Measuring the impact of menopausal symptoms on quality of life.

OBJECTIVE--To examine the impact of menopausal symptoms on the overall quality of life of women. DESIGN--Data collection with a questionnaire administered by an interviewer, incorporating two different quality of life measurement techniques (time trade off and rating scale). SETTING--Specialist menopause clinic and two general practices in Oxford. SUBJECTS--63 women aged 45-60 years recruited opportunistically during a clinic or appointment with a general practitioner; no exclusion criteria. RESULTS--Subjects gave very low quality of life ratings for health states with menopausal symptoms. The time trade off method of measuring preferences for these health states (on a scale from 0 to 1, where preference for full health is given as 1) yielded utility values of 0.64 for severe menopausal symptoms and 0.85 for mild symptoms. The rating scale measurement technique yielded even lower values: utilities of 0.30 and 0.65 were obtained for severe and mild symptoms respectively. Kappa scores indicated that the two methods produced results that were poorly related but not contradictory. Comparison of quality of life ratings before and after treatment with hormone replacement therapy showed significant improvements: with the rating scale measurement technique mean increases in utility values after the relief of severe and mild menopausal symptoms were 0.56 and 0.18 respectively. CONCLUSIONS--Quality of life may be severely compromised in women with menopausal symptoms, and perceived improvements in quality of life in users of hormone replacement therapy seem to be substantial. This emphasises the need to include quality of life measurements when assessing outcomes of hormone replacement therapy. Several limitations may exist with widely applied measurement techniques, calling for the development of appropriate and well validated instruments for measuring quality of life associated with reduced health states.     

Reliability of maternal-reports regarding the use of household pesticides: experience from a case-control study of childhood leukemia

Introduction: Self-reported household pesticide use has been associated with higher risk of childhood leukemia in a number of case–control studies. The aim of this study is to assess the reliability of self-reported household use of pesticides and potential differences in reliability by case–control status, and by socio-demographic characteristics. Methods: Analyses are based on a subset of the Northern California Childhood Leukemia Study population. Eligible households included those with children less than 8 years old who lived in the same residence since diagnosis (reference date for controls). The reliability was based on two repeated in-person interviews. Kappa, percent positive and negative agreements were used to assess reliability of responses to ever/never use of six pesticides categories. Results: Kappa statistics ranged from 0.31 to 0.61 (fair to substantial agreement), with 9 out of the 12 tests indicating moderate agreement. The percent positive agreement ranged from 46 to 80% and the percent negative agreement from 54 to 95%. Reliability for all pesticide types as assessed by the three reliability measures did not differ significantly for cases and controls as confirmed by bootstrap analysis. For most pesticide types, Kappa and percent positive agreement were higher for non-Hispanics than Hispanics and for households with higher income vs. lower income. Conclusions: Reproducibility of maternal-reported pesticide use was moderate to high and was similar among cases and controls suggesting that differential recall is not likely to be a major source of bias.     

Fine-Grained Semantic Categorization across the Abstract and Concrete Domains

A consolidated approach to the study of the mental representation of word meanings has consisted in contrasting different domains of knowledge, broadly reflecting the abstract-concrete dichotomy. More fine-grained semantic distinctions have emerged in neuropsychological and cognitive neuroscience work, reflecting semantic category specificity, but almost exclusively within the concrete domain. Theoretical advances, particularly within the area of embodied cognition, have more recently put forward the idea that distributed neural representations tied to the kinds of experience maintained with the concepts'' referents might distinguish conceptual meanings with a high degree of specificity, including those within the abstract domain. Here we report the results of two psycholinguistic rating studies incorporating such theoretical advances with two main objectives: first, to provide empirical evidence of fine-grained distinctions within both the abstract and the concrete semantic domains with respect to relevant psycholinguistic dimensions; second, to develop a carefully controlled linguistic stimulus set that may be used for auditory as well as visual neuroimaging studies focusing on the parametrization of the semantic space beyond the abstract-concrete dichotomy. Ninety-six participants rated a set of 210 sentences across pre-selected concrete (mouth, hand, or leg action-related) and abstract (mental state-, emotion-, mathematics-related) categories, with respect either to different semantic domain-related scales (rating study 1), or to concreteness, familiarity, and context availability (rating study 2). Inferential statistics and correspondence analyses highlighted distinguishing semantic and psycholinguistic traits for each of the pre-selected categories, indicating that a simple abstract-concrete dichotomy is not sufficient to account for the entire semantic variability within either domains.     

