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Sample records for treatment scoring interaction

  1. Retrieval/ex situ thermal treatment scoring interaction report

    Energy Technology Data Exchange (ETDEWEB)

    Raivo, B.D.; Richardson, J.G.

    1993-11-01

    A retrieval/ex situ thermal treatment technology process for the Idaho National Engineering Laboratory transuranic waste pits and trenches is present. A system performance score is calculated, and assumptions, requirements, and reference baseline technologies for all subelements are included.

  2. Genetic Interaction Score (S-Score) Calculation, Clustering, and Visualization of Genetic Interaction Profiles for Yeast.

    Science.gov (United States)

    Roguev, Assen; Ryan, Colm J; Xu, Jiewei; Colson, Isabelle; Hartsuiker, Edgar; Krogan, Nevan

    2018-02-01

    This protocol describes computational analysis of genetic interaction screens, ranging from data capture (plate imaging) to downstream analyses. Plate imaging approaches using both digital camera and office flatbed scanners are included, along with a protocol for the extraction of colony size measurements from the resulting images. A commonly used genetic interaction scoring method, calculation of the S-score, is discussed. These methods require minimal computer skills, but some familiarity with MATLAB and Linux/Unix is a plus. Finally, an outline for using clustering and visualization software for analysis of resulting data sets is provided. © 2018 Cold Spring Harbor Laboratory Press.

  3. Learning Predictive Interactions Using Information Gain and Bayesian Network Scoring.

    Directory of Open Access Journals (Sweden)

    Xia Jiang

    Full Text Available The problems of correlation and classification are long-standing in the fields of statistics and machine learning, and techniques have been developed to address these problems. We are now in the era of high-dimensional data, which is data that can concern billions of variables. These data present new challenges. In particular, it is difficult to discover predictive variables, when each variable has little marginal effect. An example concerns Genome-wide Association Studies (GWAS datasets, which involve millions of single nucleotide polymorphism (SNPs, where some of the SNPs interact epistatically to affect disease status. Towards determining these interacting SNPs, researchers developed techniques that addressed this specific problem. However, the problem is more general, and so these techniques are applicable to other problems concerning interactions. A difficulty with many of these techniques is that they do not distinguish whether a learned interaction is actually an interaction or whether it involves several variables with strong marginal effects.We address this problem using information gain and Bayesian network scoring. First, we identify candidate interactions by determining whether together variables provide more information than they do separately. Then we use Bayesian network scoring to see if a candidate interaction really is a likely model. Our strategy is called MBS-IGain. Using 100 simulated datasets and a real GWAS Alzheimer's dataset, we investigated the performance of MBS-IGain.When analyzing the simulated datasets, MBS-IGain substantially out-performed nine previous methods at locating interacting predictors, and at identifying interactions exactly. When analyzing the real Alzheimer's dataset, we obtained new results and results that substantiated previous findings. We conclude that MBS-IGain is highly effective at finding interactions in high-dimensional datasets. This result is significant because we have increasingly

  4. Scoring protein interaction decoys using exposed residues (SPIDER): a novel multibody interaction scoring function based on frequent geometric patterns of interfacial residues.

    Science.gov (United States)

    Khashan, Raed; Zheng, Weifan; Tropsha, Alexander

    2012-08-01

    Accurate prediction of the structure of protein-protein complexes in computational docking experiments remains a formidable challenge. It has been recognized that identifying native or native-like poses among multiple decoys is the major bottleneck of the current scoring functions used in docking. We have developed a novel multibody pose-scoring function that has no theoretical limit on the number of residues contributing to the individual interaction terms. We use a coarse-grain representation of a protein-protein complex where each residue is represented by its side chain centroid. We apply a computational geometry approach called Almost-Delaunay tessellation that transforms protein-protein complexes into a residue contact network, or an undirectional graph where vertex-residues are nodes connected by edges. This treatment forms a family of interfacial graphs representing a dataset of protein-protein complexes. We then employ frequent subgraph mining approach to identify common interfacial residue patterns that appear in at least a subset of native protein-protein interfaces. The geometrical parameters and frequency of occurrence of each "native" pattern in the training set are used to develop the new SPIDER scoring function. SPIDER was validated using standard "ZDOCK" benchmark dataset that was not used in the development of SPIDER. We demonstrate that SPIDER scoring function ranks native and native-like poses above geometrical decoys and that it exceeds in performance a popular ZRANK scoring function. SPIDER was ranked among the top scoring functions in a recent round of CAPRI (Critical Assessment of PRedicted Interactions) blind test of protein-protein docking methods. Copyright © 2012 Wiley Periodicals, Inc.

  5. Risk score modeling of multiple gene to gene interactions using aggregated-multifactor dimensionality reduction

    Directory of Open Access Journals (Sweden)

    Dai Hongying

    2013-01-01

    Full Text Available Abstract Background Multifactor Dimensionality Reduction (MDR has been widely applied to detect gene-gene (GxG interactions associated with complex diseases. Existing MDR methods summarize disease risk by a dichotomous predisposing model (high-risk/low-risk from one optimal GxG interaction, which does not take the accumulated effects from multiple GxG interactions into account. Results We propose an Aggregated-Multifactor Dimensionality Reduction (A-MDR method that exhaustively searches for and detects significant GxG interactions to generate an epistasis enriched gene network. An aggregated epistasis enriched risk score, which takes into account multiple GxG interactions simultaneously, replaces the dichotomous predisposing risk variable and provides higher resolution in the quantification of disease susceptibility. We evaluate this new A-MDR approach in a broad range of simulations. Also, we present the results of an application of the A-MDR method to a data set derived from Juvenile Idiopathic Arthritis patients treated with methotrexate (MTX that revealed several GxG interactions in the folate pathway that were associated with treatment response. The epistasis enriched risk score that pooled information from 82 significant GxG interactions distinguished MTX responders from non-responders with 82% accuracy. Conclusions The proposed A-MDR is innovative in the MDR framework to investigate aggregated effects among GxG interactions. New measures (pOR, pRR and pChi are proposed to detect multiple GxG interactions.

  6. Risk score modeling of multiple gene to gene interactions using aggregated-multifactor dimensionality reduction

    Science.gov (United States)

    2013-01-01

    Background Multifactor Dimensionality Reduction (MDR) has been widely applied to detect gene-gene (GxG) interactions associated with complex diseases. Existing MDR methods summarize disease risk by a dichotomous predisposing model (high-risk/low-risk) from one optimal GxG interaction, which does not take the accumulated effects from multiple GxG interactions into account. Results We propose an Aggregated-Multifactor Dimensionality Reduction (A-MDR) method that exhaustively searches for and detects significant GxG interactions to generate an epistasis enriched gene network. An aggregated epistasis enriched risk score, which takes into account multiple GxG interactions simultaneously, replaces the dichotomous predisposing risk variable and provides higher resolution in the quantification of disease susceptibility. We evaluate this new A-MDR approach in a broad range of simulations. Also, we present the results of an application of the A-MDR method to a data set derived from Juvenile Idiopathic Arthritis patients treated with methotrexate (MTX) that revealed several GxG interactions in the folate pathway that were associated with treatment response. The epistasis enriched risk score that pooled information from 82 significant GxG interactions distinguished MTX responders from non-responders with 82% accuracy. Conclusions The proposed A-MDR is innovative in the MDR framework to investigate aggregated effects among GxG interactions. New measures (pOR, pRR and pChi) are proposed to detect multiple GxG interactions. PMID:23294634

  7. Risk score modeling of multiple gene to gene interactions using aggregated-multifactor dimensionality reduction.

    Science.gov (United States)

    Dai, Hongying; Charnigo, Richard J; Becker, Mara L; Leeder, J Steven; Motsinger-Reif, Alison A

    2013-01-08

    Multifactor Dimensionality Reduction (MDR) has been widely applied to detect gene-gene (GxG) interactions associated with complex diseases. Existing MDR methods summarize disease risk by a dichotomous predisposing model (high-risk/low-risk) from one optimal GxG interaction, which does not take the accumulated effects from multiple GxG interactions into account. We propose an Aggregated-Multifactor Dimensionality Reduction (A-MDR) method that exhaustively searches for and detects significant GxG interactions to generate an epistasis enriched gene network. An aggregated epistasis enriched risk score, which takes into account multiple GxG interactions simultaneously, replaces the dichotomous predisposing risk variable and provides higher resolution in the quantification of disease susceptibility. We evaluate this new A-MDR approach in a broad range of simulations. Also, we present the results of an application of the A-MDR method to a data set derived from Juvenile Idiopathic Arthritis patients treated with methotrexate (MTX) that revealed several GxG interactions in the folate pathway that were associated with treatment response. The epistasis enriched risk score that pooled information from 82 significant GxG interactions distinguished MTX responders from non-responders with 82% accuracy. The proposed A-MDR is innovative in the MDR framework to investigate aggregated effects among GxG interactions. New measures (pOR, pRR and pChi) are proposed to detect multiple GxG interactions.

  8. Medical treatment of ectopic pregnancy and clinical score

    OpenAIRE

    Glišić Andreja

    2007-01-01

    Introduction: Ectopic pregnancy is an important cause of morbidity and mortality worldwide. Furthermore, with earlier diagnosis, medical therapy with methotrexate can be offered and surgery avoided in some women, though the best regimen remains unclear. Although there have been advances in the management of ectopic pregnancy, there are still questions to be answered. Objective. The use of clinical score was evaluated after the clinical treatment for selection of patients for medical treatment...

  9. Development of the knowledge-based and empirical combined scoring algorithm (KECSA) to score protein-ligand interactions.

    Science.gov (United States)

    Zheng, Zheng; Merz, Kenneth M

    2013-05-24

    We describe a novel knowledge-based protein-ligand scoring function that employs a new definition for the reference state, allowing us to relate a statistical potential to a Lennard-Jones (LJ) potential. In this way, the LJ potential parameters were generated from protein-ligand complex structural data contained in the Protein Databank (PDB). Forty-nine (49) types of atomic pairwise interactions were derived using this method, which we call the knowledge-based and empirical combined scoring algorithm (KECSA). Two validation benchmarks were introduced to test the performance of KECSA. The first validation benchmark included two test sets that address the training set and enthalpy/entropy of KECSA. The second validation benchmark suite included two large-scale and five small-scale test sets, to compare the reproducibility of KECSA, with respect to two empirical score functions previously developed in our laboratory (LISA and LISA+), as well as to other well-known scoring methods. Validation results illustrate that KECSA shows improved performance in all test sets when compared with other scoring methods, especially in its ability to minimize the root mean square error (RMSE). LISA and LISA+ displayed similar performance using the correlation coefficient and Kendall τ as the metric of quality for some of the small test sets. Further pathways for improvement are discussed for which would allow KECSA to be more sensitive to subtle changes in ligand structure.

  10. Development and validation of a prognostic score during tuberculosis treatment.

    Science.gov (United States)

    Pefura-Yone, Eric Walter; Balkissou, Adamou Dodo; Poka-Mayap, Virginie; Fatime-Abaicho, Hadja Koté; Enono-Edende, Patrick Thierry; Kengne, André Pascal

    2017-04-08

    Death under care is a major challenge for tuberculosis (TB) treatment programs. We derived and validated a simple score to predict mortality during tuberculosis treatment in high endemicity areas. We used data for patients aged ≥15 years, diagnosed and treated for tuberculosis at the Yaounde Jamot Hospital between January 2012 and December 2013. Baseline characteristics associated with mortality were investigated using logistic regressions. A simple prognosis score (CABI) was constructed with regression coefficients for predictors in the final model. Internal validation used bootstrap resampling procedures. Models discrimination was assessed using c-statistics and calibration assessed via calibration plots and the Hosmer and Lemeshwow (H-L) statistics. The optimal score was based on the Youden's index. A total of 2250 patients (men 57.2%) with a mean age of 35.8 years were included; among whom 213 deaths (cumulative incidence 9.5%) were recorded. Clinical form of tuberculosis (C), age (A, years), adjusted body mass index (B, BMI, kg/m 2 ) and status for HIV (Human immunodefiency virus) infection (I) were significant predictors in the final model (p < 0.0001) which was of the form Death risk = 1/(1 + e - (-1.3120 + 0.0474 ∗ age - 0.1866 ∗ BMI + 1.1637 (if smear negative TB) + 0.5418(if extra - pulmonary TB) + 1.3820(if HIV+)) ). The c-statistic was 0.812 in the derivation sample and 0.808 after correction for optimism. The calibration was good [H-Lχ 2  = 6.44 (p = 0.60)]. The optimal absolute risk threshold was 4.8%, corresponding to a sensitivity of 81% and specificity of 67%. The preliminary promising findings from this study require confirmation through independent external validation studies. If confirmed, the model derived could facilitate the stratification of TB patients for mortality risk and implementation of additional monitoring and management measures in vulnerable patients.

  11. Interactively exploring optimized treatment plans.

    Science.gov (United States)

    Rosen, Isaac; Liu, H Helen; Childress, Nathan; Liao, Zhongxing

    2005-02-01

    A new paradigm for treatment planning is proposed that embodies the concept of interactively exploring the space of optimized plans. In this approach, treatment planning ignores the details of individual plans and instead presents the physician with clinical summaries of sets of solutions to well-defined clinical goals in which every solution has been optimized in advance by computer algorithms. Before interactive planning, sets of optimized plans are created for a variety of treatment delivery options and critical structure dose-volume constraints. Then, the dose-volume parameters of the optimized plans are fit to linear functions. These linear functions are used to show in real time how the target dose-volume histogram (DVH) changes as the DVHs of the critical structures are changed interactively. A bitmap of the space of optimized plans is used to restrict the feasible solutions. The physician selects the critical structure dose-volume constraints that give the desired dose to the planning target volume (PTV) and then those constraints are used to create the corresponding optimized plan. The method is demonstrated using prototype software, Treatment Plan Explorer (TPEx), and a clinical example of a patient with a tumor in the right lung. For this example, the delivery options included 4 open beams, 12 open beams, 4 wedged beams, and 12 wedged beams. Beam directions and relative weights were optimized for a range of critical structure dose-volume constraints for the lungs and esophagus. Cord dose was restricted to 45 Gy. Using the interactive interface, the physician explored how the tumor dose changed as critical structure dose-volume constraints were tightened or relaxed and selected the best compromise for each delivery option. The corresponding treatment plans were calculated and compared with the linear parameterization presented to the physician in TPEx. The linear fits were best for the maximum PTV dose and worst for the minimum PTV dose. Based on the root

  12. Scoring of treatment-related late effects in prostate cancer

    International Nuclear Information System (INIS)

    Livsey, Jacqueline E.; Routledge, Jacqueline; Burns, Meriel; Swindell, Rick; Davidson, Susan E.; Cowan, Richard A.; Logue, John P.; Wylie, James P.

    2002-01-01

    Background and purpose: To assess the correlation between different general and organ specific quality of life and morbidity scoring methods in a cohort of men treated with radical radiotherapy for prostate cancer. Materials and methods: Men who had been treated with radical radiotherapy (50 Gy in 16 fractions over 21 days) for localized prostate cancer more than 3 years previously and who had no evidence of recurrent disease were invited to take part in the study. A total of 101 of 135 invited patients agreed and completed LENT/SOMA, UCLA Prostate Cancer Index, and 36 item RAND Health survey questionnaires. Results: The patients had comparable results with other published series with respect to the UCLA and SF-36 indices. There was significant correlation between the corresponding parts of the UCLA and LENT/SOMA scales (P<0.0005). However, for the same symptoms, a patient tended to score lower (worse) on the UCLA scale in comparison to LENT/SOMA. The relationship between the average LENT/SOMA score and maximum score was also not straightforward with each set of data revealing different information. Conclusions: The LENT/SOMA questions were, in the main, more wide-ranging and informative than the UCLA index. It is helpful to give both the overall and maximum LENT/SOMA scores to most efficiently use all of the data. There may need to be a further LENT/SOMA question to allow both symptoms of tenesmus and faecal urgency to be fully addressed

  13. Neurointerventional Treatment in Acute Stroke. Whom to Treat? (Endovascular Treatment for Acute Stroke: Utility of THRIVE Score and HIAT Score for Patient Selection)

    International Nuclear Information System (INIS)

    Fjetland, Lars; Roy, Sumit; Kurz, Kathinka D.; Solbakken, Tore; Larsen, Jan Petter; Kurz, Martin W.

    2013-01-01

    Purpose: Intra-arterial therapy (IAT) is used increasingly as a treatment option for acute stroke caused by central large vessel occlusions. Despite high rates of recanalization, the clinical outcome is highly variable. The authors evaluated the Houston IAT (HIAT) and the totaled health risks in vascular events (THRIVE) score, two predicting scores designed to identify patients likely to benefit from IAT. Methods: Fifty-two patients treated at the Stavanger University Hospital with IAT from May 2009 to June 2012 were included in this study. We combined the scores in an additional analysis. We also performed an additional analysis according to high age and evaluated the scores in respect of technical efficacy. Results: Fifty-two patients were evaluated by the THRIVE score and 51 by the HIAT score. We found a strong correlation between the level of predicted risk and the actual clinical outcome (THRIVE p = 0.002, HIAT p = 0.003). The correlations were limited to patients successfully recanalized and to patients <80 years. By combining the scores additional 14.3 % of the patients could be identified as poor candidates for IAT. Both scores were insufficient to identify patients with a good clinical outcome. Conclusions: Both scores showed a strong correlation to poor clinical outcome in patients <80 years. The specificity of the scores could be enhanced by combining them. Both scores were insufficient to identify patients with a good clinical outcome and showed no association to clinical outcome in patients aged ≥80 years

  14. A novel scoring approach for protein co-purification data reveals high interaction specificity.

    Directory of Open Access Journals (Sweden)

    Xueping Yu

    2009-09-01

    Full Text Available Large-scale protein interaction networks (PINs have typically been discerned using affinity purification followed by mass spectrometry (AP/MS and yeast two-hybrid (Y2H techniques. It is generally recognized that Y2H screens detect direct binary interactions while the AP/MS method captures co-complex associations; however, the latter technique is known to yield prevalent false positives arising from a number of effects, including abundance. We describe a novel approach to compute the propensity for two proteins to co-purify in an AP/MS data set, thereby allowing us to assess the detected level of interaction specificity by analyzing the corresponding distribution of interaction scores. We find that two recent AP/MS data sets of yeast contain enrichments of specific, or high-scoring, associations as compared to commensurate random profiles, and that curated, direct physical interactions in two prominent data bases have consistently high scores. Our scored interaction data sets are generally more comprehensive than those of previous studies when compared against four diverse, high-quality reference sets. Furthermore, we find that our scored data sets are more enriched with curated, direct physical associations than Y2H sets. A high-confidence protein interaction network (PIN derived from the AP/MS data is revealed to be highly modular, and we show that this topology is not the result of misrepresenting indirect associations as direct interactions. In fact, we propose that the modularity in Y2H data sets may be underrepresented, as they contain indirect associations that are significantly enriched with false negatives. The AP/MS PIN is also found to contain significant assortative mixing; however, in line with a previous study we confirm that Y2H interaction data show weak disassortativeness, thus revealing more clearly the distinctive natures of the interaction detection methods. We expect that our scored yeast data sets are ideal for further

  15. A novel scoring approach for protein co-purification data reveals high interaction specificity.

    Science.gov (United States)

    Yu, Xueping; Ivanic, Joseph; Wallqvist, Anders; Reifman, Jaques

    2009-09-01

    Large-scale protein interaction networks (PINs) have typically been discerned using affinity purification followed by mass spectrometry (AP/MS) and yeast two-hybrid (Y2H) techniques. It is generally recognized that Y2H screens detect direct binary interactions while the AP/MS method captures co-complex associations; however, the latter technique is known to yield prevalent false positives arising from a number of effects, including abundance. We describe a novel approach to compute the propensity for two proteins to co-purify in an AP/MS data set, thereby allowing us to assess the detected level of interaction specificity by analyzing the corresponding distribution of interaction scores. We find that two recent AP/MS data sets of yeast contain enrichments of specific, or high-scoring, associations as compared to commensurate random profiles, and that curated, direct physical interactions in two prominent data bases have consistently high scores. Our scored interaction data sets are generally more comprehensive than those of previous studies when compared against four diverse, high-quality reference sets. Furthermore, we find that our scored data sets are more enriched with curated, direct physical associations than Y2H sets. A high-confidence protein interaction network (PIN) derived from the AP/MS data is revealed to be highly modular, and we show that this topology is not the result of misrepresenting indirect associations as direct interactions. In fact, we propose that the modularity in Y2H data sets may be underrepresented, as they contain indirect associations that are significantly enriched with false negatives. The AP/MS PIN is also found to contain significant assortative mixing; however, in line with a previous study we confirm that Y2H interaction data show weak disassortativeness, thus revealing more clearly the distinctive natures of the interaction detection methods. We expect that our scored yeast data sets are ideal for further biological discovery

  16. Evaluation of Two Methods for Modeling Measurement Errors When Testing Interaction Effects with Observed Composite Scores

    Science.gov (United States)

    Hsiao, Yu-Yu; Kwok, Oi-Man; Lai, Mark H. C.

    2018-01-01

    Path models with observed composites based on multiple items (e.g., mean or sum score of the items) are commonly used to test interaction effects. Under this practice, researchers generally assume that the observed composites are measured without errors. In this study, we reviewed and evaluated two alternative methods within the structural…

  17. Physics-based scoring of protein-ligand interactions: explicit polarizability, quantum mechanics and free energies.

    Science.gov (United States)

    Bryce, Richard A

    2011-04-01

    The ability to accurately predict the interaction of a ligand with its receptor is a key limitation in computer-aided drug design approaches such as virtual screening and de novo design. In this article, we examine current strategies for a physics-based approach to scoring of protein-ligand affinity, as well as outlining recent developments in force fields and quantum chemical techniques. We also consider advances in the development and application of simulation-based free energy methods to study protein-ligand interactions. Fuelled by recent advances in computational algorithms and hardware, there is the opportunity for increased integration of physics-based scoring approaches at earlier stages in computationally guided drug discovery. Specifically, we envisage increased use of implicit solvent models and simulation-based scoring methods as tools for computing the affinities of large virtual ligand libraries. Approaches based on end point simulations and reference potentials allow the application of more advanced potential energy functions to prediction of protein-ligand binding affinities. Comprehensive evaluation of polarizable force fields and quantum mechanical (QM)/molecular mechanical and QM methods in scoring of protein-ligand interactions is required, particularly in their ability to address challenging targets such as metalloproteins and other proteins that make highly polar interactions. Finally, we anticipate increasingly quantitative free energy perturbation and thermodynamic integration methods that are practical for optimization of hits obtained from screened ligand libraries.

  18. A scored human protein-protein interaction network to catalyze genomic interpretation

    DEFF Research Database (Denmark)

    Li, Taibo; Wernersson, Rasmus; Hansen, Rasmus B

    2017-01-01

    Genome-scale human protein-protein interaction networks are critical to understanding cell biology and interpreting genomic data, but challenging to produce experimentally. Through data integration and quality control, we provide a scored human protein-protein interaction network (InWeb_InBioMap,......Web_InBioMap, or InWeb_IM) with severalfold more interactions (>500,000) and better functional biological relevance than comparable resources. We illustrate that InWeb_InBioMap enables functional interpretation of >4,700 cancer genomes and genes involved in autism....

  19. Correcting for Test Score Measurement Error in ANCOVA Models for Estimating Treatment Effects

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    Lockwood, J. R.; McCaffrey, Daniel F.

    2014-01-01

    A common strategy for estimating treatment effects in observational studies using individual student-level data is analysis of covariance (ANCOVA) or hierarchical variants of it, in which outcomes (often standardized test scores) are regressed on pretreatment test scores, other student characteristics, and treatment group indicators. Measurement…

  20. ROCS: a Reproducibility Index and Confidence Score for Interaction Proteomics Studies

    Directory of Open Access Journals (Sweden)

    Dazard Jean-Eudes

    2012-06-01

    Full Text Available Abstract Background Affinity-Purification Mass-Spectrometry (AP-MS provides a powerful means of identifying protein complexes and interactions. Several important challenges exist in interpreting the results of AP-MS experiments. First, the reproducibility of AP-MS experimental replicates can be low, due both to technical variability and the dynamic nature of protein interactions in the cell. Second, the identification of true protein-protein interactions in AP-MS experiments is subject to inaccuracy due to high false negative and false positive rates. Several experimental approaches can be used to mitigate these drawbacks, including the use of replicated and control experiments and relative quantification to sensitively distinguish true interacting proteins from false ones. Methods To address the issues of reproducibility and accuracy of protein-protein interactions, we introduce a two-step method, called ROCS, which makes use of Indicator Prey Proteins to select reproducible AP-MS experiments, and of Confidence Scores to select specific protein-protein interactions. The Indicator Prey Proteins account for measures of protein identifiability as well as protein reproducibility, effectively allowing removal of outlier experiments that contribute noise and affect downstream inferences. The filtered set of experiments is then used in the Protein-Protein Interaction (PPI scoring step. Prey protein scoring is done by computing a Confidence Score, which accounts for the probability of occurrence of prey proteins in the bait experiments relative to the control experiment, where the significance cutoff parameter is estimated by simultaneously controlling false positives and false negatives against metrics of false discovery rate and biological coherence respectively. In summary, the ROCS method relies on automatic objective criterions for parameter estimation and error-controlled procedures. Results We illustrate the performance of our method by applying

  1. Optimizing scoring function of protein-nucleic acid interactions with both affinity and specificity.

    Directory of Open Access Journals (Sweden)

    Zhiqiang Yan

    Full Text Available Protein-nucleic acid (protein-DNA and protein-RNA recognition is fundamental to the regulation of gene expression. Determination of the structures of the protein-nucleic acid recognition and insight into their interactions at molecular level are vital to understanding the regulation function. Recently, quantitative computational approach has been becoming an alternative of experimental technique for predicting the structures and interactions of biomolecular recognition. However, the progress of protein-nucleic acid structure prediction, especially protein-RNA, is far behind that of the protein-ligand and protein-protein structure predictions due to the lack of reliable and accurate scoring function for quantifying the protein-nucleic acid interactions. In this work, we developed an accurate scoring function (named as SPA-PN, SPecificity and Affinity of the Protein-Nucleic acid interactions for protein-nucleic acid interactions by incorporating both the specificity and affinity into the optimization strategy. Specificity and affinity are two requirements of highly efficient and specific biomolecular recognition. Previous quantitative descriptions of the biomolecular interactions considered the affinity, but often ignored the specificity owing to the challenge of specificity quantification. We applied our concept of intrinsic specificity to connect the conventional specificity, which circumvents the challenge of specificity quantification. In addition to the affinity optimization, we incorporated the quantified intrinsic specificity into the optimization strategy of SPA-PN. The testing results and comparisons with other scoring functions validated that SPA-PN performs well on both the prediction of binding affinity and identification of native conformation. In terms of its performance, SPA-PN can be widely used to predict the protein-nucleic acid structures and quantify their interactions.

  2. Optimal caliper width for propensity score matching of three treatment groups: a Monte Carlo study.

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    Wang, Yongji; Cai, Hongwei; Li, Chanjuan; Jiang, Zhiwei; Wang, Ling; Song, Jiugang; Xia, Jielai

    2013-01-01

    Propensity score matching is a method to reduce bias in non-randomized and observational studies. Propensity score matching is mainly applied to two treatment groups rather than multiple treatment groups, because some key issues affecting its application to multiple treatment groups remain unsolved, such as the matching distance, the assessment of balance in baseline variables, and the choice of optimal caliper width. The primary objective of this study was to compare propensity score matching methods using different calipers and to choose the optimal caliper width for use with three treatment groups. The authors used caliper widths from 0.1 to 0.8 of the pooled standard deviation of the logit of the propensity score, in increments of 0.1. The balance in baseline variables was assessed by standardized difference. The matching ratio, relative bias, and mean squared error (MSE) of the estimate between groups in different propensity score-matched samples were also reported. The results of Monte Carlo simulations indicate that matching using a caliper width of 0.2 of the pooled standard deviation of the logit of the propensity score affords superior performance in the estimation of treatment effects. This study provides practical solutions for the application of propensity score matching of three treatment groups.

  3. An improved method for scoring protein-protein interactions using semantic similarity within the gene ontology

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    Jain Shobhit

    2010-11-01

    Full Text Available Abstract Background Semantic similarity measures are useful to assess the physiological relevance of protein-protein interactions (PPIs. They quantify similarity between proteins based on their function using annotation systems like the Gene Ontology (GO. Proteins that interact in the cell are likely to be in similar locations or involved in similar biological processes compared to proteins that do not interact. Thus the more semantically similar the gene function annotations are among the interacting proteins, more likely the interaction is physiologically relevant. However, most semantic similarity measures used for PPI confidence assessment do not consider the unequal depth of term hierarchies in different classes of cellular location, molecular function, and biological process ontologies of GO and thus may over-or under-estimate similarity. Results We describe an improved algorithm, Topological Clustering Semantic Similarity (TCSS, to compute semantic similarity between GO terms annotated to proteins in interaction datasets. Our algorithm, considers unequal depth of biological knowledge representation in different branches of the GO graph. The central idea is to divide the GO graph into sub-graphs and score PPIs higher if participating proteins belong to the same sub-graph as compared to if they belong to different sub-graphs. Conclusions The TCSS algorithm performs better than other semantic similarity measurement techniques that we evaluated in terms of their performance on distinguishing true from false protein interactions, and correlation with gene expression and protein families. We show an average improvement of 4.6 times the F1 score over Resnik, the next best method, on our Saccharomyces cerevisiae PPI dataset and 2 times on our Homo sapiens PPI dataset using cellular component, biological process and molecular function GO annotations.

  4. A new multimodal interactive way of subjective scoring of 3D video quality of experience

    Science.gov (United States)

    Kim, Taewan; Lee, Kwanghyun; Lee, Sanghoon; Bovik, Alan C.

    2014-03-01

    People that watch today's 3D visual programs, such as 3D cinema, 3D TV and 3D games, experience wide and dynamically varying ranges of 3D visual immersion and 3D quality of experience (QoE). It is necessary to be able to deploy reliable methodologies that measure each viewers subjective experience. We propose a new methodology that we call Multimodal Interactive Continuous Scoring of Quality (MICSQ). MICSQ is composed of a device interaction process between the 3D display and a separate device (PC, tablet, etc.) used as an assessment tool, and a human interaction process between the subject(s) and the device. The scoring process is multimodal, using aural and tactile cues to help engage and focus the subject(s) on their tasks. Moreover, the wireless device interaction process makes it possible for multiple subjects to assess 3D QoE simultaneously in a large space such as a movie theater, and at di®erent visual angles and distances.

  5. Comparison of weighting approaches for genetic risk scores in gene-environment interaction studies.

    Science.gov (United States)

    Hüls, Anke; Krämer, Ursula; Carlsten, Christopher; Schikowski, Tamara; Ickstadt, Katja; Schwender, Holger

    2017-12-16

    Weighted genetic risk scores (GRS), defined as weighted sums of risk alleles of single nucleotide polymorphisms (SNPs), are statistically powerful for detection gene-environment (GxE) interactions. To assign weights, the gold standard is to use external weights from an independent study. However, appropriate external weights are not always available. In such situations and in the presence of predominant marginal genetic effects, we have shown in a previous study that GRS with internal weights from marginal genetic effects ("GRS-marginal-internal") are a powerful and reliable alternative to single SNP approaches or the use of unweighted GRS. However, this approach might not be appropriate for detecting predominant interactions, i.e. interactions showing an effect stronger than the marginal genetic effect. In this paper, we present a weighting approach for such predominant interactions ("GRS-interaction-training") in which parts of the data are used to estimate the weights from the interaction terms and the remaining data are used to determine the GRS. We conducted a simulation study for the detection of GxE interactions in which we evaluated power, type I error and sign-misspecification. We compared this new weighting approach to the GRS-marginal-internal approach and to GRS with external weights. Our simulation study showed that in the absence of external weights and with predominant interaction effects, the highest power was reached with the GRS-interaction-training approach. If marginal genetic effects were predominant, the GRS-marginal-internal approach was more appropriate. Furthermore, the power to detect interactions reached by the GRS-interaction-training approach was only slightly lower than the power achieved by GRS with external weights. The power of the GRS-interaction-training approach was confirmed in a real data application to the Traffic, Asthma and Genetics (TAG) Study (N = 4465 observations). When appropriate external weights are unavailable, we

  6. Scoring protein relationships in functional interaction networks predicted from sequence data.

    Directory of Open Access Journals (Sweden)

    Gaston K Mazandu

    Full Text Available UNLABELLED: The abundance of diverse biological data from various sources constitutes a rich source of knowledge, which has the power to advance our understanding of organisms. This requires computational methods in order to integrate and exploit these data effectively and elucidate local and genome wide functional connections between protein pairs, thus enabling functional inferences for uncharacterized proteins. These biological data are primarily in the form of sequences, which determine functions, although functional properties of a protein can often be predicted from just the domains it contains. Thus, protein sequences and domains can be used to predict protein pair-wise functional relationships, and thus contribute to the function prediction process of uncharacterized proteins in order to ensure that knowledge is gained from sequencing efforts. In this work, we introduce information-theoretic based approaches to score protein-protein functional interaction pairs predicted from protein sequence similarity and conserved protein signature matches. The proposed schemes are effective for data-driven scoring of connections between protein pairs. We applied these schemes to the Mycobacterium tuberculosis proteome to produce a homology-based functional network of the organism with a high confidence and coverage. We use the network for predicting functions of uncharacterised proteins. AVAILABILITY: Protein pair-wise functional relationship scores for Mycobacterium tuberculosis strain CDC1551 sequence data and python scripts to compute these scores are available at http://web.cbio.uct.ac.za/~gmazandu/scoringschemes.

  7. Acute ischemic stroke treatment, part 2: TreatmentRoles of Capillary Index Score, Revascularization and Time

    Directory of Open Access Journals (Sweden)

    Firas eAL-ALI

    2015-06-01

    Full Text Available Due to recent results from clinical intra-arterial treatment for acute ischemic stroke (IAT-AIS trials such as the Interventional Management of Stroke (IMS III, IAT-AIS and the merit of revascularization have been contested. Even though intra-arterial treatment (IAT has been shown to improve revascularization rates, a corresponding increase in good outcomes has only recently been noted. Even though a significant percentage of patients achieve good revascularization in a timely manner, results do not translate into good clinical outcomes (GCOs. Based on a review of the literature, the authors suspect limited good clinical outcomes following timely and successful revascularization are due to poor patient selection that led to futile and possibly even harmful revascularization. The Capillary Index Score (CIS is a simple angiography-based scale that can potentially be used to improve patient selection to prevent revascularization being performed on patients who are unlikely to benefit from treatment. The CIS characterizes presence of capillary blush related to collateral flow as a marker of residual viable tissue, with absence of blush indicating the tissue is no longer viable due to ischemia. By only selecting patients with a favorable CIS for IAT, the rate of GCOs should consistently approach 80-90%. Current methods of patient selection are primarily dependent on time from ischemia. Time from cerebral ischemia to irreversible tissue damage seems to vary from patient to patient, however, so focusing on viable tissue based on the CIS rather than relying on an artificial time window seems to be a more appropriate approach to patient selection.

  8. Scores on the eysenck personality questionnaire for a sample of children and adolescents receiving psychological treatment in Puerto Rico.

    Science.gov (United States)

    Porrata, Jose Luis; Rosa, Abraham; Mendez, Viviana

    2003-08-01

    Personality questionnaire scores obtained by children and adolescents (n = 28) receiving psychological treatment at a health facility in Humacao, Puerto Rico were examined. The scores were compared with those of regular school children of the same age, of Gurabo, Puerto Rico, who were not in treatment (n = 30). The children in treatment obtained higher scores on Psychoticism, lower scores on Extraversion, and similar scores on Neuroticism and Dissimulation by comparison with regular students.

  9. A novel interaction fingerprint derived from per atom score contributions: exhaustive evaluation of interaction fingerprint performance in docking based virtual screening.

    Science.gov (United States)

    Jasper, Julia B; Humbeck, Lina; Brinkjost, Tobias; Koch, Oliver

    2018-03-16

    Protein ligand interaction fingerprints are a powerful approach for the analysis and assessment of docking poses to improve docking performance in virtual screening. In this study, a novel interaction fingerprint approach (PADIF, protein per atom score contributions derived interaction fingerprint) is presented which was specifically designed for utilising the GOLD scoring functions' atom contributions together with a specific scoring scheme. This allows the incorporation of known protein-ligand complex structures for a target-specific scoring. Unlike many other methods, this approach uses weighting factors reflecting the relative frequency of a specific interaction in the references and penalizes destabilizing interactions. In addition, and for the first time, an exhaustive validation study was performed that assesses the performance of PADIF and two other interaction fingerprints in virtual screening. Here, PADIF shows superior results, and some rules of thumb for a successful use of interaction fingerprints could be identified.

  10. Red cell indexes made easy using an interactive animation: do students and their scores concur?

    Science.gov (United States)

    Kachroo, Upasana; Vinod, Elizabeth; Balasubramanian, Sivakumar; W, Jesi; Prince, Neetu

    2018-03-01

    A good understanding of red cell indexes can aid medical students in a considerable manner, serving as a basis to unravel both concepts in red cell physiology and abnormalities associated with the same. In this study, we tried to assess whether an interactive animation was helpful in improving student comprehension and understanding of red cell indexes compared with conventional classroom teaching. Eighty-eight first-year MBBS students participated, of which 44 were assigned to group A and 44 were assigned to group B after randomization. After further creation of smaller groups, students were provided with 45 min to revise red cell indexes, after which they were required to complete a multimodal questionnaire. Group A subgroups used written material for revision, whereas group B subgroups had access to an interactive animation. After completion of the questionnaire, group A students also used the animation after which feedback was collected from all students. Efficacy of the animation to improve learning and retention was demonstrated, as group B students scored significantly higher than group A students on the questionnaire ( P = 0.0003). A clear majority of the students agreed/strongly agreed that the animation was easy to operate, conveyed important concepts efficiently, and improved their knowledge of related clinical aspects as well. From the results and feedback, we found that the animation was a simple, well-received model, which, by significantly improving student performance, corroborated our hypothesis that inclusion of interactive animation into student curriculum can advance their academic attainment, compared with didactic teaching alone.

  11. Applying Computational Scoring Functions to Assess Biomolecular Interactions in Food Science: Applications to the Estrogen Receptors

    Directory of Open Access Journals (Sweden)

    Francesca Spyrakis

    2016-10-01

    Thus, key computational medicinal chemistry methods like molecular dynamics can be used to decipher protein flexibility and to obtain stable models for docking and scoring in food-related studies, and virtual screening is increasingly being applied to identify molecules with potential to act as endocrine disruptors, food mycotoxins, and new nutraceuticals [3,4,5]. All of these methods and simulations are based on protein-ligand interaction phenomena, and represent the basis for any subsequent modification of the targeted receptor's or enzyme's physiological activity. We describe here the energetics of binding of biological complexes, providing a survey of the most common and successful algorithms used in evaluating these energetics, and we report case studies in which computational techniques have been applied to food science issues. In particular, we explore a handful of studies involving the estrogen receptors for which we have a long-term interest.

  12. 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.

  13. Low SNOT-22 Scores in Chronic Rhinosinusitis: Why do patients seek treatment?

    Science.gov (United States)

    Levy, Joshua M.; Mace, Jess C.; Rudmik, Luke; Soler, Zachary M.; Smith, Timothy L.

    2016-01-01

    Objective Patients with chronic rhinosinusitis (CRS) who experience minimal reductions in quality-of-life (QoL) may present for treatment despite QoL scores comparable to controls without CRS. This study seeks to identify cofactors influencing patients with CRS and low 22-item Sinonasal Outcome Test (SNOT-22) scores to seek care. Study Design Prospective, multi-center, observational cohort. Methods Patients with CRS were enrolled between April 2011 and September 2015. Patients with sinonasal mucocele or unilateral sinus opacification were excluded. Control subjects without CRS were enrolled for comparison. Low-SNOT CRS was defined by a SNOT-22 score<20. Results 774 subjects (“low-SNOT” CRS (n=38); “high-SNOT” CRS (n=641, SNOT-22≥20); controls without CRS (n=95)) were enrolled. Low-SNOT scores were identified in 6% of subjects with CRS. After adjustment, low-SNOT CRS and control groups without CRS report similar baseline average SNOT-22 total scores (p=0.879). Unexpectedly, compared to controls, low-SNOT CRS patients had significantly better average psychological (2.1[2.3] vs. 5.8[6.0]; p=0.030) and sleep dysfunction (2.7[3.4] vs. 6.0[5.2]; p=0.016) scores. 14/38 (37%) low-SNOT patients elected to undergo endoscopic sinus surgery (ESS) with a significantly lower likelihood of reporting a minimal clinically important difference (MCID) when compared to high-SNOT patients (43% vs. 82%; p<0.001) after a mean follow-up of ~15 months. Conclusion Low-SNOT CRS patients represent an outlier population for which measures of QoL fail to identify factors influencing the decision to seek treatment. Low-SNOT CRS patients electing ESS have a decreased likelihood of reporting MCIDs following ESS. Further study is required to identify novel factors associated with treatment seeking behavior in this population. PMID:27377575

  14. Real-time interactive treatment planning

    International Nuclear Information System (INIS)

    Otto, Karl

    2014-01-01

    The goal of this work is to develop an interactive treatment planning platform that permits real-time manipulation of dose distributions including DVHs and other dose metrics. The hypothesis underlying the approach proposed here is that the process of evaluating potential dose distribution options and deciding on the best clinical trade-offs may be separated from the derivation of the actual delivery parameters used for the patient’s treatment. For this purpose a novel algorithm for deriving an Achievable Dose Estimate (ADE) was developed. The ADE algorithm is computationally efficient so as to update dose distributions in effectively real-time while accurately incorporating the limits of what can be achieved in practice. The resulting system is a software environment for interactive real-time manipulation of dose that permits the clinician to rapidly develop a fully customized 3D dose distribution. Graphical navigation of dose distributions is achieved by a sophisticated method of identifying contributing fluence elements, modifying those elements and re-computing the entire dose distribution. 3D dose distributions are calculated in ∼2–20 ms. Including graphics processing overhead, clinicians may visually interact with the dose distribution (e.g. ‘drag’ a DVH) and display updates of the dose distribution at a rate of more than 20 times per second. Preliminary testing on various sites shows that interactive planning may be completed in ∼1–5 min, depending on the complexity of the case (number of targets and OARs). Final DVHs are derived through a separate plan optimization step using a conventional VMAT planning system and were shown to be achievable within 2% and 4% in high and low dose regions respectively. With real-time interactive planning trade-offs between Target(s) and OARs may be evaluated efficiently providing a better understanding of the dosimetric options available to each patient in static or adaptive RT. (paper)

  15. Laboratory recommendations for scoring deep molecular responses following treatment for chronic myeloid leukemia

    DEFF Research Database (Denmark)

    Cross, N. C. P.; White, H. E.; Colomer, D.

    2015-01-01

    Treatment of chronic myeloid leukemia (CML) with tyrosine kinase inhibitors has advanced to a stage where many patients achieve very low or undetectable levels of disease. Remarkably, some of these patients remain in sustained remission when treatment is withdrawn, suggesting that they may be at ...... of sensitivity. Here we present detailed laboratory recommendations, developed as part of the European Treatment and Outcome Study for CML (EUTOS), to enable testing laboratories to score MR in a reproducible manner for CML patients expressing the most common BCR-ABL1 variants....

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

    Science.gov (United States)

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

    2014-01-01

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

  17. Investigating the importance of Delaunay-based definition of atomic interactions in scoring of protein-protein docking results.

    Science.gov (United States)

    Jafari, Rahim; Sadeghi, Mehdi; Mirzaie, Mehdi

    2016-05-01

    The approaches taken to represent and describe structural features of the macromolecules are of major importance when developing computational methods for studying and predicting their structures and interactions. This study attempts to explore the significance of Delaunay tessellation for the definition of atomic interactions by evaluating its impact on the performance of scoring protein-protein docking prediction. Two sets of knowledge-based scoring potentials are extracted from a training dataset of native protein-protein complexes. The potential of the first set is derived using atomic interactions extracted from Delaunay tessellated structures. The potential of the second set is calculated conventionally, that is, using atom pairs whose interactions were determined by their separation distances. The scoring potentials were tested against two different docking decoy sets and their performances were compared. The results show that, if properly optimized, the Delaunay-based scoring potentials can achieve higher success rate than the usual scoring potentials. These results and the results of a previous study on the use of Delaunay-based potentials in protein fold recognition, all point to the fact that Delaunay tessellation of protein structure can provide a more realistic definition of atomic interaction, and therefore, if appropriately utilized, may be able to improve the accuracy of pair potentials. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Selection for delayed intravenous alteplase treatment based on a prognostic score.

    Science.gov (United States)

    Fulton, Rachael L; Lees, Kennedy R; Bluhmki, Erich; Biegert, Gabriele; Albers, Gregory W; Davis, Stephen M; Donnan, Geoffrey A; Grotta, James C; Hacke, Werner; Kaste, Markku; von Kummer, Rüdiger; Shuaib, Ashfaq; Toni, Danilo

    2015-01-01

    Approved use of intravenous alteplase for ischemic stroke offers net benefit. Pooled randomized controlled trial analysis suggests additional patients could benefit but others be harmed with treatment initiated beyond 4·5 h after stroke onset. We proposed prognostic scoring methods to identify a strategy for patient selection. We selected 500 patients treated by intravenous alteplase and 500 controls from Virtual International Stroke Trials Archive, matching modified Rankin score outcomes to those from pooled randomized controlled trial 4·5-6 h data. We ranked patients by prognostic score. We chose limits to optimize our sample for a net treatment benefit significant at P = 0·01 by Cochran-Mantel-Haenszel test and by ordinal regression. For validation, we had these applied to the pooled randomized controlled trial data for 4·5-6 h, testing for net benefit by Cochran-Mantel-Haenszel test, ordinal regression, and also by dichotomized outcomes: modified Rankin score 0-1, mortality and parenchymal hemorrhage type 2 bleeds. All analyses were adjusted for age and National Institutes of Health Stroke Scale. In the training dataset, limits of 56-95 on a prognostic score retained 714 patients in whom there was net benefit significant at P = 0·01. When applied to the 1120 patients in the pooled randomized controlled trial 4·5-6 h dataset, score limits of 56-95 retained 711 patients and gave odds ratio for improved modified Rankin score distribution of 1·13, 95% confidence interval 0·87-1·47, Cochran-Mantel-Haenszel P = 0·89. More patients achieved modified Rankin score 0-1 (odds ratio 1·44, 1·02-2·05, P = 0·04) but mortality and parenchymal hemorrhage type 2 bleeds were increased: odds ratio 1·56, 1·01-2·40, P = 0·04; odds ratio 15·6, 3·7-65·8, P = 0·0002, respectively. Selection of patients between 4·5 and 6 h based on simple clinical measures failed to deliver a population in whom the alteplase effect would be safe

  19. The human interactome knowledge base (hint-kb): An integrative human protein interaction database enriched with predicted protein–protein interaction scores using a novel hybrid technique

    KAUST Repository

    Theofilatos, Konstantinos A.

    2013-07-12

    Proteins are the functional components of many cellular processes and the identification of their physical protein–protein interactions (PPIs) is an area of mature academic research. Various databases have been developed containing information about experimentally and computationally detected human PPIs as well as their corresponding annotation data. However, these databases contain many false positive interactions, are partial and only a few of them incorporate data from various sources. To overcome these limitations, we have developed HINT-KB (http://biotools.ceid.upatras.gr/hint-kb/), a knowledge base that integrates data from various sources, provides a user-friendly interface for their retrieval, cal-culatesasetoffeaturesofinterest and computesaconfidence score for every candidate protein interaction. This confidence score is essential for filtering the false positive interactions which are present in existing databases, predicting new protein interactions and measuring the frequency of each true protein interaction. For this reason, a novel machine learning hybrid methodology, called (Evolutionary Kalman Mathematical Modelling—EvoKalMaModel), was used to achieve an accurate and interpretable scoring methodology. The experimental results indicated that the proposed scoring scheme outperforms existing computational methods for the prediction of PPIs.

  20. Scoring and psychometric validation of the Perception of Anticoagulant Treatment Questionnaire (PACT-Q©

    Directory of Open Access Journals (Sweden)

    Essers B

    2009-04-01

    Full Text Available Abstract Background The 'Perception of Anti-Coagulant Treatment Questionnaire' (PACT-Q was developed to assess patients' expectations of, and satisfaction with their anticoagulant treatment. This questionnaire needs to be finalised and psychometrically validated. Methods The PACT-Q was included in the United States, the Netherlands and France into three phase III multinational clinical trials conducted to evaluate efficacy and safety of a new long-acting anticoagulant drug (idraparinux compared to vitamin K antagonist (VKA. PACT-Q was administered to patients with deep venous thrombosis (DVT, atrial fibrillation (AF or pulmonary embolism (PE at Day 1, to assess patients' expectations, and at 3 and 6 months to assess patients' satisfaction and treatment convenience and burden. The final structure of the PACT-Q (Principal Component Analysis – PCA – with Varimax Rotation was first determined and its psychometric properties were then measured with validity of the structure (Multitrait analysis, internal consistency reliability (Cronbach's alpha coefficients and known-group validity. Results PCA and multitrait analyses showed the multidimensionality of the "Treatment Expectations" dimension, comprising 7 items that had to be scored independently. The "Convenience" and "Burden of Disease and Treatment" dimensions of the hypothesised original structure of the questionnaire were combined, thus resulting in 13 items grouped into the single dimension "Convenience". The "Anticoagulant Treatment Satisfaction" dimension remained unchanged and included 7 items. All items of the "Convenience" and "Anticoagulant Treatment Satisfaction" dimensions displayed good convergent and discriminant validity. The internal consistency reliability was good, with a Cronbach's alpha of 0.84 for the "Convenience" dimension, and 0.76 for the "Anticoagulant Treatment Satisfaction" dimension. Known-group validity was good, especially with regard to occurrence of

  1. A novel genetic score approach using instruments to investigate interactions between pathways and environment: application to air pollution.

    Science.gov (United States)

    Bind, Marie-Abele; Coull, Brent; Suh, Helen; Wright, Robert; Baccarelli, Andrea; Vokonas, Pantel; Schwartz, Joel

    2014-01-01

    Air pollution has been associated with increased systemic inflammation markers. We developed a new pathway analysis approach to investigate whether gene variants within relevant pathways (oxidative stress, endothelial function, and metal processing) modified the association between particulate air pollution and fibrinogen, C-reactive protein (CRP), intercellular adhesion molecule-1 (ICAM-1), and vascular cell adhesion molecule-1 (VCAM-1). Our study population consisted of 822 elderly participants of the Normative Aging Study (1999-2011). To investigate the role of biological mechanisms and to reduce the number of comparisons in the analysis, we created pathway-specific scores using gene variants related to each pathway. To select the most appropriate gene variants, we used the least absolute shrinkage and selection operator (Lasso) to relate independent outcomes representative of each pathway (8-hydroxydeoxyguanosine for oxidative stress, augmentation index for endothelial function, and patella lead for metal processing) to gene variants. A high genetic score corresponds to a higher allelic risk profile. We fit mixed-effects models to examine modification by the genetic score of the weekly air pollution association with the outcome. Among participants with higher genetic scores within the oxidative stress pathway, we observed significant associations between particle number and fibrinogen, while we did not find any association among participants with lower scores (p(interaction) = 0.04). Compared to individuals with low genetic scores of metal processing gene variants, participants with higher scores had greater effects of particle number on fibrinogen (p(interaction) = 0.12), CRP (p(interaction) = 0.02), and ICAM-1 (pinteraction = 0.08). This two-stage penalization method is easy to implement and can be used for large-scale genetic applications.

  2. LAIX-score : a design framework for live audience interaction management systems

    OpenAIRE

    Kuikkaniemi, Kai

    2017-01-01

    This study focuses on computer-supported live audience interaction. In conventional lectures audience interacts explicitly with the performer for example by waving hand and asking question directly or clapping hands. For decades, non digital audience response systems have enabled simple multiple option audience interaction patterns. Modern mobile personal computing devices, digital projectors, wireless networks and real time software platforms enable creation of new kinds of interaction patte...

  3. A unified treatment of high energy interactions

    International Nuclear Information System (INIS)

    Drescher, H.J.; Werner, K.; Ostapchenko, S.; Centre National de la Recherche Scientifique, 44 - Nantes

    1999-01-01

    It is well known that high energy interactions as different as electron-positron annihilation, deep inelastic lepton-nucleon scattering, proton-proton interactions, and nucleus-nucleus collisions have many features in common. Based upon this observation, a model for all these interactions is constructed which relies on the fundamental hypothesis that the behavior of high energy interactions is universal. (author)

  4. Comparison of nasal cytology and symptom scores in patients with seasonal allergic rhinitis, before and after treatment.

    Science.gov (United States)

    Özgür, A; Arslanoğlu, S; Etıt, D; Demıray, U; Önal, H K

    2011-10-01

    To evaluate symptom scores and nasal smear cytology findings in seasonal allergic rhinitis patients, before and after treatment. Twenty-nine consecutive adult patients with seasonal allergic rhinitis were evaluated prospectively. They received mometasone furoate nasal spray and cetirizine for 21 days. Nasal and ocular symptom scores were recorded before and after treatment. Nasal cytology was also assessed as a means of determining treatment. The combined use of an intranasal corticosteroid and an oral antihistamine caused a significant improvement in nasal and ocular symptom scores. Cytological evaluation revealed significant reduction in nasal eosinophil, neutrophil and goblet cell counts after three weeks' treatment. Symptom scoring systems are widely used for the evaluation of drug efficacy in allergic rhinitis treatment. When investigating the disease and evaluating treatment efficacy, objective as well as subjective methods are needed. Nasal cytological assessment is a simple, objective method which provides valuable information about the nasal mucosa.

  5. Effective endoscopic treatment of Mallory-Weiss syndrome using Glasgow-Blatchford score and Forrest classification.

    Science.gov (United States)

    Lee, Sunpyo; Ahn, Ji Yong; Jung, Hwoon-Yong; Jung, Kee Wook; Lee, Jeong Hoon; Kim, Do Hoon; Choi, Kee Don; Song, Ho June; Lee, Gin Hyug; Kim, Jin-Ho; Kim, Seon-Ok

    2016-10-01

    There is limited data on whether scoring systems can be used to predict clinical outcomes in patients with upper gastrointestinal bleeding due to Mallory-Weiss syndrome (MWS). We aimed to evaluate whether the Glasgow-Blatchford score (GBS) could be effective in predicting clinical outcomes of bleeding MWS and to investigate the predictive ability of the Forrest classification for rebleeding and assess the effective endoscopic modalities for bleeding control in MWS. From January 2004 to December 2012 168 patients were diagnosed with MWS in the Asan Medical Center Emergency Department. We analyzed their clinical outcomes, including endoscopic treatment, transfusion and admission as well as the rates of rebleeding and mortality using GBS and the Forrest classification, retrospectively. Endoscopic treatment was applied to patients. The GBS was significantly higher in patients treated with endoscopic therapy than in the conservative treatment group (6.8 ± 3.7 vs 5.1 ± 4.7, P = 0.011). In patients with a GBS of >6 the rates of endoscopic treatment and rebleeding and the need for transfusion and admission were significantly higher (all P < 0.05). The Forrest classification was able to predict recurrent bleeding (area under the receiver operating characteristic curve 0.723, 95% confidence interval 0.609-0.836, P = 0.025). Hemoclip-based therapy and band ligation achieved higher success rates than did injection therapy alone in preventing rebleeding (96.4%, 88.9% and 71.4%, P = 0.013). In MWS, GBS might be useful for predicting clinical outcomes and the Forrest classification in predicting recurrent bleeding. © 2016 Chinese Medical Association Shanghai Branch, Chinese Society of Gastroenterology, Renji Hospital Affiliated to Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

  6. Propensity scores as a basis for equating groups: basic principles and application in clinical treatment outcome research.

    Science.gov (United States)

    West, Stephen G; Cham, Heining; Thoemmes, Felix; Renneberg, Babette; Schulze, Julian; Weiler, Matthias

    2014-10-01

    A propensity score is the probability that a participant is assigned to the treatment group based on a set of baseline covariates. Propensity scores provide an excellent basis for equating treatment groups on a large set of covariates when randomization is not possible. This article provides a nontechnical introduction to propensity scores for clinical researchers. If all important covariates are measured, then methods that equate on propensity scores can achieve balance on a large set of covariates that mimics that achieved by a randomized experiment. We present an illustration of the steps in the construction and checking of propensity scores in a study of the effectiveness of a health coach versus treatment as usual on the well-being of seriously ill individuals. We then consider alternative methods of equating groups on propensity scores and estimating treatment effects including matching, stratification, weighting, and analysis of covariance. We illustrate a sensitivity analysis that can probe for the potential effects of omitted covariates on the estimate of the causal effect. Finally, we briefly consider several practical and theoretical issues in the use of propensity scores in applied settings. Propensity score methods have advantages over alternative approaches to equating groups particularly when the treatment and control groups do not fully overlap, and there are nonlinear relationships between covariates and the outcome. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  7. Fetal growth interacts with multilocus genetic score reflecting dopamine signaling capacity to predict spontaneous sugar intake in children.

    Science.gov (United States)

    Silveira, Patrícia P; Pokhvisneva, Irina; Gaudreau, Hélène; Atkinson, Leslie; Fleming, Alison S; Sokolowski, Marla B; Steiner, Meir; Kennedy, James L; Dubé, Laurette; Levitan, Robert D; Meaney, Michael J

    2018-01-01

    We have shown that intrauterine growth restriction (IUGR) leads to increased preference for palatable foods at different ages in both humans and rodents. In IUGR rodents, altered striatal dopamine signaling associates with a preference for palatable foods. Our aim was to investigate if a multilocus genetic score reflecting dopamine-signaling capacity is differently associated with spontaneous palatable food intake in children according to the fetal growth status. 192 four-year old children from a community sample from Montreal and Hamilton, Canada, were classified according to birth weight and administered a snack test meal containing regular as well as palatable foods. Intrauterine growth restriction was based on the birth weight ratio below 0.85; children were genotyped for polymorphisms associated with dopamine (DA) signaling, with the hypofunctional variants (TaqIA-A1 allele, DRD2-141C Ins/Ins, DRD4 7-repeat, DAT1-10-repeat, Met/Met-COMT) receiving the lowest scores, and a composite score was calculated reflecting the total number of the five genotypes. Macronutrient intake during the Snack Test was the outcome. Adjusting for z-score BMI at 48 months and sex, there was a significant interaction of the genetic profile and fetal growth on sugar intake [βˆ = -4.56, p = 0.04], showing a positive association between the genetic score and sugar intake in IUGR children, and no association in non-IUGR children. No significant interactions were seen in other macronutrients. Variations in a genetic score reflecting DA signaling are associated with differences in sugar intake only in IUGR children, suggesting that DA function is involved in this behavioral feature in these children. This may have important implications for obesity prevention in this population. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Verbal communication of students with high patient-physician interaction scores in a clinical performance examination assessed by standardized patients.

    Science.gov (United States)

    Roh, HyeRin; Park, Kyung Hye; Park, Song Yi

    2017-12-01

    Standardized patients (SPs) tend to rate medical students' communication skills subjectively and comprehensively, in contrast to such objective skill set defined in the clinical performance examination (CPX). Meanwhile, medical school instructors have a different approach in their evaluation of students' communication skills. We aim to analyze medical students' verbal communication skills using objective methods, and to determine the contributing factors of a patient-physician interaction (PPI) score. Students with high- and low-ranking scores for PPI in CPX were selected. The Roter interaction analysis system was used to compare verbal communication behaviors of the students and SPs. Patient-centeredness scores (PCSs), physician's verbal dominance, and number of utterances were compared between the two groups. PCSs and physician's verbal dominance had no difference between the groups. The number of utterances during the limited time of 5 minutes of CPX was higher for the high-ranking students. They tended to employ more paraphrase/check for understanding, and closed questions for psychosocial state and open questions for medical condition. The SPs interviewed by high-ranking students gave more medical information and requested for more services. In the case of the routine checkup, smooth conversations with more frequent utterances were detected in the high-ranking students. More medical information exchange and requests for services by SPs were higher for the high-ranking students. Medical communication instructors should keep in mind that our results could be indicators of a high PPI score.

  9. HIV Treatment: What is a Drug Interaction?

    Science.gov (United States)

    ... is an Investigational HIV Drug? What is a Therapeutic HIV Vaccine? What is a Preventive HIV Vaccine? HIV/ ... Exposure Prophylaxis (PEP) Pre-Exposure Prophylaxis (PrEP) HIV Treatment HIV Treatment: The Basics Just Diagnosed: Next Steps After ...

  10. Chemoradiotherapy versus chemotherapy as adjuvant treatment for localized gastric cancer: a propensity score-matched analysis.

    Science.gov (United States)

    Girardi, Daniel M; de Lima, Mariana A; Pereira, Gabriel C B; Negrão, Marcelo V; López, Rossana V M; Capareli, Fernanda C; Sabbaga, Jorge; Hoff, Paulo Marcelo G

    2018-04-03

    Treatment of localized gastric cancer (LGC) consists of surgical resection followed by adjuvant treatment. Both chemoradiation (CRT) and chemotherapy (CT) regimens have shown benefit in survival outcomes versus observation. However, there are few data comparing these approaches. This study included consecutive patients with LGC treated at Instituto do Cancer do Estado de Sao Paulo (ICESP) from 2012 to 2015. CRT was based on the INT-0116 regimen and CT consisted of a platinum and fluoropyrimidine doublet. Treatment choice was based on physician preference. Toxicity was evaluated for every cycle. Overall survival (OS) analysis was performed by Kaplan-Meier. A propensity score-matched analysis was performed to minimize selection bias. A total of 309 patients were evaluated, 227 in CRT group and 82 in CT group. The most prevalent grade 3/4 toxicities in CRT and CT groups were: nausea/vomiting (9.25 vs 4.9%), fatigue (9.3% vs 2.4%), mucositis (4.4% vs 1.2%), neutropenia (37.8% vs 20.9%), febrile neutropenia (3.9% vs 0%), anemia (4.3% vs 6.1%), thrombocytopenia (2.6% vs 4.9%), neuropathy (0 vs 2.4%) and hand-foot syndrome (0.4% vs 2.4%). Two grade 5 toxicities (febrile neutropenia and anemia) occurred in CRT group. There was no difference in the pattern of recurrence. After a median follow-up of 23.5 months (CRT) and 20.6 months (CT), there was no difference in OS between groups. CT and CRT present similar efficacy and tolerability as adjuvant treatment for LGC.

  11. Red Cell Indexes Made Easy Using an Interactive Animation: Do Students and Their Scores Concur?

    Science.gov (United States)

    Kachroo, Upasana; Vinod, Elizabeth; Balasubramanian, Sivakumar; W., Jesi; Prince, Neetu

    2018-01-01

    A good understanding of red cell indexes can aid medical students in a considerable manner, serving as a basis to unravel both concepts in red cell physiology and abnormalities associated with the same. In this study, we tried to assess whether an interactive animation was helpful in improving student comprehension and understanding of red cell…

  12. The performance of different propensity score methods for estimating absolute effects of treatments on survival outcomes: A simulation study.

    Science.gov (United States)

    Austin, Peter C; Schuster, Tibor

    2016-10-01

    Observational studies are increasingly being used to estimate the effect of treatments, interventions and exposures on outcomes that can occur over time. Historically, the hazard ratio, which is a relative measure of effect, has been reported. However, medical decision making is best informed when both relative and absolute measures of effect are reported. When outcomes are time-to-event in nature, the effect of treatment can also be quantified as the change in mean or median survival time due to treatment and the absolute reduction in the probability of the occurrence of an event within a specified duration of follow-up. We describe how three different propensity score methods, propensity score matching, stratification on the propensity score and inverse probability of treatment weighting using the propensity score, can be used to estimate absolute measures of treatment effect on survival outcomes. These methods are all based on estimating marginal survival functions under treatment and lack of treatment. We then conducted an extensive series of Monte Carlo simulations to compare the relative performance of these methods for estimating the absolute effects of treatment on survival outcomes. We found that stratification on the propensity score resulted in the greatest bias. Caliper matching on the propensity score and a method based on earlier work by Cole and Hernán tended to have the best performance for estimating absolute effects of treatment on survival outcomes. When the prevalence of treatment was less extreme, then inverse probability of treatment weighting-based methods tended to perform better than matching-based methods. © The Author(s) 2014.

  13. The potential interaction between ewe body condition score and nutrition during very late pregnancy and lactation on the performance of twin-bearing ewes and their lambs

    Directory of Open Access Journals (Sweden)

    L. M. Cranston

    2017-09-01

    Full Text Available Objective The present study aimed to determine the impact of ewe body condition score (BCS (over a range of 2.0 to 3.0 and nutritional treatments (consisting of differing herbage masses during very late pregnancy and lactation and their potential interaction on the performance of twin-bearing ewes and their lambs to weaning. Methods On day 142 of pregnancy, twin-bearing ewes with a BCS of 2.0, 2.5, or 3.0 were allocated to a “Moderate’ or ‘Unrestricted’ nutritional treatment until day 95 of lactation (weaning. The nutritional treatments aimed to achieve average herbage masses of 1,200 to 1,300 kg dry matter (DM/ha (Moderate and 1,500 to 1,800 kg DM/ha (Unrestricted. Results There were no three-way interactions between ewe BCS group, nutritional treatment and time for any ewe or lamb parameter. The nutritional treatments had no effect (p>0.05 on lamb birth or weaning weight. Lambs born to Moderate ewes had greater survival and total litter weight at weaning (p1,200 kg DM/ha during very late pregnancy and lactation.

  14. The potential interaction between ewe body condition score and nutrition during very late pregnancy and lactation on the performance of twin-bearing ewes and their lambs.

    Science.gov (United States)

    Cranston, L M; Kenyon, P R; Corner-Thomas, R A; Morris, S T

    2017-09-01

    The present study aimed to determine the impact of ewe body condition score (BCS) (over a range of 2.0 to 3.0) and nutritional treatments (consisting of differing herbage masses) during very late pregnancy and lactation and their potential interaction on the performance of twin-bearing ewes and their lambs to weaning. On day 142 of pregnancy, twin-bearing ewes with a BCS of 2.0, 2.5, or 3.0 were allocated to a "Moderate' or 'Unrestricted' nutritional treatment until day 95 of lactation (weaning). The nutritional treatments aimed to achieve average herbage masses of 1,200 to 1,300 kg dry matter (DM)/ha (Moderate) and 1,500 to 1,800 kg DM/ha (Unrestricted). There were no three-way interactions between ewe BCS group, nutritional treatment and time for any ewe or lamb parameter. The nutritional treatments had no effect (p>0.05) on lamb birth or weaning weight. Lambs born to Moderate ewes had greater survival and total litter weight at weaning (p1,200 kg DM/ha during very late pregnancy and lactation.

  15. Developing a high-quality scoring function for membrane protein structures based on specific inter-residue interactions

    Science.gov (United States)

    Heim, Andrew J.; Li, Zhijun

    2012-03-01

    Membrane proteins are of particular biological and pharmaceutical importance, and computational modeling and structure prediction approaches play an important role in studies of membrane proteins. Developing an accurate model quality assessment program is of significance to the structure prediction of membrane proteins. Few such programs are proposed that can be applied to a broad range of membrane protein classes and perform with high accuracy. We developed a new model scoring function Interaction-based Quality assessment (IQ), based on the analysis of four types of inter-residue interactions within the transmembrane domains of helical membrane proteins. This function was tested using three high-quality model sets: all 206 models of GPCR Dock 2008, all 284 models of GPCR Dock 2010, and all 92 helical membrane protein models of the HOMEP set. For all three sets, the scoring function can select the native structures among all of the models with the success rates of 93, 85, and 100% respectively. For comparison, these three model sets were also adopted for a recently published model assessment program for membrane protein structures, ProQM, which gave the success rates of 85, 79, and 92% separately. These results suggested that IQ outperforms ProQM when only the transmembrane regions of the models are considered. This scoring function should be useful for the computational modeling of membrane proteins.

  16. Interactions of Lipid Genetic Risk Scores with Estimates of Metabolic Health in a Danish Population

    DEFF Research Database (Denmark)

    Justesen, Johanne M; Allin, Kristine H; Sandholt, Camilla H

    2015-01-01

    , high-density lipoprotein-cholesterol, or triglyceride, 4 weighted GRS were constructed. In a cross-sectional design, we investigated whether the effect of these weighted GRSs on lipid levels were modulated by diet, alcohol consumption, physical activity, and smoking or the individual metabolic health...... nucleotide polymorphisms were genotyped in 2 Danish cohorts: inter99 (n=5961) for discovery analyses and Health2006 (n=2565) for replication. On the basis of published effect sizes of single nucleotide polymorphisms associated with circulating fasting levels of total cholesterol, low-density lipoprotein-cholesterol...... and these susceptibility loci has not been fully elucidated. We tested whether genetic risk scores (GRS) of lipid-associated single nucleotide polymorphisms associate with fasting serum lipid traits and whether the effects are modulated by lifestyle factors or estimates of metabolic health. Methods and Results—The single...

  17. Propensity Scores

    Science.gov (United States)

    Luellen, Jason K.; Shadish, William R.; Clark, M. H.

    2005-01-01

    Propensity score analysis is a relatively recent statistical innovation that is useful in the analysis of data from quasi-experiments. The goal of propensity score analysis is to balance two non-equivalent groups on observed covariates to get more accurate estimates of the effects of a treatment on which the two groups differ. This article…

  18. Prediction of residue-residue contact matrix for protein-protein interaction with Fisher score features and deep learning.

