Score List Research Articles

Authors reply: Importance of standardisation of HAI definitions in interpretation of international and/or multinational prevalence studies

To the editor: We would like to thank M Cotter et al. for their comments regarding the application of uniform definitions for infections in the nursing home setting. In our article we indeed used a ‘suspicion of infection’, i.e. having at least one symptom or sign on the healthcare-associated infections in long-term care facilities (HALT) score list. In this first European HALT study it was decided to register signs and symptoms of disease separately so that Mc Geer criteria might be applied afterwards. Previously, Rothan-Tondeur et al argued that it is time to revise the Mc Geer criteria [1].

WebDASC: a web‐based dietary assessment software for 8–11‐year‐old Danish children

The present study describes the development and formative evaluation of the Web-based Dietary Assessment Software for Children (WebDASC). WebDASC is part of the OPUS project ('Optimal well-being, development and health for Danish children through a healthy New Nordic Diet') and was intended to measure dietary change resulting from a school-based intervention. WebDASC was developed as a self-administered tool that could be used by 8-11-year-old children with or without parent's aid. The development of WebDASC followed a prototyping approach: focus groups, informal interviews, literature review, and usability tests preceded its release. Special consideration was given to age-appropriate design issues. In WebDASC an animated armadillo guides respondents through six daily eating occasions and helps them report foods and beverages previously consumed. A database of 1300 food items is available either through category browse or free text search, aided by a spell check application. A type-in format is available for foods not otherwise found through category browse or text search. Amount consumed is estimated by selecting the closest portion size among four different digital images. WebDASC includes internal checks for frequently forgotten foods, and the following features to create motivation: a food-meter displaying cumulative weight of foods reported, a most popular food ranking, and a computer game with a high score list. WebDASC was developed as an intuitive, cost-effective, and engaging method to collect detailed dietary data from 8- to 11-year-old children. Preliminary testing demonstrated that it was well accepted among children.

Scoring complications after congenital heart surgery: gut feelings versus calculations

This study constitutes the first reported attempt to quantify observed morbidity after congenital heart surgery. The completed list of complication scores (footnote, Table 1) will be further applied for a longer period. Resulting morbidity scores bear potential to accurately estimate morbidity in connection with congenital heart surgery. The morbidity scores based on observed complications will contribute to revision of the Aristotle complexity score, in the same way as the observed mortality risks [8]. Estimation over time of such morbidity scores can facilitate the assessment of quality of paediatric cardiac surgical programmes with different case-mixes, provided that it will be accepted by the paediatric cardiovascular surgery community.

Health state utilities of a population of Nigerian hypertensive patients.

BackgroundEstablishment of the health impact of hypertension on quality of life of Nigerians is a step towards controlling the disease. The study aimed to provide a Nigerian specific reference list of utility scores of hypertensive patients with various interacting conditions.FindingsAn interviewer-based, cross-sectional study was conducted using hypertensive patients in two purposively selected tertiary hospitals located in South-Eastern Nigeria. Health Utility Index Mark 3 (HUI3) was used.A total of 384 participants with either hypertension alone or with hypertension-associated complications were interviewed in the two tertiary hospitals.The overall mean utility score was 0.35 +/- 0.42. Patients with hypertension alone had the highest overall mean utility score (0.57 +/- 0.29) while hypertensive patients with stroke had the lowest overall mean score (0.04 +/- 0.36). Being a male, increase in age and mean arterial blood pressure, emergency visit and loss of work due to illness were associated with significant decrease in overall utility scores.ConclusionsThis study presented a reference for health state utilities of a population of Nigerian hypertensive patients.

