well accepted in popular culture and mainstream media, its scientific validity as an addictive behavior is still under investigation. This study evaluated the reliability and validity of the Yale Food Addiction Scale and Modified Yale Food Addiction Scale using data from two community-based convenience samples. Methods We assessed the internal and test-retest reliability of the Yale Food Addiction Scale and Modified Yale Food Addiction Scale, and estimated the sensitivity and negative predictive value of the Modified Yale Food Addiction Scale using the Yale Food Addiction Scale as the benchmark. We calculated Cronbach’s alphas and 95% confidence intervals (CIs) for internal reliability and Cohen’s Kappa coefficients and 95% CIs for test-retest reliability. Results Internal consistency (n=232) was marginal to good, ranging from α=0.63 to 0.84. The test-retest reliability (n=45) for food addiction diagnosis was substantial, with Kappa=0.73 (95% CI, 0.48–0.88) (Yale Food Addiction Scale) and 0.79 (95% CI, 0.66–1.00) (Modified Yale Food Addiction Scale). Sensitivity and negative predictive value for classifying food addiction status were excellent: compared to the Yale Food Addiction Scale, the Modified Yale Food Addiction Scale’s sensitivity was 92.3% (95% CI, 64%–99.8%), and the negative predictive value was 99.5% (95% CI, 97.5%–100%). Conclusions Our analyses suggest that the Modified Yale Food Addiction Scale may be an appropriate substitute for the Yale Food Addiction Scale when a brief measure is needed, and support the continued use of both scales to investigate food addiction. PMID:27623221

  9. [How to optimize scarring in dermatologic surgery?

    Science.gov (United States)

    Amici, J M; Chaussade, V

    2016-12-01

    Scarring is the response elicited by the skin surface to injury and loss of tissue material. Wound healing takes place through a complex natural repair system consisting of vascular, inflammatory and proliferative phenomena, followed by a remodelling and cell apoptosis phase. This incredible repair system is inevitable, but sometimes unpredictable due to individual differences based on multiple factors. The scar is the objective criterion of a skin surgery, both for the patient and the dermsurgeon. It is therefore crucial to establish with the patient during the preoperative consultation, the size and positioning of the expected scar, taking into account the oncologic, anatomic and surgical constraints. Scars can ideally blend into normal skin, but may also give rise to various abnormalities. We can manage and prevent these abnormalities by mastering initial inflammation, that may induce hyperpigmentation and hypertrophy. Early massage using cortocosteroid topic or anti-inflammatory moisturizers may be effective. Random individual scarring may be minimized by a dynamic personalized accompanying scarring. © 2016 Elsevier Masson SAS. Tous droits réservés.

  10. Overview of surgical scar prevention and management.

    Science.gov (United States)

    Son, Daegu; Harijan, Aram

    2014-06-01

    Management of incisional scar is intimately connected to stages of wound healing. The management of an elective surgery patient begins with a thorough informed consent process in which the patient is made aware of personal and clinical circumstances that cannot be modified, such as age, ethnicity, and previous history of hypertrophic scars. In scar prevention, the single most important modifiable factor is wound tension during the proliferative and remodeling phases, and this is determined by the choice of incision design. Traditional incisions most often follow relaxed skin tension lines, but no such lines exist in high surface tension areas. If such incisions are unavoidable, the patient must be informed of this ahead of time. The management of a surgical incision does not end when the sutures are removed. Surgical scar care should be continued for one year. Patient participation is paramount in obtaining the optimal outcome. Postoperative visits should screen for signs of scar hypertrophy and has a dual purpose of continued patient education and reinforcement of proper care. Early intervention is a key to control hyperplastic response. Hypertrophic scars that do not improve by 6 months are keloids and should be managed aggressively with intralesional steroid injections and alternate modalities.

  11. Scar modification. Techniques for revision and camouflage.

    Science.gov (United States)

    Horswell, B B

    1998-09-01

    The surgery and management of scars is a protracted and staged process that includes preparation of the skin through hygienic measures, scar softening (if indicated) with steroids, massage and pressure dressings, skilled execution of the surgical plan, and thorough postoperative wound care. This process generally covers a 1-year period for the various stages mentioned. Many general host and local skin factors will directly affect the final revision result. The two most important indirect factors that the surgeon must endeavor to control are optimal patient preparation and cutaneous health, and patient compliance with, and an ability to carry out, those wound care measures that the surgeon prescribes. Keloid and burn contracture scars represent two entities that are complicated and challenging to treat owing to their abnormal morphophysiologic features. Management of these scars is prolonged, and the patient must understand that the ultimate result will usually be a compromise. New grafting techniques, such as cultured autodermal grafts, offer improved initial management of burn wounds that may subsequently optimize scar revision in these patients. Keloids, and to a lesser extent hypertrophic scars, require steroid injections, pressure treatment, careful surgery, and protracted wound support and pressure treatment (exceeding 6 months) after surgery.

  12. Basin-Scale Opportunity Assessment Initiative Background Literature Review

    Energy Technology Data Exchange (ETDEWEB)

    Saulsbury, Bo [ORNL; Geerlofs, Simon H. [Pacific Northwest National Laboratory (PNNL); Cada, Glenn F [ORNL; Bevelhimer, Mark S [ORNL

    2010-10-01

    As called for in the March 24, 2010, Memorandum of Understanding (MOU) for Hydropower, the U.S. Department of Energy (DOE), the U.S. Department of the Interior (DOI), the U.S. Army Corps of Engineers (USACE), environmental stakeholders, and the hydropower industry are collaborating to identify opportunities to simultaneously increase electricity generation and improve environmental services in river basins of the United States. New analytical tools provide an improved ability to understand, model, and visualize environmental and hydropower systems. Efficiencies and opportunities that might not be apparent in site-by-site analyses can be revealed through assessments at the river-basin scale. Information from basin-scale assessments could lead to better coordination of existing hydropower projects, or to inform siting decisions (e.g., balancing the removal of some dams with the construction of others), in order to meet renewable energy production and environmental goals. Basin-scale opportunity assessments would inform energy and environmental planning and address the cumulative effects of hydropower development and operations on river basin environmental quality in a way that quantifies energy-environment tradeoffs. Opportunity assessments would create information products, develop scenarios, and identify specific actions that agencies, developers, and stakeholders can take to locate new sustainable hydropower projects, increase the efficiency and environmental performance of existing projects, and restore and protect environmental quality in our nation's river basins. Government agencies and non-governmental organizations (NGO) have done significant work to understand and assess opportunities for both hydropower and environmental protection at the basin scale. Some initiatives have been successful, others less so, and there is a need to better understand the legacy of work on which this current project can build. This background literature review is intended

  13. Clinical efficacy of utilizing Ultrapulse CO2 combined with fractional CO2 laser for the treatment of hypertrophic scars in Asians-A prospective clinical evaluation.

    Science.gov (United States)

    Lei, Ying; Li, Shi Feng; Yu, Yi Ling; Tan, Jun; Gold, Michael H

    2017-06-01

    Hypertrophic scarring is seen regularly. Tissue penetration of laser energy into hypertrophic scars using computer defaults from some lasers may be insufficient and penetration not enough. We have developed a treatment with an interrupted laser "drilling" by the Ultrapulse CO 2 (Manual Fractional Technology, MFT) and, a second pass, with fractional CO 2 . The MFT with fractional CO 2 lasers to treat hypertrophic scars is evaluated. A total of 158 patients with hypertrophic scars had three sessions of MFT with fractional CO 2 laser at 3-month intervals. Evaluations made before and 6 months after the 3rd treatment: (1) the Vancouver Scar Scale (VSS), (2) the University of North Carolina (UNC) Scar Scale, and (3) a survey of patient satisfaction. All data were analyzed using a t-test before and after treatment. The VSS score decreased from 9.35 to 3.12 (Plaser drilling by MFT and a fractional CO2 laser had profound effects on the hypertrophic scars treated. It works by increasing the penetration depth of the CO 2 laser in the scar tissue, exerting more precise effects on the hypertrophic scars. MFT combined with fractional CO 2 laser has the potential to be a major advance in the treatment of hypertrophic scars. © 2017 Wiley Periodicals, Inc.

  14. [Early hypertrophic scar after surgery on the nasal region: value of long-acting corticosteroid injections].

    Science.gov (United States)

    Amici, J-M

    2014-01-01

    "Pincushioning" is a complication of post-surgical scarring following use of transposition flaps particularly when surgery is performed on the nasal region. The transposition flap technique is very useful for the repair of certain defects of the tip of the nose, the medial canthus or of the ala nasi. The aim of this study is to define the clinical characteristics of this scarring dystrophy, which we propose to call "early hypertrophy scarring", to clarify the nature thereof and to assess the efficacy of intralesional injection of corticosteroids at the first signs of hypertrophy. A prospective, open, non-comparative, single-centre study examined the clinical and histological characteristics of early hypertrophy scarring and the effectiveness of therapy with one or two injections of corticosteroids performed on the 15th day post-operatively and optionally repeated at D45 depending on the outcome. From January 2011 to January 2013, 12 consecutive patients with early hypertrophy scarring were included (ten men and two women - mean age: 64 years). All had undergone surgery for basal cell carcinoma under local anaesthesia with one-stage repair by means of a rhombic flap or a bilobed flap located in the nasal area. Scars were injected strictly intra-lesionally with triamcinolone acetate (40 mg/1 mL) until whitening occurred. A single injection was performed in three cases of rhombic flap while a second injection was given at D45 in the remaining nine cases. Complete regression of the early hypertrophy scarring was obtained in ten of the 12 patients by D90. Incomplete regression was observed but with a marked improvement in the other two patients. Early hypertrophy scarring is distinguished by its clinical characteristics of hypertrophic or keloid scars. Biopsy performed in two cases showed the fibrous but non-fatty nature of early hypertrophy scarring. Biomechanical factors particular to the nasal region and the transposition flap technique could account for the early

  15. Development of a Scale To Assess Emotional Disturbance.

    Science.gov (United States)

    Epstein, Michael H.; Cullinan, Douglas; Ryser, Gail; Pearson, Nils

    2002-01-01

    This study reports on the standardization of the Scale for Assessing Emotional Disturbance. Data collected on 2,266 typical students (ages 5- 18) and 1,371 students with emotional disturbances led to the identification of six behavioral problem factors that correspond to the federal definition of emotional disturbance and were highly internally…

  16. A generic scale for assessment of attitudes towards social robots

    DEFF Research Database (Denmark)

    Damholdt, Malene Flensborg; Olesen, Martin Hammershøj; Nørskov, Marco

    2016-01-01

    The research field into social robotics is expanding and with it the need for consistent methods for assessing attitudinal stance towards social robots. In this paper we describe the development and planned validation of the Attitudes towards social robots scale (ASOR-5): a generic questionnaire ...

  17. Development and external validation of a new PTA assessment scale

    NARCIS (Netherlands)

    Jacobs, B.; van Ekert, J.; Vernooy, L.P.; Dieperink, P.; Andriessen, T.M.J.C.; Hendriks, M.P.; van Vugt, A.B.; Emons, M.A.; Borm, G.F.; Vos, P.E.

    2012-01-01

    BACKGROUND: Post-traumatic amnesia (PTA) is a key symptom of traumatic brain injury (TBI). Accurate assessment of PTA is imperative in guiding clinical decision making. Our aim was to develop and externally validate a short, examiner independent and practical PTA scale, by selecting the most

  18. ASSESSMENT OF TORNADOS WITH THE ENHANCED FUJITA SCALE IN ROMANIA

    Directory of Open Access Journals (Sweden)

    C. NUCUŢĂ

    2011-03-01

    Full Text Available Assessment of tornadoes with the Enhanced Fujita Scale in Romania. An analysis of the damage caused by a tornado, in order to determine the maximum wind speed that was reached, is important both in terms of documenting the phenomenon and to make improvements to the evaluation method which is used, especially if this method is not specific for the analyzed territory. An overview of the way the tornado from Silivaşu de Câmpie, on the 26th of May 2010, was termed EF2 is done to summarize the difficulties that arise in the assessment of tornadoes occurring in Romania with the Enhanced Fujita scale. The lack of correlation between damage indicators, different construction styles and building materials between those in the United States and those selected in this case study are the main issues addressed. Solutions for these issues are discussed as a starting point for the adjustment of Enhanced Fujita scale for Romania.

  19. Treatment of Mesh Skin Grafted Scars Using a Plasma Skin Regeneration System

    Directory of Open Access Journals (Sweden)

    Takamitsu Higashimori

    2010-01-01

    Full Text Available Objectives. Several modalities have been advocated to treat traumatic scars, including surgical techniques and laser resurfacing. Recently, a plasma skin regeneration (PSR system has been investigated. There are no reports on plasma treatment of mesh skin grafted scars. The objective of our study is to evaluate the effectiveness and complications of plasma treatment of mesh skin grafted scars in Asian patients. Materials and Methods. Four Asian patients with mesh skin grafted scars were enrolled in the study. The plasma treatments were performed at monthly intervals with PSR, using energy settings of 3 to 4 J. Improvement was determined by patient questionnaires and physician evaluation of digital photographs taken prior to treatment and at 3 months post treatment. The patients were also evaluated for any side effects from the treatment. Results. All patients showed more than 50% improvement. The average pain score on a 10-point scale was 6.9 +/− 1.2 SD and all patients tolerated the treatments. Temporary, localized hypopigmentation was observed in two patients. Hyperpigmentation and worsening of scarring were not observed. Conclusions. Plasma treatment is clinically effective and is associated with minimal complications when used to treat mesh skin grafted scars in Asian patients.

  20. Vertical scar versus the inverted-T scar reduction mammaplasty : A 10-year follow-up

    NARCIS (Netherlands)

    Bouwer, Lesley R.; van der Biezen, Jan Jaap; Spronk, Cees A.; van der Lei, Berend

    2012-01-01

    A retrospective study was undertaken to evaluate whether the initial outcome of two types of reduction mammaplasty techniques (vertical scar reduction mammaplasty vs. the inverted-T scar reduction mammaplasty) remains stable in the long term: Sixty-nine patients who had undergone breast reduction

  1. Refining a self-assessment of informatics competency scale using Mokken scaling analysis.

    Science.gov (United States)

    Yoon, Sunmoo; Shaffer, Jonathan A; Bakken, Suzanne

    2015-01-01

    Healthcare environments are increasingly implementing health information technology (HIT) and those from various professions must be competent to use HIT in meaningful ways. In addition, HIT has been shown to enable interprofessional approaches to health care. The purpose of this article is to describe the refinement of the Self-Assessment of Nursing Informatics Competencies Scale (SANICS) using analytic techniques based upon item response theory (IRT) and discuss its relevance to interprofessional education and practice. In a sample of 604 nursing students, the 93-item version of SANICS was examined using non-parametric IRT. The iterative modeling procedure included 31 steps comprising: (1) assessing scalability, (2) assessing monotonicity, (3) assessing invariant item ordering, and (4) expert input. SANICS was reduced to an 18-item hierarchical scale with excellent reliability. Fundamental skills for team functioning and shared decision making among team members (e.g. "using monitoring systems appropriately," "describing general systems to support clinical care") had the highest level of difficulty, and "demonstrating basic technology skills" had the lowest difficulty level. Most items reflect informatics competencies relevant to all health professionals. Further, the approaches can be applied to construct a new hierarchical scale or refine an existing scale related to informatics attitudes or competencies for various health professions.

  2. Personality Assessment Inventory scale characteristics and factor structure in the assessment of alcohol dependency.

    Science.gov (United States)

    Schinka, J A

    1995-02-01

    Individual scale characteristics and the inventory structure of the Personality Assessment Inventory (PAI; Morey, 1991) were examined by conducting internal consistency and factor analyses of item and scale score data from a large group (N = 301) of alcohol-dependent patients. Alpha coefficients, mean inter-item correlations, and corrected item-total scale correlations for the sample paralleled values reported by Morey for a large clinical sample. Minor differences in the scale factor structure of the inventory from Morey's clinical sample were found. Overall, the findings support the use of the PAI in the assessment of personality and psychopathology of alcohol-dependent patients.

  3. The Subunit Principle in Scar Face Revision.

    Science.gov (United States)

    Elshahat, Ahmed; Lashin, Riham

    2017-06-01

    Facial scaring is considered one of the most difficult cosmetic problems for any plastic surgeon to solve. The condition is more difficult if the direction of the scar is not parallel to relaxed skin tension lines. Attempts to manage this difficult situation included revisions using geometric designs, Z plasties or W plasties to camouflage the straight line visible scaring. The use of long-lasting resorbable sutures was tried too. Recently, the use of botulinum toxin during revision improved the results. Fractional CO2 lasers, microfat grafts, and platelet-rich plasma were added to the armamentarium. The scar is least visible if placed in the junction between the facial subunits. The aim of this study is to investigate the use of the subunit principle to improve the results of scar revision. Four patients were included in this study. Tissue expansion of the intact part of the subunit allowed shifting the scar to the junction between the affected subunit and the adjacent one. Tissue expansion, delivery of the expanders, and advancement of the flaps were successful in all patients. The fact that this is a 2-stage procedure and sacrifices some of the intact skin from the affected facial subunit, makes this technique reserved to patients with ugly facial scars who are ambitious to improve their appearance.

  4. In search of scar seeking radiopharmaceuticals

    Energy Technology Data Exchange (ETDEWEB)

    Salehi, N.; Lawlor, J.M.; Lichtenstein, M.; Allaway, M.; Barencevic, A. [Royal Melbourne Hospital, Melbourne, VIC (Australia). Department of Nuclear Medicine]|[University of Melbourne, VIC (Australia)

    1998-03-01

    Full text: Sensitive detection of acute peri-osseous scar tissue should be valuable for detection of partial ligamentous, tears and other common rheumatological conditions including back pain and ligamentous scars. Our aim was to investigate acute scar uptake of {sup 99m}Tc(V)-DMSA (dimercapto-succinic-acid), {sup 99m}Tc-DMAD (di- methyl-aminodiphosphonate) compared to {sup 99m}Tc-MDP (methylen-diphosphonate), the standard bone-scanning radiopharmaceutical. New Zealand white rabbits were anaesthetised and had 5-7cm of their mid-line abdominal wall surgically incised. At 24, 48, 72, 96 and 240 hours post surgery, 74 MBq (2 mCi) of the above radiopharmaceuticals were injected intravenously and scintigraphy performed 2.5 hours later. Relative count rate in scar is tabulated. In conclusion, the increased activity in the acute surgical site and lesser bone uptake confirmed that Tc (V)-DMSA and Tc-DMAD are superior to Tc- MDP for detection of new scar tissue in the region of bone. 1 tab.

  5. [Diagnostic test scale SI5: Assessment of sacroiliac joint dysfunction].

    Science.gov (United States)

    Acevedo González, Juan C; Quintero Oliveros, Silvia

    2015-01-01

    Sacroiliac joint dysfunction is a known cause of low back pain. We think that a diagnostic score scale (SI5) may be performed to assess diagnostic utility of clinical signs of sacroiliac joint dysfunction. The primary aim of the present study was to conduct the pilot study of our new diagnostic score scale, the SI5, for sacroiliac joint syndrome. We reviewed the literature on clinical characteristics, diagnostic tests and imaging most commonly used in diagnosing sacroiliac joint dysfunction. Our group evaluated the diagnostic utility of these aspects and we used those considered most representative to develop the SI5 diagnostic scale. The SI5 scale was applied to 22 patients with low back pain; afterwards, the standard test for diagnosing this pathology (selective blockage of the SI joint) was also performed on these patients. The sensitivity and specificity for each sign were also assessed and the diagnostic scale called SI5 was then proposed, based on these data. The most sensitive clinical tests for diagnosing SI joint dysfunction were 2 patient-reported clinical characteristics, the Laguerre Test, sacroiliac rocking test and Yeomans test (greater than 80% sensitivity). The tests with greatest diagnostic specificity (>80%) were the Lewitt test, Piedallu test and Gillet test. The proposed SI5 test score scale showed sensitivity of 73% and specificity of 71%. Sacroiliac joint syndrome has been shown to produce low back pain frequently; however, the diagnostic value of examination tests for sacroiliac joint pain has been questioned by other authors. The pilot study on the SI5 diagnostic score scale showed good sensitivity and specificity. However, the process of statistical validation of the SI5 needs to be continued. Copyright © 2014 Sociedad Española de Neurocirugía. Published by Elsevier España. All rights reserved.

  6. Assessment scale of risk for surgical positioning injuries.

    Science.gov (United States)

    Lopes, Camila Mendonça de Moraes; Haas, Vanderlei José; Dantas, Rosana Aparecida Spadoti; Oliveira, Cheila Gonçalves de; Galvão, Cristina Maria

    2016-08-29

    to build and validate a scale to assess the risk of surgical positioning injuries in adult patients. methodological research, conducted in two phases: construction and face and content validation of the scale and field research, involving 115 patients. the Risk Assessment Scale for the Development of Injuries due to Surgical Positioning contains seven items, each of which presents five subitems. The scale score ranges between seven and 35 points in which, the higher the score, the higher the patient's risk. The Content Validity Index of the scale corresponded to 0.88. The application of Student's t-test for equality of means revealed the concurrent criterion validity between the scores on the Braden scale and the constructed scale. To assess the predictive criterion validity, the association was tested between the presence of pain deriving from surgical positioning and the development of pressure ulcer, using the score on the Risk Assessment Scale for the Development of Injuries due to Surgical Positioning (pposicionamiento quirúrgico en pacientes adultos. investigación metodológica, conducida en dos etapas: construcción y validación de faz y de contenido de la escala e investigación de campo, con la participación de 115 pacientes. la Escala de Evaluación de Riesgo para el Desarrollo de Lesiones Debidas al Posicionamiento Quirúrgico contiene siete ítems, siendo que cada uno presenta cinco subítems. La puntuación de esa escala varia de siete a 35 puntos en que, cuanto mayor la puntuación, mayor el riesgo del paciente. El Índice de Validez de Contenido de la escala fue 0,88. Mediante la aplicación de la prueba t de Student, para igualdad de medias, fue constatada validez de criterio concurrente entre los scores de la escala de Braden y de la escala construida. Para evaluar la validez de criterio predictiva, fue testada la asociación de la presencia de dolor debido al posicionamiento quirúrgico y el desarrollo de úlcera por presión con el score de

  7. The association between Bacillus Calmette-Guérin vaccination (1331 SSI) skin reaction and subsequent scar development in infants

    DEFF Research Database (Denmark)

    Birk, Nina Marie; Nissen, Thomas Nørrelykke; Ladekarl, Monica

    2017-01-01

    BACKGROUND: The Bacillus Calmette-Guérin vaccine (BCG) against tuberculosis is administered intradermally, and vaccination is often followed by a scar at the injection site. Among BCG-vaccinated individuals, having a scar has been associated with lower mortality. We aimed to examine the impact...... of vaccination technique for scarring in a high income setting, by assessing the associations between the post injection reaction, the wheal size, and the probability of developing a scar, and scar size. METHODS: This study was nested within a clinical multicenter study randomizing 4262 infants to either BCG...... vaccination (BCG 1331 SSI) or no intervention. In this substudy, including 492 vaccinated infants, the immediate post BCG vaccination reaction was registered as either wheal (a raised, blanched papule at the injection site), bulge (a palpable element at the injection site), or no reaction. The presence...

  8. Twelve tips for assessing surgical performance and use of technical assessment scales

    DEFF Research Database (Denmark)

    Strandbygaard, Jeanett; Scheele, Fedde; Sørensen, Jette Led

    2017-01-01

    Using validated assessment scales for technical competence can help structure and standardize assessment and feedback for both the trainee and the supervisor and thereby avoid bias and drive learning. Correct assessment of operative skills can establish learning curves and allow adequate monitoring....... However, the assessment of surgical performance is not an easy task, since it includes many proxy parameters, which are hard to measure. Although numerous technical assessment scales exist, both within laparoscopic and open surgery, the validity evidence is often sparse, and this can raise doubts about...... reliability and educational outcome. Furthermore, the implementation of technical assessment scales varies due to several obstacles and doubts about accurate use. In this 12-tips article, we aim to give the readers a critical and useful appraisal of some of the common questions and misunderstandings regarding...

  9. Risk factors for renal scarring in children with primary vesicoureteral reflux disease

    Directory of Open Access Journals (Sweden)

    Sevgi Mir

    2013-01-01

    Full Text Available To determine the incidence of renal scarring among patients with primary vesicoureteral reflux (VUR and the possible risk factor(s, we studied 90 children (60 girls and 30 boys with VUR followed in the Pediatric Nephrology Unit at the Ege University Hospital from 1998 to 2003. All the patients were assessed for VUR grade by voiding cystoureterography and for presence of renal scarring by (99 m technetium dimercapto-succinic acid scintigraphy. All infants with VUR were given low-dose prophylactic antibiotics and followed-up until resolution of the reflux. Grade of reflux and number of urinary tract infection (UTI episodes (≥3 were found to be statistically significant risk factors for renal scarring (P 0.05. Similarly, there was no statistically significant difference of frequency of renal scarring among the different age groups (P >0.05. We conclude that recurrences of UTI and VUR severity are significant risk factors for renal scarring in children with VUR. Therefore, identification of VUR at an early age may offer the opportunity to prevent episodes of UTI and possible formation of renal scars that may result in end-stage renal failure.

  10. Fraxelated radiofrequency device for acne scars

    Science.gov (United States)

    Rao, Babar K.; Khokher, Sairah

    2012-09-01

    Acne scars can be improved with various treatments such as topical creams, chemical peels, dermal fillers, microdermabrasion, laser, and radiofrequency devices. Some of these treatments especially lasers and deep chemical peels can have significant side effects such as post inflammatory hyperpigmentation in darker skin types. Fraxelated RF Laser devices have been reported to have lower incidence of side effects in all skin phototypes. Nine patients between ages 18 and 35 of various skin phototypes were selected from a private practice and treated with a RF fraxelated device (E-matrix) for acne scars. Outcomes were measured by physician observation, subjective feedback received by patients, and comparison of before and after photographs. In this small group of patients with various skin phototypes, fraxelated radiofrequency device improved acne scars with minimal side effects and downtime.

  11. Confirmatory Factor Analysis of the Procrastination Assessment Scale for Students

    Directory of Open Access Journals (Sweden)

    Ronald D. Yockey

    2015-10-01

    Full Text Available The relative fit of one- and two-factor models of the Procrastination Assessment Scale for Students (PASS was investigated using confirmatory factor analysis on an ethnically diverse sample of 345 participants. The results indicated that although the two-factor model provided better fit to the data than the one-factor model, neither model provided optimal fit. However, a two-factor model which accounted for common item theme pairs used by Solomon and Rothblum in the creation of the scale provided good fit to the data. In addition, a significant difference by ethnicity was also found on the fear of failure subscale of the PASS, with Whites having significantly lower scores than Asian Americans or Latino/as. Implications of the results are discussed and recommendations made for future work with the scale.

  12. The impact of post-acne scars on the quality of life among young adults in Singapore

    Directory of Open Access Journals (Sweden)

    Sai Yee Chuah

    2015-01-01

    Full Text Available Background and Objectives: Post-acne scarring is a common and well-known sequelae of acne vulgaris. We aim to study the impact of post-acne scarring on the quality of life (QOL among young adults in Singapore. Settings and Design: This was a non-interventional prospective study. Materials and Methods: Patients aged 21-40 years with atrophic and hypertrophic acne scars who attended the National Skin Centre, Singapore were recruited in the study. They answered a simple questionnaire and the clinical severity of their acne scars were assessed by the doctor. Statistical Analysis Used: Descriptive analyses using absolute and percentage frequencies were performed on all data. The test of significance was two-sided and was set at 5% (P ≤ 0.05. Differential analyses were conducted using the parametric, independent two-sample t-test and non-parametric Mann-Whitney U-test. The statistical assessments were performed using SPSS version 18.0. Results: A total of 100 patients were studied. The mean patients′ subjective self-scoring on the severity of their post-acne scars was 5.78/10 and the mean Dermatology Life Quality Index (DLQI for post-acne scars was 5.61. Many (36%, n = 36 were self-conscious of their acne scars and 24%, (n = 24 felt that their acne scars was affecting their social activities. Conclusions: Our study showed that post-acne scars have a significant negative effect on the QOL of young adults. It highlights the need to increase public awareness of acne vulgaris and its sequelae through education programs and advocating early treatment to reduce the risk of scarring.

  13. An anatomical subunit-based outcome assessment scale for bilateral cleft lip and palate.

    Science.gov (United States)

    Bonanthaya, K; Shetty, P N; Fudalej, P S; Rao, D D; Bitra, S; Pabari, M; Rachwalski, M

    2017-08-01

    As there is currently no internationally accepted outcome measurement tool available for complete bilateral cleft lip and palate (CBCLP), the goal of this prospective study was to develop a numerical evaluation scale that allows reliable scoring of this cleft deformity. Our cohort comprised 121 Indian subjects with CBCLP who underwent surgical repair (mean age at time of surgery 6.53 months) using a modified Millard technique. A panel of three professionals evaluated each subject's outcome of bilateral cleft lip repair 6 months postoperatively on two-dimensional (2D) full-face photographs in the frontal view and worm's eye view. A simple two-point rating system was applied to separately analyse a total of 12 components of lip, nose, and scar. The results and mean scores for the analysed anatomical areas were 2.2±1.01 (max=3) for nose, 5.4±1.54 (max=8) for lip, and 1.9±1.3 (max=3) for scar, with a total score 7.7±2.21 (max=12) indicating a good surgical outcome. The inter-examiner ICC for nose, lip, scar, and total score was calculated at 0.836, 0.889, 0.723, and 0.927 respectively and indicated a strong level of repeatability and reliability that was highly significant (P<0.001). In conclusion, we were able to develop and test a scoring system for measuring outcomes in CBCLP that warrants simplicity of use, reliability and reproducibility. Copyright © 2017 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  14. Development of an ecological momentary assessment scale for appetite

    OpenAIRE

    Kikuchi, Hiroe; Yoshiuchi, Kazuhiro; Inada, Shuji; Ando, Tetsuya; Yamamoto, Yoshiharu

    2015-01-01

    Background An understanding of eating behaviors is an important element of health education and treatment in clinical populations. To understand the biopsychosocial profile of eating behaviors in an ecologically valid way, ecological momentary assessment (EMA) is appropriate because its use is able to overcome the recall bias in patient-reported outcomes (PROs). As appetite is a key PRO associated with eating behaviors, this study was done to develop an EMA scale to evaluate the within-indivi...

  15. NASA: Assessments of Selected Large-Scale Projects

    Science.gov (United States)

    2011-03-01

    REPORT DATE MAR 2011 2. REPORT TYPE 3. DATES COVERED 00-00-2011 to 00-00-2011 4. TITLE AND SUBTITLE Assessments Of Selected Large-Scale Projects...Volatile EvolutioN MEP Mars Exploration Program MIB Mishap Investigation Board MMRTG Multi Mission Radioisotope Thermoelectric Generator MMS Magnetospheric...probes designed to explore the Martian surface, to satellites equipped with advanced sensors to study the earth , to telescopes intended to explore the

  16. Evolutionary leap in large-scale flood risk assessment needed

    OpenAIRE

    Vorogushyn, Sergiy; Bates, Paul D.; de Bruijn, Karin; Castellarin, Attilio; Kreibich, Heidi; Priest, Sally J.; Schröter, Kai; Bagli, Stefano; Blöschl, Günter; Domeneghetti, Alessio; Gouldby, Ben; Klijn, Frans; Lammersen, Rita; Neal, Jeffrey C.; Ridder, Nina

    2018-01-01

    Current approaches for assessing large-scale flood risks contravene the fundamental principles of the flood risk system functioning because they largely ignore basic interactions and feedbacks between atmosphere, catchments, river-floodplain systems and socio-economic processes. As a consequence, risk analyses are uncertain and might be biased. However, reliable risk estimates are required for prioritizing national investments in flood risk mitigation or for appraisal and management of insura...

  17. Developing and validating a psychometric scale for image quality assessment

    International Nuclear Information System (INIS)

    Mraity, H.; England, A.; Hogg, P.

    2014-01-01

    Purpose: Using AP pelvis as a catalyst, this paper explains how a psychometric scale for image quality assessment can be created using Bandura's theory for self-efficacy. Background: Establishing an accurate diagnosis is highly dependent upon the quality of the radiographic image. Image quality, as a construct (i.e. set of attributes that makes up the image quality), continues to play an essential role in the field of diagnostic radiography. The process of assessing image quality can be facilitated by using criteria, such as the European Commission (EC) guidelines for quality criteria as published in 1996. However, with the advent of new technology (Computed Radiography and Digital Radiography), some of the EC criteria may no longer be suitable for assessing the visual quality of a digital radiographic image. Moreover, a lack of validated visual image quality scales in the literature can also lead to significant variations in image quality evaluation. Creating and validating visual image quality scales, using a robust methodology, could reduce variability and improve the validity and reliability of perceptual image quality evaluations

  18. Autologous fat transplantation for depressed linear scleroderma-induced facial atrophic scars.

    Science.gov (United States)

    Roh, Mi Ryung; Jung, Jin Young; Chung, Kee Yang

    2008-12-01

    Facial linear scleroderma results in depressed atrophic scars. Autologous fat transplantation has been widely used, and fat appears to be an ideal material for filling depressed atrophic scars and contour deformities, but long-term results for autologous fat transplantation are controversial. To review the short- and long-term results of 20 patients who underwent multiple autologous fat transplantations for depressed atrophic scar correction. Twenty patients with clinically inactive facial linear scleroderma were included. They received at least two transplantations and had a 12-month follow-up evaluation. On the forehead, 51% to 75% improvement (average grading scale: 2.4) was achieved when observed at least 12 months after the last treatment. For the chin, correction was poor (average grading scale: 0.7) with less than 25% improvement. The infraorbital area showed fair correction, but the nose showed poor correction. Two of three patients with scalp reduction surgery showed excellent results, showing only slight scar widening. Autologous fat transplantation is an effective method for long-term correction of depressed atrophic scars left by linear scleroderma on the forehead but is less effective for corrections on the nose, infraorbital area, and chin.

  19. The Efficacy and Safety of Ablative Fractional Resurfacing Using a 2,940-Nm Er:YAG Laser for Traumatic Scars in the Early Posttraumatic Period

    Directory of Open Access Journals (Sweden)

    Sun Goo Kim

    2012-05-01

    Full Text Available BackgroundSkin injuries, such as lacerations due to trauma, are relatively common, and patients are very concerned about the resulting scars. Recently, the use of ablative and non-ablative lasers based on the fractional approach has been used to treat scars. In this study, the authors demonstrated the efficacy and safety of ablative fractional resurfacing (AFR for traumatic scars using a 2,940-nm erbium: yttrium-aluminum-garnet (Er:YAG laser for traumatic scars after primary repair during the early posttraumatic period.MethodsTwelve patients with fifteen scars were enrolled. All had a history of facial laceration and primary repair by suturing on the day of trauma. Laser therapy was initiated at least 4 weeks after the primary repair. Each patient was treated four times at 1-month intervals with a fractional ablative 2,940-nm Er:YAG laser using the same parameters. Post-treatment evaluations were performed 1 month after the fourth treatment session.ResultsAll 12 patients completed the study. After ablative fractional laser treatment, all treated portions of the scars showed improvements, as demonstrated by the Vancouver Scar Scale and the overall cosmetic scale as evaluated by 10 independent physicians, 10 independent non-physicians, and the patients themselves.ConclusionsThis study shows that ablative fractional Er:YAG laser treatment of scars reduces scars fairly according to both objective results and patient satisfaction rates. The authors suggest that early scar treatment using AFR can be one adjuvant scar management method for improving the quality of life of patients with traumatic scars.

  20. Combining the Suicide Intent Scale and the Karolinska Interpersonal Violence Scale in suicide risk assessments.

    Science.gov (United States)

    Stefansson, J; Nordström, P; Runeson, B; Åsberg, M; Jokinen, J

    2015-09-23

    High suicide intent, childhood trauma, and violent behavior are risk factors for suicide in suicide attempters. The aim of this study was to investigate whether the combined assessment of suicide intent and interpersonal violence would provide a better prediction of suicide risk than an assessment of only suicide intent or interpersonal violence. This is a cohort study involving 81 suicide attempters included in the study between 1993 and 1998. Patients were assessed with both the Suicide Intent Scale (SIS) and the Karolinska Interpersonal Violence Scale (KIVS). Through the unique personal identification number in Sweden, patients were linked to the Cause of Death Register maintained by the Swedish National Board of Health and Welfare. Suicides were ascertained from the death certificates. Seven of 14 patients who had died before April 2013 had committed suicide. The positive predictive value for the Suicide Intent Scale alone was 16.7 %, with a specificity of 52 % and an area under the curve of 0.74. A combined assessment with the KIVS gave higher specificity (63 %) and a positive predictive value of 18.8 % with an AUC of 0.83. Combined use of SIS and KIVS expressed interpersonal violence as an adult subscale gave a sensitivity of 83.3 %, a specificity of 80.3 %, and a positive predictive value of 26 % with an AUC of 0.85. The correlation between KIVS and SIS scores was not significant. Using both the the SIS and the KIVS combined may be better for predicting completed suicide than using them separately. The nonsignificant correlation between the scales indicates that they measure different components of suicide risk.

  1. The clinical outcome of cesarean scar pregnancies implanted "on the scar" versus "in the niche".

    Science.gov (United States)

    Kaelin Agten, Andrea; Cali, Giuseppe; Monteagudo, Ana; Oviedo, Johana; Ramos, Joanne; Timor-Tritsch, Ilan

    2017-05-01

    The term cesarean scar pregnancy refers to placental implantation within the scar of a previous cesarean delivery. The rising numbers of cesarean deliveries in the last decades have led to an increased incidence of cesarean scar pregnancy. Complications of cesarean scar pregnancy include morbidly adherent placenta, uterine rupture, severe hemorrhage, and preterm labor. It is suspected that cesarean scar pregnancies that are implanted within a dehiscent scar ("niche") behave differently compared with those implanted on top of a well-healed scar. To date there are no studies that have compared pregnancy outcomes between cesarean scar pregnancies implanted either "on the scar" or "in the niche." The purpose of this study was to determine the pregnancy outcome of cesarean scar pregnancy implanted either "on the scar" or "in the niche." This was a retrospective 2-center study of 17 patients with cesarean scar pregnancy that was diagnosed from 5-9 weeks gestation (median, 8 weeks). All cesarean scar pregnancies were categorized as either implanted or "on the scar" (group A) or "in the niche" (group B), based on their first-trimester transvaginal ultrasound examination. Clinical outcomes based on gestational age at delivery, mode of delivery, blood loss at delivery, neonate weight and placental histopathologic condition were compared between the groups with the use of the Mann-Whitney U test. Myometrial thickness overlying the placenta was compared among all the patients who required hysterectomy and those who did not with the use of the Mann-Whitney U test. Myometrial thickness was also correlated with gestational age at delivery with the use of Spearman's correlation. Group A consisted of 6 patients; group B consisted of 11 patients. Gestational age at delivery was lower in group B (median, 34 weeks; range, 20-36 weeks) than in group A (median, 38 weeks; range, 37-39 weeks; P=.001). In group A, 5 patients were delivered via cesarean delivery (with normal placenta), and

  2. The Spanish version of the fatique assessment scale : Reliability and validity assessment in postpartum women

    NARCIS (Netherlands)

    Cano-Climent, A.; Oliver-Roig, A.; Cabrero-Garcia, J.; de Vries, J.; Richart-Martinez, M.

    2017-01-01

    Background Fatigue is the most widely reported symptom by women during pregnancy, labour, the postpartum period, and early parenting. The objective was to translate the Fatigue Assessment Scale (FAS) into Spanish and assess its psychometric properties. Methods Instrumental Design. The FAS was

  3. Scar Homogenization Versus Limited-Substrate Ablation in Patients With Nonischemic Cardiomyopathy and Ventricular Tachycardia.

    Science.gov (United States)

    Gökoğlan, Yalçın; Mohanty, Sanghamitra; Gianni, Carola; Santangeli, Pasquale; Trivedi, Chintan; Güneş, Mahmut F; Bai, Rong; Al-Ahmad, Amin; Gallinghouse, G Joseph; Horton, Rodney; Hranitzky, Patrick M; Sanchez, Javier E; Beheiry, Salwa; Hongo, Richard; Lakkireddy, Dhanunjaya; Reddy, Madhu; Schweikert, Robert A; Dello Russo, Antonio; Casella, Michela; Tondo, Claudio; Burkhardt, J David; Themistoclakis, Sakis; Di Biase, Luigi; Natale, Andrea

    2016-11-01

    Scar homogenization improves long-term ventricular arrhythmia-free survival compared with standard limited-substrate ablation in patients with post-infarction ventricular tachycardia (VT). Whether such benefit extends to patients with nonischemic cardiomyopathy and scar-related VT is unclear. The aim of this study was to assess the long-term efficacy of an endoepicardial scar homogenization approach compared with standard ablation in this population. Consecutive patients with dilated nonischemic cardiomyopathy (n = 93), scar-related VTs, and evidence of low-voltage regions on the basis of pre-defined criteria on electroanatomic mapping (i.e., bipolar voltage homogenization and standard ablation, respectively (p = 0.01). During a mean follow-up period of 14 ± 2 months, single-procedure success rates were 63.9% after scar homogenization and 38.6% after standard ablation (p = 0.031). After multivariate analysis, scar homogenization and left ventricular ejection fraction were predictors of long-term success. During follow-up, the rehospitalization rate was significantly lower in the scar homogenization group (p = 0.035). In patients with dilated nonischemic cardiomyopathy, scar-related VT, and evidence of low-voltage regions on electroanatomic mapping, endoepicardial homogenization of the scar significantly increased freedom from any recurrent ventricular arrhythmia compared with a standard limited-substrate ablation. However, the success rate with this approach appeared to be lower than previously reported with ischemic cardiomyopathy, presumably because of the septal and midmyocardial distribution of the scar in some patients. Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  4. "Scars" connect classical and quantum theory

    CERN Multimedia

    Monteiro, T

    1990-01-01

    Chaotic systems are unstable and extremely sensitive to initial condititions. So far, scientists have been unable to demonstrate that the same kind of behaviour exists in quantum or microscopic systems. New connections have been discovered though between classical and quantum theory. One is the phenomena of 'scars' which cut through the wave function of a particle (1 page).

  5. Recombinant human endostatin reduces hypertrophic scar ...

    African Journals Online (AJOL)

    Methods: Sixteen New Zealand white rabbits were used to establish HS models. Then, rabbit ears containing HS were randomly assigned to either the Endostar group or the control group. The changes of appearance and histology were evaluated using the naked eye, hematoxylin eosin staining, and a scar elevation index.

  6. 9 CFR 11.3 - Scar rule.

    Science.gov (United States)

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Scar rule. 11.3 Section 11.3 Animals and Animal Products ANIMAL AND PLANT HEALTH INSPECTION SERVICE, DEPARTMENT OF AGRICULTURE ANIMAL... inflammation, and, other bilateral evidence of abuse indicative of soring including, but not limited to...

  7. Assessing organizational climate: psychometric properties of the CLIOR Scale.

    Science.gov (United States)

    Peña-Suárez, Elsa; Muñiz, José; Campillo-Álvarez, Angela; Fonseca-Pedrero, Eduardo; García-Cueto, Eduardo

    2013-02-01

    Organizational climate is the set of perceptions shared by workers who occupy the same workplace. The main goal of this study is to develop a new organizational climate scale and to determine its psychometric properties. The sample consisted of 3,163 Health Service workers. A total of 88.7% of participants worked in hospitals, and 11.3% in primary care; 80% were women and 20% men, with a mean age of 51.9 years (SD= 6.28). The proposed scale consists of 50 Likert-type items, with an alpha coefficient of 0.97, and an essentially one-dimensional structure. The discrimination indexes of the items are greater than 0.40, and the items show no differential item functioning in relation to participants' sex. A short version of the scale was developed, made up of 15 items, with discrimination indexes higher than 0.40, an alpha coefficient of 0.94, and its structure was clearly one-dimensional. These results indicate that the new scale has adequate psychometric properties, allowing a reliable and valid assessment of organizational climate.

  8. MR imaging findings in cesarean scar pregnancy

    International Nuclear Information System (INIS)

    Zhang Xiangqun; Xu Yikai; Luo Xiaoqin

    2012-01-01

    Objective: To analyze MRI findings of cesarean scar pregnancy (CSP). Methods: The MR findings in 18 patients who were diagnosed as CSP by surgery from March 2010 to November 2011 were retrospectively analyzed, and comparison was made between the MRI findings and surgical results. Results: All Gestational sacs (18) were clearly detected by MRI. Among the 18 cases,gestational sac presented as cystic mass with smooth margin located within the scar of uterine wall at the lower anterior uterus in 16 cases. In 2 of the 16 cases, gestational sac was found within the myometrium, whereas in the remaining 14 cases, gestational sac was found partially within the myometrium with extension into the uterine cavity. The anterior wall of isthmus uteri became thinner. In the remaining 2 of the 18 cases, gestational sac presented as irregular, multilobolated mass, growing deep into the myometrium as well as into the uterine cavity. On T 2 WI, the mass showed heterogeneous signal intensity. A small amount of hemorrhage within the mass and uterine cavity could be seen on T 1 WI. An enhancing solid component with a heterogeneous mass could be seen. All gestational sacs in 18 cases were located at or adjacent to the previous cesarean scar. In the area of cesarean scar,the signal of the uterine wall was disconnected, with focal indentation or thinning and the previous cesarean scar exhibited hypointensity on both T 1 WI and T 2 WI. Conclusion: CSP has its unique findings on MRI, these specific features can provide useful information in the management of CSP. (authors)

  9. The application of 3D-printed transparent facemask for facial scar management and its biomechanical rationale.

    Science.gov (United States)

    Wei, Yating; Wang, Yan; Zhang, Ming; Yan, Gang; Wu, Shixue; Liu, Wenjun; Ji, Gang; Li-Tsang, Cecilia W P

    2018-03-01

    Deep facial burns leave conspicuous scar to the patients and affect their quality of life. Transparent facemask has been adopted for the prevention and treatment of facial hypertrophic scars for decades. Recently, with the advancement of 3D printing, the transparent facemask could facilitate the fitting of the facial contour. However, the effectiveness of the device and its biomechanical characteristics on pressure management of hypertrophic scar would need more objective evaluation. A biomechanical model of the transparent 3D-printed facemask was established through finite element analysis. Ten patients with extensive deep facial burns within 6 months were recruited for clinical study using 3D-printed facemask designed according to biomechanical model, and the interface pressure was measured on each patient. The patients in the treatment group (n=5) was provided with the 3D-printed transparent face mask soon after initial scar assessment, while the delayed treatment group (n=5) began the treatment one month after the initial scar assessment. The scar assessment was performed one month post intervention for both groups. The biomechanical modeling showed that the 3D, computer-generated facemask resulted in unbalanced pressure if design modifications were not incorporated to address these issues. The interface pressure between the facemask and patient's face was optimized through individualized design adjustments and the addition of silicone lining. After optimization of pressure through additional lining, the mean thickness and hardness of the scars of all 10 patients were decreased significantly after 1-month of intervention. In the delayed treatment group, the mean thickness of the scars was increased within the month without intervention, but it was also decreased after intervention. Facemask design and the silicone lining are important to ensure adequate compression pressure of 3D-printed transparent facemask. The intervention using the 3D-printed facemask

  10. Assessment of commonly used pediatric stool scales: a pilot study.

    Science.gov (United States)

    Saps, M; Nichols-Vinueza, D; Dhroove, G; Adams, P; Chogle, A

    2013-01-01

    The Bristol Stool Form Scale (BSFS) and a modified child-friendly version (M-BSFS) are frequently used in clinical practice and research. These scales have not been validated in children. 3-D stool scale models may be better adapted to the child's development. To assess the usefulness of the BSFS, M-BSFS, and a newly developed 3-D stool scale in children. Fifty children were asked to rank the picture cards of the BSFS and 3-D models from hardest to softest and to match the pictures with descriptors for each stool type. Thirty percent of the children appropriately characterized the stools as hard, loose, or normal using the BSFS vs. 36.6% with the 3-D model (p=0.27). Appropriate correlation of stools as hard, loose, or normal consistency using the BSFS vs. the 3-D model by age group was: 6 to 11-year-olds, 27.5% vs. 33.3% (p=0.58) and 12 to 17-year-olds, 32.1% vs. 39.5% (p=0.41). Thirty-three percent correlated the BSFS pictures with the correct BSFS words, 46% appropriately correlated with the M-BSFS words, and 46% correlated the 3-D stool models with the correct wording. The BSFS and M-BSFS that are widely used as stool assessment instruments are not user-friendly for children. The 3-D model was not found to be better than the BSFS and the M-BSFS. Copyright © 2013 Asociación Mexicana de Gastroenterología. Published by Masson Doyma México S.A. All rights reserved.

