Science.gov

Sample records for accepted diagnostic criteria

  1. [BMW diagnostic criteria for IBS].

    PubMed

    Matsueda, Kei

    2006-08-01

    Rome I diagnostic criteria for IBS was published in 1992 and it became a global diagnostic criteria. However, the criteria was not practical and somewhat complicated. Moreover, its symptomatic duration was too long (defined as more than 3 months) to be introduced in clinical practice. Therefore, Japanese member of BMW(Bowel Motility Workshop) tried to develop a new diagnostic criteria for IBS and it was established in 1995 by way of the Delphi method. The criteria was named as BMW diagnostic criteria and it was shown below: BMW diagnostic criteria for IBS (1995) At least one month or more of repetitive symptoms of the following 1) and 2) and no evidence of organic disease that likely to explain the symptoms. 1) Existence of abdominal pain, abdominal discomfort or abdominal distension 2) Existence of abnormal bowel movement (diarrhea, constipation) Abnormal bowel movement includes at least one of the below; (1) Abnormal stool frequency (2) Abnormal stool form (lumpy/hard or loose/wartery stool) Moreover, the following test should be performed as a rule to exclude organic diseases. (1) Urinalysis, fecal occult blood testing, CBC, chemistry (2) Barium enema or colonofiberscopic examination The other diagnostic criteria for IBS was also reviewed and their characteristics were compared with BMW diagnostic criteria.

  2. Hanford Site liquid waste acceptance criteria

    SciTech Connect

    LUECK, K.J.

    1999-09-11

    This document provides the waste acceptance criteria for liquid waste managed by Waste Management Federal Services of Hanford, Inc. (WMH). These waste acceptance criteria address the various requirements to operate a facility in compliance with applicable environmental, safety, and operational requirements. This document also addresses the sitewide miscellaneous streams program.

  3. Comparison of diagnostic criteria for polycythaemia vera.

    PubMed

    Turkington, Richard C; Arnold, E Claire; Percy, Melanie J; Ranaghan, Lisa A; Cuthbert, Robert J G; McMullin, Mary F

    2007-04-01

    Three sets of diagnostic criteria for polycythaemia vera (PV); the Polycythaemia Vera Study Group (PVSG) criteria (1975), the British Committee for Standards in Haematology (BCSH) criteria (1996) and the World Health Organisation (WHO) criteria (2001) have been described. We compared the ability of each set of criteria to accurately diagnose PV and differentiate it from secondary, apparent and idiopathic erythrocytosis. A cohort was drawn from a clinical database of erythrocytosis patients currently attending the Belfast City Hospital and the relevant information from the time of diagnosis for each patient was assessed according to each set of criteria, with the BCSH criteria used as a comparator. Sufficient data was available on 71 patients: 46 PV, 8 idiopathic, 8 apparent and 9 secondary erythrocytosis. The BCSH criteria classified 34 of 46 patients (73.9%) as PV and the WHO criteria had a sensitivity and specificity of 100% for classifying PV. For idiopathic and apparent erythrocytosis, the specificity of the WHO criteria, compared to the BCSH criteria, declined to 66.7 and 87.5%, respectively. The PVSG criteria were limited by the unavailability of required data for some patients resulting in a sensitivity and specificity of 50% for PV and specificity of 100% for all other groups. The Janus kinase 2 (JAK2) V617F mutation was present in 34 (85.3%) PV, 2 (50%) IE, 1 (50%) apparent and no secondary erythrocytosis cases. We concluded that the BCSH criteria were the most accurate diagnostic criteria for PV as they had an acceptable level of sensitivity and could differentiate between PV and other erythrocytoses.

  4. Nevada Test Site Waste Acceptance Criteria (NTSWAC)

    SciTech Connect

    NNSA /NSO Waste Management Project

    2008-06-01

    This document establishes the U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office, Nevada Test Site Waste Acceptance Criteria (NTSWAC). The NTSWAC provides the requirements, terms, and conditions under which the Nevada Test Site will accept low-level radioactive (LLW) and LLW Mixed Waste (MW) for disposal.

  5. Hanford Site Solid Waste Acceptance Criteria

    SciTech Connect

    Not Available

    1993-11-17

    This manual defines the Hanford Site radioactive, hazardous, and sanitary solid waste acceptance criteria. Criteria in the manual represent a guide for meeting state and federal regulations; DOE Orders; Hanford Site requirements; and other rules, regulations, guidelines, and standards as they apply to acceptance of radioactive and hazardous solid waste at the Hanford Site. It is not the intent of this manual to be all inclusive of the regulations; rather, it is intended that the manual provide the waste generator with only the requirements that waste must meet in order to be accepted at Hanford Site TSD facilities.

  6. Acceptance criteria for method equivalency assessments.

    PubMed

    Chatfield, Marion J; Borman, Phil J

    2009-12-15

    Quality by design (ICH-Topic Q8) requires that process control strategy requirements are met and maintained. The challenging task of setting appropriate acceptance criteria for assessment of method equivalence is a critical component of satisfying these requirements. The use of these criteria will support changes made to methods across the product lifecycle. A method equivalence assessment is required when a change is made to a method which may pose a risk to its ability to monitor the quality of the process. Establishing appropriate acceptance criteria are a vital, but not clearly understood, prerequisite to deciding the appropriate design/sample size of the equivalency study. A number of approaches are proposed in the literature for setting acceptance criteria for equivalence which address different purposes. This perspective discusses those purposes and then provides more details on setting acceptance criteria based on patient and producer risk, e.g., tolerance interval approach and the consideration of method or process capability. Applying these to a drug substance assay method for batch release illustrates that, for the equivalence assessment to be meaningful, a clear understanding and appraisal of the control requirements of the method is needed. Rather than a single exact algorithm, the analyst's judgment on a number of aspects is required in deciding the appropriate acceptance criteria.

  7. Hanford Site solid waste acceptance criteria

    SciTech Connect

    Ellefson, M.D.

    1998-07-01

    Order 5820.2A requires that each treatment, storage, and/or disposal facility (referred to in this document as TSD unit) that manages low-level or transuranic waste (including mixed waste and TSCA PCB waste) maintain waste acceptance criteria. These criteria must address the various requirements to operate the TSD unit in compliance with applicable safety and environmental requirements. This document sets forth the baseline criteria for acceptance of radioactive waste at TSD units operated by WMH. The criteria for each TSD unit have been established to ensure that waste accepted can be managed in a manner that is within the operating requirements of the unit, including environmental regulations, DOE Orders, permits, technical safety requirements, waste analysis plans, performance assessments, and other applicable requirements. Acceptance criteria apply to the following TSD units: the Low-Level Burial Grounds (LLBG) including both the nonregulated portions of the LLBG and trenches 31 and 34 of the 218-W-5 Burial Ground for mixed waste disposal; Central Waste Complex (CWC); Waste Receiving and Processing Facility (WRAP); and T Plant Complex. Waste from all generators, both from the Hanford Site and from offsite facilities, must comply with these criteria. Exceptions can be granted as provided in Section 1.6. Specific waste streams could have additional requirements based on the 1901 identified TSD pathway. These requirements are communicated in the Waste Specification Records (WSRds). The Hanford Site manages nonradioactive waste through direct shipments to offsite contractors. The waste acceptance requirements of the offsite TSD facility must be met for these nonradioactive wastes. This document does not address the acceptance requirements of these offsite facilities.

  8. Nevada Test Site Waste Acceptance Criteria

    SciTech Connect

    U. S. Department of Energy, National Nuclear Security Administration Nevada Site Office

    2005-10-01

    This document establishes the U.S. Department of Energy (DOE), National Nuclear Security Administration Nevada Site Office (NNSA/NSO) waste acceptance criteria (WAC). The WAC provides the requirements, terms, and conditions under which the Nevada Test Site (NTS) will accept low-level radioactive (LLW) and mixed waste (MW) for disposal. It includes requirements for the generator waste certification program, characterization, traceability, waste form, packaging, and transfer. The criteria apply to radioactive waste received at the NTS Area 3 and Area 5 Radioactive Waste Management Complex (RWMC) for storage or disposal.

  9. Nevada National Security Site Waste Acceptance Criteria

    SciTech Connect

    NSTec Environmental Management

    2011-01-01

    This document establishes the U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office (NNSA/NSO) Nevada National Security Site Waste Acceptance Criteria (NNSSWAC). The NNSSWAC provides the requirements, terms, and conditions under which the Nevada National Security Site (NNSS) will accept low-level radioactive waste and mixed low-level waste for disposal. The NNSSWAC includes requirements for the generator waste certification program, characterization, traceability, waste form, packaging, and transfer. The criteria apply to radioactive waste received at the NNSS Area 3 and Area 5 Radioactive Waste Management Complex for disposal. The NNSA/NSO and support contractors are available to assist you in understanding or interpreting this document. For assistance, please call the NNSA/NSO Waste Management Project at (702) 295-7063 or fax to (702) 295-1153.

  10. Nevada National Security Site Waste Acceptance Criteria

    SciTech Connect

    NSTec Environmental Management

    2010-09-03

    This document establishes the U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office (NNSA/NSO) Nevada National Security Site Waste Acceptance Criteria (NNSSWAC). The NNSSWAC provides the requirements, terms, and conditions under which the Nevada National Security Site (NNSS) will accept low-level radioactive waste and mixed low-level waste for disposal. The NNSSWAC includes requirements for the generator waste certification program, characterization, traceability, waste form, packaging, and transfer. The criteria apply to radioactive waste received at the NNSS Area 3 and Area 5 Radioactive Waste Management Complex for disposal. The NNSA/NSO and support contractors are available to assist you in understanding or interpreting this document. For assistance, please call the NNSA/NSO Waste Management Project at (702) 295-7063 or fax to (702) 295-1153.

  11. Acceptance Criteria Framework for Autonomous Biological Detectors

    SciTech Connect

    Dzenitis, J M

    2006-12-12

    The purpose of this study was to examine a set of user acceptance criteria for autonomous biological detection systems for application in high-traffic, public facilities. The test case for the acceptance criteria was the Autonomous Pathogen Detection System (APDS) operating in high-traffic facilities in New York City (NYC). However, the acceptance criteria were designed to be generally applicable to other biological detection systems in other locations. For such detection systems, ''users'' will include local authorities (e.g., facility operators, public health officials, and law enforcement personnel) and national authorities [including personnel from the Department of Homeland Security (DHS), the BioWatch Program, the Centers for Disease Control and Prevention (CDC), and the Federal Bureau of Investigation (FBI)]. The panel members brought expertise from a broad range of backgrounds to complete this picture. The goals of this document are: (1) To serve as informal guidance for users in considering the benefits and costs of these systems. (2) To serve as informal guidance for developers in understanding the needs of users. In follow-up work, this framework will be used to systematically document the APDS for appropriateness and readiness for use in NYC.

  12. Nevada National Security Site Waste Acceptance Criteria

    SciTech Connect

    NSTec Environmental Management

    2012-02-28

    This document establishes the U.S. Department of Energy (DOE), National Nuclear Security Administration Nevada Site Office (NNSA/NSO), Nevada National Security Site Waste Acceptance Criteria (NNSSWAC). The NNSSWAC provides the requirements, terms, and conditions under which the Nevada National Security Site (NNSS) will accept DOE non-radioactive classified waste, DOE non-radioactive hazardous classified waste, DOE low-level radioactive waste (LLW), DOE mixed low-level waste (MLLW), and U.S. Department of Defense (DOD) classified waste for permanent disposal. Classified waste is the only waste accepted for disposal that may be non-radioactive and will be required to meet the waste acceptance criteria for radioactive waste as specified in this document. The NNSA/NSO and support contractors are available to assist you in understanding or interpreting this document. For assistance, please call the NNSA/NSO Waste Management Project (WMP) at (702) 295-7063, and your call will be directed to the appropriate contact.

  13. Nevada National Security Site Waste Acceptance Criteria

    SciTech Connect

    none,

    2013-06-01

    This document establishes the U.S. Department of Energy (DOE), National Nuclear Security Administration Nevada Field Office (NNSA/NFO), Nevada National Security Site Waste Acceptance Criteria (NNSSWAC). The NNSSWAC provides the requirements, terms, and conditions under which the Nevada National Security Site (NNSS) will accept the following: • DOE hazardous and non-hazardous non-radioactive classified waste • DOE low-level radioactive waste (LLW) • DOE mixed low-level waste (MLLW) • U.S. Department of Defense (DOD) classified waste The LLW and MLLW listed above may also be classified waste. Classified waste is the only waste accepted for disposal that may be non-radioactive and shall be required to meet the waste acceptance criteria for radioactive waste as specified in this document. Classified waste may be sent to the NNSS as classified matter. Section 3.1.18 provides the requirements that must be met for permanent burial of classified matter. The NNSA/NFO and support contractors are available to assist the generator in understanding or interpreting this document. For assistance, please call the NNSA/NFO Environmental Management Operations (EMO) at (702) 295-7063, and the call will be directed to the appropriate contact.

  14. STOL ride quality criteria - Passenger acceptance.

    NASA Technical Reports Server (NTRS)

    Jacobson, I. D.; Kuhlthau, A. R.

    1972-01-01

    The ability to mathematically model human reaction to variables involved in transportation systems offers a very desirable tool both for the prediction of passenger acceptance of proposed systems, and for establishing acceptance criteria for the system designer. As a first step in the development of a general model for STOL systems, a mathematical formulation is presented which accepts as inputs nine variables felt to be important in flight under STOL-type conditions and presents an index of human response as the output. The variables used are three linear motions, three angular motions, pressure, temperature and noise level. The results are used to establish specifications for stability augmentation systems to improve the ride quality of existing STOL aircraft.

  15. Acceptance criteria for urban dispersion model evaluation

    NASA Astrophysics Data System (ADS)

    Hanna, Steven; Chang, Joseph

    2012-05-01

    The authors suggested acceptance criteria for rural dispersion models' performance measures in this journal in 2004. The current paper suggests modified values of acceptance criteria for urban applications and tests them with tracer data from four urban field experiments. For the arc-maximum concentrations, the fractional bias should have a magnitude <0.67 (i.e., the relative mean bias is less than a factor of 2); the normalized mean-square error should be <6 (i.e., the random scatter is less than about 2.4 times the mean); and the fraction of predictions that are within a factor of two of the observations (FAC2) should be >0.3. For all data paired in space, for which a threshold concentration must always be defined, the normalized absolute difference should be <0.50, when the threshold is three times the instrument's limit of quantification (LOQ). An overall criterion is then applied that the total set of acceptance criteria should be satisfied in at least half of the field experiments. These acceptance criteria are applied to evaluations of the US Department of Defense's Joint Effects Model (JEM) with tracer data from US urban field experiments in Salt Lake City (U2000), Oklahoma City (JU2003), and Manhattan (MSG05 and MID05). JEM includes the SCIPUFF dispersion model with the urban canopy option and the urban dispersion model (UDM) option. In each set of evaluations, three or four likely options are tested for meteorological inputs (e.g., a local building top wind speed, the closest National Weather Service airport observations, or outputs from numerical weather prediction models). It is found that, due to large natural variability in the urban data, there is not a large difference between the performance measures for the two model options and the three or four meteorological input options. The more detailed UDM and the state-of-the-art numerical weather models do provide a slight improvement over the other options. The proposed urban dispersion model acceptance

  16. Natural hazard losses and acceptable risk criteria

    NASA Astrophysics Data System (ADS)

    Khaleghy Rad, M.; Evans, S. G.; Nadim, F.; Lacasse, S.

    2009-12-01

    The criteria for the definition of acceptable risk to the lives of members of a society (commonly called societal risk) resulting from exposure to natural hazards are based in most countries on the frequency and characteristics of industrial accidents, e.g., nuclear power plants. However, historical records indicate that the frequency of natural hazard events is much higher than those involved in industrial hazards and their consequences are far greater. We find that the risk from natural hazards is unacceptable in the current risk criteria framework, i.e., they are an unacceptable risk with respect to the acceptable risk criteria based on the frequency and consequences of industrial accidents. According to a definition of risk, there are two main components; first, the probability of occurrence of the hazard and second, the consequence of the hazard. The occurrence of industrial accident events (hazard) can be controlled to a large extent in contrast to that of natural hazards. However, we can control natural hazard risk, in some cases by engineering solutions to control hazard and by reducing the consequences of the events by mitigating, risk management, warning and monitoring techniques. With reference to natural hazards reducing risk is mainly effected by reducing consequences. The FN-curve is a tool commonly used in societal risk assessment. It is built on a series of frequency-loss data associated with a particular process in a given period of time. It is also used to set acceptable risk criteria for countries or sub-national jurisdictions, by defining slopes and intercepts for plots of a particular (or group of) processes. The intercept of the acceptable risk curve is usually arbitrarily defined in the order of 10-7-10-1 deaths per year, and the slope criteria is based on an adopted aversion factor of the society to accident and disaster losses.The imposed slope criteria is usually between -1 and -2 whereas the slope of FN-curves based on real natural

  17. Proposed Diagnostic Criteria for Smartphone Addiction

    PubMed Central

    Lin, Yu-Hsuan; Chiang, Chih-Lin; Lin, Po-Hsien; Chang, Li-Ren; Ko, Chih-Hung; Lee, Yang-Han

    2016-01-01

    Background Global smartphone penetration has led to unprecedented addictive behaviors. The aims of this study are to develop diagnostic criteria of smartphone addiction and to examine the discriminative ability and the validity of the diagnostic criteria. Methods We developed twelve candidate criteria for characteristic symptoms of smartphone addiction and four criteria for functional impairment caused by excessive smartphone use. The participants consisted of 281 college students. Each participant was systematically assessed for smartphone-using behaviors by psychiatrist’s structured diagnostic interview. The sensitivity, specificity, and diagnostic accuracy of the candidate symptom criteria were analyzed with reference to the psychiatrists’ clinical global impression. The optimal model selection with its cutoff point of the diagnostic criteria differentiating the smartphone addicted subjects from non-addicted subjects was then determined by the best diagnostic accuracy. Results Six symptom criteria model with optimal cutoff point were determined based on the maximal diagnostic accuracy. The proposed smartphone addiction diagnostic criteria consisted of (1) six symptom criteria, (2) four functional impairment criteria and (3) exclusion criteria. Setting three symptom criteria as the cutoff point resulted in the highest diagnostic accuracy (84.3%), while the sensitivity and specificity were 79.4% and 87.5%, respectively. We suggested determining the functional impairment by two or more of the four domains considering the high accessibility and penetration of smartphone use. Conclusion The diagnostic criteria of smartphone addiction demonstrated the core symptoms “impaired control” paralleled with substance related and addictive disorders. The functional impairment involved multiple domains provide a strict standard for clinical assessment. PMID:27846211

  18. Development of quantitative risk acceptance criteria

    SciTech Connect

    Griesmeyer, J. M.; Okrent, D.

    1981-01-01

    Some of the major considerations for effective management of risk are discussed, with particular emphasis on risks due to nuclear power plant operations. Although there are impacts associated with the rest of the fuel cycle, they are not addressed here. Several previously published proposals for quantitative risk criteria are reviewed. They range from a simple acceptance criterion on individual risk of death to a quantitative risk management framework. The final section discussed some of the problems in the establishment of a framework for the quantitative management of risk.

  19. Steam generator tube integrity flaw acceptance criteria

    SciTech Connect

    Cochet, B.

    1997-02-01

    The author discusses the establishment of a flaw acceptance criteria with respect to flaws in steam generator tubing. The problem is complicated because different countries take different approaches to the problem. The objectives in general are grouped in three broad areas: to avoid the unscheduled shutdown of the reactor during normal operation; to avoid tube bursts; to avoid excessive leak rates in the event of an accidental overpressure event. For each degradation mechanism in the tubes it is necessary to know answers to an array of questions, including: how well does NDT testing perform against this problem; how rapidly does such degradation develop; how well is this degradation mechanism understood. Based on the above information it is then possible to come up with a policy to look at flaw acceptance. Part of this criteria is a schedule for the frequency of in-service inspection and also a policy for when to plug flawed tubes. The author goes into a broad discussion of each of these points in his paper.

  20. [Diagnostic criteria for neuromyelitisoptica spectrum disorders].

    PubMed

    Belova, A N; Boiko, A N; Belova, E M

    2016-01-01

    The review is devoted to revised international diagnostic criteria for neuromyelitisoptica spectrum disorders (NMOSD).Current diagnostic criteria allow NMOSD diagnosis not only for serum aquaporin-4 immunoglobulin G antibodies (AQP4-IgG)-seropositive patients but for AQP4-IgG-seronegative patients as well. New criteria are expected to make NMOSD diagnosis earlier and more accurate as well as to facilitate the differentiation with multiple sclerosis. Furthermore, unify international criteria should help to perform comparable epidemiologic studies and clinical trials of new drugs for NMOSD.

  1. Structural acceptance criteria Remote Handling Building Tritium Extraction Facility

    SciTech Connect

    Mertz, G.

    1999-12-16

    This structural acceptance criteria contains the requirements for the structural analysis and design of the Remote Handling Building (RHB) in the Tritium Extraction Facility (TEF). The purpose of this acceptance criteria is to identify the specific criteria and methods that will ensure a structurally robust building that will safely perform its intended function and comply with the applicable Department of Energy (DOE) structural requirements.

  2. Evolution of diagnostic criteria for multiple sclerosis.

    PubMed

    Przybek, Joanna; Gniatkowska, Inga; Mirowska-Guzel, Dagmara; Członkowska, Anna

    2015-01-01

    Multiple sclerosis is a chronic demyelinating disease of the central nervous system that occurs primarily in young adults. There is no single diagnostic test to recognize the disease. The diagnostic criteria, based on clinical examination and laboratory tests, have changed considerably over time. The first guidelines involved only the results of the patient's neurological examination. The diagnostic criteria developed by Poser in 1983 were based largely on the results of additional tests, including visual evoked potentials and analysis of cerebrospinal fluid. The McDonald criteria, developed in 2001 and updated in 2005 and 2010, reflected the diagnostic breakthrough caused by widespread use of magnetic resonance imaging (MRI). Currently, the diagnosis depends largely on the results of the MRI examination. An early diagnosis is particularly important for starting disease-modifying treatments.

  3. Nevada Test Site Waste Acceptance Criteria, December 2000

    SciTech Connect

    2000-12-01

    This document establishes the US Department of Energy, Nevada Operations Office waste acceptance criteria. The waste acceptance criteria provides the requirements, terms, and conditions under which the Nevada Test Site will accept low-level radioactive waste and mixed waste for disposal. It includes requirements for the generator waste certification program, characterization, traceability, waste form, packaging, and transfer. The criteria apply to radioactive waste received at the Nevada Test Site Area 3 and Area 5 Radioactive Waste Management Sites for storage or disposal.

  4. Acceptance Criteria for Aerospace Structural Adhesives.

    DTIC Science & Technology

    ADHESIVES, *AIRFRAMES, PRIMERS, STRUCTURAL ENGINEERING, CHEMICAL COMPOSITION, MECHANICAL PROPERTIES, INDUSTRIAL PRODUCTION , DATA ACQUISITION , PARTICLE SIZE, ACCEPTANCE TESTS, ELASTOMERS, BONDING, QUALITY CONTROL, .

  5. Editorial: acceptance criteria and editorial procedures for Optics Letters.

    PubMed

    Zhang, Xi-Cheng; Andersen, Peter E; Justus, Brian L; Galtarossa, Andrea

    2014-09-01

    Optics Letters Editors strive to provide timely reviews and decisions for authors while bringing top quality papers to the optics community. The purpose of this editorial is to explain Optics Letters' acceptance criteria and editorial procedures. Our hope is that greater transparency concerning the decision-making process will increase understanding as well as acceptance of our criteria and procedures.

  6. Nevada Test Site Waste Acceptance Criteria

    SciTech Connect

    U.S. Department of Energy, Nevada Operations Office, Waste Acceptance Criteria

    1999-05-01

    This document provides the requirements, terms, and conditions under which the Nevada Test Site will accept low-level radioactive and mixed waste for disposal; and transuranic and transuranic mixed waste for interim storage at the Nevada Test Site.

  7. Diagnostic criteria for exercise dependence in women

    PubMed Central

    Bamber, D; Cockerill, I; Rodgers, S; Carroll, D

    2003-01-01

    Objective: To formulate diagnostic criteria for exercise dependence. Method: Fifty six adult female exercisers were interviewed about their exercise behaviour and attitudes. The eating disorders examination, a semistructured clinical interview, was used to diagnose eating disorders. Interviews were taped, transcribed verbatim, and analysed from a social constructionist perspective using QSR NUD*IST. Participants also completed the exercise dependence questionnaire. Results: Two diagnostic criteria emerged from analysis of the interview data: impaired functioning and withdrawal. Impaired functioning was manifest in four areas: psychological, social and occupational, physical, and behavioural. Impairment in at least two areas was considered necessary for diagnosis. Withdrawal was evident as either an adverse reaction to the interruption of exercise or unsuccessful attempts at exercise control. Either sufficed for diagnosis. The absence or presence of an eating disorder was used to distinguish between primary and secondary exercise dependence. Ten women met these criteria for exercise dependence. All 10 also exhibited eating disorders and, accordingly, should be regarded as showing secondary, rather than primary, exercise dependence. Exercise dependent women had significantly higher scores on the exercise dependence questionnaire than non-dependent women. Conclusion: These new diagnostic criteria should now be adopted and explored further, particularly among men and individuals with possible primary exercise dependence. PMID:14514528

  8. Acceptance criteria considerations for miscellaneous wastes

    SciTech Connect

    Irvine, A.R.; Forsberg, C.W.

    1987-01-01

    EPA standards set forth limitations regarding releases to the accessible environment adjacent to a geologic repository. The NRC criteria pertaining to waste form and engineered barrier performance place certain restrictions on the physical and chemical nature of the waste form and require substantially complete confinement of radioactivity until the high-heat-production period is past. After this period, the annual release of radionuclides from the waste package is normally limited to 1 part in 100,000 of the amounts calculated to be present at 1000-y decay. The regulation permits deviation from these criteria in exceptional circumstances. One such circumstance might be the absence of a significant perturbation in temperature around the stored waste. The lack of significant heat release will eliminate the hydrologic driving force for dispersal of radionuclides. Exceptional circumstances which potentially could justify a less stringent long-term release criterion are: small quantity of radioactivity, the nature of the radioactive species, and the nature of the geology in which the waste is to be emplaced. Because the MW after a suitable decay period have low heat release rates per unit volume, they apparently could be so emplaced in a repository that there would be no compelling need, according to the reasoning presented in 10 CFR 60, for a 1000-y container. Regarding attainment of the specified long-term release rate criterion, neither the solubility limits for the various waste forms nor the conductance of potential migration barriers are currently adequately characterized. The relatively small total heat generation rate for the MW in combination with the usual low volumetric heat generation rate apparently will allow application of migration barriers in a low temperature environment where barrier performance would be expected to be unchanged with time.

  9. New diagnostic criteria for neurocysticercosis: Reliability and validity

    PubMed Central

    Fleury, Agnès; Romo, Matthew L.; Abraham, Ronaldo; Fandiño, Jaime; Durán, Juan C.; Cárdenas, Graciela; Moncayo, Jorge; Leite Rodrigues, Cleonísio; San‐Juan, Daniel; Serrano‐Dueñas, Marcos; Takayanagui, Oswaldo; Sander, Josemir W.

    2016-01-01

    Objective The diagnosis of neurocysticercosis (NCC) remains problematic because of the heterogeneity of its clinical, immunological, and imaging characteristics. Our aim was to develop and assess a new set of diagnostic criteria for NCC, which might allow for the accurate detection of, and differentiation between, parenchymal and extraparenchymal disease. Methods A group of Latin American NCC experts developed by consensus a new set of diagnostic criteria for NCC. A multicenter, retrospective study was then conducted to validate it. The reference standard for diagnosis of active NCC was the disappearance or reduction of cysts after anthelmintic treatment. In total, three pairs of independent neurologists blinded to the diagnosis evaluated 93 cases (with NCC) and 93 controls (without NCC) using the new diagnostic criteria. Mixed‐effects logistic regression models were used to estimate sensitivity and specificity. Results Inter‐rater reliability (kappa) of diagnosis among evaluators was 0.60. For diagnosis of NCC versus no NCC, the new criteria had a sensitivity of 93.2% and specificity of 81.4%. For parenchymal NCC, the new criteria had a sensitivity of 89.8% and specificity of 80.7% and for extraparenchymal NCC, the new criteria had a sensitivity of 65.9% and specificity of 94.9%. Interpretation These criteria have acceptable reliability and validity and could be a new tool for clinicians and researchers. An advantage of the new criteria is that they consider parasite location (ie, parenchymal or extraparenchymal), which is an important factor determining the clinical, immunological, and radiological presentation of the disease, and importantly, its treatment and prognosis. Ann Neurol 2016;80:434–442 PMID:27438337

  10. Implementation of acceptability criteria for dental radiology in Belgium.

    PubMed

    Clarijs, Tom

    2013-02-01

    The implementation of routine quality control (QC) tests in dental radiology in Belgium has been neglected for many years. In 2008, the (Belgian) Federal Agency for Nuclear Control determined acceptability criteria for X-ray equipment used for dentomaxillofacial imaging. An overview of the development of the criteria, together with implementation and the first results of dental QC in Belgium, is discussed.

  11. Heat exchanger, head and shell acceptance criteria

    SciTech Connect

    Lam, P.S.; Sindelar, R.L.

    1992-09-01

    Instability of postulated flaws in the head component of the heat exchanger could not produce a large break, equivalent to a DEGB in the PWS piping, due to the configuration of the head and restraint provided by the staybolts. Rather, leakage from throughwall flaws in the head would increase with flaw length with finite leakage areas that are bounded by a post-instability flaw configuration. Postulated flaws at instability in the shell of the heat exchanger or in the cooling water nozzles could produce a large break in the Cooling Water System (CWS) pressure boundary. An initial analysis of flaw stability for postulated flaws in the heat exchanger head was performed in January 1992. This present report updates that analysis and, additionally, provides acceptable flaw configurations to maintain defined structural or safety margins against flaw instability of the external pressure boundary components of the heat exchanger, namely the head, shell, and cooling water nozzles. Structural and flaw stability analyses of the heat exchanger tubes, the internal pressure boundary of the heat exchangers or interface boundary between the PWS and CWS, were previously completed in February 1992 as part of the heat exchanger restart evaluation and are not covered in this report.

  12. AAPT Diagnostic Criteria for Chronic Cancer Pain Conditions.

    PubMed

    Paice, Judith A; Mulvey, Matt; Bennett, Michael; Dougherty, Patrick M; Farrar, John T; Mantyh, Patrick W; Miaskowski, Christine; Schmidt, Brian; Smith, Thomas J

    2017-03-01

    Chronic cancer pain is a serious complication of malignancy or its treatment. Currently, no comprehensive, universally accepted cancer pain classification system exists. Clarity in classification of common cancer pain syndromes would improve clinical assessment and management. Moreover, an evidence-based taxonomy would enhance cancer pain research efforts by providing consistent diagnostic criteria, ensuring comparability across clinical trials. As part of a collaborative effort between the Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks (ACTTION) and the American Pain Society (APS), the ACTTION-APS Pain Taxonomy initiative worked to develop the characteristics of an optimal diagnostic system. After the establishment of these characteristics, a working group consisting of clinicians and clinical and basic scientists with expertise in cancer and cancer-related pain was convened to generate core diagnostic criteria for an illustrative sample of 3 chronic pain syndromes associated with cancer (ie, bone pain and pancreatic cancer pain as models of pain related to a tumor) or its treatment (ie, chemotherapy-induced peripheral neuropathy). A systematic review and synthesis was conducted to provide evidence for the dimensions that comprise this cancer pain taxonomy. Future efforts will subject these diagnostic categories and criteria to systematic empirical evaluation of their feasibility, reliability, and validity and extension to other cancer-related pain syndromes.

  13. La composition academique: les limites de l'acceptabilite (Composition for Academic Purposes: Criteria for Acceptability).

    ERIC Educational Resources Information Center

    Grenall, G. M.

    1981-01-01

    Examines the pedagogical approaches and problems attendant to the development of English writing programs for foreign students. Discusses the skills necessary to handle course work, such as essay tests, term papers and reports, theses and dissertations, and focuses particularly on diagnostic problems and acceptability criteria. Societe Nouvelle…

  14. Idaho CERCLA Disposal Facility Complex Waste Acceptance Criteria

    SciTech Connect

    W. Mahlon Heileson

    2006-10-01

    The Idaho Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA) Disposal Facility (ICDF) has been designed to accept CERCLA waste generated within the Idaho National Laboratory. Hazardous, mixed, low-level, and Toxic Substance Control Act waste will be accepted for disposal at the ICDF. The purpose of this document is to provide criteria for the quantities of radioactive and/or hazardous constituents allowable in waste streams designated for disposal at ICDF. This ICDF Complex Waste Acceptance Criteria is divided into four section: (1) ICDF Complex; (2) Landfill; (3) Evaporation Pond: and (4) Staging, Storage, Sizing, and Treatment Facility (SSSTF). The ICDF Complex section contains the compliance details, which are the same for all areas of the ICDF. Corresponding sections contain details specific to the landfill, evaporation pond, and the SSSTF. This document specifies chemical and radiological constituent acceptance criteria for waste that will be disposed of at ICDF. Compliance with the requirements of this document ensures protection of human health and the environment, including the Snake River Plain Aquifer. Waste placed in the ICDF landfill and evaporation pond must not cause groundwater in the Snake River Plain Aquifer to exceed maximum contaminant levels, a hazard index of 1, or 10-4 cumulative risk levels. The defined waste acceptance criteria concentrations are compared to the design inventory concentrations. The purpose of this comparison is to show that there is an acceptable uncertainty margin based on the actual constituent concentrations anticipated for disposal at the ICDF. Implementation of this Waste Acceptance Criteria document will ensure compliance with the Final Report of Decision for the Idaho Nuclear Technology and Engineering Center, Operable Unit 3-13. For waste to be received, it must meet the waste acceptance criteria for the specific disposal/treatment unit (on-Site or off-Site) for which it is destined.

  15. NEVADA TEST SITE WASTE ACCEPTANCE CRITERIA, JUNE 2006

    SciTech Connect

    U.S. DEPARTMENT OF ENERGY, NATIONAL NUCLEAR SECURITY ADMINISTRATION NEVADA SITE OFFICE

    2006-06-01

    This document establishes the U.S. Department of Energy (DOE), National Nuclear Security Administration Nevada Site Office (NNSA/NSO) waste acceptance criteria (WAC). The WAC provides the requirements, terms, and conditions under which the Nevada Test Site (NTS) will accept low-level radioactive (LLW) and mixed waste (MW) for disposal. It includes requirements for the generator waste certification program, characterization, traceability, waste form, packaging, and transfer. The criteria apply to radioactive waste received at the NTS Area 3 and Area 5 Radioactive Waste Management Complex (RWMC) for storage or disposal.

  16. Diagnostic criteria for pediatric multiple sclerosis.

    PubMed

    Rubin, Jennifer P; Kuntz, Nancy L

    2013-06-01

    An estimated 2 % to 5 % of all persons with multiple sclerosis (MS) have onset of symptoms before 16 years of age Krupp and Hertz (Neurology 68(Suppl 2), 2007). As in adults, the diagnosis of pediatric MS is a clinical one, requiring recurrent episodes of CNS demyelination with supportive paraclinical data (MRI findings, CSF characteristics) in the absence of another plausible diagnosis. The differential diagnosis is broad and, the more atypical the case and the younger the child, the more consideration is necessary before making a diagnosis of MS. MS must be differentiated from acute disseminated encephalomyelitis (ADEM) or neuromyelitis optica (NMO). After initial presentation with a CNS demyelinating event or clinically isolated syndrome (CIS), children can meet the diagnostic criteria for MS if serial changes are noted on MRI and other disorders are excluded. Accurate diagnosis of pediatric MS is critical because of the implications of the diagnosis, including the need for long-term disease modifying therapy.

  17. MCO combustible gas management leak test acceptance criteria

    SciTech Connect

    SHERRELL, D.L.

    1999-05-11

    Existing leak test acceptance criteria for mechanically sealed and weld sealed multi-canister overpacks (MCO) were evaluated to ensure that MCOs can be handled and stored in stagnant air without compromising the Spent Nuclear Fuel Project's overall strategy to prevent accumulation of combustible gas mixtures within MCO's or within their surroundings. The document concludes that the integrated leak test acceptance criteria for mechanically sealed and weld sealed MCOs (1 x 10{sup -5} std cc/sec and 1 x 10{sup -7} std cc/sec, respectively) are adequate to meet all current and foreseeable needs of the project, including capability to demonstrate compliance with the NFPA 60 Paragraph 3-3 requirement to maintain hydrogen concentrations [within the air atmosphere CSB tubes] t or below 1 vol% (i.e., at or below 25% of the LFL).

  18. Establishing seismic design criteria to achieve an acceptable seismic margin

    SciTech Connect

    Kennedy, R.P.

    1997-01-01

    In order to develop a risk based seismic design criteria the following four issues must be addressed: (1) What target annual probability of seismic induced unacceptable performance is acceptable? (2). What minimum seismic margin is acceptable? (3) Given the decisions made under Issues 1 and 2, at what annual frequency of exceedance should the Safe Shutdown Earthquake ground motion be defined? (4) What seismic design criteria should be established to reasonably achieve the seismic margin defined under Issue 2? The first issue is purely a policy decision and is not addressed in this paper. Each of the other three issues are addressed. Issues 2 and 3 are integrally tied together so that a very large number of possible combinations of responses to these two issues can be used to achieve the target goal defined under Issue 1. Section 2 lays out a combined approach to these two issues and presents three potentially attractive combined resolutions of these two issues which reasonably achieves the target goal. The remainder of the paper discusses an approach which can be used to develop seismic design criteria aimed at achieving the desired seismic margin defined in resolution of Issue 2. Suggestions for revising existing seismic design criteria to more consistently achieve the desired seismic margin are presented.

  19. Automated Transportation Management System (ATMS) V2.0 logistics module PBI acceptance criteria

    SciTech Connect

    Weidert, R.S.

    1995-02-28

    This document defines the acceptance criteria for the Automated Transportation Management System V2.0 Logistics Module Performance Based Incentive (PBI). This acceptance criteria will be the primary basis for the generation of acceptance test procedures. The purpose of this document is to define the minimum criteria that must be fulfilled to guarantee acceptance of the Logistics Module.

  20. Establishment of noise acceptance criteria for wind turbines

    NASA Technical Reports Server (NTRS)

    Stephens, D. G.; Shepherd, K. P.; Grosveld, F.

    1981-01-01

    A program is being conducted to develop noise criteria for wind turbines which minimize annoyance and which can be used in design specifications for future machines. The approach consists of presenting wind turbine noise stimuli to test subjects in a laboratory listening chamber. The responses of the subjects are recorded for a range of stimuli which encompass the designs, operating conditions, and ambient noise levels of current and future installations. Results to date have established the threshold of detectability for a range of impulsive stimuli of the type associated with blade/tower-wake interactions. The status of the ongoing psychoacoustic tests, the subjective data, and the approach to the development of noise acceptance criteria are described.

  1. Proposed Diagnostic Criteria for Night Eating Syndrome

    PubMed Central

    Allison, Kelly C.; Lundgren, Jennifer D.; O’Reardon, John P.; Geliebter, Allan; Gluck, Marci E.; Vinai, Piergiuseppe; Mitchell, James E.; Schenck, Carlos H.; Howell, Michael J.; Crow, Scott J.; Engel, Scott; Latzer, Yael; Tzischinsky, Orna; Mahowald, Mark W.; Stunkard, Albert J.

    2015-01-01

    Objective To propose criteria for diagnosis of the night eating syndrome (NES). Method An international research meeting was held in April 2008, and consensus criteria for NES diagnosis were determined. Results The core criterion is an abnormally increased food intake in the evening and nighttime, manifested by (1) consumption of at least 25% of intake after the evening meal, and/or (2) nocturnal awakenings with ingestions at least twice per week. Awareness of the eating episodes is required, as is distress or impairment in functioning. Three of five modifiers must also be endorsed. These criteria must be met for a minimum duration of 3 months. Discussion These criteria help standardize the definition of NES. Additional aspects of the nosology of NES yet to be fully elaborated include its relationship to other eating and sleep disorders. Assessment and analytic tools are needed to assess these new criteria more accurately. PMID:19378289

  2. Community acceptance of helicopter noise: Criteria and application

    NASA Technical Reports Server (NTRS)

    Munch, C. L.; King, R. J.

    1974-01-01

    A study was conducted to define those criteria necessary for civil helicopter operations to be acoustically acceptable to the communities from which they operate and over which they fly. The study involved surveying existing domestic and foreign Federal regulations and guidelines, state and local noise ordinances, results of community noise annoyance studies, and results of individual aircraft noise annoyance studies, and results of individual aircraft noise annoyance studies in order to establish the criteria. The final criteria selection are based on the Day-Night Level, L sub DN, a measure of total noise exposure. The basic rating unit is the A weighted sound pressure level (dbA) which has accuracy comparable to other units currently used for aircraft. An L sub DN of 60 is recommended as a criterion for areas where the ambient noise is below 58 dbA. An L sub DN value 2 dbA above the local ambient is recommended for areas where the ambient is above 58 dbA.

  3. 78 FR 53483 - Inspections, Tests, Analyses, and Acceptance Criteria; Vogtle Electric Generating Plant, Unit 3

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-29

    ... COMMISSION Inspections, Tests, Analyses, and Acceptance Criteria; Vogtle Electric Generating Plant, Unit 3 AGENCY: Nuclear Regulatory Commission. ACTION: Determination of inspections, tests, analyses, and..., tests, and analyses have been successfully completed, and that the specified acceptance criteria are...

  4. 78 FR 53484 - Inspections, Tests, Analyses, and Acceptance Criteria; Vogtle Electric Generating Plant, Unit 4

    Federal Register 2010, 2011, 2012, 2013, 2014

    2013-08-29

    ... COMMISSION Inspections, Tests, Analyses, and Acceptance Criteria; Vogtle Electric Generating Plant, Unit 4 AGENCY: Nuclear Regulatory Commission. ACTION: Determination of inspections, tests, analyses, and..., tests, and analyses have been successfully completed, and that the specified acceptance criteria are...

  5. DIAGNOSTIC CRITERIA FOR PROLIFERATIVE THYROID LESIONS IN BONY FISHES

    EPA Science Inventory

    Thyroid proliferative lesions are rather common in bony fishes but disagreement exists in the fish pathology community concerning diagnostic criteria for hyperplastic versus neoplastic lesions. To simplify the diagnosis of proliferative thyroid lesions and to reduce confusion reg...

  6. Critical appraisal of the 1977 diagnostic criteria for Minamata disease.

    PubMed

    Yorifuji, Takashi; Tsuda, Toshihide; Inoue, Sachiko; Takao, Soshi; Harada, Masazumi; Kawachi, Ichiro

    2013-01-01

    Large-scale food poisoning caused by methylmercury was identified in Minamata, Japan, in the 1950s (Minamata disease). Although the diagnostic criteria for the disease remain current, few studies have been carried out to assess the diagnostic accuracy of the criteria. From a 1971 population-based investigation, data from 2 villages were selected: Minamata (high-exposure area; n = 779) and Ariake (low-exposure area; n = 755). The authors examined the prevalence of neurologic signs characteristic of methylmercury poisoning and the validity of the criteria. A substantial number of residents in the exposed area exhibited neurologic signs even after excluding officially certified patients. Using paresthesia of the extremities as the gold standard of diagnosis, the criteria had a sensitivity of 66%. The current diagnostic criteria as well as the official certification system substantially underestimate the incidence of Minamata disease.

  7. [Acute disseminated encephalomyelitis (ADEM): its diagnostic criteria and therapy].

    PubMed

    Hara, Toshiro

    2013-05-01

    Acute disseminated encephalomyelitis (ADEM) is an immune-mediated central nervous system disorder in an individual with genetic susceptibility. It is characterized by acute or subacute onset of multifocal neurologic deficits with encephalopathy, often following a viral illness or vaccination. Since ADEM is diverse in its clinical features, the diagnostic criteria of ADEM require the exclusion of other etiologies. In this review, I will explain the diagnostic algorism and criteria, and therapy of ADEM.

  8. The DSM diagnostic criteria for vaginismus.

    PubMed

    Binik, Yitzchak M

    2010-04-01

    Vaginal spasm has been considered the defining diagnostic characteristic of vaginismus for approximately 150 years. This remarkable consensus, based primarily on expert clinical opinion, is preserved in the DSM-IV-TR. The available empirical research, however, does not support this definition nor does it support the validity of the DSM-IV-TR distinction between vaginismus and dyspareunia. The small body of research concerning other possible ways or methods of diagnosing vaginismus is critically reviewed. Based on this review, it is proposed that the diagnoses of vaginismus and dyspareunia be collapsed into a single diagnostic entity called "genito-pelvic pain/penetration disorder." This diagnostic category is defined according to the following five dimensions: percentage success of vaginal penetration; pain with vaginal penetration; fear of vaginal penetration or of genito-pelvic pain during vaginal penetration; pelvic floor muscle dysfunction; medical co-morbidity.

  9. MDS clinical diagnostic criteria for Parkinson's disease in China.

    PubMed

    Li, Jun; Jin, Miao; Wang, Li; Qin, Bin; Wang, Kang

    2017-03-01

    The Movement Disorder Society Clinical Diagnostic Criteria for Parkinson's disease (MDS-PD Criteria) was introduced by the Movement Disorder Society in 2015 for research purposes. However, its use for clinical diagnosis of Parkinson disease still needs further revision. This study compares the UK-Criteria versus MDS-PD Criteria in the clinical diagnosis of Parkinson disease referred to the China-Japan Friendship Hospital of Beijing, China. To compare the MDS-PD Criteria with the UK-Criteria and discuss the feasibility of the clinical application of MDS-PD Criteria as a general guide to clinical diagnosis of PD in Chinese PD patients. 150 patients of neurology clinic of China-Japan Friendship Hospital of Beijing were recruited in our research. They were divided into three groups: UK-Criteria group, MDS-PD Criteria group and a combined group of UK and MDS-PD Criteria. Clinical history was collected while physical and auxiliary examinations were done by a trained neurologist according to the corresponding criteria. An interrater reliability analysis using the Kappa statistic claimed substantial agreement (κ = 0.626) between the MDS-PD Criteria and the UK-Criteria. The differences between the diagnostic results of these two criteria were statistically significant by paired Chi-square test (p = 0.000). It was found that levodopa-induced dyskinesia had a good positive predictive value, while early bulbar impairment and inspiratory dysfunction presented a negative predictive value. The MDS-PD Criteria emphasize the importance of non-motor symptoms, keeping the motor symptoms as the core for the clinical diagnosis of PD, and establish categories of diagnosis features and levels of certainty which are more complete and organized to be used and replicated by non specialized physicians to evaluated patients with Parkinsonism. The higher sensitivity of MDS-PD Criteria compared with UK-Criteria is worth being widely used in clinical work.

  10. Rett syndrome diagnostic criteria: Lessons from the Natural History Study

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Analysis of 819 participants enrolled in the Rett syndrome (RTT) Natural History Study, validates recently revised diagnostic criteria. Seven hundred sixty-five females fulfilled 2002 consensus criteria for classic (653/85.4%) or variant (112/14.6%) RTT. All participants classified as classic RTT fu...

  11. The DSM diagnostic criteria for exhibitionism, voyeurism, and frotteurism.

    PubMed

    Långström, Niklas

    2010-04-01

    I reviewed the empirical literature for 1980-2008 on exhibitionism, voyeurism, and frotteurism for the American Psychiatric Association's Sexual and Gender Identity Disorders Work Group in preparation for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V). Very limited empirical support was found for major changes of the current DSM-IV-TR criteria sets for these paraphilias. Some of the criticism of current criteria and the balancing of false negatives and false positive diagnoses are examined. The report concludes with suggestions for possible diagnostic criteria changes for the DSM-V.

  12. The DSM diagnostic criteria for dyspareunia.

    PubMed

    Binik, Yitzchak M

    2010-04-01

    The DSM-IV-TR attempted to create a unitary category of dyspareunia based on the criterion of genital pain that interfered with sexual intercourse. This classificatory emphasis of interference with intercourse is reviewed and evaluated from both theoretical and empirical points of view. Neither of these points of view was found to support the notion of dyspareunia as a unitary disorder or its inclusion in the DSM-V as a sexual dysfunction. It seems highly likely that there are different syndromes of dyspareunia and that what is currently termed "superficial dyspareunia" cannot be differentiated reliably from vaginismus. It is proposed that the diagnoses of vaginismus and dyspareunia be collapsed into a single diagnostic entity called genito-pelvic pain/penetration disorder. This diagnostic category is defined according to five dimensions: percentage success of vaginal penetration; pain with vaginal penetration; fear of vaginal penetration or of genito-pelvic pain during vaginal penetration; pelvic floor muscle dysfunction; medical co-morbidity.

  13. Diagnostic criteria of acute rheumatic fever.

    PubMed

    Burke, Rebecca J; Chang, Christopher

    2014-01-01

    Acute rheumatic fever is an inflammatory sequela of Group A Streptococcal pharyngitis that affects multiple organ systems. The incidence of acute rheumatic fever has been declining even before the use of antibiotics became widespread, however the disease remains a significant cause of morbidity and mortality in children, particularly in developing countries and has been estimated to affect 19 per 100,000 children worldwide. Acute rheumatic fever is a clinical diagnosis, and therefore subject to the judgment of the clinician. Because of the variable presentation, the Jones criteria were first developed in 1944 to aid clinicians in the diagnosis of acute rheumatic fever. The Jones criteria have been modified throughout the years, most recently in 1992 to aid clinicians in the diagnosis of initial attacks of acute rheumatic fever and to minimize overdiagnosis of the disease. Diagnosis of acute rheumatic fever is based on the presence of documented preceding Group A Streptococcal infection, in addition to the presence of two major manifestations or one major and two minor manifestations of the Jones criteria. Without documentation of antecedent Group A Streptococcal infection, the diagnosis is much less likely except in a few rare scenarios. Carditis, polyarthritis and Sydenham's chorea are the most common major manifestations of acute rheumatic fever. However, despite the predominance of these major manifestations of acute rheumatic fever, there can be significant overlap with other disorders such as Lyme disease, serum sickness, drug reactions, and post-Streptococcal reactive arthritis. This overlap between disease processes has led to continued investigation of the pathophysiology as well as development of new biomarkers and laboratory studies to aid in the diagnosis of acute rheumatic fever and distinction from other disease processes.

  14. The DSM diagnostic criteria for fetishism.

    PubMed

    Kafka, Martin P

    2010-04-01

    The historical definitions of sexual Fetishism are reviewed. Prior to the advent of DSM-III-R (American Psychiatric Association, 1987), Fetishism was typically operationally described as persistent preferential sexual arousal in association with non-living objects, an over-inclusive focus on (typically non-sexual) body parts (e.g., feet, hands) and body secretions. In the DSM-III-R, Partialism, an "exclusive focus on part of the body," was cleaved from Fetishism and added to the Paraphilia Not Otherwise Specified category. The current literature reviewed suggests that Partialism and Fetishism are related, can be co-associated, and are non-exclusive domains of sexual behavior. The author suggests that since the advent and elaboration of the clinical significance criterion (Criterion B) for designating a psychiatric disorder in DSM-IV (American Psychiatric Association, 1994), a diagnostic distinction between Partialism and Fetishism is no longer clinically meaningful or necessary. It is recommended that the diagnostic Criterion A for Fetishism be modified to reflect the reintegration of Partialism and that a fetishistic focus on non-sexual body parts be a specifier of Fetishism.

  15. Radioactive waste acceptance team and generator interface yields successful implementation of waste acceptance criteria

    SciTech Connect

    Rowe, J.G.; Griffin, W.A.; Rast, D.M.

    1996-02-01

    The Fernald Environmental Management Project has developed a successful Low Level Waste Shipping Program in compliance with the Nevada Test Site Defense Waste Acceptance Criteria, Certification, and Transfer Requirements, NVO-325, Revision 1. This shipping program is responsible for the successful disposal of more than 4 million cubic feet of Low Level Waste over the past decade. The success of the Fernald Low Level Waste Shipping Program is due to the generator program staff working closely with the DOE-NV Radioactive Waste Acceptance Program Team to achieve win/win situations. The teamwork is the direct result of dedicated, proactive professionals working together toward a common objective: the safe disposition of low level radioactive waste. The growth and development of this program has many lessons learned to share with the low level waste generating community. The recognition of reciprocal interests enables consistently high annual volumes of Fernald waste disposal at the Nevada Test Site without incident. The large volumes successfully disposed serve testimony to the success of the program which is equally important to all Nevada Test Site and Fernald stakeholders. The Fernald approach to success is currently being shared with other low-level waste generators through DOE-NV sponsored outreach programs. This paper introduces examples of Fernald Environmental Restoration Management Corporation contributions to the DOE-NV Radioactive Waste Acceptance Program outreach initiatives. These practices are applicable to other low level waste disposal programs whether federal, commercial, domestic or international.

  16. How to pass a sensor acceptance test: using the gap between acceptance criteria and operational performance

    NASA Astrophysics Data System (ADS)

    Bijl, Piet

    2016-10-01

    When acquiring a new imaging system and operational task performance is a critical factor for success, it is necessary to specify minimum acceptance requirements that need to be met using a sensor performance model and/or performance tests. Currently, there exist a variety of models and test from different origin (defense, security, road safety, optometry) and they all do different predictions. This study reviews a number of frequently used methods and shows the effects that small changes in procedure or threshold criteria can have on the outcome of a test. For example, a system may meet the acceptance requirements but not satisfy the needs for the operational task, or the choice of test may determine the rank order of candidate sensors. The goal of the paper is to make people aware of the pitfalls associated with the acquisition process, by i) illustrating potential tricks to have a system accepted that is actually not suited for the operational task, and ii) providing tips to avoid this unwanted situation.

  17. Expanding the taxonomy of the diagnostic criteria for temporomandibular disorders.

    PubMed

    Peck, C C; Goulet, J-P; Lobbezoo, F; Schiffman, E L; Alstergren, P; Anderson, G C; de Leeuw, R; Jensen, R; Michelotti, A; Ohrbach, R; Petersson, A; List, T

    2014-01-01

    There is a need to expand the current temporomandibular disorders' (TMDs) classification to include less common but clinically important disorders. The immediate aim was to develop a consensus-based classification system and associated diagnostic criteria that have clinical and research utility for less common TMDs. The long-term aim was to establish a foundation, vis-à-vis this classification system, that will stimulate data collection, validity testing and further criteria refinement. A working group [members of the International RDC/TMD Consortium Network of the International Association for Dental Research (IADR), members of the Orofacial Pain Special Interest Group (SIG) of the International Association for the Study of Pain (IASP), and members from other professional societies] reviewed disorders for inclusion based on clinical significance, the availability of plausible diagnostic criteria and the ability to operationalise and study the criteria. The disorders were derived from the literature when possible and based on expert opinion as necessary. The expanded TMDs taxonomy was presented for feedback at international meetings. Of 56 disorders considered, 37 were included in the expanded taxonomy and were placed into the following four categories: temporomandibular joint disorders, masticatory muscle disorders, headache disorders and disorders affecting associated structures. Those excluded were extremely uncommon, lacking operationalised diagnostic criteria, not clearly related to TMDs, or not sufficiently distinct from disorders already included within the taxonomy. The expanded TMDs taxonomy offers an integrated approach to clinical diagnosis and provides a framework for further research to operationalise and test the proposed taxonomy and diagnostic criteria.

  18. Paroxysmal sympathetic hyperactivity after acquired brain injury: consensus on conceptual definition, nomenclature, and diagnostic criteria.

    PubMed

    Baguley, Ian J; Perkes, Iain E; Fernandez-Ortega, Juan-Francisco; Rabinstein, Alejandro A; Dolce, Giuliano; Hendricks, Henk T

    2014-09-01

    A syndrome of paroxysmal, episodic sympathetic hyperactivity after acquired brain injury has been recognized for almost 60 years. This project sought to simplify the confused nomenclature for the condition (>31 eponyms) and simplify the nine overlapping sets of diagnostic criteria. A consensus-developed questionnaire based on a systematic review of the literature was circulated to a widely representative, international expert group utilizing a Delphi approach. Diagnostic criteria were dropped if group consensus failed to agree on their relative importance, with a goal of reaching a Cronbach α of 0.8 (suitable for research purposes). The resulting criteria were combined into an assessment measure for clinical and research settings. The consensus group recommend that the term "paroxysmal sympathetic hyperactivity" replace previous terms to describe the "syndrome, recognised in a subgroup of survivors of severe acquired brain injury, of simultaneous, paroxysmal transient increases in sympathetic [elevated heart rate, blood pressure, respiratory rate, temperature, sweating] and motor [posturing] activity." An 11 point probabilistic diagnostic scale was developed with reference to published criteria, yielding an acceptable Cronbach α of 0.8. These 11 items were proceduralized and combined with a symptom severity index to produce a diagnostic tool for use with adults (the paroxysmal sympathetic hyperactivity assessment measure [PSH-AM]). Development of a pediatric version of the scale and further research into the validity of the PSH-AM is recommended. The consensus position builds on previous literature to establish diagnostic definitions and criteria, an important move to standardize research and management of this condition.

  19. 46 CFR 164.019-7 - Non-standard components; acceptance criteria and procedures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... identification number. (3) The report of a recognized laboratory's test data in accordance with the “acceptance... 46 Shipping 6 2011-10-01 2011-10-01 false Non-standard components; acceptance criteria and... Components § 164.019-7 Non-standard components; acceptance criteria and procedures. (a) General....

  20. Historical Underpinnings of Bipolar Disorder Diagnostic Criteria.

    PubMed

    Mason, Brittany L; Brown, E Sherwood; Croarkin, Paul E

    2016-07-15

    Mood is the changing expression of emotion and can be described as a spectrum. The outermost ends of this spectrum highlight two states, the lowest low, melancholia, and the highest high, mania. These mood extremes have been documented repeatedly in human history, being first systematically described by Hippocrates. Nineteenth century contemporaries Falret and Baillarger described two forms of an extreme mood disorder, with the validity and accuracy of both debated. Regardless, the concept of a cycling mood disease was accepted before the end of the 19th century. Kraepelin then described "manic depressive insanity" and presented his description of a full spectrum of mood dysfunction which could be exhibited through single episodes of mania or depression or a complement of many episodes of each. It was this concept which was incorporated into the first DSM and carried out until DSM-III, in which the description of episodic mood dysfunction was used to build a diagnosis of bipolar disorder. Criticism of this approach is explored through discussion of the bipolar spectrum concept and some recent examinations of the clinical validity of these DSM diagnoses are presented. The concept of bipolar disorder in children is also explored.

  1. Historical Underpinnings of Bipolar Disorder Diagnostic Criteria

    PubMed Central

    Mason, Brittany L.; Brown, E. Sherwood; Croarkin, Paul E.

    2016-01-01

    Mood is the changing expression of emotion and can be described as a spectrum. The outermost ends of this spectrum highlight two states, the lowest low, melancholia, and the highest high, mania. These mood extremes have been documented repeatedly in human history, being first systematically described by Hippocrates. Nineteenth century contemporaries Falret and Baillarger described two forms of an extreme mood disorder, with the validity and accuracy of both debated. Regardless, the concept of a cycling mood disease was accepted before the end of the 19th century. Kraepelin then described “manic depressive insanity” and presented his description of a full spectrum of mood dysfunction which could be exhibited through single episodes of mania or depression or a complement of many episodes of each. It was this concept which was incorporated into the first DSM and carried out until DSM-III, in which the description of episodic mood dysfunction was used to build a diagnosis of bipolar disorder. Criticism of this approach is explored through discussion of the bipolar spectrum concept and some recent examinations of the clinical validity of these DSM diagnoses are presented. The concept of bipolar disorder in children is also explored. PMID:27429010

  2. Finding NMO: The Evolving Diagnostic Criteria of Neuromyelitis Optica

    PubMed Central

    Bennett, Jeffrey L.

    2016-01-01

    Neuromyelitis optica (NMO) is an autoimmune demyelinating disorder of the central nervous system (CNS) with predilection for the optic nerves and spinal cord. Since its emergence in the medical literature in the late 1800’s, the diagnostic criteria for NMO has slowly evolved from the simultaneous presentation of neurologic and ophthalmic signs to a relapsing or monophasic CNS disorder defined by clinical, neuroimaging, and laboratory criteria. Due to the identification of a specific autoantibody response against the astrocyte water channel aquaporin-4 (AQP4) in the vast majority of affected individuals, the clinical spectrum of NMO has greatly expanded necessitating the development of new international criteria for the diagnosis of NMO spectrum disorder (NMOSD). The routine application of new diagnostic criteria for NMOSD in clinical practice will be critical for future refinement and correlation with therapeutic outcomes. PMID:27529327

  3. The DSM diagnostic criteria for female sexual arousal disorder.

    PubMed

    Graham, Cynthia A

    2010-04-01

    This article reviews and critiques the DSM-IV-TR diagnostic criteria for Female Sexual Arousal Disorder (FSAD). An overview of how the diagnostic criteria for FSAD have evolved over previous editions of the DSM is presented and research on prevalence and etiology of FSAD is briefly reviewed. Problems with the essential feature of the DSM-IV-TR diagnosis-"an inability to attain, or to maintain...an adequate lubrication-swelling response of sexual excitement"-are identified. The significant overlap between "arousal" and "desire" disorders is highlighted. Finally, specific recommendations for revision of the criteria for DSM-V are made, including use of a polythetic approach to the diagnosis and the addition of duration and severity criteria.

  4. Advancing research diagnostic criteria for Alzheimer's disease: the IWG-2 criteria.

    PubMed

    Dubois, Bruno; Feldman, Howard H; Jacova, Claudia; Hampel, Harald; Molinuevo, José Luis; Blennow, Kaj; DeKosky, Steven T; Gauthier, Serge; Selkoe, Dennis; Bateman, Randall; Cappa, Stefano; Crutch, Sebastian; Engelborghs, Sebastiaan; Frisoni, Giovanni B; Fox, Nick C; Galasko, Douglas; Habert, Marie-Odile; Jicha, Gregory A; Nordberg, Agneta; Pasquier, Florence; Rabinovici, Gil; Robert, Philippe; Rowe, Christopher; Salloway, Stephen; Sarazin, Marie; Epelbaum, Stéphane; de Souza, Leonardo C; Vellas, Bruno; Visser, Pieter J; Schneider, Lon; Stern, Yaakov; Scheltens, Philip; Cummings, Jeffrey L

    2014-06-01

    In the past 8 years, both the International Working Group (IWG) and the US National Institute on Aging-Alzheimer's Association have contributed criteria for the diagnosis of Alzheimer's disease (AD) that better define clinical phenotypes and integrate biomarkers into the diagnostic process, covering the full staging of the disease. This Position Paper considers the strengths and limitations of the IWG research diagnostic criteria and proposes advances to improve the diagnostic framework. On the basis of these refinements, the diagnosis of AD can be simplified, requiring the presence of an appropriate clinical AD phenotype (typical or atypical) and a pathophysiological biomarker consistent with the presence of Alzheimer's pathology. We propose that downstream topographical biomarkers of the disease, such as volumetric MRI and fluorodeoxyglucose PET, might better serve in the measurement and monitoring of the course of disease. This paper also elaborates on the specific diagnostic criteria for atypical forms of AD, for mixed AD, and for the preclinical states of AD.

  5. Diagnostic criteria and classification of mastocytosis in 2014.

    PubMed

    Akin, Cem; Valent, Peter

    2014-05-01

    Mastocytosis is characterized by accumulation of pathologic mast cells in tissues. Most patients with mastocytosis experience mast cell activation symptoms in response to various triggers. The diagnosis of mastocytosis should be made from objective pathologic findings. Modern diagnostic criteria and classification of mastocytosis were proposed in 2000 by an international consensus group and formed the basis of the current World Health Organization (WHO) guidelines, which have been validated to correlate with prognosis and help selection of therapy. In this article, the WHO criteria for diagnosis and classification are summarized and practical aspects to avoid common pitfalls in diagnostic workup are discussed.

  6. Improving diagnostic criteria for Propionibacterium acnes osteomyelitis: a retrospective analysis.

    PubMed

    Asseray, Nathalie; Papin, Christophe; Touchais, Sophie; Bemer, Pascale; Lambert, Chantal; Boutoille, David; Tequi, Brigitte; Gouin, François; Raffi, François; Passuti, Norbert; Potel, Gilles

    2010-07-01

    The identification of Propionibacterium acnes in cultures of bone and joint samples is always difficult to interpret because of the ubiquity of this microorganism. The aim of this study was to propose a diagnostic strategy to distinguish infections from contaminations. This was a retrospective analysis of all patient charts of those patients with >or=1 deep samples culture-positive for P. acnes. Every criterion was tested for sensitivity, specificity, and positive likelihood ratio, and then the diagnostic probability of combinations of criteria was calculated. Among 65 patients, 52 (80%) were considered truly infected with P. acnes, a diagnosis based on a multidisciplinary process. The most valuable diagnostic criteria were: >or=2 positive deep samples, peri-operative findings (necrosis, hardware loosening, etc.), and >or=2 surgical procedures. However, no single criterion was sufficient to ascertain the diagnosis. The following combinations of criteria had a diagnostic probability of >90%: >or=2 positive cultures + 1 criterion among: peri-operative findings, local signs of infection, >or=2 previous operations, orthopaedic devices; 1 positive culture + 3 criteria among: peri-operative findings, local signs of infection, >or=2 previous surgical operations, orthopaedic devices, inflammatory syndrome. The diagnosis of P. acnes osteomyelitis was greatly improved by combining different criteria, allowing differentiation between infection and contamination.

  7. Data Quality Objectives for WTP Feed Acceptance Criteria - 12043

    SciTech Connect

    Arakali, Aruna V.; Benson, Peter A.; Duncan, Garth; Johnston, Jill C.; Lane, Thomas A.; Matis, George; Olson, John W.; Banning, Davey L.; Greer, Daniel A.; Seidel, Cary M.; Thien, Michael G.

    2012-07-01

    The Hanford Tank Waste Treatment and Immobilization Plant (WTP) is under construction for the U.S. Department of Energy by Bechtel National, Inc. and subcontractor URS Corporation (contract no. DE-AC27-01RV14136). The plant when completed will be the world's largest nuclear waste treatment facility. Bechtel and URS are tasked with designing, constructing, commissioning, and transitioning the plant to the long term operating contractor to process the legacy wastes that are stored in underground tanks (from nuclear weapons production between the 1940's and the 1980's). Approximately 56 million gallons of radioactive waste is currently stored in these tanks at the Hanford Site in southeastern Washington. There are three major WTP facilities being constructed for processing the tank waste feed. The Pretreatment (PT) facility receives feed where it is separated into a low activity waste (LAW) fraction and a high level waste (HLW) fraction. These fractions are transferred to the appropriate (HLW or LAW) facility, combined with glass former material, and sent to high temperature melters for formation of the glass product. In addition to PT, HLW and LAW, other facilities in WTP include the Laboratory (LAB) for analytical services and the Balance of Facilities (BOF) for plant maintenance, support and utility services. The transfer of staged feed from the waste storage tanks and acceptance in WTP receipt vessels require data for waste acceptance criteria (WAC) parameters from analysis of feed samples. The Data Quality Objectives (DQO) development was a joint team effort between WTP and Tank Operations Contractor (TOC) representatives. The focus of this DQO effort was to review WAC parameters and develop data quality requirements, the results of which will determine whether or not the staged feed can be transferred from the TOC to WTP receipt vessels. The approach involved systematic planning for data collection consistent with EPA guidance for the seven-step DQO process

  8. DIAGNOSTIC CRITERIA FOR PROLIFERATIVE THYROID LESIONS IN BONY FISHES II

    EPA Science Inventory

    Thyroid proliferative lesions are rather common in bony fishes but diagnostic terminology and criteria for these lesions are inconsistent in the literature. The diagnosis of proliferative thyroid lesions is especially challenging in fish due to the fact that the thyroid is not a ...

  9. Diagnostic criteria for Huntington's disease based on natural history.

    PubMed

    Reilmann, Ralf; Leavitt, Blair R; Ross, Christopher A

    2014-09-15

    Huntington's disease (HD) is currently diagnosed based on the presence of motor signs indicating 99% "diagnostic confidence" for HD. Recent advances in the understanding of HD natural history and neurobiology indicate that disease-related brain changes begin at least 12 to 15 years before the formal diagnosis based on motor onset. Furthermore, subtle motor dysfunction, cognitive changes, and behavioral alterations are often seen before diagnosis made according to the current criteria. As disease-modifying treatments are developed, likely beginning therapy early will be desirable. We therefore suggest that expanded diagnostic criteria for HD should be adapted to better reflect the natural history of the disease, to enable the conduct of clinical trials in premanifest subjects targeting prevention of neurodegeneration, and to facilitate earlier symptomatic treatment. We propose a new set of criteria for HD diagnostic categories in the International Classification of Diseases that reflect our current understanding of HD natural history and pathogenesis. Based on defined criteria, for example, the Diagnostic Confidence Level and the Total Functional Capacity scales of the Unified Huntington's Disease Rating Scale, HD should be divided in the categories "genetically confirmed" with the subcategories "presymptomatic," "prodromal," and "manifest" and "not genetically confirmed" subdivided into "clinically at risk," "clinically prodromal," and "clinically manifest."

  10. Diagnostic criteria for IgG4-related ophthalmic disease.

    PubMed

    Goto, Hiroshi; Takahira, Masayuki; Takahira, Masahiro; Azumi, Atsushi

    2015-01-01

    Immunoglobulin G4 (IgG4)-related disease is a novel clinical entity characterized by infiltration of IgG4-immunopositive plasmacytes and elevated serum IgG4 concentration accompanied by enlargement of and masses in various organs, including the lacrimal gland, salivary gland, and pancreas. Recent studies have clarified that conditions previously diagnosed as Mikulicz disease as well as various types of lymphoplasmacytic infiltrative disorders of the ocular adnexa are consistent with a diagnosis of IgG4-related disease. Against this background, the diagnostic criteria for IgG4-related ophthalmic disease have recently been established, based on both the clinical and the histopathologic features of the ocular lesions. This article reviews these new criteria with reference to the comprehensive diagnostic criteria for IgG4-related disease for all systemic conditions reported in 2012.

  11. Canine atopic dermatitis diagnostic criteria: evaluation of four sets of published criteria among veterinary students.

