BACKGROUND & AIMS: BACKGROUND:Manufacturers recommend maintaining Bispectral (BIS) or Spectral Entropy (State Entropy, SE) indexes between 40 and 60 during the maintenance of anesthesia. We compared these indexes during this period. METHODS:Data were obtained from 58 patients receiving sufentanil-sevoflurane-nitrous oxide anesthesia. The anesthesiologist was blinded to BIS and SE. Artifact-free concurrent BIS and SE values (7792 pairs), automatically recorded at 1-min intervals, were compared using Bland-Altman analysis, Kappa coefficient for agreement and crude proportion of agreement. The occurrence of errors of judgment (Type 1 defined as one parameter <40 and the other >60, or Type 2 defined as BIS and SE values on different sides of a threshold [40 or 60]) was also counted. RESULTS:Bias was -2 with limits of agreement of -18 and 9. Kappa BIS/SE obtained from all patients was 0.537 +/- 0.147; crude agreement >0.80 was observed in 45% of patients. Type 1 number of errors of judgment corresponded to two instances. Median and interquartile values of Type 2 number of errors of judgment were 4.5 [3.0-6.0] when considering a difference between BIS and SE more than 5. CONCLUSION:Although limits of agreement between BIS and SE were large, Kappa value moderate, and crude agreement <0.80 in more than half of the patients, making completely contradictory decisions (e.g., deepening the anesthetic based on one parameter and lightening it based upon the other) would have been exceptional. More common would have been a risk of error between no change versus increasing or decreasing anesthetic depth.

背景与目标：

BACKGROUND & AIMS: UNLABELLED:Electronic medical records (EMRs) are used increasingly for research in clinical oncology, epidemiology, and comparative effectiveness research (CER). OBJECTIVE:To assess the utility of using EMR data in population-based cancer research by comparing a database of EMRs from community oncology clinics against Surveillance Epidemiology and End Results (SEER) cancer registry data and two claims databases (Medicare and commercial claims). STUDY DESIGN AND SETTING:DEMOGRAPHIC, CLINICAL, AND TREATMENT PATTERNS IN THE EMR, SEER, MEDICARE, AND COMMERCIAL CLAIMS DATA WERE COMPARED USING SIX TUMOR SITES: breast, lung/bronchus, head/neck, colorectal, prostate, and non-Hodgkin's lymphoma (NHL). We identified various challenges in data standardization and selection of appropriate statistical procedures. We describe the patient and clinic inclusion criteria, treatment definitions, and consideration of the administrative and clinical purposes of the EMR, registry, and claims data to address these challenges. RESULTS:Sex and 10-year age distributions of patient populations for each tumor site were generally similar across the data sets. We observed several differences in racial composition and treatment patterns, and modest differences in distribution of tumor site. CONCLUSION:Our experience with an oncology EMR database identified several factors that must be considered when using EMRs for research purposes or generalizing results to the US cancer population. These factors were related primarily to evaluation of treatment patterns, including evaluation of stage, geographic location, race, and specialization of the medical facilities. While many specialty EMRs may not provide the breadth of data on medical care, as found in comprehensive claims databases and EMR systems, they can provide detailed clinical data not found in claims that are extremely important in conducting epidemiologic and outcomes research.

背景与目标：

BACKGROUND & AIMS: :A series of experiments addressed the issue of comparability among neurological processes in pigmented rat and human visual systems. In the first set of experiments, transient visual-evoked potentials (VEPs) were elicited by the onset of sine-wave gratings of various spatial frequencies. The spatial frequency-response profiles of the first positive and immediately succeeding negative components differed from one another, but were similar in the two species. In addition, amplitude of the negative, but not the positive, component was strongly attenuated in both species following stationary pattern adaptation. In the second set of experiments, steady-state VEPs were elicited by the onset and offset of the gratings. The spatial frequency profiles of the 1F (response amplitude at the frequency of stimulus onset-offset) and 2F response components differed from one another, but were similar in both species. The final set of experiments indicated that diazepam, a GABA agonist, reduced amplitude of 2F, but not 1F, in both species. These results suggested that at least some functional subsystems mediating spatial vision in humans may have qualitatively similar counterparts in rats.

