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Planning and executing simple movements: contributions of relative-time and overall-duration specification.

In 3 experiments, the authors used a precuing protocol to examine the nature and cost of programming and the subsequent reprogramming of a movement's relative time and overall duration. Initial programming followed a fixed-order specification; knowledge of the necessary relative time was required before information regarding overall duration could be used in a manner that expedited response planning. In the case of reprogramming, however, when a modification had to be made in either the relative time or overall duration of the anticipated and already-prepared response, performers chose to completely reprogram the entire response. Complete reprogramming occurred even when the performer had correctly prepared the higher order relative-time component and only had to modify the overall duration of the movement. The data indicate that organizing movement timing before movement initiation is accomplished in a fundamentally different manner depending on whether the movement is being initially compiled or modified.

Adult↗

Abdominal pain and patient overall and cosmetic satisfaction one year after cholecystectomy: outcome of a randomized trial comparing laparoscopic and minilaparotomy cholecystectomy.

BACKGROUND: Previous studies with long-term follow-up after cholecystectomy have shown that residual abdominal symptoms are common. Laparoscopic cholecystectomy (LC) and minilaparotomy cholecystectomy (MC) can both give a smoother, early postoperative course than conventional open cholecystectomy (OC). The present study concerns abdominal pain and patient overall and cosmetic satisfaction one year after LC and MC. METHODS: In a prospective, single-blind study, 724 patients were randomly allocated to LC or MC. Patients completed questionnaires including items concerning abdominal pain before and one year after surgery and overall and cosmetic satisfaction one year after surgery. RESULTS: There was no difference in reduction of abdominal pain between LC and MC patients. For four different aspects of abdominal pain, 31%, 24%, 30% and 16% of patients operated with LC reported residual abdominal pain one year after surgery. The corresponding figures for MC were 28%, 20%, 27% and 18% (P values 0.55, 0.32, 0.55 and 0.63, respectively). According to questionnaire answers, there was no significant difference in the cosmetic result and overall patient satisfaction between LC and MC patients. CONCLUSIONS: There are no differences between laparoscopic and minilaparotomy cholecystectomy in long-term outcome regarding abdominal pain and patient overall and cosmetic satisfaction. A large proportion of patients have abdominal pain one year after cholecystectomy. Future studies should include preoperative assessment and indications for cholecystectomy.

Abdominal Pain↗

The suitability of alternative fatty food simulants for overall migration testing under both low- and high-temperature test conditions.

The suitability of various alternative, volatile fatty food simulants for overall migration testing was investigated under both low- and high-temperature test conditions. The overall migration into olive oil from a large number of commercially used food packaging materials applying various low- and high-temperature test conditions (e.g. 2 h at 175 degrees C, 30 min at 130 degrees C, 1 h at 100 degrees C followed by 10 days at 40 degrees C, 10 days at 20 degrees C) was determined. The results were compared with overall migration from these samples into iso-octane, 50% or 95% ethanol and isopropanol under appropriate test conditions. The samples investigated include homogeneous plastic films, laminates, coated board samples, a coated can, and articles. The results of the study indicate that iso-octane, 95% ethanol and isopropanol are suitable alternative fatty food simulants for overall migration testing under various time and temperature conditions.

2-Propanol↗

The effect of coarse ambient particulate matter on first, second, and overall hospital admissions for respiratory disease among the elderly.

