scholarly journals The power function of the ten test for measuring neural sensitivity in clinical pain or sensory abnormalities

2016 ◽  
Vol 26 (1) ◽  
pp. 62-65 ◽  
Author(s):  
Zakir Uddin
Keyword(s):  
Power Function ◽  
Cost Effective ◽  
Outcome Evaluation ◽  
Normative Values ◽  
Psychophysical Method ◽  
Symptom Improvement ◽  
Clinical Settings ◽  
Level Measurement ◽  
Clinical Pain ◽  
Sensitivity Change

This review highlights a simple psychophysical quantitative sensory testing (QST) method (the ten test) for research and clinical practice as it relates to sensitivity change and symptom improvement in pain populations. This cost-effective QST has a three-fold benefit of being diagnostic, prognostic and providing outcome evaluation. The power function of the ten test is discussed with the theoretical foundation of levels of measurement and psychophysical method that can approach ratio scaling in mind. The ratio level measurement might be useful for the researcher as the normative values of different QSTs are not well established. As a reliable and valid testing method, it provides an option for clinicians in busy clinical settings, and/or where QST equipment is unavailable.

Baby steps in the path of modifying the role of cardiologists for interpreting EKG for AMI

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
S Mehta ◽  
S Niklitschek ◽  
F Fernandez ◽  
C Villagran ◽  
J Avila ◽  
...  
Keyword(s):  
Human Resources ◽  
Ground Truth ◽  
Cost Effective ◽  
Clinical Settings ◽  
Dense Layer ◽  
Pass Filter ◽  
Low Pass Filter ◽  
Original Dataset ◽  
Low Pass ◽  
Normal Branch

Abstract Background EKG interpretation is slowly transitioning to a physician-free, Artificial Intelligence (AI)-driven endeavor. Our continued efforts to innovate follow a carefully laid stepwise approach, as follows: 1) Create an AI algorithm that accurately identifies STEMI against non-STEMI using a 12-lead EKG; 2) Challenging said algorithm by including different EKG diagnosis to the previous experiment, and now 3) To further validate the accuracy and reliability of our algorithm while also improving performance in a prehospital and hospital settings. Purpose To provide an accurate, reliable, and cost-effective tool for STEMI detection with the potential to redirect human resources into other clinically relevant tasks and save the need for human resources. Methods Database: EKG records obtained from Latin America Telemedicine Infarct Network (Mexico, Colombia, Argentina, and Brazil) from April 2014 to December 2019. Dataset: A total of 11,567 12-lead EKG records of 10-seconds length with sampling frequency of 500 [Hz], including the following balanced classes: unconfirmed and angiographically confirmed STEMI, branch blocks, non-specific ST-T abnormalities, normal and abnormal (200+ CPT codes, excluding the ones included in other classes). The label of each record was manually checked by cardiologists to ensure precision (Ground truth). Pre-processing: The first and last 250 samples were discarded as they may contain a standardization pulse. An order 5 digital low pass filter with a 35 Hz cut-off was applied. For each record, the mean was subtracted to each individual lead. Classification: The determined classes were STEMI (STEMI in different locations of the myocardium – anterior, inferior and lateral); Not-STEMI (A combination of randomly sampled normal, branch blocks, non-specific ST-T abnormalities and abnormal records – 25% of each subclass). Training & Testing: A 1-D Convolutional Neural Network was trained and tested with a dataset proportion of 90/10; respectively. The last dense layer outputs a probability for each record of being STEMI or Not-STEMI. Additional testing was performed with a subset of the original dataset of angiographically confirmed STEMI. Results See Figure Attached – Preliminary STEMI Dataset Accuracy: 96.4%; Sensitivity: 95.3%; Specificity: 97.4% – Confirmed STEMI Dataset: Accuracy: 97.6%; Sensitivity: 98.1%; Specificity: 97.2%. Conclusions Our results remain consistent with our previous experience. By further increasing the amount and complexity of the data, the performance of the model improves. Future implementations of this technology in clinical settings look promising, not only in performing swift screening and diagnostic steps but also partaking in complex STEMI management triage. Funding Acknowledgement Type of funding source: None

scholarly journals Symptoms of Oral Submucosal Fibrosis: Our Experience with Intralesional Injection Treatment