Characterization and Prediction of Lysine (K)-Acetyl-Transferase Specific Acetylation Sites

Lysine acetylation is a well-studied post-translational modification on both histone and nonhistone proteins. More than 2000 acetylated proteins and 4000 lysine acetylation sites have been identified by large scale mass spectrometry or traditional experimental methods. Although over 20 lysine (K)-acetyl-transferases (KATs) have been characterized, which KAT is responsible for a given protein or lysine site acetylation is mostly unknown. In this work, we collected KAT-specific acetylation sites manually and analyzed sequence features surrounding the acetylated lysine of substrates from three main KAT families (CBP/p300, GCN5/PCAF, and the MYST family). We found that each of the three KAT families acetylates lysines with different sequence features. Based on these differences, we developed a computer program, Acetylation Set Enrichment Based method to predict which KAT-families are responsible for acetylation of a given protein or lysine site. Finally, we evaluated the efficiency of our method, and experimentally detected four proteins that were predicted to be acetylated by two KAT families when one representative member of the KAT family is over expressed. We conclude that our approach, combined with more traditional experimental methods, may be useful for identifying KAT families responsible for acetylated substrates proteome-wide.

Candidate List Reduction Based on the Analysis of Fingerprint Indexing Scores

This correspondence proposes new candidate list reduction criteria for fingerprint indexing approaches. The basic idea is that, given a query fingerprint, the initial set of scores produced by an indexer could contain useful information to reduce the candidate list. Novel reduction criteria have been proposed, and extensive experiments have been carried out over five publicly available benchmarks, using two state-of-the-art fingerprint indexing techniques. Although quite simple, the proposed criteria achieved remarkable results, allowing a substantial reduction of the candidate list: for instance, at 1% error rate, the average penetration rate of a state-of-the-art minutiae-based indexer decreases from 27% to 3.9% on FVC2000 DB2. The new reduction criteria are applicable to any indexing approach, since they only require a list of scores as input.

Chemoradiation for advanced hypopharyngeal carcinoma: a retrospective study on efficacy, morbidity and quality of life

Chemoradiation (CRT) is a valuable treatment option for advanced hypopharyngeal squamous cell cancer (HSCC). However, long-term toxicity and quality of life (QOL) is scarcely reported. Therefore, efficacy, acute and long-term toxic effects, and long-term QOL of CRT for advanced HSCC were evaluated,using retrospective study and post-treatment quality of life questionnaires. in a tertiary hospital setting. Analysis was performed of 73 patients that had been treated with CRT. Toxicity was rated using the CTCAE score list. QOL questionnaires EORTC QLQ-C30, QLQ-H&N35, and VHI were analyzed. The most common acute toxic effects were dysphagia and mucositis. Dysphagia and xerostomia remained problematic during long-term follow-up. After 3 years, the disease-specific survival was 41%, local disease control was 71%, and regional disease control was 97%. The results indicated that CRT for advanced HSCC is associated with high locoregional control and disease-specific survival. However, significant acute and long-term toxic effects occur, and organ preservation appears not necessarily equivalent to preservation of function and better QOL.

Chi-square-based Scoring Function for Categorization of MEDLINE Citations

Text categorization has been used in biomedical informatics for identifying documents containing relevant topics of interest. We developed a simple method that uses a chi-square-based scoring function to determine the likelihood of MEDLINE citations containing genetic relevant topic. Our procedure requires construction of a genetic and a nongenetic domain document corpus. We used MeSH descriptors assigned to MEDLINE citations for this categorization task. We compared frequencies of MeSH descriptors between two corpora applying chi-square test. A MeSH descriptor was considered to be a positive indicator if its relative observed frequency in the genetic domain corpus was greater than its relative observed frequency in the nongenetic domain corpus. The output of the proposed method is a list of scores for all the citations, with the highest score given to those citations containing MeSH descriptors typical for the genetic domain. Validation was done on a set of 734 manually annotated MEDLINE citations. It achieved predictive accuracy of 0.87 with 0.69 recall and 0.64 precision. We evaluated the method by comparing it to three machine-learning algorithms (support vector machines, decision trees, naïve Bayes). Although the differences were not statistically significantly different, results showed that our chi-square scoring performs as good as compared machine-learning algorithms. We suggest that the chi-square scoring is an effective solution to help categorize MEDLINE citations. The algorithm is implemented in the BITOLA literature-based discovery support system as a preprocessor for gene symbol disambiguation process.

