Seasonal change in egg-volume variation within a clutch in the Bull-headed Shrike, Lanius bucephalus

2003 ◽  
Vol 81 (2) ◽  
pp. 287-293 ◽  
Author(s):  
Masaoki Takagi
Keyword(s):  
Seasonal Change ◽  
Egg Volume ◽  
Hatching Order ◽  
Volume Variation ◽  
Significant Difference ◽  
Lanius Bucephalus ◽  
Clutch Initiation ◽  
The Mean ◽  
The Cost ◽  
Breeding Seasons

I studied the seasonal change in egg volume in Bull-headed Shrikes, Lanius bucephalus, to explore the importance of egg-volume variation within a clutch. The mean egg volume did not change over a season; however, the coefficient of variation in egg volume in six-egg clutches significantly increased in 1994 and 1995 but did not change in 1996. Peaks in arthropod biomass occurred early in the breeding seasons in 1994 and 1995, but late in the season in 1996. Higher food availability was related to a reduction in variation in egg volume within a clutch. A significant difference in egg volume was found within six-egg clutches, and the first egg was the smallest. Nestlings that hatched from small eggs early in the hatching order suffered lower mortality rates than nestlings that hatched from large eggs laid late in the hatching order. The duration of time between settlement of a female in a male territory and clutch initiation decreased with date. Intraclutch variation in egg volume may be caused by a trade-off between the time to develop an egg and the volume of the first egg within a clutch. Because eggs that hatch first do not need to be large for the hatchling to survive, the Bull-headed Shrikes may advance the clutch-initiation date at the cost of reducing the volume of the first egg.

scholarly journals Cost Effectiveness Analysis of Candesartan Therapy in Comparison to Candesartan-Amlodipine Therapy on Hypertensive Outpatients

2019 ◽  
Vol 7 (22) ◽  
pp. 3837-3840
Author(s):  
Faridah Baroroh ◽  
Andriana Sari ◽  
Noviana Masruroh
Keyword(s):  
Blood Pressure ◽  
Cost Effectiveness ◽  
Cost Effective ◽  
Cost Effectiveness Analysis ◽  
Effectiveness Analysis ◽  
Significant Difference ◽  
Hypertension Therapy ◽  
The Mean ◽  
The Cost

BACKGROUND: he achievement of optimal hypertension therapy requires cost-effective medicine. The treatment of hypertensive patients needs for long-term medication have made medical costs a prime issue in health economics. AIM: This study aims to determine the cost effectiveness of candesartan therapy compared to candesartan-amlodipine therapy on hypertensive outpatients. METHODS: This is a prospective cohort study that compares candesartan therapy to candesartan-amlodipine therapy at a public hospital from payers’ perspective. The outcome is the percentage of targeted blood pressure decrease after three months of therapy. The cost effectiveness analysis uses the Incremental Cost Effectiveness Ratio (ICER) based on the ratio of cost difference to the outcome in both therapy groups. RESULTS: As many as 111 patients participated in this research, comprising 40 candesartan therapy patients and 71 patients with the combination of candesartan-amlodipine. Of the participants, 63.96% were female, 57.66% were aged 60 or older, and 56.32% had diabetes mellitus as the most common complication. Results show that the average direct medical cost per patient for a therapy of three months with candesartan was IDR 1,050,536 ± 730,007 and IDR 760,040 ± 614,290 for a candesartan-amlodipine therapy. The mean decline of systolic and diastolic blood pressure under candesartan therapy is less than that of candesartan-amlodipine, although without any significant difference (p > 0.05). It follows that the effectiveness of candesartan (85%) is greater than that of the candesartan-amlodipine combination (84.50%). Candesartan therapy is thereby more cost-effective with an ICER value of IDR 580,993/%. CONCLUSION: Hypertension therapy by candesartan is more cost-effective than candesartan-amlodipine therapy with a cost addition of IDR 580,993.

scholarly journals Costs and readmission rates for the resection of primary and metastatic spinal tumors: a comparative analysis of 181 patients

2016 ◽  
Vol 25 (3) ◽  
pp. 366-378 ◽  
Author(s):  
Darryl Lau ◽  
Andrew K. Chan ◽  
Alexander A. Theologis ◽  
Dean Chou ◽  
Praveen V. Mummaneni ◽  
...  
Keyword(s):  
Hospital Stay ◽  
Direct Costs ◽  
Spinal Tumors ◽  
Readmission Rates ◽  
Metastatic Tumors ◽  
Factors Associated ◽  
Significant Difference ◽  
Perioperative Complication ◽  
The Mean ◽  
The Cost

