Journal articles: 'Centre variation'

1

Kuenzig, E., H. Singh, A. Bitton, G. G. Kaplan, M. W. Carroll, A. Otley, T. A. Stukel, et al. "A65 VARIATION IN THE CARE OF CHILDREN WITH INFLAMMATORY BOWEL DISEASE: A CANGIEC POPULATION-BASED STUDY." Journal of the Canadian Association of Gastroenterology 3, Supplement_1 (February 2020): 78–79. http://dx.doi.org/10.1093/jcag/gwz047.064.

Full text

Abstract:

Abstract Background Inflammatory bowel disease (IBD) is rising rapidly in Canadian children. These children require consistent high-quality specialized care to prevent long-term complications. Aims Evaluate variation in health services utilization and surgery rates across pediatric IBD centres in Ontario. Methods Incident cases of IBD <16y (1999–2010), identified from health administrative data using a validated algorithm, were assigned to pediatric IBD centres based on location of IBD hospitalization, endoscopy and outpatient care. Children receiving IBD-specific care outside pediatric centres were also grouped. Frailty models, median hazard ratios (MHR), and Kendall’s t described variation in IBD-related ED visits, hospitalizations, and surgery 6–60 months after diagnosis, adjusting for age, sex, rural/urban household, and income. Mean diagnostic lag (time from first health system contact for an IBD symptom to final IBD diagnosis) and proportion of children with IBD care by gastroenterologists (GIs) at each centre were evaluated as centre-level predictors of variation. Results Of 2584 IBD cases, 73.4% were treated in a pediatric IBD centre. Between-centre differences accounted for 0.18% (MHR 1.06) and 0.41% (MHR 1.09) of variation in hospitalizations and ED visits, respectively. Children treated at centres where a higher proportion of children were cared for by GIs were more likely to be hospitalized (HR 2.09, 95% CI 1.26–3.45). Children treated at centres with a longer mean diagnostic lag were also more likely to be hospitalized (HR 1.01, 95% CI 1.003–1.02). ED visits were not associated with the proportion of children cared for by gastroenterologists or diagnostic lag. Among 1529 CD cases, 14.1% required intestinal resection; 1.79% of variation in the risk of surgery resulted from between-centre differences (MHR 1.20). Surgery was less common among patients at centres where more children were cared for by GIs (HR 0.24, 95% CI 0.07–0.84) and with a longer mean diagnostic lag (HR 0.98, 95% CI 0.97–0.99). After adjusting for these, between-centre differences accounted for 0.005% (MHR 1.01) of variation in care. Minimal variation was observed among the 11.0% of 872 UC cases requiring colectomy, with 0.37% of variation due to between-centre differences (MOR 1.09). Colectomy risk was not associated with GI care or diagnostic lag. Conclusions Variation in ED visits, hospitalizations, and surgery among children with IBD is small; however, centre-level differences in GI specialist care use and time to diagnosis were associated with hospitalization and surgery. It is essential to understand between-centre differences to reduce variation and ensure high-quality care. Funding Agencies CCC

APA, Harvard, Vancouver, ISO, and other styles

2

Hawkins, Janine, Nigel Smeeton, Amanda Busby, David Wellsted, Beth Rider, Julia Jones, Retha Steenkamp, et al. "Contributions of treatment centre and patient characteristics to patient-reported experience of haemodialysis: a national cross-sectional study." BMJ Open 11, no. 4 (April 2021): e044984. http://dx.doi.org/10.1136/bmjopen-2020-044984.

Full text

Abstract:

ObjectivesTo examine the relative importance of patient and centre level factors in determining self-reported experience of care in patients with advanced kidney disease treated by maintenance haemodialysis (HD).DesignAnalysis of data from a cross sectional national survey; the UK Renal Registry (UKRR) national Kidney patient-reported experience measure (PREM) survey (2018). Centre-level data were obtained from the UKRR report (2018).SettingNational survey of patients with advanced kidney disease receiving treatment with maintenance HD in UK renal centres in 2018.ParticipantsThe Kidney PREM was distributed to all UK renal centres by the UKRR in May 2018. Each centre invited patients receiving outpatient treatment for kidney disease to complete the PREM. These included patients with chronic kidney disease, those receiving dialysis—both HD and peritoneal dialysis, and those with a functioning kidney transplant. There were no formal inclusion/exclusion criteria.Main outcome measuresThe Kidney PREM has 38 questions in 13 subscales. Responses were captured using a 7-point Likert scale (never 1, always 7). The primary outcome of interest was the mean PREM score calculated across all questions. Multilevel modelling was used to determine the proportion of variation of the mean PREM score across centres due to patient-related and centre-related factors.ResultsThere were records for 8253 HD patients (61% men, 77% white) from 69 renal centres (9–710 patients per centre). There was significant variation in mean PREM score across centres (5.35–6.53). In the multivariable analysis there was some variation in relation to both patient- and centre-level factors but these contributed little to explaining the overall variation. However, multilevel modelling showed that the overwhelming proportion of the explained variance (45%) was explained by variation between centres (40%), only a small proportion of which is identified by measured factors. Only 5% of the variation was related to patient-level factors.ConclusionsCentre rather than patient characteristics determine the experience of care of patients receiving HD. Further work is required to define the characteristics of the treating centre which determine patient experience.

APA, Harvard, Vancouver, ISO, and other styles

3

Camps, Gonzalo A., Andrea Cosacov, and Alicia N. Sérsic. "Centre–periphery approaches based on geography, ecology and historical climate stability: what explains the variation in morphological traits of Bulnesia sarmientoi?" Annals of Botany 127, no. 7 (February 26, 2021): 943–55. http://dx.doi.org/10.1093/aob/mcab034.

Full text

Abstract:

Abstract Background and Aims The centre–periphery hypothesis posits that higher species performance is expected in geographic and ecological centres rather than in peripheral populations. However, this is not the commonly found pattern; therefore, alternative approaches, including the historical dimension of species geographical ranges, should be explored. Morphological functional traits are fundamental determinants of species performance, commonly related to environmental stability and productivity. We tested whether or not historical processes may have shaped variations in tree and leaf traits of the Chaco tree Bulnesia sarmientoi. Methods Morphological variation patterns were analysed from three centre–periphery approaches: geographical, ecological and historical. Tree (stem and canopy) and leaf (leaf size and specific leaf area) traits were measured in 24 populations across the species range. A principal component analysis was performed on morphological traits to obtain synthetic variables. Linear mixed-effects models were used to test which of the implemented centre–periphery approaches significantly explained trait spatial patterns. Key Results The patterns retrieved from the three centre–periphery approaches were not concordant. The historical approach revealed that trees were shorter in centre populations than in the periphery. Significant differences in leaf traits were observed between the geographical centre and the periphery, mainly due to low specific leaf area values towards the geographical centre. We did not find any pattern associated with the ecological centre–periphery approach. Conclusions The decoupled response between leaf and tree traits suggests that these sets of traits respond differently to processes occurring at different times. The geographical and historical approaches showed centres with extreme environments in relation to their respective peripheries, but the historical centre has also been a climatically stable area since the Last Glacial Maximum. The historical approach allowed for the recovery of historical processes underlying variation in tree traits, highlighting that centre–periphery delimitations should be based on a multi-approach framework.

APA, Harvard, Vancouver, ISO, and other styles

4

Hayman, O., and A. Palmer. "CT-based post-implant dosimetry for I-125 prostate brachytherapy: a multi-centre audit in the UK and Ireland." Journal of Radiotherapy in Practice 12, no. 4 (April 22, 2013): 297–304. http://dx.doi.org/10.1017/s1460396912000489.

Full text

Abstract:

AbstractBackground and purposeTo assess the reliability of post-implant CT (PICT) dosimetry for I-125 prostate seed brachytherapy by investigating the variation between centres in performing PICT through a multi-centre audit.Materials and methodsComputerised tomography data sets from four I-125 prostate brachytherapy patients were circulated to nine participating centres. Centres followed local protocol for PICT outlining and seed identification, dosimetry for D90, V100 and V150 for the prostate was reported. Outlines were compared to determine the variation in: quality parameters (D90, V100 and V150), dose-volume histograms and approach to PICT dosimetry between the centres.ResultsThere was significant variation in the prostate outlines drawn by the nine centres; for a prostate with mean volume 43 cm3, the range was 39–57 cm3 which led to variations of D90 of 119–154 Gy (mean 140 Gy) and V100 of 80–93% (mean of 88%). Using automatic seedfinder software reduced discrepancies between centres identifying seeds; overall consistency in seed location was good.ConclusionsThere was a significant uncertainty in the outlining of the prostate volume for PICT dosimetry with an uncertainty value of around ± 20 Gy on D90. PICT is a valuable technique but its accuracy and consistency limitations must be appreciated.

