Whitney Rank Sum Test Research Articles

Preconceptional factors associated with haemoglobin concentration in early pregnancy: a community-based cohort study in rural northeastern Tanzania.

Maternal anaemia in early pregnancy is associated with poor pregnancy outcomes. Furthermore, preconceptional health can influence the health during pregnancy. The aim of this study was to investigate which preconceptional factors were associated with haemoglobin (Hb) concentration in early pregnancy. In Tanzania, 226 women were followed at preconception and during early pregnancy. Red blood cell (RBC) morphology, serum micronutrient concentration, demographic characteristics and health status were assessed in preconception and in early pregnancy. The association between preconceptional factors and Hb concentration in early pregnancy was investigated using simple and multiple linear regression analyses stratified by preconceptional anaemia status. Mean Hb was 123 and 119g/l before conception and during early pregnancy (median gestational age 53days) respectively. Preconceptional mid-upper arm circumference (MUAC) (adjusted coefficient (AC) 0.35 95% CI 0.9-0.61) and preconceptional Hb concentration (AC 0.45 95% CI 0.36-0.54) were positively associated with early pregnancy Hb concentration, whereas preconceptional microcytic hypochromic RBC morphology (AC -6.00 95% CI -9.56 to -2.44) was negatively associated with early pregnancy Hb concentration. In addition, treatment of preconceptional malaria was positively associated with early pregnancy Hb concentration (AC 6.45 95% CI 0.74-12.2) among women with preconceptional anaemia. In contrast, among preconceptional non-anaemic women, only preconceptional Hb concentration and medium socio-economic status was positively associated with early pregnancy Hb concentration. Mid-upper arm circumference (MUAC) and Hb measurements in preconception can help to detect women at increased risk of low Hb concentration in early pregnancy.

Lifestyle intervention for gastroesophageal reflux disease: a national multicenter survey of lifestyle factor effects on gastroesophageal reflux disease in China.

Background:Poor habits can worsen gastroesophageal reflux disease (GERD) and reduce treatment efficacy. Few large-scale studies have examined lifestyle influences, particularly eating habits, on GERD in China, and research related to eating quickly, hyperphagia, and eating hot foods is quite limited. The aim of this study was to evaluate the relationship between GERD pathogenesis and lifestyle factors to produce useful information for the development of a clinical reference guide through a national multicenter survey in China.Methods:Symptom and lifestyle/habit questionnaires included 19 items were designed. The questionnaire results were subjected to correlation analysis relative to GERD symptom onset. A standard proton pump inhibitor (PPI) was advised to correct patients with unhealthful lifestyle habits.Results:A total of 1518 subjects (832 GERD, 686 non-GERD) enrolled from six Chinese hospitals completed symptom and lifestyle/habit questionnaires. The top lifestyle factors related to GERD were fast eating, eating beyond fullness, and preference for spicy food. Univariate analysis showed that 21 factors, including male gender, a supra-normal body mass index (BMI), smoking, drinking alcohol, fast eating, eating beyond fullness, eating very hot foods, and drinking soup, among others, were associated with GERD (p < 0.05). Logistic multivariate regression analysis revealed the following risk factors for GERD [with odds ratios (ORs)]: fast eating (4.058), eating beyond fullness (2.849), wearing girdles or corsets (2.187), eating very hot foods (1.811), high BMI (1.805), lying down soon after eating (1.544), and smoking (1.521). Adjuvant lifestyle interventions improved outcomes over medication alone (z = –8.578, p < 0.001 Mann–Whitney rank sum test).Conclusions:Lifestyle interventions can improve medication efficacy in GERD patients. Numerous habits, including fast eating, eating beyond fullness, and eating very hot foods, were associated with GERD pathogenesis. The present results may be useful as a reference for preventive education and treatment.