The objective of this article is to examine differences in the effect of ambient particulate matter on first, second, and overall hospital admissions for respiratory disease among the elderly. We studied 8989 adults 65 yr of age or older living in the greater Vancouver area who were admitted to hospital for any acute respiratory disease (ICD-9 codes 460-519) between June 1, 1995, and March 31, 1999. Time-series analysis was used to evaluate the association between respiratory admissions and daily measures of particulate matter (PM10, PM2.5, and PM10 - 2.5) in urban air, after adjustment for gaseous copollutants (CO, O3, NO2, and SO2) and meteorological variables. Repeated admissions for respiratory disease were common among the elderly. Approximately 30% of the subjects were readmitted to hospital after the first admission; 9% had more than 2 admissions for respiratory disease during the 4-yr study period. PM10 - 2.5 was significantly associated with the second and overall admissions for respiratory disease, but not with the first admission. The adjusted relative risks for an increment of 4.2 microg/m(3) in -day average PM10 - 2.5 concentrations were 1.03 (95% confidence interval: 0.98-1.09) for the first admission, 1.22 (1.10-1.36) for the second admission, and 1.06 (1.02, 1.11) for overall admissions. There was no significant association between PM2.5 and hospital admissions for respiratory disease among the elderly. Our data suggest that (1) people with a history of respiratory admissions are at a higher risk of respiratory disease in relation to particulate air pollution in urban areas, (2) analyses based on overall rather than repeated hospital admissions lead to lower estimates of the risk of respiratory disease associated with particulate air pollution, and (3) PM10 - 2.5 has a larger effect on respiratory admissions than PM2.5.

Aged↗

Repair of ionizing radiation induced DNA double-strand breaks (dsb) at the c-myc locus in comparison to the overall genome.

PURPOSE: The aim of this study was to determine the repair of radiation-induced DNA double-strand breaks (dsb) in actively transcribed regions and in the overall genome. MATERIALS AND METHODS: Pulsed-field gel electrophoresis was performed on Sfi I restriction enzyme digested DNA, labelled with a c-myc probe and on non-specifically 14C-labelled DNA of the adenocarcinoma cell line COLO320HSR after 400 Gy irradiation with 7 MeV electrons and repair incubation. RESULTS: At the 130 kbp c-myc locus 68 +/- 5% of all dsb induced at a dose of 400 Gy were repaired by a fast mechanism with a repair half time of 9.4 +/- 3.2 min in comparison to the overall genome where all dsb induced at 400 Gy were repaired with a half time of 86 +/- 23 min. The fraction of residual dsb was about 30% higher in the c-myc locus than in the overall genome. CONCLUSIONS: This study demonstrates intragenomic heterogeneity in half times of dsb repair with faster repair at the c-myc locus. In addition, differences in the residual dsb were found to represent region specific heterogeneity in residual damage or to possibly be attributed to the different assays used. The approach with gene probing can distinguish between correct and incorrect rejoining of dsb within the resolution of the experiments (< or = 20 kbp), in contrast to the assay at the overall genome.

DNA↗

Preferred overall loudness. I: Sound field presentation in the laboratory.

This study questions the basic assumption that prescriptive methods for nonlinear, wide dynamic range compression (WDRC) hearing aids should restore overall loudness to normal. Fifteen normal-hearing listeners and twenty-four hearing-impaired listeners (with mild to moderate hearing loss, twelve with and twelve without hearing aid experience) participated in laboratory tests. The participants first watched and listened to video sequences and rated how loud and how interesting the situations were. For the hearing-impaired participants, gain was applied according to the NAL-NL1 prescription. Despite the fact that the NAL-NL1 prescription led to less than normal overall calculated loudness, according to the loudness model of Moore and Glasberg (1997), the hearing-impaired participants rated loudness higher than the normal-hearing participants. The participants then adjusted a volume control to preferred overall loudness. Both normal-hearing and hearing-impaired participants preferred less than normal overall calculated loudness. The results from the two groups of hearing-impaired listeners did not differ significantly.

Adolescent↗

Preferred overall loudness. II: Listening through hearing aids in field and laboratory tests.

