scholarly journals Examiner reliability and clinical responsiveness of motion palpation to detect biomechanical dysfunction of the the hip joint

2017 ◽  
Author(s):  
◽  
Gina Leigh Bertolotti
Keyword(s):  
Hip Joint ◽  
Diagnostic Tool ◽  
Small Sample Size ◽  
Diagnostic Techniques ◽  
Small Sample ◽  
Hip Pain ◽  
Anatomical Landmarks ◽  
Chi Square ◽  
Left Hand ◽  
Chi Square Test

Background: Hip pain is a common problem. Motion palpation is a manual technique applied by the hands in various degrees of joint motion that specifically evaluates range of motion in relation to specific anatomical landmarks, joint play and end feel. Motion palpation remains one of the most used diagnostic techniques and yet it remains unclear whether or not it is a reliable, sensitive and specific tool; especially in the hip joint. Objectives: This study assessed intra- and inter-examiner reliability and clinical responsiveness of motion palpation when it is used as a diagnostic tool in patients with non-specific unilateral anterior hip pain and unilateral asymptomatic hip joints. Methods: Ten participants, between the ages of 18 and 60, were included in this study (three ballet dancers, three golfers and four participants from the general population). The participants were assessed randomly by three blinded examiners. All of the participants then received one adjustment delivered by the researcher (half on the symptomatic side and half on the asymptomatic). The participants were then re-assessed. Data was recorded on a data collection sheet and analysed using SPSS version 23. Intra-examiner reliability and clinical responsiveness were analysed using McNemar’s test and the Chi-Square Test of Independence. Inter-examiner reliability was analysed using Fleiss’ Kappa. Results: Intra-examiner reliability showed to be markedly better on the left-hand side for all three examiners. Kappa scores for inter-examiner reliability varied from none to perfect. The average pairwise agreement scores ranged from 33.3% to 100% at the first assessment, and from 46.6% to 100% in the second assessment. A mean and standard deviation were calculated for the pairwise agreements which represented the sensitivity and specificity respectively. Both showed improvement between the first and second assessments which is positive for inter-examiner reliability. Clinical responsiveness was shown to be absent for examiners A and B but was present for examiner C on the left. Conclusion: This study found that, contrary to the expectations of many clinicians, motion palpation has limited to poor levels of intra-examiner reliability, inter-examiner reliability and clinical responsiveness. This is however limited by the small sample size and methodological limitations in this study. Therefore, the role of palpation as a diagnostic tool used in the diagnosis hip dysfunction may be limited.

scholarly journals Conditional Inference in Small Sample Scenarios Using a Resampling Approach

Stats ◽  
2021 ◽  
Vol 4 (4) ◽  
pp. 837-849
Author(s):  
Clemens Draxler ◽  
Andreas Kurz
Keyword(s):  
Power Function ◽  
Small Sample Size ◽  
R Package ◽  
Small Sample ◽  
Conditional Inference ◽  
Test Statistics ◽  
Chi Square ◽  
Large Sample Theory ◽  
Chi Square Test ◽  
True Values

This paper discusses a non-parametric resampling technique in the context of multidimensional or multiparameter hypothesis testing of assumptions of the Rasch model. It is based on conditional distributions and it is suggested in small sample size scenarios as an alternative to the application of asymptotic or large sample theory. The exact sampling distribution of various well-known chi-square test statistics like Wald, likelihood ratio, score, and gradient tests as well as others can be arbitrarily well approximated in this way. A procedure to compute the power function of the tests is also presented. A number of examples of scenarios are discussed in which the power function of the test does not converge to 1 with an increasing deviation of the true values of the parameters of interest from the values specified in the hypothesis to be tested. Finally, an attempt to modify the critical region of the tests is made aiming at improving the power and an R package is provided.

scholarly journals An evaluation of the usefulness of British Columbia's guideline in educating food bank operators

2019 ◽  
Author(s):  
Diane K. Lee ◽  
BCIT School of Health Sciences, Environmental Health ◽  
Helen Heacock ◽  
Lorraine McIntyre
Keyword(s):  
Food Safety ◽  
Small Sample Size ◽  
Small Sample ◽  
Food Distribution ◽  
Food Banks ◽  
Food Bank ◽  
Chi Square ◽  
Chi Square Test ◽  
Meal Programs ◽  
Safety Knowledge

