What is the Impact of the Underserved Pathway program on Entering an Underserved Family Medicine Residency? A Comparison of Three Approaches for Estimating the Average Treatment Effect

Thesis (Master's)--University of Washington, 2016-06

Nitrification (DMPP) and urease (NBPT) inhibitors had no effect on pasture yield, nitrous oxide emissions nor nitrate leaching under irrigation in a hot-dry climate

Modern dairy farming in Australia relies on substantial inputs of fertiliser nitrogen (N) to underpin economic production. However, N lost from dairy systems represents an opportunity cost and can pose a number of environmental risks. Nitrogen cycle inhibitors can be co-applied with N fertilisers to slow the conversion of urea to NH4+ to reduce losses via volatilisation, and slow the conversion of NH4+ to NO3- to minimize leaching of NO3- and gaseous losses via nitrification and denitrification. In a field campaign in a high input ryegrass-kikuyu pasture system we compared the soil N pools, losses and pasture production between a) urea coated with the nitrification inhibitor (3,4-dimethyl pyrazole phosphate - DMPP) b) urea coated with the urease inhibitor (N-(n-butyl) thiophosphoric triamide - NBPT) and c) standard urea. There was no treatment effect (P>0.05) on soil mineral N, pasture yield, N2O flux nor leaching of NO3- cf. standard urea. We hypothesise that at our site, because gaseous losses were highly episodic (rainfall was erratic and displayed no seasonal rainfall nor soil wetting pattern) that there was a lack of coincidence of N application and conditions conducive to gaseous losses, thus the effectiveness of the inhibitor products was minimal and did not result in an increase in pasture yield. There remains a paucity of knowledge on N cycle inhibitors in relation to their effective use in field system to increase N use efficiency. Further research is required to define under what field conditions inhibitor products are effective in order to be able to provide accurate advice to managers of nitrogen in production systems.

Effect of Post-weld Heat-treatment on the Stress Corrosion Cracking Behaviour of Laser-welded Shape Memory NiTi Wires in Hanks’ Solution

In this study, the stress-corrosion cracking (SCC) behaviour of laser-welded NiTi wires before and after post-weld heat-treatment (PWHT) was investigated. The samples were subjected to slow strain rate testing (SSRT) under tensile loading in Hanks’ solution at 37.5 °C (or 310.5 K) at a constant anodic potential (200 mVSCE). The current density of the samples during the SSRT was captured by a potentiostat, and used as an indicator to determine the susceptibility to SCC. Fractography was analyzed using scanning-electron microscopy (SEM). The experimental results showed that the laser-welded sample after PWHT was immune to the SCC as evidenced by the stable current density throughout the SSRT. This is attributed to the precipitation of fine and coherent nano-sized Ni4Ti3 precipitates in the welded regions (weld zone, WZ and heat-affected zone, HAZ) after PWHT, resulting in (i) enrichment of TiO2 content in the passive film and (ii) higher resistance against the local plastic deformation in the welded regions.

Effect of magnetic treatment on microstructure and cycle performance of LiFePO4/C cathode material

LiFePO4/C composite was prepared by hydrothermal synthesis along with a magnetic treatment method. The LiFePO4/C composite synthesized without magnetic treatment is an integrated rhombic shape crystal, whereas the LiFePO4/C material synthesized with magnetic treatment presents a rhombus shape which is self-assembled by a number of small crystal particles with an average size of about 100 nms. The capacity retention for the LiFePO4/C cathode material synthesized without magnetic treatment is only 77% after 30 charge-discharge cycles at 0.2 C, but the LiFePO4/C composite synthesized with magnetic treatment has a capacity retention of 100% after 100 charge-discharge cycles at 1 C and 5 C. It suggests that magnetic treatment can remove Fe3+ cations effectively during the preparation process and enhance the cycle performance of the LiFePO4/C material.

Conditional treatment and its effect on recidivism

The objective of this paper is to evaluate the effect of the 1985 ”Employment Services for Ex-Offenders” (ESEO) program on recidivism. Initially, the sample has been split randomly in a control group and a treatment group. However, the actual treatment (mainly being job related counseling) only takes place conditional on finding a job, and not having been arrested, for those selected in the treatment group. We use a multiple proportional hazard model with unobserved heterogeneity for job seach and recidivism time which incorporates the conditional treatment effect. We find that the program helps to reduce criminal activity, contrary to the result of the previous analysis of this data set. This finding is important for crime prevention policy.

Effect of monomer treatment and polymerisation methods on the bond strength of resin teeth to denture base material

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Effect of cold plasma treatment on mechanical properties of PET/PMMA composites

Mechanical strength of polyethylene terephthalate (PET) fibres and polymethyl methacrylate (PMMA) matrix composites were studied with particular interest on the effects of oxygen and argon plasma treated fibres. PET. fibres were treated in a radio frequency plasma reactor using argon or oxygen for different treatment times to increase the interface adhesion. Fibre volume fraction was measured through digital image analysis. Elastic moduli resulted between 3 GPa for untreated to 6 GPa for treated composites. Tensile tests on PET fibres showed that plasma treatment caused a decrease in average tensile strength compared to untreated fibres. Fracture analysis confirmed the increase in interfacial adhesion due to plasma treatment. (c) 2004 Elsevier Ltd. All rights reserved.

