Testing M2T/T2M Transformations

Presentado en: 16th International Conference on Model Driven Engineering Languages and Systems (MODELS 2013). Del 29 de septiembre al 4 de octubre. Miami, EEUU.Testing model-to-model (M2M) transformations is becoming a prominent topic in the current Model-driven Engineering landscape. Current approaches for transformation testing, however, assume having explicit model representations for the input domain and for the output domain of the transformation. This excludes other important transformation kinds, such as model-to-text (M2T) and text-to-model (T2M) transformations, from being properly tested since adequate model representations are missing either for the input domain or for the output domain. The contribution of this paper to overcome this gap is extending Tracts, a M2M transformation testing approach, for M2T/T2M transformation testing. The main mechanism we employ for reusing Tracts is to represent text within a generic metamodel. By this, we transform the M2T/T2M transformation specification problems into equivalent M2M transformation specification problems. We demonstrate the applicability of the approach by two examples and present how the approach is implemented for the Eclipse Modeling Framework (EMF). Finally, we apply the approach to evaluate code generation capabilities of several existing UML tools.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech. Proyecto TIN2011-2379

Magnetic resonance imaging analysis of the bioabsorbable Milagro™ interference screw for graft fixation in anterior cruciate ligament reconstruction

Ligament graft fixation with bioabsorbable interference screws is a standard procedure in cruciate ligament replacement. Previous screw designs may resorb incompletely, and can cause osteolysis and sterile cysts despite being implanted for several years. The aim of this study was to examine the in vivo degradation and biocompatibility of the new Milagro™ interference screw (Mitek, Norderstedt, Germany). The Milagro™ interference screw is made of 30% ß-TCP (TriCalcium phosphate) and 70% PLGA (Poly-lactic-co-glycolic acid). In the period between June 2005 and February 2006, 38 patients underwent graft fixation with Milagro™ screws in our hospital. Arthroscopic ACL reconstruction was performed using hamstring tendon grafts in all the patients. MR imaging was performed on 12 randomly selected patients out of the total of 38 at 3, 6 and 12 months after surgery. During the examination, the volume loss of the screw, tunnel enlargement, presence of osteolysis, fluid lines, edema and postoperative screw replacement by bone tissue were evaluated. There was no edema or signs of inflammation around the bone tunnels. At 3, 6 and 12 months, the tibial screws showed an average volume loss of 0, 8.1% (±7.9%) and 82.6% (±17.2%, P < 0.05), respectively. The femoral screws showed volume losses of 2.5% (±2.1%), 31.3% (±21.6%) and 92.02% (±6.3%, P < 0.05), respectively. The femoral tunnel enlargement was 47.4% (±43.8%) of the original bone tunnel volume after 12 months, and the mean tunnel volume of the tibial tunnel was −9.5% (±58.1%) compared to the original tunnel. Bone ingrowth was observed in all the patients. In conclusion, the resorption behaviour of the Milagro™ screw is closely linked to the graft healing process. The screws were rapidly resorbed after 6 months and, at 12 months, only the screw remnants were detectable. Moreover, the Milagro™ screw is biocompatible and osteoconductive, promoting bone ingrowth during resorption. Tunnel enlargement is not prevented in the first months but is reduced by bone ingrowth after 12 months

Sedation, Analgesia, and Paralysis during Mechanical Ventilation of Premature Infants

To characterize administration of sedatives, analgesics, and paralytics in a large cohort of mechanically ventilated, premature infants

Effectiveness of Initial Transarterial Chemoembolization for Hepatocellular Carcinoma Among Medicare Beneficiaries

Optimal administration of transarterial chemoembolization (TACE), the standard approach for intermediate stage hepatocellular carcinoma (HCC), requires clinical and technical expertise. We sought to evaluate if TACE retains its effectiveness when administered across a broad range of healthcare settings. With increasing use of yttrium90 radioembolization (Y90), we explored the effectiveness of Y90 compared with TACE