  Background: Food Distribution Organizations (FDOs), such as food banks, community kitchen, and meal programs, are essential resources to relieve food insecurity in British Columbia. FDOs collect, process, store, and distribute donated food to the needy population. The BC Centre for Disease Control (BCCDC) published the Guidelines for Food Distribution Organizations with Grocery or Meal Programs in 2016 with purpose to educate FDOs on food safety and assist with their operational challenges. The guideline plays an important role especially for food bank operators who are not required to take food safety training. The purpose of this study was to evaluate the extent of the guideline use among food bank operators and assess its usefulness. This study also determines if the guideline use had a statistically significant association with higher knowledge in food safety. Methods: Self-administered electronic surveys created on Survey Monkey Canada were distributed to Foodbanks BC members by weekly online newsletter and email. The survey assessed the extent of usage of the guideline, current issues and knowledge level of FDO operators in BC. The survey response was collected over three weeks long period. Results: Among 37 FDO operators participated, 30 completed the survey. The majority of the operators was from BC, worked in food banks and had longer than 5 years long experience. 47% of participants did not know about the guideline. Among the guideline users, 83% agreed or strongly agreed that the guideline was useful. While retailers and groceries were the most common food donors, caterers and restaurants were the least common. Assessing each food item for safety was the most commonly encountered issue for FDOs. The least commonly encountered issue was having another FDO taking our donation from the donor. There was no association between the guideline use and level of food safety knowledge according to the Chi-square test (p= 0.89). There was no association between the years of experience and level of food safety knowledge (p= 0.23). The results did not show a statistically significant result potentially due to small sample size (n= 30). Conclusion: The results indicated while the guideline is useful among the users, the extent of its use should be widened. There is a need to improve accessibility of the guideline by modifying the content to address current practical issues, formatting it in a more user-friendly way, and utilizing better distribution means.  

scholarly journals P–495 Telemedicine in ART during SARS-CoV–2 pandemic : far and yet close

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
S Stigliani ◽  
C Massarotti ◽  
E Maccarini ◽  
F Sozzi ◽  
P Scaruffi ◽  
...  
Keyword(s):  
Small Sample Size ◽  
Small Sample ◽  
Drop Out ◽  
Clinical Tests ◽  
Chi Square ◽  
Oncological Patients ◽  
Registration Number ◽  
Chi Square Test ◽  
Number Of Cycles ◽  
Time To First Treatment

Abstract Study question Could telemedicine help in the management of the infertile couple’s path at a fertility center? Summary answer The introduction of telemedicine increased the number of cycles within 6 months from the first consultation and reduced the drop-out rate. What is known already In Italy during the complete lockdown due to the first pandemic wave of SARS-CoV–2 the activity of fertility centers were stopped, with the exception of fertility preservation procedures for oncological patients. We therefore proposed a service of telemedicine to our patients, that we called SmartPMA. Study design, size, duration A longitudinal study performed at a public infertility center. The SmartPMA service was offered to 93 couples referred to our center from March 9th to May 31st, 2020. Initially 72 couples was interested in SmartPMA. Our center gradually re-opened and the first oocytes retrieval was performed on June 9th . Participants/materials, setting, methods Sixty-one out of 72 couples (85%) performed the SmartPMA from April 7th to June 16th, 2020. After acquiring informed consent and sending two anamnestic questionnaires, we booked a video-consultation with a gynecologist and a biologist. Afterwards, we sent medical prescriptions for appropriate clinical tests. At the re-opening, we offered the chance to start the ART cycle. Time to the first treatment and drop-out rates were compared to historical controls (2017–2019) using chi-square test. Main results and the role of chance Eleven couples declined the SmartPMA and booked an appointment at the reopening. Only 2 of these couples (18%) actually performed an IVF treatment within six months. Three out the 61 couples that accepted the SmartPMA did not perform IVF treatments because the age of women exceeded the legal limit to access to a public ART center. Twelve out of 58 couples (21%) did not performed any IVF treatment for the following reasons: 4 women spontaneously got pregnant, 1 couple gave up for medical reasons, 3 were referred to ovodonation, and 4 were lost to follow-up. Thirty-eight out of 58 couples (66%) (median age of woman: 36 + 4 years, range 27–43) performed at least one ART treatment (14 IUI, 12 ICSI cycle, 12 FIVET cycle). Eight out of 58 couples (14%) needed further clinical tests and their treatments are ongoing. The mean time to first treatment in the SmartPMA couples was 4 + 1 months (range 1–6). After SmartPMA, 66% of the couples performed the first cycle within 6 months, compared to 37% of controls (333/898 couples at their first access to our center from 2017 to 2019), p < 0.00001. The drop-out was reduced from 39% to 20%, p = 0 .0038. Limitations, reasons for caution We cannot exclude that the couples that joined the SmartPMA service during the pandemic period were particularly motivated to perform IVF treatments. We are aware of the small sample size and that this is a monocentric study. Wider implications of the findings: Even after the pandemic, telemedicine can be an useful tool for fertility centers to reduce the discomfort of several visits in hospital, without losing patients but rather ultimately reducing the time to treatments and drop-out. Trial registration number Not applicable

