Significant Differences In Ranking Research Articles

Analytical perception and kinesthetic engagement in evaluation of copper chloride crystallization patterns of wheat, grape juice and rocket samples from conventional, organic and biodynamic cultivation

BackgroundWhen a dihydrate cupric chloride solution is crystallized in a petri dish in the presence of extracts of food products, dendritic crystal patterns emerge. The degree of growth, ripening and decomposition of the product is reflected in these patterns as salient unities (gestalts) of phenomenological features. In the present study we evaluated wheat, grape, and rocket (arugula) samples grown under different farming systems, fertilization treatments or horn silica application. The hypothesis of the present study was: samples are more precisely differentiated with a kinesthetic engagement in the perception of the gestalt decomposition than with ranking solely based on analytical criteria.ResultsIn six out of seven panel tests with three different agricultural products grown with different methods, the following rankings for accelerated decomposability were derived:For wheat: biodynamic < organic < conventional (mineral fertilization and manure) < mineral (mineral fertilization only)For grapes: biodynamic < organic < conventional (mineral fertilization and compost)For rocket (arugula): biodynamic < organic < mineralFor rocket (arugula): with horn silica < without horn silica application.Analytical assessment was compared with kinesthetic priming of the evaluation panel. In six out of seven tests kinesthetic assessments (i) yielded more highly significant differences in ranking between the cultivation methods; (ii) clearly improved matching of the samples in a confusion matrix to the ranking of the cultivation methods; and (iii) generated lower RMSE values.ConclusionsKinesthetic engagement in gestalt evaluation proved superior to an evaluation based on analytical perception. Highly significant differences between biodynamic and organic variants and also between treatments with and without horn silica application were found in six out of seven tests. In five of the six tests the only difference between organic and biodynamic variants was the application of the biodynamic preparations. The results indicate increased resistance to deterioration of the biodynamic variants, in terms of lower degradation in the crystallization images. This prompts additional research to establish whether the crystallization method can serve as a universal test to monitor the stress resistance of plants.Graphical

Application of Copulas to Improve the Modeling of Housing Tenure and Affordability

The tenure statuses made by households (renter-occupancy or owner-occupancy) are influenced by a multitude of factors, some of which cannot be directly measured. However, economists are still interested in knowing the relative severity and patterns of influence these factors have on housing tenure status. The purpose of this research was to determine the effect of assuming joint dependency between housing tenure and affordability on the model results. The effect of model-mis-specification on severity and relative importance of the explanatory variables was also assessed. Joint bivariate binary regression was applied to multi-year cross-sectional General Household Survey (GHS) data from Statistics South Africa (STATSA). An assumption of a univariate model when modeling both housing affordability and tenure led to model mis-specification, because most of the coefficients between the univariate and bivariate joint models were significantly different. Model mis-specification also led to significant differences in rankings of the levels of influence of the explanatory variables. Bivariate joint modeling with appropriate error-model copulas improved the model results. Older households that were above 49 years were consistently more likely to be owner-occupiers, and the household head age variable for older households was the most influential factor for housing owner-occupancy and affordability.

Perspective of uncertainty and risk from the CVaR-LCOE approach: An analysis of the case of PV microgeneration in Minas Gerais, Brazil

This present study proposes to investigate whether the classification based on deterministic LCOE (Levelized Cost of Electricity) for PV microgeneration in twenty cities in Minas Gerais (Brazil) presents differences in relation to risk classification, based on a stochastic approach, namely CVaR-LCOE (Conditional Value at Risk – LCOE). In this stochastic approach, the Conditional Value at Risk (CVaR) is calculated with 99.9% confidence level for 5000 LCOE values for each city, generated by Monte Carlo Simulation. CVaR-LCOE results show a significant difference in ranking in relation to the deterministic approach. Diamantina city presented the best expected LCOE and the best CVaR-LCOE results. However, the cities located in Zona da Mata (Muriaé, Juiz de Fora and Manhuaçu) are the worst in the deterministic ranking, but in CVaR-LCOE approach, Juiz de Fora and Manhuaçu results are better than Ipatinga, Governador Valadares, and Poços de Caldas, this last one which presents the worst CVaR-LCOE. It is also clear that in the CVaR-LCOE ranking, the cities in different regions appear in more shuffle positions in the ranking, the opposite was observed in the deterministic ranking. Cities with the lowest LCOE standard deviation had the best classification changes among the two rankings.