OBJECTIVE Because the surgical strategies for primary and metastatic spinal tumors are different, the respective associated costs and morbidities associated with those treatments likely vary. This study compares the direct costs and 90-day readmission rates between the resection of extradural metastatic and primary spinal tumors. The factors associated with cost and readmission are identified. METHODS Adults (age 18 years or older) who underwent the resection of spinal tumors between 2008 and 2013 were included in the study. Patients with intradural tumors were excluded. The direct costs of index hospitalization and 90-day readmission hospitalization were evaluated. The direct costs were compared between patients who were treated surgically for primary and metastatic spinal tumors. The independent factors associated with costs and readmissions were identified using multivariate analysis. RESULTS A total of 181 patients with spinal tumors were included (63 primary and 118 metastatic tumors). Overall, the mean index hospital admission cost for the surgical management of spinal tumors was $52,083. There was no significant difference in the cost of hospitalization between primary ($55,801) and metastatic ($50,098) tumors (p = 0.426). The independent factors associated with higher cost were male sex (p = 0.032), preoperative inability to ambulate (p = 0.002), having more than 3 comorbidities (p = 0.037), undergoing corpectomy (p = 0.021), instrumentation greater than 7 levels (p < 0.001), combined anterior-posterior approach (p < 0.001), presence of a perioperative complication (p < 0.001), and longer hospital stay (p < 0.001). The perioperative complication rate was 21.0%. Of this cohort, 11.6% of patients were readmitted within 90 days, and the mean hospitalization cost of that readmission was $20,078. Readmission rates after surgical treatment for primary and metastatic tumors were similar (11.1% vs 11.9%, respectively) (p = 0.880). Prior hospital stay greater than 15 days (OR 6.62, p = 0.016) and diagnosis of lung metastasis (OR 52.99, p = 0.007) were independent predictors of readmission. CONCLUSIONS Primary and metastatic spinal tumors are comparable with regard to the direct costs of the index surgical hospitalization and readmission rate within 90 days. The factors independently associated with costs are related to preoperative health status, type and complexity of surgery, and postoperative course.

Cost-effectiveness and satisfaction following arthroscopic rotator cuff repair

2019 ◽  
Vol 101-B (7) ◽  
pp. 860-866 ◽  
Author(s):  
J. A. Nicholson ◽  
H. K. C. Searle ◽  
D. MacDonald ◽  
J. McBirnie
Keyword(s):  
Cost Effectiveness ◽  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Arthroscopic Rotator Cuff Repair ◽  
Significant Difference ◽  
The Mean ◽  
One Year ◽  
Arthroscopic Rotator Cuff ◽  
The Cost ◽  
Cuff Repair

Aims The aim of this study was to investigate the influence of age on the cost-effectiveness of arthroscopic rotator cuff repair. Patients and Methods A total of 112 patients were prospectively monitored for two years after arthroscopic rotator cuff repair using the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH), the Oxford Shoulder Score (OSS), and the EuroQol five-dimension questionnaire (EQ-5D). Complications and use of healthcare resources were recorded. The incremental cost-effectiveness ratio (ICER) was used to express the cost per quality-adjusted life-year (QALY). Propensity score-matching was used to compare those aged below and above 65 years of age. Satisfaction was determined using the Net Promoter Score (NPS). Linear regression was used to identify variables that influenced the outcome at two years postoperatively. Results A total of 92 patients (82.1%) completed the follow-up. Their mean age was 59.5 years (sd 9.7, 41 to 78). There were significant improvements in the mean DASH (preoperative 47.6 vs one-year 15.3; p < 0.001) and OSS scores (26.5 vs 40.5; p < 0.001). Functional improvements were maintained with no significant change between one and two years postoperatively. The mean preoperative EQ-5D was 0.54 increasing to 0.81 at one year (p < 0.001) and maintained at 0.86, two years postoperatively. There was no significant difference between those aged below or above 65 years of age with regards to postoperative shoulder function or EQ-5D gains. Smoking was the only characteristic that significantly adversely influenced the EQ-5D at two years postoperatively (p = 0.005). A total of 87 were promoters and five were passive, giving a mean NPS of 95 (87/92). The total mean cost per patient was £3646.94 and the mean EQ-5D difference at one year was 0.2691, giving a mean ICER of £13 552.36/QALY. At two years, this decreased further to £5694.78/QALY. This was comparable for those aged below or above 65 years of age (£5209.91 vs £5525.67). Smokers had an ICER that was four times more expensive. Conclusion Arthroscopic rotator cuff repair results in excellent patient satisfaction and cost-effectiveness, regardless of age. Cite this article: Bone Joint J 2019;101-B:860–866.

