Endometrial Adenocarcinoma in SurePath™ Cervical Samples: Cytological Features Revisited

2016 ◽  
Vol 60 (1) ◽  
pp. 46-52 ◽  
Author(s):  
Nalini Gupta ◽  
John Crossley ◽  
Nick Dudding ◽  
John H.F. Smith
Keyword(s):  
Phase 1 ◽  
Endometrial Adenocarcinoma ◽  
Nuclear Chromatin ◽  
Phase 2 ◽  
Cervical Lesions ◽  
Two Phase ◽  
Endometrial Cells ◽  
Phase Study ◽  
Cytological Features ◽  
Liquid Based Cytology

Objective: The cytomorphological criteria of malignant endometrial lesions in cervical samples are less well described than those of cervical lesions. We wished to investigate if there were features in SurePath™ liquid-based cytology samples that would facilitate more accurate differentiation between benign and malignant endometrial cells. Study Design: This was a two-phase study, with a review of all SurePath™ samples reported as endometrial adenocarcinoma (n = 42) evaluating 12 cytological features in the first phase. In phase 2 (test set), all initial cases plus an additional 83 cases were reviewed using these 12 cytological features to predict the outcome. Results: Out of 12 cytological features evaluated in phase 1 (training set), nuclear chromatin pattern, apoptotic bodies and tingible body macrophages were found to be the most significant features determining malignant histological outcome. These 12 cytological features were re-evaluated in phase 2 (n = 125). Of 125 cases, 54 had a benign and 71 had a malignant or premalignant histological outcome, with a positive predictive value of 56.8%. Conclusion: Granular nuclear chromatin, tingible body macrophages and apoptosis in the background are the most significant factors in determining whether endometrial cells present in cervical samples represent malignancy or are benign. Using these features, relatively accurate predictions of endometrial pathology can be made.

scholarly journals Development and Feasibility of a Kinect-Based Constraint-Induced Therapy Program in the Home Setting for Children With Unilateral Cerebral Palsy

2021 ◽  
Vol 9 ◽  
Author(s):  
Hao-Ling Chen ◽  
Szu-Yu Lin ◽  
Chun-Fu Yeh ◽  
Ren-Yu Chen ◽  
Hsien-Hui Tang ◽  
...  
Keyword(s):  
Cerebral Palsy ◽  
Phase 1 ◽  
Training System ◽  
Phase 2 ◽  
Two Phase ◽  
Clinical Trial Registration ◽  
Home Setting ◽  
Therapy Program ◽  
Phase Study ◽  
Block Test

Introduction: Cerebral palsy (CP) is the leading cause of childhood-onset physical disability. Children with CP often have impaired upper limb (UL) function. Constraint-induced therapy (CIT) is one of the most effective UL interventions for children with unilateral CP. However, concerns about CIT for children have been repeatedly raised due to frustration caused by restraint of the child’s less-affected UL and lack of motivation for the intensive protocol. Virtual reality (VR), which can mitigate the disadvantages of CIT, potentially can be used as an alternative mediator for implementing CIT. Therefore, we developed a VR-based CIT program for children with CP using the Kinect system.Aims: The feasibility of the Kinect-based CIT program was evaluated for children with unilateral CP using a two-phase study design.Materials and Methods: In phase 1, ten children with unilateral CP were recruited. To confirm the achievement of the motor training goals, maximal UL joint angles were evaluated during gameplay. To evaluate children’s perceptions of the game, a questionnaire was used. In phase 2, eight children with unilateral CP were recruited and received an 8 weeks Kinect-based CIT intervention. Performance scores of the game and outcomes of the box and block test (BBT) were recorded weekly.Results: In phase 1, results supported that the design of the program was CIT-specific and was motivational for children with unilateral CP. In phase 2, game performance and the BBT scores began showing stable improvements in the fifth week of intervention.Conclusion: It suggested the Kinect-based CIT program was beneficial to the motor function of the affected UL for children with unilateral CP. According to the results of this feasibility study, larger and controlled effectiveness studies of the Kinect-based CIT program can be conducted to further improve its clinical utility.Clinical Trial Registration: ClinicalTrials.gov, NCT02808195; Comparative effectiveness of a Kinect-based unilateral arm training system vs. CIT for children with CP

scholarly journals Texting Older Sisters to Step: The TOSS Study

2018 ◽  
Vol 41 (3) ◽  
pp. 388-408 ◽  
Author(s):  
Pamela G. Bowen ◽  
Olivio J. Clay ◽  
Loretta T. Lee ◽  
Wesley Browning ◽  
Yu-Mei Schoenberger ◽  
...  
Keyword(s):  
Physical Activity ◽  
African American Women ◽  
Phase 1 ◽  
Text Messages ◽  
Phase 2 ◽  
Two Phase ◽  
Contemplation Stage ◽  
Phase Study ◽  
Older African American Women ◽  
The Mean