Ondansetron use in early pregnancy and the risk of late pregnancy outcomes

Background: The effects of ondansetron, used off-label to treat nausea and vomiting during pregnancy, on common pregnancy complications are understudied. Modest effects of a commonly used drug could result in adverse events for large numbers of pregnant women. Therefore, our objective was to compare the risk of stillbirth, preterm birth, gestational hypertensive disorders, small for gestational age, and differences in birth weight between women prescribed ondansetron and women prescribed alternative antiemetics in early pregnancy. Methods: A cohort of pregnant women receiving a prescription for ondansetron or comparator antiemetics (metoclopramide or promethazine) during the first 20 weeks of pregnancy was identified using electronic health record data from a health care system in North Carolina, USA. Confounding by multiple covariates was controlled using stabilized inverse probability of treatment weights. Weighted hazard ratios (HR) and 95% confidence intervals (CI) accounted for competing events. Results: We identified 2677 eligible pregnancies with antiemetic orders, 66% for ondansetron. The small number of stillbirths (n = 15) resulted in an imprecise estimate of the association with ondansetron (HR = 1.60; 95%CI 0.51, 4.97). No association was observed for preterm birth (HR = 0.90; 95%CI 0.67, 1.20) or gestational hypertensive disorders (HR = 0.87; 95%CI 0.68, 1.12). We observed an association with small for gestational age (HR = 1.37; 95%CI 0.98, 1.90), however mean birth weight among term births was similar between groups. Conclusions: Our results do not suggest that ondansetron increases the risk of preterm birth or gestational hypertensive disorders. The weak association observed between ondansetron use and small for gestational age warrants further investigation

Ondansetron use in early pregnancy and the risk of miscarriage

Background: Ondansetron is commonly used to treat nausea and vomiting in pregnancy despite inconclusive evidence of its safety. Previous studies have reported no increase in risk of miscarriage but relied on methods that failed to account for gestational weeks at risk and non-user comparators, which may increase the potential for unmeasured confounding. Our objective was to estimate the risk of miscarriage among women prescribed ondansetron vs alternative antiemetics during the first 20 weeks of pregnancy. Methods: A pregnancy cohort was created using electronic health record data from a health care system in North Carolina. Women were classified as exposed to either ondansetron or comparator antiemetics (metoclopramide or promethazine) based on the first antiemetic prescription received in the first 20 weeks of gestation. Cumulative incidence of miscarriage at 20 weeks was estimated in each antiemetic group. Hazard ratios (HR) were estimated with 95% confidence intervals and measured confounding was controlled using inverse probability of treatment weights. Sensitivity analyses assessed the potential impact of exposure misclassification, latency period, and selection bias. Results: We identified 2620 eligible pregnancies with antiemetic orders; 65% had a first ondansetron order and 35% had a first comparator antiemetic order. In total, 95 women had a miscarriage. After adjustment, there was no difference in risk of miscarriage (HR 1.21, 95% CI 0.77, 1.90). Results from the per-protocol and other sensitivity analyses were similar to the main analysis. Conclusions: We did not observe an increase in the risk of miscarriage for pregnancies exposed to ondansetron vs comparator antiemetics

Association of Long-term Child Growth and Developmental Outcomes with Metformin vs Insulin Treatment for Gestational Diabetes

Importance: Metformin is an emerging option for treating gestational diabetes (GDM). However, because metformin crosses the placenta, patients and clinicians are concerned with its long-term effect on child health. Objective: To estimate the association of treating GDM with metformin vs insulin with child growth and development. Design, Setting, and Participants: Population-based cohort study of New Zealand women treated with metformin or insulin for GDM from 2005 to 2012 and their children. This study linked national health care data to create a cohort of mothers and their children, including data from maternity care, pharmaceutical dispensing, hospitalizations, demographic records, and the B4 School Check (B4SC) preschool health assessment. Women treated pharmacologically with metformin or insulin during pregnancy were included. We excluded pregnancies with evidence of diabetes and deliveries prior to 2013. Liveborn infants were linked to their B4SC results. Data were analyzed between January 2017 and May 2018. Exposures: Pharmacologic treatment for GDM with metformin or insulin, measured using pharmaceutical claims data. Main Outcomes and Measures: Child growth (weight and height) and Strengths and Difficulties Questionnaire (SDQ) scores for behavioral development. All outcomes were derived from the B4SC screening program. Linear and log-binomial regression with inverse probability of treatment weighting was used to estimate the association of child growth and psychosocial outcomes with metformin vs insulin treatment for GDM. Results: In both treatment groups, the mean (SD) maternal age was 32 (5) years. A large proportion of mothers who were treated with insulin identified as New Zealand European (867 [44.9%]) while 576 mothers who were treated with metformin (28.9%) identified as New Zealand European. Approximately one-third of mothers who were treated with metformin (n = 639) identified as Asian. We identified 3928 pregnancies treated with metformin (n = 1996) or insulin (n = 1932). After adjustment, we observed no meaningful difference in weight for height z scores between children exposed to metformin compared with insulin (mean difference, -0.10; 95% CI, -0.20 to 0.01). Risk of being 85th percentile or greater for weight for height was similar between treatment groups (adjusted risk ratio, 0.92; 95% CI, 0.83-1.02). Mean SDQ scores were not meaningfully different between the treatment groups, Children of metformin-treated mothers were not significantly more likely to have parent-reported SDQ scores of 14 or more (adjusted risk ratio, 1.13; 95% CI, 0.88-1.46) than those of insulin-treated mothers. Conclusions and Relevance: Our study compares long-term outcomes among school-aged children following maternal use of metformin vs insulin treatment for GDM. Children of metformin-treated mothers were indistinguishable on growth and developmental assessments from those of insulin-treated mothers. These results will help inform future GDM treatment guidelines