    PubMed

    Le Roy, Lucile; Le Poder, Sophie; Desquilbet, Loïc; Perrot, Sebastien; Cavana, Paola; Marignac, Geneviève

    2015-01-01

    Canine atopic dermatitis (cAD) is a major teaching point as its diagnosis and treatment are difficult. During 11 weeks, 140 dogs and students (third, fourth, and fifth years) were recruited and paired. One of the four lists of diagnostic criteria was randomly attributed to each student. Concordance results, calculated with Cohen's kappa, ranged from slight (κ=0.07) to moderate (κ=0.53). Favrot's diagnostic criteria received the best results. It has been observed that results are improved with clinical experience. We observed that students often forgot that Favrot's criteria apply only to pruritic dogs and that the fulfillment of the criteria allows only a suspicion, not a diagnosis, of cAD. Primary pruritus and corticosteroid-responsive pruritus were often misunderstood.

  12. 7 CFR 42.107 - Lot acceptance criteria.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... and class of defects enumerated on the worksheet to the acceptance and rejection numbers shown in §§ 42.109 through 42.111 for the respective sample size and Acceptable Quality Level (AQL). (b) Unless otherwise specified, use the following AQL's for the respective class of defects: Defect class AQL at...

  13. 24 CFR 203.202 - Plan acceptability and acceptance renewal criteria-general.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... HUD acceptance of such change or modification, except that changes mandated by other applicable laws... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Plan acceptability and acceptance... Underwriting Procedures Insured Ten-Year Protection Plans (plan) § 203.202 Plan acceptability and...

  14. Evolution of the diagnostic criteria for degenerative and cognitive disorders

    PubMed Central

    Lopez, Oscar L.; McDade, Eric; Riverol, Mario; Becker, James T.

    2012-01-01

    Purpose of review This review describes the evolution of the clinical criteria for Alzheimer’s disease over the past 25 years, with special emphasis on those recently published that have incorporated the use of biomarkers. Recent findings One of the most important advances in the knowledge of Alzheimer’s disease was the development of cerebrospinal fluid, PET and MRI biomarkers. These have shown that the Alzheimer’s disease is present in cognitively normal individuals, suggesting that there is a long incubation process that precedes the onset of the symptoms. Although there are diagnostic criteria for Alzheimer’s disease, the National Institute on Aging and the Alzheimer’s Association has proposed a set of diagnostic criteria oriented to provide a unified vision of the pathological process from preclinical, to mild cognitive impairment, and to full-blown dementia. These new criteria take advantage of different biomarkers to support the clinical diagnosis of the different stages of the disease. Summary The new guidelines provide a definition of the dementia syndrome and core diagnostic features to be used in research and clinical practice, although they caution about the use of biomarkers, since they still require validation, and the longitudinal interaction and dynamics of these biomarkers in relationship to the manifestation of the symptoms are not fully understood. PMID:22071334

  15. 46 CFR 54.05-17 - Weld toughness test acceptance criteria.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 2 2011-10-01 2011-10-01 false Weld toughness test acceptance criteria. 54.05-17... PRESSURE VESSELS Toughness Tests § 54.05-17 Weld toughness test acceptance criteria. (a) For Charpy V-notch impact tests the energy absorbed in both the weld metal and heat affected zone impact tests in...

  16. 46 CFR 28.275 - Acceptance criteria for instructors and course curricula.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 46 Shipping 1 2010-10-01 2010-10-01 false Acceptance criteria for instructors and course curricula... the Aleutian Trade § 28.275 Acceptance criteria for instructors and course curricula. (a) A Fishing Vessel Safety Instructor shall submit a detailed course curriculum that relates directly to...

  17. Evaluation of the diagnostic criteria for Cushing's disease in Japan.

    PubMed

    Kageyama, Kazunori; Oki, Yutaka; Sakihara, Satoru; Nigawara, Takeshi; Terui, Ken; Suda, Toshihiro

    2013-01-01

    Adrenocorticotropic hormone (ACTH)-dependent Cushing's syndrome is caused by an ACTH-producing tumor, as is the case with Cushing's disease and ectopic ACTH syndrome (EAS). Diagnosis and differential diagnosis of Cushing's disease from EAS in ACTH-dependent Cushing's syndrome are thus challenging problems in clinical endocrinology. The diagnostic criteria for Cushing's disease in Japan, established by the working group of the Japan Ministry of Health, Labour and Welfare, were originally reported in 2003 and revised in 2007 and 2010. In addition, criteria for subclinical Cushing's disease were established in Japan in 2010. In this review, we evaluate the usefulness and accuracy of the most recent diagnostic criteria. Previous data suggest that as an initial test of Cushing's syndrome, 0.5 mg dexamethasone is more sensitive than 1 mg in the overnight dexamethasone suppression test (DST). Here, we recommend 0.5 mg plus a plasma cortisol cut-off level of 3 µg/dL as a suitable low-dose overnight DST for screening of all cases of ACTH-dependent Cushing's syndrome in Japan. Recently, standardization of cortisol measurements by the ID-LC/MS/MS method using seven assay kits with standard plasma material containing synthetic hydrocortisone-d4 was carried out in Japan. The resulting relative standard deviation was within 10%. The cut-off value remains valid even after standardization of plasma cortisol measurements. Although the recent diagnostic criteria achieve higher diagnostic specificity, care should be taken since data for Cushing's disease partially overlaps with some cases of EAS. Overall, therefore, this review suggests that the accuracy of each diagnostic test should be considered.

  18. Characteristics of binge eating disorder in relation to diagnostic criteria

    PubMed Central

    Wilfley, Denise E; Citrome, Leslie; Herman, Barry K

    2016-01-01

    The objective of this review was to examine the evidentiary basis for binge eating disorder (BED) with reference to the Diagnostic and Statistical Manual of Mental Disorders – Fifth Edition (DSM-5) diagnostic criteria for BED. A PubMed search restricted to titles and abstracts of English-language reviews, meta-analyses, clinical trials, randomized controlled trials, journal articles, and letters using human participants was conducted on August 7, 2015, using keywords that included “binge eating disorder,” DSM-5, DSM-IV, guilt, shame, embarrassment, quantity, psychological, behavior, and “shape and weight concerns.” Of the 257 retrieved publications, 60 publications were considered relevant to discussions related to DSM-5 diagnostic criteria and were included in the current review, and 20 additional references were also included on the basis of the authors’ knowledge and/or on a review of the reference lists from relevant articles obtained through the literature search. Evidence supports the duration/frequency criterion for BED and the primary importance of loss of control and marked distress in identifying individuals with BED. Although overvaluation of shape/weight is not a diagnostic criterion, its relationship to the severity of BED psychopathology may identify a unique subset of individuals with BED. Additionally, individuals with BED often exhibit a clinical profile consisting of psychiatric (eg, mood, obsessive–compulsive, and impulsive disorders) and medical (eg, gastrointestinal symptoms, metabolic syndrome, and type 2 diabetes) comorbidities and behavioral profiles (eg, overconsumption of calories outside of a binge eating episode and emotional eating). Future revisions of the BED diagnostic criteria should consider the inclusion of BED subtypes, perhaps based on the overvaluation of shape/weight, and an evidence-based reassessment of severity criteria. PMID:27621631

  19. Diagnostic criteria as dysfunction indicators: bridging the chasm between the definition of mental disorder and diagnostic criteria for specific disorders.

    PubMed

    First, Michael B; Wakefield, Jerome C

    2013-12-01

    According to the introduction to the Diagnostic and Statistical Manual of Mental Disorders (DSM), Fifth Edition, each disorder must satisfy the definition of mental disorder, which requires the presence of both harm and dysfunction. Constructing criteria sets to require harm is relatively straightforward. However, establishing the presence of dysfunction is necessarily inferential because of the lack of knowledge of internal psychological and biological processes and their functions and dysfunctions. Given that virtually every psychiatric symptom characteristic of a DSM disorder can occur under some circumstances in a normally functioning person, diagnostic criteria based on symptoms must be constructed so that the symptoms indicate an internal dysfunction, and are thus inherently pathosuggestive. In this paper, we review strategies used in DSM criteria sets for increasing the pathosuggestiveness of symptoms to ensure that the disorder meets the requirements of the definition of mental disorder. Strategies include the following: requiring a minimum duration and persistence; requiring that the frequency or intensity of a symptom exceed that seen in normal people; requiring disproportionality of symptoms, given the context; requiring pervasiveness of symptom expression across contexts; adding specific exclusions for contextual scenarios in which symptoms are best understood as normal reactions; combining symptoms to increase cumulative pathosuggestiveness; and requiring enough symptoms from an overall syndrome to meet a minimum threshold of pathosuggestiveness. We propose that future revisions of the DSM consider systematic implementation of these strategies in the construction and revision of criteria sets, with the goal of maximizing the pathosuggestiveness of diagnostic criteria to reduce the potential for diagnostic false positives.

  20. Diagnostic Criteria for the Treatment of Caries-Induced Pulpitis.

    DTIC Science & Technology

    1981-03-01

    histologically as irreversible pulpitis . The clinical usefulness of these responses as diagnostic criteria can best be visualized if they are ranked...89.9%) for treatable pulpitis . Evidence of PDL enlargement is not an absolute indicator of irreversible pulp disease, but is a useful criterion, with...456, 1960. Table 1. Frequency distribution and predictive values of pain history variables for diagnosing reversible and irreversible pulpitis

  1. 46 CFR 164.120-7 - Acceptance criteria.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL MATERIALS Fire Retardant Resins for Lifeboats and Rescue Boats § 164.120-7 Acceptance... Lifesaving Equipment 1 Property Test methods (c) Material Identification Tests 2 (1) Uncatalyzed Liquid...

  2. Nevada Test Site waste acceptance criteria [Revision 1

    SciTech Connect

    1997-08-01

    Revision one updates the requirements, terms, and conditions under which the Nevada Test Site (NTS) will accept low-level radioactive and mixed waste for disposal; and transuranic and transuranic mixed waste for interim storage at the NTS. Review each section of this document. This document is not intended to include all of the requirements; rather, it is meant as a guide toward meeting the regulations. All references in this document should be observed to avoid omission of requirements on which acceptance or rejection of waste will be based. The Department of Energy/Nevada Operations Office (DOE/NV) and support contractors are available to assist you in understanding or interpreting this document.

  3. The Will Rogers phenomenon: the effect of different diagnostic criteria.

    PubMed

    Sormani, Maria Pia

    2009-12-01

    The 'Will Rogers phenomenon' is an apparent epidemiological paradox named after a remark made by the humorist Will Rogers about migration during the American economic depression of the 1930's: "When the Okies left Oklahoma and moved to California, they raised the average intelligence level in both states." In 1985, Alvan Feinstein proposed the name 'Will Rogers Phenomenon' to describe the 'stage migration' he observed in patients with cancer. Changes in the criteria for assigning patients to the various stages of a disease can produce spurious improvements in stage-specific prognosis, even though the outcome of individual patients has not changed. In oncology, new imaging tools allowed detection of cancer metastases before they became evident clinically. In consequence, more patients are classified into the more severe metastatic disease stage from the less severe single tumour stage. Such a 'stage migration' resulted in an improved survival of patients in both the less and the more severe disease stages. Multiple sclerosis is also subject to the Will Rogers phenomenon since the introduction of the imaging-assisted McDonald criteria. Given the sensitivity of magnetic resonance imaging for detecting disease activity, which is believed to be five to ten times greater than that of clinical assessment, the McDonald criteria are expected to allow earlier diagnosis, hence the 'stage migration' relative to the previous Poser diagnostic criteria. Because of the ethical problems associated with carrying out placebo-controlled trials in multiple sclerosis owing to the wider availability of therapeutic options, the use of historical controls groups remains an attractive option. However, the Will Rogers phenomenon, which is recognised as one of the most important biases limiting the use of historical controls groups in experimental treatment trials, compromises the interest of this approach. In this context, the use of different diagnostic criteria may generate spurious

  4. Evidence for current diagnostic criteria of diabetes mellitus

    PubMed Central

    Kumar, Ritesh; Nandhini, Lakshmana Perumal; Kamalanathan, Sadishkumar; Sahoo, Jayaprakash; Vivekanadan, Muthupillai

    2016-01-01

    Diabetes mellitus is a non-communicable metabolic derangement afflicting several millions of individuals globally. It is associated with several micro and macrovascular complications and is also a leading cause of mortality. The unresolved issue is that of definition of the diagnostic threshold for diabetes. The World Health Organization and the American Diabetes Association (ADA) have laid down several diagnostic criteria for diagnosing diabetes and prediabetes based on the accumulating body of evidence.This review has attempted to analyse the scientific evidence supporting the justification of these differing criteria. The evidence for diagnosing diabetes is strong, and there is a concordance between the two professional bodies. The controversy arises when describing the normal lower limit of fasting plasma glucose (FPG) with little evidence favouring the reduction of the FPG by the ADA. Several studies have also shown the development of complications specific for diabetes in patients with prediabetes as defined by the current criteria though there is a significant overlap of such prevalence in individuals with normoglycemia. Large multinational longitudinal prospective studies involving subjects without diabetes and retinopathy at baseline will ideally help identify the threshold of glycemic measurements for future development of diabetes and its complications. PMID:27660696

  5. AAPT Diagnostic Criteria for Chronic Sickle Cell Disease Pain.

    PubMed

    Dampier, Carlton; Palermo, Tonya M; Darbari, Deepika S; Hassell, Kathryn; Smith, Wally; Zempsky, William

    2017-01-05

    Pain in sickle cell disease (SCD) is associated with increased morbidity, mortality, and high health care costs. Although episodic acute pain is the hallmark of this disorder, there is an increasing awareness that chronic pain is part of the pain experience of many older adolescents and adults. A common set of criteria for classifying chronic pain associated with SCD would enhance SCD pain research efforts in epidemiology, pain mechanisms, and clinical trials of pain management interventions, and ultimately improve clinical assessment and management. As part of the collaborative effort between the Analgesic, Anesthetic, and Addiction Clinical Trial Translations Innovations Opportunities and Networks public-private partnership with the U.S. Food and Drug Administration and the American Pain Society, the Analgesic, Anesthetic, and Addiction Clinical Trial Translations Innovations Opportunities and Networks-American Pain Society Pain Taxonomy initiative developed the outline of an optimal diagnostic system for chronic pain conditions. Subsequently, a working group of experts in SCD pain was convened to generate core diagnostic criteria for chronic pain associated with SCD. The working group synthesized available literature to provide evidence for the dimensions of this disease-specific pain taxonomy. A single pain condition labeled chronic SCD pain was derived with 3 modifiers reflecting different clinical features. Future systematic research is needed to evaluate the feasibility, validity, and reliability of these criteria.

  6. Waardenburg syndrome type II: phenotypic findings and diagnostic criteria.

    PubMed

    Liu, X Z; Newton, V E; Read, A P

    1995-01-02

    The Waardenburg syndrome (WS) consists of at least two distinct autosomal dominant hereditary disorders. WS Type I has been mapped to the distal part of chromosome 2q and the gene identified as PAX3. Other gene(s) are responsible for WS Type II. Mapping WS Type II requires accurate diagnosis within affected families. To establish diagnostic criteria for WS Type II, 81 individuals from 21 families with Type II WS were personally studied, and compared with 60 personally studied patients from 8 families with Type I and 253 cases of WS (Type I or II) from the literature. Sensorineural hearing loss (77%) and heterochromia iridum (47%) were the two most important diagnostic indicators for WS Type II. Both were more common in Type II than in Type I. Other clinical manifestations, such as white forelock and skin patches, were more frequent in Type I. We estimate the frequency of phenotypic traits and propose diagnostic criteria for WS Type II. In practice, a diagnosis of WS Type II can be made with confidence given a family history of congenital hearing loss and pigmentary disorders, where individuals have been accurately measured for ocular distances to exclude dystopia canthorum.

  7. Example Procedures for Developing Acceptance-Range Criteria for BESTEST-EX

    SciTech Connect

    Judkoff, R.; Polly, B.; Bianchi, M.; Neymark, J.

    2010-08-01

    This document provides an example procedure for establishing acceptance-range criteria to assess results from software undergoing BESTEST-EX. This example method for BESTEST-EX is a modified version of the method described in HERS BESTEST.

  8. [Neurodegenerative disorders: review of current classification and diagnostic neuropathological criteria].

    PubMed

    Matej, R; Rusina, R

    2012-04-01

    Neurodegenerative disorders are progressive diseases characterized by loss of specific neuronal populations followed by a clinical picture of a different neurodegenerative entity. Current classification of these diseases respects the names of the main pathophysiological processes involved in the groups of disorders. This is the reason why key proteins which represent neuropathological and biochemical hallmarks of diseases are found in their names. Neuropathological diagnosis is a synthesis of neurohistological changes in the brain and spinal cord and identification of pathological proteinaceous aggregates in neurons and/or glial cells. These inclusions are predominant diagnostic micromorphological and biochemical markers of disease. In the text, there is a brief summary of current knowledge about pathophysiology of neurodegenerations and diagnostic criteria for the most frequent entities.

  9. Clinical diagnostic criteria and classification controversies in frontotemporal lobar degeneration

    PubMed Central

    RASCOVSKY, KATYA; GROSSMAN, MURRAY

    2014-01-01

    Frontotemporal lobar degeneration (FTLD) can manifest as a spectrum of clinical syndromes, ranging from behavioural impairment to language or motor dysfunction. Recently, revised diagnostic criteria have been proposed for the behavioural and progressive aphasia syndromes associated with frontotemporal degeneration. The present review will summarize these diagnostic guidelines and highlight some lingering controversies in the classification of FTLD clinical syndromes. We will discuss common tools and methods used to identify the insidious changes of behavioural variant frontotemporal dementia (bvFTD), the value of new, patient-based tasks of orbitofrontal function, and the issue of a benign or ‘phenocopy’ variant of bvFTD. With regard to primary progressive aphasia (PPA), we will discuss the scope of the semantic disorder in semantic-variant PPA, the nature of the speech disorder in non-fluent, agrammatic PPA, and the preliminary utility of a logopenic PPA classification. PMID:23611345

  10. The classification and diagnostic criteria of ankylosing spondylitis.

    PubMed

    Raychaudhuri, Siba P; Deodhar, Atul

    2014-01-01

    Ankylosing spondylitis is the prototype of immune-mediated inflammatory rheumatic diseases grouped under the term spondyloarthritis (SpA). An early diagnosis has now become increasingly important because effective therapies are available and anti-TNF drugs are even more effective if used in early stages of the disease. In ankylosing spondylitis, the 1984 modified New York criteria have been used widely in clinical studies and daily practice but are not applicable in early disease when the characteristic radiographic signs of sacroiliitis are not visible but active sacroiliitis is readily detectable by magnetic resonance imaging (MRI). Thus there has been a need for new classification or diagnostic criteria to identify inflammatory spondyloarthritis at early stage of the disease. This led to the concept of axial SpA to include the entire spectrum of patients with axial disease both, with and without radiographic damage. New classification criteria for the wider group of SpA have been proposed by ASAS (Assessment of Spondylo Arthritis International Society); and the patients are sub-grouped into (1) a predominantly axial disease, termed axial SpA including AS and non-radiographic axial SpA; (2) peripheral SpA. The clinical course and disease process of non-radiographic axial spondyloarthritis remains unclear. However the development of the SpA criteria by ASAS particularly for axial SpA, is an important step for early diagnosis and better management of these patients.

  11. 10 CFR 50.46a - Acceptance criteria for reactor coolant system venting systems.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 10 Energy 1 2010-01-01 2010-01-01 false Acceptance criteria for reactor coolant system venting... criteria for reactor coolant system venting systems. Each nuclear power reactor must be provided with high point vents for the reactor coolant system, for the reactor vessel head, and for other systems...

  12. 10 CFR 50.46a - Acceptance criteria for reactor coolant system venting systems.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 10 Energy 1 2011-01-01 2011-01-01 false Acceptance criteria for reactor coolant system venting... criteria for reactor coolant system venting systems. Each nuclear power reactor must be provided with high point vents for the reactor coolant system, for the reactor vessel head, and for other systems...

  13. Definition and diagnostic criteria of sleep-related hypermotor epilepsy.

    PubMed

    Tinuper, Paolo; Bisulli, Francesca; Cross, J H; Hesdorffer, Dale; Kahane, Philippe; Nobili, Lino; Provini, Federica; Scheffer, Ingrid E; Tassi, Laura; Vignatelli, Luca; Bassetti, Claudio; Cirignotta, Fabio; Derry, Christopher; Gambardella, Antonio; Guerrini, Renzo; Halasz, Peter; Licchetta, Laura; Mahowald, Mark; Manni, Raffaele; Marini, Carla; Mostacci, Barbara; Naldi, Ilaria; Parrino, Liborio; Picard, Fabienne; Pugliatti, Maura; Ryvlin, Philippe; Vigevano, Federico; Zucconi, Marco; Berkovic, Samuel; Ottman, Ruth

    2016-05-10

    The syndrome known as nocturnal frontal lobe epilepsy is recognized worldwide and has been studied in a wide range of clinical and scientific settings (epilepsy, sleep medicine, neurosurgery, pediatric neurology, epidemiology, genetics). Though uncommon, it is of considerable interest to practicing neurologists because of complexity in differential diagnosis from more common, benign sleep disorders such as parasomnias, or other disorders like psychogenic nonepileptic seizures. Moreover, misdiagnosis can have substantial adverse consequences on patients' lives. At present, there is no consensus definition of this disorder and disagreement persists about its core electroclinical features and the spectrum of etiologies involved. To improve the definition of the disorder and establish diagnostic criteria with levels of certainty, a consensus conference using formal recommended methodology was held in Bologna in September 2014. It was recommended that the name be changed to sleep-related hypermotor epilepsy (SHE), reflecting evidence that the attacks are associated with sleep rather than time of day, the seizures may arise from extrafrontal sites, and the motor aspects of the seizures are characteristic. The etiology may be genetic or due to structural pathology, but in most cases remains unknown. Diagnostic criteria were developed with 3 levels of certainty: witnessed (possible) SHE, video-documented (clinical) SHE, and video-EEG-documented (confirmed) SHE. The main research gaps involve epidemiology, pathophysiology, treatment, and prognosis.

  14. Definition and diagnostic criteria of sleep-related hypermotor epilepsy

    PubMed Central

    Bisulli, Francesca; Cross, J.H.; Hesdorffer, Dale; Kahane, Philippe; Nobili, Lino; Provini, Federica; Scheffer, Ingrid E.; Tassi, Laura; Vignatelli, Luca; Bassetti, Claudio; Cirignotta, Fabio; Derry, Christopher; Gambardella, Antonio; Guerrini, Renzo; Halasz, Peter; Licchetta, Laura; Mahowald, Mark; Manni, Raffaele; Marini, Carla; Mostacci, Barbara; Naldi, Ilaria; Parrino, Liborio; Picard, Fabienne; Pugliatti, Maura; Ryvlin, Philippe; Vigevano, Federico; Zucconi, Marco; Berkovic, Samuel; Ottman, Ruth

    2016-01-01

    The syndrome known as nocturnal frontal lobe epilepsy is recognized worldwide and has been studied in a wide range of clinical and scientific settings (epilepsy, sleep medicine, neurosurgery, pediatric neurology, epidemiology, genetics). Though uncommon, it is of considerable interest to practicing neurologists because of complexity in differential diagnosis from more common, benign sleep disorders such as parasomnias, or other disorders like psychogenic nonepileptic seizures. Moreover, misdiagnosis can have substantial adverse consequences on patients' lives. At present, there is no consensus definition of this disorder and disagreement persists about its core electroclinical features and the spectrum of etiologies involved. To improve the definition of the disorder and establish diagnostic criteria with levels of certainty, a consensus conference using formal recommended methodology was held in Bologna in September 2014. It was recommended that the name be changed to sleep-related hypermotor epilepsy (SHE), reflecting evidence that the attacks are associated with sleep rather than time of day, the seizures may arise from extrafrontal sites, and the motor aspects of the seizures are characteristic. The etiology may be genetic or due to structural pathology, but in most cases remains unknown. Diagnostic criteria were developed with 3 levels of certainty: witnessed (possible) SHE, video-documented (clinical) SHE, and video-EEG-documented (confirmed) SHE. The main research gaps involve epidemiology, pathophysiology, treatment, and prognosis. PMID:27164717

  15. Diagnostic criteria for cryopyrin-associated periodic syndrome (CAPS).

    PubMed

    Kuemmerle-Deschner, Jasmin B; Ozen, Seza; Tyrrell, Pascal N; Kone-Paut, Isabelle; Goldbach-Mansky, Raphaela; Lachmann, Helen; Blank, Norbert; Hoffman, Hal M; Weissbarth-Riedel, Elisabeth; Hugle, Boris; Kallinich, Tilmann; Gattorno, Marco; Gul, Ahmet; Ter Haar, Nienke; Oswald, Marlen; Dedeoglu, Fatma; Cantarini, Luca; Benseler, Susanne M

    2016-10-04

    Cryopyrin-associated periodic syndrome (CAPS) is a rare, heterogeneous disease entity associated with NLRP3 gene mutations and increased interleukin-1 (IL-1) secretion. Early diagnosis and rapid initiation of IL-1 inhibition prevent organ damage. The aim of the study was to develop and validate diagnostic criteria for CAPS. An innovative process was followed including interdisciplinary team building, item generation: review of CAPS registries, systematic literature review, expert surveys, consensus conferences for item refinement, item reduction and weighting using 1000Minds decision software. Resulting CAPS criteria were tested in large cohorts of CAPS cases and controls using correspondence analysis. Diagnostic models were explored using sensitivity analyses. The international team included 16 experts. Systematic literature and registry review identified 33 CAPS-typical items; the consensus conferences reduced these to 14. 1000Minds exercises ranked variables based on importance for the diagnosis. Correspondence analysis determined variables consistently associated with the diagnosis of CAPS using 284 cases and 837 controls. Seven variables were significantly associated with CAPS (p<0.001). The best diagnosis model included: Raised inflammatory markers (C-reactive protein/serum amyloid A) plus ≥two of six CAPS-typical symptoms: urticaria-like rash, cold-triggered episodes, sensorineural hearing loss, musculoskeletal symptoms, chronic aseptic meningitis and skeletal abnormalities. Sensitivity was 81%, specificity 94%. It performed well for all CAPS subtypes and regardless of NLRP3 mutation. The novel approach integrated traditional methods of evidence synthesis with expert consensus, web-based decision tools and innovative statistical methods and may serve as model for other rare diseases. These criteria will enable a rapid diagnosis for children and adults with CAPS.

  16. Diagnostic criteria of antibody-mediated rejection in kidney transplants.

    PubMed

    Mosquera Reboredo, J M; Vázquez Martul, E

    2011-01-01

    The diagnosis and treatment of anti-donor antibody-mediated rejection or humoral rejection (ABMR) is one of the main discussions at the moment in kidney transplantation. The search for histopathological markers that help us to diagnose ABMR has been more problematic, in contrast to the histological expression of cellular or tubulointerstitial rejection. Although the relationship between post-transplant anti-donor antibodies and the allograft's prognosis has been a topic of discussion for a long time, led in the main by P.Terasaki, it was not until the beginning of 1990s when P. Halloran studied the humoral mechanisms of rejection in greater depth. Feutch described the importance of C4d deposits as a marker that shows a humoral mechanism of allograft rejection in 1993. As a result of many studies carried out, the Banff consensus group established some diagnostic histopathological criteria of acute (ABMR) in 2003. These have been modified slightly in later meetings of the group. Furthermore, in 2005 this same working group looked at the physiopathological mechanisms causing chronic allograft failure in more detail and established the criteria defining chronic humoral rejection. In this review, we are trying to update any useful histopathological criteria for diagnosing acute and chronic ABMR.

  17. The Research Diagnostic Criteria for Temporomandibular Disorders. VI: future directions.

    PubMed

    Anderson, Gary C; Gonzalez, Yoly M; Ohrbach, Richard; Truelove, Edmond L; Sommers, Earl; Look, John O; Schiffman, Eric L

    2010-01-01

    The Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Validation Project has provided the first comprehensive assessment of reliability and validity of the original Axis I and II. In addition, Axis I of the RDC/TMD was revised with estimates of reliability and validity. These findings are reported in the five preceding articles in this series. The aim of this article is to present further revisions of Axis I and II for consideration by the TMD research and clinical communities. Potential Axis I revisions include addressing concerns with orofacial pain differential diagnosis and changes in nomenclature in an attempt to provide improved consistency with other musculoskeletal diagnostic systems. In addition, expansion of the RDC/TMD to include the less common TMD conditions and disorders would make it more comprehensive and clinically useful. The original standards for diagnostic sensitivity ( < or = 0.70) and specificity (< or = 0.95) should be reconsidered to reflect changes in the field since the RDC/TMD was published in 1992. Pertaining to Axis II, current recommendations for all chronic pain conditions include standardized instruments and expansion of the domains assessed. In addition, there is need for improved clinical efficiency of Axis II instruments and for exploring methods to better integrate Axis I and II in clinical settings.

  18. Research Diagnostic Criteria for Temporomandibular Disorders: Future Directions

    PubMed Central

    Anderson, Gary C.; Gonzalez, Yoly M.; Ohrbach, Richard; Truelove, Edmond L.; Sommers, Earl; Look, John O.; Schiffman, Eric L.

    2011-01-01

    The Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Validation Project provided the first comprehensive assessment of reliability and validity of the original Axis I and II. In addition, Axis I of the RDC/TMD was revised with estimates of reliability and validity. These findings are reported in previous papers. Further revisions for Axis I and II are presented for consideration by the TMD research and clinical communities. Potential Axis I revisions include addressing concerns with orofacial pain differential diagnosis and changes in nomenclature in an attempt to provide improved consistency with other musculoskeletal diagnostic systems. In addition, expansion of the RDC/TMD to include the less common TMD conditions and disorders would make it more comprehensive and clinically useful. The original standards for diagnostic sensitivity (≤0.70) and specificity (≤0.95) should be reconsidered to reflect changes in the field since the RDC/TMD was published in 1992. Pertaining to Axis II, current recommendations for all chronic pain conditions include standardized instruments and expansion of the domains assessed. In addition there is need for improved clinical efficiency of Axis II instruments and exploring methods to better integrate Axis I and II in clinical settings. To that end, this paper recommends an international symposium to provide future direction. PMID:20213033

  19. Research Diagnostic criteria for Temporomandibular Disorders: current status & future relevance.

    PubMed

    Dworkin, S F

    2010-10-01

    The Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD), published in 1992, was based on international expert recommendations and available empirical data. The major rationale was to offer a putative diagnostic and classification system whose reliability, validity and clinical usefulness for TMD diagnosis and classification could be scientifically evaluated and then revised using an evidence-based model for successive iterations. The present journal issue attests to the accomplishment of that major objective: the RDC/TMD has been translated into 18 languages and used very extensively in international research. One important component of that research has been to yield reliable and valid data resulting in an evidence-based revision of the RDC/TMD now available for continuing research and clinical application. The present article offers recommendations and speculations regarding how the RDC/TMD may continue to serve the function of guiding future research and, most importantly, serve as an evidence-based diagnostic and classification system to aid in the rational choice of clinical care for TMD sufferers around the world.

  20. Criteria for Identifying Radiologists with Acceptable Screening Mammography Interpretive Performance based on Multiple Performance Measures

    PubMed Central

    Miglioretti, Diana L.; Ichikawa, Laura; Smith, Robert A.; Bassett, Lawrence W.; Feig, Stephen A.; Monsees, Barbara; Parikh, Jay R.; Rosenberg, Robert D.; Sickles, Edward A.; Carney, Patricia A.

    2014-01-01

    Objective Using a combination of performance measures, we updated previously proposed criteria for identifying physicians whose performance interpreting screening mammograms may indicate suboptimal interpretation skills. Materials and Methods In this Institutional Review Board-approved, HIPAA-compliant study, six expert breast imagers used a method based on the Angoff approach to update criteria for acceptable mammography performance on the basis of combined performance measures: (Group 1) sensitivity and specificity, for facilities with complete capture of false-negative cancers; and (Group 2) cancer detection rate (CDR), recall rate, and positive predictive value of a recall (PPV1), for facilities that cannot capture false negatives, but have reliable cancer follow-up information for positive mammograms. Decisions were informed by normative data from the Breast Cancer Surveillance Consortium (BCSC). Results Updated, combined ranges for acceptable sensitivity and specificity of screening mammography are: (1) sensitivity ≥80% and specificity ≥85% or (2) sensitivity 75–79% and specificity 88–97%. Updated ranges for CDR, recall rate, and PPV1 are: (1) CDR ≥6/1000, recall rate 3–20%, and any PPV1; (2) CDR 4–6/1000, recall rate 3–15%, and PPV1 ≥3%; or (3) CDR 2.5–4/1000, recall rate 5–12%, and PPV1 3–8%. Using the original criteria, 51% of BCSC radiologists had acceptable sensitivity and specificity; 40% had acceptable CDR, recall rate, and PPV1. Using the combined criteria, 69% had acceptable sensitivity and specificity and 62% had acceptable CDR, recall rate, and PPV1. Conclusion The combined criteria improve previous criteria by considering the inter-relationships of multiple performance measures and broaden the acceptable performance ranges compared to previous criteria based on individual measures. PMID:25794100

  1. Updated clinical diagnostic criteria for sporadic Creutzfeldt-Jakob disease

    PubMed Central

    Kallenberg, K.; Summers, D. M.; Romero, C.; Taratuto, A.; Heinemann, U.; Breithaupt, M.; Varges, D.; Meissner, B.; Ladogana, A.; Schuur, M.; Haik, S.; Collins, S. J.; Jansen, Gerard H.; Stokin, G. B.; Pimentel, J.; Hewer, E.; Collie, D.; Smith, P.; Roberts, H.; Brandel, J. P.; van Duijn, C.; Pocchiari, M.; Begue, C.; Cras, P.; Will, R. G.; Sanchez-Juan, P.

    2009-01-01

    Several molecular subtypes of sporadic Creutzfeldt–Jakob disease have been identified and electroencephalogram and cerebrospinal fluid biomarkers have been reported to support clinical diagnosis but with variable utility according to subtype. In recent years, a series of publications have demonstrated a potentially important role for magnetic resonance imaging in the pre-mortem diagnosis of sporadic Creutzfeldt–Jakob disease. Magnetic resonance imaging signal alterations correlate with distinct sporadic Creutzfeldt–Jakob disease molecular subtypes and thus might contribute to the earlier identification of the whole spectrum of sporadic Creutzfeldt–Jakob disease cases. This multi-centre international study aimed to provide a rationale for the amendment of the clinical diagnostic criteria for sporadic Creutzfeldt–Jakob disease. Patients with sporadic Creutzfeldt–Jakob disease and fluid attenuated inversion recovery or diffusion-weight imaging were recruited from 12 countries. Patients referred as ‘suspected sporadic Creutzfeldt–Jakob disease’ but with an alternative diagnosis after thorough follow up, were analysed as controls. All magnetic resonance imaging scans were assessed for signal changes according to a standard protocol encompassing seven cortical regions, basal ganglia, thalamus and cerebellum. Magnetic resonance imaging scans were evaluated in 436 sporadic Creutzfeldt–Jakob disease patients and 141 controls. The pattern of high signal intensity with the best sensitivity and specificity in the differential diagnosis of sporadic Creutzfeldt–Jakob disease was identified. The optimum diagnostic accuracy in the differential diagnosis of rapid progressive dementia was obtained when either at least two cortical regions (temporal, parietal or occipital) or both caudate nucleus and putamen displayed a high signal in fluid attenuated inversion recovery or diffusion-weight imaging magnetic resonance imaging. Based on our analyses, magnetic

  2. [Causes and pathophysiology of pediatric obesity and its diagnostic criteria].

    PubMed

    Ohzeki, Takehiko

    2013-02-01

    Recently, obesity has been listed as important health problems not only in adults but also in children. Prevalence of pediatric obesity has been rising in the last half century in most of the developed countries including Japan. In addition to changes in lifestyle, which are shown to have contributed greatly to promote weight gain in recent years, patients with some syndromes or diseases may have obesity as one of the manifestations of the disorders especially in childhood. Obese individuals are commonly accompanied by derangement in various organs, such as metabolic and cardiovascular systems, in children as well as adults. Diagnostic criteria for obesity-disease and metabolic syndrome were proposed on the basis of data obtained from Japanese children.

  3. The DSM diagnostic criteria for paraphilia not otherwise specified.

    PubMed

    Kafka, Martin P

    2010-04-01

    The category of "Not Otherwise Specified" (NOS) for DSM-based psychiatric diagnosis has typically retained diagnoses whose rarity, empirical criterion validation or symptomatic expression has been insufficient to be codified. This article reviews the literature on Telephone Scatologia, Necrophilia, Zoophilia, Urophilia, Coprophilia, and Partialism. Based on extant data, no changes are suggested except for the status of Partialism. Partialism, sexual arousal characterized by "an exclusive focus on part of the body," had historically been subsumed as a type of Fetishism until the advent of DSM-III-R. The rationale for considering the removal of Partialism from Paraphilia NOS and its reintegration as a specifier for Fetishism is discussed here and in a companion review on the DSM diagnostic criteria for fetishism (Kafka, 2009). In the DSM-IV and DSM-IV-TR, the essential features of a Paraphilia are recurrent, intense sexually arousing fantasies, sexual urges or behaviors generally involving nonhuman objects, the suffering or humiliation of oneself or one's partner, or children or other nonconsenting persons that occur over a period of at least 6 months (Criterion A). Given consideration for the erotic focus of Partialism and Autoerotic Asphyxia, amending the operational criteria for Paraphilia should be considered to include an atypical focus involving human subjects (self or others).

  4. Diagnostic criteria for Menière's disease.

    PubMed

    Lopez-Escamez, Jose A; Carey, John; Chung, Won-Ho; Goebel, Joel A; Magnusson, Måns; Mandalà, Marco; Newman-Toker, David E; Strupp, Michael; Suzuki, Mamoru; Trabalzini, Franco; Bisdorff, Alexandre

    2015-01-01

    This paper presents diagnostic criteria for Menière's disease jointly formulated by the Classification Committee of the Bárány Society, The Japan Society for Equilibrium Research, the European Academy of Otology and Neurotology (EAONO), the Equilibrium Committee of the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) and the Korean Balance Society. The classification includes two categories: definite Menière's disease and probable Menière's disease. The diagnosis of definite Menière's disease is based on clinical criteria and requires the observation of an episodic vertigo syndrome associated with low- to medium-frequency sensorineural hearing loss and fluctuating aural symptoms (hearing, tinnitus and/or fullness) in the affected ear. Duration of vertigo episodes is limited to a period between 20 minutes and 12 hours. Probable Menière's disease is a broader concept defined by episodic vestibular symptoms (vertigo or dizziness) associated with fluctuating aural symptoms occurring in a period from 20 minutes to 24 hours.

  5. Diagnostic criteria for mass lesions differentiating in electrical impedance mammography

    NASA Astrophysics Data System (ADS)

    A, Karpov; M, Korotkova

    2013-04-01

    The purpose of this research was to determine the diagnostic criteria for differentiating volumetric lesions in the mammary gland in electrical impedance mammography. The research was carried out utilizing the electrical impedance computer mammograph llMEIK v.5.6gg®, which enables to acquire images of 3-D conductivity distribution layers within mamma's tissues up to 5 cm depth. The weighted reciprocal projection method was employed to reconstruct the 3-D electric conductivity distribution of the examined organ. The results of 3,710 electrical impedance examinations were analyzed. The analysis of a volumetric lesion included assessment of its shape, contour, internal electrical structure and changes of the surrounding tissues. Moreover, mammary gland status was evaluated with the help of comparative and age-related electrical conductivity curves. The diagnostic chart is provided. Each criterion is measured in points. Using the numerical score for evaluation of mass and non-volumetric lesions within the mammary gland in electrical impedance mammography allowed comparing this information to BI-RADS categories developed by American College of Radiology experts. The article is illustrated with electrical impedance mammograms and tables.

  6. Right ventricular sarcoidosis: is it time for updated diagnostic criteria?

    PubMed

    Vakil, Kairav; Minami, Elina; Fishbein, Daniel P

    2014-04-01

    A 55-year-old woman with a history of complete heart block, atrial flutter, and progressive right ventricular failure was referred to our tertiary care center to be evaluated for cardiac transplantation. The patient's clinical course included worsening right ventricular dysfunction for 3 years before the current evaluation. Our clinical findings raised concerns about arrhythmogenic right ventricular cardiomyopathy. Noninvasive imaging, including a positron emission tomographic scan, did not reveal obvious myocardial pathologic conditions. Given the end-stage nature of the patient's right ventricular failure and her dependence on inotropic agents, she underwent urgent listing and subsequent heart transplantation. Pathologic examination of the explanted heart revealed isolated right ventricular sarcoidosis with replacement fibrosis. Biopsy samples of the cardiac allograft 6 months after transplantation showed no recurrence of sarcoidosis. This atypical presentation of isolated cardiac sarcoidosis posed a considerable diagnostic challenge. In addition to discussing the patient's case, we review the relevant medical literature and discuss the need for updated differential diagnostic criteria for end-stage right ventricular failure that mimics arrhythmogenic right ventricular cardiomyopathy.

  7. Nevada Test Site Waste Acceptance Criteria (NTSWAC), Rev. 7-01

    SciTech Connect

    NSTec Environmental Management

    2009-05-01

    This document establishes the U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office, Nevada Test Site Waste Acceptance Criteria (NTSWAC). The NTSWAC provides the requirements, terms, and conditions under which the Nevada Test Site (NTS) will accept low-level radioactive waste and mixed low-level waste for disposal. The NTSWAC includes requirements for the generator waste certification program, characterization, traceability, waste form, packaging, and transfer. The criteria apply to radioactive waste received at the NTS Area 3 and Area 5 Radioactive Waste Management Complex for disposal.

  8. Waste acceptance criteria for the Waste Isolation Pilot Plant. Revision 4

    SciTech Connect

    Not Available

    1991-12-01

    This Revision 4 of the Waste Acceptance Criteria (WAC), WIPP-DOE-069, identifies and consolidates existing criteria and requirements which regulate the safe handling and preparation of Transuranic (TRU) waste packages for transportation to and emplacement in the Waste Isolation Pilot Plant (WIPP). This consolidation does not invalidate any existing certification of TRU waste to the WIPP Operations and Safety Criteria (Revision 3 of WIPP-DOE--069) and/or Transportation: Waste Package Requirements (TRUPACT-II Safety Analysis Report for Packaging [SARP]). Those documents being consolidated, including Revision 3 of the WAC, currently support the Test Phase.

  9. Neurogenic thoracic outlet syndrome: current diagnostic criteria and advances in MRI diagnostics.

    PubMed

    Magill, Stephen T; Brus-Ramer, Marcel; Weinstein, Philip R; Chin, Cynthia T; Jacques, Line

    2015-09-01

    Neurogenic thoracic outlet syndrome (nTOS) is caused by compression of the brachial plexus as it traverses from the thoracic outlet to the axilla. Diagnosing nTOS can be difficult because of overlap with other complex pain and entrapment syndromes. An nTOS diagnosis is made based on patient history, physical exam, electrodiagnostic studies, and, more recently, interpretation of MR neurograms with tractography. Advances in high-resolution MRI and tractography can confirm an nTOS diagnosis and identify the location of nerve compression, allowing tailored surgical decompression. In this report, the authors review the current diagnostic criteria, present an update on advances in MRI, and provide case examples demonstrating how MR neurography (MRN) can aid in diagnosing nTOS. The authors conclude that improved high-resolution MRN and tractography are valuable tools for identifying the source of nerve compression in patients with nTOS and can augment current diagnostic modalities for this syndrome.

  10. 48 CFR 915.607 - Criteria for acceptance and negotiation of an unsolicited proposal.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... and negotiation of an unsolicited proposal. 915.607 Section 915.607 Federal Acquisition Regulations System DEPARTMENT OF ENERGY CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Unsolicited Proposals 915.607 Criteria for acceptance and negotiation of an unsolicited proposal. (c) DOE's...

  11. 48 CFR 15.607 - Criteria for acceptance and negotiation of an unsolicited proposal.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... and negotiation of an unsolicited proposal. 15.607 Section 15.607 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Unsolicited Proposals 15.607 Criteria for acceptance and negotiation of an unsolicited proposal. (a)...

  12. 48 CFR 15.607 - Criteria for acceptance and negotiation of an unsolicited proposal.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... and negotiation of an unsolicited proposal. 15.607 Section 15.607 Federal Acquisition Regulations System FEDERAL ACQUISITION REGULATION CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Unsolicited Proposals 15.607 Criteria for acceptance and negotiation of an unsolicited proposal. (a)...

  13. 48 CFR 915.607 - Criteria for acceptance and negotiation of an unsolicited proposal.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... and negotiation of an unsolicited proposal. 915.607 Section 915.607 Federal Acquisition Regulations System DEPARTMENT OF ENERGY CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION Unsolicited Proposals 915.607 Criteria for acceptance and negotiation of an unsolicited proposal. (c) DOE's...

  14. 46 CFR 164.019-5 - Standard components; acceptance criteria and procedures.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 46 Shipping 6 2011-10-01 2011-10-01 false Standard components; acceptance criteria and procedures. 164.019-5 Section 164.019-5 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL MATERIALS Personal Flotation...

  15. 46 CFR 164.019-5 - Standard components; acceptance criteria and procedures.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 46 Shipping 6 2012-10-01 2012-10-01 false Standard components; acceptance criteria and procedures. 164.019-5 Section 164.019-5 Shipping COAST GUARD, DEPARTMENT OF HOMELAND SECURITY (CONTINUED) EQUIPMENT, CONSTRUCTION, AND MATERIALS: SPECIFICATIONS AND APPROVAL MATERIALS Personal Flotation...

  16. Technical Basis For Radiological Acceptance Criteria For Uranium At The Y-12 National Security Complex

    SciTech Connect

    Veinot, K. G.

    2009-07-22

    The purpose of this report is to establish radiological acceptance criteria for uranium. Other factors for acceptance not considered include criticality safety concerns, contaminants to the process stream, and impacts to the Safety Basis for the affected facilities. Three types of criteria were developed in this report. They include limits on external penetrating and non-penetrating radiation and on the internal hazard associated with inhalation of the material. These criteria are intended to alleviate the need for any special controls beyond what are normally utilized for worker protection from uranium hazards. Any proposed exceptions would require case-by-case evaluations to determine cost impacts and feasibility. Since Y-12 has set rigorous ALARA goals for worker doses, the external limits are based on assumptions of work time involved in the movement of accepted material plus the desire that external doses normally received are not exceeded, and set so that no special personnel monitoring would be required. Internal hazard controls were established so that dose contributions from non-uranium nuclides would not exceed 10% of that expected from the uranium component. This was performed using a Hazard Index (HI) previously established for work in areas contaminated with non-uranium nuclides. The radiological acceptance criteria for uranium are summarized in Table 1. Note that these limits are based on the assumption that radioactive daughter products have reached equilibrium.

  17. 77 FR 51880 - Requirements for Maintenance of Inspections, Tests, Analyses, and Acceptance Criteria

    Federal Register 2010, 2011, 2012, 2013, 2014

    2012-08-28

    ... COMMISSION 10 CFR Parts 2 and 52 RIN 3150-AI77 Requirements for Maintenance of Inspections, Tests, Analyses... regulations related to verification of nuclear power plant construction activities through inspections, tests... determining that inspections, tests, or analyses were performed as required, or that acceptance criteria...

  18. 48 CFR 915.607 - Criteria for acceptance and negotiation of an unsolicited proposal.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 48 Federal Acquisition Regulations System 5 2013-10-01 2013-10-01 false Criteria for acceptance and negotiation of an unsolicited proposal. 915.607 Section 915.607 Federal Acquisition Regulations System DEPARTMENT OF ENERGY CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION...

  19. 48 CFR 915.607 - Criteria for acceptance and negotiation of an unsolicited proposal.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 48 Federal Acquisition Regulations System 5 2014-10-01 2014-10-01 false Criteria for acceptance and negotiation of an unsolicited proposal. 915.607 Section 915.607 Federal Acquisition Regulations System DEPARTMENT OF ENERGY CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION...

  20. 48 CFR 915.607 - Criteria for acceptance and negotiation of an unsolicited proposal.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 48 Federal Acquisition Regulations System 5 2012-10-01 2012-10-01 false Criteria for acceptance and negotiation of an unsolicited proposal. 915.607 Section 915.607 Federal Acquisition Regulations System DEPARTMENT OF ENERGY CONTRACTING METHODS AND CONTRACT TYPES CONTRACTING BY NEGOTIATION...

  1. Parents' "Hard" Knowledge of Admission Criteria and Acceptance in Philadelphia's High School Choice Process

    ERIC Educational Resources Information Center

    Haxton, Clarisse L.; Neild, Ruth Curran

    2012-01-01

    We examine parents' knowledge of discrete, verifiable facts--what we call "hard knowledge"--in a high school application process. Using parent survey data (n = 658) from the School District of Philadelphia, this study examines whether parents knew the admission criteria and acceptance rate at the high school they most wanted their child…

  2. Classification, diagnostic criteria and management of benign paroxysmal positional vertigo.

    PubMed

    Imai, Takao; Takeda, Noriaki; Ikezono, Tetsuo; Shigeno, Kohichiro; Asai, Masatsugu; Watanabe, Yukio; Suzuki, Mamoru

    2017-02-01

    Benign paroxysmal positional vertigo (BPPV) is the most common peripheral vertigo and the posterior and/or lateral semicircular canals are usually affected. BPPV is characterized by brief attacks of rotatory vertigo associated with positional and/or positioning nystagmus, which are elicited by specific head positions or changes in head position relative to gravity. In patients with the posterior-canal-type of BPPV, torsional nystagmus is induced by the Dix-Hallpike maneuver. In patients with the lateral-canal-type of BPPV, horizontal geotropic or apogeotropic nystagmus is induced by the supine roll test. The pathophysiology of BPPV is canalolithiasis comprising free-floating otoconial debris within the endolymph of a semicircular canal, or cupulolithiasis comprising otoconial debris adherent to the cupula. The observation of positional and/or positioning nystagmus is essential for the diagnosis of BPPV. BPPV is treated with the canalith repositioning procedure (CRP). Through a series of head position changes, the CRP moves otoconial debris from the affected semicircular canal to the utricle. In this review, we provide the classification, diagnostic criteria, and examinations for the diagnosis, and specific and non-specific treatments of BPPV in accordance with the Japanese practical guidelines on BPPV published by the Japan Society for Equilibrium Research.

  3. DSM-5 proposed diagnostic criteria for sexual paraphilias: tensions between diagnostic validity and forensic utility.

    PubMed

    Wakefield, Jerome C

    2011-01-01

    In order to prevent sexual crimes, "sexual predator" laws now allow indefinite preventive civil commitment of criminals who have completed their prison sentences but are judged to have a paraphilic mental disorder that makes them likely to commit another crime. Such proceedings can bypass the usual protections of criminal law as long as the basis for incarceration is the attribution of a mental disorder. Thus, the difficult conceptual distinction between deviant sexual desires that are mental disorders versus those that are normal variations in sexual preference (even if they are eccentric, repugnant, or illegal if acted upon) has attained critical forensic significance. Yet, the concept of paraphilic disorders - called "perversions" in earlier times - is inherently fuzzy and controversial and thus open to conceptual abuse for social control purposes. Consequently, the criteria used in diagnosing paraphilic disorders deserve careful scrutiny. The DSM-5 sexual disorders work group is proposing substantial revisions to the paraphilia diagnostic criteria in the DSM-5 nosology. It is claimed that the new criteria provide a reconceptualization that clarifies the distinction between normal variation and paraphilic disorder in a way relevant to forensic settings. In this article, after considering the logic of the concept of a paraphilic disorder, I examine each of the proposed changes to the DSM-5 paraphilia criteria and assess their conceptual validity. I argue that the DSM-5 proposals, while containing a kernel of an advance in distinguishing paraphilias from paraphilic disorders, nonetheless would yield criteria for paraphilic disorders that are conceptually invalid in ways open to serious forensic abuse.

  4. Examining DSM Criteria for Trichotillomania in a Dimensional Framework: Implications for DSM-5 and Diagnostic Practice

    PubMed Central

    Houghton, David C.; Balsis, Steve; Stein, Dan J.; Compton, Scott N.; Twohig, Michael P.; Saunders, Stephen M.; Franklin, Martin E.; Neal-Barnett, Angela M.; Woods, Douglas W.

    2015-01-01

    Background Diagnosis of Trichotillomania (TTM) requires meeting several criteria that aim to embody the core pathology of the disorder. These criteria are traditionally interpreted monothetically, in that they are all equally necessary for diagnosis. Alternatively, a dimensional conceptualization of psychopathology allows for examination of the relatedness of each criterion to the TTM latent continuum. Objectives First, to examine the ability of recently removed criteria (B and C) to identify the latent dimensions of TTM psychopathology, such that they discriminate between individuals with low and high degrees of hair pulling severity. Second, to determine the impact of removing criteria B and C on the information content of remaining diagnostic criteria. Third, to determine the psychometric properties of remaining TTM diagnostic criteria that remain largely unchanged in DSM-5; that is, whether they measure distinct or overlapping levels of TTM psychopathology. Fourth, to determine whether information content derived from diagnostic criteria aid in the prediction of disease trajectory (i.e., can relapse propensity be predicted from criteria endorsement patterns). Method Statistics derived from Item Response Theory were used to examine diagnostic criteria endorsement in 91 adults with TTM who underwent psychotherapy. Results The removal of two criteria in DSM-5 and psychometric validity of remaining criteria was supported. Additionally, individual trait parameters were used to predict treatment progress, uncovering predictive power where none previously existed. Conclusions Diagnostic criteria for TTM should be examined in dimensional models, which allow for nuanced and sensitive measurement of core symptomology in treatment contexts. PMID:25972228

  5. Proposed diagnostic criteria and classification of basophilic leukemias and related disorders.

    PubMed

    Valent, P; Sotlar, K; Blatt, K; Hartmann, K; Reiter, A; Sadovnik, I; Sperr, W R; Bettelheim, P; Akin, C; Bauer, K; George, T I; Hadzijusufovic, E; Wolf, D; Gotlib, J; Mahon, F-X; Metcalfe, D D; Horny, H-P; Arock, M

    2017-02-10

    Basophils form a distinct cell lineage within the hematopoietic cell family. In various myeloid neoplasms, including chronic myeloid leukemia, basophilia is frequently seen. Acute and chronic basophilic leukemias, albeit rare, have also been described. However, no generally accepted criteria and classification of basophilic leukemias have been presented to date. To address this unmet need, a series of Working Conferences and other meetings were organized between March 2015 and March 2016. The current article provides a summary of consensus statements from these meetings, together with proposed criteria to delineate acute basophilic leukemia (ABL) from chronic basophilic leukemia (CBL) and primary forms of the disease where no preceding myeloid malignancy is detected, from the more common 'secondary' variants. Moreover, the term hyperbasophilia (HB) is proposed for cases with a persistent peripheral basophil count ⩾1000 per μl of blood. This condition, HB, is highly indicative of the presence of an underlying myeloid neoplasm. Therefore, HB is an important checkpoint in the diagnostic algorithm and requires a detailed hematologic investigation. In these patients, an underlying myeloid malignancy is often found and is then labeled with the appendix -baso, whereas primary cases of ABL or CBL are very rare. The criteria and classification proposed in this article should facilitate the diagnosis and management of patients with unexplained basophilia and basophil neoplasms in routine practice, and in clinical studies.Leukemia advance online publication, 10 February 2017; doi:10.1038/leu.2017.15.

  6. LANL Waste acceptance criteria, Chapter 3, radioactive liquid waste treatment facility

    SciTech Connect

    McClenahan, Robert L.

    2006-08-01

    The Radioactive Liquid Waste Treatment Facility (RLWTF) receives and treats aqueous radioactive wastewater generated at Los Alamos National Laboratory (LANL) to meet he discharge criteria specified in a National Pollution Discharge Elimination System (NPDES) permit. The majority of this wastewater is received at the RLWTF through a network of buried pipelines, known as the Radioactive Liquid Waste Collection System (RLWCS). Other wastewater is transported to the RLWTF by truck. The Waste Acceptance Criteria (WAC) outlined in this Chapter are applicable to all radioactive wastewaters which are conveyed to the Technical Area 50(T A-50), RL WTF by the RLWCS or by truck.

  7. Addressing patient safety through the use of 'criteria of acceptability' for medical radiation equipment.

    PubMed

    Gilley, Debbie Bray; Holmberg, Ola

    2013-02-01

    Patient safety should be considered in the use of ionising radiation equipment in medicine. The International Atomic Energy Agency (IAEA) establishes standards of safety and provides for the application of these standards, also in the area of medical use of radiation. Equipment acceptability, as it relates to radiation in medicine, is the need to satisfy the requirements or standards prior to the use of the device in patient imaging or treatment. Through IAEA activities in establishing and developing Safety Standards, Safety Reports and recommendations to regulatory authorities and end-users, it encourages the adoption of acceptability criteria that are relevant to the medical equipment and its use.

  8. Development of Waste Acceptance Criteria at 221-U Building: Initial Flow and Transport Scoping Calculations

    SciTech Connect

    Freedman, Vicky L.; Zhang, Z. F.; Keller, Jason M.; Chen, Yousu

    2007-05-30

    This report documents numerical flow and transport simulations performed that establish initial waste acceptance criteria for the potential waste streams that may be safely sequestered in the 221-U Building and similar canyon structures. Specifically, simulations were executed to identify the maximum loading of contaminant mass (without respect to volume) that can be emplaced within the 221-U Building with no more than 1 pCi/m2 of contaminant migrating outside the structure within a 1,000 year time period. The initial scoping simulations were executed in one dimension to assess important processes, and then two dimensions to establish waste acceptance criteria. Two monolithic conditions were assessed: (1) a grouted canyon monolith; and (2) a canyon monolith filled with sand, both assuming no cracks or fissures were present to cause preferential transport. A three-staged approach was taken to account for different processes that may impact the amount of contaminant that can be safely sequestered in canyon structure. In the first stage, flow and transport simulations established waste acceptance criteria based on a linear (Kd) isotherm approach. In the second stage, impacts on thermal loading were examined and the differences in waste acceptance criteria quantified. In the third stage of modeling, precipitation/dissolution reactions were considered on the release and transport of the contaminants, and the subsequent impact on the maximum contaminant loading. The reactive transport modeling is considered a demonstration of the reactive transport capability, and shows the importance of its use for future performance predictions once site-specific data have been obtained.

  9. 10 CFR 51.108 - Public hearings on Commission findings that inspections, tests, analyses, and acceptance criteria...

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ..., tests, analyses, and acceptance criteria of combined licenses are met. 51.108 Section 51.108 Energy...) Production and Utilization Facilities § 51.108 Public hearings on Commission findings that inspections, tests, analyses, and acceptance criteria of combined licenses are met. In any public hearing requested under...

  10. 10 CFR 51.108 - Public hearings on Commission findings that inspections, tests, analyses, and acceptance criteria...

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ..., tests, analyses, and acceptance criteria of combined licenses are met. 51.108 Section 51.108 Energy...) Production and Utilization Facilities § 51.108 Public hearings on Commission findings that inspections, tests, analyses, and acceptance criteria of combined licenses are met. In any public hearing requested under...

  11. 10 CFR 50.60 - Acceptance criteria for fracture prevention measures for lightwater nuclear power reactors for...

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 10 Energy 1 2013-01-01 2013-01-01 false Acceptance criteria for fracture prevention measures for... of Licenses and Construction Permits § 50.60 Acceptance criteria for fracture prevention measures for... certifications required under § 50.82(a)(1) have been submitted, must meet the fracture toughness and...

  12. 10 CFR 50.60 - Acceptance criteria for fracture prevention measures for lightwater nuclear power reactors for...

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 10 Energy 1 2014-01-01 2014-01-01 false Acceptance criteria for fracture prevention measures for... of Licenses and Construction Permits § 50.60 Acceptance criteria for fracture prevention measures for... certifications required under § 50.82(a)(1) have been submitted, must meet the fracture toughness and...

  13. 10 CFR 50.60 - Acceptance criteria for fracture prevention measures for lightwater nuclear power reactors for...

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 10 Energy 1 2012-01-01 2012-01-01 false Acceptance criteria for fracture prevention measures for... of Licenses and Construction Permits § 50.60 Acceptance criteria for fracture prevention measures for... certifications required under § 50.82(a)(1) have been submitted, must meet the fracture toughness and...

  14. Corrosion control acceptance criteria for sacrificial anode type, cathodic protection systems (user guide)

    NASA Astrophysics Data System (ADS)

    Hock, Vincent F.; Noble, Michael; McLeod, Malcolm E.

    1994-07-01

    The Army currently operates and maintains more than 20,000 underground storage tanks and over 3000 miles of underground gas pipelines, all of which require some form of corrosion control. Cathodic protection is one method of corrosion control used to prevent corrosion-induced leaks when a steel structure is exposed to an aggressive soil. The corrosion control acceptance criteria for sacrificial anode type CP systems provides guidelines for the DEH/DPW cathodic protection installation inspectors whose responsibilities are to ensure that the materials and equipment specified are delivered to the job site and subsequently installed in accordance with the engineering drawings and specifications. The sacrificial anode CP acceptance criteria includes all components for the sacrificial anode system such as insulated conductors, anodes, anode backfills, and auxiliary equipment. The sacrificial anode CP acceptance criteria is composed of a checklist that lists each component and that contains a space for the inspector to either check 'yes' or 'no' to indicate whether the component complies with the job specifications. In some cases, the inspector must measure and record physical dimensions or electrical output and compare the measurements to standards shown in attached tables.

  15. Variation transmission model for setting acceptance criteria in a multi-staged pharmaceutical manufacturing process.

    PubMed

    Montes, Richard O

    2012-03-01

    Pharmaceutical manufacturing processes consist of a series of stages (e.g., reaction, workup, isolation) to generate the active pharmaceutical ingredient (API). Outputs at intermediate stages (in-process control) and API need to be controlled within acceptance criteria to assure final drug product quality. In this paper, two methods based on tolerance interval to derive such acceptance criteria will be evaluated. The first method is serial worst case (SWC), an industry risk minimization strategy, wherein input materials and process parameters of a stage are fixed at their worst-case settings to calculate the maximum level expected from the stage. This maximum output then becomes input to the next stage wherein process parameters are again fixed at worst-case setting. The procedure is serially repeated throughout the process until the final stage. The calculated limits using SWC can be artificially high and may not reflect the actual process performance. The second method is the variation transmission (VT) using autoregressive model, wherein variation transmitted up to a stage is estimated by accounting for the recursive structure of the errors at each stage. Computer simulations at varying extent of variation transmission and process stage variability are performed. For the scenarios tested, VT method is demonstrated to better maintain the simulated confidence level and more precisely estimate the true proportion parameter than SWC. Real data examples are also presented that corroborate the findings from the simulation. Overall, VT is recommended for setting acceptance criteria in a multi-staged pharmaceutical manufacturing process.

  16. DIAGNOSTIC CRITERIA FOR PROLIFERATIVE THYROID LESIONS IN BONY FISHES

    EPA Science Inventory

    Criteria for distinguishing hyperplastic thyroid lesions from thyroid neoplasia in bony fishes have long been debated by scientists. Confusion exists because the thyroid tissue in most teleosts is unencapsulated, is occasionally found in ectopic sites, and is frequently predispos...

  17. Applicability and agreement of different diagnostic criteria for sarcopenia estimation in the elderly.

    PubMed

    Pagotto, Valéria; Silveira, Erika Aparecida

    2014-01-01

    The purpose of this study cross-sectional study comprising 132 community dwelling elderly (≥ 60 years) was to identify sarcopenia prevalence in the Brazilian elderly, utilizing different diagnostic criteria and analyze agreement between criteria. Sarcopenia was assessed by nine muscle mass diagnostic criteria, by two muscle strength criteria and also by the combination of criteria. Prevalence was analyzed for each method, along with differences by gender and age group through calculation of the prevalence ratio (PR) and confidence interval (CI) 95%. The Kappa coefficient was used to analyze the level of agreement between all criteria. Sarcopenia prevalence varied between 60.6% and 8.3% with the application of muscle mass criteria, and between 54.2% and 48.8% with the application of strength criteria. The combination muscle mass+strength resulted in a decrease of prevalence in all criteria, varying between 36.6% and 6.1%. There was an increase in prevalence according to age groups for all methods. Prevalence was higher for men according to three muscle mass criteria, and higher in women for strength criteria and by two combined mass+strength criteria. The best level of agreement was obtained for two methods that utilized dual energy X-ray absorptiometry (DXA). The prevalence of sarcopenia differs by gender and age and definition criteria. The low agreement levels obtained between methods and the different prevalence values encountered indicate the necessities of an operational definition for the estimation of sarcopenia in different population.

  18. Six additional cases of the KBG syndrome: clinical reports and outline of the diagnostic criteria.

    PubMed

    Zollino, M; Battaglia, A; D'Avanzo, M G; Della Bruna, M M; Marini, R; Scarano, G; Cappa, M; Neri, G

    1994-09-01

    A diagnosis of KBG syndrome was made in six unrelated patients. They presented with slight mental retardation, macrodontia, and skeletal abnormalities. Microcephaly, short stature, facial anomalies, and syndactylies were also noted. The diagnostic criteria of the KBG syndrome are discussed.

  19. A Pilot Study on Modeling of Diagnostic Criteria Using OWL and SWRL.

    PubMed

    Hong, Na; Jiang, Guoqian; Pathak, Jyotishiman; Chute, Christopher G

    2015-01-01

    The objective of this study is to describe our efforts in a pilot study on modeling diagnostic criteria using a Semantic Web-based approach. We reused the basic framework of the ICD-11 content model and refined it into an operational model in the Web Ontology Language (OWL). The refinement is based on a bottom-up analysis method, in which we analyzed data elements (including value sets) in a collection (n=20) of randomly selected diagnostic criteria. We also performed a case study to formalize rule logic in the diagnostic criteria of metabolic syndrome using the Semantic Web Rule Language (SWRL). The results demonstrated that it is feasible to use OWL and SWRL to formalize the diagnostic criteria knowledge, and to execute the rules through reasoning.

  20. International Harmonization of Nomenclature and Diagnostic Criteria (INHAND) progress to date and future plans.

    PubMed

    Keenan, Charlotte M; Baker, Julia F; Bradley, Alys E; Goodman, Dawn G; Harada, Takanori; Herbert, Ronald; Kaufmann, Wolfgang; Kellner, Rupert; Mahler, Beth; Meseck, Emily; Nolte, Thomas; Rittinghausen, Susanne; Vahle, John; Yoshizawa, Katsuhiko

    2015-01-01

    The INHAND Proposal (International Harmonization of Nomenclature and Diagnostic Criteria for Lesions in Rats and Mice) has been operational since 2005. A Global Editorial Steering Committee (GESC) manages the overall objectives of the project and the development of harmonized terminology for each organ system is the responsibility of the Organ Working Groups (OWG), drawing upon experts from North America, Europe and Japan.Great progress has been made with 9 systems published to date - Respiratory, Hepatobiliary, Urinary, Central/Peripheral Nervous Systems, Male Reproductive and Mammary, Zymbals, Clitoral and Preputial Glands in Toxicologic Pathology and the Integument and Soft Tissue and Female Reproductive System in the Journal of Toxicologic Pathology as supplements and on a web site - www.goreni.org. INHAND nomenclature guides offer diagnostic criteria and guidelines for recording lesions observed in rodent toxicity and carcinogenicity studies. The guides provide representative photo-micrographs of morphologic changes, information regarding pathogenesis, and key references. During 2012, INHAND GESC representatives attended meetings with representatives of the FDA Center for Drug Evaluation and Research (CDER), Clinical Data Interchange Standards Consortium (CDISC), and the National Cancer Institute (NCI) Enterprise Vocabulary Services (EVS) to begin incorporation of INHAND terminology as preferred terminology for SEND (Standard for Exchange of Nonclinical Data) submissions to the FDA. The interest in utilizing the INHAND nomenclature, based on input from industry and government toxicologists as well as information technology specialists, suggests that there will be wide acceptance of this nomenclature. The purpose of this publication is to provide an update on the progress of INHAND.

  1. Towards a consensus on diagnostic criteria, measurement and trial design of the premenstrual disorders: the ISPMD Montreal consensus

    PubMed Central

    Bäckström, Torbjorn; Brown, Candace; Dennerstein, Lorraine; Endicott, Jean; Epperson, C. Neill; Eriksson, Elias; Freeman, Ellen; Halbreich, Uriel; Ismail, Khaled M. K.; Panay, Nicholas; Pearlstein, Teri; Rapkin, Andrea; Reid, Robert; Schmidt, Peter; Steiner, Meir; Studd, John; Yonkers, Kimberley

    2014-01-01

    Premenstrual disorders (PMD) are characterised by a cluster of somatic and psychological symptoms of varying severity that occur during the luteal phase of the menstrual cycle and resolve during menses (Freeman and Sondheimer, Prim Care Companion J Clin Psychiatry 5:30–39, 2003; Halbreich, Gynecol Endocrinol 19:320–334, 2004). Although PMD have been widely recognised for many decades, their precise cause is still unknown and there are no definitive, universally accepted diagnostic criteria. To consider this issue, an international multidisciplinary group of experts met at a face-to-face consensus meeting to review current definitions and diagnostic criteria for PMD. This was followed by extensive correspondence. The consensus group formally became established as the International Society for Premenstrual Disorders (ISPMD). The inaugural meeting of the ISPMD was held in Montreal in September 2008. The primary aim was to provide a unified approach for the diagnostic criteria of PMD, their quantification and guidelines on clinical trial design. This report summarises their recommendations. It is hoped that the criteria proposed here will inform discussions of the next edition of the World Health Organisation's International Classification of Diseases (ICD-11), and the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-V) criteria that are currently under consideration. It is also hoped that the proposed definitions and guidelines could be used by all clinicians and investigators to provide a consistent approach to the diagnosis and treatment of PMD and to aid scientific and clinical research in this field. PMID:21225438

  2. Masticatory muscle disorders diagnostic criteria: the American Academy of Orofacial Pain versus the research diagnostic criteria/temporomandibular disorders (RDC/TMD).

    PubMed

    Reiter, S; Goldsmith, C; Emodi-Perlman, A; Friedman-Rubin, P; Winocur, E

    2012-12-01

    In this study, relevant cases were retrospectively reviewed to identify patients who were diagnosed as suffering from myofascial pain only according to the research diagnostic criteria/temporomandibular disorders (RDC/TMD) criteria, in order to examine whether or not they could fulfil the American Academy of Orofacial Pain (AAOP) diagnostic criteria for TMD-related masticatory muscle disorders. One hundred and twenty-seven patients, diagnosed according to the RDC/TMD criteria as having myofascial pain with or without limited jaw opening only, were allocated to two groups according to their answers to the RDC/TMD 'jaw disability checklist'. The two groups were compared for Axis I and II data taken from the RDC/TMD questionnaire. Thirty-eight of the patients (29·9%) did not associate their symptoms with jaw functions (e.g. chewing and yawning). This group was characterised by increased range of motion (ROM) and older average age. The AAOP diagnostic criteria for TMD require pain on function in all subtypes of TMD-related muscle disorders. An association between pain and jaw function is common and research is needed to determine whether this should be categorised differently to muscle pain unrelated to jaw function. There may well be different pathophysiological mechanisms and consequently different management strategies for these two pain conditions.

