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Sample records for total impact score

  1. Impact of the Occlusion Duration on the Performance of J-CTO Score in Predicting Failure of Percutaneous Coronary Intervention for Chronic Total Occlusion.

    Science.gov (United States)

    de Castro-Filho, Antonio; Lamas, Edgar Stroppa; Meneguz-Moreno, Rafael A; Staico, Rodolfo; Siqueira, Dimytri; Costa, Ricardo A; Braga, Sergio N; Costa, J Ribamar; Chamié, Daniel; Abizaid, Alexandre

    2017-06-01

    The present study examined the association between Multicenter CTO Registry in Japan (J-CTO) score in predicting failure of percutaneous coronary intervention (PCI) correlating with the estimated duration of chronic total occlusion (CTO). The J-CTO score does not incorporate estimated duration of the occlusion. This was an observational retrospective study that involved all consecutive procedures performed at a single tertiary-care cardiology center between January 2009 and December 2014. A total of 174 patients, median age 59.5 years (interquartile range [IQR], 53-65 years), undergoing CTO-PCI were included. The median estimated occlusion duration was 7.5 months (IQR, 4.0-12.0 months). The lesions were classified as easy (score = 0), intermediate (score = 1), difficult (score = 2), and very difficult (score ≥3) in 51.1%, 33.9%, 9.2%, and 5.7% of the patients, respectively. Failure rate significantly increased with higher J-CTO score (7.9%, 20.3%, 50.0%, and 70.0% in groups with J-CTO scores of 0, 1, 2, and ≥3, respectively; PJ-CTO score predicted failure of CTO-PCI independently of the estimated occlusion duration (P=.24). Areas under receiver-operating characteristic curves were computed and it was observed that for each occlusion time period, the discriminatory capacity of the J-CTO score in predicting CTO-PCI failure was good, with a C-statistic >0.70. The estimated duration of occlusion had no influence on the J-CTO score performance in predicting failure of PCI in CTO lesions. The probability of failure was mainly determined by grade of lesion complexity.

  2. a locally adapted functional outcome measurement score for total

    African Journals Online (AJOL)

    Results and success of total hip arthroplasty are often measured using a functional outcome scoring system. Most current scores were developed in Europe and. North America (1-3). During the evaluation of a Total. Hip Replacement (THR) project in Ouagadougou,. Burkina Faso (4) it was felt that these scores were not.

  3. Validity and Reliability of the Achilles Tendon Total Rupture Score

    DEFF Research Database (Denmark)

    Ganestam, Ann; Barfod, Kristoffer; Klit, Jakob

    2013-01-01

    study was to validate a Danish translation of the ATRS. The ATRS was translated into Danish according to internationally adopted standards. Of 142 patients, 90 with previous rupture of the Achilles tendon participated in the validity study and 52 in the reliability study. The ATRS showed moderately......The best treatment of acute Achilles tendon rupture remains debated. Patient-reported outcome measures have become cornerstones in treatment evaluations. The Achilles tendon total rupture score (ATRS) has been developed for this purpose but requires additional validation. The purpose of the present...... = .07). The limits of agreement were ±18.53. A strong correlation was found between test and retest (intercorrelation coefficient .908); the standard error of measurement was 6.7, and the minimal detectable change was 18.5. The Danish version of the ATRS showed moderately strong criterion validity...

  4. Hospital Value-Based Purchasing (HVBP) – Total Performance Score

    Data.gov (United States)

    U.S. Department of Health & Human Services — A list of hospitals participating in the Hospital VBP Program and their Clinical Process of Care domain scores, Patient Experience of Care dimension scores, and...

  5. A locally adapted functional outcome measurement score for total ...

    African Journals Online (AJOL)

    ... in Europe or North America and seem not optimally suited for a general West ... We introduce a cross-cultural adaptation of the Lequesne index as a new score. ... Keywords: THR, Hip, Africa, Functional score, Hip replacement, Arthroscopy ...

  6. Validity and reliability of the Achilles tendon total rupture score.

    Science.gov (United States)

    Ganestam, Ann; Barfod, Kristoffer; Klit, Jakob; Troelsen, Anders

    2013-01-01

    The best treatment of acute Achilles tendon rupture remains debated. Patient-reported outcome measures have become cornerstones in treatment evaluations. The Achilles tendon total rupture score (ATRS) has been developed for this purpose but requires additional validation. The purpose of the present study was to validate a Danish translation of the ATRS. The ATRS was translated into Danish according to internationally adopted standards. Of 142 patients, 90 with previous rupture of the Achilles tendon participated in the validity study and 52 in the reliability study. The ATRS showed moderately strong correlations with the physical subscores of the Medical Outcomes Study 36-item Short-Form Health Survey (r = .70 to .75; p questionnaire (r = .71; p validity. For study and follow-up purposes, the ATRS seems reliable for comparisons of groups of patients. Its usability is limited for repeated assessment of individual patients. The development of analysis guidelines would be desirable. Copyright © 2013 American College of Foot and Ankle Surgeons. Published by Elsevier Inc. All rights reserved.

  7. Scoring the full extent of periodontal disease in the dog: development of a total mouth periodontal score (TMPS) system.

    Science.gov (United States)

    Harvey, Colin E; Laster, Larry; Shofer, Frances; Miller, Bonnie

    2008-09-01

    The development of a total mouth periodontal scoring system is described. This system uses methods to score the full extent of gingivitis and periodontitis of all tooth surfaces, weighted by size of teeth, and adjusted by size of dog.

  8. Analysing relations between specific and total liking scores

    DEFF Research Database (Denmark)

    Menichelli, Elena; Kraggerud, Hilde; Olsen, Nina Veflen

    2013-01-01

    The objective of this article is to present a new statistical approach for the study of consumer liking. Total liking data are extended by incorporating liking for specific sensory properties. The approach combines different analyses for the purpose of investigating the most important aspects...... of liking and indicating which products are similarly or differently perceived by which consumers. A method based on the differences between total liking and the specific liking variables is proposed for studying both relative differences among products and individual consumer differences. Segmentation...... is also tested out in order to distinguish consumers with the strongest differences in their liking values. The approach is illustrated by a case study, based on cheese data. In the consumer test consumers were asked to evaluate their total liking, the liking for texture and the liking for odour/taste. (C...

  9. SF-36 total score as a single measure of health-related quality of life: Scoping review.

    Science.gov (United States)

    Lins, Liliane; Carvalho, Fernando Martins

    2016-01-01

    According to the 36-Item Short Form Health Survey questionnaire developers, a global measure of health-related quality of life such as the "SF-36 Total/Global/Overall Score" cannot be generated from the questionnaire. However, studies keep on reporting such measure. This study aimed to evaluate the frequency and to describe some characteristics of articles reporting the SF-36 Total/Global/Overall Score in the scientific literature. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses method was adapted to a scoping review. We performed searches in PubMed, Web of Science, SCOPUS, BVS, and Cochrane Library databases for articles using such scores. We found 172 articles published between 1997 and 2015; 110 (64.0%) of them were published from 2010 onwards; 30.0% appeared in journals with Impact Factor 3.00 or greater. Overall, 129 (75.0%) out of the 172 studies did not specify the method for calculating the "SF-36 Total Score"; 13 studies did not specify their methods but referred to the SF-36 developers' studies or others; and 30 articles used different strategies for calculating such score, the most frequent being arithmetic averaging of the eight SF-36 domains scores. We concluded that the "SF-36 Total/Global/Overall Score" has been increasingly reported in the scientific literature. Researchers should be aware of this procedure and of its possible impacts upon human health.

  10. Towards a contemporary, comprehensive scoring system for determining technical outcomes of hybrid percutaneous chronic total occlusion treatment: The RECHARGE score.

    Science.gov (United States)

    Maeremans, Joren; Spratt, James C; Knaapen, Paul; Walsh, Simon; Agostoni, Pierfrancesco; Wilson, William; Avran, Alexandre; Faurie, Benjamin; Bressollette, Erwan; Kayaert, Peter; Bagnall, Alan J; Smith, Dave; McEntegart, Margaret B; Smith, William H T; Kelly, Paul; Irving, John; Smith, Elliot J; Strange, Julian W; Dens, Jo

    2018-02-01

    This study sought to create a contemporary scoring tool to predict technical outcomes of chronic total occlusion (CTO) percutaneous coronary intervention (PCI) from patients treated by hybrid operators with differing experience levels. Current scoring systems need regular updating to cope with the positive evolutions regarding materials, techniques, and outcomes, while at the same time being applicable for a broad range of operators. Clinical and angiographic characteristics from 880 CTO-PCIs included in the REgistry of CrossBoss and Hybrid procedures in FrAnce, the NetheRlands, BelGium and UnitEd Kingdom (RECHARGE) were analyzed by using a derivation and validation set (2:1 ratio). Variables significantly associated with technical failure in the multivariable analysis were incorporated in the score. Subsequently, the discriminatory capacity was assessed and the validation set was used to compare with the J-CTO score and PROGRESS scores. Technical success in the derivation and validation sets was 83% and 85%, respectively. Multivariate analysis identified six parameters associated with technical failure: blunt stump (beta coefficient (b) = 1.014); calcification (b = 0.908); tortuosity ≥45° (b = 0.964); lesion length 20 mm (b = 0.556); diseased distal landing zone (b = 0.794), and previous bypass graft on CTO vessel (b = 0.833). Score variables remained significant after bootstrapping. The RECHARGE score showed better discriminatory capacity in both sets (area-under-the-curve (AUC) = 0.783 and 0.711), compared to the J-CTO (AUC = 0.676) and PROGRESS (AUC = 0.608) scores. The RECHARGE score is a novel, easy-to-use tool for assessing the risk for technical failure in hybrid CTO-PCI and has the potential to perform well for a broad community of operators. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

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

    Directory of Open Access Journals (Sweden)

    T. Paajanen

    2013-11-01

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

  12. Total hip arthroplasty outcomes assessment using functional and radiographic scores to compare canine systems.

    Science.gov (United States)

    Iwata, D; Broun, H C; Black, A P; Preston, C A; Anderson, G I

    2008-01-01

    A retrospective multi-centre study was carried out in order to compare outcomes between cemented and uncemented total hip arthoplasties (THA). A quantitative orthopaedic outcome assessment scoring system was devised in order to relate functional outcome to a numerical score, to allow comparison between treatments and amongst centres. The system combined a radiographic score and a clinical score. Lower scores reflect better outcomes than higher scores. Consecutive cases of THA were included from two specialist practices between July 2002 and December 2005. The study included 46 THA patients (22 uncemented THA followed for 8.3 +/- 4.7M and 24 cemented THA for 26.0 +/- 15.7M) with a mean age of 4.4 +/- 3.3 years at surgery. Multi-variable linear and logistical regression analyses were performed with adjustments for age at surgery, surgeon, follow-up time, uni- versus bilateral disease, gender and body weight. The differences between treatment groups in terms of functional scores or total scores were not significant (p > 0.05). Radiographic scores were different between treatment groups. However, these scores were usually assessed within two months of surgery and proved unreliable predictors of functional outcome (p > 0.05). The findings reflect relatively short-term follow-up, especially for the uncemented group, and do not include clinician-derived measures, such as goniometry and thigh circumference. Longer-term follow-up for the radiographic assessments is essential. A prospective study including the clinician-derived outcomes needs to be performed in order to validate the outcome instrument in its modified form.

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

    Science.gov (United States)

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

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

  14. Coping strategies related to total stress score among post graduate medical students and residents

    Directory of Open Access Journals (Sweden)

    R. Irawati Ismail

    2013-05-01

    several dominant coping strategies related to total stress score levels.Methods:A cross-sectional purposive sampling method study among postgraduate medical students of the Faculty of Medicine, Universitas Indonesia was done April-July 2011. We used a coping strategies questionnaire and the WHO SRQ-20. Linear regression was used to identify dominant coping strategies related to stress levels.Results:This study had 272 subjects, aged 23-47 years. Four items decreased the total stress score (accepting the reality of the fact, talking to someone who could do something, seeking God’s help, and laughing about the situation. However, three factors increased the total stress score (taking one step at a time has to be done, talking to someone to find out more about the situation, and admitting can’t deal solving the situation. One point of accepting the reality of the situation reduced 0.493 points the total stress score [regression coefficient (β= -0.493; P=0.002]. While one point seeking God’s help reduced 0.307 points the total stress score (β= -0.307; P=0.056. However, one point of doing one step at a time increased 0.54 point the total stress score (β=0.540; P=0.005.Conclusions: Accepting the reality of the situation, talking to someone who could do something, seeking God’s help, and laughing about the situation decreased the stress level. However, taking one step at a time, talking to someone to find out more about the situation and admitting can’t deal solving the situation, increased the total stress score.Key words:stress level, coping strategies, age, seeking God’s help

  15. Interobserver Reliability of the Total Body Score System for Quantifying Human Decomposition.

    Science.gov (United States)

    Dabbs, Gretchen R; Connor, Melissa; Bytheway, Joan A

    2016-03-01

    Several authors have tested the accuracy of the Total Body Score (TBS) method for quantifying decomposition, but none have examined the reliability of the method as a scoring system by testing interobserver error rates. Sixteen participants used the TBS system to score 59 observation packets including photographs and written descriptions of 13 human cadavers in different stages of decomposition (postmortem interval: 2-186 days). Data analysis used a two-way random model intraclass correlation in SPSS (v. 17.0). The TBS method showed "almost perfect" agreement between observers, with average absolute correlation coefficients of 0.990 and average consistency correlation coefficients of 0.991. While the TBS method may have sources of error, scoring reliability is not one of them. Individual component scores were examined, and the influences of education and experience levels were investigated. Overall, the trunk component scores were the least concordant. Suggestions are made to improve the reliability of the TBS method. © 2016 American Academy of Forensic Sciences.

  16. Cross-cultural adaptation and validation of Persian Achilles tendon Total Rupture Score.

    Science.gov (United States)

    Ansari, Noureddin Nakhostin; Naghdi, Soofia; Hasanvand, Sahar; Fakhari, Zahra; Kordi, Ramin; Nilsson-Helander, Katarina

    2016-04-01

    To cross-culturally adapt the Achilles tendon Total Rupture Score (ATRS) to Persian language and to preliminary evaluate the reliability and validity of a Persian ATRS. A cross-sectional and prospective cohort study was conducted to translate and cross-culturally adapt the ATRS to Persian language (ATRS-Persian) following steps described in guidelines. Thirty patients with total Achilles tendon rupture and 30 healthy subjects participated in this study. Psychometric properties of floor/ceiling effects (responsiveness), internal consistency reliability, test-retest reliability, standard error of measurement (SEM), smallest detectable change (SDC), construct validity, and discriminant validity were tested. Factor analysis was performed to determine the ATRS-Persian structure. There were no floor or ceiling effects that indicate the content and responsiveness of ATRS-Persian. Internal consistency was high (Cronbach's α 0.95). Item-total correlations exceeded acceptable standard of 0.3 for the all items (0.58-0.95). The test-retest reliability was excellent [(ICC)agreement 0.98]. SEM and SDC were 3.57 and 9.9, respectively. Construct validity was supported by a significant correlation between the ATRS-Persian total score and the Persian Foot and Ankle Outcome Score (PFAOS) total score and PFAOS subscales (r = 0.55-0.83). The ATRS-Persian significantly discriminated between patients and healthy subjects. Explanatory factor analysis revealed 1 component. The ATRS was cross-culturally adapted to Persian and demonstrated to be a reliable and valid instrument to measure functional outcomes in Persian patients with Achilles tendon rupture. II.

  17. Fall Risk Score at the Time of Discharge Predicts Readmission Following Total Joint Arthroplasty.

    Science.gov (United States)

    Ravi, Bheeshma; Nan, Zhang; Schwartz, Adam J; Clarke, Henry D

    2017-07-01

    Readmission among Medicare recipients is a leading driver of healthcare expenditure. To date, most predictive tools are too coarse for direct clinical application. Our objective in this study is to determine if a pre-existing tool to identify patients at increased risk for inpatient falls, the Hendrich Fall Risk Score, could be used to accurately identify Medicare patients at increased risk for readmission following arthroplasty, regardless of whether the readmission was due to a fall. This study is a retrospective cohort study. We identified 2437 Medicare patients who underwent a primary elective total joint arthroplasty (TJA) of the hip or knee for osteoarthritis between 2011 and 2014. The Hendrich Fall Risk score was recorded for each patient preoperatively and postoperatively. Our main outcome measure was hospital readmission within 30 days of discharge. Of 2437 eligible TJA recipients, there were 226 (9.3%) patients who had a score ≥6. These patients were more likely to have an unplanned readmission (unadjusted odds ratio 2.84, 95% confidence interval 1.70-4.76, P 3 days (49.6% vs 36.6%, P = .0001), and were less likely to be sent home after discharge (20.8% vs 35.8%, P fall risk score after TJA is strongly associated with unplanned readmission. Application of this tool will allow hospitals to identify these patients and plan their discharge. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. IMPACT OF SHOTS ON FINAL SCORE OF A FOOTBALL MATCH

    Directory of Open Access Journals (Sweden)

    Miroslav Radoman

    2008-08-01

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

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

    International Nuclear Information System (INIS)

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

    2008-01-01

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

  20. Do Press Ganey Scores Correlate With Total Knee Arthroplasty-Specific Outcome Questionnaires in Postsurgical Patients?

    Science.gov (United States)

    Chughtai, Morad; Patel, Nirav K; Gwam, Chukwuweike U; Khlopas, Anton; Bonutti, Peter M; Delanois, Ronald E; Mont, Michael A

    2017-09-01

    The purpose of this study was to assess whether Center for Medicaid and Medicare services-implemented satisfaction (Press Ganey [PG]) survey results correlate with established total knee arthroplasty (TKA) assessment tools. Data from 736 patients who underwent TKA and received a PG survey between November 2009 and January 2015 were analyzed. The PG survey overall hospital rating scores were correlated with standardized validated outcome assessment tools for TKA (Short form-12 and 36 Health Survey; Knee Society Score; Western Ontario and McMaster Universities Arthritis Index; University of California, Los Angeles; and visual analog scale) at a mean follow-up of 1154 days post-TKA. There was no correlation between PG survey overall hospital rating score and the above-mentioned outcome assessment tools. Our study shows that there is no statistically significant relationship between established arthroplasty assessment tools and the PG overall hospital rating. Therefore, PG surveys may not be an appropriate tool to determine reimbursement for orthopedists performing TKAs. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Reliability and validation of the Dutch Achilles tendon Total Rupture Score.

    Science.gov (United States)

    Opdam, K T M; Zwiers, R; Wiegerinck, J I; Kleipool, A E B; Haverlag, R; Goslings, J C; van Dijk, C N

    2018-03-01

    Patient-reported outcome measures (PROMs) have become a cornerstone for the evaluation of the effectiveness of treatment. The Achilles tendon Total Rupture Score (ATRS) is a PROM for outcome and assessment of an Achilles tendon rupture. The aim of this study was to translate the ATRS to Dutch and evaluate its reliability and validity in the Dutch population. A forward-backward translation procedure was performed according to the guidelines of cross-cultural adaptation process. The Dutch ATRS was evaluated for reliability and validity in patients treated for a total Achilles tendon rupture from 1 January 2012 to 31 December 2014 in one teaching hospital and one academic hospital. Reliability was assessed by the intraclass correlation coefficients (ICC), Cronbach's alpha and minimal detectable change (MDC). We assessed construct validity by calculation of Spearman's rho correlation coefficient with domains of the Foot and Ankle Outcome Score (FAOS), Victorian Institute of Sports Assessment-Achilles questionnaire (VISA-A) and Numeric Rating Scale (NRS) for pain in rest and during running. The Dutch ATRS had a good test-retest reliability (ICC = 0.852) and a high internal consistency (Cronbach's alpha = 0.96). MDC was 30.2 at individual level and 3.5 at group level. Construct validity was supported by 75 % of the hypothesized correlations. The Dutch ATRS had a strong correlation with NRS for pain during running (r = -0.746) and all the five subscales of the Dutch FAOS (r = 0.724-0.867). There was a moderate correlation with the VISA-A-NL (r = 0.691) and NRS for pain in rest (r = -0.580). The Dutch ATRS shows an adequate reliability and validity and can be used in the Dutch population for measuring the outcome of treatment of a total Achilles tendon rupture and for research purposes. Diagnostic study, Level I.

  2. Acute Radiation Syndrome Severity Score System in Mouse Total-Body Irradiation Model.

    Science.gov (United States)

    Ossetrova, Natalia I; Ney, Patrick H; Condliffe, Donald P; Krasnopolsky, Katya; Hieber, Kevin P

    2016-08-01

    Radiation accidents or terrorist attacks can result in serious consequences for the civilian population and for military personnel responding to such emergencies. The early medical management situation requires quantitative indications for early initiation of cytokine therapy in individuals exposed to life-threatening radiation doses and effective triage tools for first responders in mass-casualty radiological incidents. Previously established animal (Mus musculus, Macaca mulatta) total-body irradiation (γ-exposure) models have evaluated a panel of radiation-responsive proteins that, together with peripheral blood cell counts, create a multiparametic dose-predictive algorithm with a threshold for detection of ~1 Gy from 1 to 7 d after exposure as well as demonstrate the acute radiation syndrome severity score systems created similar to the Medical Treatment Protocols for Radiation Accident Victims developed by Fliedner and colleagues. The authors present a further demonstration of the acute radiation sickness severity score system in a mouse (CD2F1, males) TBI model (1-14 Gy, Co γ-rays at 0.6 Gy min) based on multiple biodosimetric endpoints. This includes the acute radiation sickness severity Observational Grading System, survival rate, weight changes, temperature, peripheral blood cell counts and radiation-responsive protein expression profile: Flt-3 ligand, interleukin 6, granulocyte-colony stimulating factor, thrombopoietin, erythropoietin, and serum amyloid A. Results show that use of the multiple-parameter severity score system facilitates identification of animals requiring enhanced monitoring after irradiation and that proteomics are a complementary approach to conventional biodosimetry for early assessment of radiation exposure, enhancing accuracy and discrimination index for acute radiation sickness response categories and early prediction of outcome.

  3. MRI quantitative assessment of brain maturation and prognosis in premature infants using total maturation score

    International Nuclear Information System (INIS)

    Qi Ying; Wang Xiaoming

    2009-01-01

    Objective: To quantitatively assess brain maturation and prognosis in premature infants on conventional MRI using total maturation score (TMS). Methods: Nineteen cases of sequelae of white matter damage (WMD group )and 21 cases of matched controls (control group) in premature infants confirmed by MRI examinations were included in the study. All cases underwent conventional MR imaging approximately during the perinatal period after birth. Brain development was quantitatively assessed using Childs AM's validated scoring system of TMS by two sophisticated radiology physicians. Interobserver agreement and reliability was evaluated by using intraclass correlation (ICC). Linear regression analysis between TMS and postmenstrual age (PMA) was made(Y: TMS, X: PMA). Independent-sample t test of the two groups' TMS was made. Results: Sixteen of 19 cases revealed MRI abnormalities. Lesions showing T 1 and T 2 shortening tended to occur in clusters or a linear pattern in the deep white matter of the centrum semiovale, periventricular white matter. Diffusion-weighted MR image (DWI) showed 3 cases with greater lesions and 4 cases with new lesions in corpus callosum. There was no abnormality in control group on MRI and DWI. The average numbers of TMS between the two observers were 7.13±2.27, 7.13±2.21. Interobservcer agreement was found to be high (ICC=0.990, P 2 =0.6401,0.5156 respectively, P 0.05). Conclusion: Conventional MRI is able to quantify the brain maturation and prognosis of premature infants using TMS. (authors)

  4. Negative emotions affect postoperative scores for evaluating functional knee recovery and quality of life after total knee replacement

    Directory of Open Access Journals (Sweden)

    A. Qi

    2016-01-01

    Full Text Available This study aimed to determine whether psychological factors affect health-related quality of life (HRQL and recovery of knee function in total knee replacement (TKR patients. A total of 119 TKR patients (male: 38; female: 81 completed the Beck Anxiety Inventory (BAI, Beck Depression Inventory (BDI, State Trait Anxiety Inventory (STAI, Eysenck Personality Questionnaire-revised (EPQR-S, Knee Society Score (KSS, and HRQL (SF-36. At 1 and 6 months after surgery, anxiety, depression, and KSS scores in TKR patients were significantly better compared with those preoperatively (P<0.05. SF-36 scores at the sixth month after surgery were significantly improved compared with preoperative scores (P<0.001. Preoperative Physical Component Summary Scale (PCS and Mental Component Summary Scale (MCS scores were negatively associated with extraversion (E score (B=-0.986 and -0.967, respectively, both P<0.05. Postoperative PCS and State Anxiety Inventory (SAI scores were negatively associated with neuroticism (N score; B=-0.137 and -0.991, respectively, both P<0.05. Postoperative MCS, SAI, Trait Anxiety Inventory (TAI, and BAI scores were also negatively associated with the N score (B=-0.367, -0.107, -0.281, and -0.851, respectively, all P<0.05. The KSS function score at the sixth month after surgery was negatively associated with TAI and N scores (B=-0.315 and -0.532, respectively, both P<0.05, but positively associated with the E score (B=0.215, P<0.05. The postoperative KSS joint score was positively associated with postoperative PCS (B=0.356, P<0.05. In conclusion, for TKR patients, the scores used for evaluating recovery of knee function and HRQL after 6 months are inversely associated with the presence of negative emotions.

  5. Can an arthroplasty risk score predict bundled care events after total joint arthroplasty?

    Directory of Open Access Journals (Sweden)

    Blair S. Ashley, MD

    2018-03-01

    Full Text Available Background: The validated Arthroplasty Risk Score (ARS predicts the need for postoperative triage to an intensive care setting. We hypothesized that the ARS may also predict hospital length of stay (LOS, discharge disposition, and episode-of-care cost (EOCC. Methods: We retrospectively reviewed a series of 704 patients undergoing primary total hip and knee arthroplasty over 17 months. Patient characteristics, 90-day EOCC, LOS, and readmission rates were compared before and after ARS implementation. Results: ARS implementation was associated with fewer patients going to a skilled nursing or rehabilitation facility after discharge (63% vs 74%, P = .002. There was no difference in LOS, EOCC, readmission rates, or complications. While the adoption of the ARS did not change the mean EOCC, ARS >3 was predictive of high EOCC outlier (odds ratio 2.65, 95% confidence interval 1.40-5.01, P = .003. Increased ARS correlated with increased EOCC (P = .003. Conclusions: Implementation of the ARS was associated with increased disposition to home. It was predictive of high EOCC and should be considered in risk adjustment variables in alternative payment models. Keywords: Bundled payments, Risk stratification, Arthroplasty

  6. Comparison between the Harris- and Oxford Hip Score to evaluate outcomes one-year after total hip arthroplasty

    NARCIS (Netherlands)

    Weel, Hanneke; Lindeboom, Robert; Kuipers, Sander E.; Vervest, Ton M. J. S.

    2017-01-01

    Harris Hip Score (HHS) is a surgeon administered measurement for assessing hip function before and after total hip arthroplasties (THA). Patient reported outcome measurements (PROMs) such as the Oxford Hip Score (OHS) are increasingly used. HHS was compaired to the OHS assessing whether the HHS can

  7. Sensitivity and Specificity of the Coma Recovery Scale--Revised Total Score in Detection of Conscious Awareness.

    Science.gov (United States)

    Bodien, Yelena G; Carlowicz, Cecilia A; Chatelle, Camille; Giacino, Joseph T

    2016-03-01

    To describe the sensitivity and specificity of Coma Recovery Scale-Revised (CRS-R) total scores in detecting conscious awareness. Data were retrospectively extracted from the medical records of patients enrolled in a specialized disorders of consciousness (DOC) program. Sensitivity and specificity analyses were completed using CRS-R-derived diagnoses of minimally conscious state (MCS) or emerged from minimally conscious state (EMCS) as the reference standard for conscious awareness and the total CRS-R score as the test criterion. A receiver operating characteristic curve was constructed to demonstrate the optimal CRS-R total cutoff score for maximizing sensitivity and specificity. Specialized DOC program. Patients enrolled in the DOC program (N=252, 157 men; mean age, 49y; mean time from injury, 48d; traumatic etiology, n=127; nontraumatic etiology, n=125; diagnosis of coma or vegetative state, n=70; diagnosis of MCS or EMCS, n=182). Not applicable. Sensitivity and specificity of CRS-R total scores in detecting conscious awareness. A CRS-R total score of 10 or higher yielded a sensitivity of .78 for correct identification of patients in MCS or EMCS, and a specificity of 1.00 for correct identification of patients who did not meet criteria for either of these diagnoses (ie, were diagnosed with vegetative state or coma). The area under the curve in the receiver operating characteristic curve analysis is .98. A total CRS-R score of 10 or higher provides strong evidence of conscious awareness but resulted in a false-negative diagnostic error in 22% of patients who demonstrated conscious awareness based on CRS-R diagnostic criteria. A cutoff score of 8 provides the best balance between sensitivity and specificity, accurately classifying 93% of cases. The optimal total score cutoff will vary depending on the user's objective. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

  8. Can the pre-operative Western Ontario and McMaster score predict patient satisfaction following total hip arthroplasty?

    Science.gov (United States)

    Rogers, B A; Alolabi, B; Carrothers, A D; Kreder, H J; Jenkinson, R J

    2015-02-01

    In this study we evaluated whether pre-operative Western Ontario and McMaster Universities (WOMAC) osteoarthritis scores can predict satisfaction following total hip arthroplasty (THA). Prospective data for a cohort of patients undergoing THA from two large academic centres were collected, and pre-operative and one-year post-operative WOMAC scores and a 25-point satisfaction questionnaire were obtained for 446 patients. Satisfaction scores were dichotomised into either improvement or deterioration. Scatter plots and Spearman's rank correlation coefficient were used to describe the association between pre-operative WOMAC and one-year post-operative WOMAC scores and patient satisfaction. Satisfaction was compared using receiver operating characteristic (ROC) analysis against pre-operative, post-operative and δ WOMAC scores. We found no relationship between pre-operative WOMAC scores and one-year post-operative WOMAC or satisfaction scores, with Spearman's rank correlation coefficients of 0.16 and -0.05, respectively. The ROC analysis showed areas under the curve (AUC) of 0.54 (pre-operative WOMAC), 0.67 (post-operative WOMAC) and 0.43 (δ WOMAC), respectively, for an improvement in satisfaction. We conclude that the pre-operative WOMAC score does not predict the post-operative WOMAC score or patient satisfaction after THA, and that WOMAC scores can therefore not be used to prioritise patient care. ©2015 The British Editorial Society of Bone & Joint Surgery.

  9. Validation of use of subsets of teeth when applying the total mouth periodontal score (TMPS) system in dogs.

    Science.gov (United States)

    Harvey, Colin E; Laster, Larry; Shofer, Frances S

    2012-01-01

    A total mouth periodontal score (TMPS) system in dogs has been described previously. Use of buccal and palatal/lingual surfaces of all teeth requires observation and recording of 120 gingivitis scores and 120 periodontitis scores. Although the result is a reliable, repeatable assessment of the extent of periodontal disease in the mouth, observing and recording 240 data points is time-consuming. Using data from a previously reported study of periodontal disease in dogs, correlation analysis was used to determine whether use of any of seven different subsets of teeth can generate TMPS subset gingivitis and periodontitis scores that are highly correlated with TMPS all-site, all-teeth scores. Overall, gingivitis scores were less highly correlated than periodontitis scores. The minimal tooth set with a significant intra-class correlation (> or = 0.9 of means of right and left sides) for both gingivitis scores and attachment loss measurements consisted of the buccal surface of the maxillary third incisor canine, third premolar fourth premolar; and first molar teeth; and, the mandibular canine, third premolar, fourth premolar and first molar teeth on one side (9 teeth, 15 root sites). Use of this subset of teeth, which reduces the number of data points per dog from 240 to 30 for gingivitis and periodontitis at each scoring episode, is recommended when calculating the gingivitis and periodontitis scores using the TMPS system.

  10. The Generic Impact Scoring System (GISS): a standardized tool to quantify the impacts of alien species

    Czech Academy of Sciences Publication Activity Database

    Nentwig, W.; Bacher, S.; Pyšek, Petr; Vila, M.; Kumschick, S.

    2016-01-01

    Roč. 188, č. 5 (2016), s. 1-13, č. článku 315. ISSN 0167-6369 R&D Projects: GA ČR GB14-36079G Grant - others:AV ČR(CZ) AP1002 Program:Akademická prémie - Praemium Academiae Institutional support: RVO:67985939 Keywords : scoring * impact * biological invasions Subject RIV: EH - Ecology, Behaviour Impact factor: 1.687, year: 2016

  11. The impact of a revised EQ-5D population scoring on preference-based utility scores in an inflammatory arthritis cohort.

    LENUS (Irish Health Repository)

    Adams, Roisin

    2012-02-01

    BACKGROUND AND OBJECTIVE: It is well established that there are problems with the EQ-5D. This is due to the original scoring methods used and how negative time trade-off (TTO) values were treated. A revised scoring method has been published. This article applies this to an inflammatory arthritis cohort. The objective is to examine the impact of a revised scoring system for the EQ-5D (UK) TTO on the utility estimates and in the case of rheumatoid arthritis, to explore the impact of using different utility metrics on the incremental cost-effectiveness ratio (ICER) results of an economic model. METHODS: A total of 504 patients with inflammatory arthritis were rescored using revised EQ-5D scoring, which uses an episodic random utility model to deal with negative TTO values. Differences in utility scores were compared and the new mapping coefficients were obtained. These were then used in an economic model to examine the impact on the ICER. RESULTS: In rheumatoid arthritis, the overall change is less for the revised EQ-5D scoring than with the original EQ-5D (TTO) but greater than the SF-6D: EQ-5D UK -0.22 (95% confidence interval [CI] -0.30 to -0.15), revised EQ-5D UK -0.16 (95% CI -0.21 to -0.10) and SF-6D -0.08 (95% CI -0.11 to -0.05). A similar trend is seen in the psoriatic arthritis group. The economic model produced different ICERs, when different utility measures were used; EQ-5D (TTO) euro42,402, SF-6D euro111,788, and revised EQ-5D (TTO) euro57,747. CONCLUSION: In the context of inflammatory arthritis, this article demonstrates that a revised scoring for EQ-5D may have a significant impact on utility estimates and on the output of the economic model.

  12. Distribution of Total Depressive Symptoms Scores and Each Depressive Symptom Item in a Sample of Japanese Employees.

    Science.gov (United States)

    Tomitaka, Shinichiro; Kawasaki, Yohei; Ide, Kazuki; Yamada, Hiroshi; Miyake, Hirotsugu; Furukawa, Toshiaki A; Furukaw, Toshiaki A

    2016-01-01

    In a previous study, we reported that the distribution of total depressive symptoms scores according to the Center for Epidemiologic Studies Depression Scale (CES-D) in a general population is stable throughout middle adulthood and follows an exponential pattern except for at the lowest end of the symptom score. Furthermore, the individual distributions of 16 negative symptom items of the CES-D exhibit a common mathematical pattern. To confirm the reproducibility of these findings, we investigated the distribution of total depressive symptoms scores and 16 negative symptom items in a sample of Japanese employees. We analyzed 7624 employees aged 20-59 years who had participated in the Northern Japan Occupational Health Promotion Centers Collaboration Study for Mental Health. Depressive symptoms were assessed using the CES-D. The CES-D contains 20 items, each of which is scored in four grades: "rarely," "some," "much," and "most of the time." The descriptive statistics and frequency curves of the distributions were then compared according to age group. The distribution of total depressive symptoms scores appeared to be stable from 30-59 years. The right tail of the distribution for ages 30-59 years exhibited a linear pattern with a log-normal scale. The distributions of the 16 individual negative symptom items of the CES-D exhibited a common mathematical pattern which displayed different distributions with a boundary at "some." The distributions of the 16 negative symptom items from "some" to "most" followed a linear pattern with a log-normal scale. The distributions of the total depressive symptoms scores and individual negative symptom items in a Japanese occupational setting show the same patterns as those observed in a general population. These results show that the specific mathematical patterns of the distributions of total depressive symptoms scores and individual negative symptom items can be reproduced in an occupational population.

  13. Total Cerebral Small Vessel Disease MRI Score Is Associated With Cognitive Decline In Executive Function In Patients With Hypertension

    Directory of Open Access Journals (Sweden)

    Renske Uiterwijk

    2016-12-01

    Full Text Available Objectives: Hypertension is a major risk factor for white matter hyperintensities, lacunes, cerebral microbleeds and perivascular spaces, which are MRI markers of cerebral small vessel disease (SVD. Studies have shown associations between these individual MRI markers and cognitive functioning and decline. Recently, a total SVD score was proposed in which the different MRI markers were combined into one measure of SVD, to capture total SVD-related brain damage. We investigated if this SVD score was associated with cognitive decline over 4 years in patients with hypertension. Methods: In this longitudinal cohort study, 130 hypertensive patients (91 patients with uncomplicated hypertension and 39 hypertensive patients with a lacunar stroke were included. They underwent a neuropsychological assessment at baseline and after 4 years. The presence of white matter hyperintensities, lacunes, cerebral microbleeds, and perivascular spaces were rated on baseline MRI. Presence of each individual marker was added to calculate the total SVD score (range 0-4 in each patient. Results: Uncorrected linear regression analyses showed associations between SVD score and decline in overall cognition (p=0.017, executive functioning (p<0.001 and information processing speed (p=0.037, but not with memory (p=0.911. The association between SVD score and decline in overall cognition and executive function remained significant after adjustment for age, sex, education, anxiety and depression score, potential vascular risk factors, patient group and baseline cognitive performance.Conclusions: Our study shows that a total SVD score can predict cognitive decline, specifically in executive function, over 4 years in hypertensive patients. This emphasizes the importance of considering total brain damage due to SVD.

  14. A Novel Risk Score in Predicting Failure or Success for Antegrade Approach to Percutaneous Coronary Intervention of Chronic Total Occlusion: Antegrade CTO Score.

    Science.gov (United States)

    Namazi, Mohammad Hasan; Serati, Ali Reza; Vakili, Hosein; Safi, Morteza; Parsa, Saeed Ali Pour; Saadat, Habibollah; Taherkhani, Maryam; Emami, Sepideh; Pedari, Shamseddin; Vatanparast, Masoomeh; Movahed, Mohammad Reza

    2017-06-01

    Total occlusion of a coronary artery for more than 3 months is defined as chronic total occlusion (CTO). The goal of this study was to develop a risk score in predicting failure or success during attempted percutaneous coronary intervention (PCI) of CTO lesions using antegrade approach. This study was based on retrospective analyses of clinical and angiographic characteristics of CTO lesions that were assessed between February 2012 and February 2014. Success rate was defined as passing through occlusion with successful stent deployment using an antegrade approach. A total of 188 patients were studied. Mean ± SD age was 59 ± 9 years. Failure rate was 33%. In a stepwise multivariate regression analysis, bridging collaterals (OR = 6.7, CI = 1.97-23.17, score = 2), absence of stump (OR = 5.8, CI = 1.95-17.9, score = 2), presence of calcification (OR = 3.21, CI = 1.46-7.07, score = 1), presence of bending (OR = 2.8, CI = 1.28-6.10, score = 1), presence of near side branch (OR = 2.7, CI = 1.08-6.57, score = 1), and absence of retrograde filling (OR = 2.5, CI = 1.03-6.17, score = 1) were independent predictors of PCI failure. A score of 7 or more was associated with 100% failure rate whereas a score of 2 or less was associated with over 80% success rate. Most factors associated with failure of CTO-PCI are related to lesion characteristics. A new risk score (range 0-8) is developed to predict CTO-PCI success or failure rate during antegrade approach as a guide before attempting PCI of CTO lesions.

  15. Investigating the impact of Total Quality Management (TQM) on ...

    African Journals Online (AJOL)

    Investigating the impact of Total Quality Management (TQM) on innovation in iranian oil companies. ... Journal of Fundamental and Applied Sciences ... for competing with rival's organized management and to survive in the cycle of change.

  16. Hip disability and osteoarthritis outcome score (HOOS)--validity and responsiveness in total hip replacement

    DEFF Research Database (Denmark)

    Nilsdotter, Anna K; Lohmander, L Stefan; Klässbo, Maria

    2003-01-01

    The aim of the study was to evaluate if physical functions usually associated with a younger population were of importance for an older population, and to construct an outcome measure for hip osteoarthritis with improved responsiveness compared to the Western Ontario McMaster osteoarthritis score...

  17. Can computer assistance improve the clinical and functional scores in total knee arthroplasty?

    Science.gov (United States)

    Hernández-Vaquero, Daniel; Suarez-Vazquez, Abelardo; Iglesias-Fernandez, Susana

    2011-12-01

    Surgical navigation in TKA facilitates better alignment; however, it is unclear whether improved alignment alters clinical evolution and midterm and long-term complication rates. We determined the alignment differences between patients with standard, manual, jig-based TKAs and patients with navigation-based TKAs, and whether any differences would modify function, implant survival, and/or complications. We retrospectively reviewed 97 patients (100 TKAs) undergoing TKAs for minimal preoperative deformities. Fifty TKAs were performed with an image-free surgical navigation system and the other 50 with a standard technique. We compared femoral angle (FA), tibial angle (TA), and femorotibial angle (FTA) and determined whether any differences altered clinical or functional scores, as measured by the Knee Society Score (KSS), or complications. Seventy-three patients (75 TKAs) had a minimum followup of 8 years (mean, 8.3 years; range, 8-9.1 years). All patients included in the surgical navigation group had a FTA between 177° and 182º. We found no differences in the KSS or implant survival between the two groups and no differences in complication rates, although more complications occurred in the standard technique group (seven compared with two in the surgical navigation group). In the midterm, we found no difference in functional and clinical scores or implant survival between TKAs performed with and without the assistance of a navigation system. Level II, therapeutic study. See the Guidelines online for a complete description of levels of evidence.

  18. Noise reduction technology reduces radiation dose in chronic total occlusions percutaneous coronary intervention: a propensity score-matched analysis.

    Science.gov (United States)

    Maccagni, Davide; Benincasa, Susanna; Bellini, Barbara; Candilio, Luciano; Poletti, Enrico; Carlino, Mauro; Colombo, Antonio; Azzalini, Lorenzo

    2018-03-23

    Chronic total occlusions (CTO) percutaneous coronary intervention (PCI) is associated with high radiation dose. Our study aim was to evaluate the impact of the implementation of a noise reduction technology (NRT) on patient radiation dose during CTO PCI. A total of 187 CTO PCIs performed between February 2016 and May 2017 were analyzed according to the angiographic systems utilized: Standard (n = 60) versus NRT (n = 127). Propensity score matching (PSM) was performed to control for differences in baseline characteristics. Primary endpoints were Cumulative Air Kerma at Interventional Reference Point (AK at IRP), which correlates with patient's tissue reactions; and Kerma Area Product (KAP), a surrogate measure of patient's risk of stochastic radiation effects. An Efficiency Index (defined as fluoroscopy time/AK at IRP) was calculated for each procedure. Image quality was evaluated using a 5-grade Likert-like scale. After PSM, n = 55 pairs were identified. Baseline and angiographic characteristics were well matched between groups. Compared to the Standard system, NRT was associated with lower AK at IRP [2.38 (1.80-3.66) vs. 3.24 (2.04-5.09) Gy, p = 0.035], a trend towards reduction for KAP [161 (93-244) vs. 203 (136-363) Gycm 2 , p = 0.069], and a better Efficiency Index [16.75 (12.73-26.27) vs. 13.58 (9.92-17.63) min/Gy, p = 0.003]. Image quality was similar between the two groups (4.39 ± 0.53 Standard vs. 4.34 ± 0.47 NRT, p = 0.571). In conclusion, compared with a Standard system, the use of NRT in CTO PCI is associated with lower patient radiation dose and similar image quality.

  19. The Impact of Emotional Priming on MMPI-2 Scale Scores

    Science.gov (United States)

    Lee, Tayla T. C.; Forbey, Johnathan D.; Ritchey, Kristin A.

    2011-01-01

    The current study investigated potential emotional priming effects on Minnesota Multiphasic Personality Inventory-2 (MMPI-2) scale scores. Participants included 98 college students who completed a personal narrative intended to induce temporary mood states, the MMPI-2, and a mood rating inventory. Results of the mood manipulation indicated that…

  20. Effect of Antihypertensive Therapy on SCORE-Estimated Total Cardiovascular Risk: Results from an Open-Label, Multinational Investigation—The POWER Survey

    Directory of Open Access Journals (Sweden)

    Guy De Backer

    2013-01-01

    Full Text Available Background. High blood pressure is a substantial risk factor for cardiovascular disease. Design & Methods. The Physicians' Observational Work on patient Education according to their vascular Risk (POWER survey was an open-label investigation of eprosartan-based therapy (EBT for control of high blood pressure in primary care centers in 16 countries. A prespecified element of this research was appraisal of the impact of EBT on estimated 10-year risk of a fatal cardiovascular event as determined by the Systematic Coronary Risk Evaluation (SCORE model. Results. SCORE estimates of CVD risk were obtained at baseline from 12,718 patients in 15 countries (6504 men and from 9577 patients at 6 months. During EBT mean (±SD systolic/diastolic blood pressures declined from 160.2 ± 13.7/94.1 ± 9.1 mmHg to 134.5 ± 11.2/81.4 ± 7.4 mmHg. This was accompanied by a 38% reduction in mean SCORE-estimated CVD risk and an improvement in SCORE risk classification of one category or more in 3506 patients (36.6%. Conclusion. Experience in POWER affirms that (a effective pharmacological control of blood pressure is feasible in the primary care setting and is accompanied by a reduction in total CVD risk and (b the SCORE instrument is effective in this setting for the monitoring of total CVD risk.

  1. Effect of Antihypertensive Therapy on SCORE-Estimated Total Cardiovascular Risk: Results from an Open-Label, Multinational Investigation—The POWER Survey

    Science.gov (United States)

    De Backer, Guy; Petrella, Robert J.; Goudev, Assen R.; Radaideh, Ghazi Ahmad; Rynkiewicz, Andrzej; Pathak, Atul

    2013-01-01

    Background. High blood pressure is a substantial risk factor for cardiovascular disease. Design & Methods. The Physicians' Observational Work on patient Education according to their vascular Risk (POWER) survey was an open-label investigation of eprosartan-based therapy (EBT) for control of high blood pressure in primary care centers in 16 countries. A prespecified element of this research was appraisal of the impact of EBT on estimated 10-year risk of a fatal cardiovascular event as determined by the Systematic Coronary Risk Evaluation (SCORE) model. Results. SCORE estimates of CVD risk were obtained at baseline from 12,718 patients in 15 countries (6504 men) and from 9577 patients at 6 months. During EBT mean (±SD) systolic/diastolic blood pressures declined from 160.2 ± 13.7/94.1 ± 9.1 mmHg to 134.5 ± 11.2/81.4 ± 7.4 mmHg. This was accompanied by a 38% reduction in mean SCORE-estimated CVD risk and an improvement in SCORE risk classification of one category or more in 3506 patients (36.6%). Conclusion. Experience in POWER affirms that (a) effective pharmacological control of blood pressure is feasible in the primary care setting and is accompanied by a reduction in total CVD risk and (b) the SCORE instrument is effective in this setting for the monitoring of total CVD risk. PMID:23997946

  2. Evaluating total carrying capacity of tourism using impact indicators

    Directory of Open Access Journals (Sweden)

    R. Sharma

    2016-03-01

    Full Text Available The carrying capacity is well identified tool to manage problems due to uncontrolled tourism for any destination. This report highlights the carrying capacity estimation of Kerwa tourism area, Bhopal, India. The methodology used in this report is a new two-tier mechanism of impact analysis using index numbers derived from a survey of 123 stakeholders. From this the individual component impact analysis and the total carrying capacity of the area is computed in order to state the insight of the total carrying capacity left for the tourism activities in Kerwa tourism area. It is calculated from, the results so obtained, that the Kerwa catchment area falls in “very low impact category” and hence in a healthy state of the artwork in terms of total carrying capacity. The study conveys the current need in the destination management and tourism development as a road map for the destination managers for implementing sustainable tourism.

  3. NIH Peer Review: Scored Review Criteria and Overall Impact

    Science.gov (United States)

    Lindner, Mark D.; Vancea, Adrian; Chen, Mei-Ching; Chacko, George

    2016-01-01

    The National Institutes of Health (NIH) is the largest source of funding for biomedical research in the world. Funding decisions are made largely based on the outcome of a peer review process that is intended to provide a fair, equitable, timely, and unbiased review of the quality, scientific merit, and potential impact of the research. There have…

  4. Investigating the impact of Total Quality Management (TQM) on ...

    African Journals Online (AJOL)

    Investigating the impact of Total Quality Management (TQM) on innovation in iranian oil companies. ... The PDF file you selected should load here if your Web browser has a PDF reader plug-in installed (for example, a recent version of Adobe Acrobat Reader). If you would like more information about how to print, save, and ...

  5. Use of the Liverpool Elbow Score as a postal questionnaire for the assessment of outcome after total elbow arthroplasty.

    Science.gov (United States)

    Ashmore, Alexander M; Gozzard, Charles; Blewitt, Neil

    2007-01-01

    The Liverpool Elbow Score (LES) is a newly developed, validated elbow-specific score. It consists of a patient-answered questionnaire (PAQ) and a clinical assessment. The purpose of this study was to determine whether the PAQ portion of the LES could be used independently as a postal questionnaire for the assessment of outcome after total elbow arthroplasty and to correlate the LES and the Mayo Elbow Performance Score (MEPS). A series of 51 total elbow replacements were reviewed by postal questionnaire. Patients then attended the clinic for assessment by use of both the LES and the MEPS. There was an excellent response rate to the postal questionnaire (98%), and 44 elbows were available for clinical review. Good correlation was shown between the LES and the MEPS (Spearman correlation coefficient, 0.84; P PAQ portion of the LES and the MEPS (Spearman correlation coefficient, 0.76; P PAQ component and the MEPS, suggesting that outcome assessment is possible by postal questionnaire.

  6. Boundary curves of individual items in the distribution of total depressive symptom scores approximate an exponential pattern in a general population

    OpenAIRE

    Tomitaka, Shinichiro; Kawasaki, Yohei; Ide, Kazuki; Akutagawa, Maiko; Yamada, Hiroshi; Furukawa, Toshiaki A.; Ono, Yutaka

    2016-01-01

    [Background]Previously, we proposed a model for ordinal scale scoring in which individual thresholds for each item constitute a distribution by each item. This lead us to hypothesize that the boundary curves of each depressive symptom score in the distribution of total depressive symptom scores follow a common mathematical model, which is expressed as the product of the frequency of the total depressive symptom scores and the probability of the cumulative distribution function of each item th...

  7. The impact of a total reward system of work engagement

    Directory of Open Access Journals (Sweden)

    Crystal Hoole

    2016-11-01

    attention to which strategies have an impact on work engagement. Contribution/Value-add: Organisations must take cognisance that factors such as performance and career management significantly predicted work engagement and should be considered as part of their total reward offerings.

  8. The Impact of the 2004 Hurricanes on Florida Comprehensive Assessment Test Scores: Implications for School Counselors

    Science.gov (United States)

    Baggerly, Jennifer; Ferretti, Larissa K.

    2008-01-01

    What is the impact of natural disasters on students' statewide assessment scores? To answer this question, Florida Comprehensive Assessment Test (FCAT) scores of 55,881 students in grades 4 through 10 were analyzed to determine if there were significant decreases after the 2004 hurricanes. Results reveal that there was statistical but no practical…

  9. The Impact of Misspelled Words on Automated Computer Scoring: A Case Study of Scientific Explanations

    Science.gov (United States)

    Ha, Minsu; Nehm, Ross H.

    2016-06-01

    Automated computerized scoring systems (ACSSs) are being increasingly used to analyze text in many educational settings. Nevertheless, the impact of misspelled words (MSW) on scoring accuracy remains to be investigated in many domains, particularly jargon-rich disciplines such as the life sciences. Empirical studies confirm that MSW are a pervasive feature of human-generated text and that despite improvements, spell-check and auto-replace programs continue to be characterized by significant errors. Our study explored four research questions relating to MSW and text-based computer assessments: (1) Do English language learners (ELLs) produce equivalent magnitudes and types of spelling errors as non-ELLs? (2) To what degree do MSW impact concept-specific computer scoring rules? (3) What impact do MSW have on computer scoring accuracy? and (4) Are MSW more likely to impact false-positive or false-negative feedback to students? We found that although ELLs produced twice as many MSW as non-ELLs, MSW were relatively uncommon in our corpora. The MSW in the corpora were found to be important features of the computer scoring models. Although MSW did not significantly or meaningfully impact computer scoring efficacy across nine different computer scoring models, MSW had a greater impact on the scoring algorithms for naïve ideas than key concepts. Linguistic and concept redundancy in student responses explains the weak connection between MSW and scoring accuracy. Lastly, we found that MSW tend to have a greater impact on false-positive feedback. We discuss the implications of these findings for the development of next-generation science assessments.

  10. Coronary collateral circulation in patients with chronic coronary total occlusion; its relationship with cardiac risk markers and SYNTAX score.

    Science.gov (United States)

    Börekçi, A; Gür, M; Şeker, T; Baykan, A O; Özaltun, B; Karakoyun, S; Karakurt, A; Türkoğlu, C; Makça, I; Çaylı, M

    2015-09-01

    Compared to patients without a collateral supply, long-term cardiac mortality is reduced in patients with well-developed coronary collateral circulation (CCC). Cardiovascular risk markers, such as N-terminal pro-brain natriuretic peptide (NT-proBNP), high-sensitive C-reactive protein (hs-CRP) and high-sensitive cardiac troponin T (hs-cTnT) are independent predictors for cardiovascular mortality. The main goal of this study was to examine the relationship between CCC and cardiovascular risk markers. We prospectively enrolled 427 stable coronary artery disease patients with chronic total occlusion (mean age: 57.5±11.1 years). The patients were divided into two groups, according to their Rentrop scores: (a) poorly developed CCC group (Rentrop 0 and 1) and (b) well-developed CCC group (Rentrop 2 and 3). NT-proBNP, hs-CRP, hs-cTnT, uric acid and other biochemical markers were also measured. The SYNTAX score was calculated for all patients. The patients in the poorly developed CCC group had higher frequencies of diabetes and hypertension (prisk markers, such as NT-proBNP, hs-cTnT and hs-CRP are independently associated with CCC in stable coronary artery disease with chronic total occlusion. © The Author(s) 2014.

  11. Knee injury and Osteoarthritis Outcome Score (KOOS – validation and comparison to the WOMAC in total knee replacement

    Directory of Open Access Journals (Sweden)

    Roos Ewa M

    2003-05-01

    Full Text Available Abstract Background The Knee injury and Osteoarthritis Outcome Score (KOOS is an extension of the Western Ontario and McMaster Universities Osteoarthrtis Index (WOMAC, the most commonly used outcome instrument for assessment of patient-relevant treatment effects in osteoarthritis. KOOS was developed for younger and/or more active patients with knee injury and knee osteoarthritis and has in previous studies on these groups been the more responsive instrument compared to the WOMAC. Some patients eligible for total knee replacement have expectations of more demanding physical functions than required for daily living. This encouraged us to study the use of the Knee injury and Osteoarthritis Outcome Score (KOOS to assess the outcome of total knee replacement. Methods We studied the test-retest reliability, validity and responsiveness of the Swedish version LK 1.0 of the KOOS when used to prospectively evaluate the outcome of 105 patients (mean age 71.3, 66 women after total knee replacement. The follow-up rates at 6 and 12 months were 92% and 86%, respectively. Results The intraclass correlation coefficients were over 0.75 for all subscales indicating sufficient test-retest reliability. Bland-Altman plots confirmed this finding. Over 90% of the patients regarded improvement in the subscales Pain, Symptoms, Activities of Daily Living, and knee-related Quality of Life to be extremely or very important when deciding to have their knee operated on indicating good content validity. The correlations found in comparison to the SF-36 indicated the KOOS measured expected constructs. The most responsive subscale was knee-related Quality of Life. The effect sizes of the five KOOS subscales at 12 months ranged from 1.08 to 3.54 and for the WOMAC from 1.65 to 2.56. Conclusion The Knee injury and Osteoarthritis Outcome Score (KOOS is a valid, reliable, and responsive outcome measure in total joint replacement. In comparison to the WOMAC, the KOOS improved validity

  12. Anesthesia Technique and Mortality after Total Hip or Knee Arthroplasty: A Retrospective, Propensity Score-matched Cohort Study.

    Science.gov (United States)

    Perlas, Anahi; Chan, Vincent W S; Beattie, Scott

    2016-10-01

    This propensity score-matched cohort study evaluates the effect of anesthetic technique on a 30-day mortality after total hip or knee arthroplasty. All patients who had hip or knee arthroplasty between January 1, 2003, and December 31, 2014, were evaluated. The principal exposure was spinal versus general anesthesia. The primary outcome was 30-day mortality. Secondary outcomes were (1) perioperative myocardial infarction; (2) a composite of major adverse cardiac events that includes cardiac arrest, myocardial infarction, or newly diagnosed arrhythmia; (3) pulmonary embolism; (4) major blood loss; (5) hospital length of stay; and (6) operating room procedure time. A propensity score-matched-pair analysis was performed using a nonparsimonious logistic regression model of regional anesthetic use. We identified 10,868 patients, of whom 8,553 had spinal anesthesia and 2,315 had general anesthesia. Ninety-two percent (n = 2,135) of the patients who had general anesthesia were matched to similar patients who did not have general anesthesia. In the matched cohort, the 30-day mortality rate was 0.19% (n = 4) in the spinal anesthesia group and 0.8% (n = 17) in the general anesthesia group (risk ratio, 0.42; 95% CI, 0.21 to 0.83; P = 0.0045). Spinal anesthesia was also associated with a shorter hospital length of stay (5.7 vs. 6.6 days; P anesthesia and lower 30-day mortality, as well as a shorter hospital length of stay, after elective joint replacement surgery.

  13. Boundary curves of individual items in the distribution of total depressive symptom scores approximate an exponential pattern in a general population.

    Science.gov (United States)

    Tomitaka, Shinichiro; Kawasaki, Yohei; Ide, Kazuki; Akutagawa, Maiko; Yamada, Hiroshi; Furukawa, Toshiaki A; Ono, Yutaka

    2016-01-01

    Previously, we proposed a model for ordinal scale scoring in which individual thresholds for each item constitute a distribution by each item. This lead us to hypothesize that the boundary curves of each depressive symptom score in the distribution of total depressive symptom scores follow a common mathematical model, which is expressed as the product of the frequency of the total depressive symptom scores and the probability of the cumulative distribution function of each item threshold. To verify this hypothesis, we investigated the boundary curves of the distribution of total depressive symptom scores in a general population. Data collected from 21,040 subjects who had completed the Center for Epidemiologic Studies Depression Scale (CES-D) questionnaire as part of a national Japanese survey were analyzed. The CES-D consists of 20 items (16 negative items and four positive items). The boundary curves of adjacent item scores in the distribution of total depressive symptom scores for the 16 negative items were analyzed using log-normal scales and curve fitting. The boundary curves of adjacent item scores for a given symptom approximated a common linear pattern on a log normal scale. Curve fitting showed that an exponential fit had a markedly higher coefficient of determination than either linear or quadratic fits. With negative affect items, the gap between the total score curve and boundary curve continuously increased with increasing total depressive symptom scores on a log-normal scale, whereas the boundary curves of positive affect items, which are not considered manifest variables of the latent trait, did not exhibit such increases in this gap. The results of the present study support the hypothesis that the boundary curves of each depressive symptom score in the distribution of total depressive symptom scores commonly follow the predicted mathematical model, which was verified to approximate an exponential mathematical pattern.

  14. Boundary curves of individual items in the distribution of total depressive symptom scores approximate an exponential pattern in a general population

    Directory of Open Access Journals (Sweden)

    Shinichiro Tomitaka

    2016-10-01

    Full Text Available Background Previously, we proposed a model for ordinal scale scoring in which individual thresholds for each item constitute a distribution by each item. This lead us to hypothesize that the boundary curves of each depressive symptom score in the distribution of total depressive symptom scores follow a common mathematical model, which is expressed as the product of the frequency of the total depressive symptom scores and the probability of the cumulative distribution function of each item threshold. To verify this hypothesis, we investigated the boundary curves of the distribution of total depressive symptom scores in a general population. Methods Data collected from 21,040 subjects who had completed the Center for Epidemiologic Studies Depression Scale (CES-D questionnaire as part of a national Japanese survey were analyzed. The CES-D consists of 20 items (16 negative items and four positive items. The boundary curves of adjacent item scores in the distribution of total depressive symptom scores for the 16 negative items were analyzed using log-normal scales and curve fitting. Results The boundary curves of adjacent item scores for a given symptom approximated a common linear pattern on a log normal scale. Curve fitting showed that an exponential fit had a markedly higher coefficient of determination than either linear or quadratic fits. With negative affect items, the gap between the total score curve and boundary curve continuously increased with increasing total depressive symptom scores on a log-normal scale, whereas the boundary curves of positive affect items, which are not considered manifest variables of the latent trait, did not exhibit such increases in this gap. Discussion The results of the present study support the hypothesis that the boundary curves of each depressive symptom score in the distribution of total depressive symptom scores commonly follow the predicted mathematical model, which was verified to approximate an

  15. Predicting placebo response in adolescents with major depressive disorder: The Adolescent Placebo Impact Composite Score (APICS).

    Science.gov (United States)

    Nakonezny, Paul A; Mayes, Taryn L; Byerly, Matthew J; Emslie, Graham J

    2015-09-01

    The aim of this study was to construct a composite scoring system to predict the probability of placebo response in adolescents with Major Depressive Disorder (MDD). Participants of the current study were 151 adolescents (aged 12-17 years) who were randomized to the placebo arm (placebo transdermal patches) of a randomized controlled trial (RCT) comparing the selegiline transdermal patch with placebo (DelBello et al., 2014). The primary outcome of response was defined as a CGI-I score of 1 or 2 (very much or much improved) at week 12 (study-end) or exit. As a first step, a multiple logistic mixed model was used to estimate the odds of placebo response from each predictor in the model, including age, CDRS-R total at baseline (depressive symptom severity), history of recurrent depression (yes vs. no), sex (female vs. male), and race (non-Caucasian vs. Caucasian). On the basis of the initial logistic mixed model analysis, we then constructed an Adolescent Placebo Impact Composite Score (APICS) that became the sole predictor in a re-specified Bayesian logistic regression model to estimate the probability of placebo response. Finally, the AUC for the APICS was tested against a nominal area of 0.50 to evaluate how well the APICS discriminated placebo response status. Among the 151 adolescents, with a mean age of 14.6 years (SD = 1.6) and a mean baseline CDRS-R total of 60.6 (SD = 12.1), 68.2% were females, 50.3% was Caucasian, and 39.7% had a history of recurrent depression. Placebo response rate was 58.3%. Based on the logistic mixed model, the re-specified equation with the highest discriminatory ability to estimate the probability of placebo response was APICS = age + (0.32 × CDRS-R Total at baseline) + (-2.85 × if female) + (-5.50 × if history of recurrent depression) + (-5.85 × if non-Caucasian). The AUC for this model was 0.59 (p = .049). Within a Bayesian decision-theoretic framework, in 95.5% of the time, the 10,000 posterior Monte Carlo samples suggested

  16. Poor WOMAC scores in contralateral knee negatively impact TKA outcomes: data from the osteoarthritis initiative.

    Science.gov (United States)

    Kahn, Timothy L; Soheili, Aydin C; Schwarzkopf, Ran

    2014-08-01

    While total knee arthroplasty (TKA) has been shown to have excellent outcomes, a significant proportion of patients experience relatively poor post-operative function. In this study, we test the hypothesis that the level of osteoarthritic symptoms in the contralateral knee at the time of TKA is associated with poorer post-operative outcomes in the operated knee. Using longitudinal cohort data from the Osteoarthritis Initiative (OAI), we included 171 patients who received a unilateral TKA. We compared pre-operative Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores in the contralateral knee to post-operative WOMAC scores in the index knee. Pre-operative contralateral knee WOMAC scores were associated with post-operative index knee WOMAC Total scores, indicating that the health of the pre-operative contralateral knee is a significant factor in TKA outcomes. Copyright © 2014 Elsevier Inc. All rights reserved.

  17. Diabetes that impacts on routine activities predicts slower recovery after total knee arthroplasty: an observational study

    Directory of Open Access Journals (Sweden)

    Nurudeen Amusat

    2014-12-01

    Full Text Available Question: In the 6 months after total knee arthroplasty (TKA, what is the pattern of pain resolution and functional recovery in people without diabetes, with diabetes that does not impact on routine activities, and with diabetes that does impact on routine activities? Is diabetes that impacts on routine activities an independent predictor of slower resolution of pain and functional recovery after TKA? Design: Community-based prospective observational study. Participants: A consecutive cohort of 405 people undergoing primary TKA, of whom 60 (15% had diabetes. Participants with diabetes were also asked preoperatively whether diabetes impacted on their routine activities. Participants were categorised into three groups: no diabetes (n = 345, diabetes with no impact on activities (n = 41, and diabetes that impacted activities (n = 19. Outcome measures: Pain and function were measured using the Western Ontario and McMaster Universities (WOMAC Osteoarthritis Index within the month before surgery and 1, 3 and 6 months after surgery. Demographic, medical and surgical factors were also measured, along with depression, social support and health-related quality of life. Results: No baseline differences in pain and function were seen among the three groups (p > 0.05. Adjusting for age, gender and contralateral joint involvement across the 6 postoperative months, participants with diabetes that impacted on routine activities had pain scores that were 8.3 points higher (indicating greater pain and function scores that were 5.4 points higher (indicating lower function than participants without diabetes. Participants with diabetes that doesn’t impact on routine activities had similar recovery to those without diabetes. Conclusion: People undergoing TKA who report preoperatively that diabetes impacts on their routine activities have less recovery over 6 months than those without diabetes or those with diabetes that does not impact on routine activities

  18. Alternative Payment Models Should Risk-Adjust for Conversion Total Hip Arthroplasty: A Propensity Score-Matched Study.

    Science.gov (United States)

    McLawhorn, Alexander S; Schairer, William W; Schwarzkopf, Ran; Halsey, David A; Iorio, Richard; Padgett, Douglas E

    2017-12-06

    For Medicare beneficiaries, hospital reimbursement for nonrevision hip arthroplasty is anchored to either diagnosis-related group code 469 or 470. Under alternative payment models, reimbursement for care episodes is not further risk-adjusted. This study's purpose was to compare outcomes of primary total hip arthroplasty (THA) vs conversion THA to explore the rationale for risk adjustment for conversion procedures. All primary and conversion THAs from 2007 to 2014, excluding acute hip fractures and cancer patients, were identified in the National Surgical Quality Improvement Program database. Conversion and primary THA patients were matched 1:1 using propensity scores, based on preoperative covariates. Multivariable logistic regressions evaluated associations between conversion THA and 30-day outcomes. A total of 2018 conversions were matched to 2018 primaries. There were no differences in preoperative covariates. Conversions had longer operative times (148 vs 95 minutes, P reimbursement models shift toward bundled payment paradigms, conversion THA appears to be a procedure for which risk adjustment is appropriate. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Scoring environmental and socioeconomic impacts of alien plants invasive in Europe

    Czech Academy of Sciences Publication Activity Database

    Rumlerová, Zuzana; Vila, M.; Pergl, Jan; Nentwig, W.; Pyšek, Petr

    2016-01-01

    Roč. 18, č. 12 (2016), s. 3697-3711 ISSN 1387-3547 R&D Projects: GA ČR(CZ) GAP504/11/1028; GA ČR GB14-36079G Grant - others:AV ČR(CZ) AP1002 Program:Akademická prémie - Praemium Academiae Institutional support: RVO:67985939 Keywords : invasion impacts * scoring * Europe Subject RIV: EH - Ecology, Behaviour Impact factor: 2.473, year: 2016

  20. Evaluation of a daily practice composite score for the assessment of Crohn's disease: the treatment impact of certolizumab pegol.

    Science.gov (United States)

    Feagan, B G; Hanauer, S B; Coteur, G; Schreiber, S

    2011-05-01

    Successful treatment of systemic inflammatory symptoms is essential for improving health-related quality of life in patients with active Crohn's disease. Patient-reported outcomes provide unique perspectives on the impact of chronic disease. It is unknown whether a combination of different instruments might improve sensitivity to clinically relevant changes in health status. To develop a composite score based upon Crohn's Disease Activity Index (CDAI) and Inflammatory Bowel Disease Questionnaire (IBDQ) items. Patients from the PRECiSE 2 trial who responded at week 6 to certolizumab pegol (CZP) were randomised to receive treatment with CZP 400 mg or placebo for up to 26 weeks. IBDQ and CDAI scores were assessed at weeks 0, 6, 16 and 26. A 'daily practice' composite score (DP-6) containing two items from the CDAI and four items from IBDQ was constructed. Correlation coefficients between the CDAI score and IBDQ total score at baseline and at week 26 were -0.344 and -0.603, respectively (Pimpact of different treatments on patient-reported outcomes, and to determine if the use of the DP-6 improves the care of patients in clinical practice. © 2011 Blackwell Publishing Ltd.

  1. The Analysis of the Impact of Individual Weighting Factor on Individual Scores

    Science.gov (United States)

    Kilic, Gulsen Bagci; Cakan, Mehtap

    2006-01-01

    In this study, category-based self and peer assessment were applied twice in a semester in an Elementary Science Teaching Methods course in order to assess individual contributions of group members to group projects as well as to analyze the impact of Individual Weighting Factors (IWF) on individual scores and individual grades. IWF were…

  2. The Impact of Overreporting on MMPI-2-RF Substantive Scale Score Validity

    Science.gov (United States)

    Burchett, Danielle L.; Ben-Porath, Yossef S.

    2010-01-01

    This study examined the impact of overreporting on the validity of Minnesota Multiphasic Personality Inventory-2-Restructured Form (MMPI-2-RF) substantive scale scores by comparing correlations with relevant external criteria (i.e., validity coefficients) of individuals who completed the instrument under instructions to (a) feign psychopathology…

  3. Explaining the black-white gap in cognitive test scores: Toward a theory of adverse impact.

    Science.gov (United States)

    Cottrell, Jonathan M; Newman, Daniel A; Roisman, Glenn I

    2015-11-01

    In understanding the causes of adverse impact, a key parameter is the Black-White difference in cognitive test scores. To advance theory on why Black-White cognitive ability/knowledge test score gaps exist, and on how these gaps develop over time, the current article proposes an inductive explanatory model derived from past empirical findings. According to this theoretical model, Black-White group mean differences in cognitive test scores arise from the following racially disparate conditions: family income, maternal education, maternal verbal ability/knowledge, learning materials in the home, parenting factors (maternal sensitivity, maternal warmth and acceptance, and safe physical environment), child birth order, and child birth weight. Results from a 5-wave longitudinal growth model estimated on children in the NICHD Study of Early Child Care and Youth Development from ages 4 through 15 years show significant Black-White cognitive test score gaps throughout early development that did not grow significantly over time (i.e., significant intercept differences, but not slope differences). Importantly, the racially disparate conditions listed above can account for the relation between race and cognitive test scores. We propose a parsimonious 3-Step Model that explains how cognitive test score gaps arise, in which race relates to maternal disadvantage, which in turn relates to parenting factors, which in turn relate to cognitive test scores. This model and results offer to fill a need for theory on the etiology of the Black-White ethnic group gap in cognitive test scores, and attempt to address a missing link in the theory of adverse impact. (c) 2015 APA, all rights reserved).

  4. Method of administration of PROMIS scales did not significantly impact score level, reliability, or validity

    DEFF Research Database (Denmark)

    Bjorner, Jakob B; Rose, Matthias; Gandek, Barbara

    2014-01-01

    OBJECTIVES: To test the impact of the method of administration (MOA) on score level, reliability, and validity of scales developed in the Patient Reported Outcomes Measurement Information System (PROMIS). STUDY DESIGN AND SETTING: Two nonoverlapping parallel forms each containing eight items from......, no significant mode differences were found and all confidence intervals were within the prespecified minimal important difference of 0.2 standard deviation. Parallel-forms reliabilities were very high (ICC = 0.85-0.93). Only one across-mode ICC was significantly lower than the same-mode ICC. Tests of validity...... questionnaire (PQ), personal digital assistant (PDA), or personal computer (PC) and a second form by PC, in the same administration. Method equivalence was evaluated through analyses of difference scores, intraclass correlations (ICCs), and convergent/discriminant validity. RESULTS: In difference score analyses...

