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Objective Evaluation (objective + evaluation)
Selected AbstractsCutting Torque Measurements in Conjunction with Implant Placement in Grafted and Nongrafted Maxillas as an Objective Evaluation of Bone Density: A Possible Method for Identifying Early Implant Failures?CLINICAL IMPLANT DENTISTRY AND RELATED RESEARCH, Issue 1 2004Björn Johansson DDS ABSTRACT Background: Bone grafts are frequently used to enable the placement of dental implants in atrophied jaws. The biomechanical properties of bone grafts used in one- or two-stage implant procedures (in comparison with the use of nongrafted bone) are not well known. Purpose: The purpose of this study was (1) to measure cutting torques during the placement of self-tapping dental implants in nongrafted bone and in bone grafts, either as blocks or in a milled particulate form, in patients undergoing implant treatment in an edentulous maxilla and (2) to identify implants with reduced initial stability and to correlate these findings with a clinical classification of jawbone quality. Materials and Methods: The study included 40 consecutive patients with edentulous maxillas, 27 of whom were subjected to bone grafting prior to or in conjunction with implant placement (grafting group) and 13 of whom received implants without grafting (nongrafted group). Grafted bone from the iliac crest bone was used (1) as onlay blocks, (2) as maxillary sinus inlay blocks, or (3) in particulate form in the maxillary sinus. Implants were placed after 6 to 7 months of healing, except in the maxillary sinus inlay blocks, where implants were placed simultaneously. Cutting torque values were obtained from 113 grafted implant sites and from 109 nongrafted implant sites. Results: Significantly lower cutting torque values were assessed in grafted regions than in nongrafted regions, irrespective of grafting technique. Lower values were also seen for implants placed in block grafts after 6 months when compared to other grafting techniques used. The cutting torque values revealed an inverse linear relation to the Lekholm and Zarb bone quality index. Conclusion: The cutting torque values correlated well with the Lekholm and Zarb index of bone quality. Significantly lower cutting torque values were seen in grafted bone than in nongrafted bone. [source] McGill Pain Questionnaire: A multi-dimensional verbal scale assessing postoperative changes in pain symptoms associated with severe endometriosisJOURNAL OF OBSTETRICS AND GYNAECOLOGY RESEARCH (ELECTRONIC), Issue 4 2009Elena Fabbri Abstract Background:, Objective evaluation of pelvic pain symptoms using a standard pain questionnaire is essential to assessing the treatment of endometriosis and related pain. Aim:, To evaluate the McGill Pain Questionnaire (MPQ) as a multi-dimensional verbal scale in providing information about chronic pelvic pain associated with endometriosis, before and after laparoscopic surgery. Methods:, Fifty-five women undergoing laparoscopy for severe endometriosis were asked to complete the MPQ before surgery and at the 6-month follow up. All patients presented with preoperative pain symptoms of variable severity. We obtained the pain indexes and studied their relation with: patients' characteristics (age, body mass index, parity, qualification, occupation); operative findings (number, site and size of endometriotic lesions and presence of pelvic adhesions); and postoperative evolution of variable MPQ pain indexes at the 6-month follow up. Results:, Median present pain index (PPI) (index of pain intensity), before surgical treatment was 3 (2,4): preoperative PPI was <2 in 25% of patients while 25% of patients had PPI > 4. Overall median PPI after surgical treatment was 1 (0,2): postoperative index of pain intensity was <1 in 50% of patients, >2 in 25% of patients while 25% of patients did not experience postoperative pain. Overall pain intensity significantly decreased after laparoscopic treatment of endometriosis (Wilcoxon test P < 0.0005). None of the patients' characteristics were found to be significantly correlated with the severity or improvement of preoperative pain at postoperative follow up (P > 0.05), and the intensity of preoperative pain was not correlated to any of the operative variables. There was a significant reduction in all individual MPQ pain indexes; however 18.2% of women did not show improvement of pain symptoms after laparoscopic surgery. An increasing endometrioma diameter was associated with a significant decrease in the difference in evaluative rank score of pain rating index between pain indexes at the 6-month follow up and preoperatively (P = 0.04, Spearman's rank correlation Rho = ,0.277). Conclusions:, MPQ appears to be useful as a multi-dimensional scale in describing patients' pain semiology and evaluating pain evolution after surgical treatment. However, due to the extreme variability of pain experience, MPQ results don't clarify the relationship between pain intensity and the severity of endometriosis. [source] 3D In-Vivo Optical Skin Imaging for Topographical Quantitative Assessment of Non-Ablative Laser TechnologyDERMATOLOGIC SURGERY, Issue 3 2002Paul M. Friedman MD background. A new method for treating facial rhytides and acne scars with nonablative laser and light source techniques has recently been introduced. Given the inherent limitations of photographic and clinical evaluation to assess subtle changes in rhytides and surface topography, a new noninvasive objective assessment is required to accurately assess the