Effect of decompressive craniectomy in the postoperative expansion of traumatic intracerebral hemorrhage: a propensity score–based analysis

2020 ◽  
Vol 132 (5) ◽  
pp. 1623-1635 ◽  
Author(s):  
Santiago Cepeda ◽  
Ana María Castaño-León ◽  
Pablo M. Munarriz ◽  
Igor Paredes ◽  
Irene Panero ◽  
...  
Keyword(s):  
Risk Factor ◽  
Propensity Score ◽  
Intracerebral Hemorrhage ◽  
Decompressive Craniectomy ◽  
Selection Criteria ◽  
Volume Increase ◽  
Volumetric Expansion ◽  
The Mean ◽  
The Difference ◽  
The Relationship

OBJECTIVETraumatic intracerebral hemorrhage (TICH) represents approximately 13%–48% of the lesions after a traumatic brain injury (TBI), and hemorrhagic progression (HP) occurs in 38%–63% of cases. In previous studies, decompressive craniectomy (DC) has been characterized as a risk factor in the HP of TICH; however, few studies have focused exclusively on this relationship. The object of the present study was to analyze the relationship between DC and the growth of TICH and to reveal any correlation with the size of the craniectomy, degree of cerebral parenchymal herniation (CPH), or volumetric expansion of the TICH.METHODSThe authors retrospectively analyzed the records of 497 adult patients who had been consecutively admitted after suffering a severe or moderate closed TBI. An inclusion criterion was presentation with one or more TICHs on the initial or control CT. Demographic, clinical, radiological, and treatment variables were assessed for associations.RESULTSTwo hundred three patients presenting with 401 individual TICHs met the selection criteria. TICH growth was observed in 281 cases (70.1%). Eighty-two cases (20.4%) underwent craniectomy without TICH evacuation. In the craniectomy group, HP was observed in 71 cases (86.6%); in the noncraniectomy group (319 cases), HP occurred in 210 cases (65.8%). The difference in the incidence of HP between the two groups was statistically significant (OR 3.41, p < 0.01). The mean area of the craniectomy was 104.94 ± 27.5 cm2, and the mean CPH distance through the craniectomy was 17.85 ± 11.1 mm. The mean increase in the TICH volume was greater in the groups with a craniectomy area > 115 cm2 and CPH > 25 mm (16.12 and 14.47 cm3, respectively, p = 0.01 and 0.02). After calculating the propensity score (PS), the authors followed three statistical methods—matching, stratification, and inverse probability treatment weighting (IPTW)—thereby obtaining an adequate balance of the covariates. A statistically significant relationship was found between HP and craniectomy (OR 2.77, p = 0.004). This correlation was confirmed with the three methodologies based on the PS with odds greater than 2.CONCLUSIONSDC is a risk factor for the growth of TICH, and there is also an association between the size of the DC and the magnitude of the volume increase in the TICH.

scholarly journals Review of Academic Dishonesty among College Students

2016 ◽  
Vol 8 (4) ◽  
pp. 158
Author(s):  
Abolfazl Zolfaghari
Keyword(s):  
Academic Dishonesty ◽  
English Language ◽  
Academic Environment ◽  
Language Test ◽  
Chi Square ◽  
Quasi Experimental ◽  
The Mean ◽  
The Difference ◽  
Basic English ◽  
The Relationship

<p>Cheating and academic dishonesty is a moral anomaly in the field of scientific research and reflecting, i.e., academic environment and studies show that this phenomenon in many of the worlds is important problem.</p><p>This study measured the dishonesty of students in a quasi-experimental design. For this purpose, features lack of integrity by manipulating the facts were examined and meanwhile first, basic English language test coordination between the strict terms of the 280 students come to practice and after correction of examination papers by teachers, without leaving any traces on them instead, the plates are returned to students and provide them with answers to their paper to correct their score Master announced. The difference between the actual score (score of master) and score of the students to have their own, amount of honesty or lack of integrity appointed them and its relationship with some demographic and socio-ethical characteristics have been studied.</p><p>The results showed that more than 62 percent of the students in your grade to master completely honest with 26.6 percent have low honesty and the rest did not have the necessary integrity and the mean difference of scores announced by the professors and students have been about two score. Also results of chi-square tests and gamma, about the relationship between students’ evaluation of amount of sincerity with sincerity in the declared objective amount of the master score was not significant, this finding means that between demonstrators and people of integrity and honesty in practice, there are gaps.</p>

scholarly journals Urine CA-2 as a biomarker for diagnosis urinary stone and prediction of its complications

