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Find video protocols related to scientific articles indexed in Pubmed.
A New Population-based Reference for Gestational Age-specific Size-at-birth of Singapore Infants.
Ann. Acad. Med. Singap.
PUBLISHED: 10-25-2014
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There is currently a lack of representative data for local gestational age-specific size-at- birth percentile charts. Existing charts also suffer from limitations relating to the measurement of gestational age (GA) and an outdated population. We aim to construct reference values and charts for size-at-birth from 35 to 41 weeks, based on the healthy local population.
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Quality of life domains important and relevant to family caregivers of advanced cancer patients in an Asian population: a qualitative study.
Qual Life Res
PUBLISHED: 10-17-2014
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This study aims to identify domains of quality of life (QoL) that are culturally relevant to Chinese caregivers of advanced cancer patients in Singapore and to evaluate content adequacy of currently available instruments for use in the target population.
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Lipid-based nutrient supplements do not affect the risk of malaria or respiratory morbidity in 6- to 18-month-old malawian children in a randomized controlled trial.
J. Nutr.
PUBLISHED: 09-17-2014
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There is evidence to support the use of lipid-based nutrient supplements (LNSs) to promote child growth and development in low-income countries, but there is also a concern regarding the safety of using iron-fortified products in malaria-endemic areas.
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Anti-caries effect of CPP-ACP in irradiated nasopharyngeal carcinoma patients.
Clin Oral Investig
PUBLISHED: 09-09-2014
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The aim of this study was to determine the effect of casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) on caries progression in irradiated nasopharyngeal carcinoma (NPC) patients.
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Patient-reported outcomes are associated with patient-oncologist agreement of performance status in a multi-ethnic Asian population.
Support Care Cancer
PUBLISHED: 06-23-2014
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This study aims to compare the performance status assessed by breast cancer patients and their oncologist and investigate the factors associated with the patient-oncologist disagreement in a multi-ethnic Asian population.
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Estimation of intervention effect using paired interval-censored data with clumping below lower detection limit.
Stat Med
PUBLISHED: 05-28-2014
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Outcome variables that are semicontinuous with clumping at zero are commonly seen in biomedical research. In addition, the outcome measurement is sometimes subject to interval censoring and a lower detection limit (LDL). This gives rise to interval-censored observations with clumping below the LDL. Level of antibody against influenza virus measured by the hemagglutination inhibition assay is an example. The interval censoring is due to the assay's technical procedure. The clumping below LDL is likely a result of the lack of prior exposure in some individuals such that they either have zero level of antibodies or do not have detectable level of antibodies. Given a pair of such measurements from the same subject at two time points, a binary 'fold-increase' endpoint can be defined according to the ratio of these two measurements, as it often is in vaccine clinical trials. The intervention effect or vaccine immunogenicity can be assessed by comparing the binary endpoint between groups of subjects given different vaccines or placebos. We introduce a two-part random effects model for modeling the paired interval-censored data with clumping below the LDL. Based on the estimated model parameters, we propose to use Monte Carlo approximation for estimation of the 'fold-increase' endpoint and the intervention effect. Bootstrapping is used for variance estimation. The performance of the proposed method is demonstrated by simulation. We analyze antibody data from an influenza vaccine trial for illustration. Copyright © 2014 John Wiley & Sons, Ltd.
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A Simple and Powerful Method for the Estimation of Intervention Effects on Serological Endpoints Using Paired Interval-Censored Data.
J Biopharm Stat
PUBLISHED: 05-20-2014
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Clinical trials often use a binary "fold increase" endpoint defined according to the ratio of interval-censored measurement at end-of-study to that at baseline. We propose a simple yet principled analytic approach based on the linear mixed effects model for interval-censored data for the analysis of such paired measurements. Having estimated the model parameters, the risk ratio can be estimated by explicit composite estimand and the variance is estimated using the delta method. The estimation can be implemented using existing procedures in popular statistical software. We use antibody data from the Chloroquine for Influenza Prevention Trial for illustration.
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Unconditional and Conditional Standards Using Cognitive Function Curves for the Modified Mini-Mental State Exam: Cross-Sectional and Longitudinal Analyses in Older Chinese Adults in Singapore.
Am J Geriatr Psychiatry
PUBLISHED: 05-01-2014
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The conventional practice of assessing cognitive status and monitoring change over time in older adults using normative values of the Mini-Mental State Exam (MMSE) based on age bands is imprecise. Moreover, population-based normative data on changes in MMSE score over time are scarce and crude because they do not include age- and education-specific norms. This study aims to develop unconditional standards for assessing current cognitive status and conditional standards that take prior MMSE score into account for assessing longitudinal change, with percentile curves as smooth functions of age.
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Body shape indices and cardiometabolic risk in adolescents.
Ann. Hum. Biol.
PUBLISHED: 04-17-2014
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Abstract Background: "A Body Shape Index" (ABSI) is a recently proposed index that standardizes waist circumference for body mass index (BMI) and height using the scaling exponents 2/3 and 1/2, respectively, estimated from adults. Incidentally, waist-to-height ratio has been suggested as an indicator of cardiometabolic risk in adolescents. Aims: This study aims to estimate the scaling exponents for standardizing waist circumference for BMI and height in Chinese adolescents and to estimate and compare the ability of various body shape indices in predicting cardiometabolic risk in adolescents. Subjects and methods: Participants aged 10-17 years in the 2009 China Health and Nutrition Survey were analysed. Results: The appropriate scaling exponents for standardizing waist circumference for BMI and height in this adolescent sample were 0.45 and 0.55, respectively. A new ABSI-adolescents was defined accordingly. Ignoring the age dependence in the scaling exponents would lead to confounded associations. The ABSI-adolescents and the waist-to-height ratio were more associated with glycated haemoglobin and pre-diabetes, but not blood pressure, than the BMI was. Conclusion: The scaling exponent for standardizing waist circumference for BMI is age-dependent. Indices based on waist circumference adjusted for BMI are more associated with glycated haemoglobin than BMI in adolescents.
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Impact of lipid-based nutrient supplements and corn-soy blend on energy and nutrient intake among moderately underweight 8-18-month-old children participating in a clinical trial.
