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PubMed1992

Comparison of pathologic and clinical evaluation of lymph nodes in prostate cancer: implications of RTOG data for patient management and trial design and stratification.

RTOG 77-06 and 75-06 were studies of nodal irradiation in prostate cancer, for which the status of nodes was determined by lymph node dissection (LND), lymphangiography (LAG), or computer assisted tomography (CT) based on investigator preference. Actuarial 5 year endpoints of survival, NED survival, local recurrence and distant metastasis have been determined by stage for 805 eligible patients with a comparison of pathologic vs clinical (imaging test) determined nodal status. Patients with pathologically negative lymph nodes show significantly improved 5 year survival (Stage T-2 (B) 84% vs 77%, Stage T-3,4 (C) 82% vs 65%) and NED survival (Stage T-2 (B) 72% vs 63%, Stage T-3,4 (C) 64% vs 44%) compared to patients clinically negative. Free of metastasis rates are increased in Stage T-3,4 (C) pathologic negative patients compared to imaging negative patients (75% vs 60%). A comparison of clinical positive versus clinical negative patients shows no difference in survival, NED survival or rate of metastasis, while a similar comparison of pathologic positive versus pathologic negative shows significant difference for all three endpoints (survival: Stage T-2 (B) 84% vs 61%, Stage T-3,4 (C) 82% vs 66%, NED survival: Stage T-2 (B) 72% vs 32%, Stage T-3,4 (C) 64% vs 32%; free of metastasis: Stage T-2 (B) 82% vs 64%, Stage T-3,4 (C) 75% vs 44%). The clinical determination of nodal status, therefore, has no prognostic value in contrast to pathologic determination and should not be used for stratifying patients in clinical trials. The CT scans often used to evaluate nodal status are more useful if delayed until they can be done as part of the treatment planning process where the CT has value. When imaging tests suggest positive lymph nodes in prostate cancer patients, the imaging finding is confirmed by biopsy.

Humans↗

PubMed1992

A comparison of radial dose functions for 103Pd, 125I, 145Sm, 241Am, 169Yb, 192Ir, and 137Cs brachytherapy sources.

Recently, encapsulated sources of 103Pd (21 keV average), 145Sm (41 keV average), 241Am (60 keV), and 169Yb (93 keV average) have been introduced as alternatives to conventional brachytherapy sources of 125I Model 6711 (27 keV average), 125I Model 6702 (28 keV average), 192Ir (369 keV average), and 137Cs (662 keV). To illustrate the dependence of the penetrating ability of photons from brachytherapy sources as a function of photon energy, a comparison of their radial dose functions is presented. Using the ITS Monte Carlo simulation code for photon-electron transport, the radial dose functions were calculated for monoenergetic photon sources with energies in the range of 30 keV to 1 MeV. Also, similar calculations were performed using the photon spectra emitted by the encapsulated brachytherapy sources. To verify the accuracy of Monte Carlo calculations, comparisons are made with our new measured data for 241Am and existing experimental and theoretical data from other investigators. A comparison of radial dose functions indicates that for 241Am, 169Yb, 192Ir and 137Cs sources radial dose functions are close to unity for distances up to 10 cm, for 145Sm the radial dose function drops to about 0.4 at 10 cm, and for 125I and 103Pd it drops precipitously to less than 0.20 at 7 cm. At 5 cm, the measured radial dose functions for 103Pd, 125I Model 6711, 125I Model 6702, 145Sm, 241Am, and 192Ir have values of 0.09, 0.34, 0.38, 0.86, 1.12, and 0.97, respectively. While all of these radioisotopes provide adequate penetrating power for interstitial brachytherapy, only the radioisotopes emitting photons with energies greater than about 40 keV can provide adequate depth dose (that is, small or no tissue attenuation) for intracavitary irradiation. Our criterion for choice of minimum photon energy suitable for intracavitary irradiation is that the radial dose function at 5 cm should not be less than 0.90. Also, note that photons with energies around 80 keV exhibit maximum penetrating ability in solid water for distances up to 5 cm.

Americium↗

PubMed1993

Comparison of the Drosophila melanogaster, human and murine Sm B cDNAs: evolutionary conservation.

