808 results
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2. Detection of HBV-DNA in Dried Bloodstains on Filter Paper by Nested Polymerase Chain Reaction.
- Author
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Jie Zhang, Ling Zhang, Manshu Song, and Wei Wang
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BLOOD collection , *HEPATITIS B , *POLYMERASE chain reaction methodology , *ENZYME-linked immunosorbent assay , *RESEARCH methodology , *PROBABILITY theory , *RESEARCH funding , *STATISTICS , *DATA analysis , *DIAGNOSIS - Abstract
Objective: To describe the technical performance of nested PCR for identifying hepatitis B viral (HBV) DNA. Methods: Hepatitis B viral DNA was extracted from a dried bloodstain on filter paper by a Chelex-100 method. Then the DNA fragment was amplified by nested polymerase chain reaction (PCR). The sensitivity and specificity of this method were also analyzed. The positive rate of the nested PCR-based method was compared with that of the enzyme-linked immunosorbent assays (ELISA) method. Results: The lowest detection limit of the test was 5 copies of HBV DNA per μL by this method. McNemar's test showed that the difference between the positive rates of these 2 methods was not statistically significant (P=0.289, P>0.05). Hepatitis B viral test results showed a good concordance between these 2 methods (kappa=0.727). Conclusion: A very small amount of the dried blood sample is required for the detection, which could overcome the shortage of the normal ELISA method that requires a relatively large amount of fresh blood samples. [ABSTRACT FROM AUTHOR]
- Published
- 2010
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3. Bayesian Methods for Information Borrowing in Basket Trials: An Overview.
- Author
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Zhou, Tianjian and Ji, Yuan
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TUMOR treatment ,STATISTICS ,EXPERIMENTAL design ,CLINICAL trials ,CLINICAL medicine research ,DATA analysis ,STATISTICAL models ,DRUG development ,PROBABILITY theory - Abstract
Simple Summary: This paper provides a review of statistical methods for tumor-agnostic clinical trials. In particular, the review focuses on basket trials and provides methodological insights into various Bayesian approaches. The key concept of borrowing information through Bayesian hierarchical models is emphasized, and some novel trial designs are introduced. The review is expected to provide oncology and biostatistics researchers with more exposure to powerful Bayesian methods for the design and analysis of tumor-agnostic clinical trials. Basket trials allow simultaneous evaluation of a single therapy across multiple cancer types or subtypes of the same cancer. Since the same treatment is tested across all baskets, it may be desirable to borrow information across them to improve the statistical precision and power in estimating and detecting the treatment effects in different baskets. We review recent developments in Bayesian methods for the design and analysis of basket trials, focusing on the mechanism of information borrowing. We explain the common components of these methods, such as a prior model for the treatment effects that embodies an assumption of exchangeability. We also discuss the distinct features of these methods that lead to different degrees of borrowing. Through simulation studies, we demonstrate the impact of information borrowing on the operating characteristics of these methods and discuss its broader implications for drug development. Examples of basket trials are presented in both phase I and phase II settings. [ABSTRACT FROM AUTHOR]
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- 2024
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4. Inverse Probability Weighting to Estimate Exposure Effects on the Burden of Recurrent Outcomes in the Presence of Competing Events.
- Author
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Gaber, Charles E, Edwards, Jessie K, Lund, Jennifer L, Peery, Anne F, Richardson, David B, and Kinlaw, Alan C
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NONPARAMETRIC statistics ,STATISTICS ,SCIENTIFIC observation ,SIMULATION methods in education ,TREATMENT effectiveness ,CONCEPTUAL structures ,ATTRIBUTION (Social psychology) ,DATA analysis ,PROBABILITY theory - Abstract
Recurrent events—outcomes that an individual can experience repeatedly over the course of follow-up—are common in epidemiologic and health services research. Studies involving recurrent events often focus on time to first occurrence or on event rates, which assume constant hazards over time. In this paper, we contextualize recurrent event parameters of interest using counterfactual theory in a causal inference framework and describe an approach for estimating a target parameter referred to as the mean cumulative count. This approach leverages inverse probability weights to control measured confounding with an existing (and underutilized) nonparametric estimator of recurrent event burden first proposed by Dong et al. in 2015. We use simulations to demonstrate the unbiased estimation of the mean cumulative count using the weighted Dong-Yasui estimator in a variety of scenarios. The weighted Dong-Yasui estimator for the mean cumulative count allows researchers to use observational data to flexibly estimate and contrast the expected number of cumulative events experienced per individual by a given time point under different exposure regimens. We provide code to ease application of this method. [ABSTRACT FROM AUTHOR]
- Published
- 2023
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5. Reply to the letter of Katayev and Fleming.
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Haeckel, Rainer and Wosniok, Werner
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REFERENCE values ,STATISTICS ,CONFLICT (Psychology) ,DATA analysis ,RESEARCH bias ,ALGORITHMS ,PROBABILITY theory - Published
- 2022
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6. Maximum Entropy Technique and Regularization Functional for Determining the Pharmacokinetic Parameters in DCE-MRI.
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Amini Farsani, Zahra and Schmid, Volker J
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ARTERIAL physiology ,LEFT heart ventricle ,STATISTICS ,PHYSICS ,NOISE ,CONTRAST media ,MAGNETIC resonance imaging ,MACHINE learning ,UNCERTAINTY ,DATABASE management ,COMPUTED tomography ,DATA analysis ,ALGORITHMS ,PROBABILITY theory ,BREAST tumors - Abstract
This paper aims to solve the arterial input function (AIF) determination in dynamic contrast-enhanced MRI (DCE-MRI), an important linear ill-posed inverse problem, using the maximum entropy technique (MET) and regularization functionals. In addition, estimating the pharmacokinetic parameters from a DCE-MR image investigations is an urgent need to obtain the precise information about the AIF–the concentration of the contrast agent on the left ventricular blood pool measured over time. For this reason, the main idea is to show how to find a unique solution of linear system of equations generally in the form of y = A x + b , named an ill-conditioned linear system of equations after discretization of the integral equations, which appear in different tomographic image restoration and reconstruction issues. Here, a new algorithm is described to estimate an appropriate probability distribution function for AIF according to the MET and regularization functionals for the contrast agent concentration when applying Bayesian estimation approach to estimate two different pharmacokinetic parameters. Moreover, by using the proposed approach when analyzing simulated and real datasets of the breast tumors according to pharmacokinetic factors, it indicates that using Bayesian inference—that infer the uncertainties of the computed solutions, and specific knowledge of the noise and errors—combined with the regularization functional of the maximum entropy problem, improved the convergence behavior and led to more consistent morphological and functional statistics and results. Finally, in comparison to the proposed exponential distribution based on MET and Newton's method, or Weibull distribution via the MET and teaching–learning-based optimization (MET/TLBO) in the previous studies, the family of Gamma and Erlang distributions estimated by the new algorithm are more appropriate and robust AIFs. [ABSTRACT FROM AUTHOR]
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- 2022
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7. Rethinking data analysis -- part one.
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Kent, Ray
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DATA analysis ,MARKETING research ,STATISTICS ,LINEAR statistical models ,PROBABILITY theory ,EXPERIMENTAL design - Abstract
The analysis of data from market research has, until fairly recently, been reliant upon statistical techniques that were developed during the nineteenth and early twentieth centuries for uses entirely other than the analysis of survey and other types of observational, non-experimental data. Such techniques rely on reviewing and relating the frequency distributions of variables that have been concocted and measured by researchers. This paper argues that key features of such 'frequentist' statistics are also limitations that need to be recognised by academics, market research practitioners and the managers to whom they report findings. By focusing on variable distributions across cases, they overlook patterns of within-case configuration; they seek out only symmetrical, linear patterns by reviewing the 'net effects' of individual variables; they rely on a very circumscribed view of statistical inference from samples to populations; they are not good at demonstrating causal connections between variables or at handling system complexity. A follow-up paper, 'Rethinking data analysis -- part two: some alternatives to frequentist approaches', examines ways of approaching data sets that can be seen as viable alternatives. [ABSTRACT FROM AUTHOR]
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- 2009
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8. Community Engagement: Outcomes for Occupational Therapy Students, Faculty and Clients.
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Schindler, Victoria P.
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INFORMATION services ,COMMUNITY health services ,ANALYSIS of variance ,HEALTH occupations students ,RESEARCH methodology ,OCCUPATIONAL therapists ,PROBABILITY theory ,STATISTICS ,OCCUPATIONAL therapy education ,DATA analysis ,PRE-tests & post-tests ,DATA analysis software ,HEALTH occupations school faculty ,DESCRIPTIVE statistics ,PSYCHOLOGY - Abstract
Students in health care professions, including occupational therapy, are required to develop knowledge, skills and attitudes in mental health and research. Persons diagnosed with a mental illness, a learning disability or an autism-spectrum disorder desire to achieve goals in higher education and employment. Faculty in health care programmes strives to meet professional goals and accreditation and institution requirements for teaching, service and scholarship. The Bridge Program, a programme based on principles of community engagement, was developed to meet the needs of these three stakeholders. The objective of this paper is to provide programme description and outcomes of the effectiveness of the Bridge Program for all three stakeholders. This uses mixed methods research design including descriptive and quantitative and qualitative one-group pre-test-post-test designs. Instruments consisted of the Occupational Therapy Student and Mental Health Population Scale and the Canadian Occupational Performance Measure. Quantitative results support that graduate occupational therapy students gained research and clinical skills ( n = 100; p = .000); clients increased performance and satisfaction toward goals ( n = 113; p = .000) and faculty ( n = 1) achieved goals related to teaching, service and scholarship. Programmes based on principles of community engagement can address the needs of the community, can provide outcomes that advance knowledge about community practice and can result in benefits for all stakeholders. This paper is limited to generalization and instrumentation and recommends an ongoing evaluation of other community engagement programmes involving all stakeholders in the future research. Copyright © 2014 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]
- Published
- 2014
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9. Semiparametric likelihood inference for left-truncated and right-censored data.
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CHIUNG-YU HUANG, JING NING, JING QIN, Huang, Chiung-Yu, Ning, Jing, and Qin, Jing
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CENSORING (Statistics) ,NONPARAMETRIC estimation ,BIOMETRY ,DECONVOLUTION (Mathematics) ,EXPECTATION-maximization algorithms ,GOODNESS-of-fit tests ,AGING ,EPIDEMIOLOGICAL research ,EXPERIMENTAL design ,PROBABILITY theory ,RESEARCH funding ,STATISTICS ,DATA analysis ,RESEARCH bias ,STATISTICAL models - Abstract
This paper proposes a new estimation procedure for the survival time distribution with left-truncated and right-censored data, where the distribution of the truncation time is known up to a finite-dimensional parameter vector. The paper expands on the Vardis multiplicative censoring model (Vardi, 1989. Multiplicative censoring, renewal processes, deconvolution and decreasing density: non-parametric estimation. Biometrika 76: , 751-761), establishes the connection between the likelihood under a generalized multiplicative censoring model and that for left-truncated and right-censored survival time data, and derives an Expectation-Maximization algorithm for model estimation. A formal test for checking the truncation time distribution is constructed based on the semiparametric likelihood ratio test statistic. In particular, testing the stationarity assumption that the underlying truncation time is uniformly distributed is performed by embedding the null uniform truncation time distribution in a smooth alternative (Neyman, 1937. Smooth test for goodness of fit. Skandinavisk Aktuarietidskrift 20: , 150-199). Asymptotic properties of the proposed estimator are established. Simulations are performed to evaluate the finite-sample performance of the proposed methods. The methods and theories are illustrated by analyzing the Canadian Study of Health and Aging and the Channing House data, where the stationarity assumption with respect to disease incidence holds for the former but not the latter. [ABSTRACT FROM AUTHOR]
- Published
- 2015
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10. Tobacco quitline performance: Comparing the impacts of early cessation and proactive re-engagement on callers' smoking status at follow-up at 12 months.