  5. Association between Diet-Quality Scores, Adiposity, Total Cholesterol and Markers of Nutritional Status in European Adults: Findings from the Food4Me Study

    Directory of Open Access Journals (Sweden)

    Rosalind Fallaize

    2018-01-01

    Full Text Available Diet-quality scores (DQS, which are developed across the globe, are used to define adherence to specific eating patterns and have been associated with risk of coronary heart disease and type-II diabetes. We explored the association between five diet-quality scores (Healthy Eating Index, HEI; Alternate Healthy Eating Index, AHEI; MedDietScore, MDS; PREDIMED Mediterranean Diet Score, P-MDS; Dutch Healthy Diet-Index, DHDI and markers of metabolic health (anthropometry, objective physical activity levels (PAL, and dried blood spot total cholesterol (TC, total carotenoids, and omega-3 index in the Food4Me cohort, using regression analysis. Dietary intake was assessed using a validated Food Frequency Questionnaire. Participants (n = 1480 were adults recruited from seven European Union (EU countries. Overall, women had higher HEI and AHEI than men (p < 0.05, and scores varied significantly between countries. For all DQS, higher scores were associated with lower body mass index, lower waist-to-height ratio and waist circumference, and higher total carotenoids and omega-3-index (p trends < 0.05. Higher HEI, AHEI, DHDI, and P-MDS scores were associated with increased daily PAL, moderate and vigorous activity, and reduced sedentary behaviour (p trend < 0.05. We observed no association between DQS and TC. To conclude, higher DQS, which reflect better dietary patterns, were associated with markers of better nutritional status and metabolic health.

  6. Impact on quality culture of total quality management practices factors

    Directory of Open Access Journals (Sweden)

    Faihan Mosaad Saud Alotaibi

    2014-09-01

    Full Text Available This study investigated total quality management practices and quality culture of Saudi Arabian contractors. Improving the quality can be achieved through implementation of total quality management although studies and researches work regarding this improvement is still lacking. A quantitative approach using the survey method was employed. With assistance from the Saudi Arabia Ministry of Municipal and Rural Affairs, survey questionnaires were distributed to selected contractors in Saudi Arabia. The collected data were analysed using correlation, and multiple regression analyses. The key findings were the confirmation of significant relationships between all total quality management practices and quality culture and a positive relationship between quality management practices and quality culture. Furthermore, total quality management practices were found to be able to explain 68.1% of the variance in quality culture, while quality culture explained 12.5% of the variance in competitiveness. Quality culture was found to only partially mediate the relationship between total quality management practices and competitiveness.

  7. SENSITIVITY AND SPECIFICITY OF INDIVIDUAL BERG BALANCE ITEMS COMPARED WITH THE TOTAL SCORE TO PREDICT FALLS IN COMMUNITY DWELLING ELDERLY INDIVIDUALS

    Directory of Open Access Journals (Sweden)

    Hazel Denzil Dias

    2014-09-01

    Full Text Available Background: Falls are a major problem in the elderly leading to increased morbidity and mortality in this population. Scores from objective clinical measures of balance have frequently been associated with falls in older adults. The Berg Balance Score (BBS which is a frequently used scale to test balance impairments in the elderly ,takes time to perform and has been found to have scoring inconsistencies. The purpose was to determine if individual items or a group of BBS items would have better accuracy than the total BBS in classifying community dwelling elderly individuals according to fall history. Method: 60 community dwelling elderly individuals were chosen based on a history of falls in this cross sectional study. Each BBS item was dichotomized at three points along the scoring scale of 0 – 4: between scores of 1 and 2, 2 and 3, and 3 and 4. Sensitivity (Sn, specificity (Sp, and positive (+LR and negative (-LR likelihood ratios were calculated for all items for each scoring dichotomy based on their accuracy in classifying subjects with a history of multiple falls. These findings were compared with the total BBS score where the cut-off score was derived from receiver operating characteristic curve analysis. Results: On analysing a combination of BBS items, B9 and B11 were found to have the best sensitivity and specificity when considered together. However the area under the curve of these items was 0.799 which did not match that of the total score (AUC= 0.837. A, combination of 4 BBS items - B9 B11 B12 and B13 also had good Sn and Sp but the AUC was 0.815. The combination with the AUC closest to that of the total score was a combination items B11 and B13. (AUC= 0.824. hence these two items can be used as the best predictor of falls with a cut off of 6.5 The ROC curve of the Total Berg balance Scale scores revealed a cut off score of 48.5. Conclusion: This study showed that combination of items B11 and B13 may be best predictors of falls in

  8. SENSITIVITY AND SPECIFICITY OF INDIVIDUAL BERG BALANCE ITEMS COMPARED WITH THE TOTAL SCORE TO PREDICT FALLS IN COMMUNITY DWELLING ELDERLY INDIVIDUALS

    Directory of Open Access Journals (Sweden)

    Hazel Denzil Dias

    2014-06-01

    Full Text Available Background: Falls are a major problem in the elderly leading to increased morbidity and mortality in this population. Scores from objective clinical measures of balance have frequently been associated with falls in older adults. The Berg Balance Score (BBS which is a frequently used scale to test balance impairments in the elderly ,takes time to perform and has been found to have scoring inconsistencies. The purpose was to determine if individual items or a group of BBS items would have better accuracy than the total BBS in classifying community dwelling elderly individuals according to fall history. Method: 60 community dwelling elderly individuals were chosen based on a history of falls in this cross sectional study. Each BBS item was dichotomized at three points along the scoring scale of 0 – 4: between scores of 1 and 2, 2 and 3, and 3 and 4. Sensitivity (Sn, specificity (Sp, and positive (+LR and negative (-LR likelihood ratios were calculated for all items for each scoring dichotomy based on their accuracy in classifying subjects with a history of multiple falls. These findings were compared with the total BBS score where the cut-off score was derived from receiver operating characteristic curve analysis. Results: On analysing a combination of BBS items, B9 and B11 were found to have the best sensitivity and specificity when considered together. However the area under the curve of these items was 0.799 which did not match that of the total score (AUC= 0.837. A, combination of 4 BBS items - B9 B11 B12 and B13 also had good Sn and Sp but the AUC was 0.815. The combination with the AUC closest to that of the total score was a combination items B11 and B13. (AUC= 0.824. hence these two items can be used as the best predictor of falls with a cut off of 6.5 The ROC curve of the Total Berg balance Scale scores revealed a cut off score of 48.5. Conclusion: This study showed that combination of items B11 and B13 may be best predictors of falls in

  9. Impact Of Total Quality Management (TQM), Activity Based Costing ...

    African Journals Online (AJOL)

    Time (JIT), and Total Quality Management (TQM) as strategic initiatives lead to improved financial performance in the Turkish textile industry. Strong evidence emerged that there is a strong positive association between using ABC, JIT or TQM ...

  10. A validated risk score to estimate mortality risk in patients with dementia and pneumonia: barriers to clinical impact

    NARCIS (Netherlands)

    van der Steen, J.T.; Albers, G.; Strunk, E.; Muller, M.T.; Ribbe, M.W.

    2011-01-01

    Background: The clinical impact of risk score use in end-of-life settings is unknown, with reports limited to technical properties. Methods: We conducted a mixed-methods study to evaluate clinical impact of a validated mortality risk score aimed at informing prognosis and supporting clinicians in

  11. Good validity and reliability of the forgotten joint score in evaluating the outcome of total knee arthroplasty

    DEFF Research Database (Denmark)

    Thomsen, Morten G; Latifi, Roshan; Kallemose, Thomas

    2016-01-01

    . We investigated the validity and reliability of the FJS. Patients and methods - A Danish version of the FJS questionnaire was created according to internationally accepted standards. 360 participants who underwent primary TKA were invited to participate in the study. Of these, 315 were included...... in a validity study and 150 in a reliability study. Correlation between the Oxford knee score (OKS) and the FJS was examined and test-retest evaluation was performed. A ceiling effect was defined as participants reaching a score within 15% of the maximum achievable score. Results - The validity study revealed...... of the FJS (ICC? 0.79). We found a high level of internal consistency (Cronbach's? = 0.96). The ceiling effect for the FJS was 16%, as compared to 37% for the OKS. Interpretation - The FJS showed good construct validity and test-retest reliability. It had a lower ceiling effect than the OKS. The FJS appears...

  12. The colostomy impact score: development and validation of a patient reported outcome measure for rectal cancer patients with a permanent colostomy. A population-based study.

    Science.gov (United States)

    Thyø, A; Emmertsen, K J; Pinkney, T D; Christensen, P; Laurberg, S

    2017-01-01

    The aim was to develop and validate a simple scoring system evaluating the impact of colostomy dysfunction on quality of life (QOL) in patients with a permanent stoma after rectal cancer treatment. In this population-based study, 610 patients with a permanent colostomy after previous rectal cancer treatment during the period 2001-2007 completed two questionnaires: (i) the basic stoma questionnaire consisting of 22 items about stoma function with one anchor question addressing the overall stoma impact on QOL and (ii) the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ) C30. Answers from half of the cohort were used to develop the score and subsequently validated on the remaining half. Logistic regression analyses identified and selected items for the score and multivariate analysis established the score value allocated to each item. The colostomy impact score includes seven items with a total range from 0 to 38 points. A score of ≥ 10 indicates major colostomy impact (Major CI). The score has a sensitivity of 85.7% for detecting patients with significant stoma impact on QOL. Using the EORTC QLQ scales, patients with Major CI experienced significant impairment in their QOL compared to the Minor CI group. This new scoring system appears valid for the assessment of the impact on QOL from having a permanent colostomy in a Danish rectal cancer population. It requires validation in non-Danish populations prior to its acceptance as a valuable patient-reported outcome measure for patients internationally. Colorectal Disease © 2016 The Association of Coloproctology of Great Britain and Ireland.

  13. Impact of a new simplified disability scoring system for adult patients with localized scleroderma.

    Science.gov (United States)

    Okiyama, Naoko; Asano, Yoshihide; Hamaguchi, Yasuhito; Jinnin, Masatoshi; Motegi, Sei-Ichiro; Koizumi, Haruka; Hasegawa, Minoru; Ishikawa, Osamu; Sato, Shinichi; Takehara, Kazuhiko; Yamamoto, Toshiyuki; Fujimoto, Manabu; Ihn, Hironobu

    2018-04-01

    Localized scleroderma (LoS) involves dermal but not internal inflammation and fibrosis. Cosmetic changes often impact quality of life (QOL), however, impairment of activities of daily living (ADL) in LoS patients has not been investigated. To determine what factor(s) are associated with ADL in adult patients with LoS, we performed a retrospective observational study in 177 Japanese adult LoS patients using a novel LoS disability score based on Barthel's indices of ADL: feeding, bathing, grooming, dressing, bowels, bladder, toilet use, transfers, mobility and stairs. LoS disability scores increased in proportion to the number of affected body parts but were not correlated to age and duration of illness. The presence of leg lesions significantly impaired ADL of LoS patients compared with lesions on other body parts. Patients treated with systemic medications, who tended to have multiple lesions, presented higher LoS disability scores than those without systemic treatments. Our study proposes that physicians evaluate ADL, not only QOL, in LoS patients. Our findings using LoS disability scoring indicate that multiple affected body parts and leg lesions are risk factors for ADL impairment. © 2018 Japanese Dermatological Association.

  14. Association between the COMT Val158Met polymorphism and fibromyalgia susceptibility and fibromyalgia impact questionnaire score: a meta-analysis.

    Science.gov (United States)

    Lee, Young Ho; Kim, Jae-Hoon; Song, Gwan Gyu

    2015-01-01

    The aim of this study was to explore whether the catechol-O-methyltransferase (COMT) Val158Met polymorphism is associated with susceptibility to fibromyalgia and fibromyalgia impact questionnaire (FIQ) score in fibromyalgia patients. We conducted a meta-analysis of the associations of the COMT Val158Met polymorphism with fibromyalgia risk as well as FIQ score in fibromyalgia patients. A total of 993 fibromyalgia patients and 778 controls from 10 studies on the COMT Val158Met polymorphism and 538 fibromyalgia patients from 5 studies on the COMT Val158Met polymorphism and FIQ score were included in this meta-analysis. The meta-analysis revealed an association between fibromyalgia and the COMT Met/Met + Val/Met genotype in all study subjects (odds ratio (OR) 1.635, 95 % confidence interval (CI) 1.029-2.597, p = 0.037). However, stratification by ethnicity indicated no association between the Met/Met + Val/Met genotype and fibromyalgia in the European and Turkish populations (OR 1.202, 95 % CI 0.876-1.649, p = 0.255; OR 2.132, 95 % CI 0.764-5.949, p = 0.148, respectively). Analysis using other genetic models showed no association between the COMT Val158Met polymorphism and fibromyalgia. The meta-analysis also revealed that the FIQ score was significantly higher in individuals with the COMT Met/Met genotype than in those with the Val/Val genotype [weighted mean difference (WMD) = 14.39, 95 % CI 3.316-25.48, p = 0.011] and the Val/Met genotype (WMD = 5.108, 95 % CI 2.212-4.891, p = 0.021). This meta-analysis identified an association between fibromyalgia risk and the COMT Val158Met polymorphism as well as the FIQ score in fibromyalgia patients.

  15. Prognostic impact of controlling nutritional status score in resected lung squamous cell carcinoma.

    Science.gov (United States)

    Toyokawa, Gouji; Kozuma, Yuka; Matsubara, Taichi; Haratake, Naoki; Takamori, Shinkichi; Akamine, Takaki; Takada, Kazuki; Katsura, Masakazu; Shimokawa, Mototsugu; Shoji, Fumihiro; Okamoto, Tatsuro; Maehara, Yoshihiko

    2017-09-01

    The preoperative immune-nutritional status has been shown to predict the postoperative prognosis in various types of cancer; however, the prognostic significance of the controlling nutritional status (CONUT) score in resected lung squamous cell carcinoma (SCC) has yet to be elucidated. A total of 108 patients with resected lung SCC were analyzed for their clinicopathological factors, including the CONUT score, which can be calculated from the serum albumin, total cholesterol, and total peripheral lymphocyte count. The patients were divided into two groups: CONUT low (0 or 1) or high (≥2). Among 108 patients, 76 (70.4%) were CONUT low, while 32 (29.6%) were CONUT high. No significant association between the CONUT score and the clinicopathological factors was found. Patients with CONUT high exhibited significantly shorter disease-free and overall survivals (DFS and OS) than those with CONUT low (P=0.016 and P=0.006, respectively). Multivariate analyses showed that the CONUT score [hazard ratio (HR): 1.902, 95% confidence interval (CI): 1.045-3.373, P=0.036], age (HR: 2.286, 95% CI: 1.246-4.304, P=0.007), pathological stage (HR: 2.527, 95% CI: 1.391-4.644, P=0.002), and lymphatic invasion (HR: 2.321, 95% CI: 1.110-4.493, P=0.027) were independent prognostic factors for the DFS. Furthermore, in a multivariate analysis, the CONUT score (HR: 1.909, 95% CI: 0.902-3.860, P=0.081), age (HR: 2.455, 95% CI: 1.208-5.178, P=0.013), pathological stage (HR: 2.488, 95% CI: 1.201-5.306, P=0.014), and lymphatic invasion (HR: 3.409, 95% CI: 1.532-7.240, P=0.004) were shown to be independent prognostic factors for the OS. The current study showed that the CONUT score was an independent prognostic factor for the DFS and OS in patients with resected lung SCC.

  16. The Short-run Impact on Total Factor Productivity Growth

    DEFF Research Database (Denmark)

    Fosse, Henrik Barslund; Jacobsen, Joannes; Højbjerg Jacobsen, Rasmus

    This project was prepared for The Danish Agency for Science, Technology and Innovation (DASTI) under The Ministry of Science, Innovation and Higher Education. The scope of the project was to conduct the first comprehensive productivity impact assessment of the Danish system of innovation...

  17. The impact of total laryngectomy: the patient's perspective.

    LENUS (Irish Health Repository)

    Noonan, Brendan J

    2012-02-01

    PURPOSE\\/OBJECTIVES: To describe the experiences of patients who had total laryngectomy from their perspective. RESEARCH APPROACH: Descriptive, qualitative study.Setting: Participants\\' homes or investigator\\'s hospital office. PARTICIPANTS: 10 patients after total laryngectomy. METHODOLOGIC APPROACH: Data were collected by semistructured, open-ended interviews during a period of six months, with an interview topic guide built on the framework of the literature review. Data were analyzed with descriptive content analysis. Trustworthiness of the study was enhanced through the use of verbatim quotations, audible data analysis trail, and a reflexive approach. MAIN RESEARCH VARIABLES: Patients\\' experiences of undergoing total laryngectomy. FINDINGS: Patients who have undergone a total laryngectomy report difficulties and concerns that are largely functional and psychological. The functional difficulties reported included descriptions of altered swallow, excess phlegm, speech difficulties, weak neck muscles, and altered energy levels. The psychological concerns reported included descriptions of depression, regrets, and personal resolve. CONCLUSIONS: As a group, patients experience a broad range of problems well after completion of treatment, reinforcing the need for rehabilitation management for prolonged periods after surgery. INTERPRETATION: Nurses are suitably positioned to support this group of patients across the disease management trajectory, from the initial preoperative period to the postoperative period and through to the rehabilitative period and beyond.

  18. Impact of total quality management on students' academic ...

    African Journals Online (AJOL)

    Low academic performance of secondary school students in our society has been the greatest challenges facing the educational system in the country. The challenges associated with the country's educational performance especially at the secondary schools could be improved upon if total quality management control is ...

  19. The impact of embedded total productive maintenance with six ...

    African Journals Online (AJOL)

    The purpose of the work presented in this paper is to capture the current state of Six Sigma and Total Productive Maintenance (TPM) as well as to propose the embedded approach of Six Sigma and TPM on improving supply chain performance. The approach to this paper is to answer the questions such as “how does TPM ...

  20. Pattern analysis of total item score and item response of the Kessler Screening Scale for Psychological Distress (K6 in a nationally representative sample of US adults

    Directory of Open Access Journals (Sweden)

    Shinichiro Tomitaka

    2017-02-01

    Full Text Available Background Several recent studies have shown that total scores on depressive symptom measures in a general population approximate an exponential pattern except for the lower end of the distribution. Furthermore, we confirmed that the exponential pattern is present for the individual item responses on the Center for Epidemiologic Studies Depression Scale (CES-D. To confirm the reproducibility of such findings, we investigated the total score distribution and item responses of the Kessler Screening Scale for Psychological Distress (K6 in a nationally representative study. Methods Data were drawn from the National Survey of Midlife Development in the United States (MIDUS, which comprises four subsamples: (1 a national random digit dialing (RDD sample, (2 oversamples from five metropolitan areas, (3 siblings of individuals from the RDD sample, and (4 a national RDD sample of twin pairs. K6 items are scored using a 5-point scale: “none of the time,” “a little of the time,” “some of the time,” “most of the time,” and “all of the time.” The pattern of total score distribution and item responses were analyzed using graphical analysis and exponential regression model. Results The total score distributions of the four subsamples exhibited an exponential pattern with similar rate parameters. The item responses of the K6 approximated a linear pattern from “a little of the time” to “all of the time” on log-normal scales, while “none of the time” response was not related to this exponential pattern. Discussion The total score distribution and item responses of the K6 showed exponential patterns, consistent with other depressive symptom scales.

  1. The Impact of Total Risk Management on Company's Performance

    OpenAIRE

    Mohammed, Hamdu Kedir; Knapkova, Adriana

    2016-01-01

    Traditionally risk management used to be considered as a means to alleviate perhaps eliminate negative outcomes of exposures. However, the result of this and other empirical studies shows the ability of risk management to go beyond this and respond to market factors which are out of management control in order to control volatilities in earning which ultimately improve corporate performance. The empirical study investigates the relationship between total risk management and company's performa...

  2. Impact of total laryngectomy on return to work.

    Science.gov (United States)

    Costa, Jose Miguel; López, Montserrat; García, Jacinto; León, Xavier; Quer, Miquel

    Total laryngectomy is one of the most mutilating oncological operations. There are no specific studies evaluating return to work after this surgery. A cross-sectional study was performed on a sample of 116 laryngectomized patients who were disease- free and had a minimum follow-up of 2 years from total laryngectomy. A survey was conducted to find out their employment situation before and after surgery. At the time of surgery, 62 (53%) were working, 40 (35%) were retired and 14 (12%) were in a disability situation. 60% had professions with low qualification requirements, the largest group being construction workers. Of the 62 patients active at the time of total laryngectomy, 29 became inactive and 33 (53%) maintained their work activity. The most important factors in maintaining work activity were the level of professional qualification and the method of vocal rehabilitation. Eighty percent of the patients with high-intermediate qualification maintained their jobs, compared to 35% of those with low professional qualifications (Pde Otorrinolaringología y Cirugía de Cabeza y Cuello. All rights reserved.

  3. The Impact of Personality Traits on the Outcome of Total Knee Arthroplasty.

    Science.gov (United States)

    Giurea, A; Fraberger, G; Kolbitsch, P; Lass, R; Schneider, E; Kubista, B; Windhager, R

    2016-01-01

    Ten to twenty percent of patients with total knee arthroplasty (TKA) are dissatisfied with their clinical outcome. Aim of this study was to investigate the impact of personality traits on the subjective outcome of TKA. We investigated 80 patients with 86 computer navigated TKAs. We asked for patients satisfaction and divided patients into two groups (satisfied or dissatisfied). 12 personality traits were tested by the Freiburg Personality Inventory (FPI-R). Postoperative examination included Knee Society Score (KSS), Western Ontario and McMaster University Osteoarthritis Index (WOMAC), and the Visual Analogue Scale (VAS). Radiologic investigation was done in all patients. 84% of our patients were satisfied, while 16% were not satisfied. The FPI-R showed statistical significant influence of four personality traits on patient satisfaction: life satisfaction (p = 0.006), performance orientation (p = 0.015), somatic distress (p = 0.001), and emotional stability (p = 0.002). All clinical scores (VAS, WOMAC, and KSS) showed significantly better results in the satisfied patient. Radiological examination showed optimal alignment of all TKAs. There were no complications requiring revision surgery. The results of our study show that personality traits may influence patients satisfaction and clinical outcome after TKA. Therefore patients personality traits may be a useful predictive factor for postoperative satisfaction after TKA.

  4. Validation of the total dysphagia risk score (TDRS) in head and neck cancer patients in a conventional and a partially accelerated radiotherapy scheme

    NARCIS (Netherlands)

    Nevens, Daan; Deschuymer, Sarah; Langendijk, Johannes A.; Daisne, Jean -Francois; Duprez, Frederic; De Neve, Wilfried; Nuyts, Sandra

    Background and purpose: A risk model, the total dysphagia risk score (TDRS), was developed to predict which patients are most at risk to develop grade >= 2 dysphagia at 6 months following radiotherapy (RT) for head and neck cancer. The purpose of this study was to validate this model at 6 months and

  5. Pharmacokinetic-pharmacodynamic modeling of antipsychotic drugs in patients with schizophrenia Part I : The use of PANSS total score and clinical utility

    NARCIS (Netherlands)

    Reddy, Venkatesh Pilla; Kozielska, Magdalena; Suleiman, Ahmed Abbas; Johnson, Martin; Vermeulen, An; Liu, Jing; de Greef, Rik; Groothuis, Geny M. M.; Danhof, Meindert; Proost, Johannes H.

    Background: To develop a pharmacokinetic-pharmacodynamic (PK-PD) model using individual-level data of Positive and Negative Syndrome Scale (PANSS) total score to characterize the antipsychotic drug effect taking into account the placebo effect and dropout rate. In addition, a clinical utility (CU)

  6. Achilles tendon Total Rupture Score at 3 months can predict patients' ability to return to sport 1 year after injury

    DEFF Research Database (Denmark)

    Hansen, Maria Swennergren; Christensen, Marianne; Budolfsen, Thomas

    2016-01-01

    PURPOSE: To investigate how the Achilles tendon Total Rupture Score (ATRS) at 3 months and 1 year after injury is associated with a patient's ability to return to work and sports as well as to investigate whether sex and age influence ATRS after 3 months and 1 year. METHOD: This is a retrospectiv...

  7. Complex versus Simple Modeling for DIF Detection: When the Intraclass Correlation Coefficient (?) of the Studied Item Is Less Than the ? of the Total Score

    Science.gov (United States)

    Jin, Ying; Myers, Nicholas D.; Ahn, Soyeon

    2014-01-01

    Previous research has demonstrated that differential item functioning (DIF) methods that do not account for multilevel data structure could result in too frequent rejection of the null hypothesis (i.e., no DIF) when the intraclass correlation coefficient (?) of the studied item was the same as the ? of the total score. The current study extended…

  8. Environmental and health impacts of fine and ultrafine metallic particles: Assessment of threat scores

    Energy Technology Data Exchange (ETDEWEB)

    Goix, Sylvaine [Université de Toulouse, INP-ENSAT, Av. Agrobiopôle, 31326 Castanet-Tolosan (France); UMR 5245 CNRS-INP-UPS, EcoLab (Laboratoire d' écologie fonctionnelle), Avenue de l' Agrobiopôle, BP 32607, 31326 Castanet-Tolosan (France); Lévêque, Thibaut [Université de Toulouse, INP-ENSAT, Av. Agrobiopôle, 31326 Castanet-Tolosan (France); UMR 5245 CNRS-INP-UPS, EcoLab (Laboratoire d' écologie fonctionnelle), Avenue de l' Agrobiopôle, BP 32607, 31326 Castanet-Tolosan (France); ADEME (French Agency for Environment and Energy Management), 20 Avenue du Grésillé, BP 90406, 49004 Angers Cedex 01 (France); Xiong, Tian-Tian [Université de Toulouse, INP-ENSAT, Av. Agrobiopôle, 31326 Castanet-Tolosan (France); UMR 5245 CNRS-INP-UPS, EcoLab (Laboratoire d' écologie fonctionnelle), Avenue de l' Agrobiopôle, BP 32607, 31326 Castanet-Tolosan (France); Schreck, Eva [Géosciences Environnement Toulouse (GET), Observatoire Midi Pyrénées, Université de Toulouse, CNRS, IRD, 14 Avenue E. Belin, F-31400 Toulouse (France); and others

    2014-08-15

    This study proposes global threat scores to prioritize the harmfulness of anthropogenic fine and ultrafine metallic particles (FMP) emitted into the atmosphere at the global scale. (Eco)toxicity of physicochemically characterized FMP oxides for metals currently observed in the atmosphere (CdO, CuO, PbO, PbSO{sub 4}, Sb{sub 2}O{sub 3}, and ZnO) was assessed by performing complementary in vitro tests: ecotoxicity, human bioaccessibility, cytotoxicity, and oxidative potential. Using an innovative methodology based on the combination of (eco)toxicity and physicochemical results, the following hazard classification of the particles is proposed: CdCl{sub 2}∼CdO>CuO>PbO>ZnO>PbSO{sub 4}>Sb{sub 2}O{sub 3}. Both cadmium compounds exhibited the highest threat score due to their high cytotoxicity and bioaccessible dose, whatever their solubility and speciation, suggesting that cadmium toxicity is due to its chemical form rather than its physical form. In contrast, the Sb{sub 2}O{sub 3} threat score was the lowest due to particles with low specific area and solubility, with no effects except a slight oxidative stress. As FMP physicochemical properties reveal differences in specific area, crystallization systems, dissolution process, and speciation, various mechanisms may influence their biological impact. Finally, this newly developed and global approach could be widely used in various contexts of pollution by complex metal particles and may improve risk management. - Highlights: • Seven micro- and nano- monometallic characterized particles were studied as references. • Bioaccessibility, eco and cytotoxicity, and oxidative potential assays were performed. • According to calculated threat scores: CdCl{sub 2}∼CdO>CuO>PbO>ZnO>PbSO{sub 4}>Sb{sub 2}O{sub 3}.

  9. Impact of socioeconomic factors on outcome of total knee arthroplasty.

    Science.gov (United States)

    Barrack, Robert L; Ruh, Erin L; Chen, Jiajing; Lombardi, Adolph V; Berend, Keith R; Parvizi, Javad; Della Valle, Craig J; Hamilton, William G; Nunley, Ryan M

    2014-01-01

    Few data exist regarding the impact of socioeconomic factors on results of current TKA in young patients. Predictors of TKA outcomes have focused primarily on surgical technique, implant details, and individual patient clinical factors. The relative importance of these factors compared to patient socioeconomic status is not known. We determined whether (1) socioeconomic factors, (2) demographic factors, or (3) implant factors were associated with satisfaction and functional outcomes after TKA in young patients. We surveyed 661 patients (average age, 54 years; range, 18-60 years; 61% female) 1 to 4 years after undergoing modern primary TKA for noninflammatory arthritis at five orthopaedic centers. Data were collected by an independent third party with expertise in collecting healthcare data for state and federal agencies. We examined specific questions regarding satisfaction, pain, and function after TKA and socioeconomic (household income, education, employment) and demographic (sex, minority status) factors. Multivariable analysis was conducted to examine the relative importance of these factors for each outcome of interest. Patients reporting incomes of less than USD 25,000 were less likely to be satisfied with TKA outcomes and more likely to have functional limitations after TKA than patients with higher incomes; no other socioeconomic factors were associated with satisfaction. Women were less likely to be satisfied and more likely to have functional limitations than men, and minority patients were more likely to have functional limitations than nonminority patients. Implants were not associated with outcomes after surgery. Socioeconomic factors, in particular low income, are more strongly associated with satisfaction and functional outcomes in young patients after TKA than demographic or implant factors. Future studies should be directed to determining the causes of this association, and studies of clinical results after TKA should consider stratifying patients

  10. Standardized Total Average Toxicity Score: A Scale- and Grade-Independent Measure of Late Radiotherapy Toxicity to Facilitate Pooling of Data From Different Studies

    Energy Technology Data Exchange (ETDEWEB)

    Barnett, Gillian C., E-mail: gillbarnett@doctors.org.uk [University of Cambridge Department of Oncology, Oncology Centre, Cambridge (United Kingdom); Cancer Research-UK Centre for Genetic Epidemiology and Department of Oncology, Strangeways Research Laboratories, Cambridge (United Kingdom); West, Catharine M.L. [School of Cancer and Enabling Sciences, Manchester Academic Health Science Centre, University of Manchester, Christie Hospital, Manchester (United Kingdom); Coles, Charlotte E. [University of Cambridge Department of Oncology, Oncology Centre, Cambridge (United Kingdom); Pharoah, Paul D.P. [Cancer Research-UK Centre for Genetic Epidemiology and Department of Oncology, Strangeways Research Laboratories, Cambridge (United Kingdom); Talbot, Christopher J. [Department of Genetics, University of Leicester, Leicester (United Kingdom); Elliott, Rebecca M. [School of Cancer and Enabling Sciences, Manchester Academic Health Science Centre, University of Manchester, Christie Hospital, Manchester (United Kingdom); Tanteles, George A. [Department of Clinical Genetics, University Hospitals of Leicester, Leicester (United Kingdom); Symonds, R. Paul [Department of Cancer Studies and Molecular Medicine, University Hospitals of Leicester, Leicester (United Kingdom); Wilkinson, Jennifer S. [University of Cambridge Department of Oncology, Oncology Centre, Cambridge (United Kingdom); Dunning, Alison M. [Cancer Research-UK Centre for Genetic Epidemiology and Department of Oncology, Strangeways Research Laboratories, Cambridge (United Kingdom); Burnet, Neil G. [University of Cambridge Department of Oncology, Oncology Centre, Cambridge (United Kingdom); Bentzen, Soren M. [University of Wisconsin, School of Medicine and Public Health, Department of Human Oncology, Madison, WI (United States)

    2012-03-01

    Purpose: The search for clinical and biologic biomarkers associated with late radiotherapy toxicity is hindered by the use of multiple and different endpoints from a variety of scoring systems, hampering comparisons across studies and pooling of data. We propose a novel metric, the Standardized Total Average Toxicity (STAT) score, to try to overcome these difficulties. Methods and Materials: STAT scores were derived for 1010 patients from the Cambridge breast intensity-modulated radiotherapy trial and 493 women from University Hospitals of Leicester. The sensitivity of the STAT score to detect differences between patient groups, stratified by factors known to influence late toxicity, was compared with that of individual endpoints. Analysis of residuals was used to quantify the effect of these covariates. Results: In the Cambridge cohort, STAT scores detected differences (p < 0.00005) between patients attributable to breast volume, surgical specimen weight, dosimetry, acute toxicity, radiation boost to tumor bed, postoperative infection, and smoking (p < 0.0002), with no loss of sensitivity over individual toxicity endpoints. Diabetes (p = 0.017), poor postoperative surgical cosmesis (p = 0.0036), use of chemotherapy (p = 0.0054), and increasing age (p = 0.041) were also associated with increased STAT score. When the Cambridge and Leicester datasets were combined, STAT was associated with smoking status (p < 0.00005), diabetes (p = 0.041), chemotherapy (p = 0.0008), and radiotherapy boost (p = 0.0001). STAT was independent of the toxicity scale used and was able to deal with missing data. There were correlations between residuals of the STAT score obtained using different toxicity scales (r > 0.86, p < 0.00005 for both datasets). Conclusions: The STAT score may be used to facilitate the analysis of overall late radiation toxicity, from multiple trials or centers, in studies of possible genetic and nongenetic determinants of radiotherapy toxicity.

  11. The Impact of an Academic Integrity Module and Turnitin® on Similarity Index Scores of Undergraduate Student Papers

    Science.gov (United States)

    Ballard, Iva B.

    2013-01-01

    In this quasi-experimental 2 x 2 factorial design study, the impact of an academic integrity module and Turnitin® on undergraduate student similarity index scores was investigated. Similarity index scores were used to measure suggested plagiarism rates of student papers. A purposive sample consisting of 96 undergraduate education students enrolled…

  12. Public R&D Policy Impact Evaluation:Propensity Score Matching and Structural Modeling Estimations

    OpenAIRE

    Ilbeigi, Alireza

    2017-01-01

    This dissertation is about public research and development (R&D) subsidies to support private firms doing innovative activities and quantitative impact evaluation of the policy on total factor productivity (TFP) change and additional R&D effort. Public R&D subsidization as a public R&D policy, beside different types of public interventions, has been widely used by governments to stimulate private R&D. These policies aim to fill the gap between the private and social rates of returns by encour...

  13. No impact of perioperative blood transfusion on prognosis after curative resection for hepatocellular carcinoma: a propensity score matching analysis.

    Science.gov (United States)

    Peng, T; Zhao, G; Wang, L; Wu, J; Cui, H; Liang, Y; Zhou, R; Liu, Z; Wang, Q

    2017-10-27

    The relationship between perioperative blood transfusion and long-term survival after curative resection for hepatocellular carcinoma (HCC) remains controversial. The aim of the present study was to investigate the impact of blood transfusion on the long-term prognosis of HCC patients. Patients with primary HCC who underwent a curative hepatectomy from 2003 to 2011 were enrolled and then retrospectively studied. The clinicopathologic characteristics between patients in the blood transfusion and non-transfusion groups were matched using a propensity score matching (PSM) analysis. Univariate and multivariate Cox regression analyses were used to identify whether perioperative blood transfusion affects long-term survival after resection for HCC. A total of 374 patients were enrolled and 113 patients received perioperative transfusions. The 1-, 3- and 5-year disease-free and overall survival rates of the entire cohort were 65.0, 37.3 and 23.9%, and 90.9, 70.7 and 57.5%, respectively. The disease-free and overall survival rates of the blood transfusion group were significantly worse than the disease-free and overall survival rates of the non-transfusion group in the entire cohort (p blood transfusion was not an independent predictor of disease-free and overall survival in the propensity-matched cohort (p = 0.154, p = 0.667). The present study demonstrates that perioperative blood transfusion has no impact on disease-free and overall survival after curative resection for HCC.

  14. THE IMPACT OF THE MELD SCORE ON LIVER TRANSPLANT ALLOCATION AND RESULTS: AN INTEGRATIVE REVIEW.

    Science.gov (United States)

    Moraes, Ana Claudia Oliveira de; Oliveira, Priscilla Caroliny de; Fonseca-Neto, Olival Cirilo Lucena da

    2017-01-01

    Liver transplantation is intended to increase the survival of patients with chronic liver disease in terminal phase, as well as improved quality of life. Since the first transplant until today many changes have occurred in the organ allocation system. To review the literature on the Model for End-stage Liver Disease (MELD) and analyze its correlation with survival after liver transplantation. An integrative literature review in Lilacs, SciELO, and Pubmed in October 2015, was realized. Were included eight studies related to the MELD score and its impact on liver transplant. There was predominance of transplants in male between 45-55 y. The main indications were hepatitis C, hepatocellular carcinoma and alcoholic cirrhosis. The most important factors post-surgery were related to the MELD score, the recipient age, expanded donor criteria and hemotransfusion. The MELD system reduced the death rate in patients waiting for a liver transplant. However, this score by itself is not a good predictor of survival after liver transplantation. O transplante de fígado tem como finalidade o aumento da sobrevida dos pacientes com doença hepática crônica em fase terminal, além de melhora na qualidade de vida. Desde o primeiro transplante até os dias atuais, muitas mudanças ocorreram no sistema de alocação de órgãos. Analisar o conhecimento produzido sobre o Model for End-stage Liver Disease (MELD) e a sua relação com a sobrevida no pós-transplante de fígado. Realizou-se revisão integrativa nas bases de dados Lilacs, SciELO e Pubmed no mês de outubro de 2015. A amostra contou com oito estudos relacionando o escore MELD e o seu impacto no transplante de fígado. Houve predomínio dos transplantes realizados em homens e faixa etária entre 45-55 anos. Como principais indicações tem-se hepatite C, hepatocarcinoma e cirrose por álcool. Os fatores que tiveram maior impacto no pós-operatório estão associados ao alto valor do MELD, idade do receptor, crit

  15. Equity in interviews: do personal characteristics impact on admission interview scores?

    Science.gov (United States)

    Lumb, Andrew B; Homer, Matthew; Miller, Amy

    2010-11-01

    Research indicates that some social groups are disadvantaged by medical school selection systems. The stage(s) of a selection process at which this occurs is unknown, but at interview, when applicant and interviewer are face-to-face, there is potential for social bias to occur. We performed a detailed audit of the interview process for a single-entry year to a large UK medical school. Our audit included investigating the personal characteristics of both interviewees and interviewers to find out whether any of these factors, including the degree of social matching between individual pairs of interviewees and interviewers, influenced the interview scores awarded. A total of 320 interviewers interviewed 734 applicants, providing complete data for 2007 interviewer-interviewee interactions. The reliability of the interview process was estimated using generalisability theory at 0.82-0.87. For both interviewers and interviewees, gender, ethnic background, socio-economic group and type of school attended had no influence on the interview scores awarded or achieved. Staff and student interviewer marks did not differ significantly. Although numbers in each group of staff interviewers were too small for formal statistical analysis, there were no obvious differences in marks awarded between different medical specialties or between interviewers with varying amounts of interviewing experience. Our data provide reassurance that the interview does not seem to be the stage of selection at which some social groups are disadvantaged. These results support the continued involvement of senior medical students in the interview process. Despite the lack of evidence that an interview is useful for predicting future academic or clinical success, most medical schools continue to use interviews as a fundamental component of their selection process. Our study has shown that at least this arguably misplaced reliance upon interviewing is not introducing further social bias into the selection

  16. Delineating the impact of obesity and its relationship on recovery after total joint arthroplasties.

    Science.gov (United States)

    Jones, C A; Cox, V; Jhangri, G S; Suarez-Almazor, M E

    2012-06-01

    The primary aim of this study was to determine the impact of obesity in predicting short and long-term pain relief and functional recovery in total joint arthroplasty (TJA) either as an independent risk factor or a factor mediated by two chronic conditions associated with obesity-cardiac disease and diabetes mellitus. A prospective observational study of 520 patients with primary joint arthroplasties. Pain and functional outcomes were evaluated with the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index within a month of surgery and then 6 months and 3 years post-operatively. Obesity, cardiac disease and diabetes mellitus were examined as potential risk factors for poor recovery. Patients were classified into four groups based on body mass index (BMI): (normaloverweight 25.0-29.9 kg/m(2); obese Class 1 30.0-34.9 kg/m(2); severe obese Class 2&3 35.0 ≥ kg/m(2)). Linear mixed models for each joint type (hip and knee arthroplasty) were developed to examine the pattern of recovery and the effect of obesity. Ninety-nine (19%) patients were severely obese, 127 (24%) had cardiac disease and 58 (11%) had diabetes mellitus. Baseline pain and functional scores were similar regardless of BMI classification. Severe obesity was a significant risk factor for worse pain and functional recovery at 6 months but no longer at 3 years following total hip and knee arthroplasty. Cardiac disease predicted a slower recovery after hip arthroplasty. No significant interactions existed between obesity and cardiac disease or diabetes mellitus. Severe obesity is an independent risk factor for slow recovery over 3 years for both hip and knee arthroplasties. Copyright © 2012 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  17. Making the Cut in Gifted Selection: Score Combination Rules and Their Impact on Program Diversity

    Science.gov (United States)

    Lakin, Joni M.

    2018-01-01

    The recommendation of using "multiple measures" is common in policy guidelines for gifted and talented assessment systems. However, the integration of multiple test scores in a system that uses cut-scores requires choosing between different methods of combining quantitative scores. Past research has indicated that OR combination rules…

  18. Intra- and inter-rater reliability of the Knee Society Knee Score when used by two physiotherapists in patients post total knee arthroplasty

    Directory of Open Access Journals (Sweden)

    S. Gopal

    2010-01-01

    Full Text Available Background and Purpose: It has yet to be shown whether routine physiotherapy plays a role in the rehabilitation of patients post totalknee arthroplasty (Rajan et al 2004. Physiotherapists should be using validoutcome measures to provide evidence of the benefit of their intervention. The aim of this study was to establish the intra and inter-rater reliability of the Knee Society Knee Score, a scoring system developed by Insall et al(1989. The Knee Society Knee Score can be used to assess the integrity of theknee joint of patients undergoing total knee arthroplasty. Since the scoreinvolves clinical testing, the intra-rater reliability of the clinician should be established prior to using the scores as datain clinical research. W here multiple clinicians are involved, inter-rater reliability should also be established.Design: This was a correlation study.Subjects: A  sample of thirty patients post total knee arthroplasty attending the arthroplasty clinic at Johannesburg Hospital between six weeks and twelve months postoperatively.M ethod: Recruited patients were evaluated twice with a time interval of one hour between each assessment. Statistical A nalysis: The intra- and inter-rater reliability were estimated using Intraclass Correlation Coefficient (ICC. R esults: The intra-rater reliability showed excellent reliability (h= 0.95 for Examiner A  and good reliability (h= 0.71for Examiner B. The inter-rater reliability showed moderate reliability (h= 0.67 during test one and h= 0.66 during test two.Conclusion: The KSKS has good intra-rater reliability when tested within a period of one hour. The KSKS demonstrated moderate agreement for inter rater reliability.

  19. Impact scores of invasive plants are biased by disregard of environmental co-variation and non-linearity

    Directory of Open Access Journals (Sweden)

    Jan Thiele

    2011-10-01

    Full Text Available Prioritisation of high-impact species is becoming increasingly important for management of introduced species (‘neobiota’ because of their growing number of which, however, only a small fraction has substantial impacts. Impact scores for prioritising species may be affected by the type of effect model used. Recent studies have shown that environmental co-variation and non-linearity may be significant for effect models of biological invasions. Here, we test for differences in impact scores between simple and complex effect models of three invasive plant species (Heracleum mantegazzianum, Lupinus polyphyllus, Rosa rugosa.We investigated the effects of cover percentages of the invasive plants on species richness of invaded communities using both simple linear effect models (‘basic models’ and more complex linear or non-linear models including environmental co-factors (‘full models’. Then, we calculated impact scores for each invasive species as the average reduction of species richness predicted by basic and full effect models.All three non-native species had negative effects on species richness, but the full effect models also indicated significant influence of habitat types. Heracleum mantegazzianum had uniform linear effects in all habitats, while effects of L. polyphyllus interacted strongly with habitat type, and R. rugosa showed a marked non-linear relationship. Impact scores were overestimated by basic effect models for H. mantegazzianum and R. rugosa due to disregard of habitat effects and non-linearity, respectively. In contrast, impact of L. polyphyllus was underestimated by the basic model that did not account for the strong interaction of invader cover and habitat type.We conclude that simple linear models will often yield inaccurate impact scores of non-native species. Hence, effect models should consider environmental co-variation and, if necessary, non-linearity of the effects of biological invasions on native ecosystems.

  20. A propensity score analysis of the impact of surgical intervention on unexpected 30-day readmission following admission for subdural hematoma.

    Science.gov (United States)

    Franko, Lynze R; Sheehan, Kyle M; Roark, Christopher D; Joseph, Jacob R; Burke, James F; Rajajee, Venkatakrishna; Williamson, Craig A

    2017-12-22

    OBJECTIVE Subdural hematoma (SDH) is a common disease that is increasingly being managed nonoperatively. The all-cause readmission rate for SDH has not previously been described. This study seeks to describe the incidence of unexpected 30-day readmission in a cohort of patients admitted to an academic neurosurgical center. Additionally, the relationship between operative management, clinical outcome, and unexpected readmission is explored. METHODS This is an observational study of 200 consecutive adult patients with SDH admitted to the neurosurgical ICU of an academic medical center. Demographic information, clinical characteristics, and treatment strategies were compared between readmitted and nonreadmitted patients. Multivariable logistic regression, weighted by the inverse probability of receiving surgery using propensity scores, was used to evaluate the association between operative management and unexpected readmission. RESULTS Of 200 total patients, 18 (9%) died during hospitalization and were not included in the analysis. Overall, 48 patients (26%) were unexpectedly readmitted within 30 days. Sixteen patients (33.3%) underwent SDH evacuation during their readmission. Factors significantly associated with unexpected readmission were nonoperative management (72.9% vs 54.5%, p = 0.03) and female sex (50.0% vs 32.1%, p = 0.03). In logistic regression analysis weighted by the inverse probability of treatment and including likely confounders, surgical management was not associated with likelihood of a good outcome at hospital discharge, but was associated with significantly reduced odds of unexpected readmission (OR 0.19, 95% CI 0.08-0.49). CONCLUSIONS Over 25% of SDH patients admitted to an academic neurosurgical ICU were unexpectedly readmitted within 30 days. Nonoperative management does not affect outcome at hospital discharge but is significantly associated with readmission, even when accounting for the probability of treatment by propensity score weighted

  1. An empirical study using range of motion and pain score as determinants for continuous passive motion: outcomes following total knee replacement surgery in an adult population.

    Science.gov (United States)

    Tabor, Danielle

    2013-01-01

    The continuous passive motion (CPM) machine is one means by which to rehabilitate the knee after total knee replacement surgery. This study sought to determine which total knee replacement patients, if any, benefit from the use of the CPM machine. For the study period, most patients received active physical therapy. Patients were placed in the CPM machine if, on postoperative day 1, they had a range of motion less than or equal to 45° and/or pain score of 8 or greater on a numeric rating scale of 0-10, 0 being no pain and 10 being the worst pain. Both groups of patients healed at similar rates. The incidence of adverse events, length of stay, and functional outcomes was comparable between groups. Given the demonstrated lack of relative benefit to the patient and the cost of the CPM, this study supported discontinuing the routine use of the CPM.

  2. Impact of Science Tutoring on African Americans' Science Scores on the High School Students' Graduation Examination

    Science.gov (United States)

    Davis, Edward

    This study investigated the relationship between an after-school tutorial program for African American high school students at a Title I school and scores on the science portion of the High School Graduation Examination (HSGE). Passing the examination was required for graduation. The target high school is 99% African American and the passing rate of the target high school was 42%---lower than the state average of 76%. The purpose of the study was to identify (a) the relationship between a science tutorial program and scores on the science portion of the HSGE, (b) the predictors of tutoring need by analyzing the relationship between biology grades and scores on the science portion of the HSGE, and (c) the findings between biology grades and scores on the science portion of the HSGE by analyzing the relationship between tutorial attendance and HSGE scores. The study was based on Piaget's cognitive constructivism, which implied the potential benefits of tutorials on high-stakes testing. This study used a 1-group pretest-posttest, quantitative methodology. Results showed a significant relationship between tutoring and scores on the biology portion of the HSGE. Results found no significant relationship between the tutorial attendance and the scores on the biology portion of the HSGE or between the biology grades and scores on the biology portion of the HSGE before tutoring. It has implications for positive social change by providing educational stakeholders with empirically-based guidance in determining the potential benefit of tutorial intervention strategies on high school graduation examination scores.

  3. Test-retest reliability at the item level and total score level of the Norwegian version of the Spinal Cord Injury Falls Concern Scale (SCI-FCS).

    Science.gov (United States)

    Roaldsen, Kirsti Skavberg; Måøy, Åsa Blad; Jørgensen, Vivien; Stanghelle, Johan Kvalvik

    2016-05-01

    Translation of the Spinal Cord Injury Falls Concern Scale (SCI-FCS), and investigation of test-retest reliability on item-level and total-score-level. Translation, adaptation and test-retest study. A specialized rehabilitation setting in Norway. Fifty-four wheelchair users with a spinal cord injury. The median age of the cohort was 49 years, and the median number of years after injury was 13. Interventions/measurements: The SCI-FCS was translated and back-translated according to guidelines. Individuals answered the SCI-FCS twice over the course of one week. We investigated item-level test-retest reliability using Svensson's rank-based statistical method for disagreement analysis of paired ordinal data. For relative reliability, we analyzed the total-score-level test-retest reliability with intraclass correlation coefficients (ICC2.1), the standard error of measurement (SEM), and the smallest detectable change (SDC) for absolute reliability/measurement-error assessment and Cronbach's alpha for internal consistency. All items showed satisfactory percentage agreement (≥69%) between test and retest. There were small but non-negligible systematic disagreements among three items; we recovered an 11-13% higher chance for a lower second score. There was no disagreement due to random variance. The test-retest agreement (ICC2.1) was excellent (0.83). The SEM was 2.6 (12%), and the SDC was 7.1 (32%). The Cronbach's alpha was high (0.88). The Norwegian SCI-FCS is highly reliable for wheelchair users with chronic spinal cord injuries.

  4. Combined impact of lifestyle-related factors on total and cause-specific mortality among Chinese women: prospective cohort study.

    Directory of Open Access Journals (Sweden)

    Sarah J Nechuta

    2010-09-01

    Full Text Available Although cigarette smoking, excessive alcohol drinking, obesity, and several other well-studied unhealthy lifestyle-related factors each have been linked to the risk of multiple chronic diseases and premature death, little is known about the combined impact on mortality outcomes, in particular among Chinese and other non-Western populations. The objective of this study was to quantify the overall impact of lifestyle-related factors beyond that of active cigarette smoking and alcohol consumption on all-cause and cause-specific mortality in Chinese women.We used data from the Shanghai Women's Health Study, an ongoing population-based prospective cohort study in China. Participants included 71,243 women aged 40 to 70 years enrolled during 1996-2000 who never smoked or drank alcohol regularly. A healthy lifestyle score was created on the basis of five lifestyle-related factors shown to be independently associated with mortality outcomes (normal weight, lower waist-hip ratio, daily exercise, never exposed to spouse's smoking, higher daily fruit and vegetable intake. The score ranged from zero (least healthy to five (most healthy points. During an average follow-up of 9 years, 2,860 deaths occurred, including 775 from cardiovascular disease (CVD and 1,351 from cancer. Adjusted hazard ratios for mortality decreased progressively with an increasing number of healthy lifestyle factors. Compared to women with a score of zero, hazard ratios (95% confidence intervals for women with four to five factors were 0.57 (0.44-0.74 for total mortality, 0.29 (0.16-0.54 for CVD mortality, and 0.76 (0.54-1.06 for cancer mortality. The inverse association between the healthy lifestyle score and mortality was seen consistently regardless of chronic disease status at baseline. The population attributable risks for not having 4-5 healthy lifestyle factors were 33% for total deaths, 59% for CVD deaths, and 19% for cancer deaths.In this first study, to our knowledge, to

  5. The Impact of Use of Manipulatives on the Math Scores of Grade 2 Students

    Science.gov (United States)

    Liggett, Robert Scott

    2017-01-01

    Today's society places a lot of pressure on schools, teachers, and students to improve test scores. This paper discusses the possibility of using mathematical manipulatives to improve student test scores and students' attitudes towards mathematics. Forty-three Grade 2 students with age ranges between six and eight from a rural town in Saskatchewan…

  6. The Impact of Computer-Assisted Writing on Improving Writing Scores for Urban Eighth-Grade Students

    Science.gov (United States)

    Williams-Butler, LaTilya

    2016-01-01

    The purpose of this study was to investigate the impact standards-based aligned computer-assisted writing instruction had on improving writing scores for eighth-grade students that attend an urban middle school. The researcher wanted to remedy the problem of low writing achievement of eighth-grade students and determine if writing across the…

  7. The impacts of fracking on the environment: A total environmental study paradigm.

    Science.gov (United States)

    Meng, Qingmin

    2017-02-15

    Fracking has become a hot topic in the media and public discourse not only because of its economic benefit but also its environmental impacts. Recently, scientists have investigated the environmental impacts of fracking, and most studies focus on its air and ground water pollution. A systematic research structure and an overall evaluation of fracking's impacts on the environment are needed, because fracking does not only influence ground water but most environmental elements including but not limited to air, water, soil, rock, vegetation, wildlife, human, and many other ecosystem components. From the standpoint of the total environment, this communication assesses the overall impacts of fracking on the environment and then designs a total environmental study paradigm that effectively examines the complicated relationship among the total environment. Fracking dramatically changes the anthroposphere, which in turn significantly impacts the atmosphere, hydrosphere, lithosphere, and biosphere through the significant input or output of water, air, liquid or solid waste disposals, and the complex chemical components in fracking fluids. The proposed total environment study paradigm of fracking can be applied to other significant human activities that have dramatic impacts on the environment, such as mountain top coal mining or oil sands for environmental studies. Copyright © 2016 Elsevier B.V. All rights reserved.

  8. Cross-cultural adaptation and validation of the Japanese version of the new Knee Society Scoring System for osteoarthritic knee with total knee arthroplasty.

    Science.gov (United States)

    Hamamoto, Yosuke; Ito, Hiromu; Furu, Moritoshi; Ishikawa, Masahiro; Azukizawa, Masayuki; Kuriyama, Shinichi; Nakamura, Shinichiro; Matsuda, Shuichi

    2015-09-01

    The purposes of this study were to translate the new Knee Society Score (KSS) into Japanese and to evaluate the construct and content validity, test-retest reliability, and internal consistency of the Japanese version of the new KSS. The Japanese version of the KSS was developed according to cross-cultural guidelines by using the "translation-back translation" method to ensure content validity. KSS data were then obtained from patients who had undergone total knee arthroplasty (TKA). The psychometric properties evaluated were as follows: for feasibility, response rate, and floor and ceiling effects; for construct validity, internal consistency using Cronbach's alpha, and correlations with quality of life. Construct validity was evaluated by using Spearman's correlation coefficient to quantify the correlation between the KSS and the Japanese version of the Oxford 12-item Knee Score or Short Form 36 Health Survey (SF-36) questionnaires. The Japanese version of the KSS was sent to 93 consecutive osteoarthritic patients who underwent primary TKA in our institution. Fifty-five patients completed the questionnaires and were included in this study. Neither a floor nor ceiling effect was observed. The reliability proved excellent in the majority of domains, with intraclass correlation coefficients of 0.65-0.88. Internal consistency, assessed by Cronbach's alpha, was good to excellent for all domains (0.78-0.94). All of the four domains of the KSS correlated significantly with the Oxford 12-item Knee Score. The activity and satisfaction domains of the KSS correlated significantly with all and the majority of subscales of the SF-36, respectively, whereas symptoms and expectation domains showed significant correlations only with bodily pain and vitality subscales and with the physical function, bodily pain, and vitality subscales, respectively. The Japanese version of the new KSS is a valid, reliable, and responsive instrument to capture subjective aspects of the functional

  9. The Impact of Correction for Guessing Formula on MC and Yes/No Vocabulary Tests' Scores

    Directory of Open Access Journals (Sweden)

    abdollah baradaran

    2009-10-01

    Full Text Available A standard correction for random guessing (cfg formula on multiple-choice and Yes/Noexaminations was examined retrospectively in the scores of the intermediate female EFL learners in an English language school. The correctionwas a weighting formula for points awarded for correct answers,incorrect answers, and unanswered questions so that the expectedvalue of the increase in test score due to guessing was zero. The researcher compared uncorrected and corrected scores on examinationsusing multiple-choice and Yes/No formats. These short-answer formats eliminatedor at least greatly reduced the potential for guessing the correctanswer. The expectation for students to improve their grade by guessingon multiple-choice and Yes/No format examinations is well known. The researcher examined a method for correcting for random guessing (cfg " no knowledge" on multiple- choice and Yes/No vocabulary examinations by comparing application and non-application of correction for guessing (cfg formula on scores on these examinations. It was done to determine whether the test takers really knew the correct answer, or they had resorted to a kind of guessing. This study represented a unique opportunity to compare scores from multiple-choice and Yes/No examinations in a settingin which students were given the same number of questions ineach of the two format types testing their knowledge over thesame subject matter. The results of this study indicated that the significant differences were highlighted between the subjects' scores when cfg formula was applied and when it was not.

  10. The Impact of EuroSCORE II Risk Factors on Prediction of Long-Term Mortality.

    Science.gov (United States)

    Barili, Fabio; Pacini, Davide; D'Ovidio, Mariangela; Dang, Nicholas C; Alamanni, Francesco; Di Bartolomeo, Roberto; Grossi, Claudio; Davoli, Marina; Fusco, Danilo; Parolari, Alessandro

    2016-10-01

    The European System for Cardiac Operation Risk Evaluation (EuroSCORE) II has not been tested yet for predicting long-term mortality. This study was undertaken to evaluate the relationship between EuroSCORE II and long-term mortality and to develop a new algorithm based on EuroSCORE II factors to predict long-term survival after cardiac surgery. Complete data on 10,033 patients who underwent major cardiac surgery during a 7-year period were retrieved from three prospective institutional databases and linked with the Italian Tax Register Information System. Mortality at follow-up was analyzed with time-to-event analysis. The Kaplan-Meier estimates of survival at 1 and 5 were, respectively, 95.0% ± 0.2% and 84.7% ± 0.4%. Both discrimination and calibration of EuroSCORE II decreased in the prediction of 1-year and 5-year mortality. Nonetheless, EuroSCORE II was confirmed to be an independent predictor of long-term mortality with a nonlinear trend. Several EuroSCORE II variables were independent risk factors for long-term mortality in a regression model, most of all very low ejection fraction (less than 20%), salvage operation, and dialysis. In the final model, isolated mitral valve surgery and isolated coronary artery bypass graft surgery were associated with improved long-term survival. The EuroSCORE II cannot be considered a direct estimator of long-term risk of death, as its performance fades for mortality at follow-up longer than 30 days. Nonetheless, it is nonlinearly associated with long-term mortality, and most of its variables are risk factors for long-term mortality. Hence, they can be used in a different algorithm to stratify the risk of long-term mortality after surgery. Copyright © 2016 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

  11. Impact of Total, Internal and External Government Debt on Interest Rate in Pakistan

    OpenAIRE

    Perveen, Asma; Munir, Kashif

    2017-01-01

    The objective of the study is to examine impact of total, internal and external government debt on nominal interest rate in Pakistan. To attain these objectives, the study used annual time series data from 1973 to 2016. The study used loanable fund theory as theoretical model and ARDL bound testing approach for cointegration and Granger causality test to estimate the results. The results of the study found negative relation between total government debt, external debt and nominal interest rat...

  12. Quantifying the impact of using Coronary Artery Calcium Score for risk categorization instead of Framingham Score or European Heart SCORE in lipid lowering algorithms in a Middle Eastern population.

    Science.gov (United States)

    Isma'eel, Hussain A; Almedawar, Mohamad M; Harbieh, Bernard; Alajaji, Wissam; Al-Shaar, Laila; Hourani, Mukbil; El-Merhi, Fadi; Alam, Samir; Abchee, Antoine

    2015-10-01

    The use of the Coronary Artery Calcium Score (CACS) for risk categorization instead of the Framingham Risk Score (FRS) or European Heart SCORE (EHS) to improve classification of individuals is well documented. However, the impact of reclassifying individuals using CACS on initiating lipid lowering therapy is not well understood. We aimed to determine the percentage of individuals not requiring lipid lowering therapy as per the FRS and EHS models but are found to require it using CACS and vice versa; and to determine the level of agreement between CACS, FRS and EHS based models. Data was collected for 500 consecutive patients who had already undergone CACS. However, only 242 patients met the inclusion criteria and were included in the analysis. Risk stratification comparisons were conducted according to CACS, FRS, and EHS, and the agreement (Kappa) between them was calculated. In accordance with the models, 79.7% to 81.5% of high-risk individuals were down-classified by CACS, while 6.8% to 7.6% of individuals at intermediate risk were up-classified to high risk by CACS, with slight to moderate agreement. Moreover, CACS recommended treatment to 5.7% and 5.8% of subjects untreated according to European and Canadian guidelines, respectively; whereas 75.2% to 81.2% of those treated in line with the guidelines would not be treated based on CACS. In this simulation, using CACS for risk categorization warrants lipid lowering treatment for 5-6% and spares 70-80% from treatment in accordance with the guidelines. Current strong evidence from double randomized clinical trials is in support of guideline recommendations. Our results call for a prospective trial to explore the benefits/risks of a CACS-based approach before any recommendations can be made.

  13. Comparisons of American, Israeli, Italian and Mexican physicians and nurses on the total and factor scores of the Jefferson scale of attitudes toward physician-nurse collaborative relationships.

    Science.gov (United States)

    Hojat, Mohammadreza; Gonnella, Joseph S; Nasca, Thomas J; Fields, Sylvia K; Cicchetti, Americo; Lo Scalzo, Alessandra; Taroni, Francesco; Amicosante, Anna Maria Vincenza; Macinati, Manuela; Tangucci, Massimo; Liva, Carlo; Ricciardi, Gualtiero; Eidelman, Shmuel; Admi, Hanna; Geva, Hana; Mashiach, Tanya; Alroy, Gideon; Alcorta-Gonzalez, Adelina; Ibarra, David; Torres-Ruiz, Antonio

    2003-05-01

    This cross-cultural study was designed to compare the attitudes of physicians and nurses toward physician-nurse collaboration in the United States, Israel, Italy and Mexico. Total participants were 2522 physicians and nurses who completed the Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration (15 Likert-type items, (Hojat et al., Evaluation and the Health Professions 22 (1999a) 208; Nursing Research 50 (2001) 123). They were compared on the total scores and four factors of the Jefferson Scale (shared education and team work, caring as opposed to curing, nurses, autonomy, physicians' dominance). Results showed inter- and intra-cultural similarities and differences among the study groups providing support for the social role theory (Hardy and Conway, Role Theory: Perspectives for Health Professionals, Appelton-Century-Crofts, New York, 1978) and the principle of least interest (Waller and Hill, The Family: A Dynamic Interpretation, Dryden, New York, 1951) in inter-professional relationships. Implications for promoting physician-nurse education and inter-professional collaboration are discussed.

  14. Associations between preoperative Oxford hip and knee scores and costs and quality of life of patients undergoing primary total joint replacement in the NHS England: an observational study.

    Science.gov (United States)

    Eibich, Peter; Dakin, Helen A; Price, Andrew James; Beard, David; Arden, Nigel K; Gray, Alastair M

    2018-04-10

    To assess how costs and quality of life (measured by EuroQoL-5 Dimensions (EQ-5D)) before and after total hip replacement (THR) and total knee replacement (TKR) vary with age, gender and preoperative Oxford hip score (OHS) and Oxford knee score (OKS). Regression analyses using prospectively collected data from clinical trials, cohort studies and administrative data bases. UK secondary care. Men and women undergoing primary THR or TKR. The Hospital Episode Statistics data linked to patient-reported outcome measures included 602 176 patients undergoing hip or knee replacement who were followed up for up to 6 years. The Knee Arthroplasty Trial included 2217 patients undergoing TKR who were followed up for 12 years. The Clinical Outcomes in Arthroplasty Study cohort included 806 patients undergoing THR and 484 patients undergoing TKR who were observed for 1 year. EQ-5D-3L quality of life before and after surgery, costs of primary arthroplasty, costs of revision arthroplasty and the costs of hospital readmissions and ambulatory costs in the year before and up to 12 years after joint replacement. Average postoperative utility for patients at the 5th percentile of the OHS/OKS distribution was 0.61/0.5 for THR/TKR and 0.89/0.85 for patients at the 95th percentile. The difference between postoperative and preoperative EQ-5D utility was highest for patients with preoperative OHS/OKS lower than 10. However, postoperative EQ-5D utility was higher than preoperative utility for all patients with OHS≤46 and those with OKS≤44. In contrast, costs were generally higher for patients with low preoperative OHS/OKS than those with high OHS/OKS. For example, costs of hospital readmissions within 12 months after primary THR/TKR were £740/£888 for patients at the 5th percentile compared with £314/£404 at the 95th percentile of the OHS/OKS distribution. Our findings suggest that costs and quality of life associated with total joint replacement vary systematically with

  15. The 2007 AASM recommendations for EEG electrode placement in polysomnography: impact on sleep and cortical arousal scoring.

    Science.gov (United States)

    Ruehland, Warren R; O'Donoghue, Fergal J; Pierce, Robert J; Thornton, Andrew T; Singh, Parmjit; Copland, Janet M; Stevens, Bronwyn; Rochford, Peter D

    2011-01-01

    To examine the impact of using American Academy of Sleep Medicine (AASM) recommended EEG derivations (F4/M1, C4/M1, O2/M1) vs. a single derivation (C4/M1) in polysomnography (PSG) on the measurement of sleep and cortical arousals, including inter- and intra-observer variability. Prospective, non-blinded, randomized comparison. Three Australian tertiary-care hospital clinical sleep laboratories. 30 PSGs from consecutive patients investigated for obstructive sleep apnea (OSA) during December 2007 and January 2008. N/A. To examine the impact of EEG derivations on PSG summary statistics, 3 scorers from different Australian clinical sleep laboratories each scored separate sets of 10 PSGs twice, once using 3 EEG derivations and once using 1 EEG derivation. To examine the impact on inter- and intra-scorer reliability, all 3 scorers scored a subset of 10 PSGs 4 times, twice using each method. All PSGs were de-identified and scored in random order according to the 2007 AASM Manual for the Scoring of Sleep and Associated Events. Using 3 referential EEG derivations during PSG, as recommended in the AASM manual, instead of a single central EEG derivation, as originally suggested by Rechtschaffen and Kales (1968), resulted in a mean ± SE decrease in N1 sleep of 9.6 ± 3.9 min (P = 0.018) and an increase in N3 sleep of 10.6 ± 2.8 min (P = 0.001). No significant differences were observed for any other sleep or arousal scoring summary statistics; nor were any differences observed in inter-scorer or intra-scorer reliability for scoring sleep or cortical arousals. This study provides information for those changing practice to comply with the 2007 AASM recommendations for EEG placement in PSG, for those using portable devices that are unable to comply with the recommendations due to limited channel options, and for the development of future standards for PSG scoring and recording. As the use of multiple EEG derivations only led to small changes in the distribution of derived sleep

  16. Integrating GIS in the Middle School Curriculum: Impacts on Diverse Students' Standardized Test Scores

    Science.gov (United States)

    Goldstein, Donna; Alibrandi, Marsha

    2013-01-01

    This case study conducted with 1,425 middle school students in Palm Beach County, Florida, included a treatment group receiving GIS instruction (256) and a control group without GIS instruction (1,169). Quantitative analyses on standardized test scores indicated that inclusion of GIS in middle school curriculum had a significant effect on student…

  17. The Impact of the Use of Hierarchical Teaching on Test Scores of Students’ Technology

    Directory of Open Access Journals (Sweden)

    Zhao Guorong

    2015-01-01

    Full Text Available Test scores of students’ technology is the main basis for physical examination of college students’ physical, fitness evaluation based on test results. To change the view by the stratified teaching method consistent system of teaching mode, special movement technical level of students is improved significantly.

  18. Assessing Impact, DIF, and DFF in Accommodated Item Scores: A Comparison of Multilevel Measurement Model Parameterizations

    Science.gov (United States)

    Beretvas, S. Natasha; Cawthon, Stephanie W.; Lockhart, L. Leland; Kaye, Alyssa D.

    2012-01-01

    This pedagogical article is intended to explain the similarities and differences between the parameterizations of two multilevel measurement model (MMM) frameworks. The conventional two-level MMM that includes item indicators and models item scores (Level 1) clustered within examinees (Level 2) and the two-level cross-classified MMM (in which item…

  19. Social Skills Scores: The Impact of Primary School Population Characteristics and Parental Involvement

    Science.gov (United States)

    Dekker, Karien; Kamerling, Margje

    2017-01-01

    Purpose: The paper aims to examine to what extent and why parental involvement as well as characteristics of ethnic school population influence social skills scores (social position, behavioural skills) of students. Design/methodology/approach: The study used the COOL5-18 database (2010) that included 553 Dutch primary schools and nearly 38,000…

  20. The Impact of SIM on FCAT Reading Scores of Special Education and At-Risk Students

    Science.gov (United States)

    Matyo-Cepero, Jude

    2013-01-01

    The purpose of this study was to determine if special education and at-risk students educated exclusively in a school-within-a-school setting showed improved high-stakes standardized reading test scores after learning the strategic instruction model (SIM) inference strategy. This study was focused on four groups of eighth-grade students attending…

  1. Total cross section for chloroflouromethanes and CClx radicals by electron impact

    International Nuclear Information System (INIS)

    Gupta, Dhanoj; Antony, Bobby

    2013-01-01

    Highlights: ► A model to find total CS for freons and CCl x by e − impact is employed. ► Complex optical potential formalism is used to find total inelastic and elastic CS. ► Result shows very good agreement with previous data wherever available. ► Maiden attempt to find cross section for the CCl x radicals. -- Abstract: We report here the total cross section for chloroflouromethanes namely CCl 3 F (Freon 11), CCl 2 F 2 (Freon 12), CClF 3 (Freon 13), CCl 4 and CCl x (x = 1–3), radicals by electron impact 50 to 5000 eV. The total inelastic and elastic cross sections are obtained employing a complex optical potential formalism and solving the Schrödinger equation through partial wave analysis. The total cross section is obtained as the sum of total inelastic and elastic cross sections. The results obtained are compared with the existing experimental and theoretical data, wherever available. The present result shows reasonable agreement with previous data. For the CCl x radicals, we have predicted the total cross sections for the first time. The data reported here has immense interest to atmospheric and technological plasma modelling

  2. Prosthetic alignment after total knee replacement is not associated with dissatisfaction or change in Oxford Knee Score: A multivariable regression analysis.

    Science.gov (United States)

    Huijbregts, Henricus J T A M; Khan, Riaz J K; Fick, Daniel P; Jarrett, Olivia M; Haebich, Samantha

    2016-06-01

    Approximately 18% of the patients are dissatisfied with the result of total knee replacement. However, the relation between dissatisfaction and prosthetic alignment has not been investigated before. We retrospectively analysed prospectively gathered data of all patients who had a primary TKR, preoperative and one-year postoperative Oxford Knee Scores (OKS) and postoperative computed tomography (CT). The CT protocol measures hip-knee-ankle (HKA) angle, and coronal, sagittal and axial component alignment. Satisfaction was defined using a five-item Likert scale. We dichotomised dissatisfaction by combining '(very) dissatisfied' and 'neutral/not sure'. Associations with dissatisfaction and change in OKS were calculated using multivariable logistic and linear regression models. 230 TKRs were implanted in 105 men and 106 women. At one year, 12% were (very) dissatisfied and 10% neutral. Coronal alignment of the femoral component was 0.5 degrees more accurate in patients who were satisfied at one year. The other alignment measurements were not different between satisfied and dissatisfied patients. All radiographic measurements had a P-value>0.10 on univariate analyses. At one year, dissatisfaction was associated with the three-months OKS. Change in OKS was associated with three-months OKS, preoperative physical SF-12, preoperative pain and cruciate retaining design. Neither mechanical axis, nor component alignment, is associated with dissatisfaction at one year following TKR. Patients get the best outcome when pain reduction and function improvement are optimal during the first three months and when the indication to embark on surgery is based on physical limitations rather than on a high pain score. 2. Copyright © 2016 Elsevier B.V. All rights reserved.

  3. Continued Inpatient Care After Primary Total Knee Arthroplasty Increases 30-Day Post-Discharge Complications: A Propensity Score-Adjusted Analysis.

