A pilot study of orthopaedic resident self-assessment using a milestones' survey just prior to milestones implementation.

OBJECTIVE: To pilot test if Orthopaedic Surgery residents could self-assess their performance using newly created milestones, as defined by the Accreditation Council on Graduate Medical Education. METHODS: In June 2012, an email was sent to Program Directors and administrative coordinators of the 154 accredited Orthopaedic Surgery Programs, asking them to send their residents a link to an online survey. The survey was adapted from the Orthopaedic Surgery Milestone Project. Completed surveys were aggregated in an anonymous, confidential database. SAS 9.3 was used to perform the analyses. RESULTS: Responses from 71 residents were analyzed. First and second year residents indicated through self-assessment that they had substantially achieved Level 1 and Level 2 milestones. Third year residents reported they had substantially achieved 30/41, and fourth year residents, all Level 3 milestones. Fifth year, graduating residents, reported they had substantially achieved 17 Level 4 milestones, and were extremely close on another 15. No milestone was rated at Level 5, the maximum possible. Earlier in training, Patient Care and Medical Knowledge milestones were rated lower than the milestones reflecting the other four competencies of Practice Based Learning and Improvement, Systems Based Practice, Professionalism, and Interpersonal Communication. The gap was closed by the fourth year. CONCLUSIONS: Residents were able to successfully self-assess using the 41 Orthopaedic Surgery milestones. Respondents' rate improved proficiency over time. Graduating residents report they have substantially, or close to substantially, achieved all Level 4 milestones. Milestone self-assessment may be a useful tool as one component of a program's overall performance assessment strategy.

Prospective Estimation of Organ Dose Prior to Examination: Matching Patient to Digital Phantoms

Prospective estimation of patient CT organ dose prior to examination can help technologist adjust CT scan settings to reduce radiation dose to patient while maintaining certain image quality. One possible way to achieve this is matching patient to digital models precisely. In previous work, patient matching was performed manually by matching the trunk height which was defined as the distance from top of clavicle to bottom of pelvis. However, this matching method is time consuming and impractical in scout images where entire trunk is not included. Purpose of this work was to develop an automatic patient matching strategy and verify its accuracy.

Prior knowledge transfer across transcriptional data sets and technologies using compositional statistics yields new mislabelled ovarian cell line

Here, we describe gene expression compositional assignment (GECA), a powerful, yet simple method based on compositional statistics that can validate the transfer of prior knowledge, such as gene lists, into independent data sets, platforms and technologies. Transcriptional profiling has been used to derive gene lists that stratify patients into prognostic molecular subgroups and assess biomarker performance in the pre-clinical setting. Archived public data sets are an invaluable resource for subsequent in silico validation, though their use can lead to data integration issues. We show that GECA can be used without the need for normalising expression levels between data sets and can outperform rank-based correlation methods. To validate GECA, we demonstrate its success in the cross-platform transfer of gene lists in different domains including: bladder cancer staging, tumour site of origin and mislabelled cell lines. We also show its effectiveness in transferring an epithelial ovarian cancer prognostic gene signature across technologies, from a microarray to a next-generation sequencing setting. In a final case study, we predict the tumour site of origin and histopathology of epithelial ovarian cancer cell lines. In particular, we identify and validate the commonly-used cell line OVCAR-5 as non-ovarian, being gastrointestinal in origin. GECA is available as an open-source R package.

Memory Bias for Anxiety Prior to Academic Achievement Situations: Influences of Time, Mood, Personality and Post-Event-Processing

