Comparison between the triglycerides standardization of routine methods used in Japan and the chromotropic acid reference measurement procedure used by the CDC Lipid Standardization Programme

PubMed Central

Nakamura, Masakazu; Iso, Hiroyasu; Kitamura, Akihiko; Imano, Hironori; Noda, Hiroyuki; Kiyama, Masahiko; Sato, Shinichi; Yamagishi, Kazumasa; Nishimura, Kunihiro; Nakai, Michikazu; Vesper, Hubert W; Teramoto, Tamio; Miyamoto, Yoshihiro

2017-01-01

Background The US Centers for Disease Control and Prevention ensured adequate performance of the routine triglycerides methods used in Japan by a chromotropic acid reference measurement procedure used by the Centers for Disease Control and Prevention lipid standardization programme as a reference point. We examined standardized data to clarify the performance of routine triglycerides methods. Methods The two routine triglycerides methods were the fluorometric method of Kessler and Lederer and the enzymatic method. The methods were standardized using 495 Centers for Disease Control and Prevention reference pools with 98 different concentrations ranging between 0.37 and 5.15 mmol/L in 141 survey runs. The triglycerides criteria for laboratories which perform triglycerides analyses are used: accuracy, as bias ≤5% from the Centers for Disease Control and Prevention reference value and precision, as measured by CV, ≤5%. Results The correlation of the bias of both methods to the Centers for Disease Control and Prevention reference method was: y (%bias) = 0.516 × (Centers for Disease Control and Prevention reference value) −1.292 (n = 495, R2 = 0.018). Triglycerides bias at medical decision points of 1.13, 1.69 and 2.26 mmol/L was −0.71%, −0.42% and −0.13%, respectively. For the combined precision, the equation y (CV) = −0.398 × (triglycerides value) + 1.797 (n = 495, R2 = 0.081) was used. Precision was 1.35%, 1.12% and 0.90%, respectively. It was shown that triglycerides measurements at Osaka were stable for 36 years. Conclusions The epidemiologic laboratory in Japan met acceptable accuracy goals for 88.7% of all samples, and met acceptable precision goals for 97.8% of all samples measured through the Centers for Disease Control and Prevention lipid standardization programme and demonstrated stable results for an extended period of time. PMID:26680645

ASSESSMENT OF NUTRITIONAL STATUS OF CHILDREN AND ADOLESCENTS WITH SPASTIC QUADRIPLEGIC CEREBRAL PALSY.

PubMed

Caselli, Thaisa Barboza; Lomazi, Elizete Aparecida; Montenegro, Maria Augusta Santos; Bellomo-Brandão, Maria Angela

2017-01-01

Due to several factors, such as gastrointestinal's diseases and difficulty in feeding, children with Spastic Quadriplegic Cerebral Palsy tend to present nutritional deficits. To assess the nutritional status of pediatric patients with Spastic Quadriplegic Cerebral Palsy according to reference curves for this population and with the measures of folds and circumferences, obtained by the upper arm circumference and triceps skin fold. The data were obtained from: knee-height, estimated height, weight, upper arm circumference, and triceps skin fold. Values of folds and circumferences were compared with Frisancho, and specific curves for these patients were used as reference. The relationship between the values in the growth curve for healthy children, Z-Score, and comparison with the reference curve were verified by Fisher's exact test. We adopted the significance level of 5%. We evaluated 54 patients. The mean age was 10.2 years, and 34 were male, 25 fed by gastrostomy and 29, orally. The frequency of low weight by the reference curve was 22.22%. More than half of the patients presented the parameters indicating lean mass below the 5th percentile. The height of all patients was classified as adequate for the age by the reference curve. Low weight was found in 22% of patients, and there is a greater tendency to present reduced muscle mass and increased fat mass, showing the need for evaluation and appropriate interventions for patients with Spastic Quadriplegic Cerebral Palsy.

FEV1/FVC and FEV1 for the assessment of chronic airflow obstruction in prevalence studies: do prediction equations need revision?

PubMed

Roche, Nicolas; Dalmay, François; Perez, Thierry; Kuntz, Claude; Vergnenègre, Alain; Neukirch, Françoise; Giordanella, Jean-Pierre; Huchon, Gérard

2008-11-01

Little is known on the long-term validity of reference equations used in the calculation of FEV(1) and FEV(1)/FVC predicted values. This survey assessed the prevalence of chronic airflow obstruction in a population-based sample and how it is influenced by: (i) the definition of airflow obstruction; and (ii) equations used to calculate predicted values. Subjects aged 45 or more were recruited in health prevention centers, performed spirometry and fulfilled a standardized ECRHS-derived questionnaire. Previously diagnosed cases and risk factors were identified. Prevalence of airflow obstruction was calculated using: (i) ATS-GOLD definition (FEV(1)/FVC<0.70); and (ii) ERS definition (FEV(1)/FVC

[Muscle strength of the cervical and lumbar spine in triathletes].

PubMed

Miltner, O; Siebert, C H; Müller-Rath, R; Kieffer, O

2010-12-01

The goal of this study was to analyse the muscle strength of the cervical and lumbar spine in ironman triathletes. The values were compared to the results obtained from a reference group. The test of the triathletes was carried out in an attempt to define a specific strength profile for these athletes. In this study, 20 long-distance triathletes (∅ 37.3 ± 7.6 years of age, ∅ 1.80 ± 0.1 m, ∅ 73.7 ± 6.0 kg) were evaluated with regard to their individual and sport-specific strengths of the cervical spine in 2 planes and of the trunk strengths in all 3 planes of motion. The trunk strength profile of the triathletes revealed good average results in the trunk extensors and the lateral flexors of the left trunk. The reference group is the data base of the company Proxomed®, Alzenau. It is based on results of 1045 untrained, symptom-free subjects of different ages. Lumbar extension: The extension of the force values shows no significant difference from the reference group. Lumbar flexion: The flexion tests show highly significantly lower force values (5.025 ± 0.81 N/kg vs. 6.67 ± 0.6 N/kg) than the reference group. Flexion/extension: In the sagittal plane values for the triathletes demonstrate an imbalance in muscle strength ratios. The abdominal muscles turn in relation to the back extensor muscles too weakly to be very significant. Lumbar rotation: The force values of the athletes in both directions (right: 6.185 ± 1.46 N/kg, left: 7.1 ± 1.57 N/kg vs. 10.05 ± 0.34 N/kg) are highly significantly (p ≤ 0.001) lower than the reference values. Ratio of rotation left/right: The ratio of left/right rotation in the reference group is set at 1 and thus shows an equally strong force level between the two sides. Lumbar lateral flexion: The triathletes do not show any significant differences between the force values. Compared to the reference group there is no significant difference to the left side flexion. In the lateral bending the athletes have significantly better values than the reference group. Ratio of lateral left/right: In the reference group the ratio is set at 1. For triathletes, it shows an average value of 0.93. This difference is not significant. Cervical extension: The extension of the force values (1.96 ± 0.59 N/kg vs. 3.03 ± 0.24 N/kg) shows a highly significant difference from the reference group. Cervical flexion: In flexion (1.3 ± 0.42 N/kg vs. 2.17 ± 0.22 N/kg) triathletes have highly significantly lower strength values than the reference group. Flexion/extension: The triathletes did not differ significantly from the reference values (0.69 ± 0.23 and 0.72 ± 0.08). Lateral cervical spine: In comparison to the reference group (left: 1.67 ± 0.48 N/kg, right: 1.55 ± 0.46 N/kg vs. 2.36 ± 0.15 N/kg) in which there is left/right lateral flexion, there is a highly significant difference. Right lateral flexion is weaker than the left. Ratio of lateral left/right: The triathletes have a significant imbalance in the lateral flexion of the cervical spine compared to the reference group (1.07 ± 0.15 to 1). In conclusion, in the triathlon there is a specific stress that is obviously not an adequate stimulus for the muscles of the cervical spine in order to achieve a balanced musculature and the athletes should be advised to practice a preventive approach with regard to these areas. © Georg Thieme Verlag KG Stuttgart · New York.

Pantothenic acid and biotin

MedlinePlus

... all (97% to 98%) healthy people. Adequate Intake (AI): established when there is not enough evidence to ... during pregnancy Lactation: 7 mg/day *Adequate Intake (AI) Dietary Reference Intakes for biotin: Age 0 to ...

Dimensional accuracy of jaw scans performed on alginate impressions or stone models: A practice-oriented study.

PubMed

Vogel, Annike B; Kilic, Fatih; Schmidt, Falko; Rübel, Sebastian; Lapatki, Bernd G

2015-07-01

Digital jaw models offer more extensive possibilities for analysis than casts and make it easier to share and archive relevant information. The aim of this study was to compare the dimensional accuracy of scans performed on alginate impressions and on stone models to reference scans performed on underlying resin models. Precision spheres 5 mm in diameter were occlusally fitted to the sites of the first premolars and first molars on a pair of jaw models fabricated from resin. A structured-light scanner was used for digitization. Once the two reference models had been scanned, alginate impressions were taken and scanned after no later than 1 h. A third series of scans was performed on type III stone models derived from the impressions. All scans were analyzed by performing five repeated measurements to determine the distances between the various sphere centers. Compared to the reference scans, the stone-model scans were larger by a mean of 73.6 µm (maxilla) or 65.2 µm (mandible). The impression scans were only larger by 7.7 µm (maxilla) or smaller by 0.7 µm (mandible). Median standard deviations over the five repeated measurements of 1.0 µm for the reference scans, 2.35 µm for the impression scans, and 2.0 µm for the stone-model scans indicate that the values measured in this study were adequately reproducible. Alginate impressions can be suitably digitized by structured-light scanning and offer considerably better dimensional accuracy than stone models. Apparently, however, both impression scans and stone-model scans can offer adequate precision for orthodontic purposes. The main issue of impression scans (which is incomplete representation of model surfaces) is being systematically explored in a follow-up study.

Stopping cross section of vanadium for H+ and He+ ions in a large energy interval deduced from backscattering spectra

NASA Astrophysics Data System (ADS)

Moro, M. V.; Bruckner, B.; Grande, P. L.; Tabacniks, M. H.; Bauer, P.; Primetzhofer, D.

2018-06-01

We have experimentally determined electronic stopping cross sections of vanadium for 50-2750 keV protons and for 250-6000 keV He ions by relative measurements in backscattering geometry. To check the consistency of the employed procedure we investigate how to define adequate reference stopping cross section data and chose different reference materials. To proof consistency of different reference data sets, an intercomparison is performed to test the reliability of the evaluation procedure for a wide range of energies. This process yielded consistent results. The resulting stopping cross section data for V are compared to values from the IAEA database, to the most commonly employed semi-empirical program SRIM, and to calculations according to CasP. For helium, our results show a significant deviation of up to 10% with respect to literature and to SRIM, but are in very good agreement with the CasP predictions, in particular when charge-exchange processes are included in the model.

The concept of underinsurance: a general typology.

PubMed

Ward, Andrew

2006-10-01

In a 2002 speech, Mark McClellan, a member of the Council of Economic Advisors at the White House, said that "[I]n the president's vision, all Americans should have access to high-quality and affordable healthcare." However, many healthcare researchers believe that a growing number of Americans are underinsured. Because any characterization of underinsurance will refer to the value judgments of people about what counts as "adequate" and "inadequate" healthcare, the goal of characterizing and measuring the underinsured is difficult to achieve. In this article, I examine the various dimensions of underinsurance, and propose a typology incorporating those dimensions.

HDRK-Man: a whole-body voxel model based on high-resolution color slice images of a Korean adult male cadaver

NASA Astrophysics Data System (ADS)

Kim, Chan Hyeong; Hyoun Choi, Sang; Jeong, Jong Hwi; Lee, Choonsik; Chung, Min Suk

2008-08-01

A Korean voxel model, named 'High-Definition Reference Korean-Man (HDRK-Man)', was constructed using high-resolution color photographic images that were obtained by serially sectioning the cadaver of a 33-year-old Korean adult male. The body height and weight, the skeletal mass and the dimensions of the individual organs and tissues were adjusted to the reference Korean data. The resulting model was then implemented into a Monte Carlo particle transport code, MCNPX, to calculate the dose conversion coefficients for the internal organs and tissues. The calculated values, overall, were reasonable in comparison with the values from other adult voxel models. HDRK-Man showed higher dose conversion coefficients than other models, due to the facts that HDRK-Man has a smaller torso and that the arms of HDRK-Man are shifted backward. The developed model is believed to adequately represent average Korean radiation workers and thus can be used for more accurate calculation of dose conversion coefficients for Korean radiation workers in the future.

Processing of pulse oximeter signals using adaptive filtering and autocorrelation to isolate perfusion and oxygenation components

NASA Astrophysics Data System (ADS)

Ibey, Bennett; Subramanian, Hariharan; Ericson, Nance; Xu, Weijian; Wilson, Mark; Cote, Gerard L.

2005-03-01

A blood perfusion and oxygenation sensor has been developed for in situ monitoring of transplanted organs. In processing in situ data, motion artifacts due to increased perfusion can create invalid oxygenation saturation values. In order to remove the unwanted artifacts from the pulsatile signal, adaptive filtering was employed using a third wavelength source centered at 810nm as a reference signal. The 810 nm source resides approximately at the isosbestic point in the hemoglobin absorption curve where the absorbance of light is nearly equal for oxygenated and deoxygenated hemoglobin. Using an autocorrelation based algorithm oxygenation saturation values can be obtained without the need for large sampling data sets allowing for near real-time processing. This technique has been shown to be more reliable than traditional techniques and proven to adequately improve the measurement of oxygenation values in varying perfusion states.

An administrative data validation study of the accuracy of algorithms for identifying rheumatoid arthritis: the influence of the reference standard on algorithm performance.

PubMed

Widdifield, Jessica; Bombardier, Claire; Bernatsky, Sasha; Paterson, J Michael; Green, Diane; Young, Jacqueline; Ivers, Noah; Butt, Debra A; Jaakkimainen, R Liisa; Thorne, J Carter; Tu, Karen

2014-06-23

We have previously validated administrative data algorithms to identify patients with rheumatoid arthritis (RA) using rheumatology clinic records as the reference standard. Here we reassessed the accuracy of the algorithms using primary care records as the reference standard. We performed a retrospective chart abstraction study using a random sample of 7500 adult patients under the care of 83 family physicians contributing to the Electronic Medical Record Administrative data Linked Database (EMRALD) in Ontario, Canada. Using physician-reported diagnoses as the reference standard, we computed and compared the sensitivity, specificity, and predictive values for over 100 administrative data algorithms for RA case ascertainment. We identified 69 patients with RA for a lifetime RA prevalence of 0.9%. All algorithms had excellent specificity (>97%). However, sensitivity varied (75-90%) among physician billing algorithms. Despite the low prevalence of RA, most algorithms had adequate positive predictive value (PPV; 51-83%). The algorithm of "[1 hospitalization RA diagnosis code] or [3 physician RA diagnosis codes with ≥1 by a specialist over 2 years]" had a sensitivity of 78% (95% CI 69-88), specificity of 100% (95% CI 100-100), PPV of 78% (95% CI 69-88) and NPV of 100% (95% CI 100-100). Administrative data algorithms for detecting RA patients achieved a high degree of accuracy amongst the general population. However, results varied slightly from our previous report, which can be attributed to differences in the reference standards with respect to disease prevalence, spectrum of disease, and type of comparator group.

Nutritional status of adventure racers.

PubMed

Zalcman, Ioná; Guarita, Heloisa Vidigal; Juzwiak, Claudia Ridel; Crispim, Cibele Aparecida; Antunes, Hanna Karen Moreira; Edwards, Ben; Tufik, Sérgio; de Mello, Marco Túlio

2007-05-01

We describe the usual food intake, body composition, and biochemical profile of adventure racers during their training season and evaluate their energy and nutrient intake in relation to current recommendations for ultraendurance athletes. Twenty-four adventure race athletes (18 men and 6 women), 24 to 42 y of age, participated in the study. Food intake was determined with a 3-d food record and body composition by plethysmography. Blood samples were obtained from all subjects for biochemical analyses. All assessments were made during the usual training phase. Female athletes had a higher body fat percentage than did male athletes (20.2 +/- 5.7% versus 12.5 +/- 3.5%). For men and women, food intake was high in protein (1.9 +/- 0.5 g/kg in men, 2.0 +/- 0.4 g/kg in women) and fat (1.6 +/- 0.3 g/kg in men, 1.5 +/- 1.3 g/kg in women). Carbohydrate intake of male athletes was at the lower limit of that recommended (5.9 +/- 1.8 g/kg). For most vitamins and minerals, athletes' intake was adequate, with the exception of magnesium, zinc, and potassium in men and women and vitamin E and calcium in women, which presented a high probability of being inadequate compared with reference values. High blood levels of total cholesterol and low-density lipoprotein cholesterol were found in female athletes (201.0 +/- 44.7 and 104.1 +/- 43.1 mg/dL, respectively) and all other biochemical analyses were within normal reference values. The adventure racers presented an inadequate nutritional profile when compared with recommendations for endurance exercise. These athletes need to be educated about consuming an adequate diet to meet the nutritional needs of their activity.

Enhancing clinician provision of informed consent and counseling: some pedagogical strategies.

PubMed

Wear, S

1999-02-01

Although long touted as an ethical and legal requirement, some clinicians still seem to offer less than fully adequate informed consent processes; similarly the counseling of patients and families, particularly about post-intervention scenarios, is often perfunctory at best. Keyed to a narrative of a patient's experience with surgery for a deviated septum, this article reflects on why such less than adequate clinician behaviors tend to occur and what might be done about them. Certain legal misconceptions about informed consent are highlighted in this reflection, as well as why certain clinicians seem to take such a narrow view of their responsibilities to patients. Further reference in this regard is also made to a recently constructed module on informed consent for medical residents. In it, though legal requirements for informed consent are reviewed, the basic perspective taken regards informed consent as a clinical intervention that pursues certain basic goods and values, only one of which lies in determining when legal closure for such processes has occurred.

Nonlinear differential equations for the wavefront surface at arbitrary Hartmann-plane distances.

PubMed

Téllez-Quiñones, Alejandro; Malacara-Doblado, Daniel; Flores-Hernández, Ricardo; Gutiérrez-Hernández, David A; León-Rodríguez, Miguel

2016-03-20

In the Hartmann test, a wave aberration function W is estimated from the information of the spot diagram drawn in an observation plane. The distance from a reference plane to the observation plane, the Hartmann-plane distance, is typically chosen as z=f, where f is the radius of a reference sphere. The function W and the transversal aberrations {X,Y} calculated at the plane z=f are related by two well-known linear differential equations. Here, we propose two nonlinear differential equations to denote a more general relation between W and the transversal aberrations {U,V} calculated at any arbitrary Hartmann-plane distance z=r. We also show how to directly estimate the wavefront surface w from the information of {U,V}. The use of arbitrary r values could improve the reliability of the measurements of W, or w, when finding difficulties in adequate ray identification at z=f.

Evaluation of dose‐area product of common radiographic examinations towards establishing a preliminary diagnostic reference levels (PDRLs) in Southwestern Nigeria

PubMed Central

Jibiri, Nnamdi N.

2016-01-01

In Nigeria, a large number of radiographic examinations are conducted yearly for various diagnostic purposes. However, most examinations carried out do not have records of doses received by the patients, and the employed exposure parameters used are not documented; therefore, adequate radiation dose management is hindered. The aim of the present study was to estimate the dose‐area product (DAP) of patients examined in Nigeria, and to propose regional reference dose levels for nine common examinations (chest PA, abdomen AP, pelvis AP, lumbar AP, skull AP, leg AP, knee AP, hand AP, and thigh AP) undertaken in Nigeria. Measurement of entrance surface dose (ESD) was carried out using thermoluminescent dosimeter (TLD). Measured ESDS were converted into DAP using the beam area of patients in 12 purposely selected hospitals. Results of the study show that the maximum/minimum ratio ranged from 3 for thigh AP to 57 in abdomen AP. The range of determined mean and 75th percentile DAPs were 0.18–17.16, and 0.25–28.59 Gy cm2, respectively. Data available for comparison show that 75th percentile DAPs in this study (in chest PA, abdomen AP, pelvis AP, lumbar AP) are higher than NRPB‐HPE reference values. The DAP in this study is higher by factor of 31.4 (chest PA), 9.9 (abdomen AP), 2.2 (pelvis AP), and 2.1 (lumbar AP) than NRPB‐HPE values. The relative higher dose found in this study shows nonoptimization of practice in Nigeria. It is expected that regular dose auditing and dose optimization implementation in Nigeria would lead to lower DAP value, especially in abdomen AP. The 75th percentile DAP distribution reported in this study could be taken as regional diagnostic reference level in the Southwestern Nigeria; however, a more extensive nationwide dose survey is required to establish national reference dose. PACS number(s): 87.53.Bn, 87.59.B PMID:27929511

Evaluation of dose-area product of common radiographic examinations towards establishing a preliminary diagnostic reference levels (PDRLs) in Southwestern Nigeria.

PubMed

Jibiri, Nnamdi N; Olowookere, Christopher J

2016-11-08

In Nigeria, a large number of radiographic examinations are conducted yearly for various diagnostic purposes. However, most examinations carried out do not have records of doses received by the patients, and the employed exposure parameters used are not documented; therefore, adequate radiation dose management is hin-dered. The aim of the present study was to estimate the dose-area product (DAP) of patients examined in Nigeria, and to propose regional reference dose levels for nine common examinations (chest PA, abdomen AP, pelvis AP, lumbar AP, skull AP, leg AP, knee AP, hand AP, and thigh AP) undertaken in Nigeria. Measurement of entrance surface dose (ESD) was carried out using thermoluminescent dosimeter (TLD). Measured ESDS were converted into DAP using the beam area of patients in 12 purposely selected hospitals. Results of the study show that the maximum/ minimum ratio ranged from 3 for thigh AP to 57 in abdomen AP. The range of determined mean and 75th percentile DAPs were 0.18-17.16, and 0.25-28.59 Gy cm2, respectively. Data available for comparison show that 75th percentile DAPs in this study (in chest PA, abdomen AP, pelvis AP, lumbar AP) are higher than NRPB-HPE reference values. The DAP in this study is higher by factor of 31.4 (chest PA), 9.9 (abdomen AP), 2.2 (pelvis AP), and 2.1 (lumbar AP) than NRPB-HPE values. The relative higher dose found in this study shows nonoptimization of practice in Nigeria. It is expected that regular dose auditing and dose optimization implementation in Nigeria would lead to lower DAP value, especially in abdomen AP. The 75th percentile DAP distribution reported in this study could be taken as regional diagnostic reference level in the Southwestern Nigeria; however, a more extensive nationwide dose survey is required to establish national reference dose. © 2016 The Authors.

Comparative Analysis of Different Measurement Techniques for MLC Characterization: Preliminary Results

DOE Office of Scientific and Technical Information (OSTI.GOV)

Larraga-Gutierrez, J. M.; Ballesteros-Zebadua, P.; Garcia-Garduno, O. A.

2008-08-11

Radiation transmission, leakage and beam penumbra are essential dosimetric parameters related to the commissioning of a multileaf collimation system. This work shows a comparative analysis of commonly used film detectors: X-OMAT V2 and EDR2 radiographic films, and GafChromic EBT registered radiochromic film. The results show that X-OMAT over-estimates radiation leakage and 80-20% beam penumbra. However, according to the reference values reported by the manufacturer for these dosimetric parameters, all three films are adequate for MLC dosimetric characterization, but special care must be taken when X-OMAT V2 film is used due to its low energy photon dependence.

Visual enhancements in pick-and-place tasks: Human operators controlling a simulated cylindrical manipulator

NASA Technical Reports Server (NTRS)

Kim, Won S.; Tendick, Frank; Stark, Lawrence

1989-01-01

A teleoperation simulator was constructed with vector display system, joysticks, and a simulated cylindrical manipulator, in order to quantitatively evaluate various display conditions. The first of two experiments conducted investigated the effects of perspective parameter variations on human operators' pick-and-place performance, using a monoscopic perspective display. The second experiment involved visual enhancements of the monoscopic perspective display, by adding a grid and reference lines, by comparison with visual enhancements of a stereoscopic display; results indicate that stereoscopy generally permits superior pick-and-place performance, but that monoscopy nevertheless allows equivalent performance when defined with appropriate perspective parameter values and adequate visual enhancements.

Objects and processes: Two notions for understanding biological information.

PubMed

Mercado-Reyes, Agustín; Padilla-Longoria, Pablo; Arroyo-Santos, Alfonso

2015-09-07

In spite of being ubiquitous in life sciences, the concept of information is harshly criticized. Uses of the concept other than those derived from Shannon׳s theory are denounced as metaphoric. We perform a computational experiment to explore whether Shannon׳s information is adequate to describe the uses of said concept in commonplace scientific practice. Our results show that semantic sequences do not have unique complexity values different from the value of meaningless sequences. This result suggests that quantitative theoretical frameworks do not account fully for the complex phenomenon that the term "information" refers to. We propose a restructuring of the concept into two related, but independent notions, and conclude that a complete theory of biological information must account completely not only for both notions, but also for the relationship between them. Copyright © 2015 Elsevier Ltd. All rights reserved.