    Science.gov (United States)

    McLawhorn, Alexander S; Fu, Michael C; Schairer, William W; Sculco, Peter K; MacLean, Catherine H; Padgett, Douglas E

    2017-09-01

    Discharge destination, either home or skilled care facility, after total knee arthroplasty (TKA) may be associated with significant variation in postacute care outcomes. The purpose of this study was to characterize the 30-day postdischarge outcomes after primary TKA relative to discharge destination. All primary unilateral TKAs performed for osteoarthritis from 2011-2014 were identified in the National Surgical Quality Improvement Program database. Propensity scores based on predischarge characteristics were used to adjust for selection bias in discharge destination. Propensity-adjusted multivariable logistic regressions were used to examine associations between discharge destination and postdischarge complications. Among 101,256 primary TKAs identified, 70,628 were discharged home and 30,628 to skilled care facilities. Patients discharged to facilities were more frequently were female, older, higher body mass index class, higher Charlson comorbidity index and American Society of Anesthesiologists scores, had predischarge complications, received general anesthesia, and classified as nonindependent preoperatively. Propensity adjustment accounted for this selection bias. Patients discharged to skilled care facilities after TKA had higher odds of any major complication (odds ratio = 1.25; 95% confidence interval, 1.13-1.37) and readmission (odds ratio = 1.81; 95% confidence interval, 1.50-2.18). Skilled care was associated with increased odds for respiratory, septic, thromboembolic, and urinary complications. Associations with death, cardiac, and wound complications were not significant. After controlling for predischarge characteristics, discharge to skilled care facilities vs home after primary TKA is associated with higher odds of numerous complications and unplanned readmission. These results support coordination of care pathways to facilitate home discharge after hospitalization for TKA whenever possible. Copyright © 2017 Elsevier Inc. All rights reserved.

  4. An exploration of the impact of invalid MMPI-2 protocols on collateral self-report measure scores.

    Science.gov (United States)

    Forbey, Johnathan D; Lee, Tayla T C

    2011-11-01

    Although a number of studies have examined the impact of invalid MMPI-2 (Butcher et al., 2001) response styles on MMPI-2 scale scores, limited research has specifically explored the effects that such response styles might have on conjointly administered collateral self-report measures. This study explored the potential impact of 2 invalidating response styles detected by the Validity scales of the MMPI-2, overreporting and underreporting, on scores of collateral self-report measures administered conjointly with the MMPI-2. The final group of participants included in analyses was 1,112 college students from a Midwestern university who completed all measures as part of a larger study. Results of t-test analyses suggested that if either over- or underreporting was indicated by the MMPI-2 Validity scales, the scores of most conjointly administered collateral measures were also significantly impacted. Overall, it appeared that test-takers who were identified as either over- or underreporting relied on such a response style across measures. Limitations and suggestions for future study are discussed.

  5. Impact of a narrative medicine programme on healthcare providers' empathy scores over time.

    Science.gov (United States)

    Chen, Po-Jui; Huang, Chien-Da; Yeh, San-Jou

    2017-07-05

    The cultivation of empathy for healthcare providers is an important issue in medical education. Narrative medicine (NM) has been shown to foster empathy. To our knowledge, there has been no research that examines whether a NM programme affects multi-professional healthcare providers' empathy. Our study aims to fill this gap by investigating whether a NM programme effects multi-professional healthcare providers' empathy. A pre-post questionnaire method was used.142 participants (n = 122 females) who attended the NM programme were divided into single (n = 58) and team groups (n = 84) on the basis of inter-professional education during a period of 2 months. Perceptions of the NM programme were collected using our developed questionnaire. Empathy levels were measured using the Chinese version of Jefferson Scale of Empathy - Healthcare Providers Version (JSE-HP) - at three time points: prior to (Time 1), immediately after (T2), and 1.5 years (T3) after the programme. Participants' perceptions about the NM programme (n = 116; n = 96 females) suggested an in enhancement of empathy (90.5%). Empathy scores via the JSE-HP increased after the NM programme (T1 mean 111.05, T2 mean 116.19) and were sustainable for 1.5 years (T3 mean 116.04) for all participants (F(2297) = 3.74, p empathy scores was found (F(1298) = 5.33, p empathy scores at T2, sustaining at T3, but males demonstrating a slow rise in empathy scores over time. NM programme as an educational tool for empathy is feasible. However, further research is needed to examine gender difference as it might be that males and females respond differently to a NM programme intervention.

  6. THE IMPACT OF MODERATE AND HIGH INTENSITY TOTAL BODY FATIGUE ON PASSING ACCURACY IN EXPERT AND NOVICE BASKETBALL PLAYERS

    Directory of Open Access Journals (Sweden)

    Mark Lyons

    2006-06-01

    Full Text Available Despite the acknowledged importance of fatigue on performance in sport, ecologically sound studies investigating fatigue and its effects on sport-specific skills are surprisingly rare. The aim of this study was to investigate the effect of moderate and high intensity total body fatigue on passing accuracy in expert and novice basketball players. Ten novice basketball players (age: 23.30 ± 1.05 yrs and ten expert basketball players (age: 22.50 ± 0.41 yrs volunteered to participate in the study. Both groups performed the modified AAHPERD Basketball Passing Test under three different testing conditions: rest, moderate intensity and high intensity total body fatigue. Fatigue intensity was established using a percentage of the maximal number of squat thrusts performed by the participant in one minute. ANOVA with repeated measures revealed a significant (F 2,36 = 5.252, p = 0.01 level of fatigue by level of skill interaction. On examination of the mean scores it is clear that following high intensity total body fatigue there is a significant detriment in the passing performance of both novice and expert basketball players when compared to their resting scores. Fundamentally however, the detrimental impact of fatigue on passing performance is not as steep in the expert players compared to the novice players. The results suggest that expert or skilled players are better able to cope with both moderate and high intensity fatigue conditions and maintain a higher level of performance when compared to novice players. The findings of this research therefore, suggest the need for trainers and conditioning coaches in basketball to include moderate, but particularly high intensity exercise into their skills sessions. This specific training may enable players at all levels of the game to better cope with the demands of the game on court and maintain a higher standard of play

  7. Clinical impact and risk stratification of balloon angioplasty for femoropopliteal disease in nitinol stenting era: Retrospective multicenter study using propensity score matching analysis

    Directory of Open Access Journals (Sweden)

    Taketsugu Tsuchiya

    2016-07-01

    Full Text Available Objective: Nitinol stenting could bring the better outcome in endovascular therapy for femoropopliteal disease. However, it might be expected that recent marked advances in both device technology and operator technique had led to improved efficacy of balloon angioplasty even in this segment. The aims of this study were to evaluate the clinical impact of balloon angioplasty for femoropopliteal disease and make risk stratification clear by propensity score matching analysis. Methods: Based on the multicenter retrospective data, 2758 patients (balloon angioplasty: 729 patients and nitinol stenting: 2029 patients, those who underwent endovascular therapy for femoropopliteal disease, were analyzed. Results: The propensity score matching procedure extracted a total of 572 cases per group, and the primary patency rate of balloon angioplasty and nitinol stenting groups after matching was significantly the same (77.2% vs 82.7% at 1 year; 62.2% vs 64.3% at 3 years; 47.8% vs 54.3% at 5 years. In multivariate Cox hazard regression analysis, significant predictors for primary patency were diabetes mellitus, regular dialysis, cilostazol use, chronic total occlusion, and intra-vascular ultra-sonography use. The strategy of balloon angioplasty was not evaluated as a significant predictor for the primary patency. After risk stratification using five items (diabetes mellitus, regular dialysis, no use of intra-vascular ultra-sonography, chronic total occlusion, and no use of cilostazol: the DDICC score, the estimated primary patency rates of each group (low, DDICC score 0–2; moderate, DDICC score 3; high risk, DDICC score 4–5 were 88.6%, 78.3%, and 63.5% at 1 year; 75.2%, 60.7%, and 39.8% at 3 years; and 66.0%, 47.1%, and 26.3% at 5 years (p < 0.0001. The primary patency rate of balloon angioplasty and nitinol stenting groups was significantly the same in each risk stratification. Conclusion: This study suggests that balloon angioplasty does

  8. Comparing impacts of alien plants and animals in Europe using a standard scoring system

    Czech Academy of Sciences Publication Activity Database

    Kumschick, S.; Bacher, S.; Evans, T.; Marková, Zuzana; Pergl, Jan; Pyšek, Petr; Vaes-Petignat, S.; van der Veer, G.; Vila, M.; Nentwig, W.

    2015-01-01

    Roč. 52, č. 3 (2015), s. 552-561 ISSN 0021-8901 R&D Projects: GA ČR GB14-36079G; GA ČR(CZ) GAP504/11/1028 Grant - others:AV ČR(CZ) AP1002 Program:Akademická prémie - Praemium Academiae Institutional support: RVO:67985939 Keywords : biological invasions * ecological impact * plants and animals Subject RIV: EH - Ecology, Behaviour Impact factor: 5.196, year: 2015

  9. Performance on large-scale science tests: Item attributes that may impact achievement scores

    Science.gov (United States)

    Gordon, Janet Victoria

    Significant differences in achievement among ethnic groups persist on the eighth-grade science Washington Assessment of Student Learning (WASL). The WASL measures academic performance in science using both scenario and stand-alone question types. Previous research suggests that presenting target items connected to an authentic context, like scenario question types, can increase science achievement scores especially in underrepresented groups and thus help to close the achievement gap. The purpose of this study was to identify significant differences in performance between gender and ethnic subgroups by question type on the 2005 eighth-grade science WASL. MANOVA and ANOVA were used to examine relationships between gender and ethnic subgroups as independent variables with achievement scores on scenario and stand-alone question types as dependent variables. MANOVA revealed no significant effects for gender, suggesting that the 2005 eighth-grade science WASL was gender neutral. However, there were significant effects for ethnicity. ANOVA revealed significant effects for ethnicity and ethnicity by gender interaction in both question types. Effect sizes were negligible for the ethnicity by gender interaction. Large effect sizes between ethnicities on scenario question types became moderate to small effect sizes on stand-alone question types. This indicates the score advantage the higher performing subgroups had over the lower performing subgroups was not as large on stand-alone question types compared to scenario question types. A further comparison examined performance on multiple-choice items only within both question types. Similar achievement patterns between ethnicities emerged; however, achievement patterns between genders changed in boys' favor. Scenario question types appeared to register differences between ethnic groups to a greater degree than stand-alone question types. These differences may be attributable to individual differences in cognition

  10. The impact of old age on surgical outcomes of totally laparoscopic gastrectomy for gastric cancer.

    Science.gov (United States)

    Kim, Min Gyu; Kim, Hee Sung; Kim, Byung Sik; Kwon, Sung Joon

    2013-11-01

    Old age is regarded as the risk factor of major abdominal surgery due to the lack of functional reserve and the increased presence of comorbidities. This study aimed to evaluate the impact of old age on the surgical outcomes of totally laparoscopic gastrectomy for gastric cancer. This study enrolled 389 gastric cancer patients who underwent totally laparoscopic gastrectomy at Hanyang University Guri Hospital and ASAN Medical Center. The patients were classified into two groups according to age as those older than 70 years and those younger than 70 years. Early surgical outcomes such as operation time, postoperative complications, time to first flatus, days until soft diet began, and hospital stay were evaluated. No patient was converted to open surgery. The two groups differed significantly in terms of overall postoperative complication rate, time to first flatus, days until soft diet began, and hospital stay. The patients who underwent Roux-en-Y gastrojejunostomy differed in incidence of postoperative ileus but not in severe postoperative complication rate. The results of this study demonstrated that old age can have an effect on the surgical outcomes of totally laparoscopic gastrectomy. This study especially showed that elderly patients are affected by the return of bowel movement after totally laparoscopic gastrectomy. On the other hand, however, it is presumed that old age has not had a serious impact on surgical outcomes in totally laparoscopic gastrectomy because no difference in the severe postoperative complication rate was observed.

  11. Ionization of molecules by electron impact: Differential and total cross sections

    Energy Technology Data Exchange (ETDEWEB)

    Rezkallah, Z. [Laboratoire de Physique Quantique et Systemes Dynamiques, Departement de physique, Faculte des sciences, Universite Ferhat Abbas, Setif 19000 (Algeria); Houamer, S., E-mail: hosalim@yahoo.com [Laboratoire de Physique Quantique et Systemes Dynamiques, Departement de physique, Faculte des sciences, Universite Ferhat Abbas, Setif 19000 (Algeria); Dal Cappello, C. [Laboratoire de Physique Moleculaire et des Collisions, Universite Paul Verlaine-Metz, Institut de Physique, 1 Boulevard Arago, 57078 Metz Cedex 3 (France); Charpentier, I. [Laboratoire de Physique et Mecanique des Materiaux, Universite Paul Verlaine-Metz UMR 7554, ile du Saulcy, 57045 Metz Cedex 1 (France); Roy, A.C. [School of Mathematical Sciences, Ramakrishna Mission Vivekananda University, Belur Math 711202, West Bengal (India)

    2011-12-01

    The first Born approximation is applied to calculate differential and total ionization cross sections of a set of small molecules, namely, HF, H{sub 2}O, NH{sub 3} and CH{sub 4} by electron impact. The molecular targets are described by single center molecular orbitals consisting of linear combinations of atomic orbitals (MO-LCAO). First, we have considered electron momentum spectroscopy experiments to check the accuracy of the wave functions. The triply, doubly, singly differential and total cross sections are then evaluated in a systematic way for a variety of kinematics. The results are discussed and compared with experiments.

  12. Impact of predictive scoring model and e-mail messages on African American blood donors.

    Science.gov (United States)

    Bachegowda, Lohith S; Timm, Brad; Dasgupta, Pinaki; Hillyer, Christopher D; Kessler, Debra; Rebosa, Mark; France, Christopher R; Shaz, Beth H

    2017-06-01

    Expanding the African American (AA) donor pool is critical to sustain transfusion support for sickle cell disease patients. The aims were to: 1) apply cognitive computing on donation related metrics to develop a predictive model that effectively identifies repeat AA donors, 2) determine whether a single e-mail communication could improve AA donor retention and compare retention results on higher versus lower predictive score donors, and 3) evaluate the effect of e-mail marketing on AA donor retention with culturally versus nonculturally tailored message. Between 2011 and 2012, 30,786 AA donors donated blood at least once on whom predictive repeat donor scores (PRDSs) was generated from donor-related metrics (frequency of donations, duration between donations, age, blood type, and sex). In 2013, 28% (8657/30,786) of 2011 to 2012 donors returned to donate on whom PRDS was validated. Returning blood donors had a higher mean PRDS compared to nonreturning donors (0.649 vs. 0.268; p e-mail pilot, high PRDS (≥0.6) compared to low PRDS (e-mail opening rate (p e-mail, 159% higher presentation rate (p e-mail communication has the potential to increase the efficiency of donor marketing. © 2017 AABB.

  13. Impact of Answer-Switching Behavior on Multiple-Choice Test Scores in Higher Education

    Directory of Open Access Journals (Sweden)

    Ramazan BAŞTÜRK

    2011-06-01

    Full Text Available The multiple- choice format is one of the most popular selected-response item formats used in educational testing. Researchers have shown that Multiple-choice type test is a useful vehicle for student assessment in core university subjects that usually have large student numbers. Even though the educators, test experts and different test recourses maintain the idea that the first answer should be retained, many researchers argued that this argument is not dependent with empirical findings. The main question of this study is to examine how the answer switching behavior affects the multiple-choice test score. Additionally, gender differences and relationship between number of answer switching behavior and item parameters (item difficulty and item discrimination were investigated. The participants in this study consisted of 207 upper-level College of Education students from mid-sized universities. A Midterm exam consisted of 20 multiple-choice questions was used. According to the result of this study, answer switching behavior statistically increase test scores. On the other hand, there is no significant gender difference in answer-switching behavior. Additionally, there is a significant negative relationship between answer switching behavior and item difficulties.

  14. The impact of total quality management on competitive advantage of pharmaceutical manufacturing companies in Jordan

    OpenAIRE

    Kamal A. M. Al-Qudah

    2012-01-01

    TQM is a general philosophy of management that attempts to enhance competitive advantage of organizations, This paper aims to investigate the impact of total quality management on competitive advantage of Pharmaceutical manufacturing companies in Jordan. The data are collected from mid- to senior-level managerial employees of Pharmaceutical manufacturing companies in Jordan. The data were analyzed using correlation and multiple regression analyses. The results indicate that, there is effec...

  15. Hadronic total cross-sections through soft gluon summation in impact parameter space

    International Nuclear Information System (INIS)

    Grau, A.

    1999-01-01

    IThe Bloch-Nordsieck model for the parton distribution of hadrons in impact parameter space, constructed using soft gluon summation, is investigated in detail. Its dependence upon the infrared structure of the strong coupling constant α s is discussed, both for finite as well as singular, but integrable, α s . The formalism is applied to the prediction of total proton-proton and proton-antiproton cross-sections, where screening, due to soft gluon emission from the initial valence quarks, becomes evident

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

    Science.gov (United States)

    Airola, Denise Tobin

    2011-01-01

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

  17. Impact of white matter hyperintensities scoring method on correlations with clinical data: the LADIS study

    DEFF Research Database (Denmark)

    van Straaten, EC; Fazekas, F; Rostrup, Egill

    2006-01-01

    BACKGROUND AND PURPOSE: White matter hyperintensities (WMH) are associated with decline in cognition, gait, mood, and urinary continence. Associations may depend on the method used for measuring WMH. We investigated the ability of different WMH scoring methods to detect differences in WMH load...... between groups with and without symptoms. METHODS: We used data of 618 independently living elderly with WMH collected in the Leukoaraiosis And DISability (LADIS) study. Subjects with and without symptoms of depression, gait disturbances, urinary incontinence, and memory decline were compared with respect...... to WMH load measured qualitatively using 3 widely used visual rating scales (Fazekas, Scheltens, and Age-Related White Matter Changes scales) and quantitatively with a semiautomated volumetric technique and an automatic lesion count. Statistical significance between groups was assessed with the chi2...

  18. Coverage of Acta Dermatovenerologica Alpina, Pannonica et Adriatica in Elsevier's CiteScore index: a new tool for measuring the citation impact of academic journals.

    Science.gov (United States)

    Poljak, Mario

    2017-03-01

    In December 2016, Elsevier launched a new tool that helps measure the citation impact of academic journals, called the CiteScore index. The CiteScore index values for 2015 confirmed the status of Acta Dermatovenerologica Alpina, Pannonica et Adriatica (Acta Dermatovenerol APA) as the leading journal in dermatology and sexually transmitted infections in the region. Sixty-five articles published in Acta Dermatovenerol APA from 2012 to 2014 received a total of 77 citations in 2015, resulting in a CiteScore index value of 1.18 for the journal. More than half of the articles published from 2012 to 2014 received at least one citation in 2015. Acta Dermatovenerol APA performed well in all three categories listed because it is ranked 384th out of 1,549 journals in the category General Medicine (75th percentile), 53rd out of 122 journals in the category Dermatology (56th percentile), and 142nd out of 246 journals in the category Infectious Diseases (42nd percentile).

  19. Association between diet-quality scores, adiposity, total cholesterol and markers of nutritional status in european adults: Findings from the Food4Me study

    NARCIS (Netherlands)

    Fallaize, R.; Livingstone, K.M.; Celis-Morales, C.; Macready, A.L.; San-Cristobal, R.; Navas-Carretero, S.; Marsaux, C.F.M.; O’Donovan, C.B.; Kolossa, S.; Moschonis, G.; Walsh, M.C.; Gibney, E.R.; Brennan, L.; Bouwman, J.; Manios, Y.; Jarosz, M.; Martinez, J.A.; Daniel, H.; Saris, W.H.M.; Gundersen, T.E.; Drevon, C.A.; Gibney, M.J.; Mathers, J.C.; Lovegrove, J.A.

    2018-01-01

    Diet-quality scores (DQS), which are developed across the globe, are used to define adherence to specific eating patterns and have been associated with risk of coronary heart disease and type-II diabetes. We explored the association between five diet-quality scores (Healthy Eating Index, HEI;

  20. Prospective associations of C-reactive protein (CRP) levels and CRP genetic risk scores with risk of total knee and hip replacement for osteoarthritis in a diverse cohort.

    Science.gov (United States)

    Shadyab, A H; Terkeltaub, R; Kooperberg, C; Reiner, A; Eaton, C B; Jackson, R D; Krok-Schoen, J L; Salem, R M; LaCroix, A Z

    2018-05-22

    To examine associations of high-sensitivity C-reactive protein (CRP) levels and polygenic CRP genetic risk scores (GRS) with risk of end-stage hip or knee osteoarthritis (OA), defined as incident total hip (THR) or knee replacement (TKR) for OA. This study included a cohort of postmenopausal white, African American, and Hispanic women from the Women's Health Initiative. Women were followed from baseline to date of THR or TKR, death, or December 31, 2014. Medicare claims data identified THR and TKR. Hs-CRP and genotyping data were collected at baseline. Three CRP GRS were constructed: 1) a 4-SNP GRS comprised of genetic variants representing variation in the CRP gene among European populations; 2) a multilocus 18-SNP GRS of genetic variants significantly associated with CRP levels in a meta-analysis of genome-wide association studies; and 3) a 5-SNP GRS of genetic variants significantly associated with CRP levels among African American women. In analyses conducted separately among each race and ethnic group, there were no significant associations of ln hs-CRP with risk of THR or TKR, after adjusting for age, body mass index, lifestyle characteristics, chronic diseases, hormone therapy use, and non-steroidal anti-inflammatory drug use. CRP GRS were not associated with risk of THR or TKR in any ethnic group. Serum levels of ln hs-CRP and genetically-predicted CRP levels were not associated with risk of THR or TKR for OA among a diverse cohort of women. Copyright © 2018 Osteoarthritis Research Society International. Published by Elsevier Ltd. All rights reserved.

  1. Patients' Expectations Impact Their Satisfaction following Total Hip or Knee Arthroplasty.

    Science.gov (United States)

    Neuprez, Audrey; Delcour, Jean-Pierre; Fatemi, Firouzeh; Gillet, Philippe; Crielaard, Jean-Michel; Bruyère, Olivier; Reginster, Jean-Yves

    2016-01-01

    The objective of this study was to assess the number and magnitude of preoperative expectations and to correlate them with the degree of satisfaction expressed one year after Total Hip Arthroplasty (THA) or Total Knee Arthroplasty (TKA), in patients with severe and painful osteoarthritis (OA). Preoperative expectations (within 20 days prior to surgery) and postoperative satisfaction (one year after the intervention) were measured using the previously validated French version of the Hospital for Special Surgery Hip or Knee Replacement Expectations Survey. Postoperative satisfaction was measured using a specific scale, following the same methodology as that used for the assessment of expectations. Prediction of the satisfaction of the patients was performed using multivariate linear regression modelling. A total of 138 patients (80 THA and 58 TKA) completed the two parts of the study. The expectations score (mean ± SD) (range 0-100) was 72.58 ± 12.63 before THA and 69.10 ± 13.72 before TKA (p = 0.13). The number of expectations expressed was 14.34 ± 1.32 (out of a potential maximum of 18) before THA and 14.70 ± 2.29 (out of a potential maximum of 19) before TKA. After 1 year, THA generated a significantly higher degree of satisfaction compared to TKA (69.70 ± 14.46 v 60.44 ± 17.54, poptimal preoperative interaction between health care providers and patients, to allow patients a chance to foresee a reasonable outcome after TJA.

  2. Impact of Primary Gleason Grade on Risk Stratification for Gleason Score 7 Prostate Cancers

    International Nuclear Information System (INIS)

    Koontz, Bridget F.; Tsivian, Matvey; Mouraviev, Vladimir; Sun, Leon; Vujaskovic, Zeljko; Moul, Judd; Lee, W. Robert

    2012-01-01

    Purpose: To evaluate the primary Gleason grade (GG) in Gleason score (GS) 7 prostate cancers for risk of non-organ-confined disease with the goal of optimizing radiotherapy treatment option counseling. Methods: One thousand three hundred thirty-three patients with pathologic GS7 were identified in the Duke Prostate Center research database. Clinical factors including age, race, clinical stage, prostate-specific antigen at diagnosis, and pathologic stage were obtained. Data were stratified by prostate-specific antigen and clinical stage at diagnosis into adapted D’Amico risk groups. Univariate and multivariate analyses were performed evaluating for association of primary GG with pathologic outcome. Results: Nine hundred seventy-nine patients had primary GG3 and 354 had GG4. On univariate analyses, GG4 was associated with an increased risk of non-organ-confined disease. On multivariate analysis, GG4 was independently associated with seminal vesicle invasion (SVI) but not extracapsular extension. Patients with otherwise low-risk disease and primary GG3 had a very low risk of SVI (4%). Conclusions: Primary GG4 in GS7 cancers is associated with increased risk of SVI compared with primary GG3. Otherwise low-risk patients with GS 3+4 have a very low risk of SVI and may be candidates for prostate-only radiotherapy modalities.

  3. Impact of Primary Gleason Grade on Risk Stratification for Gleason Score 7 Prostate Cancers

    Energy Technology Data Exchange (ETDEWEB)

    Koontz, Bridget F., E-mail: bridget.koontz@duke.edu [Department of Radiation Oncology, Duke Prostate Center, Duke University Medical Center, Durham, NC (United States); Tsivian, Matvey [Division of Urology, Department of Surgery, Duke Prostate Center, Duke University Medical Center, Durham, NC (United States); Mouraviev, Vladimir [Department of Radiation Oncology, Duke Prostate Center, Duke University Medical Center, Durham, NC (United States); Sun, Leon [Division of Urology, Department of Surgery, Duke Prostate Center, Duke University Medical Center, Durham, NC (United States); Vujaskovic, Zeljko [Department of Radiation Oncology, Duke Prostate Center, Duke University Medical Center, Durham, NC (United States); Moul, Judd [Division of Urology, Department of Surgery, Duke Prostate Center, Duke University Medical Center, Durham, NC (United States); Lee, W. Robert [Department of Radiation Oncology, Duke Prostate Center, Duke University Medical Center, Durham, NC (United States)

    2012-01-01

    Purpose: To evaluate the primary Gleason grade (GG) in Gleason score (GS) 7 prostate cancers for risk of non-organ-confined disease with the goal of optimizing radiotherapy treatment option counseling. Methods: One thousand three hundred thirty-three patients with pathologic GS7 were identified in the Duke Prostate Center research database. Clinical factors including age, race, clinical stage, prostate-specific antigen at diagnosis, and pathologic stage were obtained. Data were stratified by prostate-specific antigen and clinical stage at diagnosis into adapted D'Amico risk groups. Univariate and multivariate analyses were performed evaluating for association of primary GG with pathologic outcome. Results: Nine hundred seventy-nine patients had primary GG3 and 354 had GG4. On univariate analyses, GG4 was associated with an increased risk of non-organ-confined disease. On multivariate analysis, GG4 was independently associated with seminal vesicle invasion (SVI) but not extracapsular extension. Patients with otherwise low-risk disease and primary GG3 had a very low risk of SVI (4%). Conclusions: Primary GG4 in GS7 cancers is associated with increased risk of SVI compared with primary GG3. Otherwise low-risk patients with GS 3+4 have a very low risk of SVI and may be candidates for prostate-only radiotherapy modalities.

  4. Microcredit in theory and practice: using randomized credit scoring for impact evaluation.

    Science.gov (United States)

    Karlan, Dean; Zinman, Jonathan

    2011-06-10

    Microcredit institutions spend billions of dollars fighting poverty by making small loans primarily to female entrepreneurs. Proponents argue that microcredit mitigates market failures, spurs micro-enterprise growth, and boosts borrowers' well-being. We tested these hypotheses with the use of an innovative, replicable experimental design that randomly assigned individual liability microloans (of $225 on average) to 1601 individuals in the Philippines through credit scoring. After 11 to 22 months, we found evidence consistent with unmet demand at the current price (a roughly 60% annualized interest rate): Net borrowing increased in the treatment group relative to controls. However, the number of business activities and employees in the treatment group decreased relative to controls, and subjective well-being declined slightly. We also found little evidence that treatment effects were more pronounced for women. However, we did find that microloans increase ability to cope with risk, strengthen community ties, and increase access to informal credit. Thus, microcredit here may work, but through channels different from those often hypothesized by its proponents.

  5. The achievement impact of the inclusion model on the standardized test scores of general education students

    Science.gov (United States)

    Garrett-Rainey, Syrena

    The purpose of this study was to compare the achievement of general education students within regular education classes to the achievement of general education students in inclusion/co-teach classes to determine whether there was a significant difference in the achievement between the two groups. The school district's inclusion/co-teach model included ongoing professional development support for teachers and administrators. General education teachers, special education teachers, and teacher assistants collaborated to develop instructional strategies to provide additional remediation to help students to acquire the skills needed to master course content. This quantitative study reviewed the end-of course test (EoCT) scores of Grade 10 physical science and math students within an urban school district. It is not known whether general education students in an inclusive/co-teach science or math course will demonstrate a higher achievement on the EoCT in math or science than students not in an inclusive/co-teach classroom setting. In addition, this study sought to determine if students classified as low socioeconomic status benefited from participating in co-teaching classrooms as evidenced by standardized tests. Inferential statistics were used to determine whether there was a significant difference between the achievements of the treatment group (inclusion/co-teach) and the control group (non-inclusion/co-teach). The findings can be used to provide school districts with optional instructional strategies to implement in the diverse classroom setting in the modern classroom to increase academic performance on state standardized tests.

  6. Reappraising the Impact of Offending on Victimization: A Propensity Score Matching Approach.

    Science.gov (United States)

    Posick, Chad

    2017-05-01

    Existing evidence clearly supports an empirical connection between offending and victimization. Often called the "victim-offender overlap," this relationship holds for both sexes, across the life course, and across a wide range of countries and cultural environments. In addition, the relationship is sustained regardless of the study sample and statistical methods applied in the analyses of the sample data. However, there has yet to be a study that examines this relationship for violent and property crime using quasi-experimental methods accounting for a wide range of potential confounders including individual differences and cultural contexts. This study subjects the victim-offender relationship to testing through propensity score matching for both violent and property crimes using an international dataset. The results show that previous violent and theft offending increases the odds of victimization when matching on individual and contextual factors. This finding supports previous literature and suggests that delinquent behavior may act as a "switch" that exposes one to subsequent violent and theft victimization.

  7. Evaluation of Severity Score in Patients with Lower Limb and Pelvic Fractures Injured in Motor Vehicle Front-Impact Collisions.

    Science.gov (United States)

    Gokalp, Mehmet Ata; Hekimoglu, Yavuz; Gozen, Abdurrahim; Guner, Savas; Asirdizer, Mahmut

    2016-12-01

    BACKGROUND Lower limb and pelvic injuries and fractures occur at a very high incidence in motor vehicle accidents. In this study, the characteristics (e.g., body side, bone location, and fracture severity) of lower limb and pelvic fractures that occurred during front-impact collisions were correlated with the injured patients' sex, age, and position in the vehicle. MATERIAL AND METHODS We retrospectively evaluated 191 patients (136 males, 55 females) who were injured in motor vehicle accidents, specifically in frontal collisions. RESULTS This study revealed that most of lower limb and pelvic fractures occurred in males (71.2%; p=.000), 19-36 years old (55.5%; p=.000), small vehicles (86.4%; p=.000), and rear seat passengers (49.2%; p=.000). Fractures most commonly occurred in the left side of the body (46.6%; p=.000) and upper legs (37.7%; p=.000). Severity scores were higher (2.76) in males than females (2.07). No statistically significant was found in severity scores of patients and other personal characteristics and fracture features of patients with lower limb and pelvic fractures who were injured in a vehicle during front-impact collisions (p>0.05). CONCLUSIONS The results of this study will be useful for the automobile industry, forensics and criminal scientists, and for trauma research studies.

  8. Absolute total and partial dissociative cross sections of pyrimidine at electron and proton intermediate impact velocities

    Energy Technology Data Exchange (ETDEWEB)

    Wolff, Wania, E-mail: wania@if.ufrj.br; Luna, Hugo; Sigaud, Lucas; Montenegro, Eduardo C. [Instituto de Física, Universidade Federal do Rio de Janeiro, PO 68528, 21941-972 Rio de Janeiro, RJ (Brazil); Tavares, Andre C. [Departamento de Física, Pontificia Universidade Católica do Rio de Janeiro, PO 38071, Rua Marquês de São Vicente 225, 22453-900 Rio de Janeiro, RJ (Brazil)

    2014-02-14

    Absolute total non-dissociative and partial dissociative cross sections of pyrimidine were measured for electron impact energies ranging from 70 to 400 eV and for proton impact energies from 125 up to 2500 keV. MOs ionization induced by coulomb interaction were studied by measuring both ionization and partial dissociative cross sections through time of flight mass spectrometry and by obtaining the branching ratios for fragment formation via a model calculation based on the Born approximation. The partial yields and the absolute cross sections measured as a function of the energy combined with the model calculation proved to be a useful tool to determine the vacancy population of the valence MOs from which several sets of fragment ions are produced. It was also a key point to distinguish the dissociation regimes induced by both particles. A comparison with previous experimental results is also presented.

  9. Prognostic Impact of 21-Gene Recurrence Score in Patients With Stage IV Breast Cancer: TBCRC 013.

    Science.gov (United States)

    King, Tari A; Lyman, Jaclyn P; Gonen, Mithat; Voci, Amy; De Brot, Marina; Boafo, Camilla; Sing, Amy Pratt; Hwang, E Shelley; Alvarado, Michael D; Liu, Minetta C; Boughey, Judy C; McGuire, Kandace P; Van Poznak, Catherine H; Jacobs, Lisa K; Meszoely, Ingrid M; Krontiras, Helen; Babiera, Gildy V; Norton, Larry; Morrow, Monica; Hudis, Clifford A

    2016-07-10

    The objective of this study was to determine whether the 21-gene Recurrence Score (RS) provides clinically meaningful information in patients with de novo stage IV breast cancer enrolled in the Translational Breast Cancer Research Consortium (TBCRC) 013. TBCRC 013 was a multicenter prospective registry that evaluated the role of surgery of the primary tumor in patients with de novo stage IV breast cancer. From July 2009 to April 2012, 127 patients from 14 sites were enrolled; 109 (86%) patients had pretreatment primary tumor samples suitable for 21-gene RS analysis. Clinical variables, time to first progression (TTP), and 2-year overall survival (OS) were correlated with the 21-gene RS by using log-rank, Kaplan-Meier, and Cox regression. Median patient age was 52 years (21 to 79 years); the majority had hormone receptor-positive/human epidermal growth factor receptor 2 (HER2)-negative (72 [66%]) or hormone receptor-positive/HER2-positive (20 [18%]) breast cancer. At a median follow-up of 29 months, median TTP was 20 months (95% CI, 16 to 26 months), and median survival was 49 months (95% CI, 40 months to not reached). An RS was generated for 101 (93%) primary tumor samples: 22 (23%) low risk (< 18), 29 (28%) intermediate risk (18 to 30); and 50 (49%) high risk (≥ 31). For all patients, RS was associated with TTP (P = .01) and 2-year OS (P = .04). In multivariable Cox regression models among 69 patients with estrogen receptor (ER)-positive/HER2-negative cancer, RS was independently prognostic for TTP (hazard ratio, 1.40; 95% CI, 1.05 to 1.86; P = .02) and 2-year OS (hazard ratio, 1.83; 95% CI, 1.14 to 2.95; P = .013). The 21-gene RS is independently prognostic for both TTP and 2-year OS in ER-positive/HER2-negative de novo stage IV breast cancer. Prospective validation is needed to determine the potential role for this assay in the clinical management of this patient subset. © 2016 by American Society of Clinical Oncology.

  10. The impact of the total tax rate reduction on public services provided in Romania

    Directory of Open Access Journals (Sweden)

    Adina TRANDAFIR

    2014-09-01

    Full Text Available Against the background of economic globalization, governments tend to take tax measures disadvantageous to society in order to increase the attractiveness of the business environment. A common measures for this purpose is the reduction in tax rate. According to the classical theory of tax competition such measure leads to under the provision of public goods. This article aims to show, through an econometric analysis, whether in Romania, in the period 2006-2013, reducing total tax rate had a negative impact on public services. For this, using linear regression technique, the article analysed the correlation between total tax rate and the variation in the share of the main public service spending in GDP.

  11. Impact of Total Vending Machine Restrictions on US Young Adult Smoking

    Science.gov (United States)

    Kelly, Brian C.; Kadowaki, Joy

    2016-01-01

    Introduction: In an analysis of smoking using a longitudinal sample of US young adults, we extend research on tobacco vending machine restrictions beyond its prior focus on minors by examining the influence of total vending machine restrictions, which apply to adult-only facilities and represents the only remaining vending machine exemption since the enactment of the Family Smoking Prevention and Tobacco Control Act. We identify whether the passage of a restriction influences an individual’s smoking on repeated observations, and if the propensity is lower among those who live in locations with a restriction. Methods: Combining a repository of US tobacco policies at all geographic levels with the nationally-representative geocoded National Longitudinal Survey of Youth 1997 and Census data, we use multilevel logistic regression to examine the impact of total vending machine restrictions on any past 30-day smoking and past 30-day smoking of one pack per day among young adults (ages 19–31), while accounting for other tobacco control policy, community, and individual covariates. Results: We find that total vending machine restrictions decrease any recent smoking (OR = 0.451; p vending machine restrictions on smoking a pack daily. Conclusions: Total vending machine restrictions appear to be an effective, yet highly underutilized, means of tobacco control. Implications: Past scientific inquiries examining vending machine restrictions have focused upon minor access, adolescent perceptions of availability, and subsequent smoking. The potential for total vending machine restrictions, which extend to adult-only facilities, to influence patterns of smoking among those of legal age, remains significant. Those who are subject to total vending machine restrictions for longer periods are less likely to have recently smoked, but individuals do not change their smoking behavior in response to the passage of a restriction. These restrictions do not affect heavy smokers. Such

  12. What Is the Impact of Smoking on Revision Total Knee Arthroplasty?

    Science.gov (United States)

    Bedard, Nicholas A; Dowdle, S Blake; Wilkinson, Brandon G; Duchman, Kyle R; Gao, Yubo; Callaghan, John J

    2018-07-01

    There is a paucity of literature evaluating the impact of smoking on revision arthroplasty procedures. The purpose of this study was to identify the effect of smoking on complications after revision total knee arthroplasty (rTKA). We queried the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database to identify patients who underwent rTKA between 2006 and 2014. Patients were divided into current smokers and nonsmokers according to the NSQIP definitions. Each cohort was compared in terms of demographic data, preoperative comorbidities, and operative time. Infection end points were created from composite surgical site infection variables defined by the NSQIP database. Multivariate logistic regression analysis was utilized to adjust for confounding variables and calculate adjusted odds ratios (ORs) and associated 95% confidence intervals (95% CIs). In total, 8776 patients underwent rTKA. Of these patients, 11.6% were current smokers. Univariate analyses demonstrated that smokers had a higher rate of any wound complication (3.8% vs 1.8%, P < .0001), deep infection (2.5% vs 1.0%, P < .0001), pneumonia (1.3% vs 0.4%, P < .0001), and reoperation (5.0% vs 3.1%, P = .001) compared to nonsmokers undergoing revision total knee arthroplasty. Multivariate analysis identified current smokers as being at a significantly increased risk of any wound complication (OR 2.1; 95% CI 1.4-3.1) and deep infection (OR 2.1, 95% CI 1.2-3.6) after rTKA. This study demonstrates that smoking significantly increases the risk of infection, wound complications, and reoperation after rTKA. The results are even more magnified for revision procedures compared to published effects of smoking on primary total knee arthroplasty complications. Further research is needed regarding the impact of smoking cessation on mitigation of these observed risks. Copyright © 2018 Elsevier Inc. All rights reserved.

  13. Partial Cutting of Sternothyroid Muscle during Total Thyroidectomy: Impact on Postoperative Vocal Outcomes

    Directory of Open Access Journals (Sweden)

    Hyoung Shin Lee

    2013-01-01

    Full Text Available Background. Cutting the sternothyroid (ST muscle is a useful technique to expose the superior pole of thyroid gland during thyroidectomy. In this study, we evaluated the impact of partial cutting of the ST muscle on postoperative vocal outcomes after total thyroidectomy. Methods. A retrospective review of 57 patients who underwent total thyroidectomy with central neck dissection for micropapillary thyroid carcinoma was conducted. Group A (n=26 included those without cutting the ST muscle, while group B (n=31 included patients whose muscle was partially cut at the superior pole. All patients underwent voice analysis before the operation and 2 weeks and 1 month after the surgery, and the outcomes were compared between the two groups. Results. There were no differences between the two groups regarding the outcomes at each time of voice analysis. Group A showed a decrease of maximum frequency 2 weeks after surgery but showed no difference after 1 month. Group B showed a mild decrease in maximum frequency 2 weeks after surgery, but the difference was not significant. Conclusion. Partial cutting of ST muscle during thyroidectomy is useful to expose the superior pole without significant negative impact on postoperative outcomes of vocal analysis.

  14. The Impact of Scholastic Instrumental Music and Scholastic Chess Study on the Standardized Test Scores of Students in Grades Three, Four, and Five

    Science.gov (United States)

    Martinez, Edwin E.

    2012-01-01

    This study examines the impact of instrumental music study and group chess lessons on the standardized test scores of suburban elementary public school students (grades three through five) in Levittown, New York. The study divides the students into the following groups and compares the standardized test scores of each: a) instrumental music…

  15. PSS32 Impact of dry eye on everyday life (Ideel) - Symptom bother: Estimating cut-off scores for dry eye severity groups

    OpenAIRE

    Acaster, S.; Verboven, Y.; Begley, C.; Chalmers, R.; Abetz, L.; Thompson, T.

    2011-01-01

    The aims of the study were to estimate score ranges associated with dry eye severity based on the Impact of Dry Eye on Everyday Life (IDEEL) Symptom Bother (SB) domain, and to evaluate the overall performance of the SB domain.

  16. Power and color Doppler ultrasound settings for inflammatory flow: impact on scoring of disease activity in patients with rheumatoid arthritis.

    Science.gov (United States)

    Torp-Pedersen, Søren; Christensen, Robin; Szkudlarek, Marcin; Ellegaard, Karen; D'Agostino, Maria Antonietta; Iagnocco, Annamaria; Naredo, Esperanza; Balint, Peter; Wakefield, Richard J; Torp-Pedersen, Arendse; Terslev, Lene

    2015-02-01

    To determine how settings for power and color Doppler ultrasound sensitivity vary on different high- and intermediate-range ultrasound machines and to evaluate the impact of these changes on Doppler scoring of inflamed joints. Six different types of ultrasound machines were used. On each machine, the factory setting for superficial musculoskeletal scanning was used unchanged for both color and power Doppler modalities. The settings were then adjusted for increased Doppler sensitivity, and these settings were designated study settings. Eleven patients with rheumatoid arthritis (RA) with wrist involvement were scanned on the 6 machines, each with 4 settings, generating 264 Doppler images for scoring and color quantification. Doppler sensitivity was measured with a quantitative assessment of Doppler activity: color fraction. Higher color fraction indicated higher sensitivity. Power Doppler was more sensitive on half of the machines, whereas color Doppler was more sensitive on the other half, using both factory settings and study settings. There was an average increase in Doppler sensitivity, despite modality, of 78% when study settings were applied. Over the 6 machines, 2 Doppler modalities, and 2 settings, the grades for each of 7 of the patients varied between 0 and 3, while the grades for each of the other 4 patients varied between 0 and 2. The effect of using different machines, Doppler modalities, and settings has a considerable influence on the quantification of inflammation by ultrasound in RA patients, and this must be taken into account in multicenter studies. Copyright © 2015 by the American College of Rheumatology.

  17. Impact of Students' Participation to a Facebook Group on their Motivation and Scores and on Teacher's Evaluation

    Directory of Open Access Journals (Sweden)

    Bernard Montoneri

    2015-01-01

    Full Text Available The development of Information and communications technology (ICT has brought rapid and profound changes in the field of Education. Nowadays, teachers and students alike are engaging on social networks such as Facebook. This study discusses the benefits of using social network in the classroom. It aims at assessing the impact of Facebook on students' motivation and scores in a course of European Literature in a university of central Taiwan. A class of students was taught during the first semester of academic year 2013-2014 (September-January using a traditional way of teaching. During the second semester (February-June 2014, the teacher used multimedia and Facebook to teach to the same students. They joined a "secret group", that is a group in which only students from the class can join, post, view posts, like, and comment. This research compares various data from the first and second semester to measure students' improvement in motivation, their participation to the group and their scores. The data collected from the Facebook group during the whole second semester and students' evaluation of the educator at the end of each semester. Students are expected to make some progress and teacher's evaluation should improve. Even though Taiwanese students generally read and write in Chinese on Facebook, it is expected that they exclusively use English to read, share, and comment texts and information concerning the books studied during the second semester, thus increasing their chances to improve their reading and writing skills.

  18. The impact of allogenic blood transfusion on the outcomes of total pancreatectomy with islet autotransplantation.

    Science.gov (United States)

    Yoshimatsu, Gumpei; Shahbazov, Rauf; Saracino, Giovanna; Lawrence, Michael C; Kim, Peter T; Onaca, Nicholas; Beecherl, Ernest E; Naziruddin, Bashoo; Levy, Marlon F

    2017-11-01

    Allogenic blood transfusion (ABT) may be needed for severe bleeding during total pancreatectomy with autotransplantation (TPIAT), but may induce inflammation. This study investigated the impact of ABT. With a population of 83 patients who underwent TPIAT from 2006 to 2014, this study compared cytokine levels, patient characteristics, islet characteristics, metabolic outcomes, insulin requirements, and hemoglobin A1c for those who received a blood transfusion (BT) versus no blood transfusion (NBT). Initially, proinflammatory cytokines were moderately higher in the BT group than the NBT group. Despite longer procedures and more severe bleeding, the BT group had similar values to the NBT group for insulin requirements, serum C-peptide, hemoglobin A1c, and insulin independence rate. The probability of insulin independence was slightly higher in patients receiving ≥3 units of blood. ABT induced elevation of proinflammatory cytokines during the perioperative period in TPIAT, but these changes did not significantly change posttransplant islet function. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Global tilt and lumbar lordosis index: two parameters correlating with health-related quality of life scores-but how do they truly impact disability?

    Science.gov (United States)

    Boissière, Louis; Takemoto, Mitsuru; Bourghli, Anouar; Vital, Jean-Marc; Pellisé, Ferran; Alanay, Ahmet; Yilgor, Caglar; Acaroglu, Emre; Perez-Grueso, Francisco Javier; Kleinstück, Frank; Obeid, Ibrahim

    2017-04-01

    Many radiological parameters have been reported to correlate with patient's disability including sagittal vertical axis (SVA), pelvic tilt (PT), and pelvic incidence minus lumbar lordosis (PI-LL). European literature reports other parameters such as lumbar lordosis index (LLI) and the global tilt (GT). If most parameters correlate with health-related quality of life scores (HRQLs), their impact on disability remains unclear. This study aimed to validate these parameters by investigating their correlation with HRQLs. It also aimed to evaluate the relationship between each of these sagittal parameters and HRQLs to fully understand the impact in adult spinal deformity management. A retrospective review of a multicenter, prospective database was carried out. The database inclusion criteria were adults (>18 years old) presenting any of the following radiographic parameters: scoliosis (Cobb ≥20°), SVA ≥5 cm, thoracic kyphosis ≥60° or PT ≥25°. All patients with complete data at baseline were included. Health-related quality of life scores, demographic variables (DVs), and radiographic parameters were collected at baseline. Differences in HRQLs among groups of each DV were assessed with analyses of variance. Correlations between radiographic variables and HRQLs were assessed using the Spearman rank correlation. Multivariate linear regression models were fitted for each of the HRQLs (Oswestry Disability Index [ODI], Scoliosis Research Society-22 subtotal score, or physical component summaries) with sagittal parameters and covariants as independent variables. A p<.05 value was considered statistically significant. Among a total of 755 included patients (mean age, 52.1 years), 431 were non-surgical candidates and 324 were surgical candidates. Global tilt and LLI significantly correlated with HRQLs (r=0.4 and -0.3, respectively) for univariate analysis. Demographic variables such as age, gender, body mass index, past surgery, and surgical or non-surgical candidate

  20. Economic impacts of the total nuclear waste management program envisioned for the United States

    International Nuclear Information System (INIS)

    Busch, L.; Zielen, A.J.; Parry, S.J.S.

    1978-01-01

    This paper presents information on the costs of nuclear waste management and on the impacts of those costs on the price of power and on the capital and labor markets. It is assumed that the LWR would be the sole commercial reactor used through the year 2000. Two fuel cycle options are considered: the throwaway mode (spent fuel is waste), and the full recycle for comparison. Total costs are calculated for all facilities needed to store, package, and reposit all the spent fuel through the lifetime of 380 GW capacity installed by 2000 and operating for 30 y. The economic impact is: the price of power produced by the reactors would be increased by 1.4%; the capital for nuclear plants would apply to waste management; the average annual labor effort needed over the next 50 to 75 years is 3000 to 5000 man years; and the unit cost of spent fuel disposal is $129/kg ($119/kg for full recycle). 7 tables

  1. IMPACTS OF AFRICA'S TOTAL AND COMMODITY-BASED TRADE WITH CHINA AND OECD COUNTRIES

    Directory of Open Access Journals (Sweden)

    Nihal Bayraktar

    2017-02-01

    Full Text Available This paper studies the changes in the pattern of Africa’s trade with China and OECD countries, and the impacts of these changes on sub-Saharan Africa’s economic growth. In the study, the country-level total exports and imports, as well as the commodity-based exports and imports are considered for 42 sub-Saharan African countries between 1980 and 2014. The results show that as the share of China in sub-Saharan Africa’s trade has significantly increased, a declining trend is observed for OECD countries, traditional trading partners. Despite changing trade links, the investigation of the commodity-based exports and imports indicate that the types of imported and exported commodities have not changed much for Africa. However, a strong link is observed between economic growth in SSA and its changing trade links from the OECD countries towards China at the total level as well as at the commodity level. The study concludes that there is an increase in the international competition for Africa’s commodities, and resulting in improvements in the terms of trade has led to higher income growth in the region.

  2. Measuring the impact of total quality management on financial performance of croatian companies

    Directory of Open Access Journals (Sweden)

    Dubravka Pekanov Starčević

    2012-12-01

    Full Text Available Changes in the business environment have resulted in increasing the importance of the quality of products and services of a company. Insisting on quality has become a strategic goal of a company and a determiner of competitiveness both in the home and international market. The traditional approach to quality included determination of product quality after production was completed. High costs of testing to determine the quality of products and services concludes that quality assurance must be approached differently. Product controls and tests used until that moment had to be replaced with a more modern, more efficient and more effective approach known as total quality management (TQM. TQM supporters suggest that TQM implementation results in improved product quality, reduced product return, reduced costs of serving unsatisfied customers and other benefits that ultimately lead to improved financial performance of the company. This paper examines the impact of TQM imple- mentation on the financial performance of Croatian companies whose securities are traded within the regulated market. General characteristics of companies were compared in terms of (nonsystematic application of total quality management. Furthermore, the financial performance of the companies that have successfully implemented the method was measured.

  3. Impact Of Health Care Delivery System Innovations On Total Cost Of Care.

    Science.gov (United States)

    Smith, Kevin W; Bir, Anupa; Freeman, Nikki L B; Koethe, Benjamin C; Cohen, Julia; Day, Timothy J

    2017-03-01

    Using delivery system innovations to advance health care reform continues to be of widespread interest. However, it is difficult to generalize about the success of specific types of innovations, since they have been examined in only a few studies. To gain a broader perspective, we analyzed the results of forty-three ambulatory care programs funded by the first round of the Center for Medicare and Medicaid Innovation's Health Care Innovations Awards. The innovations' impacts on total cost of care were estimated by independent evaluators using multivariable difference-in-differences models. Through the first two years, most of the innovations did not show a significant effect on total cost of care. Using meta-regression, we assessed the effects on costs of five common components of these innovations. Innovations that used health information technology or community health workers achieved the greatest cost savings. Savings were also relatively large in programs that targeted clinically fragile patients-clinically complex populations at risk for disease progression. While the magnitude of these effects was often substantial, none achieved conventional levels of significance in our analyses. Meta-analyses of a larger number of delivery system innovations are needed to more clearly establish their potential for patient care cost savings. Project HOPE—The People-to-People Health Foundation, Inc.

  4. The impact of a resident-run review curriculum and USMLE scores on the Otolaryngology in-service exam.

    Science.gov (United States)

    Redmann, Andrew J; Tawfik, Kareem O; Myer, Charles M

    2018-01-01

    Describe the association of USMLE Step 1 scores and the institution of a dedicated board review curriculum with resident performance on the Otolaryngology training examination. Retrospective cross sectional study. We reviewed American Board of Otolaryngology Training Examination (OTE) scores for an otolaryngology residency program between 2005 and 2016. USMLE Step 1 scores were collected. In 2011 a resident-run OTE review curriculum was instituted with the goal of improving test preparation. Scores were compared before and after curriculum institution. Linear regression was performed to identify predictors of OTE scores. 47 residents were evaluated, 24 before and 23 after instituting the curriculum. There was a moderate correlation between USMLE step 1 scores and OTE scores for all years. For PGY-2 residents, mean OTE scores improved from 25th percentile to 41st percentile after institution of the review curriculum (p = 0.05). PGY 3-5 residents demonstrated no significant improvement. On multivariate linear regression, after controlling for USMLE step 1 scores, a dedicated board review curriculum predicted a 23-point percentile improvement in OTE scores for PGY-2 residents (p = 0.003). For other post-graduate years, the review curriculum did not predict score improvement. USMLE step 1 scores are moderately correlated with OTE performance. A dedicated OTE review curriculum may improve OTE scores for PGY-2 residents, but such a curriculum may have less benefit for intermediate- and senior-level residents. 4. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Assessing the impact of continuous quality improvement/total quality management: concept versus implementation.

    Science.gov (United States)

    Shortell, S M; O'Brien, J L; Carman, J M; Foster, R W; Hughes, E F; Boerstler, H; O'Connor, E J

    1995-01-01

    OBJECTIVE: This study examines the relationships among organizational culture, quality improvement processes and selected outcomes for a sample of up to 61 U. S. hospitals. DATA SOURCES AND STUDY SETTING: Primary data were collected from 61 U. S. hospitals (located primarily in the midwest and the west) on measures related to continuous quality improvement/total quality management (CQI/TQM), organizational culture, implementation approaches, and degree of quality improvement implementation based on the Baldrige Award criteria. These data were combined with independently collected data on perceived impact and objective measures of clinical efficiency (i.e., charges and length of stay) for six clinical conditions. STUDY DESIGN: The study involved cross-sectional examination of the named relationships. DATA COLLECTION/EXTRACTION METHODS: Reliable and valid scales for the organizational culture and quality improvement implementation measures were developed based on responses from over 7,000 individuals across the 61 hospitals with an overall completion rate of 72 percent. Independent data on perceived impact were collected from a national survey and independent data on clinical efficiency from a companion study of managed care. PRINCIPAL FINDINGS: A participative, flexible, risk-taking organizational culture was significantly related to quality improvement implementation. Quality improvement implementation, in turn, was positively associated with greater perceived patient outcomes and human resource development. Larger-size hospitals experienced lower clinical efficiency with regard to higher charges and higher length of stay, due in part to having more bureaucratic and hierarchical cultures that serve as a barrier to quality improvement implementation. CONCLUSIONS: What really matters is whether or not a hospital has a culture that supports quality improvement work and an approach that encourages flexible implementation. Larger-size hospitals face more difficult

  6. The Impact of Imaging Modality on the Measurement of Coronal Plane Alignment After Total Knee Arthroplasty.

    Science.gov (United States)

    Nam, Denis; Vajapey, Sravya; Nunley, Ryan M; Barrack, Robert L

    2016-10-01

    The optimal coronal alignment after total knee arthroplasty (TKA) has become an area of increased debate. Sources of variability among investigations include the radiographic technique used for both preoperative surgical planning and postoperative alignment assessments. This study's purpose was to assess the impact of the imaging modality used on the measurement of coronal plane alignment after TKA. A consecutive series of patients undergoing TKA using the same cruciate-retaining prosthesis were included for analysis. Postoperatively, all patients received both a rotationally controlled, scout computed tomography scan and a hip-knee-ankle (HKA) image using the EOS Imaging system (EOS Inc., Paris, France). Two, independent observers measured the HKA angle, and femoral and tibial component alignment from each image. After classifying overall and component alignment as neutral, varus, or valgus, 40.6% (65 of 160) of knees had a discordant alignment classification for HKA, 28.1% (45 of 160) for femoral component alignment, and 26.9% (43 of 160) for tibial component alignment between their computed tomography and EOS images. Overall, 24.4% (39 of 160) of patients had a HKA difference of ≥3° between the 2 images, whereas 18.8% (30 of 160) and 20.0% (32 of 160) of patients had a femoral and tibial component alignment difference of ≥2°, respectively. Significant differences are present when comparing 2 measurement techniques of mechanical alignment after TKA. The impact of imaging modality on postoperative assessments must be accounted for and be consistent when comparing the results of different investigations. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Prospective analysis of a first MTP total joint replacement. Evaluation by bone mineral densitometry, pedobarography, and visual analogue score for pain

    DEFF Research Database (Denmark)

    Wetke, Eva; Zerahn, Bo; Kofoed, Hakon

    2012-01-01

    We hypothesized that a total replacement of the first metatarsophalangeal joint (MTP-1) would alter the walking pattern with medialisation of the ground reaction force (GRF) of the foot and subsequently cause an increase in bone mineral density (BMD) in the medial metatarsal bones and a decline o...

  8. Every antibiotic, every day: Maximizing the impact of prospective audit and feedback on total antibiotic use.

    Science.gov (United States)

    Campbell, Tonya J; Decloe, Melissa; Gill, Suzanne; Ho, Grace; McCready, Janine; Powis, Jeff

    2017-01-01

    The success of antimicrobial stewardship is dependent on how often it is completed and which antimicrobials are targeted. We evaluated the impact of an antimicrobial stewardship program (ASP) in three non-ICU settings where all systemic antibiotics, regardless of spectrum, were targeted on the first weekday after initiation. Prospective audit and feedback (PAAF) was initiated on the surgical, respiratory, and medical wards of a community hospital on July 1, 2010, October 1, 2010, and April 1, 2012, respectively. We evaluated rates of total antibiotic use, measured in days on therapy (DOTs), among all patients admitted to the wards before and after PAAF initiation using an interrupted time series analysis. Changes in antibiotic costs, rates of C. difficile infection (CDI), mortality, readmission, and length of stay were evaluated using univariate analyses. Time series modelling demonstrated that total antibiotic use decreased (± standard error) by 100 ± 51 DOTs/1,000 patient-days on the surgical wards (p = 0.049), 100 ± 46 DOTs/1,000 patient-days on the respiratory ward (p = 0.029), and 91 ± 33 DOTs/1,000 patient-days on the medical wards (p = 0.006) immediately following PAAF initiation. Reductions in antibiotic use were sustained up to 50 months after intervention initiation, and were accompanied by decreases in antibiotic costs. There were no significant changes to patient outcomes on the surgical and respiratory wards following intervention initiation. On the medical wards, however, readmission increased from 4.6 to 5.6 per 1,000 patient-days (p = 0.043), while mortality decreased from 7.4 to 5.0 per 1,000 patient-days (p = 0.001). CDI rates showed a non-significant declining trend after PAAF initiation. ASPs can lead to cost-effective, sustained reductions in total antibiotic use when interventions are conducted early in the course of therapy and target all antibiotics. Shifting to such a model may help strengthen the effectiveness of ASPs in non

  9. Impact of preoperative antithrombotic therapy on blood management after implantation of primary total knee arthroplasty.

    Science.gov (United States)

    Leitner, Lukas; Musser, Ewald; Kastner, Norbert; Friesenbichler, Jörg; Hirzberger, Daniela; Radl, Roman; Leithner, Andreas; Sadoghi, Patrick

    2016-08-04

    Red blood cell concentrates (RCC) substitution after total knee arthroplasty (TKA) is correlated with multifold of complications and an independent predictor for higher postoperative mortality. TKA is mainly performed in elderly patients with pre-existing polymorbidity, often requiring permanent preoperative antithrombotic therapy (PAT). The aim of this retrospective analysis was to investigate the impact of demand for PAT on inpatient blood management in patients undergoing TKA. In this study 200 patients were retrospectively evaluated after TKA for differences between PAT and non-PAT regarding demographic parameters, preoperative ASA score > 2, duration of operation, pre-, and intraoperative hemoglobin level, and postoperative parameters including amount of wound drainage, RCC requirement, and inpatient time. In a multivariate logistic regression analysis the independent influences of PAT, demographic parameters, ASA score > 2, and duration of the operation on RCC demand following TKA were analyzed. Patients with PAT were significantly older, more often had an ASA > 2 at surgery, needed a higher number of RCCs units and more frequently and had lower perioperative hemoglobin levels. Multivariate logistic regression revealed PAT was an independent predictor for RCC requirement. PAT patients are more likely to require RCC following TKA and should be accurately monitored with respect to postoperative blood loss.

  10. [Impact of air fresheners and deodorizers on the indoor total volatile organic compounds].

    Science.gov (United States)

    Jinno, Hideto; Tanaka-Kagawa, Toshiko; Obama, Tomoko; Miyagawa, Makoto; Yoshikawa, Jun; Komatsu, Kazuhiro; Tokunaga, Hiroshi

    2007-01-01

    Indoor air quality is a growing health concern because of the increased incidence of the building-related illness, such as sick-building syndrome and multiple chemical sensitivity/idiopathic environmental intolerance. In order to effectively reduce the unnecessary chemical exposure in the indoor environment, it would be important to quantitatively compare the emissions from many types of sources. Besides the chemical emissions from the building materials, daily use of household products may contribute at significant levels to the indoor volatile organic compounds (VOCs). In this study, we investigated the emission rate of VOCs and carbonyl compounds for 30 air fresheners and deodorizers by the standard small chamber test method (JIS A 1901). The total VOC (TVOC) emission rates of these household products ranged from the undetectable level (fragrances in the products account for the major part of the TVOC emissions. Based on the emission rates, the impacts on the indoor TVOC were estimated by the simple model with a volume of 17.4 m3 and a ventilation frequency of 0.5 times/h. The mean of the TVOC increment for the indoor air fresheners was 170 microg/m3, accounting for 40% of the current provisional target value, 400 microg/m3. These results suggest that daily use of household products can significantly influence the indoor air quality.

  11. Medical Comorbidities Impact the Episode-of-Care Reimbursements of Total Hip Arthroplasty.

    Science.gov (United States)

    Rosas, Samuel; Sabeh, Karim G; Buller, Leonard T; Law, Tsun Yee; Roche, Martin W; Hernandez, Victor H

    2017-07-01

    Total hip arthroplasty (THA) costs are a source of great interest in the currently evolving health care market. The initiation of a bundled payment system has led to further research into costs drivers of this commonly performed procedure. One aspect that has not been well studied is the effect of comorbidities on the reimbursements of THA. The purpose of this study was to determine if common medical comorbidities affect these reimbursements. A retrospective, level of evidence III study was performed using the PearlDiver supercomputer to identify patients who underwent primary THA between 2007 and 2015. Patients were stratified by medical comorbidities and compared using the analysis of variance for reimbursements of the day of surgery, and over the 90-day postoperative period. A cohort of 250,343 patients was identified. Greatest reimbursements on the day of surgery were found among patients with a history of cirrhosis, morbid obesity, obesity, chronic kidney disease (CKD) and hepatitis C. Patients with cirrhosis, hepatitis C, chronic obstructive pulmonary disease, atrial fibrillation, and CKD incurred in the greatest reimbursements over the 90-day period after surgery. Medical comorbidities significantly impact reimbursements, and inferentially costs, after THA. The most costly comorbidities at 90 days include cirrhosis, hepatitis C, chronic obstructive pulmonary disease, atrial fibrillation, and CKD. Copyright © 2017 Elsevier Inc. All rights reserved.

  12. AbioCor totally implantable artificial heart. How will it impact hospitals?

    Science.gov (United States)

    2002-09-01

    Although heart transplantation remains the most effective treatment for severe heart failure, there are far fewer donor hearts available than there are patients who could benefit from them. One approach to addressing this shortfall is the total artificial heart, or TAH. To date, however, no TAH design has been able to achieve one of the ultimate goals of heart replacement: to allow a patient to live a reasonably normal life without being connected to external machinery. A new design, the AbioCor TAH developed by Abiomed Inc., may make this goal achievable. Thanks to a power system that transfers energy through the skin without the aid of wires, the AbioCor--currently undergoing clinical trials in the United States--allows the patient to be completely mobile. The lack of transcutaneous wires also eliminates the primary source of the infections that have plagued TAH patients in the past. Though it is not without drawbacks, the AbioCor could represent a crucial advance in TAH technology. In this Technology Overview, we describe the operation of the AbioCor and discuss its likely impact on hospitals if it is approved for marketing in the United States. We also discuss a related cardiac-support technology: ventricular assist devices (VADs), which may also be used for permanent cardiac support someday.

  13. The Impact of Relative Poverty on Norwegian Adolescents’ Subjective Health: A Causal Analysis with Propensity Score Matching

    Directory of Open Access Journals (Sweden)

    Jon Ivar Elstad

    2012-12-01

    Full Text Available Studies have revealed that relative poverty is associated with ill health, but the interpretations of this correlation vary. This article asks whether relative poverty among Norwegian adolescents is causally related to poor subjective health, i.e., self-reported somatic and mental symptoms. Data consist of interview responses from a sample of adolescents (N = 510 and their parents, combined with register data on the family’s economic situation. Relatively poor adolescents had significantly worse subjective health than non-poor adolescents. Relatively poor adolescents also experienced many other social disadvantages, such as parental unemployment and parental ill health. Comparisons between the relatively poor and the non-poor adolescents, using propensity score matching, indicated a negative impact of relative poverty on the subjective health among those adolescents who lived in families with relatively few economic resources. The results suggest that there is a causal component in the association between relative poverty and the symptom burden of disadvantaged adolescents. Relative poverty is only one of many determinants of adolescents’ subjective health, but its role should be acknowledged when policies for promoting adolescent health are designed.

  14. The relation of putamen nucleus 6-[18F]fluoro-L-m-tyrosine uptake to total Unified Parkinson's Disease Rating Scale scores

    International Nuclear Information System (INIS)

    Buchy, R.

    2002-01-01

    The contribution of dopaminergic deficiency in the striatum to the severity of locomotor disability in Parkinson's disease has been consistently shown with 6-[ 18 F]fluoro-L-DOPA in positron emission tomography. Recently, 6-[ 18 F]fluoro-L-m-tyrosine, an alternative tracer with similar distribution kinetics has been used to facilitate data analysis. Locomotor disability in Parkinson's disease can be measured using the Unified Parkinson's Disease Rating Scale. The Unified Parkinson's Disease Rating Scale was used in conjunction with 6-[ 18 F]fluoro-L-m-tyrosine -PET to clinically examine a group of five Parkinson's disease patients. An inverse relation similar to that previously demonstrated with 6-[ 18 F]fluoro-L-DOPA was found between the putamen nucleus 6-[ 18 F]fluoro-L-m-tyrosine influx constant and Unified Parkinson's Disease Rating Scale score. This finding suggests that like 6-[ 18 F]fluoro-L-m-tyrosine can be used to accurately measure the degree of locomotor disability caused by Parkinson's disease. (author)

  15. Impact of the branched-chain amino acid to tyrosine ratio and branched-chain amino acid granule therapy in patients with hepatocellular carcinoma: A propensity score analysis.

    Science.gov (United States)

    Tada, Toshifumi; Kumada, Takashi; Toyoda, Hidenori; Kiriyama, Seiki; Tanikawa, Makoto; Hisanaga, Yasuhiro; Kanamori, Akira; Kitabatake, Shusuke; Yama, Tsuyoki

    2015-09-01

    It has been reported that the branched-chain amino acid (BCAA) to tyrosine ratio (BTR) is a useful indicator of liver function and BCAA therapy is associated with a decreased incidence of hepatocellular carcinoma (HCC). However, there has not been sufficient research on the relationship between BTR and the effects of BCAA therapy after initial treatment of HCC. We investigated the impact of BTR and BCAA therapy on survival in patients with HCC. A total of 315 patients with HCC who were treated (n = 66) or not treated (n = 249) with BCAA were enrolled; of these, 66 were selected from each group using propensity score matching. Survival from liver-related mortality was analyzed. In patients who did not receive BCAA therapy (n = 249), multivariate analysis for factors associated with survival indicated that low BTR (≤ 4.4) was independently associated with poor prognosis in patients with HCC (hazard ratio, 1.880; 95% confidence interval, 1.125-3.143; P = 0.016). In addition, among patients selected by propensity score matching (n = 132), multivariate analysis indicated that BCAA therapy was independently associated with good prognosis in patients with HCC (hazard ratio, 0.524; 95% confidence interval, 0.282-0.973; P = 0.041). BTR was not significantly associated with survival. Intervention involving BCAA therapy improved survival in patients with HCC versus untreated controls, regardless of BTR. In addition, low BTR was associated with poor prognosis in patients who did not receive BCAA therapy. © 2015 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.

  16. Category fluency test: effects of age, gender and education on total scores, clustering and switching in Brazilian Portuguese-speaking subjects

    Directory of Open Access Journals (Sweden)

    Brucki S.M.D.

    2004-01-01

    Full Text Available Verbal fluency tests are used as a measure of executive functions and language, and can also be used to evaluate semantic memory. We analyzed the influence of education, gender and age on scores in a verbal fluency test using the animal category, and on number of categories, clustering and switching. We examined 257 healthy participants (152 females and 105 males with a mean age of 49.42 years (SD = 15.75 and having a mean educational level of 5.58 (SD = 4.25 years. We asked them to name as many animals as they could. Analysis of variance was performed to determine the effect of demographic variables. No significant effect of gender was observed for any of the measures. However, age seemed to influence the number of category changes, as expected for a sensitive frontal measure, after being controlled for the effect of education. Educational level had a statistically significant effect on all measures, except for clustering. Subject performance (mean number of animals named according to schooling was: illiterates, 12.1; 1 to 4 years, 12.3; 5 to 8 years, 14.0; 9 to 11 years, 16.7, and more than 11 years, 17.8. We observed a decrease in performance in these five educational groups over time (more items recalled during the first 15 s, followed by a progressive reduction until the fourth interval. We conclude that education had the greatest effect on the category fluency test in this Brazilian sample. Therefore, we must take care in evaluating performance in lower educational subjects.

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

    Science.gov (United States)

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

    2014-01-01

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

  18. The Health Impacts of Energy Policy Pathways in Ulaanbaatar, Mongolia: A Total Exposure Assessment

    Science.gov (United States)

    Hill, L. A.; Damdinsuren, Y.; Olkhanud, P. B.; Smith, K. R.; Turner, J. R.; Edwards, R.; Odsuren, M.; Ochir, C.

    2015-12-01

    Ulaanbaatar is home to nearly half of Mongolia's 2.8 million residents. The city's rapid growth, frigid winters, valley topography, and reliance on coal-fired stoves have led to some of the worst winter pollution levels in the world. To better understand this issue, we modeled integrated PM2.5exposures and related health impacts for various city-wide heating policies through 2024. This assessment is one of the first to employ a total exposure approach and results of the 2014 Comparative Risk Assessments of the Global Burden of Disease Project (CRA/GBD) in a policy-relevant energy study. Emissions related to heating, traffic, and power generation were considered under Business as Usual, Moderate Improvement, and Max Improvement scenarios. Calibrated outdoor models were combined with indoor models, local infiltration and time activity estimates, and demographic projections to estimate PM2.5exposures in 2014 and 2024. Indoor exposures were assigned by heating type, home type, and smoking status; outdoor exposures were assigned through geocoding. Population average annual exposures were calculated and applied to local disease rates and integrated exposure-response curves (2014 CRA/GBD) to arrive at annual projections of premature deaths and DALYs. We estimate 2014 annual average exposures at 68 μg/m3, dictated almost exclusively by indoor winter exposures. Under current trends, annual exposures increase 10% to 75 μg/m3 in 2024. This is in stark contrast to the moderate and max improvement scenarios, which lead to 2024 annual exposures that are 31%, and 68% lower, respectively. Under the Moderate scenario, 2024 per capita annual DALY and death burdens drop 26% and 22%, respectively, from 2014 levels. Under the Max scenario, 2024 per capita annual DALY and death burdens drop 71% and 66%, respectively, from 2014. SHS becomes a major contributor as emissions from other sectors decrease. Reductions are dominated by cardiovascular and lower respiratory diseases in children.

  19. Impact of postoperative glycemic control and nutritional status on clinical outcomes after total pancreatectomy.

    Science.gov (United States)

    Shi, Hao-Jun; Jin, Chen; Fu, De-Liang

    2017-01-14

    To evaluate the impact of glycemic control and nutritional status after total pancreatectomy (TP) on complications, tumor recurrence and overall survival. Retrospective records of 52 patients with pancreatic tumors who underwent TP were collected from 2007 to 2015. A series of clinical parameters collected before and after surgery, and during the follow-up were evaluated. The associations of glycemic control and nutritional status with complications, tumor recurrence and long-term survival were determined. Risk factors for postoperative glycemic control and nutritional status were identified. High early postoperative fasting blood glucose (FBG) levels (OR = 4.074, 95%CI: 1.188-13.965, P = 0.025) and low early postoperative prealbumin levels (OR = 3.816, 95%CI: 1.110-13.122, P = 0.034) were significantly associated with complications after TP. Postoperative HbA1c levels over 7% (HR = 2.655, 95%CI: 1.299-5.425, P = 0.007) were identified as one of the independent risk factors for tumor recurrence. Patients with postoperative HbA1c levels over 7% had much poorer overall survival than those with HbA1c levels less than 7% (9.3 mo vs 27.6 mo, HR = 3.212, 95%CI: 1.147-8.999, P = 0.026). Patients with long-term diabetes mellitus (HR = 15.019, 95%CI: 1.278-176.211, P = 0.031) and alcohol history (B = 1.985, SE = 0.860, P = 0.025) tended to have poor glycemic control and lower body mass index levels after TP, respectively. At least 3 mo are required after TP to adapt to diabetes and recover nutritional status. Glycemic control appears to have more influence over nutritional status on long-term outcomes after TP. Improvement in glycemic control and nutritional status after TP is important to prevent early complications and tumor recurrence, and improve survival.