Natural History of Functional Dyspepsia: A 10-Year Population-Based Study

Background: Functional dyspepsia (FD) is a common disorder, but information on its natural history is limited. Aim: To study the natural history of FD as assessed by 2 criteria over a 10-year period. Method: A population-based study conducted by mailing a questionnaire to the same age- and gender-stratified random sample of the Icelandic population aged 18–75 in 1996 and again in 2006. FD was estimated by the Functional Dyspepsia Score List and by dyspepsia subgroups categorized into 4 groups: (1) frequent upper pain, (2) meal-related, (3) nausea or vomiting, and (4) combinations of these groups. Results: FD was diagnosed in 13.9% of the subjects in the 1996 sample (11.3% male, 15.8% female) and 16.7% in 2006 (12.3% male, 20.2% female) with a significant difference between males and females in 2006. Dyspepsia subgroup criteria showed a higher prevalence than conventional FD criteria. The proportion of FD subjects in one of the dyspepsia subgroups was low. There was a significant relationship between FD and heartburn and irritable bowel syndrome. A high proportion of subjects who seek medical care have FD. Conclusion: FD was stable over the 10-year period, but there was turnover in symptoms and increased intensity and frequency of gastrointestinal pain. Dyspepsia subgroup criteria showed a higher prevalence than FD, which was more common in young subjects and females. FD poses a heavy burden on the health care system.

Video Registration of Trauma Team Performance in the Emergency Department: The Results of a 2-Year Analysis in a Level 1 Trauma Center

Trauma teams responsible for the first response to patients with multiple injuries upon arrival in a hospital consist of medical specialists or resident physicians. We hypothesized that 24-hour video registration in the trauma room would allow for precise evaluation of team functioning and deviations from Advanced Trauma Life Support (ATLS) protocols. We analyzed all video registrations of trauma patients who visited the emergency room of a Level I trauma center in the Netherlands between September 1, 2000, and September 1, 2002. Analysis was performed with a score list based on ATLS protocols. From a total of 1,256 trauma room presentations, we found a total of 387 video registrations suitable for analysis. The majority of patients had an injury severity score lower than 17 (264 patients), whereas 123 patients were classified as multiple injuries (injury severity score >or=17). Errors in team organization (omission of prehospital report, no evident leadership, unorganized resuscitation, not working according to protocol, and no continued supervision of the patient) lead to significantly more deviations in the treatment than when team organization was uncomplicated. Video registration of diagnostic and therapeutic procedures by a multidisciplinary trauma team facilitates an accurate analysis of possible deviations from protocol. In addition to identifying technical errors, the role of the team leader can clearly be analyzed and related to team actions. Registration strongly depends on availability of video tapes, timely started registration, and hardware functioning. The results from this study were used to develop a training program for trauma teams in our hospital that specifically focuses on the team leader's functioning.

A scoring system for histopathologic and immunohistochemical evaluations of uterine leiomyosarcomas

Uterine leiomyosarcomas (LMS) are difficult to distinguish from benign leiomyomas without surgery. In this study we performed transcervical needle biopsy on 475 patients, 8 LMS patients and 467 patients with non-sarcomas (non-LMS) in a high-risk group for LMS, and evaluated whether examinations performed with Ki-67 and CD34 immunohistochemical analyses in addition to the standard hematoxylin-eosin (H&E)-stained sections would improve preoperative diagnostic precision of the uterine smooth muscle tumors. Histopathologic analysis included three factors: degree of cytologic atypia, mitotic index and coagulative tumor cell necrosis (CTCN). We also evaluated cell proliferation with Ki-67 expression. In cases of suspected CTCN, we examined CD34 expression and counted positive blood vessels in the necrotic area. Three of the 8 LMS cases satisfied the diagnostic criteria of LMS by histopathologic evaluation with H&E-stained sections. We made a score list based on these analyses; scores for LMS specimens ranged from 6-14 points; non-LMS specimens scored 0-2 points. At the cut-off score of 6 points, the positive predictive value to distinguish LMS from non-LMS was 100%, showing that this scoring system, is a useful method for preoperative differentiation between LMS and non-LMS tumors.