Decision-making system for higher education university selection: comparison of priorities pre- and post-COVID-19

PurposeUniversity selection in higher education is a complex task for aspirants from a decision-making perspective. This study first aims to understand the essential parameters that affect potential students' choice of higher education institutions. It then aims to explore how these parameters or priorities have changed given the impact of the COVID-19 pandemic. Learning about the differences in priorities for university selection pre- and post-COVID-19 pandemic might help higher education institutions focus on relevant parameters in the post-pandemic era.Design/methodology/approachThis study uses a mixed-method approach, with primary and secondary data (university parameters from the website and LinkedIn Insights). We developed a university selector system by scraping LinkedIn education data of various universities and their alumni records. The final decision-making tool was hosted on the web to collect potential students' responses (primary data). Response data were analyzed via a multicriteria decision-making (MCDM) model. Portal-based data collection was conducted twice to understand the differences in university selection priorities pre- and post-COVID-19 pandemic. A one-way MANOVA was performed to find the differences in priorities related to the university decision-making process pre- and post-COVID-19.FindingsThis study considered eight parameters of the university selection process. MANOVA demonstrated a significant change in decision-making priorities of potential students between the pre- and post-COVID-19 phases. Four out of eight parameters showed significant differences in ranking and priority. Respondents made significant changes in their selection criteria on four parameters: cost (went high), ranking (went low), presence of e-learning mode (went high) and student life (went low).Originality/valueThe current COVID-19 pandemic poses many uncertainties for educational institutions in terms of mode of delivery, student experience, campus life and others. The study sheds light on the differences in priorities resulting from the pandemic. It attempts to show how social priorities change over time and influence the choices students make.

Investigating the importance of clinical topics for developing a curriculum on gastroenterology for pediatric residents.

BackgroundFocused objectives provide effective learning. Pediatric residents in Canada follow objectives set by the Royal College of Physicians and Surgeons of Canada (RCPSC) with the goal of becoming competent general pediatricians. During the gastroenterology rotation, it remains unclear as to what clinical problems listed in the aforementioned objectives are crucial to understand as part of general pediatric practice. The purpose of this study was to identify the gastroenterological conditions of most importance to incorporate into a focused curriculum for pediatric residents.MethodsAll pediatricians across four Canadian Atlantic provinces were surveyed by a mailed questionnaire. Questions included demographics and ranking of the 14 clinical problems currently listed in the RCPSC objectives along with six more generated after input was gained from pediatric gastroenterologists.ResultsOf the 234 pediatricians surveyed, 132 (56%) responded, 48% of whom were general pediatricians. Celiac disease, gastroesophageal reflux, and obesity (currently not on the RCPSC list) were identified as important/very important conditions to understand by 94.4%, 96.1%, and 96.0% of respondents, respectively. There were no significant differences in rankings between general pediatricians and subspecialists. A large majority recommended that a rotation in gastroenterology be mandatory during pediatric residency.ConclusionsPediatricians from four Canadian Atlantic provinces recommended a list of gastrointestinal conditions to be included in pediatric residency training. It would be important to consider these recommendations to keep the training curriculum in sync with real world needs.

Patients' Perceptions To Reduced Orthodontic Treatment Time In Saudi Arabia.

PurposeTo evaluate patients’ perceptions regarding orthodontic treatment duration, cost, and willingness to undergo different procedures and techniques available to accelerate orthodontic tooth movement in Saudi Arabia.Patients and methodsA cross-sectional survey was conducted in Saudi Arabia from January to March 2019. Patients from multiple centers were electronically surveyed regarding their perception of orthodontic treatment duration, acceptance of appliances and techniques available to shorten the duration of orthodontic treatment, and how much increase in fees they were willing to pay for those appliances and techniques. Descriptive and group comparison statistics were conducted, and the significance level was set at p<0.05.ResultsThe response rate was 200/400 (50%): 50.5% were (>18–25 years old), 67.5% female, 80% Saudi, 67.5% self-pay and 52% with annual income <10,000 SR. A total of 83% of the participants agree that orthodontic treatment takes too long, and 55.5% wish it takes less than 6 months. The preferences for additional procedures were ranked in the following order: customized wires ranked 1 by 52.5%, followed by FDA (Food & Drug Administration) approved teeth vibrators by 40.5%, FDA approved drug injections by 33.5%, piezocision by 32.5%, and corticotomies by 46% of the participants. No significant differences in ranking between the groups according to age and annual income (p>0.05). 47.5% of the participants were able to pay for additional procedures. An increase in treatment fees was reported for up to (30–40%) for FDA approved teeth vibrators by 59% of the participants, followed by FDA approved drug injections by 33% of the participants. A significant difference in responses between the groups was reported according to gender and annual income (p<0.05).ConclusionMost of the patients strongly agreed that orthodontics treatment takes too long. The highest percentages of patients perceived customized wires as the most acceptable technique to undergo to shorten orthodontic treatment duration, followed by teeth vibrators.

