Hyperlipidemia associated with the use of protease inhibitors.
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Adult↗
Biomedical subjects
G J Martin
Publications and source records attributed to G J Martin.
Measuring physical activity in peripheral arterial disease: a comparison of two physical activity questionnaires with an accelerometer.
Peripheral arterial disease (PAD)-related exertional leg pain may limit physical activity, thereby contributing to mobility loss and increasing cardiovascular morbidity and mortality in men and women with PAD. The objectives of this study were: (1) to compare objectively measured physical activity levels between patients with and without PAD, (2) to assess the validity of two physical activity questionnaires in patients with PAD. Twenty PAD patients from a noninvasive vascular laboratory and 21 patients without PAD from a general medicine practice wore an accelerometer continuously for 7 days to measure physical activity objectively. After 7 days, participants completed the leisure time physical activity questionnaire (LTPAQ), derived from the Health Interview Survey, (continued on next page)and the Stanford 7-day physical activity recall questionnaire (PARQ). PAD participants had markedly lower physical activity levels than non-PAD participants as measured by accelerometer (803 kcal/week +/-364 (range=284-2,000, median=708) vs 1,750 kcal/week +/-1,296 (range=882-6,586, median=1,278), p<0.001). For the LTPAQ, physical activity levels in PAD and non-PAD participants were 609 kcal/week +/-576 (range=0-2,085, median=529) vs 832 kcal/week +/-784 (range=53-2,820, median= 623), p=0.128. For the PARQ, physical activity levels in PAD and non-PAD participants were 234 METS/week +/-21 (range=214-301, median=229) vs 238 METS/week +/- 11 (range=225-268, median=234), p=0.454, respectively. Pearson's correlation coefficient for the association between the accelerometer and the log-transformed LTPAQ measure was 0.419 (p=0.006). Pearson's correlation coefficient was 0.348 for the association between the accelerometer and the log-transformed PARQ measure of physical activity (p=0.026). In conclusion, PAD patients have significantly lower physical activity levels than non-PAD patients. Two commonly used physical activity questionnaires were less sensitive than objective measurement to the association between PAD and inactivity.
Aged↗
Recombinant human bone morphogenetic protein-2 overcomes the inhibitory effect of ketorolac, a nonsteroidal anti-inflammatory drug (NSAID), on posterolateral lumbar intertransverse process spine fusion.
STUDY DESIGN: An animal model of posterolateral intertransverse process spine fusion healing. OBJECTIVE: To evaluate the effect of systemic ketorolac, alone and in combination with locally applied recombinant human bone morphogenetic protein-2, on spine fusion healing. SUMMARY OF BACKGROUND DATA: The effect of nonsteroidal anti-inflammatory drugs on bone graft healing in animals remains controversial. However, most studies point to the inhibition of fracture repair, especially during the early healing period. METHODS: Forty-nine adult New Zealand white rabbits underwent single-level lumbar fusion with autologous iliac bone graft. Two mini-osmotic pumps were implanted subcutaneously and filled with saline as a control or ketorolac. Rabbits were divided into three groups: 1) control (saline in pump); 2) nonsteroidal anti-inflammatory drug (ketorolac in pump); 3) nonsteroidal anti-inflammatory drug (ketorolac in pump) and bone morphogenetic protein (bone graft soaked in a 3.0 mg solution of recombinant human bone morphogenetic protein-2. All rabbits were killed after 6 weeks. RESULTS: In the control group, 75% (12 in 16) of the surviving rabbits were judged to have solidly fused lumbar spines as compared with only 35% (6 in 17) of the animals that received ketorolacachieved fusion (P = 0.037). Of the animals that received ketorolac and recombinant bone morphogenetic protein-2, 100% (9 in 9) fused. CONCLUSIONS: The results of this study confirm the detrimental effect of a commonly used nonsteroidal anti-inflammatory drug on spinal fusion during the immediate postoperation period in a established rabbit model of posterolateral lumbar spine fusion. The addition of recombinant bone morphogenetic protein-2 to the autograft bone was able to compensate for the inhibitory effect of ketorolac on bone formation. On the basis of these data, caution is urged in the routine use of nonsteroidal anti-inflammatory drugs for postoperation analgesia in patients undergoing spine arthrodesis.
Animals↗
Posterolateral lumbar intertransverse process spine arthrodesis with recombinant human bone morphogenetic protein 2/hydroxyapatite-tricalcium phosphate after laminectomy in the nonhuman primate.
