Home About us Contact
|
Home About us Contact | ||
|
|
||
Important Differences (important + difference)
Kinds of Important Differences Selected AbstractsMethods to Determine the Minimum Important Difference for a Sexual Event Diary Used by Postmenopausal Women with Hypoactive Sexual Desire DisorderTHE JOURNAL OF SEXUAL MEDICINE, Issue 5 2007Tara Symonds PhD ABSTRACT Introduction., Recently, there has been much discussion in the literature about how to determine the meaningfulness of results generated from a patient-reported outcome measure. A number of reviews have shown that there are two main approaches: anchor- and distribution-based approaches for determining the minimum important difference (MID) for a new measure. There are issues with calculating an MID using each method: Will the two approaches give the same estimate? If the estimates differ, how do you decide on one estimate? Would asking patients directly be more beneficial? Aim., A case study was presented to address these issues based on a newly developed diary assessing number of satisfactory sexual events (SSEs) per week in women with hypoactive sexual desire disorder (HSDD). Methods., Anchor- and distribution-based estimates were generated from data gathered in two double-blind, placebo-controlled, parallel group trials for the treatment of HSDD (N = 788). A novel interview study was used to ask women directly about an MID for SSEs (N = 77). Main Outcome Measures., Defining the MID for an SSE diary in women with HSDD. Results., The estimates varied, producing a range of mean MID estimates between 0.04 and 0.46 SSEs per week. Conclusion., We recommend that rather than defining the MID, a range should be selected from the set of estimates formed by the limits of the 95% confidence intervals. Symonds T, Spino C, Sisson M, Soni P, Martin M, Gunter L, and Patrick DL. Methods to determine the minimum important difference for a sexual event diary used by postmenopausal women with hypoactive sexual desire disorder. J Sex Med 2007;4;1328,1335. [source] A Comparison of Clinically Important Differences in Health-Related Quality of Life for Patients with Chronic Lung Disease, Asthma, or Heart DiseaseHEALTH SERVICES RESEARCH, Issue 2 2005Kathleen W. Wyrwich Objective. On the eight scales of the Medical Outcomes Study Short-Form 36-Item Health Survey (SF-36), Version 2, we compared the clinically important difference (CID) thresholds for change over time developed by three separate expert panels of physicians with experience in quality of life assessment among patients with chronic obstructive pulmonary disease (COPD), asthma, and heart disease. Study Design. We used a modified Delphi technique combined with a face-to-face panel meeting within each disease to organize and conduct the consensus process among the expert panelists, who were familiar with the assessment and evaluations of health-related quality of life (HRQL) measures among patients with the panel-specific disease. Principal Findings. Each of the expert panels first determined the magnitude of the smallest numerically possible change on each SF-36 scale, referred to as a state change, and then built their CIDs from this metric. All three panels attained consensus on the scale changes that constituted small, moderate, and large clinically important SF-36 change scores. The CIDs established by the heart disease panel were generally greater than the CIDs agreed on by the asthma and COPD panels. Conclusions. These panel-derived thresholds reflect possible differences in disease management among the represented panel-specific diseases, and are all greater than the minimal CID thresholds previously developed for the SF-36 scales among patients with arthritis. If confirmed among patients with the relevant diseases and those patients' physicians, these disease-specific CIDs could assist both researchers and practicing clinicians in the use and interpretation of HRQL changes over time. [source] Investigation into the nutritional status, dietary intake and smoking habits of patients with chronic obstructive pulmonary diseaseJOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 1 2004W. J. Cochrane Abstract Background and aims Weight loss and reduced fat-free mass are prevalent amongst patients with chronic obstructive pulmonary disease (COPD). However, the causes of this weight loss are not clear. The aims of this study are to investigate the factors affecting body weight and dietary intake in a group of outpatients with COPD, and to investigate any differences between adequately nourished and malnourished patients. Methods In 103 stable outpatients, nutritional status was assessed using Body Mass Index (BMI) and upper arm anthropometry. Lung function, smoking status, exercise tolerance, dietary intake, dietary problems and health-related quality of life were assessed. Patients were classed as either adequately nourished or malnourished. Results Twenty-three per cent of subjects were classed as malnourished. The malnourished subjects had lower lung function measurements, suffered more dietary problems and had lower nutritional intake compared with the adequately nourished subjects. They also had poorer fatigue scores. In linear regression analysis, the factors that had the most effect on BMI were a low transfer factor, presence of early satiety, and being a current smoker. Conclusion Important differences were found between adequately nourished and malnourished subjects. These differences move us closer to understanding how best to screen and treat this group of patients. [source] Systematic review: pancreatic enzyme treatment of malabsorption associated with chronic pancreatitisALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 3 2009A. K. WALJEE Summary Background, Pancreatic enzyme supplementation is standard treatment for malabsorption caused by chronic pancreatitis. The FDA recently required all manufacturers to submit New Drug Applications to continue to market these agents because published data demonstrated variation in formulation, bioavailability and shelf-life while providing limited data about efficacy and safety. Aim, To review systematically the design and results of randomized, parallel-design trials of pancreatic enzyme supplements in chronic pancreatitis patients with steatorrhea. Methods, A computer-assisted search of MEDLINE