  3. An investigation of the validity of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition avoidant personality disorder construct as a prototype category and the psychometric properties of the diagnostic criteria.

    PubMed

    Hummelen, Benjamin; Wilberg, Theresa; Pedersen, Geir; Karterud, Sigmund

    2006-01-01

    This study investigated several aspects of the validity of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition avoidant personality disorder (APD) construct, with emphasis on the psychometric properties of the diagnostic criteria and the prototype nature of the construct. A sample of 1,058 patients from the Norwegian Network of Psychotherapeutic Day Hospitals was examined by means of exploratory factor analysis, correlation, and diagnostic efficiency statistics, chi(2) analysis, and frequency distribution. The results indicated that APD is a 1-dimensional construct with good internal consistency. The criteria had acceptable diagnostic efficiency; criterion 3 performed poorest. Number of APD criteria showed no distinct threshold between No-APD and patients with APD. Sixty-two different combinations of any 4 APD criteria occurred. It can be concluded that the prototype model fitted the data well and that the APD diagnostic criteria perform well in the current classification system. The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition hierarchy of criteria was not supported.

  4. Diagnostic Clast-Texture Criteria for Recognition of Impact Deposits

    NASA Technical Reports Server (NTRS)

    Marshall, J. R.; Bratton, C.; Pope, K. O.; Ocampo, A. C.

    1999-01-01

    It is difficult to find definitive evidence for impact in the geological record because there are many endogenous geological processes that can produce diamictites similar to those generated by impact ejecta. The classic impact criteria of shock fabrics in certain minerals, and iridium layers, for example, may be either difficult to find, or long-since erased from the impact site (shock fabrics also anneal with time). It is important to be able to recognize impact-generated materials in order to understand earth's crustal development and biological evolution. In future exploration of Mars and other solar-system bodies, recognition of impact materials will be important for elucidating planetary evolution, planetary volatile inventories, and exobiological issues. The cobble depicted is typical of many that have been found in diamictite deposits in Belize generated by the Chicxulub K-T impact event. The pebbles are roughly-hewn in general shape with smoothed corners and edges. Surfaces are almost uniformly frosted (on both protuberances and hollows), but some asperities are glazed. Optical microscopy and thin-section petrographic microscopy reveal the frosting to be only a few microns thick, with a well-defined granular structure; grains are the same size as those composing the bulk of the limestone, but their clearer appearance may represent annealing. One or two adjacent pebble faces are often decorated with striated gouges and closely-spaced hemispherical depressions representing indentation hollows produced by well-rounded impacting clasts of up to 0.5 cm in diameter. Some of the impactors are still embedded in the cobble surface. Non-destructive x-ray diffraction techniques showed the impactors to be of the same mineralogy as the target cobble. We believe this unusual glazing and frosting to be related to the impact event, but this must be reconciled with its survival for over 60 my. since it is composed of one of the most alterable substances, CaCO3. We focus

  5. Diagnostic Clast-Texture Criteria for Recognition of Impact Deposits

    NASA Astrophysics Data System (ADS)

    Marshall, J. R.; Bratton, C.; Pope, K. O.; Ocampo, A. C.

    1999-09-01

    It is difficult to find definitive evidence for impact in the geological record because there are many endogenous geological processes that can produce diamictites similar to those generated by impact ejecta. The classic impact criteria of shock fabrics in certain minerals, and iridium layers, for example, may be either difficult to find, or long-since erased from the impact site (shock fabrics also anneal with time). It is important to be able to recognize impact-generated materials in order to understand earth's crustal development and biological evolution. In future exploration of Mars and other solar-system bodies, recognition of impact materials will be important for elucidating planetary evolution, planetary volatile inventories, and exobiological issues. The cobble depicted is typical of many that have been found in diamictite deposits in Belize generated by the Chicxulub K-T impact event. The pebbles are roughly-hewn in general shape with smoothed corners and edges. Surfaces are almost uniformly frosted (on both protuberances and hollows), but some asperities are glazed. Optical microscopy and thin-section petrographic microscopy reveal the frosting to be only a few microns thick, with a well-defined granular structure; grains are the same size as those composing the bulk of the limestone, but their clearer appearance may represent annealing. One or two adjacent pebble faces are often decorated with striated gouges and closely-spaced hemispherical depressions representing indentation hollows produced by well-rounded impacting clasts of up to 0.5 cm in diameter. Some of the impactors are still embedded in the cobble surface. Non-destructive x-ray diffraction techniques showed the impactors to be of the same mineralogy as the target cobble. We believe this unusual glazing and frosting to be related to the impact event, but this must be reconciled with its survival for over 60 my. since it is composed of one of the most alterable substances, CaCO3. We focus

  6. Training in Structured Diagnostic Assessment Using DSM-IV Criteria

    ERIC Educational Resources Information Center

    Ponniah, Kathryn; Weissman, Myrna M.; Bledsoe, Sarah E.; Verdeli, Helen; Gameroff, Marc J.; Mufson, Laura; Fitterling, Heidi; Wickramaratne, Priya

    2011-01-01

    Objectives: Determining a patient's psychiatric diagnosis is an important first step for the selection of empirically supported treatments and a critical component of evidence-based practice. Structured diagnostic assessment covers the range of psychiatric diagnoses and is usually more complete and accurate than unstructured assessment. Method: We…

  7. ENVIROCARE OF UTAH: EXPANDING WASTE ACCEPTANCE CRITERIA TO PROVIDE LOW-LEVEL AND MIXED WASTE DISPOSAL OPTIONS

    SciTech Connect

    Rogers, B.; Loveland, K.

    2003-02-27

    Envirocare of Utah operates a low-level radioactive waste disposal facility 80 miles west of Salt Lake City in Clive, Utah. Accepted waste types includes NORM, 11e2 byproduct material, Class A low-level waste, and mixed waste. Since 1988, Envirocare has offered disposal options for environmental restoration waste for both government and commercial remediation projects. Annual waste receipts exceed 12 million cubic feet. The waste acceptance criteria (WAC) for the Envirocare facility have significantly expanded to accommodate the changing needs of restoration projects and waste generators since its inception, including acceptable physical waste forms, radiological acceptance criteria, RCRA requirements and treatment capabilities, PCB acceptance, and liquids acceptance. Additionally, there are many packaging, transportation, and waste management options for waste streams acceptable at Envirocare. Many subcontracting vehicles are also available to waste generators for both government and commercial activities.

  8. Comparative Capabilities of Clinical Assessment, Diagnostic Criteria, and Polysomnography in Detecting Sleep Bruxism

    PubMed Central

    Palinkas, Marcelo; De Luca Canto, Graziela; Rodrigues, Laíse Angélica Mendes; Bataglion, César; Siéssere, Selma; Semprini, Marisa; Regalo, Simone Cecilio Hallak

    2015-01-01

    Objective: To evaluate the diagnostic capability of signs and symptoms of sleep bruxism (SB) as per the American Academy of Sleep Medicine (AASM) criteria and a diagnostic grading system proposed by international experts for assessing SB. Methods: The study was conducted in three phases (interview, physical examination, and sleep studies). Subjects were asked about self-reported tooth grinding sounds occurring during sleep, muscle fatigue, temporal headaches, jaw muscle pain, and jaw locking. A visual examination was conducted to check for presence of abnormal tooth wear. A full-night polysomnography (PSG) was performed. After three phases, the subjects were divided into two groups matched by age and gender: Case Group, 45 SB subjects, and Control Group, 45 non-SB subjects. Diagnostic accuracy measurements were calculated for each sign or symptom individually and for the two diagnostic criteria analyzed. Results: Muscle fatigue, temporal headaches, and AASM criteria were associated with highest sensitivity (78%, 67%, 58%, respectively) and also with highest diagnostic odds ratio (OR = 9.63, 9.25, 6.33, respectively). Jaw locking, muscle pain, and the criterion of “probable SB” were associated with the worst sensitivity (16%, 18%, 22%, respectively). Conclusions: Presence of muscle fatigue and temporal headaches can be considered good tools to screen SB patients. None of the diagnostic criteria evaluated was able to accurately identify patients with SB. AASM criteria had the strongest diagnostic capabilities and—although they do not attain diagnostic values high enough to replace the current gold standard (PSG)—should be used as a screening tool to identify SB. Citation: Palinkas M, De Luca Canto G, Rodrigues LA, Bataglion C, Siéssere S, Semprini M, Regalo SC. Comparative capabilities of clinical assessment, diagnostic criteria, and polysomnography in detecting sleep bruxism. J Clin Sleep Med 2015;11(11):1319–1325. PMID:26235152

  9. Elastic-Plastic Strain Acceptance Criteria for Structures Subject to Rapidly Applied Transient Dynamic Loading

    SciTech Connect

    W.R. Solonick

    2003-04-01

    Rapidly applied transient dynamic loads produce stresses and deflections in structures that typically exceed those from static loading conditions. Previous acceptance criteria for structures designed for rapidly applied transient dynamic loading limited stresses to those determined from elastic analysis. Different stress limits were established for different grades of structure depending upon the amount of permanent set considered acceptable. Structure allowed to sustain very limited permanent set is designed to stress limits not significantly greater than yield stress. Greater permanent set in structure under rapidly applied transient dynamic loading conditions is permitted by establishing stress limits that are significantly greater than yield stress but still provide adequate safety margin (with respect to failure). This paper presents a strain-based elastic-plastic (i.e., inelastic) analysis criterion developed as an alternative to the more conservative stress-based elastic analysis stress criterion for structures subjected to rapidly applied transient dynamic loading. The strain limits established are based on material ductility considerations only and are set as a fraction of the strain at ultimate stress obtained from an engineering stress/strain curve of the material. Strains limits are categorized by type as membrane or surface and by region as general, local , or concentrated. The application of the elastic-plastic criterion provides a more accurate, less conservative design/analysis basis for structures than that used in elastic stress-based analysis criteria, while still providing adequate safety margins.

  10. Methods for verifying compliance with low-level radioactive waste acceptance criteria

    SciTech Connect

    1993-09-01

    This report summarizes the methods that are currently employed and those that can be used to verify compliance with low-level radioactive waste (LLW) disposal facility waste acceptance criteria (WAC). This report presents the applicable regulations representing the Federal, State, and site-specific criteria for accepting LLW. Typical LLW generators are summarized, along with descriptions of their waste streams and final waste forms. General procedures and methods used by the LLW generators to verify compliance with the disposal facility WAC are presented. The report was written to provide an understanding of how a regulator could verify compliance with a LLW disposal facility`s WAC. A comprehensive study of the methodology used to verify waste generator compliance with the disposal facility WAC is presented in this report. The study involved compiling the relevant regulations to define the WAC, reviewing regulatory agency inspection programs, and summarizing waste verification technology and equipment. The results of the study indicate that waste generators conduct verification programs that include packaging, classification, characterization, and stabilization elements. The current LLW disposal facilities perform waste verification steps on incoming shipments. A model inspection and verification program, which includes an emphasis on the generator`s waste application documentation of their waste verification program, is recommended. The disposal facility verification procedures primarily involve the use of portable radiological survey instrumentation. The actual verification of generator compliance to the LLW disposal facility WAC is performed through a combination of incoming shipment checks and generator site audits.

  11. Preliminary Mark-18A (Mk-18A) Target Material Recovery Program Product Acceptance Criteria

    SciTech Connect

    Robinson, Sharon M.; Patton, Bradley D.

    2016-09-01

    The Mk-18A Target Material Recovery Program (MTMRP) was established in 2015 to preserve the unique materials, e.g. 244Pu, in 65 previously irradiated Mk-18A targets for future use. This program utilizes existing capabilities at SRS and Savannah River National Laboratory (SRNL) to process targets, recover materials from them, and to package the recovered materials for shipping to ORNL. It also utilizes existing capabilities at ORNL to receive and store the recovered materials, and to provide any additional processing of the recovered materials or residuals required to prepare them for future beneficial use. The MTMRP is presently preparing for the processing of these valuable targets which is expected to begin in ~2019. As part of the preparations for operations, this report documents the preliminary acceptance criteria for the plutonium and heavy curium materials to be recovered from the Mk-18A targets at SRNL for transport and storage at ORNL. These acceptance criteria were developed based on preliminary concepts developed for processing, transporting, and storing the recovered Mk-18A materials. They will need to be refined as these concepts are developed in more detail.

  12. Psychiatric presentation of sporadic Creutzfeldt-Jakob disease: a challenge to current diagnostic criteria.

    PubMed

    Ali, Rehiana; Baborie, Atik; Larner, Andrew J; White, Richard

    2013-01-01

    Pathological diagnosis remains the gold standard for the diagnosis of sporadic Creutzfeldt-Jakob disease (sCJD), but being able to differentiate between CJD and non-prion diseases clinically is important because many of the non-prion, rapidly progressive dementias are treatable. Diagnostic criteria need both high sensitivity and specificity while remaining applicable to clinical practice. Despite extensive updates to the clinical criteria for sCJD, there remains a heavy emphasis on neurological signs. We describe a psychiatric presentation of sCJD that did not fulfill the diagnostic criteria until very late in a prolonged disease course and required biopsy for diagnosis.

  13. Diagnostic Criteria for Acute Kidney Injury: Present and Future

    PubMed Central

    Kellum, John A.

    2015-01-01

    Synopsis Acute kidney injury in a clinical diagnosis guided by standard criteria based on changes in serum creatinine, urine output or both. Severity of acute kidney injury is determined by the magnitude of increase in serum creatinine or decrease in urine output. Patients manifesting both oliguria and azotemia and those in which these impairments are persistent are more likely to have worse disease and worse outcomes. Both short- and long-term outcomes are worse when patients have some stage of AKI by both criteria. Duration of AKI was also a significant predictor of long-term outcomes irrespective of severity. New biomarkers for AKI may substantially aid in the risk assessment and evaluation of patients at risk for AKI. PMID:26410133

  14. Initial Acceptance Criteria Concepts and Data for Assessing Longevity of Low-Voltage Cable Insulations and Jackets

    SciTech Connect

    Gary toman

    2005-03-30

    This report establishes a basis for acceptance criteria, provides a method for estimating remaining low-voltage cable life, and provides aging profiles under various thermal and radiation conditions for available cable polymer condition-monitoring techniques. This report is not meant to be the final comprehensive source of acceptance criteria, but rather is intended for trial usage so that it can be further refined for easier reference in the future.

  15. Developmental trauma disorder: pros and cons of including formal criteria in the psychiatric diagnostic systems

    PubMed Central

    2013-01-01

    Background This article reviews the current debate on developmental trauma disorder (DTD) with respect to formalizing its diagnostic criteria. Victims of abuse, neglect, and maltreatment in childhood often develop a wide range of age-dependent psychopathologies with various mental comorbidities. The supporters of a formal DTD diagnosis argue that post-traumatic stress disorder (PTSD) does not cover all consequences of severe and complex traumatization in childhood. Discussion Traumatized individuals are difficult to treat, but clinical experience has shown that they tend to benefit from specific trauma therapy. A main argument against inclusion of formal DTD criteria into existing diagnostic systems is that emphasis on the etiology of the disorder might force current diagnostic systems to deviate from their purely descriptive nature. Furthermore, comorbidities and biological aspects of the disorder may be underdiagnosed using the DTD criteria. Summary Here, we discuss arguments for and against the proposal of DTD criteria and address implications and consequences for the clinical practice. PMID:23286319

  16. Clinical comparison of human and canine atopic dermatitis using human diagnostic criteria (Japanese Dermatological Association, 2009): proposal of provisional diagnostic criteria for canine atopic dermatitis.

    PubMed

    Terada, Yuri; Nagata, Masahiko; Murayama, Nobuo; Nanko, Hiroko; Furue, Masutaka

    2011-08-01

    Atopic dermatitis (AD) is a common skin disease encountered in both humans and dogs. Canine AD can be used in the analysis of naturally occurring AD; however, details of clinical comparison have been lacking. The purpose of this study is to compare those clinical features using the human diagnostic criteria (Japanese Dermatological Association, 2009). Fifty-one dogs with canine AD were evaluated by the human criteria. Prior to this study, canine AD was basically diagnosed by the fulfillment of two authentic canine AD criteria and a positive reaction against Dermatophagoides farinae in serum immunoglobulin E levels and/or in intradermal tests. Among the human AD criteria items, behavior corresponding to pruritus was observed in all 51 dogs. Skin lesions corresponding to eczematous dermatitis were seen in 50 dogs, and symmetrical distribution of skin lesions was noted in all 51 dogs. A chronic or chronically relapsing course was observed in 50 dogs. Based on these results, the concordance rate for the criteria was 96% (49/51). Differential diagnoses of AD were also investigated in the same manner. The concordance rate for the criteria was 0% (0/69) in scabies, 2% (1/50) in pyoderma, 0% (0/50) in demodicosis, 0% (0/9) in cutaneous lymphoma, 0% (0/2) in ichthyosis, 25% (2/7) in flea allergy, 48% (24/50) in seborrheic dermatitis and 75% (3/4) in food allergy. Canine AD is thus indicated as a valuable counterpart to human AD in clinical aspects. In addition, the human AD criteria could be applicable, with some modification, as provisional diagnostic criteria for canine AD.

  17. Survey of compliance with European acceptability criteria for HVL and AEC.

    PubMed

    Kepler, K; Vladimirov, A

    2013-02-01

    Half value layer (HVL) was measured for 226 general radiographic X-ray tube assemblies at 80 kV and for 53 dental X-ray tube assemblies at 70 kV, and evaluated by the previous (1997) and the new draft of European acceptability criteria (2009) for HVL as adopted from the IEC collateral standards. Fourteen per cent of the tested general radiography X-ray tube assemblies were subject to readjustment by the new criteria. In routine quality control tests, receptor entrance dose was estimated for 54 AEC systems by using post-exposure mAs values, taking into account the measured tube output at different tube potentials, HVL and estimated scattering for 10, 15 and 21 cm PMMA phantom. Receptor dose (third quartile) varied from 6.4 μGy at 60 kV to 3.8 μGy at 125 kV. The results correspond well to the draft criteria for maximum receptor dose of 10 μGy and for the patient thickness compensation.

  18. 40 CFR 90.510 - Compliance with acceptable quality level and passing and failing criteria for selective...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... level and passing and failing criteria for selective enforcement audits. 90.510 Section 90.510....510 Compliance with acceptable quality level and passing and failing criteria for selective... test sample until a pass decision is reached for all pollutants or a fail decision is reached for...

  19. 40 CFR 89.510 - Compliance with acceptable quality level and passing and failing criteria for selective...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... level and passing and failing criteria for selective enforcement audits. 89.510 Section 89.510... Compliance with acceptable quality level and passing and failing criteria for selective enforcement audits... test sample until a pass decision is reached for all pollutants or a fail decision is reached for...

  20. 40 CFR 91.608 - Compliance with acceptable quality level and passing and failing criteria for selective...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... level and passing and failing criteria for selective enforcement audits. 91.608 Section 91.608... with acceptable quality level and passing and failing criteria for selective enforcement audits. (a... manufacturer must test engines comprising the test sample until a pass decision is reached for HC+NOX or a...

  1. How should we revise diagnostic criteria for substance use disorders in the DSM-V?

    PubMed

    Martin, Christopher S; Chung, Tammy; Langenbucher, James W

    2008-08-01

    This article reviews literature on the validity and performance characteristics of the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994) diagnostic criteria for substance use disorders (SUDs) and recommends changes in these criteria that should be considered for the next edition of the DSM (DSM-V). Substantial data indicate that DSM-IV substance abuse and substance dependence are not distinct categories and that SUD criteria are best modeled as reflecting a unidimensional continuum of substance-problem severity. The conceptually and empirically problematic substance abuse diagnosis should be abandoned in the DSM-V, with substance dependence defined by a single set of criteria. Data also indicate that various individual SUD criteria should be revised, dropped, or considered for inclusion in the DSM-V. The DSM-V should provide a framework that allows the integration of categorical and dimensional approaches to diagnosis. Important areas for further research are noted.

  2. Contact-Handled Transuranic Waste Acceptance Criteria for the Waste Isolation Pilot Plant

    SciTech Connect

    Washington TRU Solutions LLC

    2005-12-29

    The purpose of this document is to summarize the waste acceptance criteria applicable to the transportation, storage, and disposal of contact-handled transuranic (CH-TRU) waste at the Waste Isolation Pilot Plant (WIPP). These criteria serve as the U.S. Department of Energy's (DOE) primary directive for ensuring that CH-TRU waste is managed and disposed of in a manner that protects human health and safety and the environment.The authorization basis of WIPP for the disposal of CH-TRU waste includes the U.S.Department of Energy National Security and Military Applications of Nuclear EnergyAuthorization Act of 1980 (reference 1) and the WIPP Land Withdrawal Act (LWA;reference 2). Included in this document are the requirements and associated criteriaimposed by these acts and the Resource Conservation and Recovery Act (RCRA,reference 3), as amended, on the CH-TRU waste destined for disposal at WIPP.|The DOE TRU waste sites must certify CH-TRU waste payload containers to thecontact-handled waste acceptance criteria (CH-WAC) identified in this document. Asshown in figure 1.0, the flow-down of applicable requirements to the CH-WAC istraceable to several higher-tier documents, including the WIPP operational safetyrequirements derived from the WIPP CH Documented Safety Analysis (CH-DSA;reference 4), the transportation requirements for CH-TRU wastes derived from theTransuranic Package Transporter-Model II (TRUPACT-II) and HalfPACT Certificates ofCompliance (references 5 and 5a), the WIPP LWA (reference 2), the WIPP HazardousWaste Facility Permit (reference 6), and the U.S. Environmental Protection Agency(EPA) Compliance Certification Decision and approval for PCB disposal (references 7,34, 35, 36, and 37). The solid arrows shown in figure 1.0 represent the flow-down of allapplicable payload container-based requirements. The two dotted arrows shown infigure 1.0 represent the flow-down of summary level requirements only; i.e., the sitesmust reference the regulatory source

  3. Dynamic light scattering in veterinary medicine: refinement of diagnostic criteria

    NASA Astrophysics Data System (ADS)

    Dubin, Stephen; Zietz, Stanley; Gabriel, Karl L.; Gabriel, David; DellaVecchia, Michael A.; Ansari, Rafat R.

    2001-05-01

    In dynamic light scattering (DLS), the structure or material of interest, suspended in a fluid, is illuminated by a beam of laser light and the scattered light is interpreted in terms of diffusion coefficient, particle size or its distribution. DLS has shown clear promise as a non-invasive, objective and precise diagnostic modality for investigation of lens opacity (cataract) and other medical and toxicological problems. The clinical potential of LDS has been demonstrated in several species both in vivo and in vitro. In many clinical cases, discernment between normal and diseased patients is possible by simple inspection of the particle size distribution. However a more rigorous and sensitive classification scheme is needed, particularly for evaluation of therapy and estimation of tissue injury. The data supplied by DLS investigation is inherently multivariate and its most efficient interpretation requires a multivariate approach which includes the variability among specimens as well as any correlation among the variables (e.g. across the particle size distribution). We present a brief review of DLS methodology, illustrative data and our efforts toward a diagnostic classification scheme. In particular we will describe application of the Mahalanobis distance and related statistical methods to DLS data.

  4. Diagnostic criteria for primary neuronal degeneration of the Alzheimer's type.

    PubMed

    Eisdorfer, C; Cohen, D

    1980-10-01

    The diagnosis of patients presenting with memory or attentional deficits characteristic of dementia is a growing problem. Dementia may be symptomatic of a range of reversible medical and psychiatric conditions which appear to be indistinguishable from primary neuronal degeneration of the Alzheimer's type. While Alzheimer's disease is a neuropathological diagnosis, the importance of establishing a presumptive diagnosis which can be employed for investigational as well as clinical use is underscored. This paper proposes a diagnostic schema which reflects the current understanding of this disorder. There must be evidence of gradual progressive mental deterioration in attention, learning, memory, cognitive style, motivation, and higher order thinking. A comprehensive medical and psychiatric evaluation is obligatory to eliminate reversible physical illness, psychiatric disorder, or cerebrovascular condition as underlying causes of cognitive dysfunction.

  5. Proposed GTA welding specification and acceptance criteria for the MC4163

    SciTech Connect

    Kwiatkowski, J.J.

    1991-04-12

    This specification documents the gas tungsten arc (GTA) welding process and production weld acceptance criteria requirements for the MC4163. This document is written specifically to apply to the welds on the MC4163 and is not to be used as a general gas tungsten arc welding specification. All sections of this specification must be complied with unless specifically exempted in writing. There are a total of five welds with three different joint designs required to fabricate the MC4163. In the order of fabrication they are (1) initiator closure disc, (2) nozzle to case girth welds, two and, (3) nozzle closure disc welds, two. This specification will only address the nozzle to case girth welds and the nozzle closure disc welds.

  6. CHARACTERIZATION OF TANK 50 SLURRY FOR SALTSTONE WASTE ACCEPTANCE CRITERIA, APRIL 2007 SAMPLES

    SciTech Connect

    Zeigler, K; Ned Bibler, N; David Diprete, D

    2007-12-07

    This report summarizes the results from the characterization of the second quarter April 2007 sampling of Tank 50H for the Saltstone Waste Acceptance Criteria (WAC). Six one liter samples were taken in polyethylene bottles to analyze for the WAC contaminants and a 200 mL sample was taken in a steel container for analysis of volatile organic compounds. The information from this characterization will be given to Waste Solidification Engineering personnel to qualify the transfer of aqueous waste to the Saltstone Facility. The following conclusions are drawn from the analytical results found in this report: (1) All six of the one liter samples taken in April 2007 from the mixed slurry in Tank 50 have the same compositions within the experimental uncertainty of the analyses. (2) Of the ninety-one process, chemical, and radioactive WAC target or limit contaminants listed in Revision 7 of the 'Waste Acceptance Criteria for Aqueous Waste sent to the Z-Area Saltstone Production Facility', eighty-nine had concentrations that were unequivocally less than the WAC limit or target. (3) The two contaminants whose concentrations could not be shown to be less than their WAC targets were methanol and radioactive Nb-93m. Currently the AD Section of SRNL does not have a method for measuring methanol in caustic solutions. For Nb-93m the results are ambiguous due to possible interferences in the ICP-MS analysis from Zr-93 or Mo-93. (4) Of the six additional chemical and radioactive contaminants requested in the TTR for Saltstone qualification, five were measured or calculated. These were Sb, Be, Tl, along with total beta and gamma. The AD Section does not have a method to measure the 6th contaminant which was the cyanide ion.

  7. Diagnostic criteria for selenium toxicosis in aquatic birds: histologic lesions

    USGS Publications Warehouse

    Green, D.E.; Albers, P.H.

    1997-01-01

    Chronic selenium toxicosis was induced in 1-year-old male mallard ducks (Anas platyrhynchos) by feeding selenium, as seleno-DL-methionine, in amounts of 0, 10, 20, 40, and 80 parts per million (ppm) to five groups of 21 ducks each for 16 wk during March to July 1988. All mallards in the 80 ppm group, three in the 40 ppm group, and one in the 20 ppm group died. Histologic lesions in mallards that died of selenosis were hepatocellular vacuolar degeneration progressing to centrolobular and panlobular necrosis, nephrosis, apoptosis of pancreatic exocrine cells, hypermaturity and avascularity of contour feathers of the head with atrophy of feather follicles, lymphocytic necrosis and atrophy of lymphoid organs (spleen, gut-associated lymphoid tissue, and lumbar lymph nodes), and severe atrophy and degeneration of fat. Histologic lesions in surviving mallards in the 40 ppm group, which had tissue residues of selenium comparable to mallards that died, were fewer and much milder than mallards that died; lesions consisted of atrophy of lymphoid tissue, hyalinogranular swelling of hepatocytes, atrophy of seminiferous tubules, and senescence of feathers. No significant histologic lesions were detected in euthanized mallards in the 0, 10 and 20 ppm groups. Based on tissue residues and histologic findings, primarily in the liver, there was a threshold of selenium accumulation above which pathophysiologic changes were rapid and fatal. Pathognomonic histologic lesions of fatal and nonfatal selenosis were not detected. Criteria for diagnosis of fatal selenosis in aquatic birds include consistent histologic lesions in the liver, kidneys, and organs of the immune system. Although histologic changes were present in cases of chronic non-fatal selenosis, these were inconsistent. Consistent features of fatal and non-fatal chronic selenosis were marked weight loss and elevated concentrations of selenium in organs.

  8. Diagnostic Criteria for Polycystic Ovary Syndrome: Pitfalls and Controversies

    PubMed Central

    Lujan, Marla E.; Chizen, Donna R.; Pierson, Roger A.

    2010-01-01

    It is estimated that as many as 1.4 million Canadian women may be afflicted with polycystic ovary syndrome (PCOS). Although PCOS is heralded as one of the most common endocrine disorders occurring in women, its diagnosis, management, and associated long-term health risks remain controversial. Historically, the combination of androgen excess and anovulation has been considered the hallmark of PCOS. To date, while these symptoms remain the most prevalent among PCOS patients, neither is considered an absolute requisite for the syndrome. Inclusion of ultrasonographic evidence of polycystic ovaries as a diagnostic marker has substantially broadened the phenotypic spectrum of PCOS, yet much debate surrounds the validity of these newly identified milder variants of the syndrome. Difficulty in resolving the spectrum of PCOS stems from the continued use of inconsistent and inaccurate methods of evaluating androgen excess, anovulation, and polycystic ovaries on ultrasound. At present, there is no clear-cut definition of biochemical hyperandrogenemia, particularly since we depend on poor laboratory standards for measuring androgens in women. Clinical signs of hyperandrogenism are ill-defined in women with PCOS, and the diagnosis of both hirsutism and polycystic ovarian morphology remains alarmingly subjective. Lastly, there is an inappropriate tendency to assign ovulatory status solely on the basis of menstrual cycle history or poorly timed endocrine measurements. In this review, we elaborate on these limitations and propose possible resolutions for clinical and research settings. By stimulating awareness of these limitations, we hope to generate a dialogue aimed at solidifying the evaluation of PCOS in Canadian women. PMID:18786289

  9. Children's Deviant Behavior in Primary Education: Comparing Physical Educator's Implicit Theory With Diagnostic Criteria.

    PubMed

    Efstratopoulou, Maria A; Janssen, Rianne; Simons, Johan

    2012-06-11

    Objective: Physical educators' implicit theory of children's deviant behavior in primary education was investigated and compared with diagnostic criteria. Method: A total of 60 physical education (PE) teachers reported deviant behaviors during lessons. Experts sorted these behaviors together with the official diagnostic criteria into categories based on perceived similarity in content. Results: Hierarchical cluster analysis on the derived similarity matrix among the behaviors suggested that PE teachers focus more on attention problems, disobedience, and aggressiveness when internalizing behaviors, such as anxiety and low energy, were less reported. Conclusion: PE teachers may be important and useful informants on children's behavior in school settings. (J. of Att. Dis. 2012; XX(X) 1-XX).

  10. Epidemiologic variability of chronic inflammatory demyelinating polyneuropathy with different diagnostic criteria: study of a UK population.

    PubMed

    Rajabally, Yusuf A; Simpson, Benjamin S; Beri, Sushil; Bankart, John; Gosalakkal, Jayaprakash A

    2009-04-01

    Epidemiologic data on chronic inflammatory demyelinating polyneuropathy (CIDP) is limited, and previous studies have shown variable results. The frequencies of CIDP subtypes remain unknown. Variations due to use of different diagnostic criteria have not been studied. We examined the prevalence and incidence of CIDP in Leicestershire and Rutland, UK (population 963,600). Prevalence day was 1 May 2008. The prevalence of CIDP fulfilling the 2006 clinical and electrophysiologic European Federation of Neurological Societies/Peripheral Nerve Society (EFNS/PNS) criteria was 4.77 per 100,000 (95% confidence interval [CI] 3.49-6.37). Using the 1991 American Academy of Neurology (AAN) criteria, the prevalence was 1.97 per 100,000 in this population (95% CI 1.19-3.08). Lewis-Sumner syndrome was diagnosed in 15.2% of patients, and 23.9% had pure sensory onset. Over 40% required no immunotherapy, and 84.6% of those treated responded. More than 80% of the AAN criteria-negative but EFNS/PNS criteria-positive patients were responsive to treatment. Both sets of criteria were equally likely to identify patients who required therapy. The mean annual incidence rate over the 3 years preceding the prevalence day was 0.70 per 100,000/year using EFNS/PNS criteria (95% CI 0.43-1.08), and 0.35 per 100,000/year using AAN criteria (95% CI 0.17-0.64). We conclude that the AAN criteria may underestimate prevalence and incidence of the disease. The EFNS/PNS criteria provide higher diagnostic sensitivity and are of greater clinical relevance, and they also offer a useful breakdown of the epidemiologic data for CIDP subtypes.

  11. Sensitivity of revised diagnostic criteria for the behavioural variant of frontotemporal dementia

    PubMed Central

    Hodges, John R.; Knopman, David; Mendez, Mario F.; Kramer, Joel H.; Neuhaus, John; van Swieten, John C.; Seelaar, Harro; Dopper, Elise G. P.; Onyike, Chiadi U.; Hillis, Argye E.; Josephs, Keith A.; Boeve, Bradley F.; Kertesz, Andrew; Seeley, William W.; Rankin, Katherine P.; Johnson, Julene K.; Gorno-Tempini, Maria-Luisa; Rosen, Howard; Prioleau-Latham, Caroline E.; Lee, Albert; Kipps, Christopher M.; Lillo, Patricia; Piguet, Olivier; Rohrer, Jonathan D.; Rossor, Martin N.; Warren, Jason D.; Fox, Nick C.; Galasko, Douglas; Salmon, David P.; Black, Sandra E.; Mesulam, Marsel; Weintraub, Sandra; Dickerson, Brad C.; Diehl-Schmid, Janine; Pasquier, Florence; Deramecourt, Vincent; Lebert, Florence; Pijnenburg, Yolande; Chow, Tiffany W.; Manes, Facundo; Grafman, Jordan; Cappa, Stefano F.; Freedman, Morris; Grossman, Murray; Miller, Bruce L.

    2011-01-01

    criteria were significantly older and most had atypical presentations with marked memory impairment. In conclusion, the revised criteria for behavioural variant frontotemporal dementia improve diagnostic accuracy compared with previously established criteria in a sample with known frontotemporal lobar degeneration. Greater sensitivity of the proposed criteria may reflect the optimized diagnostic features, less restrictive exclusion features and a flexible structure that accommodates different initial clinical presentations. Future studies will be needed to establish the reliability and specificity of these revised diagnostic guidelines. PMID:21810890

  12. Updating of Safety Criteria for Basic Diagnostic Indicators of Dam at the Sayano-Shushenskaya HPP

    SciTech Connect

    Gordon, L. A.; Skvortsova, A. E.

    2013-09-15

    Values of diagnostic indicators [K]-limitations placed on radial displacements and turn angles of horizontal sections of the dam - which are permitted for each upper-pool level within the range from 520 to 539 m are determined and proposed for inclusion in the Declaration of Safety. Empirical relationships used to develop safety criteria K1 and K2 are modified.

  13. Sensitivity and Specificity of Proposed "DSM-5" Diagnostic Criteria for Autism Spectrum Disorder

    ERIC Educational Resources Information Center

    McPartland, James C.; Reichow, Brian; Volkmar, Fred R.

    2012-01-01

    Objective: This study evaluated the potential impact of proposed "DSM-5" diagnostic criteria for autism spectrum disorder (ASD). Method: The study focused on a sample of 933 participants evaluated during the "DSM-IV" field trial; 657 carried a clinical diagnosis of an ASD, and 276 were diagnosed with a non-autistic disorder. Sensitivity and…

  14. Relationship between Diagnostic Criteria, Depressive Equivalents and Diagnosis of Depression among Older Adults with Intellectual Disability

    ERIC Educational Resources Information Center

    Langlois, L.; Martin, L.

    2008-01-01

    Background: Depression is more common among persons with an intellectual disability (ID) than the general population, and may be expected to increase with age just as in the general population. However, little is known about depression among older adults with ID. The literature has questioned the use of standard diagnostic criteria for depression…

  15. [Epidemiology of Minamata Disease--Focus on the Clinical Features Related to the 1977 Diagnostic Criteria].

    PubMed

    Futatsuka, Makoto

    2015-01-01

    Large-scale food poisoning caused by methylmercury was identified in Minamata, Japan, in the 1950s (Minamata Disease). Although the diagnostic criteria for the disease was controversial and difficult during that time, we, the Kumamoto University Study Group, carried out a large-scale study to assess the clinical features in 1972-1973. The author tried to reassess the results of that study to appraise the diagnostic criteria established in 1977 on the basis of those results. A substantial number of residents in the exposed area exhibited neurologic signs, especially paresthesia of only the extremities, namely, the male residents of Minamata City showed a positive predictive value of 0.73 and a negative predictive value of 0.23. The relative risks of paresthesia only were 2.6 (2.0-3.3) and 1.2 (0.9-1.5), in Minamata and Goshonoura related to Ariake (control), respectively. At least until 1977, the diagnostic criteria remained valid, although it was inadequate. Nevertheless, presently, a follow-up study of the certified patients may lead to the development of efficient new diagnostic criteria.

  16. Functional Nausea in Children: A Review of the Literature and Need for Diagnostic Criteria

    PubMed Central

    Russell, Alexandra C.; Stone, Amanda L.; Walker, Lynn S.

    2016-01-01

    Nausea is common amongst children with functional gastrointestinal disorders and is associated with a high burden of somatic and psychosocial comorbidities in both the short and long-term. Current treatments including medications, phytotherapy, stress-reduction techniques, and gastric electrical stimulation for recalcitrant cases, are reviewed. Functional nausea merits its own diagnostic criteria as a pediatric functional gastrointestinal disorder. PMID:27417243

  17. Improving the diagnostic criteria for alcohol use disorders through survey methodology and cognitive interviewing.

    PubMed

    Mewton, Louise; Slade, Tim; Teesson, Maree; Memedovic, Sonja; Krueger, Robert F

    2014-09-01

    This study aims to identify problems in the structure and wording of questions designed to operationalize four DSM-IV diagnostic criteria for alcohol use disorders (AUDs): (1) use of alcohol in hazardous situations (hazard); (2) tolerance; (3) use of alcohol in larger amounts/longer periods than intended (larger/longer); (4) unsuccessful attempts to cut down or control alcohol use (quit/cut down). Ten experts appraised the questions related to these criteria in the WMH-CIDI according to a standardized checklist. These experts identified three main problems: (1) the double-barrelled nature of some of the questions; (2) definitional issues; and (3) unclear thresholds for criterion endorsement. Cognitive interviews of 100 young adult drinkers aged 18-24 were then conducted. The double-barrelled nature of the DSM-IV criteria led to their subsequent over- or under-endorsement. Key terms in the questions under investigation were defined inconsistently. There was also a large amount of variability in the thresholds at which larger/longer and quit/cut down were endorsed. Many of these problems could be linked back to the DSM-IV text. The findings raise questions as to the validity of AUD diagnoses when established via structured diagnostic interview. Further research should focus on testing alternative structure and wording of key AUD criteria to ensure accurate operationalizations of these criteria in structured diagnostic interviews.

  18. Scrotal infrared digital thermography in assessment of varicocele--pilot study to assess diagnostic criteria.

    PubMed

    Kulis, T; Kolaric, D; Karlovic, K; Knezevic, M; Antonini, S; Kastelan, Z

    2012-05-01

    The aim of this study was to assess scrotal thermography in diagnostics of varicocele and suggest potential diagnostic criteria. Twelve patients with clinically diagnosed varicocele were examined with scrotal infrared digital thermography, physical examination and ultrasound/doppler. The main outcome measure was evaluation of thermography diagnostic criteria for varicocele. Mean temperature at left pampiniform plexus was ≥ 34 °C in 83%, and at right pampiniform plexus in all cases was ≤ 34 °C. In 92% of patients, temperature at the left testicle was ≥ 32 °C, whereas at the right testicle it was >32 °C in 50% patients. Temperatures between left and right pampiniform plexus and between left and right testicle were significantly different with P < 0.0001 and P < 0.006 respectively. In all patients, temperature difference between pampiniform plexuses was ≥ 0.6 °C. In 92% of patients, temperature at left pampiniform plexus was equal or higher to thigh temperature with the mean temperature difference of 1.1 ± 1.1 °C. Temperature at right pampiniform plexus was colder than the thigh in 92% of patients. This study suggests diagnostic criteria of five thermographic signs to easily diagnose varicocele. Scrotal thermography presents feasible, short and low cost diagnostic method for varicocele. Further study on a larger number of patients and healthy participants is needed to evaluate sensitivity and specificity of this method.

  19. Evaluation of ISDP Batch 2 Qualification Compliance to 512-S, DWPF, Tank Farm, and Saltstone Waste Acceptance Criteria

    SciTech Connect

    Shafer, A.

    2010-05-05

    The purpose of this report is to document the acceptability of the second macrobatch (Salt Batch 2) of Tank 49H waste to H Tank Farm, DWPF, and Saltstone for operation of the Interim Salt Disposition Project (ISDP). Tank 49 feed meets the Waste Acceptance Criteria (WAC) requirements specified by References 11, 12, and 13. Salt Batch 2 material is qualified and ready to be processed through ARP/MCU to the final disposal facilities.

  20. Fraser syndrome: a clinical study of 59 cases and evaluation of diagnostic criteria.

    PubMed

    van Haelst, Mieke M; Scambler, Peter J; Hennekam, Raoul C M

    2007-12-15

    Fraser syndrome is an autosomal recessive congenital malformation syndrome characterized by cryptophthalmos, syndactyly, and urogenital defects. We studied the clinical features in 59 affected individuals from 40 families (25 consanguineous), and compared our findings to data from previous reviews. We found a higher frequency of abnormalities of the skull, larynx, umbilicus, urinary tract, and anus in our series of patients, and mental retardation and cleft lip with or without cleft palate were observed less frequently than previously reported. Clinical features in probands and sibs were remarkably similar. As can be expected prenatally diagnosed patients had more manifestations that gave rise to a pathological amount of amniotic fluid. Otherwise patients diagnosed before and after birth had similar frequencies of symptoms. Based on the present results we suggest an adaptation of diagnostic criteria for FS, including adding airway tract and urinary tract anomalies as major criteria. The specificity of the proposed diagnostic criteria was evaluated using the London Medical Database as a search tool.

  1. Do we need new diagnostic criteria for Sjögren's syndrome?

    PubMed

    Daniels, Troy E

    2012-09-01

    Diagnostic and classification criteria for Sjögren's syndrome (SS) continue to evolve as more is learned about SS and about autoimmune diseases in general. Among diagnostic or classification criteria for SS that are in current use, most include various and variable combinations of results from questions about symptoms and objective tests, many of which are not specific to SS. Given the rapid increase of genetic knowledge about other autoimmune diseases and the potential of finding and testing new biological agents to treat SS, selection of patients who have as uniform a disease process as possible becomes an important goal to better understand and treat this prevalent autoimmune disease. Such is the goal and promise of the latest entry into the SS classification criteria field.

  2. Diagnostic Criteria for Problematic Internet Use among U.S. University Students: A Mixed-Methods Evaluation

    PubMed Central

    Li, Wen; O’Brien, Jennifer E.; Snyder, Susan M.; Howard, Matthew O.

    2016-01-01

    Empirical studies have identified increasing rates of problematic Internet use worldwide and a host of related negative consequences. However, researchers disagree as to whether problematic Internet use is a subtype of behavioral addiction. Thus, there are not yet widely accepted and validated diagnostic criteria for problematic Internet use. To address this gap, we used mixed-methods to examine the extent to which signs and symptoms of problematic Internet use mirror DSM-5 diagnostic criteria for substance use disorder, gambling disorder, and Internet gaming disorder. A total of 27 university students, who self-identified as intensive Internet users and who reported Internet-use-associated health and/or psychosocial problems were recruited. Students completed two measures that assess problematic Internet use (Young’s Diagnostic Questionnaire and the Compulsive Internet Use Scale) and participated in focus groups exploring their experiences with problematic Internet use. Results of standardized measures and focus group discussions indicated substantial overlap between students’ experiences of problematic Internet use and the signs and symptoms reflected in the DSM-5 criteria for substance use disorder, gambling disorder, and Internet gaming disorder. These signs and symptoms included: a) use Internet longer than intended, b) preoccupation with the Internet, c) withdrawal symptoms when unable to access the Internet, d) unsuccessful attempts to stop or reduce Internet use, e) craving, f) loss of interest in hobbies or activities other than the Internet, g) excessive Internet use despite the knowledge of related problems, g) use of the Internet to escape or relieve a negative mood, and h) lying about Internet use. Tolerance, withdrawal symptoms, and recurrent Internet use in hazardous situations were uniquely manifested in the context of problematic Internet use. Implications for research and practice are discussed. PMID:26751569

  3. Diagnostic Criteria for Problematic Internet Use among U.S. University Students: A Mixed-Methods Evaluation.

    PubMed

    Li, Wen; O'Brien, Jennifer E; Snyder, Susan M; Howard, Matthew O

    2016-01-01

    Empirical studies have identified increasing rates of problematic Internet use worldwide and a host of related negative consequences. However, researchers disagree as to whether problematic Internet use is a subtype of behavioral addiction. Thus, there are not yet widely accepted and validated diagnostic criteria for problematic Internet use. To address this gap, we used mixed-methods to examine the extent to which signs and symptoms of problematic Internet use mirror DSM-5 diagnostic criteria for substance use disorder, gambling disorder, and Internet gaming disorder. A total of 27 university students, who self-identified as intensive Internet users and who reported Internet-use-associated health and/or psychosocial problems were recruited. Students completed two measures that assess problematic Internet use (Young's Diagnostic Questionnaire and the Compulsive Internet Use Scale) and participated in focus groups exploring their experiences with problematic Internet use. Results of standardized measures and focus group discussions indicated substantial overlap between students' experiences of problematic Internet use and the signs and symptoms reflected in the DSM-5 criteria for substance use disorder, gambling disorder, and Internet gaming disorder. These signs and symptoms included: a) use Internet longer than intended, b) preoccupation with the Internet, c) withdrawal symptoms when unable to access the Internet, d) unsuccessful attempts to stop or reduce Internet use, e) craving, f) loss of interest in hobbies or activities other than the Internet, g) excessive Internet use despite the knowledge of related problems, g) use of the Internet to escape or relieve a negative mood, and h) lying about Internet use. Tolerance, withdrawal symptoms, and recurrent Internet use in hazardous situations were uniquely manifested in the context of problematic Internet use. Implications for research and practice are discussed.

  4. Development of flaw acceptance criteria for aging management of spent nuclear fuel multi-purpose canisters

    SciTech Connect

    Lam, Poh -Sang; Sindelar, Robert L.

    2015-03-09

    A typical multipurpose canister (MPC) is made of austenitic stainless steel and is loaded with spent nuclear fuel assemblies. The canister may be subject to service-induced degradation when it is exposed to aggressive atmospheric environments during a possibly long-term storage period if the permanent repository is yet to be identified and readied. Because heat treatment for stress relief is not required for the construction of an MPC, stress corrosion cracking may be initiated on the canister surface in the welds or in the heat affected zone. An acceptance criteria methodology is being developed for flaw disposition should the crack-like defects be detected by periodic in-service Inspection. The first-order instability flaw sizes has been determined with bounding flaw configurations, that is, through-wall axial or circumferential cracks, and part-through-wall long axial flaw or 360° circumferential crack. The procedure recommended by the American Petroleum Institute (API) 579 Fitness-for-Service code (Second Edition) is used to estimate the instability crack length or depth by implementing the failure assessment diagram (FAD) methodology. The welding residual stresses are mostly unknown and are therefore estimated with the API 579 procedure. It is demonstrated in this paper that the residual stress has significant impact on the instability length or depth of the crack. The findings will limit the applicability of the flaw tolerance obtained from limit load approach where residual stress is ignored and only ligament yielding is considered.

  5. Development of flaw acceptance criteria for aging management of spent nuclear fuel multiple-purpose canisters

    SciTech Connect

    Lam, P.; Sindelar, R.

    2015-03-09

    A typical multipurpose canister (MPC) is made of austenitic stainless steel and is loaded with spent nuclear fuel assemblies. The canister may be subject to service-induced degradation when it is exposed to aggressive atmospheric environments during a possibly long-term storage period if the permanent repository is yet to be identified and readied. Because heat treatment for stress relief is not required for the construction of an MPC, stress corrosion cracking may be initiated on the canister surface in the welds or in the heat affected zone. An acceptance criteria methodology is being developed for flaw disposition should the crack-like defects be detected by periodic In-service Inspection. The first-order instability flaw sizes has been determined with bounding flaw configurations, that is, through-wall axial or circumferential cracks, and part-through-wall long axial flaw or 360° circumferential crack. The procedure recommended by the American Petroleum Institute (API) 579 Fitness-for-Service code (Second Edition) is used to estimate the instability crack length or depth by implementing the failure assessment diagram (FAD) methodology. The welding residual stresses are mostly unknown and are therefore estimated with the API 579 procedure. It is demonstrated in this paper that the residual stress has significant impact on the instability length or depth of the crack. The findings will limit the applicability of the flaw tolerance obtained from limit load approach where residual stress is ignored and only ligament yielding is considered.

  6. Expanding the Taxonomy of the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD)

    PubMed Central

    Peck, Christopher C.; Goulet, Jean-Paul; Lobbezoo, Frank; Schiffman, Eric L.; Alstergren, Per; Anderson, Gary C.; de Leeuw, Reny; Jensen, Rigmor; Michelotti, Ambra; Ohrbach, Richard; Petersson, Arne; List, Thomas

    2014-01-01

    Background There is a need to expand the current temporomandibular disorder (TMD) classification to include less common, but clinically important disorders. The immediate aim was to develop a consensus-based classification system and associated diagnostic criteria that have clinical and research utility for less common TMDs. The long-term aim was to establish a foundation, vis-à-vis this classification system, that will stimulate data collection, validity testing, and further criteria refinement. Methods A working group [members of the International RDC/TMD Consortium Network of the International Association for Dental Research (IADR), members of the Orofacial Pain Special Interest Group (SIG) of the International Association for the Study of Pain (IASP), and members from other professional societies] reviewed disorders for inclusion based on clinical significance, the availability of plausible diagnostic criteria, and the ability to operationalize and study the criteria. The disorders were derived from the literature when possible and based on expert opinion as necessary. The expanded TMD taxonomy was presented for feedback at international meetings. Results Of 56 disorders considered, 37 were included in the expanded taxonomy and were placed into the following four categories: temporomandibular joint disorders, masticatory muscle disorders, headache disorders, and disorders affecting associated structures. Those excluded were extremely uncommon, lacking operationalized diagnostic criteria, not clearly related to TMDs, or not sufficiently distinct from disorders already included within the taxonomy. Conclusions The expanded TMD taxonomy offers an integrated approach to clinical diagnosis and provides a framework for further research to operationalize and test the proposed taxonomy and diagnostic criteria. PMID:24443898

  7. [A proposal for diagnostic and clinical assessment criteria for Alzheimer's disease].

    PubMed

    Shoji, Mikio; Kuwano, Ryozo; Asada, Takasi; Imagawa, Masaki; Higuchi, Susumu; Urakami, Katsuya; Arai, Hiroyuki; Ihara, Yasuo

    2005-02-01

    To clarify the risk and associated genes of Alzheimer's disease by genome-wide screening, a Japanese study group was organized in 2000 under Yasuo Ihara, Tokyo University, supported by a Grant-in-Aid for Science Research on Priority Areas (C) -Advanced Brain Science Project from Ministry of Education, Culture, Sports, Science and Technology, Japan. This is the first Japanese consortium study under permission of the ethical committees of the enrolled institutes based on the ethics guidelines for human genome/gene analysis research, Ministry of Education, Culture, Sports, Science and Technology Ministry of Health, Labor and Welfare Ministry of Economy, Trade and Industry. In this project, 2,000 genome samples from patients with Alzheimer's disease, 2,000 control subjects, and 200 siblings affected with Alzheimer's disease are collected and analyzed. For this purpose, it is necessary to analyze samples from accurately diagnosed Alzheimer patients and controls using standard criteria for diagnosis and neuropsychological evaluation, which have been confirmed by an evidence-based studying a Japanese population. Here, we propose criteria for the diagnosis and clinical assessment of Alzheimer's disease. This proposal consists of a definition of Alzheimer's disease based on recent advances in research, diagnostic criteria based on DSM-IV, NINCDS-ADRDA and ICD-10, exclusion criteria for other dementia disorders, routine and detailed tests for neuropsychological and laboratory evaluations, criteria for neuroimaging and biomarkers, definitive diagnostic criteria and classification of clinical subtypes.

  8. The potential impact of new diagnostic criteria on the frequency of gestational diabetes mellitus in Sweden.

    PubMed

    Claesson, Rickard; Ekelund, Magnus; Berntorp, Kerstin

    2013-10-01

    The International Association of Diabetes and Pregnancy Study Groups (IADPSG) has suggested new diagnostic criteria for gestational diabetes mellitus. Many centers in Europe still use the World Health Organization (WHO) criteria. In southern Sweden we use the 2-h threshold of the European Association for the Study of Diabetes criteria based on universal screening with a 75-g oral glucose tolerance test. We have retrospectively scrutinized oral glucose tolerance tests in a subset of 174 women included in a previous study, diagnosed with gestational diabetes mellitus 1996-1999. A complete repeat oral glucose tolerance test was performed directly after diagnosis in 120 women. When applying the current Swedish criteria, and the IADPSG and the WHO criteria to the material, gestational diabetes mellitus was confirmed in 67% (80/120), 84% (101/120), and 80% (96/120), respectively. Hence, 26% (101/80) more women were identified by the IADPSG criteria and 20% (96/80) more women by the WHO criteria, compared with the criteria presently in use.

  9. Prevalence of Metabolic Syndrome in Elderly and Agreement among Four Diagnostic Criteria

    PubMed Central

    Saad, Maria Auxiliadora Nogueira; Cardoso, Gilberto Perez; Martins, Wolney de Andrade; Velarde, Luis Guillermo Coca; da Cruz, Rubens Antunes

    2014-01-01

    Background Metabolic syndrome (MS) is an aggregation of risk factors that increase the incidence of cardiovascular events and diabetes mellitus (DM). Population aging is accompanied by higher prevalence of MS, which varies depending on the population studied and the diagnostic criteria used. Objective To determine prevalence of MS in the elderly using four diagnostic criteria and agreement between them. Methods Cross-sectional study on 243 patients older than 60 years (180 women) in Niterói, RJ. They were evaluated by clinical examination, fasting glucose, fasting insulin, lipid profile and anthropometric measurements - weight, height, waist circumference and waist/hip ratio. Prevalence of MS was estimated by World Health Organization (WHO) modified, National Cholesterol Education Program - Adult Treatment Panel III (NCEP-ATP III), International Diabetes Federation (IDF) and Joint Interim Statement (JIS) criteria. Results Prevalence was high with the four criteria WHO (51.9%), NCEP-ATPIII (45.2%), IDF (64.1%) and JIS (69.1%), and agreement between criteria by kappa was moderate in almost all comparisons WHO vs. IDF (k = 0.47;95% confidence interval (CI), 0.35 to 0.58); WHO vs. NCEP-ATPIII (k = 0.51; 95% CI, 0.40 to 0.61); WHO vs. JIS (k = 0.45; 95% CI, 0.33 to 0.56); IDF vs. NCEP-ATPIII (k = 0.55; 95% CI, 0.45 to 0.65) and NCEP-ATPIII vs. JIS (k = 0.53; 95% CI, 0.43-0.64), except between IDF vs. JIS (K = 0.89;95% CI, 0.83 to 0.95), which was considered good. Conclusion Prevalence of MS was high with the four diagnostic criteria, mainly by JIS. There was good agreement between JIS and IDF criteria and moderate among the others. PMID:24676226

  10. 21 CFR 212.70 - What controls and acceptance criteria must I have for my finished PET drug products?

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 4 2010-04-01 2010-04-01 false What controls and acceptance criteria must I have for my finished PET drug products? 212.70 Section 212.70 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE...

  11. 21 CFR 212.70 - What controls and acceptance criteria must I have for my finished PET drug products?

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 4 2011-04-01 2011-04-01 false What controls and acceptance criteria must I have for my finished PET drug products? 212.70 Section 212.70 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE...

  12. 21 CFR 212.70 - What controls and acceptance criteria must I have for my finished PET drug products?

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 4 2013-04-01 2013-04-01 false What controls and acceptance criteria must I have for my finished PET drug products? 212.70 Section 212.70 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE...

  13. 21 CFR 212.70 - What controls and acceptance criteria must I have for my finished PET drug products?

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 4 2014-04-01 2014-04-01 false What controls and acceptance criteria must I have for my finished PET drug products? 212.70 Section 212.70 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE...

  14. 21 CFR 212.70 - What controls and acceptance criteria must I have for my finished PET drug products?

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 4 2012-04-01 2012-04-01 false What controls and acceptance criteria must I have for my finished PET drug products? 212.70 Section 212.70 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE...

  15. 32 CFR 37.530 - What criteria do I use in deciding whether to accept a recipient's cost sharing?

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... THE SECRETARY OF DEFENSE DoD GRANT AND AGREEMENT REGULATIONS TECHNOLOGY INVESTMENT AGREEMENTS Pre-Award Business Evaluation Cost Sharing § 37.530 What criteria do I use in deciding whether to accept a... reimbursed by the Government through other awards. It is standard business practice for all for-profit...

  16. 32 CFR 37.530 - What criteria do I use in deciding whether to accept a recipient's cost sharing?

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... and development (IR&D) costs, as described at 32 CFR 34.13(a)(5)(ii), that meet all of the criteria in paragraphs (a) through (e) of this section. IR&D is acceptable as cost sharing, even though it may be... procurement contracts is recovered as IR&D) through prices charged to their customers. Thus, the...

  17. 32 CFR 37.530 - What criteria do I use in deciding whether to accept a recipient's cost sharing?

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... and development (IR&D) costs, as described at 32 CFR 34.13(a)(5)(ii), that meet all of the criteria in paragraphs (a) through (e) of this section. IR&D is acceptable as cost sharing, even though it may be... procurement contracts is recovered as IR&D) through prices charged to their customers. Thus, the...

  18. 32 CFR 37.530 - What criteria do I use in deciding whether to accept a recipient's cost sharing?

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... and development (IR&D) costs, as described at 32 CFR 34.13(a)(5)(ii), that meet all of the criteria in paragraphs (a) through (e) of this section. IR&D is acceptable as cost sharing, even though it may be... procurement contracts is recovered as IR&D) through prices charged to their customers. Thus, the...

  19. [Primary ciliary dyskinesia, immotile cilia syndrome, and Kartagener syndrome: diagnostic criteria].

    PubMed

    Dombi, V H; Walt, H

    1996-03-16

    Primary ciliary dyskinesia is the generic term for a heterogeneous group of inherited diseases in which ciliary ultrastructure is defective and as a consequence ciliary motility is disturbed. An international consensus on the diagnostic criteria has not yet been reached. This paper reviews some recent findings which are useful in the diagnosis of the disease and attempts to establish the best diagnostic criteria. The marker symptoms are chronic bronchitis, otitis, and sinusitis since childhood. Additionally, one or more of the following criteria must be present: Kartagener syndrome, a dextrocardia situation, markedly reduced frequency in ciliary motility, or an essential ultrastructure deviation in more than 20% of the square cuts (e.g. reduced number of dynein arms). Biopsy of the ciliated mucosa is usually required for the above criteria and is studied by vital microscopy and transmission electron microscopy. Primary and secondary ciliary dyskinesia can be distinguished by these methods and the rare case of PCD without ultrastructure deficiency ruled out. In special cases a cell culture is recommended for the diagnosis. Practical aspects of the sampling methods and diagnostic pitfalls are reviewed.

  20. Gender bias in diagnostic criteria for personality disorders: an item response theory analysis.

    PubMed

    Jane, J Serrita; Oltmanns, Thomas F; South, Susan C; Turkheimer, Eric

    2007-02-01

    The authors examined gender bias in the diagnostic criteria for Diagnostic and Statistical Manual of Mental Disorders (4th ed., text revision; American Psychiatric Association, 2000) personality disorders. Participants (N=599) were selected from 2 large, nonclinical samples on the basis of information from self-report questionnaires and peer nominations that suggested the presence of personality pathology. All were interviewed with the Structured Interview for DSM-IV Personality (B. Pfohl, N. Blum, & M. Zimmerman, 1997). Using item response theory methods, the authors compared data from 315 men and 284 women, searching for evidence of differential item functioning in the diagnostic features of 10 personality disorder categories. Results indicated significant but moderate measurement bias pertaining to gender for 6 specific criteria. In other words, men and women with equivalent levels of pathology endorsed the items at different rates. For 1 paranoid personality disorder criterion and 3 antisocial criteria, men were more likely to endorse the biased items. For 2 schizoid personality disorder criteria, women were more likely to endorse the biased items.

  1. How Should We Revise Diagnostic Criteria for Substance Use Disorders in the DSM—V?

    PubMed Central

    Martin, Christopher S.; Chung, Tammy; Langenbucher, James W.

    2009-01-01

    This article reviews literature on the validity and performance characteristics of the Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM—IV; American Psychiatric Association, 1994) diagnostic criteria for substance use disorders (SUDs) and recommends changes in these criteria that should be considered for the next edition of the DSM (DSM—V). Substantial data indicate that DSM—IV substance abuse and substance dependence are not distinct categories and that SUD criteria are best modeled as reflecting a unidimensional continuum of substance-problem severity. The conceptually and empirically problematic substance abuse diagnosis should be abandoned in the DSM—V, with substance dependence defined by a single set of criteria. Data also indicate that various individual SUD criteria should be revised, dropped, or considered for inclusion in the DSM–V. The DSM–V should provide a framework that allows the integration of categorical and dimensional approaches to diagnosis. Important areas for further research are noted. PMID:18729609

  2. Creutzfeldt-Jakob disease: updated diagnostic criteria, treatment algorithm, and the utility of brain biopsy.

    PubMed

    Manix, Marc; Kalakoti, Piyush; Henry, Miriam; Thakur, Jai; Menger, Richard; Guthikonda, Bharat; Nanda, Anil

    2015-11-01

    Creutzfeldt-Jakob disease (CJD) is a rare neurodegenerative condition with a rapid disease course and a mortality rate of 100%. Several forms of the disease have been described, and the most common is the sporadic type. The most challenging aspect of this disease is its diagnosis-the gold standard for definitive diagnosis is considered to be histopathological confirmation-but newer tests are providing means for an antemortem diagnosis in ways less invasive than brain biopsy. Imaging studies, electroencephalography, and biomarkers are used in conjunction with the clinical picture to try to make the diagnosis of CJD without brain tissue samples, and all of these are reviewed in this article. The current diagnostic criteria are limited; test sensitivity and specificity varies with the genetics of the disease as well as the clinical stage. Physicians may be unsure of all diagnostic testing available, and may order outdated tests or prematurely request a brain biopsy when the diagnostic workup is incomplete. The authors review CJD, discuss the role of brain biopsy in this patient population, provide a diagnostic pathway for the patient presenting with rapidly progressive dementia, and propose newer diagnostic criteria.

  3. Diagnostic Criteria, Classification and Treatment Goals in Multiple Sclerosis: The Chronicles of Time and Space.

    PubMed

    Ntranos, Achilles; Lublin, Fred

    2016-10-01

    Multiple sclerosis (MS) is one of the most diverse human diseases. Since its first description by Charcot in the nineteenth century, the diagnostic criteria, clinical course classification, and treatment goals for MS have been constantly revised and updated to improve diagnostic accuracy, physician communication, and clinical trial design. These changes have improved the clinical outcomes and quality of life for patients with the disease. Recent technological and research breakthroughs will almost certainly further change how we diagnose, classify, and treat MS in the future. In this review, we summarize the key events in the history of MS, explain the reasoning behind the current criteria for MS diagnosis, classification, and treatment, and provide suggestions for further improvements that will keep enhancing the clinical practice of MS.

  4. KBG syndrome: report of twins, neurological characteristics, and delineation of diagnostic criteria.

    PubMed

    Skjei, K L; Martin, M M; Slavotinek, A M

    2007-02-01

    KBG syndrome is a multiple congenital anomaly (MCA) syndrome comprising developmental delay, postnatal short stature, and delayed bone age. Many physical anomalies involving the face, hands, and costovertebral axis have been described in this syndrome. We present twin males with KBG syndrome and a review of 50 published case reports, with particular emphasis on the neurological aspects of KBG syndrome, including seizures, MRI findings, and behavior difficulties. It is argued that diagnostic criteria for KBG syndrome should include neurological involvement, that is, global developmental delay, seizures, and/or mental retardation (MR). The characteristic facial changes and representative hand and costovertebral anomalies are also defined. These diagnostic criteria were obtained from 50 publications and appeared to support the diagnosis in 43 cases. They will be helpful to pediatricians, geneticists, and neurologists in evaluating patients for this condition.

  5. Diagnostic criteria for selenium toxicosis in aquatic birds: dietary exposure, tissue concentrations, and macroscopic effects

    USGS Publications Warehouse

    Albers, P.H.; Green, D.E.; Sanderson, C.J.

    1996-01-01

    A feeding study with mallard ducks (Anas platyrhynchos) was conducted during March-July, 1988 in Laurel, Maryland, to identify diagnostic criteria for selenium toxicosis in birds. One-year-old male mallards in groups of 21 were fed diets containing 0, 10, 20, 40, or 80 parts per million (ppm) selenium, as seleno-DL-methionine, for 16 weeks. All ducks receiving 80 ppm died. Ducks receiving 40 or 80 ppm selenium consumed less feed than ducks in the other treatment groups. Body weights of ducks receiving 40 or 80 ppm selenium declined during the study. The post-breeding molt was delayed in ducks receiving 40 ppm; most ducks receiving 80 ppm selenium died prior to the onset of molt. At necropsy, numerous abnormalities were observed in ducks that died but only a small number of abnormalities were observed in ducks surviving to the end of the study in the 40 ppm group. Weights of the heart, spleen, and pancreas were mostly lower and weights of the kidney were higher for ducks dying during the study than for euthanized ducks. Liver weights were unaffected. Selenium accumulated in soft tissues approximately in proportion to dietary concentrations. Selenium concentrations in tissues of all ducks that died were different from those of surviving ducks in the 0, 10, and 20 ppm groups, but were not different from those of surviving ducks in the 40 ppm group. Proposed diagnostic criteria for fatal chronic selenosis were derived from body weight, macroscopic abnormalities, organ weights, and concentrations of selenium in the liver. Proposed diagnostic criteria for non-fatal chronic selenosis were derived from body weight, plumage condition, macroscopic abnormalities, concentrations of selenium in the liver, reproductive failure, and alterations of blood and tissue chemistries. Lead or dioxin poisoning have diagnostic criteria most similar to selenium toxicosis.

  6. Diabetic Neuropathies: Update on Definitions, Diagnostic Criteria, Estimation of Severity, and Treatments

    PubMed Central

    Tesfaye, Solomon; Boulton, Andrew J.M.; Dyck, Peter J.; Freeman, Roy; Horowitz, Michael; Kempler, Peter; Lauria, Giuseppe; Malik, Rayaz A.; Spallone, Vincenza; Vinik, Aaron; Bernardi, Luciano; Valensi, Paul

    2010-01-01

    Preceding the joint meeting of the 19th annual Diabetic Neuropathy Study Group of the European Association for the Study of Diabetes (NEURODIAB) and the 8th International Symposium on Diabetic Neuropathy in Toronto, Canada, 13–18 October 2009, expert panels were convened to provide updates on classification, definitions, diagnostic criteria, and treatments of diabetic peripheral neuropathies (DPNs), autonomic neuropathy, painful DPNs, and structural alterations in DPNs. PMID:20876709

  7. Prevalence of restless legs syndrome in Ankara, Turkey: an analysis of diagnostic criteria and awareness.

    PubMed

    Yilmaz, Nesrin Helvaci; Akbostanci, Muhittin Cenk; Oto, Aycan; Aykac, Ozlem

    2013-09-01

    The aim of this study was threefold: (1) to investigate the prevalence of restless legs syndrome (RLS), in Ankara, Turkey; (2) to determine the predictive values of diagnostic criteria; and (3) to determine the frequency of physician referrals and the frequency of getting the correct diagnosis. A total of 815 individuals, from randomly selected addresses, above the age of 15, were reached using the questionnaire composed of the four diagnostic criteria. Individuals who responded by answering 'yes' for at least one question were interviewed by neurologists for the diagnosis of RLS. Frequency of physician referrals and frequency of getting the correct diagnosis of RLS were also determined for patients getting the final diagnoses of RLS. Prevalence of RLS in Ankara was 5.52 %; 41.0 % of the individuals diagnosed with RLS had replied 'yes' to either one, two or three questions asked by interviewers. However, only 21.3 % of individuals who replied 'yes' to all four questions received the diagnosis of RLS. Among the patients who had the final diagnosis of RLS, 25.7 % had referred to a physician for the symptoms and 22.2 % got the correct diagnosis. The RLS prevalence in Ankara was somewhere between Western and Far East countries compatible with the geographical location. Diagnostic criteria may not be fully predictive when applied by non-physician pollsters. Physician's probability of correctly diagnosing RLS is still low.

  8. Diagnostic criteria for the characterization of quasireversible electron transfer reactions by cyclic square wave voltammetry.

    PubMed

    Mann, Megan A; Helfrick, John C; Bottomley, Lawrence A

    2014-08-19

    Theory for cyclic square wave voltammetry of quasireversible electron transfer reactions is presented and experimentally verified. The impact of empirical parameters on the shape of the current-voltage curve is examined. From the trends, diagnostic criteria enabling the use of this waveform as a tool for mechanistic analysis of electrode reaction processes are presented. These criteria were experimentally confirmed using Eu(3+)/Eu(2+), a well-established quasireversible analyte. Using cyclic square wave voltammetry, both the electron transfer coefficient and rate were calculated for this analyte and found to be in excellent agreement with literature. When properly applied, these criteria will enable nonexperts in voltammetry to assign the electrode reaction mechanism and accurately measure electrode reaction kinetics.