STUDY DESIGN: A nonhuman primate lumbar intertransverse process arthrodesis model was used to evaluate recombinant human bone morphogenetic protein 2 (rhBMP-2) in a hydroxyapatite-tricalcium phosphate (HA-TCP) carrier as a complete bone graft substitute. OBJECTIVES: To assess the ability of a ceramic material to serve as a carrier for various doses of rhBMP-2 as a bone graft substitute in a primate model of posterolateral intertransverse process spinal fusion after laminectomy. SUMMARY OF BACKGROUND DATA: The reported non-union rates for posterolateral lumbar spine fusion with autogenous iliac crest bone range from 5-35%. Recombinant human bone morphogenetic protein 2 has shown potential to serve as a bone graft substitute for posterolateral intertransverse process spine fusion. Although a resorbable collagen sponge was a suitable carrier in rabbits and dogs, it was too compressible for the paraspinal muscles in rhesus monkeys. This failure of the collagen carrier has prompted evaluation of the feasibility of an alternative carrier material and the required dose of rhBMP-2. METHODS: Twenty-one adult rhesus monkeys underwent a laminectomy at L4-L5 followed by bilateral intertransverse process arthrodesis via the same midline incision (n = 16) or a minimally invasive video-assisted posterolateral approach (n = 5). Bone graft implants on each side consisted of either 5 cm3 of autogenous iliac crest bone or 60:40 HA-TCP blocks (1.2 x 0.5 x 3.7 cm) loaded with a solution containing 0, 6, 9, or 12 mg of rhBMP-2 per side. The monkeys were killed 24 weeks after surgery. Inspection, manual palpation, radiography, and histology were used to assess fusion and to detect any bony growth into the laminectomy defect. RESULTS: Fusion was not achieved in any of the monkeys treated with autogenous iliac crest bone graft. Both of the monkeys treated with the HA-TCP blocks with 0 mg rhBMP-2 achieved fusion. All 15 monkeys treated with the HA-TCP blocks and either of the three doses of rhBMP-2 achieved solid fusion. Two animals had extension of the fusion on one side because of malpositioned ceramic block. The results in animals fused via the minimally invasive video-assisted technique were the same as inthose fused with the open technique. Histologic analysis showed some ingrowth of bone into the ends but not-through the ceramic block in the absence of rhBMP-2. When the ceramic blocks were loaded with rhBMP-2 there was a dose-dependent increase in the amount and quality of bone throughout the ceramic carrier based on qualitative assessment. No significant bone encroachment on the exposed thecal sac through the laminectomy defect was observed in any of the monkeys. CONCLUSION: Hydroxyapatite-tricalcium phosphate proved to be a suitable carrier for rhBMP-2 in the posterolateral spine fusion model in rhesus monkeys. Even in the presence of a laminectomy defect, there was no evidence of bone induction outside the confines of the ceramic carrier.
Animals↗
Anterior cervical discectomy with freeze-dried fibula allograft. Overview of 317 cases and literature review.
STUDY DESIGN: A retrospective review of 317 patients to determine the efficacy of allogeneic fibula arthrodesis after anterior cervical discectomy. OBJECTIVE: To examine the efficacy of allogeneic fibula as an alternative fusion substrate after anterior cervical discectomy, and to determine the effects of cigarette smoking on the healing of fibula allografts. SUMMARY OF BACKGROUND DATA: The use of autogeneic iliac crest is associated with graft harvest complications in up to 20% of patients. Most studies reporting on the use of allogeneic iliac crest cite a high collapse rate. Few studies exist that note the efficacy of allogeneic fibula in this procedure and the effects of cigarette smoking on fusion rate. METHODS: From 1988 to 1993, 317 patients underwent grafting by the Smith-Robinson technique with allogeneic fibula after anterior cervical discectomy. Patients who described themselves as habitual cigarette smokers or who smoked during the perioperative or postoperative period were categorized as smokers. All patients were immobilized in a rigid cervical orthosis (Philadelphia collar) for at least 10 weeks postoperatively. RESULTS: A minimum of 2 years follow-up was achieved in 289 patients. In all, 162 men and 127 women had a total of 311 levels grafted, and the mean follow-up period was 33 months (range, 24 to 51 months). Of patients who received allogeneic fibula at one level, 90% (242/269) achieved radiologic fusion. The fusion rate was 92% (182/198) among nonsmokers compared with 85% (60/71) among smokers (not a statistically significant difference; P = 0.120). After two-level procedures, 72% (13/18) of the patients showed fusion. The fusion rate was 50% (2/4) among smokers compared with 79% (11/14) among nonsmokers (P = 0.53). When one-level arthrodesis (90%) was compared with two-level arthrodesis (72%), the difference approached statistical significance (P = 0.054). Neither of the two patients, both nonsmokers, who received grafts at three levels achieved fusion. There were no infections, and no grafts collapsed. Two grafts extruded (0.6%), but these were partial and did not require reoperation. Both patients fused and constituted the only patients with more than 10 degrees of angulation in the series. Graft subsidence occurred in 5% (17/311) of the grafts, mostly in the beginning of the series, and was not problematic. This phenomenon was thought to have been caused by overaggressive removal of the cortical endplate. CONCLUSION: Allogeneic fibula is an effective substrate for use in achieving fusion after anterior cervical discectomy. Maximal results are achieved with its use at one level in nonsmokers. Cigarette smoking decreased the fusion rate with allogeneic fibula in the anterior cervical spine, but not by a statistically significant amount.
