Rectal area as surrogate measure of rectal emptying during MR defecography

Abstract A long-standing criticism of the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) has been the inequity between the internal medicine ratings and the orthopedic ratings; in the comparison, internal medicine ratings appear inflated. A specific goal of the AMA Guides, Sixth Edition, was to diminish, where possible, those disparities. This led to the use of the International Classification of Functioning, Disability, and Health from the World Health Organization in the AMA Guides, Sixth Edition, including the addition of the burden of treatment compliance (BOTC). The BOTC originally was intended to allow rating internal medicine conditions using the types and numbers of medications as a surrogate measure of the severity of a condition when other, more traditional methods, did not exist or were insufficient. Internal medicine relies on step-wise escalation of treatment, and BOTC usefully provides an estimate of impairment based on the need to be compliant with treatment. Simplistically, the need to take more medications may indicate a greater impairment burden. BOTC is introduced in the first chapter of the AMA Guides, Sixth Edition, which clarifies that “BOTC refers to the impairment that results from adhering to a complex regimen of medications, testing, and/or procedures to achieve an objective, measurable, clinical improvement that would not occur, or potentially could be reversed, in the absence of compliance.

MR defecography in ano-rectal dysfunction: a clinical-radiological correlation study

Egyptian Journal of Radiology and Nuclear Medicine ◽

10.1186/s43055-020-00286-z ◽

2020 ◽

Vol 51 (1) ◽

Author(s):

Samira Saraya ◽

Ahmed Awad ◽

Rehab El EL Bakry

Keyword(s):

Correlation Study ◽

Mr Defecography ◽

Rectal Dysfunction

The Systematic Bias of Entropy Calculation in the Multi-Scale Entropy Algorithm

Entropy ◽

10.3390/e23060659 ◽

2021 ◽

Vol 23 (6) ◽

pp. 659

Author(s):

Jue Lu ◽

Ze Wang

Keyword(s):

Time Series ◽

Standard Deviation ◽

Coarse Graining ◽

Sample Entropy ◽

Systematic Bias ◽

Original Time Series ◽

Multi Scale ◽

Calculation Results ◽

Surrogate Measure ◽

Original Time

Entropy indicates irregularity or randomness of a dynamic system. Over the decades, entropy calculated at different scales of the system through subsampling or coarse graining has been used as a surrogate measure of system complexity. One popular multi-scale entropy analysis is the multi-scale sample entropy (MSE), which calculates entropy through the sample entropy (SampEn) formula at each time scale. SampEn is defined by the “logarithmic likelihood” that a small section (within a window of a length m) of the data “matches” with other sections will still “match” the others if the section window length increases by one. “Match” is defined by a threshold of r times standard deviation of the entire time series. A problem of current MSE algorithm is that SampEn calculations at different scales are based on the same matching threshold defined by the original time series but data standard deviation actually changes with the subsampling scales. Using a fixed threshold will automatically introduce systematic bias to the calculation results. The purpose of this paper is to mathematically present this systematic bias and to provide methods for correcting it. Our work will help the large MSE user community avoiding introducing the bias to their multi-scale SampEn calculation results.

Adding low concentrations of clonidine to ropivacaine for transversus abdominis plane blocks does not reduce plasma ropivacaine levels, suggesting a lack of vasoconstrictor effect

Anaesthesia and Intensive Care ◽

10.1177/0310057x19838731 ◽

2019 ◽

Vol 47 (2) ◽

pp. 134-140

Author(s):

Jennifer M Crawford ◽

John A Loadsman ◽

Kenny XF Yang ◽

Peter CA Kam

Keyword(s):