  9. Comparing Diagnostic Outcomes of Autism Spectrum Disorder Using DSM-IV-TR and DSM-5 Criteria.

    PubMed

    Harstad, Elizabeth B; Fogler, Jason; Sideridis, Georgios; Weas, Sarah; Mauras, Carrie; Barbaresi, William J

    2015-05-01

    Controversy exists regarding the DSM-5 criteria for ASD. This study tested the psychometric properties of the DSM-5 model and determined how well it performed across different gender, IQ, and DSM-IV-TR sub-type, using clinically collected data on 227 subjects (median age = 3.95 years, majority had IQ > 70). DSM-5 was psychometrically superior to the DSM-IV-TR model (Comparative Fit Index of 0.970 vs 0.879, respectively). Measurement invariance revealed good model fit across gender and IQ. Younger children tended to meet fewer diagnostic criteria. Those with autistic disorder were more likely to meet social communication and repetitive behaviors criteria (p < .001) than those with PDD-NOS. DSM-5 is a robust model but will identify a different, albeit overlapping population of individuals compared to DSM-IV-TR.

  10. The problem of obesity among adolescents in Hong Kong: a comparison using various diagnostic criteria

    PubMed Central

    Ko, Gary TC; Ozaki, Risa; Wong, Gary WK; Kong, Alice PS; So, Wing-Yee; Tong, Peter CY; Chan, Michael HM; Ho, Chung-Shun; Lam, Christopher WK; Chan, Juliana CN

    2008-01-01

    Background Obesity is now a global epidemic. In this study, we aimed to assess the rates of obesity using several major diagnostic criteria in Chinese school adolescents in Hong Kong. Methods This is a cross-sectional study. Using a computer-generated coding system, we randomly selected schools from different geographical regions in Hong Kong to obtain a representative sample. Subjects aged 11–18 years of age were randomly selected from different class of the schools. Their rates of obesity according to four different international and local criteria were compared [International Obesity Task Force (IOTF) 2000 criterion; the Group of China Obesity Task Force (COTF) 2004 criterion; Centers for Disease Control and Prevention (CDC) 2000 Growth Charts and the Hong Kong Growth Survey (HKGS) charts in 1993]. Results Of the 2098 adolescents [982 (46.8%) boys and 1116 (53.2%) girls], the mean age (± SD) was 15.1 ± 1.8 years (range: 11–18 years; median: 15.0 years). The crude rates of obesity were similar based on IOTF, COTF or CDC criteria (boys: 3.9–6.0%, girls: 1.8–3.7%), however, the rate increased to 11–27% if the HKGS charts were used. Obesity rate varied markedly according to age. It decreased from 8–10% among those aged 12–13 years to 2–4% among those aged 17–18 years. Conclusion The prevalence of obesity in Hong Kong adolescents using various diagnostic criteria were similar except for the 1993 HKGS criteria, which gave an exceeding high figure. Using the IOTF, COTF or CDC criteria, the adolescent obesity in Hong Kong varied from 1.8% to 6.0%. PMID:18315886

  11. Commentary on pathologic diagnosis of asbestosis and critique of the 2010 Asbestosis Committee of the College of American Pathologists (CAP) and Pulmonary Pathology Society's (PPS) update on the diagnostic criteria for pathologic asbestosis.

    PubMed

    Hammar, Samuel P; Abraham, Jerrold L

    2015-10-01

    We reviewed the 2010 Asbestosis Committee's update on the diagnostic criteria for pathologic asbestosis. We must respectfully disagree with many of the criteria set forth therein, especially for recognizing asbestosis at its earliest stages; with statements focusing on the number of asbestos bodies needed in order to make a pathologic diagnosis of asbestosis; and regarding the benefits and pitfalls of relying on fiber analysis for diagnostic purposes, especially where chrysotile asbestos is concerned, including the methodology used for fiber determination. This critique has become even more relevant with the 2014 Helsinki criteria publication, which adopted the 2010 CAP/PPS criteria. Based on our review of these newer criteria and our experience in this field, we find that the CAP-NIOSH 1982 criteria is still the most acceptable method for the pathologic diagnosis and grading of asbestosis, which can be described as pulmonary fibrosis caused by inhalation of asbestos fibers.

  12. A comparative study of the different diagnostic criteria of gestational diabetes mellitus and its incidence

    PubMed Central

    Somani, BL; Arora, MM; Bhatia, Kapil; Arora, Devendra; Banerjee, Mithu

    2012-01-01

    Background High prevalence of diabetes and genetic predisposition to metabolic syndrome among Indians places Indian women at risk to develop gestational diabetes mellitus (GDM) and its complications. Literature defines multiple criteria for GDM. This prospective study compares available diagnostic criteria for GDM in Indian women and their correlation with perinatal morbidity. Method Nine hundred and forty-eight consecutive voluntary nondiabetic pregnant women were recruited for the study. Seven hundred and twenty-three of these (mean age 23.45 years; 75.7% < 25 years) who reported for the follow-up were screened for GDM at 24–28 weeks gestation by American College of Obstetrics and Gynaecology (ACOG) guidelines and World Health Organization (WHO) criteria. Glycated haemoglobin (HbA1c) and fasting and two-hours postglucose plasma insulin levels were also analysed. Pregnancy outcome was known for 291 of these. Concordance of risk factors and perinatal complications was analysed with respect to GDM. Results Prevalence of GDM at 24–28 weeks gestation was found to be 4.8% by WHO criteria, 6.36% by Carpenter and Coustan's criteria, and 3.5% by O'Sullivan's criteria. Prevalence was marginally higher in women of higher age, having past history of abortion or family history of diabetes mellitus (DM) (P > 0.05). None of these women had HbA1c > 6%. Relative risk of abnormal delivery (pregnancy outcome) was 1.93, 1.39, and 1.17 in women with GDM by O'Sullivan's, WHO, and Carpenter's criteria, respectively (P > 0.05). Abnormal deliveries were marginally higher in women with high postglucose load insulin levels. Mean weight of the newborns was essentially the same in GDM and nonGDM women by any of the criteria. One-hour and two-hours postglucose values were more sensitive in diagnosing GDM by O'Sullivan's criteria while fasting plasma glucose value had the poorest specificity with 2.5% of nonGDM women having values above the cut-off. Modifications of these criteria did not

  13. Intermittent explosive disorder: development of integrated research criteria for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition.

    PubMed

    Coccaro, Emil F

    2011-01-01

    This study was designed to develop a revised diagnostic criteria set for intermittent explosive disorder (IED) for consideration for inclusion in Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-V). This revised criteria set was developed by integrating previous research criteria with elements from the current DSM-IV set of diagnostic criteria. Evidence supporting the reliability and validity of IED-IR ("IED Integrated Criteria") in a new and well-characterized group of subjects with personality disorder is presented. Clinical, phenomenologic, and diagnostic data from 201 individuals with personality disorder were reviewed. All IED diagnoses were assigned using a best-estimate process (eg, kappa for IED-IR >0.85). In addition, subjects meeting IED-IR criteria had higher scores on dimensional measures of aggression and had lower global functioning scores than non-IED-IR subjects, even when related variables were controlled. The IED-IR criteria were more sensitive than the DSM-IV criteria only in identifying subjects with significant impulsive-aggressive behavior by a factor of 16. We conclude that the IED-IR criteria can be reliably applied and have sufficient validity to warrant consideration as DSM-V criteria for IED.

  14. Validation of secondary data sources to identify Parkinson disease against clinical diagnostic criteria.

    PubMed

    Jain, Samay; Himali, Jayandra; Beiser, Alexa; Ton, Thanh G N; Kelly-Hayes, Margaret; Biggs, Mary Lou; Delaney, Joseph A C; Rosano, Caterina; Seshadri, Sudha; Frank, Samuel A

    2015-02-01

    Parkinson disease (PD) is the second most common neurodegenerative disorder. Its diagnosis relies solely on a clinical examination and is not straightforward because no diagnostic test exists. Large, population-based, prospective cohort studies designed to examine other outcomes that are more common than PD might provide cost-efficient alternatives for studying the disease. However, most cohort studies have not implemented rigorous systematic screening for PD. A majority of epidemiologic studies that utilize population-based prospective designs rely on secondary data sources to identify PD cases. Direct validation of these secondary sources against clinical diagnostic criteria is lacking. The Framingham Heart Study has prospectively screened and evaluated participants for PD based on clinical diagnostic criteria. We assessed the predictive value of secondary sources for PD identification relative to clinical diagnostic criteria in the Framingham Heart Study (2001-2012). We found positive predictive values of 1.0 (95% confidence interval: 0.868, 1.0), 1.0 (95% confidence interval: 0.839, 1.0), and 0.50 (95% confidence interval: 0.307, 0.694) for PD identified from self-report, use of antiparkinsonian medications, and Medicare claims, respectively. The negative predictive values were all higher than 0.99. Our results highlight the limitations of using only Medicare claims data and suggest that population-based cohorts may be utilized for the study of PD determined via self-report or medication inventories while preserving a high degree of confidence in the validity of PD case identification.

  15. Analysis of diagnostic criteria in adamantiades-behçet disease: a retrospective study.

    PubMed

    di Meo, Nicola; Bergamo, S; Vidimari, P; Bonin, S; Trevisan, G

    2013-07-01

    Adamantiades-Behçet's disease (ABD) is a chronic-relapsing, inflammatory and multi-systemic disease. Any organ or system may be involved: ABD presents a great variety of cutaneous and mucosal lesions, ocular manifestations, central and peripheral nervous system abnormalities, joint as well as gastrointestinal involvement. Since clear pathognomonic clinical features and laboratory tests are lacking, the diagnosis of ABD mainly relies on the characteristic clinical features. Several sets of diagnostic criteria have been used. The International Study Group for Behçet Disease (ISGBD) in 1990 formulated a set of criteria to warrant uniformity of both diagnosis and classification. Therefore, in 2006, a new set was proposed by the International Team for the Revision of the International Criteria for Behçet's Disease (ITR-ICBD) not only to uniform the previous criteria but also to establish best accuracy, along with an optimum sensivity and specificity. The aims of this study are both to analyze the clinical features of ABD patients and to validate the ISGBD and ITR-ICDB criteria for the diagnosis of ABD in our cohort.

  16. Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD): Development of Image Analysis Criteria and Examiner Reliability for Image Analysis

    PubMed Central

    Ahmad, Mansur; Hollender, Lars; Odont; Anderson, Quentin; Kartha, Krishnan; Ohrbach, Richard K.; Truelove, Edmond L.; John, Mike T.; Schiffman, Eric L.

    2011-01-01

    Introduction As a part of a multi-site RDC/TMD Validation Project, comprehensive TMJ diagnostic criteria were developed for image analysis using panoramic radiography, magnetic resonance imaging (MRI), and computed tomography (CT). Methods Inter-examiner reliability was estimated using the kappa (k) statistic, and agreement between rater pairs was characterized by overall, positive, and negative percent agreement. CT was the reference standard for assessing validity of other imaging modalities for detecting osteoarthritis (OA). Results For the radiological diagnosis of OA, reliability of the three examiners was poor for panoramic radiography (k = 0.16), fair for MRI (k = 0.46), and close to the threshold for excellent for CT (k = 0.71). Using MRI, reliability was excellent for diagnosing disc displacements (DD) with reduction (k = 0.78) and for DD without reduction (k = 0.94), and was good for effusion (k = 0.64). Overall percent agreement for pair-wise ratings was ≥ 82% for all conditions. Positive percent agreement for diagnosing OA was 19% for panoramic radiography, 59% for MRI, and 84% for CT. Using MRI, positive percent agreement for diagnoses of any DD was 95% and for effusion was 81%. Negative percent agreement was ≥ 88% for all conditions. Compared to CT, panoramic radiography and MRI had poor to marginal sensitivity, respectively, but excellent specificity, in detecting OA. Conclusion Comprehensive image analysis criteria for RDC/TMD Validation Project were developed, which can reliably be employed for assessing OA using CT, and for disc position and effusion using MRI. PMID:19464658

  17. The U.S. Nuclear Regulatory Commission's Strategy for Revising the RIA Acceptance Criteria

    SciTech Connect

    Clifford, Paul M.

    2007-07-01

    The U.S. Nuclear Regulatory Commission (NRC) has issued interim criteria and guidance for the reactivity-initiated accident (RIA) within the latest revision to NUREG-0800, 'Standard Review Plan' (SRP), Section 4.2, 'Fuel System Design', Appendix B (Revision 03, March 2007). The purpose of this paper is as follows: 1. present a change in regulatory staff position regarding the requirements of 10 CFR 50, Appendix A, General Design Criteria 28 (GDC28) and changes in regulatory guidance provided in Regulatory Guide (RG) 1.77, RG 1.195, RG 1.183, and previous versions of NUREG-0800 SRP; 2. describe the implementation strategy and schedule for both new reactors and the existing fleet; and 3. encourage licensees and nuclear fuel vendors to (1) develop improved core physics analytical methods to allow a more deliberate transition to the new fuel cladding failure criteria and (2) develop the technical basis to address the new core coolability criteria. (authors)

  18. DSM-V diagnostic criteria for bereavement-related disorders in children and adolescents: developmental considerations.

    PubMed

    Kaplow, Julie B; Layne, Christopher M; Pynoos, Robert S; Cohen, Judith A; Lieberman, Alicia

    2012-01-01

    Two bereavement-related disorders are proposed for the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V): Adjustment Disorder Related to Bereavement, to be located in the main body of the text as an official diagnostic entity; and Bereavement-Related Disorder, including a Traumatic Death Specifier, to be located in the Appendix as an invitation for further research. These diagnoses currently do not include developmentally informed criteria, despite the importance of developmental processes in the ways children and adolescents grieve. In this article, we draw upon a selective review of the empirical literature and expert clinical knowledge to recommend developmentally informed modifications and specifiers of the proposed criteria for both bereavement disorders and strategies to improve future research. This article is derived from an invited report submitted to the DSM-V Posttraumatic Stress Disorder, Trauma, and Dissociative Disorders Sub-Work Group, and suggested modifications have received preliminary approval to be incorporated into the DSM-V at the time of this writing. Adoption of these proposals will have far-reaching consequences, given that DSM-V criteria will influence both critical treatment choices for bereaved youth and the next generation of research studies.

  19. International Harmonization of Nomenclature and Diagnostic Criteria (INHAND) for Lesions in the Minipig.

    PubMed

    Skydsgaard, Mikala

    2016-04-01

    The International Harmonization of Nomenclature and Diagnostic Criteria (INHAND) is a global project establishing diagnostic criteria and nomenclature for both proliferative and nonproliferative changes in laboratory animals. Nonrodent working groups (NRWGs) have been established for the dog, nonhuman primate, minipig, and the rabbit. The Global Editorial and Steering Committee (GESC) oversees the activities of the INHAND projects and is composed of toxicologic pathologists from all of the participating societies. In 2012, INHAND GESC began a collaboration with the U.S. Food and Drug Administration (USFDA) in adapting INHAND terminology for standardized nonclinical data submission to the FDA. The Standard for Exchange of Nonclinical Data is an implementation of the Clinical Data Interchange Standards Consortium Study Data Tabulation Model for nonclinical studies. The NRWG for the minipig consists of toxicologic and diagnostic pathologists from Japan, North America, and Europe, and the group has 15 members including a GESC representative. The NRWGs are reviewing the applicability of the rodent nomenclature for the species and providing terminology unique for the species as well as determining rodent terminology not appropriate for the species. This information will be published with representative illustrations and references.

  20. The DSM-5 diagnostic criteria for anorexia nervosa may change its population prevalence and prognostic value.

    PubMed

    Mustelin, Linda; Silén, Yasmina; Raevuori, Anu; Hoek, Hans W; Kaprio, Jaakko; Keski-Rahkonen, Anna

    2016-06-01

    The definition of anorexia nervosa was revised for the Fifth Edition of the Diagnostic and Statistical Manual (DSM-5). We examined the impact of these changes on the prevalence and prognosis of anorexia nervosa. In a nationwide longitudinal study of Finnish twins born 1975-1979, the women (N = 2825) underwent a 2-stage screening for eating disorders at mean age 24. Fifty-five women fulfilled DSM-IV criteria for lifetime anorexia nervosa. When we recoded the interviews using DSM-5 criteria, we detected 37 new cases. We contrasted new DSM-5 vs. DSM-IV cases to assess their clinical characteristics and prognosis. We also estimated lifetime prevalences and incidences and tested the association of minimum BMI with prognosis. We observed a 60% increase in the lifetime prevalence of anorexia nervosa using the new diagnostic boundaries, from 2.2% to 3.6%. The new cases had a later age of onset (18.8 y vs. 16.5, p = 0.002), higher minimum BMI (16.9 vs. 15.5 kg/m(2), p = 0.0004), a shorter duration of illness (one year vs. three years, p = 0.002), and a higher 5-year probability or recovery (81% vs. 67%, p = 0.002). Minimum BMI was not associated with prognosis. It therefore appears that the substantial increase in prevalence of anorexia nervosa is offset by a more benign course of illness in new cases. Increased diagnostic heterogeneity underscores the need for reliable indicators of disease severity. Our findings indicate that BMI may not be an ideal severity marker, but should be complemented by prognostically informative criteria. Future studies should focus on identifying such factors in prospective settings.

  1. Scientific Statement on the Diagnostic Criteria, Epidemiology, Pathophysiology, and Molecular Genetics of Polycystic Ovary Syndrome

    PubMed Central

    Dumesic, Daniel A.; Oberfield, Sharon E.; Stener-Victorin, Elisabet; Marshall, John C.; Laven, Joop S.

    2015-01-01

    Polycystic ovary syndrome (PCOS) is a heterogeneous and complex disorder that has both adverse reproductive and metabolic implications for affected women. However, there is generally poor understanding of its etiology. Varying expert-based diagnostic criteria utilize some combination of oligo-ovulation, hyperandrogenism, and the presence of polycystic ovaries. Criteria that require hyperandrogenism tend to identify a more severe reproductive and metabolic phenotype. The phenotype can vary by race and ethnicity, is difficult to define in the perimenarchal and perimenopausal period, and is exacerbated by obesity. The pathophysiology involves abnormal gonadotropin secretion from a reduced hypothalamic feedback response to circulating sex steroids, altered ovarian morphology and functional changes, and disordered insulin action in a variety of target tissues. PCOS clusters in families and both female and male relatives can show stigmata of the syndrome, including metabolic abnormalities. Genome-wide association studies have identified a number of candidate regions, although their role in contributing to PCOS is still largely unknown. PMID:26426951

  2. [Diagnostic Criteria for Amyotrophic Lateral Sclerosis/Parkinsonism-Dementia Complex in the Kii Peninsula, Japan].

    PubMed

    Kokubo, Yasumasa

    2015-07-01

    The diagnostic criteria for amyotrophic lateral sclerosis/parkinsonism-dementia complex in the Kii peninsula of Japan (Kii ALS/PDC) have been proposed. Muro disease has been considered an endemic neurodegenerative disease in the southern part of the Kii peninsula. Recent intensive and comprehensive research has revealed it to be a complex and genetically heterogeneous disease. At present, there are four subtypes of Muro disease: sporadic amyotrophic lateral sclerosis (ALS), Kii ALS/PDC with tauopathy, ALS with C9orf72 gene mutation, and ALS with optineurin gene mutation. The present criteria are applicable to only one of these subtypes, Kii ALS/PDC with tauopathy, which is quite similar to ALS/PDC in Guam.

  3. Neuropsychiatric symptoms as early manifestations of emergent dementia: Provisional diagnostic criteria for mild behavioral impairment.

    PubMed

    Ismail, Zahinoor; Smith, Eric E; Geda, Yonas; Sultzer, David; Brodaty, Henry; Smith, Gwenn; Agüera-Ortiz, Luis; Sweet, Rob; Miller, David; Lyketsos, Constantine G

    2016-02-01

    Neuropsychiatric symptoms (NPS) are common in dementia and in predementia syndromes such as mild cognitive impairment (MCI). NPS in MCI confer a greater risk for conversion to dementia in comparison to MCI patients without NPS. NPS in older adults with normal cognition also confers a greater risk of cognitive decline in comparison to older adults without NPS. Mild behavioral impairment (MBI) has been proposed as a diagnostic construct aimed to identify patients with an increased risk of developing dementia, but who may or may not have cognitive symptoms. We propose criteria that include MCI in the MBI framework, in contrast to prior definitions of MBI. Although MBI and MCI can co-occur, we suggest that they are different and that both portend a higher risk of dementia. These MBI criteria extend the previous literature in this area and will serve as a template for validation of the MBI construct from epidemiologic, neurobiological, treatment, and prevention perspectives.

  4. Diagnostic criteria for proliferative hepatic lesions in brown bullhead Ameiurus nebulosus

    USGS Publications Warehouse

    Blazer, V.S.; Fournie, J.W.; Wolf, J.C.; Wolfe, M.J.

    2006-01-01

    Brown bullhead Ameiurus nebulosus is used as indicator species for contaminant effects at areas of concern (AOC) in the Great Lakes and other areas. One of the beneficial use impairments at numerous AOC is 'fish tumors and other deformities'. An impairment occurs when the prevalence of fish tumors and other deformities exceeds those at unimpacted or control sites or when survey data confirm the presence of neoplastic or preneoplastic liver lesions in bullhead or white sucker Catostomus commersonii. Numerous surveys have been conducted over the years assessing neoplasia in these fishes, both liver and skin tumors. However, a major problem in comparing the results has been a lack of consistent criteria for evaluating histological changes in bullhead livers. As individual AOC develop and implement remedial action plans, realistic and attainable delisting targets need to be specified. For this to occur and be consistent from site to site there must be standardization of the criteria being used to evaluate specific impairments. In this report, specific diagnostic criteria are provided for both non-neoplastic and neoplastic proliferative hepatocellular and biliary lesions. These criteria should assist fish pathologists in describing and categorizing proliferative liver lesions from brown bullhead. ?? Inter-Research 2006.

  5. The DSM diagnostic criteria for hypoactive sexual desire disorder in women.

    PubMed

    Brotto, Lori A

    2010-04-01

    Hypoactive Sexual Desire Disorder (HSDD) is one of two sexual desire disorders in the Diagnostic and Statistical Manual of Mental Disorders (DSM) and is defined by the monosymptomatic criterion "persistently or recurrently deficient (or absent) sexual fantasies and desire for sexual activity" that causes "marked distress or interpersonal difficulty." This article reviews the diagnosis of HSDD in prior and current (DSM-IV-TR) editions of the DSM, critiques the existing criteria, and proposes criteria for consideration in DSM-V. Problems in coming to a clear operational definition of desire, the fact that sexual activity often occurs in the absence of desire for women, conceptual issues in understanding untriggered versus responsive desire, the relative infrequency of unprovoked sexual fantasies in women, and the significant overlap between desire and arousal are reviewed and highlight the need for revised DSM criteria for HSDD that accurately reflect women's experiences. The article concludes with the recommendation that desire and arousal be combined into one disorder with polythetic criteria.

  6. Holoprosencephaly-polydactyly (pseudotrisomy 13) syndrome: case report and diagnostic criteria.

    PubMed

    Sergi, Consolato; Gekas, Jean; Kamnasaran, Deepak

    2012-10-01

    We report a new case of a fetus with holoprosencephaly-polydactyly syndrome, also known as pseudo-trisomy 13 syndrome, and no other apparent abnormalities except for septal agenesis of the left lung. The fetal karyotype was normal. Mutational analysis of five genes (SHH, SIX3, TGIF, ZIC2, and GLI3), which are major genes associated with holoprosencephaly, did not disclose any mutational findings. We therefore propose that the abnormalities of our fetus support the demarcation of this syndrome as an autonomous phenotype. Specific diagnostic criteria for holoprosencephaly-polydactyly syndrome need to be complemented by the absence of mutations in the major holoprosencephaly genes.

  7. [Myocardial infarction and acute coronary syndrome: definitions, classification, and diagnostic criteria].

    PubMed

    Zaĭrat'iants, O V; Mishnev, O D; Kakturskiĭ, L V

    2014-01-01

    The review gives the definitions and classification of and diagnostic criteria for myocardial infarction and acute coronary syndrome in accordance with the "The third universal definition of myocardial infarction" adopted in 2012 (Joint ESC/ACCF/AHA/WHF Task Force for the Universal Definition of Myocardial Infarction, 2012). It also discusses the clinical and morphological comparisons of and the problems in the differential diagnosis of myocardial infarction as a nosological entity within coronary heart disease with other coronarogenic and non-coronarogenic necroses of the myocardium.

  8. The pattern and diagnostic criteria of sensory neuronopathy: a case–control study

    PubMed Central

    Camdessanché, Jean-Philippe; Jousserand, Guillemette; Ferraud, Karine; Vial, Christophe; Petiot, Philippe; Honnorat, Jérôme

    2009-01-01

    Acquired sensory neuronopathies encompass a group of paraneoplastic, dysimmune, toxic or idiopathic disorders characterized by degeneration of peripheral sensory neurons in dorsal root ganglia. As dorsal root ganglia cannot easily be explored, the clinical diagnosis of these disorders may be difficult. The question as to whether there exists a common clinical pattern of sensory neuronopathies, allowing the establishment of validated and easy-to-use diagnostic criteria, has not yet been addressed. In this study, logistic regression was used to construct diagnostic criteria on a retrospective study population of 78 patients with sensory neuronopathies and 56 with other sensory neuropathies. For this, sensory neuronopathy was provisionally considered as unambiguous in 44 patients with paraneoplastic disorder or cisplatin treatment and likely in 34 with a dysimmune or idiopathic setting who may theoretically have another form of neuropathy. To test the homogeneity of the sensory neuronopathy population, likely candidates were compared with unambiguous cases and then the whole population was compared with the other sensory neuropathies population. Criteria accuracy was checked on 37 prospective patients referred for diagnosis of sensory neuropathy. In the study population, sensory neuronopathy showed a common clinical and electrophysiological pattern that was independent of the underlying cause, including unusual forms with only patchy sensory loss, mild electrical motor nerve abnormalities and predominant small fibre or isolated lower limb involvement. Logistic regression allowed the construction of a set of criteria that gave fair results with the following combination: ataxia in the lower or upper limbs + asymmetrical distribution + sensory loss not restricted to the lower limbs + at least one sensory action potential absent or three sensory action potentials <30% of the lower limit of normal in the upper limbs + less than two nerves with abnormal motor nerve

  9. Acceptance criteria for the evaluation of Category 1 fuel cycle facility physical security plans

    SciTech Connect

    Dwyer, P.A.

    1991-10-01

    This NUREG document presents criteria developed from US Nuclear Regulatory Commission regulations for the evaluation of physical security plans submitted by Category 1 fuel facility licensees. Category 1 refers to those licensees who use or possess a formula quantity of strategic special nuclear material.

  10. Data Acceptance Criteria for Standardized Human-Associated Fecal Source Identification Quantitative Real-Time PCR Methods

    PubMed Central

    Kelty, Catherine A.; Oshiro, Robin; Haugland, Richard A.; Madi, Tania; Brooks, Lauren; Field, Katharine G.; Sivaganesan, Mano

    2016-01-01

    There is growing interest in the application of human-associated fecal source identification quantitative real-time PCR (qPCR) technologies for water quality management. The transition from a research tool to a standardized protocol requires a high degree of confidence in data quality across laboratories. Data quality is typically determined through a series of specifications that ensure good experimental practice and the absence of bias in the results due to DNA isolation and amplification interferences. However, there is currently a lack of consensus on how best to evaluate and interpret human fecal source identification qPCR experiments. This is, in part, due to the lack of standardized protocols and information on interlaboratory variability under conditions for data acceptance. The aim of this study is to provide users and reviewers with a complete series of conditions for data acceptance derived from a multiple laboratory data set using standardized procedures. To establish these benchmarks, data from HF183/BacR287 and HumM2 human-associated qPCR methods were generated across 14 laboratories. Each laboratory followed a standardized protocol utilizing the same lot of reference DNA materials, DNA isolation kits, amplification reagents, and test samples to generate comparable data. After removal of outliers, a nested analysis of variance (ANOVA) was used to establish proficiency metrics that include lab-to-lab, replicate testing within a lab, and random error for amplification inhibition and sample processing controls. Other data acceptance measurements included extraneous DNA contamination assessments (no-template and extraction blank controls) and calibration model performance (correlation coefficient, amplification efficiency, and lower limit of quantification). To demonstrate the implementation of the proposed standardized protocols and data acceptance criteria, comparable data from two additional laboratories were reviewed. The data acceptance criteria

  11. Data Acceptance Criteria for Standardized Human-Associated Fecal Source Identification Quantitative Real-Time PCR Methods.

    PubMed

    Shanks, Orin C; Kelty, Catherine A; Oshiro, Robin; Haugland, Richard A; Madi, Tania; Brooks, Lauren; Field, Katharine G; Sivaganesan, Mano

    2016-05-01

    There is growing interest in the application of human-associated fecal source identification quantitative real-time PCR (qPCR) technologies for water quality management. The transition from a research tool to a standardized protocol requires a high degree of confidence in data quality across laboratories. Data quality is typically determined through a series of specifications that ensure good experimental practice and the absence of bias in the results due to DNA isolation and amplification interferences. However, there is currently a lack of consensus on how best to evaluate and interpret human fecal source identification qPCR experiments. This is, in part, due to the lack of standardized protocols and information on interlaboratory variability under conditions for data acceptance. The aim of this study is to provide users and reviewers with a complete series of conditions for data acceptance derived from a multiple laboratory data set using standardized procedures. To establish these benchmarks, data from HF183/BacR287 and HumM2 human-associated qPCR methods were generated across 14 laboratories. Each laboratory followed a standardized protocol utilizing the same lot of reference DNA materials, DNA isolation kits, amplification reagents, and test samples to generate comparable data. After removal of outliers, a nested analysis of variance (ANOVA) was used to establish proficiency metrics that include lab-to-lab, replicate testing within a lab, and random error for amplification inhibition and sample processing controls. Other data acceptance measurements included extraneous DNA contamination assessments (no-template and extraction blank controls) and calibration model performance (correlation coefficient, amplification efficiency, and lower limit of quantification). To demonstrate the implementation of the proposed standardized protocols and data acceptance criteria, comparable data from two additional laboratories were reviewed. The data acceptance criteria

  12. Variability among Research Diagnostic Interview Instruments in the Application of "DSM-IV-TR" Criteria for Pediatric Bipolar Disorder

    ERIC Educational Resources Information Center

    Galanter, Cathryn A.; Hundt, Stephanie R.; Goyal, Parag; Le, Jenna; Fisher, Prudence W.

    2012-01-01

    Objective: The "DSM-IV-TR "criteria for a manic episode and bipolar disorder (BD) were developed for adults but are used for children. The manner in which clinicians and researchers interpret these criteria may have contributed to the increase in BD diagnoses given to youth. Research interviews are designed to improve diagnostic reliability and…

  13. Riluzole treatment, survival and diagnostic criteria in Parkinson plus disorders: The NNIPPS Study

    PubMed Central

    Bensimon, Gilbert; Ludolph, Albert; Agid, Yves; Vidailhet, Marie; Payan, Christine; Leigh, P. Nigel

    2009-01-01

    Parkinson plus diseases, comprising mainly progressive supranuclear palsy (PSP) and multiple system atrophy (MSA) are rare neurodegenerative conditions. We designed a double-blind randomized placebo-controlled trial of riluzole as a potential disease-modifying agent in Parkinson plus disorders (NNIPPS: Neuroprotection and Natural History in Parkinson Plus Syndromes). We analysed the accuracy of our clinical diagnostic criteria, and studied prognostic factors for survival. Patients with an akinetic-rigid syndrome diagnosed as having PSP or MSA according to modified consensus diagnostic criteria were considered for inclusion. The psychometric validity (convergent and predictive) of the NNIPPS diagnostic criteria were tested prospectively by clinical and pathological assessments. The study was powered to detect a 40% decrease in relative risk of death within PSP or MSA strata. Patients were randomized to riluzole or matched placebo daily and followed up to 36 months. The primary endpoint was survival. Secondary efficacy outcomes were rates of disease progression assessed by functional measures. A total of 767 patients were randomized and 760 qualified for the Intent to Treat (ITT) analysis, stratified at entry as PSP (362 patients) or MSA (398 patients). Median follow-up was 1095 days (range 249–1095). During the study, 342 patients died and 112 brains were examined for pathology. NNIPPS diagnostic criteria showed for both PSP and MSA excellent convergent validity with the investigators’ assessment of diagnostic probability (point-biserial correlation: MSA rpb = 0.93, P < 0.0001; PSP, rpb = 0.95, P < 0.0001), and excellent predictive validity against histopathology [sensitivity and specificity (95% CI) for PSP 0.95 (0.88–0.98) and 0.84 (0.77–0.87); and for MSA 0.96 (0.88–0.99) and 0.91 (0.86–0.93)]. There was no evidence of a drug effect on survival in the PSP or MSA strata (3 year Kaplan–Meier estimates PSP-riluzole: 0.51, PSP-placebo: 0.50; MSA

  14. Preliminary waste acceptance criteria for the ICPP spent fuel and waste management technology development program

    SciTech Connect

    Taylor, L.L.; Shikashio, R.

    1993-09-01

    The purpose of this document is to identify requirements to be met by the Producer/Shipper of Spent Nuclear Fuel/High-LeveL Waste SNF/HLW in order for DOE to be able to accept the packaged materials. This includes defining both standard and nonstandard waste forms.

  15. International Harmonization of Nomenclature and Diagnostic Criteria (INHAND): Progress to Date and Future Plans.

    PubMed

    Keenan, C M; Baker, J; Bradley, A; Goodman, D G; Harada, T; Herbert, R; Kaufmann, W; Kellner, R; Mahler, B; Meseck, E; Nolte, T; Rittinghausen, S; Vahle, J; Yoshizawa, K

    2015-07-01

    The International Harmonization of Nomenclature and Diagnostic Criteria for Lesions in Rats and Mice proposal (INHAND) has been operational since 2005. A Global Editorial Steering Committee manages the overall objectives of the project, and the development of harmonized terminology for each organ system is the responsibility of the Organ Working Groups, drawing upon experts from North America, Europe, and Japan. Great progress has been made with 9 systems published to date--respiratory, hepatobiliary, urinary, central/peripheral nervous systems, male reproductive and mammary, zymbals, clitoral, and preputial glands in Toxicologic Pathology and the integument and soft tissue and female reproductive in the Journal of Toxicologic Pathology as supplements and on a Web site--www.goReni.org. INHAND nomenclature guides offer diagnostic criteria and guidelines for recording lesions observed in rodent toxicity and carcinogenicity studies. The guides provide representative photomicrographs of morphologic changes, information regarding pathogenesis, and key references. The purpose of this brief communication is to provide an update on the progress of INHAND.

  16. High-Dimensional Medial Lobe Morphometry: An Automated MRI Biomarker for the New AD Diagnostic Criteria

    PubMed Central

    Valdivia, Fernando

    2014-01-01

    Introduction. Medial temporal lobe atrophy assessment via magnetic resonance imaging (MRI) has been proposed in recent criteria as an in vivo diagnostic biomarker of Alzheimer's disease (AD). However, practical application of these criteria in a clinical setting will require automated MRI analysis techniques. To this end, we wished to validate our automated, high-dimensional morphometry technique to the hypothetical prediction of future clinical status from baseline data in a cohort of subjects in a large, multicentric setting, compared to currently known clinical status for these subjects. Materials and Methods. The study group consisted of 214 controls, 371 mild cognitive impairment (147 having progressed to probable AD and 224 stable), and 181 probable AD from the Alzheimer's Disease Neuroimaging Initiative, with data acquired on 58 different 1.5 T scanners. We measured the sensitivity and specificity of our technique in a hierarchical fashion, first testing the effect of intensity standardization, then between different volumes of interest, and finally its generalizability for a large, multicentric cohort. Results. We obtained 73.2% prediction accuracy with 79.5% sensitivity for the prediction of MCI progression to clinically probable AD. The positive predictive value was 81.6% for MCI progressing on average within 1.5 (0.3 s.d.) year. Conclusion. With high accuracy, the technique's ability to identify discriminant medial temporal lobe atrophy has been demonstrated in a large, multicentric environment. It is suitable as an aid for clinical diagnostic of AD. PMID:25254139

  17. Comparison of Current Diagnostic Criteria for Acute-On-Chronic Liver Failure

    PubMed Central

    Han, Tao; Nie, CaiYun; Cai, JunJun; Liu, Hua; Liu, Ying

    2015-01-01

    Background and Aims Currently, acute-on-chronic liver failure (ACLF) has been defined differently by Asia–Pacific Association for the Study of the Liver (APASL) and Chinese Medical Association (CMA) in the East, as well as EASL-Chronic Liver Failure (EASL-CLIF) Consortium in the West. This study aimed to compare current different diagnostic criteria for ACLF and to determine predictors of the progression into post-enrollment EASL-CLIF ACLF from ACLF at enrollment defined by APASL alone or by both APASL and CMA but not by EASL-CLIF Consortium. Methods We retrospectively analyzed clinical data from 394 eligible cirrhotic patients fulfilling at least APASL criteria for ACLF at enrollment. Patient survival was estimated by Kaplan-Meier analysis and subsequently compared by log-rank test. Independent predictors of disease progression were determined using univariate analysis and multivariate Cox regression analysis. Results The 90-day mortality rate was 13.1% in patients with ACLF at enrollment defined by APASL alone, 25.3% in patients with ACLF at enrollment defined by both APASL and CMA but not EASL-CLIF Consortium, and 59.3% in patients with ACLF at enrollment defined by EASL-CLIF Consortium in addition to APASL. Baseline Chronic Liver Failure-Sequential Organ Failure Assessment (CLIF-SOFA) score, and the maximum rising rates of CLIF-SOFA score, Model for End-Stage Liver Disease-Sodium (MELD-Na) score and total bilirubin were independent predictors of progression into post-enrollment EASL-CLIF ACLF from ACLF at enrollment defined by APASL alone or by both APASL and CMA but not by EASL-CLIF Consortium. Conclusion Different diagnostic criteria for ACLF caused different patient prognosis. So, it is imperative to formulate a unifying diagnostic criteria for ACLF worldwide, thus attaining early identification and treatment, and eventual improvement in survival of ACLF patients. Baseline CLIF-SOFA score, and the maximum rising rates of CLIF-SOFA score, MELD-Na score and

  18. Radioactive waste management: review on clearance levels and acceptance criteria legislation, requirements and standards.

    PubMed

    Maringer, F J; Suráň, J; Kovář, P; Chauvenet, B; Peyres, V; García-Toraño, E; Cozzella, M L; De Felice, P; Vodenik, B; Hult, M; Rosengård, U; Merimaa, M; Szücs, L; Jeffery, C; Dean, J C J; Tymiński, Z; Arnold, D; Hinca, R; Mirescu, G

    2013-11-01

    In 2011 the joint research project Metrology for Radioactive Waste Management (MetroRWM)(1) of the European Metrology Research Programme (EMRP) started with a total duration of three years. Within this project, new metrological resources for the assessment of radioactive waste, including their calibration with new reference materials traceable to national standards will be developed. This paper gives a review on national, European and international strategies as basis for science-based metrological requirements in clearance and acceptance of radioactive waste.

  19. How do the Properties of Allan Hills 84001 Compare With Accepted Criteria for Evidence of Ancient Life?

    NASA Technical Reports Server (NTRS)

    Gibson, E. K., Jr.; McKay, D. S.; Thomas-Keprta, K.; Westall, F.; Romanek, C. A.

    1998-01-01

    Criteria for Past Life: To be confident that any sample contains evidence of past life or biogenic activity, one must determine beyond a shadow of a doubt that certain well-established features or biomarker signatures are present in the sample. In the case of martian samples, the criteria for past life have not been established because if life existed on the planet, we have no way of knowing its detailed characteristics. Lacking independent evidence about the nature of possible past life on Mars, the scientific community must use, for the time being, the criteria established for ancient samples from the Earth: (1) Do we know the geologic context of the sample? Is it compatible with past life? (2) Do we know the age of the sample and its stratigraphic location? Are they understood enough to relate possible life to geologic history? (3) Does the sample contain evidence of cellular morphology? (4) What structural remains of colonies or communities exist within the samples? (5) Is there any evidence of biominerals showing chemical or mineral disequilibria? (6) Is there any evidence of stable isotope patterns unique to biology? (7) Are there any organic biomarkers present? (8) Are the features indigenous to the sample? For acceptance of past life in a geologic sample, essentially all of these criteria must he met.

  20. Improve Quality of Life - additional criteria for health and social care information technology acceptance in an ageing world.

    PubMed

    Monteiro, Jorge

    2012-01-01

    Reversing the rising cost of health and social systems is needed in ageing developed and developing countries. A new model of ageing is advocated by the World Health Organization. This new model asks for more personal health accountability and a more integrated approach on care and preventive cure. Information systems and technologies can play an important role in supporting the changes needed in order to have better and more sustainable health and social care systems. Using value and results for patients as criteria by which systems are accepted by users and by organizations can contribute to a value based competition in health and social care systems. The unified theory of acceptance and use of technology is presented, and the pertinence of adding an extension to the theory in order capture Quality of Life improvements expectations is explored.

  1. Tissue dissociation enzymes for isolating human islets for transplantation: factors to consider in setting enzyme acceptance criteria.

    PubMed

    McCarthy, Robert C; Breite, Andrew G; Green, Michael L; Dwulet, Francis E

    2011-01-27

    Tissue dissociation enzymes are critical reagents that affect the yield and quality of human pancreatic islets required for islet transplantation. The United States Food and Drug Administration's oversight of this procedure recommends laboratories to set acceptance criteria for enzymes used in the manufacture of islet products for transplantation. Currently, many laboratories base this selection on personal experience because biochemical analysis is not predictive of success of the islet isolation procedure. This review identifies the challenges of correlating results from enzyme biochemical analysis to their effectiveness in human islet isolation and suggests a path forward to address these challenges to improve control of the islet manufacturing process.

  2. SU-E-T-60: A Plan Quality Index in IMRT QA That Is Independent of the Acceptance Criteria

    SciTech Connect

    Kim, D; Kang, S; Kim, T; Kim, K; Cho, M; Shin, D; Suh, T; Kim, S; Park, S

    2015-06-15

    Purpose: In IMRT QA, plan quality evaluation is made based on pass rate under preset acceptance criteria, mostly using gamma-values. This method is convenient but, its Result highly depends on what the acceptance criteria are and suffers from the lack of sensitivity in judging how good the plan is. In this study, we introduced a simple but effective plan quality index of IMRT QA based on dose difference only to supplement such shortcomings, and investigated its validity. Methods: The proposed index is a single value which is calculated mainly based on point-by-point comparison between planned and measured dose distributions, and it becomes “1” in an ideal case. A systematic evaluation was performed with one-dimensional test dose distributions. For 3 hypothetical dose profiles, various displacements (in both dose and space) were introduced, the proposed index was calculated for each case, and the behavior of obtained indices was analyzed and compared with that of gamma evaluation. In addition, the feasibility of the index was assessed with clinical IMRT/VMAT/SBRT QA cases for different sites (prostate, head & neck, liver, lung, spine, and abdomen). Results: The proposed index showed more robust correlation with the amount of induced displacement compared to the gamma evaluation method. No matter what the acceptance criteria are (e.g., whether 3%/3mm or 2%/2mm), it was possible to clearly rank every case with the proposed index while it was difficult to do with the gamma evaluation method. Conclusion: IMRT plan quality can be evaluated quantitatively by the proposed index. It is considered that the proposed index would provide useful information for better judging the level of goodness of each plan and its Result is independent of the acceptance criteria. This work was supported by the Radiation Technology R&D program (No. 2013M2A2A7043498) and the Mid-career Researcher Program (2014R1A2A1A10050270) through the National Research Foundation of Korea funded by the

  3. A critical review of ADHD diagnostic criteria: what to address in the DSM-V.

    PubMed

    Bell, Allison S

    2011-01-01

    ADHD is an impairing psychological disorder that predominantly affects children, but also adults to a lesser extent. As a result, a considerable amount of research has been completed in recent years to better understand the nature of the disorder to best treat individuals experiencing symptoms of ADHD. Especially with the publication of the Diagnostic and Statistical Manual of Mental Disorders (5th ed.) (DSM-V) on the horizon, substantial empirical work has been analyzing current ADHD diagnostic criteria and what upcoming changes should be made. Among child and adult populations, adjusting or completely eradicating the age of onset criterion is well supported. With specifically adult populations, amending symptoms to be more developmentally and environmentally appropriate also appears necessary. Even though research additionally questions the state of ADHD subtypes (with both child and adult populations) and other general diagnostic issues (model for diagnosis and level of impairment), continued research is needed to better clarify what other changes should be made in the DSM-V and beyond.

  4. Prototype Training Materials for Acceptance Criteria of Maintenance ASAP Events Occurring Within Social Context

    NASA Technical Reports Server (NTRS)

    Taylor, J. C.

    2004-01-01

    The aviation maintenance community is at a crossroads with respect to implementing the Aviation Safety Action Program (ASAP). While there is considerable interest, several key issues have emerged that cast doubt on how to assure a successful implementation, including buy-in from all levels of the company and training for key participants. There are two objectives for the present report. The first is to provide an examination of limits (or more properly, examples) of the degree of acceptability of more problematic events for risk-based decisions within the current ASAP guidelines. The second objective is to apply these limits of community standards to a set of further refined ASAP training scenarios.

  5. Building Energy Simulation Test for Existing Homes (BESTEST-EX): Instructions for Implementing the Test Procedure, Calibration Test Reference Results, and Example Acceptance-Range Criteria

    SciTech Connect

    Judkoff, R.; Polly, B.; Bianchi, M.; Neymark, J.; Kennedy, M.

    2011-08-01

    This publication summarizes building energy simulation test for existing homes (BESTEST-EX): instructions for implementing the test procedure, calibration tests reference results, and example acceptance-range criteria.

  6. Clinical relevance of the proposed sexual addiction diagnostic criteria: relation to the Sexual Addiction Screening Test-Revised.

    PubMed

    Carnes, Patrick J; Hopkins, Tiffany A; Green, Bradley A

    2014-01-01

    The present article examines and compares the various diagnostic rubrics proposed to codify symptoms of sexual addiction, and then briefly summarizes the ongoing controversy on whether sexual addiction is a valid construct. Using the diagnostic criteria proposed by , the prevalence rate of each criterion is examined in terms of scores on the Sexual Addiction Screening Test-Revised scales (). Differences in diagnostic criteria endorsement associated with sex, sexual orientation, and setting were also explored. Results from a clinical sample of men and women seeking treatment for sexual addiction demonstrated clinical relevance of the criteria, in that all but 3 criteria are endorsed at more than 50% of participants screening positive for sexual addiction on the Sexual Addiction Screening Test-Revised. Sex differences were also noted for endorsement rates of several of the criteria. Finally, several proposed criteria may pose a higher clinical threshold and thus be utilized by clinicians to identify patients with increased pathology. Results are discussed in the context of existing diagnostic frameworks across etiological perspectives.

  7. Ancillary testing, diagnostic/classification criteria and severity grading in Behçet disease.

    PubMed

    Okada, Annabelle A; Stanford, Miles; Tabbara, Khalid

    2012-12-01

    Since there is no pathognomonic clinical sign or laboratory test to distinguish Behçet disease from other uveitic entities, the diagnosis must be made based on characteristic ocular and systemic findings in the absence of evidence of other disease that can explain the findings. Ancillary tests, including ocular and brain imaging studies, are used to assess the severity of intraocular inflammation and systemic manifestations of Behçet disease, to identify latent infections and other medical conditions that might worsen with systemic treatment, and to monitor for adverse effects of drugs used. There are two diagnostic or classification criteria in general use by the uveitis community, one from Japan and one from an international group; both rely on a minimum number and/or combination of clinical findings to identify Behçet disease. Finally, several grading schemes have been proposed to assess severity of ocular disease and response to treatment.

  8. On orthorexia nervosa: A review of the literature and proposed diagnostic criteria.

    PubMed

    Dunn, Thomas M; Bratman, Steven

    2016-04-01

    There has been a growing interest among clinicians and researchers about a condition where people restrict their diet based not on quantity of food they consume, but based on its quality. Bratman (1997) coined the term "orthorexia nervosa" to describe people whose extreme diets - intended for health reasons - are in fact leading to malnutrition and/or impairment of daily functioning. There has also recently been intense media interest in people whose highly restrictive "healthy" diet leads to disordered eating. Despite this condition being first described in the U.S., and receiving recent media interest here, orthorexia has largely gone unnoticed in the North American literature. This review article details the literature of orthorexia nervosa, describing its emergence as a condition first described by a physician in a yoga magazine, to its being discussed in the scientific literature. It also reviews prevalence studies and discusses marked shortcomings in the literature. Finally, diagnostic criteria are proposed, as are future directions for research.

  9. Diagnostic criteria for adverse health effects in the environs of wind turbines.

    PubMed

    McMurtry, Robert Y; Krogh, Carmen Me

    2014-10-01

    In an effort to address climate change, governments have pursued policies that seek to reduce greenhouse gases. Alternative energy, including wind power, has been proposed by some as the preferred approach. Few would debate the need to reduce air pollution, but the means of achieving this reduction is important not only for efficiency but also for health protection. The topic of adverse health effects in the environs of industrial wind turbines (AHE/IWT) has proven to be controversial and can present physicians with challenges regarding the management of an exposure to IWT. Rural physicians in particular must be aware of the possibility of people presenting to their practices with a variety of sometimes confusing complaints. An earlier version of the diagnostic criteria for AHE/IWT was published in August 2011. A revised case definition and a model for a study to establish a confirmed diagnosis is proposed.

  10. Diagnostic criteria for adverse health effects in the environs of wind turbines

    PubMed Central

    Krogh, Carmen ME

    2014-01-01

    Summary In an effort to address climate change, governments have pursued policies that seek to reduce greenhouse gases. Alternative energy, including wind power, has been proposed by some as the preferred approach. Few would debate the need to reduce air pollution, but the means of achieving this reduction is important not only for efficiency but also for health protection. The topic of adverse health effects in the environs of industrial wind turbines (AHE/IWT) has proven to be controversial and can present physicians with challenges regarding the management of an exposure to IWT. Rural physicians in particular must be aware of the possibility of people presenting to their practices with a variety of sometimes confusing complaints. An earlier version of the diagnostic criteria for AHE/IWT was published in August 2011. A revised case definition and a model for a study to establish a confirmed diagnosis is proposed. PMID:25383200

  11. Proposed Diagnostic Criteria, Classification Schema, and Review of Literature of Notochord-Derived Ecchordosis Physaliphora.

    PubMed

    Lagman, Carlito; Varshneya, Kunal; Sarmiento, J Manuel; Turtz, Alan R; Chitale, Rohan V

    2016-03-30

    Ecchordosis physaliphora (EP) is a benign notochordal remnant derived from ectopic nests found along the craniospinal axis. It typically presents asymptomatically and is diagnosed using classic radiologic features, particularly location, T1-hypointensity, T2-hyperintensity, and lack of enhancement following gadolinium (Gd) contrast administration. Distinguishing EP from its malignant counterpart, chordoma, is of paramount importance, given the aggressive nature of the latter. Advances in imaging and immunohistochemistry have aided in diagnosis to an extent but, to our knowledge, identification of the genetic fingerprint of EP has yet to take place. Further cytological analysis of these lesions in search of a genetic link is warranted. We propose here a set of diagnostic criteria based on features consistently cited in the literature. In this literature review, 23 case reports were identified and collated into a summary of symptomatic cases of ecchordosis physaliphora. An illustrative case report of two patients was also included.

  12. Proposed Diagnostic Criteria, Classification Schema, and Review of Literature of Notochord-Derived Ecchordosis Physaliphora

    PubMed Central

    Lagman, Carlito; Sarmiento, J. Manuel; Turtz, Alan R; Chitale, Rohan V

    2016-01-01

    Ecchordosis physaliphora (EP) is a benign notochordal remnant derived from ectopic nests found along the craniospinal axis. It typically presents asymptomatically and is diagnosed using classic radiologic features, particularly location, T1-hypointensity, T2-hyperintensity, and lack of enhancement following gadolinium (Gd) contrast administration. Distinguishing EP from its malignant counterpart, chordoma, is of paramount importance, given the aggressive nature of the latter. Advances in imaging and immunohistochemistry have aided in diagnosis to an extent but, to our knowledge, identification of the genetic fingerprint of EP has yet to take place. Further cytological analysis of these lesions in search of a genetic link is warranted. We propose here a set of diagnostic criteria based on features consistently cited in the literature. In this literature review, 23 case reports were identified and collated into a summary of symptomatic cases of ecchordosis physaliphora. An illustrative case report of two patients was also included.  PMID:27158576

  13. Symptoms to Use for Diagnostic Criteria of Hwa-Byung, an Anger Syndrome

    PubMed Central

    Suh, Shin-Young; Song, Ki-Jun

    2009-01-01

    Objective The aim of this study was to identify the characteristic symptoms which can be used for the diagnosis of hwa-byung, a culture-related anger syndrome in Korea. Methods The symptoms of the Hwa-byung Scale were correlated with the Korean versions of the Hamilton Depression Rating Scale (K-HDRS) and the State and Trait Anger Inventory (K-STAXI) in 89 patients, who were diagnosed as having major depressive disorder, dysthymic disorder, anxiety disorders, somatoform disorders, or adjustment disorder according to the Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV) criteria and who had self-labeled hwa-byung. Also, the symptoms of the Hwa-byung Scale were correlated with each other. Results The symptoms of the Hwa-byung Scale which were significantly correlated with the state anger of the K-STAXI but not with the depressive mood (item 1 of K-HDRS) included feelings of unfairness, subjective anger, external anger, heat sensation, pushing-up in the chest, dry mouth, and sighing. The symptoms which were significantly correlated with state anger and depressed mood included respiratory stuffiness, "haan" and hate. The symptoms which were not significantly correlated with depressed mood and state anger included going-out, epigastric mass, palpitation, headache/pain, frightening easily, many thoughts, and much pleading. These symptoms also showed higher correlation with each other in the correlation matrix. Conclusion Our findings suggest that hwa-byung is different from depressive syndrome in terms of its symptom profile, and suggest what symptoms should be included in the diagnostic criteria of hwa-byung, an anger disorder. PMID:20046367

  14. [Preanalytical phase and accreditation: acceptance criteria for samples of multisite laboratory].

    PubMed

    Dialma, Pascale; Piaulenne, Stéphane; Baty, Sonia; Zeitoun, Thierry

    2013-01-01

    Performing high quality analyses in order to help physicians in their diagnoses and to ensure better patient care: this represents our routine mission for clinical lab. To achieve this goal, all steps from sampling to the final data transfer must be controlled. The preanalytical phase is one of the most crucial, but also one of the most complicated, especially in the context of a consolidated laboratory network. Transport conditions, delays, temperature, regulatory constraints are all criteria that we need to take into consideration in order to comply to ISO 15189, section 5.4. In this context, our laboratory would like to address the following issues: to control the transport conditions in order to guarantee optimal preservation of the samples, and to define an internal process and identify non-conforming situations linked to delay in sample delivery. An original study dealing with the stability in whole blood of common clinical chemistry and immunochemistry tests in defined transport conditions (delays, temperature, tube position) was performed on a panel of 100 patients' samples. This panel is intended to be a good reflection of the patients usually seen in multi-site laboratory. We observed that most of the analytes (35 of 41) were stable in whole blood; however, some of them demonstrated instability over time. All these results were integrated into our collection manual.

  15. Sotos syndrome: a study of the diagnostic criteria and natural history.

    PubMed Central

    Cole, T R; Hughes, H E

    1994-01-01

    Seventy-nine patients with a provisional diagnosis of Sotos syndrome were clinically assessed, and their photographs between the ages of 1 and 6 years evaluated. These photographs, together with photographs of first degree relatives, also at ages 1 to 6 years, were reviewed by four clinical geneticists. Forty-one probands (but no first degree relatives) were identified in whom the facial gestalt was thought to be characteristic of Sotos syndrome. Comparison of anthropometric measurements, bone age, and developmental delay in these 41 probands showed marked differences between them and the remaining 38 probands, and allowed the formulation of guidelines for the diagnosis of Sotos syndrome. Length was identified as the most significantly increased prenatal parameter. In childhood occipitofrontal head circumference (OFC), height, and weight were all increased. OFC remained above the 97th centile in all but one case throughout childhood and adulthood, whereas height and weight had a tendency to return towards the mean. This 'normalisation' was more pronounced in females and was probably related to their early puberty. Early developmental delay and an advanced bone age, seen in 100% and 84% respectively of study cases, may be invariable in Sotos syndrome, but selection bias and limited data prevented confirmation of this supposition. The authors suggest that facial gestalt, growth pattern, bone age, and developmental delay are the major diagnostic criteria. Using these criteria, no affected first degree relatives were identified. There were few long term medical complications in the probands, but behavioural difficulties caused considerable parental concern. Images PMID:7512144

  16. How Preclinical Models Evolved to Resemble the Diagnostic Criteria of Drug Addiction.

    PubMed

    Belin-Rauscent, Aude; Fouyssac, Maxime; Bonci, Antonello; Belin, David

    2016-01-01

    Drug addiction is a complex neuropsychiatric disorder that affects a subset of the individuals who take drugs. It is characterized by maladaptive drug-seeking habits that are maintained despite adverse consequences and intense drug craving. The pathophysiology and etiology of addiction is only partially understood despite extensive research because of the gap between current preclinical models of addiction and the clinical criteria of the disorder. This review presents a brief overview, based on selected methodologies, of how behavioral models have evolved over the last 50 years to the development of recent preclinical models of addiction that more closely mimic diagnostic criteria of addiction. It is hoped that these new models will increase our understanding of the complex neurobiological mechanisms whereby some individuals switch from controlled drug use to compulsive drug-seeking habits and relapse to these maladaptive habits. Additionally, by paving the way to bridge the gap that exists between biobehavioral research on addiction and the human situation, these models may provide new perspectives for the development of novel and effective therapeutic strategies for drug addiction.

  17. Validation of Three Early Ejaculation Diagnostic Tools: A Composite Measure Is Accurate and More Adequate for Diagnosis by Updated Diagnostic Criteria

    PubMed Central

    Jern, Patrick; Piha, Juhana; Santtila, Pekka

    2013-01-01

    Purpose To validate three early ejaculation diagnostic tools, and propose a new tool for diagnosis in line with proposed changes to diagnostic criteria. Significant changes to diagnostic criteria are expected in the near future. Available screening tools do not necessarily reflect proposed changes. Materials and Methods Data from 148 diagnosed early ejaculation patients (Mage = 42.8) and 892 controls (Mage = 33.1 years) from a population-based sample were used. Participants responded to three different questionnaires (Premature Ejaculation Profile; Premature Ejaculation Diagnostic Tool; Multiple Indicators of Premature Ejaculation). Stopwatch measured ejaculation latency times were collected from a subsample of early ejaculation patients. We used two types of responses to the questionnaires depending on the treatment status of the patients 1) responses regarding the situation before starting pharmacological treatment and 2) responses regarding current situation. Logistic regressions and Receiver Operating Characteristics were used to assess ability of both the instruments and individual items to differentiate between patients and controls. Results All instruments had very good precision (Areas under the Curve ranging from .93-.98). A new five-item instrument (named CHecklist for Early Ejaculation Symptoms – CHEES) consisting of high-performance variables selected from the three instruments had validity (Nagelkerke R2 range .51-.79 for backwards/forwards logistic regression) equal to or slightly better than any individual instrument (i.e., had slightly higher validity statistics, but these differences did not achieve statistical significance). Importantly, however, this instrument was more in line with proposed changes to diagnostic criteria. Conclusions All three screening tools had good validity. A new 5-item diagnostic tool (CHEES) based on the three instruments had equal or somewhat more favorable validity statistics compared to the other three tools, but is

  18. Proposed diagnostic criteria for the case definition of amniotic fluid embolism in research studies.

    PubMed

    Clark, Steven L; Romero, Roberto; Dildy, Gary A; Callaghan, William M; Smiley, Richard M; Bracey, Arthur W; Hankins, Gary D; D'Alton, Mary E; Foley, Mike; Pacheco, Luis D; Vadhera, Rakesh B; Herlihy, J Patrick; Berkowitz, Richard L; Belfort, Michael A

    2016-10-01

    Amniotic fluid embolism is a leading cause of maternal mortality in developed countries. Our understanding of risk factors, diagnosis, treatment, and prognosis is hampered by a lack of uniform clinical case definition; neither histologic nor laboratory findings have been identified unique to this condition. Amniotic fluid embolism is often overdiagnosed in critically ill peripartum women, particularly when an element of coagulopathy is involved. Previously proposed case definitions for amniotic fluid embolism are nonspecific, and when viewed through the eyes of individuals with experience in critical care obstetrics, would include women with a number of medical conditions much more common than amniotic fluid embolism. We convened a working group under the auspices of a committee of the Society for Maternal-Fetal Medicine and the Amniotic Fluid Embolism Foundation whose task was to develop uniform diagnostic criteria for the research reporting of amniotic fluid embolism. These criteria rely on the presence of the classic triad of hemodynamic and respiratory compromise accompanied by strictly defined disseminated intravascular coagulopathy. It is anticipated that limiting research reports involving amniotic fluid embolism to women who meet these criteria will enhance the validity of published data and assist in the identification of risk factors, effective treatments, and possibly useful biomarkers for this condition. A registry has been established in conjunction with the Perinatal Research Branch of the Eunice Kennedy Shriver National Institute of Child Health and Human Development to collect both clinical information and laboratory specimens of women with suspected amniotic fluid embolism in the hopes of identifying unique biomarkers of this condition.

  19. Assessment of the Validity of the Research Diagnostic Criteria for Temporomandibular Disorders: Overview and Methodology

    PubMed Central

    Schiffman, Eric L.; Truelove, Edmond L.; Ohrbach, Richard; Anderson, Gary C.; John, Mike T.; List, Thomas; Look, John O.

    2011-01-01

    AIMS The purpose of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Validation Project was to assess the diagnostic validity of this examination protocol. An overview is presented, including Axis I and II methodology and descriptive statistics for the study participant sample. This paper details the development of reliable methods to establish the reference standards for assessing criterion validity of the Axis I RDC/TMD diagnoses. Validity testing for the Axis II biobehavioral instruments was based on previously validated reference standards. METHODS The Axis I reference standards were based on the consensus of 2 criterion examiners independently performing a comprehensive history, clinical examination, and evaluation of imaging. Intersite reliability was assessed annually for criterion examiners and radiologists. Criterion exam reliability was also assessed within study sites. RESULTS Study participant demographics were comparable to those of participants in previous studies using the RDC/TMD. Diagnostic agreement of the criterion examiners with each other and with the consensus-based reference standards was excellent with all kappas ≥ 0.81, except for osteoarthrosis (moderate agreement, k = 0.53). Intrasite criterion exam agreement with reference standards was excellent (k ≥ 0.95). Intersite reliability of the radiologists for detecting computed tomography-disclosed osteoarthrosis and magnetic resonance imaging-disclosed disc displacement was good to excellent (k = 0.71 and 0.84, respectively). CONCLUSION The Validation Project study population was appropriate for assessing the reliability and validity of the RDC/TMD Axis I and II. The reference standards used to assess the validity of Axis I TMD were based on reliable and clinically credible methods. PMID:20213028

  20. Redefined clinical features and diagnostic criteria in autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy

    PubMed Central

    Ferre, Elise M.N.; Rose, Stacey R.; Rosenzweig, Sergio D.; Burbelo, Peter D.; Romito, Kimberly R.; Niemela, Julie E.; Rosen, Lindsey B.; Break, Timothy J.; Gu, Wenjuan; Hunsberger, Sally; Browne, Sarah K.; Hsu, Amy P.; Rampertaap, Shakuntala; Swamydas, Muthulekha; Collar, Amanda L.; Kong, Heidi H.; Chascsa, David; Simcox, Thomas; Pham, Angela; Bondici, Anamaria; Natarajan, Mukil; Monsale, Joseph; Kleiner, David E.; Quezado, Martha; Alevizos, Ilias; Moutsopoulos, Niki M.; Yockey, Lynne; Frein, Cathleen; Soldatos, Ariane; Calvo, Katherine R.; Adjemian, Jennifer; Similuk, Morgan N.; Lang, David M.; Stone, Kelly D.; Uzel, Gulbu; Bishop, Rachel J.; Holland, Steven M.; Olivier, Kenneth N.; Fleisher, Thomas A.; Heller, Theo; Winer, Karen K.

    2016-01-01

    Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) is a rare primary immunodeficiency disorder typically caused by homozygous AIRE mutations. It classically presents with chronic mucocutaneous candidiasis and autoimmunity that primarily targets endocrine tissues; hypoparathyroidism and adrenal insufficiency are most common. Developing any two of these classic triad manifestations establishes the diagnosis. Although widely recognized in Europe, where nonendocrine autoimmune manifestations are uncommon, APECED is less defined in patients from the Western Hemisphere. We enrolled 35 consecutive American APECED patients (33 from the US) in a prospective observational natural history study and systematically examined their genetic, clinical, autoantibody, and immunological characteristics. Most patients were compound heterozygous; the most common AIRE mutation was c.967_979del13. All but one patient had anti–IFN-ω autoantibodies, including 4 of 5 patients without biallelic AIRE mutations. Urticarial eruption, hepatitis, gastritis, intestinal dysfunction, pneumonitis, and Sjögren’s-like syndrome, uncommon entities in European APECED cohorts, affected 40%–80% of American cases. Development of a classic diagnostic dyad was delayed at mean 7.38 years. Eighty percent of patients developed a median of 3 non-triad manifestations before a diagnostic dyad. Only 20% of patients had their first two manifestations among the classic triad. Urticarial eruption, intestinal dysfunction, and enamel hypoplasia were prominent among early manifestations. Patients exhibited expanded peripheral CD4+ T cells and CD21loCD38lo B lymphocytes. In summary, American APECED patients develop a diverse syndrome, with dramatic enrichment in organ-specific nonendocrine manifestations starting early in life, compared with European patients. Incorporation of these new manifestations into American diagnostic criteria would accelerate diagnosis by approximately 4 years and

  1. Redefined clinical features and diagnostic criteria in autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy.

    PubMed

    Ferre, Elise M N; Rose, Stacey R; Rosenzweig, Sergio D; Burbelo, Peter D; Romito, Kimberly R; Niemela, Julie E; Rosen, Lindsey B; Break, Timothy J; Gu, Wenjuan; Hunsberger, Sally; Browne, Sarah K; Hsu, Amy P; Rampertaap, Shakuntala; Swamydas, Muthulekha; Collar, Amanda L; Kong, Heidi H; Lee, Chyi-Chia Richard; Chascsa, David; Simcox, Thomas; Pham, Angela; Bondici, Anamaria; Natarajan, Mukil; Monsale, Joseph; Kleiner, David E; Quezado, Martha; Alevizos, Ilias; Moutsopoulos, Niki M; Yockey, Lynne; Frein, Cathleen; Soldatos, Ariane; Calvo, Katherine R; Adjemian, Jennifer; Similuk, Morgan N; Lang, David M; Stone, Kelly D; Uzel, Gulbu; Kopp, Jeffrey B; Bishop, Rachel J; Holland, Steven M; Olivier, Kenneth N; Fleisher, Thomas A; Heller, Theo; Winer, Karen K; Lionakis, Michail S

    2016-08-18

    Autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy (APECED) is a rare primary immunodeficiency disorder typically caused by homozygous AIRE mutations. It classically presents with chronic mucocutaneous candidiasis and autoimmunity that primarily targets endocrine tissues; hypoparathyroidism and adrenal insufficiency are most common. Developing any two of these classic triad manifestations establishes the diagnosis. Although widely recognized in Europe, where nonendocrine autoimmune manifestations are uncommon, APECED is less defined in patients from the Western Hemisphere. We enrolled 35 consecutive American APECED patients (33 from the US) in a prospective observational natural history study and systematically examined their genetic, clinical, autoantibody, and immunological characteristics. Most patients were compound heterozygous; the most common AIRE mutation was c.967_979del13. All but one patient had anti-IFN-ω autoantibodies, including 4 of 5 patients without biallelic AIRE mutations. Urticarial eruption, hepatitis, gastritis, intestinal dysfunction, pneumonitis, and Sjögren's-like syndrome, uncommon entities in European APECED cohorts, affected 40%-80% of American cases. Development of a classic diagnostic dyad was delayed at mean 7.38 years. Eighty percent of patients developed a median of 3 non-triad manifestations before a diagnostic dyad. Only 20% of patients had their first two manifestations among the classic triad. Urticarial eruption, intestinal dysfunction, and enamel hypoplasia were prominent among early manifestations. Patients exhibited expanded peripheral CD4(+) T cells and CD21(lo)CD38(lo) B lymphocytes. In summary, American APECED patients develop a diverse syndrome, with dramatic enrichment in organ-specific nonendocrine manifestations starting early in life, compared with European patients. Incorporation of these new manifestations into American diagnostic criteria would accelerate diagnosis by approximately 4 years and

  2. Is there any evidence for the validity of diagnostic criteria used for accommodative and nonstrabismic binocular dysfunctions?