Validity and feasibility of the self-report EQ-5D-Y as a generic Health-Related Quality of Life outcome measure in children and adolescents with Juvenile Idiopathic Arthritis in Western Cape, South Africa.

BackgroundHealth-Related Quality of Life (HRQoL) data together with clinical findings allow for monitoring of intervention efficacy and the effect on HRQoL. Children with Juvenile Idiopathic Arthritis (JIA) experience symptoms often persisting into adulthood, emphasising the need to track HRQoL.ObjectivesThe aim of this study was to investigate psychometric properties of the EuroQol five-dimensional youth questionnaire (EQ-5D-Y) in children with JIA.MethodsA cross-sectional, analytical study design was used. Children 8 to 15 years were recruited, completing the self-report EQ-5D-Y and two other HRQoL questionnaires. Known group validity was established by comparing the effect size between children with different disease severities. Concurrent validity was tested using Kruskal–Wallis to compare the ranking of scores on different questionnaires. Feasibility was assessed by number of missing responses and time to complete each questionnaire.ResultsAll questionnaires were able to distinguish between children with different JIA severity. There was a significant difference in ranking of most Juvenile Arthritis Multidimensional Assessment Report dimension scores across EQ-5D-Y levels, (p < 0.05), indicating concurrent validity. There was poor concurrent validity with the PedsQL dimensions tested with EQ-5D-Y, except for ‘pain’ (p = 0.001). The EQ-5D-Y was the quickest to complete with no missing values.ConclusionThis study showed that the EQ-5D-Y is valid and feasible in measuring HRQoL in JIA children and adequately responsive to detect change over time.Clinical implicationsIt is quick and easy to use in a busy clinical setting, allowing for effective JIA management monitoring.

Disability Weights for Osteoporosis and Osteoporotic Fractures in South Korea.

BackgroundKorea is expected to become an ultra-aged society, in which the elderly population will account for more than 20% of the total population, after 2025. Thus, the social costs due to osteoporotic fractures are expected to increase. Therefore, this study aimed to measure disability weights (DWs) of osteoporosis and osteoporotic fractures in Korea.MethodsThe scenarios were developed to standardize the severity of 6 health statuses: osteoporosis and osteoporotic fractures including wrist, hip, post-hip, vertebral, and post-vertebral fracture. The values for these 6 health statuses were sought via a person trade-off (PTO) approach. We measured the value by PTO and we calculated it to DW of 6 health statuses. Three clinical expertise panels of 33 experts were established, and face-to-face interviews were conducted from July to December 2017.ResultsThe distribution of DW varied by panel. DWs ranged from 0.5 (Osteoporosis) to 0.857 (Hip fracture) for Panel 1, 0.091 (Osteoporosis) to 0.5 (Hip fracture) for Panel 2, and 0.091 (Osteoporosis) to 0.726 (Hip fracture) for Panel 3. The final values for the 6 health statuses obtained by pooling all data from 3 panels ranged from 0.286 (Osteoporosis) to 0.750 (Hip fracture). There was no significant difference in rankings for the 6 health statuses among the 3 panels.ConclusionsComparing the DW of osteoporotic fracture in this study with other diseases in previous studies, it is predicted that osteoporotic fractures, especially hip fractures, will have a considerable burden of disease.

Messaging for Interventions Aiming to Improve Calcium Intake in Young Adults-A Mixed Methods Study.