APA, Harvard, Vancouver, ISO, and other styles

5

GOLDBERG, D. P., T. OLDEHINKEL, and J. ORMEL. "Why GHQ threshold varies from one place to another." Psychological Medicine 28, no. 4 (July 1998): 915–21. http://dx.doi.org/10.1017/s0033291798006874.

Full text

Abstract:

Background. No convincing explanation has been forthcoming for the variation in best threshold to adopt for the GHQ in different settings.Methods. Data dealing with the GHQ and the CIDI in 15 cities from a recent WHO study was subjected to further analysis.Results. The mean number of CIDI symptoms for those with single diagnoses, or those with multiple diagnoses, does not vary between cities. However, the best threshold is found to be related to the prevalence both of single and of multiple diagnoses in a centre. Variations in the diagnoses to be included in the ‘gold standard’ did not account for the variation observed. There was a strong relationship between area under the ROC curve (as a measure of the discriminatory power of the GHQ) and the best threshold, with higher thresholds being associated with superior performance of the GHQ. The items on the GHQ-12 that provided most discrimination between cases and non-cases varied from one centre to another.Conclusions. The GHQ threshold is partly determined by the prevalence of multiple diagnoses, with higher thresholds being associated by higher rates of both single and multiple diagnosis. The mean GHQ score for the whole population of respondents provides a rough guide to the best threshold. In those centres where the discriminatory power of the GHQ is lowest, it is necessary to use a low threshold as a way of ensuring that sensitivity is protected, but the positive predictive value of the GHQ is then lower. Some of the variation between centres is due to variation in the discriminatory power of different items.

APA, Harvard, Vancouver, ISO, and other styles

6

Kim, S. J., D. E. Schaubel, J. R. Jeffery, and S. S. A. Fenton. "Centre-specific variation in renal transplant outcomes in Canada." Nephrology Dialysis Transplantation 19, no. 7 (April 6, 2004): 1856–61. http://dx.doi.org/10.1093/ndt/gfh247.

Full text

APA, Harvard, Vancouver, ISO, and other styles

7

Diaz, Abbey, Brenda Vo, Peter D. Baade, Veronica Matthews, Barbara Nattabi, Jodie Bailie, Lisa J. Whop, Ross Bailie, and Gail Garvey. "Service Level Factors Associated with Cervical Screening in Aboriginal and Torres Strait Islander Primary Health Care Centres in Australia." International Journal of Environmental Research and Public Health 16, no. 19 (September 27, 2019): 3630. http://dx.doi.org/10.3390/ijerph16193630.

Full text

Abstract:

Aboriginal and Torres Strait Islander women have significantly higher cervical cancer incidence and mortality than other Australian women. In this study, we assessed the documented delivery of cervical screening for women attending Indigenous Primary Health Care (PHC) centres across Australia and identified service-level factors associated with between-centre variation in screening coverage. We analysed 3801 clinical audit records for PHC clients aged 20–64 years from 135 Indigenous PHC centres participating in the Audit for Best Practice in Chronic Disease (ABCD) continuous quality improvement (CQI) program across five Australian states/territories during 2005 to 2014. Multilevel logistic regression models were used to identify service-level factors associated with screening, while accounting for differences in client-level factors. There was substantial variation in the proportion of clients who had a documented cervical screen in the previous two years across the participating PHC centres (median 50%, interquartile range (IQR): 29–67%), persisting over years and audit cycle. Centre-level factors explained 40% of the variation; client-level factors did not reduce the between-centre variation. Screening coverage was associated with longer time enrolled in the CQI program and very remote location. Indigenous PHC centres play an important role in providing cervical screening to Aboriginal and Torres Strait Islander women. Thus, their leadership is essential to ensure that Australia’s public health commitment to the elimination of cervical cancer includes Aboriginal and Torres Strait Islander women. A sustained commitment to CQI may improve PHC centres delivery of cervical screening; however, factors that may impact on service delivery, such as organisational, geographical and environmental factors, warrant further investigation.

APA, Harvard, Vancouver, ISO, and other styles

8

Pasquali, Sara K., Michael G. Gaies, Jeffrey P. Jacobs, J. William Gaynor, and Marshall L. Jacobs. "Centre variation in cost and outcomes for congenital heart surgery." Cardiology in the Young 22, no. 6 (December 2012): 796–99. http://dx.doi.org/10.1017/s104795111200159x.

Full text

Abstract:

AbstractAlthough overall outcomes for children undergoing heart surgery have improved, there is a significant variation in outcomes across hospitals. This review discusses the variation in cost and outcomes across centres performing congenital heart surgery, potential underlying mechanisms, and efforts to reduce variation and improve outcome.

APA, Harvard, Vancouver, ISO, and other styles

9

Sánchez Cuberes, M., M. Vázquez, J. A. Bonet, and M. Sobotka. "Centre-to-limb variation of solar granulation in the infrared." Astronomy & Astrophysics 397, no. 3 (January 2003): 1075–81. http://dx.doi.org/10.1051/0004-6361:20021603.

Full text

APA, Harvard, Vancouver, ISO, and other styles

10

Drake, T. M., M. J. Lee, A. Senapati, and S. R. Brown. "Resource variation in colorectal surgery: a national centre level analysis." Colorectal Disease 19, no. 7 (July 2017): 641–48. http://dx.doi.org/10.1111/codi.13596.

Full text

APA, Harvard, Vancouver, ISO, and other styles

11

Hakama, Matti, Sue M. Moss, Ulf-Hakan Stenman, Monique J. Roobol, Marco Zappa, Sigrid Carlsson, Marco Randazzo, Vera Nelen, and Jonas Hugosson. "Design-corrected variation by centre in mortality reduction in the ERSPC randomised prostate cancer screening trial." Journal of Medical Screening 24, no. 2 (August 9, 2016): 98–103. http://dx.doi.org/10.1177/0969141316652174.

Full text

Abstract:

Objectives To calculate design-corrected estimates of the effect of screening on prostate cancer mortality by centre in the European Randomised Study of Screening for Prostate Cancer (ERSPC). Setting The ERSPC has shown a 21% reduction in prostate cancer mortality in men invited to screening with follow-up truncated at 13 years. Centres either used pre-consent randomisation (effectiveness design) or post-consent randomisation (efficacy design). Methods In six centres (three effectiveness design, three efficacy design) with follow-up until the end of 2010, or maximum 13 years, the effect of screening was estimated as both effectiveness (mortality reduction in the target population) and efficacy (reduction in those actually screened). Results The overall crude prostate cancer mortality risk ratio in the intervention arm vs control arm for the six centres was 0.79 ranging from a 14% increase to a 38% reduction. The risk ratio was 0.85 in centres with effectiveness design and 0.73 in those with efficacy design. After correcting for design, overall efficacy was 27%, 24% in pre-consent and 29% in post-consent centres, ranging between a 12% increase and a 52% reduction. Conclusion The estimated overall effect of screening in attenders (efficacy) was a 27% reduction in prostate cancer mortality at 13 years’ follow-up. The variation in efficacy between centres was greater than the range in risk ratio without correction for design. The centre-specific variation in the mortality reduction could not be accounted for by the randomisation method.

APA, Harvard, Vancouver, ISO, and other styles

12

Papachristofi, Olympia, Andrew A. Klein, John Mackay, Samer Nashef, Nick Fletcher, and Linda D. Sharples. "Effect of individual patient risk, centre, surgeon and anaesthetist on length of stay in hospital after cardiac surgery: Association of Cardiothoracic Anaesthesia and Critical Care (ACTACC) consecutive cases series study of 10 UK specialist centres." BMJ Open 7, no. 9 (September 2017): e016947. http://dx.doi.org/10.1136/bmjopen-2017-016947.

