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In a joint effort involving scientists from academia, industry and regulatory agencies, ECETOC's activities in Omics have led to conceptual proposals for: (1) A framework that assures data quality for reporting and inclusion of Omics data in regulatory assessments; and (2) an approach to robustly quantify these data, prior to interpretation for regulatory use. In continuation of these activities this workshop explored and identified areas of need to facilitate robust interpretation of such data in the context of deriving points of departure (POD) for risk assessment and determining an adverse change from normal variation. ECETOC was amongst the first to systematically explore the application of Omics methods, now incorporated into the group of methods known as New Approach Methodologies (NAMs), to regulatory toxicology. This support has been in the form of both projects (primarily with CEFIC/LRI) and workshops. Outputs have led to projects included in the workplan of the Extended Advisory Group on Molecular Screening and Toxicogenomics (EAGMST) group of the Organisation for Economic Co-operation and Development (OECD) and to the drafting of OECD Guidance Documents for Omics data reporting, with potentially more to follow on data transformation and interpretation. The current workshop was the last in a series of technical methods development workshops, with a sub-focus on the derivation of a POD from Omics data. Workshop presentations demonstrated that Omics data developed within robust frameworks for both scientific data generation and analysis can be used to derive a POD. The issue of noise in the data was discussed as an important consideration for identifying robust Omics changes and deriving a POD. Such variability or "noise" can comprise technical or biological variation within a dataset and should clearly be distinguished from homeostatic responses. Adverse outcome pathways (AOPs) were considered a useful framework on which to assemble Omics methods, and a number of case examples were presented in illustration of this point. What is apparent is that high dimension data will always be subject to varying processing pipelines and hence interpretation, depending on the context they are used in. Yet, they can provide valuable input for regulatory toxicology, with the pre-condition being robust methods for the collection and processing of data together with a comprehensive description how the data were interpreted, and conclusions reached.

Drug–target interaction is crucial in the discovery of new drugs. Computational methods can be used to identify new drug–target interactions at low costs and with reasonable accuracy. Recent studies pay more attention to machine-learning methods, ranging from matrix factorization to deep learning, in the DTI prediction. Since the interaction matrix is often extremely sparse, DTI prediction performance is significantly decreased with matrix factorization-based methods. Therefore, some matrix factorization methods utilize side information to address both the sparsity issue of the interaction matrix and the cold-start issue. By combining matrix factorization and autoencoders, we propose a hybrid DTI prediction model that simultaneously learn the hidden factors of drugs and targets from their side information and interaction matrix. The proposed method is composed of two steps: the pre-processing of the interaction matrix, and the hybrid model. We leverage the similarity matrices of both drugs and targets to address the sparsity problem of the interaction matrix. The comparison of our approach against other algorithms on the same reference datasets has shown good results regarding area under receiver operating characteristic curve and the area under precision–recall curve. More specifically, experimental results achieve high accuracy on golden standard datasets (e.g., Nuclear Receptors, GPCRs, Ion Channels, and Enzymes) when performed with five repetitions of tenfold cross-validation. Graphical abstract: [Figure not available: see fulltext.]Display graphical of the hybrid model of Matrix Factorization with Denoising Autoencoderswith the help side information of drugs and targets for Prediction of Drug-Target Interactions.

We investigate the value of a two-armed Bayesian response adaptive randomization (RAR) design to investigate early preterm birth rates of high versus low dose of docosahexaenoic acid during pregnancy. Unexpectedly, the COVID-19 pandemic forced recruitment to pause at 1100 participants rather than the planned 1355. The difference in power between number of participants at the pause and planned was 87% and 90% respectively. We decided to stop the study. This paper describes how the RAR was used to execute the study. The value of RAR in two-armed studies is quite high and their use in the future is promising.

Rates of overweight and obesity are problematic among systematically marginalized youth; however, these youth and their families are a hard-to-reach research population. The purpose of our study was to identify facilitators and barriers for recruiting systematically marginalized families in youth weight-management intervention research. This study built upon existing evidence through involvement of youth, parents, community agency workers, and school nurses, and an exploration of both recruitment materials and processes. Seven focus groups were conducted with 48 participants from 4 stakeholder groups (youth, parents, school nurses, and community agency workers). A codebook approach to thematic analysis was used to identify key facilitator and barrier themes related to recruitment materials and processes across the stakeholder groups. Ecological systems theory was applied to contextualize the facilitators and barriers identified. Participants reported the need to actively recruit youth in the study through engaging, fun recruitment materials and processes. Participants reported greater interest in recruitment at community-based events, as compared to recruitment through health care providers, underscoring the depth of distrust that this sample group has for the health care system. Recommendations for recruitment materials and processes for weight-management intervention research with systematically marginalized families are proposed.

Quality of life is widely acknowledged as one of the most important outcomes in autism research, but few measures of this construct have been validated for use in autistic people. The goal of the current study was to examine the psychometric properties of the Patient-Reported Outcomes Measurement Information System Global–10, an established self-report measure of health-related quality of life, in a sample of 901 autistic adults (predominantly female and adult-diagnosed) recruited from the Simons Foundation Powering Autism Research for Knowledge cohort. Using an item response theory framework, we performed a comprehensive psychometric evaluation of the Patient-Reported Outcomes Measurement Information System Global–10 in this sample, examining its latent structure, differential item functioning, reliability, and construct validity. After developing an autism-specific measurement model, the Patient-Reported Outcomes Measurement Information System Global–10 demonstrated excellent psychometric properties in the current sample, including excellent model-data fit, high reliability, minimal differential item functioning across subgroups of autistic adults, and an expected pattern of correlations with external variables. Exploratory analyses indicated that lower quality of life was associated with female sex and identified as a sexual/gender minority. A free online score calculator has been created to facilitate the use and interpretation of normed Patient-Reported Outcomes Measurement Information System Global–10 general quality of life latent trait scores for clinical and research applications (available at https://asdmeasures.shinyapps.io/promis_qol ). Lay Abstract Quality of Life an outcome that both researchers and autistic advocates agree is extremely important to consider when implementing services, interventions, and supports for autistic people. However, there has been little research on the topic of how quality of life can best be measured in autistic people or whether existing quality of life questionnaires are appropriate for use in the autistic population. This study aimed to validate an established quality of life measure, the Patient-Reported Outcomes Measurement Information System Global–10, in a large sample of autistic adults recruited online. We created a new way to score the Patient-Reported Outcomes Measurement Information System Global–10 scale and generate a “General quality of life” score specific to autistic adults. This new score performed very well in this sample, showing very little measurement error and relating in expected ways to similar constructs, such as physical health and emotional distress. Exploratory analyses found that lower quality of life was associated with female sex and self-identification as a sexual or gender minority (i.e. LGBTQ + identity). These findings suggest that the new Patient-Reported Outcomes Measurement Information System Global–10 quality of life score is a reliable and valid measure of quality of life in autistic adults, although additional studies are necessary to further explore its measurement properties in other subsets of the autistic population, such as individuals with intellectual disabilities. This measure is freely available for use as an outcome in both research and clinical practice, and an online score calculator is available to support the use of this measure in real-world applications.