Matern Child Nutr
PUBLISHED: 02-18-2014
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Nutrition interventions have an effect on growth, energy and nutrient intake, and development, but there are mixed reports on the effect of supplementation of energy-dense foods on dietary intake. This substudy aimed at assessing the effect of supplementation with corn-soy blend (CSB) or lipid-based nutrient supplement (LNS) on energy and nutrient intake in moderately underweight children participating in a clinical trial. A total of 188 children aged 8-18 months participated and received daily either 284?kcal from CSB or 220?kcal from LNS and no supplements (control). An interactive 24-h recall method was used to estimate energy and nutrient intakes in the groups. Total mean energy intake was 548?kcal, 551?kcal and 692?kcal in the control, CSB and LNS groups, respectively (P?=?0.011). The mean (95% confidence interval) intake of energy and protein were 144 (37-250; P?
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How is the most severe health state being valued by the general population?
Health Qual Life Outcomes
PUBLISHED: 02-06-2014
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BackgroundIt has been reported that valuation of health states that are close to death, such as the most severe health state, can be affected by health state valuation procedure, and their utility values are difficult to predict. We examined how the most severe health states of Short Form-6 dimension (SF-6D) and EuroQoL-5 dimension-3 level (EQ-5D-3L) were valued by the Singapore general population.MethodsOverall, 249 SF-6D and 42 EQ-5D-3L states were valued by two separate samples from the Singapore general population using the visual analogue scale (VAS) method. Ordinary least-square regression model was employed to explain deficit in the valuation of the most severe state using the health state descriptors.ResultsA total of 1021 participants from the SF-6D sample and 1015 participants from the EQ-5D-3L sample were included in the analysis. We observed that 67% of the SF-6D participants and 74% of the EQ-5D-3L participants considered the most severe state worse than dead. The most severe state had mean VAS valuation scores more than 20¿25 points lower than the adjacent states that are better by only one level in only one dimension. SF-6D VAS valuation score for the most severe state was 27 points and 12 points lower than expected according to the health state descriptors among the participants who considered the most severe state worse than dead and better than dead, respectively. Similar results were found for the EQ-5D-3L valuation.ConclusionsThe most severe health state was valued lower than expected according to its descriptors.
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Estimation of intervention effects using recurrent event time data in the presence of event dependence and a cured fraction.
Stat Med
PUBLISHED: 01-22-2014
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Recurrent event data with a fraction of subjects having zero event are often seen in randomized clinical trials. Those with zero event may belong to a cured (or non-susceptible) fraction. Event dependence refers to the situation that a person's past event history affects his future event occurrences. In the presence of event dependence, an intervention may have an impact on the event rate in the non-cured through two pathways-a primary effect directly on the outcome event and a secondary effect mediated through event dependence. The primary effect combined with the secondary effect is the total effect. We propose a frailty mixture model and a two-step estimation procedure for the estimation of the effect of an intervention on the probability of cure and the total effect on event rate in the non-cured. A summary measure of intervention effects is derived. The performance of the proposed model is evaluated by simulation. Data on respiratory exacerbations from a randomized, placebo-controlled trial are re-analyzed for illustration.
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"A Body Shape Index" in middle-age and older Indonesian population: scaling exponents and association with incident hypertension.
PLoS ONE
PUBLISHED: 01-01-2014
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"A Body Shape Index" (ABSI) is a recently proposed index that standardizes waist circumference for body mass index (BMI) and height. This study aims to: (a) examine if the ABSI scaling exponents for standardizing waist circumference for BMI and height are valid in middle-aged and older Indonesian population, and (b) compare the association between incident hypertension and ABSI and other anthropometric measures.
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A longitudinal study of weight gain in pregnancy in Malawi: unconditional and conditional standards.
Am. J. Clin. Nutr.
PUBLISHED: 11-13-2013
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To monitor weight gain during pregnancy and assess its relation with perinatal health outcomes, both unconditional (cross-sectional) and conditional (longitudinal) standards of maternal weight are needed.
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Association of carbamazepine-induced severe cutaneous drug reactions and HLA-B*1502 allele status, and dose and treatment duration in paediatric neurology patients in Singapore.
Arch. Dis. Child.
PUBLISHED: 11-13-2013
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To determine the association between severe cutaneous drug reactions (SCDR), HLA-B*1502 allelism, carbamazepine dose and treatment duration in a Singapore paediatric population.
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Adoptive T-cell Transfer and Chemotherapy in the First-line Treatment of Metastatic and/or Locally Recurrent Nasopharyngeal Carcinoma.
Mol. Ther.
PUBLISHED: 07-29-2013
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The outcomes for patients with metastatic or locally recurrent Epstein-Barr virus (EBV)-positive nasopharyngeal carcinoma (NPC) remain poor. Adoptive immunotherapy with EBV-specific cytotoxic T lymphocytes (EBV-CTLs) has proven clinical efficacy, but it has never been evaluated in the first-line treatment setting in combination with chemotherapy. To evaluate the safety and efficacy of a chemotherapy in combination with adoptive EBV-CTL transfer, we conducted a phase 2 clinical trial consisting of four cycles of gemcitabine and carboplatin (GC) followed by up to six doses of EBV-CTL. Thirty-eight patients were enrolled, and 35 received GC and EBV-CTL. GC-CTL therapy resulted in a response rate of 71.4% with 3 complete responses and 22 partial responses. With a median follow up of 29.9 months, the 2-year and 3-year overall survival (OS) rate was 62.9 and 37.1%, respectively. Five patients did not require further chemotherapy for more than 34 months since initiation of CTL. Infusion of CTL products containing T cells specific for LMP2 positively correlated with OS (hazard ratio: 0.35; 95% confidence interval: 0.14-0.84; P = 0.014). Our study achieved one of the best survival outcomes in patients with advanced NPC, setting the stage for a future randomized study of chemotherapy with and without EBV-CTL.
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Effect of complementary feeding with lipid-based nutrient supplements and corn-soy blend on the incidence of stunting and linear growth among 6- to 18-month-old infants and children in rural Malawi.