Cervical Vertebrae↗
New formulations of demineralized bone matrix as a more effective graft alternative in experimental posterolateral lumbar spine arthrodesis.
STUDY DESIGN: A rabbit model of posterolateral intertransverse process spine arthrodesis was used. OBJECTIVE: To determine the efficacy of two new formulations of demineralized bone matrix. SUMMARY OF BACKGROUND DATA: The flowable gel form of Grafton (Osteotech, Eatontown, NJ) demineralized bone matrix has been shown to have osteoinductive properties in various models and currently is used clinically as bone graft material in posterolateral lumbar spine arthrodesis. Two new formulations of Grafton, one made of flexible sheets (Flex) and the other made in a malleable consistency (Putty), have improved handling characteristics compared with the gel form. METHODS: In this study, 108 New Zealand white rabbits underwent bilateral posterolateral intertransverse spine arthrodesis at L5-L6 using autogenous iliac crest bone graft alone (control), one of the new forms of demineralized bone matrix (DBM; made from rabbit bone) alone or in combination with autogenous iliac crest bone. Rabbits were killed 6 weeks after surgery. The lumbar spines were excised, and fusion success or failure was determined by manual palpation and radiography. Specimens also were processed for undecalcified histologic analysis. RESULTS: Manual palpation of the harvested lumbar spines revealed that the fusion rates of the Flex-DBM/Auto group (9/9, 100%) and Putty-DBM/Auto group (10/10, 100%) were superior (P < 0.01) to those of the Auto/control group (3/9, 33%). As a stand-alone graft substitute, Flex-DBM performed superiorly with a fusion rate of 11/11 (100%) compared with that of Putty-DBM (10/12, 83%) and Gel-DBM (7/12, 58%). The devitalized version of Flex-DBM had a fusion rate of 4/11 (36%), which was comparable with the devitalized Putty-DBM rate of 4/12 (33%). Both were superior (P < 0.05) to the devitalized Gel-DBM rate of 0/12 (0%). More mature fusions with greater amounts of trabecular bone were present radiographically and histologically in rabbits that received all forms of demineralized bone matrix than in those in which autograft was used. CONCLUSIONS: The new flexible sheet and malleable putty forms of demineralized bone matrix were effective as graft extender and graft enhancer in a model of posterolateral lumbar spine fusion. These newer formulations of Grafton appear to have a greater capacity to form bone than the gel form or autogenous bone graft alone in this model.
Animals↗
Impact of same-day screening mammography availability: results of a controlled clinical trial.
BACKGROUND: We conducted a prospective controlled clinical trial in an urban academic general medicine practice to test the effect of same-day mammography availability on adherence to physicians' screening mammography recommendations. PATIENTS AND METHODS: Participants were a consecutive sample of 920 female patients aged 50 years or older who had received a physician's recommendation for screening mammography at an office visit and had no active breast symptoms, history of breast cancer, or a mammogram within the previous 12 months. Women were assigned to same-day screening mammography availability (intervention group) or usual screening mammography scheduling (control group). MAIN OUTCOME MEASURES: Three-, 6-, and 12-month rates of adherence to physicians' recommendations for screening mammography. RESULT: Twenty-six percent of women in the intervention group obtained a same-day screening mammogram. At 3 months, 58% of the women in the intervention group underwent the recommended screening mammography compared with 43% of the women in the control group (P<.001), increasing to 61% and 49% at 6 months (P<.001), and 268 (66%) of 408 vs 287 (56%) of 512 at 12 months (P = .003). The difference between the intervention and control groups 3-month adherence rates was most marked among women aged 65 years or older (58% vs 34%; P<.001), women who were not employed (54% vs 36%; P<.001), and women with a history of having had either no mammograms (39% vs 20%; P = .02) or only 1 to 2 mammograms (57% vs 38%; P<.001) within the last 5 years. CONCLUSIONS: Same-day mammography availability increased 3-, 6-, and 12-month screening mammography adherence rates in this urban academic general medicine practice. The effect was most marked among women aged 65 years or older, women who were not employed, and those who had had fewer than 3 mammograms in the last 5 years. The efficacy of this intervention in other settings still needs to be demonstrated.
