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PubMed1985

Chronic changes in male rats' hormone-sensitive systems after suprathreshold pulses of testosterone.

Adult male rats were castrated and maintained on daily SC injections of a threshold amount (200 micrograms) of testosterone propionate (TP). To mimic naturally occurring pulses of suprathreshold testicular hormones in intact males, animals in the experimental groups also received either one (single TP) or five (multiple TP) injections of 800 micrograms TP over 12 days. The rats were examined on the following day (acute) or 15 days later (chronic) for changes in hormone-sensitive behavior, physiology, and morphology. The hypothesis tested was that the hormonal pulses function to provoke chronic changes in substrates underlying the reproductive system. The results were that multiple doses of suprathreshold TP provoked acute modifications in aggressive behavior, sex accessory glands, and glans penis integrity. Chronic changes were observed in sex accessory gland functioning and penile morphology, particularly in the size of penile papillae. A single exposure to suprathreshold TP was considerably less effective, though there was some evidence of acute changes in sex accessory glands and chronic changes in penile papillae. There was substantial variation in the responses of individual animals, particularly the chronic responses. The data were interpreted as supporting the hypothesis.

Animals↗
PubMed1997

[The Mallampati Score. Prediction of difficult intubation in otolaryngologic laser surgery by Mallampati Score].

UNLABELLED: The Mallampati score (MS), later modified by Samsoon and Young, is a common method used to predict difficult intubation. We tested its predictive value in otolaryngologic (ENT) laser surgery. METHODS: Ninety-one patients scheduled for elective ENT laser surgery had the modified MS noted prior to induction in the supine position, with the tongue fully protruded and phonating "ah"; 22 patients were female, 69 male. The mean age was 54 +/- 15 (6-84) years, height 171 +/- 9 (130-190) cm, and weight 72 +/- 21 (20-99) kg. After a standard induction, the laryngoscopic view was graded according to Cormack and Lehane (C&L). An intubation was considered difficult if the C&L score was > or = 3, i.e., no part of the glottis seen during laryngoscopy. The hypothesis tested was that a MS > or = 3 (i.e., only the base of the uvula or nine of the uvula was seen) is predictive of difficult intubation in this group of patients. This chi-square test was used for calculation of significance. RESULTS: All intubations were performed in less than three attempts, and no C&L score of 4 (i.e., not even the epiglottis seen during laryngoscopy) was observed; 10 patients had a C&L score > or = 3, i.e., a difficult intubation according to our definition. Sixty-two patients had a MS < or = 2; of these, 4 (= 6%) were difficult to intubate. Twenty-nine patients had MS > or = 3; of these, 6 (= 21%) were difficult to intubate. This difference was significant (chi-square = 4.1, P < 0.05). CONCLUSION: Difficult intubation was significantly more common in patients with MS > or = 3. Low sensitivity (60%) and specificity (72%) limit the clinical value of this test, however.

Adolescent↗
PubMed1985

An evaluation of methods for estimating the area under the receiver operating characteristic (ROC) curve.

The area under the receiver operating characteristic (ROC) curve serves as one means for evaluating the performance of diagnostic and predictive test systems. The most commonly used method for estimating the area under an ROC curve utilizes the maximum-likelihood-estimation technique, and a nonparametric method to calculate the area under an ROC curve was recently described. We compared the performance of these two methods. The results for the area under the ROC curve and the standard error of the estimate as calculated by each of the two methods exhibited high correlation. Generally, the nonparametric method yields lower area estimates than the maximum-likelihood-estimation technique. However, these differences generally were small, particularly with ROC curves derived from five or more cutoff points. Consistent results of hypothesis testing of the significance of differences between two ROC curves will be similar, regardless of which method is used, as long as one uses the same estimation technique on the two curves and as long as the two ROC curves being compared are of similar shape.

Computers↗
PubMed1997

Bond strengths and SEM morphology of dentin-amalgam adhesives.