Local Anaesthetics ◽

Transversus Abdominis ◽

Control Group ◽

Transversus Abdominis Plane ◽

Nerve Blocks ◽

Duration Of Action ◽

Low Concentrations ◽

Vasoconstrictor Effect ◽

Surrogate Measure ◽

To Receive

Clonidine has been used successfully to prolong the duration of action of local anaesthetics in peripheral nerve blocks, but its mechanism of action in this setting remains unclear. Some studies suggest that clonidine exerts a vasoconstrictor effect, limiting the washout of local anaesthetic from its site of deposition. We investigated this potential vasoconstrictor effect, using plasma ropivacaine concentrations as a surrogate measure of vasoconstriction, in patients who received transversus abdominis plane (TAP) blocks with and without clonidine. Eighty women undergoing laparoscopic gynaecological surgery were randomly assigned to receive one of four TAP block solutions: 0.2% ropivacaine (control), ropivacaine with clonidine 2 μg/kg (clonidine), ropivacaine with 1:400,000 adrenaline (adrenaline) or ropivacaine and a subcutaneous injection of clonidine 2 μg/kg (SC clonidine). The primary outcome was total venous plasma ropivacaine concentrations up to 6 h after the block. There were no significant differences in plasma ropivacaine concentrations between the control group and the clonidine group at any timepoint in the study, nor were there differences in either the mean maximum ropivacaine concentration ( Cmax) (1.99 μg/mL versus 2.05 μg/mL, P = 0.712) or the time to maximum concentration ( Tmax) (51.0 min versus 56.0 min, P = 0.537). The SC clonidine group also did not differ significantly from the controls ( Cmax 2.13 μg/mL versus 1.99 μg/mL, P = 0.424; Tmax 43.5 min versus 51.0 min, P = 0.201). Plasma ropivacaine concentrations in the adrenaline group were significantly lower than the controls from 10 to 90 min ( P < 0.003 for each comparison), and the Cmax was less than that of the control group (1.36 μg/mL versus 1.99 μg/mL, P < 0.001) with a longer Tmax (103.5 min versus 51.0 min, P = 0.001). These findings indicate that clonidine at a concentration of 1.35 μg/mL added to ropivacaine for TAP blocks did not produce a reduction in plasma ropivacaine concentrations. This suggests a lack of vasoconstrictor effect during TAP blocks. Further studies should evaluate whether vasoconstriction occurs when clonidine is used at higher concentrations or for other blocks.

Oral Fluoride Levels 1 h after Use of a Sodium Fluoride Rinse: Effect of Sodium Lauryl Sulfate

Caries Research ◽

10.1159/000381192 ◽

2015 ◽

Vol 49 (3) ◽

pp. 291-296 ◽

Cited By ~ 4

Author(s):

Gerald L. Vogel ◽

Gary E. Schumacher ◽

Laurence C. Chow ◽

Livia M.A. Tenuta

Keyword(s):

Sodium Fluoride ◽

Sodium Lauryl Sulfate ◽

Lauryl Sulfate ◽

Fluoride Release ◽

Important Goal ◽

Oral Fluids ◽

Surrogate Measure ◽

Significant Change ◽

Topical Fluoride

Increasing the concentration of free fluoride in oral fluids is an important goal in the use of topical fluoride agents. Although sodium lauryl sulfate (SLS) is a common dentifrice ingredient, the influence of this ion on plaque fluid and salivary fluid fluoride has not been examined. The purpose of this study was to investigate the effect of SLS on these parameters and to examine the effect of this ion on total (or whole) plaque fluoride, an important source of plaque fluid fluoride after a sufficient interval following fluoride administration, and on total salivary fluoride, a parameter often used as a surrogate measure of salivary fluid fluoride. Ten subjects accumulated plaque for 48 h before rinsing with a 12 mmol/l NaF (228 µg/g F) rinse containing or not containing 0.5% (w/w) SLS. SLS had no statistically significant effect on total plaque and total saliva fluoride but significantly increased salivary fluid and plaque fluid fluoride (by 147 and 205%, respectively). These results suggest that the nonfluoride components of topical agents can be manipulated to improve the fluoride release characteristics from oral fluoride reservoirs and that statistically significant change may be observed in plaque fluid and salivary fluid fluoride concentrations that may not be observed in total plaque and total saliva fluoride concentrations.