Matern Child Nutr
PUBLISHED: 06-26-2013
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Low nutritional value of complementary foods is associated with high incidence of childhood growth stunting in low-income countries. This study was done to test a hypothesis that dietary complementation with lipid-based nutrient supplements (LNS) promotes linear growth and reduces the incidence of severe stunting among at-risk infants. A total of 840 6-month-old healthy infants in rural Malawi were enrolled to a randomised assessor-blinded trial. The participants received 12-month supplementation with nothing, milk-LNS, soy-LNS, or corn-soy blend (CSB). Supplements provided micronutrients and approximately 280?kcal energy per day. Outcomes were incidence of severe and very severe stunting [length-for-age z-score, (LAZ)?
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Providing lipid-based nutrient supplements does not affect developmental milestones among Malawian children.
Acta Paediatr.
PUBLISHED: 06-13-2013
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To assess whether using lipid-based nutrient supplements (LNS) to complement the diets of infants and young children affected when they achieved selected developmental milestones.
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Height and mental health and health utility among ethnic Chinese in a polyclinic sample in Singapore.
Ann. Acad. Med. Singap.
PUBLISHED: 03-22-2013
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Whether fi nal height is associated with quality of life and mental health is a matter of epidemiological and medical concern. Both social and biological explanations have been previously proposed. This study aims to assess the associations in ethnic Chinese in Singapore.
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The effect of antenatal monthly sulphadoxine-pyrimethamine, alone or with azithromycin, on foetal and neonatal growth faltering in Malawi: a randomised controlled trial.
Trop. Med. Int. Health
PUBLISHED: 02-22-2013
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To examine the potential to reduce foetal and neonatal growth faltering through intermittent preventive treatment in pregnancy (IPTp) of malaria and reproductive tract infections with monthly sulphadoxine-pyrimethamine (SP), alone or with two doses of azithromycin.
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Trajectory of quality of life for poor prognosis stage 5D chronic kidney disease with and without dialysis.
Am. J. Nephrol.
PUBLISHED: 01-20-2013
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Renal replacement therapy (RRT) has not always been shown to benefit end-stage renal failure patients who are elderly or have multiple comorbidities in terms of survival or symptom control. Conservative management may be a viable alternative offering comparable health-related quality of life.
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A brain-computer interface based cognitive training system for healthy elderly: a randomized control pilot study for usability and preliminary efficacy.
PLoS ONE
PUBLISHED: 01-01-2013
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Cognitive decline in aging is a pressing issue associated with significant healthcare costs and deterioration in quality of life. Previously, we reported the successful use of a novel brain-computer interface (BCI) training system in improving symptoms of attention deficit hyperactivity disorder. Here, we examine the feasibility of the BCI system with a new game that incorporates memory training in improving memory and attention in a pilot sample of healthy elderly. This study investigates the safety, usability and acceptability of our BCI system to elderly, and obtains an efficacy estimate to warrant a phase III trial. Thirty-one healthy elderly were randomized into intervention (n?=?15) and waitlist control arms (n?=?16). Intervention consisted of an 8-week training comprising 24 half-hour sessions. A usability and acceptability questionnaire was administered at the end of training. Safety was investigated by querying users about adverse events after every session. Efficacy of the system was measured by the change of total score from the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS) before and after training. Feedback on the usability and acceptability questionnaire was positive. No adverse events were reported for all participants across all sessions. Though the median difference in the RBANS change scores between arms was not statistically significant, an effect size of 0.6SD was obtained, which reflects potential clinical utility according to Simons randomized phase II trial design. Pooled data from both arms also showed that the median change in total scores pre and post-training was statistically significant (Mdn?=?4.0; p<0.001). Specifically, there were significant improvements in immediate memory (p?=?0.038), visuospatial/constructional (p?=?0.014), attention (p?=?0.039), and delayed memory (p<0.001) scores. Our BCI-based system shows promise in improving memory and attention in healthy elderly, and appears to be safe, user-friendly and acceptable to senior users. Given the efficacy signal, a phase III trial is warranted.
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Responsive feeding and child interest in food vary when rural Malawian children are fed lipid-based nutrient supplements or local complementary food.
Matern Child Nutr
PUBLISHED: 11-24-2011
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Caregiver and child behaviours during feeding have been used to measure responsiveness, which has been recognised as important for child growth and development. The aims of this study were to understand how caregiver and child behaviours differ when feeding lipid-based nutrient supplements (LNS) vs. local complementary food and to detect associations between behaviours and child interest in food. Sixteen moderately underweight 6-17-month-old Malawian children receiving 50 g/day of supplementary LNS for 12 weeks were videotaped during LNS (n = 32) and local complementary feeding (n = 28) episodes. Behaviours were coded at the level of the intended bite (1674 total bites). The analysis used regression models adjusted for within-subject correlation. Caregivers were less likely to allow children to self-feed and more likely to use physical pressure during LNS vs. complementary food bites. Positive caregiver verbalization was infrequent and did not differ by type of food. Higher odds of accepting a bite were associated with the bite containing LNS, odds ratio (OR) 3.05; 90% confidence interval (CI) (1.98, 4.71), the child self-feeding, OR 5.70; 90% CI (2.77, 11.69), and positive caregiver verbalization, OR 2.46; 90% CI (1.26, 4.80), while lower odds of acceptance were associated with negative child verbalization during feeding, OR 0.27; 90% CI (0.17, 0.42). In this sample, caregivers used more responsive feeding practices during bites of local complementary food and were more controlling when feeding LNS. Responsive caregiver behaviours predicted child acceptance of food. These results could be used to design interventions in Malawi to improve responsive feeding practices in general and during LNS use.
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Measurement properties of the English and Chinese versions of the Functional Assessment of Cancer Therapy-Breast (FACT-B) in Asian breast cancer patients.
Breast Cancer Res. Treat.