- Author
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Cassidy, Daniel G., Xin-Qun Wang, Mallawaarachchi, Indika, Wiseman, Kara P., Ebbert, Jon O., Blue Star, John A., Aycock, Chase A., Estevez Burns, Rosemary, Jones, John R., Krunnfusz, Andrea E., Halbert, Jennifer P., Roy, Natalie M., Ellis, Jordan M., Williams, Juinell B., Klesges, Robert C., and Talcott, Gerald W.
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STATISTICS ,SMOKING cessation ,PATIENT participation ,CONFIDENCE intervals ,HEALTH status indicators ,HELPLINES ,NICOTINE replacement therapy ,DESCRIPTIVE statistics ,RESEARCH funding ,SMOKING ,LOGISTIC regression analysis ,ODDS ratio ,DATA analysis ,HEALTH promotion ,PROBABILITY theory - Abstract
INTRODUCTION While tobacco Quitlines are effective in the promotion of smoking cessation, the majority of callers who wish to quit still fail to do so. The aim of this study was to determine if 12-month tobacco Quitline smoking cessation rates could be improved with re-engagement of callers whose first Quitline treatment failed to establish abstinence. METHODS In an adaptive trial, 614 adult smokers, who were active duty, retired, and family of military personnel with TRICARE insurance who called a tobacco Quitline, received a previously evaluated and efficacious four-session tobacco cessation intervention with nicotine replacement therapy (NRT). At the scheduled follow-up at 3 months, callers who had not yet achieved abstinence were offered the opportunity to re-engage. This resulted in three caller groups: 1) those who were abstinent, 2) those who were still smoking but willing to re-engage with an additional Quitline treatment; and 3) individuals who were still smoking but declined re-engagement. A propensity score-adjusted logistic regression model was generated to compare past-7-day point prevalence abstinence at 12 months post Quitline consultation. RESULTS Using a propensity score adjusted logistic regression model, comparison of the three groups resulted in higher odds of past-7-day point prevalence abstinence at follow-up at 12 months for those who were abstinent at 3 months compared to those who re-engaged (OR=9.6; 95% CI: 5.2-17.8; Bonferroni adjusted p<0.0001), and relative to those who declined re-engagement (OR=13.4; 95% CI: 6.8-26.3; Bonferroni adjusted p<0.0001). There was no statistically significant difference in smoking abstinence between smokers at 3 months who re-engaged and those who declined re-engagement (OR=1.39; 95% CI: 0.68-2.85). CONCLUSIONS Tobacco Quitlines seeking to select a single initiative by which to maximize abstinence at follow-up at 12 months may benefit from diverting additional resources from the re-engagement of callers whose initial quit attempt failed, toward changes which increase callers' probability of success within the first 3 months of treatment. TRIAL REGISTRATION This study is registered at clinicaltrials.gov (NCT02201810). [ABSTRACT FROM AUTHOR]
- Published
- 2023
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11. The accuracy and consistency of mastery for each content domain using the Rasch and deterministic inputs, noisy "and" gate diagnostic classification models: a simulation study and a real-world analysis using data from the Korean Medical Licensing Examination.
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Dong Gi Seo and Jae Kum Kim
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STATISTICS ,RESEARCH evaluation ,PROFESSIONAL licenses ,PSYCHOMETRICS ,COMPARATIVE studies ,DATA analysis ,STATISTICAL models ,STATISTICAL correlation ,PROBABILITY theory - Abstract
Purpose: Diagnostic classification models (DCMs) were developed to identify the mastery or non-mastery of the attributes required for solving test items, but their application has been limited to very low-level attributes, and the accuracy and consistency of high-level attributes using DCMs have rarely been reported compared with classical test theory (CTT) and item response theory models. This paper compared the accuracy of high-level attribute mastery between deterministic inputs, noisy "and" gate (DINA) and Rasch models, along with sub-scores based on CTT. Methods: First, a simulation study explored the effects of attribute length (number of items per attribute) and the correlations among attributes with respect to the accuracy of mastery. Second, a real-data study examined model and item fit and investigated the consistency of mastery for each attribute among the 3 models using the 2017 Korean Medical Licensing Examination with 360 items. Results: Accuracy of mastery increased with a higher number of items measuring each attribute across all conditions. The DINA model was more accurate than the CTT and Rasch models for attributes with high correlations (>0.5) and few items. In the real-data analysis, the DINA and Rasch models generally showed better item fits and appropriate model fit. The consistency of mastery between the Rasch and DINA models ranged from 0.541 to 0.633 and the correlations of person attribute scores between the Rasch and DINA models ranged from 0.579 to 0.786. Conclusion: Although all 3 models provide a mastery decision for each examinee, the individual mastery profile using the DINA model provides more accurate decisions for attributes with high correlations than the CTT and Rasch models. The DINA model can also be directly applied to tests with complex structures, unlike the CTT and Rasch models, and it provides different diagnostic information from the CTT and Rasch models. [ABSTRACT FROM AUTHOR]
- Published
- 2021
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12. The association between students’ perceptions of a caring teacher and sexual initiation. A study among South African high school students.
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Helleve, Arnfinn, Flisher, Alan J., Onya, Hans, Mathews, Catherine, Aarø, Leif Edvard, and Klepp, Knut-Inge
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ANALYSIS of variance ,CARING ,CONFIDENCE intervals ,EPIDEMIOLOGY ,PSYCHOLOGY of high school students ,LONGITUDINAL method ,PROBABILITY theory ,RESEARCH funding ,SELF-evaluation ,HUMAN sexuality ,STATISTICS ,SURVEYS ,T-test (Statistics) ,TEACHER-student relationships ,LOGISTIC regression analysis ,DATA analysis ,DATA analysis software ,ADOLESCENCE - Abstract
This paper has the following aims: (i) to explore the extent to which students who received an intervention involving HIV/AIDS and sexuality perceived that their teacher cared for their health and well-being, (ii) to investigate the characteristics of students who reported to have caring teachers and (iii) to document the association between students’ perceptions of care and reported onset of sexual activity. Data were obtained from the second follow-up survey of a prospective study carried out among high school students in South Africa (Cape Town and Mankweng). We analyzed data from 3483 students who met the inclusion criteria. Students from the intervention group perceived greater care from teachers than students in the control group. Female students and students from Cape Town perceived having received more care, and their perception of care was associated with the number of lessons received, how often students expressed their opinions in class and how often teachers talked about HIV/AIDS, condoms and abstinence. Students who perceived that their teacher cared for their health and well-being were less likely to initiate sexual intercourse. This is the first paper to demonstrate the salience of the concept of care in studies of school-based HIV/AIDS prevention programs in sub-Saharan Africa. [ABSTRACT FROM PUBLISHER]
- Published
- 2011
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13. Iron metabolism and lymphocyte characterisation during Covid-19 infection in ICU patients: an observational cohort study.
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Bolondi, Giuliano, Russo, Emanuele, Gamberini, Emiliano, Circelli, Alessandro, Meca, Manlio Cosimo Claudio, Brogi, Etrusca, Viola, Lorenzo, Bissoni, Luca, Poletti, Venerino, and Agnoletti, Vanni
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IRON metabolism ,MORTALITY risk factors ,C-reactive protein ,CELL receptors ,EPIDEMICS ,FERRITIN ,LENGTH of stay in hospitals ,HOSPITAL admission & discharge ,INTENSIVE care units ,IRON ,LACTATE dehydrogenase ,LONGITUDINAL method ,SCIENTIFIC observation ,PATIENTS ,PROBABILITY theory ,HEMOPHAGOCYTIC lymphohistiocytosis ,RISK assessment ,STATISTICS ,TRANSFERRIN ,CD4 antigen ,DATA analysis ,SEVERITY of illness index ,FIBRIN fibrinogen degradation products ,LYMPHOPENIA ,TROPONIN ,LYMPHOCYTE count ,MANN Whitney U Test ,KRUSKAL-Wallis Test ,COVID-19 ,BLOOD ,DISEASE risk factors - Abstract
Background: Iron metabolism and immune response to SARS-CoV-2 have not been described yet in intensive care patients, although they are likely involved in Covid-19 pathogenesis. Methods: We performed an observational study during the peak of pandemic in our intensive care unit, dosing D-dimer, C-reactive protein, troponin T, lactate dehydrogenase, ferritin, serum iron, transferrin, transferrin saturation, transferrin soluble receptor, lymphocyte count and NK, CD3, CD4, CD8 and B subgroups of 31 patients during the first 2 weeks of their ICU stay. Correlation with mortality and severity at the time of admission was tested with the Spearman coefficient and Mann–Whitney test. Trends over time were tested with the Kruskal–Wallis analysis. Results: Lymphopenia is severe and constant, with a nadir on day 2 of ICU stay (median 0.555 10
9 /L; interquartile range (IQR) 0.450 109 /L); all lymphocytic subgroups are dramatically reduced in critically ill patients, while CD4/CD8 ratio remains normal. Neither ferritin nor lymphocyte count follows significant trends in ICU patients. Transferrin saturation is extremely reduced at ICU admission (median 9%; IQR 7%), then significantly increases at days 3 to 6 (median 33%, IQR 26.5%, p value 0.026). The same trend is observed with serum iron levels (median 25.5 μg/L, IQR 69 μg/L at admission; median 73 μg/L, IQR 56 μg/L on days 3 to 6) without reaching statistical significance. Hyperferritinemia is constant during intensive care stay: however, its dosage might be helpful in individuating patients developing haemophagocytic lymphohistiocytosis. D-dimer is elevated and progressively increases from admission (median 1319 μg/L; IQR 1285 μg/L) to days 3 to 6 (median 6820 μg/L; IQR 6619 μg/L), despite not reaching significant results. We describe trends of all the abovementioned parameters during ICU stay. Conclusions: The description of iron metabolism and lymphocyte count in Covid-19 patients admitted to the intensive care unit provided with this paper might allow a wider understanding of SARS-CoV-2 pathophysiology. [ABSTRACT FROM AUTHOR]- Published
- 2020
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14. Group association test using a hidden Markov model.
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CHENG, YICHEN, DAI, JAMES Y., and KOOPERBERG, CHARLES
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GENOMICS ,MARKOV processes ,BIOMETRIC research ,BIOLOGICAL mathematical modeling ,BIOMETRY ,PROBABILITY theory ,RESEARCH funding ,STATISTICS ,DATA analysis ,SEQUENCE analysis - Abstract
In the genomic era, group association tests are of great interest. Due to the overwhelming number of individual genomic features, the power of testing for association of a single genomic feature at a time is often very small, as are the effect sizes for most features. Many methods have been proposed to test association of a trait with a group of features within a functional unit as a whole, e.g. all SNPs in a gene, yet few of these methods account for the fact that generally a substantial proportion of the features are not associated with the trait. In this paper, we propose to model the association for each feature in the group as a mixture of features with no association and features with non-zero associations to explicitly account for the possibility that a fraction of features may not be associated with the trait while other features in the group are. The feature-level associations are first estimated by generalized linear models; the sequence of these estimated associations is then modeled by a hidden Markov chain. To test for global association, we develop a modified likelihood ratio test based on a log-likelihood function that ignores higher order dependency plus a penalty term. We derive the asymptotic distribution of the likelihood ratio test under the null hypothesis. Furthermore, we obtain the posterior probability of association for each feature, which provides evidence of feature-level association and is useful for potential follow-up studies. In simulations and data application, we show that our proposed method performs well when compared with existing group association tests especially when there are only few features associated with the outcome. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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15. A Prospective Cross-Sectional Study on the Vitamin D Status of Neonates and the Impact of Neonates' Standard Vitamin D Supplementation on Neonatal Morbidities.