  11. Digital representation of oil and natural gas well pad scars in southwest Wyoming: 2012 update

    Science.gov (United States)

    Garman, Steven L.; McBeth, Jamie L.

    2015-01-01

    The recent proliferation of oil and natural gas energy development in the Greater Green River Basin of southwest Wyoming has accentuated the need to understand wildlife responses to this development. The location and extent of surface disturbance that is created by oil and natural gas well pad scars are key pieces of information used to assess the effects of energy infrastructure on wildlife populations and habitat. A digital database of oil and natural gas pad scars had previously been generated from 1-meter (m) National Agriculture Imagery Program imagery (NAIP) acquired in 2009 for a 7.7-million hectare (ha) (19,026,700 acres) region of southwest Wyoming. Scars included the pad area where wellheads, pumps, and storage facilities reside and the surrounding area that was scraped and denuded of vegetation during the establishment of the pad. Scars containing tanks, compressors, the storage of oil and gas related equipment, and produced-water ponds were also collected on occasion. This report updates the digital database for the five counties of southwest Wyoming (Carbon, Lincoln, Sublette, Sweetwater, Uinta) within the Wyoming Landscape Conservation Initiative (WLCI) study area and for a limited portion of Fremont, Natrona, and Albany Counties using 2012 1-m NAIP imagery and 2012 oil and natural gas well permit information. This report adds pad scars created since 2009, and updates attributes of all pad scars using the 2012 well permit information. These attributes include the origination year of the pad scar, the number of active and inactive wells on or near each pad scar in 2012, and the overall status of the pad scar (active or inactive). The new 2012 database contains 17,404 pad scars of which 15,532 are attributed as oil and natural gas well pads. Digital data are stored as shapefiles projected to the Universal Transverse Mercator (zones 12 and 13) coordinate system. These data are available from the U.S. Geological Survey (USGS) at http://dx.doi.org/10

  12. A Rat Excised Larynx Model of Vocal Fold Scar

    Science.gov (United States)

    Welham, Nathan V.; Montequin, Douglas W.; Tateya, Ichiro; Tateya, Tomoko; Choi, Seong Hee; Bless, Diane M.

    2009-01-01

    Purpose: To develop and evaluate a rat excised larynx model for the measurement of acoustic, aerodynamic, and vocal fold vibratory changes resulting from vocal fold scar. Method: Twenty-four 4-month-old male Sprague-Dawley rats were assigned to 1 of 4 experimental groups: chronic vocal fold scar, chronic vocal fold scar treated with 100-ng basic…

  13. Prevalence of scar contractures after burn : A systematic review

    NARCIS (Netherlands)

    Oosterwijk, Anouk M; Mouton, Leonora J; Schouten, Hennie; Disseldorp, Laurien M; van der Schans, Cees P.; Nieuwenhuis, Marianne K

    OBJECTIVE: Burn scar contractures are the pathological outcome of excessive scarring and ongoing scar contraction. Impairment of joint range of motion is a threat to performing activities in daily living. To direct treatment strategies to prevent and/or correct such contractures, insight into the

  14. Pulmonary scar carcinoma in South Africa | Jenkins | South African ...

    African Journals Online (AJOL)

    Post-obstructive bronchiectasis and other changes secondary to cancer were considered not to represent scarring. Results. We identified 435 cases of primary lung cancer. In total, 95 patients (21.8%) had CT evidence of pulmonary scarring. Eighty-three of 85 patients (97.6%) had focal scarring in the same lobe as the ...

  15. Development of an ecological momentary assessment scale for appetite.

    Science.gov (United States)

    Kikuchi, Hiroe; Yoshiuchi, Kazuhiro; Inada, Shuji; Ando, Tetsuya; Yamamoto, Yoshiharu

    2015-01-01

    An understanding of eating behaviors is an important element of health education and treatment in clinical populations. To understand the biopsychosocial profile of eating behaviors in an ecologically valid way, ecological momentary assessment (EMA) is appropriate because its use is able to overcome the recall bias in patient-reported outcomes (PROs). As appetite is a key PRO associated with eating behaviors, this study was done to develop an EMA scale to evaluate the within-individual variation of momentary appetite and uses this scale to discuss the relationships between appetite and various psychological factors. Twenty healthy participants (age 23.6 ± 4.2 years old) wore a watch-type computer for a week. Several times a day, including just before and after meals, they recorded their momentary psychological stress, mood states, and ten items related to appetite. In addition, they recorded everything they ate and drank into a personal digital assistant (PDA)-based food diary. Multilevel factor analysis was used to investigate the factor structure of the scale, and the reliability and validity of the scale were also explored. Multilevel factor analyses found two factors at the within-individual level (hunger/fullness and cravings) and one factor at the between-individual level. Medians for the individually calculated Cronbach's alphas were 0.89 for hunger/fullness, 0.71 for cravings, and 0.86 for total appetite (the sum of all items). Hunger/fullness, cravings, and total appetite all decreased significantly after meals compared with those before meals, and hunger/fullness, cravings, and total appetite before meals were positively associated with energy intake. There were significant negative associations between both hunger/fullness and total appetite and anxiety and depression as well as between cravings, and depression, anxiety and stress. The within-individual reliability of the EMA scale to assess momentary appetite was confirmed in most subjects and it

  16. A Social Development Assessment Scale for Mexican Children

    Directory of Open Access Journals (Sweden)

    Rocío Aguiar Sierra

    2005-05-01

    Full Text Available This work described the design of an instrument able to measure social development for Mexican children and the process of the establishment of its psychometric properties. Theoretical aspects considered for its construction and the process of validating forms for parents and teachers are described in a three stage processes that resulted in a final version of the Social Development Scale that measures, disruptive behavior, social interaction, cooperation, acceptance and attachment as core dimensions associated with the concept of social competence. The importance of assessing social development and competence for education, children rearing and general well being are analyzed and discussed.

  17. Studying intense pulsed light method along with corticosteroid injection in treating keloid scars.

    Science.gov (United States)

    Shamsi Meymandi, Simin; Rezazadeh, Azadeh; Ekhlasi, Ali

    2014-02-01

    Results of various studies suggest that the hypertrophic and keloid scars are highly prevalent in the general population and are irritating both physically and mentally. Considering the variety of existing therapies, intense pulsed light (IPL) method along with corticosteroid injection was evaluated in treating these scars. 86 subjects were included in this clinical trial. Eight sessions of therapeutic intervention were done with IPL along with corticosteroid intralesional injection using 450 to 1200 NM filter, Fluence 30-40 J/cm2, pulse duration of 2.1-10 ms and palsed delay 10-40 ms with an interval of three weeks. To specify the recovery consequences and complication rate and to determine features of the lesion, the criteria specified in the study of Eroll and Vancouver scar scale were used. The level of clinical improvement, color improvement and scar height was 89.1%, 88.8% and 89.1% respectively. The incidence of complications (1 telangiectasia case, 7 hyperpigmentation cases and 2 atrophy cases) following treatment with IPL was 11.6%. Moreover, the participants' satisfaction with IPL method was 88.8%. This study revealed that a combined therapy (intralesional corticosteroid injection + IPL) increases the recovery level of hypertrophic and keloid scars. It was also demonstrated that this method had no significant side effect and patients were highly satisfied with this method.

  18. Comparing Two Methods of Cryotherapy and Intense Pulsed Light with Triamcinolone Injection in the Treatment of Keloid and Hypertrophic Scars: A Clinical Trial.

    Science.gov (United States)

    Meymandi, Simin Shamsi; Moosazadeh, Mahmood; Rezazadeh, Azadeh

    2016-10-01

    Keloid and hypertrophic scars are abnormal manifestations of wounds that occur following skin injuries in the form of local proliferation of fibroblasts and increased production of collagen. There are several ways to cure these scars; treatment must be selected based on the nature of the scars. In this clinical trial, two methods-cryotherapy and intense pulsed light (IPL)-are compared in the treatment of scars, and the results are presented in terms of improvement level, complications, and patient satisfaction. This clinical trial was conducted in southeastern Iran. The intervention group included scars that underwent the IPL method and the control group, which consisted of scars that were subjected to cryotherapy. In both methods, intralesional corticosteroid injection was administered. To select samples, the easy sampling method was used. To determine the expected outcomes, the criteria determined in the Vancouver scar scale were used. Data were analyzed using the Mix Model, chi-square test, and t test. In this study, 166 samples of keloid and hypertrophic scars were cured using two methods (Cryotherapy, 83; IPL, 83). The recovery rate was higher in the Cryotherapy group than in the IPL group ( p  > 0.05), and the incidence of complications was also higher in the Cryotherapy group (14.5% vs. 12%). Moreover, patients were more satisfied, although not significantly so, with the cryotherapy method ( p  = 0.09). Both methods were highly successful in curing scars; participants were totally satisfied with both methods.

  19. Development of an assessment of functioning scale for prison environments.

    Science.gov (United States)

    Shelton, Deborah; Wakai, Sara

    2015-01-01

    This paper reports the development of a global assessment of functioning (GAF), modified from the DSM Axis V GAF for the prison environment. Focus groups, which were conducted with 36 correctional officers and clinicians in two prisons, provided descriptions of behavior in prison settings to re-align the GAF scale. Face validity was established. It was found that Habitation/Behavior, Social, and Symptoms emerged as important domains of functioning in prison. Gender differences were noted with regard to cleanliness, relationships and coping strategies. The cut-off score was identified at a score where offenders were unable to participate in a disciplinary process due to their mental illness. The structure of prison alters human functioning, requiring different assessment language and ratings to measure perceived behavioral norms and/or expectations. Front-line staff need the ability to observe and communicate behavioral changes quickly and accurately in a prison environment without undue burden upon their workload. This assessment was modified by front-line staff specifically for the prison environment to document quick and frequent assessments of observed changes over time in the offender population.

  20. DWI in breast MRI: Role of ADC value to determine diagnosis between recurrent tumor and surgical scar in operated patients

    Energy Technology Data Exchange (ETDEWEB)

    Rinaldi, Pierluigi, E-mail: pierluigi.rinaldi@rm.unicatt.i [Department of Bio-Imaging and Radiological Sciences, Catholic University - Policlinic A. Gemelli, L.go A. Gemelli 8, 00168 Rome (Italy); Giuliani, Michela, E-mail: micgiuli@yahoo.i [Department of Bio-Imaging and Radiological Sciences, Catholic University - Policlinic A. Gemelli, L.go A. Gemelli 8, 00168 Rome (Italy); Belli, Paolo, E-mail: pbelli@rm.unicatt.i [Department of Bio-Imaging and Radiological Sciences, Catholic University - Policlinic A. Gemelli, L.go A. Gemelli 8, 00168 Rome (Italy); Costantini, Melania, E-mail: mcostantini@rm.unicatt.i [Department of Bio-Imaging and Radiological Sciences, Catholic University - Policlinic A. Gemelli, L.go A. Gemelli 8, 00168 Rome (Italy); Romani, Maurizio, E-mail: mromani@rm.unicatt.i [Department of Bio-Imaging and Radiological Sciences, Catholic University - Policlinic A. Gemelli, L.go A. Gemelli 8, 00168 Rome (Italy); Distefano, Daniela, E-mail: daniela_distefano@hotmail.i [Department of Bio-Imaging and Radiological Sciences, Catholic University - Policlinic A. Gemelli, L.go A. Gemelli 8, 00168 Rome (Italy); Bufi, Enida, E-mail: reagandus@alice.i [Department of Bio-Imaging and Radiological Sciences, Catholic University - Policlinic A. Gemelli, L.go A. Gemelli 8, 00168 Rome (Italy); Mule, Antonino, E-mail: amule@rm.unicatt.i [Division of Pathology and Histology, Catholic University - Policlinic A. Gemelli, L.go A. Gemelli 8, 00168 Rome (Italy); Magno, Stefano, E-mail: smagno@rm.unicatt.i [Department of Surgery, Breast Unit, Catholic University Policlinic A. Gemelli, L.go A. Gemelli 8, 00168 Rome (Italy); Masetti, Riccardo, E-mail: riccardo.masetti@rm.unicatt.i [Department of Surgery, Breast Unit, Catholic University Policlinic A. Gemelli, L.go A. Gemelli 8, 00168 Rome (Italy); Bonomo, Lorenzo, E-mail: lbonomo@rm.unicatt.i [Dept. of Bio-Imaging and Radiological Sciences, Catholic Univ. - Policlinic A. Gemelli, L.go A. Gemelli 8, 00168 Rome (Italy)

    2010-08-15

    Introduction: Purpose of our study is to evaluate the role of the apparent diffusion coefficient (ADC) in the diagnosis of recurrent tumor on the scar in patients operated for breast cancer. Assess, therefore, the weight of diagnostic diffusion echo-planar sequence, in association with the morphological and dynamic sequences in the diagnosis of tumor recurrence versus surgical scar. Materials and methods: From September 2007 to March 2009, 72 patients operated for breast cancer with suspected recurrence on the scar were consecutively subjected to magnetic resonance imaging (MRI), including use of a diffusion sequence. All patients with pathological enhancement in the scar were then subjected to histological typing. MRI was considered negative in the absence of areas of suspicious enhancement. In all cases it was measured the ADC value in the scar area or in the area with pathological enhancement. The ADC values were compared with MRI findings and histological results obtained. Results: 26 cases were positive/doubtful at MRI and then subjected to histological typing: of these recurrences were 20 and benign were 6. 46 cases were judged negative at MRI and therefore not sent to cyto-histology. The average ADC value of recurrences was statistically lower of scarring (p < 0.001). Conclusions: ADC value can be a specific parameter in differential diagnosis between recurrence and scar. The diffusion sequence, in association with the morphological and dynamic sequences, can be considered a promising tool for the surgical indication in suspected recurrence of breast cancer.

  1. Adipose-Derived Mesenchymal Stem Cells in the Regeneration of Vocal Folds: A Study on a Chronic Vocal Fold Scar

    Directory of Open Access Journals (Sweden)

    Angelou Valerie

    2016-01-01

    Full Text Available Background. The aim of the study was to assess the histological effects of autologous infusion of adipose-derived stem cells (ADSC on a chronic vocal fold scar in a rabbit model as compared to an untreated scar as well as in injection of hyaluronic acid. Study Design. Animal experiment. Method. We used 74 New Zealand rabbits. Sixteen of them were used as control/normal group. We created a bilateral vocal fold wound in the remaining 58 rabbits. After 18 months we separated our population into three groups. The first group served as control/scarred group. The second one was injected with hyaluronic acid in the vocal folds, and the third received an autologous adipose-derived stem cell infusion in the scarred vocal folds (ADSC group. We measured the variation of thickness of the lamina propria of the vocal folds and analyzed histopathologic changes in each group after three months. Results. The thickness of the lamina propria was significantly reduced in the group that received the ADSC injection, as compared to the normal/scarred group. The collagen deposition, the hyaluronic acid, the elastin levels, and the organization of elastic fibers tend to return to normal after the injection of ADSC. Conclusions. Autologous injection of adipose-derived stem cells on a vocal fold chronic scar enhanced the healing of the vocal folds and the reduction of the scar tissue, even when compared to other treatments.

  2. Adipose-Derived Mesenchymal Stem Cells in the Regeneration of Vocal Folds: A Study on a Chronic Vocal Fold Scar

    Science.gov (United States)

    Vassiliki, Kalodimou; Irini, Messini; Nikolaos, Psychalakis; Karampela, Eleftheria; Apostolos, Papalois

    2016-01-01

    Background. The aim of the study was to assess the histological effects of autologous infusion of adipose-derived stem cells (ADSC) on a chronic vocal fold scar in a rabbit model as compared to an untreated scar as well as in injection of hyaluronic acid. Study Design. Animal experiment. Method. We used 74 New Zealand rabbits. Sixteen of them were used as control/normal group. We created a bilateral vocal fold wound in the remaining 58 rabbits. After 18 months we separated our population into three groups. The first group served as control/scarred group. The second one was injected with hyaluronic acid in the vocal folds, and the third received an autologous adipose-derived stem cell infusion in the scarred vocal folds (ADSC group). We measured the variation of thickness of the lamina propria of the vocal folds and analyzed histopathologic changes in each group after three months. Results. The thickness of the lamina propria was significantly reduced in the group that received the ADSC injection, as compared to the normal/scarred group. The collagen deposition, the hyaluronic acid, the elastin levels, and the organization of elastic fibers tend to return to normal after the injection of ADSC. Conclusions. Autologous injection of adipose-derived stem cells on a vocal fold chronic scar enhanced the healing of the vocal folds and the reduction of the scar tissue, even when compared to other treatments. PMID:26933440

  3. DWI in breast MRI: Role of ADC value to determine diagnosis between recurrent tumor and surgical scar in operated patients

    International Nuclear Information System (INIS)

    Rinaldi, Pierluigi; Giuliani, Michela; Belli, Paolo; Costantini, Melania; Romani, Maurizio; Distefano, Daniela; Bufi, Enida; Mule, Antonino; Magno, Stefano; Masetti, Riccardo; Bonomo, Lorenzo

    2010-01-01

    Introduction: Purpose of our study is to evaluate the role of the apparent diffusion coefficient (ADC) in the diagnosis of recurrent tumor on the scar in patients operated for breast cancer. Assess, therefore, the weight of diagnostic diffusion echo-planar sequence, in association with the morphological and dynamic sequences in the diagnosis of tumor recurrence versus surgical scar. Materials and methods: From September 2007 to March 2009, 72 patients operated for breast cancer with suspected recurrence on the scar were consecutively subjected to magnetic resonance imaging (MRI), including use of a diffusion sequence. All patients with pathological enhancement in the scar were then subjected to histological typing. MRI was considered negative in the absence of areas of suspicious enhancement. In all cases it was measured the ADC value in the scar area or in the area with pathological enhancement. The ADC values were compared with MRI findings and histological results obtained. Results: 26 cases were positive/doubtful at MRI and then subjected to histological typing: of these recurrences were 20 and benign were 6. 46 cases were judged negative at MRI and therefore not sent to cyto-histology. The average ADC value of recurrences was statistically lower of scarring (p < 0.001). Conclusions: ADC value can be a specific parameter in differential diagnosis between recurrence and scar. The diffusion sequence, in association with the morphological and dynamic sequences, can be considered a promising tool for the surgical indication in suspected recurrence of breast cancer.

  4. Combination laser treatment for immediate post-surgical scars: a retrospective analysis of 33 immature scars.

    Science.gov (United States)

    Lee, Yongsoo; Kim, Wooram

    2017-07-01

    The application of laser treatments beginning on the day of stitch removal has been demonstrated to improve scar quality. However, there are few guidelines for the treatment of immature scars (ISs), which are defined as "scars whose features are not yet expressed." The purpose of this study was to extract information about early combination laser treatment (CLT) beyond what is currently known by analyzing 33 pairs of pre-treatment and post-treatment photographs of ISs. Two hundred fifty medical records of patients with scars were reviewed, and 33 scars were included in the study. The included scars were treated with vascular lasers (585 or 532 nm) followed by 1550-nm fractional lasers from May 2014 to July 2015 (fewer than 52 days after stitch removal, Fitzpatrick's skin types III-IV, mean age = 16.0 years). Blinded evaluators (one plastic surgeon and two dermatologists) evaluated the pre-treatment and post-treatment photographs. The pre-treatment photographs were scored on a spectrum from "0," when no difference with the surrounding unaffected skin was observed, to "100," when the worst scarring was present. The pre-treatment and post-treatment photographs were compared, and the results were graded on a spectrum from 0, when no difference between the pre-treatment and post-treatment photographs was observed, to 100, when no difference was observed between the post-treatment skin and the surrounding unaffected skin. Statistical analyses were performed with PASW 17.0, SPSS Korea, Seoul, Korea (p laser groups. Patient age and Wtd score were negatively correlated, and a significant difference was observed in the Wtd scores between the age groups (≥15 and lasers are equally effective for CLT of ISs.

  5. The effects of electroacupuncture on analgesia and peripheral sensory thresholds in patients with burn scar pain.

    Science.gov (United States)

    Cuignet, Olivier; Pirlot, A; Ortiz, S; Rose, T

    2015-09-01

    The aim of this study is to observe if the effects of electro-acupuncture (EA) on analgesia and peripheral sensory thresholds are transposable from the model of heat pain in volunteers to the clinical setting of burn scar pain. After severe burns, pathological burn scars (PPBS) may occur with excruciating pain that respond poorly to treatment and prevent patients from wearing their pressure garments, thereby leading to unesthetic and function-limiting scars. EA might be of greater benefit in terms of analgesia and functional recovery, should it interrupt this vicious circle by counteracting the peripheral hyperalgesia characterizing PPBS. Therefore we enrolled 32 patients (22 males/10 females) aged of 46±11 years with clinical signs of PPBS and of neuropathic pain despite treatment. The study protocol consisted in 3 weekly 30-min sessions of standardized EA with extra individual needles in accordance to Traditional Chinese Medicine, in addition of previous treatments. We assessed VAS for pain and quantitative sensory testing (QST) twice: one week before and one after protocol. QST measured electrical thresholds for non-nociceptive A-beta fibers, nociceptive A-delta and C fibers in 2 dermatomes, respectively from the PPBS and from the contralateral pain-free areas. Based on heat pain studies, EA consisted in sessions at the extremity points of the main meridian flowing through PPBS (0.300s, 5Hz, sub noxious intensity, 15min) and at the bilateral paravertebral points corresponding to the same metameric level, 15min. VAS reduction of 3 points or below 3 on a 10 points scale was considered clinically relevant. Paired t-test compared thresholds (mean [SD]) and Wilcoxon test compared VAS (median [IQR]) pre and after treatment, significant ppatients - even those from the subgroup of non-responders to pain - that is worth to be mentioned and requires further studies to be confirmed. This observational study is the first that confirms the effects of acupuncture on

  6. Current options for the treatment of pathological scarring.

    Science.gov (United States)

    Poetschke, Julian; Gauglitz, Gerd G

    2016-05-01

    Scarring is the consequence of surgery, trauma or different skin diseases. Apart from fresh, immature scars,that transform into mature scars over the course of would healing and that do not require further treatment,linear hypertrophic scars, widespread hypertrophic scars, keloids and atrophic scars exist. Symptoms like pruritusand pain, stigmatization as well as functional and aesthetic impairments that are very disturbing for the affected patients can bethe basis for the desire for treatment. Today, a multitude of options for the treatment and prevention of scars exists. Topical agents based on silicone or onion extract, intralesional injections of cristalline glucocorticoids (oftentimes in combinationwith cryotherapy) or 5-Fluorouracil as well as ablative and nonablative laser treatment are used. Current guidelines summarize the multitude of available treatment options and the currently available datafor the treating physicians, allowing them to make clear therapy recommendations for every single scar type. Relieving patients of their discomfort and doing their aesthetic demands justice is thus possible. Apart from scar prevention becoming more and more important, the increased use of modernlaser treatment options constitutes a key point in clinical scar treatment. At the same time the attention is turned to evaluating current therapeutic options with the help of contemporary study designs so as to graduallyimprove the level of evidence in scar treatment. © 2016 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

  7. Umbilical scarring in hatchling American alligators

    Science.gov (United States)

    Wiebe, J.J.; Sepulveda, M.S.; Buckland, J.E.; Anderson, S.R.; Gross, T.S.

    2004-01-01

    Umbilical scarring is the presence of excess scar tissue deposited between abdominal dermal layers at the site of yolk sac absorption in hatchling American alligators (Alligator mississippiensis). The presence of this dermal condition plays a key evaluatory role in the overall quality and subsequent value for various commercial leather products. Despite the prevalent nature of this condition, currently the industry has no standardized protocols for its quantification. The objectives of this study were to examine the relationship between hatchling weight and age and incidence of umbilical scarring and to develop a quantifiable and reproducible technique to measure this dermal condition in hatchling American alligators. Thirty eggs from each of nine clutches were incubated in two separate incubators at different facilities and hatchling umbilical scarring was measured at 2 and 10 days of age using digital calipers. Umbilical area was calculated by multiplying umbilical length times umbilical width. There was a significant effect of both age and clutch on umbilical area (overall decline of 64%) by 10 days post-hatch. However, only five of the nine clutches utilized expressed a noticeable decline in the size of this dermal condition (range 67-74%). We had hypothesized that larger hatchlings would have larger umbilical areas and a slower rate of improvement in this condition during the first few days post-hatch. The differences in umbilical area and percent decline with age across clutches, however, were not associated with differences in initial hatchling weights. Within clutches and time periods, hatchling weight had no significant effect on the size and/or rate of decline of this condition. ?? 2004 Published by Elsevier B.V.

  8. Post-fire vegetation behaviour in large burnt scars from 2005 fire season in Spain

    Science.gov (United States)

    Bastos, A.; Gouveia, C. M.; DaCamara, C. C.; Trigo, R. M.

    2012-04-01

    Wildfires have a wide diversity of impacts on landscape which, in turn, depend on the interaction of fire regimes (e.g. intensity, extent, frequency) and the response of vegetation to them in short and long-terms. The increase in erosion rates and the loss of nutrients by runoff in the first months following the fire are among the major impacts of wildfires. A minimum of 30% of vegetation cover is enough to protect soils against erosion but vegetation may require a long period to reach this threshold after severe fires. Since erosion risk is strongly linked to vegetation recovery rates, post-fire vegetation monitoring becomes crucial in land management. Fire regimes in the Mediterranean have been changing in the past decades due to modifications in both socio-economic and climate patterns. Although many vegetation species in Mediterranean ecosystems are adapted to wildfires, changes in fire regime characteristics affect the ability of ecosystems to recover to their previous state. In Spain, fire is an important driver of changes in landscape composition, leading to dominance of shrubland following fire and to a major decrease of pine woodlands (Viedma et al., 2006). Remote sensing is a powerful tool in land management, allowing vegetation monitoring on large spatial scales for relatively long periods of time. In order to assess vegetation dynamics, monthly NDVI data from 1998-2009 from SPOT/VEGETATION at 1km spatial resolution over the Iberian Peninsula were used. This work focuses on 2005 fire season in Spain, which registered the highest amount of burnt area since 1994, with more than 188000 ha burnt. Burnt scars in this fire season were identified by cluster analysis. Post-fire vegetation recovery was assessed based on the monoparametric model developed by Gouveia et al. (2010) that was applied to four large scars located in different geographical settings with different land cover characteristics. While the two northern regions presented fast recovery, in the

  9. Mesenchymal Stem Cell Therapy for the Treatment of Vocal Fold Scarring

    DEFF Research Database (Denmark)

    Wingstrand, Vibe Lindeblad; Larsen, Christian Grønhøj; Jensen, David H

    2016-01-01

    OBJECTIVES: Therapy with mesenchymal stem cells exhibits potential for the development of novel interventions for many diseases and injuries. The use of mesenchymal stem cells in regenerative therapy for vocal fold scarring exhibited promising results to reduce stiffness and enhance...... the biomechanical properties of injured vocal folds. This study evaluated the biomechanical effects of mesenchymal stem cell therapy for the treatment of vocal fold scarring. DATA SOURCES: PubMed, Embase, the Cochrane Library and Google Scholar were searched. METHODS: Controlled studies that assessed...... the biomechanical effects of mesenchymal stem cell therapy for the treatment of vocal fold scarring were included. Primary outcomes were viscoelastic properties and mucosal wave amplitude. RESULTS: Seven preclinical animal studies (n = 152 single vocal folds) were eligible for inclusion. Evaluation of viscoelastic...

  10. Persistent scarring and dilated cardiomyopathy suggest incomplete regeneration of the apex resected neonatal mouse myocardium

    DEFF Research Database (Denmark)

    Andersen, Ditte Caroline; Jensen, Charlotte Harken; Baun, Christina

    2016-01-01

    Heart damage in mammals is generally considered to result in scar formation, whereas zebrafish completely regenerate their hearts following an intermediate and reversible state of fibrosis after apex resection (AR). Recently, using the AR procedure, one-day-old mice were suggested to have full...... capacity for cardiac regeneration as well. In contrast, using the same mouse model others have shown that the regeneration process is incomplete and that scarring still remains 21days after AR. The present study tested the hypothesis that like in zebrafish, fibrosis in neonatal mammals could...... be an intermediate response before the onset of complete heart regeneration. Myocardial damage was performed by AR in postnatal day 1 C57BL/6 mice, and myocardial function and scarring assessed at day 180 using F-18-fluorodeoxyglucose positron emission tomography (FDG-PET) and histology, respectively. AR mice...

  11. Pain Assessment Scale for Patients With Disorders of Consciousness

    DEFF Research Database (Denmark)

    Poulsen, Ingrid; Brix, Pia; Andersen, Sylvia

    2016-01-01

    and after repositioning in bed and before and after administration of analgesics. We used Cohen's kappa test for interrater reliability. Sensitivity to change was tested by Wilcoxon signed rank test. RESULTS: Cohen's kappa for the presence or absence of each item was above 0.8 for 13 items, between 0...... of four domains: physiological/autonomic, body language, verbal communication, and behavior. The domains consist of 27 items. Interrater reliability was tested through three experienced nurses who rated 26 patients with acquired brain injury. The patients were rated in two different situations: before.......6 and 0.8 for eight items, and less than 0.6 for only three items. The sensitivity test showed a significant change from before to after repositioning (p = .004). CONCLUSION: It appeared that many of the pain assessment scale items held potential for inclusion in a new, more comprehensively developed...

  12. A Watershed Scale Life Cycle Assessment Framework for Hydrologic Design

    Science.gov (United States)

    Tavakol-Davani, H.; Tavakol-Davani, PhD, H.; Burian, S. J.

    2017-12-01

    Sustainable hydrologic design has received attention from researchers with different backgrounds, including hydrologists and sustainability experts, recently. On one hand, hydrologists have been analyzing ways to achieve hydrologic goals through implementation of recent environmentally-friendly approaches, e.g. Green Infrastructure (GI) - without quantifying the life cycle environmental impacts of the infrastructure through the ISO Life Cycle Assessment (LCA) method. On the other hand, sustainability experts have been applying the LCA to study the life cycle impacts of water infrastructure - without considering the important hydrologic aspects through hydrologic and hydraulic (H&H) analysis. In fact, defining proper system elements for a watershed scale urban water sustainability study requires both H&H and LCA specialties, which reveals the necessity of performing an integrated, interdisciplinary study. Therefore, the present study developed a watershed scale coupled H&H-LCA framework to bring the hydrology and sustainability expertise together to contribute moving the current wage definition of sustainable hydrologic design towards onto a globally standard concept. The proposed framework was employed to study GIs for an urban watershed in Toledo, OH. Lastly, uncertainties associated with the proposed method and parameters were analyzed through a robust Monte Carlo simulation using parallel processing. Results indicated the necessity of both hydrologic and LCA components in the design procedure in order to achieve sustainability.

  13. Fuel pin integrity assessment under large scale transients

    International Nuclear Information System (INIS)

    Dutta, B.K.

    2006-01-01

    The integrity of fuel rods under normal, abnormal and accident conditions is an important consideration during fuel design of advanced nuclear reactors. The fuel matrix and the sheath form the first barrier to prevent the release of radioactive materials into the primary coolant. An understanding of the fuel and clad behaviour under different reactor conditions, particularly under the beyond-design-basis accident scenario leading to large scale transients, is always desirable to assess the inherent safety margins in fuel pin design and to plan for the mitigation the consequences of accidents, if any. The severe accident conditions are typically characterized by the energy deposition rates far exceeding the heat removal capability of the reactor coolant system. This may lead to the clad failure due to fission gas pressure at high temperature, large- scale pellet-clad interaction and clad melting. The fuel rod performance is affected by many interdependent complex phenomena involving extremely complex material behaviour. The versatile experimental database available in this area has led to the development of powerful analytical tools to characterize fuel under extreme scenarios

  14. A scale for assessing Italian schools and classes inclusiveness

    Directory of Open Access Journals (Sweden)

    Lucio Cottini

    2016-07-01

    Full Text Available The paper presents in detail the procedures for developing and validating a tool for assessing the inclusive process pertaining to school contexts called “Inclusive Process Assessment Scale”. The Scale, which is the outcome of the joined work of the authors, sets itself both as an assessing and self-assessing tool, useful for allowing on one hand specific types of evaluation and, on the other, promoting thoughts on inclusive education’s quality indicators, thus contributing to the planning and ongoing adjustment of the educational project of the school and the class. The tool, in its computer version as well, allows for the planning of researches that can collect evidences supporting the full inclusion organization of Italian schools.Una scala per valutare l’inclusività delle scuole e delle classi italianeIl contributo presenta in dettaglio le procedure di costruzione e validazione di uno strumento per valutare i processi inclusivi riferiti ai contesti scolastici, chiamato “Scala di Valutazione dei Processi Inclusivi”. Frutto del lavoro congiunto svolto dagli autori, la Scala si pone come uno strumento valutativo e autovalutativo utile a consentire da un lato, la realizzazione di specifiche forme di misurazione e, dall’altro, la promozione di processi di riflessione sugli indicatori di qualità dell’educazione inclusiva, per contribuire alla progettazione e alla regolazione in itinere del progetto educativo della scuola e della classe. Lo strumento, anche nella sua versione digitale, consente di pianificare ricerche, che possono raccogliere evidenze in grado di avvalorare l’organizzazione scolastica italiana di full inclusion.

  15. Psychometrics of the neonatal oral motor assessment scale.

    Science.gov (United States)

    Zarem, Cori; Kidokoro, Hiroyuki; Neil, Jeffrey; Wallendorf, Michael; Inder, Terrie; Pineda, Roberta

    2013-12-01

    To establish the psychometrics of the Neonatal Oral Motor Assessment Scale (NOMAS). In this prospective cohort study of 75 preterm infants (39 females, 36 males) born at or before 30 weeks gestation (mean gestational age 26.56 wks, SD 1.90, range 23-30 wks; mean birthweight 967.33 g, SD 288.54, range 480-2240), oral feeding was videotaped before discharge from the neonatal intensive care unit (NICU). The NOMAS was used to classify feeding as normal, disorganized, or dysfunctional. Neurobehavior was assessed at term equivalent, and infants underwent magnetic resonance imaging. Children returned for developmental testing at 2 years corrected age. Associations between NOMAS scores and (1) neurobehavior; (2) cerebral injury and metrics; and (3) developmental outcome were investigated using χ(2) -analyses, t-tests, and linear regression. For reliability, six certified NOMAS evaluators rated five randomly selected NOMAS recordings and re-scored them 2 weeks later in a second randomized order. Reliability was calculated with Cohen's kappa statistics. Dysfunctional NOMAS scores were associated with lower Dubowitz scores [t=-2.14; mean difference -2.32 (95% confidence interval [CI] -0.157 to -4.49); p=0.036], higher stress on the NICU Network Neurobehavioral Scale (t=2.61; mean difference 0.073 [95% CI 0.017-0.129]; p=0.0110), and decreased transcerebellar diameter (t=-2.22; mean difference -2.04 [CI=-3.89 to -0.203]; p=0.03). No significant associations were found between NOMAS scores and 2-year outcome. Some concurrent validity was established with associations between NOMAS scores and measures of infant behavior and cerebral structure. The NOMAS did not show predictive validity in this study of preterm infants at high risk of developmental delay. Reliability was variable and suboptimal. © 2013 Mac Keith Press.

  16. Clinical evaluation of the SmartSkin fractional laser for the treatment of photodamage and acne scars.

    Science.gov (United States)

    Gold, Michael H; Heath, Amanda D; Biron, Julie A

    2009-11-01

    Fractional photothermolysis with a CO2 laser shows promise in the treatment of photodamaged skin. The purpose of this study was to evaluate a fractional CO2 laser device (SmartSkin, Cynosure, Westford, MA) for the treatment of facial photodamage. Twelve subjects seeking treatment of facial hyperpigmentation, skin laxity, wrinkles and fine lines, enlarged pores and acne scars enrolled in the study. Each subject was treated twice with the SmartSkin device at three- to five-week intervals. Results were evaluated at one week, one month and three months after the final treatment. All 12 subjects completed the study. Physician and subject assessments both indicated that clinical improvements in all photodamage parameters were apparent at one month and persisted at least three months. Improvements in acne scars were noted but not graded. Eleven subjects would recommend the treatment to family and friends. The median pain scores during the initial and final treatments were 2.00 and 2.00, respectively, on a scale of 0-5. Only one adverse effect, facial edema, was judged "probably related to treatment." The SmartSkin fractional laser device improves photodamaged skin for at least three months. The treatment was well tolerated and adverse effects were limited to transient facial edema.

  17. Improvement of Atrophic Acne Scars in Skin of Color Using Topical Synthetic Epidermal Growth Factor (EGF) Serum: A Pilot Study.

    Science.gov (United States)

    Stoddard, Marie Alexia; Herrmann, Jennifer; Moy, Lauren; Moy, Ronald

    2017-04-01

    BACKGROUND: Atrophic scarring in skin of color is a common, permanent, and distressing result of uncontrolled acne vulgaris. Ablative lasers and chemical peels are frequently used to improve the appearance of atrophic scars, primarily through the stimulation of collagen and elastin; however, these treatment modalities are associated with risks, such as dyspigmentation and hypertrophic scarring, especially in patients with darker skin. OBJECTIVE: We evaluated the efficacy of topically applied synthetic epidermal growth factor (EGF) serum in reducing the appearance of atrophic acne scars in skin of color. METHODS: A single-center clinical trial was performed on twelve healthy men and women (average age 32.5) with Fitzpatrick Type IV-V skin and evidence of facial grade II-IV atrophic acne scars. Subjects applied topical EGF serum to the full-face twice daily for 12 weeks. Scar improvement was investigated at each visit using an Investigator Global Assessment (IGA), a Goodman grade, clinical photography, and patient self-assessment. RESULTS: Eleven subjects completed the trial. Compared to baseline, there was an improvement in mean IGA score from 3.36 (SEM = 0.15) to 2.18 (SEM = 0.33). Mean Goodman grade was reduced from 2.73 (SEM = 0.19) to 2.55 (SEM = 0.21). Of the eleven pairs of before and after photographs, nine were correctly chosen as the post-treatment image by a blind investigator. On self-assessment, 81% reported a "good" to "excellent" improvement in their scars compared to baseline (P = 0.004). CONCLUSION: Topical EGF may improve the appearance of atrophic acne scars in skin of color. Additional, larger studies should be conducted to better characterize improvement. J Drugs Dermatol. 2017;16(4):322-326..

  18. A novel visual facial anxiety scale for assessing preoperative anxiety.

    Directory of Open Access Journals (Sweden)

    Xuezhao Cao

    Full Text Available There is currently no widely accepted instrument for measuring preoperative anxiety. The objective of this study was to develop a simple visual facial anxiety scale (VFAS for assessing acute preoperative anxiety.The initial VFAS was comprised of 11 similarly styled stick-figure reflecting different types of facial expressions (Fig 1. After obtaining IRB approval, a total of 265 participant-healthcare providers (e.g., anesthesiologists, anesthesiology residents, and perioperative nurses were recruited to participate in this study. The participants were asked to: (1 rank the 11 faces from 0-10 (0 = no anxiety, while 10 = highest anxiety and then to (2 match one of the 11 facial expression with a numeric verbal rating scale (NVRS (0 = no anxiety and 10 = highest level of anxiety and a specific categorical level of anxiety, namely no anxiety, mild, mild-moderate, moderate, moderate-high or highest anxiety. Based on these data, the Spearman correlation and frequencies of the 11 faces in relation to the 11-point numerical anxiety scale and 6 categorical anxiety levels were calculated. The highest frequency of a face assigned to a level of the numerical anxiety scale resulted in a finalized order of faces corresponding to the 11-point numeric rating scale.The highest frequency for each of the NVRS anxiety scores were as follow: A0, A1, A2, A3, A4, A5, A7, A6, A8, A9 and A10 (Fig 2. For the six categorical anxiety levels, a total of 260 (98.1% participants chose the face A0 as representing 'no' anxiety, 250 (94.3% participants chose the face A10 as representing 'highest' anxiety and 147 (55.5% participants chose the face A8 as representing 'moderate-high' anxiety. Spearman analysis showed a significant correlation between the faces A3 and A5 assigned to the mild-moderate anxiety category (r = 0.58, but A5 was ultimately chosen due to its higher frequency compared to the frequency of A3 (30.6% vs 24.9%(Fig 3. Similarly, the correlation of the faces A7

  19. Fire scar mapping for disaster response in KwaZulu-Natal South ...

    African Journals Online (AJOL)

    This study assessed the potential of the new Landsat 8 multispectral imagery in rapidly mapping fire scars to aid disaster management response teams in emergency efforts. Maximum likelihood and iso cluster algorithms where used to classify burnt and unburnt areas in KwaZulu-Natal, South Africa. The Landsat 8 sensor ...

  20. Impact of facial burns: relationship between depressive symptoms, self-esteem and scar severity

    NARCIS (Netherlands)

    Hoogewerf, C.J.; van Baar, M.E.; Middelkoop, E.; van Loey, N.E.

    2014-01-01

    Objective: This study assessed the role of self-reported facial scar severity as a possible influencing factor on self-esteem and depressive symptoms in patients with facial burns. Method: A prospective multicentre cohort study with a 6 months follow-up was conducted including 132 patients with

  1. Impact of facial burns : relationship between depressive symptoms, self-esteem and scar severity

    NARCIS (Netherlands)

    Hoogewerf, Cornelis Johannes; van Baar, Margriet Elisabeth; Middelkoop, Esther; Van Loey, N.E.E.

    2014-01-01

    OBJECTIVE: This study assessed the role of self-reported facial scar severity as a possible influencing factor on self-esteem and depressive symptoms in patients with facial burns. METHOD: A prospective multicentre cohort study with a 6 months follow-up was conducted including 132 patients with

  2. Risk Assessment and Scaling for the SLS LH2 ET

    Science.gov (United States)

    Hafiychuk, Halyna; Ponizovskaya-Devine, Ekaterina; Luchinsky, Dmitry; Khasin, Michael; Osipov, Viatcheslav V.; Smelyanskiy, Vadim N.

    2012-01-01

    In this report the main physics processes in LH2 tank during prepress and rocket flight are studied. The goal of this investigation is to analyze possible hazards and to make risk assessment in proposed LH2 tank designs for SLS with 5 engines (the situation with 4 engines is less critical). For analysis we use the multinode model (MNM) developed by us and presented in a separate report and also 3D ANSYS simulations. We carry out simulation and theoretical analysis the physics processes such as (i) accumulation of bubbles in LH2 during replenish stage and their collapsing in the liquid during the prepress; (ii) condensation-evaporation at the liquid-vapor interface and tank wall, (iv) heating the liquid near the interface and wall due to condensation and environment heat, (v) injection of hot He during prepress and of hot GH2 during flight, (vi) mixing and cooling of the injected gases due to heat transfer between the gases, liquid and the tank wall. We analyze the effects of these physical processes on the thermo- and fluid gas dynamics in the ullage and on the stratification of temperature in the liquid and assess the associated hazards. A special emphasize is put on the scaling predictions for the larger SLS LH2 tank.

  3. Assessment of competence for caesarean section with global rating scale

    International Nuclear Information System (INIS)

    Qureshi, R.N.; Ali, S.K.

    2013-01-01

    Objective: To establish as reliable and valid the nine-point global rating scale for assessing residents' independent performance of Caesarean Section. Methods: The validation study was conducted at the Department of Obstetrics and Gynaecology, Aga Khan University Hospital, from April to December 2008, and comprised 15 residents during 40 Caesarean Sections over 9 months. Independently two evaluators rated each procedure and the difficulty of each case. Results: The observations per faculty ranged from 1-8 (mean 4.07+- 2.56). The Year 4 residents were observed the most i.e. 32 (40%), followed by Year 3, 30 (37.5%); Year 2; 14 (17.5%); and Year 1, 4 (5%). Mean time required for observation of the surgery was 43.81+-14.28 (range: 20-90) with a mode of 45 min. Mean aggregate rating on all items showed gradual progression with the year of residency. The assessment tool had an internal consistency reliability (Cronbach's alpha) of 0.9097 with low inter-rater reliability. Conclusion: The evaluation tool was found to be reliable and valid for evaluating a resident's competence for performing Caesarean Section. Training of the assessors is required for a better inter-rater agreement. (author)

  4. Comprehensive large-scale assessment of intrinsic protein disorder.

    Science.gov (United States)

    Walsh, Ian; Giollo, Manuel; Di Domenico, Tomás; Ferrari, Carlo; Zimmermann, Olav; Tosatto, Silvio C E

    2015-01-15

    Intrinsically disordered regions are key for the function of numerous proteins. Due to the difficulties in experimental disorder characterization, many computational predictors have been developed with various disorder flavors. Their performance is generally measured on small sets mainly from experimentally solved structures, e.g. Protein Data Bank (PDB) chains. MobiDB has only recently started to collect disorder annotations from multiple experimental structures. MobiDB annotates disorder for UniProt sequences, allowing us to conduct the first large-scale assessment of fast disorder predictors on 25 833 different sequences with X-ray crystallographic structures. In addition to a comprehensive ranking of predictors, this analysis produced the following interesting observations. (i) The predictors cluster according to their disorder definition, with a consensus giving more confidence. (ii) Previous assessments appear over-reliant on data annotated at the PDB chain level and performance is lower on entire UniProt sequences. (iii) Long disordered regions are harder to predict. (iv) Depending on the structural and functional types of the proteins, differences in prediction performance of up to 10% are observed. The datasets are available from Web site at URL: http://mobidb.bio.unipd.it/lsd. Supplementary data are available at Bioinformatics online. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  5. Scaling studies and conceptual experiment designs for NGNP CFD assessment

    Energy Technology Data Exchange (ETDEWEB)

    D. M. McEligot; G. E. McCreery

    2004-11-01

    The objective of this report is to document scaling studies and conceptual designs for flow and heat transfer experiments intended to assess CFD codes and their turbulence models proposed for application to prismatic NGNP concepts. The general approach of the project is to develop new benchmark experiments for assessment in parallel with CFD and coupled CFD/systems code calculations for the same geometry. Two aspects of the complex flow in an NGNP are being addressed: (1) flow and thermal mixing in the lower plenum ("hot streaking" issue) and (2) turbulence and resulting temperature distributions in reactor cooling channels ("hot channel" issue). Current prismatic NGNP concepts are being examined to identify their proposed flow conditions and geometries over the range from normal operation to decay heat removal in a pressurized cooldown. Approximate analyses have been applied to determine key non-dimensional parameters and their magnitudes over this operating range. For normal operation, the flow in the coolant channels can be considered to be dominant turbulent forced convection with slight transverse property variation. In a pressurized cooldown (LOFA) simulation, the flow quickly becomes laminar with some possible buoyancy influences. The flow in the lower plenum can locally be considered to be a situation of multiple hot jets into a confined crossflow -- with obstructions. Flow is expected to be turbulent with momentumdominated turbulent jets entering; buoyancy influences are estimated to be negligible in normal full power operation. Experiments are needed for the combined features of the lower plenum flows. Missing from the typical jet experiments available are interactions with nearby circular posts and with vertical posts in the vicinity of vertical walls - with near stagnant surroundings at one extreme and significant crossflow at the other. Two types of heat transfer experiments are being considered. One addresses the "hot channel" problem, if necessary

  6. Novel use of a flowable collagen-glycosaminoglycan matrix (Integra™ Flowable Wound Matrix) combined with percutaneous cannula scar tissue release in treatment of post-burn malfunction of the hand--A preliminary 6 month follow-up.

