The Egyptian Cardiothoracic Surgeon (ECTS - E-Journal)
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Bayesian Inference for Joint Modelling of Longitudinal Continuous, Binary and Ordinal Events
No full textIn medical studies, repeated measurements of continuous, binary and ordinal outcomes are routinely collected from the same patient. Instead of modeling each outcome separately, in this study we propose to jointly model the trivariate longitudinal responses, so as to take account of the inherent association between the different outcomes and thus improve statistical inferences. This work is motivated by a large cohort study in the North West of England, involving trivariate responses from each patient: Body Mass Index, Depression (Yes/No) ascertained with cut-off score not less than 8 at the Hospital Anxiety and Depression Scale, and Pain Interference generated from the Medical Outcomes Study 36-item short-form health survey with values returned on an ordinal scale 1-5. There are some well-established methods for combined continuous and binary, or even continuous and ordinal responses, but little work was done on the joint analysis of continuous, binary, and ordinal responses. We propose conditional joint random-effects models which take into account the inherent association between the continuous, binary and ordinal outcomes. Bayesian analysis methods are used to make statistical inferences. Simulation studies show that, by jointly modeling the trivariate outcomes, standard deviations of the estimates of parameters in the models are smaller and much more stable, leading to more efficient parameter estimates and reliable statistical inferences. In the real data analysis, the proposed joint analysis yields a much smaller DIC value than the separate analysis, and shows other good statistical properties too
Clinical scenario-based assessments to measure reasoning in complex cases:are we fully realising their potential in speciality training?
No full textPlanning the management of complex cases requires years of structured training, with experienced gained both by attending joint/multidisciplinary clinics and through managing patients needing interdisciplinary care. Together, these reinforce basic skills and develop high-order thinking. It is crucial, however, that the development of these advanced planning skills can be measured, so as to assess the progress of trainees and the effectiveness of training programmes. Here, the validity, reliability and consistency of a clinical, hypodontia case-based structured assessment tool of clinical reasoning and higher-order thinking is tested
Negotiating secularity: Indira Gandhi, Anandamayi Ma and the Eliya Rajah of Travancore
No full textTensions between views of India as a secular state and India as Hindu are aggravated by the association of politics with the secular public and religion with the private personal. Studies of modern gurus, even where they challenge this divide, tend to reduce the personal to the political or vice versa, thus perpetuating it further. By tracing the connections between a Prime Minister, a modern ‘godwoman’ and the head of an erstwhile Princely State, I establish how they may respectively be associated with discourses of secularity, spirituality and servanthood. However, I argue that these all converge ultimately upon a discourse of service, whether to guru, deity, kingdom or nation. This suggests a model of service as an alternative basis for analysing the ways in which secularity is negotiated in modern India
Narrative abilities in early successive bilingual Slovak–English children: A cross-language comparison
No full textThis study investigates macrostructure skill transfer in successive bilingual children speaking Slovak and English, a new language combination for narrative research. We examined whether narrative performance reflected language dominance and assessed relationships between nonword repetition (NWR) and narrative skills within and across languages. Forty typically developing Slovak–English bilingual children (mean age = 5 years, 10 months) were evaluated for microstructure and macrostructure performance in both languages through story telling and retelling tasks. In addition, NWR was assessed in Slovak, the children's first language (L1). Macrostructure scores were higher in their L1 than in their second language (L2), but comprehension did not differ across languages. L1 NWR was significantly related to L1 microstructure scores, but not to L1/L2 macrostructure or L2 microstructure. Implications for assessing bilingual children's language are discussed
Longitudinal mode magnetostrictive patch transducer array employing a multi-splitting meander coil for pipe inspection
No full textReply to comment by Marques et al. on "The insular shelves of the Faial-Pico Ridge (Azores archipelago): A morphological record of its evolution"
No full textCool white dwarf companions to four millisecond pulsars
No full textWe report on photometric and spectroscopic observations of white dwarf companions to four binary radio millisecond pulsars, leading to the discovery of companions to PSRs J0614-3329, J1231-1411 and J2017+0603. We place limits on the brightness of the companion to PSR J0613-0200. Optical spectroscopy of the companion to PSR J0614-3329 identifies it as a DA-type white dwarf with a temperature of Teff = 6460 ± 80 K, a surface gravity log g = 7.0 ± 0.2 cgs and a mass of MWD = 0.24 ± 0.04 M⊙. We find that the distance to PSR J0614-3329 is smaller than previously estimated, removing the need for the pulsar to have an unrealistically high γ-ray efficiency. Comparing the photometry with predictions from white dwarf cooling models allows us to estimate temperatures and cooling ages of the companions to PSRs J0613-0200, J1231-1411 and J2017+0603. We find that the white dwarfs in these systems are cool Teff <4000 K and old ≳ 5 Gyr. Thin hydrogen envelopes are required for these white dwarfs to cool to the observed temperatures, and we suggest that besides hydrogen shell flashes, irradiation driven mass loss by the pulsar may have been important