PURPOSEPostconsolidation immunotherapy including dinutuximab, granulocyte-macrophage colony-stimulating factor, and interleukin-2 improved outcomes for patients with high-risk neuroblastoma enrolled on the randomized portion of Children's Oncology Group study ANBL0032. After random assignment ended, all patients were assigned to immunotherapy. Survival and toxicities were assessed.PATIENTS AND METHODSPatients with a pre-autologous stem cell transplant (ASCT) response (excluding bone marrow) of partial response or better were eligible. Demographics, stage, tumor biology, pre-ASCT response, and adverse events were summarized using descriptive statistics. Event-free survival (EFS) and overall survival (OS) from time of enrollment (up to day +200 from last ASCT) were evaluated.RESULTSFrom 2009 to 2015, 1,183 patients were treated. Five-year EFS and OS for the entire cohort were 61.1 ± 1.9% and 71.9 ± 1.7%, respectively. For patients ≥ 18 months old at diagnosis with International Neuroblastoma Staging System stage 4 disease (n = 662) 5-year EFS and OS were 57.0 ± 2.4% and 70.9 ± 2.2%, respectively. EFS was superior for patients with complete response/very good partial response pre-ASCT compared with those with PR (5-year EFS: 64.2 ± 2.2% v 55.4 ± 3.2%, P = .0133); however, OS was not significantly different. Allergic reactions, capillary leak, fever, and hypotension were more frequent during interleukin-2–containing cycles than granulocyte-macrophage colony-stimulating factor–containing cycles ( P < .0001). EFS was superior in patients with higher peak dinutuximab levels during cycle 1 ( P = .034) and those with a high affinity FCGR3A genotype ( P = .0418). Human antichimeric antibody status did not correlate with survival.CONCLUSIONAnalysis of a cohort assigned to immunotherapy after cessation of random assignment on ANBL0032 confirmed previously described survival and toxicity outcomes. EFS was highest among patients with end-induction complete response/very good partial response. Among patients with available data, higher dinutuximab levels and FCGR3A genotype were associated with superior EFS. These may be predictive biomarkers for dinutuximab therapy.

Aim Necrotizing enterocolitis (NEC) is the most lethal disease of the gastrointestinal tract of preterm infants. New and existing management strategies need clinical evaluation. Large heterogeneity exists in the selection, measurement, and reporting of outcome measures in NEC intervention studies. This hampers meta-analyses and the development of evidence-based management guidelines. We aim to develop a Core Outcome Set (COS) for NEC that includes the most relevant outcomes for patients and physicians, from moment of diagnosis into adulthood. This COS is designed for use in NEC treatment trials, in infants with confirmed NEC. Methods This study is designed according to COS-STAD (Core Outcome Set-STAndards for Development) recommendations and the COMET (Core Outcome Measures in Effectiveness Trials) Initiative Handbook. We obtained a waiver from the Ethics Review Board and prospectively registered this study with COMET (Study 1920). We will approach 125 clinicians and/or researchers from low-middle and high-income countries based on their scientific output (using SCIVAL, a bibliometric tool). Patients and parents will be approached through local patient organisations. Participants will be separated into three panels, to assess differences in priorities between former patients and parents (1. lay panel), clinicians and researchers involved in the neonatal period (2. neonatal panel) and after the neonatal period (3. post-neonatal panel). They will be presented with outcomes currently used in NEC research, identified through a systematic review, in a Delphi process. Eligible outcome domains are also identified from the patients and parents’ perspectives. Using a consensus process, including three online Delphi rounds and a final face-to-face consensus meeting, the COS will be finalised and include outcomes deemed essential to all stakeholders: health care professionals, parents and patients’ representatives. The final COS will be reported in accordance with the COS-Standards for reporting (COS-STAR) statement. Conclusions Development of an international COS will help to improve homogeneity of outcome measure reporting in NEC, will enable adequate and efficient comparison of treatment strategies, and will help the interpretation and implementation of clinical trial results. This will contribute to high-quality evidence regarding the best treatment strategy for NEC in preterm infants.

Despite nonanimal methods (NAMs) are more and more exploited and new NAMs are developed and validated, animal models are still used in cancer research. Animals are used at multiple levels, from understanding molecular traits and pathways, to mimicking clinical aspects of tumor progression, to drug testing. In vivo approaches are not trivial and involve cross-disciplinary knowledge: animal biology and physiology, genetics, pathology, and animal welfare.The aim of this chapter is not to list and address all animal models used in cancer research. Instead, the authors would like to guide experimenters in the strategies to adopt in both planning and performing in vivo experimental procedures, including the choice of cancer animal models.

Twin and family studies have historically aimed to partition phenotypic variance into components corresponding to additive genetic effects (A), common environment (C), and unique environment (E). Here we present the ACE Model and several extensions in the Adolescent Brain Cognitive Development℠ Study (ABCD Study®), employed using the new Fast Efficient Mixed Effects Analysis (FEMA) package. In the twin sub-sample (n = 924; 462 twin pairs), heritability estimates were similar to those reported by prior studies for height (twin heritability = 0.86) and cognition (twin heritability between 0.00 and 0.61), respectively. Incorporating SNP-derived genetic relatedness and using the full ABCD Study® sample (n = 9,742) led to narrower confidence intervals for all parameter estimates. By leveraging the sparse clustering method used by FEMA to handle genetic relatedness only for participants within families, we were able to take advantage of the diverse distribution of genetic relatedness within the ABCD Study® sample.