The current thesis examines memory bias for state anxiety prior to academic achievement situations like writing an exam and giving a speech. The thesis relies on the reconstruction principle, which assumes that memories for past emotions are reconstructed rather than stored permanently and accurately. This makes them prone to memory bias, which is af-fected by several influencing factors. A major aim is to include four important influencing factors simultaneously. Early research on mood and emotional autobiographical memory found evidence for the existence of a propositional associative network (Bower, 1981; Col-lins & Loftus, 1975), leading to mood congruent recall. But empirical findings gave also strong evidence for the existence of mood incongruent recall for one’s own emotions, which was for example linked to mood regulation via mood repair (e.g. Clark & Isen, 1982), which seems to be associated to the personality traits extraversion and neuroticism (Lischetzke & Eid, 2006; Ng & Diener, 2009). Moreover, neuroticism and trait anxiety are related to rumination, which is seen as negative post-event-processing (e.g. Wells & Clark, 1997). Overall, the elapsed time since the emotional event happened should have an impact on recall of emotions. Following the affect infusion model by Robinson and Clore (2002a), the influence of personality on memory bias should increase over time. Therefore, three longitudinal studies were realized, using naturally occurring as well as laboratory settings. The used paradigm was equivalent in all studies. Subjects were asked about their actual state anxiety prior to an academic achievement situation. Directly after the situation, cur-rent mood and recall of former anxiety were assessed. The same procedure was repeated a few weeks later. Personality traits and post-event-processing were also assessed. The results suggest a need to have a differentiated view on predicting memory bias. Study 1 (N = 131) as well as study 3 (N = 53) found evidence for mood incongruent memory in the sense of mood repair and downward regulation as a function of personality. Rumination was found to cause stable overestimation of pre-event anxiety in study 2 (N = 141) as well as in study 3. Although the relevance of the influencing factors changed over time, an increasing relevance of personality could not consistently be observed. The tremendously different effects of the laboratory study 2 indicated that such settings are not appropriate to study current issues. Theoretical and psychotherapeutically relevant conclusions are drawn and several limitations are discussed.

Os paradoxos de Prior e o calculo proposicional deôntico relevante E¹.

Cruz, Ângela Maria Paiva. Os paradoxos de Prior e o cálculo proposicional deôntico relevante. Princípios, Natal, v. 4, p. 05-18, 1996.

Pooling Restaurant Reservations to Increase Service Efficiency

This paper examines whether restaurant reservations should be locked to specific tables at the time the reservation is made, or whether the reservations should be pooled and assigned to tables in real-time. In two motivating studies, we find that there is a lack of consensus in the restaurant industry on handling reservations. Contrary to what might be expected based on research that shows the benefits of resource pooling in other contexts, a survey of 425 restaurants indicated that over 80% lock reservations to tables. In two simulation studies, we determine that pooling reservations enables a 15-minute reduction in table turn times more than 15% of the time, which consequently increases service efficiency and enables a restaurant to serve more customers during peak periods. Pooling had the most consistent advantage with higher customer service levels, with larger restaurants, with customers who arrive late, and with larger variation in customer arrival time.

Neuromuscular adaptations in football athletes with prior history of hamstring strain injury

Background: Hamstring strain injuries (HSI) are one of the most common injuries in a wide variety of running-sports, resulting in a considerable loss of competition and training time. One of the most problematic consequences regarding HSI is the recurrence rate and its non-decrease over the past decades, despite increasing evidence. Recent studies also found several maladaptations post-HSI probably due to neuromuscular inhibition and it has been proposed that these adaptations post-injury may contribute as risk factors for the injury-reinjury cycle and high recurrence rates. Furthermore it has been recently proposed not to disregard the inter-relationship between these adaptations and risk-factors post-injury in order to better understand the mechanisms of this complex injury. Objective: To determine, analyze and correlate neuromuscular adaptations in amateur football players with prior history of HSI per comparison to uninjured athletes in similar conditions. Methodology: Every participant was subjected to isokinetic concentric (60 and 240deg.sec) and eccentric (30 and 120deg.sec¯¹) testing, and peak torque, angle of peak torque and hamstrings to quadriceps (H:Q) conventional ratios were measured, myoelectrical activity of Bicep Femoris (BF) and Medial Hamstrings (MH) were also measured during isokinetic eccentric testing at both velocities and muscle activation percentages were calculated at 30, 50 and 100ms after onset of contraction. Furthermore active and passive knee extension, knee joint position sense (JPS) test, triple-hop distance (THD) test and core stability (flexors and extensors endurance, right and left side bridge test) were used and correlated. Results: Seventeen players have participated in this study: 10 athletes with prior history of HSI, composing the Hamstring injury group (HG) and 7 athletes without prior severe injuries as control group (CG). We found statistical significant differences between HG injured and uninjured sides in the BF myoelectrical activity at almost all times in both velocities and between HG injured and CG non-dominant sides at 100ms in eccentric 120deg.sec¯¹ velocity (p<.05). We found no differences in MH activity. Regarding proprioception we found differences between the HG injured and uninjured sides (p=.027). We found no differences in the rest of used tests. However, significant correlation between myoelectrical activation at 100ms in 120deg.sec¯¹ testing and JPS with initial position at 90º (r-.372; p=0.031) was found, as well as between isokinetic H:Q ratio at 240deg.sec and THD score (r=-.345; p=.045). Conclusion: We found significant differences that support previous research regarding neuromuscular adaptations and BF inhibition post-HSI. Moreover, to our knowledge, this was the first study that found correlation between these adaptations, and may open a door to new perspectives and future studies.

