479 research outputs found

    Midday measurements of leaf water potential and stomatal conductance are highly correlated with daily water use of Thompson Seedless grapevines

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    A study was conducted to determine the relationship between midday measurements of vine water status and daily water use of grapevines measured with a weighing lysimeter. Water applications to the vines were terminated on August 24th for 9 days and again on September 14th for 22 days. Daily water use of the vines in the lysimeter (ETLYS) was approximately 40 L vine−1 (5.3 mm) prior to turning the pump off, and it decreased to 22.3 L vine−1 by September 2nd. Pre-dawn leaf water potential (ΨPD) and midday Ψl on August 24th were −0.075 and −0.76 MPa, respectively, with midday Ψl decreasing to −1.28 MPa on September 2nd. Leaf g s decreased from ~500 to ~200 mmol m−2 s−1 during the two dry-down periods. Midday measurements of g s and Ψl were significantly correlated with one another (r = 0.96) and both with ETLYS/ETo (r = ~0.9). The decreases in Ψl, g s, and ETLYS/ETo in this study were also a linear function of the decrease in volumetric soil water content. The results indicate that even modest water stress can greatly reduce grapevine water use and that short-term measures of vine water status taken at midday are a reflection of daily grapevine water us

    The melanoma-specific graded prognostic assessment does not adequately discriminate prognosis in a modern population with brain metastases from malignant melanoma

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    The melanoma-specific graded prognostic assessment (msGPA) assigns patients with brain metastases from malignant melanoma to 1 of 4 prognostic groups. It was largely derived using clinical data from patients treated in the era that preceded the development of newer therapies such as BRAF, MEK and immune checkpoint inhibitors. Therefore, its current relevance to patients diagnosed with brain metastases from malignant melanoma is unclear. This study is an external validation of the msGPA in two temporally distinct British populations.Performance of the msGPA was assessed in Cohort I (1997-2008, n=231) and Cohort II (2008-2013, n=162) using Kaplan-Meier methods and Harrell's c-index of concordance. Cox regression was used to explore additional factors that may have prognostic relevance.The msGPA does not perform well as a prognostic score outside of the derivation cohort, with suboptimal statistical calibration and discrimination, particularly in those patients with an intermediate prognosis. Extra-cerebral metastases, leptomeningeal disease, age and potential use of novel targeted agents after brain metastases are diagnosed, should be incorporated into future prognostic models.An improved prognostic score is required to underpin high-quality randomised controlled trials in an area with a wide disparity in clinical care

    Using ordinal logistic regression to evaluate the performance of laser-Doppler predictions of burn-healing time

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    Background Laser-Doppler imaging (LDI) of cutaneous blood flow is beginning to be used by burn surgeons to predict the healing time of burn wounds; predicted healing time is used to determine wound treatment as either dressings or surgery. In this paper, we do a statistical analysis of the performance of the technique. Methods We used data from a study carried out by five burn centers: LDI was done once between days 2 to 5 post burn, and healing was assessed at both 14 days and 21 days post burn. Random-effects ordinal logistic regression and other models such as the continuation ratio model were used to model healing-time as a function of the LDI data, and of demographic and wound history variables. Statistical methods were also used to study the false-color palette, which enables the laser-Doppler imager to be used by clinicians as a decision-support tool. Results Overall performance is that diagnoses are over 90% correct. Related questions addressed were what was the best blood flow summary statistic and whether, given the blood flow measurements, demographic and observational variables had any additional predictive power (age, sex, race, % total body surface area burned (%TBSA), site and cause of burn, day of LDI scan, burn center). It was found that mean laser-Doppler flux over a wound area was the best statistic, and that, given the same mean flux, women recover slightly more slowly than men. Further, the likely degradation in predictive performance on moving to a patient group with larger %TBSA than those in the data sample was studied, and shown to be small. Conclusion Modeling healing time is a complex statistical problem, with random effects due to multiple burn areas per individual, and censoring caused by patients missing hospital visits and undergoing surgery. This analysis applies state-of-the art statistical methods such as the bootstrap and permutation tests to a medical problem of topical interest. New medical findings are that age and %TBSA are not important predictors of healing time when the LDI results are known, whereas gender does influence recovery time, even when blood flow is controlled for. The conclusion regarding the palette is that an optimum three-color palette can be chosen 'automatically', but the optimum choice of a 5-color palette cannot be made solely by optimizing the percentage of correct diagnoses