    Science.gov (United States)

    Hirche, C; Senghaas, A; Fischer, S; Hollenbeck, S T; Kremer, T; Kneser, U

    2016-02-01

    Long-term function following severe burns to the hand may be poor secondary to scar adhesions to the underlying tendons, webspaces, and joints. In this pilot study, we report the feasibility of applying a pasty dermal matrix combined with percutaneous cannula teno- and adhesiolysis. In this 6 month follow-up pilot study, we included eight hands in five patients with hand burns undergoing minimal-invasive, percutaneous cannula adhesiolysis and injection of INTEGRA™ Flowable Wound Matrix for a pilot study of this new concept. The flowable collagen-glycosaminoglycan wound matrix (FCGWM) was applied with a buttoned 2mm cannula to induce formation of a neo-gliding plane. Post treatment follow-up was performed to assess active range of motion (AROM), grip strength, Disabilities of the Arm, Shoulder and Hand (DASH) score, Vancouver Scar Scale (VSS) and quality of life Short-Form (SF)-36 questionnaire. No complications were detected associated with the treatment of FCGWM injection. The mean improvement (AROM) at 6 months was 30.6° for digits 2-5. The improvement in the DASH score was a mean of 9 points out of 100. The VSS improved by a mean of 2 points out of 14. The study demonstrates the feasibility and safety of percutaneous FCGWM for dermal augmentation after burn. Results from this pilot study show improvements in AROM for digits 2-5, functional scores from the patient's perspective (DASH) and scar quality (VSS). The flowable form of established INTEGRA™ wound matrix offers the advantage of minimal-invasive injection after scar release in the post-burned hand with a reduction in the risk of postsurgical re-scarring. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

  7. Cesarean Scar Ectopic Pregnancy: Laparoscopic Resection and Total Scar Dehiscence Repair.

    Science.gov (United States)

    Mahgoub, Sara; Gabriele, Victor; Faller, Emilie; Langer, Bruno; Wattiez, Arnaud; Lecointre, Lise; Akladios, Cherif

    2018-02-01

    To illustrate a laparoscopic technique for the resection of cesarean scar ectopic pregnancy, associated with isthmocele repair. Case report (Canadian Task Force classification III). A tertiary referral center in Strasbourg, France. Cesarean scar pregnancy is a rare form of ectopic pregnancy. The major risk of this type of pregnancy is the early uterine rupture with massive, sometimes life-threatening, bleeding. Thus, active management of these pregnancies starting immediately after diagnosis is crucial. Therapeutic options can be medical, surgical, or a combination. Numerous case reports or case series can be found in the literature, but there are few clinical studies, which are difficult to conduct because of case rarity and inconclusiveness. A 2016 meta-analysis that included 194 articles published between 1978 and 2014 (126 case reports, 45 cases series, and 23 clinical studies) concluded that hysteroscopy or laparoscopic hysterotomy seems to be the best first-line approach to treating cesarean scar ectopic pregnancy, with uterine artery embolization reserved for significant bleeding and/or a high suspicion index for arteriovenous malformation [1]. There is no consensus on the treatment of reference, however. The case involves a 38-year-old primiparous women who underwent a cesarean section delivery in 2010 and who was diagnosed by ultrasound scan at 7 weeks gestation with cesarean scar ectopic pregnancy, which was confirmed by pelvic magnetic resonance imaging. The patient initially received medical treatment with 2 intramuscular injections of methotrexate and one local intragestational injection of KCl. Her initial human chorionic gonadotropin (hCG) level was 82 000 IU/L. Rigorous weekly biological and ultrasound monitoring revealed an involution of the ectopic pregnancy associated with decreasing hCG. No bleeding or infectious complications occurred during this period. After 10 weeks of monitoring, her hCG had stabilized at 300 IU/L, and a residual image

  8. Psychometric Properties of the Persian Version of the Relationship Assessment Scale among Couples

    Directory of Open Access Journals (Sweden)

    غلامرضا دهشیری

    2016-06-01

    Full Text Available This research administrated to evaluate the psychometric properties of the Persian version of Relationship Assessment scale. Therefore, 315 married individuals (199 women and 116 men from Tehran city were volunteered to respond to four scales: the Relationship Assessment, the Kansas Marital Satisfaction, the Oxford Happiness and the Life Satisfaction. Results from exploratory & confirmatory factor analysis showed that factor structure of Relationship Assessment scale was unidimensional. The internal consistency of the scale in the total sample was 0.88. Significant correlations between scores of the Relationship Assessment scale with the scores of the Kansas Marital Satisfaction Scale, the Life Satisfaction Scale and the Oxford Happiness Questionnaire demonstrated good convergent validity of the scale. Also, the results showed that there was no significant gender difference between the mean scores of relationship satisfaction. In conclusion, the Relationship Assessment scale is a valid and reliable tool to measure marital satisfaction in Iran.

  9. Prosthodontist contribution in treating post-burn hypertrophic facial scars

    Directory of Open Access Journals (Sweden)

    Padmanabhan T

    2010-01-01

    Full Text Available The formation of hypertrophic scars is common following healing of the burn wound, particularly in children. The face is one of the areas of the body most frequently affected by burns. Scar formation as a result of burn wounds leads to contraction of the formed granulation tissue, which causes both aesthetic and functional impairment for the patient. Scarring has major psychological and physical repercussions. Scarring on the face and visible regions of the body can be very distressing for the patient. Prevention of scars involves early and continuous use of a compressive orthesis. However, their efficacy is often limited to the facial region because of the contours of this area of body. This paper describes a clinical case of post-burn hypertrophic scars treated with silicone gel sheeting applied with pressure under custom made auto-polymerizing resin stent.

  10. Cutaneous Scar Prevention and Management; Overview of current therapies

    Directory of Open Access Journals (Sweden)

    Sultan Al-Shaqsi

    2016-02-01

    Full Text Available Cutaneous scarring is common after trauma, surgery and infection and occurs when normal skin tissue is replaced by fibroblastic tissue during the healing process. The pathophysiology of scar formation is not yet fully understood, although the degree of tension across the wound edges and the speed of cell growth are believed to play central roles. Prevention of scars is essential and can be achieved by attention to surgical techniques and the use of measures to reduce cell growth. Grading and classifying scars is important to determine available treatment strategies. This article presents an overview of the current therapies available for the prevention and treatment of scars. It is intended to be a practical guide for surgeons and other health professionals involved with and interested in scar management.

  11. Casual and ambulatory blood pressure monitoring in children with renal scarring

    Directory of Open Access Journals (Sweden)

    Miloševski Gordana

    2005-01-01

    Full Text Available INTRODUCTION Renal scarring is the most common cause of arterial hypertension in children. High blood pressure (BP and microalbuminuria contribute to the progression of chronic renal disease. OBJECTIVE The aims of the study were: to assess BP in children with renal scarring by continuous ambulatory blood pressure measurement (ABPM in comparison to the casual method (CBP, and to determine the correlation between ambulatory blood pressure (ABP and/or casual blood pressure (CBP values and proteinuria in children with renal scarring. METHOD This forward-looking study comprised thirty-five children (26 girls and 9 boys, aged between 3-13 years, 10.4±3.9, X+SD. Blood pressure was measured using the casual method (CBP with a mercury manometer; BP was measured three times and the average was taken as a referent value. ABPM was performed using the oscillometric method with the Space Labs device, model 90207. RESULTS 45.71% of patients were classified as hypertensive by ABPM, while only 22.6% of CBP measurements were above the 95th percentile (p<0.01. "White coat hypertension" was present in 40% of the patients. Non-dipping BP alteration was detected in 37.14% of the patients. CONCLUSION Nocturnal systolic hypertension (systolic non-dipping alteration is very frequent in children with renal scarring. Nocturnal diastolic blood pressure, detectable only via ABPM, is positively correlated with proteinuria and may be an initial sign of the progression of renal scarring. ABPM is more sensitive than CBP in the evaluation of BP in children with renal scarring.

  12. Toward Instructional Leadership: Principals' Perceptions of Large-Scale Assessment in Schools

    Science.gov (United States)

    Prytula, Michelle; Noonan, Brian; Hellsten, Laurie

    2013-01-01

    This paper describes a study of the perceptions that Saskatchewan school principals have regarding large-scale assessment reform and their perceptions of how assessment reform has affected their roles as principals. The findings revealed that large-scale assessments, especially provincial assessments, have affected the principal in Saskatchewan…

  13. Microneedle physical contact as a therapeutic for abnormal scars

    OpenAIRE

    Yeo, David C.; Balmayor, Elizabeth R.; Schantz, Jan-Thorsten; Xu, Chenjie

    2017-01-01

    Background Abnormal (keloid and hypertrophic) scars are a significant affliction with no satisfactory single modality therapy to-date. Available options are often ineffective, painful, potentially hazardous, and require healthcare personnel involvement. Herein a self-administered microneedle device based on drug-free physical contact for inhibiting abnormal scars is reported. Its therapeutic activity through microneedle contact eliminates hazards associated with toxic anti-scarring drugs whil...

  14. Developing a comprehensive scale to assess college multicultural programming.

    Science.gov (United States)

    Mallinckrodt, Brent; Miles, Joseph R; Bhaskar, Tripti; Chery, Nicole; Choi, Gahee; Sung, Mi-Ra

    2014-01-01

    A barrier to assessing effectiveness of multicultural programming is lack of a relatively brief instrument to measure the wide range of intended outcomes. A frequent goal of programming is to increase cultural empathy, but this is rarely the only intended outcome. We conducted focus groups of campus administrators, student affairs staff, and undergraduate instructors who identified a full range of racial/ethnic multicultural competencies that undergraduates should possess. An 84-item pool generated from these focus groups was combined with the 31-item Scale of Ethnocultural Empathy (SEE; Wang et al., 2003). These 115 items, together with instruments used to gauge concurrent validity, were administered to White undergraduate students in introductory psychology courses at the midpoint (n = 602) and end (n = 676) of fall semester. Exploratory factor analysis suggested 6 subscales for the Everyday Multicultural Competencies/Revised SEE (EMC/RSEE): (a) Cultural Openness and Desire to Learn; (b) Resentment and Cultural Dominance; (c) Anxiety and Lack of Multicultural Self-Efficacy; (d) Empathic Perspective-Taking; (e) Awareness of Contemporary Racism and Privilege; and (f) Empathic Feeling and Acting as an Ally. Item response theory principles guided final selection of subscale items. Analyses suggested good factor stability, reliability, and discriminant validity of the 48-item EMC/RSEE in these undergraduate samples. EMC/RSEE subscales were not strongly correlated with a measure of impression management and were significantly associated with measures of Openness to Diversity Challenge, and Universal-Diverse Orientation. (c) 2014 APA, all rights reserved.

  15. Assessing large-scale wildlife responses to human infrastructure development.

    Science.gov (United States)

    Torres, Aurora; Jaeger, Jochen A G; Alonso, Juan Carlos

    2016-07-26

    Habitat loss and deterioration represent the main threats to wildlife species, and are closely linked to the expansion of roads and human settlements. Unfortunately, large-scale effects of these structures remain generally overlooked. Here, we analyzed the European transportation infrastructure network and found that 50% of the continent is within 1.5 km of transportation infrastructure. We present a method for assessing the impacts from infrastructure on wildlife, based on functional response curves describing density reductions in birds and mammals (e.g., road-effect zones), and apply it to Spain as a case study. The imprint of infrastructure extends over most of the country (55.5% in the case of birds and 97.9% for mammals), with moderate declines predicted for birds (22.6% of individuals) and severe declines predicted for mammals (46.6%). Despite certain limitations, we suggest the approach proposed is widely applicable to the evaluation of effects of planned infrastructure developments under multiple scenarios, and propose an internationally coordinated strategy to update and improve it in the future.

  16. Referred Students' Performance on the Reynolds Intellectual Assessment Scales and the Wechsler Intelligence Scale for Children--Fourth Edition

    Science.gov (United States)

    Edwards, Oliver W.; Paulin, Rachel V.

    2007-01-01

    This study investigates the convergent relations of the Reynolds Intellectual Assessment Scales (RIAS) and the Wechsler Intelligence Scale for Children--Fourth Edition (WISC-IV). Data from counterbalanced administrations of each instrument to 48 elementary school students referred for psychoeducational testing were examined. Analysis of the 96…

  17. Scarred resonances and steady probability distribution in a chaotic microcavity

    International Nuclear Information System (INIS)

    Lee, Soo-Young; Rim, Sunghwan; Kim, Chil-Min; Ryu, Jung-Wan; Kwon, Tae-Yoon

    2005-01-01

    We investigate scarred resonances of a stadium-shaped chaotic microcavity. It is shown that two components with different chirality of the scarring pattern are slightly rotated in opposite ways from the underlying unstable periodic orbit, when the incident angles of the scarring pattern are close to the critical angle for total internal reflection. In addition, the correspondence of emission pattern with the scarring pattern disappears when the incident angles are much larger than the critical angle. The steady probability distribution gives a consistent explanation about these interesting phenomena and makes it possible to expect the emission pattern in the latter case

  18. NEW MOLECULAR MEDICINE-BASED SCAR MANAGEMENT STRATEGIES

    Science.gov (United States)

    Arno, Anna I; Gauglitz, Gerd G; Barret, Juan P; Jeschke, Marc G

    2014-01-01

    Keloids and hypertrophic scars are prevalent disabling conditions with still suboptimal treatments. Basic science and molecular-based medicine research has contributed to unravel new bench-to-bedside scar therapies, and to dissect the complex signaling pathways involved. Peptides such as transforming growth factor beta (TGF-β) superfamily, with SMADs, Ski, SnoN, Fussels, endoglin, DS-Sily, Cav-1p, AZX100, thymosin-β4 and other related molecules may emerge as targets to prevent and treat keloids and hypertrophic scars. The aim of this review is to describe the basic complexity of these new molecular scar management strategies, and point out new fibrosis research lines. PMID:24438742

  19. Abnormal pigmentation within cutaneous scars: A complication of wound healing

    Directory of Open Access Journals (Sweden)

    Sarah Chadwick

    2012-01-01

    Full Text Available Abnormally pigmented scars are an undesirable consequence of cutaneous wound healing and are a complication every single individual worldwide is at risk of. They present a challenge for clinicians, as there are currently no definitive treatment options available, and render scars much more noticeable making them highly distressing for patients. Despite extensive research into both wound healing and the pigment cell, there remains a scarcity of knowledge surrounding the repigmentation of cutaneous scars. Pigment production is complex and under the control of many extrinsic and intrinsic factors and patterns of scar repigmentation are unpredictable. This article gives an overview of human skin pigmentation, repigmentation following wounding and current treatment options.

  20. Construction and pilot assessment of the Lower Limb Function Assessment Scale.

    Science.gov (United States)

    Allart, Etienne; Paquereau, Julie; Rogeau, Caroline; Daveluy, Walter; Kozlowski, Odile; Rousseaux, Marc

    2014-01-01

    Stroke often leads to upright standing and walking impairments. Clinical assessments do not sufficiently address ecological aspects and the patient's subjective evaluation of function. To perform a pilot assessment of the psychometric properties of the Lower Limb-Function Assessment Scale (LL-FAS). The LL-FAS includes 30 items assessing the patient's perception (in a questionnaire) and the examiner's perception (in a practical test) of upright standing and walking impairments and their impact on activities of daily living. We analyzed the LL-FAS's reliability, construct validity, internal consistency, predictive validity and feasibility. Thirty-five stroke patients were included. The scale's mean ± SD completion time was 25 ± 6 min. Intra-observer reliability was good to excellent (intraclass correlation coefficients (ICC >0.82). Interobserver reliability was moderate (0.67 0.9) and predictive validity were excellent. The LL-FAS showed fair psychometric properties in this pilot study and may be of value for evaluating post-stroke lower limb impairment.

  1. The Efficacy of Fibroblast Growth Factor for the Treatment of Chronic Vocal Fold Scarring: From Animal Model to Clinical Application.

    Science.gov (United States)

    Ban, Myung Jin; Park, Jae Hong; Kim, Jae Wook; Park, Ki Nam; Lee, Jae Yong; Kim, Hee Kyung; Lee, Seung Won

    2017-12-01

    This study assessed the regenerative efficacy of basic fibroblast growth factor (FGF) in a rabbit model of chronic vocal fold scarring and then confirmed its utility and safety in a prospective trial of patients with this condition. FGF was injected three times, at 1-week intervals, into a chronic vocal fold scar created in a rabbit model. After 1 month, mRNA level of procollagen I, hyaluronic acid synthetase 2 (HAS 2), and matrix metalloproteinase 2 (MMP 2) were analyzed by real-time polymerase chain reaction. The relative densities of hyaluronic acid (HA) and collagen were examined 3 months post-injection. From April 2012 to September 2014, a prospective clinical trial was conducted at a tertiary hospital in Korea. FGF was injected into the mild vocal fold scar of 17 consecutive patients with a small glottic gap. The patients underwent perceptual, stroboscopic, acoustic aerodynamic test, and Voice Handicap Index (VHI) survey prior to and 3, 6, and 12 months after FGF injection. FGF injection of the vocal fold scar decreased the density of collagen and increased mRNA level of HAS 2 and MMP 2 expression significantly compared to the control group injected with phosphate buffered solution in a rabbit model (Pvocal fold injections of FGF in patients with mild chronic vocal fold scarring can significantly improve voice quality for as long as 1 year and without side effects. Our results recommend the use of FGF vocal fold injection as an alternative treatment modality for mild chronic vocal fold scarring.

  2. Treatment of facial atrophic scars with Esthélis, a hyaluronic acid filler with polydense cohesive matrix (CPM).

    Science.gov (United States)

    Hasson, Ariel; Romero, William A

    2010-12-01

    The treatment of atrophic scars is difficult and dermal filler materials provide a simple alternative with immediate results. Esthélis® is an injectable non-animal crosslinked hyaluronic acid of Swiss origin characterized by a polydense cohesive matrix (CPM®) which produces a gel of uniform consistency with better biointegration to the tissues and a longer duration. To evaluate Esthélis in the treatment of atrophic scars. Twelve patients aged 18-56 years with facial atrophic scars caused by acne vulgaris, dog bite, piercing, basal cell carcinoma and leishmaniasis were treated with Esthélis. The injection technique was linear threading, serial puncture or a combination of both. Clinical efficacy was assessed independently by the authors and by patients immediately, one week and one month after the injection. Adverse events were registered. Authors described the results as moderate (27%), good (57%) and excellent (17%), immediately, one week and one month after the injection. Patients evaluated the cosmetic improvement as good (42%) or excellent (58%) one month after the treatment. Pain during the injection was described as slight or moderate. Only mild erythema was observed immediately after injection, which spontaneously resolved within few hours. Esthélis showed good or excellent results in most patients with atrophic scars, and these were perceived as even better when patients evaluated the cosmetic improvement. The best results were observed in patients with more deforming scars such as surgical scars or trauma.

  3. Management of periocular post burn scarring in the epileptics

    International Nuclear Information System (INIS)

    Cheema, A.M.; Saeed, M.; Ghani, A.; Akhter, S.W.

    2003-01-01

    Objective: To assess the clinical presentation and management of patients with epilepsy presenting with periocular post burn scarring. Results: There were 18 (78.26%) female and 5(21.73%) male patients. The age range was from 18 to 45 years with a mean of 28 years. In 17 (73.91%) patients, lid contracture was released to cover their eyeballs. In 6 (26.08%) patients the eyeball was lost due to late presentation. Conclusion: There should be a high index of suspicion in facial burns for ophthalmic damage and early referral to an ophthalmologist should be made to prevent complications. Early release of contracture with application of full or partial thickness skin grafts is advisable. (author)

  4. Photogrammetric techniques for across-scale soil erosion assessment

    OpenAIRE

    Eltner, Anette

    2016-01-01

    Soil erosion is a complex geomorphological process with varying influences of different impacts at different spatio-temporal scales. To date, measurement of soil erosion is predominantly realisable at specific scales, thereby detecting separate processes, e.g. interrill erosion contrary to rill erosion. It is difficult to survey soil surface changes at larger areal coverage such as field scale with high spatial resolution. Either net changes at the system outlet or remaining traces after the ...

  5. The effect of scale in daily precipitation hazard assessment

    Directory of Open Access Journals (Sweden)

    J. J. Egozcue

    2006-01-01

    Full Text Available Daily precipitation is recorded as the total amount of water collected by a rain-gauge in 24 h. Events are modelled as a Poisson process and the 24 h precipitation by a Generalised Pareto Distribution (GPD of excesses. Hazard assessment is complete when estimates of the Poisson rate and the distribution parameters, together with a measure of their uncertainty, are obtained. The shape parameter of the GPD determines the support of the variable: Weibull domain of attraction (DA corresponds to finite support variables as should be for natural phenomena. However, Fréchet DA has been reported for daily precipitation, which implies an infinite support and a heavy-tailed distribution. Bayesian techniques are used to estimate the parameters. The approach is illustrated with precipitation data from the Eastern coast of the Iberian Peninsula affected by severe convective precipitation. The estimated GPD is mainly in the Fréchet DA, something incompatible with the common sense assumption of that precipitation is a bounded phenomenon. The bounded character of precipitation is then taken as a priori hypothesis. Consistency of this hypothesis with the data is checked in two cases: using the raw-data (in mm and using log-transformed data. As expected, a Bayesian model checking clearly rejects the model in the raw-data case. However, log-transformed data seem to be consistent with the model. This fact may be due to the adequacy of the log-scale to represent positive measurements for which differences are better relative than absolute.

  6. Fractional ablative carbon dioxide laser resurfacing for skin rejuvenation and acne scars in Asians.

    Science.gov (United States)

    Chan, Nicola P Y; Ho, Stephanie G Y; Yeung, Chi K; Shek, Samantha Y N; Chan, Henry H

    2010-11-01

    Ablative fractional resurfacing (AFR) is a new modality for photorejuvenation and acne scars which combines carbon dioxide (CO₂) laser ablation with fractional photothermolysis. The objective is to evaluate the efficacy and side effects of a new fractional CO₂ ablative device (Fraxel Re:pair) for skin rejuvenation and acne scars in Asians. Nine patients underwent one full-face treatment. The energy levels ranged from 30-70 mJ with coverage between 30% and 45%. Improvement in skin texture, laxity, wrinkles, enlarged pores, overall pigmentation irregularity, and adverse effects were assessed up to 6 months post-treatment. Standardized photographs using the Canfield Visia CR system® were assessed by two independent observers. Subjective improvement was assessed by patient questionnaires. Nine Chinese patients (skin types III and IV, mean age 44.8) were included. Statistically significant improvements were seen for skin texture, skin laxity, wrinkles, enlarged pores, and acne scars. The post-inflammatory hyperpigmentation rate was 55.5% and 11.1% at 1 and 6 months post-treatment, respectively. Eighty-six percent of patients were overall satisfied to very satisfied with the treatment. Ablative fractional CO₂ laser resurfacing was overall safe and effective for skin rejuvenation and acne scars in Asians. However, in view of the high post-inflammatory rate and the statistically significant but only mild to moderate improvement after a single treatment as observed in this study, there is a need to review the current role of fractional ablative CO₂ laser treatment as compared to fractional non-ablative for skin rejuvenation and acne scar treatment in Asians. © 2010 Wiley-Liss, Inc.

  7. Ten-year review of rating scales. III: scales assessing suicidality, cognitive style, and self-esteem.

    Science.gov (United States)

    Winters, Nancy C; Myers, Kathleen; Proud, Laura

    2002-10-01

    This is the third article in a series of 10-year reviews of rating scales. Here, the authors review scales that are useful in tapping the affective disturbances experienced with various psychiatric disorders, including suicidality, cognitive style, and self-esteem. The authors sampled articles incorporating these constructs over the past 25 years and selected scales with established uses or new development. Those presented here have adequate psychometric properties and high utility for efficiently elucidating youths' functioning, plus either wide literature citations or a special niche. These scales were developed bimodally. Many were developed in the 1980s when internalizing disorders were elucidated, but there has been a resurgence of interest in these constructs. Scales assessing suicidality have clear constructs, whereas scales of cognitive style demonstrate deficits in developmental relevance, and scales of self-esteem suffer from lax constructs. The constructs underlying these scales tap core symptoms of internalizing disorders, mediate the expression of affective disturbances associated with various disorders, and depict the impairments resulting from these disorders. Overall, the psychometrics of these scales are adequate. These scales provide a broader representation of youths' functioning than that conveyed with diagnostic scales alone.

  8. Development and Assessment of the Social Issues Advocacy Scale

    Science.gov (United States)

    Nilsson, Johanna E.; Marszalek, Jacob M.; Linnemeyer, Rachel M.; Bahner, Angela D.; Misialek, Leah Hanson

    2011-01-01

    This article describes the development and the initial psychometric evaluation of the Social Issues Advocacy Scale in two studies. In the first study, an exploratory factor analysis (n = 278) revealed a four-factor scale, accounting for 71.4% of the variance, measuring different aspects of social issue advocacy: Political and Social Advocacy,…

  9. Scaling of Thermal-Hydraulic Phenomena and System Code Assessment

    International Nuclear Information System (INIS)

    Wolfert, K.

    2008-01-01

    In the last five decades large efforts have been undertaken to provide reliable thermal-hydraulic system codes for the analyses of transients and accidents in nuclear power plants. Many separate effects tests and integral system tests were carried out to establish a data base for code development and code validation. In this context the question has to be answered, to what extent the results of down-scaled test facilities represent the thermal-hydraulic behaviour expected in a full-scale nuclear reactor under accidental conditions. Scaling principles, developed by many scientists and engineers, present a scientific technical basis and give a valuable orientation for the design of test facilities. However, it is impossible for a down-scaled facility to reproduce all physical phenomena in the correct temporal sequence and in the kind and strength of their occurrence. The designer needs to optimize a down-scaled facility for the processes of primary interest. This leads compulsorily to scaling distortions of other processes with less importance. Taking into account these weak points, a goal oriented code validation strategy is required, based on the analyses of separate effects tests and integral system tests as well as transients occurred in full-scale nuclear reactors. The CSNI validation matrices are an excellent basis for the fulfilling of this task. Separate effects tests in full scale play here an important role.

  10. Medicine in words and numbers: a cross-sectional survey comparing probability assessment scales

    Directory of Open Access Journals (Sweden)

    Koele Pieter

    2007-06-01

    Full Text Available Abstract Background In the complex domain of medical decision making, reasoning under uncertainty can benefit from supporting tools. Automated decision support tools often build upon mathematical models, such as Bayesian networks. These networks require probabilities which often have to be assessed by experts in the domain of application. Probability response scales can be used to support the assessment process. We compare assessments obtained with different types of response scale. Methods General practitioners (GPs gave assessments on and preferences for three different probability response scales: a numerical scale, a scale with only verbal labels, and a combined verbal-numerical scale we had designed ourselves. Standard analyses of variance were performed. Results No differences in assessments over the three response scales were found. Preferences for type of scale differed: the less experienced GPs preferred the verbal scale, the most experienced preferred the numerical scale, with the groups in between having a preference for the combined verbal-numerical scale. Conclusion We conclude that all three response scales are equally suitable for supporting probability assessment. The combined verbal-numerical scale is a good choice for aiding the process, since it offers numerical labels to those who prefer numbers and verbal labels to those who prefer words, and accommodates both more and less experienced professionals.

  11. External charring and fire scarring in three western conifers

    Science.gov (United States)

    E. K. Sutherland; Josh Farella; David K Wright; Ian Hyp; K. T. Smith; Donald A. Falk; Estelle Arbellay; Markus Stoffel

    2013-01-01

    Fires that injure but do not kill trees cause scars used as proxies for the reconstruction of wildfire history. Understanding about these wildfires - and their relationship to vegetation dynamics and climate - has profoundly affected wildfire and land management policy globally. To better understand scarring in the context of wildfire behavior, landscape and biological...

  12. Macroanatomy of compartmentalization in fire scars of three western conifers

    Science.gov (United States)

    Kevin T. Smith; Elaine Sutherland; Estelle Arbellay; Markus Stoffel; Donald. Falk

    2013-01-01

    Fire scars are visible evidence of compartmentalization and closure processes that contribute to tree survival after fire injury. Preliminary observations of dissected fire scars from trees injured within the last decade showed centripetal development of wound-initiated discoloration (WID) through 2-3 decades of former sapwood in Larix occidentalis and Pseudotsuga...

  13. Fractional CO2 laser resurfacing for atrophic acne scars

    DEFF Research Database (Denmark)

    Hedelund, Lene; Haak, Christina Skovbølling; Togsverd-Bo, Katrine

    2012-01-01

    The treatment of acne scars with fractional CO(2) lasers is gaining increasing impact, but has so far not been compared side-by-side to untreated control skin.......The treatment of acne scars with fractional CO(2) lasers is gaining increasing impact, but has so far not been compared side-by-side to untreated control skin....

  14. Relationship between tuberculous scar and carcinomas of the lung

    International Nuclear Information System (INIS)

    Richardson, S.; Hirsch, A.; Bickel, M.

    1987-01-01

    Results of a transversal case-control study are reported which shows that there is a statistically significant association between tuberculous scars and carcinoma of the lung. Accordingly the possibility of malignancy has to be kept in mind when radiological or scintigraphic scanning reveal the presence of lung scars. (orig.)

  15. Trachomatous Scar Ranking: A Novel Outcome for Trachoma Studies.

    Science.gov (United States)

    Baldwin, Angela; Ryner, Alexander M; Tadesse, Zerihun; Shiferaw, Ayalew; Callahan, Kelly; Fry, Dionna M; Zhou, Zhaoxia; Lietman, Thomas M; Keenan, Jeremy D

    2017-06-01

    AbstractWe evaluated a new trachoma scarring ranking system with potential use in clinical research. The upper right tarsal conjunctivas of 427 individuals from Ethiopian villages with hyperendemic trachoma were photographed. An expert grader first assigned a scar grade to each photograph using the 1981 World Health Organization (WHO) grading system. Then, all photographs were ranked from least (rank = 1) to most scarring (rank = 427). Photographic grading found 79 (18.5%) conjunctivae without scarring (C0), 191 (44.7%) with minimal scarring (C1), 105 (24.6%) with moderate scarring (C2), and 52 (12.2%) with severe scarring (C3). The ranking method demonstrated good internal validity, exhibiting a monotonic increase in the median rank across the levels of the 1981 WHO grading system. Intrarater repeatability was better for the ranking method (intraclass correlation coefficient = 0.84, 95% CI = 0.74-0.94). Exhibiting better internal and external validity, this ranking method may be useful for evaluating the difference in scarring between groups of individuals.

  16. Intralesional Cryotherapy for Treatment of Keloid Scars: A Prospective Study

    NARCIS (Netherlands)

    van Leeuwen, M.C.E.; van der Wal, M.B.A.; Bulstra, A.E.J.; Galindo Garre, F.; Molier, J.; van Zuijlen, P.P.M.; van Leeuwen, P.A.M.; Niessen, F.B.

    2015-01-01

    Background: Intralesional cryotherapy is a novel treatment for keloid scars in which the scar is frozen from inside. Published results are promising, but the treatment has only been tested in a Caucasian patient population. Therefore, the authors evaluated intralesional cryotherapy in a patient

  17. Validity, reliability and support for implementation of independence-scaled procedural assessment in laparoscopic surgery.

    Science.gov (United States)

    Kramp, Kelvin H; van Det, Marc J; Veeger, Nic J G M; Pierie, Jean-Pierre E N

    2016-06-01

    There is no widely used method to evaluate procedure-specific laparoscopic skills. The first aim of this study was to develop a procedure-based assessment method. The second aim was to compare its validity, reliability and feasibility with currently available global rating scales (GRSs). An independence-scaled procedural assessment was created by linking the procedural key steps of the laparoscopic cholecystectomy to an independence scale. Subtitled and blinded videos of a novice, an intermediate and an almost competent trainee, were evaluated with GRSs (OSATS and GOALS) and the independence-scaled procedural assessment by seven surgeons, three senior trainees and six scrub nurses. Participants received a short introduction to the GRSs and independence-scaled procedural assessment before assessment. The validity was estimated with the Friedman and Wilcoxon test and the reliability with the intra-class correlation coefficient (ICC). A questionnaire was used to evaluate user opinion. Independence-scaled procedural assessment and GRS scores improved significantly with surgical experience (OSATS p = 0.001, GOALS p < 0.001, independence-scaled procedural assessment p < 0.001). The ICCs of the OSATS, GOALS and independence-scaled procedural assessment were 0.78, 0.74 and 0.84, respectively, among surgeons. The ICCs increased when the ratings of scrub nurses were added to those of the surgeons. The independence-scaled procedural assessment was not considered more of an administrative burden than the GRSs (p = 0.692). A procedural assessment created by combining procedural key steps to an independence scale is a valid, reliable and acceptable assessment instrument in surgery. In contrast to the GRSs, the reliability of the independence-scaled procedural assessment exceeded the threshold of 0.8, indicating that it can also be used for summative assessment. It furthermore seems that scrub nurses can assess the operative competence of surgical trainees.

  18. [Concurrent validation of the suicidal risk assessment scale (R.S.D.) with the Beck's suicidal ideation scale].

    Science.gov (United States)

    Ducher, J-L; Daléry, J

    2004-01-01

    The prevention of suicide is a top priority in mental health. The determination of high risk suicidal groups is not sufficient. The expressing suicidal ideas is not a protective factor, but in contrary a risk factor to take into account, or even to search and to quantify: 80% of the subjects who attempt to commit suicide or commit suicide express such ideas months before. Several evaluation instruments try to help the practitioners or the research workers in this reasoning. The suicidal risk assessment scale RSD can be cited in particular. It is composed of eleven sections. The 0 level corresponds to the absence of particular ideas of death or suicide. Levels 1 and 2, the presence of ideas of death. Levels 3-4-5, the presence of suicidal ideas. The difference compared to the majority of the other scales consecrated to the same subject, the passif desire of death, occupies a place totally particular in the RSD (level 6). From the level 7, the risk of acting out seems to become more important. It stops being a simple idea of suicide, but becomes a real will of dying, firstly retained by something or someone (level 7), the fear of causing suffering to dear ones or a religious belief., then determined (level 8). Finally, the patient has elaborated a concrete plan (level 9) or he has already started the preparation of acting out (level 10). It is just necessary to evaluate and to note the highest level of the scale. The inclusion of the suicidal risk assessment scale RSD and of the Suicidal Ideation Scale by Beck in an international multicenters, phase IV, double-blind study, according to two parallel groups, with a fixed dose of fluoxétine or fluvoxamine for six weeks, allowed to search correlations which could exist between the two scales. The ana-lysis before the beginning of the treatment was done on 108 outpatients depressive, male and female, aged 18 or over. It finds a satisfactory concurrent validity between the suicidal risk assessment scale RSD and the

  19. Semiclassical scar functions in phase space

    International Nuclear Information System (INIS)

    Rivas, Alejandro M F

    2007-01-01

    We develop a semiclassical approximation for the scar function in the Weyl-Wigner representation in the neighborhood of a classically unstable periodic orbit of chaotic two-dimensional systems. The prediction of hyperbolic fringes, asymptotic to the stable and unstable manifolds, is verified computationally for a (linear) cat map, after the theory is adapted to a discrete phase space appropriate to a quantized torus. Characteristic fringe patterns can be distinguished even for quasi-energies where the fixed point is not Bohr-quantized. Also the patterns are highly localized in the neighborhood of the periodic orbit and along its stable and unstable manifolds without any long distance patterns that appear for the case of the spectral Wigner function

  20. Breast Cancer from the Excisional Scar of a Benign Mass

    International Nuclear Information System (INIS)

    Kim, Min Jung; Kim, Eun Kyung; Lee, Ji Young; Youk, Ji Hyun; Park, Byeong Woo; Kim, Hae Ryoung; Oh, Ki Keun

    2007-01-01

    Burns and chronic inflammation are well-known circumstances in which malignant transformation may occur during wound healing. There are many reports of malignancies developing from a burn scar; however, there are only a few reports of malignancy arising from chronic inflammation or from the skin of a surgical scar following excision of a benign mass, in any part of the body. There are only twelve reported cases of breast cancer developing from a surgical scar, moreover, there have been no reports in the last 30 years. This case is a recent example of breast cancer developing in a surgical scar that showed subtle changes on sequential sonograms. The imaging findings of this case were subtle but the mass that had been shrinking developed an angular margin in one region. These findings, along with the penetrating vascularity revealed on Doppler, prompted us to proceed to a biopsy of the lesion. It was of critical importance to compare the size and the shape of the lesion with previous ultrasounds in order to exclude malignancy in any iatrogenically altered lesion. Based on this case, we conclude that whenever a subtle change is detected, at a surgical site, a biopsy should be performed. Breast cancer developing from a surgical scar is rare; this type of malignancy has been reported in only 12 cases to date. Herein, we report on a 52-year-old female who developed infiltrating ductal carcinoma in a surgical scar following excision of a benign mass. Two years previously, the patient underwent surgery and radiotherapy for invasive ductal carcinoma of the contralateral breast. The initial appearance of the scar was similar to fat necrosis; it was observed to be progressively shrinking on follow-up sonography. On the two year follow-up ultrasound, the appearance changed, an angular margin and vascularity at the periphery of the scar were noted. A biopsy and subsequent excision of the scar were performed; the diagnosis of infiltrating ductal carcinoma of the scar was

  1. 3D-printed transparent facemasks in the treatment of facial hypertrophic scars of young children with burns.

    Science.gov (United States)

    Wei, Yating; Li-Tsang, Cecilia W P; Liu, Jun; Xie, Lihua; Yue, Shukai

    2017-05-01

    Facial burns could create serious scar problems resulting disfigurement particularly on children. The conventional methods of producing transparent face masks for scar control remains complex and require dexterous skills of experienced clinician and patients' compliance during fitting. In this study, we adopted a portable 3D scanning and Computer-Aided Design (CAD) to produce 3D-printed transparent facemasks. Its efficacy was tested on two children with facial burns resulting hypertrophic scars. This study adopted a longitudinal case follow up research design. Two children with facial burns were recruited in the study upon consent. Their facial features were scanned with a portable 3D scanner and then edited and converted to the target files: the customized printable facemask files. The transparent facemask was directly printed out on the transparent biocompatible material followed by adding the medical grade silicone gel to provide extra pressure on the scar site. The facemasks were fitted to the patients with elastic straps connecting the printed anchoring bolts. Both children and family were instructed to wear the facemask for at least 20h per day and they were assessed before treatment, one month and three months after treatment on the facial scar conditions. At the one-month and three-month assessments after treatment, a decrease in average scar thickness was shown and the facial appearance was satisfactory. The 3D-printed facemasks were well fitted on both patients. The treatment was well-tolerated and no complication was reported. 3D-printed transparent facemask is convenient and efficient to fabricate, and is suitable for treating pediatric facial hypertrophic scars after burn. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  2. Genomic scar signatures associated with homologous recombination deficiency predict adverse clinical outcomes in patients with ovarian clear cell carcinoma.

    Science.gov (United States)

    Chao, Angel; Lai, Chyong-Huey; Wang, Tzu-Hao; Jung, Shih-Ming; Lee, Yun-Shien; Chang, Wei-Yang; Yang, Lan-Yang; Ku, Fei-Chun; Huang, Huei-Jean; Chao, An-Shine; Wang, Chin-Jung; Chang, Ting-Chang; Wu, Ren-Chin

    2018-05-03

    We investigated whether genomic scar signatures associated with homologous recombination deficiency (HRD), which include telomeric allelic imbalance (TAI), large-scale transition (LST), and loss of heterozygosity (LOH), can predict clinical outcomes in patients with ovarian clear cell carcinoma (OCCC). We enrolled patients with OCCC (n = 80) and high-grade serous carcinoma (HGSC; n = 92) subjected to primary cytoreductive surgery, most of whom received platinum-based adjuvant chemotherapy. Genomic scar signatures based on genome-wide copy number data were determined in all participants and investigated in relation to prognosis. OCCC had significantly lower genomic scar signature scores than HGSC (p < 0.001). Near-triploid OCCC specimens showed higher TAI and LST scores compared with diploid tumors (p < 0.001). While high scores of these genomic scar signatures were significantly associated with better clinical outcomes in patients with HGSC, the opposite was evident for OCCC. Multivariate survival analysis in patients with OCCC identified high LOH scores as the main independent adverse predictor for both cancer-specific (hazard ratio [HR] = 3.22, p = 0.005) and progression-free survival (HR = 2.54, p = 0.01). In conclusion, genomic scar signatures associated with HRD predict adverse clinical outcomes in patients with OCCC. The LOH score was identified as the strongest prognostic indicator in this patient group. Genomic scar signatures associated with HRD are less frequent in OCCC than in HGSC. Genomic scar signatures associated with HRD have an adverse prognostic impact in patients with OCCC. LOH score is the strongest adverse prognostic factor in patients with OCCC.

  3. Fibromodulin reduces scar size and increases scar tensile strength in normal and excessive-mechanical-loading porcine cutaneous wounds.

    Science.gov (United States)

    Jiang, Wenlu; Ting, Kang; Lee, Soonchul; Zara, Janette N; Song, Richard; Li, Chenshuang; Chen, Eric; Zhang, Xinli; Zhao, Zhihe; Soo, Chia; Zheng, Zhong

    2018-04-01

    Hypertrophic scarring is a major postoperative complication which leads to severe disfigurement and dysfunction in patients and usually requires multiple surgical revisions due to its high recurrence rates. Excessive-mechanical-loading across wounds is an important initiator of hypertrophic scarring formation. In this study, we demonstrate that intradermal administration of a single extracellular matrix (ECM) molecule-fibromodulin (FMOD) protein-can significantly reduce scar size, increase tensile strength, and improve dermal collagen architecture organization in the normal and even excessive-mechanical-loading red Duroc pig wound models. Since pig skin is recognized by the Food and Drug Administration as the closest animal equivalent to human skin, and because red Duroc pigs show scarring that closely resembles human proliferative scarring and hypertrophic scarring, FMOD-based technologies hold high translational potential and applicability to human patients suffering from scarring-especially hypertrophic scarring. © 2018 The Authors. Journal of Cellular and Molecular Medicine published by John Wiley & Sons Ltd and Foundation for Cellular and Molecular Medicine.

  4. Reliability and validity of a physical activity social support assessment scale in adolescents - ASAFA Scale

    Directory of Open Access Journals (Sweden)

    José Cazuza de Farias Júnior

    2014-06-01

    Full Text Available Objective: To analyze the reliability and validity of a scale used to measure social support for physical activity in adolescents - ASAFA Scale. Methods: This study included 2,755 adolescents (57.6% girls, 16.5 ± 1.2 years of age, from Joao Pessoa, Paraiba, Brazil. Initially, the scale was consisted of 12 items (6 for social support from parents and 6 from friends. The reliability of the scale was estimated by Cronbach's alpha coefficient (α, by the Composite Reliability (CR, and by the model with two factors and factorial invariance by Confirmatory Factor Analysis (CFA adequacy. Results: The CFA results confirmed that the social support scale contained two factors (factor 1: social support from parents; factor 2: social support from friends with five items each (one item was excluded from each scale, all with high factor loadings (> 0.65 and acceptable adjustment indexes (RMR = 0.050; RMSEA = 0.063; 90%CI: 0.060 - 0.067; AGFI = 0.903; GFI = 0.940; CFI = 0.934, NNFI = 0.932. The internal consistency was satisfactory (parents: α ≥ 0.77 and CR ≥ 0.83; friends: α ≥ 0.87 and CR ≥ 0.91. The scale's factorial invariance was confirmed (p > 0.05; Δχ2 and ΔCFI ≤ 0.01 across all subgroups analyzed (gender, age, economic class. The construct validity was evidenced by the significant association (p < 0.05 between the adolescents physical activity level and the social support score of parents (rho = 0.29 and friends (rho = 0.39. Conclusions: The scale showed reliability, factorial invariance and satisfactory validity, so it can be used in studies with adolescents.

  5. Item reduction and psychometric validation of the Oily Skin Self Assessment Scale (OSSAS) and the Oily Skin Impact Scale (OSIS).

    Science.gov (United States)

    Arbuckle, Robert; Clark, Marci; Harness, Jane; Bonner, Nicola; Scott, Jane; Draelos, Zoe; Rizer, Ronald; Yeh, Yating; Copley-Merriman, Kati

    2009-01-01

    Developed using focus groups, the Oily Skin Self Assessment Scale (OSSAS) and Oily Skin Impact Scale (OSIS) are patient-reported outcome measures of oily facial skin. The aim of this study was to finalize the item-scale structure of the instruments and perform psychometric validation in adults with self-reported oily facial skin. The OSSAS and OSIS were administered to 202 adult subjects with oily facial skin in the United States. A subgroup of 152 subjects returned, 4 to 10 days later, for test–retest reliability evaluation. Of the 202 participants, 72.8% were female; 64.4% had self-reported nonsevere acne. Item reduction resulted in a 14-item OSSAS with Sensation (five items), Tactile (four items) and Visual (four items) domains, a single blotting item, and an overall oiliness item. The OSIS was reduced to two three-item domains assessing Annoyance and Self-Image. Confirmatory factor analysis supported the construct validity of the final item-scale structures. The OSSAS and OSIS scales had acceptable item convergent validity (item-scale correlations >0.40) and floor and ceiling effects (skin severity (P skin (P skin), as assessments of self-reported oily facial skin severity and its emotional impact, respectively.

  6. The value of the 12-lead electrocardiogram in localizing the scar in non-ischaemic cardiomyopathy.

    Science.gov (United States)

    Oloriz, Teresa; Wellens, Hein J J; Santagostino, Giulia; Trevisi, Nicola; Silberbauer, John; Peretto, Giovanni; Maccabelli, Giuseppe; Della Bella, Paolo

    2016-12-01

    Patients with non-ischaemic cardiomyopathy (NICM) and ventricular tachycardia can be categorized as anteroseptal (AS) or inferolateral (IL) scar sub-types based on imaging and voltage mapping studies. The aim of this study was to correlate the baseline electrocardiogram (ECG) with endo-epicardial voltage maps created during ablation procedures and identify the ECG characteristics that may help to distinguish the scar as AS or IL. We assessed 108 baseline ECGs; 72 patients fulfilled criteria for dilated cardiomyopathy whereas 36 showed minimal structural abnormalities. Based on the unipolar low-voltage distribution, the scar pattern was classified as predominantly AS (n = 59) or IL (n = 49). Three ECG criteria (PR interval 230 ms or QRS > 170 ms or an r ≤ 0.3 mV in V3 having 92 and 81% of sensitivity and specificity, respectively, in predicting AS scar pattern. A significant negative correlation was found between the extension of the endocardial unipolar low voltage area and left ventricular EF (r s = -0.719, P < 0.001). The extent of endocardial AS unipolar low voltage was correlated with PR interval and QRS duration (r s = 0.583 and r s = 0.680, P < 0.001, respectively) and the IL epicardial unipolar low voltage with the mean voltage of the limb leads (r s = -0.639, P < 0.001). Baseline ECG features are well correlated with the distribution of unipolar voltage abnormalities in NICM and may help to predict the location of scar in this population. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2015. For permissions please email: journals.permissions@oup.com.

  7. Efficacy and safety of Erbium-doped Yttrium Aluminium Garnet fractional resurfacing laser for treatment of facial acne scars

    Directory of Open Access Journals (Sweden)

    Balakrishnan Nirmal

    2013-01-01

    Full Text Available Background: Treatment of acne scars with ablative fractional laser resurfacing has given good improvement. But, data on Indian skin are limited. A study comparing qualitative, quantitative, and subjective assessments is also lacking. Aim: Our aim was to assess the improvement of facial acne scars with Erbium-doped Yttrium Aluminium Garnet (Er:YAG 2940 nm fractional laser resurfacing and its adverse effects in 25 patients at a tertiary care teaching hospital. Methods: All 25 patients received four treatment sessions with Er:YAG fractional laser at 1-month interval. The laser parameters were kept constant for each of the four sittings in all patients. Qualitative and quantitative assessments were done using Goodman and Barron grading. Subjective assessment in percentage of improvement was also documented 1 month after each session. Photographs were taken before each treatment session and 1 month after the final session. Two unbiased dermatologists performed independent clinical assessments by comparing the photographs. The kappa statistics was used to monitor the agreement between the dermatologists and patients. Results: Most patients (96% showed atleast fair improvement. Rolling and superficial box scars showed higher significant improvement when compared with ice pick and deep box scars. Patient′s satisfaction of improvement was higher when compared to physician′s observations. No serious adverse effects were noted with exacerbation of acne lesions forming the majority. Conclusion: Ablative fractional photothermolysis is both effective and safe treatment for atrophic acne scars in Indian skin.Precise evaluation of acne scar treatment can be done by taking consistent digital photographs.

  8. Using Longitudinal Scales Assessment for Instrumental Music Students

    Science.gov (United States)

    Simon, Samuel H.

