scholarly journals Identifying Consensus and Open Questions around Assessing or Predicting the Quality and Success of Cartilage Repair: A Delphi Study

Surgeries ◽  
2021 ◽  
Vol 2 (3) ◽  
pp. 286-302
Author(s):  
Timothy Hopkins ◽  
James Richardson ◽  
Jan Herman Kuiper
Keyword(s):  
Cartilage Repair ◽  
Delphi Study ◽  
Surgical Techniques ◽  
Scoring Systems ◽  
Structural Quality ◽  
Delphi Consensus ◽  
Related Factors ◽  
Open Questions ◽  
Wide Range

A range of surgical techniques have been developed for the repair or regeneration of lesioned cartilage in the human knee and a corresponding array of scoring systems have been created to assess their outcomes. The published literature displays a wide range of opinions regarding the factors that influence the success of surgical cartilage repair and which parameters are the most useful for measuring the quality of the repair at follow-up. Our objective was to provide some clarity to the field by collating items that were agreed upon by a panel of experts to be important in these areas. A modified, three-round Delphi consensus study was carried out consisting of one idea-generating focus-group and two subsequent, self-completed questionnaire rounds. In each round, items were assessed for their importance and level of consensus against pre-determined threshold levels. In total, 31 items reached consensus, including a hierarchy of tissues in the joint based on their importance in cartilage repair, markers of repair cartilage quality and the implications of environmental and patient-related factors. Items were stratified into those that can be employed for predicting the success of cartilage repair and those that could be used for assessing the structural quality of the resulting repair cartilage. Items that did not reach consensus represent areas where dissent remains and could, therefore, be used to guide future clinical and fundamental scientific research.

scholarly journals Management of Malnutrition in Older Patients—Current Approaches, Evidence and Open Questions

2019 ◽  
Vol 8 (7) ◽  
pp. 974 ◽  
Author(s):  
Dorothee Volkert ◽  
Anne Marie Beck ◽  
Tommy Cederholm ◽  
Emanuele Cereda ◽  
Alfonso Cruz-Jentoft ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Older Patients ◽  
Future Research ◽  
Geriatric Syndrome ◽  
Open Questions ◽  
Conflicting Evidence ◽  
Wide Range ◽  
Patient Groups ◽  
Enteral And Parenteral Nutrition

Malnutrition is widespread in older people and represents a major geriatric syndrome with multifactorial etiology and severe consequences for health outcomes and quality of life. The aim of the present paper is to describe current approaches and evidence regarding malnutrition treatment and to highlight relevant knowledge gaps that need to be addressed. Recently published guidelines of the European Society for Clinical Nutrition and Metabolism (ESPEN) provide a summary of the available evidence and highlight the wide range of different measures that can be taken—from the identification and elimination of potential causes to enteral and parenteral nutrition—depending on the patient’s abilities and needs. However, more than half of the recommendations therein are based on expert consensus because of a lack of evidence, and only three are concern patient-centred outcomes. Future research should further clarify the etiology of malnutrition and identify the most relevant causes in order to prevent malnutrition. Based on limited and partly conflicting evidence and the limitations of existing studies, it remains unclear which interventions are most effective in which patient groups, and if specific situations, diseases or etiologies of malnutrition require specific approaches. Patient-relevant outcomes such as functionality and quality of life need more attention, and research methodology should be harmonised to allow for the comparability of studies.

scholarly journals Consumer Evaluation of the Quality of Online Health Information: Systematic Literature Review of Relevant Criteria and Indicators (Preprint)

2018 ◽  
Author(s):  
Yalin Sun ◽  
Yan Zhang ◽  
Jacek Gwizdka ◽  
Ciaran B. Trace
Keyword(s):  
Health Information ◽  
Information Quality ◽  
Quality Evaluation ◽  
Qualitative Content Analysis ◽  
Online Health Information ◽  
Related Factors ◽  
Consumer Evaluation ◽  
Wide Range ◽  
User Groups