Full text

Abstract:

ObjectivesTo determine the relative contributions of patient risk profile, local and individual clinical practice on length of hospital stay after cardiac surgery.DesignTen-year audit of prospectively collected consecutive cardiac surgical cases. Case-mix adjusted outcomes were analysed in models that included random effects for centre, surgeon and anaesthetist.SettingUK centres providing adult cardiac surgery.Participants10 of 36 UK specialist centres agreed to provide outcomes for all major cardiac operations over 10 years. After exclusions (duplicates, cases operated by more than one consultant, deaths and procedures for which the EuroSCORE risk score for cardiac surgery is not appropriate), there were 107 038 cardiac surgical procedures between April 2002 and March 2012, conducted by 127 consultant surgeons and 190 consultant anaesthetists.Main outcome measureLength of stay (LOS) up to 3 months postoperatively.ResultsThe principal component of variation in outcomes was patient risk (represented by the EuroSCORE and remaining patient heterogeneity), accounting for 95.43% of the variation for postoperative LOS. The impact of the surgeon and centre was moderate (intra-class correlation coefficients ICC=2.79% and 1.59%, respectively), whereas the impact of the anaesthetist was negligible (ICC=0.19%). Similarly, 96.05% of the variation for prolonged LOS (>11 days) was attributable to the patient, with surgeon and centre less but still influential components (ICC=2.12% and 1.66%, respectively, 0.17% only for anaesthetists). Adjustment for year of operation resulted in minor reductions in variation attributable to surgeons (ICC=2.52% for LOS and 2.23% for prolonged LOS).ConclusionsPatient risk profile is the primary determinant of variation in LOS, and as a result, current initiatives to reduce hospital stay by modifying consultant performance are unlikely to have a substantial impact. Therefore, substantially reducing hospital stay requires shifting away from a one-size-fits-all approach to cardiac surgery, and seeking alternative treatment options personalised to high-risk patients.

APA, Harvard, Vancouver, ISO, and other styles

13

Katsahian, Sandrine, Myriam Labopin, Francesco Frassoni, Vanderson Rocha, and Sylvie Chevret. "Persistent Centre Effect but Improvement of Leukemia-Free Survival of HLA Identical Hematopoietic Stem Cell Transplantation for Adults with AML in First CR in Europe over the Period 1987–2005 an Analysis on Behalf of the ALWP of EBMT." Blood 108, no. 11 (November 16, 2006): 3027. http://dx.doi.org/10.1182/blood.v108.11.3027.3027.

Full text

Abstract:

Abstract Background. Among major European centres which had undertaken more than 30 bone-marrow transplantations(BMT) between Jan 1, 1987, and Dec 31, 1995, the outcome of allogenic BMT for acute myeloid leukemia (AML) in first complete remission has been shown to be influenced by the centre in which the procedure is done. To determine whether similar variation exists 10 years later, we analysed leukaemia free survival (LFS), relapse incidence (RI) and treatment related mortality (TRM) across the same 13 transplant centres. Methods. Thirteen centres were included in the analysis which enrolled 515 patients (aged 16–55 years), between 1987 and 1995, for acute myeloid leukaemia in first complete remission and 455 patients were enrolled between 1996 and 2005. Patients were followed from the date of transplantation to the time of event (Relapse and/or deaths). Regression models taking into account centre effect was adapted to the outcome and adjusted for relevant covariates Findings The overall results at 5 years were 57% (95% CI 54–61) for leukaemia-free survival (LFS), 22% (19–25) for relapse incidence (RI), and 21% (18–24) for treatment related mortality (TRM) with a range for centres of 41–67%, 13–41%, and 13–41%, respectively. LFS at 5 years before 1995 was significantly lower 54% than after 1995 62% (p=0.02). Relapse Incidence at 5 years before 1995 was not significantly lower 23% than after 1995 21% (p=0.34). Treatment-related mortality incidence at 5 years before 1995 was not significantly lower 25% than after 1995 21% (p=0.13). Analysis showed the centre effect to be highly significant for LFS and TRM, but not for RI. Interpretation These findings show that the results of BMT have improved over time in Europe. At the same time this study confirms a significant centre-specific variation in the success of bone transplantation in Europe. This effect has persisted despite advances in transplantation, which have lead to improvements in patient outcomes (leukaemia free survival and Treatment Related Mortality). Further studies are needed to elucidate the causes of this variation, with the goal of developing strategies to minimize the centre effect and ensure the best possible outcomes for all transplant recipients.

APA, Harvard, Vancouver, ISO, and other styles

14

Eckhauser, Aaron W., Maria I. Van Rompay, Chitra Ravishankar, Jane W. Newburger, S. Ram Kumar, Christian Pizarro, Nancy Ghanayem, et al. "Variation in care for children undergoing the Fontan operation for hypoplastic left heart syndrome." Cardiology in the Young 29, no. 12 (November 26, 2019): 1510–16. http://dx.doi.org/10.1017/s1047951119002658.

Full text

Abstract:

AbstractBackground:The Single Ventricle Reconstruction Trial randomised neonates with hypoplastic left heart syndrome to a shunt strategy but otherwise retained standard of care. We aimed to describe centre-level practice variation at Fontan completion.Methods:Centre-level data are reported as median or median frequency across all centres and range of medians or frequencies across centres. Classification and regression tree analysis assessed the association of centre-level factors with length of stay and percentage of patients with prolonged pleural effusion (>7 days).Results:The median Fontan age (14 centres, 320 patients) was 3.1 years (range from 1.7 to 3.9), and the weight-for-age z-score was −0.56 (−1.35 + 0.44). Extra-cardiac Fontans were performed in 79% (4–100%) of patients at the 13 centres performing this procedure; lateral tunnels were performed in 32% (3–100%) at the 11 centres performing it. Deep hypothermic circulatory arrest (nine centres) ranged from 6 to 100%. Major complications occurred in 17% (7–33%). The length of stay was 9.5 days (9–12); 15% (6–33%) had prolonged pleural effusion. Centres with fewer patients (<6%) with prolonged pleural effusion and fewer (<41%) complications had a shorter length of stay (<10 days; sensitivity 1.0; specificity 0.71; area under the curve 0.96). Avoiding deep hypothermic circulatory arrest and higher weight-for-age z-score were associated with a lower percentage of patients with prolonged effusions (<9.5%; sensitivity 1.0; specificity = 0.86; area under the curve 0.98).Conclusions:Fontan perioperative practices varied widely among study centres. Strategies to decrease the duration of pleural effusion and minimise complications may decrease the length of stay. Further research regarding deep hypothermic circulatory arrest is needed to understand its association with prolonged pleural effusion.

APA, Harvard, Vancouver, ISO, and other styles

15

Chin-Yee, Nicolas J., Andrew Yan, George A. Tomlinson, Craig Earle, Maureen E. Trudeau, Murray Krahn, Dennis Ko, et al. "Impact of center case volume on cardiotoxicity during adjuvant trastuzumab in breast cancer." Journal of Clinical Oncology 31, no. 15_suppl (May 20, 2013): 6625. http://dx.doi.org/10.1200/jco.2013.31.15_suppl.6625.

