Childhood tumours with a high probability of being part of a tumour predisposition syndrome; reason for referral for genetic consultation

2017 ◽  
Vol 80 ◽  
pp. 48-54 ◽  
Author(s):  
Floor A.M. Postema ◽  
Saskia M.J. Hopman ◽  
Cora M. Aalfs ◽  
Lieke P.V. Berger ◽  
Fonnet E. Bleeker ◽  
...  
Keyword(s):  
High Probability ◽  
Childhood Tumours ◽  
Genetic Consultation

Quick Consult: Quick Consult: Acromioplasty

2002 ◽  
Vol 7 (3) ◽  
pp. 4-5
Keyword(s):  
Glasgow Coma Scale ◽  
Outcome Assessment ◽  
High Probability ◽  
Vegetative State ◽  
Behavioral Impairment ◽  
Whole Person ◽  
Ordinal Scales ◽  
Probability Of Death ◽  
The Individual ◽  
Assessment Scales

Abstract Different jurisdictions use the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides) for different purposes, and this article reviews a specific jurisdictional definition in the Province of Ontario of catastrophic impairment that incorporates the AMA Guides. In Ontario, a whole person impairment (WPI) exceeding 54% or a mental or behavioral impairment of Class 4 or 5 qualifies the individual for catastrophic benefits, and individuals who do not meet the test receive a lesser benefit. By inference, this establishes a parity threshold among dissimilar injuries and dissimilar outcome assessment scales for benefits. In Ontario, the Glasgow Coma Scale (GCS) identifies patients who have a high probability of death or of severely disabled survival. The GCS recognizes gradations of vegetative state and disability, but translating the gradations for rating individual impairment on ordinal scales into a method of assessing percentage impairments cannot be done reliably, as explained in the AMA Guides, Fifth Edition. The AMA Guides also notes that mental and behavioral impairment in Class 4 (marked impairment) or 5 (extreme impairment) indicates “catastrophic impairment” by significantly impeding useful functioning (Class 4) or significantly impeding useful functioning and implying complete dependency on another person for care (Class 5). Translating the AMA Guides guidelines into ordinal scales cannot be done reliably.

The Effect of Outcome Probability on Generalization in Predictive Learning

2019 ◽  
Vol 66 (1) ◽  
pp. 23-39 ◽  
Author(s):  
Hadar Ram ◽  
Dieter Struyf ◽  
Bram Vervliet ◽  
Gal Menahem ◽  
Nira Liberman
Keyword(s):  
High Probability ◽  
Lower Probability ◽  
Perceptual Similarity ◽  
Learning Paradigm ◽  
Predictive Learning ◽  
Lightning Bolt ◽  
Outcome Probability

Abstract. People apply what they learn from experience not only to the experienced stimuli, but also to novel stimuli. But what determines how widely people generalize what they have learned? Using a predictive learning paradigm, we examined the hypothesis that a low (vs. high) probability of an outcome following a predicting stimulus would widen generalization. In three experiments, participants learned which stimulus predicted an outcome (S+) and which stimulus did not (S−) and then indicated how much they expected the outcome after each of eight novel stimuli ranging in perceptual similarity to S+ and S−. The stimuli were rings of different sizes and the outcome was a picture of a lightning bolt. As hypothesized, a lower probability of the outcome widened generalization. That is, novel stimuli that were similar to S+ (but not to S−) produced expectations for the outcome that were as high as those associated with S+.

A Comparative Analysis of D-Dimer Assays in Patients with Clinically Suspected Pulmonary Embolism

1993 ◽  
Vol 70 (03) ◽  
pp. 408-413 ◽  
Author(s):  
Edwin J R van Beek ◽  
Bram van den Ende ◽  
René J Berckmans ◽  
Yvonne T van der Heide ◽  
Dees P M Brandjes ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Comparative Analysis ◽  
High Probability ◽  
Pulmonary Emboli ◽  
Plasma Samples ◽  
Suspected Pulmonary Embolism ◽  
Lung Scan ◽  
D Dimer