PURPOSE: To compare two one-bottle dentin bonding systems (DBS) with five multi-bottle DBS and one resin-modified glass-ionomer cement, regarding their ability to bond spherical amalgam to freshly prepared dentin surfaces, in vitro. The tested hypothesis was that one-bottle DBS would result in lower shear bond strengths than multi-bottle DBS. MATERIALS AND METHODS: Eighty flat dentin bonding sites were prepared to 600-grit on middle dentin of caries-free human molars mounted in acrylic resin. The bonding surfaces were treated with eight different bonding systems, according to manufacturer's instructions: All-Bond 2; Amalgambond Plus; Fuji Duet; One-Step/Resinomer; OptiBond; OptiBond FL; Prime & Bond 2.0/Dyract Cem; and Scotchbond Multi-Purpose Plus. A spherical amalgam alloy (Megalloy) was hand-condensed on the treated surfaces. After thermocycling, the bond strengths were calculated by testing the specimens in shear. Field-emission SEM examinations were carried out to evaluate the effects of different treatments on the dentin-amalgam interface of MO/OD cavities treated under the same protocol. RESULTS: Statistical analysis revealed that Prime & Bond 2.0/Dyract Cem, Amalgambond Plus, and Scotchbond Multi-Purpose Plus resulted in the highest shear bond strengths. The field-emission SEM observations showed accumulation of the fluid adhesive resin underneath the amalgam restoration, and an interpenetration between the amalgam and the adhesive resin, except for OptiBond and OptiBond FL. All systems, but Fuji Duet, formed an acid-resistant resin-dentin interdiffusion zone.

Analysis of Variance↗
PubMed1999

Polytomies and phylogenetically independent contrasts: examination of the bounded degrees of freedom approach.

We examined the effect of soft polytomies on the performance (Type I error rate and bias) of Felsenstein's (1985; Am. Nat. 125:1-15) method of phylogenetically independent contrasts for estimating a bivariate correlation. We specifically tested the adequacy of bounding degrees of freedom, as suggested by Purvis and Garland (1993; Syst. Biol. 42:569-575). We simulated bivariate character evolution under Brownian motion (assumed by independent contrasts) and eight other models on five phylogenetic trees. For non-Brownian motion simulations, the adequacy of branch-length standardization was checked with a simple diagnostic (Garland et al., 1992; Syst. Biol. 41:18-32), and transformations were applied as indicated. Surprisingly, soft polytomies tended to have negligible effects on Type I error rates when models other than Brownian motion were used. Overall, and irrespective of evolutionary model, degrees of freedom were appropriately bounded for hypothesis testing, and unbiased estimates of the correlation coefficient were obtained. Our results, along with those of previous simulation studies, suggest that independent contrasts can reliably be applied to real data, even with phylogenetic uncertainty.

Models, Genetic↗
PubMed2006

'Severe' wear challenge to 'as-cast' and 'double heat-treated' large-diameter metal-on-metal hip bearings.

The wear generation of double-heat-treated and as-cast large-diameter metal-on-metal (MOM) hip bearings was investigated using standard- and 'severe'-gait simulations. The test hypothesis was that double heat treatment would change MOM hip wear compared with the as-cast condition. Two groups of high-carbon MOM bearings of 40 mm diameter were manufactured and subjected to either hot isostatic pressing (HIP) and solution annealing (SA) or no heat treatment (as cast). The results showed no statistical difference between the two groups under both running-in and steady state conditions. Even under the most 'severe'-gait simulation published to date, the mean volumetric wear rates were 2.9 and 3.9 mm3 per 10(6) cycles for the HIP-SA and as-cast bearings respectively, showing a ten-fold increase in wear compared with walking. These differences were not statistically different; therefore our hypothesis was negated. Changes in alloy microstructure do not appear to influence the wear behaviour of high-carbon cast MOM articulations with similar chemical compositions. This is in sharp contrast with the published significance of bearing diameter and radial clearance on the wear of MOM hip bearings.

Biocompatible Materials↗
PubMed1990

Stress, health and performance in university students.