To analyze the evolutionary stability of the Sm B polypeptides, the cDNA nucleotide (nt) sequence was derived for the Drosophila melanogaster Sm B polypeptide and compared to the cDNAs encoding human and murine Sm B. The three cDNAs were transcribed and translated in reticulocyte lysates followed by analysis of the synthesized proteins by SDS-PAGE. D. melanogaster B migrated at approximately 25 kDa, in comparison to 28 kDa for the murine and human B proteins, although all three proteins were immunoprecipitated by human anti-Sm autoantibodies and by the Y12 anti-Sm murine monoclonal antibody (Y12 mAb). Immunoblots and immunoprecipitations of [35S]methionine-labeled D. melanogaster S2/M3 cells confirmed the smaller size of the D. melanogaster protein, and revealed that B' was absent in this cell line, as in murine cells. In comparison to the 231 amino acids (aa) of human and murine B, the deduced sequence for the D. melanogaster clone was 199 aa (predicted M(r) of 24,598) with two 5-aa deletions and a 19-aa truncation at the 3' end, compared to the other two clones. D. melanogaster protein B shared 65% aa sequence identity with the human and mouse clones, and 80% similarity when conservative aa substitutions were noted. The C-terminal portion of the D. melanogaster protein was the most evolutionarily variable in comparison to the deduced aa sequences for the other two proteins; however, autoantigenic epitopes bound by human anti-Sm antibodies and the Y12 mAb in this region of the protein were conserved across species lines.(ABSTRACT TRUNCATED AT 250 WORDS)

Amino Acid Sequence↗

PubMed1988

Comparisons of psychophysical and neurophysiological studies of cochlear implants.

This paper compares psychophysical and neural studies of electrical stimulation of the auditory nerve with the goal of evaluating the relevance of single-unit animal models for the development of cochlear prostheses for profoundly deaf humans. Comparative psychophysical studies with implanted deaf subjects indicate that animal models, at least nonhuman primates, provide a close match to humans, though this is not always true for acoustic stimulation of normal-hearing subjects. However, the human-animal comparisons, especially those involving electrical stimuli, need further study using more carefully matched conditions. Comparisons of psychophysical and neurophysiological thresholds for electrical stimulation in animals reveal consistently higher thresholds in the neural studies. A number of factors which may account for these differences are discussed. A partial resolution of the problem could result from conducting neurophysiological and behavioral studies in the same animal. Finally, comparison of psychophysical and neurophysiological studies of temporal encoding suggest that there may be more information encoded in the auditory nerve than is used by the system, at least for nonspectral frequency discrimination. This points to a need for further analysis of the processing of this information at higher levels in the auditory pathway.

Animals↗

PubMedDate not supplied

A comparison of the anticonvulsant effects of 1,4- and 1,5-benzodiazepines in the amygdala-kindled rat and their effects on motor function.

Studies suggest that the 1,5-benzodiazepine clobazam possesses a favorable anticonvulsant profile due to its minimal neurotoxicity. The anticonvulsant and motor impairment effects of clobazam and 2 1,4-benzodiazepine, diazepam and clonazepam, were compared by dose-response analysis in amygdala-kindled rats and on 3 tests of motor function: gross motor impairment, a vertical screen test, and muscle tone. All drugs produced a significant, dose-dependent decrease in the duration of both behavioral and electrographic kindled seizure measures. Forelimb clonus suppression was the most sensitive measure of anticonvulsant drug effect. The order of potency for all effects was clonazepam greater than diazepam greater than clobazam. ED50s for the benzodiazepines' effects on motor impairment were compared to their ability to protect rats from forelimb clonus. Different spectrums of action for the various benzodiazepines were found depending on the comparison measure. Clonazepam had the most favorable ratio of potency for anticonvulsant vs. motor impairment activity when ataxia rating was the comparison measure. Diazepam had the most advantageous profile when the more sensitive screen test was used for comparison. Clobazam was not found to have a superior spectrum of action when compared across these measures. The results emphasize the importance of dose-response analyses and the consideration of behavioral measures used to assess beneficial and adverse effects of anticonvulsants.

Amygdala↗

PubMed1995

Lumbrical-interosseous latency comparison in the diagnosis of carpal tunnel syndrome.