U.S. foster care policy prioritizes keeping siblings together while in foster care. However, prior research on the effects of sibling placement is limited in sample, measures, and research design. In this study, we use data on 2,297 children from an urban county in years 2015–2019 and assess how sibling separation is associated with placement instability. We use multilevel parametric hazard modeling with adjustments for child, sibling, and placement characteristics. Findings indicate that children placed with at least one sibling are less likely to experience a placement move and are specifically less likely to experience a non-progress move (e.g., moves due to problems or negative experiences in their foster home). For larger sibling groups, sibling separation was not consistently associated with placement instability and there was little difference in placement instability for children placed with some versus all siblings. Results were robust to differences in measurement and model specification. Black or Hispanic race/ethnicity was also associated with increased risk of instability, and associations between sibling separation and instability were stronger for Black children, implying enhanced efforts to maintain sibling groups may be especially beneficial for Black children. Overall, findings provide support for the continuation and expansion of policies promoting sibling placement.

Objectives. To develop an imputation method to produce estimates for suppressed values within a shared government administrative data set to facilitate accurate data sharing and statistical and spatial analyses. Methods. We developed an imputation approach that incorporated known features of suppressed Massachusetts surveillance data from 2011 to 2017 to predict missing values more precisely. Our methods for 35 de-identified opioid prescription data sets combined modified previous or next substitution followed by mean imputation and a count adjustment to estimate suppressed values before sharing. We modeled 4 methods and compared the results to baseline mean imputation. Results. We assessed performance by comparing root mean squared error (RMSE), mean absolute error (MAE), and proportional variance between imputed and suppressed values. Our method outperformed mean imputation; we retained 46% of the suppressed value’s proportional variance with better precision (22% lower RMSE and 26% lower MAE) than simple mean imputation. Conclusions. Our easy-to-implement imputation technique largely overcomes the adverse effects of low count value suppression with superior results to simple mean imputation. This novel method is generalizable to researchers sharing protected public health surveillance data. (Am J Public Health. 2021; 111(10):1830–1838. https://doi.org/10.2105/AJPH.2021.306432 )

Whereas advocates point to benefits of employing people with disabilities for organizations, employers’ concern over negative customer reactions is still a barrier to the employment of people with ...

To describe first author gender differences and characteristics in 1) Society for Academic Emergency Medicine (SAEM) Annual Meeting abstracts and 2) resulting manuscript publications.We performed cross-sectional evaluation of SAEM abstracts from 1990, 1995, 2000, 2005, 2010, 2015, and 2020, compiling and reviewing a random sample of 100 abstracts for each year (total n = 700 abstracts). We documented abstract characteristics, including first author gender, and used the 2020 SAEM scoring rubric. We then searched PubMed to identify manuscript publications resulting from abstracts from 1990 to 2015 (n = 600). Finally, among abstracts that resulted in manuscript publication, we identified first and last author gender on both the abstracts and the resulting publication.Overall, 29% (202/695; n = 5 missing gender) of abstracts had female first authors. Female first authors increased over time (e.g., 17% in 1990 to 35% in 2020). Abstract quality scores were similar (both median [interquartile range] of 11 ([9-12]). Overall, 42% (n = 254/600) of abstracts resulted in a manuscript publication, 39% (n = 65/202) with female and 44% (n = 189/493) with male first authors (p = 0.26). The median time (IQR) from abstract to manuscript publication was longer for abstracts with female first authors vs. those with male first authors (2 [1-3] years and 1 [1, 2] years, p0.02); 77% and 78% of publications resulting from abstracts with female and male first authors, respectively, had the same first author. Female first author abstracts more often converted to a male first author manuscript publication (18%, n = 12/65) compared to male first author abstracts converting to female first author publications (7%, n = 14/189).A minority of SAEM abstracts, and manuscript publications resulting from them, had female first authors. Abstracts with female first authors took longer to achieve manuscript publication, and almost a fifth of female first author abstracts resulted in male first author manuscript publication.

Public Significance Statement Increasingly, researchers use frequently repeated self-report measures to assess individuals' experiences in the context of their daily lives. We find signs of changes in response behavior, affect, and emotional awareness that are triggered by these frequent assessments. The possibility of such reactive changes over time is important to consider when collecting repeated self-report measures in daily life.Since the introduction of the experience sampling method (ESM), there have been concerns that the repeated assessments typically related to this method may alter the behavior, thoughts, or feelings of participants. Previous studies have offered mixed results with some studies reporting reactive changes, while others failed to find such effects. Our aim was to investigate under which circumstances ESM induces reactive effects. Students (N = 151) were randomly assigned to receive a questionnaire containing 30 or 60 items three, six, or nine times per day for 14 days. A random sample of 50 participants took part in qualitative interviews after the end of the data collection. We investigated changes over time in the data, while taking into account the sampling protocol and characteristics of participants, and analyzed qualitative reports of measurement reactivity. Decreases in completion time, within-person variance of ratings and subjective reports of habituation point toward the existence of a habituation period. While participants reported increases in emotional awareness in interviews, ESM measures indicated a decrease in emotional awareness over time. Changes in behavior were rare in quantitative and qualitative reports. Positive affect was decreasing over time in the ESM data, and various changes in affect, emotion regulation, and thoughts were reported in interviews. Individual characteristics and sampling protocol had inconsistent effects on changes over time. The results suggest that ESM induces changes in within-person variability, completion times, affect, or emotional awareness over time. Further research is needed to explore whether observed changes affect the validity of ESM data.

There is an increased desire for miniature ultrasound probes with small apertures to provide volumetric images at high frame rates for in-body applications. Satisfying these increased requirements makes simultaneous achievement of a good lateral resolution a challenge. As micro-beamforming is often employed to reduce data rate and cable count to acceptable levels, receive processing methods that try to improve spatial resolution will have to compensate the introduced reduction in focusing. Existing beamformers do not realize sufficient improvement and/or have a computational cost that prohibits their use. Here we propose the use of adaptive beamforming by deep learning (ABLE) in combination with training targets generated by a large aperture array, which inherently has better lateral resolution. In addition, we modify ABLE to extend its receptive field across multiple voxels. We illustrate that this method improves lateral resolution both quantitatively and qualitatively, such that image quality is improved compared with that achieved by existing delay-and-sum, coherence factor, filtered-delay-multiplication-and-sum and Eigen-based minimum variance beamformers. We found that only in silica data are required to train the network, making the method easily implementable in practice.

