Use Of Additional Criteria Research Articles

Prospective Assessment of mrTRG System Used for Determining the Efficiency of Neoadjuvant Chemoradiotherapy in Patients with Rectal Cancer

Background. Evaluation of the therapeutic effect of neoadjuvant chemoradiotherapy (nCRT) for rectal cancer (RC) is of prognostic value and allows to individually plan the type and extent of further surgical intervention. One of the most promising methods of MRI evaluation is magnetic resonance tumour regression grade (mrTRG) system. However, the reliability and safety of this method must be confirmed by the results of clinical trials and practical application.Objective: to analyze our experience in the prospective use of mrTRG system and evaluate the additional contribution of diffusion-weighted images (DWI) to its diagnostic efficiency.Material and methods. The mrTRG values were determined in 125 (including 30 with DWI) patients with locally advanced RC who received combined treatment with nCRT in Tsyb Medical Radiological Research Centre from 2015 to 2019. The obtained data were compared with the modified pathologic response based on Lushnikov’s definition, and the diagnostic parameters of differentiation of patients responding and nonresponding to nCRT were calculated.Results. When the mrTRG system was used without DWI, the following sensitivity and specificity values as well as positive and negative predictive values were obtained: 75%, 60%, 70% and 67%, respectively, with DWI – 87%, 87%, 87% and 87%, respectively.Conclusion. A prospective evaluation of the result of nCRT using the mrTRG system has moderate accuracy for stratification of patients responding and non-responding to nCRT, which requires the use of additional criteria for MRI scores to select patients who may receive less aggressive surgical treatment. Despite the small number of patients with DWI, we obtained higher values of the diagnostic parameters. In this regard, we consider it appropriate to use DWI when assessing the treatment response.

Does ICT make city compactness higher? Evidences from compact city attributes in Yogyakarta City’s districts.

From discourse to implementation compact urban development has grown rapidly in nearly two decades. In the era of information communication technology use and popularity of smart city concept, inevitably compact city has entered a new phase: Compact City Version 2.0. In Indonesia, the smart city concept is also flourishing in some cities, even though they are still in early stages of exploring some appropriate strategies. This study aims to look at the effect of the use of ICT in the Yogyakarta City’s districts, proven in previous research to be categorized as districts with high compactness, especially on the attributes of density of population, concentration of activities and social welfare. This research continuously examines how far the influence of ICT is able to give effects on making urban compactness higher. Three districts in the city of Yogyakarta generally with high to very high-density score of compactness were taken as objects of this research. Furthermore, the compact city attributes and its indicators were explored in more detail associated with the use of additional criteria, the ICT usage. The result informs that ICT was able to improve performance for a better compactness. Some of the attributes that were previously weak, such as local public transport services and range of public services were capable of being upgraded by the use of ICT. Meanwhile, attributes that had good performance previously also became stronger. This suggests that ICT with various applications that are appropriate for the life of the urban residents significantly help the performance of the city to be more compact. Welcome to the Compact City Version 2.0!

Biological Markers in Older People at Risk of Mobility Limitations

Due to the progressive ageing of the worldwide population, prevention and treatment of late-life dysfunctions, including functional decline and mobility limitations, represent leading targets of scientists and clinicians, but are also receiving growing attention from governments and healthcare systems. The early identification of elderly patients more prone to physical decline represents a crucial step for establishing preventive measures. Although functional capacity can easily be assessed, the use of additional criteria that anticipate the onset of mobility limitations seems much more advantageous. The most challenging issues in the identification of biological markers for assessing the risk of functional decline in the elderly originates from the complex and multifaceted pathogenesis of sarcopenia and the resulting physiological decrement, so that bridging the gap between basic research and clinical practice may appear intricate. Nevertheless, several lines of evidence now confirm the existence of negative associations between functional mobility and values of hemoglobin, total and HDL-cholesterol, vitamin D, testosterone, adiponectin and antioxidants such carotenoids, vitamin C and E, selenium and magnesium, whereas positive associations have been reported with the values of uric acid, white blood cells, plasma and blood viscosity, erythrocyte sedimentation rate (ESR), triglycerides, homocysteine, plasma glucose, glycated hemoglobin (HbA1c), markers of renal functions (i.e., creatine and cystatin C), insulin-like growth factor-1 (IGF-1), as well as several inflammatory (e.g., C reactive protein, Intereleukin-6, Interleukin- 1 receptor antagonist), hemostatic (e.g., fibrinogen, Von Willebrand Factor, factors VIII and IX) and oxidative (oxidized lipoproteins, 8-oxo-7,8-2'-deoxyguanosine, protein carbonylation) biomarkers. In the foreseeable future, proteomic studies might predictably help identify novel associations between putative biomarkers and functional decline.