BACKGROUND As the quality of online health information remains questionable, there is a pressing need to understand how consumers evaluate this information. Past reviews identified content-, source-, and individual-related factors that influence consumer judgment in this area. However, systematic knowledge concerning the evaluation process, that is, why and how these factors influence the evaluation behavior, is lacking. OBJECTIVE This review aims (1) to identify criteria (rules that reflect notions of value and worth) that consumers use to evaluate the quality of online health information and the indicators (properties of information objects to which criteria are applied to form judgments) they use to support the evaluation in order to achieve a better understanding of the process of information quality evaluation and (2) to explicate the relationship between indicators and criteria to provide clear guidelines for designers of consumer health information systems. METHODS A systematic literature search was performed in seven digital reference databases including Medicine, Psychology, Communication, and Library and Information Science to identify empirical studies that report how consumers directly and explicitly describe their evaluation of online health information quality. Thirty-seven articles met the inclusion criteria. A qualitative content analysis was performed to identify quality evaluation criteria, indicators, and their relationships. RESULTS We identified 25 criteria and 165 indicators. The most widely reported criteria used by consumers were trustworthiness, expertise, and objectivity. The indicators were related to source, content, and design. Among them, 114 were positive indicators (entailing positive quality judgments), 35 were negative indicators (entailing negative judgments), and 16 indicators had both positive and negative quality influence, depending on contextual factors (eg, source and individual differences) and criteria applied. The most widely reported indicators were site owners/sponsors; consensus among multiple sources; characteristics of writing and language; advertisements; content authorship; and interface design. CONCLUSIONS Consumer evaluation of online health information is a complex cost-benefit analysis process that involves the use of a wide range of criteria and a much wider range of quality indicators. There are commonalities in the use of criteria across user groups and source types, but the differences are hard to ignore. Evidently, consumers’ health information evaluation can be characterized as highly subjective and contextualized, and sometimes, misinformed. These findings invite more research into how different user groups evaluate different types of online sources and a personalized approach to educate users about evaluating online health information quality.

Spectroscopic Properties of Herbig-Haro Flows

1997 ◽  
Vol 182 ◽  
pp. 47-62 ◽  
Author(s):  
Karl-Heinz Böhm ◽  
Anthony P. Goodson
Keyword(s):  
Ultra Violet ◽  
Spectroscopic Properties ◽  
Plane Shock ◽  
Open Questions ◽  
High Ionization ◽  
Shock Models ◽  
Wide Range ◽  
Hh Objects ◽  
Insight Into

While recent studies of Herbig-Haro (HH) objects have focused less on the details of their spectra than on the hydrodynamics of jets and their working surfaces, many open questions concerning these spectra remain. Attempts to quantitatively explain a wide range of lines for many HH objects point to discrepancies between theory and observation. Some lines (specifically [S II](6716+6731)) are much stronger than predicted by simple plane-shock and bow-shock models, while in general high ionization lines (e.g. lines of [O III], [Ne III] and [S III] in the optical and the [C IV] and [N V] in the ultra-violet) are much weaker than expected, pointing to difficulties with current models. On the other hand, examination of these lines has lent new insight into both the quality of our predictions and the nature of HH outflows. Examination of many Fe lines have demonstrated that our ability to estimate abundances from faint lines is surprisingly good (or surprisingly consistent). Position velocity diagrams have also been constructed (using forbidden emission lines), allowing outflows to be mapped to within 0.″3 arcseconds of the source star.

scholarly journals Use of Antipsychotics in Patients with Behavioral and Psychological Symptoms of Dementia: Results of a Spanish Delphi Consensus

2020 ◽  
pp. 1-10
Author(s):  
Sagrario Manzano-Palomo ◽  
Luis F. Agüera-Ortiz ◽  
Alexandre García-Caballero ◽  
José Martínez-Raga ◽  
Tomás Ojea-Ortega ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Delphi Study ◽  
Atypical Antipsychotics ◽  
Psychological Symptoms ◽  
High Rate ◽  
Delphi Consensus ◽  
Almost All ◽  
Behavioral And Psychological Symptoms ◽  
Typical Antipsychotics