outcomes of these procedures. objective. The purpose of this study was to measure and objectively quantify facial skin using a novel, noninvasive, In-vivo method for assessing three-dimensional topography. This device was used to quantify the efficacy of five treatment sessions with the 1064 nm QS Nd:YAG laser for rhytides and acne scarring, for up to six months following laser treatment. methods. Two subjects undergoing facial rejuvenation procedures were analyzed before and after therapy using a 30-mm, three-dimensional microtopography imaging system (PRIMOS, GFM, Teltow, Germany). The imaging system projects light on to a specific surface of the skin using a Digital Micromirror Device (DMDÔ Texas Instruments, Irving, TX) and records the image with a CCD camera. Skin Surface microtopography is reconstructed using temporal phase shift algorithms to generate three-dimensional images. Measurements were taken at baseline, at various times during the treatment protocol, and then at three and six-month follow-up visits. Silicone skin replicas (FLEXICO, Herts, England) were also made before and after the laser treatment protocol for comparison to In-vivo acquisition. results. Skin roughness decreased by 11% from baseline after three treatment sessions in the wrinkles subject, while a 26% improvement of skin roughness was recorded by 3D In-vivo assessment six months following the fifth treatment session. The subject with acne scarring demonstrated a 33% decrease in roughness analysis after three treatment sessions by 3D In-vivo assessment. A 61% improvement in surface topography was recorded 3-months following the fifth treatment session, which was maintained at the 6-month follow-up. conclusion. Three-dimensional In-vivo optical skin imaging provided a rapid and quantitative assessment of surface topography and facial fine lines following multiple treatment sessions with a 1064-nm QS Nd:YAG laser, correlating with clinical and subjective responses. This imaging technique provided objective verification and technical understanding of nonablative laser technology. Wrinkle depth and skin roughness decreased at the three and six-month follow-up evaluations by 3D In-vivo assessment, indicating ongoing dermal collagen remodeling after the laser treatment protocol. Future applications may include comparison of nonablative laser technology, optimization of treatment regimens, and objective evaluation of other aesthetic procedures performed by dermatologists. [source] Outcomes of surgical treatment of intrathoracic stomachDISEASES OF THE ESOPHAGUS, Issue 3 2009F. Yano SUMMARY The purpose of this study is to assess the long-term outcomes after surgical repair of intrathoracic stomach. Prospectively collected data was retrospectively reviewed. Patients underwent a phone questionnaire 1 year postoperatively to assess gastroesophageal reflux disease-related symptoms and surgical satisfaction. In addition, objective evaluation for integrity of hiatal hernia repair was undertaken either by esophagram or endoscopy. Any recurrence was considered a failure. Forty-one patients underwent surgical repair of a large paraesophageal hernia with intrathoracic stomach during the study period. Thirty-four patients underwent a laparoscopic repair, and seven patients underwent a transthoracic repair. An antireflux procedure was performed on 28 patients, and 13 patients had only hernia reduction and hiatal closure. In the laparoscopic group, two patients required conversion to open laparotomy, as one was unable to tolerate the pneumoperitoneum, and the other had mediastinal bleeding. Thirty-eight (93%) were available for 1-year follow-up. There were three (7.8%) recurrences, one requiring emergency transabdominal repair, and the other two being asymptomatic 1-cm recurrences. All patients report a high degree of satisfaction with surgery. There is a high incidence of short esophagus in patients with intrathoracic stomach. The surgical repair is safe and durable, with high patient satisfaction at 1-year follow-up. [source] Lumbosacral spinal cord somatosensory evoked potentials for quantification of nociception in horsesEQUINE VETERINARY JOURNAL, Issue 3 2010J. P. A. M. Van LOON Summary Reasons for performing study: There is a need for objective evaluation and quantification of the efficacy of analgesic drugs and analgesic techniques in horses. Objectives: To determine whether lumbosacral spinal cord somatosensory evoked potentials (SSEP) can be a useful and reliable tool to assess nociception in equines. Methods: SSEPs and electromyograms (EMG) from the epaxial muscles were recorded simultaneously, following electrical stimulation applied to the distal hindlimb in lightly anaesthetised Shetland ponies (n = 7). In order to validate the model, the effect of increasing stimulus intensity was documented and the conduction velocities (CV) of the stimulated nerves were calculated. The effect of epidurally applied methadone (0.4 mg/kg bwt) in a randomised, crossover design was investigated. Results: Two distinct complexes (N1P1 and N2P2) were identified in the SSEP waveform. Based on their latency and conduction velocity and the depressant effect of epidurally applied methadone, the SSEP N2P2 was ascribed to nociceptive A,-afferent stimulation. The SSEP N1P1 originated from non-nociceptive A,-afferent stimulation and was not influenced by epidurally applied methadone. Conclusions and potential relevance: The nociceptive A, component of the SSEP, the N2P2 complex, is presented as a valid and quantitative parameter of spinal