The purpose of our two-phase study was to develop acceptable text messages to increase physical activity. Four focus groups (two for each phase) were conducted with older African American women who had access to texting-capable mobile phones and were in the contemplation stage for physical activity. The mean age of Phase 1 participants ( n = 12) was 71 and ranged from 65 to 86 years. Content analysis was used to identify fundamental themes that were later used to develop text messages. Six categories emerged from the data and 31 text messages were developed based on focus group input and national recommendations. The mean age of Phase 2 participants ( n = 9) was 67 and ranged from 65 to 75 years. Descriptive statistics revealed 100% of participants understood all messages. When messages were evaluated individually, a minimum of 78% felt each message motivated activity and 67% said lengths were perfect. Findings identified messages that were relevant and potentially motivational to stimulate physical activity among this population.

Effects of Aerosolized Dexamethasone on Acute Subglottic Injury

1992 ◽  
Vol 101 (1) ◽  
pp. 95-99 ◽  
Author(s):  
Thomas C. Kryzer ◽  
Carlos Gonzalez ◽  
Lawrence P. A. Burgess
Keyword(s):  
Phase 1 ◽  
Control Group ◽  
Phase 2 ◽  
Histomorphometric Analysis ◽  
Untreated Control Group ◽  
Phase 1 Study ◽  
Two Phase ◽  
Phase Study ◽  
Significant Difference ◽  
Made In

Aerosolized dexamethasone was used in a two-phase study to determine the possible effects on acute subglottic injury in the ferret animal model. In phase 1, equivalent subglottic injuries were made in 10 animals by using the brush technique, and the animals were divided into two groups. The treatment group received aerosolized dexamethasone at 2, 4, and 6 hours postinjury. All animals were examined 2, 4, 6, and 24 hours after the injury. The clinical condition of each animal was evaluated and their airways were measured. The animals were then painlessly killed and the larynges were frozen, sectioned, and photographed at 1-mm intervals. A computer-linked digitizer pad was used to measure the subglottic dimensions. The results show a trend for the treated animals to have a larger subglottic airway as compared to the untreated (control) group. The phase 1 study suggests that there may be an improvement in the subglottic airway when treated acutely with aerosolized dexamethasone. In phase 2, 20 additional animals were studied by using the same methods of injury and treatment as in phase 1. The subglottic airways of these animals were evaluated with histomorphometric analysis on fixed histologic sections. A statistically significant difference was found between the subglottic airways of the treated and untreated animals favoring treatment with aerosolized dexamethasone. Aerosolized dexamethasone appears to be beneficial in preserving the subglottic airway after injury, possibly secondary to decreasing the edema associated with injury.

scholarly journals Developing a realist theory of psychosocial rehabilitation: the Clubhouse model

2021 ◽  
Author(s):  
Christina Mutschler ◽  
Jen Rouse ◽  
Kelly McShane ◽  
Criss Habal-Brosek
Keyword(s):  
Phase 1 ◽  
Psychosocial Rehabilitation ◽  
Theory Development ◽  
Realist Evaluation ◽  
Self Determination ◽  
Phase 2 ◽  
Two Phase ◽  
Realist Theory ◽  
Clubhouse Model ◽  
Two Phases

Background Psychosocial rehabilitation is a service that supports recovery from mental illness by providing opportunities for skill development, self-determination, and social interaction. One type of psychosocial rehabilitation is the Clubhouse model. The purpose of the current project was to create, test, and refine a realist theory of psychosocial rehabilitation at Progress Place, an accredited Clubhouse. Method Realist evaluation is a theory driven evaluation that uncovers contexts, mechanisms, and outcomes, in order to develop a theory as to how a program works. The current study involved two phases, encompassing four steps: Phase 1 included (1) initial theory development and (2) initial theory refinement; and Phase 2 included (3) theory testing and (4) refinement. Results The data from this two-phase approach identified three demi-regularities of recovery comprised of specific mechanisms and outcomes: the Restorative demi-regularity, the Reaffirming demi-regularity, and the Re-engaging demi-regularity. The theory derived from these demi-regularities suggests that there are various mechanisms that produce outcomes of recovery from the psychosocial rehabilitation perspective, and as such, it is necessary that programs promote a multifaceted, holistic perspective on recovery. Conclusions The realist evaluation identified that Progress Place promotes recovery for members. Additional research on the Clubhouse model should be conducted to further validate that the model initiates change and promotes recovery outcomes.

scholarly journals Whole system approaches to health in higher education

2019 ◽  
Vol 119 (4) ◽  
pp. 246-258
Author(s):  
Mark Dooris ◽  
Alan Farrier ◽  
Susan Powell ◽  
Maxine Holt
Keyword(s):  
Higher Education ◽  
Phase 1 ◽  
International Perspective ◽  
Phase 2 ◽  
Structured Interviews ◽  
Two Phase ◽  
Content Type ◽  
Key Issues ◽  
Strategic Influence ◽  
The Uk

