PubMed · 9262389
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S Lehrman. 1997-08-14. Make marijuana research easier, panel urges NIH.. https://doi.org/10.1038/41626
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In this study, we report the coding-complete genome sequence of Grapevine leafroll-associated virus 13 (GLRaV-13), isolate CA8881, detected in Vitis vinifera in California, USA. The genome sequence exhibited over 95% nucleotide identity with previously reported GLRaV-13 isolates and contributed to better understanding of the genetic diversity of ampeloviruses infecting grapevine.
OBJECTIVE: To describe the development and validation of a test of knowledge and skills in evidence based medicine. DESIGN: Cross sectional study. SETTING: Family practice residency programme in California; a list server for those who teach evidence based medicine; and an evidence based medicine seminar series. PARTICIPANTS: Family practice residents and faculty members (n=43); volunteers self identified as experts in evidence based medicine (n=53); family practice teachers (19) beginning a seminar series on evidence based medicine. INTERVENTION: The Fresno test is a performance based measure for use in medical education that assesses a wide range of evidence based medicine skills. Open ended questions are scored with standardised grading rubrics. Calculation skills are assessed by fill in the blank questions. MAIN OUTCOME MEASURES: Inter-rater reliability, internal reliability, item analyses, and construct validity. RESULTS: Inter-rater correlations ranged from 0.76 to 0.98 for individual items. Cronbach's alpha was 0.88. Item difficulties ranged from moderate to difficult, all with positive and strong ability to discriminate between candidates. Experts scored consistently higher than novices. On the 212 point test, the novice mean was 95.6 and the expert mean was 147.5 (P<0.001). On individual items, a higher proportion of experts than novices earned passing scores on 15 of the 17 items. CONCLUSION: The Fresno test is a reliable and valid test for detecting the effect of instruction in evidence based medicine. Its use in other settings requires further exploration.
BACKGROUND: Some spells consistent with TIA may be benign, such as those produced by migraine or migraine accompaniments in the elderly. Distinguishing these from embolic or thrombotic events may be difficult. METHODS: Emergency department physicians identified patients who presented with a presumed TIA at one of 16 hospitals in Northern California from March 1997 through February 1998. Recurrent TIAs and strokes were recorded for 90 days afterwards. RESULTS: Of 1,707 patients in whom TIA had been diagnosed in the emergency department, 191 (11.2%) had a recurrent TIA and 180 (10.5%) had a stroke during 90-day followup. Independent risk factors for recurrent TIA were age >60 years (odds ratio 1.9; 95% CI 1.2 to 2.9; p = 0.003), history of multiple TIAs (odds ratio 2.9; 2.1 to 4.0; p < 0.001), duration of spell </=10 minutes (odds ratio 2.3; 1.6 to 3.3; p < 0.001), and sensory abnormality associated with the spell (odds ratio 1.9; 1.4 to 2.6; p < 0.001). Independent risk factors for stroke from a previous analysis were age, duration >10 minutes, diabetes, weakness, and speech impairment. Among the 30 patients with isolated sensory symptoms lasting </=10 minutes, the risk of recurrent TIA was 40% and none had a stroke. CONCLUSIONS: In patients in whom TIA has been diagnosed in the emergency department, risk factors for subsequent stroke and recurrent TIA are different. A subset of patients with presumed TIA has a benign short-term course with multiple brief TIAs more frequently characterized by sensory symptoms.