Objectives: Recently, research has focused both on the influence of institutional racism and how the Global Majority, which includes Black, Indigenous and People of Color, heal from processes related to racial and other forms of oppression. We propose a framework of healing research methodologies that is situated within emerging diversity science trends. This framework specifically is designed to apply diversity science principles to develop research that is culturally relevant and can help explain intragroup processes related to healing from institutional racism. Methods: Drawing from the diversity science, liberation and critical research methodologies, and psychological healing practices literature, we propose a healing research methodologies framework. Results: The healing research methodologies framework consists of six critical components: maintains social justice ethics, adopts liberation methodologies, implements healing methods, embraces interdisciplinary approaches, catalyzes action, and promotes community accessibility. Conclusions: We offer recommendations to guide future diversity science healing research. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Just-in-time adaptive interventions (JITAIs) represent an intervention design that adapts the provision and type of support over time to an individual’s changing status and contexts, intending to deliver the right support on the right occasion. As a novel strategy for delivering mobile health interventions, JITAIs have the potential to improve access to quality care in underserved communities and, thus, alleviate health disparities, a significant public health concern. Valid experimental designs and analysis methods are required to inform the development of JITAIs. Here, we briefly review the cutting-edge design of microrandomized trials (MRTs), covering both the classical MRT design and its outcome-adaptive counterpart. Associated statistical challenges related to the design and analysis of MRTs are also discussed. Two case studies are provided to illustrate the aforementioned concepts and designs throughout the article. We hope our work leads to better design and application of JITAIs, advancing public health research and practice. (Am J Public Health. 2023;113(1):60–69. https://doi.org/10.2105/AJPH.2022.307150 )

This article, the sixth in a series aiming to provide practical guidance for qualitative research in primary care, introduces two approaches for addressing longitudinal and complex health themes in primary care research. The first approach - longitudinal qualitative research - supports the study of change during the life course. The second approach - mixed-methods research - integrates quantitative and qualitative research to gain new insights to address the complex and multifaceted themes in primary care.We discuss the context, what, why, when and how of these approaches and their main practical and methodological challenges. We provide examples of empirical studies using these approaches and sources for further reading.

Successful outpatient anterior cruciate ligament (ACL) reconstruction hinges on effective analgesia. Routinely, oral narcotic agents have been the preferred analgesic postoperatively in orthopaedic surgery. However, these agents have several known adverse effects and are associated with a potential for abuse. This study evaluates the efficacy of ketorolac, a nonsteroidal anti-inflammatory drug with analgesic properties, as an adjuvant agent for postoperative pain control after ACL reconstruction.Adult patients undergoing primary ACL reconstruction were prospectively enrolled. Exclusion criteria involved patients with a history of bleeding diathesis, renal dysfunction, chronic analgesia use, or alcohol abuse. Eligible patients were randomized into one of two groups. The control group received a standard-of-care pain protocol involving oxycodone-acetaminophen 5 to 325 on discharge. The ketorolac group additionally received intravenous ketorolac postoperatively and 3 days of oral ketorolac on discharge. Pain levels and total narcotic utilization were recorded three times per day for the first 5 days after surgery. Pain and functional outcomes were obtained at 2 and 6 weeks postoperatively.The final analysis included 48 patients; the mean age of the cohort was 32 ± 11.6 years, and 60.4% of patients were female. No differences were observed in preoperative demographics, comorbidities, and preoperative functional scores between the two groups. Over the first 5 days after surgery, patients in the ketorolac group consumed a mean of 45.4% fewer narcotic pills than the control group (P0.001). In addition, mean postoperative pain scores were 22.36 points lower for patients in the ketorolac group (P0.001). There was no difference in functional outcome scores at up to 6 weeks postoperatively or adverse events between the two groups with no reported cases of gastrointestinal bleeding.The use of adjunctive intravenous and short-term oral ketorolac substantially reduces narcotic utilization and pain levels after ACL reconstruction.NCT04246554.

Interviewing is a vital and common method of collecting data in qualitative research. The interview is usually recorded and a written transcription is created from the recording. The transcription document is then analysed by reading and re-reading to fracture the data and develop initial codes, as in grounded theory methodology. However, this method has disadvantages.To report on how the authors used the process of generating initial codes during their analysis in a research study.The authors compare the rigour and efficiency of generating initial codes from reading written transcripts with generating initial codes from listening to recordings. The most notable difference between the two methods is the length of time needed to transcribe the recording before coding can start. The authors discuss the lessons they learned from their pragmatic decision to expedite initial coding by listening to rather than reading the interview data.Grounded theory requires concurrent data generation and analysis. Audio analysis is efficient in developing initial codes from interview recordings.Nurse researchers can use the audio method of analysing interview data.

Questionnaires are perhaps the most widely used measuring tools in nursing research, as many studies conducted by nurses focus on understanding the underlying complex factors that are amenable to questionnaires. However, most questionnaires used in nursing research continue to display inadequate evidence of validity under the traditional methods while ignoring the modern Rasch techniques with better proofs of objective measurement.To draw researchers' attention to the recurrent limitations of the classical approach to questionnaire design and to suggest advanced psychometric analysis exemplified in Rasch methodology as a more appropriate alternative.For questionnaire data to be suitable for statistical analysis, transparent demonstration of mathematical assumptions embodied in the questionnaire is compulsory. The failure to engage contemporary measurement models in designing good questionnaires raises concerns about researchers' awareness of the application and usefulness of the evidence generated by the modern approach. This paper illustrates with examples the problems inherent in the traditional or classical test theory and advanced dimensionality and category functioning as requisite psychometric properties of a questionnaire. It also outlines several diagnostic parameters that proponents of Rasch techniques recommend for testing.Traditional methods of assessing and analysing a questionnaire's psychometric properties are no longer tenable because the modern Rasch approach offers exemplary proofs of questionnaire validity rooted in objective measurement theories.Nurse researchers using questionnaires for clinical decisions and education purposes should apply the fundamental principles of objective measurements demonstrated in Rasch theory.