Teacher autonomy and responsibility variation and association with student performance in Didaktik and curriculum traditions

ABSTRACTThe primary objective of the study was to empirically test theoretical claims made about differences between Didaktik and curriculum traditions concerning teacher autonomy (TA) and teacher responsibility (TR). It tests the hypothesis that TA and TR are higher among Didaktik than curriculum countries. The second objective was to explore associations of TA and responsibility measures with students’ science performance? Nationally representative data from 2009 Programme for International Student Assessment (PISA), collected through a two-step random selection process were used. For TA individual items Mann–Whitney rank-sum test was employed, while a difference of proportion test was used for TR items to examine the differences. Hierarchical linear modelling (HLM) was used to examine association of TA and TR items with students’ science performance in PISA 2009. Overall and contrary to the initial hypothesis, teachers in curriculum countries enjoy both more autonomy and responsibility than teachers in Didaktik countries, but differences were substantively weak. Furthermore, within-country associations of autonomy and responsibility measures with students’ science performance were found in a few countries. Further research is recommended to address TA and responsibility and complexities that accompany them in current stakeholder-crowded school contexts.

CT texture features are associated with overall survival in pancreatic ductal adenocarcinoma \u2013 a quantitative analysis

BackgroundTo assess whether CT-derived texture features predict survival in patients undergoing resection for pancreatic ductal adenocarcinoma (PDAC).MethodsThirty patients with pre-operative CT from 2007 to 2012 for PDAC were included. Tumor size and five texture features namely uniformity, entropy, dissimilarity, correlation, and inverse difference normalized were calculated. Mann–Whitney rank sum test was used to compare tumor with normal pancreas. Receiver operating characteristics (ROC) analysis, Cox regression and Kaplan-Meier tests were used to assess association of texture features with overall survival (OS).ResultsUniformity (p < 0.001), entropy (p = 0.009), correlation (p < 0.001), and mean intensity (p < 0.001) were significantly different in tumor regions compared to normal pancreas. Tumor dissimilarity (p = 0.045) and inverse difference normalized (p = 0.046) were associated with OS whereas tumor intensity (p = 0.366), tumor size (p = 0.611) and other textural features including uniformity (p = 0.334), entropy (p = 0.330) and correlation (p = 0.068) were not associated with OS.ConclusionCT-derived PDAC texture features of dissimilarity and inverse difference normalized are promising prognostic imaging biomarkers of OS for patients undergoing curative intent surgical resection.

A "placement of death" approach for studies of treatment effects on ICU length of stay.

Length of stay in the intensive care unit (ICU) is a common outcome measure in randomized trials of ICU interventions. Because many patients die in the ICU, it is difficult to disentangle treatment effects on length of stay from effects on mortality; conventional analyses depend on assumptions that are often unstated and hard to interpret or check. We adapt a proposal from Rosenbaum that addresses concerns about selection bias and makes its assumptions explicit. A composite outcome is constructed that equals ICU length of stay if the patient was discharged alive and indicates death otherwise. Given any preference ordering that compares death with possible lengths of stay, we can estimate the intervention's effects on the composite outcome distribution. Sensitivity analyses can show results for different preference orderings. We discuss methods for constructing approximate confidence intervals for treatment effects on quantiles of the outcome distribution or on proportions of patients with outcomes preferable to various cutoffs. Strengths and weaknesses of possible primary significance tests (including the Wilcoxon-Mann-Whitney rank sum test and a heteroskedasticity-robust variant due to Brunner and Munzel) are reviewed. An illustrative example reanalyzes a randomized trial of an ICU staffing intervention.

P034 Detection of soluble HLA antigens (sHLA) in blood for early detection of non-small cell lung carcinoma (NSCLC)