SummaryTo avoid angiography in patients with clinically suspected pulmonary embolism and non-diagnostic lung scan results, the use of D-dimer has been advocated. We assessed plasma samples of 151 consecutive patients with clinically suspected pulmonary embolism. Lung scan results were: normal (43), high probability (48) and non-diagnostic (60; angiography performed in 43; 12 pulmonary emboli). Reproducibility, cut-off values, specificity, and percentage of patients in whom angiography could be avoided (with sensitivity 100%) were determined for two latex and four ELISA assays.The latex methods (cut-off 500 μg/1) agreed with corresponding ELISA tests in 83% (15% normal latex, abnormal ELISA) and 81% (7% normal latex, abnormal ELISA). ELISA methods showed considerable within- (2–17%) and between-assay Variation (12–26%). Cut-off values were 25 μg/l (Behring), 50 μg/l (Agen), 300 μg/l (Stago) and 550 μg/l (Organon). Specificity was 14–38%; in 4–15% of patients angiography could be avoided.We conclude that latex D-dimer assays appear not useful, whereas ELISA methods may be of limited value in the exclusion of pulmonary embolism.

The Role of a Decision Rule in Symptomatic Pulmonary Embolism Patients with a Non-high Probability Ventilation-perfusion Scan

1997 ◽  
Vol 78 (02) ◽  
pp. 794-798 ◽  
Author(s):  
Bowine C Michel ◽  
Philomeen M M Kuijer ◽  
Joseph McDonnell ◽  
Edwin J R van Beek ◽  
Frans F H Rutten ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Decision Rule ◽  
Predictive Value ◽  
Patient Population ◽  
High Probability ◽  
Characteristic Curve ◽  
Stepwise Logistic Regression ◽  
Pulmonary Angiogram ◽  
Symptomatic Pulmonary Embolism ◽  
Perfusion Scan

Summary Background: In order to improve the use of information contained in the medical history and physical examination in patients with suspected pulmonary embolism and a non-high probability ventilation-perfusion scan, we assessed whether a simple, quantitative decision rule could be derived for the diagnosis or exclusion of pulmonary embolism. Methods: In 140 consecutive symptomatic patients with a non- high probability ventilation-perfusion scan and an interpretable pulmonary angiogram, various clinical and lung scan items were collected prospectively and analyzed by multivariate stepwise logistic regression analysis to identify the most informative combination of items. Results: The prevalence of proven pulmonary embolism in the patient population was 27.1%. A decision rule containing the presence of wheezing, previous deep venous thrombosis, recently developed or worsened cough, body temperature above 37° C and multiple defects on the perfusion scan was constructed. For the rule the area under the Receiver Operating Characteristic curve was larger than that of the prior probability of pulmonary embolism as assessed by the physician at presentation (0.76 versus 0.59; p = 0.0097). At the cut-off point with the maximal positive predictive value 2% of the patients scored positive, at the cut-off point with the maximal negative predictive value pulmonary embolism could be excluded in 16% of the patients. Conclusions: We derived a simple decision rule containing 5 easily interpretable variables for the patient population specified. The optimal use of the rule appears to be in the exclusion of pulmonary embolism. Prospective validation of this rule is indicated to confirm its clinical utility.

Costs and Benefits of the Transition to Low-carbon Economyin Russia: Perspectives up to 2050

2014 ◽  
pp. 70-91 ◽  
Author(s):  
I. Bashmakov ◽  
A. Myshak
Keyword(s):  
Emission Reduction ◽  
High Probability ◽  
Ghg Emissions ◽  
Mitigation Measures ◽  
Low Carbon ◽  
Costs And Benefits ◽  
Ghg Emission ◽  
Research Groups ◽  
Emissions Mitigation ◽  
Very High

This paper investigates costs and benefits associated with low-carbon economic development pathways realization to the mid XXI century. 30 scenarios covering practically all “visions of the future” were developed by several research groups based on scenario assumptions agreed upon in advance. It is shown that with a very high probability Russian energy-related GHG emissions will reach the peak before 2050, which will be at least 11% below the 1990 emission level. The height of the peak depends on portfolio of GHG emissions mitigation measures. Efforts to keep 2050 GHG emissions 25-30% below the 1990 level bring no GDP losses. GDP impact of deep GHG emission reduction - by 50% of the 1990 level - varies from plus 4% to minus 9%. Finally, very deep GHG emission reduction - by 80% - may bring GDP losses of over 10%.

