scholarly journals Identification of Trichomonas vaginalis in Different Papanicolaou Test Preparations: Trends Over Time in the College of American Pathologists Educational Interlaboratory Comparison Program

2013 ◽  
Vol 137 (8) ◽  
pp. 1043-1046
Author(s):  
Lydia Pleotis Howell ◽  
Teresa M. Darragh ◽  
Rhona J. Souers ◽  
Nicole Thomas ◽  
Ann T. Moriarty
Keyword(s):  
Proficiency Testing ◽  
Repeated Measures ◽  
Trichomonas Vaginalis ◽  
Mixed Model ◽  
Interlaboratory Comparison ◽  
Papanicolaou Test ◽  
Nonlinear Mixed Model ◽  
Before And After ◽  
Performance Results ◽  
Over Time

Context.—The College of American Pathologists' Interlaboratory Comparison Program in Gynecologic Cytology has seen an increase in enrollment in liquid-based Papanicolaou test challenges with a decrease for conventional Papanicolaou tests. Trichomonas vaginalis can be difficult to identify in all preparation types. Objectives.—To evaluate 20 years of participant results from the College of American Pathologists Interlaboratory Comparison Program in Gynecologic Cytology for Trichomonas to ascertain whether performance has changed because of the introduction of liquid-based Papanicolaou and proficiency testing. Design.—Concordance rates for the target diagnosis of Trichomonas vaginalis were evaluated for 167 956 participant responses (1990–2010). A nonlinear mixed model was fit with participant type, preparation type, and a 2-level program year (1990–2005 and 2006–2010) reflecting before and after proficiency testing began. A repeated-measures component allowed modeling of the slide-specific performance to ensure that the overall results were not based on the performance of a few slides. Results.—Cytotechnologists had higher concordance with the target diagnosis than did pathologists (89.8% [72 992 of 81 319] versus 83.4% [72 271 of 86 637], P < .001) and better performance for each preparation type (P = .003). Concordance initially dropped after the introduction of proficiency testing (P < .001) for conventional and liquid-based (SurePath) preparations by both participant types, followed by quick, parallel improvement. Conclusions.—Performance is high in the detection of Trichomonas vaginalis in the College of American Pathologists Interlaboratory Comparison Program in Gynecologic Cytology. Liquid-based Papanicolaou and proficiency testing minimally affected participant performance. Cytotechnologists performed better over time and across preparation types than did pathologists, although pathologists showed performance results parallel to that of the cytotechnologists. Awareness of the performance differences by pathologists and cytotechnologists, as well as their difference in proficiency among liquid-based techniques, may help ensure accurate results in clinical practice.

Dividend initiators, winners during 2008 financial crisis

2016 ◽  
Vol 42 (3) ◽  
pp. 212-224 ◽  
Author(s):  
John Consler ◽  
Greg M. Lepak
Keyword(s):  
Financial Crisis ◽  
Repeated Measures ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Penalized Splines ◽  
2008 Financial Crisis ◽  
Content Type ◽  
Financial Variables ◽  
Before And After ◽  
Over Time

Purpose – The purpose of this paper is to describe and compare the mean response for selected financial variables in three dividend paying groups before and after the financial crisis of 2008. Dividend initiators are expected to be rewarded by investors over traditional dividend paying firms. Design/methodology/approach – Quarterly CRSP data from 2000 to 2012 are used to define dividend paying groups. Highly unbalanced financial data on dividend paying firms are analyzed in two truncated sample periods defined before and after the financial crisis. Fitted models describing differences in dividend paying groups are based on the linear mixed model representation of penalized splines with random effects to account for repeated measures over time. Findings – Results are presented on the important differences in selected financial variables before and after the financial crisis by dividend paying pattern group (traditional, initiators, residual/catering). Special emphasis is given to the analysis of market/book value ratio. Results demonstrate dividend initiators are rewarded over traditional dividend firms by investors. Firms with an intermittent paying pattern have no advantage. All dividend paying firms grow during the 2008 financial crisis. Traditional dividend payers have larger size than other dividend payers. The size effect explains results for several of the financial variables studied. Research limitations/implications – Future work can include an industry effect on the three dividend paying groups. Practical implications – Investors appear to prefer certainty as to when they receive a dividend over uncertainty, especially in times of economic downturn and economic recovery. Social implications – Enhanced awareness that different payment patterns exist and are rewarded differently over time on both the corporate issuer and investor sides. Originality/value – This study adds to body of knowledge of practical dividend payment patterns around a financial crisis. It also provides added support for dividend initiators.