and EMBASE was performed to identify relevant studies. Two authors performed duplicate data extraction on study design, improvement in coefficient of fat absorption (CFA), diarrhoea and adverse events using pre-specified forms. Agreement between investigators for data extraction was greater than 95%. Results, Of 619 articles found through literature searching, 20 potentially relevant articles were identified and four manuscripts met inclusion criteria. No studies performed head-to-head comparisons of different supplements. Enzyme supplementation is more likely to improve CFA compared with placebo, but fat malabsorption remained abnormal. Important differences in patient population, study endpoint, study design, pancreatic enzyme dosage and measurement of CFA were present across trials, which precluded comparison of different agents. Conclusions, Enzyme supplementation improves CFA compared to placebo, but may not abolish steatorrhoea. [source] A weighting proposal for an ensemble of regional climate models over Europe driven by 1961,2000 ERA40 based on monthly precipitation probability density functionsATMOSPHERIC SCIENCE LETTERS, Issue 4 2009E. Sánchez Present climate over Europe is simulated by 12 regional climate models (RCMs), forced by ERA40 reanalysis. A method is proposed to score models from the 1961,1990 monthly precipitation cumulative density functions (CDFs) for each season and eight chosen subregions, compared with the CRU observational database. Ensemble CDF curves compare well against observations for all the subregions and seasons. Higher percentiles (heavy precipitation amounts) show a larger spread among results. Important differences in scores are obtained among models, regions and seasons. Applying the scores to compute 1991,2000 weighted ensemble precipitation, results are slightly closer to observations than the direct (unweighted) ensemble, and some cases show a larger improvement. Copyright © 2009 Royal Meteorological Society [source] Predictors of parenting self-efficacy in mothers and fathers of toddlersCHILD: CARE, HEALTH AND DEVELOPMENT, Issue 2 2010P. R. Sevigny Abstract Background Researchers interested in child developmental outcomes have highlighted the role that parenting self-efficacy (PSE) plays in psychosocial child adjustment. PSE is a cognitive construct that can be broadly defined as an individual's appraisal of his or her competence in the parental role. PSE has emerged in the literature as an important variable when exploring variance in parenting skills. Despite this, much remains to be learned about PSE. Little is known about the predictors of PSE, with much of the existing research conducted in a piecemeal fashion that lacks a solid theoretical framework. In addition, PSE in fathers has been understudied and relatively little is known about PSE in families with toddler age children. Informed by Belsky's process model of parenting, this study explored similarities and differences in PSE and the predictors of PSE for mothers and fathers of toddlers. Methods A total of 62 cohabiting couples whose first-born child was 18,36 months old completed self-report measures of PSE, general self-efficacy, depression, marital satisfaction, parenting stress, child difficultness and family functioning. Results For fathers, parenting stress and their relational functioning (i.e. marital satisfaction and family functioning) with their spouse predicted PSE scores. For mothers, general self-efficacy and relational functioning were predictive of PSE. Conclusions and limitations The results of this study support the use of Belsky's process model of parenting to study the predictors of PSE. Important differences were found in the prediction models for mothers and fathers. Future studies need to clarify the nature of parental self-efficacy beliefs in fathers and continue to use comprehensive theoretical models to identify potentially relevant covariates of PSE. Limitations of the current investigation include reliance on self-report measures and the homogeneity of the sample. [source] NMR diffusion measurements under chemical exchange between sites involving a large chemical shift differenceCONCEPTS IN MAGNETIC RESONANCE, Issue 2 2010S. Leclerc Abstract This study concerns the thallium-205 cation in aqueous solution in the presence of a calixarene molecule. Although the measurement of the self-diffusion coefficient of pure thallium (without calixarene in the aqueous solution) does not pose any particular problem, major difficulties are encountered with the standard method using gradient strength increment as soon as thallium is partly complexed by calixarene. With static magnetic field gradients, the NMR signal is so weak that it prevents any reliable measurement, whereas radio frequency (rf) field gradients lead to an unrealistic value of the diffusion coefficient. This failure is explained by the fact that thallium is in fast exchange between two sites (complexed and free thallium) thus exhibiting a single NMR signal although, in the course of the experiment, two signals, with an important difference in resonance frequencies (due to the large thallium chemical shift range), are effectively involved. With the objective to understand these quite unexpected observations, the theory underlying NMR diffusion experiments is first reviewed, and criteria of fast exchange are discussed for three parameters: chemical shifts, relaxation rates, and diffusion coefficients. It turns out that off-resonance effects are responsible for unwanted defocusing due to rf pulses in the static magnetic field gradient method and for time-dependent gradients in the rf field gradient method. Concerning the latter, a remedy is proposed which consists in applying the stronger gradient and incrementing the gradient pulse durations. After correction for relaxation, the expected value of the diffusion coefficient is retrieved. © 2010 Wiley Periodicals, Inc. Concepts Magn Reson Part A 36A: 127,137, 2010. [source] Developing a Multicultural Curriculum in a Predominantly White Teaching Context: Lessons From an African American Teacher in a Suburban English ClassroomCURRICULUM INQUIRY, Issue 4 2005H. RICHARD MILNER ABSTRACT The author sought to understand an African American English teacher's multicultural curriculum transformation and teaching in a suburban, mostly