    2014-01-01

    In music education, current assessment trends emphasize student reflection, tracking progress over time, and formative as well as summative measures. This view of assessment requires instrumental music educators to modernize their approaches without interfering with methods that have proven to be successful. To this end, the Longitudinal Scales…

  9. Vaccination technique, PPD reaction and BCG scarring in a cohort of children born in Guinea-Bissau 2000-2002

    DEFF Research Database (Denmark)

    Roth, Adam Anders Edvin; Sodemann, Morten; Jensen, Henrik

    2005-01-01

    and scarring in Guinea-Bissau. In a cohort of children born in suburban Bissau from March 2000 to July 2002, we assessed a Mantoux test with Purified protein derivative (PPD) (SSI, 2 T.U.) at 2 (2689 children), 6 (N=2148) and 12 months (N=1638) of age, and BCG scar was assessed at 2 (N=2698) and 6 months (N......=2225) of age. In a subgroup of the children the vaccination technique was monitored by direct observation of post-vaccination wheal and route of administration. Three different types of BCG vaccine supplied by the local Extended Programme on Immunization were used. At 6 months of age the rate of PPD...... reactors (>1mm) after BCG vaccination was 25% and the rate of scarring was 89%. One BCG strain was associated with fewer PPD reactors (OR=0.54 (0.31-0.91)) and BCG scars (OR=0.13 (0.05-0.37)) and larger post-vaccination wheals produced more PPD reactions (OR 1.21 (95% CI 1.02-1.43)) and BCG scars (OR 1...

  10. Evaluation of the clinical efficacy of fractional radiofrequency microneedle treatment in acne scars and large facial pores.

    Science.gov (United States)

    Cho, Soo Ick; Chung, Bo Young; Choi, Min Gyu; Baek, Ji Hwoon; Cho, Hee Jin; Park, Chun Wook; Lee, Cheol Heon; Kim, Hye One

    2012-07-01

    Fractional technology overcomes the problems of ablative lasers, such as inaccurate depth control and damage to the epidermis. Minimally invasive fractional radiofrequency microneedle devices allow for more-selective heating of the dermis. To evaluate the clinical efficacy of fractional radiofrequency microneedle (ERM) treatment in acne scars and large facial pores. Thirty patients with acne scars and large facial pores were enrolled. Bipolar radiofrequency energy was delivered to the skin through the electrodes of the FRM device. Skin lesions were evaluated according to grade of acne scars, Investigator Global Assessment of large pores, skin surface roughness, transepidermal water loss (TEWL), dermal density, microscopic and composite image, sebum measurement, and questionnaires regarding patient satisfaction. The grade of acne scars and Investigator Global Assessment of large pores improved in more than 70% of all patients. Skin surface roughness, dermal density, and microscopic and composite images also improved, whereas TEWL and sebum measurement did not change. Clinical improvement from FRM treatment appeared to be related to dermal matrix regeneration. FRM treatment may be effective in improving acne scars and facial pores. © 2012 by the American Society for Dermatologic Surgery, Inc. Published by Wiley Periodicals, Inc.

  11. Fatigue Assessment of Full-Scale Retrofitted Orthotropic Bridge Decks

    NARCIS (Netherlands)

    Teixeira De Freitas, S.; Kolstein, M.H.; Bijlaard, F.S.K.

    2017-01-01

    Full-scale fatigue tests were performed on two retrofitted orthotropic bridge decks (OBDs). The retrofitting systems consist of adding a second steel plate on the top of the existing deck. The aim is to reduce the stresses at the fatigue-sensitive details and therefore extend the fatigue life of

  12. Assessment of climate change impacts on rainfall using large scale ...

    Indian Academy of Sciences (India)

    Many of the applied techniques in water resources management can be directly or indirectly influenced by ... is based on large scale climate signals data around the world. In order ... predictand relationships are often very complex. .... constraints to solve the optimization problem. ..... social, and environmental sustainability.

  13. Psychological and psychosocial functioning of children with burn scarring using cosmetic camouflage: a multi-centre prospective randomised controlled trial.

    Science.gov (United States)

    Maskell, Jessica; Newcombe, Peter; Martin, Graham; Kimble, Roy

    2014-02-01

    Burns leave patients with long-term physical scarring. Children with scarring are required to face challenges of reintegration into their community, including acceptance of an altered appearance and acceptance by others. This can be difficult given society's preoccupation with physical appearance. Limited research exists investigating validity of cosmetic camouflage as a psychosocial intervention for children with scarring. This study investigated whether using cosmetic camouflage (Microskin™) had a positive impact on health-related quality of life, self-concept and psychopathology for children and adolescents (8-17 years) with burn scarring. A prospective multi-centre randomised controlled trial was conducted across Australian and New Zealand paediatric hospitals. 63 participants (49 females, mean age 12.7 ± 2.1 years) were enrolled. Data points were baseline (Time 1) and at 8 weeks (Time 2) using reliable and valid psychometric measures. Findings indicate there were significant improvements in socialisation, school and appearance scales on the Paediatric Quality of Life Inventory and psychopathology scores particularly peer problems decreased. However self-concept remained stable from baseline throughout intervention use. Cosmetic camouflage appears to have a positive impact on quality of life particularly socialisation. Cosmetic camouflage is a valid tool to assist children with scarring to actively participate socially within their communities. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

  14. Extracorporeal shock wave therapy with low-energy flux density inhibits hypertrophic scar formation in an animal model.

    Science.gov (United States)

    Zhao, Jing-Chun; Zhang, Bo-Ru; Hong, Lei; Shi, Kai; Wu, Wei-Wei; Yu, Jia-Ao

    2018-04-01

    Hypertrophic scar is characterized by excessive deposits of collagen during skin wound healing, which could become a challenge to clinicians. This study assessed the effects of the extracorporeal shock wave therapy (ESWT) on hypertrophic scar formation and the underlying gene regu-lation. A rabbit ear hypertrophic scar model was generated and randomly divided into three groups: L-ESWT group to receive L-ESWT (energy flux density of 0.1 mJ/mm2), H-ESWT (energy flux density of 0.2 mJ/mm2) and sham ESWT group (S-ESWT). Hypertrophic scar tissues were then collected and stained with hematoxylin and eosin (H&E) and Masson's trichrome staining, respectively, to assess scar elevation index (SEI), fibroblast density and collagen fiber arrangement. Expression of cell proliferation marker proliferating cell nuclear antigen (PCNA) and α-smooth muscle actin (α-SMA) were assessed using RT-PCR and immunohistochemistry in hypertrophic scar tissues. H&E staining sections showed significant reduction of SEI and fibroblast density in both ESWT treatment groups compared to S-ESWT, but there was no dramatic difference between L-ESWT and H-ESWT groups. Masson's trichrome staining showed that collagen fibers were more slender and broader and oriented in parallel to skin surface after administration of ESWT compared to control tissues. At the gene level, PCNA‑positive fibroblasts and α-SMA-positive myofibroblasts were significantly decreased after L-ESWT or H-ESWT compared to the controls. Furthermore, there was no significant difference in expression of PCNA mRNA between L-ESWT or H-ESWT and S-ESWT, whereas expression of α-SMA mRNA significantly decreased in L-ESWT compared to that of H-ESWT and S-ESWT (P=0.002 and P=0.030, respectively). In conclusion, L-ESWT could be effective on suppression of hypertrophic scar formation by inhibition of scar elevation index and fibroblast density as well as α-SMA expression in hypertrophic scar tissues of the rabbit model.

  15. Medicinal Plants for the Treatment of Hypertrophic Scars

    Directory of Open Access Journals (Sweden)

    Qi Ye

    2015-01-01

    Full Text Available Hypertrophic scar is a complication of wound healing and has a high recurrence rate which can lead to significant abnormity in aesthetics and functions. To date, no ideal treatment method has been established. Meanwhile, the underlying mechanism of hypertrophic scarring has not been clearly defined. Although a large amount of scientific research has been reported on the use of medicinal plants as a natural source of treatment for hypertrophic scarring, it is currently scattered across a wide range of publications. Therefore, a systematic summary and knowledge for future prospects are necessary to facilitate further medicinal plant research for their potential use as antihypertrophic scar agents. A bibliographic investigation was accomplished by focusing on medicinal plants which have been scientifically tested in vitro and/or in vivo and proved as potential agents for the treatment of hypertrophic scars. Although the chemical components and mechanisms of action of medicinal plants with antihypertrophic scarring potential have been investigated, many others remain unknown. More investigations and clinical trials are necessary to make use of these medical plants reasonably and phytotherapy is a promising therapeutic approach against hypertrophic scars.

  16. Personality in proportion : A bipolar proportional scale for personality assessments and its consequences for trait structure

    NARCIS (Netherlands)

    Hofstee, W.K.B.; Ten Berge, J.M.F.

    2004-01-01

    Trait structures resulting from personality assessments on Likert scales are affected by the additive and multiplicative transformations implied in interval scaling and correlational analysis. The effect comes into view on selecting a plausible alternative scale. To this end, we propose a bipolar

  17. Nursing-care dependency : Development of an assessment scale for demented and mentally handicapped patients

    NARCIS (Netherlands)

    Dijkstra, Ate; Buist, Girbe; Dassen, T

    1996-01-01

    This article describing the first phase in the development of an assessment scale of nursing-care dependency (NCD) for Dutch demented and mentally handicapped patients focuses on the background to the study and the content validation of the nursing-care dependency scale. The scale aims to

  18. Split face comparative study of microneedling with PRP versus microneedling with vitamin C in treating atrophic post acne scars

    Directory of Open Access Journals (Sweden)

    Simran Chawla

    2014-01-01

    Full Text Available Introduction: Acne scars are largely preventable complications of acne. 95% of the scars occur over the face thus impacting the quality of life. Correction of scars is the priority for acne patients. Materials and Methods: Thirty patients with post acne atrophic facial scars attending the OPD during the period from April to October 2013 were offered four sittings of microneedling with PRP on one side and microneedling with vitamin C on other side of the face at an interval of 1 month. Results: Twenty-seven out of the total 30 patients completed the treatment schedule. Two patients were lost to follow up and one dropped out of the study due to severe PIH. Mean age of the patients was 27.5 years. Out of 30 patients, 23 achieved reduction in scarring by one or two grades. Excellent response was seen in five (18.5% patients with platelet-rich plasma (PRP as compared to two (7% patients who received treatment with vitamin C according to physician′s assessment. As far as up gradation by 1 score is considered, i.e., good response, it was similar in both cases. Vitamin C did not prove to be as efficacious as PRP since 10 (37% patients had poor response in vitamin C-treated area compared to only 6 (22.2% patients who underwent PRP therapy, but vitamin C proved to be efficacious in dealing with post inflammatory hyper-pigmentation secondary to acne. Patients were more satisfied with PRP as compared to vitamin C. The results were evaluated and statistical analysis was done using SPSS 16.0.2. Conclusions: Overall results were better with microneedling and PRP. Vitamin C combined with microneedling also showed improvement with respect to firmness and smoothness of skin; as well as post inflammatory hyper-pigmentation. Microneedling combined with PRP proved to be good in treating boxcar and rolling scars but had limited efficacy in dealing with ice pick scars.

  19. EI Scale: an environmental impact assessment scale related to the construction materials used in the reinforced concrete

    OpenAIRE

    Gilson Morales; Antonio Edésio Jungles; Sheila Elisa Scheidemantel Klein; Juliana Guarda

    2010-01-01

    This study aimed to create EI Scal, an environmental impact assessment scal, related to construction materials used in the reinforced concrete structure production. The main reason for that was based on the need to classify the environmental impact levels through indicators to assess the damage level process. The scale allowed converting information to estimate the environmental impact caused. Indicators were defined trough the requirements and classification criteria of impact aspects consid...

  20. A 1-Year Follow-Up of Post-operative Scars After the Use of a 1210-nm Laser-Assisted Skin Healing (LASH) Technology: A Randomized Controlled Trial.

    Science.gov (United States)

    Casanova, D; Alliez, A; Baptista, C; Gonelli, D; Lemdjadi, Z; Bohbot, S

    2017-08-01

    Laser therapies are used prophylactically for excessive scar formation. The Laser-Assisted Skin Healing treatment induces a controlled heat stress that promotes tissue regeneration. This comparative trial is the first to evaluate the performance of a new automated 1210-nm laser system, compatible with all Fitzpatrick scale phototypes. Forty women undergoing bilateral breast reduction were enrolled in this double-blinded randomized controlled trial. The horizontal sutured incision of one breast was treated with the portable 1210-nm laser while in the operating theatre. The other breast was used as the study control. Objective measurements, subjective clinical assessments and safety evaluation were carried out over 1 year by both clinicians and patients. Six weeks following surgery, better overall appearance and modified OSAS scores were reported for the laser-treated scars when compared to the control group (p = 0.024 and p = 0.079). This supports an early effect of the laser treatment during the inflammatory stage of the healing process. After a post-treatment period of 6 months, there continued to be a strong tendency in favour of the laser treatment based on the subjective scores and corroborated by the objective improvement of the treated scar volume (p = 0.038). At 1 year, the laser-treated scars continued to improve compared to the control ones in terms of volume (p = 0.004), surface (p = 0.017) and roughness (p = 0.002), and these comparatively better results were strengthened with the blind expression of patients' preference for their laser-treated scar (p = 0.025). This new 1210-nm laser treatment, used as a single session performed immediately after surgery, provides significant objective and subjective improvements in scar appearance. These data can be useful when preparing patients to undergo their surgical procedure. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence

  1. External rhinoplasty for the Arabian nose: a columellar scar analysis.

    Science.gov (United States)

    Foda, Hossam M T

    2004-01-01

    This study aimed to evaluate columellar scar problems after external rhinoplasty in the Arabian population, and to analyze the technical factors that help prevent such problems and maximize the scar cosmesis. The investigation was conducted in university and private practice settings of the author in Alexandria, Egypt. A total of 600 Arab patients who underwent external rhinoplasty were included in the study. All the patients underwent surgery using the external rhinoplasty approach, in which bilateral alar marginal incisions were connected by an inverted V-shaped transcolumellar incision. At completion of the procedure, a two-layer closure of the columellar incision was performed. At a minimum of 1 year postoperatively, the columellar scar was evaluated subjectively by means of a patient questionnaire, and objectively by clinical examination and comparison of the close-up pre- and postoperative basal view photographs. Objectively, anything less than a barely visible, leveled, thin, linear scar was considered unsatisfactory. Subjectively, 95.5% of the patients rated the scar as unnoticeable, 3% as noticeable but acceptable, and 1.5% as unacceptable. Objectively, the scar was unsatisfactory in 7% of the cases. This was because of scar widening with or without depression (5%), hyperpigmentation (1.5%), and columellar rim notching (0.5%). The use of a deep 6/0 polydioxanon (PDS) suture significantly decreased the incidence of scar widening (p < 0.005).The columellar incision can be used safely in the Arab population regardless of their thick, dark, and oily skin. Technical factors that contributed to the favorable outcome of the columellar scar included proper planning of location and design of the incision used, precise execution, meticulous multilayered closure, and good postoperative care.

  2. Nonlinear optics for the study of human scar tissue

    Science.gov (United States)

    Ferro, D. P.; Vieira-Damiani, G.; Adam, R. L.; Cesar, C. L.; Metze, Konradin

    2012-03-01

    Collagen fibers are an essential component of the dynamic process of scarring, which accompanies various diseases. Scar tissue may reveal different morphologic expressions, such as hypertrophic scars or keloids. Collagen fibers can be visualized by fluorescent light when stained with eosin. Second Harmonic Generation (SHG) creates a non linear signal that occurs only in molecules without inversion symmetry and is particularly strong in the collagen fibers arranged in triple helices. The aim of this study was to describe the methodology for the analysis of the density and texture of collagen in keloids, hypertrophic scars and conventional scars. Samples were examined in the National Institute of Science and Technology on Photonics Applied to Cell Biology (INFABIC) at the State University of Campinas. The images were acquired in a multiphoton microscopy LSM 780-NLO Zeiss 40X. Both signals, two-photon fluorescence (TPEF) and SHG, were excited by a Mai-Tai Ti:Sapphire laser at 940 nm. We used a LP490/SP485 NDD filter for SHG, and a BP565-610 NDD filter for fluorescence In each case, ten images were acquired serially (512×512 μm) in Z-stack and joined together to one patchwork-image . Image analysis was performed by a gliding-box-system with in-house made software. Keloids, hypertrophic scars and normal scar tissue show different collagen architecture. Inside an individual case differences of the scar process may be found between central and peripheral parts. In summary, the use of nonlinear optics is a helpful tool for the study of scars tissue.

  3. Microneedle physical contact as a therapeutic for abnormal scars.

    Science.gov (United States)

    Yeo, David C; Balmayor, Elizabeth R; Schantz, Jan-Thorsten; Xu, Chenjie

    2017-08-14

    Abnormal (keloid and hypertrophic) scars are a significant affliction with no satisfactory single modality therapy to-date. Available options are often ineffective, painful, potentially hazardous, and require healthcare personnel involvement. Herein a self-administered microneedle device based on drug-free physical contact for inhibiting abnormal scars is reported. Its therapeutic activity through microneedle contact eliminates hazards associated with toxic anti-scarring drugs while self-treatment enables administration flexibility. The microneedle patch was fabricated with FDA-approved liquid crystalline polymer under good manufacturing practice. It was first tested to ascertain its ability to inhibit (keloid) fibroblast proliferation. Later the microneedle patch was examined on the rabbit ear hypertrophic scar model to explore its potential in inhibiting the generation of abnormal scars post-injury. Finally, the microneedle patch was applied to the caudal region of a hypertrophic scar located on a female patient's dorsum to verify clinical efficacy. On untreated control cultures, barely any non-viable fibroblasts could be seen. After 12-h treatment with the microneedle patch, the non-viable proportion increased to 83.8 ± 11.96%. In rabbit ear hypertrophic scar model, 100% of the control wounds without the presence of patches on rabbit ears generated regions of raised dermis originating from the wound site (3/3), whereas microneedle treatment prevented dermis tissue thickening in 83.33% of the wounds (15/18). In the clinical test, the microneedle patch was well tolerated by the patient. Compared to the untreated region, microneedle treatment decreased the number of infiltrated inflammatory cells, with less disrupted dermis tissue architecture and more flattened appearance. A self-administered, drug-free microneedle patch appears highly promising in reducing abnormal scarring as observed from in vitro, in vivo and clinical experiments. Larger cohort clinical

  4. Large-Scale Assessment, Rationality, and Scientific Management: The Case of No Child Left Behind

    Science.gov (United States)

    Roach, Andrew T.; Frank, Jennifer

    2007-01-01

    This article examines the ways in which NCLB and the movement towards large-scale assessment systems are based on Weber's concept of formal rationality and tradition of scientific management. Building on these ideas, the authors use Ritzer's McDonaldization thesis to examine some of the core features of large-scale assessment and accountability…

  5. Numerical assessment of the ion turbulent thermal transport scaling laws

    International Nuclear Information System (INIS)

    Ottaviani, M.; Manfredi, G.

    2001-01-01

    Numerical simulations of ion temperature gradient (ITG) driven turbulence were carried out to investigate the parametric dependence of the ion thermal transport on the reduced gyroradius and on the local safety factor. Whereas the simulations show a clear proportionality of the conductivity to the gyroradius, the dependence on the safety factor cannot be represented as a simple power law like the one exhibited by the empirical scaling laws. (author)

  6. Assessing Impacts of National Scale Droughts on Cereal Production

    Science.gov (United States)

    Udmale, P. D.; Ichikawa, Y.

    2017-12-01

    Till date, several drought indices have been developed and used to monitor local to regional scale droughts on various temporal scales. However, there are no generalized criteria to define a threshold to declare a national level drought using drought indices. EM-DAT (a global database on natural and technological disasters) lists disasters (including drought) from 1900 until the present confirming one of the following criteria: 10 or more people dead; 100 or more people affected; the declaration of a state of emergency; or a call for international assistance. This data is gathered from various organizations like United Nations Institutes, Governments, etc. and do not cover all disasters or have political limitations that could affect the numbers. These criteria are neither objective nor quantitative, and accordingly may cause uncertainties when the data is used for further investigation on disaster impacts. Here we present a methodology to define drought at a national scale and its impacts on national level crop production (mainly cereals). We define drought based on the percentage of cropland area affected by drought in a country during its seasonal rainfall. For this purpose meteorological definition of drought in combination with country's cropland area is proposed to prepare a drought inventory for major cereal producing countries (1902-2012). This drought inventory together with FAO's Crop data is used to identify the impacts of drought on a national level cereal production (and yield) using Superposed Epoch Analysis for the period 1961-2012.

  7. The Use of Locally Applied Vibration to Minimize Pain during Fractional CO Laser Therapy in Living Liver-Donor Scar Management

    Directory of Open Access Journals (Sweden)

    Sinyoung Song

    2016-11-01

    Full Text Available BackgroundFractional CO2 laser is an effective treatment for scars, but most patients complain about sharp burning pain, even after the application of lidocaine ointment. This study analyzed the impact of a vibrating device to nonpharmacologically reduce the acute pain of laser treatment, in accordance with the gate control theory of pain management.MethodsThis is a prospective study performed from May 2013 through March 2014. Fifty-three patients (mean age, 26.7 years; range, 16–44 years who had donated livers for liver transplantation were treated with a fractional CO2 laser (10,600 nm; model eCO2, Lutronic Corp for their abdomen scars. Laser treatment was applied 4 months after surgery. A commercially available, locally applied vibrating device (model UM-30M, Unix Electronics Co. Ltd. was used, in an on-and-off pattern, together with the CO2 laser. A visual analogue scale (VAS; 0, no pain; 10, most severe pain of pain sensation was assessed and statistically analyzed using a paired t-test.ResultsThe average VAS score for pain with the vibrating device was 4.60 and the average VAS score without the vibrating device was 6.11. The average difference between scores was 1.51 (P=0.001.ConclusionsA locally applied vibrating device was demonstrated to be effective in reducing pain when treating with a fractional CO2 laser. Vibration treatment could be helpful when treating scars with fractional CO2 laser in pain-sensitive patients, particularly children.

  8. EI Scale: an environmental impact assessment scale related to the construction materials used in the reinforced concrete

    Directory of Open Access Journals (Sweden)

    Gilson Morales

    2010-12-01

    Full Text Available This study aimed to create EI Scal, an environmental impact assessment scal, related to construction materials used in the reinforced concrete structure production. The main reason for that was based on the need to classify the environmental impact levels through indicators to assess the damage level process. The scale allowed converting information to estimate the environmental impact caused. Indicators were defined trough the requirements and classification criteria of impact aspects considering the eco-design theory. Moreover, the scale allowed classifying the materials and processes environmental impact through four score categories which resulted in a single final impact score. It was concluded that the EI scale could be cheap, accessible, and relevant tool for environmental impact controlling and reduction, allowing the planning and material specification to minimize the construction negative effects caused in the environment.

  9. miR-29b promotes skin wound healing and reduces excessive scar formation by inhibition of the TGF-β1/Smad/CTGF signaling pathway.

    Science.gov (United States)

    Guo, Jingdong; Lin, Quan; Shao, Ying; Rong, Li; Zhang, Duo

    2017-04-01

    The hypertrophic scar is a medical difficulty of humans, which has caused great pain to patients. Here, we investigated the inhibitory effect of miR-29b on scar formation. The scalded model was established in mice and miR-29b mimics or a negative control was subcutaneously injected into the injury skin. Then various molecular biological experiments were performed to assess the effect of miR-29b on scar formation. According to our present study, first, the results demonstrated that miR-29b was down-regulated in thermal injury tissue and miR-29b treatment could promote wound healing, inhibit scar formation, and alleviate histopathological morphologic alteration in scald tissues. Additionally, miR-29b treatment suppressed collagen deposition and fibrotic gene expression in scar tissues. Finally, we found that miR-29b treatment inhibited the TGF-β1/Smad/CTGF signaling pathway. Taken together, our data suggest that miR-29b treatment has an inhibitory effect against scar formation via inhibition of the TGF-β1/Smad/CTGF signaling pathway and may provide a potential molecular basis for future treatments for hypertrophic scars.

  10. Comparative study between intravenous urography and renal scintigraphy with DMSA for the diagnosis of renal scars in children with vesicoureteral reflux

    Directory of Open Access Journals (Sweden)

    Clarissa B. Araújo

    2003-12-01

    Full Text Available PURPOSE: To assess the value of intravenous urography (IVU in detecting and grading the renal scar, comparing its results with those of scintigraphy with dimercaptosuccinic acid (DMSA. MATERIALS AND METHODS: The study included 43 children investigated by DMSA and IVU, who had vesicoureteral reflux diagnosed and classified through voiding cystourethrography. RESULTS: Among the kidneys with reflux, there was agreement between the results of DMSA and IVU concerning the presence and the absence of scars in 82.4% of the cases. Based on the results obtained, IVU would have a sensitivity of 66.6%, specificity of 94.4%; accuracy of 82.5%; positive predictive value (PPV of 90% and negative predictive value (NPV of 79%, when compared with DMSA results. Our data also confirm the close relation between the reflux grade and the presence of renal scar, since 75% of the kidneys with grade IV and V reflux presented scars. In relation to the grading of nephropathy, in 78% of patients the classification of the scar by both methods was identical. The highest disagreement was verified in the group with segmental scar on DMSA, where 41.6% of the kidneys were classified as normal on IVU. CONCLUSION: The data obtained confirm that the scintigraphy with DMSA is essential in the investigation of patients with renal scar, and cannot be replaced by IVU, due to its low sensitivity and lower ability of satisfactory grading.

  11. A histological study on the effect of pressure therapy on the activities of myofibroblasts and keratinocytes in hypertrophic scar tissues after burn.

    Science.gov (United States)

    Li-Tsang, Cecilia W P; Feng, Beibei; Huang, Lin; Liu, Xusheng; Shu, Bin; Chan, Yvonne T Y; Cheung, Kwok-Kuen

    2015-08-01

    Although pressure therapy (PT) has been widely used as the first-line treatment for hypertrophic scars (HS), the histopathological changes involved have seldom been studied. This study aimed to examine the longitudinal effect of PT on the histopathological changes in HS. Ten scar samples were selected from six patients with HS after burn and they were given a standardized PT intervention for 3 months while 16 scar samples were obtained on those without PT. The scar biopsies were collected pre-treatment, 1 and 3 months post-intervention for both clinical and histopathological examinations. Clinical assessments demonstrated significant improvement in the thickness and redness of the scars after PT. Histological examination revealed that cell density in the dermal layer was markedly reduced in the 3-months post-pressurized scar tissues, while the arrangement of the collagen fiber was changed from nodular to wave-like pattern. The α-smooth muscle actin immunoreactivity was significantly decreased after 1-month pressure treatment. There was a significant reduction of myofibroblasts population and a concomitant increase in the apoptotic index in the dermal layer in the 3-months' post-pressurized scars. A significant negative correlation was found between the myofibroblasts population and the apoptotic index. The keratinocyte proliferation was found inhibited after PT. Results demonstrated that PT appeared to promote HS maturation by inhibiting the keratinocyte proliferation and suppressing myofibroblasts population, the latter possibly via apoptosis. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

  12. The relationship of the Reynolds Intellectual Assessment Scales and the Wechsler Adult Intelligence Scale-Third Edition.

    Science.gov (United States)

    Smith, Billy L; McChristian, Chrystal L; Smith, Teresa D; Meaux, Julie

    2009-08-01

    The purpose of this study was to compare scores on the Reynolds Intellectual Assessment Scales (RIAS) with scores on the Wechsler Adult Intelligence Scale-Third Edition (WAIS-III) in a group of college students diagnosed with a Learning Disability, Attention-Deficit Hyperactivity Disorder (ADHD), or a combination of the two. The RIAS Composite Index score was significantly higher than the WAIS-III Full Scale IQ, although scores on both tests were in the average range. Correlations between the two tests were significant on all measures. Male students were significantly higher than female students on both the RIAS Composite Index and on the WAIS-III Full Scale IQ. Although the ADHD group was higher on IQ than the Learning Disabled and combined disorder groups on all IQ measures, no significant differences were found.

  13. Vulnerability of Forests in India: A National Scale Assessment.

    Science.gov (United States)

    Sharma, Jagmohan; Upgupta, Sujata; Jayaraman, Mathangi; Chaturvedi, Rajiv Kumar; Bala, Govindswamy; Ravindranath, N H

    2017-09-01

    Forests are subjected to stress from climatic and non-climatic sources. In this study, we have reported the results of inherent, as well as climate change driven vulnerability assessments for Indian forests. To assess inherent vulnerability of forests under current climate, we have used four indicators, namely biological richness, disturbance index, canopy cover, and slope. The assessment is presented as spatial profile of inherent vulnerability in low, medium, high and very high vulnerability classes. Fourty percent forest grid points in India show high or very high inherent vulnerability. Plantation forests show higher inherent vulnerability than natural forests. We assess the climate change driven vulnerability by combining the results of inherent vulnerability assessment with the climate change impact projections simulated by the Integrated Biosphere Simulator dynamic global vegetation model. While 46% forest grid points show high, very high, or extremely high vulnerability under future climate in the short term (2030s) under both representative concentration pathways 4.5 and 8.5, such grid points are 49 and 54%, respectively, in the long term (2080s). Generally, forests in the higher rainfall zones show lower vulnerability as compared to drier forests under future climate. Minimizing anthropogenic disturbance and conserving biodiversity can potentially reduce forest vulnerability under climate change. For disturbed forests and plantations, adaptive management aimed at forest restoration is necessary to build long-term resilience.

  14. Comparison between full- and small-scale sensory assessments of air quality

    DEFF Research Database (Denmark)

    Wargocki, Pawel; Sabikova, J.; Lagercrantz, Love Per

    2002-01-01

    Thirty-nine untrained subjects made small- and full-scale evaluations of the acceptability of the quality of air at 22 deg.C and 40% RH, polluted by either carpet, felt floor covering, painted gypsum board, linoleum or chipboard. Small-scale evaluations were made on the air extracted from 200-L......-scale sensory ratings of acceptability of air polluted by carpet and by linoleum were systematically better than small-scale assessments, but not for the other three materials. Calculated sensory emission rates from carpet and linoleum were significantly lower in full scale than in small scale. When modelling...

  15. Alzheimer's Disease Assessment Scale - Cognitive Subscale (ADAS-Cog): Normative Data for the Portuguese Population.

    Science.gov (United States)

    Nogueira, Joana; Freitas, Sandra; Duro, Diana; Tábuas-Pereira, Miguel; Guerreiro, Manuela; Almeida, Jorge; Santana, Isabel

    2018-02-28

    The Alzheimer's Disease Assessment Scale - Cognitive Subscale is a brief battery developed to assess cognitive functioning in Alzheimer's disease that encompasses the core characteristics of cognitive decline (e.g. memory, language, praxis, constructive ability and orientation). The early detection, as well as the monitoring of cognitive decline along disease progression, is extremely important in clinical care and interventional research. The main goals of the present study were to analyze the psychometric properties of the Portuguese version of the Alzheimer's Disease Assessment Scale - Cognitive Subscale, and to establish normative values for the Portuguese population. The Portuguese version of Alzheimer's Disease Assessment Scale - Cognitive Subscale was administered to 223 cognitively healthy participants according to a standard assessment protocol consisting of the Mini-Mental State Examination, the Montreal Cognitive Assessment and the Adults and Older Adults Functional Assessment Inventory. Normal performance on the assessment protocol was the inclusion criteria for the study. The Alzheimer's Disease Assessment Scale - Cognitive Subscale revealed good psychometric properties when used in the Portuguese population. Age was the main predictor of the Alzheimer's Disease Assessment Scale - Cognitive Subscale total score (R2 = 0.123), whereas the influence of education level was lower (R2 = 0.027). These two variables explained 14.4% of the variance on the Alzheimer's Disease Assessment Scale - Cognitive Subscale scores and were used to stratify the normative values for the Portuguese population presented here. On the total sample, the average total score in the Alzheimer's Disease Assessment Scale - Cognitive Subscale was 6 points. The normative data were determined according to age and educational level as these were the sociodemographic variables that significantly contributed to the prediction of the Alzheimer's Disease Assessment Scale - Cognitive Subscale

  16. Comparison of W-Plasty and Straight-Line Trichophytic Closure on Aesthetic Outcomes of Occipital Hairline Scars in Rhytidectomy.

    Science.gov (United States)

    Roy, Sudeep; Buckingham, Edward D

    2018-01-01

    Incision placement and design in rhytidectomy is critical for patient satisfaction. To evaluate the aesthetic outcome of W-plasty vs traditional straight-line (SL) trichophytic closure techniques on posterior occipital hairline scars in rhytidectomy. A retrospective cohort study was conducted at the Buckingham Center for Facial Plastic Surgery. Clinical history and operative reports were reviewed for 46 patients who underwent rhytidectomy (23 using W-plasty and 23 using SL technique) between June 1, 2014 and August 31, 2015. Blinded photographic analysis of 1-year postoperative photographs was performed. The posterior occipital hairline incision was primarily closed with either a W-plasty or SL trichophytic technique. Standard photographs of the posterior occipital incision site obtained after the 1-year postoperative mark were reviewed and scored in a blinded fashion by 3 nonphysician medical staff members using a modified Manchester Scar Scale (MSS: from 0 [best possible outcome] to 24 [worst possible outcome]). Interrater reliability was assessed via Cronbach α testing. There were 23 patients in each group. The W-plasty and SL groups were similar in terms of age (mean [SD] age, 59.6 [6.3] years and 64.1 [7.3] years, respectively), sex (21 [91%] and 21 [91%] women, respectively), race-ethnicity, and absence of risk factors (smoking and diabetes) predisposing to poor wound healing (0 and 0 smoking/diabetes, respectively). Mean (SD) follow-up times for the W-plasty and SL groups were 388 (38.8) and 475 (100.1) days, respectively. No statistical difference was demonstrated in the mean aggregate MSS scores from all evaluators between the W-plasty group and the SL group (reviewer 1: 5.69 vs 5.86, P = .60; reviewer 2: 10.09 vs 9.56, P = .65; and reviewer 3: 5.30 vs 6.17, P = .08). Overall interrater reliability for the MSS scores was 0.56. Primary W-plasty and SL trichophytic closures in the posterior occipital hairline appear to yield highly acceptable

  17. [Retrospective analysis of effects of metacarpus and phalanx traction on correction of scar contracture of hand after burn on the palm side].

    Science.gov (United States)

    Chunsheng, Hou; Qingye, Liu; Hongfei, Hao; Yuying, Dong; Feng, Wang; Jin, Lei

    2015-06-01

    contracture to wrist crease was measured before treatment, at the termination of treatment, and 1 month after the termination of treatment. Scar condition was assessed with the Vancouver Scar Scale (VSS) before treatment and 1, 3, and 6 month(s) after the termination of treatment. Before treatment and 1 month after the termination of treatment, the range of motion was measured with the Total Active Movement (TAM) method; band function was evaluated by the Jebsen Test of Hand Function (JTHF), and the completion time was recorded. Data were processed with analysis of variance, LSD-t test, and t test. Twenty-four patients with 27 affected hands were treated with scheme A + B; 5 patients with 7 affected hands were treated with method C exclusively; 2 patients with 3 affected hands were treated with scheme A + B + C; 1 patient with 2 affected hands were treated with scheme C + A + C. During the course of treatment, no complication such as infection or slicing of tissue was observed, but there was a slight shifting of U-shaped Kirschner wire in 14 affected hands of 13 patients. Tendency of recurrence of scar contracture was observed in 11 affected hands of 10 patients, but the scar contracture did not reoccur after treatment with orthosis. The skin length of palmar side was respectively (131.8 ± 9.8) and (127.6 ± 7.5) mm at the termination of treatment and 1 month after, and they were both significantly longer than that before treatment [(114.5 ± 2.4) mm, with values respectively 10.71 and 10.39, P values below 0.001]. The score of VSS was respectively (9.8 ± 2.4), (9.7 ± 1.7), (9.3 ± 0.8), and (7.7 ± 0.5) points before treatment and 1, 3, and 6 month(s) after the termination of treatment. Only the score at 6 months after the termination of treatment was significantly lower than that before treatment (t = 3.28, P burn can lengthen the contracted tissue, and it is beneficial for the restoration of function and appearance of affected hand.

  18. Surgical correction of gynecomastia with minimal scarring.

    Science.gov (United States)

    Lee, Jun-Ho; Kim, Il-Kug; Kim, Tae-Gon; Kim, Yong-Ha

    2012-12-01

    Gynecomastia is a benign, excessive development of the male breast that occurs at an overall incidence of 32-36 %. The authors effectively removed peripheral fat tissues with power-assisted liposuction (PAL) and periareolar glandular tissues with a cartilage shaver in a series of patients. The small periareolar incisions were not easily recognized. Between February 2010 and April 2012, the charts of 15 patients (28 breasts) treated with PAL and a cartilage shaver were retrospectively reviewed. The mean volume of fat tissue removed with liposuction was 319 mL, and the mean volume of glandular tissue removed with the cartilage shaver was 70 mL. The mean follow-up period was 11.2 months. No infection, nipple-areola complex necrosis, nipple retraction, or saucer deformity was encountered in this series. Intraoperative bleeding occurred in one patient. Mild asymmetries developed in three patients. Use of PAL and a cartilage shaver for the treatment of gynecomastia allows for effective removal of both the fat and the glandular tissue of the breast through a minimal periareolar incision. This technique can achieve excellent aesthetic results with inconspicuous scarring. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

  19. Missense Variant in MAPK Inactivator PTPN5 Is Associated with Decreased Severity of Post-Burn Hypertrophic Scarring.

    Directory of Open Access Journals (Sweden)

    Ravi F Sood

    Full Text Available Hypertrophic scarring (HTS is hypothesized to have a genetic mechanism, yet its genetic determinants are largely unknown. The mitogen-activated protein kinase (MAPK pathways are important mediators of inflammatory signaling, and experimental evidence implicates MAPKs in HTS formation. We hypothesized that single-nucleotide polymorphisms (SNPs in MAPK-pathway genes would be associated with severity of post-burn HTS.We analyzed data from a prospective-cohort genome-wide association study of post-burn HTS. We included subjects with deep-partial-thickness burns admitted to our center who provided blood for genotyping and had at least one Vancouver Scar Scale (VSS assessment. After adjusting for HTS risk factors and population stratification, we tested MAPK-pathway gene SNPs for association with the four VSS variables in a joint regression model. In addition to individual-SNP analysis, we performed gene-based association testing.Our study population consisted of 538 adults (median age 40 years who were predominantly White (76% males (71% admitted to our center from 2007-2014 with small-to-moderate-sized burns (median burn size 6% total body surface area. Of 2,146 SNPs tested, a rare missense variant in the PTPN5 gene (rs56234898; minor allele frequency 1.5% was significantly associated with decreased severity of post-burn HTS (P = 1.3×10-6. In gene-based analysis, PTPN5 (P = 1.2×10-5 showed a significant association and BDNF (P = 9.5×10-4 a borderline-significant association with HTS severity.We report PTPN5 as a novel genetic locus associated with HTS severity. PTPN5 is a MAPK inhibitor expressed in neurons, suggesting a potential role for neurotrophic factors and neuroinflammatory signaling in HTS pathophysiology.

  20. Quality Control Charts in Large-Scale Assessment Programs

    Science.gov (United States)

    Schafer, William D.; Coverdale, Bradley J.; Luxenberg, Harlan; Jin, Ying

    2011-01-01

    There are relatively few examples of quantitative approaches to quality control in educational assessment and accountability contexts. Among the several techniques that are used in other fields, Shewart charts have been found in a few instances to be applicable in educational settings. This paper describes Shewart charts and gives examples of how…

  1. Adaptation and Assessment of a Public Speaking Rating Scale

    Science.gov (United States)

    Iberri-Shea, Gina

    2017-01-01

    Prominent spoken language assessments such as the Oral Proficiency Interview and the Test of Spoken English have been primarily concerned with speaking ability as it relates to conversation. This paper looks at an additional aspect of spoken language ability, namely public speaking. This study used an adapted form of a public speaking rating scale…

  2. Is stair negotiation measured appropriately in functional assessment scales?

    NARCIS (Netherlands)

    Iersel, M.B. van; Olde Rikkert, M.G.M.; Mulley, G.P.

    2003-01-01

    BACKGROUND: A decline in mobility may result in problems with the negotiation of stairs, which can potentially be hazardous. In practice, stair negotiation is an important aspect of daily living and therefore needs to be assessed carefully. METHODS: We conducted a systematic literature review to

  3. Multi-scale landslide risk assessment in Cuba

    NARCIS (Netherlands)

    Castellanos Abella, E.A.

    2008-01-01

    Landslides cause a considerable amount of damage in the mountainous regions of Cuba, which cover about 25% of the territory. Until now, only a limited amount of research has been carried out in the field of landslide risk assessment in the country. This research presents a methodology and its

  4. Assessing severity of delirium by the Delirium Observation Screening Scale

    NARCIS (Netherlands)

    Scheffer, Alice C.; van Munster, Barbara C.; Schuurmans, Marieke J.; de Rooij, Sophia E.

    Objective: Delirium is the most common acute neuropsychiatric disorder in hospitalized elderly. Assessment of the severity of delirium is important for adjusting medication. The minimal dose of medication is preferable to prevent side effects. Only few nurse based severity measures are available.

  5. [Psychometric assessment of a brief Modern Racism Scale].

    Science.gov (United States)

    Campo-Arias, Adalberto; Herazo, Edwin; Oviedo, Heidi C

    2016-06-01

    Objective To find the internal consistency of the Modern Racism Scale (MRS) among medical students in Bucaramanga, Colombia. Methods A total of 352 medical students, mean age=20.0 years (SD=1.9) reported their attitudes towards Afro-Colombians; 59.4 % were women. Students completed the 10-item version of MRS. Cronbach alpha and McDonald omega were calculated. Exploratory factor analyses were done to propose a brief version of the MRS. Results The 10-item version showed a Cronbach alpha of 0.48 and a McDonald omega of 0.15. The short version, the Brief Modern Racism Scale (BMRS) (items 1, 4, 5, 7 and 8) presented a Cronbach alpha of 0.64 and McDonald omega of 0.65. The BMRS showed one salient factor responsible of 41.6 % of the total variance. Conclusions A Spanish-language short version of the MRS shows better psychometric performance than the original version. Further study is needed to corroborate these findings or make adjustments for Colombian cultural regions.

  6. Relationship of myocardial hibernation, scar, and angiographic collateral flow in ischemic cardiomyopathy with coronary chronic total occlusion.

    Science.gov (United States)

    Wang, Li; Lu, Min-Jie; Feng, Lei; Wang, Juan; Fang, Wei; He, Zuo-Xiang; Dou, Ke-Fei; Zhao, Shi-Hua; Yang, Min-Fu

    2018-03-07

    The relationship between myocardial viability and angiographic collateral flow is not fully elucidated in ischemic cardiomyopathy (ICM) with coronary artery chronic total occlusion (CTO). We aimed to clarify the relationship between myocardial hibernation, myocardial scar, and angiographic collateral flow in these patients. Seventy-one consecutive ICM patients with 122 CTOs and 652 dysfunctional segments within CTO territories were retrospectively analyzed. Myocardial hibernation (perfusion-metabolism mismatch) and the extent of 18 F-fluorodeoxyglucose (FDG) abnormalities were assessed using 99m Tc-sestamibi and 18 F-FDG imaging. Myocardial scar was evaluated by late gadolinium enhancement (LGE) cardiac magnetic resonance (CMR) imaging. Collateral flow observed on coronary angiography was assessed using Rentrop classification. In these patients, neither the extent nor frequency of myocardial hibernation or scar was related to the status of collateral flow. Moreover, the matching rate in determining myocardial viability was poor between any 2 imaging indices. The extent of 18 F-FDG abnormalities was linearly related to the extent of LGE rather than myocardial hibernation. Of note, nearly one-third (30.4%) of segments with transmural scar still had hibernating tissue. Hibernation and non-transmural scar had higher sensitivity (63.0% and 66.7%) than collateral flow (37.0%) in predicting global functional improvement. Angiographic collateral cannot accurately predict myocardial viability, and has lower sensitivity in prediction of functional improvement in CTO territories in ICM patients. Hence, assessment of myocardial viability with non-invasive imaging modalities is of importance. Moreover, due to the lack of correlation between myocardial hibernation and scar, these two indices are complementary but not interchangeable.

  7. Sequence characterized amplified region (SCAR) markers-based ...

    African Journals Online (AJOL)

    ajl yemi

    2011-12-19

    Dec 19, 2011 ... reverse transcription polymerase chain reaction (RT-PCR), differential-display .... were synthesized by Sangon Biological Engineering Technology and. Services ..... to cold tolerance to scar markers in common carp. J. Dalian.

  8. Managing Caesarean Scar Pregnancy in low Resource Settings: 2 ...

    African Journals Online (AJOL)

    AJRH Managing Editor

    ultrasound guided approach with dilatation of uterine cervix and subsequent evacuation of uterine ... Keywords: caesarean scar pregnancy, transrectal ultrasound guided surgical approach. ... a viable embryo with a crown rump length (CRL).

  9. Before and After Photos: Treatment of Hypertrophic Scars

    Science.gov (United States)

    ... for Every Season How to Choose the Best Skin Care Products In This Section Dermatologic Surgery What is dermatologic ... for Every Season How to Choose the Best Skin Care Products Before and after photos: Treatment of hypertrophic scars ...

  10. Before and After Photos: Treatment of Hypertrophic Scars

    Science.gov (United States)

    ... Back Injectable Deoxycholic Acid Injectable Hyaluronic Acid Injectable Poly-l-lactic Acid Injectable Polymethylmethacrylate + Bovine Collagen Filler ... Does acne scar removal hurt? What are my pain management and anesthesia options? How long is the ...

  11. RMS Pictorial Scale (RMS-PS: An innovative scale for the assessment of child′s dental anxiety

    Directory of Open Access Journals (Sweden)

    R M Shetty

    2015-01-01

    Full Text Available Background: Dental anxiety assessment for young children is as important as performing their treatment. Appropriate knowledge of patient′s anxiety boosts confidence and will help us to review potential management options specific to every child. Aim: This study aimed to validate (RMS Pictorial Scale (RMS-PS and to compare it with Venham Picture Test (VPT and Facial image scale (FIS in measuring dental anxiety for young children during their first dental visit. Materials and Methods: A total of 102 healthy children aged between 4 and 14 years during their first dental visit were randomly selected for the study. Childs anxiety level was measured using three different scales namely (i RMS-PS (ii VPT, and (iii FIS. Statistical Analysis: Student t test was used to compare the scores obtained from all the three scales. Pearson correlation test was used to obtain correlation among the scales used in the study. Results: A strong correlation (0·76 was found between the VPT and RMS-PS, and a moderate correlation (0.5 was found between RMS-PS and FIS, indicating good validity for the RMS-PS. Conclusions: The findings of this study suggest that the RMS-PS can be a newer and easiest means for the assessment of dental anxiety for young children in a clinical context.

  12. Applicability of SCAR markers to food genomics: olive oil traceability.

    Science.gov (United States)

    Pafundo, Simona; Agrimonti, Caterina; Maestri, Elena; Marmiroli, Nelson

    2007-07-25

    DNA analysis with molecular markers has opened a shortcut toward a genomic comprehension of complex organisms. The availability of micro-DNA extraction methods, coupled with selective amplification of the smallest extracted fragments with molecular markers, could equally bring a breakthrough in food genomics: the identification of original components in food. Amplified fragment length polymorphisms (AFLPs) have been instrumental in plant genomics because they may allow rapid and reliable analysis of multiple and potentially polymorphic sites. Nevertheless, their direct application to the analysis of DNA extracted from food matrixes is complicated by the low quality of DNA extracted: its high degradation and the presence of inhibitors of enzymatic reactions. The conversion of an AFLP fragment to a robust and specific single-locus PCR-based marker, therefore, could extend the use of molecular markers to large-scale analysis of complex agro-food matrixes. In the present study is reported the development of sequence characterized amplified regions (SCARs) starting from AFLP profiles of monovarietal olive oils analyzed on agarose gel; one of these was used to identify differences among 56 olive cultivars. All the developed markers were purposefully amplified in olive oils to apply them to olive oil traceability.

  13. Assessing Politicized Sexual Orientation Identity: Validating the Queer Consciousness Scale.

    Science.gov (United States)

    Duncan, Lauren E; Mincer, Elizabeth; Dunn, Sarah R

    2017-01-01

    Building on psychological theories of motivation for collective action, we introduce a new individual difference measure of queer consciousness, defined as a politicized collective identity around sexual orientation. The Queer Consciousness Scale (QCS) consists of 12 items measuring five aspects of a politicized queer identity: sense of common fate, power discontent, system blame, collective orientation, and cognitive centrality. In four samples of adult women and men of varied sexual orientations, the QCS showed good test-retest and Cronbach's reliability and excellent known-groups and predictive validity. Specifically, the QCS was positively correlated with identification as a member of the LGBTQ community, political liberalism, personal political salience, and LGBTQ activism and negatively correlated with right-wing authoritarianism and social dominance orientation. QCS mediated relationships between several individual difference variables and gay rights activism and can be used with both LGBTQ people and allies.