  20. Impact of neoadjuvant treatment on total mesorectal excision for ultra-low rectal cancers

    Directory of Open Access Journals (Sweden)

    Fan Joe FM

    2010-03-01

    Full Text Available Abstract Background This study reviewed the impact of pre-operative chemoradiotherapy or post-operative chemotherapy and/or radiotherapy on total mesorectal excision (TME for ultralow rectal cancers that required either low anterior resection with peranal coloanal anastomosis or abdomino-perineal resection (APR. We examined surgical complications, local recurrence and survival. Methods Of the 1270 patients who underwent radical resection for rectal cancer from 1994 till 2007, 180 with tumors within 4 cm with either peranal coloanal anastomosis or APR were analyzed. Patients were compared in groups that had surgery only (Group A, pre-operative chemoradiotherapy (Group B, and post-operative therapy (Group C. Results There were 115 males and the mean age was 65.43 years (range 30-89. APR was performed in 134 patients while 46 had a sphincter-preserving resection with peranal coloanal anastomosis. The mean follow-up period was 52.98 months (range: 0.57 to 178.9. There were 69, 58 and 53 patients in Groups A, B, and C, respectively. Nine patients in Group B could go on to have sphincter-saving rectal resection. The overall peri-operative complication rate was 43.4% in Group A vs. 29.3% in Group B vs. 39.6% in Group C, respectively. The local recurrence rate was significantly lower in Group B (8.6.9% vs. 21.7% in Group A vs. 33.9% in Group C p . The 5-year cancer-specific survival rates for Group A was 49.3%, Group B was 69.9% and Group C was 38.8% (p = 0.14. Conclusion Pre-operative chemoradiation in low rectal cancer is not associated with a higher incidence of peri-operative complications and its benefits may include reduction local recurrence.

  1. Impact of biomass burning emission on total peroxy nitrates: fire plume identification during the BORTAS campaign

    Directory of Open Access Journals (Sweden)

    E. Aruffo

    2016-11-01

    Full Text Available Total peroxy nitrate ( ∑ PN concentrations have been measured using a thermal dissociation laser-induced fluorescence (TD-LIF instrument during the BORTAS campaign, which focused on the impact of boreal biomass burning (BB emissions on air quality in the Northern Hemisphere. The strong correlation observed between the  ∑ PN concentrations and those of carbon monoxide (CO, a well-known pyrogenic tracer, suggests the possible use of the  ∑ PN concentrations as marker of the BB plumes. Two methods for the identification of BB plumes have been applied: (1  ∑ PN concentrations higher than 6 times the standard deviation above the background and (2  ∑ PN concentrations higher than the 99th percentile of the  ∑ PNs measured during a background flight (B625; then we compared the percentage of BB plume selected using these methods with the percentage evaluated, applying the approaches usually used in literature. Moreover, adding the pressure threshold ( ∼  750 hPa as ancillary parameter to  ∑ PNs, hydrogen cyanide (HCN and CO, the BB plume identification is improved. A recurrent artificial neural network (ANN model was adapted to simulate the concentrations of  ∑ PNs and HCN, including nitrogen oxide (NO, acetonitrile (CH3CN, CO, ozone (O3 and atmospheric pressure as input parameters, to verify the specific role of these input data to better identify BB plumes.

  2. The Impact of Medical Comorbidities on Primary Total Knee Arthroplasty Reimbursements.

    Science.gov (United States)

    Sabeh, Karim G; Rosas, Samuel; Buller, Leonard T; Freiberg, Andrew A; Emory, Cynthia L; Roche, Martin W

    2018-05-23

    Medical comorbidities have been shown to cause an increase in peri-and postoperative complications following total knee arthroplasty (TKA). However, the increase in cost associated with these complications has yet to be determined. Factors that influence cost have been of great interest particularly after the initiation of bundled payment initiatives. In this study, we present and quantify the influence of common medical comorbidities on the cost of care in patients undergoing primary TKA. A retrospective level of evidence III study was performed using the PearlDiver supercomputer to identify patients who underwent primary TKA between 2007 and 2015. Patients were stratified by medical comorbidities and compared using analysis of variance for reimbursements for the day of surgery and over 90 days postoperatively. A cohort of 137,073 US patients was identified as having undergone primary TKA between 2007 and 2015. The mean entire episode-of-care reimbursement was $23,701 (range: $21,294-26,299; standard deviation [SD] $2,611). The highest reimbursements were seen in patients with chronic obstructive pulmonary disease (mean $26,299; SD $3,030), hepatitis C (mean $25,662; SD $2,766), morbid obesity (mean $25,450; SD $2,154), chronic kidney disease (mean $25,131, $3,361), and cirrhosis (mean $24,890; SD $2,547). Medical comorbidities significantly impact reimbursements, and therefore cost, after primary TKA. Comprehensive preoperative optimization for patients with medical comorbidities undergoing TKA is highly recommended and may reduce perioperative complications, improve patient outcome, and ultimately reduce cost. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  3. Intraobserver and interobserver variability of the bone marrow burden (BMB) score for the assessment of disease severity in Gaucher disease. Possible impact of reporting experience.

    Science.gov (United States)

    Lai, Jeffrey K C; Robertson, Patricia L; Goh, Christine; Szer, Jeff

    2018-02-01

    To evaluate the intraobserver and interobserver agreement for bone marrow burden (BMB) scores for individual examinations and for the change in BMB score over time in the same patient. A total of 119 sets of MR images of the lumbar spine and femora from 60 patients with Gaucher disease were included. Each set of MR images was scored using the BMB score independently by two experienced MSK radiologists. One radiologist performed a second read four weeks later. Intraobserver and interobserver agreement was assessed using Bland-Altman analysis and weighted kappa scores. BMB scores (n=119) demonstrated fair intraobserver agreement (weighted kappa=0.53) with a mean difference of -0.20 and 95% limits of agreement (LOA) of (-3.41, 3.01). Inter observer agreement was poor with weighted kappa 0.28 with mean difference of -0.16 and 95% LOA of (-4.45, 4.11). Change in BMB scores over time (n=59) demonstrated poor/fair intraobserver agreement (weighted kappa 0.41, mean difference-0.20 and 95% LOA (-4.35, 3.94)). Interobserver agreement was poor (weighted kappa 0.25, mean difference -0.12 with wide 95% LOA (-6.23, 5.99)). Significant interobserver, and to a lesser extent intraobserver, variation occurs with blinded BMB scoring of Gaucher disease. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Analysis the Impact of Technology Spillovers on Total Factor Productivity of Agricultural Sector in Iran

    Directory of Open Access Journals (Sweden)

    Mostafa Baniasadi

    2016-09-01

    Full Text Available Introduction: The growth of agricultural production and natural resources are from primary objectives of any political system, because this section has a vital role in providing food security. According to the production theories, production growth will come from two sources; more use of production factors within the framework of existing technologies and second, with using more advanced and more efficient production methods and effective use of production factors. In fact, the second one is tied to the concept of productivity. New and efficient technologies are the most important factor for productivity growth. Technology was enhanced through internal and external sources. External sources include spillover technology from developed countries into another country. Empirical evidence on the impact of spillover technology on productivity growth of indigenous producer is vague. One perspective proposes that FDI, technology transferred from developed countries has positive effects on developing countries and another perspective is against it. This paper explores the role of technological spillover on total factor productivity (TFP growth in agricultural sectors of Iran uses time series data during 1971-2011. Materials and Methods: In this study, Kendrick model was used to calculate total factor productivity. After calculating productivity, affective factors on it, were examined through ARDL model. The aim of this study is examination of technology spillover on the productivity of agricultural sectors. The degree of technology diffusion grows with increase in technology distance between the hosts and the foreign countries. The greater the technology distance, the more difficult it becomes for developing countries to boost independent innovation. To calculate the index of technology spillover, commercial partners should be considered that are more advanced in science and technology than Iran. For this purpose, commercial partners in this study are

  5. The responsiveness of the International Prostate Symptom Score, Incontinence Impact Questionnaire-7 and Depression, Anxiety and Stress Scale-21 in patients with lower urinary tract symptoms.

    Science.gov (United States)

    Choi, Edmond P H; Chin, Weng Yee; Lam, Cindy L K; Wan, Eric Y F

    2015-08-01

    To examine the responsiveness of a combined symptom severity and health-related quality of life measure, condition-specific health-related quality of life measure and mental health measure in patients with lower urinary tract symptoms. To establish the responsiveness of measures that accurately capture the change in health status of patients is crucial before any longitudinal studies can be appropriately planned and evaluated. Prospective longitudinal observational study. 402 patients were surveyed at baseline and 1-year using the International Prostate Symptom Score, the Incontinence Impact Questionnaire-7 and Depression, Anxiety and Stress Scales-21. The internal and external responsiveness were assessed. Surveys were conducted from March 2013-July 2014. In participants with improvements, the internal responsiveness for detecting positive changes was satisfactory in males and females for all scales, expect for the Depression subscale. The health-related quality of life question of the International Prostate Symptom Score was more externally responsive than the Incontinence Impact Questionnaire-7. The International Prostate Symptom Score and Anxiety and Stress subscales were more responsive in males than in females. The symptom questions of the International Prostate Symptom Score and Anxiety and Stress subscales were not externally responsive in females. The health-related quality of life question of the International Prostate Symptom Score outperformed the Incontinence Impact Questionnaire-7 in both males and females, in terms of external responsiveness. © 2015 John Wiley & Sons Ltd.

  6. Prognostic impact of nutritional status assessed by the Controlling Nutritional Status score in patients with stable coronary artery disease undergoing percutaneous coronary intervention.

    Science.gov (United States)

    Wada, Hideki; Dohi, Tomotaka; Miyauchi, Katsumi; Doi, Shinichiro; Konishi, Hirokazu; Naito, Ryo; Tsuboi, Shuta; Ogita, Manabu; Kasai, Takatoshi; Okazaki, Shinya; Isoda, Kikuo; Suwa, Satoru; Daida, Hiroyuki

    2017-11-01

    Recently, malnutrition has been shown to be related to worse clinical outcomes in patients with heart failure. However, the association between nutritional status and clinical outcomes in patients with coronary artery disease (CAD) remains unclear. We investigated the prognostic value of malnutrition assessed by the Controlling Nutritional Status (CONUT; range 0-12, higher = worse, consisting of serum albumin, cholesterol and lymphocytes) score in patients with CAD. The CONUT score was measured on admission in a total of 1987 patients with stable CAD who underwent elective percutaneous coronary intervention (PCI) between 2000 and 2011. Patients were divided into two groups according to their CONUT score (0-1 vs. ≥2). The incidence of major adverse cardiac events (MACE), including all-cause death and non-fatal myocardial infarction, was evaluated. The median CONUT score was 1 (interquartile range 0-2). During the median follow-up of 7.4 years, 342 MACE occurred (17.2%). Kaplan-Meier curves revealed that patients with high CONUT scores had higher rates of MACE (log-rank p < 0.0001). High CONUT scores showed a significant increase in the incidence of MACE compared with low CONUT scores, even after adjusting for confounding factors (hazard ratio: 1.64, 95% confidence interval 1.30-2.07, p < 0.0001). Adding CONUT scores to a baseline model with established risk factors improved the C-index (p = 0.02), net reclassification improvement (p = 0.004) and integrated discrimination improvement (p = 0.0003). Nutritional status assessed by the CONUT score was significantly associated with long-term clinical outcomes in patients with CAD. Pre-PCI assessment of the CONUT score may provide useful prognostic information.

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

    Science.gov (United States)

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

    2012-01-01

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

  8. Genetic parameters for somatic cell score according to udder infection status in Valle del Belice dairy sheep and impact of imperfect diagnosis of infection.

    NARCIS (Netherlands)

    Riggio, V.; Portolano, B.; Bovenhuis, H.; Scatassa, S.; Bishop, S.C.

    2010-01-01

    Background Somatic cell score (SCS) has been promoted as a selection criterion to improve mastitis resistance. However, SCS from healthy and infected animals may be considered as separate traits. Moreover, imperfect sensitivity and specificity could influence animals' classification and impact on

  9. An Analysis of Peer-Reviewed Scores and Impact Factors with Different Citation Time Windows: A Case Study of 28 Ophthalmologic Journals.

    Science.gov (United States)

    Liu, Xue-Li; Gai, Shuang-Shuang; Zhang, Shi-Le; Wang, Pu

    2015-01-01

    An important attribute of the traditional impact factor was the controversial 2-year citation window. So far, several scholars have proposed using different citation time windows for evaluating journals. However, there is no confirmation whether a longer citation time window would be better. How did the journal evaluation effects of 3IF, 4IF, and 6IF comparing with 2IF and 5IF? In order to understand these questions, we made a comparative study of impact factors with different citation time windows with the peer-reviewed scores of ophthalmologic journals indexed by Science Citation Index Expanded (SCIE) database. The peer-reviewed scores of 28 ophthalmologic journals were obtained through a self-designed survey questionnaire. Impact factors with different citation time windows (including 2IF, 3IF, 4IF, 5IF, and 6IF) of 28 ophthalmologic journals were computed and compared in accordance with each impact factor's definition and formula, using the citation analysis function of the Web of Science (WoS) database. An analysis of the correlation between impact factors with different citation time windows and peer-reviewed scores was carried out. Although impact factor values with different citation time windows were different, there was a high level of correlation between them when it came to evaluating journals. In the current study, for ophthalmologic journals' impact factors with different time windows in 2013, 3IF and 4IF seemed the ideal ranges for comparison, when assessed in relation to peer-reviewed scores. In addition, the 3-year and 4-year windows were quite consistent with the cited peak age of documents published by ophthalmologic journals. Our study is based on ophthalmology journals and we only analyze the impact factors with different citation time window in 2013, so it has yet to be ascertained whether other disciplines (especially those with a later cited peak) or other years would follow the same or similar patterns. We designed the survey questionnaire

  10. Scoring methods and results for qualitative evaluation of public health impacts from the Hanford high-level waste tanks. Integrated Risk Assessment Program

    International Nuclear Information System (INIS)

    Buck, J.W.; Gelston, G.M.; Farris, W.T.

    1995-09-01

    The objective of this analysis is to qualitatively rank the Hanford Site high-level waste (HLW) tanks according to their potential public health impacts through various (groundwater, surface water, and atmospheric) exposure pathways. Data from all 149 single-shell tanks (SSTs) and 23 of the 28 double-shell tanks (DSTs) in the Tank Waste Remediation System (TWRS) Program were analyzed for chemical and radiological carcinogenic as well as chemical noncarcinogenic health impacts. The preliminary aggregate score (PAS) ranking system was used to generate information from various release scenarios. Results based on the PAS ranking values should be considered relative health impacts rather than absolute risk values

  11. Impact of the use of contrast-enhancement multidetector CT for acute appendicitis: a prospective comparison with the Alvarado score

    International Nuclear Information System (INIS)

    Choi, Mi Young; Yoon, Seong Eon; Lee, Young Hwan; Choi, Shi Sung; Park, Seong Hoon; Juhng, Seong Kwan; Yoon, Kwon Ha; Park, Seong Ho

    2007-01-01

    To determine the diagnostic performance of contrast-enhanced multidetector CT (MDCT) and the Alvarado score for acute appendicitis. MDCT and determination of the Alvarado score were prospectively performed in 282 patients with 146 pathologically proven cases of acute appendicitis and 136 pathologically proven or clinically diagnosed cases of non-acute appendicitis. To compare the diagnostic performance of MDCT and the Alvarado score, the patients were subdivided according to age and sex, and receiver operating characteristics (ROC) analysis and Spearman rank correlation were performed. ROC analysis revealed that the optimal cut off value of the CT appendicitis grades was 2 in all patients, resulting in a sensitivity of 96.6% and a specificity of 94.9%. The optimal cut off values of the Alvarado score was different according to age and sex, resulting in a sensitivity of 85.6% and a specificity of 48.5%. There was a significant correlation between the CT appendicitis grades and the surgical-pathological grades (r = 0.496, ρ < .0001). However, no significant correlation was observed between the Alvarado score and the surgical-pathological grades. Contrast-enhanced MDCT has a higher diagnostic accuracy and significant correlation with pathological findings than those of the Alvarado score in patients with acute appendicitis

  12. Impact of the use of contrast-enhancement multidetector CT for acute appendicitis: a prospective comparison with the Alvarado score

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Mi Young; Yoon, Seong Eon; Lee, Young Hwan; Choi, Shi Sung; Park, Seong Hoon; Juhng, Seong Kwan; Yoon, Kwon Ha [Wonkwang University School of Medicine, Iksan (Korea, Republic of); Park, Seong Ho [University of Ulsan College of Medicine, Asan Medical Center, Seoul (Korea, Republic of)

    2007-12-15

    To determine the diagnostic performance of contrast-enhanced multidetector CT (MDCT) and the Alvarado score for acute appendicitis. MDCT and determination of the Alvarado score were prospectively performed in 282 patients with 146 pathologically proven cases of acute appendicitis and 136 pathologically proven or clinically diagnosed cases of non-acute appendicitis. To compare the diagnostic performance of MDCT and the Alvarado score, the patients were subdivided according to age and sex, and receiver operating characteristics (ROC) analysis and Spearman rank correlation were performed. ROC analysis revealed that the optimal cut off value of the CT appendicitis grades was 2 in all patients, resulting in a sensitivity of 96.6% and a specificity of 94.9%. The optimal cut off values of the Alvarado score was different according to age and sex, resulting in a sensitivity of 85.6% and a specificity of 48.5%. There was a significant correlation between the CT appendicitis grades and the surgical-pathological grades (r = 0.496, {rho} < .0001). However, no significant correlation was observed between the Alvarado score and the surgical-pathological grades. Contrast-enhanced MDCT has a higher diagnostic accuracy and significant correlation with pathological findings than those of the Alvarado score in patients with acute appendicitis.

  13. [Impact to Z-score Mapping of Hyperacute Stroke Images by Computed Tomography in Adaptive Statistical Iterative Reconstruction].

    Science.gov (United States)

    Watanabe, Shota; Sakaguchi, Kenta; Hosono, Makoto; Ishii, Kazunari; Murakami, Takamichi; Ichikawa, Katsuhiro

    The purpose of this study was to evaluate the effect of a hybrid-type iterative reconstruction method on Z-score mapping of hyperacute stroke in unenhanced computed tomography (CT) images. We used a hybrid-type iterative reconstruction [adaptive statistical iterative reconstruction (ASiR)] implemented in a CT system (Optima CT660 Pro advance, GE Healthcare). With 15 normal brain cases, we reconstructed CT images with a filtered back projection (FBP) and ASiR with a blending factor of 100% (ASiR100%). Two standardized normal brain data were created from normal databases of FBP images (FBP-NDB) and ASiR100% images (ASiR-NDB), and standard deviation (SD) values in basal ganglia were measured. The Z-score mapping was performed for 12 hyperacute stroke cases by using FBP-NDB and ASiR-NDB, and compared Z-score value on hyperacute stroke area and normal area between FBP-NDB and ASiR-NDB. By using ASiR-NDB, the SD value of standardized brain was decreased by 16%. The Z-score value of ASiR-NDB on hyperacute stroke area was significantly higher than FBP-NDB (pASiR100% for Z-score mapping had potential to improve the accuracy of Z-score mapping.

  14. Impact of total ionizing dose on the electromagnetic susceptibility of a single bipolar transistor

    International Nuclear Information System (INIS)

    Doridant, A.; Jarrix, S.; Raoult, J.; Blain, A.; Dusseau, L.; Chatry, N.; Calvel, P.; Hoffmann, P.

    2012-01-01

    Space or military electronic components are subject to both electromagnetic fields and total ionizing dose. This paper deals with the electromagnetic susceptibility of a discrete low frequency transistor subject to total ionizing dose deposition. The electromagnetic susceptibility is investigated on both non-irradiated and irradiated transistors mounted in common emitter configuration. The change in susceptibility to 100 MHz-1.5 GHz interferences lights up a synergy effect between near field electromagnetic waves and total ionizing dose. Physical mechanisms leading to changes in signal output are detailed. (authors)

  15. Impaction Force Influences Taper-Trunnion Stability in Total Hip Arthroplasty.

    Science.gov (United States)

    Danoff, Jonathan R; Longaray, Jason; Rajaravivarma, Raga; Gopalakrishnan, Ananthkrishnan; Chen, Antonia F; Hozack, William J

    2018-01-31

    This study investigated the influence of femoral head impaction force, number of head strikes, the energy sequence of head strikes, and head offset on the strength of the taper-trunnion junction. Thirty titanium-alloy trunnions were mated with 36-mm zero-offset cobalt-chromium femoral heads of corresponding taper angle. A drop tower impacted the head with 2.5J or 8.25J, resulting in 6 kN or 14 kN impaction force, respectively, in a single strike or combinations of 6 kN + 14 kN or 14 kN + 14 kN. In addition, ten 36-mm heads with -5 and +5 offset were impacted with sequential 14 kN + 14 kN strikes. Heads were subsequently disassembled using a screw-driven mechanical testing frame, and peak distraction force was recorded. Femoral head pull-off force was 45% the strike force, and heads struck with a single 14 kN impact showed a pull-off force twice that of the 6 kN group. Two head strikes with the same force did not improve pull-off force for either 6 kN (P = .90) or 14 kN (P = .90). If the forces of the 2 impactions varied, but either impact measured 14 kN, a 51% higher pull-off force was found compared to impactions of either 6 kN or 6 kN + 6 kN. Femoral head offset did not significantly change the pull-off force among -5, 0, and +5 heads (P = .37). Femoral head impaction force influenced femoral head trunnion-taper stability, whereas offset did not affect pull-off force. Multiple head strikes did not add additional stability, as long as a single strike achieved 14 kN force at the mallet-head impactor interface. Insufficient impaction force may lead to inadequate engagement of the trunnion-taper junction. Copyright © 2018 Elsevier Inc. All rights reserved.

  16. The Impact of Total Quality Management Practices on Non-Financial Performance Perceptions

    Directory of Open Access Journals (Sweden)

    Fetullah EVLİYAOĞLU

    2012-09-01

    Full Text Available This study examines the effect of total quality management applications on non-financial performance perceptions of employees. The research applied by surveys on employees in quality departments of five companies which have businesses in the field of tourism, transportation, construction, food and technology. “Leadership and continuous improvement”, “costumer focused” and “stakeholder participation” dimensions for total quality management and “customer perspective”, “innovation and learning perspective” and “internal processes perspective” dimensions for non-financial performance are derived from factor analysis. Customer focus, one of the total quality management, has significant relationship with customer perspective and innovation and learning perspective of non-financial performance. Customer focus dimension of total quality management has a significant negative effect on innovation and learning perspective of non-financial performance. There are no relationships between the rests of the dimensions.

  17. Potential Impact of Rainfall on the Air-Surface Exchange of Total Gaseous Mercury from Two Common Urban Ground Surfaces

    Science.gov (United States)

    The impact of rainfall on total gaseous mercury (TGM) flux from pavement and street dirt surfaces was investigated in an effort to determine the influence of wet weather events on mercury transport in urban watersheds. Street dirt and pavement are common urban ground surfaces tha...

  18. Supplier managed inventory in the OEM supply chain : the impact of relationship types on total costs and cost distribution

    NARCIS (Netherlands)

    Nyen, van P.L.M.; Bertrand, J.W.M.; Ooijen, van H.P.G.; Vandaele, N.J.

    2009-01-01

    We investigate the impact of four variants of supplier managed inventory on total costs and cost distribution in a capital goods supply chain consisting of a parts supplier who delivers parts to an original equipment manufacturer’s assembly plant. The four supplier managed inventory variants differ

  19. The impact of CT radiation dose reduction and iterative reconstruction algorithms from four different vendors on coronary calcium scoring

    Energy Technology Data Exchange (ETDEWEB)

    Willemink, Martin J.; Takx, Richard A.P.; Jong, Pim A. de; Budde, Ricardo P.J.; Schilham, Arnold M.R.; Leiner, Tim [Utrecht University Medical Center, Department of Radiology, Utrecht (Netherlands); Bleys, Ronald L.A.W. [Utrecht University Medical Center, Department of Anatomy, Utrecht (Netherlands); Das, Marco; Wildberger, Joachim E. [Maastricht University Medical Center, Department of Radiology, Maastricht (Netherlands); Prokop, Mathias [Radboud University Nijmegen Medical Center, Department of Radiology, Nijmegen (Netherlands); Buls, Nico; Mey, Johan de [UZ Brussel, Department of Radiology, Brussels (Belgium)

    2014-09-15

    To analyse the effects of radiation dose reduction and iterative reconstruction (IR) algorithms on coronary calcium scoring (CCS). Fifteen ex vivo human hearts were examined in an anthropomorphic chest phantom using computed tomography (CT) systems from four vendors and examined at four dose levels using unenhanced prospectively ECG-triggered protocols. Tube voltage was 120 kV and tube current differed between protocols. CT data were reconstructed with filtered back projection (FBP) and reduced dose CT data with IR. CCS was quantified with Agatston scores, calcification mass and calcification volume. Differences were analysed with the Friedman test. Fourteen hearts showed coronary calcifications. Dose reduction with FBP did not significantly change Agatston scores, calcification volumes and calcification masses (P > 0.05). Maximum differences in Agatston scores were 76, 26, 51 and 161 units, in calcification volume 97, 27, 42 and 162 mm{sup 3}, and in calcification mass 23, 23, 20 and 48 mg, respectively. IR resulted in a trend towards lower Agatston scores and calcification volumes with significant differences for one vendor (P < 0.05). Median relative differences between reference FBP and reduced dose IR for Agatston scores remained within 2.0-4.6 %, 1.0-5.3 %, 1.2-7.7 % and 2.6-4.5 %, for calcification volumes within 2.4-3.9 %, 1.0-5.6 %, 1.1-6.4 % and 3.7-4.7 %, for calcification masses within 1.9-4.1 %, 0.9-7.8 %, 2.9-4.7 % and 2.5-3.9 %, respectively. IR resulted in increased, decreased or similar calcification masses. CCS derived from standard FBP acquisitions was not affected by radiation dose reductions up to 80 %. IR resulted in a trend towards lower Agatston scores and calcification volumes. (orig.)

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

    Directory of Open Access Journals (Sweden)

    Karen A. Friedman

    2014-11-01

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

  1. High self-assessment of disability and the surgeon's recommendation against surgical intervention may negatively impact satisfaction scores in patients with spinal disorders.

    Science.gov (United States)

    Mazur, Marcus D; McEvoy, Sara; Schmidt, Meic H; Bisson, Erica F

    2015-06-01

    OBJECT Patient satisfaction scores have become a common metric for health care quality. Because satisfaction scores are right-skewed, even small differences in mean scores can have a large impact. Little information, however, is available on the specific factors that play a role in satisfaction in patients with spinal disorders. The authors investigated whether disability severity and the surgeon's recommendation for or against surgical intervention were associated with patient satisfaction scores. METHODS The authors conducted a retrospective cohort study involving adult patients who were referred to a spine surgeon for an outpatient evaluation of back pain. Patients completed the Oswestry Disability Index (ODI) before their clinic appointment and a Press Ganey patient satisfaction survey after their visit. Patients were grouped by self-assessed disability severity: mild to moderate (ODI Satisfaction scores were graded from 0 (very poor) to 100 (very good). Nonparametric tests were used to evaluate the association between patient satisfaction and current disability self-assessment. The authors also investigated whether the surgeon's recommendation against surgery negatively affected patient satisfaction. RESULTS One hundred thirty patients completed the ODI questionnaire before and satisfaction surveys after seeing a spine surgeon for a new outpatient back pain consultation. Of these, 68 patients had severe disability, 62 had mild to moderate disability, 67 received a recommendation for surgery, and 63 received a recommendation against surgery. Composite satisfaction scores were lower among patients who had severe disability than among those with mild to moderate disability (median [interquartile range]: 91.7 [83.7-96.4] vs 95.8 [91.0-99.3], respectively; p = 0.0040). Patients who received a recommendation against surgery reported lower satisfaction scores than those who received a recommendation for surgery (91.7 [83.5-95.8] vs 95.8 [88.5-99.8]; p = 0

  2. The Impact of Environmental Regulation on Total Factor Energy Efficiency: A Cross-Region Analysis in China

    Directory of Open Access Journals (Sweden)

    Jianting Lin

    2017-10-01

    Full Text Available Environmental regulations are the key measure by which governments achieve sustainable environmental and economic development. This study aimed to determine the direct and indirect impacts of environmental regulations on total factor energy efficiency of regions in China. Since regions have different levels of economic development and resource endowment, we used the slacks-based measure (SBM-undesirable model to calculate total factor energy efficiency considering regional technology heterogeneity and examined the regional impacts of environmental regulation on this efficiency using the Tobit regression model. A positive direct impact was generated in the eastern region of China by the forced mechanism, which forced enterprises to reduce fossil fuel energy demand and increase clean energy consumption; whereas a negative direct impact was generated in the middle and western regions owing to the green paradox, which is the observation that expected stringent environmental regulation prompts energy owners to accelerate resource extraction. Moreover, indirect impacts through technological progress and foreign direct investment were taken into account in the model, and the results show that the indirect impacts vary across regions. A logical response to these findings would be to develop different policies for different regions.

  3. Total cross section of furfural by electron impact: Experiment and theory.

    Science.gov (United States)

    Traoré Dubuis, A; Verkhovtsev, A; Ellis-Gibbings, L; Krupa, K; Blanco, F; Jones, D B; Brunger, M J; García, G

    2017-08-07

    We present experimental total cross sections for electron scattering from furfural in the energy range from 10 to 1000 eV, as measured using a double electrostatic analyzer gas cell electron transmission experiment. These results are compared to theoretical data for furfural, as well as to experimental and theoretical values for the structurally similar molecules furan and tetrahydrofuran. The measured total cross section is in agreement with the theoretical results obtained by means of the independent-atom model with screening corrected additivity rule including interference method. In the region of higher electron energies, from 500 eV to 10 keV, the total electron scattering cross section is also estimated using a semi-empirical model based on the number of electrons and dipole polarizabilities of the molecular targets. Together with the recently measured differential and integral cross sections, and the furfural energy-loss spectra, the present total cross section data nearly complete the data set that is required for numerical simulation of low-energy electron processes in furfural, covering the range of projectile energies from a few electron volts up to 10 keV.

  4. Total cross section of furfural by electron impact: Experiment and theory

    Science.gov (United States)

    Traoré Dubuis, A.; Verkhovtsev, A.; Ellis-Gibbings, L.; Krupa, K.; Blanco, F.; Jones, D. B.; Brunger, M. J.; García, G.

    2017-08-01

    We present experimental total cross sections for electron scattering from furfural in the energy range from 10 to 1000 eV, as measured using a double electrostatic analyzer gas cell electron transmission experiment. These results are compared to theoretical data for furfural, as well as to experimental and theoretical values for the structurally similar molecules furan and tetrahydrofuran. The measured total cross section is in agreement with the theoretical results obtained by means of the independent-atom model with screening corrected additivity rule including interference method. In the region of higher electron energies, from 500 eV to 10 keV, the total electron scattering cross section is also estimated using a semi-empirical model based on the number of electrons and dipole polarizabilities of the molecular targets. Together with the recently measured differential and integral cross sections, and the furfural energy-loss spectra, the present total cross section data nearly complete the data set that is required for numerical simulation of low-energy electron processes in furfural, covering the range of projectile energies from a few electron volts up to 10 keV.

  5. The impact of splenectomy on outcomes after distal and total pancreatectomy

    Directory of Open Access Journals (Sweden)

    Bramhall Simon

    2007-06-01

    Full Text Available Abstract Background Several authors advocate spleen preserving distal pancreatectomy, because of the increased complication rate after splenectomy. Methods Postoperative complications and survival after distal and total pancreatectomy, were recorded and retrospectively analyzed according to spleen preservation. Patients, who underwent distal and total pancreatectomy without histologically proven adenocarcinoma, or extrapancreatic disease, were included in the cohort which was divided into splenectomy and no splenectomy groups. Statistical analysis was performed using Fisher's test. Results The study group consisted of 62 patients who underwent distal and total pancreatectomy between 26/11/1987 to 6/1/2006. Splenectomy was performed in 35 out of 62 patients (56.5%, distal pancreatectomy was performed in 49 out of 62 patients (79%. Morbidity rate was 28.6% in splenectomy group and 14.8% in the no splenectomy group (p = 0.235, while 30 days mortality rate was 2.9%; one patient died in the splenectomy group (p = 1. Conclusion Spleen-preservation did not influence the outcomes after distal and total pancreatectomy in our series.

  6. Impact of diabetes mellitus on acute outcomes of percutaneous coronary intervention in chronic total occlusions: insights from a US multicentre registry.

    Science.gov (United States)

    Martinez-Parachini, J R; Karatasakis, A; Karmpaliotis, D; Alaswad, K; Jaffer, F A; Yeh, R W; Patel, M; Bahadorani, J; Doing, A; Nguyen-Trong, P-K; Danek, B A; Karacsonyi, J; Alame, A; Rangan, B V; Thompson, C A; Banerjee, S; Brilakis, E S

    2017-04-01

    To examine the impact of diabetes mellitus on procedural outcomes of patients who underwent percutaneous coronary intervention for chronic total occlusion. We assessed the impact of diabetes mellitus on the outcomes of percutaneous coronary intervention for chronic total occlusion among 1308 people who underwent such procedures at 11 US centres between 2012 and 2015. The participants' mean ± sd age was 66 ± 10 years, 84% of the participants were men and 44.6% had diabetes. As compared with participants without diabetes, participants with diabetes were more likely to have undergone coronary artery bypass graft surgery (38 vs 31%; P = 0.006), and to have had previous heart failure (35 vs 22%; P = 0.0001) and peripheral arterial disease (19 vs 13%; P = 0.002). They also had a higher BMI (31 ± 6 kg/m 2 vs 29 ± 6 kg/m 2 ; P = 0.001), similar Japanese chronic total occlusion scores (2.6 ± 1.2 vs 2.5 ± 1.2; P = 0.82) and similar final successful crossing technique: antegrade wire escalation (46 vs 47%; P = 0.66), retrograde (30 vs 28%; P = 0.66) and antegrade dissection re-entry (24 vs 25%; P = 0.66). Technical (91 vs 90%; P = 0.80) and procedural (89 vs 89%; P = 0.93) success was similar in the two groups, as was the incidence of major adverse cardiac events (2.2 vs 2.5%; P = 0.61). In a contemporary cohort of people undergoing percutaneous coronary intervention for chronic total occlusion, nearly one in two (45%) had diabetes mellitus. Procedural success and complication rates were similar in people with and without diabetes. © 2016 Diabetes UK.

  7. Impact of Prenatal Cognitive-Behavioral Stress Management Intervention on Maternal Anxiety and Depression and Newborns’ Apgar Scores

    Directory of Open Access Journals (Sweden)

    Mahsa Karamoozian

    2015-06-01

    Full Text Available Background: Motherhood is a transformative and pleasing experience in a woman’s life. However, given the physical and psychological changes, it can induce a degree of stress and anxiety in mothers. The aim of the present study was to evaluate the effects of cognitive-behavioral stress management (CBSM on maternal anxiety and depression during pregnancy and newborns’ Apgar scores. Methods: This semi-experimental study was performed by applying a pretest-posttest control-group design. Overall, 30 primiparous mothers were selected among women referring to health clinics of Kerman, Iran, using convenience sampling. Subjects were randomly allocated to experimental and control groups. Data were collected, using Pregnancy-Related Anxiety Questionnaire and Edinburgh Postnatal Depression Questionnaire. After completing the pretest, the experimental group was subjected to 12 sessions of CBSM training; posttest data were collected after the intervention. Multivariate analysis of covariance was performed, using SPSS version 16. P-value < 0.05 was considered statistically significant. Results: The obtained results revealed a significant decrement in the average posttest scores of anxiety and depression in the experimental group, compared to pretest scores and the control group. Moreover, differences in 1- and 5-minute Apgar scores between the two groups were statistically significant. These findings indicated the effectiveness of CBSM during pregnancy in reducing maternal anxiety and depression. Conclusion: Pregnant women can benefit from psychological interventions such as CBSM in medical and health care centers.

  8. Impact of strong geomagnetic storms on total ozone at southern higher middle latitudes

    Czech Academy of Sciences Publication Activity Database

    Laštovička, Jan; Križan, Peter

    2009-01-01

    Roč. 53, č. 1 (2009), s. 151-156 ISSN 0039-3169 R&D Projects: GA MŠk 1P05OC030 Grant - others:European Commission(XE) COST 724 Institutional research plan: CEZ:AV0Z30420517 Keywords : ozone * Southern Hemisphere * geomagnetic storms * Forbush decreases of cosmic rays Subject RIV: DG - Athmosphere Sciences, Meteorology Impact factor: 1.000, year: 2009

  9. A Multicenter Approach Evaluating the Impact of Vitamin E-Blended Polyethylene in Cementless Total Hip Replacement

    Science.gov (United States)

    Jäger, Marcus; van Wasen, Andrea; Warwas, Sebastian; Landgraeber, Stefan; Haversath, Marcel; Group, VITAS

    2014-01-01

    Since polyethylene is one of the most frequently used biomaterials as a liner in total hip arthroplasty, strong efforts have been made to improve design and material properties over the last 50 years. Antioxidants seems to be a promising alternative to further increase durability and reduce polyethylene wear in long term. As of yet, only in vitro results are available. While they are promising, there is yet no clinical evidence that the new material shows these advantages in vivo. To answer the question if vitamin-E enhanced ultra-high molecular weight polyethylene (UHMWPE) is able to improve long-term survivorship of cementless total hip arthroplasty we initiated a randomized long-term multicenter trial. Designed as a superiority study, the oxidation index assessed in retrieval analyses of explanted liners was chosen as primary parameter. Radiographic results (wear rate, osteolysis, radiolucency) and functional outcome (Harris Hip Scores, University of California-Los Angeles, Hip Disability and Osteoarthritis Outcome Score, Visual Analogue Scale) will serve as secondary parameters. Patients with the indication for a cementless total hip arthroplasty will be asked to participate in the study and will be randomized to either receive a standard hip replacement with a highly cross-linked UHMWPE-X liner or a highly cross-linked vitamin-E supplemented UHMWPE-XE liner. The follow-up will be 15 years, with evaluation after 5, 10 and 15 years. The controlled randomized study has been designed to determine if Vitamin-E supplemented highly cross-linked polyethylene liners are superior to standard XLPE liners in cementless total hip arthroplasty. While several studies have been started to evaluate the influence of vitamin-E, most of them evaluate wear rates and functional results. The approach used for this multicenter study, to analyze the oxidation status of retrieved implants, should make it possible to directly evaluate the ageing process and development of the implant

  10. A multicenter approach evaluating the impact of vitamin E-blended polyethylene in cementless total hip replacement

    Directory of Open Access Journals (Sweden)

    Marcus Jäger

    2014-04-01

    Full Text Available Since polyethylene is one of the most frequently used biomaterials as a liner in total hip arthroplasty, strong efforts have been made to improve design and material properties over the last 50 years. Antioxidants seems to be a promising alternative to further increase durability and reduce polyethylene wear in long term. As of yet, only in vitro results are available. While they are promising, there is yet no clinical evidence that the new material shows these advantages in vivo. To answer the question if vitamin-E enhanced ultra-high molecular weight polyethylene (UHMWPE is able to improve long-term survivorship of cementless total hip arthroplasty we initiated a randomized long-term multicenter trial. Designed as a superiority study, the oxidation index assessed in retrieval analyses of explanted liners was chosen as primary parameter. Radiographic results (wear rate, osteolysis, radiolucency and functional outcome (Harris Hip Scores, University of California-Los Angeles, Hip Disability and Osteoarthritis Outcome Score, Visual Analogue Scale will serve as secondary parameters. Patients with the indication for a cementless total hip arthroplasty will be asked to participate in the study and will be randomized to either receive a standard hip replacement with a highly cross-linked UHMWPE-X liner or a highly cross-linked vitamin-E supplemented UHMWPE-XE liner. The follow-up will be 15 years, with evaluation after 5, 10 and 15 years. The controlled randomized study has been designed to determine if Vitamin-E supplemented highly cross-linked polyethylene liners are superior to standard XLPE liners in cementless total hip arthroplasty. While several studies have been started to evaluate the influence of vitamin-E, most of them evaluate wear rates and functional results. The approach used for this multicenter study, to analyze the oxidation status of retrieved implants, should make it possible to directly evaluate the ageing process and development

  11. Differential and total cross sections for the ionization of water molecule by electron impact

    International Nuclear Information System (INIS)

    Houamer, S.; Dal Cappello, C.; Mansouri, A.

    2007-01-01

    A theoretical approach is presented to calculate multiply differential and total cross sections of the ionization of H 2 O molecule in the vapour phase. The wave function of the target is described by molecular orbitals consisting of a linear combination of slater type atomic orbitals centered on the heaviest atom which is the oxygen atom in this case. The calculations are carried out in the first Born approximation where the projectile is described by a plane wave while the ejected electron is described by a coulomb wave taking into account its interaction with the residual ion. The spherical average over the Euler solid angle due to the randomly oriented gaseous target molecule is carried out analytically using the rotation matrix properties. The differential and total cross sections are thus evaluated without any special difficulty and compared with experiments and distorted wave calculations. Fair agreements are observed

  12. TEWI - Total Equivalent Warming Impact. The environmental and climatic impact of the German refrigeration industry 1989/2005

    International Nuclear Information System (INIS)

    Lotz, H.

    1993-01-01

    Development of concepts and new technologies will have to pay more heed to the ecological balance of a product than in the past. The Umweltbundesamt (Federal Environmental Office) suggests to divide an ecological balance into a balance of facts, a balance of impact and include a balance sheet valuation. As there are no valid socio-political valuation criteria they suggest to use partial criteria as for instance the climate-relevant air pollution for the valuation of the refrigeration industry. This article attempts to forecast existing and foreseeable developments of the refrigeration industry under this particular aspect. (BWI) [de

  13. The assessment of chronic health conditions on work performance, absence, and total economic impact for employers.

    Science.gov (United States)

    Collins, James J; Baase, Catherine M; Sharda, Claire E; Ozminkowski, Ronald J; Nicholson, Sean; Billotti, Gary M; Turpin, Robin S; Olson, Michael; Berger, Marc L

    2005-06-01

    The objective of this study was to determine the prevalence and estimate total costs for chronic health conditions in the U.S. workforce for the Dow Chemical Company (Dow). Using the Stanford Presenteeism Scale, information was collected from workers at five locations on work impairment and absenteeism based on self-reported "primary" chronic health conditions. Survey data were merged with employee demographics, medical and pharmaceutical claims, smoking status, biometric health risk factors, payroll records, and job type. Almost 65% of respondents reported having one or more of the surveyed chronic conditions. The most common were allergies, arthritis/joint pain or stiffness, and back or neck disorders. The associated absenteeism by chronic condition ranged from 0.9 to 5.9 hours in a 4-week period, and on-the-job work impairment ranged from a 17.8% to 36.4% decrement in ability to function at work. The presence of a chronic condition was the most important determinant of the reported levels of work impairment and absence after adjusting for other factors (P < 0.000). The total cost of chronic conditions was estimated to be 10.7% of the total labor costs for Dow in the United States; 6.8% was attributable to work impairment alone. For all chronic conditions studied, the cost associated with performance based work loss or "presenteeism" greatly exceeded the combined costs of absenteeism and medical treatment combined.

  14. The impact of maternal separation on adult mouse behaviour and on the total neuron number in the mouse hippocampus

    DEFF Research Database (Denmark)

    Fabricius, K.; Wörtwein, Gitta; Pakkenberg, B.

    2008-01-01

    , the number of errors made by the MS24 mice compared to controls and in total distance moved. The mice were subsequently sacrificed and the total number of neurons estimated in the hippocampus using the optical fractionator. We found a significant loss of neurons in the dentate gyrus in MS mice compared...... to controls. Apparently a single maternal separation can impact the number of neurons in mouse hippocampus either by a decrease of neurogenesis or as an increase in neuron apoptosis. This study is the first to assess the result of maternal separation combining behaviour and stereology Udgivelsesdato: 2008/2...

  15. Impact of total substitution of corn for soybean hulls in diets for lambs

    Directory of Open Access Journals (Sweden)

    Milena Patricia Viana Bastos

    2015-03-01

    Full Text Available The experiment was conducted to assess the effect of substituting corn for soybean hulls on the apparent digestibility of nutrients, carcass performance and characteristics, and yield of cuts of 25 non-castrated male Santa Ines lambs with an initial body weight of 20±2 kg, at approximately 6 months of age, sheltered individually in stalls (1.10 × 1.0 m, considering a totally randomized design, fed 600 g/kg of forage and 400 g/kg of concentrate. Soybean hulls replaced corn at 0, 250, 500, 750, and 1,000 g/kg of dry matter. The intake of dry matter (DM, organic matter (OM, neutral detergent fiber (NDF, acid detergent fiber (ADF, NDF corrected for ash and protein (NDFap, total carbohydrates (TC, non-fibrous carbohydrates (NFC and total digestible nutrients (TDN in g/day, and the digestibility of NFC increased linearly with the soybean hull replacement. Crude protein intake displayed a quadratic response, whereas the intake of EE in g/day, the apparent digestibility coefficients of DM, OM, CP, EE, NDF, ADF, NDFap and TC, TDN, average daily gain, carcass characteristics, and yield of cuts were not affected by the soybean hull levels. Soybean hull substitution increased the intake of DM and nutrients, making it possible to replace up to 1,000 g/kg of dry matter in the diets for confined sheep, as it does not compromise performance, digestibility, carcass characteristics, or yield of cuts when used in sheep nutrition.

  16. The impact of total suspended particulate concentration on workers’ health at ceramic industry

    Science.gov (United States)

    Sintorini, M. M.

    2018-01-01

    Ceramic production process pollutes the air with particulate matter at high concentration and has negative impact on the workers. The objective of this research was to determine the particulate concentration in the air and to analyse its impact on the workers. This research used cross sectional method to correlate the particulate concentration, temperature, humidity, smoke level and level of workers’ compliance with safety regulations. Sampling was conducted from April to May 2012 in three locations, i.e. exposure area (Mass Preparation I, II) and non-exposure area (Forming area). In the exposure area (Mass Preparation I and II) where the particulate concentrations were 22.3673 mg/m3 and 14.8277 mg/m3, and 58.33%, the workers had bad health status. In the non-exposure area, where the particulate concentration was 3.2185 mg/m3 and 25% the workers had bad health status. The Odds Ratio among the workers in exposure area was 4.2 times higher than the workers in the non-exposure area.

  17. Impact of Driving Cessation on Trajectories of Life-Space Scores Among Community-Dwelling Older Adults.

    Science.gov (United States)

    Huisingh, Carrie; Levitan, Emily B; Sawyer, Patricia; Kennedy, Richard; Brown, Cynthia J; McGwin, Gerald

    2017-12-01

    The purpose of this study was to examine the trajectories of life-space before and after the transition to driving cessation among a diverse sample of community-dwelling older adults. Life-space scores and self-reported driving cessation were assessed at annual visits from baseline through Year 6 among participants in the University of Alabama at Birmingham Study of Aging. Approximately 58% of older adults reported having stopped driving during the 6 years of follow-up. After adjusting for potential confounders, results from a random intercept model indicate that mean life-space scores decreased about 1 to 2 points every year ( p = .0011) and approximately 28 points at the time of driving cessation ( p space decline post driving cessation was not significantly different from the rate of decline prior to driving cessation. Driving cessation was associated with a precipitous decline in life-space score; however, the driving cessation event did not accelerate the rate of life-space decline.

  18. Total and single differential cross sections for the electron impact ionization of the ground state of helium

    International Nuclear Information System (INIS)

    Singh, T.S.C.; Choudhury, K.B.; Singh, M.B.; Deb, N.C.; Mukherjee, S.C.; Mazumdar, P.S.

    1997-01-01

    Total cross sections (TCS) and single differential cross sections (SDCS) have been computed for the single ionization of the ground state of helium by electron impact in a distorted wave formalism which takes into account the effects of the initial and final channel distortions. The present TCS and SDCS results are in fair agreement with the measured values and other theoretical predictions for the incident electron energy E i > 150 eV. (orig.)

  19. The Impact of Discharge Disposition on Episode-of-Care Reimbursement After Primary Total Hip Arthroplasty.

    Science.gov (United States)

    Sabeh, Karim G; Rosas, Samuel; Buller, Leonard T; Roche, Martin W; Hernandez, Victor H

    2017-10-01

    Total joint arthroplasty (TJA) accounts for more Medicare expenditure than any other inpatient procedure. The Comprehensive Care for Joint Replacement model was introduced to decrease cost and improve quality in TJA. The largest portion of episode-of-care costs occurs after discharge. This study sought to quantify the cost variation of primary total hip arthroplasty (THA) according to discharge disposition. The Medicare and Humana claims databases were used to extract charges and reimbursements to compare day-of-surgery and 91-day postoperative costs simulating episode-of-care reimbursements. Of the patients who underwent primary THA, 257,120 were identified (204,912 from Medicare and 52,208 from Humana). Patients were stratified by discharge disposition: home with home health, skilled nursing facility, or inpatient rehabilitation facility. There is a significant difference in the episode-of-care costs according to discharge disposition, with discharge to an inpatient rehabilitation facility the most costly and discharge to home the least costly. Postdischarge costs represent a sizeable portion of the overall expense in THA, and optimizing patients to allow safe discharge to home may help reduce the cost of THA. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Surgical resident learning styles: faculty and resident accuracy at identification of preferences and impact on ABSITE scores.

    Science.gov (United States)

    Kim, Roger H; Gilbert, Timothy; Ristig, Kyle; Chu, Quyen D

    2013-09-01

    As a consequence of surgical resident duty hour restrictions, there is a need for faculty to utilize novel teaching methods to convey information in a more efficient manner. The current paradigm of surgical training, which has not changed significantly since the time of Halsted, assumes that all residents assimilate information in a similar fashion. However, recent data has shown that learners have preferences for the ways in which they receive and process information. The VARK model categorizes learners as visual (V), aural (A), read/write (R), and kinesthetic (K). The VARK learning style preferences of surgical residents have not been previously evaluated. In this study, the preferred learning styles of general surgery residents were determined, along with faculty and resident perception of resident learning styles. In addition, we hypothesized that American Board of Surgery In-Training Exam (ABSITE) scores are associated with preference for a read/write (R) learning style. The Fleming VARK learning styles inventory was administered to all general surgery residents at a university hospital-based program. Responses on the inventory were scored to determine the preferred learning style for each resident. Faculty members were surveyed to determine their accuracy in identifying the preferred learning style of each resident. All residents were also surveyed to determine their accuracy in identifying their peers' VARK preferences. Resident ABSITE scores were examined for association with preferred learning styles. Twenty-nine residents completed the inventory. Most (18 of 29, 62%) had a multimodal preference, although more than a third (11 of 29, 38%) demonstrated a single-modality preference. Seventy-six percent of all residents (22 of 29) had some degree of kinesthetic (K) learning, while under 50% (14 of 29) were aural (A) learners. Although not significant, dominant (R) learners had the highest mean ABSITE scores. Faculty identified residents' learning styles

  1. Impact of sarcopenia on the outcomes of elective total arch replacement in the elderly†.

    Science.gov (United States)

    Ikeno, Yuki; Koide, Yutaka; Abe, Noriyuki; Matsueda, Takashi; Izawa, Naoto; Yamazato, Takahiro; Miyahara, Shunsuke; Nomura, Yoshikatsu; Sato, Shunsuke; Takahashi, Hiroaki; Inoue, Takeshi; Matsumori, Masamichi; Tanaka, Hiroshi; Ishihara, Satoshi; Nakayama, Shinichi; Sugimoto, Koji; Okita, Yutaka

    2017-06-01

    The purpose of this study was to identify the cut-off value of sarcopenia based on the psoas muscle area index and evaluate early and late outcomes following elective total arch replacement in the elderly. Sarcopenia was assessed by the psoas muscle area index [defined as the psoas muscle area at the L3 level on computed tomography (cm 2 )/body surface area (m 2 )]. The cut-off value for sarcopenia was defined as > 2 standard deviations below the mean psoas muscle area index value obtained from 464 normal control patients. Between October 1999 and July 2015, 266 patients who were ≥ 65 years and had undergone psoas muscle area index measurement underwent elective total arch replacement. These patients were classified into the sarcopenia (Group S, n  = 81) and non-sarcopenia (Group N, n  = 185) groups. The mean age was 76.2 ± 5.6 years in Group S and 75.7 ± 5.7 years in Group N ( P  = 0.553). Hospital mortality was 3.7% (3/81) in Group S and 2.2% (4/185) in Group N ( P  = 0.483). Mean follow-up was 48.3 ± 38.7 months. Five-year survival was significantly worse in Group S (S: 63.2 ± 6.6% vs N: 88.7 ± 2.6%, P  sarcopenia significantly predicted poor survival (hazard ratio 2.59; 95% confidence interval 1.27-5.29; P  = 0.011). Sarcopenia did not predict hospital death following total arch replacement, but it was negatively associated with overall survival. Sarcopenia can be an additional risk factor to estimate the outcomes of thoracic aortic surgery. © The Author 2017. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

  2. Impact of dietary vitamin A interventions on total body stores in Thai lactating women

    International Nuclear Information System (INIS)

    Wasanwisut, E.; West, K.P.

    1997-01-01

    Vitamin A deficiency (VAD) is increasingly being recognized as a public health problem among pregnant and lactating women in developing countries. This proposed study will be a randomized trial to evaluate the efficacy of consuming provitamin A-rich foods in one prepared, on-site meal per weekday for 3 months on total body vitamin A stores and other aspects of vitamin A status in marginally nourished lactating women in rural Northeast Thailand. Approximately 400 lactating women, 2-18 months post-partum, will be screened in the population for marginal vitamin A status by a tier of indicators beginning from low intake or history of night blindness or impaired dark adaptability followed by low serum retinol. Assuming a prevalence of low serum retinol of ∼20%, 90 women will be identified and recruited, matched by serum retinol and month post-partum and randomized in a block fashion into three groups to receive daily cooked (fat-added) meal and snack with (1) dark green leafy and yellow/orange vegetables and fruits, (2) beta-carotene- enriched rice chips and (3) non-enriched rice chips. Groups 1 and 2 will receive ∼3.6 mg of beta-carotene per day. Prior to and following the intervention hepatic vitamin A reserves will be estimated by isotopic dilution techniques and other indicators of vitamin A status. In addition, serum C-reactive protein and maternal anthropometry will be measured. Food consumption data based on 24-hour recall for 3 randomized days will be collected every 2 weeks to assess routine intakes of vitamin A, fat and other nutrients. Morbidity will be monitored on a weekly basis throughout the study. Between-group comparisons will provide a basis for (1) estimating the adequacy of local diets to improve or maintain total body stores of vitamin A in women during lactation and (2) assessing the validity and responsiveness of widely used measures of vitamin A status in this high-risk group

  3. Impact of the total absorption gamma-ray spectroscopy on FP decay heat calculations

    International Nuclear Information System (INIS)

    Yoshida, Tadashi; Tachibana, Takahiro; Katakura, Jun-ichi

    2004-01-01

    We calculated the average β- and γ-ray energies, E β and E γ , for 44 short-lived isotopes of Rb, Sr, Y, Cs, Ba, La, Ce, Pr, Nd, Pm, Sm and Eu from the data by Greenwood et al, who measured the β-feed in the decay of these nuclides using the total absorption γ-ray spectrometer. These E β and E γ were incorporated into the decay files from JENDL, JEF2.2 and ENDF-B/VI, and the decay heats were calculated. The results were compared with the integral measurements by the University of Tokyo, ORNL and Lowell. In the case of JENDL, where the correction for the so-called Pandemonium effect is applied on the basis of the gross theory, the very good agreement is no longer maintained. The γ-ray component is overestimated in the cooling time range from 3 to 300 seconds, suggesting a kind of an over-correction as for the Pandemonium effect. We have to evaluate both the applicability of the TAGS results and the correction method itself in order to generate a more consistent data basis for decay heat summation calculations. (author)

  4. Methodology of Evaluation of the Impact of Picking Area Location on the Total Costs of Warehouse

    Directory of Open Access Journals (Sweden)

    Apsalons Raitis

    2017-12-01

    Full Text Available The picking system and the layout of the picking area are the key drivers for the evaluation of a warehouse picking cost. There are five variants for organizing the picking process of orders in a warehouse. The choice of a specific variant depends on the total cost of picking. The picking cost is evaluated within an uninterrupted picking process. It means that no stock out occurs in the time period of the picking process. The storing area and the picking area are created as two separate zones for picking quantities of the customer’s orders; the principle of division of orders is observed strictly. Referring to the locations of stock keeping units (SKU, two approaches of the layout of SKU in the picking area can be estimated. The first one is the single picking location for each single SKU, where replenishment is realized in the picking process. The second one - various picking locations for each single SKU, and the replenishment here is realized just only prior to a picking process or after it. The main benefits of the economy of the picking cost as far as these two approaches are concerned are the shortest picking route in the first case and one common replenishment option in the second case.

  5. Impact of INTERMACS Profile on Clinical Outcomes for Patients Supported With the Total Artificial Heart.

    Science.gov (United States)

    Shah, Keyur B; Thanavaro, Kristin L; Tang, Daniel G; Quader, Mohammed A; Mankad, Anit K; Tchoukina, Inna; Thacker, Leroy R; Smallfield, Melissa C; Katlaps, Gundars; Hess, Michael L; Cooke, Richard H; Kasirajan, Vigneshwar

    2016-11-01

    Insufficient data delineate outcomes for Interagency Registry for Mechanically Assisted Circulatory Support (INTERMACS) profile 1 patients with the total artificial heart (TAH). We studied 66 consecutive patients implanted with the TAH at our institution from 2006 through 2012 and compared outcome by INTERMACS profile. INTERMACS profiles were adjudicated retrospectively by a reviewer blinded to clinical outcomes. Survival after TAH implantation at 6 and 12 months was 76% and 71%, respectively. INTERMACS profile 1 patients had decreased 6-month survival on the device compared with those in profiles 2-4 (74% vs 95%, log rank: P = .015). For the 50 patients surviving to heart transplantation, the 1-year posttransplant survival was 82%. There was no difference in 1-year survival when comparing patients in the INTERMACS 1 profile with less severe profiles (79% vs 84%; log rank test P = .7; hazard ratio [confidence interval] 1.3 [0.3-4.8]). Patients implanted with the TAH as INTERMACS profile 1 had reduced survival to transplantation compared with less sick profiles. INTERMACS profile at the time of TAH implantation did not affect 1-year survival after heart transplantation. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Posterior tibial slope impacts intraoperatively measured mid-flexion anteroposterior kinematics during cruciate-retaining total knee arthroplasty.

    Science.gov (United States)

    Dai, Yifei; Cross, Michael B; Angibaud, Laurent D; Hamad, Cyril; Jung, Amaury; Jenny, Jean-Yves

    2018-02-23

    Posterior tibial slope (PTS) for cruciate-retaining (CR) total knee arthroplasty (TKA) is usually pre-determined by the surgeon. Limited information is available comparing different choices of PTS on the kinematics of the CR TKA, independent of the balancing of the extension gap. This study hypothesized that with the same balanced extension gap, the choice of PTS significantly impacts the intraoperatively measured kinematics of CR TKA. Navigated CR TKAs were performed on seven fresh-frozen cadavers with healthy knees and intact posterior cruciate ligament (PCL). A custom designed tibial baseplate was implanted to allow in situ modification of the PTS, which altered the flexion gap but maintained the extension gap. Knee kinematics were measured by performing passive range of motion (ROM) tests from full extension to 120° of flexion on the intact knee and CR TKAs with four different PTSs (1°, 4°, 7°, and 10°). The measured kinematics were compared across test conditions to assess the impact of PTS. With a consistent extension gap, the change of PTS had significant impact on the anteroposterior (AP) kinematics of the CR TKA knees in mid-flexion range (45°-90°), but not so much for the high-flexion range (90°-120°). No considerable impacts were found on internal/external (I/E) rotation and hip-knee-ankle (HKA) angle. However, the findings on the individual basis suggested the impact of PTS on I/E rotation and HKA angle may be patient-specific. The data suggested that the choice of PTS had the greatest impact on the mid-flexion AP translation among the intraoperatively measured kinematics. This impact may be considered while making surgical decisions in the context of AP kinematics. When using a tibial component designed with "center" pivoting PTS, a surgeon may be able to fine tune the PTS to achieve proper mid-flexion AP stability.

  7. Impact of the Intracoronary Rendezvous technique on coronary angioplasty for chronic total occlusion.

    Science.gov (United States)

    Nihei, Taro; Yamamoto, Yoshito; Kudo, Shun; Hanawa, Kenichiro; Hasebe, Yuhi; Takagi, Yusuke; Minatoya, Yutaka; Sugi, Masafumi; Shimokawa, Hiroaki

    2017-10-01

    The Rendezvous technique, which requires bidirectional wiring, is one of the useful methods for improving the success rate of recanalization for chronic total occlusion (CTO) in the field of peripheral intervention. Recently, advanced new devices for percutaneous coronary intervention have enabled us to perform the Rendezvous technique for peripheral as well as for coronary CTO lesions. We used the Intracoronary Rendezvous technique to perform angioplasty for coronary CTO. "Intracoronary Rendezvous" means that Rendezvous was achieved within the CTO lesion. From March 2009 to November 2015, 189 patients underwent CTO angioplasty at our institute, and we treated 10 patients with the Intracoronary Rendezvous technique. This technique involves crossing the Gaia series guidewire to the contralateral Corsair microcatheter located inside the plaque of CTO lesions. The majority of the CTO sites examined were in the proximal RCA (60 %). Lesion length of the occlusion was relatively long (64.4 ± 12.2 mm). Using the biplane imaging system, we were able to control the Gaia guidewires in a specific direction. Furthermore, if the antegrade and retrograde wires can be advanced into contiguous space inside the CTO lesion, we intentionally entered either wire into the contralateral Corsair microcatheter, followed by successful CTO crossing. CTO recanalization was completed for all patients without controlled antegrade retrograde subintimal tracking (CART) or reverse CART. No major complications occurred during hospitalization. These results indicate that the Rendezvous technique, assisted by new devices and a biplane imaging system, represents one of the primary options to achieve successful coronary CTO recanalization.

  8. The Impact of Lumbar Spine Disease and Deformity on Total Hip Arthroplasty Outcomes.

    Science.gov (United States)

    Blizzard, Daniel J; Sheets, Charles Z; Seyler, Thorsten M; Penrose, Colin T; Klement, Mitchell R; Gallizzi, Michael A; Brown, Christopher R

    2017-05-01

    Concomitant spine and hip disease in patients undergoing total hip arthroplasty (THA) presents a management challenge. Degenerative lumbar spine conditions are known to decrease lumbar lordosis and limit lumbar flexion and extension, leading to altered pelvic mechanics and increased demand for hip motion. In this study, the effect of lumbar spine disease on complications after primary THA was assessed. The Medicare database was searched from 2005 to 2012 using International Classification of Diseases, Ninth Revision, procedure codes for primary THA and diagnosis codes for preoperative diagnoses of lumbosacral spondylosis, lumbar disk herniation, acquired spondylolisthesis, and degenerative disk disease. The control group consisted of all patients without a lumbar spine diagnosis who underwent THA. The risk ratios for prosthetic hip dislocation, revision THA, periprosthetic fracture, and infection were significantly higher for all 4 lumbar diseases at all time points relative to controls. The average complication risk ratios at 90 days were 1.59 for lumbosacral spondylosis, 1.62 for disk herniation, 1.65 for spondylolisthesis, and 1.53 for degenerative disk disease. The average complication risk ratios at 2 years were 1.66 for lumbosacral spondylosis, 1.73 for disk herniation, 1.65 for spondylolisthesis, and 1.59 for degenerative disk disease. Prosthetic hip dislocation was the most common complication at 2 years in all 4 spinal disease cohorts, with risk ratios ranging from 1.76 to 2.00. This study shows a significant increase in the risk of complications following THA in patients with lumbar spine disease. [Orthopedics. 2017; 40(3):e520-e525.]. Copyright 2017, SLACK Incorporated.

  9. The impact of total sleep deprivation upon cognitive functioning in firefighters

    Directory of Open Access Journals (Sweden)

    Kujawski S

    2018-05-01

    Full Text Available Sławomir Kujawski,1 Joanna Słomko,1 Małgorzata Tafil-Klawe,2 Monika Zawadka-Kunikowska,1 Justyna Szrajda,1 Julia L Newton,3 Paweł Zalewski,1 Jacek J Klawe1 1Department of Hygiene, Epidemiology and Ergonomics, Nicolaus Copernicus University, Toruń, Poland; 2Department of Human Physiology, Nicolaus Copernicus University, Toruń, Poland; 3Institute for Cellular Medicine, Faculty of Medical Sciences, Newcastle University, Framlington Place, Newcastle-upon-Tyne, UK Introduction: Firefighters as a profession are required to maintain high levels of attention for prolonged periods. However, total sleep deprivation (TSD could influence negatively upon performance, particularly when the task is prolonged and repetitive. Purpose: The aim of this study is to examine the influence of TSD on cognitive functioning in a group of firefighters. Subjects and methods: Sixty volunteers who were active male fire brigade officers were examined with a computerized battery test that consisted of simple reaction time (SRT (repeated three times, choice reaction time, visual attention test, and delayed matching to sample. Six series of measurements were undertaken over a period of TSD. Results: Performance in the second attempt in SRT test was significantly worse in terms of increased number of errors and, consequently, decreased number of correct responses during TSD. In contrast, the choice reaction time number of correct responses as well as the visual attention test reaction time for all and correct responses significantly improved compared to initial time points. Conclusion: The study has confirmed that subjects committed significantly more errors and, consequently, noted a smaller number of correct responses in the second attempt of SRT test. However, the remaining results showed reversed direction of TSD influence. TSD potentially leads to worse performance in a relatively easy task in a group of firefighters. Errors during repetitive tasks in firefighting

  10. The Impact of HbA1c Testing on Total Annual Healthcare Expenditures Among Newly Diagnosed Patients with Diabetes.

    Science.gov (United States)

    Bhounsule, Prajakta; Peterson, Andrew M

    2015-09-01

    In 2010, diabetes was the seventh leading cause of death in the United States. Diabetes also imposes a huge financial burden on the US economy. In 2009, the American Diabetes Association International Expert Committee recommended the use of the glycated hemoglobin (HbA1c) test as a uniform diagnostic measure to identify patients with diabetes. Although HbA1c is a convenient diagnostic test, it is also more expensive than older tests and could, therefore, have an impact on patients' healthcare expenditures. To determine if HbA1c testing has an impact on total annual healthcare expenditures among newly diagnosed patients with diabetes and to analyze the factors that are associated with the total healthcare expenditures among diabetic patients before and after HbA1c was implemented as a standard diagnostic factor. This was an observational, retrospective, cross-sectional study. The Medical Expenditure Panel Survey-Household Component 2009 and 2011 databases were used to form the study cohort of patients with diabetes. The total mean healthcare expenditures among patients with diabetes formed the dependent variable. A proxy variable representing a diagnosis of diabetes with and without the use of HbA1c testing in 2009 and in 2011, respectively, formed the main independent variable along with demographic factors, comorbidities, and healthcare services utilization in both years. A generalized linear regression was conducted to determine the association of HbA1c testing with total diabetes-related healthcare expenditures. The mean total healthcare expenditure decreased in 2011 compared with 2009. The HbA1c test did not show an association with the total healthcare expenditures versus earlier diabetes-related diagnostic factors. The total expenditures were associated with private insurance, the incidence of a previous heart attack, prescription drug refills, inpatient hospital stays, home care, hospital discharges, and visits to outpatient providers and physicians in both

  11. An Analysis of the Impact of Single-Sex Schools on Seventh Grade Math and Reading Tasks Scores

    Science.gov (United States)

    Groves-Redwood, Tarawa F.

    2012-01-01

    The purpose of this study was to determine if there is a statistically significant mean difference in math and reading student performance by types of schools. The types of schools were identified as all-male and all-female public middle schools. Specifically, this study examined the impact of public single-sex schools on the mathematics and…

  12. Impact of Students' Participation to a Facebook Group on Their Motivation and Scores and on Teacher's Evaluation

    Science.gov (United States)

    Montoneri, Bernard

    2015-01-01

    The development of Information and communications technology (ICT) has brought rapid and profound changes in the field of Education. Nowadays, teachers and students alike are engaging on social networks such as Facebook. This study discusses the benefits of using social network in the classroom. It aims at assessing the impact of Facebook on…

  13. Impact of Time Lapse on ASCP Board of Certification Medical Laboratory Scientist (MLS) and Medical Laboratory Technician (MLT) Examination Scores.

    Science.gov (United States)

    Brown, Karen A; Fenn, JoAnn P; Freeman, Vicki S; Fisher, Patrick B; Genzen, Jonathan R; Goodyear, Nancy; Houston, Mary Lunz; O'Brien, Mary Elizabeth; Tanabe, Patricia A

    2015-01-01

    Research in several professional fields has demonstrated that delays (time lapse) in taking certification examinations may result in poorer performance by examinees. Thirteen states and/or territories require licensure for laboratory personnel. A core component of licensure is passing a certification exam. Also, many facilities in states that do not require licensure require certification for employment or preferentially hire certified individuals. To analyze examinee performance on the American Society for Clinical Pathology (ASCP) Board of Certification (BOC) Medical Laboratory Scientist (MLS) and Medical Laboratory Technician (MLT) certification examinations to determine whether delays in taking the examination from the time of program completion are associated with poorer performance. We obtained examination data from April 2013 through December 2014 to look for changes in mean (SD) exam scaled scores and overall pass/fail rates. First-time examinees (MLS: n = 6037; MLT, n = 3920) were divided into 3-month categories based on the interval of time between date of program completion and taking the certification exam. We observed significant decreases in mean (SD) scaled scores and pass rates after the first quarter in MLS and MLT examinations for applicants who delayed taking their examination until the second, third, and fourth quarter after completing their training programs. Those who take the ASCP BOC MLS and MLT examinations are encouraged to do so shortly after completion of their educational training programs. Delays in taking an exam are generally not beneficial to the examinee and result in poorer performance on the exam. Copyright© by the American Society for Clinical Pathology (ASCP).

  14. The Impact of Coercive Migrations on the Changes of Total Population Flux in the War-Engulfed Croatian Counties

    Directory of Open Access Journals (Sweden)

    Ana Pažanin

    2006-01-01

    Full Text Available The author deals with the war impact and the impact of coercive migrations on the changes of total population fl ux between two censuses. On the eve of and during the Croatian War of Independence, the migration of population of the Republic of Croatia from the war-engulfed areas to the free areas of the country or to the foreign countries increased. The war in Bosnia and Herzegovina has caused a new wave of refugees from that country and a further migrational fl ux in our country. In the article, the author has established, on the case of the war-engulfed areas of eleven Croatian counties, that the war and coercive migrations have caused a decline of population, the growth of aged population, as well as changes in national and confessional structure.

  15. Impact of dietary fiber energy on the calculation of food total energy value in the Brazilian Food Composition Database.

    Science.gov (United States)

    Menezes, Elizabete Wenzel de; Grande, Fernanda; Giuntini, Eliana Bistriche; Lopes, Tássia do Vale Cardoso; Dan, Milana Cara Tanasov; Prado, Samira Bernardino Ramos do; Franco, Bernadette Dora Gombossy de Melo; Charrondière, U Ruth; Lajolo, Franco Maria

    2016-02-15

    Dietary fiber (DF) contributes to the energy value of foods and including it in the calculation of total food energy has been recommended for food composition databases. The present study aimed to investigate the impact of including energy provided by the DF fermentation in the calculation of food energy. Total energy values of 1753 foods from the Brazilian Food Composition Database were calculated with or without the inclusion of DF energy. The energy values were compared, through the use of percentage difference (D%), in individual foods and in daily menus. Appreciable energy D% (⩾10) was observed in 321 foods, mainly in the group of vegetables, legumes and fruits. However, in the Brazilian typical menus containing foods from all groups, only D%foods, when individually considered. Copyright © 2015 Elsevier Ltd. All rights reserved.