2011 ◽  
Vol 2 (1) ◽  
pp. 45-48 ◽  
Author(s):  
PV Dhond ◽  
Rajesh Yadav ◽  
Mudit Mittal ◽  
Shashi Kant
Keyword(s):  
Indian Population ◽  
Cost Effective ◽  
Injection Technique ◽  
Intralesional Injection ◽  
Clinical Settings ◽  
Care Hospital ◽  
Primary Care Hospital ◽  
Intralesional Injections ◽  
Oral Submucosal Fibrosis ◽  
Submucosal Fibrosis

ABSTRACT Objective This study evaluates the symptoms and effects of peroral intralesional injections in relieving the symptoms of oral submucosal fibrosis (OSMF) in our clinical settings. Study design Retrospective clinical review at a primary care hospital of 32 patients with extensive OSMF who underwent peroral intralesional injections of steroid, hyaluronidase, placentrex and lignocaine performed in office setting. Results The main symptoms were change in color of buccal mucosa, trismus, burning mouth, vesicles in oral cavity. All patients experienced considerable improvement in their symptoms over a duration of 2 to 6 weeks. Conclusions Though, a large number of Indian population is suffering and seeking treatment for OSMF, unfortunately not much has been done in this area. It is difficult to find studies on peroral intralesional injection technique. When there is lack of reliable evidence of oral submucosal fibrosis treatment, the old technique of peroral intralesion shots of steroid, hyaluronidase, placentrex in lignocaine is safe and effective in resolving the symptoms associated with OSMF. The therapy is very cost effective and also reduces the need of surgery.

Smart Water Level Monitoring System for Farmers

2019 ◽  
pp. 213-228
Author(s):  
Nalina Suresh ◽  
Valerianus Hashiyana ◽  
Victor Panduleni Kulula ◽  
Shreekanth Thotappa
Keyword(s):  
Water Level ◽  
Monitoring System ◽  
Cost Effective ◽  
Weather Conditions ◽  
Water Levels ◽  
Measurement Systems ◽  
Smart Water ◽  
Level Measurement ◽  
Level Monitoring ◽  
Water Level Monitoring

With advancement in technology and ever-changing weather conditions, accurate and affordable water level measurement systems has become necessary for farmers. This therefore brings about the need for a system incorporating the use of IoT technology that will monitor water levels at a cost-effective price with accurate and dependable results. The prototype will monitor water levels on a regular basis and the data captured will be stored in a database to help farmers improve the way they manage their water resource. Farmers will be able to monitor the water levels from any location at any given time. This chapter focuses on a Smart Water Level Monitoring System for Farmers and provides a smart way to manage water resources on farms in the most cost-effective and convenient manner for farmers.

scholarly journals Untangling Species-Level Composition of Complex Bacterial Communities through a Novel Metagenomic Approach

mSystems ◽  
2020 ◽  
Vol 5 (4) ◽  
Author(s):  
Christian Milani ◽  
Giulia Alessandri ◽  
Marta Mangifesta ◽  
Leonardo Mancabelli ◽  
Gabriele Andrea Lugli ◽  
...  
Keyword(s):  
Bacterial Communities ◽  
Internal Transcribed Spacer ◽  
Its Region ◽  
Cost Effective ◽  
Species Level ◽  
Clinical Settings ◽  
Mucosal Biopsy ◽  
Environmental Matrices ◽  
Novel Biomarkers ◽  
Bacterial Profiling