The hypothesis tested was that cognitive factors in the generation of stress, namely perceived coping incapacity (PCI), relate to the extent of psychosomatic ailments. We developed a new scale, CAST (Cognitive Appraisal Stress Test), with a 10 point self-rating of PCI using 16 questions on different aspects of perceived demands versus perceived capabilities. For the assessment of ailments relevant to stress we constructed a scale (PSYSOM) based on a translation of the Scheuch-Vogel symptom list (developed in the GDR from self-report of teachers who could not work as a result of work stress). A special scoring system combined duration, intensity and frequency of 30 symptoms and provided normalisation of distributions. The scales were administered on separate days to 75 female students in their second year (working to obtain admission to an honours degree course). The hypothesis was strongly supported, since the overall scale of PSYSOM correlated with CAST: r = 0.42, p less than .001. The physiologically defined subscale of 'skeletal muscle tension' correlated r = 0.65 with CAST. Subsequently CAST and PSYSOM have been shortened and factor analysed to give, in each case, a general principal component scale and several identifiable varimax subscales. Research using these scales on employees has now provided cross-validation of the first findings reported here.

Achievement↗
PubMed1993

The triple-jump examination as an assessment tool in the problem-based medical curriculum at the University of Hawaii.

BACKGROUND: The three-step triple jump (TJ) examination aims to assess students' clinical problem-solving processes predominantly by means of subjective assessments administered by faculty. But training TJ administrators to ensure interrater reliability is both time- and cost-intensive, and difficult at best--hence the desire to test a more objective system of scoring students' TJ performances. METHOD: The sample was the 58 first-year students of the class of 1995, who in March 1992 were finishing the second 13-week unit in the problem-based curriculum at the University of Hawaii John A. Burns School of Medicine. To determine how well the school had succeeded in standardizing and objectifying its TJ examination (used for all units in the first two years), scores were correlated for various objective examinations independent of the TJ, the TJ administrators' subjective assessments, and the TJ objective assessments (regarding number of problem-based hypotheses generated and number of hypothesis-testing clinical database items elicited). The statistical methods used were linear regression, Student's unpaired t-test, chi-square, and the z-test. RESULTS: The TJ scores and independent objective examinations did not correlate significantly (suggesting that they assess different aspects of student achievement), but the TJ subjective and objective scores did correlate significantly. There were large standard deviations on the TJ objective scores, largely because one problem was significantly more difficult than the others (each student works on only one of several problems). However, the administrators' subjective scores for all problems were comparable. CONCLUSION: Because problems vary in difficulty, objective scores cannot be used across problems as a major component of all students' grades; but when a student has received an unsatisfactory score, an external reviewer can evaluate the appropriateness of the subjective score by comparing the student's objective performance with those of students who had the same problem and received higher subjective scores. That the administrators' subjective assessments for all problems were comparable not only suggests that the administrators were able to adjust for problem variability but also reinforces the appropriateness of using subjective assessments for the TJ examination.

Educational Measurement↗
PubMed2004

Reliability and validity of the self-efficacy for exercise and outcome expectations for exercise scales with minority older adults.

Older African Americans and Latinos tend to exercise less than older Whites and are more likely to have chronic diseases that could benefit from exercise. Measurement of self-efficacy of exercise and exercise outcome expectations in this older population is required if exercise is to be monitored carefully and enhanced in this population. The purpose of this study was to test the reliability and validity of the Self-Efficacy for Exercise Scale (SEE) and Outcome Expectations for Exercise Scale (OEE) in a sample of African American and Latino older adults. A total of 166 individuals, 32 males (19%) and 134 females (81%) with an average age of 72.8 +/- 8.4 years participated in the study. The SEE and OEE scales were completed using face-to-face interviews. There was evidence of internal consistency for both scales with alphas of .89 and .90 for the SEE scale and .72 and .88 for the OEE scale. There was some evidence of validity for both scales based on confirmatory factor analysis and hypothesis testing, because factor loadings were greater than .50 in all but two items in the OEE, and there were significant relationships between self-efficacy and outcome expectations and exercise behavior at all testing time-points. The measurement models showed a fair fit of the data to the models. The study provided some evidence for the reliability and validity of the SEE and OEE when used with minority older adults, and it provides some guidelines for future scale revisions and use.

Black or African American↗
PubMed2006

Effects of exogenous collagenase and cholesterol esterase on the durability of the resin-dentin bond.