Full text

Abstract:

6625 Background: A recent study suggested that cardiotoxicity from trastuzumab (T) was associated with regional variation and insufficient cardiac monitoring (Ng et al.SABCS 2012). Few studies have examined the impact of centre or physician (MD) case volume (vol) on outcomes in systemic therapy. Methods: All breast cancer patients who were diagnosed in 2003-2009 in Ontario and treated with adjuvant T were identified through a provincial drug funding program, and linked to administrative databases to ascertain patient demographics, hospitalizations, cardiac risk factors, cardiac imaging, comorbidities, and treating centre and MD. For each year, we calculated case vol as the number of patients treated with adjuvant T by each MD and by each centre. Cardiotoxicity was defined as receiving less than 16 out of 18 doses of T because of heart failure (HF) admission, HF diagnosis by physician claims, or discontinuation after cardiac imaging. Insufficient cardiac monitoring was defined as per recent guideline and per Ng et al. Logistic regression and mixed models were constructed to examine factors associated with cardiotoxicity. Results: Our cohort consisted of 3,777 patients, 214 MDs and 68 centres. For patients, 16.5% were over age 65; 30.3%, 9.4%, and 1.2% had previous diagnoses of hypertension, diabetes, and HF, respectively; 16.9% had cardiotoxicity. Univariate analyses found that high centre vol, but not MD vol, was associated with lower cardiotoxicity. Cardiotoxicity rates by centre vol quintiles (Q) were 23.4% (Q1-3), 18.2% (Q4), and 15.2% (Q5). Multivariable analyses found that lower cardiotoxicity was associated with higher centre vol (OR=0.85 per Q, p=0.02) and diagnosis in recent years (2008-2009 vs. before 2008; OR=0.50, p<0.001), after adjusting for age, previous HF, comorbidities, regional variation, and cardiac monitoring. Accounting for clustering within centres, there remained a strong trend of lower cardiotoxicity with higher centre vol (OR=0.77 per Q, p=0.06) and recent diagnosis (OR=0.50, p<0.001). Conclusions: Our findings suggest a reduction in cardiotoxicity with experience and over time, and support the notion of centralization of systemic therapy in high vol centres to optimize outcomes.

APA, Harvard, Vancouver, ISO, and other styles

16

Tofts, P. S., S. C. A. Steens, M. Cercignani, F. Admiraal-Behloul, P. A. M. Hofman, M. J. P. van Osch, W. M. Teeuwisse, et al. "Sources of variation in multi-centre brain MTR histogram studies: body-coil transmission eliminates inter-centre differences." Magnetic Resonance Materials in Physics, Biology and Medicine 19, no. 4 (September 2006): 209–22. http://dx.doi.org/10.1007/s10334-006-0049-8.

Full text

APA, Harvard, Vancouver, ISO, and other styles

17

Larkin, Daniel F. P., Lisa L. Mumford, and Mark N. A. Jones. "Centre-Specific Variation in Corneal Transplant Outcomes in the United Kingdom." Transplantation 91, no. 3 (February 2011): 354–59. http://dx.doi.org/10.1097/tp.0b013e318201ac62.

Full text

APA, Harvard, Vancouver, ISO, and other styles

18

Domingo, Vicente, Ada Ortiz, Blai Sanahuja, and Iballa Cabello. "Centre-to-limb variation of photospheric facular radiance and image resolution." Advances in Space Research 35, no. 3 (January 2005): 345–49. http://dx.doi.org/10.1016/j.asr.2005.01.083.

Full text

APA, Harvard, Vancouver, ISO, and other styles

19

Nogueras-Lara, F., R. Schödel, N. Neumayer, E. Gallego-Cano, B. Shahzamanian, A. T. Gallego-Calvente, and F. Najarro. "GALACTICNUCLEUS: A high angular-resolution JHKs imaging survey of the Galactic centre." Astronomy & Astrophysics 641 (September 2020): A141. http://dx.doi.org/10.1051/0004-6361/202038606.

Full text

Abstract:

Context. The characterisation of the extinction curve in the near-infrared (NIR) is fundamental to analysing the structure and stellar population of the Galactic centre (GC), whose analysis is hampered by the extreme interstellar extinction (AV ~ 30 mag) that varies on arc-second scales. Recent studies indicate that the behaviour of the extinction curve might be more complex than previously assumed, pointing towards a variation of the extinction curve as a function of wavelength. Aims. We aim to analyse the variations of the extinction index, α, with wavelength, line-of-sight, and absolute extinction, extending previous analyses to a larger area of the innermost regions of the Galaxy. Methods. We analysed the whole GALACTICNUCLEUS survey, a high-angular resolution (~0.2″) JHKs NIR survey specially designed to observe the GC in unprecedented detail. It covers a region of ~6000 pc2, comprising fields in the nuclear stellar disc, the inner bulge, and the transition region between them. We applied two independent methods based on red clump (RC) stars to constrain the extinction curve and analysed its variation superseding previous studies. Results. We used more than 165 000 RC stars and increased the size of the regions analysed significantly to confirm that the extinction curve varies with the wavelength. We estimated a difference Δα = 0.21 ± 0.07 between the obtained extinction indices, αJH = 2.44 ± 0.05 and αHKs = 2.23 ± 0.05. We also concluded that there is no significant variation of the extinction curve with wavelength, with the line-of-sight or the absolute extinction. Finally, we computed the ratios between extinctions, AJ∕AH = 1.87 ± 0.03 and AH/AKs = 1.84 ± 0.03, consistent with all the regions of the GALACTICNUCLEUS catalogue.

APA, Harvard, Vancouver, ISO, and other styles

20

Lucas-Herald, Angela K., Jillian Bryce, Andreas Kyriakou, Marie Lindhardt Ljubicic, Wiebke Arlt, Laura Audi, Antonio Balsamo, et al. "Gonadectomy in conditions affecting sex development: a registry-based cohort study." European Journal of Endocrinology 184, no. 6 (June 1, 2021): 791–801. http://dx.doi.org/10.1530/eje-20-1058.

Full text

Abstract:

Objectives To determine trends in clinical practice for individuals with DSD requiring gonadectomy. Design Retrospective cohort study. Methods Information regarding age at gonadectomy according to diagnosis; reported sex; time of presentation to specialist centre; and location of centre from cases reported to the International DSD Registry and who were over 16 years old in January 2019. Results Data regarding gonadectomy were available in 668 (88%) individuals from 44 centres. Of these, 248 (37%) (median age (range) 24 (17, 75) years) were male and 420 (63%) (median age (range) 26 (16, 86) years) were female. Gonadectomy was reported from 36 centres in 351/668 cases (53%). Females were more likely to undergo gonadectomy (n = 311, P < 0.0001). The indication for gonadectomy was reported in 268 (76%). The most common indication was mitigation of tumour risk in 172 (64%). Variations in the practice of gonadectomy were observed; of the 351 cases from 36 centres, 17 (5%) at 9 centres had undergone gonadectomy before their first presentation to the specialist centre. Median age at gonadectomy of cases from high-income countries and low-/middle-income countries (LMIC) was 13.0 years (0.1, 68) years and 16.5 years (1, 28), respectively (P < 0.0001) with the likelihood of long-term retention of gonads being higher in LMIC countries. Conclusions The likelihood of gonadectomy depends on the underlying diagnosis, sex of rearing and the geographical setting. Clinical benchmarks, which can be studied across all forms of DSD will allow a better understanding of the variation in the practice of gonadectomy.

APA, Harvard, Vancouver, ISO, and other styles

21

Ahrenfeldt, E. J., B. K. Klatt, J. Arildsen, N. Trandem, G. K. S. Andersson, T. Tscharntke, H. G. Smith, and L. Sigsgaard. "Pollinator communities in strawberry crops – variation at multiple spatial scales." Bulletin of Entomological Research 105, no. 4 (April 24, 2015): 497–506. http://dx.doi.org/10.1017/s000748531500036x.

Full text

Abstract:

AbstractPredicting potential pollination services of wild bees in crops requires knowledge of their spatial distribution within fields. Field margins can serve as nesting and foraging habitats for wild bees and can be a source of pollinators. Regional differences in pollinator community composition may affect this spill-over of bees. We studied how regional and local differences affect the spatial distribution of wild bee species richness, activity-density and body size in crop fields. We sampled bees both from the field centre and at two different types of semi-natural field margins, grass strips and hedges, in 12 strawberry fields. The fields were distributed over four regions in Northern Europe, representing an almost 1100 km long north-south gradient. Even over this gradient, daytime temperatures during sampling did not differ significantly between regions and did therefore probably not impact bee activity. Bee species richness was higher in field margins compared with field centres independent of field size. However, there was no difference between centre and margin in body-size or activity-density. In contrast, bee activity-density increased towards the southern regions, whereas the mean body size increased towards the north. In conclusion, our study revealed a general pattern across European regions of bee diversity, but not activity-density, declining towards the field interior which suggests that the benefits of functional diversity of pollinators may be difficult to achieve through spill-over effects from margins to crop. We also identified dissimilar regional patterns in bee diversity and activity-density, which should be taken into account in conservation management.

