Validation of a statistical shape model-based 2D/3D reconstruction method for determination of cup orientation after THA

The aim of this study was to validate the accuracy and reproducibility of a statistical shape model-based 2D/3D reconstruction method for determining cup orientation after total hip arthroplasty. With a statistical shape model, this method allows reconstructing a patient-specific 3D-model of the pelvis from a standard AP X-ray radiograph. Cup orientation (inclination and anteversion) is then calculated with respect to the anterior pelvic plane that is derived from the reconstructed model.

Validation of a novel robotic-assisted partial nephrectomy surgical training model

What's known on the subject? and What does the study add? One area of particular growth for robotic surgery has been partial nephrectomy. Despite a perceived notion that robotic-assisted partial nephrectomy is more easily adaptable compared to laparoscopic partial nephrectomy, there is nonetheless an associated learning curve. Validated training models with a corresponding assessment method for robotic-assisted partial nephrectomy were previously unavailable. We have designed and validated a RAPN surgical model appropriate for resident and fellow training.

Golden-winged Warbler habitat model validation for northern Wisconsin and central Minnesota

Between 1966 and 2003, the Golden-winged Warbler (Vermivora chrysoptera) experienced declines of 3.4% per year in large parts of the breeding range and has been identified by Partners in Flight as one of 28 land birds requiring expedient action to prevent its continued decline. It is currently being considered for listing under the Endangered Species Act. A major step in advancing our understanding of the status and habitat preferences of Golden-winged Warbler populations in the Upper Midwest was initiated by the publication of new predictive spatially explicit Golden-winged Warbler habitat models for the northern Midwest. Here, I use original data on observed Golden-winged Warbler abundances in Wisconsin and Minnesota to compare two population models: the hierarchical spatial count (HSC) model with the Habitat Suitability Index (HSI) model. I assessed how well the field data compared to the model predictions and found that within Wisconsin, the HSC model performed slightly better than the HSI model whereas both models performed relatively equally in Minnesota. For the HSC model, I found a 10% error of commission in Wisconsin and a 24.2% error of commission for Minnesota. Similarly, the HSI model has a 23% error of commission in Minnesota; in Wisconsin due to limited areas where the HSI model predicted absences, there was incomplete data and I was unable to determine the error of commission for the HSI model. These are sites where the model predicted presences and the Golden-winged Warbler did not occur. To compare predicted abundance from the two models, a 3x3 contingency table was used. I found that when overlapped, the models do not complement one another in identifying Golden-winged Warbler presences. To calculate discrepancy between the models, the error of commission shows that the HSI model has only a 6.8% chance of correctly classifying absences in the HSC model. The HSC model has only 3.3% chance of correctly classifying absences in the HSI model. These findings highlight the importance of grasses for nesting, shrubs used for cover and foraging, and trees for song perches and foraging as key habitat characteristics for breeding territory occupancy by singing males.

Tropopause level Rossby wave breaking in the Northern Hemisphere: a feature-based validation of the ECHAM5-HAM climate model

Breaking synoptic-scale Rossby waves (RWB) at the tropopause level are central to the daily weather evolution in the extratropics and the subtropics. RWB leads to pronounced meridional transport of heat, moisture, momentum, and chemical constituents. RWB events are manifest as elongated and narrow structures in the tropopause-level potential vorticity (PV) field. A feature-based validation approach is used to assess the representation of Northern Hemisphere RWB in present-day climate simulations carried out with the ECHAM5-HAM climate model at three different resolutions (T42L19, T63L31, and T106L31) against the ERA-40 reanalysis data set. An objective identification algorithm extracts RWB events from the isentropic PV field and allows quantifying the frequency of occurrence of RWB. The biases in the frequency of RWB are then compared to biases in the time mean tropopause-level jet wind speeds. The ECHAM5-HAM model captures the location of the RWB frequency maxima in the Northern Hemisphere at all three resolutions. However, at coarse resolution (T42L19) the overall frequency of RWB, i.e. the frequency averaged over all seasons and the entire hemisphere, is underestimated by 28%.The higher-resolution simulations capture the overall frequency of RWB much better, with a minor difference between T63L31 and T106L31 (frequency errors of −3.5 and 6%, respectively). The number of large-size RWB events is significantly underestimated by the T42L19 experiment and well represented in the T106L31 simulation. On the local scale, however, significant differences to ERA-40 are found in the higher-resolution simulations. These differences are regionally confined and vary with the season. The most striking difference between T106L31 and ERA-40 is that ECHAM5-HAM overestimates the frequency of RWB in the subtropical Atlantic in all seasons except for spring. This bias maximum is accompanied by an equatorward extension of the subtropical westerlies.