2020 ◽  
Author(s):  
Yuan-jing Leng ◽  
Hai-bin Zhou ◽  
Jiang-ling Fu ◽  
Wen-juan Wang
Keyword(s):  
Healthy Subjects ◽  
Characteristic Curve ◽  
Urinary Stone ◽  
Urinary Stones ◽  
Enzyme Linked Immunosorbent Assay ◽  
Control Group ◽  
Healthy Control ◽  
The Mean ◽  
The Difference ◽  
The Relationship

Abstract PURPOSECarbonic anhydrase-2 (CA-2) plays a role in mineralization and calcification in organism. Strong evidence suggests that CA-2 is associated with urolithiasis. However, the relationship between CA-2 and urinary stone remains unclear. The study aimed to assess the association of urine CA-2 (uCA-2) level and the potential risk of urinary stone.METHODSFrom March 2017 to November 2019, a prospective cohort study was conducted on patients with urinary stones and healthy subjects to determine the pretreatment uCA-2 level detection by Enzyme linked immunosorbent assay (ELISA). The difference of uCA-2 level between patients with urinary stones and healthy subjects was compared. Then comparison between stone patients with complications and without complications was carried out as well as correlation analysis to detect factors associated with biomarker expression.RESULTS118 patients with urinary stones were into urinary stones group and 42 healthy subjects were into healthy control group. The mean pretreatment uCA-2 level was significantly higher in patients with urinary stones group than healthy controls group (P=0.028). Furthermore, The uCA-2 level was positive correlation with urinary stones complications (R=0.379, P=0.000), especially pain complications (R=0.524, P=0.000) and hematuria complications (R=0.374, P=0.000). Receiver operating characteristic curve (ROC) analysis that a uCA-2 level threshold of 10.94 ng/mL had 83.67% sensitivity and 68.12% specificity for predicting urinary stones complications. CONCLUSIONSExcessive uCA-2 excretion is a major risk factor for urinary stone. Our findings suggested that uCA-2 may be used as an unappreciated biomarker for the diagnosis urinary stone in patients and to predict its complications.

scholarly journals Three-dimensional analysis of acetabular cup orientation and an evaluation of the relationship with pelvic sagittal parameters

2019 ◽  
Vol 27 (2) ◽  
pp. 230949901986122
Author(s):  
Ali Sahin ◽  
Mehmet Emin Simsek ◽  
Safa Gursoy ◽  
Mustafa Akkaya ◽  
Cetin Isik ◽  
...  
Keyword(s):  
Pelvic Tilt ◽  
Three Dimensional ◽  
Preoperative Assessment ◽  
Statistical Correlation ◽  
Acetabular Cup ◽  
Pelvic Parameters ◽  
Sagittal Parameters ◽  
The Mean ◽  
The Difference ◽  
The Relationship

Background: This study aimed to evaluate the effect of total hip arthroplasty (THA) on sagittal pelvic parameters and to evaluate the effect of sagittal pelvic parameters on acetabular cup orientation. Methods: The study included 86 patients who underwent THA for a diagnosis of unilateral coxarthrosis between 2011 and 2015. Measurements were taken of the preoperative and postoperative acetabular cup inclination (ACI), anteversion, and sagittal pelvic parameters. The effect of THA on sagittal pelvic parameters and the effects of the sagittal pelvic parameters on acetabular cup orientation were investigated. Results: The sagittal pelvic tilt values calculated were mean 9.7° ± 6.3° (2°; 23°) preoperatively and 11.0° ± 6.1° (2°; 25°) postoperatively. The increase in postoperative pelvic incidence (PI) values was determined to be statistically significant ( p < 0.05). The preoperative PI values had no significant effect on ACI, but in cases with high preoperative PI values, a tendency to high anteversion values was determined. The mean inclination values were found to be 40.2° ± 11.0° in the low PI group, 41.7° ± 7.4° in the normal PI group, and 44.1° ± 8.3° in the high PI group. As no increase in inclination values was observed with an increase in PI values, no statistical correlation was determined ( p = 0.343). Average of anteversion values in the low PI group was 9.2° ± 13.7°, in the normal PI group 19.3° ± 10.5°, and in the high PI group 21.1° ± 12.5°. The difference between the groups was statistically significant ( p = 0.001). Conclusion: Evaluating the results of this study, it can be concluded that varying PI values do affect the acetabular cup anterversion in THA. So, preoperative assessment of PI values is important in preventing postoperative acetabular cup malposition.