    Convergent Foraging Tactics of Marine Predators with Different Feeding Strategies across Heterogeneous Ocean Environments

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    Advances in satellite tracking and archival technologies now allow marine animal movements and behavior to be recorded at much finer temporal scales, providing a more detailed ecological understanding that can potentially be applicable to conservation and management strategies. Pelagic sharks are commercially exploited worldwide with current concerns that populations are declining, however, how pelagic sharks use exploited environments remains enigmatic for most species. Here we analyzed high-resolution dive depth profiles of two pelagic shark species with contrasting feeding strategies to investigate movement patterns in relation to environmental heterogeneity. Seven macropredatory blue (Prionace glauca) and six plankton-feeding basking (Cetorhinus maximus) sharks were tagged with pop-off satellite-linked archival tags in the North Atlantic Ocean to examine habitat use and investigate the function of dives. We grouped dives of both species into five major categories based on the two-dimensional dive profile shape. Each dive-shape class presented similar frequency and characteristics among the two species with U- and V-shaped dives predominating. We tested the spatial occurrence of different U- and V-shape dive parameters in response to environmental field gradients and found that mean depth and mean depth range decreased with increasing levels of primary productivity (chlorophyll “a”), whereas ascent velocities displayed a positive correlation. The results suggest that a planktivore and a macropredator responded behaviourally in similar ways to environmental heterogeneity. This indicates fine-scale dive profiles of shark species with different feeding strategies can be used to identify key marine habitats, such as foraging areas where sharks aggregate and which may represent target areas for conservation

    Differing clinical features between Japanese and Caucasian patients with myelodysplastic syndromes:Analysis from the International Working Group for Prognosis of MDS

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    Clinical features of myelodysplastic syndromes (MDS) could be influenced by many factors, such as disease intrinsic factors (e.g., morphologic, cytogenetic, molecular), extrinsic factors (e.g, management, environment), and ethnicity. Several previous studies have suggested such differences between Asian and European/USA countries. In this study, to elucidate potential differences in primary untreated MDS between Japanese (JPN) and Caucasians (CAUC), we analyzed the data from a large international database collected by the International Working Group for Prognosis of MDS (300 and 5838 patients, respectively). JPN MDS were significantly younger with more severe cytopenias, and cytogenetic differences: less del(5q) and more +1/+1q, -1/del(1p), der(1;7), -9/del(9q), del(16q), and del(20q). Although differences in time to acute myeloid leukemia transformation did not occur, a significantly better survival in JPN was demonstrated, even after the adjustment for age and FAB subtypes, especially in lower, but not in higher prognostic risk categories. Certain clinical factors (cytopenias, blast percentage, cytogenetic risk) had different impact on survival and time to transformation to leukemia between the two groups. Although possible confounding events (e.g., environment, diet, and access to care) could not be excluded, our results indicated the existence of clinically relevant ethnic differences regarding survival in MDS between JPN and CAUC patients. The good performance of the IPSS-R in both CAUC and JP patients underlines that its common risk model is adequate for CAUC and JP

    Cost calculation and prediction in adult intensive care: A ground-up utilization study