    PubMed Central

    Cacho-Martínez, Pilar; García-Muñoz, Ángel; Ruiz-Cantero, María Teresa

    2013-01-01

    Purpose To analyze the diagnostic criteria used in the scientific literature published in the past 25 years for accommodative and nonstrabismic binocular dysfunctions and to explore if the epidemiological analysis of diagnostic validity has been used to propose which clinical criteria should be used for diagnostic purposes. Methods We carried out a systematic review of papers on accommodative and non-strabic binocular disorders published from 1986 to 2012 analysing the MEDLINE, CINAHL, PsycINFO and FRANCIS databases. We admitted original articles about diagnosis of these anomalies in any population. We identified 839 articles and 12 studies were included. The quality of included articles was assessed using the QUADAS-2 tool. Results The review shows a wide range of clinical signs and cut-off points between authors. Only 3 studies (regarding accommodative anomalies) assessed diagnostic accuracy of clinical signs. Their results suggest using the accommodative amplitude and monocular accommodative facility for diagnosing accommodative insufficiency and a high positive relative accommodation for accommodative excess. The remaining 9 articles did not analyze diagnostic accuracy, assessing a diagnosis with the criteria the authors considered. We also found differences between studies in the way of considering patients’ symptomatology. 3 studies of 12 analyzed, performed a validation of a symptom survey used for convergence insufficiency. Conclusions Scientific literature reveals differences between authors according to diagnostic criteria for accommodative and nonstrabismic binocular dysfunctions. Diagnostic accuracy studies show that there is only certain evidence for accommodative conditions. For binocular anomalies there is only evidence about a validated questionnaire for convergence insufficiency with no data of diagnostic accuracy. PMID:24646897

  3. R&D Plan for RISMC Industry Application #1: ECCS/LOCA Cladding Acceptance Criteria

    SciTech Connect

    Szilard, Ronaldo Henriques; Zhang, Hongbin; Epiney, Aaron Simon; Tu, Lei

    2016-04-01

    The Nuclear Regulatory Commission (NRC) is finalizing a rulemaking change that would revise the requirements in 10 CFR 50.46. In the proposed new rulemaking, designated as 10 CFR 50.46c, the NRC proposes a fuel performance-based equivalent cladding reacted (ECR) criterion as a function of cladding hydrogen content before the accident (pre-transient) in order to include the effects of higher burnup on cladding performance as well as to address other technical issues. A loss of operational margin may result due to the more restrictive cladding embrittlement criteria. Initial and future compliance with the rule may significantly increase vendor workload and licensee costs as a spectrum of fuel rod initial burnup states may need to be analyzed to demonstrate compliance. The Idaho National Laboratory (INL) has initiated a project, as part of the DOE Light Water Reactor Sustainability Program (LWRS), to develop analytical capabilities to support the industry in the transition to the new rule. This project is called the Industry Application 1 (IA1) within the Risk-Informed Safety Margin Characterization (RISMC) Pathway of LWRS. The general idea behind the initiative is the development of an Integrated Evaluation Model (IEM). The motivation is to develop a multiphysics framework to analyze how uncertainties are propagated across the stream of physical disciplines and data involved, as well as how risks are evaluated in a LOCA safety analysis as regulated under 10 CFR 50.46c. This IEM is called LOTUS which stands for LOCA Toolkit for US, and it represents the LWRS Program’s response to the proposed new rule making. The focus of this report is to complete an R&D plan to describe the demonstration of the LOCA/ECCS RISMC Industry Application # 1 using the advanced RISMC Toolkit and methodologies. This report includes the description and development plan for a RISMC LOCA tool that fully couples advanced MOOSE tools already in development in order to characterize and optimize

  4. EU landfill waste acceptance criteria and EU Hazardous Waste Directive compliance testing of incinerated sewage sludge ash.

    PubMed

    Donatello, S; Tyrer, M; Cheeseman, C R

    2010-01-01

    A hazardous waste assessment has been completed on ash samples obtained from seven sewage sludge incinerators operating in the UK, using the methods recommended in the EU Hazardous Waste Directive. Using these methods, the assumed speciation of zinc (Zn) ultimately determines if the samples are hazardous due to ecotoxicity hazard. Leaching test results showed that two of the seven sewage sludge ash samples would require disposal in a hazardous waste landfill because they exceed EU landfill waste acceptance criteria for stabilised non-reactive hazardous waste cells for soluble selenium (Se). Because Zn cannot be proven to exist predominantly as a phosphate or oxide in the ashes, it is recommended they be considered as non-hazardous waste. However leaching test results demonstrate that these ashes cannot be considered as inert waste, and this has significant implications for the management, disposal and re-use of sewage sludge ash.

  5. Acceptance criteria for flattening filter-free photon beam from standard medical electron linear accelerator: AERB task group recommendations

    PubMed Central

    Sahani, G.; Sharma, S. D.; Sharma, P. K. Dash; Deshpande, D. D.; Negi, P. S.; Sathianarayanan, V. K.; Rath, G. K.

    2014-01-01

    Medical electron linear accelerators with the capability of generating unflat photon (flattening filter-free, FFF) beams are also available commercially for clinical applications in radiotherapy. However, the beam characteristics evaluation criteria and parameters are not yet available for such photon beams. Atomic Energy Regulatory Board (AERB) of India constituted a Task Group comprising experts from regulatory agency, advisory body/research and technical institutions, and clinical radiotherapy centers in the country to evolve and recommend the acceptance criteria for the flattening filter-free (FFF) photon beams. The Task Group thoroughly reviewed the literature and inputs of the manufactures/suppliers of the FFF linac and recommended a set of dosimetry parameters for evaluating the characteristics of the unflat photon beam. The recommendations included the evaluation of quality index, degree of unflatness, difference in percentage surface dose between flat and unflat photon beams, percentage depth dose at 10 cm depth, off-axis-ratios and radiation beam penumbra. The recommended parameters were evaluated for FFF photon beams generated by three different models of the linac, and it was observed that recommended evaluation methods are simple and easy to be implemented with the existing dosimetry and quality assurance infrastructure of the linac facilities of the radiotherapy departments. Recommendations were also made for periodic quality control check of the unflat photon beams and constancy evaluation in the beam characteristics. PMID:25525307

  6. Analytical method transfer using equivalence tests with reasonable acceptance criteria and appropriate effort: extension of the ISPE concept.

    PubMed

    Kaminski, L; Schepers, U; Wätzig, H

    2010-12-15

    A method development process is commonly finalized by a method transfer from the developing to the routine laboratory. Statistical tests are performed in order to survey if a transfer succeeded or failed. However, using the classic two-sample t-test can lead to misjudgments and unsatisfying transfer results due to its test characteristics. Therefore the International Society of Pharmaceutical Engineering (ISPE) employed a fixed method transfer design using equivalence tests in their Guide for Technology Transfer. Although it was well received by analytical laboratories worldwide this fixed design can easily bring about high beta-errors (rejection of successful transfers) or high workload (many analysts employed during transfer) if sigma(AN) (error due to different analysts) exceeds 0.6%. Hence this work introduces an extended concept which will help to circumvent this disadvantage by providing guidance to select a personalized and more appropriate experimental design. First of all it demonstrates that former t-test related acceptance criteria can be scaled by a factor of 1.15, which allows for a broader tolerance without a loss of decision certainty. Furthermore a decision guidance to choose the proper number of analysts or series at given percentage acceptance limits (%AL) is presented.

  7. Hepatocellular Carcinoma, Fibrolamellar Variant: Diagnostic Pathologic Criteria and Molecular Pathology Update. A Primer

    PubMed Central

    Sergi, Consolato M.

    2015-01-01

    Fibrolamellar hepatocellular carcinoma (FL-HCC) is generally a fairly rare event in routine pathology practice. This variant of hepatocellular carcinoma (HCC) is peculiarly intriguing and,in addition, poorly understood. Young people or children are often the target individuals with this type of cancer. Previously, I highlighted some pathology aspects of FL-HCC, but in this review, the distinctive clinico-pathologic features of FL-HCC and the diagnostic pathologic criteria of FL-HCC are fractionally reviewed and expanded upon. Further, molecular genetics update data with reference to this specific tumor are particularly highlighted as a primer for general pathologists and pediatric histopathologists. FL-HCC may present with metastases, and regional lymph nodes may be sites of metastatic spread. However, peritoneal and pulmonary metastatic foci have also been reported. To the best of our knowledge, FL-HCC was initially considered having an indolent course, but survival outcomes have recently been updated reconsidering the prognosis of this tumor. Patients seem to respond well to surgical resection, but recurrences are common. Thus, alternative therapies, such as chemotherapy and radiation, are ongoing. Overall, it seems that this aspect has not been well-studied for this variant of HCC and should be considered as target for future clinical trials. Remarkably, FL-HCC data seem to point to a liver neoplasm of uncertain origin and unveiled outcome. A functional chimeric transcript incorporating DNAJB1 and PRKACA was recently added to FL-HCC. This sensational result may give remarkable insights into the understanding of this rare disease and potentially provide the basis for its specific diagnostic marker. Detection of DNAJB1-PRKACA seems to be, indeed, a very sensitive and specific finding in supporting the diagnosis of FL-HCC. In a quite diffuse opinion, prognosis of this tumor should be reconsidered following the potentially mandatory application of new molecular

  8. Research Diagnostic Criteria for Temporomandibular Disorders: Validity of Axis I Diagnoses

    PubMed Central

    Truelove, Edmond; Pan, Wei; Look, John O.; Mancl, Lloyd A.; Ohrbach, Richard K.; Velly, Ana; Huggins, Kimberly; Lenton, Patricia; Schiffman, Eric L.

    2011-01-01

    AIMS To estimate the criterion validity of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I TMD diagnoses. METHODS A combined total of 614 TMD community and clinic cases and 91 controls were examined at 3 study sites. RDC/TMD Axis I diagnoses were algorithmically derived from an examination performed by calibrated dental hygienists. Reference standards (Gold Standards) were established by means of consensus diagnoses rendered by 2 TMD experts using all available clinical data, including imaging studies. Validity of the RDC/TMD Axis I TMD diagnoses was estimated relative to reference-standard diagnoses (gold standard diagnoses). Target sensitivity and specificity were set a priori at ≥ 0.70 and ≥ 0.95, respectively. RESULTS Target sensitivity and specificity were not observed for any of the 8 RDC/TMD diagnoses. The highest validity was achieved for Group Ia myofascial pain (sensitivity 0.65, specificity 0.92) and Group Ib myofascial pain with limited opening (sensitivity 0.79, specificity 0.92). Target sensitivity and specificity were observed only when both Group I diagnoses were combined (0.87 and 0.98, respectively). For Group II (disc displacements) and Group III (arthralgia, arthritis, arthrosis) diagnoses, all estimates for sensitivity were below target (0.03 to 0.53), and specificity ranged from below to on target (0.86 to 0.99). CONCLUSION The RDC/TMD Axis I TMD diagnoses did not reach the targets set at sensitivity of ≥ 0.70 and specificity of ≥ 0.95. Target validity was obtained only for myofascial pain without differentiation between normal and limited opening. Revision of the current Axis I TMD diagnostic algorithms is warranted to improve their validity. PMID:20213030

  9. Hepatocellular Carcinoma, Fibrolamellar Variant: Diagnostic Pathologic Criteria and Molecular Pathology Update. A Primer.

    PubMed

    Sergi, Consolato M

    2015-12-30

    Fibrolamellar hepatocellular carcinoma (FL-HCC) is generally a fairly rare event in routine pathology practice. This variant of hepatocellular carcinoma (HCC) is peculiarly intriguing and,in addition, poorly understood. Young people or children are often the target individuals with this type of cancer. Previously, I highlighted some pathology aspects of FL-HCC, but in this review, the distinctive clinico-pathologic features of FL-HCC and the diagnostic pathologic criteria of FL-HCC are fractionally reviewed and expanded upon. Further, molecular genetics update data with reference to this specific tumor are particularly highlighted as a primer for general pathologists and pediatric histopathologists. FL-HCC may present with metastases, and regional lymph nodes may be sites of metastatic spread. However, peritoneal and pulmonary metastatic foci have also been reported. To the best of our knowledge, FL-HCC was initially considered having an indolent course, but survival outcomes have recently been updated reconsidering the prognosis of this tumor. Patients seem to respond well to surgical resection, but recurrences are common. Thus, alternative therapies, such as chemotherapy and radiation, are ongoing. Overall, it seems that this aspect has not been well-studied for this variant of HCC and should be considered as target for future clinical trials. Remarkably, FL-HCC data seem to point to a liver neoplasm of uncertain origin and unveiled outcome. A functional chimeric transcript incorporating DNAJB1 and PRKACA was recently added to FL-HCC. This sensational result may give remarkable insights into the understanding of this rare disease and potentially provide the basis for its specific diagnostic marker. Detection of DNAJB1-PRKACA seems to be, indeed, a very sensitive and specific finding in supporting the diagnosis of FL-HCC. In a quite diffuse opinion, prognosis of this tumor should be reconsidered following the potentially mandatory application of new molecular

  10. Diagnostic Criteria and Accuracy of Categorizing Malignant Thyroid Nodules by Ultrasonography and Ultrasound Elastography with Pathologic Correlation.

    PubMed

    Elsayed, Naglaa Mostafa; Elkhatib, Yasser Atta

    2016-03-01

    Thyroid nodules are a common medical and surgical concern. Thyroid ultrasound (US) is the primary imaging modality used for initial evaluation and assortment of nodules for fine needle aspiration (FNA) cytology/biopsy. Ultrasound elastography (USE) is believed to improve the diagnostic accuracy of US in distinguishing benign from malignant nodules. The aim of the work described here is to evaluate the diagnostic criteria and accuracy of US and USE in the diagnosis of malignant thyroid nodules. A prospective study of 88 patients who have thyroid nodules was performed. US, color Doppler, and USE were evaluated using a Philips iU22 equipped with a 5 to 12 MHz, linear transducer, followed by FNA of the each scanned nodule. The most sensitive US criteria for malignant nodules were a height-to-width ratio greater than one and the absence of a halo sign (sensitivity 0.875% and 1.000%, respectively). The most specific criteria for malignancy were a spiculated/blurred margin and the presence of microcalcifications (specificity 0.968% and 0.888%, respectively). The receiver operating characteristic curve showed that the cutoff diagnostic criteria of malignancy are two US characteristics and an elastography score of 4. The diagnostic accuracy of US for malignant thyroid nodules increases by combining US and USE.

  11. A Comparison of DSM-5 and DSM-IV Diagnostic Criteria for Posttraumatic Stress Disorder in Traumatized Refugees.

    PubMed

    Schnyder, Ulrich; Müller, Julia; Morina, Naser; Schick, Matthis; Bryant, Richard A; Nickerson, Angela

    2015-08-01

    The aim of this study was to compare the prevalence rate and factor structure of posttraumatic stress disorder (PTSD) based on the diagnostic criteria of the fourth and fifth editions of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV; DSM-5; American Psychiatric Association, , ) in traumatized refugees. There were 134 adult treatment-seeking, severely and multiply traumatized patients from various refugee backgrounds were assessed in their mother tongue using a computerized set of questionnaires consisting of a trauma list, the Posttraumatic Diagnostic Scale, and the new PTSD items that had been suggested by the DSM-5 Task Force of the American Psychiatric Association. Using DSM-IV, 60.4% of participants met diagnostic criteria for PTSD; using DSM-5, only 49.3% fulfilled all criteria (p < .001). Confirmatory factor analysis of DSM-IV and DSM-5 items showed good and comparable model fits. Furthermore, classification functions in the DSM-5 were satisfactory. The new Cluster D symptoms showed relatively high sensitivity, specificity, positive predictive power, and negative predictive power. The DSM-5 symptom structure appears to be applicable to traumatized refugees. Negative alterations in cognitions and mood may be especially useful for clinicians, not only to determine the extent to which an individual refugee is likely to meet criteria for PTSD, but also in providing targets for clinical intervention.

  12. Gender Incongruence of Adolescence and Adulthood: Acceptability and Clinical Utility of the World Health Organization's Proposed ICD-11 Criteria.

    PubMed

    Beek, Titia F; Cohen-Kettenis, Peggy T; Bouman, Walter P; de Vries, Annelou L C; Steensma, Thomas D; Witcomb, Gemma L; Arcelus, Jon; Richards, Christina; Elaut, Els; Kreukels, Baudewijntje P C

    2016-01-01

    The World Health Organization (WHO) is currently updating the tenth version of their diagnostic tool, the International Classification of Diseases (ICD, WHO, 1992). Changes have been proposed for the diagnosis of Transsexualism (ICD-10) with regard to terminology, placement and content. The aim of this study was to gather the opinions of transgender individuals (and their relatives/partners) and clinicians in the Netherlands, Flanders (Belgium) and the United Kingdom regarding the proposed changes and the clinical applicability and utility of the ICD-11 criteria of 'Gender Incongruence of Adolescence and Adulthood' (GIAA). A total of 628 participants were included in the study: 284 from the Netherlands (45.2%), 8 from Flanders (Belgium) (1.3%), and 336 (53.5%) from the UK. Most participants were transgender people (or their partners/relatives) (n = 522), 89 participants were healthcare providers (HCPs) and 17 were both healthcare providers and (partners/relatives of) transgender people. Participants completed an online survey developed for this study. Most participants were in favor of the proposed diagnostic term of 'Gender Incongruence' and thought that this was an improvement on the ICD-10 diagnostic term of 'Transsexualism'. Placement in a separate chapter dealing with Sexual- and Gender-related Health or as a Z-code was preferred by many and only a small number of participants stated that this diagnosis should be excluded from the ICD-11. In the UK, most transgender participants thought there should be a diagnosis related to being trans. However, if it were to be removed from the chapter on "psychiatric disorders", many transgender respondents indicated that they would prefer it to be removed from the ICD in its entirety. There were no large differences between the responses of the transgender participants (or their partners and relatives) and HCPs. HCPs were generally positive about the GIAA diagnosis; most thought the diagnosis was clearly defined and easy

  13. Effects of Professional Group Membership, Intervention Type, and Diagnostic Label on Treatment Acceptability.

    ERIC Educational Resources Information Center

    Fairbanks, Larry D.; Stinnett, Terry A.

    1997-01-01

    Investigates professionals' ratings of treatment acceptability for two interventions. Teachers, school psychologists, and school social workers (N=97) viewed a vignette of a student exhibiting disruptive behavior and then rated the intervention's acceptability. Results show that professional group membership produced a significant interaction…

  14. Metabolic Syndrome in People Living with Human Immunodeficiency Virus: An Assessment of the Prevalence and the Agreement between Diagnostic Criteria

    PubMed Central

    de Villiers, Anniza; Mukasa, Barbara; Mills, Edward J.

    2017-01-01

    Objectives. We determined metabolic syndrome (MetS) prevalence and assessed the agreement between different diagnostic criteria in HIV-infected South Africans. Method. A random sample included 748 HIV-infected adult patients (79% women) across 17 HIV healthcare facilities in the Western Cape Province. MetS was defined using the Joint Interim Statement (JIS 2009), International Diabetes Federation (IDF 2005), and Adult Treatment Panel III (ATPIII 2005) criteria. Results. Median values were 38 years (age), 5 years (diagnosed HIV duration), and 392 cells/mm3 (CD4 count), and 93% of the participants were on antiretroviral therapy (ART). MetS prevalence was 28.2% (95%CI: 25–31.4), 26.5% (23.3–29.6), and 24.1% (21–27.1) by the JIS, IDF, and ATPIII 2005 criteria, respectively. Prevalence was always higher in women than in men (all p < 0.001), in participants with longer duration of diagnosed HIV (all p ≤ 0.003), and in ART users not receiving 1st-line regimens (all p ≤ 0.039). The agreement among the three criteria was very good overall and in most subgroups (all kappa ≥ 0.81). Conclusions. The three most popular diagnostic criteria yielded similarly high MetS prevalence in this relatively young population receiving care for HIV infection. Very good levels of agreement between criteria are unaffected by some HIV-specific features highlighting the likely comparable diagnostic utility of those criteria in routine HIV care settings. PMID:28392801

  15. Compiler Acceptance Criteria Guidebook

    DTIC Science & Technology

    1977-05-01

    rrograms generated by a compiler coupled with the expected life of the compiled program (number of times to be used) can often make ? 1 -6 : ! this aspect...concern are! " CPU time per statement or program * core usaae " 1 /0 access time " wait or dead ti-e " disk storage • tape drive mounts In large...left to the specification agency discretion. A prime example is the OS 370 P1eP system. 1 1 -7 0 Level of Expertise Another often neglected cost item is

  16. Comparing Symptoms of Autism Spectrum Disorders Using the Current "DSM-IV-TR" Diagnostic Criteria and the Proposed "DSM-V" Diagnostic Criteria

    ERIC Educational Resources Information Center

    Worley, Julie A.; Matson, Johnny L.

    2012-01-01

    The American Psychiatric Association has proposed major revisions for the diagnostic category encompassing Autism Spectrum Disorders (ASD), which will reportedly increase the specificity and maintain the sensitivity of diagnoses. As a result, the aim of the current study was to compare symptoms of ASD in children and adolescents (N = 208) who met…

  17. Which Diagnostic Criteria are Most Useful in Discriminating Between Social Gamblers and Individuals with Gambling Problems? An Examination of DSM-IV and DSM-5 Criteria.

    PubMed

    Temcheff, Caroline E; Paskus, Thomas S; Potenza, Marc N; Derevensky, Jeffrey L

    2016-09-01

    The current study sought to identify which diagnostic criteria for gambling disorder have the greatest ability to differentiate between social and problem gamblers. This study was conducted on a sample of male and female college student athletes across the U.S. (n = 8674). Classification and regression tree analysis represents an appropriate technique when addressing the question of an item's diagnostic value, as it sequentially selects variables to isolate sets of observations with similar outcomes. The current results suggest that the item related to preoccupation ("Have there been periods in the past year where you spent a lot of time thinking about gambling?") was the DSM-5 item best able to differentiate between male and female social and problem gamblers in this sample. When considering only the nine criteria retained in the DSM-5, three criteria were identified as key for distinguishing between social and disordered gamblers among men, and one criterion was identified for distinguishing between groups of women. In addition, these results do not support the notion that the illegal acts criterion has a particularly low base rate and found that it can be an important indicator of disordered gambling in a college-aged sample.

  18. The Awaji criteria increases the diagnostic sensitivity of the revised El Escorial criteria for amyotrophic lateral sclerosis diagnosis in a Chinese population

    PubMed Central

    Li, Da-Wei; Liu, Mingsheng; Cui, Bo; Fang, Jia; Guan, Yu-Zhou; Ding, Qingyun; Li, Xiaoguang; Cui, Liying

    2017-01-01

    Objectives The accurate and early diagnosis of amyotrophic lateral sclerosis (ALS) is important for extending the life expectancy of patients. However, previous studies that have assessed the diagnostic sensitivities of the Awaji criteria (AC) and the revised El Escorial criteria (rEEC) in patients with ALS have been inconsistent, most of them were consensual regarding the advantage of Awaji over conventional criteria. Our study sought to compare the roles of AC and rEEC in the diagnosis of ALS. Methods Data from a total of 294 consecutive patients with ALS were collected between January 2014 and August 2015 in the Peking Union Medical College Hospital. The clinical and electrophysiological records of 247 patients were eventually analyzed. The primary outcome measures were the sensitivities of the AC and rEEC for the diagnosis of ALS. Results The sensitivity of probable or definite ALS as diagnosed with the AC (78%) was greater than that of the rEEC (36%, P <0.001). Following the application of the AC, 103 of the 147 patients categorized as probable ALS-laboratory supported from the rEEC were upgraded to probable or definite ALS, and 44 were downgraded to possible ALS. Conclusions Our data demonstrated that the AC exhibited greater diagnostic sensitivity than the rEEC in a Chinese ALS population. The use of the AC should be considered in clinical practice. PMID:28249004

  19. 38 CFR 4.100 - Application of the evaluation criteria for diagnostic codes 7000-7007, 7011, and 7015-7020.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... evaluation criteria for diagnostic codes 7000-7007, 7011, and 7015-7020. 4.100 Section 4.100 Pensions... Ratings The Cardiovascular System § 4.100 Application of the evaluation criteria for diagnostic codes 7000..., METs testing is required in all cases except: (1) When there is a medical contraindication. (2)...

  20. 38 CFR 4.100 - Application of the evaluation criteria for diagnostic codes 7000-7007, 7011, and 7015-7020.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... evaluation criteria for diagnostic codes 7000-7007, 7011, and 7015-7020. 4.100 Section 4.100 Pensions... Ratings The Cardiovascular System § 4.100 Application of the evaluation criteria for diagnostic codes 7000..., METs testing is required in all cases except: (1) When there is a medical contraindication. (2)...

  1. 38 CFR 4.100 - Application of the evaluation criteria for diagnostic codes 7000-7007, 7011, and 7015-7020.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... evaluation criteria for diagnostic codes 7000-7007, 7011, and 7015-7020. 4.100 Section 4.100 Pensions... Ratings The Cardiovascular System § 4.100 Application of the evaluation criteria for diagnostic codes 7000..., METs testing is required in all cases except: (1) When there is a medical contraindication. (2)...

  2. Delineation and diagnostic criteria of Oral-Facial-Digital Syndrome type VI.

    PubMed

    Poretti, Andrea; Vitiello, Giuseppina; Hennekam, Raoul C M; Arrigoni, Filippo; Bertini, Enrico; Borgatti, Renato; Brancati, Francesco; D'Arrigo, Stefano; Faravelli, Francesca; Giordano, Lucio; Huisman, Thierry A G M; Iannicelli, Miriam; Kluger, Gerhard; Kyllerman, Marten; Landgren, Magnus; Lees, Melissa M; Pinelli, Lorenzo; Romaniello, Romina; Scheer, Ianina; Schwarz, Christoph E; Spiegel, Ronen; Tibussek, Daniel; Valente, Enza Maria; Boltshauser, Eugen

    2012-01-11

    worse, suggesting a correlation with the more severe neuroimaging findings. Based on the literature and this study we suggest as diagnostic criteria for OFD VI: MTS and one or more of the following: 1) tongue hamartoma(s) and/or additional frenula and/or upper lip notch; 2) mesoaxial polydactyly of one or more hands or feet; 3) hypothalamic hamartoma.

  3. McDonald Criteria 2010 and 2005 Compared: Persistence of High Oligoclonal Band Prevalence Despite Almost Doubled Diagnostic Sensitivity

    PubMed Central

    Schwenkenbecher, Philipp; Sarikidi, Anastasia; Wurster, Ulrich; Bronzlik, Paul; Sühs, Kurt-Wolfram; Raab, Peter; Stangel, Martin; Pul, Refik; Skripuletz, Thomas

    2016-01-01

    The 2010 McDonald criteria were developed to allow a more rapid diagnosis of relapsing-remitting multiple sclerosis (MS) by only one MRI of the brain. Although cerebrospinal fluid (CSF) is not a mandatory part of the latest criteria, the evidence of an intrathecal humoral immunoreaction in the form of oligoclonal bands (OCB) is crucial in the diagnostic workup. To date, the impact of the 2010 McDonald criteria on the prevalence of OCB has not been investigated. We retrospectively evaluated data of 325 patients with a clinical relapse suggestive of demyelination that were treated in a German university hospital between 2010 and 2015. One hundred thirty-six patients (42%) were diagnosed with MS and 189 patients with CIS when the criteria of 2010 were applied. The criteria of 2005 allowed only 70 patients (22%) to be designated as MS. In contrast, the prevalence of OCB was marginal affected in MS patients with 96% for the criteria of 2010 and 98.5% for the criteria of 2005. In conclusion, OCB are prevalent in most MS patients and reflect the chronic inflammatory nature of the disease. We recommend CSF examination to exclude alternative diagnoses and reevaluation of the diagnosis MS in patients with negative OCB. PMID:27657060

  4. Paroxysmal hemicrania: a retrospective study of a consecutive series of 22 patients and a critical analysis of the diagnostic criteria

    PubMed Central

    2013-01-01

    Background Paroxysmal hemicrania (PH) is a probably underreported primary headache disorder. It is characterized by repeated attacks of severe, strictly unilateral pain lasting 2 to 30 minutes localized to orbital, supraorbital, and temporal areas accompanied by ipsilateral autonomic features. The hallmark of PH is the absolute cessation of the headache with indomethacin. However, these all features may not be present in all cases and a few cases may remain unclassified according to the 2nd Edition of The International classification of Headache Disorders (ICHD-II) criteria for PH. Methods Twenty-two patients were included in this retrospective observation. Results We describe 17 patients, observed over six years, who fulfilled the ICHD-II criteria for PH. In parallel, we identified five more patients in whom one of the features of the diagnostic criteria for PH was missing. Two patients did not show any evidence of cranial autonomic feature during the attacks of headache. Another two patients did not fulfill the criteria for PH as the maximum attack frequency was less than five. One patient had an incomplete response to indomethacin. Conclusion A subset of patients may not have all the defined features of PH and there is a need for refinement of the existing diagnostic criteria. PMID:23566235

  5. Research Diagnostic Criteria for Temporomandibular Disorders: Reliability of Axis I Diagnoses and Selected Clinical Measures

    PubMed Central

    Look, John O.; John, Mike T.; Tai, Feng; Huggins, Kimberly H.; Lenton, Patricia A.; Truelove, Edmond L.; Ohrbach, Richard; Anderson, Gary C.; Schiffman, Eric L.

    2011-01-01

    AIM To estimate inter-examiner reliability of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) protocol. METHODS Kappa (k), computed by generalized estimate equation procedures, was selected as the primary estimate of inter-examiner reliability. Intersite reliability of six examiners from 3 study sites was assessed annually over the 5-year period of the RDC/TMD Validation Project. Intrasite reliability was monitored throughout the validation study by comparing RDC/TMD data collections performed on the same day by the test examiner and a criterion examiner. RESULTS Intersite calibrations included a total of 180 subjects. Intersite reliability of RDC/TMD diagnoses was excellent (k > 0.75) when myofascial pain diagnoses (Ia or Ib) were grouped. Good reliability was observed for discrete myofascial pain diagnoses, Ia (k = 0.62) and Ib (k = 0.58), for disc displacement with reduction (k = 0.63), disc displacement without reduction with limited opening (k = 0.62), arthralgia (k = 0.55), and when joint pain (IIIa or IIIb) was grouped (k = 0.59). Reliability of less frequently observed diagnoses such as disc displacements without reduction without limited opening, and osteoarthrosis (IIIb, IIIc), was poor to marginally fair (k = 0.31- 0.43). Intrasite monitoring results (n = 705) approximated well intersite reliability estimates. The greatest difference in paired estimates was 0.18 (IIc). CONCLUSION Reliability of the RDC/TMD protocol was good to excellent for myofascial pain, arthralgia, disc displacement with reduction, and disc displacement without reduction with limited opening. Reliability was poor to marginally fair for disc displacement without reduction without limited opening and osteoarthrosis. PMID:20213029

  6. SGCE and myoclonus dystonia: motor characteristics, diagnostic criteria and clinical predictors of genotype.

    PubMed

    Peall, Kathryn J; Kurian, Manju A; Wardle, Mark; Waite, Adrian J; Hedderly, Tammy; Lin, Jean-Pierre; Smith, Martin; Whone, Alan; Pall, Hardev; White, Cathy; Lux, Andrew; Jardine, Philip E; Lynch, Bryan; Kirov, George; O'Riordan, Sean; Samuel, Michael; Lynch, Timothy; King, Mary D; Chinnery, Patrick F; Warner, Thomas T; Blake, Derek J; Owen, Michael J; Morris, Huw R

    2014-12-01

    Myoclonus dystonia syndrome (MDS) is a young-onset movement disorder. A proportion of cases are due to mutations in the maternally imprinted SGCE gene. We assembled the largest cohort of MDS patients to date, and determined the frequency and type of SGCE mutations. The aim was to establish the motor phenotype in mutation carriers and utility of current diagnostic criteria. Eighty-nine probands with clinical features compatible with MDS were recruited from the UK and Ireland. Patients were phenotypically classified as "definite", "probable" or "possible" MDS according to previous guidelines. SGCE was analyzed using direct sequencing and copy number variant analysis. In those where no mutation was found, DYT1 (GAG deletion), GCH1, THAP1 and NKX2.1 genes were also sequenced. Nineteen (21.3%) probands had an SGCE mutation. Three patterns of motor symptoms emerged: (1) early childhood onset upper body myoclonus and dystonia, (2) early childhood onset lower limb dystonia, progressing later to more pronounced myoclonus and upper body involvement, and (3) later childhood onset upper body myoclonus and dystonia with evident cervical involvement. Five probands had large contiguous gene deletions ranging from 0.7 to 2.3 Mb in size with distinctive clinical features, including short stature, joint laxity and microcephaly. Our data confirms that SGCE mutations are most commonly identified in MDS patients with (1) age at onset ≤10 years and (2) predominant upper body involvement of a pure myoclonus-dystonia. Cases with whole SGCE gene deletions had additional clinical characteristics, which are not always predicted by deletion size or gene involvement.

  7. Primary graft dysfunction of the liver: definitions, diagnostic criteria and risk factors.

    PubMed

    Neves, Douglas Bastos; Rusi, Marcela Balbo; Diaz, Luiz Gustavo Guedes; Salvalaggio, Paolo

    2016-01-01

    Primary graft dysfunction is a multifactorial syndrome with great impact on liver transplantation outcomes. This review article was based on studies published between January 1980 and June 2015 and retrieved from PubMed database using the following search terms: "primary graft dysfunction", "early allograft dysfunction", "primary non-function" and "liver transplantation". Graft dysfunction describes different grades of graft ischemia-reperfusion injury and can manifest as early allograft dysfunction or primary graft non-function, its most severe form. Donor-, surgery- and recipient-related factors have been associated with this syndrome. Primary graft dysfunction definition, diagnostic criteria and risk factors differ between studies. RESUMO A disfunção primária do enxerto hepático é uma síndrome multifatorial com grande impacto no resultado do transplante de fígado. Foi realizada uma ampla revisão da literatura, consultando a base de dados PubMed, em busca de estudos publicados entre janeiro de 1980 e junho de 2015. Os termos descritivos utilizados foram: "primary graft dysfunction", "early allograft dysfunction", "primary non-function" e "liver transplantation". A disfunção traduz graus diferentes da lesão de isquemia e reperfusão do órgão, e pode se manifestar como disfunção precoce ou, na forma mais grave, pelo não funcionamento primário do enxerto. Fatores relacionados ao doador, ao transplante e ao receptor contribuem para essa síndrome. Existem definições diferentes na literatura quanto ao diagnóstico e aos fatores de risco associados à disfunção primária.

  8. The diagnostic criteria for iron deficiency in infants should be reevaluated.

    PubMed

    Domellöf, Magnus; Dewey, Kathryn G; Lönnerdal, Bo; Cohen, Roberta J; Hernell, Olle

    2002-12-01

    Diagnostic criteria for iron deficiency (ID) and iron deficiency anemia (IDA) in infants are poorly defined. Our aim was to establish appropriate cut-off values for hemoglobin (Hb), plasma ferritin, erythrocyte mean cell volume (MCV), zinc protoporphyrin (ZPP) and soluble transferrin receptors (TfR) in infancy. Exclusively breast-fed infants (n = 263) in Honduras and Sweden were randomly assigned to receive iron supplementation or placebo, and blood samples were obtained at 4, 6 and 9 mo of age. Reference ranges were determined using three different approaches for defining iron-replete infants. The usefulness of several variables for predicting the Hb response to iron was evaluated. We found the following 2 SD cut-off values in iron-replete infants: Hb <105 g/L at 4-6 mo and <100 g/L at 9 mo; ZPP >75 micro mol/mol heme at 4-6 mo and >90 micro mol/mol heme at 9 mo; ferritin <20 micro g/L at 4 mo, <9 micro g/L at 6 mo and <5 micro g/L at 9 mo; and TfR >11 mg/L at 4-9 mo. The Hb response to iron was not a useful definition of IDA at 4 mo of age. Hb, MCV and ZPP at 6 mo as well as growth variables predicted the Hb response at 6-9 mo, but ferritin and TfR at 6 mo did not. We conclude that there is need for a reevaluation of the definitions of ID and IDA in infants.

  9. Diagnostic criteria and follow-up in neuroendocrine cell hyperplasia of infancy: a case series*

    PubMed Central

    Gomes, Vivianne Calheiros Chaves; Silva, Mara Cristina Coelho; Maia, José Holanda; Daltro, Pedro; Ramos, Simone Gusmão; Brody, Alan S.; Marchiori, Edson

    2013-01-01

    OBJECTIVE: Neuroendocrine cell hyperplasia of infancy (NEHI) is a form of childhood interstitial lung disease characterized by tachypnea, retractions, crackles, and hypoxia. The aim of this study was to report and discuss the clinical, imaging, and histopathological findings in a series of NEHI cases at a tertiary pediatric hospital, with an emphasis on diagnostic criteria and clinical outcomes. METHODS: Between 2003 and 2011, 12 full-term infants were diagnosed with NEHI, based on clinical and tomographic findings. Those infants were followed for 1-91 months. Four infants were biopsied, and the histopathological specimens were stained with bombesin antibody. RESULTS: In this case series, symptoms appeared at birth in 6 infants and by 3 months of age in the remaining 6. In all of the cases, NEHI was associated with acute respiratory infection. The most common initial chest HRCT findings were ground-glass opacities that were in the middle lobe/lingula in 12 patients and in other medullary areas in 10. Air trapping was the second most common finding, being observed in 7 patients. Follow-up HRCT scans (performed in 10 patients) revealed normal results in 1 patient and improvement in 9. The biopsy findings were nonspecific, and the staining was positive for bombesin in all samples. Confirmation of NEHI was primarily based on clinical and tomographic findings. Symptoms improved during the follow-up period (mean, 41 months). A clinical cure was achieved in 4 patients. CONCLUSIONS: In this sample of patients, the diagnosis of NEHI was made on the basis of the clinical and tomographic findings, independent of the lung biopsy results. Most of the patients showed clinical improvement and persistent tomographic changes during the follow-up period, regardless of the initial severity of the disease or type of treatment. PMID:24310630

  10. Mind the gap: Assessing impairment among children affected by proposed revisions to the diagnostic criteria for oppositional defiant disorder

    PubMed Central

    Keenan, Kate

    2012-01-01

    The DSM-5 workgroup for disruptive behavior disorders is considering adopting a frequency threshold for symptoms of Oppositional Defiant Disorder (ODD). In the present study, the impact of substituting the term “often” with a specific age-based frequency on impairment and prognosis among preschool children was tested in a longitudinal design. Mutually exclusive groups were created to identify children who met criteria for ODD based on a symptom threshold of “often,” as in DSM-4, and those that met criteria for ODD based on a threshold of “1–2 times per day,” which approximated the proposal for DSM-5. Comparisons of these groups to each other and to non-diagnosed peers determined the impact of changing the symptom threshold on impairment and prognosis. Close to a third of children who met DSM-4 criteria for ODD did not meet criteria under the alternative diagnosis; African American children were overrepresented in this group. Preschoolers who met DSM-4, but not the alternative criteria had higher rates of ODD, CD, and were more impaired than their non-diagnosed peers at baseline and follow-up. Preschoolers meeting DSM-4 criteria were less impaired than children meeting the alternative ODD criteria at baseline according to parent, but not according to teacher report. No differences could be detected between those meeting DSM-4 and those meeting the alternative criteria in rate of ODD, CD, or impairment at follow-up. Among clinically referred preschool children, changing the symptom threshold for ODD could result in a sizable group of children who would no longer meet diagnostic criteria, despite demonstrating significant morbidity concurrently and prospectively. PMID:21707124

  11. OBSESSIVE–COMPULSIVE DISORDER: A REVIEW OF THE DIAGNOSTIC CRITERIA AND POSSIBLE SUBTYPES AND DIMENSIONAL SPECIFIERS FOR DSM-V

    PubMed Central

    Leckman, James F.; Denys, Damiaan; Simpson, H. Blair; Mataix-Cols, David; Hollander, Eric; Saxena, Sanjaya; Miguel, Euripedes C.; Rauch, Scott L.; Goodman, Wayne K.; Phillips, Katharine A.; Stein, Dan J.

    2014-01-01

    Background Since the publication of the DSM-IV in 1994, research on obsessive–compulsive disorder (OCD) has continued to expand. It is timely to reconsider the nosology of this disorder, assessing whether changes to diagnostic criteria as well as subtypes and specifiers may improve diagnostic validity and clinical utility. Methods The existing criteria were evaluated. Key issues were identified. Electronic databases of PubMed, ScienceDirect, and PsycINFO were searched for relevant studies. Results This review presents a number of options and preliminary recommendations to be considered for DSM-V. These include: (1) clarifying and simplifying the definition of obsessions and compulsions(criterion A); (2) possibly deleting the requirement that people recognize that their obsessions or compulsions are excessive or unreasonable (criterion B); (3) rethinking the clinical significance criterion (criterion C) and, in the interim, possibly adjusting what is considered “time-consuming” for OCD; (4) listing additional disorders to help with the differential diagnosis (criterion D); (5) rethinking the medical exclusion criterion (criterion E) and clarifying what is meant by a “general medical condition”; (6) revising the specifiers (i.e., clarifying that OCD can involve a range of insight, in addition to “poor insight,” and adding “tic-related OCD”); and (7) highlighting in the DSM-V text important clinical features of OCD that are not currently mentioned in the criteria (e.g., the major symptom dimensions). Conclusions A number of changes to the existing diagnostic criteria for OCD are proposed. These proposed criteria may change as the DSM-V process progresses. PMID:20217853

  12. 40 CFR 86.610-98 - Compliance with acceptable quality level and passing and failing criteria for Selective...

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... level and passing and failing criteria for Selective Enforcement Audits. 86.610-98 Section 86.610-98... quality level and passing and failing criteria for Selective Enforcement Audits. (a) The prescribed... test procedures pursuant to § 86.608-98(a). (c)(1) Pass/fail criteria. The manufacturer shall...

  13. Developing a Standards-Based Information Model for Representing Computable Diagnostic Criteria: A Feasibility Study of the NQF Quality Data Model.

    PubMed

    Jiang, Guoqian; Solbrig, Harold R; Pathak, Jyotishman; Chute, Christopher G

    2015-01-01

    The lack of a standards-based information model has been recognized as a major barrier for representing computable diagnostic criteria. In this paper we describe our efforts in examining the feasibility of the Quality Data Model (QDM)-developed by the National Quality Forum (NQF)-for representing computable diagnostic criteria. We collected the diagnostic criteria for a number of diseases and disorders (n=12) from textbooks and profiled the data elements of the criteria using the QDM data elements. We identified a number of common patterns informed by the QDM. In conclusion, the common patterns informed by the QDM are useful and feasible in building a standards-based information model for computable diagnostic criteria.

  14. Reliability, Validity, and Classification Accuracy of the DSM-5 Diagnostic Criteria for Gambling Disorder and Comparison to DSM-IV.

    PubMed

    Stinchfield, Randy; McCready, John; Turner, Nigel E; Jimenez-Murcia, Susana; Petry, Nancy M; Grant, Jon; Welte, John; Chapman, Heather; Winters, Ken C

    2016-09-01

    The DSM-5 was published in 2013 and it included two substantive revisions for gambling disorder (GD). These changes are the reduction in the threshold from five to four criteria and elimination of the illegal activities criterion. The purpose of this study was to twofold. First, to assess the reliability, validity and classification accuracy of the DSM-5 diagnostic criteria for GD. Second, to compare the DSM-5-DSM-IV on reliability, validity, and classification accuracy, including an examination of the effect of the elimination of the illegal acts criterion on diagnostic accuracy. To compare DSM-5 and DSM-IV, eight datasets from three different countries (Canada, USA, and Spain; total N = 3247) were used. All datasets were based on similar research methods. Participants were recruited from outpatient gambling treatment services to represent the group with a GD and from the community to represent the group without a GD. All participants were administered a standardized measure of diagnostic criteria. The DSM-5 yielded satisfactory reliability, validity and classification accuracy. In comparing the DSM-5 to the DSM-IV, most comparisons of reliability, validity and classification accuracy showed more similarities than differences. There was evidence of modest improvements in classification accuracy for DSM-5 over DSM-IV, particularly in reduction of false negative errors. This reduction in false negative errors was largely a function of lowering the cut score from five to four and this revision is an improvement over DSM-IV. From a statistical standpoint, eliminating the illegal acts criterion did not make a significant impact on diagnostic accuracy. From a clinical standpoint, illegal acts can still be addressed in the context of the DSM-5 criterion of lying to others.

  15. Fraser syndrome and cryptophthalmos: review of the diagnostic criteria and evidence for phenotypic modules in complex malformation syndromes

    PubMed Central

    Slavotinek, A; Tifft, C

    2002-01-01

    Fraser syndrome is characterised by cryptophthalmos, cutaneous syndactyly, malformations of the larynx and genitourinary tract, craniofacial dysmorphism, orofacial clefting, mental retardation, and musculoskeletal anomalies. The inheritance is autosomal recessive. No diagnostic cytogenetic abnormalities have been documented in affected patients, and no molecular genetic studies have been reported. We have reviewed 117 cases diagnosed as Fraser syndrome or cryptophthalmos published since the comprehensive review of Thomas et al in 1986 in order to validate the published diagnostic criteria and to delineate the phenotype associated with this syndrome. Our series showed more females (57/117) than males and consanguinity was present in 29/119 (24.8%). Eighty-eight patients satisfied the diagnostic criteria for Fraser syndrome (75%). Cryptophthalmos was present in 103/117 (88%), syndactyly in 72/117 (61.5%), and ambiguous genitalia in 20/117 (17.1%). Ear malformations were recorded in 69/117 (59%), and renal agenesis in 53/117 (45.3%). Use of the published diagnostic criteria excluded several patients with cryptophthalmos and one or more physical feature(s) consistent with Fraser syndrome. The frequency of additional anomalies in our series was also higher than previously reported (for example, imperforate anus or anal stenosis were found in 34/117 (29%) compared with 2/124 (2%) in the series of Thomas et al (1986) and choanal stenosis or atresia was present in 7/117 (6%) compared to 0/124. These findings emphasise the clinical variability associated with Fraser syndrome and support genetic heterogeneity of the syndrome. We also noted patterns of anomalies (for example, bicornuate uterus with imperforate anus or anal stenosis and renal malformations) that are found in other syndromes and associations without cryptophthalmos, suggesting that common modifier genes may explain some of the phenotypic variation in Fraser syndrome. PMID:12205104

  16. Fraser syndrome and cryptophthalmos: review of the diagnostic criteria and evidence for phenotypic modules in complex malformation syndromes.

    PubMed

    Slavotinek, A M; Tifft, C J

    2002-09-01

    Fraser syndrome is characterised by cryptophthalmos, cutaneous syndactyly, malformations of the larynx and genitourinary tract, craniofacial dysmorphism, orofacial clefting, mental retardation, and musculoskeletal anomalies. The inheritance is autosomal recessive. No diagnostic cytogenetic abnormalities have been documented in affected patients, and no molecular genetic studies have been reported. We have reviewed 117 cases diagnosed as Fraser syndrome or cryptophthalmos published since the comprehensive review of Thomas et al in 1986 in order to validate the published diagnostic criteria and to delineate the phenotype associated with this syndrome. Our series showed more females (57/117) than males and consanguinity was present in 29/119 (24.8%). Eighty-eight patients satisfied the diagnostic criteria for Fraser syndrome (75%). Cryptophthalmos was present in 103/117 (88%), syndactyly in 72/117 (61.5%), and ambiguous genitalia in 20/117 (17.1%). Ear malformations were recorded in 69/117 (59%), and renal agenesis in 53/117 (45.3%). Use of the published diagnostic criteria excluded several patients with cryptophthalmos and one or more physical feature(s) consistent with Fraser syndrome. The frequency of additional anomalies in our series was also higher than previously reported (for example, imperforate anus or anal stenosis were found in 34/117 (29%) compared with 2/124 (2%) in the series of Thomas et al (1986) and choanal stenosis or atresia was present in 7/117 (6%) compared to 0/124. These findings emphasise the clinical variability associated with Fraser syndrome and support genetic heterogeneity of the syndrome. We also noted patterns of anomalies (for example, bicornuate uterus with imperforate anus or anal stenosis and renal malformations) that are found in other syndromes and associations without cryptophthalmos, suggesting that common modifier genes may explain some of the phenotypic variation in Fraser syndrome.

  17. ALS diagnostic criteria of El Escorial Revisited: do they meet the needs of clinicians as well as researchers?

    PubMed

    Belsh, J M

    2000-03-01

    The El Escorial criteria for diagnosis of amyotrophic lateral sclerosis (ALS) have been in use for almost a decade. A revised set of criteria, meant to supersede the original set, was developed at a 1998 World Federation of Neurology (WFN) ALS meeting at Airlie House in Warrenton, Virginia, USA. This revised document, nicknamed El Escorial Revisited, has been published on the WFN-ALS website. El Escorial has proven useful in standardizing diagnostic criteria for entry into research trials and it is expected that El Escorial Revisited will help to liberalize such entry requirements. However, general neurologists and neuromuscular clinicians have found El Escorial to be unwieldy and generally unhelpful in achieving an earlier, accurate diagnosis of ALS. The El Escorial Revisited document is a step toward lessening these problems, but more 'user-friendly' criteria may be necessary for clinicians and those not conducting research. Such ALS criteria would improve categorization of ALS patients, would allow clinicians more latitude in beginning ALS treatment, and would educate practitioners to differentiate ALS from other motor neuron and non-motor neuron diseases. Intensive education of physicians will help improve earlier patient referral and accurate ALS diagnosis. There remains a group of 'difficult cases' that will continue to challenge the neuromuscular specialist. Earlier diagnosis in this latter group will require significant advances in the fields of electrodiagnosis, neuroimaging, immunobiochemistry, and neurogenetics.

  18. What is in a name? Comparing diagnostic criteria for chronic fatigue syndrome with or without fibromyalgia.

    PubMed

    Meeus, Mira; Ickmans, Kelly; Struyf, Filip; Kos, Daphne; Lambrecht, Luc; Willekens, Barbara; Cras, Patrick; Nijs, Jo

    2016-01-01

    The current study had two objectives. (1) to compare objective and self-report measures in patients with chronic fatigue syndrome (CFS) according to the 1994 Center for Disease Control (CDC) criteria, patients with multiple sclerosis (MS), and healthy controls, and (2) to contrast CFS patients who only fulfill CDC criteria to those who also fulfill the criteria for myalgic encephalomyelitis (ME), the 2003 Canadian criteria for ME/CFS, or the comorbid diagnosis of fibromyalgia (FM). One hundred six participants (48 CFS patients diagnosed following the 1994 CDC criteria, 19 MS patients, and 39 healthy controls) completed questionnaires assessing symptom severity, quality of life, daily functioning, and psychological factors. Objective measures consisted of activity monitoring, evaluation of maximal voluntary contraction and muscle recovery, and cognitive performance. CFS patients were screened whether they also fulfilled ME criteria, the Canadian criteria, and the diagnosis of FM. CFS patients scored higher on symptom severity, lower on quality of life, and higher on depression and kinesiophobia and worse on MVC, muscle recovery, and cognitive performance compared to the MS patients and the healthy subjects. Daily activity levels were also lower compared to healthy subjects. Only one difference was found between those fulfilling the ME criteria and those who did not regarding the degree of kinesiophobia (lower in ME), while comorbidity for FM significantly increased the symptom burden. CFS patients report more severe symptoms and are more disabled compared to MS patients and healthy controls. Based on the present study, fulfillment of the ME or Canadian criteria did not seem to give a clinically different picture, whereas a diagnosis of comorbid FM selected symptomatically worse and more disabled patients.

  19. Prevalence of signs and symptoms of temporomandibular disorders in children in the State of Puebla, Mexico, evaluated with the research diagnostic criteria for temporomandibular disorders (RDC/TMD).

    PubMed

    Moyaho-Bernal, Angeles; Lara-Muñoz, Ma Del Carmen; Espinosa-De Santillana, Irene; Etchegoyen, Graciela

    2010-01-01

    The aim of this work was to describe the prevalence of signs and symptoms of temporomandibular disorders (TMD) in children of the State of Puebla, Mexico. A descriptive observational study was performed. After calculating sample size, children who met the following selection criteria were included: registered at an official elementary school, either sex, ages between 8 and 12 years, who accept to participate in the study and whose parents have signed the informed consent forms. The Research Diagnostic Criteria for Temporomandibular Disorders were used by calibrated researchers (Kappa 90) under the same conditions. Descriptive statistics were applied by using SPSSv15 software. The study included 235 children, 129 (54.9%) female and 106 (45.1%) male, of average age 9.31 + 1.2 years. Prevalence of signs and symptoms was 33.2%, and predominately muscular (82%), 48.1% showed signs of muscular pain and 19.1% joint pain. 63.4% showed signs of alteration in the mouth opening pattern, 39.1% presented joint sounds on opening or closing the mouth and 20.4% on mandibular excursions. The high prevalence of signs and symptoms related to temporomandibular disorders, in particular in children with mixed dentition, shows the importance of TMD evaluation during this period, when morphological changes associated to growth and craniofacial development prevail.

  20. Structural acceptance criteria for the evaulation of existing double-shell waste storage tanks located at the Hanford site, Richland, Washington

    SciTech Connect

    Julyk, L.J.; Day, A.D.; Dyrness, A.D.; Moore, C.J.; Peterson, W.S.; Scott, M.A.; Shrivastava, H.P.; Sholman, J.S.; Watts, T.N.

    1995-09-01

    The structural acceptance criteria contained herein for the evaluation of existing underground double-shell waste storage tanks located at the Hanford Site is part of the Life Management/Aging Management Program of the Tank Waste Remediation System. The purpose of the overall life management program is to ensure that confinement of the waste is maintained over the required service life of the tanks. Characterization of the present condition of the tanks, understanding and characterization of potential degradation mechanisms, and development of tank structural acceptance criteria based on previous service and projected use are prerequisites to assessing tank integrity, to projecting the length of tank service, and to developing and applying prudent fixes or repairs. The criteria provided herein summarize the requirements for the analysis and structural qualification of the existing double-shell tanks for continued operation. Code reconciliation issues and material degradation under aging conditions are addressed. Although the criteria were developed for double-shell tanks, many of the provisions are equally applicable to single-shell tanks. However, the criteria do not apply to the evaluation of tank appurtenances and buried piping.

  1. Selecting the Acceptance Criteria of Medicines in the Reimbursement List of Public Health Insurance of Iran, Using the “Borda” Method: a Pilot Study

    PubMed Central

    Viyanchi, Amir; Rasekh, Hamid Reza; Rajabzadeh Ghatari, Ali; SafiKhani, Hamid Reza

    2015-01-01

    Decision-making for medicines to be accepted in Iran’s public health insurance reimbursement list is a complex process and involves factors, which should be considered in applying a coverage for medicine costs. These processes and factors are not wholly assessed, while assessment of these factors is an essential need for getting a transparent and evidence-based approach toward medicine reimbursement in Iran. This paper aims to show an evidence-based approach toward medicine selection criteria to inform the medical reimbursement decision makers in Iranian health insurance organizations. To explore an adaptable decision-making framework while incorporating a method called “Borda” in medicine reimbursement assessment, we used the help of an expert group including decision makers and clinical researchers who are also policy makers to appraise the five chief criteria that have three sub criteria (Precision, Interpretability, and Cost). Also software “Math-lab”7, “SPSS” 17 and Excel 2007 were used in this study. “Borda” estimates the amount of perceived values from different criteria and creates a range from one to five while providing a comprehensive measurement of a large spectrum of criteria. Participants reported that the framework provided an efficient approach to systematic consideration in a pragmatic format consisting of many parts to guide decision-makings, including criteria and value (a model with the core of Borda) and evidences (medicine reimbursement based on criteria). The most important criterion for medicine acceptance in health insurance companies, in Iran, is the "life-threatening" factor and "evidence quality" is accounted as the fifth important factor. This pilot study showed the usefulness of incorporating Borda in medicine reimbursement decisions to support a transparent and systematic appraisal of health insurance companies' deeds. Further research is needed to advance Borda-based approaches that are effective on health insurance

  2. Gender-related differential item functioning in DSM-IV/DSM-5-III (alternative model) diagnostic criteria for borderline personality disorder.

    PubMed

    Benson, Kathryn T; Donnellan, M Brent; Morey, Leslie C

    2017-01-01

    A number of studies have evaluated the possibility of bias in the diagnostic criteria in borderline personality disorder as an explanation of gender differences in prevalence. Previous studies have used both regression and latent trait approaches but the results have been inconsistent. The current study extended prior investigations in testing differential function of Borderline diagnostic criteria using both regression and latent-trait methods in the same sample, examining both Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) and DSM-5 alternative model criteria for borderline personality. Data were obtained from a national sample of 337 clinicians providing diagnostic information on 1 of their target patients. Chronic feelings of emptiness was the only criterion that demonstrated consistent evidence of potential differential functioning across methods and diagnostic models. Implications of these results for the conceptualization of borderline personality are discussed. (PsycINFO Database Record

  3. Performance deterioration due to acceptance testing and flight loads; JT90 jet engine diagnostic program

    NASA Technical Reports Server (NTRS)

    Olsson, W. J.

    1982-01-01

    The results of a flight loads test of the JT9D-7 engine are presented. The goals of this test program were to: measure aerodynamic and inertia loads on the engine during flight, explore the effects of airplane gross weight and typical maneuvers on these flight loads, simultaneously measure the changes in engine running clearances and performance resulting from the maneuvers, make refinements of engine performance deterioration prediction models based on analytical results of the tests, and make recommendations to improve propulsion system performance retention. The test program included a typical production airplane acceptance test plus additional flights and maneuvers to encompass the range of flight loads in revenue service. The test results indicated that aerodynamic loads, primarily at take-off, were the major cause of rub-indicated that aerodynamic loads, primarily at take-off, were the major cause of rub-induced deterioration in the cold sectin of the engine. Differential thermal expansion between rotating and static parts plus aerodynamic loads combined to cause blade-to-seal rubs in the turbine.

  4. Prevalence of Premorbid Metabolic Syndrome in Spanish Adult Workers Using IDF and ATPIII Diagnostic Criteria: Relationship with Cardiovascular Risk Factors

    PubMed Central

    Tauler, Pedro; Bennasar-Veny, Miquel; Morales-Asencio, Jose M.; Lopez-Gonzalez, Angel A.; Vicente-Herrero, Teofila; De Pedro-Gomez, Joan; Royo, Vanessa; Pericas-Beltran, Jordi; Aguilo, Antoni

    2014-01-01

    Background Metabolic Syndrome (MetS) is a complex disorder defined as a cluster of interconnected risk factors such as hypertension, dyslipidemia, obesity and high blood glucose levels. Premorbid metabolic syndrome (PMetS) is defined by excluding patients with previously diagnosed cardiovascular disease or diabetes mellitus from those suffering MetS. We aimed to determine the prevalence of PMetS in a working population, and to analyse the relationship between the diagnostic criteria of the International Diabetes Federation (IDF) and of the National Cholesterol Education Program Adult Treatment Panel III (ATPIII). The relationship between the presence of PMetS and cardiovascular risk factors was also analysed. Research Methodology/Findings A cross-sectional study was conducted in 24,529 male and 18,736 female Spanish (white western European) adult workers (20–65 years) randomly selected during their work health periodic examinations. Anthropometrics, blood pressure and serum parameters were measured. The presence of MetS and PMetS was ascertained using ATPIII and IDF criteria. Cardiovascular risk was determined using the Framingham-REGICOR equation. The results showed MetS had an adjusted global prevalence of 12.39% using ATPIII criteria and 16.46% using IDF criteria. The prevalence of PMetS was slightly lower (11.21% using ATPIII criteria and 14.72% using IDF criteria). Prevalence in males was always higher than in females. Participants with PMetS displayed higher values of BMI, waist circumference, blood pressure, glucose and triglycerides, and lower HDL-cholesterol levels. Logistic regression models reported lower PMetS risk for females, non-obese subjects, non-smokers and younger participants. Cardiovascular risk determined with Framingham-REGICOR was higher in participants with PMetS. Conclusions PMetS could be a reliable tool for the early identification of apparently healthy individuals who have a significant risk for developing cardiovascular events and

  5. [The compensatory and adaptive e reactions of the respiratory system as the diagnostic criteria for histological studies in forensic medicine].

    PubMed

    Os'minkin, V A; Os'minkin, S V

    2015-01-01

    The objective of the present study was to characterize the structural changes in the respiratory system equivalent to its compensatory and adaptive reactions in response to the action of various factors under the normal and extreme conditions for the assessment of the possibility of their further use for the purpose of diagnostics. The action of various factors on the tissues obtained from the human respiratory system for forensic medical examination was shown to cause combined histomorphological alterations that refelect a wide spectrum of protective, compensatory, and adaptive reactions. The range of potential morphological and functional changes in the respiratory system depends on the characteristics of endogenous and exogenous factors influencing the organism of the affected subjects. It is concluded that the use of the proposed approach to morphological diagnostics may be useful for the development of criteria for the evaluation of various variants of tanatogenesis with their objective confirmation by mathematical models.

  6. Evaluation of the stomatognathic system in patients with rheumatoid arthritis according to the research diagnostic criteria for temporomandibular disorders.

    PubMed

    Bracco, Pietro; Debernardi, Cesare; Piancino, Maria Grazia; Cirigliano, Maria Francesca; Salvetti, Giovanni; Bazzichi, Laura; De Feo, Francesca; Bosco, Mario

    2010-07-01

    The aim of this study was to investigate the clinical features of stomatognathic dysfunction in patients with rheumatoid arthritis (RA). The study sample consisted of 40 patients with RA (34 female, 6 male), mean age 44 years, recruited at the Rheumatology Division of the Department of Internal Medicine, University of Pisa, Italy. The inclusion criteria were diagnosis of RA according to the criteria of the American Rheumatism Association (ARA). In the study, 82.5% (n=33) of patients affected by RA satisfied at least the criteria of one diagnosis of temporomandibular disorders (TMD), according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). The results are in agreement with the literature and the prevalence of such involvement ranges between 53% and 94% of patients. Several studies reported an involvement of the stomatognathic system in RA. In fact, RA can affect the temporomandibular joint as much as any other synovial joint. A more thorough analysis is required for a multidisciplinary approach to gnathological patients, including assessment by a rheumatologist. This issue and its epidemiologic relevance need further scientific research. Dentistry has a fundamental role in this process since patients who present with a systemic disease such as RA can be recognized and intercepted and referred to medical specialists, i.e., rheumatologists, to provide a diagnosis and therapy.

  7. Major Salivary Gland Ultrasonography in the Diagnosis of Sjögren's Syndrome: A Place in the Diagnostic Criteria?

    PubMed

    Jonsson, Malin V; Baldini, Chiara

    2016-08-01

    Major salivary gland (SG) ultrasonography (US) represents a noninvasive, nonirradiating imaging modality for evaluation of the major SGs in the diagnosis and follow-up of primary and secondary Sjögren syndrome. Structural changes can be visualized as hyperechogenic and hypoechogenic areas, inhomogeneity, and altered echogenicity in general. The reliability of SG-US is poorly investigated, and the definition of US abnormalities varies in previously published studies. Recent studies have shown correlations between SG-US findings and focus score in the minor SGs; however further studies are needed to validate a US criterion in updated classification/diagnostic criteria.

  8. Developmentally sensitive diagnostic criteria for mental health disorders in early childhood: the diagnostic and statistical manual of mental disorders-IV, the research diagnostic criteria-preschool age, and the diagnostic classification of mental health and developmental disorders of infancy and early childhood-revised.

    PubMed

    Egger, Helen L; Emde, Robert N

    2011-01-01

    As the infant mental health field has turned its focus to the presentation, course, and treatment of clinically significant mental health disorders, the need for reliable and valid criteria for identifying and assessing mental health symptoms and disorders in early childhood has become urgent. In this article we offer a critical perspective on diagnostic classification of mental health disorders in young children. We place the issue of early childhood diagnosis within the context of classification of psychopathology at other ages and describe, in some detail, diagnostic classifications that have been developed specifically for young children, including the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood (DC:0-3R; ZERO TO THREE, 2005), a diagnostic classification for mental health symptoms and disorders in infants, toddlers, and preschoolers. We briefly outline the role of diagnostic classification in clinical assessment and treatment planning. Last, we review the limitations of current approaches to the diagnostic classification of mental health disorders in young children.

  9. Computer-aided DSM-IV-diagnosticsacceptance, use and perceived usefulness in relation to users' learning styles

    PubMed Central

    Bergman, Lars G; Fors, Uno GH

    2005-01-01

    Background CDSS (computerized decision support system) for medical diagnostics have been studied for long. This study was undertaken to investigate how different preferences of Learning Styles (LS) of psychiatrists might affect acceptance, use and perceived usefulness of a CDSS for diagnostics in psychiatry. Methods 49 psychiatrists (specialists and non-specialists) from 3 different clinics volunteered to participate in this study and to use the CDSS to diagnose a paper-based case (based on a real patient). LS, attitudes to CDSS and complementary data were obtained via questionnaires and interviews. To facilitate the study, a special version of the CDSS was created, which automatically could log interaction details. Results The LS preferences (according to Kolb) of the 49 physicians turned out as follows: 37% were Assimilating, 31% Converging, 27% Accommodating and 6% Diverging. The CDSS under study seemed to favor psychiatrists with abstract conceptualization information perceiving mode (Assimilating and Converging learning styles). A correlation between learning styles preferences and computer skill was found. Positive attitude to computer-aided diagnostics and learning styles preferences was also found to correlate. Using the CDSS, the specialists produced only 1 correct diagnosis and the non-specialists 2 correct diagnoses (median values) as compared to the three predetermined correct diagnoses of the actual case. Only 10% had all three diagnoses correct, 41 % two correct, 47 % one correct and 2 % had no correct diagnose at all. Conclusion Our results indicate that the use of CDSS does not guarantee correct diagnosis and that LS might influence the results. Future research should focus on the possibility to create systems open to individuals with different LS preferences and possibility to create CDSS adapted to the level of expertise of the user. PMID:15638940

  10. Comparing Diagnostic Outcomes of Autism Spectrum Disorder Using "DSM-IV-TR" and "DSM-5" Criteria

    ERIC Educational Resources Information Center

    Harstad, Elizabeth B.; Fogler, Jason; Sideridis, Georgios; Weas, Sarah; Mauras, Carrie; Barbaresi, William J.

    2015-01-01

    Controversy exists regarding the "DSM-5" criteria for ASD. This study tested the psychometric properties of the "DSM-5" model and determined how well it performed across different gender, IQ, and "DSM-IV-TR" sub-type, using clinically collected data on 227 subjects (median age = 3.95 years, majority had IQ > 70).…

  11. Establishment of diagnostic criteria for feline nonflea-induced hypersensitivity dermatitis.

    PubMed

    Favrot, Claude; Steffan, Jean; Seewald, Wolfgang; Hobi, Stefan; Linek, Monika; Marignac, Geneviève; Olivry, Thierry; Beco, Luc; Nett, Claudia; Fontaine, Jacques; Roosje, Petra; Bergvall, Kerstin; Belova, Svetlana; Koebrich, Stefanie; Pin, Didier; Kovalik, Marcel; Meury, Sabrina; Wilhelm, Sylvia

    2012-02-01

    Hypersensitivity dermatitides (HD) are commonly seen in cats, and they are usually caused by environmental, food and/or flea allergens. Affected cats normally present with one of the following clinical reaction patterns: head and neck excoriations, usually symmetrical self-induced alopecia, eosinophilic skin lesions or miliary dermatitis. Importantly, none of these clinical presentations is considered to be pathognomonic for HD skin diseases, and the diagnosis of HD is usually based on the exclusion of other pruritic diseases and on a positive response to therapy. The objectives of this study were to propose sets of criteria for the diagnosis of nonflea-induced HD (NFHD). We recruited 501 cats with pruritus and skin lesions and compared clinical parameters between cats with NFHD (encompassing those with nonflea, nonfood HD and those with food HD), flea HD and other pruritic conditions. Using simulated annealing techniques, we established two sets of proposed criteria for the following two different clinical situations: (i) the diagnosis of NFHD in a population of pruritic cats; and (ii) the diagnosis of NFHD after exclusion of cats with flea HD. These criteria sets were associated with good sensitivity and specificity and may be useful for homogeneity of enrolment in clinical trials and to evaluate the probability of diagnosis of NFHD in clinical practice. Finally, these criteria were not useful to differentiate cats with NFHD from those with food HD.

  12. Diagnostic Efficiency of DSM-IV Criteria for Borderline Personality Disorder: An Evaluation in Hispanic Men and Women with Substance Use Disorders

    ERIC Educational Resources Information Center

    Grilo, Carlos M.; Becker, Daniel F.; Anez, Luis Miguel; McGlashan, Thomas H.

    2004-01-01

    This study examined diagnostic efficiency of Diagnostic and Statistical Manual of Mental Disorders, fourth edition (DSM-IV), criteria for borderline personality disorder (BPD). One hundred thirty monolingual Hispanic adults (90 men, 40 women) at an outpatient psychiatric and substance abuse clinic were assessed with the Spanish-Language Version of…

  13. Comparison of the Minnesota Percepto-Diagnostic Test and Bender-Gestalt: Relationship with Achievement Criteria.

    ERIC Educational Resources Information Center

    Fuller, Gerald B.; Wallbrown, Fred H.

    1983-01-01

    Compared the Bender Gestalt (BD) and Minnesota Percepto-Diagnostic Test (MPD) in predicting academic achievement for younger children (N=69). Results suggested that the MPD is more sensitive than the Bender in identifying visual-motor perception areas of achievement performance problems. (LLL)

  14. Revised diagnostic criteria and classification for the autoimmune lymphoproliferative syndrome (ALPS): report from the 2009 NIH International Workshop.

    PubMed

    Oliveira, Joao B; Bleesing, Jack J; Dianzani, Umberto; Fleisher, Thomas A; Jaffe, Elaine S; Lenardo, Michael J; Rieux-Laucat, Frederic; Siegel, Richard M; Su, Helen C; Teachey, David T; Rao, V Koneti

    2010-10-07

    Lymphadenopathy in children for which no infectious or malignant cause can be ascertained constitutes a challenging diagnostic dilemma. Autoimmune lymphoproliferative syndrome (ALPS) is a human genetic disorder of lymphocyte apoptosis resulting in an accumulation of lymphocytes and childhood onset chronic lymphadenopathy, splenomegaly, multilineage cytopenias, and an increased risk of B-cell lymphoma. In 1999, investigators at the National Institutes of Health (NIH) suggested criteria to establish the diagnosis of ALPS. Since then, with approximately 500 patients with ALPS studied worldwide, significant advances in our understanding of the disease have prompted the need for revisions to the existing diagnostic criteria and classification scheme. The rationale and recommendations outlined here stem from an international workshop held at NIH on September 21 and 22, 2009, attended by investigators from the United States, Europe, and Australia engaged in clinical and basic science research on ALPS and related disorders. It is hoped that harmonizing the diagnosis and classification of ALPS will foster collaborative research and better understanding of the pathogenesis of autoimmune cytopenias and B-cell lymphomas.

  15. The inclusion of child pornography in the DSM-5 diagnostic criteria for pedophilia: conceptual and practical problems.

    PubMed

    First, Michael B

    2011-01-01

    The proposal to add use of child pornography to Criterion B of pedophilia is in direct conflict with the newly proposed distinction between paraphilia and paraphilic disorder, muddying rather than clarifying the diagnostic definition of pedophilia. The proposal to distinguish paraphilic disorder from paraphilia derives from the fact that the diagnostic criteria for the paraphilias have two components: Criterion A, defining the presence of a paraphilic erotic interest, and Criterion B, requiring clinically significant distress, impairment, or acting out the paraphilia with a nonconsenting person. Meeting Criteria A and B is necessary for a diagnosis of paraphilic disorder; meeting only Criterion A indicates a paraphilia. Use of pornography is better placed within Criterion A, perhaps as an example of a behavioral manifestation of pedophilia. If the Sexual and Gender Identity Disorders Work Group's true intent was to add a third prong to Criterion B, then the criterion must be modified to restrict it to the use of illegal forms of pornography (i.e., visual depictions of real children), excluding written or aural forms or virtual images.