In a laboratory study, we found that normal-hearing and hearing-impaired listeners preferred less than normal overall calculated loudness (according to a loudness model of Moore & Glasberg, 1997). The current study verified those results using a research hearing aid. Fifteen hearing-impaired and eight normal-hearing participants used the hearing aid in the field and adjusted a volume control to give preferred loudness. The hearing aid logged the preferred volume control setting and the calculated loudness at that setting. The hearing-impaired participants preferred, in median, loudness levels of -14 phon re normal for input levels from 50 to 89 dB SPL. The normal-hearing participants preferred close to normal overall loudness. In subsequent laboratory tests, using the same hearing aid, both hearing-impaired and normal-hearing listeners preferred less than normal overall calculated loudness, and larger reductions for higher input levels In summary, the hearing-impaired listeners preferred less than normal overall calculated loudness, whereas the results for the normal-hearing listeners were inconclusive.

Adult↗

Evaluating overall significance levels in multifactor ANOVA.

Multifactor ANOVA procedures are commonly used by practitioners. A hierarchical process for testing the interaction effect(s) first, followed by tests for the main effects, is usually employed. Generally, no consideration is given to the overall type I error rate for these dependent (or conditional) tests. In this article, we formulate a method to evaluate the true overall significance levels for two-factor fixed-effect ANOVA models. Methods for evaluating conditional p-values are discussed. We present the overall significance levels for several specific two-factor designs. We discuss upper bounds on the overall significance level and extensions of the computational methods to higher-order designs as well as applications to random-effect models and mixed models.

Analysis of Variance↗

Using graphical displays of exact overall significance levels as a guideline for choosing a significance level for pairwise comparisons of a dichotomous variable.

Exact overall significance levels for selected sample sizes and response probabilities are graphically displayed when a dichotomous variable is compared between a placebo and two or more active treatments. A Z-statistic with a pooled variance estimator is used as the test statistic and critical values are based on the (1 - alpha/2)th percentile of the standard normal distribution. These figures are used as a simple guideline for choosing significance levels that achieve a desired overall significance level. If an overall significance level of 0.05 is desired when comparing a placebo to two, three, or four active treatments, the recommended significance levels to be used for each of the two, three, or four pairwise comparisons are 0.027, 0.019, or 0.015. If an overall significance level of 0.10 is desired, the corresponding recommended significance levels are 0.055, 0.039, or 0.031.

Computer Graphics↗

On the surviving fraction in irradiated multicellular tumour spheroids: calculation of overall radiosensitivity parameters, influence of hypoxia and volume effects.

We model the heterogeneous response to radiation of multicellular tumour spheroids assuming position- and volume-dependent radiosensitivity. We propose a method to calculate the overall radiosensitivity parameters to obtain the surviving fraction of tumours. A mathematical model of a spherical tumour with a hypoxic core and a viable rim which is a caricature of a real tumour is constructed. The model is embedded in a two-compartment linear-quadratic (LQ) model, assuming a mixed bivariated Gaussian distribution to attain the radiosensitivity parameters. Ergodicity, i.e., the equivalence between ensemble and volumetric averages is used to obtain the overall radiosensitivities for the two compartments. We obtain expressions for the overall radiosensitivity parameters resulting from the use of both a linear and a nonlinear dependence of the local radiosensitivity with position. The model's results are compared with experimental data of surviving fraction (SF) for multicellular spheroids of different sizes. We make one fit using only the smallest spheroid data and we are able to predict the SF for the larger spheroids. These predictions are acceptable particularly using bounded sensitivities. We conclude with the importance of taking into account the contribution of clonogenic hypoxic cells to radiosensitivity and with the convenience of using bounded local sensitivities to predict overall radiosensitivity parameters.

Animals↗

Factors that influence cancer patients' overall perceptions of the quality of care.