  14. Matrix Sampling of Items in Large-Scale Assessments

    Directory of Open Access Journals (Sweden)

    Ruth A. Childs

    2003-07-01

    Full Text Available Matrix sampling of items -' that is, division of a set of items into different versions of a test form..-' is used by several large-scale testing programs. Like other test designs, matrixed designs have..both advantages and disadvantages. For example, testing time per student is less than if each..student received all the items, but the comparability of student scores may decrease. Also,..curriculum coverage is maintained, but reporting of scores becomes more complex. In this paper,..matrixed designs are compared with more traditional designs in nine categories of costs:..development costs, materials costs, administration costs, educational costs, scoring costs,..reliability costs, comparability costs, validity costs, and reporting costs. In choosing among test..designs, a testing program should examine the costs in light of its mandate(s, the content of the..tests, and the financial resources available, among other considerations.

  15. Do Preexisting Abdominal Scars Threaten Wound Healing in Abdominoplasty?

    OpenAIRE

    Shermak, Michele A.; Mallalieu, Jessie; Chang, David

    2010-01-01

    Purpose: Abdominal scars may impair healing after abdominoplasty. We aimed to determine whether right subcostal or upper midline scars led to increased wound healing problems. Methods and Materials: Review of all patients who had abdominoplasty from March 1998 to February 2008 was performed. Variables studied included age, gender, body mass index (BMI), medical history, and postoperative complications. Statistical analysis was performed in Stata SE, version 10. Results: Of 420 abdominoplasty ...

  16. Postoperative pain assessment using four behavioral scales in Pakistani children undergoing elective surgery

    Directory of Open Access Journals (Sweden)

    Faisal Shamim

    2015-01-01

    Full Text Available Background: Several measurement tools have been used for assessment of postoperative pain in pediatric patients. Self-report methods have limitations in younger children and parent, nurse or physician assessment can be used as a surrogate measure. These tools should be tested in different cultures as pain can be influenced by sociocultural factors. The objective was to assess the inter-rater agreement on four different behavioral pain assessment scales in our local population. Materials and Methods: This prospective, descriptive, observational study was conducted in Pakistan. American Society of Anesthesiologists I and II children, 3-7 years of age, undergoing elective surgery were enrolled. Four pain assessment scales were used, Children′s Hospital of Eastern Ontario Pain Scale (CHEOPS, Toddler Preschool Postoperative Pain Scale (TPPPS, objective pain scale (OPS, and Face, Legs, Activity, Cry, Consolability (FLACC. After 15 and 60 min of arrival in the postanesthesia care unit (PACU, each child evaluated his/her postoperative pain by self-reporting and was also independently assessed by the PACU nurse, PACU anesthetist and the parent. The sensitivity and specificity of the responses of the four pain assessment scales were compared to the response of the child. Results: At 15 min, sensitivity and specificity were >60% for doctors and nurses on FLACC, OPS, and CHEOPS scales and for FLACC and CHEOPS scale for the parents. Parents showed poor agreement on OPS and TPPS. At 60 min, sensitivity was poor on the OPS scale by all three observers. Nurses showed a lower specificity on FLACC tool. Parents had poor specificity on CHEOPS and rate of false negatives was high with TPPS. Conclusions: We recommend the use of FLACC scale for assessment by parents, nurses, and doctors in Pakistani children aged between 3 and 7.

  17. Integra artificial skin dermal regeneration templates in burn scar surgery

    International Nuclear Information System (INIS)

    Rexon Ngim

    1999-01-01

    Integra artificial skin is a porous matrix used as a permanent dermal replacement. Developed in the 1970's, it has been used successfully in the treatment of acute bums requiring full or deep partial thickness skin replacement. Three patients with burn scars received Integra Artificial Skin to resurface various areas of burn scars and also contractures. The first was a 24-year-old woman who had two pieces of Integra to resurface a forearm/elbow/wrist defect. The second was a 28-year-old woman who had two pieces of Integra to resurface a neck contracture. The third was a 44 year-old woman who had two pieces to correct severe burn contractures/ scars of her hands. The results of these three patients, probably the first time Integra was used for bum scar and contracture revision, indicate that there is a place for Integra in Burn Scar surgery. However, the basic principle of its application must be adhered to. These include excision to remove the complete scar, recreation of original size of skin defect and meticulous application of the Artificial Skin and its care post-operatively. Details of its application will be highlighted

  18. Renal scar formation after urinary tract infection in children

    Directory of Open Access Journals (Sweden)

    Young Seo Park

    2012-10-01

    Full Text Available Urinary tract infection (UTI is a common bacterial illness in children. Acute pyelonephritis in children may lead to renal scarring with the risk of later hypertension, preeclampsia during pregnancy, proteinuria, and renal insufficiency. Until now, vesicoureteral reflux (VUR has been considered the most important risk factor for post-UTI renal scar formation in children. VUR predisposes children with UTI to pyelonephritis, and both are associated with renal scarring. However, reflux nephropathy is not always acquired; rather, it reflects refluxassociated congenital dysplastic kidneys. The viewpoint that chronic kidney disease results from renal maldevelopment-associated VUR has led to questioning the utility of any regimen directed at identifying or treating VUR. Despite the recognition that underlying renal anomalies may be the cause of renal scarring that was previously attributed to infection, the prevention of renal scarring remains the goal of all therapies for childhood UTI. Therefore, children at high risk of renal scar formation after UTI should be treated and investigated until a large clinical study and basic research give us more information.

  19. A modified technique for application of tissue expanders for extremities in burn scars patients

    International Nuclear Information System (INIS)

    Ghalambor, A.

    2007-01-01

    Tissue expansion is considered a major advancement in reconstructive surgery. However, there are limitations to their application in the extremities and carries relatively higher rates of complications. The aim of this study was to propose a modification to this technique and assess the rate of complications with slower rate of expansion. Thirty females (age range 14 to 40) with burn scars in the upper or lower extremity (15 cases in each) were the subjects of this investigation. Various sized rectangular expanders were used and expanded at a rate of 5% of the maximum inflatable size over 20 weeks. All of the cases of expansion completed the procedure uneventfully. In one case that developed necrosis at the edge of the flap, one week after removal of the expander, which was debrided and repaired successfully completed the treatment. Slow expansion method is a useful method which can safely be applied for burn scars in the extremities. (author)

  20. The Neurologic Assessment in Neuro-Oncology (NANO) Scale as an Assessment Tool for Survival in Patients With Primary Glioblastoma.

    Science.gov (United States)

    Ung, Timothy H; Ney, Douglas E; Damek, Denise; Rusthoven, Chad G; Youssef, A Samy; Lillehei, Kevin O; Ormond, D Ryan

    2018-03-30

    The Neurologic Assessment in Neuro-Oncology (NANO) scale is a standardized objective metric designed to measure neurological function in neuro-oncology. Current neuroradiological evaluation guidelines fail to use specific clinical criteria for progression. To determine if the NANO scale was a reliable assessment tool in glioblastoma (GBM) patients and whether it correlated to survival. Our group performed a retrospective review of all patients with newly diagnosed GBM from January 1, 2010, through December 31, 2012, at our institution. We applied the NANO scale, Karnofsky performance score (KPS), Eastern Cooperative Oncology Group (ECOG) scale, Macdonald criteria, and the Response Assessment in Neuro-Oncology (RANO) criteria to patients at the time of diagnosis as well as at 3, 6, and 12 mo. Initial NANO score was correlated with overall survival at time of presentation. NANO progression was correlated with decreased survival in patients at 6 and 12 mo. A decrease in KPS was associated with survival at 3 and 6 mo, an increase in ECOG score was associated only at 3 mo, and radiological evaluation (RANO and Macdonald) was correlated at 3 and 6 mo. Only the NANO scale was associated with patient survival at 1 yr. NANO progression was the only metric that was linked to decreased overall survival when compared to RANO and Macdonald at 6 and 12 mo. The NANO scale is specific to neuro-oncology and can be used to assess patients with glioma. This retrospective analysis demonstrates the usefulness of the NANO scale in glioblastoma.

  1. North Carolina Family Assessment Scale: Measurement Properties for Youth Mental Health Services

    Science.gov (United States)

    Lee, Bethany R.; Lindsey, Michael A.

    2010-01-01

    Objective: The purpose of this study is to assess the reliability and validity of the North Carolina Family Assessment Scale (NCFAS) among families involved with youth mental health services. Methods: Using NCFAS data collected by child mental health intake workers with 158 families, factor analysis was conducted to assess factor structure, and…

  2. Evaluating the Risk of Child Abuse: The Child Abuse Risk Assessment Scale (CARAS)

    Science.gov (United States)

    Chan, Ko Ling

    2012-01-01

    The present study developed the Child Abuse Risk Assessment Scale (CARAS), an actuarial instrument for the assessment of the risk of physical child abuse. Data of 2,363 Chinese parents (47.7% male) living in Hong Kong were used in the analyses. Participants were individually interviewed with a questionnaire assessing their perpetration of child…

  3. Temporalis Fascia Transplantation for Sulcus Vocalis and Vocal Fold Scar: Long-Term Outcomes.

    Science.gov (United States)

    Karle, William E; Helman, Samuel N; Cooper, Amy; Zhang, Yuan; Pitman, Michael J

    2018-04-01

    Sulcus vocalis and vocal fold scar involve derangement of the superficial lamina propria of the vocal fold, which results in significant dysphonia. Many options exist for treatment, most of which have unsatisfactory and unpredictable outcomes. Autologous transplantation of temporalis fascia into the vocal fold (ATFV) has the potential to be a better treatment option, but long-term outcomes have not been well studied. Retrospective chart review and patient survey. Twenty-one patients diagnosed with vocal fold scar or sulcus vocalis and treated with ATFV with at least 1-year follow-up were included. Voice Handicap Index 10 (VHI-10) questionnaires were collected preoperatively and 6 months postoperatively. Patients were reached at the time of the study to complete another VHI-10 and a Likert scale survey. The mean decrease in VHI-10 scores between preoperation and 6 months postoperation was 8.35 ( P vocal fold for the treatment of vocal fold scar and sulcus vocalis is a safe surgery with good long-term outcomes and high patient satisfaction.

  4. Quality Assessment of Physical and Organoleptic Instant Corn Rice on Scale-Up Process

    Science.gov (United States)

    Kumalasari, R.; Ekafitri, R.; Indrianti, N.

    2017-12-01

    Development of instant corn rice product has been successfully conducted on a laboratory scale. Corn has high carbohydrate content but low in fiber. The addition of fiber in instant corn rice, intended to improve the functioning of the product, and replace fiber loss during the process. Scale up process of Instant corn rice required to increase the production capacity. Scale up was the process to get identic output on a larger scale based on predetermined production scale. This study aimed to assess the changes and differences in the quality of instant corn rice during scale up. Instant corn rice scale up was done on production capacity 3 kg, 4 kg and 5 kg. Results showed that scale up of instant corn rice producing products with rehydration ratio ranges between 514% - 570%, the absorption rate ranged between 414% - 470%, swelling rate ranging between 119% - 134%, bulk density ranged from 0.3661 to 0.4745 (g/ml) and porosity ranging between 30-37%. The physical quality of instant corn rice on scale up were stable from the ones at laboratory scale on swelling rate, rehydration ratio, and absorption rate but not stable on bulk density and porosity. Organoleptic qualities were stable at increased scale compared on a laboratory scale. Bulk density was higher than those at laboratory scale, and the porosity was lower than those at laboratory scale.

  5. Assessing motivation orientations in schizophrenia: Scale development and validation.

    Science.gov (United States)

    Cooper, Shanna; Lavaysse, Lindsey M; Gard, David E

    2015-01-30

    Motivation deficits are common in several disorders including schizophrenia, and are an important factor in both functioning and treatment adherence. Self-Determination Theory (SDT), a leading macro-theory of motivation, has contributed a number of insights into how motivation is impaired in schizophrenia. Nonetheless, self-report measures of motivation appropriate for people with severe mental illness (including those that emphasize SDT) are generally lacking in the literature. To fill this gap, we adapted and abbreviated the well-validated General Causality Orientation Scale for use with people with schizophrenia and with other severe mental disorders (GCOS-clinical populations; GCOS-CP). In Study 1, we tested the similarity of our measure to the existing GCOS (using a college sample) and then validated this new measure in a schizophrenia and healthy control sample (Study 2). Results from Study 1 (N=360) indicated that the GCOS-CP was psychometrically similar to the original GCOS and provided good convergent and discriminant validity. In Study 2, the GCOS-CP was given to individuals with (N=44) and without schizophrenia (N=42). In line with both laboratory-based and observer-based research, people with schizophrenia showed lower motivational autonomy and higher impersonal/amotivated orientations. Additional applications of the GCOS-CP are discussed. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  6. Scaling earthquake ground motions for performance-based assessment of buildings

    Science.gov (United States)

    Huang, Y.-N.; Whittaker, A.S.; Luco, N.; Hamburger, R.O.

    2011-01-01

    The impact of alternate ground-motion scaling procedures on the distribution of displacement responses in simplified structural systems is investigated. Recommendations are provided for selecting and scaling ground motions for performance-based assessment of buildings. Four scaling methods are studied, namely, (1)geometric-mean scaling of pairs of ground motions, (2)spectrum matching of ground motions, (3)first-mode-period scaling to a target spectral acceleration, and (4)scaling of ground motions per the distribution of spectral demands. Data were developed by nonlinear response-history analysis of a large family of nonlinear single degree-of-freedom (SDOF) oscillators that could represent fixed-base and base-isolated structures. The advantages and disadvantages of each scaling method are discussed. The relationship between spectral shape and a ground-motion randomness parameter, is presented. A scaling procedure that explicitly considers spectral shape is proposed. ?? 2011 American Society of Civil Engineers.

  7. Development and testing of a scale to assess physician attitudes about handheld computers with decision support.

    Science.gov (United States)

    Ray, Midge N; Houston, Thomas K; Yu, Feliciano B; Menachemi, Nir; Maisiak, Richard S; Allison, Jeroan J; Berner, Eta S

    2006-01-01

    The authors developed and evaluated a rating scale, the Attitudes toward Handheld Decision Support Software Scale (H-DSS), to assess physician attitudes about handheld decision support systems. The authors conducted a prospective assessment of psychometric characteristics of the H-DSS including reliability, validity, and responsiveness. Participants were 82 Internal Medicine residents. A higher score on each of the 14 five-point Likert scale items reflected a more positive attitude about handheld DSS. The H-DSS score is the mean across the fourteen items. Attitudes toward the use of the handheld DSS were assessed prior to and six months after receiving the handheld device. Cronbach's Alpha was used to assess internal consistency reliability. Pearson correlations were used to estimate and detect significant associations between scale scores and other measures (validity). Paired sample t-tests were used to test for changes in the mean attitude scale score (responsiveness) and for differences between groups. Internal consistency reliability for the scale was alpha = 0.73. In testing validity, moderate correlations were noted between the attitude scale scores and self-reported Personal Digital Assistant (PDA) usage in the hospital (correlation coefficient = 0.55) and clinic (0.48), p DSS scale was reliable, valid, and responsive. The scale can be used to guide future handheld DSS development and implementation.

  8. Scales

    Science.gov (United States)

    Scales are a visible peeling or flaking of outer skin layers. These layers are called the stratum ... Scales may be caused by dry skin, certain inflammatory skin conditions, or infections. Examples of disorders that ...

  9. Replication assessment of surface texture at sub-micrometre scale

    DEFF Research Database (Denmark)

    Quagliotti, Danilo; Tosello, Guido; Hansen, Hans Nørgaard

    2017-01-01

    [2]. A replication process requires reproducing a master geometry by conveying it to a substrate material. It is typically induced by means of different energy sources (usually heat and force) and a direct physical contact between the master and the substrate. Furthermore, concepts of advanced......, because of the replication nature of molding processes, the required specifications for the manufacture of micro molded components must be ensured by means of a metrological approach to surface replication and dimensional control of both master geometry and replicated substrate [3]-[4]. Therefore...... replication was assessed by the replication fidelity, i.e., comparing the produced parts with the tool used to replicate the geometry. Furthermore, the uncertainty of the replication fidelity was achieved by propagating the uncertainties evaluated for both masters and replicas. Finally, despite the specimens...

  10. Ozone time scale decomposition and trend assessment from surface observations

    Science.gov (United States)

    Boleti, Eirini; Hueglin, Christoph; Takahama, Satoshi

    2017-04-01

    Emissions of ozone precursors have been regulated in Europe since around 1990 with control measures primarily targeting to industries and traffic. In order to understand how these measures have affected air quality, it is now important to investigate concentrations of tropospheric ozone in different types of environments, based on their NOx burden, and in different geographic regions. In this study, we analyze high quality data sets for Switzerland (NABEL network) and whole Europe (AirBase) for the last 25 years to calculate long-term trends of ozone concentrations. A sophisticated time scale decomposition method, called the Ensemble Empirical Mode Decomposition (EEMD) (Huang,1998;Wu,2009), is used for decomposition of the different time scales of the variation of ozone, namely the long-term trend, seasonal and short-term variability. This allows subtraction of the seasonal pattern of ozone from the observations and estimation of long-term changes of ozone concentrations with lower uncertainty ranges compared to typical methodologies used. We observe that, despite the implementation of regulations, for most of the measurement sites ozone daily mean values have been increasing until around mid-2000s. Afterwards, we observe a decline or a leveling off in the concentrations; certainly a late effect of limitations in ozone precursor emissions. On the other hand, the peak ozone concentrations have been decreasing for almost all regions. The evolution in the trend exhibits some differences between the different types of measurement. In addition, ozone is known to be strongly affected by meteorology. In the applied approach, some of the meteorological effects are already captured by the seasonal signal and already removed in the de-seasonalized ozone time series. For adjustment of the influence of meteorology on the higher frequency ozone variation, a statistical approach based on Generalized Additive Models (GAM) (Hastie,1990;Wood,2006), which corrects for meteorological

  11. The efficacy of autologous platelet rich plasma combined with ablative carbon dioxide fractional resurfacing for acne scars: a simultaneous split-face trial.

    Science.gov (United States)

    Lee, Jin Woong; Kim, Beom Joon; Kim, Myeung Nam; Mun, Seog Kyun

    2011-07-01

    Ablative carbon dioxide (CO(2) ) fractional resurfacing is a promising therapeutic intervention for the treatment of acne scars, although this technique is associated with prolonged surgical site erythema and edema, which may affect the daily lives of patients. Autologous platelet-rich plasma (PRP) is known to enhance wound healing and has applications in many areas of medicine. To evaluate the synergistic effects of autologous PRP with CO(2) fractional resurfacing for acne scars. A split-face trial was conducted in 14 Korean participants with acne scars. All participants received one session of ablative CO(2) fractional resurfacing. Immediately after resurfacing, facial halves were randomly assigned to receive treatment with autologous PRP injections on one side (experimental side) and normal saline injections on the other side (control side). The participants were monitored for degree of recovery and resurfacing-associated adverse events, including prolonged erythema, edema, and other effects on days 0, 2, 4, 6, 8, 15, and 30. The intensity of erythema was objectively measured using a chromometer at the same time intervals. After one additional treatment session using the same protocol, two independent dermatologists evaluated clinical improvement using a quartile grading scale. All participants completed the study. Erythema on the experimental side improved faster than on the control side and was significantly less at day 4 (p=.01). This difference was confirmed using a chromometer (p=.049). Total duration of erythema was an average of 10.4±2.7 days on the control side and 8.6±2.0 days on the experimental side (p=.047). Edema also improved faster on the experimental side than on the control side. The total duration of edema was an average of 7.1±1.5 days on the control side and 6.1±1.1 days on the experimental side (p=.04). Participants were also assessed for duration of post-treatment crusting, with a mean of 6.8±1.0 days on the control side and 5.9±1

  12. Can the Frost Multidimensional Perfectionism Scale assess perfeccionismo?

    Science.gov (United States)

    Burgess, Alexandra M; DiBartolo, Patricia Marten; Rendón, María Jose

    2017-07-01

    Although culture-based measurement bias threatens the validity of intergroup comparison research, measurement invariance is often assumed rather than demonstrated by researchers who draw conclusions about cross-cultural similarities or differences. The current article investigates the cross-cultural invariance of a popular measure of perfectionism, the Frost Multidimensional Perfectionism Scale (F-MPS; Frost, Marten, Lahart, & Rosenblate, 1990) for a Hispanic/Latina sample. Perfectionism, which encompasses high goal setting and sensitivity to critical evaluation, is a transdiagnostic risk factor for internalizing psychopathology that especially warrants focus among groups burdened by mental health disparities. Multiple samples were used in a series of analyses to construct a baseline first-order measurement model and test for cross-group equivalence. For model development, confirmatory factor analyses (CFAs) were used with 320 female participants (M age = 19.61 years) who identified primarily (n = 301) as European/European American. Measurement invariance testing was conducted with multigroup CFAs using another sample of female adults (n = 574; Mage = 21.21 years), identifying either as European/European American (n = 217) or Hispanic/Latina/Latin American (n = 357). Evidence was found for invariance across the revised F-MPS factor structure, pattern of factor loadings, and factor variances/covariances. Results indicate that predictive relationships may be compared across these groups, but caution is suggested when interpreting raw mean score differences due to intercept nonequivalence. Further, second-order model testing demonstrated support for the bidimensional model of perfectionism cross-culturally. Future research on perfectionism within the Latino/a population is encouraged using this equivalent item set. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  13. The effect of Web-based Braden Scale training on the reliability and precision of Braden Scale pressure ulcer risk assessments.

    Science.gov (United States)

    Magnan, Morris A; Maklebust, Joann

    2008-01-01

    To evaluate the effect of Web-based Braden Scale training on the reliability and precision of pressure ulcer risk assessments made by registered nurses (RN) working in acute care settings. Pretest-posttest, 2-group, quasi-experimental design. Five hundred Braden Scale risk assessments were made on 102 acute care patients deemed to be at various levels of risk for pressure ulceration. Assessments were made by RNs working in acute care hospitals at 3 different medical centers where the Braden Scale was in regular daily use (2 medical centers) or new to the setting (1 medical center). The Braden Scale for Predicting Pressure Sore Risk was used to guide pressure ulcer risk assessments. A Web-based version of the Detroit Medical Center Braden Scale Computerized Training Module was used to teach nurses correct use of the Braden Scale and selection of risk-based pressure ulcer prevention interventions. In the aggregate, RN generated reliable Braden Scale pressure ulcer risk assessments 65% of the time after training. The effect of Web-based Braden Scale training on reliability and precision of assessments varied according to familiarity with the scale. With training, new users of the scale made reliable assessments 84% of the time and significantly improved precision of their assessments. The reliability and precision of Braden Scale risk assessments made by its regular users was unaffected by training. Technology-assisted Braden Scale training improved both reliability and precision of risk assessments made by new users of the scale, but had virtually no effect on the reliability or precision of risk assessments made by regular users of the instrument. Further research is needed to determine best approaches for improving reliability and precision of Braden Scale assessments made by its regular users.

  14. Developing an Assessment Method of Active Aging: University of Jyvaskyla Active Aging Scale.

    Science.gov (United States)

    Rantanen, Taina; Portegijs, Erja; Kokko, Katja; Rantakokko, Merja; Törmäkangas, Timo; Saajanaho, Milla

    2018-01-01

    To develop an assessment method of active aging for research on older people. A multiphase process that included drafting by an expert panel, a pilot study for item analysis and scale validity, a feedback study with focus groups and questionnaire respondents, and a test-retest study. Altogether 235 people aged 60 to 94 years provided responses and/or feedback. We developed a 17-item University of Jyvaskyla Active Aging Scale with four aspects in each item (goals, ability, opportunity, and activity; range 0-272). The psychometric and item properties are good and the scale assesses a unidimensional latent construct of active aging. Our scale assesses older people's striving for well-being through activities pertaining to their goals, abilities, and opportunities. The University of Jyvaskyla Active Aging Scale provides a quantifiable measure of active aging that may be used in postal questionnaires or interviews in research and practice.

  15. Psychometric Analysis of the Work/Life Balance Self-Assessment Scale.

    Science.gov (United States)

    Smeltzer, Suzanne C; Cantrell, Mary Ann; Sharts-Hopko, Nancy C; Heverly, Mary Ann; Jenkinson, Amanda; Nthenge, Serah

    2016-01-01

    This study investigated the psychometric properties of the Work/Life Balance Self-Assessment scale among nurse faculty involved in doctoral education. A national random sample of 554 respondents completed the Work/Life Balance Self-Assessment scale, which addresses 3 factors: work interference with personal life (WIPL), personal life interference with work (PLIW), and work/personal life enhancement (WPLE). A principal components analysis with varimax rotation revealed 3 internally consistent aspects of work-life balance, explaining 40.5% of the variance. The Cronbach's alpha coefficients for reliability of the scale were .88 for the total scale and for the subscales, .93 (WIPL), .85 (PLIW), and .69 (WPLE). The Work/Life Balance Self-Assessment scale appears to be a reliable and valid instrument to examine work-life balance among nurse faculty.

  16. Scale changes in air quality modelling and assessment of associated uncertainties

    International Nuclear Information System (INIS)

    Korsakissok, Irene

    2009-01-01

    After an introduction of issues related to a scale change in the field of air quality (existing scales for emissions, transport, turbulence and loss processes, hierarchy of data and models, methods of scale change), the author first presents Gaussian models which have been implemented within the Polyphemus modelling platform. These models are assessed by comparison with experimental observations and with other commonly used Gaussian models. The second part reports the coupling of the puff-based Gaussian model with the Eulerian Polair3D model for the sub-mesh processing of point sources. This coupling is assessed at the continental scale for a passive tracer, and at the regional scale for photochemistry. Different statistical methods are assessed

  17. Process assessment of small scale low temperature methanol synthesis

    Energy Technology Data Exchange (ETDEWEB)

    Hendriyana [Chemical Engineering Department, Faculty of Engineering, Jenderal Achmad Yani Univerity (Indonesia); Chemical Engineering Department, Faculty of Industrial Technology, InstitutTeknologi Bandung (Indonesia); Susanto, Herri, E-mail: herri@che.itb.ac.id; Subagjo [Chemical Engineering Department, Faculty of Industrial Technology, InstitutTeknologi Bandung (Indonesia)

    2015-12-29

    Biomass is a renewable energy resource and has the potential to make a significant impact on domestic fuel supplies. Biomass can be converted to fuel like methanol via several step process. The process can be split into following main steps: biomass preparation, gasification, gas cooling and cleaning, gas shift and methanol synthesis. Untill now these configuration still has a problem like high production cost, catalyst deactivation, economy of scale and a huge energy requirements. These problems become the leading inhibition for biomass conversion to methanol, which should be resolved to move towards the economical. To address these issues, we developed various process and new configurations for methanol synthesis via methyl formate. This configuration combining two reactors: the one reactor for the carbonylation of methanol and CO to form methyl formate, and the second for the hydrogenolysis of methyl formate and H{sub 2} to form two molecule of methanol. Four plant process configurations were compared with the biomass basis is 300 ton/day. The first configuration (A) is equipped with a steam reforming process for converting methane to CO and H{sub 2} for increasing H{sub 2}/CO ratio. CO{sub 2} removal is necessary to avoid poisoning the catalyst. COSORB process used for the purpose of increasing the partial pressure of CO in the feed gas. The steam reforming process in B configuration is not used with the aim of reducing the number of process equipment, so expect lower investment costs. For C configuration, the steam reforming process and COSORB are not used with the aim of reducing the number of process equipment, so expect lower investment costs. D configuration is almost similar to the configuration A. This configuration difference is in the synthesis of methanol which was held in a single reactor. Carbonylation and hydrogenolysis reactions carried out in the same reactor one. These processes were analyzed in term of technical process, material and energy

  18. Process assessment of small scale low temperature methanol synthesis

    International Nuclear Information System (INIS)

    Hendriyana; Susanto, Herri; Subagjo

    2015-01-01

    Biomass is a renewable energy resource and has the potential to make a significant impact on domestic fuel supplies. Biomass can be converted to fuel like methanol via several step process. The process can be split into following main steps: biomass preparation, gasification, gas cooling and cleaning, gas shift and methanol synthesis. Untill now these configuration still has a problem like high production cost, catalyst deactivation, economy of scale and a huge energy requirements. These problems become the leading inhibition for biomass conversion to methanol, which should be resolved to move towards the economical. To address these issues, we developed various process and new configurations for methanol synthesis via methyl formate. This configuration combining two reactors: the one reactor for the carbonylation of methanol and CO to form methyl formate, and the second for the hydrogenolysis of methyl formate and H 2 to form two molecule of methanol. Four plant process configurations were compared with the biomass basis is 300 ton/day. The first configuration (A) is equipped with a steam reforming process for converting methane to CO and H 2 for increasing H 2 /CO ratio. CO 2 removal is necessary to avoid poisoning the catalyst. COSORB process used for the purpose of increasing the partial pressure of CO in the feed gas. The steam reforming process in B configuration is not used with the aim of reducing the number of process equipment, so expect lower investment costs. For C configuration, the steam reforming process and COSORB are not used with the aim of reducing the number of process equipment, so expect lower investment costs. D configuration is almost similar to the configuration A. This configuration difference is in the synthesis of methanol which was held in a single reactor. Carbonylation and hydrogenolysis reactions carried out in the same reactor one. These processes were analyzed in term of technical process, material and energy balance and economic

  19. Tools and Techniques for Basin-Scale Climate Change Assessment

    Science.gov (United States)

    Zagona, E.; Rajagopalan, B.; Oakley, W.; Wilson, N.; Weinstein, P.; Verdin, A.; Jerla, C.; Prairie, J. R.

    2012-12-01

    The Department of Interior's WaterSMART Program seeks to secure and stretch water supplies to benefit future generations and identify adaptive measures to address climate change. Under WaterSMART, Basin Studies are comprehensive water studies to explore options for meeting projected imbalances in water supply and demand in specific basins. Such studies could be most beneficial with application of recent scientific advances in climate projections, stochastic simulation, operational modeling and robust decision-making, as well as computational techniques to organize and analyze many alternatives. A new integrated set of tools and techniques to facilitate these studies includes the following components: Future supply scenarios are produced by the Hydrology Simulator, which uses non-parametric K-nearest neighbor resampling techniques to generate ensembles of hydrologic traces based on historical data, optionally conditioned on long paleo reconstructed data using various Markov Chain techniuqes. Resampling can also be conditioned on climate change projections from e.g., downscaled GCM projections to capture increased variability; spatial and temporal disaggregation is also provided. The simulations produced are ensembles of hydrologic inputs to the RiverWare operations/infrastucture decision modeling software. Alternative demand scenarios can be produced with the Demand Input Tool (DIT), an Excel-based tool that allows modifying future demands by groups such as states; sectors, e.g., agriculture, municipal, energy; and hydrologic basins. The demands can be scaled at future dates or changes ramped over specified time periods. Resulting data is imported directly into the decision model. Different model files can represent infrastructure alternatives and different Policy Sets represent alternative operating policies, including options for noticing when conditions point to unacceptable vulnerabilities, which trigger dynamically executing changes in operations or other

  20. A multi-scale metrics approach to forest fragmentation for Strategic Environmental Impact Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Eunyoung, E-mail: eykim@kei.re.kr [Korea Environment Institute, 215 Jinheungno, Eunpyeong-gu, Seoul 122-706 (Korea, Republic of); Song, Wonkyong, E-mail: wksong79@gmail.com [Suwon Research Institute, 145 Gwanggyo-ro, Yeongtong-gu, Suwon-si, Gyeonggi-do 443-270 (Korea, Republic of); Lee, Dongkun, E-mail: dklee7@snu.ac.kr [Department of Landscape Architecture and Rural System Engineering, Seoul National University, 599 Gwanakro, Gwanak-gu, Seoul 151-921 (Korea, Republic of); Research Institute for Agriculture and Life Sciences, Seoul National University, Seoul 151-921 (Korea, Republic of)

    2013-09-15

    Forests are becoming severely fragmented as a result of land development. South Korea has responded to changing community concerns about environmental issues. The nation has developed and is extending a broad range of tools for use in environmental management. Although legally mandated environmental compliance requirements in South Korea have been implemented to predict and evaluate the impacts of land-development projects, these legal instruments are often insufficient to assess the subsequent impact of development on the surrounding forests. It is especially difficult to examine impacts on multiple (e.g., regional and local) scales in detail. Forest configuration and size, including forest fragmentation by land development, are considered on a regional scale. Moreover, forest structure and composition, including biodiversity, are considered on a local scale in the Environmental Impact Assessment process. Recently, the government amended the Environmental Impact Assessment Act, including the SEA, EIA, and small-scale EIA, to require an integrated approach. Therefore, the purpose of this study was to establish an impact assessment system that minimizes the impacts of land development using an approach that is integrated across multiple scales. This study focused on forest fragmentation due to residential development and road construction sites in selected Congestion Restraint Zones (CRZs) in the Greater Seoul Area of South Korea. Based on a review of multiple-scale impacts, this paper integrates models that assess the impacts of land development on forest ecosystems. The applicability of the integrated model for assessing impacts on forest ecosystems through the SEIA process is considered. On a regional scale, it is possible to evaluate the location and size of a land-development project by considering aspects of forest fragmentation, such as the stability of the forest structure and the degree of fragmentation. On a local scale, land-development projects should

  1. Chemical concentrations, exposures, health risks by census tract from National Scale Air Toxics Assessment (NATA)

    Data.gov (United States)

    U.S. Environmental Protection Agency — Chemical concentrations, exposures, health risks by census tract for the United States from National Scale Air Toxics Assessment (NATA). This dataset is associated...

  2. Acidification of Earth: An assessment across mechanisms and scales

    Science.gov (United States)

    Rice, Karen; Herman, Janet S.

    2012-01-01

    In this review article, anthropogenic activities that cause acidification of Earth’s air, waters, and soils are examined. Although there are many mechanisms of acidification, the focus is on the major ones, including emissions from combustion of fossil fuels and smelting of ores, mining of coal and metal ores, and application of nitrogen fertilizer to soils, by elucidating the underlying biogeochemical reactions as well as assessing the magnitude of the effects. These widespread activities have resulted in (1) increased CO2concentration in the atmosphere that acidifies the oceans; (2) acidic atmospheric deposition that acidifies soils and bodies of freshwater; (3) acid mine drainage that acidifies bodies of freshwater and groundwaters; and (4) nitrification that acidifies soils. Although natural geochemical reactions of mineral weathering and ion exchange work to buffer acidification, the slow reaction rates or the limited abundance of reactant phases are overwhelmed by the onslaught of anthropogenic acid loading. Relatively recent modifications of resource extraction and usage in some regions of the world have begun to ameliorate local acidification, but expanding use of resources in other regions is causing environmental acidification in previously unnoticed places. World maps of coal consumption, Cu mining and smelting, and N fertilizer application are presented to demonstrate the complex spatial heterogeneity of resource consumption as well as the overlap in acidifying potential derived from distinctly different phenomena. Projected population increase by country over the next four decades indicates areas with the highest potential for acidification, so enabling anticipation and planning to offset or mitigate the deleterious environmental effects associated with these global shifts in the consumption of energy, mineral, and food resources.

  3. Assessing Competition with the Panzar-Rosse Model: The Role of Scale, Costs, and Equilibrium

    NARCIS (Netherlands)

    Bikker, J.A.|info:eu-repo/dai/nl/06912261X; Shaffer, S.; Spierdijk, L.

    2009-01-01

    The Panzar-Rosse test has been widely applied to assess competitive conduct, often in specifcations controlling for firm scale or using a price equation. We show that neither a price equation nor a scaled revenue function yields a valid measure for competitive conduct. Moreover, even an unscaled

  4. Assessment of renewable energy resources potential for large scale and standalone applications in Ethiopia

    NARCIS (Netherlands)

    Tucho, Gudina Terefe; Weesie, Peter D.M.; Nonhebel, Sanderine

    2014-01-01

    This study aims to determine the contribution of renewable energy to large scale and standalone application in Ethiopia. The assessment starts by determining the present energy system and the available potentials. Subsequently, the contribution of the available potentials for large scale and

  5. Capturing subregional variability in regional-scale climate change vulnerability assessments of natural resources

    Science.gov (United States)

    Polly C. Buotte; David L. Peterson; Kevin S. McKelvey; Jeffrey A. Hicke

    2016-01-01

    Natural resource vulnerability to climate change can depend on the climatology and ecological conditions at a particular site. Here we present a conceptual framework for incorporating spatial variability in natural resource vulnerability to climate change in a regional-scale assessment. The framework was implemented in the first regional-scale vulnerability...

  6. Brief Assessment of Motor Function: Content Validity and Reliability of the Upper Extremity Gross Motor Scale

    Science.gov (United States)

    Cintas, Holly Lea; Parks, Rebecca; Don, Sarah; Gerber, Lynn

    2011-01-01

    Content validity and reliability of the Brief Assessment of Motor Function (BAMF) Upper Extremity Gross Motor Scale (UEGMS) were evaluated in this prospective, descriptive study. The UEGMS is one of five BAMF ordinal scales designed for quick documentation of gross, fine, and oral motor skill levels. Designed to be independent of age and…

  7. Matrix Metalloproteinases Are Differentially Regulated and Responsive to Compression Therapy in a Red Duroc Model of Hypertrophic Scar.

    Science.gov (United States)

    Travis, Taryn E; Ghassemi, Pejhman; Prindeze, Nicholas J; Moffatt, Lauren T; Carney, Bonnie C; Alkhalil, Abdulnaser; Ramella-Roman, Jessica C; Shupp, Jeffrey W

    2018-01-01

    Objective: Proteins of the matrix metalloproteinases family play a vital role in extracellular matrix maintenance and basic physiological processes in tissue homeostasis. The function and activities of matrix metalloproteinases in response to compression therapies have yet to be defined. Here, a swine model of hypertrophic scar was used to profile the transcription of all known 26 matrix metalloproteinases in scars treated with a precise compression dose. Methods: Full-thickness excisional wounds were created. Wounds underwent healing and scar formation. A subset of scars underwent 2 weeks of compression therapy. Biopsy specimens were preserved, and microarrays, reverse transcription-polymerase chain reaction, Western blotting, and immunohistochemistry were performed to characterize the transcription and expression of various matrix metalloproteinase family members. Results: Microarray results showed that 13 of the known 26 matrix metalloproteinases were differentially transcribed in wounds relative to the preinjury skin. The predominant upregulation of these matrix metalloproteinases during early wound-healing stages declined gradually in later stages of wound healing. The use of compression therapy reduced this decline in 10 of the 13 differentially regulated matrix metalloproteinases. Further investigation of MMP7 using reverse transcription-polymerase chain reaction confirmed the effect of compression on transcript levels. Assessment of MMP7 at the protein level using Western blotting and immunohistochemistry was concordant. Conclusions: In a swine model of hypertrophic scar, the application of compression to hypertrophic scar attenuated a trend of decreasing levels of matrix metalloproteinases during the process of hypertrophic wound healing, including MMP7, whose enzyme regulation was confirmed at the protein level.

  8. Assessment of respondent acceptability of preference measures: discriminatory power of graphic positioning scale versus traditional scaling measures.

    Science.gov (United States)

    Franic, Duska M; Pathak, Dev S

    2003-01-01

    The objective of this study was to compare discriminatory power of two different measures-graphic positioning scale (GPS) versus traditional scale (TS)-in assessing respondent acceptability of three preference measures: visual analog scale (VAS), standard gamble (SG), and willingness to pay (WTP). Two face-to-face interviews were conducted at least 1 week apart in a convenience sample of women aged 22 to 50 years with no history of breast cancer or cancer requiring chemotherapy. Study participation required completion of two surveys: one evaluating health preferences for an acute condition (chemotherapy-induced nausea and vomiting) and one evaluating a chronic condition (breast cancer). Data were collected from March 2000 to June 2000 at Ohio State University. Respondents were randomized to either GPS or TS surveys. Data analysis was a two-step process. First, a four-way multivariate repeated-measures analysis of variance (MANOVA) was conducted to assess respondent acceptability of three-preference metrics-VAS, SG, and WTP-in health-care decision making. Each of the four dependent variables, difficulty, clarity, reasonableness, and comfort in use in decision making, was measured on 9-point Likert scale. Second, a mixed design univariate analysis of variance (ANOVA) was performed for each dependent variable to optimize MANOVA analysis. Univariate ANOVAs, 2 x (2 x 3), were composed of three independent variables: assessment (GPS/TS), condition (acute and chronic), and preferences (VAS, SG, WTP). Of 126 respondents, 119 were usable and complete. MANOVA results showed (P <.05) for two main effects, condition (F4,114 = 6.375) and preferences (F8,110 = 9.290), and two significant interactions, condition x assessment (F4,114 = 3.421) and condition x preferences (F8,110 = 2.087). GPS has higher discriminatory power than TS in assessing respondent attitudes toward health preference measures. Results showed that respondents had more difficulty and less comfort when making

  9. ["Palimpsest scar" lesions in a context of torture (Darfur, Sudan)].

    Science.gov (United States)

    Charlier, P; Bou Abdallah, F; Mostefai Dulac, Y; Deo, S; Jacqueline, S; Brun, L; Hervé, C

    2017-11-01

    As a result of the current exponentially growing refugee population from the Middle-East and East Africa (Sudan, Darfur, Eritrea), clinicians (including forensic pathologists) are seeing atypical skin lesions, mainly of a traumatic nature, but in some cases associated with long-standing lesions related to ethnic practices. A case of torture sequelae is presented herein in a patient originally from Darfur (Sudan): cutaneous incisions were made on old scars several times using a knife. The clinical presentation of scarification lesions and that of atypically healed wounds (presumably an effect of inflammation induced by the introduction of irritating foreign bodies such as sand, salt, etc.) are completely different: in all cases they indicate a relative timeframe of the facts, which the clinician should not overlook in reconstructing the patient's course and the injuries to which he has been subjected (hence the proposed designation of "palimpsest scar", in the sense that a palimpsest is a manuscript on a parchment that previously contained writing but has been scratched clean to be overwritten). Thus, a "palimpsest scar" constitutes a fresh scar on top of and hiding another (ritual) scar in a context of ethnic cleansing. The diagnostic and clinical significance comes from the importance of differentiating between ethnic-type lesions and those induced by physical violence and abuse in a context of war. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  10. [Comparision of Different Methods of Area Measurement in Irregular Scar].

    Science.gov (United States)

    Ran, D; Li, W J; Sun, Q G; Li, J Q; Xia, Q

    2016-10-01

    To determine a measurement standard of irregular scar area by comparing the advantages and disadvantages of different measurement methods in measuring same irregular scar area. Irregular scar area was scanned by digital scanning and measured by coordinate reading method, AutoCAD pixel method, Photoshop lasso pixel method, Photoshop magic bar filled pixel method and Foxit PDF reading software, and some aspects of these methods such as measurement time, repeatability, whether could be recorded and whether could be traced were compared and analyzed. There was no significant difference in the scar areas by the measurement methods above. However, there was statistical difference in the measurement time and repeatability by one or multi performers and only Foxit PDF reading software could be traced back. The methods above can be used for measuring scar area, but each one has its advantages and disadvantages. It is necessary to develop new measurement software for forensic identification. Copyright© by the Editorial Department of Journal of Forensic Medicine

  11. Caesarean section greatly increases risk of scar endometriosis.

    Science.gov (United States)

    Nominato, Nilo Sérgio; Prates, Luis Felipe Victor Spyer; Lauar, Isabela; Morais, Jaqueline; Maia, Laura; Geber, Selmo

    2010-09-01

    To estimate the incidence of scar endometriosis after different surgical procedures. A retrospective study of 72 patients diagnosed with scar endometriosis between 1978 and 2003 was performed. Patient age, site of endometriosis, previous operations, time-gap between last surgery and onset of symptoms, nodule characteristics, and recurrence were evaluated. Age ranged from 16 to 48 years. Location varied according to the previous surgery: 46 caesarean section, one hysterectomy, one in abdominal surgery, 19 episiotomy, one was a relapse and two pelvic floor procedures, two women with no previous surgery. The incidence of scar endometriosis after caesarean section was significantly higher than after episiotomy (0.2 and 0.06%, respectively: p<0.00001) with a relative risk of 3.3. Pain was the most frequent symptom. The mean time between surgery and onset of symptoms was 3.7 years. Our findings confirm that scar endometriosis is a rare condition and indicate, probably for the first time, that caesarean section greatly increases the risk of developing scar endometriosis. Copyright 2010 Elsevier Ireland Ltd. All rights reserved.

  12. Emergent scar lines in chaotic advection of passive directors

    Science.gov (United States)

    Hejazi, Bardia; Mehlig, Bernhard; Voth, Greg A.

    2017-12-01

    We examine the spatial field of orientations of slender fibers that are advected by a two-dimensional fluid flow. The orientation field of these passive directors are important in a wide range of industrial and geophysical flows. We introduce emergent scar lines as the dominant coherent structures in the orientation field of passive directors in chaotic flows. Previous work has identified the existence of scar lines where the orientation rotates by π over short distances, but the lines that were identified disappeared as time progressed. As a result, earlier work focused on topological singularities in the orientation field, which we find to play a negligible role at long times. We use the standard map as a simple time-periodic two-dimensional flow that produces Lagrangian chaos. This class of flows produces persistent patterns in passive scalar advection and we find that a different kind of persistent pattern develops in the passive director orientation field. We identify the mechanism by which emergent scar lines grow to dominate these patterns at long times in complex flows. Emergent scar lines form where the recent stretching of the fluid element is perpendicular to earlier stretching. Thus these scar lines can be labeled by their age, defined as the time since their stretching reached a maximum.

  13. Understanding the NG2 glial scar after spinal cord injury

    Directory of Open Access Journals (Sweden)

    Amber R Hackett

    2016-11-01

    Full Text Available NG2 cells, also known as oligodendrocyte progenitor cells, are located throughout the central nervous system and serve as a pool of progenitors to differentiate into oligodendrocytes. In response to spinal cord injury, NG2 cells increase their proliferation and differentiation into remyelinating oligodendrocytes. While astrocytes are typically associated with being the major cell type in the glial scar, many NG2 cells also accumulate within the glial scar but their function remains poorly understood. Similar to astrocytes, these cells hypertrophy, upregulate expression of chondroitin sulfate proteoglycans, inhibit axon regeneration, contribute to the glial-fibrotic scar border, and some even differentiate into astrocytes. Whether NG2 cells also have a role in other astrocyte functions, such as preventing the spread of infiltrating leukocytes and expression of inflammatory cytokines, is not yet known. Thus, NG2 cells are not only important for remyelination after spinal cord injury, but are also a major component of the glial scar with functions that overlap with astrocytes in this region. In this review, we describe the signaling pathways important for the proliferation and differentiation of NG2 cells, as well as the role of NG2 cells in scar formation and tissue repair.

  14. Lactic acid peeling in superficial acne scarring in Indian skin.

    Science.gov (United States)

    Sachdeva, Silonie

    2010-09-01

    Chemical peeling with both alpha and beta hydroxy acids has been used to improve acne scarring with pigmentation. Lactic acid, a mild alpha hydroxy acid, has been used in the treatment of various dermatological indications but no study is reported in acne scarring with pigmentation. To evaluate the efficacy and safety of full strength pure lactic acid 92% (pH 2.0) chemical peel in superficial acne scarring in Indian skin. Seven patients, Fitzpatrick skin type IV-V, in age group 20-30 years with superficial acne scarring were enrolled in the study. Chemical peeling was done with lactic acid at an interval of 2 weeks to a maximum of four peels. Pre- and post-peel clinical photographs were taken at every session. Patients were followed every month for 3 months after the last peel to evaluate the effects. At the end of 3 months, there was definite improvement in the texture, pigmentation, and appearance of the treated skin, with lightening of scars. Significant improvement (greater than 75% clearance of lesions) occurred in one patient (14.28%), good improvement (51-75% clearance) in three patients (42.84%), moderate improvement (26-50% clearance) in two patients (28.57%), and mild improvement (1-25% clearance) in one patient (14.28%). © 2010 Wiley Periodicals, Inc.

  15. A psychometric assessment of the LPME scale for the South African skills development context

    Directory of Open Access Journals (Sweden)

    Maelekanyo Christopher Tshilongamulenzhe

    2015-09-01

    Full Text Available A thorough examination of psychometric properties of measurement scales is necessary to ensure that these scales comply with the existing scientific conventions. This article assesses the psychometric properties of the Learning Programme Management and Evaluation (LPME scale. A quantitative, non-experimental cross-sectional survey design was used. Data were collected from a sample of 652 respondents comprising skills development practitioners and learners/apprentices. Data were analyzed using Winsteps, SPSS and AMOS computer software. The findings show that the LPME scale meets the psychometric expectations and complies with the established scientific conventions in terms of validity, reliability, fit and unidimensionality.