背景与目标： : 一系列实验解决了有色大鼠和人类视觉系统中神经过程之间的可比性问题。在第一组实验中，通过各种空间频率的正弦波光栅的出现引起了瞬态视觉诱发电位 (vep)。第一个正分量和紧随其后的负分量的空间频率响应曲线彼此不同，但在两个物种中相似。此外，在固定模式适应之后，两个物种的负成分 (而非正成分) 的振幅都强烈减弱。在第二组实验中，稳态vep是由光栅的开始和偏移引起的。1F (刺激开始偏移频率下的响应幅度) 和2F响应分量的空间频率分布彼此不同，但两种物种相似。最后一组实验表明，地西epa (一种GABA激动剂) 在两种物种中均降低了2F的振幅，但没有降低1F的振幅。这些结果表明，至少一些介导人类空间视觉的功能子系统在大鼠中可能具有定性相似的对应物。

BACKGROUND & AIMS: :The present study examined the comparability of 4 alternate forms of the Digit Symbol Substitution test and the Symbol Digit Modalities (written) test, including the original versions. Male contact-sport athletes (N = 112) were assessed on 1 of the 4 forms of each test. Reasonable alternate form comparability was demonstrated through establishing normality of form distributions and conducting pairwise form comparisons of means, variability, and intraclass correlations. Nonetheless, alternate forms are likely an insufficient means of controlling practice in speeded measures at brief (1-2 weeks) retest intervals. Reliable change indices demonstrated that practice must be accounted for in individual retesting.

背景与目标： : 本研究检查了数字符号替换测试和符号数字模态 (书面) 测试的4种替代形式的可比性，包括原始版本。对每种测试的4种形式中的1种进行男性接触运动运动员 (N = 112) 的评估。通过建立形式分布的正态性并对均值，变异性和类内相关性进行成对形式比较，证明了合理的替代形式可比性。尽管如此，在短暂的 (1-2周) 重新测试间隔内，替代形式可能不足以控制快速措施的实践。可靠的变化指数表明，必须在个人重新测试中考虑实践。

BACKGROUND & AIMS: :The SCID was administered twice, once by telephone and once in person (1 week later) to 41 college age men. For major depression (lifetime k =.64, current k =.66), results indicated good agreement. The lifetime occurrence estimate based on the telephone SCID diagnosis was lower than the in-person SCID estimate. Kappas for specific diagnoses were calculable for simple phobia (lifetime k =. 47, current k = .03) and social phobia (lifetime k =.29). Base rates were less than 10% for all individual diagnoses except lifetime major depression; therefore, the kappas may be unstable. For all diagnoses where there were any positive cases, percentages of negative agreement and specificity were high, whereas percentages of positive agreement and sensitivity were lower. Overall agreement was fair for specific lifetime diagnoses but poor for current diagnoses. These results suggest caution in assuming comparability of in-person and telephone SCID diagnoses. Circumstances under which a telephone SCID may be useful and ways to improve reliability are discussed.

背景与目标： : 对41名大学年龄的男性进行了两次SCID，一次是通过电话进行的，一次是亲自进行的 (1周后)。对于重度抑郁症 (终生k =.64，当前k =.66)，结果表明良好的一致性。基于电话SCID诊断的终生发生估计值低于面对面SCID估计值。对于简单恐惧症 (终生k = 0.47，当前k = .03) 和社交恐惧症 (终生k =.29)，可计算特定诊断的Kappas。除终生严重抑郁症外，所有个体诊断的基本率均低于10%; 因此，kappas可能不稳定。对于所有存在阳性病例的诊断，阴性一致性和特异性的百分比较高，而阳性一致性和敏感性的百分比较低。对于特定的终生诊断，总体协议是公平的，但对于当前诊断而言，总体协议较差。这些结果表明，在假设面对面和电话SCID诊断的可比性时要谨慎。讨论了电话SCID可能有用的情况以及提高可靠性的方法。