We examined 66 hands referred with suspected carpal tunnel syndrome (CTS) using the second lumbrical-interosseous distal motor latency difference (2LI-DML) as well as standard tests: Forty-nine cases of CTS were diagnosed by the standard tests, 48 of whom had an abnormal median-ulnar palmar velocity comparison and 48 an abnormal 2LI-DML. The results of these 2 tests were closely correlated. The 2LI-DML supported the diagnosis of CTS in all cases except one, where the result was borderline. In one suspected case the 2LI-DML was the only abnormality. In 9 severe cases no median palmar responses could be obtained but an abnormal 2LI-DML was found. We conclude that the 2LI-DML is as sensitive as the palmar comparison and thus will support the diagnosis of CTS made by standard tests by providing an additional abnormality but that its routine use is unlikely to increase the diagnostic yield. Its value therefore may be in mild cases where the median-ulnar palmar comparison is normal or equivocal and in severe cases where standard test responses are unobtainable. It has also proved useful as a quick and simple screening test for CTS on the asymptomatic side.

Adult↗

PubMed1995

Comparison of monoclonal biotin-avidin enzyme immunoassay and monoclonal time-resolved fluoroimmunoassay in detection of respiratory virus antigens.

BACKGROUND: Detection of respiratory viruses by time-resolved fluoroimmunoassay based on monoclonal antibodies were developed in our laboratories in the late 1980s and they have been successfully used in daily diagnosis for more than seven years. Later, similar Biotin-EIAs were developed but the sensitivities were unsatisfactory. OBJECTIVES: Further optimization of monoclonal Biotin-EIAs and comparison of the optimized assays with TR-FIAs. STUDY DESIGN: Variations in test format, diluents, incubation times and temperatures, and different monoclonal antibodies were tested, and the final comparisons were made with TR-FIA using stored nasopharyngeal aspirates. RESULTS: The improvements in Biotin-EIA featured four changes which increased sensitivity in the assay: (a) test diluent contained diethylenetriamino-pentaacetic acid; (b) antigen and biotinylated detector antibody were added simultaneously; (c) reaction time was extended from 1 h at 37 degrees C to overnight at 4 degrees C; (d) from the thirteen monoclonal antibodies used in TR-FIA, ten were optimal also in Biotin-EIA, but in the parainfluenza 1 and 2 assays other monoclonals proved more sensitive. Out of 257 originally positive specimens tested in the comparison studies, 192 (74.7%) were again positive and 54 (21.0%) were negative in both assays; nine were negative in TR-FIA but positive in Biotin-EIA, while two specimens were negative in Biotin-EIA but positive in TR-FIA. The overall agreement between the two assays was 95.7%. CONCLUSIONS: All monoclonal Biotin-EIAs can be optimized to the same sensitivity as TR-FIAs for the detection of respiratory viruses. Laboratories which have no TR-FIA expertise may use Biotin-EIA in the diagnosis of acute respiratory infections.

Journal Article↗

PubMed2005

Dose-comparison study of the combination of ezetimibe and simvastatin (Vytorin) versus atorvastatin in patients with hypercholesterolemia: the Vytorin Versus Atorvastatin (VYVA) study.

BACKGROUND: Low-density lipoprotein cholesterol (LDL-C) is the primary therapeutic target in the National Cholesterol Education Program Adult Treatment Panel III (ATP III) guidelines. This study tested the hypothesis that ezetimibe/simvastatin, a lipid-lowering agent that inhibits both intestinal cholesterol absorption and cholesterol synthesis, provides greater LDL-C reductions than atorvastatin across dose ranges. METHODS: This multicenter, double-blind, 6-week parallel-group study randomized 1902 patients with LDL-C above ATP III goal to atorvastatin (10, 20, 40, or 80 mg) or to ezetimibe/simvastatin (10/10, 10/20, 10/40, or 10/80 mg). Patients were stratified by prerandomization LDL-C level. RESULTS: At each milligram-equivalent statin dose comparison, and averaged across doses, ezetimibe/simvastatin provided greater LDL-C reductions (47%-59%) than atorvastatin (36%-53%). Ezetimibe/simvastatin 10/40 and 10/80 mg also provided significantly greater high-density lipoprotein cholesterol (HDL-C) increases than atorvastatin 40 and 80 mg. Triglyceride reductions were similar for all comparisons. More ezetimibe/simvastatin than atorvastatin patients with coronary heart disease (CHD) or CHD risk equivalents attained the ATP III LDL-C goal of <100 mg/dL and the optional LDL-C target of <70 mg/dL. C-reactive protein reductions were similar between treatment groups. Consecutive elevations in alanine aminotransferase and/or aspartate aminotransferase occurred in significantly more atorvastatin patients than ezetimibe/simvastatin patients. No myopathy or liver-related adverse events led to study discontinuation with either drug. CONCLUSIONS: Ezetimibe/simvastatin was more effective than atorvastatin in lowering LDL-C at each dose comparison and provided greater increases in HDL-C at the 40- and 80-mg statin dose. Ezetimibe/simvastatin is a highly efficacious, well-tolerated treatment option for hypercholesterolemic patients.