APA, Harvard, Vancouver, ISO, and other styles

22

Buckley, Jason R., Eric M. Graham, Michael Gaies, Jeffrey A. Alten, David S. Cooper, John M. Costello, Yuliya Domnina, et al. "Clinical epidemiology and centre variation in chylothorax rates after cardiac surgery in children: a report from the Pediatric Cardiac Critical Care Consortium." Cardiology in the Young 27, no. 9 (May 29, 2017): 1678–85. http://dx.doi.org/10.1017/s104795111700097x.

Full text

Abstract:

AbstractIntroductionChylothorax after paediatric cardiac surgery incurs significant morbidity; however, a detailed understanding that does not rely on single-centre or administrative data is lacking. We described the present clinical epidemiology of postoperative chylothorax and evaluated variation in rates among centres with a multicentre cohort of patients treated in cardiac ICU.MethodsThis was a retrospective cohort study using prospectively collected clinical data from the Pediatric Cardiac Critical Care Consortium registry. All postoperative paediatric cardiac surgical patients admitted from October, 2013 to September, 2015 were included. Risk factors for chylothorax and association with outcomes were evaluated using multivariable logistic or linear regression models, as appropriate, accounting for within-centre clustering using generalised estimating equations.ResultsA total of 4864 surgical hospitalisations from 15 centres were included. Chylothorax occurred in 3.8% (n=185) of hospitalisations. Case-mix-adjusted chylothorax rates varied from 1.5 to 7.6% and were not associated with centre volume. Independent risk factors for chylothorax included age <1 year, non-Caucasian race, single-ventricle physiology, extracardiac anomalies, longer cardiopulmonary bypass time, and thrombosis associated with an upper-extremity central venous line (all p<0.05). Chylothorax was associated with significantly longer duration of postoperative mechanical ventilation, cardiac ICU and hospital length of stay, and higher in-hospital mortality (all p<0.001).ConclusionsChylothorax after cardiac surgery in children is associated with significant morbidity and mortality. A five-fold variation in chylothorax rates was observed across centres. Future investigations should identify centres most adept at preventing and managing chylothorax and disseminate best practices.

APA, Harvard, Vancouver, ISO, and other styles

23

Rangaswamy, Dharshan, Vasudeva Guddattu, Angela C. Webster, Monique Borlace, Neil Boudville, Philip Clayton, Sunil Badve, David W. Johnson, and Kamal Sud. "Icodextrin use for peritoneal dialysis in Australia: A cohort study using Australia and New Zealand Dialysis and Transplant Registry." Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis 40, no. 2 (January 17, 2020): 209–19. http://dx.doi.org/10.1177/0896860819894058.

Full text

Abstract:

Background: Icodextrin is a high molecular weight, starch-derived glucose polymer that is used as an osmotic agent in peritoneal dialysis (PD) to promote ultrafiltration. There has been wide variation in its use across Australia and the rest of the world, but it is unclear whether these differences are due to patient- or centre-related factors. Methods: Using the Australia and New Zealand Dialysis and Transplant Registry, all adult patients (>18 years) who started PD in Australia between 1 January 2007 and 31 December 2014 were included. The primary outcome was icodextrin use at PD commencement. Hierarchical logistic regression clustered around the treatment centre was applied to determine the patient- and centre-related characteristics associated with icodextrin use. The impact of centre-level practice pattern variability on icodextrin uptake was estimated using the intra-cluster correlation coefficient (ICC). Results: Of 5948 patients starting on PD in 58 centres during the study period, 2002 (33.7%) received icodextrin from the outset. Overall uptake of icodextrin increased from 29% in 2010 to 42.5% in 2014. Patient-level characteristics associated with an increased likelihood of commencing PD with icodextrin included male sex (adjusted odds ratio (OR) 1.55, 95% confidence interval (CI) 1.35–1.77; p < 0.001), prior haemodialysis or kidney transplantation (OR 1.26, 95% CI 1.09–1.47), obesity (OR 1.66, 95% CI 1.41–1.96), diabetes mellitus (OR 2.32, 95% CI 2.03–2.64) and residing in a postcode with the highest decile of socio-economic status (OR 1.43, 95% CI 1.11–1.85). The centre-level characteristic associated with an increased likelihood of commencing PD with icodextrin was routine assessment of a peritoneal equilibration test (OR 1.45, 95% CI 1.27–1.66). Centres with fewer patients on automated peritoneal dialysis (APD) were less likely to start on icodextrin (APD proportion <57%; OR 0.45, 95% CI 0.20–0.99). Centre factors accounted for 25% of the variation in icodextrin use solution among incident PD patients (ICC 0.25). Conclusions: Icodextrin use in incident Australian PD patients is increasing variable and associated with both patient and centre characteristics. Centre-related factors explained 25% of variability in icodextrin use.

APA, Harvard, Vancouver, ISO, and other styles

24

Pedersen, Susanne Bendesgaard, Dóra Körmendiné Farkas, Søren Pihlkjær Hjortshøj, Hans Erik Bøtker, Jens Brock Johansen, Berit Thornvig Philbert, Jens Haarbo, Reimar Wernich Thomsen, and Jens Cosedis Nielsen. "Significant regional variation in use of implantable cardioverter-defibrillators in Denmark." European Heart Journal - Quality of Care and Clinical Outcomes 5, no. 4 (February 20, 2019): 352–60. http://dx.doi.org/10.1093/ehjqcco/qcz008.

Full text

Abstract:

Abstract Aims Implantable cardioverter-defibrillator (ICD) treatment prevents sudden cardiac death in high-risk patients. This study examined geographical variation in ICD implantation rates in Denmark and potential causes of variation. Methods and results We obtained numbers of ICD implantations in the 5 Danish regions and 98 municipalities during 2007–13 from the Danish Pacemaker and ICD Registry. Standardized implantation rates (SIRs) were computed as ICD implantations per 1 000 000 person-years, and age- and gender-standardized to the Danish population. We examined associations of the municipal SIR with mean age and Charlson Comorbidity Index score of ICD recipients, percentage of implantations with primary prophylactic indication, and distance from patient residency to ICD implanting centre. Based on 7192 ICD implantations, the nationwide SIR was 186 [95% confidence interval (CI) 182–190], ranging from 170 (95% CI 158–183) in the North Denmark Region to 206 (95% CI 195–218) in the Region of Zealand. Municipalities with higher patient comorbidity scores, higher percentages of implantations with primary prophylactic indication, and shorter distances to ICD implanting centres, had higher SIRs [differences between SIRs of municipalities in highest and lowest quartiles 22 (95% CI 10–34), 45 (95% CI 33–58), and 35 (95% CI 24–47), respectively]. Regional differences in SIRs decreased over time and had become insignificant during 2011–13. Conclusion Implantable cardioverter-defibrillator implantation rates in Denmark varied significantly between regions but variation decreased during 2007–13. Geographical variation was associated with differences in patient comorbidity score, variation in use of primary prophylactic ICD treatment, and distance to ICD implanting centre.

APA, Harvard, Vancouver, ISO, and other styles

25

Baxter, Josh R., Thomas A. Novack, Herman Van Werkhoven, David R. Pennell, and Stephen J. Piazza. "Ankle joint mechanics and foot proportions differ between human sprinters and non-sprinters." Proceedings of the Royal Society B: Biological Sciences 279, no. 1735 (December 21, 2011): 2018–24. http://dx.doi.org/10.1098/rspb.2011.2358.

Full text

Abstract:

Recent studies of sprinters and distance runners have suggested that variations in human foot proportions and plantarflexor muscle moment arm correspond to the level of sprint performance or running economy. Less clear, however, is whether differences in muscle moment arm are mediated by altered tendon paths or by variation in the centre of ankle joint rotation. Previous measurements of these differences have relied upon assumed joint centres and measurements of bone geometry made externally, such that they would be affected by the thickness of the overlying soft tissue. Using magnetic resonance imaging, we found that trained sprinters have shorter plantarflexor moment arms ( p = 0.011) and longer forefoot bones ( p = 0.019) than non-sprinters. The shorter moment arms of sprinters are attributable to differences in the location of the centre of rotation ( p < 0.001) rather than to differences in the path of the Achilles tendon. A simple computer model suggests that increasing the ratio of forefoot to rearfoot length permits more plantarflexor muscle work during plantarflexion that occurs at rates expected during the acceleration phase following the sprint start.