  16. Gender differences in developmental dyscalculia depend on diagnostic criteria.

    PubMed

    Devine, Amy; Soltész, Fruzsina; Nobes, Alison; Goswami, Usha; Szűcs, Dénes

    2013-10-01

    Developmental dyscalculia (DD) is a learning difficulty specific to mathematics learning. The prevalence of DD may be equivalent to that of dyslexia, posing an important challenge for effective educational provision. Nevertheless, there is no agreed definition of DD and there are controversies surrounding cutoff decisions, specificity and gender differences. In the current study, 1004 British primary school children completed mathematics and reading assessments. The prevalence of DD and gender ratio were estimated in this sample using different criteria. When using absolute thresholds, the prevalence of DD was the same for both genders regardless of the cutoff criteria applied, however gender differences emerged when using a mathematics-reading discrepancy definition. Correlations between mathematics performance and the control measures selected to identify a specific learning difficulty affect both prevalence estimates and whether a gender difference is in fact identified. Educational implications are discussed.

  17. The DSM diagnostic criteria for gender identity disorder in adolescents and adults.

    PubMed

    Cohen-Kettenis, Peggy T; Pfäfflin, Friedemann

    2010-04-01

    Apart from some general issues related to the Gender Identity Disorder (GID) diagnosis, such as whether it should stay in the DSM-V or not, a number of problems specifically relate to the current criteria of the GID diagnosis for adolescents and adults. These problems concern the confusion caused by similarities and differences of the terms transsexualism and GID, the inability of the current criteria to capture the whole spectrum of gender variance phenomena, the potential risk of unnecessary physically invasive examinations to rule out intersex conditions (disorders of sex development), the necessity of the D criterion (distress and impairment), and the fact that the diagnosis still applies to those who already had hormonal and surgical treatment. If the diagnosis should not be deleted from the DSM, most of the criticism could be addressed in the DSM-V if the diagnosis would be renamed, the criteria would be adjusted in wording, and made more stringent. However, this would imply that the diagnosis would still be dichotomous and similar to earlier DSM versions. Another option is to follow a more dimensional approach, allowing for different degrees of gender dysphoria depending on the number of indicators. Considering the strong resistance against sexuality related specifiers, and the relative difficulty assessing sexual orientation in individuals pursuing hormonal and surgical interventions to change physical sex characteristics, it should be investigated whether other potentially relevant specifiers (e.g., onset age) are more appropriate.

  18. Amyotrophic lateral sclerosis - frontotemporal spectrum disorder (ALS-FTSD): Revised diagnostic criteria.

    PubMed

    Strong, Michael J; Abrahams, Sharon; Goldstein, Laura H; Woolley, Susan; Mclaughlin, Paula; Snowden, Julie; Mioshi, Eneida; Roberts-South, Angie; Benatar, Michael; HortobáGyi, Tibor; Rosenfeld, Jeffrey; Silani, Vincenzo; Ince, Paul G; Turner, Martin R

    2017-01-05

    This article presents the revised consensus criteria for the diagnosis of frontotemporal dysfunction in amyotrophic lateral sclerosis (ALS) based on an international research workshop on frontotemporal dementia (FTD) and ALS held in London, Canada in June 2015. Since the publication of the Strong criteria, there have been considerable advances in the understanding of the neuropsychological profile of patients with ALS. Not only is the breadth and depth of neuropsychological findings broader than previously recognised - - including deficits in social cognition and language - but mixed deficits may also occur. Evidence now shows that the neuropsychological deficits in ALS are extremely heterogeneous, affecting over 50% of persons with ALS. When present, these deficits significantly and adversely impact patient survival. It is the recognition of this clinical heterogeneity in association with neuroimaging, genetic and neuropathological advances that has led to the current re-conceptualisation that neuropsychological deficits in ALS fall along a spectrum. These revised consensus criteria expand upon those of 2009 and embrace the concept of the frontotemporal spectrum disorder of ALS (ALS-FTSD).

  19. Measurement and Analysis Infrastructure Diagnostic (MAID) Evaluation Criteria, Version 1.0

    DTIC Science & Technology

    2010-02-01

    model is developed (e.g., linear regression ), confidence intervals are calculated and displayed to illustrate the uncertainty associated with the...fitted regression line (the average dependent variable values). 3.10 When a statistical model is used (e.g., linear regression ) for prediction, a... Regression Diagnostics: An Introduction. Sage, 1991. [Frees 1996] Frees, Edward W. Data Analysis Using Regression Models . Prentice Hall, 1996

  20. Ultrasound criteria and guided fine-needle aspiration diagnostic yields in small animal peritoneal, mesenteric and omental disease.

    PubMed

    Feeney, Daniel A; Ober, Christopher P; Snyder, Laura A; Hill, Sara A; Jessen, Carl R

    2013-01-01

    Peritoneal, mesenteric, and omental diseases are important causes of morbidity and mortality in humans and animals, although information in the veterinary literature is limited. The purposes of this retrospective study were to determine whether objectively applied ultrasound interpretive criteria are statistically useful in differentiating among cytologically defined normal, inflammatory, and neoplastic peritoneal conditions in dogs and cats. A second goal was to determine the cytologically interpretable yield on ultrasound-guided, fine-needle sampling of peritoneal, mesenteric, or omental structures. Sonographic criteria agreed upon by the authors were retrospectively and independently applied by two radiologists to the available ultrasound images without knowledge of the cytologic diagnosis and statistically compared to the ultrasound-guided, fine-needle aspiration cytologic interpretations. A total of 72 dogs and 49 cats with abdominal peritoneal, mesenteric, or omental (peritoneal) surface or effusive disease and 17 dogs and 3 cats with no cytologic evidence of inflammation or neoplasia were included. The optimized, ultrasound criteria-based statistical model created independently for each radiologist yielded an equation-based diagnostic category placement accuracy of 63.2-69.9% across the two involved radiologists. Regional organ-associated masses or nodules as well as aggregated bowel and peritoneal thickening were more associated with peritoneal neoplasia whereas localized, severely complex fluid collections were more associated with inflammatory peritoneal disease. The cytologically interpretable yield for ultrasound-guided fine-needle sampling was 72.3% with no difference between species, making this a worthwhile clinical procedure.

  1. Sideroblastic anemias: variations on imprecision in diagnostic criteria, proposal for an extended classification of sideroblastic anemias.

    PubMed

    Koc, S; Harris, J W

    1998-01-01

    Sideroblastic anemias are caused by a diversity of hereditary, congenital, or acquired disorders. Criteria used in describing sideroblastic anemias vary widely among standard medical textbooks and even so have been imprecisely applied in the literature. Recent discoveries concerning the basic pathophysiologic mechanisms involving the molecular biology of nuclear and mitochondrial DNA, erythroid ALA synthase (ALAS-2), and iron transport have made the classification of sideroblastic anemias very complex. We recommend a more precise evaluation and documentation of the components that characterize the sideroblastic abnormality and propose an extended classification of the sideroblastic anemias.

  2. A FRAMEWORK TO DEVELOP FLAW ACCEPTANCE CRITERIA FOR STRUCTURAL INTEGRITY ASSESSMENT OF MULTIPURPOSE CANISTERS FOR EXTENDED STORAGE OF USED NUCLEAR FUEL

    SciTech Connect

    Lam, P.; Sindelar, R.; Duncan, A.; Adams, T.

    2014-04-07

    A multipurpose canister (MPC) made of austenitic stainless steel is loaded with used nuclear fuel assemblies and is part of the transfer cask system to move the fuel from the spent fuel pool to prepare for storage, and is part of the storage cask system for on-site dry storage. This weld-sealed canister is also expected to be part of the transportation package following storage. The canister may be subject to service-induced degradation especially if exposed to aggressive environments during possible very long-term storage period if the permanent repository is yet to be identified and readied. Stress corrosion cracking may be initiated on the canister surface in the welds or in the heat affected zone because the construction of MPC does not require heat treatment for stress relief. An acceptance criteria methodology is being developed for flaw disposition should the crack-like defects be detected by periodic Inservice Inspection. The external loading cases include thermal accident scenarios and cask drop conditions with the contribution from the welding residual stresses. The determination of acceptable flaw size is based on the procedure to evaluate flaw stability provided by American Petroleum Institute (API) 579 Fitness-for-Service (Second Edition). The material mechanical and fracture properties for base and weld metals and the stress analysis results are obtained from the open literature such as NUREG-1864. Subcritical crack growth from stress corrosion cracking (SCC), and its impact on inspection intervals and acceptance criteria, is not addressed.

  3. Evolving "Diagnostic" Criteria for Axial Spondyloarthritis in the Context of Anterior Uveitis.

    PubMed

    Rosenbaum, James T

    2016-08-01

    Anterior uveitis is far more common than intermediate, posterior or panuveitis. About 50% of patients with acute anterior uveitis are HLA B27+. Those who are HLA B27+ are highly likely to have associated back, joint, or tendon disease. The majority of patients with acute anterior uveitis and inflammatory low back pain are suffering from axial spondyloarthritis and radiographic evidence for abnormal sacroiliac joints is not required to make this diagnosis. Received 12 October 2015; revised 31 January 2016; accepted 16 February 2016; published online 12 April 2016.

  4. Refining the Phenotype of Borderline Personality Disorder: Diagnostic Criteria and Beyond

    PubMed Central

    Hallquist, Michael N.; Pilkonis, Paul A.

    2013-01-01

    Borderline personality disorder (BPD) is a heterogeneous disorder, and previous analyses have parsed its phenotype in terms of subtypes or underlying traits. We refined the BPD construct by testing a range of latent variable models to ascertain whether BPD is composed of traits, latent classes, or both. We also tested whether subtypes of BPD could be distinguished by anger, aggressiveness, antisocial behavior, and mistrustfulness, additional putative indicators drawn from Kernberg’s (1967, 1975) theory of BPD. In a mixed clinical and nonclinical sample (n = 362), a factor mixture model consisting of two latent classes (symptomatic and asymptomatic) and a single severity dimension fit the DSM-IV BPD criteria data better than latent class or factor analytic approaches. In the second analytic phase, finite mixture modeling of the symptomatic latent class (n = 100) revealed four BPD subtypes: angry/aggressive, angry/mistrustful, poor identity/low anger, and prototypical. Our results support a hybrid categorical-dimensional model of the BPD DSM criteria. The BPD subtypes emerging from this model have important implications for treatment and etiological research. PMID:22823231

  5. Quality of laboratory studies assessing effects of Bt-proteins on non-target organisms: minimal criteria for acceptability.

    PubMed

    De Schrijver, Adinda; Devos, Yann; De Clercq, Patrick; Gathmann, Achim; Romeis, Jörg

    2016-08-01

    The potential risks that genetically modified plants may pose to non-target organisms and the ecosystem services they contribute to are assessed as part of pre-market risk assessments. This paper reviews the early tier studies testing the hypothesis whether exposure to plant-produced Cry34/35Ab1 proteins as a result of cultivation of maize 59122 is harmful to valued non-target organisms, in particular Arthropoda and Annelida. The available studies were assessed for their scientific quality by considering a set of criteria determining their relevance and reliability. As a case-study, this exercise revealed that when not all quality criteria are met, weighing the robustness of the study and its relevance for risk assessment is not obvious. Applying a worst-case expected environmental concentration of bioactive toxins equivalent to that present in the transgenic crop, confirming exposure of the test species to the test substance, and the use of a negative control were identified as minimum criteria to be met to guarantee sufficiently reliable data. This exercise stresses the importance of conducting studies meeting certain quality standards as this minimises the probability of erroneous or inconclusive results and increases confidence in the results and adds certainty to the conclusions drawn.

  6. Development of quantitative neuropsychological tests for diagnosis of subclinical hepatic encephalopathy in liver cirrhosis patients and establishment of diagnostic criteria-multicenter collaborative study in Japanese.

    PubMed

    Kato, Akinobu; Kato, Motoichiro; Ishii, Hiromasa; Ichimiya, Yosuke; Suzuki, Kazuyuki; Kawasaki, Hironaka; Yamamoto, Shin-Ichiro; Kumashiro, Ryukichi; Yamamoto, Kyosuke; Kawamura, Naohiro; Hayashi, Naoaki; Matsuzaki, Shohei; Terano, Akira; Okita, Kiwamu; Watanabe, Akiharu

    2004-10-01

    At present, there are no generally accepted diagnostic criteria or methods for subclinical hepatic encephalopathy (SHE) associated with liver cirrhosis. We therefore developed an easily conducted computer-aided quantitative neuropsychiatric function test system for use in routine medical practice. We established normal values in healthy Japanese subjects and determined differences between healthy persons and liver cirrhosis patients without clinical encephalopathy in a multi-center clinical trial. The test system consists of eight tests: number connection tests A and B, a figure position test, a digit symbol test, a block design test, and reaction time tests A, B and C. The test results were affected by age, but not by gender or facility. No learning effect was noted. The results were therefore reported by 5-year quartile ranges and differences were evaluated between 542 healthy subjects and 292 cirrhotic patients. When the cut-off value was set at the 10th/90th percentile of the results in healthy subjects, the results of each of the 8 tests were abnormal in about 25% of cirrhotic patients, and at least 1 of the 8 tests gave values greater than the 10th/90th percentile cut-off value in 58.2% of the 292 liver cirrhosis patients. SHE patients were thought to be included in these 58.2% of patients. The developed test makes it possible to quantitatively assess neuropsychiatric function, and the results obtained can be used as a basis for the diagnosis of SHE.

  7. Metabolic syndrome in overweight children from the city of Botucatu - São Paulo State - Brazil: agreement among six diagnostic criteria

    PubMed Central

    2010-01-01

    Background The metabolic syndrome has been described in children; however, a standard criterion has not been established for its diagnosis. Also, few studies have been conducted to specifically observe the possible existence of agreement among the existing diagnostic criteria. The purpose of the study is to evaluate agreement concerning prevalence rates of the metabolic syndrome diagnosed by six different criteria in overweight schoolchildren in the city of Botucatu - SP -Brazil. Methods This is a cross-sectional study on 128 overweight schoolchildren. Clinical examination included anthropometry, pubertal staging evaluation, and blood pressure. Triacylglycerol, glycemia, HDL-cholesterol, insulin levels, and HOMA-IR were determined. The Kappa index, the Mann-Whitney test and the chi-square test were used for statistical analysis. Results The prevalence of the metabolic syndrome varied from 10 to 16.5% according to different diagnostic criteria. Results were similar for boys and girls and pubertal stage. Great agreement was observed among the six different diagnostic criteria for the metabolic syndrome. Conclusions Different diagnostic criteria, when adopted for subjects with similar demographic characteristics, generate similar and compatible prevalence. Results suggest that it is possible to adopt any of the analyzed criteria, and the choice should be according to the components available for each situation. PMID:20529375

  8. Post craniotomy extra-ventricular drain (EVD) associated nosocomial meningitis: CSF diagnostic criteria.

    PubMed

    Muñoz-Gómez, Sigridh; Wirkowski, Elizabeth; Cunha, Burke A

    2015-01-01

    Because external ventricular drains (EVDs) provide access to cerebrospinal fluid (CSF), there is potential for EVD associated acute bacterial meningitis (EVD-AM). Post-craniotomy, in patients with EVDs, one or more CSF abnormalities are commonly present making the diagnosis of EVD-AM problematic. EVD-AM was defined as elevated CSF lactic acid (>6 nmol/L), plus CSF marked pleocytosis (>50 WBCs/mm(3)), plus a positive Gram stain (same morphology as CSF isolate), plus a positive CSF culture of neuropathogen (same morphology as Gram stained organism). We reviewed 22 adults with EVDs to determine if our four CSF parameters combined accurately identified EVD-AM. No single or combination of <4 CSF parameters correctly diagnosed or ruled out EVD-AM. Combined our four CSF parameters clearly differentiated EVD-AM from one case of pseudomeningitis due to E. cloacae. We conclude that our four CSF criteria combined are useful in diagnosing EVD-AM in adults.

  9. Unexpected post-mortem diagnosis of systemic sclerosis presenting as pneumatosis intestinalis: revised diagnostic criteria and medicolegal implications.

    PubMed

    Leduc, Charles; Young, Iain D; Joneja, Mala G; Parker, Christopher M

    2015-01-01

    Systemic sclerosis is a challenging diagnosis for clinicians and pathologists alike due to its protean manifestations and often insidious onset, particularly in cases without significant titres of auto-antibodies. Herein we present a case of a female in her sixties who died rapidly following a clinical diagnosis of pneumatosis intestinalis and respiratory failure of unclear etiology. Recently revised clinical diagnostic criteria were applied to the clinical history and postmortem findings to reach an unexpected diagnosis of systemic sclerosis. The diagnosis of systemic sclerosis at autopsy has important medicolegal implications largely related to premature death due to delayed treatment or poor post-operative outcome. Moreover, familial clustering of this disease underscores the importance of maintaining a high index of suspicion in the postmortem setting.

  10. Development of acceptance criteria for batches of silane primer for external tank thermal protection system bonding applications

    NASA Technical Reports Server (NTRS)

    Mikes, F.

    1985-01-01

    Fourier transform infrared spectroscopy is currently the best technique for observing hydrolytic changes in DC 1200 silane the primers caused by moisture in the atmosphere. To further prove that FTIR can be used as a criterion test for acceptance of silane primer lots, intensities of the FTIR OH- band are being compared with primer adhesive bond strength using a mechanical test suggested by NASA. Results of tests for shear strength and Oh-absorption are tabulated and compared with FTIR absorption intensities in the OH-region.

  11. [Diffuse idiopathic skeletal hyperostosis. Review of diagnostic criteria and analysis of 915 cases].

    PubMed

    Scutellari, P N; Orzincolo, C; Princivalle, M; Franceschini, F

    1992-06-01

    DISH is a common systemic skeletal disease, probably of dysmetabolic and/or degenerative origin, yet of unknown etiology. It is observed in middle-aged or elderly patients of both sexes, and is characterized by ossification of the anterior longitudinal ligament on the antero-lateral aspect of the spine, and by ossifying enthesopathy, in both the central and the peripheral skeleton. Diagnosis is solely based on radiographic abnormalities, according to the so-called Resnick criteria. In the present study, the spines of 915 patients (414 males, 501 females, mean age: 65 years) were considered, and the peripheral entheses (heel, patella and elbow) of 494 of them (234 males and 260 females). The incidence of DISH was 14.09% (129 cases): 17.6% in males (73 cases) and 11.7% in females (56 cases). DISH strikes in the VI and VII decades of life most. The most affected sites of the spine were: the dorsal portion (100%), especially in the D7-D11 segment (93%); the lumbar spine in L1-L3 (81%), and the cervical spine, in the C5-C7 segment (69%). Peripheral areas of involvement were: pelvis (90%), heel (76%), elbow (46%) and knee (29%). The symptoms of DISH must be promptly detected: the disease is not asymptomatic, but presents with pain and stiffness in the spine, recurrent tendinitis and bursitis, and myelopathy.

  12. Ventilator-associated pneumonias in children (I)--diagnostic criteria, etiology and pathogenesis.

    PubMed

    Yankov, Ivan V; Shmilev, Tonyo I

    2012-01-01

    Ventilator-associated pneumonias have been estimated to be the second most common nosocomial infections among children treated in intensive care units. They occur in mechanically ventilated patients through intubation tube or tracheostomy, the inflammation usually involving the lung parenchyma. The ventilator-associated pneumonia is associated with a longer antibiotic treatment, greater duration of mechanical ventilation (MV) and higher mortality rates in children. The condition is also associated with a higher cost of the treatment. This paper reviews and comments in detail the criteria formulated by the National Nosocomial Infection Surveillance (NNSI) and the Centers for Disease Control and Prevention (CDC) for diagnosis of ventilator-associated pneumonias in children. The disease etiology is associated with the typical causes of nosocomial infections in this age: P. aeruginosa, E. coli and K. pneumoniae. The pathogenesis of the condition is inadequately studied but the aspiration of gastric contents and immune deficiency are proven risk factors. Two mechanisms have a major role in the development of the disease--micro-aspiration of gastric contents and colonization of the lower airways with pathogens.

  13. Comparison of the Minnesota Percepto-Diagnostic Test and Bender-Gestalt: relationship with achievement criteria.

    PubMed

    Fuller, G B; Wallbrown, F H

    1983-11-01

    Administered the Bender-Gestalt (BG) and Minnesota Percepto-Diagnostic Test (MPD) to 69 first-grade children prior to administration of the California Achievement Test (CAT). Order of administration for the BG and MPD was counterbalanced to control for practice effects. Correlations (rs) were computed between the 9 CAT subtests and scores from the BG and MPD. The DD score from the MPD correlated significantly with all 9 CAT subtests. The SpCD score from the MPD correlated significantly with 6 of the 9 CAT subtests. The BG Koppitz score correlated significantly with 6 of the 9 CAT subtests. Both the DD and SpCD scores showed a significantly higher negative r with Reading Vocabulary, Total Reading, and Arithmetic Computation than the BG. Furthermore, both types of MPD scores showed a much higher average r with the 9 CAT subtests than was evident for the BG. These findings suggest that DD and SpCD scores from the MPD provide a more sensitive measure of deficits in visual-motor perception than the Koppitz score from the BG.

  14. Prepubertal periodontitis: a review of diagnostic criteria, pathogenesis, and differential diagnosis.

    PubMed

    Watanabe, K

    1990-01-01

    This paper reviews the literature on prepubertal periodontitis (PP) according to the definition and the classification of PP by Page. The generalized form of PP (G-PP) defined by Page was identified as the oral manifestation of a systemic disease called leukocyte adhesion deficiency (LAD) and thus the pathogenesis is known at the molecular level. On the other hand, the localized form of PP (L-PP) is a disease defined by clinical criteria and its pathogenesis is not known at the molecular level. The reported prevalence of L-PP differs widely in reports, according to the methodology and population studied. However, it seems to be at least 0.84% or greater. Potential periodontal pathogens that have been associated with L-PP include the following bacteria: Actinobacillus actinomycetemcomitans (A.a.), Bacteroides intermedius, Bacteroides gingivalis, Capnocytophaga sputigena, and Eikenella corrodens. Suggested contributing factors have included PMN or monocyte chemotactic defects and cementum defects. There is no unique pattern of bone loss in L-PP; however, there may be a type of periodontitis that affects all deciduous teeth, in the absence of LAD. L-PP may lead to localized juvenile periodontitis (LJP) or generalized juvenile periodontitis (GJP). Histiocytosis X, hypophosphatasia and mild forms of blood dyscrasias may have minimal or no clinical signs and symptoms except for alveolar bone loss. Therefore diseases known to be associated with alveolar bone loss must be definitively excluded in prepubertal children until the pathogenesis of L-PP at the cellular and molecular levels is understood and L-PP can be definitively diagnosed either as a distinct disease entity or entities.

  15. Data Quality Objectives and Criteria for Basic Information, Acceptable Uncertainty, and Quality-Assurance and Quality-Control Documentation

    USGS Publications Warehouse

    Granato, Gregory E.; Bank, Fred G.; Cazenas, Patricia A.

    1998-01-01

    The Federal Highway Administration and State transportation agencies have the responsibility of determining and minimizing the effects of highway runoff on water quality; therefore, they have been conducting an extensive program of water-quality monitoring and research during the last 25 years. The objectives and monitoring goals of highway runoff studies have been diverse, because the highway community must address many different questions about the characteristics and impacts of highway runoff. The Federal Highway Administration must establish that available data and procedures that are used to assess and predict pollutant loadings and impacts from highway stormwater runoff are valid, current, and technically supportable. This report examines criteria for evaluating water-quality data and resultant interpretations. The criteria used to determine if data are valid (useful for intended purposes), current, and technically supportable are derived from published materials from the Federal Highway Administration, the U.S. Environmental Protection Agency, the Intergovernmental Task Force on Monitoring Water Quality, the U.S. Geological Survey and from technical experts throughout the U.S. Geological Survey. Water-quality data that are documented to be meaningful, representative, complete, precise, accurate, comparable, and admissible as legal evidence will meet the scientific, engineering, and regulatory needs of highway agencies. Documentation of basic information, such as compatible monitoring objectives and program design features; metadata (when, where, and how data were collected as well as who collected and analyzed the data); ancillary information (explanatory variables and study-site characteristics); and legal requirements are needed to evaluate data. Documentation of sufficient quality-assurance and quality-control information to establish the quality and uncertainty in the data and interpretations also are needed to determine the comparability and utility of

  16. Utilizing current diagnostic criteria and treatment algorithms for managing type 2 diabetes mellitus.

    PubMed

    Kruger, Davida F; Boucher, Jackie L; Banerji, Mary Ann

    2011-07-01

    Within the past 2 years, the American Diabetes Association (ADA)/European Association for the Study of Diabetes (EASD) and the American Association of Clinical Endocrinologists (AACE)/American College of Endocrinology (ACE) have revised their guidelines for the diagnosis and treatment of type 2 diabetes mellitus (T2DM). Both organizations recommend a diagnostic glycated hemoglobin (HbA1c) of >6.5% (based on a new appreciation of the relationship between glycemia and complications) and fasting plasma glucose levels or an oral glucose tolerance test. Findings from major trials of glucose control in patients with T2DM and the approval of novel medications have prompted revised treatment algorithms from both organizations. While both treatment guidelines recommend starting metformin in most patients on diagnosis of T2DM, they differ in terms of the "trigger" for treatment intensification (HbA1c≥7% and >6.5%, respectively) and which agents are preferred as second-line therapies. The ADA/EASD recommends a tiered approach to treatment, starting with well-validated second-line agents, such as sulfonylureas and basal insulin for patients unable to achieve target glucose levels with metformin. The AACE/ACE recommendations are based on the patient's HbA1c level and include a broader range of first- and second-line therapies and combinations. In addition to metformin, the ACCE/ACE treatment algorithm includes dipeptidyl peptidase-4 inhibitors, glucagon-like peptide-1 agonists, thiazolidinediones, α-glucosidase inhibitors, sulfonylureas, and glinides. Both organizations advocate individualizing therapy to meet patient needs. This review highlights recent changes in the guidelines and uses a case-based format to illustrate how the current guidelines may be tailored to fit individual patient characteristics and circumstances.

  17. Update on pre-diabetes: Focus on diagnostic criteria and cardiovascular risk

    PubMed Central

    Di Pino, Antonino; Urbano, Francesca; Piro, Salvatore; Purrello, Francesco; Rabuazzo, Agata Maria

    2016-01-01

    Pre-diabetes, which is typically defined as blood glucose concentrations higher than normal but lower than the diabetes threshold, is a high-risk state for diabetes and cardiovascular disease development. As such, it represents three groups of individuals: Those with impaired fasting glucose (IFG), those with impaired glucose tolerance (IGT) and those with a glycated haemoglobin (HbA1c) between 39-46 mmol/mol. Several clinical trials have shown the important role of IFG, IGT and HbA1c-pre-diabetes as predictive tools for the risk of developing type 2 diabetes. Moreover, with regard to cardiovascular disease, pre-diabetes is associated with more advanced vascular damage compared with normoglycaemia, independently of confounding factors. In view of these observations, diagnosis of pre-diabetes is mandatory to prevent or delay the development of the disease and its complications; however, a number of previous studies reported that the concordance between pre-diabetes diagnoses made by IFG, IGT or HbA1c is scarce and there are conflicting data as to which of these methods best predicts cardiovascular disease. This review highlights recent studies and current controversies in the field. In consideration of the expected increased use of HbA1c as a screening tool to identify individuals with alteration of glycaemic homeostasis, we focused on the evidence regarding the ability of HbA1c as a diagnostic tool for pre-diabetes and as a useful marker in identifying patients who have an increased risk for cardiovascular disease. Finally, we reviewed the current evidence regarding non-traditional glycaemic biomarkers and their use as alternatives to or additions to traditional ones. PMID:27795816

  18. Diagnostic Criteria for the Characterization of Electrode Reactions with Chemically Coupled Reactions Preceding the Electron Transfer by Cyclic Square Wave Voltammetry.

    PubMed

    Helfrick, John C; Mann, Megan A; Bottomley, Lawrence A

    2016-08-18

    Theory for cyclic square wave voltammetry of electrode reactions with chemical reactions preceding the electron transfer is presented. Theoretical voltammograms were calculated following systematic variation of empirical parameters to assess their impact on the shape of the voltammogram. From the trends obtained, diagnostic criteria for this mechanism were deduced. When properly applied, these criteria will enable non-experts in voltammetry to assign the electrode reaction mechanism and accurately measure reaction kinetics.

  19. Establishment of design criteria for acceptable failure modes and fail safe considerations for the space shuttle structural system

    NASA Technical Reports Server (NTRS)

    Westrup, R. W.

    1972-01-01

    Investigations of fatigue life, and safe-life and fail-safe design concepts as applied to space shuttle structure are summarized. The results are evaluated to select recommended structural design criteria to provide assurance that premature failure due to propagation of undetected crack-like defects will not occur during shuttle operational service. The space shuttle booster, GDC configuration B-9U, is selected as the reference vehicle. Structural elements used as basis of detail analyses include wing spar caps, vertical stabilizer skins, crew compartment skin, orbiter support frame, and propellant tank shell structure. Fatigue life analyses of structural elements are performed to define potential problem areas and establish upper limits of operating stresses. Flaw growth analyses are summarized in parametric form over a range of initial flaw types and sizes, operating stresses and service life requirements. Service life of 100 to 500 missions is considered.

  20. Acceptance Criteria for Corrosion Resistance of Medical Devices: Statistical Analysis of Nitinol Pitting in In Vivo Environments

    NASA Astrophysics Data System (ADS)

    Eiselstein, Lawrence E.; Steffey, Duane; Nissan, Andrew; Corlett, Nigel; Dugnani, Roberto; Kus, Esra; Stewart, Sarah G.

    2009-08-01

    ASTM F 2129 test method nor the FDA provides any guidance as to what constitutes an acceptance criterion for the corrosion resistance of implantable medical devices. Neither provide any guidance on how many samples to test or how to handle censored data, i.e. datasets where there are only a few tests that breakdown. The development of both a statistically valid acceptance criterion for corrosion resistance and a method of evaluation would be of significant benefit to the medical device community. This study of 420 nitinol cyclic polarization tests, which builds on previous research that was presented at SMST 2007, investigates the effect of long-term exposure to simulated in vivo environments with differing degrees of aeration. This was accomplished by pre-exposing electropolished (EP) nitinol to phosphate buffered saline (PBS) at 37 °C that had been sparged with either ultra high purity nitrogen or laboratory air. Immersion times ranged from 1 h up to 30 days. A total of 290 EP samples were tested in order to obtain a reasonable number of samples with breakdown, i.e. pitted. In addition, a total of 130 mechanical polished (MP) samples were also analyzed. This data allow us to test our statistical model that was presented at SMST 2007. This model takes into account the probability of breakdown per unit of exposed surface area and, if breakdown occurs, predicts the probability that E b - E r is greater than some threshold value. Aerated PBS environments were found to have a large influence on the margin of safety against pitting in vivo. Statistical methods for treating highly right censored pitting data are presented.

  1. Multiple system atrophy presenting as parkinsonism: clinical features and diagnostic criteria.

    PubMed Central

    Albanese, A; Colosimo, C; Bentivoglio, A R; Fenici, R; Melillo, G; Colosimo, C; Tonali, P

    1995-01-01

    To evaluate the possibility that parkinsonian signs may be the only presenting feature of multiple system atrophy (MSA), parkinsonian patients were studied who had no atypical clinical signs and had no symptoms of autonomic dysfunction, but who reported that they had not experienced the anticipated good response to dopaminergic treatment. These stringent criteria identified 20 patients from a series of 298 consecutive parkinsonian outpatients. The following clinical pointers were analysed: (a) rate of disease progression; (b) symmetry of parkinsonian symptoms and signs; (c) occurrence of resting tremor during the first three years from onset. In addition, all patients underwent (d) acute and chronic challenge with dopaminergic drugs; (e) cardiovascular reflex autonomic function tests; (f) high field MRI. Rapid progression of disease was seen in 45% of patients, onset was symmetric in 25%, tremor was absent at onset in 70%, response to dopaminergic drug challenges was inadequate in 40%, abnormal cardiovascular reflexes occurred in 50%, and some abnormal MRI finding occurred in 35% of cases. Each of these features was equally weighted by giving to each patient a 0 to 6 point score corresponding to the number of abnormal findings. Fifteen patients scoring higher than 1 were considered at risk for having MSA: five of them were classified as clinically possible (score 2), six as clinically probable (score 3-4), and four patients were classified as clinically definite multiple system atrophy (score 5). The six pointers considered were variably combined in each patient, none of them being universally abnormal in patients with high scores. The patients were followed up for a mean 2.1 (SEM 0.65) years. All but one of the 10 patients prospectively classified as probable or definite MSA developed unequivocal clinical signs of fully symptomatic MSA. A receiver operator characteristic cure was plotted for the prospective score based on follow up diagnosis. The best compromise

  2. How do different diagnostic criteria, age and gender affect the prevalence of attention deficit hyperactivity disorder in adults? An epidemiological study in a Hungarian community sample.

    PubMed

    Bitter, István; Simon, Viktoria; Bálint, Sára; Mészáros, Agnes; Czobor, Pál

    2010-06-01

    The goal of the study was twofold: (1) to investigate the effect of different diagnostic criteria on prevalence estimates of adult attention deficit hyperactivity disorder (ADHD), and (2) to provide prevalence estimates of adult ADHD for the first time in a Hungarian sample. Subjects between 18 and 60 years were included in the screening phase of the study (N = 3,529), conducted in 17 GP practices in Budapest. Adult self-report scale 6-item version was used for screening. Out of 279 positively screened subjects 161 subjects participated in a clinical interview and filled out a self-report questionnaire to confirm the diagnosis. Beside DSM-IV diagnostic criteria, we applied four alternative diagnostic criteria: 'No-onset' (DSM-IV criteria without the specific requirement for onset); full/Sx (DSM-IV "symptoms only" criteria); and reduced/Sx (DSM-IV "symptoms only" criteria with a reduced threshold for symptom count). Crude prevalence estimates adjusted for the specificity and sensitivity data of the screener were 1.35% in the 'DSM-IV' group, 1.64% in the 'No-onset' group, 3.65% in the 'Sx/full' group and 4.16% in the 'Sx/reduced' group. Logistic regression analysis showed that ADHD was significantly more prevalent with younger age and male gender [chi(2) = 14.46; P = 0.0007]. Prevalence estimates corrected for the 'not-interviewed' subsample and adjusted for specificity and sensitivity data of the screener was 2.3% in males, 0.91% in females; 2.02% in the < or =40 years age group and 0.70% in the >40 years age group, based on DSM-IV diagnostic criteria. Prevalence rates found in this study are somewhat lower, but still are in line with those reported in the literature.

  3. Examining the Application of the DC-IA-A Diagnostic Criteria for Internet Addiction Disorder in At-Risk College Students.

    PubMed

    Hsu, Wen-Yu; Chang, Shan-Mei; Chiu, Nan-Ying; Lin, Sunny S J; Tseng, Yin-Hsing

    2015-01-01

    Internet addiction disorder is a relatively new condition, and the criteria for its diagnosis have been developed only over the last several years. The criteria for Internet addiction remain controversial. We strive to further elucidate the clinical validity of the diagnostic criteria for Internet addiction. To test items of the diagnostic criteria for Internet addiction among adolescents, we conducted a clinical interview study of college students based on longitudinal data on their risky use of the Internet. Forty-one high-risk cases were selected from a 3-year 5-time point longitudinal survey of 716 college freshmen. We examined disputes relevant to symptoms and impairment in the DC-IA-A (Diagnostic Criteria for Internet Addiction among Taiwanese Adolescents). Of the 41 cases, 21 were diagnosed with Internet addiction via a psychiatric interview. In the Internet addiction disorder group, 23.8% of cases had a diagnosis of depression, whereas only 15.0% of the cases in the non-Internet addiction group had a diagnosis of depression. Two major criteria (A8 and A3) had low incidences in these high-risk college students and thus did not help provide a differential diagnosis between the groups. We suggest that A8, 'excessive effort spent on activities necessary to obtain access to the Internet', should be omitted, and that A3, 'tolerance: a marked increase in the duration of Internet use needed to achieve satisfaction', should be modified. A1 and A9 should be discussed regarding their role in the diagnosis of Internet addiction disorder. Additional well-designed studies examining the diagnostic criteria and the relationship between factors are needed.

  4. Meta-Review of CSF Core Biomarkers in Alzheimer’s Disease: The State-of-the-Art after the New Revised Diagnostic Criteria

    PubMed Central

    Ferreira, Daniel; Perestelo-Pérez, Lilisbeth; Westman, Eric; Wahlund, Lars-Olof; Sarría, Antonio; Serrano-Aguilar, Pedro

    2014-01-01

    Background: Current research criteria for Alzheimer’s disease (AD) include cerebrospinal fluid (CSF) biomarkers into the diagnostic algorithm. However, spreading their use to the clinical routine is still questionable. Objective: To provide an updated, systematic and critical review on the diagnostic utility of the CSF core biomarkers for AD. Data sources: MEDLINE, PreMedline, EMBASE, PsycInfo, CINAHL, Cochrane Library, and CRD. Eligibility criteria: (1a) Systematic reviews with meta-analysis; (1b) Primary studies published after the new revised diagnostic criteria; (2) Evaluation of the diagnostic performance of at least one CSF core biomarker. Results: The diagnostic performance of CSF biomarkers is generally satisfactory. They are optimal for discriminating AD patients from healthy controls. Their combination may also be suitable for mild cognitive impairment (MCI) prognosis. However, CSF biomarkers fail to distinguish AD from other forms of dementia. Limitations: (1) Use of clinical diagnosis as standard instead of pathological postmortem confirmation; (2) variability of methodological aspects; (3) insufficiently long follow-up periods in MCI studies; and (4) lower diagnostic accuracy in primary care compared with memory clinics. Conclusion: Additional work needs to be done to validate the application of CSF core biomarkers as they are proposed in the new revised diagnostic criteria. The use of CSF core biomarkers in clinical routine is more likely if these limitations are overcome. Early diagnosis is going to be of utmost importance when effective pharmacological treatment will be available and the CSF core biomarkers can also be implemented in clinical trials for drug development. PMID:24715863

  5. Clinical spectrum, diagnostic criteria, and polymerase chain reaction of aqueous humor in viral and toxoplasma detection in Fuchs’ uveitis syndrome

    PubMed Central

    Sabhapandit, Swapnali; Murthy, Somasheila I; Balne, Praveen K; Sangwan, Virender Singh; Sumanth, V; Reddy, Ashok K

    2016-01-01

    Aim: The aim of this study is to describe the clinical features and diagnostic criteria of Fuchs’ uveitis (FU) and to determine whether it has an association with virus and toxoplasma in the aqueous humor during cataract surgery. Setting and Design: This is a prospective, case–control study. Materials and Methods: Patients with FU (n = 25), anterior uveitis (n = 15), and no uveitis (normal) (n = 50) were included based on predefined inclusion and exclusion criteria for all three groups. Polymerase chain reaction (PCR) of aqueous humor and serum for rubella, herpes simplex virus (HSV), cytomegalovirus (CMV), varicella-zoster virus (VZV), and toxoplasma was done using conventional uniplex PCR. Statistical Analysis: It was done using SPSS software using Chi-square test for categorical variables, and P < 0.05 was considered statistically significant. Results: Ninety patients were enrolled in the study in three groups, comparable for age, gender, and laterality of ocular involvement. All patients had diffuse keratic precipitates in FU group (P = 0001) with none having posterior synechiae (P = 0.046) which was statistically significant when compared to anterior uveitis patients. Iris nodules were noted in one case in both groups. Serum and aqueous PCR was negative for detection of VZV, CMV, toxoplasma, and rubella in all groups. PCR for HSV was positive in one patient in “normal” group but was not statistically significant. Conclusion: Our study shows that diagnosis of FU is mainly clinical. There appears to be no role of aqueous humor testing for viruses by PCR to aid in etiological diagnosis. PMID:27688274

  6. Examining vulnerability to smokeless tobacco use among adolescents and adults meeting diagnostic criteria for major depressive disorder.

    PubMed

    Redner, Ryan; White, Thomas J; Harder, Valerie S; Higgins, Stephen T

    2014-08-01

    Smoking prevalence is unevenly distributed in the U.S. population, with those with mental illness, other substance use disorders, and lower socioeconomic status being especially vulnerable. Less research has been conducted on the association between these same vulnerabilities and smokeless tobacco (ST) use. The present study examined cigarette and ST use among adolescents and adults who met diagnostic criteria for major depressive disorder in the National Survey on Drug Use and Health (NSDUH). Utilizing the most recent (2011) NSDUH, we compared odds for current cigarette smoking and ST use among adolescents and adults meeting criteria for past-year major depressive disorder to the general population, after adjusting for potential confounding influences of sociodemographic and other substance use characteristics. Analyses were conducted to examine sex as a moderator of the relation between major depressive disorder and tobacco use. Odds for current cigarette smoking among those classified with major depressive disorder were increased among adolescents (OR = 1.33, 95% CI [1.05, 1.69], p = .021) and adults (OR = 1.70, 95% CI [1.47, 1.97], p < .0005), and odds for current ST use did not differ among adolescents (OR = 0.90, 95% CI [0.54, 1.49], p = .678) and were lower among adults (OR = 0.68, 95% CI [0.51, 0.91], p = .010). Sex was not a significant moderator in adolescents or adults. Major depressive disorder is associated with increased risk for smoking but not ST use among adolescents and adults further demonstrating heterogeneity in predictors of vulnerability to use of different tobacco products.

  7. PIK3CA-related overgrowth spectrum (PROS): diagnostic and testing eligibility criteria, differential diagnosis, and evaluation.

    PubMed

    Keppler-Noreuil, Kim M; Rios, Jonathan J; Parker, Victoria E R; Semple, Robert K; Lindhurst, Marjorie J; Sapp, Julie C; Alomari, Ahmad; Ezaki, Marybeth; Dobyns, William; Biesecker, Leslie G

    2015-02-01

    Somatic activating mutations in the phosphatidylinositol-3-kinase/AKT/mTOR pathway underlie heterogeneous segmental overgrowth phenotypes. Because of the extreme differences among patients, we sought to characterize the phenotypic spectrum associated with different genotypes and mutation burdens, including a better understanding of associated complications and natural history. Historically, the clinical diagnoses in patients with PIK3CA activating mutations have included Fibroadipose hyperplasia or Overgrowth (FAO), Hemihyperplasia Multiple Lipomatosis (HHML), Congenital Lipomatous Overgrowth, Vascular Malformations, Epidermal Nevi, Scoliosis/Skeletal and Spinal (CLOVES) syndrome, macrodactyly, Fibroadipose Infiltrating Lipomatosis, and the related megalencephaly syndromes, Megalencephaly-Capillary Malformation (MCAP or M-CM) and Dysplastic Megalencephaly (DMEG). A workshop was convened at the National Institutes of Health (NIH) to discuss and develop a consensus document regarding diagnosis and treatment of patients with PIK3CA-associated somatic overgrowth disorders. Participants in the workshop included a group of researchers from several institutions who have been studying these disorders and have published their findings, as well as representatives from patient-advocacy and support groups. The umbrella term of "PIK3CA-Related Overgrowth Spectrum (PROS)" was agreed upon to encompass both the known and emerging clinical entities associated with somatic PIK3CA mutations including, macrodactyly, FAO, HHML, CLOVES, and related megalencephaly conditions. Key clinical diagnostic features and criteria for testing were proposed, and testing approaches summarized. Preliminary recommendations for a uniform approach to assessment of overgrowth and molecular diagnostic testing were determined. Future areas to address include the surgical management of overgrowth tissue and vascular anomalies, the optimal approach to thrombosis risk, and the testing of potential

  8. Metabolic syndrome a widespread threatening condition; risk factors, diagnostic criteria, therapeutic options, prevention and controversies: an overview.

    PubMed

    Amihăesei, Ioana Cristina; Chelaru, Liliana

    2014-01-01

    Metabolic syndrome diagnostic criteria include at least three of five of the following medical conditions: abdominal obesity, high blood pressure, abnormal high fasting plasma glucose, elevated serum triglycerides and low HDL (high-density cholesterol) level. Sedentary, overweight and obesity are characteristically associated with the syndrome, nevertheless there are new studies which indicate that chronic stress, through deregulation of the hypothalamic-pituitary-adrenal (HPA) axis is also involved in the development of the syndrome. Metabolic syndrome represents a significant risk for the development of the cardiovascular diseases. New studies in the USA have estimated its prevalence at approximately 34% of the adult population and its prevalence is increasing with age. Diagnosis guidelines are establishing the metabolic syndrome diagnostic when are met three of the following five conditions: fasting glucose > or = 100 mg/dL or type 2 diabetes receiving drug therapy for hyperglycemia; high blood pressure > or = 130/85 mm Hg or high blood pressure receiving drug therapy; triglycerides > or =150 mg/dL or treatment for plasma hyper-triglyceride value; HDL-C < 40 mg/dL in men and < 50 mg/dL in women or if under therapy for reduced HDL-C levels and waist circumference of > or = 102 cm in men and > or = 88 cm in women. Besides important change of lifestyle, often drug therapy is needed (diuretics and ACE inhibitors, cholesterol drugs and weight loss medications). The value of physical activity and diet in prevention and treatment of the syndrome is supported by numerous studies. Association of metabolic syndrome and cardiovascular risk is still a matter of controversy, in what concerns the lack of significant cardiovascular risk in the case of obesity itself without metabolic syndrome.

  9. Assessment of Generalized Anxiety Disorder Diagnostic Criteria in the National Comorbidity Survey and Virginia Adult Twin Study of Psychiatric and Substance Use Disorders

    ERIC Educational Resources Information Center

    Kubarych, Thomas S.; Aggen, Steven H.; Hettema, John M.; Kendler, Kenneth S.; Neale, Michael C.

    2008-01-01

    The authors investigated measurement properties of the "Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition," generalized anxiety disorder (GAD) criteria in the National Comorbidity Survey and the Virginia Adult Twin Study of Psychiatric and Substance Use Disorders (VATSPSUD). The two studies used different widely used…

  10. A proposal for the use of uniform diagnostic criteria for gestational diabetes in Europe: an opinion paper by the European Board & College of Obstetrics and Gynaecology (EBCOG).

    PubMed

    Benhalima, Katrien; Mathieu, Chantal; Damm, Peter; Van Assche, André; Devlieger, Roland; Desoye, Gernot; Corcoy, Rosa; Mahmood, Tahir; Nizard, Jacky; Savona-Ventura, Charles; Dunne, Fidelma

    2015-07-01

    Screening and diagnostic criteria for gestational diabetes (GDM) are inconsistent across Europe, and the development of a uniform GDM screening strategy is necessary. Such a strategy would create opportunities for more women to receive timely treatment for GDM. Developing a consensus on screening for GDM in Europe is challenging, as populations are diverse and healthcare delivery systems also differ. The European Board & College of Obstetrics and Gynaecology (EBCOG) has responded to this challenge by appointing a steering committee, including members of the EBCOG and the Diabetic Pregnancy Study Group (DPSG) associated with the EASD, to develop a proposal for the use of uniform diagnostic criteria for GDM in Europe. A proposal has been developed and has now been approved by the Council of the EBCOG. The current proposal is to screen for overt diabetes at the first prenatal contact using cut-off values for diabetes outside pregnancy, with particular efforts made to screen high-risk groups. When screening for GDM is performed at 24 weeks' gestation or later, the proposal is now to use the 75 g OGTT with the new WHO diagnostic criteria for GDM. However, more research is necessary to evaluate the best GDM screening strategy for different populations in Europe. Therefore, no clear recommendation has been made on whether a universal one-step, two-step or a risk-factor-based screening approach should be used. The use of the same WHO diagnostic GDM criteria across Europe will be an important step towards uniformity.

  11. An Investigation of Adherence to Diagnostic Criteria, Revisited: Clinical Diagnosis of the DSM-IV/DSM-5 Section II Personality Disorders.

    PubMed

    Morey, Leslie C; Benson, Kathryn T

    2016-02-01

    In an initial investigation by Morey and Ochoa (1989), adherence to DSM-III personality disorder diagnostic criteria was examined as an agreement rate between clinician (global) diagnoses and diagnoses algorithmically generated from DSM-III criteria rules. Morey and Ochoa (1989) findings suggested significant clinician-criterion diagnostic incongruity, a result that cross-validated in a DSM-III-R replication performed by Blashfield and Herkov (1996). The current study examined such adherence, utilizing DSM-IV decision rules, in a national sample of 337 clinicians and their target patients. The results of the current study are largely consistent with the earlier findings, with clinician-criterion agreement rates comparable to those commonly reported for interdiagnostician reliability. Ramifications for the future of personality disorder diagnostic classification are discussed.

  12. Impact of obesity on the psychometric properties of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for major depressive disorder.

    PubMed

    Zimmerman, Mark; Hrabosky, Joshua I; Francione, Caren; Young, Diane; Chelminski, Iwona; Dalrymple, Kristy; Galione, Janine N

    2011-01-01

    Obesity is associated with several symptoms that are components of the diagnostic criteria for major depressive disorder (MDD). Compared with nonobese individuals, obese individuals report more fatigue, sleep disturbance, and overeating. Obesity might, therefore, impact the psychometric properties of the MDD criteria. The goal of the present report from the Rhode Island Hospital Methods to Improve Diagnostic Assessment and Services project was to examine the impact of obesity on the psychometric characteristics of the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition symptom criteria for major depression. Two thousand four hundred forty-eight psychiatric outpatients were administered a semistructured diagnostic interview. We inquired about all symptoms of depression for all patients. The mean sensitivity of the 9 criteria in the nonobese and obese patients was nearly identical (74.6% vs 74.3%). The mean specificity was slightly higher in the nonobese patients (82.0% vs 79.5%). No symptom was more specific in the obese than the nonobese patients, whereas the specificity of increased appetite, increased weight, and fatigue was more than 5% lower in the obese patients. Increased appetite, increased weight, hypersomnia, and fatigue had a higher sensitivity in the obese than the nonobese patients, whereas decreased appetite, weight loss, and diminished concentration had a higher sensitivity in the nonobese than the obese patients. Thus, although there were small differences between obese and nonobese patients in the operating characteristics of some symptoms, the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria for MDD generally performed equally well for obese and nonobese patients.

  13. Genetic predisposition to peripheral nerve neoplasia: diagnostic criteria and pathogenesis of neurofibromatoses, Carney complex, and related syndromes.

    PubMed

    Rodriguez, Fausto J; Stratakis, Constantine A; Evans, D Gareth

    2012-03-01

    Neoplasms of the peripheral nerve sheath represent essential clinical manifestations of the syndromes known as the neurofibromatoses. Although involvement of multiple organ systems, including skin, central nervous system, and skeleton, may also be conspicuous, peripheral nerve neoplasia is often the most important and frequent cause of morbidity in these patients. Clinical characteristics of neurofibromatosis type 1 (NF1) and neurofibromatosis type 2 (NF2) have been extensively described and studied during the last century, and the identification of mutations in the NF1 and NF2 genes by contemporary molecular techniques have created a separate multidisciplinary field in genetic medicine. In schwannomatosis, the most recent addition to the neurofibromatosis group, peripheral nervous system involvement is the exclusive (or almost exclusive) clinical manifestation. Although the majority of cases of schwannomatosis are sporadic, approximately one-third occur in families and a subset of these has recently been associated with germline mutations in the tumor suppressor gene SMARCB1/INI1. Other curious syndromes that involve the peripheral nervous system are associated with predominant endocrine manifestations, and include Carney complex and MEN2b, secondary to inactivating mutations in the PRKAR1A gene in a subset, and activating mutations in RET, respectively. In this review, we provide a concise update on the diagnostic criteria, pathology and molecular pathogenesis of these enigmatic syndromes in relation to peripheral nerve sheath neoplasia.

  14. Consensus on the integrated traditional Chinese and Western medicine criteria of diagnostic classification in polycystic ovary syndrome (draft).

    PubMed

    Yu, Jin; Yu, Chao-Qin; Cao, Qi; Wang, Li; Wang, Wen-Jun; Zhou, Li-Rong; Li, Jing; Qian, Qiao-Hong

    2017-03-01

    Polycystic ovary syndrome (PCOS) is the most common endocrine and metabolic disorder of women, with complex pathogenesis and heterogeneous manifestations. Professor Jin Yu recently wrote an article entitled "Proposal of Diagnosis and Diagnostic Classification of PCOS in Integrated Traditional Chinese and Western Medicine."From this, the Obstetrics and Gynecology branches of the Chinese Association of Integrative Medicine and the China Association of Chinese Medicine collaborated with the Gynecology branch of the Chinese Association for Research and Advancement of Chinese Medicine to draft a report on the consensus of criteria for the diagnosis and classification of PCOS in integrated traditional Chinese and Western medicine. The diagnosis for PCOS includes all three features: (1) oligo-ovulation or anovulation; (2) clinical and/or laboratory evidence of hyperandrogenism;(3) PCOS is classified into four types: types Ia,Ib, IIa, and IIb. Syndrome differentiation types for PCOS in traditional Chinese medicine are as follows: Kidney deficiency with phlegm blockage syndrome, Kidney Yin deficiency with phlegm blockage and blood stasis syndrome, and Kidney deficiency with Liver Qi stagnation syndrome.

  15. Redefining dermatomyositis: a description of new diagnostic criteria that differentiate pure dermatomyositis from overlap myositis with dermatomyositis features.

    PubMed

    Troyanov, Yves; Targoff, Ira N; Payette, Marie-Pier; Raynauld, Jean-Pierre; Chartier, Suzanne; Goulet, Jean-Richard; Bourré-Tessier, Josiane; Rich, Eric; Grodzicky, Tamara; Fritzler, Marvin J; Joyal, France; Koenig, Martial; Senécal, Jean-Luc

    2014-11-01

    cutaneous score and chronicity. Concurrent heliotrope rash and Gottron papules (positive predictive value [PPV] 91%), as well as the V-sign and/or shawl sign (PPV 100%), were diagnostic of pure DM. Anti-Mi-2, anti-MJ, and anti-p155 autoantibodies were present in 50% of pure DM patients and were restricted to this subset (PPV 100%). Cancer was present in 21% of pure DM patients. The 15-year survival was excellent (92%).In contrast, in patients with OMDM, the first manifestation was proximal muscle weakness or other skeletal muscle-related complaints. The DM rash appeared at diagnosis or at follow-up, was associated with a low cutaneous extent score and was transient. Adermatopathic DM, which was absent in pure DM, was highly predictive (PPV 100%) of OMDM. Overlap autoantibodies (including anti-Jo-1, anti-PL-7, anti-PM-Scl, anti-U1RNP, and/or anti-U5-RNP) were found in 70% of OMDM patients. OMDM was not associated with cancer, but the 15-year survival was significantly decreased (65%).Perifascicular atrophy occurred as commonly in OMDM (n = 6/20, 30%) as in pure DM (n = 4/24, 17%) patients. These 6 OMDM patients had adermatopathic DM at myositis diagnosis, and only 1 of them developed a DM rash at follow-up, emphasizing the lack of specificity of perifascicular atrophy for pure DM.In conclusion, using the modified Bohan and Peter classification of AIM allowed identification of OMDM, a new clinical subset of OM. Furthermore, identification of OMDM allowed recognition of pure DM as a new entity that was distinct from OMDM or from OM without DM features. However, the absolute specificity of a DM rash and perifascicular muscle atrophy for the diagnosis of pure DM was lost. The distinctive clinical manifestations and autoantibody profiles presented are proposed as diagnostic criteria to differentiate pure DM from OMDM.

  16. The Prevalence and Symptoms Characteristic of Functional Constipation Using Rome III Diagnostic Criteria among Tertiary Education Students

    PubMed Central

    2016-01-01

    Background and Aims Functional constipation is very common with heterogeneous symptoms that have substantial impact on patient quality of life as well as medical resources which are rarely reported as life-threatening. The aim of this study is to examine the prevalence and symptoms characteristic of functional constipation (FC) by using Rome III diagnostic criteria among tertiary education students with an intention to introduce treatment in the future. Methods Demographic, socio-economics characteristics and symptoms of FC using the Rome III criteria were sought using a questionnaire administered to Malaysian students in a tertiary education setting. Other data obtained were the general health status, lifestyle factors and anthropometric measurements. Using a simple random sampling method, a total of 1662 students were recruited in the study with a response rate of 95.0%. Sampled data are presented as frequency and percentage and stratified accordingly into categories for Chi-square analysis. Results The prevalence of functional constipation among the students was 16.2%, with a significantly higher prevalence among women (17.4%) than men (12.5%). Hard or lumpy stool, incomplete evacuation, anorectal obstruction and straining were reported as the commonest symptoms experienced. Type 3 was the most frequent stool consistency experienced among the constipated individuals (35.2%). Only 4.4% of individuals reported having less than three defecations per week. Using univariable analysis, FC was significantly associated with sex (odds ratio: 1.48, 95% CI: 1.06–2.06) and age group (odds ratio: 1.34, 95% CI: 1.01–1.79) with P value < 0.05 significance level. In multivariate logistic regression analysis, only sex was found significantly associated with FC (adjusted odds ratio: 1.53, 95% CI: 1.08–2.17, P < 0.05). Conclusions Based on the prevalence rate, constipation is a common problem among tertiary education students (16.2%), with significantly more prevalence among

  17. Gender Incongruence of Adolescence and Adulthood: Acceptability and Clinical Utility of the World Health Organization’s Proposed ICD-11 Criteria

    PubMed Central

    Beek, Titia F.; Cohen-Kettenis, Peggy T.; Bouman, Walter P.; de Vries, Annelou L. C.; Steensma, Thomas D.; Witcomb, Gemma L.; Arcelus, Jon; Richards, Christina; Elaut, Els; Kreukels, Baudewijntje P. C.

    2016-01-01

    The World Health Organization (WHO) is currently updating the tenth version of their diagnostic tool, the International Classification of Diseases (ICD, WHO, 1992). Changes have been proposed for the diagnosis of Transsexualism (ICD-10) with regard to terminology, placement and content. The aim of this study was to gather the opinions of transgender individuals (and their relatives/partners) and clinicians in the Netherlands, Flanders (Belgium) and the United Kingdom regarding the proposed changes and the clinical applicability and utility of the ICD-11 criteria of ‘Gender Incongruence of Adolescence and Adulthood’ (GIAA). A total of 628 participants were included in the study: 284 from the Netherlands (45.2%), 8 from Flanders (Belgium) (1.3%), and 336 (53.5%) from the UK. Most participants were transgender people (or their partners/relatives) (n = 522), 89 participants were healthcare providers (HCPs) and 17 were both healthcare providers and (partners/relatives of) transgender people. Participants completed an online survey developed for this study. Most participants were in favor of the proposed diagnostic term of ‘Gender Incongruence’ and thought that this was an improvement on the ICD-10 diagnostic term of ‘Transsexualism’. Placement in a separate chapter dealing with Sexual- and Gender-related Health or as a Z-code was preferred by many and only a small number of participants stated that this diagnosis should be excluded from the ICD-11. In the UK, most transgender participants thought there should be a diagnosis related to being trans. However, if it were to be removed from the chapter on “psychiatric disorders”, many transgender respondents indicated that they would prefer it to be removed from the ICD in its entirety. There were no large differences between the responses of the transgender participants (or their partners and relatives) and HCPs. HCPs were generally positive about the GIAA diagnosis; most thought the diagnosis was clearly

  18. Neuroimaging in the Differential Diagnosis of Primary Progressive Aphasia – Illustrative Case Series in the Light of New Diagnostic Criteria

    PubMed Central

    Sitek, Emilia J.; Narożańska, Ewa; Brockhuis, Bogna; Muraszko-Klaudel, Anna; Lass, Piotr; Harciarek, Michał; Sławek, Jarosław

    2014-01-01

    Summary Background Primary progressive aphasia (PPA) is a progressive language disorder associated with atrophy of the dominant language hemisphere, typically left. Current PPA criteria divide PPA into three variants: non-fluent (nfvPPA), semantic (svPPA) and logopenic (lvPPA). The classification of PPA into one of the three variants may be performed at 3 levels: I) clinical, II) imaging-supported, III) definite pathologic diagnosis. This paper aimed at assessing the feasibility of the imaging-supported diagnostics of PPA variants in the Polish clinical setting with access to magnetic resonance imaging (MRI) and single-photon emission computed tomography (SPECT) examinations. Case Report We present the clinical and neuroimaging data on 6 patients (4 women, 2 men) clinically diagnosed with PPA (3 with nfvPPA and 3 with lvPPA) in whom MRI and SPECT were performed in order to determine if imaging-supported diagnosis could be established in those cases. In 4 individuals (2 with nfvPPA and 2 with lvPPA) clinical diagnosis was supported by neuroimaging (SPECT, albeit not MRI), thus level II of PPA diagnosis could be established in those cases. MRI results were either inconsistent with the clinical diagnosis (Patients 1 and 2) or a mixed pattern of atrophy was observed (Patients 3–6). Conclusions Imaging-supported diagnosis of PPA variant is more feasible with quantitative analysis of SPECT images than with purely qualitative visual analysis of MRI. Hypoperfusion abnormalities evidenced by SPECT are more variant-specific than patterns of atrophy. PMID:25343001

  19. Does customer information fulfill MEDDEV criteria in cases of product problems of in vitro diagnostics for infection testing?

    PubMed

    Hannig, Jürgen; Siekmeier, Rüdiger

    2015-01-01

    The European Directive 98/79/EC on in vitro diagnostics (IVD) regulates marketing and post market surveillance of IVD in the European Economic Area. In cases of incidents and field safety corrective actions (FSCA) manufacturers have to inform responsible competent authority (CA) and public by field safety notices (FSN). We analyzed FSCA and FSN of IVD for infection testing (culture media, reagents, kits, control materials, as well as culture-based analyzers and their general consumables) published by the Federal Institute for Drugs and Medical Devices (BfArM) in Bonn, Germany in 2005-2012 in regard to the European Regulatory Framework of Medical Devices (MEDDEV). One hundred and sixty-nine FSCA were published and German and English FSN were found in 157 and 154 cases, respectively. FSN were clearly characterized as FSN in 110 German and 134 English cases and product names were provided in 157 and 154 cases, respectively. Lot numbers and other information for product characterization were available in 146 and 137 cases, respectively. The information regarding FSCA and product malfunction was provided in 157 and 151 and 144 and 136 cases and that regarding the product related risks with continued use of affected IVD in 116 and 116 cases, respectively. In 156 German and 152 English cases, manufacturers provided the information for risk mitigation, including retesting in 69 and 75 cases, respectively. Requests to pass FSN to persons needing awareness were found in 108 and 87 cases, and contact data were provided in 127 and 131 cases, respectively. We conclude that most FSN fulfilled the MEDDEV criteria. However, type and content of FSN should be improved to ensure a better mitigation of risks due to product failure.

  20. Assessing Acceptability of a Diagnostic and Malaria Treatment Package Delivered by Community Health Workers in Malaria-Endemic Settings of Burkina Faso, Nigeria, and Uganda

    PubMed Central

    Jegede, Ayodele S.; Oshiname, Frederick O.; Sanou, Armande K.; Nsungwa-Sabiiti, Jesca; Ajayi, IkeOluwapo O.; Siribié, Mohamadou; Afonne, Chinenye; Sermé, Luc; Falade, Catherine O.

    2016-01-01

    Background. The efficacy of artemisinin-based combination therapy (ACT) and rectal artesunate for severe malaria in children is proven. However, acceptability of a package of interventions that included use of malaria rapid diagnostic tests (RDTs), ACTs, and rectal artesunate when provided by community health workers (CHWs) is uncertain. This study assessed acceptability of use of CHWs for case management of malaria using RDTs, ACTs, and rectal artesunate. Methods. The study was carried out in Burkina Faso, Nigeria, and Uganda in 2015 toward the end of an intervention using CHWs to provide diagnosis and treatment. Focus group discussions (FGDs) and key informant interviews (KIIs) were conducted with parents of sick children, community leaders, and health workers to understand whether they accepted the package for case management of malaria using CHWs. Transcripts from FGDs and KII recordings were analyzed using content analysis. The findings were described, interpreted, and reported in the form of narratives. Results. Treatment of malaria using the CHWs was acceptable to caregivers and communities. The CHWs were perceived to be accessible, diligent, and effective. There were no physical, social, or cultural barriers to accessing the CHWs’ services. Respondents were extremely positive about the intervention and were concerned that CHWs had limited financial and nonfinancial incentives that would reduce their motivation and willingness to continue. Conclusions. Treatment of malaria using CHWs was fully accepted. CHWs should be compensated, trained, and well supervised. Clinical Trials Registration. ISRCTN13858170. PMID:27941109

  1. Revising the personality disorder diagnostic criteria for the Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (DSM-V): consider the later life context.

    PubMed

    Balsis, Steve; Segal, Daniel L; Donahue, Cailin

    2009-10-01

    The categorical measurement approach implemented by the Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition (DSM-IV) personality disorder (PD) diagnostic system is theoretically and pragmatically limited. As a result, many prominent psychologists now advocate for a shift away from this approach in favor of more conceptually sound dimensional measurement. This shift is expected to improve the psychometric properties of the personality disorder (PD) diagnostic system and make it more useful for clinicians and researchers. The current article suggests that despite the probable benefits of such a change, several limitations will remain if the new diagnostic system does not closely consider the context of later life. A failure to address the unique challenges associated with the assessment of personality in older adults likely will result in the continued limited validity, reliability, and utility of the Diagnostic and Statistical Manual of Mental Disorders (DSM) system for this growing population. This article discusses these limitations and their possible implications.

  2. An Update on Neurofibromatosis Type 1: Not Just Café-au-Lait Spots, Freckling, and Neurofibromas. An Update. Part I. Dermatological Clinical Criteria Diagnostic of the Disease.

    PubMed

    Hernández-Martín, A; Duat-Rodríguez, A

    2016-01-01

    Neurofibromatosis type 1 (NF1) is the most common neurocutaneous syndrome and probably the one best known to dermatologists, who are generally the first physicians to suspect its diagnosis. Although the genetic locus of NF1 was identified on chromosome 17 in 1987, diagnosis of the disease is still mainly based on clinical observations and the diagnostic criteria of the National Institute of Health, dating from 1988. Cutaneous manifestations are particularly important because café-au-lait spots, freckling on flexural areas, and cutaneous neurofibromas comprise 3 of the 7 clinical diagnostic criteria. However, café-au-lait spots and freckling can also be present in other diseases. These manifestations are therefore not pathognomonic and are insufficient for definitive diagnosis in the early years of life. NF1 is a multisystemic disease associated with a predisposition to cancer. A multidisciplinary follow-up is necessary and dermatologists play an important role.

  3. REGIONAL DATABASE FOR WATERSHED CLASSIFICATION, NUTRIENT-RESPONSE RELATIONSHIPS, AND DIAGNOSTIC INDICATORS IN SUPPORT OF NUTRIENT CRITERIA DEVELOPMENT

    EPA Science Inventory

    USEPA has published recommended nutrient criteria for streams as a starting point for protecting surface water resources and is encouraging states/tribes to refine the proposed nutrient criteria, with help from EPA's Regional offices. . . In cooperation with EPA's Office of Envir...

  4. Opioid-use disorder among patients on long-term opioid therapy: impact of final DSM-5 diagnostic criteria on prevalence and correlates

    PubMed Central

    Boscarino, Joseph A; Hoffman, Stuart N; Han, John J

    2015-01-01

    Aims Previously, we estimated the prevalence and risk factors for prescription opioid-use disorder among outpatients on opioid therapy using the Diagnostic and Statistical Manual of Mental Disorders (DSM)-5 and DSM-4 criteria. However, at the time, the DSM-5 criteria were not finalized. In the current study, we analyzed these data using the final DSM-5 criteria and compared these results. Methods Using electronic records from a large US health care system, we identified outpatients receiving five or more prescription orders for opioid therapy in the past 12 months for noncancer pain (mean prescription orders =10.72; standard deviation =4.96). In 2008, we completed diagnostic interviews with 705 of these patients using the DSM-4 criteria. In the current study, we reassessed these results using the final DSM-5 criteria. Results The lifetime prevalence of DSM-5 opioid-use disorders using the final DSM-5 criteria was 58.7% for no or few symptoms (<2), 28.1% for mild symptoms (2–3), 9.7% for moderate symptoms (4–5), and 3.5% for severe symptoms (six or more). Thus, the lifetime prevalence of “any” prescription opioid-use disorder in this cohort was 41.3% (95% confidence interval [CI] =37.6–45.0). A comparison to the DSM-4 criteria indicated that the majority of patients with lifetime DSM-4 opioid dependence were now classified as having mild opioid-use disorder, based on the DSM-5 criteria (53.6%; 95% CI =44.1–62.8). In ordinal logistic regression predicting no/few, mild, moderate, and severe opioid-use disorder, the best predictors were age <65 years, current pain impairment, trouble sleeping, suicidal thoughts, anxiety disorders, illicit drug use, and history of substance abuse treatment. Conclusion Given the final DSM-5 criteria, including the elimination of tolerance and withdrawal, inclusion of craving and abuse symptoms, and introduction of a new graded severity classification, the prevalence of opioid-use disorders has changed, while many of the DSM-4

  5. Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) for Clinical and Research Applications: Recommendations of the International RDC/TMD Consortium Network* and Orofacial Pain Special Interest Group†

    PubMed Central

    Schiffman, Eric; Ohrbach, Richard; Truelove, Edmond; Look, John; Anderson, Gary; Goulet, Jean-Paul; List, Thomas; Svensson, Peter; Gonzalez, Yoly; Lobbezoo, Frank; Michelotti, Ambra; Brooks, Sharon L.; Ceusters, Werner; Drangsholt, Mark; Ettlin, Dominik; Gaul, Charly; Goldberg, Louis J.; Haythornthwaite, Jennifer A.; Hollender, Lars; Jensen, Rigmor; John, Mike T.; De Laat, Antoon; de Leeuw, Reny; Maixner, William; van der Meulen, Marylee; Murray, Greg M.; Nixdorf, Donald R.; Palla, Sandro; Petersson, Arne; Pionchon, Paul; Smith, Barry; Visscher, Corine M.; Zakrzewska, Joanna; Dworkin, Samuel F.