Prognosis following acute coronary syndromes according to prior coronary artery bypass grafting: Meta-analysis

PURPOSE: Conduct a meta-analysis to study the prognostic influence of a previous coronary artery bypass grafting (CABG) in patients admitted for an acute coronary syndrome (ACS). METHODS: A systematic review of the literature was performed using electronic reference databases through January 2013 (MEDLINE, Cochrane Library, Web of Knowledge, Google Scholar and references cited in other studies). Studies in which ACS outcomes with a previous history of CABG were compared with ACS outcomes with no history of previous CABG were considered for inclusion. The main endpoints of interest were mortality and non-fatal acute myocardial infarction. Data was aggregated at three follow-up times using random-effects meta-analysis models. RESULTS: Twenty-four studies were included which provided 387,181 patients for analysis. Previous CABG ACS patients were older, more diabetic and had a more frequent history of a previous myocardial infarction. Pooled in-hospital mortality was higher for the previous CABG ACS patients (OR 1.22 [1.04-1.44], p<0.01, I(2) 88%). The pooled adjusted OR showed no significant differences for the two groups (adjusted OR 1.13 [0.93-1.37], p=0.22, I(2) 92%). Previous CABG ACS patient had a higher pooled 30-day mortality (OR 1.28 [1.05-1.55], p=0.02, I(2) 74%); a higher non-adjusted (OR 1.61 [1.38-1.88], p<0.01, I(2) 70%) and adjusted (adjusted OR 1.37 [1.15-1.65], p<0.01, I(2) 0%) long-term mortality. Both the in-hospital and the long-term re-infarction rates were higher for the previous CABG ACS patients. CONCLUSIONS: According to our data, ACS patients with previous CABG history had a higher risk for short- and long-term adverse events.

Os paradoxos de Prior e o calculo proposicional deôntico relevante E¹.

Cruz, Ângela Maria Paiva. Os paradoxos de Prior e o cálculo proposicional deôntico relevante. Princípios, Natal, v. 4, p. 05-18, 1996.

Energy efficiency and appliance’s characteristics considered prior to purchase: Differences and similarities between the United Kingdom, Germany, Portugal, Greece, Poland, Spain and Italy

This article reports country differences in the consumer’s most considered characteristics when choosing electrical appliances, including but not restricted to the energy efficiency aspect. A survey was performed to store customers from 7 countries: the United Kingdom; Germany; Portugal; Greece; Poland; Spain; Italy. Results showed consistency between countries in the top three characteristics considered: cost; quality; and a balance between price and quality. Differences were found for reported environmental attitudes and behaviours, purchase motives, and store employees evaluation. The results may support national policies and store level energy efficiency interventions. Specifically, they can provide input for store employee’s training, in persuading customers towards the purchase of energy efficient appliances.