PUBLISHED: 06-22-2011
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The objective of the study was to examine the measurement properties of and comparability between the English and Chinese versions of the Functional Assessment of Cancer Therapy-Breast (FACT-B) in breast cancer patients in Singapore. This is an observational study of 271 Singaporean breast cancer patients. The known-group validity of FACT-B total score and Trial Outcome Index (TOI) were assessed in relation to performance status, evidence of disease, and treatment status cross-sectionally; responsiveness to change was assessed in relation to change in performance status longitudinally. Internal consistency and test-retest reliability were evaluated by the Cronbachs alpha and intraclass correlation coefficient (ICC), respectively. Multiple regression analyses were performed to compare the scores on the two language versions, adjusting for covariates. The FACT-B total score and TOI demonstrated known-group validity in differentiating patients with different clinical status. They showed high internal consistency and test-retest reliability, with Cronbachs alpha ranging from 0.87 to 0.91 and ICC ranging from 0.82 to 0.89. The English version was responsive to the change in performance status. The Chinese version was shown to be responsive to decline in performance status but the sample size of Chinese-speaking patients who improved in performance status was too small (N = 6) for conclusive analysis about responsiveness to improvement. Two items concerning sexuality had a high item non-response rate (50.2 and 14.4%). No practically significant difference was found in the total score and TOI between the two language versions despite minor differences in two of the 37 items. The English and Chinese versions of the FACT-B are valid, responsive, and reliable instruments in assessing health-related quality of life in breast cancer patients in Singapore. Data collected from the English and Chinese versions can be pooled and either version could be used for bilingual patients.
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Chloroquine for influenza prevention: a randomised, double-blind, placebo controlled trial.
Lancet Infect Dis
PUBLISHED: 05-05-2011
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Chloroquine has in-vitro activity against influenza and could be an ideal candidate for worldwide prevention of influenza in the period between onset of a pandemic with a virulent influenza strain and the development and widespread dissemination of an effective vaccine. We aimed to assess the efficacy of such an intervention.
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Acceptability of three novel lipid-based nutrient supplements among Malawian infants and their caregivers.
Matern Child Nutr
PUBLISHED: 04-21-2011
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We tested the acceptability of three new lipid-based nutrient supplements (LNSs) in two independent phases among 18 8-12-month-old healthy rural Malawians and their caregivers. In phase 1, acceptability was assessed by offering three new LNSs in random order, and an LNS already determined to be acceptable, Nutributter(®), each added to 30 g of warm maize porridge over three consecutive days. In phase 2, infants from each village were provided one of the new supplements for a 2-week home-use trial. Outcome measures included the amount consumed, time completion of the dose and the maternal rating of likeability on a 5-point scale. The supplements were rated acceptable if consumption was over 50% of the offered dose in phase 1. The mean (95% confidence interval) proportion of the LNS test meals consumed under direct observation was 88% (82-94%) for LNS-10gM, 90% (84-95%) for LNS-20gM, 87% (79-95%) for LNS-20gNoM, and 86% (83-90%) for Nutributter. The median (25th and 75th centile) time (minutes) for completing the offered test meal was 4 (2, 7) for LNS-10gM, 5 (3, 6) for LNS-20gM, 4 (3, 8) for LNS-20gNoM and 4 (2, 6) for Nutributter. During both phases, almost all caregivers rated all study foods very likeable for themselves and their children, with mean scores slightly lower among the caregivers than among the infants. In the home-use phase, the test foods were almost exclusively used by the study participants with minimal sharing with siblings and other household members. Some infants were reported to prefer the new investigational products over traditional complementary food. Considering that the novel LNS was largely acceptable. Efficacy trials are now needed to assess their impact on child growth and development.
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Atropine for the treatment of childhood myopia: safety and efficacy of 0.5%, 0.1%, and 0.01% doses (Atropine for the Treatment of Myopia 2).
Ophthalmology
PUBLISHED: 04-05-2011
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Our previous study, Atropine for the Treatment of Myopia 1 (ATOM1), showed that atropine 1% eyedrops were effective in controlling myopic progression but with visual side effects resulting from cycloplegia and mydriasis. The aim of this study was to compare efficacy and visual side effects of 3 lower doses of atropine: 0.5%, 0.1%, and 0.01%.
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Height gain during early childhood is an important predictor of schooling and mathematics ability outcomes.
Acta Paediatr.
PUBLISHED: 03-24-2011
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To examine the association between height gain at different stages of early childhood and schooling and cognitive outcomes in 12-year-old Malawian children.
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Domains of health-related quality of life important and relevant to multiethnic English-speaking Asian systemic lupus erythematosus patients: a focus group study.
Arthritis Care Res (Hoboken)
PUBLISHED: 03-23-2011
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To identify health-related quality of life (HRQOL) domains of importance to multiethnic Asian systemic lupus erythematosus (SLE) patients, to identify content gaps in existing SLE-specific HRQOL measures, and to determine whether the Patient-Reported Outcomes Measurement Information System (PROMIS) item banks could serve as a core set of questions for HRQOL assessment among SLE patients.
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Developmental outcomes among 18-month-old Malawians after a year of complementary feeding with lipid-based nutrient supplements or corn-soy flour.
Matern Child Nutr
PUBLISHED: 02-22-2011
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The major aim of this trial was to compare the development of 18-month-old infants who received complementary feeding for 1 year either with lipid-based nutrient supplements or micronutrient fortified corn-soy porridge. Our secondary aim was to determine the socio-economic factors associated with developmental outcomes in the same population. A total of 163 six-month-old rural Malawian children were enrolled in a randomized controlled trial where the control population received daily supplementation with 71 g corn-soy flour [Likuni Phala (LP)] (282 kcal) and individuals in the intervention groups received daily either 50 g of lipid-based nutrient supplement (FS50) (264 kcal) or 25 g of lipid-based nutrient supplement (FS25) (130 kcal). The main outcome measures were Griffiths developmental scores at 0-2 years. Independent comparison of study groups was carried out using analysis of variance (ANOVA) statistics where mean raw scores, quotients, or mental ages were compared. Association of developmental outcome with predictor variables were examined using multiple regression. At 18 months of chronological age, the mean ± standard deviation (SD) mental ages in the LP, FS50, and FS25 groups were 17.9 ± 1.3, 17.9 ± 1.3, and 17.9 ± 1.2 (P > 0.99), respectively. Likewise, the mean raw developmental scores and mean developmental quotients did not differ significantly. Length-for-age z-score gain during the intervention period, and maternal education were associated with developmental outcome at 18 months (P = 0.03 and P = 0.04; respectively). In conclusion, rural Malawian infants receiving 12-month daily supplementation of their diet either with the tested lipid-based nutrient supplements or fortified corn-soy flour have comparable development outcomes by 18 months of age.