PURPOSE: The purpose of this work was to determine microtensile dentin bond strengths (microTBS) of dentin-resin composite bonds after three-month storage in artificial saliva containing either collagenase (COL) or cholesterol esterase (EST). The null hypothesis tested is that the resin-dentin bond strength is equivalent for each storage medium at the tested storage times. MATERIALS AND METHODS: Resin composite was bonded to occlusal dentin, and microTBS specimens were formed and stored in the artificial saliva, COL, EST, or synthetic oil. After 24 h and 12-week storage, microTBS was determined and failure modes were characterized by SEM. The interfacial ultrastructure was evaluated by transmission electron microscopy as unstained and stained sections (phosphotungstic acid/uranyl acetate). Statistical analysis was performed by ANOVA and Weibull survival analyses at the 0.05 level of statistical significance. RESULTS: There were significantly weaker bond strengths after 12 weeks for all experimental storage media (p < 0.001). Artificial saliva containing EST lowered bond strengths to a significantly greater extent than did COL after 12 weeks of storage, while no difference between these groups could be discerned after 24 h. Therefore, the null hypothesis of this experiment is rejected. CONCLUSION: Exogenous enzymatic challenge to resin-dentin bonds decreased bond durability only with EST. However, when further challenges to ideal infiltration of the comonomers into the hybrid layer were carried out using inadequate removal of solvent, additional alterations in hybrid layer ultrastructure were discerned by TEM that may represent different potential degradative processes. The contribution of endogenous enzymatic challenges to the primary degradative process, ie, hydrolysis, is unknown and deserves continued attention.

Acid Etching, Dental↗
PubMed2005

Tryptophan 64 --> arginine polymorphism of beta-3-adrenergic receptor in Chilean women with polycystic ovary syndrome.

OBJECTIVE: To establish the frequency of the Trp64Arg polymorphism of the beta3 adrenergic receptor (ADRB3) in women with polycystic ovary syndrome (PCOS) from a Chilean population, focusing particularly on the interaction with body weight. In addition, we evaluated the relationship of the Trp64Arg variant with other metabolic components of this syndrome. PATIENTS AND DESIGN: In a case-control design study, a total of 106 women with clinical and hormonal evidence of PCOS and 82 healthy women (HW) were evaluated. MEASUREMENTS: An oral glucose tolerance test (OGTT) was performed and serum glucose and insulin were measured before the glucose load and 30, 60, 90 and 120 min after. Lipid profile was determined in the basal sample. Insulin resistance was assessed by the homeostatic model assessment (HOMA(IR)) and insulin sensitivity index (ISI) composite. A polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) analysis was performed to determine the Trp64Arg polymorphism of ADRB3. RESULTS: The frequency of the heterozygous condition was similar between PCOS and HW (39%vs. 35%). Only two subjects were homozygous for arginine, both belonging to the PCOS group and having a body mass index (BMI) > 30 kg/m2. In the crude analysis, hypothesis tests and odds ratios show that there is no evidence of association between the ADRB3 Trp64Arg variant and PCOS (P = 0.47). Moreover, when data were stratified by BMI categories, the statistical test for interaction between Trp64 carrier status and obesity was not significant (P = 0.29). This variant was present in 52% of the obese PCOS patients and 40% of the obese HW. In normal weight and obese PCOS carriers, the presence of the Trp64Arg variant was associated with high triglyceride (TG) levels. A major effect of the Trp64Arg variant on insulin resistance parameters could not be demonstrated. CONCLUSIONS: The frequency of the Trp64Arg polymorphism was similar in healthy women and PCOS women, and a possible interaction between the effect of this variant and obesity in PCOS could not be demonstrated. However, our results showed an association between triglyceride levels and the presence of this genetic variant in PCOS women.

Adolescent↗
PubMed1997

Dissolution of mercury from dental amalgam at different pH values.

Dissolution of mercury from dental amalgam has been shown to be diminished by the formation of a tin oxide film on the surface of the mercury-rich gamma 1 phase (Marek, 1990b). Since tin oxides dissolve at low pH values (Deltombe et al., 1974), acidic conditions in the oral cavity may cause an increase in the mercury release. The purpose of this study was to determine the effect of acidity in the range of pH 1 to pH 8 on the rate of mercury dissolution in synthetic saliva from tin-free and tin-containing gamma 1 phase and two commercial dental amalgams. The tested hypothesis was that pH affects mercury dissolution only when a protective oxide film dissolves in an acidic environment. After exposures of the specimens for 2 hr or 24 hr in sealed glass bottles, the solutions were analyzed by flameless atomic absorption spectrophotometry for mercury and silver. The results have shown pH-independent mercury dissolution in the range of pH 3 to 8, and a much faster dissolution at pH 1. At all pH values, more mercury dissolved from the tin-free phase than from the tin-containing phase, and the rate of dissolution was lowest for the dental amalgams. The results were affected by the length of the test exposure. The pH independence in a wide range of pH values has been attributed to the atomic mechanism of mercury dissolution. The low rate of mercury dissolution from specimens containing tin has been explained by the formation of a barrier tin oxide film, which dissolved only at the lowest pH. Dissolution of silver at low pH values is believed to have accelerated dissolution of mercury from the tin-free gamma 1 phase. Variation of the dissolution rate with concentration of the dissolved species and kinetics of oxide film dissolution caused the effect of the exposure period.