Academic Medical Centers↗
The use of coralline hydroxyapatite with bone marrow, autogenous bone graft, or osteoinductive bone protein extract for posterolateral lumbar spine fusion.
STUDY DESIGN: A posterolateral lumbar arthrodesis animal model using coralline hydroxyapatite as a bone graft substitute. OBJECTIVE: To determine the effectiveness of coralline hydroxyapatite as a bone graft substitute for lumbar spine fusion when used with bone marrow, autogenous bone graft, or an osteoinductive bone protein extract. SUMMARY OF BACKGROUND DATA: Coralline hydroxyapatite is commonly used as a bone graft substitute in metaphysial defects but its use in a more challenging healing environment such as the posterolateral spine remains controversial. There are no published animal studies in which the use of coralline hydroxyapatite has been evaluated in a posterolateral lumbar arthrodesis model. METHODS: Single-level posterolateral lumbar arthrodesis was performed at L5-L6 in 48 adult New Zealand White rabbits. Rabbits were assigned to one of three groups based on the graft material they received: 3.0 mL coralline hydroxyapatite 1.5 mL plus bone marrow; 1.5 mL coralline hydroxyapatite plus 1.5 mL autogenous iliac crest bone; and, 3.0 mL coralline hydroxyapatite plus 500 micrograms bovine-derived osteoinductive bone protein extract on each side. Rabbits were killed after 2, 5, or 10 weeks, and the spines were excised and evaluated by manual palpation, radiographs, tensile biomechanical testing, and nondecalcified histology. RESULTS: Fusions were assessed by manual palpation at 5 weeks for comparisons among the three groups of graft materials. The coralline hydroxyapatite used with bone marrow produced no solid fusions (0/14). When combined with an equal amount of autogenous iliac crest bone, coralline hydroxyapatite resulted in solid fusion in 50% (7/14) of the rabbits (P < 0.05). When combined with the osteoinductive growth factor extract, the coralline hydroxyapatite resulted in solid fusion in 100% (11/11) of the rabbits (P < 0.05). The fusion masses in the growth factor group were significantly stronger (1.8 +/- 0.2 vs. 1.3 +/- 0.1; P = 0.02) and stiffer (1.5 +/- 0.2 vs. 1.2 +/- 0.1, P = 0.04) based on tensile testing to failure when normalized to the adjacent unfused level. CONCLUSION: These data indicate that coralline hydroxyapatite with bone marrow was not an acceptable bone graft substitute for posterolateral spine fusion. When combined with autogenous iliac crest bone graft-coralline hydroxyapatite served as a graft extender yielding results comparable to those obtained with autograft alone. Coralline hydroxyapatite served as an excellent carrier for the bovine osteoinductive bone protein extract yielding superior results to those obtained with autograft or bone marrow.
Animals↗
15N enrichment of casein amino acids in the milk from goats given a single intravenous dose of L-[15N]leucine.
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Amino Acids↗
Stable isotope characterization of milk components and whey ethanol.
A multi-isotopic study of several components of milk has been carried out on commercial samples and on milk produced in feeding experiments involving different kinds of diets originating from C(3) or C(4) photosynthetic metabolisms and exhibiting a relatively wide range of isotope ratios. The dispersion of the carbon, hydrogen, and nitrogen isotope parameters of dried matter and of the lactose, protein, and lipid components has been estimated. In addition, the carbohydrates were represented by the site specific isotope ratios (SNIF-NMR) of ethanol resulting from standardized fermentation of lactose. The rates of response of the isotopic parameters to changes in the feeding materials is slower for the minor components, proteins, and lipids than for lactose and ethanol. For similar diets, the nonexchangeable sites of lactose and the methyl site of ethanol, in particular, are relatively enriched in deuterium in the case of polygastric animals, cow, goat, and ewe, as compared to the monogastric species, sow and mare, and woman. From an analytical point of view, the carbon and hydrogen parameters of ethanol provide efficient criteria for identifying a whey origin with respect to other agricultural and fossil sources.