    Science.gov (United States)

    Du, Tianchuan; Liao, Li; Wu, Cathy H; Sun, Bilin

    2016-11-01

    Protein-protein interactions play essential roles in many biological processes. Acquiring knowledge of the residue-residue contact information of two interacting proteins is not only helpful in annotating functions for proteins, but also critical for structure-based drug design. The prediction of the protein residue-residue contact matrix of the interfacial regions is challenging. In this work, we introduced deep learning techniques (specifically, stacked autoencoders) to build deep neural network models to tackled the residue-residue contact prediction problem. In tandem with interaction profile Hidden Markov Models, which was used first to extract Fisher score features from protein sequences, stacked autoencoders were deployed to extract and learn hidden abstract features. The deep learning model showed significant improvement over the traditional machine learning model, Support Vector Machines (SVM), with the overall accuracy increased by 15% from 65.40% to 80.82%. We showed that the stacked autoencoders could extract novel features, which can be utilized by deep neural networks and other classifiers to enhance learning, out of the Fisher score features. It is further shown that deep neural networks have significant advantages over SVM in making use of the newly extracted features. Copyright © 2016. Published by Elsevier Inc.

  19. A new plan-scoring method using normal tissue complication probability for personalized treatment plan decisions in prostate cancer

    Science.gov (United States)

    Kim, Kwang Hyeon; Lee, Suk; Shim, Jang Bo; Yang, Dae Sik; Yoon, Won Sup; Park, Young Je; Kim, Chul Yong; Cao, Yuan Jie; Chang, Kyung Hwan

    2018-01-01

    The aim of this study was to derive a new plan-scoring index using normal tissue complication probabilities to verify different plans in the selection of personalized treatment. Plans for 12 patients treated with tomotherapy were used to compare scoring for ranking. Dosimetric and biological indexes were analyzed for the plans for a clearly distinguishable group ( n = 7) and a similar group ( n = 12), using treatment plan verification software that we developed. The quality factor ( QF) of our support software for treatment decisions was consistent with the final treatment plan for the clearly distinguishable group (average QF = 1.202, 100% match rate, n = 7) and the similar group (average QF = 1.058, 33% match rate, n = 12). Therefore, we propose a normal tissue complication probability (NTCP) based on the plan scoring index for verification of different plans for personalized treatment-plan selection. Scoring using the new QF showed a 100% match rate (average NTCP QF = 1.0420). The NTCP-based new QF scoring method was adequate for obtaining biological verification quality and organ risk saving using the treatment-planning decision-support software we developed for prostate cancer.

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

    International Nuclear Information System (INIS)

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

    2005-01-01

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

  1. AASM criteria for scoring respiratory events: interaction between apnea sensor and hypopnea definition.

    Science.gov (United States)

    Thornton, Andrew T; Singh, Parmjit; Ruehland, Warren R; Rochford, Peter D

    2012-03-01

    To examine the impact of using a nasal pressure sensor only vs the American Academy of Sleep Medicine (AASM) recommended combination of thermal and nasal pressure sensors on (1) the apnea index (AI), (2) the apnea-hypopnea index (AHI), where the AHI is calculated using both AASM definitions of hypopnea, and (3) the accuracy of a diagnosis of obstructive sleep apnea (OSA). Retrospective review of previously scored in-laboratory polysomnography. A tertiary-hospital clinical sleep laboratory. One hundred sixty-four consecutive adult patients with a potential diagnosis of OSA, who were examined during a 3-month period. N/A. Studies were scored with and without the use of the oronasal thermal sensor. AIs and AHIs, using the nasal pressure sensor alone (AI(np) and AHI(np)), were compared with those using both a thermal sensor for the detection of apnea and a nasal pressure transducer for the detection of hypopnea (AI(th) and AHI(th)). Comparisons were repeated using the AASM recommended (AASM(rec)) and alternative (AASM(alt)) hypopnea definitions. AI was significantly different when measured from the different sensors, with AI(np) being 51% higher on average. Using the AASM(rec) hypopnea definition, the mean AHI(np) was 15% larger than the AHI(th); with large interindividual differences and an estimated 9.8% of patients having a false-positive OSA diagnosis at a cutpoint of 15 events and 4.3% at 30 events per hour. Using AASM(alt) hypopnea definition, the mean AHI(np) was 3% larger than the AHI(th), with estimated false-positive rates of 4.6% and 2.4%, respectively. The false-negative rate was negligible at 0.1% for both hypopnea definitions. This study demonstrates that using only a nasal pressure sensor for the detection of apnea resulted in higher values of AI and AHI than when the AASM recommended thermal sensor was added to detect apnea. When the AASM(alt) hypopnea definition was used, the differences in AHI and subsequent OSA diagnosis were small and less than when

  2. Evaluation of the "assessment for continuous treatment with hepatic arterial infusion chemotherapy" scoring system in patients with advanced hepatocellular carcinoma.

    Science.gov (United States)

    Saeki, Issei; Yamasaki, Takahiro; Maeda, Masaki; Hisanaga, Takuro; Iwamoto, Takuya; Matsumoto, Toshihiko; Hidaka, Isao; Ishikawa, Tsuyoshi; Takami, Taro; Sakaida, Isao

    2018-02-01

    Sorafenib is the recommended standard of care for advanced hepatocellular carcinoma (HCC) patients. However, hepatic arterial infusion chemotherapy (HAIC) is a treatment option in Asia. We recently developed the assessment for continuous treatment with HAIC (ACTH) score to guide decision-making for continuous HAIC treatment. The purpose of this study was to validate the utility of the ACTH score in a dedicated cohort. One hundred and thirty-one patients with advanced HCC were enrolled in this study (90 in the training group and 41 in the validation group). The point score (range, 0-3) was calculated as follows: Child-Pugh score before HAIC (A = 0, B = 1), α-fetoprotein (AFP) response (yes = 0, no = 1), and des-γ-carboxy prothrombin (DCP) response (yes = 0, no = 1). The AFP and DCP responses were assessed 2 weeks after HAIC induction; a positive response was defined as a reduction of ≥20% from the baseline. The DCP response in the validation group was significantly associated with treatment response, and the median survival time (MST) was longer in patients with an ACTH score ≤1 (15.9 months) than in those with a score ≥2 (7.0 months; P = 0.002). Survival in all patients showed significant stratification according to the ACTH score; the MSTs associated with scores of 0, 1, 2, and 3 points were 21.7, 14.4, 9.5, and 3.8 months, respectively. The ACTH score can aid in the therapeutic assessment and continued treatment planning of HCC patients receiving HAIC. © 2017 The Japan Society of Hepatology.

  3. How the modified Clinical Pulmonary Infection Score can identify treatment failure and avoid overusing antibiotics in ventilator-associated pneumonia.

    Science.gov (United States)

    da Silva, Paulo Sérgio Lucas; de Aguiar, Vânia Euzébio; Fonseca, Marcelo Cunio Machado

    2014-09-01

    Although the modified Clinical Pulmonary Infection Score (CPIS) has been used to guide treatment decisions in adults with ventilator-associated pneumonia (VAP), paediatric studies are lacking. We assessed a modified CPIS tool to define VAP resolution and identify treatment failure at an early stage. We identified 70 mechanically ventilated children with VAP according to the Center for Disease Control criteria. Modified CPIS was initially measured at VAP onset and then three and five days afterwards. Children were defined as low risk or high risk based on a cut-off score of six. There were 50 high-risk and 20 low-risk patients. Culture results were positive in 64% of the high-risk patients and just 10% of the low-risk patients. Patients on adequate therapy significantly improved their CPIS scores by day three, regardless of the likelihood of VAP. A lack of score improvement demonstrated sensitivity of 100% and specificity of 83% when it came to detecting treatment failure. The area under the receiver operating curve was 0.92. Serial modified CPIS measurements showed that low-risk patients with negative cultures at day three should be considered for a short course of antibiotics. In contrast, high-risk patients with no score improvement were potentially failing their treatment. ©2014 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  4. Compliance score as a monitoring tool to promote treatment adherence in children with thalassemia major for improved physical growth

    Science.gov (United States)

    Kannan, Sarala; Singh, Amarjeet

    2017-01-01

    BACKGROUND/HYPOTHESIS: Creeping monotony in the treatment provides minimal motivation for children with beta-thalassemia major, leading to noncompliance for adequate blood transfusions and iron chelation therapy. This study was envisaged to formulate a clinical compliance score and correlate the score with their linear growth velocity and weight gain. MATERIALS AND METHODS: A prospective longitudinal study among 30 thalassemia children aged between 1 and 18 years was conducted in the Department of Pediatrics, Tata Main Hospital (TMH), Jamshedpur, from July 2012 to January 2014. Relevant clinical information and investigations were recorded using a predesigned pro forma. Compliance score was calculated using pre-, post-transfusion hemoglobin and serum ferritin levels. The height velocity and weight gain were calculated. The same patients were re-assessed in January 2015. RESULTS AND DISCUSSION: Mean age of children was 10.18 ± 4.98 years. Forty percent were females. Using the scoring table, 33% were in good category of compliance while 4% had poor compliance. The mean height velocity was significantly higher in good compliance category as compared to average or poor score category in 2014 (P = 0.017). Good compliance score children continued to maintain higher height velocity during the 1-year follow-up (P = 0.02). Average weight gain was higher in good compliance category. CONCLUSION: This paper brings out a simple, regularly monitored scoring system to promote growth in thalassemia children through improved compliance to treatment, which incentivized them to maintain or improve their scores for better height velocity and weight gain. No such compliance score has been tabulated for thalassemia patients as of date. PMID:28970676

  5. Paralytic Ectropion Treatment with Lateral Periosteal Flap Canthoplasty and Introduction of the Ectropion Severity Score

    Directory of Open Access Journals (Sweden)

    Steven F. S. Korteweg, MD

    2014-05-01

    Conclusions: The ESS is a useful instrument to score the severity of paralytic ectropion. The periosteal flap canthoplasty is an effective procedure, with durable results in paralytic ectropion patients. The same periosteal flap can be used in a revision procedure.

  6. Aptitude-Treatment Interactions: Bad Rap or Bad Idea?

    Science.gov (United States)

    Speece, Deborah L.

    1990-01-01

    The paper presents an analysis of aptitude-treatment interaction (ATI) as it relates to individual differences in special education. Stressed is the importance of heterogeneity of participants and interventions, of psychological interactions, and the need for applying multivariate and transactional approaches to ATI concepts. (DB)

  7. Qualitative interaction trees: A tool to identify qualitative treatment-subgroup interactions

    NARCIS (Netherlands)

    Dusseldorp, E.; Mechelen, I. van

    2014-01-01

    When two alternative treatments (A and B) are available, some subgroup of patients may display a better outcome with treatment A than with B, whereas for another subgroup, the reverse may be true. If this is the case, a qualitative (i.e., disordinal) treatment-subgroup interaction is present. Such

  8. The translation and validation of Chinese overactive bladder symptom score for assessing overactive bladder syndrome and response to solifenacin treatment

    Directory of Open Access Journals (Sweden)

    Eric Chieh-Lung Chou

    2014-08-01

    Conclusion: The Chinese OABSS has been validated as a reliable instrument for assessing OAB. Solifenacin 5 mg once daily improved urgency and other symptoms of OAB including frequency, urge incontinence, OABSS and International Prostatic Symptom Score. The adverse effects were acceptable and became less significant with time in the three months of treatment.

  9. Genetic risk scores, sex and dietary factors interact to alter serum uric acid trajectory among African-American urban adults

    Science.gov (United States)

    Beydoun, May A.; Canas, Jose-Atilio; Fanelli-Kuczmarski, Marie T.; Tajuddin, Salman M.; Evans, Michele K.; Zonderman, Alan B.

    2017-01-01

    Serum uric acid (SUA), a causative agent for gout among others, is affected by both genetic and dietary factors, perhaps differentially by sex. We evaluated cross-sectional (SUAbase) and longitudinal (SUArate) associations of SUA with a genetic risk score (GRS), diet and sex. We then tested the interactive effect of GRS, diet and sex on SUA. Longitudinal data on 766 African-American urban adults participating in the Healthy Aging in Neighborhood of Diversity across the Lifespan study were used. In all, three GRS for SUA were created from known SUA-associated SNP (GRSbase (n 12 SNP), GRSrate (n 3 SNP) and GRStotal (n 15 SNP)). Dietary factors included added sugar, total alcohol, red meat, total fish, legumes, dairy products, caffeine and vitamin C. Mixed-effects linear regression models were conducted. SUAbase was higher among men compared with that among women, and increased with GRStotal tertiles. SUArate was positively associated with legume intake in women (γ = + 014; 95% CI +0.06, +0.22, P = 0.001) and inversely related to dairy product intake in both sexes combined (γ = −0.042; 95% CI −0.075, −0.009), P = 0.010). SUAbase was directly linked to alcohol consumption among women (γ = +0.154; 95% CI +0.046, +0.262, P = 0.005). GRSrate was linearly related to SUArate only among men. Legume consumption was also positively associated with SUArate within the GRStotal's lowest tertile. Among women, a synergistic interaction was observed between GRSrate and red meat intake in association with SUArate. Among men, a synergistic interaction between low vitamin C and genetic risk was found. In sum, sex–diet, sex–gene and gene–diet interactions were detected in determining SUA. Further similar studies are needed to replicate our findings. PMID:28345493

  10. Interpreting treatment x environment interaction in agronomy trials

    NARCIS (Netherlands)

    Vargas, M.; Crossa, J.; Eeuwijk, van F.A.; Sayre, K.; Reynolds, M.P.

    2001-01-01

    Multienvironment trials are important in agronomy because the effects of agronomic treatments can change differentially in relation to environmental changes, producing a treatment × environment interaction (T × E). The aim of this study was to find a parsimonious description of the T × E existing in

  11. The translation and validation of Chinese overactive bladder symptom score for assessing overactive bladder syndrome and response to solifenacin treatment.

    Science.gov (United States)

    Chou, Eric Chieh-Lung; Hung, Man-Jung; Yen, Ta-Wei; Chuang, Yao-Chi; Meng, En; Huang, Shih-Tsung; Kuo, Hann-Chorng

    2014-08-01

    Overactive bladder symptom score (OABSS) was developed by a Japanese urologist and is widely used in Asian countries. The aim of this study was to develop and validate a Chinese OABSS for assessing overactive bladder (OAB) and treatment outcome after solifenacin. The Chinese OABSS was developed by linguistic validation of the original version. Its reliability and validity, and correlations with a three-day bladder diary were tested. Patients answered the Chinese OABSS at enrollment and repeated the questionnaire after a non-treatment period of 2 weeks, and at 4 and 12 weeks after solifenacin (5mg/day). Patients also completed a three-day bladder diary and forms including patient perception of bladder condition, International Prostatic Symptom Score and quality of life index at each study visit (for a total of four visits). An analysis was conducted to evaluate the reliability and validity of the Chinese OABSS and the correlations with a three-day bladder diary and a patient perception of bladder condition, respectively. A total of 60 patients with OAB, including 31 OAB wet and 29 OAB dry, were enrolled. The test-retest reliability of Chinese OABSS was moderate to good with weighted kappa coefficients of 0.515-0.721 for each symptom score and 0.610 for total symptom score. Forty-eight (80%) patients completed the responsiveness study and were followed-up at all time points. Patients' OAB symptoms improved significantly from baseline to 3 months after solifenacin treatment. The changes in OABSS decreased gradually with time within the three months of solifenacin treatment. The Chinese OABSS has been validated as a reliable instrument for assessing OAB. Solifenacin 5mg once daily improved urgency and other symptoms of OAB including frequency, urge incontinence, OABSS and International Prostatic Symptom Score. The adverse effects were acceptable and became less significant with time in the three months of treatment. Copyright © 2012. Published by Elsevier B.V.

  12. Predicting treatment failure, death and drug resistance using a computed risk score among newly diagnosed TB patients in Tamaulipas, Mexico.

    Science.gov (United States)

    Abdelbary, B E; Garcia-Viveros, M; Ramirez-Oropesa, H; Rahbar, M H; Restrepo, B I

    2017-10-01

    The purpose of this study was to develop a method for identifying newly diagnosed tuberculosis (TB) patients at risk for TB adverse events in Tamaulipas, Mexico. Surveillance data between 2006 and 2013 (8431 subjects) was used to develop risk scores based on predictive modelling. The final models revealed that TB patients failing their treatment regimen were more likely to have at most a primary school education, multi-drug resistance (MDR)-TB, and few to moderate bacilli on acid-fast bacilli smear. TB patients who died were more likely to be older males with MDR-TB, HIV, malnutrition, and reporting excessive alcohol use. Modified risk scores were developed with strong predictability for treatment failure and death (c-statistic 0·65 and 0·70, respectively), and moderate predictability for drug resistance (c-statistic 0·57). Among TB patients with diabetes, risk scores showed moderate predictability for death (c-statistic 0·68). Our findings suggest that in the clinical setting, the use of our risk scores for TB treatment failure or death will help identify these individuals for tailored management to prevent these adverse events. In contrast, the available variables in the TB surveillance dataset are not robust predictors of drug resistance, indicating the need for prompt testing at time of diagnosis.

  13. Weighted risk score-based multifactor dimensionality reduction to detect gene-gene interactions in nasopharyngeal carcinoma.

    Science.gov (United States)

    Li, Chao-Feng; Luo, Fu-Tian; Zeng, Yi-Xin; Jia, Wei-Hua

    2014-06-13

    Determining the complex relationships between diseases, polymorphisms in human genes and environmental factors is challenging. Multifactor dimensionality reduction (MDR) has been proven to be capable of effectively detecting the statistical patterns of epistasis, although classification accuracy is required for this approach. The imbalanced dataset can cause seriously negative effects on classification accuracy. Moreover, MDR methods cannot quantitatively assess the disease risk of genotype combinations. Hence, we introduce a novel weighted risk score-based multifactor dimensionality reduction (WRSMDR) method that uses the Bayesian posterior probability of polymorphism combinations as a new quantitative measure of disease risk. First, we compared the WRSMDR to the MDR method in simulated datasets. Our results showed that the WRSMDR method had reasonable power to identify high-order gene-gene interactions, and it was more effective than MDR at detecting four-locus models. Moreover, WRSMDR reveals more information regarding the effect of genotype combination on the disease risk, and the result was easier to determine and apply than with MDR. Finally, we applied WRSMDR to a nasopharyngeal carcinoma (NPC) case-control study and identified a statistically significant high-order interaction among three polymorphisms: rs2860580, rs11865086 and rs2305806.

  14. Weighted Risk Score-Based Multifactor Dimensionality Reduction to Detect Gene-Gene Interactions in Nasopharyngeal Carcinoma

    Directory of Open Access Journals (Sweden)

    Chao-Feng Li

    2014-06-01

    Full Text Available Determining the complex relationships between diseases, polymorphisms in human genes and environmental factors is challenging. Multifactor dimensionality reduction (MDR has been proven to be capable of effectively detecting the statistical patterns of epistasis, although classification accuracy is required for this approach. The imbalanced dataset can cause seriously negative effects on classification accuracy. Moreover, MDR methods cannot quantitatively assess the disease risk of genotype combinations. Hence, we introduce a novel weighted risk score-based multifactor dimensionality reduction (WRSMDR method that uses the Bayesian posterior probability of polymorphism combinations as a new quantitative measure of disease risk. First, we compared the WRSMDR to the MDR method in simulated datasets. Our results showed that the WRSMDR method had reasonable power to identify high-order gene-gene interactions, and it was more effective than MDR at detecting four-locus models. Moreover, WRSMDR reveals more information regarding the effect of genotype combination on the disease risk, and the result was easier to determine and apply than with MDR. Finally, we applied WRSMDR to a nasopharyngeal carcinoma (NPC case-control study and identified a statistically significant high-order interaction among three polymorphisms: rs2860580, rs11865086 and rs2305806.

  15. Comparison of Ponseti and Kite's method of treatment for congenital Talipes Equino using the Pirani scoring system.

    Science.gov (United States)

    Kaseke, F; Mudawarima, T

    2013-01-01

    The study was carried out to compare the effectiveness of the Ponseti manipulation versus the Kite's manipulation in the treatment of idiopathic Congenital Talipes Equino Varus (CTEV) as evaluated by the Pirani score. An intervention study, prospective non randomized trial. Hospital based study at three central hospitals namely Harare Central Hospital (HCH), Parirenyatwa Group of Hospitals (PGH) and Chitungwiza Central Hospitals (CCH) in Zimbabwe. Subjects: 38 feet in 25 patients, 13 bilateral and 12 unilateral CTEV deformities in children less than one year of age and without prior manipulation or surgical treatment were purposively allocated to either Ponseti (20 feet) or Kite's method (18 feet) at three central hospitals. There were no dropouts. Participants in two hospitals were managed using the Ponseti method and one hospital managed participants using the kite's method. Baseline Pirani scores were measured before the first treatment was done. Thereafter they were followed up weekly and analysis was done for three and six week outcomes using the Pirani score. Correction was measured by the difference between the baseline hindfoot, midfoot and total scores and the Pirani scores at three weeks and six weeks. Within group analysis of the data was done using a single student t - test and between groups analysis was done using the independent student t - test. Both methods were effective in correcting CTEV deformity. Feet managed by the Ponseti method showed faster rates of decrease in Pirani score (improvement) as compared to feet treated by Kite's method. The between group analysis (Kite Ponseti) at three weeks was -1,4056 (p = 0.0000) [CI = -1.900 to -0.9103] showing a significantly difference between the methods at three weeks. The between group analysis (Kite Ponseti) at six weeks was -2.2302 (p = 0.0000) [CI = -2.9789 to -1.4815] showing a significantly difference between the methods at six weeks. Ponseti management causes faster improvement in CTEV

  16. Epileptic Seizures in Patients Following Surgical Treatment of Acute Subdural Hematoma-Incidence, Risk Factors, Patient Outcome, and Development of New Scoring System for Prophylactic Antiepileptic Treatment (GATE-24 score).

    Science.gov (United States)

    Won, Sae-Yeon; Dubinski, Daniel; Herrmann, Eva; Cuca, Colleen; Strzelczyk, Adam; Seifert, Volker; Konczalla, Juergen; Freiman, Thomas M

    2017-05-01

    Clinically evident or subclinical seizures are common manifestations in acute subdural hematoma (aSDH); however, there is a paucity of research investigating the relationship between seizures and aSDH. The purpose of this study is 2-fold: determine incidence and predictors of seizures and then establish a guideline in patients with aSDH to standardize the decision for prophylactic antiepileptic treatment. The author analyzed 139 patients with aSDH treated from 2007 until 2015. Baseline characteristics and clinical findings including Glasgow Coma Scale (GCS) at admission, 24 hours after operation, timing of operation, anticoagulation, and Glasgow Outcome Scale at hospital discharge and after 3 months were analyzed. Multivariate logistic regression analysis was performed to detect independent predictors of seizures, and a scoring system was developed. Of 139 patients, overall incidence of seizures was 38%, preoperatively 16% and postoperatively 24%. Ninety percent of patients with preoperative seizures were seizure free after operation for 3 months. Independent predictors of seizures were GCS <9 (odds ratio [OR] 3.3), operation after 24 hours (OR 2.0), and anticoagulation (OR 2.2). Patients with seizures had a significantly higher rate of unfavorable outcome at hospital discharge (P = 0.001) and in 3-month follow-up (P = 0.002). Furthermore, a score system (GATE-24) was developed. In patients with GCS <14, anticoagulation, or surgical treatment 24 hours after onset, a prophylactic antiepileptic treatment is recommended. Occurrence of seizures affected severity and outcomes after surgical treatment of aSDH. Therefore seizure prophylaxis should be considered in high-risk patients on the basis of the GATE-24 score to promote better clinical outcome. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Treatment for Schistosoma japonicum, reduction of intestinal parasite load, and cognitive test score improvements in school-aged children.

    Science.gov (United States)

    Ezeamama, Amara E; McGarvey, Stephen T; Hogan, Joseph; Lapane, Kate L; Bellinger, David C; Acosta, Luz P; Leenstra, Tjalling; Olveda, Remigio M; Kurtis, Jonathan D; Friedman, Jennifer F

    2012-01-01

    To determine whether treatment of intestinal parasitic infections improves cognitive function in school-aged children, we examined changes in cognitive testscores over 18 months in relation to: (i) treatment-related Schistosoma japonicum intensity decline, (ii) spontaneous reduction of single soil-transmitted helminth (STH) species, and (iii) ≥2 STH infections among 253 S. japonicum-infected children. Helminth infections were assessed at baseline and quarterly by the Kato-Katz method. S. japonicum infection was treated at baseline using praziquantel. An intensity-based indicator of lower vs. no change/higher infection was defined separately for each helminth species and joint intensity declines of ≥2 STH species. In addition, S. japonicum infection-free duration was defined in four categories based on time of schistosome re-infection: >18 (i.e. cured), >12 to ≤18, 6 to ≤12 and ≤6 (persistently infected) months. There was no baseline treatment for STHs but their intensity varied possibly due to spontaneous infection clearance/acquisition. Four cognitive tests were administered at baseline, 6, 12, and 18 months following S. japonicum treatment: learning and memory domains of Wide Range Assessment of Memory and Learning (WRAML), verbal fluency (VF), and Philippine nonverbal intelligence test (PNIT). Linear regression models were used to relate changes in respective infections to test performance with adjustment for sociodemographic confounders and coincident helminth infections. Children cured (β = 5.8; P = 0.02) and those schistosome-free for >12 months (β = 1.5; P = 0.03) scored higher in WRAML memory and VF tests compared to persistently infected children independent of STH infections. A decline vs. no change/increase of any individual STH species (β:11.5-14.5; all PSTH (β = 13.1; P = 0.01) species were associated with higher scores in WRAML learning test independent of schistosome infection. Hookworm and Trichuris trichiura

  18. Spondylodiscitis severity code: scoring system for the classification and treatment of non-specific spondylodiscitis.

    Science.gov (United States)

    Homagk, L; Homagk, N; Klauss, J R; Roehl, K; Hofmann, G O; Marmelstein, D

    2016-04-01

    Established treatment options of spondylodiscitis, a rare but serious infection of the spine, are immobilization and systemic antibiosis. However, the available data for specific treatment recommendations are very heterogeneous. Our intention was to develop a classification of the severity of spondylodiscitis with appropriate treatment recommendations. From 10/1/1998 until 12/31/2004, 37 cases of spondylodiscitis were examined regarding medical history, gender status, location and extent of spondylodiscitis, type and number of operations. Subsequently, a classification of six grades according to severity has been developed with specific treatment recommendations. The further evaluation of our classification and corresponding treatment modalities from 1/1/2005 to 12/31/2009 including further 132 cases, resulted in a classification of only three grades of severity (the SSC--spondylodiscitis severity code), with a follow-up until 12/31/2011. Between 01/01/2012 and 12/31/2013, a prospective study of 42 cases was carried out. Overall, 296 cases were included in the study. 26 conservatively treated cases were excluded. The main localization of spondylodiscitis was the lumbar spine (55%) followed by the thoracic spine (34%). The classification of patients into 3 grades of severity depends on clinical and laboratory parameters, the morphological vertebral destruction seen in radiological examinations and the current neurological status. Therapies are adapted according to severity and they include a specific surgical management, systemic antibiotic therapy according to culture and sensitivity tests, physiotherapy and initiation of post-hospital follow-up. 40.6% of patients are associated with neurological deficits, classified as severity grade 3 and treated surgically with spinal stabilization and decompression. 46.9% of patients corresponded to severity grade 2, with concomitant vertebral destruction were dorsoventrally stabilized. The 31 patients of severity Grade 1 were

  19. Can the painDETECT Questionnaire score and MRI help predict treatment outcome in rheumatoid arthritis

    DEFF Research Database (Denmark)

    Rifbjerg-Madsen, Signe; Christensen, Anton Wulf; Boesen, Mikael

    2014-01-01

    -modifying antirheumatic drug treatment, or (B) initiating or switching to biological therapy. We anticipate that 100 patients will be enrolled, tested and reassessed after 4 months of treatment. DATA COLLECTION INCLUDES: Clinical data, conventional MRI, DCE-MRI, blood samples and patient-reported outcomes. ETHICS...... contrast-enhanced MRI (DCE-MRI) is performed. METHOD AND ANALYSIS: The painDETECT Questionnaire (PDQ), originally developed to screen for a neuropathic pain component, is applied to indicate the presence of central sensitisation. Adults diagnosed with RA are included when either (A) initiating disease...

  20. Design of the Growth hormone deficiency and Efficacy of Treatment (GET) score and non-interventional proof of concept study.

    Science.gov (United States)

    Kann, Peter H; Bergmann, Simona; Bidlingmaier, Martin; Dimopoulou, Christina; Pedersen, Birgitte T; Stalla, Günter K; Weber, Matthias M; Meckes-Ferber, Stefanie

    2018-02-13

    The adverse effects of growth hormone (GH) deficiency (GHD) in adults (AGHD) on metabolism and health-related quality of life (HRQoL) can be improved with GH substitution. This investigation aimed to design a score summarising the features of GHD and evaluate its ability to measure the effect of GH substitution in AGHD. The Growth hormone deficiency and Efficacy of Treatment (GET) score (0-100 points) assessed (weighting): HRQoL (40%), disease-related days off work (10%), bone mineral density (20%), waist circumference (10%), low-density lipoprotein cholesterol (10%) and body fat mass (10%). A prospective, non-interventional, multicentre proof-of-concept study investigated whether the score could distinguish between untreated and GH-treated patients with AGHD. A 10-point difference in GET score during a 2-year study period was expected based on pre-existing knowledge of the effect of GH substitution in AGHD. Of 106 patients eligible for analysis, 22 were untreated GHD controls (9 females, mean ± SD age 52 ± 17 years; 13 males, 57 ± 13 years) and 84 were GH-treated (31 females, age 45 ± 13 years, GH dose 0.30 ± 0.16 mg/day; 53 males, age 49 ± 15 years, GH dose 0.25 ± 0.10 mg/day). Follow-up was 706 ± 258 days in females and 653 ± 242 days in males. The GET score differed between the untreated control and treated groups with a least squares mean difference of + 10.01 ± 4.01 (p = 0.0145). The GET score appeared to be a suitable integrative instrument to summarise the clinical features of GHD and measure the effects of GH substitution in adults. Exercise capacity and muscle strength/body muscle mass could be included in the GET score. NCT number: NCT00934063 . Date of registration: 02 July 2009.

  1. Explicit treatment of active-site waters enhances quantum mechanical/implicit solvent scoring: Inhibition of CDK2 by new pyrazolo[1,5-a]pyrimidines.

    Science.gov (United States)

    Hylsová, Michaela; Carbain, Benoit; Fanfrlík, Jindřich; Musilová, Lenka; Haldar, Susanta; Köprülüoğlu, Cemal; Ajani, Haresh; Brahmkshatriya, Pathik S; Jorda, Radek; Kryštof, Vladimír; Hobza, Pavel; Echalier, Aude; Paruch, Kamil; Lepšík, Martin

    2017-01-27

    We present comprehensive testing of solvent representation in quantum mechanics (QM)-based scoring of protein-ligand affinities. To this aim, we prepared 21 new inhibitors of cyclin-dependent kinase 2 (CDK2) with the pyrazolo[1,5-a]pyrimidine core, whose activities spanned three orders of magnitude. The crystal structure of a potent inhibitor bound to the active CDK2/cyclin A complex revealed that the biphenyl substituent at position 5 of the pyrazolo[1,5-a]pyrimidine scaffold was located in a previously unexplored pocket and that six water molecules resided in the active site. Using molecular dynamics, protein-ligand interactions and active-site water H-bond networks as well as thermodynamics were probed. Thereafter, all the inhibitors were scored by the QM approach utilizing the COSMO implicit solvent model. Such a standard treatment failed to produce a correlation with the experiment (R 2  = 0.49). However, the addition of the active-site waters resulted in significant improvement (R 2  = 0.68). The activities of the compounds could thus be interpreted by taking into account their specific noncovalent interactions with CDK2 and the active-site waters. In summary, using a combination of several experimental and theoretical approaches we demonstrate that the inclusion of explicit solvent effects enhance QM/COSMO scoring to produce a reliable structure-activity relationship with physical insights. More generally, this approach is envisioned to contribute to increased accuracy of the computational design of novel inhibitors. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  2. Correlation of Pirani score and Foot bimalleolar angle in the treatment of idiopathic congenital talipes equino varus by Ponseti method in infants.

    Science.gov (United States)

    Anshuman, R; Singh, M; Jain, B K; Verma, N; Arora, R

    2016-12-01

    Correlation of Pirani score and Foot bimalleolar (FBM) angle in the treatment of idiopathic congenital talipes equino varus (CTEV) by Ponseti method in infants. 35 feet with idiopathic CTEV deformity <1 year were prospectively treated by Ponseti method. Deformity evaluated each successive week of treatment by Pirani score and FBM angle. Feet were divided according to Pirani score in groups : one(0-2.0), two(2.5-4) and three(4.5-6). Correlation between mean Pirani score and mean FBM angle was evaluated every week and at follow up, firstly by using Pearson's and Spearman's correlation and then, after dividing data in groups by using ANOVA. Correlation between Pirani score and FBM angle was statistically significant(p value <0.05). Pirani score decreases and FBM angle increases with correction. Pirani score and FBM angle correlated in severity of deformity and correction achieved, thus FBM angle provides objective evidence of clubfoot deformity/improvement/deterioration.

  3. A New Prognostic Score Supporting Treatment Allocation for Multimodality Therapy for Malignant Pleural Mesothelioma: A Review of 12 Years' Experience.

    Science.gov (United States)

    Opitz, Isabelle; Friess, Martina; Kestenholz, Peter; Schneiter, Didier; Frauenfelder, Thomas; Nguyen-Kim, Thi Dan Linh; Seifert, Burkhardt; Hoda, Mir Alireza; Klepetko, Walter; Stahel, Rolf A; Weder, Walter

    2015-11-01

    Treatment of malignant pleural mesothelioma (MPM) remains a clinical challenge. The aim of this study was to identify selection factors for allocation of MPM patients to multimodal therapy based on survival data from 12 years of experience. Eligible patients had MPM of all histological subtypes with clinical stage T1-3 N0-2 M0. Induction chemotherapy consisted of cisplatin/gemcitabine (cis/gem) or cisplatin/pemetrexed (cis/pem), followed by extrapleural pneumonectomy (EPP). Multivariate analysis was performed to assess independent prognosticators for overall survival (OS). A Multimodality Prognostic Score was developed based on clinical variables available before surgery. From May 1999 to August 2011, 186 MPM patients were intended to be treated with induction chemotherapy followed by EPP. Hematologic toxicity was significantly less frequent after cis/pem compared to cis/gem, but there was no difference in response or OS between the regimens. One hundred and twenty-eight patients underwent EPP with a 30-day mortality of 4.7%. Fifty-two percent of the patients received adjuvant radiotherapy. The median OS of patients undergoing EPP was significantly longer with 22 months (95% confidence interval: 20-24) when compared to 11 months (9-12) for patients treated without EPP. A prognostic score was defined considering tumor volume, histology, C-reactive protein level, and response to chemotherapy that identified patient groups not benefitting from multimodality treatment which was confirmed in an independent cohort. Patients receiving induction chemotherapy followed by EPP for MPM of all histological subtypes and irrespective of nodal status showed a median survival of 22 months. A prognostic score is proposed to help patient allocation for surgery after validation in an independent cohort.

  4. A novel genetic score approach using instruments to investigate interactions between pathways and environment: application to air pollution.

    Directory of Open Access Journals (Sweden)

    Marie-Abele Bind

    Full Text Available Air pollution has been associated with increased systemic inflammation markers. We developed a new pathway analysis approach to investigate whether gene variants within relevant pathways (oxidative stress, endothelial function, and metal processing modified the association between particulate air pollution and fibrinogen, C-reactive protein (CRP, intercellular adhesion molecule-1 (ICAM-1, and vascular cell adhesion molecule-1 (VCAM-1. Our study population consisted of 822 elderly participants of the Normative Aging Study (1999-2011. To investigate the role of biological mechanisms and to reduce the number of comparisons in the analysis, we created pathway-specific scores using gene variants related to each pathway. To select the most appropriate gene variants, we used the least absolute shrinkage and selection operator (Lasso to relate independent outcomes representative of each pathway (8-hydroxydeoxyguanosine for oxidative stress, augmentation index for endothelial function, and patella lead for metal processing to gene variants. A high genetic score corresponds to a higher allelic risk profile. We fit mixed-effects models to examine modification by the genetic score of the weekly air pollution association with the outcome. Among participants with higher genetic scores within the oxidative stress pathway, we observed significant associations between particle number and fibrinogen, while we did not find any association among participants with lower scores (p(interaction = 0.04. Compared to individuals with low genetic scores of metal processing gene variants, participants with higher scores had greater effects of particle number on fibrinogen (p(interaction = 0.12, CRP (p(interaction = 0.02, and ICAM-1 (pinteraction = 0.08. This two-stage penalization method is easy to implement and can be used for large-scale genetic applications.

  5. Comparison of ceiling effects between two patient-rating scores and a physician-rating score in the assessment of outcome after the surgical treatment of distal radial fractures.

    Science.gov (United States)

    Kim, S-J; Lee, B-G; Lee, C-H; Choi, W-S; Kim, J-H; Lee, K-H

    2015-12-01

    We compared the ceiling effects of two patient-rating scores, the Disability of the Arm, Shoulder and Hand (DASH) and Patient-Rated Wrist Evaluation (PRWE), and a physician-rating score, the Modified Mayo Wrist Score (MMWS) in assessing the outcome of surgical treatment of an unstable distal radial fracture. A total of 77 women with a mean age of 64.2 years (50 to 88) who underwent fixation using a volar locking plate for an unstable distal radial fracture between 2011 and 2013 were enrolled in this study. All completed the DASH and PRWE questionnaires one year post-operatively and were assessed using the MMWS by the senior author. The ceiling effects in the outcome data assessed for each score were estimated. The data assessed with both patient-rating scores, the DASH and PRWE, showed substantial ceiling effects, whereas the data assessed with MMWS showed no ceiling effect. Researchers should be aware of a possible ceiling effect in the assessment of the outcome of the surgical treatment of distal radial fractures using patient-rating scores. It could also increase the likelihood of a type II error. ©2015 The British Editorial Society of Bone & Joint Surgery.

  6. Evaluation of cortical bone mass, thickness and density by z-scores in osteopenic conditions and in relation to menopause and estrogen treatment

    Energy Technology Data Exchange (ETDEWEB)

    Meema, S.; Meema, H.E.

    1982-08-01

    Z-scores express, differences from normals in standard deviation units, and are particularly useful for comparison of changes where normal values are age- and sex-dependent. We determined z-scores for bone mineral mass, cortical thickness, and bone mineral density in the radius in various conditions and diseases in both sexes. In the males, z-scores were calculated for age, but in the females z-scores for menopausal status (years postmenopausal exclusive of years on estrogen treatment) were found to be more appropriate. With few exceptions, changes in a disease were of a similar order in both sexes. For bone minerals mass few mean z-scores were significantly increased, but diseases with significantly decreased mean z-scores were numerous. The usefulness of z-scores in diagnosis and study of metabolic bone disease is discussed.

  7. Evaluation of cortical bone mass, thickness and density by z-scores in osteopenic conditions and in relation to menopause and estrogen treatment

    International Nuclear Information System (INIS)

    Meema, S.; Meema, H.E.

    1982-01-01

    Z-scores express, differences from normals in standard deviation units, and are particularly useful for comparison of changes where normal values are age- and sex-dependent. We determined z-scores for bone mineral mass, cortical thickness, and bone mineral density in the radius in various conditions and diseases in both sexes. In the males, z-scores were calculated for age, but in the females z-scores for menopausal status (years postmenopausal exclusive of years on estrogen treatment) were found to be more appropriate. With few exceptions, changes in a disease were of a similar order in both sexes. For bone minerals mass few mean z-scores were significantly increased, but diseases with significantly decreased mean z-scores were numerous. The usefulness of z-scores in diagnosis and study of metabolic bone disease is discussed. (orig.)

  8. Beyond Fuel Treatment Effectiveness: Characterizing Interactions between Fire and Treatments in the US

    Directory of Open Access Journals (Sweden)

    Kevin Barnett

    2016-10-01

    Full Text Available In the United States, fuel reduction treatments are a standard land management tool to restore the structure and composition of forests that have been degraded by past management. Although treatments can have multiple purposes, their principal objective is to create landscape conditions where wildland fire can be safely managed to help achieve long-term land management goals. One critique is that fuel treatment benefits are unlikely to transpire due to the low probability that treated areas will be burned by a subsequent fire within a treatment’s lifespan, but little quantitative information exists to corroborate this argument. We summarized the frequency, extent, and geographic variation of fire and fuel treatment interactions on federal lands within the conterminous United States (CONUS. We also assessed how the encounters between fuel treatments and fires varied with treatment size, treatment age, and number of times treated. Overall, 6.8% of treatment units evaluated were encountered by a subsequent fire during the study period, though this rate varied among ecoregions across the CONUS. Larger treatment units were more likely to be encountered by a fire, and treatment units were most frequently burned within one year of the most recent treatment, the latter of which is likely because of ongoing maintenance of existing treatments. Our results highlight the need to identify and prioritize additional opportunities to reduce fuel loading and fire risk on the millions of hectares of federal lands in the CONUS that are in need of restoration.

  9. Effect of diagnosis and treatment of clinical endometritis based on vaginal discharge score grading system in postpartum Holstein cows.

    Science.gov (United States)

    Okawa, Hiroaki; Fujikura, Atsushi; Wijayagunawardane, Missaka M P; Vos, Peter L A M; Taniguchi, Masayasu; Takagi, Mitsuhiro

    2017-09-12

    In this study, the prevalence, effectiveness of diagnosis, and treatment based on vaginal discharge score (VDS) of clinical endometritis in cattle were evaluated. To detect clinical endometritis and classify its severity, vaginoscopy was performed during 21 to 60 days postpartum in 164 Holstein cows consisting of 229 lactations. Groups were defined using the 4-point VDS scale. Study groups included the following: non-endometritis (VDS=0; no/clear mucus; NEM group; n=168); mild endometritis, no treatment (VDS=1; mucus containing flecks of white/off-white pus; NTR group; n=30); and severe endometritis, treated with PGF2α (VDS≥2; discharge containing discharge containing >50% pus, and fluid or uterine horn asymmetry; TEM group; n=31). Cows treated with PGF2α that did not recover (VDS≥1, n=5) received intrauterine procaine penicillin and streptomycin. Prevalence of clinical endometritis (VDS≥1) was 26.6%. The NTR group required significantly more artificial inseminations per pregnancy than NEM and TEM groups (2.8 ± 1.8 vs 2.0 ± 1.3, 1.9 ± 0.8, PDiagnosis and treatment of clinical endometritis based on a VDS grading system may improve dairy herd reproductive performance.

  10. Radioembolization Is a Safe and Effective Treatment for Hepatocellular Carcinoma with Portal Vein Thrombosis: A Propensity Score Analysis.

    Directory of Open Access Journals (Sweden)

    Young Youn Cho

    Full Text Available Limited treatment options are available for patients with hepatocellular carcinoma (HCC with portal vein thrombosis (PVT. Transarterial radioembolization using Yttrium-90 microspheres is a new treatment modality for HCC with PVT. For this analysis, we compared responses to treatment with radioembolization and with sorafenib.We evaluated 32 patients who were part of a multicenter retrospective cohort. All patients had PVT without extrahepatic metastasis and were treated with radioembolization in one of six tertiary referral hospitals in Korea. We retrospectively enrolled another 31 consecutive PVT patients without extrahepatic metastasis from a single center who received sorafenib treatment to serve as the control group. We used inverse probability weighting (IPW using propensity scores to adjust for the between-group differences in baseline characteristics.At 3 months, the response rate and disease control rate were 32.1% (9/32 and 57.1% (16/32, respectively, in the radioembolization group and 3.2% (1/31 and 41.9% (13/31 in the sorafenib group. Median overall survival (OS and time to progression (TTP were not significantly different between the radioembolization group and the sorafenib group (13.8 months and 10.0 months, P = 0.22; and 6.0 months and 6.0 months, P = 0.08; respectively. No differences in OS (P = 0.97 or TTP (P = 0.34 were observed after IPW was applied to balance the population characteristics. The sorafenib group showed significantly more grade 3/4 adverse effects than the radioembolization group (P < 0.01.HCC patients with PVT who underwent radioembolization achieved comparable survival to patients who received sorafenib, even after application of IPW. The radioembolization group also experienced fewer severe adverse effects. Radioembolization can be considered a new treatment option for patients with HCC with PVT.

  11. Body condition score as a selection tool for targeted selective treatment-based nematode control strategies in Merino ewes.

    Science.gov (United States)

    Cornelius, M P; Jacobson, C; Besier, R B

    2014-12-15

    Sheep nematode control utilising refugia-based strategies have been shown to delay anthelmintic resistance, but the optimal indices to select individuals to be left untreated under extensive sheep grazing conditions are not clear. This experiment tested the hypothesis that high body condition can indicate ability of mature sheep to better cope with worms and therefore remain untreated in a targeted treatment programme. Adult Merino ewes from flocks on two private farms located in south-west Western Australia (Farm A, n = 271, and Farm B, n = 258) were measured for body condition score (BCS), body weight and worm egg counts (WEC) on four occasions between May and December (pre-lambing, lamb marking, lamb weaning and post-weaning). Half of the ewes in each flock received anthelmintic treatments to suppress WEC over the experimental period and half remained untreated (unless critical limits were reached). Response to treatment was analysed in terms of BCS change and percentage live weight change. No effect of high or low initial WEC groups was shown for BCS response, and liveweight responses were inconsistent. A relatively greater BCS response to treatment was observed in ewes in low BCS pre-lambing compared to better-conditioned ewes on one farm where nutrition was sub-optimal and worm burdens were high. Sheep in low body condition pre-lambing were more than three times more likely to fall into a critically low BCS (<2.0) if left untreated. Recommendations can be made to treat ewes in lower BCS and leave a proportion of the higher body condition sheep untreated in a targeted selective treatment programme, to provide a population of non-resistant worms to delay the development of resistance. Copyright © 2014 Elsevier B.V. All rights reserved.

  12. Optimal Dosage of Methylprednisolone for the Treatment of Sudden Hearing Loss in Geriatric Patients: A Propensity Score-Matched Analysis

    Science.gov (United States)

    Choi, Myoung Su; Lee, Ho Yun; Cho, Chin Saeng

    2014-01-01

    We aimed to compare the treatment outcomes and the occurrence rates of adverse events associated with different steroid regimens in geriatric patients (aged 65 years or older) with unilateral idiopathic sudden sensorineural hearing loss (ISSNHL). After thorough medical chart reviews of 109 patients with ISSNHL between May 2006 and December 2013, we performed a propensity score-matched analysis using previously known prognostic factors, steroid regimens, and other cointerventions. Patients were divided based on their steroid regimens into group I (which initially received 48 mg of methylprednisolone daily with a subsequently tapered dose) and group II (which initially received 24 mg of methylprednisolone daily with a subsequently tapered dose). We compared final hearing and the occurrence of adverse events between the two groups. As a result, 20 pairs of propensity score-matched patients (n = 40) were enrolled. Group I patients showed better final hearing levels compared with group II patients (42.00±22.35 dB and 57.38±26.40 dB, respectively), although this difference was marginally significant (p = 0.058). Based on the comparative analysis of each of the frequencies in the final audiograms, lower hearing thresholds at 2 KHz were observed in group I (p = 0.049). There was no significant difference in the occurrence of adverse effects between the two groups (p>0.05). In conclusion, conventional steroid regimens produced adverse event occurrence rates that were similar to those of low-dose treatment but may also have produced superior hearing recovery. The use of steroid dose reduction in geriatric patients with ISSNHL is not preferable to conventional steroid regimens. PMID:25383617

  13. Optimal dosage of methylprednisolone for the treatment of sudden hearing loss in geriatric patients: a propensity score-matched analysis.

    Directory of Open Access Journals (Sweden)

    Myoung Su Choi

    Full Text Available We aimed to compare the treatment outcomes and the occurrence rates of adverse events associated with different steroid regimens in geriatric patients (aged 65 years or older with unilateral idiopathic sudden sensorineural hearing loss (ISSNHL. After thorough medical chart reviews of 109 patients with ISSNHL between May 2006 and December 2013, we performed a propensity score-matched analysis using previously known prognostic factors, steroid regimens, and other cointerventions. Patients were divided based on their steroid regimens into group I (which initially received 48 mg of methylprednisolone daily with a subsequently tapered dose and group II (which initially received 24 mg of methylprednisolone daily with a subsequently tapered dose. We compared final hearing and the occurrence of adverse events between the two groups. As a result, 20 pairs of propensity score-matched patients (n = 40 were enrolled. Group I patients showed better final hearing levels compared with group II patients (42.00 ± 22.35 dB and 57.38 ± 26.40 dB, respectively, although this difference was marginally significant (p = 0.058. Based on the comparative analysis of each of the frequencies in the final audiograms, lower hearing thresholds at 2 KHz were observed in group I (p = 0.049. There was no significant difference in the occurrence of adverse effects between the two groups (p>0.05. In conclusion, conventional steroid regimens produced adverse event occurrence rates that were similar to those of low-dose treatment but may also have produced superior hearing recovery. The use of steroid dose reduction in geriatric patients with ISSNHL is not preferable to conventional steroid regimens.

  14. An Alternative Approach to Scoring the MTA-SNAP-IV to Guide Attention-Deficit/Hyperactivity Disorder Medication Treatment Titration towards Symptom Remission: A Preliminary Consideration.

    Science.gov (United States)

    Wagner, Daniel J; McLennan, John D

    2015-12-01

    The Multimodal Treatment Study for Attention-Deficit/Hyperactivity Disorder Swanson, Nolan, and Pelham, Version IV (MTA-SNAP-IV) is a common rating scale to measure attention-deficit/hyperactivity disorder (ADHD) symptoms during medication treatment. Relying on the traditional scoring approach for this instrument to identify symptom remission, however, may leave a child with significant residual symptoms. The objective of this study was to examine an alternative scoring approach for this instrument to identify the extent of residual symptoms for children completing ADHD medication treatment. Parent and teacher ratings on the ADHD symptom component of the MTA-SNAP-IV were extracted from medical records of 80 children completing medication treatment at a specialty clinic in Canada. Data were scored in two ways. 1) Traditional scoring based on assigning a value ranging from 0 to 3 for response options: "Not at all," "Just a little," "Pretty much," or "Very much," for each symptom and then determining a mean across items, and 2) alternative scoring based on assigning values of 0, 0, 0.5, and 1 across the same response options and summing the total across items. Symptom remission based on the former is defined as a mean value ≤ 1, and for the latter it is defined as a summed value equal to 0. Children were significantly less likely to be classified as symptom remitted under the alternative scoring method based on parent, teacher, and combined parent-teacher ratings. Using the alternative scoring approach, residual symptoms were identified for 25%, 39%, and 70% of children classified as symptom remitted (under traditional scoring rules) by parents, teachers, and parents/teachers combined, respectively. Potential "residual" ADHD symptoms were identified in many children attaining symptom remission using the traditional scoring approach; however, further scrutiny of this alternative scoring approach is required. Although it may improve the ability to detect residual

  15. Application Of Treatment Trait Interaction To Improve Learning Of Chemistry

    Directory of Open Access Journals (Sweden)

    Aswirna Prima

    2018-01-01

    Full Text Available This research leave from the fact that performance study of Majors student of Tadris Natural Sciences Concentration Physics (IPA-FISIKA State Islamic University Imam Bonjol. The aims of this research were: (1 Searching ability correlation between content of capability in Chemistry and religiosity. (2 Differentiating study performance by using model of Trait Treatment Interaction (TTI between class with capable student group early is high (learner fastern and class with student group ably early lowering (slower learner by using method study of autodidact (learning self and learn habit (teaching regular added with tutorial. This research use method of quasy experiment. Technique data collecting through test and observation, Total of population counted 101 people. But, only 66 students as a sample. The research conclude : (1 The self-learning was suitable to teach for students with high capability of knowledge (faster lesrner. (2 The regular teaching + tutorial was suitable to teach for students with lower capability of knowledge (slower learner. (3 There were correlation between religiosity and capability of content (chemistry of knowledge. (4 Trait treatment interaction can be improve the capability of academic performance of students Chemistry Science.

  16. The relationship between observer-based toxicity scoring and patient assessed symptom severity after treatment for head and neck cancer. A correlative cross sectional study of the DAHANCA toxicity scoring system and the EORTC quality of life questionnaires

    International Nuclear Information System (INIS)

    Jensen, Kenneth; Bonde Jensen, Anders; Grau, Cai

    2006-01-01

    Background and purpose: Morbidity is an important issue in cancer research. The observer-based toxicity scoring system used by DAHANCA (the Danish head and neck cancer study group) has proved itself sensitive to differences in toxicity in a large randomised study, but like other toxicity scoring systems it has not been formally validated. Conversely, the EORTC quality of life questionnaire (QLQ) has been validated as a tool for collecting information about the consequences of disease and treatment on the well being of cancer patients. The purpose of this study was to examine the relationship between the two methods of side effect recording. Patients and methods: One hundred and sixteen recurrence free patients with laryngeal (n=44), pharyngeal (n=34) and oral cavity (n=38) cancer attending follow-up after radiotherapy (n=83) or surgery (n=33) completed EORTC C30, the core questionnaire concerning general symptoms and function and EORTC H and N35 the head and neck specific questionnaire. The attending physicians in the follow-up clinic evaluated and recorded DAHANCA toxicity scores on the same patients. Results: The DAHANCA toxicity scoring system and the EORTC QLQ correlated with several clinical endpoints. The conceptually similar endpoints of the two methods correlated significantly. The objective endpoints of the DAHANCA scoring system were only correlated with quality of life endpoints to a very low degree. The DAHANCA toxicity scores had a low sensitivity (0.48-0.74) in detecting equivalent subjective complaints from the questionnaires and the observer-based scoring system severely underestimated patient complaints. A specific patient group where the DAHANCA score had a higher tendency to fail could not be detected. Conclusion: The DAHANCA toxicity score is an effective instrument in assessing objective treatment induced toxicity in head and neck cancer patients but insensitive and non-specific with regard to patient assessed subjective endpoints. This

  17. Improvement in Depression Scores After 1 Hour of Light Therapy Treatment in Patients With Seasonal Affective Disorder

    Science.gov (United States)

    Reeves, Gloria M.; Nijjar, Gagan Virk; Langenberg, Patricia; Johnson, Mary A.; Khabazghazvini, Baharak; Sleemi, Aamar; Vaswani, Dipika; Lapidus, Manana; Manalai, Partam; Tariq, Muhammad; Acharya, Monika; Cabassa, Johanna; Snitker, Soren; Postolache, Teodor T.

    2016-01-01

    The purpose of this study was to investigate possible rapid effects of light therapy on depressed mood in patients with seasonal affective disorder. Participants received 1 hour of bright light therapy and 1 hour of placebo dim red light in a randomized order crossover design. Depressed mood was measured at baseline and after each hour of light treatment using two self-report depression scales (Profile of Mood States–Depression-Dejection [POMS-D] subscale and the Beck Depression Inventory II [BDI-II]). When light effects were grouped for the two sessions, there was significantly greater reduction in self-report depression scores by −1.3 (p = 0.02) on the BDI-II and −1.2 (p = 0.02) on the POMS-D. A significant but modest improvement was detected after a single active light session. This is the first study, to our knowledge, to document an immediate improvement with light treatment using a placebo-controlled design with a clinical sample of depressed individuals. PMID:22210362

  18. Validation of the Risk Prediction Models STATE-Score and START-Strategy to Guide TACE Treatment in Patients with Hepatocellular Carcinoma.

    Science.gov (United States)

    Mähringer-Kunz, Aline; Kloeckner, Roman; Pitton, Michael B; Düber, Christoph; Schmidtmann, Irene; Galle, Peter R; Koch, Sandra; Weinmann, Arndt

    2017-07-01

    Several scoring systems that guide patients' treatment regimen for transarterial chemoembolization (TACE) of hepatocellular carcinoma (HCC) have been introduced, but none have gained widespread acceptance in clinical practice. The purpose of this study is to externally validate the Selection for TrAnsarterial chemoembolization TrEatment (STATE)-score and START-strategy [i.e., sequential use of the STATE-score and Assessment for Retreatment with TACE (ART)-score]. From January 2000 to September 2015, 933 patients with HCC underwent TACE at our institution. All variables needed to calculate the STATE-score and implement the START-strategy were determined. STATE comprised serum albumin, up-to-seven criteria, and C-reactive protein (CRP). ART comprised an increase in aspartate aminotransferase, the Child-Pugh score, and a radiological tumor response. Overall survival was calculated, and multivariate analysis performed. In addition, the STATE-score and START-strategy were validated using the Harrell's C-index and integrated Brier score (IBS). The STATE-score was calculated in 228 patients. Low and high STATE-scores corresponded to median survival of 14.3 and 20.2 months, respectively. Harrell's C was 0.558 and IBS 0.133. For the STATE-score, significant predictors of survival were up-to-seven criteria (p = 0.006) and albumin (p = 0.022). CRP values were not predictive (p = 0.367). The ART-score was calculated in 207 patients. Combining the STATE-score and ART-score led to a Harrell's C of 0.580 and IBS of 0.132. The STATE-score was unable to reliably determine the suitability for initial TACE. The START-strategy only slightly improved the predictive ability compared to the ART-score alone. Therefore, neither the STATE-score nor START-strategy alone provides sufficient certainty for clear-cut clinical decisions.

  19. A systems biology approach to identify intelligence quotient score-related genomic regions, and pathways relevant to potential therapeutic treatments

    Science.gov (United States)

    Zhao, Min; Kong, Lei; Qu, Hong

    2014-01-01

    Although the intelligence quotient (IQ) is the most popular intelligence test in the world, little is known about the underlying biological mechanisms that lead to the differences in human. To improve our understanding of cognitive processes and identify potential biomarkers, we conducted a comprehensive investigation of 158 IQ-related genes selected from the literature. A genomic distribution analysis demonstrated that IQ-related genes were enriched in seven regions of chromosome 7 and the X chromosome. In addition, these genes were enriched in target lists of seven transcription factors and sixteen microRNAs. Using a network-based approach, we further reconstructed an IQ-related pathway from known human pathway interaction data. Based on this reconstructed pathway, we incorporated enriched drugs and described the importance of dopamine and norepinephrine systems in IQ-related biological process. These findings not only reveal several testable genes and processes related to IQ scores, but also have potential therapeutic implications for IQ-related mental disorders. PMID:24566931

  20. Application of a body condition score index for targeted selective treatment in adult Merino sheep--A modelling study.

    Science.gov (United States)

    Cornelius, M P; Jacobson, C; Besier, R B

    2015-11-30

    This study aimed to establish whether sheep flock production losses due to nematode (worm) infections are typically greater in mature sheep selected for anthelmintic treatment at random compared to sheep selected for treatment based on low (poorer) body condition score (BCS). The study also examined the proportion of sheep in flocks that could be left untreated before production losses became evident, and projected worm egg pasture contamination. Sheep were monitored at two experimental sites in Western Australia (Mediterranean climate). Sheep were stratified for BCS, liveweight and faecal worm egg count (WEC) and allocated into treatment groups (treated or untreated), with equal numbers for each. Liveweight, BCS and WEC measurements were taken on 6 occasions at Farm A and 10 occasions at Farm B. Comparisons of sheep production (liveweight and BCS change) and pasture contamination potential (WEC) were conducted by generating "virtual flocks" of varying proportions sheep untreated (10%, 20%, 30%, 40%, and 50% untreated). For the comparison of the selection mode of sheep for treatment, the untreated sheep were either selected at random, or as the highest BCS animals at the commencement of observations. Univariate general linear models with least square difference post-hoc tests were used to examine differences between flocks for liveweight, BCS and WEC, and regression analysis was used to examine relationships between BCS and WEC, and liveweight and WEC. No difference in body weights was observed between flocks with varying proportions of ewes notionally left untreated at Farm B, and until more than 30% were left untreated at Farm A. There was no difference in BCS between flocks with varying proportions of ewes left untreated at either site. At no point were there differences in cumulative liveweight change or BCS between selection methods (BCS versus random) where the same proportion of sheep in virtual flocks were left untreated, suggesting that effort committed to

  1. Interactive Software "Isotonic Design using Normalized Equivalent Toxicity Score (ID-NETS©TM)" for Cancer Phase I Clinical Trials.

    Science.gov (United States)

    Chen, Zhengjia; Wang, Zhibo; Wang, Haibin; Owonikoko, Taofeek K; Kowalski, Jeanne; Khuri, Fadlo R

    2013-01-01

    Isotonic Design using Normalized Equivalent Toxicity Score (ID-NETS) is a novel Phase I design that integrates the novel toxicity scoring system originally proposed by Chen et al. [1] and the original Isotonic Design proposed by Leung et al. [2]. ID-NETS has substantially improved the accuracy of maximum tolerated dose (MTD) estimation and trial efficiency in the Phase I clinical trial setting by fully utilizing all toxicities experienced by each patient and treating toxicity response as a quasi-continuous variable instead of a binary indicator of dose limiting toxicity (DLT). To facilitate the incorporation of the ID-NETS method into the design and conduct of Phase I clinical trials, we have designed and developed a user-friendly software, ID-NETS(©TM), which has two functions: 1) Calculating the recommended dose for the subsequent patient cohort using available completed data; and 2) Performing simulations to obtain the operating characteristics of a trial designed with ID-NETS. Currently, ID-NETS(©TM)v1.0 is available for free download at http://winshipbbisr.emory.edu/IDNETS.html.

  2. What causes treatment failure - the patient, primary care, secondary care or inadequate interaction in the health services?

    Directory of Open Access Journals (Sweden)

    Lange Ove

    2011-05-01

    Full Text Available Abstract Background Optimal treatment gives complete relief of symptoms of many disorders. But even if such treatment is available, some patients have persisting complaints. One disorder, from which the patients should achieve complete relief of symptoms with medical or surgical treatment, is gastroesophageal reflux disease (GERD. Despite the fact that such treatment is cheap, safe and easily available; some patients have persistent complaints after contact with the health services. This study evaluates the causes of treatment failure. Methods Twelve patients with GERD and persistent complaints had a semi-structured interview which focused on the patients' evaluation of treatment failure. The interviews were taped, transcribed and evaluated by 18 physicians, (six general practitioners, six gastroenterologists and six gastrointestinal surgeons who completed a questionnaire for each patient. The questionnaires were scored, and the relative responsibility for the failure was attributed to the patient, primary care, secondary care and interaction in the health services. Results Failing interaction in the health services was the most important cause of treatment failure, followed by failure in primary care, secondary care and the patient himself; the relative responsibilities were 35%, 28%, 27% and 10% respectively. There was satisfactory agreement about the causes between doctors with different specialities, but significant inter-individual differences between the doctors. The causes of the failures differed between the patients. Conclusions Treatment failure is a complex problem. Inadequate interaction in the health services seems to be important. Improved communication between parts of the health services and with the patients are areas of improvement.

  3. Osteopathic Manipulative Treatment Technique Scores on the COMLEX-USA Level 2-PE: An Analysis of the Skills Assessed.

    Science.gov (United States)

    Smith, Larissa L; Xu, Wei; Sandella, Jeanne M; Dowling, Dennis J

    2016-06-01

    The National Board of Osteopathic Medical Examiners uses the Osteopathic Manipulative Treatment (OMT) Global Rating Tool to score candidate performance in OMT during standardized patient encounters. To the authors' knowledge, no validity research has been published on the underlying constructs measured by this instrument to date. To evaluate whether the OMT Global Rating Tool measures 1 holistic skill or multiple skill sets. Structural equation models were fit to data from first-time test-takers who took the Comprehensive Osteopathic Medical Licensing Examination-USA Level 2-Performance Evaluation (COMLEX-USA Level 2-PE) between July 7, 2014, and April 30, 2015. Two theoretical models were evaluated: a model that posited a single underlying skill set, and a model that posited 2 related but distinct skill sets. The 1-factor and 2-factor models were fit to data from 4673 third- and fourth-year osteopathic medical students. Fit statistics indicated that the data were best fit by a model representing 2 factors: pre- and post-OMT technique assessment and OMT technique (r=0.47). The OMT Global Rating Tool seems to measure 2 distinct but related skills. Although the results of this study are applicable to broad populations and cannot be used to provide skill-specific subscores, it might be helpful to remediation efforts to target pre- and post-OMT technique assessments and OMT techniques as distinct areas for intervention.

  4. Bayesian additive decision trees of biomarker by treatment interactions for predictive biomarker detection and subgroup identification.

    Science.gov (United States)

    Zhao, Yang; Zheng, Wei; Zhuo, Daisy Y; Lu, Yuefeng; Ma, Xiwen; Liu, Hengchang; Zeng, Zhen; Laird, Glen

    2017-10-11

    Personalized medicine, or tailored therapy, has been an active and important topic in recent medical research. Many methods have been proposed in the literature for predictive biomarker detection and subgroup identification. In this article, we propose a novel decision tree-based approach applicable in randomized clinical trials. We model the prognostic effects of the biomarkers using additive regression trees and the biomarker-by-treatment effect using a single regression tree. Bayesian approach is utilized to periodically revise the split variables and the split rules of the decision trees, which provides a better overall fitting. Gibbs sampler is implemented in the MCMC procedure, which updates the prognostic trees and the interaction tree separately. We use the posterior distribution of the interaction tree to construct the predictive scores of the biomarkers and to identify the subgroup where the treatment is superior to the control. Numerical simulations show that our proposed method performs well under various settings comparing to existing methods. We also demonstrate an application of our method in a real clinical trial.

  5. Utility of the R.E.N.A.L.-Nephrometry Scoring System in Objectifying Treatment Decision-Making of the Enhancing Renal Mass

    Science.gov (United States)

    Canter, Daniel; Kutikov, Alexander; Manley, Brandon; Egleston, Brian; Simhan, Jay; Smaldone, Marc; Teper, Ervin; Viterbo, Rosalia; Chen, David Y.T.; Greenberg, Richard E.; Uzzo, Robert G.

    2012-01-01

    Objectives The treatment of localized renal cell carcinoma remains overly subjective. The R.E.N.A.L.- Nephrometry Score (NS) quantifies the salient characteristics of renal mass anatomy in an objective and reproducible manner. We evaluated treatment patterns of solid renal masses based on quantifiable anatomic features using Nephrometry. Methods Nephrometry scores were available in 615 patients in our prospective kidney tumor database (2000-2010). The NS sum and its individual component scores were analyzed to determine their relationship to treatment approach. Results Median age, age-adjusted Charlson Co-Morbidity Index (CCI), and estimated GFR were 60 years (25-89), 2 (0-10), and 80.5 ml/min (5.1-120.0), respectively. Increasing tumor complexity as measured by a higher overall Nephrometry Score was associated with both radical nephrectomy (RN) and open partial nephrectomy (PN) (p<0.0001). Compared to patients who underwent PN, patients treated with RN had significantly higher size (R), central proximity (N), and location (L) component scores (p<0.001). Furthermore, tumors treated with a RN were more often hilar (p<0.001). Similarly, compared to minimally-invasive PN (laparoscopic or robotic), open PN was associated with an increasing individual component score for size, endophycity and central proximity to the collecting system (p<0.001) and non-polar location (p=0.016). Conclusions The R.E.N.A.L. – Nephrometry score standardizes reporting of solid renal masses and appears to effectively stratify by treatment type. Although only one part of the treatment decision-making process, Nephrometry aids in objectifying previously subjective measures. PMID:22054378

  6. Randomized Controlled Trial of a Computerized Interactive Media-Based Problem Solving Treatment for Depression.

    Science.gov (United States)

    Sandoval, Luis R; Buckey, Jay C; Ainslie, Ricardo; Tombari, Martin; Stone, William; Hegel, Mark T

    2017-05-01

    This study evaluated the efficacy of an interactive media-based, computer-delivered depression treatment program (imbPST) compared to a no-treatment control condition (NTC) in a parallel-group, randomized, controlled trial conducted in an outpatient psychiatric research clinic. 45 adult participants with major depressive disorder or dysthymia were randomized to receive either 6 weekly sessions of imbPST or no treatment (No Treatment Control; NTC). The primary outcome measure was the Beck Depression Inventory II (BDI-II). There was a significant Group x Time interaction effect [F (1.73, 43)= 58.78; p<.001; η2=.58, Cohens d=1.94], such that the patients receiving imbPST had a significantly greater reduction in depressive symptoms compared to the patients in the NTC condition. Participants in the imbPST group improved their depression symptoms significantly from moderate (BDI-II=21.9±4.20) to mild levels of depression (BDI-II=17.9±4.0) after receiving 3 weekly sessions of imbPST (p<0.001), and progressed to still milder levels of depression after six weekly sessions (BDI-II=14.5±3.7, p<0.001). NTC participants showed no significant reduction in BDI-II scores (BDI-II=21.8±4.2 pre, BDI-II=21.5±5.2 post, N.S.). Additionally, 40% of the imbPST group showed a clinically significant and reliable change in depression levels while none of the NTC group met this criterion. imbPST participants rated the program highly usable on the system usability scale (SUS) after the first session (SUS Session 1=74.6±7.2) and usability scores increased significantly by the last session (SUS Session 6=85.4±5.6). We conclude that imbPST is an effective, engaging, and easily used depression treatment program that warrants further evaluation with heterogeneous depressed populations in a stand-alone, self-administered fashion. Copyright © 2016. Published by Elsevier Ltd.

  7. Quantified visual scoring of metastatic melanoma patient treatment response using computed tomography: improving on the current standard.