BACKGROUND & AIMS: :The peak amplitude of the M response from the extensor digitorum longus muscle (EDL) was measured in 26 healthy subjects (12 women and 14 men, aged 19 to 45 years) using conventional peroneal nerve stimulation at the fibular head. The mean amplitude of the EDL was 6.5 mV (+/- 1.3 mV) and 6.1 mV (+/- 1.2 mV) for the right and left sides, respectively. The side to side difference in amplitude of the M response was 0.4 mV (+/- 1.1 mV). Twenty-five of the twenty-six subjects had side to side amplitude differences within two standard deviations of the mean. None of the subjects had an EDL amplitude from the right lower limb over 1.8 mV less than that of the left, nor an EDL amplitude from the left lower limb over 2.8 mV less than that of the right. The technique used in the present study allows an accurate assessment of the M response amplitude from the EDL muscle. These reference data should prove useful in the evaluation of early focal nerve root injury (e.g. after 4 days, within 3 weeks) and in establishing prognosis for recovery in such conditions.

背景与目标： : 使用腓骨头的常规腓神经刺激，在26名健康受试者 (12名女性和14名男性，年龄19至45岁) 中测量了趾长伸肌 (EDL) 的M反应峰值幅度。EDL的平均振幅在右侧和左侧分别为6.5 mV (+/- 1.3 mV) 和6.1 mV (+/- 1.2 mV)。M响应的振幅的左右差异为0.4 mV (+/- 1.1 mV)。26名受试者中有25名在平均值的两个标准偏差内具有左右振幅差异。没有一个受试者的右下肢EDL振幅1.8 mV小于左下肢的EDL振幅，左下肢的EDL振幅2.8 mV小于右下肢的EDL振幅。本研究中使用的技术可以准确评估EDL肌肉的M响应幅度。这些参考数据应被证明可用于评估早期局灶性神经根损伤 (例如，在4天后，3周内) 并确定在这种情况下恢复的预后。

BACKGROUND & AIMS: INTRODUCTION:Comparability and Quality Control in Cancer Registration remains an essential component of standardisation of cancer incidence data. The information provided by registries is used as a base-line data for cancer control and cancer research. As such misleading information will encourage fictious cancer patterns with over or under registration of some cancer sites. METHODOLOGY:The registration in Karachi started in 1995 and was confined to a single district of Karachi, the South District. Since 1998 the registration has extended to Karachi Division. For both the data sets, recommendations of the International Agency for Research on Cancer (IARC) and the International Association of Cancer Registries (IACR) have been followed to assure comparability and Quality Control of the results. RESULTS:The 2 data sets from Karachi show well-recorded demographic details of cases. Age was not a true indicator of validity in our case, as we have approximate ages of patients aggregated around quintiles and decades. All the cancer cases were reported from a minimum of 3 sources. Microscopic verifications (MV) were high. Cancers with the highest histological verification (HV) were those located in easily accessible sites e.g. breast, oral cavity and cervix. The age specific incidence rates (ASR) for Karachi South, all sites (1995-1999) was 148.1 males and 175.5 females. The same for Karachi Division (1998-99) was 132.4 males and 133.0 females. CONCLUSION:The cancer data in 1995 during the initial phase of registration was incomplete and suffered from inaccuracies associated with a lack of awareness in early years of registration. By the year 2001, the data (1995-1999) showed improved completion and accuracy. The incidence rates have shown no dramatic changes during the past 2 years. The malignancies also show a stable pattern, despite the possibility of under-registration of clinically diagnosed cases. The microscopic verification is high compared with the world region and similar to those observed in developed countries. This may be due to the widely available diagnostic facilities in Karachi and should therefore be considered an indicator of validity of registered data.

背景与目标：

BACKGROUND & AIMS: The purpose of this study was to determine whether a motor adjustment (method of average error) and a verbal response (method of constant stimuli) procedure would yield comparable estimates of depth acuity using the classic Howard apparatus. The findings were that(1) thresholds derived from the two procedures were not significantly correlated under either binocular or monocular viewing conditions; (2) essentially equivalent thresholds were derived from the two procedures under the binocular viewing condition; (3) thresholds derived from the verbal procedure were significantly higher than those derived from the motor adjustment procedure under monocular viewing conditions.