White, high school. Building on Banks's (1998) model of multicultural curriculum integration, the study focused on a context that might otherwise be ignored because there was not a large student-of-color representation in the school. The teacher in the study was operating at one of the highest levels of Banks's model, the transformational approach. Although the teacher shared characteristics with many of the Black teachers explored in the literature, there was one important difference: much of the research and theory about Black teachers and their instruction focus on Black teachers and their effectiveness in predominantly Black settings. The Black teacher in this study taught in a predominantly White teaching context. The study suggested that even teachers highly conscious of race, culture, gender, and ethnicity may find it difficult to reach the highest level of Banks's model: the social action approach. Implications of this study suggest that multicultural curricula can be well developed and received in a predominantly White setting as long as the curriculum is thoughtfully and carefully transformed. However, the study pointed out that the pervasive discourses and belief systems against multicultural education in a school can discourage highly effective curriculum transformers, and there is a great need to help critically minded teachers persevere in the face of such adversity. [source] IQ IN THE PRODUCTION FUNCTION: EVIDENCE FROM IMMIGRANT EARNINGSECONOMIC INQUIRY, Issue 3 2010GARETT JONES We show that a country's average IQ score is a useful predictor of the wages that immigrants from that country earn in the United States, whether or not one adjusts for immigrant education. Just as in numerous microeconomic studies, 1 IQ point predicts 1% higher wages, suggesting that IQ tests capture an important difference in cross-country worker productivity. In a cross-country development accounting exercise, about one-sixth of the global inequality in log income can be explained by the effect of large, persistent differences in national average IQ on the private marginal product of labor. This suggests that cognitive skills matter more for groups than for individuals. (JEL J24, J61, O47) [source] The Public Role of Teaching: To keep the door closedEDUCATIONAL PHILOSOPHY AND THEORY, Issue 5-6 2010Goele Cornelissen Abstract In this article, I turn my attention to the figure of the ignorant master, Joseph Jacotot, that is depicted in The Ignorant Schoolmaster. Five Lessons in Intellectual Emancipation (1991). I will show that the voice of Jacotot can actually be read as a reaction against the progressive figure of the teacher which, following Rancičre's view, can be seen as effecting a stultification. In some respects, however, Rancičre's analysis of the pedagogical order no longer seems to be valid in today's partly reconfigured, pedagogical order that depicts the teacher in terms of facilitation. Yet, the figure of the facilitator can be seen as effecting a stultification as well. Therefore, I will stress that Jacotot's voice is highly relevant today. The most important difference between the figure of the (old and current) figure of the stultifyer and that of the ignorant master is identified in their starting point. The stultifying master starts from the assumption of inequality. S/he transforms taught material (words, text, images, etc.) into objects of knowledge or resources for competence development that open the door to another world. The ignorant master (Jacotot) assumes equal intelligence and draws attention to a thing in common. According to Rancičre, the ignorant master keeps the door closed and puts his/her students in the presence of a thing in common. [source] What changes in health-related quality of life matter to multiple myeloma patients?EUROPEAN JOURNAL OF HAEMATOLOGY, Issue 4 2010A prospective study Abstract Objective: To determine the clinical significance of changes in quality-of-life scores in patients with multiple myeloma (MM), we have estimated the minimal important difference (MID) for the health-related quality-of-life instrument, the European Organization for Research and Treatment of Cancer (EORTC) QLQ-C30. The MID is the smallest change in a quality-of-life score considered important to patients. Methods: Between 2006 and 2008, 239 patients with MM completed the EORTC QLQ-C30 at inclusion (T1) and after 3 months (T2). At T2, a structured quality-of-life interview was also performed. MIDs were calculated by using mean score changes (T2,T1) for patients who in the interview stated they had improved, deteriorated or were unchanged. MIDs were also estimated by the receiver-operating characteristic (ROC) curve method as well as by calculation effect sizes using standard deviations of baseline scores. Results: MIDs varied slightly depending on the method used. Patients stating in the interview that they had ,improved' or ,deteriorated' had a corresponding change in EORTC QLQ-C30 score ranging from 6 to15 (improvement) and from 9 to17 (deterioration) (scale range 0,100). The ROC analysis indicated that changes in score from 7 to17 represent clinically important changes to patients. The effect size method suggested 5,6 to be a small and 11,15 to be a medium change. Conclusion: Calculation of MIDs as mean score changes or by ROC analysis suggested that a change in the EORTC QLQ-C30 score in the range of approximately 6,17 is considered important by patients with MM. These MIDs are closer to a medium effect size than to a small effect size. Our findings imply that mean score changes smaller than 6 are unlikely to be important to the patients, even if these changes are statistically significant. [source] Strategies of self-regulation in goal attainment versus goal maintenanceEUROPEAN JOURNAL OF SOCIAL PSYCHOLOGY, Issue 4 2007Jeff C. Brodscholl We propose that there exists an important difference between attainment and maintenance in terms of the goal pursuit strategies for which they call. Specifically, we propose that goal attainment calls for the use of eager approach strategies, whereas goal maintenance calls for the use of vigilant avoidance strategies. We distinguish between attainment versus maintenance as two different goal pursuit conditions on the one hand, and promotion versus prevention focus as two different self-regulatory concerns on