Objective: : To develop an international Core Outcome Set (COS), a minimal collection of outcomes that should be measured and reported in all future clinical trials evaluating treatments of acute simple appendicitis in children.Summary Background Data: A previous systematic review identified 115 outcomes in 60 trials and systematic reviews evaluating treatments for children with appendicitis, suggesting the need for a COS.Methods: The development process consisted of four phases: (1) an updated systematic review identifying all previously reported outcomes, (2) a two-stage international Delphi study in which parents with their children and surgeons rated these outcomes for inclusion in the COS, (3) focus groups with young people to identify missing outcomes, and (4) international expert meetings to ratify the final COS.Results: The systematic review identified 129 outcomes which were mapped to 43 unique outcome terms for the Delphi survey. The first-round included 137 parents (eight countries) and 245 surgeons (10 countries), the second-round response rates were 61% and 85% respectively, with ten outcomes emerging with consensus. After two young peoples’ focus groups, two additional outcomes were added to the final COS (12): mortality, bowel obstruction, intra-abdominal abscess, recurrent appendicitis, complicated appendicitis, return to baseline health, readmission, reoperation, unplanned appendectomy, adverse events related to treatment, major and minor complications.Conclusion: An evidence-informed COS based on international consensus, including patients and parents has been developed. This COS is recommended for all future studies evaluating treatment of simple appendicitis in children, to reduce heterogeneity between studies and facilitate data synthesis and evidence-based decision-making.

Up to now, the discussion about research designs in subject-matter didactics has mainly taken place within the disciplines of this academic field. A generic model is useful in order to stimulate a discussion across different disciplines as it provides a common reference point. Such a model was the goal of a Delphi study, which consisted of two rounds. This paper describes the basic results of this Delphi study. On the one hand it brought about the basic contours of such a model: it is characterized by three basic dimensions (subject areas, methodologies, reference theories) and categories by which these three dimensions were operationalized. On the other hand, the Delphi brought about those topics that need to be discussed in future. This is especially true for categories on the dimensions of methodologies and reference theories. In summary, this study offers arguments and impulses for further discussion about the understanding of research in subject-matter didactics.

Vascular research questions can be answered using various study designs. Observational studies are used frequently to address a wide range of clinical questions when randomized clinical trials are not feasible or practical. One of the powerful vascular research tools is the cohort study. The cohort study is a reliable observational study design in which individuals who share a common characteristic (a cohort) are followed over time and their outcomes are assessed at various intervals. This review focuses on the essential characteristics, design, implementation, bias, validity, and clinical significance of cohort studies and provides illustrative examples. A cohort study can be either a prospective or a retrospective study, depending on whether the outcome occurred before or after the enrollment of the cohort. Each type has its advantages and disadvantages. Confounding, selection, and information biases can all occur in cohort studies. Applications of the cohort study design include studying the natural history of a disease, describing a condition's frequency, and investigating multiple outcomes simultaneously.

Although adults aged 65 years or older make up a strong majority of cancer patients, their underrepresentation in cancer clinical trials leads to the lack of representative data to guide evidence-based therapeutic decisions in this patient population. The Trial Design Working Group, convened as part of the workshop titled, Engaging Older Adults in the National Cancer Institute Clinical Trials Network: Challenges and Opportunities, recommended study designs and design elements that could improve accrual of older adults in National Cancer Institute–funded clinical trials. These include trials that are specifically designed to enroll older adults, trials that include a cohort of older patients (parallel cohort, stratified cohort, or embedded cohort), and trials with pragmatic design elements to facilitate enrollment of older adults. This manuscript provides brief descriptions of the recommended designs, examples of successful trials, and considerations for implementation of these designs. As with any clinical trial, the scientific questions and trial objectives should drive the study design, the selection of endpoints and intervention, and eligibility criteria. When designing trials that include older adults, the heterogeneity of fitness levels is an important consideration as fitness can influence accrual rates and outcomes. Appropriately incorporating geriatric assessments can help identify the optimal subset of older patients for inclusion and minimize selection bias. Incorporating pragmatic design elements to reduce the burden on trial participants as well as on accruing sites and retaining essential elements to ensure that the main goal of the trial can be accomplished can enhance enrollment without compromising the integrity of trials.

The field of vascular surgery is in constant evolution. Administrative data and registries can provide important contemporary evidence to inform clinical decision making and delivery of health services. This review outlines some important considerations for retrospective studies using administrative health databases and registries. First, these data sources have advantages (e.g., real-world applicability, timely data access, and relatively lower research cost) and disadvantages (e.g., potential missing data, selection bias, and confounding bias) that may be more or less relevant to different administrative databases or registries. Second, a framework to guide data source selection and provide a summary of frequently used data sources in vascular surgery research is discussed. Third, a retrospective study design warrants planned exposure, outcome, and covariate definitions and, when studying an exposure-outcome association, careful consideration of confounders through direct acyclic graphs. Finally, investigators must plan the most appropriate analytic approach, and we distinguish descriptive, explanatory, and predictive analyses.

In this work, a novel environment-friendly stability indicating capillary zone electrophoresis (CZE) method has been developed and validated for assaying the aripiprazole (ARP) in tablet dosage form. The separation of ARP from its degradation products and internal standard was achieved using a fused silica capillary column (30.2 cm x 75 μm ID), a background electrolyte containing 6 mmol L

INTRODUCTION: The relationships between healthcare use and social needs are not fully understood. In 2015, International Classification of Diseases, Tenth Revision coding introduced voluntary Z codes for social needs–related healthcare encounters. This study evaluated early national patterns of Z codes in privately insured adults. METHODS: In 2021, the authors conducted a case-control analysis of national commercial health payer claims from 2016 to 2019. Among adults with ≥6 months of continuous enrollment and ≥1 medical claims, patients with any assigned Z codes were defined as cases. Controls were selected through stratified random sampling. Z codes were organized under 3 categories: socioeconomic, community/social, and environmental. RESULTS: Of 29.5 million adults, 521,334 patients (1.8%) had any assigned Z codes. Among all the Z codes, 53.5% identified community/social issues, 30.3% identified environmental issues, and 16.2% identified socioeconomic issues. Among socioeconomic Z codes, housing needs were frequently identified, but needs for food, utility bills, and transportation were very rarely identified. In multivariable regression analysis, females had higher odds of Z code assignment than males. Depression and chronic pulmonary disease were the 2 common comorbidities (≥5% prevalence in cases and controls) that were highly associated with Z code assignment. Less common comorbidities strongly associated with Z code assignment were drug abuse, alcohol abuse, psychoses, and AIDS/HIV. CONCLUSIONS: In this national study of privately insured patients, many Z codes identified healthcare encounters caused by social stressors, whereas few identified food- or transportation-related causes. Depression and chronic pulmonary disease were highly associated with Z code assignment.