Stages of Concern: Vorerfahrungen, Interessen und Einstellungen von Lehrkräften in Bezug auf Lehr-Lernplattform-gestütztem Unterricht in den Naturwissenschaften

The pandemic-related measures highlighted the value of digitalization as a major issue in the education sector. Digital teaching units on teaching-learning platforms can make a decisive contribution in this field. In this study, data collected in summer 2019 on the affective-cognitive processes of examinations of science education using digitally formatted units, implemented on teaching-learning platforms and the particular usage of teaching-learning platforms themselves are re-analysed (N = 83). The study relies on the Stages of Concern (SoC) as a standardized instrument. A cluster analysis helps to identify three specific SoC-profiles in terms of the specific approach to and handling with the digital teaching-learning platforms. Common to all these profiles is that they concentrate on the impact on teaching and the students’ activities. In addition, the analysis shows a traditional use of the platforms in school (subgroup, N = 44 for teachers with access to teaching-learning platforms in school). Furthermore, correlation analyses show that there is no correlation between the type of use and the SoC-Profiles, but there is a correlation between the frequency of use and the SoC-profilesDie pandemiebedingten Maßnahmen haben den Wert der Digitalisierung im Bildungssektor deutlich gemacht. Digitale Unterrichtseinheiten auf Lehr-Lernplattformen können dazu einen entscheidenden Beitrag leisten. In der hier vorgelegten Studie werden Daten aus dem Sommer 2019 zu der affektiv-kognitiven Auseinandersetzung von naturwissenschaftlichen Lehrkräften mit digitalen Unterrichtseinheiten auf Lehr-Lernplattformen sowie deren Nutzung und Fortbildungswünsche neu analysiert (N = 83). Die Erhebung der affektiv-kognitiven Auseinandersetzung erfolgte mit dem standardisierten Instrument Stages of Concern (SoC). Mithilfe einer Clusteranalyse werden drei spezifische SoC-Profile in Bezug auf den Einsatz digitaler Unterrichtseinheiten auf einer Lehr-Lernplattform identifiziert. Dabei wird deutlich, dass allen Profilen die Beschäftigung mit der Auswirkung auf den Unterricht und auf die Schülerinnen und Schüler gemein ist. Zudem wird gezeigt, dass der Einsatz von Lehr-Lernplattformen vor der Pandemie eher traditionell geprägt war (Subgruppe, N = 44 für Lehrkräfte mit Zugang in der Schule zu einer Lehr-Lernplattform). Zusammenhangsanalysen zeigen des Weiteren, dass zwischen der Nutzungsart und den SoC-Profilen kein Zusammenhang festzustellen ist, ein solcher aber zwischen der Nutzungshäufigkeit und den SoC-Profilen besteh

DETERMINANTS OF ADJUVANT OXALIPLATIN RECEIPT AMONG OLDER STAGE II AND III COLORECTAL CANCER PATIENTS

Controversy exists regarding adjuvant oxaliplatin treatment among older stage II and III colorectal cancer (CRC) patients. We sought to identify patient/tumor, physician, hospital, and geographic factors associated with oxaliplatin use among older patients