the other hand. We then use insights from Regulatory Fit Theory to make predictions concerning the interactive effects of these two motivational dimensions on outcome valuations. Consistent with our proposal about attainment and maintenance, we found that participants in a promotion focus valued the outcome of an attainment task more than did participants in a prevention focus, whereas the opposite was true for a maintenance task. Implications for maintenance-related phenomena such as belief perseverance effects are subsequently discussed. Copyright © 2006 John Wiley & Sons, Ltd. [source] Somatic loss of wild type NF1 allele in neurofibromas: Comparison of NF1 microdeletion and non-microdeletion patientsGENES, CHROMOSOMES AND CANCER, Issue 10 2006Thomas De Raedt Neurofibromatosis type I (NF1) is an autosomal dominant familial tumor syndrome characterized by the presence of multiple benign neurofibromas. In 95% of NF1 individuals, a mutation is found in the NF1 gene, and in 5% of the patients, the germline mutation consists of a microdeletion that includes the NF1 gene and several flanking genes. We studied the frequency of loss of heterozygosity (LOH) in the NF1 region as a mechanism of somatic NF1 inactivation in neurofibromas from NF1 patients with and without a microdeletion. There was a statistically significant difference between these two patient groups in the proportion of neurofibromas with LOH. None of the 40 neurofibromas from six different NF1 microdeletion patients showed LOH, whereas LOH was observed in 6/28 neurofibromas from five patients with an intragenic NF1 mutation (P = 0.0034, Fisher's exact). LOH of the NF1 microdeletion region in NF1 microdeletion patients would de facto lead to a nullizygous state of the genes located in the deletion region and might be lethal. The mechanisms leading to LOH were further analyzed in six neurofibromas. In two out of six neurofibromas, a chromosomal microdeletion was found; in three, a mitotic recombination was responsible for the observed LOH; and in one, a chromosome loss with reduplication was present. These data show an important difference in the mechanisms of second hit formation in the 2 NF1 patient groups. We conclude that NF1 is a familial tumor syndrome in which the type of germline mutation influences the type of second hit in the tumors. © 2006 Wiley-Liss, Inc. [source] Optimal clinical trial design using value of information methods with imperfect implementationHEALTH ECONOMICS, Issue 5 2010Andrew R. Willan Abstract Traditional sample size calculations for randomized clinical trials are based on the tests of hypotheses and depend on somewhat arbitrarily chosen factors, such as type I and II errors rates and the smallest clinically important difference. In response to this, many authors have proposed the use of methods based on the value of information as an alternative. Previous attempts have assumed perfect implementation, i.e. if current evidence favors the new intervention and no new information is sought or expected, all future patients will receive it. A framework is proposed to allow for this assumption to be relaxed. The profound effect that this can have on the optimal sample size and expected net gain is illustrated on two recent examples. In addition, a model for assessing the value of implementation strategies is proposed and illustrated. Copyright © 2009 John Wiley & Sons, Ltd. [source] A Comparison of Clinically Important Differences in Health-Related Quality of Life for Patients with Chronic Lung Disease, Asthma, or Heart DiseaseHEALTH SERVICES RESEARCH, Issue 2 2005Kathleen W. Wyrwich Objective. On the eight scales of the Medical Outcomes Study Short-Form 36-Item Health Survey (SF-36), Version 2, we compared the clinically important difference (CID) thresholds for change over time developed by three separate expert panels of physicians with experience in quality of life assessment among patients with chronic obstructive pulmonary disease (COPD), asthma, and heart disease. Study Design. We used a modified Delphi technique combined with a face-to-face panel meeting within each disease to organize and conduct the consensus process among the expert panelists, who were familiar with the assessment and evaluations of health-related quality of life (HRQL) measures among patients with the panel-specific disease. Principal Findings. Each of the expert panels first determined the magnitude of the smallest numerically possible change on each SF-36 scale, referred to as a state change, and then built their CIDs from this metric. All three panels attained consensus on the scale changes that constituted small, moderate, and large clinically important SF-36 change scores. The CIDs established by the heart disease panel were generally greater than the CIDs agreed on by the asthma and COPD panels. Conclusions. These panel-derived thresholds reflect possible differences in disease management among the represented panel-specific diseases, and are all greater than the minimal CID thresholds previously developed for the SF-36 scales among patients with arthritis. If confirmed among patients with the relevant diseases and those patients' physicians, these disease-specific CIDs could assist both researchers and practicing clinicians in the use and interpretation of HRQL changes over time. [source] Mutation rate of MAP2K4/MKK4 in breast carcinoma ,,HUMAN MUTATION, Issue 1 2002Gloria H. Su Abstract The stress-activated protein kinase (SAPK) pathways represent phosphorylation cascades that convey pro-apoptotic signals. The relevant inputs include Ras proteins as well as exposure of cells to ultraviolet light, tumor-necrosis factor, and other stress-related inputs. The mitogen-activated protein kinase kinase (MAPKK) homolog MAP2K4 (MKK4, SEK, JNKK1) is a centrally-placed mediator of the SAPK pathways. MAP2K4 mutations or homozygous deletions are reported in about 5% of a wide variety of tumor types. The exception is breast cancer, where genetic inactivation in 3 of 22 (15%) cell lines had suggested that the mutational involvement of MAP2K4 might be accentuated in this tumor type. This finding might have represented an important difference, or solely a chance numerical variation. To address this question, we studied an independent panel of 20 breast cancer cell lines and xenografts for MAP2K4 alterations. We found a splice acceptor mutation accompanied by loss of the other allele in the cell line MPE600. This was the sole alteration in this panel (5% of tumors). These data seem to re-establish a rather consistent rate of genetic inactivation of MAP2K4 among most tumor types, including breast cancer. The genetic evaluation of other mediators of the SAPK pathways might offer insight into a promising, but as yet poorly defined, tumor-suppressive system. © 2001 Wiley-Liss, Inc. [source] Effects of flexible-dose fesoterodine on overactive bladder symptoms and treatment satisfaction: an open-label studyINTERNATIONAL JOURNAL OF CLINICAL PRACTICE, Issue 4 2009J.