Aim Non-small and small cell lung cancer (NSCLC and SCLC) is the leading cause of cancer-related deaths worldwide. Early detection and appropriate intervention are critical for successful treatment. Current screening methods cannot clearly distinguish between benign and malignant nodules. The human histocompatibility antigens (HLA), which control the immune response, can be crucial in escape from tumor immune surveillance resulting in tumor progression and metastasis. Increased HLA levels in circulation of cancer patients have been detected in the past. Therefore, the aim was to determine circulating HLA antigens could serve as potential biomarkers to distinguish between benign and malignant lung cancer nodules. Methods HLA class I (ABC) and class II (DRB1 and DQ) antigen levels were analyzed in cell lines and conditioned media of epithelial H358 and mesenchymal H1703. Then, serum samples from 25 patients with benign nodules (non-invasive cells) and 25 patients with malignant nodule (Stage I NSCLC-with invasive cells) were analyzed for HLA-class I (ABC), HLA-class II (DRB1, DQA1, DQ, DMB) antigens in their serum. Equal amounts of total proteins from each group were used for comparison of HLA antigen levels. Western Blot with Chemiluminiscence detection system was used for evaluating HLA antigen levels in samples. Results A significantly higher level of HLA class I antigens was observed in conditioned medium from the invasive cell line compared to conditioned medium from non-invasive cell line ( p p Conclusion In-vitro studies using non-invasive and invasive cell lines showed significantly increased levels of HLA-class I in conditioned medium obtained from the invasive cell line compared to the non-invasive cell line. The Mann–Whitney Rank Sum Test showed significant differences in the serum levels of HLA-ABC, DQA1, HLA-DQ, HLA-DRB1, HLA-DMB, between patients with benign nodule and Stage I NSCLC patients. These preliminary data suggest that levels of HLA class I and class II antigens could act as potential biomarkers to diagnose early stages of NSCLC.

Age over 55 Years at Diagnosis Increases Risk of Second Malignancies after Auto-Transplantation for Hodgkin's Lymphoma Patients

Introduction: Age at diagnosis is of prognostic value in Hodgkin's lymphoma (HL) patients. However, there is paucity of data on the impact of age on outcomes of autologous hematopoietic transplantation (auto-HCT) for patients with relapsed and refractory HL. We studied impact of age at diagnosis on long-term outcomes of patients with HL undergoing auto-HCT.Patients and Methods: All consecutive patients with relapsed/refractory HL who underwent auto-HCT at our center between January 1996 and December 2010 were included. Baseline patient and disease characteristics were collected. As HL has bimodal peak incidence betweenages of 15 and 34 years and over age of 50 to 55 years, we stratified patients into 3 groups: > 55, 26 to 55 years, and ≤ 25 year age groups. We compared overall survival (OS), progression free survival (PFS), relapse rate and rates of secondary malignancies between these groups. As the outcomes were similar between ≤ 25 and 26 to 55 years groups, subsequent analysis of these two groups was done together as ≤ 55 years vs. > 55 years groups. Baseline patient and disease-related characteristics were compared using the chi-square test for categorical variables and Mann Whitney's rank-sum test for continuous variables. Actuarial OS was estimated using the Kaplan-Meier method. Prognostic factors for OS, disease progression and non-relapse mortality (NRM) were assessed on univariate and multivariate analyses using Cox proportional hazards regression analysis.Results: 30 (9.7%) patients were > 55, 168 (54.1%) patients were between 26 to 55, and 112 (36.1%) were ≤ 25 years of age. At a median follow-up of 80 months, patients > 55 were at significantly higher risk for mortality with hazard ratio (HR) of 2.3 (95% CI, 1.3-4.2; P = 0.007) compared to patients ≤25 years of age. There was no difference in mortality when between age 26 to 55 years and ≤ 25 years group (HR 1.0; 95% CI, 0.6-1.6; P = 0.9). Risk for progression was similar between the 3 groups, with HRs of 1.3 (95% CI, 0.7-1.5; P = 0.5) and 1.2 (95% CI, 0.8-1.8; P = 0.3) for > 55 group and 26 to 55 groups, respectively compared to ≤ 25 years group (Table 1). Patients > 55 years at diagnosis had significantly higher incidence of secondary malignancies mostly MDS/AML(30% vs. 8%; P<0.001) than patients ≤ 55 years (Figures 1) leading to higher NRM. Prior radiation therapy, time from initial diagnosis to transplant and number of prior therapies did not impact risk for second malignancies.Conclusion: Patients >55 years at diagnosis who receive auto-HCT for relapsed/refractory HL experience higher mortality from secondary malignancies.Table 1Outcomes of Auto-HCT at Median Follow-Up of 80 MonthsOutcomesEntire Cohort> 55 yearsN = 30≤ 55 yearsN = 280P valueOS65% (59-71)27% (9-49)69% (63-74)0.003PFS54% (48-60)31% (12-53)56% (50-62)0.2CI of progression41% (26-64)52% (36-75)37% (32-44)0.7CI of NRM8% (5-12)33% (16-65)5% (3-9)0.001CI of second malignancy11% (7-16)30% (16-57)8% (5-14)< 0.001CI of second malignancy excluding skin cancers9% (6-13)22% (10-49)7% (4-12)0.003SHAPEP=0.001P <0.001 [Display omitted] DisclosuresFanale:Merck: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; BMS: Research Funding; Celgene: Honoraria, Membership on an entity's Board of Directors or advisory committees, Research Funding; Takeda: Honoraria, Research Funding; Infinity: Membership on an entity's Board of Directors or advisory committees; Spectrum: Membership on an entity's Board of Directors or advisory committees; Seattle Genetics: Honoraria, Research Funding; Genentech: Research Funding; Medimmune: Research Funding; Novartis: Research Funding; Bayer: Membership on an entity's Board of Directors or advisory committees; Amgen: Membership on an entity's Board of Directors or advisory committees; Molecular Templates: Research Funding; ADC Therapeutics: Research Funding; Onyx: Research Funding; Gilead: Research Funding.