    2015-01-01

    Aims The original Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) Axis I diagnostic algorithms have been demonstrated to be reliable. However, the Validation Project determined that the RDC/TMD Axis I validity was below the target sensitivity of ≥ 0.70 and specificity of ≥ 0.95. Consequently, these empirical results supported the development of revised RDC/TMD Axis I diagnostic algorithms that were subsequently demonstrated to be valid for the most common pain-related TMD and for one temporomandibular joint (TMJ) intra-articular disorder. The original RDC/TMD Axis II instruments were shown to be both reliable and valid. Working from these findings and revisions, two international consensus workshops were convened, from which recommendations were obtained for the finalization of new Axis I diagnostic algorithms and new Axis II instruments. Methods Through a series of workshops and symposia, a panel of clinical and basic science pain experts modified the revised RDC/TMD Axis I algorithms by using comprehensive searches of published TMD diagnostic literature followed by review and consensus via a formal structured process. The panel's recommendations for further revision of the Axis I diagnostic algorithms were assessed for validity by using the Validation Project's data set, and for reliability by using newly collected data from the ongoing TMJ Impact Project—the follow-up study to the Validation Project. New Axis II instruments were identified through a comprehensive search of the literature providing valid instruments that, relative to the RDC/TMD, are shorter in length, are available in the public domain, and currently are being used in medical settings. Results The newly recommended Diagnostic Criteria for TMD (DC/TMD) Axis I protocol includes both a valid screener for detecting any pain-related TMD as well as valid diagnostic criteria for differentiating the most common pain-related TMD (sensitivity ≥ 0.86, specificity ≥ 0

  6. A review of the reported cases of chronic intestinal pseudo-obstruction in Japan and an investigation of proposed new diagnostic criteria.

    PubMed

    Iida, Hiroshi; Inamori, Masahiko; Sekino, Yusuke; Sakamoto, Yasunari; Yamato, Shigeru; Nakajima, Atsushi

    2011-06-01

    Intestinal pseudo-obstruction is a clinical syndrome in which the clinical symptoms of intestinal obstruction appear without mechanical obstruction of the intestine. We searched for articles from Japana Centra Revuo Medicina for the period 1983-2009 using the keywords 'chronic' and 'intestinal pseudo-obstruction'. 124 articles were identified, and of these 121 cases were investigated using our diagnostic criteria. The patients were between 0 (just after birth) and 84 years of age, indicating that chronic intestinal pseudo-obstruction (CIP) can occur at any age. The mean age was 43.6 years and the median age was 47 years. Forty-nine patients were male and 72 were female, showing a slight tendency towards female predominance. Five cases (4.2%) had a definitive family history. Of the identified causes of secondary CIP, systemic sclerosis was the most common. Abdominal bloating was the most common initial symptom, seen in 90 (81%) patients. Patients having poor intestinal peristalsis with stagnation of the contents of the small intestines causing fatty stools and bacterial overgrowth complained of diarrhea. The interval between the initial symptoms and diagnosis ranged from 0 to 60 years, with a mean and median interval of 7.3 and 2 years, respectively. In case reports of CIP in Japan, the sensitivity of our diagnostic criteria was found to be 85.9%, indicating that the criteria are useful. For improvement in the rate of recognition of CIP and practical application of the diagnostic criteria in Japan, it is important to conduct further studies.

  7. Classification of neuropathic pain in cancer patients: A Delphi expert survey report and EAPC/IASP proposal of an algorithm for diagnostic criteria.

    PubMed

    Brunelli, Cinzia; Bennett, Michael I; Kaasa, Stein; Fainsinger, Robin; Sjøgren, Per; Mercadante, Sebastiano; Løhre, Erik T; Caraceni, Augusto

    2014-12-01

    Neuropathic pain (NP) in cancer patients lacks standards for diagnosis. This study is aimed at reaching consensus on the application of the International Association for the Study of Pain (IASP) special interest group for neuropathic pain (NeuPSIG) criteria to the diagnosis of NP in cancer patients and on the relevance of patient-reported outcome (PRO) descriptors for the screening of NP in this population. An international group of 42 experts was invited to participate in a consensus process through a modified 2-round Internet-based Delphi survey. Relevant topics investigated were: peculiarities of NP in patients with cancer, IASP NeuPSIG diagnostic criteria adaptation and assessment, and standardized PRO assessment for NP screening. Median consensus scores (MED) and interquartile ranges (IQR) were calculated to measure expert consensus after both rounds. Twenty-nine experts answered, and good agreement was found on the statement "the pathophysiology of NP due to cancer can be different from non-cancer NP" (MED=9, IQR=2). Satisfactory consensus was reached for the first 3 NeuPSIG criteria (pain distribution, history, and sensory findings; MEDs⩾8, IQRs⩽3), but not for the fourth one (diagnostic test/imaging; MED=6, IQR=3). Agreement was also reached on clinical examination by soft brush or pin stimulation (MEDs⩾7 and IQRs⩽3) and on the use of PRO descriptors for NP screening (MED=8, IQR=3). Based on the study results, a clinical algorithm for NP diagnostic criteria in cancer patients with pain was proposed. Clinical research on PRO in the screening phase and on the application of the algorithm will be needed to examine their effectiveness in classifying NP in cancer patients.

  8. A trans-diagnostic review of anxiety disorder comorbidity and the impact of multiple exclusion criteria on studying clinical outcomes in anxiety disorders.

    PubMed

    Goldstein-Piekarski, A N; Williams, L M; Humphreys, K

    2016-06-28

    Anxiety disorders are highly comorbid with each other and with other serious mental disorders. As our field progresses, we have the opportunity to pursue treatment study designs that consider these comorbidities. In this perspective review, we first characterized the prevalence of multiple anxiety disorder comorbidity by reanalyzing national survey data, then conducted an English-language PubMed search of studies analyzing the impact of exclusion criteria on treatment outcome data. In the prevalence data, 60% of people with an anxiety disorder had one or more additional anxiety or depression diagnosis. Because our commonly applied exclusion criteria focus on a single diagnosis and do not consider a multiple comorbidity profile, the impact of the criteria may be to exclude up to 92% of anxiety disorder treatment seekers. Moreover, the findings do not suggest a consistent relationship between the number of exclusion criteria and the effect size of treatment outcomes. Thus, future studies might consider a more trans-diagnostic rationale for determining exclusion criteria, one that is generalizable to real-world settings in which multiple diagnoses commonly co-occur. The findings also encourage a more systematic reporting of rationales for the choice of-and the implications of-each exclusion criterion.

  9. A trans-diagnostic review of anxiety disorder comorbidity and the impact of multiple exclusion criteria on studying clinical outcomes in anxiety disorders

    PubMed Central

    Goldstein-Piekarski, A N; Williams, L M; Humphreys, K

    2016-01-01

    Anxiety disorders are highly comorbid with each other and with other serious mental disorders. As our field progresses, we have the opportunity to pursue treatment study designs that consider these comorbidities. In this perspective review, we first characterized the prevalence of multiple anxiety disorder comorbidity by reanalyzing national survey data, then conducted an English-language PubMed search of studies analyzing the impact of exclusion criteria on treatment outcome data. In the prevalence data, 60% of people with an anxiety disorder had one or more additional anxiety or depression diagnosis. Because our commonly applied exclusion criteria focus on a single diagnosis and do not consider a multiple comorbidity profile, the impact of the criteria may be to exclude up to 92% of anxiety disorder treatment seekers. Moreover, the findings do not suggest a consistent relationship between the number of exclusion criteria and the effect size of treatment outcomes. Thus, future studies might consider a more trans-diagnostic rationale for determining exclusion criteria, one that is generalizable to real-world settings in which multiple diagnoses commonly co-occur. The findings also encourage a more systematic reporting of rationales for the choice of—and the implications of—each exclusion criterion. PMID:27351601

  10. Pathogen inactivation of whole blood and red cell components: an overview of concept, design, developments, criteria of acceptability and storage lesion.

    PubMed

    Seghatchian, Jerard; Putter, Jeffrey S

    2013-10-01

    Multilayer preventative strategies have been instituted to enhance transfusion safety for patients in need of critical blood components. Presently blood safety is at its highest levels, with the implementation of precautionary/preventative measures against vCJD, bacterial and viral contamination of the blood supply. The implementation of these strategies together with advances in automation and computerization led to significant improvements in standardisation for transfusion practices. These include validation, verification, adherence to GLP and GMP and other regulatory requirements. In most European countries, universal prestorage leukodepletion is routine practice. In France proactive pathogen inactivation treatments [PITs] have been implemented emphasizing patient safety. This at least conceptually reduces the risk of transfusing viable WBCs, emerging bacteria and viruses, all with potential transfusion complications. In the UK, prion removal filters for red cell products are used selectively for special groups of patients. Some research establishments are exploring the potential impact of pathogen inactivation of whole blood or red cell components, using the new generation of S-303 PIT and the prion removal filters in combination. It needs to be determined whether such a combined strategy, applied synergistically, enhances red cell transfusion safety without compromising the overall criteria of acceptability. It is necessary to critically examine the impact of a new generation of PIT technologies, which may exacerbate the red cell storage lesion and cause the development of undesirable antibodies in the recipient. The development of innovative laboratory tools is vital to study impacts of these measures on the quality of stored blood and their clinical outcome. The ultimate aim of red cell transfusion is to provide oxygen enriched red blood cells to the microcirculations and tissues. Definitive studies are needed to establish the potential unforeseen negative

  11. The Clinical Features of Paranoia in the 20th Century and Their Representation in Diagnostic Criteria From DSM-III Through DSM-5.

    PubMed

    Kendler, Kenneth S

    2016-12-21

    This review traces, through psychiatric textbooks, the history of the Kraepelinian concept of paranoia in the 20th century and then relates the common reported symptoms and signs to the diagnostic criteria for paranoia/delusional disorder in DSM-III through DSM-5. Clinical descriptions of paranoia appearing in 10 textbooks, published 1899 to 1970, revealed 11 prominent symptoms and signs reported by 5 or more authors. Three symptoms (systematized delusions, minimal hallucinations, and prominent ideas of reference) and 2 signs (chronic course and minimal affective deterioration) were reported by 8 or 9 of the authors. Four textbook authors rejected the Kraepelinian concept of paranoia. A weak relationship was seen between the frequency with which the clinical features were reported and the likelihood of their inclusion in modern DSM manuals. Indeed, the diagnostic criteria for paranoia/delusional disorder shifted substantially from DSM-III to DSM-5. The modern operationalized criteria for paranoia/delusional disorder do not well reflect the symptoms and signs frequently reported by historical experts. In contrast to results of similar reviews for depression, schizophrenia and mania, the clinical construct of paranoia/delusional disorder has been somewhat unstable in Western Psychiatry since the turn of the 20th century as reflected in both textbooks and the DSM editions.

  12. Human adjuvant-related syndrome or autoimmune/inflammatory syndrome induced by adjuvants. Where have we come from? Where are we going? A proposal for new diagnostic criteria.

    PubMed

    Alijotas-Reig, J

    2015-09-01

    In 1964, Miyoshi reported a series of patients with diverse symptoms after receiving treatment with silicone or paraffin fillers. Miyoshi named this condition 'human adjuvant disease'. Since then, the literature has been flooded with case reports and case series of granulomatous and systemic autoimmune disorders related to vaccines, infection or other adjuvants such as silicone and other biomaterials. A new term -autoimmune/inflammatory syndrome induced by adjuvants--has recently been coined for a process that includes several clinical features previously described by Miyoshi plus other clinical and laboratory parameters related to exposure to diverse external stimuli. Disorders such as siliconosis, Gulf War syndrome, macrophagic myofasciitis syndrome, sick building syndrome and post-vaccination syndrome have been included in autoimmune/inflammatory syndrome induced by adjuvants. Disorders such as Spanish toxic oil syndrome and Ardystil syndrome could also be included. Furthermore, biomaterials other than silicone should also be considered as triggering factors for these adjuvant-related syndromes. New diagnostic criteria in this field have been proposed. Nevertheless, many of these criteria are too subjective, leading to some patients being diagnosed with chronic fatigue syndrome or other 'central sensitization syndromes'. Diagnostic criteria based only on objective clinical and laboratory data to be further discussed and validated are proposed herein.

  13. Diagnostics of Sacroiliitis According to ASAS Criteria: A Comparative Evaluation of Conventional Radiographs and MRI in Patients with a Clinical Suspicion of Spondyloarthropathy. Preliminary Results

    PubMed Central

    Sudoł-Szopińska, Iwona; Kwiatkowska, Brygida; Włodkowska-Korytkowska, Monika; Matuszewska, Genowefa; Grochowska, Elżbieta

    2015-01-01

    Summary Background The objective of this study was a comparative evaluation of radiography and MRI in the diagnostics of sacroiliitis in patients with a clinical diagnosis of spondyloartropathy, according to the current ASAS criteria. Material/Methods Sacroiliac joints radiograms and MRI were conducted in 101 consecutive patients, aged 19–71 yrs (mean age: 40.6 yrs). The patients were referred by a senior rheumatologist, with symptoms of the chronic back pain. The sacroiliac joints were assessed on AP radiograms of the pelvis according to the modified New York criteria for ankylosing spondylitis. MRI was performed to look for active and chronic inflammatory lesions. Results Of 14 patients with radiographic sacroiliitis according to modified New York criteria, only 50% had sacroiliitis on MRI. The sensitivity and specificity of conventional radiography were 22% and 94% and of MRI were 71% and 90%. Cohen’s kappa coefficient was κ=0.0187, agreement of radiograms and MRI was 58%. Among 86 patients displaying no sacroiliitis on radiograms, MRI showed sacroiliitis in 34 patients (39.5%). Positive predictive value was 0.429, negative predictive value was 0.605. Conclusions MRI allowed to diagnose sacroiliitis in 39,5 % of patients in preradiographic stage. MRI ruled out the presence of active inflammatory lesions in 60.4% of patients with sacroiliitis on radiograms according to modified New York criteria. PMID:26082819

  14. Posttraumatic stress disorder according to DSM-5 and DSM-IV diagnostic criteria: a comparison in a sample of Congolese ex-combatants

    PubMed Central

    Schaal, Susanne; Koebach, Anke; Hinkel, Harald; Elbert, Thomas

    2015-01-01

    Background Compared to DSM-IV, the criteria for diagnosing posttraumatic stress disorder (PTSD) have been modified in DSM-5. Objective The first aim of this study was to examine how these modifications impact rates of PTSD in a sample of Congolese ex-combatants. The second goal of this study was to investigate whether PTSD symptoms were associated with perpetrator-related acts or victim-related traumatic events. Method Ninety-five male ex-combatants in the eastern Democratic Republic of Congo were interviewed. Both the DSM-IV and the DSM-5 PTSD symptom criteria were assessed. Results The DSM-5 symptom criteria yielded a PTSD rate of 50% (n=47), whereas the DSM-IV symptom criteria were met by 44% (n=42). If the DSM-5 would be set as the current “gold standard,” then DSM-IV would have produced more false negatives (8%) than false positives (3%). A minority of participants (19%, n=18) indicated an event during which they were involved as a perpetrator as their most stressful event. Results of a regression analysis (R 2=0.40) showed that, after accounting for the number of types of traumatic events, perpetrated violent acts were not associated with the symptom severity of PTSD. Conclusions The findings demonstrate that more diagnostic cases were produced with the DSM-5 diagnostic rules than were dropped resulting in an increase in PTSD rates compared to the DSM-IV system. The missing association between PTSD symptoms and perpetrated violent acts might be explained by a potential fascinating and excited perception of these acts. PMID:25720994

  15. "Diagnostic shift" from eating disorder not otherwise specified to bulimia nervosa using DSM-5 criteria: a clinical comparison with DSM-IV bulimia.

    PubMed

    MacDonald, Danielle E; McFarlane, Traci L; Olmsted, Marion P

    2014-01-01

    In the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), the diagnostic threshold for binging and compensation in bulimia nervosa (BN) decreased from twice to once weekly for 3 months. This study investigates the validity of this change by examining whether BN patients and those whose diagnoses "shift" to BN with DSM-5 are similar in their psychological functioning. EDNOS patients whose symptoms met DSM-5 BN criteria (n=25) were compared to DSM-IV BN patients (n=146) on clinically relevant variables. No differences were found on: BMI; weight-based self-evaluation; perfectionism; depression and anxiety symptoms; or readiness for change. Differences were found on one Eating Disorder Inventory subscale (i.e., bulimia), with the BN group reporting higher scores, consistent with group definitions. These findings support the modified criteria, suggesting that psychopathology both directly and indirectly related to eating disorders is comparable between those with once weekly versus more frequent bulimic episodes.

  16. Parent PDD behavior inventory profiles of young children classified according to autism diagnostic observation schedule-generic and autism diagnostic interview-revised criteria.

    PubMed

    Cohen, Ira L; Gomez, Tina Rovito; Gonzalez, Maripaz G; Lennon, Elizabeth M; Karmel, Bernard Z; Gardner, Judith M

    2010-02-01

    Quantitative variations in score profiles from the parent version of the PDD Behavior Inventory (PDDBI) were examined in young Autism and PDD-NOS groups defined by ADOS-G and ADI-R criteria, relative to a not spectrum (NS) group of similar age. Both the Autism and the PDD-NOS group profiles markedly differed from the NS group. The most sensitive measures of group differences were those domain and composite scores that assessed social communication competence, as well as the overall Autism Composite score. Sensitivity, specificity and positive and negative predictability measures were quite good for these measures. It was concluded that the PDDBI is useful in assisting in the differential diagnosis of autism spectrum disorder.

  17. Acute Cytomegalovirus (CMV) Infection Associated with Hemophagocytic Lymphohistiocytosis (HLH) in an Immunocompetent Host Meeting All Eight HLH 2004 Diagnostic Criteria

    PubMed Central

    Willeford, Wesley G; Lichstein, Peter; Ohar, Jill

    2017-01-01

    Hemophagocytic lymphohistiocytosis (HLH) is a rare and often deadly syndrome characterized by severe inflammation and cytokine dysregulation. The disease is defined by the HLH-2004 criteria, requiring five of eight findings, and is further differentiated into either primary or secondary causes. Primary HLH tends to be of genetic etiology, while secondary HLH results from other insults such as infection. Secondary HLH is most commonly associated with viral infections in immunocompromised patients. Acute cytomegalovirus (CMV) associated HLH in the immunocompetent host is exceedingly rare and only documented in four case reports to date. We describe the fifth documented case of CMV-associated HLH in an immunocompetent patient, and furthermore, we demonstrate that this patient is the first published case of its type to satisfy all eight of HLH-2004 criteria.

  18. Clinical subtypes of chronic traumatic encephalopathy: literature review and proposed research diagnostic criteria for traumatic encephalopathy syndrome

    PubMed Central

    2014-01-01

    The long-term consequences of repetitive head impacts have been described since the early 20th century. Terms such as punch drunk and dementia pugilistica were first used to describe the clinical syndromes experienced by boxers. A more generic designation, chronic traumatic encephalopathy (CTE), has been employed since the mid-1900s and has been used in recent years to describe a neurodegenerative disease found not just in boxers but in American football players, other contact sport athletes, military veterans, and others with histories of repetitive brain trauma, including concussions and subconcussive trauma. This article reviews the literature of the clinical manifestations of CTE from 202 published cases. The clinical features include impairments in mood (for example, depression and hopelessness), behavior (for example, explosivity and violence), cognition (for example, impaired memory, executive functioning, attention, and dementia), and, less commonly, motor functioning (for example, parkinsonism, ataxia, and dysarthria). We present proposed research criteria for traumatic encephalopathy syndrome (TES) which consist of four variants or subtypes (TES behavioral/mood variant, TES cognitive variant, TES mixed variant, and TES dementia) as well as classifications of ‘probable CTE’ and ‘possible CTE’. These proposed criteria are expected to be modified and updated as new research findings become available. They are not meant to be used for a clinical diagnosis. Rather, they should be viewed as research criteria that can be employed in studies of the underlying causes, risk factors, differential diagnosis, prevention, and treatment of CTE and related disorders. PMID:25580160

  19. Incidence, Predictors, and Impact on Hospital Mortality of Amphotericin B Nephrotoxicity Defined Using Newer Acute Kidney Injury Diagnostic Criteria

    PubMed Central

    Kobayashi, Carla Dinamérica; de Carvalho Almeida, Luna; de Oliveira dos Reis, Camilla; Santos, Barbara Mendes; Glesby, Marshall Jay

    2015-01-01

    Studies on amphotericin B (AmB) nephrotoxicity use diverse definitions of acute kidney injury (AKI). Here, we used the new Kidney Disease Improving Global Outcome (KDIGO) system to describe the incidence, predictors, and impact of AmB-induced AKI on hospital mortality in 162 patients treated with AmB (120 with deoxycholate preparation and 42 with liposomal preparation). KDIGO stage 1 requires an absolute increase of ≥0.3 mg/dl or ≥1.5× over baseline serum creatinine (SCr), while stage 2 requires ≥2×, and stage 3 requires ≥3×. A binary KDIGO definition (KDIGObin) corresponds to stage ≥1. For comparison, we included two definitions of AKI traditionally utilized in nephrotoxicity studies: ≥0.5 mg/dl (NT0.5) and ≥2× (NT2×) increase in baseline SCr. The overall incidence of AmB-induced AKI by KDIGObin was 58.6% (stage 1, 30.9%; stage 2, 18.5%; stage 3, 9.3%). Predictors of AKI by KDIGObin were older age and use of furosemide and angiotensin-converting enzyme inhibitor (ACE-I). Traditional criteria detected lower incidences of AKI, at 45.1% (NT0.5) and 27.8% (NT2×). Predictors of AKI by traditional criteria were older age and use of vancomycin (NT0.5) and use of vancomycin and vasopressors (NT2×). KDIGObin detected AKI 2 days earlier than the most sensitive traditional criterion. However, only traditional criteria were associated with intensive care unit (ICU) admission, mechanical ventilation, and mortality. In conclusion, the increase in sensitivity of KDIGObin is accompanied by a loss of specificity and ability to predict outcomes. Prospective studies are required to weigh the potential gain from early AKI detection against the potential loss from undue changes in management in patients with subtle elevations in SCr. PMID:26014956

  20. Improving the diagnostic criteria for primary liver graft non-function in adults utilizing standard and transportable laboratory parameters. An outcome based analysis.

    PubMed

    Al-Freah, Mohammad A B; McPhail, Mark J W; Dionigi, Elena; Foxton, Matthew R; Auzinger, Georg; Rela, Mohamed; Wendon, Julia A; O'Grady, John G; Heneghan, Michael A; Heaton, Nigel D; Bernal, William

    2017-02-15

    Current diagnostic criteria for primary non-function (PNF) of liver grafts are based on clinical experience rather than statistical methods. A retrospective, single centre study was conducted of all adults (n=1,286) who underwent primary liver transplant 2000-2008 in our centre. Laboratory variable during the first post-liver transplant week were analysed. Forty two patients (3.7%) had 2-week graft failure. Transplant albumin, day-1 AST, day-1 lactate, day-3 bilirubin, day-3 INR and day-7 AST were independently associated with PNF on multivariate logistic regression. PNF score =(0.000280*D1AST)+(0.361*D1 Lactate)+(0.00884*D3 Bilirubin)+(0.940*D 3 INR)+(0.00153*D7 AST)-(0.0972*TxAlbumin)-4.5503. ROC analysis showed the model AUROC of 0.912 (0.889 -0.932) was superior to the current United Kingdom (UK) PNF criteria of 0.669 (0.634-0.704, p<0.0001). When applied to a validation cohort (n=386, 34.4% patients) the model had AUROC of 0.831 (0.789 -0.867) compared to the UK EGD criteria of 0.674 (0.624-0.721). The new model performed well after exclusion of patients with marginal grafts and when modified to include variables from the first three post-LT days only (AUROC of 0.818, 0.776-0.856, p=0.001). This model is superior to the current UK PNF criteria and is based on statistical methods. The model is also applicable to recipients of all types of grafts (marginal and non-marginal). This article is protected by copyright. All rights reserved.

  1. Characterization of the spectrum of Korean inflammatory demyelinating diseases according to the diagnostic criteria and AQP4-Ab status

    PubMed Central

    2014-01-01

    Background The relative frequencies of demyelinating diseases among Korean patients with idiopathic inflammatory demyelinating disease of the central nervous system (IIDD) have not been sufficiently studied. We therefore describe a cohort of 203 patients with IIDD from three centers in Korea whose syndromes were identified precisely according to international clinical criteria and autoantibody to aquaporin 4 (AQP4-Ab) status. Methods In total, 260 consecutive patients were screened and 203 were included from three hospitals in Korea. All were tested for AQP4-Ab by using a cell-based assay. Patients who met the criteria for definite neuromyelitis optica (NMO) or had a positive AQP4-Ab test result were defined as the NMO group. Among the others, patients were assessed if they had acute disseminated encephalomyelitis, multiple sclerosis (MS), acute transverse myelitis, optic neuritis, or other demyelinating disease as a clinically isolated syndrome of the brain. Results Eighteen percent of patients were classified as the NMO group, 2% as acute disseminated encephalomyelitis, 18% as MS, 41% as acute transverse myelitis, 11% as optic neuritis, and 8% as other clinically isolated syndrome of the brain. AQP4-Ab was positive in 18% of patients and the relative frequency of NMO to MS (NMO/MS ratio) was 1.06. The mean duration of follow up in our patients was 64 months. Conclusions Among Korean patients with idiopathic inflammatory demyelinating diseases, the incidence of NMO may be similar to that of MS, and the overall positivity of AQP4-Ab could be lower than previously reported. In addition, acute transverse myelitis that is not associated with MS or NMO can be relatively common in these patients. Further population-based studies with AQP4-Ab are needed to determine the exact incidence of NMO and other idiopathic inflammatory demyelinating diseases in Korea. PMID:24779645

  2. IgM-lambda paraproteinemia with associated cutaneous lymphoplasmacytic infiltrate in a patient who meets diagnostic criteria for POEMS syndrome.

    PubMed

    Colaco, Shanthi M; Miller, Tara; Ruben, Beth S; Fogarty, Patrick F; Fox, Lindy P

    2008-04-01

    POEMS is a rare multisystem paraneoplastic syndrome featuring polyneuropathy, organomegaly, endocrinopathy, a monoclonal protein, and skin changes. In the relatively few reported biopsies of POEMS-associated cutaneous hyperpigmentation, the most common skin finding seen in patients with the disorder, only a non-specific inflammatory infiltrate has been demonstrated histologically. We present the case of a 79-year-old man with polyneuropathy, autoimmune thyroiditis, pancytopenia, and a history of lymphadenopathy who presented to the inpatient dermatology service with cutaneous hyperpigmentation. A skin biopsy of a hyperpigmented area showed a cutaneous lymphoplasmacytic infiltrate, prompting further investigation. A monoclonal IgM-lambda paraprotein was subsequently identified, leading to administration of combination chemotherapy for a diagnosis of POEMS syndrome. The novel finding of a lymphoplasmacytic infiltrate in POEMS-associated hyperpigmentation suggests a diagnostic role for skin biopsy in these patients.

  3. Evaluation of the Sensitivity and Specificity of the New Clinical Diagnostic and Classification Criteria for Kashin-Beck Disease, an Endemic Osteoarthritis, in China.

    PubMed

    Yu, Fang Fang; Ping, Zhi Guang; Yao, Chong; Wang, Zhi Wen; Wang, Fu Qi; Guo, Xiong

    2017-02-01

    This study aimed to evaluate the sensitivity and specificity of the new clinical diagnostic and classification criteria for Kashin-Beck disease (KBD) using six clinical markers: flexion of the distal part of fingers, deformed fingers, enlarged finger joints, shortened fingers, squat down, and dwarfism. One-third of the total population in Linyou County was sampled by stratified random sampling. The survey included baseline characteristics and clinical diagnoses, and the sensitivity and specificity of the new criteria was evaluated. We identified 3,459 KBD patients, of which 69 had early stage KBD, 1,952 had stage I, 1,132 had stage II, and 306 had stage III. A screening test classified enlarged finger joints as stage I KBD, with a sensitivity and specificity of 0.978 and 0.045, respectively. Shortened fingers were classified as stage II KBD, with a sensitivity and specificity of 0.969 and 0.844, respectively, and dwarfism was classified as stage III KBD with a sensitivity and specificity of 0.951 and 0.992, respectively. Serial screening test revealed that the new clinical classification of KBD classified stages I, II, and III KBD with sensitivities of 0.949, 0.945, and 0.925 and specificities of 0.967, 0.970, and 0.993, respectively. The screening tests revealed that enlarged finger joints, shortened fingers, and dwarfism were appropriate markers for the clinical diagnosis and classification of KBD with high sensitivity and specificity.

  4. Disorder of Executive Function of the Brain after Head Injury and Mild Traumatic Brain Injury - Neuroimaging and Diagnostic Criteria for Implementation of Administrative Support in Japan.

    PubMed

    Shinoda, Jun; Asano, Yoshitaka

    2017-04-06

    The diagnotic criteria for disorder of the executive function of the brain (DEFB) as a syndrome of sequela were administratively established (ad-DEFB) in Japan in 2006 to support disabled patients whose impairment, limited to cognition (memory, attention, execution, and behavior), emerges after organic brain injuries regardless of physical deficits. However, some patients suffering from traumatic brain injury (TBI) have been excluded from receiving medico-social services. In particular, this tendency is more prominent in patients with mild TBI because no lesions are apparent on conventional computed tomography (CT) or magnetic resonance imaging (MRI) in the chronic phase. Recent development of new MRI neuroimaging modalities and positron emission tomography (PET) imaging makes it possible to detect regions of minute organic lesions and metabolic dysfunction in the brain where organic lesions may be absent or cannot be detected on conventional CT or MRI. In this review, we discuss diagnostic criteria for mild TBI and ad-DEFB, the relationship between the two disorders, characteristic neuroimaging [(MRI and 18F-fluorodeoxyglucose-positron emission tomography (FDG-PET)] of diffuse brain injury including cerebral concussion, which is the principal cause of mild TBI, and suggested pathological mechanisms of ad-DEFB in DBI.

  5. An examination of the factor structure of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, narcissistic personality disorder criteria: one or two factors?

    PubMed

    Miller, Joshua D; Hoffman, Brian J; Campbell, W Keith; Pilkonis, Paul A

    2008-01-01

    A growing body of research has suggested that narcissistic personality disorder (NPD) contains 2 factors or types: overt/grandiose and covert/vulnerable. A recent factor analysis of Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), NPD symptoms supported a similar 2-factor model. The present research tested this proposed 2-factor solution against a 1-factor solution (N = 289; 72% patients) using both confirmatory factor analysis and an examination of associations between the resultant factors and theoretically relevant criteria (other personality disorders; depression, anxiety). The results of the confirmatory factor analysis supported a 1-factor solution. Likewise, the 2 factors each yielded a similar pattern of correlations with relevant criteria. Together, these results argue against a 2-factor structure for the current DSM-IV NPD symptoms. Given the broader research literature suggesting a 2-factor structure of narcissism, strategies for assessing both overt/grandiose and covert/vulnerable forms of narcissism in DSM-V are discussed.

  6. Plasma cell leukemia: consensus statement on diagnostic requirements, response criteria and treatment recommendations by the International Myeloma Working Group.

    PubMed

    Fernández de Larrea, C; Kyle, R A; Durie, B G M; Ludwig, H; Usmani, S; Vesole, D H; Hajek, R; San Miguel, J F; Sezer, O; Sonneveld, P; Kumar, S K; Mahindra, A; Comenzo, R; Palumbo, A; Mazumber, A; Anderson, K C; Richardson, P G; Badros, A Z; Caers, J; Cavo, M; LeLeu, X; Dimopoulos, M A; Chim, C S; Schots, R; Noeul, A; Fantl, D; Mellqvist, U-H; Landgren, O; Chanan-Khan, A; Moreau, P; Fonseca, R; Merlini, G; Lahuerta, J J; Bladé, J; Orlowski, R Z; Shah, J J

    2013-04-01

    Plasma cell leukemia (PCL) is a rare and aggressive variant of myeloma characterized by the presence of circulating plasma cells. It is classified as either primary PCL occurring at diagnosis or as secondary PCL in patients with relapsed/refractory myeloma. Primary PCL is a distinct clinic-pathological entity with different cytogenetic and molecular findings. The clinical course is aggressive with short remissions and survival duration. The diagnosis is based upon the percentage (≥ 20%) and absolute number (≥ 2 × 10(9)/l) of plasma cells in the peripheral blood. It is proposed that the thresholds for diagnosis be re-examined and consensus recommendations are made for diagnosis, as well as, response and progression criteria. Induction therapy needs to begin promptly and have high clinical activity leading to rapid disease control in an effort to minimize the risk of early death. Intensive chemotherapy regimens and bortezomib-based regimens are recommended followed by high-dose therapy with autologous stem cell transplantation if feasible. Allogeneic transplantation can be considered in younger patients. Prospective multicenter studies are required to provide revised definitions and better understanding of the pathogenesis of PCL.

  7. Developmentally Sensitive Diagnostic Criteria for Mental Health Disorders in Early Childhood: The Diagnostic and Statistical Manual of Mental Disorders-IV, the Research Diagnostic Criteria-Preschool Age, and the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood-Revised

    ERIC Educational Resources Information Center

    Egger, Helen L.; Emde, Robert N.

    2011-01-01

    As the infant mental health field has turned its focus to the presentation, course, and treatment of clinically significant mental health disorders, the need for reliable and valid criteria for identifying and assessing mental health symptoms and disorders in early childhood has become urgent. In this article we offer a critical perspective on…

  8. Viral diagnostic criteria for Feline immunodeficiency virus and Feline leukemia virus infections in domestic cats from Buenos Aires, Argentina.

    PubMed

    Galdo Novo, Sabrina; Bucafusco, Danilo; Diaz, Leandro M; Bratanich, Ana Cristina

    A cross-sectional study was carried out on cats attending the Small Animal Hospital at the Faculty of Veterinary Sciences of the University of Buenos Aires to assess the prevalence and associated risk factors of Feline immunodeficiency virus (FIV) and Feline leukemia virus (FeLV) in the city of Buenos Aires, Argentina. Blood samples from 255 cats with symptoms compatible with FIV or FeLV infection, collected between 2009 and 2013 were analyzed by serology (immunochromatography, IA) and by hemi-nested PCR (n-PCR). The IA and n-PCR assays showed similar percentages of positivity for FIV while the n-PCR test was more sensitive for FeLV. Differences between the diagnostic tests and their choice according to the age of the animal are discussed. The clinical histories of ninety of the 255 cats showed blood profiles similar to others previously reported and revealed a higher risk of infection in male adult cats with outdoor access.

  9. Laboratory diagnostic outcome applying detection criteria recommended by the Scientific and Standardization Committee of the ISTH on Lupus Anticoagulant.

    PubMed

    Chantarangkul, Veena; Biguzzi, Eugenia; Asti, Daniela; Palmucci, Claudia; Tripodi, Armando

    2013-07-01

    This study shows the diagnostic outcome of an APTT-based and two dRVVT-based commercial confirmatory integrated tests with the application of the recommendations by the Scientific and Standardization Committee (SSC) on Lupus anticoagulant (LA)/antiphospholipid syndrome (APS) of the International Society on Thrombosis and Haemostasis (ISTH) issued in 2009 concerning the cut-off values for the screening, mixing and confirmatory tests for the detection of LA and the mandatory need to perform mixing tests of patient plasma with pooled normal plasma. The study population included 565 patients collected from a large central coagulation laboratory, for which the attending physicians requested LA detection. One-hundred-six healthy subjects (HS) and 131 selected patients on oral anticoagulant therapy (OAT) were included as negative controls. The results suggest that the performance of mixing tests is indicated for those methods with relatively poor specificity, but is less needed for those methods with high specificity. Furthermore, the SSC recommendation to use normal mid-value (i.e. the 50th percentile of distribution of results from healthy subjects) as the cut-off to interpret results of confirmatory tests, showed a modest increase in LA detection rate (sensitivity) but at the expense of specificity, particularly in methods with low specificity.

  10. [Permanent essential defacement--remarks on the possibilities of verification of the accepted criteria in medico-legal certification in criminal and civil law proceedings].

    PubMed

    Chowaniec, Czesław; Nowak, Agnieszka; Jabłoński, Christian; Neniczka, Stanisława

    2007-01-01

    Despite the fact that some criteria of medico-legal certification in criminal and civil proceedings have been established, there are still some topics which are controversial and thus require modification. This is also true of the notion of "permanent essential defacement". In the opinion of the authors, changes in social conventions that are occurring nowadays, as well as a highly diversified, subjective perception of esthetic values indicate the need for discussing a possible modification of the presently obligatory criteria. Apart from the assessment of posttraumatic changes, an important problem is posed by defining the notion of "a part of the body customarily open to the view ". Additionally, the authors bring up for discussion the issue of experts taking into consideration the age and sex of the victims while assessing damages. A separate problem lies in difficulties in assessing the degree of detriment to health because of defacement due to the fact that official tables for evaluating permanent or long-term detriment to health do not include relevant information.

  11. Criteria for the development and use of the methodology for environmentally-acceptable fossil energy site evaluation and selection. Volume 2. Final report

    SciTech Connect

    Eckstein, L.; Northrop, G.; Scott, R.

    1980-02-01

    This report serves as a companion document to the report, Volume 1: Environmentally-Acceptable Fossil Energy Site Evaluation and Selection: Methodology and Users Guide, in which a methodology was developed which allows the siting of fossil fuel conversion facilities in areas with the least environmental impact. The methodology, known as SELECS (Site Evaluation for Energy Conversion Systems) does not replace a site specific environmental assessment, or an environmental impact statement (EIS), but does enhance the value of an EIS by thinning down the number of options to a manageable level, by doing this in an objective, open and selective manner, and by providing preliminary assessment and procedures which can be utilized during the research and writing of the actual impact statement.

  12. Candidate-gene criteria for clinical reporting: diagnostic exome sequencing identifies altered candidate genes among 8% of patients with undiagnosed diseases

    PubMed Central

    Farwell Hagman, Kelly D.; Shinde, Deepali N.; Mroske, Cameron; Smith, Erica; Radtke, Kelly; Shahmirzadi, Layla; El-Khechen, Dima; Powis, Zöe; Chao, Elizabeth C.; Alcaraz, Wendy A.; Helbig, Katherine L.; Sajan, Samin A.; Rossi, Mari; Lu, Hsiao-Mei; Huether, Robert; Li, Shuwei; Wu, Sitao; Nuñes, Mark E.; Tang, Sha

    2017-01-01

    Purpose: Diagnostic exome sequencing (DES) is now a commonly ordered test for individuals with undiagnosed genetic disorders. In addition to providing a diagnosis for characterized diseases, exome sequencing has the capacity to uncover novel candidate genes for disease. Methods: Family-based DES included analysis of both characterized and novel genetic etiologies. To evaluate candidate genes for disease in the clinical setting, we developed a systematic, rule-based classification schema. Results: Testing identified a candidate gene among 7.7% (72/934) of patients referred for DES; 37 (4.0%) and 35 (3.7%) of the genes received evidence scores of “candidate” and “suspected candidate,” respectively. A total of 71 independent candidate genes were reported among the 72 patients, and 38% (27/71) were subsequently corroborated in the peer-reviewed literature. This rate of corroboration increased to 51.9% (27/52) among patients whose gene was reported at least 12 months previously. Conclusions: Herein, we provide transparent, comprehensive, and standardized scoring criteria for the clinical reporting of candidate genes. These results demonstrate that DES is an integral tool for genetic diagnosis, especially for elucidating the molecular basis for both characterized and novel candidate genetic etiologies. Gene discoveries also advance the understanding of normal human biology and more common diseases. Genet Med 19 2, 224–235. PMID:27513193

  13. Accuracy of the Composite International Diagnostic Interview (CIDI 2.1) for diagnosis of post-traumatic stress disorder according to DSM-IV criteria.

    PubMed

    Quintana, Maria Inês; Mari, Jair de Jesus; Ribeiro, Wagner Silva; Jorge, Miguel Roberto; Andreoli, Sergio Baxter

    2012-07-01

    The objective was to study the accuracy of the post-traumatic stress disorder (PTSD) section of the Composite International Diagnostic Interview (CIDI 2.1) DSM-IV diagnosis, using the Structured Clinical Interview (SCID) as gold standard, and compare the ICD-10 and DSM IV classifications for PTSD. The CIDI was applied by trained lay interviewers and the SCID by a psychologist. The subjects were selected from a community and an outpatient program. A total of 67 subjects completed both assessments. Kappa coefficients for the ICD-10 and the DSM IV compared to the SCID diagnosis were 0.67 and 0.46 respectively. Validity for the DSM IV diagnosis was: sensitivity (51.5%), specificity (94.1%), positive predictive value (9.5%), negative predictive value (66.7%), misclassification rate (26.9%). The CIDI 2.1 demonstrated low validity coefficients for the diagnosis of PTSD using DSM IV criteria when compared to the SCID. The main source of discordance in this study was found to be the high probability of false-negative cases with regards to distress and impairment as well as to avoidance symptoms.

  14. Impact of the Implementation of New WHO Diagnostic Criteria for Gestational Diabetes Mellitus on Prevalence and Perinatal Outcomes: A Population-Based Study.

    PubMed

    Erjavec, Katja; Poljičanin, Tamara; Matijević, Ratko

    2016-01-01

    Objectives. To determine the impact of the implementation of new WHO diagnostic criteria for gestational diabetes mellitus (GDM) on prevalence, predictors, and perinatal outcomes in Croatian population. Methods. A cross-sectional study was performed using data from medical birth certificates collected in 2010 and 2014. Data collected include age, height, and weight before and at the end of pregnancy, while perinatal outcome was assessed by onset of labor, mode of delivery, and Apgar score. Results. A total of 81.748 deliveries and 83.198 newborns were analysed. Prevalence of GDM increased from 2.2% in 2010 to 4.7% in 2014. GDM was a significant predictor of low Apgar score (OR 1.656), labor induction (OR 2.068), and caesarean section (OR 1.567) in 2010, while in 2014 GD was predictive for labor induction (OR 1.715) and caesarean section (OR 1.458) only. Age was predictive for labor induction only in 2014 and for caesarean section in both years, while BMI before pregnancy was predictive for all observed perinatal outcomes in both years. Conclusions. Despite implementation of new guidelines, GDM remains burdened with increased risk of labor induction and caesarean section, but no longer with low Apgar score, while BMI remains an important predictor for all three perinatal outcomes.

  15. Impact of the Implementation of New WHO Diagnostic Criteria for Gestational Diabetes Mellitus on Prevalence and Perinatal Outcomes: A Population-Based Study

    PubMed Central

    Poljičanin, Tamara; Matijević, Ratko

    2016-01-01

    Objectives. To determine the impact of the implementation of new WHO diagnostic criteria for gestational diabetes mellitus (GDM) on prevalence, predictors, and perinatal outcomes in Croatian population. Methods. A cross-sectional study was performed using data from medical birth certificates collected in 2010 and 2014. Data collected include age, height, and weight before and at the end of pregnancy, while perinatal outcome was assessed by onset of labor, mode of delivery, and Apgar score. Results. A total of 81.748 deliveries and 83.198 newborns were analysed. Prevalence of GDM increased from 2.2% in 2010 to 4.7% in 2014. GDM was a significant predictor of low Apgar score (OR 1.656), labor induction (OR 2.068), and caesarean section (OR 1.567) in 2010, while in 2014 GD was predictive for labor induction (OR 1.715) and caesarean section (OR 1.458) only. Age was predictive for labor induction only in 2014 and for caesarean section in both years, while BMI before pregnancy was predictive for all observed perinatal outcomes in both years. Conclusions. Despite implementation of new guidelines, GDM remains burdened with increased risk of labor induction and caesarean section, but no longer with low Apgar score, while BMI remains an important predictor for all three perinatal outcomes. PMID:28097023

  16. Perspective: Towards environmentally acceptable criteria for downstream fish passage through mini hydro and irrigation infrastructure in the Lower Mekong River Basin

    SciTech Connect

    Baumgartner, Lee J.; Daniel Deng, Z.; Thorncraft, Garry; Boys, Craig A.; Brown, Richard S.; Singhanouvong, Douangkham; Phonekhampeng, Oudom

    2014-01-01

    Tropical rivers have high annual discharges optimal for hydropower and irrigation development. The Mekong River is one of the largest tropical river systems, supporting a unique mega-diverse fish community. Fish are an important commodity in the Mekong, contributing a large proportion of calcium, protein, and essential nutrients to the diet of the local people and providing a critical source of income for rural households. Many of these fish migrate not only upstream and downstream within main-channel habitats but also laterally into highly productive floodplain habitat to both feed and spawn. Most work to date has focused on providing for upstream fish passage, but downstream movement is an equally important process to protect. Expansion of hydropower and irrigation weirs can disrupt downstream migrations and it is important to ensure that passage through regulators or mini hydro systems is not harmful or fatal. Many new infrastructure projects (<6 m head) are proposed for the thousands of tributary streams throughout the Lower Mekong Basin and it is important that designs incorporate the best available science to protect downstream migrants. Recent advances in technology have provided new techniques which could be applied to Mekong fish species to obtain design criteria that can facilitate safe downstream passage. Obtaining and applying this knowledge to new infrastructure projects is essential in order to produce outcomes that are more favorable to local ecosystems and fisheries.

  17. Standard format and content acceptance criteria for the Material Control and Accounting (MC and A) Reform Amendment: 10 CFR Part 74, Subpart E. Revision 1

    SciTech Connect

    1995-04-01

    In 1987 the NRC revised the material control and accounting requirements for NRC licensees authorized to possess and use a formula quantity (i.e., 5 formula kilograms or more) of strategic special nuclear material. Those revisions issued as 10 CFR 74.51-59 require timely monitoring of in-process inventory and discrete items to detect anomalies potentially indicative of material losses. Timely detection and enhanced loss localization capabilities are beneficial to alarm resolution and also for material recovery in the event of an actual loss. NUREG-1280 was issued in 1987 to present criteria that could be used by applicants, licensees, and NRC license reviewers in the initial preparation and subsequent review of fundamental nuclear material control (FNMC) plans submitted in response to the Reform Amendment. This document is also intended for both licensees and license reviewers with respect to FNMC plan revisions. General performance objectives, system capabilities, process monitoring, item monitoring, alarm resolution, quality assurance, and accounting are addressed. This revision to NUREG-1280 is an expansion of the initial edition, which clarifies and expands upon several topics and addresses issues identified under Reform Amendment implementation experience.

  18. CERISE, a French radioprotection code, to assess the radiological impact and acceptance criteria of installations for material handling, and recycling or disposal of very low-level radioactive waste

    SciTech Connect

    Santucci, P.; Guetat, P.

    1993-12-31

    This document describes the code CERISE, Code d`Evaluations Radiologiques Individuelles pour des Situations en Enterprise et dans l`Environnement. This code has been developed in the frame of European studies to establish acceptance criteria of very low-level radioactive waste and materials. This code is written in Fortran and runs on PC. It calculates doses received by the different pathways: external exposure, ingestion, inhalation and skin contamination. Twenty basic scenarios are already elaborated, which have been determined from previous studies. Calculations establish the relation between surface, specific and/or total activities, and doses. Results can be expressed as doses for an average activity unit, or as average activity limits for a set of reference doses (defined for each scenario analyzed). In this last case, the minimal activity values and the corresponding limiting scenarios, are selected and summarized in a final table.

  19. A proposed approach for quantitative benefit-risk assessment in diagnostic radiology guideline development: the American College of Radiology Appropriateness Criteria Example.

    PubMed

    Agapova, Maria; Bresnahan, Brian B; Higashi, Mitchell; Kessler, Larry; Garrison, Louis P; Devine, Beth

    2017-02-01

    The American College of Radiology develops evidence-based practice guidelines to aid appropriate utilization of radiological procedures. Panel members use expert opinion to weight trade-offs and consensus methods to rate appropriateness of imaging tests. These ratings include an equivocal range, assigned when there is disagreement about a technology's appropriateness and the evidence base is weak or for special circumstances. It is not clear how expert consensus merges with the evidence base to arrive at an equivocal rating. Quantitative benefit-risk assessment (QBRA) methods may assist decision makers in this capacity. However, many methods exist and it is not clear which methods are best suited for this application. We perform a critical appraisal of QBRA methods and propose several steps that may aid in making transparent areas of weak evidence and barriers to consensus in guideline development. We identify QBRA methods with potential to facilitate decision making in guideline development and build a decision aid for selecting among these methods. This study identified 2 families of QBRA methods suited to guideline development when expert opinion is expected to contribute substantially to decision making. Key steps to deciding among QBRA methods involve identifying specific benefit-risk criteria and developing a state-of-evidence matrix. For equivocal ratings assigned for reasons other than disagreement or weak evidence base, QBRA may not be needed. In the presence of disagreement but the absence of a weak evidence base, multicriteria decision analysis approaches are recommended; and in the presence of weak evidence base and the absence of disagreement, incremental net health benefit alone or combined with multicriteria decision analysis is recommended. Our critical appraisal further extends investigation of the strengths and limitations of select QBRA methods in facilitating diagnostic radiology clinical guideline development. The process of using the decision

  20. [Classification of Histopathological Findings in the Liver Cited in the Pesticides Risk Assessment Reports Published by the Food Safety Commission of Japan and Thesaurus Construction Based on the International Harmonization of Nomenclature and Diagnostic (INHAND) Criteria].

    PubMed

    Inoue, Kaoru; Takahashi, Miwa; Umemura, Takashi; Yoshida, Midori

    2015-01-01

    Histopathological findings are important to the understanding of toxicity profiles of pesticides. The liver is often a target organ of chemicals. In the present study, histopathological findings in the liver cited in the pesticides risk assessment reports published by the Food Safety Commission of Japan were classified. The histopathological findings were obtained in repeated-dose 90-day oral toxicity studies of mice, rats and dogs and carcinogenicity studies of rodents. After the classification, a thesaurus was constructed based on the International Harmonization of Nomenclature and Diagnostic (INHAND) Criteria. We recommend the use of INHAND criteria in risk assessment reports to improve mutual understanding between applicants and risk assessors.

  1. Multiformat video and laser cameras: history, design considerations, acceptance testing, and quality control. Report of AAPM Diagnostic X-Ray Imaging Committee Task Group No. 1.

    PubMed

    Gray, J E; Anderson, W F; Shaw, C C; Shepard, S J; Zeremba, L A; Lin, P J

    1993-01-01

    Acceptance testing and quality control of video and laser cameras is relatively simple, especially with the use of the SMPTE test pattern. Photographic quality control is essential if one wishes to be able to maintain the quality of video and laser cameras. In addition, photographic quality control must be carried out with the film used clinically in the video and laser cameras, and with a sensitometer producing a light spectrum similar to that of the video or laser camera. Before the end of the warranty period a second acceptance test should be carried out. At this time the camera should produce the same results as noted during the initial acceptance test. With the appropriate acceptance and quality control the video and laser cameras should produce quality images throughout the life of the equipment.

  2. Diagnosing gestational diabetes mellitus: implications of recent changes in diagnostic criteria and role of glycated haemoglobin (HbA1c).

    PubMed

    Hanna, Fahmy W; Duff, Christopher J; Shelley-Hitchen, Ann; Hodgson, Ellen; Fryer, Anthony A

    2017-04-01

    Gestational diabetes mellitus (GDM; approximately 5% of pregnancies) represents the most important risk factor for development of later-onset diabetes mellitus. We examined concordance between GDM diagnosis defined using the original 1999 World Health Organization (WHO) criteria and the more recent 2013 WHO criteria and 2015 National Institute for Health and Care Excellence (NICE) criteria. We studied two groups: a case-control group of 257 GDM positive and 266 GDM negative cases, and an incident cohort 699 GDM positive and 6,231 GDM negative cases. In the incident cohort, GDM prevalence was 3.7% (WHO 1999 criteria), 11.4% (NICE 2015 criteria) and 13.7% (WHO 2013 criteria). Our results showed that a significant number of additional cases are detected using the more recent NICE and WHO criteria than the original 1999 WHO criteria, but these additional cases represent an intermediate group with 'moderate' dysglycaemia (abnormal blood glucose levels). Our results also show that use of these newer criteria misses a similar group of intermediate cases that were defined as GDM by the 1999 WHO criteria and that glycated haemoglobin in isolation is unlikely to replace the oral glucose tolerance test in GDM diagnosis.

  3. Physiological Acceptance Criteria for Cold Weather Clothing

    DTIC Science & Technology

    1991-04-01

    subjective feelings of thermal comfort and temperature sensation were examined. Under many conditions that Navy cold weather clothing items are worn, it...is not practical to expect that the optimal level of thermal comfort can be obtained. Allowing for a moderate level of cold sensation and thermal

  4. WIPP waste acceptance criteria and transportation system

    SciTech Connect

    Wu, C.F.; Ward, T.R.; Gregory, P.C.

    1991-12-31

    The Waste Isolation Pilot Plant (WIPP), located near Carlsbad, New Mexico, USA, is a US Department of Energy (DOE) facility designed as a permanent repository for transuranic wastes in the center of a 2,000-foot-thick salt bed situated 2,150 feet underground. Construction of the facility started in 1975, under a congressional act of site selection. In 1979, demonstration of safe disposal at the WIPP was authorized by Public Law 96-164. The operational philosophy and practice at the facility are: (1) start clean -- stay clean, (2) meet or exceed regulatory requirements, and (3) control radiation exposure levels to as low as reasonably achievable (ALARA). Strict safety measures must be taken in the areas of waste preparation, transportation, and facility operation.

  5. Comparison of the results between two diagnostic criteria by ADA and WHO among subjects with FPG 5.6-7.8 mmol/l in Kin-Hu and Kin-Chen, Kinmen, 1991-94.

    PubMed

    Li, C L; Tsai, S T; Chou, P

    1999-08-01

    The objective of this study was to compare the results between two diagnostic criteria by ADA (1997) and WHO (1985) among those with fasting plasma glucose (FPG) level 5.6-7.8 mmol/l from a community-based survey in Kin-Hu and Kin-Chen, Kinmen conducted in 1991-94. According to official household registry, 10,797 residents aged over 30 were eligible for screening. 7580 had completed FPG screening and 1855 with FPG 5.6-7.8 mmol/l were invited to receive a 75-g oral glucose tolerance test (OGTT). 78.5% (1456/1855) had completed OGTT. The prevalence of impaired fasting glucose (IFG, by ADA) was 15.7%; the prevalence of impaired glucose tolerance (IGT, by WHO) was 22.7%; the prevalence of undiagnosed diabetes was 7.4% by ADA criteria and 10.9% by WHO criteria. It should be noticed that, among subjects with FPG 5.6-7.8 mmol/l, 50.3% of individuals with undiagnosed diabetes and 67.6% of individuals with IGT by WHO criteria would be missed by ADA criteria. Based on the above findings, the two-step screening strategy using FPG as the first line screening and OGTT for high-risk group (FPG 5.6-7.8 mmol/l) only was recommended in epidemiological study and case finding in consideration of feasibility and validity.

  6. Diagnostic criteria for bipolarity based on an international sample of 5,635 patients with DSM-IV major depressive episodes.

    PubMed

    Angst, J; Gamma, A; Bowden, C L; Azorin, J M; Perugi, G; Vieta, E; Young, A H

    2012-02-01

    To assess the clinical validity of individual DSM-IV criteria for hypomania. In an international sample of 5,635 patients with major depressive episodes (Bridge Study), DSM-IV criteria for hypomania (stem questions, number and quality of symptoms, duration and exclusion criteria) were systematically assessed and their validity analysed on the basis of clinical data including family history, course, and other clinical characteristics. Three stem questions for hypomania, irritability, elevated mood and the added question of increased activity, showed comparable validity. The results support the current DSM-IV requirement for a higher symptom threshold (4 of 7 hypomanic symptoms) in cases of irritable mood. Longer durations of hypomanic episodes were associated with higher scores on all validators. The results did not support the DSM-IV durational requirements for hypomanic episodes (4 days) and manic episodes (7 days). Brief hypomanic episodes of 1, 2 or 3 days were valid and would meet validity criteria for inclusion. The three exclusion criteria in DSM-IV (hypomania due to the use of antidepressants or of other substances, or to other medical conditions) were found to exclude patients with bipolar depression and should therefore not be retained. These results support several revisions of the DSM-IV concept of hypomanic episodes: specifically, the inclusion of increased activity as a gate question, the inclusion of 1 or 2 to 3-day episodes and the elimination of all exclusion criteria.

  7. Update on diagnosis of acute rheumatic fever: 2015 Jones criteria.

    PubMed

    Eroğlu, Ayşe Güler

    2016-03-01

    In the final Jones criteria, different diagnostic criteria were established for the diagnosis of acute rheumatic fever for low risk and moderate-high risk populations. Turkey was found to be compatible with moderate-high risk populations as a result of regional screenings performed in terms of acute rheumatic fever and rheumatic heart disease. The changes in the diagnostic criteria for low-risk populations include subclinical carditis found on echocardiogram as a major criterion in addition to carditis found clinically and a body temperature of 38.5°C and above as a minor criterion. In moderate-high risk populations including Turkey, subclinical carditis found on echocardiogram in addition to clinical carditis is used as a major criterion as a new amendment. In addition, aseptic monoarthritis and polyarthralgia are used as major criteria in addition to migratory arthritis and monoarhtralgia is used as a minor criterion among joint findings. However, differentiation of subclinical carditis from physiological valve regurgitation found in healthy individuals and exclusion of other diseases involving joints when aseptic monoarthritis and polyarthralgia are used as major criteria are very important. In addition, a body temperature of 38°C and above and an erythrocyte sedimentation rate of 30 mm/h and above have been accepted as minor criteria. The diagnostic criteria for the first attack have not been changed; three minor findings have been accepted in presence of previous sterptococcal infection in addition to the old cirteria for recurrent attacks. In the final Jones criteria, it has been recommended that patients who do not fully meet the diagnostic criteria of acute rheumatic fever should be treated as acute rheumatic fever if another diagnosis is not considered and should be followed up with benzathine penicilin prophylaxis for 12 months. It has been decided that these patients be evaluated 12 months later and a decision for continuation or discontinuation of

  8. Update on diagnosis of acute rheumatic fever: 2015 Jones criteria

    PubMed Central

    Eroğlu, Ayşe Güler

    2016-01-01

    In the final Jones criteria, different diagnostic criteria were established for the diagnosis of acute rheumatic fever for low risk and moderate-high risk populations. Turkey was found to be compatible with moderate-high risk populations as a result of regional screenings performed in terms of acute rheumatic fever and rheumatic heart disease. The changes in the diagnostic criteria for low-risk populations include subclinical carditis found on echocardiogram as a major criterion in addition to carditis found clinically and a body temperature of 38.5°C and above as a minor criterion. In moderate-high risk populations including Turkey, subclinical carditis found on echocardiogram in addition to clinical carditis is used as a major criterion as a new amendment. In addition, aseptic monoarthritis and polyarthralgia are used as major criteria in addition to migratory arthritis and monoarhtralgia is used as a minor criterion among joint findings. However, differentiation of subclinical carditis from physiological valve regurgitation found in healthy individuals and exclusion of other diseases involving joints when aseptic monoarthritis and polyarthralgia are used as major criteria are very important. In addition, a body temperature of 38°C and above and an erythrocyte sedimentation rate of 30 mm/h and above have been accepted as minor criteria. The diagnostic criteria for the first attack have not been changed; three minor findings have been accepted in presence of previous sterptococcal infection in addition to the old cirteria for recurrent attacks. In the final Jones criteria, it has been recommended that patients who do not fully meet the diagnostic criteria of acute rheumatic fever should be treated as acute rheumatic fever if another diagnosis is not considered and should be followed up with benzathine penicilin prophylaxis for 12 months. It has been decided that these patients be evaluated 12 months later and a decision for continuation or discontinuation of

  9. Diagnosing attention-deficit hyperactivity disorder (ADHD) in children involved with child protection services: are current diagnostic guidelines acceptable for vulnerable populations?

    PubMed

    Klein, B; Damiani-Taraba, G; Koster, A; Campbell, J; Scholz, C

    2015-03-01

    Children involved with child protection services (CPS) are diagnosed and treated for attention-deficit hyperactivity disorder (ADHD) at higher rates than the general population. Children with maltreatment histories are much more likely to have other factors contributing to behavioural and attentional regulation difficulties that may overlap with or mimic ADHD-like symptoms, including language and learning problems, post-traumatic stress disorder, attachment difficulties, mood disorders and anxiety disorders. A higher number of children in the child welfare system are diagnosed with ADHD and provided with psychotropic medications under a group care setting compared with family-based, foster care and kinship care settings. However, children's behavioural trajectories change over time while in care. A reassessment in the approach to ADHD-like symptoms in children exposed to confirmed (or suspected) maltreatment (e.g. neglect, abuse) is required. Diagnosis should be conducted within a multidisciplinary team and practice guidelines regarding ADHD diagnostic and management practices for children in CPS care are warranted both in the USA and in Canada. Increased education for caregivers, teachers and child welfare staff on the effects of maltreatment and often perplexing relationship with ADHD-like symptoms and co-morbid disorders is also necessary. Increased partnerships are needed to ensure the mental well-being of children with child protection involvement.

  10. A Comparison of Brunt Criteria, the Non Alcoholic Fatty Liver Disease Activity Score (NAS) & a Proposed NAS-including fibrosis as Valid Diagnostic Scores for NASH

    PubMed Central

    Santiago-Rolón, Amarilys; Purcell, Dagmary; Rosado, Kathia; Toro, Doris H.

    2016-01-01

    Objective Non-alcoholic steatohepatitis (NASH) can result in cirrhosis and end stage liver disease. It is of utmost importance to differentiate NASH from simple steatosis. The aim of this study is to determine the prevalence of NASH in Latino veterans with metabolic syndrome and compare histologic grading using Brunt Criteria, the NAFLD activity score (NAS), and a proposed NAS score including fibrosis. Methods Veterans with metabolic syndrome, hepatic steatosis and elevation of ALT/AST who underwent a liver biopsy from 2004-2010 were included in this study. Biopsies were evaluated by a single blinded Hepatopathologist. Steatosis, lobular inflammation, ballooning and fibrosis were graded per specimen. Each biopsy was evaluated using Brunt criteria, NAS and NAS plus fibrosis. Results Sixty patients were included in this study, 88.3% men with a mean age of 50.4 (± 12.8). 50.0% met criteria for NASH according to the Brunt system. When classifying biopsies using NAS, only 30.0% (18/60) had a score ≥5, while when adding fibrosis, the number of patients with a score ≥5 increased to 33 (55.0%). When evaluating the predictive ability of the two scoring systems, we found that NAS including fibrosis had a higher sensitivity than NAS (86.7% vs. 40.0%) and a lower specificity (76.7% vs. 80.0%). Conclusion In our population with metabolic syndrome and altered liver function tests, about 50-55% had steatohepatitis. There were significant differences between the scoring systems. When using NAS-plus-fibrosis more patients were recognized and the sensitivity increased. Further validation studies are required to evaluate this proposed NAS scoring System. PMID:26602577

  11. Normative values for stool frequency and form using Rome III diagnostic criteria for functional constipation in adults: systematic review with meta-analysis.

    PubMed

    Miller, Larry E; Ibarra, Alvin; Ouwehand, Arthur C; Zimmermann, Angela K

    2017-01-01

    When designing clinical trials focused on functional constipation therapies, understanding the normative values of populations selected using the Rome III criteria is important for estimating baseline symptom severity, and for power analysis and sample size calculations. The objective of this review was to determine normative ranges for stool frequency and form in adults with functional constipation (Rome III criteria). Eligible studies reported stool frequency or form; random effects meta-analysis was performed with subgroup analyses to explore sources of heterogeneity. A total of 25 studies (43 groups, 2292 subjects) were included. Pooled estimates were 2.7 (95% CI 2.4-3.0) for weekly stools and 2.4 (95% CI 2.1-2.6) for stool form (Bristol scale). Heterogeneity was high for both outcomes (both I(2)=96%, P<0.001). Subgroup analysis revealed that weekly bowel movement frequency was higher in larger than in smaller studies (3.1 vs. 2.3, P<0.001) and in studies conducted in Europe compared with those in the Americas (3.1 vs. 2.2, P=0.02). For stool form, the use of a daily diary versus subject recall was the sole explanatory variable (2.5 vs. 2.1, P<0.05). We conclude that adults with functional constipation have significant variation in stool frequency and form, explained in part by geography and study design.

  12. Normative values for stool frequency and form using Rome III diagnostic criteria for functional constipation in adults: systematic review with meta-analysis

    PubMed Central

    Miller, Larry E.; Ibarra, Alvin; Ouwehand, Arthur C.; Zimmermann, Angela K.

    2017-01-01

    When designing clinical trials focused on functional constipation therapies, understanding the normative values of populations selected using the Rome III criteria is important for estimating baseline symptom severity, and for power analysis and sample size calculations. The objective of this review was to determine normative ranges for stool frequency and form in adults with functional constipation (Rome III criteria). Eligible studies reported stool frequency or form; random effects meta-analysis was performed with subgroup analyses to explore sources of heterogeneity. A total of 25 studies (43 groups, 2292 subjects) were included. Pooled estimates were 2.7 (95% CI 2.4-3.0) for weekly stools and 2.4 (95% CI 2.1-2.6) for stool form (Bristol scale). Heterogeneity was high for both outcomes (both I2=96%, P<0.001). Subgroup analysis revealed that weekly bowel movement frequency was higher in larger than in smaller studies (3.1 vs. 2.3, P<0.001) and in studies conducted in Europe compared with those in the Americas (3.1 vs. 2.2, P=0.02). For stool form, the use of a daily diary versus subject recall was the sole explanatory variable (2.5 vs. 2.1, P<0.05). We conclude that adults with functional constipation have significant variation in stool frequency and form, explained in part by geography and study design. PMID:28243036

  13. Diagnostic criteria for an enzyme-linked immunosorbent assay for occult heartworm disease: standardization of the test system in naturally exposed dogs.

    PubMed

    Gillis, J M; Smith, R D; Todd, K S

    1984-11-01

    The development of criteria for interpreting and reporting the results of an occult heartworm enzyme-linked immunosorbent assay to practitioners is described. The antigen is a saline extract of adult female Dirofilaria immitis. The cutoff absorbance A400 nm values were estimated, using 106 dogs free of infection. Any A400 nm value less than 0.526 is considered negative and values greater than or equal to 0.784 are positive. Intermediate A400 nm values are interpreted as suspect. Absorbance values for serum samples from 13 client-owned amicrofilaremic dogs revealed a bimodal distribution consistent with presumptive diagnosis based on clinical signs, which indicates that the test may be used to support a diagnosis of occult heartworm disease. The present serotest, however, is unable to distinguish microfilaremic dogs from noninfected dogs. Serum from dogs infected with other common helminths failed to crossreact with the D immitis antigen, with the exception of Dipetalonema reconditum.

  14. Nodular Mucinosis of the Breast in a Male: Reassessment of Diagnostic Criteria and Proposal for Its Classification as a Soft Tissue Tumor in the Myofibroblastoma and Spindle Cell Lipoma Spectrum.

    PubMed

    Fernández-Figueras, Maria Teresa; Kazakov, Dmitry V; López Martos, Raquel; Ojanguren, Isabel; Vila, Jordi; Ariza, Aurelio

    2014-01-01

    Nodular mucinosis of the breast (NMB) is a rare entity with only a few cases described in the literature, most of them in young girls. All cases are located in the nipple and areolar area and microscopically consist of a multinodular myxoid mesenchymal proliferation. Bands of sclerotic collagen containing preexisting breast ducts and abundant vascularization are other features typical of NMB. No relation to Carney complex has been reported, and an indolent behavior is the rule in all patients. We present a case of NMB occurring in the nipple of a 46-year-old man and analyze the clinicopathological features of the other cases of NMB reported in the English literature, concluding that two of them most likely correspond to trauma-induced cutaneous focal mucinosis of the mammary areola. Finally, we review diagnostic criteria for NMB and elaborate an ontogenetic hypothesis based on both its morphological resemblance to myofibroblastoma and its immunohistochemical profile.

  15. Referral for cancer genetics consultation: a review and compilation of risk assessment criteria

    PubMed Central

    Hampel, H; Sweet, K; Westman, J; Offit, K; Eng, C

    2004-01-01

    Methods: The criteria were based on a comprehensive review of publications describing diagnostic criteria for hereditary cancer syndromes and risk to first degree relatives of cancer patients. Priority was given to diagnostic criteria from consensus statements (for example, those from the National Comprehensive Cancer Network). Expert opinion from study personnel was then used to adopt a single set of criteria from other publications whenever guidelines differed. Results: Based on family history, a set of criteria was developed to identify patients at risk for a hereditary cancer susceptibility syndrome, patients with moderate risk who might benefit from increased cancer surveillance, and patients who are at average risk. The criteria were applied to 4360 individuals who provided their cancer family history between July 1999 and April 2002, using a touch screen computer system in the lobby of a comprehensive cancer centre. They categorised an acceptable number of users into each risk level: 14.9% high risk, 13.7% moderate risk, and 59.6% average risk; 11.8% provided insufficient information for risk assessment. Conclusions: These criteria should improve ease of referral and promote consistency across centres when evaluating patients for referral to cancer genetics specialists. PMID:14757853

  16. Monitoring Reading Behavior: Criteria for Performance.

    ERIC Educational Resources Information Center

    Powell, William R.

    Effective use of the informal reading inventory (IRI) depends upon the criteria used in determining the functional reading levels and more specifically the word recognition criteria employed in describing acceptable limits of oral reading behavior. The author of this paper looks at the diverse sets of criteria commonly used, the problems…

  17. The effects of tumor location on diagnostic criteria for canine malignant peripheral nerve sheath tumors (MPNSTs) and the markers for distinction between canine MPNSTs and canine perivascular wall tumors.

    PubMed

    Suzuki, S; Uchida, K; Nakayama, H

    2014-07-01

    Canine malignant peripheral nerve sheath tumors (MPNSTs) occur not only in the peripheral nervous system (PNS) but also in soft tissue and various organs (non-PNS). The most important diagnostic criterion is proof of peripheral nerve sheath origin. This is difficult in non-PNS MPNSTs, and its differential diagnosis is challenging. Canine perivascular wall tumors (PWTs) also commonly arise in soft tissue. Their histopathological features are quite similar to those of canine MPNSTs, making their differential diagnosis challenging. To elucidate whether the morphological features are applicable to diagnose non-PNS MPNSTs and to demonstrate useful markers for distinction between canine MPNSTs and PWTs, the authors examined 30 canine MPNSTs and 31 PWTs immunohistochemically for S100, nestin, NGFR, Olig2, claudin-1, CD57, PRX, α-SMA, desmin, and calponin. Among canine MPNSTs, the PNS tumors displayed significantly higher S100 and Olig2 expression than the non-PNS tumors. The expression levels of the other markers did not differ significantly, suggesting that the same morphological diagnostic criteria are applicable regardless of their location. The PWT cells displayed significantly weaker immunoreactivity than MPNSTs to markers used except α-SMA and desmin. Cluster analysis sorted most canine MPNSTs and PWTs into 2 distinctly different clusters, whereas 3 MPNSTs and 6 PWTs were assigned to the opposing cluster. These 3 MPNSTs were negative for almost all markers, while these 6 PWTs were positive for only neuronal markers. In particular, NGFR and Olig2 were almost negative in the rest of PWT cases. These findings suggest that NGFR and Olig2 are useful to distinguish these 2 tumors.