Calcium Intake and Nutritional Adequacy in Spanish Children: The ANIVA Study

PubMed Central

Rubio-López, Nuria; Llopis-González, Agustín; Morales-Suárez-Varela, María

2017-01-01

Calcium is an important nutrient for child development. The main objective of this study was to assess calcium intake and its adequacy with dietary reference intake (DRI) in Spanish children. The ANIVA (Antropometría y Nutrición Infantil de Valencia) study is a descriptive cross-sectional study. During two academic years 2013–2014 and 2014–2015, 1176 schoolchildren aged 6–9 years were selected from 14 primary schools in Valencia (Spain). Three-day food records were used to assess dietary intake, completed by parents/guardian. Anthropometric data (weight and height) were evaluated in all subjects. Nutritional intake was compared to estimated average requirements (EARs) and adequate intake (AI) values to determine nutritional adequacy. A percentage of 25.77% had inadequate calcium intake, and a significantly higher prevalence was observed in girls (p = 0.006). Adequate calcium intake showed a positive association with the height z-score (p = 0.032). When assessing dietary patterns, schoolchildren with adequate calcium intakes had better nutritional adequacy in all nutrients, except cholesterol (p = 0.086) and fluorine (p = 0.503). These results suggest a public health problem that must be addressed through nutrition education programs to increase intake of calcium-rich food and to correct the associated dietary pattern. PMID:28230804

Calcium Intake and Nutritional Adequacy in Spanish Children: The ANIVA Study.

PubMed

Rubio-López, Nuria; Llopis-González, Agustín; Morales-Suárez-Varela, María

2017-02-21

Calcium is an important nutrient for child development. The main objective of this study was to assess calcium intake and its adequacy with dietary reference intake (DRI) in Spanish children. The ANIVA (Antropometría y Nutrición Infantil de Valencia) study is a descriptive cross-sectional study. During two academic years 2013-2014 and 2014-2015, 1176 schoolchildren aged 6-9 years were selected from 14 primary schools in Valencia (Spain). Three-day food records were used to assess dietary intake, completed by parents/guardian. Anthropometric data (weight and height) were evaluated in all subjects. Nutritional intake was compared to estimated average requirements (EARs) and adequate intake (AI) values to determine nutritional adequacy. A percentage of 25.77% had inadequate calcium intake, and a significantly higher prevalence was observed in girls ( p = 0.006). Adequate calcium intake showed a positive association with the height z -score ( p = 0.032). When assessing dietary patterns, schoolchildren with adequate calcium intakes had better nutritional adequacy in all nutrients, except cholesterol ( p = 0.086) and fluorine ( p = 0.503). These results suggest a public health problem that must be addressed through nutrition education programs to increase intake of calcium-rich food and to correct the associated dietary pattern.

[Investigation of adolescents' bone metabolism in the western part of Transdanubia].

PubMed

Csákváry, Violetta; Puskás, Tamás; Bödecs, Tamás; Lôcsei, Zoltán; Oroszlán, György; Kovács, L Gábor; Toldy, Erzsébet

2009-10-25

Childhood reference range based on the age is not available in Hungary, therefore the diagnosis and therapy of bone metabolic diseases of childhood are subject to difficulties. The aim of this work is to provide information about the adolescents' results of bone mineral density and bone biomarkers. Measurements were performed in 169 healthy adolescents (98 girls, 71 boys, age: 17.0+/-1.2 years). Bone mineral content (BMC) and bone mineral density (BMD) of the lumbar spine were measured using Double X-ray Absorptiometry (DXA, LUNAR, GE Health Care, USA) and Z-score values were analyzed using different reference population. In the serum, bone biomarkers osteocalcin (OC) and beta-crosslaps (beta-Cl) were measured by a fully automated, electrochemiluminescence immunoassay method (Elecsys-2010, Roche). Data were analyzed according to gender and the Tanner stage and grade system. Associations between body mass index (BMI), calcium intake, consumption of soft drinks and coke, and physical exercise were investigated. BMC values for both age groups were significantly elevated in boys of the Tanner stage V. (15-16 years: 62.9+/-14.3 g; 17-19 years: 69.8+/-9.3g) than in girls (58.1+/-10.4; 61.6+/-8.5 g) (p<0.001). BMD values were higher in girls, than in boys (1.17+/-0.12 g/cm 2 vs. 1.13+/-0.11 g/cm 2) (p<0.05). OC and beta-Cl levels showed negative correlation with age in both gender (p<0.01), while OC and beta-Cl levels were higher in boys, than in girls (p<0.001). Elevation of BMC and BMD values were associated with increase of BMI in both gender (p<0.05), but the biomarkers in thin girls were higher, than in overweight girls (p<0.05). Authors obtained excellent correlations between the BMD-Z-score values compared to the German standard and to their own population (girls: r=0.97, boys: 0.88), but the absolute values significantly differed from one another. 80% of adolescents are on a diet with insufficient calcium intake, while 38% of them do not play sport regularly. Excessive intake of soft drinks was determined in 60% of adolescents. In the case of insufficient calcium intake (4.7%, 6/127), low bone mass was measured using the Z-score of the German reference values. Among children with adequate calcium intake, BMD assessed by DXA was normal. These data help to determine normal reference values among healthy high school students. Further studies are needed in wider range of young population for the establishment of Hungarian reference values of bone markers.

Modifications of haematology analyzers to improve cell counting and leukocyte differentiating in cerebrospinal fluid controls of the Joint German Society for Clinical Chemistry and Laboratory Medicine.

PubMed

Kleine, Tilmann O; Nebe, C Thomas; Löwer, Christa; Lehmitz, Reinhard; Kruse, Rolf; Geilenkeuser, Wolf-Jochen; Dorn-Beineke, Alexandra

2009-08-01

Flow cytometry (FCM) is used with haematology analyzers (HAs) to count cells and differentiate leukocytes in cerebrospinal fluid (CSF). To evaluate the FCM techniques of HAs, 10 external DGKL trials with CSF controls were carried out in 2004 to 2008. Eight single platform HAs with and without CSF equipment were evaluated with living blood leukocytes and erythrocytes in CSF like DGKL controls: Coulter (LH750,755), Abbott CD3200, CD3500, CD3700, CD4000, Sapphire, ADVIA 120(R) CSF assay, and Sysmex XE-2100(R). Results were compared with visual counting of native cells in Fuchs-Rosenthal chamber, unstained, and absolute values of leukocyte differentiation, assayed by dual platform analysis with immune-FCM (FACSCalibur, CD45, CD14) and the chamber counts. Reference values X were compared with HA values Y by statistical evaluation with Passing/Bablock (P/B) linear regression analysis to reveal conformity of both methods. The HAs, studied, produced no valid results with DGKL CSF controls, because P/B regression revealed no conformity with the reference values due to:-blank problems with impedance analysis,-leukocyte loss with preanalytical erythrocyte lysis procedures, especially of monocytes,-inaccurate results with ADVIA cell sphering and cell differentiation with algorithms and enzyme activities (e.g., peroxidase). HA techniques have to be improved, e.g., using no erythrocyte lysis and CSF adequate techniques, to examine CSF samples precise and accurate. Copyright 2009 International Society for Advancement of Cytometry.

Analysis of on-line clinical laboratory manuals and practical recommendations.

PubMed

Beckwith, Bruce; Schwartz, Robert; Pantanowitz, Liron

2004-04-01

On-line clinical laboratory manuals are a valuable resource for medical professionals. To our knowledge, no recommendations currently exist for their content or design. To analyze publicly accessible on-line clinical laboratory manuals and to propose guidelines for their content. We conducted an Internet search for clinical laboratory manuals written in English with individual test listings. Four individual test listings in each manual were evaluated for 16 data elements, including sample requirements, test methodology, units of measure, reference range, and critical values. Web sites were also evaluated for supplementary information and search functions. We identified 48 on-line laboratory manuals, including 24 academic or community hospital laboratories and 24 commercial or reference laboratories. All manuals had search engines and/or test indices. No single manual contained all 16 data elements evaluated. An average of 8.9 (56%) elements were present (range, 4-14). Basic sample requirements (specimen and volume needed) were the elements most commonly present (98% of manuals). The frequency of the remaining data elements varied from 10% to 90%. On-line clinical laboratory manuals originate from both hospital and commercial laboratories. While most manuals were user-friendly and contained adequate specimen-collection information, other important elements, such as reference ranges, were frequently absent. To ensure that clinical laboratory manuals are of maximal utility, we propose the following 13 data elements be included in individual test listings: test name, synonyms, test description, test methodology, sample requirements, volume requirements, collection guidelines, transport guidelines, units of measure, reference range, critical values, test availability, and date of latest revision.

Staffing by Design: A Methodology for Staffing Reference

ERIC Educational Resources Information Center

Ward, David; Phetteplace, Eric

2012-01-01

The growth in number and kind of online reference services has resulted in both new users consulting library research services as well as new patterns of service use. Staffing in-person and virtual reference services desks adequately requires a systematic analysis of patterns of use across service points in order to successfully meet fluctuating…

Evaluation of five commercially available assays and measurement of serum total protein concentration via refractometry for the diagnosis of failure of passive transfer of immunity in foals.

PubMed

Davis, Rachel; Giguère, Steeve

2005-11-15

To determine and compare sensitivity, specificity, accuracy, and predictive values of measurement of serum total protein concentration by refractometry as well as 5 commercially available kits for the diagnosis of failure of passive transfer (FPT) of immunity in foals. Prospective study. 65 foals with various medical problems and 35 clinically normal foals. IgG concentration in serum was assessed by use of zinc sulfate turbidity (assay C), glutaraldehyde coagulation (assay D), 2 semiquantitative immunoassays (assays F and G), and a quantitative immunoassay (assay H). Serum total protein concentration was assessed by refractometry. Radial immunodiffusion (assays A and B) was used as the reference method. For detection of IgG < 400 mg/dL, sensitivity of assay H (100%) was not significantly different from that of assays C, E, and G (88.9%). Specificity of assays H (96.0%) and G (95.8%) was significantly higher than that of assays C (79.4%) and E (78.1 %). For detection of IgG < 800 mg/dL, sensitivities of assays H (976%), D (92.9%), C (81.0%), and G (81.0%) were significantly higher than that of assay F (52.4%). Specificity of assays F (100%), G (94.7%), and H (82.8%) was significantly higher than that of assays C (56.9%) and D (58.6%). Serum total protein concentration < or = 4.5 g/dL was suggestive of FPT, whereas values > or = 6.0 g/dL indicated adequate IgG concentrations. Most assays were adequate as initial screening tests. However, their use as a definitive test would result in unnecessary treatment of foals with adequate IgG concentrations.

The valuation of nursing begins with identifying value drivers.

PubMed

Rutherford, Marcella M

2010-03-01

Adequate investment in a profession links to its ability to define and document its value. This requires identifying those elements or value drivers that demonstrate its worth. To completely identify nursing's value drivers requires meshing the economic, technical, and caring aspects of its profession. Nursing's valuation includes assessing nursing's tangible and intangible assets and documenting these assets. This information communicates nursing's worth and ensures adequate economic investment in its services.

Now you see it. Now you don't: fair balance and adequate provision in advertisements for drugs before and after the switch from prescription to over-the-counter.

PubMed

Faerber, Adrienne E; Kreling, David H

2012-01-01

The objective of this study was to measure differences in fair balance (benefit and risk statements) and adequate provision (toll-free numbers, Internet URLs, print ad references, and medical professional references) in advertising content for drugs that have switched from prescription to over-the-counter (OTC). The Vanderbilt TV News Archive was used to select products to study, to measure the frequency and placement of ads for those products, and to view advertising content for those products. Unique advertisements (n = 108) for loratadine (Claritin), citirizine (Zyrtec), and omeprazole (Prilosec) were analyzed for the presence of adequate provision statements and for the frequency of benefit, risk, and other statements. OTC ads were shorter than prescription ads by 10.6 seconds but contained the same total number of statements. Most prescription ads (n (RX) = 31) contained toll-free numbers (97%), Internet URLs (94%), medical professional references (100%) and print ad references (68%). Few OTC ads (n (OTC) = 77) contained adequate provision statements: 4% contained toll-free numbers and 10% contained Internet URLs. Prescription ads had similar numbers of benefits (1.5) and risks (1.8) per 30 seconds of ad time, and OTC ads had more benefits (6.6) than risks (1.2) per 30 seconds of ad time. Prescription drug ads contained risk statements that listed specific side effects and explicit harms from taking the product, but OTC ads contained nonspecific risk information and statements that implied risk rather than directly identifying risk. Differences in the Food and Drug Administration (FDA) and Federal Trade Commission (FTC) regulation of advertising affected the balance of risk and benefit information that appeared and the specificity of risk information available.

Two-dimensional myoelectric control of a robotic arm for upper limb amputees

NASA Astrophysics Data System (ADS)

López Celani, Natalia M.; Soria, Carlos M.; Orosco, Eugenio C.; di Sciascio, Fernando A.; Valentinuzzi, Max E.

2007-11-01

Rehabilitation engineering and medicine have become integral and significant parts of health care services, particularly and unfortunately in the last three or four decades, because of wars, terrorism and large number of car accidents. Amputees show a high rate of rejection to wear prosthetic devices, often because of lack of an adequate period of adaptation. A robotic arm may appear as a good preliminary stage. To test the hypothesis, myoelectric signals from two upper limb amputees and from four normal volunteers were fed, via adequate electronic conditioning and using MATLAB, to an industrial robotic arm. Proportional strength control was used for two degrees of freedom (x-y plane) by means of eight signal features of control (four traditional statistics plus energy, integral of the absolute value, Willison's amplitude, waveform length and envelope) for comparison purposes, and selecting the best of them as final reference. Patients easily accepted the system and learned in short time how to operate it. Results were encouraging so that valuable training, before prosthesis is implanted, appears as good feedback; besides, these patients can be hired as specialized operators in semi-automatized industry.

PERFORMANCE OF HIGH SCHOOL FOOTBALL PLAYERS ON CLINICAL MEASURES OF DEEP CERVICAL FLEXOR ENDURANCE AND CERVICAL ACTIVE RANGE OF MOTION: IS HISTORY OF CONCUSSION A FACTOR?

PubMed Central

Ruediger, Thomas; Alsalaheen, Bara; Bean, Ryan

2016-01-01

Background More than one million adolescent athletes participated in organized high school sanctioned football during the 2014-15 season. These athletes are at risk for sustaining concussion. Although cervical spine active range of motion (AROM) and deep neck flexor endurance may serve a preventative role in concussion, and widespread clinical use of measurements of these variables, reference values are not available for this population. Cost effective, clinically relevant methods for measuring neck endurance are also well established for adolescent athletes. Purpose The purpose of this study was to report reference values for deep cervical flexor endurance and cervical AROM in adolescent football players and examine whether differences in these measures exist in high school football players with and without a history of concussion. Methods Concussion history, cervical AROM, and deep neck flexor endurance were measured in 122 high school football players. Reference values were calculated for AROM and endurance measures; association were examined between various descriptive variables and concussion. Results No statistically significant differences were found between athletes with a history of concussion and those without. A modest inverse correlation was seen between body mass and AROM in the sagittal and transverse planes. Conclusion The results of this study indicate that the participants with larger body mass had less cervical AROM in some directions. While cervical AROM and endurance measurements may not be adequate to identify adolescents with a history of previous concussions among high school football players. However, if a concussion is sustained, these measures can offer a baseline to examine whether cervical AROM is affected as compared to healthy adolescents. Level of Evidence 2c PMID:27104049

PERFORMANCE OF HIGH SCHOOL FOOTBALL PLAYERS ON CLINICAL MEASURES OF DEEP CERVICAL FLEXOR ENDURANCE AND CERVICAL ACTIVE RANGE OF MOTION: IS HISTORY OF CONCUSSION A FACTOR?

PubMed

Smith, Laura; Ruediger, Thomas; Alsalaheen, Bara; Bean, Ryan

2016-04-01

More than one million adolescent athletes participated in organized high school sanctioned football during the 2014-15 season. These athletes are at risk for sustaining concussion. Although cervical spine active range of motion (AROM) and deep neck flexor endurance may serve a preventative role in concussion, and widespread clinical use of measurements of these variables, reference values are not available for this population. Cost effective, clinically relevant methods for measuring neck endurance are also well established for adolescent athletes. The purpose of this study was to report reference values for deep cervical flexor endurance and cervical AROM in adolescent football players and examine whether differences in these measures exist in high school football players with and without a history of concussion. Concussion history, cervical AROM, and deep neck flexor endurance were measured in 122 high school football players. Reference values were calculated for AROM and endurance measures; association were examined between various descriptive variables and concussion. No statistically significant differences were found between athletes with a history of concussion and those without. A modest inverse correlation was seen between body mass and AROM in the sagittal and transverse planes. The results of this study indicate that the participants with larger body mass had less cervical AROM in some directions. While cervical AROM and endurance measurements may not be adequate to identify adolescents with a history of previous concussions among high school football players. However, if a concussion is sustained, these measures can offer a baseline to examine whether cervical AROM is affected as compared to healthy adolescents. 2c.

Use of an intravascular fluorescent continuous glucose sensor in subjects with type 1 diabetes mellitus.

PubMed

Romey, Matthew; Jovanovič, Lois; Bevier, Wendy; Markova, Kateryna; Strasma, Paul; Zisser, Howard

2012-11-01

Stress hyperglycemia in the critically ill is associated with increased morbidity and mortality. Continuous glucose monitoring offers a solution to the difficulties of dosing intravenous insulin properly to maintain glycemic control. The purpose of this study was to evaluate an intravascular continuous glucose monitoring (IV-CGM) system with a sensing element based on the concept of quenched fluorescence. A second-generation intravascular continuous glucose sensor was evaluated in 13 volunteer subjects with type 1 diabetes mellitus. There were 21 study sessions of up to 24 h in duration. Sensors were inserted into peripheral veins of the upper extremity, up to two sensors per subject per study session. Sensor output was compared with temporally correlated reference measurements obtained from venous samples on a laboratory glucose analyzer. Data were obtained from 23 sensors in 13 study sessions with 942 paired reference values. Fourteen out of 23 sensors (60.9%) had a mean absolute relative difference ≤ 10%. Eighty-nine percent of paired points were in the clinically accurate A zone of the Clarke error grid and met ISO 15197 performance criteria. Adequate venous blood flow was identified as a necessary condition for accuracy when local sensor readings are compared with venous blood glucose. The IV-CGM system was capable of achieving a high level of glucose measurement accuracy. However, superficial peripheral veins may not provide adequate blood flow for reliable indwelling blood glucose monitoring. © 2012 Diabetes Technology Society.

Use of an Intravascular Fluorescent Continuous Glucose Sensor in Subjects with Type 1 Diabetes Mellitus

PubMed Central

Romey, Matthew; Jovanovič, Lois; Bevier, Wendy; Markova, Kateryna; Strasma, Paul; Zisser, Howard

2012-01-01

Background Stress hyperglycemia in the critically ill is associated with increased morbidity and mortality. Continuous glucose monitoring offers a solution to the difficulties of dosing intravenous insulin properly to maintain glycemic control. The purpose of this study was to evaluate an intravascular continuous glucose monitoring (IV-CGM) system with a sensing element based on the concept of quenched fluorescence. Method A second-generation intravascular continuous glucose sensor was evaluated in 13 volunteer subjects with type 1 diabetes mellitus. There were 21 study sessions of up to 24 h in duration. Sensors were inserted into peripheral veins of the upper extremity, up to two sensors per subject per study session. Sensor output was compared with temporally correlated reference measurements obtained from venous samples on a laboratory glucose analyzer. Results Data were obtained from 23 sensors in 13 study sessions with 942 paired reference values. Fourteen out of 23 sensors (60.9%) had a mean absolute relative difference ≤ 10%. Eighty-nine percent of paired points were in the clinically accurate A zone of the Clarke error grid and met ISO 15197 performance criteria. Adequate venous blood flow was identified as a necessary condition for accuracy when local sensor readings are compared with venous blood glucose. Conclusions The IV-CGM system was capable of achieving a high level of glucose measurement accuracy. However, superficial peripheral veins may not provide adequate blood flow for reliable indwelling blood glucose monitoring. PMID:23294770

Reference equations for 6-min walk test in healthy Indian subjects (25-80 years).

PubMed

Palaniappan Ramanathan, Ramanathan; Chandrasekaran, Baskaran

2014-01-01

Six-min walk test (6MWT), a simple functional capacity evaluation tool used globally to determine the prognosis and effectiveness of any therapeutic/medical intervention. However, variability in reference equations derived from western population (due to racial and ethnicity variations) hinders from adequate use of 6MWT clinically. Further, there are no valid Indian studies that predict reference values for 6-min walk distance (6MWD) in healthy Indian normal. We aimed for framing individualized reference equations for 6MWT in healthy Indian population. Anthropometric variables (age, weight, height, and body mass index (BMI)) and 6-min walk in a 30 m corridor were evaluated in 125 subjects (67 females) in a cross-sectional trial. 6MWD significantly correlated with age (r = -0.29), height (r = 0.393), weight (r = 0.08), and BMI (r = -0.17). The gender specific reference equations for healthy Indian individuals were: (1) Males: 561.022 - (2.507 × age [years]) + (1.505 × weight [kg]) - (0.055 × height [cm]). R (2) = 0.288. (2) Indian females: 30.325 - (0.809 × age [years]) - (2.074 × weight [kg]) + (4.235 × height [cm]). R (2) = 0.272. Though the equations possess a small coefficient of determination and larger standard error estimate, the former applicability to Indian population is justified. These reference equations are probably most appropriate for evaluating the walked capacity of Indian patients with chronic diseases.

A control strategy for grid-side converter of DFIG under unbalanced condition based on Dig SILENT/Power Factory

NASA Astrophysics Data System (ADS)

Han, Pingping; Zhang, Haitian; Chen, Lingqi; Zhang, Xiaoan

2018-01-01

The models of doubly fed induction generator (DFIG) and its grid-side converter (GSC) are established under unbalanced grid condition based on DIgSILENT/PowerFactory. According to the mathematical model, the vector equations of positive and negative sequence voltage and current are deduced in the positive sequence synchronous rotating reference frame d-q-0 when the characteristics of the simulation software are considered adequately. Moreover, the reference value of current component of GSC in the positive sequence frame d-q-0 under unbalanced condition can be obtained to improve the traditional control of GSC when the national issue of unbalanced current limits is combined. The simulated results indicate that the control strategy can restrain negative sequence current and the two times frequency power wave of GSC’s ac side effectively. The voltage of DC bus can be maintained a constant to ensure the uninterrupted operation of DFIG under unbalanced grid condition eventually.

PATIENT'S RIGHT TO INFORMED CONSENT IN REPUBLIC SRPSKA: LEGAL AND ETHICAL ASPECTS (WITH SPECIAL REFERENCE TO PHYSICAL REHABILITATION).

PubMed

Milinkovic, Igor; Majstorovic, Biljana

2014-12-01

The principle of informed consent, which requires a patient's fully-informed consent prior to the medical treatment, is closely connected with the value of human dignity. The realization and protection of a patient's dignity is not possible without his/her right to choose the character and scope of medical treatment. This goal cannot be adequately achieved within the traditional model of medical paternalism characterized by the physician's authoritative position. The first part of the article deals with the content and ethical significance of the informed consent doctrine. The legal framework of informed consent in Republic Srpska (RS), one of the two Bosnia and Herzegovina (BH)entities, is analyzed. Special reference is made to the relevance of the informed consent principle within the physical rehabilitation process. Although ethical aspects of physical rehabilitation are often overlooked, this medical field possesses a strong ethical dimension (including an appropriate realization of the patient's right to informed consent).

Role of Negative Trans-Thoracic Echocardiography in the Diagnosis of Infective Endocarditis.

PubMed

Leitman, Marina; Peleg, Eli; Shmueli, Ruthie; Vered, Zvi

2016-07-01

The search for the presence of vegetations in patients with suspected infective endocarditis is a major indication for trans-esophageal echocardiographic (TEE) examinations. Advances in harmonic imaging and ongoing improvement in modern echocardiographic systems allow adequate quality of diagnostic images in most patients. To investigate whether TEE examinations are always necessary for the assessment of patients with suspected infective endocarditis. During 2012-2014 230 trans-thoracic echo (TTE) exams in patients with suspected infective endocarditis were performed at our center. Demographic, epidemiological, clinical and echocardiographic data were collected and analyzed, and the final clinical diagnosis and outcome were determined. Of 230 patients, 24 had definite infective endocarditis by clinical assessment. TEE examination was undertaken in 76 of the 230 patients based on the clinical decision of the attending physician. All TTE exams were classified as: (i) positive, i.e., vegetations present; (ii) clearly negative; or (iii) non-conclusive. Of the 92 with clearly negative TTE exams, 20 underwent TEE and all were negative. All clearly negative patients had native valves, adequate quality images, and in all 92 the final diagnosis was not infective endocarditis. Thus, the negative predictive value of a clearly negative TTE examination was 100%. In patients with native cardiac valves referred for evaluation for infective endocarditis, an adequate quality TTE with clearly negative examination may be sufficient for the diagnosis.

Mental Health: Knowledge, Attitudes and Training of Professionals on Dual Diagnosis of Intellectual Disability and Psychiatric Disorder

ERIC Educational Resources Information Center

Werner, S.; Stawski, M.

2012-01-01

Background: Dual diagnosis (DD) refers to the coexistence of intellectual disability and psychiatric disorder. In order to provide individuals with DD with adequate care, it is essential for mental health workers to have adequate knowledge and positive attitudes. These may be achieved through proper training. Aims: To summarise the available…

Direct dose mapping versus energy/mass transfer mapping for 4D dose accumulation: fundamental differences and dosimetric consequences.