Effect of ridge lap surface treatment and thermocycling on microtensile bond strength of acrylic teeth to denture base resins

This study evaluated the effect of denture base polymer type (heat- and microwave-polymerized), ridge lap surface treatment (with and without methyl methacrylate-MMA etching) and thermocycling on the microtensile bond strength (mTBS) of Biotone acrylic teeth. Flat-ground, ridge-lap surface of posterior artifcial teeth were bonded to cylinders of each denture base resin, resulting in the following groups (n=6): G1a - Clássico/with MMA etching; G1b - Clássico/without MMA etching; G2a - OndaCryl/with MMA etching; G2b - OndaCryl/without MMA etching. Rectangular bar specimens with a cross-sectional area of 1 mm 2 were prepared. Half of the bars in each group were thermocycled (5,000 cycles between 4°C and 60°C). mTBS testing was performed in an universal testing machine at a crosshead speed of 0.5 mm/min. Data were analyzed statistically by three-way ANOVA (a=0.05). There was no statisti-caly signifcant difference (p>0.05) for the factors (resin, surface treatment,and thermocycling) or their interactions. The mean mTBS values (MPa) and standard deviations were as follows: Thermocycling - G1a: 41.00 (14.00); G1b: 31.00 (17.00); G2a: 50.00 (27.00); G2b: 40.00 (18.00); No thermocycling - G1a: 37.00 (14.00); G1b: 43.00 (25.00); G2a: 43.00 (14.00); G2b: 40.00 (27.00). The mTBS of Biotone artifcial teeth to the denture base acrylic resins was not infuenced by the polymer type, surface treatment or thermocycling.

Comparação entre diferentes taxas de sêmen na viabilidade espermática em garanhões de alta e baixa congelabilidade

Pós-graduação em Medicina Veterinária - FMVZ

Randomized trial of effect of bifocal and prismatic bifocal spectacles on myopic progression

Objective: To determine whether bifocal and prismatic bifocal spectacles could control myopia in children with high rates of myopic progression. ---------- Methods: This was a randomized controlled clinical trial. One hundred thirty-five (73 girls and 62 boys) myopic Chinese Canadian children (myopia of 1.00 diopters [D]) with myopic progression of at least 0.50 D in the preceding year were randomly assigned to 1 of 3 treatments: (1) single-vision lenses (n = 41), (2) +1.50-D executive bifocals (n = 48), or (3) +1.50-D executive bifocals with a 3–prism diopters base-in prism in the near segment of each lens (n = 46). ---------- Main Outcome Measures: Myopic progression measured by an automated refractor under cycloplegia and increase in axial length (secondary) measured by ultrasonography at 6-month intervals for 24 months. Only the data of the right eye were used. ---------- Results: Of the 135 children (mean age, 10.29 years [SE, 0.15 years]; mean visual acuity, –3.08 D [SE, 0.10 D]), 131 (97%) completed the trial after 24 months. Myopic progression averaged –1.55 D (SE, 0.12 D) for those who wore single-vision lenses, –0.96 D (SE, 0.09 D) for those who wore bifocals, and –0.70 D (SE, 0.10 D) for those who wore prismatic bifocals. Axial length increased an average of 0.62 mm (SE, 0.04 mm), 0.41 mm (SE, 0.04 mm), and 0.41 mm (SE, 0.05 mm), respectively. The treatment effect of bifocals (0.59 D) and prismatic bifocals (0.85 D) was significant (P < .001) and both bifocal groups had less axial elongation (0.21 mm) than the single-vision lens group (P < .001). ---------- Conclusions: Bifocal lenses can moderately slow myopic progression in children with high rates of progression after 24 months.

Effect of bifocal and prismatic bifocal spectacles on myopia progression in children