  16. To explore the community rehabilitation assessment scales for patients with stroke sequelae

    Directory of Open Access Journals (Sweden)

    Ling Tian

    2015-01-01

    Full Text Available Objective: To choose the scales that can comprehensively assess the function of patients with stroke sequelae for the grassroots medical staff. Methods: The commonly used scales were selected. The patients with stroke sequelae were assessed by the MOS item short from health survey(SF-36, Modified Barthel Index(MBI, Brain Injury Community Rehabilitation Outcome Scales(BICRO-39,WHO Disability Assessment Scale II(WHO-DAS II and Anxiety and Depression Self-rating Scales(SAS and SDS. The assessment datum was conducted by Pearson correlation coefficient. Results: The data of MBI have significant correlation among the datum of WHO-DASII, SF-36 and BICRO 39 scales(P<0.05. The datum of MBI doesn’t have correlation among the datum of the SAS and SDS (P>0.05. Conclusions: Community doctors can choose MBI which can effectively assess the activities of daily living for the community patients with stroke sequelae. MBI also can reflect the functional levels of community patients with stroke sequelae.

  17. A Study Of 7 Cases Of Depressed Facial Scars Corrected By Subcision

    Directory of Open Access Journals (Sweden)

    Malakar Subrata

    1997-01-01

    Full Text Available Seven (7 cases of depressed facial scars which included depressed distensile acne scars, depressed bound down scars of acne excluding deep ice pick scars, and scars of varicella constituted the study group. The scars were treated with a new method named subcuticular undermining. A tri-bevelled hypodermic needle was inserted through a puncture in the skin surface and its sharp edges were manouevered under the scar. The depression was lifted by the releasing action of the needle maneuevere and from connective tissue that forms in course of normal wound healing. Approximately 50% to 80% improvement of all the scars were noticed. Patient’s compliance was highly satisfactory. Subcision is an appropriate, option in depressed scars of black skin (Type IV-Type VI where dermabrasion and medium-depth and deep chemical peeling are contraindicated.

  18. A visual analogue scale and a Likert scale are simple and responsive tools for assessing dysphagia in eosinophilic oesophagitis.

    Science.gov (United States)

    Reed, C C; Wolf, W A; Cotton, C C; Dellon, E S

    2017-06-01

    While symptom scores have been developed to evaluate dysphagia in eosinophilic oesophagitis (EoE), their complexity may limit clinical use. To evaluate a visual analogue scale (VAS) and a 10-point Likert scale (LS) for assessment of dysphagia severity before and after EoE treatment. We conducted a prospective cohort study enrolling consecutive adults undergoing out-patient endoscopy. Incident cases of EoE were diagnosed per consensus guidelines. At diagnosis and after 8 weeks of treatment, symptoms were measured using the VAS, LS and the Mayo Dysphagia Questionnaire (MDQ). The percentage change in scores before and after treatment were compared overall, in treatment responders (dysphagia severity in EoE in clinical practice. © 2017 John Wiley & Sons Ltd.

  19. A Visual Analogue Scale and a Likert Scale are Simple and Responsive Tools for Assessing Dysphagia in Eosinophilic Esophagitis

    Science.gov (United States)

    Reed, Craig C.; Wolf, W. Asher; Cotton, Cary C.; Dellon, Evan S.

    2017-01-01

    Background While symptom scores have been developed to evaluate dysphagia in eosinophilic oesophagitis (EoE), their complexity may limit clinical use. Aim We aimed to evaluate a visual analogue scale (VAS) and a 10 point Likert scale (LS) for assessment of dysphagia severity before and after EoE treatment. Methods We conducted a prospective cohort study enrolling consecutive adults undergoing outpatient endoscopy. Incident cases of EoE were diagnosed per consensus guidelines. At diagnosis and after 8 weeks of treatment, symptoms were measured using the VAS, LS, and the Mayo Dysphagia Questionnaire (MDQ). The percentage change in scores before and after treatment were compared overall, in treatment responders (dysphagia severity in EoE in clinical practice. PMID:28370355

  20. An Assessment of Five (PANSS, SAPS, SANS, NSA-16, CGI-SCH) commonly used Symptoms Rating Scales in Schizophrenia and Comparison to Newer Scales (CAINS, BNSS).

    Science.gov (United States)

    Kumari, Suneeta; Malik, Mansoor; Florival, Christina; Manalai, Partam; Sonje, Snezana

    2017-01-01

    Scales measuring positive and negative symptoms in schizophrenia remain the primary mo Scales measuring positive and negative symptoms in schizophrenia remain the primary mode of assessing and diagnosing schizophrenia by clinicians and researchers. The scales are mainly used to monitor the severity of positive and negative symptoms and track treatment response in schizophrenics. Although these scales are widely used, quality as well as general utility of each scale varies. The quality is determined by the validity and reliability of the scales. The utility of the scale is determined by the time of administration and the settings for which the scales can be administered in research or clinical settings. There are relatively fewer articles on the utility of newer scales like CAINS (Clinical Assessment Interview for Negative Symptoms) and the BNSS (Brief Negative Symptom Scale) that compare them to the older scales PANSS (Positive and Negative Symptoms Scale), SAPS (Scale for the Assessment of Positive Symptoms) SANS (the Scale for the Assessment of Negative Symptoms), NSA-16 (Negative Symptom Assessment-16) and CGI-SCH (Clinical Global Impression Schizophrenia. The older scales were developed more than 30 years ago. Since then, our understanding of negative symptoms has evolved and currently there are newer rating scales evaluating the validity of negative symptoms. The older scales do not incorporate the latest research on negative symptoms. CAINS and BNSS are attractive for both their reliability and their concise accessible format, however, a scale that is simpler, accessible, user-friendly, that incorporates a multidimensional model of schizophrenia, addresses the psychosocial and cognitive component has yet to be developed.

  1. Establishing the Validity of the Personality Assessment Inventory Drug and Alcohol Scales in a Corrections Sample

    Science.gov (United States)

    Patry, Marc W.; Magaletta, Philip R.; Diamond, Pamela M.; Weinman, Beth A.

    2011-01-01

    Although not originally designed for implementation in correctional settings, researchers and clinicians have begun to use the Personality Assessment Inventory (PAI) to assess offenders. A relatively small number of studies have made attempts to validate the alcohol and drug abuse scales of the PAI, and only a very few studies have validated those…

  2. Evidence Based Clinical Assessment of Child and Adolescent Social Phobia: A Critical Review of Rating Scales

    Science.gov (United States)

    Tulbure, Bogdan T.; Szentagotai, Aurora; Dobrean, Anca; David, Daniel

    2012-01-01

    Investigating the empirical support of various assessment instruments, the evidence based assessment approach expands the scientific basis of psychotherapy. Starting from Hunsley and Mash's evaluative framework, we critically reviewed the rating scales designed to measure social anxiety or phobia in youth. Thirteen of the most researched social…

  3. Including Performance Assessments in Accountability Systems: A Review of Scale-Up Efforts

    Science.gov (United States)

    Tung, Rosann

    2010-01-01

    The purpose of this literature and field review is to understand previous efforts at scaling up performance assessments for use across districts and states. Performance assessments benefit students and teachers by providing more opportunities for students to demonstrate their knowledge and complex skills, by providing teachers with better…

  4. Nurses assessing pain with the Nociception Coma Scale: interrater reliability and validity

    NARCIS (Netherlands)

    Vink, Peter; Eskes, Anne Maria; Lindeboom, Robert; van den Munckhof, Pepijn; Vermeulen, Hester

    2014-01-01

    The Nociception Coma Scale (NCS) is a pain observation tool, developed for patients with disorders of consciousness (DOC) due to acquired brain injury (ABI). The aim of this study was to assess the interrater reliability of the NCS and NCS-R among nurses for the assessment of pain in ABI patients

  5. A Multitrait-Multimethod Examination of the Reynolds Intellectual Assessment Scales in a College Sample

    Science.gov (United States)

    Beaujean, A. Alexander; Firmin, Michael W.; Michonski, Jared D.; Berry, Theodore; Johnson, Courtney

    2010-01-01

    This study assessed trait validity of the Reynolds Intellectual Assessment Scales' (RIAS) Verbal Index (VIX) and Nonverbal Index (NIX) scores in a group of college students. Using both observation of patterns and latent variable modeling of a multitrait-multimethod correlation/covariance matrix, the results indicate that the RIAS VIX scores…

  6. [An assessment scale for the prevention of pressure sores in children].

    Science.gov (United States)

    Chauvet, Corinne; Poirier, Marie-Renée; Sourisseau, Petronela Rachieru; Béduneau, Denis; Soulard, Anthony; Delacroix, Delphine

    2015-04-01

    Pressure sores in children are rare. However, when they do occur they can have significant consequences. Professionals in paediatric units realised the importance of assessing the risk of pressure sores and developed a pressure sore assessment scale specific to children. This project, carried out through a hospital-training school partnership, emphasises the importance of clinical reasoning in nursing practices.

  7. Secondary Analysis of Large-Scale Assessment Data: An Alternative to Variable-Centred Analysis

    Science.gov (United States)

    Chow, Kui Foon; Kennedy, Kerry John

    2014-01-01

    International large-scale assessments are now part of the educational landscape in many countries and often feed into major policy decisions. Yet, such assessments also provide data sets for secondary analysis that can address key issues of concern to educators and policymakers alike. Traditionally, such secondary analyses have been based on a…

  8. Factor Analytic Study of Lecturer's Teaching Assessment Scale in Obafemi Awolowo University, Nigeria

    Science.gov (United States)

    Jegede, Olu Philip; Faleye, Bamidele Abiodun; Adeyemo, Emily Oluseyi

    2015-01-01

    This study presents a validation report of the Lecturer's Teaching Assessment Scale (LTAS) developed for the assessment of lecturer's teaching effectiveness in Obafemi Awolowo University, Ile-Ife, Nigeria. It also examined the factor structure of the LTAS, its construct validity, and internal consistency reliability coefficients. The study adopted…

  9. Clinical relevance of aberrant polypoid nodule scar after endoscopic submucosal dissection

    Science.gov (United States)

    Arantes, Vitor; Uedo, Noriya; Pedrosa, Moises Salgado; Tomita, Yasuhiko

    2016-01-01

    AIM To describe a series of patients with aberrant polypoid nodule scar developed after gastric endoscopic submucosal dissection (ESD), and to discuss its pathogenesis and clinical management. METHODS We reviewed retrospectively the endoscopic database of two academic institutions located in Brazil and Japan and searched for all patients that underwent ESD to manage gastric neoplasms from 2003 to 2015. The criteria for admission in the study were: (1) successful en bloc ESD procedure with R0 and curative resection confirmed histologically; (2) postoperative endoscopic examination with identification of a polypoid nodule scar (PNS) at ESD scar; (3) biopsies of the PNS with hyperplastic or regenerative tissue, reviewed by two independent experienced gastrointestinal pathologists, one from each Institution. Data were examined for patient demographics, Helicobacter pylori status, precise neoplastic lesion location in the stomach, tumor size, histopathological assessment of the ESD specimen, and postoperative information including medical management, endoscopic and histological findings, and clinical outcome. RESULTS A total of 14 patients (10 men/4 women) fulfilled the inclusion criteria and were enrolled in this study. One center contributed with 8 cases out of 60 patients (13.3%) from 2008 to 2015. The second center contributed with 6 cases (1.7%) out of 343 patients from 2003 to 2015. Postoperative endoscopic follow-up revealed similar findings in all patients: A protruded polypoid appearing nodule situated in the center of the ESD scar surrounded by convergence of folds. Biopsies samples were taken from PNS, and histological assessment revealed in all cases regenerative and hyperplastic tissue, without recurrent tumor or dysplasia. Primary neoplastic lesions were located in the antrum in 13 patients and in the angle in one patient. PNS did not develop in any patient after ESD undertaken for tumors located in the corpus, fundus or cardia. All patients have been

  10. The efficacy of autologous platelet-rich plasma combined with erbium fractional laser therapy for facial acne scars or acne.

    Science.gov (United States)

    Zhu, Jiang-Ting; Xuan, Min; Zhang, Ya-Ni; Liu, Hong-Wei; Cai, Jin-Hui; Wu, Yan-Hong; Xiang, Xiao-Fei; Shan, Gui-Qiu; Cheng, Biao

    2013-07-01

    The aim of this study was to evaluate the efficacy of autologous platelet-rich plasma (PRP) combined with erbium fractional laser therapy for facial acne or acne scars. PRP combined with erbium fractional laser therapy was used for the treatment of 22 patients, including 16 patients who suffered from facial acne scars and 6 patients who suffered from acne scars concomitant with acne. Whole blood (40 ml) was collected from each patient, and following differential centrifugation, PRP was harvested. After using an erbium fractional laser, we applied PRP to the entire face of every patient. Digital photos were taken before and after the treatment for evaluation by dermatologists and the patients rated the efficacy on a 5-point scale. The erythema was moderate or mild, while its total duration was 50%, and 91% of the patients were satisfied; no acne inflammation was observed after treatment. PRP combined with erbium fractional laser therapy is an effective and safe approach for treating acne scars or acne, with minimal side-effects, and it simultaneously enhanced the recovery of laser-damaged skin.

  11. Investigating the reliability and validity of the waterlow risk assessment scale: a literature review.

    LENUS (Irish Health Repository)

    Walsh, Breda

    2012-02-01

    The aim of this review was to examine health literature on the reliability and validity of the Waterlow pressure sore assessment scale. A systematic review of published studies relating to the topic was conducted and literature was examined for its relevancy to the topic under investigation. Findings suggest that despite the availability of over 40 assessment tools, the Waterlow assessment scale is the most frequently used by health care staff. Research suggests that the Waterlow Scale is an unreliable method of assessing individuals at risk of pressure sore development with all studies indicating a poor interrater reliability status. Its validity has also been criticized because of its high-sensitivity but low-specificity levels.

  12. Investigating the reliability and validity of the waterlow risk assessment scale: a literature review.

    LENUS (Irish Health Repository)

    Walsh, Breda

    2011-05-01

    The aim of this review was to examine health literature on the reliability and validity of the Waterlow pressure sore assessment scale. A systematic review of published studies relating to the topic was conducted and literature was examined for its relevancy to the topic under investigation. Findings suggest that despite the availability of over 40 assessment tools, the Waterlow assessment scale is the most frequently used by health care staff. Research suggests that the Waterlow Scale is an unreliable method of assessing individuals at risk of pressure sore development with all studies indicating a poor interrater reliability status. Its validity has also been criticized because of its high-sensitivity but low-specificity levels.

  13. Surgical Scar Site Recurrence in Patients With Cervical Cancer on 18F-FDG PET-CT: A Case-Control Study.

    Science.gov (United States)

    Dhull, Varun S; Khangembam, Bangkim C; Sharma, Punit; Rana, Neelima; Verma, Satyavrat; Sharma, Dayanand; Shamim, Shamim A; Kumar, Sunesh; Kumar, Rakesh

    2016-02-01

    The purpose of this study was to assess the role of fluorine 18 ((18)F)-fluorodeoxyglucose positron emission tomography-computed tomography ((18)F-FDG PET-CT) in evaluating various parameters in patients with surgical scar site recurrence in cervical carcinoma. Data of all patients with cervical cancer (n = 329) who underwent PET-CT at our institute between 2005 and 2013 was reviewed. Of these 329 patients, 132 patients who were surgically treated and underwent restaging/follow-up PET-CT were included in the present study for final analysis. Tumor recurrence at the abdominal surgical scar site was looked for. Abnormal uptakes suggestive of active disease at other sites were also noted. Maximum standardized uptake value was measured for all the lesions. Patients with scar site recurrence were taken as cases (n = 6), whereas the remaining patients served as controls (n = 126). Comparison with conventional imaging modalities was made wherever available. Histopathological examination was always sought for. The incidence of scar site recurrence after surgery was found to be 4.5% (6/117). A total of 56 of 132 patients had recurrent disease, including 6 patients with scar site recurrence. All of the patients with scar site recurrence also had recurrent disease at other sites (local, nodal, or distant). Conventional imaging modalities were available in 4 of these 6 patients and detected scar site recurrence in 3 of those 4 patients. In patients with scar site recurrence, the mean ± SD time to scar site recurrence was 14.0 ± 10.9 months (median, 10 months; range, 7-36 months). Significant difference was seen between cases and control for International Federation of Genecology and Oncology stage (P = 0.001) and nodal recurrence (P = 0.007). Additionally, age, nodal recurrence, distant recurrence, and scar site recurrence were significantly associated with death. Scar site recurrence carries a poor prognosis, and the incidence is much higher than previously known when PET

  14. Etiopathogenesis of Post-endodontic Periapical Scar Formation

    Directory of Open Access Journals (Sweden)

    Edita Horká

    2012-01-01

    Full Text Available Introduction: A periapical scar represents a clinically asymptomatic, non-progressive, small, periapical radiolucency in patients with a previously well-performed root canal treatment.The hypothesis: We introduce a hypothesis that periapical scar formation is caused by osseoinhibitory molecular signaling from the epithelial cell rests of Malassez.Evaluation of the hypothesis: When epithelial cell rests of Malassez are present in teeth with an infected root canal system, a periapical cyst develops, whereas in the case of a treated root canal system infection, periapical inflammation is diminished and the periapical leasion heals until the regeneration process reaches the apical part of the tooth where epithelial cell rests of Malassez are present. Cytokines cause rapidly progressive defensive fibroproduction and scar formation, in which osteoblasts cannot differentiate into

  15. Treating kleptomania: Cross-cultural adaptation of the kleptomania symptom assessment scale and assessment of an outpatient program

    OpenAIRE

    Christianini, AR; Conti, MA; Hearst, N; Cordás, TA; De Abreu, CN; Tavares, H

    2015-01-01

    © 2014 Elsevier Inc. All rights reserved. Background Kleptomania is characterized by repetitive stealing and has severe consequences for patients. Stigma, a lack of standardized therapy and a limited number of assessment tools hinder advances in treatment. This study provides preliminary data on the Portuguese-language version of the Kleptomania Symptom Assessment Scale (P-K-SAS) and preliminary data on an outpatient program. Methods Experts in the field analyzed an initial P-K-SAS version, p...

  16. Reproducibility of small animal cine and scar cardiac magnetic resonance imaging using a clinical 3.0 tesla system

    International Nuclear Information System (INIS)

    Manka, Robert; Jahnke, Cosima; Hucko, Thomas; Dietrich, Thore; Gebker, Rolf; Schnackenburg, Bernhard; Graf, Kristof; Paetsch, Ingo

    2013-01-01

    To evaluate the inter-study, inter-reader and intra-reader reproducibility of cardiac cine and scar imaging in rats using a clinical 3.0 Tesla magnetic resonance (MR) system. Thirty-three adult rats (Sprague–Dawley) were imaged 24 hours after surgical occlusion of the left anterior descending coronary artery using a 3.0 Tesla clinical MR scanner (Philips Healthcare, Best, The Netherlands) equipped with a dedicated 70 mm solenoid receive-only coil. Left-ventricular (LV) volumes, mass, ejection fraction and amount of myocardial scar tissue were measured. Intra-and inter-observer reproducibility was assessed in all animals. In addition, repeat MR exams were performed in 6 randomly chosen rats within 24 hours to assess inter-study reproducibility. The MR imaging protocol was successfully completed in 32 (97%) animals. Bland-Altman analysis demonstrated high intra-reader reproducibility (mean bias%: LV end-diastolic volume (LVEDV), -1.7%; LV end-systolic volume (LVESV), -2.2%; LV ejection fraction (LVEF), 1.0%; LV mass, -2.7%; and scar mass, -1.2%) and high inter-reader reproducibility (mean bias%: LVEDV, 3.3%; LVESV, 6.2%; LVEF, -4.8%; LV mass, -1.9%; and scar mass, -1.8%). In addition, a high inter-study reproducibility was found (mean bias%: LVEDV, 0.1%; LVESV, -1.8%; LVEF, 1.0%; LV mass, -4.6%; and scar mass, -6.2%). Cardiac MR imaging of rats yielded highly reproducible measurements of cardiac volumes/function and myocardial infarct size on a clinical 3.0 Tesla MR scanner system. Consequently, more widely available high field clinical MR scanners can be employed for small animal imaging of the heart e.g. when aiming at serial assessments during therapeutic intervention studies

  17. Assessing depression outcome in patients with moderate dementia: sensitivity of the HoNOS65+ scale.

    Science.gov (United States)

    Canuto, Alessandra; Rudhard-Thomazic, Valérie; Herrmann, François R; Delaloye, Christophe; Giannakopoulos, Panteleimon; Weber, Kerstin

    2009-08-15

    To date, there is no widely accepted clinical scale to monitor the evolution of depressive symptoms in demented patients. We assessed the sensitivity to treatment of a validated French version of the Health of the Nation Outcome Scale (HoNOS) 65+ compared to five routinely used scales. Thirty elderly inpatients with ICD-10 diagnosis of dementia and depression were evaluated at admission and discharge using paired t-test. Using the Brief Psychiatric Rating Scale (BPRS) "depressive mood" item as gold standard, a receiver operating characteristic curve (ROC) analysis assessed the validity of HoNOS65+F "depressive symptoms" item score changes. Unlike Geriatric Depression Scale, Mini Mental State Examination and Activities of Daily Living scores, BPRS scores decreased and Global Assessment Functioning Scale score increased significantly from admission to discharge. Amongst HoNOS65+F items, "behavioural disturbance", "depressive symptoms", "activities of daily life" and "drug management" items showed highly significant changes between the first and last day of hospitalization. The ROC analysis revealed that changes in the HoNOS65+F "depressive symptoms" item correctly classified 93% of the cases with good sensitivity (0.95) and specificity (0.88) values. These data suggest that the HoNOS65+F "depressive symptoms" item may provide a valid assessment of the evolution of depressive symptoms in demented patients.

  18. The Validity and Reliability of the Turkish Version of the Neonatal Skin Risk Assessment Scale.

    Science.gov (United States)

    Sari, Çiğdem; Altay, Naime

    2017-03-01

    The study created a Turkish translation of the Neonatal Skin Risk Assessment Scale (NSRAS) that was developed by Huffines and Longsdon in 1997. Study authors used a cross-sectional survey design in order to determine the validity and reliability of the Turkish translation. The study was conducted at the neonatal intensive care unit of a university hospital in Ankara between March 15 and June 30, 2014. The research sample included 130 neonatal assessments from 17 patients. Data were collected by questionnaire regarding the characteristics of the participating neonates, 7 nurse observers, and the NSRAS and its subarticles. After translation and back-translation were performed to assess language validity of the scale, necessary corrections were made in line with expert suggestions, and content validity was ensured. Internal consistency of the scale was assessed by its homogeneity, Cronbach's α, and subarticle-general scale grade correlation. Cronbach's α for the scale overall was .88, and Cronbach's α values for the subarticles were between .83 and .90. Results showed a positive relationship among all the subarticles and the overall NSRAS scale grade (P Kaiser-Meyer-Olkin analysis was applied for sample sufficiency, and Bartlett test analysis was applied in order to assess the factor analysis of the sample. The Kaiser-Meyer-Olkin coefficient was 0.73, and the χ value found according to the Bartlett test was statistically significant at an advanced level (P < .05). In the 6 subarticles of the scale and in the general scale total grade, a high, positive, and significant relationship among the grades given by the researcher and the nurse observers was found (P < .05). The Turkish NSRAS is reliable and valid.

  19. Disfiguring scarring following mesotherapy-associated Mycobacterium cosmeticum infection.

    Science.gov (United States)

    Beer, Kenneth; Waibel, Jill

    2009-04-01

    Mesotherapy is a popular procedure that poses risks that include scarring, contour changes and bacterial infections. The benefits of the procedure remain to be objectively delineated in a placebo-controlled, blinded study. Despite the lack of evidence to support its use, it is marketed as a "nonsurgical and safe" way to remove fat. The authors report a case of mycobacterial infection resulting from mesotherapy. This infection should be considered when a patient presents with a mesotherapy complication and should be discussed with the patient prior to the procedure. Options for treatment of the scarring are considered.

  20. Functional Assessment of School Attendance Problems : An Adapted Version of the School Refusal Assessment Scale-Revised

    NARCIS (Netherlands)

    Heyne, D. A.; Vreeke, L. J.; Maric, M.; Boelens, H.; Van Widenfelt, B. M.

    2017-01-01

    The School Refusal Assessment Scale (SRAS) was developed to identify four factors that might maintain a youth’s school attendance problem (SAP), and thus be targeted for treatment. There is still limited support for the four-factor model inherent to the SRAS and its revision (SRAS-R). Recent studies

  1. Evaluation of the Validity and Reliability of the Waterlow Pressure Ulcer Risk Assessment Scale.

    Science.gov (United States)

    Charalambous, Charalambos; Koulori, Agoritsa; Vasilopoulos, Aristidis; Roupa, Zoe

    2018-04-01

    Prevention is the ideal strategy to tackle the problem of pressure ulcers. Pressure ulcer risk assessment scales are one of the most pivotal measures applied to tackle the problem, much criticisms has been developed regarding the validity and reliability of these scales. To investigate the validity and reliability of the Waterlow pressure ulcer risk assessment scale. The methodology used is a narrative literature review, the bibliography was reviewed through Cinahl, Pubmed, EBSCO, Medline and Google scholar, 26 scientific articles where identified. The articles where chosen due to their direct correlation with the objective under study and their scientific relevance. The construct and face validity of the Waterlow appears adequate, but with regards to content validity changes in the category age and gender can be beneficial. The concurrent validity cannot be assessed. The predictive validity of the Waterlow is characterized by high specificity and low sensitivity. The inter-rater reliability has been demonstrated to be inadequate, this may be due to lack of clear definitions within the categories and differentiating level of knowledge between the users. Due to the limitations presented regarding the validity and reliability of the Waterlow pressure ulcer risk assessment scale, the scale should be used in conjunction with clinical assessment to provide optimum results.

  2. The effect of assessment scale and metric selection on the greenhouse gas benefits of woody biomass

    International Nuclear Information System (INIS)

    Galik, Christopher S.; Abt, Robert C.

    2012-01-01

    Recent attention has focused on the net greenhouse gas (GHG) implications of using woody biomass to produce energy. In particular, a great deal of controversy has erupted over the appropriate manner and scale at which to evaluate these GHG effects. Here, we conduct a comparative assessment of six different assessment scales and four different metric calculation techniques against the backdrop of a common biomass demand scenario. We evaluate the net GHG balance of woody biomass co-firing in existing coal-fired facilities in the state of Virginia, finding that assessment scale and metric calculation technique do in fact strongly influence the net GHG balance yielded by this common scenario. Those assessment scales that do not include possible market effects attributable to increased biomass demand, including changes in forest area, forest management intensity, and traditional industry production, generally produce less-favorable GHG balances than those that do. Given the potential difficulty small operators may have generating or accessing information on the extent of these market effects, however, it is likely that stakeholders and policy makers will need to balance accuracy and comprehensiveness with reporting and administrative simplicity. -- Highlights: ► Greenhouse gas (GHG) effects of co-firing forest biomass with coal are assessed. ► GHG effect of replacing coal with forest biomass linked to scale, analytic approach. ► Not accounting for indirect market effects yields poorer relative GHG balances. ► Accounting systems must balance comprehensiveness with administrative simplicity.

  3. Evaluation of the Validity and Reliability of the Waterlow Pressure Ulcer Risk Assessment Scale

    Science.gov (United States)

    Charalambous, Charalambos; Koulori, Agoritsa; Vasilopoulos, Aristidis; Roupa, Zoe

    2018-01-01

    Introduction Prevention is the ideal strategy to tackle the problem of pressure ulcers. Pressure ulcer risk assessment scales are one of the most pivotal measures applied to tackle the problem, much criticisms has been developed regarding the validity and reliability of these scales. Objective To investigate the validity and reliability of the Waterlow pressure ulcer risk assessment scale. Method The methodology used is a narrative literature review, the bibliography was reviewed through Cinahl, Pubmed, EBSCO, Medline and Google scholar, 26 scientific articles where identified. The articles where chosen due to their direct correlation with the objective under study and their scientific relevance. Results The construct and face validity of the Waterlow appears adequate, but with regards to content validity changes in the category age and gender can be beneficial. The concurrent validity cannot be assessed. The predictive validity of the Waterlow is characterized by high specificity and low sensitivity. The inter-rater reliability has been demonstrated to be inadequate, this may be due to lack of clear definitions within the categories and differentiating level of knowledge between the users. Conclusion Due to the limitations presented regarding the validity and reliability of the Waterlow pressure ulcer risk assessment scale, the scale should be used in conjunction with clinical assessment to provide optimum results. PMID:29736104

  4. Assessing social isolation in motor neurone disease: a Rasch analysis of the MND Social Withdrawal Scale.

    Science.gov (United States)

    Gibbons, Chris J; Thornton, Everard W; Ealing, John; Shaw, Pamela J; Talbot, Kevin; Tennant, Alan; Young, Carolyn A

    2013-11-15

    Social withdrawal is described as the condition in which an individual experiences a desire to make social contact, but is unable to satisfy that desire. It is an important issue for patients with motor neurone disease who are likely to experience severe physical impairment. This study aims to reassess the psychometric and scaling properties of the MND Social Withdrawal Scale (MND-SWS) domains and examine the feasibility of a summary scale, by applying scale data to the Rasch model. The MND Social Withdrawal Scale was administered to 298 patients with a diagnosis of MND, alongside the Hospital Anxiety and Depression Scale. The factor structure of the MND Social Withdrawal Scale was assessed using confirmatory factor analysis. Model fit, category threshold analysis, differential item functioning (DIF), dimensionality and local dependency were evaluated. Factor analysis confirmed the suitability of the four-factor solution suggested by the original authors. Mokken scale analysis suggested the removal of item five. Rasch analysis removed a further three items; from the Community (one item) and Emotional (two items) withdrawal subscales. Following item reduction, each scale exhibited excellent fit to the Rasch model. A 14-item Summary scale was shown to fit the Rasch model after subtesting the items into three subtests corresponding to the Community, Family and Emotional subscales, indicating that items from these three subscales could be summed together to create a total measure for social withdrawal. Removal of four items from the Social Withdrawal Scale led to a four factor solution with a 14-item hierarchical Summary scale that were all unidimensional, free for DIF and well fitted to the Rasch model. The scale is reliable and allows clinicians and researchers to measure social withdrawal in MND along a unidimensional construct. © 2013. Published by Elsevier B.V. All rights reserved.

  5. High- and ultrahigh-field magnetic resonance imaging of na?ve, injured and scarred vocal fold mucosae in rats

    OpenAIRE

    Kishimoto, Ayami Ohno; Kishimoto, Yo; Young, David L.; Zhang, Jinjin; Rowland, Ian J.; Welham, Nathan V.

    2016-01-01

    ABSTRACT Subepithelial changes to the vocal fold mucosa, such as fibrosis, are difficult to identify using visual assessment of the tissue surface. Moreover, without suspicion of neoplasm, mucosal biopsy is not a viable clinical option, as it carries its own risk of iatrogenic injury and scar formation. Given these challenges, we assessed the ability of high- (4.7?T) and ultrahigh-field (9.4?T) magnetic resonance imaging to resolve key vocal fold subepithelial tissue structures in the rat, an...

  6. Urban land use, air toxics and public health: Assessing hazardous exposures at the neighborhood scale

    International Nuclear Information System (INIS)

    Corburn, Jason

    2007-01-01

    Land use data are increasingly understood as important indicators of potential environmental health risk in urban areas where micro-scale or neighborhood level hazard exposure data are not routinely collected. This paper aims to offer a method for estimating the distribution of air toxics in urban neighborhoods using land use information because actual air monitoring data rarely exist at this scale. Using Geographic Information System spatial modeling tools, we estimate air toxics concentrations across neighborhoods in New York City and statistically compare our model with the US Environmental Protection Agency's National Air Toxic Assessment and air monitoring data across three NYC neighborhoods. We conclude that land use data can act as a good proxy for estimating neighborhood scale air toxics, particularly in the absence of monitoring data. In addition, the paper suggests that land use data can expand the reach of environmental impact assessments that routinely exclude analyses of potential exposures to urban air toxics at the neighborhood scale

  7. Scar-free cutaneous wound healing in the leopard gecko, Eublepharis macularius.

    Science.gov (United States)

    Peacock, Hanna M; Gilbert, Emily A B; Vickaryous, Matthew K

    2015-11-01

    Cutaneous wounds heal with two possible outcomes: scarification or near-perfect integumentary restoration. Whereas scar formation has been intensively investigated, less is known about the tissue-level events characterising wounds that spontaneously heal scar-free, particularly in non-foetal amniotes. Here, a spatiotemporal investigation of scar-free cutaneous wound healing following full-thickness excisional biopsies to the tail and body of leopard geckos (Eublepharis macularius) is provided. All injuries healed without scarring. Cutaneous repair involves the development of a cell-rich aggregate within the wound bed, similar to scarring wounds. Unlike scar formation, scar-free healing involves a more rapid closure of the wound epithelium, and a delay in blood vessel development and collagen deposition within the wound bed. It was found that, while granulation tissue of scarring wounds is hypervascular, scar-free wound healing conspicuously does not involve a period of exuberant blood vessel formation. In addition, during scar-free wound healing the newly formed blood vessels are typically perivascular cell-supported. Immunohistochemistry revealed widespread expression of both the pro-angiogenic factor vascular endothelial growth factor A and the anti-angiogenic factor thrombospondin-1 within the healing wound. It was found that scar-free wound healing is an intrinsic property of leopard gecko integument, and involves a modulation of the cutaneous scar repair program. This proportional revascularisation is an important factor in scar-free wound healing. © 2015 Anatomical Society.

  8. Assessment of scale formation and corrosion of drinking water supplies in Ilam city (Iran)

    OpenAIRE

    Zabihollah Yousefi; Farzad Kazemi; Reza Ali Mohammadpour

    2016-01-01

    Background: Scaling and corrosion are the two most important indexes in water quality evaluation. Pollutants are released in water due to corrosion of pipelines. The aim of this study is to assess the scale formation and corrosion of drinking water supplies in Ilam city (Iran). Methods: This research is a descriptive and cross-sectional study which is based on the 20 drinking water sources in Ilam city. Experiments were carried out in accordance with the Water and Wastewater Co. ...

  9. Development of scales to assess children's perceptions of friend and parental influences on physical activity

    Directory of Open Access Journals (Sweden)

    Brockman Rowan

    2009-10-01

    . Conclusion Three scales that assess how parents, friends and group normative values may be associated with children's physical activity have been shown to be reliable and internally consistent. Examination of the extent to which these new scales improve our understanding of children's physical activity in datasets with a range of participant and family characteristics is needed.

  10. How the Internet Will Help Large-Scale Assessment Reinvent Itself

    Directory of Open Access Journals (Sweden)

    Randy Elliot Bennett

    2001-02-01

    Full Text Available Large-scale assessment in the United States is undergoing enormous pressure to change. That pressure stems from many causes. Depending upon the type of test, the issues precipitating change include an outmoded cognitive-scientific basis for test design; a mismatch with curriculum; the differential performance of population groups; a lack of information to help individuals improve; and inefficiency. These issues provide a strong motivation to reconceptualize both the substance and the business of large-scale assessment. At the same time, advances in technology, measurement, and cognitive science are providing the means to make that reconceptualization a reality. The thesis of this paper is that the largest facilitating factor will be technological, in particular the Internet. In the same way that it is already helping to revolutionize commerce, education, and even social interaction, the Internet will help revolutionize the business and substance of large-scale assessment.

  11. Relationship status: Scales for assessing the vitality of late adolescents' relationships with their parents.

    Science.gov (United States)

    Klos, D S; Paddock, J R

    1978-12-01

    Three criteria for assessing relationship status were proposed: self-disclosure despite the risk of parental disapproval; openness to critical feedback from parents; constructive confrontation when angry with parents. These concepts were operationalized as narratives of nine interpersonal dilemmas, to which late adolescents responded by indicating "What would you do if you were in this situation?" Reliable example-anchored scales were constructed from the responses of one sample of college students and then cross-validated with two other samples. Social class had a significant but small effect on the relationship status scores; but age and sex of adolescent and sex of parent did not. The patterns of correlations of the Relationship Status Scales among themselves and with the Parent-Child Relations Questionnaire, the College Self-Expression Scale, the Fear of Negative Evaluation Scale, and Hogan's Empathy Scale were interpreted as evidence of construct validity.

  12. A research agenda for data and scale issues in Strategic Environmental Assessment (SEA)

    International Nuclear Information System (INIS)

    Joao, Elsa

    2007-01-01

    The way in which Strategic Environmental Assessment (SEA) succeeds in its key aim - to integrate the environment into strategic decision-making - is affected by the choice of both data and scale. The data and scale used within SEA fundamentally shape the process. However, in the past, these issues were often not discussed in an explicit or in-depth way. This article proposes a research agenda, and recommendations for future practice, on data and scale issues in SEA. Future research on data issues, spatial and temporal scales (both in terms of detail and extent), tiering, data quality and links to decision-making are recommended. The article concludes that questions of data and scale in SEA are not just technical, they are essential to identifying and understanding the issues that SEA should be addressing, and therefore are a core element of SEA

  13. Scaling up success to improve health: Towards a rapid assessment guide for decision makers

    Directory of Open Access Journals (Sweden)

    Jason Paltzer

    2015-01-01

    Full Text Available Introduction Evidence-based health interventions exist and are effectively implemented throughout resource-limited settings. The literature regarding scale-up strategies and frameworks is growing. The purpose of this paper is to identify and systematically document the variation in scale-up strategies to develop a rapid assessment tool for decision-makers looking to identify the most appropriate strategy for their organizational and environmental contexts. Methods A list of scale-up strategies and frameworks were identified through an in-depth literature review and conversations with scale-up and quality improvement leaders. The literature search included a broad range of terms that might be used interchangeably with scale-up of best practices. Terms included: implementation research, knowledge translation, translational research, quality improvement research, health systems improvement, scale-up, best practices, improvement collaborative, and community based research. Based on this research, 18 strategies and frameworks were identified, and nine met our inclusion criteria for scale-up of health-related strategies. We interviewed the key contact for four of the nine strategies to obtain additional information regarding the strategy’s scale-up components, targets, underlying theories, evaluation efforts, facilitating factors, and barriers. A comparative analysis of common elements and strategy characteristics was completed by two of the authors on the nine selected strategies. Key strategy characteristics and common factors that facilitate or hinder the strategy’s success in scaling up health-related interventions were identified. Results Common features of scale-up strategies include: 1 the development of context-specific evidence; 2 collaborative partnerships; 3 iterative processes; and 4 shared decision-making. Facilitating factors include strong leadership, community engagement, communication, government collaboration, and a focus on

  14. Systematic Review of Pain assessment scales in newborns under maxillofacial surgery Admitted to the surgical ward

    Directory of Open Access Journals (Sweden)

    Shapour Yaripoor

    2016-10-01

    Full Text Available Having standard tools for measuring pain in infants is essential. The aim of this study is to review the scale of pain in newborns under maxillofacial surgery Admitted to the surgical ward. Integrative review study of articles published from 2000 to 2015, carried out in the following databases: Scopus, PubMed, CINAHL, LILACS, Cochrane, medscape and google scholar. The sample consisted of 17 articles. MeSH headings searched included pain measurement, pain scale, newborn pain, infant pain scale, maxillofacial surgery and pain perception. 16 neonatal pain assessment tools were found. Of the 232 original articles, 17 review articles in the field of pain assessment tools in infant under maxillofacial surgery who had inclusion criteria were selected. The most studied was the Premature Infant Pain Profile (PIPP, The CRIES and the Neonatal Infant Pain Scale (NIPS. Infant pain assessment is not universally standardized. Practitioners may assess pain; however, they may not consistently use the same criteria to do so. The use of Neonatal Facial Coding System, the Neonatal Infant Pain Scale and the Premature Infant Pain Profile Can accurately show the amount of pain in newborns.

  15. Development and testing of a scale for assessing the quality of home nursing.

    Science.gov (United States)

    Chiou, Chii-Jun; Wang, Hsiu-Hung; Chang, Hsing-Yi

    2016-03-01

    To develop a home nursing quality scale and to evaluate its psychometric properties. This was a 3-year study. In the first year, 19 focus group interviews with caregivers of people using home nursing services were carried out in northern, central and southern Taiwan. Content analysis was carried out and a pool of questionnaire items compiled. In the second year (2007), study was carried out on a stratified random sample selected from home nursing organizations covered by the national health insurance scheme in southern Taiwan. The study population was the co-resident primary caregivers of home care nursing service users. Item analysis and exploratory factor analysis were carried out on data from 365 self-administered questionnaires collected from 13 selected home care organizations. In the third year (2008), a random sample of participants was selected from 206 hospital-based home care nursing organizations throughout Taiwan, resulting in completion of 294 questionnaires from 27 organizations. Confirmatory factor analysis was then carried out on the scale, and the validity and reliability of the scale assessed. The present study developed a reliable and valid home nursing quality scale from the perspective of users of home nursing services. The scale comprised three factors: dependability, communication skills and service usefulness. This scale is of practical value for the promotion of long-term community care aging in local policies. The scale is ready to be used to assess the quality of services provided by home care nursing organizations. © 2015 Japan Geriatrics Society.

  16. Analysis of environmental impact assessment for large-scale X-ray medical equipments

    International Nuclear Information System (INIS)

    Fu Jin; Pei Chengkai

    2011-01-01

    Based on an Environmental Impact Assessment (EIA) project, this paper elaborates the basic analysis essentials of EIA for the sales project of large-scale X-ray medical equipment, and provides the analysis procedure of environmental impact and dose estimation method under normal and accident conditions. The key points of EIA for the sales project of large-scale X-ray medical equipment include the determination of pollution factor and management limit value according to the project's actual situation, the utilization of various methods of assessment and prediction such as analogy, actual measurement and calculation to analyze, monitor, calculate and predict the pollution during normal and accident condition. (authors)

  17. Laboratory Scale Coal And Biomass To Drop-In Fuels (CBDF) Production And Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Lux, Kenneth [Altex Technologies Corporation, Sunnyvale, CA (United States); Imam, Tahmina [Altex Technologies Corporation, Sunnyvale, CA (United States); Chevanan, Nehru [Altex Technologies Corporation, Sunnyvale, CA (United States); Namazian, Mehdi [Altex Technologies Corporation, Sunnyvale, CA (United States); Wang, Xiaoxing [Pennsylvania State Univ., University Park, PA (United States); Song, Chunshan [Pennsylvania State Univ., University Park, PA (United States)

    2016-06-29

    This Final Technical Report describes the work and accomplishments of the project entitled, “Laboratory Scale Coal and Biomass to Drop-In Fuels (CBDF) Production and Assessment.” The main objective of the project was to fabricate and test a lab-scale liquid-fuel production system using coal containing different percentages of biomass such as corn stover and switchgrass at a rate of 2 liters per day. The system utilizes the patented Altex fuel-production technology, which incorporates advanced catalysts developed by Pennsylvania State University. The system was designed, fabricated, tested, and assessed for economic and environmental feasibility relative to competing technologies.

  18. Development and properties of a brief scale to assess intimate partner relationship in the postnatal period.

    Science.gov (United States)

    Wynter, Karen; Tran, Thach Duc; Rowe, Heather; Fisher, Jane

    2017-06-01

    Poor quality intimate partner relationship is associated with postnatal depression and anxiety among women. Existing scales assessing the quality of this relationship are long and measure stable aspects of the relationship rather than specific behaviours which may respond to targeted interventions. The aim was to develop and investigate the properties of a brief, life stage-specific scale to assess potentially modifiable partner behaviours in the postpartum period. Participants were primiparous women from diverse geographical and socio-economic backgrounds in Victoria, Australia. Seven study-specific items were developed to assess potentially modifiable aspects of the intimate partner relationship at 6 months postpartum. Women's mental health was assessed using the Composite International Diagnostic Interview and the Patient Health Questionnaire depression and generalised anxiety modules. Factor analysis was conducted on the 7 items, and associations calculated between factor scores. Factor scores were compared for women with and without mental health problems. Mean inter-item correlations were computed to assess internal consistency. Factor analysis on data from 355 women revealed two factors with good internal consistency: Caring Partner Behaviours and Emotionally Abusive Partner Behaviours. Having mental health problems was associated with lower Caring Partner Behaviours and higher Emotionally Abusive Partner Behaviours scores. Interaction between partners was not observed; thus external criterion validity was not assessed. This brief scale is a promising means of assessing potentially modifiable aspects of the intimate partner relationship in the postnatal period. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. The persistence to slaughter age of scars resulting from damage ...

    African Journals Online (AJOL)

    Cut wounds were persistent to slaughter as were scratch marks, with only a small percentage of scratch wounds incurred at a young age not persisting to slaughter age. Mean scar size at slaughter became smaller with an increase in age at which the wounds were inflicted, except at 13 months of age where it was assumed ...

  20. Macular scar secondary to congenital toxoplasmosis | El Hamichi ...

    African Journals Online (AJOL)

    A 8 years old girl suffers from strabismus since her first months of life. Her visual acuity was very low and could only see fingers moving in her left eye. Her left eye fundus showed a chorioretinal scar in the macula due to congenital toxoplasmosis. The biological findings proved the diagnosis of congenital toxoplasmosis.

  1. Episiotomy scar endometriosis diagnosed on cytology - a case report

    African Journals Online (AJOL)

    Endometriosis, the presence of functioning endometrial tissue outside the uterus, is a common gynaecological condition. Perineal endometriosis is a rare disease characterized by the presence of ectopic endometrial stroma and glands in the perineum. Most commonly observed in the episiotomy scar after normal vaginal ...

  2. Basal Cell Carcinoma Arising in a Breast Augmentation Scar.

    Science.gov (United States)

    Edwards, Lisa R; Cresce, Nicole D; Russell, Mark A

    2017-04-01

    We report a case of a 46-year-old female who presented with a persistent lesion on the inferior right breast. The lesion was located within the scar from a breast augmentation procedure 12 years ago. The lesion had been treated as several conditions with no improvement. Biopsy revealed a superficial and nodular basal cell carcinoma, and the lesion was successfully removed with Mohs micrographic surgery. Basal cell carcinoma arising in a surgical scar is exceedingly rare with only 13 reported cases to date. This is the first reported case of basal cell carcinoma arising in a breast augmentation scar. We emphasize the importance of biopsy for suspicious lesions or those refractory to treatment, particularly those lesions that form within a scar. Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

  3. Episiotomy Scar Endometriosis Diagnosed on Cytology - A Case ...

    African Journals Online (AJOL)

    2017-06-30

    Jun 30, 2017 ... Dnyanada Kokode*, Anne Wilkinson, Sadhana Mahore and Trupti Dongre ... Endometriosis, the presence of functioning endometrial tissue outside the ... examination, a tender, irregular, raised nodule measuring .... hematoma, hypertrophic scar tissue, traumatic neuroma, ... CT and MRI seem to be useful in.

  4. Using a sequence characterized amplified region (SCAR) marker for ...

    African Journals Online (AJOL)

    GREGORY

    2010-09-13

    Sep 13, 2010 ... This work used sequence characterized amplified region (SCAR) marker to detect the Bacillus cereus strain in strawberry fields. The purpose was to develop an effective molecular method for detecting the functional target microorganisms applied in agricultural fields. A 3×109. CFU/ml vegetative cell.

  5. The Purse-String Reinforced SMASectomy Short Scar Facelift

    NARCIS (Netherlands)

    van der Lei, Berend; Cromheecke, Michel; Hofer, Stefan O. P.

    Background: Over the last two decades, short scar facelifts, often referred to as "mini'' facelifts, have gained popularity. We use a purse-string reinforced (PRS) superficial musculoaponeurotic system rhytidectomy (SMASectomy) shortscar facelift that combines a SMASectomy in the vertical direction

  6. Terminology and biology of fire scars in selected central hardwoods

    Science.gov (United States)

    Kevin T. Smith; Elaine Kennedy Sutherland

    2001-01-01

    Dendrochronological analysis of fire scars requires tree survival of fire exposure. Trees survive fire exposure by: (1) avoidance of injury through constitutive protection and (2) induced defense. Induced defenses include (a) compartmentalization processes that resist the spread of injury and infection and (b) closure processes that restore the continuity of the...