Solid Microneedles for Transdermal Delivery of Amantadine Hydrochloride and Pramipexole Dihydrochloride.

The aim of this project was to study the influence of microneedles on transdermal delivery of amantadine hydrochloride and pramipexole dihydrochloride across porcine ear skin in vitro. Microchannel visualization studies were carried out and characterization of the microchannel depth was performed using confocal laser scanning microscopy (CLSM) to demonstrate microchannel formation following microneedle roller application. We also report, for the first time, the use of TA.XT Plus Texture Analyzer to characterize burst force in pig skin for transdermal drug delivery experiments. This is the force required to rupture pig skin. The mean passive flux of amantadine hydrochloride, determined using a developed LC–MS/MS technique, was 22.38 ± 4.73 µg/cm2/h, while the mean flux following the use of a stainless steel microneedle roller was 49.04 ± 19.77 µg/cm2/h. The mean passive flux of pramipexole dihydrochloride was 134.83 ± 13.66 µg/cm2/h, while the flux following the use of a stainless steel microneedle roller was 134.04 ± 0.98 µg/cm2/h. For both drugs, the difference in flux values following the use of solid stainless steel microneedle roller was not statistically significantly (p > 0.05). Statistical analysis was carried out using the Mann–Whitney Rank sum test.

Thyroid Hormone and Thyrotropin Concentrations and Responses to Thyrotropin Releasing Hormone in Ageing Horses

Reasons for performing studyThyroid hormones (THs) decrease with age in healthy dogs and cats, although they tend to remain within established reference ranges. Thyrotropin (TSH) is increased in elderly people, with or without mild alterations in THs.ObjectivesTo test the hypothesis that geriatric horses will have lower THs and/or higher TSH compared with younger horses.Study designCross‐sectional study.MethodsResting THs and TSH, and responses to thyrotropin releasing hormone (TRH) were compared between young and old horses. Data from 71 normal, healthy horses that had participated in prior research projects were examined, and found to contain 42 horses 3–10 years of age, 16 horses &gt;15 years and 10 horses &gt;20 years. All samples had been assayed in the same previously validated radioimmunoassays. Statistical analysis was performed with commercial software.ResultsAlthough lower, THs were not significantly different between young and old horses when compared with the Mann–Whitney rank sum test. However, TSH concentration was significantly higher in horses aged &gt;20 (median 0.52 ng/ml) or &gt;15 years (0.44 ng/ml) compared to younger horses (0.33 ng/ml). TRH stimulation tests were performed in 19 of the younger horses, 7 of the horses &gt;20, and 11 of the horses &gt;15. Two‐way repeated measures ANOVA on ranks revealed no significant differences in TH responses to TRH. The TSH response to TRH appeared to be slightly greater in the older horses, but did not quite reach significance (P = 0.06).ConclusionSimilar to reports in elderly humans, aged horses have higher serum TSH concentrations than younger horses.Ethical animal research: All horses in this study were part of a NCSU IACUC approved study. Owners gave informed consent for their horses' inclusion in the study. Sources of funding: College of Veterinary Medicine North Carolina State University, USA Equestrian. Competing interests: None declared.

