Preferences for a third-trimester ultrasound scan in a low-risk obstetric population: a discrete choice experiment

Objective: Establish maternal preferences for a third-trimester ultrasound scan in a healthy, low-risk pregnant population.

Design: Cross-sectional study incorporating a discrete choice experiment.

Setting: A large, urban maternity hospital in Northern Ireland.

Participants: One hundred and forty-six women in their second trimester of pregnancy.

Methods: A discrete choice experiment was designed to elicit preferences for four attributes of a third-trimester ultrasound scan: health-care professional conducting the scan, detection rate for abnormal foetal growth, provision of non-medical information, cost. Additional data collected included age, marital status, socio-economic status, obstetric history, pregnancy-specific stress levels, perceived health and whether pregnancy was planned. Analysis was undertaken using a mixed logit model with interaction effects.

Main outcome measures: Women's preferences for, and trade-offs between, the attributes of a hypothetical scan and indirect willingness-to-pay estimates.

Results: Women had significant positive preference for higher rate of detection, lower cost and provision of non-medical information, with no significant value placed on scan operator. Interaction effects revealed subgroups that valued the scan most: women experiencing their first pregnancy, women reporting higher levels of stress, an adverse obstetric history and older women.

Conclusions: Women were able to trade on aspects of care and place relative importance on clinical, non-clinical outcomes and processes of service delivery, thus highlighting the potential of using health utilities in the development of services from a clinical, economic and social perspective. Specifically, maternal preferences exhibited provide valuable information for designing a randomized trial of effectiveness and insight for clinical and policy decision makers to inform woman-centred care.

Sensitivity and specificity of frequency-doubling technology, tendency-oriented perimetry, and Humphrey Swedish interactive threshold algorithm-fast perimetry in a glaucoma practice

PURPOSE: To evaluate the sensitivity and specificity of the screening mode of the Humphrey-Welch Allyn frequency-doubling technology (FDT), Octopus tendency-oriented perimetry (TOP), and the Humphrey Swedish Interactive Threshold Algorithm (SITA)-fast (HSF) in patients with glaucoma. DESIGN: A comparative consecutive case series. METHODS: This was a prospective study which took place in the glaucoma unit of an academic department of ophthalmology. One eye of 70 consecutive glaucoma patients and 28 age-matched normal subjects was studied. Eyes were examined with the program C-20 of FDT, G1-TOP, and 24-2 HSF in one visit and in random order. The gold standard for glaucoma was presence of a typical glaucomatous optic disk appearance on stereoscopic examination, which was judged by a glaucoma expert. The sensitivity and specificity, positive and negative predictive value, and receiver operating characteristic (ROC) curves of two algorithms for the FDT screening test, two algorithms for TOP, and three algorithms for HSF, as defined before the start of this study, were evaluated. The time required for each test was also analyzed. RESULTS: Values for area under the ROC curve ranged from 82.5%-93.9%. The largest area (93.9%) under the ROC curve was obtained with the FDT criteria, defining abnormality as presence of at least one abnormal location. Mean test time was 1.08 ± 0.28 minutes, 2.31 ± 0.28 minutes, and 4.14 ± 0.57 minutes for the FDT, TOP, and HSF, respectively. The difference in testing time was statistically significant (P <.0001). CONCLUSIONS: The C-20 FDT, G1-TOP, and 24-2 HSF appear to be useful tools to diagnose glaucoma. The test C-20 FDT and G1-TOP take approximately 1/4 and 1/2 of the time taken by 24 to 2 HSF. © 2002 by Elsevier Science Inc. All rights reserved.