PubMed

Li, Haisen S; Zhong, Hualiang; Kim, Jinkoo; Glide-Hurst, Carri; Gulam, Misbah; Nurushev, Teamour S; Chetty, Indrin J

2014-01-06

The direct dose mapping (DDM) and energy/mass transfer (EMT) mapping are two essential algorithms for accumulating the dose from different anatomic phases to the reference phase when there is organ motion or tumor/tissue deformation during the delivery of radiation therapy. DDM is based on interpolation of the dose values from one dose grid to another and thus lacks rigor in defining the dose when there are multiple dose values mapped to one dose voxel in the reference phase due to tissue/tumor deformation. On the other hand, EMT counts the total energy and mass transferred to each voxel in the reference phase and calculates the dose by dividing the energy by mass. Therefore it is based on fundamentally sound physics principles. In this study, we implemented the two algorithms and integrated them within the Eclipse treatment planning system. We then compared the clinical dosimetric difference between the two algorithms for ten lung cancer patients receiving stereotactic radiosurgery treatment, by accumulating the delivered dose to the end-of-exhale (EE) phase. Specifically, the respiratory period was divided into ten phases and the dose to each phase was calculated and mapped to the EE phase and then accumulated. The displacement vector field generated by Demons-based registration of the source and reference images was used to transfer the dose and energy. The DDM and EMT algorithms produced noticeably different cumulative dose in the regions with sharp mass density variations and/or high dose gradients. For the planning target volume (PTV) and internal target volume (ITV) minimum dose, the difference was up to 11% and 4% respectively. This suggests that DDM might not be adequate for obtaining an accurate dose distribution of the cumulative plan, instead, EMT should be considered.

Direct dose mapping versus energy/mass transfer mapping for 4D dose accumulation: fundamental differences and dosimetric consequences

NASA Astrophysics Data System (ADS)

Li, Haisen S.; Zhong, Hualiang; Kim, Jinkoo; Glide-Hurst, Carri; Gulam, Misbah; Nurushev, Teamour S.; Chetty, Indrin J.

2014-01-01

The direct dose mapping (DDM) and energy/mass transfer (EMT) mapping are two essential algorithms for accumulating the dose from different anatomic phases to the reference phase when there is organ motion or tumor/tissue deformation during the delivery of radiation therapy. DDM is based on interpolation of the dose values from one dose grid to another and thus lacks rigor in defining the dose when there are multiple dose values mapped to one dose voxel in the reference phase due to tissue/tumor deformation. On the other hand, EMT counts the total energy and mass transferred to each voxel in the reference phase and calculates the dose by dividing the energy by mass. Therefore it is based on fundamentally sound physics principles. In this study, we implemented the two algorithms and integrated them within the Eclipse treatment planning system. We then compared the clinical dosimetric difference between the two algorithms for ten lung cancer patients receiving stereotactic radiosurgery treatment, by accumulating the delivered dose to the end-of-exhale (EE) phase. Specifically, the respiratory period was divided into ten phases and the dose to each phase was calculated and mapped to the EE phase and then accumulated. The displacement vector field generated by Demons-based registration of the source and reference images was used to transfer the dose and energy. The DDM and EMT algorithms produced noticeably different cumulative dose in the regions with sharp mass density variations and/or high dose gradients. For the planning target volume (PTV) and internal target volume (ITV) minimum dose, the difference was up to 11% and 4% respectively. This suggests that DDM might not be adequate for obtaining an accurate dose distribution of the cumulative plan, instead, EMT should be considered.

Reference intervals and discrimination values of the Lanthony desaturated D-15 panel test in young to middle-aged Japanese army officials: the Okubo Color Study Report 1.

PubMed

Shoji, T; Sakurai, Y; Chihara, E; Nishikawa, S; Omae, K

2009-06-01

To better understand the reference values and adequate discrimination values of colour vision function with described quantitative systems for the Lanthony desaturated D-15 panel (D-15DS). A total of 1042 Japanese male officials were interviewed and underwent testing using Ishihara pseudoisochromatic plates, standard pseudoisochromatic plates part 2, and the D-15DS. The Farnsworth-Munsell (F-M) 100-hue test and the criteria of Verriest et al were used as definitive tests. Outcomes of the D-15DS were calculated using Bowman's Colour Confusion Index (CCI). The study design included two criteria. In criterion A, subjects with current or past ocular disease and a best-corrected visual acuity less than 0.7 on a decimal visual acuity chart were excluded. In criterion B, among subjects who satisfied criterion A, those who had a congenital colour sense anomaly were excluded. Overall, the 90th percentile (95th percentile) CCI values for criteria A and B in the worse eye were 1.70 (1.95) and 1.59 (1.73), respectively. In subjects satisfying criterion B, the area under the receiver operating characteristic curve was 0.951 (95% confidence interval, 0.931-0.971). The CCI discrimination values of 1.52 or 1.63 showed 90.3% sensitivity and 90% specificity, or 71.5% sensitivity and 95% specificity, respectively, for discriminating acquired colour vision impairment (ACVI). We provided the 90th and 95th percentiles in a young to middle-aged healthy population. The CCI is in good agreement with the diagnosis of ACVI. Our results could be helpful for using D-15DS for screening purposes.

Accuracy of body mass index for age to diagnose obesity in Mexican schoolchildren.

PubMed

Mendoza Pablo, Pedro A; Valdés, Jesús; Ortiz-Hernández, Luis

2015-06-01

To compare the accuracy of three BMI-forage references (World Health Organization reference, WHO; the updated International Obesity Task Force reference, IOTF; and Centers for Disease Control and Prevention (CDC) growth charts) to diagnose obesity in Mexican children. A convenience sample of Mexican schoolchildren (n = 218) was assessed. The gold standard was the percentage of body fat estimated by deuterium dilution technique. Sensitivity and specificity of the classical cutoff point of BMI-for-age to identify obesity (i.e. > 2.00 standard deviation, SD) were estimated. The accuracy (i.e. area under the curve, AUC) of three BMI-for-age references for the diagnosis of obesity was estimated with the receiver operating characteristic (ROC) curves method. The optimal cutoff point (OCP) was determined. The cutoff points to identify obesity had low (WHO reference: 57.6%, CDC: 53.5%) to very low (IOTF reference: 40.4%) sensitivities, but adequate specificities (91.6%, 95.0%, and, 97.5%, respectively). The AUC of the three references were adequate (0.89). For the IOTF reference, the AUC was lower among the older children. The OCP for the CDC reference (1.24 SD) was lower than the OCP for WHO (1.53 SD) and IOTF charts (1.47 SD). The classical cutoff point for obesity has low sensitivity--especially for the IOTF reference. The accuracy of the three references was similar. However, to obtain comparable diagnosis of obesity different cutoff points should be used depending of the reference. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Higher-order correlations for fluctuations in the presence of fields.

PubMed

Boer, A; Dumitru, S

2002-10-01

The higher-order moments of the fluctuations for thermodynamic systems in the presence of fields are investigated in the framework of a theoretical method. The method uses a generalized statistical ensemble consistent with an adequate expression for the internal energy. The applications refer to the case of a system in a magnetoquasistatic field. In the case of linear magnetic media, one finds that, for the description of the magnetic induction fluctuations, the Gaussian approximation is satisfactory. For nonlinear media, the corresponding fluctuations are non-Gaussian, having a non-null asymmetry. Furthermore, the respective fluctuations have characteristics of leptokurtic, mesokurtic and platykurtic type, depending on the value of the magnetic field strength as compared with a scaling factor of the magnetization curve.

40 CFR 160.47 - Facilities for handling test, control, and reference substances.

Code of Federal Regulations, 2011 CFR

2011-07-01

... the test systems and shall be adequate to preserve the identity, strength, purity, and stability of... 40 Protection of Environment 24 2011-07-01 2011-07-01 false Facilities for handling test, control... for handling test, control, and reference substances. (a) As necessary to prevent contamination or...

40 CFR 160.47 - Facilities for handling test, control, and reference substances.

Code of Federal Regulations, 2013 CFR

2013-07-01

... the test systems and shall be adequate to preserve the identity, strength, purity, and stability of... 40 Protection of Environment 25 2013-07-01 2013-07-01 false Facilities for handling test, control... for handling test, control, and reference substances. (a) As necessary to prevent contamination or...

40 CFR 160.47 - Facilities for handling test, control, and reference substances.

Code of Federal Regulations, 2014 CFR

2014-07-01

... the test systems and shall be adequate to preserve the identity, strength, purity, and stability of... 40 Protection of Environment 24 2014-07-01 2014-07-01 false Facilities for handling test, control... for handling test, control, and reference substances. (a) As necessary to prevent contamination or...

40 CFR 160.47 - Facilities for handling test, control, and reference substances.

Code of Federal Regulations, 2012 CFR

2012-07-01

... the test systems and shall be adequate to preserve the identity, strength, purity, and stability of... 40 Protection of Environment 25 2012-07-01 2012-07-01 false Facilities for handling test, control... for handling test, control, and reference substances. (a) As necessary to prevent contamination or...

Revision of dietary reference intakes for energy in preschool-age children

USDA-ARS?s Scientific Manuscript database

Dietary Reference Intakes (DRI) for energy aim to balance energy expenditure at a level of physical activity consistent with health and support adequate growth in children. DRIs were derived from total energy expenditure (TEE) measured by using the doubly labeled water (DLW) method; however, the dat...

Proceedings, Resource Sharing II, 22nd Military Librarians Workshop

DTIC Science & Technology

1979-01-01

nation Provide adequate trained personnel for the varied and changing Vi demands of librarianship 3 To satisfy these objectives, which can only be met...scholarly research and to library reference work. This ’new’ reference service is seen by some as a revolution in professional librarianship and by others

Correlations of Apparent Cellulose Crystallinity Determined by XRD, NMR, IR, Raman, and SFG Methods

DOE Office of Scientific and Technical Information (OSTI.GOV)

Johnson, David K; Lee, Christopher; Dazen, Kevin

2015-07-04

Although the cellulose crystallinity index (CI) is used widely, its limitations have not been adequately described. In this study, the CI values of a set of reference samples were determined from X-ray diffraction (XRD), nuclear magnetic resonance (NMR), and infrared (IR), Raman, and vibrational sum frequency generation (SFG) spectroscopies. The intensities of certain crystalline peaks in IR, Raman, and SFG spectra positively correlated with the amount of crystalline cellulose in the sample, but the correlation with XRD was nonlinear as a result of fundamental differences in detection sensitivity to crystalline cellulose and improper baseline corrections for amorphous contributions. It ismore » demonstrated that the intensity and shape of the XRD signal is affected by both the amount of crystalline cellulose and crystal size, which makes XRD analysis complicated. It is clear that the methods investigated show the same qualitative trends for samples, but the absolute CI values differ depending on the determination method. This clearly indicates that the CI, as estimated by different methods, is not an absolute value and that for a given set of samples the CI values can be compared only as a qualitative measure.« less

Correlations of Apparent Cellulose Crystallinity Determined by XRD, NMR, IR, Raman, and SFG Methods

DOE Office of Scientific and Technical Information (OSTI.GOV)

Lee, Christopher M; Dazen, Kevin; Kafle, Kabindra

2015-01-01

Although the cellulose crystallinity index (CI) is used widely, its limitations have not been adequately described. In this study, the CI values of a set of reference samples were determined from X-ray diffraction (XRD), nuclear magnetic resonance (NMR), and infrared (IR), Raman, and vibrational sum frequency generation (SFG) spectroscopies. The intensities of certain crystalline peaks in IR, Raman, and SFG spectra positively correlated with the amount of crystalline cellulose in the sample, but the correlation with XRD was nonlinear as a result of fundamental differences in detection sensitivity to crystalline cellulose and improper baseline corrections for amorphous contributions. It ismore » demonstrated that the intensity and shape of the XRD signal is affected by both the amount of crystalline cellulose and crystal size, which makes XRD analysis complicated. It is clear that the methods investigated show the same qualitative trends for samples, but the absolute CI values differ depending on the determination method. This clearly indicates that the CI, as estimated by different methods, is not an absolute value and that for a given set of samples the CI values can be compared only as a qualitative measure.« less

Calculation for simulation of archery goal value using a web camera and ultrasonic sensor

NASA Astrophysics Data System (ADS)

Rusjdi, Darma; Abdurrasyid, Wulandari, Dewi Arianti

2017-08-01

Development of the device simulator digital indoor archery-based embedded systems as a solution to the limitations of the field or open space is adequate, especially in big cities. Development of the device requires simulations to calculate the value of achieving the target based on the approach defined by the parabolic motion variable initial velocity and direction of motion of the arrow reaches the target. The simulator device should be complemented with an initial velocity measuring device using ultrasonic sensors and measuring direction of the target using a digital camera. The methodology uses research and development of application software from modeling and simulation approach. The research objective to create simulation applications calculating the value of the achievement of the target arrows. Benefits as a preliminary stage for the development of the simulator device of archery. Implementation of calculating the value of the target arrows into the application program generates a simulation game of archery that can be used as a reference development of the digital archery simulator in a room with embedded systems using ultrasonic sensors and web cameras. Applications developed with the simulation calculation comparing the outer radius of the circle produced a camera from a distance of three meters.

Japanese Society for Laboratory Hematology flow cytometric reference method of determining the differential leukocyte count: external quality assurance using fresh blood samples.

PubMed

Kawai, Y; Nagai, Y; Ogawa, E; Kondo, H

2017-04-01

To provide target values for the manufacturers' survey of the Japanese Society for Laboratory Hematology (JSLH), accurate standard data from healthy volunteers were needed for the five-part differential leukocyte count. To obtain such data, JSLH required an antibody panel that achieved high specificity (particularly for mononuclear cells) using simple gating procedures. We developed a flow cytometric method for determining the differential leukocyte count (JSLH-Diff) and validated it by comparison with the flow cytometric differential leukocyte count of the International Council for Standardization in Haematology (ICSH-Diff) and the manual differential count obtained by microscopy (Manual-Diff). First, the reference laboratory performed an imprecision study of JSLH-Diff and ICSH-Diff, as well as performing comparison among JSLH-Diff, Manual-Diff, and ICSH-Diff. Then two reference laboratories and seven participating laboratories performed imprecision and accuracy studies of JSLH-Diff, Manual-Diff, and ICSH-Diff. Simultaneously, six manufacturers' laboratories provided their own representative values by using automated hematology analyzers. The precision of both JSLH-Diff and ICSH-Diff methods was adequate. Comparison by the reference laboratory showed that all correlation coefficients, slopes and intercepts obtained by the JSLH-Diff, ICSH-Diff, and Manual-Diff methods conformed to the criteria. When the imprecision and accuracy of JSLH-Diff were assessed at seven laboratories, the CV% for lymphocytes, neutrophils, monocytes, eosinophils, and basophils was 0.5~0.9%, 0.3~0.7%, 1.7~2.6%, 3.0~7.9%, and 3.8~10.4%, respectively. More than 99% of CD45 positive leukocytes were identified as normal leukocytes by JSLH-Diff. When JSLH-Diff method were validated by comparison with Manual-Diff and ICSH-Diff, JSLH-Diff showed good performance as a reference method. © 2016 John Wiley & Sons Ltd.

Pica

MedlinePlus

... eating nonfood materials. Prevention There is no specific prevention. Getting adequate nutrition may help. Alternative Names Geophagy; Lead poisoning - pica References Ginder GD. Microcytic and hepochromic anemias. ...

Decentralized model reference adaptive control of large flexible structures

NASA Technical Reports Server (NTRS)

Lee, Fu-Ming; Fong, I-Kong; Lin, Yu-Hwan

1988-01-01

A decentralized model reference adaptive control (DMRAC) method is developed for large flexible structures (LFS). The development follows that of a centralized model reference adaptive control for LFS that have been shown to be feasible. The proposed method is illustrated using a simply supported beam with collocated actuators and sensors. Results show that the DMRAC can achieve either output regulation or output tracking with adequate convergence, provided the reference model inputs and their time derivatives are integrable, bounded, and approach zero as t approaches infinity.

[Evaluation of a thyroid disease referral protocal in a health area of Madrid].

PubMed

López, A; Rollán, M T; Bedoya, M J; García, C

The collaboration between healthcare levels is essential for our patients. The aim of this study is to determine the suitability of a referral protocol between the different healthcare levels. A collaboration study was carried out between general practitioners, endocrinologists, and the Department of Biochemistry. After creating the protocol together and implementing it, the suitability was evaluated. A total of 284 referral sheets were evaluated, 65% were adequately sent, and 51% were referred due to laboratory abnormalities, 42% for morphological alterations, and 7% for both reasons. Just under three-quarters (72%) were referred in the normal way (adequacy 90.6%). The clinical information in the referral sheet was considered adequate in 59%, and the request for ultrasound was adequate in 78%. A significant number (16%) of patients should have been returned to Primary Care. It is considered that creating protocols is part of our task. The compliance with the protocol can be improved in Primary Care and specialised care. Publicado por Elsevier España, S.L.U.

[Reference values of folic acid for the Venezuelan population].

PubMed

García-Casal, María Nieves; Carias, Diamela; Soto de Sanabria, Ingrid; Victoria López, Ana

2013-12-01

The review on folic acid requirements for Venezuela comprise the definitions adopted worldwide known as Dietary Reference Intakes (DRIs) that include Recommended Dietary Allowance (RDA), Estimated Average Requirement (EAR), Adequate Intake (AI) and Tolerable Upper Intake Levels (UL). In contrast with the situation in some countries, that required adjustments in fortification policies in order to avoid excessive folic acid consumption, in Venezuela several studies show an elevated prevalence of deficiency. National evidence at this point is insufficient to establish the recommendation, and as in the 2000 review of the Venezuelan RDAs, the actual recommendations are based on the reported for the United States population. The Recommended Dietary Allowances for Venezuela are 65-80 microg/day for infants less than 1 year old, 150-300 microg/day for children and 400 microg/day for adolescents and adults, increasing to 600 microg/day during pregnancy and to 500 microg/day during lactation. The estimated average requirement is 120-250 microg/day for children, 330 microg/day for adolescents, 320 microg/day for adults, 520 microg/day for pregnancy and 450 microg/day during lactation. The tolerable upper intake levels for folic acid are 300-600 microg/day for children, 800 microg/day for adolescents and 1000 microg/day for adults. During pregnancy and lactation the UL is 800 microg/day for pregnant and lactating women between 14 and 18 years of age, and 1000 microg/day for older pregnant and lactating women. The continuous evaluation of folic acid status is important to design adequate and efficient policies to control both, the deficiency and the excess of folic acid consumption.

The Psychological Cost of Making Control Responses in the Nonstereotype Direction.

PubMed

Chan, Alan H S; Hoffmann, Errol R

2016-12-01

The aim of this study was to develop a scale for the "psychological cost" of making control responses in the nonstereotype direction. Wickens, Keller, and Small suggested values for the psychological cost arising from having control/display relationships that were not in the common stereotype directions. We provide values of such costs specifically for these situations. Working from data of Chan and Hoffmann for 168 combinations of display location, control type, and display movement direction, we define values for the cost and compare these with the suggested values of Wickens et al.'s Frame of Reference Transformation Tool (FORT) model. We found marked differences between the values of the FORT model and the data of our experiments. The differences arise largely from the effects of the Worringham and Beringer visual field principle not being adequately considered in the previous research. A better indication of the psychological cost for use of incorrect control/display stereotypes is given. It is noted that these costs are applicable only to the factor of stereotype strength and not other factors considered in the FORT model. Effects of having controls and displays that are not arranged to operate with population expectancies can be readily determined from the data in this paper. © 2016, Human Factors and Ergonomics Society.

Voids characteristics of asphaltic concrete containing coconut shell

NASA Astrophysics Data System (ADS)

Ezree Abdullah, Mohd; Hannani Madzaili, Amirah; Putra Jaya, Ramadhansyah; Yaacob, Haryati; Hassan, Norhidayah Abdul; Nazri, Fadzli Mohamed

2017-07-01

Asphalt durability is often linked to the thickness of the asphalt coating on the aggregate particles. In order to have adequate film thickness in asphaltic concrete, there must be sufficient space between the aggregate particles in the compacted pavement. This void space is referred to as voids in total mix (VTM), voids with filled bitumen (VFB), and voids in mineral aggregate (VMA). Hence, this study investigates the performance of coconut shell (CS) as coarse aggregate replacement on voids characteristics of asphaltic concrete. Four CS were used as coarse aggregates replacement in asphalt mixture namely 0%, 10%, 20%, 30%, and 40% (by weight volume). The voids properties of asphalt mixture were determined based on Marshall Mix design test. Test results show that VTM and VMA values were decrease with the increasing bitumen content where VFB was increase with increasing bitumen content. Furthermore, increasing the percentage of coconut shell in asphalt mixture was found to increases the voids value up to a peak level and then decreases with further additions of CS.

Presumed primary thiamine deficiency in a young African lion (Panthera leo).

PubMed

DiGesualdo, Cynthia L; Hoover, John P; Lorenz, Michael D

2005-09-01

A 1-yr-old intact male African lion (Panthera leo) fed only beef muscle meat was evaluated for episodes of hypermetric ataxia, generalized weakness and tonic-clonic front limb movements. A hemogram, biochemical profile, blood lead, electrocardiogram, survey radiographs, and brain computed tomography were normal. Cerebral spinal fluid analyses suggested mild inflammation. Acetylcholine receptor antibody and serologic tests for all infectious agents tested were negative. Clinical signs resolved completely 9 days after instituting oral thiamine (3 mg/kg/day) and a completely nutritional diet. This lion's pretreatment thiamine blood value (11 nmol/L) was markedly lower than that of a healthy lion (191 nmol/L) and a proposed reference range for adult African lions (160-350 nmol/L). The lion remained clinically normal 2 yr later when his blood thiamine value was 340 nmol/L. African lions can develop clinical primary thiamine deficiency and may respond favorably when thiamine treatment and adequate diet are instituted prior to irreversible neuronal necrosis.

Serum Copper Status in School-Age Children and Pregnant Women in China Nutrition and Health Survey 2010-2012.

PubMed

Liu, Xiaobing; Piao, Jianhua; Zhang, Yu; Li, Min; Li, Weidong; Yang, Lichen; Yang, Xiaoguang

2016-10-01

Serum copper is an insensitive but reliable biomarker reflecting the change of copper nutritional status in both depleted and replete populations. The current study aimed to establish the reference values of serum copper in school-age children and pregnant women in China and to explore the adequate range of serum copper for both these two categories of people. A multistage, stratified, random sampling combined with probability proportionate to regional size sampling method was employed. A total of 4019 subjects (2736 school-age children and 1283 pregnant women) were selected from China Nutrition and Health Survey 2010-2012 (CNHS 2010-2012). The concentration of serum copper was determined by sector field inductively coupled plasma mass spectrometry (SF-ICP-MS). The adequate range of serum copper was determined by the logistic sigmoid saturation curve of the median derivatives. The median concentration of serum copper was 1140.9 μg/L with a range of 746.7-1677.6 μg/L for school-age children and 1933.4 μg/L with a range of 947.4-3391.4 μg/L for pregnant women. The adequate range of serum copper was 905.7-1440.7 μg/L for school-age children and 1308.8-2537.8 μg/L for pregnant women. These parameters represent an essential prerequisite for the assessment of copper nutritional status, as well as nutrition interventions.

Knowledge and misconceptions about immunizations among medical students, pediatric, and family medicine resident.

PubMed

Tañón, Vilmarie; Borrero, Clarimar; Pedrogo, Yasmín

2010-01-01

Previous research has indicated that, despite being the most trusted source of health information, medical students, residents and other health related professionals lack accurate and current knowledge regarding immunization practices. To evaluate medical students and primary care resident knowledge about immunizations. Self-administered survey given to students from four medical schools, Pediatrics residents (2 training programs) and Family Medicine residents (2 programs). Data was analyzed using Statistix 8.0. One-way ANOVA test was used to compare means, and a p-value less than 0.05 was considered statistically significant. Participants (N=376) included 3rd (64%) and 4th (18%) year medical students and a homogenous distribution of 1st, 2nd and 3rd year residents. The mean percent of correct answers about immunizations was 61%. The participants showed poor knowledge about indications (62% correct answers), contraindications (46% correct answers) and myths (71% correct answers). Knowledge about immunizations correlated with higher levels of education (p < 0.01). Most participants identified conferences (72%) as their primary source to learn about immunizations followed by books (48%) and the internet (36%). They referred poor exposure to immunizations in clinical settings. Most medical students do not have the expected knowledge about immunization indications and contraindications. Residents were not proficient in immunization contraindications. Both groups had an adequate understanding about vaccination myths. Efforts towards ensuring adequate exposure to immunizations education during training years are needed in order to eliminate one of the barriers to adequate immunizations in children.

Muscle Injuries in Sports: A New Evidence-Informed and Expert Consensus-Based Classification with Clinical Application.

PubMed

Valle, Xavier; Alentorn-Geli, Eduard; Tol, Johannes L; Hamilton, Bruce; Garrett, William E; Pruna, Ricard; Til, Lluís; Gutierrez, Josep Antoni; Alomar, Xavier; Balius, Ramón; Malliaropoulos, Nikos; Monllau, Joan Carles; Whiteley, Rodney; Witvrouw, Erik; Samuelsson, Kristian; Rodas, Gil

2017-07-01

Muscle injuries are among the most common injuries in sport and continue to be a major concern because of training and competition time loss, challenging decision making regarding treatment and return to sport, and a relatively high recurrence rate. An adequate classification of muscle injury is essential for a full understanding of the injury and to optimize its management and return-to-play process. The ongoing failure to establish a classification system with broad acceptance has resulted from factors such as limited clinical applicability, and the inclusion of subjective findings and ambiguous terminology. The purpose of this article was to describe a classification system for muscle injuries with easy clinical application, adequate grouping of injuries with similar functional impairment, and potential prognostic value. This evidence-informed and expert consensus-based classification system for muscle injuries is based on a four-letter initialism system: MLG-R, respectively referring to the mechanism of injury (M), location of injury (L), grading of severity (G), and number of muscle re-injuries (R). The goal of the classification is to enhance communication between healthcare and sports-related professionals and facilitate rehabilitation and return-to-play decision making.