There are many resources available for retrospective analyses in vascular surgery research. Methods used commonly when conducting clinical research include data gathering, literature review, database integration, and statistical analysis. In this review, the databases used commonly in vascular surgery are discussed, including the following institutional data sets: Vascular Quality Initiative, American College of Surgeons National Surgical Quality Improvement Program, National Inpatient Sample, and Nationwide Readmissions Database. Each type has advantages and limitations. Retrospective clinical research can help answer questions and advance knowledge in vascular surgery. Clinical research begins by having a clear question and knowing the best data source and methods, as well as presenting the findings well at the podium and in the manuscript to optimize dispersion and chances for success.

It is widely believed that posture and balance stressors are factors in playing-related pain for musicians using hand-held musical instruments. This purpose of this scoping review was to assess the available literature relative to the effects of posture and balance in musicians with neuromusculoskeletal injuries. A search of Medline, Web of Science, and SportDiscus seeking articles combining posture and balance considerations with pain in performing artists was performed. From 1,403 articles initially identified by the search parameters, the further abstract/title review for relevance and inclusiveness of pain and posture/balance variables in performing artists resulted in the retention of 29 articles for this full-text scoping review. The full-text analysis assessed publication type, study design, participant population, methodology, statistical methods, main results, and whether the study evaluated the relationship between posture/balance and pain in musicians. Overall, most of the studies including musicians were observational or descriptive. Although, in recent years, there has been an increase in the number of interventional studies regarding posture, balance and pain in musicians, there is still minimal evidence about the contribution of posture and balance characteristics to pain in musician performers. To reliably establish a predictable relationship with injury symptomatology experienced by musicians, it is essential to integrate standardized, validated measurements of posture and balance in the evaluation of all musicians who report to a health professional with neuromusculoskeletal pain. This will not only allow researchers to determine the effect of postural righting dysfunction on neuromusculoskeletal injuries in musicians, but also may provide a foundation for clinicians to develop effective interventions.

The aim of this special issue is to present empirical research outcomes and theoretical works that use the concept of legal culture to characterize the approach of the sociology of law. The papers presented were called for at the Oñati Workshop on Legal Culture and empirical research, originally planned for May 2020, but actually held in May 2021, on the initiative of the International Institute of Sociology of Law, and the Sociology of Law Section of the Italian Sociological Association. After an intense meeting, papers were submitted for the standard review process of the Iisl series. We considered that including the concept of legal culture into the research design and insisting on this focus for debate, could be a way of improving the socio-legal character of our research and settling the many disputes in a continuous debate. So, we looked for research experiences in which the concept of legal culture was used to configure legal phenomena in a specifically socio-legal way.

O'Malley et al. (2009) and Haufe (2013) suggest that the philosophical idea of science as hypothesis testing generates a pernicious bias towards hypothesis-driven research and against exploratory research in the review process of research proposals and the allocation of resources. This paper addresses a conceptual objection to the argument by O'Malley et al. (2009) and Haufe (2013). We argue that the funding agencies' concepts of good science do not belong to epistemological or philosophical contexts but to political and institutional contexts. This means that correcting (potential) biases in research funding does not entail correcting funding agencies' (supposed) philosophies of science. To illustrate this point, we provide an in-depth historical case study: the granting of funds to neuroscientist Pedro Maldonado by the Chilean funding programme FONDECYT. This is a relevant comparison as FONDECYT's guidelines explicitly promote hypothesis-driven research and endorse a view of "good science" as hypothesis testing. However, we will see that the overall influence of the philosophical idea of science as hypothesis testing over this funding programme, the research project, and the actual practice of hypothesis testing is somewhat limited. The concept of science as hypothesis testing seems to play a crucial institutional or political (not philosophical) role in allowing the conceptual articulation of social expectations and researchers' expectations.

Stress responses are believed to involve corticotropin releasing factor (CRF), its two cognate receptors (CRFWe miniaturized a cell-based assay, where CRFBP(10kD) is fused as a chimera with CRFWe found that CRFBP(10kD) potentiates CRF-intracellular CaThese results provide the first evidence of specific roles for CRF

To identify the most disruptive publications, which are those that are cited more frequently than their own references, in academic radiology journals and their characteristics, such as the number of authors and relative time to publication.A comprehensive literature search was undertaken to identify the 100 most disruptive publications in the field of radiology. Subsequently, statistical analysis was applied to establish the distribution of disruptive scores of the isolated publications using a non-parametric probability density function. The relation between disruptive scores and citation counts was then determined, with the aid of a correlation coefficient. Finally, data regarding any significant connection between disruption scores and time of publication, number of authors, and study design were examined.Analysing the top 100 papers in increments of 10-year periods showed no significant difference in the distribution of disruption scores over time. No correlation between an article's citation count and disruption score was established. Additionally, no significant relation between the number of authors/study design and disruption scores was identified.The disruption score highlights significant impact elements not entirely accounted for by citation count. Its potential benefit in assessing scientific impact should be contemplated.

In this article, we compare and contrast methods of reviewing, summarizing, and synthesizing the literature, including systematic reviews, scoping reviews, and narrative reviews. Review articles are essential to help investigators wade through the plethora of exponentially growing medical literature. In the era of evidence-based medicine, a systematic approach is required. A systematic review is a formalized method to address a specific clinical question by analyzing the breadth of published literature while minimizing bias. Systematic reviews are designed to answer narrow clinical questions in the PICO (population, intervention, comparison, and outcome) format. Alternatively, scoping reviews use a similar systematic approach to a literature search in order to determine the breadth and depth of knowledge on a topic; to clarify definitions, concepts, and themes; or sometimes as a precursor to a systematic review or hypothesis generator to guide future research. However, scoping reviews are less constrained by a priori decisions about which interventions, controls, and outcomes may be of interest. Traditional narrative reviews still have a role in informing practice and guiding research, particularly when there is a paucity of high-quality evidence on a topic.

Objectives: Poor complementary feeding practices have consistently contributed to the burden of child undernutrition in Indonesia. This study aimed to estimate the prevalence and predictors of the time of the introduction of solid, semi-solid, and soft foods (ISSSF), minimum dietary diversity (MDD), minimum meal frequency (MMF), and minimum acceptable diet (MAD).Methods: We analyzed 4804 last-born infants aged 6-23 months from the 2017 Indonesia Demographic and Health Survey, which employed multistage cluster random sampling. The outcomes were calculated based on the 2021 World Health Organization/United Nations Children’s Fund guidelines. The predictors of the 4 complementary feeding indicators were assessed using multivariate Poisson regression with robust variance adjusting for potential confounders and study design.Results: The prevalence of ISSSF, MDD, MMF, and MAD was 86.1%, 54.3%, 71.8%, and 37.6%, respectively, with younger children less likely to meet 3 out of the 4 outcomes. Parental education, the presence of a birth attendant, and maternal media consumption were among the predictors of MDD and MAD. Children from families with higher income were more likely to meet MDD than those from low-income households (adjusted prevalence ratio [aPR], 1.16; 95% confidence interval [CI], 1.05 to 1.28). Living in an urban area was positively associated with MMF (aPR, 1.09; 95% CI, 1.04 to 1.15) and MAD (aPR, 1.12; 95% CI 1.02 to 1.24). In eastern regions, the prevalence of children achieving MDD and MAD was lower than in those living in Java and Bali.Conclusions: It is crucial that more attention and efforts are made to improve the recommended practices throughout Indonesia, since the prevalence of adequate complementary feeding practices remains low.