    Science.gov (United States)

    Gottlieb, Ronald H; Krupinski, Elizabeth; Chalasani, Pavani; Cranmer, Lee

    2012-04-01

    To assess whether quantitative visual scoring (QVS) is a better early predictor of progression-free survival (PFS) in patients on chemotherapy for metastatic melanoma using CT than the currently used Response Evaluation Criteria in Solid Tumors (RECIST) standard. Retrospective evaluation of 65 consecutive patients with metastatic melanoma on treatment who had a baseline and follow-up CT after two cycles of therapy. QVS was used to code imaging findings on the radiology reports considering size change, brain metastases, new lesions, mixed lesion response, and the number of organ systems involved. RECIST 1.1 criteria placed patients in the progressive disease, stable disease, or partial response groups. Multiple regression analysis was used to correlate the various independent variables with PFS. The Cox hazard proportions ratio, median survival, and Kaplan-Meier curves of the different prognostic groups were calculated. QVS of size change was found more sensitive in detecting patients deteriorating (57.1% versus 37.5%) or improving (23.8% versus 10.7%), more correlated with the median PFS for the deteriorating (1.8 versus 1.7 months), stable (5.6 versus 4.0 month), and improving (8.3 versus 5.5 months) categories and more predictive of PFS (Cox hazard proportion ratio of 3.070 versus 1.860) than RECIST 1.1 categorization. Multiple regression analysis demonstrated QVS of lesion size correlated most closely with PFS among the variables assessed (r = 0.519, p metastatic melanoma patients likely to have longer PFS.

  8. The effects of acupoint-catgut embedment combined with medical treatment on the BODE index scores of chronic obstructive pulmonary disease (COPD) patients

    Science.gov (United States)

    Giri, P. B. S. W.; Srilestari, A.; Abdurrohim, K.; Yunus, F.

    2017-08-01

    Chronic Obstructive Pulmonary Disease (COPD) is now the fourth leading cause of death in the world. As COPD medications are associated with high mortality levels, continuous research into the improvement of treatment modalities is being conducted. This study aimed to identify the effects of acupoint-catgut embedment combined with medical treatment on the Body mass index, airflow Obstruction, Dyspnea and Exercise capacity (BODE) index scores of COPD patients. A single-blind randomized controlled trial was conducted on 48 patients; participants were allocated into either the acupoint-catgut embedment with medication group (case group) or the sham acupuncture with medication group (control group). Acupoint-catgut embedment was conducted at the BL13 Feishu, BL43 Gaohuangshu, BL20 Pishu, BL23 Shenshu, and ST40 Fenglong points two times at an interval of 15 days. The BODE index, a primary outcome indicator, was assessed on Day 1 and Day 30. The results showed statistically and clinically significant differences between the two groups—in fact, BODE index scores were reduced by 1.83 points in the case group (p = 0.000). Ultimately, BODE index scores were lower in the intervention group than in the control group, thus indicating a statistically significant and clinically important improvement of COPD-related symptoms. According to these results, acupoint-catgut embedment combined with medical treatment is concluded to be more effective than medical treatment alone in reducing BODE index scores.

  9. Use of the probability of stone formation (PSF score to assess stone forming risk and treatment response in a cohort of Brazilian stone formers

    Directory of Open Access Journals (Sweden)

    Benjamin Turney

    2014-08-01

    Full Text Available Introduction The aim was to confirm that PSF (probability of stone formation changed appropriately following medical therapy on recurrent stone formers. Materials and Methods Data were collected on 26 Brazilian stone-formers. A baseline 24-hour urine collection was performed prior to treatment. Details of the medical treatment initiated for stone-disease were recorded. A PSF calculation was performed on the 24 hour urine sample using the 7 urinary parameters required: voided volume, oxalate, calcium, urate, pH, citrate and magnesium. A repeat 24-hour urine sample was performed for PSF calculation after treatment. Comparison was made between the PSF scores before and during treatment. Results At baseline, 20 of the 26 patients (77% had a high PSF score (> 0.5. Of the 26 patients, 17 (65% showed an overall reduction in their PSF profiles with a medical treatment regimen. Eleven patients (42% changed from a high risk (PSF > 0.5 to a low risk (PSF 0.5 during both assessments. Conclusions The PSF score reduced following medical treatment in the majority of patients in this cohort.

  10. Electronic problem-solving treatment: description and pilot study of an interactive media treatment for depression.

    Science.gov (United States)

    Cartreine, James Albert; Locke, Steven E; Buckey, Jay C; Sandoval, Luis; Hegel, Mark T

    2012-09-25

    Computer-automated depression interventions rely heavily on users reading text to receive the intervention. However, text-delivered interventions place a burden on persons with depression and convey only verbal content. The primary aim of this project was to develop a computer-automated treatment for depression that is delivered via interactive media technology. By using branching video and audio, the program simulates the experience of being in therapy with a master clinician who provides six sessions of problem-solving therapy. A secondary objective was to conduct a pilot study of the program's usability, acceptability, and credibility, and to obtain an initial estimate of its efficacy. The program was produced in a professional multimedia production facility and incorporates video, audio, graphics, animation, and text. Failure analyses of patient data are conducted across sessions and across problems to identify ways to help the user improve his or her problem solving. A pilot study was conducted with persons who had minor depression. An experimental group (n = 7) used the program while a waitlist control group (n = 7) was provided with no treatment for 6 weeks. All of the experimental group participants completed the trial, whereas 1 from the control was lost to follow-up. Experimental group participants rated the program high on usability, acceptability, and credibility. The study was not powered to detect clinical improvement, although these pilot data are encouraging. Although the study was not powered to detect treatment effects, participants did find the program highly usable, acceptable, and credible. This suggests that the highly interactive and immersive nature of the program is beneficial. Further clinical trials are warranted. ClinicalTrials.gov NCT00906581; http://clinicaltrials.gov/ct2/show/NCT00906581 (Archived by WebCite at http://www.webcitation.org/6A5Ni5HUp).

  11. Propensity Score-Based Approaches to Confounding by Indication in Individual Patient Data Meta-Analysis: Non-Standardized Treatment for Multidrug Resistant Tuberculosis.

    Directory of Open Access Journals (Sweden)

    Gregory J Fox

    Full Text Available In the absence of randomized clinical trials, meta-analysis of individual patient data (IPD from observational studies may provide the most accurate effect estimates for an intervention. However, confounding by indication remains an important concern that can be addressed by incorporating individual patient covariates in different ways. We compared different analytic approaches to account for confounding in IPD from patients treated for multi-drug resistant tuberculosis (MDR-TB.Two antibiotic classes were evaluated, fluoroquinolones--considered the cornerstone of effective MDR-TB treatment--and macrolides, which are known to be safe, yet are ineffective in vitro. The primary outcome was treatment success against treatment failure, relapse or death. Effect estimates were obtained using multivariable and propensity-score based approaches.Fluoroquinolone antibiotics were used in 28 included studies, within which 6,612 patients received a fluoroquinolone and 723 patients did not. Macrolides were used in 15 included studies, within which 459 patients received this class of antibiotics and 3,670 did not. Both standard multivariable regression and propensity score-based methods resulted in similar effect estimates for early and late generation fluoroquinolones, while macrolide antibiotics use was associated with reduced treatment success.In this individual patient data meta-analysis, standard multivariable and propensity-score based methods of adjusting for individual patient covariates for observational studies yielded produced similar effect estimates. Even when adjustment is made for potential confounding, interpretation of adjusted estimates must still consider the potential for residual bias.

  12. Treatment of asymptomatic adults with elevated coronary calcium scores with atorvastatin, vitamin C, and vitamin E: the St. Francis Heart Study randomized clinical trial.

    Science.gov (United States)

    Arad, Yadon; Spadaro, Louise A; Roth, Marguerite; Newstein, David; Guerci, Alan D

    2005-07-05

    We sought to determine whether lipid-lowering therapy and antioxidants retard the progression of coronary calcification and prevent atherosclerotic cardiovascular disease (ASCVD) events. The electron beam computed tomography-derived coronary calcium score predicts coronary disease events. Small, uncontrolled studies suggest that vigorous lipid-lowering therapy slows progression of coronary calcification and prevents coronary artery disease events, but controlled, scientific demonstration of these effects is lacking. We conducted a double-blind, placebo-controlled randomized clinical trial of atorvastatin 20 mg daily, vitamin C 1 g daily, and vitamin E (alpha-tocopherol) 1,000 U daily, versus matching placebos in 1,005 asymptomatic, apparently healthy men and women age 50 to 70 years with coronary calcium scores at or above the 80th percentile for age and gender. All study participants also received aspirin 81 mg daily. Mean duration of treatment was 4.3 years. Treatment reduced total cholesterol by 26.5% to 30.4% (p 400 (8.7% vs. 15.0%, p = 0.046 [not a pre-specified analysis]). Treatment with alpha-tocopherol, vitamin C, and low doses of atorvastatin (20 mg once daily) did not affect the progression of coronary calcification. Treatment may have reduced ASCVD events, especially in subjects with calcium scores >400, but these effects did not achieve conventional levels of statistical significance.

  13. Effects of Treatment Intensification on Acute Local Toxicity During Radiotherapy for Head and Neck Cancer: Prospective Observational Study Validating CTCAE, Version 3.0, Scoring System

    International Nuclear Information System (INIS)

    Palazzi, Mauro; Tomatis, Stefano; Orlandi, Ester; Guzzo, Marco; Sangalli, Claudia; Potepan, Paolo; Fantini, Simona; Bergamini, Cristiana; Gavazzi, Cecilia; Licitra, Lisa; Scaramellini, Gabriele; Cantu', Giulio; Olmi, Patrizia

    2008-01-01

    Purpose: To quantify the incidence and severity of acute local toxicity in head and neck cancer patients treated with radiotherapy (RT), with or without chemotherapy (CHT), using the Common Terminology Criteria for Adverse Events, version 3.0 (CTCAE v3.0), scoring system. Methods and Materials: Between 2004 and 2006, 149 patients with head and neck cancer treated with RT at our center were prospectively evaluated for local toxicity during treatment. On a weekly basis, patients were monitored and eight toxicity items were recorded according to the CTCAE v3.0 scoring system. Of the 149 patients, 48 (32%) were treated with RT alone (conventional fractionation), 82 (55%) with concomitant CHT and conventional fractionation RT, and 20 (13%) with accelerated-fractionation RT and CHT. Results: Severe (Grade 3-4) adverse events were recorded in 28% (mucositis), 33% (dysphagia), 40% (pain), and 12% (skin) of patients. Multivariate analysis showed CHT to be the most relevant factor independently predicting for worse toxicity (mucositis, dysphagia, weight loss, salivary changes). In contrast, previous surgery, RT acceleration and older age, female gender, and younger age, respectively, predicted for a worse outcome of mucositis, weight loss, pain, and dermatitis. The T-score method confirmed that conventional RT alone is in the 'low-burden' class (T-score = 0.6) and suggests that concurrent CHT and conventional fractionation RT is in the 'high-burden' class (T-score = 1.15). Combined CHT and accelerated-fractionation RT had the highest T-score at 1.9. Conclusions: The CTCAE v3.0 proved to be a reliable tool to quantify acute toxicity in head and neck cancer patients treated with various treatment intensities. The effect of CHT and RT acceleration on the acute toxicity burden was clinically relevant

  14. A Retrospective Study of the Impact of 21-Gene Recurrence Score Assay on Treatment Choice in Node Positive Micrometastatic Breast Cancer

    Directory of Open Access Journals (Sweden)

    Thomas G. Frazier

    2015-03-01

    Full Text Available To assess clinical utility of the 21-gene assay (Oncotype DX® Recurrence Score®, we determined whether women with HER2(−/ER+ pN1mi breast cancer with low (<18 Recurrence Scores results are given adjuvant chemotherapy in a lower proportion than those with high scores (≥31. This was a multicenter chart review of ≥18 year old women with pN1mi breast cancer, HER2(−/ER+ tumors, ductal/lobular/mixed histology, with the assay ordered on or after 1 January 2007. One hundred and eighty one patients had a mean age of 60.7 years; 82.9% had ECOG performance status 0; 33.7% had hypertension, 22.7% had osteoporosis, 18.8% had osteoarthritis, and 8.8% had type-2 diabetes. Mean Recurrence Score was 17.8 (range: 0–50. 48.6% had a mastectomy; 55.8% had a lumpectomy. 19.8% of low-risk group patients were recommended chemotherapy vs. 57.9% in the intermediate-risk group and 100% in the high-risk group (p < 0.001. A total of 80.2% of the low-risk group were recommended endocrine therapy alone, while 77.8% of the high-risk group were recommended both endocrine and chemotherapy (p < 0.001. The Oncotype DX Recurrence Score result provides actionable information that can be incorporated into treatment planning for women with HER2(−/ER+ pN1mi breast cancer. The Recurrence Score result has clinical utility in treatment planning for HER2(−/ER+ pN1mi breast cancer patients.

  15. Effect of a community intervention programme promoting social interactions on functional disability prevention for older adults: propensity score matching and instrumental variable analyses, JAGES Taketoyo study.

    Science.gov (United States)

    Hikichi, Hiroyuki; Kondo, Naoki; Kondo, Katsunori; Aida, Jun; Takeda, Tokunori; Kawachi, Ichiro

    2015-09-01

    The efficacy of promoting social interactions to improve the health of older adults is not fully established due to residual confounding and selection bias. The government of Taketoyo town, Aichi Prefecture, Japan, developed a resident-centred community intervention programme called 'community salons', providing opportunities for social interactions among local older residents. To evaluate the impact of the programme, we conducted questionnaire surveys for all older residents of Taketoyo. We carried out a baseline survey in July 2006 (prior to the introduction of the programme) and assessed the onset of functional disability during March 2012. We analysed the data of 2421 older people. In addition to the standard Cox proportional hazard regression, we conducted Cox regression with propensity score matching (PSM) and an instrumental variable (IV) analysis, using the number of community salons within a radius of 350 m from the participant's home as an instrument. In the 5 years after the first salon was launched, the salon participants showed a 6.3% lower incidence of functional disability compared with non-participants. Even adjusting for sex, age, equivalent income, educational attainment, higher level activities of daily living and depression, the Cox adjusted HR for becoming disabled was 0.49 (95% CI 0.33 to 0.72). Similar results were observed using PSM (HR 0.52, 95% CI 0.33 to 0.83) and IV-Cox analysis (HR 0.50, 95% CI 0.34 to 0.74). A community health promotion programme focused on increasing social interactions among older adults may be effective in preventing the onset of disability. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  16. A genetic risk score for CAD, psychological stress, and their interaction as predictors of CAD, fatal MI, non-fatal MI and cardiovascular death

    Science.gov (United States)

    Svensson, Thomas; Kitlinski, Mariusz; Engström, Gunnar; Melander, Olle

    2017-01-01

    Background Psychological stress is an independent risk factor for cardiovascular disease (CVD), but the mechanism by which stress is associated with CVD is not entirely understood. Although genetic factors are implied in both stress responsivity and cardiovascular reactivity, no studies to date have investigated their interactions with stress for cardiovascular end points. The objective was to elucidate the association and interactions between a genetic risk score (GRS), individual genetic variants and stress for three cardiovascular end points: coronary artery disease (CAD), fatal myocardial infarction (MI), non-fatal MI, and cardiovascular death. Methods and findings 18,559 participants from the Malmö Diet Cancer Study, a population-based prospective study, were included in the analyses. Cox proportional hazards regression models were used and adjusted for a large number of known predictors of cardiovascular end points. Mean follow-up time in years was 14.6 (CAD; n = 1938), 14.8 (fatal MI; n = 436), 14.8 (non-fatal MI; n = 1108), and 15.1 (cardiovascular death; n = 1071) respectively. GRS was significantly associated with increased risks of CAD (top quartile hazard ratio [HR], 1.72; 95% confidence interval [CI], 1.51–1.96), fatal MI (top quartile HR, 1.62; 95%CI, 1.23–2.15), non-fatal MI (top quartile HR, 1.55; 95%CI, 1.31–1.84), and cardiovascular death (top quartile HR, 1.29; 95%CI, 1.08–1.53). Stress was not independently associated with any end point and did not interact with GRS. Four individual genetic variants interacted unfavorably with stress for end points with mortality outcomes. Conclusion A GRS composed of 50 SNPs and predictive of CAD was found for the first time to also strongly predict fatal MI, non-fatal MI and cardiovascular death. A stress-sensitive component of the GRS was isolated on the basis of individual genetic variants that interacted unfavorably with stress. PMID:28426714

  17. Targeting the Adipocyte Tumor Cell Interaction in Prostate Cancer Treatment

    Science.gov (United States)

    2015-10-01

    performed in task 4.1. Task 7. 3D Organotypic cultures to study the adipocyte-PCa cell interaction in vitro (Months 30-36; Diaz-Meco & Moscat). This...Targeting Metabolic Reprograming in Cancer” Centro Nacional de Biotecnologia, Madrid, Spain, 2015. Speaker (Moscat) “Cell Death and Survival Networks...PCa, we profited from a recently devel- oped technology for creating 3D prostate organoid cultures (Gao et al., 2014; Karthaus et al., 2014). Murine

  18. Emulsion droplet interactions: a front-tracking treatment

    Science.gov (United States)

    Mason, Lachlan; Juric, Damir; Chergui, Jalel; Shin, Seungwon; Craster, Richard V.; Matar, Omar K.

    2017-11-01

    Emulsion coalescence influences a multitude of industrial applications including solvent extraction, oil recovery and the manufacture of fast-moving consumer goods. Droplet interaction models are vital for the design and scale-up of processing systems, however predictive modelling at the droplet-scale remains a research challenge. This study simulates industrially relevant moderate-inertia collisions for which a high degree of droplet deformation occurs. A hybrid front-tracking/level-set approach is used to automatically account for interface merging without the need for `bookkeeping' of interface connectivity. The model is implemented in Code BLUE using a parallel multi-grid solver, allowing both film and droplet-scale dynamics to be resolved efficiently. Droplet interaction simulations are validated using experimental sequences from the literature in the presence and absence of background turbulence. The framework is readily extensible for modelling the influence of surfactants and non-Newtonian fluids on droplet interaction processes. EPSRC, UK, MEMPHIS program Grant (EP/K003976/1), RAEng Research Chair (OKM), PETRONAS.

  19. Detection of gene-environment interactions in the presence of linkage disequilibrium and noise by using genetic risk scores with internal weights from elastic net regression.

    Science.gov (United States)

    Hüls, Anke; Ickstadt, Katja; Schikowski, Tamara; Krämer, Ursula

    2017-06-12

    For the analysis of gene-environment (GxE) interactions commonly single nucleotide polymorphisms (SNPs) are used to characterize genetic susceptibility, an approach that mostly lacks power and has poor reproducibility. One promising approach to overcome this problem might be the use of weighted genetic risk scores (GRS), which are defined as weighted sums of risk alleles of gene variants. The gold-standard is to use external weights from published meta-analyses. In this study, we used internal weights from the marginal genetic effects of the SNPs estimated by a multivariate elastic net regression and thereby provided a method that can be used if there are no external weights available. We conducted a simulation study for the detection of GxE interactions and compared power and type I error of single SNPs analyses with Bonferroni correction and corresponding analysis with unweighted and our weighted GRS approach in scenarios with six risk SNPs and an increasing number of highly correlated (up to 210) and noise SNPs (up to 840). Applying weighted GRS increased the power enormously in comparison to the common single SNPs approach (e.g. 94.2% vs. 35.4%, respectively, to detect a weak interaction with an OR ≈ 1.04 for six uncorrelated risk SNPs and n = 700 with a well-controlled type I error). Furthermore, weighted GRS outperformed the unweighted GRS, in particular in the presence of SNPs without any effect on the phenotype (e.g. 90.1% vs. 43.9%, respectively, when 20 noise SNPs were added to the six risk SNPs). This outperforming of the weighted GRS was confirmed in a real data application on lung inflammation in the SALIA cohort (n = 402). However, in scenarios with a high number of noise SNPs (>200 vs. 6 risk SNPs), larger sample sizes are needed to avoid an increased type I error, whereas a high number of correlated SNPs can be handled even in small samples (e.g. n = 400). In conclusion, weighted GRS with weights from the marginal genetic effects of the

  20. Interactive treatment planning in toothwear: are we doing it right?

    Science.gov (United States)

    Eliyas, Shiyana; Shah, Kewal; Briggs, Peter F A

    2014-04-01

    Toothwear is now common, especially in younger patients, with high demand for the restoration of the damaged teeth which is likely to increase further over time. Fixed prosthodontic options range from direct composite resin to conventional tooth preparation and cemented indirect restorations. This paper summarizes the views of a variety of clinicians on a plan delivered to a patient with toothwear in secondary care and explores the possible reasons for the variation in decision-making in the treatment of toothwear. With levels of toothwear increasing, the clinician needs to be aware of the different treatment modalities which are appropriate.

  1. Score Correlation

    Czech Academy of Sciences Publication Activity Database

    Fabián, Zdeněk

    2010-01-01

    Roč. 20, č. 6 (2010), s. 793-798 ISSN 1210-0552 R&D Projects: GA ČR GA205/09/1079 Institutional research plan: CEZ:AV0Z10300504 Keywords : score function * correlation * rank correlation coefficient * heavy tails Subject RIV: BB - Applied Statistics, Operational Research Impact factor: 0.511, year: 2010

  2. Is there a role for coronary artery calcium scoring for management of asymptomatic patients at risk for coronary artery disease?: Clinical risk scores are not sufficient to define primary prevention treatment strategies among asymptomatic patients.

    Science.gov (United States)

    Blaha, Michael J; Silverman, Michael G; Budoff, Matthew J

    2014-03-01

    Although risk factors have proven to be useful therapeutic targets, they are poor predictors of risk. Traditional risk scores are moderately successful in predicting future CHD events and can be a starting place for general risk categorization. However, there is substantial heterogeneity between traditional risk and actual atherosclerosis burden, with event rates predominantly driven by burden of atherosclerosis. Serum biomarkers have yet to show any clinically significant incremental value to the FRS and even when combined cannot match the predictive value of atherosclerosis imaging. As clinicians, are we willing to base therapy decisions on risk models that lack optimum-achievable accuracy and limit personalization? The decision to treat a patient in primary prevention must be a careful one because the benefit of therapy in an asymptomatic patient must clearly outweigh the potential risk. CAC, in particular, provides a personalized assessment of risk and may identify patients who will be expected to derive the most, and the least, net absolute benefit from treatment. Emerging evidence hints that CAC may also promote long-term adherence to aspirin, exercise, diet, and statin therapy. When potentially lifelong treatment decisions are on the line, clinicians must arm their patients with the most accurate risk prediction tools, and subclinical atherosclerosis testing with CAC is, at the present time, superior to any combination of risk factors and serum biomarkers.

  3. A simulation study on estimating biomarker-treatment interaction effects in randomized trials with prognostic variables.

    Science.gov (United States)

    Haller, Bernhard; Ulm, Kurt

    2018-02-20

    To individualize treatment decisions based on patient characteristics, identification of an interaction between a biomarker and treatment is necessary. Often such potential interactions are analysed using data from randomized clinical trials intended for comparison of two treatments. Tests of interactions are often lacking statistical power and we investigated if and how a consideration of further prognostic variables can improve power and decrease the bias of estimated biomarker-treatment interactions in randomized clinical trials with time-to-event outcomes. A simulation study was performed to assess how prognostic factors affect the estimate of the biomarker-treatment interaction for a time-to-event outcome, when different approaches, like ignoring other prognostic factors, including all available covariates or using variable selection strategies, are applied. Different scenarios regarding the proportion of censored observations, the correlation structure between the covariate of interest and further potential prognostic variables, and the strength of the interaction were considered. The simulation study revealed that in a regression model for estimating a biomarker-treatment interaction, the probability of detecting a biomarker-treatment interaction can be increased by including prognostic variables that are associated with the outcome, and that the interaction estimate is biased when relevant prognostic variables are not considered. However, the probability of a false-positive finding increases if too many potential predictors are included or if variable selection is performed inadequately. We recommend undertaking an adequate literature search before data analysis to derive information about potential prognostic variables and to gain power for detecting true interaction effects and pre-specifying analyses to avoid selective reporting and increased false-positive rates.

  4. Detecting treatment-subgroup interactions in clustered data with generalized linear mixed-effects model trees.

    Science.gov (United States)

    Fokkema, M; Smits, N; Zeileis, A; Hothorn, T; Kelderman, H

    2017-10-25

    Identification of subgroups of patients for whom treatment A is more effective than treatment B, and vice versa, is of key importance to the development of personalized medicine. Tree-based algorithms are helpful tools for the detection of such interactions, but none of the available algorithms allow for taking into account clustered or nested dataset structures, which are particularly common in psychological research. Therefore, we propose the generalized linear mixed-effects model tree (GLMM tree) algorithm, which allows for the detection of treatment-subgroup interactions, while accounting for the clustered structure of a dataset. The algorithm uses model-based recursive partitioning to detect treatment-subgroup interactions, and a GLMM to estimate the random-effects parameters. In a simulation study, GLMM trees show higher accuracy in recovering treatment-subgroup interactions, higher predictive accuracy, and lower type II error rates than linear-model-based recursive partitioning and mixed-effects regression trees. Also, GLMM trees show somewhat higher predictive accuracy than linear mixed-effects models with pre-specified interaction effects, on average. We illustrate the application of GLMM trees on an individual patient-level data meta-analysis on treatments for depression. We conclude that GLMM trees are a promising exploratory tool for the detection of treatment-subgroup interactions in clustered datasets.

  5. Traumatic extremity arterial injury in children: Epidemiology, diagnostics, treatment and prognostic value of Mangled Extremity Severity Score

    Directory of Open Access Journals (Sweden)

    Lange Nadine

    2010-04-01

    Full Text Available Abstract Background Traumatic paediatric arterial injuries are a great challenge due to low incidence and specific characteristics of paediatric anatomy and physiology. The aim of the present study was to investigate their epidemiology, diagnostic and therapeutic options and complications. Furthermore, the prognostic value of the Mangled Extremity Severity Score (MESS was evaluated. Methods In a retrospective clinical study 44 children aged 9.0 ± 3.2 years treated for traumatic extremity arterial lesions in our Level I trauma center between 1971 and 2006 were enrolled. Exclusion criteria were age > 14, venous and iatrogenic vascular injury. Demographic data, mechanism of injury, severity of arterial lesions (by Vollmar and MESS, diagnostic and therapeutic management, complications and outcome were evaluated. Results The most commonly injured vessel was the femoral artery (25% followed by the brachial artery (22.7%. The mechanism of injury was penetrating (31.8%, isolated severe blunt extremity trauma (29.6%, multiple trauma (25% and humeral supracondylar fractures (13.6%. In 63.6% no specific vascular diagnostic procedure was performed in favour of emergency surgery. Surgical reconstructive strategies were preferred (68.2%. A MESS Conclusions Traumatic paediatric vascular injuries are very rare. The most common situations of vascular lesions in childhood were penetrating injuries and fractures of the extremities either as isolated injuries or in multiply injured patients. In paediatric patients, the MESS could serve as a basis for decision making for limb salvage or amputation.

  6. The Teaching of Transformation Geometry in Grade Eight: A Search for Aptitude-Treatment Interactions.

    Science.gov (United States)

    Rowell, Jack; Mansfield, Helen

    1980-01-01

    In a classroom investigation of the teaching of transformation geometry, an attempt was made to generate aptitude-treatment interactions by using various teaching methods among groups of students. (CJ)

  7. The Implementation of Aptitude Treatment Interaction (ATI to Improve Learning Motivation of Low Achievement Students

    Directory of Open Access Journals (Sweden)

    Syawal - Syawal

    2017-10-01

    Full Text Available This research was classroom action research, which aims at improving students' motivation of their poor performance through learning model Aptitude Treatment Interaction (ATI on VII.3 grade students of SMP Negeri 6 Parepare. Aptitude Treatment Interaction (ATI can serve individual student differences by adjusting treatment or learning method with students' abilities. The use of this model was emphasizing to create small groups of students that have achievement alike. Students with have low academic achievement based on test results and teacher interview will be grouped into one group and will be given preferential treatment by tutoring intensity rather than the group of high academic achievement. Subjects of this research were students of class VII.3 SMP Negeri 6 Parepare which is consist of 25 students. This research was conducted in two cycles. The procedure of this research involved four phases: (1 planning, (2 Implementation of action, (3 observation, (4 Reflection. The data collection was done by observation, tests, and questionnaires for each cycle after giving treatment through learning model Aptitude Treatment Interaction (ATI. Data collected were analyzed using quantitative and qualitative analysis. The results of this research indicate that the Aptitude Treatment Interaction (ATI can be an alternative method to improve learning motivation of low achievement students. The results of this research also showed that the Aptitude Treatment Interaction (ATI can be an alternative to problem-solving in the classroom, especially for low achievement students.

  8. 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...

  9. Effectiveness of Parent-Child Interaction Therapy (PCIT) in the Treatment of Young Children's Behavior Problems. A Randomized Controlled Study.

    Science.gov (United States)

    Bjørseth, Åse; Wichstrøm, Lars

    2016-01-01

    The aim of the present investigation was to compare the effectiveness of Parent-Child Interaction Therapy (PCIT) with treatment as usual (TAU) in young children who were referred to regular child and adolescent mental health clinics for behavior problems. Eighty-one Norwegian families with two- to seven-year-old children (52 boys) who had scored ≥ 120 on the Eyberg Child Behavior Inventory (ECBI) were randomly assigned to receive either PCIT or TAU. The families were assessed 6 and 18 months after beginning treatment. Parenting skills were measured using the Dyadic Parent-Child Interaction Coding System (DPICS), and child behavior problems were measured using the ECBI and the Child Behavior Checklist (CBCL). Linear growth curve analyses revealed that the behavior problems of children receiving PCIT improved more compared with children receiving TAU according to mother reports (ECBI d = .64, CBCL d = .61, both p assessment, which often occurred before treatment was finished, children who had received PCIT had lower father-rated ECBI and mother-rated CBCL-scores (p = .06) compared with those who had received TAU. At the 18-month follow-up, the children who had received PCIT showed fewer behavior problems compared with TAU according to mother (d = .37) and father (d = .56) reports on the ECBI and mother reports on the CBCL regarding externalizing problems (d = .39). Parents receiving PCIT developed more favorable Do Skills (6-month d = 1.81; 18-month d = 1.91) and Don't Skills (6-month d = 1.46; 18-month d = 1.42) according to observer ratings on the DPICS compared with those receiving TAU. Children receiving PCIT in regular clinical practice exhibited a greater reduction in behavior problems compared with children receiving TAU, and their parents' parenting skills improved to a greater degree compared with those receiving TAU. ClinicalTrials.gov NTC01085305.

  10. A comparison of manual therapy and active rehabilitation in the treatment of non specific low back pain with particular reference to a patient's Linton & Hallden psychological screening score: a pilot study

    Directory of Open Access Journals (Sweden)

    Stephenson Richard

    2007-11-01

    Full Text Available Abstract Background Clinical guidelines for the management of back pain frequently recommend 'manual therapy' as a first line intervention, with psychosocial screening and 'active rehabilitation' for those not improving at 6 weeks post onset. The potential for psychosocial factors to predict treatment response and therefore outcome has not been adequately explored. The purpose of this pilot study was to determine the feasibility of a study to compare manual therapy and active rehabilitation outcomes for subjects with sub-acute/chronic back pain, investigate whether any difference in outcome was related to psychosocial factors, and to inform the design of a main study. Methods A convenience sample of 39 patients with non-specific low back pain referred to the physiotherapy department of an acute NHS Trust hospital was recruited over a nine month period. Patients completed the Linton and Hallden psychological screening questionnaire (LH and were allocated to a low LH (105 or below or high LH (106 or above scoring group. The low or high LH score was used to sequentially allocate patients to one of two treatment groups – Manual Therapy comprising physiotherapy based on manual means as chosen by the treating therapist or Active Rehabilitation comprising a progressive exercise and education programme – with the first low LH scoring patient being allocated to active rehabilitation and the next to manual therapy and so on. Treatment was administered for eight sessions over a four-week period and outcome measures were taken at baseline and at four weeks. Measures used were the Roland Morris Questionnaire (RMQ, two components of the Short Form McGill (total pain rating index [PRI] and pain intensity via visual analogue scale [VAS], and the LH. Results The manual therapy group demonstrated a greater treatment effect compared with active rehabilitation for RMQ (mean difference 3.6, 95% CI 1.1 – 6.2, p = 0.006 and PRI (7.1, 95% CI 2.0 – 12.2, p = 0

  11. Evaluating Treatments for Functionally Equivalent Problem Behavior Maintained by Adult Compliance with Mands during Interactive Play

    Science.gov (United States)

    Schmidt, Jonathan D.; Bednar, Mary K.; Willse, Lena V.; Goetzel, Amanda L.; Concepcion, Anthony; Pincus, Shari M.; Hardesty, Samantha L.; Bowman, Lynn G.

    2017-01-01

    A primary goal of behavioral interventions is to reduce dangerous or inappropriate behavior and to generalize treatment effects across various settings. However, there is a lack of research evaluating generalization of treatment effects while individuals with functionally equivalent problem behavior interact with each other. For the current study,…

  12. An overview of history, pathogenesis and treatment of perforated peptic ulcer disease with evaluation of prognostic scoring in adults.

    Science.gov (United States)

    Prabhu, V; Shivani, A

    2014-01-01

    Peptic ulcer disease including both gastric and duodenal ulcer form a substantial part of patients seeking surgical opinion world-wide. The concept of acid in peptic ulcer disease, which was the basis of treatment of peptic ulcer was revolutionized by the discovery of H2-receptor antagonists, that led to the principle of acid suppression therapy for duodenal ulcer which followed decades of preference for surgical interventions in the form of gastric resections, vagotomy etc., After the discovery of Helicobacter pylori organism as the causative factor a triple drug regime was identified to treat peptic disease which was further modified to sequential therapy to avoid antibiotic resistance. This recognition has not concluded the chapter on peptic ulcers. The management of ulcer disease and its complications remain a surgical challenge. All the materials for this review have been accessed from various internet search engines. The references have been narrowed down to 34 by excluding cross references, duplicated citations, pediatric studies, case reports, iatrogenic and malignant perforations and including microbiological, immunohistochemistry references and studies with more than a sample size of ten. Case control, cohort studies, prospective/retrospective, metaanalytical studies were preferred in that order. This article attempts to take an overview of all aspects of the management of peptic ulcer.

  13. A computerized three-dimensional treatment planning system utilizing interactive colour graphics

    International Nuclear Information System (INIS)

    McShan, D.L.; Silverman, A.; Lanza, D.M.; Reinstein, L.E.; Glicksman, A.S.

    1979-01-01

    A new computerized radiation treatment planning system has been developed to aid in three-dimensional treatment planning. Using interactive colour graphics in conjunction with a PDP 11/45 computer, the system can take multiple transverse contours and construct a perspective display of the treatment region showing organ surfaces as well as cross-sectional contours. With interactively selected orientations, the display allows easy perception of the relative positioning of the treatment volume and the neighbouring anatomy. For external beam treatment planning, interactive computer simulation is used to select diaphragm sizes which best conform to the target area while avoiding sensitive structures. Dose calculations for the selected beams are carried out on multiple transverse planes. The calculational planes and surfaces are displayed in perspective with radiation dosage displayed in an interactively manipulated colour display. Altogether the system provides an easy assessment of the volume to be irradiated, interactive selection of optimal arrangements of treatment fields and a means of visualizing and evaluating the resulting dose distributions. (author)

  14. Comparison of the Ability of Different Clinical Treatment Scores to Estimate Prognosis in High-Risk Early Breast Cancer Patients: A Hellenic Cooperative Oncology Group Study.

    Directory of Open Access Journals (Sweden)

    Flora Stavridi

    Full Text Available Early breast cancer is a heterogeneous disease, and, therefore, prognostic tools have been developed to evaluate the risk for distant recurrence. In the present study, we sought to develop a risk for recurrence score (RRS based on mRNA expression of three proliferation markers in high-risk early breast cancer patients and evaluate its ability to predict risk for relapse and death. In addition the Adjuvant! Online score (AOS was also determined for each patient, providing a 10-year estimate of relapse and mortality risk. We then evaluated whether RRS or AOS might possibly improve the prognostic information of the clinical treatment score (CTS, a model derived from clinicopathological variables.A total of 1,681 patients, enrolled in two prospective phase III trials, were treated with anthracycline-based adjuvant chemotherapy. Sufficient RNA was extracted from 875 samples followed by multiplex quantitative reverse transcription-polymerase chain reaction for assessing RACGAP1, TOP2A and Ki67 mRNA expression. The CTS, slightly modified to fit our cohort, integrated the prognostic information from age, nodal status, tumor size, histological grade and treatment. Patients were also classified to breast cancer subtypes defined by immunohistochemistry. Likelihood ratio (LR tests and concordance indices were used to estimate the relative increase in the amount of information provided when either RRS or AOS is added to CTS.The optimal RRS, in terms of disease-free survival (DFS and overall survival (OS, was based on the co-expression of two of the three evaluated genes (RACGAP1 and TOP2A. CTS was prognostic for DFS (p3 positive nodes (LR-Δχ2 23.9, p3 positive nodes.

  15. Comparisons of treatment means when factors do not interact in two-factorial studies

    KAUST Repository

    Wei, Jiawei

    2011-05-06

    Scientists in the fields of nutrition and other biological sciences often design factorial studies to test the hypotheses of interest and importance. In the case of two-factorial studies, it is widely recognized that the analysis of factor effects is generally based on treatment means when the interaction of the factors is statistically significant, and involves multiple comparisons of treatment means. However, when the two factors do not interact, a common understanding among biologists is that comparisons among treatment means cannot or should not be made. Here, we bring this misconception into the attention of researchers. Additionally, we indicate what kind of comparisons among the treatment means can be performed when there is a nonsignificant interaction among two factors. Such information should be useful in analyzing the experimental data and drawing meaningful conclusions.

  16. Assessing therapeutic effectiveness of scalp treatments for dandruff and seborrheic dermatitis, part 1: a reliable and relevant method based on the adherent scalp flaking score (ASFS).

    Science.gov (United States)

    Bacon, Robert A; Mizoguchi, Haruko; Schwartz, James R

    2014-06-01

    Dandruff and seborrheic dermatitis (D/SD) are common and troublesome scalp conditions with the primary signs and symptoms being presence of skin flakes, pruritus, a tight feeling, and sometimes erythema. To demonstrate the reliability and relevance of a clinical model for the assessment of therapeutic efficacy of a treatment using the Adherent Scalp Flaking Score (ASFS) method to quantitate the flaking severity. Six randomized, double-blind, parallel design studies were conducted in either North America or Asia with subjects suffering from dandruff using the ASFS grading method before and after a 3-week test product treatment period. Treatment with a commercial potentiated 1% zinc pyrithione (ZPT) shampoo resulted in statistically significant (p < 0.0001) improvements in total ASFS compared with the placebo cosmetic shampoo. Results were consistent across all studies, geographies, and product usage protocols (controlled on-site versus home use conditions), and were associated with statistically significant improvements in self-perception of scalp condition. The ASFS-based clinical model was demonstrated to be a reliable and proven methodology to assess the effectiveness of widely used anti-dandruff treatments. The results are consistent with patient self-assessments, establishing this methodology as relevant to patient perception of product benefits.

  17. Qualitative Treatment-Subgroup Interactions in a Randomized Clinical Trial of Treatments for Adolescents with ADHD: Exploring What Cognitive-Behavioral Treatment Works for Whom.

    Directory of Open Access Journals (Sweden)

    Bianca E Boyer

    Full Text Available This study explored qualitative treatment-subgroup interactions within data of a RCT with two cognitive behavioral treatments (CBT for adolescents with ADHD: a planning-focused (PML and a solution-focused CBT (SFT. Qualitative interactions imply that which treatment is best differs across subgroups of patients, and are therefore most relevant for personalized medicine.Adolescents with ADHD (N = 159 received either PML or SFT. Pre-, post- and three-month follow-up data were gathered on parent-rated ADHD symptoms and planning problems. Pretreatment characteristics were explored as potential qualitative moderators of pretest to follow-up treatment effects, using an innovative analyses technique (QUINT; Dusseldorp & Van Mechelen, 2014. In addition, qualitative treatment-subgroup interactions for the therapeutic changes from pre- to posttest and from post- to follow-up test were investigated.For the entire time span from pretest to follow-up only a quantitative interaction was found, while from posttest to follow-up qualitative interactions were found: Adolescents with less depressive symptoms but more anxiety symptoms showed more improvement when receiving PML than SFT, while for other adolescents the effects of PML and SFT were comparable.Whereas subgroups in both treatments followed different trajectories, no subgroup was found for which SFT outperformed PML in terms of the global change in symptoms from pretest to three months after treatment. This implies that, based on this exploratory study, there is no need for personalized treatment allocation with regard to the CBTs under study for adolescents with ADHD. However, for a subgroup with comorbid anxiety symptoms but low depression PML clearly appears the treatment of preference.Nederlands Trial Register NTR2142.

  18. Can Mapping Algorithms Based on Raw Scores Overestimate QALYs Gained by Treatment? A Comparison of Mappings Between the Roland-Morris Disability Questionnaire and the EQ-5D-3L Based on Raw and Differenced Score Data.

    Science.gov (United States)

    Madan, Jason; Khan, Kamran A; Petrou, Stavros; Lamb, Sarah E

    2017-05-01

    Mapping algorithms are increasingly being used to predict health-utility values based on responses or scores from non-preference-based measures, thereby informing economic evaluations. We explored whether predictions in the EuroQol 5-dimension 3-level instrument (EQ-5D-3L) health-utility gains from mapping algorithms might differ if estimated using differenced versus raw scores, using the Roland-Morris Disability Questionnaire (RMQ), a widely used health status measure for low back pain, as an example. We estimated algorithms mapping within-person changes in RMQ scores to changes in EQ-5D-3L health utilities using data from two clinical trials with repeated observations. We also used logistic regression models to estimate response mapping algorithms from these data to predict within-person changes in responses to each EQ-5D-3L dimension from changes in RMQ scores. Predicted health-utility gains from these mappings were compared with predictions based on raw RMQ data. Using differenced scores reduced the predicted health-utility gain from a unit decrease in RMQ score from 0.037 (standard error [SE] 0.001) to 0.020 (SE 0.002). Analysis of response mapping data suggests that the use of differenced data reduces the predicted impact of reducing RMQ scores across EQ-5D-3L dimensions and that patients can experience health-utility gains on the EQ-5D-3L 'usual activity' dimension independent from improvements captured by the RMQ. Mappings based on raw RMQ data overestimate the EQ-5D-3L health utility gains from interventions that reduce RMQ scores. Where possible, mapping algorithms should reflect within-person changes in health outcome and be estimated from datasets containing repeated observations if they are to be used to estimate incremental health-utility gains.

  19. On the interaction of a fan stator and acoustic treatments using the transfer element method

    International Nuclear Information System (INIS)

    Wang Xiaoyu; Sun Xiaofeng

    2010-01-01

    In the present investigation, a theoretical model is suggested to study the interaction of a fan stator and acoustic treatments using the transfer element method. Firstly, the solution of an acoustic field caused by a fan stator in an infinite duct is extended to that in a finite domain with all knowns and unknowns on the interface plane. Secondly, the related numerical results for an annular cascade are compared with the data obtained by directly solving an integral equation based on the blade boundary condition, which have good agreement with each other. Finally, more emphasis is placed on studying how a fan stator interacts with both upstream and downstream acoustic treatments. It is found that the interaction has an important influence on sound attenuation. In addition, optimal sound attenuation will depend on the combined design of both acoustic treatment and the fan stator. (invited paper)

  20. Elderly patients with gastrointestinal stromal tumour (GIST) receive less treatment irrespective of performance score or comorbidity - A retrospective multicentre study in a large cohort of GIST patients.

    Science.gov (United States)

    Farag, Sheima; van Coevorden, Frits; Sneekes, Esther; Grunhagen, Dirk J; Reyners, Anna K L; Boonstra, Pieter A; van der Graaf, Winette T; Gelderblom, Hans J; Steeghs, Neeltje

    2017-11-01

    Although gastrointestinal stromal tumours (GIST) predominantly occur in older patients, data on treatment patterns in elderly GIST patients are scarce. Patients registered in the Dutch GIST Registry (DGR) from January 2009 until December 2016 were included. Differences in treatment patterns between elderly (≥75 years) and younger patients were compared. Multivariate analyses were conducted using logistic regression. Data of 145 elderly and 665 non-elderly patients were registered (median age 78 and 60 years respectively). In elderly patients, performance score (WHO-PS) and age-adjusted Charlson comorbidity index (ACCI) were significantly higher (p elderly and 503 (75.6%) non-elderly patients had only localised disease. Surgery was performed in 57% of elderly versus 84% of non-elderly patients (p = 0.003, OR: 0.26, 95% CI: 0.11-0.63). No differences in surgery outcome or complications were found. Thirty-eight percent of elderly with an indication for adjuvant treatment did receive imatinib versus 68% of non-elderly (p = 0.04, OR: 0.47, 95% CI: 0.23-0.95). Thirty-six elderly and 162 non-elderly patients had metastatic disease. Palliative imatinib was equally given (mean dose 400 mg) and adverse events were mostly minor (p = 0.71). In elderly, drug-related toxicity was in 32.7% reason to discontinue imatinib versus 5.1% in non-elderly (p = 0.001, OR 13.5, 95% CI: 2.8-65.0). Median progression-free survival (PFS) was 24 months in elderly and 33 months in non-elderly (p = 0.10). Median overall survival (OS) was 34 months and 59 months respectively (p = 0.01). Elderly GIST patients with localised disease receive less surgery and adjuvant treatment, irrespective of comorbidity and performance score. Drug-related toxicity results more often in treatment discontinuation. This possibly results in poor outcome. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Prolonged efficacy of the 300IR 5-grass pollen tablet up to 2 years after treatment cessation, as measured by a recommended daily combined score

    DEFF Research Database (Denmark)

    Didier, Alain; Malling, Hans-Jørgen; Worm, Margitta

    2015-01-01

    BACKGROUND: The 300IR (index of reactivity) 5-grass pollen tablet has favorable short-term and sustained clinical efficacy in patients with grass pollen-induced allergic rhinoconjunctivitis (ARC). Here, we report maintenance of efficacy and safety over 2 years following treatment discontinuation....... METHODS: Randomized, double-blind, placebo-controlled, parallel-group, multicenter Phase 3 trial in patients aged 18-50 years with ARC. During study years 1-3, patients received a daily sublingual tablet containing either 300IR 5-grass pollen extract or placebo, according to a discontinuous pre...... medication score (DRMS). RESULTS: 633 patients with ARC were randomized to placebo (n = 219) or 300IR 5-grass pollen tablet, beginning 4 months (4 M, n = 207) or 2 months (2 M, n = 207) prior to the estimated start of the grass pollen season and continuing until season's end. During the first post...

  2. Low-Dose Acetylsalicylic Acid Treatment and Impact on Short-Term Mortality in Staphylococcus aureus Bloodstream Infection: A Propensity Score-Matched Cohort Study.

    Science.gov (United States)

    Osthoff, Michael; Sidler, Jan A; Lakatos, Botond; Frei, Reno; Dangel, Marc; Weisser, Maja; Battegay, Manuel; Widmer, Andreas F

    2016-04-01

    Staphylococcus aureus bloodstream infection is associated with considerable mortality. Experimental models suggest a direct antistaphylococcal effect of acetylsalicylic acid, but evidence from human studies is scarce. We aimed to estimate the effect of low-dose acetylsalicylic acid therapy on mortality in bloodstream infections caused by S. aureus compared with Escherichia coli. Retrospective cohort study based on observational data from 838 and 602 episodes of S. aureus and E. coli bloodstream infection, respectively. Swiss tertiary referral center. Adult patients with S. aureus and E. coli bloodstream infection, respectively, categorized according to low-dose acetylsalicylic acid therapy as outpatient or inpatient before bacteremia. None. Thirty-day all-cause mortality was analyzed in a total of 314 propensity score-matched S. aureus bloodstream infection and in 268 E. coli bloodstream infection patients, respectively (1:1 match of low-dose acetylsalicylic acid users and nonusers). S. aureus bloodstream infection cases and controls were equally matched for relevant confounders except treatment with statins, which was strongly associated with a low-dose acetylsalicylic acid use (p acetylsalicylic acid use was associated with a reduced 30-day all-cause mortality in multivariate analysis (hazard ratio, 0.38; 95% CI, 0.21-0.69; p = 0.001) of matched patients and also of the entire cohort (n = 689) after adjustment for the propensity score (hazard ratio, 0.58, 95% CI, 0.34-0.98; p = 0.04). In contrast, low-dose acetylsalicylic acid use was not associated with the primary endpoint in patients with E. coli bloodstream infection (hazard ratio, 0.78; 95% CI, 0.40-1.55; p = 0.8). Low-dose acetylsalicylic acid at the time of bloodstream infection was strongly associated with a reduced short-term mortality in patients with S. aureus bloodstream infection. Future studies are required to investigate if early low-dose acetylsalicylic acid is a suitable treatment in patients

  3. Pathways to treatment retention for individuals legally coerced to substance use treatment: the interaction of hope and treatment motivation.

    Science.gov (United States)

    Hampton, Ashley S; Conner, Bradley T; Albert, Dustin; Anglin, M Douglas; Urada, Darren; Longshore, Douglas

    2011-11-01

    Although several states have adopted policies diverting individuals convicted of non-violent drug offenses to substance use treatment, in lieu of incarceration or as a condition of probation, previous research has produced inconsistent findings on the effectiveness of such programs when comparing outcomes for legally coerced individuals to more voluntary entrants. Less studied in these populations is within group variation in treatment expectations and motivation influences, which have been shown to affect retention as well. As motivation has traditionally been viewed as contributing to treatment retention and higher levels of hope (the perception that goals can be met) are viewed as an asset in treatment, the role of these factors in predicting better retention between legally coerced and more voluntary clients were examined in a sample of 289 treatment admissions in California. Results found that motivation mediates the relationship between hope and retention for participants in general. Although the differences in mediation between the legally coerced and the non-legally coerced were not significant, when examining the groups separately, there was a significant mediation of the relationship between hope and retention by motivation only for those individuals who were not legally coerced into treatment (plead to different pathways to treatment retention, for individuals who were not legally coerced, higher levels of hope may play an important role in determining treatment retention. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  4. Estimation of genotype X environment interactions, in a grassbased system, for milk yield, body condition score,and body weight using random regression models

    NARCIS (Netherlands)

    Berry, D.P.; Buckley, F.; Dillon, P.; Evans, R.D.; Rath, M.; Veerkamp, R.F.

    2003-01-01

    (Co)variance components for milk yield, body condition score (BCS), body weight (BW), BCS change and BW change over different herd-year mean milk yields (HMY) and nutritional environments (concentrate feeding level, grazing severity and silage quality) were estimated using a random regression model.

  5. The Value of Learning Talk: Applying a Novel Dialogue Scoring Method to Inform Interaction Design in an Open-Ended, Embodied Museum Exhibit

    Science.gov (United States)

    Roberts, Jessica; Lyons, Leilah

    2017-01-01

    Museum researchers have long acknowledged the importance of dialogue in informal learning, particularly for open-ended exploratory exhibits. Novel interaction techniques like full-body interaction are appealing for these exploratory exhibits, but designers have not had a metric for determining how their designs are supporting productive learning…

  6. The Interactive Seminar: An Educational Approach for Voluntary HIV Testing in a Drug Dependence Treatment Unit.

    Science.gov (United States)

    Sedhom, Laila; And Others

    1994-01-01

    A survey of 118 male patients in a drug dependence treatment unit before and after an interactive seminar with a nonjudgmental professional showed that seminar participants, especially intravenous drug users, had higher rates of voluntary HIV testing than nonparticipants. Drug users who completed detoxification and attended the seminar also had…

  7. A Characteristic Destabilization Profile in Parent-Child Interactions Associated with Treatment Efficacy for Aggressive Children

    NARCIS (Netherlands)

    Lichtwarck-Aschoff, Anna; Hasselman, Fred; Cox, Ralf; Pepler, Debra; Granic, Isabela

    This study examined profiles of change in repeated mother-child interactions over the course of a 12 week treatment period for childhood aggression. The aim of this study was to investigate whether it was possible to detect the characteristic profile of change, typical for phase transitions, over

  8. A characteristic destabilization profile in parent-child interactions associated with treatment efficacy for aggressive children

    NARCIS (Netherlands)

    Lichtwarck-Aschoff, A.; Hasselman, F.W.; Cox, R.F.A.; Pepler, D.; Granic, I.

    2012-01-01

    This study examined profiles of change in repeated mother-child interactions over the course of a 12 week treatment period for childhood aggression. The aim of this study was to investigate whether it was possible to detect the characteristic profile of change, typical for phase transitions, over

  9. Application of a methicillin-resistant Staphylococcus aureus risk score for community-onset pneumonia patients and outcomes with initial treatment.

    Science.gov (United States)

    Teshome, Besu F; Lee, Grace C; Reveles, Kelly R; Attridge, Russell T; Koeller, Jim; Wang, Chen-pin; Mortensen, Eric M; Frei, Christopher R

    2015-09-18

    Community-onset (CO) methicillin-resistant Staphylococcus aureus (MRSA) pneumonia is an evolving problem, and there is a great need for a reliable method to assess MRSA risk at hospital admission. A new MRSA prediction score classifies CO-pneumonia patients into low, medium, and high-risk groups based on objective criteria available at baseline. Our objective was to assess the effect of initial MRSA therapy on mortality in these three risk groups. We conducted a retrospective cohort study using data from the Veterans Health Administration (VHA). Patients were included if they were hospitalized with pneumonia and received antibiotics within the first 48 h of admission. They were stratified into MRSA therapy and no MRSA therapy treatment arms based on antibiotics received in the first 48 h. Multivariable logistic regression was used to adjust for potential confounders. A total of 80,330 patients met inclusion criteria, of which 36% received MRSA therapy and 64% did not receive MRSA therapy. The majority of patients were classified as either low (51%) or medium (47%) risk, with only 2% classified as high-risk. Multivariable logistic regression analysis demonstrated that initial MRSA therapy was associated with a lower 30-day mortality in the high-risk group (adjusted odds ratio 0.57; 95% confidence interval 0.42-0.77). Initial MRSA therapy was not beneficial in the low or medium-risk groups. This study demonstrated improved survival with initial MRSA therapy in high-risk CO-pneumonia patients. The MRSA risk score might help spare MRSA therapy for only those patients who are likely to benefit.

  10. Exploring optimum cut-off scores to screen for probable posttraumatic stress disorder within a sample of UK treatment-seeking veterans

    Science.gov (United States)

    Murphy, Dominic; Ross, Jana; Ashwick, Rachel; Armour, Cherie; Busuttil, Walter

    2017-01-01

    ABSTRACT Background: Previous research exploring the psychometric properties of the scores of measures of posttraumatic stress disorder (PTSD) suggests there is variation in their functioning depending on the target population. To date, there has been little study of these properties within UK veteran populations. Objective: This study aimed to determine optimally efficient cut-off values for the Impact of Event Scale-Revised (IES-R) and the PTSD Checklist for DSM-5 (PCL-5) that can be used to assess for differential diagnosis of presumptive PTSD. Methods: Data from a sample of 242 UK veterans assessed for mental health difficulties were analysed. The criterion-related validity of the PCL-5 and IES-R were evaluated against the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5). Kappa statistics were used to assess the level of agreement between the DSM-IV and DSM-5 classification systems. Results: The optimal cut-off scores observed within this sample were 34 or above on the PCL-5 and 46 or above on the IES-R. The PCL-5 cut-off is similar to the previously reported values, but the IES-R cut-off identified in this study is higher than has previously been recommended. Overall, a moderate level of agreement was found between participants screened positive using the DSM-IV and DSM-5 classification systems of PTSD. Conclusions: Our findings suggest that the PCL-5 and IES-R can be used as brief measures within veteran populations presenting at secondary care to assess for PTSD. The use of a higher cut-off for the IES-R may be helpful for differentiating between veterans who present with PTSD and those who may have some sy`mptoms of PTSD but are sub-threshold for meeting a diagnosis. Further, the use of more accurate optimal cut-offs may aid clinicians to better monitor changes in PTSD symptoms during and after treatment. PMID:29435200

  11. Exploring optimum cut-off scores to screen for probable posttraumatic stress disorder within a sample of UK treatment-seeking veterans.

    Science.gov (United States)

    Murphy, Dominic; Ross, Jana; Ashwick, Rachel; Armour, Cherie; Busuttil, Walter

    2017-01-01

    Background : Previous research exploring the psychometric properties of the scores of measures of posttraumatic stress disorder (PTSD) suggests there is variation in their functioning depending on the target population. To date, there has been little study of these properties within UK veteran populations. Objective : This study aimed to determine optimally efficient cut-off values for the Impact of Event Scale-Revised (IES-R) and the PTSD Checklist for DSM-5 (PCL-5) that can be used to assess for differential diagnosis of presumptive PTSD. Methods : Data from a sample of 242 UK veterans assessed for mental health difficulties were analysed. The criterion-related validity of the PCL-5 and IES-R were evaluated against the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5). Kappa statistics were used to assess the level of agreement between the DSM-IV and DSM-5 classification systems. Results : The optimal cut-off scores observed within this sample were 34 or above on the PCL-5 and 46 or above on the IES-R. The PCL-5 cut-off is similar to the previously reported values, but the IES-R cut-off identified in this study is higher than has previously been recommended. Overall, a moderate level of agreement was found between participants screened positive using the DSM-IV and DSM-5 classification systems of PTSD. Conclusions : Our findings suggest that the PCL-5 and IES-R can be used as brief measures within veteran populations presenting at secondary care to assess for PTSD. The use of a higher cut-off for the IES-R may be helpful for differentiating between veterans who present with PTSD and those who may have some sy`mptoms of PTSD but are sub-threshold for meeting a diagnosis. Further, the use of more accurate optimal cut-offs may aid clinicians to better monitor changes in PTSD symptoms during and after treatment.

  12. Effectiveness of Parent-Child Interaction Therapy (PCIT in the Treatment of Young Children's Behavior Problems. A Randomized Controlled Study.

    Directory of Open Access Journals (Sweden)

    Åse Bjørseth

    Full Text Available The aim of the present investigation was to compare the effectiveness of Parent-Child Interaction Therapy (PCIT with treatment as usual (TAU in young children who were referred to regular child and adolescent mental health clinics for behavior problems.Eighty-one Norwegian families with two- to seven-year-old children (52 boys who had scored ≥ 120 on the Eyberg Child Behavior Inventory (ECBI were randomly assigned to receive either PCIT or TAU. The families were assessed 6 and 18 months after beginning treatment. Parenting skills were measured using the Dyadic Parent-Child Interaction Coding System (DPICS, and child behavior problems were measured using the ECBI and the Child Behavior Checklist (CBCL.Linear growth curve analyses revealed that the behavior problems of children receiving PCIT improved more compared with children receiving TAU according to mother reports (ECBI d = .64, CBCL d = .61, both p < .05 but not according to father report. Parents also improved with regard to Do and Don't skills (d = 2.58, d = 1.46, respectively, both p ≤ .001. At the 6-month assessment, which often occurred before treatment was finished, children who had received PCIT had lower father-rated ECBI and mother-rated CBCL-scores (p = .06 compared with those who had received TAU. At the 18-month follow-up, the children who had received PCIT showed fewer behavior problems compared with TAU according to mother (d = .37 and father (d = .56 reports on the ECBI and mother reports on the CBCL regarding externalizing problems (d = .39. Parents receiving PCIT developed more favorable Do Skills (6-month d = 1.81; 18-month d = 1.91 and Don't Skills (6-month d = 1.46; 18-month d = 1.42 according to observer ratings on the DPICS compared with those receiving TAU.Children receiving PCIT in regular clinical practice exhibited a greater reduction in behavior problems compared with children receiving TAU, and their parents' parenting skills improved to a greater degree

  13. Effect of baseline Alberta Stroke Program Early CT Score on safety and efficacy of intra-arterial treatment: a subgroup analysis of a randomised phase 3 trial (MR CLEAN)

    NARCIS (Netherlands)

    Yoo, Albert J.; Berkhemer, Olvert A.; Fransen, Puck S. S.; van den Berg, Lucie A.; Beumer, Debbie; Lingsma, Hester F.; Schonewille, Wouter J.; Sprengers, Marieke E. S.; van den Berg, René; van Walderveen, Marianne A. A.; Beenen, Ludo F. M.; Wermer, Marieke J. H.; Nijeholt, Geert J. Lycklama À; Boiten, Jelis; Jenniskens, Sjoerd F. M.; Bot, Joseph C. J.; Boers, Anna M. M.; Marquering, Henk A.; Roos, Yvo B. W. E. M.; van Oostenbrugge, Robert J.; Dippel, Diederik W. J.; van der Lugt, Aad; van Zwam, Wim H.; Majoie, Charles B. L. M.

    2016-01-01

    Whether infarct size modifies intra-arterial treatment effect is not certain, particularly in patients with large infarcts. We examined the effect of the baseline Alberta Stroke Program Early CT Score (ASPECTS) on the safety and efficacy of intra-arterial treatment in a subgroup analysis of the

  14. Effect of baseline Alberta Stroke Program Early CT Score on safety and efficacy of intra-arterial treatment: a subgroup analysis of a randomised phase 3 trial (MR CLEAN)

    NARCIS (Netherlands)

    Yoo, A.J.; Berkhemer, O.A.; Fransen, P.S.; Berg, L.A. van den; Beumer, D.; Lingsma, H.F.; Schonewille, W.J.; Sprengers, M.E.; Berg, R. van den; Walderveen, M.A. van; Beenen, L.F.; Wermer, M.J.; Nijeholt, G.J.; Boiten, J.; Jenniskens, S.F.M.; Bot, J.C.; Boers, A.M.; Marquering, H.A.; Roos, Y.B.; Oostenbrugge, R.J. van; Dippel, D.W.; Lugt, A. van der; Zwam, W.H. van; Majoie, C.B.; et al.,

    2016-01-01

    BACKGROUND: Whether infarct size modifies intra-arterial treatment effect is not certain, particularly in patients with large infarcts. We examined the effect of the baseline Alberta Stroke Program Early CT Score (ASPECTS) on the safety and efficacy of intra-arterial treatment in a subgroup analysis

  15. Safety, efficacy, and response predictors of anticoagulation for the treatment of nonmalignant portal-vein thrombosis in patients with cirrhosis: a propensity score matching analysis

    Directory of Open Access Journals (Sweden)

    Jung Wha Chung

    2014-12-01

    Full Text Available Background/AimsPortal-vein thrombosis (PVT develops in 10-25% of cirrhotic patients and may aggravate portal hypertension. There are few data regarding the effects of anticoagulation on nonmalignant PVT in liver cirrhosis. The aim of this study was to elucidate the safety, efficacy, and predictors of response to anticoagulation therapy in cirrhotic patients.MethodsPatients with liver cirrhosis and nonmalignant PVT were identified by a hospital electronic medical record system (called BESTCARE. Patients with malignant PVT, Budd-Chiari syndrome, underlying primary hematologic disorders, or preexisting extrahepatic thrombosis were excluded from the analysis. Patients were divided into two groups (treatment and nontreatment, and propensity score matching analysis was performed to identify control patients. The sizes of the thrombus and spleen were evaluated using multidetector computed tomography.ResultsTwenty-eight patients were enrolled in this study between 2003 and 2014: 14 patients who received warfarin for nonmalignant PVT and 14 patients who received no anticoagulation. After 112 days of treatment, 11 patients exhibited significantly higher response rates (complete in 6 and partial in 5 compared to the control patients, with decreases in thrombus size of >30%. Compared to nonresponders, the 11 responders were older, and had a thinner spleen and fewer episodes of previous endoscopic variceal ligations, whereas pretreatment liver function and changes in prothrombin time after anticoagulation did not differ significantly between the two groups. Two patients died after warfarin therapy, but the causes of death were not related to anticoagulation.ConclusionsWarfarin can be safely administered to cirrhotic patients with nonmalignant PVT. The presence of preexisting portal hypertension is a predictor of nonresponse to anticoagulation.

  16. Bispectoral index scores of pediatric patients under dental treatment and recovery conditions: Study of children assigned for general anesthesia under propofol and isofloran regimes

    Directory of Open Access Journals (Sweden)

    Dana Tahririan

    2016-01-01

    Full Text Available Background: This study was planned to determine the relationship between bispectoral index (BIS during dental treatment and recovery conditions in children undergoing two regimes of anesthesia of propofol and isoflurane. Materials and Methods: In this single-blind clinical trial study, 57 4-7-year-old healthy children who had been referred for dental treatment under general anesthesia between 60 and 90 min were selected by convenience sampling and assigned to two groups, after obtaining their parents′ written consent. The anesthesia was induced by inhalation. For the first group, the anesthesia was preserved by a mixture of oxygen (50%, nitrous oxide (50%, and isoflurane (1%. For the second group, the anesthesia was preserved by a mixture of oxygen (50%, nitrous oxide (50%, and propofol was administered intravenously at a dose of 100 Ng/kg/min. The patients′ vital signs, BIS, and agitation scores were recorded every 10 min. The data were analyzed by repeated measure ANOVA and t-tests at a significance level of α = 0.05 using SPSS version 20. Results: The results of independent t-test for anesthesia time showed no statistically significant difference between isoflurane and propofol (P = 0.87. Controlling age, the BIS difference between the two anesthetic agents was not significant (P > 0.05; however, it was negatively correlated with the duration of anesthesia and the discharge time (P = 0.001, r = -0.308 and (P < 0.001, r = -0.55. Conclusion: The same depth of anesthesia is produced by propofol and isoflurane, but lower recovery complications from anesthesia are observed with isoflurane.

  17. 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.

  18. Interaction of low-dose irradiation with subsequent mutagenic treatment. Role of mitotic delay

    International Nuclear Information System (INIS)

    Salone, B.; Pretazzoli, V.; Bosi, A.; Olivieri, G.

    1996-01-01

    Experiments were carried out with human lymphocytes to test whether there was any relation between the changes that conditioning treatment can produce in cell progression or in mitotic delay induced by the challenge dose and the presence of an 'adaptive response' (AR). In experiments in which the cells were successively fixed after the challenge dose, the interaction between conditioning treatment and challenge was of the same sign for all the fixation times: therefore it is likely that modifications of the cytogenetic damage in primed cells is not a mere reflection of stage sensitivity. In experiments in which using 1 Gy as conditioning treatment we induced a drastic extension of G 2 , we did not observe any AR; therefore, even if conditioning treatment can induce modifications in the cell-cycle phases before and/or after challenge, there is probably no link between these modifications and the presence of an AR

  19. Using an electronic platform interactively to improve treatment outcome in patients with rheumatoid arthritis

    DEFF Research Database (Denmark)

    Hetland, Merete Lund; Krogh, Niels Steen; Hørslev-Petersen, Kim

    2016-01-01

    OBJECTIVES: Electronic platforms have been developed to help the clinician monitor disease activity in rheumatoid arthritis (RA) to support at treat-to-target strategy. We present an initiative to interactively improve disease control in patients with rheumatoid arthritis. METHODS: In patients who...... presented with one or more swollen joints AND moderate/high disease activity (i.e. either CDAI≥10.1 and/or DAS-28CRP>3.2, which is automatically calculated in the DANBIO registry), a red alert was shown, which activated a pop-up: "This patient has at least one swollen joint AND either CDAI≥ 10.1 or DAS28CRP......>3.2. Which action do you as a physician take today: □ Intensify treatment, □ Treatment intensification is not possible currently/awaiting results of additional investigations, □ No further treatment intensification is possible, □ The patient does not want to intensify treatment, □ Other decisions...

  20. Using an electronic platform interactively to improve treatment outcome in patients with rheumatoid arthritis

    DEFF Research Database (Denmark)

    Hetland, Merete Lund; Krogh, Niels Steen; Hørslev-Petersen, Kim

    2016-01-01

    Objective. Electronic platforms have been developed to help the clinician monitor disease activity in rheumatoid arthritis (RA) to support at treat-to-target strategy. We present an initiative to interactively improve disease control in patients with rheumatoid arthritis. Methods. In patients who...... presented with one or more swollen joints AND moderate/high disease activity (i.e. either CDAI≥10.1 and/or DAS- 28CRP > 3.2, which is automatically calculated in the DANBIO registry), a red alert was shown, which activated a pop-up: "This patient has at least one swollen joint AND either CDAI≥ 10.1 or DAS28......CRP > 3.2. Which action do you as a physician take today: □ Intensify treatment, □Treatment intensification is not possible currently/awaiting results of additional investigations, □ No further treatment intensification is possible, □ The patient does not want to intensify treatment, □ Other decisions...