Predicting Credit Risks Using Sustainability Criteria Into Credit Risk Management

Many researchers have reported that there is a correlation between a company's environmental performances with its financial performance. The role of criteria pertaining to sustainability and environmental orientation could play important roles in credit risk management process. The sustainability criteria can be used to predict financial performance of a debtor and, thus, improve predictive ability of a credit rating process. This article tests the relationship by using three sustainability measures as independent variables and traditional rating as dependent variable in a stepwise regression model. The result shows improvement in prediction. However, the use of additional criteria will increase cost in the prediction process. Further cost-benefit analysis related to the addition of those criteria would be valuable for credit risk management practices.

Application of a design code for estimating fouling on-line in a power plant condenser cooled by seawater

A study of the data that allows us to carry out heat balances as well as other important data needed to estimate fouling evolution for a seawater refrigerated condenser in a 550 MW power plant is presented. The data was collected during several months and subsequently analyzed. The goal was to test the utilization and reliability of indirect methods, such as those proposed by The Standards for Steam Surface Condensers (SSSC), to estimate fouling by means of the cleanliness factor in a condenser cooled by seawater. A review of the working conditions of the power plant was carried out, as well as of the conditions prescribed by manufacturers for the condenser evaluations. Most of the conditions were maintained to select the points or the times to be analyzed for the on-line evaluation of the cleanliness factor. The use of additional criteria for point selection was analyzed. These criteria are useful in order to obtain a clearer representation of the evolution of the cleanliness factor.

One-month prevalence of depression and other DSM-IV disorders among young adults.

We aimed to provide prevalence data on depression and other current mental disorders, impairment, need of psychiatric care and use of mental health services among young adults. Based on a semi-structured clinical interview, current DSM-IV disorders, impairment, need of psychiatric care and use of mental health services were evaluated in a sample of 20-24-year-old young urban adults (N = 245), mean age 21.8, screened from a baseline population of 706. One-month prevalence estimates for disorders were calculated by the double sampling method, using various additional criteria to identify cases. One in four young adults (23.8%) suffered from a current mental disorder, the most prevalent being depressive (10.8%), anxiety (6.9%), substance use (6.2%) and personality disorders (6.0%). Prevalence estimates varied substantially according to the use of additional diagnostic criteria. Impairment (GAF < 61) together with DSM-IV symptom criteria produced an overall disorder prevalence of 10.3%, and 5.5% for depression. Prevalences were higher for females than males, except for alcohol abuse and personality disorders. Current co-morbidity was found in 39% of subjects with any disorder, and in more than half of those with depression. One-third of subjects with a current disorder reported an associated contact with psychiatric services and 16% had an ongoing contact. Our findings support the use of additional criteria to produce clinically relevant prevalence data. Co-morbidity should receive special attention due to its amplification of both need for psychiatric care and severity of impairment. Finally, our results show disturbed young adults to be severely undertreated.

What features improve the accuracy of clinical diagnosis in Parkinson's disease: a clinicopathologic study.

Many authorities have drawn attention to the difficulties in clinically distinguishing Parkinson's disease (PD) from other parkinsonian syndromes. We assessed the clinical features of 100 patients diagnosed prospectively by a group of consultant neurologists as having idiopathic PD according to their pathologic findings. Seventy-six percent of these cases were confirmed to have PD. By using selected criteria (asymmetrical onset, no atypical features, and no possible etiology for another parkinsonian syndrome) the proportion of true PD cases identified was increased to 93%, but 32% of pathologically confirmed cases were rejected on this basis. These observations suggest that studies based on consultant diagnosis of PD, using standard diagnostic criteria, will include cases other than PD, thus distorting results from clinical trials and epidemiologic studies. The strict use of additional criteria can reduce misdiagnosis but at the cost of excluding genuine PD cases.

Are Lectures Necessary?