Asymptotic distributions of kappa statistics and their differences with many raters,many rating categories and two conditions

In clinical research and in more general classification problems, a frequent concern is the reliability of a rating system. In the absence of a gold standard, agreement may be considered as an indication of reliability. When dealing with categorical data, the well‐known kappa statistic is often used to measure agreement. The aim of this paper is to obtain a theoretical result about the asymptotic distribution of the kappa statistic with multiple items, multiple raters, multiple conditions, and multiple rating categories (more than two), based on recent work. The result settles a long lasting quest for the asymptotic variance of the kappa statistic in this situation and allows for the construction of asymptotic confidence intervals. A recent application to clinical endoscopy and to the diagnosis of inflammatory bowel diseases (IBDs) is shortly presented to complement the theoretical perspective.     

基于NDVI_Ts特征空间的中国土地覆盖分类研究

 归一化植被指数（NDVI）与地表温度（Ts）是描述地表覆盖特征的两个重要参数, 其构成的NDVI_Ts特征空间具有丰富的地学和生态学内涵。该文在NOAA/AVHRR连续时间序列数据反演Ts的基础上,通过主成分分析、非监督分类和基于DEM的分类后处理等方法,以Ts/NDVI为指标对中国土地覆盖进行分类。结果表明,Ts/NDVI对中国较大尺度上不同土地覆盖类型的差异具有较强的敏感性,其对中国土地覆盖分类结果的野外抽样检验精度比传统的单独利用NDVI时间序列进行非监督分类提高了3.3%,Kappa系数提高了0.020 2;在综合其它反映植被特征及其环境的指标（如气候、地形等）的基础上,利用Ts/NDVI将有可能较为准确 地提取中国植被或土地覆盖的信息,有利于对其进行分类和变化监测,具有深远的研究潜力 和应用价值。     

Modeling and measuring urban sustainability in multi-criteria based systems — A challenging issue

This paper addresses how urban sustainability is modeled and the ways criteria-based systems deal with its measurability for an effective and reliable assessment. Twelve sustainability models are reviewed and a subset is briefly presented. More importantly, this research work investigates five national rating systems of sustainable urban development compared with the newly developed CAMSUD system. The comparison focuses on the systems' structure, categorization, technical content and measurability. The main findings about the selected national rating systems thoroughly discussed in the paper are: (i) They all have a tree-like structure, (ii) their conceptualization and categorization follow three or four sustainability pillars models, sustainability topics or spatial scale; (iii) they use either planning-oriented or performance-oriented weighting approaches; (iv) the criteria are defined as sustainability goals, action measures or assignments to be fulfilled; (v) the sustainability items can hardly be juxtaposed since they are differently handled, (vi) overlapping criteria might occur, (vii) similar criteria can be categorized under different categories and this affects the emphasis put on these categories, (viii) all criteria are independently rated with no consideration of mutual interrelationships. In an attempt to solve some of these weaknesses, the newly developed CAMSUD system is introduced as alternative and relies on the following: (i) the system structure is considered as a network, (ii) the conceptualization and categorization is based on spatial scaling as well as on sustainability topics and pillars, (iii) many criteria are directly planning-relevant (23 of 40), (iv) the criteria are defined as sustainability goals rather than action measures and (v) the quantification of criteria is planned as to account for mutual interactions.     