Preliminary field study of soil TKN in a wastewater land application system

Abstract An accurate nitrogen mass balance is necessary when designing a municipal wastewater land application system in order to reduce the potential for nitrogen contamination of groundwater. Limited information on soil total Kjehldahl nitrogen (TKN) is available to estimate the TKN variance in the soil that can be used for calculating the nitrogen mass balance. This study investigated the soil TKN temporal variance at two different depth ranges within three different soil types irrigated with municipal wastewater effluent in a short-term at a long-term running site under field conditions. Three plots were chosen with each plot growing different plants and with different soil types in Lubbock, Texas, USA. Kruskal–Wallis one way analysis of variance on ranks and Mann–Whitney rank sum test were employed to compare the differences of medians of many groups of data and of two groups of data at p

Chronic neurokinin-1 receptor antagonism fails to ameliorate clinical signs, airway hyper-responsiveness or airway eosinophilia in an experimental model of feline asthma.

Feline allergic asthma is a common chronic lower airway disease characterized by clinical signs attributed to eosinophilic inflammation, airway hyper-responsiveness (AHR) and airway remodeling. Tachykinins released from sensory nerves and immune cells bind neurokinin-1 (NK-1) receptors in the lung. The resultant neurogenic airway inflammation has been implicated in asthma pathogenesis. In mouse models and spontaneous human asthma, NK receptor antagonists reduce bronchospasm and inflammation. We hypothesized that chronic administration of maropitant, an NK-1 receptor antagonist, would decrease clinical signs of asthma, AHR and eosinophilic inflammation in experimentally asthmatic cats. Cats (n = 6) induced to have asthma using Bermuda grass allergen (BGA) were enrolled in a randomized, prospective, placebo-controlled crossover design study. Cats received either oral maropitant (2 mg/kg) or placebo q48h for 4 weeks; following a 2 week washout, cats were crossed-over to the alternate treatment. Study endpoints included subjective clinical scoring systems after BGA challenge, ventilator-acquired pulmonary mechanics to assess AHR after bronchoprovocation with methacholine, and collection of bronchoalveolar lavage fluid to quantify airway eosinophilia. Statistical analysis was performed using a Mann-Whitney rank sum test with P <0.05 considered significant. Administration of maropitant for 1 month in experimentally asthmatic cats produced no significant difference in clinical scoring scheme (P = 0.589 and P = 1.0), AHR (P = 0.818) or airway eosinophilia (P = 0.669) compared with placebo. Chronic administration of maropitant was ineffective at blunting clinical signs, AHR and airway eosinophilia in experimental feline asthma and thus cannot be recommended as a novel treatment for this disorder.

OC19.06: The psychological effects and patient acceptability of a test to predict viability in early pregnancy: a prospective randomised study

Objective: To establish if women obtain any measurable short term psychological benefit or perceived benefit from having a test to determine the probability of their pregnancy being on-going when this is uncertain on ultrasound examination. Study design: This was a prospective randomised controlled study conducted January 2012–June 2012 at the EPU of King’s College Hospital. The study population was women who conceived spontaneously and had a single intrauterine gestational sac of <20 mm mean diameter, with no visible embryo on their first ultrasound scan. Eligible women were randomised to have a test to calculate the probability of viability (cases) or not (controls). Depression and anxiety levels were calculated using the Hospital Anxiety and Depression Score (HADS) and were performed prior to randomisation and seven days later. A repeat scan for pregnancy outcome was performed after one to two weeks as clinically indicated. A sample size of 69 in each group was calculated to have 80% power to detect a probability of 0.362 that an observation in the cases was less than an observation in controls using a Wilcoxon Mann–Whitney rank-sum test with a 0.05 two-sided significance. Results: At recruitment there was no significant difference in anxiety levels between cases and controls. After seven days anxiety levels were significantly lower in cases than controls (p = 0.04). Of those who received the probability score, 55/70 (78.6% 95% CI 67.5–86.7%) found it useful and 58/70 (82.9% 95% CI 72.2–90.1) would choose to have the test in a future pregnancy if indicated. Conclusions: This study has demonstrated that there is evidence of psychological benefit from a simple blood test that gives women the likelihood that their pregnancy will be on-going at the next scan.