OBJECTIVE: This study outlines predictors of cancer patients' overall perceptions of the quality of care. DESIGN AND SETTING: Our sample included 2790 patients who received cancer care services during 2004 in 15 comprehensive cancer programmes across Ontario, Canada. Patients were classified into three groups: those receiving both chemotherapy and radiotherapy (n = 752), those receiving only chemotherapy (n = 1044), and those receiving only radiotherapy (n = 994). An ordinal logistic regression model for each patient group was performed to determine which variables most affected the probabilities of the patients' overall evaluations of the quality of care. Potential control variables were patients' age, sex, type of cancer, self-assessed health, and who completed the survey. RESULTS: Among seven common predictors of the overall quality perception across the three models, four should be of particular interest because patients perceived them as relatively problematic aspects of care. These are 'was informed about follow-up care after completing treatment', 'knew next step in care', 'knew who to go to with questions', and 'providers were aware of test results'. These predictors explained between 25 and 34% of the variance (depending on the model) of the overall perception of quality. The explanatory power of these predictors did not change across sex and age group. 'Self-assessed health' was the only control variable that remained in all three models. CONCLUSIONS: From a practical perspective, improvement efforts are best focused on factors that are strong predictors as well as on those for which there is a low score. Thus, on the basis of this study, practitioners' improvement efforts might be constructively focused on the four predictors mentioned above.

Adolescent↗

A comparison of the overall NRMP match results with the results for 19 specialties for senior U.S. medical students, 1996.

PURPOSE: To compare U.S. medical student Match results in 1996 for 19 categorical residency positions by specialty with those of the overall Match reported by the National Resident Matching Program (NRMP). METHOD: Data for the numbers of "active" senior U.S. student applicants (those who submitted rank lists), the numbers of U.S. seniors matched, and the numbers of unfilled positions for 19 specialties were obtained from a variety of sources. Chi-square analysis was performed to compare Match results for each independent specialty with the overall Match results. The level for statistical significant was set at p < .005. RESULTS: Eight specialties were identified as significantly more competitive than the overall Match process for both the percentage of U.S. seniors who successfully matched in that specialty and the ratio of unmatched U.S. senior applicants to unfilled categorical positions. Five specialties were identified as significantly less competitive for these two measures. Six specialties showed no significant difference in the percentages of U.S. students matching, but for three of these specialties there were more unmatched students than unfilled categorical positions. CONCLUSION: U.S. medical student Match results for categorical residency positions for different specialties vary significantly from the overall Match process. This information can be used in counseling senior medical students on their specialty selection and the residency application process.

Chi-Square Distribution↗

Lymphocyte counts independently predict overall survival in advanced cancer patients: a biomarker for IL-2 immunotherapy.

Interleukin-2 (IL-2) targets cells bearing IL-2 receptors and induces different degrees of lymphocytosis. This study retrospectively evaluated whether lymphocytosis, in addition to clinical characteristics at baseline and to tumor objective response, may predict overall survival in metastatic renal cell carcinoma patients who received IL-2 subcutaneously (s.c.). Overall survival, clinical characteristics, tumor response, and total lymphocyte count at baseline and during the first treatment cycle of 266 advanced renal cell cancer patients, treated with 1 of 4 different first-line s.c. IL-2-based protocols, were studied using the Cox multivariate analysis. Median IL-2 cumulative dose and length of treatment (+/-SD) were 232 +/- 282 x 10(6)/m(2) in 7 +/- 5.9 weeks, respectively. Median overall survival (os) was 13.1 months (range 0.7-86.9+) in all. Tumor outcome consisted of: 9 CR (3%) (os = NR); 35 PR (13%) (os = 19.7 months.); 117 SD (44%) (os = 15.1 months); 105 PD (39%) (os = 6.4 months). Median lymphocyte counts were 1400/mm(3) at baseline (25th-75th, 900-1900/mm(3)) and 3600/mm(3) as a maximum value (25th-75th, 2600-4800/mm(3)). Death risk significantly decreased by 11% for each 1,000 lymphocytes/mm(3) (RR 0.89; 95% CI 0.82-0.97), after correcting for clinical characteristics (PS ECOG 0 versus > or =1, time from primary diagnosis > or =2 years versus <2 years, number of metastatic sites 1 versus >1) and tumor response (CR, PR). A two-step bootstrapping procedure confirmed such predictive performance. Lymphocyte count monitoring represents a biomarker of the host response to subcutaneous IL-2 treatment useful for multimodal clinical assessment, as it predicts overall survival in advanced cancer patients independently from tumor response and from main clinical characteristics.