  1. Racial prejudice and unfair treatment: interactive effects with poverty and foreign nativity on problem drinking.

    Science.gov (United States)

    Zemore, Sarah E; Karriker-Jaffe, Katherine J; Keithly, Sarah; Mulia, Nina

    2011-05-01

    Although racial and ethnic minorities are often disadvantaged in multiple ways, little research has examined the interactive effects of multiple forms of disadvantage in these populations. The current study describes the independent and interactive effects of perceived prejudice, perceived unfair treatment, poverty, and foreign nativity on problem drinking outcomes among Black and Latino adults. The data source was Black (n = 504) and Latino (n = 766) drinkers from the nationally representative, weighted 2005 National Alcohol Survey. Perceived prejudice was assessed using a composite measure of racial stigma consciousness; perceived unfair treatment was assessed using a single item. Respondents whose per capita household income was below the 2004 poverty guidelines were coded as "poor"; nativity status was assessed among Latinos. Outcomes included past-year drinking to drunkenness, any drinking-related consequences, and two or more dependence symptoms. In bivariate tests, higher levels of unfair treatment were significantly associated with all three outcomes among Blacks (marginally so for drunkenness) and dependence symptoms among Latinos. Further, higher racial stigma was significantly associated with higher rates of any drinking consequences among Latinos. In multivariate logistic regressions, six significant or marginally significant interactions emerged. For each, the pattern of results suggested stronger associations between perceived prejudice/unfair treatment and problem drinking given either poverty or foreign nativity. Although findings were somewhat mixed, the pattern of results tentatively supports the hypothesis that associations between problem drinking and both prejudice and unfair treatment can be exacerbated given the presence of other stressors, particularly among Latinos. Results extend the literature on the health consequences of prejudice and discrimination, highlighting important effects of cumulative adversity and suggesting a need to focus

  2. Racial Prejudice and Unfair Treatment: Interactive Effects With Poverty and Foreign Nativity on Problem Drinking*

    Science.gov (United States)

    Zemore, Sarah E.; Karriker-Jaffe, Katherine J.; Keithly, Sarah; Mulia, Nina

    2011-01-01

    Objective: Although racial and ethnic minorities are often disadvantaged in multiple ways, little research has examined the interactive effects of multiple forms of disadvantage in these populations. The current study describes the independent and interactive effects of perceived prejudice, perceived unfair treatment, poverty, and foreign nativity on problem drinking outcomes among Black and Latino adults. Method: The data source was Black (n = 504) and Latino (n = 766) drinkers from the nationally representative, weighted 2005 National Alcohol Survey. Perceived prejudice was assessed using a composite measure of racial stigma consciousness; perceived unfair treatment was assessed using a single item. Respondents whose per capita household income was below the 2004 poverty guidelines were coded as “poor”; nativity status was assessed among Latinos. Outcomes included past-year drinking to drunkenness, any drinking-related consequences, and two or more dependence symptoms. Results: In bivariate tests, higher levels of unfair treatment were significantly associated with all three outcomes among Blacks (marginally so for drunkenness) and dependence symptoms among Latinos. Further, higher racial stigma was significantly associated with higher rates of any drinking consequences among Latinos. In multivariate logistic regressions, six significant or marginally significant interactions emerged. For each, the pattern of results suggested stronger associations between perceived prejudice/unfair treatment and problem drinking given either poverty or foreign nativity. Conclusions: Although findings were somewhat mixed, the pattern of results tentatively supports the hypothesis that associations between problem drinking and both prejudice and unfair treatment can be exacerbated given the presence of other stressors, particularly among Latinos. Results extend the literature on the health consequences of prejudice and discrimination, highlighting important effects of

  3. No interactions between genetic polymorphisms and stressful life events on outcome of antidepressant treatment

    DEFF Research Database (Denmark)

    Bukh, Jens Drachmann; Bock, Camilla; Vinberg, Maj

    2009-01-01

    Genetic polymorphisms seem to influence the response on antidepressant treatment and moderate the impact of stress on depression. The present study aimed to assess, whether allelic variants and stressful life events interact on the clinical outcome of depression. In a sample of 290 systematically...... recruited patients diagnosed with a single depressive episode according to ICD-10, we assessed the outcome of antidepressant treatment and the presence of stressful life events in a 6-month period preceding onset of depression by means of structured interviews. Further, we genotyped nine polymorphisms...... dependent on stressful life events experienced by the individual prior to onset of depression....

  4. Simplified clinical prediction scores to target viral load testing in adults with suspected first line treatment failure in Phnom Penh, Cambodia.

    Directory of Open Access Journals (Sweden)

    Johan van Griensven

    Full Text Available BACKGROUND: For settings with limited laboratory capacity, 2013 World Health Organization (WHO guidelines recommend targeted HIV-1 viral load (VL testing to identify virological failure. We previously developed and validated a clinical prediction score (CPS for targeted VL testing, relying on clinical, adherence and laboratory data. While outperforming the WHO failure criteria, it required substantial calculation and review of all previous laboratory tests. In response, we developed four simplified, less error-prone and broadly applicable CPS versions that can be done 'on the spot'. METHODOLOGY/PRINCIPAL: Findings From May 2010 to June 2011, we validated the original CPS in a non-governmental hospital in Phnom Penh, Cambodia applying the CPS to adults on first-line treatment >1 year. Virological failure was defined as a single VL >1000 copies/ml. The four CPSs included CPS1 with 'current CD4 count' instead of %-decline-from-peak CD4; CPS2 with hemoglobin measurements removed; CPS3 having 'decrease in CD4 count below baseline value' removed; CPS4 was purely clinical. Score development relied on the Spiegelhalter/Knill-Jones method. Variables independently associated with virological failure with a likelihood ratio ≥ 1.5 or ≤ 0.67 were retained. CPS performance was evaluated based on the area-under-the-ROC-curve (AUROC and 95% confidence intervals (CI. The CPSs were validated in an independent dataset. A total of 1490 individuals (56.6% female, median age: 38 years (interquartile range (IQR 33-44; median baseline CD4 count: 94 cells/µL (IQR 28-205, median time on antiretroviral therapy 3.6 years (IQR 2.1-5.1, were included. Forty-five 45 (3.0% individuals had virological failure. CPS1 yielded an AUROC of 0.69 (95% CI: 0.62-0.75 in validation, CPS2 an AUROC of 0.68 (95% CI: 0.62-0.74, and CPS3, an AUROC of 0.67 (95% CI: 0.61-0.73. The purely clinical CPS4 performed poorly (AUROC-0.59; 95% CI: 0.53-0.65. CONCLUSIONS: Simplified CPSs retained

  5. Interaction between nanoparticles generated by zinc chloride treatment and oxidative responses in rat liver

    Directory of Open Access Journals (Sweden)

    Azzouz I

    2013-12-01

    Full Text Available Inès Azzouz, Hamdi Trabelsi, Amel Hanini, Soumaya Ferchichi, Olfa Tebourbi, Mohsen Sakly, Hafedh AbdelmelekLaboratory of Integrative Physiology, Faculty of Sciences of Bizerte, Carthage University, TunisiaAbstract: The aim of the present study was to investigate the interaction of zinc chloride (3 mg/kg, intraperitoneally [ip] in rat liver in terms of the biosynthesis of nanoparticles. Zinc treatment increased zinc content in rat liver. Analysis of fluorescence revealed the presence of red fluorescence in the liver following zinc treatment. Interestingly, the co-exposure to zinc (3 mg/kg, ip and selenium (0.20 mg/L, per os [by mouth] led to a higher intensity of red fluorescence compared to zinc-treated rats. In addition, X-ray diffraction measurements carried out on liver fractions of zinc-treated rats point to the biosynthesis of zinc sulfide and/or selenide nanocomplexes at nearly 51.60 nm in size. Moreover, co-exposure led to nanocomplexes of about 72.60 nm in size. The interaction of zinc with other mineral elements (S, Se generates several nanocomplexes, such as ZnS and/or ZnSe. The nanocomplex ZnX could interact directly with enzyme activity or indirectly by the disruption of mineral elements' bioavailability in cells. Subacute zinc or selenium treatment decreased malondialdehyde levels, indicating a drop in lipid peroxidation. In addition, antioxidant enzyme assays showed that treatment with zinc or co-treatment with zinc and selenium increased the activities of glutathione peroxidase, catalase, and superoxide dismutase. Consequently, zinc complexation with sulfur and/or selenium at nanoscale level could enhance antioxidative responses, which is correlated to the ratio of number of ZnX nanoparticles (X=sulfur or X=selenium to malondialdehyde level in rat liver.Keywords: nanocomplexes biosynthesis, antioxidative responses, X-ray diffraction, fluorescence microscopy, liver

  6. 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 ...

  7. Score of liver ultrasonography predicts treatment-related severe neutropenia and neutropenic fever in induction chemotherapy with docetaxel for locally advanced head and neck cancer patients with normal serum transamines.

    Science.gov (United States)

    Wang, Ting-Yao; Chen, Wei-Ming; Yang, Lan-Yan; Chen, Chao-Yu; Chou, Wen-Chi; Chen, Yi-Yang; Chen, Chih-Cheng; Lee, Kuan-Der; Lu, Chang-Hsien

    2016-11-01

    Induction chemotherapy with docetaxel improved outcome in advanced head and neck squamous cell carcinoma (HNSCC) patients, but docetaxel was not recommended in liver dysfunction patients for treatment toxicities. Severe neutropenic events (SNE) including severe neutropenia (SN) and febrile neutropenia (FN) still developed in these patients with normal serum transaminases. Ultrasonography (US) fibrotic score represented degree of hepatic parenchymal damage and showed good correlation to fibrotic changes histologically. This study aims to evaluate the association of US fibrotic score with docetaxel treatment-related SNE in advanced HNSCC patients with normal serum transaminases. Between 1 January 2011 and 31 December 2013, a total of 47 advanced HNSCC patients treated with induction docetaxel were enrolled. The clinical features were collected to assess predictive factors for SNE. The patients were divided into two groups by the US fibrotic score with a cutoff value of 7. The Mann-Whitney U test and logistic regression method were used for the risk factor analysis. The background, treatment, and response were similar in both groups except for lower lymphocyte and platelet count in patients with higher US score. Twenty-seven patients (51 %) developed grade 3/4 neutropenia, and more SNE developed in patients with US score ≧7. In multivariate analysis, only US score ≥7 was independent predictive factor for developing SN (hazard ratio 7.71, p = 0.043) and FN (hazard ratio 20.95, p = 0.008). US score ≥7 is an independent risk factor for SNE in advanced HNSCC patients treated with induction docetaxel. US score could be used for risk prediction of docetaxel-related SNE.

  8. Anti-tuberculosis treatment defaulting: an analysis of perceptions and interactions in Chiapas, Mexico.

    Science.gov (United States)

    Reyes-Guillén, Ivett; Sánchez-Pérez, Héctor Javier; Cruz-Burguete, Jorge; Izaurieta-de Juan, Miren

    2008-01-01

    To analyze the perceptions and interactions of the actors involved in anti-tuberculosis treatment, and to explore their influence in treatment defaulting in Los Altos region of Chiapas, Mexico. From November 2002 to August 2003, in-depth interviews were administered to patients with PTB, patients' family members, institutional physicians, community health coordinators, and traditional medicine practitioners. We found different perceptions about PTB between patients and their families and among health personnel, as well as communication barriers between actors. Defaulting is considered to be mainly due to the treatment's adverse effects. It is necessary to conduct research and interventions in the studied area with the aim of changing perceptions, improving sensitization, quality and suitability of management of patients with PTB in a multicultural context, and promoting collaboration between institutional and traditional medicine.

  9. Small Versus Large-Sized Drug-Eluting Beads (DEBIRI) for the Treatment of Hepatic Colorectal Metastases: A Propensity Score Matching Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Akinwande, Olaguoke K., E-mail: gokeakin@gmail.com [University of Louisville Hospital, Department of Interventional Radiology (United States); Philips, Prejesh, E-mail: prejesh.philips@louisville.edu [University of Louisville, Division of Surgical Oncology, Department of Surgery (United States); Duras, Petr, E-mail: durasp@seznam.cz [Fakultní nemocnice Plzeň (Czech Republic); Pluntke, Stefan, E-mail: stefan.pluntke@t-online.de [Onkologe bei Kliniken Essen-Mitte (Germany); Scoggins, Charles, E-mail: charles.scoggins@louisville.edu; Martin, Robert C. G., E-mail: Robert.Martin@louisville.edu [University of Louisville, Division of Surgical Oncology, Department of Surgery (United States)

    2015-04-15

    PurposeTo compare the feasibility, safety, and efficacy with small and large irinotecan drug-eluting beads (DEBIRI) for treating hepatic colorectal metastases.MethodsUsing our prospectively maintained, multi-center, intra-arterial therapy registry, we identified 196 patients treated with a combination of large beads (100–300 to 500–700 μm) and patients treated with a combination of small beads (70–150 to 100–300 μm). To minimize selection bias, a propensity score analysis was performed to compare both groups.ResultsUnadjusted analysis consisted of 196 and 30 patients treated with large and small beads, respectively. The adjusted analysis consisted of 19 patients each. Unadjusted analysis showed decreased all-grade (p = <0.001) and high-grade adverse effects (p = 0.02) in the small bead group, with a persisting trend toward decreased overall side effects in the adjusted analysis favoring small beads (p = 0.09) The adjusted analysis showed the percentage dose delivered (delivered dose/intended dose) was significantly greater in the small bead group compared to the large bead group (96 vs 79 %; p = 0.005). There were also a lower percentage of treatments terminating in complete stasis in the adjusted analysis (0.0035). Adjusted analysis also showed increased objective response rate (ORR) at 12 months (p = 0.04), with a corresponding trend also seen in the unadjusted analysis (0.09).ConclusionSmaller beads result in increased dose delivery probably due to less propensity to reach complete stasis. It may also lead to more durable long-term efficacy. Smaller beads also demonstrate similarly low toxicity compared to large-sized beads with a trend toward less toxicity.

  10. The interactions among impact factors affecting 131I treatment efficacy of Graves' disease

    International Nuclear Information System (INIS)

    Wang Peng; Tan Jian; Zhang Guizhi; He Yajing; Dong Feng; Wang Renfei; Xiao Qian

    2011-01-01

    Objective: To evaluate the possible interactions among different impact factors possibly affecting the treatment efficacy of 131 I in Graves' disease (GD). Methods: Six hundred and thirty two GD patients that had been treated by 131 I, with or without antithyroid drugs (ATD), were included in this study. The impact factors were pre-defined as age (x 1 ), sex (x 2 ), mass of thyroid (x 3 ), course of disease (x 4 ), initial symptom (x 5 ), condition of disease (x 6 ), ATD treatment duration (x 7 ), effective half life time (x 8 ), maximum 131 I uptake rate (x 9 ), total dose of 131 I (x 10 ), dose of 131 I per gram of thyroid (x 11 ), TRAb (x 12 ), TSI (x 13 ), TgAb (x 14 ), and thyroid microsomal antibody(TMAb) level (x 15 ). Interactions among different impact factors were studied by t-test, χ 2 test and multi-variant logistic regression. Results: Age, mass of thyroid, ATD treatment duration, maximum 131 I uptake rate, dose of 131 I per gram of thyroid tissue and TSI level were identified as independent impact factors affecting the 131 I treatment efficacy on GD (χ 2 =6.908, t=-4.063, χ 2 =13.558, t=-2.553, t=4.528, χ 2 =9.716, all P 131 I uptake rate (likelihood χ 2 =8.176, P>0.05; F=2.928, 1.992, 2.629, 2.215, all P 131 I treatment, which might guide the prescription of 131 I dosage for GD treatment. (authors)

  11. Interactive Dose Shaping - efficient strategies for CPU-based real-time treatment planning

    Science.gov (United States)

    Ziegenhein, P.; Kamerling, C. P.; Oelfke, U.

    2014-03-01

    Conventional intensity modulated radiation therapy (IMRT) treatment planning is based on the traditional concept of iterative optimization using an objective function specified by dose volume histogram constraints for pre-segmented VOIs. This indirect approach suffers from unavoidable shortcomings: i) The control of local dose features is limited to segmented VOIs. ii) Any objective function is a mathematical measure of the plan quality, i.e., is not able to define the clinically optimal treatment plan. iii) Adapting an existing plan to changed patient anatomy as detected by IGRT procedures is difficult. To overcome these shortcomings, we introduce the method of Interactive Dose Shaping (IDS) as a new paradigm for IMRT treatment planning. IDS allows for a direct and interactive manipulation of local dose features in real-time. The key element driving the IDS process is a two-step Dose Modification and Recovery (DMR) strategy: A local dose modification is initiated by the user which translates into modified fluence patterns. This also affects existing desired dose features elsewhere which is compensated by a heuristic recovery process. The IDS paradigm was implemented together with a CPU-based ultra-fast dose calculation and a 3D GUI for dose manipulation and visualization. A local dose feature can be implemented via the DMR strategy within 1-2 seconds. By imposing a series of local dose features, equal plan qualities could be achieved compared to conventional planning for prostate and head and neck cases within 1-2 minutes. The idea of Interactive Dose Shaping for treatment planning has been introduced and first applications of this concept have been realized.

  12. Patient-physician interactions during early breast-cancer treatment: results from an international online survey.

    Science.gov (United States)

    Lansdown, M; Martin, L; Fallowfield, L

    2008-07-01

    To examine, via an international survey, the impact of positive and negative interactions on the patient-physician relationship. This online survey was conducted in five countries (USA, UK, Germany, Italy and France) in two populations: (1) postmenopausal women diagnosed with early breast cancer (EBC) in the past 5 years, who had undergone surgery; (2) breast-cancer physicians. The survey covered several topics: patient-physician interactions, EBC treatment options and sources of information. In total, 462 physicians and 600 patients responded. Most (85%) physicians considered having a good relationship with their patient the most rewarding part of their job. Although 60% of physicians were satisfied with the consultation time (average 17.9 min), 30% considered it insufficient, whilst 49% of patients would prefer more time. Patients reported that physicians were a primary source of information, with 81% indicating that trust in their physician was a vital component of their care. Many physicians (63%) felt that patients are overwhelmed by the amount of information available, but only 16% of patients felt overwhelmed. Most physicians (78%) consider that telling a patient she has EBC is easier than talking about recurrence; 44% rated talking about recurrence as the most stressful part of their job. Most physicians (91%) considered availability of clinical trial data to be crucial for building trust and 74% believed that treatments that minimise recurrence enable more positive conversations. Good-quality patient care extends beyond effective treatment to include good communication about therapeutic options, side effects, and the development of trust and confidence. The survey revealed some disparities in physicians' and patients' views, but demonstrated that a strong patient-physician relationship is highly valued by both. Patients need access to accurate information and adequate consultation time. Providing effective and well-tolerated treatments that minimise

  13. Benznidazole and posaconazole in experimental Chagas disease: positive interaction in concomitant and sequential treatments.

    Directory of Open Access Journals (Sweden)

    Lívia de Figueiredo Diniz

    Full Text Available Current chemotherapy for Chagas disease is unsatisfactory due to its limited efficacy, particularly in the chronic phase, with frequent side effects that can lead to treatment discontinuation. Combined therapy is envisioned as an ideal approach since it may improve treatment efficacy whilst decreasing toxicity and the likelihood of resistance development. We evaluated the efficacy of posaconazole in combination with benznidazole on Trypanosoma cruzi infection in vivo.Benznidazole and posaconazole were administered individually or in combination in an experimental acute murine infection model. Using a rapid treatment protocol for 7 days, the combined treatments were more efficacious in reducing parasitemia levels than the drugs given alone, with the effects most evident in combinations of sub-optimal doses of the drugs. Subsequently, the curative action of these drug combinations was investigated, using the same infection model and 25, 50, 75 or 100 mg/kg/day (mpk of benznidazole in combination with 5, 10 or 20 mpk of posaconazole, given alone or concomitantly for 20 days. The effects of the combination treatments on parasitological cures were higher than the sum of such effects when the drugs were administered separately at the same doses, indicating synergistic activity. Finally, sequential therapy experiments were carried out with benznidazole or posaconazole over a short interval (10 days, followed by the second drug administered for the same period of time. It was found that the sequence of benznidazole (100 mpk followed by posaconazole (20 mpk provided cure rates comparable to those obtained with the full (20 days treatments with either drug alone, and no cure was observed for the short treatments with drugs given alone.Our data demonstrate the importance of investigating the potential beneficial effects of combination treatments with marketed compounds, and showed that combinations of benznidazole with posaconazole have a positive

  14. Interactive approach to segment organs at risk in radiotherapy treatment planning

    Science.gov (United States)

    Dolz, Jose; Kirisli, Hortense A.; Viard, Romain; Massoptier, Laurent

    2014-03-01

    Accurate delineation of organs at risk (OAR) is required for radiation treatment planning (RTP). However, it is a very time consuming and tedious task. The use in clinic of image guided radiation therapy (IGRT) becomes more and more popular, thus increasing the need of (semi-)automatic methods for delineation of the OAR. In this work, an interactive segmentation approach to delineate OAR is proposed and validated. The method is based on the combination of watershed transformation, which groups small areas of similar intensities in homogeneous labels, and graph cuts approach, which uses these labels to create the graph. Segmentation information can be added in any view - axial, sagittal or coronal -, making the interaction with the algorithm easy and fast. Subsequently, this information is propagated within the whole volume, providing a spatially coherent result. Manual delineations made by experts of 6 OAR - lungs, kidneys, liver, spleen, heart and aorta - over a set of 9 computed tomography (CT) scans were used as reference standard to validate the proposed approach. With a maximum of 4 interactions, a Dice similarity coefficient (DSC) higher than 0.87 was obtained, which demonstrates that, with the proposed segmentation approach, only few interactions are required to achieve similar results as the ones obtained manually. The integration of this method in the RTP process may save a considerable amount of time, and reduce the annotation complexity.

  15. Combined sequential use of HAP and ART scores to predict survival outcome and treatment failure following chemoembolization in hepatocellular carcinoma: a multi-center comparative study.

    Science.gov (United States)

    Pinato, David J; Arizumi, Tadaaki; Jang, Jeong Won; Allara, Elias; Suppiah, Puvan I; Smirne, Carlo; Tait, Paul; Pai, Madhava; Grossi, Glenda; Kim, Young Woon; Pirisi, Mario; Kudo, Masatoshi; Sharma, Rohini

    2016-07-12

    The prognosis of patients with hepatocellular carcinoma (HCC) undergoing transarterial chemoembolization (TACE) is variable, despite a myriad of prognostic markers. We compared and integrated the established prognostic models, HAP and ART scores, for their accuracy of overall survival (OS) prediction. In both training and validation sets, HAP and ART scores emerged as independent predictors of OS (pHAP achieving better prognostic accuracy (c-index: 0.68) over ART (0.57). We tested both scores in combination to evaluate their combined ability to predict OS. Subgroup analysis of BCLC-C patients revealed favorable HAP stage (pCancer (BCLC) A/B stage from UK and Italy (training set), and 660 from Korea and Japan (validation set), all treated with conventional TACE. Scores were further validated in an separate analysis of patients with BCLC-C stage disease (n=63) receiving initial TACE. ART and HAP scores are validated indices in patients with intermediate stage HCC undergoing TACE. The HAP score is best suited for screening patients prior to initial TACE, whilst sequential ART assessment improves early detection of chemoembolization failure. BCLC-C patients with low HAP stage may be a subgroup where TACE should be explored in clinical studies.

  16. Using the interaction of mental health symptoms and treatment status to estimate lost employee productivity.

    Science.gov (United States)

    Hilton, Michael F; Scuffham, Paul A; Vecchio, Nerina; Whiteford, Harvey A

    2010-02-01

    In Australia it has been estimated that mental health symptoms result in a loss of $ AU2.7 billion in employee productivity. To date, however, there has been only one study quantifying employee productivity decrements due to mental disorders when treatment-seeking behaviours are considered. The aim of the current paper was to estimate employee work productivity by mental health symptoms while considering different treatment-seeking behaviours. A total of 60 556 full-time employees responded to the World Health Organization Health and Work Performance Questionnaire. This questionnaire is designed to monitor the work productivity of employees for chronic and acute physical and mental health conditions. Contained within the questionnaire is the Kessler 6, a scale measuring psychological distress along with an evaluation of employee treatment-seeking behaviours for depression, anxiety and any other emotional problems. A univariate analysis of variance was performed for employee productivity using the interaction between Kessler 6 severity categories and treatment-seeking behaviours. A total of 9.6% of employees have moderate psychological distress and a further 4.5% have high psychological distress. Increasing psychological distress from low to moderate then to high levels is associated with increasing productivity decrements (6.4%, 9.4% and 20.9% decrements, respectively) for employees in current treatment. Combining the prevalence of Kessler 6 categories with treatment-seeking behaviours, mean 2009 salaries and number of Australian employees in 2009, it is estimated that psychological distress produces an $ AU5.9 billion reduction in Australian employee productivity per annum. The estimated loss of $ AU5.9 billion in employee productivity due to mental health problems is substantially higher than previous estimates. This finding is especially pertinent given the global economic crisis, when psychological distress among employees is likely to be increasing. Effective

  17. Interactive, three dimensional, CT-based treatment planning of stereotaxic I-125 brain implants. 132

    International Nuclear Information System (INIS)

    Lulu, B.; Lewis, J.; Smith, V.; Stuart, A.

    1987-01-01

    Brain implants of I-125 seeds are done with the Brown-Roberts-Wells stereotaxic frame. The patient is CT scanned with the frame bolted to the skull. In the time between the scan and surgery, while the patient is under anesthesia, an interactive three dimensional CT-based treatment plan is performed on a VAX computer. The program is menu driven, easy to use, and easily modifiable. Device dependencies are limited to a small number of subroutines, and an array processor is used to speed dose calculations

  18. Asymptomatic Individuals With a Positive Family History for Premature Coronary Artery Disease and Elevated Coronary Calcium Scores Benefit From Statin Treatment A Post Hoc Analysis From the St. Francis Heart Study

    NARCIS (Netherlands)

    Mulders, Ties A.; Sivapalaratnam, Suthesh; Stroes, Erik S. G.; Kastelein, John J. P.; Guerci, Alan D.; Pinto-Sietsma, Sara-Joan

    2012-01-01

    OBJECTIVES The goal of this study was to evaluate whether individuals with a positive family history for premature coronary artery disease (CAD) and coronary calcium scoring (CCS) above the 80th percentile might benefit from preventive treatment. BACKGROUND First-degree relatives of patients with

  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. 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

  1. Care interaction adding challenges to old patients’ well-being during surgical hospital treatment

    Directory of Open Access Journals (Sweden)

    Lisbeth Uhrenfeldt

    2015-10-01

    Full Text Available Today, hospitals offer surgical treatment within a short hospital admission. This brief interaction may challenge the well-being of old patients. The aim of this study was to explore how the well-being of old hospitalized patients was affected by the interaction with staff during a fast-track surgical treatment and hospital admission for colon cancer. We used an ethnographic methodology with field observations and unstructured interviews focusing on one patient at a time (n=9 during a full day; the hours ranging from 7:45 a.m. to 8 p.m. Participants were between 74 and 85 years of age and of both sexes. The study was reported to the Danish Data Protection Agency with reference number (2007-58-0010. The encounter between old patients and the staff was a main theme in our findings elucidating a number of care challenges. The identified care challenges illustrated “well-being as a matter of different perspectives,” “vulnerability in contrast to well-being,” and “staff mix influencing the care encounter.” The experience of well-being in old cancer patients during hospital admission was absent or challenged when staff did not acknowledge their individual vulnerability and needs.

  2. Exposure to virtual social interactions in the treatment of social anxiety disorder: A randomized controlled trial.

    Science.gov (United States)

    Kampmann, Isabel L; Emmelkamp, Paul M G; Hartanto, Dwi; Brinkman, Willem-Paul; Zijlstra, Bonne J H; Morina, Nexhmedin

    2016-02-01

    This randomized controlled trial investigated the efficacy of a stand-alone virtual reality exposure intervention comprising verbal interaction with virtual humans to target heterogeneous social fears in participants with social anxiety disorder. Sixty participants (Mage = 36.9 years; 63.3% women) diagnosed with social anxiety disorder were randomly assigned to individual virtual reality exposure therapy (VRET), individual in vivo exposure therapy (iVET), or waiting-list. Multilevel regression analyses revealed that both treatment groups improved from pre-to postassessment on social anxiety symptoms, speech duration, perceived stress, and avoidant personality disorder related beliefs when compared to the waiting-list. Participants receiving iVET, but not VRET, improved on fear of negative evaluation, speech performance, general anxiety, depression, and quality of life relative to those on waiting-list. The iVET condition was further superior to the VRET condition regarding decreases in social anxiety symptoms at post- and follow-up assessments, and avoidant personality disorder related beliefs at follow-up. At follow-up, all improvements were significant for iVET. For VRET, only the effect for perceived stress was significant. VRET containing extensive verbal interaction without any cognitive components can effectively reduce complaints of generalized social anxiety disorder. Future technological and psychological improvements of virtual social interactions might further enhance the efficacy of VRET for social anxiety disorder. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. INTERACT

    DEFF Research Database (Denmark)

    Jochum, Elizabeth; Borggreen, Gunhild; Murphey, TD

    This paper considers the impact of visual art and performance on robotics and human-computer interaction and outlines a research project that combines puppetry and live performance with robotics. Kinesics—communication through movement—is the foundation of many theatre and performance traditions...... including puppetry and dance. However, the aesthetics of these traditions vary across cultures and carry different associative and interpretive meanings. Puppetry offers a useful frame for understanding the relationship between abstract and imitative gestures and behavior, and instantiates the complex...... interaction between a human operator and an artificial actor or agent. We can apply insights from puppetry to develop culturally-aware robots. Here we describe the development of a robotic marionette theatre wherein robotic controllers assume the role of human puppeteers. The system has been built, tested...

  4. Interactions

    DEFF Research Database (Denmark)

    The main theme of this anthology is the unique interaction between mathematics, physics and philosophy during the beginning of the 20th century. Seminal theories of modern physics and new fundamental mathematical structures were discovered or formed in this period. Significant physicists such as ......The main theme of this anthology is the unique interaction between mathematics, physics and philosophy during the beginning of the 20th century. Seminal theories of modern physics and new fundamental mathematical structures were discovered or formed in this period. Significant physicists...... such as Lorentz and Einstein as well as mathematicians such as Poincare, Minkowski, Hilbert and Weyl contributed to this development. They created the new physical theories and the mathematical disciplines that play such paramount roles in their mathematical formulations. These physicists and mathematicians were...... also key figures in the philosophical discussions of nature and science - from philosophical tendencies like logical empiricism via critical rationalism to various neo-Kantian trends....

  5. The Intracranial-B2LEED3S Score and the Risk of Intracranial Hemorrhage in Ischemic Stroke Patients Under Antiplatelet Treatment

    NARCIS (Netherlands)

    Amarenco, Pierre; Sissani, Leila; Labreuche, Julien; Vicaut, Eric; Bousser, Marie Germaine; Chamorro, Angel; Fisher, Marc; Ford, Ian; Fox, Kim M; Hennerici, Michael G; Mattle, Heinrich; Rothwell, Peter M; Steg, Philippe Gabriel; Diener, Hans-Christoph; Sacco, Ralph L; Greving, Jacoba P; Algra, Ale

    2017-01-01

    BACKGROUND: Chronic antiplatelet therapy in the post-acute phase of non-cardioembolic ischemic stroke is limited by the risk of intracranial hemorrhage (ICH) complications. METHODS: We developed an ICH risk score based on the PERFORM trial cohort (n = 19,100), which included patients with a

  6. Interaction Structures between a Child and Two Therapists in the Psychodynamic Treatment of a Child with Asperger's Disorder

    Science.gov (United States)

    Goodman, Geoff; Athey-Lloyd, Laura

    2011-01-01

    Leading the charge to link intervention research with clinical practice is the development of process research, which involves a detailed analysis of specific therapeutic processes over the course of treatment. The delineation of interaction structures--repetitive patterns of interactions between patient and therapist over the course of…

  7. Whole plant extracts versus single compounds for the treatment of malaria: synergy and positive interactions

    Directory of Open Access Journals (Sweden)

    Wright Colin W

    2011-03-01

    Full Text Available Abstract Background In traditional medicine whole plants or mixtures of plants are used rather than isolated compounds. There is evidence that crude plant extracts often have greater in vitro or/and in vivo antiplasmodial activity than isolated constituents at an equivalent dose. The aim of this paper is to review positive interactions between components of whole plant extracts, which may explain this. Methods Narrative review. Results There is evidence for several different types of positive interactions between different components of medicinal plants used in the treatment of malaria. Pharmacodynamic synergy has been demonstrated between the Cinchona alkaloids and between various plant extracts traditionally combined. Pharmacokinetic interactions occur, for example between constituents of Artemisia annua tea so that its artemisinin is more rapidly absorbed than the pure drug. Some plant extracts may have an immunomodulatory effect as well as a direct antiplasmodial effect. Several extracts contain multidrug resistance inhibitors, although none of these has been tested clinically in malaria. Some plant constituents are added mainly to attenuate the side-effects of others, for example ginger to prevent nausea. Conclusions More clinical research is needed on all types of interaction between plant constituents. This could include clinical trials of combinations of pure compounds (such as artemisinin + curcumin + piperine and of combinations of herbal remedies (such as Artemisia annua leaves + Curcuma longa root + Piper nigum seeds. The former may enhance the activity of existing pharmaceutical preparations, and the latter may improve the effectiveness of existing herbal remedies for use in remote areas where modern drugs are unavailable.

  8. INTERACT

    DEFF Research Database (Denmark)

    Jochum, Elizabeth; Borggreen, Gunhild; Murphey, TD

    This paper considers the impact of visual art and performance on robotics and human-computer interaction and outlines a research project that combines puppetry and live performance with robotics. Kinesics—communication through movement—is the foundation of many theatre and performance traditions...... including puppetry and dance. However, the aesthetics of these traditions vary across cultures and carry different associative and interpretive meanings. Puppetry offers a useful frame for understanding the relationship between abstract and imitative gestures and behavior, and instantiates the complex...

  9. ABCB1 haplotype and OPRM1 118A > G genotype interaction in methadone maintenance treatment pharmacogenetics

    Directory of Open Access Journals (Sweden)

    Barratt DT

    2012-04-01

    Full Text Available Daniel T Barratt1, Janet K Coller1, Richard Hallinan2, Andrew Byrne2, Jason M White1, David JR Foster3, Andrew A Somogyi1,41Discipline of Pharmacology, School of Medical Sciences, University of Adelaide, Adelaide, South Australia; 2The Byrne Surgery, Specialist Drug and Alcohol Practice, Redfern, New South Wales; 3Division of Health Sciences, Sansom Institute, School of Pharmacy and Medical Sciences, University of South Australia, Adelaide, South Australia; 4Department of Clinical Pharmacology, Royal Adelaide Hospital, Adelaide, South Australia, AustraliaBackground: Genetic variability in ABCB1, encoding the P-glycoprotein efflux transporter, has been linked to altered methadone maintenance treatment dose requirements. However, subsequent studies have indicated that additional environmental or genetic factors may confound ABCB1 pharmacogenetics in different methadone maintenance treatment settings. There is evidence that genetic variability in OPRM1, encoding the mu opioid receptor, and ABCB1 may interact to affect morphine response in opposite ways. This study aimed to examine whether a similar gene-gene interaction occurs for methadone in methadone maintenance treatment.Methods: Opioid-dependent subjects (n = 119 maintained on methadone (15–300 mg/day were genotyped for five single nucleotide polymorphisms of ABCB1 (61A > G; 1199G > A; 1236C > T; 2677G > T; 3435C > T, as well as for the OPRM1 18A > G single nucleotide polymorphism. Subjects’ methadone doses and trough plasma (R-methadone concentrations (Ctrough were compared between ABCB1 haplotypes (with and without controlling for OPRM1 genotype, and between OPRM1 genotypes (with and without controlling for ABCB1 haplotype.Results: Among wild-type OPRM1 subjects, an ABCB1 variant haplotype group (subjects with a wild-type and 61A:1199G:1236C:2677T:3435T haplotype combination, or homozygous for the 61A:1199G:1236C:2677T:3435T haplotype had significantly lower doses (median ± standard

  10. Maxillofacial trauma scoring systems.

    Science.gov (United States)

    Sahni, Vaibhav

    2016-07-01

    The changing complexity of maxillofacial fractures in recent years has created a situation where classical systems of classification of maxillofacial injuries fall short of defining trauma particularly that observed with high-velocity collisions where more than one region of the maxillofacial skeleton is affected. Trauma scoring systems designed specifically for the maxillofacial region are aimed to provide a more accurate assessment of the injury, its prognosis, the possible treatment outcomes, economics, length of hospital stay, and triage. The evolution and logic of such systems along with their merits and demerits are discussed. The author also proposes a new system to aid users in quickly and methodically choosing the system best suited to their needs without having to study a plethora of literature available in order to isolate their choice. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. Aptitude-Treatment Interactions during Creativity Training in E-Learning: How Meaning-Making, Self-Regulation, and Knowledge Management Influence Creativity

    Science.gov (United States)

    Yeh, Yu-chu; Lin, Chun Fu

    2015-01-01

    The goal of aptitude-treatment interactions (ATIs) is to find the interactions between treatments and learners' aptitudes and therefore to achieve optimal learning. This study aimed at understanding whether the aptitudes of meaning-making, self-regulation, and knowledge management (KM) would interact with the treatment of 17-week KM-based training…

  12. Pre-treatment ASPECTS-DWI score has a relation with functional outcome at 3 months following intravenous rt-PA therapy

    International Nuclear Information System (INIS)

    Nezu, Tomohisa; Koga, Masatoshi; Naganuma, Masaki

    2009-01-01

    The clinical importance of early ischemic changes (EIC) on diffusion-weighted imaging (DWI) before recombinant tissue-plasminogen activator (rt-PA) thrombolysis has not been elucidated well. The present study aimed evaluating whether Alberta Stroke Programme Early CT Score (ASPECTS)-DWI before rt-PA therapy could predict chronic independent outcome. Consecutive stroke patients treated with rt-PA from October 2005 through July 2008 were registered from 10 major stroke centers located without regional imbalance in Japan. Before rt-PA IV infusion, we assessed EIC on DWI by using ASPECTS-DWI (11 points). Independent outcome was defined by modified Rankin Scale score (mRS) 0-2 at 3 months after stroke onset. A total of 420 patients (280 men, 71±11 years in age) were studied, and 221 (52.6%) of them were independent (mRS 0-2) at 3 months. The independent patients were younger, had less hypertension and atrial fibrillation, lower baseline National Institutes of Health Stroke Scale (NIHSS) score, higher ASPECTS-DWI, less internal carotid artery occlusion than dependent patients (mRS 3-6, P<0.05 for all). The optimal cutoff score of ASPECTS-DWI to predict independent outcome was ≥7 with a sensitivity of 92% and specificity of 31%, and the area under the receiver-operating characteristic curve was 0.622. After multivariate logistic regression analysis, ASPECTS-DWI ≥7 was independently predictive of an independent outcome at 3 months (odds ratio (OR) 2.78, 95% confidence interval (CI) 1.45-5.49). ASPECTS-DWI before rt-PA therapy is useful to predict patients' chronic functional outcome. (author)

  13. [Interactions between synthetic drugs used in treatment of selected central nervous system disorders and dietary supplements and herbal drugs].

    Science.gov (United States)

    Zabłocka-Słowińska, Katarzyna; Jawna, Katarzyna; Biernat, Jadwiga

    2013-01-01

    The risk of interaction between dietary supplements, herbal drugs and synthetic drugs increases when patients are treated chronically, e.g. due to impairment of central nervous system (CNS)--depression, psychotic disorders, Parkinson's and Alzheimer's diseases. On the basis of scientific literature, there was shown that simultaneous intake of antidepressants, antipsychotic drugs and herbal drugs or dietary supplements containing: St. John's wort, valerian root, ginkgo biloba leaf, hops, and food ingredients: dietary fiber or folic acid, may lead to interactions. Dietary fiber supplementation should be applied carefully during treatment of Parkinson's disease and in case of Alzheimer disease treatment--supplements containing ginkgo biloba leaf can increase the risk of interaction. Knowledge of these interactions is essential in effective treatment of this illness. However this area of science should be verified constantly due to growing number of new products registered as a supplements--often with complex composition.

  14. A treatment of the final-state interaction for photonuclear reactions

    International Nuclear Information System (INIS)

    Eden, J.A.; Thompson, M.N.

    1991-01-01

    The final state interaction is considered for the Gottfried factorized cross section. Numerical examples are presented for the 40 Ca(γ,pn) and 40 Ca(γ,n) reactions. The surface refraction process, allowing photonucleons to refract as they emerge from the nuclear potential well, cannot change the magnitude of the total cross section, but may redistribute the strength in the angular dependence of the differential cross section. The absorption process accounts for the loss of photonucleons as a result of inelastic collisions while escaping the nucleus. The surface refraction correction is calculated in a plane-wave Born approximation and the absorption correction is presented as a simple development of earlier phenomenological treatments. 12 refs., 7 figs

  15. The Role of St Johns Wort (Hypericum Perforatum and Orphanin Interaction on Depression Treatment

    Directory of Open Access Journals (Sweden)

    Sena Yalcin

    2015-12-01

    Full Text Available St. John's Wort (Hypericum perforatum/ Cantarion has been well-studied which has been showed to have antidepressant, antiviral, and antibacterial effects. St Johns Wort gained popularity as an alternative treatment for mild to moderate depression. On the other hand, the neuropeptide, orphanin FQ/nociceptin (OFQ/N, is expressed in both neuronal and non-neuronal tissue. In the brain, OFQ/N has been investigated in relation to stress, anxiety, learning and memory, and addiction. The purpose opf this article is to review the current pharmacological, and clinical papers on St. John's wort, to provide information on orphanin FQ/nociceptin and finally to evaluate probable interaction between two. [Archives Medical Review Journal 2015; 24(4.000: 531-541

  16. Nonlinear PI Control with Adaptive Interaction Algorithm for Multivariable Wastewater Treatment Process

    Directory of Open Access Journals (Sweden)

    S. I. Samsudin

    2014-01-01

    Full Text Available The wastewater treatment plant (WWTP is highly known with the nonlinearity of the control parameters, thus it is difficult to be controlled. In this paper, the enhancement of nonlinear PI controller (ENon-PI to compensate the nonlinearity of the activated sludge WWTP is proposed. The ENon-PI controller is designed by cascading a sector-bounded nonlinear gain to linear PI controller. The rate variation of the nonlinear gain kn is automatically updated based on adaptive interaction algorithm. Initiative to simplify the ENon-PI control structure by adapting kn has been proved by significant improvement under various dynamic influents. More than 30% of integral square error and 14% of integral absolute error are reduced compared to benchmark PI for DO control and nitrate in nitrogen removal control. Better average effluent qualities, less number of effluent violations, and lower aeration energy consumption resulted.

  17. Interactive contour delineation and refinement in treatment planning of image-guided radiation therapy.

    Science.gov (United States)

    Zhou, Wu; Xie, Yaoqin

    2014-01-06

    The accurate contour delineation of the target and/or organs at risk (OAR) is essential in treatment planning for image-guided radiation therapy (IGRT). Although many automatic contour delineation approaches have been proposed, few of them can fulfill the necessities of applications in terms of accuracy and efficiency. Moreover, clinicians would like to analyze the characteristics of regions of interests (ROI) and adjust contours manually during IGRT. Interactive tool for contour delineation is necessary in such cases. In this work, a novel approach of curve fitting for interactive contour delineation is proposed. It allows users to quickly improve contours by a simple mouse click. Initially, a region which contains interesting object is selected in the image, then the program can automatically select important control points from the region boundary, and the method of Hermite cubic curves is used to fit the control points. Hence, the optimized curve can be revised by moving its control points interactively. Meanwhile, several curve fitting methods are presented for the comparison. Finally, in order to improve the accuracy of contour delineation, the process of the curve refinement based on the maximum gradient magnitude is proposed. All the points on the curve are revised automatically towards the positions with maximum gradient magnitude. Experimental results show that Hermite cubic curves and the curve refinement based on the maximum gradient magnitude possess superior performance on the proposed platform in terms of accuracy, robustness, and time calculation. Experimental results of real medical images demonstrate the efficiency, accuracy, and robustness of the proposed process in clinical applications.

  18. Sci—Thur PM: Planning and Delivery — 06: Real-Time Interactive Treatment Planning

    International Nuclear Information System (INIS)

    Matthews, Q; Mestrovic, A; Otto, K

    2014-01-01

    Purpose: To describe and evaluate a novel system for generalized Real-Time Interactive Planning (RTIP) applied to head and neck (H and N) VMAT. Methods: The clinician interactively manipulates dose distributions using DVHs, isodoses, or rate of dose fall-off, which may be subjected to user-defined constraints. Dose is calculated using a fast Achievable Dose Estimate (ADE) algorithm, which simulates the limits of what can be achieved during treatment. After each manipulation contributing fluence elements are modified and the dose distribution updates in effectively real-time. For H and N VMAT planning, structure sets for 11 patients were imported into RTIP. Each dose distribution was interactively modified to minimize OAR dose while constraining target DVHs. The resulting RTIP DVHs were transferred to the Eclipse™ VMAT optimizer, and conventional VMAT optimization was performed. Results: Dose calculation and update times for the ADE algorithm ranged from 2.4 to 22.6 milliseconds, thus facilitating effectively real-time manipulation of dose distributions. For each of the 11 H and N VMAT cases, the RTIP process took ∼2–10 minutes. All RTIP plans exhibited acceptable PTV coverage, mean dose, and max dose. 10 of 11 RTIP plans achieved substantially improved sparing of one or more OARs without compromising dose to targets or other OARs. Importantly, 10 of the 11 RTIP plans required only one or two post-RTIP optimizations. Conclusions: RTIP is a novel system for manipulating and updating achievable dose distributions in real-time. H and N VMAT plans generated using RTIP demonstrate improved OAR sparing and planning efficiency. Disclosures: One author has a commercial interest in the presented materials

  19. Interactive Effect of Parent and Adolescent Psychiatric Symptoms on Substance Use among Adolescents in Community Treatment.

    Science.gov (United States)

    Kelly, Lourah M; Becker, Sara J; Wolff, Jennifer C; Graves, Hannah; Spirito, Anthony

    2017-05-01

    Both adolescent and parent psychiatric symptoms are well-established risk factors for adolescent substance use (SU), but the ways that these symptoms interact are not well understood. This study examined the interactive effects of parent and adolescent psychiatric symptoms on adolescent frequency of alcohol and marijuana use, over and above the effects of parental SU. Seventy adolescents presenting to a community mental health center (CMHC) participated. Parent and adolescent psychiatric symptoms were measured with the brief symptom inventory (BSI) and child behavior checklist (CBCL), respectively. Hierarchical regressions revealed different patterns for adolescent alcohol and marijuana use. For alcohol, the BSI parent phobic anxiety subscale predicted increased adolescent use while the parent interpersonal sensitivity subscale predicted decreased use: the effects of these parental symptoms were strongest among adolescents with higher levels of externalizing problems on the CBCL. For marijuana, the BSI parent psychoticism subscale predicted increased adolescent use, whereas paranoid ideation predicted decreased use. Results suggest that adolescent SU treatment and assessment should attend to both adolescent and parent psychiatric symptoms.

  20. The Interactive Effects of Antisocial Personality Disorder and Court-Mandated Status on Substance Abuse Treatment Dropout

    Science.gov (United States)

    Daughters, Stacey B.; Stipelman, Brooke A.; Sargeant, Marsha N.; Schuster, Randi; Bornovalova, Marina A.; Lejuez, C.W.

    2013-01-01

    The present study sought to examine the interactive effects of court-mandated (CM) treatment and antisocial personality disorder (ASPD) on treatment dropout among 236 inner-city male substance users receiving residential substance abuse treatment through a pretrial release to treatment program. Of the 236 participants, 39.4% (n = 93) met criteria for ASPD and 72.5 % (n = 171) were mandated to treatment by the court system. Results indicated a significant interaction between ASPD and CM status, such that ASPD patients voluntarily receiving treatment were significantly more likely to drop out of treatment than each of the other groups. Subsequent discrete-time survival analyses to predict days until dropout using Cox proportional hazards regression indicated similar findings, with ASPD patients voluntarily receiving treatment completing fewer days of treatment than each of the other groups. These findings suggest the effectiveness of the court system in retaining ASPD patients, as well as the role of ASPD in predicting treatment dropout for individuals who are voluntarily in treatment. Implications are discussed including the potential value of early implementation of specialized interventions aimed at improving adherence for ASPD patients who are receiving treatment voluntarily. PMID:17869050

  1. Which patient and treatment factors are related to successful cardiovascular risk score reduction in general practice? : Results from a randomized controlled trial

    NARCIS (Netherlands)

    Tiessen, Ans H.; Smit, Andries J.; Broer, Jan; Groenier, Klaas H.; Van der Meer, Klaas

    2013-01-01

    Background: Cardiovascular disease is a leading cause of death. It is important to identify patient and treatment factors that are related to successful cardiovascular risk reduction in general practice. This study investigates which patient and treatment factors are related to changes in

  2. Gene x environment interactions in conduct disorder: Implications for future treatments.

    Science.gov (United States)

    Holz, Nathalie E; Zohsel, Katrin; Laucht, Manfred; Banaschewski, Tobias; Hohmann, Sarah; Brandeis, Daniel

    2016-08-18

    Conduct disorder (CD) causes high financial and social costs, not only in affected families but across society, with only moderately effective treatments so far. There is consensus that CD is likely caused by the convergence of many different factors, including genetic and adverse environmental factors. There is ample evidence of gene-environment interactions in the etiology of CD on a behavioral level regarding genetically sensitive designs and candidate gene-driven approaches, most prominently and consistently represented by MAOA. However, conclusive indications of causal GxE patterns are largely lacking. Inconsistent findings, lack of replication and methodological limitations remain a major challenge. Likewise, research addressing the identification of affected brain pathways which reflect plausible biological mechanisms underlying GxE is still very sparse. Future research will have to take multilevel approaches into account, which combine genetic, environmental, epigenetic, personality, neural and hormone perspectives. A better understanding of relevant GxE patterns in the etiology of CD might enable researchers to design customized treatment options (e.g. biofeedback interventions) for specific subgroups of patients. Copyright © 2016 Elsevier Ltd. All rights reserved.

  3. Proposal for evaluating the quality of reports of surgical interventions in the treatment of trigeminal neuralgia: the Surgical Trigeminal Neuralgia Score.

    Science.gov (United States)

    Akram, Harith; Mirza, Bilal; Kitchen, Neil; Zakrzewska, Joanna M

    2013-09-01

    The aim of this study was to design a checklist with a scoring system for reporting on studies of surgical interventions for trigeminal neuralgia (TN) and to validate it by a review of the recent literature. A checklist with a scoring system, the Surgical Trigeminal Neuralgia Score (STNS), was devised partially based on the validated STrengthening the Reporting of OBservational studies in Epidemiology (STROBE) criteria and customized for TN after a literature review and then applied to a series of articles. These articles were identified using a prespecified MEDLINE and Embase search covering the period from 2008 to 2010. Of the 584 articles found, 59 were studies of interventional procedures for TN that fulfilled the inclusion criteria and 56 could be obtained in full. The STNS was then applied independently by 3 of the authors. The maximum STNS came to 30, and was reliable and reproducible when used by the 3 authors who performed the scoring. The range of scores was 6-23.5, with a mean of 14 for all the journals. The impact factor scores of the journals in which the papers were published ranged from 0 to 4.8. Twenty-four of the studies were published in the Journal of Neurosurgery or in Neurosurgery. Studies published in neurosurgical journals ranked higher on the STNS scale than those published in nonneurosurgical journals. There was no statistically significant correlation between STNS and impact factors. Stereotactic radiosurgery (n = 25) and microvascular decompression (n = 15) were the most commonly reported procedures. The diagnostic criteria were stated in 35% of the studies, and 4 studies reported subtypes of TN. An increasing number of studies (46%) used the recommended Kaplan-Meier methodology for pain survival outcomes. The follow-up period was unclear in 8 studies, and 26 reported follow-ups of more than 5 years. Complications were reported fairly consistently but the temporal course was not always indicated. Direct interview, telephone conversation

  4. Explicit treatment of active-site waters enhances quantum mechanical/implicit solvent scoring: Inhibition of CDK2 by new pyrazolo[1,5-a]pyrimidines

    Czech Academy of Sciences Publication Activity Database

    Hylsová, M.; Carbain, B.; Fanfrlík, Jindřich; Musilová, L.; Haldar, Susanta; Köprülüoglu, Cemal; Ajani, Haresh; Brahmkshatriya, Pathik; Jorda, Radek; Kryštof, Vladimír; Hobza, Pavel; Echalier, A.; Paruch, K.; Lepšík, Martin

    2017-01-01

    Roč. 126, Jan 27 (2017), s. 1118-1128 ISSN 0223-5234 R&D Projects: GA ČR(CZ) GA15-15264S; GA ČR(CZ) GBP208/12/G016 Institutional support: RVO:61388963 ; RVO:61389030 Keywords : cyclin-dependent kinase 2 * ATP-competitive type I inhibitors * pyrazolo[1,5-a]pyrimidine * quantum mechanical scoring * protein-ligand binding * molecular dynamics Subject RIV: CC - Organic Chemistry OBOR OECD: Organic chemistry Impact factor: 4.519, year: 2016

  5. Interaction of acupuncture treatment and manipulation laterality modulated by the default mode network.

    Science.gov (United States)

    Niu, Xuan; Zhang, Ming; Liu, Zhenyu; Bai, Lijun; Sun, Chuanzhu; Wang, Shan; Wang, Xiaocui; Chen, Zhen; Chen, Hongyan; Tian, Jie

    2017-01-01

    Appropriate selection of ipsilateral or contralateral electroacupuncture (corresponding to the pain site) plays an important role in reaching its better curative effect; however, the involving brain mechanism still remains unclear. Compared with the heat pain model generally established in previous study, capsaicin pain model induces reversible cutaneous allodynia and is proved to be better simulating aspects of clinical nociceptive and neuropathic pain. In the current study, 24 subjects were randomly divided into two groups with a 2 × 2 factorial design: laterality (ipsi- or contralateral side, inter-subject) × treatment with counter-balanced at an interval of one week (verum and placebo electroacupuncture, within-subject). We observed subjective pain intensity and brain activations changes induced by capsaicin allodynia pain stimuli before and after electroacupuncture treatment at acupoint LI4 for 30 min. Analysis of variance results indicated that ipsilateral electroacupuncture treatment produced significant pain relief and wide brain signal suppressions in pain-related brain areas compared with contralateral electroacupuncture. We also found that verum electroacupuncture at either ipsi- or contralateral side to the pain site exhibited comparable significant magnitudes of analgesic effect. By contrast, placebo electroacupuncture elicited significant pain reductions only on the ipsilateral rather than contralateral side. It was inferred that placebo analgesia maybe attenuated on the region of the body (opposite to pain site) where attention was less focused, suggesting that analgesic effect of placebo electroacupuncture mainly rely on the motivation of its spatial-specific placebo responses via attention mechanism. This inference can be further supported by the evidence that the significant interaction effect of manipulation laterality and treatment was exclusively located within the default mode network, including the bilateral superior parietal

  6. BrachyTPS -Interactive point kernel code package for brachytherapy treatment planning of gynaecological cancers

    International Nuclear Information System (INIS)

    Thilagam, L.; Subbaiah, K.V.

    2008-01-01

    Brachytherapy treatment planning systems (TPS) are always recommended to account for the effect of tissue, applicator and shielding material heterogeneities exist in Intracavitary brachytherapy (ICBT) applicators. Most of the commercially available brachytherapy TPS softwares estimate the absorbed dose at a point, only taking care of the contributions of individual sources and the source distribution, neglecting the dose perturbations arising from the applicator design and construction. So the doses estimated by them are not much accurate under realistic clinical conditions. In this regard, interactive point kernel rode (BrachyTPS) has been developed to perform independent dose calculations by taking into account the effect of these heterogeneities, using two regions build up factors, proposed by Kalos. As primary input data, the code takes patients' planning data including the source specifications, dwell positions, dwell times and it computes the doses at reference points by dose point kernel formalisms, with multi-layer shield build-up factors accounting for the contributions from scattered radiation. In addition to performing dose distribution calculations, this code package is capable of displaying an isodose distribution curve into the patient anatomy images. The primary aim of this study is to validate the developed point kernel code integrated with treatment planning systems against the other tools which are available in the market. In the present work, three brachytherapy applicators commonly used in the treatment of uterine cervical carcinoma, Board of Radiation Isotope and Technology (BRIT) made low dose rate (LDR) applicator, Fletcher Green type LDR applicator and Fletcher Williamson high dose rate (HDR) applicator were studied to test the accuracy of the software

  7. An interactive beam-weight optimization tool for three-dimensional radiotherapy treatment planning

    International Nuclear Information System (INIS)

    Burba, S.; Gardey, K.; Nadobny, J.; Stalling, D.; Seebass, M.; Beier, J.; Wust, P.; Budach, V.; Felix, R.

    1997-01-01

    that the beam configuration is inappropriate. Possible reasons for this may be that part of the target volume may have been missed by one or more beams, or there may have been excessive beam overlap. The beam-weight optimization tool can then be used to warn the treatment planner of this occurrence, thus avoiding excessive planner time in attempting to find an acceptable solution. In addition the possibilities of the three-dimensional representation of dose distribution offered by the high-performance visualization workstation could be combined with the first attempt at a feasibility search for enhancing the degree of interactive optimization of treatment planning. Conclusions: We have demonstrated how a beam-weight optimization tool can be incorporated into a treatment planning system offering plenty of visualization tools for realizing virtual therapy planning. Further software development is required with respect to the acceleration of calculation time, the implication of borderline cases and the inclusion of further biological and clinical relevant parameters according to the definition of further objective functions. The software tools developed up to now constitute the basis for the development of an alternative voxel oriented mathematical formulation of inverse treatment planning for optimizing conformation therapy

  8. [The Psychoanalytic-interactional Method (PIM): A Psychodynamic Treatment for Adolescents with Severe Disorders of Personality Functioning].

    Science.gov (United States)

    Cropp, Carola

    2017-07-01

    The Psychoanalytic-interactional Method (PIM): A Psychodynamic Treatment for Adolescents with Severe Disorders of Personality Functioning The psychoanalytic-interactional method (PIM) was developed as a psychodynamic treatment for adult patients with severe disorders of personality functioning (Streeck u. Leichsenring, 2015). However, it is also well suited for the treatment of adolescent patients because its techniques fit with specific conditions of adolescence. A modified version of the PIM for adolescents (Streeck-Fischer, Cropp, Streeck, Salzer, 2016) has proven to be efficacious. The paper describes the basic principles of the PIM and names aspects that have to be taken into account in the treatment of adolescents with severe disorders of personality functioning. Finally, previous empirical results regarding the PIM treatment in adolescence are presented.

  9. Changes in subclinical organ damage vs. in Framingham risk score for assessing cardiovascular risk reduction during continued antihypertensive treatment: a LIFE substudy

    DEFF Research Database (Denmark)

    Olsen, Michael H; Wachtell, Kristian; Ibsen, Hans

    2011-01-01

    To investigate whether in-treatment measurements of subclinical organ damage (SOD) assessed by elevated urine albumin/creatinine ratio (UACR) or electrocardiographic left ventricular hypertrophy improved the prediction of the composite cardiovascular endpoint of cardiovascular death, nonfatal...

  10. Measuring patients’ satisfaction with their anti-TNF treatment in severe Crohn’s disease: scoring and psychometric validation of the Satisfaction for PAtients in Crohn’s diseasE Questionnaire (SPACE-Q©

    Directory of Open Access Journals (Sweden)

    Gilet H

    2014-12-01

    Full Text Available Hélène Gilet,1 Benoit Arnould,1 Fatoumata Fofana,1 Pierre Clerson,2 Jean-Frédéric Colombel,10 Olivier D’Hondt,2 Patrick Faure,4 Hervé Hagège,5 Maria Nachury,3 Stéphane Nahon,6 Gilbert Tucat,7 Luc Vandromme,8 Ines Cazala-Telinge,9 Emmanuel Thibout9 1HEOR and Strategic Market Access, Mapi, Lyon, France; 2Orgamétrie, Roubaix, France; 3Hôpital Claude Huriez, Lille, France; 4Clinique Saint-Jean du Languedoc, Toulouse, France; 5Centre Hospitalier Intercommunal, Créteil, France; 6Centre Hospitalier Intercommunal, Le Raincy Montfermeil, France; 7Gastroenterologist, Private Clinical Practice, Paris, France; 8Gastroenterologist, Private Clinical Practice, Reims, France; 9Abbvie France, Rungis, France; 10Icahn School of Medicine at Mount Sinai, New York, NY, USA Background: Severe Crohn’s disease management includes anti-tumor necrosis factor (anti-TNF drugs that differ from early-stage treatments regarding efficacy, safety, and convenience. This study aimed to finalize and psychometrically validate the Satisfaction for PAtients in Crohn’s diseasE Questionnaire (SPACE-Q©, developed to measure satisfaction with anti-TNF treatment in patients with severe Crohn’s disease. Methods: A total of 279 patients with severe Crohn’s disease receiving anti-TNF therapy completed the SPACE-Q 62-item pilot version at inclusion and 12 and 13 weeks after first anti-TNF injection. The final SPACE-Q scoring was defined using multitrait and regression analyses and clinical relevance considerations. Psychometric validation included clinical validity against Harvey–Bradshaw score, concurrent validity against Treatment Satisfaction Questionnaire for Medication (TSQM, internal consistency reliability, test–retest reliability, and responsiveness against the patient global impression of change (PGIC.Results: Quality of completion was good (55%–67% of patients completed all items. Four items were removed from the questionnaire. Eleven scores were defined

  11. Effects of insulin pump vs. injection treatment on quality of life and impact of disease scores in children with type 1 diabetes mellitus in a randomised, prospective comparison

    NARCIS (Netherlands)

    Nuboer, R.; Borsboom, G.J.J.M.; Zoethout, J.A.; Koot, H.M.; Bruining, G.J.

    2008-01-01

    Objective: Effects of pump treatment vs. four times daily injections were explored in children with diabetes with regard to quality of life and impact of disease as well as adverse effects and parameters of metabolic control. Methods: An open, parallel, randomized controlled prospective comparative

  12. Improved darunavir genotypic mutation score predicting treatment response for patients infected with HIV-1 subtype B and non-subtype B receiving a salvage regimen

    DEFF Research Database (Denmark)

    De Luca, Andrea; Flandre, Philippe; Dunn, David

    2016-01-01

    OBJECTIVES: The objective of this study was to improve the prediction of the impact of HIV-1 protease mutations in different viral subtypes on virological response to darunavir. METHODS: Darunavir-containing treatment change episodes (TCEs) in patients previously failing PIs were selected from la...

  13. Progressive Improvement of T-Scores in Men with Osteoporosis and Subnormal Serum Testosterone Levels upon Treatment with Testosterone over Six Years

    NARCIS (Netherlands)

    Haider, A.; Meergans, U.; Traish, A.; Saad, F.; Doros, G.; Lips, P.T.A.M.; Gooren, L.

    2014-01-01

    Testosterone deficiency leads to bone loss and testosterone treatment has a beneficial effect. This study investigated the effects of normalizing serum testosterone on bone mineral density in 45 men with osteoporosis, diagnosed with testosterone deficiency (serum testosterone levels <12.1 nmol/L,

  14. Tumor-immune interaction, surgical treatment, and cancer recurrence in a mathematical model of melanoma.

    Directory of Open Access Journals (Sweden)

    Steffen Eikenberry

    2009-04-01

    Full Text Available Malignant melanoma is a cancer of the skin arising in the melanocytes. We present a mathematical model of melanoma invasion into healthy tissue with an immune response. We use this model as a framework with which to investigate primary tumor invasion and treatment by surgical excision. We observe that the presence of immune cells can destroy tumors, hold them to minimal expansion, or, through the production of angiogenic factors, induce tumorigenic expansion. We also find that the tumor-immune system dynamic is critically important in determining the likelihood and extent of tumor regrowth following resection. We find that small metastatic lesions distal to the primary tumor mass can be held to a minimal size via the immune interaction with the larger primary tumor. Numerical experiments further suggest that metastatic disease is optimally suppressed by immune activation when the primary tumor is moderately, rather than minimally, metastatic. Furthermore, satellite lesions can become aggressively tumorigenic upon removal of the primary tumor and its associated immune tissue. This can lead to recurrence where total cancer mass increases more quickly than in primary tumor invasion, representing a clinically more dangerous disease state. These results are in line with clinical case studies involving resection of a primary melanoma followed by recurrence in local metastases.

  15. Study of plasma-material surface interaction using Langmuir probe technique during plasma treatment

    International Nuclear Information System (INIS)

    Saloum, S.; Akel, M.

    2009-06-01

    In this study, we tried to understand the plasma-surface interactions by using Langmuir probes. Two different types of plasmas were studied, the first is the electropositive plasma in Argon and the second is the electronegative plasma in Sulfur Hexafluoride. In the first type, the effects of Argon gas pressure, the injection of Helium in the remote zone and the substrate bias on the measurements of the Electron Energy Probability Function (EEPF) and on the plasma parameters (electron density (n e ), effective electron temperature (T e ff), plasma potential (V p ) and floating potential (V f )) have been investigated. The obtained EEPFs and plasma parameters have been used to control two remote plasma processes. The first is the remote Plasma Enhanced Chemical Vapor Deposition (PE-CVD) of thin films, on silicon wafers, from Hexamethyldisoloxane (HMDSO) precursor diluted in the remote Ar-He plasma. The second is the pure Argon remote plasma treatment of polymethylmethacrylate (PMMA) polymer surface. In the second type, the plasma diagnostics were performed in the remote zone as a function of SF 6 flow rate, where relative concentrations of fluorine atoms were measured using actinometry optical emission spectroscopy; electron density, electron temperature and plasma potential were determined using single cylindrical Langmuir probe, positive ion flux and negative ion fraction were determined using an planar probe. The silicon etching process in SF 6 plasma was studied. (author)

  16. Survey of methadone-drug interactions among patients of methadone maintenance treatment program in Taiwan

    Science.gov (United States)

    2012-01-01

    Background Although methadone has been used for the maintenance treatment of opioid dependence for decades, it was not introduced in China or Taiwan until 2000s. Methadone-drug interactions (MDIs) have been shown to cause many adverse effects. However, such effects have not been scrutinized in the ethnic Chinese community. Methods The study was performed in two major hospitals in southern Taiwan. A total of 178 non-HIV patients aged ≥ 20 years who had participated in the Methadone Maintenance Treatment Program (MMTP) ≥ 1 month were recruited. An MDI is defined as concurrent use of drug(s) with methadone that may result in an increase or decrease of effectiveness and/or adverse effect of methadone. To determine the prevalence and clinical characteristics of MDIs, credible data sources, including the National Health Insurance (NHI) database, face-to-face interviews, medical records, and methadone computer databases, were linked for analysis. Socio-demographic and clinical factors associated with MDIs and co-medications were also examined. Results 128 (72%) MMTP patients took at least one medication. Clinically significant MDIs included withdrawal symptoms, which were found among MMTP patients co-administered with buprenorphine or tramadol; severe QTc prolongation effect, which might be associated with use of haloperidol or droperidol; and additive CNS and respiratory depression, which could result from use of methadone in combination with chlorpromazine or thioridazine. Past amphetamine use, co-infection with hepatitis C, and a longer retention in the MMTP were associated with increased odds of co-medication. Among patients with co-medication use, significant correlates of MDIs included the male gender and length of co-medication in the MMTP. Conclusions The results demonstrate clinical evidence of significant MDIs among MMTP patients. Clinicians should check the past medical history of MMTP clients carefully before prescribing medicines. Because combinations of

  17. Survey of methadone-drug interactions among patients of methadone maintenance treatment program in Taiwan

    Directory of Open Access Journals (Sweden)

    Lee Hsin-Ya

    2012-03-01

    Full Text Available Abstract Background Although methadone has been used for the maintenance treatment of opioid dependence for decades, it was not introduced in China or Taiwan until 2000s. Methadone-drug interactions (MDIs have been shown to cause many adverse effects. However, such effects have not been scrutinized in the ethnic Chinese community. Methods The study was performed in two major hospitals in southern Taiwan. A total of 178 non-HIV patients aged ≥ 20 years who had participated in the Methadone Maintenance Treatment Program (MMTP ≥ 1 month were recruited. An MDI is defined as concurrent use of drug(s with methadone that may result in an increase or decrease of effectiveness and/or adverse effect of methadone. To determine the prevalence and clinical characteristics of MDIs, credible data sources, including the National Health Insurance (NHI database, face-to-face interviews, medical records, and methadone computer databases, were linked for analysis. Socio-demographic and clinical factors associated with MDIs and co-medications were also examined. Results 128 (72% MMTP patients took at least one medication. Clinically significant MDIs included withdrawal symptoms, which were found among MMTP patients co-administered with buprenorphine or tramadol; severe QTc prolongation effect, which might be associated with use of haloperidol or droperidol; and additive CNS and respiratory depression, which could result from use of methadone in combination with chlorpromazine or thioridazine. Past amphetamine use, co-infection with hepatitis C, and a longer retention in the MMTP were associated with increased odds of co-medication. Among patients with co-medication use, significant correlates of MDIs included the male gender and length of co-medication in the MMTP. Conclusions The results demonstrate clinical evidence of significant MDIs among MMTP patients. Clinicians should check the past medical history of MMTP clients carefully before prescribing medicines

  18. Comparison of outcome and cost among open, laparoscopic, and robotic surgical treatments for rectal cancer: A propensity score matched analysis of nationwide inpatient sample data.

    Science.gov (United States)

    Chen, Szu-Ta; Wu, Meng-Che; Hsu, Tzu-Chun; Yen, Debra W; Chang, Chia-Na; Hsu, Wan-Ting; Wang, Chia-Chun; Lee, Matthew; Liu, Shing-Hwa; Lee, Chien-Chang

    2018-03-01

    Population-based studies evaluating outcomes of different approaches for rectal cancer are scarce. We conducted a retrospective cohort study using the Nationwide Inpatient Sample database between 2008 and 2012. We compared the outcomes and costs among rectal cancer patients undergoing robotic, laparoscopic, or open surgeries using propensity scores for adjusted and matched analysis. We identified 194 957 rectal cancer patients. Over the 5-year period, the annual admission number decreased by 13.9%, the in-hospital mortality rate decreased by 32.2%, while the total hospitalization cost increased by 13.6%. Compared with laparoscopic surgery, robotic surgery had significantly lower length of stay (LOS) (OR 0.69, 95%CI 0.57-0.84), comparable wound complications (OR 1.08, 95%CI 0.70-1.65) and higher cost (OR 1.42, 95%CI 1.13-1.79), while open surgery had significantly longer LOS (OR 1.38, 95%CI 1.19-1.59), more wound complications (OR 1.49, 95%CI 1.08-1.79), and comparable cost (OR 0.92, 95%CI 0.79-1.07). There were no difference in in-hospital mortality among three approaches. Laparoscopic surgery was associated with better outcomes than open surgery. Robotic surgery was associated with higher cost, but no advantage over laparoscopic surgery in terms of mortality and complications. Studies on cost-effectiveness of robotic surgery may be warranted. © 2017 Wiley Periodicals, Inc.

  19. Histologic Appearance After Preoperative Radiation Therapy for Soft Tissue Sarcoma: Assessment of the European Organization for Research and Treatment of Cancer-Soft Tissue and Bone Sarcoma Group Response Score.