APA, Harvard, Vancouver, ISO, and other styles

26

Maffei, Luigi, Maria Di Gabriele, and Francesco Aletta. "Soundscape variation in a historical city centre due to new traffic regulation." Journal of the Acoustical Society of America 131, no. 4 (April 2012): 3438. http://dx.doi.org/10.1121/1.4708901.

Full text

APA, Harvard, Vancouver, ISO, and other styles

27

Cho, Y., S. V. Badve, C. M. Hawley, S. P. McDonald, F. G. Brown, N. Boudville, K. J. Wiggins, K. M. Bannister, P. A. Clayton, and D. W. Johnson. "Seasonal variation in peritoneal dialysis-associated peritonitis: a multi-centre registry study." Nephrology Dialysis Transplantation 27, no. 5 (October 6, 2011): 2028–36. http://dx.doi.org/10.1093/ndt/gfr582.

Full text

APA, Harvard, Vancouver, ISO, and other styles

28

Figueiredo, P., P. L. Kjendlie, J. Vilas-Boas, and R. Fernandes. "Intracycle Velocity Variation of the Body Centre of Mass in Front Crawl." International Journal of Sports Medicine 33, no. 04 (February 8, 2012): 285–90. http://dx.doi.org/10.1055/s-0031-1301323.

Full text

APA, Harvard, Vancouver, ISO, and other styles

29

Zhang, J., G. Shen, and L. Yang. "New hybrid adaptive control approach for aircraft with centre of gravity variation." IET Control Theory & Applications 6, no. 14 (September 20, 2012): 2179–87. http://dx.doi.org/10.1049/iet-cta.2011.0418.

Full text

APA, Harvard, Vancouver, ISO, and other styles

30

Anthonisen, Nick R. "Canadian Normal Lung Function Values." Canadian Respiratory Journal 11, no. 6 (2004): 391–92. http://dx.doi.org/10.1155/2004/121025.

Full text

Abstract:

In this issue of theCanadian Respiratory Journal, Gutierrez et al (pages 414-424) present normal lung function values and prediction equations for white Canadians. They had six laboratories across the country each test approximately 100 volunteer, nonsmoking white adults (the target was 120 each), with appropriate variation in age and sex. Adequate representation of different ages and sex were obtained, although it appeared to be harder to recruit elderly men than elderly women. A full battery of tests was performed on each person. The equipment was not standardized and varied from centre to centre, and some centres performed slightly different tests than others; in other words, the study was done under field conditions. The results were analyzed for each centre and pooled to produce the Canadian model. This was compared with several similar models developed in Europe and the United States (1-5).

APA, Harvard, Vancouver, ISO, and other styles

31

Kowalski, Julia, and Jim N. McElwaine. "Shallow two-component gravity-driven flows with vertical variation." Journal of Fluid Mechanics 714 (January 2, 2013): 434–62. http://dx.doi.org/10.1017/jfm.2012.489.

Full text

Abstract:

AbstractGravity-driven geophysical mass flows often consist of a heterogeneous fluid–solid mixture. The complex interplay between the components leads to phenomena such as lateral levee formation in avalanches, or a granular front and an excess fluid pore pressure in debris flows. These effects are very important for predicting runout and the forces on structures, yet they are only partially represented in simplified shallow flow theories, since rearrangement of the mixture composition perpendicular to the main flow direction is neglected. In realistic flows, however, rheological properties and effective basal drag may depend strongly on the relative concentration of the components. We address this problem and present a depth-averaged model for shallow mixtures that explicitly allows for rearrangement in this direction. In particular we consider a fluid–solid mixture that experiences bulk horizontal motion, as well as internal sedimentation and resuspension of the particles, and therefore resembles the case of a debris flow. Starting from general mixture theory we derive bulk balance laws and an evolution equation for the particle concentration. Depth-integration yields a shallow mixture flow model in terms of bulk mass, depth-averaged particle concentration, the particle vertical centre of mass and the depth-averaged velocity. This new equation in this model for the particle vertical centre of mass is derived by taking the first moment, with respect to the vertical coordinate, of the particle mass conservation equation. Our approach does not make the Boussinesq approximation and results in additional terms coupling the momentum flux to the vertical centre of mass. The system is hyperbolic and reduces to the shallow-water equations in the homogeneous limit of a pure fluid or perfect mixing. We highlight the effects of sedimentation on resuspension and finally present a simple friction feedback which qualitatively resembles a large-scale experimental debris flow data set acquired at the Illgraben, Switzerland.

APA, Harvard, Vancouver, ISO, and other styles

32

Onea, Florin, and Liliana Rusu. "Wave Power Variation near the Romanian Coastal Waters." E3S Web of Conferences 103 (2019): 01006. http://dx.doi.org/10.1051/e3sconf/201910301006.

Full text

Abstract:

In the present work, the relationship between Romanian wave power and the distance to the shoreline is evaluated, by taking also into account the performances of some wave energy converters. Several reference sites located on northern, centre and southern part of this area were taken into account, the wave energy being assessed at 5 km, 15 km and 30 km from the shore. More important resources were noticed close to the Vama Veche (in south) were an average of 4.27 kW/m is reported offshore. As we go from shore to offshore, the wave variations may reach a maximum of 7.7% in the case of the Navodari site (centre), while a 3.3% is expected for Vama Veche. In the case of the wave generators, three types of systems (Seabased, Pelamis and Wave Dragon) were considered, that cover a rated capacity ranging from 15 kW to 7000 kW. For the Saint George s ite (north), the power production is insignificant being located close to zero, while in terms of the capacity factor a maximum of 0.12% may be expected from the Seabased system. The capacity factor significantly increases as we go to south, being reported during winter time values close to 3% for Pelamis system or 6% in the case of Seabased, respectively.

APA, Harvard, Vancouver, ISO, and other styles

33

Stark, Elisabeth. "Sprache, Grammatik, Variation – viticulture linguistique." Romanistisches Jahrbuch 69, no. 1 (November 1, 2018): 96–118. http://dx.doi.org/10.1515/roja-2018-0004.

Full text

Abstract:

Abstract The aim of this contribution is to reposition a key notion to the centre of Wulf Oesterreicher’s theoretical disciplinary reasoning: grammar, or more generally, ‘rules and norms’ specific to single languages and varieties the linguist deals with. This includes contingent, non-motivated structures, and claiming the necessity to analyse their existence ‘as such’ (i.e., also independently of communicative, social etc. factors) as the core task of linguistics. This point is illustrated with a much debated variable in French descriptive linguistics: past participle agreement. Combining theoretical and corpus linguistic observations, the distribution of the two variants (absence vs. realization of agreement) in constructions with the auxiliary avoir shows that a grammatical analysis interested in the derivation of certain rules and their application in actual language usage permits to understand the logic of linguistic variation - at least the one observable alongside the standard - non-standard opposition in French.

APA, Harvard, Vancouver, ISO, and other styles

34

Jarrett, K. J., N. Kirby, C. E. Buckley, and C. J. Garvey. "The spatial modulation of microfibril angle in the woody tissue of maturing tree stems studied with synchrotron radiation." Australian Journal of Botany 68, no. 4 (2020): 267. http://dx.doi.org/10.1071/bt18229.

Full text

Abstract:

Spatial variations in the microfibril angle (MFA) of cellulose are mapped on individual radial sections of wood from the maturing stems of Australian tree species (Acacia floribunda, Acacia suaveolens, Acacia doratoxylon, Acacia havilandiorum, Brachychiton populneus and Bertya cunninghamii) from different rainfall and soil nutrient availabilities using synchrotron wide angle X-ray scattering. For the three species with the smallest radial variation there is a clear linear relationship between the MFA with Young’s modulus and wood density with data published previously for these samples. The other three samples show a large radially symmetric variation in MFA across the radial section either having a continuous change from large MFA in the stem’s centre to small value close to the bark or the reverse, small MFA at the centre to larger values close to the bark. For these samples, a strong linear correlation between the Young’s modulus and density and the MFA is not apparent. We conclude that spatially localised measurements of MFA provide an important insight in the adaptation of wood tissue to environmental conditions.