Adult↗

Choice of and overall satisfaction with pharmacies among a community-dwelling elderly population.

OBJECTIVES: To identify factors related to elderly consumers' choice of pharmacy types and their overall satisfaction with pharmacy services provided by: a single community pharmacy, multiple pharmacies with a primary community pharmacy, a single mail order pharmacy, and multiple pharmacies with a primary mail order pharmacy. DATA: Data were extracted from the Texas Tech 5000 survey of consumers, age 65 years or older, in West Texas. The survey contains information about the respondents' health services use, pharmacy service use, satisfaction with accessibility and quality, health insurance coverage, health beliefs, health status, and demographics, as well as other health-related factors. METHODS: An endogenous treatment effect model was used to examine elderly consumers' choice of and satisfaction with different types of pharmacies. The first stage of the estimation identified factors related to consumers' choice of pharmacies. The second stage estimated the effects of pharmacy types on consumers' overall satisfaction with pharmacy services, controlling for self-selection. RESULTS: The type of pharmacy was a significant determinant of satisfaction. Self-selection was found in the determination of consumers' overall satisfaction with pharmacy services. Controlling for self-selection, elderly consumers who used a single community pharmacy and who used multiple pharmacies with a primary mail order pharmacy were the most satisfied with their pharmacy services. The type of pharmacy that ranked lowest in overall consumer satisfaction was multiple pharmacies with a primary community pharmacy. Insurance coverage of prescription drugs was significantly associated with consumers' choice of pharmacy. The greater the number of prescription drugs a consumer took, the higher the odds were that they used multiple pharmacies. CONCLUSIONS: Although using a single community pharmacy may create close patient-pharmacist relationships and improve health outcomes, consumers may be diverted from this choice because of price concerns and insurance diversification.

Aged↗

Health insurance coverage and the risk of decline in overall health and death among the near elderly, 1992-2002.

BACKGROUND: Although individuals' health insurance coverage changes frequently, previous analyses have not accounted for changes in insurance coverage over time. OBJECTIVE: We sought to determine the independent association between lack of insurance and the risk of a decline in self-reported overall health and death from 1992 to 2002, accounting for changes in self-reported overall health and insurance coverage. METHODS: We analyzed data from the Health and Retirement study, a prospective cohort study of a national sample of community-dwelling adults age 51-61 years old at baseline. Major decline in self-reported overall health and mortality was determined at 2-year intervals. RESULTS: People who were uninsured at baseline had a 35% (95% confidence interval [CI] 12-62%) higher risk-adjusted mortality from 1992 to 2002 compared with those with private insurance. However, when we analyzed outcomes over 2-year intervals, individuals who were uninsured at the start of each interval were more likely to have a major decline in their overall health (pooled adjusted relative risk 1.43, 95% CI 1.28-1.63), but they were equally likely to die (pooled adjusted relative risk 0.96, 95% CI 0.73-1.27). Of the 1512 people who were uninsured at baseline, 220 (14.6%) died; of those who died, only 70 (31.8%) were still uninsured at the HRS interview prior to death. CONCLUSIONS: Death does not appear to be a short-term consequence of being uninsured. Instead, higher long-term mortality among the uninsured results from erosion in this population's health status over time and the attendant higher mortality associated with this. Most deaths among the uninsured occur after individuals have gained either public or private health insurance.

Cohort Studies↗

Correlation of preoperative thallium SPECT with histological grading and overall survival in adult gliomas.