    Science.gov (United States)

    Schaefer, Inga-Marie; Hornick, Jason L; Barysauskas, Constance M; Raut, Chandrajit P; Patel, Sagar A; Royce, Trevor J; Fletcher, Christopher D M; Baldini, Elizabeth H

    2017-06-01

    To critically assess the prognostic value of the European Organization for Research and Treatment of Cancer-Soft Tissue and Bone Sarcoma Group (EORTC-STBSG) response score and define histologic appearance after preoperative radiation therapy (RT) for soft tissue sarcoma (STS). For a cohort of 100 patients with STS of the extremity/trunk treated at our institution with preoperative RT followed by resection, 2 expert sarcoma pathologists evaluated the resected specimens for percent residual viable cells, necrosis, hyalinization/fibrosis, and infarction. The EORTC response score and other predictors of recurrence-free survival (RFS) and overall survival (OS) were assessed by Kaplan-Meier and proportional hazard models. Median tumor size was 7.5 cm; 92% were intermediate or high grade. Most common histologies were unclassified sarcoma (34%) and myxofibrosarcoma (25%). Median follow-up was 60 months. The 5-year local recurrence rate was 5%, 5-year RFS was 68%, and 5-year OS was 75%. Distribution of cases according to EORTC response score tiers was as follows: no residual viable tumor for 9 cases (9% pathologic complete response); <1% viable tumor for 0, ≥1% to <10% for 9, ≥10% to <50% for 44, and ≥50% for 38. There was no association between EORTC-STBSG response score and RFS or OS. Conversely, hyalinization/fibrosis was a significant independent favorable predictor for RFS (hazard ratio 0.49, P=.007) and OS (hazard ratio 0.36, P=.02). Histologic evaluation after preoperative RT for STS showed a 9% pathologic complete response rate. The EORTC-STBSG response score and percent viable cells were not prognostic. Hyalinization/fibrosis was associated with favorable outcome, and if validated, may become a valid endpoint for neoadjuvant trials. Copyright © 2017 Elsevier Inc. All rights reserved.

  20. Histologic Appearance After Preoperative Radiation Therapy for Soft Tissue Sarcoma: Assessment of the European Organization for Research and Treatment of Cancer–Soft Tissue and Bone Sarcoma Group Response Score

    Energy Technology Data Exchange (ETDEWEB)

    Schaefer, Inga-Marie; Hornick, Jason L. [Department of Pathology, Brigham and Women' s Hospital, Harvard Medical School, Boston, Massachusetts (United States); Barysauskas, Constance M. [Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts (United States); Raut, Chandrajit P. [Division of Surgical Oncology, Brigham and Women' s Hospital, Harvard Medical School, Boston, Massachusetts (United States); Center for Sarcoma and Bone Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts (United States); Patel, Sagar A.; Royce, Trevor J. [Department of Radiation Oncology, Brigham and Women' s Hospital, Harvard Medical School, Boston, Massachusetts (United States); Fletcher, Christopher D.M. [Department of Pathology, Brigham and Women' s Hospital, Harvard Medical School, Boston, Massachusetts (United States); Baldini, Elizabeth H., E-mail: ebaldini@partners.org [Center for Sarcoma and Bone Oncology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, Massachusetts (United States); Department of Radiation Oncology, Brigham and Women' s Hospital, Harvard Medical School, Boston, Massachusetts (United States)

    2017-06-01

    Purpose: To critically assess the prognostic value of the European Organization for Research and Treatment of Cancer–Soft Tissue and Bone Sarcoma Group (EORTC-STBSG) response score and define histologic appearance after preoperative radiation therapy (RT) for soft tissue sarcoma (STS). Methods and Materials: For a cohort of 100 patients with STS of the extremity/trunk treated at our institution with preoperative RT followed by resection, 2 expert sarcoma pathologists evaluated the resected specimens for percent residual viable cells, necrosis, hyalinization/fibrosis, and infarction. The EORTC response score and other predictors of recurrence-free survival (RFS) and overall survival (OS) were assessed by Kaplan-Meier and proportional hazard models. Results: Median tumor size was 7.5 cm; 92% were intermediate or high grade. Most common histologies were unclassified sarcoma (34%) and myxofibrosarcoma (25%). Median follow-up was 60 months. The 5-year local recurrence rate was 5%, 5-year RFS was 68%, and 5-year OS was 75%. Distribution of cases according to EORTC response score tiers was as follows: no residual viable tumor for 9 cases (9% pathologic complete response); <1% viable tumor for 0, ≥1% to <10% for 9, ≥10% to <50% for 44, and ≥50% for 38. There was no association between EORTC-STBSG response score and RFS or OS. Conversely, hyalinization/fibrosis was a significant independent favorable predictor for RFS (hazard ratio 0.49, P=.007) and OS (hazard ratio 0.36, P=.02). Conclusion: Histologic evaluation after preoperative RT for STS showed a 9% pathologic complete response rate. The EORTC-STBSG response score and percent viable cells were not prognostic. Hyalinization/fibrosis was associated with favorable outcome, and if validated, may become a valid endpoint for neoadjuvant trials.

  1. A Novel Murine Candidiasis Model with Severe Colonization in the Stomach Induced by N-acetylglucosamine-treatment and Its Scoring System Based on Local Characteristic Stomach Symptoms.

    Science.gov (United States)

    Ishijima, Sanae A; Abe, Shigeru

    2015-01-01

    We developed a novel murine candidiasis model of the gastrointestinal tract using N-acetylglucosamine ( GlcNAc ) as a tool to aggravate symptoms. Forty-eight hours after intragastrically inoculating Candida albicans cells to immunosuppressed and GlcNAc-treated mice, vigorously accumulating patchy whitish plaques were observed on their inner stomach surface. Candida cells colonizing the plaques consisted of both yeast and mycelia, and were directly stained with Calcofluor White M2R. Aggravation of the candidiasis symptoms was dependent on GlcNAc concentration in drinking water, wherein administration of 50 mM GlcNAc not only severely worsened stomach symptoms, but also significantly increased Candida cell number in the stomach and small intestine. The aggravation effect of GlcNAc was enhanced by addition of sedative chemical chlorpromazine chloride after inoculation. In order to semi-quantitatively assess colonization by Candida in the stomach, we devised a new symptom scoring system that represents the extent of the patchy whitish plaques on the mucosal epithelium of the stomach. Histochemical analysis of Candida-infected tissues revealed not only a large amount of thick Candida mycelia invading mucosal epithelial stomach tissues but also infiltrating inflammatory cells. These results suggest that this murine gastrointestinal candidiasis model could serve as a useful tool for evaluating the protective activity of antifungal agents, probiotics, or functional foods against gastrointestinal candidiasis. Furthermore, from another point of view, this novel murine model could also be used to analyze the pathological mechanisms behind the translocation of C. albicans across intestinal barriers, which results in systemic Candida dissemination and infection.

  2. Counselor Nonverbal Self-Disclosure and Fear of Intimacy during Employment Counseling: An Aptitude-Treatment Interaction Illustration

    Science.gov (United States)

    Carrein, Cindy; Bernaud, Jean-Luc

    2010-01-01

    This study investigated the effects of nonverbal self-disclosure within the dynamic of aptitude-treatment interaction. Participants (N = 94) watched a video of a career counseling session aimed at helping the jobseeker to find employment. The video was then edited to display 3 varying degrees of nonverbal self-disclosure. In conjunction with the…

  3. 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.

  4. South African Scoring System

    African Journals Online (AJOL)

    2014-11-18

    Nov 18, 2014 ... suitability of the rapid macroinvertebrate biomonitoring tool (the South African Scoring System) was investigated by determining the ... for 80% (SASS score) and 75% (NOT) of the variation in the regression model. Consequently ... et al., 2012), while settled sediments can alter habitat (Wood and Armitage ...

  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. Syncope diagnostic scores.

    Science.gov (United States)

    Sheldon, Robert

    2013-01-01

    The diagnosis of syncope poses unique challenges. Syncope has multiple etiologies, with most carrying benign prognoses, and a few less common causes carrying a risk of serious morbidity or death. The history at first glance carries few clues. Faced with this many patients are heavily investigated with tests known to be both useless and expensive. For these reasons considerable emphasis has been placed on developing evidence-based and quantitative histories that might distinguish among the main causes of syncope. Quantitative histories were first developed in populations of several hundred patients with definite diagnoses of various losses of consciousness. Their derivation and use mirror those of experienced clinicians. The first score - the Calgary Syncope Seizures Score - discriminates between epileptic convulsions and syncope with a sensitivity and specificity of about 94%. The second score, the Calgary Syncope Score for normal hearts, discriminates between vasovagal syncope and other causes of syncope with a sensitivity and specificity of about 90%. The third score, the Calgary Syncope Score for Structural Heart Disease, diagnoses ventricular tachycardia with 98% sensitivity and 71% specificity. It also accurately predicts serious arrhythmic outcomes and all cause death. Gaps in the accuracy of the second score have been identified and are being addressed. These scores are proving useful in the clinic, and as entry criteria for observation studies, genetic studies, and randomized clinical trials. A very simple score predicts vasovagal syncope recurrences, based on the number of faints in the preceding year. Work from several centres indicates that scores will distinguish among competing causes of syncope in select populations, such as those with bifascicular heart block, Brugada syndrome, and Long QT syndrome. Copyright © 2013 Elsevier Inc. All rights reserved.

  7. Development of the siriraj clinical asthma score.

    Science.gov (United States)

    Vichyanond, Pakit; Veskitkul, Jittima; Rienmanee, Nuanphong; Pacharn, Punchama; Jirapongsananuruk, Orathai; Visitsunthorn, Nualanong

    2013-09-01

    Acute asthmatic attack in children commonly occurs despite the introduction of effective controllers such as inhaled corticosteroids and leukotriene modifiers. Treatment of acute asthmatic attack requires proper evaluation of attack severity and appropriate selection of medical therapy. In children, measurement of lung function is difficult during acute attack and thus clinical asthma scoring may aid physician in making further decision regarding treatment and admission. We enrolled 70 children with acute asthmatic attack with age range from 1 to 12 years (mean ± SD = 51.5 ± 31.8 months) into the study. Twelve selected asthma severity items were assessed by 2 independent observers prior to administration of salbutamol nebulization (up to 3 doses at 20 minutes interval). Decision for further therapy and admission was made by emergency department physician. Three different scoring systems were constructed from items with best validity. Sensitivity, specificity and accuracy of these scores were assessed. Inter-rater reliability was assessed for each score. Review of previous scoring systems was also conducted and reported. Three severity items had poor validity, i.e., cyanosis, depressed cerebral function, and I:E ratio (p > 0.05). Three items had poor inter-rater reliability, i.e., breath sound quality, air entry, and I:E ratio. These items were omitted and three new clinical scores were constructed from the remaining items. Clinical scoring system comprised retractions, dyspnea, O2 saturation, respiratory rate and wheezing (rangeof score 0-10) gave the best accuracy and inter-rater variability and were chosen for clinical use-Siriraj Clinical Asthma Score (SCAS). A Clinical Asthma Score that is simple, relatively easy to administer and with good validity and variability is essential for treatment of acute asthma in children. Several good candidate scores have been introduced in the past. We described the development of the Siriraj Clinical Asthma Score (SCAS) in

  8. Hyperspherical Treatment of Strongly-Interacting Few-Fermion Systems in One Dimension

    DEFF Research Database (Denmark)

    Volosniev, A. G.; Fedorov, D. V.; Jensen, A. S.

    2015-01-01

    We examine a one-dimensional two-component fermionic system in a trap, assuming that all particles have the same mass and interact through a strong repulsive zero-range force. First we show how a simple system of three strongly interacting particles in a harmonic trap can be treated using...

  9. The relationship between observer-based toxicity scoring and patient assessed symptom severity after treatment for head and neck cancer. A correlative cross sectional study of the DAHANCA toxicity scoring system      and the EORTC quality of life questionnaires

    DEFF Research Database (Denmark)

    Jensen, Kenneth; Jensen, Anders Bonde; Grau, Cai

    2006-01-01

    BACKGROUND AND PURPOSE: Morbidity is an important issue in cancer       research. The observer-based toxicity scoring system used by DAHANCA (the       Danish head and neck cancer study group) has proved itself sensitive to       differences in toxicity in a large randomised study, but like other......       toxicity scoring systems it has not been formally validated. Conversely,       the EORTC quality of life questionnaire (QLQ) has been validated as a tool       for collecting information about the consequences of disease and treatment       on the well being of cancer patients. The purpose of this study...... was to       examine the relationship between the two methods of side effect recording.       PATIENTS AND METHODS: One hundred and sixteen recurrence free patients       with laryngeal (n=44), pharyngeal (n=34) and oral cavity (n=38) cancer       attending follow-up after radiotherapy (n=83) or surgery (n=33...

  10. The Comparison of Effectiveness of Applied Behavioral Analysis and Treatment-Education Approach on Stereotyped Behavior, Interactional and Communicational Problems in Autistic Children

    Directory of Open Access Journals (Sweden)

    Hossein Ghamari-Givi

    2012-10-01

    Full Text Available Objective: The aim of this study was to consider the effectiveness of Applied Behavioral Analysis (ABA therapy and Treatment and Education of Autistic and related Communication handicapped children (TEACCH on stereotyped behavior, interactional and communicational problems in the autistic Children. Materials & Methods: Subjects of this experimental study were all of children in Tabriz autism school in second half of year 1388. Sample size was 29 children (21 boys and 8 girls in age range of 6-14 who were selected using random sampling method and were placed in Applied Behavioral Analysis group (8 boys and 2 girls, Treatment- Education group (9 boys and 1 girl, and control group (4 boys and 5 girls. The two scales applied for the study were Modified Checklist for Autism in Toddlers and Gilliam Autism Rating Scale. The data were analyzed using analysis of covariance. Results: The results of the research showed that the means of behavioral problem indicators in both ABA and TEACCH methods were reduced significantly in comparison with control group (P<0.01. Also in comparison of ABA therapy and TEACCH method, decline in the mean scores of communication problems was significant and in favour of ABA therapy (P<0.05. Conclusion: According to the results of study, although both ABA therapy and TEACCH method were effective in reducing symptoms of behavioral problems but because of being more effective, Applied Behavioral Analysis is suggested as a selective therapeutic approach for this research.

  11. A LONG-TERM FOLLOW-UP STUDY OF A RANDOMIZED CONTROLLED TRIAL OF MOTHER-INFANT PSYCHOANALYTIC TREATMENT: OUTCOMES ON MOTHERS AND INTERACTIONS.

    Science.gov (United States)

    Salomonsson, Majlis Winberg; Sorjonen, Kimmo; Salomonsson, Björn

    2015-01-01

    An earlier randomized controlled trial (RCT) compared 80 mother-infant dyads in a Stockholm sample. One had received mother-infant psychoanalytic treatment [mother-infant psychoanalytic therapies (MIP) group], and the other received Child Health Center care (CHCC group). Effects were found on mother-reported depression and expert-rated mother-infant relationship qualities and maternal sensitivity. When the children were 412 years, the dyads were followed up with assessments of the children's attachment representations, social and emotional development, and global functioning, and the mothers' psychological well-being and representations of the child as well as the mother-child interactions. We gathered data from 66 cases approximately 312 years' posttreatment. All scores involving the mothers had now approached community levels. We found effects on maternal depression in favor of MIP, but no other between-group differences. The MIP treatments seemed to have helped the mothers to recover more quickly on personal well-being, to become more sensitive to their babies' suffering, and to better support and appreciate their children throughout infancy and toddlerhood. If so, this would explain why the MIP children had a better global functioning and were more often "OK" and less often "Troubled" at 412 years. © 2015 Michigan Association for Infant Mental Health.

  12. Group Parent-Child Interaction Therapy: A Randomized Control Trial for the Treatment of Conduct Problems in Young Children

    Science.gov (United States)

    Niec, Larissa N.; Barnett, Miya L.; Prewett, Matthew S.; Shanley, Jenelle

    2016-01-01

    Objective Although efficacious interventions exist for childhood conduct problems, a majority of families in need of services do not receive them. To address problems of treatment access and adherence, innovative adaptations of current interventions are needed. This randomized control trial investigated the relative efficacy of a novel format of parent-child interaction therapy (PCIT), a treatment for young children with conduct problems. Methods Eighty-one families with three- to six-year-old children (71.6% male; 85.2% Caucasian) with diagnoses of oppositional defiant or conduct disorder were randomized to individual PCIT (n = 42) or the novel format, group PCIT. Parents completed standardized measures of children’s conduct problems, parenting stress, and social support at intake, posttreatment, and six-month follow-up. Therapist ratings, parent attendance, and homework completion provided measures of treatment adherence. Throughout treatment, parenting skills were assessed using the Dyadic Parent-Child Interaction Coding System. Results Parents in both group and individual PCIT reported significant improvements from intake to posttreatment and follow-up in their children’s conduct problems and adaptive functioning, as well as significant decreases in parenting stress. Parents in both treatment conditions also showed significant improvements in their parenting skills. There were no interactions between time and treatment format. Contrary to expectation, parents in group PCIT did not experience greater social support or treatment adherence. Conclusions Group PCIT was not inferior to individual PCIT and may be a valuable format to reach more families in need of services. Future work should explore the efficiency and sustainability of group PCIT in community settings. PMID:27018531

  13. Group parent-child interaction therapy: A randomized control trial for the treatment of conduct problems in young children.

    Science.gov (United States)

    Niec, Larissa N; Barnett, Miya L; Prewett, Matthew S; Shanley Chatham, Jenelle R

    2016-08-01

    Although efficacious interventions exist for childhood conduct problems, a majority of families in need of services do not receive them. To address problems of treatment access and adherence, innovative adaptations of current interventions are needed. This randomized control trial investigated the relative efficacy of a novel format of parent-child interaction therapy (PCIT), a treatment for young children with conduct problems. Eighty-one families with 3- to 6-year-old children (71.6% boys, 85.2% White) with diagnoses of oppositional defiant or conduct disorder were randomized to individual PCIT (n = 42) or the novel format, Group PCIT. Parents completed standardized measures of children's conduct problems, parenting stress, and social support at intake, posttreatment, and 6-month follow-up. Therapist ratings, parent attendance, and homework completion provided measures of treatment adherence. Throughout treatment, parenting skills were assessed using the Dyadic Parent-Child Interaction Coding System. Parents in both group and individual PCIT reported significant improvements from intake to posttreatment and follow-up in their children's conduct problems and adaptive functioning, as well as significant decreases in parenting stress. Parents in both treatment conditions also showed significant improvements in their parenting skills. There were no interactions between time and treatment format. Contrary to expectation, parents in Group PCIT did not experience greater social support or treatment adherence. Group PCIT was not inferior to individual PCIT and may be a valuable format to reach more families in need of services. Future work should explore the efficiency and sustainability of Group PCIT in community settings. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  14. Effects of pre- and post-electrospinning plasma treatments on electrospun PCL nanofibers to improve cell interactions

    International Nuclear Information System (INIS)

    Asadian, M; Grande, S; Morent, R; Nikiforov, A; De Geyter, N; Declercq, H

    2017-01-01

    In this study, liquid plasma treatment was used to improve the morphology of Poly-ε-CaproLactone (PCL) NanoFibers (NFs), followed by performing a Dielectric Barrier Discharge (DBD) plasma surface modification to enhance the hydrophilicity of electrospun mats generated from plasma-modified PCL solutions. Cell interaction studies performed after 1 day and 7 days clearly revealed the highly increased cellular interactions on the double plasma-treated nanofibers compared to the pristine ones due to the combination of (1) a better NF morphology and (2) an increased surface hydrophilicity. (paper)

  15. A Systematic Review and Meta-Analysis of a Measure of Staff/Child Interaction Quality (the Classroom Assessment Scoring System in Early Childhood Education and Care Settings and Child Outcomes.

    Directory of Open Access Journals (Sweden)

    Michal Perlman

    Full Text Available The quality of staff/child interactions as measured by the Classroom Assessment Scoring System (CLASS in Early Childhood Education and Care (ECEC programs is thought to be important for children's outcomes. The CLASS is made of three domains that assess Emotional Support, Classroom Organization and Instructional Support. It is a relatively new measure that is being used increasingly for research, quality monitoring/accountability and other applied purposes. Our objective was to evaluate the association between the CLASS and child outcomes. Searches of Medline, PsycINFO, ERIC, websites of large datasets and reference sections of all retrieved articles were conducted up to July 3, 2015. Studies that measured association between the CLASS and child outcomes for preschool-aged children who attended ECEC programs were included after screening by two independent reviewers. Searches and data extraction were conducted by two independent reviewers. Thirty-five studies were systematically reviewed of which 19 provided data for meta-analyses. Most studies had moderate to high risk of bias. Of the 14 meta-analyses we conducted, associations between Classroom Organization and Pencil Tapping and between Instructional Support and SSRS Social Skills were significant with pooled correlations of .06 and .09 respectively. All associations were in the expected direction. In the systematic review, significant correlations were reported mainly from one large dataset. Substantial heterogeneity in use of the CLASS, its dimensions, child outcomes and statistical measures was identified. Greater consistency in study methodology is urgently needed. Given the multitude of factors that impact child development it is encouraging that our analyses revealed some, although small, associations between the CLASS and children's outcomes.

  16. A Systematic Review and Meta-Analysis of a Measure of Staff/Child Interaction Quality (the Classroom Assessment Scoring System) in Early Childhood Education and Care Settings and Child Outcomes.

    Science.gov (United States)

    Perlman, Michal; Falenchuk, Olesya; Fletcher, Brooke; McMullen, Evelyn; Beyene, Joseph; Shah, Prakesh S

    2016-01-01

    The quality of staff/child interactions as measured by the Classroom Assessment Scoring System (CLASS) in Early Childhood Education and Care (ECEC) programs is thought to be important for children's outcomes. The CLASS is made of three domains that assess Emotional Support, Classroom Organization and Instructional Support. It is a relatively new measure that is being used increasingly for research, quality monitoring/accountability and other applied purposes. Our objective was to evaluate the association between the CLASS and child outcomes. Searches of Medline, PsycINFO, ERIC, websites of large datasets and reference sections of all retrieved articles were conducted up to July 3, 2015. Studies that measured association between the CLASS and child outcomes for preschool-aged children who attended ECEC programs were included after screening by two independent reviewers. Searches and data extraction were conducted by two independent reviewers. Thirty-five studies were systematically reviewed of which 19 provided data for meta-analyses. Most studies had moderate to high risk of bias. Of the 14 meta-analyses we conducted, associations between Classroom Organization and Pencil Tapping and between Instructional Support and SSRS Social Skills were significant with pooled correlations of .06 and .09 respectively. All associations were in the expected direction. In the systematic review, significant correlations were reported mainly from one large dataset. Substantial heterogeneity in use of the CLASS, its dimensions, child outcomes and statistical measures was identified. Greater consistency in study methodology is urgently needed. Given the multitude of factors that impact child development it is encouraging that our analyses revealed some, although small, associations between the CLASS and children's outcomes.

  17. Biochemical markers identify influences on bone and cartilage degradation in osteoarthritis - the effect of sex, Kellgren-Lawrence (KL score, Body Mass Index (BMI, oral salmon calcitonin (sCT treatment and diurnal variation

    Directory of Open Access Journals (Sweden)

    Henriksen K

    2010-06-01

    Full Text Available Abstract Background Osteoarthritis (OA involves changes in both bone and cartilage. These processes might be associated under some circumstances. This study investigated correlations between bone and cartilage degradation in patients with OA as a function of sex, Kellgren-Lawrence (KL score, Body Mass Index (BMI, oral salmon calcitonin (sCT treatment and diurnal variation. Methods This study was a 2-week, double-blind, double-dummy, randomized study including 37 postmenopausal women and 36 men, aged 57-75 years, with painful knee OA, and a KL-score of I - III. Subjects were allocated to one of three treatment arms: 0.6 mg or 0.8 mg oral sCT, or placebo given twice-daily for 14 days. Correlations between gender, KL score, or BMI and the bone resorption marker, serum C-terminal telopeptide of collagen type I (CTX-I, or the cartilage degradation marker, urine C-terminal telopeptide of collagen type II (CTX-II were investigated. Results At baseline, biomarkers indicated women with OA experienced higher bone and cartilage degradation than men. CTX-I levels were significantly higher, and CTX-II levels only marginally higher, in women than in men (p = 0.04 and p = 0.06, respectively. Increasing KL score was not correlated with bone resorption, but was significantly associated with the cartilage degradation CTX-II marker in both men and women (p = 0.007. BMI was significantly and negatively correlated to the bone resorption marker CTX-I, r = -0.40 (p = 0.002, but showed only a borderline positive correlation to CTX-II, r = 0.25 (p = 0.12. Before morning treatments on days 1 and 14, no correlation was seen between CTX-I and CTX-II in either the sCT or placebo group. However, oral sCT and food intake induced a clear correlation between these bone and cartilage degradation markers. Four hours after the first sCT dose on treatment days 1 and 14, a significant correlation (r = 0.71, p p = 0.02, but not on day 14. Conclusion Bone resorption was higher in

  18. 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)

  19. Resistance to temptation: the interaction of external and internal control on alcohol use during residential treatment for alcohol use disorder.

    Science.gov (United States)

    Soravia, Leila M; Schläfli, Katrin; Stutz, Sonja; Rösner, Susanne; Moggi, Franz

    2015-11-01

    There is evidence that drinking during residential treatment is related to various factors, such as patients' general control beliefs and self-efficacy, as well as to external control of alcohol use by program's staff and situations where there is temptation to drink. As alcohol use during treatment has been shown to be associated with the resumption of alcohol use after discharge from residential treatment, we aimed to investigate how these variables are related to alcohol use during abstinence-oriented residential treatment programs for alcohol use disorders (AUD). In total, 509 patients who entered 1 of 2 residential abstinence-oriented treatment programs for AUD were included in the study. After detoxification, patients completed a standardized diagnostic procedure including interviews and questionnaires. Drinking was assessed by patients' self-report of at least 1 standard drink or by positive breathalyzer testing. The 2 residential programs were categorized as high or low control according to the average number of tests per patient. Regression analysis revealed a significant interaction effect between internal and external control suggesting that patients with high internal locus of control and high frequency of control by staff demonstrated the least alcohol use during treatment (16.7%) while patients with low internal locus of control in programs with low external control were more likely to use alcohol during treatment (45.9%). No effects were found for self-efficacy and temptation. As alcohol use during treatment is most likely associated with poor treatment outcomes, external control may improve treatment outcomes and particularly support patients with low internal locus of control, who show the highest risk for alcohol use during treatment. High external control may complement high internal control to improve alcohol use prevention while in treatment. Copyright © 2015 The Authors. Alcoholism: Clinical and Experimental Research published by Wiley

  20. Baseline ICIQ-UI score, body mass index, age, average birth weight, and perineometry duration as promising predictors of the short-term efficacy of Er:YAG laser treatment in stress urinary incontinent women: A prospective cohort study.

    Science.gov (United States)

    Fistonić, Ivan; Fistonić, Nikola

    2018-01-23

    A growing body of evidence indicates that a non-invasive erbium yttrium-aluminum-garnet (Er:YAG) laser may be an effective and highly tolerable treatment for stress urinary incontinence (SUI) in women. The primary objective was to identify pre-intervention predictors of short-term Er:YAG outcomes. The secondary objective was to identify patient segments with the best Er:YAG laser treatment short-term outcomes. A prospective cohort study performed in 2016 at Ob/Gyn Clinic, Zagreb, Croatia, recruited 85 female patients who suffered from SUI. The intervention was performed with a 2940 nm wave length Er:YAG laser (XS Dynamis, Fotona, Slovenia). Outcomes were absolute change in the International Consultation on Incontinence Questionnaire-Short Form (ICIQ-UI SF) and a relative decrease in ICIQ-UI score of ≥30% 2-6 months after the intervention. Age and pre-intervention ICIQ-UI values were independent significant predictors of laser treatment efficacy for SUI. A decrease in ICIQ-UI score (minimum important difference, MID) of ≥30% was independently significantly associated with body mass index and ICIQ-UI values before the intervention. All patients with four or five positive predictors saw a clinically relevant decrease in ICIQ-UI of ≥30%. The total accuracy of the predictive model defined by the area under the curve was 0.83 (95%CI 0.74-0.91). At the cut-off ≥3 positive predictors, C-index was 0.80 (95%CI 0.71-0.90), positive predictive value was 0.97 (95%CI 0.87-0.99), and negative predictive value was 0.53 (95%CI 0.45-0.55). A relevant decrease in ICIQ-UI (MID) of ≥30% can be predicted based on age, body mass index, average birth weight, perineometer squeeze duration, and ICIQ-UI scores before the intervention. The association between Q-tip test and treatment outcome was moderated by age. Q-tip was a significant predictor for patients between 44 and 53 years of age. The best results should be expected in younger women with a body mass index of ≤23

  1. Budget Scoring: An Impediment to Alternative Financing

    National Research Council Canada - National Science Library

    Summers, Donald E; San Miguel, Joseph G

    2007-01-01

    .... One of the major impediments to using alternative forms of procurement financing for acquiring defense capabilities is in the budgetary treatment, or scoring, of these initiatives by the Congressional Budget Office (CBO...

  2. INTERACTIVE ABANDONED MINE LANDS WORKSHOP SERIES - ACID MINE WATER TREATMENT TECHNOLOGIES

    Science.gov (United States)

    The purpose of this interactive workshop is to present and discuss active and passive acid mine wastes cleanup technologies and to discuss the apparent disconnect between their development and their implementation. The workshop addressed five main barriers to implementing innovat...

  3. Transporter-mediated natural product-drug interactions for the treatment of cardiovascular diseases.

    Science.gov (United States)

    Zha, Weibin

    2018-04-01

    The growing use of natural products in cardiovascular (CV) patients has been greatly raising the concerns about potential natural product-CV drug interactions. Some of these may lead to unexpected cardiovascular adverse effects and it is, therefore, essential to identify or predict potential natural product-CV drug interactions, and to understand the underlying mechanisms. Drug transporters are important determinants for the pharmacokinetics of drugs and alterations of drug transport has been recognized as one of the major causes of natural product-drug interactions. In last two decades, many CV drugs (e.g., angiotensin II receptor blockers, beta-blockers and statins) have been identified to be substrates and inhibitors of the solute carrier (SLC) transporters and the ATP-binding cassette (ABC) transporters, which are two major transporter superfamilies. Meanwhile, in vitro and in vivo studies indicate that a growing number of natural products showed cardioprotective effects (e.g., gingko biloba, danshen and their active ingredients) are also substrates and inhibitors of drug transporters. Thus, to understand transporter-mediated natural product-CV drug interactions is important and some transporter-mediated interactions have already shown to have clinical relevance. In this review, we review the current knowledge on the role of ABC and SLC transporters in CV therapy, as well as transporter modulation by natural products used in CV diseases and their induced natural product-CV drug interactions through alterations of drug transport. We hope our review will aid in a comprehensive summary of transporter-mediated natural product-CV drug interactions and help public and physicians understand these type of interactions. Copyright © 2017. Published by Elsevier B.V.

  4. The Mystery of the Z-Score.

    Science.gov (United States)

    Curtis, Alexander E; Smith, Tanya A; Ziganshin, Bulat A; Elefteriades, John A

    2016-08-01

    Reliable methods for measuring the thoracic aorta are critical for determining treatment strategies in aneurysmal disease. Z-scores are a pragmatic alternative to raw diameter sizes commonly used in adult medicine. They are particularly valuable in the pediatric population, who undergo rapid changes in physical development. The advantage of the Z-score is its inclusion of body surface area (BSA) in determining whether an aorta is within normal size limits. Therefore, Z-scores allow us to determine whether true pathology exists, which can be challenging in growing children. In addition, Z-scores allow for thoughtful interpretation of aortic size in different genders, ethnicities, and geographical regions. Despite the advantages of using Z-scores, there are limitations. These include intra- and inter-observer bias, measurement error, and variations between alternative Z-score nomograms and BSA equations. Furthermore, it is unclear how Z-scores change in the normal population over time, which is essential when interpreting serial values. Guidelines for measuring aortic parameters have been developed by the American Society of Echocardiography Pediatric and Congenital Heart Disease Council, which may reduce measurement bias when calculating Z-scores for the aortic root. In addition, web-based Z-score calculators have been developed to aid in efficient Z-score calculations. Despite these advances, clinicians must be mindful of the limitations of Z-scores, especially when used to demonstrate beneficial treatment effect. This review looks to unravel the mystery of the Z-score, with a focus on the thoracic aorta. Here, we will discuss how Z-scores are calculated and the limitations of their use.

  5. The Alzheimer’s Prevention Initiative composite cognitive test score: Sample size estimates for the evaluation of preclinical Alzheimer’s disease treatments in presenilin 1 E280A mutation carriers

    Science.gov (United States)

    Ayutyanont, Napatkamon; Langbaum, Jessica B.; Hendrix, Suzanne B.; Chen, Kewei; Fleisher, Adam S.; Friesenhahn, Michel; Ward, Michael; Aguirre, Camilo; Acosta-Baena, Natalia; Madrigal, Lucìa; Muñoz, Claudia; Tirado, Victoria; Moreno, Sonia; Tariot, Pierre N.; Lopera, Francisco; Reiman, Eric M.

    2014-01-01

    Objective There is a need to identify a cognitive composite that is sensitive to tracking preclinical AD decline to be used as a primary endpoint in treatment trials. Method We capitalized on longitudinal data, collected from 1995 to 2010, from cognitively unimpaired presenilin 1 (PSEN1) E280A mutation carriers from the world’s largest known early-onset autosomal dominant AD (ADAD) kindred to identify a composite cognitive test with the greatest statistical power to track preclinical AD decline and estimate the number of carriers age 30 and older needed to detect a treatment effect in the Alzheimer’s Prevention Initiative’s (API) preclinical AD treatment trial. The mean-to-standard-deviation ratios (MSDRs) of change over time were calculated in a search for the optimal combination of one to seven cognitive tests/sub-tests drawn from the neuropsychological test battery in cognitively unimpaired mutation carriers during a two and five year follow-up period, using data from non-carriers during the same time period to correct for aging and practice effects. Combinations that performed well were then evaluated for robustness across follow-up years, occurrence of selected items within top performing combinations and representation of relevant cognitive domains. Results This optimal test combination included CERAD Word List Recall, CERAD Boston Naming Test (high frequency items), MMSE Orientation to Time, CERAD Constructional Praxis and Ravens Progressive Matrices (Set A) with an MSDR of 1.62. This composite is more sensitive than using either the CERAD Word List Recall (MSDR=0.38) or the entire CERAD-Col battery (MSDR=0.76). A sample size of 75 cognitively normal PSEN1-E280A mutation carriers age 30 and older per treatment arm allows for a detectable treatment effect of 29% in a 60-month trial (80% power, p=0.05). Conclusions We have identified a composite cognitive test score representing multiple cognitive domains that has improved power compared to the most

  6. Predictors and Correlates of Homework Completion and Treatment Outcomes in Parent-Child Interaction Therapy

    Science.gov (United States)

    Danko, Christina M.; Brown, Tasha; Van Schoick, Lauren; Budd, Karen S.

    2016-01-01

    Background: Behavioral parent training has been demonstrated to be an effective treatment for child behavior problems; however, lack of parent engagement can limit the effectiveness of treatment. Understanding more about predictors and correlates of a specific measure of parent engagement--homework completion--in parent training can help to…

  7. Ethnicity as a Moderator of Treatment Effects on Parent-Child Interaction for Children with ADHD

    Science.gov (United States)

    Jones, Heather A.; Epstein, Jeffery N.; Hinshaw, Stephen P.; Owens, Elizabeth B.; Chi, Terry C.; Arnold, L. Eugene; Hoza, Betsy; Wells, Karen C.

    2010-01-01

    Objective: To examine ethnic differences in observed parenting and child behavior and the moderating effects of ethnicity on the relationship between treatment and parent and child behavior. Method: Observations of 508 children with ADHD (ages 7-9) and their caregivers, collected during the Multimodal Treatment Study of ADHD, were analyzed using…

  8. Assessing the acceptability and usability of an interactive serious game in aiding treatment decisions for patients with localized prostate cancer.

    Science.gov (United States)

    Reichlin, Lindsey; Mani, Nithya; McArthur, Kara; Harris, Amy M; Rajan, Nithin; Dacso, Clifford C

    2011-01-12

    Men diagnosed with localized prostate cancer face a potentially life-altering treatment decision that can be overwhelming. Enhancing patient knowledge through education can significantly reduce feelings of uncertainty while simultaneously increasing confidence in decision making. Serious games have been shown in other populations to increase health knowledge and assist with the health decision-making process. We developed an interactive serious game, Time After Time, which translates evidence-based treatment outcome data into an accessible and understandable format that men can utilize in their prostate cancer treatment decision-making process. The game specifically aims to raise men's awareness and understanding of the impact of health-related quality of life issues associated with the major treatment options and to enrich their conversations with their health care providers. This study determined the acceptability and usability of the alpha version of Time After Time, an interactive decision aid for men diagnosed with localized prostate cancer, in order to inform future iterations of the serious game. The study employed a mixed methods approach to assess the acceptability and usability of the Time After Time serious game using qualitative focus groups and a quantitative Likert scale survey. A total of 13 men who had already completed treatment for localized prostate cancer completed the survey and participated in focus group meetings. The majority of the study participants rated Time After Time as an appropriate decision tool for localized prostate cancer and verified that it meets its goals of increasing focus on side effects and generating questions for the patient's health care team. However, participants also expressed concerns about game usability and the diversity of information covered regarding treatment options and potential treatment outcomes. Serious games are a promising approach to health education and decision support for older men. Participants

  9. A hybrid configuration interaction treatment based on seniority number and excitation schemes

    Energy Technology Data Exchange (ETDEWEB)

    Alcoba, Diego R.; Capuzzi, Pablo [Departamento de Física, Facultad de Ciencias Exactas y Naturales, Universidad de Buenos Aires and Instituto de Física de Buenos Aires, Consejo Nacional de Investigaciones Científicas y Técnicas, Ciudad Universitaria, 1428 Buenos Aires (Argentina); Torre, Alicia; Lain, Luis, E-mail: qfplapel@lg.ehu.es [Departamento de Química Física, Facultad de Ciencia y Tecnología, Universidad del País Vasco, Apdo. 644 E-48080 Bilbao (Spain); Oña, Ofelia B. [Instituto de Investigaciones Fisicoquímicas Teóricas y Aplicadas, Universidad Nacional de La Plata, CCT La Plata, Consejo Nacional de Investigaciones Científicas y Técnicas, Diag. 113 y 64 (S/N), Sucursal 4, CC 16, 1900 La Plata (Argentina); Van Raemdonck, Mario; Bultinck, Patrick [Department of Inorganic and Physical Chemistry, Ghent University, Krijgslaan 281 (S3), 9000 Gent (Belgium); Van Neck, Dimitri [Center for Molecular Modelling, Ghent University, Technologiepark 903, 9052 Zwijnaarde (Belgium)

    2014-12-28

    We present a configuration interaction method in which the Hamiltonian of an N-electron system is projected on Slater determinants selected according to the seniority-number criterion along with the traditional excitation-based procedure. This proposed method is especially useful to describe systems which exhibit dynamic (weak) correlation at determined geometric arrangements (where the excitation-based procedure is more suitable) but show static (strong) correlation at other arrangements (where the seniority-number technique is preferred). The hybrid method amends the shortcomings of both individual determinant selection procedures, yielding correct shapes of potential energy curves with results closer to those provided by the full configuration interaction method.

  10. 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.

  11. Evaluation of a treatment manual and workshops for disseminating, parent-child interaction therapy.

    Science.gov (United States)

    Herschell, Amy D; McNeil, Cheryl B; Urquiza, Anthony J; McGrath, Jean M; Zebell, Nancy M; Timmer, Susan G; Porter, Alissa

    2009-01-01

    This study's main purposes were to: (a) evaluate a treatment manual as a dissemination strategy, (b) compare two workshop formats for evidence-based treatment (EBT) training, and (c) provide preliminary data on therapist characteristics potentially associated with successful EBT adoption. Forty-two community-based clinicians were assigned to one of two training groups (didactic or experiential). Behavior observation and self-report data were collected at four time points. Results suggest that reading a treatment manual is useful, but not sufficient. Experiential and didactic training were equally effective in increasing knowledge, skill, and satisfaction; however, after a 2-day training, few participants demonstrated mastery of skills.

  12. Interaction of crude oil and manure treatments and its effects on the ...

    African Journals Online (AJOL)

    An experiment was conducted at the Teaching and Research Farm of the Faculty of Agriculture and Veterinary Medicine, Imo State, University, Owerri Nigeria to investigate the interaction of crude oil and manure on the agronomic characteristics of maize. The experiment was arranged in Randomized Complete Block ...

  13. Exposure to virtual social interactions in the treatment of social anxiety disorder: A randomized controlled trial

    NARCIS (Netherlands)

    Kampmann, I.L.; Emmelkamp, P.M.G.; Hartanto, D.; Brinkman, W.P.; Zijlstra, B.J.H.; Morina, N.

    2016-01-01

    This randomized controlled trial investigated the efficacy of a stand-alone virtual reality exposure intervention comprising verbal interaction with virtual humans to target heterogeneous social fears in participants with social anxiety disorder. Sixty participants (Mage = 36.9 years; 63.3% women)

  14. Social interaction and self-esteem of children with cerebral palsy after treatment for severe drooling.

    NARCIS (Netherlands)

    Burg, J.J.W. van der; Jongerius, P.H.; Limbeek, J. van; Hulst, K. van; Rotteveel, J.J.

    2006-01-01

    The impact of salivary flow reduction following medication (scopolamine and botulinum neurotoxin) on social interaction and emotional development (self-esteem) was evaluated in a group of 45 children with cerebral palsy who suffered from severe drooling. The children ranged in age from 3 to 16 years

  15. Interaction of post harvest disease control treatments and gamma irradiation on mangoes

    International Nuclear Information System (INIS)

    Johnson, G.I.; Cooke, A.W.; Boag, T.S.; Panitz, M.; Sangchote, S.

    1990-01-01

    The effects of gamma irradiation and disease control treatments on disease severity and post harvest quality of several mango cultivars were investigated. In mangoes cv. Kensington Pride, irradiation doses ranging from 300-1200 Gy reduced disease, but the level of control was not commercially acceptable. Hot benomyl immediately followed by irradiation provided effective control of anthracnose (Colletotrichum gloeosporioides) and stem end rot (Dothiorella dominicana) during short-term storage (15 days at 20degC). The effects of the two treatments were additive. Satisfactory disease control was achieved during long-term controlled atmosphere storage when mangoes were treated with hot benomyl followed by prochloraz and then irradiated. Effects of fungicide treatment and irradiation were additive. Fungicide, or irradiation treatments alone, were unsatisfactory. Irradiation of cv. Kensington Pride at doses in excess of 600 Gy caused unacceptable surface damage. (author)

  16. Delayed conifer mortality after fuel reduction treatments: interactive effects of fuel, fire intensity, and bark beetles.

    Science.gov (United States)

    Youngblood, Andrew; Grace, James B; McIver, James D

    2009-03-01

    Many low-elevation dry forests of the western United States contain more small trees and fewer large trees, more down woody debris, and less diverse and vigorous understory plant communities compared to conditions under historical fire regimes. These altered structural conditions may contribute to increased probability of unnaturally severe wildfires, susceptibility to uncharacteristic insect outbreaks, and drought-related mortality. Broad-scale fuel reduction and restoration treatments are proposed to promote stand development on trajectories toward more sustainable structures. Little research to date, however, has quantified the effects of these treatments on the ecosystem, especially delayed and latent tree mortality resulting directly or indirectly from treatments. In this paper, we explore complex hypotheses relating to the cascade of effects that influence ponderosa pine (Pinus ponderosa) and Douglas-fir (Pseudotsuga menziesii) mortality using structural equation modeling (SEM). We used annual census and plot data through six growing seasons after thinning and four growing seasons after burning from a replicated, operational-scale, completely randomized experiment conducted in northeastern Oregon, USA, as part of the national Fire and Fire Surrogate study. Treatments included thin, burn, thin followed by burn (thin + burn), and control. Burn and thin + burn treatments increased the proportion of dead trees while the proportion of dead trees declined or remained constant in thin and control units, although the density of dead trees was essentially unchanged with treatment. Most of the new mortality (96%) occurred within two years of treatment and was attributed to bark beetles. Bark beetle-caused tree mortality, while low overall, was greatest in thin + burn treatments. SEM results indicate that the probability of mortality of large-diameter ponderosa pine from bark beetles and wood borers was directly related to surface fire severity and bole charring, which

  17. Nursing activities score

    NARCIS (Netherlands)

    Miranda, DR; Nap, R; de Rijk, A; Schaufeli, W; Lapichino, G

    Objectives. The instruments used for measuring nursing workload in the intensive care unit (e.g., Therapeutic Intervention Scoring System-28) are based on therapeutic interventions related to severity of illness. Many nursing activities are not necessarily related to severity of illness, and

  18. 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

  19. 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.

  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. Clinical efficacy of oral linezolid compared with intravenous vancomycin for the treatment of methicillin-resistant Staphylococcus aureus-complicated skin and soft tissue infections: a retrospective, propensity score-matched, case-control analysis.

    Science.gov (United States)

    Itani, Kamal M F; Biswas, Pinaki; Reisman, Arlene; Bhattacharyya, Helen; Baruch, Alice M

    2012-08-01

    Linezolid is 100% bioavailable in oral and intravenous formulations. In a recent prospective, randomized, open-label, comparator-controlled, multicenter, phase 4 clinical trial in adults with complicated skin and soft tissue infections (cSSTIs) caused by methicillin-resistant Staphylococcus aureus (MRSA), linezolid achieved clinical and microbiologic success comparable to appropriately dosed intravenous vancomycin. Although patients were randomly assigned to receive linezolid or vancomycin, the protocol allowed patients to start therapy using oral or intravenous linezolid on the basis of investigator discretion and patient ability to tolerate oral medication. The objective of this study was to assess the efficacy and tolerability of linezolid when administered orally in adults with cSSTI caused by MRSA. In this retrospective analysis, we examined data collected from the aforementioned trial to compare outcomes in patients who received either oral linezolid or intravenous vancomycin therapy. This study analyzed outcomes in patients who received treatment for 7 to 14 days with either oral linezolid (600 mg q12h; n = 95) or intravenous vancomycin (15 mg/kg q12h, adjusted for creatinine clearance and trough concentration; n = 210). By design, these groups were not randomized. Propensity score matching on baseline variables was used to balance these groups by identifying a comparable group of patients who received vancomycin therapy and comparing them with patients who received oral linezolid therapy. Clinical and microbiologic success rates at the end of treatment and the end of the study (EOS) were then directly compared between the groups using matched-pair logistic regression. The tolerability of the 2 treatments (within this matched group) was also described. Ninety-two patients with well-matched baseline characteristics were included in each treatment group. At EOS, the odds ratio for clinical success of oral linezolid therapy vs intravenous vancomycin therapy was

  2. Automated Essay Scoring

    Directory of Open Access Journals (Sweden)

    Semire DIKLI

    2006-01-01

    Full Text Available Automated Essay Scoring Semire DIKLI Florida State University Tallahassee, FL, USA ABSTRACT The impacts of computers on writing have been widely studied for three decades. Even basic computers functions, i.e. word processing, have been of great assistance to writers in modifying their essays. The research on Automated Essay Scoring (AES has revealed that computers have the capacity to function as a more effective cognitive tool (Attali, 2004. AES is defined as the computer technology that evaluates and scores the written prose (Shermis & Barrera, 2002; Shermis & Burstein, 2003; Shermis, Raymat, & Barrera, 2003. Revision and feedback are essential aspects of the writing process. Students need to receive feedback in order to increase their writing quality. However, responding to student papers can be a burden for teachers. Particularly if they have large number of students and if they assign frequent writing assignments, providing individual feedback to student essays might be quite time consuming. AES systems can be very useful because they can provide the student with a score as well as feedback within seconds (Page, 2003. Four types of AES systems, which are widely used by testing companies, universities, and public schools: Project Essay Grader (PEG, Intelligent Essay Assessor (IEA, E-rater, and IntelliMetric. AES is a developing technology. Many AES systems are used to overcome time, cost, and generalizability issues in writing assessment. The accuracy and reliability of these systems have been proven to be high. The search for excellence in machine scoring of essays is continuing and numerous studies are being conducted to improve the effectiveness of the AES systems.

  3. Social interaction and self-esteem of children with cerebral palsy after treatment for severe drooling.

    Science.gov (United States)

    van der Burg, Jan J W; Jongerius, Peter H; van Limbeek, Jacques; van Hulst, Karen; Rotteveel, Jan J

    2006-01-01

    The impact of salivary flow reduction following medication (scopolamine and botulinum neurotoxin) on social interaction and emotional development (self-esteem) was evaluated in a group of 45 children with cerebral palsy who suffered from severe drooling. The children ranged in age from 3 to 16 years (median 9.1 years); 28 were male, 17 female. A questionnaire to document the impact of drooling on social interaction and self-esteem for both the children and their parents was developed and administered during the use of scopolamine and up to 24 weeks after intraglandular botulinum neurotoxin in the submandibular glands. The reduction of drooling was related to increased social contacts with peers. In addition, parents perceived that the impact of drooling on the level of the child's satisfaction on physical appearance, relations within the extended family, and life in general increased. Although medication led to (temporary) positive changes, many social and emotional consequences remained unchanged. Interventions to treat drooling should not only be evaluated using measurements of drooling, but the consequences on social interaction and self-esteem should also be assessed.

  4. Effects of secondary interactions on the dose calculation in treatments with Boron Neutron Capture Therapy (BNCT)

    International Nuclear Information System (INIS)

    Monteiro, E.

    2004-01-01

    The aimed of this work consists of evaluating the influence of the secondary contributions of dose (thermal neutrons dose, epithermal neutrons dose, fast neutrons dose and photon dose) in treatment planning with BNCT. MCNP4B Code was used to calculate RBE-Gy doses through the irradiation of the modified Snyder head head phantom.A reduction of the therapeutical gain of monoenergetic neutron beans was observed in non invasive treatments, provoked for the predominance of the fast neutron dose component in the skin, showing that the secondary contributions of dose can contribute more in the direction to raise the dose in the fabric healthy that in the tumor, thus reducing the treatment efficiency. (author)

  5. A neuroimaging study of emotion-cognition interaction in schizophrenia: the effect of ziprasidone treatment.

    Science.gov (United States)

    Stip, Emmanuel; Cherbal, Adel; Luck, David; Zhornitsky, Simon; Bentaleb, Lahcen Ait; Lungu, Ovidiu

    2017-04-01

    Functional and structural brain changes associated with the cognitive processing of emotional visual stimuli were assessed in schizophrenic patients after 16 weeks of antipsychotic treatment with ziprasidone. Forty-five adults aged 18 to 40 were recruited: 15 schizophrenia patients (DSM-IV criteria) treated with ziprasidone (mean daily dose = 120 mg), 15 patients treated with other antipsychotics, and 15 healthy controls who did not receive any medication. Functional and structural neuroimaging data were acquired at baseline and 16 weeks after treatment initiation. In each session, participants selected stimuli, taken from standardized sets, based on their emotional valence. After ziprasidone treatment, several prefrontal regions, typically involved in cognitive control (anterior cingulate and ventrolateral prefrontal cortices), were significantly activated in patients in response to positive versus negative stimuli. This effect was greater whenever they had to select negative compared to positive stimuli, indicating an asymmetric effect of cognitive treatment of emotionally laden information. No such changes were observed for patients under other antipsychotics. In addition, there was an increase in the brain volume commonly recruited by healthy controls and patients under ziprasidone, in response to cognitive processing of emotional information. The structural analysis showed no significant changes in the density of gray and white matter in ziprasidone-treated patients compared to patients receiving other antipsychotic treatments. Our results suggest that functional changes in brain activity after ziprasidone medication precede structural and clinical manifestations, as markers that the treatment is efficient in restoring the functionality of prefrontal circuits involved in processing emotionally laden information in schizophrenia.

  6. Emotional Intolerance and Core Features of Anorexia Nervosa: A Dynamic Interaction during Inpatient Treatment? Results from a Longitudinal Diary Study

    Science.gov (United States)

    Stroe-Kunold, Esther; Friederich, Hans-Christoph; Stadnitski, Tatjana; Wesche, Daniela; Herzog, Wolfgang; Schwab, Michael; Wild, Beate

    2016-01-01

    Objective The role of emotion dysregulation with regard to the psychopathology of anorexia nervosa (AN) is increasingly discussed. It is both assumed that AN symptoms have an impact on difficulties in tolerating aversive emotions and that—conversely—emotion dysregulation influences AN. To date, such conclusions are drawn on the basis of cross-sectional data not allowing for inferences on the temporal dynamics. The current study investigates the longitudinal interaction between emotional intolerance and core AN symptoms over the course of inpatient treatment by comparing patients with high (BMIintolerance and their AN-specific cognitions and behaviours. The temporal dynamics between emotional intolerance and these variables were analysed using a multivariate time series approach. Results The time series of the processes under investigation adequately reflected the individual treatment courses. The majority of significant linear time trends was found for HSS patients. Most importantly, analysis revealed significant temporal interactions between emotional intolerance and AN symptoms in almost 70% of HSS patients. Thereby, up to 37% of variance in eating restraint and up to 23% in weight concern could be attributed to changes in emotional intolerance. Conclusions The findings support the notion that intolerable unpleasant emotions in severely affected AN patients influence their psychopathology. Additionally, time series analysis outlined the inter-individual heterogeneity of psychosomatic treatment courses of AN patients. PMID:27191959

  7. Feasibility assessment of the interactive use of a Monte Carlo algorithm in treatment planning for intraoperative electron radiation therapy

    International Nuclear Information System (INIS)

    Guerra, Pedro; Ledesma-Carbayo, María J; Santos, Andrés; Udías, José M; Herranz, Elena; Herraiz, Joaquín L; Santos-Miranda, Juan Antonio; Calvo, Felipe A; Valdivieso, Manlio F; Rodríguez, Raúl; Illana, Carlos; Calama, Juan A; Pascau, Javier

    2014-01-01

    This work analysed the feasibility of using a fast, customized Monte Carlo (MC) method to perform accurate computation of dose distributions during pre- and intraplanning of intraoperative electron radiation therapy (IOERT) procedures. The MC method that was implemented, which has been integrated into a specific innovative simulation and planning tool, is able to simulate the fate of thousands of particles per second, and it was the aim of this work to determine the level of interactivity that could be achieved. The planning workflow enabled calibration of the imaging and treatment equipment, as well as manipulation of the surgical frame and insertion of the protection shields around the organs at risk and other beam modifiers. In this way, the multidisciplinary team involved in IOERT has all the tools necessary to perform complex MC dosage simulations adapted to their equipment in an efficient and transparent way. To assess the accuracy and reliability of this MC technique, dose distributions for a monoenergetic source were compared with those obtained using a general-purpose software package used widely in medical physics applications. Once accuracy of the underlying simulator was confirmed, a clinical accelerator was modelled and experimental measurements in water were conducted. A comparison was made with the output from the simulator to identify the conditions under which accurate dose estimations could be obtained in less than 3 min, which is the threshold imposed to allow for interactive use of the tool in treatment planning. Finally, a clinically relevant scenario, namely early-stage breast cancer treatment, was simulated with pre- and intraoperative volumes to verify that it was feasible to use the MC tool intraoperatively and to adjust dose delivery based on the simulation output, without compromising accuracy. The workflow provided a satisfactory model of the treatment head and the imaging system, enabling proper configuration of the treatment planning

  8. 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.

  9. Feasibility study of an interactive multimedia electronic problem solving treatment program for depression: a preliminary uncontrolled trial.

    Science.gov (United States)

    Berman, Margit I; Buckey, Jay C; Hull, Jay G; Linardatos, Eftihia; Song, Sueyoung L; McLellan, Robert K; Hegel, Mark T

    2014-05-01

    Computer-based depression interventions lacking live therapist support have difficulty engaging users. This study evaluated the usability, acceptability, credibility, therapeutic alliance and efficacy of a stand-alone multimedia, interactive, computer-based Problem Solving Treatment program (ePST™) for depression. The program simulated live treatment from an expert PST therapist, and delivered 6 ePST™ sessions over 9weeks. Twenty-nine participants with moderate-severe symptoms received the intervention; 23 completed a minimally adequate dose of ePST™ (at least 4 sessions). Program usability, acceptability, credibility, and therapeutic alliance were assessed at treatment midpoint and endpoint. Depressive symptoms and health-related functioning were assessed at baseline, treatment midpoint (4weeks), and study endpoint (10weeks). Depression outcomes and therapeutic alliance ratings were also compared to previously published research on live PST and computer-based depression therapy. Participants rated the program as highly usable, acceptable, and credible, and reported a therapeutic alliance with the program comparable to that observed in live therapy. Depressive symptoms improved significantly over time. These findings also provide preliminary evidence that ePST™ may be effective as a depression treatment. Larger clinical trials with diverse samples are indicated. Copyright © 2014. Published by Elsevier Ltd.

  10. Feasibility Study of an Interactive Multimedia Electronic Problem Solving Treatment Program for Depression: A Preliminary Uncontrolled Trial

    Science.gov (United States)

    Berman, Margit I.; Jr., Jay C. Buckey; Hull, Jay G.; Linardatos, Eftihia; Song, Sueyoung L.; McLellan, Robert K.; Hegel, Mark T.

    2014-01-01

    Computer-based depression interventions lacking live therapist support have difficulty engaging users. This study evaluated the usability, acceptability, credibility, therapeutic alliance and efficacy of a stand-alone multimedia, interactive, computer-based Problem Solving Treatment program (ePST™) for depression. The program simulated live treatment from an expert PST therapist, and delivered 6 ePST™ sessions over 9 weeks. Twenty-nine participants with moderate-severe symptoms received the intervention; 23 completed a mini mally adequate dose of ePST™ (at least 4 sessions). Program usability, acceptability, credibility, and therapeutic alliance were assessed at treatment midpoint and endpoint. Depressive symptoms and health-related functioning were assessed at baseline, treatment midpoint (4 weeks), and study endpoint (10 weeks). Depression outcomes and therapeutic alliance ratings were also compared to previously published research on live PST and computer-based depression therapy. Participants rated the program as highly usable, acceptable, and credible, and reported a therapeutic alliance with the program comparable to that observed in live therapy. Depressive symptoms improved significantly over time. These findings also provide preliminary evidence that ePST™ may be effective as a depression treatment. Larger clinical trials with diverse samples are indicated. PMID:24680231

  11. Interaction of counseling rapport and topics discussed in sessions with methadone treatment clients.

    Science.gov (United States)

    Joe, George W; Simpson, D Dwayne; Rowan-Szal, Grace A

    2009-01-01

    Therapeutic rapport between counselors and clients in drug user treatment has been shown to be an important predictor of follow-up outcomes. This naturalistic study investigated the relationship of counseling rapport to drug-related topics discussed in counseling sessions in a sample of 330 clients and nine counselors. These voluntary clients had been admitted to a private, for-profit outpatient methadone treatment in Texas between September 1995 and August 1997 and received no-fee services for a year for participation in this study. The data were gathered using forms in the TCU community treatment assessments (www.ibr.tcu.edu) that measured intake information, counseling session topics, and counselor evaluation of the client. A majority were males, Hispanic, had a pending legal status and the average age was 39. Co-occurring drug dependence for these heroin users included cocaine (38%) and alcohol (31%). The results supported the hypothesis that higher rapport would be associated with addressing clients in a more "supportive approach" that emphasized relapse prevention and strengths-building while lower rapport would be associated with a punitive counseling style that stressed program rules and compliance. The influences of client background, counselor differences, and during-treatment positive urines were also examined. Although counselors differed in their general manner of dealing with clients, each also showed flexibility determined in part by client behavior (such as continued cocaine use). The findings indicate that focusing on constructive solutions is the preferred counseling approach.

  12. Effects of heat treatment and moisture contents on interactions between lauric acid and starch granules.

    Science.gov (United States)

    Chang, Fengdan; He, Xiaowei; Fu, Xiong; Huang, Qiang; Jane, Jay-lin

    2014-08-06

    This study aimed to understand the effects of the moisture content of granular normal cornstarch (NC), heat treatment at 80 °C, and order of adding lauric acid (LA) to starch before or after the heat treatment on the physicochemical properties and digestibility of the starch. LA was added to NC priority heated with different moisture contents (10, 20, 30, 40, and 50%) or added to dried NC and then heated with different moisture contents. The hydrothermal/LA treatments increased the pasting temperature but decreased the peak viscosity of the NC. Light and scanning electron microscopy revealed that the addition of LA retarded gelatinization. The hydrothermal/LA treatments changed the X-ray pattern of the NC to a mixture of A- and V-type patterns. The thermal property and digestibility analysis showed that 40% was the optimum moisture content for the formation of the amylose-LA complex and adding LA prior to heating the NC favored the formation of slowly digestible starch.

  13. The Use of Nonspeech Oral Motor Treatments for Developmental Speech Sound Production Disorders: Interventions and Interactions

    Science.gov (United States)

    Powell, Thomas W.

    2008-01-01

    Purpose: The use of nonspeech oral motor treatments (NSOMTs) in the management of pediatric speech sound production disorders is controversial. This article serves as a prologue to a clinical forum that examines this topic in depth. Method: Theoretical, historical, and ethical issues are reviewed to create a series of clinical questions that…

  14. Parental Homework Completion and Treatment Knowledge during Group Parent-Child Interaction Therapy

    Science.gov (United States)

    Ros, Rosmary; Graziano, Paulo A.; Hart, Katie C.

    2017-01-01

    The purpose of this study was to examine how parental homework completion, session attendance, and treatment knowledge influenced parenting practices and confidence in using learned skills during behavioral parent training (BPT). Parents of 54 preschoolers (M[subscript age] = 5.07, 82% Hispanic/Latino) with externalizing behavior problems…

  15. Prediction Scores as a Window into Classifier Behavior

    NARCIS (Netherlands)

    M. Katehara (Medha); E.M.A.L. Beauxis-Aussalet (Emmanuelle); B. Alsallakh (Bilal)

    2017-01-01

    textabstractMost multi-class classifiers make their prediction for a test sample by scoring the classes and selecting the one with the highest score. Analyzing these prediction scores is useful to understand the classifier behavior and to assess its reliability. We present an interactive

  16. Automatic Dialogue Scoring for a Second Language Learning System

    Science.gov (United States)

    Huang, Jin-Xia; Lee, Kyung-Soon; Kwon, Oh-Woog; Kim, Young-Kil

    2016-01-01

    This paper presents an automatic dialogue scoring approach for a Dialogue-Based Computer-Assisted Language Learning (DB-CALL) system, which helps users learn language via interactive conversations. The system produces overall feedback according to dialogue scoring to help the learner know which parts should be more focused on. The scoring measures…

  17. Visually scoring hirsutism.

    Science.gov (United States)

    Yildiz, Bulent O; Bolour, Sheila; Woods, Keslie; Moore, April; Azziz, Ricardo

    2010-01-01

    Hirsutism is the presence of excess body or facial terminal (coarse) hair growth in females in a male-like pattern, affects 5-15% of women, and is an important sign of underlying androgen excess. Different methods are available for the assessment of hair growth in women. We conducted a literature search and analyzed the published studies that reported methods for the assessment of hair growth. We review the basic physiology of hair growth, the development of methods for visually quantifying hair growth, the comparison of these methods with objective measurements of hair growth, how hirsutism may be defined using a visual scoring method, the influence of race and ethnicity on hirsutism, and the impact of hirsutism in diagnosing androgen excess and polycystic ovary syndrome. Objective methods for the assessment of hair growth including photographic evaluations and microscopic measurements are available but these techniques have limitations for clinical use, including a significant degree of complexity and a high cost. Alternatively, methods for visually scoring or quantifying the amount of terminal body and facial hair growth have been in use since the early 1920s; these methods are semi-quantitative at best and subject to significant inter-observer variability. The most common visual method of scoring the extent of body and facial terminal hair growth in use today is based on a modification of the method originally described by Ferriman and Gallwey in 1961 (i.e. the mFG method). Overall, the mFG scoring method is a useful visual instrument for assessing excess terminal hair growth, and the presence of hirsutism, in women.

  18. 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

  19. Treatment of system dependencies and human interactions in PRA studies: a review and sensitivity study

    International Nuclear Information System (INIS)

    Orvis, D.D.; Joksimovich, V.; Worledge, D.H.

    1985-01-01

    The Electric Power Research Institute sponsored the review and comparison of five PRA studies: Arkansas Nuclear One - Unit 1, Big Rock Point, Grand Gulf, Limerick, and Zion - Unit 1. The review has been conducted in two phases. The Phase I review may be characterized as a qualitative look into many aspects of a PRA study. The Phase II review was performed to quantify the extent that differences in analytical techniques or key assumptions in these areas affect the differences in study results. In each of the PRA studies reviewed, the general descriptions of analytical approaches and descriptions of the analyses of event tree, fault tree and human interaction analyses that affected the dominant core damage sequences were reviewed. When these descriptions aroused interest because of seeming inconsistencies within the study or with other studies, they were pursued in some depth. The approaches or assumptions were contrasted to similar elements from other studies, and sensitivity analyses were performed in many cases to test the significance of results to the analytical models or assumptions. Inferences were drawn from the results regarding significance of the item to plant-specific results and, where possible, were generalized to other PRAs. This paper describes the results of the review of system dependencies and human interactions

  20. Interaction of multi-walled carbon nanotubes with perfluorinated sulfonic acid ionomers and surface treatment studies

    DEFF Research Database (Denmark)

    Andersen, Shuang Ma; Dhiman, Rajnish; Borghei, Maryam

    2014-01-01

    The interaction between high surface area nano-carbon catalyst supports for proton exchange membrane fuel cells (PEMFCs) and perfluorinated sulfonic acid (Nafion®) ionomer was studied 19 fluorine nuclear magnetic resonance spectroscopy (19F-NMR). The method was developed and improved for more eff....... The results will contribute to optimize electrode preparation with novel nano-carbon catalyst supports and durable catalyst for low temperature (LT) PEMFCs.......The interaction between high surface area nano-carbon catalyst supports for proton exchange membrane fuel cells (PEMFCs) and perfluorinated sulfonic acid (Nafion®) ionomer was studied 19 fluorine nuclear magnetic resonance spectroscopy (19F-NMR). The method was developed and improved for more...... efficient, user-friendly and systematic studies based on our earlier experience. In this work, multi-walled carbon nanotubes (MWCNTs) from Showa Denko® and the corresponding acid modified products were explored. The adsorption at low concentration was found to follow a Langmuir isotherm. Adsorption...

  1. [Spanish versions of the Simplified Motor Score and the Glasgow Coma Scale in out-of-hospital treatment of head injury in adults: a preliminary study of each scale's ability to predict adverse events].

    Science.gov (United States)

    Roca, Guillem; Mayol, Sergi; García, Esteban; Casajuana, Edgar; Quintana, Salvador

    2015-06-01

    To determine the ability of the modified (Spanish) version of the Simplified Motor Score (mSMS) to predict adverse events during hospitalization and to compare its predictive ability to that of the Glasgow Coma Scale (GCS) in adults with head injuries treated outside the hospital. Observational study of retrospective cohorts including all patients over the age of 14 years attended for head injuries occurring within 24 hours of treatment by an advanced life-support unit staffed by nurses between May 1, 2013, and May 1, 2014. The mSMS was a translation of the English original, created through a process of discussions of direct and back translations to arrive at consensus. Out-of-hospital patient records were searched to find GCS and mSMS scores. To predict the ability of each scale to predict brain injuries, neurosurgery, intubation, and/or inhospital death, we calculated the area under the receiving operator characteristic curves (AUCs). Of the total of 115 head-injury patients attended, 64 met the inclusion criteria. The mean (SD) age was 47 (24) years. Twelve (18.8%) patients developed some form of adverse event during hospitalization; 91.6% had brain damage, 58.3% required intubation, 8.3% required surgery, and 41.6% died. The AUC for the GCS was 0.907 (95% CI, 0.81-1.00; P<.001); the AUC for the mSMS was 0.796 (95% CI, 0.64-0.95; P=.001). Although the ability of the mSMS to predict in-hospital adverse outcomes is good, it is inferior to the GCS in adults with head injuries attended outside the hospital.

  2. Interactive effects of dietary composition and hormonal treatment on reproductive development of cultured female European eel, Anguilla anguilla

    DEFF Research Database (Denmark)

    da Silva, Filipa; Støttrup, Josianne Gatt; Kjørsvik, Elin

    2016-01-01

    approximately 4.5 and 2.6 times higher compared to the other diet, respectively. After the feeding period, each diet group was divided into two and each half received one of two hormonal treatments using salmon pituitary extract (SPE) for 13 weeks: i) a constant hormone dose of 18.75mg SPE/kg initial body......Farmed female eels were fed two experimental diets with similar proximate composition but different n-3 polyunsaturated fatty acid (PUFA) levels. Both diets had similar levels of arachidonic acid (ARA), while levels of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in one diet were...... weight (BW) and ii) a variable hormone dosage that increased from 12.5mg SPE/kg initial BW to 25mg SPE/kg initial BW. Results showed a significant interaction between diets and hormonal treatments on gonadosomatic index (GSI), indicating that the effect of broodstock diets on ovarian development depends...

  3. Emotional Intolerance and Core Features of Anorexia Nervosa: A Dynamic Interaction during Inpatient Treatment? Results from a Longitudinal Diary Study.