The Effect of Waking Suggestion on Post-Hypnotic Amnesia

1981 ◽  
Vol 11 (1) ◽  
pp. 44-46 ◽  
Author(s):  
D.P. Fourie
Keyword(s):  
Point Of View ◽  
The Other ◽  
Hypnotic Susceptibility ◽  
The Subject ◽  
The Mean ◽  
The Difference ◽  
The One ◽  
The Relationship ◽  
Female Subjects

It is increasingly realized that hypnosis may be seen from an interpersonal point of view, meaning that it forms part of the relationship between the hypnotist and the subject. From this premise it follows that what goes on in the relationship prior to hypnosis probably has an influence on the hypnosis. Certain of these prior occurences can then be seen as waking suggestionns (however implicitly given) that the subject should behave in a certain way with regard to the subsequent hypnosis. A study was conducted to test the hypothesis that waking suggestions regarding post-hypnotic amnesia are effective. Eighteen female subjects were randomly divided into two groups. The groups listened to a tape-recorded talk on hypnosis in which for the one group amnesia for the subsequent hypnotic experience and for the other group no such amnesia was suggested. Thereafter the Stanford Hypnotic Susceptibility Scale was administered to all subjects. Only the interrogation part of the amnesia item of the scale was administered. The subjects to whom post-hypnotic amnesia was suggested tended to score lower on the amnesia item than the other subjects, as was expected, but the difference between the mean amnesia scores of the two groups was not significant.

Size of tumour as a risk factor for malignancy in patients with peripheral pulmonary nodules

Folia Medica ◽  
2012 ◽  
Vol 54 (2) ◽  
pp. 17-21 ◽  
Author(s):  
Georgi Tz. Prisadov ◽  
Angel P. Uchikov ◽  
Kathrin Welker ◽  
Herbert Wallimann ◽  
Krassimir A. Murdzhev ◽  
...  
Keyword(s):  
Risk Factor ◽  
Tumour Size ◽  
Pulmonary Nodules ◽  
Malignant Tumours ◽  
Number Of Patients ◽  
Mean Size ◽  
Malignant Lesions ◽  
The Mean ◽  
The Difference ◽  
Benign Tumours

ABSTRACT Peripheral pulmonary tumours are often quite difficult to diagnose and treat. Their detection brings immediately the problem of whether clinicians should just wait and observe or operate the patients. The AIM of this study was to determine if there is a direct correlation between tumour size and the risk for malignancy and whether the tumor size should be considered a risk factor for malignancy. PATIENTS AND METHODS: Between 1997 and 2009, 145 patients with peripheral pulmonary tumours of less than 3 cm in diameter underwent video-assisted thoracoscopic (VATS) resection for the purpose of histologic examination of the tumor. RESULTS: The mean age of the patients was 62.60 ± 0.95 years. The youngest patient was 17 years old and the oldest - 82. The study sample included 61 women and 84 men; the men were statistically signifi cantly more than the women (57.3% and 42.07%, respectively) (t = 2.74 , P < 0.01). The total number of patients we operated were 145 with 198 resected tumours. The diameter of the lesions ranged between 0.30 cm and 3 cm (mean 1.41 ± 0.06 cm). We found that 108 (54.55%) of the tumours were malignant, and 90 (45.45%) were benign, the difference between them failing to reach statistical signifi cance (t = 1.82, P > 0.05). The mean size of malignant lesions was statistically signifi cantly greater than that of benign tumours (1.62 ± 0.08 cm vs 1.15 ± 0.06 cm). CONCLUSION: The results of this study suggest that the bigger the diameter of the nodule, the greater the percentage share of malignant tumours, which means that the size of the tumour is an important risk factor for malignancy.

THE EFFECT OF FASTING AND GLUCOSE LOAD ON INSULIN SECRETION AND THE STAUB—TRAUGOTT PHENOMENON IN PIGS

1973 ◽  
Vol 58 (3) ◽  
pp. 613-625 ◽  
Author(s):  
D. M. ANDERSON
Keyword(s):  
Fatty Acids ◽  
Free Fatty Acids ◽  
Maximum Rate ◽  
Insulin Concentration ◽  
Glucose Load ◽  
Plasma Insulin Concentration ◽  
The Mean ◽  
The Difference ◽  
Special Circumstances ◽  
The Relationship