The handbook of national legislatures: a global survey

1. Introduction 2. Country studies 3. Comprehensive lists of country scores 4. List of expert consultants.

Learning intimate examinations with simulated patients: The evaluation of medical students’ performance

Background: For fifth-year undergraduates of the medical school, a project with simulated patients (Intimate Examination Associates, IEA) was implemented in 2002 at the University of Antwerp. In this project, students from the new curriculum (NC) learned uro-genital, rectal, gynaecological and breast examination in healthy, trained volunteers and received feedback focused on personal attitude, technical and communication skills. Former curriculum (FC) students however trained these skills only during internship in the sixth year after a single training on manikins.Aims: This study assessed the effect of learning intimate examinations with IEAs by comparing students from FC and NC on four different outcome parameters.Methods: Three groups were compared: FC after internships without IEA training, NC after internships with IEA training and fifth year NC immediately after the IEA training. Four assessment instruments: an OSCE using checklists and global rating scales to assess the technical skills, a score list on students attitudes and performance filled in by the IEAs, a student questionnaire on self-assessed competence and a questionnaire on the frequency of performing intimate skills during internships.Results: Both NC groups scored globally better in the OSCE (significance for male examination). Sub-scores for ‘completeness’ and ‘systematic’ approach was significantly higher in both NC groups for male and female examinations. NC students reported better self-assessed competence and performance concerning gynaecological and urological clinical and communication skills during internship. The best results were obtained after IEA training and internship was done for the four outcomes. IEAs are influenced by the ‘experienced’ students after internship: FC and NC after internship both scored better than the fifth year NC who only received the IEA training so far.Conclusion: Learning intimate examinations with IEAs has a positive effect on the performance of medical students. This beneficial effect is on its turn reinforced during internships.

Score lists in [h-k]-bipartite hypertournaments

Let m, n, h and k be integers such that m ≥ h > 1 and n ≥ k > 1. An [h-k]-bipartite hypertournament on m + n vertices is a triple (U, V, E), with two vertex sets U and V, |U| = m, |V| = n, together with an arc set E, a set of (h + k)-tuples of vertices, with exactly h vertices from U and exactly k vertices from V, called arcs, such that for any h-subset U1 of U and k-subset V1 of V, E contains exactly one of the (h + k)! (h + k)-tuples whose h entries belong to U1 and k entries belong to V1. We obtain necessary and sufficient conditions for a pair of nondecreasing sequences of nonnegative integers to be the losing score lists or score lists of some [h-k]-bipartite hypertournament.

Criteria of acceptance in the Saudi program of anesthesia and intensive care

Background:The scientific congress of Anesthesia and Intensive Care of the Saudi Commission for Health Specialties aims to review and improve the guidelines for the selection process of trainees, a selection process that is based on equal opportunity and upholds the principles of consistency, objectiveness, transparency, and procedural fairness. The study represents a step toward the goal of fostering quality patient care, by adopting a selection process that would result in graduating good, committed, and competent specialists.Materials and Methods:Reports of admission examinations in Jeddah, Riyadh, and the Eastern region have been collected, and they contain detailed lists of names, scores, and percentages of the criteria of admissions, that is, MBBS 25%, General Examination 50%, Interview 25%, and overall score of 100%.Results:Mean MBBS scores, average general examination scores, average interview scores, and average overall scores were not statistically different between candidates from different regions. The leading predictor was the ‘Interview Score’. 49.5% of variation in the dependent variable (overall score) could be significantly explained (F = 69.4, P < 0.05) by the independent variable ‘Interview Score’. The second predictor was the ‘MBBS score’.Conclusion:The three components MBBS, General Examination, and Interview, were significant predictors of the overall score. The leading predictor was the ‘Interview Score’. The author recommended that the selection process should be under continuous review. The general interview guide approach is recommended to ensure that the same general areas of information are collected from each interviewer. Questions of a personal or discriminatory nature should be avoided.