Social media channels are the preferred communication tools for many young adults and therefore may have applications in health promotion. The framing of messages is important, as an intervention must resonate with the target group. The aim of this study was to determine what type of messaging is preferred by young adults to improve their calcium intake. A cross-sectional web-based survey was conducted and young adults aged 18 to 25 years recruited. A 14-item survey collected information on the participants’ demographics, ranking of text messages, mock Facebook posts with images, preferences related to type of posts they find personally relevant, and frequency and likelihood of engagement with posts and polls in social media. In addition, optional responses from participants about factors that motivate them to consume more calcium-rich foods were included and thematically analysed using NVivo. Eighty-one participants (17 males) completed the survey. No significant difference in ranking of the text messages and Facebook posts were found. Participants indicated that recipe demonstrations (n = 71), cost-saving tips (n = 70), and information on recommended daily intake (n = 62) were personally relevant, while meal inspiration (n = 70), awareness-raising posts (n = 41), and messages about obtaining enough calcium from non-dairy sources (n = 38) would encourage them to eat more calcium-rich foods. The qualitative replies indicated the tone (in young adults’ language) and length (short) of messages preferred, and the messaging they perceived would motivate young adults. In conclusion, short, aesthetically pleasing and personally relevant messages written in the language of young adults were recommended.

Customer Satisfaction Measurement - Clustering Approach

The paper deals with the issue of customer satisfaction measurement. The aim of this study is to determine the importance of the individual factors and their impact on total customer satisfaction for multiple segments by using linear regression and hierarchical clustering. This study is focused on the market of café establishment. We applied hierarchical clustering with Ward’s criterion to partition customers into segments and then we developed linear regression models for each segment. Linear models for partitioned data showed higher coefficient of determination than the model for the whole market. The results revealed that there are quite significant differences in rankings of customer satisfaction factors among the segments. This is caused by the different preferences of customers. The clustered data allows to achieve a higher homogeneity of data within the segment, which is crucial both for marketing theory and practice. The approach i.e. partitioning the market into smaller more specific segments could become perspective for marketing use in different economic sectors. This attitude can allow marketers to target better on customer segments according to the importance of individual factors.

The Role of Receptor Activator of Nuclear Factor Kappa B (RANK) and Receptor Activator of Nuclear Factor Kappa B Ligand (RANKL) in Osteoporosis Risk: Gene Polymorphism and Soluble RANKL Level in Indonesia Post-Menopausal Women

Hormonal changes in postmenopausal women may increase osteoclastogenesis that can lead to increased risk of osteoporosis. Receptor Activator of Nuclear factor Kappa B (RANK) and Receptor Activator of Nuclear factor Kappa B Ligand (RANKL) have an important role in osteoclastogenesis that involve in the regulation of bone resorption. In this study, we analyzed the Single Nucleotide Polymorphism (SNPs) within the RANK/RANKL gene and the associated sRANKL level to assess the risk of osteoporosis in postmenopausal Indonesian women. Research was conducted as case control study that involved 210 postmenopausal Indonesian women. 105 of the women were classified as osteoporosis and 105 as normal. Genetic analysis was performed by PCR-RFLP. BMD was measured by Dual energy X-ray Absorptiometry (DXA) and the RANKL serum level was determined by ELISA. For statistical analysis, Chi-square testing, Kruskal Wallis testing, Mann-Whitney U testing and odds ratio testing were mainly applied, with a significance level of p<0.05. Genotype frequencies of RANK and RANKL polymorphism were compared between osteoporosis and normal group. Statistical analysis showed significant difference between the two group for genetic (p<0.05) and allele (p<0.05) of RANK gene (rs121908659) polymorphism. The elevated odd ratio suggests an increased risk (4.83-folds) to osteoporosis with the genotype CG in compare with genotype GG. No significant difference in RANK (rs1805034) and RANKL (rs9594759) in genotypes and allotypes. Even though there were no significant differences in the RANKL genotype, but we found that CT genotype was protective factor than CC genotypes. sRANKL levels in the RANKL genotype was significantly different (p<0.05), with RANKL level of TT genotype was higher than CC/CT genotype. Genotype and allele frequencies of RANK polymorphism (rs121908659) have been found to be associated with an elevated risk to osteoporosis in postmenopausal Indonesian women. Moreover, polymorphism of RANKL at the SNP location rs9594759 was significantly associated with level of sRANKL.