76 FR 53162 - Acceptance of Public Submissions Regarding the Study of Stable Value Contracts

Federal Register 2010, 2011, 2012, 2013, 2014

2011-08-25

... the risk of a run on a SVF? To the extent that SVC providers use value-at-risk (``VaR'') models, do such VaR models adequately assess the risk of loss resulting from such events or other possible but extremely unlikely events? Do other loss models more adequately assess the risk of loss, such as the...

Children with Disabilities Are Often Misdiagnosed Initially and Children with Neuropsychiatric Disorders Are Referred to Adequate Resources 30 Months Later than Children with Other Disabilities

ERIC Educational Resources Information Center

Tuominen-Eriksson, Alli-Marie; Svensson, Yvonne; Gunnarsson, Ronny K.

2013-01-01

Disabilities in a child may lead to low self-esteem and social problems. The lives of parents and siblings are also affected. Early intervention may decrease these consequences. To promote early intervention early referral to adequate resources is essential. In a longitudinal retrospective observational study it was found that children with…

Uncertainly Analysis of Two Types of Humidity Sensors by a Humidity Generator with a Divided-Flow System.

PubMed

Chen, Ling-Hsi; Chen, Chiachung

2018-02-21

Humidity measurement is an important technique for the agricultural, foods, pharmaceuticals, and chemical industries. For the sake of convenience, electrical relative humidity (RH) sensors have been widely used. These sensors need to be calibrated to ensure their accuracy and the uncertainty measurement of these sensors has become a major concern. In this study, a self-made divided-flow generator was established to calibrate two types of electrical humidity sensors. The standard reference humidity was calculated from dew-point temperature and air dry-bulb temperature measured by a chilled mirror monitor. This divided-flow generator could produce consistent result of RH measurement results. The uncertainty of the reference standard increased with the increase of RH values. The combined uncertainty with the adequate calibration equations were ranged from 0.82% to 1.45% RH for resistive humidity sensors and 0.63% to 1.4% for capacitive humidity sensors, respectively. This self-made, divided-flow generator, and calibration method are cheap, time-saving, and easy to be used. Thus, the proposed approach can easily be applied in research laboratories.

Uncertainly Analysis of Two Types of Humidity Sensors by a Humidity Generator with a Divided-Flow System

PubMed Central

Chen, Ling-Hsi

2018-01-01

Humidity measurement is an important technique for the agricultural, foods, pharmaceuticals, and chemical industries. For the sake of convenience, electrical relative humidity (RH) sensors have been widely used. These sensors need to be calibrated to ensure their accuracy and the uncertainty measurement of these sensors has become a major concern. In this study, a self-made divided-flow generator was established to calibrate two types of electrical humidity sensors. The standard reference humidity was calculated from dew-point temperature and air dry-bulb temperature measured by a chilled mirror monitor. This divided-flow generator could produce consistent result of RH measurement results. The uncertainty of the reference standard increased with the increase of RH values. The combined uncertainty with the adequate calibration equations were ranged from 0.82% to 1.45% RH for resistive humidity sensors and 0.63% to 1.4% for capacitive humidity sensors, respectively. This self-made, divided-flow generator, and calibration method are cheap, time-saving, and easy to be used. Thus, the proposed approach can easily be applied in research laboratories. PMID:29466313

Nutrient reference value: non-communicable disease endpoints--a conference report.

PubMed

Lupton, J R; Blumberg, J B; L'Abbe, M; LeDoux, M; Rice, H B; von Schacky, C; Yaktine, A; Griffiths, J C

2016-03-01

Nutrition is complex-and seemingly getting more complicated. Most consumers are familiar with "essential nutrients," e.g., vitamins and minerals, and more recently protein and important amino acids. These essential nutrients have nutrient reference values, referred to as dietary reference intakes (DRIs) developed by consensus committees of scientific experts convened by the Institute of Medicine of the National Academy of Sciences, Engineering, and Medicine and carried out by the Food and Nutrition Board. The DRIs comprise a set of four nutrient-based reverence values, the estimated average requirements, the recommended dietary allowances (RDAs), the adequate intakes and the tolerable upper intake levels for micronutrient intakes and an acceptable macronutrient distribution range for macronutrient intakes. From the RDA, the US Food and Drug Administration (FDA) derives a labeling value called the daily value (DV), which appears on the nutrition label of all foods for sale in the US. The DRI reports do not make recommendations about whether the DV labeling values can be set only for what have been defined to date as "essential nutrients." For example, the FDA set a labeling value for "dietary fiber" without having the DV. Nutrient reference values-requirements are set by Codex Alimentarius for essential nutrients, and regulatory bodies in many countries use these Codex values in setting national policy for recommended dietary intakes. However, the focus of this conference is not on essential nutrients, but on the "nonessential nutrients," also termed dietary bioactive components. They can be defined as "Constituents in foods or dietary supplements, other than those needed to meet basic human nutritional needs, which are responsible for changes in health status (Office of Disease Prevention and Health Promotion, Office of Public Health and Science, Department of Health and Human Services in Fed Regist 69:55821-55822, 2004)." Substantial and often persuasive scientific evidence does exist to confirm a relationship between the intake of a specific bioactive constituent and enhanced health conditions or reduced risk of a chronic disease. Further, research on the putative mechanisms of action of various classes of bioactives is supported by national and pan-national government agencies, and academic institutions, as well as functional food and dietary supplement manufacturers. Consumers are becoming educated and are seeking to purchase products containing bioactives, yet there is no evaluative process in place to let the public know how strong the science is behind the benefits or the quantitative amounts needed to achieve these beneficial health effects or to avoid exceeding the upper level (UL). When one lacks an essential nutrient, overt deficiency with concomitant physiological determents and eventually death are expected. The absence of bioactive substances from the diet results in suboptimal health, e.g., poor cellular and/or physiological function, which is relative and not absolute. Regrettably at this time, there is no DRI process to evaluate bioactives, although a recent workshop convened by the National Institutes of Health (Options for Consideration of Chronic Disease Endpoints for Dietary Reference Intakes (DRIs); March 10-11, 2015; http://health.gov/dietaryguidelines/dri/ ) did explore the process to develop DVs for nutrients, the lack of which result in increased risk of chronic disease (non-communicable disease) endpoints. A final report is expected soon. This conference (CRN-International Scientific Symposium; "Nutrient Reference Value-Non-Communicable Disease (NRV-NCD) Endpoints," 20 November in Kronberg, Germany; http://www.crn-i.ch/2015symposium/ ) explores concepts related to the Codex NRV process, the public health opportunities in setting NRVs for bioactive constituents, and further research and details on the specific class of bioactives, n-3 long-chain polyunsaturated fatty acids (also termed omega-3 fatty acids) and their constituents, specifically docosahexaenoic acid and eicosapentaenoic acid.

Efficacy of dialysis in peritoneal dialysis: utility of bioimpedance to calculate Kt/V and the search for a target Kt.

PubMed

Martínez Fernández, G; Ortega Cerrato, A; Masiá Mondéjar, J; Pérez Rodríguez, A; Llamas Fuentes, F; Gómez Roldán, C; Pérez-Martínez, Juan

2013-04-01

To calculate Kt/V, volume (V) is usually obtained by Watson formula, but bioimpedance spectroscopy (BIS) is a simple and applicable technique to determinate V, along with other hydration and nutrition parameters, in peritoneal dialysis (PD) patients. Dialysis efficacy can also be measured with Kt, but no experience exists in PD, so there is no reference/target value for Kt that must be achieved in these patients to be considered adequately dialyzed. We evaluated the efficacy of PD with Kt/V using Watson formula and BIS for V calculation, assessed hydration status in a PD unit by data obtained by BIS, and attempted to find a reference Kt from the Kt/V previously obtained by BIS. In this observational prospective study of 78 PD patients, we measured V using BIS (V bis) and Watson formula (V w) and calculated weekly Kt/V using both volumes (Kt/V bis/V bis and Kt/V w). With the BIS technique, we obtained and subsequently analyzed other hydration status parameters. We achieved a reference Kt, extrapolating the value desired (weekly Kt/V 1.7) to the target Kt using the simple linear regression statistical technique, basing it on the results of the previously calculated Pearson's linear correlation coefficient. Volume was 1.8 l higher by Watson formula than with BIS (p < 0.001). Weekly Kt/V bis was 2.33 ± 0.68, and mean weekly Kt/V w was 2.20 ± 0.63 (p < 0.0001); 60.25 % of patients presented overhydration according to the BIS study (OH >1.1 l). The target value of Kt for the reference weekly Kt/V bis (1.7) was 64.87 l. BIS is a simple, applicable technique for calculating V in dialysis that can be especially useful in PD patients compared with the anthropometric formulas, by the abnormally distributed body water in these patients. Other parameters obtained by BIS will serve to assess both the distribution of body volume and nutritional status in the clinical setting. The target Kt value obtained from Kt/V bis allowed us to measure the efficacy of PD in a practical way, omitting V measurement.

Combining Relevance Vector Machines and exponential regression for bearing residual life estimation

NASA Astrophysics Data System (ADS)

Di Maio, Francesco; Tsui, Kwok Leung; Zio, Enrico

2012-08-01

In this paper we present a new procedure for estimating the bearing Residual Useful Life (RUL) by combining data-driven and model-based techniques. Respectively, we resort to (i) Relevance Vector Machines (RVMs) for selecting a low number of significant basis functions, called Relevant Vectors (RVs), and (ii) exponential regression to compute and continuously update residual life estimations. The combination of these techniques is developed with reference to partially degraded thrust ball bearings and tested on real world vibration-based degradation data. On the case study considered, the proposed procedure outperforms other model-based methods, with the added value of an adequate representation of the uncertainty associated to the estimates of the quantification of the credibility of the results by the Prognostic Horizon (PH) metric.

Selected reference aids for small medical libraries.

PubMed

Duncan, H F

1970-04-01

This annotated list of 178 items is compiled as a guide to the development of the reference collection in a small medical library.Arrangement, following the pattern of the previous revision, is by broad subject groups. Titles are chiefly in English. Textbooks in subject fields have been omitted since these are covered adequately in several comprehensive guides to the literature.

International Bibliography of Computer-Assisted Terminology.

ERIC Educational Resources Information Center

Krommer-Benz, Magdalena, Comp.

Because of the need for adequate reference tools in the new area of data banks for the field of terminology (there are currently 25 term banks in existence and more are planned), this bibliography lists some 350 references selected from a large number of both primary and secondary sources. It includes some entries selected from a list of…

Accuracy evaluation of intraoral optical impressions: A clinical study using a reference appliance.

PubMed

Atieh, Mohammad A; Ritter, André V; Ko, Ching-Chang; Duqum, Ibrahim

2017-09-01

Trueness and precision are used to evaluate the accuracy of intraoral optical impressions. Although the in vivo precision of intraoral optical impressions has been reported, in vivo trueness has not been evaluated because of limitations in the available protocols. The purpose of this clinical study was to compare the accuracy (trueness and precision) of optical and conventional impressions by using a novel study design. Five study participants consented and were enrolled. For each participant, optical and conventional (vinylsiloxanether) impressions of a custom-made intraoral Co-Cr alloy reference appliance fitted to the mandibular arch were obtained by 1 operator. Three-dimensional (3D) digital models were created for stone casts obtained from the conventional impression group and for the reference appliances by using a validated high-accuracy reference scanner. For the optical impression group, 3D digital models were obtained directly from the intraoral scans. The total mean trueness of each impression system was calculated by averaging the mean absolute deviations of the impression replicates from their 3D reference model for each participant, followed by averaging the obtained values across all participants. The total mean precision for each impression system was calculated by averaging the mean absolute deviations between all the impression replicas for each participant (10 pairs), followed by averaging the obtained values across all participants. Data were analyzed using repeated measures ANOVA (α=.05), first to assess whether a systematic difference in trueness or precision of replicate impressions could be found among participants and second to assess whether the mean trueness and precision values differed between the 2 impression systems. Statistically significant differences were found between the 2 impression systems for both mean trueness (P=.010) and mean precision (P=.007). Conventional impressions had higher accuracy with a mean trueness of 17.0 ±6.6 μm and mean precision of 16.9 ±5.8 μm than optical impressions with a mean trueness of 46.2 ±11.4 μm and mean precision of 61.1 ±4.9 μm. Complete arch (first molar-to-first molar) optical impressions were less accurate than conventional impressions but may be adequate for quadrant impressions. Copyright © 2016 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

Normal probabilities for Cape Kennedy wind components: Monthly reference periods for all flight azimuths. Altitudes 0 to 70 kilometers

NASA Technical Reports Server (NTRS)

Falls, L. W.

1973-01-01

This document replaces Cape Kennedy empirical wind component statistics which are presently being used for aerospace engineering applications that require component wind probabilities for various flight azimuths and selected altitudes. The normal (Gaussian) distribution is presented as an adequate statistical model to represent component winds at Cape Kennedy. Head-, tail-, and crosswind components are tabulated for all flight azimuths for altitudes from 0 to 70 km by monthly reference periods. Wind components are given for 11 selected percentiles ranging from 0.135 percent to 99,865 percent for each month. Results of statistical goodness-of-fit tests are presented to verify the use of the Gaussian distribution as an adequate model to represent component winds at Cape Kennedy, Florida.

The six-minute walk test and body weight-walk distance product in healthy Brazilian subjects.

PubMed

Iwama, A M; Andrade, G N; Shima, P; Tanni, S E; Godoy, I; Dourado, V Z

2009-11-01

We assessed the 6-min walk distance (6MWD) and body weight x distance product (6MWw) in healthy Brazilian subjects and compared measured 6MWD with values predicted in five reference equations developed for other populations. Anthropometry, spirometry, reported physical activity, and two walk tests in a 30-m corridor were evaluated in 134 subjects (73 females, 13-84 years). Mean 6MWD and 6MWw were significantly greater in males than in females (622 +/- 80 m, 46,322 +/- 10,539 kg.m vs 551 +/- 71 m, 36,356 +/- 8,289 kg.m, P < 0.05). Four equations significantly overestimated measured 6MWD (range, 32 +/- 71 to 137 +/- 74 m; P < 0.001), and one significantly underestimated it (-36 +/- 86 m; P < 0.001). 6MWD significantly correlated with age (r = -0.39), height (r = 0.44), body mass index (r = -0.24), and reported physical activity (r = 0.25). 6MWw significantly correlated with age (r = -0.21), height (r = 0.66) and reported physical activity (r = 0.25). The reference equation devised for walk distance was 6MWDm = 622.461 - (1.846 x Ageyears) + (61.503 x Gendermales = 1; females = 0); r2 = 0.300. In an additional group of 85 subjects prospectively studied, the difference between measured and the 6MWD predicted with the equation proposed here was not significant (-3 +/- 68 m; P = 0.938). The measured 6MWD represented 99.6 +/- 11.9% of the predicted value. We conclude that 6MWD and 6MWw variances were adequately explained by demographic and anthropometric attributes. This reference equation is probably most appropriate for evaluating the exercise capacity of Brazilian patients with chronic diseases.

Reference values for leptin, cortisol, insulin and glucose, among European adolescents and their association with adiposity: the HELENA study.

PubMed

Koester-Weber, Thabata; Valtueña, Jara; Breidenassel, Christina; Beghin, Laurent; Plada, Maria; Moreno, Sara; Huybrechts, Inge; Palacios, Gonzalo; Gómez-Martínez, Sonia; Albers, Ulrike; De Henauw, Stefaan; Maiani, Guiseppe; Kafatos, Anthony; Molnar, Denes; Sjöstrom, Michael; Widhalm, Kurt; Manios, Yannis; Moreno, Luis A; Marcos, Ascensión; Castillo, Manuel J; Stehle, Peter; Gonzalez-Gross, Marcela

2014-11-01

Adequate concentrations of leptin, cortisol, and insulin are important for a suitable metabolism and development during adolescence. These hormones jointly with glucose play a major role in fat metabolism and development of childhood obesity. Our main objective was to quantify biomarkers as leptin, cortisol, insulin and glucose status in European adolescents to contribute to establish reference ranges. A representative sample of 927 adolescents (45% males, 14.9±1.2 years for the overall population) from ten European cities of the HELENA study was used to obtain fasting blood samples for these biomarkers. The percentile distributions were computed by sex and age and percentiles were associated with BMI classification. Serum leptin concentration in adolescents varied significantly according to BMI, sex and age (all p < 0.001). Cortisol presented a tendency to increase with age, both for females and males, while insulin and glucose were stable with age. Leptin and insulin were highest in obese adolescents (p < 0.001), whilst cortisol and glucose did not vary with BMI. Percentiles 5, 25, 50, 75 and 95, for hormones values were, respectively: 1.27, 4.06, 11.54, 26.70 and 65.33 ng/ml for leptin; 5.00, 8.11, 11.14, 15.00 and 24.51 μg/dl for cortisol and 3.65, 6.15, 8.52, 11.90 and 20.53 μlU/ml for insulin. In adolescents, leptin, cortisol, insulin and glucose concentrations are differently affected by age, sex and BMI. Establishment of reference ranges (percentiles) of these biomarkers would be of great interest when pediatricians have to assess the trend of an adolescent to develop obesity years after. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Justifying Alternative Models in Learning Astronomy: A Study of K-8 Science Teachers' Understanding of Frames of Reference

ERIC Educational Resources Information Center

Shen, Ji; Confrey, Jere

2010-01-01

Understanding frames of reference is critical in describing planetary motion and learning astronomy. Historically, the geocentric and heliocentric models were defended and advocated against each other. Today, there are still many people who do not understand the relationship between the two models. This topic is not adequately treated in astronomy…

[Reference values of iron, iodine, zinc, selenium, copper, molybdenum, vitamin C, vitamin E, vitamin K, carotenoids and polyphenols for the Venezuelan population].

PubMed

García-Casal, Maria Nieves; Landaeta, Maritza; Adrianza de Baptista, Gertrudis; Murillo, Carolain; Rincón, Mariela; Bou Rached, Lizet; Bilbao, Arantza; Anderson, Hazel; García, Doris; Franquiz, Julia; Puche, Rafael; Garcia, Omar; Quintero, Yurimay; Peña-Rosas, Juan Pablo

2013-12-01

The review on iron, iodine, zinc, selenium, copper, molybdenum, vitamin C, vitamin E, vitamin K, carotenoids and polyphenols recommendations for Venezuela comprise the definitions adopted worldwide known as Dietary Reference Intakes (DRIs) that include Recommended Dietary Allowance (RDA), Estimated Average Requirement (EAR), Adequate Intake (AI) and Tolerable Upper Intake Levels (UL). The RDA for iron: 11 mg/day for infants < 1 year of age, 7-10 mg/day for children, 8-11 mg/day for males, 8-18 mg/day for females and 27 mg/day during pregnancy. RDA for iodine: 110-130 microg/day for infants, 90-120 microg/ day for children and adolescents, 150 microg/day for adults, 220 microg/ day for pregnancy and 290 microg/day during lactation. RDA Zinc: 2-3 mg/day for infants, 3-5 mg/day for children, 8-11 mg/day for male adolescents and adults, 8-9 mg/day for female adolescents and adults, 12 mg/day during pregnancy and 13 mg/day for lactation. RDA Vitamin C: 40-50 mg/day for infants, 15-45 mg/ day for children, 75 mg/day for male adolescents, 65 mg/day for female adolescents, 90 mg/day for adult males, 75 mg/day for adult females, 80-85 mg/day during pregnancy and 115-120 mg/day during lactation. Recommendations for copper, selenium, molybdenum, vitamins E, K, carotenoids and polyphenols are also presented. These recommendations will help to design adequate and efficient policies that could help to avoid or to treat the consequences derived from the deficiency or the excess of these nutrients.

Symposium on ‘Nutrition and health in children and adolescents’ Session 1: Nutrition in growth and development

PubMed Central

Prentice, Ann; Schoenmakers, Inez; Laskey, M. Ann; de Bono, Stephanie; Ginty, Fiona; Goldberg, Gail R.

2007-01-01

The growth and development of the human skeleton requires an adequate supply of many different nutritional factors. Classical nutrient deficiencies are associated with stunting (e.g. energy, protein, Zn), rickets (e.g. vitamin D) and other bone abnormalities (e.g. Cu, Zn, vitamin C). In recent years there has been interest in the role nutrition may play in bone growth at intakes above those required to prevent classical deficiencies, particularly in relation to optimising peak bone mass and minimising osteoporosis risk. There is evidence to suggest that peak bone mass and later fracture risk are influenced by the pattern of growth in childhood and by nutritional exposures in utero, in infancy and during childhood and adolescence. Of the individual nutrients, particular attention has been paid to Ca, vitamin D, protein and P. There has also been interest in several food groups, particularly dairy products, fruit and vegetables and foods contributing to acid–base balance. However, it is not possible at the present time to define dietary reference values using bone health as a criterion, and the question of what type of diet constitutes the best support for optimal bone growth and development remains open. Prudent recommendations (Department of Health, 1998; World Health Organization/Food and Agriculture Organization, 2003) are the same as those for adults, i.e. to consume a Ca intake close to the reference nutrient intake, optimise vitamin D status through adequate summer sunshine exposure (and diet supplementation where appropriate), be physically active, have a body weight in the healthy range, restrict salt intake and consume plenty of fruit and vegetables. PMID:17181901

Renal function assessment in patients with systemic lupus erythematosus.

PubMed

Martínez-Martínez, Marco Ulises; Borjas-García, Jaime Antonio; Magaña-Aquino, Martín; Cuevas-Orta, Enrique; Llamazares-Azuara, Lilia; Abud-Mendoza, Carlos

2012-08-01

Few studies have evaluated the glomerular filtration rate (GFR) in patients with systemic lupus erythematosus (SLE). Even though the National Kidney Foundation (NKF) suggests using the equations to estimate GFR, rheumatologists continue using creatinine clearance (CCl). The main objective of our study was the assessment of different equations to estimate GFR in patients with SLE: Simplified MDRD study equation (sMDRD), CCl, Cockcroft Gault (CG), CG calculated with ideal weight (CGi), Mayo Clinic Quadratic (MCQ), and Chronic Kidney Disease Epidemiology Collaboration Equation (CKD-EPI). CKD-EPI was considered as the reference standard, and it was compared with the other equations to evaluate bias, correlation (r), sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), percentage of measurement of GFR between 70-130% of GFR measured through CKD-EPI (P30) and to compute the ROC curves. Adequacy of the 24-h urine collection was evaluated. To classify patients into GFR < 60 ml/min/1.73 m(2), the best sensitivity and NVP were obtained with sMDRD: the best PPV and specificity with MCQ. P30 was 99.3% with sMDRD, 77.5% CCl, 91.7% CG, 96.7% CGi, and 77.2% with MCQ. The lowest bias was for sMDRD and the highest for CCl. Only 159 (52.6%) urine collections were considered adequate, and when these patients were re-evaluated, the statistical results improved for CCl. CGi was better in general than CG. CCl should not be considered as an adequate GFR estimation. Ideal weight is better than real weight to calculate GFR through CG in patients with SLE.

High test positivity and low positive predictive value for colorectal cancer of continued faecal occult blood test screening after negative colonoscopy.

PubMed

Brown, Jeremy P; Wooldrage, Kate; Wright, Suzanne; Nickerson, Claire; Cross, Amanda J; Atkin, Wendy S

2018-06-01

Objectives The English Bowel Cancer Screening Programme offers biennial guaiac faecal occult blood test (gFOBT) screening to 60-74-year-olds. Participants with positive results are referred for follow-up, but many do not have significant findings. If they remain age eligible, these individuals are reinvited for gFOBT screening. We evaluated the performance of repeat screening in this group. Methods We analysed data on programme participants reinvited to gFOBT screening after either previous negative gFOBT ( n = 327,542), or positive gFOBT followed by a diagnostic investigation negative for colorectal cancer (CRC) or adenomas requiring surveillance ( n = 42,280). Outcomes calculated were uptake, test positivity, yield of CRC, and positive predictive value (PPV) of gFOBT for CRC. Results For participants with a previous negative gFOBT, uptake in the subsequent screening round was 87.5%, positivity was 1.3%, yield of CRC was 0.112% of those adequately screened, and the PPV of gFOBT for CRC was 9.1%. After a positive gFOBT and a negative diagnostic investigation, uptake in the repeat screening round was 82.6%, positivity was 11.3%, CRC yield was 0.172% of participants adequately screened, and the PPV of gFOBT for CRC was 1.7%. Conclusion With high positivity and low PPV for CRC, the suitability of routine repeat gFOBT screening in two years among individuals with a previous positive test and a negative diagnostic examination needs to be carefully considered.

Duplex ultrasonography for the detection of vertebral artery stenosis: A comparison with CT angiography.