scholarly journals Mood and Global Symptom Changes among Psychotherapy Clients with Depressive Personality

2012 ◽  
Vol 2012 ◽  
pp. 1-12
Author(s):  
Rachel E. Maddux ◽  
Lars-Gunnar Lundh
Keyword(s):  
Repeated Measures ◽  
Mixed Model ◽  
Psychological Symptoms ◽  
Self Report ◽  
Treatment Results ◽  
Repeated Measures Analysis ◽  
Depressive Personality ◽  
Symptom Changes ◽  
Psychotherapy Clients ◽  
Over Time

The present study assessed the rate of depressive personality (DP), as measured by the self-report instrument depressive personality disorder inventory (DPDI), among 159 clients entering psychotherapy at an outpatient university clinic. The presenting clinical profile was evaluated for those with and without DP, including levels of depressed mood, other psychological symptoms, and global severity of psychopathology. Clients were followed naturalistically over the course of therapy, up to 40 weeks, and reassessed on these variables again after treatment. Results indicated that 44 percent of the sample qualified for DP prior to treatment, and these individuals had a comparatively more severe and complex presenting disposition than those without DP. Mixed-model repeated-measures analysis of variance was used to examine between-groups changes on mood and global severity over time, with those with DP demonstrating larger reductions on both outcome variables, although still showing more symptoms after treatment, than those without DP. Only eleven percent of the sample continued to endorse DP following treatment. These findings suggest that in routine clinical situations, psychotherapy may benefit individuals with DP.

scholarly journals Impacts of rTMS on Refractory Depression and Comorbid PTSD Symptoms at a Military Treatment Facility

2020 ◽  
Vol 185 (9-10) ◽  
pp. e1420-e1427
Author(s):  
Sean Wilkes ◽  
Celia Ona ◽  
Michael Yang ◽  
Pingyang Liu ◽  
Amber Benton ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Mixed Model ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Active Duty ◽  
Ptsd Symptoms ◽  
Refractory Depression ◽  
Antidepressant Medications ◽  
Treatment Of Depression ◽  
Changes Over Time ◽  
Over Time

Abstract Introduction Repetitive transcranial magnetic stimulation (rTMS) as a treatment for depression has been studied for over two decades. Repetitive TMS was approved by the Food and Drug Administration in 2008 for the treatment of depression after at least one failed trial of an antidepressant medication of adequate dose and duration. This study evaluated whether rTMS treatments may be associated with measurable improvements in depression and post-traumatic stress disorder (PTSD) symptoms for treated military beneficiaries in Hawaii suffering from depression. It also examined the number of failed medication trials that patients underwent before rTMS treatment. Materials and Methods A retrospective chart review of 77 rTMS patients who received and completed treatment between January 1, 2010 and October 31, 2016 was performed. Under a typical treatment regimen, patients receive rTMS for 6 weeks as well as weekly psychiatric assessments, which included completion of Beck’s Depression Inventory (BDI) and PTSD Checklist (PCL). A mixed model repeated measures analysis was done assuming an autoregressive order one covariance structure to evaluate changes over time. Adjusted analyses were done to assess whether changes over time differed by age, prior diagnosis of PTSD, active duty status, and gender. Results The majority of patients were from the army (74%) and 56% were on active duty. Just over half (53%) were male. Most patients (52%) had completed trials of three or more different antidepressant medications before initiation of treatment with rTMS. The mean number of antidepressant trials was 2.7. BDI and PCL scores were significantly lower at end of treatment on average compared to the pretreatment baseline scores. Mean differences for BDI and PCL were significant with P < 0.001 15, 30, and 45 days after TMS treatment was initiated. Overall, 44% of patients experienced a reduction ≥10 points on BDI, and 38% experienced a reduction ≥10 points on PCL. Additionally, scores fell similarly regardless of whether or not patients had a comorbid diagnosis of PTSD. Conclusions Our research suggests that rTMS treatments may produce a reduction in symptoms of both depression and PTSD in patients with refractory depression and comorbid PTSD. It may be a useful alternative to antidepressants in the treatment of depression in the military population, including those with comorbid PTSD. Broader implementation of this treatment modality may prove beneficial for the purposes of military readiness, given current policies and restrictions on service members who are initiated on antidepressant medications.