  16. Calculations of elastic, ionization and total cross sections for inert gases upon electron impact: threshold to 2 keV

    Energy Technology Data Exchange (ETDEWEB)

    Vinodkumar, Minaxi [V P and R P T P Science College, Vallabh Vidyanagar 388 120, Gujarat (India); Limbachiya, Chetan [P S Science College, Kadi 382 715, Gujarat (India); Antony, Bobby [Department of Environmental, Earth and Atmospheric Sciences, University of Massachusetts Lowell, 265 Riverside Street, Lowell, MA 01854-5045 (United States); Joshipura, K N [Department of Physics, Sardar Patel University, Vallabh Vidyanagar 388 120, Gujarat (India)

    2007-08-28

    In this paper we report comprehensive calculations of total elastic (Q{sub el}), total ionization (Q{sub ion}) and total (complete) cross sections (Q{sub T}) for the impact of electrons on inert gases (He, Ne, Ar, Kr and Xe) at energies from about threshold to 2000 eV. We have employed the spherical complex optical potential (SCOP) formalism to evaluate Q{sub el} and Q{sub T} and used the complex spherical potential-ionization contribution (CSP-ic) method to derive Q{sub ion}. The dependence of Q{sub T} on polarizability and incident energy is presented for these targets through an analytical formula. Mutual comparison of various cross sections is provided to show their relative contribution to the total cross sections Q{sub T}. Comparison of Q{sub T} for all these targets is carried out to present a general theoretical picture of collision processes. The present calculations also provide information, hitherto sparse, on the excitation processes of these atomic targets. These results are compared with available experimental and other theoretical data and overall good agreement is observed.

  17. Impact of intravascular enhancement, heart rate, and calcium score on diagnostic accuracy in multislice Computed Tomography coronary angiography

    International Nuclear Information System (INIS)

    Cademartiri, Filippo; Mollet, Nico R.; Kriestin, Gabriel P.; Runza, Giuseppe; Bartolotta, Tommaso Vincenzo; Galia, Massimo; Midiri, Massimo; Belgrano, Manuel; Pozzi Mucelli, Roberto

    2005-01-01

    Purpose. To assess the effect of intravascular enhancement, heart rate, and calcium score on diagnostic accuracy in the detection of significant coronary artery stenosis using 16-row multislice computed tomography (MSCT). Materials and methods. One hundred patients (88 males; 59±11 years) with suspected coronary artery disease who had undergone conventional coronary angiography (CA) and MSCT-CA were retrospectively enrolled for the study. Patients underwent a MSCT-CA, with the following protocol: collimation 16x0.75 mm, gantry rotation time 420 ms, feed/rotation 2.8 mm, kV 120, mAs 400-500. The protocol for contrast material administration was 100 ml of Iodixanol 320 mgI/nl at 4 ml/s and the scan delay was defined with a bolus tracking technique. In all patients vascular enhancement was measured in the aortic root, and the left and the right coronary arteries. The average enhancement was used to divide the population in two groups of 50 patients each, one with lower enhancement (Low), and one with higher enhancement (High). In the two groups diagnostic accuracy (per coronary segment) for the detection of significant stenosis (≥50% lumen reduction) was evaluated in vessels ≥2mm in diameter using quantitative CA as the reference standard. The differences in diagnostic accuracy were compared with a Chi-square test and a p [it

  18. Impact of a Genetic Risk Score for Coronary Artery Disease on Reducing Cardiovascular Risk: A Pilot Randomized Controlled Study

    Directory of Open Access Journals (Sweden)

    Joshua W. Knowles

    2017-08-01

    Full Text Available PurposeWe tested whether providing a genetic risk score (GRS for coronary artery disease (CAD would serve as a motivator to improve adherence to risk-reducing strategies.MethodsWe randomized 94 participants with at least moderate risk of CAD to receive standard-of-care with (N = 49 or without (N = 45 their GRS at a subsequent 3-month follow-up visit. Our primary outcome was change in low density lipoprotein cholesterol (LDL-C between the 3- and 6-month follow-up visits (ΔLDL-C. Secondary outcomes included other CAD risk factors, weight loss, diet, physical activity, risk perceptions, and psychological outcomes. In pre-specified analyses, we examined whether there was a greater motivational effect in participants with a higher GRS.ResultsSixty-five participants completed the protocol including 30 participants in the GRS arm. We found no change in the primary outcome between participants receiving their GRS and standard-of-care participants (ΔLDL-C: −13 vs. −9 mg/dl. Among participants with a higher GRS, we observed modest effects on weight loss and physical activity. All other secondary outcomes were not significantly different, including anxiety and worry.ConclusionAdding GRS to standard-of-care did not change lipids, adherence, or psychological outcomes. Potential modest benefits in weight loss and physical activity for participants with high GRS need to be validated in larger trials.

  19. The Impacts of Satellite Remotely Sensed Winds and Total Precipitable Vapour in WRF Tropical Cyclone Track Forecasts

    Directory of Open Access Journals (Sweden)

    Diandong Ren

    2016-01-01

    Full Text Available This study assesses the impact assimilating the scatterometer near-surface wind observations and total precipitable water from the SSMI, into WRF on genesis and track forecasting of four tropical cyclones (TCs. These TCs are selected to be representative of different intensity categories and basins. Impact is via a series of data denial experiments that systematically exclude the remote sensed information. Compared with the control case, in which only the final analysis atmospheric variables are used to initialize and provide the lateral boundary conditions, the data assimilation runs performed consistently better, but with very different skill levels for the different TCs. Eliassen-Palm flux analyses are employed. It is confirmed that if a polar orbital satellite footprint passes over the TC’s critical genesis region, the forecast will profit most from assimilating the remotely sensed information. If the critical genesis region lies within an interorbital gap then, regardless of how strong the TC later becomes (e.g., Katrina 2005, the improvement from assimilating near-surface winds and total precipitable water in the model prediction is severely limited. This underpins the need for a synergy of data from different scatterometers/radiometers. Other approaches are suggested to improve the accuracy in the prediction of TC genesis and tracks.

  20. Achieving Minimum Clinically Important Difference in Oxford Knee Score and Short Form-36 Physical Component Summary Is Less Likely with Single-Radius Compared with Multiradius Total Knee Arthroplasty in Asians.

    Science.gov (United States)

    Lee, Wu Chean; Bin Abd Razak, Hamid Rahmatullah; Allen, John Carson; Chong, Hwei Chi; Tan, Hwee Chye Andrew

    2018-04-10

    Single-radius (SR) and multiradius (MR) total knee arthroplasties (TKAs) have produced similar outcomes, albeit most studies originate from Western nations. There are known knee kinematic differences between Western and Asian patients after TKA. The aim of this study is to compare the short-term patient-reported outcome measures (PROMs) of SR-TKA versus MR-TKA in Asians. Registry data of 133 SR-TKA versus 363 MR-TKA by a single surgeon were analyzed. Preoperative and 2-year postoperative range of motion (ROM) and PROMs were compared with Student's t -test and Mann-Whitney U-test. Logistic regression model was used to evaluate the odds of SR-TKA or MR-TKA achieving the minimum clinically important difference (MCID) of studied outcomes. Patients in both groups had similar age (65.7 ± 7.6 vs. 65.8 ± 8.2 years; p  = 0.317), gender proportion (71% females vs. 79% females; p  = 0.119), and ethnic distribution (80% Chinese vs. 84% Chinese; p  = 0.258). Preoperatively, there were no statistically significant differences between both groups for ROM, Knee Society Score (KSS), Oxford Knee Score (OKS), and Short Form (SF)-36 scores. At 2 years, all outcomes were statistically similar or failed to achieve a difference of MCID. Controlling for all preoperative variables, SR-TKA has significantly lower odds of achieving MCID for OKS (odds ratio [OR]: 0.275, 95% confidence interval [CI]: 0.114-0.663; p  = 0.004) and SF-36 Physical Component Summary (PCS) (OR: 0.547; 95% CI: 0.316-0.946; p  = 0.031) compared with MR-TKA. In conclusion, there are no significant differences in the absolute PROMs between SR-TKA and MR-TKA at 2 years following TKA in Asians. However, SR-TKA has significantly lower odds of achieving the MCID for OKS and SF-36 PCS. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  1. Reporting surgical site infections following total hip and knee arthroplasty: impact of limiting surveillance to the operative hospital.

    Science.gov (United States)

    Yokoe, Deborah S; Avery, Taliser R; Platt, Richard; Huang, Susan S

    2013-11-01

    Public reporting of surgical site infections (SSIs) by hospitals is largely limited to infections detected during surgical hospitalizations or readmissions to the same facility. SSI rates may be underestimated if patients with SSIs are readmitted to other hospitals. We assessed the impact of readmissions to other facilities on hospitals' SSI rates following primary total hip arthroplasty (THA) or total knee arthroplasty (TKA). This was a retrospective cohort study of all patients who underwent primary THA or TKA at California hospitals between 1 January 2006 and 31 December 2009. SSIs were identified using ICD-9-CM diagnosis codes predictive of SSI assigned at any California hospital within 365 days of surgery using a statewide repository of hospital data that allowed tracking of patients between facilities. We used statewide data to estimate the fraction of each hospital's THA and TKA SSIs identified at the operative hospital versus other hospitals. A total of 91 121 THA and 121 640 TKA procedures were identified. Based on diagnosis codes, SSIs developed following 2214 (2.3%) THAs and 2465 (2.0%) TKAs. Seventeen percent of SSIs would have been missed by operative hospital surveillance alone. The proportion of hospitals' SSIs detected at nonoperative hospitals ranged from 0% to 100%. Including SSIs detected at nonoperative hospitals resulted in better relative ranking for 61% of THA hospitals and 61% of TKA hospitals. Limiting SSI surveillance to the operative hospital caused varying degrees of SSI underestimation and substantially impacted hospitals' relative rankings, suggesting that alternative methods for comprehensive postdischarge surveillance are needed for accurate benchmarking.

  2. Improving risk stratification among veterans diagnosed with prostate cancer: impact of the 17-gene prostate score assay.

    Science.gov (United States)

    Lynch, Julie A; Rothney, Megan P; Salup, Raoul R; Ercole, Cesar E; Mathur, Sharad C; Duchene, David A; Basler, Joseph W; Hernandez, Javier; Liss, Michael A; Porter, Michael P; Wright, Jonathan L; Risk, Michael C; Garzotto, Mark; Efimova, Olga; Barrett, Laurie; Berse, Brygida; Kemeter, Michael J; Febbo, Phillip G; Dash, Atreya

    2018-01-01

    Active surveillance (AS) has been widely implemented within Veterans Affairs' medical centers (VAMCs) as a standard of care for low-risk prostate cancer (PCa). Patient characteristics such as age, race, and Agent Orange (AO) exposure may influence advisability of AS in veterans. The 17-gene assay may improve risk stratification and management selection. To compare management strategies for PCa at 6 VAMCs before and after introduction of the Oncotype DX Genomic Prostate Score (GPS) assay. We reviewed records of patients diagnosed with PCa between 2013 and 2014 to identify management patterns in an untested cohort. From 2015 to 2016, these patients received GPS testing in a prospective study. Charts from 6 months post biopsy were reviewed for both cohorts to compare management received in the untested and tested cohorts. Men who just received their diagnosis and have National Comprehensive Cancer Network (NCCN) very low-, low-, and select cases of intermediate-risk PCa. Patient characteristics were generally similar in the untested and tested cohorts. AS utilization was 12% higher in the tested cohort compared with the untested cohort. In men younger than 60 years, utilization of AS in tested men was 33% higher than in untested men. AS in tested men was higher across all NCCN risk groups and races, particular in low-risk men (72% vs 90% for untested vs tested, respectively). Tested veterans exposed to AO received less AS than untested veterans. Tested nonexposed veterans received 19% more AS than untested veterans. Median GPS results did not significantly differ as a factor of race or AO exposure. Men who receive GPS testing are more likely to utilize AS within the year post diagnosis, regardless of age, race, and NCCN risk group. Median GPS was similar across racial groups and AO exposure groups, suggesting similar biology across these groups. The GPS assay may be a useful tool to refine risk assessment of PCa and increase rates of AS among clinically and

  3. Predictive impact on medium-term mortality of hematological parameters in Acute Coronary Syndromes: added value on top of GRACE risk score.

    Science.gov (United States)

    Timóteo, Ana T; Papoila, Ana L; Lousinha, Ana; Alves, Marta; Miranda, Fernando; Ferreira, Maria L; Ferreira, Rui C

    2015-04-01

    Red Cell Distribution Width (RDW) prognostic value in patients with Acute Coronary Syndrome (ACS) has been well validated whereas that of Platelet Distribution Width (PDW) is less well known. Investigate the incremental prognostic value, on top of GRACE risk score, of a new variable resulting from the combination of RDW and PDW. Consecutive patients with ACS. Complete blood count, with RDW and PDW, was obtained. Primary endpoint was one-year all-cause mortality and Cox regression models were used to measure the influence of RDW and PDW on patients' survival time. A new combination categorical variable (RDW/PDW) was created with both discretized RDW and PDW and logistic regression models were used. Predictive value and discriminative ability of the model with GRACE risk score alone and of the model with inclusion of RDW/PDW was assessed. We included 787 patients. Hospital and one-year mortality rates were 5.1% and 7.8%, respectively. Both continuous RDW and PDW were independent predictors of death. The best cut-off for RDW was 13.9%, and 14.5% for PDW. Inclusion of RDW/PDW in a model with GRACE risk score improved the AUC from 0.81 (95% CI 0.75-0.86) to 0.84 (95% CI 0.79-0.90) (p=0.024) with an improvement in total NRI (56%) and IDI (0.048). Simple markers such as RDW and PDW can be useful in risk stratification of death after ACS. Combining both markers with GRACE risk score improved the predictive value for all-cause mortality and reduced the estimated risk of those who did not die. © The European Society of Cardiology 2014.

  4. Impact of robotic surgery on sexual and urinary functions after fully robotic nerve-sparing total mesorectal excision for rectal cancer.

    Science.gov (United States)

    Luca, Fabrizio; Valvo, Manuela; Ghezzi, Tiago Leal; Zuccaro, Massimiliano; Cenciarelli, Sabina; Trovato, Cristina; Sonzogni, Angelica; Biffi, Roberto

    2013-04-01

    Urinary and sexual dysfunctions are recognized complications of rectal cancer surgery. Their incidence after robotic surgery is as yet unknown. The aim of this study was to prospectively evaluate the impact of robotic surgery for rectal cancer on sexual and urinary functions in male and female patients. From April 2008 to December 2010, 74 patients undergoing fully robotic resection for rectal cancer were prospectively included in the study. Urinary and sexual dysfunctions affecting quality of life were assessed with specific self-administered questionnaires in all patients undergoing robotic total mesorectal excision (RTME). Results were calculated with validated scoring systems and statistically analyzed. The analyses of the questionnaires completed by the 74 patients who underwent RTME showed that sexual function and general sexual satisfaction decreased significantly 1 month after intervention: 19.1 ± 8.7 versus 11.9 ± 10.2 (P surgery, the values were comparable to those measured before surgery. Concerning urinary function, the grade of incontinence measured 1 year after the intervention was unchanged for both sexes. RTME allows for preservation of urinary and sexual functions. This is probably due to the superior movements of the wristed instruments that facilitate fine dissection, coupled with a stable and magnified view that helps in recognizing the inferior hypogastric plexus.

  5. Effects of levan-type fructan on growth performance, nutrient digestibility, diarrhoea scores, faecal shedding of total lactic acid bacteria and coliform bacteria, and faecal gas emission in weaning pigs.

    Science.gov (United States)

    Lei, Xin Jian; Kim, Yong Min; Park, Jae Hong; Baek, Dong Heon; Nyachoti, Charles Martin; Kim, In Ho

    2018-03-01

    The use of antibiotics as growth promoters in feed has been fully or partially banned in several countries. The objective of this study was to evaluate effects of levan-type fructan on growth performance, nutrient digestibility, faecal shedding of lactic acid bacteria and coliform bacteria, diarrhoea scores, and faecal gas emission in weaning pigs. A total of 144 weaning pigs [(Yorkshire × Landrace) × Duroc] were randomly allocated to four diets: corn-soybean meal-based diets supplemented with 0, 0.1, 0.5, or 1.0 g kg -1 levan-type fructan during this 42-day experiment. During days 0 to 21 and 0 to 42, average daily gain and average daily feed intake were linearly increased (P bacteria counts were linearly increased (P = 0.001). The results indicate that dietary supplementation with increasing levan-type fructan enhanced growth performance, improved nutrient digestibility, and increased faecal lactic acid bacteria counts in weaning pigs linearly. © 2017 Society of Chemical Industry. © 2017 Society of Chemical Industry.

  6. New neutron capture and total cross section measurements on 88Sr and their impact on s-process nucleosynthesis

    International Nuclear Information System (INIS)

    Koehler, P.E.; Spencer, R.R.; Guber, K.H.

    1998-01-01

    The authors have made new and improved measurements of the neutron capture and total cross sections of 88 Sr at the Oak Ridge Electron Linear Accelerator (ORELA). Improvements over previous measurements include a wider incident neutron energy range, the use of metallic rather than carbonate samples, better background subtraction, reduced sensitivity to sample-dependent backgrounds, and better pulse-height weighting functions. Because of its small cross section, the 88 Sr(n,γ) reaction is an important bottleneck during the s-process nucleosynthesis. Hence, an accurate determination of this rate is needed to better constrain the neutron exposure in s-process models and to more fully exploit the recently discovered isotopic anomalies in certain meteorites. They describe the experimental procedures, compare the results to previous data, and discuss their astrophysical impact

  7. Impact of Proximal Cap Ambiguity on Outcomes of Chronic Total Occlusion Percutaneous Coronary Intervention: Insights From a Multicenter US Registry.

    Science.gov (United States)

    Karatasakis, Aris; Danek, Barbara A; Karmpaliotis, Dimitri; Alaswad, Khaldoon; Jaffer, Farouc A; Yeh, Robert W; Patel, Mitul P; Bahadorani, John N; Wyman, R Michael; Lombardi, William L; Grantham, J Aaron; Kandzari, David E; Lembo, Nicholas J; Doing, Anthony H; Moses, Jeffrey W; Kirtane, Ajay J; Garcia, Santiago; Parikh, Manish A; Ali, Ziad A; Karacsonyi, Judit; Kalra, Sanjog; Rangan, Bavana V; Kalsaria, Pratik; Thompson, Craig A; Banerjee, Subhash; Brilakis, Emmanouil S

    2016-10-01

    We sought to determine the impact of proximal cap ambiguity on procedural techniques and outcomes for coronary chronic total occlusion (CTO) percutaneous coronary intervention (PCI). We examined the clinical and angiographic characteristics and outcomes of 1021 CTO-PCIs performed between 2012 and 2015 at 11 United States centers. Proximal cap ambiguity was present in 31% of target lesions and was associated with increased clinical and angiographic complexity (prior coronary artery bypass graft surgery: 43% vs 33%; P=.01; moderate/severe calcification 66% vs 51%; Pambiguity (68% vs 33%; Pambiguity was associated with increased use of intravascular ultrasound (49% vs 36%; P=.01) and contrast (281 mL vs 250 mL; Pambiguity is present in one-third of CTO-PCI target lesions and is associated with lower success rates, higher utilization of the retrograde approach, and lower procedural efficiency, but no significant difference in the incidence of major adverse cardiac events.

  8. Impact of airflow interaction on inhaled air quality and transport of contaminants in rooms with personalized and total volume ventilation

    DEFF Research Database (Denmark)

    Melikov, Arsen Krikor; Cermak, Radim; Kovar, O.

    2003-01-01

    The impact of airflow interaction on inhaled air quality and transport of contaminants between occupants was studied in regard to pollution from floor covering, human bioeffluents and exhaled air, with combinations of two personalized ventilation systems (PV) with mixing and displacement...... quality with personalized and mixing ventilation was higher or at least similar compared to mixing ventilation alone. In the case of PV combined with displacement ventilation, the interaction caused mixing of the room air, an increase in the transport of bioeffluents and exhaled air between occupants and...... ventilation. In total, 80 L/s of clean air supplied at 20°C was distributed between the ventilation systems at different combinations of personalized airflow rate. Two breathing thermal manikins were used to simulate occupants in a full-scale test room. Regardless of the airflow interaction, the inhaled air...

  9. An audit of the impact of a consultation with a paediatric dermatology team on quality of life in infants with atopic eczema and their families: further validation of the Infants' Dermatitis Quality of Life Index and Dermatitis Family Impact score.

    Science.gov (United States)

    Beattie, P E; Lewis-Jones, M S

    2006-12-01

    Atopic dermatitis (AD) accounts for 10-20% of referrals to secondary care dermatology, often requiring multiple visits and occupying much valuable time and resources. We audited the usefulness (ease of use, reliability and sensitivity to change) of two simple and easy to use quality of life (QoL) measures, the Infants' Dermatitis Quality of Life Index (IDQOL) and Dermatitis Family Impact (DFI), for assessing the impact on QoL of AD in infants and their families in a routine clinical setting. We also examined the impact of an initial consultation with a dermatology team on AD severity and QoL impairment from the parent's perspective. The parents of 203 infants (mean age 19.8 months) with AD attending paediatric dermatology clinics completed the DFI and IDQOL. The parents of 50 of these infants completed both questionnaires before first and second consultations. In the 203 children the mean of both the IDQOL and DFI scores was 8.47 (median 8 and 7 and SD 5.8 and 6.5, respectively). The IDQOL and DFI correlated well (r(s) = 0.776, P emotional distress. In both measures these domains also correlated most strongly with eczema severity. After dermatology consultation the median global severity score, rated by 50 parents, fell from 2 (SD 0.83) to 1 (SD 0.8; 95% confidence interval, CI 0.5-1), the median IDQOL score fell from 8 (SD 5.92) to 5.5 (SD 5.92; 95% CI 2-5.5) and the median DFI score fell from 9 (SD 6.45) to 3 (SD 6.56; 95% CI 2-5.5). In 50 infants the median IDQOL scores for those infants with global AD severity scores of 1, 2 and 3 were 5 (SD 5.65), 8 (SD 4.27) and 14 (SD 5.67), respectively and improved by 10%, 38% and 64%, respectively while the median DFI scores improved by 54%, 56% and 79%, respectively. The most improved IDQOL items were the time taken to get to sleep and difficulty at mealtimes and the most improved DFI domains were tiredness/exhaustion and emotional distress in the parents. We have provided further important information on the effects of

  10. Fatty acid composition of total lipids and phospholipids of muscular tissue and brain of rats under the impact of vibration

    Directory of Open Access Journals (Sweden)

    N. M. Kostyshyn

    2016-06-01

    Full Text Available Fatty acids are important structural components of biological membranes, energy substrate of cells involved in fixing phospholipid bilayer proteins, and acting as regulators and modulators of enzymatic activity. Under the impact of vibration oscillations there can occur shifts in the ratio of different groups of fatty acids, and degrees of their saturation may change. The imbalance between saturated, monounsaturated and polyunsaturated fatty acids, which occurs later in the cell wall, disrupts fluidity and viscosity of lipid phase and causes abnormal cellular metabolism. Aim. In order to study the impact of vibration on the level of fatty acids of total lipids in muscular tissue and fatty acid composition of phospholipids in muscles and brain, experimental animals have been exposed to vertical vibration oscillations with different frequency for 28 days. Methods and results. Tissues fragments of hip quadriceps and brain of rats were used for obtaining methyl esters of fatty acids studied by the method of gas-liquid chromatography. It was found that the lipid content, ratio of its separate factions and fatty acid composition in muscular tissue and brain of animals with the action of vibration considerably varies. With the increase of vibration acceleration tendency to increase in absolute quantity of total lipids fatty acids can be observed at the account of increased level of saturated and monounsaturated ones. These processes are caused by activation of self-defense mechanisms of the body under the conditions of deviations from stabilized physiological norm, since adaptation requires certain structural and energy costs. Increase in the relative quantity of saturated and monounsaturated fatty acids in phospholipids of muscles and brain and simultaneous reduction in concentration of polyunsaturated fatty acids are observed. Conclusion. These changes indicate worsening of structural and functional organization of muscles and brain cell membranes of

  11. The impact of a pain assessment intervention on pain score and analgesic use in older nursing home residents with severe dementia: A cluster randomised controlled trial.

    Science.gov (United States)

    Rostad, Hanne Marie; Utne, Inger; Grov, Ellen Karine; Småstuen, Milada Cvancarova; Puts, Martine; Halvorsrud, Liv

    2018-04-30

    Pain is highly prevalent in older adults, especially those in institutional settings such as nursing homes. The presence of dementia may increase the risk of underdiagnosed and undertreated pain. Pain assessment tools are not regularly used in clinical practice, however, there are indications that the regular use of pain assessments tools may influence the recognition of pain by nursing staff and thereby affect pain management. To assess whether regular pain assessment using a pain assessment tool is associated with changes in i) pain scores and ii) analgesic use in nursing home residents with severe dementia. Cluster-randomised controlled trial. The study was conducted in 16 nursing homes in four counties in Norway. A total of 112 nursing home residents aged 65 years and older with dementia who lacked the capacity for self-reporting pain or were non-verbal. The experimental group were regularly assessed pain with a standardised pain scale (the Doloplus-2) twice a week for a 12-week intervention period. The control group received usual care. The primary outcome was pain score measured with the Doloplus-2, and the secondary outcome was analgesic use (oral morphine equivalents and milligram/day paracetamol). Data on the outcomes were collected at baseline and at the end of week 12. The nursing staff in both the experimental and the control groups received training to collect the data. Linear mixed models were used to assess possible between-group difference over time. No overall effect of regular pain assessment was found on pain score or analgesic use. The mean score of Doloplus-2 and analgesic use remained unchanged and above the established cut-off in both groups. The current intervention did not change analgesic use or pain score compared with the control condition. However, there is not sufficient evidence to conclude that regular pain assessment using a pain assessment tool is not clinically relevant. Furthermore, our results indicated that pain continued to be

  12. Total Environment of Change: Impacts of Climate Change and Social Transitions on Subsistence Fisheries in Northwest Alaska

    Directory of Open Access Journals (Sweden)

    Katie J. Moerlein

    2012-03-01

    Full Text Available Arctic ecosystems are undergoing rapid changes as a result of global climate change, with significant implications for the livelihoods of Arctic peoples. In this paper, based on ethnographic research conducted with the Iñupiaq communities of Noatak and Selawik in northwestern Alaska, we detail prominent environmental changes observed over the past twenty to thirty years and their impacts on subsistence-based lifestyles. However, we suggest that it is ultimately insufficient to try to understand how Arctic communities are experiencing and responding to climate change in isolation from other stressors. During interviews and participant observation documenting local observations of climatic and related environmental shifts and impacts to subsistence fishing practices, we find the inseparability of environmental, social, economic, cultural, and political realms for community residents. Many of our informants, who live in a mixed economy based on various forms of income and widespread subsistence harvesting of fish and game, perceive and experience climate change as embedded among numerous other factors affecting subsistence patterns and practices. Changing lifestyles, decreasing interest by younger generations in pursuing subsistence livelihoods, and economic challenges are greatly affecting contemporary subsistence patterns and practices in rural Alaska. Observations of climate change are perceived, experienced, and articulated to researchers through a broader lens of these linked lifestyle and cultural shifts. Therefore, we argue that to properly assess and understand the impacts of climate change on the subsistence practices in Arctic communities, we must also consider the total environment of change that is dramatically shaping the relationship between people, communities, and their surrounding environments.

  13. Nonmassive acute pulmonary embolism: evaluation of the impact of pulmonary arterial wall distensibility on the assessment of the CT obstruction score.

    Science.gov (United States)

    Bigot, Julien; Rémy-Jardin, Martine; Duhamel, Alain; Gorgos, Andréi-Bogdan; Faivre, Jean-Baptiste; Rémy, Jacques

    2010-02-01

    To evaluate the impact of pulmonary arterial wall distensibility on the assessment of a computed tomography (CT) score in patients with nonmassive pulmonary embolism (PE) (ie, Mastora score). The arterial wall distensibility of five central pulmonary arteries (pulmonary artery trunk, right and left main pulmonary arteries, right and left interlobar pulmonary arteries) was studied on ECG-gated CT angiographic studies of the chest in 15 patients with no pulmonary arterial hypertension (group 1; mean pulmonary artery pressure: 17.2 mm Hg) and 9 patients with nonmassive PE (group 2), using 2D reconstructions at every 10% of the R-R interval. The systolic and diastolic reconstruction time windows of the examined arteries were identical in the 2 groups, obtained at 20% and 80% of the R-R interval, respectively. No statistically significant difference was observed between the mean values of the pulmonary arterial wall distensibility between the 2 groups, varying between 20.5% and 24% in group 1 and between 23.3% and 25.9% in group 2. The coefficients of variation of the average arterial surfaces were found to vary between 4.30% and 6.50% in group 1 and 4.2% and 8.4% in group 2. Except the pulmonary artery trunk in group 2, all the intraclass correlation coefficients were around 0.8 or greater than 0.8, that is the cutoff for good homogeneity of measurements. The pulmonary arterial wall systolic-diastolic distensibility does not interfere with the assessment of a CT obstruction score in the setting of nonmassive PE.

  14. Impact of radiation technique, radiation fraction dose, and total cisplatin dose on hearing. Retrospective analysis of 29 medulloblastoma patients

    International Nuclear Information System (INIS)

    Scobioala, Sergiu; Kittel, Christopher; Ebrahimi, Fatemeh; Wolters, Heidi; Eich, Hans Theodor; Parfitt, Ross; Matulat, Peter; Am Zehnhoff-Dinnesen, Antoinette

    2017-01-01

    To analyze the incidence and degree of sensorineural hearing loss (SNHL) resulting from different radiation techniques, fractionation dose, mean cochlear radiation dose (D mean ), and total cisplatin dose. In all, 29 children with medulloblastoma (58 ears) with subclinical pretreatment hearing thresholds participated. Radiotherapy (RT) and cisplatin had been applied sequentially according to the HIT MED Guidance. Audiological outcomes up to the latest follow-up (median 2.6 years) were compared. Bilateral high-frequency SNHL was observed in 26 patients (90%). No significant differences were found in mean hearing threshold between left and right ears at any frequency. A significantly better audiological outcome (p < 0.05) was found after tomotherapy at the 6 kHz bone-conduction threshold (BCT) and left-sided 8 kHz air-conduction threshold (ACT) than after a combined radiotherapy technique (CT). Fraction dose was not found to have any impact on the incidence, degree, and time-to-onset of SNHL. Patients treated with CT had a greater risk of SNHL at high frequencies than tomotherapy patients even though D mean was similar. Increase in severity of SNHL was seen when the total cisplatin dose reached above 210 mg/m 2 , with the highest abnormal level found 8-12 months after RT regardless of radiation technique or fraction dose. The cochlear radiation dose should be kept as low as possible in patients who receive simultaneous cisplatin-based chemotherapy. The risk of clinically relevant HL was shown when D mean exceeds 45 Gy independent of radiation technique or radiation regime. Cisplatin ototoxicity was shown to have a dose-dependent effect on bilateral SNHL, which was more pronounced in higher frequencies. (orig.) [de

  15. Bone Metabolism after Total Hip Revision Surgery with Impacted Grafting: Evaluation using H215O and [18F]fluoride PET; A Pilot Study

    NARCIS (Netherlands)

    Temmerman, Olivier; Raijmakers, Pieter; Heyligers, Ide; Comans, Emile; Lubberink, Mark; Teule, Gerrit; Lammertsma, Adriaan

    2008-01-01

    Purpose: To evaluate bone blood flow and bone formation in patients after total hip revision surgery with impacted bone grafting using H2 15O and [18F]fluoride positron emission tomography (PET). Procedures: To asses bone blood flow and bone metabolism in bone allograft after impaction grafting,

  16. Risk of pneumonia and urinary tract infection within the first week after total hip arthroplasty and the impact on survival

    Directory of Open Access Journals (Sweden)

    Glassou EN

    2017-01-01

    Full Text Available Eva N Glassou,1,2 Torben B Hansen,1,3 Alma B Pedersen2 1University Clinic of Hand, Hip and Knee Surgery, Department of Orthopedic Surgery, Regional Hospital West Jutland, Aarhus University, 2Department of Clinical Epidemiology, Aarhus University Hospital, 3The Lundbeck Foundation Centre for Fast-track Hip and Knee Replacement, Aarhus University, Aarhus, Denmark Background: Pneumonia and urinary tract infections (UTIs increase morbidity and mortality. There is little epidemiological evidence from large population-based studies on risk factors for these infections and subsequent mortality in total hip arthroplasty (THA patients.Aim: To examine the risk factors of postoperative pneumonia and UTI after THA and their impact on survival.Patients and methods: We used the Danish Hip Arthroplasty Register to identify THAs due to osteoarthritis registered from 2000 to 2013. We collected data about comorbidities, mortality and infections in relation to primary hospitalization and potential predictive variables from administrative databases. Regression models were used to estimate associations between potential risk factors and infection, and subsequently, between infection and mortality.Results: In total 84,812 THAs were included. The cumulative incidence of pneumonia and UTI within 7 days of the primary procedure were 0.21 (95% confidence interval [CI]: 0.18–0.25 and 0.29 (95% CI: 0.26–0.33, respectively. Patient-related risk factors for infection were being 80 years or older, gender and a comorbidity burden at time of surgery. The hazard ratio (HR of dying within 90 days of the primary THA was 10.67 (95% CI: 5.79–19.57 compared to patients without pneumonia. For patients with UTIs, the HR was 1.64 (95% CI: 0.41–6.59 compared to those without a UTI.Conclusion: Pneumonia was associated with an increased short-term risk of dying, despite adjustment for coexisting comorbidity and other potential confounders. Age, gender and comorbidity were the most

  17. Impact on adenosine stress cardiac magnetic resonance for recanalisation and follow up of chronic total coronary occlusions

    Energy Technology Data Exchange (ETDEWEB)

    Heyne, J.P. [Institute of Diagnostic and Interventional Radiology, Friedrich Schiller University Jena, Erlanger Allee 101, D-07740 Jena (Germany)], E-mail: Jens-Peter.Heyne@med.uni-jena.de; Goernig, M. [Clinic for Internal Medicine I, Friedrich Schiller University Jena, Erlanger Allee 101, D-07740 Jena (Germany)], E-mail: Matthias.Goernig@med.uni-jena.de; Feger, J. [Institute of Diagnostic and Interventional Radiology, Friedrich Schiller University Jena, Erlanger Allee 101, D-07740 Jena (Germany)], E-mail: Joachim.Feger@email.de; Kurrat, C. [Institute of Diagnostic and Interventional Radiology, Friedrich Schiller University Jena, Erlanger Allee 101, D-07740 Jena (Germany)], E-mail: Claudia.Kurrat@med.uni-jena.de; Werner, G.S. [Clinic for Internal Medicine I, Friedrich Schiller University Jena, Erlanger Allee 101, D-07740 Jena (Germany)], E-mail: Gerald.Werner@Klinikum-Darmstadt.de; Figulla, H.R. [Clinic for Internal Medicine I, Friedrich Schiller University Jena, Erlanger Allee 101, D-07740 Jena (Germany)], E-mail: Hans.Figulla@med.uni-jena.de; Kaiser, W.A. [Institute of Diagnostic and Interventional Radiology, Friedrich Schiller University Jena, Erlanger Allee 101, D-07740 Jena (Germany)], E-mail: Werner.Kaiser@med.uni-jena.de

    2007-09-15

    Objective: To evaluate the impact on cardiac magnetic resonance imaging (CMRI) with adenosine stress and delayed enhancement for indication and follow up after interventional recanalisation of chronic total coronary occlusions (CTOs). Material and methods: Twenty consecutive patients (15 males; 5 females; mean age 65 years) with CTO verified by cardiac catheterisation referred to CMRI. Sixteen of them got CMRI before and after coronary recanalisation. Wall motion abnormalities (WMAs), first pass perfusion with adenosine and viability were assessed using a 1.5 T MR scanner (Sonata; Siemens). CMRI results were compared with clinical classifications, the results of cardiac catheterisation and follow up angiography. Results: Sixteen patients had a successful recanalisation, 15 of the occluded coronary artery and one of collateral donor artery stenosis. After recanalisation all stress-induced progressive or new wall motion abnormalities (WMAs) of the corresponding segments and in the collateral donor territory (5 patients) and all adenosine induced perfusion defects (PD) or delay (12 patients) were regredient. 13/16 patients showed no transmural and one patient transmural delayed enhancement (DE) indicating myocardial scar. In 10/16 patients CSS grading of angina improved after recanalisation. Conclusion: After successful recanalisation of CTOs, patients with preinterventional stress-induced PDs and WMAs in viable myocardium did not display any signs of stress-induced ischemia postinterventionally. A comprehensive CMRI approach, including assessment of rest and stress WMAs, first pass perfusion and myocardial viability represents an important tool for the pre-interventional decision to recanalise CTOs and follow up.

  18. [Impact of atmospheric total suspended particulate pollution on photosynthetic parameters of street mango trees in Xiamen City].

    Science.gov (United States)

    Yu, Yu-xian; Chen, Jin-sheng; Ren, Yin; Li, Fang-yi; Cui, Sheng-hui

    2010-05-01

    With the development of urbanization, total suspended particulate (TSP) pollution is getting serious, and the normal physiological processes of urban vegetation are profoundly affected while adsorbing and purifying the particulates. In this study, four areas were selected, i.e., Tingxi reservoir (clean control area), Xiamen University (cultural and educational area), Xianyue (business area), and Haicang (industrial area), with their atmospheric TSP concentrations and the photosynthetic parameters of street Mango (Mangifera indica) trees monitored in April and May, 2009. The daily average concentration of TSP in Tingxi, Xiamen University, Xianyue, and Haicang was 0.061, 0.113, 0.120 and 0.205 mg x m(-3), respectively, and the impact of TSP stress on M. indica was in the sequence of Haicang > Xianyue > Xiamen University > Tingxi. TSP pollution negatively affected the net photosynthetic rate, stomatal conductance, and transpiration rate of M. indica, and induced intercellular CO2 concentration changed significantly. High TSP concentration could cause the decline of net photosynthetic rate via stomatal limitation.

  19. Impact of Intraluminal Brachytherapy on Survival Outcome for Radiation Therapy for Unresectable Biliary Tract Cancer: A Propensity-Score Matched-Pair Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Yoshioka, Yasuo [Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka (Japan); Ogawa, Kazuhiko, E-mail: kogawa@radonc.med.osaka-u.ac.jp [Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka (Japan); Oikawa, Hirobumi [Department of Radiology, Iwate Medical University, Iwate (Japan); Onishi, Hiroshi [Department of Radiology, University of Yamanashi, Yamanashi (Japan); Kanesaka, Naoto [Department of Radiology, Tokyo Medical University, Tokyo (Japan); Tamamoto, Tetsuro [Department of Radiation Oncology, Nara Medical University of Medicine, Nara (Japan); Kosugi, Takashi [Department of Radiology, Hamamatsu University School of Medicine, Shizuoka (Japan); Hatano, Kazuo [Department of Radiation Oncology, Chiba Cancer Center, Chiba (Japan); Kobayashi, Masao [Department of Radiology, Jikei University School of Medicine, Tokyo (Japan); Ito, Yoshinori [Department of Radiation Oncology, National Cancer Center Hospital, Tokyo (Japan); Takayama, Makoto [Department of Radiology, Kyorin University School of Medicine, Tokyo (Japan); Takemoto, Mitsuhiro [Department of Radiology, Okayama University, Okayama (Japan); Karasawa, Katsuyuki [Department of Radiation Oncology, Tokyo Metropolitan Komagome Hospital, Tokyo (Japan); Nagakura, Hisayasu [Department of Radiology, KKR Sapporo Medical Center, Hokkaido (Japan); Imai, Michiko [Department of Radiation Oncology, Iwata City Hospital, Shizuoka (Japan); Kosaka, Yasuhiro [Department of Radiation Oncology, Kobe City Medical Center General Hospital, Hyogo (Japan); Yamazaki, Hideya [Department of Radiology, Kyoto Prefectural University of Medicine, Kyoto (Japan); Isohashi, Fumiaki [Department of Radiation Oncology, Osaka University Graduate School of Medicine, Osaka (Japan); Nemoto, Kenji [Department of Radiation Oncology, Yamagata University, Yamagata (Japan); Nishimura, Yasumasa [Department of Radiation Oncology, Kinki University Faculty of Medicine, Osaka (Japan)

    2014-07-15

    Purpose: To determine whether adding intraluminal brachytherapy (ILBT) to definitive radiation therapy (RT) for unresectable biliary tract cancer has a positive impact on survival outcome. Methods and Materials: The original cohort comprised 209 patients, including 153 who underwent external beam RT (EBRT) alone and 56 who received both ILBT and EBRT. By matching propensity scores, 56 pairs (112 patients) consisting of 1 patient with and 1 patient without ILBT were selected. They were well balanced in terms of sex, age, performance status, clinical stage, jaundice, and addition of chemotherapy. The impact of ILBT on overall survival (OS), disease-specific survival (DSS), and local control (LC) was investigated. Results: The 2-year OS rates were 31% for the ILBT+ group and 40% for theILBT– group (P=.862). The 2-year DSS rates were 42% for the ILBT+ group and 41% for the ILBT– group (P=.288). The 2-year LC rates were 65% for the ILBT+ group and 35% for the ILBT– group (P=.094). Three of the 4 sensitivity analyses showed a significantly better LC for the ILBT+ group (P=.010, .025, .049), and another showed a marginally better LC (P=.068), and none of the sensitivity analyses showed any statistically significant differences in OS or DSS. Conclusions: In the treatment for unresectable biliary tract cancer, the addition of ILBT to RT has no impact on OS or DSS but is associated with better LC. Therefore, the role of ILBT should be addressed by other measures than survival benefit, for example, by less toxicity, prolonged biliary tract patency decreasing the need for further palliative interventions, or patient quality of life.

  20. Impact of Intraluminal Brachytherapy on Survival Outcome for Radiation Therapy for Unresectable Biliary Tract Cancer: A Propensity-Score Matched-Pair Analysis

    International Nuclear Information System (INIS)

    Yoshioka, Yasuo; Ogawa, Kazuhiko; Oikawa, Hirobumi; Onishi, Hiroshi; Kanesaka, Naoto; Tamamoto, Tetsuro; Kosugi, Takashi; Hatano, Kazuo; Kobayashi, Masao; Ito, Yoshinori; Takayama, Makoto; Takemoto, Mitsuhiro; Karasawa, Katsuyuki; Nagakura, Hisayasu; Imai, Michiko; Kosaka, Yasuhiro; Yamazaki, Hideya; Isohashi, Fumiaki; Nemoto, Kenji; Nishimura, Yasumasa

    2014-01-01

    Purpose: To determine whether adding intraluminal brachytherapy (ILBT) to definitive radiation therapy (RT) for unresectable biliary tract cancer has a positive impact on survival outcome. Methods and Materials: The original cohort comprised 209 patients, including 153 who underwent external beam RT (EBRT) alone and 56 who received both ILBT and EBRT. By matching propensity scores, 56 pairs (112 patients) consisting of 1 patient with and 1 patient without ILBT were selected. They were well balanced in terms of sex, age, performance status, clinical stage, jaundice, and addition of chemotherapy. The impact of ILBT on overall survival (OS), disease-specific survival (DSS), and local control (LC) was investigated. Results: The 2-year OS rates were 31% for the ILBT+ group and 40% for theILBT– group (P=.862). The 2-year DSS rates were 42% for the ILBT+ group and 41% for the ILBT– group (P=.288). The 2-year LC rates were 65% for the ILBT+ group and 35% for the ILBT– group (P=.094). Three of the 4 sensitivity analyses showed a significantly better LC for the ILBT+ group (P=.010, .025, .049), and another showed a marginally better LC (P=.068), and none of the sensitivity analyses showed any statistically significant differences in OS or DSS. Conclusions: In the treatment for unresectable biliary tract cancer, the addition of ILBT to RT has no impact on OS or DSS but is associated with better LC. Therefore, the role of ILBT should be addressed by other measures than survival benefit, for example, by less toxicity, prolonged biliary tract patency decreasing the need for further palliative interventions, or patient quality of life

  1. Adjuvant treatment for resected rectal cancer: impact of standard and intensified postoperative chemotherapy on disease-free survival in patients undergoing preoperative chemoradiation-a propensity score-matched analysis of an observational database.

    Science.gov (United States)

    Garlipp, Benjamin; Ptok, Henry; Benedix, Frank; Otto, Ronny; Popp, Felix; Ridwelski, Karsten; Gastinger, Ingo; Benckert, Christoph; Lippert, Hans; Bruns, Christiane

    2016-12-01

    Adjuvant chemotherapy for resected rectal cancer is widely used. However, studies on adjuvant treatment following neoadjuvant chemoradiotherapy (CRT) and total mesorectal excision (TME) have yielded conflicting results. Recent studies have focused on adding oxaliplatin to both preoperative and postoperative therapy, making it difficult to assess the impact of adjuvant oxaliplatin alone. This study was aimed at determining the impact of (i) any adjuvant treatment and (ii) oxaliplatin-containing adjuvant treatment on disease-free survival in CRT-pretreated, R0-resected rectal cancer patients. Patients undergoing R0 TME following 5-fluorouracil (5FU)-only-based CRT between January 1, 2008, and December 31, 2010, were selected from a nationwide registry. After propensity score matching (PSM), comparison of disease-free survival (DFS) using Kaplan-Meier analysis and log-rank test was performed in (i) patients receiving no vs. any adjuvant treatment and (ii) patients treated with adjuvant 5FU/capecitabine without vs. with oxaliplatin. Out of 1497 patients, 520 matched pairs were generated for analysis of no vs. any adjuvant treatment. Mean DFS was significantly prolonged with adjuvant treatment (81.8 ± 2.06 vs. 70.1 ± 3.02 months, p rectal cancer patients treated with neoadjuvant CRT and TME surgery under routine conditions, adjuvant chemotherapy significantly improved DFS. No benefit was observed for the addition of oxaliplatin to adjuvant chemotherapy in this setting.

  2. Impaction grafting in the femur in cementless modular revision total hip arthroplasty: a descriptive outcome analysis of 243 cases with the MRP-TITAN revision implant

    Directory of Open Access Journals (Sweden)

    Wimmer Matthias D

    2013-01-01

    Full Text Available Abstract Background We present a descriptive and retrospective analysis of revision total hip arthroplasties (THA using the MRP-TITAN stem (Peter Brehm, Weisendorf, GER with distal diaphyseal fixation and metaphyseal defect augmentation. Our hypothesis was that the metaphyseal defect augmentation (Impaction Bone Grafting improves the stem survival. Methods We retrospectively analyzed the aggregated and anonymized data of 243 femoral stem revisions. 68 patients with 70 implants (28.8% received an allograft augmentation for metaphyseal defects; 165 patients with 173 implants (71.2% did not, and served as controls. The mean follow-up was 4.4 ± 1.8 years (range, 2.1–9.6 years. There were no significant differences (p > 0.05 between the study and control group regarding age, body mass index (BMI, femoral defects (types I-III as described by Paprosky, and preoperative Harris Hip Score (HHS. Postoperative clinical function was evaluated using the HHS. Postoperative radiologic examination evaluated implant stability, axial implant migration, signs of implant loosening, periprosthetic radiolucencies, as well as bone regeneration and resorption. Results There were comparable rates of intraoperative and postoperative complications in the study and control groups (p > 0.05. Clinical function, expressed as the increase in the postoperative HHS over the preoperative score, showed significantly greater improvement in the group with Impaction Bone Grafting (35.6 ± 14.3 vs. 30.8 ± 15.8; p ≤ 0.05. The study group showed better outcome especially for larger defects (types II C and III as described by Paprosky and stem diameters ≥ 17 mm. The two groups did not show significant differences in the rate of aseptic loosening (1.4% vs. 2.9% and the rate of revisions (8.6% vs. 11%. The Kaplan-Meier survival for the MRP-TITAN stem in both groups together was 93.8% after 8.8 years. [Study group 95.7% after 8.54 years ; control group 93

  3. Credit scoring methods

    Czech Academy of Sciences Publication Activity Database

    Vojtek, Martin; Kočenda, Evžen

    2006-01-01

    Roč. 56, 3-4 (2006), s. 152-167 ISSN 0015-1920 R&D Projects: GA ČR GA402/05/0931 Institutional research plan: CEZ:AV0Z70850503 Keywords : banking sector * credit scoring * discrimination analysis Subject RIV: AH - Economics Impact factor: 0.190, year: 2006 http://journal.fsv.cuni.cz/storage/1050_s_152_167.pdf

  4. Impact of CHA2DS2VASc Score on Candidacy for Anticoagulation in Patients With Atrial Fibrillation: A Multi-payer Analysis.

    Science.gov (United States)

    Patel, Aarti A; Nelson, Winnie W; Schein, Jeff

    2016-10-01

    The purpose of this study is to report on the effect of using CHA 2 DS 2 VASc (congestive heart failure, hypertension, age ≥75 years [doubled], type 1 or type 2 diabetes mellitus, stroke or transient ischemic attack or thromboembolism [doubled], vascular disease [prior myocardial infarction, peripheral artery disease, or aortic plaque], age 65-75 years, sex category [female]) rather than CHADS 2 (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, and prior stroke) to determine candidacy for anticoagulant prophylaxis in insured patients with atrial fibrillation (AF). Six administrative claims databases that included medical and pharmacy claims for patients aged ≥18 years with a new or existing diagnosis of AF and patient outcomes assessed for 1 year after diagnosis were analyzed. Retrospective health plan data analyses were performed using a software tool (Anticoagulant Quality Improvement Analyzer). Study measures included stroke risk (identified by CHADS 2 and CHA 2 DS 2 VASc scores), bleeding risk (identified by the Anticoagulation and Risk Factors in Atrial Fibrillation score), and anticoagulant use. A total of 115,906 patients with AF (range of mean ages among the 6 databases, 56-79 years) met the inclusion criteria. All ranges reported represent the minimum and maximum values among the 6 databases. Using the CHA 2 DS 2 VASc compared with the CHADS 2 index to assess stroke risk resulted in a 23% to 32% increase in patients considered potential candidates for anticoagulant prophylaxis. This translated to a 38% to 114% increase in the number of ostensibly undertreated patients. Among patients with high stroke and low bleeding risk, 18% to 28% more patients were considered potential candidates for anticoagulation treatment using CHA 2 DS 2 VASc compared with CHADS 2 , or a 57% to 151% increase in the number of undertreated patients. Use of the CHA 2 DS 2 VASc score to determine the risk of stroke increased the number of AF patients for

  5. African-American Men with Gleason Score 3+3=6 Prostate Cancer Produce Less Prostate Specific Antigen than Caucasian Men: A Potential Impact on Active Surveillance.

    Science.gov (United States)

    Kryvenko, Oleksandr N; Balise, Raymond; Soodana Prakash, Nachiketh; Epstein, Jonathan I

    2016-02-01

    We assess the difference in prostate specific antigen production between African-American and Caucasian men with Gleason score 3+3=6 prostate cancer. We measured tumor volume in 414 consecutive radical prostatectomies from men with National Comprehensive Cancer Network(®) low risk prostate cancer (348 Caucasian, 66 African-American) who had Gleason score 3+3=6 disease at radical prostatectomy. We then compared clinical presentation, pathological findings, prostate specific antigen, prostate specific antigen density and prostate specific antigen mass (an absolute amount of prostate specific antigen in patient's circulation) between African-American and Caucasian men. The t-test and Wilcoxon rank sum were used for comparison of means. African-American and Caucasian men had similar clinical findings based on age, body mass index and prostate specific antigen. There were no statistically significant differences between the dominant tumor nodule volume and total tumor volume (mean 0.712 vs 0.665 cm(3), p=0.695) between African-American and Caucasian men. Prostates were heavier in African-American men (mean 55.4 vs 46.3 gm, p prostate tissue contributing to prostate specific antigen in African-American men, prostate specific antigen mass was not different from that of Caucasian men (mean 0.55 vs 0.558 μg, p=0.95). Prostate specific antigen density was significantly less in African-American men due to larger prostates (mean 0.09 vs 0.105, p prostate cancer produce less prostate specific antigen than Caucasian men. African-American and Caucasian men had equal serum prostate specific antigen and prostate specific antigen mass despite significantly larger prostates in African-American men with all other parameters, particularly total tumor volume, being the same. This finding has practical implications in T1c cases diagnosed with prostate cancer due to prostate specific antigen screening. Lowering the prostate specific antigen density threshold in African-American men may

  6. A2-3: Impact of Mild Chronic Kidney Disease Stage on Outcomes after Total Hip or Knee Arthroplasty

    Science.gov (United States)

    Graham, Jove; Deegan, Brian; Bowen, Thomas; Richard, Raveesh; Perkins, Robert; Foltzer, Michael

    2014-01-01

    Background/Aims Dialysis and kidney transplantation adversely impact outcomes of total hip or knee arthroplasty (THA, TKA), but complication rates have not been reported for patients with less advanced stages of chronic kidney disease (CKD). Surgeons lack the data necessary to have informed discussions regarding anticipated outcomes of joint replacement for these patients. Methods We retrospectively reviewed electronic health records of 779 adults with stages 1, 2, and 3 CKD not requiring dialysis or transplantation who underwent THA or TKA from 2004–2011, to assess infection, revision, 90-day readmission and mortality rates. Patients with less than 12 months follow-up, open fracture, prior joint surgery, pregnancy, or acute kidney injury were excluded. Chi-square analysis and Cox survival analysis compared these outcomes between the stage 1–2 and stage 3 groups, stratified by joint replaced (THA vs TKA). All models adjusted for age, sex and BMI at surgery. Results No statistically different rates of revision or infection between Stage 3 vs. Stages 1–2 were seen, although there was a trend toward increased infections in Stage 3. THA patients with Stage 3 showed a significantly increased mortality rate compared to Stage 1–2 THA patients (HR 3.40, 95% CI = 1.25–9.23, P = 0.02). Conclusions CKD affects nearly 15% of the U.S. population many of whom undergo joint replacement. End stage kidney disease (patients post-transplant or on hemodialysis) has been consistently associated with increased rates of infection and revision in excess of our observed outcomes, but the overall rate of infection/revision in our study population was only slightly higher than reported rates in the general population (2–7% vs. 1–2%, respectively). CKD should not preclude joint replacement, but these data can help clinicians engage in meaningful informed discussions with patients with mild kidney disease regarding risks for infection, revision and death following joint

  7. Psychosocial and Quality of Life in Women Receiving the 21-Gene Recurrence Score Assay: The Impact of Decision Style in Women with Intermediate RS

    Directory of Open Access Journals (Sweden)

    Nadiyah Sulayman

    2012-01-01

    Full Text Available Multigene assays such as the 21-gene recurrence score (RS quantify risk for recurrence and potential benefit from chemotherapy in early-stage, ER+ breast cancers. Few studies have assessed the impact of testing on patient-reported outcomes such as cancer-related distress or quality of life. The few studies that have assessed these outcomes do not consider potential modifiers, such as the patients’ level of involvement in the treatment decision-making process. In the current study, 81 breast cancer patients who received the RS assay completed cross-sectional surveys. We used linear multiple regression to assess whether test result, decision-making role (passive versus shared/active, and their interaction contributed to current levels of distress, quality of life, and decisional conflict. There were no associations between these variables and test result or decision-making role. However, women who received an intermediate RS and took a passive role in their care reported higher-cancer-related distress and cancer worry and lower quality of life than those who took a shared or active role. These data should be confirmed in prospective samples, as these poorer outcomes could be amenable to intervention.

  8. Psychosocial and Quality of Life in Women Receiving the 21-Gene Recurrence Score Assay: The Impact of Decision Style in Women with Intermediate RS

    International Nuclear Information System (INIS)

    Sulayman, N.; Spellman, E.; Graves, K. D.; Peshkin, B. N.; Isaacs, C.; Schwartz, M. D.; O’Neill, S. C.

    2012-01-01

    Multigene assays such as the 21-gene recurrence score (RS) quantify risk for recurrence and potential benefit from chemotherapy in early-stage, ER+ breast cancers. Few studies have assessed the impact of testing on patient-reported outcomes such as cancer-related distress or quality of life. The few studies that have assessed these outcomes do not consider potential modifiers, such as the patients’ level of involvement in the treatment decision-making process. In the current study, 81 breast cancer patients who received the RS assay completed cross-sectional surveys. We used linear multiple regression to assess whether test result, decision-making role (passive versus shared/active), and their interaction contributed to current levels of distress, quality of life, and decisional conflict. There were no associations between these variables and test result or decision-making role. However, women who received an intermediate RS and took a passive role in their care reported higher-cancer-related distress and cancer worry and lower quality of life than those who took a shared or active role. These data should be confirmed in prospective samples, as these poorer outcomes could be amenable to intervention

  9. Impact of marital status at diagnosis on survival and its change over time between 1973 and 2012 in patients with nasopharyngeal carcinoma: a propensity score-matched analysis.

    Science.gov (United States)

    Xu, Cheng; Liu, Xu; Chen, Yu-Pei; Mao, Yan-Ping; Guo, Rui; Zhou, Guan-Qun; Tang, Ling-Long; Lin, Ai-Hua; Sun, Ying; Ma, Jun

    2017-12-01

    The impact of marital status at diagnosis on survival outcomes and its change over time in patients with nasopharyngeal carcinoma (NPC) are unclear. The Surveillance, Epidemiology, and End Results (SEER) database was used to identify patients diagnosed with NPC in the United States from 1973 to 2012. A primary comparison (married vs. unmarried) was implemented with 1:1 propensity score matching. Secondary comparisons were performed individually between three unmarried subgroups (single, separated/divorced, widowed) and married group. The effect of marital status on cause-specific survival (CSS) and overall survival (OS) were evaluated using univariate/multivariate analysis. Moreover, we investigated the change over time (1973-2012) in the effect of marital status on NPC survival. Married patients had better 5-year CSS/OS than unmarried patients (61.1% vs. 52.6%, P vs. 45.3%, P unmarried patients had significantly poorer CSS/OS than married patients (adjusted hazard ratio [aHR] = 1.35, P married was only detected in non-Hispanic white and Chinese American patients. Single, separated/divorced, and widowed patients had significantly poorer CSS/OS than married patients (aHR = 1.37 and 1.37; 1.46 and 1.42; 1.43 and 1.48, respectively; all P married status. Single and widowed patients are regarded as high-risk population. © 2017 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

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

    Science.gov (United States)

    Gatot, D.; Mardia, A. I.

    2018-03-01

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

  11. Total Environmental Impact of Three Main Dietary Patterns in Relation to the Content of Animal and Plant Food

    Directory of Open Access Journals (Sweden)

    Luciana Baroni

    2014-07-01

    Full Text Available Based on a review of the most recent available scientific evidence, the new Dietary Guidelines for Americans 2010 (USDA DG provide information and advice for choosing a healthy diet. To compare the environmental impacts of, respectively, omnivorous (OMN, lacto-ovo-vegetarian (LOV and vegan (VEG dietary patterns as suggested in the USDA DG, we analyzed the three patterns by Life Cycle Assessment (LCA methodology. The presence of animal food in the diet was the main determinant of environmental impact. The major impact always stemmed from land and water use. The second largest impact came from energy use. Emission of toxic inorganic compounds into the atmosphere was the third cause of impact. Climate change and acidification/eutrophication represented other substantial impacts.

  12. Total Environmental Impact of Three Main Dietary Patterns in Relation to the Content of Animal and Plant Food.

    Science.gov (United States)

    Baroni, Luciana; Berati, Marina; Candilera, Maurizio; Tettamanti, Massimo

    2014-07-25

    Based on a review of the most recent available scientific evidence, the new Dietary Guidelines for Americans 2010 (USDA DG) provide information and advice for choosing a healthy diet. To compare the environmental impacts of, respectively, omnivorous (OMN), lacto-ovo-vegetarian (LOV) and vegan (VEG) dietary patterns as suggested in the USDA DG, we analyzed the three patterns by Life Cycle Assessment (LCA) methodology. The presence of animal food in the diet was the main determinant of environmental impact. The major impact always stemmed from land and water use. The second largest impact came from energy use. Emission of toxic inorganic compounds into the atmosphere was the third cause of impact. Climate change and acidification/eutrophication represented other substantial impacts.

  13. Validity of the rheumatoid arthritis impact of disease (RAID) score and definition of cut-off points for disease activity states in a population-based European cohort of patients with rheumatoid arthritis.

    Science.gov (United States)

    Salaffi, Fausto; Di Carlo, Marco; Vojinovic, Jelena; Tincani, Angela; Sulli, Alberto; Soldano, Stefano; Andreoli, Laura; Dall'Ara, Francesca; Ionescu, Ruxandra; Simić Pašalić, Katarina; Balčune, Ineta; Ferraz-Amaro, Iván; Tlustochowicz, Malgorzata; Butrimienė, Irena; Punceviciene, Egle; Toroptsova, Natalia; Grazio, Simeon; Morović-Vergles, Jadranka; Masaryk, Pavol; Otsa, Kati; Bernardes, Miguel; Boyadzhieva, Vladimira; Cutolo, Maurizio

    2017-05-24

    To assess the validity of the rheumatoid arthritis impact of disease (RAID) for measuring disease activity of rheumatoid arthritis (RA) and to determine cut-off values for defining the disease activity states. A total of 622 RA patients from an European database have been included. Cross-validation was based on assessment of convergent and discriminant validity. Optimal cut-offs were determined against external criteria by calculating the respective 25th and 75th percentiles mean values of RAID. External criteria included definitions for remission (REM), low disease activity (LDA), moderate disease activity (MDA) and high disease activity (HDA), cut-offs of the 28-joint disease activity score-C-reactive protein (DAS28-CRP) score. The RAID showed a moderate degree of correlation with respect to DAS28-CRP (rho=0.417; Pdisease was very good with an area under the curve (AUC) of 0.847 (95% confidence interval [CI]: 0.816 to 0.878; Pdisease activity groups, we propose the following cut-off values for REM: RAID ≤3; for LDA: RAID >3 and ≤4; for MDA: RAID >4 and ≤6; for HDA: RAID >6. Mean RAID differed significantly between patients classified as REM, LDA, MDA or HDA (P=0.001). The cut-offs revealed good measurement characteristics in cross-validation analysis, had great discriminatory performance in distinguishing patients with different levels of disease activity and are suited for widespread use in everyday practice application and research. Copyright © 2017 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

  14. Impact of radiation technique, radiation fraction dose, and total cisplatin dose on hearing. Retrospective analysis of 29 medulloblastoma patients

    Energy Technology Data Exchange (ETDEWEB)

    Scobioala, Sergiu; Kittel, Christopher; Ebrahimi, Fatemeh; Wolters, Heidi; Eich, Hans Theodor [University Hospital of Muenster, Department of Radiotherapy and Radiooncology, Muenster (Germany); Parfitt, Ross; Matulat, Peter; Am Zehnhoff-Dinnesen, Antoinette [University Hospital of Muenster, Department of Phoniatrics and Pediatric Audiology, Muenster (Germany)

    2017-11-15

    To analyze the incidence and degree of sensorineural hearing loss (SNHL) resulting from different radiation techniques, fractionation dose, mean cochlear radiation dose (D{sub mean}), and total cisplatin dose. In all, 29 children with medulloblastoma (58 ears) with subclinical pretreatment hearing thresholds participated. Radiotherapy (RT) and cisplatin had been applied sequentially according to the HIT MED Guidance. Audiological outcomes up to the latest follow-up (median 2.6 years) were compared. Bilateral high-frequency SNHL was observed in 26 patients (90%). No significant differences were found in mean hearing threshold between left and right ears at any frequency. A significantly better audiological outcome (p < 0.05) was found after tomotherapy at the 6 kHz bone-conduction threshold (BCT) and left-sided 8 kHz air-conduction threshold (ACT) than after a combined radiotherapy technique (CT). Fraction dose was not found to have any impact on the incidence, degree, and time-to-onset of SNHL. Patients treated with CT had a greater risk of SNHL at high frequencies than tomotherapy patients even though D{sub mean} was similar. Increase in severity of SNHL was seen when the total cisplatin dose reached above 210 mg/m{sup 2}, with the highest abnormal level found 8-12 months after RT regardless of radiation technique or fraction dose. The cochlear radiation dose should be kept as low as possible in patients who receive simultaneous cisplatin-based chemotherapy. The risk of clinically relevant HL was shown when D{sub mean} exceeds 45 Gy independent of radiation technique or radiation regime. Cisplatin ototoxicity was shown to have a dose-dependent effect on bilateral SNHL, which was more pronounced in higher frequencies. (orig.) [German] Analyse von Inzidenz und Schweregrad einer sensorineuralen Schwerhoerigkeit (''sensorineural hearing loss'', SNHL) infolge der Wirkung unterschiedlicher Bestrahlungstechniken, Fraktionierungen, mittlerer

  15. Impact of a Disposable Sterile Radiation Shield on Operator Radiation Exposure During Percutaneous Coronary Intervention of Chronic Total Occlusions.

    Science.gov (United States)

    Shorrock, Deborah; Christopoulos, Georgios; Wosik, Jedrek; Kotsia, Anna; Rangan, Bavana; Abdullah, Shuaib; Cipher, Daisha; Banerjee, Subhash; Brilakis, Emmanouil S

    2015-07-01

    Daily radiation exposure over many years can adversely impact the health of medical professionals. Operator radiation exposure was recorded for 124 percutaneous coronary interventions (PCIs) performed at our institution between August 2011 and May 2013: 69 were chronic total occlusion (CTO)-PCIs and 55 were non-CTO PCIs. A disposable radiation protection sterile drape (Radpad; Worldwide Innovations & Technologies, Inc) was used in all CTO-PCI cases vs none of the non-CTO PCI cases. Operator radiation exposure was compared between CTO and non-CTO PCIs. Mean age was 64.6 ± 6.2 years and 99.2% of the patients were men. Compared with non-CTO PCI, patients undergoing CTO-PCI were more likely to have congestive heart failure, to be current smokers, and to have longer lesions, and less likely to have prior PCI and a saphenous vein graft target lesion. CTO-PCI cases had longer procedural time (median: 123 minutes [IQR, 85-192 minutes] vs 27 minutes [IQR, 20-44 minutes]; P<.001), fluoroscopy time (35 minutes [IQR, 19-54 minutes] vs 8 minutes [IQR, 5-16 minutes]; P<.001), number of stents placed (2.4 ± 1.5 vs 1.7 ± 0.9; P<.001), and patient air kerma radiation exposure (3.92 Gray [IQR, 2.48-5.86 Gray] vs 1.22 Gray [IQR, 0.74-1.90 Gray]; P<.001), as well as dose area product (267 Gray•cm² [IQR, 163-4.25 Gray•cm²] vs 84 Gray•cm² [IQR, 48-138 Gray•cm²]; P<.001). In spite of higher patient radiation exposure, operator radiation exposure was similar between the two groups (20 μSv [IQR, 9.5-31 μSv] vs 15 μSv [IQR, 7-23 μSv]; P=.07). Operator radiation exposure during CTO-PCI can be reduced to levels similar to less complicated cases with the use of a disposable sterile radiation protection shield.

  16. Calcium scoring in unenhanced and enhanced CT data of the aorta-iliacal arteries: impact of image acquisition, reconstruction, and analysis parameter settings

    Energy Technology Data Exchange (ETDEWEB)

    Komen, N. (Dept. of Surgery, Univ. Medical Center Rotterdam, Erasmus MC, Rotterdam (Netherlands); Dept. of Surgery, Univ. Hospital Antwerp, Edegem (Belgium)), email: nielskomen@hotmail.com; Klitsie, P.; Jeekel, J.; Lange, J.F. (Dept. of Surgery, Univ. Medical Center Rotterdam, Erasmus MC, Rotterdam (Netherlands)); Hermans, J.J.; Niessen, W.J. (Dept. of Radiology, Univ. Medical Center Rotterdam, Erasmus MC, Rotterdam (Netherlands)); Kleinrensink, G.J. (Dept. of Neurosciences and Anatomy, Univ. Medical Center Rotterdam, Erasmus MC, Rotterdam (Netherlands))

    2011-11-15

    Background. Several studies have been published on the matter of abdominal aortic and iliac calcifications and the association to clinical entities such as diabetes mellitus and renal failure. However, comparing of these studies is questionable since quantification methods for atherosclerosis differ. Purpose. To evaluate the effect of image acquisition settings, reconstruction parameters, and analysis methods on calcium quantification in the abdominal aorta. Material and Methods. Calcium scores were retrospectively determined on standardized abdominal CT scans of 15 patients. Two researchers obtained calcium scores with 10 different lower thresholds (LT) (130, 145, 160, 175, 200, 300, 400, 500, 600, 1000) in CT scans with and without contrast enhancement, with slice thicknesses (ST) varying between 2.0-5.0 mm for the non-contrast-enhanced series and between 1.0-5.0 mm for the contrast-enhanced series. In addition calcium scores obtained with two convolution kernels (B10f, B20f) were compared. Inter-observer variability was calculated. Results. Calcium scoring at higher STs is overestimated compared to smaller STs and this effect was more pronounced with increasing calcium loads. Concerning the convolution kernel, scores obtained with kernel B10f were overestimated compared to kernel B20f. Increase of LT resulted in a decrease of the calcium score and scoring in contrast-enhanced series resulted in higher scores compared to non-contrast-enhanced series. These effects are more apparent in patients with higher calcium loads. Calcium scoring reproducibility with the reference standard is limited for the aorta-iliac trajectory, whereas scoring with the remaining settings is reproducible. Conclusion. Scores obtained with different settings cannot be compared. The inter-observer reproducibility was limited using the reference standard and practical difficulties were substantial. Scoring with higher LT, ST, and contrast enhancement is faster and has less practical

  17. Impact-parameter dependence of the total probability for electromagnetic electron-positron pair production in relativistic heavy-ion collisions

    International Nuclear Information System (INIS)

    Hencken, K.; Trautmann, D.; Baur, G.

    1995-01-01

    We calculate the impact-parameter-dependent total probability P total (b) for the electromagnetic production of electron-positron pairs in relativistic heavy-ion collisions in lowest order. We study expecially impact parameters smaller than the Compton wavelength of the electron, where the equivalent-photon approximation cannot be used. Calculations with and without a form factor for the heavy ions are done; the influence is found to be small. The lowest-order results are found to violate unitarity and are used for the calculation of multiple-pair production probabilities with the help of the approximate Poisson distribution already found in earlier publications

  18. RELIABILITY OF BARR, LEECH, AND BLETHYN SCORE IN USING OF PLAIN RADIOGRAPHY IN DETERMINING FECAL IMPACTION IN CHILDREN WITH AND WITHOUT CONSTIPATION

    Directory of Open Access Journals (Sweden)

    Afshin REZAZADEH

    Full Text Available ABSTRACT Background - Several scoring was developed for evaluation of children with fecal retention using plain radiograph. There are controversies about specificity and sensitivity of these scoring system. Objectives - The aim of this study was to evaluate Barr, Blethyn, and Leech score in evaluation of fecal load in plain radiograph. Methods - This case control study was conducted on children aged 2-14 years old with abdominal pain who visited Abuzar children's Hospital of Ahvaz University of Medical Sciences. This study was conducted in fall season. Children with history of previous abdominal surgery, any systemic illness including sickle cell anemia were excluded. Children with constipation were placed in case group. Subjects without constipation were placed in control group. Subjects without exclusion criteria were examined by physician who is blind to aim of the study. Careful history and physical examination was done. Demographic features, history of gastrointestinal problem, duration of abdominal pain, defecation habit, stool consistency (loose, hard, and results of physical examination were recorded. Rome III criteria was used for definition of constipation. Abdominal x-ray was ordered for each patients. Abdominal radiography was reviewed by radiologist. Barr, Leach, and Blethyn scores were calculated for each case. Results - In this study 102 children with functional constipation and 102 children without constipation as a control were included. Mean ±SD for case and control group was 68.39±34.88 and 69.46±32.60 (P=0.82.Leech score (mean ±SD was 11.05±2.177 and 5.67±3.228 for case and control group respectively (P<0.0001. Barr score (mean ±SD was 14.86±3.54 and 7.16±5.59 for case and control group respectively (P=<0.0001. Blethyn (mean ±SD score was 1.97±0.667 and 1.04±0.900 for case and control group respectively (P=0.000. Sensitivity and specificity of Barr score was 83% and 79% respectively. Sensitivity and specificity of

  19. Analyzing the impacts of final demand changes on total output using input-output approach: The case of Japanese ICT sectors

    Science.gov (United States)

    Zuhdi, Ubaidillah

    2014-03-01

    The purpose of this study is to analyze the impacts of final demand changes on total output of Japanese Information and Communication Technologies (ICT) sectors in future time. This study employs one of analysis tool in Input-Output (IO) analysis, demand-pull IO quantity model, in achieving the purpose. There are three final demand changes used in this study, namely (1) export, (2) import, and (3) outside households consumption changes. This study focuses on "pure change" condition, the condition that final demand changes only appear in analyzed sectors. The results show that export and outside households consumption modifications give positive impact while opposite impact could be seen in import change.

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

    Science.gov (United States)

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

    2017-01-01

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

  1. Potential impact of single-risk-factor versus total risk management for the prevention of cardiovascular events in Seychelles.