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The validity of a structured interactive 24-hour recall in estimating energy and nutrient intakes in 15-month-old rural Malawian children.
Matern Child Nutr
PUBLISHED: 02-15-2011
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This study aimed to compare the nutritional intake values among 15-month-old rural Malawian children obtained by weighed food record (WFR) with those obtained by modified 24-hour recall (mod 24-HR), and to develop algorithm for adjusting mod 24-HR values so as to predict mean intake based on WFRs. The study participants were 169 15-month-old children who participated in a clinical trial. Food consumption on one day was observed and weighed (established criterion) by a research assistant to provide the estimates of energy and nutrient intakes. On the following day, another research assistant, blinded to the direct observation, conducted the structured interactive 24-hour recall (24-HR) interview (test method). Paired t-tests and scatter-plots were used to compare intake values of the two methods. The structured interactive 24-HR method tended to overestimate energy and nutrient intakes (each P < 0.001). The regression-through-the-origin method was used to develop adjustment algorithms. Results showed that multiplying the mean energy, protein, fat, iron, zinc and vitamin A intake estimates based on the test method by 0.86, 0.80, 0.68, 0.69, 0.72 and 0.76, respectively, provides an approximation of the mean values based on WFRs.
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Randomized trial of safety and effectiveness of chlorproguanil-dapsone and lumefantrine-artemether for uncomplicated malaria in children in the Gambia.
PLoS ONE
PUBLISHED: 02-01-2011
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Chlorproguanil-dapsone (Lapdap), developed as a low-cost antimalarial, was withdrawn in 2008 after concerns about safety in G6PD deficient patients. This trial was conducted in 2004 to evaluate the safety and effectiveness of CD and comparison with artemether-lumefantrine (AL) under conditions of routine use in G6PD normal and G6PD deficient patients with uncomplicated malaria in The Gambia. We also examined the effects of a common genetic variant that affects chlorproguanil metabolism on risk of treatment failure.
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The early clinical features of dengue in adults: challenges for early clinical diagnosis.
PLoS Negl Trop Dis
PUBLISHED: 01-31-2011
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The emergence of dengue throughout the tropical world is affecting an increasing proportion of adult cases. The clinical features of dengue in different age groups have not been well examined, especially in the context of early clinical diagnosis.
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Effect of repeated treatment of pregnant women with sulfadoxine-pyrimethamine and azithromycin on preterm delivery in Malawi: a randomized controlled trial.
Am. J. Trop. Med. Hyg.
PUBLISHED: 12-02-2010
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Preterm delivery, which is associated with infections during pregnancy, is common in sub-Saharan Africa. We enrolled 1,320 pregnant women into a randomized, controlled trial in Malawi to study whether preterm delivery and low birth weight (LBW) incidence can be reduced by intermittent preventive treatment of maternal malaria and reproductive tract infections. The participants received either sulfadoxine-pyrimethamine (SP) twice (controls), monthly SP, or monthly SP and two doses of azithromycin (AZI-SP). The incidence of preterm delivery was 17.9% in controls, 15.4% in the monthly SP group (P = 0.32), and 11.8% in AZI-SP group (risk ratio = 0.66, P = 0.01). Compared with controls, those in AZI-SP group had a risk ratio of 0.61 (P = 0.02) for LBW. Incidence of serious adverse events was low in all groups. In conclusion, the incidence of preterm delivery and LBW can in some conditions be reduced by treating pregnant women with monthly SP and two azithromycin doses.
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How you ask really matters: randomised comparison of four sexual behaviour questionnaire delivery modes in Zimbabwean youth.
Sex Transm Infect
PUBLISHED: 10-13-2010
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A sexual health survey among rural Zimbabwean youth was used to compare the validity and reliability of sexual behaviour measures between four questionnaire delivery modes.
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A lipid-based nutrient supplement but not corn-soy blend modestly increases weight gain among 6- to 18-month-old moderately underweight children in rural Malawi.
J. Nutr.
PUBLISHED: 09-22-2010
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Although widely used, there is little information concerning the efficacy of corn-soy blend (CSB) supplementation in the treatment of moderate underweight in African children. Lipid-based nutrient supplements (LNS), which have proven to be beneficial treatment for severely wasted children, could offer benefits to less severely affected individuals. We conducted a clinical randomized trial to determine whether LNS or CSB supplementation improves weight gain of moderately underweight children. A total of 182 underweight [weight-for-age Z-score (WAZ) < -2] 6- to 15-mo-old children were randomized to receive for 12 wk a ration of 43 g/d LNS or 71 g/d CSB, providing 1189 and 921 kJ, respectively, or no supplementation (control). The primary outcome was weight change; secondary outcomes included changes in anthropometric indices, hemoglobin levels, and morbidity. The body weight increases (mean ± SD) did not differ and were 620 ± 470, 510 ± 350, and 470 ± 350 g in the LNS, CSB, and control groups, respectively (P = 0.11). Compared with controls, infants and children in the LNS group gained more weight [mean (95% CI) = 150 g (0-300 g); P = 0.05] and had a greater increase in WAZ [0.33 (-0.02-0.65); P = 0.04]. Weight and WAZ changes did not differ between the control and CSB groups. In exploratory stratified analysis, the weight increase was higher in the LNS group compared with the control group among those with lower initial WAZ [250 g (60-430 g; P = 0.01]. Supplementation with LNS but not CSB modestly increases weight gain among moderately underweight children and the effect appears most pronounced among those with a lower initial WAZ.
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Effectiveness of a brain-computer interface based programme for the treatment of ADHD: a pilot study.