Choral Public Domain Library (review)

Choral Public Domain Library. Managed by Rafael Ornes. http://www .cpdl.org/wiki/index.php/Main_Page. (Accessed November-December 2007) [Requires a Web browser and an Internet connection. Down - loading scores may require software dependent on the file format.] The Choral Public Domain Library (CPDL) is a free, Web-based, wiki-style portal dedicated to providing free, legal scores of choral music. Rafael Ornes, minister of music at Valley Presbyterian Church in Portola Valley, California, started CPDL in 1998. The core of the way is collaborative self-governance. With Ornes as the site manager, users contribute the majority of content and are encouraged to report or fix errors as they are detected. In addition to content where copyright has lapsed, composers are welcome to add their own original scores to the database. The goals of the CPDL are well defined: * To make sheet music available for free. * To create a website for public domain music that includes only legally downloadable scores. * To develop a viable collaborative model for sheet music distribution. * To publish scores that are not otherwise commercially viable. * To create a website that catalogs a large number of free sheet music websites. (http://www.cpdl.org/wiki/index.php/ Help:What_is_CPDL_anyway%3F). The interface for CPDL has the look and feel of a Wiki (it is a Wiki, and identifies itself as ChoralWiki in different parts of the database), and requires no special software for searching and browsing, but it has a number of requirements for downloading scores in various formats. The record for each entry is supplied with a legend that identifies in which format the score is available. The legend also indicates other types of files, such as picture files (.GIF) and Midi sound files (.MID). The vast majority of scores are available as .PDF (portable document format) files, which require installation of the free Adobe Acrobat reader. Some scores are uploaded as Sibelius notation files. Files of this type require Scorch, a free utility that allows the user to view, play, and print Sibelius scores from the Internet. Alternatively, users can download the free demo version of the full Sibelius notation program. Other files are submitted as Finale notation files, which require the Finale viewer, or Finale Notepad (Notepad is preferable, as it allows more options for editing, and Finale viewer does not operate under Windows 95). SCORES AND COMPOSERS CATALOG CPDL contains approximately 8,857 score pages, and 1,245 composer pages from over 320 contributors. The site is updated regularly, with new scores being added almost daily. Navigation around the site is intui - tive. The interface is not very slick in design. Its appearance follows the general Wiki model, which has more to do with the concept of uncomplicated collaborative document editing than it does with cosmetic aspects. Information on the main page of the portal is clearly described. Users are given the option to search or, as many users prefer, browse by score or composer. For browsing, each of these two divisions is further divided by subcategories. The score subcategories organize music by genre: sacred music (e.g., Anglican chant, evening canticles, shape notes); secular music (e.g., barbershop, folksongs, villancicos); historic period (e.g., classical, baroque); and number of voices (from unison to 16 parts). There is another subcategory for style of accompaniment (e.g., ensemble, keyboard, orchestra, jazz band), which is largely incomplete. The composer subcategories are grouped by era, and by nationality and ethnicity. There is also a subcategory for women composers, as well as an A-Z listing of all composers. The composer and score lists are also available as PDF documents, with links into the database, but these pages tend to be more outof- date than the more dynamic HTML lists. There are several other browsing options available to users. …

Score lists in (h,k)-bipartite hypertournaments

Given non-negative integers m, n, h and k with m ≥ h > 1 and n ≥ k > 1, an (h, k)-bipartite hypertournament on m + n vertices is a triple (U, V, A), where U and V are two sets of vertices with |U| = n, and |V| = n, and A is a set of (h + k)-tuples of vertices, called arcs, with at most h vertices from U and at most k vertices from V, such that for any h + k subsets U 1 ∪ V 1 of U ∪ V, A contains exactly one of the (h + k)! (h + k)-tuples whose entries belong to U 1 ∪ V 1. Necessary and sufficient conditions for a pair of non-decreasing sequences of non-negative integers to be the losing score lists or score lists of some(h, k)-bipartite hypertournament are obtained.

Neurocognitive Impairment Following Recovery from ADAMTS13-Deficient Thrombotic Thrombocytopenia Purpura (TTP).