  7. Triterpenes for Well-Balanced Scar Formation in Superficial Wounds

    Directory of Open Access Journals (Sweden)

    Stefan Kindler

    2016-08-01

    Full Text Available Triterpenes are demonstrably effective for accelerating re-epithelialisation of wounds and known to improve scar formation for superficial lesions. Among the variety of triterpenes, betuline is of particular medical interest. Topical betuline gel (TBG received drug approval in 2016 from the European Commission as the first topical therapeutic agent with the proven clinical benefit of accelerating wound healing. Two self-conducted randomized intra-individual comparison clinical studies with a total of 220 patients involved in TBG treatment of skin graft surgical wounds have been screened for data concerning the aesthetic aspect of wound healing. Three months after surgery wound treatment with TBG resulted in about 30% of cases with more discreet scars, and standard of care in about 10%. Patients themselves appreciate the results of TBG after 3 months even more (about 50% compared to standard of care (about 10%. One year after surgery, the superiority of TBG counts for about 25% in comparison with about 10%, and from the patients’ point of view, for 25% compared to 4% under standard of care. In the majority of wound treatment cases, there is no difference visible between TBG treatment and standard of care after 1 year of scar formation. However, in comparison, TBG still offers a better chance for discreet scars and therefore happens to be superior in good care of wounds.

  8. Histologic features of alopecias: part II: scarring alopecias.

    Science.gov (United States)

    Bernárdez, C; Molina-Ruiz, A M; Requena, L

    2015-05-01

    The diagnosis of disorders of the hair and scalp can generally be made on clinical grounds, but clinical signs are not always diagnostic and in some cases more invasive techniques, such as a biopsy, may be necessary. This 2-part article is a detailed review of the histologic features of the main types of alopecia based on the traditional classification of these disorders into 2 major groups: scarring and nonscarring alopecias. Scarring alopecias are disorders in which the hair follicle is replaced by fibrous scar tissue, a process that leads to permanent hair loss. In nonscarring alopecias, the follicles are preserved and hair growth can resume when the cause of the problem is eliminated. In the second part of this review, we describe the histologic features of the main forms of scarring alopecia. Since a close clinical-pathological correlation is essential for making a correct histopathologic diagnosis of alopecia, we also include a brief description of the clinical features of the principal forms of this disorder. Copyright © 2014 Elsevier España, S.L.U. and AEDV. All rights reserved.

  9. The cosmetic outcome of the scar formation after cesarean section

    DEFF Research Database (Denmark)

    Lindholt, Jes Sanddal; Möller-Christensen, T; Steele, R E

    1994-01-01

    Three methods of skin closure after cesarean section were tested and compared in a prospective trial. Eighty-nine (82.5%) appeared for follow-up investigation 4-5 months after delivery. The mean scar width was significantly narrower after phannenstiel incision compared with percutaneous nylon sut...

  10. 5-Fluorouracil-Loaded Transfer some as Theranostics in Dermal Tumor of Hypertrophic Scar Tissue

    International Nuclear Information System (INIS)

    Zhang, Z.; Wang, X.; Chen, X.; Wo, Y.; Zhang, Y.; Biskup, E.

    2015-01-01

    To investigate the ability of transfersomal gel carrying the anti scarring agent (5-FU) to permeate hypertrophic scars in vivo and in vitro, scar permeation studies were performed after the agent was labeled with the fluorescent agent, rhodamine 6GO. Laser con focal microscope was employed to dynamically observe the effects of transfersomal gel carrying 5-FU at different time points. High-performance liquid chromatography (HPLC) was used to analyze the contents of the agent in the scar tissues at different hours after administration. Scar elevation index (SEI) was used to evaluate the changes of the ear scar models in rabbits. Compared with the PBS gel of 5-FU, the transfers omal gel displayed greater permeation rate and depth, as well as a higher content retention of the agent in scar tissues. Local administrations of the agent for some certain periods effectively inhibited the hyperplasia of ear scars in rabbits. Transfersomes can be chosen as a potential transdermal drug delivery system

  11. Keratinocyte-derived growth factors play a role in the formation of hypertrophic scars

    NARCIS (Netherlands)

    Niessen, FB; Andriessen, MP; Schalkwijk, J; Visser, L; Timens, W

    In predisposed individuals, wound healing can lead to hypertrophic scar or keloid formation, characterized by an overabundant extracellular matrix. It has recently been shown that hypertrophic scars are accompanied by abnormal keratinocyte differentiation and proliferation, and significantly

  12. Efficacy of Punch Elevation Combined with Fractional Carbon Dioxide Laser Resurfacing in Facial Atrophic Acne Scarring: A Randomized Split-face Clinical Study

    Science.gov (United States)

    Faghihi, Gita; Nouraei, Saeid; Asilian, Ali; Keyvan, Shima; Abtahi-Naeini, Bahareh; Rakhshanpour, Mehrdad; Nilforoushzadeh, Mohammad Ali; Hosseini, Sayed Mohsen

    2015-01-01

    Background: A number of treatments for reducing the appearance of acne scars are available, but general guidelines for optimizing acne scar treatment do not exist. The aim of this study was to compare the clinical effectiveness and side effects of fractional carbon dioxide (CO2) laser resurfacing combined with punch elevation with fractional CO2 laser resurfacing alone in the treatment of atrophic acne scars. Materials and Methods: Forty-two Iranian subjects (age range 18–55) with Fitzpatrick skin types III to IV and moderate to severe atrophic acne scars on both cheeks received randomized split-face treatments: One side received fractional CO2 laser treatment and the other received one session of punch elevation combined with two sessions of laser fractional CO2 laser treatment, separated by an interval of 1 month. Two dermatologists independently evaluated improvement in acne scars 4 and 16 weeks after the last treatment. Side effects were also recorded after each treatment. Results: The mean ± SD age of patients was 23.4 ± 2.6 years. Clinical improvement of facial acne scarring was assessed by two dermatologists blinded to treatment conditions. No significant difference in evaluation was observed 1 month after treatment (P = 0.56). Their evaluation found that fractional CO2 laser treatment combined with punch elevation had greater efficacy than that with fractional CO2 laser treatment alone, assessed 4 months after treatment (P = 0.02). Among all side effects, coagulated crust formation and pruritus at day 3 after fractional CO2 laser treatment was significant on both treatment sides (P < 0.05). Conclusion: Concurrent use of fractional laser skin resurfacing with punch elevation offers a safe and effective approach for the treatment of acne scarring. PMID:26538695

  13. Efficacy of punch elevation combined with fractional carbon dioxide laser resurfacing in facial atrophic acne scarring: A randomized split-face clinical study

    Directory of Open Access Journals (Sweden)

    Gita Faghihi

    2015-01-01

    Full Text Available Background: A number of treatments for reducing the appearance of acne scars are available, but general guidelines for optimizing acne scar treatment do not exist. The aim of this study was to compare the clinical effectiveness and side effects of fractional carbon dioxide (CO 2 laser resurfacing combined with punch elevation with fractional CO 2 laser resurfacing alone in the treatment of atrophic acne scars. Materials and Methods: Forty-two Iranian subjects (age range 18-55 with Fitzpatrick skin types III to IV and moderate to severe atrophic acne scars on both cheeks received randomized split-face treatments: One side received fractional CO 2 laser treatment and the other received one session of punch elevation combined with two sessions of laser fractional CO 2 laser treatment, separated by an interval of 1 month. Two dermatologists independently evaluated improvement in acne scars 4 and 16 weeks after the last treatment. Side effects were also recorded after each treatment. Results: The mean ± SD age of patients was 23.4 ± 2.6 years. Clinical improvement of facial acne scarring was assessed by two dermatologists blinded to treatment conditions. No significant difference in evaluation was observed 1 month after treatment (P = 0.56. Their evaluation found that fractional CO 2 laser treatment combined with punch elevation had greater efficacy than that with fractional CO 2 laser treatment alone, assessed 4 months after treatment (P = 0.02. Among all side effects, coagulated crust formation and pruritus at day 3 after fractional CO 2 laser treatment was significant on both treatment sides (P < 0.05. Conclusion: Concurrent use of fractional laser skin resurfacing with punch elevation offers a safe and effective approach for the treatment of acne scarring.

  14. Inflammatory responses, matrix remodeling, and re-epithelialization after fractional CO2 laser treatment of scars.

    Science.gov (United States)

    DeBruler, Danielle M; Blackstone, Britani N; Baumann, Molly E; McFarland, Kevin L; Wulff, Brian C; Wilgus, Traci A; Bailey, J Kevin; Supp, Dorothy M; Powell, Heather M

    2017-09-01

    Fractional CO 2 laser therapy has been used to improve scar pliability and appearance; however, a variety of treatment protocols have been utilized with varied outcomes. Understanding the relationship between laser power and extent of initial tissue ablation and time frame for remodeling could help determine an optimum power and frequency for laser treatment. The characteristics of initial injury caused by fractional CO 2 laser treatment, the rates of dermal remodeling and re-epithelialization, and the extent of inflammation as a function of laser stacking were assessed in this study in a porcine scar model. Full-thickness burn wounds were created on female Red Duroc pigs followed by immediate excision of the eschar and split-thickness autografting. Three months after injury, the resultant scars were treated with a fractional CO 2 laser with 70 mJ of energy delivered as either a single pulse or stacked for three consecutive pulses. Immediately prior to laser treatment and at 1, 24, 96, and 168 hours post-laser treatment, transepidermal water loss (TEWL), erythema, and microscopic characteristics of laser injury were measured. In addition, markers for inflammatory cytokines, extracellular matrix proteins, and re-epithelialization were quantified at all time points using qRT-PCR. Both treatments produced erythema in the scar that peaked 24 hours after treatment then decreased to basal levels by 168 hours. TEWL increased after laser treatment and returned to normal levels between 24 and 96 hours later. Stacking of the pulses did not significantly increase the depth of ablated wells or extend the presence of erythema. Interleukin 6 and monocyte chemoattractant protein-1 were found to increase significantly 1 hour after treatment but returned to baseline by 24 hours post laser. In contrast, expression of transforming growth factor β1 and transforming growth factor β3 increased slowly after treatment with a more modest increase than interleukin 6 and monocyte

  15. Affordable, automatic quantitative fall risk assessment based on clinical balance scales and Kinect data.

    Science.gov (United States)

    Colagiorgio, P; Romano, F; Sardi, F; Moraschini, M; Sozzi, A; Bejor, M; Ricevuti, G; Buizza, A; Ramat, S

    2014-01-01

    The problem of a correct fall risk assessment is becoming more and more critical with the ageing of the population. In spite of the available approaches allowing a quantitative analysis of the human movement control system's performance, the clinical assessment and diagnostic approach to fall risk assessment still relies mostly on non-quantitative exams, such as clinical scales. This work documents our current effort to develop a novel method to assess balance control abilities through a system implementing an automatic evaluation of exercises drawn from balance assessment scales. Our aim is to overcome the classical limits characterizing these scales i.e. limited granularity and inter-/intra-examiner reliability, to obtain objective scores and more detailed information allowing to predict fall risk. We used Microsoft Kinect to record subjects' movements while performing challenging exercises drawn from clinical balance scales. We then computed a set of parameters quantifying the execution of the exercises and fed them to a supervised classifier to perform a classification based on the clinical score. We obtained a good accuracy (~82%) and especially a high sensitivity (~83%).

  16. Test-retest reliability of Brazilian version of Memorial Symptom Assessment Scale for assessing symptoms in cancer patients.

    Science.gov (United States)

    Menezes, Josiane Roberta de; Luvisaro, Bianca Maria Oliveira; Rodrigues, Claudia Fernandes; Muzi, Camila Drumond; Guimarães, Raphael Mendonça

    2017-01-01

    To assess the test-retest reliability of the Memorial Symptom Assessment Scale translated and culturally adapted into Brazilian Portuguese. The scale was applied in an interview format for 190 patients with various cancers type hospitalized in clinical and surgical sectors of the Instituto Nacional de Câncer José de Alencar Gomes da Silva and reapplied in 58 patients. Data from the test-retest were double typed into a Microsoft Excel spreadsheet and analyzed by the weighted Kappa. The reliability of the scale was satisfactory in test-retest. The weighted Kappa values obtained for each scale item had to be adequate, the largest item was 0.96 and the lowest was 0.69. The Kappa subscale was also evaluated and values were 0.84 for high frequency physic symptoms, 0.81 for low frequency physical symptoms, 0.81 for psychological symptoms, and 0.78 for Global Distress Index. High level of reliability estimated suggests that the process of measurement of Memorial Symptom Assessment Scale aspects was adequate. Avaliar a confiabilidade teste-reteste da versão traduzida e adaptada culturalmente para o português do Brasil do Memorial Symptom Assessment Scale. A escala foi aplicada em forma de entrevista em 190 pacientes com diversos tipos de câncer internados nos setores clínicos e cirúrgicos do Instituto Nacional de Câncer José de Alencar Gomes da Silva e reaplicada em 58 pacientes. Os dados dos testes-retestes foram inseridos num banco de dados por dupla digitação independente em Excel e analisados pelo Kappa ponderado. A confiabilidade da escala mostrou-se satisfatória nos testes-retestes. Os valores do Kappa ponderado obtidos para cada item da escala apresentaram-se adequados, sendo o maior item de 0,96 e o menor de 0,69. Também se avaliou o Kappa das subescalas, sendo de 0,84 para sintomas físicos de alta frequência, de 0,81 para sintomas físicos de baixa frequência, de 0,81 também para sintomas psicológicos, e de 0,78 para Índice Geral de Sofrimento

  17. Postmastectomy radiotherapy with integrated scar boost using helical tomotherapy

    International Nuclear Information System (INIS)

    Rong Yi; Yadav, Poonam; Welsh, James S.; Fahner, Tasha; Paliwal, Bhudatt

    2012-01-01

    The purpose of this study was to evaluate helical tomotherapy dosimetry in postmastectomy patients undergoing treatment for chest wall and positive nodal regions with simultaneous integrated boost (SIB) in the scar region using strip bolus. Six postmastectomy patients were scanned with a 5-mm-thick strip bolus covering the scar planning target volume (PTV) plus 2-cm margin. For all 6 cases, the chest wall received a total cumulative dose of 49.3–50.4 Gy with daily fraction size of 1.7–2.0 Gy. Total dose to the scar PTV was prescribed to 58.0–60.2 Gy at 2.0–2.5 Gy per fraction. The supraclavicular PTV and mammary nodal PTV received 1.7–1.9 dose per fraction. Two plans (with and without bolus) were generated for all 6 cases. To generate no-bolus plans, strip bolus was contoured and overrode to air density before planning. The setup reproducibility and delivered dose accuracy were evaluated for all 6 cases. Dose-volume histograms were used to evaluate dose-volume coverage of targets and critical structures. We observed reduced air cavities with the strip bolus setup compared with what we normally see with the full bolus. The thermoluminescence dosimeters (TLD) in vivo dosimetry confirmed accurate dose delivery beneath the bolus. The verification plans performed on the first day megavoltage computed tomography (MVCT) image verified that the daily setup and overall dose delivery was within 2% accuracy compared with the planned dose. The hotspot of the scar PTV in no-bolus plans was 111.4% of the prescribed dose averaged over 6 cases compared with 106.6% with strip bolus. With a strip bolus only covering the postmastectomy scar region, we observed increased dose uniformity to the scar PTV, higher setup reproducibility, and accurate dose delivered beneath the bolus. This study demonstrates the feasibility of using a strip bolus over the scar using tomotherapy for SIB dosimetry in postmastectomy treatments.

  18. Delirium assessed by Memorial Delirium Assessment Scale in advanced cancer patients admitted to an acute palliative/supportive care unit.

    Science.gov (United States)

    Mercadante, Sebastiano; Adile, Claudio; Ferrera, Patrizia; Cortegiani, Andrea; Casuccio, Alessandra

    2017-07-01

    Delirium is often unrecognized in cancer patients. The aim of this study was to investigate the prevalence of delirium assessed by the Memorial Delirium Assessment Scale (MDAS) and possible associated factors on admission to an acute palliative/supportive care unit (APSCU). The secondary outcome was to assess changes in MDAS and symptom burden at time of discharge. A consecutive sample of advanced cancer patients who were admitted to an APSCU was prospectively assessed for a period of 10 months. Patient demographics, including age, gender, primary diagnosis, Karnofsky status, stage of disease, and educational level were collected. The Edmonton Symptom Assessment Scale (ESAS) and the MDAS were measured at hospital admission and discharge. A total of 314 patients were surveyed. Of 292 patients with MDAS available at T0, 74 (25.3%) and 24 (8.2%) had a MDAS of 7-12 and ≥13, respectively. At discharge, there was a significant decrease in the number of patients with a MDAS ≥7/30. Higher values of MDAS were associated with age (p = .028), a lower Karnofsky status (p symptoms (p = .026), hospital stay (p = .038) and death (p Delirium is highly prevalent in patients admitted to APSCU, characterized by a low mortality due to early referral. Comprehensive assessment and treatment may allow a decrease in the level of cognitive disorders and symptom burden.

  19. [Upper limb functional assessment scale for children with Duchenne muscular dystrophy and Spinal muscular atrophy].

    Science.gov (United States)

    Escobar, Raúl G; Lucero, Nayadet; Solares, Carmen; Espinoza, Victoria; Moscoso, Odalie; Olguín, Polín; Muñoz, Karin T; Rosas, Ricardo

    2016-08-16

    Duchenne muscular dystrophy (DMD) and Spinal muscular atrophy (SMA) causes significant disability and progressive functional impairment. Readily available instruments that assess functionality, especially in advanced stages of the disease, are required to monitor the progress of the disease and the impact of therapeutic interventions. To describe the development of a scale to evaluate upper limb function (UL) in patients with DMD and SMA, and describe its validation process, which includes self-training for evaluators. The development of the scale included a review of published scales, an exploratory application of a pilot scale in healthy children and those with DMD, self-training of evaluators in applying the scale using a handbook and video tutorial, and assessment of a group of children with DMD and SMA using the final scale. Reliability was assessed using Cronbach and Kendall concordance and with intra and inter-rater test-retest, and validity with concordance and factorial analysis. A high level of reliability was observed, with high internal consistency (Cronbach α=0.97), and inter-rater (Kendall W=0.96) and intra-rater concordance (r=0.97 to 0.99). The validity was demonstrated by the absence of significant differences between results by different evaluators with an expert evaluator (F=0.023, P>.5), and by the factor analysis that showed that four factors account for 85.44% of total variance. This scale is a reliable and valid tool for assessing UL functionality in children with DMD and SMA. It is also easily implementable due to the possibility of self-training and the use of simple and inexpensive materials. Copyright © 2016 Sociedad Chilena de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.

  20. Mercury use in small scale gold mining in Ghana: an assessment of its impact on miners

    International Nuclear Information System (INIS)

    Biagya, Robert Yakubu

    2002-12-01

    Small scale gold mining is responsible for about 5% of Ghana’s annual gold production. It is estimated that between 80,000 and 100,000 people are engaged in small scale gold mining either on part-time or permanent basis. Amalgamation is the preferred method used by small scale gold miners for extracting free gold from its ores. The rate at which mercury, an important input in this method, is discharged into the atmosphere and water bodies is alarming. This research describes the various mining and processing methods in small scale gold mining and the extent of mercury use and releases to the environment. It discusses mercury and its human and environmental effects. It defines the various forms of mercury, routes of exposure, toxic effects. The levels of exposure to mercury by all groups of small scale gold miners are determined, and the impacts on the miners and the environment are assessed. It concludes that: • Mercury is mainly released into the environment as a result of small scale gold mining through spillage of elemental mercury and evaporation of mercury from the amalgam and sponge gold when they are heated on open fire. • Mercury in environmental samples from small scale gold mining areas is well above standard limit values. • Mercury released into the environment through small scale gold mining impacts negatively on the miners themselves and the general environment. Finally, it recommends the need for the adoption of mercury emission reduction strategies for dealing with the mercury problem. (au)

  1. Vitiligo impact scale: An instrument to assess the psychosocial burden of vitiligo

    Directory of Open Access Journals (Sweden)

    Gaurang S Krishna

    2013-01-01

    Full Text Available Background : Vitiligo is a disease that significantly impairs quality of life. Previous studies have shown that vitiligo has an impact that may not correlate with the size and extent of depigmentation, indicating a need for an independent measure of the psychosocial burden. Aims : To develop a rating scale to assess the psychosocial impact of vitiligo. Methods : The study was undertaken in three broad phases: item generation, pre- and pilot testing, and test administration. Items were generated largely from a qualitative study using semi-structured interviews of patients. Face and content validity were assessed through pre- and pilot testing in 80 patients and the final version was administered to 100 patients who also received the Dermatology Life Quality Index (DLQI and the Skindex-16. Each patient also underwent a physician global assessment (PGA of the impact of vitiligo. Test-retest reliability was assessed in 20 patients. Results: Of 72 items initially generated for the scale, 27 were retained in the final version. Subjects were able to comprehend the items and took about 5-7 min to complete the instrument. The scale was internally consistent (Cronbach′s α = 0.85. Scores on the scale correlated moderately well with the DLQI and the Skindex (Spearman rank correlation: 0.51 and 0.65, respectively. The scale was able to discriminate between patients having mild and those having moderate and severe impact as assessed by PGA. The test-retest reliability coefficient (Spearman rank correlation was 0.80. Conclusion: The Vitiligo Impact Scale appears to be a valid measure of the psychosocial impact of vitiligo and this instrument may be useful both in the clinic and in clinical trials.

  2. Early treatment using fractional CO2 laser before skin suture during scar revision surgery in Asians.

    Science.gov (United States)

    Du, Feiya; Yu, Yusheng; Zhou, Zhiqin; Wang, Liujia; Zheng, Shusen

    2018-04-01

    Fractional CO 2 laser is one of the most effective treatment options used to resurface scars. However, most previous studies have been performed on mature scars at least 2 months after surgery. Recent studies have emphasized the importance of early treatment to reduce scar formation. In the present study, we described our experience with fractional CO 2 laser intervention before skin suture during scar revision surgery in Asians, and found the treatment was safe and effective.

  3. Blockade of mast cell activation reduces cutaneous scar formation.

    Directory of Open Access Journals (Sweden)

    Lin Chen

    Full Text Available Damage to the skin initiates a cascade of well-orchestrated events that ultimately leads to repair of the wound. The inflammatory response is key to wound healing both through preventing infection and stimulating proliferation and remodeling of the skin. Mast cells within the tissue are one of the first immune cells to respond to trauma, and upon activation they release pro-inflammatory molecules to initiate recruitment of leukocytes and promote a vascular response in the tissue. Additionally, mast cells stimulate collagen synthesis by dermal fibroblasts, suggesting they may also influence scar formation. To examine the contribution of mast cells in tissue repair, we determined the effects the mast cell inhibitor, disodium cromoglycate (DSCG, on several parameters of dermal repair including, inflammation, re-epithelialization, collagen fiber organization, collagen ultrastructure, scar width and wound breaking strength. Mice treated with DSCG had significantly reduced levels of the inflammatory cytokines IL-1α, IL-1β, and CXCL1. Although DSCG treatment reduced the production of inflammatory mediators, the rate of re-epithelialization was not affected. Compared to control, inhibition of mast cell activity caused a significant decrease in scar width along with accelerated collagen re-organization. Despite the reduced scar width, DSCG treatment did not affect the breaking strength of the healed tissue. Tryptase β1 exclusively produced by mast cells was found to increase significantly in the course of wound healing. However, DSCG treatment did not change its level in the wounds. These results indicate that blockade of mast cell activation reduces scar formation and inflammation without further weakening the healed wound.

  4. 射频消融治疗增生性瘢痕的疗效观察%Radiofrequency ablation therapy for patholo gical scar

    Institute of Scientific and Technical Information of China (English)

    黄丽萍; 王兴林; 张冷; 毕胜; 林碧文

    2014-01-01

    目的:评估射频消融治疗增生性瘢痕的临床疗效。方法选择病史在1年以上,瘢痕处于成熟期,病情稳定的增生性瘢痕患者共36例。每例选择两处瘢痕相似的部位,进行自身对照。治疗组采用射频消融祛除瘢痕;对照组不做处理。采用温哥华瘢痕量表于术后6个月和12个月对瘢痕进行评分。结果在射频消融治疗后6个月、12个月治疗组与对照组的温哥华瘢痕评分结果差异均有显著性意义(P<0.05),治疗组经射频消融治疗后,瘢痕的颜色、厚度、柔软度都得到了显著改善。结论射频消融治疗增生性瘢痕可使瘢痕颜色变淡、厚度变平,是一种理想的祛除瘢痕的方法。%Objective To evaluated the clinical efficacy of the radiofrequency ablation for pathological scar .Methods We treated the hyperplastic scar of 36 patients with radiofrequency ablation .All of the patients had were diagnosed with syrin-gomas for at least1 years and the scars were in the mature period .Two similar hyperplastic scar regions are chosen in each patient for self-comparison .The treatment group was treated by radiofrequency ablation and for the control group no any management was performed.The vancouver scar scale was tested in the 6th,12th month after the operation.Results The vancouver scar scale of the treatment group is lower than the control group in the 6th,12th month after operation , and the difference has statistical significance( P<0.05).After be treated by radiofrequency ablation , the color, thickness and soft-ness of scar had been significantly improved .Conclusion After be treated by RF ablation , the color of pathological scars would be fade , the thickness be flattening , and the contracture be alleviate .It is an ideal method to dispel scars .

  5. Questa Baseline and Pre-mining Ground-Water Quality Investigation, 7. A Pictorial Record of Chemical Weathering, Erosional Processes, and Potential Debris-flow Hazards in Scar Areas Developed on Hydrothermally Altered Rocks

    Science.gov (United States)

    Plumlee, Geoffrey S.; Ludington, Steve; Vincent, Kirk R.; Verplanck, Philip L.; Caine, Jonathan S.; Livo, K. Eric

    2009-01-01

    Erosional scar areas developed along the lower Red River basin, New Mexico, reveal a complex natural history of mineralizing processes, rapid chemical weathering, and intense physical erosion during periodic outbursts of destructive, storm-induced runoff events. The scar areas are prominent erosional features with craggy headwalls and steep, denuded slopes. The largest scar areas, including, from east to west, Hottentot Creek, Straight Creek, Hansen Creek, Lower Hansen Creek, Sulfur Gulch, and Goat Hill Gulch, head along high east-west trending ridges that form the northern and southern boundaries of the lower Red River basin. Smaller, topographically lower scar areas are developed on ridge noses in the inner Red River valley. Several of the natural scar areas have been modified substantially as a result of large-scale open-pit and underground mining at the Questa Mine; for example, much of the Sulfur Gulch scar was removed by open pit mining, and several scars are now partially or completely covered by mine waste dumps.

  6. A novel, simple scale for assessing the symptom severity of atrial fibrillation at the bedside: the CCS-SAF scale.

    Science.gov (United States)

    Dorian, Paul; Cvitkovic, Suzan S; Kerr, Charles R; Crystal, Eugene; Gillis, Anne M; Guerra, Peter G; Mitchell, L Brent; Roy, Denis; Skanes, Allan C; Wyse, D George

    2006-04-01

    The severity of symptoms caused by atrial fibrillation (AF) is extremely variable. Quantifying the effect of AF on patient well-being is important but there is no simple, commonly accepted measure of the effect of AF on quality of life (QoL). Current QoL measures are cumbersome and impractical for clinical use. To create a simple, concise and readily usable AF severity score to facilitate treatment decisions and physician communication. The Canadian Cardiovascular Society (CCS) Severity of Atrial Fibrillation (SAF) Scale is analogous to the CCS Angina Functional Class. The CCS-SAF score is determined using three steps: documentation of possible AF-related symptoms (palpitations, dyspnea, dizziness/syncope, chest pain, weakness/fatigue); determination of symptom-rhythm correlation; and assessment of the effect of these symptoms on patient daily function and QoL. CCS-SAF scores range from 0 (asymptomatic) to 4 (severe impact of symptoms on QoL and activities of daily living). Patients are also categorized by type of AF (paroxysmal versus persistent/permanent). The CCS-SAF Scale will be validated using accepted measures of patient-perceived severity of symptoms and impairment of QoL and will require 'field testing' to ensure its applicability and reproducibility in the clinical setting. This type of symptom severity scale, like the New York Heart Association Functional Class for heart failure symptoms and the CCS Functional Class for angina symptoms, trades precision and comprehensiveness for simplicity and ease of use at the bedside. A common language to quantify AF severity may help to improve patient care.

  7. Renal scar formation and kidney function following antibiotic-treated murine pyelonephritis

    Directory of Open Access Journals (Sweden)

    Patrick D. Olson

    2017-11-01

    Full Text Available We present a new preclinical model to study treatment, resolution and sequelae of severe ascending pyelonephritis. Urinary tract infection (UTI, primarily caused by uropathogenic Escherichia coli (UPEC, is a common disease in children. Severe pyelonephritis is the primary cause of acquired renal scarring in childhood, which may eventually lead to hypertension and chronic kidney disease in a small but important fraction of patients. Preclinical modeling of UTI utilizes almost exclusively females, which (in most mouse strains exhibit inherent resistance to severe ascending kidney infection; consequently, no existing preclinical model has assessed the consequences of recovery from pyelonephritis following antibiotic treatment. We recently published a novel mini-surgical bladder inoculation technique, with which male C3H/HeN mice develop robust ascending pyelonephritis, highly prevalent renal abscesses and evidence of fibrosis. Here, we devised and optimized an antibiotic treatment strategy within this male model to more closely reflect the clinical course of pyelonephritis. A 5-day ceftriaxone regimen initiated at the onset of abscess development achieved resolution of bladder and kidney infection. A minority of treated mice displayed persistent histological abscess at the end of treatment, despite microbiological cure of pyelonephritis; a matching fraction of mice 1 month later exhibited renal scars featuring fibrosis and ongoing inflammatory infiltrates. Successful antibiotic treatment preserved renal function in almost all infected mice, as assessed by biochemical markers 1 and 5 months post-treatment; hydronephrosis was observed as a late effect of treated pyelonephritis. An occasional mouse developed chronic kidney disease, generally reflecting the incidence of this late sequela in humans. In total, this model offers a platform to study the molecular pathogenesis of pyelonephritis, response to antibiotic therapy and emergence of sequelae

  8. Scar Pain, Cosmesis and Patient Satisfaction in Laparoscopic and Open Cholecystectomy.

    Science.gov (United States)

    Rafiq, Muhammad Salman; Khan, Mah Muneer

    2016-03-01

    To compare patient-satisfaction, scar-pain and cosmesis between laparoscopic and open-cholecystectomy. Cross-sectional survey. Khyber Teaching Hospital, Peshawar, from August 2012 to May 2014. A total of 400 patients, who had undergone open or laparoscopic cholecystectomy in all units of the Surgical Department, were included. Data was collected on questionnaires given and read to the patients along with counselling and information regarding scar-pain using visual analog score, and satisfaction and cosmesis on a 0 - 10 scale, by a medical professional in the patients' native language. This was done postoperatively on patients' follow-up visits at 1 and 4 weeks. Mean scar pain score at 1 and 4 weeks postoperatively was higher for open-cholecystectomy; 4.96 ±1 and 0.96 ±1, compared to 2.24 ±0.6 and 0, respectively for laparoscopic-cholecystectomy (p < 0.001 and < 0.001). Cosmesis was higher for laparoscopic-group; 8.6 ±1.2 vs. 6.2 ±1.46 for open-cholecystectomy (p < 0.001). Patient-satisfaction was higher for laparoscopic-cholecystectomy; 9.28 ±1.5 vs. 8.32 ±2.3 for open-cholecystectomy (p < 0.001). Mean-cosmesis score was higher for laparoscopic-cholecystectomy for those younger than 40, females and unmarried. Mean patient-satisfaction score was higher for those older than 40 years who had undergone open-cholecystectomy, women who had undergone laparoscopic-cholecystectomy and for unmarried patients who had laparoscopic-cholecystectomy. Overall patient-satisfaction and cosmesis scoring was higher for laparoscopic-cholecystectomy especially among females, unmarried and younger than 40 years. Patients of 40 years and older had greater satisfaction scoring for open-cholecystectomy. Therefore, laparoscopic-cholecystectomy should be favoured in females and unmarried patients and those younger than 40 years.

  9. Fall risk assessment: retrospective analysis of Morse Fall Scale scores in Portuguese hospitalized adult patients.

    Science.gov (United States)

    Sardo, Pedro Miguel Garcez; Simões, Cláudia Sofia Oliveira; Alvarelhão, José Joaquim Marques; Simões, João Filipe Fernandes Lindo; Melo, Elsa Maria de Oliveira Pinheiro de

    2016-08-01

    The Morse Fall Scale is used in several care settings for fall risk assessment and supports the implementation of preventive nursing interventions. Our work aims to analyze the Morse Fall Scale scores of Portuguese hospitalized adult patients in association with their characteristics, diagnoses and length of stay. Retrospective cohort analysis of Morse Fall Scale scores of 8356 patients hospitalized during 2012. Data were associated to age, gender, type of admission, specialty units, length of stay, patient discharge, and ICD-9 diagnosis. Elderly patients, female, with emergency service admission, at medical units and/or with longer length of stays were more frequently included in the risk group for falls. ICD-9 diagnosis may also be an important risk factor. More than a half of hospitalized patients had "medium" to "high" risk of falling during the length of stay, which determines the implementation and maintenance of protocoled preventive nursing interventions throughout hospitalization. There are several fall risk factors not assessed by Morse Fall Scale. There were no statistical differences in Morse Fall Scale score between the first and the last assessment. Copyright © 2015 Elsevier Inc. All rights reserved.

  10. Macroanatomy and compartmentalization of recent fire scars in three North American conifers

    Science.gov (United States)

    Kevin T. Smith; Estelle Arbellay; Donald A. Falk; Elaine Kennedy Sutherland

    2016-01-01

    Fire scars are initiated by cambial necrosis caused by localized lethal heating of the tree stem. Scars develop as part of the linked survival processes of compartmentalization and wound closure. The position of scars within dated tree ring series is the basis for dendrochronological reconstruction of fire history. Macroanatomical features were described for western...

  11. Epithelioid sarcoma and squamous cell carcinoma arising in a burn scar

    Directory of Open Access Journals (Sweden)

    Kusum D Jashnani

    2011-01-01

    Full Text Available Development of a malignant tumor is a well known complication of a chronic burn scar. Most of these tumors are squamous cell carcinomas and only 28 cases of burn scar sarcomas have been reported in literature. We report the first occurrence of the combination of squamous cell carcinoma and epithelioid sarcoma arising in a burn scar.

  12. Evidence-Based Scar Management: How to Improve Results with Technique and Technology.

    Science.gov (United States)

    Khansa, Ibrahim; Harrison, Bridget; Janis, Jeffrey E

    2016-09-01

    Scars represent the visible sequelae of trauma, injury, burn, or surgery. They may induce distress in the patient because of their aesthetically unpleasant appearance, especially if they are excessively raised, depressed, wide, or erythematous. They may also cause the patient symptoms of pain, tightness, and pruritus. Numerous products are marketed for scar prevention or improvement, but their efficacy is unclear. A literature review of high-level studies analyzing methods to prevent or improve hypertrophic scars, keloids, and striae distensae was performed. The evidence from these articles was analyzed to generate recommendations. Each intervention's effectiveness at preventing or reducing scars was rated as none, low, or high, depending on the strength of the evidence for that intervention. For the prevention of hypertrophic scars, silicone, tension reduction, and wound edge eversion seem to have high efficacy, whereas onion extract, pulsed-dye laser, pressure garments, and scar massage have low efficacy. For the treatment of existing hypertrophic scars, silicone, pulsed-dye laser, CO2 laser, corticosteroids, 5-fluorouracil, bleomycin, and scar massage have high efficacy, whereas onion extract and fat grafting seem to have low efficacy. For keloid scars, effective adjuncts to excision include corticosteroids, mitomycin C, bleomycin, and radiation therapy. No intervention seems to have significant efficacy in the prevention or treatment of striae distensae. Although scars can never be completely eliminated in an adult, this article presents the most commonly used, evidence-based methods to improve the quality and symptoms of hypertrophic scars, as well as keloid scars and striae distensae.

  13. Weather, logging, and tree growth associated with fir engraver attack scars in white fir

    Science.gov (United States)

    George T. Ferrell

    1973-01-01

    The boles of 32 recently killed, and 41 living, white fir were examined for embedded fir engraver (Scolytus ventralis) attack scars. Of 287 scars found in annual rings for the years 1934-69, only 2 to 3 percent represented reproductively successful attacks. Trends in scar abundance were directly correlated with trends in white fir killed by ...

  14. Psychometric assessment of the Spiritual Climate Scale Arabic version for nurses in Saudi Arabia.

    Science.gov (United States)

    Cruz, Jonas Preposi; Albaqawi, Hamdan Mohammad; Alharbi, Sami Melbes; Alicante, Jerico G; Vitorino, Luciano M; Abunab, Hamzeh Y

    2017-12-07

    To assess the psychometric properties of the Spiritual Climate Scale Arabic version for Saudi nurses. Evidence showed that a high level of spiritual climate in the workplace is associated with increased productivity and performance, enhanced emotional intelligence, organisational commitment and job satisfaction among nurses. A convenient sample of 165 Saudi nurses was surveyed in this descriptive, cross-sectional study. Cronbach's α and intraclass correlation coefficient of the 2 week test-retest scores were computed to establish reliability. Exploratory factor analysis was performed to support the validity of the Spiritual Climate Scale Arabic version. The Spiritual Climate Scale Arabic version manifested excellent content validity. Exploratory factor analysis supported a single factor with an explained variance of 73.2%. The Cronbach's α values of the scale ranged from .79 to .88, while the intraclass correlation coefficient value was .90. The perceived spiritual climate was associated with the respondents' hospital, gender, age and years of experience. Findings of this study support the sound psychometric properties of the Spiritual Climate Scale Arabic version. The Spiritual Climate Scale Arabic version can be used by nurse managers to assess the nurses' perception of the spiritual climate in any clinical area. This process can lead to spiritually centred interventions, thereby ensuring a clinical climate that accepts and respects different spiritual beliefs and practices. © 2017 John Wiley & Sons Ltd.

  15. A partnership development process assessment scale for public health nurses in Japan.

    Science.gov (United States)

    Shigematsu, Yukako; Hatano, Yoko; Kimura, Hitoe

    2015-01-01

    The objective of this study was to develop and test a Partnership Development Process Assessment (PDPA) scale for content and construct validity and internal consistency reliability. This is needed to document and evaluate community health partnership development processes between public health nurses and community-based organizations in Japan. The study was conducted in three phases. Ten semi-structured interviews were conducted to generate items for a new scale. Thirty items were generated and reviewed by an expert panel for content validity and item refinement. A national postal survey of public health nurses was conducted to determine the scale's internal structure, evaluate its reliability, and explore its construct and criterion validity. Validity and reliability testing of the PDPA scale using a content validity index and analysis of correlations with an existing scale were performed. Twenty-six items were selected and grouped into four factors: activities to share roles to manage community health issues, platform activities to support partnerships, activities to evaluate partnership practices, and activities to share information regarding community health issues. After factor analysis, 23 items were retained. The PDPA scale is a valid and reliable instrument for public health nurses to assess partnership development activities. © 2015 Wiley Periodicals, Inc.

  16. An Integrated Assessment of Location-Dependent Scaling for Microalgae Biofuel Production Facilities

    Energy Technology Data Exchange (ETDEWEB)

    Coleman, Andre M.; Abodeely, Jared; Skaggs, Richard; Moeglein, William AM; Newby, Deborah T.; Venteris, Erik R.; Wigmosta, Mark S.

    2014-06-19

    Successful development of a large-scale microalgae-based biofuels industry requires comprehensive analysis and understanding of the feedstock supply chain—from facility siting/design through processing/upgrading of the feedstock to a fuel product. The evolution from pilot-scale production facilities to energy-scale operations presents many multi-disciplinary challenges, including a sustainable supply of water and nutrients, operational and infrastructure logistics, and economic competitiveness with petroleum-based fuels. These challenges are addressed in part by applying the Integrated Assessment Framework (IAF)—an integrated multi-scale modeling, analysis, and data management suite—to address key issues in developing and operating an open-pond facility by analyzing how variability and uncertainty in space and time affect algal feedstock production rates, and determining the site-specific “optimum” facility scale to minimize capital and operational expenses. This approach explicitly and systematically assesses the interdependence of biofuel production potential, associated resource requirements, and production system design trade-offs. The IAF was applied to a set of sites previously identified as having the potential to cumulatively produce 5 billion-gallons/year in the southeastern U.S. and results indicate costs can be reduced by selecting the most effective processing technology pathway and scaling downstream processing capabilities to fit site-specific growing conditions, available resources, and algal strains.

  17. Scale-Dependent Assessment of Relative Disease Resistance to Plant Pathogens

    Directory of Open Access Journals (Sweden)

    Peter Skelsey

    2014-03-01

    Full Text Available Phenotyping trials may not take into account sufficient spatial context to infer quantitative disease resistance of recommended varieties in commercial production settings. Recent ecological theory—the dispersal scaling hypothesis—provides evidence that host heterogeneity and scale of host heterogeneity interact in a predictable and straightforward manner to produce a unimodal (“humpbacked” distribution of epidemic outcomes. This suggests that the intrinsic artificiality (scale and design of experimental set-ups may lead to spurious conclusions regarding the resistance of selected elite cultivars, due to the failure of experimental efforts to accurately represent disease pressure in real agricultural situations. In this model-based study we investigate the interaction of host heterogeneity and scale as a confounding factor in the inference from ex-situ assessment of quantitative disease resistance to commercial production settings. We use standard modelling approaches in plant disease epidemiology and a number of different agronomic scenarios. Model results revealed that the interaction of heterogeneity and scale is a determinant of relative varietal performance under epidemic conditions. This is a previously unreported phenomenon that could provide a new basis for informing the design of future phenotyping platforms, and optimising the scale at which quantitative disease resistance is assessed.

  18. Perioperative interstitial brachytherapy for recurrent keloid scars; La curietherapie interstitielle perioperatoire dans le traitement des cicatrices cheloides recidivantes

    Energy Technology Data Exchange (ETDEWEB)

    Rio, E; Bardet, E; Peuvrel, P [CRLCC Nantes-Atlantique, Service de radiotherapie, 44 - Nantes-St-Herblain (France); Martinet, L; Perrot, P [CHU Hotel-Dieu, Service de chirurgie plastique, 44 - Nantes (France); Baraer, F; Loirat, Y [Clinique Breteche, Service de chirurgie plastique, 44 - Nantes (France); Sartre, J Y [Clinique Jules-Verne, Service de chirurgie plastique, 44 - Nantes (France); Malard, O; Ferron, C [CHU Hotel-Dieu, Service de Chirurgie ORL, 44 - Nantes (France); Dreno, B [CHU Hotel-Dieu, Service de dermatologie, 44 - Nantes (France)

    2010-01-15

    Purpose: Evaluation of the results of perioperative interstitial brachytherapy with low dose-rate (L.D.R.) Ir-192 in the treatment of keloid scars. Patients and methods: We performed a retrospective analysis of 73 histologically confirmed keloids (from 58 patients) resistant to medico surgical treated by surgical excision plus early perioperative brachytherapy. All lesions were initially symptomatic. Local control was evaluated by clinical evaluation. Functional and cosmetic results were assessed in terms of patient responses to a self-administered questionnaire. Results: Median age was 28 years (range 13-71 years). Scars were located as follows: 37% on the face, 32% on the trunk or abdomen, 16% on the neck, and 15% on the arms or legs. The mean delay before loading was four hours (range, 1-6 h). The median dose was 20 Gy (range, 15-40 Gy). Sixty-four scars (from 53 patients) were evaluated. Local control was 86% (follow-up, 44.5 months; range, 14-150 months). All relapses occurred early within 2 years posttreatment. At 20 months, survival without recurrence was significantly lower when treated lengths were more than 6 cm long. The rate was 100% for treated scars below 4.5 cm in length, 95% (95% CI: 55-96) for those 4.5-6 cm long, and 75% (95% CI: 56-88) beyond 6 cm (p = 0.038). Of the 35 scars (28 patients) whose results were reassessed, six remained symptomatic and the esthetic results were considered to be good in 51% (18/35) and average in 37% (13/35) (median follow-up, 70 months; range, 16-181 months). Conclusion: Early perioperative L.D.R. brachytherapy delivering 20 Gy at 5 mm reduced the rate of recurrent keloids resistant to other treatments and gave good functional results. (authors)

  19. Validation of the Rowland Universal Dementia Assessment Scale for Multicultural Screening in Danish Memory Clinics

    DEFF Research Database (Denmark)

    Nielsen, Thomas Rune; Andersen, Birgitte Bo; Gottrup, Hanne

    2013-01-01

    Background/Aims: The Rowland Universal Dementia Assessment Scale (RUDAS) is a brief cognitive screening test that was developed to detect dementia in multicultural populations. The RUDAS has not previously been validated in multicultural populations outside of Australia. The aim of this study...

  20. A Scale for the Assessment of Attitudes and Knowledge Regarding Sexuality in the Aged.

    Science.gov (United States)

    White, Charles B.

    This paper presents the Aging Sexuality Knowledge and Attitudes Scale (ASKAS), an instrument designed to assess the particular aspects of sexual knowledge and attitudes as they relate to the aged. Development of ASKAS items from a survey of existant physiological research on sexuality in older adults and a review of social-psychological writing on…

  1. The Development of a Scale on Assessing Peer Mentoring at the College Level

    Science.gov (United States)

    Kocadere, Selay Arkün

    2015-01-01

    The purpose of my study was to develop and validate a scale to assess peer mentoring practices that aim to enhance learning. In the development process, 4 focus group interviews were conducted with 10 mentors and 12 mentees who participated in 8 weeks of peer mentoring. In addition to the literature, the findings from interviews were used to…

  2. Explore the Usefulness of Person-Fit Analysis on Large-Scale Assessment

    Science.gov (United States)

    Cui, Ying; Mousavi, Amin

    2015-01-01

    The current study applied the person-fit statistic, l[subscript z], to data from a Canadian provincial achievement test to explore the usefulness of conducting person-fit analysis on large-scale assessments. Item parameter estimates were compared before and after the misfitting student responses, as identified by l[subscript z], were removed. The…

  3. Response shift in severity assessment of hand eczema with visual analogue scales

    DEFF Research Database (Denmark)

    Mollerup, Annette; Johansen, Jeanne D

    2015-01-01

    BACKGROUND: Hand eczema is a common and fluctuating disease. Visual analogue scales (VASs) are used to assess disease severity, both currently and when at its worst. However, such patient-reported outcomes may be at risk of being flawed owing to recall bias or response shifts. OBJECTIVE: To explore...

  4. Balancing Tensions in Educational Policy Reforms: Large-Scale Implementation of Assessment for Learning in Norway

    Science.gov (United States)

    Hopfenbeck, Therese N.; Flórez Petour, María Teresa; Tolo, Astrid

    2015-01-01

    This study investigates how different stakeholders in Norway experienced a government-initiated, large-scale policy implementation programme on "Assessment for Learning" ("AfL"). Data were collected through 58 interviews with stakeholders in charge of the policy; Ministers of Education and members of the Directorate of…

  5. Examiner Errors on the Reynolds Intellectual Assessment Scales Committed by Graduate Student Examiners

    Science.gov (United States)

    Loe, Scott A.

    2014-01-01

    Protocols from 108 administrations of the Reynolds Intellectual Assessment Scales were evaluated to determine the frequency of examiner errors and their impact on the accuracy of three test composite scores, the Composite Ability Index (CIX), Verbal Ability Index (VIX), and Nonverbal Ability Index (NIX). Students committed at least one…

  6. [A scale for the assessment of the risk of pressure sores in paediatric intensive care].

    Science.gov (United States)

    Weigel, Virginie

    2014-01-01

    Pressure sores are a frequent complication in paediatric intensive care. A multi-disciplinary nursing team has drawn up an assessment scale for the risk of pressure sores and has put in place guidelines for caring for children in intensive care. Prevention actions are thereby adapted to each young patient.

  7. Assessing heterogeneity in soil nitrogen cycling: a plot-scale approach

    Science.gov (United States)

    Peter Baas; Jacqueline E. Mohan; David Markewitz; Jennifer D. Knoepp

    2014-01-01

    The high level of spatial and temporal heterogeneity in soil N cycling processes hinders our ability to develop an ecosystem-wide understanding of this cycle. This study examined how incorporating an intensive assessment of spatial variability for soil moisture, C, nutrients, and soil texture can better explain ecosystem N cycling at the plot scale. Five sites...