Assesment of perfusion in glial tumors with arterial spin labeling; comparison with dynamic susceptibility contrast method

PurposeArterial spin labeling perfusion imaging (ASL-PI) is a non-invasive perfusion imaging method that can be used for evaluation and quantification of cerebral blood flow (CBF). Aim of our study was to evaluating the efficiency of ASL in histopathological grade estimation of glial tumors and comparing findings with dynamic susceptibility contrast perfusion imaging (DSC-PI) method. MethodsThis study involved 33 patients (20 high-grade and 13 low-grade gliomas). Multiphase multislice pulsed ASL MRI sequence and a first-passage gadopentetate dimeglumine T2*-weighted gradient-echo single-shot echo-planar sequence were acquired for all the patients. For each patient, perfusion relative signal intensity (rSI), CBF and relative CBF (rCBF) on ASL-PI and relative cerebral blood volume (rCBV) and relative cerebral blood flow (rCBF) values on DSC-PI were determined. The relative signal intensity of each tumor was determined as the maximal SI within the tumor divided by SI within symetric region in the contralateral hemisphere on ASL-PI. rCBV and rCBF were calculated by deconvolution of an arterial input function. Relative values of the lesions were obtained by dividing the values to the normal appearing symmetric region on the contralateral hemisphere. For statistical analysis, Mann–Whitney ranksum test was carried out. Receiver operating characteristic curve (ROC) analysis was performed to assess the relationship between the rCBF-ASL, rSI-ASL, rCBV and rCBF ratios and grade of gliomas. Their cut-off values permitting best discrimination was calculated. The correlation between rCBV, rCBF, rSI-ASL and rCBF-ASL and glioma grade was assessed using Spearman correlation analysis. ResultsThere was a statistically significant difference between low and high-grade tumors for all parameters. Correlation analyses revealed significant positive correlations between rCBV and rCBF-ASL (r=0.81, p<0.001). However correlation between rCBF and rCBF-ASL was weaker (r=0.64, p<0.001). ConclusionArterial spin labeling is an employable imaging technique for evaluating tumor perfusion non-invasively and may be useful in differentiating high and low grade gliomas.

乙型肝炎相关性肝衰竭患者HBV DNA低水平复制及特异性抗体表达的临床意义

Objective To investigate the influential factors and clinical significance of low- level hepatitis B virus ( HBV) DNA replication and specific antibody expression in patients with HBV- related liver failure. Methods A retrospective analysis was performed on the medical records of 391 patients with HBV- related liver failure and 394 patients with chronic hepatitis B ( CHB) hospitalized in the Tianjin Second People's Hospital from June 2008 to December 2013. The HBV DNA level was compared between patients with HBV- related liver failure and those with CHB, and the influential factors were analyzed. According to the expression of HBV serum markers ( HBV- Ms) , patients with liver failure were divided into specific antibody- positive group ( positive for anti- HBs, anti- HBe or anti- HBc) and specific antibody- negative group ( negative for anti- HBs, anti- HBe or anti- HBc) . The changes in HBV DNA level and survival were compared between the two groups. Between- group comparison was made by independent- samples t test or Mann- Whitney rank sum test, and comparison of enumeration data was made by chi- square test. Results The patients with HBV- related liver failure had a significantly lower HBV DNA level than the CHB patients ( Z =- 16. 469, P < 0. 05) . The levels of HBV DNA in HBeAg- positive and- negative patients with liver failure were significantly lower than those in patients with CHB ( Z1=- 11. 665, P < 0. 05; Z2=- 12. 853, P < 0. 05) . Of the391 patients with HBV- related liver failure, 29 ( 7. 42%) were specific antibody- positive, and 25 ( 86. 21%) of them died; 362 ( 92. 58%) were specific antibody-negative, and 157 ( 43.37%) of them died. There was a significant difference in mortality between the specific antibody- positive and specific antibody- negative groups ( P < 0. 05) . The specific antibody- positive group had a significantly lower HBV DNA level than the specific antibody- negative group ( Z =- 3. 594, P < 0. 05) . For either group, the HBV DNA level was significantly lower in HBeAg- negative patients than in HBeAg- positive patients ( Z = 7. 427 or 7. 513, P < 0. 05) . Conclusion HBV M expression and the body's immune status play a role in the progression of HBV- related liver failure. HBV DNA replication is at a low level in the immune clearance phase. Being positive for anti- HBs, anti- HBe, and anti- HBc suggest a super immune response to HBV, leading to rapid progression of disease and high mortality.