-J. Wyndaele Summary Aims:, To evaluate the efficacy and tolerability of flexible-dose fesoterodine in subjects with overactive bladder (OAB) who were dissatisfied with previous tolterodine treatment. Methods:, This was a 12-week, open-label, flexible-dose study of adults with OAB (, 8 micturitions and , 3 urgency episodes per 24 h) who had been treated with tolterodine (immediate- or extended-release) for OAB within 2 years of screening and reported dissatisfaction with tolterodine treatment. Subjects received fesoterodine 4 mg once daily for 4 weeks; thereafter, daily dosage was maintained at 4 mg or increased to 8 mg based on the subject's and physician's subjective assessment of efficacy and tolerability. Subjects completed 5-day diaries, the Patient Perception of Bladder Condition (PPBC) and the Overactive Bladder Questionnaire (OAB-q) at baseline and week 12 and rated treatment satisfaction at week 12 using the Treatment Satisfaction Question (TSQ). Safety and tolerability were assessed. Results:, Among 516 subjects treated, approximately 50% opted for dose escalation to 8 mg at week 4. Significant improvements from baseline to week 12 were observed in micturitions, urgency urinary incontinence episodes, micturition-related urgency episodes and severe micturition-related urgency episodes per 24 h (all p < 0.0001). Approximately 80% of subjects who responded to the TSQ at week 12 reported satisfaction with treatment; 38% reported being very satisfied. Using the PPBC, 83% of subjects reported improvement at week 12 with 59% reporting improvement , 2 points. Significant improvements from baseline (p < 0.0001) exceeding the minimally important difference (10 points) were observed in OAB-q Symptom Bother and Health-Related Quality of Life (HRQL) scales and all four HRQL domains. Dry mouth (23%) and constipation (5%) were the most common adverse events; no safety issues were identified. Conclusion:, Flexible-dose fesoterodine significantly improved OAB symptoms, HRQL, and rates of treatment satisfaction and was well tolerated in subjects with OAB who were dissatisfied with prior tolterodine therapy. [source] A CSOV study of the difference between HF and DFT intermolecular interaction energy values: The importance of the charge transfer contributionJOURNAL OF COMPUTATIONAL CHEMISTRY, Issue 10 2005Jean-Philip Piquemal Abstract Intermolecular interaction energy decompositions using the Constrained Space Orbital Variation (CSOV) method are carried out at the Hartree,Fock level on the one hand and using DFT with usual GGA functionals on the other for a number of model complexes to analyze the role of electron correlation in the intermolecular stabilization energy. In addition to the overall stabilization, the results provide information on the variation, with respect to the computational level, of the different contributions to the interaction energy. The complexes studied are the water linear dimer, the N -methylformamide dimer, the nucleic acid base pairs, the benzene,methane and benzene-N2 van der Waals complexes, [Cu+ -(ImH)3]2, where "ImH" stands for the Imidazole ligand, and ImH-Zn++. The variation of the frozen core energy (the sum of the intermolecular electrostatic energy and the Pauli repulsion energy) calculated from the unperturbed orbitals of the interacting entities indicates that the intramolecular correlation contributions can be stabilizing as well as destabilizing, and that general trends can be derived from the results obtained using usual density functionals. The most important difference between the values obtained from HF and DFT computations concerns the charge transfer contribution, which, in most cases, undergoes the largest increase. The physical meaning of these results is discussed. The present work gives reference calculations that might be used to parametrize new correlated molecular mechanics potentials. © 2005 Wiley Periodicals, Inc. J Comput Chem 26: 1052,1062, 2005 [source] Crack Healing Behavior of Silicon Carbide CeramicsJOURNAL OF THE AMERICAN CERAMIC SOCIETY, Issue 11 2000Jan Korou This study focuses on the crack healing behavior of three kinds of commercial SiC ceramics. Specimens with and without cracks were subjected to thermal treatment at different temperatures, and their strengths were measured by a three-point bending test in accordance with JIS standards. The tests were performed in air at both room temperature and elevated temperatures between 600° and 1500°C. The healed specimens showed a complete recovery of strength at room temperature for the investigated crack sizes of 2c, 100 ,m and 2c, 200 ,m, and their strength increased in accordance with the healing temperature. The behavior of the healed specimens at elevated temperatures was influenced by the material used and the test temperature. Generally, the strength decreased at a high temperature, but the degree of strength reduction was determined by the kind of ceramic. The most important difference between the healed and smooth specimens was exhibited in material A. It was observed that at 1400°C, the bending strength of the healed specimens made from this ceramic was about 37% of the value for specimens in an as-received state. Static fatigue tests were also performed for ceramic B at 900° and 1000°C. The experiment demonstrated that the static fatigue limit of a healed specimen is about 75% of the monotonic bending strength at the same temperature. [source] Measuring irritable bowel syndrome patient-reported outcomes with an abdominal pain numeric rating scaleALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 11-12 2009B. SPIEGEL Summary Background, Controversy exists on how to measure patient-reported