Smile esthetics: Impact of variations in the vertical and horizontal dimensions of the maxillary lateral incisors.

Objective:The purpose of this study was to determine the perception of trained dental professionals and laypersons toward the esthetic impact of variations in the vertical position, width, and gingival height of the maxillary lateral incisor.Materials and Methods:The present study analyzed the perspective of smile photographs by dental professionals such as “fifty orthodontics and fifty general dental practitioners (GDPs)” as well as fifty laypersons, consisting of an equal number of male and female participants. Photographs edited to depict alteration of golden proportion, incisal length, and gingival height of lateral incisor. SPSS software was used to analyze the data and determine the significant difference within all the participants, at 0.05% level (95% confidence interval).Results:There was no significant difference in ranking between the genders. Golden proportion of 62%–67% were ranked the highest by orthodontists, whereas GDPs and laypersons preferred 67%. Regarding gingival display, corrected height of −0.5 and −1 mm received highest ranking from all the three groups. In case of lateral incisal length, −0.5 mm was ranked highest by laypersons, in contrast to −1 mm by orthodontists and GDPs.Conclusion:Specific differences were observed in the ranking of smile esthetics by health-care professionals and laypersons. Golden proportion of 62% and 67% were ranked the highest by orthodontists, whereas GDPs and laypersons preferred 67%. Corrected gingival height of −0.5 and −1 mm received highest ranking from all the three groups. In case of lateral incisal length, −0.5 mm was ranked highest by laypersons, in contrast to −1 mm by orthodontists and GDPs.

Environmental taxation policy in the EU – new methodology approach

Abstract Main problem addressed in this paper is assessment of quality of current methodologies for expressing environmental tax revenue, since measurements' outcomes have significant influence on the future environmental policies and legislation. The main goal of this paper is to analyze the existing way of measuring financial effects of environmental taxation in EU27 and propose new methodology approach, based on use of ETE – Environmental Taxation Efficiency as a new indicator suggested by authors. The first phase of the study involves the analysis of quality of measuring two existing methodologies (based on the use of GDP and total revenues). In second research stage, the authors apply the newly proposed methodology for determining a composite ETE indicator that, apart from existing indicators, takes into account the environmental taxation effects per capita, as an indicator unjustifiably neglected in previous methods of measuring. Measurement of environmental taxation by using a newly-proposed composite indicator shows significant differences in ranking compared to two current methodologies in use. Only 6 countries showed a very similar rank, regardless of the methodology applied. Differences by more than ten ranking positions were found in 12 countries. The overall results showed significant differences in ranking of all EU-27 countries by using all four indicated methodologies, which clearly points to the conclusion that further improvements are needed. ETE methodology limits predominant role of GDP and introduces a social component which should serve as a basis for further development of a unique methodology for establishing efficient environmental taxation implementation.

Parents of Children with Congenital Heart Disease Prefer More Information than Cardiologists Provide

To determine whether pediatric cardiologists and parents of older children with congenital heart disease (CHD) share similar expectations regarding the education and counseling that should be provided to parents of children with CHD in both the prenatal and neonatal period. Consenting parents of older children with CHD (age >3 years) and cardiologists ranked the importance of education topics on a scale of 1 (unimportant) to 10 (very important). The rankings of parents and cardiologists were compared using Student's t-test. We had 38 cardiologists and 41 parents complete the questionnaire. There was a statistically significant difference in rankings between cardiologist and parents of children with CHD (P<0.03). Parents consistently ranked topics as more important than cardiologists with a mean difference in rank score of 0.85 ±0.3. In the prenatal period, the most significant differences between parents and cardiologists were noted for information related to the child's quality of life. For neonatal counseling, the most significant differences were noted for information regarding follow-up care and the parent's ability to describe the child's CHD to medical personnel. Parents of older children with CHD would prefer to receive more counseling and education in the prenatal and newborn period than cardiologists perceive is wanted.

Paediatricians' perspectives on global health priorities for newborn care in a developing country: a national survey from Nigeria.