PubMed

Rozeman, Anouk D; Hund, Hajo; Westein, Michel; Wermer, Marieke J H; Lycklama À Nijeholt, Geert J; Boiten, Jelis; Schimsheimer, Robert-Jan; Algra, Ale

2017-08-01

Vertebrobasilar stenosis is frequent in patients with posterior circulation stroke and it increases risk of recurrence. We investigated feasibility of duplex ultrasonography (DUS) for screening for extracranial vertebral artery stenosis and compared it with CT angiography (CTA). We gathered data on 337 consecutive patients who had DUS because of posterior circulation stroke or TIA. Matching CTA studies were retrieved and used as reference. Stenosis on CTA was considered "significant" if >50%, at DUS if Peak Systolic Velocity (PSV) > 140 cm/s for the V1 segment and PSV > 125 cm/s for the V2 segment. We determined the area under the ROC curve (AUROC). In addition, we calculated which PSV cut-off value resulted in highest sensitivity with acceptable specificity. DUS was able to make an adequate measurement in 378 of 674 V1 segments and 673 of 674 V2 segments. DUS detected a significant stenosis in 52 of 378 V1 segments; 12 were confirmed by CTA (AUROC 0.73, 95% Confidence Interval 0.63-0.83). The optimal DUS PSV cut-off value for this segment was 90 cm/s. For the V2 segment there were too few stenoses to allow reliable assessment of diagnostic characteristics of DUS. Although DUS has a fair AUROC for detecting significant stenosis, adequate assessment of the V1 segment is often not possible due to anatomic difficulties. Assessment of the V2 segment is feasible but yielded few stenoses. Hence, we consider usefulness of DUS for screening of extracranial vertebral artery stenosis limited.

Expressing the sense of the Congress that the lack of adequate housing must be addressed as a barrier to effective HIV prevention, treatment, and care, and that the United States should make a commitment to providing adequate funding for developing housing as a response to the AIDS pandemic.

THOMAS, 111th Congress

Rep. Nadler, Jerrold [D-NY-8

2009-06-02

Senate - 05/25/2010 Received in the Senate and referred to the Committee on Banking, Housing, and Urban Affairs. (All Actions) Tracker: This bill has the status Agreed to in HouseHere are the steps for Status of Legislation:

Semantics and metaphysics in informatics: toward an ontology of tasks.

PubMed

Figdor, Carrie

2011-04-01

This article clarifies three principles that should guide the development of any cognitive ontology. First, that an adequate cognitive ontology depends essentially on an adequate task ontology; second, that the goal of developing a cognitive ontology is independent of the goal of finding neural implementations of the processes referred to in the ontology; and third, that cognitive ontologies are neutral regarding the metaphysical relationship between cognitive and neural processes. Copyright © 2011 Cognitive Science Society, Inc.

The development of discourse referencing in Cantonese-speaking children.

PubMed

Wong, Anita M Y; Johnston, Judith R

2004-08-01

The ability to make clear reference in connected discourse was examined in children learning Cantonese, a Chinese language where noun phrase constituents, whatever their grammatical role, are omissible from sentences under discourse conditions that are not well-understood. Forty-three typically developing children aged 3 ; 0, 5 ; 0, 7 ; 0 and 12 ; 0 told 16 stories based on picture sequences. A panel of adult native Cantonese speakers was asked to judge the referential adequacy of each child's stories by identifying the character the child was talking about in 32 targeted referential acts. The targeted acts were of three sorts: MAINTENANCE of a known character, INTRODUCTION of a second new character, and REINTRODUCTION of a known character. Reference was judged to be adequate when 3 out of 4 'listeners' could successfully identify the character. Children's referential expressions were most adequate for Maintenance, less adequate for Introduction, and least adequate for Reintroduction. The twelve- and seven-year-olds approached ceiling on all three functions. The five-year-olds scored poorly on Reintroduction, and the three-year-olds failed both Introduction and Reintroduction, despite knowledge of at least one of the possible linguistic forms required for these acts as evidenced in a sentence imitation task. Viewed within the framework of Levelt's (1989) discourse model, the data improve our understanding of the developmental period during which children learn to make appropriate presuppositions about the listener's knowledge and attentional states.

Model Reduction via Principe Component Analysis and Markov Chain Monte Carlo (MCMC) Methods

NASA Astrophysics Data System (ADS)

Gong, R.; Chen, J.; Hoversten, M. G.; Luo, J.

2011-12-01

Geophysical and hydrogeological inverse problems often include a large number of unknown parameters, ranging from hundreds to millions, depending on parameterization and problems undertaking. This makes inverse estimation and uncertainty quantification very challenging, especially for those problems in two- or three-dimensional spatial domains. Model reduction technique has the potential of mitigating the curse of dimensionality by reducing total numbers of unknowns while describing the complex subsurface systems adequately. In this study, we explore the use of principal component analysis (PCA) and Markov chain Monte Carlo (MCMC) sampling methods for model reduction through the use of synthetic datasets. We compare the performances of three different but closely related model reduction approaches: (1) PCA methods with geometric sampling (referred to as 'Method 1'), (2) PCA methods with MCMC sampling (referred to as 'Method 2'), and (3) PCA methods with MCMC sampling and inclusion of random effects (referred to as 'Method 3'). We consider a simple convolution model with five unknown parameters as our goal is to understand and visualize the advantages and disadvantages of each method by comparing their inversion results with the corresponding analytical solutions. We generated synthetic data with noise added and invert them under two different situations: (1) the noised data and the covariance matrix for PCA analysis are consistent (referred to as the unbiased case), and (2) the noise data and the covariance matrix are inconsistent (referred to as biased case). In the unbiased case, comparison between the analytical solutions and the inversion results show that all three methods provide good estimates of the true values and Method 1 is computationally more efficient. In terms of uncertainty quantification, Method 1 performs poorly because of relatively small number of samples obtained, Method 2 performs best, and Method 3 overestimates uncertainty due to inclusion of random effects. However, in the biased case, only Method 3 correctly estimates all the unknown parameters, and both Methods 1 and 2 provide wrong values for the biased parameters. The synthetic case study demonstrates that if the covariance matrix for PCA analysis is inconsistent with true models, the PCA methods with geometric or MCMC sampling will provide incorrect estimates.

The technique for Simulation of Transient Combustion Processes in the Rocket Engine Operating with Gaseous Fuel “Hydrogen and Oxygen”

NASA Astrophysics Data System (ADS)

Zubanov, V. M.; Stepanov, D. V.; Shabliy, L. S.

2017-01-01

The article describes the method for simulation of transient combustion processes in the rocket engine. The engine operates on gaseous propellant: oxygen and hydrogen. Combustion simulation was performed using the ANSYS CFX software. Three reaction mechanisms for the stationary mode were considered and described in detail. Reactions mechanisms have been taken from several sources and verified. The method for converting ozone properties from the Shomate equation to the NASA-polynomial format was described in detail. The way for obtaining quick CFD-results with intermediate combustion components using an EDM model was found. Modeling difficulties with combustion model Finite Rate Chemistry, associated with a large scatter of reference data were identified and described. The way to generate the Flamelet library with CFX-RIF is described. Formulated adequate reaction mechanisms verified at a steady state have also been tested for transient simulation. The Flamelet combustion model was recognized as adequate for the transient mode. Integral parameters variation relates to the values obtained during stationary simulation. A cyclic irregularity of the temperature field, caused by precession of the vortex core, was detected in the chamber with the proposed simulation technique. Investigations of unsteady processes of rocket engines including the processes of ignition were proposed as the area for application of the described simulation technique.

[Geographical distribution of the Serum creatinine reference values of healthy adults].

PubMed

Wei, De-Zhi; Ge, Miao; Wang, Cong-Xia; Lin, Qian-Yi; Li, Meng-Jiao; Li, Peng

2016-11-20

To explore the relationship between serum creatinine (Scr) reference values in healthy adults and geographic factors and provide evidence for establishing Scr reference values in different regions. We collected 29 697 Scr reference values from healthy adults measured by 347 medical facilities from 23 provinces, 4 municipalities and 5 autonomous regions. We chose 23 geographical factors and analyzed their correlation with Scr reference values to identify the factors correlated significantly with Scr reference values. According to the Principal component analysis and Ridge regression analysis, two predictive models were constructed and the optimal model was chosen after comparison of the two model's fitting degree of predicted results and measured results. The distribution map of Scr reference values was drawn using the Kriging interpolation method. Seven geographic factors, including latitude, annual sunshine duration, annual average temperature, annual average relative humidity, annual precipitation, annual temperature range and topsoil (silt) cation exchange capacity were found to correlate significantly with Scr reference values. The overall distribution of Scr reference values featured a pattern that the values were high in the south and low in the north, varying consistently with the latitude change. The data of the geographic factors in a given region allows the prediction of the Scr values in healthy adults. Analysis of these geographical factors can facilitate the determination of the reference values specific to a region to improve the accuracy for clinical diagnoses.

Error Correction, Control Systems and Fuzzy Logic

NASA Technical Reports Server (NTRS)

Smith, Earl B.

2004-01-01

This paper will be a discussion on dealing with errors. While error correction and communication is important when dealing with spacecraft vehicles, the issue of control system design is also important. There will be certain commands that one wants a motion device to execute. An adequate control system will be necessary to make sure that the instruments and devices will receive the necessary commands. As it will be discussed later, the actual value will not always be equal to the intended or desired value. Hence, an adequate controller will be necessary so that the gap between the two values will be closed.

Psychometric properties of a sign language version of the Mini International Neuropsychiatric Interview (MINI).

PubMed

Øhre, Beate; Saltnes, Hege; von Tetzchner, Stephen; Falkum, Erik

2014-05-22

There is a need for psychiatric assessment instruments that enable reliable diagnoses in persons with hearing loss who have sign language as their primary language. The objective of this study was to assess the validity of the Norwegian Sign Language (NSL) version of the Mini International Neuropsychiatric Interview (MINI). The MINI was translated into NSL. Forty-one signing patients consecutively referred to two specialised psychiatric units were assessed with a diagnostic interview by clinical experts and with the MINI. Inter-rater reliability was assessed with Cohen's kappa and "observed agreement". There was 65% agreement between MINI diagnoses and clinical expert diagnoses. Kappa values indicated fair to moderate agreement, and observed agreement was above 76% for all diagnoses. The MINI diagnosed more co-morbid conditions than did the clinical expert interview (mean diagnoses: 1.9 versus 1.2). Kappa values indicated moderate to substantial agreement, and "observed agreement" was above 88%. The NSL version performs similarly to other MINI versions and demonstrates adequate reliability and validity as a diagnostic instrument for assessing mental disorders in persons who have sign language as their primary and preferred language.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Efroymson, Rebecca Ann; Dale, Virginia H; Kline, Keith L

Indicators of the environmental sustainability of biofuel production, distribution, and use should be selected, measured, and interpreted with respect to the context in which they are used. These indicators include measures of soil quality, water quality and quantity, greenhouse-gas emissions, biodiversity, air quality, and vegetation productivity. Contextual considerations include the purpose for the sustainability analysis, the particular biofuel production and distribution system (including supply chain, management aspects, and system viability), policy conditions, stakeholder values, location, temporal influences, spatial scale, baselines, and reference scenarios. Recommendations presented in this paper include formulating the problem for particular analyses, selecting appropriate context-specific indicators ofmore » environmental sustainability, and developing indicators that can reflect multiple environmental properties at low cost within a defined context. In addition, contextual considerations such as technical objectives, varying values and perspectives of stakeholder groups, and availability and reliability of data need to be understood and considered. Sustainability indicators for biofuels are most useful if adequate historical data are available, information can be collected at appropriate spatial and temporal scales, organizations are committed to use indicator information in the decision-making process, and indicators can effectively guide behavior toward more sustainable practices.« less

A survey of blood pressure in Lebanese children and adolescence

PubMed Central

Merhi, Bassem Abou; Al-Hajj, Fatima; Al-Tannir, Mohamad; Ziade, Fouad; El-Rajab, Mariam

2011-01-01

Background: Blood pressure varies between populations due to ethnic and environmental factors. Therefore, normal blood pressure values should be determined for different populations. Aims: The aim of this survey was to produce blood pressure nomograms for Lebanese children in order to establish distribution curves of blood pressure by age and sex. Subjects and Methods: We conducted a survey of blood pressure in 5710 Lebanese schoolchildren aged 5 to 15 years (2918 boys and 2792 girls), and studied the distribution of systolic and diastolic blood pressure in these children and adolescents. Blood pressure was measured with a mercury sphygmomanometer using a standardized technique. Results: Both systolic and diastolic blood pressure had a positive correlation with weight, height, age, and body mass index (r= 0.648, 0.643, 0.582, and 0.44, respectively) (P < .001). There was no significant difference in the systolic and diastolic blood pressure in boys compared to girls of corresponding ages. However, the average annual increase in systolic blood pressure was 2.86 mm Hg in boys and 2.63 mm Hg in girls, whereas the annual increase in diastolic blood pressure was 1.72 mm Hg in boys and 1.48 mm Hg in girls. The prevalence of high and high-normal blood pressure at the upper limit of normal (between the 90th and 95th percentile, at risk of future hypertension if not managed adequately), was 10.5% in boys and 6.9% in girls, with similar distributions among the two sexes. Conclusions: We present the first age-specific reference values for blood pressure of Lebanese children aged 5 to 15 years based on a good representative sample. The use of these reference values should help pediatricians identify children with normal, high-normal and high blood pressure. PMID:22540059

A survey of blood pressure in Lebanese children and adolescence.

PubMed

Merhi, Bassem Abou; Al-Hajj, Fatima; Al-Tannir, Mohamad; Ziade, Fouad; El-Rajab, Mariam

2011-01-01

Blood pressure varies between populations due to ethnic and environmental factors. Therefore, normal blood pressure values should be determined for different populations. The aim of this survey was to produce blood pressure nomograms for Lebanese children in order to establish distribution curves of blood pressure by age and sex. We conducted a survey of blood pressure in 5710 Lebanese schoolchildren aged 5 to 15 years (2918 boys and 2792 girls), and studied the distribution of systolic and diastolic blood pressure in these children and adolescents. Blood pressure was measured with a mercury sphygmomanometer using a standardized technique. Both systolic and diastolic blood pressure had a positive correlation with weight, height, age, and body mass index (r= 0.648, 0.643, 0.582, and 0.44, respectively) (P < .001). There was no significant difference in the systolic and diastolic blood pressure in boys compared to girls of corresponding ages. However, the average annual increase in systolic blood pressure was 2.86 mm Hg in boys and 2.63 mm Hg in girls, whereas the annual increase in diastolic blood pressure was 1.72 mm Hg in boys and 1.48 mm Hg in girls. The prevalence of high and high-normal blood pressure at the upper limit of normal (between the 90(th) and 95(th) percentile, at risk of future hypertension if not managed adequately), was 10.5% in boys and 6.9% in girls, with similar distributions among the two sexes. We present the first age-specific reference values for blood pressure of Lebanese children aged 5 to 15 years based on a good representative sample. The use of these reference values should help pediatricians identify children with normal, high-normal and high blood pressure.

Ovine echinococcosis I. Immunological diagnosis by enzyme immunoassay.

PubMed

Gatti, Antonio; Alvarez, Angela Rosa; Araya, Daniel; Mancini, Sergio; Herrero, Eduardo; Santillan, Graciela; Larrieu, Edmundo

2007-01-31

Immunodiagnosis in sheep presents problems of sensitivity and specificity, limiting its applicability in surveillance systems. The objective of this study was to develop a sensitive, specific and accessible technique for diagnosing cystic echinococcosis in naturally infected sheep and to evaluate the validity of necropsy as a reference test. A total of 247 sheep were studied at slaughterhouses, confirming the parasitological diagnosis with histology. Serum was processed with enzyme immunoassay (EIA) using three antigen preparations: total hydatid liquid (LHT), purified fraction of LHT (S2B) and purified lipoprotein (B). Western Blot (WB) was used as a control. EIA proved effective for differentiating Echinococcus granulosus from larval stage of Taenia hydatigena and intestinal cestodes in all three antigen preparations. Serums from macroscopically negative sheep were reactive to EIA and positive with WB. In the whole flock, sensitivity was 89.2% for LHT, 80.0% for S2B and 86.4% for B. Sensitivity in lambs was 78.6% for LHT, 75.0% for S2B and 64.3% for B. Macroscopic diagnosis at the time of slaughter was found to have limitations as a reference test for immunodiagnosis of cystic equinococcosis in sheep, so it was necessary to include histology and WB as reference tests. LHT was the antigen preparation of greatest value and EIA proved to be a sensitive and specific technique, adequate for surveillance systems and for evaluating control programmes.

Real-time polymerase chain reaction-based approach for quantification of the pat gene in the T25 Zea mays event.

PubMed

Weighardt, Florian; Barbati, Cristina; Paoletti, Claudia; Querci, Maddalena; Kay, Simon; De Beuckeleer, Marc; Van den Eede, Guy

2004-01-01

In Europe, a growing interest for reliable techniques for the quantification of genetically modified component(s) of food matrixes is arising from the need to comply with the European legislative framework on novel food products. Real-time polymerase chain reaction (PCR) is currently the most powerful technique for the quantification of specific nucleic acid sequences. Several real-time PCR methodologies based on different molecular principles have been developed for this purpose. The most frequently used approach in the field of genetically modified organism (GMO) quantification in food or feed samples is based on the 5'-3'-exonuclease activity of Taq DNA polymerase on specific degradation probes (TaqMan principle). A novel approach was developed for the establishment of a TaqMan quantification system assessing GMO contents around the 1% threshold stipulated under European Union (EU) legislation for the labeling of food products. The Zea mays T25 elite event was chosen as a model for the development of the novel GMO quantification approach. The most innovative aspect of the system is represented by the use of sequences cloned in plasmids as reference standards. In the field of GMO quantification, plasmids are an easy to use, cheap, and reliable alternative to Certified Reference Materials (CRMs), which are only available for a few of the GMOs authorized in Europe, have a relatively high production cost, and require further processing to be suitable for analysis. Strengths and weaknesses of the use of novel plasmid-based standards are addressed in detail. In addition, the quantification system was designed to avoid the use of a reference gene (e.g., a single copy, species-specific gene) as normalizer, i.e., to perform a GMO quantification based on an absolute instead of a relative measurement. In fact, experimental evidences show that the use of reference genes adds variability to the measurement system because a second independent real-time PCR-based measurement must be performed. Moreover, for some reference genes no sufficient information on copy number in and among genomes of different lines is available, making adequate quantification difficult. Once developed, the method was subsequently validated according to IUPAC and ISO 5725 guidelines. Thirteen laboratories from 8 EU countries participated in the trial. Eleven laboratories provided results complying with the predefined study requirements. Repeatability (RSDr) values ranged from 8.7 to 15.9%, with a mean value of 12%. Reproducibility (RSDR) values ranged from 16.3 to 25.5%, with a mean value of 21%. Following Codex Alimentarius Committee guidelines, both the limits of detection and quantitation were determined to be <0.1%.

Predictive value and efficiency of laboratory testing.

PubMed

Galen, R S

1980-11-01

Literature on determining reference values and reference intervals on "normal" or "healthy" individuals is abundant. It is impossible, however, to evaluate a data set of reference values and select a suitable reference interval that will be meaningful for the practice of medicine. The reference interval, no matter how derived statistically, tells us nothing about disease. This is the main reason the concepts of "normal values" have failed us and why "reference values" will prove similarly disappointing. By studying these same constituents in a variety of disease states as well, it will be possible to select "referent values" that will make the test procedure meaningful for diagnostic purposes. In order to obtain meaningful referent values for predicting disease, it is necessary to study not only the "healthy" reference population, but patients with the disease in question, and patients who are free of the disease in question but who have other diseases. Studies of this type are not frequently found for laboratory tests that are in common use today.

Analysis of Mass Averaged Tissue Doses in CAM, CAF, MAX, and FAX

NASA Technical Reports Server (NTRS)

Slaba, Tony C.; Qualls, Garry D.; Clowdsley, Martha S.; Blattnig, Steve R.; Simonsen, Lisa C.; Walker, Steven A.; Singleterry, Robert C.

2009-01-01

To estimate astronaut health risk due to space radiation, one must have the ability to calculate exposure-related quantities averaged over specific organs and tissue types. In this study, we first examine the anatomical properties of the Computerized Anatomical Man (CAM), Computerized Anatomical Female (CAF), Male Adult voXel (MAX), and Female Adult voXel (FAX) models by comparing the masses of various tissues to the reference values specified by the International Commission on Radiological Protection (ICRP). Major discrepancies are found between the CAM and CAF tissue masses and the ICRP reference data for almost all of the tissues. We next examine the distribution of target points used with the deterministic transport code HZETRN to compute mass averaged exposure quantities. A numerical algorithm is used to generate multiple point distributions for many of the effective dose tissues identified in CAM, CAF, MAX, and FAX. It is concluded that the previously published CAM and CAF point distributions were under-sampled and that the set of point distributions presented here should be adequate for future studies involving CAM, CAF, MAX, or FAX. It is concluded that MAX and FAX are more accurate than CAM and CAF for space radiation analyses.

Basic reference aids for small medical libraries.

PubMed

Blair, E D

1967-04-01

Selected primarily for the small medical library, this list is compiled to serve as a practical guide for the librarian in developing and utilizing an effective reference collection. Arrangement is by broad subject groups; titles chosen are chiefly in English with geographic coverage limited to the United States and Canada. Texts in subject fields have been omitted since these are adequately covered in several comprehensive guides to the literature.

Reference Values for Cardiorespiratory Fitness and Incidence of Type 2 Diabetes

PubMed Central

Kawakami, Ryoko; Sawada, Susumu S.; Matsushita, Munehiro; Okamoto, Takashi; Tsukamoto, Koji; Higuchi, Mitsuru; Miyachi, Motohiko

2014-01-01

Background In “Physical Activity Reference for Health Promotion 2013” the Japan Ministry of Health, Labour and Welfare publication gives reference values for cardiorespiratory fitness (CRF) required for good health. We examined the associations between the CRF reference values and incidence of type 2 diabetes. Methods This prospective cohort study enrolled 4633 nondiabetic Japanese men aged 20 to 39 years at baseline. CRF was measured using the cycle ergometer test, and maximal oxygen uptake was estimated. On the basis of the CRF reference value, participants were classified into 2 groups: those with values less than the reference value (under-RV) and those with values equal to or greater than reference value (over-RV). Hazard ratios (HRs) and 95% CIs for incident type 2 diabetes were estimated using a Cox proportional hazards model. Results A total of 266 participants developed type 2 diabetes during the 14 years of follow-up. As compared with the under-RV group, the over-RV group had a significantly lower multivariable-adjusted HR for type 2 diabetes (HR 0.67; 95% CI, 0.51–0.89). In receiver operating characteristic analysis, the optimal CRF cut-off value for predicting incident type 2 diabetes was 10.8 metabolic equivalents (sensitivity, 0.64; specificity, 0.64), which was close to the CRF reference value of 11.0 metabolic equivalents. Conclusions The reference CRF value appears to be reasonably valid for prevention of type 2 diabetes, especially among Japanese men younger than 40 years. Development of type 2 diabetes can be prevented by maintaining a CRF level above the reference value. PMID:24240630

Reference-free ground truth metric for metal artifact evaluation in CT images.

PubMed

Kratz, Bärbel; Ens, Svitlana; Müller, Jan; Buzug, Thorsten M

2011-07-01

In computed tomography (CT), metal objects in the region of interest introduce data inconsistencies during acquisition. Reconstructing these data results in an image with star shaped artifacts induced by the metal inconsistencies. To enhance image quality, the influence of the metal objects can be reduced by different metal artifact reduction (MAR) strategies. For an adequate evaluation of new MAR approaches a ground truth reference data set is needed. In technical evaluations, where phantoms can be measured with and without metal inserts, ground truth data can easily be obtained by a second reference data acquisition. Obviously, this is not possible for clinical data. Here, an alternative evaluation method is presented without the need of an additionally acquired reference data set. The proposed metric is based on an inherent ground truth for metal artifacts as well as MAR methods comparison, where no reference information in terms of a second acquisition is needed. The method is based on the forward projection of a reconstructed image, which is compared to the actually measured projection data. The new evaluation technique is performed on phantom and on clinical CT data with and without MAR. The metric results are then compared with methods using a reference data set as well as an expert-based classification. It is shown that the new approach is an adequate quantification technique for artifact strength in reconstructed metal or MAR CT images. The presented method works solely on the original projection data itself, which yields some advantages compared to distance measures in image domain using two data sets. Beside this, no parameters have to be manually chosen. The new metric is a useful evaluation alternative when no reference data are available.

40 CFR 230.30 - Threatened and endangered species.

Code of Federal Regulations, 2010 CFR

2010-07-01

..., fish and reptiles. (b) Possible loss of values: The major potential impacts on threatened or endangered... species include adequate good quality water, spawning and maturation areas, nesting areas, protective cover, adequate and reliable food supply, and resting areas for migratory species. Each of these...

Requirements for data integration platforms in biomedical research networks: a reference model.

PubMed

Ganzinger, Matthias; Knaup, Petra

2015-01-01

Biomedical research networks need to integrate research data among their members and with external partners. To support such data sharing activities, an adequate information technology infrastructure is necessary. To facilitate the establishment of such an infrastructure, we developed a reference model for the requirements. The reference model consists of five reference goals and 15 reference requirements. Using the Unified Modeling Language, the goals and requirements are set into relation to each other. In addition, all goals and requirements are described textually in tables. This reference model can be used by research networks as a basis for a resource efficient acquisition of their project specific requirements. Furthermore, a concrete instance of the reference model is described for a research network on liver cancer. The reference model is transferred into a requirements model of the specific network. Based on this concrete requirements model, a service-oriented information technology architecture is derived and also described in this paper.