Adult↗

PubMed2005

Comparison of transvaginal sonography with digital examination and transabdominal sonography for the determination of fetal head position in the second stage of labor.

OBJECTIVE: Precise determination of fetal head position in labor is a prerequisite for safe instrumental deliveries, and essential for the assessment of labor progress. Recent studies have cast serious doubts on the accuracy of the time-honored digital vaginal examination (DVE) in comparison to transabdominal ultrasound scans (TUS). However, transabdominal imaging is technically difficult with a deeply engaged fetal head in the second stage of labor. We examined the accuracy and time requirements of transvaginal scans (TVS) in the second stage of labor for determination of fetal head position. STUDY DESIGN: Sixty laboring women in the second stage of labor with a deeply engaged fetal head were examined by experienced nurse midwives and senior residents. Fetal head position was recorded as "time on a 12-hour clock." Subsequently, TUS and TVS were independently performed by a skilled sonographer. Accuracy and time requirements for all 3 examinations were recorded. RESULTS: Fetal head position could be determined in all cases by TVS, but not in 7 cases and 9 cases by DVE and TUS, respectively (P < .03; P < .008). A discrepancy of 60 degrees or more between the DVE and TUS or TVS was found in 13/60 cases (21.7%) and 14/60 cases (23.3%), respectively. A > or = 90 degrees discrepancy was found in 9/60 cases (15%) and 12/60 cases (20%), respectively (P < .02 for comparison of TUS and TVS). In 5 cases, the digital examination erroneously perceived an occiput posterior position as occiput anterior. No significant differences in fetal head position were detected between TUS and TVS, when the examination was technically feasible. The mean time (+/-SD) required for determining fetal head position was shortest for TVS (8.7 +/- 5.8 seconds) in comparison to DVE (22.7 +/- 14.6 seconds; P < .0001) or TAS (31.7 +/- 19.1 seconds; P < .0001). CONCLUSION: Transvaginal sonography was the most successful and accurate method for determination of fetal head position in the second stage of labor, and required the least time for performance. We believe that TVS should be routinely performed in the labor room setting for the determination of fetal head position.

Abdomen↗

PubMed2006

In vivo comparison of various polymeric and low molecular mass inhibitors of intestinal P-glycoprotein.

Several polymers have been reported to modulate drug absorption by inhibition of intestinal P-glycoprotein (P-gp). The aim of the present study was to provide a direct in vivo comparison of delivery systems based on Pluronic P85, Myrj 52 and chitosan-4-thiobutylamidine (Ch-TBA) in vivo in rats, using rhodamine-123 (Rho-123) as representative P-gp substrate. Furthermore, the postulated low molecular mass P-gp inhibitors 6-mercaptopurine and reduced glutathione (GSH) were evaluated in vitro and in vivo. In vitro, the permeation enhancing effect of 6-mercaptopurine, GSH, Pluronic P85, Myrj 52, and the combination of Ch-TBA with GSH was evaluated by using freshly excised rat intestinal mucosa mounted in Ussing-type diffusion chambers. In comparison to buffer only, Rho-123 transport in presence of 100 microm 6-mercaptopurine, 0.5% (w/v) GSH, 0.5% (w/v) Pluronic P85, 0.5% (w/v) Myrj 52 and the combination of 0.5% (w/v) Ch-TBA/ 0.5% (w/v) GSH, was 2.1, 1.6, 1.9, 1.8, 3.0-fold improved, respectively. In vivo in rat, enteric-coated tablets based on Pluronic P85, Myrj 52 or Ch-TBA/GSH increased the area under the plasma concentration time curve (AUC(0-12)) of Rho-123 1.6-fold, 2.4-fold, 4.3-fold, respectively, in comparison to control only. Contrariwise, the low molecular mass excipients 6-mercaptopurine and GSH showed no significant effect in vivo at all. This in vivo study showed that polymeric P-gp inhibitors and especially the delivery system based on thiolated chitosan significantly increased the oral bioavailability of P-gp substrate Rho-123.