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Yangin Ergon, Ezgi, Dorum, Bayram Ali, Balki, Hanife Gul, Bako, Derya, and Alkan Ozdemir, Senem
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THERAPEUTIC use of vitamin D ,BREASTFEEDING ,VITAMIN D deficiency ,CROSS-sectional method ,PEARSON correlation (Statistics) ,ACADEMIC medical centers ,DATA analysis ,PROBABILITY theory ,QUESTIONNAIRES ,TREATMENT effectiveness ,BREAST milk ,DESCRIPTIVE statistics ,CHI-squared test ,DISEASES ,LONGITUDINAL method ,ONE-way analysis of variance ,STATISTICS ,RESPIRATORY distress syndrome ,TACHYPNEA ,DATA analysis software ,ANTHROPOMETRY ,VITAMIN D ,DIETARY supplements ,NEONATAL sepsis ,NONPARAMETRIC statistics ,CHILDREN - Abstract
(1) Background: This study aimed to determine whether standard-dose vitamin D supplementation could provide adequate levels in exclusively breastfed infants born with different cord 25(OH)D levels and to evaluate related neonatal morbidities. (2) Methods: A prospective cross-sectional study was designed in term infants. Three groups were formed based on cord 25(OH)D levels; Group1 Deficiency:25(OH)D < 12 ng/mL, Group2 Insufficiency:25(OH)D = 12–19 ng/mL, and Group3 Optimum:25(OH)D = 20–100 ng/mL. Cord and 1st month 25(OH)D levels, after receiving standard-dose vitamin D prophylaxis, neonatal outcomes and anthropometric measurements were compared. (3) Results: The study involved 86 infants. Group1 Deficiency had also significantly lower 25(OH)D levels at 1st month compared to the others (p < 0.001). There was a significant positive correlation between cord and 1st month 25(OH)D levels (r = 0.78, p < 0.001). Despite the fact that the mother's age and clothing style were similar, Group1 Deficiency mothers had higher parity numbers and used less vitamin D during pregnancy (p = 0.03, p = 0.04). Neonatal outcomes analysis revealed that newborns in Group1 Deficiency experienced more respiratory distress, transient tachypnea, and early-onset sepsis, as well as more and longer hospital stays in the first-month of life (p < 0.05). (4) Conclusions: Infants with low cord 25(OH)D levels had also lower 25(OH)D values in the 1st month of life and experienced higher rates of neonatal morbidities. Given its numerous biological activities and impact on neonatal morbidities, determining an individualized dose of vitamin D supplementation may be more accurate than using the standard approach. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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16. Examining the Impact of Imputation Errors on Fine-Mapping Using DNA Methylation QTL as a Model Trait.
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Chundru, V. Kartik, Marioni, Riccardo E., Prendergast, James G. D., Vallerga, Costanza L., Tian Lin, Beveridge, Allan J., Gratten, Jacob, Hume, David A., Deary, Ian J., Wray, Naomi R., Visscher, Peter M., and McRae, Allan F.
- Subjects
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NUCLEOTIDE analysis , *GENETIC polymorphisms , *GENOMES , *PAPER chromatography , *PROBABILITY theory , *STATISTICS , *DATA analysis , *DNA methylation , *HAPLOTYPES , *SEQUENCE analysis ,RESEARCH evaluation - Abstract
Genetic variants disrupting DNA methylation at CpG dinucleotides (CpG-SNP) provide a set of known causal variants to serve as models to test fine-mapping methodology. We use 1716 CpG-SNPs to test three fine-mapping approaches (Bayesian imputation-based association mapping, Bayesian sparse linear mixed model, and the J-test), assessing the impact of imputation errors and the choice of reference panel by using both whole-genome sequence (WGS), and genotype array data on the same individuals (n = 1166). The choice of imputation reference panel had a strong effect on imputation accuracy, with the 1000 Genomes Project Phase 3 (1000G) reference panel (n = 2504 from 26 populations) giving a mean nonreference discordance rate between imputed and sequenced genotypes of 3.2% compared to 1.6% when using the Haplotype Reference Consortium (HRC) reference panel (n = 32,470 Europeans). These imputation errors had an impact on whether the CpG-SNP was included in the 95% credible set, with a difference of ~23% and ~7% between the WGS and the 1000G and HRC imputed datasets, respectively. All of the fine-mapping methods failed to reach the expected 95% coverage of the CpG-SNP. This is attributed to secondary cis genetic effects that are unable to be statistically separated from the CpG-SNP, and through a masking mechanism where the effect of the methylation disrupting allele at the CpG-SNP is hidden by the effect of a nearby SNP that has strong linkage disequilibrium with the CpG-SNP. The reduced accuracy in fine-mapping a known causal variant in a low-level biological trait with imputed genetic data has implications for the study of higher-order complex traits and disease. [ABSTRACT FROM AUTHOR]
- Published
- 2019
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17. Nurses' reported use of standing orders in primary health care settings.
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Wilkinson, Jill
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PRIMARY health care ,MEDICAL prescriptions ,PSYCHOLOGY of nurses ,PROBABILITY theory ,STATISTICAL sampling ,SELF-evaluation ,STATISTICS ,SURVEYS ,DECISION making in clinical medicine ,DATA analysis ,CROSS-sectional method ,DATA analysis software ,DESCRIPTIVE statistics - Abstract
INTRODUCTION: The Medicines (Standing Order) Amendment Regulations 2011 allow medicines to be supplied or administered to a patient by a nurse in the absence of a medical practitioner and without a prescription. Regulations have been in place since 2002, but no substantive research has occurred in New Zealand concerning their use. AIM: This paper reports a survey of registered nurses (RNs) who work in primary health care (PHC) settings and explores aspects of their practice relating to their use of standing orders. METHODS: A self-reported survey using a non-probability sample of RNs working in PHC who use standing orders in their practice (n=231). Data were analysed descriptively. RESULTS: The sample were experienced RNs (mean 24 years since registration) and 53% have a post-graduate qualification. Some nurses' understanding of a standing order included provision of a prescription to a patient. Standing orders were used frequently (42% reported use 1 to >5 times/day) for a wide variety of conditions. There is a significant relationship between undertaking the stated professional development requirements and confidence in the clinical decisions made (p=0.025). Over half (52%) would like to use standing orders more often. DISCUSSION: Standing orders are used extensively in PHC settings. The conditions nurses are involved in treating are usually already differentiated or have a high degree of diagnostic certainty. Nurses can effectively provide medicines under standing orders when doctors support their use, issue evidence-based orders, and have confidence in nurses with advanced skills. Doctors need to meet their responsibilities under the Regulations. [ABSTRACT FROM AUTHOR]
- Published
- 2015
18. Examining the Use of Therapeutic Recreation in Schools and the Implications on Students' Social Interaction Behaviors.
- Author
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Shultz, Heather L., Wozencroft, Angela J., and Cihak, David F.
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STUDENTS with disabilities ,LONGITUDINAL method ,SCIENTIFIC observation ,PROBABILITY theory ,RECREATIONAL therapy ,SOCIAL skills ,SPECIAL education ,STATISTICS ,SERVICE learning ,DATA analysis ,UNOBTRUSIVE measures ,CONTENT mining ,DATA analysis software ,DESCRIPTIVE statistics ,MANN Whitney U Test - Abstract
The purpose of this study was to determine the impact of a therapeutic recreation program on social interaction behaviors of students with disabilities. Specifically, this paper examines a service-learning course called Project Therapeutic Recreation in Public Schools (TRiPS) offered at a large public university in the Southeast. In the current study, 18 students with disabilities were observed on five social interaction behaviors: (1) "motor gestural positive" behaviors, (2) "motor gestural negative" behaviors, (3) "vocal verbal positive" behaviors, (4) "vocal verbal negative" behaviors, and (5) "response to environment" behaviors. Results indicated instances where there was an increase in the frequency of students with disabilities' social interaction behaviors. Further examination of the developed activities implemented provides insight into why significant differences in some social interaction behaviors exists and direction for future research. Limitations of the study and implications are discussed. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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19. Two Sides of the Same Virtual Coin: Investigating Psychosocial Effects of Video Game Play, including Stress Relief Motivations as a Gateway to Problematic Video Game Usage.
- Author
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Farmer, George and Lloyd, Joanne
- Subjects
SELF-evaluation ,MOBILE apps ,PEARSON correlation (Statistics) ,COMPULSIVE behavior ,T-test (Statistics) ,DATA analysis ,UNIVERSITIES & colleges ,QUESTIONNAIRES ,ALEXITHYMIA ,PROBABILITY theory ,EMOTIONS ,DESCRIPTIVE statistics ,MOTIVATION (Psychology) ,EXPERIMENTAL design ,HEART beat ,PSYCHOLOGICAL stress ,TECHNOLOGY ,EPILEPSY ,ANALYSIS of variance ,STATISTICS ,PSYCHOLOGY of college students ,COMPARATIVE studies ,VIDEO games ,NONPARAMETRIC statistics - Abstract
Video gamers can play to negate the psychological impact of stress, which may become problematic when users over-rely on the stress relief potential of gaming. This study used a repeated measures experimental design to investigate the relationships between stress, video gaming, and problematic video gaming behaviours in a convenience sample of 40 students at a UK university. The results indicated that positive affect increased and negative affect decreased, whilst a biological stress measure (instantaneous pulse rate) also decreased after a short video gaming session (t(36) = 4.82, p < 0.001, d = 0.79). The results also suggested that video gaming can act as a short-term buffer against the physiological impact of stress. Further research should focus on testing individuals who have been tested for gaming disorder, as opposed to the general population. Research could also utilise variations of the methodological framework used in this study to examine the intensity of a stress relief effect under different social situations. The study's findings in relation to published works are also discussed. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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20. Dynamic associations between glucose and ecological momentary cognition in Type 1 Diabetes.
- Author
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Hawks, Z. W., Beck, E. D., Jung, L., Fonseca, L. M., Sliwinski, M. J., Weinstock, R. S., Grinspoon, E., Xu, I., Strong, R. W., Singh, S., Van Dongen, H. P. A., Frumkin, M. R., Bulger, J., Cleveland, M. J., Janess, K., Kudva, Y. C., Pratley, R., Rickels, M. R., Rizvi, S. R., and Chaytor, N. S.