Analysis of Variance↗
PubMed1998

Balance of proinflammatory and antiinflammatory cytokines at thoracic cancer operation.

BACKGROUND: A homeostatic balance of proinflammatory and antiinflammatory cytokines is thought to be important for the maintenance of health. Cytokine baseline levels and response patterns to cardiac and nonmalignant abdominal operations have been investigated. The purpose of this study was to investigate the cytokine patterns at operation for thoracic cancer; the hypothesis tested was that cytokine baseline levels and response patterns would be unique for patients with malignant disease undergoing thoracic operation. METHODS: Ten patients undergoing pulmonary tumor resections were studied. Blood samples were collected at six perioperative time points. RESULTS: The cytokine response of these patients differed from patients undergoing cardiac operations: baseline tumor necrosis factor-alpha (39.1 pg/mL) and interleukin-10 (76.76 pg/mL) were elevated without significant changes. Interleukin-1 receptor antagonist became elevated postoperatively (871.6 pg/mL) compared with baseline (332.8 pg/mL) (p < 0.01). The level of tumor necrosis factor soluble receptor-2 was elevated at baseline (4,823.3 pg/mL) and remained elevated postoperatively (7,293.4 pg/mL) (p < 0.01). CONCLUSIONS: Our hypothesis was supported; a separate pattern of proinflammatory and antiinflammatory cytokine levels and responses to thoracic operation was determined. This pattern may be indicative of tumor burden or detrimental to tumor surveillance; it merits further evaluation.

Aged↗
PubMed1978

A two-factor theory of stimulus-repetition effects.

It is a well-documented finding that children respond more slowly to a stimulus that has been presented repeatedly just before test than to a novel stimulus. The effect, for which a two-factor theory has recently been proposed, did not occur in the only previous study of adults using a comparable procedure. Experiment 1 demonstrated the effect with adults. The previous negative finding may have been the result of too few repetitions of the stimulus. Experiment 2 provided additional support for the two-factor theory. The theory suggests that the effect is the net result of partially counteracting changes in two attentional processes. One process, the alertness elicited by a stimulus, is held to decrease as a result of repeated presentation of the stimulus, while the second process, encoding, is facilitated. The hypothesis tested in Experiment 2 was that the alertness decrement dissipates over a brief passage of time, while the facilitation of encoding does not. Subjects exposed to a repeatedly presented color were tested either immediately thereafter or after a 15-min or 30-min interval. As predicted, the observed effect shifted from one of flower response to one of faster response to the repeated stimulus as the delay interval increased.

Adult↗
PubMed2002

Indirect measurement of the production of plasma triacylglycerols by horses given a high-fat diet.

The hypothesis tested was that the feeding of extra fat to horses would raise the production of plasma triacylglycerols (TAG). To measure TAG secretion, the indirect Triton method was used. Six adult horses were given a low-fat control or a high-fat diet according to a crossover design. In keeping with our earlier work, the high-fat diet lowered fasting plasma TAG concentrations by an average of 42% and raised post-heparin total lipoprotein lipase activity by 79%. The rate of increase in plasma TAG concentration after Triton administration was 49% lower when the horses were fed the high-fat diet instead of the low-fat control diet. Thus, the hypothesis is rejected. It is suggested that the dose of Triton used in the study might have been too low to fully depress lipoprotein lipase activity, leading to an outcome of the study that was opposite to that expected.

Animals↗
PubMed1997

Role of diameter differences among follicles in selection of a future dominant follicle in mares.