nociceptive processing in the horse. Validation of the equine SSEP model enables the analgesic effects of new analgesics/analgesic techniques to be quantified and analgesia protocols for caudal epidural analgesia in equidae improved. [source] Objective determination of fatigue development following sun exposure using Advanced Trail Making TestINTERNATIONAL JOURNAL OF COSMETIC SCIENCE, Issue 1 2004T. Horikoshi Synopsis Sun exposure during leisure activity evokes fatigue. We employed the Advanced Trail Making Test (ATMT), a recently developed objective method of evaluating brain function performance used to measure mental fatigue, for objective determination of fatigue development caused by solar exposure to the human body. First, a survey of consumer awareness was performed, and fatigue development from solar exposure was generally recognized in both summer and spring. In the field test, 15 males (26,41 years old) received sun exposure equivalent to 100 kJ m,2 of ultraviolet radiation three to four times each day for 3 days, during which the subjects wore a short sleeve shirt and a short pant, and covered their head with a towel. A significant increase in scores for subjective sense of fatigue was observed in the evening of all 3 days following sun exposure and on the fourth day, which had no exposure, as well as in the morning of the third and fourth days, as compared with those periods during the control week, which did not have experimental solar exposure. ATMT showed a significant increase in average value in the evening of the first and second days following sun exposure, as well as in the morning of the third and fourth days. In addition, increases in body temperature and heart rate were observed during the exposure periods. The results of multiple regression analysis of subjective feelings showed that fatigue caused by solar exposure was qualitatively different from that in the control week. These results suggest that brain function performance declined following solar exposure as did fatigue development. ATMT results may be useful for quantitative and objective evaluation of mental fatigue caused by sun exposure, along with development of sun care products for the prevention of solar-caused fatigue. Résumé L'exposition au soleil pendant les activités de loisir provoque la fatigue. Nous avons utilisé la méthode ,Advanced Trail Making Test (ATMT)', une méthode d'évaluation objective de la faculté du fonctionnement du cerveau, récemment développée pour mesurer la fatigue mentale, dans le but de déterminer objectivement le processus de la fatigue du corps humain causée par l'exposition au soleil. Premièrement, nous avons mené un sondage sur la conscience du consommateur, et une évolution de la fatigue venant de l'exposition au soleil a été notée dans l'ensemble au printemps et en été. Lors des expériences sur le terrain, 15 sujets mâles (de 26 à 41 ans) ont été exposés au soleil, 3 à 4 fois par jour, pendant 3 jours. L'exposition était égale à 100 kJ m,2 de radiation ultraviolette. Pendant ces 3 jours, les sujets étaient vêtus d'une chemize à manches courtes et d'un pantalon court, et avaient la tête couverte d'une serviette. Nous avons observé une augmentation considérable du score représentant la sensation subjective de fatigue le soir des 3 jours suivant l'exposition au soleil, et le soir du quatrième jour, sans exposition, de même que le matin des troisième et quatrième jours, en comparaison avec les mêmes périodes de la semaine de contrôle, sans exposition expérimentale au soleil. Les résultats du test de l'ATMT ont montré une augmentation considérable de la valeur moyenne le soir des premier et second jours suivant l'exposition au soleil, aussi bien que le matin des troisième et quatrième jours. De plus, nous avons observé une augmentation de la température du corps et du pouls pendant les moments d'exposition. L'analyse de régression multiple des résultats de la sensation subjective a montré que la fatigue causée par l'exposition était qualitativement différente que celle de la semaine de contrôle. Ces résultats suggèrent que la faculté de fonctionnement du cerveau baisse après l'exposition au soleil, comme le fait la fatigue. Les résultats de l'ATMT peuvent être utiles pour l'évaluation quantitative et objective de la fatigue mentale causée par l'exposition au soleil, ceci allant de pair avec le développement des produits de soin contre le soleil pour la prévention de la fatigue causée par le soleil. [source] The DSM-IV ,minor depression' disorder in the oldest-old: prevalence rate, sleep patterns, memory function and quality of life in elderly people of Italian descent in Southern BrazilINTERNATIONAL JOURNAL OF GERIATRIC PSYCHIATRY, Issue 2 2002Flávio M. F. Xavier Abstract Objectives (1) To describe the prevalence of minor depression in a community-dwelling population aged 80 years and over. (2) To compare the sleep pattern, memory function and the prevalence rate of other psychiatric diagnoses between normal controls and subjects with minor depressive disorder. Design A random representative sample (sample,=,77 subjects/county population of oldest-old,=,219,35%) aged 80 years or more was selected from the county of Veranópolis in the Brazilian rural southern region. Of this group, eight subjects who met the DSM-IV criteria for minor depression, and 50 subjects without diagnosed delirium disorder, cognitive or affective problems were compared. Results The prevalence rate of minor depression was 12%. Subjects with this diagnosis were more likely to complain about sleep and