- Subjects
BLOOD sugar analysis ,TYPE 1 diabetes ,COGNITIVE testing ,GLYCOSYLATED hemoglobin ,DATA analysis ,TASK performance ,COGNITIVE processing speed ,PROBABILITY theory ,FATIGUE (Physiology) ,AGE distribution ,DESCRIPTIVE statistics ,ATTENTION ,STATISTICS ,NEUROPSYCHOLOGICAL tests ,BLOOD sugar monitoring ,TIME ,HYPOGLYCEMIA ,REGRESSION analysis - Abstract
Type 1 diabetes (T1D) is a chronic condition characterized by glucose fluctuations. Laboratory studies suggest that cognition is reduced when glucose is very low (hypoglycemia) and very high (hyperglycemia). Until recently, technological limitations prevented researchers from understanding how naturally-occurring glucose fluctuations impact cognitive fluctuations. This study leveraged advances in continuous glucose monitoring (CGM) and cognitive ecological momentary assessment (EMA) to characterize dynamic, within-person associations between glucose and cognition in naturalistic environments. Using CGM and EMA, we obtained intensive longitudinal measurements of glucose and cognition (processing speed, sustained attention) in 200 adults with T1D. First, we used hierarchical Bayesian modeling to estimate dynamic, within-person associations between glucose and cognition. Consistent with laboratory studies, we hypothesized that cognitive performance would be reduced at low and high glucose, reflecting cognitive vulnerability to glucose fluctuations. Second, we used data-driven lasso regression to identify clinical characteristics that predicted individual differences in cognitive vulnerability to glucose fluctuations. Large glucose fluctuations were associated with slower and less accurate processing speed, although slight glucose elevations (relative to person-level means) were associated with faster processing speed. Glucose fluctuations were not related to sustained attention. Seven clinical characteristics predicted individual differences in cognitive vulnerability to glucose fluctuations: age, time in hypoglycemia, lifetime severe hypoglycemic events, microvascular complications, glucose variability, fatigue, and neck circumference. Results establish the impact of glucose on processing speed in naturalistic environments, suggest that minimizing glucose fluctuations is important for optimizing processing speed, and identify several clinical characteristics that may exacerbate cognitive vulnerability to glucose fluctuations. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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- View/download PDF
21. Does aligner refinement have the same efficiency in deep bite correction?: A retrospective study.
- Author
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Kang, Jessica, Jeon, Hyeran Helen, and Shahabuddin, Nishat
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TREATMENT of malocclusion ,PREDICTION models ,T-test (Statistics) ,DATA analysis ,RESEARCH funding ,PROBABILITY theory ,CORRECTIVE orthodontics ,RETROSPECTIVE studies ,DESCRIPTIVE statistics ,TORQUE ,ORTHODONTIC appliances ,STATISTICS ,COMPARATIVE studies - Abstract
Background: Refinements are very common in clear aligner treatments. The aim of this study is to assess whether the predictability of deep overbite correction is similar over several refinements using clear aligners (Invisalign, Align Technology, San Jose, Calif) and examine the accuracy of vertical movement and inclination change of individual teeth. Methods: This retrospective study included 20 deep bite patients (7M and 13F; 32.63 ± 11.88 years old; an initial overbite of 5.09 ± 0.98 mm), consecutively treated from September 2016 and March 2023, who completed at least two sets of aligners, including refinements. The initial, predicted, and achieved models were exported from ClinCheck or OrthoCAD (Cadent Inc, Carlstadt, NJ) and superimposed via best-fit surface-based registration using SlicerCMF (version 4.9.0; cmf.slicer.org). We also examined 15 out of 20 patients who completed treatments. The overbite correction and changes in vertical movement and inclination for individual teeth were measured. Descriptive statistics and a paired t-test or Wilcoxon signed-rank test were performed. P < 0.05 was considered statistically significant. Results: The mean accuracy of overbite correction was 37.63% after 1
st set, followed by 11.19%, 6.32%, and 13.80% (2nd -4th sets), respectively. There were statistically significant differences between the predicted and achieved vertical movements and inclination changes for all teeth for the 1st and 2nd sets. For the completed cases, the mean overbite correction was 38.54% compared to the initially planned overbite correction, which is similar to one of the 1st set. Still, the vertical movements and inclination changes of all teeth present statistically significant differences between the initially planned and finally achieved movements except for maxillary lateral incisor torque. Conclusions: The most overbite correction occurs during the 1st set of aligners, and refinement treatment does not significantly improve the deep bite correction. [ABSTRACT FROM AUTHOR]- Published
- 2024
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- View/download PDF
22. The Effect of Simulation-Based Education on Patient Training Correct Inhaler Technique of Nursing Students: A Randomized Controlled Trial.
- Author
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Abdali, Mahnaz, Alilu, Leyla, and Feizi, Aram
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COMPUTER simulation ,PATIENT education ,SCALE analysis (Psychology) ,T-test (Statistics) ,DATA analysis ,RESEARCH funding ,BLIND experiment ,STATISTICAL sampling ,PROBABILITY theory ,RANDOMIZED controlled trials ,DESCRIPTIVE statistics ,CONFIDENCE ,MOTIVATION (Psychology) ,NEBULIZERS & vaporizers ,STATISTICAL reliability ,STATISTICS ,DATA analysis software ,NURSING students - Abstract
Introduction: Teaching inhaler techniques to nursing students is crucial. Objective: This study aimed to investigate the effect of simulation-based education on patient training correct inhaler technique in nursing students. Methods: This is a single-blind, randomized controlled trial in which nursing students are randomly allocated into two groups of control (n = 41) and intervention (n = 40). The students' mean score of correct inhaler technique was measured before and one week after intervention, using checklists of inhaler techniques. Results: The mean score of control group was significantly lower than the intervention group (p <.001). The results also revealed that there was no significant difference in students' level of confidence regarding the ability to educate patients on inhaler techniques before the intervention, while all students were shown to have higher levels of confidence in this term after the intervention. Conclusions: Simulation is an effective way to train nursing students in the correct inhaler techniques. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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- View/download PDF
23. The Relationship between Family Support and Self-care in Stroke Patients.
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Setyoadi, Setyoadi, Kusumaningrum, Bintari, Purbandari, Taramita, and Sartika Lestari Ismai, Dina Dewi
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HEALTH self-care ,HOME care services ,CROSS-sectional method ,STATISTICAL correlation ,PEARSON correlation (Statistics) ,DATA analysis ,SCIENTIFIC observation ,QUESTIONNAIRES ,PROBABILITY theory ,JUDGMENT sampling ,DESCRIPTIVE statistics ,CAREGIVERS ,STROKE rehabilitation ,RESEARCH ,RESEARCH methodology ,STATISTICS ,FAMILY support ,STROKE patients ,BARTHEL Index ,DATA analysis software - Abstract
Background: Stroke is caused by a disruption in blood flow to the brain. Some people die from a stroke, while others are left with disabilities that reduce their self-care, requiring assistance from others to meet their daily needs. The family becomes a crucial source of support when a patient is at home. Purpose: This study examines the correlation between family support and self-care in stroke patients. Methods: The study employed an analytic observational design with a cross-sectional approach. The samples included families and stroke patients. Samples were selected using non-probability purposive sampling, with a sample size of 75 for each group. The instruments used for data collection were the Family Support Questionnaire and the Barthel Index Questionnaire. Data was analyzed using descriptive analysis and Spearman’s rank test. Results: The characteristics of stroke patients indicate an average age of 52 years, with an average time since suffering a stroke being 4.1 months. The gender distribution among patients is nearly equal. Family caregivers, with an average age of 43 years, also show a balanced gender distribution and the majority (49.3%) are partners. Concerning the support received from family caregivers, patients commonly receive emotional support, appreciation support and instrumental support. The analysis revealed a Spearman’s correlation coefficient of p < 0.05 between family support and self-care. Conclusion: This study illustrates the importance of family support in helping improve self-care for patients with stroke undergoing outpatient care and receiving home care from family caregivers. Implications for Nursing: Discharge planning for stroke patients receiving outpatient care needs to highlight the significance of family competence in assisting with home care to enhance patient self-care. [ABSTRACT FROM AUTHOR]
- Published
- 2024
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24. Influence of Image Metrics When Assessing Image Quality from a Test Object in Cardiac X-ray Systems: Part II.
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Sanchez, Roberto, Vano, Eliseo, Ubeda, Carlos, Fernandez, Jose, Balter, Stephen, and Hoornaert, Bart
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HEART radiography ,ALGORITHMS ,ANALYSIS of variance ,ARCHIVES ,IMAGING phantoms ,PROBABILITY theory ,QUALITY assurance ,INTERVENTIONAL radiology ,RESEARCH funding ,STATISTICS ,VIDEO compression ,DATA analysis ,EVALUATION research ,DATA analysis software - Abstract
The images generated in modern IC laboratories are created with high-quality standard (1,024 × 1,024 pixels and 10-12 bits/pixel) enabling cardiologists to perform interventions in the best conditions. But these images are in most of the cases archived in a basic quality standard (512 × 512 pixels and 8 bits/pixel). The purpose of this work is to complete the research developed in a previous paper and analyze the influence of the matrix size and the bit depth reduction on the image quality acquired on a polymethylmethacrylate (PMMA) phantom with a test object. The variation in contrast-to-noise ratio (CNR) and high contrast spatial resolution (HCSR) were investigated when the matrix size and the bit depth were independently modified for different phantom thicknesses. These two image quality parameters did not suffer noticeable alterations under bits depth reduction from 10 to 8 bits. Such a result seems to imply that bits depth reduction could be used to reduce file sizes with a suitable algorithm and without losing perceptible image quality information. But when the matrix size was reduced from 1,024 × 1,024 to 512 × 512 pixels, a reduction from 17% to 25% in HCSR was noticed when changing phantom thickness, and an increase of 27% in CNR was observed. These findings should be taken into account and it would be wise to conduct further investigations in the field of clinical images. [ABSTRACT FROM AUTHOR]
- Published
- 2012
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25. Understanding results: P-values, confidence intervals, and number need to treat.
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Flechner, Lawrence and Tseng, Timothy Y.
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ENZYME inhibitors ,BIOPSY ,CONFIDENCE intervals ,CASE studies ,MEDLINE ,ONLINE information services ,PROBABILITY theory ,PROSTATE tumors ,STATISTICS ,UROLOGY ,EVIDENCE-based medicine ,DECISION making in clinical medicine ,PROSTATE-specific antigen ,DATA analysis - Abstract
Objectives: With the increasing emphasis on evidence-based medicine, the urology literature has seen a rapid growth in the number of high-quality randomized controlled trials along with increased statistical rigor in the reporting of study results. P-values, CI, and number needed to treat (NNT) are becoming increasingly common in the literature. This paper seeks to familiarize the reader with statistical measures commonly used in the evidence-based literature. Materials and Methods: The meaning and appropriate interpretation of these statistical measures is reviewed through the use of a clinical scenario. Results: The reader will be better able to understand such statistical measures and apply them to the critical appraisal of the literature. Conclusions: P-values, CI, and NNT each provide a slightly different estimate of statistical truth. Together, they provide a more complete picture of the true effect observed in a study. An understanding of these measures is essential to the critical appraisal of study results in evidence-based medicine. [ABSTRACT FROM AUTHOR]
- Published
- 2011
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26. Reliability, Validity, and Feasibility of a Computer-Based Geriatric Assessment for Older Adults With Cancer.