Vaccines provided by family physicians.

PubMed

Campos-Outcalt, Doug; Jeffcott-Pera, Michelle; Carter-Smith, Pamela; Schoof, Bellinda K; Young, Herbert F

2010-01-01

This study was conducted to document current immunization practices by family physicians. In 2008 the American Academy of Family Physicians (AAFP) conducted a survey among a random sample of 2,000 of its members who reported spending 80% or more of their time in direct patient care. The survey consisted of questions regarding the demographics of the practice, vaccines that are provided at the physicians' clinical site, whether the practice refers patients elsewhere for vaccines, and participation in the Vaccines for Children (VFC) program. The response rate was 38.5%, 31.8% after non-office-based respondents were deleted. A high proportion of respondents (80% or more) reported providing most routinely recommended child, adolescent, and adult vaccines at their practice sites. The exceptions were rotavirus vaccine for children and herpes zoster vaccine for adults., A significant proportion, however, reported referring elsewhere for some vaccines (44.1% for children and adolescent vaccines and 53.5% for adult vaccines), with the most frequent referral location being a public health department. A higher proportion of solo and 2-physician practices than larger practices reported referring patients. A lack of adequate payment was listed as the reason for referring patients elsewhere for vaccines by one-half of those who refer patients. One-half of responders do not participate in the VFC program. Provision of recommended vaccines by most family physicians remains an important service. Smaller practices have more difficulty offering a full array of vaccine products, and lack of adequate payment contributes to referring patients outside the medical home. The reasons behind the lack of participation in the VFC program deserve further study.

Development of an evidence-based approach to external quality assurance for breast cancer hormone receptor immunohistochemistry: comparison of reference values.

PubMed

Makretsov, Nikita; Gilks, C Blake; Alaghehbandan, Reza; Garratt, John; Quenneville, Louise; Mercer, Joel; Palavdzic, Dragana; Torlakovic, Emina E

2011-07-01

External quality assurance and proficiency testing programs for breast cancer predictive biomarkers are based largely on traditional ad hoc design; at present there is no universal consensus on definition of a standard reference value for samples used in external quality assurance programs. To explore reference values for estrogen receptor and progesterone receptor immunohistochemistry in order to develop an evidence-based analytic platform for external quality assurance. There were 31 participating laboratories, 4 of which were previously designated as "expert" laboratories. Each participant tested a tissue microarray slide with 44 breast carcinomas for estrogen receptor and progesterone receptor and submitted it to the Canadian Immunohistochemistry Quality Control Program for analysis. Nuclear staining in 1% or more of the tumor cells was a positive score. Five methods for determining reference values were compared. All reference values showed 100% agreement for estrogen receptor and progesterone receptor scores, when indeterminate results were excluded. Individual laboratory performance (agreement rates, test sensitivity, test specificity, positive predictive value, negative predictive value, and κ value) was very similar for all reference values. Identification of suboptimal performance by all methods was identical for 30 of 31 laboratories. Estrogen receptor assessment of 1 laboratory was discordant: agreement was less than 90% for 3 of 5 reference values and greater than 90% with the use of 2 other reference values. Various reference values provide equivalent laboratory rating. In addition to descriptive feedback, our approach allows calculation of technical test sensitivity and specificity, positive and negative predictive values, agreement rates, and κ values to guide corrective actions.

The Neurobiology of Reference-Dependent Value Computation

PubMed Central

De Martino, Benedetto; Kumaran, Dharshan; Holt, Beatrice; Dolan, Raymond J.

2009-01-01

A key focus of current research in neuroeconomics concerns how the human brain computes value. Although, value has generally been viewed as an absolute measure (e.g., expected value, reward magnitude), much evidence suggests that value is more often computed with respect to a changing reference point, rather than in isolation. Here, we present the results of a study aimed to dissociate brain regions involved in reference-independent (i.e., “absolute”) value computations, from those involved in value computations relative to a reference point. During functional magnetic resonance imaging, subjects acted as buyers and sellers during a market exchange of lottery tickets. At a behavioral level, we demonstrate that subjects systematically accorded a higher value to objects they owned relative to those they did not, an effect that results from a shift in reference point (i.e., status quo bias or endowment effect). Our results show that activity in orbitofrontal cortex and dorsal striatum track parameters such as the expected value of lottery tickets indicating the computation of reference-independent value. In contrast, activity in ventral striatum indexed the degree to which stated prices, at a within-subjects and between-subjects level, were distorted with respect to a reference point. The findings speak to the neurobiological underpinnings of reference dependency during real market value computations. PMID:19321780

Capturing patients' needs in casemix: a systematic literature review on the value of adding functioning information in reimbursement systems.

PubMed

Hopfe, Maren; Stucki, Gerold; Marshall, Ric; Twomey, Conal D; Üstün, T Bedirhan; Prodinger, Birgit

2016-02-03

Contemporary casemix systems for health services need to ensure that payment rates adequately account for actual resource consumption based on patients' needs for services. It has been argued that functioning information, as one important determinant of health service provision and resource use, should be taken into account when developing casemix systems. However, there has to date been little systematic collation of the evidence on the extent to which the addition of functioning information into existing casemix systems adds value to those systems with regard to the predictive power and resource variation explained by the groupings of these systems. Thus, the objective of this research was to examine the value of adding functioning information into casemix systems with respect to the prediction of resource use as measured by costs and length of stay. A systematic literature review was performed. Peer-reviewed studies, published before May 2014 were retrieved from CINAHL, EconLit, Embase, JSTOR, PubMed and Sociological Abstracts using keywords related to functioning ('Functioning', 'Functional status', 'Function*, 'ICF', 'International Classification of Functioning, Disability and Health', 'Activities of Daily Living' or 'ADL') and casemix systems ('Casemix', 'case mix', 'Diagnosis Related Groups', 'Function Related Groups', 'Resource Utilization Groups' or 'AN-SNAP'). In addition, a hand search of reference lists of included articles was conducted. Information about study aims, design, country, setting, methods, outcome variables, study results, and information regarding the authors' discussion of results, study limitations and implications was extracted. Ten included studies provided evidence demonstrating that adding functioning information into casemix systems improves predictive ability and fosters homogeneity in casemix groups with regard to costs and length of stay. Collection and integration of functioning information varied across studies. Results suggest that, in particular, DRG casemix systems can be improved in predicting resource use and capturing outcomes for frail elderly or severely functioning-impaired patients. Further exploration of the value of adding functioning information into casemix systems is one promising approach to improve casemix systems ability to adequately capture the differences in patient's needs for services and to better predict resource use.

Quantifying the added value of BNP in suspected heart failure in general practice: an individual patient data meta-analysis.

PubMed

Kelder, Johannes C; Cowie, Martin R; McDonagh, Theresa A; Hardman, Suzanna M C; Grobbee, Diederick E; Cost, Bernard; Hoes, Arno W

2011-06-01

Diagnosing early stages of heart failure with mild symptoms is difficult. B-type natriuretic peptide (BNP) has promising biochemical test characteristics, but its diagnostic yield on top of readily available diagnostic knowledge has not been sufficiently quantified in early stages of heart failure. To quantify the added diagnostic value of BNP for the diagnosis of heart failure in a population relevant to GPs and validate the findings in an independent primary care patient population. Individual patient data meta-analysis followed by external validation. The additional diagnostic yield of BNP above standard clinical information was compared with ECG and chest x-ray results. Derivation was performed on two existing datasets from Hillingdon (n=127) and Rotterdam (n=149) while the UK Natriuretic Peptide Study (n=306) served as validation dataset. Included were patients with suspected heart failure referred to a rapid-access diagnostic outpatient clinic. Case definition was according to the ESC guideline. Logistic regression was used to assess discrimination (with the c-statistic) and calibration. Of the 276 patients in the derivation set, 30.8% had heart failure. The clinical model (encompassing age, gender, known coronary artery disease, diabetes, orthopnoea, elevated jugular venous pressure, crackles, pitting oedema and S3 gallop) had a c-statistic of 0.79. Adding, respectively, chest x-ray results, ECG results or BNP to the clinical model increased the c-statistic to 0.84, 0.85 and 0.92. Neither ECG nor chest x-ray added significantly to the 'clinical plus BNP' model. All models had adequate calibration. The 'clinical plus BNP' diagnostic model performed well in an independent cohort with comparable inclusion criteria (c-statistic=0.91 and adequate calibration). Using separate cut-off values for 'ruling in' (typically implying referral for echocardiography) and for 'ruling out' heart failure--creating a grey zone--resulted in insufficient proportions of patients with a correct diagnosis. BNP has considerable diagnostic value in addition to signs and symptoms in patients suspected of heart failure in primary care. However, using BNP alone with the currently recommended cut-off levels is not sufficient to make a reliable diagnosis of heart failure.

ASSESSMENT OF THE FOOD PATTERNS OF IMMIGRANT ECUADORIAN POPULATION IN SOUTHERN SPAIN BASED ON A 24-H FOOD RECALL SURVEY.

PubMed

Neira-Mosquera, Juan Alejandro; Sanchez-Llaguno, Sungey; Pérez-Rodríguez, Fernando; Moreno-Rojas, Rafael

2015-08-01

Ecuador is a country with limited nutritional information, with exception of some general studies supported by Food Agriculture Organization (FAO) Aims: to carry out a nutritional assessment of the diet of Ecuadorian immigrant population in Southern Spain to determine differences in food patterns and possible nutritional deficiencies. the nutritional assessment was based on a 24-h food recall survey applied to the Ecuadorian population residing in Seville and Córdoba (Spain) in combination with the application of national and international food composition data bases. Nutrient intake levels and fulfillment of Dietary Reference Intakes (DRIs) were estimated and statistically tested for social, sex, age and geographical factors. macronutrient distributions and nutrient intake levels in relation with DRIs were adequate in most cases. Importantly, Ecuadorian food habits were still present in immigrant population, with rice being the main energy source. Intakes levels were significantly different for several nutrients depending on age group, sex, place of residence and professional occupation. Comparison with previous nutritional data from Ecuador revealed a better nutritional status of immigrant population in Spain, though deficiencies in fiber, vitamin E, I and Se were detected in the diet of both populations. Nevertheless, data for these deficiencies were insufficient to be conclusive given both limitations in the food composition data bases (e.g. Se) and the lack of more adequate information tools for its assessment (e.g. long-term studies for vitamin E). the results in the present study evidenced that Ecuadorian immigrants in Spain showed more adequate food patterns that those reported for Ecuador. These data can be helpful to get further insight into the nutritional value of Ecuadorian diet and develop suitable nutrition intervention. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Clinical diagnosis of ventilator associated pneumonia revisited: comparative validation using immediate post-mortem lung biopsies.

PubMed

Fàbregas, N; Ewig, S; Torres, A; El-Ebiary, M; Ramirez, J; de La Bellacasa, J P; Bauer, T; Cabello, H

1999-10-01

A study was undertaken to assess the diagnostic value of different clinical criteria and the impact of microbiological testing on the accuracy of clinical diagnosis of suspected ventilator associated pneumonia (VAP). Twenty five deceased mechanically ventilated patients were studied prospectively. Immediately after death, multiple bilateral lung biopsy specimens (16 specimens/patient) were obtained for histological examination and quantitative lung cultures. The presence of both histological pneumonia and positive lung cultures was used as a reference test. The presence of infiltrates on the chest radiograph and two of three clinical criteria (leucocytosis, purulent secretions, fever) had a sensitivity of 69% and a specificity of 75%; the corresponding numbers for the clinical pulmonary infection score (CPIS) were 77% and 42%. Non-invasive as well as invasive sampling techniques had comparable values. The combination of all techniques achieved a sensitivity of 85% and a specificity of 50%, and these values remained virtually unchanged despite the presence of previous treatment with antibiotics. When microbiological results were added to clinical criteria, adequate diagnoses originating from microbiological results which might have corrected false positive and false negative clinical judgements (n = 5) were countered by a similar proportion of inadequate diagnoses (n = 6). Clinical criteria had reasonable diagnostic values. CPIS was not superior to conventional clinical criteria. Non-invasive and invasive sampling techniques had diagnostic values comparable to clinical criteria. An algorithm guiding antibiotic treatment exclusively by microbiological results does not increase the overall diagnostic accuracy and carries the risk of undertreatment.

Plastic surgery practice models and research aims under the Patient Protection and Affordable Care Act.

PubMed

Giladi, Aviram M; Yuan, Frank; Chung, Kevin C

2015-02-01

As the health care landscape in the United States changes under the Affordable Care Act, providers are set to face numerous new challenges. Although concerns about practice sustainability with declining reimbursement have dominated the dialogue, there are more pressing changes to the health care funding mechanism as a whole that must be addressed. Plastic surgeons, involved in various practice models each with different relationships to hospitals, referring physicians, and payers, must understand these reimbursement changes to dictate adequate compensation in the future. In this article, the authors discuss bundle payments and accountable care organizations, and how plastic surgeons might best engage in these new system designs. In addition, the authors review the value of a focused and driven health-services research agenda in plastic surgery, and the importance of this research in supporting long-term financial stability for the specialty.

Plastic Surgery Practice Models and Research Aims Under the Patient Protection and Affordable Care Act

PubMed Central

Giladi, Aviram M.; Yuan, Frank; Chung, Kevin C.

2014-01-01

As the healthcare landscape in the United States changes under the Affordable Care Act (ACA), providers are set to face numerous new challenges. Although concerns about practice sustainability with declining reimbursement have dominated the dialogue, there are more pressing changes to the healthcare funding mechanism as a whole that must be addressed. Plastic surgeons, involved in various practice models each with different relationships to hospitals, referring physicians, and payers, must understand these reimbursement changes in order to dictate adequate compensation in the future. Here we discuss bundle payments and Accountable Care Organizations (ACOs), and how plastic surgeons might best engage in these new system designs. In addition, we review the value of a focused and driven health-services research agenda in plastic surgery, and the importance of this research in supporting long-term financial stability for the specialty. PMID:25626805

Anthropometric parameters of schoolchildren with different life-styles.

PubMed

Sabaté, J; Lindsted, K D; Harris, R D; Johnston, P K

1990-10-01

Height and weight data obtained from a 2-year longitudinal survey were analyzed for 2272 children aged 6 through 18 years who were attending public schools or Seventh-Day Adventist (SDA) schools in southern California. The SDAs do not use alcohol or tobacco, and many adhere to a lacto-ovovegetarian diet. For both sexes, in each school group, the mean height and weight were at or above national reference values. Age-adjusted regression analysis showed that SDA school-boys were 1.6 cm taller than public schoolboys. There were no significant differences in height for girls. After controlling for height, boys and girls in the SDA schools were found to be leaner than their public school peers, ie, 1.27 and 1.16 kg, respectively. These results suggest that a health-oriented life-style in childhood and adolescence, such as the one followed by SDAs, is compatible with adequate growth and associated with a lower weight for height.

Relation of coronary collateral circulation with epicardial fat volume in patients with stable coronary artery disease

PubMed Central

Enhos, Asım; Sahin, Irfan; Can, Mehmet Mustafa; Biter, Ibrahim; Dinckal, Mustafa Hakan; Serebruany, Victor

2013-01-01

Objective To investigated the relationship between epicardial fat volume (EFV) and coronary collateral circulation (CCC) in patients with stable coronary artery disease (CAD). Methods The study population consisted of 152 consecutive patients with CAD who underwent coronary angiography and were found to have at least 95% significiant lesion in at least one major coronary artery. EFV was assessed utilizing 64-multislice computed tomography. The patients were classifield into impaired CCC group (Group 1, Rentrop grades 0−1, n = 58), or adequate CCC (Group 2, Rentrop grades 2−3, n = 94). Results The EFV values were significantly higher in paitients with adequate CCC than in those with impaired CCC. In multivariate logistic regression analysis, EFV (OR = 1.059; 95% CI: 1.035−1.085; P = 0.001); and presence of angina were independent predictors of adequate CCC. In receiver-operating characteristic curve analysis, the EFV value > 106.5 mL yielded an area under the curve value of 0.84, with the test sensitivity of 49.3%, and with 98.3% specifity. Conclusions High EFV, and the presence of angina independently predict adequate CCC in patients with stable coronary artery disease. This association offers new diagnostic opportinities to assess collateral flow by conventional ultrasound techniques. PMID:24454327

Validated age-specific reference values for CSF total protein levels in children.

PubMed

Kahlmann, V; Roodbol, J; van Leeuwen, N; Ramakers, C R B; van Pelt, D; Neuteboom, R F; Catsman-Berrevoets, C E; de Wit, M C Y; Jacobs, B C

2017-07-01

To define age-specific reference values for cerebrospinal fluid (CSF) total protein levels for children and validate these values in children with Guillain-Barré syndrome (GBS), acute disseminated encephalomyelitis (ADEM) and multiple sclerosis (MS). Reference values for CSF total protein levels were determined in an extensive cohort of diagnostic samples from children (<18 year) evaluated at Erasmus Medical Center/Sophia Children's Hospital. These reference values were confirmed in children diagnosed with disorders unrelated to raised CSF total protein level and validated in children with GBS, ADEM and MS. The test results of 6145 diagnostic CSF samples from 3623 children were used to define reference values. The reference values based on the upper limit of the 95% CI (i.e. upper limit of normal) were for 6 months-2 years 0.25 g/L, 2-6 years 0.25 g/L, 6-12 years 0.28 g/L, 12-18 years 0.34 g/L. These reference values were confirmed in a subgroup of 378 children diagnosed with disorders that are not typically associated with increased CSF total protein. In addition, the CSF total protein levels in these children in the first 6 months after birth were highly variable (median 0.47 g/L, IQR 0.26-0.65). According to these new reference values, CSF total protein level was elevated in 85% of children with GBS, 66% with ADEM and 23% with MS. More accurate age-specific reference values for CSF total protein levels in children were determined. These new reference values are more sensitive than currently used values for diagnosing GBS and ADEM in children. Copyright © 2017 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

Haematological values in pregnant women in Port Harcourt, Nigeria II: Serum iron and transferrin, total and unsaturated iron binding capacity and some red cell and platelet indices.

PubMed

Amah-Tariah, F S; Ojeka, S O; Dapper, D V

2011-12-20

Previous studies on the normal values of serum iron, unsaturated iron binding capacity, total iron binding capacity, serum transferrin, percent transferrin saturation, red cell distribution width, and various platelet indices: Platelet count, mean platelet volume, platelet distribution width, plateletcrit and platelet larger cell ratio in pregnant subjects in Nigeria are relatively scanty. Present study aims to determine the values of these parameters in apparently healthy pregnant subjects residing in Port Harcourt south eastern Nigeria; and help establish normal reference ranges of these parameters for the population under reference. Cross sectional prospective study involving 220 female subjects attending for the first time, the ante-natal clinics of a tertiary health care facility in Port Harcourt. Subjects were divided into 73, 75 and 72 subjects in the first, second and third trimester of pregnancy respectively. Serum iron and unsaturated iron binding capacity, red cell distribution width, platelet count and platelet distribution width were determined by automated methods; total iron binding capacity, serum transferrin concentrations, percent transferrin saturation, mean platelet volume and plateletcrit were calculated using appropriate formulas. The values of serum iron, unsaturated iron binding capacity, total iron binding capacity and serum transferrin concentrations were found to show significant variations between the various trimesters of pregnancy. However, while serum iron showed significant decreases during pregnancy; unsaturated iron binding capacity, total iron binding capacity and serum transferrin concentrations were found to show significant increases during pregnancy amongst our subjects (p<0.05). By contrast the values of red cell distribution width, platelet count, mean platelet volume, platelet distribution width, plateletcrit and platelet larger cell ratio did not show any significant differences at the different trimesters of pregnancy in our subjects (p>0.05). The present study reports, for the first time, normative values for these parameters in apparently healthy pregnant subjects in Port Harcourt south eastern Nigeria. Apparently, increases in unsaturated and total iron binding capacity and serum transferrin values seen amongst our subjects with increasing gestation may perhaps be a mechanism to ensure a fetal adequate iron delivery on account of the decreasing serum iron concentration with gestation in our subjects. The study suggests that values of serum transferrin are perhaps a more useful screening tool for iron deficiency anemia during pregnancy amongst our subjects.

[Nutritional status of children in the North Backa Region based on the body mass index].

PubMed

Pavlović, M

2000-01-01

Monitoring nutritional status of children at a population level represents an important index of the nutritional quality and quantity in a certain period of time. The aim of this paper was to determine the body mass index (BMI kg/m2) and evaluate the nutritional status of children in the North Backa Region (Subotica, Backa Topola and Mali Idos). A transversal anthropometric study examining body weight and height during a mass screening of children in Health centers in the North Backa Region, 25.790 children aged 1-18 have been examined in the period 1995-1998. Evidence and statistical evaluation of data have been processed using the software "CHILD" determining the percentile values of BMI and nutritional status according to reference values of the First National Healts and Nutrition Examination Survey (NHANES 1). Analyzing the nutritional status of children aged 6-18 in the North Backa Region we found 4.39% boys and 5.41 girls with BMI < P5 as underweight, moderate underweight with BMI P5-15 were 7.28% boys and 6.96% girls, whereas normal nutritional status (BMI P15-85) was found in 67.13% boys and 67.25% girls. 12.77% of boys and 11.78% of girls were overweight (BMI P85-95) and obesity (BMI > P95) was registered in 8.46% boys and 8.60% girls. Using the same software and based on results for the whole group of children aged 1-18, reference values were calculated for BMI as a regional reference data which can be used in everyday public health setting. This research is the first examination of the nutritional status of children at a population level in the North Backa Region in regard to BMI. This model of nutritional status monitoring in children using the above mentioned software will be used at a national level. These results show an inadequate nutritional status of children in the North Backa Region which can be associated with unbalanced nutrition and life style. Therefore, permanent monitoring of the nutritional status in children has been established in order to take adequate preventive measures to realize nutrition of children and adolescents.

Strategies for improving the collection of 24-hour urine for analysis in the clinical laboratory: redesigned instructions, opinion surveys, and application of reference change value to micturition.

PubMed

Tormo, Consuelo; Lumbreras, Blanca; Santos, Ana; Romero, Luis; Conca, Minerva

2009-12-01

-The preanalytic phase of 24-hour urine collection, before clinical analysis, requires the active participation of patients and usually takes place outside the laboratory. -We verify whether distribution of adequate information to health care personnel and patients will result in fewer preanalytic incidents. We also determine the intraindividual biologic variability associated with micturition and the corresponding reference change value (RCV). -The intervention provided training for 24-hour urine collection to the health care personnel of the 20th health district of the Valencian community in Spain. The preanalytic incidents related to 24-hour micturition were estimated before and after the intervention. An opinion survey on the problems involved in urine collection was also conducted among patients. The Harris formula was used to calculate the RCV. -Before the intervention, 130 preanalytic incidents were recorded (11.5%) and after the intervention, 76 (8.6%) (P = .04) were recorded. Of the 130 incidents recorded before the intervention, 63 (48.5%) involved omission to indicate the urine volume, and of the 76 incidents recorded after the intervention, only 1 (1.3%) (P < .001) involved this omission. Forty of 302 patients (13.2%) surveyed reported problems and more than half (175; 57.9%) had to collect various urine samples sequentially. The RCV determined was 54.5% for a percentage of variation in volume of 24-hour urine (PVVI) of 19.0 +/- 16.5%. Therefore, micturition associated with a PVVI >+/-54.5% suggests that 24-hour urine collection by the patient was incomplete. The results obtained when applying the RCV after the intervention showed that 6.3% of the 24-hour urine samples should be rejected. -The percentage of preanalytic incidents was reduced by providing health care personnel with information and training. The percentage of variation in volume of 24-hour urine can be used to evaluate the variation in patients' micturition. Reference change value was shown to be useful when determining whether 24-hour urine was properly collected.

Vestibulo-ocular reflex gain values in the suppression head impulse test of healthy subjects.

PubMed

Rey-Martinez, Jorge; Thomas-Arrizabalaga, Izaskun; Espinosa-Sanchez, Juan Manuel; Batuecas-Caletrio, Angel; Trinidad-Ruiz, Gabriel; Matiño-Soler, Eusebi; Perez-Fernandez, Nicolas

2018-02-15

To assess whether there are differences in vestibulo-ocular reflex (VOR) gain for suppression head impulse (SHIMP) and head impulse (HIMP) video head impulse test paradigms, and if so, what are their causes. Prospective multicenter observational double-blind nonrandomized clinical study was performed by collecting 80 healthy subjects from four reference hospitals. SHIMP data was postprocessed to eliminate impulses in which early SHIMP saccades were detected. Differences between HIMP and SHIMP VOR gain values were statistically evaluated. Head impulse maximum velocity, gender, age, direction of impulse, and hospital center were considered as possible influential factors. A small significant statistical difference between HIMP and SHIMP VOR gain values was found on repeated measures analysis of variance (-0.05 ± 0.006, P < 0.001). Optimized linear model showed a significant influence of age variable on the observed differences for HIMP and SHIMP gain values and did not find influence between gain values differences and maximum head impulse velocity. Both HIMP and SHIMP VOR gain values were significant lower (-0.09, P < 0.001) when the impulses were performed to the left side. We had observed a difference in SHIMP and HIMP gain values not adequately explained by known gain modification factors. The persistence of this slight but significant difference indicates that there are more factors causing lower SHIMP VOR gain values. This difference must to be considered in further studies as well as in the clinical SHIMP testing protocols. We hypothesized that VOR phasic response inhibition could be the underlying cause of this difference. IIb. Laryngoscope, 2018. © 2018 The American Laryngological, Rhinological and Otological Society, Inc.