A mid much concern about need for change in jHL higher education (e.g., Goulet, 1968) a major source of friction between students and the establish ment seems to derive from fact that our society is committed to a goal of mass education while many stu dents want individual contact with faculty members. It seems apparent that these joint goals cannot be achieved by relying on educational practices such as lec ture, which exist today for largely irrelevant reasons. As a form of information dissemination, lectures may be appropriate for presenting material which is not avail able in written form, or for material to be presented only once, and hence not worth publishing. Neither of these conditions holds for most of undergraduate education. Yet remains. It has not been shown to be inferior. Many studies of variations in teaching tech niques support a general conclusion that there is no measurable difference among methods of teaching when evaluated by one criterion of student performance on final examinations. (Dubin and Taveggia, 1968, p. 35). A possible exception to this conclusion may exist in ?instruction procedures described by Keller (1968), but even here, examination data were focal criteria. Without downgrading content in any way, one can make a case for use of additional criteria in evalu ating teaching procedures (e.g. Rogers, 1969). The present study was designed to investigate several meth ods of instruction using as criteria examination per formance, voluntary attendance, and students' evaluative ratings and by considering relationships among these criterion variables. Subjects were all regularly scheduled students en rolled in undergraduate Abnormal Psychology course taught by author during four consecutive quarters excluding summer quarter. The sample sizes for each quarter are given below, and are based on number of students taking midterm examination. Each quarter a limit of 75 students was set by in structor, but up to 15 of students closed out of course who were seniors were permitted to enroll. In no quarter did as many as 15 such students petition to en roll. In each quarter a few students dropped course after having been enrolled. The study contained four treatment conditions, each consisting of procedures used during a particular one quarter undergraduate course in Abnormal Psychology. According to formal description of course, there were to be 2 one-hour periods per week plus a one-hour recitation period. Recitations were conducted in several groups of 15-20 students, each meeting once a week with a post-internship level graduate student in clinical psychology. The recitation sections were con ducted according to desires of their individual in structors, consistent with goals of part of course, but not dictated by those goals. Grades for recitation were sole responsibility of recitation instructor and constituted one-fourth of course grade. The procedures described in present paper refer only to part of course. In first two quarters (A and B), course was taught accord ing to a standard format. The instructor lectured from notes and answered questions when asked. Though questions arose in essentially every period, focus of class meetings was clearly on lecture, and student participation in course was largely pas sive, or elicited (e.g., Rogers, 1969, p. 35). In these two quarters conditions which were to be used in subsequent two quarters (C and D) were not generated until after midterm examination of quarter A. During second lecture quarter (B), then, E had formulated conditions to follow, and even though every effort was made to present a nor mal course, bias was obviously possible. Bias was less likely in quarter A, particularly prior to midterm exam. After midterm, E was beginning to formulate possible alternatives to format of course, although procedures that did evolve had not yet been developed. The two experimental quarters (C and D) in volved use of typed notes. The notes from which all lectures had been taken were put into sentence and para graph form, were typed, and were reproduced for dis tribution to students. A resulting handout consisted of 76 double spaced typed pages. In first handout quarter (C), notes were distributed on a by basis. The students arrived at regular sched uled class hour, just as in format. However, immediately upon arrival, notes for that period were distributed. The instructor remained in class for remainder of hour, and would answer any questions any student had about assigned read ing materials or any materials that had been dis tributed. He would discuss with students anything they wished to discuss, but did not himself initiate topics for discussion. This procedure was designed to parallel usual format as closely as possible, with ex 253

Computer analysis of the orthogonal electrocardiogram in pulmonary emphysema

Orthogonal electrocardiograms (Frank system) were recorded from 405 patients with pulmonary emphysema of moderate and severe degree. The diagnosis was based on clinical and radiologic or pulmonary function studies, or both, according to uniform study protocols. Of 333 electrocardiographic measurements computed from each record, different sets of diagnostic criteria were selected for optimal separation of records of patients with pulmonary emphysema from those of normal subjects, using a variety of statistical techniques. The first set consisted of five scalar and vector measurements which can be easily obtained and which do not require access to computer facilities. With these criteria, 80 percent of the records of patients with pulmonary emphysema could be correctly classified, with a false positive rate of 11 percent. With a second set of 14 more complex measurements intended for computer use, 81 percent of pulmonary emphysema tracings were classified correctly, with a reduction in false positives to 5 percent. With the use of additional criteria, a series of 140 records from patients with right ventricular hypertrophy due to pure mitral stenosis could be differentiated from records of patients with pulmonary emphysema in 80 percent of cases. Reduction of the R wave and the R:S ratio in lead X proved to be the best discriminators between records of normal subjects and those of patients with pulmonary emphysema. Correlations with arterial pCO 2 showed progression of R x changes, a QRS shift in a superior direction and a rightward shift of the P wave as the best indicators of deteriorating pulmonary function. Classification procedures were tested on independent record samples including 1 sample of 22 autopsy cases of pulmonary emphysema. Results were nearly identical. They exceeded those reported in the literature, which may be attributed to the use of more reliable electrocardiographic leads and to application of more efficient multivariate classification procedures.