    Science.gov (United States)

    Ndindjock, Roger; Gedeon, Jude; Mendis, Shanthi; Paccaud, Fred; Bovet, Pascal

    2011-04-01

    To assess the prevalence of cardiovascular (CV) risk factors in Seychelles, a middle-income African country, and compare the cost-effectiveness of single-risk-factor management (treating individuals with arterial blood pressure ≥ 140/90 mmHg and/or total serum cholesterol ≥ 6.2 mmol/l) with that of management based on total CV risk (treating individuals with a total CV risk ≥ 10% or ≥ 20%). CV risk factor prevalence and a CV risk prediction chart for Africa were used to estimate the 10-year risk of suffering a fatal or non-fatal CV event among individuals aged 40-64 years. These figures were used to compare single-risk-factor management with total risk management in terms of the number of people requiring treatment to avert one CV event and the number of events potentially averted over 10 years. Treatment for patients with high total CV risk (≥ 20%) was assumed to consist of a fixed-dose combination of several drugs (polypill). Cost analyses were limited to medication. A total CV risk of ≥ 10% and ≥ 20% was found among 10.8% and 5.1% of individuals, respectively. With single-risk-factor management, 60% of adults would need to be treated and 157 cardiovascular events per 100000 population would be averted per year, as opposed to 5% of adults and 92 events with total CV risk management. Management based on high total CV risk optimizes the balance between the number requiring treatment and the number of CV events averted. Total CV risk management is much more cost-effective than single-risk-factor management. These findings are relevant for all countries, but especially for those economically and demographically similar to Seychelles.

  2. Cattle impact on composition of archaeal, bacterial, and fungal communities by comparative fingerprinting of total and extracellular DNA

    Czech Academy of Sciences Publication Activity Database

    Chroňáková, Alica; Ascher, J.; Jirout, Jiří; Ceccherini, M.T.; Elhottová, Dana; Pietramellara, G.; Šimek, Miloslav

    2013-01-01

    Roč. 49, č. 3 (2013), s. 351-361 ISSN 0178-2762 R&D Projects: GA ČR GA526/09/1570; GA ČR GAP504/10/2077; GA MŠk LC06066 Institutional support: RVO:60077344 Keywords : SSU rRNA gene-DGGE * soil microbial community * cattle impact Subject RIV: EE - Microbiology, Virology Impact factor: 3.396, year: 2013

  3. Impact of the economic downturn on total joint replacement demand in the United States: updated projections to 2021.

    Science.gov (United States)

    Kurtz, Steven M; Ong, Kevin L; Lau, Edmund; Bozic, Kevin J

    2014-04-16

    Few studies have explored the role of the National Health Expenditure and macroeconomics on the utilization of total joint replacement. The economic downturn has raised questions about the sustainability of growth for total joint replacement in the future. Previous projections of total joint replacement demand in the United States were based on data up to 2003 using a statistical methodology that neglected macroeconomic factors, such as the National Health Expenditure. Data from the Nationwide Inpatient Sample (1993 to 2010) were used with United States Census and National Health Expenditure data to quantify historical trends in total joint replacement rates, including the two economic downturns in the 2000s. Primary and revision hip and knee arthroplasty were identified using codes from the International Classification of Diseases, Ninth Revision, Clinical Modification. Projections in total joint replacement were estimated using a regression model incorporating the growth in population and rate of arthroplasties from 1993 to 2010 as a function of age, sex, race, and census region using the National Health Expenditure as the independent variable. The regression model was used in conjunction with government projections of National Health Expenditure from 2011 to 2021 to estimate future arthroplasty rates in subpopulations of the United States and to derive national estimates. The growth trend for the incidence of joint arthroplasty, for the overall United States population as well as for the United States workforce, was insensitive to economic downturns. From 2009 to 2010, the total number of procedures increased by 6.0% for primary total hip arthroplasty, 6.1% for primary total knee arthroplasty, 10.8% for revision total hip arthroplasty, and 13.5% for revision total knee arthroplasty. The National Health Expenditure model projections for primary hip replacement in 2020 were higher than a previously projected model, whereas the current model estimates for total

  4. Digestive tract reconstruction using isoperistaltic jejunum-later-cut overlap method after totally laparoscopic total gastrectomy for gastric cancer: Short-term outcomes and impact on quality of life.

    Science.gov (United States)

    Huang, Ze-Ning; Huang, Chang-Ming; Zheng, Chao-Hui; Li, Ping; Xie, Jian-Wei; Wang, Jia-Bin; Lin, Jian-Xian; Lu, Jun; Chen, Qi-Yue; Cao, Long-Long; Lin, Mi; Tu, Ru-Hong; Lin, Ju-Li

    2017-10-21

    To evaluate the short-term outcomes and quality of life (QoL) in gastric cancer patients undergoing digestive tract construction using the isoperistaltic jejunum-later-cut overlap method (IJOM) after totally laparoscopic total gastrectomy (TLTG). A total of 507 patients who underwent laparoscopic gastrectomy (D2) from January 2014 to March 2016 were originally included in the study. The patients were divided into two groups to undergo digestive tract construction using either IJOM after TLTG (group T, n = 51) or Roux-en-Y anastomosis after laparoscopic-assisted total gastrectomy (LATG) (group A, n = 456). The short-term outcomes and QoL were compared between the two groups after 1:2 propensity-score matching (PSM). We used a questionnaire to assess QoL. Before matching, age, sex, tumor size, tumor location, preoperative albumin and blood loss were significantly different between the two groups ( P < 0.05). After PSM, the patients were well balanced in terms of their clinicopathological characteristics, although both blood loss and in-hospital postoperative days in group T were significantly lower than those in group A ( P < 0.05). After matching, group T reported better QoL in the domains of pain and dysphagia. Among the items evaluating pain and dysphagia, group T tended to report better QoL ("Have you felt pain" and "Have you had difficulty eating solid food") ( P < 0.05). The IJOM for digestive tract reconstruction after TLTG is associated with reduced blood loss and less pain and dysphagia, thus improving QoL after laparoscopic gastrectomy.

  5. EFFECTS OF COMMONLY USED COOKING PRACTICES ON TOTAL MERCURY CONCENTRATION IN FISH AND THEIR IMPACT ON EXPOSURE ASSESSMENTS

    Science.gov (United States)

    The effects of cooking practices commonly used by Native Americans on total mercury concentrations in fish were investigated. A preparation factor relating mercury concentrations in fish as prepared for consumption to mercury concentration data as measured in typical environmenta...

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

    Science.gov (United States)

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

    2013-03-01

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

  7. The Impact of Protein Structure and Sequence Similarity on the Accuracy of Machine-Learning Scoring Functions for Binding Affinity Prediction.

    Science.gov (United States)

    Li, Hongjian; Peng, Jiangjun; Leung, Yee; Leung, Kwong-Sak; Wong, Man-Hon; Lu, Gang; Ballester, Pedro J

    2018-03-14

    It has recently been claimed that the outstanding performance of machine-learning scoring functions (SFs) is exclusively due to the presence of training complexes with highly similar proteins to those in the test set. Here, we revisit this question using 24 similarity-based training sets, a widely used test set, and four SFs. Three of these SFs employ machine learning instead of the classical linear regression approach of the fourth SF (X-Score which has the best test set performance out of 16 classical SFs). We have found that random forest (RF)-based RF-Score-v3 outperforms X-Score even when 68% of the most similar proteins are removed from the training set. In addition, unlike X-Score, RF-Score-v3 is able to keep learning with an increasing training set size, becoming substantially more predictive than X-Score when the full 1105 complexes are used for training. These results show that machine-learning SFs owe a substantial part of their performance to training on complexes with dissimilar proteins to those in the test set, against what has been previously concluded using the same data. Given that a growing amount of structural and interaction data will be available from academic and industrial sources, this performance gap between machine-learning SFs and classical SFs is expected to enlarge in the future.

  8. Cross-sectional neck response of a total human body FE model during simulated frontal and side automobile impacts.

    Science.gov (United States)

    White, Nicholas A; Moreno, Daniel P; Gayzik, F Scott; Stitzel, Joel D

    2015-01-01

    Human body finite element (FE) models are beginning to play a more prevalent role in the advancement of automotive safety. A methodology has been developed to evaluate neck response at multiple levels in a human body FE model during simulated automotive impacts. Three different impact scenarios were simulated: a frontal impact of a belted driver with airbag deployment, a frontal impact of a belted passenger without airbag deployment and an unbelted side impact sled test. Cross sections were created at each vertebral level of the cervical spine to calculate the force and moment contributions of different anatomical components of the neck. Adjacent level axial force ratios varied between 0.74 and 1.11 and adjacent level bending moment ratios between 0.55 and 1.15. The present technique is ideal for comparing neck forces and moments to existing injury threshold values, calculating injury criteria and for better understanding the biomechanical mechanisms of neck injury and load sharing during sub-injurious and injurious loading.

  9. Impact of Inpatient Versus Outpatient Total Joint Arthroplasty on 30-Day Hospital Readmission Rates and Unplanned Episodes of Care.

    Science.gov (United States)

    Springer, Bryan D; Odum, Susan M; Vegari, David N; Mokris, Jeffrey G; Beaver, Walter B

    2017-01-01

    This article describes a study comparing 30-day readmission rates between patients undergoing outpatient versus inpatient total hip (THA) and knee (TKA) arthroplasty. A retrospective review of 137 patients undergoing outpatient total joint arthroplasty (TJA) and 106 patients undergoing inpatient (minimum 2-day hospital stay) TJA was conducted. Unplanned hospital readmissions and unplanned episodes of care were recorded. All patients completed a telephone survey. Seven inpatients and 16 outpatients required hospital readmission or an unplanned episode of care following hospital discharge. Readmission rates were higher for TKA than THA. The authors found no statistical differences in 30-day readmission or unplanned care episodes. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. The impact of drying techniques on phenolic compound, total phenolic content and antioxidant capacity of oat flour tarhana.

    Science.gov (United States)

    Değirmencioğlu, Nurcan; Gürbüz, Ozan; Herken, Emine Nur; Yıldız, Aysun Yurdunuseven

    2016-03-01

    In this study, the changes in phenolic composition, total phenolic content, and antioxidant capacity of tarhanas supplemented with oat flour (OF) at the levels of 20-100% (w/w) after three drying treatments (sun-, oven-, and microwave drying) were investigated. A total of seventeen phenolic standards have been screened in tarhanas, and the most abundant flavonol and phenolic acid compounds were kaempferol (23.62mg/g) and 3-hydroxy-4-metoxy cinnamic acid (9.60mg/g). The total phenolic content amount gradually increased with the addition of OF to tarhana, but decidedly higher total phenolic content was found in samples oven dried at 55°C as compared with other methods. The microwave- and oven dried tarhana samples showed higher TEACDPPH and TEACABTS values than those dried with the other methods, respectively, in higher OF amounts. Consequently, oven- and microwave-drying can be recommended to retain the highest for phenolic compounds as well as maximal antioxidant capacity in OF supplemented tarhana samples. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. Economic Impacts of Total Water Use Control in the Heihe River Basin in Northwestern China—An Integrated CGE-BEM Modeling Approach

    Directory of Open Access Journals (Sweden)

    Na Li

    2015-03-01

    Full Text Available This paper develops an integrated modeling approach combined with a top-down dynamic computable general equilibrium (CGE model and a bottom-up bio-economic model (BEM to study the economic impact of a total water use control policy in the Heihe river basin, northwestern China. The integrated CGE-BEM model is regionally disaggregated with a variety of crops and livestock, and includes the responses of farmers and consequent feedback effects in the regional economic system. The results show that under the total water use control scenario, the water use structure is changed and water use efficiency is improved. The total water use control policy has limited negative impact on the regional economic growth with only a slightly lower growth rate of 13.38% compared with a growth rate of 14% by 2020 under a business as usual water use scenario. However, the total water use control policy has significant negative impacts on several sectors, especially agriculture and food processing. It is expected cropping systems will change through a replacement of water-intensive crops with water-efficient crops. Farmers’ incomes will decrease by 3.14%. In order to alleviate farmers’ income loss and deal with water use conflicts across different sectors and regions, the promotion of migration of surplus labor from agriculture to non-agricultural sectors and the improvement of water use efficiency in agriculture are needed.

  12. Combined impact of lifestyle-related factors on total and cause-specific mortality among Chinese women: prospective cohort study.

    OpenAIRE

    Sarah J Nechuta; Xiao-Ou Shu; Hong-Lan Li; Gong Yang; Yong-Bing Xiang; Hui Cai; Wong-Ho Chow; Butian Ji; Xianglan Zhang; Wanqing Wen; Yu-Tang Gao; Wei Zheng

    2010-01-01

    Editors' Summary Background It is well established that lifestyle-related factors, such as limited physical activity, unhealthy diets, excessive alcohol consumption, and exposure to tobacco smoke are linked to an increased risk of many chronic diseases and premature death. However, few studies have investigated the combined impact of lifestyle-related factors and mortality outcomes, and most of such studies of combinations of established lifestyle factors and mortality have been conducted in ...

  13. A multicenter approach evaluating the impact of vitamin E-blended polyethylene in cementless total hip replacement

    OpenAIRE

    Marcus Jäger; Andrea van Wasen; Sebastian Warwas; Stefan Landgraeber; Marcel Haversath; VITAS Group

    2014-01-01

    Since polyethylene is one of the most frequently used biomaterials as a liner in total hip arthroplasty, strong efforts have been made to improve design and material properties over the last 50 years. Antioxidants seems to be a promising alternative to further increase durability and reduce polyethylene wear in long term. As of yet, only in vitro results are available. While they are promising, there is yet no clinical evidence that the new material shows these advantages in vivo. To answer t...

  14. Warming and organic matter sources impact the proportion of dissolved to total activities in marine extracellular enzymatic rates

    KAUST Repository

    Baltar, Federico

    2017-04-19

    Extracellular enzymatic activities (EEAs) are the rate-limiting step in the degradation of organic matter. Extracellular enzymes can be found associated to cells or dissolved in the surrounding water. The proportion of cell-free EEA constitutes in many marine environments more than half of the total activity. This high proportion causes an uncoupling between hydrolysis rates and the actual bacterial activity. However, we do not know what factors control the proportion of dissolved relative to total EEA, nor how this may change in the future ocean. To resolve this, we performed laboratory experiments with water from the Great Barrier Reef (Australia) to study the effects of temperature and dissolved organic matter sources on EEA and the proportion of dissolved EEA. We found that warming increases the rates of organic matter hydrolysis and reduces the proportion of dissolved relative to total EEA. This suggests a potential increase of the coupling between organic matter hydrolysis and heterotrophic activities with increasing ocean temperatures, although strongly dependent on the organic matter substrates available. Our study suggests that local differences in the organic matter composition in tropical coastal ecosystems will strongly affect the proportion of dissolved EEA in response to ocean warming.

  15. Evaluating the impact of extraction and cleanup parameters on the yield of total petroleum hydrocarbons in soil

    Energy Technology Data Exchange (ETDEWEB)

    Saari, Eija; Peraemaeki, Paavo; Jalonen, Jorma [University of Oulu, Department of Chemistry (Finland)

    2008-11-15

    Interlaboratory comparisons for the analysis of mineral oil in polluted soil using the GC-FID method indicate that extraction and cleanup conditions have significant effects on the analytical results. In this investigation a ruggedness test was performed on the extraction and cleanup method for the determination of total petroleum hydrocarbons in soil. A two-level Plackett-Burman design was utilized to study the effect of 11 different method parameters on the extraction recovery of total petroleum hydrocarbons (TPH) in soil. Both qualitative and quantitative factors were investigated. The results indicate that total petroleum hydrocarbons can be relatively reliably monitored through strict implementation of the ISO and CEN draft standards. However, variation in certain method parameters readily affects the validity of the results. The most critical factors affecting TPH recovery were the solvent and co-solvent used for extraction, the extraction time, adsorbent and its weight and sample TPH concentration. Because adaptation of the draft standards especially with respect to these factors easily leads to TPH recoveries higher than 200% or lower than 70%, the validity of the adapted method should always be verified. A proper estimate of the expanded uncertainty should also be appended to TPH results, because only then can the reliability of the results be guaranteed and further justification is gained to support the end-use of the data. This also supports the credibility of the analytical services and prevents the data end-users from drawing misleading conclusions concerning the environmental risks and potential remediation requirements. (orig.)

  16. Total cross-sections for single electron capture from H, He and H2 targets by impact of Be4+ and B5+ ions

    International Nuclear Information System (INIS)

    Busnengo, H.F.; Rivarola, R.D.; Universidad Nacional de Rosario; Rosario Univ. Nacional

    1996-01-01

    Single electron capture from H, He and H 2 targets by impact of Be 4+ and B 5+ projectiles is studied for intermediate and high collision energies. Total cross-sections are calculated using the continuum distorted wave-eikonal final state model. Theoretical results corresponding to capture to selective final bound states and to all final states are presented for impact energies ranging from 50 keV/amu to 3 MeV/amu. A comparison with available experimental data is also shown. (orig.)

  17. The Impact of use of Double Set-up on Infection Rates in Revision Total Knee Replacement and Limb Salvage Procedures

    Directory of Open Access Journals (Sweden)

    Jennifer Waterman

    2015-03-01

    Full Text Available A retrospective analysis was performed to determine the impact of utilizing a double set-up procedure on reducing infection rates revision total knee and limb salvage procedures in patients with known joint infection.  Eighteen cases fit selection criteria.  The recurrence rate of infection was 5.5% which is less than reported recent literature review.   This suggests the use of a double set-up in combination with other infection reducing protocols may help further reduce recurrent infection.  Keywords: double set-up, infection, revision total knee arthroplasty, limb-salvage

  18. Total environmental impacts of biofuels from corn stover using a hybrid life cycle assessment model combining process life cycle assessment and economic input-output life cycle assessment.

    Science.gov (United States)

    Liu, Changqi; Huang, Yaji; Wang, Xinye; Tai, Yang; Liu, Lingqin; Liu, Hao

    2018-01-01

    Studies on the environmental analysis of biofuels by fast pyrolysis and hydroprocessing (BFPH) have so far focused only on the environmental impacts from direct emissions and have included few indirect emissions. The influence of ignoring some indirect emissions on the environmental performance of BFPH has not been well investigated and hence is not really understood. In addition, in order to avoid shifting environmental problems from one medium to another, a comprehensive assessment of environmental impacts caused by the processes must quantify the environmental emissions to all media (air, water, and land) in relation to each life cycle stage. A well-to-wheels assessment of the total environmental impacts resulting from direct emissions and indirect emissions of a BFPH system with corn stover is conducted using a hybrid life cycle assessment (LCA) model combining the economic input-output LCA and the process LCA. The Tool for the Reduction and Assessment of Chemical and other environmental Impacts (TRACI) has been used to estimate the environmental impacts in terms of acidification, eutrophication, global climate change, ozone depletion, human health criteria, photochemical smog formation, ecotoxicity, human health cancer, and human health noncancer caused by 1 MJ biofuel production. Taking account of all the indirect greenhouse gas (GHG) emissions, the net GHG emissions (81.8 g CO 2 eq/MJ) of the biofuels are still less than those of petroleum-based fuels (94 g CO 2 eq/MJ). Maize production and pyrolysis and hydroprocessing make major contributions to all impact categories except the human health criteria. All impact categories resulting from indirect emissions except eutrophication and smog air make more than 24% contribution to the total environmental impacts. Therefore, the indirect emissions are important and cannot be ignored. Sensitivity analysis has shown that corn stover yield and bio-oil yield affect the total environmental impacts of the biofuels

  19. Allegheny County Walk Scores

    Data.gov (United States)

    Allegheny County / City of Pittsburgh / Western PA Regional Data Center — Walk Score measures the walkability of any address using a patented system developed by the Walk Score company. For each 2010 Census Tract centroid, Walk Score...

  20. Wilderness and woodland ranchers in California: A total income case study of public grazing permits and their impacts on conservation

    Science.gov (United States)

    Oviedo Pro, J. L.; Huntsinger, L.; Campos, P.; Caparros, A.

    2009-04-01

    Mediterranean woodlands in California are managed as agro-silvo-pastoral systems producing a number of commercial products as well as a huge variety of environmental services, including private amenities for the landowner. In many parts of the woodlands, grazing on government owned (public) lands has traditionally had an important role in private ranching. In recent decades the risk of conversion to alternative uses (such as urban development or vineyards) has threatened these woodlands due to the increasing opportunity costs of capital. Understanding the economy of these woodlands and the potential effects of public grazing policies on the total income perceived by the landowner is crucial when considering strategies attempting to slow or stop land use change. However, traditional cash-flow analyses are lacking crucial information needed to understand all the elements that have an important role in the economic decisions that landowners make about their woodlands. For more than half a century, the use of public lands by private ranchers has been one of the most controversial debates in the American west. Wilderness conservationist groups have denounced grazing as destructive and argue for the removal of any kind of livestock. Ranchers have fought for their right to hold public grazing leases, arguing that they are crucial for the continuity of private ranching and consequently for the conservation of extensive rangeland habitat that otherwise could be converted to alternative uses. In this study, we apply the Agroforestry Accounting System (AAS) methodology to a California oak woodland case study to estimate the total private income generated in an accounting period. The presented case study is characterized by a household economy with self-employed labour and with part of the grazing dependent on public land leases. The AAS methodology extends traditional cash-flow analysis in order to estimate the total private income that would accurately explain the woodland

  1. Electron-impact rotationally elastic total cross sections for H2CO and HCOOH over a wide range of incident energy (0.01-2000 eV)

    International Nuclear Information System (INIS)

    Vinodkumar, Minaxi; Bhutadia, Harshad; Antony, Bobby; Mason, Nigel

    2011-01-01

    This paper reports computational results of the total cross sections for electron impact on H 2 CO and HCOOH over a wide range of electron impact energies from 0.01 eV to 2 keV. The total cross section is presented as sum of the elastic and electronic excitation cross sections for incident energies. The calculation uses two different methodologies, below the ionization threshold of the target the cross section is calculated using the UK molecular R-matrix code through the Quantemol-N software package while cross sections at higher energies are evaluated using the spherical complex optical potential formalism. The two methods are found to be consistent at the transition energy (∼15 eV). The present results are, in general, found to be in good agreement with previous experimental and theoretical results (wherever available) and, thus, the present results can serve as a benchmark for the cross section over a wide range of energy.

  2. Impact of Altitudes and Habitats on Valerenic Acid, Total Phenolics, Flavonoids, Tannins, and Antioxidant Activity of Valeriana jatamansi.

    Science.gov (United States)

    Jugran, Arun K; Bahukhandi, Amit; Dhyani, Praveen; Bhatt, Indra D; Rawal, Ranbeer S; Nandi, Shyamal K

    2016-07-01

    The changes in total phenolics, flavonoids, tannins, valerenic acid, and antioxidant activity were assessed in 25 populations of Valeriana jatamansi sampled from 1200 to 2775 m asl and four habitat types of Uttarakhand, West Himalaya. Significant (p analysis, and principal component analysis (PCA) identified Talwari, Jaberkhet, Manjkhali, and Khirshu populations as promising sources with higher phytochemicals and antioxidant activity. The results recommended that the identified populations with higher value of phytochemicals and antioxidants can be utilized for mass multiplication and breeding program to meet the domestic as well as commercial demand.

  3. Perioperative and mid-term oncologic outcomes of robotic assisted radical cystectomy with totally intracorporeal neobladder: Results of a propensity score matched comparison with open cohort from a single-centre series.

    Science.gov (United States)

    Simone, Giuseppe; Tuderti, Gabriele; Misuraca, Leonardo; Anceschi, Umberto; Ferriero, Mariaconsiglia; Minisola, Francesco; Guaglianone, Salvatore; Gallucci, Michele

    2018-04-17

    In this study, we compared perioperative and oncologic outcomes of patients treated with either open or robot-assisted radical cystectomy and intracorporeal neobladder at a tertiary care center. The institutional prospective bladder cancer database was queried for "cystectomy with curative intent" and "neobladder". All patients underwent robot-assisted radical cystectomy and intracorporeal neobladder or open radical cystectomy and orthotopic neobladder for high-grade non-muscle invasive bladder cancer or muscle invasive bladder cancer with a follow-up length ≥2 years were included. A 1:1 propensity score matching analysis was used. Kaplan-Meier method was performed to compare oncologic outcomes of selected cohorts. Survival rates were computed at 1,2,3 and 4 years after surgery and the log rank test was applied to assess statistical significance between the matched groups. Overall, 363 patients (299 open and 64 robotic) were included. Open radical cystectomy patients were more frequently male (p = 0.08), with higher pT stages (p = 0.003), lower incidence of urothelial histologies (p = 0.05) and lesser adoption of neoadjuvant chemotherapy (open radical cystectomy cases (all p ≥ 0.22). Open cohort showed a higher rate of perioperative overall complications (91.3% vs 42.2%, p 0.001). At Kaplan-Meier analysis robotic and open cohorts displayed comparable disease-free survival (log-rank p = 0.746), cancer-specific survival (p = 0.753) and overall-survival rates (p = 0.909). Robot-assisted radical cystectomy and intracorporeal neobladder provides comparable oncologic outcomes of open radical cystectomy and orthotopic neobladder at intermediate term survival analysis. Copyright © 2018 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.

  4. Effects of memantine on cognition in patients with moderate to severe Alzheimer's disease: post-hoc analyses of ADAS-cog and SIB total and single-item scores from six randomized, double-blind, placebo-controlled studies.

    Science.gov (United States)

    Mecocci, Patrizia; Bladström, Anna; Stender, Karina

    2009-05-01

    The post-hoc analyses reported here evaluate the specific effects of memantine treatment on ADAS-cog single-items or SIB subscales for patients with moderate to severe AD. Data from six multicentre, randomised, placebo-controlled, parallel-group, double-blind, 6-month studies were used as the basis for these post-hoc analyses. All patients with a Mini-Mental State Examination (MMSE) score of less than 20 were included. Analyses of patients with moderate AD (MMSE: 10-19), evaluated with the Alzheimer's disease Assessment Scale (ADAS-cog) and analyses of patients with moderate to severe AD (MMSE: 3-14), evaluated using the Severe Impairment Battery (SIB), were performed separately. The mean change from baseline showed a significant benefit of memantine treatment on both the ADAS-cog (p ADAS-cog single-item analyses showed significant benefits of memantine treatment, compared to placebo, for mean change from baseline for commands (p < 0.001), ideational praxis (p < 0.05), orientation (p < 0.01), comprehension (p < 0.05), and remembering test instructions (p < 0.05) for observed cases (OC). The SIB subscale analyses showed significant benefits of memantine, compared to placebo, for mean change from baseline for language (p < 0.05), memory (p < 0.05), orientation (p < 0.01), praxis (p < 0.001), and visuospatial ability (p < 0.01) for OC. Memantine shows significant benefits on overall cognitive abilities as well as on specific key cognitive domains for patients with moderate to severe AD. (c) 2009 John Wiley & Sons, Ltd.

  5. Organizational culture in public institutions and its impact in the process of implementation of total quality management (case of Kosovo

    Directory of Open Access Journals (Sweden)

    Mr.Sc. Ilir Rexhepi

    2012-12-01

    Full Text Available Total Quality Management (TQM is a management philosophy and approach, whose importance is growing evermore after the 90s. Kosovo's public institutions for a short time now organise activities as part of an independent state and as such they are facing ahead management challenges which are becoming more acute and in the framework of the EU integration processes. Total Quality Management in public institutions, is preceded by establishment and implementation phase ISO 9001 systems. In this paper we tried that through an empirical study in three public institutions of Kosovo, evidence the factors that facilitate or impede timely and successful implementation of quality systems and therefore of TQM. Moreover, we will concentrate on organizational culture. Analysis on the norms, beliefs, principles that characterize the organizational culture of Kosovo institutions and furthermore intertwined with the Law on Public Administration and the political context, will serve to shape the changes that need to be designed to proceed to successful implementation of TQM. In function of the analysis of impeding factors, elements of organizational culture as well as modeling the changes there will be used a number of interviews and questionnaires.

  6. Health impact assessment of transport policies in Rotterdam: Decrease of total traffic and increase of electric car use

    Energy Technology Data Exchange (ETDEWEB)

    Tobollik, Myriam, E-mail: mtobollik@uni-bielefeld.de [School of Public Health, Bielefeld University, Bielefeld (Germany); German Environment Agency, Section Exposure Assessment and Environmental Health Indicators, Corrensplatz 1, 14195 Berlin (Germany); Keuken, Menno [Netherlands Applied Research Organization (TNO), Utrecht (Netherlands); Sabel, Clive [School of Geographical Sciences, University of Bristol, Bristol (United Kingdom); Cowie, Hilary [Institute of Occupational Medicine, Edinburgh (United Kingdom); Tuomisto, Jouni [National Institute for Health and Welfare Kuopio, Kuopio (Finland); Sarigiannis, Denis [Aristotle University of Thessaloniki, Thessaloniki (Greece); Künzli, Nino; Perez, Laura [Swiss Tropical and Public Health Institute, Basel (Switzerland); University of Basel, Basel (Switzerland); Mudu, Pierpaolo, E-mail: mudup@ecehbonn.euro.who.int [WHO European Centre for Environment and Health, World Health Organization Regional Office for Europe, Bonn (Germany)

    2016-04-15

    Background: Green house gas (GHG) mitigation policies can be evaluated by showing their co-benefits to health. Method: Health Impact Assessment (HIA) was used to quantify co-benefits of GHG mitigation policies in Rotterdam. The effects of two separate interventions (10% reduction of private vehicle kilometers and a share of 50% electric-powered private vehicle kilometers) on particulate matter (PM{sub 2.5}), elemental carbon (EC) and noise (engine noise and tyre noise) were assessed using Years of Life Lost (YLL) and Years Lived with Disability (YLD). The baseline was 2010 and the end of the assessment 2020. Results: The intervention aimed at reducing traffic is associated with a decreased exposure to noise resulting in a reduction of 21 (confidence interval (CI): 11–129) YLDs due to annoyance and 35 (CI: 20–51) YLDs due to sleep disturbance for the population per year. The effects of 50% electric-powered car use are slightly higher with a reduction of 26 (CI: 13–116) and 41 (CI: 24–60) YLDs, respectively. The two interventions have marginal effects on air pollution, because already implemented traffic policies will reduce PM{sub 2.5} and EC by around 40% and 60% respectively, from 2010 to 2020. Discussion: The evaluation of planned interventions, related to climate change policies, targeting only the transport sector can result in small co-benefits for health, if the analysis is limited to air pollution and noise. This urges to expand the analysis by including other impacts, e.g. physical activity and well-being, as a necessary step to better understanding consequences of interventions and carefully orienting resources useful to build knowledge to improve public health. - Highlights: • We estimated co-benefits of greenhouse gas reduction policies from 2010 to 2020. • The city scale health impact assessment base on real transport policy scenarios. • Effects of particulate matter, elemental carbon and noise on health are assessed. • The effects are

  7. Health impact assessment of transport policies in Rotterdam: Decrease of total traffic and increase of electric car use

    International Nuclear Information System (INIS)

    Tobollik, Myriam; Keuken, Menno; Sabel, Clive; Cowie, Hilary; Tuomisto, Jouni; Sarigiannis, Denis; Künzli, Nino; Perez, Laura; Mudu, Pierpaolo

    2016-01-01

    Background: Green house gas (GHG) mitigation policies can be evaluated by showing their co-benefits to health. Method: Health Impact Assessment (HIA) was used to quantify co-benefits of GHG mitigation policies in Rotterdam. The effects of two separate interventions (10% reduction of private vehicle kilometers and a share of 50% electric-powered private vehicle kilometers) on particulate matter (PM 2.5 ), elemental carbon (EC) and noise (engine noise and tyre noise) were assessed using Years of Life Lost (YLL) and Years Lived with Disability (YLD). The baseline was 2010 and the end of the assessment 2020. Results: The intervention aimed at reducing traffic is associated with a decreased exposure to noise resulting in a reduction of 21 (confidence interval (CI): 11–129) YLDs due to annoyance and 35 (CI: 20–51) YLDs due to sleep disturbance for the population per year. The effects of 50% electric-powered car use are slightly higher with a reduction of 26 (CI: 13–116) and 41 (CI: 24–60) YLDs, respectively. The two interventions have marginal effects on air pollution, because already implemented traffic policies will reduce PM 2.5 and EC by around 40% and 60% respectively, from 2010 to 2020. Discussion: The evaluation of planned interventions, related to climate change policies, targeting only the transport sector can result in small co-benefits for health, if the analysis is limited to air pollution and noise. This urges to expand the analysis by including other impacts, e.g. physical activity and well-being, as a necessary step to better understanding consequences of interventions and carefully orienting resources useful to build knowledge to improve public health. - Highlights: • We estimated co-benefits of greenhouse gas reduction policies from 2010 to 2020. • The city scale health impact assessment base on real transport policy scenarios. • Effects of particulate matter, elemental carbon and noise on health are assessed. • The effects are rather

  8. Analyzing the impacts of final demand changes on total output using input-output approach: The case of Japanese ICT sectors

    International Nuclear Information System (INIS)

    Zuhdi, Ubaidillah

    2014-01-01

    The purpose of this study is to analyze the impacts of final demand changes on total output of Japanese Information and Communication Technologies (ICT) sectors in future time. This study employs one of analysis tool in Input-Output (IO) analysis, demand-pull IO quantity model, in achieving the purpose. There are three final demand changes used in this study, namely (1) export, (2) import, and (3) outside households consumption changes. This study focuses on ''pure change'' condition, the condition that final demand changes only appear in analyzed sectors. The results show that export and outside households consumption modifications give positive impact while opposite impact could be seen in import change

  9. Health impact assessment of transport policies in Rotterdam: Decrease of total traffic and increase of electric car use.

    Science.gov (United States)

    Tobollik, Myriam; Keuken, Menno; Sabel, Clive; Cowie, Hilary; Tuomisto, Jouni; Sarigiannis, Denis; Künzli, Nino; Perez, Laura; Mudu, Pierpaolo

    2016-04-01

    Green house gas (GHG) mitigation policies can be evaluated by showing their co-benefits to health. Health Impact Assessment (HIA) was used to quantify co-benefits of GHG mitigation policies in Rotterdam. The effects of two separate interventions (10% reduction of private vehicle kilometers and a share of 50% electric-powered private vehicle kilometers) on particulate matter (PM2.5), elemental carbon (EC) and noise (engine noise and tyre noise) were assessed using Years of Life Lost (YLL) and Years Lived with Disability (YLD). The baseline was 2010 and the end of the assessment 2020. The intervention aimed at reducing traffic is associated with a decreased exposure to noise resulting in a reduction of 21 (confidence interval (CI): 11-129) YLDs due to annoyance and 35 (CI: 20-51) YLDs due to sleep disturbance for the population per year. The effects of 50% electric-powered car use are slightly higher with a reduction of 26 (CI: 13-116) and 41 (CI: 24-60) YLDs, respectively. The two interventions have marginal effects on air pollution, because already implemented traffic policies will reduce PM2.5 and EC by around 40% and 60% respectively, from 2010 to 2020. The evaluation of planned interventions, related to climate change policies, targeting only the transport sector can result in small co-benefits for health, if the analysis is limited to air pollution and noise. This urges to expand the analysis by including other impacts, e.g. physical activity and well-being, as a necessary step to better understanding consequences of interventions and carefully orienting resources useful to build knowledge to improve public health. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. The Combined Impact of Postoperative Heart Failure and EuroSCORE on Long-Term Outcome after Surgery for Aortic Stenosis

    NARCIS (Netherlands)

    Hultkvist, Henrik; Vanky, Farkas; Svedjeholm, Rolf

    2011-01-01

    Background and aim of the study: Although the EuroSCORE was developed for predicting operative mortality after cardiac surgery, it has also been shown to predict long-term mortality. It has been reported that postoperative heart failure (PHF) in association with surgery, albeit comparatively benign

  11. Impact of baseline Diabetic Retinopathy Severity Scale scores on visual outcomes in the VIVID-DME and VISTA-DME studies.

    Science.gov (United States)

    Staurenghi, Giovanni; Feltgen, Nicolas; Arnold, Jennifer J; Katz, Todd A; Metzig, Carola; Lu, Chengxing; Holz, Frank G

    2017-10-19

    To evaluate intravitreal aflibercept versus laser in subgroups of patients with baseline Diabetic Retinopathy Severity Scale (DRSS) scores ≤43, 47, and ≥53 in VIVID-DME and VISTA-DME. Patients with diabetic macular oedema were randomised to receive intravitreal aflibercept 2 mg every 4 weeks (2q4), intravitreal aflibercept 2 mg every 8 weeks after five initial monthly doses (2q8), or macular laser photocoagulation at baseline with sham injections at every visit. These post hoc analyses evaluate outcomes based on baseline DRSS scores in patients in the integrated dataset. The 2q4 and 2q8 treatment groups were also pooled. 748 patients had a baseline DRSS score based on fundus photographs (≤43, n=301; 47, n=153; ≥53, n=294). At week 100, the least squares mean difference between treatment groups (effect of intravitreal aflibercept above that of laser, adjusting for baseline best-corrected visual acuity) was 8.9 (95% CI 5.99 to 11.81), 9.7 (95% CI 5.54 to 13.91), and 11.0 (95% CI 7.96 to 14.1) letters in those with baseline DRSS scores ≤43, 47, and ≥53, respectively. The proportions of patients with ≥2 step DRSS score improvement were greater in the intravitreal aflibercept group versus laser, respectively, for those with baseline DRSS scores of ≤43 (13% vs 5.9%), 47 (25.8% vs 4.5%), and ≥53 (64.5% vs 28.4%). Regardless of baseline DRSS score, functional outcomes were superior in intravitreal aflibercept-treated patients, demonstrating consistent treatment benefit across various baseline levels of retinopathy. NCT01331681 and NCT01363440, Post-results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  12. The Impact of the Subsidy Policy on Total Factor Productivity: An Empirical Analysis of China's Cotton Production

    Directory of Open Access Journals (Sweden)

    Yanwen Tan

    2013-01-01

    Full Text Available This paper develops one model to explore the relationship between the subsidy policy and the agricultural total factor productivity (TFP. It indicates that the agricultural TFP will be lower after the subsidy policy is implemented and there exists a negative relation between the subsidy and TFP, if subsidies are associated with the acreage. Using Malmquist index, this paper measures the changes of TFP in China's cotton production before and after the subsidy policy is implemented. The results verify that the subsidy policy could not increase but decrease the TFP of China's cotton production, not only in the whole country but also in major provinces of China. Based on the positive study, some policy implications are provided in the end of this paper.

  13. Impact of levels of total digestible nutrients on microbiome, enzyme profile and degradation of feeds in buffalo rumen.

    Science.gov (United States)

    Kala, Anju; Kamra, D N; Kumar, Avinash; Agarwal, Neeta; Chaudhary, L C; Joshi, C G

    2017-01-01

    The present study was aimed at understanding a shift in rumen microbiome of buffaloes fed various levels of total digestible nutrients. To understand the process, the metagenomics of rumen microbes, in vivo and in vitro rumen fermentation studies were carried out. Three rumen fistulated adult male Murrah buffaloes were fed three isonitrogenous diets varying in total digestible nutrients (70, 85 and 100% of TDN requirement) in 3X3 switch over design. On dry matter basis, wheat straw/ roughage content were 81, 63 and 51% and that of maize grain was 8, 16 and 21% in three diets respectively. After 20 d of feeding, rumen liquor and rumen contents were sampled just before (0h) and 4h post feeding. Ruminococcus flavefaciens and R. albus (estimated with real time PCR) were higher in high roughage diets. The predominant phyla in all the three groups were Bacteroidetes, Firmicutes followed by Proteobacteria, Actinobacteria and Fibrobacteres. A core group of more than fifty rumen bacteria was present in all the animals with very little variations due to level of TDN. The most predominant bacterial genera reported in order of decreasing abundance were: Prevotella, Bacteroides, Clostridium, Ruminococcus, Eubacterium, Parabacteroides, Fibrobacter, Butyrivibrio etc. The higher diversity of the enyzmes families GH 23, GH 28, GH 39, GH 97, GH 106, and GH 127 (the enzymes active in fibre and starch degradation) were significantly higher on 100%TDN diet while CE 14 (required for the hydrolysis of bond between carbohydrate and lignin) was higher on low TDN (70%) diet, indicating ester bond cleavage was better in animals fed high roughage (wheat straw) diet.

  14. Impact of Anterior vs Posterior Approach for Total Hip Arthroplasty on Post-Acute Care Service Utilization.

    Science.gov (United States)

    L'Hommedieu, Coles E; Gera, James J; Rupp, Gerald; Salin, Jeffery W; Cox, John S; Duwelius, Paul J

    2016-09-01

    Controversy exists as to which surgical approach is best for total hip arthroplasty (THA). Previous studies suggested that the tissue-sparing anterior approach should result in a more rapid recovery requiring fewer postacute services, ultimately decreasing overall episodic cost. The purpose of this cross-sectional study was to determine if any significant differences exist between the anterior vs posterior approaches on postacute care service utilization, readmissions, or episodic cost. Claims data from 26,773 Medicare fee-for-service beneficiaries receiving elective THAs (Medical Severity-Diagnosis Related Groups (MS-DRGs) 469/470) were analyzed. Claims data were collected from the 2-year period, January 2013 through December 2014. The posterior surgical approach was performed on 23,653 patients while 3120 patients received the anterior approach. Data analysis showed negligible effect sizes in postacute care service utilization, readmission rate, and cost between the surgical approaches for elective THA (MS-DRG 469 and 470). Average THA total episode cost was negligibly higher for procedures using the anterior approach compared to the posterior approach ($22,517 and $22,068, respectively). Statistically significant differences were observed in inpatient rehab and home health cost and service utilization. However, the effect sizes of these comparisons are negligible when accounting for the large sample size. All other comparisons showed minimal and statistically insignificant variation. The results indicate that surgical approach alone is not the primary driver of postacute care service utilization, quality outcomes, or cost. Other factors such as physician-led patient-focused care pathways, care coordination, rapid rehabilitation protocols, perioperative pain management protocols, and patient education are integral for effective patient care. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Total protein

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/003483.htm Total protein To use the sharing features on this page, please enable JavaScript. The total protein test measures the total amount of two classes ...

  16. Impact of operative time on early joint infection and deep vein thrombosis in primary total hip arthroplasty.

    Science.gov (United States)

    Wills, B W; Sheppard, E D; Smith, W R; Staggers, J R; Li, P; Shah, A; Lee, S R; Naranje, S M

    2018-03-22

    Infections and deep vein thrombosis (DVT) after total hip arthroplasty (THA) are challenging problems for both the patient and surgeon. Previous studies have identified numerous risk factors for infections and DVT after THA but have often been limited by sample size. We aimed to evaluate the effect of operative time on early postoperative infection as well as DVT rates following THA. We hypothesized that an increase in operative time would result in increased odds of acquiring an infection as well as a DVT. We conducted a retrospective analysis of prospectively collected data using the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database from 2006 to 2015 for all patients undergoing primary THA. Associations between operative time and infection or DVT were evaluated with multivariable logistic regressions controlling for demographics and several known risks factors for infection. Three different types of infections were evaluated: (1) superficial surgical site infection (SSI), an infection involving the skin or subcutaneous tissue, (2) deep SSI, an infection involving the muscle or fascial layers beneath the subcutaneous tissue, and (3) organ/space infection, an infection involving any part of the anatomy manipulated during surgery other than the incisional components. In total, 103,044 patients who underwent THA were included in our study. Our results suggested a significant association between superficial SSIs and operative time. Specifically, the adjusted odds of suffering a superficial SSI increased by 6% (CI=1.04-1.08, ptime. When using dichotomized operative time (90minutes), the adjusted odds of suffering a superficial SSI was 56% higher for patients with prolonged operative time (CI=1.05-2.32, p=0.0277). The adjusted odds of suffering a deep SSI increased by 7% for every 10-minute increase in operative time (CI=1.01-1.14, p=0.0335). No significant associations were detected between organ/space infection, wound

  17. The Impact of Total Ischemic Time, Donor Age and the Pathway of Donor Death on Graft Outcomes After Deceased Donor Kidney Transplantation.

    Science.gov (United States)

    Wong, Germaine; Teixeira-Pinto, Armando; Chapman, Jeremy R; Craig, Jonathan C; Pleass, Henry; McDonald, Stephen; Lim, Wai H

    2017-06-01

    Prolonged ischemia is a known risk factor for delayed graft function (DGF) and its interaction with donor characteristics, the pathways of donor death, and graft outcomes may have important implications for allocation policies. Using data from the Australian and New Zealand Dialysis and Transplant registry (1994-2013), we examined the relationship between total ischemic time with graft outcomes among recipients who received their first deceased donor kidney transplants. Total ischemic time (in hours) was defined as the time of the donor renal artery interruption or aortic clamp, until the time of release of the clamp on the renal artery in the recipient. A total of 7542 recipients were followed up over a median follow-up time of 5.3 years (interquartile range of 8.2 years). Of these, 1823 (24.6%) experienced DGF and 2553 (33.9%) experienced allograft loss. Recipients with total ischemic time of 14 hours or longer experienced an increased odd of DGF compared with those with total ischemic time less than 14 hours. This effect was most marked among those with older donors (P value for interaction = 0.01). There was a significant interaction between total ischemic time, donor age, and graft loss (P value for interaction = 0.03). There was on average, a 9% increase in the overall risk of graft loss per hour increase in the total ischemic time (adjusted hazard ratio, 1.09; 95% confidence interval, 1.01-1.18; P = 0.02) in recipients with older donation after circulatory death grafts. There is a clinically important interaction between donor age, the pathway of donor death, and total ischemic time on graft outcomes, such that the duration of ischemic time has the greatest impact on graft survival in recipients with older donation after circulatory death kidneys.

  18. The impact of differences between patient and general population EQ-5D-3L values on the mean tariff scores of different patient groups.

    Science.gov (United States)

    Little, Matthew H R; Reitmeir, Peter; Peters, Annette; Leidl, Reiner

    2014-06-01

    Health states can be valued by those who currently experience a health state (experienced health states [EHS]) or by the general public, who value a set of given health states (GHS) described to them. There has been debate over which method is more appropriate when making resource allocation decisions. This article informs this debate by assessing whether differences between these methods have an effect on the mean EQ-5D-3L tariff scores of different patient groups. The European tariff based on GHS valuations was compared with a German EHS tariff. Comparison was made in the context of EQ-5D-3L health states describing a number of diagnosed chronic diseases (stroke, diabetes, myocardial infarction, and cancer) taken from the Cooperative Health Research in the Augsburg Region population surveys. Comparison was made of both the difference in weighting of the dimensions of the EQ-5D-3L and differences in mean tariff scores for patient groups. Weighting of the dimensions of the EQ-5D-3L were found to be systematically different. The EHS tariff gave significantly lower mean scores for most, but not all, patient groups despite tariff scores being lower for 213 of 243 EQ-5D-3L health states using the GHS tariff. Differences were found to vary between groups, with the largest change in difference being 5.45 in the multiple stoke group. The two tariffs have systematic differences that in certain patient groups could drive the results of an economic evaluation. Therefore, the choice as to which is used may be critical when making resource allocation decisions. Copyright © 2014 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

  19. THE EVALUATION OF EIGHT PILLARS TOTAL PRODUCTIVE MAINTENANCE (TPM IMPLEMENTATION AND THEIR IMPACT ON OVERALL EQUIPMENT EFFECTIVENESS (OEE AND WASTE

    Directory of Open Access Journals (Sweden)

    Herry Agung Prabowo

    2018-02-01

    Full Text Available In this global era where the level of competition is higher, in addition to the influence of the suitable marketing strategy is also required strategy from the side of production/productivity. PT. XYZ is a company engaged in the manufacturing of snacks especially biscuits. The problem that often occurs in this company is the number of biscuits that are not in accordance with the standard and the production does not reach the target set because the machine suddenly breaks down frequently. To overcome the problems PT. XYZ then choose to implement the Total Productive Maintenance (TPM strategy. This study aims to evaluate the implementation of 8 TPM Pillars and measure the effects on manufacturing performance in the form of Overall Equipment Effectiveness (OEE and Waste. This study uses questionnaire-based survey method. The number of samples distributed is 40 units. Which returned and filled 33 questionnaires and which is worth to be processed as many as 30 samples. Then tested the validity and reliability of data using SPSS program. Validity critical value R = 0.361 for n = 30 and error rate 5%. For reliability test, R value = 0.60 was selected. From the validity test, there are 7 items of questions that are not valid so it is not included in the next process. For the reliability test of the questionnaire is quite reliable with the value of Cronbach's alpha of 0.811. From the CFA analysis, only 6 of 8 TPM pillars are significant while for manufacturing performance only OEE variable is significant. Correlation between 8 Pillars of TPM and manufacturing performance is Strong enough with a value of R = 0.862, which also means 74.3% (R2 variable manufacturing performance can be explained/influenced by variable 8 Pillar TPM and 26.7% the rest by other variables.

  20. The Impact of Early Visual Deprivation on Spatial Hearing: A Comparison between Totally and Partially Visually Deprived Children

    Science.gov (United States)

    Cappagli, Giulia; Finocchietti, Sara; Cocchi, Elena; Gori, Monica

    2017-01-01

    The specific role of early visual deprivation on spatial hearing is still unclear, mainly due to the difficulty of comparing similar spatial skills at different ages and to the difficulty in recruiting young blind children from birth. In this study, the effects of early visual deprivation on the development of auditory spatial localization have been assessed in a group of seven 3–5 years old children with congenital blindness (n = 2; light perception or no perception of light) or low vision (n = 5; visual acuity range 1.1–1.7 LogMAR), with the main aim to understand if visual experience is fundamental to the development of specific spatial skills. Our study led to three main findings: firstly, totally blind children performed overall more poorly compared sighted and low vision children in all the spatial tasks performed; secondly, low vision children performed equally or better than sighted children in the same auditory spatial tasks; thirdly, higher residual levels of visual acuity are positively correlated with better spatial performance in the dynamic condition of the auditory localization task indicating that the more residual vision the better spatial performance. These results suggest that early visual experience has an important role in the development of spatial cognition, even when the visual input during the critical period of visual calibration is partially degraded like in the case of low vision children. Overall these results shed light on the importance of early assessment of spatial impairments in visually impaired children and early intervention to prevent the risk of isolation and social exclusion. PMID:28443040

  1. Clinical impact of preoperative brain MR angiography and MR imaging in candidates for liver transplantation: a propensity score-matching study in a single institution

    Energy Technology Data Exchange (ETDEWEB)

    Chung, Mi Sun; Kim, Ho Sung; Jung, Seung Chai; Choi, Choong Gon; Kim, Sang Joon [University of Ulsan College of Medicine, Department of Radiology and Research Institute of Radiology, Song pa-gu, Seoul (Korea, Republic of); Lim, Young-Suk [University of Ulsan College of Medicine, Department of Gastroenterology, Seoul (Korea, Republic of); Jeon, Sang-Beom [University of Ulsan College of Medicine, Department of Neurology, Seoul (Korea, Republic of); Kim, Seon-Ok [University of Ulsan College of Medicine, Department of Clinical Epidemiology and Biostatistics, Seoul (Korea, Republic of); Kim, Hwa Jung [University of Ulsan College of Medicine, Department of Preventive Medicine, Seoul (Korea, Republic of); Hwang, Shin [University of Ulsan College of Medicine, Division of Liver Transplantation and Hepatobiliary Surgery, Department of Surgery, Seoul (Korea, Republic of)

    2017-08-15

    To investigate the prevalence of cerebrovascular stenosis and white matter lesions on preoperative magnetic resonance angiography (MRA) and magnetic resonance imaging (MRI) in liver transplantation candidates. This retrospective study included 1,460 consecutive patients with liver cirrhosis (LC) who underwent MRA with/without brain MRI for pretransplantation evaluation. These patients were matched with 5,331 controls using propensity scores, and the prevalences of significant cerebrovascular stenosis and white matter lesions were compared. A matched analysis of 1,264 pairs demonstrated that the prevalence of significant stenosis was comparable between LC patients and controls (2.2% vs. 1.4%, P = 0.143). LC and most of LC-related parameters were not associated with stenosis. Significant white matter lesions were more common in LC patients (2.8% vs. 1.3%, P = 0.036). A high Model for End-Stage Liver Disease (MELD) score (OR 1.11, CI 1.03-1.20, P = 0.008, for infarction; OR 1.1, CI 1.04-1.16, P = 0.001, for haemorrhage) and stroke history (OR 179.06, CI 45.19-709.45, P < 0.001) were predictors of perioperative stroke. LC patients and control subjects demonstrated similar cerebrovascular stenosis prevalences, whereas white matter lesions were more common in LC patients. A high MELD score and stroke history contribute as predictors of perioperative stroke. (orig.)

  2. Impact of the Processes of Total Testicular Regression and Recrudescence on the Epididymal Physiology of the Bat Myotis nigricans (Chiroptera: Vespertilionidae.

    Directory of Open Access Journals (Sweden)

    Mateus R Beguelini

    Full Text Available Myotis nigricans is a species of vespertilionid bat, whose males show two periods of total testicular regression within the same annual reproductive cycle in the northwest São Paulo State, Brazil. Studies have demonstrated that its epididymis has an elongation of the caudal portion, which stores spermatozoa during the period of testicular regression in July, but that they had no sperm during the regression in November. Thus, the aim of this study was to analyze the impact of the total testicular regression in the epididymal morphophysiology and patterns of its hormonal regulation. The results demonstrate a continuous activity of the epididymis from the Active to the Regressing periods; a morphofunctional regression of the epididymis in the Regressed period; and a slow recrudescence process. Thus, we concluded that the processes of total testicular regression and posterior recrudescence suffered by M. nigricans also impact the physiology of the epididymis, but with a delay in epididymal response. Epididymal physiology is regulated by testosterone and estrogen, through the production and secretion of testosterone by the testes, its conduction to the epididymis (mainly through luminal fluid, conversion of testosterone to dihydrotestosterone by the 5α-reductase enzyme (mainly in epithelial cells and to estrogen by aromatase; and through the activation/deactivation of the androgen receptor and estrogen receptor α in epithelial cells, which regulate the epithelial cell morphophysiology, prevents cell death and regulates their protein expression and secretion, which ensures the maturation and storage of the spermatozoa.

  3. Impact of Neuromuscular Electrical Stimulation (NMES) on 90-Day Episode Costs and Post-Acute Care Utilization in Total Knee Replacement Patients with Disuse Atrophy.

    Science.gov (United States)

    Pal, Sarmistha; Chughtai, Morad; Sultan, Assem A; Khlopas, Anton; Sodhi, Nipun; George, Nicole E; Etcheson, Jennifer I; Gwam, Chukwuweike U; Newman, Jared M; Samuel, Linsen T; Bhave, Anil; DaVanzo, Joan E; Mont, Michael A

    2017-12-22

    This study evaluated differences in: 1) total episode payments, 2) probability of hospital readmission, 3) probability of inpatient rehab facility (IRF) and utilization, and 4) probability of skilled nursing care facility (SNF) utilization in patients who had disuse atrophy and underwent a total knee arthroplasty (TKA) and either did, or did not, receive preoperative home-based neuromuscular electrical stimulation (NMES) therapy. We used the Medicare limited dataset for a 5% sample of beneficiaries from 2014 and 2015 to construct episodes-of-care for TKA (DRG-470) patients with disuse atrophy who underwent a TKA during the 30 days prior to hospital admission and 90 days post-discharge. Patients were stratified into those who either did or did not receive pre- and postoperative NMES therapy. An ordinary least square (OLS) model was used to estimate the impact of NMES on total episode. Linear probability models were used to estimate the impact of NMES on SNF or IRF utilization and readmission. A $3,274 reduction in episode payments for patients who used preoperative NMES versus those who did not (ptotal episode payments and SNF utilization for TKA patients with disuse atrophy who had NMES therapy was demonstrated.

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

    Science.gov (United States)

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

    2014-01-01

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

  5. Prognostic factors in Chinese patients with prostate cancer receiving primary androgen deprivation therapy: validation of Japan Cancer of the Prostate Risk Assessment (J-CAPRA) score and impacts of pre-existing obesity and diabetes mellitus.

    Science.gov (United States)

    Hu, Meng-Bo; Yang, Tian; Hu, Ji-Meng; Zhu, Wen-Hui; Jiang, Hao-Wen; Ding, Qiang

    2018-06-01

    Our aim was to determine the prognostic factors in Chinese patients with prostate cancer receiving primary androgen deprivation therapy (PADT), validate the Japan Cancer of the Prostate Risk Assessment (J-CAPRA) score, and investigate the impacts of pre-existing obesity and diabetes mellitus (DM). The study enrolled Chinese patients diagnosed with prostatic adenocarcinoma and treated with bilateral orchiectomy as PADT at Huashan Hospital, Fudan University (Shanghai, China), from January 2003 to December 2015. The overall survival (OS) and prognostic value of J-CAPRA score, pre-existing obesity, DM, and various clinicopathological variables were analyzed. Of the 435 patients enrolled, 174 (40.0%) deaths occurred during follow-up; 3- and 5-year OS were 74.0 and 58.9%, respectively. Multivariate analysis identified that higher Gleason score and metastasis were both correlated with worse OS and that higher J-CAPRA score was correlated with worse OS [hazard ratio (HR) 1.110, 95% confidence interval (CI) 1.035-1.190, P = 0.003). Different risk categories based on J-CAPRA score showed good stratification in OS (log-rank P = 0.015). In subgroup analysis, pre-existing obesity as a protective factor in younger patients (age ≤ 65, HR 0.271, 95% CI 0.075-0.980, P = 0.046) and pre-existing DM as a risk factor in older patients (> 75, HR 1.854, 95% CI 1.026-3.351, P = 0.041) for OS were recognized, and the prediction accuracy of J-CAPRA was elevated after incorporating pre-existing obesity and DM. The J-CAPRA score presented with good OS differentiation among Chinese patients under PADT. Younger patients (age ≤ 65) had better OS with pre-existing obesity, while older patients (age > 75) had worse OS with pre-existing DM.

  6. The ERICE-score: the new native cardiovascular score for the low-risk and aged Mediterranean population of Spain.

    Science.gov (United States)

    Gabriel, Rafael; Brotons, Carlos; Tormo, M José; Segura, Antonio; Rigo, Fernando; Elosua, Roberto; Carbayo, Julio A; Gavrila, Diana; Moral, Irene; Tuomilehto, Jaakko; Muñiz, Javier

    2015-03-01

    In Spain, data based on large population-based cohorts adequate to provide an accurate prediction of cardiovascular risk have been scarce. Thus, calibration of the EuroSCORE and Framingham scores has been proposed and done for our population. The aim was to develop a native risk prediction score to accurately estimate the individual cardiovascular risk in the Spanish population. Seven Spanish population-based cohorts including middle-aged and elderly participants were assembled. There were 11800 people (6387 women) representing 107915 person-years of follow-up. A total of 1214 cardiovascular events were identified, of which 633 were fatal. Cox regression analyses were conducted to examine the contributions of the different variables to the 10-year total cardiovascular risk. Age was the strongest cardiovascular risk factor. High systolic blood pressure, diabetes mellitus and smoking were strong predictive factors. The contribution of serum total cholesterol was small. Antihypertensive treatment also had a significant impact on cardiovascular risk, greater in men than in women. The model showed a good discriminative power (C-statistic=0.789 in men and C=0.816 in women). Ten-year risk estimations are displayed graphically in risk charts separately for men and women. The ERICE is a new native cardiovascular risk score for the Spanish population derived from the background and contemporaneous risk of several Spanish cohorts. The ERICE score offers the direct and reliable estimation of total cardiovascular risk, taking in consideration the effect of diabetes mellitus and cardiovascular risk factor management. The ERICE score is a practical and useful tool for clinicians to estimate the total individual cardiovascular risk in Spain. Copyright © 2014 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.

  7. An investigation of the impact of total reward packages on employee job satisfaction in a particular fast food industry: a case of McDonald’s, Pakistan

    OpenAIRE

    Santosh, Jaishaal

    2017-01-01

    2017 dissertation for MSc in International Business Management. Selected by academic staff as a good example of a masters level dissertation. Purpose – The purpose of this paper is to investigate the impact of total\\ud reward packages and their components, offered by McDonald’s in Pakistan\\ud to its employees, on employee job satisfaction. The study explored the\\ud factors that influenced the job satisfaction of employees in the sample. The\\ud study also examined the relationship between tota...

  8. Total algorithms

    NARCIS (Netherlands)

    Tel, G.

    We define the notion of total algorithms for networks of processes. A total algorithm enforces that a "decision" is taken by a subset of the processes, and that participation of all processes is required to reach this decision. Total algorithms are an important building block in the design of

  9. Lower bounds to the reliabilities of factor score estimators

    NARCIS (Netherlands)

    Hessen, D.J.

    2017-01-01

    Under the general common factor model, the reliabilities of factor score estimators might be of more interest than the reliability of the total score (the unweighted sum of item scores). In this paper, lower bounds to the reliabilities of Thurstone’s factor score estimators, Bartlett’s factor score

  10. The Zhongshan Score

    Science.gov (United States)

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

    2015-01-01

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

  11. An assessment of the impact of behavioural cognitions on function in patients partaking in a trial of early home-based progressive resistance training after total hip replacement surgery.

    Science.gov (United States)

    Okoro, T; Morrison, V; Maddison, P; Lemmey, A B; Andrew, J G

    2013-01-01

    Control cognitions have been directly related to positive engagement with rehabilitation regimes. The impact of such cognitions on recovery following surgery is not well understood. To assess whether perceived control cognitions predict function 9-12 months following total hip replacement (THR). Prospective cohort study performed as part of a randomised controlled trial. Behavioural cognitions (BC) (recovery locus of control (RLOC); perceived external behavioural control (PEBC))) and subjective functional outcome measures (Oxford hip score (OHS) and a reduced version of the Western Ontario and McMasters University Osteoarthritis Function scale (rWOMAC PF)) were administered pre-operatively and up to 12 months post-operatively to 50 patients randomised to home-based progressive resistance training (N = 26) or standard rehabilitation (N = 24), post-THR. Regression analysis investigated variance in functional scores. Group randomisation had no effect on BC. RLOC and OHS (6 months) correlated significantly with 12-month OHS, with 6-month OHS predicting 62.3% of the variance in 12-month OHS. 12-month rWOMAC PF was determined by each of its three previous assessments (pre-operative 8.8%, 6 weeks 17.8% and 6 months 67.3%). Variance in functional gain at 12 months (OHS and rWOMAC PF) was explained by pre-operative OHS and rWOMAC PF (63.7% and 63.8%, respectively). BC had no impact on functional outcome in this population. Subjectively assessed function at 12 months, as well as the levels of functional gain over time, was best explained by the patients' earlier functional status. Implications for Rehabilitation It is important to assess psychological factors such as poor pre-operative mental health and pain catastrophising in patients undergoing joint replacement surgery as these factors have an adverse effect on subjective patient outcomes. Pre-operative behavioural cognitions appear to have no impact on subjective functional outcome at 12 months post-THR. The pre

  12. GER values and environmental impact scores production of auxiliaries for the water chain; GER-waarden en milieu-impactscores productie van hulpstoffen in de waterketen

    Energy Technology Data Exchange (ETDEWEB)

    Afman, M.; Bijleveld, M. [CE Delft, Delft (Netherlands); Mulder, M. [Mrabella Mulder Waste Water Management, Utrecht (Netherlands)

    2012-03-15

    Alternative processes are available for both wastewater treatment at sewage works and drinking water preparation at water production plants. Some of these involve greater use of chemicals and auxiliary materials, and an important issue is therefore how the energy savings achieved with a particular option compare with the energy required to produce the auxiliaries in question. Against this background a study was carried out to assess the energy consumption of auxiliaries production. For the auxiliaries most frequently used the following were determined: (1) the energy impact of production, expressed as the Gross Energy Requirements (GER) of the materials in question, broken down into renewable versus non-renewable energy; and (2) the environmental impact of production, expressed as a single indicator according to the ReCiPe methodology. The report also provides 'user recommendations' for the calculated values (what they should and should not be used for) and an explanation of the methodology used. The study dovetails with the STOWA research programme 'The Energy Plant', a study exploring the potential for reducing the energy consumption of sewage works to such an extent as to make them net suppliers of energy [Dutch] Voor de behandeling van afvalwater in een rioolwaterzuiveringsinstallatie (RWZI) en de bereiding van drinkwater bij waterproductiebedrijven bestaan alternatieve processen. Sommige processen zorgen voor een hogere dosering van chemicaliën en hulpstoffen in het zuiveringsproces. Een belangrijk aandachtspunt hierbij is of de energiebesparing die behaald wordt met een zuiveringsvariant, opweegt tegen de energie-impact van de productie van de benodigde hulpstoffen. Om deze reden is een studie uitgevoerd gericht op het energieverbruik van de productie van de hulpstoffen. Van de meest gebruikte hulpstoffen zijn bepaald: (1) de energie-impact van de productie van de hulpstoffen, uitgedrukt in de GER-waarde (bruto primaire energie) van de

  13. Totally James

    Science.gov (United States)

    Owens, Tom

    2006-01-01

    This article presents an interview with James Howe, author of "The Misfits" and "Totally Joe". In this interview, Howe discusses tolerance, diversity and the parallels between his own life and his literature. Howe's four books in addition to "The Misfits" and "Totally Joe" and his list of recommended books with lesbian, gay, bisexual, transgender,…

  14. Development and Validation of the Total HUman Model for Safety (THUMS) Version 5 Containing Multiple 1D Muscles for Estimating Occupant Motions with Muscle Activation During Side Impacts.

    Science.gov (United States)

    Iwamoto, Masami; Nakahira, Yuko

    2015-11-01

    Accurate prediction of occupant head kinematics is critical for better understanding of head/face injury mechanisms in side impacts, especially far-side occupants. In light of the fact that researchers have demonstrated that muscle activations, especially in neck muscles, can affect occupant head kinematics, a human body finite element (FE) model that considers muscle activation is useful for predicting occupant head kinematics in real-world automotive accidents. In this study, we developed a human body FE model called the THUMS (Total HUman Model for Safety) Version 5 that contains 262 one-dimensional (1D) Hill-type muscle models over the entire body. The THUMS was validated against 36 series of PMHS (Post Mortem Human Surrogate) and volunteer test data in this study, and 16 series of PMHS and volunteer test data on side impacts are presented. Validation results with force-time curves were also evaluated quantitatively using the CORA (CORrelation and Analysis) method. The validation results suggest that the THUMS has good biofidelity in the responses of the regional or full body for side impacts, but relatively poor biofidelity in its local level of responses such as brain displacements. Occupant kinematics predicted by the THUMS with a muscle controller using 22 PID (Proportional-Integral- Derivative) controllers were compared with those of volunteer test data on low-speed lateral impacts. The THUMS with muscle controller reproduced the head kinematics of the volunteer data more accurately than that without muscle activation, although further studies on validation of torso kinematics are needed for more accurate predictions of occupant head kinematics.

  15. The impact on human health and the environment of different types of German and Polish power plants. A first scoring approach in Germany

    International Nuclear Information System (INIS)

    Voigt, Kristina; Scherb, Hagen; Bartoszczuk, Pawel

    2014-01-01

    This paper gives a short overview about the types of power stations in Germany and Poland. The energy production in Germany in 2012 was 629,7 TWh. Every type of power plant poses a risk to humans and the environment but in a different way and to a different extent. A discrete mathematical method, named Hasse diagram technique is applied. The software package used is the PyHasse software. A first ranking approach is presented taking the 8 most used types of power plants in Germany into account and ranking those applying 5 different evaluation criteria, including 3 environmental health attributes. In this first approach not only nuclear power stations but also coal-driven power stations come worst in this ranking method. Renewable energies come best in our approach. Unfortunately their percentage of the overall energy production is still too low (about 22,1 % in Germany and 10,4 % in Poland). This underlines the necessity for urgently supporting the development of renewable energy power plants. Furthermore, we plan to extend our scoring approach to other European countries, starting with the neighboring country Poland.

  16. The impact on human health and the environment of different types of German and Polish power plants. A first scoring approach in Germany

    Energy Technology Data Exchange (ETDEWEB)

    Voigt, Kristina; Scherb, Hagen [Helmholtz Zentrum Muenchen, Neuherberg (Germany). Inst. of Computational Biology; Bartoszczuk, Pawel [Warsaw School of Economics (Poland). Enterprise Inst.

    2014-07-01

    This paper gives a short overview about the types of power stations in Germany and Poland. The energy production in Germany in 2012 was 629,7 TWh. Every type of power plant poses a risk to humans and the environment but in a different way and to a different extent. A discrete mathematical method, named Hasse diagram technique is applied. The software package used is the PyHasse software. A first ranking approach is presented taking the 8 most used types of power plants in Germany into account and ranking those applying 5 different evaluation criteria, including 3 environmental health attributes. In this first approach not only nuclear power stations but also coal-driven power stations come worst in this ranking method. Renewable energies come best in our approach. Unfortunately their percentage of the overall energy production is still too low (about 22,1 % in Germany and 10,4 % in Poland). This underlines the necessity for urgently supporting the development of renewable energy power plants. Furthermore, we plan to extend our scoring approach to other European countries, starting with the neighboring country Poland.

  17. Impact of the occurrence of a response shift on the determination of the minimal important difference in a health-related quality of life score over time.

    Science.gov (United States)

    Ousmen, Ahmad; Conroy, Thierry; Guillemin, Francis; Velten, Michel; Jolly, Damien; Mercier, Mariette; Causeret, Sylvain; Cuisenier, Jean; Graesslin, Olivier; Hamidou, Zeinab; Bonnetain, Franck; Anota, Amélie

    2016-12-03

    An important challenge of the longitudinal analysis of health-related quality of life (HRQOL) is the potential occurrence of a Response Shift (RS) effect. While the impact of RS effect on the longitudinal analysis of HRQOL has already been studied, few studies have been conducted on its impact on the determination of the Minimal Important Difference (MID). This study aims to investigate the impact of the RS effect on the determination of the MID over time for each scale of both EORTC QLQ-C30 and QLQ-BR23 questionnaires in breast cancer patients. Patients with breast cancer completed the EORTC QLQ-C30 and the EORTC QLQ-BR23 questionnaires at baseline (time of diagnosis; T0), three months (T1) and six months after surgery (T2). Four hospitals and care centers participated in this study: cancer centers of Dijon and Nancy, the university hospitals of Reims and Strasbourg At T1 and T2, patients were asked to evaluate their HRQOL change during the last 3 months using the Jaeschke transition question. They were also asked to assess retrospectively their HRQOL level of three months ago. The occurrence of the RS effect was explored using the then-test method and its impact on the determination of the MID by using the Anchor-based method. Between February 2006 and February 2008, 381 patients were included of mean age 58 years old (SD = 11). For patients who reported a deterioration of their HRQOL level at each follow-up, an increase of RS effect has been detected between T1 and T2 in 13/15 dimensions of QLQ-C30 questionnaire, and 4/7 dimensions of QLQ-BR23 questionnaire. In contrast, a decrease of the RS effect was observed in 8/15 dimensions of QLQ-C30 questionnaire and in 5/7 dimensions of QLQ-BR23 questionnaire in case of improvement. At T2, the MID became ≥ 5 points when taking into account the RS effect in 10/15 dimensions of QLQ-C30 questionnaire and in 5/7 dimensions of QLQ-BR23 questionnaire. This study highlights that the RS effect increases over time in

  18. Venous thrombo-embolism (VTE prevention of patients undergoing total hip and knee replacement: budget impact analysis of apixaban in Italy

    Directory of Open Access Journals (Sweden)

    Lorenzo Giovanni Mantovani

    2013-09-01

    Full Text Available BACKGROUND: Venous thromboembolism (VTE is a common and burdensome cardiovascular condition, frequently leading to severe complications and requiring high-cost healthcare interventions. New oral anticoagulants (nOACs have demonstrated to be efficacious and safe in VTE prevention of patients undergoing total hip replacement (THR and total knee replacement (TKR, a condition that is typically associated to cardiovascular disease. The Italian Healthcare Service (SSN has recently approved the latest nOAC, apixaban. The present article aims to evaluate its economic impact in the perspective of the Italian SSN.METHODS: We conducted a budget impact analysis to estimate clinical outcomes and economic consequences associated to the reimbursement of apixaban, in the prevention of VTE as a consequence of major orthopedic surgery, over a three-year time horizon. In our analysis we compared two alternative scenarios, with apixaban either reimbursed (Scenario B or not reimbursed (Scenario A by the Italian SSN, and estimated the difference of healthcare costs between the two scenarios. Only direct healthcare costs have been considered.RESULTS: According to market assumptions, it is estimated that 1.2%, 3.7%, and 6.5% of THR patients, and 1.2%, 3.8% and 6.7% of TKR patients, would be treated with apixaban over the first three years since launch. At the estimated daily cost of apixaban (€2.48/die, this would translate into a budget impact of €14.3 mln, €45.5 mln, and €81.4 mln at years 1, 2 and 3 since launch, respectively. This expenditure would be more than offset by savings, due to: i reduction of prescriptions of alternative treatment options (other nOACs, low-molecular weight heparins, fondaparinux; ii reduction of the economic burden attributable of CV complications of VTE. Finally, Scenario B resulted slightly favourable compared to Scenario A, leading to economic savings for about €50 thousands over three years. Sensitivity analyses confirmed

  19. Impact of Serum Apolipoprotein A-I on Prognosis and Bevacizumab Efficacy in Patients with Metastatic Colorectal Cancer: a Propensity Score-Matched Analysis

    Directory of Open Access Journals (Sweden)

    Qi Quan

    2017-04-01

    Full Text Available PURPOSE: We aimed to investigate the role of apolipoprotein A-I (ApoA-I as a predictor of prognosis and treatment efficacy of bevacizumab in patients with metastatic colorectal cancer (mCRC treated with first-line chemotherapy with or without bevacizumab. METHODS: We conducted a retrospective study on consecutive patients who were diagnosed with mCRC at Sun Yat-sen University Cancer Center. According to their pretreatment ApoA-I level, patients were divided into low– and high–ApoA-I groups. Propensity score-matched method was performed to balance baseline characteristics between two groups. Based on whether they accepted bevacizumab as a first-line therapy, patients were further divided into the chemo + bevacizumab group and the chemo group. Overall survival (OS and progression-free survival (PFS were assessed with Kaplan-Meier method, log-rank test, and Cox regression. RESULTS: The optimal cutoff value for the ApoA-I level was determined to be 1.105 g/l. In the propensity-matched cohort of 508 patients, low ApoA-I was significantly associated with inferior OS (P < .001 and PFS (P < .001 than high ApoA-I. Multivariate analysis showed that ApoA-I level was an independent prognostic maker of OS (P < .001 and PFS (P = .001. PFS (P < .001 in either the high– or low–ApoA-I groups could be extended significantly after the administration of bevacizumab, and patients with a high ApoA-I level also had a better OS in the chemo + bevacizumab group than the chemo group (P = .049. CONCLUSIONS: Patients with a low ApoA-I level have poor prognoses, and they did not display an OS benefit from bevacizumab.

