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BackgroundThe contrasting groups’ standard setting method is commonly used for consequences analysis in validity studies for performance in medicine and surgery. The method identifies a pass/fail cut-off score, from which it is possible to determine false positives and false negatives based on observed numbers in each group. Since groups in validity studies are often small, e.g., due to a limited number of experts, these analyses are sensitive to outliers on the normal distribution curve.MethodsWe propose that these shortcomings can be addressed in a simple manner using the cumulative distribution function.ResultsWe demonstrate considerable absolute differences between the observed false positives/negatives and the theoretical false positives/negatives. In addition, several important examples are given.ConclusionsWe propose that a better reporting strategy is to report theoretical false positives and false negatives together with the observed false positives and negatives, and we have developed an Excel sheet to facilitate such calculations.Trial registrationNot relevant.Electronic supplementary materialThe online version of this article (10.1186/s41077-018-0064-7) contains supplementary material, which is available to authorized users.

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Patients with chronic pain may have cognitive dysfunction related to some reversible factors, which can be optimized by therapeutic interventions.

Background Cognitive disturbances are common and disabling features of major depressive disorder (MDD). Previous studies provide limited insight into the co-occurrence of hot (emotion-dependent) and cold (emotion-independent) cognitive disturbances in MDD. Therefore, we here map both hot and cold cognition in depressed patients compared to healthy individuals. Methods We collected neuropsychological data from 92 antidepressant-free MDD patients and 103 healthy controls. All participants completed a comprehensive neuropsychological test battery assessing hot cognition including emotion processing, affective verbal memory and social cognition as well as cold cognition including verbal and working memory and reaction time. Results The depressed patients showed small to moderate negative affective biases on emotion processing outcomes, moderate increases in ratings of guilt and shame and moderate deficits in verbal and working memory as well as moderately slowed reaction time compared to healthy controls. We observed no correlations between individual cognitive tasks and depression severity in the depressed patients. Lastly, an exploratory cluster analysis suggested the presence of three cognitive profiles in MDD: one characterised predominantly by disturbed hot cognitive functions, one characterised predominantly by disturbed cold cognitive functions and one characterised by global impairment across all cognitive domains. Notably, the three cognitive profiles differed in depression severity. Conclusion We identified a pattern of small to moderate disturbances in both hot and cold cognition in MDD. While none of the individual cognitive outcomes mapped onto depression severity, cognitive profile clusters did. Overall cognition-based stratification tools may be useful in precision medicine approaches to MDD.

The paper contains the results of light microscopical, electron microscopical and histochemical examinations of chronic otitis media, with and without cholesteatoma, with special focus on the problems regarding bone resorption. It is demonstrated that bone resorption takes place without the presence of cholesteatoma itself, even though the magnitude of resorption is higher in the cases with cholesteatoma. It is demonstrated that there is always a layer of subepithelial granulation tissue between the cholesteatoma membrane and the underlying bone. The picture in the resorbing zone is dominated by mononuclear histiocyte like cells, containing dense cytoplasmatic bodies, called lysosomes, and it is demonstrated that the marker enzyme for acid hydrolases, the acid phosphatase, is present in large quantities, both in the histiocytes, as well as spread along the bony surface. It is concluded that a possible mechanism for bone resorption is performed by the acid hydrolases, contained in the histiocytes, working at acid pH. It is noteworthy that the multinucleated osteoclast is not demonstrated in the resorbing margin of bone and that the picture is dominated by capillary proliferation, indicating that ischemia does not play a role in bone resorption. On the contrary, this is in the author's opinion caused by inflammation and hyperemia. The various factors influencing bone resorption in general and in chronic otitis media are discussed and a new model for studying cholesteatoma pathology in the middle ear is presented.

PT clearly benefitted the patients studied, except for IC disease where differences between PT and XT were modest, and comparative PT and XT treatment planning is warranted prior to referral.

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