Rational and design of an individual participant data meta-analysis of spinal manipulative therapy for chronic low back pain-a protocol

Background Chronic low back pain (LBP) is the leading cause of pain and disability, resulting in a major socioeconomic impact. The Cochrane Review which examined the effect of spinal manipulative therapy (SMT) for chronic LBP concluded that SMT is moderately effective, but was based on conventional meta-analysis of aggregate data. The use of individual participant data (IPD) from trials allows for a more precise estimate of the treatment effect and has the potential to identify moderators and/or mediators. The aim is (1) to assess the overall treatment effect of SMT for primary and secondary outcomes in adults with chronic LBP, (2) to determine possible moderation of baseline characteristics on treatment effect, (3) to identify characteristics of intervention (e.g., manipulation/mobilization) that influence the treatment effect, and (4) to identify mediators of treatment effects. Methods All trials included in the Cochrane Review on SMT for chronic LBP will be included which were published after the year 2000, and the search will be updated. No restrictions will be placed on the type of comparison or size of the study. Primary outcomes are pain intensity and physical functioning. A dataset will be compiled consisting of individual trials and variables included according to a predefined coding scheme. Variables to be included are descriptive of characteristics of the study, treatment, comparison, participant characteristics, and outcomes at all follow-up periods. A one-stage approach with a mixed model technique based on the intention-to-treat principle will be used for the analysis. Subsequent analyses will focus on treatment effect moderators and mediators. Discussion We will analyze IPD for LBP trials in which SMT is one of the interventions. IPD meta-analysis has been shown to be more reliable and valid than aggregate data meta-analysis, although this difference might also be attributed to the number of studies that can be used or the amount of data that can be utilized. Therefore, this project may identify important gaps in our knowledge with respect to prognostic factors of treatment effects

Amtliches Mitteilungsblatt der BTU Cottbus–Senftenberg, 2017,23 (26.09.2017)

Neufassung der fachspezifischen Prüfungs- und Studienordnung für den Bachelor-Studiengang Kultur und Technik vom 22. September 201

Measurement of K^0_e3 form factors

The semileptonic decay of the neutral K meson, KL -> pi e nu (Ke3), was used to study the strangeness-changing weak interaction of hadrons. A sample of 5.6 million reconstructed events recorded by the NA48 experiment was used to measure the Dalitz plot density. Admitting all possible Lorentz-covariant couplings, the form factors for vector (f_+(q^2)), scalar (f_S) and tensor (f_T) interactions were measured. The linear slope of the vector form factor lambda_+ = 0.0284+-0.0007+-0.0013 and values for the ratios |f_S/f_+(0)| = 0.015^{+0.007}_{-0.010}+-0.012 and |f_T/f_+(0)| = 0.05^{+0.03}_{-0.04}+-0.03 were obtained. The values for f_S and f_T are consistent with zero. Assuming only Vector-Axial vector couplings, lambda_+ = 0.0288+-0.0004+-0.0011 and a good fit consistent with pure V-A couplings were obtained. Alternatively, a fit to a dipole form factor yields a pole mass of M = 859+-18 MeV, consistent with the K^*(892) mass.Comment: 16 pages, 7 figures. submitted to Phys. Lett.

Using verbal autopsy to measure causes of death: the comparative performance of existing methods

Background: Monitoring progress with disease and injury reduction in many populations will require widespread use of verbal autopsy (VA). Multiple methods have been developed for assigning cause of death from a VA but their application is restricted by uncertainty about their reliability. Methods: We investigated the validity of five automated VA methods for assigning cause of death: InterVA-4, Random Forest (RF), Simplified Symptom Pattern (SSP), Tariff method (Tariff), and King-Lu (KL), in addition to physician review of VA forms (PCVA), based on 12,535 cases from diverse populations for which the true cause of death had been reliably established. For adults, children, neonates and stillbirths, performance was assessed separately for individuals using sensitivity, specificity, Kappa, and chance-corrected concordance (CCC) and for populations using cause specific mortality fraction (CSMF) accuracy, with and without additional diagnostic information from prior contact with health services. A total of 500 train-test splits were used to ensure that results are robust to variation in the underlying cause of death distribution. Results: Three automated diagnostic methods, Tariff, SSP, and RF, but not InterVA-4, performed better than physician review in all age groups, study sites, and for the majority of causes of death studied. For adults, CSMF accuracy ranged from 0.764 to 0.770, compared with 0.680 for PCVA and 0.625 for InterVA; CCC varied from 49.2% to 54.1%, compared with 42.2% for PCVA, and 23.8% for InterVA. For children, CSMF accuracy was 0.783 for Tariff, 0.678 for PCVA, and 0.520 for InterVA; CCC was 52.5% for Tariff, 44.5% for PCVA, and 30.3% for InterVA. For neonates, CSMF accuracy was 0.817 for Tariff, 0.719 for PCVA, and 0.629 for InterVA; CCC varied from 47.3% to 50.3% for the three automated methods, 29.3% for PCVA, and 19.4% for InterVA. The method with the highest sensitivity for a specific cause varied by cause. Conclusions: Physician review of verbal autopsy questionnaires is less accurate than automated methods in determining both individual and population causes of death. Overall, Tariff performs as well or better than other methods and should be widely applied in routine mortality surveillance systems with poor cause of death certification practices. © 2014 Murray et al.; licensee BioMed Central Ltd

The backward-bending commute times of married women with household responsibility