A Surrogate Measure for the Firm's Investment in Human Resources

Journal of Accounting Research ◽

10.2307/2490374 ◽

1974 ◽

Vol 12 (2) ◽

pp. 235 ◽

Cited By ~ 31

Author(s):

Abraham Friedman ◽

Baruch Lev

Keyword(s):

Human Resources ◽

Surrogate Measure

Safety Evaluation of Transit Signal Priority with Bus Speed Volatility as a Surrogate Measure: Case Study in Minnesota

International Conference on Transportation and Development 2021 ◽

10.1061/9780784483534.041 ◽

2021 ◽

Author(s):

Yu Song ◽

Hoki Tse ◽

Eric M. Lind ◽

Madhav V. Chitturi ◽

David A. Noyce

Keyword(s):

Safety Evaluation ◽

Transit Signal Priority ◽

Surrogate Measure

The number of deformed joints as a surrogate measure of damage in rheumatoid arthritis

Arthritis & Rheumatism ◽

10.1002/art1.10160 ◽

2002 ◽

Vol 47 (1) ◽

pp. 67-72 ◽

Cited By ~ 30

Author(s):

Carlos H. Orces ◽

Inmaculada Del Rincón ◽

Michael P. Abel ◽

Agustín Escalante

Keyword(s):

Rheumatoid Arthritis ◽

Surrogate Measure

Hospital mortality under surgical care

Annals of The Royal College of Surgeons of England ◽

10.1308/003588411x563411 ◽

2011 ◽

Vol 93 (3) ◽

pp. 193-200 ◽

Cited By ~ 4

Author(s):

O Aziz ◽

D Fink ◽

L Hobbs L ◽

G Williams ◽

TC Holme

Keyword(s):

Surgical Care ◽

Hospital Performance ◽

General Surgeon ◽

Mortality Data ◽

Co Morbidity ◽

Specific Mortality ◽

Mortality Ratio ◽

Case Mix Adjustment ◽

Surrogate Measure ◽

Morbidity Index

INTRODUCTION The ‘hospital standardised mortality ratio’ (HSMR) has been used in England since 1999 to measure NHS hospital performance. Large variations in reported HSMR between English hospitals have recently led to heavy criticism of their use as a surrogate measure of hospital performance. This paper aims to review the mortality data for a consultant general surgeon contributed by his NHS trust over a 3-year period as part of the trust's HSMR calculation and evaluate the accuracy of coding the diagnoses and covariates for case mix adjustment. SUBJECTS AND METHODS The Dr Foster Intelligence database was interrogated to extract the NHS trust's HSMR benchmark data on inpatient mortality for the surgeon from 1 April 2006 to 31 March 2009 and compared to the hospital notes. RESULTS 30 patients were identified of whom 12 had no evidence of being managed by the surgeon. This represents a potential 40% inaccuracy rate in designating consultant responsibility. The remaining 18 patients could be separated into ‘operative’ (11 patients) and ‘non-operative’ (7 patients) groups. Only 27% in the operative group and 43% of the non-operative mortality group respectively had a Charlson co-morbidity index recorded despite 94% of the cases having significant co-morbidities CONCLUSIONS Highlighting crude and inaccurate clinician-specific mortality data when only 1-5% of deaths under surgical care may be associated with avoidable adverse events seems potentially irresponsible.

Dynamic MR defecography of the posterior compartment: indications, techniques, and MRI features

Clinical Imaging ◽

10.1016/j.clinimag.2007.06.009 ◽

2007 ◽

Vol 31 (5) ◽

pp. 371 ◽

Cited By ~ 3

Author(s):

K. Mortele ◽

J. Fairhurst

Keyword(s):

Posterior Compartment ◽

Mr Defecography ◽

Mri Features ◽

Dynamic Mr