  8. Psychometric properties of the Fatigue Assessment Scale (FAS) in women with breast problems

    NARCIS (Netherlands)

    de Vries, J.; van der Steeg, A.F.; Roukema, J.A.

    2010-01-01

    To examine the usefulness of the Fatigue Assessment Scale (FAS) in women with benign breast problems (BBP) and women with early stage breast cancer (BC). Women with a palpable lump in the breast or an abnormality on a screening mammography (N = 560) completed the FAS (four time points) and measures

  9. The internal consistency and validity of the Self-assessment Parkinson's Disease Disability Scale.

    NARCIS (Netherlands)

    Biemans, M.A.J.E.; Dekker, J.; Woude, L.H.V. van der

    2001-01-01

    OBJECTIVE: To test the consistency and validity of the Self-assessment Parkinson's Disease Disability Scale in patients with Parkinson's disease living at home. DESIGN: Patients with Parkinson's disease responded to a set of questionnaires. In addition, an observation of the performance of daily

  10. Internal consistency and validity of the self-assessment Parkinson's Disease disability scale. Abstract.

    NARCIS (Netherlands)

    Dekker, J.; Biemans, M.A.J.E.; Woude, L.H.V. van der

    2000-01-01

    OBJECTIVE: To test the consistency and validity of the Self-assessment Parkinson's Disease Disability Scale in patients with Parkinson's disease living at home. DESIGN: Patients with Parkinson's disease responded to a set of questionnaires. In addition, an observation of the performance of daily

  11. How to Measure and Explain Achievement Change in Large-Scale Assessments: A Rejoinder

    Science.gov (United States)

    Hickendorff, Marian; Heiser, Willem J.; van Putten, Cornelis M.; Verhelst, Norman D.

    2009-01-01

    In this rejoinder, we discuss substantive and methodological validity issues of large-scale assessments of trends in student achievement, commenting on the discussion paper by Van den Heuvel-Panhuizen, Robitzsch, Treffers, and Koller (2009). We focus on methodological challenges in deciding what to measure, how to measure it, and how to foster…

  12. An assessment of basin-scale glaciological and hydrological sensitivities in the Hindu Kush-Himalaya

    NARCIS (Netherlands)

    Shea, Joseph M.; Immerzeel, Walter W.

    2016-01-01

    Glacier responses to future climate change will affect hydrology at sub-basin scales. The main goal of this study is to assess glaciological and hydrological sensitivities of sub-basins throughout the Hindu Kush-Himalaya region. We use a simple geometrical analysis based on a full glacier inventory

  13. A Scale to Assess Science Activity Videos (SASAV): The Study of Validity and Reliability

    Science.gov (United States)

    Kara, Yilmaz; Bakirci, Hasan

    2018-01-01

    The purpose of the study was to develop an assessment scale for science activity videos that can be used to determine qualified science activity videos that can fulfill the objectives of activity based science education, help teachers to evaluate any science activity videos and decide whether to include into science learning process. The subjects…

  14. Translation and adaptation of the Disability Assessment for Dementia scale in the Spanish population.

    Science.gov (United States)

    Sánchez-Pérez, Alicia; López-Roig, Sofia; Pampliega Pérez, Ana; Peral Gómez, Paula; Pastor, María Ángeles; Hurtado-Pomares, Miriam

    2017-09-20

    Functional assessment is especially relevant in patients with cognitive impairment (CI). The Disability Assessment for Dementia (DAD) scale assesses functional ability and its use is becoming increasingly popular. This study aims to perform the translation and cultural adaptation of the DAD scale in order to create a Spanish version: DAD-E. A double translation/back-translation process was developed, as well as a pilot study with 14 caregivers of patients with CI, and 3 review meetings to achieve general agreement. The DAD-E includes the 40 original items. Four response options and 8 scores were added in order to detect functional disability induced by CI independently of other possible causes. More detailed instructions for administration and scoring of the scale have been provided in order to improve the reliability of the content. The DAD-E was shown to be a cultural and linguistic adaptation equivalent of the original scale, which allows it to be applied to the Spanish population. It may be a useful instrument in clinical practice since it provides a more accurate assessment of functional disability due to cognitive impairment. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  15. Estimating the Effectiveness of Special Education Using Large-Scale Assessment Data

    Science.gov (United States)

    Ewing, Katherine Anne

    2009-01-01

    The inclusion of students with disabilities in large scale assessment and accountability programs has provided new opportunities to examine the impact of special education services on student achievement. Hanushek, Kain, and Rivkin (1998, 2002) evaluated the effectiveness of special education programs by examining students' gains on a large-scale…

  16. A conceptual analysis of standard setting in large-scale assessments

    NARCIS (Netherlands)

    van der Linden, Willem J.

    1994-01-01

    Elements of arbitrariness in the standard setting process are explored, and an alternative to the use of cut scores is presented. The first part of the paper analyzes the use of cut scores in large-scale assessments, discussing three different functions: (1) cut scores define the qualifications used

  17. The blepharospasm disability scale: an instrument for the assessment of functional health in blepharospasm

    NARCIS (Netherlands)

    Lindeboom, R.; de Haan, R.; Aramideh, M.; Speelman, J. D.

    1995-01-01

    Assessment of the functional status in patients with blepharospasm is of major importance for clinical practice and outcome studies. The Blepharospasm Disability Scale (BDS) is specifically directed to measure the disability in these patients. The metric properties of this instrument were evaluated.

  18. Taxometric Analysis of the Antisocial Features Scale of the Personality Assessment Inventory in Federal Prison Inmates

    Science.gov (United States)

    Walters, Glenn D.; Diamond, Pamela M.; Magaletta, Philip R.; Geyer, Matthew D.; Duncan, Scott A.

    2007-01-01

    The Antisocial Features (ANT) scale of the Personality Assessment Inventory (PAI) was subjected to taxometric analysis in a group of 2,135 federal prison inmates. Scores on the three ANT subscales--Antisocial Behaviors (ANT-A), Egocentricity (ANT-E), and Stimulus Seeking (ANT-S)--served as indicators in this study and were evaluated using the…

  19. Treatment of acne scars and wrinkles in asian patients using carbon-dioxide fractional laser resurfacing: its effects on skin biophysical profiles.

    Science.gov (United States)

    Hwang, Young Ji; Lee, Yu Na; Lee, Yang Won; Choe, Yong Beom; Ahn, Kyu Joong

    2013-11-01

    Although ablative fractional resurfacing is known to be effective against photoaging and acne scars, studies on its efficacy, safety and changes in the skin characteristics of Asians are limited. The aim of this study is to assess the efficacy and safety of carbon dioxide fractional laser (CO2FL) in Koreans treated for wrinkles and acne scars, and to define the changes in skin characteristics during recovery period. We administered one session of CO2FL on 10 acne scar patients and 14 wrinkles patients with skin types IV and V. The surveillance of efficacy and side effects along with the measurement of biophysical properties was carried out before 1 day, 1 week, 1 month and 3 months after treatment. Using a non-invasive method, skin barrier damage, erythema and bronzing of skin during the recovery period were assessed, and all of the items eventually returned to the pre-treatment level. Skin elasticity was measured in the wrinkle group, and the statistically significant effect was sustained throughout the next three months. The outcome of treatment was found to be better than 'moderate improvement' in both the acne scar and wrinkle groups. Further, there were no serious side effects three months post-procedure. CO2 FL is thought to be an effective and safe method for treating moderate to severe acne scars and wrinkles in Asians.

  20. Psychometric properties of the Doloplus-2 observational pain assessment scale and comparison to self-assessment in hospitalized elderly.

    Science.gov (United States)

    Pautex, Sophie; Herrmann, François R; Michon, Agnès; Giannakopoulos, Panteleimon; Gold, Gabriel

    2007-01-01

    Self-report is the "gold standard" for pain assessment, however, observational pain scales, such as Doloplus-2 must be used for patients who cannot communicate. In this follow-up study, we report the psychometric properties of the observational Doloplus-2 scale using the visual analog scale (VAS) pain score as a gold standard and evaluate its performance. Prospective clinical study of 180 hospitalized older patients who demonstrated good comprehension and reliable use of the VAS: 131 participants with dementia and 49 without. All participants assessed their chronic pain using the VAS. Doloplus-2 was independently completed by the nursing team. Mean age of patients (133 women, 47 men) was 83.7+/-6.5. Median mini-mental state examination of patients with diagnosis of dementia was 18.0+/-7.7. Nearly half of the patients (49%) reported that they experienced pain in response to a direct question. The administration of Doloplus-2 was possible in all 180 patients. Doloplus-2 correlated moderately with self-assessment (Spearman coefficient: 0.46). In a multiple regression model, Doloplus-2 predicted 41% of the variability in pain intensity measured by VAS. The somatic dimension alone explained 36% of the variance, the psychosocial bloc 5% with no better contribution of the psychomotor bloc. To shorten Doloplus-2, we constructed a version with only the 5 items that were significantly associated with the VAS score in the multiple regression models. The observational Doloplus-2 scale correlates moderately with self-assessment pain score and has adequate internal consistency. Our data also suggest that Doloplus-2 could be substantially shortened as the brief version performed similarly to the complete Doloplus-2.

  1. Comparing the Fullerton Advanced Balance Scale with the Mini-BESTest and Berg Balance Scale to assess postural control in patients with Parkinson disease.

    Science.gov (United States)

    Schlenstedt, Christian; Brombacher, Stephanie; Hartwigsen, Gesa; Weisser, Burkhard; Möller, Bettina; Deuschl, Günther

    2015-02-01

    To validate the Fullerton Advanced Balance (FAB) Scale for patients with idiopathic Parkinson disease (PD); and to compare the FAB Scale with the Mini-Balance Evaluation Systems Test (Mini-BESTest) and Berg Balance Scale (BBS). Observational study to assess concurrent validity, test-retest, and interrater reliability of the FAB Scale in patients with PD and to compare the distribution of the scale with the Mini-BESTest and BBS. University hospital in an urban community. Patients with idiopathic PD (N=85; Hoehn and Yahr stages 1-4). Not applicable. FAB Scale, Mini-BESTest, BBS, timed Up and Go test, Unified Parkinson's Disease Rating Scale, and visual analog scale. Interrater (3 raters) and test-retest (3±1 d) reliability were high for all scales (ICCs≥.95). The FAB Scale was highly correlated with the Mini-BESTest (Spearman ρ=.87) and timed Up and Go test item of the Mini-BESTest (Spearman ρ=.83). In contrast with the BBS, the FAB Scale and Mini-BESTest have only minimal ceiling effects. The FAB Scale demonstrated the most symmetric distribution when compared with the Mini-BESTest and BBS (skewness: FAB scale: -.54; Mini-BESTest: -1.07; BBS: -2.14). The FAB Scale is a valid and reliable tool to assess postural control in patients with PD. No ceiling effect was noted for the FAB Scale. Although the items of the FAB Scale are more detailed when compared with the Mini-BESTest, interrater and test-retest reliability were excellent. The scale is a promising tool to detect small changes of the postural control system in individuals with PD. Copyright © 2015 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  2. Utility of a Validated Rating Scale for Self-Assessment in Microsurgical Training.

    Science.gov (United States)

    Grant, Aaron L; Temple-Oberle, Claire

    The purpose of this study is to determine the utility of self-assessment in microsurgical training using a previously validated rating scale. A prospective study of surgical residents taking a hands-on 5-day microsurgical training course. Learners completed multiple self-assessments of their technical skills using the University of Western Ontario Microsurgical Acquisition/Assessment instrument. Simultaneously, preceptors assessed the learners using the same scale. Self-assessment and preceptor scores were compared using the Pearson correlation coefficient (PCC). There was a significant agreement noted between the 32 preceptor assessments and 36 self-assessments that were completed. Correlation between scores for the knot-tying (PCC = 0.62) and anastomosis modules (PCC = 0.77) was good and excellent, respectively. Preceptor scores and self-scores improved over the duration of the course: for preceptors, knot-tying scores increased from 58% on day 1 to 78% on day 5 (p = 0.02) and anastomosis scores improved from 56% to 82% (p = 0.004); for self-scores, knot-tying scores increased from 44% to 81% (p = 0.001) and anastomosis scores from 49% to 84% (p = 0.001). Learners with greater experience (higher postgraduate year level) tended to have higher self as well as preceptor ratings, albeit not statistically significant. Self-assessment using the University of Western Ontario Microsurgical Acquisition/Assessment instrument has good to excellent agreement with preceptor-assessment scores suggesting good interrater reliability. Self-assessment using such tools may, therefore, be used along with preceptor supervision and assessment to potentially improve self-directed learning during these courses. Copyright © 2017 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  3. Assessing attitude toward same-sex marriage: scale development and validation.

    Science.gov (United States)

    Lannutti, Pamela J; Lachlan, Kenneth A

    2007-01-01

    This paper reports the results of three studies conducted to develop, refine, and validate a scale which assessed heterosexual adults' attitudes toward same-sex marriage, the Attitude Toward Same-Sex Marriage Scale (ASSMS). The need for such a scale is evidenced in the increasing importance of same-sex marriage in the political arena of the United States and other nations, as well as the growing body of empirical research examining same-sex marriage and related issues (e.g., Lannutti, 2005; Solomon, Rothblum, & Balsam, 2004). The results demonstrate strong reliability, convergent validity, and predictive validity for the ASSMS and suggest that the ASSMS may be adapted to measure attitudes toward civil unions and other forms of relational recognition for same-sex couples. Gender comparisons using the validated scale showed that in college and non-college samples, women had a significantly more positive attitude toward same-sex marriage than did men.

  4. Brief pain inventory scale: An emerging assessment modality for orofacial pain

    Directory of Open Access Journals (Sweden)

    Ruchika Khanna

    2015-01-01

    Full Text Available Pain is an emotional experience almost experienced by almost every one of us. Since the pain can neither be seen nor measured, it poses a challenge to the patient as well as the clinician in understanding its complicated nature and the best way of managing it. There is no simple method of pain evaluation due to its subjective nature. However, comprehensive approaches for its evaluation exists, of which most common pain scale used are visual analog scale, Mc-Gills questionnaire, brief pain inventory (BPI to name a few. We have tried to highlight the various advantages of the BPI scale over the other pain scales and to emphasize an improved instrument, which can be used as a promising modality for the assessment of orofacial pain.

  5. Hypothesis testing on the fractal structure of behavioral sequences: the Bayesian assessment of scaling methodology.

    Science.gov (United States)

    Moscoso del Prado Martín, Fermín

    2013-12-01

    I introduce the Bayesian assessment of scaling (BAS), a simple but powerful Bayesian hypothesis contrast methodology that can be used to test hypotheses on the scaling regime exhibited by a sequence of behavioral data. Rather than comparing parametric models, as typically done in previous approaches, the BAS offers a direct, nonparametric way to test whether a time series exhibits fractal scaling. The BAS provides a simpler and faster test than do previous methods, and the code for making the required computations is provided. The method also enables testing of finely specified hypotheses on the scaling indices, something that was not possible with the previously available methods. I then present 4 simulation studies showing that the BAS methodology outperforms the other methods used in the psychological literature. I conclude with a discussion of methodological issues on fractal analyses in experimental psychology. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  6. Development and validation of a psychometric scale for assessing PA chest image quality: A pilot study

    International Nuclear Information System (INIS)

    Mraity, H.; England, A.; Akhtar, I.; Aslam, A.; De Lange, R.; Momoniat, H.; Nicoulaz, S.; Ribeiro, A.; Mazhir, S.; Hogg, P.

    2014-01-01

    Purpose: To develop and validate a psychometric scale for assessing image quality perception for chest X-ray images. Methods: Bandura's theory was used to guide scale development. A review of the literature was undertaken to identify items/factors which could be used to evaluate image quality using a perceptual approach. A draft scale was then created (22 items) and presented to a focus group (student and qualified radiographers). Within the focus group the draft scale was discussed and modified. A series of seven postero-anterior chest images were generated using a phantom with a range of image qualities. Image quality perception was confirmed for the seven images using signal-to-noise ratio (SNR 17.2–36.5). Participants (student and qualified radiographers and radiology trainees) were then invited to independently score each of the seven images using the draft image quality perception scale. Cronbach alpha was used to test interval reliability. Results: Fifty three participants used the scale to grade image quality perception on each of the seven images. Aggregated mean scale score increased with increasing SNR from 42.1 to 87.7 (r = 0.98, P < 0.001). For each of the 22 individual scale items there was clear differentiation of low, mid and high quality images. A Cronbach alpha coefficient of >0.7 was obtained across each of the seven images. Conclusion: This study represents the first development of a chest image quality perception scale based on Bandura's theory. There was excellent correlation between the image quality perception scores derived using the scale and the SNR. Further research will involve a more detailed item and factor analysis

  7. Ranking of small scale proposals for water system repair using the Rapid Impact Assessment Matrix (RIAM)

    Energy Technology Data Exchange (ETDEWEB)

    Shakib-Manesh, T.E.; Hirvonen, K.O.; Jalava, K.J.; Ålander, T.; Kuitunen, M.T., E-mail: markku.kuitunen@jyu.fi

    2014-11-15

    Environmental impacts of small scale projects are often assessed poorly, or not assessed at all. This paper examines the usability of the Rapid Impact Assessment Matrix (RIAM) as a tool to prioritize project proposals for small scale water restoration projects in relation to proposals' potential to improve the environment. The RIAM scoring system was used to assess and rank the proposals based on their environmental impacts, the costs of the projects to repair the harmful impacts, and the size of human population living around the sites. A four-member assessment group (The expert panel) gave the RIAM-scores to the proposals. The assumed impacts of the studied projects at the Eastern Finland water systems were divided into the ecological and social impacts. The more detailed assessment categories of the ecological impacts in this study were impacts on landscape, natural state, and limnology. The social impact categories were impacts to recreational use of the area, fishing, industry, population, and economy. These impacts were scored according to their geographical and social significance, their magnitude of change, their character, permanence, reversibility, and cumulativeness. The RIAM method proved to be an appropriate and recommendable method for the small-scale assessment and prioritizing of project proposals. If the assessments are well documented, the RIAM can be a method for easy assessing and comparison of the various kinds of projects. In the studied project proposals there were no big surprises in the results: the best ranks were received by the projects, which were assumed to return watersheds toward their original state.

  8. Ranking of small scale proposals for water system repair using the Rapid Impact Assessment Matrix (RIAM)

    International Nuclear Information System (INIS)

    Shakib-Manesh, T.E.; Hirvonen, K.O.; Jalava, K.J.; Ålander, T.; Kuitunen, M.T.

    2014-01-01

    Environmental impacts of small scale projects are often assessed poorly, or not assessed at all. This paper examines the usability of the Rapid Impact Assessment Matrix (RIAM) as a tool to prioritize project proposals for small scale water restoration projects in relation to proposals' potential to improve the environment. The RIAM scoring system was used to assess and rank the proposals based on their environmental impacts, the costs of the projects to repair the harmful impacts, and the size of human population living around the sites. A four-member assessment group (The expert panel) gave the RIAM-scores to the proposals. The assumed impacts of the studied projects at the Eastern Finland water systems were divided into the ecological and social impacts. The more detailed assessment categories of the ecological impacts in this study were impacts on landscape, natural state, and limnology. The social impact categories were impacts to recreational use of the area, fishing, industry, population, and economy. These impacts were scored according to their geographical and social significance, their magnitude of change, their character, permanence, reversibility, and cumulativeness. The RIAM method proved to be an appropriate and recommendable method for the small-scale assessment and prioritizing of project proposals. If the assessments are well documented, the RIAM can be a method for easy assessing and comparison of the various kinds of projects. In the studied project proposals there were no big surprises in the results: the best ranks were received by the projects, which were assumed to return watersheds toward their original state

  9. Is small beautiful? A multicriteria assessment of small-scale energy technology applications in local governments

    International Nuclear Information System (INIS)

    Burton, Jonathan; Hubacek, Klaus

    2007-01-01

    In its 2003 White Paper the UK government set ambitious renewable energy targets. Local governments and households have an increasing role in the overall energy system as consumers, suppliers of smaller-scale applications and citizens discussing energy projects. In this paper, we consider if small-scale or large-scale approaches to renewable energy provision can achieve energy targets in the most socially, economically and environmentally (SEE) effective way. We take a local case study of renewable energy provision in the Metropolitan Borough of Kirklees in Yorkshire, UK, and apply a multi-criteria decision analysis methodology to compare the small-scale schemes implemented in Kirklees with large-scale alternatives. The results indicate that small-scale schemes are the most SEE effective, despite large-scale schemes being more financially viable. The selection of the criteria on which the alternatives are assessed and the assigned weights for each criterion are of crucial importance. It is thus very important to include the relevant stakeholders to elicit this information

  10. Psychometric Properties of the Theory of Mind Assessment Scale in a Sample of Adolescents and Adults.

    Science.gov (United States)

    Bosco, Francesca M; Gabbatore, Ilaria; Tirassa, Maurizio; Testa, Silvia

    2016-01-01

    This research aimed at the evaluation of the psychometric properties of the Theory of Mind Assessment Scale (Th.o.m.a.s.). Th.o.m.a.s. is a semi-structured interview meant to evaluate a person's Theory of Mind (ToM). It is composed of several questions organized in four scales, each focusing on one of the areas of knowledge in which such faculty may manifest itself: Scale A (I-Me) investigates first-order first-person ToM; Scale B (Other-Self) investigates third-person ToM from an allocentric perspective; Scale C (I-Other) again investigates third-person ToM, but from an egocentric perspective; and Scale D (Other-Me) investigates second-order ToM. The psychometric proprieties of Th.o.m.a.s. were evaluated in a sample of 156 healthy persons: 80 preadolescent and adolescent (aged 11-17 years, 42 females) and 76 adults (aged from 20 to 67 years, 35 females). Th.o.m.a.s. scores show good inter-rater agreement and internal consistency; the scores increase with age. Evidence of criterion validity was found as Scale B scores were correlated with those of an independent instrument for the evaluation of ToM, the Strange Stories task. Confirmatory factor analysis (CFA) showed good fit of the four-factors theoretical model to the data, although the four factors were highly correlated. For each of the four scales, Rasch analyses showed that, with few exceptions, items fitted the Partial credit model and their functioning was invariant for gender and age. The results of this study, along with those of previous researches with clinical samples, show that Th.o.m.a.s. is a promising instrument to assess ToM in different populations.

  11. Comparison of fractional microneedling radiofrequency and bipolar radiofrequency on acne and acne scar and investigation of mechanism: comparative randomized controlled clinical trial.

    Science.gov (United States)

    Min, Seonguk; Park, Seon Yong; Yoon, Ji Young; Suh, Dae Hun

    2015-12-01

    Fractional microneedling radiofrequency (FMR) is one of the promising methods in acne treatment. Moreover, bipolar radiofrequency (BR) generates heat thereby which induces neocollagenosis. FMR may have the potential to be a safe and effective treatment for the patients both with acne and acne scar. This study was performed to compare the efficacy and safety of FMR and BR in acne and acne scar treatment. Furthermore, mechanism of the FMR treatment was investigated through skin tissues obtained from subjects. Twenty subjects with mild-to-moderate acne and acne scars were treated in a split-face manner with FMR and BR. Two sessions of treatment was done 4 weeks apart in a total 12-week prospective single-blind, randomized clinical trial. Clinical assessment and sebum measurement were carried out for the evaluation of efficacy and safety. Skin tissues were acquired for investigation of molecular changes. FMR was more effective for acne scar especially in icepick and boxcar scar compared to BR. Both inflammatory and non-inflammatory acne lesions decreased by 80 and 65 % in the FMR-treated side at the final visit of 12 weeks, respectively. FMR treatment resulted in significant reduction of sebum excretion. Both treatments showed no severe adverse effects other than erythema. The FMR showed superior efficacy in acne and acne scar compared with BR. Increased expression of TGFβ and collagen I and decreased expression of NF-κB, IL-8 are suggested to involve in the improvement of acne scar and acne lesion by FMR.

  12. Use of onion extract, heparin, allantoin gel in prevention of scarring in chinese patients having laser removal of tattoos: a prospective randomized controlled trial.

    Science.gov (United States)

    Ho, Wai Sun; Ying, Shun Yuen; Chan, Pik Chu; Chan, Henry H

    2006-07-01

    With rapid advancement in cutaneous laser therapy, Q-switched lasers have become the standard treatment for tattoo removal. The longer wavelength Q-switched Nd:YAG laser is used when removing tattoos in darker skin patients to avoid scarring and permanent pigment changes. Nevertheless, the local experience revealed that nearly 25% of the Chinese patients developed scarring. Meanwhile, multiple clinical studies have shown that Contractubex gel (Merz Pharma, Frankfurt, Germany) was effective in the treatment and prevention of hypertrophic scars and keloids. To evaluate the efficacy of Contractubex gel in the prevention of scarring after laser removal of tattoos in Chinese patients. A total of 120 Chinese patients with 144 professional blue-black tattoos were recruited into the study. They were randomly assigned into the Contractubex group or the control group. All patients were treated with a QS 1,064-nm Nd:YAG laser using a 3-mm spot size, a 10-Hz repeat rate, a pulse duration of 6 nanoseconds, and fluences that ranged from 3.6 to 4.8 J/cm2 (mean fluence, 4.2 J/cm2). The treated areas were assessed 3 months after the last treatments for clinical clearance and complications. Fifty-two patients with 61 tattoos in the Contractubex group were able to achieve a mean clearing rate of 82.3+/-11.6%. There were 7 tattoos in 7 patients that developed scarring, 4 patients had permanent hypopigmentation, and 3 patients had transient hyperpigmentation. In contrast, 55 patients with 68 tattoos in the control group had a mean clearing rate of 80.4+/-11.3%. Among them, 16 tattoos in 14 patients developed scarring, 4 patients had permanent hypopigmentation, and 5 patients had transient hyperpigmentation. Although there was no significant difference in age, sex, fluence, treatment session, and clinical clearance between the two groups, the Contractubex group had a statistically significantly lower rate of scarring than the control group (ptattoos.

  13. The Learning Loss Scale as an Assessment Tool: An Empirical Examination of Convergent Validity with Performative Measures

    Science.gov (United States)

    Hooker, John; Denker, Katherine

    2014-01-01

    Higher education has placed an increasingly greater value on assessment. The Learning Loss Scale may be an appropriate tool to assess learning across disciplines. In this paper, we review the culture of assessment, conceptualizations of cognitive learning, the Learning Loss Scale, and a theoretical explanation, and then we test this measure to…

  14. Scale for Assessment of Giftedness - teacher's version: evidence of validity content

    Directory of Open Access Journals (Sweden)

    Tatiana de Cassia Nakano

    2016-07-01

    Full Text Available The assessment of high abilities is of great importance in psychology, despite scarce studies in literature. Therefore, the aim of this study was to verify, through content validity, the appropriateness of the items of the High Assessment Scale Skills - Teacher Version. The judges were six post-graduate students in the psychological assessment area who rated the 41 items of the instrument in six factors (academic intellectual ability, specific academic skills, leadership, creativity, artistic talent. The results demonstrated the suitability of the items, most of them with concordance rates above 80% (n = 29 and between 60 and 80% (n = 8. Only four items showed agreement at or below 50%, suggesting the need for reformulation. The analysis of the Kappa coefficients showed indices between 0.69 and 0.81. In general, the results indicated the suitability of the scale to the contents of the pretended model.

  15. Lower energy radial shock wave therapy improves characteristics of hypertrophic scar in a rabbit ear model.

    Science.gov (United States)

    Zhao, Jing-Chun; Zhang, Bo-Ru; Shi, Kai; Wang, Jian; Yu, Qing-Hua; Yu, Jia-Ao

    2018-01-01

    The aim of the present study was to investigate the effects of radial extracorporeal shock wave therapy (rESWT) on scar characteristics and transforming growth factor (TGF)-β1/Smad signaling in order to explore a potential modality for the treatment of hypertrophic scars (HS). The HS model was generated in rabbit ears, then rabbits were randomly divided into 3 groups: Lower (L)-ESWT [treated with rESWT with lower energy flux density (EFD) of 0.1 mJ/mm 2 ], higher (H)-ESWT (treated with a higher EFD of 0.18 mJ/mm 2 ) and the sham ESWT group (S-ESWT; no ESWT treatment). Scar characteristics (wrinkles, texture, diameter, area, volume of elevation, hemoglobin and melanin) were assessed using the Antera 3D ® system. The protein and mRNA expression of TGF-β1, Smad2, Smad3 and Smad7 was assessed by enzyme-linked immunosorbent assay and reverse transcription-quantitative polymerase chain reaction, respectively. The Antera 3D ® results indicated that wrinkles and hemoglobin of the HS were significantly improved in both of the rESWT groups when compared with the S-ESWT group. However, these changes appeared much earlier in the L-ESWT group than the H-ESWT. Scar texture was also improved in the L-ESWT group. However, rESWT did not influence HS diameter, area, volume of elevation or melanin levels. rESWT had no effect on TGF-β1 or Smad7 expression in either of rESWT groups. Although no difference was observed in Smad2 mRNA expression in the L-ESWT group, the Smad3 mRNA and protein expression significantly decreased when compared with the H-ESWT and S-ESWT groups. By contrast, Smad2 and Smad3 mRNA expression were upregulated in the H-ESWT group. These results demonstrated that rESWT with 0.1 mJ/mm 2 EFD improved some characteristics of the HS tissue. Downregulation of Smad3 expression may underlie this inhibitory effect. Inhibition of the TGF-β1/Smad signal transduction pathway may be a potential therapeutic target for the management of HS.

  16. Validity of self-assessment of hallux valgus using the Manchester scale

    Directory of Open Access Journals (Sweden)

    Wee Elin

    2010-09-01

    Full Text Available Abstract Background Hallux valgus (HV is a common condition involving the progressive subluxation of the first metatarsophalangeal joint due to lateral deviation of the hallux and medial deviation of the first metatarsal. The objective of this study was to evaluate the re-test reliability and validity of self-assessment of HV using a simple clinical screening tool involving four standardised photographs (the Manchester scale, in order to determine whether this tool could be used for postal surveys of the condition. Methods HV was assessed with the Manchester scale in 138 people aged 65 to 93 years of age (102 women and 36 men as part of a larger randomised controlled trial. At the six month follow-up assessment, HV was reassessed to determine re-test reliability, and participants were asked to self-assess their degree of HV independent of the examiners. Associations between (i baseline and follow-up assessments of the examiners and (ii participant and examiner assessments were performed using weighted kappa statistics. Analyses were then repeated after HV was dichotomised as present or absent using unweighted kappa, and sensitivity and specificity of self-assessment of HV was determined. Results Re-test reliability of the examiners was substantial to almost perfect (weighted kappa = 0.78 to 0.90, and there was a substantial level of agreement between observations of the participants and the examiners (weighted kappa = 0.71 to 0.80. Overall, there was a slight tendency for participants to rate their HV as less severe than the examiners. When the Manchester scale scores were dichotomised, agreement was substantial to almost perfect for both re-test comparisons (kappa = 0.80 to 0.89 and substantial for comparisons between participants and examiners (kappa = 0.64 to 0.76. The sensitivity and specificity of self-assessment of HV using the dichotomous scale were 85 and 88%, respectively. Conclusions The Manchester scale demonstrates high re

  17. Universal happiness? Cross-cultural measurement invariance of scales assessing positive mental health.

    Science.gov (United States)

    Bieda, Angela; Hirschfeld, Gerrit; Schönfeld, Pia; Brailovskaia, Julia; Zhang, Xiao Chi; Margraf, Jürgen

    2017-04-01

    Research into positive aspects of the psyche is growing as psychologists learn more about the protective role of positive processes in the development and course of mental disorders, and about their substantial role in promoting mental health. With increasing globalization, there is strong interest in studies examining positive constructs across cultures. To obtain valid cross-cultural comparisons, measurement invariance for the scales assessing positive constructs has to be established. The current study aims to assess the cross-cultural measurement invariance of questionnaires for 6 positive constructs: Social Support (Fydrich, Sommer, Tydecks, & Brähler, 2009), Happiness (Subjective Happiness Scale; Lyubomirsky & Lepper, 1999), Life Satisfaction (Diener, Emmons, Larsen, & Griffin, 1985), Positive Mental Health Scale (Lukat, Margraf, Lutz, van der Veld, & Becker, 2016), Optimism (revised Life Orientation Test [LOT-R]; Scheier, Carver, & Bridges, 1994) and Resilience (Schumacher, Leppert, Gunzelmann, Strauss, & Brähler, 2004). Participants included German (n = 4,453), Russian (n = 3,806), and Chinese (n = 12,524) university students. Confirmatory factor analyses and measurement invariance testing demonstrated at least partial strong measurement invariance for all scales except the LOT-R and Subjective Happiness Scale. The latent mean comparisons of the constructs indicated differences between national groups. Potential methodological and cultural explanations for the intergroup differences are discussed. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  18. Use of makeup, hairstyles, glasses, and prosthetics as adjuncts to scar camouflage.

    Science.gov (United States)

    Sidle, Douglas M; Decker, Jennifer R

    2011-08-01

    Scars after facial trauma or surgery can be a source of distress for patients, and facial plastic surgeons are frequently called upon to help manage them. Although no technique can remove a scar, numerous treatment modalities have been developed to improve facial scar appearance with varying levels of invasiveness. This article reviews techniques that camouflage scars without surgical intervention. Topical scar treatments, camouflage cosmetics, use of hairstyling and glasses, and facial prosthetics are discussed. In addition, professional counseling is provided on selection and application of topical cosmetics for use as part of an office practice. 2011 Elsevier Inc. All rights reserved.

  19. Prevention and Reduction of Atrophic Acne Scars with Adapalene 0.3%/Benzoyl Peroxide 2.5% Gel in Subjects with Moderate or Severe Facial Acne: Results of a 6-Month Randomized, Vehicle-Controlled Trial Using Intra-Individual Comparison.

    Science.gov (United States)

    Dréno, Brigitte; Bissonnette, Robert; Gagné-Henley, Angélique; Barankin, Benjamin; Lynde, Charles; Kerrouche, Nabil; Tan, Jerry

    2018-04-01

    Very few clinical trials have investigated the effect of topical acne treatment on scarring. Our objective was to evaluate the efficacy of adapalene 0.3%/benzoyl peroxide 2.5% gel (A0.3/BPO2.5) in atrophic acne scar formation in patients with acne. In this multicenter, randomized, investigator-blinded, vehicle-controlled study, subjects with moderate or severe facial acne (Investigator's Global Assessment [IGA] score 3 or 4; ≥ 25 inflammatory lesions; ten or more atrophic acne scars) applied A0.3/BPO2.5 or vehicle daily per half face for 24 weeks. Subjects with acne requiring systemic treatment were excluded. Assessments included investigator atrophic acne scar count, Scar Global Assessment (SGA), acne lesion count, IGA, skin roughness and skin texture, subject self-assessment of clinical acne-related scars and satisfaction questionnaire, tolerability, and safety. Included subjects (n = 67) had mainly moderate acne (92.5% IGA 3); mean scores at baseline were approximately 40 acne lesions and 12 scars per half face. By week 24, the change from baseline in total scar count was - 15.5% for A0.3/BPO2.5 versus  + 14.4% for vehicle (approximately 30% difference), with a mean of 9.5 scars versus 13.3 per half face, respectively (p vehicle (p vehicle (p vehicle side, most commonly skin irritation (14.9 vs. 6%, respectively). Topical A0.3/BPO2.5 prevented and reduced atrophic scar formation. Scar count increased with vehicle (+ 14.4%) but decreased with A0.3/BPO2.5 (- 15.5%) over 24 weeks. ClinicalTrials.gov identifier NCT02735421.

  20. The Cultural Socialization Scale: Assessing Family and Peer Socialization toward Heritage and Mainstream Cultures

    Science.gov (United States)

    Wang, Yijie; Benner, Aprile D.; Kim, Su Yeong

    2015-01-01

    In a culturally diverse society, youth learn about multiple cultures from a variety of sources, yet the existing assessment of cultural socialization has been limited to parents' efforts to teach youth about their heritage culture. The current study adapted and extended an existing cultural socialization measure (Umaña-Taylor & Fine, 2004) to assess four types of socialization practices encountered specifically during adolescence: cultural socialization by families and peers toward both one's heritage culture and the mainstream culture. In a pilot study, we developed the cultural socialization scale based on retrospective reports from 208 young adults, maximizing young adults' ability to reason and reflect their adolescent experiences with various socialization practices. In the primary study, we examined the psychometric properties of the scale using reports from 252 adolescents. Cultural socialization occurred from both socialization agents toward both cultures. Our cultural socialization scale demonstrated stable factor structures and high reliabilities. We observed strong factorial invariance across the four subscales (six items). MIMIC models also demonstrated invariance for each subscale across adolescents' demographic characteristics (i.e., gender, race/ethnicity, nativity, SES, language of assessment). The implications of the cultural socialization scale are discussed. PMID:25961139

  1. The breastfeeding self-efficacy scale: psychometric assessment of the short form.

    Science.gov (United States)

    Dennis, Cindy-Lee

    2003-01-01

    The purpose of this study was to reduce the number of items on the original Breastfeeding Self-Efficacy Scale (BSES) and psychometrically assess the revised BSES-Short Form (BSES-SF). As part of a longitudinal study, participants completed mailed questionnaires at 1, 4, and 8 weeks postpartum. Health region in British Columbia. A population-based sample of 491 breastfeeding mothers. BSES, Edinburgh Postnatal Depression Scale, Rosenberg Self-Esteem Scale, and Perceived Stress Scale. Internal consistency statistics with the original BSES suggested item redundancy. As such, 18 items were deleted, using explicit reduction criteria. Based on the encouraging reliability analysis of the new 14-item BSES-SF, construct validity was assessed using principal components factor analysis, comparison of contrasted groups, and correlations with measures of similar constructs. Support for predictive validity was demonstrated through significant mean differences between breastfeeding and bottle feeding mothers at 4 (p self-efficacy and considered ready for clinical use to (a) identify breastfeeding mothers at high risk, (b) assess breastfeeding behaviors and cognitions to individualize confidence-building strategies, and (c) evaluate the effectiveness of various interventions and guide program development.

  2. The Irvine, Beatties, and Bresnahan (IBB) Forelimb Recovery Scale: An Assessment of Reliability and Validity

    Science.gov (United States)

    Irvine, Karen-Amanda; Ferguson, Adam R.; Mitchell, Kathleen D.; Beattie, Stephanie B.; Lin, Amity; Stuck, Ellen D.; Huie, J. Russell; Nielson, Jessica L.; Talbott, Jason F.; Inoue, Tomoo; Beattie, Michael S.; Bresnahan, Jacqueline C.

    2014-01-01

    The IBB scale is a recently developed forelimb scale for the assessment of fine control of the forelimb and digits after cervical spinal cord injury [SCI; (1)]. The present paper describes the assessment of inter-rater reliability and face, concurrent and construct validity of this scale following SCI. It demonstrates that the IBB is a reliable and valid scale that is sensitive to severity of SCI and to recovery over time. In addition, the IBB correlates with other outcome measures and is highly predictive of biological measures of tissue pathology. Multivariate analysis using principal component analysis (PCA) demonstrates that the IBB is highly predictive of the syndromic outcome after SCI (2), and is among the best predictors of bio-behavioral function, based on strong construct validity. Altogether, the data suggest that the IBB, especially in concert with other measures, is a reliable and valid tool for assessing neurological deficits in fine motor control of the distal forelimb, and represents a powerful addition to multivariate outcome batteries aimed at documenting recovery of function after cervical SCI in rats. PMID:25071704

  3. Internal consistency & validity of Indian Disability Evaluation and Assessment Scale (IDEAS in patients with schizophrenia

    Directory of Open Access Journals (Sweden)

    Sandeep Grover

    2014-01-01

    Full Text Available Background & objectives: The Indian Disability Evaluation and Assessment Scale (IDEAS has been recommended for assessment and certification of disability by the Government of India (GOI. However, the psychometric properties of IDEAS as adopted by GOI remain understudied. Our aim, thus, was to study the internal consistency and validity of IDEAS in patients with schizophrenia. Methods: A total of 103 consenting patients with residual schizophrenia were assessed for disability, quality of life (QOL and psychopathology using the IDEAS, WHO QOL-100 and Positive and Negative symptom scale (PANSS respectively. Internal consistency was calculated using Cronbach′s alpha. For construct validity, relations between IDEAS, and psychopathology and QOL were studied. Results: The inter-item correlations for IDEAS were significant with a Cronbach′s alpha of 0.721. All item scores other than score on communication and understanding; total and global IDEAS scores correlated significantly with the positive, negative and general sub-scales, and total PANSS scores. Communication and understanding was significantly related to negative sub-scale score only. Total and global disability scores correlated negatively with all the domains of WHOQOL-100 (ρ<0.01. The individual IDEAS item scores correlated negatively with various WHOQOL-100 domains (ρ0< 0.01. Interpretation & conclusions: This study findings showed that the GOI-modified IDEAS had good internal consistency and construct validity as tested in patients with residual schizophrenia. Similar studies need to be done with other groups of patients.

  4. Short scales to assess cannabis-related problems: a review of psychometric properties

    Directory of Open Access Journals (Sweden)

    Klempova Danica

    2008-12-01

    Full Text Available Abstract Aims The purpose of this paper is to summarize the psychometric properties of four short screening scales to assess problematic forms of cannabis use: Severity of Dependence Scale (SDS, Cannabis Use Disorders Identification Test (CUDIT, Cannabis Abuse Screening Test (CAST and Problematic Use of Marijuana (PUM. Methods A systematic computer-based literature search was conducted within the databases of PubMed, PsychINFO and Addiction Abstracts. A total of 12 publications reporting measures of reliability or validity were identified: 8 concerning SDS, 2 concerning CUDIT and one concerning CAST and PUM. Studies spanned adult and adolescent samples from general and specific user populations in a number of countries worldwide. Results All screening scales tended to have moderate to high internal consistency (Cronbach's α ranging from .72 to .92. Test-retest reliability and item total correlation have been reported for SDS with acceptable results. Results of validation studies varied depending on study population and standards used for validity assessment, but generally sensitivity, specificity and predictive power are satisfactory. Standard diagnostic cut-off points that can be generalized to different populations do not exist for any scale. Conclusion Short screening scales to assess dependence and other problems related to the use of cannabis seem to be a time and cost saving opportunity to estimate overall prevalences of cannabis-related negative consequences and to identify at-risk persons prior to using more extensive diagnostic instruments. Nevertheless, further research is needed to assess the performance of the tests in different populations and in comparison to broader criteria of cannabis-related problems other than dependence.

  5. The Effect of Dry Eye Disease on Scar Formation in Rabbit Glaucoma Filtration Surgery

    Directory of Open Access Journals (Sweden)

    Hong Ji

    2017-05-01

    Full Text Available The success rate of glaucoma filtration surgery is closely related to conjunctival inflammation, and the main mechanism of dry eye disease (DED is inflammation. The aim of this study was to evaluate the effect of DED on bleb scar formation after rabbit glaucoma filtration surgery. Sixteen New Zealand white rabbits were randomly divided into control and DED groups. A DED model was induced by twice-daily topical administration of 0.1% benzalkonium chloride (BAC drops for three weeks. Ocular examinations were performed to verify the DED model. Surgical effects were assessed, and histologic assessments were performed on the 28th postoperative day. Higher fluorescein staining scores, lower basal tear secretion levels and goblet cell counts, and increased interleukin 1β (IL-1β levels were observed in the DED group. The DED eyes displayed significantly higher intraocular pressure (IOP% on the 14th postoperative day; a smaller bleb area on days 14, 21 and 28; and a shorter bleb survival time. Moreover, proliferating cell nuclear antigen (PCNA and alpha-smooth muscle actin (α-SMA levels were significantly increased in the DED group. These results demonstrate that DED promotes filtering bleb scar formation and shortens bleb survival time; these effects may be mediated via IL-1β.

  6. A preliminary psychometric evaluation of Music in Dementia Assessment Scales (MiDAS)

    DEFF Research Database (Denmark)

    McDermott, Orii; Orgeta, Vasiliki; Ridder, Hanne Mette Ochsner

    2014-01-01

    despite the small sample size. Future research with a larger sample size could provide a more in-depth psychometric evaluation, including further exploration of the underlying factors. MiDAS provides a measure of engagement with musical experience and offers insight into who is likely to benefit on other......Background: Music in Dementia Assessment Scales (MiDAS), an observational outcome measure for music therapy with people with moderate to severe dementia, was developed from qualitative data of focus groups and interviews. Expert and peer consultations were conducted at each stage of the scale...

  7. Marburg biosafety and biosecurity scale (MBBS): a framework for risk assessment and risk communication.

    Science.gov (United States)

    Dickmann, Petra; Apfel, Franklin; Biedenkopf, Nadine; Eickmann, Markus; Becker, Stephan

    2015-01-01

    Current risk assessment and risk communication of biosafety and biosecurity concerns lack a convenient metric and conceptual framework. The absence of such a systematic tool makes communication more difficult and can lead to ambiguous public perception of and response to laboratory biosafety incidents and biosecurity threats. A new 7-category scoring scale is proposed for incidents and situations in laboratories related to the handling of human and animal pathogens. The scale aims to help clarify risk categories, facilitate coordination and communication, and improve public understanding of risk related to biosafety and biosecurity.

  8. A Guttman scale for assessing condom use skills among college students.

    Science.gov (United States)

    Lindemann, Dana F; Brigham, Thomas A

    2003-03-01

    HIV risk-reduction interventions frequently teach correct condom use skills, yet few researchers actually measure those skills. Without measuring condom use skills, it is not possible to evaluate the effectiveness of condom use interventions, or determine what variables may be related to those skills. The Measure of Observed Condom Use Skills (MOCUS) was developed using standard Guttman scaling procedures, and administered to 106 female and 71 male undergraduates. The MOCUS was administered by the primary investigator to each participant individually. Guttman scale analyses demonstrated the MOCUS has acceptable reproducibility. These findings support future use of the MOCUS to assess condom use skills.

  9. The cultural validation of two scales to assess social stigma in leprosy.

    Science.gov (United States)

    Peters, Ruth M H; Dadun; Van Brakel, Wim H; Zweekhorst, Marjolein B M; Damayanti, Rita; Bunders, Joske F G; Irwanto

    2014-01-01

    Stigma plays in an important role in the lives of persons affected by neglected tropical diseases, and assessment of stigma is important to document this. The aim of this study is to test the cross-cultural validity of the Community Stigma Scale (EMIC-CSS) and the Social Distance Scale (SDS) in the field of leprosy in Cirebon District, Indonesia. Cultural equivalence was tested by assessing the conceptual, item, semantic, operational and measurement equivalence of these instruments. A qualitative exploratory study was conducted to increase our understanding of the concept of stigma in Cirebon District. A process of translation, discussions, trainings and a pilot study followed. A sample of 259 community members was selected through convenience sampling and 67 repeated measures were obtained to assess the psychometric measurement properties. The aspects and items in the SDS and EMIC-CSS seem equally relevant and important in the target culture. The response scales were adapted to ensure that meaning is transferred accurately and no changes to the scale format (e.g. lay out, statements or questions) of both scales were made. A positive correlation was found between the EMIC-CSS and the SDS total scores (r=0.41). Cronbach's alphas of 0.83 and 0.87 were found for the EMIC-CSS and SDS. The exploratory factor analysis indicated for both scales an adequate fit as unidimensional scale. A standard error of measurement of 2.38 was found in the EMIC-CSS and of 1.78 in the SDS. The test-retest reliability coefficient was respectively, 0.84 and 0.75. No floor or ceiling effects were found. According to current international standards, our findings indicate that the EMIC-CSS and the SDS have adequate cultural validity to assess social stigma in leprosy in the Bahasa Indonesia-speaking population of Cirebon District. We believe the scales can be further improved, for instance, by adding, changing and rephrasing certain items. Finally, we provide suggestions for use with other

  10. The Cultural Validation of Two Scales to Assess Social Stigma in Leprosy

    Science.gov (United States)

    Peters, Ruth M. H.; Dadun; Van Brakel, Wim H.; Zweekhorst, Marjolein B. M.; Damayanti, Rita; Bunders, Joske F. G.; Irwanto

    2014-01-01

    Background Stigma plays in an important role in the lives of persons affected by neglected tropical diseases, and assessment of stigma is important to document this. The aim of this study is to test the cross-cultural validity of the Community Stigma Scale (EMIC-CSS) and the Social Distance Scale (SDS) in the field of leprosy in Cirebon District, Indonesia. Methodology/principle findings Cultural equivalence was tested by assessing the conceptual, item, semantic, operational and measurement equivalence of these instruments. A qualitative exploratory study was conducted to increase our understanding of the concept of stigma in Cirebon District. A p