- Author
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Hurria, Arti, Akiba, Chie, Kim, Jerome, Mitani, Dale, Loscalzo, Matthew, Katheria, Vani, Koczywas, Marianna, Pal, Sumanta, Chung, Vincent, Forman, Stephen, Nathwani, Nitya, Fakih, Marwan, Karanes, Chatchada, Lim, Dean, Popplewell, Leslie, Cohen, Harvey, Canin, Beverly, Cella, David, Ferrell, Betty, and Goldstein, Leanne
- Subjects
- *
GERIATRIC assessment , *ATTITUDE (Psychology) , *CANCER patients , *CHI-squared test , *COMPUTERS , *STATISTICAL correlation , *PROBABILITY theory , *RESEARCH funding , *STATISTICS , *DECISION making in clinical medicine , *PILOT projects , *DATA analysis , *STATISTICAL reliability , *DATA analysis software , *PATIENTS' attitudes , *DESCRIPTIVE statistics , *KRUSKAL-Wallis Test , *EVALUATION ,RESEARCH evaluation - Abstract
Purpose The goal of this study was to evaluate the feasibility, reliability, and validity of a computer-based geriatric assessment via two methods of electronic data capture (SupportScreen and REDCap) compared with paper-and-pencil data capture among older adults with cancer. Methods Eligible patients were ≥65 years old, had a cancer diagnosis, and were fluent in English. Patients were randomly assigned to one of four arms, in which they completed the geriatric assessment twice: (1) REDCap and paper and pencil in sessions 1 and 2; (2) REDCap in both sessions; (3) SupportScreen and paper and pencil in sessions 1 and 2; and (4) SupportScreen in both sessions. The feasibility, reliability, and validity of the computer-based geriatric assessment compared with paper and pencil were evaluated. Results The median age of participants (N = 100) was 71 years (range, 65 to 91 years) and the diagnosis was solid tumor (82%) or hematologic malignancy (18%). For session 1, REDCap took significantly longer to complete than paper and pencil (median, 21 minutes [range, 11 to 44 minutes] v median, 15 minutes [range, 9 to 29 minutes], P < .01) or SupportScreen (median, 16 minutes [range, 6 to 38 minutes], P < .01). There were no significant differences in completion times between SupportScreen and paper and pencil (P = .50). The computer-based geriatric assessmentwasfeasible. Few participants (8%) needed help with completing the geriatric assessment (REDCap, n = 7 and SupportScreen, n = 1), 89% reported that the length was "just right," and 67% preferred the computer-based geriatric assessment to paper and pencil. Test-retest reliability was high (Spearman correlation coefficient ≥ 0.79) for all scales except for social activity. Validity among similar scales was demonstrated. Conclusion Delivering a computer-based geriatric assessment is feasible, reliable, and valid. SupportScreen methodology is preferred to REDCap. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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27. Perception of barriers to postoperative pain management in elderly patients in Polish hospitals - a multicentre study.
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Wioletta, Mędrzycka‐Dąbrowska, Sebastian, Dąbrowski, and Andrzej, Basiński
- Subjects
POSTOPERATIVE pain treatment ,ELDER care ,CHI-squared test ,COMMUNICATION ,CONFIDENCE intervals ,CONTENT analysis ,STATISTICAL correlation ,FISHER exact test ,RESEARCH methodology ,MEDICAL quality control ,MEDICAL cooperation ,MEDICAL protocols ,NURSES ,PROBABILITY theory ,QUESTIONNAIRES ,RESEARCH ,STATISTICAL sampling ,STATISTICS ,T-test (Statistics) ,DATA analysis ,ACCESS to information ,DATA analysis software ,DESCRIPTIVE statistics ,MANN Whitney U Test ,KRUSKAL-Wallis Test - Abstract
Aim The purpose of the paper was to compare the prevalence of barriers to optimum postoperative pain management in elderly patients, observed by nurses in a clinical, provincial and municipal hospital in Poland. Background It is currently estimated that the lack of adequate pain management affects 80% of the global population and the phenomenon poses a serious problem in more than 150 countries. Methods A questionnaire-based study of 1602 nurses working at clinical, provincial and municipal hospitals. Results In the clinical hospitals barriers more often related to a poorly organised systems of care and obstacles in discussing pain management within the team. In provincial and municipal hospitals lack of uninform pain measurement was more evident. Conclusions Despite the availability of effective pain treatments in hospitals difficulties continue with communication, poorly organised care and limited access to clinical guidelines. Implications for nursing management Although there are possibilities of pain relief after surgery, they are still used insufficiently. Postoperative pain management in Poland needs considerable improvement. This study can contribute to the improvement of pain management quality by supporting and developing practical guidelines or management algorithms for nurses, facilitating the effective implementation of new pain management practices. [ABSTRACT FROM AUTHOR]
- Published
- 2016
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28. What are we paying for? A cost-effectiveness analysis of patented denosumab and generic alendronate for postmenopausal osteoporotic women in Australia.
- Author
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Karnon, Jonathan, Shaie, Ainul Shakirah, Orji, Nneka, and Usman, Sofoora Kawsar
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CONFIDENCE intervals ,COST effectiveness ,LIFE expectancy ,PROBABILITY theory ,RESEARCH evaluation ,STATISTICS ,COST analysis ,DATA analysis ,BONE density ,RELATIVE medical risk ,CONTENT mining ,QUALITY-adjusted life years ,ALENDRONATE ,ZOLEDRONIC acid - Abstract
Objective: Zoledronic acid and denosumab were funded by the Australian government for the management of osteoporosis at an equivalent price to alendronate. The price of alendronate has declined by around 65 %, but the price of the other two therapies has remained stable. Using data published since the listing, this paper reports current estimates of the value of denosumab compared to alendronate from an Australian health system perspective. Methods: A cohort-based state transition model was developed that predicted changes in bone mineral density (BMD), and calibrated fracture probabilities as a function of BMD, age and previous fracture to estimate differences in costs and QALYs gained over a 10-year time horizon. Results: The base-case incremental cost per QALY gained for denosumab versus alendronate was $246,749. There is a near zero probability that denosumab is cost-effective at a threshold value of $100,000 per QALY gained. If the price of denosumab was reduced by 50 %, the incremental cost per QALY gained falls to $50,068. Discussion: Current Australian legislation precludes price reviews when comparator therapies come of patent. The presented analysis illustrates a review process, incorporating clinical data collected since the original submission to inform a price at which denosumab would provide value for money. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
29. Bayesian predictive probabilities: a good way to monitor clinical trials.
- Author
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Ferreira, David, Ludes, Pierre-Olivier, Diemunsch, Pierre, Noll, Eric, Torp, Klaus D., and Meyer, Nicolas
- Subjects
- *
CLINICAL trials monitoring , *SEQUENTIAL analysis , *RANDOM numbers , *PROBABILITY theory , *EXPERIMENTAL design , *STATISTICS , *CLINICAL trials , *PRODUCT design , *TREATMENT effectiveness , *ENDOSCOPES , *STATISTICAL models , *DATA analysis , *LARYNGOSCOPY - Abstract
Background: Bayesian methods, with the predictive probability (PredP), allow multiple interim analyses with interim posterior probability (PostP) computation, without the need to correct for multiple looks at the data. The objective of this paper was to illustrate the use of PredP by simulating a sequential analysis of a clinical trial.Methods: We used data from the Laryngobloc trial that planned to include 480 patients to demonstrate the equivalence of success between a laryngoscopy performed with the Laryngobloc® device and a control device. A crossover Bayesian design was used. The success rates of the two laryngoscopy devices were compared. Interim analyses, computed from random numbers of subjects, were simulated.Results: The PostP of equivalence rapidly reached the predefined bound of 0.95. The PredP computed with an equivalence margin of 10% reached the efficacy bound between 352 and 409 of the 480 included patients. If a frequentist analysis had been made on the basis of 217 out of 480 subjects, the study would have been prematurely stopped for equivalence. The PredP indicated that this result was nonetheless unstable and that the equivalence was, thus far, not guaranteed.Conclusions: Based on these interim analyses, we can conclude with a sufficiently high probability that the equivalence would have been met on the primary outcome before the predetermined end of this particular trial. If a Bayesian approach using PredP had been used, it would have allowed an early termination of the trial by reducing the calculated sample size by 15-20%. [ABSTRACT FROM AUTHOR]- Published
- 2021
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30. Bayesian accrual prediction for interim review of clinical studies: open source R package and smartphone application.
- Author
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Yu Jiang, Guarino, Peter, Shuangge Ma, Simon, Steve, Mayo, Matthew S., Raghavan, Rama, Gajewski, Byron J., Jiang, Yu, and Ma, Shuangge
- Subjects
CLINICAL trial registries ,MOBILE apps ,BAYESIAN analysis ,GRAPHICAL user interfaces ,MEDICAL robotics ,STROKE diagnosis ,STROKE treatment ,CLINICAL trials ,COMPUTER graphics ,MEDICAL cooperation ,PROBABILITY theory ,RESEARCH ,RESEARCH funding ,ROBOTICS ,STATISTICS ,STROKE ,TIME ,USER interfaces ,SAMPLE size (Statistics) ,DATA analysis ,PATIENT selection ,STATISTICAL models - Abstract
Background: Subject recruitment for medical research is challenging. Slow patient accrual leads to increased costs and delays in treatment advances. Researchers need reliable tools to manage and predict the accrual rate. The previously developed Bayesian method integrates researchers' experience on former trials and data from an ongoing study, providing a reliable prediction of accrual rate for clinical studies.Methods: In this paper, we present a user-friendly graphical user interface program developed in R. A closed-form solution for the total subjects that can be recruited within a fixed time is derived. We also present a built-in Android system using Java for web browsers and mobile devices.Results: Using the accrual software, we re-evaluated the Veteran Affairs Cooperative Studies Program 558- ROBOTICS study. The application of the software in monitoring and management of recruitment is illustrated for different stages of the trial.Conclusions: This developed accrual software provides a more convenient platform for estimation and prediction of the accrual process. [ABSTRACT FROM AUTHOR]- Published
- 2016
- Full Text
- View/download PDF
31. Survey Instruments for Knowledge, Skills, Attitudes and Behaviour Related to Evidence-based Practice in Occupational Therapy: A Systematic Review.
- Author
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Buchanan, Helen, Siegfried, Nandi, and Jelsma, Jennifer
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EDUCATION of occupational therapists ,RESEARCH methodology evaluation ,CINAHL database ,STATISTICAL correlation ,ERIC (Information retrieval system) ,PSYCHOLOGY information storage & retrieval systems ,MEDLINE ,OCCUPATIONAL therapy services ,ONLINE information services ,PROBABILITY theory ,PROFESSIONS ,PSYCHOMETRICS ,RESEARCH evaluation ,RESEARCH funding ,STATISTICS ,SYSTEMATIC reviews ,EVIDENCE-based medicine ,DATA analysis ,JOB performance ,DATA analysis software ,OCCUPATIONAL therapists ,DESCRIPTIVE statistics ,INTRACLASS correlation ,ATTITUDE (Psychology) - Abstract
The article discusses a study which examines the effectiveness of assessment instruments used in evidence-based occupational therapy practice. Through a systematic review, the study also aims to assess the psychometric properties and the methodological quality of identified instruments used in evidence-based practice in occupational therapy.
- Published
- 2016
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32. Why such success? Nursing students show consistently high satisfaction with bioscience courses at a regional university.
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Clifton, I. Delma and McKillup, Stephen C.