1729-P: Insulin Resistance Cutoff for High Probability of Blood Glucose Normalization in T2DM Patients with Obesity after Bariatric Surgery

Diabetes ◽  
2020 ◽  
Vol 69 (Supplement 1) ◽  
pp. 1729-P
Author(s):  
IGOR SKLYANIK ◽  
EKATERINA SHESTAKOVA ◽  
IURII STAFEEV ◽  
SVETLANA MICHURINA ◽  
ANDREY KARMADONOV ◽  
...  
Keyword(s):  
Insulin Resistance ◽  
Bariatric Surgery ◽  
Blood Glucose ◽  
High Probability

Spatial suppression due to statistical regularities is driven by distractor suppression not by target activation

2018 ◽  
Author(s):  
Michel Failing ◽  
Benchi Wang ◽  
Jan Theeuwes
Keyword(s):  
High Probability ◽  
Target Location ◽  
Target Selection ◽  
Visual Space ◽  
Alternative Interpretation ◽  
Distractor Location ◽  
Target Presentation ◽  
Statistical Regularities ◽  
Low Probability ◽  
Presentation Experiment

Where and what we attend to is not only determined by what we are currently looking for but also by what we have encountered in the past. Recent studies suggest that biasing the probability by which distractors appear at locations in visual space may lead to attentional suppression of high probability distractor locations which effectively reduces capture by a distractor but also impairs target selection at this location. However, in many of these studies introducing a high probability distractor location was tantamount to increasing the probability of the target appearing in any of the other locations (i.e. the low probability distractor locations). Here, we investigate an alternative interpretation of previous findings according to which attentional selection at high probability distractor locations is not suppressed. Instead, selection at low probability distractor locations is facilitated. In two visual search tasks, we found no evidence for this hypothesis: neither when there was only a bias in target presentation but no bias in distractor presentation (Experiment 1), nor when there was only a bias in distractor presentation but no bias in target presentation (Experiment 2). We conclude that recurrent presentation of a distractor in a specific location leads to attentional suppression of that location through a mechanism that is unaffected by any regularities regarding the target location.

The Ethics of Unwinnable War

2017 ◽  
Author(s):  
Dominic Tierney
Keyword(s):  
High Probability ◽  
Just War ◽  
Just War Theory ◽  
Moral Dilemmas ◽  
Probability Of Success ◽  
Military Campaigns ◽  
Military Campaign

According to just war theory, military campaigns should only be fought as a last resort, with the goal of correcting a grave evil, and where there is a high probability of success. But what happens when a military campaign unravels and becomes unwinnable? How can a leader reconcile just war theory with the need to extricate the country from a quagmire? In recent decades, US presidents have repeatedly faced such moral dilemmas, as campaigns in Korea, Vietnam, Afghanistan, and Iraq all became unwinnable. When victory is no longer achievable, leaders should dial down the goals of the war, resist the pressure to embrace barbarism, negotiate with the adversary, and seek the best possible peace from the range of plausible alternatives.

scholarly journals Validation of an algorithm for semiautomated surveillance to detect deep surgical site infections after primary total hip or knee arthroplasty—A multicenter study

2020 ◽  
Vol 42 (1) ◽  
pp. 69-74
Author(s):  
Janneke D. M. Verberk ◽  
Stephanie M. van Rooden ◽  
Mayke B. G. Koek ◽  
David J. Hetem ◽  
Annelies E. Smilde ◽  
...  
Keyword(s):  
Knee Arthroplasty ◽  
High Probability ◽  
Surgical Site Infections ◽  
Data Interpretation ◽  
Routine Care ◽  
Successful Implementation ◽  
Subjective Data ◽  
Essential Information ◽  
Total Hip ◽  
Healthcare Associated