ATP Binding Cassette Transporter, Subfamily B, Mem↗

PubMed2005

Comparison of cellulose solubilisation rates in rumen and landfill leachate inoculated reactors.

The aim of this study was to conduct a number of controlled digestions to obtain easily comparable cellulose solubilisation rates and to compare these rates to those found in the literature to see which operational differences were significant in affecting cellulose degradation during anaerobic digestion. The results suggested that differences in volumetric cellulose solubilisation rates were not indicative of the true performance of cellulose digestion systems. When cellulose solubilisation rates were normalised by the mass of cellulose in the reactor at each time step, the comparison of the rates became more meaningful. Cellulose solubilisation was surface area limited. Therefore, changes in the loading rate of cellulose to the reactor altered the volumetric solubilisation rate without changing the mass normalised rate. Comparison of mass normalised solubilisation rates from this study and the literature demonstrated that differences in reactor configuration and operational conditions did not significantly impact on the solubilisation rate whereas the difference in composition of the microbial communities showed a marked effect. This work highlights the importance of using appropriately normalised data when making comparisons between systems with differing operational conditions.

Animals↗

PubMed2005

Accelerated partial breast irradiation: a dosimetric comparison of three different techniques.

PURPOSE: We report the first single-institutional dosimetric comparison of patients treated with three forms of accelerated partial breast irradiation: interstitial HDR brachytherapy, the MammoSite balloon apparatus, and 3D conformal external beam quadrant irradiation (3D-CRT). METHODS: A retrospective dosimetric comparison of interstitial HDR brachytherapy, MammoSite balloon brachytherapy, and 3D-CRT was performed. Thirty patients including 10 from each treatment technique were included for a dosimetric comparison of the dose received by the ipsilateral breast, PTV, heart, and ipsilateral lung. Interstitial patients were treated with 4 Gy in 8 fractions to 32 Gy, and the MammoSite patients were treated with 3.4 Gy in 10 fractions to 34 Gy. 3D-CRT patients were treated with 3.85 Gy in 10 fractions to 38.5 Gy using multiple isocentric beams. The CT images from simulation or implant evaluation were transferred into our 3D treatment planning software. The lumpectomy cavities were outlined for every patient, except the MammoSite patients, where the cavity was defined by the balloon edge. The PTV was constructed as a uniform expansion of 1.5 cm for all interstitial HDR patients, 1.0 cm for the MammoSite patients, and a 1.0 cm expansion in addition to the CTV expansion of 1.0 cm (n=2), and 1.5 cm (n=8) for the 3D-CRT patients. The CTV expansion for 3D-CRT and the PTV expansion for the brachytherapy patients were limited to the chest wall and skin. Normal structures including both ipsilateral lung and breast and heart for left-sided lesions were outlined. The lumpectomy cavity was subtracted from the PTV and normal breast tissue for evaluation. To evaluate dose to the ipsilateral breast and lung, PTV, and heart, a dose-volume histogram (DVH) analysis was performed. All histograms were normalized to the volume of the structure (i.e., expressed as percent volume). RESULTS: The average percentage of the breast receiving 100% and 50% of the prescribed dose (PD) was higher in the 3D-CRT group (24% and 48%, respectively) compared with the MammoSite (5% and 18%, respectively) and interstitial patients (10% and 26%, respectively). Improved coverage of the PTV was noted in the 3D-CRT plans compared with the MammoSite and interstitial HDR plans. With the interstitial HDR technique, 58% of the PTV received 100% of the PD compared with 76% with MammoSite and 100% with 3D-CRT techniques. The percentage of the PTV receiving 90% of the PD was 68%, 91%, and 100% for the interstitial HDR, MammoSite, and 3D-CRT patients, respectively. The ipsilateral lung V20 was slightly higher for 3D-CRT at 5% compared with 0% for both brachytherapy techniques. CONCLUSION: In those treated with 3D-CRT, coverage of the PTV was better with 3D-CRT but varied with the definition used. At the coverage at 90% of the PD, no difference was observed between 3D-CRT and MammoSite (which were both better than interstitial). 3D-CRT resulted in better coverage of the PTV compared with MammoSite or interstitial brachytherapy techniques. Better PTV coverage with 3D-CRT came at the cost of a higher integral dose to the remaining normal breast. Dosimetrically, the best partial breast irradiation technique appears to depend on the clinical situation. Of the brachytherapy techniques, MammoSite appears to be superior in PTV coverage. When comparing MammoSite vs. 3D-CRT PTV coverage at 90% of the PD, the difference was not significantly different.