Speed Constancy or Only Slowness: What Drives the Kappa Effect

In the Kappa effect, two visual stimuli are given, and their spatial distance affects their perceived temporal interval. The classical model assumes constant speed while a competing Bayesian model assumes a slow speed prior. The two models are based on different assumptions about the statistical structure of the environment. Here we introduce a new visual experiment to distinguish between these models. When fit to the data, both the two models replicated human response, but the slowness model makes better behavioral predictions than the speed constancy model, and the estimated constant speed is close to the absolute threshold of speed. Our findings suggest that the Kappa effect appears to be due to slow speeds, and also modulated by spatial variance.     

洞庭湖洲滩速生杨树林变化信息提取方法

洞庭湖是我国第二大淡水湖,其湿地资源具有重要的生态功能和经济价值。近20年来,洞庭湖洲滩速生杨树林发展迅速,其中西洞庭湖杨树林的扩张最为明显,极大改变了湖区湿地植被分布格局,隐含极大的生态风险。以Landsat ETM+和HJ-1A/1B CCD影像为数据源,提出了洞庭湖速生杨树林变化信息提取的两种方法,并对这两种方法进行了比较研究。一种是分类的方法,即采用面向对象分层信息提取的方法先提取出树林滩地信息,再将距离大堤一定范围内的树林滩地归为防护林,速生杨树林变化的面积即为两个时相提取结果的差值。另一种是变化检测的方法,它是基于像元进行变化检测,先确定出总的变化区域,再从中筛选速生杨树林的变化信息。结果表明:(1)两种提取方法都是可行的,不同方法提取的速生林变化信息存在一定差异,但空间分布大体一致;(2)基于分类的方法总体精度和Kappa系数均略高于基于变化检测的方法:其中基于分类的方法总体精度达84.00%,Kappa系数为0.67,基于变化检测的方法总体精度达83.00%,Kappa系数为0.65;(3)基于分类的方法图斑较大、图斑数较少,基于变化检测的方法图斑较小且较破碎、图斑数多;(4)基于分类的方法漏分较少、错分较多,基于变化检测的方法漏分较多、错分较少。为洞庭湖洲滩杨树林的动态监测提供了研究方法,也为杨树林扩张原因及其生态效应分析提供研究基础。     

Identification of differentially expressed gene categories in microarray studies using nonparametric multivariate analysis

MOTIVATION: The field of microarray data analysis is shifting emphasis from methods for identifying differentially expressed genes to methods for identifying differentially expressed gene categories. The latter approaches utilize a priori information about genes to group genes into categories and enhance the interpretation of experiments aimed at identifying expression differences across treatments. While almost all of the existing approaches for identifying differentially expressed gene categories are practically useful, they suffer from a variety of drawbacks. Perhaps most notably, many popular tools are based exclusively on gene-specific statistics that cannot detect many types of multivariate expression change. RESULTS: We have developed a nonparametric multivariate method for identifying gene categories whose multivariate expression distribution differs across two or more conditions. We illustrate our approach and compare its performance to several existing procedures via the analysis of a real data set and a unique data-based simulation study designed to capture the challenges and complexities of practical data analysis. We show that our method has good power for differentiating between differentially expressed and non-differentially expressed gene categories, and we utilize a resampling based strategy for controlling the false discovery rate when testing multiple categories. AVAILABILITY: R code (www.r-project.org) for implementing our approach is available from the first author by request.     

The relationship of life events and stress to neurosis in China: Comparison of 105 neurotic patients to 103 normal controls

Modified versions of Hohnes' Schedule of Recent Experience (SRE) and Social Readjustment Rating Scale (SRRS) are used to compare the stress rating of 43 life events of 105 neurotic patients to 103 normal controls and to compare the quantity of life event changes experienced by the two groups. Life events are divided into three categories on the basis of their frequency of occurrence and the intensity of stress they induce. Significantly higher stress ratings for the neurotic patients are found in 17 of 43 life event items studied. In the year prior to the onset of the neurotic illness, the patient group experienced more life event changes and had significantly higher levels of stress than the control group. The results are compared to Holmes' findings in Japan.     