Cost-Utility Study of the Economics of Bunion Correction Surgery

2018 ◽  
Vol 40 (3) ◽  
pp. 336-342 ◽  
Author(s):  
Jason M. Sutherland ◽  
Janice Mok ◽  
Guiping Liu ◽  
Trafford Crump ◽  
Kevin Wing ◽  
...  
Keyword(s):  
Cost Utility ◽  
First Metatarsophalangeal Joint ◽  
Utility Values ◽  
Life Years ◽  
Significant Difference ◽  
Bunion Correction ◽  
Correction Surgery ◽  
The Mean ◽  
The Cost ◽  
The Impact

Background: Bunion correction surgery is a very common procedure to improve patients’ pain and physical function attributable to a misaligned first metatarsophalangeal joint. The objective of this study was to apply a health utility framework to estimate the cost utility of bunion correction surgery. Methods: Patients were prospectively recruited from the population of patients seen in a lower-extremity orthopedic clinic and scheduled for isolated bunion surgery. Participants completed EuroQoL’s EQ-5D(3L) to measure patients’ current general health preoperatively and 6 months postoperatively. Participants’ change in quality-adjusted life years (QALYs) were calculated by comparing the difference between postoperative utility values and preoperative utility values. The study had 95 patients representing 53% of eligible patients. Results: The mean preoperative utility value was 0.6816 and the mean postoperative value was 0.7451, a statistically significant difference denoting an improvement in self-reported health. The cost per QALY, assuming gains in health accrued for 15 years, was $4911 (the 95% confidence interval ranged from $4736 to $5088). The cost per QALY was highest among the oldest patients. Assuming gains in health accrued for 20 years, the cost per QALY was $3922. Conclusion: This study demonstrated that bunion correction surgery was inexpensive relative to its gains in health compared with commonly applied thresholds for women and men in all age groups, though the gains were not uniformly distributed across age categories. Future research should examine the impact of recurrence on the robustness of these findings. Level of Evidence: Level III, comparative study.

scholarly journals Induction of labour at term: 25 mcg 2 hourly oral misoprostol or 6 hourly intracervical cerviprime, safety and efficacy

2019 ◽  
Vol 9 (1) ◽  
pp. 240
Author(s):  
Indrani Mukhopadhyay ◽  
Dishant Sisodia
Keyword(s):  
Induction Of Labour ◽  
Singleton Pregnancy ◽  
Chi Square ◽  
Hourly Interval ◽  
Oral Misoprostol ◽  
Significant Difference ◽  
Misoprostol Group ◽  
Unfavorable Cervix ◽  
The Mean ◽  
The Cost

Background: There are various methods for induction of labour, both mechanical and pharmacological. Prostaglandins in induction have been commonly used. Studies have been done using vaginal and sublingual use of misoprostol. This study analyses efficacy of both oral misoprostol used in low frequent doses as per FIGO 2017 guidelines and intracervical prostaglandins for induction of labour.Methods: A total 159 consecutive pregnant term mothers with singleton pregnancy, intact membranes and unfavorable cervix were subdivided into two subgroups, first subgroup was administered 25 mcg oral misoprostol at 2 hourly interval and those in subgroup B were given intracervical PGE2. Both these subgroups were prospectively followed to assess efficacy in induction of labour at term and outcome in foetus and mother. Statistical analysis was done using chi square test.Results: It was found that the induction to delivery interval was significantly lesser in the cerviprime group (19.31 hours) compared to the misoprostol group (25.19 hours). However, there was no significant difference in the rate of vaginal delivery and mean duration of labour, rates of caesarean section, maternal and neonatal complications in both the groups. More women in the cerviprime group required augmentation with oxytocin. However, on comparing the cost of induction as per the mean doses used, the cost of induction with misoprostol was much lesser than that of cerviprime use.Conclusions: Oral use of Tab. misoprostol was not more efficacious than the use of cerviprime gel in induction of labour.