- Subjects
- *
UNIVERSITIES & colleges , *ANALYSIS of variance , *LIFE sciences , *NURSING students , *PROBABILITY theory , *QUESTIONNAIRES , *SATISFACTION , *SCALE analysis (Psychology) , *STATISTICS , *STUDENTS , *DATA analysis , *QUANTITATIVE research , *COURSE evaluation (Education) , *DATA analysis software , *DESCRIPTIVE statistics , *BACCALAUREATE nursing education - Abstract
Background An understanding of anatomy, physiology and pathophysiology is considered essential for graduate nurses, but many nursing students find such courses difficult and anxiety-provoking. This was contrary to the authors' experiences, so student perceptions were studied at the survey institution. Objective This paper examines nursing students' satisfaction with bioscience and nursing courses in the first two years of a Bachelor of Nursing at an Australian university, in order to suggest strategies for effective bioscience teaching. Design Quantitative data for student satisfaction, measured on the Likert scale, were collected for three bioscience and 11 nursing courses from 2010 - 2012. Mean satisfaction was compared among courses and offerings by ANOVA, with offerings nested within courses, and correlation analysis was used to examine the relationship between student satisfaction and pass rate. Qualitative data were sourced from open questions, emails and forum posts and examined for recurrent themes. Results Students rated the three bioscience courses in the top four of the 14 courses. There was no relationship between satisfaction and pass rate. Qualitative responses showed satisfaction with the course content, the learning materials, the delivery style and lecturer support. Conclusion It is possible to deliver bioscience courses that are appreciated by nursing students. Four principles are suggested in this paper that may improve student satisfaction with bioscience courses and, therefore, result in more effective learning and better prepared nursing graduates. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
33. Just How Useful Are Health Rankings?
- Author
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Arndt, Stephan
- Subjects
LOCAL government ,PROBABILITY theory ,PUBLIC health surveillance ,STATISTICS ,DATA analysis - Abstract
The author reflects on the reliability of health rankings and how it can be too unreliable to be helpful. Topics discussed include the innovative aspects of the work of C. Courtemanche, R. Tchernis and S. Soneji on modeling area-level health rankings, a statistical analysis of mortality in Iowa, and the reliability of final rankings which were found to vary from state to state.
- Published
- 2015
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34. Patterns of use of a maternal mental health service in a low-resource antenatal setting in South Africa.
- Author
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Baron, Emily, Field, Sally, Kafaar, Zuhayr, and Honikman, Simone
- Subjects
MENTAL depression ,THERAPEUTICS ,MENTAL health services ,CHI-squared test ,CONFIDENCE intervals ,STATISTICAL correlation ,COUNSELING ,HEALTH services accessibility ,INTEGRATED health care delivery ,MATERNAL health services ,NONPARAMETRIC statistics ,PRENATAL care ,PROBABILITY theory ,PSYCHOLOGICAL tests ,QUESTIONNAIRES ,RESEARCH funding ,RISK assessment ,SCALE analysis (Psychology) ,STATISTICS ,DATA analysis ,MULTIPLE regression analysis ,EDINBURGH Postnatal Depression Scale ,EFFECT sizes (Statistics) ,DATA analysis software ,DESCRIPTIVE statistics ,ODDS ratio ,PREGNANCY - Abstract
The prevalence of perinatal common mental disorders in South Africa is high, yet little is known about mental health service use among pregnant and postnatal women. This paper reports on pregnant women's patterns of use of a counselling service at a primary level obstetric facility in Cape Town, South Africa, between January 2010 and December 2011. It investigates whether these are associated with demographics, severity and risk of depressive symptoms. Participants ( N = 3311) were screened for psychological distress using the Edinburgh Postnatal Depression Scale ( EPDS) at their first antenatal visit. Risk factors for antenatal depression were assessed using a 11-item checklist. Questionnaires were self-administered, but some participants required assistance. Participants scoring positive (≥13) on the EPDS were offered referral to on-site, individual counselling, and assigned to one of three groups according to their service use: declined referral; accepted referral and attended counselling sessions; and accepted referral but defaulted all appointments. Consent to participate was received by 3437 (96.4%) participants who were offered screening, of which 627 (18.9%) screened positive on the EPDS. Of these, 363 (57.9%) attended counselling. Both bivariate analyses and regression analyses revealed that age and risk factor assessment score were associated with screening positive on the EPDS. Odds ratios ( OR) for accepting counselling were OR = 0.94 (95% CI = 0.92-0.97) for gestation, OR = 1.27 (95% CI = 1.15-1.39) for EPDS score and OR = 0.48 (95% CI = 0.23-0.99) for reporting three or more risk factors. OR for attending counselling were, for age: OR = 1.06 (95% CI = 1.00-1.12) and for reporting three or more risk factors: OR = 0.60 (95% CI = 0.37-0.97). While the majority of women with psychological distress accessed the counselling service provided, strategies to increase service use of younger pregnant women specifically are required. [ABSTRACT FROM AUTHOR]
- Published
- 2015
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35. Invited Commentary: Lost in Estimation—Searching for Alternatives to Markov Chains to Fit Complex Bayesian Models.
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Molitor, John
- Subjects
STATISTICS methodology ,DATA analysis ,EPIDEMIOLOGY research methodology ,COMPUTER simulation ,MATHEMATICAL models ,PROBABILITY theory ,PROBLEM solving ,STATISTICAL sampling ,STATISTICS ,DATA analysis software - Abstract
Bayesian methods have seen an increase in popularity in a wide variety of scientific fields, including epidemiology. One of the main reasons for their widespread application is the power of the Markov chain Monte Carlo (MCMC) techniques generally used to fit these models. As a result, researchers often implicitly associate Bayesian models with MCMC estimation procedures. However, Bayesian models do not always require Markov-chain-based methods for parameter estimation. This is important, as MCMC estimation methods, while generally quite powerful, are complex and computationally expensive and suffer from convergence problems related to the manner in which they generate correlated samples used to estimate probability distributions for parameters of interest. In this issue of the Journal, Cole et al. (Am J Epidemiol. 2012;175(5):368–375) present an interesting paper that discusses non-Markov-chain-based approaches to fitting Bayesian models. These methods, though limited, can overcome some of the problems associated with MCMC techniques and promise to provide simpler approaches to fitting Bayesian models. Applied researchers will find these estimation approaches intuitively appealing and will gain a deeper understanding of Bayesian models through their use. However, readers should be aware that other non-Markov-chain-based methods are currently in active development and have been widely published in other fields. [ABSTRACT FROM AUTHOR]
- Published
- 2012
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36. Comparing a trauma focused and non trauma focused intervention with war affected Congolese youth: a preliminary randomised trial.
- Author
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O'Callaghan, Paul, McMullen, John, Shannon, Ciarán, and Rafferty, Harry
- Subjects
- *
TREATMENT of post-traumatic stress disorder , *WAR , *PSYCHOLOGY , *ANALYSIS of covariance , *ANALYSIS of variance , *CLINICAL trials , *COGNITIVE therapy , *CONFIDENCE intervals , *FOCUS groups , *PROBABILITY theory , *PSYCHOLOGICAL tests , *QUESTIONNAIRES , *RESEARCH funding , *STATISTICAL sampling , *SELF-evaluation , *STATISTICS , *DATA analysis , *EFFECT sizes (Statistics) , *POST-traumatic stress disorder in adolescence , *RANDOMIZED controlled trials , *TREATMENT effectiveness , *PRE-tests & post-tests , *BLIND experiment , *DATA analysis software , *DESCRIPTIVE statistics , *CHILDREN - Abstract
While there is broad consensus about the need for interventions to help psychologically distressed, war ajfectedyouth, there is also limited research and even less agreement on which interventions work best. Therefore, this paper presents a randomised trial of trauma focused, and non trauma focused, interventions with war affected Congolese youth. Fifty war affected Congolese youth, who had been exposed to multiple adverse life events, were randomly assigned to either a Trauma Focused Cognitive Behavioural Therapy group or a non trauma based psychosocial intervention ( Child Friendly Spaces). Non clinically trained, Congolese facilitators ran both groups. A convenience sample, waiting list group was also formed. Using blind assessors, participants were individually interviewed at pre intervention, post intervention and a 6-month follow-up using self-report post-traumatic stress and internalising symptoms, conduct problems and pro social behaviour. Both treatment groups made statistically significant improvements, compared to the control group. Large, within subject, effect sizes were reported at both post intervention and follow-up. At the 6-month follow-up, only the Child Friendly Spaces group showed a significant decrease in pro social behaviour. The paper concludes that both trauma focused and non trauma focused interventions led to reductions in psychological distress in war affected youth. [ABSTRACT FROM AUTHOR]
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- 2015
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37. Invited Commentary: Pushing the Mediation Envelope.
- Author
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Have, Thomas Ten
- Subjects
CONCEPTUAL structures ,STATISTICAL correlation ,EPIDEMIOLOGY ,EPIDEMIOLOGICAL research ,HEALTH outcome assessment ,PROBABILITY theory ,REGRESSION analysis ,STATISTICS ,TIME ,MATHEMATICAL variables ,LOGISTIC regression analysis ,DATA analysis ,ENVIRONMENTAL exposure ,EFFECT sizes (Statistics) ,TREATMENT effectiveness - Abstract
The very insightful and clear paper by VanderWeele and Vansteelandt in this issue of the Journal (Am J Epidemiol. 2010;172(12):1339–1348) bridges the gap between biostatistics methodologists focusing on causal methods for mediation analyses and the practitioners of mediational analyses to the benefit of both groups. In an effort to continue the bridging of this gap, this invited commentary relates the important issue of “natural direct effects” to the well-known epidemiologic method of direct standardization. Additionally, attention is paid to the importance of temporal sequencing to help substantiate the mediation relations among the exposure, mediation, and outcome. A crucial mathematical distortion under the logistics model, called “absence of collapsibility,” is noted in motivating VanderWeele and Vansteelandt's use of the log-linear model for comparing the effect of exposure adjusted for the mediator with the effect of exposure unadjusted for the mediator. It is also noted that this issue applies to one approach to assessing confounding. Finally, some issues are raised for consideration when testing the interaction between the exposure and mediator before assessing mediation. [ABSTRACT FROM PUBLISHER]
- Published
- 2010
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38. Place of death in the Czech Republic and Slovakia: a population based comparative study using death certificates data.
- Author
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Loucka, Martin, Payne, Sheila A., and Brearley, Sarah G.