Background The promotion of healthy lifestyles has high priority on the global public health agenda. Evidence on the real-world (cost-)effectiveness of policies addressing nutrition and physical activity is needed. To estimate short-term policy impacts, quasi-experimental methods using observational data are useful, while simulation models can estimate long-term impacts. We review the methods, challenges and potential synergies of both approaches for the evaluation of nutrition and physical activity policies. Methods We performed an integrative review applying purposive literature sampling techniques to synthesize original articles, systematic reviews and lessons learned from public international workshops conducted within the European Union Policy Evaluation Network. Results We highlight data requirements for policy evaluations, discuss the distinct assumptions of instrumental variable, difference-in-difference, and regression discontinuity designs and describe the necessary robustness and falsification analyses to test them. Further, we summarize the specific assumptions of comparative risk assessment and Markov state-transition simulation models, including their extension to microsimulation. We describe the advantages and limitations of these modelling approaches and discuss future directions, such as the adequate consideration of heterogeneous policy responses. Finally, we highlight how quasi-experimental and simulation modelling methods can be integrated into an evidence cycle for policy evaluation. Conclusions Assumptions of quasi-experimental and simulation modelling methods in policy evaluations should be credible, rigorously tested and transparently communicated. Both approaches can be applied synergistically within a coherent framework to compare policy implementation scenarios and improve the estimation of nutrition and physical activity policy impacts, including their distribution across population sub-groups.

Motivation. In the modern world of information technology, the need for ensuring the safety of wireless transmissions while transiting through a given network is growing rapidly. The process of transmitting images via a wireless network is fraught with difficulty. There is a possibility that data may be corrupted while being transmitted, which would result in an image with low resolution. Both of these issues were investigated head-on in this research methodology using the aiding double space-time block coding (DSTTD) system and the self-super-resolution (SSR) method. Description. In recent times, medical image transmission over a wireless network has received a significant amount of attention, as a result of the sharing of medical images between patients and doctors. They would want to make sure that the image was sent in a risk-free and protected manner. Arnold cat map, often known as ACM, is a well-known and widely implemented method of image transmission encryption that has been in use for quite some time. At the receiver end, SSR is now being employed in order to view the transmitted medical image in the finest possible resolution. It is anticipated that in the near future, image transmission through wireless DSTTD will be technically feasible. This is performed in order to maximize the benefits that the system has to offer in terms of both spatial diversity and multiplexing as much as is possible. Conclusion. The SSR approach is used in order to represent the image in a document pertaining to human resources. ACM is used so that the image may be sent in a risk-free and protected way. The adoption of a DSTTD-based architecture for wireless communication is suggested. A comparison of the results is provided, and PSNR and SSIM values are detailed towards the results and discussion of the article.

OBJECTIVE To assess the prevalence of household food insecurity (HFI) and Supplemental Nutrition Assistance Program (SNAP) participation among youth and young adults (YYA) with diabetes overall and by type, and sociodemographic characteristics. RESEARCH DESIGN AND METHODS The study included participants with youth-onset type 1 diabetes and type 2 diabetes from the SEARCH for Diabetes in Youth study. HFI was assessed using the 18-item U.S. Household Food Security Survey Module (HFSSM) administered from 2016 to 2019; three or more affirmations on the HFSSM were considered indicative of HFI. Participants were asked about SNAP participation. We used χ2 tests to assess whether the prevalence of HFI and SNAP participation differed by diabetes type. Multivariable logistic regression models were used to examine differences in HFI by participant characteristics. RESULTS Of 2,561 respondents (age range, 10–35 years; 79.6% ≤25 years), 2,177 had type 1 diabetes (mean age, 21.0 years; 71.8% non-Hispanic White, 11.8% non-Hispanic Black, 13.3% Hispanic, and 3.1% other) and 384 had type 2 diabetes (mean age, 24.7 years; 18.8% non-Hispanic White, 45.8% non-Hispanic Black, 23.7% Hispanic, and 18.7% other). The overall prevalence of HFI was 19.7% (95% CI 18.1, 21.2). HFI was more prevalent in type 2 diabetes than type 1 diabetes (30.7% vs. 17.7%; P < 0.01). In multivariable regression models, YYA receiving Medicaid or Medicare or without insurance, whose parents had lower levels of education, and with lower household income had greater odds of experiencing HFI. SNAP participation was 14.1% (95% CI 12.7, 15.5), with greater participation among those with type 2 diabetes compared with those with type 1 diabetes (34.8% vs. 10.7%; P < 0.001). CONCLUSIONS Almost one in three YYA with type 2 diabetes and more than one in six with type 1 diabetes reported HFI in the past year—a significantly higher prevalence than in the general U.S. population.

Objectives The aim of this study was to evaluate, using echocardiography, the effects of oral administration of a single dose of gabapentin on the physiologic variables (heart rate [HR], respiratory rate [RR] and systolic blood pressure [SBP]) and systolic and diastolic cardiac function of healthy cats. Methods This was a prospective, randomized and blinded study with 40 healthy cats aged between 6 months and 2 years. The cats’ health status was assessed on the first appointment (T1) when they underwent a physical examination, complete blood count, biochemical profile, assessment of physiologic variables and echocardiogram. The echocardiogram was used to measure the left ventricle’s (LV) internal diameter during systole and diastole, isovolumic relaxation time, transmitral flow, E-wave deceleration time and HR. The cats were randomly divided into two groups: (1) a treatment group with 20 cats that received a single oral dose of gabapentin (100 mg/cat); and (2) a control group with 20 cats that received a single oral dose of placebo. All variables of the physiologic and echocardiographic variables were re-evaluated 1–3 weeks after T1 (T2), 90 mins after medication or placebo administration. Results There was no difference in the physiologic variables evaluated in both groups. The proportion of cats in the treatment group that had their ventricular filling waves fused on T1 but did not have them fused on T2 was significantly higher (45%) compared with cats in the control group (15%; P = 0.0384). Conclusions and relevance There was no difference between the groups in regard to SBP, HR, RR and echocardiographic variables. Gabapentin improved evaluation of diastolic function on echocardiogram because it reduced the fusion of ventricular filling waves during the evaluation of the diastolic function of the LV. Gabapentin did not cause adverse effects on the cardiovascular hemodynamics of young healthy cats.