SUMMARY Pigs were fasted for 18, 39, or 72 h; they were then given two glucose infusions, the second infusion 40 min after the first. Either 0·15, 0·30 or 0·75 g glucose/kg were given at each infusion. Plasma glucose, free fatty acids, insulin and 3-hydroxybutyrate concentrations were measured. The rate of glucose removal Kt was calculated after the first infusions, (Kt1), and after the second infusion (Kt2). When food was withheld the peak insulin concentration decreased in response to glucose but lack of food only affected the mean increase in insulin concentration when 0·75 g glucose/kg was given. The value of Kt1 decreased as the period without food increased and additions of insulin did not affect the difference in Kt1 between animals fasted for 18 h and those fasted for 72 h. Plasma insulin concentration was closely related to the rate of glucose removal; the correlation coefficient (r) for maximum rate of glucose removal versus maximum insulin concentration was 0·9; and that for mean rate of glucose removal versus mean increment in insulin concentration was 0·84. It is suggested that insulin does not itself determine the rate of glucose removal but is secreted in response to the amount of glucose removed. In the pig, the Staub—Traugott phenomenon was found to occur only under special circumstances. The relationship between Kt1 and Kt2 depended on the amount of glucose infused and the time during which food was withheld. Kt2 ranged from smaller than—through the same as—to greater than Kt1. The concentrations of free fatty acids, ketones or insulin did not explain the differences.

scholarly journals Recalling Experiences: Looking at Momentary, Retrospective and Global Assessments of Relationship Satisfaction

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Caroline Zygar-Hoffmann ◽  
Felix D. Schönbrodt
Keyword(s):  
Relationship Satisfaction ◽  
Experience Sampling ◽  
Global Evaluation ◽  
Summary Statistics ◽  
Recall Bias ◽  
Sampling Studies ◽  
The Mean ◽  
The Difference ◽  
The Relationship ◽  
Momentary State

Relationship satisfaction can be assessed in retrospection, as a global evaluation, or as a momentary state. In two experience sampling studies (N = 130, N = 510) the specificities of these assessment modalities are examined. We show that 1) compared to other summary statistics like the median, the mean of relationship satisfaction states describes retrospective and global evaluations best (but the difference to some other summary statistics was negligible); 2) retrospection introduces an overestimation of the average annoyance in the relationship reported on a momentary basis, which results in an overall negative mean-level bias for retrospective relationship satisfaction; 3) this bias is most strongly moderated by global relationship satisfaction at the time of retrospection; 4) snapshots of momentary relationship satisfaction get representative of global evaluations after approximately two weeks of sampling. The findings extend the recall bias reported in the literature for retrospection of negative affect to the domain of relationship evaluations and assist researchers in designing efficient experience sampling studies.

scholarly journals Invasive and Doppler Transvalvular gradients after transcatheter aortic valve replacement

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
S Fugar ◽  
K Deka ◽  
C Anderson ◽  
C Lama Von Buchwald ◽  
R Geroux ◽  
...  
Keyword(s):  
Aortic Valve ◽  
Valve Replacement ◽  
Pressure Gradients ◽  
Entire Cohort ◽  
Funding Sources ◽  
Transcatheter Aortic Valve ◽  
The Mean ◽  
The Difference ◽  
Transcatheter Valve ◽  
The Relationship

Abstract Background Differences in mean gradients after Transcatheter valve replacement (TAVR) vary depending on the valve type and the modality used to measure the gradients. Currently there is a paucity of data on the relationship between invasive and doppler derived gradients after TAVR. Purpose We sort to assess the difference in doppler, and catheter derived aortic valve gradients after TAVR Methods This is a single center retrospective study using consecutive patients who presented for TAVR on account of native aortic valve stenosis at our institution from May 2012 till December 2020. Patients with both intraoperative invasive and postoperative doppler derived pressure gradients were included in the analysis. Student T-test were used to compare mean gradients. Pearson's correlation test was used to examine the correlation between measured gradients. Results A total of 587 patients were included in our study. Fifty one percent were male and 462 (78.7%) underwent TAVR with a balloon expandable valve. In the entire cohort the mean gradient measured invasively was significantly lower than those measured by echo doppler (4.48±3.25 vs. 5.57±3.11, P&lt;0.001). There, however, was a positive correlation between invasive and doppler measured gradients (figure 1). In those who received balloon expandable valves, the invasive gradient was 4.39±3.30 and the doppler derived gradient was 5.47±3.04 (P&lt;0.001), while in those self-expanding valves, the invasive gradient was 4.81±3.04 and doppler derived gradient was 5.94±3.36 (P&lt;0.001). Conclusion Post TAVR gradients were all significantly lower when measured invasively as compared to those measured using doppler. Self-expanding valves overall had higher residual gradients. Further studies are needed to assess the correlations between invasively measured gradients and clinical outcomes post TAVR. FUNDunding Acknowledgement Type of funding sources: None.