Importance Myopia is a significant public health problem, making it important to determine whether a bifocal spectacle treatment involving near prism slows myopia progression in children. Objective To determine whether bifocal and prismatic bifocal spectacles control myopia in children with high rates of myopia progression and to assess whether the treatment effect is dependent on the lag of accommodation and/or near phoria status. Design, Setting, and Participants This 3-year randomized clinical trial was conducted in a private practice. A total of 135 (73 female and 62 male) Chinese-Canadian children (aged 8-13 years; mean [SE] age, 10.29 [0.15] years; mean [SE] myopia, −3.08 [0.10] D) with myopia progression of at least 0.50 D in the preceding year were randomly assigned to 1 of 3 treatments. A total of 128 (94.8%) completed the trial. Interventions Single-vision lenses (control, n = 41), +1.50-D executive bifocals (n = 48), and +1.50-D executive bifocals with 3-Δ base-in prism in the near segment of each lens (n = 46). Main Outcomes and Measures Myopia progression (primary) measured using an automated refractor following cycloplegia and increase in axial length (secondary) measured using ultrasonography at intervals of 6 months for 36 months. Results Myopia progression over 3 years was an average (SE) of −2.06 (0.13) D for the single-vision lens group, −1.25 (0.10) D for the bifocal group, and −1.01 (0.13) D for the prismatic bifocal group. Axial length increased an average (SE) of 0.82 (0.05) mm, 0.57 (0.07) mm, and 0.54 (0.06) mm, respectively. The treatment effect of bifocals (0.81 D) and prismatic bifocals (1.05 D) was significant (P < .001). Both bifocal groups had less axial elongation (0.25 mm and 0.28 mm, respectively) than the single-vision lens group (P < .001). For children with high lags of accommodation (≥1.01 D), the treatment effect of both bifocals and prismatic bifocals was similar (1.1 D) (P < .001). For children with low lags (<1.01 D), the treatment effect of prismatic bifocals (0.99 D) was greater than of bifocals (0.50 D) (P = .03). The treatment effect of both bifocals and prismatic bifocals was independent of the near phoria status. Conclusions and Relevance Bifocal spectacles can slow myopia progression in children with an annual progression rate of at least 0.50 D after 3 years. These results suggest that prismatic bifocals are more effective for myopic children with low lags of accommodation.

Complete cytogenetic response and major molecular response as surrogate outcomes for overall survival in first-line treatment of chronic myelogenous leukemia: A case study for technology appraisal on the basis of surrogate outcomes evidence

Objectives In 2012, the National Institute for Health and Care Excellence assessed dasatinib, nilotinib, and standard-dose imatinib as first-line treatment of chronic phase chronic myelogenous leukemia (CML). Licensing of these alternative treatments was based on randomized controlled trials assessing complete cytogenetic response (CCyR) and major molecular response (MMR) at 12 months as primary end points. We use this case study to illustrate the validation of CCyR and MMR as surrogate outcomes for overall survival in CML and how this evidence was used to inform National Institute for Health and Care Excellence’s recommendation on the public funding of these first-line treatments for CML. Methods We undertook a systematic review and meta-analysis to quantify the association between CCyR and MMR at 12 months and overall survival in patients with chronic phase CML. We estimated life expectancy by extrapolating long-term survival from the weighted overall survival stratified according to the achievement of CCyR and MMR. Results Five studies provided data on the observational association between CCyR or MMR and overall survival. Based on the pooled association between CCyR and MMR and overall survival, our modeling showed comparable predicted mean duration of survival (21–23 years) following first-line treatment with imatinib, dasatinib, or nilotinib. Conclusions This case study illustrates the consideration of surrogate outcome evidence in health technology assessment. Although it is often recommended that the acceptance of surrogate outcomes be based on randomized controlled trial data demonstrating an association between the treatment effect on both the surrogate outcome and the final outcome, this case study shows that policymakers may be willing to accept a lower level of evidence (i.e., observational association).

Effect of accelerated rehabilitation on function after ankle sprain: randomised controlled trial

Objective: To compare an accelerated intervention incorporating early therapeutic exercise after acute ankle sprains with a standard protection, rest, ice, compression, and elevation intervention.

Design: Randomised controlled trial with blinded outcome assessor.

Setting: Accident and emergency department and university based sports injury clinic.

Participants: 101 patients with an acute grade 1 or 2 ankle sprain.

Interventions: Participants were randomised to an accelerated intervention with early therapeutic exercise (exercise group) or a standard protection, rest, ice, compression, and elevation intervention (standard group).

Main outcome measures: The primary outcome was subjective ankle function (lower extremity functional scale). Secondary outcomes were pain at rest and on activity, swelling, and physical activity at baseline and at one, two, three, and four weeks after injury. Ankle function and rate of reinjury were assessed at 16 weeks.

Results: An overall treatment effect was in favour of the exercise group (P=0.0077); this was significant at both week 1 (baseline adjusted difference in treatment 5.28, 98.75% confidence interval 0.31 to 10.26; P=0.008) and week 2 (4.92, 0.27 to 9.57; P=0.0083). Activity level was significantly higher in the exercise group as measured by time spent walking (1.2 hours, 95% confidence interval 0.9 to 1.4 v 1.6, 1.3 to 1.9), step count (5621 steps, 95% confidence interval 4399 to 6843 v 7886, 6357 to 9416), and time spent in light intensity activity (53 minutes, 95% confidence interval 44 to 60 v 76, 58 to 95). The groups did not differ at any other time point for pain at rest, pain on activity, or swelling. The reinjury rate was 4% (two in each group).

Conclusion: An accelerated exercise protocol during the first week after ankle sprain improved ankle function; the group receiving this intervention was more active during that week than the group receiving standard care.