Effects of Exercise Restriction on Patients With Anomalous Aortic Origin of a Coronary Artery

2016 ◽  
Vol 8 (1) ◽  
pp. 18-24 ◽  
Author(s):  
Matthew D. Elias ◽  
James Meza ◽  
Brian W. McCrindle ◽  
Julie A. Brothers ◽  
Stephen Paridon ◽  
...  
Keyword(s):  
Coronary Artery ◽  
Exercise Capacity ◽  
Repeated Measures ◽  
Mixed Model ◽  
Linear Mixed Model ◽  
Multivariable Analysis ◽  
Young Patients ◽  
Significant Difference ◽  
Exercise Restriction ◽  
Over Time

Background: Management of young patients with anomalous aortic origin of a coronary artery (AAOCA) may involve exercise restriction. We sought to identify the association of exercise restriction with changes over time in body mass index (BMI) and exercise capacity in this cohort. Methods: We performed a retrospective review of patients with AAOCA seen at The Children’s Hospital of Philadelphia between January 1, 1998, and August 31, 2014. Linear mixed model repeated-measures analysis assessed changes in BMI and exercise capacity. Results: We included 72 patients with a median age at presentation of 12.6 years (interquartile range: 10.1-15.8) and mean follow-up of 3.6 ± 3.0 years. The majority had an anomalous right coronary artery (71%) and interarterial ± intramural coronary course (90%). Surgery was performed in 54%, more often in those with interarterial/intramural course ( P < .001) and symptoms ( P = .003). Most patients (82%) were exercise-restricted on presentation, and restricted patients were older than those who were not restricted ( P = .01). There was no significant difference between restricted and nonrestricted patients in initial BMI z scores, percentage of patients with BMI over 85th percentile (26%) or exercise capacity variables. In univariable analysis, exercise restriction over time was not associated with change in BMI z score ( P = .25) or change in exercise variables. Restriction was not associated with significant change in these variables in multivariable analysis. Conclusions: Although further investigation is warranted to determine the degree of adherence to exercise restriction, the recommendation of restriction alone is not associated with increasing BMI or decreasing exercise performance in the short-term.

scholarly journals Musculoskeletal Outcomes from Chronic High-Speed High-Impact Resistive Exercise

2019 ◽  
Vol 7 (1) ◽  
pp. 22-32 ◽  
Author(s):  
L. Chen ◽  
E.A. Selimovic ◽  
M. Daunis ◽  
T.A. Bayers T ◽  
L.J. Vargas ◽  
...  
Keyword(s):  
Repeated Measures ◽  
High Speed ◽  
Time Course ◽  
Exercise Intervention ◽  
Knee Extensor ◽  
Peak Torque ◽  
Resistive Exercise ◽  
Before And After ◽  
Independent Variable ◽  
Over Time