outcomes in irritable bowel syndrome (IBS) clinical trials effectively. Pain numeric rating scales (NRS) are widely used in the non-IBS pain literature. The Food and Drug Administration has proposed using the NRS in IBS. Aim, To test the psychometrics of an abdominal pain NRS in IBS. Methods, We analysed data from a longitudinal cohort of Rome III IBS subjects. At entry, subjects completed a 10-point NRS, bowel symptoms, IBS severity measurements (IBS-SSS, FBDSI), health-related quality of life indices (IBS-QOL, EQ5D), and the Worker Productivity Activity Index (WPAI). We repeated assessments at 3 months along with a response scale to calculate the minimal clinically important difference. Results, There were 277 subjects (82% women; age = 42 ± 15) at baseline and 90 at 3 months. The NRS correlated cross-sectionally with IBS-SSS (r = 0.60; P < 0.0011), FBDSI (r = 0.49; P < 0.0001), IBS-QOL (r = 0.43; P < 0.0001), EQ5D (r = 0.48; P < 0.0001), presenteeism (r = 0.39; P < 0.0001), absenteeism (r = 0.17; P = 0.04) and distension (r = 0.46; P < 0.0001), but not stool frequency or form. The minimal clinically important difference was 2.2 points, correlating with a 29.5% reduction over time. Conclusions, An abdominal pain NRS exhibits excellent validity and can be readily interpreted with a minimal clinically important difference in patients with IBS. These data support the use of the NRS in IBS clinical trials. [source] Evaluation of the meaningfulness of health-related quality of life improvements as assessed by the SF-36 and the EQ-5D VAS in patients with active Crohn's diseaseALIMENTARY PHARMACOLOGY & THERAPEUTICS, Issue 9 2009G. COTEUR Summary Background, Crohn's disease (CD) is a chronic inflammatory illness characterized by episodic abdominal pain, diarrhoea, fever, bleeding and obstruction. While the Crohn's Disease Activity Index (CDAI) remains the most commonly accepted measure for assessing the disease status in clinical trials, patient-reported outcome (PRO) instruments are being utilized more frequently to provide information about health-related quality of life (HRQOL). To facilitate interpretation of results, it is common to identify a meaningful unit of PRO score change, such as a minimal clinically important difference (MCID). Aim, To define and apply MCID estimates for the SF-36 and EuroQol-5D visual analogue scale (EQ-5D VAS) for use in CD treatment evaluation. Methods, Data from two phase III randomized controlled trials of certolizumab pegol were utilized. MCID estimates were computed from one trial using anchor-based and distribution-based methods. These estimates were applied to data from the other trial. Results, SF-36 PCS and MCS MCID estimates ranged from 1.6 to 7.0 and 2.3 to 8.7 respectively, depending on approach. EQ-5D VAS MCID estimates ranged from 4.2 to 14.8. Conclusions, For the first time, the MCID values provided interpretation guidelines for PRO results in CD. This research demonstrates that patients treated with certolizumab pegol benefit from meaningful and sustained HRQOL improvements. [source] Recommendations for assessing Patient-Reported Outcomes and Health-Related quality of life in clinical trials on allergy: a GA2LEN taskforce position paperALLERGY, Issue 3 2010I. Baiardini To cite this article: Baiardini I, Bousquet PJ, Brzoza Z, Canonica GW, Compalati E, Fiocchi A, Fokkens W, van Wijk RG, La Grutta S, Lombardi C, Maurer M, Pinto AM, Ridolo E, Senna GE, Terreehorst I, Todo Bom A, Bousquet J, Zuberbier T, Braido F. Recommendations for assessing Patient-Reported Outcomes and Health-Related quality of life in clinical trials on allergy: a GA2LEN taskforce position paper. Allergy 2010; 65: 290,295. Abstract The aim of this Global Allergy and Asthma European Network (GA2LEN) consensus report is to provide recommendations for patient-reported outcomes (PROs) evaluation in clinical trials for allergic diseases, which constitute a global health problem in terms of physical, psychological economic and social impact. During the last 40 years, PROs have gained large consideration and use in the scientific community, to gain a better understanding of patients' subjective assessment with respect to elements concerning their health condition. They include all health-related reports coming from the patient, without involvement or interpretation by physician or others. PROs assessment should be performed by validated tools (disease-specific tools when available or generic ones) selected taking into account the aim of the study, the expected intervention effects and the determinant and confounding factors or patient-related factors which could influence PROs. Moreover, each tool should be used exclusively in the patient population following the authors' indications without modification and performing a cross-cultural validation if the tool must be used in a language that differs from the original. The result analysis also suggests that the relevance of PROs results in any interventional study should include a pre,post assessment providing information concerning statistical differences within or among groups, rates of response for the PROs and a minimal important difference for the population. The report underlines the importance of further investigation on some topics, such as the quality assessment of existing PROs tools, the definition of inclusion and exclusion criteria and a more extensive evaluation of the correlation between PROs, besides health-related quality of life, and clinical data. [source] Desloratadine relieves nasal congestion and improves quality-of-life in persistent allergic rhinitisALLERGY, Issue 11 2009K. Holmberg Background:, Symptoms of allergic rhinitis (AR), particularly nasal congestion, can impair quality-of-life (QoL). However, only a modest correlation exists between these symptoms and Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) scores, suggesting that both be evaluated for a complete assessment of health. Methods:, Subjects with a ,2-year history of moderate-to-severe AR to dust mite or cat dander were randomized to desloratadine 5 mg/day (n = 293) or placebo/day (n = 291) for 28 days. Primary endpoint was change from baseline in a.m./p.m. nasal congestion score. Secondary outcomes included change from baseline in total nasal symptom score, individual symptom scores and RQLQ scores (completed