    Directory of Open Access Journals (Sweden)

    Esther Stroe-Kunold

    Full Text Available The role of emotion dysregulation with regard to the psychopathology of anorexia nervosa (AN is increasingly discussed. It is both assumed that AN symptoms have an impact on difficulties in tolerating aversive emotions and that-conversely-emotion dysregulation influences AN. To date, such conclusions are drawn on the basis of cross-sectional data not allowing for inferences on the temporal dynamics. The current study investigates the longitudinal interaction between emotional intolerance and core AN symptoms over the course of inpatient treatment by comparing patients with high (BMI<15 kg/m2 vs. low symptom severity (HSS vs. LSS.The study adopted a longitudinal, process-oriented design with N = 16 analysed electronic diaries. Throughout the course of their inpatient treatment, the patients answered questions daily about emotional intolerance and their AN-specific cognitions and behaviours. The temporal dynamics between emotional intolerance and these variables were analysed using a multivariate time series approach.The time series of the processes under investigation adequately reflected the individual treatment courses. The majority of significant linear time trends was found for HSS patients. Most importantly, analysis revealed significant temporal interactions between emotional intolerance and AN symptoms in almost 70% of HSS patients. Thereby, up to 37% of variance in eating restraint and up to 23% in weight concern could be attributed to changes in emotional intolerance.The findings support the notion that intolerable unpleasant emotions in severely affected AN patients influence their psychopathology. Additionally, time series analysis outlined the inter-individual heterogeneity of psychosomatic treatment courses of AN patients.

  4. Non-relativistic treatment of diatomic molecules interacting with a generalized Kratzer potential in hyperspherical coordinates

    International Nuclear Information System (INIS)

    Durmus, Aysen

    2011-01-01

    We investigate solutions of a non-relativistic wave equation in hyperspherical coordinates for a diatomic molecule system interacting with a generalized Kratzer potential. Rovibrational eigenvalues and corresponding wavefunctions of non-relativistic diatomic molecules have been determined within the framework of the asymptotic iteration method. Certain fundamental conditions for the applications of the asymptotic iteration method, such as a suitable asymptotic form for the wave-function and the termination condition for the iteration process, are discussed. N-dimensional bound state eigenfunction solutions used in studying the dynamical variables of diatomic molecules are obtained in terms of a confluent hypergeometric function and a generalized Laguerre polynomial. This systematic approach is tested by calculating the rovibrational energy spectra of hydrogen and sodium chloride molecules.

  5. Functional behavior of bio-electrochemical treatment system with increasing azo dye concentrations: Synergistic interactions of biocatalyst and electrode assembly.

    Science.gov (United States)

    Sreelatha, S; Velvizhi, G; Naresh Kumar, A; Venkata Mohan, S

    2016-08-01

    Treatment of dye bearing wastewater through biological machinery is particularly challenging due to its recalcitrant and inhibitory nature. In this study, functional behavior and treatment efficiency of bio-electrochemical treatment (BET) system was evaluated with increasing azo dye concentrations (100, 200, 300 and 500mg dye/l). Maximum dye removal was observed at 300mg dye/l (75%) followed by 200mg dye/l (65%), 100mg dye/l (62%) and 500mg dye/l (58%). Concurrent increment in dye load resulted in enhanced azo reductase and dehydrogenase activities respectively (300mg dye/l: 39.6U; 4.96μg/ml). Derivatives of cyclic voltammograms also supported the involvement of various membrane bound redox shuttlers, viz., cytochrome-c, cytochrome-bc1 and flavoproteins during the electron transfer. Bacterial respiration during BET operation utilized various electron acceptors such as electrodes and dye intermediates with simultaneous bioelectricity generation. This study illustrates the synergistic interaction of biocatalyst with electrode assembly for efficient treatment of azo dye wastewater. Copyright © 2016 Elsevier Ltd. All rights reserved.

  6. Inorganic mercury exposure, mercury-copper interaction, and DMPS treatment in rats.

    OpenAIRE

    Blanusa, M; Prester, L; Radić, S; Kargacin, B

    1994-01-01

    The aim of this study was to evaluate the efficiency of oral treatment with sodium 2,3-dimercaptopropane-1-sulfonate (DMPS) on reducing mercury deposits in rat kidney after chronic exposure to inorganic mercury. The effect on kidney copper levels was also evaluated. The results showed that after two months of exposure to 50 ppm of mercury (as mercuric chloride) the concentration of mercury in the kidney was 124 micrograms/g wet tissue. At the same time copper concentration rose from 11 to 77 ...

  7. Microbes in biological processes for municipal landfill leachate treatment: Community, function and interaction

    DEFF Research Database (Denmark)

    Zhang, Duoying; Vahala, Riku; Wang, Yu

    2016-01-01

    of Planctomycetes, Nitrosomonas sp., the phylum of Proteobacteria, Bacteroidetes and Firmicutes. The bioreactor's operational parameters influence the microbial community, inversely affect the bioreactor's performance. It is practical to accumulate desirable microbes by managing the bioreactor's running condition......Landfill leachate (LFL) contains high strength of ammonium and complex organic substances including biodegradable volatile fatty acids (VFAs), refractory aquatic humic substances (AHS) and micro-scale xenobiotic organic chemicals (XOCs), which promotes the diverse microbial community in LFL....... High ammonium loading, low DO (desirable AOB and realize the partial nitrification. Nitrite and organic matters inhibit the anaerobic ammonium oxidation bacteria (AnAOB). In anaerobic LFL treatment bioreactors, Methanosaeta...

  8. Interactive voice response technology for symptom monitoring and as an adjunct to the treatment of chronic pain.

    Science.gov (United States)

    Lieberman, Gregory; Naylor, Magdalena R

    2012-03-01

    Chronic pain is a medical condition that severely decreases the quality of life for those who struggle to cope with it. Interactive voice response (IVR) technology has the ability to track symptoms and disease progression, to investigate the relationships between symptom patterns and clinical outcomes, to assess the efficacy of ongoing treatments, and to directly serve as an adjunct to therapeutic treatment for chronic pain. While many approaches exist toward the management of chronic pain, all have their pitfalls and none work universally. Cognitive behavioral therapy (CBT) is one approach that has been shown to be fairly effective, and therapeutic interactive voice response technology provides a convenient and easy-to-use means of extending the therapeutic gains of CBT long after patients have discontinued clinical visitations. This review summarizes the advantages and disadvantages of IVR technology, provides evidence for the efficacy of the method in monitoring and managing chronic pain, and addresses potential future directions that the technology may take as a therapeutic intervention in its own right.

  9. Molecular interactions of milk protein with phenolic components in oat-based liquid formulations following UHT treatment and prolonged storage.

    Science.gov (United States)

    Kaur, Jasmeet; Katopo, Lita; Ashton, John; Whitson, Andrew; Kasapis, Stefan

    2017-09-05

    Nowadays there is a growing demand for nutritionally balanced breakfast beverages enriched with functional ingredients including wholegrain oat, which is rich in phenolic acids. Such beverages typically contain added food ingredients (e.g. milk protein, sugar and lipids) and undergo thermal processing that initiates many molecular processes. Therefore, this work aims to investigate the molecular interactions between milk protein and phenolic acids that govern bioactivity in model oat-based beverages. Findings showed the susceptibility of ferulic and p-coumaric acids, in model oat beverages, to ultra-high temperature (UHT) processing at 145 °C for 8 s. Among model beverages, those with added milk protein demonstrated a considerable loss of phenolic acids following UHT processing due to the interaction between these micronutrients and the protein. The nature of molecular interactions was mainly categorized as covalent with hydrogen bonds playing a supportive role. UHT processing of oat-based beverage formulations facilitates the formation of protein-phenolic acid complexes, which are largely covalent and static in nature. This finding underlines the ability of UHT treatment to induce chemical modifications of food ingredients. © 2017 Society of Chemical Industry. © 2017 Society of Chemical Industry.

  10. Bayesian Model Averaging for Propensity Score Analysis.

    Science.gov (United States)

    Kaplan, David; Chen, Jianshen

    2014-01-01

    This article considers Bayesian model averaging as a means of addressing uncertainty in the selection of variables in the propensity score equation. We investigate an approximate Bayesian model averaging approach based on the model-averaged propensity score estimates produced by the R package BMA but that ignores uncertainty in the propensity score. We also provide a fully Bayesian model averaging approach via Markov chain Monte Carlo sampling (MCMC) to account for uncertainty in both parameters and models. A detailed study of our approach examines the differences in the causal estimate when incorporating noninformative versus informative priors in the model averaging stage. We examine these approaches under common methods of propensity score implementation. In addition, we evaluate the impact of changing the size of Occam's window used to narrow down the range of possible models. We also assess the predictive performance of both Bayesian model averaging propensity score approaches and compare it with the case without Bayesian model averaging. Overall, results show that both Bayesian model averaging propensity score approaches recover the treatment effect estimates well and generally provide larger uncertainty estimates, as expected. Both Bayesian model averaging approaches offer slightly better prediction of the propensity score compared with the Bayesian approach with a single propensity score equation. Covariate balance checks for the case study show that both Bayesian model averaging approaches offer good balance. The fully Bayesian model averaging approach also provides posterior probability intervals of the balance indices.

  11. Matching Alcoholics to Coping Skills or Interactional Therapies: Two-Year Follow-Up Results.

    Science.gov (United States)

    Cooney, Ned L.; And Others

    1991-01-01

    Assigned 96 inpatients in alcoholism treatment to aftercare group treatment with either coping skills training or interactional therapy. Survival analyses using two-year outcome data provided evidence for durability of matching interaction effects. Individuals scoring high on sociopathy or global psychopathology had better outcomes in coping…

  12. Treatment of migraine attacks based on the interaction with the trigemino-cerebrovascular system

    DEFF Research Database (Denmark)

    Link, A.S.; Kuris, A.; Edvinsson, L.

    2008-01-01

    with the intensity of the headache. The development of drugs of the triptan class has provided relief for the acute attacks but at the cost of, mainly cardiovascular, side effects. Thus, the intention to improve treatment led to the development of small CGRP receptor antagonists such as olcegepant (BIBN4096BS......) and MK-0974 that alleviate the acute migraine attack without acute side events. The purpose of this review is to give a short overview of the pathological background of migraine headache and to illustrate the mechanisms behind the actions of triptans and the promising CGRP receptor blockers...... disorder. It has been discovered that the trigemino-cerebrovascular system plays a key role in migraine headache pathophysiology by releasing the potent vasodilator calcitonin gene-related peptide (CGRP). This neuropeptide is released in parallel with the pain and its concentration correlates well...

  13. Improved Social Interaction, Recognition and Working Memory with Cannabidiol Treatment in a Prenatal Infection (poly I:C) Rat Model.

    Science.gov (United States)

    Osborne, Ashleigh L; Solowij, Nadia; Babic, Ilijana; Huang, Xu-Feng; Weston-Green, Katrina

    2017-06-01

    Neuropsychiatric disorders such as schizophrenia are associated with cognitive impairment, including learning, memory and attention deficits. Antipsychotic drugs are limited in their efficacy to improve cognition; therefore, new therapeutic agents are required. Cannabidiol (CBD), the non-intoxicating component of cannabis, has anti-inflammatory, neuroprotective and antipsychotic-like properties; however, its ability to improve the cognitive deficits of schizophrenia remains unclear. Using a prenatal infection model, we examined the effect of chronic CBD treatment on cognition and social interaction. Time-mated pregnant Sprague-Dawley rats (n=16) were administered polyinosinic-polycytidilic acid (poly I:C) (POLY; 4 mg/kg) or saline (CONT) at gestation day 15. Male offspring (PN56) were injected twice daily with 10 mg/kg CBD (CONT+CBD, POLY+CBD; n=12 per group) or vehicle (VEH; CONT+VEH, POLY+VEH; n=12 per group) for 3 weeks. Body weight, food and water intake was measured weekly. The Novel Object Recognition and rewarded T-maze alternation tests assessed recognition and working memory, respectively, and the social interaction test assessed sociability. POLY+VEH offspring exhibited impaired recognition and working memory, and reduced social interaction compared to CONT+VEH offspring (peffect in control animals (all p>0.05). In conclusion, chronic CBD administration can attenuate the social interaction and cognitive deficits induced by prenatal poly I:C infection. These novel findings present interesting implications for potential use of CBD in treating the cognitive deficits and social withdrawal of schizophrenia.

  14. Drug Interaction and Serotonin Toxicity with Opioid Use: Another Reason to Avoid Opioids in Headache and Migraine Treatment.

    Science.gov (United States)

    Ansari, Hossein; Kouti, Leila

    2016-08-01

    Treatment of headache, specifically migraine attacks, has always been a challenging subject, especially for neurologist and pain specialists. Triptans are generally underutilized, despite being the gold standard abortive medication for migraine attacks. On the other hand, opioid analgesics are overused as a treatment for headache. One reason for this could be physician unfamiliarity with drug interactions between opioids and other medications, especially the possibility of serotonin toxicity. The general awareness of potential serotonin toxicity with using opioid analgesics is low. In this review, we will conduct a theoretic and evidence-based review of the potential for developing serotonin syndrome in patients who are using opioids analgesics, especially in combination with antidepressants, a common co-prescribed combination. We also review the current diagnostic criteria for serotonin syndrome and identify possible shortcomings of those criteria. Our aim is to increase the awareness of health care providers about potential drug interaction of opioid analgesics with other classes of medication. We place particular emphasis on tramadol since this drug is one of the most commonly used opioid analgesics for headache. The potential for developing serotonin syndrome is relatively high in the patients who are using opioid for pain control. The use of opioids in migraine headache is already discouraged due to the high risk of medication overuse headache and also an increase in headache-related disability (Katsarava et al. Neurology 62:788-790, 2004; Bigal and Lipton. Neurology 71:1821-8, 2008; Casucci and Cevoli. Neurol Sci. 34 Suppl 1:S125-8, 2013). This is another reason that physicians and health care providers should avoid using this class of medication for pain, specifically headache and migraine treatment.

  15. Effectiveness of Psychoanalytic-Interactional Group Therapy vs. Behavioral Group Therapy in Routine Outpatient Treatment of Alcohol-Dependent Patients.

    Science.gov (United States)

    Nyhuis, Peter W; Niederhofer, Eva; Scherbaum, Norbert; Schifano, Fabrizio; Bonnet, Udo; Dembski, Nikolai; Niederhofer, Anna; Specka, Michael; Tenbergen, Meike

    2018-02-23

    The cognitive behavioral therapy has been extensively investigated to assess relapse prevention rates in patients with alcohol dependence. In contrast, only little is known regarding the effectiveness of psychoanalytical psychotherapy in relapse prevention, although this treatment is widely used and especially so in Germany. The aim of this quasi-randomized study was to compare the effectiveness of these two group treatments' approaches under the condition of routine outpatient treatment in a non-university hospital. After inpatient detoxification, patients with alcohol dependence were allocated either to combined behavioral intervention (CBI) or to psychoanalytic-interactional therapy (PIT). The group treatment was carried out weekly over a period of six months. Also, the clinical care package included both individual treatment sessions (e.g. every 4-6 weeks) and abstinence supporting medication. The main outcome criteria included retention rates and frequency of alcohol relapse. Some 215 patients (mean age 49.6 years [standard deviation, 10], 56.7% males, with a mean duration of alcohol dependence of 16.5 years [range: 1-50 years]) were included in the study. Overall, CBI clients showed a retention rate of 66.7%, compared to 81.8% for PIT clients (p =.008). An intention-to-treat analysis of alcohol relapses showed a significant difference between PIT and CBI groups (PIT: 33.6%; CBI: 49.5%; p =.018). There were no statistically significant differences between the 2 groups in terms of prescription rates of disulfiram, naltrexone or acamprosate. Notwithstanding the study limitations, PIT seemed here to be at least as effective as CBI in terms of retention and relapse prevention rates' levels.

  16. Graphical Presentation of Patient-Treatment Interaction Elucidated by Continuous Biomarkers. Current Practice and Scope for Improvement.

    Science.gov (United States)

    Shen, Yu-Ming; Le, Lien D; Wilson, Rory; Mansmann, Ulrich

    2017-01-09

    Biomarkers providing evidence for patient-treatment interaction are key in the development and practice of personalized medicine. Knowledge that a patient with a specific feature - as demonstrated through a biomarker - would have an advantage under a given treatment vs. a competing treatment can aid immensely in medical decision-making. Statistical strategies to establish evidence of continuous biomarkers are complex and their formal results are thus not easy to communicate. Good graphical representations would help to translate such findings for use in the clinical community. Although general guidelines on how to present figures in clinical reports are available, there remains little guidance for figures elucidating the role of continuous biomarkers in patient-treatment interaction (CBPTI). To combat the current lack of comprehensive reviews or adequate guides on graphical presentation within this topic, our study proposes presentation principles for CBPTI plots. In order to understand current practice, we review the development of CBPTI methodology and how CBPTI plots are currently used in clinical research. The quality of a CBPTI plot is determined by how well the presentation provides key information for clinical decision-making. Several criteria for a good CBPTI plot are proposed, including general principles of visual display, use of units presenting absolute outcome measures, appropriate quantification of statistical uncertainty, correct display of benchmarks, and informative content for answering clinical questions especially on the quantitative advantage for an individual patient with regard to a specific treatment. We examined the development of CBPTI methodology from the years 2000 - 2014, and reviewed how CBPTI plots were currently used in clinical research in six major clinical journals from 2013 - 2014 using the principle of theoretical saturation. Each CBPTI plot found was assessed for appropriateness of its presentation and clinical utility

  17. Surface interactions between nanoscale iron and organic material: Potential uses in water treatment process units

    Science.gov (United States)

    Storms, Max

    Membrane systems are among the primary emergent technologies in water treatment process units due to their ease of use, small physical footprint, and high physical rejection. Membrane fouling, the phenomena by which membranes become clogged or generally soiled, is an inhibitor to optimal efficiency in membrane systems. Novel, composite, and modified surface materials must be investigated to determine their efficacy in improving fouling behavior. Ceramic membranes derived from iron oxide nanoparticles called ferroxanes were coated with a superhydrophillic, zwitterionic polymer called poly (sulfobetaine methacrylate) (polySBMA) to form a composite ceramic-polymeric membrane. Membrane samples with and without polySBMA coating were subjected to fouling with a bovine serum albumin solution and fouling was observed by measuring permeate flux at 10 mL intervals. Loss of polySBMA was measured using total organic carbon analysis, and membrane samples were characterized using x-ray diffraction, scanning electron microscopy, and optical profilometry. The coated membrane samples decreased initial fouling rate by 27% and secondary fouling rate by 24%. Similarly, they displayed a 30% decrease in irreversible fouling during the initial fouling stage, and a 27% decrease in irreversible fouling in the secondary fouling stage; however, retention of polySBMA sufficient for improved performance was not conclusive. The addition of chemical disinfectants into drinking water treatment processes results in the formation of compounds called disinfection by-products (DBPs). The formation of DBPs occurs when common chemical disinfectants (i.e. chlorine) react with organic material. The harmful effects of DBP exposure require that they be monitored and controlled for public safety. This work investigated the ability of nanostructured hematite derived from ferroxane nanoparticles to remove organic precursors to DBPs in the form of humic acid via adsorption processes. The results show that p

  18. Investigation of herb-drug interactions with ginkgo biloba in women receiving hormonal treatment for early breast cancer.

    Science.gov (United States)

    Vardy, Janette; Dhillon, Haryana M; Clarke, Stephen J; Olesen, Inger; Leslie, Felicity; Warby, Anne; Beith, Jane; Sullivan, Anne; Hamilton, Anne; Beale, Philip; Rittau, Anneliese; McLachlan, Andrew J

    2013-12-01

    Women receiving treatment for breast cancer commonly ingest herbal medicines. Little is known about the potential for herb-drug interactions in this population. The aim of this study is to investigate the effect of ginkgo biloba co-administration on the pharmacokinetics of tamoxifen, anastrozole and letrozole. This was a prospective open-label cross-over study in 60 women with early stage breast cancer taking either tamoxifen, anastrozole or letrozole (n=20/group). Participants received ginkgo biloba (EGb 761) for 3 weeks (120 mg twice daily). Trough concentrations of drugs were measured before and after ginkgo biloba treatment using LC-MS/MS. Toxicities were graded according to National Cancer Institute Common Terminology Criteria for Adverse Events. Trough concentrations before and after treatment with ginkgo biloba were not significantly different for tamoxifen (93.5 ± 29.0, 86.5 ± 25.3 ng/mL; p=0.16), letrozole (91.1 ± 50.4, 89.6 ± 52.14 ng/mL; p=0.60) or anastrozole (29.1 ± 8.6, 29.1 ± 7.6 ng/mL; p=0.97). Ginkgo biloba was well tolerated, with no difference in toxicity during ginkgo biloba. Co-administration of ginkgo biloba does not significantly affect the pharmacokinetics of tamoxifen, anastrozole or letrozole. There was no difference in the toxicity profile of hormone therapy with ginkgo biloba use in women with early stage breast cancer.

  19. Effects Influencing Plutonium-Absorber Interactions and Distributions in Routine and Upset Waste Treatment Plant Operations

    Energy Technology Data Exchange (ETDEWEB)

    Delegard, Calvin H. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Sinkov, Sergey I. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Fiskum, Sandra K. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2015-05-01

    This report is the third in a series of analyses written in support of a plan to revise the Hanford Waste Treatment and Immobilization Plant (WTP) Preliminary Criticality Safety Evaluation Report (CSER) that is being implemented at the request of the U.S. Department of Energy (DOE) Criticality Safety Group. A report on the chemical disposition of plutonium in Hanford tank wastes was prepared as Phase 1 of this plan (Delegard and Jones 2015). Phase 2 is the provision of a chemistry report to describe the potential impacts on criticality safety of waste processing operations within the WTP (Freer 2014). In accordance with the request from the Environmental and Nuclear Safety Department of the WTP (Miles and Losey 2012), the Phase 2 report assessed the potential for WTP process conditions within and outside the range of normal control parameters to change the ratio of fissile material to neutron-absorbing material in the waste as it is processed with an eye towards potential implications for criticality safety. The Phase 2 study also considered the implications should WTP processes take place within the credible range of chemistry upset conditions. In the present Phase 3 report, the 28 phenomena described in the Phase 2 report were considered with respect to the disposition of plutonium and various absorber elements. The phenomena identified in the Phase 2 report are evaluated in light of the Phase 1 report and other resources to determine the impacts these phenomena might have to alter the plutonium/absorber dispositions and ratios. The outcomes of the Phase 3 evaluations then can be used to inform subsequent engineering decisions and provide reasonable paths forward to mitigate or overcome real or potential criticality concern in plant operations.

  20. Postoperative infection treatment score for the spine (PITSS): construction and validation of a predictive model to define need for single versus multiple irrigation and debridement for spinal surgical site infection.

    Science.gov (United States)

    Dipaola, Christian P; Saravanja, Davor D; Boriani, Luca; Zhang, Hongbin; Boyd, Michael C; Kwon, Brian K; Paquette, Scott J; Dvorak, Marcel F S; Fisher, Charles G; Street, John T

    2012-03-01

    There is very little evidence to guide treatment of patients with spinal surgical site infection (SSI) who require irrigation and debridement (I&D) in deciding need for single or multiple I&Ds or more complex wound management such as vacuum-assisted closure dressing or soft-tissue flaps. The purpose of this study was to build a predictive model that stratifies patients with spinal SSI, allowing us to determine which patients will need single versus multiple I&D. The model will be validated and will serve as evidence to support a scoring system to guide treatment. A consecutive series of 128 patients from a tertiary spine center (collected from 1999 to 2005) who required I&D for spinal SSI were studied based on data from a prospectively collected outcomes database. More than 30 variables were identified by extensive literature review as possible risk factors for SSI and tested as possible predictors of risk for multiple I&D. Logistic regression was conducted to assess each variable's predictability by a "bootstrap" statistical method. A prediction model was built in which single or multiple I&D was treated as the "response" and risk factors as "predictors." Next, a second series of 34 different patients meeting the same criteria as the first population were studied. External validation of the predictive model was performed by applying the model to the second data set, and predicted probabilities were generated for each patient. Receiver operating characteristic curves were constructed, and the area under the curve (AUC) was calculated. Twenty-four of one hundred twenty-eight patients with spinal SSI required multiple I&D. Six predictors: anatomical location, medical comorbidities, specific microbiology of the SSI, the presence of distant site infection (ie, urinary tract infection or bacteremia), the presence of instrumentation, and the bone graft type proved to be the most reliable predictors of need for multiple I&D. Internal validation of the predictive model

  1. The FAt Spondyloarthritis Spine Score (FASSS)

    DEFF Research Database (Denmark)

    Pedersen, Susanne Juhl; Zhao, Zheng; Lambert, Robert Gw

    2013-01-01

    an important measure of treatment efficacy as well as a surrogate marker for new bone formation. The aim of this study was to develop and validate a new scoring method for fat lesions in the spine, the Fat SpA Spine Score (FASSS), which in contrast to the existing scoring method addresses the localization......Studies have shown that fat lesions follow resolution of inflammation in the spine of patients with axial spondyloarthritis (SpA). Fat lesions at vertebral corners have also been shown to predict development of new syndesmophytes. Therefore, scoring of fat lesions in the spine may constitute both...... and phenotypic diversity of fat lesions in patients with axial SpA....

  2. An interactional test of the reformulated helplessness theory of depression in women receiving clinical treatment for eating disorders.

    Science.gov (United States)

    Rotenberg, Ken J; Costa, Paula; Trueman, Mark; Lattimore, Paul

    2012-08-01

    The study tested the Reformulated Helplessness model that individuals who show combined internal locus of control, high stability and high globality attributions for negative life events are prone to depression. Thirty-six women (M=29 years-8 months of age) receiving clinical treatment for eating disorders completed: the Attribution Style Questionnaire, the Beck Depression Inventory, and the Stirling Eating Disorder Scales. An HRA yielded a three-way interaction among the attributional dimensions on depressive symptoms. Plotting of the slopes showed that the attribution of negative life events to the combination of internal locus of control, high stability, and a high globality, was associated with the optimal level of depressive symptoms. The findings supported the Reformulated Helplessness as a model of depression. Copyright © 2012 Elsevier Ltd. All rights reserved.

  3. Using Interactive Web-Based Screening, Brief Intervention and Referral to Treatment in an Urban, Safety-Net HIV Clinic.

    Science.gov (United States)

    Dawson Rose, Carol; Cuca, Yvette P; Kamitani, Emiko; Eng, Shannon; Zepf, Roland; Draughon, Jessica; Lum, Paula

    2015-06-01

    Substance use among people living with HIV is high, and screening, brief intervention, and referral to treatment (SBIRT) is an evidence-based approach to addressing the issue. We examined whether patients would participate in a technology-based SBIRT program in an urban HIV clinic. An SBIRT intervention was programmed into the clinic's web-based patient portal linked to their personal health record. We examined: demographic, health, HIV, and substance use characteristics of participants who completed the web-based intervention compared to those who did not. Fewer than half of the 96 participants assigned to the web-based SBIRT completed it (n = 39; 41 %). Participants who completed the web-based intervention had significantly higher amphetamine SSIS scores than those who did not complete the intervention. Participants whose substance use is more harmful may be more motivated to seek help from a variety of sources. In addition, it is important that technology-based approaches to behavioral interventions in clinics take into consideration feasibility, client knowledge, and comfort using technology.

  4. The Hippo Pathway and YAP/TAZ-TEAD Protein-Protein Interaction as Targets for Regenerative Medicine and Cancer Treatment.

    Science.gov (United States)

    Santucci, Matteo; Vignudelli, Tatiana; Ferrari, Stefania; Mor, Marco; Scalvini, Laura; Bolognesi, Maria Laura; Uliassi, Elisa; Costi, Maria Paola

    2015-06-25

    The Hippo pathway is an important organ size control signaling network and the major regulatory mechanism of cell-contact inhibition. Yes associated protein (YAP) and transcriptional co-activator with PDZ-binding motif (TAZ) are its targets and terminal effectors: inhibition of the pathway promotes YAP/TAZ translocation to the nucleus, where they interact with transcriptional enhancer associate domain (TEAD) transcription factors and coactivate the expression of target genes, promoting cell proliferation. Defects in the pathway can result in overgrowth phenotypes due to deregulation of stem-cell proliferation and apoptosis; members of the pathway are directly involved in cancer development. The pharmacological regulation of the pathway might be useful in cancer prevention, treatment, and regenerative medicine applications; currently, a few compounds can selectively modulate the pathway. In this review, we present an overview of the Hippo pathway, the sequence and structural analysis of YAP/TAZ, the known pharmacological modulators of the pathway, especially those targeting YAP/TAZ-TEAD interaction.

  5. Credit Scoring Modeling

    Directory of Open Access Journals (Sweden)

    Siana Halim

    2014-01-01

    Full Text Available It is generally easier to predict defaults accurately if a large data set (including defaults is available for estimating the prediction model. This puts not only small banks, which tend to have smaller data sets, at disadvantage. It can also pose a problem for large banks that began to collect their own historical data only recently, or banks that recently introduced a new rating system. We used a Bayesian methodology that enables banks with small data sets to improve their default probability. Another advantage of the Bayesian method is that it provides a natural way for dealing with structural differences between a bank’s internal data and additional, external data. In practice, the true scoring function may differ across the data sets, the small internal data set may contain information that is missing in the larger external data set, or the variables in the two data sets are not exactly the same but related. Bayesian method can handle such kind of problem.

  6. Intra-arterial therapy of neuroendocrine tumour liver metastases: comparing conventional TACE, drug-eluting beads TACE and yttrium-90 radioembolisation as treatment options using a propensity score analysis model

    Energy Technology Data Exchange (ETDEWEB)

    Minh, Duc Do; Gorodetski, Boris; Smolka, Susanne; Savic, Lynn Jeanette; Wainstejn, David [Charite Universitaetsmedizin, Campus Virchow Klinikum, Department of Diagnostic and Interventional Radiology, Berlin (Germany); Yale University School of Medicine, Department of Radiology and Biomedical Imaging, New Haven, CT (United States); Chapiro, Julius; Schlachter, Todd [Yale University School of Medicine, Department of Radiology and Biomedical Imaging, New Haven, CT (United States); Huang, Qiang [Yale University School of Medicine, Department of Radiology and Biomedical Imaging, New Haven, CT (United States); Capital Medical University, Department of Interventional Radiology, Beijing Chaoyang Hospital, Beijing (China); Liu, Cuihong [Yale University School of Medicine, Department of Radiology and Biomedical Imaging, New Haven, CT (United States); Shandong Provincial Hospital Affiliated to Shandong University, The Ultrasound Department, Jinan (China); Lin, MingDe [Yale University School of Medicine, Department of Radiology and Biomedical Imaging, New Haven, CT (United States); Philips Research North America, U/S Imaging and Interventions (UII), Cambridge, MA (United States); Gebauer, Bernhard [Charite Universitaetsmedizin, Campus Virchow Klinikum, Department of Diagnostic and Interventional Radiology, Berlin (Germany); Geschwind, Jean-Francois [Yale University School of Medicine, Department of Radiology and Biomedical Imaging, New Haven, CT (United States)

    2017-12-15

    To compare efficacy, survival outcome and prognostic factors of conventional transarterial chemoembolisation (cTACE), drug-eluting beads TACE (DEB-TACE) and yttrium-90 radioembolisation (Y90) for the treatment of liver metastases from gastroenteropancreatic (GEP) neuroendocrine tumours (NELM). This retrospective analysis included 192 patients (58.6 years mean age, 56% men) with NELM treated with cTACE (N = 122), DEB-TACE (N = 26) or Y90 (N = 44) between 2000 and 2014. Radiologic response to therapy was assessed according to Response Evaluation Criteria in Solid Tumours (RECIST) and World Health Organization (WHO) criteria using periprocedural MR imaging. Survival analysis included propensity score analysis (PSA), median overall survival (MOS), hepatic progression-free survival, Kaplan-Meier using log-rank test and the uni- and multivariate Cox proportional hazards model (MVA). MOS of the entire study population was 28.8 months. As for cTACE, DEB-TACE and Y90, MOS was 33.8 months, 21.7 months and 23.6 months, respectively. According to the MVA, cTACE demonstrated a significantly longer MOS as compared to DEB-TACE (p <.01) or Y90 (p =.02). The 5-year survival rate after initial cTACE, DEB-TACE and Y90 was 28.2%, 10.3% and 18.5%, respectively. Upon PSA, our study suggests significant survival benefits for patients treated with cTACE as compared to DEB-TACE and Y90. This data supports the therapeutic decision for cTACE as the primary intra-arterial therapy option in patients with unresectable NELM until proven otherwise. (orig.)

  7. Using nuclear microscopy to characterize the interaction of textile-used silver nanoparticles with a biological wastewater treatment system

    Science.gov (United States)

    Bento, J. B.; Franca, R. D. G.; Pinheiro, T.; Alves, L. C.; Pinheiro, H. M.; Lourenço, N. D.

    2017-08-01

    The use of engineered nanoparticles in the textile industry has been rapidly increasing but their fate during biological wastewater treatment is largely unknown. The goal of the current study was to characterize the interaction of silver nanoparticles (AgNPs), used in the textile industry, with a biological wastewater treatment system based on aerobic granular sludge (AGS). The exposure tests were performed using a laboratory-scale sequencing batch reactor (SBR) system with AGS. The behavior and fate of textile AgNPs in the AGS system was studied with nuclear microscopy techniques. Elemental maps of AGS samples collected from the SBR showed that AgNPs typically clustered in agglomerates of small dimensions (application of nuclear microscopy for the characterization of the behavior and fate of AgNPs in AGS. The detailed compartmentalization of AgNPs in AGS components obtained with nuclear microscopy provides new and relevant information concerning AgNPs retention. This will be important in biotechnological terms to delineate strategies for AgNPs removal from textile wastewater.

  8. Systematic review and network meta-analysis of combination and monotherapy treatments in disease-modifying antirheumatic drug-experienced patients with rheumatoid arthritis: analysis of American College of Rheumatology criteria scores 20, 50, and 70

    Science.gov (United States)

    Orme, Michelle E; MacGilchrist, Katherine S; Mitchell, Stephen; Spurden, Dean; Bird, Alex

    2012-01-01

    Background Biologic disease-modifying antirheumatic drugs (bDMARDs) extend the treatment choices for rheumatoid arthritis patients with suboptimal response or intolerance to conventional DMARDs. The objective of this systematic review and meta-analysis was to compare the relative efficacy of EU-licensed bDMARD combination therapy or monotherapy for patients intolerant of or contraindicated to continued methotrexate. Methods Comprehensive, structured literature searches were conducted in Medline, Embase, and the Cochrane Library, as well as hand-searching of conference proceedings and reference lists. Phase II or III randomized controlled trials reporting American College of Rheumatology (ACR) criteria scores of 20, 50, and 70 between 12 and 30 weeks’ follow-up and enrolling adult patients meeting ACR classification criteria for rheumatoid arthritis previously treated with and with an inadequate response to conventional DMARDs were eligible. To estimate the relative efficacy of treatments whilst preserving the randomized comparisons within each trial, a Bayesian network meta-analysis was conducted in WinBUGS using fixed and random-effects, logit-link models fitted to the binomial ACR 20/50/70 trial data. Results The systematic review identified 10,625 citations, and after a review of 2450 full-text papers, there were 29 and 14 eligible studies for the combination and monotherapy meta-analyses, respectively. In the combination analysis, all licensed bDMARD combinations had significantly higher odds of ACR 20/50/70 compared to DMARDs alone, except for the rituximab comparison, which did not reach significance for the ACR 70 outcome (based on the 95% credible interval). The etanercept combination was significantly better than the tumor necrosis factor-α inhibitors adalimumab and infliximab in improving ACR 20/50/70 outcomes, with no significant differences between the etanercept combination and certolizumab pegol or tocilizumab. Licensed-dose etanercept, adalimumab

  9. Systematic review and network meta-analysis of combination and monotherapy treatments in disease-modifying antirheumatic drug-experienced patients with rheumatoid arthritis: analysis of American College of Rheumatology criteria scores 20, 50, and 70

    Directory of Open Access Journals (Sweden)

    Orme ME

    2012-12-01

    Full Text Available Michelle E Orme,1 Katherine S MacGilchrist,2 Stephen Mitchell,2 Dean Spurden,3 Alex Bird31Icera Consulting, Swindon, Wiltshire, UK; 2Systematic Review Department, Abacus International, Bicester, Oxfordshire, UK; 3Pfizer UK Limited, Tadworth, Surrey, UKBackground: Biologic disease-modifying antirheumatic drugs (bDMARDs extend the treatment choices for rheumatoid arthritis patients with suboptimal response or intolerance to conventional DMARDs. The objective of this systematic review and meta-analysis was to compare the relative efficacy of EU-licensed bDMARD combination therapy or monotherapy for patients intolerant of or contraindicated to continued methotrexate.Methods: Comprehensive, structured literature searches were conducted in Medline, Embase, and the Cochrane Library, as well as hand-searching of conference proceedings and reference lists. Phase II or III randomized controlled trials reporting American College of Rheumatology (ACR criteria scores of 20, 50, and 70 between 12 and 30 weeks' follow-up and enrolling adult patients meeting ACR classification criteria for rheumatoid arthritis previously treated with and with an inadequate response to conventional DMARDs were eligible. To estimate the relative efficacy of treatments whilst preserving the randomized comparisons within each trial, a Bayesian network meta-analysis was conducted in WinBUGS using fixed and random-effects, logit-link models fitted to the binomial ACR 20/50/70 trial data.Results: The systematic review identified 10,625 citations, and after a review of 2450 full-text papers, there were 29 and 14 eligible studies for the combination and monotherapy meta-analyses, respectively. In the combination analysis, all licensed bDMARD combinations had significantly higher odds of ACR 20/50/70 compared to DMARDs alone, except for the rituximab comparison, which did not reach significance for the ACR 70 outcome (based on the 95% credible interval. The etanercept combination was

  10. 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…

  11. Whole-word response scoring underestimates functional spelling ability for some individuals with global agraphia

    Directory of Open Access Journals (Sweden)

    Andrew Tesla Demarco

    2015-05-01

    These data suggest that conventional whole-word scoring may significantly underestimate functional spelling performance. Because by-letter scoring boosted pre-treatment scores to the same extent as post-treatment scores, the magnitude of treatment gains was no greater than estimates from conventional whole-word scoring. Nonetheless, the surprisingly large disparity between conventional whole-word scoring and by-letter scoring suggests that by-letter scoring methods may warrant further investigation. Because by-letter analyses may hold interest to others, we plan to make the software tool used in this study available on-line for use to researchers and clinicians at large.

  12. Disease severity scoring systems in dermatology

    Directory of Open Access Journals (Sweden)

    Cemal Bilaç

    2016-06-01

    Full Text Available Scoring systems have been developed to interpret the disease severity objectively by evaluating the parameters of the disease. Body surface area, visual analogue scale, and physician global assessment are the most frequently used scoring systems for evaluating the clinical severity of the dermatological diseases. Apart from these scoring systems, many specific scoring systems for many dermatological diseases, including acne (acne vulgaris, acne scars, alopecia (androgenetic alopecia, tractional alopecia, bullous diseases (autoimmune bullous diseases, toxic epidermal necrolysis, dermatitis (atopic dermatitis, contact dermatitis, dyshidrotic eczema, hidradenitis suppurativa, hirsutismus, connective tissue diseases (dermatomyositis, skin involvement of systemic lupus erythematosus (LE, discoid LE, scleroderma, lichen planoplaris, mastocytosis, melanocytic lesions, melasma, onychomycosis, oral lichen planus, pityriasis rosea, psoriasis (psoriasis vulgaris, psoriatic arthritis, nail psoriasis, sarcoidosis, urticaria, and vitiligo, have also been developed. Disease severity scoring methods are ever more extensively used in the field of dermatology for clinical practice to form an opinion about the prognosis by determining the disease severity; to decide on the most suitable treatment modality for the patient; to evaluate the efficacy of the applied medication; and to compare the efficiency of different treatment methods in clinical studies.

  13. RISK FACTOR DIAGNOSTIC SCORE IN DIABETIC FOOT

    Directory of Open Access Journals (Sweden)

    Mohamed Shameem P. M

    2016-09-01

    Full Text Available INTRODUCTION Diabetic foot ulcers vary in their clinical presentation and nature of severity and therefore create a challenging problem to the treating surgeon regarding the prediction of the clinical course and the end result of the treatment. Clinical studies have shown that there are certain risk factors for the progression of foot ulcers in diabetics and it may therefore be possible to predict the course of an ulcer foot at presentation itself, thus instituting proper therapy without delay. Spoken otherwise clinical scoring may tell that this particular ulcer is having highest chance of amputation, then one may be able to take an early decision for the same and avoid the septic complications, inconvenience to the patient, long hospital stay and cost of treatments. AIM OF THE STUDY Aim of the study is to evaluate the above-mentioned scoring system in predicting the course the diabetic foot ulcers. MATERIALS AND METHODS 50 patients with Diabetic Foot attending the OPD of Department of Surgery of Government Hospital attached to Calicut Medical College are included in the present study. After thorough history taking and clinical examination, six risk factors like Age, pedal vessels, renal function, neuropathy, radiological findings and ulcers were observed in the patients by giving certain scoring points to each of them. The total number of points scored by the patients at the time of admission or OPD treatment was correlated with the final outcome in these patients, whether leading to amputation or conservative management. All the data was analysed using standard statistical methods. OBSERVATIONS AND RESULTS There were 12 females and 38 males with a female to male ratio 1:3.1. All were aged above 30 years. Twenty-four (48% of them were between 30-60 years and twenty six (52% were above 60 years. 10 patients were treated conservatively with risk score range: 10 to 35. Six had single toe loss with risk score: 25 to 35. Six had multiple toe loss

  14. Can Early Intervention Have an Impact on Future Life? A Study of Life Events, Social Interaction, and Child Behavior among Mothers at Psychosocial Risk and Their Children Eight Years after Interaction Treatment

    Science.gov (United States)

    Wadsby, Marie

    2012-01-01

    Forty-six mothers at psychosocial risk who had undergone interaction treatment when their children were babies were studied with respect to experienced negative life events, social network, and behavior problems in children. One reference group comprising 45 nontreated mothers at psychosocial risk and one comprising 56 mothers without psychosocial…

  15. Understanding the tissue interaction of new treatment modalities in laparoscopic surgery in view of safe and effective application (Conference Presentation)

    Science.gov (United States)

    Grimbergen, Matthijs C. M.; Klaessens, John H.; van der Veen, Albert J.; Verdaasdonk, Rudolf M.

    2016-03-01

    During laparoscopic surgery, devices are require to either cut, ablate or coagulate tissue and veins with high precision and controlled lateral damage preferably in an one-for-all modality. The tissue interactions of 3 new treatment modalities were studied using special imaging techniques to obtain a better understanding the working mechanism in view of effective and safe application. The Plasmajet produces a high temperature ionized gas 'flame' directed to the tissue surface at the tip of a 4 mm diameter rigid hand piece. The Lumenis DUO CO2 laser enables endoscopic laser energy delivery through a 1 mm outer diameter flexible hollow waveguide. The 2 µm 'Thulium' laser is delivered by (standard) 400 µm diameter optical fiber. Thermal imaging and Schlieren techniques were used to assess the superficial ablative and coagulation effects these surgical instruments scanning at preset velocities and distances from the surface of biological tissues and phantoms . The CO2 was very effective in tissue ablation even at a distance up to 10 mm due to a very small diverging beam from the hollow waveguide. In contrast, the Thulium laser showed less ablation and increasing coagulation at larger distance to the tissue. The gas 'flame' of the Plasmajet spread the thermal energy over the surface for effective superficial ablation and coagulation. However, the pressure of the gas flow is substantial on the tissue surface creating turbulence and even indirect cooling. The specific ablation and coagulation effects of the three treatment modalities have to be appreciate and the effective and safe application will depend on the preference and skills of the surgeon

  16. Complex interactions among nutrients, chlorophyll-a, and microcystins in three stormwater wet detention basins with floating treatment wetlands.

    Science.gov (United States)

    Hartshorn, Nicholas; Marimon, Zachary; Xuan, Zhemin; Cormier, Jessica; Chang, Ni-Bin; Wanielista, Martin

    2016-02-01

    Stormwater wet detention ponds hold a permanent pool of water and offer many beneficial uses including flood mitigation, pollution prevention, downstream erosion control, increased aesthetics, and recreational uses. Although the removal of nutrients is generally low for stormwater wet detention ponds in urban areas, floating treatment wetlands (FTWs) can be installed to offer an innovative solution toward naturally removing excess nutrients and aiding in stormwater management. To improve the stormwater reuse potential, this study assessed nutrient, microcystin, and chlorophyll-a interactions in three Florida stormwater wet detention ponds with recently implemented FTWs. Both episodic (storm events) and routine (non-storm events) sampling campaigns were carried out at the three ponds located in Ruskin, Gainesville, and Orlando. The results showed a salient negative correlation between total phosphorus and microcystin concentrations for both storm and non-storm events across all three ponds. The dominant nutrient species in correlation seemed to be total phosphorus, which correlated positively with chlorophyll-a concentrations at all ponds and sampling conditions, with the exception of Orlando non-storm events. These results showed a correlation conditional to the candidate pond and sampling conditions for microcystin and chlorophyll-a concentrations. Copyright © 2015 Elsevier Ltd. All rights reserved.

  17. Effect of cultivar x ozone treatment interaction on the total polyphenols content and antioxidant activity of globe artichoke

    Directory of Open Access Journals (Sweden)

    Sara Lombardo

    2015-06-01

    Full Text Available Two globe artichoke cultivars (Violet de Provence and Apollo were harvested at an experimental field in Sicily, immediately washed with ozonised water and stored in: i normal atmosphere; ii ozone-enriched atmosphere for 3 days and for the last 4 days in normal atmosphere; iii ozone-enriched atmosphere for 7 days. A control (samples unwashed and stored at room temperature was also investigated. The effect of cultivar x ozone treatment interaction on water content losses, total polyphenols content and antioxidant activity was evaluated after 0, 3 and 7 days of storage. Washing with ozonised water and storage under O3- enriched atmosphere allowed higher water retention compared with the control, especially for Violet de Provence. After 3 days of storage in ozone-enriched atmosphere, on average of cultivars, the total polyphenols content and antioxidant activity increased by 11.7% and 5.5%, respectively. By contrast, after further 4 days of storage in ozonised atmosphere, Apollo and Violet de Provence displayed a significant reduction in their level of total polyphenols and aantioxidant activity. The exposure of globe artichoke heads to an ozone-enriched atmosphere should not exceed 3 days aimed at preserving their high nutritional value, with special emphasis on total polyphenols content.

  18. Throughfall chemistry and canopy interactions in a Sitka spruce plantation sprayed with six different simulated polluted mist treatments

    International Nuclear Information System (INIS)

    Chiwa, M.; Crossley, A.; Sheppard, L.J.; Sakugawa, H.; Cape, J.N.

    2004-01-01

    Throughfall chemistry was studied in a mature Sitka spruce plantation in order to investigate canopy interactions, such as nitrogen absorption, cation leaching, and neutralization of rainfall passing through the canopy. The plantation had been exposed to six different simulated mist treatments including N (NH 4 NO 3 ) and S (H 2 SO 4 at pH 2.5) in four replicated blocks since 1996. Throughfall and rainfall were collected from May to September 2000. The results showed that 30-35% of the applied N was retained by the canopy. There were linear relationships between the loss of H + and increased K + , Mg 2+ and Ca 2+ deposition through the canopy. However these increases in K + , Mg 2+ and Ca 2+ deposition accounted for only about 50% of total neutralization of the acidity. The relationship between the anion deficits in throughfall and the loss of H + implied that weak organic acid anions were involved in the neutralization of the acidity in throughfall. - Weak organic acids may be involved in neutralizing acidity of throughfall

  19. Risks and realities: dyadic interaction between 6-month-old infants and their mothers in opioid maintenance treatment.

    Science.gov (United States)

    Sarfi, Monica; Smith, Lars; Waal, Helge; Sundet, Jon Martin

    2011-12-01

    A number of studies point to methadone exposure in utero as a possible risk factor in the developing mother-infant relationship in the first year of life. This study is part of a larger, national follow-up of 38 infants prenatally exposed to methadone or buprenorphine and 36 comparison, low-risk infants. The aim of the present paper is to assess the quality of mother-infant relationship when the infants are 6 months old. Videotaped mother-infant interactions were rated in a global scale (NICHD). Maternal and infant contributions collapsed into the variables "infant style" and "maternal style" showed that the only factor making significant contribution to the outcome measure "dyadic mutuality" was maternal style. The importance of group membership (exposed versus non-exposed), was reduced when controlling for maternal drug use prior to opioid maintenance treatment (OMT), maternal depression and parenting stress as well as infants' developmental status and sensory-integrative functions. This suggests that prediction of dyadic mutuality should be based on individual characteristics rather than group characteristics. These results support previous research findings that methadone and buprenorphine use per se does not have direct influence on the quality of early mother-infant relationship, but tailored follow-up procedures targeting drug-free pregnancies and parenting support are beneficial for women in OMT and their children. Copyright © 2011 Elsevier Inc. All rights reserved.

  20. Surgically treated spinal metastases: Do prognostic scores have a role?

    Science.gov (United States)

    Afsar, Afifa; Qadeer, Mohsin; Sharif, Salman

    2017-01-01

    The outcome for patients with metastatic disease in spine is difficult to predict. Multiple scoring systems were utilized in this study to determine their effectiveness in predicting long-term prognoses. A retrospective analysis of surgically treated patients of spinal metastasis was performed between 2005 and 2016. Data were collected prospectively during which 8 patients were lost to follow-up. Ultimately, data from 63 patients were reviewed. Treatment and prognoses were analyzed utilizing various scoring systems including the SINS, the Tomita, the modified Tokouhashi and Bauer scores. Records of 63 patients, averaging 54 years of age, were analyzed. The Tomita score was applied in 44 patients, a modified Bauer score was studied in 49 patients, while SINS and modified Tokouhashi scores were calculated in all 63 patients. The hazard ratios for the Tomita score were 1, 0.030, 0.622, and 0.272, respectively. The hazard ratios for the modified Bauer scores were 1, 4.663, and 1.622, respectively. The Tokouhashi ratios were 1, 1.656, and 0.501, respectively. Of interest, the Tomita scores provided the highest statistical significance ( P = 0.000) followed by the Bauer ( P = 0.002) and Tokuhashi scores ( P = 0.003). Notably, the SINS score showed no significant correlation in predicting patient survival. For evaluating the metastatic spine disease, this study evaluated the prognostic efficacy of four widely used scores: the Tomita, score, the modified Tokouhashi and Bauer scores, and the SINS scores. The Tomita scores provided the highest statistical significance, followed by the Bauer, and Tokuhashi scores, while the SINS score showed no significant correlation in predicting patient survival.

  1. [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.

  2. 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.

  3. 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

  4. Peer Scores for Group Work.

    Science.gov (United States)

    Culp, Linda; Malone, Virginia

    1992-01-01

    Explains how peer scores can be used to constitute one part of students' grades on group projects. Contributions students make to a project are defined in four categories: creativity/ideas contributed, research/data collection, writing/typing/artwork, and organizing/collating. A scoring rubric for these categories is presented. (PR)

  5. 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

  6. 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.…

  7. Value of Quantitative Collateral Scoring on CT Angiography in Patients with Acute Ischemic Stroke.

    Science.gov (United States)

    Boers, A M M; Sales Barros, R; Jansen, I G H; Berkhemer, O A; Beenen, L F M; Menon, B K; Dippel, D W J; van der Lugt, A; van Zwam, W H; Roos, Y B W E M; van Oostenbrugge, R J; Slump, C H; Majoie, C B L M; Marquering, H A

    2018-04-19

    Many studies have emphasized the relevance of collateral flow in patients presenting with acute ischemic stroke. Our aim was to evaluate the relationship of the quantitative collateral score on baseline CTA with the outcome of patients with acute ischemic stroke and test whether the timing of the CTA acquisition influences this relationship. From the Multicenter Randomized Clinical Trial of Endovascular Treatment of Acute Ischemic Stroke in the Netherlands (MR CLEAN) data base, all baseline thin-slice CTA images of patients with acute ischemic stroke with intracranial large-vessel occlusion were retrospectively collected. The quantitative collateral score was calculated as the ratio of the vascular appearance of both hemispheres and was compared with the visual collateral score. Primary outcomes were 90-day mRS score and follow-up infarct volume. The relation with outcome and the association with treatment effect were estimated. The influence of the CTA acquisition phase on the relation of collateral scores with outcome was determined. A total of 442 patients were included. The quantitative collateral score strongly correlated with the visual collateral score (ρ = 0.75) and was an independent predictor of mRS (adjusted odds ratio = 0.81; 95% CI, .77-.86) and follow-up infarct volume (exponent β = 0.88; P collateral score showed areas under the curve of 0.71 and 0.69 for predicting functional independence (mRS 0-2) and follow-up infarct volume of >90 mL, respectively. We found significant interaction of the quantitative collateral score with the endovascular therapy effect in unadjusted analysis on the full ordinal mRS scale ( P = .048) and on functional independence ( P = .049). Modification of the quantitative collateral score by acquisition phase on outcome was significant (mRS: P = .004; follow-up infarct volume: P collateral scoring in patients with acute ischemic stroke is a reliable and user-independent measure of the collateral capacity on baseline CTA and

  8. Application programming in C# environment with recorded user software interactions and its application in autopilot of VMAT/IMRT treatment planning.

    Science.gov (United States)

    Wang, Henry; Xing, Lei

    2016-11-08

    An autopilot scheme of volumetric-modulated arc therapy (VMAT)/intensity-modulated radiation therapy (IMRT) planning with the guidance of prior knowl-edge is established with recorded interactions between a planner and a commercial treatment planning system (TPS). Microsoft (MS) Visual Studio Coded UI is applied to record some common planner-TPS interactions as subroutines. The TPS used in this study is a Windows-based Eclipse system. The interactions of our application program with Eclipse TPS are realized through a series of subrou-tines obtained by prerecording the mouse clicks or keyboard strokes of a planner in operating the TPS. A strategy to autopilot Eclipse VMAT/IMRT plan selection process is developed as a specific example of the proposed "scripting" method. The autopiloted planning is navigated by a decision function constructed with a reference plan that has the same prescription and similar anatomy with the case at hand. The calculation proceeds by alternating between the Eclipse optimization and the outer-loop optimization independent of the Eclipse. In the C# program, the dosimetric characteristics of a reference treatment plan are used to assess and modify the Eclipse planning parameters and to guide the search for a clinically sensible treatment plan. The approach is applied to plan a head and neck (HN) VMAT case and a prostate IMRT case. Our study demonstrated the feasibility of application programming method in C# environment with recorded interactions of planner-TPS. The process mimics a planner's planning process and automatically provides clinically sensible treatment plans that would otherwise require a large amount of manual trial and error of a planner. The proposed technique enables us to harness a commercial TPS by application programming via the use of recorded human computer interactions and provides an effective tool to greatly facilitate the treatment planning process. © 2016 The Authors.

  9. Direct concurrent comparison of multiple pediatric acute asthma scoring instruments.

    Science.gov (United States)

    Johnson, Michael D; Nkoy, Flory L; Sheng, Xiaoming; Greene, Tom; Stone, Bryan L; Garvin, Jennifer

    2017-09-01

    Appropriate delivery of Emergency Department (ED) treatment to children with acute asthma requires clinician assessment of acute asthma severity. Various clinical scoring instruments exist to standardize assessment of acute asthma severity in the ED, but their selection remains arbitrary due to few published direct comparisons of their properties. Our objective was to test the feasibility of directly comparing properties of multiple scoring instruments in a pediatric ED. Using a novel approach supported by a composite data collection form, clinicians categorized elements of five scoring instruments before and after initial treatment for 48 patients 2-18 years of age with acute asthma seen at the ED of a tertiary care pediatric hospital ED from August to December 2014. Scoring instruments were compared for inter-rater reliability between clinician types and their ability to predict hospitalization. Inter-rater reliability between clinician types was not different between instruments at any point and was lower (weighted kappa range 0.21-0.55) than values reported elsewhere. Predictive ability of most instruments for hospitalization was higher after treatment than before treatment (p < 0.05) and may vary between instruments after treatment (p = 0.054). We demonstrate the feasibility of comparing multiple clinical scoring instruments simultaneously in ED clinical practice. Scoring instruments had higher predictive ability for hospitalization after treatment than before treatment and may differ in their predictive ability after initial treatment. Definitive conclusions about the best instrument or meaningful comparison between instruments will require a study with a larger sample size.

  10. Are Low Patient Satisfaction Scores Always Due to the Provider?: Determinants of Patient Satisfaction Scores During Spine Clinic Visits.

    Science.gov (United States)

    Bible, Jesse E; Shau, David N; Kay, Harrison F; Cheng, Joseph S; Aaronson, Oran S; Devin, Clinton J

    2018-01-01

    A prospective study. The aim of this study was to investigate the impact of various components on patient satisfaction scores SUMMARY OF BACKGROUND DATA.: Patient satisfaction has become an important component of quality assessments. However, with many of these sources collecting satisfaction data reluctant to disclose detailed information, little remains known about the potential determinants of patient satisfaction. Two hundred patients were contacted via phone within 3 weeks of new patient encounter with 11 spine providers. Standardized patient satisfaction phone survey consisting of 25 questions (1-10 rating scale) was administered. Questions inquired about scheduling, parking, office staff, teamwork, wait-time, radiology, provider interactions/behavior, treatment, and follow-up communication. Potential associations between these factors and three main outcome measures were investigated: (1) provider satisfaction, (2) overall clinic visit satisfaction, and (3) quality of care. Significant associations (P  0.05).In multivariate regression analysis, explanation of medical condition/treatment (P = 0.002) and provider empathy (P = 0.04) were significantly associated with provider satisfaction scores, while the amount of time spent with the provider was not. Conversely, teamwork of staff/provider and follow-up communication were significantly associated with both overall clinic visit satisfaction and quality of care (P ≤ 0.03), while provider behaviors or satisfaction were not. Satisfaction with the provider was associated with better explanations of the spine condition/treatment plan and provider empathy, but was not a significant factor in either overall clinic visit satisfaction or perceived quality of care. Patients' perception of teamwork between staff and providers along with reliable follow-up communication were found to be significant determinants of overall patient satisfaction and perceived quality of care. 3.

  11. Adherence is associated with the quality of professional-patient interaction in Directly Observed Treatment Short-course, DOTS

    DEFF Research Database (Denmark)

    Mishra, Pranaya; Hansen, Ebba Holme; Sabroe, Svend

    2006-01-01

    : Better communication between health professionals, particularly dispensers, and patients is essential for improving treatment adherence in TB treatment, even under DOTS. PRACTICE IMPLICATIONS: Drug dispensers should be trained to develop their communication skills about the use of medications, associated...

  12. Prediction of IOI-HA Scores Using Speech Reception Thresholds and Speech Discrimination Scores in Quiet

    DEFF Research Database (Denmark)

    Brännström, K Jonas; Lantz, Johannes; Nielsen, Lars Holme

    2014-01-01

    of HA use, time since last HA fitting, best ear PTA, best ear SRT, or best ear SDS) were examined. A multiple forward stepwise regression analysis was conducted using scores on the separate IOI-HA items, the global score, and scores on the introspection and interaction subscales as dependent variables....... The relation between SDS and IOI-HA suggests that a poor unaided SDS might in itself be a limiting factor for the HA rehabilitation efficacy and hence the IOI-HA outcome. The clinician could use this information to align the user's HA expectations to what is within possible reach.......BACKGROUND: Outcome measures can be used to improve the quality of the rehabilitation by identifying and understanding which variables influence the outcome. This information can be used to improve outcomes for clients. In clinical practice, pure-tone audiometry, speech reception thresholds (SRTs...

  13. 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....

  14. Can score databanks help teaching?

    Science.gov (United States)

    de Mendonça, Vitor Rosa Ramos; Andrade, Bruno Bezerril; Almeida, Alessandro; Barral-Netto, Manoel

    2011-01-05

    Basic courses in most medical schools assess students' performance by conferring scores. The objective of this work is to use a large score databank for the early identification of students with low performance and to identify course trends based on the mean of students' grades. We studied scores from 2,398 medical students registered in courses over a period of 10 years. Students in the first semester were grouped into those whose ratings remained in the lower quartile in two or more courses (low-performance) and students who had up to one course in the lower quartile (high-performance). ROC curves were built, aimed at the identification of a cut-off average score in the first semesters that would be able to predict low performances in future semesters. Moreover, to follow the long-term pattern of each course, the mean of all scores conferred in a semester was compared to the overall course mean obtained by averaging 10 years of data. Individuals in the low-performance group had a higher risk of being in the lower quartile of at least one course in the second semester (relative risk 3.907; 95% CI: 3.378-4.519) and in the eighth semester (relative risk 2.873; 95% CI: 2.495-3.308). The prediction analysis revealed that an average score of 7.188 in the first semester could identify students that presented scores below the lower quartiles in both the second and eighth semesters (pstudents with low performance may be useful in promoting pedagogical strategies for these individuals. Evaluation of the time trend of scores conferred by courses may help departments monitoring changes in personnel and methodology that may affect a student's performance.

  15. Artemether-Lumefantrine Combination Therapy for Treatment of Uncomplicated Malaria: The Potential for Complex Interactions with Antiretroviral Drugs in HIV-Infected Individuals

    Directory of Open Access Journals (Sweden)

    Pauline Byakika-Kibwika

    2011-01-01

    Full Text Available Treatment of malaria in HIV-infected individuals receiving antiretroviral therapy (ART poses significant challenges. Artemether-lumefantrine (AL is one of the artemisisnin-based combination therapies recommended for treatment of malaria. The drug combination is highly efficacious against sensitive and multidrug resistant falciparum malaria. Both artemether and lumefantrine are metabolized by hepatic cytochrome P450 (CYP450 enzymes which metabolize the protease inhibitors (PIs and nonnucleoside reverse transcriptase inhibitors (NNRTIs used for HIV treatment. Coadministration of NNRTIs and PIs with AL could potentially cause complex pharmacokinetic drug interactions. NNRTI by inducing CYP450 3A4 enzyme and PIs by inhibiting CYP450 3A4 enzymes could influence both artemether and lumefantrine concentrations and their active metabolites dihydroartemisinin and desbutyl-lumefantrine, predisposing patients to poor treatment response, toxicity, and risk for development of resistance. There are scanty data on these interactions and their consequences. Pharmacokinetic studies to evaluate these interactions in the target populations are urgently needed.

  16. Budget Scoring of Alternative Financing Methods for Defense Requirements

    National Research Council Canada - National Science Library

    Leos, Leonard; Rouleau, Paul; Wadsworth, Mark

    2007-01-01

    .... One of the major impediments to using alternative forms of procurement financing for acquiring defense capabilities is in the budgetary treatment, or scoring, of these initiatives by the Congressional Budget Office (CBO...

  17. The Budget Scoring Alternatives Financing Methods for Defense Requirements

    National Research Council Canada - National Science Library

    Leos, Leonard; Rouleau, Paul; Wadsworth, Mark

    2007-01-01

    .... One of the major impediments to using alternative forms of procurement financing for acquiring defense capabilities is in the budgetary treatment, or "scoring," of these initiatives by the Congressional Budget Office (CBO...

  18. Atomic detail brownian dynamics simulations of concentrated protein solutions with a mean field treatment of hydrodynamic interactions.

    Energy Technology Data Exchange (ETDEWEB)

    Mereghetti, Paolo; Wade, Rebecca C.

    2012-07-26

    High macromolecular concentrations are a distinguishing feature of living organisms. Understanding how the high concentration of solutes affects the dynamic properties of biological macromolecules is fundamental for the comprehension of biological processes in living systems. In this paper, we describe the implementation of mean field models of translational and rotational hydrodynamic interactions into an atomically detailed many-protein brownian dynamics simulation method. Concentrated solutions (30-40% volume fraction) of myoglobin, hemoglobin A, and sickle cell hemoglobin S were simulated, and static structure factors, oligomer formation, and translational and rotational self-diffusion coefficients were computed. Good agreement of computed properties with available experimental data was obtained. The results show the importance of both solvent mediated interactions and weak protein-protein interactions for accurately describing the dynamics and the association properties of concentrated protein solutions. Specifically, they show a qualitative difference in the translational and rotational dynamics of the systems studied. Although the translational diffusion coefficient is controlled by macromolecular shape and hydrodynamic interactions, the rotational diffusion coefficient is affected by macromolecular shape, direct intermolecular interactions, and both translational and rotational hydrodynamic interactions.

  19. Polymorphism of the Transcription Factor 7-Like 2 Gene (TCF7L2) Interacts with Obesity on Type-2 Diabetes in the PREDIMED Study Emphasizing the Heterogeneity of Genetic Variants in Type-2 Diabetes Risk Prediction: Time for Obesity-Specific Genetic Risk Scores

    Science.gov (United States)

    Corella, Dolores; Coltell, Oscar; Sorlí, Jose V.; Estruch, Ramón; Quiles, Laura; Martínez-González, Miguel Ángel; Salas-Salvadó, Jordi; Castañer, Olga; Arós, Fernando; Ortega-Calvo, Manuel; Serra-Majem, Lluís; Gómez-Gracia, Enrique; Portolés, Olga; Fiol, Miquel; Díez Espino, Javier; Basora, Josep; Fitó, Montserrat; Ros, Emilio; Ordovás, José M.

    2016-01-01

    Nutrigenetic studies analyzing gene–diet interactions of the TCF7L2-rs7903146 C > T polymorphism on type-2 diabetes (T2D) have shown controversial results. A reason contributing to this may be the additional modulation by obesity. Moreover, TCF7L2-rs7903146 is one of the most influential variants in T2D-genetic risk scores (GRS). Therefore, to increase the predictive value (PV) of GRS it is necessary to first see whether the included polymorphisms have heterogeneous effects. We comprehensively investigated gene-obesity interactions between the TCF7L2-rs7903146 C > T polymorphism on T2D (prevalence and incidence) and analyzed other T2D-polymorphisms in a sub-sample. We studied 7018 PREDIMED participants at baseline and longitudinally (8.7 years maximum follow-up). Obesity significantly interacted with the TCF7L2-rs7903146 on T2D prevalence, associations being greater in non-obese subjects. Accordingly, we prospectively observed in non-T2D subjects (n = 3607) that its association with T2D incidence was stronger in non-obese (HR: 1.81; 95% CI: 1.13–2.92, p = 0.013 for TT versus CC) than in obese subjects (HR: 1.01; 95% CI: 0.61–1.66; p = 0.979; p-interaction = 0.048). Accordingly, TCF7L2-PV was higher in non-obese subjects. Additionally, we created obesity-specific GRS with ten T2D-polymorphisms and demonstrated for the first time their higher strata-specific PV. In conclusion, we provide strong evidence supporting the need for considering obesity when analyzing the TCF7L2 effects and propose the use of obesity-specific GRS for T2D. PMID:27929407

  20. Polymorphism of the Transcription Factor 7-Like 2 Gene (TCF7L2 Interacts with Obesity on Type-2 Diabetes in the PREDIMED Study Emphasizing the Heterogeneity of Genetic Variants in Type-2 Diabetes Risk Prediction: Time for Obesity-Specific Genetic Risk Scores

    Directory of Open Access Journals (Sweden)

    Dolores Corella

    2016-12-01

    Full Text Available Nutrigenetic studies analyzing gene–diet interactions of the TCF7L2-rs7903146 C > T polymorphism on type-2 diabetes (T2D have shown controversial results. A reason contributing to this may be the additional modulation by obesity. Moreover, TCF7L2-rs7903146 is one of the most influential variants in T2D-genetic risk scores (GRS. Therefore, to increase the predictive value (PV of GRS it is necessary to first see whether the included polymorphisms have heterogeneous effects. We comprehensively investigated gene-obesity interactions between the TCF7L2-rs7903146 C > T polymorphism on T2D (prevalence and incidence and analyzed other T2D-polymorphisms in a sub-sample. We studied 7018 PREDIMED participants at baseline and longitudinally (8.7 years maximum follow-up. Obesity significantly interacted with the TCF7L2-rs7903146 on T2D prevalence, associations being greater in non-obese subjects. Accordingly, we prospectively observed in non-T2D subjects (n = 3607 that its association with T2D incidence was stronger in non-obese (HR: 1.81; 95% CI: 1.13–2.92, p = 0.013 for TT versus CC than in obese subjects (HR: 1.01; 95% CI: 0.61–1.66; p = 0.979; p-interaction = 0.048. Accordingly, TCF7L2-PV was higher in non-obese subjects. Additionally, we created obesity-specific GRS with ten T2D-polymorphisms and demonstrated for the first time their higher strata-specific PV. In conclusion, we provide strong evidence supporting the need for considering obesity when analyzing the TCF7L2 effects and propose the use of obesity-specific GRS for T2D.

  1. The effect of combined treatment with risperidone and antidepressants on the MK-801-induced deficits in the social interaction test in rats.

    Science.gov (United States)

    Kamińska, Katarzyna; Rogóż, Zofia

    2015-12-01

    Several clinical reports have suggested that augmentation of atypical antipsychotics' activity by antidepressants may efficiently improve the treatment of negative and some cognitive symptoms of schizophrenia. The aim of the present study was to investigate the effect of antidepressant mirtazapine or escitalopram and risperidone (an atypical antipsychotic), given separately or jointly, on the MK-801-induced deficits in the social interaction test in rats. Antidepressants and risperidone were given 60 and 30 min before the test, respectively. The social interaction of male Wistar rats was measured for 10 min, starting 4 h after MK-801 (0.1 mg/kg) administration. In the social interaction test, MK-801-induced deficits in the parameters studied, i.e. the number of episodes and the time of interactions. Risperidone at a higher dose (0.1 mg/kg) reversed that effect. Co-treatment with an ineffective dose of risperidone (0.01 mg/kg) and mirtazapine (2.5 or 5 mg/kg) or escitalopram only at a dose of 5 mg/kg (but not 2.5 and 10 mg/kg) abolished the deficits evoked by MK-801. The obtained results suggest that especially mirtazapine, and to a smaller degree escitalopram may enhance the antipsychotic-like effect of risperidone in the animal test modeling some negative symptoms of schizophrenia. Copyright © 2015 Institute of Pharmacology, Polish Academy of Sciences. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  2. Growth hormone treatment for Turner syndrome in Australia reveals that younger age and increased dose interact to improve response

    NARCIS (Netherlands)

    Hughes, Ian P.; Choong, Catherine S.; Harris, Mark; Ambler, Geoffrey R.; Cutfield, Wayne S.; Hofman, Paul L.; Cowell, Chris T.; Werther, George; Cotterill, Andrew; Davies, Peter S. W.