Brachytherapy↗

PubMed2006

Alpha-band activity reflects reduction of mental effort in a comparison task: a source space analysis.

Comparison processes contribute to many core phenomena of social cognition research. Whenever humans judge a given target, they rely on comparisons with a pertinent standard. We propose that comparison processes may be so ubiquitous because they reduce mental effort. To investigate this possibility, we used dense-array Electroencephalogram (EEG) recordings together with a minimum norm source projection approach. As the dependent variable, we examined changes in parietal alpha (8-12 Hz) amplitude during a judgment task. Spectral changes in the alpha frequency range have been reliably related to attentional load, cognitive arousal, or mental effort. Two groups of participants (n=22) were procedurally primed to solve a series of target judgments in a more comparative (experimental group) versus more absolute (control group) manner. While the participants performed the critical judgment tasks, we recorded changes in alpha amplitude. Continuous EEG was transformed into a spherical source space using the minimum norm (L2) estimate and spectral changes were subsequently calculated in the source domain. Statistical parametric mapping in combination with permutation statistics was employed to map regions showing significant group differences. Results demonstrate that comparative processing was associated with smaller changes in alpha amplitude than absolute processing. This difference was most pronounced at parietal source locations, where alpha reduction was at a maximum. Temporal analysis suggested that this effect was present particularly during task preparation and execution. We conclude that comparative information processing may reduce mental effort in judgment tasks.

Adult↗

PubMed2005

Analyzing the duration of recurrent events in clinical trials: a comparison of approaches using data from the UK700 trial of psychiatric case management.

In studies of chronic disease the outcome measure may be based upon the duration of recurring illness. Our example is the UK700 trial of psychiatric case management, where the total number of days spent in hospital over a 2-year follow-up was the primary outcome. Investigations of treatment effect modifiers were undertaken using an analysis of that primary outcome, a comparison of length of hospitalizations, and also a multi-state modeling approach. The days in hospital outcome was relatively straightforward to analyze, and allowed the complete randomized treatment groups to be compared. In contrast, the comparison of length of hospitalizations included only hospitalized patients, with censored observations not being well accommodated. The multi-state model provided separate treatment effect estimates for admission and discharge, this being more informative about how any reduction in days spent in hospital is achieved. Estimation of the treatment effects through the use of proportional hazards regression allowed appropriate incorporation of censored observations. However, with the multi-state model approach treatment effect estimates are not based upon comparisons of complete randomized treatment groups, as individuals are removed from the risk set for admission whilst at risk for discharge, and vice versa. We conclude that total duration is an appropriate primary outcome for clinical trials, but that multi-state models deserve greater use as an informative secondary analysis.

Case Management↗

PubMed2004

Paired comparisons of sensory pain adjectives.

BACKGROUND: Language is an important tool in the communication of pain. The most widely known verbal pain assessment tool is the McGill Pain Questionnaire (MPQ). The MPQ scoring procedure implies equal weights for different pain describing adjectives with the same rank value. AIM: In the present study the relative intensity of the most severe sensory pain adjectives of the MPQ was examined by means of Thurstone's method of paired comparison. METHOD: A questionnaire was constructed to run a balanced pairwise comparison experiment with pain describing adjectives obtained from the Dutch version of the MPQ. The questionnaire was filled out by psychology freshmen (N=528). RESULTS: Subjects were highly consistent in their choices regarding the paired comparisons but showed substantial individual differences with respect to agreement about the relative intensity of the adjectives. However, some adjectives were clearly rated as more painful than others, these were lancinating, bursting and tearing. Adjectives seen as relatively least painful were clasping, shooting and freezing. CONCLUSIONS: The results suggest that the MPQ scoring procedure is not entirely consistent with the relative ranking obtained in the present study. The authors do not consider the extent of this deviation to be a violation of one of the MPQ's underlying assumptions.

Adult↗

PubMed2006

Evidence evaluation in fingerprint comparison and automated fingerprint identification systems--modelling within finger variability.