- Subjects
HOSPITALS ,TERMINAL care ,CHI-squared test ,COMPARATIVE studies ,CONFIDENCE intervals ,DEATH ,CAUSES of death ,PROBABILITY theory ,RESEARCH funding ,SEX distribution ,STATISTICS ,LOGISTIC regression analysis ,DEATH certificates ,DATA analysis ,HOME environment ,DATA analysis software ,DESCRIPTIVE statistics ,ODDS ratio - Abstract
Background: Place of death represents an important indicator for end-of-life care policy making and is related to the quality of life of patients and their families. The aim of the paper is to analyse the place of death in the Czech Republic and Slovakia in 2011. Research questions were focused on factors influencing the place of death and specifically the likelihood of dying at home. Methods: Whole population data from death certificates for all deaths in the Czech Republic and Slovakia in 2011 were used for bivariate and multivariate analyses. Separate analysis using binary logistic regression was conducted for subpopulation of patients who died from chronic conditions. Results: The majority of population in both countries died in hospitals (58.4% the Czech Republic, 54.8% Slovakia), less than one-third died at home. In case of chronic conditions, death at home was significantly associated with underlying cause of death (cancer and heart failure), being male, age (older than 85, Slovakia only) and higher education (the Czech Republic only). Cancer and heart failure patients had higher chances to die at home than other chronic conditions. Conclusions: Czech and Slovak patients with chronic conditions are more likely to die in hospitals than in some other European Union member countries. This finding should be addressed by policy makers in promoting home hospice care services and education in palliative care for staff in nursing homes and other end-of-life settings. [ABSTRACT FROM AUTHOR]
- Published
- 2014
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- View/download PDF
39. Development of Equipment Failure Prognostics Model Based on Logical Analysis of Data (LAD).
- Author
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Ghasemi, Alireza, Esmaeili, Sasan, and Yacout, Soumaya
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- *
FAILURE analysis , *PHILOSOPHICAL analysis , *PREDICTION theory , *STATISTICS , *PROPORTIONAL hazards models , *PROBABILITY theory , *DATA analysis - Abstract
This paper develops an equipment failure prognostics model, in the context of Condition Based Maintenance (CBM), in order to predict the equipment's chance of survival, using Logical Analysis of Data (LAD). LAD has the advantage of not relying on any statistical theory, which enables it to overcome the conventional problems concerning the statistical properties of the datasets. LAD's main advantage is its straightforward procedure and self-explanatory results. In this paper, our main objective is to develop methods to calculate equipment's survival probability at a certain future moment, using LAD. We employ LAD's pattern generation procedure. Then, we introduce a guideline to employ the generated patterns to estimate the equipment's survival probability. The proposed methods are applied on Prognostics and Health Management Challenge dataset, a condition monitoring dataset collected from some mechanical equipment, provided by NASA Ames Prognostics Data Repository. Analysis of performance of the proposed methods reveals that the methods provide comprehensible results that are greatly beneficial to maintenance practitioners. Prognostics results obtained by the proposed methods are compared with that of Proportional Hazards Model (PHM). The comparison reveals that the proposed methods are promising tools that compare favorably to the PH Model. Since the proposed prognostics model is at its beginning phase, some future directions are presented to improve the performance of the model. [ABSTRACT FROM AUTHOR]
- Published
- 2013
40. Bayes and Empirical Bayes Estimators of Abundance and Density from Spatial Capture-Recapture Data.
- Author
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Dorazio, Robert M.
- Subjects
EMPIRICAL Bayes methods ,MARK & recapture (Population biology) ,DATA analysis ,STATISTICAL sampling ,POPULATION density ,BAYESIAN analysis - Abstract
In capture-recapture and mark-resight surveys, movements of individuals both within and between sampling periods can alter the susceptibility of individuals to detection over the region of sampling. In these circumstances spatially explicit capture-recapture (SECR) models, which incorporate the observed locations of individuals, allow population density and abundance to be estimated while accounting for differences in detectability of individuals. In this paper I propose two Bayesian SECR models, one for the analysis of recaptures observed in trapping arrays and another for the analysis of recaptures observed in area searches. In formulating these models I used distinct submodels to specify the distribution of individual home-range centers and the observable recaptures associated with these individuals. This separation of ecological and observational processes allowed me to derive a formal connection between Bayes and empirical Bayes estimators of population abundance that has not been established previously. I showed that this connection applies to every Poisson point-process model of SECR data and provides theoretical support for a previously proposed estimator of abundance based on recaptures in trapping arrays. To illustrate results of both classical and Bayesian methods of analysis, I compared Bayes and empirical Bayes esimates of abundance and density using recaptures from simulated and real populations of animals. Real populations included two iconic datasets: recaptures of tigers detected in camera-trap surveys and recaptures of lizards detected in area-search surveys. In the datasets I analyzed, classical and Bayesian methods provided similar – and often identical – inferences, which is not surprising given the sample sizes and the noninformative priors used in the analyses. [ABSTRACT FROM AUTHOR]
- Published
- 2013
- Full Text
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41. Implication of fermentable carbohydrates targeting the gut microbiota on conjugated linoleic acid production in high-fat-fed mice.
- Author
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Druart, Céline, Neyrinck, Audrey M., Dewulf, Evelyne M., De Backer, Fabienne C., Possemiers, Sam, Van de Wiele, Tom, Moens, Frédéric, De Vuyst, Luc, Cani, Patrice D., Larondelle, Yvan, and Delzenne, Nathalie M.
- Subjects
FATTY acid analysis ,ANALYSIS of variance ,ANIMAL experimentation ,DIETARY supplements ,FERMENTATION ,CARBOHYDRATE content of food ,FAT content of food ,MICE ,POLYMERASE chain reaction ,PROBABILITY theory ,RESEARCH funding ,STATISTICS ,STOMACH ,LINOLEIC acid ,DATA analysis ,PREBIOTICS ,DATA analysis software ,IN vitro studies - Abstract
In vitro experiments have shown that isolated human gut bacteria are able to metabolise PUFA into conjugated PUFA like conjugated linoleic acids (CLA). The hypothesis of the present paper was that high-fat (HF) diet feeding and supplementation with fermentable carbohydrates that have prebiotic properties modulate the in vivo production of CLA by the mouse gut microbiota. Mice were treated for 4 weeks as follows: control (CT) groups were fed a standard diet; HF groups were fed a HF diet rich in linoleic acid (18 : 2n-6); the third groups were fed with the HF diet supplemented with either inulin-type fructans (HF-ITF) or arabinoxylans (HF-Ax). HF diet feeding increased rumenic acid (cis-9, trans-11-18 : 2 CLA) content both in the caecal and liver tissues compared with the CT groups. ITF supplementation had no major effect compared with the HF diet whereas Ax supplementation increased further rumenic acid (cis-9, trans-11-18 : 2 CLA) in the caecal tissue. These differences between both prebiotics may be linked to the high fat-binding capacity of Ax that provides more substrates for bacterial metabolism and to differential modulation of the gut microbiota (specific increase in Roseburia spp. in HF-Ax v. HF). In conclusion, these experiments supply the proof of concept that the mouse gut microbiota produces CLA in vivo, with consequences on the level of CLA in the caecal and liver tissues. We postulate that the CLA-producing bacteria could be a mediator to consider in the metabolic effects of both HF diet feeding and prebiotic supplementation. [ABSTRACT FROM PUBLISHER]
- Published
- 2013
- Full Text
- View/download PDF
42. Potentially inappropriate medication use: the Beers' Criteria used among older adults with depressive symptoms.
- Author
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Lee, Daphne, Martini, Nataly, Moyes, Simon, Hayman, Karen, Zolezzi, Monica, and Kerse, Ngaire
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ANTIDEPRESSANTS ,MENTAL depression ,MEDICATION error prevention ,CHI-squared test ,MEDICAL prescriptions ,PROBABILITY theory ,PSYCHOLOGICAL tests ,QUESTIONNAIRES ,RESEARCH funding ,STATISTICS ,LOGISTIC regression analysis ,DATA analysis ,INDEPENDENT living ,GERIATRIC Depression Scale ,DATA analysis software ,DESCRIPTIVE statistics ,OLD age - Abstract
INTRODUCTION: The ageing population means prescribing for chronic illnesses in older people is expected to rise. Comorbidities and compromised organ function may complicate prescribing and increase medication-related risks. Comorbid depression in older people is highly prevalent and complicates medication prescribing decisions. AIM: To determine the prevalence of potentially inappropriate medication use in a community-dwelling population of older adults with depressive symptoms. METHODS: The medications of 191 community-dwelling older people selected because of depressive symptoms for a randomised trial were reviewed and assessed using the modified version of the Beers' Criteria. The association between inappropriate medication use and various population characteristics was assessed using Chi-square statistics and logistic regression analyses. RESULTS: The mean age was 81 (±4.3) years and 59% were women. The median number of medications used was 6 (range 1-21 medications). The most commonly prescribed potentially inappropriate medications were amitriptyline, dextropropoxyphene, quinine and benzodiazepines. Almost half (49%) of the participants were prescribed at least one potentially inappropriate medication; 2996 were considered to suffer significant depressive symptoms (Geriatric Depression Scale >5) and no differences were found in the number of inappropriate medications used between those with and without significant depressive symptoms (Chi-square 0.005 p=0.54). DISCUSSION: Potentially inappropriate medication use, as per the modified Beers' Criteria, is very common among community-dwelling older people with depressive symptoms. However, the utility of the Beers' Criteria is lessened by lack of clinical correlation. Ongoing research to examine outcomes related to apparent inappropriate medication use is needed. [ABSTRACT FROM AUTHOR]
- Published
- 2013
- Full Text
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43. Knowledge and Perceptions of Date Rape among Female Undergraduates of a Nigerian University.
- Author
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Oshiname, Frederick O., Ogunwale, Akintayo O., and Ajuwon, Ademola J.
- Subjects
RAPE & psychology ,DATING violence ,CHI-squared test ,PSYCHOLOGY of college students ,INTERVIEWING ,RESEARCH methodology ,PROBABILITY theory ,QUESTIONNAIRES ,RELIGION ,STATISTICAL sampling ,STATISTICS ,DATA analysis ,CROSS-sectional method ,HEALTH literacy ,DATA analysis software ,DESCRIPTIVE statistics ,PSYCHOLOGY - Abstract
Copyright of African Journal of Reproductive Health is the property of Women's Health & Action Research Centre and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
- Published
- 2013
44. Low-n-6 and low-n-6 plus high-n-3 diets for use in clinical research.
- Author
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MacIntosh, Beth A., Ramsden, Christopher E., Faurot, Keturah R., Zamora, Daisy, Mangan, Margaret, Hibbeln, Joseph R., and Mann, J. Douglas
- Subjects
ERYTHROCYTES ,ARACHIDONIC acid ,COUNSELING ,HEADACHE ,OMEGA-3 fatty acids ,OMEGA-6 fatty acids ,PATIENT education ,PROBABILITY theory ,RESEARCH funding ,STATISTICS ,WORLD Wide Web ,LINOLEIC acid ,DOCOSAHEXAENOIC acid ,EICOSAPENTAENOIC acid ,DATA analysis ,RANDOMIZED controlled trials ,FOOD diaries - Abstract
Few trials have evaluated the metabolic effects and health outcomes of lowering dietary n-6 PUFA. The objectives of the present paper were (1) to report the methods employed to lower dietary n-6 PUFA, while either increasing or maintaining n-3 PUFA intake and (2) to validate our methods with 24 h recalls and erythrocyte fatty acid analyses. A total of sixty-seven subjects were randomised to either (1) an average-n-3 PUFA, low-n-6 PUFA (L6) intervention designed to lower linoleic acid (LA; ≤ 2·5 % of energy (en%)) and arachidonic acid ( ≤ 60 mg/d), while maintaining an average US intake of n-3 PUFA or (2) a high-n-3 PUFA, low-n-6 PUFA (H3-L6) intervention designed to lower n-6 LA, while increasing the n-3 PUFA α-linolenic acid (ALA; ≥ 1·5 en%) and EPA+DHA ( ≥ 1000 mg/d). Pre- and intra-intervention nutrient intakes were estimated with six 24 h dietary recalls per subject. Both groups achieved the targeted reductions in dietary LA to ≤ 2·5 en% (median LA 2·45 (2·1, 3·1); P< 0·001). Intakes of n-3 PUFA did not change for the L6 group. Target increases in n-3 ALA (median 1·6 en%, (1·3, 2·0), P< 0·001) and EPA+DHA (1482 mg, (374, 2558), P< 0·001) were achieved in the H3-L6 group. Dietary changes were validated by corresponding changes in erythrocyte n-6 and n-3 fatty acid composition. Dietary LA can be lowered to ≤ 2·5 en%, with or without concurrent increases in dietary n-3 PUFA, in an outpatient clinical trial setting using this integrated diet method. [ABSTRACT FROM PUBLISHER]
- Published
- 2013
- Full Text
- View/download PDF
45. Study of the effect exerted by fructo-oligosaccharides from yacon (Smallanthus sonchifolius) root flour in an intestinal infection model with Salmonella Typhimurium.