Animals↗
Use of learning contracts in an office-based primary care clerkship.
OBJECTIVES: This paper describes implementation of the learner-centred learning goal within the primary care clerkship at a Midwestern, United States medical school. DESIGN: The learner-centred learning goal exercise was developed to tailor students' educational activities to their personal level of development and to enhance their commitment to life-long learning in medicine. In the learner-centred learning goal exercise, each student records three specific learning goals early in the primary care clerkship. Students record the methods by which they will pursue and document achievement of each goal. Attainment of the learner-centred learning goal is evaluated based on an oral presentation at the end of the clerkship. We compiled presented learning goals along with the corresponding grade. Students' ratings of the learner-centred learning goal exercise were also compiled. Evaluations and ratings were made on a 1-5 Likert scale, where 1 is the best rating and 5 is worst. SETTING: Department of Medicine, Northwestern University Medical School, Chicago, USA. SUBJECTS: One hundred and seventy-seven third- and fourth-year medical students who presented learner-centred learning goals between 1 July 1995 and 30 June 1996. RESULTS: Students rated pursuing their individual learning goals more worthwhile than most clerkship lectures but less worthwhile than the office experience. Several learning goals were chosen by a disproportionate number of students, potentially indicative of some perceived deficiencies elsewhere in the curriculum. Third-year students ranked the learner-centred learning goal exercise more favourably than fourth-year students (2.14 vs. 2. 51, P = 0.03). CONCLUSIONS: The learner-centred learning goal exercise is a feasible and well-received method within our primary care clerkship. Further study is required to determine whether the exercise promotes independent learning after formal medical school education is completed.
Clinical Clerkship↗
Leg symptoms, the ankle-brachial index, and walking ability in patients with peripheral arterial disease.
OBJECTIVE: To determine how functional status and walking ability are related to both severity of lower extremity peripheral arterial disease (PAD) and PAD-related leg symptoms. DESIGN: Cross-sectional study. SETTING: Academic medical center. PARTICIPANTS: Patients aged 55 years and older diagnosed with PAD in a blood flow laboratory or general medicine practice (n = 147). Randomly selected control patients without PAD were identified in a general medicine practice (n = 67). MEASUREMENTS: Severity of PAD was measured with the ankle-brachial index (ABI). All patients were categorized according to whether they had (1) no exertional leg symptoms; (2) classic intermittent claudication; (3) exertional leg symptoms that also begin at rest (pain at rest), or (4) exertional leg symptoms other than intermittent claudication or pain at rest (atypical exertional leg symptoms). Participants completed the 36-Item Short-Form Health Survey (SF-36) and the Walking Impairment Questionnaire (WIQ). The WIQ quantifies patient-reported walking speed, walking distance, and stair-climbing ability, respectively, on a scale of 0 to 100 (100 = best). MAIN RESULTS: In multivariate analyses patients with atypical exertional leg symptoms, intermittent claudication, and pain at rest, respectively, had progressively poorer scores for walking distance, walking speed, and stair climbing. The ABI was measurably and independently associated with walking distance (regression coefficient = 2.87/0.1 ABI unit, p =.002) and walking speed (regression coefficient = 2.09/0.1 ABI unit, p =.015) scores. Among PAD patients only, pain at rest was associated independently with all WIQ scores and six SF-36 domains, while ABI was an independent predictor of WIQ distance score. CONCLUSIONS: Both PAD-related leg symptoms and ABI predict patient-perceived walking ability in PAD.
Aged↗
Food intake and blood glucose in normal and diabetic cats fed ad libitum.
Ten diabetic cats were studied at intervals for up to 12 months with twice-daily insulin injections. Ten clinically healthy cats were also studied. Diets fed were based on the individual cat's performance, using mainly commercial dry or canned cat foods and fresh meat. In most cases more than one food was offered. Food was given fresh twice daily, and the cats allowed to eat ad libitum. The food intake and blood glucose were measured every 2 h in diabetic cats after insulin injection and in diabetic and normal cats without insulin injections. Food was quantified by the energy consumed (kJ ME), crude protein (g), crude fat (g), and carbohydrate (g). The blood glucose in 10 diabetic cats was measured for 2 h following a 20-min meal. Both diabetic cats and normal cats showed similar patterns of eating, with a higher food intake in the 2 h after fresh food was placed. Both groups of cats ate multiple small meals spread through the day and night. There was little or no correlation between the blood glucose and the amount of food consumed over the previous 2-h period, in insulin- or non-insulin-treated diabetic cats, or in normal cats. An overnight fast did not significantly alter morning blood glucose in diabetic cats. No demonstrable appetite stimulation occurred following an occurrence of low blood glucose; however, recorded incidences were few. No post-prandial hyperglycaemia was seen in the 10 diabetic cats during a 2-h period following the ingestion of typical cat foods.