Intracranial pressure before and after cranioplasty: insights into intracranial physiology

2020 ◽  
Vol 133 (5) ◽  
pp. 1548-1558 ◽  
Author(s):  
Alexander Lilja-Cyron ◽  
Morten Andresen ◽  
Jesper Kelsen ◽  
Trine Hjorslev Andreasen ◽  
Lonnie Grove Petersen ◽  
...  
Keyword(s):  
Intracranial Pressure ◽  
Decompressive Craniectomy ◽  
Cerebral Metabolism ◽  
Neurosurgical Procedure ◽  
Pulse Wave Amplitude ◽  
Before And After ◽  
Rehabilitation Period ◽  
The Mean ◽  
The Difference

OBJECTIVEDecompressive craniectomy (DC) is an emergency neurosurgical procedure used in cases of severe intracranial hypertension or impending intracranial herniation. The procedure is often lifesaving, but it exposes the brain to atmospheric pressure in the subsequent rehabilitation period, which changes intracranial physiology and probably leads to complications such as hydrocephalus, hygromas, and “syndrome of the trephined.” The objective of the study was to study the effect of cranioplasty on intracranial pressure (ICP), postural ICP changes, and intracranial pulse wave amplitude (PWA).METHODSThe authors performed a prospective observational study including patients who underwent DC during a 12-month period. Telemetric ICP sensors were implanted in all patients at the time of DC. ICP was evaluated before and after cranioplasty during weekly measurement sessions including a standardized postural change program.RESULTSTwelve of the 17 patients enrolled in the study had cranioplasty performed and were included in the present investigation. Their mean ICP in the supine position increased from –0.5 ± 4.8 mm Hg the week before cranioplasty to 6.3 ± 2.5 mm Hg the week after cranioplasty (p < 0.0001), whereas the mean ICP in the sitting position was unchanged (–1.2 ± 4.8 vs –1.1 ± 3.6 mm Hg, p = 0.90). The difference in ICP between the supine and sitting positions was minimal before cranioplasty (1.1 ± 1.8 mm Hg) and increased to 7.4 ± 3.6 mm Hg in the week following cranioplasty (p < 0.0001). During the succeeding 2 weeks of the follow-up period, the mean ICP in the supine and sitting positions decreased in parallel to, respectively, 4.6 ± 3.0 mm Hg (p = 0.0003) and –3.9 ± 2.7 mm Hg (p = 0.040), meaning that the postural ICP difference remained constant at around 8 mm Hg. The mean intracranial PWA increased from 0.7 ± 0.7 mm Hg to 2.9 ± 0.8 mm Hg after cranioplasty (p < 0.0001) and remained around 3 mm Hg throughout the following weeks.CONCLUSIONSCranioplasty restores normal intracranial physiology regarding postural ICP changes and intracranial PWA. These findings complement those of previous investigations on cerebral blood flow and cerebral metabolism in patients after decompressive craniectomy.

Is a Trait Really the Mean of States?

2012 ◽  
Vol 33 (3) ◽  
pp. 131-137 ◽  
Author(s):  
Adam A Augustine ◽  
Randy J. Larsen
Keyword(s):  
Measurement Error ◽  
Personality Trait ◽  
Predictive Utility ◽  
Discrepancy Theory ◽  
The Mean ◽  
The Difference ◽  
Self Discrepancy ◽  
Assessment Strategies ◽  
The Relationship ◽  
Mean State

Although several definitions exist, a personality trait can be defined as the average or expected value of personality-relevant behaviors. However, recent evidence suggests that, while trait questionnaires and aggregated momentary assessments of personality are highly related, they may also differ in meaningful ways. In this study, we examine the relationship between trait and mean state personality. Results indicate that these two assessment strategies, although highly related, do not show convergence (r = .39–.64) levels that would signify an equity of constructs. In line with this, these two assessment strategies show differential predictive utility. Although the pattern of this differential predictive utility suggests that measurement error may account for differences, the difference between trait and mean state personality predicts affect in a manner consistent with self-discrepancy theory. Thus, although these two constructs are highly related, the differences between trait and mean state personality are meaningful.

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