scholarly journals The rs2071559 AAVEGFR-2Genotype Frequency Is Significantly Lower in Neovascular Age-Related Macular Degeneration Patients

2012 ◽  
Vol 2012 ◽  
pp. 1-6 ◽  
Author(s):  
Stefano Lazzeri ◽  
Paola Orlandi ◽  
Michele Figus ◽  
Anna Fioravanti ◽  
Elisa Cascio ◽  
...  
Keyword(s):  
Macular Degeneration ◽  
Gene Polymorphisms ◽  
Small Sample Size ◽  
Case Control ◽  
Small Sample ◽  
Age Related Macular Degeneration ◽  
Chi Square ◽  
Future Studies ◽  
Age Related ◽  
Chi Square Test

In this prospective, case-control genetic study, 120 consecutive neovascular age-related macular degeneration (AMD) cases and 78 controls were enrolled. Two SNPs (rs2071559 and rs1870377) ofVEGF-Areceptor-2 (VEGFR-2) gene were analyzed with the technique of Real-Time PCR to investigate a genetic link between AMD andVEGFR-2gene polymorphisms in Italian patients. The frequency of theVEGFR-2genotype rs2071559 AA was significantly lower (18.33%) in patients with AMD than in the control subjects (34.62%;P=0.0095, chi-square test;Pcorr=0.038;OR=0.42, 95% CI 0.22 to 0.82). In conclusion, although with the limitations of a small sample size and the few SNPs studied, this study demonstrates a lower frequency ofVEGFR-2rs2071559 AA genotype in an AMD patient population, suggesting future studies on the roleVEGFR-2SNPs.

scholarly journals A Pilot Placebo Controlled Randomized Trial of Dexamethasone for Chronic Subdural Hematoma

2016 ◽  
Vol 43 (2) ◽  
pp. 284-290 ◽  
Author(s):  
Michel Prud’homme ◽  
François Mathieu ◽  
Nicolas Marcotte ◽  
Sylvine Cottin
Keyword(s):  
Conservative Treatment ◽  
Adverse Events ◽  
Small Sample Size ◽  
Chronic Subdural Hematoma ◽  
Symptomatic Patient ◽  
Placebo Treatment ◽  
Small Sample ◽  
Chi Square ◽  
Serious Adverse Events ◽  
Before And After