  20. The impact of total quality service (TQS) on healthcare and patient satisfaction: an empirical study of Turkish private and public hospitals.

    Science.gov (United States)

    Bakan, Ismail; Buyukbese, Tuba; Ersahan, Burcu

    2014-01-01

    This paper attempts to measure patients' perceptions of the quality of services in public and private healthcare centers in Turkey. The main aim was to examine the impact of the dimensions of patient-perceived total quality service (TQS) on patients' satisfaction. The research framework and hypotheses are derived from a literature review of service quality and quality in the healthcare industry. The research data were collected through questionnaires and then statistically analyzed using descriptive statistics, Pearson product moment correlation and linear regression. The results suggest that service quality perceptions positively influence patient satisfaction with overall hospital care (SOHC). The most important factors identified in the regression model regarding patient SOHC are the quality of the hospital's social responsibility, administrative processes and overall experience of medical care received. These factors explain 74% of the variance in SOHC. The findings of the study can be used to improve TQS in both private and public hospitals. Copyright © 2013 John Wiley & Sons, Ltd.

  1. Determination of metals by total reflection X-ray fluorescence and evaluation of toxicity of a river impacted by coal mining in the south of Brazil.

    Science.gov (United States)

    Lattuada, R M; Menezes, C T B; Pavei, P T; Peralba, M C R; Dos Santos, J H Z

    2009-04-30

    Metal (Fe, Mn, Zn, Ni, Cd, and Pb) concentrations in the region of Criciuma (Brazil), a region impacted by coal mining, were determined in water and sediments using total reflection X-ray fluorescence (TXRF) spectroscopy. Samples were collected from the Mãe Luzia River (south Brazil) at five different stations, from the source down to the river mouth (Ararangua estuary). Water and sediment toxicity were also evaluated using bioassays with Daphnia magna as the bioindicator. The metal present in the highest concentrations both in water (1.3-11 mg L(-1)) and in sediments (34-142 mg L(-1)) was iron. Results suggest an influence of coal mining on the aquatic receptors, showing a clear relationship between metal content (mostly Fe) and ecotoxicity.

  2. Impact of Toxicity Grade and Scoring System on the Relationship Between Mean Lung Dose and Risk of Radiation Pneumonitis in a Large Cohort of Patients With Non-Small Cell Lung Cancer

    International Nuclear Information System (INIS)

    Tucker, Susan L.; Jin Hekun; Wei Xiong

    2010-01-01

    Purpose: To compute the risk of radiation pneumonitis (RP) as a function of mean lung dose (MLD), with RP scored using three grading systems and analyzed at four threshold levels of toxicity in a large cohort of patients with non-small cell lung cancer (NSCLC) treated with definitive radiotherapy (RT). Methods and Materials: On the basis of medical records and radiographic images, RP was scored retrospectively in 442 patients with NSCLC who had ≥6 months of follow-up after the end of RT. The severity of RP was scored for each patient using the National Cancer Institute (NCI) Common Toxicity Criteria, version 2.0 (CTC2.0); the NCI Common Terminology Criteria for Adverse Events, version 3.0 (CTCAE3.0); and the grading system of the Radiation Therapy Oncology Group (RTOG). For each grading system and for each of four levels of toxicity (Grade ≥1, ≥2, ≥3, ≥4), the Lyman, logistic, and log-logistic normal tissue complication probability (NTCP) models were fitted to the data as functions of MLD. The parameter estimates from the model fits are listed in table form, and the RP risk estimates are presented graphically for the Lyman and log-logistic NTCP models. Results: The results presented here illustrate the impact of scoring system and level of toxicity on the relationship between MLD and RP risk. Conclusions: These results facilitate quantitative comparisons between our data and studies of RP risk reported by others, and several examples of such comparisons are provided.

  3. Quantifying Fire's Impacts on Total and Pyrogenic Carbon Stocks in Mixed-Conifer Forests: Results from Pre- and Post-Fire Measurements in Active Wildfire Incidents

    Science.gov (United States)

    Miesel, J. R.; Reiner, A. L.; Ewell, C. M.; Sanderman, J.; Maestrini, B.; Adkins, J.

    2016-12-01

    Widespread US fire suppression policy has contributed to an accumulation of vegetation in many western forests relative to historic conditions, and these changes can exacerbate wildfire severity and carbon (C) emissions. Serious concern exists about positive feedbacks between wildfire emissions and global climate; however, fires not only release C from terrestrial to atmospheric pools, they also create "black" or pyrogenic C (PyC) which contributes to longer-term C stability. Our objective was to quantify wildfire impacts on aboveground and belowground total C and PyC stocks in California mixed-conifer forests. We worked with incident management teams to access five active wildfires to establish and measure plots within days before and after fire. We measured pre- and post-fire aboveground forest structure and woody fuels to calculate aboveground biomass, biomass C, and PyC, and we collected pre- and post-fire forest floor and 0-5 cm mineral soil samples to measure belowground C and PyC stocks. Our preliminary results show that fire had minimal impact on the number of trees per hectare, whereas C losses from the tree layer occurred via consumption of foliage, and PyC gain occurred in tree bark. Fire released 54% to 100% of surface fuel C. In the forest floor layer, we observed 33 to 100% C loss, whereas changes in PyC stocks ranged from 100% loss to 186% gain relative to pre-fire samples. In general, fire had minimal to no impact on 0-5 cm mineral soil C. We will present relationships between total C, PyC and post-fire C and N dynamics in one of the five wildfire sites. Our data are unique because they represent nearly immediate pre- and post-fire measurements in major wildfires in a widespread western U.S. forest type. This research advances understanding of the role of fire on forest C fluxes and C sequestration potential as PyC.

  4. How to score questionnaires

    NARCIS (Netherlands)

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

    The standard practice in scoring questionnaires consists of adding item scores and standardizing these sums. We present a set of alternative procedures, consisting of (a) correcting for the acquiescence variance that disturbs the structure of the questionnaire; (b) establishing item weights through

  5. SCORE - A DESCRIPTION.

    Science.gov (United States)

    SLACK, CHARLES W.

    REINFORCEMENT AND ROLE-REVERSAL TECHNIQUES ARE USED IN THE SCORE PROJECT, A LOW-COST PROGRAM OF DELINQUENCY PREVENTION FOR HARD-CORE TEENAGE STREET CORNER BOYS. COMMITTED TO THE BELIEF THAT THE BOYS HAVE THE POTENTIAL FOR ETHICAL BEHAVIOR, THE SCORE WORKER FOLLOWS B.F. SKINNER'S THEORY OF OPERANT CONDITIONING AND REINFORCES THE DELINQUENT'S GOOD…

  6. Is right coronary artery chronic total vessel occlusion impacting the surgical revascularization results of patients with multivessel disease? A retrospective study

    Directory of Open Access Journals (Sweden)

    Janusz Konstanty-Kalandyk

    2018-06-01

    Full Text Available Introduction Chronic total occlusion (CTO is common in the presence of other significantly narrowed coronary arteries. The impact of total occlusion and its association with completeness of revascularization on patients with multivessel disease undergoing coronary artery bypass graft (CABG remains largely unknown. Aim The aim of our study was to compare CABG operation characteristics, as well as 30-day mortality, incidence of post-operative major adverse cardiac and cerebrovascular events (MACCE between patients with and without CTO in right coronary artery (RCA. Materials and Methods A total of 156 consecutive patients were included in the analysis. CTO of RCA or right posterior descending artery (RPD was diagnosed in 57 patients (CTO-RCA group. Coronary stenosis without CTO in RCA was diagnosed in 99 patients (nonCTO-RCA group. Baseline characteristics were comparable in both groups. Results The majority of patients had class II (49.1% vs. 46%, p = 0.86 or class III (42.1% vs. 43%, p = 1.0 Canadian Cardiovascular Society grading system symptoms. Patients in the CTO-RCA group had in average 2.2 grafts implanted, as opposed to 2.4 grafts in patients in the nonCTO-RCA group (p = 0.003. Graft to the RCA was performed in 40.3% patients in the CTO-RCA group and in 81% patients in the nonCTO-RCA group (p = 0.001. The 30-day mortality from any cause or cardiac cause did not differ between groups (7% vs. 2%, p = 0.14 and 3.5% vs. 2%, p = 0.57 respectively. In a multivariate analysis CTO in RCA or RPD and peripheral artery disease were independent predictors of post-operative MACCE (7.9 (1.434–43.045 p = 0.02; 18.8 (3.451–101.833 p < 0.01, respectively. Conclusions Chronic total occlusion of RCA was found to be associated with smaller number of grafts performed during the CABG procedure. Although mortality between patients in the CTO-RCA and nonCTO-RCA groups did not differ, patients in the CTO-RCA group had higher incidence of post-operative MACCE.

  7. The Bandim tuberculosis score

    DEFF Research Database (Denmark)

    Rudolf, Frauke; Joaquim, Luis Carlos; Vieira, Cesaltina

    2013-01-01

    Background: This study was carried out in Guinea-Bissau ’ s capital Bissau among inpatients and outpatients attending for tuberculosis (TB) treatment within the study area of the Bandim Health Project, a Health and Demographic Surveillance Site. Our aim was to assess the variability between 2...... physicians in performing the Bandim tuberculosis score (TBscore), a clinical severity score for pulmonary TB (PTB), and to compare it to the Karnofsky performance score (KPS). Method : From December 2008 to July 2009 we assessed the TBscore and the KPS of 100 PTB patients at inclusion in the TB cohort and...

  8. Use of Quantile Regression to Determine the Impact on Total Health Care Costs of Surgical Site Infections Following Common Ambulatory Procedures.

    Science.gov (United States)

    Olsen, Margaret A; Tian, Fang; Wallace, Anna E; Nickel, Katelin B; Warren, David K; Fraser, Victoria J; Selvam, Nandini; Hamilton, Barton H

    2017-02-01

    To determine the impact of surgical site infections (SSIs) on health care costs following common ambulatory surgical procedures throughout the cost distribution. Data on costs of SSIs following ambulatory surgery are sparse, particularly variation beyond just mean costs. We performed a retrospective cohort study of persons undergoing cholecystectomy, breast-conserving surgery, anterior cruciate ligament reconstruction, and hernia repair from December 31, 2004 to December 31, 2010 using commercial insurer claims data. SSIs within 90 days post-procedure were identified; infections during a hospitalization or requiring surgery were considered serious. We used quantile regression, controlling for patient, operative, and postoperative factors to examine the impact of SSIs on 180-day health care costs throughout the cost distribution. The incidence of serious and nonserious SSIs was 0.8% and 0.2%, respectively, after 21,062 anterior cruciate ligament reconstruction, 0.5% and 0.3% after 57,750 cholecystectomy, 0.6% and 0.5% after 60,681 hernia, and 0.8% and 0.8% after 42,489 breast-conserving surgery procedures. Serious SSIs were associated with significantly higher costs than nonserious SSIs for all 4 procedures throughout the cost distribution. The attributable cost of serious SSIs increased for both cholecystectomy and hernia repair as the quantile of total costs increased ($38,410 for cholecystectomy with serious SSI vs no SSI at the 70th percentile of costs, up to $89,371 at the 90th percentile). SSIs, particularly serious infections resulting in hospitalization or surgical treatment, were associated with significantly increased health care costs after 4 common surgical procedures. Quantile regression illustrated the differential effect of serious SSIs on health care costs at the upper end of the cost distribution.

  9. Volleyball Scoring Systems.

    Science.gov (United States)

    Calhoun, William; Dargahi-Noubary, G. R.; Shi, Yixun

    2002-01-01

    The widespread interest in sports in our culture provides an excellent opportunity to catch students' attention in mathematics and statistics classes. One mathematically interesting aspect of volleyball, which can be used to motivate students, is the scoring system. (MM)

  10. A novel technique for impaction bone grafting in acetabular reconstruction of revision total hip arthroplasty using an ex vivo compaction device

    International Nuclear Information System (INIS)

    Akiyama, Haruhiko; Takemoto, Mitsuru; Morishima, Takkan

    2011-01-01

    Impaction bone grafting allows restoration of the acetabular bone stock in revision hip arthroplasty. The success of this technique depends largely on achieving adequate initial stability of the component. To obtain well-compacted, well-graded allograft aggregates, we developed an ex vivo compaction device to apply it in revision total hip arthroplasty on the acetabular side, and characterized mechanical properties and putative osteoconductivity of allograft aggregates. Morselized allograft bone chips were compacted ex vivo using the creep technique and subsequent impaction technique to form the bone aggregates. Impaction allograft reconstruction of the acetabulum using an ex vivo compaction device was performed on eight hips. The mechanical properties and three-dimensional micro-CT-based structural characteristics of the bone aggregates were investigated. In clinical practice, this technique offered good reproducibility in reconstructing the cavity and the segmental defects of the acetabulum, with no migration and no loosening of the component. In vitro analysis showed that the aggregates generated from 25 g fresh-frozen bone chips gained compression stiffness of 13.5-15.4 MPa under uniaxial consolidation strain. The recoil of the aggregates after compaction was 2.6-3.9%. The compression stiffness and the recoil did not differ significantly from those measured using a variety of proportions of large- and small-sized bone chips. Micro-CT-based structural analysis revealed average pore sizes of 268-299 μm and average throat diameter of pores in the bone aggregates of more than 100 μm. These sizes are desirable for osteoconduction, although large interconnected pores of more than 500 μm were detectable in association with the proportion of large-sized bone chips. Cement penetration into the aggregates was related to the proportion of large-sized bone chips. This study introduces the value of an ex vivo compaction device in bone graft compaction in clinical

  11. The impact of hypoxemia on serum total and free prostate-specific antigen levels in patients with chronic obstructive pulmonary disease.

    Science.gov (United States)

    Ozge, Cengiz; Bozlu, Murat; Ozgur, Eylem Sercan; Tek, Mesut; Tunckiran, Ahmet; Muslu, Necati; Ilvan, Ahmet

    2015-05-01

    Prostate-specific antigen (PSA) is the most important biochemical marker in the diagnosis and follow-up of patients with prostate cancer. In recent years, a relationship between PSA levels and hypoxic conditions has been described. However, no study has investigated the PSA levels in patients with chronic obstructive pulmonary disease (COPD). The aim of the present study was to investigate the impact of hypoxemia on serum total (tPSA) and free PSA (fPSA) levels in patients with COPD. Between January 2010 and January 2014, 95 male patients who hospitalized for acute exacerbations of COPD and 80 control subjects were enrolled in the study. Serum tPSA and fPSA levels and f/tPSA ratios were determined in all patients on the first day of hospitalization (exacerbation) and 7 days after the treatment (stable state). Statistical analysis included paired t test and Mann-Whitney U test. No statistically significant differences were found between COPD and control groups with regard to the baseline characteristics, except for smoking status. The levels of serum tPSA and fPSA during exacerbation of COPD were significantly higher than the levels of the stable period (p 0.05). Hypoxemia during acute exacerbation of COPD can cause a rise in serum tPSA and fPSA levels, but f/tPSA ratio is not affected. Acute exacerbation of COPD may be added to list of the events in which PSA measurements must be interpreted with caution.

  12. The Impact of Combining a Low-Tube Voltage Acquisition with Iterative Reconstruction on Total Iodine Dose in Coronary CT Angiography

    Directory of Open Access Journals (Sweden)

    Toon Van Cauteren

    2017-01-01

    Full Text Available Objectives. To assess the impact of combining low-tube voltage acquisition with iterative reconstruction (IR techniques on the iodine dose in coronary CTA. Methods. Three minipigs underwent CCTA to compare a standard of care protocol with two alternative study protocols combining low-tube voltage and low iodine dose with IR. Image quality was evaluated objectively by the CT value, signal-to-noise ratio (SNR, and contrast-to-noise ratio (CNR in the main coronary arteries and aorta and subjectively by expert reading. Statistics were performed by Mann–Whitney U test and Chi-square analysis. Results. Despite reduced iodine dose, both study protocols maintained CT values, SNR, and CNR compared to the standard of care protocol. Expert readings confirmed these findings; all scans were perceived to be of at least diagnostically acceptable quality on all evaluated parameters allowing image interpretation. No statistical differences were observed (all p values > 0.11, except for streak artifacts (p=0.02 which were considered to be more severe, although acceptable, with the 80 kVp protocol. Conclusions. Reduced tube voltage in combination with IR allows a total iodine dose reduction between 37 and 50%, by using contrast media with low iodine concentrations of 200 and 160 mg I/mL, while maintaining image quality.

  13. Quantifying the role of climate variability on extreme total water level impacts: An application of a full simulation model to Ocean Beach, California

    Science.gov (United States)

    Serafin, K.; Ruggiero, P.; Stockdon, H. F.; Barnard, P.; Long, J.

    2014-12-01

    Many coastal communities worldwide are vulnerable to flooding and erosion driven by extreme total water levels (TWL), potentially dangerous events produced by the combination of large waves, high tides, and high non-tidal residuals. The West coast of the United States provides an especially challenging environment to model these processes due to its complex geological setting combined with uncertain forecasts for sea level rise (SLR), changes in storminess, and possible changes in the frequency of major El Niños. Our research therefore aims to develop an appropriate methodology to assess present-day and future storm-induced coastal hazards along the entire U.S. West coast, filling this information gap. We present the application of this framework in a pilot study at Ocean Beach, California, a National Park site within the Golden Gate National Recreation Area where existing event-scale coastal change data can be used for model calibration and verification. We use a probabilistic, full simulation TWL model (TWL-FSM; Serafin and Ruggiero, in press) that captures the seasonal and interannual climatic variability in extremes using functions of regional climate indices, such as the Multivariate ENSO index (MEI), to represent atmospheric patterns related to the El Niño-Southern Oscillation (ENSO). In order to characterize the effect of climate variability on TWL components, we refine the TWL-FSM by splitting non-tidal residuals into low (monthly mean sea level anomalies) and high frequency (storm surge) components. We also develop synthetic climate indices using Markov sequences to reproduce the autocorrelated nature of ENSO behavior. With the refined TWL-FSM, we simulate each TWL component, resulting in synthetic TWL records providing robust estimates of extreme return level events (e.g., the 100-yr event) and the ability to examine the relative contribution of each TWL component to these extreme events. Extreme return levels are then used to drive storm impact models

  14. Instant MuseScore

    CERN Document Server

    Shinn, Maxwell

    2013-01-01

    Get to grips with a new technology, understand what it is and what it can do for you, and then get to work with the most important features and tasks. Instant MuseScore is written in an easy-to follow format, packed with illustrations that will help you get started with this music composition software.This book is for musicians who would like to learn how to notate music digitally with MuseScore. Readers should already have some knowledge about musical terminology; however, no prior experience with music notation software is necessary.

  15. A diagnostic scoring system for myxedema coma.

    Science.gov (United States)

    Popoveniuc, Geanina; Chandra, Tanu; Sud, Anchal; Sharma, Meeta; Blackman, Marc R; Burman, Kenneth D; Mete, Mihriye; Desale, Sameer; Wartofsky, Leonard

    2014-08-01

    To develop diagnostic criteria for myxedema coma (MC), a decompensated state of extreme hypothyroidism with a high mortality rate if untreated, in order to facilitate its early recognition and treatment. The frequencies of characteristics associated with MC were assessed retrospectively in patients from our institutions in order to derive a semiquantitative diagnostic point scale that was further applied on selected patients whose data were retrieved from the literature. Logistic regression analysis was used to test the predictive power of the score. Receiver operating characteristic (ROC) curve analysis was performed to test the discriminative power of the score. Of the 21 patients examined, 7 were reclassified as not having MC (non-MC), and they were used as controls. The scoring system included a composite of alterations of thermoregulatory, central nervous, cardiovascular, gastrointestinal, and metabolic systems, and presence or absence of a precipitating event. All 14 of our MC patients had a score of ≥60, whereas 6 of 7 non-MC patients had scores of 25 to 50. A total of 16 of 22 MC patients whose data were retrieved from the literature had a score ≥60, and 6 of 22 of these patients scored between 45 and 55. The odds ratio per each score unit increase as a continuum was 1.09 (95% confidence interval [CI], 1.01 to 1.16; P = .019); a score of 60 identified coma, with an odds ratio of 1.22. The area under the ROC curve was 0.88 (95% CI, 0.65 to 1.00), and the score of 60 had 100% sensitivity and 85.71% specificity. A score ≥60 in the proposed scoring system is potentially diagnostic for MC, whereas scores between 45 and 59 could classify patients at risk for MC.

  16. Total Thyroidectomy

    Directory of Open Access Journals (Sweden)

    Lopez Moris E

    2016-06-01

    Full Text Available Total thyroidectomy is a surgery that removes all the thyroid tissue from the patient. The suspect of cancer in a thyroid nodule is the most frequent indication and it is presume when previous fine needle puncture is positive or a goiter has significant volume increase or symptomes. Less frequent indications are hyperthyroidism when it is refractory to treatment with Iodine 131 or it is contraindicated, and in cases of symptomatic thyroiditis. The thyroid gland has an important anatomic relation whith the inferior laryngeal nerve and the parathyroid glands, for this reason it is imperative to perform extremely meticulous dissection to recognize each one of these elements and ensure their preservation. It is also essential to maintain strict hemostasis, in order to avoid any postoperative bleeding that could lead to a suffocating neck hematoma, feared complication that represents a surgical emergency and endangers the patient’s life.It is essential to run a formal technique, without skipping steps, and maintain prudence and patience that should rule any surgical act.

  17. Impact of pH and Total Soluble Solids on Enzyme Inactivation Kinetics during High Pressure Processing of Mango (Mangifera indica) Pulp.

    Science.gov (United States)

    Kaushik, Neelima; Nadella, Tejaswi; Rao, P Srinivasa

    2015-11-01

    This study was undertaken with an aim to enhance the enzyme inactivation during high pressure processing (HPP) with pH and total soluble solids (TSS) as additional hurdles. Impact of mango pulp pH (3.5, 4.0, 4.5) and TSS (15, 20, 25 °Brix) variations on the inactivation of pectin methylesterase (PME), polyphenol oxidase (PPO), and peroxidase (POD) enzymes were studied during HPP at 400 to 600 MPa pressure (P), 40 to 70 °C temperature (T), and 6- to 20-min pressure-hold time (t). The enzyme inactivation (%) was modeled using second order polynomial equations with a good fit that revealed that all the enzymes were significantly affected by HPP. Response surface and contour models predicted the kinetic behavior of mango pulp enzymes adequately as indicated by the small error between predicted and experimental data. The predicted kinetics indicated that for a fixed P and T, higher pulse pressure effect and increased isobaric inactivation rates were possible at lower levels of pH and TSS. In contrast, at a fixed pH or TSS level, an increase in P or T led to enhanced inactivation rates, irrespective of the type of enzyme. PPO and POD were found to have similar barosensitivity, whereas PME was found to be most resistant to HPP. Furthermore, simultaneous variation in pH and TSS levels of mango pulp resulted in higher enzyme inactivation at lower pH and TSS during HPP, where the effect of pH was found to be predominant than TSS within the experimental domain. Exploration of additional hurdles such as pH, TSS, and temperature for enzyme inactivation during high pressure processing of fruits is useful from industrial point of view, as these parameters play key role in preservation process design. © 2015 Institute of Food Technologists®

  18. The lod score method.

    Science.gov (United States)

    Rice, J P; Saccone, N L; Corbett, J

    2001-01-01

    The lod score method originated in a seminal article by Newton Morton in 1955. The method is broadly concerned with issues of power and the posterior probability of linkage, ensuring that a reported linkage has a high probability of being a true linkage. In addition, the method is sequential, so that pedigrees or lod curves may be combined from published reports to pool data for analysis. This approach has been remarkably successful for 50 years in identifying disease genes for Mendelian disorders. After discussing these issues, we consider the situation for complex disorders, where the maximum lod score (MLS) statistic shares some of the advantages of the traditional lod score approach but is limited by unknown power and the lack of sharing of the primary data needed to optimally combine analytic results. We may still learn from the lod score method as we explore new methods in molecular biology and genetic analysis to utilize the complete human DNA sequence and the cataloging of all human genes.

  19. The Bayesian Score Statistic

    NARCIS (Netherlands)

    Kleibergen, F.R.; Kleijn, R.; Paap, R.

    2000-01-01

    We propose a novel Bayesian test under a (noninformative) Jeffreys'priorspecification. We check whether the fixed scalar value of the so-calledBayesian Score Statistic (BSS) under the null hypothesis is aplausiblerealization from its known and standardized distribution under thealternative. Unlike

  20. South African Scoring System

    African Journals Online (AJOL)

    2014-11-18

    Nov 18, 2014 ... for 80% (SASS score) and 75% (NOT) of the variation in the regression model. Consequently, SASS ... further investigation: spatial analyses of macroinvertebrate assemblages; and the use of structural and functional metrics. Keywords: .... conductivity levels was assessed using multiple linear regres- sion.

  1. Developing Scoring Algorithms

    Science.gov (United States)

    We developed scoring procedures to convert screener responses to estimates of individual dietary intake for fruits and vegetables, dairy, added sugars, whole grains, fiber, and calcium using the What We Eat in America 24-hour dietary recall data from the 2003-2006 NHANES.

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

    DEFF Research Database (Denmark)

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

    2012-01-01

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

  3. Credit scoring for individuals

    Directory of Open Access Journals (Sweden)

    Maria DIMITRIU

    2010-12-01

    Full Text Available Lending money to different borrowers is profitable, but risky. The profits come from the interest rate and the fees earned on the loans. Banks do not want to make loans to borrowers who cannot repay them. Even if the banks do not intend to make bad loans, over time, some of them can become bad. For instance, as a result of the recent financial crisis, the capability of many borrowers to repay their loans were affected, many of them being on default. That’s why is important for the bank to monitor the loans. The purpose of this paper is to focus on credit scoring main issues. As a consequence of this, we presented in this paper the scoring model of an important Romanian Bank. Based on this credit scoring model and taking into account the last lending requirements of the National Bank of Romania, we developed an assessment tool, in Excel, for retail loans which is presented in the case study.

  4. Peritumoral Artery Scoring System: a Novel Scoring System to Predict Renal Function Outcome after Laparoscopic Partial Nephrectomy.

    Science.gov (United States)

    Zhang, Ruiyun; Wu, Guangyu; Huang, Jiwei; Shi, Oumin; Kong, Wen; Chen, Yonghui; Xu, Jianrong; Xue, Wei; Zhang, Jin; Huang, Yiran

    2017-06-06

    The present study aimed to assess the impact of peritumoral artery characteristics on renal function outcome prediction using a novel Peritumoral Artery Scoring System based on computed tomography arteriography. Peritumoral artery characteristics and renal function were evaluated in 220 patients who underwent laparoscopic partial nephrectomy and then validate in 51 patients with split and total glomerular filtration rate (GFR). In particular, peritumoral artery classification and diameter were measured to assign arteries into low, moderate, and high Peritumoral Artery Scoring System risk categories. Univariable and multivariable logistic regression analyses were then used to determine risk factors for major renal functional decline. The Peritumoral Artery Scoring System and four other nephrometry systems were compared using receiver operating characteristic curve analysis. The Peritumoral Artery Scoring System was significantly superior to the other systems for predicting postoperative renal function decline (p system was a superior independent predictor of estimated glomerular filtration rate (eGFR) decline (area-under-the-curve = 0.865, p renal function outcome after laparoscopic partial nephrectomy.

  5. LCA single score analysis of man-made cellulose fibres

    NARCIS (Netherlands)

    Shen, L.; Patel, M.K.

    2010-01-01

    In this study, the LCA report “Life Cycle assessment of man-made cellulose fibres” [3] is extended to the single score analysis in order to provide an additional basis for decision making. The single score analysis covers 9 to 11 environmental impact categories. Three single score methods (Single

  6. Epidemiology of Functional abdominal bloating and its impact on health related quality of life: male-female stratified propensity score analysis in a population based survey in mainland China.

    Science.gov (United States)

    Wu, Meijing; Zhao, Yanfang; Wang, Rui; Zheng, Wenxin; Guo, Xiaojing; Wu, Shunquan; Ma, Xiuqiang; He, Jia

    2014-01-01

    The epidemiology of Functional abdominal bloating (FAB) and its impact on health-related quality of life (HRQoL) in Chinese people remains unclear. Randomised, stratified, multi-stage sampling methodology was used to select a representative sample of the general population from five cities in China (n = 16,078). All respondents completed the modified Rome II questionnaire; 20% were asked to complete the 36-item Short Form (SF-36). The associated factors of FAB were analyzed. The effects of FAB on HRQoL were estimated with gender stratification using propensity score techniques in 20% subsample. Overall, 643 individuals (4.00%) had FAB and it was more prevalent in males than in females (4.87% vs. 3.04%, Pproblems (P = 0.030) and bodily pain (PChina was lower than previous reports. Males who had ever been diagnosed with dyspepsia and females who were in a poor self-reported health status were correlated with a higher prevalence of FAB. FAB affected only physical health in females, but impaired both physical and mental health in males.

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

    Science.gov (United States)

    Foley-Peres, Kathleen; Poirier, Dawn

    2008-01-01

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

  8. Estimating NHL Scoring Rates

    OpenAIRE

    Buttrey, Samuel E.; Washburn, Alan R.; Price, Wilson L.; Operations Research

    2011-01-01

    The article of record as published may be located at http://dx.doi.org/10.2202/1559-0410.1334 We propose a model to estimate the rates at which NHL teams score and yield goals. In the model, goals occur as if from a Poisson process whose rate depends on the two teams playing, the home-ice advantage, and the manpower (power-play, short-handed) situation. Data on all the games from the 2008-2009 season was downloaded and processed into a form suitable for the analysis. The model...

  9. Optimizing Scoring and Sampling Methods for Assessing Built Neighborhood Environment Quality in Residential Areas

    Directory of Open Access Journals (Sweden)

    Joel Adu-Brimpong

    2017-03-01

    Full Text Available Optimization of existing measurement tools is necessary to explore links between aspects of the neighborhood built environment and health behaviors or outcomes. We evaluate a scoring method for virtual neighborhood audits utilizing the Active Neighborhood Checklist (the Checklist, a neighborhood audit measure, and assess street segment representativeness in low-income neighborhoods. Eighty-two home neighborhoods of Washington, D.C. Cardiovascular Health/Needs Assessment (NCT01927783 participants were audited using Google Street View imagery and the Checklist (five sections with 89 total questions. Twelve street segments per home address were assessed for (1 Land-Use Type; (2 Public Transportation Availability; (3 Street Characteristics; (4 Environment Quality and (5 Sidewalks/Walking/Biking features. Checklist items were scored 0–2 points/question. A combinations algorithm was developed to assess street segments’ representativeness. Spearman correlations were calculated between built environment quality scores and Walk Score®, a validated neighborhood walkability measure. Street segment quality scores ranged 10–47 (Mean = 29.4 ± 6.9 and overall neighborhood quality scores, 172–475 (Mean = 352.3 ± 63.6. Walk scores® ranged 0–91 (Mean = 46.7 ± 26.3. Street segment combinations’ correlation coefficients ranged 0.75–1.0. Significant positive correlations were found between overall neighborhood quality scores, four of the five Checklist subsection scores, and Walk Scores® (r = 0.62, p < 0.001. This scoring method adequately captures neighborhood features in low-income, residential areas and may aid in delineating impact of specific built environment features on health behaviors and outcomes.

  10. The influence of the number of cells scored on the sensitivity in the comet assay

    DEFF Research Database (Denmark)

    Sharma, Anoop Kumar; Soussaline, Françoise; Sallette, Jerome

    2012-01-01

    The impact on the sensitivity of the in vitro comet assay by increasing the number of cells scored has only been addressed in a few studies. The present study investigated whether the sensitivity of the assay could be improved by scoring more than 100 cells. Two cell lines and three different che...... of the assay. A two-way ANOVA analysis of variance showed that the contribution from the two variables “the number of cells scored” and “concentration” on the total variation in the coefficients of variance dataset was statistically significant (p...

  11. The International Bleeding Risk Score

    DEFF Research Database (Denmark)

    Laursen, Stig Borbjerg; Laine, L.; Dalton, H.

    2017-01-01

    The International Bleeding Risk Score: A New Risk Score that can Accurately Predict Mortality in Patients with Upper GI-Bleeding.......The International Bleeding Risk Score: A New Risk Score that can Accurately Predict Mortality in Patients with Upper GI-Bleeding....

  12. Total space in resolution

    Czech Academy of Sciences Publication Activity Database

    Bonacina, I.; Galesi, N.; Thapen, Neil

    2016-01-01

    Roč. 45, č. 5 (2016), s. 1894-1909 ISSN 0097-5397 R&D Projects: GA ČR GBP202/12/G061 EU Projects: European Commission(XE) 339691 - FEALORA Institutional support: RVO:67985840 Keywords : total space * resolution random CNFs * proof complexity Subject RIV: BA - General Mathematics Impact factor: 1.433, year: 2016 http://epubs.siam.org/doi/10.1137/15M1023269

  13. Calcium scoring with dual-energy CT in men and women: an anthropomorphic phantom study

    Science.gov (United States)

    Li, Qin; Liu, Songtao; Myers, Kyle; Gavrielides, Marios A.; Zeng, Rongping; Sahiner, Berkman; Petrick, Nicholas

    2016-03-01

    This work aimed to quantify and compare the potential impact of gender differences on coronary artery calcium scoring with dual-energy CT. An anthropomorphic thorax phantom with four synthetic heart vessels (diameter 3-4.5 mm: female/male left main and left circumflex artery) were scanned with and without female breast plates. Ten repeat scans were acquired in both single- and dual-energy modes and reconstructed at six reconstruction settings: two slice thicknesses (3 mm, 0.6 mm) and three reconstruction algorithms (FBP, IR3, IR5). Agatston and calcium volume scores were estimated from the reconstructed data using a segmentation-based approach. Total calcium score (summation of four vessels), and male/female calcium scores (summation of male/female vessels scanned in phantom without/with breast plates) were calculated accordingly. Both Agatston and calcium volume scores were found comparable between single- and dual-energy scans (Pearson r= 0.99, pwomen and men in calcium scoring, and for standardizing imaging protocols for improved gender-specific calcium scoring.

  14. Epidemiology of Functional abdominal bloating and its impact on health related quality of life: male-female stratified propensity score analysis in a population based survey in mainland China.

    Directory of Open Access Journals (Sweden)

    Meijing Wu

    Full Text Available BACKGROUND: The epidemiology of Functional abdominal bloating (FAB and its impact on health-related quality of life (HRQoL in Chinese people remains unclear. METHODS: Randomised, stratified, multi-stage sampling methodology was used to select a representative sample of the general population from five cities in China (n = 16,078. All respondents completed the modified Rome II questionnaire; 20% were asked to complete the 36-item Short Form (SF-36. The associated factors of FAB were analyzed. The effects of FAB on HRQoL were estimated with gender stratification using propensity score techniques in 20% subsample. RESULTS: Overall, 643 individuals (4.00% had FAB and it was more prevalent in males than in females (4.87% vs. 3.04%, P<0.001. For males, self-reported history of dyspepsia was most strongly associated with FAB (OR = 2.78; 95% CI: 1.59, 4.72. However, the most strongly associated factor was self-reported health status for females (moderate health vs. good health: OR = 2.06, 95% CI: 1.07, 3.96. P = 0.030; poor health vs. good health: OR = 5.71, 95% CI: 2.06, 15.09. Concerning HRQoL, FAB was found to be related to two domains: role limitation due to physical problems (P = 0.030 and bodily pain (P<0.001 in females. While, in males, there were significant differences in multiple domains between those with and without FAB. CONCLUSION: The prevalence of FAB in China was lower than previous reports. Males who had ever been diagnosed with dyspepsia and females who were in a poor self-reported health status were correlated with a higher prevalence of FAB. FAB affected only physical health in females, but impaired both physical and mental health in males.

  15. Optimization of Conditions for Extraction of Polyphenols and the Determination of the Impact of Cooking on Total Polyphenolic, Antioxidant, and Anticholinesterase Activities of Potato

    Science.gov (United States)

    Laib, Imen; Barkat, Malika

    2018-01-01

    In this work we optimized the cooking and extraction conditions for obtaining high yields of total polyphenols from potato and studied the effect of three domestic methods of cooking on total phenols, antioxidant activity, and anticholinesterase activities. The optimization of the experiment was carried out by the experimental designs. The extraction of the polyphenols was carried out by maceration and ultrasonication. Determination of the polyphenols was performed by using the Folin-Ciocalteau reagent method. The antioxidant activity was evaluated by three methods: 1,1-diphenyl-2-picryl-hydrazyl (DPPH), 2,2′-azino-bis(3-ethylbenzothiazoline-6-sulphonic acid) (ABTS), and CUPRAC(Cupric reducing antioxidant capacity), the anticholinesterase activity was evaluated by the method of Elmann. The optimum of total phenolic obtained was: 4.668 × 104, 1.406 × 104, 3357.009, 16,208.99 µg Gallic Acid Equivalent (GAE)/g of dry extract for crude potato, steamed potatoes, in boiling water, and by microwave, respectively. The three modes of cooking cause a decrease in the total polyphenol contents, antioxidant and anticholinesterase activities. PMID:29522482

  16. Impact of total PSA, PSA doubling time and PSA velocity on detection rates of 11C-Choline positron emission tomography in recurrent prostate cancer

    NARCIS (Netherlands)

    Rybalov, Maxim; Breeuwsma, Anthonius J.; Leliveld, Anna M.; Pruim, Jan; Dierckx, Rudi A.; de Jong, Igle J.

    PURPOSE: To evaluate the effect of total PSA (tPSA) and PSA kinetics on the detection rates of (11)C-Choline PET in patients with biochemical recurrence (BCR) after radical prostatectomy (RP) or external beam radiotherapy (EBRT). METHODS: We included 185 patients with BCR after RP (PSA >0.2 ng/ml)

  17. The Effect of English Language on Multiple Choice Question Scores of Thai Medical Students.

    Science.gov (United States)

    Phisalprapa, Pochamana; Muangkaew, Wayuda; Assanasen, Jintana; Kunavisarut, Tada; Thongngarm, Torpong; Ruchutrakool, Theera; Kobwanthanakun, Surapon; Dejsomritrutai, Wanchai

    2016-04-01

    Universities in Thailand are preparing for Thailand's integration into the ASEAN Economic Community (AEC) by increasing the number of tests in English language. English language is not the native language of Thailand Differences in English language proficiency may affect scores among test-takers, even when subject knowledge among test-takers is comparable and may falsely represent the knowledge level of the test-taker. To study the impact of English language multiple choice test questions on test scores of medical students. The final examination of fourth-year medical students completing internal medicine rotation contains 120 multiple choice questions (MCQ). The languages used on the test are Thai and English at a ratio of 3:1. Individual scores of tests taken in both languages were collected and the effect of English language on MCQ was analyzed Individual MCQ scores were then compared with individual student English language proficiency and student grade point average (GPA). Two hundred ninety five fourth-year medical students were enrolled. The mean percentage of MCQ scores in Thai and English were significantly different (65.0 ± 8.4 and 56.5 ± 12.4, respectively, p English was fair (Spearman's correlation coefficient = 0.41, p English than in Thai language. Students were classified into six grade categories (A, B+, B, C+, C, and D+), which cumulatively measured total internal medicine rotation performance score plus final examination score. MCQ scores from Thai language examination were more closely correlated with total course grades than were the scores from English language examination (Spearman's correlation coefficient = 0.73 (p English proficiency score was very high, at 3.71 ± 0.35 from a total of 4.00. Mean student GPA was 3.40 ± 0.33 from a possible 4.00. English language MCQ examination scores were more highly associated with GPA than with English language proficiency. The use of English language multiple choice question test may decrease scores

  18. Gap in gender parity: gender disparities in incidence and clinical impact of chronic total occlusion in non-infarct artery in patients with non-ST-segment elevation myocardial infarction and multivessel coronary artery disease.

    Science.gov (United States)

    Tajstra, Mateusz; Hawranek, Michał; Desperak, Piotr; Ciślak, Aneta; Gąsior, Mariusz

    2017-10-03

    A chronic total occlusion in a non-infarct-related artery is an independent predictor of mortality in non-ST elevation myocardial infarction. There are no mortality data about the impact of a chronic total occlusion in patients with non-ST elevation myocardial infarction according to gender. The purpose of this study was to evaluate the prevalence of the chronic total occlusion in in men and women and examine its impact on clinical outcomes. Data from consecutive patients with multivessel coronary artery disease treated in a high-volume center between 2006 and 2012 were included in a prospective registry and divided according to gender and the presence of chronic total occlusion. All of the analyzed patients were followed up for at least 24 months, with all-cause mortality defined as the primary endpoint. Among the 515 patients who fulfilled the inclusion criteria, 32.8% were female. In the female arm, the 24-month mortality for the groups with and without chronic total occlusion was similar (18.9% and 14.7%, respectively; p = 0.47). In contrast, in the male arm, the occurrence of chronic total occlusion was associated with higher 24-month mortality (24.3% vs. 13.4%; p = 0.009). Multivariate analysis of the male arm revealed a trend toward a positive association between the occurrence of chronic total occlusion and 24-month mortality (HR 1.62; 95% CI 0.93-2.83; p = 0.087). The presence of chronic total occlusion in men is associated with an adverse long-term prognosis, whereas in women this effect was not observed.

  19. The impact of pre-operative weight loss on incidence of surgical site infection and readmission rates after total joint arthroplasty.

    Science.gov (United States)

    Inacio, Maria C S; Kritz-Silverstein, Donna; Raman, Rema; Macera, Caroline A; Nichols, Jeanne F; Shaffer, Richard A; Fithian, Donald C

    2014-03-01

    This study characterized a cohort of obese total hip arthroplasty (THA) and total knee arthroplasty (TKA) patients (1/1/2008-12/31/2010) and evaluated whether a clinically significant amount of pre-operative weight loss (5% decrease in body weight) is associated with a decreased risk of surgical site infections (SSI) and readmissions post-surgery. 10,718 TKAs and 4066 THAs were identified. During the one year pre-TKA 7.6% of patients gained weight, 12.4% lost weight, and 79.9% remained the same. In the one year pre-THA, 6.3% of patients gained weight, 18.0% lost weight, and 75.7% remained the same. In TKAs and THAs, after adjusting for covariates, the risk of SSI and readmission was not significantly different in the patients who gained or lost weight pre-operatively compared to those who remained the same. © 2013.

  20. Impact of total organic carbon (in sediments) and dissolved organic carbon (in overlying water column) on Hg sequestration by coastal sediments from the central east coast of India

    Digital Repository Service at National Institute of Oceanography (India)

    Chakrabortya, P.; Sharma, B.M.; Babu, P.V.R.; Yao, K.M.; Jaychandran, S.

    , 1991; Liu et al., 2006; Tack and Verloo, 1995). Mercury accumulates in sediment globally from many physical, chemical, biological, geological and anthropogenic environmental processes. Thus, sediment can be a good indicator of water quality of a...-Black method (Schumacher, 2002). This method has been widely used for the determination of total organic carbon in the soil and sediments. 3.0 Results and discussion The general description and texture analysis of the studied sediments are presented...

  1. The impact of food and nutrient-based standards on primary school children's lunch and total dietary intake: a natural experimental evaluation of government policy in England.

    Science.gov (United States)

    Spence, Suzanne; Delve, Jennifer; Stamp, Elaine; Matthews, John N S; White, Martin; Adamson, Ashley J

    2013-01-01

    In 2005, the nutritional content of children's school lunches in England was widely criticised, leading to a major policy change in 2006. Food and nutrient-based standards were reintroduced requiring primary schools to comply by September 2008. We aimed to determine the effect of the policy on the nutritional content at lunchtime and in children's total diet. We undertook a natural experimental evaluation, analysing data from cross-sectional surveys in 12 primary schools in North East England, pre and post policy. Dietary data were collected on four consecutive days from children aged 4-7 years (n = 385 in 2003-4; n = 632 in 2008-9). We used linear mixed effect models to analyse the effects of gender, year, and lunch type on children's mean total daily intake. Both pre- and post-implementation, children who ate a school lunch consumed less sodium (mean change -128 mg, 95% CI: -183 to -73 mg) in their total diet than children eating home-packed lunches. Post-implementation, children eating school lunches consumed a lower % energy from fat (-1.8%, -2.8 to -0.9) and saturated fat (-1.0%; -1.6 to -0.5) than children eating packed lunches. Children eating school lunches post implementation consumed significantly more carbohydrate (16.4 g, 5.3 to 27.6), protein (3.6 g, 1.1 to 6.0), non-starch polysaccharides (1.5 g, 0.5 to 1.9), vitamin C (0.7 mg, 0.6 to 0.8), and folate (12.3 µg, 9.7 to 20.4) in their total diet than children eating packed lunches. Implementation of school food policy standards was associated with significant improvements in the nutritional content of school lunches; this was reflected in children's total diet. School food- and nutrient-based standards can play an important role in promoting dietary health and may contribute to tackling childhood obesity. Similar policy measures should be considered for other environments influencing children's diet.

  2. The impact of food and nutrient-based standards on primary school children's lunch and total dietary intake: a natural experimental evaluation of government policy in England.

    Directory of Open Access Journals (Sweden)

    Suzanne Spence

    Full Text Available In 2005, the nutritional content of children's school lunches in England was widely criticised, leading to a major policy change in 2006. Food and nutrient-based standards were reintroduced requiring primary schools to comply by September 2008. We aimed to determine the effect of the policy on the nutritional content at lunchtime and in children's total diet. We undertook a natural experimental evaluation, analysing data from cross-sectional surveys in 12 primary schools in North East England, pre and post policy. Dietary data were collected on four consecutive days from children aged 4-7 years (n = 385 in 2003-4; n = 632 in 2008-9. We used linear mixed effect models to analyse the effects of gender, year, and lunch type on children's mean total daily intake. Both pre- and post-implementation, children who ate a school lunch consumed less sodium (mean change -128 mg, 95% CI: -183 to -73 mg in their total diet than children eating home-packed lunches. Post-implementation, children eating school lunches consumed a lower % energy from fat (-1.8%, -2.8 to -0.9 and saturated fat (-1.0%; -1.6 to -0.5 than children eating packed lunches. Children eating school lunches post implementation consumed significantly more carbohydrate (16.4 g, 5.3 to 27.6, protein (3.6 g, 1.1 to 6.0, non-starch polysaccharides (1.5 g, 0.5 to 1.9, vitamin C (0.7 mg, 0.6 to 0.8, and folate (12.3 µg, 9.7 to 20.4 in their total diet than children eating packed lunches. Implementation of school food policy standards was associated with significant improvements in the nutritional content of school lunches; this was reflected in children's total diet. School food- and nutrient-based standards can play an important role in promoting dietary health and may contribute to tackling childhood obesity. Similar policy measures should be considered for other environments influencing children's diet.

  3. Preoperative Controlling Nutritional Status (CONUT) Score for Assessment of Prognosis Following Hepatectomy for Hepatocellular Carcinoma.

    Science.gov (United States)

    Takagi, Kosei; Yagi, Takahito; Umeda, Yuzo; Shinoura, Susumu; Yoshida, Ryuichi; Nobuoka, Daisuke; Kuise, Takashi; Araki, Hiroyuki; Fujiwara, Toshiyoshi

    2017-09-01

    Immune-nutritional status has been recently reported as a prognostic factor in hepatocellular carcinoma (HCC). The controlling nutritional status (CONUT) score has been established as a useful tool to evaluate immune-nutritional status. This study aimed to investigate the efficacy of the CONUT score as a prognostic factor in patients undergoing hepatectomy for HCC. A total of 295 patients who underwent curative hepatectomy for HCC between January 2007 and December 2014 were retrospectively analyzed. Patients were divided into two groups according to the CONUT score. The impact of the CONUT score on clinicopathological, surgical, and long-term outcomes was evaluated. Subsequently, the impact of prognostic factors, including the CONUT score, associated with outcomes was assessed using multivariate analyses. Of 295 patients, 118 (40%) belonged to the high CONUT group (CONUT score ≥ 3). The high CONUT group had a significantly lower 5-year recurrence-free survival rate than the low CONUT group (27.9 vs. 41.4%, p = 0.011) and a significantly lower 5-year overall survival rate (61.9 vs. 74.9%, p = 0.006). In multivariate analyses of prognostic factors, the CONUT score was an independent predictor of recurrence-free survival (hazard ratio = 1.64, p = 0.006) and overall survival (hazard ratio = 2.50, p = 0.001). The CONUT score is a valuable preoperative predictor of survival in patients undergoing hepatectomy for HCC.

  4. Do Test Scores Buy Happiness?

    Science.gov (United States)

    McCluskey, Neal

    2017-01-01

    Since at least the enactment of No Child Left Behind in 2002, standardized test scores have served as the primary measures of public school effectiveness. Yet, such scores fail to measure the ultimate goal of education: maximizing happiness. This exploratory analysis assesses nation level associations between test scores and happiness, controlling…

  5. Predicting occupational personality test scores.

    Science.gov (United States)

    Furnham, A; Drakeley, R

    2000-01-01

    The relationship between students' actual test scores and their self-estimated scores on the Hogan Personality Inventory (HPI; R. Hogan & J. Hogan, 1992), an omnibus personality questionnaire, was examined. Despite being given descriptive statistics and explanations of each of the dimensions measured, the students tended to overestimate their scores; yet all correlations between actual and estimated scores were positive and significant. Correlations between self-estimates and actual test scores were highest for sociability, ambition, and adjustment (r = .62 to r = .67). The results are discussed in terms of employers' use and abuse of personality assessment for job recruitment.

  6. Total 2003 Results

    International Nuclear Information System (INIS)

    2003-01-01

    This document presents the 2003 results of Total Group: consolidated account, special items, number of shares, market environment, 4. quarter 2003 results, full year 2003 results, upstream (key figures, proved reserves), downstream key figures, chemicals key figures, parent company accounts and proposed dividends, 2004 sensitivities, summary and outlook, operating information by segment for the 4. quarter and full year 2003: upstream (combined liquids and gas production by region, liquids production by region, gas production by region), downstream (refinery throughput by region, refined product sales by region, chemicals), impact of allocating contribution of Cepsa to net operating income by business segment: equity in income (loss) and affiliates and other items, Total financial statements: consolidated statement of income, consolidated balance sheet (assets, liabilities and shareholder's equity), consolidated statements of cash flows, business segments information. (J.S.)

  7. Lower Bounds to the Reliabilities of Factor Score Estimators.

    Science.gov (United States)

    Hessen, David J

    2016-10-06

    Under the general common factor model, the reliabilities of factor score estimators might be of more interest than the reliability of the total score (the unweighted sum of item scores). In this paper, lower bounds to the reliabilities of Thurstone's factor score estimators, Bartlett's factor score estimators, and McDonald's factor score estimators are derived and conditions are given under which these lower bounds are equal. The relative performance of the derived lower bounds is studied using classic example data sets. The results show that estimates of the lower bounds to the reliabilities of Thurstone's factor score estimators are greater than or equal to the estimates of the lower bounds to the reliabilities of Bartlett's and McDonald's factor score estimators.

  8. Quality of life and deglutition after total laryngectomy

    Science.gov (United States)

    Pernambuco, Leandro de Araújo; Oliveira, Jabson Herber Profiro de; Régis, Renata Milena Freitas Lima; Lima, Leilane Maria de; Araújo, Ana Maria Bezerra de; Balata, Patrícia Maria Mendes; Cunha, Daniele Andrade da; Silva, Hilton Justino da

    2012-01-01

    Summary Introduction: Total laryngectomy creates deglutition disorders and causes a decrease in quality of life Aim: To describe the impact of swallowing and quality of life of patients after total laryngectomy. Method: A case series study. Patients completed a Swallowing and Quality of Life questionnaire composed of 44 questions assessing 11 domains related to quality of life (burden, eating duration, eating desire, frequency of symptoms, food selection, communication, fear, mental health, social functioning, sleep, and fatigue). The analysis was performed using descriptive statistics, including measures of central tendency and variability. Results: The sample comprised 15 patients who underwent total laryngectomy and adjuvant radiotherapy. Of these, 66.7% classified their health as good and 73% reported no restrictions on food consistency. The domains “communication” and “fear” represented severe impact and “eating duration” represented moderate impact on quality of life. The items with lower scores were: longer time to eat than others (domain “eating duration”), cough and cough to remove the liquid or food of the mouth when they are stopped (domain “symptom frequency”), difficulties in understanding (domain “communication”) and fear of choking and having pneumonia (domain “fear”). Conclusion: After total laryngectomy, patients report that swallowing issues have moderate to severe impact in “communication,” “fear,” and “eating duration” domains. PMID:25991974

  9. The Danish Prostatic Symptom Score (DAN-PSS-1) questionnaire is reliable in stroke patients

    DEFF Research Database (Denmark)

    Tibaek, Sigrid; Jensen, Rigmor; Klarskov, Peter

    2006-01-01

    . The questionnaire consists of 12 questions related to lower urinary tract symptoms (LUTS). The participants were asked to state the frequency and severity of their symptoms (symptom score) and its impact on their daily life (bother score). Seventy-one stroke patients were included and 59 (83%) answered...... the questionnaire twice. The reliability test was done in two aspects: (a) detecting the frequency of each symptom and its bother factor, the scores were reduced to a two-category scale (=0, >0) and simple kappa statistics was used; (b) detecting the severity of each symptom and its bother factor, the total scale...... (kappa(w) = 0.48) to good (kappa(w) = 0.68). CONCLUSIONS: The DAN-PSS-1 questionnaire had acceptable test-retest reliability and may be suitable for measuring the frequency and severity of LUTS and its bother factor in stroke patients....

  10. The Impact of Total Quality Management Practices towards Competitive Advantage and Organizational Performance: Case of Fishery Industry in South Sulawesi Province of Indonesia

    Directory of Open Access Journals (Sweden)

    Musran Munizu

    2013-05-01

    Full Text Available This study attempt to test the effect of Total Quality Management (TQM practices towards competitive advantage and organizational performance. The design of this research has quantitative approach. Data was collected by questionnaire instrument. The unit of analysis is big and medium scale fishery companies. The respondents in this research are the managers of fishery companies. The study utilized primary data which is obtained through questionnaire. The number of population was 66 fishery companies in South Sulawesi Province, Indonesia. Random sampling is used in the study. 55 complete questionnaires were returned as a final sample. Three hypotheses have been developed through literature review and tested using Path Analysis performed by SPSS 18.00 software. The results show that TQM practices have positive and significant effect both on organizational performance and competitive advantage. Competitive advantage has a positive and significant effect on organizational performance. Organizational performance is more influenced by competitive advantage than TQM practices.

  11. Total L-shell X-ray production cross sections by 400-700 keV proton impact for elements with 34≤Z≤53

    International Nuclear Information System (INIS)

    Miranda, J.; Ledesma, R.; Lucio, O.G. de

    2001-01-01

    Total L-shell X-ray production cross sections induced by protons with energies between 400 and 700 keV were measured for elements with atomic number Z between 34 and 53. The ECPSSR theory describes appropriately the results. This model modifies the plane wave born approximation by considering projectile energy loss (E), Coulomb deflection of the incoming ion (C), polarization and change in electron binding energies through a perturbed stationary states method (PSS) and relativistic values of target electron mass (R). A comparison is given with previously published data for proton energies below 1 MeV and 26 ≤ Z ≤ 53, based on a scaling obtained from a reduced velocity parameter ξ L R . The results show that the scaling for these atomic numbers and energy ranges is adequate and a semi-empirical expression to calculate those cross sections is proposed

  12. Impact of lesion morphology on angiographic and clinical outcomes in patients with chronic total occlusion after recanalization with drug-eluting stents: a multislice computed tomography study

    Energy Technology Data Exchange (ETDEWEB)

    Ito, Tsuyoshi [Toyohashi Heart Center, Toyohashi (Japan); Nagoya City University Graduate School of Medical Sciences, Department of Cardio-Renal Medicine and Hypertension, Nagoya (Japan); Tsuchikane, Etsuo; Nasu, Kenya; Kimura, Masashi; Terashima, Mitsuyasu; Kinoshita, Yoshihisa; Habara, Maoto; Suzuki, Takahiko [Toyohashi Heart Center, Toyohashi (Japan); Suzuki, Yoriyasu; Ehara, Mariko [Nagoya Heart Center, Nagoya (Japan); Ohte, Nobuyuki [Nagoya City University Graduate School of Medical Sciences, Department of Cardio-Renal Medicine and Hypertension, Nagoya (Japan)

    2015-10-15

    The aim of this study was to investigate the multislice computed tomography (MSCT) parameters associated with adverse outcomes after chronic total occlusion percutaneous coronary intervention (CTO-PCI) with drug-eluting stents. A total of 285 patients who underwent MSCT before CTO-PCI were analyzed. Lesion morphology was assessed with MSCT. Angiographic restenosis, reocclusion, and MACE (a composite of cardiac death, myocardial infarction, stent thrombosis, and target lesion revascularization) were analyzed. MACE was observed in 36 patients (13.6 %). Occlusion length was greater (39.5 ± 19.9 mm vs. 22.3 ± 13.7 mm, p < 0.01), minimal vessel area smaller (11.2 ± 5.7 mm{sup 2} vs. 14.5 ± 5.6 mm{sup 2}, p < 0.01), and severe calcification more common (36 % vs. 12 %, p < 0.01) in the MACE group compared to the non-MACE group. We defined occluded length >25.4 mm, minimal vessel area <11.9 mm{sup 2}, which were identified by receiver operating characteristic analysis, and severe calcification as CT-derived risk factors. Angiographic restenosis (60 % vs. 12 % vs. 7 %, p < 0.01), reocclusion (29 % vs. 2 % vs. 2 %, p < 0.01), and MACE (43 % vs. 6 % vs. 3 %, p < 0.01) were more common in patients with 2 or more risk factors than in those with 1 or 0. MSCT characteristics associated with adverse outcomes after CTO-PCI were occlusion length, minimal vessel area, and severe calcification. (orig.)

  13. An analysis of the impact of native oxide, surface contamination and material density on total electron yield in the absence of surface charging effects

    Energy Technology Data Exchange (ETDEWEB)

    Iida, Susumu, E-mail: susumu.iida@toshiba.co.jp [EUVL Infrastructure Development Center, Inc., 16-1 Onogawa, Tsukuba-shi, Ibaraki-ken, 305-8569 (Japan); Ohya, Kaoru [Institute of Technology and Science, The University of Tokushima, 2-1 Minamijyousanjima-cho,Tokushima, 770-8506 (Japan); Hirano, Ryoichi; Watanabe, Hidehiro [EUVL Infrastructure Development Center, Inc., 16-1 Onogawa, Tsukuba-shi, Ibaraki-ken, 305-8569 (Japan)

    2016-10-30

    Highlights: • Total electron yields were assessed in the absence of any surface charging effect. • Experimental and simulation results showed a low native oxide energy barrier. • The yield enhancement effect of a native oxide layer was confirmed. • The yield enhancement effect of a thin surface contamination layer was confirmed. • Deviations in the material density from the theoretical values were evaluated. - Abstract: The effects of the presence of a native oxide film or surface contamination as well as variations in material density on the total electron yield (TEY) of Ru and B{sub 4}C were assessed in the absence of any surface charging effect. The experimental results were analyzed using semi-empirical Monte Carlo simulations and demonstrated that a native oxide film increased the TEY, and that this effect varied with film thickness. These phenomena were explained based on the effect of the backscattered electrons (BSEs) at the interface between Ru and RuO{sub 2}, as well as the lower potential barrier of RuO{sub 2}. Deviations in the material density from the theoretical values were attributed to the film deposition procedure based on fitting simulated TEY curves to experimental results. In the case of B{sub 4}C, the TEY was enhanced by the presence of a 0.8-nm-thick surface contamination film consisting of oxygenated hydrocarbons. The effect of the low potential barrier of the contamination film was found to be significant, as the density of the B{sub 4}C was much lower than that of the Ru. Comparing the simulation parameters generated in the present work with Joy’s database, it was found that the model and the input parameters used in the simulations were sufficiently accurate.

  14. The Impact of Total Liberalization of Domestic Air Transport on the Social Welfare and on the Dynamic of Competition: Comparison Between the United States and the European Union

    Science.gov (United States)

    Zbidi, Karim

    2003-01-01

    Since the lst of April 1997 date of the implementation of the third package of the liberalization, air transport, within the european Union has become totally liberalized. In the United States the deregulation of domestic air traffic was earlier and faster since it took place in October 1978 after the adoption of the only act of deregulation. This paper, in its first part, deals with the liberalization of the industry of air traffic in the european union. After a comparison with US system based on market demand, fare policy and network restrictions, we present our descriptive results coming from treatments on the OAG data. These results present several aspects such as the evolution of the competitive structure of the intra-european routes, the level of airport dominance and the growth of hub structure. The second part of the paper presents models of entry in the airline industry. As profitability" of route flown explains correctly decisions taken by airlines to serve or not a route, the paper focuses on the specification and the estimation of the determinants of city, pair profitability in the european union. Treatments done on the OAG data show a rapid development of leasing space agreement (partial and total) and code sharing practices between 1995 and 2000 in Europe that's why we differentiate first between the two type of competitive strategy of entry(direct entry and leasing space agreement) and second between the competitive strategy of entry and the alliance strategy of code sharing. So the estimation of model will be able to answer the question if the european air transport market is contestable and in case not to see if the decision of entry is more directed by the level of airport dominance (as in the domestic United States market)or essentially by the competitive structure of the routes. We try to explain the nature of entry(directleasing or code sharing) by the different levels of these two determinants.

  15. Impact of Indian Total Sanitation Campaign on latrine coverage and use: a cross-sectional study in Orissa three years following programme implementation.

    Directory of Open Access Journals (Sweden)

    Sharmani Barnard

    Full Text Available BACKGROUND: Faced with a massive shortfall in meeting sanitation targets, some governments have implemented campaigns that use subsidies focused on latrine construction to overcome income constraints and rapidly expand coverage. In settings like rural India where open defecation is common, this may result in sub-optimal compliance (use, thereby continuing to leave the population exposed to human excreta. METHODS: We conducted a cross-sectional study to investigate latrine coverage and use among 20 villages (447 households, 1933 individuals in Orissa, India where the Government of India's Total Sanitation Campaign had been implemented at least three years previously. We defined coverage as the proportion of households that had a latrine; for use we identified the proportion of households with at least one reported user and among those, the extent of reported use by each member of the household. RESULTS: Mean latrine coverage among the villages was 72% (compared to <10% in comparable villages in the same district where the Total Sanitation Campaign had not yet been implemented, though three of the villages had less than 50% coverage. Among these households with latrines, more than a third (39% were not being used by any member of the household. Well over a third (37% of the members of households with latrines reported never defecating in their latrines. Less than half (47% of the members of such households reported using their latrines at all times for defecation. Combined with the 28% of households that did not have latrines, it appears that most defecation events in these communities are still practiced in the open. CONCLUSION: A large-scale campaign to implement sanitation has achieved substantial gains in latrine coverage in this population. Nevertheless, gaps in coverage and widespread continuation of open defecation will result in continued exposure to human excreta, reducing the potential for health gains.

  16. Impact of hybrid iterative reconstruction on Agatston coronary artery calcium scores in comparison to filtered back projection in native cardiac CT; Einfluss der hybriden iterativen Rekonstruktion bei der nativen CT des Herzens auf die Agatston-Kalziumscores der Koronararterien

    Energy Technology Data Exchange (ETDEWEB)

    Obmann, V.C.; Heverhagen, J.T. [Inselspital - University Hospital Bern (Switzerland). University Inst. for Diagnostic, Interventional and Pediatric Radiology; Klink, T. [Wuerzburg Univ. (Germany). Inst. of Diagnostic and Interventional Radiology; Stork, A.; Begemann, P.G.C. [Roentgeninstitut Duesseldorf, Duesseldorf (Germany); Laqmani, A.; Adam, G. [University Medical Center Hamburg-Eppendorf, Hamburg (Germany). Dept. of Diagnostic and Interventional Radiology

    2015-05-15

    To investigate whether the effects of hybrid iterative reconstruction (HIR) on coronary artery calcium (CAC) measurements using the Agatston score lead to changes in assignment of patients to cardiovascular risk groups compared to filtered back projection (FBP). 68 patients (mean age 61.5 years; 48 male; 20 female) underwent prospectively ECG-gated, non-enhanced, cardiac 256-MSCT for coronary calcium scoring. Scanning parameters were as follows: Tube voltage, 120 kV; Mean tube current time-product 63.67 mAs (50 - 150 mAs); collimation, 2 x 128 x 0.625 mm. Images were reconstructed with FBP and with HIR at all levels (L1 to L7). Two independent readers measured Agatston scores of all reconstructions and assigned patients to cardiovascular risk groups. Scores of HIR and FBP reconstructions were correlated (Spearman). Interobserver agreement and variability was assessed with k-statistics and Bland-Altmann-Plots. Agatston scores of HIR reconstructions were closely correlated with FBP reconstructions (L1, R = 0.9996; L2, R = 0.9995; L3, R = 0.9991; L4, R = 0.986; L5, R = 0.9986; L6, R = 0.9987; and L7, R = 0.9986). In comparison to FBP, HIR led to reduced Agatston scores between 97% (L1) and 87.4% (L7) of the FBP values. Using HIR iterations L1-L3, all patients were assigned to identical risk groups as after FPB reconstruction. In 5.4% of patients the risk group after HIR with the maximum iteration level was different from the group after FBP reconstruction. There was an excellent correlation of Agatston scores after HIR and FBP with identical risk group assignment at levels 1 - 3 for all patients. Hence it appears that the application of HIR in routine calcium scoring does not entail any disadvantages. Thus, future studies are needed to demonstrate whether HIR is a reliable method for reducing radiation dose in coronary calcium scoring.

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

    Science.gov (United States)

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

    2016-11-01

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

  18. Impact of revascularization of coronary chronic total occlusion on left ventricular function and electrical stability: analysis by speckle tracking echocardiography and signal-averaged electrocardiogram.

    Science.gov (United States)

    Sotomi, Yohei; Okamura, Atsunori; Iwakura, Katsuomi; Date, Motoo; Nagai, Hiroyuki; Yamasaki, Tomohiro; Koyama, Yasushi; Inoue, Koichi; Sakata, Yasushi; Fujii, Kenshi

    2017-06-01

    The present study aimed to assess the mechanisms of effects of percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) from two different aspects: left ventricular (LV) systolic function assessed by two-dimensional speckle tracking echocardiography (2D-STE) and electrical stability evaluated by late potential on signal-averaged electrocardiogram (SAECG). We conducted a prospective observational study with consecutive CTO-PCI patients. 2D-STE and SAECG were performed before PCI, and after 1-day and 3-months of procedure. 2D-STE computed global longitudinal strain (GLS) and regional longitudinal strain (RLS) in CTO area, collateral blood-supplying donor artery area, and non-CTO/non-donor area. A total of 37 patients (66 ± 11 years, 78% male) were analyzed. RLS in CTO and donor areas and GLS were significantly improved 1-day after the procedure, but these improvements diminished during 3 months. The improvement of RLS in donor area remained significant after 3-months the index procedure (pre-PCI -13.4 ± 4.8% vs. post-3M -15.1 ± 4.5%, P = 0.034). RLS in non-CTO/non-donor area and LV ejection fraction were not influenced. Mitral annulus velocity was improved at 3-month follow-up (5.0 ± 1.4 vs. 5.6 ± 1.7 cm/s, P = 0.049). Before the procedure, 12 patients (35%) had a late potential. All components of the late potential (filtered QRS duration, root-mean-square voltage in the terminal 40 ms, and duration of the low amplitude signal <40 μV) were not improved. CTO-PCI improved RLS in the donor area at 3-month follow-up without changes of LV ejection fraction. Although higher prevalence of late potential in the current population compared to healthy population was observed, late potential as a surrogate of arrhythmogenic substrate was not influenced by CTO-PCI.

  19. The impact of "Ramadan fasting period" on total and differential white blood cells, haematological indices, inflammatory biomarker, respiratory symptoms and pulmonary function tests of healthy and asthmatic patients.

    Science.gov (United States)

    Askari, V R; Alavinezhad, A; Boskabady, M H

    2016-01-01

    There is no conclusive evidence regarding the effect of fasting on different features in asthmatic patients. In the present study, the effect of Ramadan fasting in asthmatic patients and healthy control was studied. Haematological indices, inflammatory mediators, pulmonary function tests (PFT) and respiratory symptoms were evaluated in 15 asthmatic patients compared to 14 healthy matched control group before and after the one-month fasting period in Ramadan. The change in each parameter from the beginning to the end of Ramadan was calculated and referred to as "variation during Ramadan". The values of MCH, MCHC in both groups and monocyte counts in asthmatic patients, were significantly increased but platelet count was reduced in asthmatic and controls respectively compared to pre-Ramadan fasting period (Pfasting month (Pfasting month in both groups were non-significantly higher compared to pre-fasting values except FVC. Respiratory symptoms in asthmatic patients were non-significantly but wheeze-o was significantly reduced after Ramadan fasting period in asthma group (Pfasting period between two groups, although reduction of hs-CRP in asthmatic group was non-significantly higher than control group. These results show that Ramadan fasting period has no negative impact on asthma and may have some positive effect on asthma severity with regard to reduction of hs-CRP concentration and chest wheeze. Copyright © 2016 SEICAP. Published by Elsevier España, S.L.U. All rights reserved.

  20. Dry anaerobic co-digestion of food waste and cattle manure: Impact of total solids, substrate ratio and thermal pre treatment on methane yield and quality of biomanure.

    Science.gov (United States)

    Arelli, Vijayalakshmi; Begum, Sameena; Anupoju, Gangagni Rao; Kuruti, Kranti; S, Shailaja

    2018-04-01

    The objective of the present study is to assess the impact of TS concentration, substrate mixing ratio (co digestion) and thermal pretreatment on biogas production, methane yield, VS reduction (%) and quality of biomanure through dry anaerobic digestion (DAD) of food waste (FW) and cattle manure (CM). Results divulged that the optimum methane yield and biomanure of 0.18 and 0.21 m 3 CH 4 /(kg VS reduced) and 3.15 and 2.8 kg/kg waste was obtained from FW at TS of 25% and 30% at an HRT of 41 and 31 days respectively whereas it was 0.32 and 0.43 m 3 CH 4 /(kg VS reduced) and 2.2 and 1.15 kg/kg waste from pretreated FW at an HRT of 16 and 20 days correspondingly. Improvement of methane from 62 to 81% was obtained due to thermal pretreatment. The highest nutrient recovery in terms of N, P, K was found to be 5.14, 2.6 and 3.2 respectively. Copyright © 2018 Elsevier Ltd. All rights reserved.

  1. Impact of Variety and Agronomic Factors on Crude Protein and Total Lysine in Chicory; N(ε)-Carboxymethyl-lysine-Forming Potential during Drying and Roasting.