  18. When should conscientious objection be accepted?

    PubMed

    Magelssen, Morten

    2012-01-01

    This paper makes two main claims: first, that the need to protect health professionals' moral integrity is what grounds the right to conscientious objection in health care; and second, that for a given claim of conscientious objection to be acceptable to society, a certain set of criteria should be fulfilled. The importance of moral integrity for individuals and society, including its special role in health care, is advocated. Criteria for evaluating the acceptability of claims to conscientious objection are outlined. The precise content of the criteria is dictated by the two main interests that are at stake in the dilemma of conscientious objection: the patient's interests and the health professional's moral integrity. Alternative criteria proposed by other authors are challenged. The bold claim is made that conscientious objection should be recognised by society as acceptable whenever the five main criteria of the proposed set are met.

  19. Acceptance and Avoidance Processes at Different Levels of Psychological Recovery from Enduring Mental Illness

    PubMed Central

    Siqueira, Vinicius R.; Oades, Lindsay G.

    2015-01-01

    Objective. This study examined the use of psychological acceptance and experiential avoidance, two key concepts of Acceptance and Commitment Therapy (ACT), in the psychological recovery process of people with enduring mental illness. Method. Sixty-seven participants were recruited from the metropolitan, regional, and rural areas of New South Wales, Australia. They all presented some form of chronic mental illness (at least 12 months) as reflected in DSM-IV Axis I diagnostic criteria. The Acceptance and Action Questionnaire (AAQ-19) was used to measure the presence of psychological acceptance and experiential avoidance; the Recovery Assessment Scale (RAS) was used to examine the levels of psychological recovery; and the Scales of Psychological Well-Being was used to observe if there are benefits in utilizing psychological acceptance and experiential avoidance in the recovery process. Results. An analysis of objectively quantifiable measures found no clear correlation between the use of psychological acceptance and recovery in mental illness as measured by the RAS. The data, however, showed a relationship between psychological acceptance and some components of recovery, thereby demonstrating its possible value in the recovery process. Conclusion. The major contribution of this research was the emerging correlation that was observed between psychological acceptance and positive levels of psychological well-being among individuals with mental illness. PMID:26576412

  20. [Diagnostic value of fasting glucose, fructosamine, and glycated haemoglobin HbA(1c) with regard to ADA 1997 and who 1998 criteria for detecting diabetes and other glucose tolerance abnormalities].

    PubMed

    Gołembiewska, Edyta

    2004-01-01

    New diagnostic criteria for diabetes mellitus proposed by the American Diabetes Association in 1997 and the World Heath Organization Consultation Report in 1998 recommend lowering of the fasting plasma glucose (FPG) to 7.0 mmol/L. This change in the diagnostic FPG cut-off point was based on the results of well-documented epidemiological studies showing that increased risk of microangiopathy starts at values closer to 7.0 than 7.8 mmol/L used in the past. To facilitate the diagnosis, ADA Expert Committee recommends using FPG as the main diagnostic tool and eliminating OGTT from routine clinical practice. In contrast to ADA, WHO Consultation Group strongly recommended keeping OGTT in routine use. Due to the inconvenience, poor reproducibility, non-physiological character and labour-intensiveness of OGTT, an alternative test has been sought. The aim of this study was to determine whether fasting capillary glucose (FCG) along with fructosamine and glycated haemoglobin (HbA(1c)) perform better for the detection of glucose tolerance abnormalities than FCG alone. OGTT was performed in 1528 patients. Serum fructosamine was determined in 480 and glycated haemoglobin in 234 of these patients. To assess the value of FCG, fructosamine and glycated haemoglobin in predicting post-load glycaemia and detecting glucose tolerance abnormalities, multiple linear regression analysis and Receiver Operating Characteristics analysis were done. Fructosamine correlated stronger with 2h-postload glucose concentrations than with fasting glucose. HbA(1c) correlated stronger with FCG than with 2h-postload glucose. Combined use of fructosamine and FCG predicted 2h-postload glucose better than combined use of FCG and HbA(1c). Receiver Operating Characteristics curve analysis showed that FCG was the best criterion in discriminating diabetes. Combined use of FCG and fructosamine slightly improved the ability to discriminate glucose tolerance abnormalities from normal glucose tolerance. The

  1. Acceptance speech.

    PubMed

    Yusuf, C K

    1994-01-01

    I am proud and honored to accept this award on behalf of the Government of Bangladesh, and the millions of Bangladeshi children saved by oral rehydration solution. The Government of Bangladesh is grateful for this recognition of its commitment to international health and population research and cost-effective health care for all. The Government of Bangladesh has already made remarkable strides forward in the health and population sector, and this was recognized in UNICEF's 1993 "State of the World's Children". The national contraceptive prevalence rate, at 40%, is higher than that of many developed countries. It is appropriate that Bangladesh, where ORS was discovered, has the largest ORS production capacity in the world. It was remarkable that after the devastating cyclone in 1991, the country was able to produce enough ORS to meet the needs and remain self-sufficient. Similarly, Bangladesh has one of the most effective, flexible and efficient control of diarrheal disease and epidemic response program in the world. Through the country, doctors have been trained in diarrheal disease management, and stores of ORS are maintained ready for any outbreak. Despite grim predictions after the 1991 cyclone and the 1993 floods, relatively few people died from diarrheal disease. This is indicative of the strength of the national program. I want to take this opportunity to acknowledge the contribution of ICDDR, B and the important role it plays in supporting the Government's efforts in the health and population sector. The partnership between the Government of Bangladesh and ICDDR, B has already borne great fruit, and I hope and believe that it will continue to do so for many years in the future. Thank you.

  2. Perspectives on the revised Ghent criteria for the diagnosis of Marfan syndrome

    PubMed Central

    von Kodolitsch, Yskert; De Backer, Julie; Schüler, Helke; Bannas, Peter; Behzadi, Cyrus; Bernhardt, Alexander M; Hillebrand, Mathias; Fuisting, Bettina; Sheikhzadeh, Sara; Rybczynski, Meike; Kölbel, Tilo; Püschel, Klaus; Blankenberg, Stefan; Robinson, Peter N

    2015-01-01

    Three international nosologies have been proposed for the diagnosis of Marfan syndrome (MFS): the Berlin nosology in 1988; the Ghent nosology in 1996 (Ghent-1); and the revised Ghent nosology in 2010 (Ghent-2). We reviewed the literature and discussed the challenges and concepts of diagnosing MFS in adults. Ghent-1 proposed more stringent clinical criteria, which led to the confirmation of MFS in only 32%–53% of patients formerly diagnosed with MFS according to the Berlin nosology. Conversely, both the Ghent-1 and Ghent-2 nosologies diagnosed MFS, and both yielded similar frequencies of MFS in persons with a causative FBN1 mutation (90% for Ghent-1 versus 92% for Ghent-2) and in persons not having a causative FBN1 mutation (15% versus 13%). Quality criteria for diagnostic methods include objectivity, reliability, and validity. However, the nosology-based diagnosis of MFS lacks a diagnostic reference standard and, hence, quality criteria such as sensitivity, specificity, or accuracy cannot be assessed. Medical utility of diagnosis implies congruency with the historical criteria of MFS, as well as with information about the etiology, pathogenesis, diagnostic triggers, prognostic triggers, and potential complications of MFS. In addition, social and psychological utilities of diagnostic criteria include acceptance by patients, patient organizations, clinicians and scientists, practicability, costs, and the reduction of anxiety. Since the utility of a diagnosis or exclusion of MFS is context-dependent, prioritization of utilities is a strategic decision in the process of nosology development. Screening tests for MFS should be used to identify persons with MFS. To confirm the diagnosis of MFS, Ghent-1 and Ghent-2 perform similarly, but Ghent-2 is easier to use. To maximize the utility of the diagnostic criteria of MFS, a fair and transparent process of nosology development is essential. PMID:26124674

  3. The influence of the oscillation angle and the neck anteversion of the prosthesis on the cup safe-zone that fulfills the criteria for range of motion in total hip replacements. The required oscillation angle for an acceptable cup safe-zone.

    PubMed

    Yoshimine, Fumihiro

    2005-01-01

    A normal hip joint has more than 120 degrees flexion. The reduced range of motion (ROM) of total hip arthroplast leads to frequent prosthetic impingement, subluxation and dislocation. Prosthetic impingement may be more serious for metal-on-metal and ceramic-on-ceramic total hip prosthesis (THP). A larger oscillation angle of THP (OsA) and proper cup and neck positions make a larger theoretical ROM of a patient's artificial hip joint. But what OsA is required and what range of cup positions is kinetically accepted are not clearly understood. A ROM of more than 120 degrees flexion, 45 degrees internal-rotation at 90 degrees flexion, 30 degrees extension and 40 degrees external-rotation was defined as severe criteria for an acceptable ROM. Theoretical cup safe-zones were created that fulfill the severe criteria of ROM for (OsA=110 degrees , 120 degrees , 135 degrees ) by the mathematical formulas. The size of the cup safe-zone mainly depends on the size of the OsA. There is no cup safe-zone for 110 degrees OsA, an extremely small safe-zone for 120 degrees OsA and an acceptable safe-zone for 135 degrees OsA. Each THP has its own OsA, because OsA is the function of head and neck diameter and cup design. More than 135 degrees OsA enlarges the safe-zone of the prosthetic position, so it extends the acceptable range of error that surgeons cannot avoid completely. However, few THPs with more than 135 degrees OsA are currently clinically available. Both surgeons and manufacturers must realize that OsA is as essential as cup and neck orientations for ROM.

  4. Psychometric properties of the Japanese version of the Adult Attention-deficit hyperactivity disorder (ADHD) Self-Report Scale (ASRS-J) and its short scale in accordance with DSM-5 diagnostic criteria.

    PubMed

    Takeda, Toshinobu; Tsuji, Yui; Kurita, Hiroshi

    2017-04-01

    We developed the Japanese version of the Adult ADHD Self-Report Scale (ASRS-J) and report its psychometric properties. The ASRS-J and other questionnaires were administered to 48 adults with ADHD, 46 adults with non-ADHD psychiatric disorders, 96 non-clinical adults, and 894 university students. ADHD diagnoses were made using the Japanese semi-structured diagnostic interview for adult ADHD, which is compatible with the DSM-5. The ASRS-J, its subscales, and the short form, all had Cronbach's α values of around 0.80. Total scores on the ASRS-J and the ASRS-J-6 were highly correlated with readministration after a two-week interval. The total and 18 individual item scores in the ASRS-J were significantly higher in the ADHD group than the other three groups. ASRS-J scores were correlated with scores on the Japanese version of Conners' Adult ADHD Rating Scales-Self Report subscales (0.59≤r≤0.77), with one exception. ASRS-J scores were also correlated (albeit more weakly; r=0.38) with Beck Depression Inventory-II total scores. Employing optimal cut-offs, sensitivity, specificity, and positive and negative predictive values of the ASRS-J and ASRS-J-6 are all above 0.69. The ASRS-J and ASRS-J-6 showed acceptable psychometric properties, although further study is necessary.

  5. 48 CFR 2811.103 - Market acceptance.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 48 Federal Acquisition Regulations System 6 2010-10-01 2010-10-01 true Market acceptance. 2811.103... Planning DESCRIBING AGENCY NEEDS Selecting and Developing Requirements Documents 2811.103 Market acceptance... offerors to demonstrate that the items offered meet the criteria set forth in FAR 11.103(a)....

  6. Cleidocranial dysplasia: diagnostic criteria and combined treatment.

    PubMed

    Suba, Zsuzsanna; Balaton, Gergely; Gyulai-Gaál, Szabolcs; Balaton, Peter; Barabás, József; Tarján, Ildikó

    2005-11-01

    Cleidocranial dysplasia (CCD) is an uncommon, generalized skeletal disorder characterized by delayed ossification of the skull, aplastic or hypoplastic clavicles, and serious, complex dental abnormalities. There are many difficulties in the early diagnosis of CCD because a majority of the craniofacial abnormalities becomes obvious only during adolescence. In the present case, a hypoplastic midface, a relative prognathia of the mandible, and close approximation of the shoulders in the anterior plane were the conspicuous extraoral findings. Prolonged exfoliation of the primary dentition, unerupted supernumerary teeth, and the irregularly and partially erupted secondary dentition produced occlusional anomalies. The presence of the second permanent molars together with the primary dentition and wide spacing in the lower incisor area were typical dental signs. Gradual extraction of the supernumerary teeth and over-retained primary teeth was the first step of oral surgery. This was followed by a surgical exposure of the unerupted teeth by thinning of the cortical bone. Orthodontic treatment was aimed at parallel growth of the jaws. Removable appliances were used to expand the narrow maxillary and mandibular arches, and a Delaire mask compensated for the lack of sagittal growth of the upper jaw. Temporary functional rehabilitation was solved by partial denture. When the jaws have been fully developed, implant insertions and bridges are the therapeutic measures. The reported case and the literature data support the importance of the early diagnosis and interdisciplinary treatment of CCD.

  7. Tinea capitis: diagnostic criteria and treatment options.

    PubMed

    Meadows-Oliver, Mikki

    2009-01-01

    Tinea capitis is a fungal infection involving the hair shaft of the scalp. It is commonly referred to as ringworm and occurs primarily in children. Treatment with a systemic anti-fungal rather than topical treatment is required. Currently, two medications, griseofulvin (Grifulvin) and terbinafine (Lamisil Granules), are FDA-approved to treat tinea capitis. Treatment with griseofulvin is usually 6 to 8 weeks, while treatment with terbinafine requires 6 weeks. There are other medications currently not FDA-approved to treat tinea capitis that have similar cure rates and shorter durations of treatment for tinea capitis, and as a result, are being used off-label. This article reviews the research-based literature related to the treatment of tinea capitis with various pharmacologic agents.

  8. [Desmoplastic ameloblastoma. Clinical and histopathological diagnostic criteria].

    PubMed

    Maresi, E; Tortorici, S; Orlando, E; Burruano, F

    2003-03-01

    A rare case of desmoplastic ameloblastoma observed in a 62-year old man presenting a swelling in the anterior mandible area with abnormal mobility of 33, 34, 43, 45, is described. Diagnosis of desmoplastic ameloblastoma was based on: anterior localization, radiopaque appearance, severe desmoplastic stroma and increasing infiltrate pattern of the tumor. The authors suggest to consider the desmoplastic histotype as a different nosological entity defined "desmoplastic ameloblastoma" since these clinical and histopathological features are missing in the other histologic variants of common ameloblastoma. A radical surgical treatment is suggested for this neoplasia.

  9. [Diagnostic criteria. Benefits of early diagnosis].

    PubMed

    Gil Gregorio, Pedro

    2016-06-01

    Almost 36 million persons live with dementia worldwide. This figure is set to double by 2030, with 66 million patients, and by 2050 there will be 116 million affected persons. Dementia has an economic impact on individuals and health services and affects the global economy. It is important to evaluate costs to plan social services and healthcare and to provide information on the cost-effectiveness of treatments. The economic cost of dementia was around 604 billion dollars in 2010 and estimates are obviously set to rise.

  10. International Conference on Harmonisation; guidance on Q4B Evaluation and Recommendation of Pharmacopoeial Texts for use in the International Conference on Harmonisation Regions; Annex 4C on Microbiological Examination of Nonsterile Products: Acceptance Criteria for Pharmaceutical Preparations and Substances for Pharmaceutical Use General Chapter; availability. Notice.

    PubMed

    2009-04-08

    The Food and Drug Administration (FDA) is announcing the availability of a guidance entitled "Q4B Evaluation and Recommendation of Pharmacopoeial Texts for Use in the ICH Regions; Annex 4C: Microbiological Examination of Nonsterile Products: Acceptance Criteria for Pharmaceutical Preparations and Substances for Pharmaceutical Use General Chapter." The guidance was prepared under the auspices of the International Conference on Harmonisation of Technical Requirements for Registration of Pharmaceuticals for Human Use (ICH). The guidance provides the results of the ICH Q4B evaluation of the Microbiological Examination of Nonsterile Products: Acceptance Criteria for Pharmaceutical Preparations and Substances for Pharmaceutical Use General Chapter harmonized text from each of the three pharmacopoeias (United States, European, and Japanese) represented by the Pharmacopoeial Discussion Group (PDG). The guidance conveys recognition of the three pharmacopoeial methods by the three ICH regulatory regions and provides specific information regarding the recognition. The guidance is intended to recognize the interchangeability between the local regional pharmacopoeias, thus avoiding redundant testing in favor of a common testing strategy in each regulatory region. In the Federal Register of February 21, 2008 (73 FR 9575), FDA made available a guidance on the Q4B process entitled "Q4B Evaluation and Recommendation of Pharmacopoeial Texts for Use in the ICH Regions."

  11. Development of explicit criteria for cholecystectomy

    PubMed Central

    Quintana, J; Cabriada, J; d Lopez; Varona, M; Oribe, V; Barrios, B; Arostegui, I; Bilbao, A

    2002-01-01

    Objective: Consensus development techniques were used in the late 1980s to create explicit criteria for the appropriateness of cholecystectomy. New diagnostic and treatment techniques have been developed in the last decade, so an updated appropriateness of indications tool was developed for cholecystectomy in patients with non-malignant diseases. The validity and reliability of panel results using this tool were tested. Methods: Criteria were developed using a modified Delphi panel judgement process. The level of agreement between the panellists (six gastroenterologists and six surgeons) was analysed and the ratings were compared with those of a second different panel using weighted kappa statistics. Results: The results of the main panel were presented as a decision tree. Of the 210 scenarios evaluated by the main panel in the second round, 51% were found appropriate, 26% uncertain, and 23% inappropriate. Agreement was achieved in 54% of the scenarios and disagreement in 3%. Although the gastroenterologists tended to score fewer scenarios as appropriate, as a group they did not differ from the surgeons. Comparison of the ratings of the main panel with those of a second panel resulted in a weighted kappa statistic of 0.75. Conclusions: The parameters tested showed acceptable validity and reliability results for an evaluation tool. These results support the use of this algorithm as a screening tool for assessing the appropriateness of cholecystectomy. PMID:12468691

  12. The European Community Study Group on diagnostic criteria for Sjögren's syndrome. Sensitivity and specificity of tests for ocular and oral involvement in Sjögren's syndrome.

    PubMed Central

    Vitali, C; Moutsopoulos, H M; Bombardieri, S

    1994-01-01

    AIM--To establish a definitive set of diagnostic criteria in a multicentre European study a selected number of oral and ocular tests were performed on a large number of patients with Sjögrens Syndrome (SS) and controls. The diagnostic accuracy of each test for patients with primary and secondary SS and for controls at different ages, was studied. METHODS--Each centre received a clinical chart describing the series of tests to be conducted. The tests included: questionnaires for dry eye and dry mouth symptoms, Schirmer's-I-test (ScT), tear fluid lactoferrin level (TFLL), break-up time (BUT) and rose Bengal score (RBS) for the eye evaluation; unstimulated and stimulated whole saliva collection (UWSC and SWSC), salivary gland scintigraphy (SGS), parotid sialography (PS) and minor salivary gland biopsy (MSGB) for oral involvement. RESULTS--Data from 22 centres and 11 countries was collected on a total of 447 patients with SS (246 with primary SS and 201 with secondary SS) and 246 controls (of whom 113 had a connective tissue disease without SS). Among the ocular symptoms, the feeling of dry eye and 'sand in the eye' were the ones most commonly recorded in patients with SS. Similarly, the feeling of dry mouth, appearing either spontaneously or when the patient was eating or breathing, was the most frequent subjective oral symptom. Among the ocular tests, ScT showed the best balance between sensitivity and specificity (76.9% and 72.4% respectively), while RBS was the most specific test (81.7%). ScT and RBS gave also sufficiently concordant results. TFLL and BUT gave considerably less reliable results, which were not concordant with each other or with the other ocular tests. The quantitative lacrimal tests ScT and TFLL produced significantly different results in elderly controls, while RBS did not. Abnormal results for all of the ocular tests were less marked and less frequent in patients with secondary SS than in those with primary SS. The oral tests (except SWSC) were

  13. Crew Transportation Technical Standards and Design Evaluation Criteria

    NASA Technical Reports Server (NTRS)

    Lueders, Kathryn L.; Thomas, Rayelle E. (Compiler)

    2015-01-01

    Crew Transportation Technical Standards and Design Evaluation Criteria contains descriptions of technical, safety, and crew health medical processes and specifications, and the criteria which will be used to evaluate the acceptability of the Commercial Providers' proposed processes and specifications.

  14. Are the ADA hemoglobin A(1c) criteria relevant for the diagnosis of type 2 diabetes in youth?

    PubMed

    Kapadia, Chirag R

    2013-02-01

    Diagnostic criteria for diabetes in children have not been established with nearly the rigor as that employed in adults. Recently revised American Diabetes Association (ADA) criteria allowed utilization of hemoglobin A(1c) (HbA1c) ≥ 6.5 % for diagnosis of diabetes. A recent series of pediatric studies appear to show that HbA1c has lower sensitivity than Fasting plasma glucose (FPG) or oral glucose tolerance test (OGTT). However, FPG and OGTT have themselves never been validated in children. Studies to validate diagnostic thresholds in children appear unlikely to take place. Thus, accepting the major ADA diagnostic criteria appears to be the best course of action for the pediatric community. One area in which correlation studies between HbA1c and FPG or OGTT might shed light is in the definition of criteria for intervention in 'pre-diabetes,' as the Diabetes Prevention Program Trial did not use HbA1c. However, such treatment, and the exact diagnostic thresholds at which it should be initiated in children, remains unproven.

  15. 16 CFR 1031.12 - Membership criteria.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 16 Commercial Practices 2 2011-01-01 2011-01-01 false Membership criteria. 1031.12 Section 1031.12... EMPLOYEE INVOLVEMENT IN VOLUNTARY STANDARDS ACTIVITIES Employee Involvement § 1031.12 Membership criteria..., the Commission's Voluntary Standards Coordinator may accept such membership. (c) Commission...

  16. 16 CFR 1031.12 - Membership criteria.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 16 Commercial Practices 2 2014-01-01 2014-01-01 false Membership criteria. 1031.12 Section 1031.12... EMPLOYEE INVOLVEMENT IN VOLUNTARY STANDARDS ACTIVITIES Employee Involvement § 1031.12 Membership criteria..., the Commission's Voluntary Standards Coordinator may accept such membership. (c) Commission...

  17. 16 CFR 1031.12 - Membership criteria.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Membership criteria. 1031.12 Section 1031.12... EMPLOYEE INVOLVEMENT IN VOLUNTARY STANDARDS ACTIVITIES Employee Involvement § 1031.12 Membership criteria..., the Commission's Voluntary Standards Coordinator may accept such membership. (c) Commission...

  18. 16 CFR 1031.12 - Membership criteria.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 16 Commercial Practices 2 2012-01-01 2012-01-01 false Membership criteria. 1031.12 Section 1031.12... EMPLOYEE INVOLVEMENT IN VOLUNTARY STANDARDS ACTIVITIES Employee Involvement § 1031.12 Membership criteria..., the Commission's Voluntary Standards Coordinator may accept such membership. (c) Commission...

  19. 16 CFR 1031.12 - Membership criteria.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 16 Commercial Practices 2 2013-01-01 2013-01-01 false Membership criteria. 1031.12 Section 1031.12... EMPLOYEE INVOLVEMENT IN VOLUNTARY STANDARDS ACTIVITIES Employee Involvement § 1031.12 Membership criteria..., the Commission's Voluntary Standards Coordinator may accept such membership. (c) Commission...

  20. Common Risk Criteria for National Test Ranges

    DTIC Science & Technology

    2010-12-01

    operations, excluding aviation operations. 15. SUBJECT TERMS Range Safety Group; debris injury thresholds; debris hazard thresholds; acceptable...excluding aviation operations. 15. SUBJECT TERMS Range Safety Group; debris injury thresholds; debris hazard thresholds; acceptable risk criteria 16...uncertainty applies to all hazards, not just debris . h. Modifying the description of catastrophic risk in Chapter 4 and Chapter 7 of the Supplement

  1. 46 CFR 164.120-7 - Acceptance criteria.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... inspections and tests required by this section, including weathering of samples, are the responsibility of the... of this subpart) and must be tested and meet the requirements of weathering and post-weathering mechanical testing as shown in Table 164.120-7 of this section. Samples for the weathering must be...

  2. DWPF COAL CARBON WASTE ACCEPTANCE CRITERIA LIMIT EVALUATION

    SciTech Connect

    Lambert, D.; Choi, A.

    2010-06-21

    A paper study was completed to assess the impact on the Defense Waste Processing Facility (DWPF)'s Chemical Processing Cell (CPC) acid addition and melter off-gas flammability control strategy in processing Sludge Batch 10 (SB10) to SB13 with an added Fluidized Bed Steam Reformer (FBSR) stream and two Salt Waste Processing Facility (SWPF) products (Strip Effluent and Actinide Removal Stream). In all of the cases that were modeled, an acid mix using formic acid and nitric acid could be achieved that would produce a predicted Reducing/Oxidizing (REDOX) Ratio of 0.20 Fe{sup +2}/{Sigma}Fe. There was sufficient formic acid in these combinations to reduce both the manganese and mercury present. Reduction of manganese and mercury are both necessary during Sludge Receipt and Adjustment Tank (SRAT) processing, however, other reducing agents such as coal and oxalate are not effective in this reduction. The next phase in this study will be experimental testing with SB10, FBSR, and both SWPF simulants to validate the assumptions in this paper study and determine whether there are any issues in processing these streams simultaneously. The paper study also evaluated a series of abnormal processing conditions to determine whether potential abnormal conditions in FBSR, SWPF or DWPF would produce melter feed that was too oxidizing or too reducing. In most of the cases that were modeled with one parameter at its extreme, an acid mix using formic acid and nitric acid could be achieved that would produce a predicted REDOX of 0.09-0.30 (target 0.20). However, when a run was completed with both high coal and oxalate, with minimum formic acid to reduce mercury and manganese, the final REDOX was predicted to be 0.49 with sludge and FBSR product and 0.47 with sludge, FBSR product and both SWPF products which exceeds the upper REDOX limit.

  3. 44 CFR 362.3 - Criteria for determining acceptance.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... gift of services is offered to the Administrator for the benefit of the National Earthquake Hazards... objectives of the National Earthquake Hazards Reduction Program, as defined in 42 U.S.C. 7702. (b) All...

  4. 44 CFR 362.3 - Criteria for determining acceptance.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... gift of services is offered to the Administrator for the benefit of the National Earthquake Hazards... objectives of the National Earthquake Hazards Reduction Program, as defined in 42 U.S.C. 7702. (b) All...

  5. 44 CFR 362.3 - Criteria for determining acceptance.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... gift of services is offered to the Administrator for the benefit of the National Earthquake Hazards... objectives of the National Earthquake Hazards Reduction Program, as defined in 42 U.S.C. 7702. (b) All...

  6. 44 CFR 362.3 - Criteria for determining acceptance.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... gift of services is offered to the Administrator for the benefit of the National Earthquake Hazards... objectives of the National Earthquake Hazards Reduction Program, as defined in 42 U.S.C. 7702. (b) All...

  7. 44 CFR 362.3 - Criteria for determining acceptance.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... gift of services is offered to the Administrator for the benefit of the National Earthquake Hazards... objectives of the National Earthquake Hazards Reduction Program, as defined in 42 U.S.C. 7702. (b) All...

  8. 49 CFR 173.57 - Acceptance criteria for new explosives.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... (Test Method D-3 in appendix D to this part), a non-gelatin dynamite loses more than 3 percent by weight of the liquid explosive or a gelatin dynamite loses more than 10 percent by weight of the...

  9. 49 CFR 173.57 - Acceptance criteria for new explosives.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... (Test Method D-3 in appendix D to this part), a non-gelatin dynamite loses more than 3 percent by weight of the liquid explosive or a gelatin dynamite loses more than 10 percent by weight of the...

  10. 49 CFR 173.57 - Acceptance criteria for new explosives.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... (Test Method D-3 in appendix D to this part), a non-gelatin dynamite loses more than 3 percent by weight of the liquid explosive or a gelatin dynamite loses more than 10 percent by weight of the...

  11. 49 CFR 173.57 - Acceptance criteria for new explosives.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... appendix D to this part), a non-gelatin dynamite loses more than 3 percent by weight of the liquid explosive or a gelatin dynamite loses more than 10 percent by weight of the liquid explosive; or (3)...

  12. 49 CFR 173.57 - Acceptance criteria for new explosives.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... (Test Method D-3 in appendix D to this part), a non-gelatin dynamite loses more than 3 percent by weight of the liquid explosive or a gelatin dynamite loses more than 10 percent by weight of the...

  13. Design, Test, and Acceptance Criteria for Helicopter Transparent Enclosures

    DTIC Science & Technology

    1978-11-01

    Visibility Data From Ballistic Tests . . .*. . 212 37 Dispersion of Penetrations in Witness Sheet . 219 38 Foam Penetration Data . . . . . . . . . o 224 39...light scattered and therefore lost in passage through the material. To provide a frame of reference, a material with 30% haze would be considered...polycarbonate materials were superior to glass in resisting impinge- ment abrasion; apparently due to ductility of the coating which minimized spallation

  14. 7 CFR 42.133 - Portion of production acceptance criteria.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Section 42.133 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE COMMODITY STANDARDS AND STANDARD CONTAINER REGULATIONS STANDARDS FOR CONDITION OF FOOD CONTAINERS On-Line Sampling and Inspection...

  15. 7 CFR 42.107 - Lot acceptance criteria.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE COMMODITY STANDARDS AND STANDARD CONTAINER REGULATIONS STANDARDS FOR CONDITION OF FOOD CONTAINERS Procedures for Stationary Lot Sampling and...

  16. Acceptance criteria for reactor coolant pumps and valves

    SciTech Connect

    Gupta, N.K.; Miller, R.F.; Sindelar, R.L.

    1993-05-01

    Each of the six primary coolant loop systems of the Savannah River Site (SRS) production reactors contains one reactor coolant pump, one PUMP suction side motor operated valve, and other smaller valves. The pumps me double suction, double volute, and radially split type pumps. The valves are different size shutoff and control valves rated from ANSI B16.5 construction class 150 to class 300. The reactor coolant system components, also known as the process water system (PWS), are classified as nuclear Safety Class I components. These components were constructed in the 1950`s in accordance with the then prevailing industry practices. No uniform construction codes were used for design and analysis of these components. However, no pressure boundary failures or bolting failures have ever been recorded throughout their operating history. Over the years, the in-service inspection (ISI) was limited to visual inspection of the pressure boundaries, and surface and volumetric examination of the pressure retaining bolts. Efforts are now underway to implement ISI requirements similar to the ASME Section XI requirements for pumps and valves. This report discusses the new ISI requirements which also call for volumetric examination of the pump casing and valve body welds.

  17. 7 CFR 42.133 - Portion of production acceptance criteria.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Section 42.133 Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE COMMODITY STANDARDS AND STANDARD CONTAINER REGULATIONS STANDARDS FOR CONDITION OF FOOD CONTAINERS On-Line Sampling and Inspection...

  18. 7 CFR 42.107 - Lot acceptance criteria.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... Agriculture Regulations of the Department of Agriculture AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE COMMODITY STANDARDS AND STANDARD CONTAINER REGULATIONS STANDARDS FOR CONDITION OF FOOD CONTAINERS Procedures for Stationary Lot Sampling and...

  19. 46 CFR 164.120-7 - Acceptance criteria.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... ASTM D 695 241 MPa (35,000 ln/in2). (v) Fire retardant MSC Circ. 1006 Pass. (vi) Water absorption, 24... hours in boiling distilled water as per ASTM D 570 paragraph 7.5. The specimens must then be cooled in water at 23 °C and tested wet at standard conditions immediately after removal from the water.):...

  20. [Proposal of criteria for clinical diagnosis of mild cognitive impairment, dementia and Alzheimer's disease].

    PubMed

    Robles, A; Del Ser, T; Alom, J; Peña-Casanova, J

    2002-01-01

    The most widely accepted criteria for Alzheimer's disease (AD) diagnosis (NINCDS-ADRDA and DSM-IV) do not allow to differentiate accurately between AD and other degenerative dementias which have recently formulated criteria for its clinical diagnosis. Therefore, it is necessary to bring AD diagnostic criteria up to date in order to optimise their specificity, by assessing its most specific clinical manifestations, its most representative markers and those features typical of other diseases which are usually taken into account for a differential diagnosis. According to the latest reports on the subject, the disturbances suffered by memory, behaviour and the rest of cognitive and executive functions must be equally considered when establishing the syndromic diagnosis of dementia; this will always require the coexistence of an evident functional impairment. Due to this, the concepts of "dementia" and "mild cognitive impairment" should be clearly distinguished. For the time being, AD can only be diagnosed when dementia has been proved and this shows a series of cognitive, behavioural and neurological features which are representative of it. Nevertheless, some diagnostic markers appear to be precocious and specific enough to try to identify those patients who suffer from mild cognitive impairment due to an incipient stage of AD. We are suggesting some criteria for the clinical diagnosis of dementia, mild cognitive impairment and AD that seem to be more detail

  1. W-087 Acceptance test procedure. Revision 1

    SciTech Connect

    Joshi, A.W.

    1997-06-10

    This Acceptance Test Procedure/Operational Test Procedure (ATP/OTP) has been prepared to demonstrate that the Electrical/Instrumentation and Mechanical systems function as required by project criteria and to verify proper operation of the integrated system including the interlocks.

  2. Will patients accept randomization to psychoanalysis? A feasibility study.

    PubMed

    Caligor, Eve; Hilsenroth, Mark J; Devlin, Michael; Rutherford, Bret R; Terry, Madeleine; Roose, Steven P

    2012-04-01

    The feasibility of using a randomized design in a psychoanalytic outcome study was evaluated. Our hypothesis was that it would be feasible to randomize patients to psychoanalysis three or four times weekly on the couch for five years, supportive expressive therapy once or twice weekly for up to forty sessions, and cognitive behavior therapy once or twice weekly for up to forty sessions. Successful randomization was defined as a 30% recruitment rate among eligible patients. Recruitment began in September 2009 and closed in April 2010. A total of 132 subjects responded to study advertisements, 107 of whom (81%) were triaged out. The remaining 25 were scheduled for the first of two clinical interviews, and 21 of 25 (88%) completed the interview. Eleven of the 25 (44%) were determined to be eligible based on inclusion and exclusion criteria. Eight of the 11 accepted the idea of randomization and completed the diagnostic assessment phase. Calculated on the basis of 8 of 11 eligible patients accepting randomization, the 95% confidence interval was that 39% to 92% of eligible subjects would participate in a larger study of this design. Our findings support the feasibility of implementing an RCT comparing psychoanalysis as defined by the American Psychoanalytic Association (three or four times weekly on the couch for approximately five years) with shorter-term dynamic or cognitive behavioral therapy once or twice a week. Pre-treatment characteristics of these eight patients are presented, as are initial reliability data for the treatment adherence scales used in this trial.

  3. Cardiometabolic Risk Profiles in Patients With Impaired Fasting Glucose and/or Hemoglobin A1c 5.7% to 6.4%: Evidence for a Gradient According to Diagnostic Criteria: The PREDAPS Study.

    PubMed

    Giráldez-García, Carolina; Sangrós, F Javier; Díaz-Redondo, Alicia; Franch-Nadal, Josep; Serrano, Rosario; Díez, Javier; Buil-Cosiales, Pilar; García-Soidán, F Javier; Artola, Sara; Ezkurra, Patxi; Carrillo, Lourdes; Millaruelo, J Manuel; Seguí, Mateu; Martínez-Candela, Juan; Muñoz, Pedro; Goday, Albert; Regidor, Enrique

    2015-11-01

    It has been suggested that the early detection of individuals with prediabetes can help prevent cardiovascular diseases. The purpose of the current study was to examine the cardiometabolic risk profile in patients with prediabetes according to fasting plasma glucose (FPG) and/or hemoglobin A1c (HbA1c) criteria.Cross-sectional analysis from the 2022 patients in the Cohort study in Primary Health Care on the Evolution of Patients with Prediabetes (PREDAPS Study) was developed. Four glycemic status groups were defined based on American Diabetes Association criteria. Information about cardiovascular risk factors-body mass index, waist circumference, blood pressure, cholesterol, triglycerides, uric acid, gamma-glutamyltransferase, glomerular filtration-and metabolic syndrome components were analyzed. Mean values of clinical and biochemical characteristics and frequencies of metabolic syndrome were estimated adjusting by age, sex, educational level, and family history of diabetes.A linear trend (P < 0.001) was observed in most of the cardiovascular risk factors and in all components of metabolic syndrome. Normoglycemic individuals had the best values, individuals with both criteria of prediabetes had the worst, and individuals with only one-HbA1c or FPG-criterion had an intermediate position. Metabolic syndrome was present in 15.0% (95% confidence interval: 12.6-17.4), 59.5% (54.0-64.9), 62.0% (56.0-68.0), and 76.2% (72.8-79.6) of individuals classified in normoglycemia, isolated HbA1c, isolated FPG, and both criteria groups, respectively.In conclusion, individuals with prediabetes, especially those with both criteria, have worse cardiometabolic risk profile than normoglycemic individuals. These results suggest the need to use both criteria in the clinical practice to identify those individuals with the highest cardiovascular risk, in order to offer them special attention with intensive lifestyle intervention programs.

  4. Cardiometabolic Risk Profiles in Patients With Impaired Fasting Glucose and/or Hemoglobin A1c 5.7% to 6.4%: Evidence for a Gradient According to Diagnostic Criteria

    PubMed Central

    Giráldez-García, Carolina; Sangrós, F. Javier; Díaz-Redondo, Alicia; Franch-Nadal, Josep; Serrano, Rosario; Díez, Javier; Buil-Cosiales, Pilar; García-Soidán, F. Javier; Artola, Sara; Ezkurra, Patxi; Carrillo, Lourdes; Millaruelo, J. Manuel; Seguí, Mateu; Martínez-Candela, Juan; Muñoz, Pedro; Goday, Albert; Regidor, Enrique

    2015-01-01

    Abstract It has been suggested that the early detection of individuals with prediabetes can help prevent cardiovascular diseases. The purpose of the current study was to examine the cardiometabolic risk profile in patients with prediabetes according to fasting plasma glucose (FPG) and/or hemoglobin A1c (HbA1c) criteria. Cross-sectional analysis from the 2022 patients in the Cohort study in Primary Health Care on the Evolution of Patients with Prediabetes (PREDAPS Study) was developed. Four glycemic status groups were defined based on American Diabetes Association criteria. Information about cardiovascular risk factors–body mass index, waist circumference, blood pressure, cholesterol, triglycerides, uric acid, gamma-glutamyltransferase, glomerular filtration–and metabolic syndrome components were analyzed. Mean values of clinical and biochemical characteristics and frequencies of metabolic syndrome were estimated adjusting by age, sex, educational level, and family history of diabetes. A linear trend (P < 0.001) was observed in most of the cardiovascular risk factors and in all components of metabolic syndrome. Normoglycemic individuals had the best values, individuals with both criteria of prediabetes had the worst, and individuals with only one–HbA1c or FPG–criterion had an intermediate position. Metabolic syndrome was present in 15.0% (95% confidence interval: 12.6–17.4), 59.5% (54.0–64.9), 62.0% (56.0–68.0), and 76.2% (72.8–79.6) of individuals classified in normoglycemia, isolated HbA1c, isolated FPG, and both criteria groups, respectively. In conclusion, individuals with prediabetes, especially those with both criteria, have worse cardiometabolic risk profile than normoglycemic individuals. These results suggest the need to use both criteria in the clinical practice to identify those individuals with the highest cardiovascular risk, in order to offer them special attention with intensive lifestyle intervention programs. PMID:26554799

  5. Offer/Acceptance Ratio.

    ERIC Educational Resources Information Center

    Collins, Mimi

    1997-01-01

    Explores how human resource professionals, with above average offer/acceptance ratios, streamline their recruitment efforts. Profiles company strategies with internships, internal promotion, cooperative education programs, and how to get candidates to accept offers. Also discusses how to use the offer/acceptance ratio as a measure of program…

  6. Integrated diagnostics

    NASA Technical Reports Server (NTRS)

    Hunthausen, Roger J.

    1988-01-01

    Recently completed projects in which advanced diagnostic concepts were explored and/or demonstrated are summarized. The projects begin with the design of integrated diagnostics for the Army's new gas turbine engines, and advance to the application of integrated diagnostics to other aircraft subsystems. Finally, a recent project is discussed which ties together subsystem fault monitoring and diagnostics with a more complete picture of flight domain knowledge.

  7. AD8 Informant Questionnaire for Cognitive Impairment: Pragmatic Diagnostic Test Accuracy Study.

    PubMed

    Larner, A J

    2015-09-01

    The diagnostic accuracy of the AD8 informant questionnaire for cognitive impairment was assessed in patients referred to a dedicated memory clinic. This pragmatic prospective study of consecutive referrals attending with an informant who completed AD8 (n = 212) lasted 12 months. Diagnosis used standard clinical diagnostic criteria for dementia and mild cognitive impairment as reference standard (prevalence of cognitive impairment = 0.62). The AD8 proved acceptable to informants, was quick, and easy to use. Using the cutoff of ≥2/8, AD8 was highly sensitive (0.97) for diagnosis of cognitive impairment but specificity was poor (0.17). Combining AD8 with either the Mini-Mental State Examination or the Six-Item Cognitive Impairment Test showed little additional diagnostic benefit. In conclusion, AD8 is very sensitive for cognitive impairment in a memory clinic but specificity may be inadequate.

  8. The diagnostic accuracy of the Kemp’s test: a systematic review

    PubMed Central

    Stuber, Kent; Lerede, Caterina; Kristmanson, Kevyn; Sajko, Sandy; Bruno, Paul

    2014-01-01

    Background: The objective of this review was to evaluate the existing literature regarding the accuracy of the Kemp’s test in the diagnosis of facet joint pain compared to a reference standard. Methods: Several databases were searched. All diagnostic accuracy studies comparing the Kemp’s test with an acceptable reference standard were included. Included studies were scored for quality and internal validity. Results: Five articles met the inclusion criteria of this review. Two studies had a low risk of bias, and three had a low concern regarding applicability. Pooling of data from studies using similar methods revealed that the test’s negative predictive value was the only diagnostic accuracy measure above 50% (56.8%, 59.9%). Conclusions: Currently, the literature supporting the use of the Kemp’s test is limited and indicates that it has poor diagnostic accuracy. It is debatable whether clinicians should continue to use this test to diagnose facet joint pain. PMID:25202153

  9. Diagnostic mistakes of culturally diverse individuals when using North American neuropsychological tests.

    PubMed

    Daugherty, Julia C; Puente, Antonio E; Fasfous, Ahmed F; Hidalgo-Ruzzante, Natalia; Pérez-Garcia, Miguel

    2017-01-01

    Although the role of culture has increasingly gained acceptance in clinical neuropsychology, relatively minimal research exists regarding the actual impact on clinical activities. In this study, we assess how using North American neuropsychological tests affects diagnostic accuracy in cognitive disorders of culturally diverse individuals. To address this question, participants from Colombia, Morocco, and Spain were administered five commonly used neuropsychological tests and the test results were used to determine whether they would be classified as having the DSM-5 diagnostic criteria for Mild Cognitive and Major Cognitive Disorder. Results reveal that diagnostic error occurred up to 20% of the time, and that the frequency of misdiagnosis differed by nationality. These results provide evidence that using tests from one culture to assess individuals from other cultures produces significant false positives. Findings are discussed in terms of the foundations of neuropsychological assessment and its relationship to cultural variables.

  10. Recommendations for Glass Durability Test Criteria

    SciTech Connect

    Strachan, D.M.

    1999-01-28

    The objective of this short report is to define a set of activities that should lead to a specification for a test that can be used as one of the acceptance criteria and as an indicator of acceptable long-term behavior in contact with water. Since the glass composition is not yet defined and is likely to change as the composition of the waste changes, a strategy for developing criteria for what is acceptable involves a series of tests and modeling activities. The results of these activities lead to a criterion for an acceptable product and the data that are needed to reliably determine the behavior of the glass in the storage environment.

  11. LIMS user acceptance testing.

    PubMed

    Klein, Corbett S

    2003-01-01

    Laboratory Information Management Systems (LIMS) play a key role in the pharmaceutical industry. Thorough and accurate validation of such systems is critical and is a regulatory requirement. LIMS user acceptance testing is one aspect of this testing and enables the user to make a decision to accept or reject implementation of the system. This paper discusses key elements in facilitating the development and execution of a LIMS User Acceptance Test Plan (UATP).

  12. On Maximum FODO Acceptance

    SciTech Connect

    Batygin, Yuri Konstantinovich

    2014-12-24

    This note illustrates maximum acceptance of FODO quadrupole focusing channel. Acceptance is the largest Floquet ellipse of a matched beam: A = $\\frac{a^2}{β}$$_{max}$ where a is the aperture of the channel and βmax is the largest value of beta-function in the channel. If aperture of the channel is restricted by a circle of radius a, the s-s acceptance is available for particles oscillating at median plane, y=0. Particles outside median plane will occupy smaller phase space area. In x-y plane, cross section of the accepted beam has a shape of ellipse with truncated boundaries.

  13. Virtual human as a new diagnostic tool, a proof of concept study in the field of major depressive disorders

    PubMed Central

    Philip, Pierre; Micoulaud-Franchi, Jean-Arthur; Sagaspe, Patricia; Sevin, Etienne De; Olive, Jérôme; Bioulac, Stéphanie; Sauteraud, Alain

    2017-01-01

    Embodied Conversational Agents (ECAs) are promising software to communicate with patients but no study has tested them in the diagnostic field of mental disorders. The aim of this study was 1) to test the performance of a diagnostic system for major depressive disorders (MDD), based on the identification by an ECA of specific symptoms (the MDD DSM 5 criteria) in outpatients; 2) to evaluate the acceptability of such an ECA. Patients completed two clinical interviews in a randomized order (ECA versus psychiatrist) and filled in the Acceptability E-scale (AES) to quantify the acceptability of the ECA. 179 outpatients were included in this study (mean age 46.5 ± 12.9 years, 57.5% females). Among the 35 patients diagnosed with MDD by the psychiatrist, 14 (40%) patients exhibited mild, 12 (34.3%) moderate and 9 (25.7%) severe depressive symptoms. Sensitivity increased across the severity level of depressive symptoms and reached 73% for patients with severe depressive symptoms, while specificity remained above 95% for all three severity levels. The acceptability of the ECA evaluated by the AES was very good (25.4). We demonstrate here the validity and acceptability of an ECA to diagnose major depressive disorders. ECAs are promising tools to conduct standardized and well-accepted clinical interviews. PMID:28205601

  14. Preliminary Criteria for Global Flares in Childhood-Onset Systemic Lupus Erythematosus

    PubMed Central

    Brunner, Hermine I.; Mina, Rina; Pilkington, Clarissa; Beresford, Michael W.; Reiff, Andreas; Levy, Deborah M.; Tucker, Lori B.; Eberhard, B. Anne; Ravelli, Angelo; Schanberg, Laura E.; Saad-Magalhaes, Claudia; Higgins, Gloria C.; Onel, Karen; Singer, Nora G.; von Scheven, Emily; Itert, Lukasz; Klein-Gitelman, Marisa S.; Punaro, Marilynn; Ying, Jun; Giannini, Edward H.

    2011-01-01

    Objectives To develop widely acceptable preliminary criteria of global flare for childhood-onset SLE (cSLE). Methods Pediatric rheumatologists (n=138) rated a total of 358 unique patient profiles (PP) with information about the cSLE flare descriptors (cSLE-FD) from two consecutive visits: patient global assessment of well-being, physician global assessment of disease activity (MD-global), health-related quality of life, anti-dsDNA antibodies, disease activity index score, protein/creatinine (P/C) ratio, complement levels and ESR. Based on 2996 rater responses about the course of cSLE (baseline vs. follow-up) the accuracy (sensitivity, specificity, area under the receiver operating characteristic curve) of candidate flare criteria was assessed. An international consensus conference was held to rank these candidate flare criteria as per the ACR-recommendations for the development and validation of criteria sets. Results The highest ranked candidate criteria considered absolute changes (Δ) of the SLEDAI or BILAG, MD-global, P/C ratio, and ESR; Flare scores can be calculated [0.5 × ΔSLEDAI + 0.45 × ΔP/C ratio + 0.5 × ΔMD-global + 0.02 × ΔESR], where values ≥ 1.04 are reflective of a flare. Similarly, BILAG-based flare scores [0.4 × ΔBILAG + 0.65 × ΔP/C ratio + 0.5 × ΔMD-global + 0.02 × ΔESR] of ≥ 1.15 were diagnostic of a flare. Flare scores increase with flare severity. Conclusions Consensus has been reached on preliminary criteria for global flares in cSLE. Further validation studies are needed to confirm the usefulness of the cSLE flare criteria in research and for clinical care. PMID:21618452

  15. IHE material qualification tests description and criteria

    SciTech Connect

    Slape, R J

    1984-06-01

    This report describes the qualification tests presently being used at Pantex Plant, Lawrence Livermore National Laboratory, and Los Alamos National Laboratory that are required by the Department of Energy prior to the approval for an explosive as an Insensitive High Explosive (IHE) material. The acceptance criteria of each test for IHE qualification is also discussed. 5 references, 10 figures.

  16. Acceptance Probability (P a) Analysis for Process Validation Lifecycle Stages.

    PubMed

    Alsmeyer, Daniel; Pazhayattil, Ajay; Chen, Shu; Munaretto, Francesco; Hye, Maksuda; Sanghvi, Pradeep

    2016-04-01

    This paper introduces an innovative statistical approach towards understanding how variation impacts the acceptance criteria of quality attributes. Because of more complex stage-wise acceptance criteria, traditional process capability measures are inadequate for general application in the pharmaceutical industry. The probability of acceptance concept provides a clear measure, derived from specific acceptance criteria for each quality attribute. In line with the 2011 FDA Guidance, this approach systematically evaluates data and scientifically establishes evidence that a process is capable of consistently delivering quality product. The probability of acceptance provides a direct and readily understandable indication of product risk. As with traditional capability indices, the acceptance probability approach assumes that underlying data distributions are normal. The computational solutions for dosage uniformity and dissolution acceptance criteria are readily applicable. For dosage uniformity, the expected AV range may be determined using the s lo and s hi values along with the worst case estimates of the mean. This approach permits a risk-based assessment of future batch performance of the critical quality attributes. The concept is also readily applicable to sterile/non sterile liquid dose products. Quality attributes such as deliverable volume and assay per spray have stage-wise acceptance that can be converted into an acceptance probability. Accepted statistical guidelines indicate processes with C pk > 1.33 as performing well within statistical control and those with C pk < 1.0 as "incapable" (1). A C pk > 1.33 is associated with a centered process that will statistically produce less than 63 defective units per million. This is equivalent to an acceptance probability of >99.99%.

  17. Newbery Medal Acceptance.

    ERIC Educational Resources Information Center

    Freedman, Russell

    1988-01-01

    Presents the Newbery Medal acceptance speech of Russell Freedman, writer of children's nonfiction. Discusses the place of nonfiction in the world of children's literature, the evolution of children's biographies, and the author's work on "Lincoln." (ARH)

  18. Acceptance Priority Ranking & Annual Capacity Report

    SciTech Connect

    2004-07-31

    The Nuclear Waste Policy Act of 1982, as amended (the Act), assigns the Federal Government the responsibility for the disposal of spent nuclear fuel and high-level waste. Section 302(a) of the Act authorizes the Secretary to enter into contracts with the owners and generators of commercial spent nuclear fuel and/or high-level waste. The Standard Contract for Disposal of Spent Nuclear Fuel and/or High-Level Radioactive Waste (Standard Contract) established the contractual mechanism for the Department's acceptance and disposal of spent nuclear fuel and high-level waste. It includes the requirements and operational responsibilities of the parties to the Standard Contract in the areas of administrative matters, fees, terms of payment, waste acceptance criteria, and waste acceptance procedures. The Standard Contract provides for the acquisition of title to the spent nuclear fuel and/or high-level waste by the Department, its transportation to Federal facilities, and its subsequent disposal.

  19. [Diagnostic criteria for Menière's disease. Consensus document of the Bárány Society, the Japan Society for Equilibrium Research, the European Academy of Otology and Neurotology (EAONO), the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) and the Korean Balance Society].

    PubMed

    Lopez-Escamez, José A; Carey, John; Chung, Won-Ho; Goebel, Joel A; Magnusson, Måns; Mandalà, Marco; Newman-Toker, David E; Strupp, Michael; Suzuki, Mamoru; Trabalzini, Franco; Bisdorff, Alexandre

    2016-01-01

    This paper presents diagnostic criteria for Menière's disease jointly formulated by the Classification Committee of the Bárány Society, The Japan Society for Equilibrium Research, the European Academy of Otology and Neurotology (EAONO), the Equilibrium Committee of the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) and the Korean Balance Society. The classification includes 2 categories: definite Menière's disease and probable Menière's disease. The diagnosis of definite Menière's disease is based on clinical criteria and requires the observation of an episodic vertigo syndrome associated with low-to medium-frequency sensorineural hearing loss and fluctuating aural symptoms (hearing, tinnitus and/or fullness) in the affected ear. Duration of vertigo episodes is limited to a period between 20 min and 12h. Probable Menière's disease is a broader concept defined by episodic vestibular symptoms (vertigo or dizziness) associated with fluctuating aural symptoms occurring in a period from 20 min to 24h.

  20. Potential Applications of the National Institute of Mental Health's Research Domain Criteria (RDoC) to Clinical Psychiatric Practice: How RDoC Might Be Used in Assessment, Diagnostic Processes, Case Formulation, Treatment Planning, and Clinical Notes.

    PubMed

    Yager, Joel; Feinstein, Robert E

    2016-12-20

    Offering a new framework for understanding and studying basic dimensions of normal and abnormal human functioning and mental disorders, the National Institute of Mental Health (NIMH) has initiated the Research Domain Criteria (RDoC) project in which a series of higher order domains, representing major systems of emotion, cognition, motivation, and social behavior, and their constituent operationally defined constructs serve as organizing templates for further research and inquiry, eg, to discover validated biomarkers and endophenotypes. Cutting across traditional DSM diagnoses, the domains are defined as Negative Valence Systems, Positive Valence Systems, Cognitive Systems, Systems for Social Processes, and Arousal/Regulatory Systems. To inform educators, trainees, and practitioners about RDoC, alert them to potential practical applications, and encourage their broad exploration in clinical settings, this article reviews the RDoC domains and their subsystem constructs with regard to potential current clinical considerations and applications. We describe ways in which the RDoC domains and constructs offer transdiagnostic frameworks for complementing traditional practice; suggest clinical questions to help elucidate salient information; and, translating RDoC domains and constructs headings into clinically friendly language, offer a template for the psychiatric review of systems that can serve in clinical notes.

  1. [Thalassaemia diagnostics].

    PubMed

    Kusters, Elske; Kerkhoffs, Jean-Louis H; van Rossum, André P

    2014-01-01

    The thalassaemias are characterised by quantitative aberrations in the production of the globin chains that make up haemoglobin, and are a subgroup of the haemoglobinopathies. In this LabQuiz we show how thalassaemia carrier status can be indicated in the results of regular laboratory tests, and discuss the laboratory diagnostics that can confirm or rule out thalassaemia. In these two cases we will present a man of Moroccan descent, and two brothers of Filipino descent, all with anaemia and microcytosis. We show it is possible to differentiate between iron-deficiency anaemia and thalassaemia carrier status on the basis of a complete blood count and measurement of ferritin levels, and which laboratory diagnostics can be subsequently performed in order to confirm a suspicion of thalassaemia. The background section discusses the properties and pitfalls of routine laboratory diagnostics for the thalassaemias, and thalassaemia diagnostics in the Dutch newborn screening programme.

  2. Accepting space radiation risks.

    PubMed

    Schimmerling, Walter

    2010-08-01

    The human exploration of space inevitably involves exposure to radiation. Associated with this exposure are multiple risks, i.e., probabilities that certain aspects of an astronaut's health or performance will be degraded. The management of these risks requires that such probabilities be accurately predicted, that the actual exposures be verified, and that comprehensive records be maintained. Implicit in these actions is the fact that, at some point, a decision has been made to accept a certain level of risk. This paper examines ethical and practical considerations involved in arriving at a determination that risks are acceptable, roles that the parties involved may play, and obligations arising out of reliance on the informed consent paradigm seen as the basis for ethical radiation risk acceptance in space.

  3. Why was Relativity Accepted?

    NASA Astrophysics Data System (ADS)

    Brush, S. G.

    Historians of science have published many studies of the reception of Einstein's special and general theories of relativity. Based on a review of these studies, and my own research on the role of the light-bending prediction in the reception of general relativity, I discuss the role of three kinds of reasons for accepting relativity (1) empirical predictions and explanations; (2) social-psychological factors; and (3) aesthetic-mathematical factors. According to the historical studies, acceptance was a three-stage process. First, a few leading scientists adopted the special theory for aesthetic-mathematical reasons. In the second stage, their enthusiastic advocacy persuaded other scientists to work on the theory and apply it to problems currently of interest in atomic physics. The special theory was accepted by many German physicists by 1910 and had begun to attract some interest in other countries. In the third stage, the confirmation of Einstein's light-bending prediction attracted much public attention and forced all physicists to take the general theory of relativity seriously. In addition to light-bending, the explanation of the advance of Mercury's perihelion was considered strong evidence by theoretical physicists. The American astronomers who conducted successful tests of general relativity became defenders of the theory. There is little evidence that relativity was `socially constructed' but its initial acceptance was facilitated by the prestige and resources of its advocates.

  4. UGV acceptance testing

    NASA Astrophysics Data System (ADS)

    Kramer, Jeffrey A.; Murphy, Robin R.

    2006-05-01

    With over 100 models of unmanned vehicles now available for military and civilian safety, security or rescue applications, it is important to for agencies to establish acceptance testing. However, there appears to be no general guidelines for what constitutes a reasonable acceptance test. This paper describes i) a preliminary method for acceptance testing by a customer of the mechanical and electrical components of an unmanned ground vehicle system, ii) how it has been applied to a man-packable micro-robot, and iii) discusses the value of testing both to ensure that the customer has a workable system and to improve design. The test method automated the operation of the robot to repeatedly exercise all aspects and combinations of components on the robot for 6 hours. The acceptance testing process uncovered many failures consistent with those shown to occur in the field, showing that testing by the user does predict failures. The process also demonstrated that the testing by the manufacturer can provide important design data that can be used to identify, diagnose, and prevent long-term problems. Also, the structured testing environment showed that sensor systems can be used to predict errors and changes in performance, as well as uncovering unmodeled behavior in subsystems.

  5. Approaches to acceptable risk

    SciTech Connect

    Whipple, C.

    1997-04-30

    Several alternative approaches to address the question {open_quotes}How safe is safe enough?{close_quotes} are reviewed and an attempt is made to apply the reasoning behind these approaches to the issue of acceptability of radiation exposures received in space. The approaches to the issue of the acceptability of technological risk described here are primarily analytical, and are drawn from examples in the management of environmental health risks. These include risk-based approaches, in which specific quantitative risk targets determine the acceptability of an activity, and cost-benefit and decision analysis, which generally focus on the estimation and evaluation of risks, benefits and costs, in a framework that balances these factors against each other. These analytical methods tend by their quantitative nature to emphasize the magnitude of risks, costs and alternatives, and to downplay other factors, especially those that are not easily expressed in quantitative terms, that affect acceptance or rejection of risk. Such other factors include the issues of risk perceptions and how and by whom risk decisions are made.

  6. Takotsubo cardiomyopathy systematic review: Pathophysiologic process, clinical presentation and diagnostic approach to Takotsubo cardiomyopathy.

    PubMed

    Ono, Ryohei; Falcão, L Menezes

    2016-04-15

    Takotsubo cardiomyopathy (TTC) is characterized by transient left ventricular apical ballooning with the absence of coronary occlusion, which typically occurs in older women after emotional or physical stress. The pathophysiology of TTC is not well established, though several possible causes such as catecholamine cardiotoxicity, metabolic disturbance, coronary microvascular impairment and multivessel epicardial coronary artery spasm have been proposed. A number of diagnostic criteria have been suggested in the world and not unified as single, but the most common accepted one is Mayo Clinic proposed criteria. Since the clinical presentation of TTC is usually similar to acute coronary syndrome, differential diagnosis is essential to exclude other diseases and also for its treatment. Imaging modality including echocardiogram, angio CT and cardiac MRI, and lab tests for catecholamine, troponin T, creatine kinase MB and B-type natriuretic peptide can be useful to differentiate TTC from other diseases. Prognosis is generally favorable and in-hospital mortality is from 0% to within 10%.

  7. A Novel Screening and Diagnostic Tool for Child and Adolescent Psychiatric Disorders for Telepsychiatry

    PubMed Central

    Malhotra, Savita; Chakrabarti, Subho; Shah, Ruchita; Mehta, Anurati; Gupta, Aarzoo; Sharma, Minali

    2015-01-01

    Background: A diagnostic tool designed as part of a telepsychiatry application for diagnosis and management of child and adolescent psychiatric disorders in India was developed considering the paucity of trained child psychiatrists and mental health professionals in India. Materials and Methods: The diagnostic tool consisted of screening and 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) criteria-based diagnostic algorithms for 18 psychiatric disorders seen in childhood and adolescence. Accuracy of diagnoses and feasibility of use of the tool was examined by comparing it with detailed semi-structured clinical evaluations by a qualified psychiatrist with 50 psychiatric patients (children and adolescents). Statistical Analysis: Descriptive analyses and paired t-tests were conducted to compare the mean number of diagnosis generated by the two interviews. Sensitivity, specificity, positive and negative predictive values were computed for the screening and the diagnostic sub-modules of the tool, compared to the clinical diagnoses. Kappa coefficients were computed to assess agreement between the diagnoses generated by the diagnostic sub-module and the clinical diagnoses. Results: The screening sub-module had high sensitivity, high specificity and negative predictive values for all disorders. For the diagnostic sub-module, there was moderate (kappa-0.4–0.6) to substantial agreement (kappa > 0.6) for all the disorders, (except psychosis) and high sensitivity (barring a few disorders) and specificity for almost all the disorders. Positive predictive values were found to be acceptable to high for most disorders, with consistently high negative predictive values. Conclusion: The new tool was found to be comprehensive, reasonably short and feasible. Results showed acceptable level of accuracy in diagnosis generated by the tool. PMID:26424901

  8. Summary of the evidence file demonstrating completion of the NIF Project Completion Criteria

    SciTech Connect

    Haynam, C. A.

    2014-12-04

    This document summarizes the results of performance verification tests on NIF that demonstrate it has met its performance-related Project Completion Criteria (PCC). It includes measurements made on NIF with the NIF diagnostics, the calibration of these diagnostics and the supporting analyses that verify the NIF performance criteria have been met.

  9. Astrovirus Diagnostics

    PubMed Central

    Pérot, Philippe; Lecuit, Marc; Eloit, Marc

    2017-01-01

    Various methods exist to detect an astrovirus infection. Current methods include electron microscopy (EM), cell culture, immunoassays, polymerase chain reaction (PCR) and various other molecular approaches that can be applied in the context of diagnostic or in surveillance studies. With the advent of metagenomics, novel human astrovirus (HAstV) strains have been found in immunocompromised individuals in association with central nervous system (CNS) infections. This work reviews the past and current methods for astrovirus detection and their uses in both research laboratories and for medical diagnostic purposes. PMID:28085120

  10. Diagnostic Labeling in Juvenile Court: How Do Descriptions of Psychopathy and Conduct Disorder Influence Judges?

    ERIC Educational Resources Information Center

    Murrie, Daniel C.; Boccaccini, Marcus T.; McCoy, Wendy; Cornell, Dewey G.

    2007-01-01

    This study examined the influence of diagnostic criteria and diagnostic labels for psychopathy or conduct disorder on judicial decisions. A national sample of judges (N = 326) rendered hypothetical dispositions based on 1 of 12 mock psychological evaluations. The evaluations varied the presence of 2 sets of diagnostic criteria (antisocial…

  11. Defining Language Ability: The Criteria for Criteria.

    ERIC Educational Resources Information Center

    Brindley, Geoff

    Problems associated with criterion-referenced language testing are discussed in the context of both standardized proficiency testing and classroom assessment. First, different interpretations of criterion-referencing are examined. A range of approaches for defining criteria and performance levels in second language assessment are outlined, and…

  12. Acceptability of human risk.

    PubMed

    Kasperson, R E

    1983-10-01

    This paper has three objectives: to explore the nature of the problem implicit in the term "risk acceptability," to examine the possible contributions of scientific information to risk standard-setting, and to argue that societal response is best guided by considerations of process rather than formal methods of analysis. Most technological risks are not accepted but are imposed. There is also little reason to expect consensus among individuals on their tolerance of risk. Moreover, debates about risk levels are often at base debates over the adequacy of the institutions which manage the risks. Scientific information can contribute three broad types of analyses to risk-setting deliberations: contextual analysis, equity assessment, and public preference analysis. More effective risk-setting decisions will involve attention to the process used, particularly in regard to the requirements of procedural justice and democratic responsibility.

  13. Acceptability of human risk.

    PubMed Central

    Kasperson, R E

    1983-01-01

    This paper has three objectives: to explore the nature of the problem implicit in the term "risk acceptability," to examine the possible contributions of scientific information to risk standard-setting, and to argue that societal response is best guided by considerations of process rather than formal methods of analysis. Most technological risks are not accepted but are imposed. There is also little reason to expect consensus among individuals on their tolerance of risk. Moreover, debates about risk levels are often at base debates over the adequacy of the institutions which manage the risks. Scientific information can contribute three broad types of analyses to risk-setting deliberations: contextual analysis, equity assessment, and public preference analysis. More effective risk-setting decisions will involve attention to the process used, particularly in regard to the requirements of procedural justice and democratic responsibility. PMID:6418541

  14. Acceptance Test Plan.

    DTIC Science & Technology

    2014-09-26

    7 RD-Ai507 154 CCEPTANCE TEST PLN(U) WESTINGHOUSE DEFENSE ND i/i ELECTRO ICS CENTER BALTIMORE MD DEVELOPMENT AND OPERATIONS DIY D C KRRiJS 28 JUN...Ln ACCEPTANCE TEST PLAN FOR SPECIAL RELIABILITY TESTS FOR BROADBAND MICROWAVE AMPLIFIER PANEL David C. Kraus, Reliability Engineer WESTINGHOUSE ...ORGANIZATION b. OFFICE SYMBOL 7g& NAME OF MONITORING ORGANIZATION tIf appdeg ble) WESTINGHOUSE ELECTRIC CORP. - NAVAL RESEARCH LABORATORY e. AOORES$ (Ci7t

  15. Acceptance test report for the safety class shutdown system

    SciTech Connect

    Zuroff, W.F.

    1996-10-17

    This document provides the Acceptance Test Report for the successful testing of the Safety Shutdown Circuit. The test was done in accordance with the requirements that were defined in WHC-SD-WM-SCH-003, Interim Stabilization Safety Class Trip Circuit CGI Dedication Criteria. The actual test procedure document was contained in WHC-SD-WM-ATP-185, Acceptance Test Procedure for the Safety Class Shutdown System.

  16. Age and Acceptance of Euthanasia.

    ERIC Educational Resources Information Center

    Ward, Russell A.

    1980-01-01

    Study explores relationship between age (and sex and race) and acceptance of euthanasia. Women and non-Whites were less accepting because of religiosity. Among older people less acceptance was attributable to their lesser education and greater religiosity. Results suggest that quality of life in old age affects acceptability of euthanasia. (Author)

  17. [Histiocytoses: General classification and molecular criteria].

    PubMed

    Emile, Jean-François; Charlotte, Frédéric; Chassagne-Clement, Catherine; Copin, Marie-Christine; Fraitag, Sylvie; Mokhtari, Karima; Moreau, Anne

    2017-01-01

    Histiocytoses are rare and heterogeneous disease sharing histology, characterized by accumulation of histiocytes. They may be inherited or sporadic, and related to the accumulation of endo- or exogenous material in macrophages or to macrophage activation. Recent discoveries have shown that some histiocytoses, such as Langerhans cell histiocytosis or Erdheim-Chester disease, previously considered as idiopathic or inflammatory were clonal myeloid proliferations. This review presents the general classification of histiocytoses, and describes diagnostic and molecular criteria of idiopathic histiocytoses and histiocytic neoplasms.

  18. Plutonium storage criteria

    SciTech Connect

    Chung, D.; Ascanio, X.

    1996-05-01

    The Department of Energy has issued a technical standard for long-term (>50 years) storage and will soon issue a criteria document for interim (<20 years) storage of plutonium materials. The long-term technical standard, {open_quotes}Criteria for Safe Storage of Plutonium Metals and Oxides,{close_quotes} addresses the requirements for storing metals and oxides with greater than 50 wt % plutonium. It calls for a standardized package that meets both off-site transportation requirements, as well as remote handling requirements from future storage facilities. The interim criteria document, {open_quotes}Criteria for Interim Safe Storage of Plutonium-Bearing Solid Materials{close_quotes}, addresses requirements for storing materials with less than 50 wt% plutonium. The interim criteria document assumes the materials will be stored on existing sites, and existing facilities and equipment will be used for repackaging to improve the margin of safety.

  19. Validation and acceptance of synthetic infrared imagery

    NASA Astrophysics Data System (ADS)

    Smith, Moira I.; Bernhardt, Mark; Angell, Christopher R.; Hickman, Duncan; Whitehead, Philip; Patel, Dilip

    2004-08-01

    This paper describes the use of an image query database (IQ-DB) tool as a means of implementing a validation strategy for synthetic long-wave infrared images of sea clutter. Specifically it was required to determine the validity of the synthetic imagery for use in developing and testing automatic target detection algorithms. The strategy adopted for exploiting synthetic imagery is outlined and the key issues of validation and acceptance are discussed in detail. A wide range of image metrics has been developed to achieve pre-defined validation criteria. A number of these metrics, which include post processing algorithms, are presented. Furthermore, the IQ-DB provides a robust mechanism for configuration management and control of the large volume of data used. The implementation of the IQ-DB is reviewed in terms of its cardinal point specification and its central role in synthetic imagery validation and EOSS progressive acceptance.

  20. High acceptance recoil polarimeter

    SciTech Connect

    The HARP Collaboration

    1992-12-05

    In order to detect neutrons and protons in the 50 to 600 MeV energy range and measure their polarization, an efficient, low-noise, self-calibrating device is being designed. This detector, known as the High Acceptance Recoil Polarimeter (HARP), is based on the recoil principle of proton detection from np[r arrow]n[prime]p[prime] or pp[r arrow]p[prime]p[prime] scattering (detected particles are underlined) which intrinsically yields polarization information on the incoming particle. HARP will be commissioned to carry out experiments in 1994.