memory problems than elderly people without any other affective disorder (major depression or dysthymic disorder). Otherwise, objective evaluation of these two areas, memory and sleep, did not show differences between the groups. Moreover, in terms of factors such as life satisfaction and some domains from the Short-form 36 Quality of Life Scale (SF-36), subjects with minor depression presented worse self-reported evaluations. Female gender was associated (p,=,0.01) with a more frequent presence of minor depression disorder, and those with this diagnosis were more likely to have co-morbidity with generalized anxiety disorder (p,=,0.007) when compared with elderly people without any depressive disorder. Conclusion In this study, minor depression has been significantly associated with lower life satisfaction and worse indexes of life quality. The results supported the current concept that minor depression is prevalent in later life, especially among the oldest-old. Subjects with minor depression had worse self-reported opinions about memory and sleep patterns, but when these variables were objectively measured, no meaningful differences could be determined by the research team. Female gender and the concurring presence of generalized anxiety disorder were both significantly associated with the presence of minor depression diagnosis. Copyright © 2002 John Wiley & Sons, Ltd. [source] Diversity in five goat populations of the Lombardy Alps: comparison of estimates obtained from morphometric traits and molecular markersJOURNAL OF ANIMAL BREEDING AND GENETICS, Issue 3 2001P. Crepaldi Phenotypic and genetic variability were studied within and between the goat populations of Bionda dell'Adamello, Frisa, Orobica, Verzaschese and Val di Livo. These are populations reared for most of the year on pastures of the Lombardy Alps, numbering a minimum of 1000 and a maximum of 8000 individuals per breed. The first four are standardized breeds of recent formation; at present they are supported by the European Union measures for the conservation of rare breeds. On the basis of its visible genetic profile the Val di Livo goat may be classified as a primary population. Phenotypic variability was estimated on the basis of six somatic measurements on 60,140 adult goats per breed, whereas genetic variation was measured on the basis of 201 AFLP loci. The partition of the total molecular variation into the within and between breed components indicates that the majority of the molecular variability is conserved within populations, whereas only 8.8% can be attributed to between population variation. Morphometric and molecular marker data produced unrelated distance values and different topology of UPGMA clusters. It may be hypothesized that the morphometric originality of the Val di Livo goat is mostly determined by environmental factors and selection pressure rather than by different origin and genome evolution. Conversely Orobica seems to have diverged from the other breeds at the genome level, which may be explained by an undocumented Southern Italian origin. An objective evaluation of conservation priorities may in the near future be based on the integrated use of molecular markers and of information on quantitative traits and allelic variation with adaptive relevance. Diversité dans cinq populations de chèvres des Alpes lombardes: comparaisons entre estmations obtenues par des mesures somatiques et par des marqueurs moléculaires On a etudié la variabilité phénotypique et génétique entre et parmi les populations de chèvres Bionda dell'Adamello, Frisa, Orobica, Verzaschese et Val di Livo. Il s'agit de populations qui content entre 1000 et 8000 sujets, elevés pour la plus part de l'année sur les pâturages des Alpes de Lombardie. Les quatre premières, actuellement sauvegardées par des mesures communautaires, sont des races à standard recemment constituées. La chèvre de la Val di Livo peut être rangée parmi les races primaires. La diversité phénotypique a été montrée par un dendrogramme obtenus des distances euclidiennes calculées à partir de six mesures somatiques qui avaient été prises sur 60,140 chèvres adultes pour chaque race. La diversité génétique a été montrée par un dendrogramme bâti sur la matrice des distances de Nei obtenues des 201 marqueurs moléculaires AFLP, produits par 7 combinaisons de primers, sur 30 sujets pour chaque race. La décomposition de la variabilité génétique totale estimée par les données moléculaires a montré que la plus part de la variabilité est conservée parmi la population, tandis que seulement l,8,8% peut être imputé aux différences entre populations. Les données moléculaires et somatiques ont donné lieu à des distances qui ne sont pas corrélées et à des cluster avec une topologie nettement différente. La comparaison entre les deux approches permet d'avancer l'hypothèse que l'originalité somatique de la chèvre de la Val di Livo pourrait être due à des facteurs d'environnement et/ou à la pression de sélection plutôt qu'à des facteurs liés à l'évolution du genome. Au contraire ces derniers seraient responsables de l'originalité génétique de la race Orobica et confirmeraient des témoignages orals non documentés. Un choix objectif des ressources génétiques qui méritent d'être conservées pourra probablement se baser sur l'employ conjoint des marqueurs et de renseignements sur les caractères quantitatifs et sur les variantes alléliques des gènes qui ont une valeur adaptative. Diversität in fünf Ziegenpopulationen der lombardischen Alpen: Vergleich von Schätzungen auf der Basis