APA, Harvard, Vancouver, ISO, and other styles

35

Shahbakhti, M., and C. R. Koch. "Characterizing the cyclic variability of ignition timing in a homogeneous charge compression ignition engine fuelled with n-heptane/iso-octane blend fuels." International Journal of Engine Research 9, no. 5 (October 1, 2008): 361–97. http://dx.doi.org/10.1243/14680874jer01408.

Full text

Abstract:

The cyclic variations of homogeneous charge compression ignition (HCCI) ignition timing is studied for a range of charge properties by varying the equivalence ratio, intake temperature, intake pressure, exhaust gas recirculation (EGR) rate, engine speed, and coolant temperature. Characterization of cyclic variations of ignition timing in HCCI at over 430 operating points on two single-cylinder engines for five different blends of primary reference fuel (PRF), (iso-octane and n-heptane) is performed. Three distinct patterns of cyclic variation for the start of combustion (SOC), combustion peak pressure ( Pmax), and indicated mean effective pressure (i.m.e.p.) are observed. These patterns are normal cyclic variations, periodic cyclic variations, and cyclic variations with weak/misfired ignitions. Results also show that the position of SOC plays an important role in cyclic variations of HCCI combustion with less variation observed when SOC occurs immediately after top dead centre (TDC). Higher levels of cyclic variations are observed in the main (second) stage of HCCI combustion compared with that of the first stage for the PRF fuels studied. The sensitivity of SOC to different charge properties varies. Cyclic variation of SOC increases with an increase in the EGR rate, but it decreases with an increase in equivalence ratio, intake temperature, and coolant temperature.

APA, Harvard, Vancouver, ISO, and other styles

36

S., Suguna, and Vidyasagar V. "Study to determine gender variation in severe acute malnutrition at nutrition rehabilitation centre." International Journal of Contemporary Pediatrics 6, no. 2 (February 23, 2019): 602. http://dx.doi.org/10.18203/2349-3291.ijcp20190695.

Full text

Abstract:

Background: The objective of this study is to know the gender variation in number of admissions, severity of malnutrition at the time of admission, gaining of weight and adherence to follow up in children admitted to nutrition rehabilitation center and during follow up.Methods: This is a retrospective study involving the review of existing programme records. Children who were admitted to nutrition rehabilitation centre, district hospital, Chamarajanagar, Karnataka, India, between January 2017 to December 2017 with severe acute malnutrition were involved in the study. The programme included 2 weeks of in-patient care, and four follow-up visits to the NRC subsequently as follows; 1st visit at 7 days, 2nd at 14 days, 3rd at 1 month and 4th at 2 months after discharge.Results: Among 57 children who admitted to NRC females were 30 (52.6%) and males 27 47.4%). 25 among 57 children (43.9%) could sustain weight gain of >5grams/kg/day as per one of the discharge criteria. 13 (52%) were females and 12 (48%) were males. 32(56%) among 57 admitted children to NRC, could achieve <-1SD during entire programmed. 15(46.8%) were females and 17 (53.1%) were males.Conclusions: There was no gender variation in either number of admission or severity of malnutrition at the time of admission or weight gain during NRC programme.

APA, Harvard, Vancouver, ISO, and other styles

37

Nogueras-Lara, F., R. Schödel, F. Najarro, A. T. Gallego-Calvente, E. Gallego-Cano, B. Shahzamanian, and N. Neumayer. "Variability of the near-infrared extinction curve towards the Galactic centre." Astronomy & Astrophysics 630 (September 23, 2019): L3. http://dx.doi.org/10.1051/0004-6361/201936322.

Full text

Abstract:

Context. Due to the extreme extinction towards the Galactic centre (AV ∼ 30 mag), its stellar population is mainly studied in the near-infrared (NIR) regime. Therefore, a proper analysis of the NIR extinction curve is necessary to fully characterise the stellar structure and population of the inner part of the galaxy. Aims. We studied the dependence of the extinction index (αλ) in the NIR on the line of sight, wavelength, and extinction. Methods. We used the GALACTICNUCLEUS imaging survey, a high angular resolution catalogue (0.2″) for the inner part of the Galaxy in JHKs, and studied the spatial variation in the extinction index. We also applied two independent methods based on red clump stars to compute the extinction index between different bands and its variation with wavelength. Results. We did not detect any significant line-of-sight or extinction variation in α within the studied region in the nuclear stellar disc. The extinction index between JH and HKs differs by 0.19 ± 0.05. We obtained mean values for the extinction indices αJH = 2.43 ± 0.03 and αHKs = 2.23 ± 0.03. The dependence of the extinction index on the wavelength could explain the differences obtained for αλ in the literature since it was assumed constant for the NIR regime.

APA, Harvard, Vancouver, ISO, and other styles

38

Kumar, Ujjwal, Krishnendra Varma, and Pawan Kumar Khairwar. "Seasonal variation of pediatric dermatoses: a retrospective study conducted in tertiary care centre Ujjain." International Journal of Research in Dermatology 4, no. 2 (April 25, 2018): 168. http://dx.doi.org/10.18203/issn.2455-4529.intjresdermatol20181816.

Full text

Abstract:

Background: Skin diseases in pediatric age are common health problem with wide variation in the presentation in various regions. Association of seasonal variation in skin disease has been studied for centuries. Environmental factors plays significant role in skin disease. Different climatic factors that may decide the incidence of skin diseases. Cold, warmth, light and humidity play direct or indirect role in occurrence of various dermatosis. Many studies have been done to study pattern of skin disease in pediatric population but only few studies are done for its clinical correlation of seasonal variation. Hence we decided to study seasonal variation in pediatric dermatoses. The objective of the study was to study the seasonal variation, age-wise variation and distribution of common dermatoses in pediatric population in 0-15 years.Methods: This was a retrospective study done in R.D. Gardi Medical College, Ujjain over a period of one year. A total of 1110 cases of age 0-15 years, who presented in out-patient clinic of dermatology deparment were included in this study. Demographic profile and clinical details were recorded. Data were collected and patient’s details were categorized according to four seasons summer, autumn, winter and spring. Microsoft excel was used for data entry and analysis was done using SPSS version 22.Results: Out of all the subjects recruited, 55.7% were males and 44.3% were females with M:F ratio1.25:1. The maximum numbers of patients were in the age group of 10-15 years (43.3%). Majority of visits were in summer (n=360, 32.43%) followed by winter and spring season. Most common dermatosis seen during summer was bacterial infection (n=93, 8.37%) and during winter was eczema (n=62, 5.58%).Conclusions: Dermatoses in children are wide spread problem responsible for significant morbidity in them. In the present study there is seasonal variation of dermatological diseases in pediatric age group.

APA, Harvard, Vancouver, ISO, and other styles

39

Kipping, David M., Ignasi Ribas, and Andreu Font-Ribera. "Eccentric Planets & Transit Time Variation." Proceedings of the International Astronomical Union 4, S253 (May 2008): 490–91. http://dx.doi.org/10.1017/s1743921308027014.

Full text

Abstract:

AbstractFor an extrasolar planet on an eccentric orbit, the orbital velocity is constantly changing, even during a planetary transit. This changing orbital velocity will, in general, cause lightcurve assymetry. The asymmetry causes the mid-transit time to be slightly off-centre from the halfway point between transit ingress and egress. For GJ436b, we estimate that the mid-transit time is shifted by 20 seconds. In the case of a system experiencing secular changes, this difference will lead to a long period transit time variation (L-TTV) signal, under the typical definition of the mid-transit time. In this work, we describe the origins of the effect and evaluate it in the case of GJ436b experiencing hypothetical secular changes. We predict L-TTV could be used to map secular changes in such systems.

APA, Harvard, Vancouver, ISO, and other styles

40

Ilić, Predrag, Zoran Popović, and Dragana Nešković Markić. "Assessment of Meteorological Effects and Ozone Variation in Urban Area." Ecological Chemistry and Engineering S 27, no. 3 (September 1, 2020): 373–85. http://dx.doi.org/10.2478/eces-2020-0024.