    Science.gov (United States)

    Loaëc, Grégory; Niquet-Léridon, Céline; Henry, Nicolas; Jacolot, Philippe; Jouquand, Céline; Janssens, Myriam; Hance, Philippe; Cadalen, Thierry; Hilbert, Jean-Louis; Desprez, Bruno; Tessier, Frédéric J

    2015-12-02

    During the heat treatment of coffee and its substitutes some compounds potentially deleterious to health are synthesized by the Maillard reaction. Among these, N(ε)-carboxymethyl-lysine (CML) was detected at high levels in coffee substitutes. The objective of this study was to evaluate the impact of changes in agricultural practice on the lysine content present in chicory roots and try to limit CML formation during roasting. Of the 24 varieties analyzed, small variations in lysine content were observed, 213 ± 8 mg/100 g dry matter (DM). The formation of lysine tested in five commercial varieties was affected by the nitrogen treatment with mean levels of 176 ± 2 mg/100 g DM when no fertilizer was added and 217 ± 7 mg/100 g DM with a nitrogen supply of 120 kg/ha. The lysine content of fresh roots was significantly correlated to the concentration of CML formed in roasted roots (r = 0.51; p < 0.0001; n = 76).

  2. Structural and biochemical changes induced by pulsed electric field treatments on Cabernet Sauvignon grape berry skins: impact on cell wall total tannins and polysaccharides.

    Science.gov (United States)

    Cholet, Céline; Delsart, Cristèle; Petrel, Mélina; Gontier, Etienne; Grimi, Nabil; L'hyvernay, Annie; Ghidossi, Remy; Vorobiev, Eugène; Mietton-Peuchot, Martine; Gény, Laurence

    2014-04-02

    Pulsed electric field (PEF) treatment is an emerging technology that is arousing increasing interest in vinification processes for its ability to enhance polyphenol extraction performance. The aim of this study was to investigate the effects of PEF treatment on grape skin histocytological structures and on the organization of skin cell wall polysaccharides and tannins, which, until now, have been little investigated. This study relates to the effects of two PEF treatments on harvested Cabernet Sauvignon berries: PEF1 (medium strength (4 kV/cm); short duration (1 ms)) and PEF2 (low intensity (0.7 kV/cm); longer duration (200 ms)). Histocytological observations and the study of levels of polysaccharidic fractions and total amounts of tannins allowed differentiation between the two treatments. Whereas PEF1 had little effect on the polyphenol structure and pectic fraction, PEF2 profoundly modified the organization of skin cell walls. Depending on the PEF parameters, cell wall structure was differently affected, providing variable performance in terms of polyphenol extraction and wine quality.

  3. The Impact of an Educational Program Regarding Total Parenteral Nutrition on Infection Indicators in Neonates Admitted to the Neonatal Intensive Care Unit.

    Science.gov (United States)

    Marofi, Maryam; Bijani, Nahid; Abdeyazdan, Zahra; Barekatain, Behzad

    2017-01-01

    One of the basic care measures for preterm infants is providing nutrition through total parenteral nutrition (TPN) and one of the most important complications of it is infection. Because prevention of nosocomial infections is an important issue for neonate's safety, this study aimed to determine the effects of a continuing medical education (CME) course on TPN for neonatal intensive care unit (NICU) nurses on indicators of infection in newborns. This quasi-experimental study was conducted on 127 neonates who fulfilled the inclusion criteria. They were selected through simple convenience sampling method at two stages of before and after the CME program. The inclusion criteria were prescription of TPN by the physician and lack of clinical evidences for infection in newborns before the beginning of TPN. Death of the infant during each stage of the study was considered as the exclusion criteria. The data gathering tool was a data record sheet including clinical signs of infection in the infants and their demographic characteristics. Data were analyzed using Chi-square test, Fisher's exact test, and student's t -test in SPSS software. The results showed the frequency of clinical markers for infection in newborns at the pre-intervention stage ( n = 41; 65.10%) was significantly less than at the post-intervention stage ( n = 30; 46.90%) ( p = 0.04). Nursing educational programs on TPN reduce infection rates among neonates in NICUs.

  4. The Impact of Regression to the Mean on Economic Evaluation in Quasi-Experimental Pre-Post Studies: The Example of Total Knee Replacement Using Data from the Osteoarthritis Initiative.

    Science.gov (United States)

    Schilling, Chris; Petrie, Dennis; Dowsey, Michelle M; Choong, Peter F; Clarke, Philip

    2017-12-01

    Many treatments are evaluated using quasi-experimental pre-post studies susceptible to regression to the mean (RTM). Ignoring RTM could bias the economic evaluation. We investigated this issue using the contemporary example of total knee replacement (TKR), a common treatment for end-stage osteoarthritis of the knee. Data (n = 4796) were obtained from the Osteoarthritis Initiative database, a longitudinal observational study of osteoarthritis. TKR patients (n = 184) were matched to non-TKR patients, using propensity score matching on the predicted hazard of TKR and exact matching on osteoarthritis severity and health-related quality of life (HrQoL). The economic evaluation using the matched control group was compared to the standard method of using the pre-surgery score as the control. Matched controls were identified for 56% of the primary TKRs. The matched control HrQoL trajectory showed evidence of RTM accounting for a third of the estimated QALY gains from surgery using the pre-surgery HrQoL as the control. Incorporating RTM into the economic evaluation significantly reduced the estimated cost effectiveness of TKR and increased the uncertainty. A generalized ICER bias correction factor was derived to account for RTM in cost-effectiveness analysis. RTM should be considered in economic evaluations based on quasi-experimental pre-post studies. Copyright © 2017 John Wiley & Sons, Ltd. Copyright © 2017 John Wiley & Sons, Ltd.

  5. Comparative Study between Sequential Automatic and Manual Home Respiratory Polygraphy Scoring Using a Three-Channel Device: Impact of the Manual Editing of Events to Identify Severe Obstructive Sleep Apnea

    Directory of Open Access Journals (Sweden)

    Glenda Ernst

    2015-01-01

    Full Text Available Objective. According to current guidelines, autoscoring of respiratory events in respiratory polygraphy requires manual scoring. The aim of this study was to evaluate the agreement between automatic analysis and manual scoring to identify patients with suspected OSA. Methods. This retrospective study analyzed 791 records from respiratory polygraphy (RP performed at home. The association grade between automatic scoring and manual scoring was evaluated using Kappa coefficient and the agreement using Bland and Altman test and intraclass correlation coefficient (CCI. To determine the accuracy in the identification of AHI≥30 eV/h, the ROC curve analysis was used. Results. The population analyzed consisted of 493 male (62.3% and 298 female patients, with an average age of 54.7±14.20 years and BMI of 32.7±8.21 kg/m2. There was no significant difference between automatic and manual apnea/hypopnea indexes (aAHI, mAHI: aAHI 17.25 (SD: 17.42 versus mAHI 21.20±7.96 (p; NS. The agreement between mAHI and aAHI to AHI≥30 was 94%, with a Kappa coefficient of 0.83 (p<0.001 and a CCI of 0.83. The AUC-ROC, sensitivity, and specificity were 0.99 (CI 95%: 0.98-0.99, p<0.001, 86% (CI 95%: 78.7–91.4, and 97% (CI 95%: 96–98.3, respectively. Conclusions. We observed good agreement between automatic scoring and sequential manual scoring to identify subjects with AHI≥30 eV/h.

  6. The Effect of Pretest Exercise on Baseline Computerized Neurocognitive Test Scores.

    Science.gov (United States)

    Pawlukiewicz, Alec; Yengo-Kahn, Aaron M; Solomon, Gary

    2017-10-01

    Baseline neurocognitive assessment plays a critical role in return-to-play decision making following sport-related concussions. Prior studies have assessed the effect of a variety of modifying factors on neurocognitive baseline test scores. However, relatively little investigation has been conducted regarding the effect of pretest exercise on baseline testing. The aim of our investigation was to determine the effect of pretest exercise on baseline Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT) scores in adolescent and young adult athletes. We hypothesized that athletes undergoing self-reported strenuous exercise within 3 hours of baseline testing would perform more poorly on neurocognitive metrics and would report a greater number of symptoms than those who had not completed such exercise. Cross-sectional study; Level of evidence, 3. The ImPACT records of 18,245 adolescent and young adult athletes were retrospectively analyzed. After application of inclusion and exclusion criteria, participants were dichotomized into groups based on a positive (n = 664) or negative (n = 6609) self-reported history of strenuous exercise within 3 hours of the baseline test. Participants with a positive history of exercise were then randomly matched, based on age, sex, education level, concussion history, and hours of sleep prior to testing, on a 1:2 basis with individuals who had reported no pretest exercise. The baseline ImPACT composite scores of the 2 groups were then compared. Significant differences were observed for the ImPACT composite scores of verbal memory, visual memory, reaction time, and impulse control as well as for the total symptom score. No significant between-group difference was detected for the visual motor composite score. Furthermore, pretest exercise was associated with a significant increase in the overall frequency of invalid test results. Our results suggest a statistically significant difference in ImPACT composite scores between

  7. The total flavonoids of Clerodendrum bungei suppress A549 cells proliferation, migration, and invasion by impacting Wnt/β-Catenin signaling

    Directory of Open Access Journals (Sweden)

    Na Yu

    2017-01-01

    Full Text Available Objectives: The objective of this study is to evaluate the effect of the total flavonoids of Clerodendrum bungei (TFCB on the proliferation, invasion, and metastasis of A549 lung cancer cells through the Wnt signaling pathway. Materials and Methods: A549 cells were transfected with a β-catenin overexpression plasmid and the empty vector pcDNA3.1. The A549 cells were divided into six groups: normal A549 cell group, normal A549 cells with TFCB group, vector control group, vector with TFCB group, β-catenin overexpression group, and β-catenin with TFCB group. We used the 3-(4,5-dimethylthiazol-2-yl-2,5-diphenyltetrazolium bromide assay to detect cell proliferation, a scratch test was used to observe cell migration, and a transwell experiment was employed to evaluate cell invasion. Proteins related to the Wnt pathway were detected with Western blot analysis, including β-catenin, GSK-3 β, P-GSK-3 β, c-Myc, and CyclinD1. Results: The proliferation, invasion, and metastasis of A549 cells were significantly enhanced after being transfected with the β-catenin overexpression plasmid (P < 0.05 or 0.01, accompanied by increased expression of β-catenin, C-Myc, CyclinD1 and reduced expression of Gsk-3 β and P-GSK-3 β. Treatment of cells with TFCB resulted in inhibition of cell proliferation, migration, and invasion; downregulated expression of β-catenin, C-Myc, and CyclinD1; and upregulated expression of GSK-3 β and P-GSK-3 β, especially in the β-catenin overexpression group. Conclusion: TFCB has the potential to inhibit the Wnt/β-catenin pathway by prohibiting the overexpression of β-catenin and regulating its downstream factors.

  8. Application of the FOUR Score in Intracerebral Hemorrhage Risk Analysis.

    Science.gov (United States)

    Braksick, Sherri A; Hemphill, J Claude; Mandrekar, Jay; Wijdicks, Eelco F M; Fugate, Jennifer E

    2018-06-01

    The Full Outline of Unresponsiveness (FOUR) Score is a validated scale describing the essentials of a coma examination, including motor response, eye opening and eye movements, brainstem reflexes, and respiratory pattern. We incorporated the FOUR Score into the existing ICH Score and evaluated its accuracy of risk assessment in spontaneous intracerebral hemorrhage (ICH). Consecutive patients admitted to our institution from 2009 to 2012 with spontaneous ICH were reviewed. The ICH Score was calculated using patient age, hemorrhage location, hemorrhage volume, evidence of intraventricular extension, and Glasgow Coma Scale (GCS). The FOUR Score was then incorporated into the ICH Score as a substitute for the GCS (ICH Score FS ). The ability of the 2 scores to predict mortality at 1 month was then compared. In total, 274 patients met the inclusion criteria. The median age was 73 years (interquartile range 60-82) and 138 (50.4%) were male. Overall mortality at 1 month was 28.8% (n = 79). The area under the receiver operating characteristic curve was .91 for the ICH Score and .89 for the ICH Score FS . For ICH Scores of 1, 2, 3, 4, and 5, 1-month mortality was 4.2%, 29.9%, 62.5%, 95.0%, and 100%. In the ICH Score FS model, mortality was 10.7%, 26.5%, 64.5%, 88.9%, and 100% for scores of 1, 2, 3, 4, and 5, respectively. The ICH Score and the ICH Score FS predict 1-month mortality with comparable accuracy. As the FOUR Score provides additional clinical information regarding patient status, it may be a reasonable substitute for the GCS into the ICH Score. Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  9. [Propensity score matching in SPSS].

    Science.gov (United States)

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

    2015-11-01

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

  10. [Prognostic scores for pulmonary embolism].

    Science.gov (United States)

    Junod, Alain

    2016-03-23

    Nine prognostic scores for pulmonary embolism (PE), based on retrospective and prospective studies, published between 2000 and 2014, have been analyzed and compared. Most of them aim at identifying PE cases with a low risk to validate their ambulatory care. Important differences in the considered outcomes: global mortality, PE-specific mortality, other complications, sizes of low risk groups, exist between these scores. The most popular score appears to be the PESI and its simplified version. Few good quality studies have tested the applicability of these scores to PE outpatient care, although this approach tends to already generalize in the medical practice.

  11. The impact of high total cholesterol and high low-density lipoprotein on avascular necrosis of the femoral head in low-energy femoral neck fractures.

    Science.gov (United States)

    Zeng, Xianshang; Zhan, Ke; Zhang, Lili; Zeng, Dan; Yu, Weiguang; Zhang, Xinchao; Zhao, Mingdong; Lai, Zhicheng; Chen, Runzhen

    2017-02-17

    Avascular necrosis of the femoral head (AVNFH) typically constitutes 5 to 15% of all complications of low-energy femoral neck fractures, and due to an increasingly ageing population and a rising prevalence of femoral neck fractures, the number of patients who develop AVNFH is increasing. However, there is no consensus regarding the relationship between blood lipid abnormalities and postoperative AVNFH. The purpose of this retrospective study was to investigate the relationship between blood lipid abnormalities and AVNFH following the femoral neck fracture operation among an elderly population. A retrospective, comparative study was performed at our institution. Between June 2005 and November 2009, 653 elderly patients (653 hips) with low-energy femoral neck fractures underwent closed reduction and internal fixation with cancellous screws (Smith and Nephew, Memphis, Tennessee). Follow-up occurred at 1, 6, 12, 18, 24, 30, and 36 months after surgery. Logistic multi-factor regression analysis was used to assess the risk factors of AVNFH and to determine the effect of blood lipid levels on AVNFH development. Inclusion and exclusion criteria were predetermined to focus on isolated freshly closed femoral neck fractures in the elderly population. The primary outcome was the blood lipid levels. The secondary outcome was the logistic multi-factor regression analysis. A total of 325 elderly patients with low-energy femoral neck fractures (AVNFH, n = 160; control, n = 165) were assessed. In the AVNFH group, the average TC, TG, LDL, and Apo-B values were 7.11 ± 3.16 mmol/L, 2.15 ± 0.89 mmol/L, 4.49 ± 1.38 mmol/L, and 79.69 ± 17.29 mg/dL, respectively; all of which were significantly higher than the values in the control group. Logistic multi-factor regression analysis showed that both TC and LDL were the independent factors influencing the postoperative AVNFH within femoral neck fractures. This evidence indicates that AVNFH was significantly

  12. Test Score Equating Using Discrete Anchor Items versus Passage-Based Anchor Items: A Case Study Using "SAT"® Data. Research Report. ETS RR-14-14

    Science.gov (United States)

    Liu, Jinghua; Zu, Jiyun; Curley, Edward; Carey, Jill

    2014-01-01

    The purpose of this study is to investigate the impact of discrete anchor items versus passage-based anchor items on observed score equating using empirical data.This study compares an "SAT"® critical reading anchor that contains more discrete items proportionally, compared to the total tests to be equated, to another anchor that…

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

    Science.gov (United States)

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

    2013-03-01

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

  14. Trends in Classroom Observation Scores

    Science.gov (United States)

    Casabianca, Jodi M.; Lockwood, J. R.; McCaffrey, Daniel F.

    2015-01-01

    Observations and ratings of classroom teaching and interactions collected over time are susceptible to trends in both the quality of instruction and rater behavior. These trends have potential implications for inferences about teaching and for study design. We use scores on the Classroom Assessment Scoring System-Secondary (CLASS-S) protocol from…

  15. Quadratic prediction of factor scores

    NARCIS (Netherlands)

    Wansbeek, T

    1999-01-01

    Factor scores are naturally predicted by means of their conditional expectation given the indicators y. Under normality this expectation is linear in y but in general it is an unknown function of y. II is discussed that under nonnormality factor scores can be more precisely predicted by a quadratic

  16. The Machine Scoring of Writing

    Science.gov (United States)

    McCurry, Doug

    2010-01-01

    This article provides an introduction to the kind of computer software that is used to score student writing in some high stakes testing programs, and that is being promoted as a teaching and learning tool to schools. It sketches the state of play with machines for the scoring of writing, and describes how these machines work and what they do.…

  17. Matching score based face recognition

    NARCIS (Netherlands)

    Boom, B.J.; Beumer, G.M.; Spreeuwers, Lieuwe Jan; Veldhuis, Raymond N.J.

    2006-01-01

    Accurate face registration is of vital importance to the performance of a face recognition algorithm. We propose a new method: matching score based face registration, which searches for optimal alignment by maximizing the matching score output of a classifier as a function of the different

  18. Modelling sequentially scored item responses

    NARCIS (Netherlands)

    Akkermans, W.

    2000-01-01

    The sequential model can be used to describe the variable resulting from a sequential scoring process. In this paper two more item response models are investigated with respect to their suitability for sequential scoring: the partial credit model and the graded response model. The investigation is

  19. Complex dynamics in the distribution of players’ scoring performance in Rugby Union world cups

    Science.gov (United States)

    Seuront, Laurent

    2013-09-01

    The evolution of the scoring performance of Rugby Union players is investigated over the seven rugby world cups (RWC) that took place from 1987 to 2011, and a specific attention is given to how they may have been impacted by the switch from amateurism to professionalism that occurred in 1995. The distribution of the points scored by individual players, Ps, ranked in order of performance were well described by the simplified canonical law Ps∝(, where r is the rank, and ϕ and α are the parameters of the distribution. The parameter α did not significantly change from 1987 to 2007 (α=0.92±0.03), indicating a negligible effect of professionalism on players’ scoring performance. In contrast, the parameter ϕ significantly increased from ϕ=1.32 for 1987 RWC, ϕ=2.30 for 1999 to 2003 RWC and ϕ=5.60 for 2007 RWC, suggesting a progressive decrease in the relative performance of the best players. Finally, the sharp decreases observed in both α(α=0.38) and ϕ(ϕ=0.70) in the 2011 RWC indicate a more even distribution of the performance of individuals among scorers, compared to the more heterogeneous distributions observed from 1987 to 2007, and suggest a sharp increase in the level of competition leading to an increase in the average quality of players and a decrease in the relative skills of the top players. Note that neither α nor ϕ significantly correlate with traditional performance indicators such as the number of points scored by the best players, the number of games played by the best players, the number of points scored by the team of the best players or the total number of points scored over each RWC. This indicates that the dynamics of the scoring performance of Rugby Union players is influenced by hidden processes hitherto inaccessible through standard performance metrics; this suggests that players’ scoring performance is connected to ubiquitous phenomena such as anomalous diffusion.

  20. Extension of the lod score: the mod score.

    Science.gov (United States)

    Clerget-Darpoux, F

    2001-01-01

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

  1. Impacts

    NARCIS (Netherlands)

    Hellmuth, M.; Kabat, P.

    2003-01-01

    Even without the impacts of climate change, water managers face prodigious challenges in meeting sustainable development goals. Growing populations need affordable food, water and energy. Industrial development demands a growing share of water resources and contaminates those same resources with its

  2. Ripasa score: a new diagnostic score for diagnosis of acute appendicitis

    International Nuclear Information System (INIS)

    Butt, M.Q.

    2014-01-01

    Objective: To determine the usefulness of RIPASA score for the diagnosis of acute appendicitis using histopathology as a gold standard. Study Design: Cross-sectional study. Place and Duration of Study: Department of General Surgery, Combined Military Hospital, Kohat, from September 2011 to March 2012. Methodology: A total of 267 patients were included in this study. RIPASA score was assessed. The diagnosis of appendicitis was made clinically aided by routine sonography of abdomen. After appendicectomies, resected appendices were sent for histopathological examination. The 15 parameters and the scores generated were age (less than 40 years = 1 point; greater than 40 years = 0.5 point), gender (male = 1 point; female = 0.5 point), Right Iliac Fossa (RIF) pain (0.5 point), migration of pain to RIF (0.5 point), nausea and vomiting (1 point), anorexia (1 point), duration of symptoms (less than 48 hours = 1 point; more than 48 hours = 0.5 point), RIF tenderness (1 point), guarding (2 points), rebound tenderness (1 point), Rovsing's sign (2 points), fever (1 point), raised white cell count (1 point), negative urinalysis (1 point) and foreign national registration identity card (1 point). The optimal cut-off threshold score from the ROC was 7.5. Sensitivity analysis was done. Results: Out of 267 patients, 156 (58.4%) were male while remaining 111 patients (41.6%) were female with mean age of 23.5 +- 9.1 years. Sensitivity of RIPASA score was 96.7%, specificity 93.0%, diagnostic accuracy was 95.1%, positive predictive value was 94.8% and negative predictive value was 95.54%. Conclusion: RIPASA score at a cut-off total score of 7.5 was a useful tool to diagnose appendicitis, in equivocal cases of pain. (author)

  3. How does preclinical laboratory training impact physical examination skills during the first clinical year? A retrospective analysis of routinely collected objective structured clinical examination scores among the first two matriculating classes of a reformed curriculum in one Polish medical school.

    Science.gov (United States)

    Świerszcz, Jolanta; Stalmach-Przygoda, Agata; Kuźma, Marcin; Jabłoński, Konrad; Cegielny, Tomasz; Skrzypek, Agnieszka; Wieczorek-Surdacka, Ewa; Kruszelnicka, Olga; Chmura, Kaja; Chyrchel, Bernadeta; Surdacki, Andrzej; Nowakowski, Michał

    2017-09-01

    As a result of a curriculum reform launched in 2012 at our institution, preclinical training was shortened to 2 years instead of the traditional 3 years, creating additional incentives to optimise teaching methods. In accordance with the new curriculum, a semester-long preclinical module of clinical skills (CS) laboratory training takes place in the second year of study, while an introductory clinical course (ie, brief introductory clerkships) is scheduled for the Fall semester of the third year. Objective structured clinical examinations (OSCEs) are carried out at the conclusion of both the preclinical module and the introductory clinical course. Our aim was to compare the scores at physical examination stations between the first and second matriculating classes of a newly reformed curriculum on preclinical second-year OSCEs and early clinical third-year OSCEs. Analysis of routinely collected data. One Polish medical school. Complete OSCE records for 462 second-year students and 445 third-year students. OSCE scores by matriculation year. In comparison to the first class of the newly reformed curriculum, significantly higher (ie, better) OSCE scores were observed for those students who matriculated in 2013, a year after implementing the reformed curriculum. This finding was consistent for both second-year and third-year cohorts. Additionally, the magnitude of the improvement in median third-year OSCE scores was proportional to the corresponding advancement in preceding second-year preclinical OSCE scores for each of two different sets of physical examination tasks. In contrast, no significant difference was noted between the academic years in the ability to interpret laboratory data or ECG - tasks which had not been included in the second-year preclinical training. Our results suggest the importance of preclinical training in a CS laboratory to improve students' competence in physical examination at the completion of introductory clinical clerkships during

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

    Energy Technology Data Exchange (ETDEWEB)

    Vult von Steyern, Kristina; Bjoerkman-Burtscher, Isabella M.; Bozovic, Gracijela; Wiklund, Marie; Geijer, Mats [Skaane University Hospital, Lund University, Centre for Medical Imaging and Physiology, Lund (Sweden); Hoeglund, Peter [Skaane University Hospital, Competence Centre for Clinical Research, Lund (Sweden)

    2012-12-15

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

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

    Science.gov (United States)

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

    2012-12-01

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

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

    International Nuclear Information System (INIS)

    Vult von Steyern, Kristina; Bjoerkman-Burtscher, Isabella M.; Bozovic, Gracijela; Wiklund, Marie; Geijer, Mats; Hoeglund, Peter

    2012-01-01

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

  7. IMPACTS !

    CERN Multimedia

    2008-01-01

    (Photo courtesy of Don Davis / NASA)The University of Geneva (UNIGE) and the Ecole Polytechnique Fédérale of Lausanne (EPFL) are organising the 4th series of public lectures on astronomy, on the theme of "Impacts". The schedule is as follows: Il y a 100 ans : une explosion dans la Tunguska – Dr. Frédéric COURBIN, EPFL Les impacts sur Terre – Prof. Didier Queloz, UNIGE La fin des dinosaures – Dr. Stéphane Paltani, UNIGE Wednesday 7 May 2008, from 7.00 p.m. to 9.00 p.m. Auditoire CO1, EPFL, Ecublens Thursday 08 May 2008, from 7.00 p.m. to 9.00 p.m. Auditoire Rouiller, Uni-Dufour, Genève All 3 lectures will be givent each evening! Admission free Information: 022 379 22 00

  8. From Rasch scores to regression

    DEFF Research Database (Denmark)

    Christensen, Karl Bang

    2006-01-01

    Rasch models provide a framework for measurement and modelling latent variables. Having measured a latent variable in a population a comparison of groups will often be of interest. For this purpose the use of observed raw scores will often be inadequate because these lack interval scale propertie....... This paper compares two approaches to group comparison: linear regression models using estimated person locations as outcome variables and latent regression models based on the distribution of the score....

  9. Shower reconstruction in TUNKA-HiSCORE

    Energy Technology Data Exchange (ETDEWEB)

    Porelli, Andrea; Wischnewski, Ralf [DESY-Zeuthen, Platanenallee 6, 15738 Zeuthen (Germany)

    2015-07-01

    The Tunka-HiSCORE detector is a non-imaging wide-angle EAS cherenkov array designed as an alternative technology for gamma-ray physics above 10 TeV and to study spectrum and composition of cosmic rays above 100 TeV. An engineering array with nine stations (HiS-9) has been deployed in October 2013 on the site of the Tunka experiment in Russia. In November 2014, 20 more HiSCORE stations have been installed, covering a total array area of 0.24 square-km. We describe the detector setup, the role of precision time measurement, and give results from the innovative WhiteRabbit time synchronization technology. Results of air shower reconstruction are presented and compared with MC simulations, for both the HiS-9 and the HiS-29 detector arrays.

  10. Nursing Activities Score and Acute Kidney Injury

    Directory of Open Access Journals (Sweden)

    Filipe Utuari de Andrade Coelho

    Full Text Available ABSTRACT Objective: to evaluate the nursing workload in intensive care patients with acute kidney injury (AKI. Method: A quantitative study, conducted in an intensive care unit, from April to August of 2015. The Nursing Activities Score (NAS and Kidney Disease Improving Global Outcomes (KDIGO were used to measure nursing workload and to classify the stage of AKI, respectively. Results: A total of 190 patients were included. Patients who developed AKI (44.2% had higher NAS when compared to those without AKI (43.7% vs 40.7%, p <0.001. Patients with stage 1, 2 and 3 AKI showed higher NAS than those without AKI. A relationship was identified between stage 2 and 3 with those without AKI (p = 0.002 and p <0.001. Conclusion: The NAS was associated with the presence of AKI, the score increased with the progression of the stages, and it was associated with AKI, stage 2 and 3.

  11. Association between value-based purchasing score and hospital characteristics

    Directory of Open Access Journals (Sweden)

    Borah Bijan J

    2012-12-01

    Full Text Available Abstract Background Medicare hospital Value-based purchasing (VBP program that links Medicare payments to quality of care will become effective from 2013. It is unclear whether specific hospital characteristics are associated with a hospital’s VBP score, and consequently incentive payments. The objective of the study was to assess the association of hospital characteristics with (i the mean VBP score, and (ii specific percentiles of the VBP score distribution. The secondary objective was to quantify the associations of hospital characteristics with the VBP score components: clinical process of care (CPC score and patient satisfaction score. Methods Observational analysis that used data from three sources: Medicare Hospital Compare Database, American Hospital Association 2010 Annual Survey and Medicare Impact File. The final study sample included 2,491 U.S. acute care hospitals eligible for the VBP program. The association of hospital characteristics with the mean VBP score and specific VBP score percentiles were assessed by ordinary least square (OLS regression and quantile regression (QR, respectively. Results VBP score had substantial variations, with mean score of 30 and 60 in the first and fourth quartiles of the VBP score distribution. For-profit status (vs. non-profit, smaller bed size (vs. 100–199 beds, East South Central region (vs. New England region and the report of specific CPC measures (discharge instructions, timely provision of antibiotics and beta blockers, and serum glucose controls in cardiac surgery patients were positively associated with mean VBP scores (p Conclusions Although hospitals serving the poor and the elderly are more likely to score lower under the VBP program, the correlation appears small. Profit status, geographic regions, number and type of CPC measures reported explain the most variation among scores.

  12. Assessment of voice related quality of life and its correlation with socioeconomic status after total laryngectomy.

    Science.gov (United States)

    Agarwal, Sangeet Kumar; Gogia, Shweta; Agarwal, Alok; Agarwal, Rajiv; Mathur, Ajay Swaroop

    2015-10-01

    After total laryngectomy for laryngeal cancer, the major determinants of QOL is the patient's voice related quality of life (V-RQOL). The primary aim of this study was to assess the V-RQOL and impact of socioeconomic status over it in Indian population by using two validated scales [voice handicap index (VHI) and V-RQOL questionnaires]. Total 104 patients underwent total laryngectomy but 71 were eligible for study. Patients filled the VHI and V-RQOL questionnaires after completion of 1 year of usage of the TEP voice. The socioeconomic status of the patients was calculated according to various domains related to their life and were divided into lower and higher status. A total of 76.1% patients had VHI score between 0 to 30 (minimal voice handicap), 19.7% had score between 31 to 60 (moderate voice handicap) and only 4.2% patients had VHI score more than 61 (serious voice handicap). On V-RQOL scores, 16.9% patients had score between 10 to 15 (excellent), 40.8% patients, between 16 to 20 (very good), 22.5% patients, between 21 and 25 (good voice), 15.5% patients, between 26 and 30 (fair) and only 4.2% patients scored more than 30 with poor quality of voice. Patients with lower socioeconomic group had better V-RQOL than with high socioeconomic group. VHI and V-RQOL scores in our series were superior to other studies due to major population with lower socioeconomic status and better social support which exists in our society.

  13. Validation of dengue infection severity score

    Directory of Open Access Journals (Sweden)

    Pongpan S

    2014-03-01

    Full Text Available Surangrat Pongpan,1,2 Jayanton Patumanond,3 Apichart Wisitwong,4 Chamaiporn Tawichasri,5 Sirianong Namwongprom1,6 1Clinical Epidemiology Program, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand; 2Department of Occupational Medicine, Phrae Hospital, Phrae, Thailand; 3Clinical Epidemiology Program, Faculty of Medicine, Thammasat University, Bangkok, Thailand; 4Department of Social Medicine, Sawanpracharak Hospital, Nakorn Sawan, Thailand; 5Clinical Epidemiology Society at Chiang Mai, Chiang Mai, Thailand; 6Department of Radiology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand Objective: To validate a simple scoring system to classify dengue viral infection severity to patients in different settings. Methods: The developed scoring system derived from 777 patients from three tertiary-care hospitals was applied to 400 patients in the validation data obtained from another three tertiary-care hospitals. Percentage of correct classification, underestimation, and overestimation was compared. The score discriminative performance in the two datasets was compared by analysis of areas under the receiver operating characteristic curves. Results: Patients in the validation data were different from those in the development data in some aspects. In the validation data, classifying patients into three severity levels (dengue fever, dengue hemorrhagic fever, and dengue shock syndrome yielded 50.8% correct prediction (versus 60.7% in the development data, with clinically acceptable underestimation (18.6% versus 25.7% and overestimation (30.8% versus 13.5%. Despite the difference in predictive performances between the validation and the development data, the overall prediction of the scoring system is considered high. Conclusion: The developed severity score may be applied to classify patients with dengue viral infection into three severity levels with clinically acceptable under- or overestimation. Its impact when used in routine

  14. Impact of mobile intensive care unit use on total ischemic time and clinical outcomes in ST-elevation myocardial infarction patients - real-world data from the Acute Coronary Syndrome Israeli Survey.

    Science.gov (United States)

    Koifman, Edward; Beigel, Roy; Iakobishvili, Zaza; Shlomo, Nir; Biton, Yitschak; Sabbag, Avi; Asher, Elad; Atar, Shaul; Gottlieb, Shmuel; Alcalai, Ronny; Zahger, Doron; Segev, Amit; Goldenberg, Ilan; Strugo, Rafael; Matetzky, Shlomi

    2017-01-01

    Ischemic time has prognostic importance in ST-elevation myocardial infarction patients. Mobile intensive care unit use can reduce components of total ischemic time by appropriate triage of ST-elevation myocardial infarction patients. Data from the Acute Coronary Survey in Israel registry 2000-2010 were analyzed to evaluate factors associated with mobile intensive care unit use and its impact on total ischemic time and patient outcomes. The study comprised 5474 ST-elevation myocardial infarction patients enrolled in the Acute Coronary Survey in Israel registry, of whom 46% ( n=2538) arrived via mobile intensive care units. There was a significant increase in rates of mobile intensive care unit utilization from 36% in 2000 to over 50% in 2010 ( pcare unit use were Killip>1 (odds ratio=1.32, pcare units benefitted from increased rates of primary reperfusion therapy (odds ratio=1.58, pcare unit benefitted from shorter median total ischemic time compared with non-mobile intensive care unit patients (175 (interquartile range 120-262) vs 195 (interquartile range 130-333) min, respectively ( pcare unit use was the most important predictor in achieving door-to-balloon time care unit group (odds ratio=0.79, 95% confidence interval (0.66-0.94), p=0.01). Among patients with ST-elevation myocardial infarction, the utilization of mobile intensive care units is associated with increased rates of primary reperfusion, a reduction in the time interval to reperfusion, and a reduction in one-year adjusted mortality.

  15. Evaluation of modified Alvarado scoring system and RIPASA scoring system as diagnostic tools of acute appendicitis.

    Science.gov (United States)

    Shuaib, Abdullah; Shuaib, Ali; Fakhra, Zainab; Marafi, Bader; Alsharaf, Khalid; Behbehani, Abdullah

    2017-01-01

    Acute appendicitis is the most common surgical condition presented in emergency departments worldwide. Clinical scoring systems, such as the Alvarado and modified Alvarado scoring systems, were developed with the goal of reducing the negative appendectomy rate to 5%-10%. The Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) scoring system was established in 2008 specifically for Asian populations. The aim of this study was to compare the modified Alvarado with the RIPASA scoring system in Kuwait population. This study included 180 patients who underwent appendectomies and were documented as having "acute appendicitis" or "abdominal pain" in the operating theatre logbook (unit B) from November 2014 to March 2016. The sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), diagnostic accuracy, predicted negative appendectomy and receiver operating characteristic (ROC) curve of the modified Alvarado and RIPASA scoring systems were derived using SPSS statistical software. A total of 136 patients were included in this study according to our criteria. The cut-off threshold point of the modified Alvarado score was set at 7.0, which yielded a sensitivity of 82.8% and a specificity of 56%. The PPV was 89.3% and the NPV was 42.4%. The cut-off threshold point of the RIPASA score was set at 7.5, which yielded a 94.5% sensitivity and an 88% specificity. The PPV was 97.2% and the NPV was 78.5%. The predicted negative appendectomy rates were 10.7% and 2.2% for the modified Alvarado and RIPASA scoring systems, respectively. The negative appendectomy rate decreased significantly, from 18.4% to 10.7% for the modified Alvarado, and to 2.2% for the RIPASA scoring system, which was a significant difference (PAsian populations. It consists of 14 clinical parameters that can be obtained from a good patient history, clinical examination and laboratory investigations. The RIPASA scoring system is more accurate and specific than the modified Alvarado

  16. Re-Scoring the Game’s Score

    DEFF Research Database (Denmark)

    Gasselseder, Hans-Peter

    2014-01-01

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

  17. The impact of extended release exenatide as adjuvant therapy on hemoglobin A1C, weight, and total daily dose of insulin in patients with type 2 diabetes mellitus using U-500 insulin.

    Science.gov (United States)

    Farwig, Phillip A; Zielinski, Angela J; Accursi, Mallory L; Burant, Christopher J

    2017-12-01

    To evaluate the efficacy and safety of adjuvant exenatide extended release (ER) therapy in patients treated with regular U-500 insulin. In this retrospective chart review at an ambulatory care center in the Midwest, 18 patients with type 2 diabetes being treated with regular U-500 insulin and adjuvant exenatide ER were identified. These patients were evaluated for outcomes following the addition of exenatide ER. The primary outcome was change in HbA 1C from baseline to 3, 6, and 12months. Secondary outcomes included change in weight, total daily dose (TDD) of insulin, and hypoglycemia. Repeated measures ANOVA was performed to assess the differences in mean scores over four time periods. A total of 18 of 50 patients met inclusion criteria with sufficient data to be included in analysis. HbA 1C showed non-significant findings from baseline to 12months (8.08% vs. 8.23%; p=0.75). A non-significant, modest weight loss occurred (146.4kgvs. 144.2kg; -2.2kg; p=0.31). A significant decrease in TDD of insulin was observed (378 units vs. 326 units; p1). There was a trend towards hypoglycemia from baseline to month 3 post addition of exenatide ER (0.33 events vs. 1.33 events; p=0.055). In patients treated with regular U-500 insulin, adjuvant exenatide ER therapy showed no significant improvement in HbA 1C , but did show modest weight loss as well as decreased insulin requirements to achieve a HbA 1C that was comparable to baseline. Published by Elsevier B.V.

  18. Retail clinic utilization associated with lower total cost of care.

    Science.gov (United States)

    Sussman, Andrew; Dunham, Lisette; Snower, Kristen; Hu, Min; Matlin, Olga S; Shrank, William H; Choudhry, Niteesh K; Brennan, Troyen

    2013-04-01

    To better understand the impact of retail clinic use on a patient's annual total cost of care. A propensity score matched-pair, cohort design was used to analyze healthcare spending patterns among CVS Caremark employees in the year following a visit to a MinuteClinic, the retail clinics inside CVS pharmacies. De-identified medical and pharmacy claims for CVS Caremark employees and their dependents who received care at a retail clinic between June 1, 2009, and May 31, 2010, were matched to those of subjects who received care elsewhere. High-dimensional propensity score and greedy matching techniques were used to create a 1-to-1 matched cohort that was analyzed using generalized linear regression models. Individuals using a retail clinic had a lower total cost of care (-$262; 95% confidence interval, -$510 to -$31; P = .025) in the year following their clinic visit than individuals who received care in other settings. This savings was primarily due to lower medical expenses at physicians' offices ($77 savings, P = .008) and hospital inpatient care ($121 savings, P = .049). The 6022 retail clinic users also had 142 (12%) fewer emergency department visits (P = .01), though this was not related to significant cost savings. This study found that retail clinic use was associated with lower overall total cost of care compared with that at alternative sites. Savings may extend beyond the retail clinic visit itself to other types of medical utilization.

  19. Practical determination of aortic valve calcium volume score on contrast-enhanced computed tomography prior to transcatheter aortic valve replacement and impact on paravalvular regurgitation: Elucidating optimal threshold cutoffs.

    Science.gov (United States)

    Bettinger, Nicolas; Khalique, Omar K; Krepp, Joseph M; Hamid, Nadira B; Bae, David J; Pulerwitz, Todd C; Liao, Ming; Hahn, Rebecca T; Vahl, Torsten P; Nazif, Tamim M; George, Isaac; Leon, Martin B; Einstein, Andrew J; Kodali, Susheel K

    The threshold for the optimal computed tomography (CT) number in Hounsfield Units (HU) to quantify aortic valvular calcium on contrast-enhanced scans has not been standardized. Our aim was to find the most accurate threshold to predict paravalvular regurgitation (PVR) after transcatheter aortic valve replacement (TAVR). 104 patients who underwent TAVR with the CoreValve prosthesis were studied retrospectively. Luminal attenuation (LA) in HU was measured at the level of the aortic annulus. Calcium volume score for the aortic valvular complex was measured using 6 threshold cutoffs (650 HU, 850 HU, LA × 1.25, LA × 1.5, LA+50, LA+100). Receiver-operating characteristic (ROC) analysis was performed to assess the predictive value for > mild PVR (n = 16). Multivariable analysis was performed to determine the accuracy to predict > mild PVR after adjustment for depth and perimeter oversizing. ROC analysis showed lower area under the curve (AUC) values for fixed threshold cutoffs (650 or 850 HU) compared to thresholds relative to LA. The LA+100 threshold had the highest AUC (0.81), and AUC was higher than all studied protocols, other than the LA x 1.25 and LA + 50 protocols, where the difference approached statistical significance (p = 0.05, and 0.068, respectively). Multivariable analysis showed calcium volume determined by the LAx1.25, LAx1.5, LA+50, and LA+ 100 HU protocols to independently predict PVR. Calcium volume scoring thresholds which are relative to LA are more predictive of PVR post-TAVR than those which use fixed cutoffs. A threshold of LA+100 HU had the highest predictive value. Copyright © 2017 Society of Cardiovascular Computed Tomography. Published by Elsevier Inc. All rights reserved.

  20. Comparing the Scoring of Human Decomposition from Digital Images to Scoring Using On-site Observations.

    Science.gov (United States)

    Dabbs, Gretchen R; Bytheway, Joan A; Connor, Melissa

    2017-09-01

    When in forensic casework or empirical research in-person assessment of human decomposition is not possible, the sensible substitution is color photographic images. To date, no research has confirmed the utility of color photographic images as a proxy for in situ observation of the level of decomposition. Sixteen observers scored photographs of 13 human cadavers in varying decomposition stages (PMI 2-186 days) using the Total Body Score system (total n = 929 observations). The on-site TBS was compared with recorded observations from digital color images using a paired samples t-test. The average difference between on-site and photographic observations was -0.20 (t = -1.679, df = 928, p = 0.094). Individually, only two observers, both students with human decomposition based on digital images can be substituted for assessments based on observation of the corpse in situ, when necessary. © 2017 American Academy of Forensic Sciences.

  1. Skin scoring in systemic sclerosis

    DEFF Research Database (Denmark)

    Zachariae, Hugh; Bjerring, Peter; Halkier-Sørensen, Lars

    1994-01-01

    Forty-one patients with systemic sclerosis were investigated with a new and simple skin score method measuring the degree of thickening and pliability in seven regions together with area involvement in each region. The highest values were, as expected, found in diffuse cutaneous systemic sclerosis...... (type III SS) and the lowest in limited cutaneous systemic sclerosis (type I SS) with no lesions extending above wrists and ancles. A positive correlation was found to the aminoterminal propeptide of type III procollagen, a serological marker for synthesis of type III collagen. The skin score...

  2. Mobile health technology transforms injury severity scoring in South Africa.

    Science.gov (United States)

    Spence, Richard Trafford; Zargaran, Eiman; Hameed, S Morad; Navsaria, Pradeep; Nicol, Andrew

    2016-08-01

    The burden of data collection associated with injury severity scoring has limited its application in areas of the world with the highest incidence of trauma. Since January 2014, electronic records (electronic Trauma Health Records [eTHRs]) replaced all handwritten records at the Groote Schuur Hospital Trauma Unit in South Africa. Data fields required for Glasgow Coma Scale, Revised Trauma Score, Kampala Trauma Score, Injury Severity Score (ISS), and Trauma Score-Injury Severity Score calculations are now prospectively collected. Fifteen months after implementation of eTHR, the injury severity scores were compared as predictors of mortality on three accounts: (1) ability to discriminate (area under receiver operating curve, ROC); (2) ability to calibrate (observed versus expected ratio, O/E); and (3) feasibility of data collection (rate of missing data). A total of 7460 admissions were recorded by eTHR from April 1, 2014 to July 7, 2015, including 770 severely injured patients (ISS > 15) and 950 operations. The mean age was 33.3 y (range 13-94), 77.6% were male, and the mechanism of injury was penetrating in 39.3% of cases. The cohort experienced a mortality rate of 2.5%. Patient reserve predictors required by the scores were 98.7% complete, physiological injury predictors were 95.1% complete, and anatomic injury predictors were 86.9% complete. The discrimination and calibration of Trauma Score-Injury Severity Score was superior for all admissions (ROC 0.9591 and O/E 1.01) and operatively managed patients (ROC 0.8427 and O/E 0.79). In the severely injured cohort, the discriminatory ability of Revised Trauma Score was superior (ROC 0.8315), but no score provided adequate calibration. Emerging mobile health technology enables reliable and sustainable injury severity scoring in a high-volume trauma center in South Africa. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Resiliency scoring for business continuity plans.

    Science.gov (United States)

    Olson, Anna; Anderson, Jamie

    Through this paper readers will learn of a scoring methodology, referred to as resiliency scoring, which enables the evaluation of business continuity plans based upon analysis of their alignment with a predefined set of criteria that can be customised and are adaptable to the needs of any organisation. This patent pending tool has been successful in driving engagement and is a powerful resource to improve reporting capabilities, identify risks and gauge organisational resilience. The role of business continuity professionals is to aid their organisations in planning and preparedness activities aimed at mitigating the impacts of potential disruptions and ensuring critical business functions can continue in the event of unforeseen circumstances. This may seem like a daunting task for what can typically be a small team of individuals. For this reason, it is important to be able to leverage industry standards, documented best practices and effective tools to streamline and support your continuity programme. The resiliency scoring methodology developed and implemented at Target has proven to be a valuable tool in taking the organisation's continuity programme to the next level. This paper will detail how the tool was developed and provide guidance on how it can be customised to fit your organisation's unique needs.

  4. Objective scoring of hidradenitis suppurativa reflecting the role of tobacco smoking and obesity

    DEFF Research Database (Denmark)

    Sartorius, K; Emtestam, L; Jemec, G B E

    2009-01-01

    in HS. OBJECTIVES: To evaluate the modified Hidradenitis Suppurativa Score (HSS) and to study the impact of body mass index (BMI) and smoking habits on disease severity. METHODS: Two hundred and fifty-one consecutive patients with HS referred to a clinic with special interest in the disease were...... included, of whom 115 were scored. Points were given for regions involved, types of lesion (nodules, fistulas), total area involved and whether lesions were separated by normal skin. Background characteristics included BMI and smoking habits. Two hundred and forty-six patients completed the Dermatology...... as smoking habits in patients with HS is presented. The results suggest that the HSS may be a relevant outcome measure in future therapeutic trials in HS....

  5. Outcomes of Total Knee Arthroplasty in Patients With Poliomyelitis.

    Science.gov (United States)

    Gan, Zhi-Wei Jonathan; Pang, Hee Nee

    2016-11-01

    We report our experience with outcomes of poliomyelitis in the Asian population. Sixteen total knee replacements in 14 patients with polio-affected knees were followed up for at least 18 months. Follow-up assessment included scoring with the American Knee Society Score (AKSS), Oxford knee score, and Short Form 36 Health Survey scores. The mean AKSS improved from 25.59 preoperatively to 82.94 at 24 months, with greater improvement in the knee score. The mean Oxford knee score improved from 40.82 preoperatively to 20.53 at 24 months. The mean AKSS pain score rose from 2.35 to 47.66 at 24 months. The Short Form 36 Health Survey physical functioning and bodily pain scores improved for all patients. Primary total knee arthroplasty of poliomyelitis-affected limbs shows good outcomes, improving quality of life, and decreasing pain. Copyright © 2016 Elsevier Inc. All rights reserved.

  6. Environmental structure and competitive scoring advantages in team competitions

    Science.gov (United States)

    Merritt, Sears; Clauset, Aaron

    2013-10-01

    In most professional sports, playing field structure is kept neutral so that scoring imbalances may be attributed to differences in team skill. It thus remains unknown what impact environmental heterogeneities can have on scoring dynamics or competitive advantages. Applying a novel generative model of scoring dynamics to roughly 10 million team competitions drawn from an online game, we quantify the relationship between the structure within a competition and its scoring dynamics, while controlling the impact of chance. Despite wide structural variations, we observe a common three-phase pattern in the tempo of events. Tempo and balance are highly predictable from a competition's structural features alone and teams exploit environmental heterogeneities for sustained competitive advantage. Surprisingly, the most balanced competitions are associated with specific environmental heterogeneities, not from equally skilled teams. These results shed new light on the design principles of balanced competition, and illustrate the potential of online game data for investigating social dynamics and competition.

  7. The persistence of depression score

    NARCIS (Netherlands)

    Spijker, J.; de Graaf, R.; Ormel, J.; Nolen, W. A.; Grobbee, D. E.; Burger, H.

    2006-01-01

    Objective: To construct a score that allows prediction of major depressive episode (MDE) persistence in individuals with MDE using determinants of persistence identified in previous research. Method: Data were derived from 250 subjects from the general population with new MDE according to DSM-III-R.

  8. Score distributions in information retrieval

    NARCIS (Netherlands)

    Arampatzis, A.; Robertson, S.; Kamps, J.

    2009-01-01

    We review the history of modeling score distributions, focusing on the mixture of normal-exponential by investigating the theoretical as well as the empirical evidence supporting its use. We discuss previously suggested conditions which valid binary mixture models should satisfy, such as the

  9. Developing Scoring Algorithms (Earlier Methods)

    Science.gov (United States)

    We developed scoring procedures to convert screener responses to estimates of individual dietary intake for fruits and vegetables, dairy, added sugars, whole grains, fiber, and calcium using the What We Eat in America 24-hour dietary recall data from the 2003-2006 NHANES.

  10. Patients with type 2 diabetes benefit from primary care-based disease management: a propensity score matched survival time analysis.

    Science.gov (United States)

    Drabik, Anna; Büscher, Guido; Thomas, Karsten; Graf, Christian; Müller, Dirk; Stock, Stephanie

    2012-08-01

    This study aimed to assess the impact of a nationwide German diabetes mellitus disease management program (DMP) on survival time and costs in comparison to routine care. The authors conducted a retrospective observational cohort study using routine administration data from Germany's largest sickness fund to identify insured suffering from diabetes in 2002. A total of 95,443 insured with type 2 diabetes mellitus who were born before January 1, 1962 met the defined inclusion criteria, resulting in 19,888 pairs of DMP participants and nonparticipants matched for socioeconomic and health status using propensity score matching methods. This is the first time propensity score matching has been used to evaluate a survival benefit of DMPs. In the time frame analyzed (3 years), mean survival time for the DMP group was 1045 days vs. 985 days for the routine care group (Ptime. They also incurred lower costs compared to propensity score matched insured in routine care.

  11. Impact of using DSM-5 criteria for diagnosing binge eating disorder in bariatric surgery candidates: change in prevalence rate, demographic characteristics, and scores on the Minnesota Multiphasic Personality Inventory--2 restructured form (MMPI-2-RF).

    Science.gov (United States)

    Marek, Ryan J; Ben-Porath, Yossef S; Ashton, Kathleen; Heinberg, Leslie J

    2014-07-01

    Binge eating disorder (BED) was recently included in the DSM-5. The prevalence rate for BED using the DSM-IV-TR research criteria tends to be higher in bariatric surgery candidates than the normative population; however, no studies have examined how many more bariatric surgery candidates will meet the new, less conservative criteria of DSM-5. We explore the current BED prevalence rate change in a sample of bariatric surgery candidates. Data were obtained for 1,283 bariatric surgery candidates. 84 men and 213 women were diagnosed with current BED using DSM-IV-TR research criteria. A semi-structured interview, the binge eating scale (BES), and a Minnesota Multiphasic Personality Inventory-2 Restructured Form (MMPI-2-RF) were given to every patient as part of standard procedures mandated by the facility. An additional 3.43% (p MMPI-2-RF and BES scores when compared with patients who met DSM-IV-TR criteria for BED. Thus, the current investigation indicates that individuals meeting BED criteria based on DSM-5 are similar to those meeting the more conservative diagnostic threshold outlined in DSM-IV-TR in a sample of bariatric surgery candidates. © 2014 Wiley Periodicals, Inc.

  12. Gleason Score Correlation Between Prostate Biopsy and Radical Prostatectomy Specimens

    Directory of Open Access Journals (Sweden)

    Erdem Öztürk

    2018-04-01

    Full Text Available Objective: Prostate cancer is the most common malignancy in men and the second cause of cancer-related mortality. Prostate biopsy and the Gleason score guide treatment decisions in prostate cancer. Several studies have investigated the correlation between biopsy scores and radical prostatectomy specimen scores. We also evaluated the correlation of Gleason scores of these specimens in our patient series. Materials and Methods: We retrospectively reviewed the data of 468 men who were diagnosed with prostate cancer and underwent radical prostatectomy between 2008 and 2017. Patients’ age, prostate-specific antigen levels at diagnosis, and prostate biopsy and radical prostatectomy specimen Gleason scores were recorded. Upgrading and downgrading were defined as increase or decrease of Gleason score of radical prostate specimen compared to Gleason score of prostate biopsy. Results: A total of 442 men diagnosed with prostate cancer were included in the study. The mean age of the patients was 62.62±6.26 years (44-84 years and mean prostate specific antigen level was 9.01±6.84 ng/mL (1.09-49 ng/mL. Prostate biopsy Gleason score was 7 in 27 (6.1% men. Radical prostatectomy specimen Gleason score was 7 in 62 (14% men. Gleason correlation was highest in the 240 patients (71.6% with score <7 and was lowest in the 31 (38.75% patients with score =7. Conclusion: This study demonstrated that the discordance rate between Gleason scores of prostate biopsy and radical prostatectomy specimens was 35.7%.

  13. PASI and PQOL-12 score in psoriasis : Is there any correlation?

    Directory of Open Access Journals (Sweden)

    Vikas Shankar

    2011-01-01

    Full Text Available Background: Psoriasis, a common papulo-squamous disorder of the skin, is universal in occurrence and may interfere with the quality of life adversely. Whether extent of the disease has any bearing upon the patients′ psychology has not much been studied in this part of the world. Aims: The objective of this hospital-based cross-sectional study was to assess the disease severity objectively using Psoriasis area and severity index (PASI score and the quality of life by Psoriasis quality-of-life questionnaire-12 (PQOL-12 and to draw correlation between them, if any. Materials and Methods PASI score denotes an objective method of scoring severity of psoriasis, reflecting not only the body surface area but also erythema, induration and scaling. The PQOL-12 represents a 12-item self-administered, disease-specific psychometric instrument created to specifically assess quality-of-life issues that are more important with psoriasis patients. PASI and PQOL-12 score were calculated in each patient for objectively assessing their disease severity and quality of life. Results: In total, 34 psoriasis patients (16 males, 18 females, of age ranging from 8 to 55 years, were studied. Maximum and minimum PASI scores were 0.8 and 32.8, respectively, whereas maximum and minimum PQOL-12 scores were 4 and 120, respectively. PASI and PQOL-12 values showed minimal positive correlation (r = +0.422. Conclusion: Disease severity of psoriasis had no direct reflection upon their quality of life. Limited psoriasis on visible area may also have greater impact on mental health.

  14. Total parenteral nutrition - infants

    Science.gov (United States)

    ... medlineplus.gov/ency/article/007239.htm Total parenteral nutrition - infants To use the sharing features on this page, please enable JavaScript. Total parenteral nutrition (TPN) is a method of feeding that bypasses ...

  15. Total parenteral nutrition

    Science.gov (United States)

    ... medlineplus.gov/ency/patientinstructions/000177.htm Total parenteral nutrition To use the sharing features on this page, please enable JavaScript. Total parenteral nutrition (TPN) is a method of feeding that bypasses ...

  16. Technique of total thyroidectomy

    International Nuclear Information System (INIS)

    Rao, R.S.

    1999-01-01

    It is essential to define the various surgical procedures that are carried out for carcinoma of the thyroid gland. They are thyroid gland, subtotal lobectomy, total thyroidectomy and near total thyroidectomy

  17. Total iron binding capacity

    Science.gov (United States)

    ... page: //medlineplus.gov/ency/article/003489.htm Total iron binding capacity To use the sharing features on this page, please enable JavaScript. Total iron binding capacity (TIBC) is a blood test to ...

  18. Combining Teacher Assessment Scores with External Examination ...

    African Journals Online (AJOL)

    Combining Teacher Assessment Scores with External Examination Scores for Certification: Comparative Study of Four Statistical Models. ... University entrance examination scores in mathematics were obtained for a subsample of 115 ...

  19. Scoring System Improvements to Three Leadership Predictors

    National Research Council Canada - National Science Library

    Dela

    1997-01-01

    .... The modified scoring systems were evaluated by rescoring responses randomly selected from the sample which had been scored according to the scoring systems originally developed for the leadership research...

  20. Total well dominated trees

    DEFF Research Database (Denmark)

    Finbow, Arthur; Frendrup, Allan; Vestergaard, Preben D.

    cardinality then G is a total well dominated graph. In this paper we study composition and decomposition of total well dominated trees. By a reversible process we prove that any total well dominated tree can both be reduced to and constructed from a family of three small trees....

  1. Interpreting force concept inventory scores: Normalized gain and SAT scores

    Directory of Open Access Journals (Sweden)

    Jeffrey J. Steinert

    2007-05-01

    Full Text Available Preinstruction SAT scores and normalized gains (G on the force concept inventory (FCI were examined for individual students in interactive engagement (IE courses in introductory mechanics at one high school (N=335 and one university (N=292 , and strong, positive correlations were found for both populations ( r=0.57 and r=0.46 , respectively. These correlations are likely due to the importance of cognitive skills and abstract reasoning in learning physics. The larger correlation coefficient for the high school population may be a result of the much shorter time interval between taking the SAT and studying mechanics, because the SAT may provide a more current measure of abilities when high school students begin the study of mechanics than it does for college students, who begin mechanics years after the test is taken. In prior research a strong correlation between FCI G and scores on Lawson’s Classroom Test of Scientific Reasoning for students from the same two schools was observed. Our results suggest that, when interpreting class average normalized FCI gains and comparing different classes, it is important to take into account the variation of students’ cognitive skills, as measured either by the SAT or by Lawson’s test. While Lawson’s test is not commonly given to students in most introductory mechanics courses, SAT scores provide a readily available alternative means of taking account of students’ reasoning abilities. Knowing the students’ cognitive level before instruction also allows one to alter instruction or to use an intervention designed to improve students’ cognitive level.

  2. Interpreting force concept inventory scores: Normalized gain and SAT scores

    Directory of Open Access Journals (Sweden)

    Vincent P. Coletta

    2007-05-01

    Full Text Available Preinstruction SAT scores and normalized gains (G on the force concept inventory (FCI were examined for individual students in interactive engagement (IE courses in introductory mechanics at one high school (N=335 and one university (N=292, and strong, positive correlations were found for both populations (r=0.57 and r=0.46, respectively. These correlations are likely due to the importance of cognitive skills and abstract reasoning in learning physics. The larger correlation coefficient for the high school population may be a result of the much shorter time interval between taking the SAT and studying mechanics, because the SAT may provide a more current measure of abilities when high school students begin the study of mechanics than it does for college students, who begin mechanics years after the test is taken. In prior research a strong correlation between FCI G and scores on Lawson’s Classroom Test of Scientific Reasoning for students from the same two schools was observed. Our results suggest that, when interpreting class average normalized FCI gains and comparing different classes, it is important to take into account the variation of students’ cognitive skills, as measured either by the SAT or by Lawson’s test. While Lawson’s test is not commonly given to students in most introductory mechanics courses, SAT scores provide a readily available alternative means of taking account of students’ reasoning abilities. Knowing the students’ cognitive level before instruction also allows one to alter instruction or to use an intervention designed to improve students’ cognitive level.

  3. Ganga hospital open injury score in management of open injuries.

    Science.gov (United States)

    Rajasekaran, S; Sabapathy, S R; Dheenadhayalan, J; Sundararajan, S R; Venkatramani, H; Devendra, A; Ramesh, P; Srikanth, K P

    2015-02-01

    Open injuries of the limbs offer challenges in management as there are still many grey zones in decision making regarding salvage, timing and type of reconstruction. As a result, there is still an unacceptable rate of secondary amputations which lead to tremendous waste of resources and psychological devastation of the patient and his family. Gustilo Anderson's classification was a major milestone in grading the severity of injury but however suffers from the disadvantages of imprecise definition, a poor interobserver correlation, inability to address the issue of salvage and inclusion of a wide spectrum of injuries in Type IIIb category. Numerous scores such as Mangled Extremity Severity Score, the Predictive Salvage Index, the Limb Salvage Index, Hannover Fracture Scale-97 etc have been proposed but all have the disadvantage of retrospective evaluation, inadequate sample sizes and poor sensitivity and specificity to amputation, especially in IIIb injuries. The Ganga Hospital Open Injury Score (GHOIS) was proposed in 2004 and is designed to specifically address the outcome in IIIb injuries of the tibia without vascular deficit. It evaluates the severity of injury to the three components of the limb--the skin, the bone and the musculotendinous structures separately on a grade from 0 to 5. Seven comorbid factors which influence the treatment and the outcome are included in the score with two marks each. The application of the total score and the individual tissue scores in management of IIIB injuries is discussed. The total score was shown to predict salvage when the value was 14 or less; amputation when the score was 17 and more. A grey zone of 15 and 16 is provided where the decision making had to be made on a case to case basis. The additional value of GHOIS was its ability to guide the timing and type of reconstruction. A skin score of more than 3 always required a flap and hence it indicated the need for an orthoplastic approach from the index procedure. Bone

  4. Blind Grid Scoring Record No. 290

    National Research Council Canada - National Science Library

    Overbay, Larry; Robitaille, George

    2005-01-01

    ...) utilizing the APG Standardized UXO Technology Demonstration Site Blind Grid. Scoring Records have been coordinated by Larry Overbay and the Standardized UXO Technology Demonstration Site Scoring Committee...

  5. Blind Grid Scoring Record No. 293

    National Research Council Canada - National Science Library

    Overbay, Larry; Robitaille, George; Archiable, Robert; Fling, Rick; McClung, Christina

    2005-01-01

    ...) utilizing the YPG Standardized UXO Technology Demonstration Site Blind Grid. Scoring Records have been coordinated by Larry Overbay and the Standardized UXO Technology Demonstration Site Scoring Committee...

  6. Open Field Scoring Record No. 298

    National Research Council Canada - National Science Library

    Overbay, Jr., Larry; Robitaille, George; Fling, Rick; McClung, Christina

    2005-01-01

    ...) utilizing the APG Standardized UXO Technology Demonstration Site Open Field. Scoring Records have been coordinated by Larry Overbay and the Standardized UXO Technology Demonstration Site Scoring Committee...

  7. Open Field Scoring Record No. 299

    National Research Council Canada - National Science Library

    Overbay, Larry; Robitaille, George

    2005-01-01

    ...) utilizing the YPG Standardized UXO Technology Demonstration Site Open Field. Scoring Records have been coordinated by Larry Overbay and the standardized UXO Technology Demonstration Site Scoring Committee...

  8. Translation and validation of the new version of the Knee Society Score - The 2011 KS Score - into Brazilian Portuguese.

    Science.gov (United States)

    Silva, Adriana Lucia Pastore E; Croci, Alberto Tesconi; Gobbi, Riccardo Gomes; Hinckel, Betina Bremer; Pecora, José Ricardo; Demange, Marco Kawamura

    2017-01-01

    Translation, cultural adaptation, and validation of the new version of the Knee Society Score - The 2011 KS Score - into Brazilian Portuguese and verification of its measurement properties, reproducibility, and validity. In 2012, the new version of the Knee Society Score was developed and validated. This scale comprises four separate subscales: (a) objective knee score (seven items: 100 points); (b) patient satisfaction score (five items: 40 points); (c) patient expectations score (three items: 15 points); and (d) functional activity score (19 items: 100 points). A total of 90 patients aged 55-85 years were evaluated in a clinical cross-sectional study. The pre-operative translated version was applied to patients with TKA referral, and the post-operative translated version was applied to patients who underwent TKA. Each patient answered the same questionnaire twice and was evaluated by two experts in orthopedic knee surgery. Evaluations were performed pre-operatively and three, six, or 12 months post-operatively. The reliability of the questionnaire was evaluated using the intraclass correlation coefficient (ICC) between the two applications. Internal consistency was evaluated using Cronbach's alpha. The ICC found no difference between the means of the pre-operative, three-month, and six-month post-operative evaluations between sub-scale items. The Brazilian Portuguese version of The 2011 KS Score is a valid and reliable instrument for objective and subjective evaluation of the functionality of Brazilian patients who undergo TKA and revision TKA.

  9. The BRICS (Bronchiectasis Radiologically Indexed CT Score): A Multicenter Study Score for Use in Idiopathic and Postinfective Bronchiectasis.

    Science.gov (United States)

    Bedi, Pallavi; Chalmers, James D; Goeminne, Pieter C; Mai, Cindy; Saravanamuthu, Pira; Velu, Prasad Palani; Cartlidge, Manjit K; Loebinger, Michael R; Jacob, Joe; Kamal, Faisal; Schembri, Nicola; Aliberti, Stefano; Hill, Uta; Harrison, Mike; Johnson, Christopher; Screaton, Nicholas; Haworth, Charles; Polverino, Eva; Rosales, Edmundo; Torres, Antoni; Benegas, Michael N; Rossi, Adriano G; Patel, Dilip; Hill, Adam T

    2018-05-01

    The goal of this study was to develop a simplified radiological score that could assess clinical disease severity in bronchiectasis. The Bronchiectasis Radiologically Indexed CT Score (BRICS) was devised based on a multivariable analysis of the Bhalla score and its ability in predicting clinical parameters of severity. The score was then externally validated in six centers in 302 patients. A total of 184 high-resolution CT scans were scored for the validation cohort. In a multiple logistic regression model, disease severity markers significantly associated with the Bhalla score were percent predicted FEV 1 , sputum purulence, and exacerbations requiring hospital admission. Components of the Bhalla score that were significantly associated with the disease severity markers were bronchial dilatation and number of bronchopulmonary segments with emphysema. The BRICS was developed with these two parameters. The receiver operating-characteristic curve values for BRICS in the derivation cohort were 0.79 for percent predicted FEV 1 , 0.71 for sputum purulence, and 0.75 for hospital admissions per year; these values were 0.81, 0.70, and 0.70, respectively, in the validation cohort. Sputum free neutrophil elastase activity was significantly elevated in the group with emphysema on CT imaging. A simplified CT scoring system can be used as an adjunct to clinical parameters to predict disease severity in patients with idiopathic and postinfective bronchiectasis. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

  10. Interval Coded Scoring: a toolbox for interpretable scoring systems

    Directory of Open Access Journals (Sweden)

    Lieven Billiet

    2018-04-01

    Full Text Available Over the last decades, clinical decision support systems have been gaining importance. They help clinicians to make effective use of the overload of available information to obtain correct diagnoses and appropriate treatments. However, their power often comes at the cost of a black box model which cannot be interpreted easily. This interpretability is of paramount importance in a medical setting with regard to trust and (legal responsibility. In contrast, existing medical scoring systems are easy to understand and use, but they are often a simplified rule-of-thumb summary of previous medical experience rather than a well-founded system based on available data. Interval Coded Scoring (ICS connects these two approaches, exploiting the power of sparse optimization to derive scoring systems from training data. The presented toolbox interface makes this theory easily applicable to both small and large datasets. It contains two possible problem formulations based on linear programming or elastic net. Both allow to construct a model for a binary classification problem and establish risk profiles that can be used for future diagnosis. All of this requires only a few lines of code. ICS differs from standard machine learning through its model consisting of interpretable main effects and interactions. Furthermore, insertion of expert knowledge is possible because the training can be semi-automatic. This allows end users to make a trade-off between complexity and performance based on cross-validation results and expert knowledge. Additionally, the toolbox offers an accessible way to assess classification performance via accuracy and the ROC curve, whereas the calibration of the risk profile can be evaluated via a calibration curve. Finally, the colour-coded model visualization has particular appeal if one wants to apply ICS manually on new observations, as well as for validation by experts in the specific application domains. The validity and applicability

  11. How well can we assess impacts of agricultural land management changes on the total greenhouse gas balance (CO2, CH4 and N2O) of tropical rice-cropping systems with biogeochemical models?

    Science.gov (United States)

    Kraus, David; Weller, Sebastian; Janz, Baldur; Klatt, Steffen; Santabárbara, Ignacio; Haas, Edwin; Werner, Christian; Wassmann, Reiner; Kiese, Ralf; Butterbach-Bahl, Klaus

    2016-04-01

    Paddy rice cultivation is increasingly challenged by physical and economic irrigation water scarcity. This already results in the trend of converting paddy rice to upland crop cultivation (e.g., maize, aerobic rice) in large parts of South East Asia. Such land management change from flooded lowland systems to well-aerated upland systems drastically affects soil C and N cycling and related emissions of greenhouse gases. Emissions of methane (CH4) are expected to decrease, while emissions of nitrous oxide (N2O) will most likely increase. In addition to such fast evolving 'pollution swapping' it is expected that on longer time scales significant amounts of soil organic carbon (SOC) stocks will be lost in form of carbon dioxide (CO2). Within the DFG-funded research unit ICON (Introducing non-flooded crops in rice-dominated landscapes: Impact on carbon, nitrogen and water cycles), we investigated environmental impacts of land management change from historical paddy rice cultivation to the upland crops maize and aerobic rice at experimental sites at the International Rice Research Institute (IRRI), the Philippines. To present, more than three years of continuous measurement data of CH4 and N2O emissions under different fertilization regimes have been collected. In addition, measurements of SOC contents and bulk densities in different soil horizons allow for an overall very good characterization of the environmental impacts of mentioned land management change. In this contribution we will show how well mentioned land management change effects in tropical agricultural systems can be represented and thus better understood by the help of process-based biogeochemical models. Seasonal emissions of CH4 and N2O are simulated with r2 values of 0.85 and 0.78 and average underestimations of 15 and 14 %, respectively. These underestimations predominantly originate from treatments in which no fertilizer is applied (CH4) as well as uncertainties of soil hydrology (N2O). Long

  12. Toplam Kalite Yönetiminin Mavi Yakalı İşgören Motivasyonu Üzerindeki Etkisi: Mobilya Sektöründe Ampirik Bir Araştırma(The Impact of “Total Quality Management” on the Labours’ Motivation: An Empirical Research in the Furniture Industry

    Directory of Open Access Journals (Sweden)

    Aysun KANBUR

    2008-01-01

    Full Text Available In this study, the impact of “Total Quality Management” on “motivation” which is thought as one of the factors which motivate the organization workers, is examined with a survey conducted on the sector of furniture industry and data of the survey was collected by a questionnaire developed by the researchers. The results of the analysis demonstrated that “Total Quality Management” has an impact on satisfaction taken from social–psychological and organizational–managerial motivation factors but, there wasn’t found same impact on satisfaction taken from economical motivation factors.

  13. High-Throughput Scoring of Seed Germination.

    Science.gov (United States)

    Ligterink, Wilco; Hilhorst, Henk W M

    2017-01-01

    High-throughput analysis of seed germination for phenotyping large genetic populations or mutant collections is very labor intensive and would highly benefit from an automated setup. Although very often used, the total germination percentage after a nominated period of time is not very informative as it lacks information about start, rate, and uniformity of germination, which are highly indicative of such traits as dormancy, stress tolerance, and seed longevity. The calculation of cumulative germination curves requires information about germination percentage at various time points. We developed the GERMINATOR package: a simple, highly cost-efficient, and flexible procedure for high-throughput automatic scoring and evaluation of germination that can be implemented without the use of complex robotics. The GERMINATOR package contains three modules: (I) design of experimental setup with various options to replicate and randomize samples; (II) automatic scoring of germination based on the color contrast between the protruding radicle and seed coat on a single image; and (III) curve fitting of cumulative germination data and the extraction, recap, and visualization of the various germination parameters. GERMINATOR is a freely available package that allows the monitoring and analysis of several thousands of germination tests, several times a day by a single person.

  14. The Rectal Cancer Female Sexuality Score

    DEFF Research Database (Denmark)

    Thyø, Anne; Emmertsen, Katrine J; Laurberg, Søren

    2018-01-01

    BACKGROUND: Sexual dysfunction and impaired quality of life is a potential side effect to rectal cancer treatment. OBJECTIVE: The objective of this study was to develop and validate a simple scoring system intended to evaluate sexual function in women treated for rectal cancer. DESIGN......: This is a population-based cross-sectional study. SETTINGS: Female patients diagnosed with rectal cancer between 2001 and 2014 were identified by using the Danish Colorectal Cancer Group's database. Participants filled in the validated Sexual Function Vaginal Changes questionnaire. Women declared to be sexually active...... in the validation group. PATIENTS: Female patients with rectal cancer above the age of 18 who underwent abdominoperineal resection, Hartmann procedure, or total/partial mesorectal excision were selected. MAIN OUTCOME MEASURES: The primary outcome measured was the quality of life that was negatively affected because...

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

    Science.gov (United States)

    Huggins-Manley, Anne Corinne; Qiu,