    P>Objective To investigate response to growth hormone (GH) in the first, second and third years of treatment in the total clinical cohort of Turner syndrome (TS) patients in Australia. Context Short stature is the most common clinical manifestation of TS. GH treatment improves growth. Design

  3. Oral treatments of Echinococcus multilocularis-infected mice with the antimalarial drug mefloquine that potentially interacts with parasite ferritin and cystatin.

    Science.gov (United States)

    Küster, Tatiana; Stadelmann, Britta; Rufener, Reto; Risch, Corina; Müller, Joachim; Hemphill, Andrew

    2015-11-01

    This study investigated the effects of oral treatments of Echinococcus multilocularis-infected mice with the antimalarial drug mefloquine (MEF) and identified proteins that bind to MEF in parasite extracts and human cells by affinity chromatography. In a pilot experiment, MEF treatment was applied 5 days per week and was intensified by increasing the dosage stepwise from 12.5 mg/kg to 200 mg/kg during 4 weeks followed by treatments of 100 mg/kg during the last 7 weeks. This resulted in a highly significant reduction of parasite weight in MEF-treated mice compared with mock-treated mice, but the reduction was significantly less efficacious compared with the standard treatment regimen of albendazole (ABZ). In a second experiment, MEF was applied orally in three different treatment groups at dosages of 25, 50 or 100 mg/kg, but only twice a week, for a period of 12 weeks. Treatment at 100 mg/kg had a profound impact on the parasite, similar to ABZ treatment at 200 mg/kg/day (5 days/week for 12 weeks). No adverse side effects were noted. To identify proteins in E. multilocularis metacestodes that physically interact with MEF, affinity chromatography of metacestode extracts was performed on MEF coupled to epoxy-activated Sepharose(®), followed by SDS-PAGE and in-gel digestion LC-MS/MS. This resulted in the identification of E. multilocularis ferritin and cystatin as MEF-binding proteins. In contrast, when human cells were exposed to MEF affinity chromatography, nicotinamide phosphoribosyltransferase was identified as a MEF-binding protein. This indicates that MEF could potentially interact with different proteins in parasites and human cells. Copyright © 2015 Elsevier B.V. and the International Society of Chemotherapy. All rights reserved.

  4. 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...

  5. Treatment

    Directory of Open Access Journals (Sweden)

    Safaa M. Raghab

    2013-08-01

    The main goal of this study is to utilize a natural low cost material “as an accelerator additive to enhance the chemical treatment process using Alum coagulant and the accelerator substances were Perlite and Bentonite. The performance of the chemical treatment was enhanced using the accelerator substances with 90 mg/l Alum as a constant dose. Perlite gave better performance than the Bentonite effluent. The removal ratio for conductivity, turbidity, BOD and COD for Perlite was 86.7%, 87.4%, 89.9% and 92.8% respectively, and for Bentonite was 83.5%, 85.0%, 86.5% and 85.0% respectively at the same concentration of 40 mg/l for each.

  6. Unified treatment of weak and electromagnetic interactions in a SU(4) x SU(4) chiral theory of mesons

    International Nuclear Information System (INIS)

    Ebert, D.; Volkov, M.K.

    1978-01-01

    Starting from a phenomenological chiral SU(4)xSU(4) Lagrangian for hadrons weak and electromagnetic interactions are introduced by considering nonlinear realizations of the gauge group SU(2)sub(L)xU(1) of the Weinberg-Salam model. The final effective Lagrangian for the weak interaction of hadrons has the usual current x current structure. The charmed charged currents are of the Cabibbo type, the neutral current satisfies the condition Δ S = 0 of the G.I.M. scheme

  7. Preferences and flexibility in decision-making among dental clinicians regarding the treatment of multirooted teeth: an interactive communication device-based survey at two academic conferences

    Science.gov (United States)

    2016-01-01

    Purpose Decision-making by dental and medical experts can be influenced by their biases, interests, and experiences, and academic arguments about controversial issues may additionally be considered indirect experiences capable of affecting decision-making. This study reports on the use of interactive communication devices to evaluate preferences and flexibility in decision-making among dental care providers who attended two distinct academic conferences. Methods Two debates were presented by a team of two lecturers at two academic conferences (focusing on periodontology and implant dentistry, respectively) and the audience members of each session were surveyed. Before each lecture, two case modules about the diagnosis and treatment of multirooted molar lesions were provided, and interactive communication devices were used to collect responses about decision-making preferences in treatment planning immediately before and after a debate about treatment strategies. Results In total, 81 and 84 completed answers from both conferences were obtained for the first and second case modules, respectively. The preferred treatment plan differed significantly according to the focus of the conference, and a tendency emerged for the clinicians participating in each conference to express uniform preferences. However, attending the debates resulted in significant changes in decision-making preferences regardless of the conference focus or the characteristics of the participants. Conclusions Our findings suggest that providing continuing education via debates on controversial issues may be effective in widening conceptual knowledge and reducing biases among experts in the dental and medical fields. PMID:27382505

  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...

  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. A Proposed Treatment for Visual Field Loss caused by Traumatic Brain Injury using Interactive Visuotactile Virtual Environment

    Science.gov (United States)

    Farkas, Attila J.; Hajnal, Alen; Shiratuddin, Mohd F.; Szatmary, Gabriella

    In this paper, we propose a novel approach of using interactive virtual environment technology in Vision Restoration Therapy caused by Traumatic Brain Injury. We called the new system Interactive Visuotactile Virtual Environment and it holds a promise of expanding the scope of already existing rehabilitation techniques. Traditional vision rehabilitation methods are based on passive psychophysical training procedures, and can last up to six months before any modest improvements can be seen in patients. A highly immersive and interactive virtual environment will allow the patient to practice everyday activities such as object identification and object manipulation through the use 3D motion sensoring handheld devices such data glove or the Nintendo Wiimote. Employing both perceptual and action components in the training procedures holds the promise of more efficient sensorimotor rehabilitation. Increased stimulation of visual and sensorimotor areas of the brain should facilitate a comprehensive recovery of visuomotor function by exploiting the plasticity of the central nervous system. Integrated with a motion tracking system and an eye tracking device, the interactive virtual environment allows for the creation and manipulation of a wide variety of stimuli, as well as real-time recording of hand-, eye- and body movements and coordination. The goal of the project is to design a cost-effective and efficient vision restoration system.

  11. LoCo: a novel main chain scoring function for protein structure prediction based on local coordinates

    Directory of Open Access Journals (Sweden)

    Samudrala Ram

    2011-09-01

    Full Text Available Abstract Background Successful protein structure prediction requires accurate low-resolution scoring functions so that protein main chain conformations that are close to the native can be identified. Once that is accomplished, a more detailed and time-consuming treatment to produce all-atom models can be undertaken. The earliest low-resolution scoring used simple distance-based "contact potentials," but more recently, the relative orientations of interacting amino acids have been taken into account to improve performance. Results We developed a new knowledge-based scoring function, LoCo, that locates the interaction partners of each individual residue within a local coordinate system based only on the position of its main chain N, Cα and C atoms. LoCo was trained on a large set of experimentally determined structures and optimized using standard sets of modeled structures, or "decoys." No structure used to train or optimize the function was included among those used to test it. When tested against 29 other published main chain functions on a group of 77 commonly used decoy sets, our function outperformed all others in Cα RMSD rank of the best-scoring decoy, with statistically significant p-values Conclusions Our function demonstrates an unmatched combination of accuracy, speed, and simplicity and shows excellent promise for protein structure prediction. Broader applications may include protein-protein interactions and protein design.

  12. The effectiveness of Lee Silverman Voice Treatment therapy issued interactively through an iPad device: A non-inferiority study.

    Science.gov (United States)

    Griffin, Murray; Bentley, John; Shanks, Joseph; Wood, Carly

    2018-04-01

    Introduction This study compared the differences in recorded speech variables between people treated with conventional 'in person' Lee Silverman Voice Treatment (LSVT) and those treated remotely via iPad-based 'Facetime'. Method Eight participants were selected for the iPad LSVT, and 21 similarly matched subjects were selected from existing data to form the 'in person' group. Participants in both groups had diagnosed idiopathic Parkinson's disease and moderate hypokinetic dysarthria. Eighteen sessions of prescribed LSVT comprising a pre-treatment assessment, 16 treatment sessions, and a six months' post-treatment assessment were administered for each person. In both groups, pre- and post-treatment assessments were conducted face-to-face. Performance measures were recorded during assessment and treatment. Average measures were determined for all tasks at all time points and a summary outcome variable was composed from across-task performance. Results Non-inferiority testing confirmed that iPad LSVT was non-inferior in treating all LSVT task 3 variables except generating words, with the 90% upper confidence intervals (CI) lying between the non-inferiority margin of ± 2.25 and zero. The iPad was superior in treating the task 3 rainbow reading passage and describing motor task variables with upper and lower 90% CI values being negative. The improvement in the summary outcome variable score was also superior in the iPad group. Discussion Non-inferiority testing implies that the iPad LSVT is non-inferior in treating task three variables when compared to traditional LSVT. The study supports further development of remote delivery solutions involving the Apple iPad and 'Facetime' system as a means of improving access to services and the participant's experience.

  13. 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......-report questionnaires of experiential states each time after playing the game 'Batman: Arkham City' in one of three randomized conditions accounting for [1] dynamic music, [2] non-dynamic music/low arousal potential and [3] non-dynamic music/high arousal potential, aiming to manipulate emotional arousal and structural......-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...

  14. High throughput sample processing and automated scoring

    Directory of Open Access Journals (Sweden)

    Gunnar eBrunborg

    2014-10-01

    Full Text Available The comet assay is a sensitive and versatile method for assessing DNA damage in cells. In the traditional version of the assay, there are many manual steps involved and few samples can be treated in one experiment. High throughput modifications have been developed during recent years, and they are reviewed and discussed. These modifications include accelerated scoring of comets; other important elements that have been studied and adapted to high throughput are cultivation and manipulation of cells or tissues before and after exposure, and freezing of treated samples until comet analysis and scoring. High throughput methods save time and money but they are useful also for other reasons: large-scale experiments may be performed which are otherwise not practicable (e.g., analysis of many organs from exposed animals, and human biomonitoring studies, and automation gives more uniform sample treatment and less dependence on operator performance. The high throughput modifications now available vary largely in their versatility, capacity, complexity and costs. The bottleneck for further increase of throughput appears to be the scoring.

  15. Targeted scoring criteria reduce variance in global impressions.

    Science.gov (United States)

    Targum, Steven D; Busner, Joan; Young, Allan H

    2008-10-01

    This study examined the confounding effect of treatment emergent physical or psychic symptoms on clinical global impression (CGI) ratings in CNS trials and examined the benefit of targeted scoring criteria on clarifying ratings and reducing scoring variance. Twenty-four raters participating in an investigator meeting training session scored a series of scripted CGI scenarios that included treatment emergent symptoms. The addition of treatment emergent gastrointestinal (GI) symptoms or anxiety symptoms significantly changed the rating of clinical global improvement and caused a broad CGI-improvement (CGI-I) scoring variance reflecting scoring ambiguity amongst these raters. Re-rating after a presentation of well-defined criteria that addressed these scoring issues narrowed the variance and significantly improved inter-rater reliability. It is clear that CNS trials must define scoring criteria for global ratings prior to the initiation of a study to assure ratings consistency. The actual definition of global must be study-specific and may depend upon the targeted symptoms of interest and mechanism of drug action. The targeted criteria that define global must be included in all published reports about the trial.

  16. Genetic effect on apgar score

    Directory of Open Access Journals (Sweden)

    Carla Franchi-Pinto

    1999-03-01

    Full Text Available Intraclass correlation coefficients for one- and five-min Apgar scores of 604 twin pairs born at a southeastern Brazilian hospital were calculated, after adjusting these scores for gestational age and sex. The data support a genetic hypothesis only for 1-min Apgar score, probably because it is less affected by the environment than 4 min later, after the newborns have been under the care of a neonatology team. First-born twins exhibited, on average, better clinical conditions than second-born twins. The former showed a significantly lower proportion of Apgar scores under seven than second-born twins, both at 1 min (17.5% vs. 29.8% and at 5 min (7.2% vs. 11.9%. The proportion of children born with "good" Apgar scores was significantly smaller among twins than among 1,522 singletons born at the same hospital. Among the latter, 1- and 5-min Apgar scores under seven were exhibited by 9.2% and 3.4% newborns, respectively.Os coeficientes de correlação intraclasse foram calculados para os índices de Apgar 1 e 5 minutos após o nascimento de 604 pares de gêmeos em uma maternidade do sudeste brasileiro, depois que esses índices foram ajustados para idade gestacional e sexo. Os dados obtidos apoiaram a hipótese genética apenas em relação ao primeiro índice de Apgar, provavelmente porque ele é menos influenciado pelo ambiente do que 4 minutos depois, quando os recém-nascidos já estiveram sob os cuidados de uma equipe de neonatologistas. Os gêmeos nascidos em primeiro lugar apresentaram, em média, melhor estado clínico que os nascidos em segundo lugar, visto que os primeiros mostraram uma proporção de índices de Apgar inferiores a 7 significativamente menor do que os nascidos em segundo lugar, tanto um minuto (17,5% contra 29,8% quanto cinco minutos após o nascimento (7,2% contra 11,9%. A proporção de recém-nascidos com índices de Apgar que indicam bom prognóstico foi significativamente menor nos gêmeos do que em 1.522 conceptos

  17. A Bootstrap Procedure of Propensity Score Estimation

    Science.gov (United States)

    Bai, Haiyan

    2013-01-01

    Propensity score estimation plays a fundamental role in propensity score matching for reducing group selection bias in observational data. To increase the accuracy of propensity score estimation, the author developed a bootstrap propensity score. The commonly used propensity score matching methods: nearest neighbor matching, caliper matching, and…

  18. Interactions of iron with manganese, zinc, chromium, and selenium as related to prophylaxis and treatment of iron deficiency.

    Science.gov (United States)

    Bjørklund, Geir; Aaseth, Jan; Skalny, Anatoly V; Suliburska, Joanna; Skalnaya, Margarita G; Nikonorov, Alexandr A; Tinkov, Alexey A

    2017-05-01

    Iron (Fe) deficiency is considered as the most common nutritional deficiency. Iron deficiency is usually associated with low Fe intake, blood loss, diseases, poor absorption, gastrointestinal parasites, or increased physiological demands as in pregnancy. Nutritional Fe deficiency is usually treated with Fe tablets, sometimes with Fe-containing multimineral tablets. Trace element interactions may have a significant impact on Fe status. Existing data demonstrate a tight interaction between manganese (Mn) and Fe, especially in Fe-deficient state. The influence of Mn on Fe homeostasis may be mediated through its influence on Fe absorption, circulating transporters like transferrin, and regulatory proteins. The existing data demonstrate that the influence of zinc (Zn) on Fe status may be related to their competition for metal transporters. Moreover, Zn may be involved in regulation of hepcidin production. At the same time, human data on the interplay between Fe and Zn especially in terms of Fe-deficiency and supplementation are contradictory, demonstrating both positive and negative influence of Zn on Fe status. Numerous data also demonstrate the possibility of competition between Fe and chromium (Cr) for transferrin binding. At the same time, human data on the interaction between these metals are contradictory. Therefore, while managing hypoferremia and Fe-deficiency anemia, it is recommended to assess the level of other trace elements in parallel with indices of Fe homeostasis. It is supposed that simultaneous correction of trace element status in Fe deficiency may help to decrease possible antagonistic or increase synergistic interactions. Copyright © 2017 Elsevier GmbH. All rights reserved.

  19. Experimental and molecular docking studies on DNA binding interaction of adefovir dipivoxil: Advances toward treatment of hepatitis B virus infections

    Science.gov (United States)

    Shahabadi, Nahid; Falsafi, Monireh

    The toxic interaction of adefovir dipivoxil with calf thymus DNA (CT-DNA) was investigated in vitro under simulated physiological conditions by multi-spectroscopic techniques and molecular modeling study. The fluorescence spectroscopy and UV absorption spectroscopy indicated drug interacted with CT-DNA in a groove binding mode. The binding constant of UV-visible and the number of binding sites were 3.33 ± 0.2 × 104 L mol-1and 0.99, respectively. The fluorimetric studies showed that the reaction between the drug and CT-DNA is exothermic (ΔH = 34.4 kJ mol-1; ΔS = 184.32 J mol-1 K-1). Circular dichroism spectroscopy (CD) was employed to measure the conformational change of CT-DNA in the presence of adefovir dipivoxil, which verified the groove binding mode. Furthermore, the drug induces detectable changes in its viscosity. The molecular modeling results illustrated that adefovir strongly binds to groove of DNA by relative binding energy of docked structure -16.83 kJ mol-1. This combination of multiple spectroscopic techniques and molecular modeling methods can be widely used in the investigation on the toxic interaction of small molecular pollutants and drugs with bio macromolecules, which contributes to clarify the molecular mechanism of toxicity or side effect in vivo.

  20. Classifying snakebite in South Africa: Validating a scoring system ...

    African Journals Online (AJOL)

    Objective. To develop and validate a scoring system for managing snakebites in South Africa (SA). Methods. We studied all snakebite admissions to a regional hospital in KwaZulu-Natal, SA. The primary outcome was an active treatment intervention (ATI) defined as antivenom treatment or any surgical procedure.

  1. Illustrating idiographic methods for translation research: moderation effects, natural clinical experiments, and complex treatment-by-subgroup interactions.

    Science.gov (United States)

    Ridenour, Ty A; Wittenborn, Andrea K; Raiff, Bethany R; Benedict, Neal; Kane-Gill, Sandra

    2016-03-01

    A critical juncture in translation research involves the preliminary studies of intervention tools, provider training programs, policies, and other mechanisms used to leverage knowledge garnered at one translation stage into another stage. Potentially useful for such studies are rigorous techniques for conducting within-subject clinical trials, which have advanced incrementally over the last decade. However, these methods have largely not been utilized within prevention or translation contexts. The purpose of this manuscript is to demonstrate the flexibility, wide applicability, and rigor of idiographic clinical trials for preliminary testing of intervention mechanisms. Specifically demonstrated are novel uses of state-space modeling for testing intervention mechanisms of short-term outcomes, identifying heterogeneity in and moderation of within-person treatment mechanisms, a horizontal line plot to refine sampling design during the course of a clinic-based experimental study, and the need to test a treatment's efficacy as treatment is administered along with (e.g., traditional 12-month outcomes).

  2. Treatment of concentrated industrial wastewaters originating from oil shale and the like by electrolysis polyurethane foam interaction

    Science.gov (United States)

    Tiernan, Joan E.

    1990-01-01

    Highly concentrated and toxic petroleum-based and synthetic fuels wastewaters such as oil shale retort water are treated in a unit treatment process by electrolysis in a reactor containing oleophilic, ionized, open-celled polyurethane foams and subjected to mixing and laminar flow conditions at an average detention time of six hours. Both the polyurethane foams and the foam regenerate solution are re-used. The treatment is a cost-effective process for waste-waters which are not treatable, or are not cost-effectively treatable, by conventional process series.

  3. Interactions of hard tissues, soft tissues, and growth over time, and their impact on orthodontic diagnosis and treatment planning.

    Science.gov (United States)

    Sarver, David M

    2015-09-01

    The approach to orthodontic diagnosis has changed gradually but steadily over the past 2 decades. The shift away from diagnosis based entirely on hard tissue evaluations has been a result of a broadened recognition of the importance of facial and smile appearance to our patients, and how they change over time. The purpose of this article is to describe and illustrate the integration of the new soft tissue paradigm into long-term treatment planning, with a focus on the esthetic goals of treatment. Copyright © 2015 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

  4. Chemical interactions study of antiretroviral drugs efavirenz and lamivudine concerning the development of stable fixed-dose combination formulations for AIDS treatment

    Energy Technology Data Exchange (ETDEWEB)

    Gomes, Elionai C. de L.; Mussel, Wagner N.; Resende, Jarbas M.; Yoshida, Maria I., E-mail: mirene@ufmg.br [Universidade Federal de Minas Gerais (UFMG), Belo Horizonte, MG (Brazil). Instituto de Ciencias Exatas. Departamento de Quimica; Fialho, Silvia L.; Barbosa, Jamile; Fialho, Silvia L. [Fundacao Ezequiel Dias, Belo Horizonte, MG (Brazil)

    2013-04-15

    Lamivudine and efavirenz are among the most worldwide used drugs for acquired immune deficiency syndrome (AIDS) treatment. Solid state nuclear magnetic resonance (ssNMR), Fourier-transformed infrared spectroscopy (FTIR), differential scanning calorimetry (DSC) and thermo-optical analysis (TOA) were used to study possible interactions between these drugs, aiming the development of a fixed-dose drug combination. DSC and TOA have evidenced significant shifts on the melting points of both drugs in the mixture, which may be due to interaction between them. Although DSC and TOA results indicated incompatibility between the drugs, FTIR spectra were mostly unmodified due to overlapping peaks. The ssNMR analyses showed significant changes in chemical shifts values of the mixture when compared with spectra of pure drugs, especially in the signals relating to the deficient electron carbon atoms of both drugs. These results confirm the interactions suggested by DSC and TOA, which is probably due to acid-base interactions between electronegative and deficient electron atoms of both lamivudine and efavirenz. (author)

  5. Chemical interactions study of antiretroviral drugs efavirenz and lamivudine concerning the development of stable fixed-dose combination formulations for AIDS treatment

    International Nuclear Information System (INIS)

    Gomes, Elionai C. de L.; Mussel, Wagner N.; Resende, Jarbas M.; Yoshida, Maria I.

    2013-01-01

    Lamivudine and efavirenz are among the most worldwide used drugs for acquired immune deficiency syndrome (AIDS) treatment. Solid state nuclear magnetic resonance (ssNMR), Fourier-transformed infrared spectroscopy (FTIR), differential scanning calorimetry (DSC) and thermo-optical analysis (TOA) were used to study possible interactions between these drugs, aiming the development of a fixed-dose drug combination. DSC and TOA have evidenced significant shifts on the melting points of both drugs in the mixture, which may be due to interaction between them. Although DSC and TOA results indicated incompatibility between the drugs, FTIR spectra were mostly unmodified due to overlapping peaks. The ssNMR analyses showed significant changes in chemical shifts values of the mixture when compared with spectra of pure drugs, especially in the signals relating to the deficient electron carbon atoms of both drugs. These results confirm the interactions suggested by DSC and TOA, which is probably due to acid-base interactions between electronegative and deficient electron atoms of both lamivudine and efavirenz. (author)

  6. Novel Interactive Data Visualization: Exploration of the ESCAPE Trial (Endovascular Treatment for Small Core and Anterior Circulation Proximal Occlusion With Emphasis on Minimizing CT to Recanalization Times) Data.

    Science.gov (United States)

    Brigdan, Matthew; Hill, Michael D; Jagdev, Abhijeet; Kamal, Noreen

    2018-01-01

    The ESCAPE (Endovascular Treatment for Small Core and Anterior Circulation Proximal Occlusion With Emphasis on Minimizing CT to Recanalization Times) randomized clinical trial collected a large diverse data set. However, it is difficult to fully understand the effects of the study on certain patient groups and disease progression. We developed and evaluated an interactive visualization of the ESCAPE trial data. We iteratively designed an interactive visualization using Python's Bokeh software library. The design was evaluated through a user study, which quantitatively evaluated its efficiency and accuracy against traditional modified Rankin Scalegraphic. Qualitative feedback was also evaluated. The novel interactive visualization of the ESCAPE data are publicly available at http://escapevisualization.herokuapp.com/. There was no difference in the efficiency and accuracy when comparing the use of the novel with the traditional visualization. However, users preferred the novel visualization because it allowed for greater exploration. Some insights obtained through exploration of the ESCAPE data are presented. Novel interactive visualizations can be applied to acute stroke trial data to allow for greater exploration of the results. URL: http://www.clinicaltrials.gov. Unique identifier: NCT01778335. © 2017 American Heart Association, Inc.

  7. Wastewater treatment plant effluent as a source of microplastics: review of the fate, chemical interactions and potential risks to aquatic organisms.

    Science.gov (United States)

    Ziajahromi, Shima; Neale, Peta A; Leusch, Frederic D L

    2016-11-01

    Wastewater treatment plant (WWTP) effluent has been identified as a potential source of microplastics in the aquatic environment. Microplastics have recently been detected in wastewater effluent in Western Europe, Russia and the USA. As there are only a handful of studies on microplastics in wastewater, it is difficult to accurately determine the contribution of wastewater effluent as a source of microplastics. However, even the small amounts of microplastics detected in wastewater effluent may be a remarkable source given the large volumes of wastewater treatment effluent discharged to the aquatic environment annually. Further, there is strong evidence that microplastics can interact with wastewater-associated contaminants, which has the potential to transport chemicals to aquatic organisms after exposure to contaminated microplastics. In this review we apply lessons learned from the literature on microplastics in the aquatic environment and knowledge on current wastewater treatment technologies, with the aim of identifying the research gaps in terms of (i) the fate of microplastics in WWTPs, (ii) the potential interaction of wastewater-based microplastics with trace organic contaminants and metals, and (iii) the risk for aquatic organisms.

  8. 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%.

  9. Assessing the usage of a guideline-driven interactive case simulation tool for insomnia screening and treatment in an HIV clinical education program.

    Science.gov (United States)

    Le, Xuan Hung; Luque, Amneris E; Wang, Dongwen

    2013-01-01

    Interactive case simulation tools (ICSTs) are important vehicles to disseminate medical knowledge. We conducted a study to examine the usage of an insomnia screening and treatment case simulation tool in an HIV clinical education program. Using system usage diagrams (SUDs) as an instrument, we quantified visit frequency and length of stay for different types of system resources. Preliminary results have shown that both recommendations and interactive decision diagrams were frequently used, with the former having a longer length of stay but fewer visits. Case simulation functions seemed to be able to engage users. Future research is required to verify the generalizability of the identified usage patterns, to investigate issues in usability design, and to perform correlation analyses on system usage and context parameters.

  10. Interaction of co-insult treatments wth cadmium chloride and gamma irradiation on lethality and blood indices

    International Nuclear Information System (INIS)

    Morgan, R.M.

    1981-01-01

    The main objectives of this study were (1) to gain insight into sensitivities of vital organs systems after treatments with cadmium chloride (CdCl 2 ), gamma ( 60 Co) radiation, and combined CdCl 2 -gamma radiation; (2) to determine physiological and cellular/molecular changes after these same treatments; and (3) to develop a summary of biochemical/hematological indicators for each insult individually, as well as for the co-insult treatment. Three lethality studies, Acute CdCl 2 , Chronic CdCl 2 , and Acute Radiation, wwere used to determine sublethal doses for the fourth study (Co-insult), which utilized various combinations of CdCl 2 and gamma radiation and from which the hematological and biochemical data were derived. Radiation groups exhibited statistically significant decreases in the total number of leukocytes, lymphocytes, and polyneutrophils. Significant increases were seen in serum iron, lactate dehydrogenase (LDH), alkaline phosphatase, and triglycerides. Cadmium groups had increased total numbers of leukocytes, polyneutrophils, and serum glutamic oxaloacetate transminase (SGOT). Decreases were seen in lymphocytes, hemoglobin, hematocrit, total red blood cell counts, and total protein. When co-insult treatments were used, significant decreases were seen in the total number of leukocytes, polyneutrophils, lymphocytes, hemoglobin, total red blood cells, and serum iron

  11. Assessment of the Performance of MP2 and MP2 Variants for the Treatment of Noncovalent Interactions

    Czech Academy of Sciences Publication Activity Database

    Riley, Kevin Eugene; Platts, J. A.; Řezáč, Jan; Hobza, Pavel; Hill, J. G.

    2012-01-01

    Roč. 116, č. 16 (2012), s. 4159-4169 ISSN 1089-5639 R&D Projects: GA ČR GBP208/12/G016 Grant - others:European Social Fund(XE) CZ1.05/2.1.00/03/0058 Institutional research plan: CEZ:AV0Z40550506 Keywords : plesset perturbation-theory * density-functional-theory * intermolecular interaction energies * molecular-orbital methods * auxiliary basis-sets * ab-initio Subject RIV: CF - Physical ; Theoretical Chemistry Impact factor: 2.771, year: 2012

  12. Society for Vascular Surgery Wound, Ischemia, foot Infection (WIfI) score correlates with the intensity of multimodal limb treatment and patient-centered outcomes in patients with threatened limbs managed in a limb preservation center.

    Science.gov (United States)

    Robinson, William P; Loretz, Lorraine; Hanesian, Colleen; Flahive, Julie; Bostrom, John; Lunig, Nicholas; Schanzer, Andres; Messina, Louis

    2017-08-01

    The Society for Vascular Surgery Wound, Ischemia, foot Infection (WIfI) system aims to stratify threatened limbs according to their anticipated natural history and estimate the likelihood of benefit from revascularization, but whether it accurately stratifies outcomes in limbs undergoing aggressive treatment for limb salvage is unknown. We investigated whether the WIfI stage correlated with the intensity of limb treatment required and patient-centered outcomes. We stratified limbs from a prospectively maintained database of consecutive patients referred to a limb preservation center according to WIfI stage (October 2013-May 2015). Comorbidities, multimodal limb treatment, including foot operations and revascularization, and patient-centered outcomes (wound healing, limb salvage, amputation-free survival, maintenance of ambulatory and independent living status, and mortality) were compared among WIfI stages. Multivariate analysis was performed to identify predictors of wound healing and limb salvage. We identified 280 threatened limbs encompassing all WIfI stages in 257 consecutive patients: stage 1, 48 (17%); stage 2, 67 (24%); stage 3, 64 (23%); stage 4, 83 (30%); and stage 5 (unsalvageable), 18 (6%). Operative foot débridement, minor amputation, and use of revascularization increased with increasing WIfI stage (P ≤ .04). Revascularization was performed in 106 limbs (39%), with equal use of open and endovascular procedures. Over a median follow-up of 209 days (interquartile range, 95, 340) days, 1-year Kaplan-Meier wound healing cumulative incidence was 71%, and the proportion with complete wound healing decreased with increasing WIfI stage. Major amputation was required in 26 stage 1 to 4 limbs (10%). Increasing WIfI stage was associated with decreased 1-year Kaplan-Meier limb salvage (stage 1: 96%, stage 2: 84%, stage 3: 90%, and stage 4: 78%; P = .003) and amputation-free survival (P = .006). Stage 4 WIfI independently predicted amputation (hazard ratio

  13. 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...

  14. 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...

  15. Interactive adaptation of a volumetric imaging radiotherapy treatment: development and validation of tools for its implementation in clinical routine

    International Nuclear Information System (INIS)

    Huger, Sandrine

    2013-01-01

    Changing anatomy during radiotherapy can lead to significant dosimetric consequences for organs at risk (OARs) and/or target volumes. Adaptive radiotherapy can compensate for these variations however its deployment for clinical work is hampered by the increased workload for the medical staff and there is still no commercialized software available for clinical use. We developed a simple in vivo dosimetric alert tool allowing rapid identification of patients who might benefit from an adaptive radiotherapy. Dosimetric evaluation of delivered treatment has been conducted onto 3D on board imaging (CBCT) whose dose calculation accuracy has been evaluated. The tool does not require a new volume of interest delineation. Tool alert is based on objectives and quantifiable criteria defined by the exceeding volumes of interest dose thresholds. Tool precision and detectability have been validated and applied in a retrospective study on 10 head and neck patients. The tool allows detecting patients where an adaptive treatment could have been considered. In its clinical implementation, adaptive radiotherapy process requires deformable matching algorithms to follow patient local's deformations occurring during treatment. Nevertheless, their use has not been validated. We conducted an evaluation of the Block Matching deformable algorithm, suitable for multimodality imaging (CT/CBCT), in comparison to rigid algorithm. A study has been conducted for 10 head and neck patients based on volume of interest contours comparison for 76 CBCT. Similarity parameters used consisted on Dice Similarity Index, Robust Hausdorff Distance (in mm) and the absolute volume difference (in cc). (author)

  16. Thyroid disorders in patients with newly diagnosed rheumatoid arthritis is associated with poor initial treatment response evaluated by disease activity score in 28 joints-C-reactive protein (DAS28-CRP)

    DEFF Research Database (Denmark)

    Emamifar, Amir; Hangaard, Jørgen; Jensen Hansen, Inger Marie

    2017-01-01

    To determine the prevalence of thyroid disorders among newly diagnosed rheumatoid arthritis (RA) patients and evaluate the association between clinical characteristics of RA and thyroid disorders, and also initial treatment response in the RA patients with thyroid disorders.Newly diagnosed, adult...... years were reviewed to reveal if they had been diagnosed with thyroid disorders or they had abnormal thyroid test.In all, 439 patients were included, female 60.1%, mean age 64.6 ± 15.0 years and disease duration 2.6 ± 1.7 years. Prevalence of thyroid disorders was 69/439 (15.7%) and hypothyroidism...... was the most frequent disorder (30.4%). The presence of thyroid disorders among RA patients was significantly associated with female sex (P thyroid disorders had significantly poorer initial response to RA...

  17. Robust estimation of the expected survival probabilities from high-dimensional Cox models with biomarker-by-treatment interactions in randomized clinical trials

    Directory of Open Access Journals (Sweden)

    Nils Ternès

    2017-05-01

    Full Text Available Abstract Background Thanks to the advances in genomics and targeted treatments, more and more prediction models based on biomarkers are being developed to predict potential benefit from treatments in a randomized clinical trial. Despite the methodological framework for the development and validation of prediction models in a high-dimensional setting is getting more and more established, no clear guidance exists yet on how to estimate expected survival probabilities in a penalized model with biomarker-by-treatment interactions. Methods Based on a parsimonious biomarker selection in a penalized high-dimensional Cox model (lasso or adaptive lasso, we propose a unified framework to: estimate internally the predictive accuracy metrics of the developed model (using double cross-validation; estimate the individual survival probabilities at a given timepoint; construct confidence intervals thereof (analytical or bootstrap; and visualize them graphically (pointwise or smoothed with spline. We compared these strategies through a simulation study covering scenarios with or without biomarker effects. We applied the strategies to a large randomized phase III clinical trial that evaluated the effect of adding trastuzumab to chemotherapy in 1574 early breast cancer patients, for which the expression of 462 genes was measured. Results In our simulations, penalized regression models using the adaptive lasso estimated the survival probability of new patients with low bias and standard error; bootstrapped confidence intervals had empirical coverage probability close to the nominal level across very different scenarios. The double cross-validation performed on the training data set closely mimicked the predictive accuracy of the selected models in external validation data. We also propose a useful visual representation of the expected survival probabilities using splines. In the breast cancer trial, the adaptive lasso penalty selected a prediction model with 4

  18. Lessons Learned in Empirical Scoring with smina from the CSAR 2011 Benchmarking Exercise

    OpenAIRE

    Koes, David Ryan; Baumgartner, Matthew P.; Camacho, Carlos J.

    2013-01-01

    We describe a general methodology for designing an empirical scoring function and provide smina, a version of AutoDock Vina specially optimized to support high-throughput scoring and user-specified custom scoring functions. Using our general method, the unique capabilities of smina, a set of default interaction terms from AutoDock Vina, and the CSAR (Community Structure-Activity Resource) 2010 dataset, we created a custom scoring function and evaluated it in the context of the CSAR 2011 bench...

  19. The Inter-Rater Reliability in Scoring Composition

    Science.gov (United States)

    Wang, Ping

    2009-01-01

    This paper makes a study of the rater reliability in scoring composition in the test of English as a foreign language (EFL) and focuses on the inter-rater reliability as well as several interactions between raters and the other facets involved (that is examinees, rating criteria and rating methods). Results showed that raters were fairly…

  20. The Natural Aging Effect on Hardenability in Al-Mg-Si: A Complex Interaction between Composition and Heat Treatment Parameters

    Directory of Open Access Journals (Sweden)

    Alex Poznak

    2018-05-01

    Full Text Available The technological relevance of Al-Mg-Si alloys has been rapidly growing over the last decade. Of particular interest to current and future applications is the problematic negative effect of prior natural aging on subsequent artificial age hardening. The influence of natural aging is dependent on both processing and compositional variables and has origins that are far from well-understood. This work examines the hardenability of 6000 series alloys under a wide range of conditions, paying particular attention to the natural aging effect. Experimental variables include alloy composition (Mg + Si, Mg/Si, cooling rate after solutionization, and duration of prior natural aging. Hardenability was evaluated with full hardness and conductivity aging curves for each condition, as well as select Transmission Electron Microscopy (TEM. Results are discussed based on the actions of naturally aged solute clusters during artificial aging. In particular, a complex interaction between vacancy concentration, cluster stability, and precipitation driving force is suggested.

  1. Myelodysplastic syndromes: a scoring system with prognostic significance.

    Science.gov (United States)

    Mufti, G J; Stevens, J R; Oscier, D G; Hamblin, T J; Machin, D

    1985-03-01

    141 patients with MDS were classified according to the FAB criteria and followed up for a period of 4-192 months. It was recognized that patients with RAEBT had a uniformly poor prognosis. However, there was a wide variation in survival among the other subgroups. A score of 1 was assigned to each of the following presenting haematological features: bone marrow blasts greater than or equal to 5%, platelets less than or equal to 100 X 10(9)/l, neutrophils less than or equal to 2.5 X 10(9)/l and Hb less than or equal to 10.0 g/dl. Therefore the score for each patient ranged between 0 and 4. There were no statistically significant differences between those patients who scored 0 or 1, or between those who scored 2 and 3. Therefore patients were put into three groups: Group A (score 0 or 1), Group B (score 2 or 3), Group C (score 4). The differences in survival between each of the three groups are highly significant (P less than 0.00001). This system further separates patients with RA, RAS, RAEB into good and bad prognostic groups. This study also confirms that deaths due to cytopenias are more common than those due to transformation to AML. The use of this scoring system in conjunction with the FAB criteria for MDS should serve as a prognostic tool on which to base treatment.

  2. The effect of surface treatment on the surface texture and contact angle of electrochemically deposited hydroxyapatite coating and on its interaction with bone-forming cells.

    Science.gov (United States)

    Eliaz, Noam; Shmueli, Sharon; Shur, Irena; Benayahu, Dafna; Aronov, Daniel; Rosenman, Gil

    2009-10-01

    This work demonstrates the effects of both surface preparation and surface post-treatment by exposure to electron beam on the surface texture, contact angle and the interaction with bone-forming cells of electrochemically deposited hydroxyapatite (HAp) coating. Both the surface texture and the contact angle of the ground titanium substrate changed as a result of either heat treatment following soaking in NaOH solution or soaking in H(2)O(2) solution. Consequently, the shape of the current transients during potentiostatic deposition of HAp changed, and the resulting coatings exhibited different surface textures and contact angles. The developed interfacial area ratio Sdr and the core fluid retention index Sci were found more reliable than the mean roughness R(a) and the root-mean-square roughness Z(rms) in correlating the adhesion of the coating to the metal substrate and the cellular response with surface texture. The NaOH pretreatment provided the highest surface area and induced the highest cell attachment, even though the H(2)O(2) treatment provided the highest hydrophilicity to the metal substrate. Electrodeposition at pH 6 was found preferable compared to electrodeposition at pH 4.2. The ability to modify the cellular response by exposure to unique electron-beam surface treatment was demonstrated. The very high hydrophilicity of the as-deposited HAp coating enhanced its bioactivity.

  3. Evaluation of adherence predictors for the treatment of moderate to severe psoriasis with biologics: the importance of physician-patient interaction and communication.

    Science.gov (United States)

    Zschocke, I; Ortland, C; Reich, K

    2017-06-01

    Treatment efficacy of biologic agents in moderate to severe psoriasis is regarded as high with patient adherence being higher than for traditional therapies. However, use of biologics is connected to high discontinuation rates. The current investigator-initiated study was conducted to improve the understanding of adherence. The study was designed as non-interventional retrospective multicentre trial in Germany. Questionnaires were developed based on the adherence dimensions identified by the World Health Organization, WHO. Thirteen dermatologists and 246 patients participated in the study and replied to the questionnaires. Study data were analysed for potential predictors of adherence in an explorative manner. Based on the physician's assessment of the patients' individual adherence, subsets of adherent and non-adherent patients were discriminated. Two main drivers were identified on the patients' side that were positively connected to adherence: a lack of efficacy of the previous treatments and the knowledge of comorbidities associated with severe psoriasis. Furthermore, physician-patient communication seems to play a central role, as on the dermatologists' side, there was a strong association of adherence and positive personal interrelation between dermatologist and patient. The data reported here underline the importance of patient education and information delivery to optimize patient adherence and thereby treatment outcomes. Treating physicians should be aware that soft aspects of their interaction with the patient might influence treatment adherence. © 2017 European Academy of Dermatology and Venereology.

  4. Interactive highly realistic virtual reality as a tool for understanding the genesis and treatment of psychotic symptoms.

    Science.gov (United States)

    Zányi, Eva; Selmanovic, Elmedin; Broome, Matthew; Czanner, Silvester; Birchwood, Max; Chalmers, Alan; Singh, Swaran

    2009-01-01

    Schizophrenia can be a devastating lifelong psychotic disorder with a poor prognosis. National guidelines in the UK recommend the provision of cognitive behavioral therapy (CBT) to all those suffering with psychotic disorders, but there is a lack of trained therapists in the UK able to provide such a treatment. Developing high quality automated technologies that can serve as an adjunct to conventional CBT should enhance the provision of this therapy, and increase the efficiency of the therapists in practice. The latter will occur by enabling alternate professionals to aid in the delivery of therapy, to enable behavioral experiments to be conducted in the clinic, and for sessions to be recorded and re-played such that the patient can deliver therapy to him or herself. As such the system will enable patients to become experts in, and providers of, their own treatment and decrease the number of sessions needed to be led by a trained CBT therapist. A key feature of any such system is the level of realism required to ensure a compelling session in which the user is not adversely affected by the system itself. This paper presents a high-fidelity virtual environment to help better understand the environmental triggers for psychosis.

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

    Science.gov (United States)

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

    2018-01-01

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

  6. Barthel Index-Enhanced Feedback for Effective Cardiac Treatment (BI-EFFECT) Study: contribution of the Barthel Index to the Heart Failure Risk Scoring System model in elderly adults with acute heart failure in the emergency department.

    Science.gov (United States)

    Martín-Sánchez, F Javier; Gil, Víctor; Llorens, Pere; Herrero, Pablo; Jacob, Javier; Fernández, Cristina; Miró, Òscar

    2012-03-01

    To evaluate whether the Enhanced Feedback for Effective Cardiac Treatment (EFFECT) scale for 30-day prediction of mortality is applicable to elderly adults with acute heart failure (AHF) in emergency departments (EDs) and whether discriminatory power is added with the inclusion of the Barthel Index (BI) to this scale (BI-EFFECT scale). BI-EFFECT is a multipurpose, nonintervention, multicenter cohort study. Twenty EDs. Individuals aged 65 and older with AHF. Information on baseline and episode characteristics and 30-day mortality was collected, and participants were categorized according to the EFFECT scale. Baseline degree of functional dependence was measured using the BI. Receiver operating characteristic (ROC) curves were made of the EFFECT and BI-EFFECT scales to predict mortality. One thousand sixty-eight participants were included. Thirty-day mortality was 5.1% and was directly and independently associated with high and very high risk categories of the EFFECT scale and with severe dependence. These two variables remained significant after adjustment of the model for both (OR = 4.5, 95% CI = 1.8-11.1 and OR = 2.9, 95% CI = 1.6-5.4, respectively). The EFFECT and the BI-EFFECT scales had significant ROC curves (area under the ROC curve (AUC) = 0.69, 95% CI = from 0.62 to 0.76; and AUC = 0.75, 95% CI = 0.69-0.81, respectively), and the difference in discriminatory power between the second and the first was also statistically significant (P = .02). The EFFECT scale may be applied in the elderly population, and inclusion of functional status according to the BI in the new BI-EFFECT scale significantly improves the model for the prediction of 30-day mortality. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.

  7. Scoring Models of Bank Credit Policy Management

    OpenAIRE

    Aida Hanic; Emina Zunic; Adnan Dzelihodzic

    2013-01-01

    The aim of this paper is to present how credit scoring models can be used in financial institutions, in this case in banks, in order to simplify credit lending. Unlike traditional models of credit analysis, scoring models provides valuation based on numerical score who represent clients’ possibility to fulfil their obligation. Using credit scoring models, bank can create a numerical snapshot of consumers risk profile. One of the most important characteristic of scoring models is objectivity w...

  8. Confidence scores for prediction models

    DEFF Research Database (Denmark)

    Gerds, Thomas Alexander; van de Wiel, MA

    2011-01-01

    In medical statistics, many alternative strategies are available for building a prediction model based on training data. Prediction models are routinely compared by means of their prediction performance in independent validation data. If only one data set is available for training and validation......, then rival strategies can still be compared based on repeated bootstraps of the same data. Often, however, the overall performance of rival strategies is similar and it is thus difficult to decide for one model. Here, we investigate the variability of the prediction models that results when the same...... to distinguish rival prediction models with similar prediction performances. Furthermore, on the subject level a confidence score may provide useful supplementary information for new patients who want to base a medical decision on predicted risk. The ideas are illustrated and discussed using data from cancer...

  9. Executive Control and Striatal Resting-State Network Interact with Risk Factors to Influence Treatment Outcomes in Alcohol-Use Disorder

    Directory of Open Access Journals (Sweden)

    Milky Kohno

    2017-09-01

    Full Text Available Alterations within mesocorticolimbic terminal regions commonly occur with alcohol use disorder (AUD. As pathological drug-seeking behavior may arise as a consequence of alcohol-induced neuroadaptations, it is critical to understand how such changes increase the likelihood of relapse. This report examined resting-state functional connectivity (RSFC using both a seed-based and model-free approach in individuals in treatment for AUD and how dysregulation of network connectivity contributes to treatment outcomes. In order to provide a mechanism by which neural networks promote relapse, interactive effects of mesocorticolimbic connectivity and AUD risk factors in treatment completers and non-completers were examined. AUD group showed stronger RSFC between striatum, insula, and anterior cingulate cortex than controls. Within the AUD group, non-completers compared to completers showed enhanced RSFC between (1 striatum–insula, (2 executive control network (ECN–amygdala, and (3 basal ganglia/salience network and striatum, precuneus, and insula. Completers showed enhanced RSFC between striatum-right dorsolateral prefrontal cortex. Furthermore, completers and non-completers differed in relationships between RSFC and relapse risk factors, where non-completers exhibited positive associations between craving intensity and RSFC of striatum–insula and ECN–amygdala. These findings provide evidence for interactions between corticolimbic connectivity in AUD and craving and establish an important link between network connectivity and dynamic risk factors that contribute to relapse. Results demonstrate that relapse vulnerability is attributed to craving dysregulation manifested by enhanced connectivity in striato-limbic regions and diminished corticostriatal connectivity.

  10. Social Anxiety in Online and Real-Life Interaction and Their Associated Factors

    Science.gov (United States)

    Yen, Ju-Yu; Yen, Cheng-Fang; Chen, Cheng-Sheng; Wang, Peng-Wei; Chang, Yi-Hsin

    2012-01-01

    Abstract Social anxiety was compared between online and real-life interaction in a sample of 2,348 college students. Severity of social anxiety in both real-life and online interaction was tested for associations with depression, Internet addiction, Internet activity type (gaming versus chatting), and scores on Behavioral Inhibition System (BIS)/Behavioral Activation System (BAS) scales. The results showed that social anxiety was lower when interacting online than when interacting offline. Depression, Internet addiction, and high BIS and BAS scores were associated with high social anxiety. The social anxiety decreased more in online interaction among subjects with high social anxiety, depression, BIS, and BAS. This result suggests that the Internet has good potential as an alternative medium for delivering interventions for social anxiety. Further, the effect of BIS on social anxiety is decreased in online interaction. More attention should be paid for BIS when the treatment for social anxiety is delivered online. PMID:22175853

  11. Social anxiety in online and real-life interaction and their associated factors.

    Science.gov (United States)

    Yen, Ju-Yu; Yen, Cheng-Fang; Chen, Cheng-Sheng; Wang, Peng-Wei; Chang, Yi-Hsin; Ko, Chih-Hung

    2012-01-01

    Social anxiety was compared between online and real-life interaction in a sample of 2,348 college students. Severity of social anxiety in both real-life and online interaction was tested for associations with depression, Internet addiction, Internet activity type (gaming versus chatting), and scores on Behavioral Inhibition System (BIS)/Behavioral Activation System (BAS) scales. The results showed that social anxiety was lower when interacting online than when interacting offline. Depression, Internet addiction, and high BIS and BAS scores were associated with high social anxiety. The social anxiety decreased more in online interaction among subjects with high social anxiety, depression, BIS, and BAS. This result suggests that the Internet has good potential as an alternative medium for delivering interventions for social anxiety. Further, the effect of BIS on social anxiety is decreased in online interaction. More attention should be paid for BIS when the treatment for social anxiety is delivered online.

  12. Interactive music as a treatment for pain and stress in children during venipuncture: a randomized prospective study.

    Science.gov (United States)

    Caprilli, Simona; Anastasi, Francesca; Grotto, Rosa Pia Lauro; Scollo Abeti, Marianna; Abeti, Mariana Scollo; Messeri, Andrea

    2007-10-01

    The experience of venipuncture is seen by children as one of the most fearful experiences during hospitalization. Children experience anxiety both before and during the procedure. Therefore, any intervention aiming to prevent or reduce distress should focus on the entire experience of the procedure, including waiting, actual preparation, and conclusion. This study was designed to determine whether the presence of musicians, who had attended specific training to work in medical settings, could reduce distress and pain in children undergoing blood tests. Our sample population was composed of 108 unpremedicated children (4-13 years of age) undergoing blood tests. They were randomly assigned to a music group (n=54), in which the child underwent the procedure while interacting with the musicians in the presence of a parent or to a control group (n=54), in which only the parent provided support to the child during the procedure. The distress experienced by the child before, during and after the blood test was assessed with the Amended Form of the Observation Scale of Behavioral Distress, and pain experience with FACES scale (Wong Baker Scale) only after the venipuncture. Our results show that distress and pain intensity was significantly lower (p<.001; p<.05) in the music group compared with the control group before, during, and after blood sampling. This controlled study demonstrates that songs and music, performed by "professional" musicians, have a beneficial effect in reducing distress before, during, and after blood tests. This study shows, moreover, that the presence of musicians has a minor, but yet significant, effect on pain due to needle insertion.

  13. Kappa opioid receptor antagonism and chronic antidepressant treatment have beneficial activities on social interactions and grooming deficits during heroin abstinence.

    Science.gov (United States)

    Lalanne, L; Ayranci, G; Filliol, D; Gavériaux-Ruff, C; Befort, K; Kieffer, B L; Lutz, P-E

    2017-07-01

    Addiction is a chronic brain disorder that progressively invades all aspects of personal life. Accordingly, addiction to opiates severely impairs interpersonal relationships, and the resulting social isolation strongly contributes to the severity and chronicity of the disease. Uncovering new therapeutic strategies that address this aspect of addiction is therefore of great clinical relevance. We recently established a mouse model of heroin addiction in which, following chronic heroin exposure, 'abstinent' mice progressively develop a strong and long-lasting social avoidance phenotype. Here, we explored and compared the efficacy of two pharmacological interventions in this mouse model. Because clinical studies indicate some efficacy of antidepressants on emotional dysfunction associated with addiction, we first used a chronic 4-week treatment with the serotonergic antidepressant fluoxetine, as a reference. In addition, considering prodepressant effects recently associated with kappa opioid receptor signaling, we also investigated the kappa opioid receptor antagonist norbinaltorphimine (norBNI). Finally, we assessed whether fluoxetine and norBNI could reverse abstinence-induced social avoidance after it has established. Altogether, our results show that two interspaced norBNI administrations are sufficient both to prevent and to reverse social impairment in heroin abstinent animals. Therefore, kappa opioid receptor antagonism may represent a useful approach to alleviate social dysfunction in addicted individuals. © 2016 Society for the Study of Addiction.

  14. A comparison of five common drug-drug interaction software programs regarding accuracy and comprehensiveness.

    Science.gov (United States)

    Kheshti, Raziyeh; Aalipour, Mohammadsadegh; Namazi, Soha

    2016-01-01

    Drug-drug interactions (DDIs) can cause failure in treatment and adverse events. DDIs screening software is an important tool to aid clinicians in the detection and management of DDIs. However, clinicians should be aware of the advantages and limitations of these programs. We compared the ability of five common DDI programs to detect clinically important DDIs. Lexi-Interact, Micromedex Drug Interactions, iFacts, Medscape, and Epocrates were evaluated. The programs' sensitivity, specificity, and positive and negative predictive values were determined to assess their accuracy in detecting DDIs. The accuracy of each program was identified using 360 unknown pair interactions, taken randomly from prescriptions, and forty pairs of clinically important ones. The major reference was a clinical pharmacist alongside the Stockley's Drug Interaction and databases including PubMed, Scopus, and Google Scholar. Comprehensiveness of each program was determined by the number of components in the drug interaction monograph. The aggregate score for accuracy and comprehensiveness was calculated. Scoring 250 out of possible 400 points, Lexi-Interact and Epocrates, provided the most accurate software programs. Micromedex, Medscape, and iFacts ranked third, fourth, and fifth, scoring 236, 202, and 191, respectively. In comprehensiveness test, iFacts showed the highest score, 134 out of possible 134 points, whereas Lexi-Interact rated second, with a score of 120. Scoring 370 and 330 out of possible 534 points, Lexi-Interact and Micromedex, respectively, provided the most competent, complete, and user-friendly applications. Lexi-Interact and Micromedex showed the best performances. An increase in sensitivity is possible by the combination of more than one programs and expert pharmacist intervention.

  15. Lecture Evaluations by Medical Students: Concepts That Correlate With Scores.

    Science.gov (United States)

    Jen, Aaron; Webb, Emily M; Ahearn, Bren; Naeger, David M

    2016-01-01

    The didactic lecture remains one of the most popular teaching formats in medical education; yet, factors that most influence lecturing success in radiology education are unknown. The purpose of this study is to identify patterns of narrative student feedback that are associated with relatively higher and lower evaluation scores. All student evaluations from our core radiology elective during 1 year were compiled. All evaluation comments were tagged, to identify discrete descriptive concepts. Correlation coefficients were calculated, for each tag with mean evaluation scores. Tags that were the most strongly associated with the highest- versus lowest-rated (> or < 1 SD) lectures were identified. A total of 3,262 comments, on 273 lectures, rated by 77 senior medical students, were analyzed. The mean lecture score was 8.96 ± 0.62. Three tags were significantly positively correlated with lecture score: "interactive"; "fun/engaging"; and "practical/important content" (r = 0.39, r = 0.34, and r = 0.32, respectively; all P < .001). More tags (n = 12) were significantly negatively correlated with score; the three tags with the strongest such correlation were: "not interactive"; "poorly structured or unevenly paced"; and "content too detailed or abundant" (r = -0.44, r = -0.39, and r = -0.36, respectively; all P < .001). Analysis of only the highest- and lowest-rated lectures yielded similar results. Several factors were identified that were strongly associated with lecture score. Among the actionable characteristics, interactive lectures with appropriately targeted content (ie, practical/useful) were the most highly rated. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  16. Towards an international standard for PCR-based detection of foodborne thermotolerant campylobacters: interaction of enrichment media and pre-PCR treatment on carcass rinse samples

    DEFF Research Database (Denmark)

    Josefsen, Mathilde Hartmann; Lübeck, Peter Stephensen; Hansen, F.

    2004-01-01

    As part of a large EU project for standardisation of polymerase chain reaction (PCR), a systematic evaluation of the interaction of enrichment media, type of DNA polymerase and pre-PCR sample treatment for a PCR detecting thermotolerant campylobacters was carried out. The growth-supporting capacity...... and PCR compatibility of enrichment in Preston, Mueller-Hinton and Bolton broth (blood-containing and blood-free) were evaluated. The effect of resin-based DNA extraction and DNA extraction by boiling on the final PCR assay was investigated. The time-course studies indicated that a 20-h sample enrichment...... in blood-containing Bolton broth, followed by a simple resin-based extraction of DNA and a PCR amplification using Tth polymerase, resulted in strong and clear PCR amplicons for target (287 bp) and internal amplification control (IAC, 124 bp). The enrichment PCR-based method, tested on 68 presumably...

  17. An interactive tool for CT volume rendering and sagittal plane-picking of the prostate for radiotherapy treatment planning

    International Nuclear Information System (INIS)

    Jani, Ashesh B.; Pelizzari, Charles A.; Chen, George T.Y.; Grzezcszuk, Robert P.; Vijayakumar, Srinivasan

    1997-01-01

    Objective: Accurate and precise target volume and critical structure definition is a basic necessity in radiotherapy. The prostate, particularly the apex (an important potential site of recurrence in prostate cancer patients), is a challenging structure to define using any modality, including conventional axial CT. Invasive or expensive techniques, such as retrograde urethrography or MRI, could be avoided if localization of the prostate were possible using information already available on the planning CT. Our primary objective was to build a software tool to determine whether volume rendering and sagittal plane-picking, which are CT-based, noninvasive visualization techniques, were of utility in radiotherapy treatment planning for the prostate. Methods: Using AVS (Application Visualization System) on a Silicon Graphics Indigo 2 High Impact workstation, we have developed a tool that enables the clinician to efficiently navigate a CT volume and to use volume rendering and sagittal plane-picking to better define structures at any anatomic site. We applied the tool to the specific example of the prostate to compare the two visualization techniques with the current standard of axial CT. The prostate was defined on 80-slice CT scans (scanning thickness 4mm, pixel size 2mm x 2mm) of prostate cancer patients using axial CT images, volume-rendered CT images, and sagittal plane-picked images. Results: The navigation of the prostate using the different visualization techniques qualitatively demonstrated that the sagittal plane-picked images, and even more so the volume-rendered images, revealed the prostate (particularly the lower border) better in relationship to the surrounding regional anatomy (bladder, rectum, pelvis, and penile structures) than did the axial images. A quantitative comparison of the target volumes obtained by navigating using the different visualization techniques demonstrated that, when compared to the prostate volume defined on axial CT, a larger volume

  18. Rivaroxaban versus warfarin in Japanese patients with nonvalvular atrial fibrillation in relation to the CHADS2 score: a subgroup analysis of the J-ROCKET AF trial.

    Science.gov (United States)

    Hori, Masatsugu; Matsumoto, Masayasu; Tanahashi, Norio; Momomura, Shin-Ichi; Uchiyama, Shinichiro; Goto, Shinya; Izumi, Tohru; Koretsune, Yukihiro; Kajikawa, Mariko; Kato, Masaharu; Ueda, Hitoshi; Iekushi, Kazuma; Yamanaka, Satoshi; Tajiri, Masahiro

    2014-02-01

    Results from a trial of rivaroxaban versus warfarin in 1280 Japanese patients with atrial fibrillation (J-ROCKET AF) revealed that rivaroxaban was noninferior to warfarin with respect to the principal safety outcome. In this subanalysis, we investigated the safety and efficacy of rivaroxaban and warfarin in relation to patients' CHADS2 scores. The mean CHADS2 score was 3.25, and the most frequent scores were 3 and 4. No statistically significant interactions were observed between principal safety outcome event rates and CHADS2 scores with respect to treatment groups (P value for interaction = .700). Irrespective of stratification into moderate- and high-risk groups based on CHADS2 scores of 2 and 3 or more, respectively, no differences in principal safety outcome event rates were observed between rivaroxaban- and warfarin-treated patients (moderate-risk group: hazard ratio [HR], 1.06; 95% confidence interval [CI], .58-1.95; high-risk group: HR, 1.11; 95% CI, .86-1.45; P value for interaction = .488). The primary efficacy end point rate in the rivaroxaban-treated group was numerically lower than in the warfarin-treated group, regardless of risk group stratification (moderate-risk group: HR, .46; 95% CI, .09-2.37; high-risk group: HR, .49; 95% CI, .22-1.11; P value for interaction = .935). This subanalysis indicated that the safety and efficacy of rivaroxaban compared with warfarin were similar, regardless of CHADS2 score. Copyright © 2014 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  19. Development and validation of a clinical score for prognosis ...

    African Journals Online (AJOL)

    Background: Mortality rates among patients initiating antiretroviral therapy (ART) in sub-Saharan Africa continue high. Also HIV treatment services from the region are affronting the challenges of been attending more patients than never. In this scenario, there are no integrated scoring systems capable of an adequate risk ...

  20. The Consumer Reports Effectiveness Score: What Did Consumers Report?

    Science.gov (United States)

    Nielsen, Stevan Lars; Smart, David W.; Isakson, Richard L.; Worthen, Vaughn E.; Gregersen, Ann T.; Lambert, Michael J.

    2004-01-01

    From readers' ratings of satisfaction, problem resolution, and perceived emotional change during treatment, Consumer Reports magazine (CR, 1995) concluded both that psychotherapy is effective and that longer, more intensive therapy is more effective. The authors compared prospectively gathered 45-Item Outcome Questionnaire scores (OQ-45; M. J.…

  1. 30-day readmission score after cardiac surgery

    Directory of Open Access Journals (Sweden)

    Juan Espinoza

    2016-08-01

    Conclusions: The present study provides a clinical score to predict early readmission after open-heart surgery and validates that score in a comparable population, which can help in planning future interventions to avoid unnecessary readmissions.

  2. Cardiovascular risk scores for coronary atherosclerosis.

    Science.gov (United States)

    Yalcin, Murat; Kardesoglu, Ejder; Aparci, Mustafa; Isilak, Zafer; Uz, Omer; Yiginer, Omer; Ozmen, Namik; Cingozbay, Bekir Yilmaz; Uzun, Mehmet; Cebeci, Bekir Sitki

    2012-10-01

    The objective of this study was to compare frequently used cardiovascular risk scores in predicting the presence of coronary artery disease (CAD) and 3-vessel disease. In 350 consecutive patients (218 men and 132 women) who underwent coronary angiography, the cardiovascular risk level was determined using the Framingham Risk Score (FRS), the Modified Framingham Risk Score (MFRS), the Prospective Cardiovascular Münster (PROCAM) score, and the Systematic Coronary Risk Evaluation (SCORE). The area under the curve for receiver operating characteristic curves showed that FRS had more predictive value than the other scores for CAD (area under curve, 0.76, P MFRS, PROCAM, and SCORE) may predict the presence and severity of coronary atherosclerosis.The FRS had better predictive value than the other scores.

  3. Codominant scoring of AFLP in association panels

    NARCIS (Netherlands)

    Gort, G.; Eeuwijk, van F.A.

    2010-01-01

    A study on the codominant scoring of AFLP markers in association panels without prior knowledge on genotype probabilities is described. Bands are scored codominantly by fitting normal mixture models to band intensities, illustrating and optimizing existing methodology, which employs the

  4. PRSice: Polygenic Risk Score software.

    Science.gov (United States)

    Euesden, Jack; Lewis, Cathryn M; O'Reilly, Paul F

    2015-05-01

    A polygenic risk score (PRS) is a sum of trait-associated alleles across many genetic loci, typically weighted by effect sizes estimated from a genome-wide association study. The application of PRS has grown in recent years as their utility for detecting shared genetic aetiology among traits has become appreciated; PRS can also be used to establish the presence of a genetic signal in underpowered studies, to infer the genetic architecture of a trait, for screening in clinical trials, and can act as a biomarker for a phenotype. Here we present the first dedicated PRS software, PRSice ('precise'), for calculating, applying, evaluating and plotting the results of PRS. PRSice can calculate PRS at a large number of thresholds ("high resolution") to provide the best-fit PRS, as well as provide results calculated at broad P-value thresholds, can thin Single Nucleotide Polymorphisms (SNPs) according to linkage disequilibrium and P-value or use all SNPs, handles genotyped and imputed data, can calculate and incorporate ancestry-informative variables, and can apply PRS across multiple traits in a single run. We exemplify the use of PRSice via application to data on schizophrenia, major depressive disorder and smoking, illustrate the importance of identifying the best-fit PRS and estimate a P-value significance threshold for high-resolution PRS studies. PRSice is written in R, including wrappers for bash data management scripts and PLINK-1.9 to minimize computational time. PRSice runs as a command-line program with a variety of user-options, and is freely available for download from http://PRSice.info jack.euesden@kcl.ac.uk or paul.oreilly@kcl.ac.uk Supplementary data are available at Bioinformatics online. © The Author 2014. Published by Oxford University Press.

  5. dBBQs: dataBase of Bacterial Quality scores.

    Science.gov (United States)

    Wanchai, Visanu; Patumcharoenpol, Preecha; Nookaew, Intawat; Ussery, David

    2017-12-28

    It is well-known that genome sequencing technologies are becoming significantly cheaper and faster. As a result of this, the exponential growth in sequencing data in public databases allows us to explore ever growing large collections of genome sequences. However, it is less known that the majority of available sequenced genome sequences in public databases are not complete, drafts of varying qualities. We have calculated quality scores for around 100,000 bacterial genomes from all major genome repositories and put them in a fast and easy-to-use database. Prokaryotic genomic data from all sources were collected and combined to make a non-redundant set of bacterial genomes. The genome quality score for each was calculated by four different measurements: assembly quality, number of rRNA and tRNA genes, and the occurrence of conserved functional domains. The dataBase of Bacterial Quality scores (dBBQs) was designed to store and retrieve quality scores. It offers fast searching and download features which the result can be used for further analysis. In addition, the search results are shown in interactive JavaScript chart framework using DC.js. The analysis of quality scores across major public genome databases find that around 68% of the genomes are of acceptable quality for many uses. dBBQs (available at http://arc-gem.uams.edu/dbbqs ) provides genome quality scores for all available prokaryotic genome sequences with a user-friendly Web-interface. These scores can be used as cut-offs to get a high-quality set of genomes for testing bioinformatics tools or improving the analysis. Moreover, all data of the four measurements that were combined to make the quality score for each genome, which can potentially be used for further analysis. dBBQs will be updated regularly and is freely use for non-commercial purpose.

  6. Lessons learned in empirical scoring with smina from the CSAR 2011 benchmarking exercise.

    Science.gov (United States)

    Koes, David Ryan; Baumgartner, Matthew P; Camacho, Carlos J

    2013-08-26

    We describe a general methodology for designing an empirical scoring function and provide smina, a version of AutoDock Vina specially optimized to support high-throughput scoring and user-specified custom scoring functions. Using our general method, the unique capabilities of smina, a set of default interaction terms from AutoDock Vina, and the CSAR (Community Structure-Activity Resource) 2010 data set, we created a custom scoring function and evaluated it in the context of the CSAR 2011 benchmarking exercise. We find that our custom scoring function does a better job sampling low RMSD poses when crossdocking compared to the default AutoDock Vina scoring function. The design and application of our method and scoring function reveal several insights into possible improvements and the remaining challenges when scoring and ranking putative ligands.

  7. Semiparametric score level fusion: Gaussian copula approach

    NARCIS (Netherlands)

    Susyanyo, N.; Klaassen, C.A.J.; Veldhuis, Raymond N.J.; Spreeuwers, Lieuwe Jan

    2015-01-01

    Score level fusion is an appealing method for combining multi-algorithms, multi- representations, and multi-modality biometrics due to its simplicity. Often, scores are assumed to be independent, but even for dependent scores, accord- ing to the Neyman-Pearson lemma, the likelihood ratio is the

  8. Credit Scores, Race, and Residential Sorting

    Science.gov (United States)

    Nelson, Ashlyn Aiko

    2010-01-01

    Credit scores have a profound impact on home purchasing power and mortgage pricing, yet little is known about how credit scores influence households' residential location decisions. This study estimates the effects of credit scores on residential sorting behavior using a novel mortgage industry data set combining household demographic, credit, and…

  9. Surgical Apgar Score predicts postoperative complications in ...

    African Journals Online (AJOL)

    Background: Predicting complications in neurotrauma patients by using an effective scoring system can reduce morbidity and mortality while facilitating objective clinical decision making during recovery. Compared to existing morbidity and mortality predictive scores, the Surgical Apgar Score (SAS) is simple and effective.

  10. An Objective Fluctuation Score for Parkinson's Disease

    Science.gov (United States)

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

    2015-01-01

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

  11. "Score Choice": A Tempest in a Teapot?

    Science.gov (United States)

    Hoover, Eric

    2009-01-01

    A new option that allows students to choose which of their test scores to send to colleges has generated renewed criticism of the College Board. College Board officials tout the option, called Score Choice, as a way to ease test taker anxiety. Some prominent admissions officials have publicly described Score Choice as a sales tactic that will…

  12. Breaking of scored tablets : a review

    NARCIS (Netherlands)

    van Santen, E; Barends, D M; Frijlink, H W

    The literature was reviewed regarding advantages, problems and performance indicators of score lines. Scored tablets provide dose flexibility, ease of swallowing and may reduce the costs of medication. However, many patients are confronted with scored tablets that are broken unequally and with

  13. Validation of Automated Scoring of Science Assessments

    Science.gov (United States)

    Liu, Ou Lydia; Rios, Joseph A.; Heilman, Michael; Gerard, Libby; Linn, Marcia C.