The purpose of this paper is to examine theoretically and empirically whether the commute times of married women follow a backward-bending pattern with respect to wage rates. The existing literature has shown that married women tend to choose short commutes because of their relatively low wages combined with comparatively heavy household responsibilities. However, a workleisure model, which includes the simultaneous decision wives take regarding commute times and wage rates, suggests that married women employed in highly paid positions also undertake short commutes, while married women with wage rates in the middle range choose long commutes. These results suggest that the commute times of married women display a backward-bending pattern. Applying an instrumental variable strategy that accounts for the endogeneity of wage rates, the empirical results for employed married women in Japan appear to support this nding. Moreover, one of our results suggests that highly paid married women can still secure greater leisure time with short commutes, despite retaining a heavy load of domestic responsibilities.Working Paper, No.234, 2008.9.1版http://hdl.handle.net/10110/254

Synthetic Testing of Load Current Interruption in Medium Voltage Load Break Switches

To conduct the mainly active load current test duty according to IEC 62271-103, a directly powered test circuit and therefore a medium voltage connection or a power generator is needed. A newly developed synthetic test circuit allows to replicate the current as well as the full transient recovery voltage (TRV) and the power frequent recovery voltage (RV) of the direct test circuit up to its crest value. It is dimensioned for voltage classes up to 52 kV and can be adapted to test currents between 630 A and 1250 A. The test circuit allows a detailed investigation of load break switches without costly high power sources and loads. Many parameters, like current and voltage steepness at current zero, as well as different parameters defining the TRV steepness can be varied individually

Incidence of Secondary Hemophagocytic Lymphohistiocytosis in Critically-Ill COVID-19 Patients.

Objective Coronavirus disease 2019 (COVID-19) is associated with diffuse lung injury that can progress to acute respiratory distress syndrome, multisystem-organ failure, and death. The inflammatory storm seen in many COVID-19 patients closely resembles secondary hemophagocytic lymphohistiocytosis (sHLH) which has been described in other virus-associated severe sepsis. We sought to describe the incidence of sHLH in COVID-19 infected patients. Design In this retrospective study, we reviewed the records of critically ill COVID-19 positive patients to determine the incidence of sHLH. An H-score for sHLH diagnosis was determined for each study participant, with a score greater than 169 points needed for diagnosis. Setting A quaternary referral center in suburban Pennsylvania, USA. Patients All study participants had a positive COVID-19 test, and were deemed critically ill defined as receiving invasive mechanical ventilation and/or who expired. Measurements and Main Results Of the 246 records identified, 242 records met inclusion criteria and were reviewed. Eighty five patients were excluded from analysis due to missing H-score data parameters. Overall, 32 of 157 (20.38%, 95% CI:14.38-27.54%) patients met diagnostic criteria for sHLH. The average age was 69.42 years (standard deviation (SD) 14.81). Patients diagnosed with sHLH were more likely to be younger (61.09 years vs 69.38 years

Direct search for light gluinos

We present the results for a direct search for light gluinos through the appearance of $\eta\rightarrow 3\pi^{0}$ with high transverse momentum in the vacuum tank of the NA48 experiment at CERN. We find one event within a lifetime range of $10^{-9}-10^{-3}$s and another one between $10^{-10}-10^{-9}$s. Both events are consistent with the expected background from neutrons in the beam, produced by 450 GeV protons impinging on the Be targets, which interact with the residual air in the tank. From these data we give limits on the production of the hypothetical $g\widetilde{g}$ bound state, the $R^0$ hadron, and its $R^0\rightarrow\eta\widetilde{\gamma}$ decay in the $R^0$ mass range between 1 and 5~GeV

Trastuzumab Associated With Recurrent Severe Thrombocytopenia and Successful Use of Pertuzumab Monotherapy.

Trastuzumab is a mainstay chemotherapeutic agent used in the treatment of human epidermal growth factor receptor 2 (HER2)/neu-positive breast cancer that, though generally well-tolerated, is classically associated with side effects like cardiotoxicity. Cytopenias can be seen but are generally secondary to other chemotherapeutic agents used in conjunction with trastuzumab. Herein, we present a case of recurrent severe thrombocytopenia following trastuzumab use that resolved following discontinuation. Our patient then finished a year of maintenance therapy with pertuzumab alone and is still in remission four years later. This is the eleventh report of this severe adverse effect described in the literature. This report contributes to the body of work describing this severe side effect by illustrating a clear temporal relationship between trastuzumab and severe thrombocytopenia, while also providing an alternate treatment option with chemotherapy and pertuzumab monotherapy. Given that pertuzumab is typically only used in addition to trastuzumab, evidence of its successful independent use is of clinical value to patients who may not be able to tolerate trastuzumab

Religious diversity and social cohesion in German classrooms. A micro-macro study based on empirical simulations

The micro-macro transition is a core problem of sociological theory building. Micro-intentions and micro-behavior do not straightforwardly translate into corresponding phenomena on the macro level, due to potentially existing rival mechanisms and the dynamics and complexity of social interactions. This chapter proposes an integrated statistical approach to studying the micro-macro transition by combining a random coefficient multilevel approach with the Stochastic Actor-Oriented Model. This is elaborated for the substantively interesting and topical question whether the growing ethnic and religious diversity in our societies, along with the well-known tendency for homophily, necessarily lead to a decline in social cohesion. The German part of the CILS4EU data is used to tackle this empirically. We investigate how religious homophily plays out differently depending on the context defined by the composition of the classroom, and explore the potential of simulation methods to explain this macro-level phenomenon from micro-level network dynamics. The empirical puzzle as stated is answered by a model representing homophily in a straightforward way, taking account of the variability between classrooms and the uncertainty about the parameter values; but a closer analysis reveals a further puzzle, which we leave for future research.</p