AbstractBackground: Current opinions regarding the use of dexamethasone in the treatment of chronic subdural hematomas (CSDH) are only based on observational studies. Moreover, the use of corticosteroids in asymptomatic or minimally symptomatic patient with this condition remains controversial. Here, we present data from a prospective randomized pilot study of CSDH patients treated with dexamethasone or placebo. Methods: Twenty patients with imaging-confirmed CSDH were recruited from a single center and randomized to receive dexamethasone (12 mg/day for 3 weeks followed by tapering) or placebo as a conservative treatment. Patients were followed for 6 months and the rate of success of conservative treatment with dexamethasone versus placebo was measured. Parameters such as hematoma thickness and clinical changes were also compared before and after treatment with chi-square tests. Adverse events and complications were documented. Results: During the 6-month follow-up, one of ten patients treated with corticosteroids had to undergo surgical drainage and three of ten patients were treated surgically after placebo treatment. At the end of the study, all remaining patients had complete radiological resolution. No significant differences were observed in terms of hematoma thickness profile and impression of change; however, patients experienced more severe side effects when treated with steroids as compared with placebo. Dexamethasone contributed to many serious adverse events. Conclusions: Given the small sample size, these preliminary results have not shown a clear beneficial effect of dexamethasone against placebo in our patients. However, the number of secondary effects reported was much greater for corticosteroids, and dexamethasone treatment was responsible for significant complications.

Single-digit fingerprint analysis for hand determination: A study of twinned loops

2020 ◽  
Vol 60 (3) ◽  
pp. 182-187 ◽  
Author(s):  
Neeti Kapoor ◽  
Swati Dubey Mishra ◽  
Ashish Badiye
Keyword(s):  
Central India ◽  
Fingerprint Analysis ◽  
Chi Square ◽  
Single Digit ◽  
Left Hand ◽  
Novel Approach ◽  
Chi Square Test ◽  
Complete Set ◽  
The Right

In fingerprint analysis, the determination of hand (right or left) is one of the keys to resolving questions regarding the identity of the donor of the print. It is rare to encounter a complete set of 10-digit fingerprints from the scene of a crime. Although vital and imperative, except for a few studies on whorl patterns, the use of single-digit prints and patterns to ascertain the hand of the donor is scarcely reported in the literature. This research describes a novel approach whereby an analysis of twinned loops was carried out to identify the various parameters that may be helpful in ascertaining the hand of the donor. Bilateral rolled fingerprints from 180 healthy consenting adults belonging to a heterogeneous population of central India were collected. Out of the total of 1800 prints taken, 100 twinned loops (50 on the right hand and 50 on the left hand) were analysed. The following six parameters were considered: the slope of the flow of the apex ridges, the distance between the left delta and the ascending core, the distance between the right delta and the ascending core, mid-core position, the position of the loop and ridge tracing. On applying the chi-square test, the results were found to be statistically significant. Therefore, these parameters were found suitable for the determination of the hand from a single twinned-loop print.

A Study of Adherence to Restrictive RBC Transfusion and 30 Day Patient Outcomes

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 5037-5037
Author(s):  
Zhen Wang ◽  
Elaine Zhai ◽  
Aleksic Sandra ◽  
Kibola Adam ◽  
Richard May ◽  
...  
Keyword(s):  
Cardiovascular Events ◽  
Small Sample Size ◽  
Small Sample ◽  
University Hospital ◽  
Red Blood Cell Transfusion ◽  
Current Guideline ◽  
Chi Square ◽  
Exact Test ◽  
Medicine Service ◽  
Rbc Transfusion