morphologischer Eigenschaften und molekularer Marker Es wurden die phänotypische und genetische Variabilität innerhalb und zwischen Bionda dell'Adamello, Frisa, Orobica, Verzaschese und Val di Livo Ziegenpopulationen untersucht. Diese Populationen, mit Größen zwischen 1000 und 8000 Tieren, werden den größten Teil des Jahres auf Weiden der lombardischen Alpen gehalten. Die vier erstgenannten Populationen sind erst kürzlich standardisierte Rassen; gegenwärtig werden sie mit EU-Mitteln für die Erhaltung seltener Rassen, unterstützt. Auf der Basis des erkennbaren genetischen Profils muß die Rasse Val di Livo als eine Primärpopulation eingeordnet werden. Phänotypische Variabilität wurde auf der Basis von sechs Körpermaßen an 60,140 ausgewachsenen Ziegen je Rasse geschätzt, die genetische Variation wurde auf der Basis von 201 AFLP-Loci gemessen. Die Aufteilung der gesamten molekularen Varianz in Varianzkomponenten innerhalb und zwischen Populationen zeigt, daß der größte Teil der molekularen Variabilität innerhalb der Populationen auftritt, und nur 8,8% der Gesamtvarianz auf die Varianz zwischen den Populationen entfällt. Morphologische und molekulare Marker erzeugten unabhängige Distanzwerte und unterschiedliche upgma-Cluster. Es kann die Hypothese aufgestellt werden, daß die morphologische Einzigartigkeit der Val di Livo Ziege stärker auf Umwelteffekte und Selektionsdruck als auf eine unterschiedliche Herkunft oder genomische Evolution zurückzuführen ist. Dagegen scheint Orobica auf Genomebene von den anderen Rassen abzuweichen, was durch einen nicht dokumentierten süditalienischen Ursprung erklärt werden könnte. Eine objektive Bewertung von Prioritäten für Konservierungsmaßnahmen dürfte in Zukunft auf einen integrierten Gebrauch molekularer Marker, Informationen über quantitative Merkmale sowie der genetischen Variation bezüglich der Adaptationsfähigkeit basieren. [source] Introduction to a culture, process, and philosophyJOURNAL OF HEALTHCARE RISK MANAGEMENT, Issue 4 2010CPHRM, DFASHRM, MT(ASCP), Robert F. Bunting Jr. MSA Patient- and family-centered care is not a new concept, but it has garnered increased interest and support during the last decade. While most healthcare providers are excellent at providing clinical care, the practice of addressing the myriad other patient and family needs requires a conscious and collaborative effort. Though the staff of hospitals and other patient settings across the country have achieved various degrees of successful implementation of patient- and family-centered care initiatives, the success has not been universal. An objective evaluation of patient- and family-centered initiatives is needed. However, underdeveloped evaluation processes should not prevent the implementation of best practices that already have shown demonstrable success. [source] The development and pilot evaluation of a nutrition education intervention programme for pregnant teenage women (food for life)JOURNAL OF HUMAN NUTRITION & DIETETICS, Issue 2 2003W. L. Wrieden Abstract Background A healthy diet in pregnancy is important for both maternal and infant health but this may be difficult to achieve particularly for groups such as teenage pregnant women, many of whom are from disadvantaged backgrounds. To our knowledge this is the first report of a practical nutrition education programme for this group in the UK. Method An intervention was designed incorporating seven informal food preparation sessions, which allowed opportunities for discussion of nutritional, and other topics (e.g. food safety and well-being in pregnancy). Midwives in a community centre setting led the sessions. The acceptability of the package to participants and midwives was recorded and pre- and post-intervention data collected on sociodemographic details, dietary intake (using an eating-habits questionnaire and a 24-h dietary recall) and cooking skills. Results The midwives found the package easy to follow and use. The 16 (of the 120 invited) women who attended found the courses helpful but objective evaluation of dietary intake was not possible because of poor compliance. Conclusions The nutrition education programme was favourably received by midwives and the women who participated. However recruitment was problematic and alternative methods of delivering and evaluating such a package should be investigated. [source] Excessive daytime sleepiness in patients suffering from different levels of obstructive sleep apnoea syndromeJOURNAL OF SLEEP RESEARCH, Issue 3 2000Sauter Excessive daytime sleepiness (EDS) is a frequent symptom of patients with obstructive sleep apnoea (OSA). EDS is a high-risk factor for accidents at work and on the road. Thirty untreated patients with different levels of severity of OSA were studied concerning night sleep and EDS. The criterion for severity was the respiratory disturbance index (RDI): 15 patients were classified as ,moderately' apnoeic (RDI < 40), 15 as ,severely' apnoeic (RDI > 40). Following night-time polysomnography, objective and subjective aspects of EDS were studied. To assess objective EDS the Maintenance of Wakefulness Test (MWT) and a computer-based vigilance performance test were used. Subjective EDS was determined using the Stanford Sleepiness Scale (SSS), the Epworth Sleepiness Scale (ESS) and the Visual Analogue Scales for Performance (VAS-P) and Tiredness (VAS-T). Well-being was assessed using the Scale of Well-Being by von Zerssen (Bf-S/Bf-S,). Severe apnoea patients spent more time in stage 1 and less in slow-wave sleep. MWT latencies tended to be shorter in the