The psychological effects and patient acceptability of a test to predict viability in early pregnancy: a prospective randomised study

ObjectiveTo establish if women obtain any measurable short term psychological benefit or perceived benefit from having a test to determine the probability of their pregnancy being on-going when this is uncertain on ultrasound examination. Study designThis was a prospective randomised controlled study conducted January 2012–June 2012 at the EPU of King's College Hospital. The study population was women who conceived spontaneously and had a single intrauterine gestational sac of <20mm mean diameter, with no visible embryo on their first ultrasound scan. Eligible women were randomised to have a test to calculate the probability of viability (cases) or not (controls). Depression and anxiety levels were calculated using the Hospital Anxiety and Depression Score (HADS) and were performed prior to randomisation and seven days later. A repeat scan for pregnancy outcome was performed after one to two weeks as clinically indicated. A sample size of 69 in each group was calculated to have 80% power to detect a probability of 0.362 that an observation in the cases was less than an observation in controls using a Wilcoxon Mann–Whitney rank-sum test with a 0.05 two-sided significance. ResultsAt recruitment there was no significant difference in anxiety levels between cases and controls. After seven days anxiety levels were significantly lower in cases than controls (p=0.04). Of those who received the probability score, 55/70 (78.6% 95% CI 67.5–86.7%) found it useful and 58/70 (82.9% 95% CI 72.2–90.1) would choose to have the test in a future pregnancy if indicated. ConclusionsThis study has demonstrated that there is evidence of psychological benefit from a simple blood test that gives women the likelihood that their pregnancy will be on-going at the next scan.

Parameters contributing to occupants’ satisfaction

Purpose– The aims of this paper is to investigate the overall satisfaction of occupants of green and conventional residential buildings and their perception of indoor environment quality (IEQ) and to study factors that may cause occupants’ dissatisfaction.Design/methodology/approach– Data were collected through a survey sent to occupants of comparable green and conventional multi-family buildings. The difference in responses between occupants of green and conventional buildings was analysed using Mann–Whitney (rank sum) test. The ordered logistic models were applied to the data to test whether the overall satisfaction changes depending on the level of acceptance of indoor environment quality and whether the building environmental profile and the apartment tenure affect occupant satisfaction.Findings– The results show that both categories of occupants are very satisfied with their apartments and that there is no statistically significant difference between the stated overall satisfaction of occupants living in green and conventional buildings, although a difference was found in the acceptance level for thermal and sound quality. The research highlights the importance of occupant feedback, user-friendly technical installations and the ability to control indoor environment. This knowledge is important for designers, engineers and developers alike in enabling them to improve dwelling quality and minimize post-occupancy problems.Research limitations/implications– It was not possible to include physical measurements of IEQ parameters; the analysis is based only on occupants’ responses, which may carry a certain subjectivity.Originality/value– The paper contributes to the understanding of IEQ from occupant perspective and to knowledge on green building performance.

Comparison of arterial and venous whole blood clot initiation, formation, and strength by thromboelastography in anesthetized swine

Thromboelastography (TEG) analysis was used to determine if differences exist between venous and arterial samples in anesthetized swine, using identical sampling techniques for each of the samples. We hypothesized that TEG parameters would not differ between native whole blood venous and arterial samples. Thirty male Landrace swines were included in the study. Both the femoral artery and vein were catheterized using standard cut-down techniques and with identically sized catheters to rule out any catheter size effects on the results. Standard TEG parameters for native whole venous and arterial blood samples (r, K, α, MA, G, and coagulation index) were measured or calculated, and t-test or Mann-Whitney rank-sum test used for comparison when appropriate. Significant differences were detected for r (venous < arterial), K (venous < arterial), α (venous > arterial), and coagulation index (venous > arterial) TEG parameters. No significant differences were measured for MA or G. These differences are important, especially when temporal changes in TEG are utilized to monitor patient stability and fluid therapy protocols using trends in coagulation properties. Taken together, these results suggest that clots are more likely to form at a faster rate in venous samples compared to arterial samples, but the overall clot strength does not differ. Therefore, if TEG analysis is being used to monitor coagulation profiles in a patient, care should be taken to use the same site and technique if results are to be used for comparative purposes.