BackgroundAn understanding of the perception of paediatricians as key stakeholders in child healthcare delivery and the degree of congruence with current investment priorities is crucial in accelerating progress towards the attainment of global targets for child survival and overall health in developing countries. This study therefore elicited the views of paediatricians on current global priorities for newborn health in Nigeria as possible guide for policy makers.MethodsPaediatric consultants and residents in the country were surveyed nationally between February and March 2011 using a questionnaire requiring the ranking of nine prominent and other neonatal conditions based separately on hospital admissions, mortality, morbidity and disability as well as based on all health indices in order of importance or disease burden. Responses were analysed with Friedman test and differences between subgroups of respondents with Mann-Whitney U test.ResultsValid responses were received from 152 (65.8%) of 231 eligible physicians. Preterm birth/low birthweight ranked highest by all measures except for birth asphyxia which ranked highest for disability. Neonatal jaundice ranked next to sepsis by all measures except for disability and above tetanus except mortality. Preterm birth/low birthweight, birth asphyxia, sepsis, jaundice and meningitis ranked highest by composite measures while jaundice had comparable rating with sepsis. Birth trauma was most frequently cited under other unspecified conditions. There were no significant differences in ranking between consultants and residents except for birth asphyxia in relation to hospital admissions and morbidity as well as sepsis and tetanus in relation to mortality.ConclusionsCurrent global priorities for neonatal survival in Nigeria largely accord with paediatricians’ views except for neonatal jaundice which is commonly subsumed under “other“ or "miscellaneous" neonatal conditions. While the importance of these priority conditions extends beyond mortality thus suggesting the need for a broader conceptualisation of newborn health to reflect the current realities, paediatricians should be actively engaged in advancing the attainment of global priorities for child survival and health in this population.

The Professional Values of Program Directors and Head Athletic Trainers: The Impact of the Hidden Curriculum

Context: Athletic training education programs (ATEPs) promote the development of foundational behaviors of professional practice. Situated in the context of professional values, ATEPs are challenged to identify outcome measures for these behaviors. These values are tacitly reflected as part of the hidden curriculum. Objective: To ascertain the importance of professional values as perceived by program directors and head athletic trainers at professional ATEPs located in the Great Lakes Athletic Trainers' Association (GLATA) district. Design: Cross-sectional survey design. Setting: 77 ATEPs in GLATA and accredited by the Commission on Accreditation of Athletic Training Education (CAATE). Participants: We surveyed a convenience sample of program directors and head athletic trainers from CAATE-accredited ATEPs in GLATA. We partitioned the 146 participants by their professional role: program director (PDs), head athletic trainer (HATs), and program director/head athletic trainer (PD/HATs). Main Outcome Measure(s): We measured differences among PDs, HATs, PD/HATs relative to their unfamiliar values, important values, top three ranked values, and perceived importance with articulating professional values. Results: Altruism and aesthetics were identified as the 2 most frequently unfamiliar values among PDs and HATs, whereas PD/HATs identified 1 value, altruism. Truth/honesty and integrity were the most frequently selected values by PDs and HATs. Truth/honesty and respect were the most frequently selected values by PD/HATs. Truth/honesty was ranked the most important value by HATs and PD/HATs. Truth/honesty and integrity were tied as the number one ranked value by PDs. There was a significant difference in ranking between PD and PD/HAT in regard to the professional values of truth/honesty and integrity. Conclusion: Truth/honesty, integrity, respect, accountability, and caring are important professional values of ATEP PDs, HATs, PD/HATs in GLATA. It is important for the NATA to explicitly articulate professional core values.

The impact of different prognostic models and their customization on institutional comparison of intensive care units*

To evaluate the influence of choice of a prognostic model and the effect of customization of these models on league tables (i.e., rank-order listing) in which intensive care units (ICUs) are ranked by standardized mortality ratios using Acute Physiology and Chronic Health Evaluation (APACHE) II, Simplified Acute Physiology Score (SAPS) II, and Mortality Probability Model II (MPM24II). Retrospective analysis of prospectively collected data on ICU admissions. Forty Dutch ICUs. A data set from a national registry of 86,427 patients from January 2002 to October 2006. The league tables associated with the different models were compared to evaluate their agreement. Bootstrapping was used to quantify the uncertainty in the ranks for ICUs. First, for each ICU the median rank and its 95% confidence interval were identified for each model. Then, for a given pair of models, for each ICU the median difference in rank and its associated 95% confidence interval were computed. A difference in rank for an ICU for a given pair of models was considered relevant if it was statistically significant and if one of the models would categorize this ICU as a performance outlier (excellent performer or very poor performer) while the other did not. For 20 ICUs, there was a significant difference in rank (2-19 positions) between one or more pairs of models. Three ICUs were rated as performance outliers by one of the models, while the other excluded this possibility with 95% certainty. Furthermore, for ten ICUs, one or more pairs of models classified these ICUs as performance outliers while the other model did not do so with certainty. Regarding the agreement between the original models and their customized versions, in all cases the median change in rank was three positions or less and the models fully agreed with respect to which ICUs should be classified as performance outliers. Institutional comparison based on case-mix adjusted league tables is sensitive to the choice of prognostic model but not to customization of these models. League tables should always display the uncertainty associated with institutional ranks.

