scholarly journals Assessing the usefulness of electroencephalography in psychiatry: Outcome of referrals at a psychiatric hospital

2016 ◽  
Vol 22 (1) ◽  
pp. 3
Author(s):  
Molokashe Molokomme ◽  
Ugasvaree Subramaney
Keyword(s):  
Retrospective Study ◽  
Psychiatric Hospital ◽  
Small Sample Size ◽  
Total Sample ◽  
Demographic Variables ◽  
Small Sample ◽  
Admission Diagnosis ◽  
Source Data ◽  
Psychiatric Conditions ◽  
Clinical Records

<p>This retrospective study was conducted at Sterkfontein psychiatric hospital in Gauteng. The objectives included investigating reasons for referral to conduct an electroencephalography (EEG) and to determine whether EEG findings have impact on clinical management. Source data included EEG reports over an 18-month period and clinical records. The total sample was 85 adult inpatients (53 males; 32 females). Seizure disorder exclusion was the main reason for EEG referral (69.0%). Seventy-four (87.0%) records were normal, 7 (8.2%) were abnormal 2 (2.4%) were inconclusive and 2 (2.4%) EEG reports were unavailable. There was no statistically significant correlation between abnormal EEG results and demographic variables, symptoms admission diagnosis and medications. EEG recording demonstrated a low yield of abnormal results. In this study, EEG results did not appear to influence the treating psychiatrists regarding management, but this could be as a result of the small sample size. As interactions between psychiatric conditions and epilepsy are important and well established, negative EEGs are indeed useful and it is recommended that clinicians should carefully consider which patients should be referred for EEGs.</p>

scholarly journals Gastric Cancer Microbiome

Pathobiology ◽  
2021 ◽  
Vol 88 (2) ◽  
pp. 156-169
Author(s):  
Williams Fernandes Barra ◽  
Dionison Pereira Sarquis ◽  
André Salim Khayat ◽  
Bruna Cláudia Meireles Khayat ◽  
Samia Demachki ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Small Sample Size ◽  
Total Sample ◽  
Clinical Situation ◽  
Gastric Carcinogenesis ◽  
Comprehensive Analysis ◽  
Small Sample ◽  
Metagenomic Data ◽  
Clinical Scenarios ◽  
H Pylori

Identifying a microbiome pattern in gastric cancer (GC) is hugely debatable due to the variation resulting from the diversity of the studied populations, clinical scenarios, and metagenomic approach. <i>H. pylori</i> remains the main microorganism impacting gastric carcinogenesis and seems necessary for the initial steps of the process. Nevertheless, an additional non-<i>H. pylori</i> microbiome pattern is also described, mainly at the final steps of the carcinogenesis. Unfortunately, most of the presented results are not reproducible, and there are no consensual candidates to share the <i>H. pylori</i> protagonists. Limitations to reach a consistent interpretation of metagenomic data include contamination along every step of the process, which might cause relevant misinterpretations. In addition, the functional consequences of an altered microbiome might be addressed. Aiming to minimize methodological bias and limitations due to small sample size and the lack of standardization of bioinformatics assessment and interpretation, we carried out a comprehensive analysis of the publicly available metagenomic data from various conditions relevant to gastric carcinogenesis. Mainly, instead of just analyzing the results of each available publication, a new approach was launched, allowing the comprehensive analysis of the total sample amount, aiming to produce a reliable interpretation due to using a significant number of samples, from different origins, in a standard protocol. Among the main results, <i>Helicobacter</i> and <i>Prevotella</i> figured in the “top 6” genera of every group. <i>Helicobacter</i> was the first one in chronic gastritis (CG), gastric cancer (GC), and adjacent (ADJ) groups, while <i>Prevotella</i> was the leader among healthy control (HC) samples. Groups of bacteria are differently abundant in each clinical situation, and bacterial metabolic pathways also diverge along the carcinogenesis cascade. This information may support future microbiome interventions aiming to face the carcinogenesis process and/or reduce GC risk.