THE POWER OF THE " A" -" NOT A" METHOD

The " A" - " Not A" method is a rating method with two categories. It is often treated as a discrimination method. Unlike forced choice procedures, the Thurstonian model for this method involves a choice criterion. In statistical tests, it is treated as a comparison of two proportions. In this paper, the power for hypothesis tests involving the monadic and replicated monadic " A" - " Not A" method is discussed. The power functions and the sample sizes needed for 80% power are given based on Thurstone's δ. Designs with equal and unequal allocations for A and A (Not A) samples are considered. The power of the method is also compared with that of four forced choice methods under the assumption that the perceptual variance is identical among methods. The comparison shows that, in general, the power for the five methods ranks from high to low: the 3-AFC, 2-AFC, " A" - " Not A", triangular and duo-trio. The comparison also shows that, based on the same number of panelists and/or the same sample size for the A and A⁻ samples for the methods, if the panelists are not too discrepant and the choice criterion in the " A" - " Not A" method is not too strict or too lax, the power of the " A" - " Not A" method is very close to that of the 2-AFC method.     

Schistosoma mansoni in a low-prevalence area in Brazil: the importance of additional methods for the diagnosis of hard-to-detect individual carriers by low-cost immunological assays

Schistosomiasis diagnosis is based on the detection of eggs in the faeces, which is laborious and lacks sensitivity, especially for patients with a low parasite burden. Immunological assays for specific antibody detection are available, but they usually demonstrate low sensitivity and/or specificity. In this study, two simple immunological assays were evaluated for the detection of soluble Schistosoma mansoni adult worm preparation (SWAP) and egg-specific IgGs. These studies have not yet been evaluated for patients with low parasite burdens. Residents of an endemic area in Brazil donated sera and faecal samples for our study. The patients were initially diagnosed by a rigorous Kato-Katz analysis of 18 thick smears from four different stool samples. The ELISA-SWAP was successful for human diagnosis with 90% sensitivity and specificity, confirming the Kato-Katz diagnosis with nearly perfect agreement, as seen by the Kappa index (0.85). Although the ELISA-soluble S. mansoni egg antigen was 85% sensitive, it exhibited low specificity (80%; Kappa index: 0.75) and was more susceptible to cross-reactivity. We believe that immunological assays should be used in conjunction with Kato-Katz analysis as a supplementary tool for the diagnosis of schistosomiasis for patients with low infection burdens, which are usually hard to detect.     

A Unified Approach to Multi‐item Reliability

Summary The reliability of multi‐item scales has received a lot of attention in the psychometric literature, where a myriad of measures like the Cronbach's α or the Spearman–Brown formula have been proposed. Most of these measures, however, are based on very restrictive models that apply only to unidimensional instruments. In this article, we introduce two measures to quantify the reliability of multi‐item scales based on a more general model. We show that they capture two different aspects of the reliability problem and satisfy a minimum set of intuitive properties. The relevance and complementary value of the measures is studied and earlier approaches are placed in a broader theoretical framework. Finally, we apply them to investigate the reliability of the Positive and Negative Syndrome Scale, a rating scale for the assessment of the severity of schizophrenia.     

Physicians in health care management: 2. Managing performance: who,what, how and when?

Physicians are becoming more involved in performance management as hospitals restructure to increase effectiveness. Although physicians are not hospital employees, they are subject to performance appraisals because the hospitals are accountable to patients and the community for the quality of hospital services. The performance of a health care professional may be appraised by the appropriate departmental manager, by other professionals in a team or program or by peers, based on prior agreement on expectations. Appraisal approaches vary. They include behavioural approaches such as rating scales, peer rating, ranking or nomination and outcome approaches such as management by objectives and goal setting. Professionals should give and receive timely feedback on a flexible schedule. Feedback can be provided one-on-one, by a group assessing quality of care or through an anonymous survey.     