Comparison of clinical outcome and ease of handling in two double-bag systems in continuous ambulatory peritoneal dialysis: A prospective, randomized, controlled, multicenter study

Background: We performed a prospective, randomized, controlled, multicenter study on the use of two double-bag disconnect systems: Stay-Safe (SS; Fresenius Deutschland GmbH2) and Ultrabag (UB; Baxter Healthcare, Deerfield, IL) to assess the ease of handling, peritonitis rate, exit-site infection rate, and clinical outcome. Methods: We enrolled 110 new continuous ambulatory peritoneal dialysis (CAPD) patients; 55 patients were randomized to SS treatment, and 55 patients, to UB treatment. Results: Patients using the UB and SS systems were followed up for 946 and 846 patient-months, respectively. There were 21 episodes of peritonitis in 18 patients in the UB group and 23 episodes in 18 patients in the SS group. No significant difference was observed in peritonitis rates between the two systems, which were 45 and 36.8 patient-months per episode for the UB and SS groups, respectively. At 12 months, 82.1% of patients in the UB group and 72.1% in the SS group were free of peritonitis; at 18 months, 71.1% and 62.2% were free of peritonitis for the UB and SS groups, respectively (P = 0.559). Gram-positive organisms accounted for 28.6% of infections in the UB group and 39.1% in the SS group. Exit-site infection rates were one episode per 21 patient-months versus 19.2 patient-months in the UB and SS groups, respectively (P = 0.743). Patients perceived SS as easier to handle in 4 of the 13 steps immediately post-CAPD training. However, there was no significant difference in rankings between the two systems after 1 month of adaptation. Median training periods were 4 and 5 days for the SS and UB groups, respectively (P = 0.640). Conclusion: The two double-bag systems (UB and SS) have similar incidences of peritonitis and exit-site infection. Both systems showed comparably good clinical outcome. The SS system is easier to learn during the initial training period, but the difference is not significant after 1 month's adaptation. © 2002 by the National Kidney Foundation, Inc.

Species assemblages of pelagic fish embryos in the southern North Sea between 1984 and 2000

The occurrence and abundance of the pelagic eggs of southern North Sea spring-spawning fish were analysed between 1984 and 2000. Species number varied between six (1986) and 14 (1999) and was positively correlated with sea surface temperature. With one exception, dab eggs were always the most abundant and usually highly dominant. Ranking of species depended on temperature, but no significant differences in ranking between years was discernible. Although with the increase in temperature in the 1990s a change in species assemblage was evident [species belonging to the boreal-Mediterranean (Lusitanian) group became more apparent in the species assemblage] this did not lead to an increased species diversity (Shannon Index) or a change in other community parameters. It appears that the recent developments regarding spawning stock biomass of commercial North Sea fish is reflected in the declining egg abundance of the respective commercial and larger species (i.e. cod, flounder, plaice) and an increase in abundance of the eggs of small species (i.e. long rough dab, rockling) over the years.

The Impact of the Appearance of Beer on its Perception

The appearance of beer influences the perception of its flavour. Three separate studies were performed. Two studies using United States residents comparing beers ranked for different attributes showed that differences in colour, head and levels of lacing impacted the perception of a number of other attributes. Rankings for best to worst poured, best to worst handled, best to worst brewed, best to worst head, most to least stable foam, highest to lowest quality foam, best to worst overall flavour, best to worst overall appearance, and most to least likely to buy all showed significant differences in rankings for both colour and levels of head and lacing. A third study using Scottish participants, comparing beers differing only in levels of head and lacing complements the American findings, suggesting that the appearance of a beer greatly influences consumer perception.