Recent challenges and errors in fingerprint identification have highlighted the need for assessing the information content of a papillary pattern in a systematic way. In particular, estimation of the statistical uncertainty associated with this type of evidence is more and more called upon. The approach used in the present study is based on the assessment of likelihood ratios (LRs). This evaluative tool weighs the likelihood of evidence given two mutually exclusive hypotheses. The computation of likelihood ratios on a database of marks of known sources (matching the unknown and non-matching the unknown mark) allows an estimation of the evidential contribution of fingerprint evidence. LRs are computed taking advantage of the scores obtained from an automated fingerprint identification system and hence are based exclusively on level II features (minutiae). The AFIS system attributes a score to any comparison (fingerprint to fingerprint, mark to mark and mark to fingerprint), used here as a proximity measure between the respective arrangements of minutiae. The numerator of the LR addresses the within finger variability and is obtained by comparing the same configurations of minutiae coming from the same source. Only comparisons where the same minutiae are visible both on the mark and on the print are therefore taken into account. The denominator of the LR is obtained by cross-comparison with a database of prints originating from non-matching sources. The estimation of the numerator of the LR is much more complex in terms of specific data requirements than the estimation of the denominator of the LR (that requires only a large database of prints from an non-associated population). Hence this paper addresses specific issues associated with the numerator or within finger variability. This study aims at answering the following questions: (1) how a database for modelling within finger variability should be acquired; (2) whether or not the visualisation technique or the choice of different minutiae arrangements may influence that modelling and (3) what is the magnitude of LRs that can be expected from such a model. Results show that within finger variability is affected by the visualisation technique used on the mark, the number of minutiae and the minutiae configuration. They also show that the rates of misleading evidence in the likelihood ratios obtained for one of the configurations examined are low.

Automation↗

PubMedDate not supplied

Characteristics of sleep in patients with stable heart failure versus a comparison group.

BACKGROUND: Sleep disturbance seems to be common among patients with heart failure (HF). However, little is known about the objective and subjective characteristics of sleep in these patients during daily life or the extent to which the sleep of patients with HF differs from the sleep of other adults. METHODS: We examined the extent to which self-reported and objective characteristics of sleep differ between patients with HF with stable systolic blood pressure (n = 59) and a comparison group of adults who did not have HF (n = 59). RESULTS: The patients with HF had a significantly lower percentage of wake after sleep onset and more frequent wake bouts, as measured with wrist actigraphs. There were no group-related differences in sleep duration. Sixty-seven percent of the patients with HF compared with 51% of the comparison group had poor global sleep quality, and 44% of the patients with HF versus 18.6% of the comparison group reported excessive daytime sleepiness. CONCLUSION: Future research is needed to examine the causes and consequences of disturbed sleep continuity and poor sleep quality and the effects of sleep-promotion strategies designed for patients with HF.

Blood Pressure↗

PubMed2005

Adjusted indirect comparison of intracoronary drug-eluting stents: evidence from a metaanalysis of randomized bare-metal-stent-controlled trials.

AIMS: Drug-eluting stents (DES) have been recently investigated, with favorable data for many devices, but comparative data are lacking. We thus performed an adjusted indirect comparison metaanalysis of DES. METHODS: Randomized trials comparing DES vs. bare-metal stents (BMS) were systematically searched, and random effect odds ratios (OR) were computed for target lesion revascularization (TLR) and binary in-stent restenosis rate (BRR) at 6-12 months. We then generated interaction OR for the comparison of different DES. RESULTS: We pooled data from 17 studies (allocating 3048 patients to BMS and 3392 to nine different DES). Indirect head-to-head comparison of sirolimus-eluting Cypher (N=1007) vs. polymeric paclitaxel-eluting Taxus (N=959) showed nonsignificant differences in TLR [OR=0.8 (0.5-1.4), p=0.45] but significant reductions in BRR favoring Cypher [OR=0.3 (0.1-0.6), p<0.001]. Everolimus-eluting stents appeared noninferior to Cypher or Taxus (p>0.50 for both TLR and BRR). Actinomycin-, mycophenolate-, and apolymeric paclitaxel-eluting stents (PES) all proved significantly worse than Cypher or Taxus for TLR or BRR. CONCLUSION: Notwithstanding its inherent limitations, the present metaanalysis confirms the effectiveness of both Cypher and Taxus, supports the promising role of everolimus-eluting stents, and suggests the significant inferiority of most other devices. These post hoc findings, albeit intriguing, await prospective confirmation.

Coronary Disease↗