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    Publisher's copy made available with the permission of the publisherThe ability of various proxy cost measures, including therapeutic activity scores (TISS and Omega) and cumulative daily severity of illness scores, to predict individual ICU patient costs was assessed in a prospective “ground-up” utilization costing study over a six month period in 1991. Daily activity (TISS and Omega scores) and utilization in consecutive admissions to three adult university associated ICUs was recorded by dedicated data collectors. Cost prediction used linear regression with determination (80%) and validation (20%) data sets. The cohort, 1333 patients, had a mean (SD) age 57.5 (19.4) years, (41% female) and admission APACHE III score of 58 (27). ICU length of stay and mortality were 3.9 (6.1) days and 17.6% respectively. Mean total TISS and Omega scores were 117 (157) and 72 (113) respectively. Mean patient costs per ICU episode (1991 AUS)wereAUS) were 6801 (10311),withmediancostsof10311), with median costs of 2534, range 106to106 to 95,602. Dominant cost fractions were nursing 43.3% and overheads 16.9%. Inflation adjusted year 2002 (mean) costs were 9343(9343 ( AUS). Total costs in survivors were predicted by Omega score, summed APACHE III score and ICU length of stay; determination R2, 0.91; validation 0.88. Omega was the preferred activity score. Without the Omega score, predictors were age, summed APACHE III score and ICU length of stay; determination R2, 0.73; validation 0.73. In non-survivors, predictors were age and ICU length of stay (plus interaction), and Omega score (determination R2, 0.97; validation 0.91). Patient costs may be predicted by a combination of ICU activity indices and severity scores.J. L. Moran, A. R. Peisach, P. J. Solomon, J. Martinhttp://www.aaic.net.au/Article.asp?D=200403

    Data-driven Iterative Refinements to Educational Development Services: Directly Measuring the Impacts of Consultations on Course and Syllabus Design

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    Evidence-based practice in educational development includes leveraging data to iteratively refine center for teaching and learning (CTL) services. However, CTL data collection is often limited to counts and satisfaction surveys rather than direct measures of outcomes. To directly assess impacts of consultations on course and syllabus design, we analyzed 94 clients’ syllabi (32 faculty, 62 graduate students and postdocs) before and after consultations. Faculty and non-faculty clients demonstrated significant change following consultations (6% and 10% gains in syllabus rubric scores, representing 50% and 31% of possible gains and effect sizes of 0.73 and 1.04 standard deviations, respectively). We compared faculty clients to quasi-experimental control groups that did not receive consultations. Syllabi from non-clients scored lower and did not demonstrate similar changes across semesters. Attendance at a CTL seminar on course and syllabus design did not explain variation in clients’ syllabi. We discuss implications for assessment of CTL services and how we leveraged formative assessments to inform and iteratively refine our educational development practices

    Sexual Abuse-Current Medico-legal, Forensic and Psychiatric Aspects

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    Abstract Violence against women and minors is a worldwide problem that has not yet been sufficiently acknowledged. There are many obstacles especially when sexual abuses have to be evaluated. These problems are present both when victims of sexual abuse are evaluated and when sex offenders are dealt with, especially when the offenders are juvenile sex offenders (JSO). These issues give cause for great concern about prognosis, and the resulting psychosocial implications, and call for a special effort from the scientific community in identifying appropriate prevention and treatment methods. This chapter is divided into two parts. The first part deals with the forensic and psychiatric features, such as diagnostic and therapeutic/rehabilitative strategies for JSO, while the second part analyzes the legal–medicine aspects related to rape/sexual assault in a European context

    Thin-Sliced Embedded Direct Assessment (T-SEDA): Measuring Impacts of Development Workshops on Participants' Learning Gains

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    How can educational developers best formatively assess impacts of their services? Standard practices tend to rely on indirect measures, such as counts of participants and feedback surveys. This paper responds to recent calls for more robust approaches directly measuring outcomes. We describe how to implement a new, transferable, evidence-based approach for directly measuring instructors’ learning gains within and across educational development workshops: the Thin-Slice Embedded Direct Assessment (T-SEDA) Process. Although this approach does not measure longterm retention of learning or effects on future teaching behaviors, it significantly enhanced our toolkit for formatively assessing educational development workshops. Through case studies, we illustrate principles underlying our approach, impacts on instructors’ learning, and how we iteratively refine our programs and practices using the T-SEDA process. We also discuss lessons learned for fostering an inclusive, collaborative culture of formative assessment among educational developers
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