<b><i>Background:</i></b> Behavioral and psychological symptoms of dementia (BPSD) are difficult to manage and associated with poor outcome. <b><i>Objectives:</i></b> The aim of this study was to reach consensus on the use of antipsychotics in patients with BPSD in Spain. <b><i>Methods:</i></b> A qualitative, multicenter, two-round Delphi study was carried out, with the participation of specialists involved in the care of dementia patients throughout Spain. They completed a 76-item questionnaire related to the identification of BPSD, treatment with antipsychotics, follow-up of patients, barriers for the use of atypical antipsychotics, and effects of antipsychotics on quality of life. <b><i>Results:</i></b> A total of 162 specialists in neurology, psychiatry, and geriatrics (61% men) with a mean (SD) age of 45.9 (10) years participated in the study. Almost all participants (96.9%) strongly agreed that atypical antipsychotics are safer and better tolerated than typical antipsychotics. There was agreement on the importance to review the indication and dose of the antipsychotic drug at least every 3 months. There was consistent high rate of agreement on the beneficial impact of atypical antipsychotics on the quality of life of patients with dementia and their caregivers. A consensus was also reached on the need of detecting BPSD in patients with dementia as it decreases the quality of life of both patients and caregivers, and the need to routinely screen for dementia in elderly patients with no previous psychiatric history in the presence of suggestive symptoms of BPSD. Finally, the participants in the study agreed that administrative barriers for the prescription of atypical antipsychotics in Spain hinder the access to this drug group and favor the prescription of typical antipsychotics. <b><i>Conclusions:</i></b> The participants in the study agreed that atypical antipsychotics should be preferred to typical antipsychotics in the management of BPSD. Wide consensus was reached about the importance of early identification of BPSD in persons with cognitive impairment, the use and management of atypical antipsychotic drugs and their favorable impact on patients and caregiver’s quality of life.

Monte Carlo Simulation of the Growth of ZnSe by MBE

1986 ◽  
Vol 77 ◽  
Author(s):  
R. Venkatasubramanian ◽  
N. Otsuka ◽  
S. Datta ◽  
L. A. Kolodziejski ◽  
R. L. Gunshor
Keyword(s):  
Monte Carlo Simulation ◽  
Monte Carlo ◽  
Molecular Beam ◽  
Flux Ratio ◽  
Monte Carlo Study ◽  
The Other ◽  
Structural Quality ◽  
Wide Range

ABSTRACTA Monte Carlo study of the growth of ZnSe by Molecular beam epitaxy is presented. The study is focused on the role of surface kinetic reactions on the structural quality of the epilayers. Two different models for the incorporation of Se molecules, one with a highly reactive physisorbed state and the other with a relatively nonreactive physisorbed state are employed for simulations. It is shown that the structural quality of the epilayers is very sensitive to the flux ratio if the physisorbed state is relatively nonreactive. It is also shown that if the physisorbed state is highly reactive, good quality epilayers are obtained over a wide range of flux ratio.

scholarly journals Histological Scoring Systems in the Cartilage Repair of Sheep

2019 ◽  
Vol 63 (4) ◽  
pp. 15-26
Author(s):  
S. Gullberg ◽  
V. Simaiová ◽  
K. Holovská ◽  
L. Luptaková ◽  
F. Koľvek ◽  
...  
Keyword(s):  
Cartilage Repair ◽  
Animal Studies ◽  
Cellular Proliferation ◽  
Histological Analysis ◽  
Hyaline Cartilage ◽  
Complex Structure ◽  
Scoring Systems ◽  
Good Surface

Abstract Researchers around the world use histological analysis to provide the most detailed morphological information of articular cartilage repair and it predominantly relies on the use of histological scoring systems which are important tools for valid evaluations. Due to hyaline cartilage complex structure and avascular nature, damaged cartilage does not heal spontaneously and it is still a challenge to regenerate and restore its tissue function. The aim of this study was to investigate the quality of regenerated cartilage by using three different histological scoring systems; O’Driscoll, Pineda and Wakitani which are all classic scores described for such animal studies. We used an in vivo ovine model in which a full thickness chondral defect was created and then implanted with the biomaterial (polyhydroxybutyrate/chitosan; PHB/ CHIT). The results of this histological analysis demonstrated that the cartilage repaired tissues received scores indicating that the majority of the regenerated tissue resembled hyaline-like cartilage. After six months of repair the regenerated cartilage showed characteristics like good surface continuity, uniformed stained extracellular matrix, clearly visible zones and cellular proliferation. In conclusion, this study may be used to investigate and improve the regenerative capacity of hyaline cartilage in preclinical models and it also sheds further light on both the evaluation and methods used for the regeneration of damaged cartilage.