Psychopharmacol Bull
PUBLISHED: 06-29-2010
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Majority of children with attention deficit hyperactivity disorder (ADHD) have significant inattentive symptoms. We developed a progressive series of activities involving brain-computer interface-based games which could train users to improve their concentration. This pilot study investigated if the intervention could be utilized in children and if it could improve inattentive symptoms of ADHD. Ten medication-naive children aged 7 to 12 diagnosed with ADHD (combined or inattentive subtypes) received 20 sessions of therapy over a 10-week period. They were compared with age- and gendermatched controls. Both parent and teacher-rated inattentive score on the ADHD Rating Scale-IV improved more in the intervention group. A larger scale trial is warranted to further investigate the efficacy of our treatment programme in treating ADHD.
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Provider-initiated symptom screening for tuberculosis in Zimbabwe: diagnostic value and the effect of HIV status.
Bull. World Health Organ.
PUBLISHED: 04-30-2010
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To assess the diagnostic value of provider-initiated symptom screening for tuberculosis (TB) and how HIV status affects it.
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Identifying recent Mycobacterium tuberculosis transmission in the setting of high HIV and TB burden.
Thorax
PUBLISHED: 04-15-2010
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Accurate diagnosis of latent tuberculosis infection (LTBI) in recently exposed HIV-infected tuberculosis (TB) contacts is a public health priority because of the high risk of progression to active TB but is hampered by the high background prevalence of LTBI in high-burden populations and poor sensitivity of tuberculin skin testing (TST) in HIV co-infection.
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A nonparametric approach to QT interval correction for heart rate.
J Biopharm Stat
PUBLISHED: 04-02-2010
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We propose to use generalized additive models to fit the relationship between QT interval and RR (RR = 60/heart rate), and develop two new methods for correcting the QT for heart rate: the linear additive model and log-transformed linear additive model. The proposed methods are compared with six commonly used parametric models that were used in four clinical trial data sets and a simulated data set. The results show that the linear additive models provide the best fit for the vast majority of individual QT-RR profiles. Moreover, the QT correction formula derived from the linear additive model outperforms other correction methods.
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Feeding patterns and behaviors during home supplementation of underweight Malawian children with lipid-based nutrient supplements or corn-soy blend.
Appetite
PUBLISHED: 01-25-2010
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The way caregivers use supplementary food for undernourished children and integrate it into feeding patterns may influence the benefits achieved by supplementation. We studied feeding patterns and behaviors in 170 underweight 6-17-month-olds who received either lipid-based nutrient supplements (LNS) (n=85) or corn-soy blend (CSB) (n=85) during a 12-week intervention trial in southern Malawi. Observational data were collected during one 11h home visit per participant. Differences were assessed by study group and by mode of serving LNS. Associations between selected caregiver behaviors and child growth were also tested. We found no difference between the CSB and LNS groups in mean number of feeding episodes per day or mean daily feeding time. Caregivers fed the child with a spoon, washed their hands before feeding, and there were leftovers significantly more often in the CSB than LNS group and when LNS mixed with porridge and plain LNS were compared. This suggests that differences between the groups were linked to the mode of serving LNS. Presence of leftovers was negatively associated with change in childs WAZ. Programs promoting LNS in Malawi should consider behaviors related to mode of serving and provide advice to caregivers in order to minimize leftovers during supplement use.
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Risk communication in clinical trials: a cognitive experiment and a survey.
BMC Med Inform Decis Mak
PUBLISHED: 01-18-2010
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A Royal Statistical Society Working Party recently recommended that "Greater use should be made of numerical, as opposed to verbal, descriptions of risk" in first-in-man clinical trials. This echoed the view of many clinicians and psychologists about risk communication. As the clinical trial industry expands rapidly across the globe, it is important to understand risk communication in Asian countries.
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Mapping the English and Chinese versions of the Functional Assessment of Cancer Therapy-General to the EQ-5D utility index.
Value Health
PUBLISHED: 12-16-2009
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This study aims to develop a function for mapping the English and Chinese versions of the Functional Assessment of Cancer Therapy-General (FACT-G) scores to the EuroQoL Groups EQ-5D utility index and to test whether a single function is sufficient for the two language versions.
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VKORC1 diplotype-derived dosing model to explain variability in warfarin dose requirements in Asian patients.
Drug Metab. Pharmacokinet.
PUBLISHED: 09-12-2009
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Warfarin-induced bleeding complications and high inter-patient variability are major hindrances to oral anticoagulant therapy. The present study identifies the influence of VKORC1 diplotypes, CYP2C9 and CYP2C19 variants on warfarin disposition and dose requirements in Chinese patients (n=107). The study subjects were genotyped for VKORC1, CYP2C9 and CYP2C19 polymorphic variants. Weekly warfarin dose requirements and S-warfarin clearance were stratified by VKORC1, CYP2C9 and CYP2C19 pharmacogenetics. The major VKORC1 diplotypes were H1-H1 (62%), H1-H7 (18%) and H1-H(*)(b) (10%). Warfarin dose requirements were significantly lower in patients with VKORC1 H1-H1 and H1-H(*)(a) diplotypes compared to patients harboring the H1-H7 and H1-H(*)(b) diplotypes (P<0.05). Hepatic tissues with H1-H1 diplotype had significantly lower expression of VKORC1 mRNA compared with liver tissues carrying the H1-H7 and H1-H(*)(b) diplotypes (P=0.006). The percent variability explained by VKORC1 diplotype status was 59.1% while the CYP2C9 genotype status accounted for 6.9% variability in warfarin dose requirements. Patient age and weight were significant covariates accounting for 29% and 8.6% of warfarin dose variability, respectively. The present study shows that VKORC1 diplotype status, CYP2C9 genotype, age and weight are significant covariates, accounting for 73.4% of interindividual variability in warfarin dose requirements among Chinese patients. Translation of these findings into clinical guidelines for warfarin dosing may be required to assess its impact on the safety and efficacy of warfarin.
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Linear growth in early life is associated with suicidal ideation in 18-year-old Filipinos.