Purpose The purpose of this paper is to report on an evaluation of the UK Healthy Universities Network (UKHUN), which explored engagement of network members; identified what members value about the network; examined facilitators and barriers to engagement; and informed the network’s future development. Design/methodology/approach The study was a two phase mixed-method study, with participants being staff from Higher Education institutions. Phase 1 involved a documentary review and an online 14-question survey (n=32). Phase 2 comprised follow-up semi-structured interviews and focus groups, conducted using Skype (n=11). These were audio recorded and transcripts were thematically analysed in a two-stage process. Findings A number of key themes emerged from the thematic analysis: value of network meetings and events; popularity of the network website; increased communication and collaboration; sense of leadership offered by the network; interest and inclusion of an international perspective; importance of institutional support. Research limitations/implications Only six universities who are involved in the network took part in Phase 2. Although a range of organisations were chosen purposively, it is possible that additional key issues at other universities were excluded. Originality/value The UKHUN is valued by its membership, particularly its biannual meetings, online presence, leadership, ethos and communication methods. Key barriers include the capacity of staff to attend meetings and contribute to the network, influenced by a lack of institutional commitment and prioritisation. Findings from the evaluation have informed a “refresh” of the network’s website and a revision of its membership structure, as well as guiding its positioning to achieve greater strategic influence.

scholarly journals Evaluation of the clinical practice of aminoglycoside use in paediatric patients in Kenya: findings and implications for lower-middle income countries

2020 ◽  
Vol 2 (1) ◽  
Author(s):  
Elias Joseph Onyango ◽  
Faith Okalebo ◽  
Margaret Oluka ◽  
Rosaline Kinuthia ◽  
Loice Achieng ◽  
...  
Keyword(s):  
Phase 1 ◽  
Therapeutic Index ◽  
Therapeutic Drug ◽  
National Guidelines ◽  
Two Phase ◽  
Middle Income ◽  
Face To Face ◽  
Skill Gaps ◽  
Aminoglycoside Therapy ◽  
Phase Study

Abstract Objectives To evaluate the practice of aminoglycoside use/monitoring in Kenya and explore healthcare worker (HCW) perceptions of aminoglycoside monitoring to identify gaps and opportunities for future improvements, given the low therapeutic index of aminoglycosides. Methods This was a two-phase study whereby we reviewed patients’ medical records at Kenyatta National Hospital (October–December 2016) in Phase 1 and interviewed HCWs face to face in Phase 2. Outcome measures included describing and evaluating the practice of aminoglycoside use and monitoring and compliance to guidelines. Data were analysed using descriptive and inferential analysis. Results Overall, out of the 2318 patients admitted, 192 patients (8.3%) were prescribed an aminoglycoside, of which 102 (53.1%) had aminoglycoside doses that did not conform to national guidelines. Aminoglycoside-related adverse effects were suspected in 65 (33.9%) patients. Monitoring of aminoglycoside therapy was performed in only 17 (8.9%) patients, with no therapeutic drug monitoring (TDM), attributed mainly to knowledge and skill gaps and lack of resources. Out of the 28 recruited HCWs, 18 (64.3%) needed training in how to perform and interpret TDM results. Conclusions The practice of using and monitoring aminoglycosides was suboptimal, raising concerns around potential avoidable harm to patients. The identified gaps could form the basis for developing strategies to improve the future use of aminoglycosides, not only in Kenya but also in other countries with similar settings and resources.

Development and Testing of the Resourcefulness Scale for Older Adults

2006 ◽  
Vol 14 (1) ◽  
pp. 57-68 ◽  
Author(s):  
Jaclene A. Zauszniewski ◽  
Chien-Yu Lai ◽  
Sukuma Tithiphontumrong
Keyword(s):  
Older Adults ◽  
Internal Consistency ◽  
Phase 1 ◽  
Chronically Ill ◽  
Potential Usefulness ◽  
Phase 2 ◽  
Middle Aged ◽  
Phase Study ◽  
Middle Aged Adults ◽  
Acceptable Internal Consistency

Resourcefulness is the ability to independently perform daily tasks (personal resourcefulness) and to seek help from others when unable to function independently (social resourcefulness). The 2 forms of resourcefulness are theoretically related, yet no current measure captures both simultaneously. This 2-phase study involved development and testing of a Resourcefulness Scale for elders from existing measures of personal and social resourcefulness. Data from 2 studies of 451 chronically ill elders were randomly split: the measure was developed in phase 1 and validated in phase 2. The new Resourcefulness Scale has acceptable internal consistency (α= .85). Two correlated subscales reflecting personal and social resourcefulness (r= .41) were confirmed. The Resourcefulness Scale has potential usefulness for older adults as well as younger and middle-aged adults.