Incorporating geographical factors with artificial neural networks to predict reference values of erythrocyte sedimentation rate

PubMed Central

2013-01-01

Background The measurement of the Erythrocyte Sedimentation Rate (ESR) value is a standard procedure performed during a typical blood test. In order to formulate a unified standard of establishing reference ESR values, this paper presents a novel prediction model in which local normal ESR values and corresponding geographical factors are used to predict reference ESR values using multi-layer feed-forward artificial neural networks (ANN). Methods and findings Local normal ESR values were obtained from hospital data, while geographical factors that include altitude, sunshine hours, relative humidity, temperature and precipitation were obtained from the National Geographical Data Information Centre in China. The results show that predicted values are statistically in agreement with measured values. Model results exhibit significant agreement between training data and test data. Consequently, the model is used to predict the unseen local reference ESR values. Conclusions Reference ESR values can be established with geographical factors by using artificial intelligence techniques. ANN is an effective method for simulating and predicting reference ESR values because of its ability to model nonlinear and complex relationships. PMID:23497145

Incorporating geographical factors with artificial neural networks to predict reference values of erythrocyte sedimentation rate.

PubMed

Yang, Qingsheng; Mwenda, Kevin M; Ge, Miao

2013-03-12

The measurement of the Erythrocyte Sedimentation Rate (ESR) value is a standard procedure performed during a typical blood test. In order to formulate a unified standard of establishing reference ESR values, this paper presents a novel prediction model in which local normal ESR values and corresponding geographical factors are used to predict reference ESR values using multi-layer feed-forward artificial neural networks (ANN). Local normal ESR values were obtained from hospital data, while geographical factors that include altitude, sunshine hours, relative humidity, temperature and precipitation were obtained from the National Geographical Data Information Centre in China.The results show that predicted values are statistically in agreement with measured values. Model results exhibit significant agreement between training data and test data. Consequently, the model is used to predict the unseen local reference ESR values. Reference ESR values can be established with geographical factors by using artificial intelligence techniques. ANN is an effective method for simulating and predicting reference ESR values because of its ability to model nonlinear and complex relationships.

Assessment Study of the State of the Art in Adaptive Control and its Applications to Aircraft Control

NASA Technical Reports Server (NTRS)

Kaufman, Howard

1998-01-01

Many papers relevant to reconfigurable flight control have appeared over the past fifteen years. In general these have consisted of theoretical issues, simulation experiments, and in some cases, actual flight tests. Results indicate that reconfiguration of flight controls is certainly feasible for a wide class of failures. However many of the proposed procedures although quite attractive, need further analytical and experimental studies for meaningful validation. Many procedures assume the availability of failure detection and identification logic that will supply adequately fast, the dynamics corresponding to the failed aircraft. This in general implies that the failure detection and fault identification logic must have access to all possible anticipated faults and the corresponding dynamical equations of motion. Unless some sort of explicit on line parameter identification is included, the computational demands could possibly be too excessive. This suggests the need for some form of adaptive control, either by itself as the prime procedure for control reconfiguration or in conjunction with the failure detection logic. If explicit or indirect adaptive control is used, then it is important that the identified models be such that the corresponding computed controls deliver adequate performance to the actual aircraft. Unknown changes in trim should be modelled, and parameter identification needs to be adequately insensitive to noise and at the same time capable of tracking abrupt changes. If however, both failure detection and system parameter identification turn out to be too time consuming in an emergency situation, then the concepts of direct adaptive control should be considered. If direct model reference adaptive control is to be used (on a linear model) with stability assurances, then a positive real or passivity condition needs to be satisfied for all possible configurations. This condition is often satisfied with a feedforward compensator around the plant. This compensator must be robustly designed such that the compensated plant satisfies the required positive real conditions over all expected parameter values. Furthermore, with the feedforward only around the plant, a nonzero (but bounded error) will exist in steady state between the plant and model outputs. This error can be removed by placing the compensator also in the reference model. Design of such a compensator should not be too difficult a problem since for flight control it is generally possible to feedback all the system states.

Pre-season dietary intake of professional soccer players.

PubMed

Raizel, Raquel; da Mata Godois, Allan; Coqueiro, Audrey Yule; Voltarelli, Fabrício Azevedo; Fett, Carlos Alexandre; Tirapegui, Julio; de Paula Ravagnani, Fabricio Cesar; de Faria Coelho-Ravagnani, Christianne

2017-12-01

Despite the well-documented importance of nutrition in optimizing performance and health, the dietary intake of soccer players has attracted little attention. We aimed to assess the pre-season dietary intake of professional soccer players and its adequacy in macro and micronutrients. The pre-season dietary intake of 19 male athletes was assessed using a semi-structured 3-day food record. To determine dietary adequacy and excess, energy and macronutrient intake were compared with the Brazilian dietary reference values for athletes, and micronutrients were compared with the Estimated Average Requirement - EAR (minimum recommendation) and Tolerable Upper Intake Level - UL (maximum recommendation). Mean daily energy intake (40.74±12.81 kcal/kg) was adequate. However, there was a low carbohydrate intake (5.44±1.86 g/kg/day) and a high amount of protein and fat (1.91±0.75 and 1.27±0.50 g/kg/day, respectively). Sodium intake (3141.77±939.76 mg/day) was higher than UL (2300 mg/day), while the majority of players showed daily intake of vitamin A (74%), vitamin D (100%), folate (58%), calcium and magnesium (68%) below the EAR (625, 10 and 320 µg/day, 800 and 330 mg/day, respectively). The dietary intake of professional soccer players was adequate in energy, but inadequate in macro and micronutrients, which suggests the need to improve nutritional practices to sustain the physical demands of soccer during pre-season.

Nutritional status of endurance athletes: what is the available information?

PubMed

Nogueira, Júlia A D; Da Costa, Teresa H M

2005-03-01

Nutritional status is a critical determinant of athletic performance. We question whether currently available studies can give adequate information on nutritional status of endurance athletes. This paper is a critical review of articles published from 1989 to 2003 that investigate nutritional status of endurance athletes. The terms, "nutrition", "diet", or "nutrient", were combined with "endurance athletes" to perform Medline and Pubmed electronic database searches. Two inclusion criteria were considered: (a) study subjects should be adults and (b) articles should report gender-specific values for total energy expenditure and intake of energy, macro and micronutrient from food. Only seven studies fulfilled inclusion criteria. In general, the conclusions of these studies are that endurance athletes have negative energy balance, low intake of carbohydrate, adequate to high intake of protein, and high intake of fat. A critical discussion of the articles' data on vitamins, minerals and trace elements adequacy is conducted using insights and methodology proposed by the newly published assessment and interpretation of Dietary Reference Intakes (DRIs). The studies evaluated give an inappropriate evaluation of the prevalence of adequacy/inadequacy of micronutrient intake among endurance athletes. In this work we indicate potential limitations of existing nutritional data, which reflects the misconceptions found in published literature on nutritional group evaluation. This review stresses the need for a comprehensive and well-conducted nutrition assessment planning to fulfill the existing gap in reliable information about micronutrient adequacy of endurance athletes.

Revised reference values for selenium intake.

PubMed

Kipp, A P; Strohm, D; Brigelius-Flohé, R; Schomburg, L; Bechthold, A; Leschik-Bonnet, E; Heseker, H

2015-10-01

The German, Austrian and Swiss nutrition societies are the joint editors of the 'reference values for nutrient intake'. They have revised the reference values for the intake of selenium and published them in February 2015. The saturation of selenoprotein P (SePP) in plasma is used as a criterion for the derivation of reference values for selenium intake in adults. For persons from selenium-deficient regions (China) SePP saturation was achieved with a daily intake of 49μg of selenium. When using the reference body weights the D-A-CH reference values are based upon, the resulting estimated value for selenium intake is 70μg/day for men and 60μg/day for women. The estimated value for selenium intake for children and adolescents is extrapolated using the estimated value for adults in relation to body weight. For infants aged 0 to under 4 months the estimated value of 10μg/day was derived from the basis of selenium intake via breast milk. For infants aged 4 to under 12 months this estimated value was used and taking into account the differences regarding body weight an estimated value of 15μg/day was derived. For lactating women compared to non-lactating women a higher reference value of 75μg/day is indicated due to the release of selenium with breast milk. The additional selenium requirement for pregnant women is negligible, so that no increased reference value is indicated. Copyright © 2015 The Authors. Published by Elsevier GmbH.. All rights reserved.

[Health risks from pest control products].

PubMed

Pieper, C; Holthenrich, D; Schneider, H

2014-05-01

According to European biocide legislation, pest control products require assessment and authorization by the responsible national or European authorities. Biocidal products can only be authorized if they have no unacceptable effects on human health. The health risk assessment performed for authorization comprises (a) the derivation of reference values for the active substances and substances of concern contained in the biocidal product and (b) an exposure assessment. These parameters are required for risk characterization. No unacceptable health risks are expected if the determined exposure is less than the relevant reference value. In addition, the toxicological information is used for classification of the biocidal product. The assessment may, where necessary, result in specific conditions for use or other restrictions aimed at minimizing risk. The risk to human health from pest control products is mainly based on the toxicological properties of their active substances. Commonly, the coformulants used in pest control products are of less concern than the active substances (e.g., food ingredients and animal feed products). For example, most rodenticides belong to the group of anticoagulants, which are also effective in humans. Regarding intoxications through insecticides, the group of pyrethroids is of particular importance. Fumigants containing metal phosphides, hydrogen cyanide, or sulfuryl difluoride are particularly toxic. This toxicity is linked to the high acute inhalation toxicity of the gaseous active substances themselves or, in the case of phosphides, of the released gas phosphane. The aim of health risk assessment for the authorization of biocidal products is to ensure their safe application for users and all other persons involved, assuming an adequate and label-compliant use.

The "Glocalization" of Medical School Accreditation: Case Studies From Taiwan, South Korea, and Japan.

PubMed

Ho, Ming-Jung; Abbas, Joan; Ahn, Ducksun; Lai, Chi-Wan; Nara, Nobuo; Shaw, Kevin

2017-12-01

In an age of globalized medical education, medical school accreditation has been hailed as an approach to external quality assurance. However, accreditation standards can vary widely across national contexts. To achieve recognition by the World Federation for Medical Education (WFME), national accrediting bodies must develop standards suitable for both local contexts and international recognition. This study framed this issue in terms of "glocalization" and aimed to shine light on this complicated multistakeholder process by exploring accreditation in Taiwan, South Korea, and Japan. This study employed a comparative case-study design, examining the national standards that three accreditation bodies in East Asia developed using international reference standards. In 2015-2016, the authors conducted document analysis of the English versions of the standards to identify the differences between the national and international reference standards as well as how and why external standards were adapted. Each country's accreditation body sought to balance local needs with global demands. Each used external standards as a template (e.g., Liaison Committee on Medical Education, General Medical Council, or WFME standards) and either revised (Taiwan, South Korea) or annotated (Japan) the standards to fit the local context. Four categories of differences emerged to account for how and why national standards departed from external references: structural, regulatory, developmental, and aspirational. These countries' glocalization of medical accreditation standards serve as examples for others seeking to bring their accreditation practices in line with global standards while ensuring that local values and societal needs are given adequate consideration.

Normalizing gene expression by quantitative PCR during somatic embryogenesis in two representative conifer species: Pinus pinaster and Picea abies.

PubMed

de Vega-Bartol, José J; Santos, Raquen Raissa; Simões, Marta; Miguel, Célia M

2013-05-01

Suitable internal control genes to normalize qPCR data from different stages of embryo development and germination were identified in two representative conifer species. Clonal propagation by somatic embryogenesis has a great application potentiality in conifers. Quantitative PCR (qPCR) is widely used for gene expression analysis during somatic embryogenesis and embryo germination. No single reference gene is universal, so a systematic characterization of endogenous genes for concrete conditions is fundamental for accuracy. We identified suitable internal control genes to normalize qPCR data obtained at different steps of somatic embryogenesis (embryonal mass proliferation, embryo maturation and germination) in two representative conifer species, Pinus pinaster and Picea abies. Candidate genes included endogenous genes commonly used in conifers, genes previously tested in model plants, and genes with a lower variation of the expression along embryo development according to genome-wide transcript profiling studies. Three different algorithms were used to evaluate expression stability. The geometric average of the expression values of elongation factor-1α, α-tubulin and histone 3 in P. pinaster, and elongation factor-1α, α-tubulin, adenosine kinase and CAC in P. abies were adequate for expression studies throughout somatic embryogenesis. However, improved accuracy was achieved when using other gene combinations in experiments with samples at a single developmental stage. The importance of studies selecting reference genes to use in different tissues or developmental stages within one or close species, and the instability of commonly used reference genes, is highlighted.

Hematological reference values of healthy Malaysian population.

PubMed

Roshan, T M; Rosline, H; Ahmed, S A; Rapiaah, M; Wan Zaidah, A; Khattak, M N

2009-10-01

Health and disease can only be distinguished by accurate and reliable reference values of a particular laboratory test. It is now a proven fact that there is considerable variation in hematology reference intervals depending on the demographic and preanalytical variables. There are evidences that values provided by manufacturers do not have appropriate application for all populations. Moreover, reference ranges provided by different laboratory manuals and books also do not solve this problem. We are presenting here normal reference ranges of Malaysian population. These values were determined by using Sysmex XE-2100 and ACL 9000 hematology and coagulation analyzers. Results from this study showed that there were considerable differences in the reference values from manufacturers, western population or laboratory manuals compared with those from the local population.

7 CFR 1436.8 - Security for loan.

Code of Federal Regulations, 2010 CFR

2010-01-01

... adequate size and value at the time of the application as determined by the county committee to adequately... such collateral except for prior liens on the underlying real estate that by operation of law attach to the collateral if it is or will become a fixture. If any such prior lien on the real estate will...

7 CFR 1436.8 - Security for loan.

Code of Federal Regulations, 2011 CFR

2011-01-01

... adequate size and value at the time of the application as determined by the county committee to adequately... such collateral except for prior liens on the underlying real estate that by operation of law attach to the collateral if it is or will become a fixture. If any such prior lien on the real estate will...

RNA-sequence data normalization through in silico prediction of reference genes: the bacterial response to DNA damage as case study.

PubMed

Berghoff, Bork A; Karlsson, Torgny; Källman, Thomas; Wagner, E Gerhart H; Grabherr, Manfred G

2017-01-01

Measuring how gene expression changes in the course of an experiment assesses how an organism responds on a molecular level. Sequencing of RNA molecules, and their subsequent quantification, aims to assess global gene expression changes on the RNA level (transcriptome). While advances in high-throughput RNA-sequencing (RNA-seq) technologies allow for inexpensive data generation, accurate post-processing and normalization across samples is required to eliminate any systematic noise introduced by the biochemical and/or technical processes. Existing methods thus either normalize on selected known reference genes that are invariant in expression across the experiment, assume that the majority of genes are invariant, or that the effects of up- and down-regulated genes cancel each other out during the normalization. Here, we present a novel method, moose 2 , which predicts invariant genes in silico through a dynamic programming (DP) scheme and applies a quadratic normalization based on this subset. The method allows for specifying a set of known or experimentally validated invariant genes, which guides the DP. We experimentally verified the predictions of this method in the bacterium Escherichia coli , and show how moose 2 is able to (i) estimate the expression value distances between RNA-seq samples, (ii) reduce the variation of expression values across all samples, and (iii) to subsequently reveal new functional groups of genes during the late stages of DNA damage. We further applied the method to three eukaryotic data sets, on which its performance compares favourably to other methods. The software is implemented in C++ and is publicly available from http://grabherr.github.io/moose2/. The proposed RNA-seq normalization method, moose 2 , is a valuable alternative to existing methods, with two major advantages: (i) in silico prediction of invariant genes provides a list of potential reference genes for downstream analyses, and (ii) non-linear artefacts in RNA-seq data are handled adequately to minimize variations between replicates.

Reference values for pulmonary diffusing capacity for adult native Finns.

PubMed

Kainu, Annette; Toikka, Jyri; Vanninen, Esko; Timonen, Kirsi L

2017-04-01

Measurement standards for pulmonary diffusing capacity were updated in 2005 by the ATS/ERS Task Force. However, in Finland reference values published in 1982 by Viljanen et al. have been used to date. The main aim of this study was to produce updated reference models for single-breath diffusing capacity for carbon monoxide for Finnish adults. Single-breath diffusing capacity for carbon monoxide was measured in 631 healthy non-smoking volunteers (41.5% male). Reference values for diffusing capacity (DLCO), alveolar volume (VA), diffusing capacity per unit of lung volume (DLCO/VA), and lung volumes were calculated using a linear regression model. Previously used Finnish reference values were found to produce too low predicted values, with mean predicted DLCO 111.0 and 104.4%, and DLCO/VA of 103.5 and 102.7% in males and females, respectively. With the European Coalition for Steel and Coal (ECSC) reference values there was a significant sex difference in DLCO/VA with mean predicted 105.4% in males and 92.8% in females (p < .001). New reference values for DLCO, DLCO/VA, VA, vital capacity (VC), inspiratory vital capacity (IVC), and inspiratory capacity (IC) are suggested for clinical use to replace technically outdated reference values for clinical applications.

Basic anatomical and physiological data for use in radiological protection: reference values. A report of age- and gender-related differences in the anatomical and physiological characteristics of reference individuals. ICRP Publication 89.

PubMed

2002-01-01

This report presents detailed information on age- and gender-related differences in the anatomical and physiological characteristics of reference individuals. These reference values provide needed input to prospective dosimetry calculations for radiation protection purposes for both workers and members of the general public. The purpose of this report is to consolidate and unify in one publication, important new information on reference anatomical and physiological values that has become available since Publication 23 was published by the ICRP in 1975. There are two aspects of this work. The first is to revise and extend the information in Publication 23 as appropriate. The second is to provide additional information on individual variation among grossly normal individuals resulting from differences in age, gender, race, or other factors. This publication collects, unifies, and expands the updated ICRP reference values for the purpose of providing a comprehensive and consistent set of age- and gender-specific reference values for anatomical and physiological features of the human body pertinent to radiation dosimetry. The reference values given in this report are based on: (a) anatomical and physiological information not published before by the ICRP; (b) recent ICRP publications containing reference value information; and (c) information in Publication 23 that is still considered valid and appropriate for radiation protection purposes. Moving from the past emphasis on 'Reference Man', the new report presents a series of reference values for both male and female subjects of six different ages: newborn, 1 year, 5 years, 10 years, 15 years, and adult. In selecting reference values, the Commission has used data on Western Europeans and North Americans because these populations have been well studied with respect to antomy, body composition, and physiology. When appropriate, comparisons are made between the chosen reference values and data from several Asian populations. The first section of the report provides summary tables of all the anatomical and physiological parameters given as reference values in this publication. These results give a comprehensive view of reference values for an individual as influenced by age and gender. The second section describes characteristics of dosimetric importance for the embryo and fetus. Information is provided on the development of the total body and the timing of appearance and development of the various organ systems. Reference values are provided on the mass of the total body and selected organs and tissues, as well as a number of physiological parameters. The third section deals with reference values of important anatomical and physiological characteristics of reference individuals from birth to adulthood. This section begins with details on the growth and composition of the total body in males and females. It then describes and quantifies anatomical and physiological characteristics of various organ systems and changes in these characteristics during growth, maturity, and pregnancy. Reference values are specified for characteristics of dosimetric importance. The final section gives a brief summary of the elemental composition of individuals. Focusing on the elements of dosimetric importance, information is presented on the body content of 13 elements: calcium, carbon, chloride, hydrogen, iodine, iron, magnesium, nitrogen, oxygen, potassium, sodium, sulphur, and phosphorus.

Optimization of the trienzyme extraction for the microbiological assay of folate in vegetables.

PubMed

Chen, Liwen; Eitenmiller, Ronald R

2007-05-16

Response surface methodology was applied to optimize the trienzyme digestion for the extraction of folate from vegetables. Trienzyme extraction is a combined enzymatic digestion by protease, alpha-amylase, and conjugase (gamma-glutamyl hydrolase) to liberate the carbohydrate and protein-bound folates from food matrices for total folate analysis. It is the extraction method used in AOAC Official Method 2004.05 for assay of total folate in cereal grain products. Certified reference material (CRM) 485 mixed vegetables was used to represent the matrix of vegetables. Regression and ridge analysis were performed by statistical analysis software. The predicted second-order polynomial model was adequate (R2 = 0.947), without significant lack of fit (p > 0.1). Both protease and alpha-amylase have significant effects on the extraction. Ridge analysis gave an optimum trienzyme digestion time: Pronase, 1.5 h; alpha-amylase, 1.5 h; and conjugase, 3 h. The experimental value for CRM 485 under this optimum digestion was close to the predicted value from the model, confirming the validity and adequacy of the model. The optimized trienzyme digestion condition was applied to five vegetables and yielded higher folate levels than the trienzyme digestion parameters employed in AOAC Official Method 2004.05.

Current Dilemmas in Defining the Boundaries of Disease.

PubMed

Doust, Jenny; Jean Walker, Mary; Rogers, Wendy A

2017-08-01

Boorse's biostatistical theory states that diseases should be defined in ways that reflect disturbances of biological function and that are objective and value free. We use three examples from contemporary medicine that demonstrate the complex issues that arise when defining the boundaries of disease: polycystic ovary syndrome, chronic kidney disease, and myocardial infarction. We argue that the biostatistical theory fails to provide sufficient guidance on where the boundaries of disease should be drawn, contains ambiguities relating to choice of reference class, and is out of step with medical processes for identifying disease boundaries. Although proponents of the biostatistical theory might regard these practical issues as irrelevant to the aim of providing a theoretical account of disease, we take them to indicate the need for a theoretical account that is adequate for current needs-including limiting new forms of medicalization that are driven by the identification of disease based on dysfunction. Our processes for determining the boundaries for disease need to recognize that there is no value-free method for making these decisions. © The Author 2017. Published by Oxford University Press, on behalf of the Journal of Medicine and Philosophy Inc. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Accuracy of ultrasound in prediction of rectosigmoid infiltration in epithelial ovarian cancer.

PubMed

Zikan, M; Fischerova, D; Semeradova, I; Slama, J; Dundr, P; Weinberger, V; Dusek, L; Cibula, D

2017-10-01

To examine prospectively the accuracy of ultrasound in predicting rectosigmoid tumor infiltration in patients with epithelial ovarian cancer. Patients referred for a suspicious pelvic mass between 2012 and 2014 were examined by ultrasound following the standard protocol for assessment of tumor infiltration. Of the 245 patients examined, 191 had proven ovarian cancer and underwent primary surgery and were included in the analysis. Patients with apparently benign or inoperable disease were excluded. Rectosigmoid infiltration was evaluated by histopathology or according to perioperative findings. Clinical, pathological and laboratory parameters were analyzed as factors potentially affecting the sensitivity and specificity of sonography. The sensitivity of ultrasound in detecting rectosigmoid infiltration in patients with ovarian cancer was 86.3%, with specificity of 95.8%, positive predictive value of 92.6%, negative predictive value of 91.9% and overall accuracy of 92.1%. Ultrasound is a highly accurate method for detecting rectosigmoid tumor infiltration in ovarian cancer patients, and thus, can be used for planning adequate management, including patient consultation, surgical team planning, suitable operating time and postoperative care. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd.

Assessment of nutritional status in noninstitutionalized elderly.

PubMed

Powers, J S; Folk, M C; Burger, C; Wilson, P; Stocking, B J; Collins, J

1989-08-01

Aging may modify both the availability of and needs for certain nutrients. Our study was done to assess the contribution of age alone to micronutrient levels in older volunteers (aged 60 or more). One hundred two healthy elderly white subjects, 63 women and 39 men, carefully screened by history or chart review, were studied in the fasting state. All were noninstitutionalized without serious chronic or acute illness; their diets were nutritionally adequate, containing more than two thirds of the recommended dietary allowance (RDA) for all nutrients, and no subject was taking more than twice the RDA of fat-soluble vitamins. These subjects had higher levels of plasma and red blood cell carnitine, and vitamins A, E, and C. They had lower levels of albumin, transferrin, and zinc than younger laboratory reference subjects. Retinol-binding protein, serum and red blood cell folate, and copper levels were not different. With increasing age, levels of transferrin and vitamins C and E fell; all other measured micronutrient levels were similar. Albumin, vitamin C, and copper values were higher among elderly women, and plasma and red blood cell carnitine values and zinc levels were higher in elderly men. There was great variability in the micronutrient levels despite similar nutrient intakes.

Comparison of CyTOF assays across sites: Results of a six-center pilot study.

PubMed

Leipold, Michael D; Obermoser, Gerlinde; Fenwick, Craig; Kleinstuber, Katja; Rashidi, Narges; McNevin, John P; Nau, Allison N; Wagar, Lisa E; Rozot, Virginie; Davis, Mark M; DeRosa, Stephen; Pantaleo, Giuseppe; Scriba, Thomas J; Walker, Bruce D; Olsen, Lars R; Maecker, Holden T

2018-02-01

For more than five years, high-dimensional mass cytometry has been employed to study immunology. However, these studies have typically been performed in one laboratory on one or few instruments. We present the results of a six-center study using healthy control human peripheral blood mononuclear cells (PBMCs) and commercially available reagents to test the intra-site and inter-site variation of mass cytometers and operators. We used prestained controls generated by the primary center as a reference to compare against samples stained at each individual center. Data were analyzed at the primary center, including investigating the effects of two normalization methods. All six sites performed similarly, with CVs for both Frequency of Parent and median signal intensity (MSI) values<30%. Increased background was seen when using the premixed antibody cocktail aliquots at each site, suggesting that cocktails are best made fresh. Both normalization methods tested performed adequately for normalizing MSI values between centers. Clustering algorithms revealed slight differences between the prestained and the sites-stained samples, due mostly to the increased background of a few antibodies. Therefore, we believe that multicenter mass cytometry assays are feasible. Copyright © 2017 The Author(s). Published by Elsevier B.V. All rights reserved.