A sequential test for assessing observed agreement between raters

Assessing the agreement between two or more raters is an important topic in medical practice. Existing techniques, which deal with categorical data, are based on contingency tables. This is often an obstacle in practice as we have to wait for a long time to collect the appropriate sample size of subjects to construct the contingency table. In this paper, we introduce a nonparametric sequential test for assessing agreement, which can be applied as data accrues, does not require a contingency table, facilitating a rapid assessment of the agreement. The proposed test is based on the cumulative sum of the number of disagreements between the two raters and a suitable statistic representing the waiting time until the cumulative sum exceeds a predefined threshold. We treat the cases of testing two raters' agreement with respect to one or more characteristics and using two or more classification categories, the case where the two raters extremely disagree, and finally the case of testing more than two raters' agreement. The numerical investigation shows that the proposed test has excellent performance. Compared to the existing methods, the proposed method appears to require significantly smaller sample size with equivalent power. Moreover, the proposed method is easily generalizable and brings the problem of assessing the agreement between two or more raters and one or more characteristics under a unified framework, thus providing an easy to use tool to medical practitioners.     

病虫发生程度预报质量评估方法

介绍了对病虫发生程度预报质量进行评估的统计检验方法———McNemar检验和Kappa检验,以及这2种检验方法的原理、假设检验和统计学意义。结合2个实例来说明2种统计检验方法在病虫发生程度预报质量评估中的应用,分析结果表明McNemar检验、Kappa检验能对病虫发生程度预测质量给出更加有效、准确的评估。     

Equipment management risk rating system based on engineering endpoints

The equipment management risk ratings system outlined here offers two significant departures from current practice: risk classifications are based on intrinsic device risks, and the risk rating system is based on engineering endpoints. Intrinsic device risks are categorized as physical, clinical and technical, and these flow from the incoming equipment assessment process. Engineering risk management is based on verification of engineering endpoints such as clinical measurements or energy delivery. This practice eliminates the ambiguity associated with ranking risk in terms of physiologic and higher-level outcome endpoints such as no significant hazards, low significance, injury, or mortality.     

Complete and Defective Bacteriophages of Classical Vibrio cholerae: Relationship to the Kappa Type Bacteriophage

The Classical Vibrio cholerae strain NIH 41 contains two temperate bacteriophages, designated VcA-1 and VcA-2, that are distinguished by immunity, plaque morphology, induction kinetics, and particle morphology. Both phage are serologically related to phage Kappa. However, only phage VcA-2 has the Kappa type host range and immunity. The induction kinetics and immunity patterns of Classical vibrios suggest that these strains may contain defective phage related to the phages isolated from NIH 41. Classical strain 569B releases phage-tail structures upon induction that are morphologically and serologically related to both phages VcA-1 and VcA-2. The possible reason for the defectiveness of these phages in 569B is discussed. It is concluded that complete or defective bacteriophages of the Kappa type morphology and serology are extremely prevalent in V. cholerae, regardless of biotype.     

Gaining confidence in biological interpretation of the microarray data: the functional consistence of the significant GO categories

MOTIVATION: In microarray studies, numerous tools are available for functional enrichment analysis based on GO categories. Most of these tools, due to their requirement of a prior threshold for designating genes as differentially expressed genes (DEGs), are categorized as threshold-dependent methods that often suffer from a major criticism on their changing results with different thresholds. RESULTS: In the present article, by considering the inherent correlation structure of the GO categories, a continuous measure based on semantic similarity of GO categories is proposed to investigate the functional consistence (or stability) of threshold-dependent methods. The results from several datasets show when simply counting overlapping categories between two groups, the significant category groups selected under different DEG thresholds are seemingly very different. However, based on the semantic similarity measure proposed in this article, the results are rather functionally consistent for a wide range of DEG thresholds. Moreover, we find that the functional consistence of gene lists ranked by SAM metric behaves relatively robust against changing DEG thresholds. AVAILABILITY: Source code in R is available on request from the authors.