severe apnoea group. Vigilance testing revealed no group differences. Patients with moderate apnoea described themselves as more impaired in all subjective scales, but only SSS scores reached statistical significance. Our results suggest that there is no simple correlation between polysomnographic and respiratory sleep variables at night on the one hand, and the extent of EDS on the other hand. Furthermore, subjective and objective evaluation of EDS does not yield the same results. New approaches which allow a more detailed analysis of night sleep and daytime function are required to identify high-risked patients. [source] Instrumental measurement of orange juice colour: a reviewJOURNAL OF THE SCIENCE OF FOOD AND AGRICULTURE, Issue 6 2005Antonio Jesús Meléndez-Martínez Abstract Colour of orange juice is provided by carotenoids, which belong to one of the main classes of natural pigments, although the colour of particular orange varieties, blood oranges, is mainly due to anthocyanins. Colour of food influences consumers' preferences. For orange juices, some studies have revealed that the colour of citrus beverages in general is related to the consumer's perception of the quality of these products. The USA attaches great importance to the objective evaluation of orange juice colour, to the point that this attribute is evaluated for the commercial classification of the product on the basis of its quality. Apart from the importance of orange juice colour in relation to the quality of the product, it is important to accurately measure this parameter since it has been demonstrated that colour measurements can be used to estimate the carotenoid content rapidly for quality control purposes. Owing to this factors, several techniques and instruments have been developed over the years. This review assesses these methods and the results gained from them. Copyright © 2005 Society of Chemical Industry [source] A comparison of learning outcomes and attitudes in student- versus faculty-led problem-based learning: an experimental studyMEDICAL EDUCATION, Issue 1 2000David J Steele Objectives To compare learning outcomes and perceptions of facilitator behaviours and small-group process in problem-based learning (PBL) groups led by students and those led by faculty. Design A prospective, Latin-square cross-over design was employed. Second-year medical students participated in 11 PBL cases over the course of the academic year. For each case, half the student groups were led by faculty and the other half by a student group member selected randomly to serve in the facilitator role. Learning outcomes were assessed by performance on objective examinations covering factual materials pertinent to the case. Perceptions of facilitator behaviours and of group functioning were assessed with a questionnaire completed at the end of each individual case. Focus-group discussions were held to gain more in-depth information about student perceptions and experience. Student-led sessions were observed at random by the investigators. Setting A state-supported, US medical school with a hybrid lecture-based and problem-based curriculum. Subjects One hundred and twenty-seven second-year medical students and 30 basic science and clinical faculty. Results No differences were detected in student performance on the objective evaluation based on whether the facilitator was a faculty member or peer group member, nor were there any differences in the perceptions of group process. Students gave peer facilitators slightly higher ratings in the second semester of the experiment. In the focus-group discussions, students voiced a general preference for student-led groups because they felt they were more efficient. Observation and focus-group reports suggest that groups led by students sometimes took short cuts in the PBL process. Conclusion In a hybrid lecture- and PBL-based curriculum, student performance on objective examinations covering PBL materials is unaffected by the status of the facilitator (student vs. faculty). However, in peer-facilitated groups, students sometimes took short cuts in the PBL process that may undermine some of the intended goals of PBL. [source] Nasal nitric oxide in objective evaluation of chronic rhinosinusitis therapyALLERGY, Issue 6 2006S. M. Ragab Background:, The assessment of the response of chronic rhinosinusitis (CRS) to therapy is difficult. Computerized tomographic (CT) scans cannot be repeatedly used so measures such as symptom scores, endoscopic findings, and parallel measures such as saccharin clearance time are employed instead. Objective:, To study the effect of CRS therapy on nasal nitric oxide and to see whether nasal nitric oxide level changes correlate with other assessments. Methods:, The study was a prospective randomized trial of patients with CRS, with or without polyps, who had failed initial medical therapy with douching and nasal corticosteroids and who then had abnormal CT scans. They were treated either medically or surgically, with follow up at 6 and 12 months whilst still taking nasal corticosteroids. Nasal nitric oxide was measured initially and at 6 and 12 months as well as symptom scores, endoscopy, polyp grading, and saccharin clearance time. Results:, Initial absolute nasal nitric oxide levels correlated inversely with CT scan changes, (P < 0.001). The percentage rise in nasal nitric oxide seen on both medical and surgical treatment correlated with changes in symptom scores (P < 0.001), saccharin clearance time (P < 0.001), endoscopic changes (P < 0.001), polyp grades (P < 0.05 