Paediatr Perinat Epidemiol
PUBLISHED: 08-20-2009
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Studies in Western societies have shown some evidence that growth in early life may be associated with suicide and suicidal ideation in later life. The pattern of growth retardation in developing countries is different from that in Western societies. This study examines the association between size at birth, postnatal growth from birth to age 24 months and suicidal ideation in 18-year-old Filipinos. The 1941 participants born in 1983 and 1984 in the Philippines were assessed for growth status bimonthly from birth to 24 months of age and were administered an interview in 2002, which included items on suicidal ideation. The pattern of growth stunting in this cohort was similar to that in many other developing countries: a minor level of shortness in crown-heel length at birth followed by sharp decline in length-for-age in the first 24 months of life. The prevalence of suicidal ideation at age 18 was 2.9%; 95% confidence interval [CI] 2.2, 3.8%. Length Z-score at 24 months (odds ratios [OR] = 0.67; 95% CI [0.52, 0.86]; P = 0.002) and gain in length Z-score from birth to age 24 months (OR = 0.74; 95% CI [0.56, 0.98]; P = 0.037) were inversely associated with the odds of suicidal ideation. Adjustment for covariates made little difference. Length at birth Z-score was associated with suicidal ideation only after adjustment for postnatal length gain (OR = 0.61; 95% CI [0.46, 0.80]; P < 0.001). The associations between linear growth in early life and suicidal ideation appeared to be partly mediated by educational attainment. In conclusion, postnatal growth stunting is an important predictor of suicidal ideation in later life. It also affects the association between birth length and suicidal ideation.
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Nasopharyngeal carriage of Streptococcus pneumoniae in Gambian children who participated in a 9-valent pneumococcal conjugate vaccine trial and in their younger siblings.
Pediatr. Infect. Dis. J.
PUBLISHED: 06-19-2009
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Nasopharyngeal carriage of Streptococcus pneumoniae is extremely prevalent in The Gambia. We studied the effects of vaccination with pneumococcal conjugate vaccines on the carriage of individual serotypes and on antimicrobial resistance in vaccinated children and their younger siblings.
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The Singaporean English and Chinese versions of the EQ-5D achieved measurement equivalence in cancer patients.
J Clin Epidemiol
PUBLISHED: 04-14-2009
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To assess measurement equivalence of the Singaporean English and Chinese versions of the EuroQol Groups 5-domain questionnaire (EQ-5D) in cancer patients.
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Measurement properties of the Chinese language version of the functional assessment of cancer therapy-general in a Singaporean population.
Ann. Acad. Med. Singap.
PUBLISHED: 04-07-2009
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Health-related quality of life is an important aspect of health outcome. The assessment of it must be done by validated instruments. There is no published data on the validity, reliability and sensitiveness to change of the official Chinese translation of the Functional Assessment of Cancer Therapy-General (version 4; FACT-G).
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Supplementary feeding with fortified spread among moderately underweight 6-18-month-old rural Malawian children.
Matern Child Nutr
PUBLISHED: 03-19-2009
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We aimed to analyse growth and recovery from undernutrition among moderately underweight ambulatory children receiving micronutrient-fortified maize-soy flour (Likuni Phala, LP) or ready-to-use fortified spread (FS) supplementary diet. One hundred and seventy-six 6-18-month-old individuals were randomized to receive 500 g LP or 350 g FS weekly for 12 weeks. Baseline and end of intervention measurements were used to calculate anthropometric gains and recovery from underweight, wasting and stunting. Mean weight-for-age increased by 0.22 (95% CI 0.07-0.37) and 0.28 (0.18-0.40) Z-score units in the LP and FS groups respectively. Comparable increase for mean weight-for-length was 0.39 (0.20-0.57) and 0.52 (0.38-0.65) Z-score units. Recovery from underweight and wasting was 20% and 93% in LP group and 16% and 75% in FS group. Few individuals recovered from stunting and mean length-for-age was not markedly changed. There were no statistically significant differences between the outcomes in the two intervention groups. In a poor food-security setting, underweight infants and children receiving supplementary feeding for 12 weeks with ready-to-use FS or maize-soy flour porridge show similar recovery from moderate wasting and underweight. Neither intervention, if limited to a 12-week duration, appears to have significant impact on the process of linear growth or stunting.
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Malawian mothers attitudes towards the use of two supplementary foods for moderately malnourished children.
Appetite
PUBLISHED: 02-13-2009
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The efficacy of lipid-based nutrient supplements (LNS) versus corn-soy blend (CSB) in promoting the growth of moderately malnourished children is currently being tested, but information about maternal attitudes towards the two supplements is lacking. This research studied 504 Malawian mothers attitudes about LNS and CSB through exit interviews completed at the end of three 12-week clinical trials and compared differences between the groups. Exploratory analyses of factors associated with withholding of supplements during fever, diarrhea, and cough were performed using logistic regression. Mothers generally had similar, positive attitudes towards LNS and CSB. Both supplements were said to be highly acceptable, children learned to eat them within two weeks, and mothers were willing to use them again. Mothers in the LNS group were reportedly more likely to withhold supplements from their children during cough, due to its sweetness, and were willing to pay more for a one-week supply of supplement than mothers in the CSB group. Maternal literacy was negatively and childs weight-for-height z-score was positively associated with withholding of supplements during illness. Our results indicate that the sweetness in LNS should be reduced, and programs using supplements in Malawi could include advice on appropriate feeding of supplements during illness.
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Evaluation of sequential multiplex PCR for direct detection of multiple serotypes of Streptococcus pneumoniae from nasopharyngeal secretions.
J. Med. Microbiol.
PUBLISHED: 02-12-2009
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Sequential multiplex PCR was evaluated for detection of multiple Streptococcus pneumoniae serotypes directly from nasopharyngeal secretions. A total of 279 nasopharyngeal swab samples were tested blindly. When limited to the 29 serotypes identifiable by the molecular method, the mean number of serotypes identified by the conventional latex/Quellung method was 0.85, which was significantly lower than that by the molecular method (P <0.0001). The multiplex PCR method identified significantly more serotypes than the latex/Quellung method if limited to the 29 serotypes (P=0.001 and P=0.014, respectively).
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Difference in prevalence of common mental disorder as measured using four questionnaire delivery methods among young people in rural Zimbabwe.
J Affect Disord
PUBLISHED: 02-10-2009
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Previous studies have suggested that interviewer-administered questionnaires can under-estimate the prevalence of depression and suicidal ideation when compared with self-administered ones. We report here on differences in prevalence of reporting mental health between four questionnaire delivery modes (QDM).
