Expected-value bias in routine third-trimester growth scans.

OBJECTIVES: Operators performing fetal growth scans are usually aware of the gestational age of the pregnancy, which may lead to expected-value bias when performing biometric measurements. We aimed to evaluate the incidence of expected-value bias in routine fetal growth scans and assess its impact on standard biometric measurements. METHODS: We collected prospectively full-length video recordings of routine ultrasound growth scans coupled with operator eye tracking. Expected value was defined as the gestational age at the time of the scan, based on the estimated due date that was established at the dating scan. Expected-value bias was defined as occurring when the operator looked at the measurement box on the screen during the process of caliper adjustment before saving a measurement. We studied the three standard biometric planes on which measurements of head circumference (HC), abdominal circumference (AC) and femur length (FL) are obtained. We evaluated the incidence of expected-value bias and quantified the impact of biased measurements. RESULTS: We analyzed 272 third-trimester growth scans, performed by 16 operators, during which a total of 1409 measurements (354 HC, 703 AC and 352 FL; including repeat measurements) were obtained. Expected-value bias occurred in 91.4% of the saved standard biometric plane measurements (85.0% for HC, 92.9% for AC and 94.9% for FL). The operators were more likely to adjust the measurements towards the expected value than away from it (47.7% vs 19.7% of measurements; P < 0.001). On average, measurements were corrected by 2.3 ± 5.6, 2.4 ± 10.4 and 3.2 ± 10.4 days of gestation towards the expected gestational age for the HC, AC, and FL measurements, respectively. Additionally, we noted a statistically significant reduction in measurement variance once the operator was biased (P = 0.026). Comparing the lowest and highest possible estimated fetal weight (using the smallest and largest biased HC, AC and FL measurements), we noted that the discordance, in percentage terms, was 10.1% ± 6.5%, and that in 17% (95% CI, 12-21%) of the scans, the fetus could be considered as small-for-gestational age or appropriate-for-gestational age if using the smallest or largest possible measurements, respectively. Similarly, in 13% (95% CI, 9-16%) of scans, the fetus could be considered as large-for-gestational age or appropriate-for-gestational age if using the largest or smallest possible measurements, respectively. CONCLUSIONS: During routine third-trimester growth scans, expected-value bias frequently occurs and significantly changes standard biometric measurements obtained. © 2019 the Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of the International Society of Ultrasound in Obstetrics and Gynecology

Extremism propagation in social networks with hubs

One aspect of opinion change that has been of academic interest is the impact of people with extreme opinions (extremists) on opinion dynamics. An agent-based model has been used to study the role of small-world social network topologies on general opinion change in the presence of extremists. It has been found that opinion convergence to a single extreme occurs only when the average number of network connections for each individual is extremely high. Here, we extend the model to examine the effect of positively skewed degree distributions, in addition to small-world structures, on the types of opinion convergence that occur in the presence of extremists. We also examine what happens when extremist opinions are located on the well-connected nodes (hubs) created by the positively skewed distribution. We find that a positively skewed network topology encourages opinion convergence on a single extreme under a wider range of conditions than topologies whose degree distributions were not skewed. The importance of social position for social influence is highlighted by the result that, when positive extremists are placed on hubs, all population convergence is to the positive extreme even when there are twice as many negative extremists. Thus, our results have shown the importance of considering a positively skewed degree distribution, and in particular network hubs and social position, when examining extremist transmission

Sampling the Uppermost Surface of Airless Bodies

The uppermost surface of an airless body is a critical source of ground-truth information for the various remote sensing techniques that only penetrate nanometers to micrometers into the surface. Such samples will also be vital for understanding conditions at the surface and acquiring information about how the body interacts with its environment, including solar wind interaction, grain charging and levitation [1]. Sampling the uppermost surface while preserving its structure (e.g. porosity, grain-to-grain contacts) however, is a daunting task that has not been achieved on any sample return mission to date

Evaluation Of Football Shoulder Pads

The development of sports protective equipment has been largely the result of trial and error and, with the exception of foot and head protective devices, has not involved the research process. Claims related to football shoulder pad innovations have not typically been supported by relevant objective data. The purpose of this study was to develop procedures and instrumentation for comparison of the effectiveness of shoulder pads. The most important criterion for protective effectiveness was considered to be the prevention of high peak pressures on body parts and tissues underneath the pads. Phase I of the study was designed to determine player perceptions of high-pressure sites following performance of drills on the field using a variety of pads. Phase II involved the development of instrumentation and procedures to directly measure pressure on sites identified in phase I during a controlled blocking drill simulating field conditions. Pressure measurements were taken using twelve pressure sensing resistors (0.6 mm thick and 12 mm in diameter) attached to selected sites underneath the pads. Signal conditioning circuity was developed to provide output from these transducers proportional to pressure. The output was routed to a digital computer via an analog-todigital interface board for subsequent analysis. The measurement system was used to evaluate six sets of shoulder pads representing the use of conventional, closed-cell foam and the use of open-cell foam (one and three layers) with an air management system. Four experienced subjects used each set of pads to hit a blocking dummy several times. Results were consistent with subjects' perceptions of areas of greatest pressure, indicating that: 1) greatest peak forces for all pads were received on the portion of the superior portion of the deltoid, acromion, and superior portion of the trapezius; and 2) pads using open-cell foam with an air management system were superior to pads using closed-cell foam in preventing high peak pressures. This study was partially supported by the Kansas State University Research Foundation

The contribution of OCTN1/2 variants within the IBD5 locus to disease susceptibility and severity in Crohn's disease

Background and Aims: Recent data suggest that polymorphisms in the organic cation transporter (OCTN) genes OCTN1 (SLC22A4) and OCTN2 (SLC22A5) represent disease-causing mutations within the IBD5 locus (chromosome 5q31). We investigated associations with disease susceptibility, phenotype, and evidence for epistasis with CARD15 in 679 patients with Crohn’s disease (CD) or ulcerative colitis (UC). Methods: A total of 374 patients with CD, 305 patients with UC, and 294 healthy controls (HCs) were studied. Genotyping for single nucleotide polymorphisms IGR2096, IGR2198, and IGR2230, OCTN1 variant (SLC22A4 1672C→T), and OCTN2 variant (SLC22A5 −207G→C) was performed using the TaqMan system. Results: The IBD5 OCTN1 and OCTN2 polymorphisms were in strong linkage disequilibrium (D′, >0.959). IGR2198 variant allele frequency (49.1% vs 40.8%; P = .0046) and homozygosity (21% vs 14.8%; P = .044) were associated with CD versus HCs. Variant allelic frequency of OCTN1 (53.6% vs 43%; P = .0008) and OCTN2 (56.1% vs 48.4%; P = .0092) polymorphisms and homozygosity for the OCTN1/2-TC haplotype (28.4% vs 16%; P = .0042) were associated with CD versus HCs. IGR2198 homozygosity and TC homozygosity were associated with stricturing/penetrating disease at follow-up (P = .011 and P = .011, respectively) and disease progression (P = .038 and P = .049, respectively) on univariate analysis and with need for surgery on multivariate analysis (P = .016 and P = .004, respectively). In the absence of the IBD5 risk haplotype, no association of OCTN1/2 variants with CD was detected. No associations were seen with UC. Conclusions: The IBD5 locus influences susceptibility, progression, and need for surgery in CD. However, the contribution of OCTN1/2 variants is not independent of the IBD5 haplotype; a causative role for these genes remains plausible but is not yet proven. Further genetic, functional, and expression data are now required. </p