AbstractSubjects (n=13) did 30 workouts with their left leg on an Inertial Exercise Trainer (IET), while their right leg served as an untreated control. Before and after the 30 workouts, they underwent isokinetic strength tests (knee and ankle extensors of both legs) whose peak torque (PT), time to PT (TTPT), and rate of torque development (RTD) values were each analyzed with 2(leg)×2(time)×3(velocity) analysis of variances (ANOVAs), with repeated measures per independent variable. Peak force (PF) and total work (TW) data were measured from each IET workout, and they represent time course strength changes produced by our exercise intervention. PF and TW values for the three IET exercises that comprised each workout were each analyzed with one-way ANOVAs with time as the independent variable. Results included significant ankle and knee extensor PT increases, whereby the left leg achieved higher values at posttesting, but there were no significant TTPT changes and a time effect for ankle extensor RTD. Our data show that PF and TW each had significant increases over time, with the latter exhibiting greater gains over the 30-workout intervention. Our results imply that the IET yields strength gains over time comparable to standard resistive exercise hardware.

Abstract 52: Efficacy and Safety of Mipomersen in Patients with Familial Hypercholesterolemia and Inadequately Controlled LDL-C Levels

2016 ◽  
Vol 36 (suppl_1) ◽  
Author(s):  
Christie Ballantyne ◽  
Alberico L Catapano ◽  
Michael Davidson ◽  
Robert Mittleman ◽  
Patrick M Moriarty ◽  
...  
Keyword(s):  
Adverse Events ◽  
Familial Hypercholesterolemia ◽  
Repeated Measures ◽  
Mixed Model ◽  
Primary Objective ◽  
Tolerability Profile ◽  
Primary Analysis ◽  
Double Blind ◽  
Absolute Reduction ◽  
Over Time

Aim: Mipomersen is an antisense oligonucleotide inhibitor of apolipoprotein B-100 synthesis, FDA-approved to treat homozygous familial hypercholesterolemia. The primary objective of this study was to determine whether mipomersen significantly reduced atherogenic lipid levels in patients with severe heterozygous familial hypercholesterolemia (HeFH). Methods: This was a randomized, double-blind, placebo-controlled, parallel-group study comprised of two cohorts (NCT01475825). Cohort 1 had severe HeFH (LDL-C ≥200 mg/dL + coronary heart disease, or LDL-C ≥300 mg/dL) and Cohort 2 had milder HeFH (LDL-C ≥160 and <200 mg/dL). For each cohort, patients were randomized 1:1 to 200 mg SC once weekly or 70 mg SC thrice weekly, then 2:1 to receive mipomersen or placebo for 60 weeks. The primary outcome was percent change from baseline in LDL-C in Cohort 1. The % change from baseline in LDL-C at Week 61 for mipomersen treated patients was compared to placebo using a mixed model for repeated measures (MMRM), as well as by ANCOVA on the value closest to 7 days post last treatment (LOCF). Results: Mean baseline LDL-C levels were 265 mg/dL in Cohort 1 (N=200) and 176 mg/dL in Cohort 2 (N=109). In Cohort 1, mipomersen 200 mg weekly reduced LDL-C levels by -29.7% (vs -7.9% placebo, P <.001) in the mixed model, and by -36.3% (vs -7.6% placebo, P <.001) using the LOCF. Analysis of LDL-C over time (Figure) showed a mean absolute reduction of 138 mg/dL in mipomersen patients who completed the blinded treatment period (n=32), achieving a mean level of 147 mg/dL from a mean 285 mg/dL baseline level. Tolerability to treatment and adverse events were similar between dose regimens. Adverse events were consistent with the drug’s known safety and tolerability profile. Conclusions: The primary analysis showed a significant reduction in LDL-C levels in patients with severe HeFH who received mipomersen 200 mg once weekly versus placebo. A highly relevant absolute reduction in LDL-C was achieved over time.

scholarly journals Update on the College of American Pathologists Experience With High-Risk Human Papillomavirus Proficiency Testing for Cytology

2016 ◽  
Vol 140 (12) ◽  
pp. 1371-1374 ◽  
Author(s):  
Mohiedean Ghofrani ◽  
Chengquan Zhao ◽  
Diane D. Davey ◽  
Fang Fan ◽  
Mujtaba Husain ◽  
...  
Keyword(s):  
Human Papillomavirus ◽  
Proficiency Testing ◽  
Mixed Model ◽  
Clinical Laboratory ◽  
Becton Dickinson ◽  
Nonlinear Mixed Model ◽  
Molecular Systems ◽  
Hybrid Capture 2 ◽  
Testing Medium ◽  
Commercial Kits