ABSTRACT 16S small-subunit (SSU) rRNA gene-based bacterial profiling is the gold standard for cost-effective taxonomic reconstruction of complex bacterial populations down to the genus level. However, it has been proven ineffective in clinical and research settings requiring higher taxonomic resolution. We therefore developed a bacterial profiling method based on the internal transcribed spacer (ITS) region employing optimized primers and a comprehensive ITS database for accurate cataloguing of bacterial communities at (sub)species resolution. Performance of the microbial ITS profiling pipeline was tested through analysis of host-associated, food, and environmental matrices, while its efficacy in clinical settings was assessed through analysis of mucosal biopsy specimens of colorectal cancer, leading to the identification of putative novel biomarkers. The data collected indicate that the proposed pipeline represents a major step forward in cost-effective identification and screening of microbial biomarkers at (sub)species level, with relevant impact in research, industrial, and clinical settings. IMPORTANCE We developed a novel method for accurate cataloguing of bacterial communities at (sub)species level involving amplification of the internal transcribed spacer (ITS) region through optimized primers, followed by next-generation sequencing and taxonomic classification of amplicons by means of a comprehensive database of bacterial ITS sequences. Host-associated, food, and environmental matrices were employed to test the performance of the microbial ITS profiling pipeline. Moreover, mucosal biopsy samples from colorectal cancer patients were analyzed to demonstrate the scientific relevance of this profiling approach in a clinical setting through identification of putative novel biomarkers. The results indicate that the ITS-based profiling pipeline proposed here represents a key metagenomic tool with major relevance for research, industrial, and clinical settings.

scholarly journals Sensitive Bioassay for Determination of Fluconazole Concentrations in Plasma Using a Candida albicans Mutant Hypersusceptible to Azoles

2001 ◽  
Vol 45 (3) ◽  
pp. 696-700 ◽  
Author(s):  
Oscar Marchetti ◽  
Paul A. Majcherczyk ◽  
Michel P. Glauser ◽  
Jacques Bille ◽  
Philippe Moreillon ◽  
...  
Keyword(s):  
High Performance ◽  
Correlation Coefficients ◽  
Experimental Treatment ◽  
Cost Effective ◽  
Clinical Settings ◽  
Multidrug Efflux ◽  
Analytical Method Validation ◽  
Accuracy And Precision ◽  
Cost Effective Method ◽  
New Bioassay

ABSTRACT The antifungal agent fluconazole (FLC) is widely used in clinical practice. Monitoring FLC levels is useful in complicated clinical settings and in experimental infection models. A bioassay usingCandida pseudotropicalis, a simple and cost-effective method, is validated only for FLC levels ranging from 5 to 40 mg/liter. An extension of the analytical range is needed to cover most yeast MICs. A new bioassay in RPMI agar containing methylene blue was developed using C. albicans DSY1024, a mutant rendered hypersusceptible to FLC constructed by the deletion of the multidrug efflux transporter genes CDR1, CDR2, CaMDR1, andFLU1. Reproducible standard curves were obtained with FLC concentrations in plasma ranging from 1 to 100 mg/liter (quadratic regression coefficient > 0.997). The absolute sensitivity was 0.026 μg of FLC. The method was internally validated according to current guidelines for analytical method validation. Both accuracy and precision lied in the required ±15% range. FLC levels measured by bioassay and by high-performance liquid chromatography (HPLC) performed with 62 plasma samples from humans and rats showed a strong correlation (coefficients, 0.979 and 0.995, respectively; percent deviations of bioassay from HPLC values, 0.44% ± 15.31% and 2.66% ± 7.54%, respectively). In summary, this newly developed bioassay is sensitive, simple, rapid, and inexpensive. It allows nonspecialized laboratories to determine FLC levels in plasma to within the clinically relevant concentration range and represents a useful tool for experimental treatment models.

What is effective care for varicose veins?