scholarly journals 175 Open vs MIS Lumbar Surgery: A Systematic Review of Cost Effectiveness

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
U Oduoza ◽  
K Eseonu ◽  
M Monem ◽  
M Tahir
Keyword(s):  
Cost Effectiveness ◽  
Open Surgery ◽  
Cochrane Library ◽  
Fusion Surgery ◽  
Manual Search ◽  
Significant Difference ◽  
The Mean ◽  
Open Versus ◽  
The Cost ◽  
Costing Analysis

Abstract Introduction Minimally invasive surgery has benefits over open surgery for lumbar decompression and/or fusion but there is no established consensus regarding its cost effectiveness. Method A systematic electronic search of databases (MEDLINE, EMBASE and Cochrane Library) and manual search from the Cost Effectiveness Analysis (CEA) database and NHS Economic Evaluation Database (NHS EED). Two authors reviewed abstracts against exclusion criteria. Studies including adult populations undergoing surgery for degenerative changes (lumbar stenosis, lumbar radiculopathy, spondylolisthesis) of the lumbar spine, reporting outcomes of costing analysis, CEA or Incremental cost effectiveness ratio (ICER) were included. Results Two of the 5 studies comparing open vs single level MIS fusion surgery (TLIF) reported a statistically significant reduction in direct cost for MIS compared to open surgery. The mean non-inflation adjusted cost was $31,626, and $34757 for the MIS and open TLIF groups respectively. One paper comparing open versus MIS two level TLIF reported a statistically significant difference in costing but not in QALYs. Conclusions Generally, studies reported a reduced cost associated with MIS versus open surgery. One study reported a statistically significant change in QALY. The majority had a high risk of bias. This review was unable to recommend MIS over open surgery from a cost effectiveness perspective.

Vowel Recognition Threshold as a Function of Temporal Segmentations

1970 ◽  
Vol 13 (4) ◽  
pp. 715-724 ◽  
Author(s):  
Richard L. Powell ◽  
Oscar Tosi
Keyword(s):  
Normal Hearing ◽  
Recognition Threshold ◽  
Vowel Sound ◽  
Significant Difference ◽  
The Mean ◽  
Vowel Recognition ◽  
Temporal Segment

Vowels were segmented into 15 different temporal segments taken from the middle of the vowel and ranging from 4 to 60 msecs, then presented to 6 subjects with normal hearing. The mean temporal-segment recognition threshold of 15 msecs with a range from 9.3 msecs for the /u/ to 27.2 milliseconds for the /a/. Misidenti-fication of vowels was most often confused with the vowel sound adjacent to it on the vowel-hump diagram. There was no significant difference between the cardinal and noncardinal vowels.

Left Ventricular Dysfunction and Blood Glycohemoglobin Levels in Young Diabetics

1991 ◽  
Vol 30 (05) ◽  
pp. 183-188
Author(s):  
A. Aydrner ◽  
A. Oto ◽  
E. Oram ◽  
O. Gedik ◽  
C. F. Bekdik ◽  
...  
Keyword(s):  
Ejection Fraction ◽  
Left Ventricular Function ◽  
Ventricular Function ◽  
Left Ventricular ◽  
Diabetic Patients ◽  
Filling Fraction ◽  
Time To Peak ◽  
Significant Difference ◽  
The Mean ◽  
Hba1c Levels

Left ventricular function including regional wall motion (RWM) was evaluated by 99mTc first-pass and equilibrium gated blood pool ventriculography and glycohemoglobin (HbA1c) blood levels determined by a quantitative column technique in 25 young patients with insulin-dependent diabetes mellitus without clinical evidence of heart disease, and in healthy controls matched for age and sex. Phase analysis revealed abnormal RWM in 19 of 21 diabetic patients. The mean left ventricular global ejection fraction, the mean regional ejection fraction and the mean 1/3 filling fraction were lower and the time to peak ejection, the time to peak filling and the time to peak ejection /cardiac cycle were longer in diabetics than in controls. We found high HbA1c levels in all diabetics. There was no significant difference between patients with and without retinopathy and with and without peripheral neuropathy in terms of left ventricular function and HbA1c levels.