Context.— Since 2008, the College of American Pathologists has provided the human papillomavirus for cytology laboratories (CHPV) proficiency testing program to help laboratories meet the requirements of the Clinical Laboratory Improvement Amendments of 1988. Objectives.— To provide an update on trends in proficiency testing performance in the College of American Pathologists CHPV program during the 4-year period from 2011 through 2014 and to compare those trends with the preceding first 3 years of the program. Design.— Responses of laboratories participating in the CHPV program from 2011 through 2014 were analyzed using a nonlinear mixed model to compare different combinations of testing medium and platform. Results.— In total, 818 laboratories participated in the CHPV program at least once during the 4 years, with participation increasing during the study period. Concordance of participant responses with the target result was more than 98% (38 280 of 38 892). Overall performance with all 3 testing media—ThinPrep (Hologic, Bedford, Massachusetts), SurePath (Becton, Dickinson and Company, Franklin Lakes, New Jersey), or Digene (Qiagen, Valencia, California)—was equivalent (P = .51), and all 4 US Food and Drug Administration (FDA)–approved platforms—Hybrid Capture 2 (Qiagen), Cervista (Hologic), Aptima (Hologic), and cobas (Roche Molecular Systems, Pleasanton, California)—outperformed laboratory-developed tests, unspecified commercial kits, and other (noncommercial) methods in ThinPrep medium (P &lt; .001). However, certain off-label combinations of platform and medium, most notably Cervista with SurePath, demonstrated suboptimal performance (P &lt; .001). Conclusions.— Laboratories demonstrated proficiency in using various combinations of testing media and platforms offered in the CHPV program, with statistically significant performance differences in certain combinations. These observations may be relevant in the current discussions about FDA oversight of laboratory-developed tests.

scholarly journals PSIV-2 Changes in free glutamine and glutamate in mare milk during early lactation

2020 ◽  
Vol 98 (Supplement_4) ◽  
pp. 276-276
Author(s):  
Morgan B Pyles ◽  
Susan Hayes ◽  
Andrea Crum ◽  
Elizabeth Radomski ◽  
Miranda Kunes ◽  
...  
Keyword(s):  
Repeated Measures ◽  
Mixed Model ◽  
Early Lactation ◽  
Gut Health ◽  
Milk Samples ◽  
Major Energy Source ◽  
Amine Carrier ◽  
Daily Milk Yield ◽  
Changes Over Time ◽  
Over Time

Abstract Glutamine plays an important role in neonatal health. This amino acid serves as a nitrogen and amine carrier between tissues, as a major energy source and as a precursor for nucleic acids and proteins in rapidly proliferating intestinal cells. This study aimed to evaluate changes over time in free Gln and Glu concentrations in mare milk in early lactation and their relationship with foal gut health. Thirteen Thoroughbred mare and foal pairs were studied. Milk samples were collected at 12 h, 3, 5, 7, 10, 14, and 21 d after parturition and daily milk yield was estimated at 7 and 14 d postpartum. Milk samples were centrifuged (10 min, 3500 x g, 4 °C) to remove fat, then centrifuged twice (5 min, 10,000 x g, 22 °C) to remove protein. Free Glu and Gln were analyzed in triplicate using a membrane-based glutaminase and glutamate oxidase method (YSI 2700 Analyzer, YSI Life Sciences, OH). Daily fecal scores were recorded to monitor foal diarrhea and body weights were recorded weekly. Mixed model ANOVA with repeated measures (SAS 9.4) were used to evaluate changes over time in free Gln and Glu. Relationships between variables were assessed using regression analyses and Pearson’s correlation coefficient. Free Gln and Glu changed over time (P &lt; 0.0001). Glutamine increased from 12 h to 5 d, (0.24±0.11 mmol/L and 1.09±.11 mmol/L, respectively; P &lt; 0.05) then decreased to 0.90±0.11 mmol/L by 21 d postpartum. In contrast, free Gln was the lowest at 12 h (0.36±0.04 mmol/L) and continued increasing through 21 d postpartum (0.80±0.04 mmol/L; P &lt; 0.05). Bouts of diarrhea were negatively related to milk Gln (P &lt; 0.05) and foal ADG was positively related to milk Glu (P &lt; 0.05). These results suggest that Gln may have a role in foal gut health while Glu may influence foal growth.