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Postintervention growth of Malawian children who received 12-mo dietary complementation with a lipid-based nutrient supplement or maize-soy flour.
Am. J. Clin. Nutr.
PUBLISHED: 02-06-2009
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Therapeutic feeding with micronutrient-fortified lipid-based nutrient supplements (LNSs) has proven useful in the rehabilitation of severely malnourished children. We recently reported that complementary feeding of 6-18-mo-old infants with an LNS known as FS50 was associated with improved linear growth and a reduction in the incidence of severe stunting during the supplementation period.
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Comparison of the measurement properties between a short and generic instrument, the 5-level EuroQoL Groups 5-dimension (EQ-5D-5L) questionnaire, and a longer and disease-specific instrument, the Functional Assessment of Cancer Therapy-Breast (FACT-B), in
Qual Life Res
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To compare the measurement precision and related properties between the 5-level EuroQoL Groups 5-dimension (EQ-5D-5L) questionnaire and the Functional Assessment of Cancer Therapy-Breast (FACT-B) questionnaire in assessing breast cancer patients.
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Child development at 5 years of age predicted mathematics ability and schooling outcomes in Malawian adolescents.
Acta Paediatr.
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This study aimed to examine the association between child development at 5 years of age and mathematics ability and schooling outcomes at 12 years of age in Malawian children.
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Measurement properties of the eight-item abbreviated functional assessment of cancer therapy--breast symptom index and comparison with its 37-item parent measure.
J Pain Symptom Manage
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The Functional Assessment of Cancer Therapy--Breast Symptom Index (FBSI) is an eight-item instrument extracted from the Functional Assessment of Cancer Therapy--Breast (FACT-B). There has been no formal assessment of this eight-item version.
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Estimation and interpretation of incidence rate difference for recurrent events when the estimation model is misspecified.
Biom J
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Recurrent events data are common in experimental and observational studies. It is often of interest to estimate the effect of an intervention on the incidence rate of the recurrent events. The incidence rate difference is a useful measure of intervention effect. A weighted least squares estimator of the incidence rate difference for recurrent events was recently proposed for an additive rate model in which both the baseline incidence rate and the covariate effects were constant over time. In this article, we relax this model assumption and examine the properties of the estimator under the additive and multiplicative rate models assumption in which the baseline incidence rate and covariate effects may vary over time. We show analytically and numerically that the estimator gives an appropriate summary measure of the time-varying covariate effects. In particular, when the underlying covariate effects are additive and time-varying, the estimator consistently estimates the weighted average of the covariate effects over time. When the underlying covariate effects are multiplicative and time-varying, and if there is only one binary covariate indicating the intervention status, the estimator consistently estimates the weighted average of the underlying incidence rate difference between the intervention and control groups over time. We illustrate the method with data from a randomized vaccine trial.
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The effect of monthly sulfadoxine-pyrimethamine, alone or with azithromycin, on PCR-diagnosed malaria at delivery: a randomized controlled trial.
PLoS ONE
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New regimens for intermittent preventive treatment in pregnancy (IPTp) against malaria are needed as the effectiveness of the standard two-dose sulfadoxine-pyrimethamine (SP) regimen is under threat. Previous trials have shown that IPTp with monthly SP benefits HIV-positive primi- and secundigravidae, but there is no conclusive evidence of the possible benefits of this regimen to HIV-negative women, or to a population comprising of both HIV-positive and -negative women of different gravidities.
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Measurement properties of the Chinese Version of the Kidney Disease Quality of Life-Short Form (KDQOL-SF™) in end-stage renal disease patients with poor prognosis in Singapore.
J Pain Symptom Manage
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The Kidney Disease Quality of Life (KDQOL™) instrument is widely used to assess care of end-stage renal disease (ESRD) patients.
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Estimation of summary protective efficacy using a frailty mixture model for recurrent event time data.
Stat Med
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Recurrent event time data are common in experimental and observational studies. The analytic strategy needs to consider three issues: within-subject event dependence, between-subject heterogeneity in event rates, and the possibility of a nonsusceptible fraction. Motivated by the need to estimate the summary protective efficacy from recurrent event time data as seen in many infectious disease clinical trials, we propose a two-part frailty mixture model that simultaneously accommodates all the three issues. In terms of vaccine action models, the proposed model is a combination of the all-or-none and the leaky models, and the summary protective efficacy is a unified measure of the vaccines twofold effects in completely or partially protecting the vaccinated individuals against the study event. The model parameters of interest are estimated using the expectation-maximization algorithm with their respective variances estimated using Louiss formula for the expectation-maximization algorithm. The summary protective efficacy is estimated by a composite estimand with its variance estimated using the delta method. The performance of the proposed estimation approach is investigated by a simulation study. Data from a trial of malaria prophylaxis conducted in Ghana are reanalyzed.
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An effectiveness trial showed lipid-based nutrient supplementation but not corn-soya blend offered a modest benefit in weight gain among 6- to 18-month-old underweight children in rural Malawi.
Public Health Nutr
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To determine if supplementation with corn-soya blend (CSB) or lipid-based nutrient supplement (LNS) improved the weight gain of moderately underweight infants and children when provided through the national health service.
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The English and Chinese versions of the five-level EuroQoL Groups five-dimension questionnaire (EQ-5D) were valid and reliable and provided comparable scores in Asian breast cancer patients.
Support Care Cancer
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To examine the measurement properties of and comparability between the English and Chinese versions of the five-level EuroQoL Groups five-dimension questionnaire (EQ-5D) in breast cancer patients in Singapore.
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JoVE Visualize is a tool created to match the last 5 years of PubMed publications to methods in JoVE's video library.

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In developing our video relationships, we compare around 5 million PubMed articles to our library of over 4,500 methods videos. In some cases the language used in the PubMed abstracts makes matching that content to a JoVE video difficult. In other cases, there happens not to be any content in our video library that is relevant to the topic of a given abstract. In these cases, our algorithms are trying their best to display videos with relevant content, which can sometimes result in matched videos with only a slight relation.