背景与目标： 这项研究的目的是确定运动调整 (平均误差方法) 和言语反应 (恒定刺激方法) 程序是否会使用经典的霍华德仪器得出可比的深度敏锐度估计值。研究结果是 :( 1) 在双眼或单目观看条件下，两种程序得出的阈值均无显着相关性; (2) 在双眼观看条件下，两种程序得出的阈值基本相等; (3) 在单眼观看条件下，从口头程序得出的阈值显着高于从运动调节程序得出的阈值。

BACKGROUND & AIMS: :A recent method, denoted in vivo g-ratio-weighted imaging, has related the microscopic g-ratio, only accessible by ex vivo histology, to noninvasive MRI markers for the fiber volume fraction (FVF) and myelin volume fraction (MVF). Different MRI markers have been proposed for g-ratio weighted imaging, leaving open the question which combination of imaging markers is optimal. To address this question, the repeatability and comparability of four g-ratio methods based on different combinations of, respectively, two imaging markers for FVF (tract-fiber density, TFD, and neurite orientation dispersion and density imaging, NODDI) and two imaging markers for MVF (magnetization transfer saturation rate, MT, and, from proton density maps, macromolecular tissue volume, MTV) were tested in a scan-rescan experiment in two groups. Moreover, it was tested how the repeatability and comparability were affected by two key processing steps, namely the masking of unreliable voxels (e.g., due to partial volume effects) at the group level and the calibration value used to link MRI markers to MVF (and FVF). Our data showed that repeatability and comparability depend largely on the marker for the FVF (NODDI outperformed TFD), and that they were improved by masking. Overall, the g-ratio method based on NODDI and MT showed the highest repeatability (90%) and lowest variability between groups (3.5%). Finally, our results indicate that the calibration procedure is crucial, for example, calibration to a lower g-ratio value (g = 0.6) than the commonly used one (g = 0.7) can change not only repeatability and comparability but also the reported dependency on the FVF imaging marker. Hum Brain Mapp 39:24-41, 2018. © 2017 Wiley Periodicals, Inc.

背景与目标： : 最近的一种称为体内g比加权成像的方法已将仅可通过离体组织学访问的微观g比与纤维体积分数 (FVF) 和髓鞘体积分数 (MVF) 的无创MRI标记相关联。对于g比加权成像，已经提出了不同的MRI标记，从而解决了哪种成像标记组合最佳的问题。为了解决这个问题，分别基于FVF的两个成像标记 (tract-fiber density，TFD和神经突取向色散和密度成像，NODDI) 和MVF的两个成像标记 (磁化传递饱和率，MT，并且，从质子密度图，大分子组织体积，MTV) 在两组的扫描-扫描实验中进行了测试。此外，测试了可重复性和可比性如何受到两个关键处理步骤的影响，即在组水平掩蔽不可靠的体素 (例如，由于部分体积效应) 以及用于将MRI标记链接到MVF (和FVF) 的校准值。我们的数据表明，可重复性和可比性在很大程度上取决于FVF的标记 (NODDI优于TFD)，并且通过掩蔽可以改善它们。总体而言，基于NODDI和MT的g比方法显示出最高的可重复性 (90%) 和组之间的最低变异性 (3.5%)。最后，我们的结果表明，校准过程是至关重要的，例如，校准到一个比常用的 (g   =   0.6) 更低的g比值 (g   =   0.7) 不仅可以改变可重复性和可比性，还可以改变报告的对FVF成像标记的依赖性。哼脑马普39:24-41，2018。©2017威利期刊公司