Tobacco exposure increased airway limitation in dogs with chronic cough

In the field of veterinary medicine, there are few reports regarding the incidence of respiratory diseases, including cancer of the nose and lung among pet animals with passive tobacco smoke...

Stomatin‐domain protein interactions with acid‐sensing ion channels modulate nociceptor mechanosensitivity

Acid-sensing ion channels (ASICs) and their interaction partners of the stomatin family have all been implicated in sensory transduction. Single gene deletion of asic3, asic2, stomatin, or stoml3 all result in deficits in the mechanosensitivity of distinct cutaneous afferents in the mouse. Here, we generated asic3−/−:stomatin−/−, asic3−/−:stoml3−/− and asic2−/−:stomatin−/− double mutant mice to characterize the functional consequences of stomatin–ASIC protein interactions on sensory afferent mechanosensitivity. The absence of ASIC3 led to a clear increase in mechanosensitivity in rapidly adapting mechanoreceptors (RAMs) and a decrease in the mechanosensitivity in both Aδ- and C-fibre nociceptors. The increased mechanosensitivity of RAMs could be accounted for by a loss of adaptation which could be mimicked by local application of APETx2 a toxin that specifically blocks ASIC3. There is a substantial loss of mechanosensitivity in stoml3−/− mice in which ∼35% of the myelinated fibres lack a mechanosensitive receptive field and this phenotype was found to be identical in asic3−/−:stoml3−/− mutant mice. However, Aδ-nociceptors showed much reduced mechanosensitivity in asic3−/−:stoml3−/− mutant mice compared to asic3−/− controls. Interestingly, in asic2−/−:stomatin−/− mutant mice many Aδ-nociceptors completely lost their mechanosensitivity which was not observed in asic2−/− or stomatin−/− mice. Examination of stomatin−/−:stoml3−/− mutant mice indicated that a stomatin/STOML3 interaction is unlikely to account for the greater Aδ-nociceptor deficits in double mutant mice. A key finding from these studies is that the loss of stomatin or STOML3 in asic3−/− or asic2−/− mutant mice markedly exacerbates deficits in the mechanosensitivity of nociceptors without affecting mechanoreceptor function.

Step-stress analysis for predicting dental ceramic reliability

ObjectiveTo test the hypothesis that step-stress analysis is effective to predict the reliability of an alumina-based dental ceramic (VITA In-Ceram AL blocks) subjected to a mechanical aging test. MethodsBar-shaped ceramic specimens were fabricated, polished to 1μm finish and divided into 3 groups (n=10): (1) step-stress accelerating test; (2) flexural strength-control; (3) flexural strength-mechanical aging. Specimens from group 1 were tested in an electromagnetic actuator (MTS Evolution) using a three-point flexure fixture (frequency: 2Hz; R=0.1) in 37°C water bath. Each specimen was subjected to an individual stress profile, and the number of cycles to failure was recorded. A cumulative damage model with an inverse power law lifetime-stress relation and Weibull lifetime distribution were used to fit the fatigue data. The data were used to predict the stress level and number of cycles for mechanical aging (group 3). Groups 2 and 3 were tested for three-point flexural strength (σ) in a universal testing machine with 1.0MPa/s stress rate, in 37°C water. Data were statistically analyzed using Mann–Whitney Rank Sum test. ResultsStep-stress data analysis showed that the profile most likely to weaken the specimens without causing fracture during aging (95% CI: 0–14% failures) was: 80MPa stress amplitude and 105 cycles. The median σ values (MPa) for groups 2 (493±54) and 3 (423±103) were statistically different (p=0.009). SignificanceThe aging profile determined by step-stress analysis was effective to reduce alumina ceramic strength as predicted by the reliability estimate, confirming the study hypothesis.