at 6 months, P < 0.01 at 12 months) and surgical scores (P < 0.01). There was no significant correlation with age, sex, smoking or allergy. Conclusion:, Nasal nitric oxide, which is easily measured, provides a valuable non-invasive objective measure of the response of CRS to therapy. Topical nasal corticosteroids may be needed to reduce the contribution of nasal epithelial nitric oxide and allow that emanating from the sinuses to be measured. [source] Mandibular reconstruction after resection of benign tumours using non-vascularised methods in a series of patients that did not undergo radiotherapyORAL SURGERY, Issue 1 2009D. Mehrotra Abstract Aim:, A case series analysis of 52 consequent subjects of immediate mandibular reconstruction after tumour resection using non-vascularised methods, undertaken at U.P. King George's University of Dental Sciences and King George's Medical University, is being reported. To assess the success of reconstruction on subjective and objective evaluation based upon Mandibular Reconstruction Assessment Scale (MRAS) questionnaire. Methods:, Patients with benign mandibular tumours irrespective of age, sex, site and socio-economic status were included. Primary reconstruction was carried out after resection in two surgical units on surgeon's choice using stainless steel wire (6/52; 12%), stainless steel reconstruction plate (10/52; 19%) or titanium reconstruction plate (36/52; 69%) without bone graft (23/52; 44%) or with bone graft (29/52; 56%). Bone grafts were harvested from iliac crest (21/52; 40%), rib (2/52; 4%) and an additional pectoralis major myocutaneous flap with iliac crest bone graft (6/52; 12%) to provide cover to the reconstruction plate was also used. Results:, The primary outcome measurements were wound healing, mouth opening, chewing efficiency, jaw movements, cosmetic achievement and speech on a five-point scale, all of which improved significantly after surgery. The overall complication rate was 17%. Three patients (6%) had loosening of the screw, two (4%) showed dehiscence of the plate, two (4%) showed tumour recurrence and one (2%) had infection of the graft that was subsequently removed. Conclusion:, Titanium reconstruction plates with iliac crest graft provided good result in the absence of microvascular reconstruction because of unavailable long operating time and lack of expertise. Long-term satisfactory rehabilitation can be achieved using removable dentures or prosthesis on dental implants on the contraption provided by the non-vascularised tissue despite non-calcified bone visible on the skiagram. [source] The place of suxamethonium in pediatric anesthesiaPEDIATRIC ANESTHESIA, Issue 6 2009MARCIN RAWICZ MD Summary Suxamethonium is a drug that promotes very strong views both for and against its use in the context of pediatric anesthesia. As such, the continuing debate is an excellent topic for a ,Pro,Con' debate. Despite ongoing efforts by drug companies, the popular view still remains that there is no single neuromuscular blocking drug that can match suxamethonium in terms of speed of onset of neuromuscular block and return of neuromuscular control. However, with this drug the balance of benefit vs risk and side effects are pivotal. Suxamethonium has significant adverse effects, some of which can be life threatening. This is particularly relevant for pediatric anesthesia because the spectrum of childhood diseases may expose susceptible individuals to an increased likelihood of adverse events compared with adults. Additionally, the concerns related to airway control in the infant may encourage the occasional pediatric anesthetist to use the drug in preference to slower onset/offset drugs. In the current environment of drug research, surveillance and licensing, it is debatable whether this drug would achieve the central place it still has in pediatric anesthesia. The arguments for and against its use are set out below by our two international experts, Marcin Rawicz from Poland and Barbara Brandom from USA. This will allow the reader an objective evaluation with which to make an informed choice about the use of suxamethonium in their practice. [source] Using statistical image models for objective evaluation of spot detection in two-dimensional gelsPROTEINS: STRUCTURE, FUNCTION AND BIOINFORMATICS, Issue 6 2003Mike Rogers Abstract Protein spot detection is central to the analysis of two-dimensional electrophoresis gel images. There are many commercially available packages, each implementing a protein spot detection algorithm. Despite this, there have been relatively few studies comparing the performance characteristics of the different packages. This is in part due to the fact that different packages employ different sets of user-adjustable parameters. It is also partly due to the fact that the images are complex. To carry out an evaluation, "ground truth" data specifying spot position, shape and intensities needs to be defined subjectively on selected test images. We address this problem by proposing a method of evaluation using synthetic images with unambiguous interpretation. The characteristics of the spots in the synthetic images are determined from statistical models of the shape, intensity, size, spread and location of real spot data. The distribution of parameters is described using a Gaussian mixture model obtained from training images. The synthetic images allow us to investigate the effects of individual image properties, such as signal-to-noise ratios and degree of spot overlap, by measuring quantifiable outcomes, e.g. accuracy