Animals↗
Stavudine-induced macrocytosis during therapy for human immunodeficiency virus infection.
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Anemia, Macrocytic↗
Evaluation of a polyurethane jugular catheter in cats placed using a modified Seldinger technique.
OBJECTIVE: To describe and evaluate the placement of a new design of polyurethane jugular catheter in cats using a modification of the technique of Seldinger. The maintenance and use of these catheters for repeated blood sampling over several days in healthy and diabetic cats is reported. PROCEDURE: Thirty polyurethane jugular catheters were placed in 10 clinically healthy cats and 10 cats with diabetes mellitus using the modified Seldinger technique. Catheters were placed while the cats were under general anaesthesia. RESULTS: The catheters remained in place for a range of 2 to 14 days (median 5 days) with no major complications. In all cats patency of the catheters was maintained until removal. All cats examined had patent jugular veins when assessed 4 or more weeks after the catheters were removed. CONCLUSIONS: These polyurethane jugular catheters, when placed by a modified Seldinger technique, are effective and safe in cats, and jugular patency returns after the catheters are removed.
Animals↗
Comparing three preprocessing strategies for longitudinal data. An example in functional outcomes research.
Longitudinal monitoring of individual patient data is becoming routine in physician office practice. This study compares three different methods for evaluating clinical outcomes for individual patients: raw change score analysis versus normative and ipsative statistical analyses. Two discrete samples of intermittent claudication patients making vascular surgery office visits--drawn from interventional management versus stable, routinely followed control groups--were tested four times using both generic and disease-specific functional status measures. Results indicated that the ipsative method was most consistent with several different types of a priori hypotheses that are often evaluated in analysis of repeated measures data.
Evaluation Studies as Topic↗
Posterolateral intertransverse process spinal arthrodesis with rhBMP-2 in a nonhuman primate: important lessons learned regarding dose, carrier, and safety.
Recombinant osteoinductive proteins have been used successfully in canine and rabbit models of posterolateral intertransverse process arthrodesis, but little is known about the ability of these compounds to achieve fusion in nonhuman primates. The goals of this investigation were to compare different combinations of recombinant human bone morphogenetic protein-2 (rhBMP-2) dosages and carriers in a nonhuman primate model of posterolateral intertransverse process spinal fusion and to determine the feasibility of using rhBMP-2 in the presence of exposed dura in a laminectomy model. Posterolateral intertransverse process arthrodeses were performed at L4-5 in 29 rhesus monkeys. The most striking findings were as follows: rhBMP-2 could induce bone in a nonhuman primate spine; the presence of a laminectomy defect with exposed dura did not preclude the safe use of rhBMP-2 for posterolateral fusion; soft tissue compression of the collagen sponge carrier prevented bone induction at standard BMP doses, presumably due to squeezing of the protein out of the sponge; and longer rhBMP-2 loading time into the collagen carrier and mechanical protection from the soft tissue compression both allowed more bone induction at a lower dose of rhBMP-2.
Animals↗
Predicting in-hospital mortality of patients receiving cardiopulmonary resuscitation: unit-weighted MultiODA for binary data.
Widely used, linear classification functions may be derived on the basis of several different statistical paradigms. Since, regardless of choice, analysis generally yields an equation with unwieldy intercept and attribute coefficients, researchers often construct simpler scoring schemes based on unit weights. Accordingly, for applications involving entirely binary data, we discuss a simple procedure for obtaining unit-weighted (that is, we restrict attribute coefficients to the values of 0, 1 or -1) MultiODA functions that explicitly maximize classification accuracy in the training sample. We illustrate this with an application involving prediction of in-hospital mortality of patients receiving cardiopulmonary resuscitation. In training analysis of 88 patients, unit-weighted MultiODA outperformed prior scoring schemes and logistic regression analysis. Unit-weighted MultiODA also yielded superior hold-out (cross-generalizability) validity for an independent sample of 26 patients.
Cardiopulmonary Resuscitation↗