scholarly journals Serial neuroimaging in infants with abusive head trauma: timing abusive injuries

2013 ◽  
Vol 12 (2) ◽  
pp. 110-119 ◽  
Author(s):  
Ray Bradford ◽  
Arabinda K. Choudhary ◽  
Mark S. Dias
Keyword(s):  
Head Trauma ◽  
Small Sample Size ◽  
Medical Center ◽  
Abusive Head Trauma ◽  
Time Frame ◽  
Small Sample ◽  
Ct Scans ◽  
Imaging Studies ◽  
T1 Hyperintensity ◽  
Clinical Records

Object The appearance and evolution of neuroimaging abnormalities following abusive head trauma (AHT) is important for establishing the time frame over which these injuries might have occurred. From a legal perspective this frames the timing of the abuse and therefore identifies and excludes potential perpetrators. A previous pilot study involving 33 infants with AHT helped to refine the timing of these injuries but was limited by its small sample size. In the present study, the authors analyzed a larger group of 210 cases involving infants with AHT to chronicle the first appearance and evolution of radiological (CT, MRI) abnormalities. Methods All children younger than 24 months admitted to the Penn State Hershey Medical Center with AHT over a 10-year period were identified from a medical record review; the time of injury was determined through an evaluation of the clinical records. All imaging studies were analyzed, and the appearance and evolution of abnormalities were chronicled on serial neuroimaging studies obtained in the days and weeks after injury. Results One hundred five infants with specific injury dates and available imaging studies were identified; a subset of 43 children additionally had documented times of injury. In infants with homogeneously hyperdense subdural hematomas (SDHs) on initial CT scans, the first hypodense component appeared within the SDH between 0.3 and 16 days after injury, and the last hyperdense subdural component disappeared between 2 and 40 days after injury. In infants with mixed-density SDHs on initial scans, the last hyperdense component disappeared between 1 and 181 days. Parenchymal hypodensities appeared on CT scans performed as early as 1.2 hours, and all were visible within 27 hours after the injury. Rebleeding into SDHs was documented in 17 cases (16%) and was always asymptomatic. Magnetic resonance imaging of the brain was performed in 49 infants. Among those with SDH, 5 patterns were observed. Patterns I and II reflected homogeneous SDH; Pattern I (T1 hyperintensity and T2/FLAIR hypointensity, “early subacute”) more commonly appeared on scans performed earlier after injury compared with Pattern II (T1 hyperintensity and T2/FLAIR hyperintensity, “late subacute”), although there was considerable overlap. Patterns III and IV reflected heterogeneous SDH; Pattern III contained relatively equal mixtures having different intensities, whereas Pattern IV had fluid that was predominantly T1 hypointense and T2/FLAIR hyperintense. Again, Pattern III more commonly appeared on scans performed earlier after injury compared with Pattern IV, although there was significant overlap. Conclusions These data extend the preliminary data reported by Dias and colleagues and provide a framework upon which injuries in AHT can be timed as well as the limitations on such timing estimates.

Transfer learning with convolutional neural networks for small sample size problem in machinery fault diagnosis

2019 ◽  
Vol 233 (14) ◽  
pp. 5131-5143 ◽  
Author(s):  
Dengyu Xiao ◽  
Yixiang Huang ◽  
Chengjin Qin ◽  
Zhiyu Liu ◽  
Yanming Li ◽  
...  
Keyword(s):  
Neural Networks ◽  
Fault Diagnosis ◽  
Sample Size ◽  
Transfer Learning ◽  
Small Sample Size ◽  
Small Sample ◽  
Diagnostic Model ◽  
Source Data ◽  
Target Data ◽  
Machinery Fault Diagnosis