BACKGROUND: The management and prognosis of a glioma depend on the tumour's histological grade. Thus, preoperative prediction of the grade is routinely needed to indicate whether surgery or biopsies are required. It has been proposed that thallium single photon emission computed tomography (SPECT), in a relative short series, will aid this prediction. AIM: To confirm the correlation between the results of preoperative thallium SPECT and grade of tumour as well as patient survival, and to define the cut-off value of the optimal thallium index for the detection of high grade gliomas in a large series of patients. METHODS: One hundred and eighteen patients treated for glioma were retrospectively included in this study. All patients underwent preoperative 201Tl SPECT upon initial presentation and were referred for neurosurgery. Initial scintigraphic findings were correlated with the histological grade of the tumour and overall patient survival. RESULTS: Thallium uptake was highly correlated with histological grade; the mean thallium indices for low grade and high grade gliomas were 1.8 and 4.9, respectively. On the basis of receiver operating characteristic analysis, the optimal cut-off value of the thallium index for the detection of high grade glioma was determined. By using 2.2 as the value for the threshold thallium index, the sensitivity and specificity were 93% and 72%, respectively. Kaplan-Meier estimates of the overall survival curves, as a function of the thallium index, indicated that it was correlated with the overall survival (P<0.001). CONCLUSION: Thallium SPECT provides useful information about the histological grade of the tumour and overall patient survival. Additionally, in spite of its relatively weak resolution, it appears to be a powerful routine clinical tool for the management of gliomas.

Brain Neoplasms↗

Overall and cause-specific mortality in ulcerative colitis: meta-analysis of population-based inception cohort studies.

OBJECTIVES: It remains debated whether patients with ulcerative colitis (UC) are at greater risk of dying and whether a possible alteration in mortality can be attributed to specific causes of death. We aimed to clarify this issue by conducting a meta-analysis of population-based inception cohort studies on overall and cause-specific mortality in patients with UC. METHODS: The MEDLINE search engine and abstracts from international conferences were searched for relevant literature by use of explicit search criteria. STATA meta-analysis software was used to calculate pooled risk estimates (SMR, standardized mortality ratio, observed/expected deaths) of overall mortality and specific causes of death and to conduct metaregression analyses of the influence of specific variables on SMR. RESULTS: Ten papers fulfilled the inclusion criteria, reporting SMRs varying from 0.7 to 1.4. The overall pooled estimate was 1.1 (95% confidence interval [CI] 0.9-1.2, P= 0.42). However, greater risk of dying was observed during the first years of follow-up, in patients with extensive colitis, and in patients from Scandinavia. Metaregression analysis showed an increase in SMR by increasing cohort size. UC-related mortality accounted for 17% of all deaths. Mortality from gastrointestinal diseases, nonalcoholic liver diseases, pulmonary embolisms, and respiratory diseases was increased whereas mortality from pulmonary cancer was reduced. CONCLUSIONS: The overall risk of dying in patients with UC did not differ from that of the background population, although subgroups of patients were at greater risk of dying. The cause-of-death distribution seemed to differ from that of the background population.

Cause of Death↗

[Study on the effects of influenza virus vaccines--relation between the rate of two-fractional vaccination and the overall rate of absenteeism].

In 1987 and 1988, in 9 elementary schools, the percentage of children who received two sessions of vaccination and the overall rate of absenteeism resulting from influenza were determined for each class, and their relationship was investigated. The following results were obtained. 1) The mean vaccination rate was 58.6% among 157 classes in 1987, whereas it was 29.9% among 151 classes in 1988, the rate being significantly higher in 1987. 2) The mean overall rate of absenteeism was 1.524% in 1987, which was significantly lower than the corresponding rate, 2.802%, in 1988. 3) There was a significant negative correlation between the vaccination rate and the overall rate of absenteeism in 7 of the 9 schools in 1987; the overall rate of absenteeism became significantly low with an increase in the vaccination rate. 4) No such trend, however, was noted in any of the schools in 1988. 5) The difference between the results in 1987 and those in 1988 seems to be attributable to the facts that variability of the prevailing strains of influenza was low (V0, 82%) in 1987, in addition to the high vaccination rate in that year, and that influenza virus type B having a high variability (V3, or more, 78%) prevailed in 1988, when the vaccination rate was low.

Absenteeism↗