on days 1, 7, and 28). Results:, The Allergic Rhinitis and its Impact on Asthma criteria for persistent allergic rhinitis (PER) were fulfilled by 99% of subjects in the placebo arm. Between-treatment difference in a.m./p.m. nasal congestion score, observed from day 8 onward, significantly favored desloratadine (P = 0.0003). Desloratadine significantly improved a.m./p.m. nasal congestion and RQLQ scores after 1 week and at treatment end (P < 0.05). Improvements in 5 of 7 RQLQ domain scores exceeded the minimal important difference. On days 7 and 28, desloratadine was also significantly superior to placebo in mean change from baseline in a.m./p.m. total nasal symptom score and rhinorrhea score (both P , 0.01). Symptomatic benefit was primarily driven by improvement in nasal congestion and rhinorrhea. Conclusions:, Desloratadine 5 mg/day significantly improved symptoms associated with PER, including nasal congestion, and provided significant improvement in QoL after 1 week of treatment. [source] Enterohaemorrhagic and enteropathogenic Escherichia coli use a different Tir-based mechanism for pedestal formationMOLECULAR MICROBIOLOGY, Issue 6 2001Rebekah DeVinney Enterohaemorrhagic Escherichia coli (EHEC) adheres to the host intestinal epithelium, resulting in the formation of actin pedestals beneath adhering bacteria. EHEC and a related pathogen, enteropathogenic E. coli (EPEC), insert a bacterial receptor, Tir, into the host plasma membrane, which is required for pedestal formation. An important difference between EPEC and EHEC Tir is that EPEC but not EHEC Tir is tyrosine phosphorylated once delivered into the host. In this study, we assessed the role of Tir tyrosine phosphorylation in pedestal formation by EPEC and EHEC. In EPEC, pedestal formation is absolutely dependent on Tir tyrosine phosphorylation and is not complemented by EHEC Tir. The protein sequence surrounding EPEC Tir tyrosine 474 is critical for Tir tyrosine phosphorylation and pedestal formation by EPEC. In contrast, Tir tyrosine phosphorylation is not required for pedestal formation by EHEC. EHEC forms pedestals with both wild-type EPEC Tir and the non-tyrosine-phosphorylatable EPEC Tir Y474F. Pedestal formation by EHEC requires the type III delivery of additional EHEC factors into the host cell. These findings highlight differences in the mechanisms of pedestal formation by these closely related pathogens and indicate that EPEC and EHEC modulate different signalling pathways to affect the host actin cytoskeleton. [source] Are Concepts Mental Representations or Abstracta?PHILOSOPHY AND PHENOMENOLOGICAL RESEARCH, Issue 1 2004JONATHAN SUTTON I argue that thoughts and concepts are mental representations rather than abstracta. I propose that the most important difference between the two views is that the mentalist believes that there are concept and thought tokens as well as types; this reveals that the dispute is not terminological but ontological. I proceed to offer an argument for mental-ism. The key step is to establish that concepts and thoughts have lexical as well as semantic properties. I then show that this entails that concepts and thoughts are susceptible to the type/token distinction. I finish by considering some objections to the argument. [source] Photodynamic effect of hypericin in primary cultures of human umbilical endothelial cells and glioma cell linesPHYTOTHERAPY RESEARCH, Issue 6 2009Viktória Stupáková Abstract Hypericin is the most powerful naturally occurring photosensitizer and as such there is renaissant interest in the potentials of this compound for anticancer photodynamic therapy (PDT). The purpose of this study was to investigate the hypericin-mediated photodynamic therapy effects on normal human umbilical endothelial cells (HUVECs) in comparison with cancer human glioma cell lines U-87 MG and U-373 MG, in in vitro conditions. The data suggest that endothelial cells as well as glioma cell lines are sensitive only to photoactivated hypericin. The inhibitory effects of photoactivated hypericin did not differ in endothelial compared with tumor cells in cytotoxicity MTT and DNA fragmentation assays. However, an important difference in sensitivity was found between the above mentioned cell types in migration and metalloproteinases inhibition assays performed as cell function tests. The findings in both function tests were supported by the high sensitivity of endothelial cells in an additional angiogenesis test of tubular formation in vitro. Copyright © 2009 John Wiley & Sons, Ltd. [source] New design of actuator using shear piezoelectricity of a chiral polymer, and prototype devicePOLYMER INTERNATIONAL, Issue 3 2010Michiya Sawano Abstract Chiral polymers have been known to exhibit small shear piezoelectricity for about fifty years. However, recently, we reported that poly(L -lactic acid) treated with supercritical carbon dioxide (sc-PLLA), which is a type of chiral polymer, exhibits much higher shear piezoelectricity than other chiral polymers. On the other hand, we found an important difference between motion due to shear piezoelectricity and that due to tensile piezoelectricity in piezoelectric materials through computer simulations. On the basis of these results, we fabricated a new type of electrically controlled tweezers constructed from a pair of sc-PLLA sheets with shear piezoelectricity. In general, when conventional tweezers open to the left and right, the trajectory of their motion becomes fanlike at the center of the connection (one end of the tweezers). In the new tweezers, the two small sheets making up the tweezers open parallel to each other, without the motion of parts near the connection. Moreover, a prototype ,finger' system using sc-PLLA sheets to realize complex motion in which the finger curled upon stretching of the sc-PLLA sheets was manufactured as a trial device. Using the prototype finger system, we demonstrated the firm grasping of a sample, but the sample could not be removed from a vessel. Thus, sc-PLLA increases the likelihood of realizing a device with highly operational pick-up in a very small region by using the shear piezoelectricity of a chiral polymer. Copyright © 2010 Society of Chemical Industry [source] Mammary Gland Architecture as a Determining Factor in the Susceptibility of the Human Breast to CancerTHE BREAST JOURNAL, Issue 5 