Data-driven machinery fault diagnosis has gained much attention from academic research and industry to guarantee the machinery reliability. Traditional fault diagnosis frameworks are commonly under a default assumption: the training and test samples share the similar distribution. However, it is nearly impossible in real industrial applications, where the operating condition always changes over time and the quantity of the same-distribution samples is often not sufficient to build a qualified diagnostic model. Therefore, transfer learning, which possesses the capacity to leverage the knowledge learnt from the massive source data to establish a diagnosis model for the similar but small target data, has shown potential value in machine fault diagnosis with small sample size. In this paper, we propose a novel fault diagnosis framework for the small amount of target data based on transfer learning, using a modified TrAdaBoost algorithm and convolutional neural networks. First, the massive source data with different distributions is added to the target data as the training data. Then, a convolutional neural network is selected as the base learner and the modified TrAdaBoost algorithm is employed for the weight update of each training sample to form a stronger diagnostic model. The whole proposition is experimentally demonstrated and discussed by carrying out the tests of six three-phase induction motors under different operating conditions and fault types. Results show that compared with other methods, the proposed framework can achieve the highest fault diagnostic accuracy with inadequate target data.

scholarly journals Laboratory detection of bacterial pathogens and clinical and laboratory response of syndromic management in patients with cervical discharge: A retrospective study

2021 ◽  
Vol 0 ◽  
pp. 1-5
Author(s):  
Deepika Yadav ◽  
Sanjay Singh ◽  
Benu Dhawan ◽  
Seema Sood ◽  
Somesh Gupta
Keyword(s):  
Polymerase Chain Reaction ◽  
Retrospective Study ◽  
Chlamydia Trachomatis ◽  
Small Sample Size ◽  
Bacterial Pathogens ◽  
Small Sample ◽  
World Health ◽  
Chain Reaction ◽  
Syndromic Management ◽  
Polymerase Chain

Background: Cervical discharge as part of cervicitis and pelvic inflammatory disease is a cause of significant morbidity in sexually active women worldwide. Non-gonococcal and non- chlamydial bacterial pathogens are becoming more prevalent. Aims: This study aims to determine bacterial pathogens causing cervical discharge using culture and/or polymerase chain reaction and assess the clinical and laboratory response to the conventional syndromic kit regimen established by the World Health Organisation. Methods: A retrospective review of records of women with cervical discharge over one year period. Culture and/or polymerase chain reaction results of endocervical swabs of various bacterial pathogens at baseline and after four weeks of treatment with syndromic kit regimen were recorded. Results: A total of 70 case records were reviewed for clinical details, out of which results of bacterial culture and polymerase chain reaction were available for 67 cases. Infectious aetiology was found in 30 (44.7%) patients with Ureaplasma species being the most common organism isolated on culture (18, 26.8%) and polymerase chain reaction (25, 37.3%), respectively. Polymerase chain reaction for Chlamydia trachomatis and Mycoplasma hominis was positive in ten (14.9%) and four (6%) cases, respectively. None of the patients showed positive culture for Neisseria gonorrhoeae. Coinfection was seen in eight (11.9%) patients with the majority showing Chlamydia trachomatis and Ureaplasma spp. coinfection (five patients). Forty one cases (58.5%) received tab. cefixime 400 mg and tab. azithromycin one gram stat (kit 1), while 29 cases (43.3%) received tab. cefixime 400 mg stat, tab. metronidazole 400 mg and cap. doxycycline 100 mg, both twice daily for 14 days (kit 6). Minimal to no clinical improvement with treatment was seen in 14 out of 32 cases (44%) at the end of four weeks with the conventional kit regimen. Post-treatment culture and/or polymerase chain reaction were positive in nine out of 28 cases (32.1%) with Ureaplasma spp. being the most common. Limitations: Retrospective study design, small sample size and fewer cases with follow-up data were the main limitations. Conclusion: Ureaplasma spp. was the most common infectious cause of cervical discharge in our patients. Treatment given as part of syndromic management led to a clinical and microbiological response in around half and two-third cases, respectively.