Comparison of diagnostic ability between a fast strategy, tendency-oriented perimetry, and the standard bracketing strategy

Purpose: To compare the diagnostic abilities of the standard bracketing strategy (BR) and a fast strategy, the tendency-oriented perimetry (TOP). Methods: Seventy-seven controls and 91 eyes from patients with glaucoma were analyzed with the strategies TOP and BR. Sensitivity (Se), specificity (Sp), the area under the receiver operating characteristic (ROC) curve (AC) and the optimum cutoff value (CO) were calculated for the visual field indices mean defect (MD), the square root of the loss variance (sLV) and the number of pathological points (NPP). Results: In the glaucoma group, the mean MD value using TOP and BR was 7.5 and 8.3 dB, respectively. The mean sLV value using TOP and BR was 5.0 and 5.3 dB, respectively. Indices provided by TOP had higher ROC values than the ones provided by BR. Using TOP, the index with the best diagnostic ability was sLV (Sp = 94.8, Se = 90.1, AC = 0.966, CO = 2.5 dB), followed by NPP and MD. Using BR, the best results were obtained for MD (Sp = 92.2, Se = 81.3, AC = 0.900, CO = 2.5 dB) followed by sLV and NPP. Conclusions: A fast strategy, TOP, had superior diagnostic ability than the standard BR. Although TOP provided lower LV values than BR, the diagnostic ability of this index was higher than that of the conventional strategy. Copyright © 2005 S. Karger AG.

Comparison of two fast strategies, SITA fast and TOP, for the assessment of visual fields in glaucoma patients

Purpose: To compare two fast threshold strategies of visual field assessment; SITA Fast (HSF) and Tendency Orientated Perimetry (TOP), in detecting visual field loss in patients with glaucoma. Methods: Seventy-six glaucoma, ocular hypertensive and normal patients had HSF and TOP performed in random order. Quantitative comparisons for the global visual field indices - mean deviation and defect (MD) for HSF and TOP, and pattern standard deviation (PSD) for HSF and loss variance (LV) for TOP - were made using correlation coefficients. Humphrey global parameters were converted to Octopus equivalents, and method comparison analysis was used to determine agreement between the two strategies. Test duration times were compared using t-test. Sensitivity and specificity for these two algorithms were determined according to predetermined criteria. Results: High correlation coefficient values were obtained for MD measurements between HSF and TOP (r=-0.89, P

Fragmentation of Neutral Amino Acids and Small Peptides by Intense, Femtosecond Laser Pulses

High power femtosecond laser pulses have unique properties that could lead to their application as ionization or activation sources in mass spectrometry. By concentrating many photons into pulse lengths approaching the timescales associated with atomic motion, very strong electric field strengths are generated, which can efficiently ionize and fragment molecules without the need for resonant absorption. However, the complex interaction between these pulses and biomolecular species is not well understood. To address this issue, we have studied the interaction of intense, femtosecond pulses with a number of amino acids and small peptides. Unlike previous studies, we have used neutral forms of these molecular targets, which allowed us to investigate dissociation of radical cations without the spectra being complicated by the action of mobile protons. We found fragmentation was dominated by fast, radical-initiated dissociation close to the charge site generated by the initial ionization or from subsequent ultrafast migration of this charge. Fragments with lower yields, which are useful for structural determinations, were also observed and attributed to radical migration caused by hydrogen atom transfer within the molecule.

The electroreduction of benzoic acid: voltammetric observation of adsorbed hydrogen at a platinum microelectrode in room temperature ionic liquids

The electrochemical reduction of benzoic acid in the presence and absence of hydrogen (H-2) has been investigated using a 10 mu m diameter platinum microelectrode in four different room temperature ionic liquids (RTILs), namely [C(4)mim][NTf2], [C(4)mpyrr][NTf2], [C(4)mim][OTf] and [C(4)mim][BF4], versus Ag/Ag+. In all cases, reductive voltammetry is observed, and is suggested to occur via a CE mechanism in which dissociation of benzoic acid is followed by electron transfer to H+ ultimately forming adsorbed hydrogen. Furthermore, the adsorbed H atoms, formed from the reduction of benzoic acid, could be used to achieve the rapid hydrogenolysis of the organic compound (bis(benzyloxycarbonyl)-L-lysine) on the timescale of the voltammetric technique under moderate conditions (25 degrees C).