Full text

Abstract:

AbstractThe paper presents results of the measurements of the tropospheric ozone (O3) concentration and meteorological parameters: temperature, air pressure, relative humidity, speed and wind direction. The data were collected from January 2016 to December 2016 at station located in locality Centre (Banja Luka), Republic of Srpska, Bosnia and Herzegovina. Ozone is one of the most harmful pollutants to plants and health and highly reactive secondary pollutant. The present study covers investigation of the relationship between the concentration of ozone and meteorological parameters as well as time variations of ozone concentration (by hours, months, seasons). This topic has not been studied up to now in this region, although the recent research data indicates that there is a correlation between them and previously obtained from the world’s relevant scientific centres, as already cited above. Statistical analysis confirms string of rolls, which shows directional connection between tropospheric ozone and meteorological parameters, specially temperature (r = 0.148), air pressure (r = –0.292) and relative humidity (r = –0.292). These parameters are the most important meteorological factors influencing the variation in ozone levels during the research. The correlation ozone concentrations with speed and direction of wind is not significant, like other parameters.

APA, Harvard, Vancouver, ISO, and other styles

41

Taylor, Dominic, Matthew Robb, Anna Casula, and Fergus Caskey. "Chapter 9 Centre Variation in Access to Kidney Transplantation (2011–2013 incident cohort)." Nephron 139, no. 1 (2018): 241–52. http://dx.doi.org/10.1159/000490967.

Full text

APA, Harvard, Vancouver, ISO, and other styles

42

Tanaka, Hidefumi, Naoyuki Komuro, and Gillian M. Turner. "Palaeosecular variation for 0.1-21 Ka from the Okataina Volcanic Centre, New Zealand." Earth, Planets and Space 61, no. 1 (January 2009): 213–25. http://dx.doi.org/10.1186/bf03352901.

Full text

APA, Harvard, Vancouver, ISO, and other styles

43

&NA;. "CENTRE VARIATION IN ACCESS TO THE RENAL TRANSPLANT WAITING LIST; THE UK EXPERIENCE." Transplantation 82, Suppl 2 (July 2006): 631. http://dx.doi.org/10.1097/00007890-200607152-01693.

Full text

APA, Harvard, Vancouver, ISO, and other styles

44

Figueiredo, Pedro, Tiago M. Barbosa, João Paulo Vilas-Boas, and Ricardo J. Fernandes. "Energy cost and body centre of mass’ 3D intracycle velocity variation in swimming." European Journal of Applied Physiology 112, no. 9 (January 20, 2012): 3319–26. http://dx.doi.org/10.1007/s00421-011-2284-6.

Full text

APA, Harvard, Vancouver, ISO, and other styles

45

Martin, C. L., J. D. Allan, J. Crosier, T. W. Choularton, H. Coe, and M. W. Gallagher. "Seasonal variation of fine particulate composition in the centre of a UK city." Atmospheric Environment 45, no. 26 (August 2011): 4379–89. http://dx.doi.org/10.1016/j.atmosenv.2011.05.050.

Full text

APA, Harvard, Vancouver, ISO, and other styles

46

Stępniak, Katarzyna, Paweł Wielgosz, and Radosław Baryła. "Field tests of L1 phase centre variation models of surveying-grade GPS antennas." Studia Geophysica et Geodaetica 59, no. 3 (March 23, 2015): 394–408. http://dx.doi.org/10.1007/s11200-014-0250-6.

Full text

APA, Harvard, Vancouver, ISO, and other styles

47

Dodd, Michael D., Amanda Balzer, Carly M. Jacobs, Michael W. Gruszczynski, Kevin B. Smith, and John R. Hibbing. "The political left rolls with the good and the political right confronts the bad: connecting physiology and cognition to preferences." Philosophical Transactions of the Royal Society B: Biological Sciences 367, no. 1589 (March 5, 2012): 640–49. http://dx.doi.org/10.1098/rstb.2011.0268.

Full text

Abstract:

We report evidence that individual-level variation in people's physiological and attentional responses to aversive and appetitive stimuli are correlated with broad political orientations. Specifically, we find that greater orientation to aversive stimuli tends to be associated with right-of-centre and greater orientation to appetitive (pleasing) stimuli with left-of-centre political inclinations. These findings are consistent with recent evidence that political views are connected to physiological predispositions but are unique in incorporating findings on variation in directed attention that make it possible to understand additional aspects of the link between the physiological and the political.

APA, Harvard, Vancouver, ISO, and other styles

48

Kang, S. L., C. Jackson, and W. Kelsall. "Electrocardiogram screening of deaf children for long QT syndrome: are we following UK national guidelines?" Journal of Laryngology & Otology 125, no. 4 (November 17, 2010): 354–56. http://dx.doi.org/10.1017/s0022215110002379.

Full text

Abstract:

AbstractIntroduction:Jervell–Lange-Nielsen syndrome is characterised by congenital deafness and a long QT interval on electrocardiography.Aim:(1) To survey UK national practice regarding electrocardiography screening of deaf children referred to cochlear implant centres, performed to evaluate for prolonged QT interval as recommended by national guidelines, and (2) to review local practice.Methods:Data were collected via a questionnaire sent to all UK cochlear implant centres, and via review of the medical records of a local cochlear implant centre database.Results:Eight (42 per cent) of the 19 cochlear implant centres surveyed performed electrocardiographic screening. Thirteen cases of long QT syndrome were reported in seven centres, with two related deaths. In our local cochlear implant centre, 14 (7.1 per cent) of 193 children had abnormal electrocardiograms; one definite long QT syndrome case and 13 borderline cases were identified.Conclusion:Despite clear national guidelines for electrocardiographic screening of deaf children, there is wide variation in practice. Our local practice of performing investigations, including electrocardiography, during magnetic resonance imaging sedation has been very successful. Electrocardiograms should be reviewed by trained clinicians, and corrected QT intervals should be calculated manually.

APA, Harvard, Vancouver, ISO, and other styles

49

Goronszy, Mervyn C., Nigel Slater, and Dennis Konicki. "The cyclic activated sludge system for resort area wastewater treatment." Water Science and Technology 32, no. 9-10 (November 1, 1995): 105–14. http://dx.doi.org/10.2166/wst.1995.0675.

Full text

Abstract:

Significant load variation is imposed on wastewater treatment infrastructure at resort centres. The type of resort centre plays a large part in both hydraulic and organic loading dynamics. Climatic conditions may also be a determining factor on the loading pattern. Holiday patterns also have a large impact upon loading dynamics. Performance of the Portage/Catawba Cyclic Activated Sludge System, located on the shores of Lake Erie, is described relative to the loading dynamics of the Summer/Winter populations.

APA, Harvard, Vancouver, ISO, and other styles

50

Oliver, Scott W., Jacqueline Campbell, David B. Kingsmore, Ram Kasthuri, Wendy Metcalfe, Jamie P. Traynor, Denis Fischbacher-Smith, Alan G. Jardine, and Peter C. Thomson. "A national appraisal of haemodialysis vascular access provision in Scotland." Journal of Vascular Access 18, no. 2 (January 31, 2017): 126–31. http://dx.doi.org/10.5301/jva.5000651.

Full text

Abstract:

Purpose Published registry data demonstrate longstanding variation in the utilisation of different vascular access (VA) modalities between Scottish renal units; this may reflect different clinical processes between centres. A comprehensive appraisal was undertaken to understand the processes underpinning VA creation and maintenance across Scotland. Methods A mixed methods approach was utilised. Fifty-two semi-structured interviews were conducted with patients and clinicians in all ten, adult and paediatric, Scottish renal units. Interview transcripts were subjected to thematic analysis. Clinical activity data were prospectively collected for six weeks, and correlated with registry data. Results VA accounts for a large clinical workload. There was significant inter-centre variation in the utilisation of different VA modalities, and patients described frustrating, dissatisfying experiences. VA creation and maintenance pathways functioned best when nephrologists, surgeons and radiologists were co-located on the same campus with close multi-disciplinary working, protected clinical time, and proactive VA maintenance. No unit routinely measured or discussed procedure outcomes or strategic aspects of their service. Conclusions Varied clinical outcomes reflected varied clinical processes. Optimised clinical pathways, staff education and measurement of clinical outcomes may improve VA service quality and facilitate safer, more effective, patient-centred care.

APA, Harvard, Vancouver, ISO, and other styles

Journal articles on the topic 'Centre variation'

Create a spot-on reference in APA, MLA, Chicago, Harvard, and other styles