A computationally fast approach to maximum‐likelihood deconvolution

Geophysics ◽  
1984 ◽  
Vol 49 (5) ◽  
pp. 550-565 ◽  
Author(s):  
Chong‐Yung Chi ◽  
Jerry M. Mendel ◽  
Dan Hampson
Keyword(s):  
Maximum Likelihood ◽  
Initial Conditions ◽  
Phase 1 ◽  
Real Data ◽  
Phase 2 ◽  
Statistical Parameters ◽  
Two Phase ◽  
Nonminimum Phase ◽  
Fast Approach ◽  
Fine Adjustment

In this paper we derive and implement a maximum‐likelihood deconvolution (MLD) algorithm, based on the same channel and statistical models used by Kormylo and Mendel (1983a), that leads to many fewer computations than their MLD algorithm. Both algorithms can simultaneously estimate a nonminimum phase wavelet and statistical parameters, detect locations of significant reflectors, and deconvolve the data. Our MLD algorithm is implemented by a two‐phase block component method (BCM). The phase‐1 block functions like a coarse adjustment of unknown quantities and provides a set of good initial conditions for the phase‐2 block, which functions like a fine adjustment of unknown quantities. We demonstrate good performance of our algorithm for both synthetic and real data.

scholarly journals Early Diagnostic Marker Panel Determination for Microarray Based Clinical Studies

2005 ◽  
Vol 4 (1) ◽  
Author(s):  
Jochen Jaeger ◽  
Dieter Weichenhan ◽  
Boris Ivandic ◽  
Rainer Spang
Keyword(s):  
Phase 1 ◽  
Classification Model ◽  
Marker Genes ◽  
Phase 2 ◽  
Two Phase ◽  
Marker Panel ◽  
Performance Loss ◽  
Genome Wide ◽  
Number Of Patients ◽  
Cost Efficient

We present a novel, cost efficient two-phase design for predictive clinical gene expression studies: early marker panel determination (EMPD). In Phase-1, genome-wide microarrays are used only for a small number of individual patient samples. From this Phase-1 data a panel of marker genes is derived. In Phase-2, the expression values of these marker panel genes are measured for a large group of patients and a predictive classification model is learned from this data. Phase-2 does not require the use of expensive whole genome microarrays, thus making EMPD a cost efficient alternative for current trials. The expected performance loss of EMPD is compared to designs which use genome-wide microarrays for all patients. We also examine the trade-off between the number of patients included in Phase-1 and the number of marker genes required in Phase-2. By analysis of five published datasets we find that in Phase-1 already 16 patients per group are sufficient to determine a suitable marker panel of 10 genes, and that this early decision compromises the final performance only marginally.

scholarly journals Stem cell factor amplifies newborn and sickle erythropoiesis in liquid cultures

Blood ◽  
1993 ◽  
Vol 81 (10) ◽  
pp. 2591-2599 ◽  
Author(s):  
RS Weinberg ◽  
JC Thomson ◽  
R Lao ◽  
G Chen ◽  
BP Alter
Keyword(s):  
Stem Cell ◽  
Progenitor Cells ◽  
Stem Cell Factor ◽  
Mononuclear Cells ◽  
Phase 1 ◽  
Newborn Infants ◽  
Cell Number ◽  
Phase 2 ◽  
Two Phase ◽  
Erythroid Progenitor

A two-phase liquid-culture system was used to substantially amplify and differentiate erythroblasts, starting with mononuclear cells from the blood of normal adults, newborn infants, and patients with sickle cell anemia. After the first 7 days (phase 1), in medium plus fetal bovine serum (FBS) alone, or in combination with stem cell factor (SCF) or conditioned medium (CM), the cell number was unchanged, and the cells all looked like lymphocytes. These cells were then diluted into medium with erythropoietin (Ep) alone, with Ep and either SCF or CM, or in methylcellulose with the same factors (phase 2). After 14 days in liquid phase 2 with SCF and Ep, the cell numbers increased an average of 30-fold in the sickle, 24-fold in the newborn, and 4-fold in the normal adult cultures; almost all the cells were erythroblasts and erythrocytes. SCF in phase 1 increased the number of late progenitors (CFU-E) assayed in methylcellulose, with the largest number in sickle, followed by newborn cultures and then adult cultures. We conclude that erythroid progenitor cells survive for at least 7 days without Ep (but with FBS). Progenitor cells are amplified, particularly with SCF. Later in culture, SCF with Ep increases the final number of differentiated erythroid cells. Both the early and the late effects of SCF are most effective in sickle, followed by newborn cultures and then adult cultures.

Sign in / Sign up

Export Citation Format

Share Document