Follicles > or = 5 mm were ablated in pony mares by a transvaginal ultrasound-guided technique on Day 10 (ovulation = Day 0). Follicle emergence (at 15 mm, experiment 1; at 6 mm, experiment 2) and development of the new wave was monitored by transrectal ultrasound. Deviation was defined as the beginning of a marked difference in growth rates between the two largest follicles. In experiment 1, mares were grouped (n = 4 per group) into controls, ablation-controls (ablations at Day 10 only), and a two-follicle model (periodic ablation sessions so that only the two largest follicles developed). There were no significant indications that the two-follicle model altered follicle diameters, growth rates, or time intervals of the two retained follicles at or between events (follicle emergence, deviation, and ovulation). In experiment 2, the two-follicle model (n = 14) was used for follicle and hormonal characterization and hypothesis testing, without the tedious and error-prone necessity for tracking many (e.g., 20) individual follicles. The future dominant follicle emerged a mean of 1 day earlier (p < 0.008) than the future subordinate follicle, the growth rates for the two follicles between emergence and deviation (6 days later) did not differ, and the dominant follicle was larger at the beginning of deviation (23.1 +/- 0.8 mm versus 19.6 +/- 0.9 mm; p < 0.0001). Mean FSH and LH concentrations increased (p < 0.05) concomitantly from emergence of the future dominant follicle and peaked 3 days later when the follicle was a mean of 13 mm. Thereafter, the two hormones disassociated until ovulation: FSH decreased and LH increased. Results supported the hypothesis that the future dominant follicle has an early size advantage over future subordinate follicles and indicated that the advantage was present as early as 6 days before deviation.

Animals↗
PubMedDate not supplied

Methods for improving clinical trials.

Over the past decades, the randomized controlled trial has entered an era of continuous improvement and has gradually become accepted as the most effective way of determining the relative efficacy and toxicity of new therapies because it controls for placebo and time effects. However, even sensitive and properly designed and executed trials do not always confirm hypotheses to be tested, and conclusions are not always confirmed by subsequent trials. Although the former may be due to wrong hypotheses, the latter is likely to be due to the presence of certain imperfections within the design and execution of the trial itself. In this opinion paper, while focusing on such imperfections, the author searched for methods for further improvement of controlled trials, particularly clinical trials. The examples used in this paper are obtained from literature search as well as recent studies performed by the Netherlands Working Group on Cardiovascular Research (WCN). Methods for improvement could include: 1. making every effort to avoid asymmetries in the treatment groups; 2. emphasis on statistical power rather than just null-hypothesis testing; 3. adjusting for asymmetries not only of patient characteristics but also of outcome variables; 4. accounting routinely for type III errors; 5. routinely weighing benefits of a new drug against risks.

Clinical Trials as Topic↗
PubMed2000

Abnormal middle ear pressures during experimental influenza A virus infection--role of Eustachian tube function.

INTRODUCTION: Experimental infection of adults with influenza A virus, rhinovirus or RSV causes abnormal ME pressure in some, but not all subjects. The hypothesis tested in this study is that the response variability is caused by constitutional differences in the functioning of the Eustachian tube. METHODS: 18 adult subjects were experimentally infected with influenza A virus. On five occasions before virus exposure, middle ear pressure (by tympanometry) and Eustachian tube function (by sonotubometry) were recorded bilaterally. Tests were repeated on days 1 through 8 and 10 after infection. Individual ears were classified with respect to the number of pre-exposure, positive sonotubometric testings and the middle ear pressure response to infection was compared between ears with Eustachian tube openings at all pre-infection test sessions (GR-A) and those with at least one negative test (GR-B). RESULTS: Pre-exposure, 19, six, four, four, one and two ears had tubal openings on five, four, three, two, one and zero sessions, respectively. For that period, GR-A had significantly lesser average intra-ear and intra-group middle ear pressure variances compared to GR-B, but there were no between-group differences in the average middle ear pressure or in the number of observations of abnormal middle ear pressure. After virus exposure, middle ear pressure variances and the number of abnormal observations increased and the average pressure decreased in both groups, but the effects were more pronounced for GR-B ears. CONCLUSIONS: These results support the hypothesis that pre-existing good Eustachian tube function reduces the otological complications of viral upper respiratory tract infection.

Adult↗