2016 ◽  
Vol 31 (1_suppl) ◽  
pp. 80-87 ◽  
Author(s):  
Mark H Meissner
Keyword(s):  
Quality Of Life ◽  
Effective Treatment ◽  
Varicose Veins ◽  
Treatment Options ◽  
Cost Effective ◽  
Symptom Improvement ◽  
Ultrasound Guided ◽  
Foam Sclerotherapy ◽  
Cyanoacrylate Glue

Varicose veins affect one-quarter to one-third of Western adult populations and consume an increasing amount of health care resources. Much of this increased utilization has been driven by the advent of minimally invasive technology including endovenous thermal ablation, foam sclerotherapy, and more recently mechanicochemical and cyanoacrylate glue ablation. This has largely been driven by patient and physician preferences in the absence of robust evidence that one therapy is truly superior to another. This partially arises from misunderstandings about appropriate outcomes measures and what truly constitutes effective treatment of varicose veins. Technical outcomes, such as saphenous closure rates, have frequently been used as surrogates for effective treatment but are poorly correlated with symptom improvement, quality of life, and risk of recurrence. Although there does appear to be a trend towards higher recurrence with ultrasound-guided foam sclerotherapy, the data are occasionally conflicting and there does not appear to be substantial differences between the various modalities. Similarly, there do not appear to be major differences in late quality of life measures between these treatment options. As long-term differences in recurrence and quality of life are small, overall cost effectiveness is driven primarily by initial treatment costs and ultrasound-guided foam sclerotherapy is the most cost-effective strategy in many models. However, there continues to be substantial uncertainty surrounding cost estimates and other factors of importance to the patient may ultimately drive treatment decisions. The benefits of some adjuncts to the treatment of axial superficial reflux, such as the concurrent versus staged management of tributary varicosities, remain ill-defined while that of others, such as routine post-procedural ultrasound surveillance and compression, need critical re-evaluation.

Diabetic Foot Examination

2013 ◽  
Vol 61 (3) ◽  
pp. 136-136 ◽  
Author(s):  
Stephanie Thatcher Weinsier
Keyword(s):  
High Risk ◽  
Occupational Health ◽  
Diabetic Foot ◽  
Cost Effective ◽  
Clinical Settings ◽  
Foot Complications ◽  
Timely Fashion

The 60-second tool (2012)© uses a cost-effective, simple, standardized approach to identifying, in a timely fashion, which individuals are at high risk for diabetic foot complications. Using this tool, occupational health nurses can screen for diabetic foot complications in varied clinical settings.

scholarly journals Sustainable Park Landscaping as an Approach for the Development of the Built Environment: Review and Employment

2019 ◽  
Vol 4 (2) ◽  
pp. 1
Author(s):  
Abdallah Haredy
Keyword(s):  
Built Environment ◽  
Social Economic ◽  
Cost Effective ◽  
Normative Values ◽  
Cultural Aspects ◽  
Clean Environment ◽  
Effective Operation ◽  
Park Design ◽  
Moderate Climate

Implementing sustainable principles when landscaping parks is vital for the development of the built environment, and should take into account environmental, social, economic, and cultural aspects, in order to eliminate conflict between developmental requirements, and the need to preserve cultural and natural resources. This paper reviews the guidelines that should be considered for current and future sustainable parks in regions with a moderate climate, in order to ensure that they incorporate ecotourism, cost effective operation and maintenance, a clean environment, the promotion of renewable energy, and resource preservation. A number of parks, located in moderate climate zones, are studied in terms of aspects such as their location, topography, operation, and landscaping characteristics, to demonstrate the prevailing normative values that can be applied to sustainable park design. Prince Meshari Park, in Al-Baha city, Saudi Arabia, is employed as a case study for applying all of the guidelines proposed in this investigation, and to highlight some of their merits and limitations in terms of the current situation of the park.

scholarly journals Reliability, validity and cut-off score of the Chinese version of the Panic Disorder Severity Scale Self-Report form in patients with panic disorder