Posting photos of luxury cuisine online: an exploratory study

2019 ◽  
Vol 121 (2) ◽  
pp. 454-465 ◽  
Author(s):  
Glyn Atwal ◽  
Douglas Bryson ◽  
Valériane Tavilla
Keyword(s):  
Social Media ◽  
Cultural Context ◽  
Small Sample Size ◽  
Demographic Variables ◽  
Small Sample ◽  
Group Discussions ◽  
Comprehensive Overview ◽  
Self Presentation ◽  
Content Type ◽  
Diary Research

Purpose The purpose of this paper is to identify the motives for posting or sharing food photos using social media, focussed within the context of fine dining (FD) restaurants. Design/methodology/approach Ethnographic fieldwork was conducted in France by combining analysis of qualitative diary research and transcripts of focus group discussions. Findings The motivation to take food images can be broadly categorised according to experiential (hedonism, altruism and passion collecting) and symbolic (social status, uniqueness, self-esteem and self-presentation) benefits. Research limitations/implications This research is limited by its relatively small sample size and the inability to consider the direct influences of demographic variables and attitudes to FD and social media. Moreover, the cultural context of the study needs to be considered as the study took place in France. Practical implications User-generated images are increasingly an integral aspect of the holistic dining experience. Luxury restaurants need to leverage the opportunities of user-generated content. The FD experience needs to be visually captured and expressed. This can include both tangible and intangible attributes. Originality/value Although the literature has provided a comprehensive overview of social media behaviour, the efficacy of a gastronomic perspective is limited. To the authors’ knowledge, this is the first study to investigate consumer-generated postings of images of food within the luxury restaurant classification.

scholarly journals Genetic structure and the search for genotype-phenotype relationships: an example from disequilibrium in the Apo B gene region.

Genetics ◽  
1991 ◽  
Vol 129 (2) ◽  
pp. 525-533
Author(s):  
K E Zerba ◽  
A M Kessling ◽  
J Davignon ◽  
C F Sing
Keyword(s):  
Small Sample Size ◽  
Total Sample ◽  
Small Sample ◽  
Type I ◽  
Type Ii ◽  
Type Ii Error ◽  
Apo B ◽  
Weinberg Equilibrium ◽  
Hardy Weinberg Equilibrium ◽  
Error Probabilities

Abstract We analyzed allelic associations (disequilibria) for four restriction fragment length polymorphisms (RFLPs) in the region of the 43-kb Apo B gene in a sample of 233 unrelated individuals from Montreal, Canada, sampled for health. This total sample (T) included 160 individuals of known French Canadian (FC) ancestry. We present a rigorous application of current methodology to these samples, including estimation of type II error probabilities and correlations between markers for estimates of disequilibria. We then consider the utility of these estimates of allelic disequilibria for the interpretation of genotype-phenotype relations. Significant deviations from Hardy-Weinberg equilibrium were not predicted by proximity to other markers in disequilibrium. We found significant quadri-allelic disequilibrium for two marker pairs despite absence of significant deviations from Hardy-Weinberg equilibrium for either marker or tri-allelic disequilibrium, respectively. Altogether these results underscore the complexity of the genotypic structure of the data. A combination of nonevolutionary factors, including sampling for health, small sample size and data exclusion due to methodological constraints of not successfully typing all members of the sample for every RFLP, is a likely explanation for this complexity. These types of factors are common to many RFLP studies. Patterns of composite di-allelic disequilibrium indicated that some RFLP allele pairs may have a longer shared evolutionary history than others and that disequilibrium is not predicted by distance between RFLPs. Type II error probabilities were generally much higher than those for type I errors. Correlations between marker pairs for disequilibria were generally not high. We show from a review of 14 published studies of association between the XbaI RFLP and variation in a total of 15 lipid traits that deviations from Hardy-Weinberg equilibrium can cause substantial differences in the estimation of variability associated with phenotypic differences among marker genotypes relative to Hardy-Weinberg conditions.