Detection of Circulating Tissue Factor and Factor VII in a Normal Population

1996 ◽  
Vol 75 (05) ◽  
pp. 772-777 ◽  
Author(s):  
Sybille Albrecht ◽  
Matthias Kotzsch ◽  
Gabriele Siegert ◽  
Thomas Luther ◽  
Heinz Großmann ◽  
...  
Keyword(s):  
Tissue Factor ◽  
Normal Population ◽  
Mean Value ◽  
Factor Vii ◽  
Significant Difference ◽  
Age Dependent ◽  
The Mean ◽  
Highly Correlated ◽  
And Gender

SummaryThe plasma tissue factor (TF) concentration was correlated to factor VII concentration (FVIIag) and factor VII activity (FVIIc) in 498 healthy volunteers ranging in age from 17 to 64 years. Immunoassays using monoclonal antibodies (mAbs) were developed for the determination of TF and FVIIag in plasma. The mAbs and the test systems were characterized. The mean value of the TF concentration was 172 ± 135 pg/ml. TF showed no age- and gender-related differences. For the total population, FVIIc, determined by a clotting test, was 110 ± 15% and the factor VIlag was 0.77 ± 0.19 μg/ml. FVII activity was significantly increased with age, whereas the concentration demonstrated no correlation to age in this population. FVII concentration is highly correlated with the activity as measured by clotting assay using rabbit thromboplastin. The ratio between FVIIc and FVIIag was not age-dependent, but demonstrated a significant difference between men and women. Between TF and FVII we could not detect a correlation.

Multi-Center Study of Thromboplastin Calibration Precision – Influence of Reagent Species, Composition, and International Sensitivity Index (ISI)

1993 ◽  
Vol 69 (01) ◽  
pp. 035-040 ◽  
Author(s):  
A M H P van den Besselaar ◽  
R M Bertina
Keyword(s):  
Oral Anticoagulants ◽  
International Normalized Ratio ◽  
The Other ◽  
World Health ◽  
Rabbit Brain ◽  
Sensitivity Index ◽  
Bovine Plasma ◽  
Significant Difference ◽  
The Mean ◽  
International Sensitivity Index

SummaryFour thromboplastin reagents were tested by 18 laboratories in Europe, North-America, and Australasia, according to a detailed protocol. One thromboplastin was the International Reference Preparation for ox brain thromboplastin combined with adsorbed bovine plasma (coded OBT/79), and the second was a certified reference material for rabbit brain thromboplastin, plain (coded CRM 149R). The other two thromboplastin reagents were another rabbit plain brain thromboplastin (RP) with a lower ISI than CRM 149R and a rabbit brain thromboplastin combined with adsorbed bovine plasma (RC). Calibration of the latter two reagents was performed according to methods recommended by the World Health Organization (W. H. O.).The purpose of this study was to answer the following questions: 1) Is the calibration of the RC reagent more precise against the bovine/combined (OBT/79) than against the rabbit/plain reagent (CRM 149R)? 2) Is the precision of calibration influenced by the magnitude of the International Sensitivity Index (ISI)?The lowest inter-laboratory variation of ISI was observed in the calibration of the rabbit/plain reagent (RP) against the other rabbit/plain reagent (CRM 149R) (CV 1.6%). The highest interlaboratory variation was obtained in the calibration of rabbit/plain (RP) against bovine/combined (OBT/79) (CV 5.1%). In the calibration of the rabbit/combined (RC) reagent, there was no difference in precision between OBT/79 (CV 4.3%) and CRM 149R (CV 4.2%). Furthermore, there was no significant difference in the precision of the ISI of RC obtained with CRM 149R (ISI = 1.343) and the rabbit/plain (RP) reagent with ISI = 1.14. In conclusion, the calibration of RC could be performed with similar precision with either OBT/79 or CRM 149R, or RP.The mean ISI values calculated with OBT/79 and CRM 149R were practically identical, indicating that there is no bias in the ISI of these reference preparations and that these reference preparations have been stable since their original calibration studies in 1979 and 1987, respectively.International Normalized Ratio (INR) equivalents were calculated for a lyophilized control plasma derived from patients treated with oral anticoagulants. There were small but significant differences in the mean INR equivalents between the bovine and rabbit thromboplastins. There were no differences in the interlaboratory variation of the INR equivalents, when the four thromboplastins were compared.

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