2020 ◽  
Author(s):  
Xitong Liu ◽  
Tingting Xu ◽  
Dandan Chen ◽  
Chen Yang ◽  
Pei Wang ◽  
...  
Keyword(s):  
Panic Disorder ◽  
Rating Scale ◽  
Reliability And Validity ◽  
Principal Component ◽  
High Sensitivity ◽  
Cost Effective ◽  
Chinese Version ◽  
Self Report ◽  
Clinical Settings ◽  
Severity Scale

Abstract Background Panic disorder (PD) is often undiagnosed, misdiagnosed, or untreated in non-psychiatric clinical settings. Therefore, a cost-effective, accurate and easy-to-administer instrument for PD assessment is still needed. For that reason, the self-report version of the Panic Disorder Severity Scale (PDSS-SR) has been developed and suggested to be a reliable and useful tool in clinical and research settings. The current study aims to evaluate the reliability and validity of the Chinese version of the PDSS-SR and determine the cut-off score of the PDSS-SR. Methods A total of 133 patients with PD in Shanghai were assessed by the PDSS-SR, PDSS and Hamilton Anxiety Rating Scale (HAMA). Moreover, 117 patients with non-PD anxiety and 51 healthy subjects also completed the PDSS-SR to construct a receiver operating characteristic (ROC) curve with the scores of PD patients. Results The internal consistency (Cronbach’s α) of the PDSS-SR was 0.72-0.80, and the interrater correlation coefficient was 0.78. The results of principal component analysis and varimax rotation indicated that the PDSS-SR had a two-factor structure, with all seven items having salient loadings. The cut-off score was 4, which was associated with high sensitivity (96.03%) and specificity (61.31%). Conclusions The findings demonstrate that these items and the total score of the PDSS-SR have acceptable reliability and validity in patients with PD and that the PDSS-SR can be used by general doctors for clinical screening in China.

What are the challenges for building real world comparative cohorts in oncology?

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. e19285-e19285
Author(s):  
Nikita Jeswani ◽  
Amanda McDonell ◽  
Finlay MacDougall ◽  
Jeff Paul Hodge
Keyword(s):  
Language Processing ◽  
Real World ◽  
International Prognostic Index ◽  
Evaluation Criteria ◽  
Prognostic Index ◽  
Cost Effective ◽  
Patient Characteristics ◽  
Outcome Evaluation ◽  
Real World Data ◽  
Indolent Lymphomas

e19285 Background: There has been a proliferation of single arm trials in oncology being presented to regulators. An external comparator using real world data (RWD) can help establish context to trial results and direct comparison to the treatment arm by mirroring the inclusion/exclusion criteria for the trial and examining trial outcomes in an RWD external comparator cohort. RWD has successfully supported some regulatory submissions, although there have been failures as well, with comparability of patients and endpoints under scrutiny. Methods: IQVIA has partnered with life sciences companies on > 20 external comparator projects from 2017-present using a mix of data acquisition strategies (e.g., chart review, database extraction) and methods (e.g., real-world cohort vs. real-world benchmark, propensity matching vs. inverse probability treatment weighting). We collated, reviewed, and synthesised the challenges and risk mitigations documented throughout study execution in aggressive and indolent lymphomas, multiple myeloma, Merkel cell carcinoma, and synovial sarcoma. Results: Patient characteristics used to assess trial eligibility (e.g., biomarker expression, International Prognostic Index, ECOG status) and outcomes (e.g., response rate) are not often captured in a structured format in RWD or recorded in routine clinical practice. As a result, there is a greater reliance on chart reviews today over database extractions to fulfil external comparator requirements, though in some diseases, databases have proven to be a faster and more cost-effective solution. Conclusions: To improve the success of external comparator studies, trial design should be informed by existing RWD so that relevant real-world endpoints and outcome evaluation criteria are included alongside RCT standards. Advances are needed to facilitate RWD capture that matches trial data more closely. This could include bespoke data collaborations, biobank linkage, and natural language processing to drive study execution in databases in the future.

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