A fast transient kinetic study of the effect of H-2 on the selective catalytic reduction of NOx with octane using isotopically labelled (NO)-N-15

The H-2-assisted hydrocarbon selective catalytic reduction (HC-SCR) of NO, was investigated using fast transient kinetic analysis coupled with isotopically labelled (NO)-N-15. This allowed monitoring of the evolution of products and reactants during switches of H-2 in and out of the SCR reaction mix. The results obtained with a time resolution of less than 1 s showed that the effect on the reaction of the removal or addition of H-2 was essentially instantaneous. This is consistent with the view that H-2 has a direct chemical effect on the reaction mechanism rather than a secondary one through the formation of "active" Ag clusters. The effect of H-2 partial pressure was investigated at 245 degrees C, it was found that increasing partial pressure of H-2 resulted in increasing conversion of NO and octane. It was also found that the addition of H-2 at 245 degrees C had different effects on the product distribution depending on its partial pressure. The change of the nitrogen balance over time during switches in and out of hydrogen showed that significant quantities of N-containing species were stored when hydrogen was introduced to the system. The positive nitrogen balance on removal of H-2 from the gas phase showed that these stored species continued to react after removal of hydrogen to form N-2. (c) 2006 Elsevier Inc. All rights reserved.

A Tunable Encryption Scheme and Analysis of Fast Selective Encryption for CAVLC and CABAC in H.264/AVC

Recently, two fast selective encryption methods for context-adaptive variable length coding and context-adaptive binary arithmetic coding in H.264/AVC were proposed by Shahid et al. In this paper, it was demonstrated that these two methods are not as efficient as only encrypting the sign bits of nonzero coefficients. Experimental results showed that without encrypting the sign bits of nonzero coefficients, these two methods can not provide a perceptual scrambling effect. If a much stronger scrambling effect is required, intra prediction modes, and the sign bits of motion vectors can be encrypted together with the sign bits of nonzero coefficients. For practical applications, the required encryption scheme should be customized according to a user's specified requirement on the perceptual scrambling effect and the computational cost. Thus, a tunable encryption scheme combining these three methods is proposed for H.264/AVC. To simplify its implementation and reduce the computational cost, a simple control mechanism is proposed to adjust the control factors. Experimental results show that this scheme can provide different scrambling levels by adjusting three control factors with no or very little impact on the compression performance. The proposed scheme can run in real-time and its computational cost is minimal. The security of the proposed scheme is also discussed. It is secure against the replacement attack when all three control factors are set to one.

Fast recognition of musical sounds based on timbre

Human listeners seem to have an impressive ability to recognize a wide variety of natural sounds. However, there is surprisingly little quantitative evidence to characterize this fundamental ability. Here the speed and accuracy of musical-sound recognition were measured psychophysically with a rich but acoustically balanced stimulus set. The set comprised recordings of notes from musical instruments and sung vowels. In a first experiment, reaction times were collected for three target categories: voice, percussion, and strings. In a go/no-go task, listeners reacted as quickly as possible to members of a target category while withholding responses to distractors (a diverse set of musical instruments). Results showed near-perfect accuracy and fast reaction times, particularly for voices. In a second experiment, voices were recognized among strings and vice-versa. Again, reaction times to voices were faster. In a third experiment, auditory chimeras were created to retain only spectral or temporal features of the voice. Chimeras were recognized accurately, but not as quickly as natural voices. Altogether, the data suggest rapid and accurate neural mechanisms for musical-sound recognition based on selectivity to complex spectro-temporal signatures of sound sources.

Water Content Determinations for Peat and Other Organic Soils Using the Oven-Drying Method

There has been much debate in the literature over the past 60 years regarding an appropriate oven-drying temperature for water content determinations in peat and other organic soils. For inorganic soils, the water content is usually based on the equilibrium dry mass corresponding to drying temperatures in the range 100-110°C. However, for peat and other organic soils, several researchers have recommended lower drying temperatures in the range 60-90°C in an attempt to prevent possible charring, oxidation, and/or vaporization of substances other than pore water. However, all of the relevant water is not fully evaporated at too low a temperature, and because specimen dry mass is a function of drying temperature, the resulting water content values are lower than those determined for the temperature range 100-110°C. Experimental data reported in this article show that oven drying of peat and other organic soils at 100-110°C using either gravity-convection or forced-draft ovens is acceptable for routine water content determinations. Because a standardized oven temperature is desirable when correlating water content with other material properties, it is recommended that oven drying of peat and other organic soils be performed over temperature ranges of either 105-110°C or 105 ± 5°C, in line with standardized ranges for inorganic soils. © 2014 Copyright Taylor & Francis Group, LLC.