- Author
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Velez, Eva, Castillo, Natalia, Mesón, Oscar, Grau, Alfredo, Bibas Bonet, María E., and Perdigón, Gabriela
- Subjects
SALMONELLA diseases ,IMMUNOGLOBULIN analysis ,ANIMAL experimentation ,COMPARATIVE studies ,CYTOKINES ,GRAIN ,IMMUNITY ,SMALL intestine ,MICE ,PROBABILITY theory ,STATISTICS ,T-test (Statistics) ,DATA analysis ,PREBIOTICS ,DATA analysis software ,PREVENTION - Abstract
Beneficial effects of prebiotics like inulin and fructo-oligosaccharides (FOS) have been proven in health and nutrition. Yacon (Smallanthus sonchifolius), an Andean crop, contains FOS (50–70 % of its dry weight) and, therefore, is considered a prebiotic. Commercial FOS can up-regulate total secretory IgA (S-IgA) in infant mice, prevent infection with Salmonella in swine or enhance immune response for Salmonella vaccine in a mouse model. Previously, we found that administration of yacon root flour regulates gut microbiota balance and has immunomodulatory effects without inflammatory responses. The aim of the present paper is to analyse if yacon prevents enteric infection caused by a strain of Salmonella enteritidis serovar Typhimurium (S. Typhimurium) in a mouse model. BALB/c mice were supplemented with yacon flour (45 d), challenged with S. Typhimurium and killed to study pathogen translocation, total and specific IgA production by ELISA, presence of IgA and other cytokines and Toll-like receptor 4 (TLR4) and clustor of differentiation 206 (CD206) receptors positive cells by immunofluorescence and histological changes. Yacon flour administration had a protective effect from 15 to 30 d of treatment. We found a peak of total S-IgA production without translocation of the pathogen for these periods. At 30 d, there was an increase in IL-6 and macrophage inflammatory proteins-1α+ cells and expression of the receptors CD206 and TLR4. Yacon flour did not have incidence in pathogen-specific S-IgA production. Longer periods (45 d) of administration had no protective effect. Therefore, yacon can prevent enteric infection caused by S. Typhimurium when given up to 30 d; this effect would be mediated by enhancing non-specific immunity, such as total S-IgA, that improves the immunological intestinal barrier. [ABSTRACT FROM PUBLISHER]
- Published
- 2013
- Full Text
- View/download PDF
46. Perceptual Pseudoneglect in Schizophrenia: Candidate Endophenotype and the Role of the Right Parietal Cortex.
- Author
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Ribolsi, Michele, Lisi, Giulia, Di Lorenzo, Giorgio, Koch, Giacomo, Oliveri, Massimiliano, Magni, Valentina, Pezzarossa, Bianca, Saya, Anna, Rociola, Giuseppe, Rubino, Ivo A., Niolu, Cinzia, and Siracusano, Alberto
- Subjects
ANALYSIS of variance ,GENES ,HAMILTON Depression Inventory ,PROBABILITY theory ,PSYCHOLOGICAL tests ,QUESTIONNAIRES ,SCALES (Weighing instruments) ,SCHIZOPHRENIA ,STATISTICS ,DATA analysis ,REPEATED measures design ,DESCRIPTIVE statistics - Abstract
Several contributions have reported an altered expression of pseudoneglect in psychiatric disorders, highlighting the existence of an anomalous brain lateralization in affected subjects. Surprisingly, no studies have yet investigated pseudoneglect in first-degree relatives (FdR) of psychiatric patients. We investigated performance on “paper and pencil” line bisection (LB) tasks in 68 schizophrenic patients (SCZ), 42 unaffected FdR, 41 unipolar depressive patients (UP), and 103 healthy subjects (HS). A subgroup of 20 SCZ and 16 HS underwent computerized LB and mental number line bisection (MNL) tasks requiring judgment of prebisected lines and numerical intervals. Moreover, we evaluated, in a subgroup of 15 SCZ, performance on LB and MNL before and after parietal transcranial direct current stimulation (tDCS). In comparison to HS and UP, SCZ showed a systematic rightward bias on LB, partially corrected by selective right posterior parietal tDCS. Interestingly, even FdR showed a lack of pseudoneglect on LB, expressing a mean error lying in the middle between those of HS and SCZ. On the other hand, our results showed no significant difference between the performance of SCZ and HS on MNL. Both groups showed a comparable leftward bias that could not be significantly altered after left or right parietal tDCS. These findings confirm the existence of reduced lateralization in SCZ, suggesting specific impaired functioning of the right parietal lobule. Notably, we report a lack of pseudoneglect not only in SCZ but also in FdR, raising the hypothesis that an inverted laterality pattern may be considered a concrete marker of schizotypal traits. [ABSTRACT FROM PUBLISHER]
- Published
- 2013
- Full Text
- View/download PDF
47. Efficacy and acceptability of an Internet platform to improve the learning of nutritional knowledge in children: the ETIOBE mates.
- Author
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Baños, R. M., Cebolla, A., Oliver, E., Alcañiz, M., and Botella, C.
- Subjects
FOOD habits ,GAMES ,NUTRITION education ,ANALYSIS of variance ,INTERNET ,PROBABILITY theory ,QUESTIONNAIRES ,RESEARCH funding ,SELF-evaluation ,STATISTICS ,DATA analysis ,DATA analysis software ,DESCRIPTIVE statistics ,CHILDREN ,EVALUATION - Abstract
Possessing sufficient nutritional knowledge is a necessary component in the prevention and treatment of obesity. A solid understanding of nutrition can help people make appropriate food selections and can also help correct irrational ideas or myths people may believe about food. It is a challenge to provide this information to children in ways that are exciting. Thus, we propose an online video game platform to deliver the information. The objective of this study was to study the efficacy and acceptability of an online game called ‘ETIOBE Mates’ that was designed to improve children’s nutritional knowledge; furthermore, we compare it with the traditional paper–pencil mode of information delivery. A sample of 228 children participated in the study. Participants were divided into two groups: an experimental group (who used ETIOBE Mates) and a control group (who were given a pamphlet). Both groups increased their scores for nutritional knowledge. The interaction between group × time was also statistically significant; it indicated that acquisition of nutritional knowledge was superior in the experimental group. The children considered the serious games platform to be a useful medium for improving their nutritional knowledge. Online games can be an effective method of delivery for preventive and treatment tasks that are otherwise tedious for children. [ABSTRACT FROM PUBLISHER]
- Published
- 2013
- Full Text
- View/download PDF
48. Visual to Parametric Interaction (V2PI).
- Author
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Leman, Scotland C., House, Leanna, Maiti, Dipayan, Endert, Alex, and North, Chris
- Subjects
COMPUTER graphics ,GRAPHICAL user interfaces ,ERGONOMICS ,COMPUTER algorithms ,PROBABILITY theory ,DATA analysis - Abstract
Typical data visualizations result from linear pipelines that start by characterizing data using a model or algorithm to reduce the dimension and summarize structure, and end by displaying the data in a reduced dimensional form. Sensemaking may take place at the end of the pipeline when users have an opportunity to observe, digest, and internalize any information displayed. However, some visualizations mask meaningful data structures when model or algorithm constraints (e.g., parameter specifications) contradict information in the data. Yet, due to the linearity of the pipeline, users do not have a natural means to adjust the displays. In this paper, we present a framework for creating dynamic data displays that rely on both mechanistic data summaries and expert judgement. The key is that we develop both the theory and methods of a new human-data interaction to which we refer as “ Visual to Parametric Interaction” (V2PI). With V2PI, the pipeline becomes bi-directional in that users are embedded in the pipeline; users learn from visualizations and the visualizations adjust to expert judgement. We demonstrate the utility of V2PI and a bi-directional pipeline with two examples. [ABSTRACT FROM AUTHOR]
- Published
- 2013
- Full Text
- View/download PDF
49. The role of home smoking bans in limiting exposure to secondhand tobacco smoke in Hungary.
- Author
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Paulik, Edit, Maróti-Nagy, Á., Nagymajtényi, L., Rogers, T., and Easterling, D.
- Subjects
PASSIVE smoking ,SMOKING prevention ,ANALYSIS of variance ,CHI-squared test ,CONFIDENCE intervals ,EPIDEMIOLOGY ,LONGITUDINAL method ,PROBABILITY theory ,QUESTIONNAIRES ,RESEARCH funding ,STATISTICAL sampling ,SELF-evaluation ,STATISTICS ,SURVEYS ,DATA analysis ,HOME environment ,MULTIPLE regression analysis ,DATA analysis software ,DESCRIPTIVE statistics ,PREVENTION - Abstract
Our objective was to assess how exposure to secondhand tobacco smoke occurs in Hungarian homes, particularly among non-smokers, and to examine the effectiveness of home smoking bans in eliminating exposure to secondhand smoke at home. In 2009, 2286 non-smokers and smokers aged 16–70 years, who were selected randomly from a nationally representative sample of 48 Hungarian settlements, completed paper-and-pencil self-administered questionnaires addressing tobacco-related attitudes, opinions and behaviors. Chi-square tests, one-way analysis of variance and multivariate logistic regression models were used to assess the effect of demographics, socio-economic characteristics and home smoking policies on the risk of exposure to secondhand tobacco smoke at home. Significantly higher risk of exposure was found among younger, lower educated and poorer people and among those having no or partial home smoking restrictions. There was a significant interaction between education level and home smoking policies: the effect of a smoking ban on exposure to secondhand tobacco smoke was stronger for the lower educated group than the higher educated group. The results suggest that Hungarians are making good progress in implementing home smoking bans, and that in the majority of population these bans are working. More can be done to promote the uptake of home smoking bans among poorer and less educated subpopulations. [ABSTRACT FROM PUBLISHER]
- Published
- 2013
- Full Text
- View/download PDF
50. Prospective foreshock forecast experiment during the last 17 years.
- Author
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Ogata, Yosihiko and Katsura, Koichi
- Subjects
EARTHQUAKE prediction ,DATA analysis ,SEISMOLOGY ,STATISTICS ,PROBABILITY theory - Abstract
SUMMARY This paper evaluates a forecasting procedure, which was based on the data for the period 1926-1993, in and around Japan. The period of the experiment is from 1994 to April 2011. According to the procedure, the probability that the first earthquake will be a foreshock varies in a range between 1 and 10-odd per cent, depending on its location. This location-dependent forecasting performed significantly better than the unconditional foreshock probability (3.7 per cent average) throughout the Japan region. Furthermore, when multiple earthquakes were observed as a cluster, the foreshock forecast probabilities varied in a much wider range, depending on the space-time distances and magnitude increments, between the earthquakes. Such forecasts performed better than the average foreshock probability, and the forecast probabilities were basically consistent with the outcomes. The improvements of the forecasts were objectively evaluated by using the log likelihood score. It is also shown that the forecasting procedure was robust enough and can be adopted for automatically determined earthquakes in real-time. [ABSTRACT FROM AUTHOR]
- Published
- 2012
- Full Text
- View/download PDF
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