Accounting Recognition of Intangible Assets: Theory and Evidence on Economic Determinants

2005 ◽  
Vol 80 (3) ◽  
pp. 967-1003 ◽  
Author(s):  
Anne Wyatt
Keyword(s):  
Intangible Assets ◽  
Balance Sheet ◽  
Order Effect ◽  
Related Factors ◽  
Economic Determinants ◽  
Wide Range ◽  
Information Set ◽  
Highly Correlated ◽  
Accounting Recognition

This paper examines the extent to which management makes accounting choices to record intangible assets based on their insights into the underlying economics of their firm. It exploits a setting in which management has accounting discretion to record a wide range of intangible assets. The results suggest that management's choice to record intangible assets is associated with the strength of the technology affecting the firms operations, the length of the technology cycle time, and propertyrights-related factors that affect the firm's ability to appropriate the investment benefits. These effects are more important than other contracting and signaling factors consistent with the underlying economics operating as a first-order effect as envisaged by GAAP. The results also indicate that the intangible assets management has a voluntary (unregulated) choice to record—identifiable intangible assets—are more highly correlated with underlying economic factors than the regulated classes, purchased goodwill and R&D assets. This result suggests that limiting managements' choices to record intangible assets tends to reduce, rather than improve, the quality of the balance sheet and investors' information set.

scholarly journals Anomalous Self- and World Experiences in Depersonalization Traits: a Qualitative Study

2021 ◽  
Author(s):  
Anna Ciaunica ◽  
Elizabeth Pienkos ◽  
Estelle Nakul ◽  
Luis Madeira ◽  
Harry Farmer
Keyword(s):  
Qualitative Study ◽  
Sense Of Self ◽  
Self Awareness ◽  
Subjective Experiences ◽  
Open Questions ◽  
Wide Range ◽  
The World ◽  
Key Aspects ◽  
Core Features

This paper proposes a qualitative study exploring anomalous self and world-experiences in individuals with high levels of depersonalization traits. Depersonalization (DP) is a condition characterized by distressing feelings of being a detached, neutral and disembodied onlooker of one’s mental and bodily processes or even of reality itself (‘derealization’). Feelings of depersonalization are extremely common in the general population, yet under-acknowledged and under-examined. Our findings indicate the presence of a wide range of anomalous experiences traditionally understood to be core features of depersonalization, such as disembodiment and disrupted self-awareness. However, our results also indicate experiential features that are less highlighted in previous work, such as faster time perception and blurriness of the self/other boundaries which may play a key role in altering one’s sense of self and sense of presence in the world. Our qualitative study provides an in-depth examination of self-reported disturbances of one’s relatedness to one’s self and the world, thereby shedding further light on the nature of altered subjective experiences in DP. In doing so, this paper draws attention to key aspects yet overlooked that may prove valuable for potential diagnosis and therapy. We conclude by highlighting limitations of this study and a number of open questions that further work needs to address in the future, in order to better understand this condition and to improve the quality of life of those experiencing depersonalization.

COMBINATORIAL POLYNOMIALLY COMPUTABLE CHARACTERISTICS OF SUBSTITUTIONS AND THEIR PROPERTIES

2020 ◽  
Vol 7 (2) ◽  
pp. 34-41
Author(s):  
VLADIMIR NIKONOV ◽  
◽  
ANTON ZOBOV ◽  
Keyword(s):  
Mathematical Expectation ◽  
Point Of View ◽  
Small Range ◽  
Computational Point ◽  
Wide Range ◽  
Bijective Function ◽  
The Difference ◽  
Element Base ◽  
Selection Of

The construction and selection of a suitable bijective function, that is, substitution, is now becoming an important applied task, particularly for building block encryption systems. Many articles have suggested using different approaches to determining the quality of substitution, but most of them are highly computationally complex. The solution of this problem will significantly expand the range of methods for constructing and analyzing scheme in information protection systems. The purpose of research is to find easily measurable characteristics of substitutions, allowing to evaluate their quality, and also measures of the proximity of a particular substitutions to a random one, or its distance from it. For this purpose, several characteristics were proposed in this work: difference and polynomial, and their mathematical expectation was found, as well as variance for the difference characteristic. This allows us to make a conclusion about its quality by comparing the result of calculating the characteristic for a particular substitution with the calculated mathematical expectation. From a computational point of view, the thesises of the article are of exceptional interest due to the simplicity of the algorithm for quantifying the quality of bijective function substitutions. By its nature, the operation of calculating the difference characteristic carries out a simple summation of integer terms in a fixed and small range. Such an operation, both in the modern and in the prospective element base, is embedded in the logic of a wide range of functional elements, especially when implementing computational actions in the optical range, or on other carriers related to the field of nanotechnology.

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