Potentially avoidable 30-day hospital readmissions in medical patients: derivation and validation of a prediction model

IMPORTANCE Because effective interventions to reduce hospital readmissions are often expensive to implement, a score to predict potentially avoidable readmissions may help target the patients most likely to benefit. OBJECTIVE To derive and internally validate a prediction model for potentially avoidable 30-day hospital readmissions in medical patients using administrative and clinical data readily available prior to discharge. DESIGN Retrospective cohort study. SETTING Academic medical center in Boston, Massachusetts. PARTICIPANTS All patient discharges from any medical services between July 1, 2009, and June 30, 2010. MAIN OUTCOME MEASURES Potentially avoidable 30-day readmissions to 3 hospitals of the Partners HealthCare network were identified using a validated computerized algorithm based on administrative data (SQLape). A simple score was developed using multivariable logistic regression, with two-thirds of the sample randomly selected as the derivation cohort and one-third as the validation cohort. RESULTS Among 10 731 eligible discharges, 2398 discharges (22.3%) were followed by a 30-day readmission, of which 879 (8.5% of all discharges) were identified as potentially avoidable. The prediction score identified 7 independent factors, referred to as the HOSPITAL score: h emoglobin at discharge, discharge from an o ncology service, s odium level at discharge, p rocedure during the index admission, i ndex t ype of admission, number of a dmissions during the last 12 months, and l ength of stay. In the validation set, 26.7% of the patients were classified as high risk, with an estimated potentially avoidable readmission risk of 18.0% (observed, 18.2%). The HOSPITAL score had fair discriminatory power (C statistic, 0.71) and had good calibration. CONCLUSIONS AND RELEVANCE This simple prediction model identifies before discharge the risk of potentially avoidable 30-day readmission in medical patients. This score has potential to easily identify patients who may need more intensive transitional care interventions.

A nonlinear QCT-based finite element model validation study for the human femur tested in two configurations in vitro

Purpose Femoral fracture is a common medical problem in osteoporotic individuals. Bone mineral density (BMD) is the gold standard measure to evaluate fracture risk in vivo. Quantitative computed tomography (QCT)-based homogenized voxel finite element (hvFE) models have been proved to be more accurate predictors of femoral strength than BMD by adding geometrical and material properties. The aim of this study was to evaluate the ability of hvFE models in predicting femoral stiffness, strength and failure location for a large number of pairs of human femora tested in two different loading scenarios. Methods Thirty-six pairs of femora were scanned with QCT and total proximal BMD and BMC were evaluated. For each pair, one femur was positioned in one-legged stance configuration (STANCE) and the other in a sideways configuration (SIDE). Nonlinear hvFE models were generated from QCT images by reproducing the same loading configurations imposed in the experiments. For experiments and models, the structural properties (stiffness and ultimate load), the failure location and the motion of the femoral head were computed and compared. Results In both configurations, hvFE models predicted both stiffness (R2=0.82 for STANCE and R2=0.74 for SIDE) and femoral ultimate load (R2=0.80 for STANCE and R2=0.85 for SIDE) better than BMD and BMC. Moreover, the models predicted qualitatively well the failure location (66% of cases) and the motion of the femoral head. Conclusions The subject specific QCT-based nonlinear hvFE model cannot only predict femoral apparent mechanical properties better than densitometric measures, but can additionally provide useful qualitative information about failure location.

Experimental validation of a mean field model of mineralized collagen fiber arrays at two levels of hierarchy

In the course of this study, stiffness of a fibril array of mineralized collagen fibrils modeled with a mean field method was validated experimentally at site-matched two levels of tissue hierarchy using mineralized turkey leg tendons (MTLT). The applied modeling approaches allowed to model the properties of this unidirectional tissue from nanoscale (mineralized collagen fibrils) to macroscale (mineralized tendon). At the microlevel, the indentation moduli obtained with a mean field homogenization scheme were compared to the experimental ones obtained with microindentation. At the macrolevel, the macroscopic stiffness predicted with micro finite element (μFE) models was compared to the experimental stiffness measured with uniaxial tensile tests. Elastic properties of the elements in μFE models were injected from the mean field model or two-directional microindentations. Quantitatively, the indentation moduli can be properly predicted with the mean-field models. Local stiffness trends within specific tissue morphologies are very weak, suggesting additional factors responsible for the stiffness variations. At macrolevel, the μFE models underestimate the macroscopic stiffness, as compared to tensile tests, but the correlations are strong.

Validation of climate model-inferred regional temperature change for late-glacial Europe

Comparisons of climate model hindcasts with independent proxy data are essential for assessing model performance in non-analogue situations. However, standardized palaeoclimate data sets for assessing the spatial pattern of past climatic change across continents are lacking for some of the most dynamic episodes of Earth’s recent past. Here we present a new chironomid-based palaeotemperature dataset designed to assess climate model hindcasts of regional summer temperature change in Europe during the late-glacial and early Holocene. Latitudinal and longitudinal patterns of inferred temperature change are in excellent agreement with simulations by the ECHAM-4 model, implying that atmospheric general circulation models like ECHAM-4 can successfully predict regionally diverging temperature trends in Europe, even when conditions differ significantly from present. However, ECHAM-4 infers larger amplitudes of change and higher temperatures during warm phases than our palaeotemperature estimates, suggesting that this and similar models may overestimate past and potentially also future summer temperature changes in Europe.