9 research outputs found

    History on the biological nitrogen fixation research in graminaceous plants: special emphasis on the Brazilian experience

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    External Validation and Modification of a Predictive Model for Acute Postsurgical Pain at Home after Day Surgery

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    OBJECTIVES: In 2009, Gramke et al have described predictive factors to pre-operatively detect those at risk for moderate to severe acute postoperative pain (APSP) after day surgery. The aim of the present study is to externally validate this initial model and to improve and internally validate a modified version of this model. METHODS: Elective patients scheduled for day surgery were prospectively enrolled from November 2008 to April 2010. Model discrimination was quantified using the area under the receiver operating characteristic curve (AUC). Model calibration was assessed by visual inspection of the calibration plot. Subsequently, we modified (different assignment of type of surgery, different cut-off for moderate to severe APSP, continuous of dichotomized variables and testing of additional variables) and internally validated this model by standard bootstrapping techniques. RESULTS: A total of 1118 patients were included. The AUC for the original model was 0.81 in the derivation dataset and 0.72 in our validation dataset. The model showed poorly calibrated risk predictions. The AUC of the modified model was 0.82 (optimism-corrected AUC=0.78). This modified model showed good calibration. CONCLUSION: The original prediction model of Gramke et al performed insufficient on our cohort of outpatients with respect to discrimination and calibration. Internal validation of a modified model shows promising results. In this model, preoperative pain, patient derived expected pain and different types of surgery are the strongest predictors of moderate to severe APSP after day surgery.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially. http://creativecommons.org/licenses/by-nc-nd/4.0

    Measures of physical functioning after hip fracture: construct validity and responsiveness of performance-based and self-reported measures

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    Objectives: this study aimed to investigate the construct validity and responsiveness of performance-based and self-reported measures of strength, mobility and balance after hip fracture.Design: secondary analysis of clinical trial data.Subjects: a total of 148 older people undergoing hip fracture rehabilitation.Methods: correlation coefficients assessed construct validity. Internal responsiveness was assessed by calculating effect sizes (ES) I and II. Area under the receiver operating characteristic curve (AUC) assessed external responsiveness with change in EuroQol as the reference.Results: correlations between performance-based and self-reported measures were small to medium (strength r = 0.17, mobility r = 0.45 and balance r = 0.37). The most responsive performance-based measures included walking speed (ESI 1.7, ESII 1.2), Physical Performance and Mobility Examination (ESI 1.3, ESII 1.0) and chair-rise test (ESI 1.1, ESII 0.8). Self-reported mobility (ESI 0.8, ESII 0.6) and strength (ESI 0.8, ESII 0.6) were more responsive than self-reported balance (ESI 0.3, ESII 0.2). External responsiveness (AUC) was greatest for walking speed (0.72) and lowest for the measures of body sway (0.53).Conclusion: self-reported and performance-based indices appear to assess different constructs and may provide complementary information about physical functioning in people after hip fracture. Measures of strength and mobility showed greater ability to detect change than measures of balance. © The Author 2012. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved

    CanScreen5, a global repository for breast, cervical and colorectal cancer screening programs

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