scholarly journals Replication and contradiction of highly cited research papers in psychiatry: 10-year follow-up

2015 ◽  
Vol 207 (4) ◽  
pp. 357-362 ◽  
Author(s):  
Aran Tajika ◽  
Yusuke Ogawa ◽  
Nozomi Takeshima ◽  
Yu Hayasaka ◽  
Toshi A. Furukawa
Keyword(s):  
Sample Size ◽  
Small Sample Size ◽  
Total Sample ◽  
Small Sample ◽  
Research Papers ◽  
Effective Interventions ◽  
Mean Differences ◽  
Larger Sample ◽  
Highly Cited

BackgroundContradictions and initial overestimates are not unusual among highly cited studies. However, this issue has not been researched in psychiatry.AimsTo assess how highly cited studies in psychiatry are replicated by subsequent studies.MethodWe selected highly cited studies claiming effective psychiatric treatments in the years 2000 through 2002. For each of these studies we searched for subsequent studies with a better-controlled design, or with a similar design but a larger sample.ResultsAmong 83 articles recommending effective interventions, 40 had not been subject to any attempt at replication, 16 were contradicted, 11 were found to have substantially smaller effects and only 16 were replicated. The standardised mean differences of the initial studies were overestimated by 132%. Studies with a total sample size of 100 or more tended to produce replicable results.ConclusionsCaution is needed when a study with a small sample size reports a large effect.

scholarly journals Value of clinical examination in the assessment of penetrating neck injuries: a retrospective study of diagnostic accuracy test

2019 ◽  
Author(s):  
Andres Isaza-Restrepo ◽  
Julián Andrés Quintero Contreras ◽  
Jorge Escobar-DiazGranados ◽  
Ángela María Ruiz-Sternberg
Keyword(s):  
Retrospective Study ◽  
Diagnostic Accuracy ◽  
Clinical Examination ◽  
Limited Resource ◽  
High Volume ◽  
Total Sample ◽  
Modern World ◽  
Neck Injuries ◽  
Accuracy Test ◽  
Clinical Records

Abstract Background: There are many high-volume trauma centers in limited resource environments where a thorough clinical examination of patients may contribute to a more economic, accurate, and widely applicable method of determining the proper management of patients with penetrating neck injuries. The purpose of this study was to validate thorough physical examination as a reliable diagnostic tool in these patients. Methods: We performed an observational retrospective study of a diagnostic accuracy test where we compared clinical findings (symptoms and soft signs on admission of the patient) with the definitive findings according to the gold standard test for each particular situation (selective studies, clinical observation and surgical exploration). The study was conducted at Hospital Occidente Kennedy (HOK) between August 2009 and June 2010. Results: The sample consisted of the clinical records of 207 (n=207) patients who went to the emergency room for penetrating neck wounds at Hospital Occidente Kennedy (HOK) . Of the total sample, 36.2% (n=75) of patients were considered “asymptomatic” as they didn’t present with any soft signs of injury. Vascular soft signs were present in 57% (n=118) of the patients, soft signs of the airway and the upper gastrointestinal tract were present in 15.9% (n=33) and 21.3% (n=44) of the patients respectively. The sensitivity and negative predictive value (NPV) of any soft sign to determine injuries which require surgical repair was 97.4% [CI] [86.5%-99.5%] and 98.7% [CI] [92.8%-99.8%] respectively, with a range of confidence [CI] of 95%. Conclusions: Our study´s main findings suggest that patients with neck injuries and no vascular, airway, or gastrointestinal soft sign can be safely managed with a conservative approach. It is important to emphasize the value of the clinical examination since there are many contexts in the modern world where a considerable amount of the population is afflicted by neck trauma and treated under conditions where technological resources are limited.