scholarly journals Plasma adrenocorticotropic hormone concentration in horses decreases after freezing for 60 days

2019 ◽  
Vol 31 (6) ◽  
pp. 856-858
Author(s):  
John C. Haffner ◽  
Dwana L. Neal ◽  
Rhonda M. Hoffman ◽  
Steven T. Grubbs
Keyword(s):  
Repeated Measures ◽  
Adrenocorticotropic Hormone ◽  
Mixed Model ◽  
Statistical Significance ◽  
Hormone Concentration ◽  
Plasma Acth ◽  
Acth Concentration ◽  
The Stability ◽  
Over Time

We investigated the stability of adrenocorticotropic hormone (ACTH) in plasma after freezing for different lengths of time. The plasma ACTH concentrations of 12 horses were measured on day 0 (baseline) and over time, after stimulation with thyrotropin-releasing hormone. Samples were stored at −80°C for 3, 7, 30, 60, and 90 d, or at −20°C for 3, 7, 30, and 60 d, or between ice packs at −20°C for 3 and 7 d prior to determination of ACTH concentration. ACTH concentrations were compared to baseline (non-frozen day 0 plasma) for each storage method using a mixed model with repeated measures in which each horse served as its own control and day was the repeated effect. Statistical significance was set at p ≤ 0.05, and 0.05 < p < 0.10 was considered a trend. Plasma ACTH frozen at −20°C or at −80°C resulted in degradation of ACTH compared to baseline samples at 60 and 90 d respectively. There was no degradation of ACTH after 7 d when stored between ice packs, or before 30 d at −20°C, or before 60 d at −80°C.

Interprofessional simulation training’s impact on process and outcome team efficacy beliefs over time

2019 ◽  
Vol 6 (3) ◽  
pp. 140-147
Author(s):  
Matthew James Kerry ◽  
Douglas S Ander ◽  
Beth P Davis
Keyword(s):  
Repeated Measures ◽  
Discriminant Validity ◽  
Survey Methodology ◽  
Multilevel Modelling ◽  
Efficacy Beliefs ◽  
Team Efficacy ◽  
Repeated Measures Design ◽  
Process And Outcome ◽  
Before And After ◽  
Over Time

IntroductionRecent findings suggest that process and outcome-based efficacy beliefs are factorially distinct with differential effects for team performance. This study extends this work by examining process and outcome efficacy (TPE, TOE) of interprofessional (IP) care teams over time.MethodsA within-team, repeated measures design with survey methodology was implemented in a sample of prelicensure IP care teams performing over three consecutive clinical simulation scenarios. TPE and TOE were assessed before and after each performance episode.ResultsInitial baseline results replicated the discriminant validity for TPE and TOE separate factors. Further findings from multilevel modelling indicated significant time effects for TPE convergence, but not TOE convergence. However, a cross-level interaction effect of ‘TOE(Start-Mean)×Time’ strengthened TOE convergence over time. A final follow-up analysis of team agreement’s substantive impact was conducted using independent faculty-observer ratings of teams’ final simulation.ConclusionIndependent sample t-tests of high/low-agreement teams indicated support for agreement’s substantive impact, such that high-agreement teams were rated as significantly better performers than low-agreement teams during the final simulation training. We discuss the substantive merit of methodological within-team agreement as an indicator of team functionality within IP and greater healthcare-simulation trainings at-large.

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