BACKGROUND & AIMS: Purpose:To investigate the natural history in patients with LRAT-associated retinal degenerations (RDs), in the advent of clinical trials testing treatment options. Methods:A retrospective cohort of 13 patients with LRAT-RDs. Results:Twelve patients from a genetic isolate carried a homozygous c.12del mutation. One unrelated patient carried a homozygous c.326G>T mutation. The mean follow-up time was 25.3 years (SD 15.2; range 4.8-53.5). The first symptom was nyctalopia (n = 11), central vision loss (n = 1), or light-gazing (n = 1), and was noticed in the first decade of life. Seven patients (54%) reached low vision (visual acuity < 20/67), four of whom reaching blindness (visual acuity < 20/400), respectively, at mean ages of 49.9 (SE 5.4) and 59.9 (SE 3.1) years. The fundus appearance was variable. Retinal white dots were seen in six patients (46%). Full-field electroretinograms (n = 11) were nondetectable (n = 2; ages 31-60), reduced in a nonspecified pattern (n = 2; ages 11-54), or showed rod-cone (n = 6; ages 38-48) or cone-rod (n = 1; age 29) dysfunction. Optical coherence tomography (n = 4) showed retinal thinning but relative preservation of the (para-)foveal outer retinal layers in the second (n = 1) and sixth decade of life (n = 2), and profound chorioretinal degeneration from the eighth decade of life (n = 1). Conclusions:LRAT-associated phenotypes in this cohort were variable and unusual, but generally milder than those seen in RPE65-associated disease, and may be particularly amenable to treatment. The window of therapeutic opportunity can be extended in patients with a mild phenotype. Translational Relevance:Knowledge of the natural history of LRAT-RDs is essential in determining the window of opportunity in ongoing and future clinical trials for novel therapeutic options.

背景与目标：

BACKGROUND & AIMS: PURPOSE:To compare retinal nerve fiber layer (RNFL) measurements between two ocular coherence tomography (OCT) instruments (OCT 2000 and Stratus OCT; Carl Zeiss Meditec, Dublin, CA) and compare their diagnostic precision. METHODS:One hundred thirty-nine consecutive subjects were imaged (3 x 3.4-mm diameter circular scans) on the same day with each instrument. Thirty-five patients were excluded due to poor-quality images. RNFL thicknesses measured by the two instruments were compared, and receiver operating characteristic (ROC) curves were used to determine diagnostic precision. RESULTS:A randomly selected eye of each of 104 participants (28 with open-angle glaucoma, 40 with suspected glaucoma, and 36 healthy subjects) was analyzed. RNFL thickness measurements generally were thicker with OCT 2000 than with Stratus OCT. The difference in global RNFL thickness between instruments was within 20 microm in 66 (65%) of subjects and within 10 microm (the instrument's limit of resolution) in 25 (25%) subjects. Application of a correction factor to OCT 2000 measurements predicted Stratus OCT RNFL thickness within 10 microm of the observed measurement in 75% of the eyes. For both instruments, highest ROC curve areas (better discrimination between glaucomatous and normal eyes) were found in the inferior sector. Discrimination using global RNFL thickness was better with Stratus OCT than OCT 2000 (P = 0.043). CONCLUSIONS:RNFL thickness measurements measured by OCT 2000 can be approximated to measurements made by Stratus OCT using correction factors calculated by this study. However, there remains considerable variability that exceeds the limits of resolution afforded by the instruments themselves. Therefore comparisons between instruments using these approximations should be interpreted with caution.

背景与目标：

BACKGROUND & AIMS: OBJECTIVES:To correct and augment the sample on which a previous study, assessing the applicability of USA WAIS III norms to the UK population, was based. To repeat this study using the modified sample. DESIGN:The WAIS III UK was administered to a supplementary sample, which was used to enhance and correct the original sample, allowing a better match to UK population demographics. METHOD:WAIS III UK scores were processed using USA norms. RESULTS:Distributions of UK IQ, Index, and subtest scores were consistent with USA norms. Means were significantly above USA values and did not show a flat profile. Correlational analysis suggested the presence of an age-related sampling bias, which was then statistically controlled for using analysis of covariance, with age as covariate, to give corrected means. These means, with the exception of two subtests (block design and picture arrangement), did not differ significantly from USA values. CONCLUSION:With a minor proviso concerning the above subtests, it is probable that USA norms can be safely used with the UK population. Future UK samples need to ensure random sampling within demographic categories if sampling bias is to be avoided.