Prognosis Following Surgical Excision of Canine Cutaneous Mast Cell Tumors With Histopathologically Tumor-Free Versus Nontumor-Free Margins: A Retrospective Study of 31 Cases

2002 ◽  
Vol 38 (5) ◽  
pp. 458-466 ◽  
Author(s):  
Gina M. Michels ◽  
Deborah W. Knapp ◽  
Dennis B. DeNicola ◽  
Nita Glickman ◽  
Patty Bonney
Keyword(s):  
Mast Cell ◽  
Retrospective Study ◽  
Small Sample Size ◽  
Surgical Excision ◽  
Local Relapse ◽  
Small Sample ◽  
Mast Cell Tumors ◽  
Statistical Support ◽  
Cutaneous Mast Cell ◽  
Tumor Related Death

The purpose of this study was to determine if the presence of histopathologically tumor-free versus nontumor-free margins was prognostic for relapse or tumor-related death in dogs following surgical excision of single or multiple cutaneous mast cell tumors confined to the skin without evidence of metastasis to lymph nodes or other noncutaneous sites. Differences in tumor-related death or frequency of relapse between the two groups were not significant. Failure to achieve histopathological tumor-free margins frequently did not lead to local relapse. All tumor-related deaths occurred following local relapse. The lack of statistical support for an association between prognosis and histopathological tumor-free versus nontumor-free margins may be a result of small sample size.

Does abiraterone withdrawal syndrome (AWS) exist also in metastatic castration-resistant prostate cancer (mCRPC) first-line setting?

2016 ◽  
Vol 34 (2_suppl) ◽  
pp. 344-344
Author(s):  
Francesca Maines ◽  
Orazio Caffo ◽  
Chiara Trentin ◽  
Antonello Veccia ◽  
Enzo Galligioni
Keyword(s):  
Withdrawal Syndrome ◽  
Small Sample Size ◽  
Objective Response ◽  
Clinical History ◽  
Abiraterone Acetate ◽  
Small Sample ◽  
Castration Resistant Prostate Cancer ◽  
First Line ◽  
Clinical Role ◽  
Clinical Records

344 Background: AWS is a recently phenomenon observed in mCRPC patients (pts) characterized by a PSA reduction with or without objective response after abiraterone acetate (AA) discontinuation. This syndrome has clinical features similar to antiandrogen withdrawal syndrome and was described in pts who treated with AA in the post-docetaxel setting. At the best of our knowledge, to date AWS was never described in chemo-naïve mCRPC pts. Methods: We retrospectively reviewed clinical records of mCRPC pts treated with first-line AA at our Institution. All pts were treated with AA 1,000 mg + prednisone (PDN) 10 mg po daily; the treatment was continued until progression disease (PD) which required an imaging confirmation too. After PD, we also discontinued the PDN administration. For each pt we recorded pre and post-AA clinical history, treatment details and outcomes. AWS was defined by PSA reduction ≥ 25% compared to the AA-end values observed in the first month after AA stop. Results: From September 2014, eight pts received first-line AA and, to date, 6 patients (75%) who discontinued the treatment due to PD are evaluable for AWS occurrence. We observed an AWS in 2/6 (33.3%). The first patient, a 76 year-old man, who experienced a PD after 12 wks AA treatment, had a 69% reduction in PSA with PSA dropping from 60 ng/mL to 19.47 ng/mL after about 30 days from the discontinuation. The second patient, 83 years old, treated with AA for 12 weeks, had a reduction in PSA from 112.2 ng/mL to 55 ng/mL at one-month (51% reduction) and to 35.36 ng/mL at two months (68.5% reduction) after AA and PDN discontinuation; after 9 wks the AWS is still ongoing. Conclusions: Notwithstanding the limits of the small sample size, our data shows for the first time that AWS can be observed also in mCRPC patients receiving AA as first-line treatment. Larger observations are needed to establish frequency and clinical role of this phenomenon. Although pathogenetic mechanisms and predictive factors are still unclear, AWS may represent a possibility to delay the second line start for mCRPC pts.

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