Patients who survive an acute episode of TTP often describe persistent problems with concentration, memory and fatigue in spite of continued remission. To assess these symptoms, we performed neuropsychological tests assessing 11 cognitive domains. We hypothesized that domains assessing complex attention/concentration skills and high level memory functions would be affected because these are characteristically abnormal in disorders with diffuse microvascular subcortical lesions. The Oklahoma TTP-HUS Registry enrolled 247 consecutive patients with their first episode of clinically diagnosed TTP from 11-13-1995 (the date of our initial ADAMTS13 measurement) to 6-30-2006; ADAMTS13 activity was measured in 228 (92%) patients immediately before their first plasma exchange treatment; 42 (18%) patients had ADAMTS13 activity <10%; 31 were currently alive; 25 (81%) were included in this study (3 patients were excluded because of dementia, 1 was too young to be evaluated, 1 was incarcerated, 1 was lost to follow-up). 21 (84%) patients were women; 9 (36%) were black; median age was 44 years (range 20–64); median time since their last episode was 46 months (range 2–127). At the time of the evaluation physical examinations and the Mini-Mental State Exams were normal. Median hematocrit was 39% (range 31–51%, 1 women had iron deficiency). Median platelet count was 303 (range 81–518; 1 woman has had persistent mild thrombocytopenia). ADAMTS13 levels remained <10% in 4 patients and were 10–20% in 4 additional patients. Results from the neuropsychological tests were compared to normal population values matched for age and education level and converted to a score with a mean value of 0 and a standard deviation of 1.Neurocognitive test domainPatients mildly impaired*Mean scoreP (score)List learning9 (36%)−0.850.001Manual dexterity10 (40%)−0.650.006Complex attention, sequencing7 (28%)−0.610.003Rapid language generation8 (32%)−0.460.013*Patients were categorized as mildly impaired if they scored ≥ 1 standard deviation below the mean (≤16th percentile).The 25 patients as a group performed significantly worse than the population norms for 4 of the 11 domains. 18 (72%) patients were mildly impaired on 1 or more of these 4 domains; 10 of these patients had no severe neurologic abnormalities (seizure, stroke, coma, focal signs) during their acute episode. These are the 4 domains that are expected to be abnormal in patients with diffuse microvascular subcortical lesions. For the 7 other domains that are expected to be unaffected in these patients, our patients did not perform worse than the normal population: general cognitive functioning, visual perceptual skills, simple sustained attention, simple reaction time, executive function, semantic and visual memory.Conclusions:1.Patients who appear to have a complete recovery from their acute episode of TTP may have persistent neurocognitive abnormalities, causing deficits of attention, processing speed, and memory, slower motor function and fatigue.2.The pattern of neurocognitive abnormalities is similar to patients with other diffuse microvascular or thrombotic abnormalities, such as sickle cell anemia.3.Awareness of these potential problems is important to provide appropriate support.

Score Lists in Tripartite Hypertournaments

Given non-negative integers l, m, n, α, β and γ with l ≥ α ≥ 1, m ≥ β ≥ 1 and n ≥ γ ≥ 1, an [α,β,γ]-tripartite hypertournament on l + m + n vertices is a four tuple (U, V, W, E), where U, V and W are three sets of vertices with |U| = l , |V| = m and |W| = n, and E is a set of (α + β + γ)-tuples of vertices, called arcs, with exactly α vertices from U, exactly β vertices from V,and exactly γ vertices from W, such that any subset U1∪ V1∪ W1 of U∪ V∪ W, E contains exactly one of the (α + β + γ)! (α + β + γ) − tuples whose entries belong to U1∪ V1∪ W1. We obtain necessary and sufficient conditions for three lists of non-negative integers in non-decreasing order to be the losing score lists or score lists of some [α, β, γ]-tripartite hypertournament.

Growing Pains for NIH Grant Review

The grant review system at the National Institutes of Health (NIH), the main mechanism by which NIH identifies research worthy of support, has been through a major overhaul. Scientists who spearheaded the change say it is time to assess how the new system is working.