Abstract Background: The American Association of Blood Banks (AABB) 2012 Guidelines recommend a restrictive transfusion strategy of 7 g/dL to 8 g/dL in asymptomatic, hemodynamically stable patients (pts) and for Hgb less than 8 g/dL in pts with preexisting cardiovascular disease. [1] Additional recommendations based on expert opinion include transfusion at threshold Hgb of 7 g/dL for hemodynamically stable ICU pts and Hgb less than 10 g/dL in pts with symptomatic anemia. We examined adherence to these guidelines and for differences in outcomes between restrictive and non-restrictive approaches at an academic hospital. Methods: We performed an IRB-approved retrospective review of all pts admitted to the Internal Medicine Service at University Hospital in Newark, New Jersey from July 1st to November 30th 2015 who received RBC transfusions. Charts were abstracted for demographic information, past medical history, indication for transfusion, presence of signs or symptoms of anemia (chest pain, orthostatic hypotension or tachycardia unresponsive to fluid resuscitation, or congestive heart failure), pre-transfusion Hgb, number of units transfused, and post-transfusion hgb. Outcomes were defined as requirement for additional transfusions, infections, cardiovascular events, adverse transfusion reactions, and death within 30 days of transfusion. Each transfusion was categorized as either adherent or non-adherent to the guidelines. Difference in outcomes between groups (adherent vs non-adherent) was tested using chi-square and Fisher's exact test with SAS studio version 3.4 (Cary, NC). Results: We reviewed 318 RBC transfusion records for 210 pts (median age: 55±17 years) with 157 (49%) transfusions in male and 161 (51%) in female pts. Site was ICU for 86 and the ward for 232 transfusions. The leading indication was acute bleeding (121 or 38%; pre-transfusion Hgb 6.9±1.3g/dL), followed by asymptomatic anemia (107 or 33%; pre-transfusion Hgb 6.8±0.8g/dL), and symptomatic anemia (91 or 29%; pre-transfusion Hgb 6.6±0.8g/dL). Of the 107 pts with asymptomatic anemia, 37 had pre-existing heart disease. Within this group, 35 were transfused at Hgb < 8g/dL (adherence of 95%). Seventy of the 107 transfusions were performed in pts without pre-existing cardiac disease. Fifty-nine were transfused at hgb < 7g/dL with an adherence of 84%. In the ICU, 21 of the 27 transfusions occurred for hgb < 7 g/dL in hemodynamically stable pts with an adherence of 78%. There were 91 transfusions for symptomatic anemia and all were adherent (100%). Regarding 30 day post-transfusion outcomes, there were 140 (44%) with subsequent transfusions; 54 (14%) infections; 7 (2.2%) cardiovascular events; 8 (2.5%) transfusion adverse reactions; 27(8%) deaths. No difference was detected for 30 day outcomes between the adherent group and the non-adherent group. (Table 1) Transfusion of at least 2unitsRBC in asymptomatic, symptomatic, and active bleeding pts were 25% (27/107), 44% (40/91), 57% (69/120) respectively. No difference in outcomes was found for the group receiving only 1 unit RBC (restrictive) compared to the group receiving 2 or more units RBC (non-restrictive). (Table 1) Conclusion: The majority of transfusions (92%) performed adhered to current guideline. While the restrictive approach was not associated with more complications or mortality, this study is limited by the small sample size and further work is being done. Acknowledgment: The authors are grateful to Dr. Koshy, Director of Blood Bank at University Hospital, for assistance. Reference: 1. Carson, J. L. et al. Red blood cell transfusion: a clinical practice guideline from the AABB. Ann Intern Med 157, 49-58 (2012). Disclosures Chang: Johnson and Johnson: Other: Stock; Amgen: Other: Research; Boehringer Ingelheim: Other: Research.

scholarly journals The perceived health effects of e-cigarette use among adult smokers

2020 ◽  
Author(s):  
Joey Cheng ◽  
BCIT School of Health Sciences, Environmental Health ◽  
Dale Chen
Keyword(s):  
Health Effects ◽  
Smoking Status ◽  
Small Sample Size ◽  
Health Benefits ◽  
Target Population ◽  
Small Sample ◽  
Multiple Choice Questions ◽  
Chi Square ◽  
Objective Health ◽  
The Government

Background: Vaping and e-cigarettes have been an epidemic among youths in recent years. In addition, as of April 2020, there has been hundreds of vaping related illnesses causing fatalities. As such there has been increased coverage by media and the government in regard to reporting vaping-related dangers and implementing regulatory changes such as bans. These actions could deter the target population from engaging in vaping – tobacco users. Research has shown that e-cigarettes are significantly less toxic relative to tobacco and that it could be more effective as a cessation treatment relative to nicotine gums or patches. This study surveyed current perceptions of Canadians with regards to vaping in order to determine if certain groups (i.e. varying ages, smoking status) hold different opinions in terms of harm, health benefits, and support for stricter e-cigarette regulations. Methods: Self-administered online surveys created on Survey Monkey were distributed to Canadians via online platforms Reddit and Facebook. The survey assessed opinions and perceptions of Canadians through multiple choice questions and were collected over a three week period. Results: This study received 157 respondents the majority of which were under 35 (73.08%) and from British Columbia (65.38%). Thirteen chi-square tests were performed comparing group variables (age, smoking status, and awareness of vaping related news) to perception variables (perceived harm, health benefits, safety). There was no association found between age and the tested perception variables. Several associations were found where e-cigarette users viewed e-cigarettes more favourably relative to tobacco users and non-users based on chi-square results. Chi-square associations between media awareness and harm perceptions could not be established due to a small sample size (n< 30). Conclusion: The results indicated that there are associations with e-cigarette perceptions and a person’s smoking status. This may be an indication that there is possible misinformation between groups when it comes to evaluating objective health effects of e-cigarettes. Non-users and a percentage of tobacco users seem to overstate