of spot position, false positive and false negative detection. We illustrate the approach by carrying out quantitative evaluations of spot detection on a number of widely used analysis packages. [source] Comparison of visual acuity measurements and Purkinje's vessel shadow perception for prediction of postoperative visual acuity in different ophthalmological diseasesACTA OPHTHALMOLOGICA, Issue 2 2007Stephan Schulze Abstract. Purpose:, Prediction of postoperative visual acuity (VA) is extremely important to the patient and highly relevant to the surgeon. However, objective evaluation of the macula is frequently impossible in cases such as mature cataract, cataract in high myopia or vitreous haemorrhage. This study compares different preoperative examination techniques used to predict postoperative VA. Methods:, We retrospectively evaluated the charts of all patients who underwent any of the following procedures at our hospital in 2004: phacoemulsification for mature cataract or cataract in high myopia; vitrectomy for diabetic vitreous haemorrhage; macular pucker, and macular hole. The following methods were evaluated: preoperative distance and reading VA; laser interferential VA; Purkinje's vessel shadow perception, and postoperative distance VA. Results:, Complete documentation was available for 136 patients (29 mature cataracts, 25 immature cataracts in high myopia, 42 vitreous haemorrhages, 19 macular puckers, 21 macular holes). In cases of preoperative mature cataract, a positive Purkinje's vessel shadow perception predicted a postoperative VA , 20/50 (odds ratio 11.2). In cases of high myopia, interferential VA correlated best with visual outcome (p < 0.05). In macular surgery laser interferential VA predicted postoperative VA to be better and preoperative reading VA predicted it to be worse than it actually turned out after surgery. Laser interferential VA and last known VA prior to vitreous haemorrhage (mean of 20 months previously) correlated best with postoperative VA (p < 0.05) in cases of vitreous haemorrhage. Purkinje's vessel shadow perception , if positive , predicted a postoperative VA , 20/300 in these cases (odds ratio 15.0). Conclusions:, Postoperative VA after vitrectomy for macular pucker or macular hole and in cases of cataract in high myopia is best predicted by laser interferential VA. Postoperative VA after vitrectomy for diabetic vitreous haemorrhage is best predicted by prehaemorrhage VA or laser interferential VA, especially when prehaemorrhage VA is unknown. Positive Purkinje's vessel shadow perception is an excellent method of predicting postoperative VA , 20/300 in cases of vitreous haemorrhage and VA = 20/50 in mature cataract. [source] Gender Bias in Cardiovascular Testing Persists after Adjustment for Presenting Characteristics and Cardiac RiskACADEMIC EMERGENCY MEDICINE, Issue 7 2007Anna Marie Chang MD Objectives:Previous studies have found that female patients receive fewer invasive tests for cardiovascular disease than male patients. The authors assessed whether different clinical characteristics at emergency department presentation account for this gender bias. Methods:Patients with potential acute coronary syndrome (ACS) who presented to a university hospital were prospectively identified. A structured data instrument that included demographic information, chest pain description, history, physical examination, chest radiography, and electrocardiogram (ECG) data was completed. Hospital course was tracked daily. Patients received 30-day telephone follow-up. The main outcome was whether the patients received objective evaluation for coronary artery disease after adjustment for cardiac risk, including race, age, total number of risk factors, Thrombolysis in Myocardial Infarction (TIMI) score, ECG, and whether the patient sustained an acute myocardial infarction on index hospitalization. Results:There were 3,514 women (58%) and 2,547 men (42%) studied. They had similar presenting characteristics: chest pain quality (pressure/tightness: female 60% vs. male 59%, p = 0.6), location (substernal: female 82% vs. male 80%; p = 0.2), radiation (female 27% vs. male 26%; p = 0.3), and most associated symptoms. Men had more cardiac risk factors (mean 1.5 vs 1.4; p < 0.001), more abnormal ECGs (59% vs. 48%; p < 0.001), and a higher TIMI risk score (p < 0.001). With respect to the main outcome, men received more cardiac catheterizations (12.6% vs. 6.0%; odds ratio [OR], 2.25; 95% confidence interval [CI] = 1.88 to 2.70) and more stress tests (14.7% vs. 12.3%; OR, 1.22; 95% CI = 1.05 to 1.42). After adjustment for age, race, cardiac risk factors, ECG, and TIMI risk score, men still received more cardiac catheterizations (adjusted OR, 1.72; 95% CI = 1.40 to 2.11) and stress tests (adjusted OR, 1.16; 95% CI = 1.01 to 1.33). Models adjusting for acute myocardial infarction or death, high-risk initial clinical impression, or emergency department disposition found similar results for increased likelihood of cardiac catheterization in men but no difference in stress testing between men and women. Conclusions:Female patients with potential ACS receive fewer cardiac catheterizations than male patients, even when presenting complaint, history, ECG, and diagnosis are taken into account. The gender bias cannot be explained by differences in presentation or clinical course. [source] Re: Correlation between subjective and objective evaluation of the nasal airwayCLINICAL OTOLARYNGOLOGY, Issue 2 2010R. Eccles No abstract is available for this article. [source] | |||||||||||||