背景与目标：

BACKGROUND & AIMS: :An array of measures of anxiety and related disorders (viz., Albany Panic and Phobia Questionnaire; Anxiety Sensitivity Index; Beck Anxiety Inventory; Beck Depression Inventory-II; Body Sensation Questionnaire; Fear Questionnaire; Padua Inventory; Penn State Worry Questionnaire; Post-Traumatic Stress Disorder Diagnostic Scale; Social Interaction Anxiety Inventory; and Worry Scale) was edited or translated from English into Spanish. Following an extensive edit and translation process, bilingual participants (n = 98) were assessed with the English and Spanish versions of these measures. Coefficient alphas were excellent and comparable across language versions. Means and standard deviations were also comparable across language versions. Evidence of convergent and discriminant validity was found for both language versions. The two language versions of each measure correlated highly with each other. This psychometric comparability adds confidence in using the newly edited or translated Spanish language measures in clinical practice and research.

背景与目标： : 一系列焦虑和相关障碍的测量 (即奥尔巴尼恐慌和恐惧症问卷; 焦虑敏感性指数; 贝克焦虑量表; 贝克抑郁量表-II; 身体感觉问卷; 恐惧问卷; 帕多瓦清单; 宾夕法尼亚州立大学担忧问卷; 创伤后应激障碍诊断量表; 社交互动焦虑量表; 和担忧量表) 是从英语编辑或翻译成西班牙语的。经过广泛的编辑和翻译过程，双语参与者 (n = 98) 接受了这些措施的英文和西班牙文版本的评估。系数阿尔法非常好，在不同语言版本中具有可比性。在不同语言版本中，均值和标准差也是可比的。两种语言版本都发现了收敛和判别有效性的证据。每个度量的两个语言版本彼此高度相关。这种心理计量学的可比性增加了在临床实践和研究中使用新编辑或翻译的西班牙语方法的信心。

BACKGROUND & AIMS: CONTEXT:The pathologic protocol for sentinel lymph node evaluation has yet to be standardized. Results from previous studies are troublesome to compare because they have been conducted on different sets of subjects with cancer. OBJECTIVE:To compare the detection of sentinel lymph node metastases by using step-sectioning methods at 20-microm and 150-microm intervals for the same patient with primary breast cancer. DESIGN:A total of 186, initially tumor-negative sentinel lymph nodes from a group of 80 patients with breast cancer were included. For all nodes, each paraffin block was cut serially to produce a total of 10 levels: 5 consecutive levels of sections for each of the 20-microm and 150-microm intervals. The nodal findings obtained at these intervals on hematoxylin-eosin and cytokeratin slides were compared by using the McNemar test. RESULTS:The overall detection rate for sentinel lymph node metastasis at intervals of 20 microm and 150 microm was 27.5% (22/80) and 20% (16/80), respectively. The overall agreement between the 20-microm and 150-microm sections was 82.5%. No macrometastasis was missed by either method. At the 20-microm interval, 2 cases of micrometastasis were missed, while 10 cases of isolated tumor cells were missed at the 150-microm interval. However, no statistical difference was observed for the final sentinel lymph node results with either method. (McNemar test, P = .18 for case-based results and P = .052 for nodal-based results). CONCLUSIONS:The 20-microm and 150-microm interval step-sectioning methods produce comparable results for detection of metastatic deposits in sentinel lymph nodes.

背景与目标：

BACKGROUND & AIMS: :The Modified Taylor Complex Figure (MTCF) was developed as an alternate form for the Rey-Osterrieth Complex Figure (ROCF) to assess visuospatial abilities. The present study examines the comparability of the figures by comparing (a) total scores and completion times on copy and recall trials using a repeated-measures design and an incidental administration procedure, and (b) the pattern of relationships between each of the figures and a number of demographic, convergent, and discriminant measures in a sample of community-dwelling adults. Overall, the study supports the use of the MTCF as a comparable measure of visuospatial memory and construction to the ROCF.

背景与目标： : 改进的泰勒复杂图形 (MTCF) 是作为Rey-Osterrieth复杂图形 (ROCF) 的替代形式开发的，用于评估视觉空间能力。本研究通过比较 (a) 使用重复测量设计和附带给药程序的复制和召回试验的总得分和完成时间，以及 (b) 每个数字之间的关系模式，来检验数字的可比性。以及社区居住成年人样本中的判别措施。总体而言，该研究支持将MTCF用作与ROCF可比的视觉空间记忆和结构度量。