AbstractObjective:Surveillance of healthcare-associated infections is often performed by manual chart review. Semiautomated surveillance may substantially reduce workload and subjective data interpretation. We assessed the validity of a previously published algorithm for semiautomated surveillance of deep surgical site infections (SSIs) after total hip arthroplasty (THA) or total knee arthroplasty (TKA) in Dutch hospitals. In addition, we explored the ability of a hospital to automatically select the patients under surveillance.Design:Multicenter retrospective cohort study.Methods:Hospitals identified patients who underwent THA or TKA either by procedure codes or by conventional surveillance. For these patients, routine care data regarding microbiology results, antibiotics, (re)admissions, and surgeries within 120 days following THA or TKA were extracted from electronic health records. Patient selection was compared with conventional surveillance and patients were retrospectively classified as low or high probability of having developed deep SSI by the algorithm. Sensitivity, positive predictive value (PPV), and workload reduction were calculated and compared to conventional surveillance.Results:Of 9,554 extracted THA and TKA surgeries, 1,175 (12.3%) were revisions, and 8,378 primary surgeries remained for algorithm validation (95 deep SSIs, 1.1%). Sensitivity ranged from 93.6% to 100% and PPV ranged from 55.8% to 72.2%. Workload was reduced by ≥98%. Also, 2 SSIs (2.1%) missed by the algorithm were explained by flaws in data selection.Conclusions:This algorithm reliably detects patients with a high probability of having developed deep SSI after THA or TKA in Dutch hospitals. Our results provide essential information for successful implementation of semiautomated surveillance for deep SSIs after THA or TKA.

Validation of a machine learned model to predict the diagnosis of myocardial infarction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
D Doudesis ◽  
J Yang ◽  
A Tsanas ◽  
C Stables ◽  
A Shah ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Coronary Syndrome ◽  
Predictive Value ◽  
High Probability ◽  
Cardiovascular Death ◽  
Gradient Boosting ◽  
Funding Source ◽  
Coronary Syndrome ◽  
Low Probability ◽  
One Year

Abstract Introduction The myocardial-ischemic-injury-index (MI3) is a promising machine learned algorithm that predicts the likelihood of myocardial infarction in patients with suspected acute coronary syndrome. Whether this algorithm performs well in unselected patients or predicts recurrent events is unknown. Methods In an observational analysis from a multi-centre randomised trial, we included all patients with suspected acute coronary syndrome and serial high-sensitivity cardiac troponin I measurements without ST-segment elevation myocardial infarction. Using gradient boosting, MI3 incorporates age, sex, and two troponin measurements to compute a value (0–100) reflecting an individual's likelihood of myocardial infarction, and estimates the negative predictive value (NPV) and positive predictive value (PPV). Model performance for an index diagnosis of myocardial infarction, and for subsequent myocardial infarction or cardiovascular death at one year was determined using previously defined low- and high-probability thresholds (1.6 and 49.7, respectively). Results In total 20,761 of 48,282 (43%) patients (64±16 years, 46% women) were eligible of whom 3,278 (15.8%) had myocardial infarction. MI3 was well discriminated with an area under the receiver-operating-characteristic curve of 0.949 (95% confidence interval 0.946–0.952) identifying 12,983 (62.5%) patients as low-probability (sensitivity 99.3% [99.0–99.6%], NPV 99.8% [99.8–99.9%]), and 2,961 (14.3%) as high-probability (specificity 95.0% [94.7–95.3%], PPV 70.4% [69–71.9%]). At one year, subsequent myocardial infarction or cardiovascular death occurred more often in high-probability compared to low-probability patients (17.6% [520/2,961] versus 1.5% [197/12,983], P<0.001). Conclusions In unselected consecutive patients with suspected acute coronary syndrome, the MI3 algorithm accurately estimates the likelihood of myocardial infarction and predicts probability of subsequent adverse cardiovascular events. Performance of MI3 at example thresholds Funding Acknowledgement Type of funding source: Foundation. Main funding source(s): Medical Research Council

Sign in / Sign up

Export Citation Format

Share Document