Purpose: The purpose of this article is to explain the key reasons for the existence of statistics in doctoral-level research, why and when statistical techniques are to be used, how to statistically describe the units of analysis/samples, how to statistically describe the data collected from units of analysis/samples; how to statistically discover the relationship between variables of the research question; a step-by-step process of statistical significance/hypothesis test, tricks for selecting an appropriate statistical significance test, and most importantly which is the most user-friendly and free software for carrying out statistical analyses. In turn, guiding Ph.D. scholars to choose appropriate statistical techniques across various stages of the doctoral-level research process to ensure a high-quality research output. Design/Methodology/Approach: Postmodernism philosophical paradigm; Inductive research approach; Observation data collection method; Longitudinal data collection time frame; Qualitative data analysis. Findings/Result: As long as the Ph.D. scholars can understand i) they need NOT be an expert in Mathematics/Statistics and it is easy to learn statistics during Ph.D.; ii) the difference between measures of central tendency and dispersion; iii) the difference between association, correlation, and causation; iv) difference between null and research/alternate hypotheses; v) difference between Type I and Type II errors; vi) key drivers for choosing a statistical significance test; vi) which is the best software for carrying out statistical analyses. Scholars will be able to (on their own) choose appropriate statistical techniques across various steps of the doctoral-level research process and comfortably claim their research findings. Originality/Value: There is a vast literature about statistics, probability theory, measures of central tendency and dispersion, formulas for finding the relationship between variables, and statistical significance tests. However, only a few have explained them together comprehensively which is conceivable to Ph.D. scholars. In this article, we have attempted to explain the reasons for the existence, objectives, purposes, and essence of ‘Statistics’ briefly and comprehensively with simple examples and tricks that would eradicate fear among Ph.D. scholars about ‘Statistics’. Paper Type: Conceptual.

Purpose: The purpose of this article is to explain various types of data collection instruments, and available techniques for checking the calibration, validity, and reliability of the data collection instrument, in turn, guiding Ph.D. scholars to use a well-calibrated, valid, and reliable data collection instrument to ensure high-quality of research output. Design/Methodology/Approach: Postmodernism philosophical paradigm; Inductive research approach; Observation data collection method; Longitudinal data collection time frame; Qualitative data analysis. Findings/Result: As long as the Ph.D. scholars can understand the existing research data collection instruments and realize the need for the development of a new instrument and make mindful choices of instruments in addition to checking their calibration, validity, and reliability before collecting the research data to answer their research question they will be able to determine (on their own) data analysis techniques and appropriate statistical techniques in subsequent stages of the doctoral-level research process to comfortably claim their research findings. Originality/Value: There is a vast literature about research data collection instruments and procedures to check their calibration, validity, and reliability. However, only a few have explained them together comprehensively which is conceivable to Ph.D. scholars. In this article, we have attempted to briefly explain various types of data collection instruments, and available techniques for checking the calibration, validity, and reliability of the data collection instrument. Paper Type: Conceptual.

Null-hypothesis significance testing (NHST) has become the main tool of inference in neuroscience, and yet evidence suggests we do not use this tool well: tests are often planned poorly, conducted unfairly, and interpreted invalidly. This editorial makes the case that in addition to reforms to increase rigor we should test less, reserving NHST for clearly confirmatory contexts in which the researcher has derived a quantitative prediction, can provide the inputs needed to plan a quality test, and can specify the criteria not only for confirming their hypothesis but also for rejecting it. A reduction in testing would be accompanied by an expansion of the use of estimation [effect sizes and confidence intervals (CIs)]. Estimation is more suitable for exploratory research, provides the inputs needed to plan strong tests, and provides important contexts for properly interpreting tests.

Experimental neuroscience typically uses “p-valued” statistical testing procedures (null hypothesis significance testing; NHST) in evaluating its results. The rote, often misguided, application of NHST (Gigerenzer, 2008) has led to errors and “questionable research practices.” Although the problems could be avoided with better statistics training (Lakens, 2021), there have been calls to abandon NHST altogether. One suggestion is to replace NHST with “estimation statistics” (Cumming and Calin-Jageman, 2017; Calin-Jageman and Cumming, 2019). Estimation statistics emphasizes the uncertainty inherent in scientific investigations and uses metrics, e.g., confidence intervals (CIs), that draw attention to uncertainty. Besides procedural steps and methods, the Estimation Approach prefers expressing “quantitative,” rather than “qualitative” conclusions and making generalizations, rather than testing scientific hypotheses. The Estimation Approach embodies a philosophy of science—its ultimate goals, experimental mindset, and specific aims—that diverges unhelpfully from what laboratory-based neuroscience needs. The Estimation Approach meshes naturally with, e.g., clinical neuroscience, drug development, human psychology, and social sciences. It fits less well with much of the neuroscience published in theJournal of Neuroscience, for example. In contrast, the philosophy behind NHST fits naturally with traditional, evaluative testing of scientific hypotheses. Finally, some Estimation Approach remedies, e.g., replication, ideally with “preregistration,” are incompatible with much experimental neuroscience. This Dual Perspective essay argues that, while neuroscience can benefit from practical aspects of estimation statistics, entirely replacing conventional methods with the Estimation Approach would be a mistake. NHST testing should be retained and improved.SIGNIFICANCE STATEMENTExperimental neuroscience relies on statistical procedures to assess the meaning and importance of its research findings. Optimal scientific communication demands a common set of assumptions for expressing and evaluating results. Problems arising from misuse of conventional significance testing methods have led to a proposal to replace significance testing with an Estimation Statistics Approach. Practical elements of the Estimation Approach can usefully be incorporated into conventional methods. However, the prevailing philosophy of the Estimation Approach does not address certain important needs of much experimental neuroscience. Neuroscience should adopt beneficial elements of the Estimation Approach without giving up the advantages of significance testing.