scholarly journals Seroprevalence of torch infections among complicated pregnancies in Atbara river Nile state - Sudan

2021 ◽  
Vol 10 (1) ◽  
pp. 18-20
Author(s):  
Mohammed Ahmed Ibrahim Ahmed ◽  
Hanaa Elzain Musaad ◽  
Nahla Ahmed Mohammed Abdurrahman ◽  
Wadei Mohammed Yasin ◽  
Mosab Nouraldein Mohammed Hamad ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Small Sample Size ◽  
Education Level ◽  
Small Sample ◽  
P Value ◽  
River Nile ◽  
Serological Evidence ◽  
Chi Square ◽  
Cross Sectional ◽  
Torch Infection

Objective: The aim of this study was to find the seroprevalence of TORCH infection among volunteered pregnant women and to find out the correlation between TORCH infection and age, complicated pregnancies and education level. Methods: A descriptive cross-sectional laboratory-based study carried out between March to June 2012 at Atbara River Nile State northern Sudan. The statistical descriptive determined in means of percentages. Chi-square used for trend analysis and calculates p-values. Results: A total of (75) voluntary pregnant women, Age between 15-55 years. The most common age group was 26-35 years (37/75) 49%.Serological evidence of Toxoplasmosis were positive for (22/75) 29 %. All volunteered pregnant women were negative for other components of TORCH complex. Study showed non-significant correlation between age, education level and complicated pregnancies, P-value 0.13, 0.43 and 0.51 respectively. Conclusion: Low prevalence of Toxoplasmosis and absent of serological evidence of other TORCH complex among volunteered pregnant women in Atbara has been documented. Insignificant correlation between toxoplasmosis and age, education level as well as number of complicated pregnancies reported. This attributed, in part, to the small sample size and using screening tool as diagnostic modalities.

Transformasi Terhadap Min bagi Menguji Taburan Terpencong

2012 ◽  
Author(s):  
Nor Haniza Sarmin ◽  
Md Hanafiah Md Zin ◽  
Rasidah Hussin
Keyword(s):  
Key Words ◽  
Simulation Study ◽  
Bias Correction ◽  
Type I Error ◽  
Small Sample Size ◽  
Small Sample ◽  
Skewed Distribution ◽  
Type I ◽  
Skewed Distributions ◽  
Chi Square

Suatu transformasi terhadap min dilakukan menggunakan penganggar pembetulan kepincangan bagi mendapatkan statistik untuk menguji min hipotesis taburan terpencong. Penghasilan statistik ini melibatkan pengubahsuaian pemboleh ubah . Kajian simulasi yang dijalankan terhadap taburan yang terpencong iaitu taburan eksponen, kuasa dua khi dan Weibull ke atas Kebarangkalian Ralat Jenis I menunjukkan bahawa statistik t3 sesuai untuk ujian satu hujung sebelah kiri dan saiz sampel yang kecil (n=5). Kata kunci: Min; statistik; taburan terpencong; penganggar pembetulan kepincangan; kebarangkalian Ralat Jenis I A transformation of mean has been done using a bias correction estimator to produce a statistic for mean hypothesis of skewed distributions. The statistic found involves a modification of the variable . A simulation study that has been done on some skewed distributions i.e. esponential, chi-square and Weibull on the Type I Error shows that t3 is suitable for the left-tailed test and a small sample size (n=5). Key words: Mean; statistic; skewed distribution; bias correction estimator; Type I Error

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