    2016-01-01

    Constructed response items can both measure the coherence of student ideas and serve as reflective experiences to strengthen instruction. We report on new automated scoring technologies that can reduce the cost and complexity of scoring constructed-response items. This study explored the accuracy of c-rater-ML, an automated scoring engine…

  14. Pneumonia Risk Stratification Scores for Children in Low-Resource Settings: A Systematic Literature Review.

    Science.gov (United States)

    Deardorff, Katrina V; McCollum, Eric D; Ginsburg, Amy Sarah

    2017-12-22

    Pneumonia is the leading infectious cause of death among children less than five years of age. Predictive tools, commonly referred to as risk scores, can be employed to identify high-risk children early for targeted management to prevent adverse outcomes. This systematic review was conducted to identify pediatric pneumonia risk scores developed, validated, and implemented in low-resource settings. We searched CAB Direct, Cochrane Reviews, Embase, PubMed, Scopus, and Web of Science for studies that developed formal risk scores to predict treatment failure or mortality among children less than five years of age diagnosed with a respiratory infection or pneumonia in low-resource settings. Data abstracted from articles included location and study design, sample size, age, diagnosis, score features and model discrimination. Three pediatric pneumonia risk scores predicted mortality specifically, and two treatment failure. Scores developed using World Health Organization recommended variables for pneumonia assessment demonstrated better predictive fit than scores developed using alternative features. Scores developed using routinely collected healthcare data performed similarly well as those developed using clinical trial data. No score has been implemented in low-resource settings. While pediatric pneumonia-specific risk scores have been developed and validated, it is yet unclear if implementation is feasible, what impact, if any, implemented scores may have on child outcomes, or how broadly scores may be generalized. To increase the feasibility of implementation, future research should focus on developing scores based on routinely collected data.

  15. Influence of laser-target interaction regime on composition and properties of surface layers grown by laser treatment of Ti plates

    Energy Technology Data Exchange (ETDEWEB)

    Lavisse, L; Cirisan, M; Jouvard, J M [Laboratoire Interdisciplinaire Carnot de Bourgogne, UMR 5209 CNRS-Universite de Bourgogne, 1 allee des Granges Forestier, F-71100 Chalon-sur-Saone (France); Berger, P [CEA/DSM/IRAMIS/SIS2M, CEA - SACLAY, F-91191 Gif sur Yvette (France); Bourgeois, S; Marco de Lucas, M C, E-mail: Luc.Lavisse@u-bourgogne.f [Laboratoire Interdisciplinaire Carnot de Bourgogne, UMR 5209 CNRS-Universite de Bourgogne, 9 Av. A. Savary, BP 47 870, F-21078 Dijon Cedex (France)

    2009-12-21

    Surface laser treatment of commercially pure titanium plates was performed in air using two different Nd : YAG sources delivering pulses of 5 and 35 ns. The laser fluence conditions were set to obtain with each source either yellow or blue surface layers. Nuclear reaction analysis (NRA) was used to quantify the amount of light elements in the formed layers. Titanium oxinitrides, containing different amounts of oxygen and nitrogen, were mainly found, except in the case of long pulses and high laser fluence, which led to the growth of titanium dioxide. The structure of the layers was studied by x-ray diffraction and Raman spectroscopy. In addition, reflectance spectra showed the transition from a metal-like behaviour to an insulating TiO{sub 2}-like behaviour as a function of the treatment conditions. Modelling of the laser-target interaction on the basis of the Semak model was performed to understand the different compositions and properties of the layers. Numerical calculations showed that vaporization dominates in the case of short pulses, whereas a liquid-ablation regime is achieved in the case of 35 ns long pulses.

  16. Laser-Neuron Interaction with Femtosecond Beat-Modulated 800-1200 nm Photon Beams, as the Treatment of Brain Cancer Tissue. Laser Neurophysics

    Science.gov (United States)

    Stefan, V. Alexander

    2011-03-01

    I propose a novel mechanism for the brain cancer tissue treatment: nonlinear interaction of ultrashort pulses of beat-photon, (ω1 -- ω2) , or double-photon, (ω1 +ω2) , beams with the cancer tissue. The multiphoton scattering is described via photon diffusion equation. The open-scull cerebral tissue can be irradiated with the beat-modulated photon pulses with the laser irradiances in the range of a few mW/cm2 , and repetition rate of a few 100s Hz generated in the beat-wave driven free electron laser. V. Stefan, B. I. Cohen, and C. Joshi, Nonlinear Mixing of Electromagnetic Waves in PlasmasScience 27 January 1989: V. Alexander Stefan, Genomic Medical Physics: A New Physics in the Making, (S-U-Press, 2008).} This highly accurate cancer tissue ablation removal may prove to be an efficient method for the treatment of brain cancer. Work supported in part by Nikola Tesla Laboratories (Stefan University), La Jolla, CA.

  17. Interaction of acid mine drainage with Ordinary Portland Cement blended solid residues generated from active treatment of acid mine drainage with coal fly ash.

    Science.gov (United States)

    Gitari, Wilson M; Petrik, Leslie F; Key, David L; Okujeni, Charles

    2011-01-01

    Fly ash (FA) has been investigated as a possible treatment agent for Acid mine drainage (AMD) and established to be an alternative, cheap and economically viable agent compared to the conventional alkaline agents. However, this treatment option also leads to generation of solid residues (SR) that require disposal and one of the proposed disposal method is a backfill in coal mine voids. In this study, the interaction of the SR with AMD that is likely to be present in such backfill scenario was simulated by draining columns packed with SR and SR + 6% Ordinary Portland Cement (OPC) unsaturated with simulated AMD over a 6 month period. The evolving geochemistry of the liquid/solid (L/S) system was evaluated in-terms of the mineral phases likely or controlling contaminants attenuation at the different pH regimes generated. Stepwise acidification of the percolates was observed as the drainage progressed. Two pH buffer zones were observed (7.5-9 and 3-4) for SR and (11.2-11.3 and 3.5-4) for SR + 6% OPC. The solid residue cores (SR) appeared to have a significant buffering capacity, maintaining a neutral to slightly alkaline pH in the leachates for an extended period of time (97 days: L/S 4.3) while SR + 6% OPC reduced this neutralization capacity to 22 days (L/S 1.9). Interaction of AMD with SR or SR + 6% OPC generated alkaline conditions that favored precipitation of Fe, Al, Mn-(oxy) hydroxides, Fe and Ca-Al hydroxysulphates that greatly contributed to the contaminants removal. However, precipitation of these phases was restricted to the pH of the leachates remaining at neutral to circum-neutral levels. Backfill of mine voids with SR promises to be a feasible technology for the disposal of the SR but its success will greatly depend on the disposal scenario, AMD generated and the alkalinity generating potential of the SR. A disadvantage would be the possible re-dissolution of the precipitated phases at pH water column. However extrapolation of this concept to a field

  18. Transdiagnostic Clinical Global Impression Scoring for Routine Clinical Settings.

    Science.gov (United States)

    Dunlop, Boadie W; Gray, Jaclyn; Rapaport, Mark H

    2017-06-27

    Although there is great interest in the improving the ability to track patients' change over time in routine clinical care settings, no standardized transdiagnostic measure is currently available for busy clinicians to apply. The Clinical Global Impression (CGI) scales are simple measures widely used as outcomes in psychiatric clinical trials. However, the CGI suffers from poorly defined scoring anchors. Efforts to improve the anchors by enhancing the anchor descriptions have proven useful but are limited by being disease-specific, thereby acting as a barrier to the routine clinical adoption of the CGI. To inform the development of more broadly applicable CGI scoring anchors, we surveyed 24 clinical trial investigators, asking them to rank-order seven elements that inform their CGI-Severity (CGI-S) scoring. Symptom severity emerged as the most important element in determining CGI-S scores; the functional status of the patient emerged as a second element. Less importance was given to self-report symptom scores, staff observations, or side effects. Relative rankings of the elements' importance did not differ by investigators' experience nor time usually spent with patients. We integrated these results with published illness-specific CGI anchors to develop the Transdiagnostic CGI (T-CGI), which employs standardized scoring anchors applicable across psychiatric illnesses. Pending validity and reliability evaluations, the T-CGI may prove well-suited for inclusion in routine clinical settings and for incorporation into electronic medical records as a simple and useful measure of treatment efficacy.

  19. Administration and scoring variance on the ADAS-Cog.

    Science.gov (United States)

    Connor, Donald J; Sabbagh, Marwan N

    2008-11-01

    The Alzheimer's Disease Assessment Scale - Cognitive (ADAS-Cog) is the most commonly used primary outcome instrument in clinical trials for treatments of dementia. Variations in forms, administration procedures and scoring rules, along with rater turnover and intra-rater drift may decrease the reliability of the instrument. A survey of possible variations in the ADAS-Cog was administered to 26 volunteer raters at a clinical trials meeting. Results indicate notable protocol variations in the forms used, administration procedures, and scoring rules. Since change over time is used to determine treatment effect in clinical trials, standardizing the instrument's ambiguities and addressing common problems will greatly increase the instrument's reliability and thereby enhance its sensitivity to treatment effects.

  20. Parents' reported preference scores for childhood atopic dermatitis disease states

    Directory of Open Access Journals (Sweden)

    Walter Emmanuel B

    2004-10-01

    Full Text Available Abstract Background We sought to elicit preference weights from parents for health states corresponding to children with various levels of severity of atopic dermatitis. We also evaluated the hypothesis that parents with children who had been diagnosed with atopic dermatitis would assign different preferences to the health state scenarios compared with parents who did not have a child with atopic dermatitis. Methods Subjects were parents of children aged 3 months to 18 years. The sample was derived from the General Panel, Mommies Sub-Panel, and Chronic Illness Sub-Panel of Harris Interactive. Participants rated health scenarios for atopic dermatitis, asthma, and eyeglasses on a visual analog scale, imagining a child was experiencing the described state. Results A total of 3539 parents completed the survey. Twenty-nine percent had a child with a history of atopic dermatitis. Mean preference scores for atopic dermatitis were as follows: mild, 91 (95% confidence interval [CI], 90.7 to 91.5; mild/moderate, 84 (95%CI, 83.5 to 84.4; moderate, 73 (95%CI, 72.5 to 73.6; moderate/severe, 61 (95%CI, 60.6 to 61.8; severe, 49 (95% CI, 48.7 to 50.1; asthma, 58 (95%CI, 57.4 to 58.8; and eyeglasses, 87(95%CI, 86.3 to 87.4. Conclusions Parents perceive that atopic dermatitis has a negative effect on quality of life that increases with disease severity. Estimates of parents' preferences can provide physicians with insight into the value that parents place on their children's treatment and can be used to evaluate new medical therapies for atopic dermatitis.

  1. Approximating frustration scores in complex networks via perturbed Laplacian spectra

    Science.gov (United States)

    Savol, Andrej J.; Chennubhotla, Chakra S.

    2015-12-01

    Systems of many interacting components, as found in physics, biology, infrastructure, and the social sciences, are often modeled by simple networks of nodes and edges. The real-world systems frequently confront outside intervention or internal damage whose impact must be predicted or minimized, and such perturbations are then mimicked in the models by altering nodes or edges. This leads to the broad issue of how to best quantify changes in a model network after some type of perturbation. In the case of node removal there are many centrality metrics which associate a scalar quantity with the removed node, but it can be difficult to associate the quantities with some intuitive aspect of physical behavior in the network. This presents a serious hurdle to the application of network theory: real-world utility networks are rarely altered according to theoretic principles unless the kinetic impact on the network's users are fully appreciated beforehand. In pursuit of a kinetically interpretable centrality score, we discuss the f-score, or frustration score. Each f-score quantifies whether a selected node accelerates or inhibits global mean first passage times to a second, independently selected target node. We show that this is a natural way of revealing the dynamical importance of a node in some networks. After discussing merits of the f-score metric, we combine spectral and Laplacian matrix theory in order to quickly approximate the exact f-score values, which can otherwise be expensive to compute. Following tests on both synthetic and real medium-sized networks, we report f-score runtime improvements over exact brute force approaches in the range of 0 to 400 % with low error (<3 % ).

  2. Assessing covariate balance when using the generalized propensity score with quantitative or continuous exposures.

    Science.gov (United States)

    Austin, Peter C

    2018-01-01

    Propensity score methods are increasingly being used to estimate the effects of treatments and exposures when using observational data. The propensity score was initially developed for use with binary exposures (e.g., active treatment vs. control). The generalized propensity score is an extension of the propensity score for use with quantitative exposures (e.g., dose or quantity of medication, income, years of education). A crucial component of any propensity score analysis is that of balance assessment. This entails assessing the degree to which conditioning on the propensity score (via matching, weighting, or stratification) has balanced measured baseline covariates between exposure groups. Methods for balance assessment have been well described and are frequently implemented when using the propensity score with binary exposures. However, there is a paucity of information on how to assess baseline covariate balance when using the generalized propensity score. We describe how methods based on the standardized difference can be adapted for use with quantitative exposures when using the generalized propensity score. We also describe a method based on assessing the correlation between the quantitative exposure and each covariate in the sample when weighted using generalized propensity score -based weights. We conducted a series of Monte Carlo simulations to evaluate the performance of these methods. We also compared two different methods of estimating the generalized propensity score: ordinary least squared regression and the covariate balancing propensity score method. We illustrate the application of these methods using data on patients hospitalized with a heart attack with the quantitative exposure being creatinine level.

  3. Combination of scoring schemes for protein docking

    Directory of Open Access Journals (Sweden)

    Schomburg Dietmar

    2007-08-01

    Full Text Available Abstract Background Docking algorithms are developed to predict in which orientation two proteins are likely to bind under natural conditions. The currently used methods usually consist of a sampling step followed by a scoring step. We developed a weighted geometric correlation based on optimised atom specific weighting factors and combined them with our previously published amino acid specific scoring and with a comprehensive SVM-based scoring function. Results The scoring with the atom specific weighting factors yields better results than the amino acid specific scoring. In combination with SVM-based scoring functions the percentage of complexes for which a near native structure can be predicted within the top 100 ranks increased from 14% with the geometric scoring to 54% with the combination of all scoring functions. Especially for the enzyme-inhibitor complexes the results of the ranking are excellent. For half of these complexes a near-native structure can be predicted within the first 10 proposed structures and for more than 86% of all enzyme-inhibitor complexes within the first 50 predicted structures. Conclusion We were able to develop a combination of different scoring schemes which considers a series of previously described and some new scoring criteria yielding a remarkable improvement of prediction quality.

  4. Oswestry Disability Index scoring made easy.

    Science.gov (United States)

    Mehra, A; Baker, D; Disney, S; Pynsent, P B

    2008-09-01

    Low back pain effects up to 80% of the population at some time during their active life. Questionnaires are available to help measure pain and disability. The Oswestry Disability Index (ODI) is the most commonly used outcome measure for low back pain. The aim of this study was to see if training in completing the ODI forms improved the scoring accuracy. The last 100 ODI forms completed in a hospital's spinal clinic were reviewed retrospectively and errors in the scoring were identified. Staff members involved in scoring the questionnaire were made aware of the errors and the correct method of scoring explained. A chart was created with all possible scores to aid the staff with scoring. A prospective audit on 50 questionnaires was subsequently performed. The retrospective study showed that 33 of the 100 forms had been incorrectly scored. All questionnaires where one or more sections were not completed by the patient were incorrectly scored. A scoring chart was developed and staff training was implemented. This reduced the error rate to 14% in the prospective audit. Clinicians applying outcome measures should read the appropriate literature to ensure they understand the scoring system. Staff must then be given adequate training in the application of the questionnaires.

  5. Forecasting the value of credit scoring

    Science.gov (United States)

    Saad, Shakila; Ahmad, Noryati; Jaffar, Maheran Mohd

    2017-08-01

    Nowadays, credit scoring system plays an important role in banking sector. This process is important in assessing the creditworthiness of customers requesting credit from banks or other financial institutions. Usually, the credit scoring is used when customers send the application for credit facilities. Based on the score from credit scoring, bank will be able to segregate the "good" clients from "bad" clients. However, in most cases the score is useful at that specific time only and cannot be used to forecast the credit worthiness of the same applicant after that. Hence, bank will not know if "good" clients will always be good all the time or "bad" clients may become "good" clients after certain time. To fill up the gap, this study proposes an equation to forecast the credit scoring of the potential borrowers at a certain time by using the historical score related to the assumption. The Mean Absolute Percentage Error (MAPE) is used to measure the accuracy of the forecast scoring. Result shows the forecast scoring is highly accurate as compared to actual credit scoring.

  6. Comparison of the Classifier Oriented Gait Score and the Gait Profile Score based on imitated gait impairments.

    Science.gov (United States)

    Christian, Josef; Kröll, Josef; Schwameder, Hermann

    2017-06-01

    Common summary measures of gait quality such as the Gait Profile Score (GPS) are based on the principle of measuring a distance from the mean pattern of a healthy reference group in a gait pattern vector space. The recently introduced Classifier Oriented Gait Score (COGS) is a pathology specific score that measures this distance in a unique direction, which is indicated by a linear classifier. This approach has potentially improved the discriminatory power to detect subtle changes in gait patterns but does not incorporate a profile of interpretable sub-scores like the GPS. The main aims of this study were to extend the COGS by decomposing it into interpretable sub-scores as realized in the GPS and to compare the discriminative power of the GPS and COGS. Two types of gait impairments were imitated to enable a high level of control of the gait patterns. Imitated impairments were realized by restricting knee extension and inducing leg length discrepancy. The results showed increased discriminatory power of the COGS for differentiating diverse levels of impairment. Comparison of the GPS and COGS sub-scores and their ability to indicate changes in specific variables supports the validity of both scores. The COGS is an overall measure of gait quality with increased power to detect subtle changes in gait patterns and might be well suited for tracing the effect of a therapeutic treatment over time. The newly introduced sub-scores improved the interpretability of the COGS, which is helpful for practical applications. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Genetic Risk Score Modelling for Disease Progression in New-Onset Type 1 Diabetes Patients

    DEFF Research Database (Denmark)

    Brorsson, Caroline A; Nielsen, Lotte B; Andersen, Marie-Louise

    2016-01-01

    Genome-wide association studies (GWAS) have identified over 40 type 1 diabetes risk loci. The clinical impact of these loci on β-cell function during disease progression is unknown. We aimed at testing whether a genetic risk score could predict glycemic control and residual β-cell function in type...... 1 diabetes (T1D). As gene expression may represent an intermediate phenotype between genetic variation and disease, we hypothesized that genes within T1D loci which are expressed in islets and transcriptionally regulated by proinflammatory cytokines would be the best predictors of disease...... of the 11 candidate genes have overlapping biological functions and interact in a common network. Our results may help predict disease progression in newly diagnosed children with T1D which can be exploited for optimizing treatment....

  8. Comparative study of four maxillofacial trauma scoring systems and expert score.

    Science.gov (United States)

    Chen, Chen; Zhang, Yi; An, Jin-gang; He, Yang; Gong, Xi

    2014-11-01

    To select a scoring system suitable for the scoring of maxillofacial trauma by comparing 4 commonly used scoring systems according to expert scoring. Twenty-eight subjects who had experienced maxillofacial trauma constituted the study cohort. Four commonly used systems were selected: New Injury Severity Score (NISS), Facial Injury Severity Scale (FISS), Maxillofacial Injury Severity Score (MFISS), and Maxillofacial Injury Severity Score (MISS). Each patient was graded using these 4 systems. From the experience of our trauma center, an expert scoring table was created. After the purpose and scheme of the study had been explained, 35 experts in maxillofacial surgery were invited to grade the injury of the 28 patients using the expert scoring table according to their clinical experience. The results of the 4 scoring systems and expert score were compared. The results of the 4 scoring systems and expert score demonstrated a normal distribution. All results demonstrated significant differences (P expert score was the greatest (0.801). The correlation coefficient between the NISS, FISS, and MISS and the expert score was 0.714, 0.699, and 0.729, respectively. Agreement between the standardized scores and the expert score was evaluated using Bland-Altman plots; the agreement between the standardized MFISS and expert score was the best. Compared with the other 3 scoring systems, the correlation and agreement between the MFISS and expert score was greater. This finding suggests that the MFISS is more suitable for scoring maxillofacial injuries. Copyright © 2014 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  9. Correlation between Single Assessment Numerical Evaluation score and Lysholm score in primary total knee arthroplasty patients

    Directory of Open Access Journals (Sweden)

    Ted Sueyoshi, ATC, PES

    2018-03-01

    Conclusions: The results of the investigation showed that there was a statistically significant, however relatively weak, correlation between SANE score and Lysholm score. SANE score may serve as an alternative method to assess TKA patients' subjective post-operative outcomes to Lysholm score.

  10. Preventative treatment in an animal model of ADHD: Behavioral and biochemical effects of methylphenidate and its interactions with ovarian hormones in female rats.

    Science.gov (United States)

    Lukkes, Jodi L; Freund, Nadja; Thompson, Britta S; Meda, Shirisha; Andersen, Susan L

    2016-09-01

    Clinical and preclinical studies on attention deficit hyperactivity disorder (ADHD) show that juvenile males that are exposed to methylphenidate (MPH) show reduced risk for substance use later in life. In contrast, little is known about whether females have the same enduring treatment response to stimulants and how gonadal hormones influence their behavior later in life. Females received either a sham or 6-hydroxydopamine (6-OHDA) microinjection in the prefrontal cortex (PFC) at postnatal day (P)10. Subjects were then treated with Vehicle or MPH (2mg/kg, p.o.) between P20-35 and tested during late adolescence/young adulthood (P60); half of these subjects underwent ovariectomy at P55 to determine hormonal influences. Females with 6-OHDA were depleted of PFC dopamine by 61% and demonstrated increased impulsive choice (delayed discounting) and preferences for cocaine-associated environments relative to control females. Both MPH and ovariectomy reduced impulsive choice and cocaine preferences in 6-OHDA females, but had no enduring effect in Sham females. Ovariectomy itself did not significantly affect impulsivity. Juvenile MPH interacted strongly with 6-OHDA to increase D4, D5, Alpha-1A, Alpha-2A, and 5-HT-1A mRNA receptor expression in the PFC. MPH alone effected D1 mRNA, while 6-OHDA increased BDNF; all markers were decreased by ovariectomy. Together, these data suggest that 6-OHDA changes in dopamine are not only relevant for ADHD-like behaviors, but their long-term modulation by treatment and the influence of cyclical differences in menstrual cycle. Copyright © 2016 Elsevier B.V. and ECNP. All rights reserved.

  11. Observational studies using propensity score analysis underestimated the effect sizes in critical care medicine.

    Science.gov (United States)

    Zhang, Zhongheng; Ni, Hongying; Xu, Xiao

    2014-08-01

    Propensity score (PS) analysis has been increasingly used in critical care medicine; however, its validation has not been systematically investigated. The present study aimed to compare effect sizes in PS-based observational studies vs. randomized controlled trials (RCTs) (or meta-analysis of RCTs). Critical care observational studies using PS were systematically searched in PubMed from inception to April 2013. Identified PS-based studies were matched to one or more RCTs in terms of population, intervention, comparison, and outcome. The effect sizes of experimental treatments were compared for PS-based studies vs. RCTs (or meta-analysis of RCTs) with sign test. Furthermore, ratio of odds ratio (ROR) was calculated from the interaction term of treatment × study type in a logistic regression model. A ROR analysis of RCTs) were more likely to report beneficial effect for the experimental treatment than PS-based studies. The result remained unchanged in sensitivity analysis and meta-regression. In critical care literature, PS-based observational study is likely to report less beneficial effect of experimental treatment compared with RCTs (or meta-analysis of RCTs). Copyright © 2014 Elsevier Inc. All rights reserved.

  12. Splitting the BLOSUM Score into Numbers of Biological Significance

    Directory of Open Access Journals (Sweden)

    Tossi Alessandro

    2007-01-01

    Full Text Available Mathematical tools developed in the context of Shannon information theory were used to analyze the meaning of the BLOSUM score, which was split into three components termed as the BLOSUM spectrum (or BLOSpectrum. These relate respectively to the sequence convergence (the stochastic similarity of the two protein sequences, to the background frequency divergence (typicality of the amino acid probability distribution in each sequence, and to the target frequency divergence (compliance of the amino acid variations between the two sequences to the protein model implicit in the BLOCKS database. This treatment sharpens the protein sequence comparison, providing a rationale for the biological significance of the obtained score, and helps to identify weakly related sequences. Moreover, the BLOSpectrum can guide the choice of the most appropriate scoring matrix, tailoring it to the evolutionary divergence associated with the two sequences, or indicate if a compositionally adjusted matrix could perform better.

  13. The interaction between stent(s) implantation, PICA involvement, and immediate occlusion degree affect symptomatic intracranial spontaneous vertebral artery dissection aneurysm (sis-VADA) recurrence after reconstructive treatment with stent(s)-assisted coiling.

    Science.gov (United States)

    Zhao, Kai-Jun; Zhao, Rui; Huang, Qing-Hai; Xu, Yi; Hong, Bo; Fang, Yi-Bin; Li, Qiang; Yang, Peng-Fei; Liu, Jian-Min; Zhao, Wen-Yuan

    2014-09-01

    We aimed to evaluate risk factors of sis-VADAs recurrence after reconstructive treatment based on 113 reconstructed lesions. A total of 111 patients (M:F = 68:43; median age, 47 years) with 113 sis-VADAs underwent reconstruction from October 2000 to March 2011, using stent(s) and coils. Treatments and predictors of recurrence were retrospectively analysed. Fifty-eight sis-VADAs underwent single-stent treatment, and the remaining 55 sis-VADAs underwent treatment with 2-4 overlapping stents. Follow-up angiography was available for 94 sis-VADAs 12 -78 months, with recurrence in ten patients, including seven angiographic recurrences and three post-treatment haemorrhagic recurrences. A higher rate of post-treatment recurrence was observed in the single stent group than in the multiple stents group (p = 0.010). The interaction between stent (s) implantation and immediate occlusion degree (odds ratio [OR] =3.152; 95% confidence interval [CI], 1.293-7.686; p = 0.012), between stent (s) implantation and the posterior inferior cerebellar artery (PICA) involvement (OR = 4.607; 95% CI, 1.172-18.113; p = 0.029), and between PICA involvement and immediate occlusion degree (OR = 5.018; 95% CI, 1.263-19.933; p = 0.022) affect recurrence in the reconstructed sis-VADAs. This single centre cohort study indicated that the interaction effect between stent (s) implantation, PICA involvement, and immediate occlusion degree were closely associated with recurrence after reconstructive treatment of sis-VADA. The interaction between stent (s) and immediate occlusion degree affect aneurysmal recurrence. The interaction between stent and PICA involvement affect aneurysmal recurrence. The interaction between PICA involvement and immediate occlusion degree affect aneurysmal recurrence.

  14. Building Energy Asset Score for Building Owners

    Energy Technology Data Exchange (ETDEWEB)

    Building Technologies Office

    2015-01-01

    The Building Energy Asset Score is a national standardized tool for evaluating the physical and structural energy efficiency of commercial and multifamily residential buildings. The Asset Score generates a simple energy efficiency rating that enables comparison among buildings, and identifies opportunities for users to invest in energy efficiency upgrades. It is web-based and free to use. This fact sheet discusses the value of the score for building owners.

  15. Building Energy Asset Score for Architects

    Energy Technology Data Exchange (ETDEWEB)

    Building Technologies Office

    2015-01-01

    The Building Energy Asset Score is a national standardized tool for evaluating the physical and structural energy efficiency of commercial and multifamily residential buildings. The Asset Score generates a simple energy efficiency rating that enables comparison among buildings, and identifies opportunities for users to invest in energy efficiency upgrades. It is web-based and free to use. This fact sheet discusses the value of the score for architects.

  16. Alberta Stroke Program Early CT Score-Time Score Predicts Outcome after Endovascular Therapy in Patients with Acute Ischemic Stroke: A Retrospective Single-Center Study.

    Science.gov (United States)

    Todo, Kenichi; Sakai, Nobuyuki; Kono, Tomoyuki; Hoshi, Taku; Imamura, Hirotoshi; Adachi, Hidemitsu; Yamagami, Hiroshi; Kohara, Nobuo

    2018-04-01

    Clinical outcomes after successful endovascular therapy in patients with acute ischemic stroke are associated with several factors including onset-to-reperfusion time (ORT), the National Institute of Health Stroke Scale (NIHSS) score, and the Alberta Stroke Program Early CT Score (ASPECTS). The NIHSS-time score, calculated as follows: [NIHSS score] × [onset-to-treatment time (h)] or [NIHSS score] × [ORT (h)], has been reported to predict clinical outcomes after intravenous recombinant tissue plasminogen activator therapy and endovascular therapy for acute stroke. The objective of the current study was to assess whether the combination of the ASPECTS and the ORT can predict the outcomes after endovascular therapy. The charts of 117 consecutive ischemic stroke patients with successful reperfusion after endovascular therapy were retrospectively reviewed. We analyzed the association of ORT, ASPECTS, and ASPECTS-time score with clinical outcome. ASPECTS-time score was calculated as follows: [11 - ASPECTS] × [ORT (h)]. Rates of good outcome for patients with ASPECTS-time scores of tertile values, scores 5.67 or less, scores greater than 5.67 to 10.40 or less, and scores greater than 10.40, were 66.7%, 56.4%, and 33.3%, respectively (P < .05). Ordinal logistic regression analysis showed that the ASPECTS-time score (per category increase) was an independent predictor for better outcome (common odds ratio: .374; 95% confidence interval: .150-0.930; P < .05). A lower ASPECTS-time score may predict better clinical outcomes after endovascular treatment. Copyright © 2018 National Stroke Association. Published by Elsevier Inc. All rights reserved.

  17. Interactive effects of apelin, renin-angiotensin system and nitric oxide in treatment of obesity-induced type 2 diabetes mellitus in male albino rats.

    Science.gov (United States)

    Sabry, Maha Mohamed; Mahmoud, Manal Moustafa; Shoukry, Heba Samy; Rashed, Laila; Kamar, Samaa Samir; Ahmed, Mona Mohamed

    2018-03-22

    Apelin and its receptor (APJ) are involved in the regulation of a variety of pathophysiological processes. We studied the effect of apelin treatment on obesity-induced type 2 diabetes mellitus (T2DM) and possible interaction between apelin/APJ system and renin-angiotensin system (RAS). Forty eight male albino rats were divided into two groups: control group and diabetic group. Diabetic group was subdivided into: control diabetic, apelin-treated, apelin + losartan-treated, apelin + l-NAME-treated and losartan-treated diabetic subgroup. Administration of apelin-13 yielded an improvement of IR, dyslipidaemia, inflammation, oxidative stress with significant decrease in AT1R gene expression and significant increase in ACE2 gene expression in adipose tissues. Losartan + apelin yielded a further significant decrease in ATR1 gene expression, glycaemic indices, serum TGs and TPA versus Apelin only. Adding l-NAME in subgroup (2D) reversed the effect of apelin. We suggested that the beneficial effect of Apelin is mainly mediated by NO-activated pathway and/or ACE2/Ang (1-7) dependent pathway.

  18. Towards an international standard for PCR-based detection of foodborne thermotolerant campylobacters: interaction of enrichment media and pre-PCR treatment on carcass rinse samples.

    Science.gov (United States)

    Josefsen, M H; Lübeck, P S; Hansen, F; Hoorfar, J

    2004-07-01

    As part of a large EU project for standardisation of polymerase chain reaction (PCR), a systematic evaluation of the interaction of enrichment media, type of DNA polymerase and pre-PCR sample treatment for a PCR detecting thermotolerant campylobacters was carried out. The growth-supporting capacity and PCR compatibility of enrichment in Preston, Mueller-Hinton and Bolton broth (blood-containing and blood-free) were evaluated. The effect of resin-based DNA extraction and DNA extraction by boiling on the final PCR assay was investigated. The time-course studies indicated that a 20-h sample enrichment in blood-containing Bolton broth, followed by a simple resin-based extraction of DNA and a PCR amplification using Tth polymerase, resulted in strong and clear PCR amplicons for target (287 bp) and internal amplification control (IAC, 124 bp). The enrichment PCR-based method, tested on 68 presumably naturally contaminated poultry-rinse samples, showed a diagnostic sensitivity of 97.5% (39 PCR-positive/40 total positive samples) and a diagnostic specificity of 100% (28 PCR-negative/28 total negative samples; P=0.32) when compared to a standard bacteriological method (ISO 10272). Copyright 2004 Elsevier B.V.

  19. Recognition Using Classification and Segmentation Scoring

    National Research Council Canada - National Science Library

    Kimball, Owen; Ostendorf, Mari; Rohlicek, Robin

    1992-01-01

    .... We describe an approach to connected word recognition that allows the use of segmental information through an explicit decomposition of the recognition criterion into classification and segmentation scoring...

  20. Reliability Assessment of an Innovative Wound Score.

    Science.gov (United States)

    Strauss, Michael B; Moon, Hojin; Busch, Jeremy A; Jones, Christopher K; Nhan, Lisa; Miller, Stuart; Le, Phi-Nga Jeannie

    2016-06-01

    The authors describe an innovative wound score and demonstrate its versatility for scoring a variety of wound types in addition to diabetic foot ulcers (DFUs). To further test its merits, they determined its interobserver reliability in a prospective series of patients. The Wound Score system the authors created integrates the most important features of 4 predominantly used wound scoring systems. It utilizes a logical 0 to 10 format based on 5 assessments each graded from 2 (best) to 0 (worst). The versatility and reliability of the Wound Score were studied in a prospective series of 94 patients with lower extremity wounds. The Wound Score was quick to determine, applicable to a variety of wound types and locations, and highly objective for grading the severity of each of the 5 assessments. The Wound Score categorized wound types as "healthy," "problem," or "futile" for evaluation and management. Diabetes was present in 75.9%, with 70% of the DFUs scoring in the "problem" wound range. Interobserver reli- ability was high (r = 0.81). The objectivity, versatility, and reliability of the Wound Score system facilitates making decisions about the management of wounds, whether DFUs or not, and provides quantification for compara- tive effectiveness research for wound management.

  1. Identification of Novel Inhibitory Peptides of Protein-Protein Interactions Involved in DNA Repair as Potential Drugs in Breast Cancer Treatment

    National Research Council Canada - National Science Library

    Beck, William

    2001-01-01

    Protein-protein interactions are critical to almost every cellular process. Disruption of these interactions would effectively interfere with the cell's functions and its ability to grow and divide normally...

  2. Identification of Naval Inhibitory Peptides of Protein-Protein Interactions Involved in DNA Repair as Potential Drugs in Breast Cancer Treatment

    National Research Council Canada - National Science Library

    Kamalakaran, Sitharthan

    2003-01-01

    Protein-protein interactions are critical to almost every cellular process. Disruption of these interactions would effectively interfere with the cell's functions and its ability to grow and divide normally...

  3. Extent of early ischemic changes on computed tomography (CT) before thrombolysis: prognostic value of the Alberta Stroke Program Early CT Score in ECASS II.

    Science.gov (United States)

    Dzialowski, Imanuel; Hill, Michael D; Coutts, Shelagh B; Demchuk, Andrew M; Kent, David M; Wunderlich, Olaf; von Kummer, Rüdiger

    2006-04-01

    The significance of early ischemic changes (EICs) on computed tomography (CT) to triage patients for thrombolysis has been controversial. The Alberta Stroke Program Early CT Score (ASPECTS) semiquantitatively assesses EICs within the middle cerebral artery territory using a10-point grading system. We hypothesized that dichotomized ASPECTS predicts response to intravenous thrombolysis and incidence of secondary hemorrhage within 6 hours of stroke onset. Data from the European-Australian Acute Stroke Study (ECASS) II study were used in which 800 patients were randomized to recombinant tissue plasminogen activator (rt-PA) or placebo within 6 hours of symptom onset. We retrospectively assessed all baseline CT scans, dichotomized ASPECTS at 7, defined favorable outcome as modified Rankin Scale score 0 to 2 after 90 days, and secondary hemorrhage as parenchymal hematoma 1 (PH1) or PH2. We performed a multivariable logistic regression analysis and assessed for an interaction between rt-PA treatment and baseline ASPECTS score. We scored ASPECTS >7 in 557 and < or =7 in 231 patients. There was no treatment-by-ASPECTS interaction with dichotomized ASPECTS (P=0.3). This also applied for the 0- to 3-hour and 3- to 6-hour cohorts. However, a treatment-by-ASPECTS effect modification was seen in predicting PH (0.043 for the interaction term), indicating a much higher likelihood of thrombolytic-related parenchymal hemorrhage in those with ASPECTS < or =7. In ECASS II, the effect of rt-PA on functional outcome is not influenced by baseline ASPECTS. Patients with low ASPECTS have a substantially increased risk of thrombolytic-related PH.

  4. Validity and reliability of Nintendo Wii Fit balance scores.

    Science.gov (United States)

    Wikstrom, Erik A

    2012-01-01

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

  5. Does comorbidity interact with colorectal cancer to increase mortality? A nationwide population-based cohort study.

    Science.gov (United States)

    Erichsen, R; Horváth-Puhó, E; Iversen, L H; Lash, T L; Sørensen, H T

    2013-10-01

    It is unknown whether comorbidity interacts with colorectal cancer (CRC) to increase the rate of mortality beyond that explained by the independent effects of CRC and comorbid conditions. We conducted a cohort study (1995-2010) of all Danish CRC patients (n=56963), and five times as many persons from the general population (n=271670) matched by age, gender, and specific comorbidities. To analyse comorbidity, we used the Charlson Comorbidity Index (CCI) scores. We estimated standardised mortality rates per 1000 person-years, and calculated interaction contrasts as a measure of the excess mortality rate not explained by the independent effects of CRC or comorbidities. Among CRC patients with a CCI score=1, the 0-1 year mortality rate was 415 out of 1000 person-years (95% confidence interval (CI): 401, 430) and the interaction accounted for 9.3% of this rate (interaction contrast=39 out of 1000 person-years, 95% CI: 22, 55). For patients with a CCI score of 4 or more, the interaction accounted for 34% of the mortality (interaction contrast=262 out of 1000 person-years, 95% CI: 215, 310). The interaction between CRC and comorbidities had limited influence on mortality beyond 1 year after diagnosis. Successful treatment of the comorbidity is pivotal and may reduce the mortality attributable to comorbidity itself, and also the mortality attributable to the interaction.

  6. Performance of a novel clinical score, the Pediatric Asthma Severity Score (PASS), in the evaluation of acute asthma.

    Science.gov (United States)

    Gorelick, Marc H; Stevens, Molly W; Schultz, Theresa R; Scribano, Philip V

    2004-01-01

    To evaluate the reliability, validity, and responsiveness of a new clinical asthma score, the Pediatric Asthma Severity Score (PASS), in children aged 1 through 18 years in an acute clinical setting. This was a prospective cohort study of children treated for acute asthma at two urban pediatric emergency departments (EDs). A total of 852 patients were enrolled at one site and 369 at the second site. Clinical findings were assessed at the start of the ED visit, after one hour of treatment, and at the time of disposition. Peak expiratory flow rate (PEFR) (for patients aged 6 years and older) and pulse oximetry were also measured. Composite scores including three, four, or five clinical findings were evaluated, and the three-item score (wheezing, prolonged expiration, and work of breathing) was selected as the PASS. Interobserver reliability for the PASS was good to excellent (kappa = 0.72 to 0.83). There was a significant correlation between PASS and PEFR (r = 0.27 to 0.37) and pulse oximetry (r = 0.29 to 0.41) at various time points. The PASS was able to discriminate between those patients who did and did not require hospitalization, with area under the receiver operating characteristic curve of 0.82. Finally, the PASS was shown to be responsive, with a 48% relative increase in score from start to end of treatment and an overall effect size of 0.62, indicating a moderate to large effect. This clinical score, the PASS, based on three clinical findings, is a reliable and valid measure of asthma severity in children and shows both discriminative and responsive properties. The PASS may be a useful tool to assess acute asthma severity for clinical and research purposes.

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

    Science.gov (United States)

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

    2018-05-01

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

  8. Growth hormone pharmacogenetics: the interactive effect of a microsatellite in the IGF1 promoter region with the GHR-exon 3 and -202 A/C IGFBP3 variants on treatment outcomes of children with severe GH deficiency.

    Science.gov (United States)

    Costalonga, E F; Antonini, S R R; Guerra, G; Coletta, R R D; Franca, M M; Braz, A F; Mendonca, B B; Arnhold, I J P; Jorge, A A L

    2012-10-01

    Insulin-like growth factor type 1 (IGF1) is a mediator of growth hormone (GH) action, and therefore, IGF1 is a candidate gene for recombinant human GH (rhGH) pharmacogenetics. Lower serum IGF1 levels were found in adults homozygous for 19 cytosine-adenosine (CA) repeats in the IGF1 promoter. The aim of this study was to evaluate the influence of (CA)n IGF1 polymorphism, alone or in combination with GH receptor (GHR)-exon 3 and -202 A/C insulin-like growth factor binding protein-3 (IGFBP3) polymorphisms, on the growth response to rhGH therapy in GH-deficient (GHD) patients. Eighty-four severe GHD patients were genotyped for (CA)n IGF1, -202 A/C IGFBP3 and GHR-exon 3 polymorphisms. Multiple linear regressions were performed to estimate the effect of each genotype, after adjustment for other influential factors. We assessed the influence of genotypes on the first year growth velocity (1st y GV) (n=84) and adult height standard deviation score (SDS) adjusted for target-height SDS (AH-TH SDS) after rhGH therapy (n=37). Homozygosity for the IGF1 19CA repeat allele was negatively correlated with 1st y GV (P=0.03) and AH-TH SDS (P=0.002) in multiple linear regression analysis. In conjunction with clinical factors, IGF1 and IGFBP3 genotypes explain 29% of the 1st y GV variability, whereas IGF1 and GHR polymorphisms explain 59% of final height-target-height SDS variability. We conclude that homozygosity for IGF1 (CA)19 allele is associated with less favorable short- and long-term growth outcomes after rhGH treatment in patients with severe GHD. Furthermore, this polymorphism exhibits a non-additive interaction with -202 A/C IGFBP3 genotype on the 1st y GV and with GHR-exon 3 genotype on adult height.

  9. Bayesian Model Averaging for Propensity Score Analysis

    Science.gov (United States)

    Kaplan, David; Chen, Jianshen

    2013-01-01

    The purpose of this study is to explore Bayesian model averaging in the propensity score context. Previous research on Bayesian propensity score analysis does not take into account model uncertainty. In this regard, an internally consistent Bayesian framework for model building and estimation must also account for model uncertainty. The…

  10. The Absolute Normal Scores Test for Symmetry

    Science.gov (United States)

    Penfield, Douglas A.; Sachdeva, Darshan

    1976-01-01

    The absolute normal scores test is described as a test for the symmetry of a distribution of scores about a location parameter. The test is compared to the sign test and the Wilcoxon test as an alternative to the "t"-test. (Editor/RK)

  11. Comparability of IQ scores over time

    NARCIS (Netherlands)

    Must, O.; te Nijenhuis, J.; Must, A.; van Vianen, A.E.M.

    2009-01-01

    This study investigates the comparability of IQ scores. Three cohorts (1933/36, 1997/98, 2006) of Estonian students (N = 2173) are compared using the Estonian National Intelligence Test. After 72 years the secular rise of the IQ test scores is.79 SD. The mean .16 SD increase in the last 8 years

  12. Correlating continuous assessment scores to junior secondary ...

    African Journals Online (AJOL)

    This study investigated the relationship between continuous assessment scores and junior secondary school certificate examination(JSCE) final scores in Imo State. A sample of four hundred students were purposively selected from thirty eight thousand students who took the 1997 JSCE in Imo State. The data used were ...

  13. Semiparametric Copula Models for Biometric Score Level

    NARCIS (Netherlands)

    Caselli, M.

    2016-01-01

    In biometric recognition systems, biometric samples (images of faces, finger- prints, voices, gaits, etc.) of people are compared and classifiers (matchers) indicate the level of similarity between any pair of samples by a score. If two samples of the same person are compared, a genuine score is

  14. School Inputs, Household Substitution, and Test Scores

    OpenAIRE

    Das, Jishnu; Dercon, Stefan; Krishnan, Pramila; Sundararaman, Venkatesh; Muralidharan, Karthik; Habyarimana, James

    2013-01-01

    Empirical studies of the relationship between school inputs and test scores typically do not account for the fact that households will respond to changes in school inputs. This paper presents a dynamic household optimization model relating test scores to school and household inputs, and tests its predictions in two very different low-income country settings -- Zambia and India. The authors...

  15. Surgical Apgar Score Predicts Post- Laparatomy Complications ...

    African Journals Online (AJOL)

    Introduction: The Surgical Apgar score (SAS) presents a simple, immediate and an objective means of determining surgical outcomes. The score has not been widely validated in low resource settings where it would be most valuable. This study aimed to evaluate its accuracy and applicability for patients undergoing ...

  16. 24 CFR 902.63 - PHAS scoring.

    Science.gov (United States)

    2010-04-01

    ... audit firm that will perform the audit of the PHA and may serve as the audit committee for the audit in... indicators. (b) Adjustments to the PHAS score. (1) Adjustments to the score may be made after a PHA's audit... changed by HUD in accordance with data included in the independent audit report, or obtained through such...

  17. Higher FKBP5, COMT, CHRNA5, and CRHR1 allele burdens are associated with PTSD and interact with trauma exposure: implications for neuropsychiatric research and treatment

    Directory of Open Access Journals (Sweden)

    Boscarino JA

    2012-03-01

    interacts with risk allele count, such that PTSD is increased in those with higher risk allele counts and higher trauma exposures. Since the single nucleotide polymorphisms studied encompass stress circuitry and addiction biology, these findings may have implications for neuropsychiatric research and treatment.Keywords: posttraumatic stress disorder, genetic association study, single nucleotide polymorphism, risk alleles, trauma exposure, neuroticism, childhood adversity

  18. One-stage individual participant data meta-analysis models: estimation of treatment-covariate interactions must avoid ecological bias by separating out within-trial and across-trial information.

    Science.gov (United States)

    Hua, Hairui; Burke, Danielle L; Crowther, Michael J; Ensor, Joie; Tudur Smith, Catrin; Riley, Richard D

    2017-02-28

    Stratified medicine utilizes individual-level covariates that are associated with a differential treatment effect, also known as treatment-covariate interactions. When multiple trials are available, meta-analysis is used to help detect true treatment-covariate interactions by combining their data. Meta-regression of trial-level information is prone to low power and ecological bias, and therefore, individual participant data (IPD) meta-analyses are preferable to examine interactions utilizing individual-level information. However, one-stage IPD models are often wrongly specified, such that interactions are based on amalgamating within- and across-trial information. We compare, through simulations and an applied example, fixed-effect and random-effects models for a one-stage IPD meta-analysis of time-to-event data where the goal is to estimate a treatment-covariate interaction. We show that it is crucial to centre patient-level covariates by their mean value in each trial, in order to separate out within-trial and across-trial information. Otherwise, bias and coverage of interaction estimates may be adversely affected, leading to potentially erroneous conclusions driven by ecological bias. We revisit an IPD meta-analysis of five epilepsy trials and examine age as a treatment effect modifier. The interaction is -0.011 (95% CI: -0.019 to -0.003; p = 0.004), and thus highly significant, when amalgamating within-trial and across-trial information. However, when separating within-trial from across-trial information, the interaction is -0.007 (95% CI: -0.019 to 0.005; p = 0.22), and thus its magnitude and statistical significance are greatly reduced. We recommend that meta-analysts should only use within-trial information to examine individual predictors of treatment effect and that one-stage IPD models should separate within-trial from across-trial information to avoid ecological bias. © 2016 The Authors. Statistics in Medicine published by John Wiley & Sons Ltd

  19. Growth hormone signaling in muscle and adipose tissue of obese human subjects: associations with measures of body composition and interaction with resveratrol treatment.

    Science.gov (United States)

    Clasen, Berthil F; Poulsen, Morten M; Escande, Carlos; Pedersen, Steen B; Møller, Niels; Chini, Eduardo N; Jessen, Niels; Jørgensen, Jens O L

    2014-12-01

    Growth hormone (GH) secretion is reduced in obesity, despite normal serum insulin-like growth factor I (IGF-1) levels, but the association between obesity and the GH signaling is unknown. Furthermore, SIRT1, an nicotinamide adenine dinucleotide-dependent protein deacetylase, reduces hepatic IGF-1 production in mice via blunting of GH-induced STAT5 signaling. To study GH signaling in muscle and fat in obese subjects and the interaction with concomitant administration of the putative SIRT1 activator resveratrol, and to assess the effects of inhibiting or knocking down SIRT1 on GH regulated genes in vitro. Twenty-four obese males were examined in a randomized, double blinded, parallel-group study with resveratrol or placebo treatment for 5 weeks followed by a GH bolus. Muscle and fat biopsies were collected before and after GH. Body composition was assessed by DEXA and MRI. (1) Effect of body composition and age on GH-stimulated STAT5b phosphorylation and IGF-1, SOCS2, and CISH mRNA in muscle and fat. (2) The impact of resveratrol treatment on GH activity. (3) Impact of inhibiting or knocking down SIRT1 on effects of GH in vitro. Significant GH-induced STAT5b phosphorylation in muscle and fat in obese subjects was recorded together with increased CISH and SOCS2 mRNA. GH-induced STAT5b phosphorylation in muscle correlated positively with age [r = 0.53, p body composition. Resveratrol administration had no impact on body composition, serum IGF-1, or GH signaling in vivo, and SIRT1 knock down or inhibition did not affect GH signaling in vitro. (1) GH induced STAT5b phosphorylation is detectable in muscle and fat in adult males with simple obesity, but is not determined by body composition. (2) Resveratrol supplementation does not impact circulating IGF-1 levels or GH signaling in human muscle and fat. (3) Our data speak against a major impact of SIRT1on GH action in human subjects.

  20. Interactions within wastewater systems

    NARCIS (Netherlands)

    Langeveld, J.G.

    2004-01-01

    Wastewater systems consist of sewer systems and wastewater treatment works. As the performance of a wastewater treatment plant is affected by the characteristics, i.e. operation and design, of the contributing sewer systems, knowledge of the interactions between sewers and wastewater treatment works

  1. Utility of coronary calcium score in women

    Directory of Open Access Journals (Sweden)

    María C. Trejo

    2018-01-01

    Full Text Available Coronary artery disease is a major cause of death and disability among women, worldwide, particularly during the postmenopausal state, with the caveat that their presenting symptoms are atypical compared to men. Also, there is conflicting data regarding the ideal method to determine their risk, particularly for primary prevention. During this review, we sought to determine the utility of the coronary calcium score for assessing such risk in asymptomatic women, by reviewing the most representative current data and analyzing additional studies to help improve the understanding of mechanisms of coronary artery calcification and determine better strategies of prevention and treatment in women with a positive CCS. Resumen: La enfermedad arterial coronaria es una causa importante de mortalidad y discapacidad en mujeres en el mundo, especialmente durante la postmenopausia, con la salvedad de que presentan síntomas atípicos comparados con los hombres. Además, existen datos contradictorios en cuanto al método para determinar su riesgo, en particular para la prevención primaria. En esta revisión se busca determinar la utilidad del puntaje de calcio coronario para determinar tal riesgo en mujeres asintomáticas, al revisar los datos actuales más representativos y analizar estudios adicionales para ayudar a mejorar la comprensión de los mecanismos de la calcificación de las arterias coronarias, y definir mejores estrategias de prevención y tratamiento en mujeres con un puntaje de calcio coronario positivo. Keywords: Coronary, Vascular, Tomography, Imaging, Coronary disease, Palabras clave: Coronario, Vascular, Tomografía, Imagenología, Enfermedad coronaria

  2. Homology model-based virtual screening for GPCR ligands using docking and target-biased scoring.

    Science.gov (United States)

    Radestock, Sebastian; Weil, Tanja; Renner, Steffen

    2008-05-01

    The current study investigates the combination of two recently reported techniques for the improvement of homology model-based virtual screening for G-protein coupled receptor (GPCR) ligands. First, ligand-supported homology modeling was used to generate receptor models that were in agreement with mutagenesis data and structure-activity relationship information of the ligands. Second, interaction patterns from known ligands to the receptor were applied for scoring and rank ordering compounds from a virtual library using ligand-receptor interaction fingerprint-based similarity (IFS). Our approach was evaluated in retrospective virtual screening experiments for antagonists of the metabotropic glutamate receptor (mGluR) subtype 5. The results of our approach were compared to the results obtained by conventional scoring functions (Dock-Score, PMF-Score, Gold-Score, ChemScore, and FlexX-Score). The IFS lead to significantly higher enrichment rates, relative to the competing scoring functions. Though using a target-biased scoring approach, the results were not biased toward the chemical classes of the reference structures. Our results indicate that the presented approach has the potential to serve as a general setup for successful structure-based GPCR virtual screening.

  3. THE EFFICIENCY OF TENNIS DOUBLES SCORING SYSTEMS

    Directory of Open Access Journals (Sweden)

    Geoff Pollard

    2010-09-01

    Full Text Available In this paper a family of scoring systems for tennis doubles for testing the hypothesis that pair A is better than pair B versus the alternative hypothesis that pair B is better than A, is established. This family or benchmark of scoring systems can be used as a benchmark against which the efficiency of any doubles scoring system can be assessed. Thus, the formula for the efficiency of any doubles scoring system is derived. As in tennis singles, one scoring system based on the play-the-loser structure is shown to be more efficient than the benchmark systems. An expression for the relative efficiency of two doubles scoring systems is derived. Thus, the relative efficiency of the various scoring systems presently used in doubles can be assessed. The methods of this paper can be extended to a match between two teams of 2, 4, 8, …doubles pairs, so that it is possible to establish a measure for the relative efficiency of the various systems used for tennis contests between teams of players.

  4. The quantile score and its decomposition

    Science.gov (United States)

    Bentzien, Sabrina; Friederichs, Petra

    2014-05-01

    Forecast verification for probabilistic weather and climate predictions gain more and more importance due to the increasing number of ensemble prediction systems. The predictive performance of probabilistic forecasts is generally assessed using proper score functions, which are applied to a set of forecast-observation pairs. The propriety of a score guarantees honesty and prevents hedging. A variety of proper scores exist for different types of probabilistic forecasts. Moreover, proper scoring functions can be decomposed into the three parts reliability, resolution, and uncertainty, which describe main characteristics of a forecasting scheme. This decomposition is well known for the Brier score and the continuous ranked probability score. This study expands the pool of verification methods for probabilistic forecasts by a decomposition of the quantile score (QS). Quantiles are suitable probabilistic measures especially for extreme forecast events, since they do not depend on an apriori defined threshold. The QS is a weighted absolute error between quantile forecasts and observations. We derive a decomposition of the QS in reliability, resolution, and uncertainty, and give a brief description of potential biases. A quantile reliability plot is presented. The quantile verification within this framework is illustrated on precipitation forecasts derived from the mesoscale ensemble prediction system COSMO-DE-EPS of the German Meteorological Service.

  5. Correlation of CPX Scores with the Scores on Written Multiple-Choice Examinations on the Certifying Examination for Family Medicine in 2009 to 2011.

    Science.gov (United States)

    Cho, Jung Jin; Kim, Ji Yong; Park, Hoon Ki; Hwang, In Hong

    2011-12-01

    Recently, the clinical practice examination (CPX) using standardized patients has been introduced into several specialty certifying examinations in Korea. The purpose of this paper was to determine the correlation of a resident's performance on the CPX with the comprehensive written multiple-choice question (MCQ) examination on the certifying examination for family medicine. The subjects of this study were 1,023 residents who completed the 1st and 2nd certifying examination for family medicine between 2009 and 2011. We determined the correlation between the total scores and 4 domain scores (history taking, physical examination, patient education, and patient-physician interaction) on the CPX with the MCQ scores of the 1st written test and 2nd slide examination and the correlation between the total CPX score and scores on the CPX domains. The correlation between CPX score with each MCQ examination (0.21~0.45 with 1st written MCQ, 0.15~0.33 with 2nd slide MCQ) was lower than that between each MCQ examination (0.46~0.59). The CPX score on patient education did not correlate with the 1st written and 2nd MCQ scores. The CPX scores on history taking and physical examination correlated slightly with the 1st written MCQ scores. The global ratings of preceptor examiners had the highest correlation (r=0.68~0.82) with the total CPX scores. Considering the mild correlation of CPX scores with each MCQ examination, the CPX is more likely to measure other qualities, such as critical thinking and communication skills.

  6. A comparison between modified Alvarado score and RIPASA score in the diagnosis of acute appendicitis.

    Science.gov (United States)

    Singla, Anand; Singla, Satpaul; Singh, Mohinder; Singla, Deeksha

    2016-12-01

    Acute appendicitis is a common but elusive surgical condition and remains a diagnostic dilemma. It has many clinical mimickers and diagnosis is primarily made on clinical grounds, leading to the evolution of clinical scoring systems for pin pointing the right diagnosis. The modified Alvarado and RIPASA scoring systems are two important scoring systems, for diagnosis of acute appendicitis. We prospectively compared the two scoring systems for diagnosing acute appendicitis in 50 patients presenting with right iliac fossa pain. The RIPASA score correctly classified 88 % of patients with histologically confirmed acute appendicitis compared with 48.0 % with modified Alvarado score, indicating that RIPASA score is more superior to Modified Alvarado score in our clinical settings.

  7. Scoring biosecurity in European conventional broiler production.

    Science.gov (United States)

    Van Limbergen, T; Dewulf, J; Klinkenberg, M; Ducatelle, R; Gelaude, P; Méndez, J; Heinola, K; Papasolomontos, S; Szeleszczuk, P; Maes, D

    2018-01-01

    Good biosecurity procedures are crucial for healthy animal production. The aim of this study was to quantify the level of biosecurity on conventional broiler farms in Europe, following a standardized procedure, thereby trying to identify factors that are amenable to improvement. The current study used a risk-based weighted scoring system (biocheck.ugent ®) to assess the level of biosecurity on 399 conventional broiler farms in 5 EU member states. The scoring system consisted of 2 main categories, namely external and internal biosecurity, which had 8 and 3 subcategories, respectively. Biosecurity was quantified by converting the answers to 97 questions into a score from 0 to 100. The minimum score, "0," represents total absence of any biosecurity measure on the broiler farm, whereas the maximum score, "100," means full application of all investigated biosecurity measures. A possible correlation between biosecurity and farm characteristics was investigated by multivariate linear regression analysis. The participating broiler farms scored better for internal biosecurity (mean score of 76.6) than for external biosecurity (mean 68.4). There was variation between the mean biosecurity scores for the different member states, ranging from 59.8 to 78.0 for external biosecurity and from 63.0 to 85.6 for internal biosecurity. Within the category of external biosecurity, the subcategory related to "infrastructure and vectors" had the highest mean score (82.4), while the subcategory with the lowest score related to biosecurity procedures for "visitors and staff" (mean 51.5). Within the category of internal biosecurity, the subcategory "disease management" had the highest mean score (65.8). In the multivariate regression model a significant negative correlation was found between internal biosecurity and the number of employees and farm size. These findings indicate that there is a lot of variation for external and internal biosecurity on the participating broiler farms

  8. Exercise Testing Score for Myocardial Ischemia Gradation

    Directory of Open Access Journals (Sweden)

    Andres Ricardo P. Riera

    2007-01-01

    Full Text Available Scores aimed at contributing to the optimization of exercise testing (ET have been developed and the experience with their application in coronary artery disease (CAD has proven to be favorable1. Although there is debate on the use of scores in clinical practice, those that stand for it argue that they may decrease the rate of undiagnosed CAD, besides reducing the number of patients without disease that undergo highly expensive tests2. Additionally, scores may be helpful, in a more consistent and organized fashion, in prognosis evaluation and in the adoption of an appropriate plan of action for the triage of this disease in the general population.

  9. Performance of an Automated Polysomnography Scoring System Versus Computer-Assisted Manual Scoring

    Science.gov (United States)

    Malhotra, Atul; Younes, Magdy; Kuna, Samuel T.; Benca, Ruth; Kushida, Clete A.; Walsh, James; Hanlon, Alexandra; Staley, Bethany; Pack, Allan I.; Pien, Grace W.

    2013-01-01

    Study Objectives: Manual scoring of polysomnograms (PSG) is labor intensive and has considerable variance between scorers. Automation of scoring could reduce cost and improve reproducibility. The purpose of this study was to compare a new automated scoring system (YST-Limited, Winnipeg, Canada) with computer-assisted manual scoring. Design: Technical assessment. Setting: Five academic medical centers. Participants: N/A. Interventions: N/A. Measurements and Results: Seventy PSG files were selected at University of Pennsylvania (Penn) and distributed to five US academic sleep centers. Two blinded technologists from each center scored each file. Automatic scoring was performed at Penn by a YST Limited technician using a laptop containing the software. Variables examined were sleep stages, arousals, and apnea-hypopnea index (AHI) using three methods of identifying hypopneas. Automatic scores were not edited and were compared to the average scores of the 10 technologists. Intraclass correlation coefficient (ICC) was obtained for the 70 pairs and compared to across-sites ICCs for manually scored results. ICCs for automatic versus manual scoring were > 0.8 for total sleep time, stage N2, and nonrapid eye movement arousals and > 0.9 for AHI scored by primary and secondary American Academy of Sleep Medicine criteria. ICCs for other variables were not as high but were comparable to the across-site ICCs for manually scored results. Conclusion: The automatic system yielded results that were similar to those obtained by experienced technologists. Very good ICCs were obtained for many primary PSG outcome measures. This automated scoring software, particularly if supplemented with manual editing, may increase laboratory efficiency and standardize PSG scoring results within and across sleep centers. Citation: Malhotra A; Younes M; Kuna ST; Benca R; Kushida CA; Walsh J; Hanlon A; Staley B; Pack AI; Pien GW. Performance of an automated polysomnography scoring system versus computer

  10. Do MCAT scores predict USMLE scores? An analysis on 5 years of medical student data

    Directory of Open Access Journals (Sweden)

    Jacqueline L. Gauer

    2016-09-01

    Full Text Available Introduction: The purpose of this study was to determine the associations and predictive values of Medical College Admission Test (MCAT component and composite scores prior to 2015 with U.S. Medical Licensure Exam (USMLE Step 1 and Step 2 Clinical Knowledge (CK scores, with a focus on whether students scoring low on the MCAT were particularly likely to continue to score low on the USMLE exams. Method: Multiple linear regression, correlation, and chi-square analyses were performed to determine the relationship between MCAT component and composite scores and USMLE Step 1 and Step 2 CK scores from five graduating classes (2011–2015 at the University of Minnesota Medical School (N=1,065. Results: The multiple linear regression analyses were both significant (p<0.001. The three MCAT component scores together explained 17.7% of the variance in Step 1 scores (p<0.001 and 12.0% of the variance in Step 2 CK scores (p<0.001. In the chi-square analyses, significant, albeit weak associations were observed between almost all MCAT component scores and USMLE scores (Cramer's V ranged from 0.05 to 0.24. Discussion: Each of the MCAT component scores was significantly associated with USMLE Step 1 and Step 2 CK scores, although the effect size was small. Being in the top or bottom scoring range of the MCAT exam was predictive of being in the top or bottom scoring range of the USMLE exams, although the strengths of the associations were weak to moderate. These results indicate that MCAT scores are predictive of student performance on the USMLE exams, but, given the small effect sizes, should be considered as part of the holistic view of the student.

  11. Walking beyond the GRACE (Global Registry of Acute Coronary Events) model in the death risk stratification during hospitalization in patients with acute coronary syndrome: what do the AR-G (ACTION [Acute Coronary Treatment and Intervention Outcomes Network] Registry and GWTG [Get With the Guidelines] Database), NCDR (National Cardiovascular Data Registry), and EuroHeart Risk Scores Provide?

    Science.gov (United States)

    Raposeiras-Roubín, Sergio; Abu-Assi, Emad; Cabanas-Grandío, Pilar; Agra-Bermejo, Rosa María; Gestal-Romarí, Santiago; Pereira-López, Eva; Fandiño-Vaquero, Rubén; Álvarez-Álvarez, Belén; Cambeiro, Cristina; Rodríguez-Cordero, Marta; Lear, Pamela; Martínez-Monzonís, Amparo; Peña-Gil, Carlos; García-Acuña, José María; González-Juanatey, José Ramón

    2012-11-01

    This study sought to compare the in-hospital prognostic values of the original and updated GRACE (Global Registry of Acute Coronary Events) risk score (RS) and the AR-G (ACTION [Acute Coronary Treatment and Intervention Outcomes Network] Registry and the GWTG [Get With the Guidelines] Database) RS in acute coronary syndromes (ACS). To evaluate the utility of recalculating risk after percutaneous coronary intervention (PCI) with newer RS models (NCDR [National Cardiovascular Data Registry] and EHS [EuroHeart Score] RS). Defined in 2003, GRACE is among the most popular systems of risk stratification in ACS. An updated version of GRACE has since appeared and new RS have been developed, aiming to improve risk prediction. From 2004 to 2010, 4,497 consecutive patients admitted to a single center in Spain with an ACS were included (32.1% ST-segment elevation myocardial infarction, 19.2% unstable angina). Discrimination (C-statistic) and calibration (Hosmer-Lemeshow [HL]) indexes were used to assess performance of each RS. A comparative analysis of RS designed to predict post-PCI mortality NCDR and EHS RS versus the GRACE and AR-G RS was performed in a subgroup of 1,113 consecutive patients included in the study. There were 265 in-hospital deaths (5.9%). Original and updated GRACE RS and the AR-G RS all demonstrated good discrimination for in-hospital death (C-statistics: 0.91, 0.90 and 0.90, respectively) with optimal calibration (HL p: 0.42, 0.50, and 0.47, respectively) in all spectra of ACS, according to different managements (PCI vs. conservative) and without significant differences between the 3 different RS. In patients undergoing PCI, EHS and NCDR RS (C-statistic = 0.80 and 0.84, respectively) were not superior to GRACE RS (C-statistic = 0.91), albeit in the subgroup of patients undergoing PCI who were categorized as high risk using the GRACE RS, both EHS and NCDR have contributed to decrease the false positive rate generated by using the GRACE RS. Despite having

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

    Science.gov (United States)

    Powers, Donald; Schedl, Mary; Papageorgiou, Spiros

    2017-01-01

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

  13. External validation of scoring instruments for evaluating pediatric resuscitation.

    Science.gov (United States)

    Levy, Arielle; Donoghue, Aaron; Bailey, Benoit; Thompson, Nathan; Jamoulle, Olivier; Gagnon, Robert; Gravel, Jocelyn

    2014-12-01

    Although many methods have been proposed to assess clinical performance during resuscitation, robust and generalizable metrics are still lacking. Further research is necessary to develop validated clinical performance assessment tools and show an improvement in outcomes after training. We aimed to establish evidence for validity of a previously published scoring instrument--the Clinical Performance Tool (CPT)--designed to evaluate clinical performance during simulated pediatric resuscitations. This was a prospective experimental trial performed in the simulation laboratory of a pediatric tertiary care facility, with a pretest/posttest design that assessed residents before and after pediatric advanced life support (PALS) certification. Thirteen postgraduate year 1 (PGY1) and 11 PGY3 pediatric residents completed 5 simulated pediatric resuscitation scenarios each during 2 consecutive sessions; between the 2 sessions, they completed a full PALS certification course. All sessions were video recorded. Sessions were scored by raters using the CPT; total scores were expressed as a percentage of maximum points possible for each scenario. Validity evidence was established and interpreted according to Messick's framework. Evidence regarding relations to other variables was assessed by calculating differences in scores between pre-PALS and post-PALS certification and PGY1 and PGY3 using a repeated-measures analysis of variance test. Internal structure evidence was established by assessing interrater reliability using intraclass correlation coefficients (ICCs) for each scenario, a G-study, and a variance component analysis of individual measurement facets (scenarios, raters, and occasions) and associated interactions. Overall scores for the entire study cohort improved by 10% after PALS training. Scores improved by 9.9% (95% confidence interval [CI], 4.5-15.4) for the pulseless nonshockable arrest (ICC, 0.85; 95% CI, 0.74-0.92), 14.6% (95% CI, 6.7-22.4) for the pulseless

  14. Climiate Resilience Screening Index and Domain Scores

    Data.gov (United States)

    U.S. Environmental Protection Agency — CRSI and related-domain scores for all 50 states and 3135 counties in the U.S. This dataset is not publicly accessible because: They are already available within the...

  15. Film scoring today - Theory, practice and analysis

    OpenAIRE

    Flach, Paula Sophie

    2012-01-01

    This thesis considers film scoring by taking a closer look at the theoretical discourse throughout the last decades, examining current production practice of film music and showcasing a musical analysis of the film Inception (2010).

  16. (IPSS) and Visual Prostate Symptoms Score

    African Journals Online (AJOL)

    O.O. Abiola

    2016-01-12

    VPSS) and International Prostate. Symptoms Score (IPSS) questionnaires for the assessment of lower urinary tract symptoms (LUTS) in. Nigerian men, with special emphasis on the ease of administration and the time needed ...

  17. Budget Scoring: An Impediment to Alternative Financing

    National Research Council Canada - National Science Library

    Summers, Donald E; San Miguel, Joseph G

    2007-01-01

    ...), the Office of Management and Budget (OMB) and the congressional Budget Committees. The current scoring policy that has been applied to many initiatives essentially negates the advantages from using alternative forms of financing...

  18. Opinions on Drug Interaction Sources in Anticancer Treatments and Parameters for an Oncology-Specific Database by Pharmacy Practitioners in Asia

    Directory of Open Access Journals (Sweden)

    2010-01-01

    Full Text Available Cancer patients undergoing chemotherapy are particularly susceptible to drug-drug interactions (DDIs. Practitioners should keep themselves updated with the most current DDI information, particularly involving new anticancer drugs (ACDs. Databases can be useful to obtain up-to-date DDI information in a timely and efficient manner. Our objective was to investigate the DDI information sources of pharmacy practitioners in Asia and their views on the usefulness of an oncology-specific database for ACD interactions. A qualitative, cross-sectional survey was done to collect information on the respondents' practice characteristics, sources of DDI information and parameters useful in an ACD interaction database. Response rate was 49%. Electronic databases (70%, drug interaction textbooks (69% and drug compendia (64% were most commonly used. Majority (93% indicated that a database catering towards ACD interactions was useful. Essential parameters that should be included in the database were the mechanism and severity of the detected interaction, and the presence of a management plan (98% each. This study has improved our understanding on the usefulness of various DDI information sources for ACD interactions