2001Jose Russo MD The developmental pattern of the breast can be assessed by determining the composition of the breast in specific lobular structures, which are designated as lobules type 1 (Lob 1), lobules type 2 (Lob 2), and lobules type 3 (Lob 3), with Lob 1 being the less developed and Lob 3 being the most differentiated or with the highest number of ductules per lobular unit. In the present work, the patient population consisted of three groups of women who underwent surgical procedures: The first group included women who underwent reduction mammoplasty (RM) for cosmetic reasons. The second group included women who underwent prophylactic subcutaneous mastectomy after genetic counseling for either carrying the BRCA-1 gene or belonging to a pedigree with familial breast cancer (FAM), and the third group included women who underwent modified radical mastectomy (MRM) for the diagnosis of invasive carcinoma. The RM group consisted of 33 women, of whom 9 were nulliparous and 24 were parous. The FAM group consisted of 17 women, of whom 8 were nulliparous and 9 were parous. The MRM group consisted of 43 women, of whom 7 were nulliparous and 36 were parous. The analysis of the lobular composition of all of the samples from the RM group, which is considered the control group, revealed that Lob 1 represented 22%, Lob 2 represented 37%, and Lob 3 represented 38%, whereas the tissue examined from the FAM and MRM groups contained a preponderance of Lob 1 at 48% and 74%, respectively, over Lob 3, which was 10% and 3%, respectively. When the results of the analysis of breast tissue were separated according to the pregnancy history of the donor, it was found that in the control group or RM, there was a significant difference in lobular composition. Nulliparous women of the RM group showed a preponderance of Lob 1 (46%) over parous women, which contained only 17%, whereas the percentage of Lob 3 in the nulliparous group was significantly lower (7%) than the parous group (48%). In the breast tissues obtained from FAM and MRM, no significant differences in lobular composition were observed, as all of the samples contained a higher concentration of Lob 1, independent of the pregnancy history. The breast tissue of FAM and MRM of parous women had a developmental pattern that was similar to that of nulliparous women of the same group and that was less developed than the breast of parous women of the control group. An important difference between the Lob 1 of the FAM group versus the control (RM) and the MRM group was that most of these lobules had thin ductules with an increase in hyalinization of the intralobular stroma manifested in the whole-mount preparation as an alteration in the branching pattern. The data suggest that the breast tissue of women with invasive cancer, as well as those from a background of familial breast cancer, have an architectural pattern different from the control or normal tissues and that the BRCA-1 or related genes may have a functional role in the branching pattern of the breast during lobular development, mainly in the epithelial stroma interaction. [source] Methods to Determine the Minimum Important Difference for a Sexual Event Diary Used by Postmenopausal Women with Hypoactive Sexual Desire DisorderTHE JOURNAL OF SEXUAL MEDICINE, Issue 5 2007Tara Symonds PhD ABSTRACT Introduction., Recently, there has been much discussion in the literature about how to determine the meaningfulness of results generated from a patient-reported outcome measure. A number of reviews have shown that there are two main approaches: anchor- and distribution-based approaches for determining the minimum important difference (MID) for a new measure. There are issues with calculating an MID using each method: Will the two approaches give the same estimate? If the estimates differ, how do you decide on one estimate? Would asking patients directly be more beneficial? Aim., A case study was presented to address these issues based on a newly developed diary assessing number of satisfactory sexual events (SSEs) per week in women with hypoactive sexual desire disorder (HSDD). Methods., Anchor- and distribution-based estimates were generated from data gathered in two double-blind, placebo-controlled, parallel group trials for the treatment of HSDD (N = 788). A novel interview study was used to ask women directly about an MID for SSEs (N = 77). Main Outcome Measures., Defining the MID for an SSE diary in women with HSDD. Results., The estimates varied, producing a range of mean MID estimates between 0.04 and 0.46 SSEs per week. Conclusion., We recommend that rather than defining the MID, a range should be selected from the set of estimates formed by the limits of the 95% confidence intervals. Symonds T, Spino C, Sisson M, Soni P, Martin M, Gunter L, and Patrick DL. Methods to determine the minimum important difference for a sexual event diary used by postmenopausal women with hypoactive sexual desire disorder. J Sex Med 2007;4;1328,1335. [source] DID THE MARKET-CLEARING POSTULATE PRE-EXIST NEW CLASSICAL ECONOMICS?THE MANCHESTER SCHOOL, Issue 3 2007THE CASE OF MARSHALLIAN THEORY Have new classicists invented market clearing or have they just rehabilitated it? This is the question addressed in the present paper. It is generally agreed that market clearing underpins Walrasian theory, so my exploration is limited to the question of whether this is also true for Marshallian theory. I will claim that this is broadly the case: once Marshallian theory is properly reconstructed, it exhibits market clearing as a constantly present result. Still, an important difference between market clearing ŕ la Walras and market clearing ŕ la Marshall exists: in the former market clearing is equilibrium, while in the latter market clearing can coexist with disequilibrium. Next, I investigate whether my conclusion extends to the labour market. Again the conclusion reached is affirmative both for Marshall's theory and for present-day Marshallian models. As to the latter, I take Friedman's Phillips curve model as a case study. I show that this is a market-clearing model in which, strictly speaking, there is no place for the concept of unemployment,quite an ironical result for the paper that introduced the notion of the natural rate of unemployment! [source] | |||||||||||||||||||||||||||||||||||||||||||||||||