Applying for, reviewing and funding public health research in Germany and beyond.

PubMed

Gerhardus, Ansgar; Becher, Heiko; Groenewegen, Peter; Mansmann, Ulrich; Meyer, Thorsten; Pfaff, Holger; Puhan, Milo; Razum, Oliver; Rehfuess, Eva; Sauerborn, Rainer; Strech, Daniel; Wissing, Frank; Zeeb, Hajo; Hummers-Pradier, Eva

2016-06-13

Public health research is complex, involves various disciplines, epistemological perspectives and methods, and is rarely conducted in a controlled setting. Often, the added value of a research project lies in its inter- or trans-disciplinary interaction, reflecting the complexity of the research questions at hand. This creates specific challenges when writing and reviewing public health research grant applications. Therefore, the German Research Foundation (DFG), the largest independent research funding organization in Germany, organized a round table to discuss the process of writing, reviewing and funding public health research. The aim was to analyse the challenges of writing, reviewing and granting scientific public health projects and to improve the situation by offering guidance to applicants, reviewers and funding organizations. The DFG round table discussion brought together national and international public health researchers and representatives of funding organizations. Based on their presentations and discussions, a core group of the participants (the authors) wrote a first draft on the challenges of writing and reviewing public health research proposals and on possible solutions. Comments were discussed in the group of authors until consensus was reached. Public health research demands an epistemological openness and the integration of a broad range of specific skills and expertise. Applicants need to explicitly refer to theories as well as to methodological and ethical standards and elaborate on why certain combinations of theories and methods are required. Simultaneously, they must acknowledge and meet the practical and ethical challenges of conducting research in complex real life settings. Reviewers need to make the rationale for their judgments transparent, refer to the corresponding standards and be explicit about any limitations in their expertise towards the review boards. Grant review boards, funding organizations and research ethics committees need to be aware of the specific conditions of public health research, provide adequate guidance to applicants and reviewers, and ensure that processes and the expertise involved adequately reflect the topic under review.

Selection of Reference Gene Expression in a Schizophrenia Brain Cohort

PubMed Central

Weickert, Cynthia Shannon; Sheedy, Donna; Rothmond, Debora A.; Dedova, Irina; Fung, Samantha; Garrick, Therese; Wong, Jenny; Harding, Antony J.; Sivagnanansundaram, Sinthuja; Hunt, Clare; Duncan, Carlotta; Sundqvist, Nina; Tsai, Shan-Yuan; Anand, Jasna; Draganic, Daren; Harper, Clive

2010-01-01

Objective To conduct postmortem human brain research into the neuropathological basis of schizophrenia, it is critical to establish cohorts that are well-characterised and well-matched. Our objective was to determine if specimen characteristics, including: diagnosis, age, postmortem interval (PMI), brain acidity (pH), and/or the agonal state of the subject at death related to RNA quality, and to determine the most appropriate reference gene mRNAs. Methods We selected a matched cohort of 74 cases (37 schizophrenia / schizoaffective disorder cases and 37 controls cases). Middle frontal gyrus tissue was pulverised, tissue pH was measured, RNA isolated for cDNA from each case, and RNA integrity number (RIN) measurements were assessed. Using RT-PCR, we measured nine housekeeper genes and calculated a geomean in each diagnostic group. Results We found that the RINs were very good (mean 7.3) and all nine housekeeper control genes were significantly correlated with RIN. Seven of nine housekeeper genes were also correlated with pH, and two clinical variables, agonal state and duration of illness did have an effect on some control mRNAs. No major impact of PMI or freezer time on housekeeper mRNAs was detected. Our results show that people with schizophrenia had significantly less PPIA, and SDHA and tended to have less GUSB and B2M mRNA suggesting that these control genes may not be good candidates for normalisation. Conclusions In our cohort, less than 10% variability in RIN values was detected and the diagnostic groups were well matched overall. Our cohort was adequately powered (0.80–0.90) to detect mRNA differences (25%) due to disease. Our study suggests that multiple factors should be considered in mRNA expression studies of human brain tissues. When schizophrenia cases are adequately matched to control cases subtle differences in gene expression can be reliably detected. PMID:20073568

Dietary protein for athletes: from requirements to metabolic advantage.

PubMed

Phillips, Stuart M

2006-12-01

The Dietary Reference Intakes (DRI) specify that the requirement for dietary protein for all individuals aged 19 y and older is 0.8 g protein.kg-1.d-1. This Recommended Dietary Allowance (RDA) is cited as adequate for all persons. This amount of protein would be considered by many athletes as the amount to be consumed in a single meal, particularly for strength-training athletes. There does exist, however, published data to suggest that individuals habitually performing resistance and (or) endurance exercise require more protein than their sedentary counterparts. The RDA values for protein are clearly set at "...the level of protein judged to be adequate... to meet the known nutrient needs for practically all healthy people...". The RDA covers protein losses with margins for inter-individual variability and protein quality; the notion of consumption of excess protein above these levels to cover increased needs owing to physical activity is not, however, given any credence. Notwithstanding, diet programs (i.e., energy restriction) espousing the virtue of high protein enjoy continued popularity. A number of well-controlled studies are now published in which "higher" protein diets have been shown to be effective in promoting weight reduction, particularly fat loss. The term "higher" refers to a diet that has people consuming more than the general populations' average intake of approximately 15% of energy from protein, e.g., as much as 30%-35%, which is within an Acceptable Macronutrient Distribution Range (AMDR) as laid out in the DRIs. Of relevance to athletes and those in clinical practice is the fact that higher protein diets have quite consistently been shown to result in greater weight loss, greater fat loss, and preservation of lean mass as compared with "lower" protein diets. A framework for understanding dietary protein intake within the context of weight loss and athletic performance is laid out.

Requirements for data integration platforms in biomedical research networks: a reference model

PubMed Central

Knaup, Petra

2015-01-01

Biomedical research networks need to integrate research data among their members and with external partners. To support such data sharing activities, an adequate information technology infrastructure is necessary. To facilitate the establishment of such an infrastructure, we developed a reference model for the requirements. The reference model consists of five reference goals and 15 reference requirements. Using the Unified Modeling Language, the goals and requirements are set into relation to each other. In addition, all goals and requirements are described textually in tables. This reference model can be used by research networks as a basis for a resource efficient acquisition of their project specific requirements. Furthermore, a concrete instance of the reference model is described for a research network on liver cancer. The reference model is transferred into a requirements model of the specific network. Based on this concrete requirements model, a service-oriented information technology architecture is derived and also described in this paper. PMID:25699205

Reassessment of the Access Testosterone chemiluminescence assay and comparison with LC-MS method.

PubMed

Dittadi, Ruggero; Matteucci, Mara; Meneghetti, Elisa; Ndreu, Rudina

2018-03-01

To reassess the imprecision and Limit of Quantitation, to evaluate the cross-reaction with dehydroepiandrosterone-sulfate (DHEAS), the accuracy toward liquid chromatography-mass spectrometry (LC-MS) and the reference interval of the Access Testosterone method, performed by DxI immunoassay platform (Beckman Coulter). Imprecision was evaluated testing six pool samples assayed in 20 different run using two reagents lots. The cross-reaction with DHEAS was studied both by a displacement curve and by spiking DHEAS standard in two serum samples with known amount of testosterone. The comparison with LC-MS was evaluated by Passing-Bablock analysis in 21 routine serum samples and 19 control samples from an External Quality Assurance (EQA) scheme. The reference interval was verified by an indirect estimation on 2445 male and 2838 female outpatients. The imprecision study showed a coefficient of variation (CV) between 2.7% and 34.7% for serum pools from 16.3 and 0.27 nmol/L. The value of Limit of Quantitation at 20% CV was 0.53 nmol/L. The DHEAS showed a cross-reaction of 0.0074%. A comparison with LC-MS showed a trend toward a slight underestimation of immunoassay vs LC-MS (Passing-Bablock equations: DxI=-0.24+0.906 LCMS in serum samples and DxI=-0.299+0.981 LCMS in EQA samples). The verification of reference interval showed a 2.5th-97.5th percentile distribution of 6.6-24.3 nmol/L for male over 14 years and <0.5-2.78 nmol/L for female subjects, in accord with the reference intervals reported by the manufacturer. The Access Testosterone method could be considered an adequately reliable tool for the testosterone measurement. © 2017 Wiley Periodicals, Inc.

Assessment of criteria used by veterinary practitioners to diagnose hypothyroidism in sighthounds and investigation of serum thyroid hormone concentrations in healthy Salukis.

PubMed

Shiel, Robert E; Sist, MaryDee; Nachreiner, Raymond F; Ehrlich, Claire P; Mooney, Carmel T

2010-02-01

To assess use of serum thyroid hormone concentrations by veterinarians to diagnose hypothyroidism in sighthounds and to evaluate serum thyroid hormone concentrations in healthy Salukis. Retrospective case series and cross-sectional study. 398 sighthounds of various breeds with a diagnosis of hypothyroidism and 283 healthy Salukis. Pretreatment thyroid hormone assay results from sighthounds subsequently classified as hypothyroid by practitioners were retrieved from a laboratory database. In healthy Salukis, serum concentrations of total thyroxine (T(4)), free T(4), total triiodothyronine (T(3)), free T(3), and thyroid-stimulating hormone (TSH) and antibodies against thyroglobulin and thyroid hormones were assayed. Records indicated hypothyroidism had been diagnosed in 303 (76.1%) sight-hounds on the basis of low serum thyroid hormone concentrations alone and in 30 (7.5%) others despite all thyroid hormone indices being within reference limits. Only 65 (16.3%) dogs had a high TSH concentration or positive thyroglobulin autoantibody result to support the diagnosis. In healthy Salukis, median (reference limits) serum concentrations of total T(4), free T(4), total T(3), free T(3), and TSH were 13.0 nmol/L (2.8 to 40.0 nmol/L), 12.0 pmol/L (2.0 to 30.3 pmol/L), 1.0 nmol/L (0.4 to 2.1 nmol/L), 4.0 pmol/L (1.6 to 7.7 pmol/L), and 0.18 ng/mL (0 to 0.86 ng/mL), respectively. Diagnosis of hypothyroidism by practitioners was most often made without adequate supportive laboratory evidence. Thyroid hormone values in healthy Salukis differed markedly from standard reference limits for some, but not all, thyroid hormone indices. Breed-specific reference limits should be used when interpreting thyroid hormone profiles of sighthounds.

The role of adequate reference materials in density measurements in hemodialysis

NASA Astrophysics Data System (ADS)

Furtado, A.; Moutinho, J.; Moura, S.; Oliveira, F.; Filipe, E.

2015-02-01

In hemodialysis, oscillation-type density meters are used to measure the density of the acid component of the dialysate solutions used in the treatment of kidney patients. An incorrect density determination of this solution used in hemodialysis treatments can cause several and adverse events to patients. Therefore, despite the Fresenius Medical Care (FME) tight control of the density meters calibration results, this study shows the benefits of mimic the matrix usually measured to produce suitable reference materials for the density meter calibrations.

Statistical considerations for harmonization of the global multicenter study on reference values.

PubMed

Ichihara, Kiyoshi

2014-05-15

The global multicenter study on reference values coordinated by the Committee on Reference Intervals and Decision Limits (C-RIDL) of the IFCC was launched in December 2011, targeting 45 commonly tested analytes with the following objectives: 1) to derive reference intervals (RIs) country by country using a common protocol, and 2) to explore regionality/ethnicity of reference values by aligning test results among the countries. To achieve these objectives, it is crucial to harmonize 1) the protocol for recruitment and sampling, 2) statistical procedures for deriving the RI, and 3) test results through measurement of a panel of sera in common. For harmonized recruitment, very lenient inclusion/exclusion criteria were adopted in view of differences in interpretation of what constitutes healthiness by different cultures and investigators. This policy may require secondary exclusion of individuals according to the standard of each country at the time of deriving RIs. An iterative optimization procedure, called the latent abnormal values exclusion (LAVE) method, can be applied to automate the process of refining the choice of reference individuals. For global comparison of reference values, test results must be harmonized, based on the among-country, pair-wise linear relationships of test values for the panel. Traceability of reference values can be ensured based on values assigned indirectly to the panel through collaborative measurement of certified reference materials. The validity of the adopted strategies is discussed in this article, based on interim results obtained to date from five countries. Special considerations are made for dissociation of RIs by parametric and nonparametric methods and between-country difference in the effect of body mass index on reference values. Copyright © 2014 Elsevier B.V. All rights reserved.

Not virtual, but a real, live, online, interactive reference service.

PubMed

Jerant, Lisa Lott; Firestein, Kenneth

2003-01-01

In today's fast-paced environment, traditional medical reference services alone are not adequate to meet users' information needs. Efforts to find new ways to provide comprehensive service to users, where and when needed, have often included the use of new and developing technologies. This paper describes the experience of an academic health science library in developing and providing an online, real-time reference service. Issues discussed include selecting software, training librarians, staffing the service, and considering the future of the service. Use statistics, question type analysis, and feedback from users of the service and librarians who staff the service, are also presented.

Vegan lifestyle behaviors: an exploration of congruence with health-related beliefs and assessed health indices.

PubMed

Dyett, Patricia A; Sabaté, Joan; Haddad, Ella; Rajaram, Sujatha; Shavlik, David

2013-08-01

This study aimed to investigate health belief as a major motive for diet and lifestyle behaviors of 100 vegans in the United States; and to determine congruence with selected health and nutrition outcomes. Response data from an administered questionnaire was analyzed. Statistical analyses determined the most common factors influencing diet choice; the number of vegans practicing particular lifestyle behaviors; body mass index; and prevalence of self-reported chronic disease diagnoses. Nutrient intakes were analyzed and assessed against Dietary Reference Intakes. Health was the most reported reason for diet choice (47%). In the health belief, animal welfare, and religious/other motive categories, low percentages of chronic disease diagnoses were reported: 27%, 11%, and 15%, respectively. There were no significant differences in health behaviors and indices among vegan motive categories, except for product fat content choices. Within the entire study population, health-related vegan motive coincided with regular exercise; 71% normal BMI (mean=22.6); minimal alcohol and smoking practices; frequently consumed vegetables, nuts, and grains; healthy choices in meal types, cooking methods, and low-fat product consumption; and adequate intakes for most protective nutrients when compared to reference values. But incongruence was found with 0% intake adequacy for vitamin D; and observation of excessive sodium use. Copyright © 2013 Elsevier Ltd. All rights reserved.

Guideline for translation and national validation of the Quality of Life in Hand Eczema Questionnaire (QOLHEQ).

PubMed

Oosterhaven, Jart A F; Schuttelaar, Marie L A; Apfelbacher, Christian; Diepgen, Thomas L; Ofenloch, Robert F

2017-08-01

There is a need for well-developed and validated questionnaires to measure patient reported outcomes. The Quality of Life in Hand Eczema Questionnaire (QOLHEQ) is such a validated instrument measuring disease-specific health-related quality of life in hand eczema patients. A re-validation of measurement properties is required before an instrument is used in a new population. With the objective of arriving at a guideline for translation and national validation of the QOLHEQ, we have developed the design of a reference study on how to adequately assess measurement properties of the QOLHEQ based on interdisciplinary discussions and current standards. We present a step-by-step guideline to assess translation (including cross-cultural adaptation), scale structure, validity, reproducibility, responsiveness, and interpretability. We describe which outcomes should be reported for each measurement property, and give advice on how to calculate these. It is also specified which sample size is needed, how to deal with missing data, and which cutoff values should be applied for the measurement properties assessed during the validation process. In conclusion, this guideline, presenting a reference validation study for the QOLHEQ, creates the possibility to harmonize the national validation of the various language versions of the QOLHEQ. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Reliability of reference distances used in photogrammetry.

PubMed

Aksu, Muge; Kaya, Demet; Kocadereli, Ilken

2010-07-01

To determine the reliability of the reference distances used for photogrammetric assessment. The sample consisted of 100 subjects with mean ages of 22.97 +/- 2.98 years. Five lateral and four frontal parameters were measured directly on the subjects' faces. For photogrammetric assessment, two reference distances for the profile view and three reference distances for the frontal view were established. Standardized photographs were taken and all the parameters that had been measured directly on the face were measured on the photographs. The reliability of the reference distances was checked by comparing direct and indirect values of the parameters obtained from the subjects' faces and photographs. Repeated measure analysis of variance (ANOVA) and Bland-Altman analyses were used for statistical assessment. For profile measurements, the indirect values measured were statistically different from the direct values except for Sn-Sto in male subjects and Prn-Sn and Sn-Sto in female subjects. The indirect values of Prn-Sn and Sn-Sto were reliable in both sexes. The poorest results were obtained in the indirect values of the N-Sn parameter for female subjects and the Sn-Me parameter for male subjects according to the Sa-Sba reference distance. For frontal measurements, the indirect values were statistically different from the direct values in both sexes except for one in male subjects. The indirect values measured were not statistically different from the direct values for Go-Go. The indirect values of Ch-Ch were reliable in male subjects. The poorest results were obtained according to the P-P reference distance. For profile assessment, the T-Ex reference distance was reliable for Prn-Sn and Sn-Sto in both sexes. For frontal assessment, Ex-Ex and En-En reference distances were reliable for Ch-Ch in male subjects.

The Detection of Individual and Group Values in Young People: Relevant Methodological Solutions

ERIC Educational Resources Information Center

Geger, A. E.

2011-01-01

Life values, value orientations, social attitudes, and other corresponding social collisions have been the object of many studies. Research on the values of youth in Russia is marred by methodological problems that have not been adequately addressed, and more careful approaches show that there may not be a finite list of values that are held and…

40 CFR 761.123 - Definitions.

Code of Federal Regulations, 2010 CFR

2010-07-01

... decontamination levels set forth in this policy as constituting adequate cleanup of PCBs. (2) “Standards” refers to the numerical decontamination levels set forth in this policy. Residential/commercial areas means... designated agent (e.g., a facility manager or foreman). Soil means all vegetation, soils and other ground...

A COMPARATIVE ANALYSIS OF THE RESEARCH UTILIZATION PROCESS.

ERIC Educational Resources Information Center

LIPPITT, RONALD; AND OTHERS

A SUGGESTED MODEL FOR ADEQUATE DISSEMINATION OF RESEARCH FINDINGS CONSIDERS FOUR PRIMARY BARRIERS TO EFFECTIVE COMMUNICATION--(1) DIVISION OF PERSONNEL LABOR INTO TASK ROLES, (2) INSTITUTIONAL DISTINCTIONS, (3) DEVELOPMENT OF PROFESSIONAL REFERENCE GROUPS, AND (4) GEOGRAPHICAL DIVISIONS. SUGGESTED SOLUTIONS INCLUDE LINKING SYSTEMS AND ROLES,…

Evaluating High School Libraries: Service Is Top Priority.

ERIC Educational Resources Information Center

Baldwin, Margaret

1988-01-01

Discusses the need for ongoing evaluation within high school libraries to ensure adequate library services, which, in turn, enhance the total educational program. The evaluation of library facilities, collections, and staff is discussed, and an annotated bibliography of evaluation tools is provided. (6 references) (CLB)

34 CFR 361.37 - Information and referral programs.

Code of Federal Regulations, 2010 CFR

2010-07-01

... State agency will implement an information and referral system adequate to ensure that individuals with... receiving vocational rehabilitation services if the agency is operating on an order of selection, are... statewide workforce investment system. (b) The State unit must refer to local extended employment providers...

The Study and Measurement of Values and Attitudes.

ERIC Educational Resources Information Center

Kerlinger, Fred N.

The author defines values, attitudes, and beliefs according to their relation to referents. A referent is a construct standing for a set or category of social objects, ideas, or behaviors that is the focus of an attitude. Attitudes and values are belief systems. Beliefs are enduring cognitions about referents; beliefs reflect the value and…

Opportunities and challenges in conducting systematic reviews to support development of nutrient reference values: vitamin A as an example

USDA-ARS?s Scientific Manuscript database

Nutrient reference values have significant public health and policy implications. Given the importance of defining reliable nutrient reference values, there is a need for an explicit, objective, and transparent process to set these values. The Tufts Medical Center Evidence-based Practice Center asse...

Estimation of ultrasound reference values for the lower limb peripheral nerves in adults: A cross-sectional study.

PubMed

Bedewi, Mohamed Abdelmohsen; Abodonya, Ahmed; Kotb, Mamdouh; Kamal, Sanaa; Mahmoud, Gehan; Aldossari, Khaled; Alqabbani, Abdullah; Swify, Sherine

2018-03-01

The objective of this study is to estimate the reference values for the lower limb peripheral nerves in adults.The demographics and physical characteristics of 69 adult healthy volunteers were evaluated and recorded. The estimated reference values and their correlations with the age, weight, height, body mass index (BMI) were evaluated.The cross sectional area reference values were obtained at 5 predetermined sites for 3 important lower limb peripheral nerves. Our CSA values correlated significantly with age, weight, and BMI. The normal reference values for each nerve were as follows: Tibial nerve at the popliteal fossa 19 mm ± 6.9, tibial nerve at the level of the medial malleolus 12.7 mm ± 4.5, common peroneal nerve at the popliteal fossa 9.5 mm ± 4, common peroneal nerve fibular head 8.9 mm ± 3.2, sural nerve 3.5 mm ± 1.4.The reference values for the lower limb peripheral nerves were identified. These values could be used for future management of peripheral nerve disorders.

Clinical diagnosis of ventilator associated pneumonia revisited: comparative validation using immediate post-mortem lung biopsies

PubMed Central

Fabregas, N.; Ewig, S.; Torres, A.; El-Ebiary, M.; Ramirez, J.; de la Bellacasa, J. P.; Bauer, T.; Cabello, H.

1999-01-01

BACKGROUND—A study was undertaken to assess the diagnostic value of different clinical criteria and the impact of microbiological testing on the accuracy of clinical diagnosis of suspected ventilator associated pneumonia (VAP).
METHODS—Twenty five deceased mechanically ventilated patients were studied prospectively. Immediately after death, multiple bilateral lung biopsy specimens (16 specimens/patient) were obtained for histological examination and quantitative lung cultures. The presence of both histological pneumonia and positive lung cultures was used as a reference test.
RESULTS—The presence of infiltrates on the chest radiograph and two of three clinical criteria (leucocytosis, purulent secretions, fever) had a sensitivity of 69% and a specificity of 75%; the corresponding numbers for the clinical pulmonary infection score (CPIS) were 77% and 42%. Non-invasive as well as invasive sampling techniques had comparable values. The combination of all techniques achieved a sensitivity of 85% and a specificity of 50%, and these values remained virtually unchanged despite the presence of previous treatment with antibiotics. When microbiological results were added to clinical criteria, adequate diagnoses originating from microbiological results which might have corrected false positive and false negative clinical judgements (n = 5) were countered by a similar proportion of inadequate diagnoses (n =6).
CONCLUSIONS—Clinical criteria had reasonable diagnostic values. CPIS was not superior to conventional clinical criteria. Non-invasive and invasive sampling techniques had diagnostic values comparable to clinical criteria. An algorithm guiding antibiotic treatment exclusively by microbiological results does not increase the overall diagnostic accuracy and carries the risk of undertreatment.

 PMID:10491448

Serum proteins by capillary zone electrophoresis: approaches to the definition of reference values.

PubMed

Petrini, C; Alessio, M G; Scapellato, L; Brambilla, S; Franzini, C

1999-10-01

The Paragon CZE 2000 (Beckman Analytical, Milan, Italy) is an automatic dedicated capillary zone electrophoresis (CZE) system, producing a five-zone serum protein pattern with quantitative estimation of the zones. With the view of substituting this instrument for two previously used serum protein electrophoresis techniques, we planned to produce reference values for the "new" systems leading to compatible interpretation of the results. High resolution cellulose acetate electrophoresis with visual inspection and descriptive reporting (HR-CAE) and five-zone cellulose acetate electrophoresis with densitometry (CAE-D) were the previously used techniques. Serum samples (n = 167) giving "normal pattern" with HR-CAE were assayed with the CZE system, and the results were statistically assessed to yield 0.95 reference intervals. One thousand normal and pathological serum samples were then assayed with the CAE-D and the CZE techniques, and the regression equations of the CAE-D values over the CZE values for the five zones were used to transform the CAE-D reference limits into the CZE reference limits. The two sets of reference values thereby produced were in good agreement with each other and also with reference values previously reported for the CZE system. Thus, reference values for the CZE techniques permit interpretation of results coherent with the previously used techniques and reporting modes.

[Sensitivity, specificity and prognostic value of CEA in colorectal cancer: results of a Tunisian series and literature review].

PubMed

Bel Hadj Hmida, Y; Tahri, N; Sellami, A; Yangui, N; Jlidi, R; Beyrouti, M I; Krichen, M S; Masmoudi, H

2001-01-01

In order to determine the sensitivity of CEA in the diagnosis of colo-rectal carcinoma, we studied a series of 48 patients with colo-rectal carcinoma (1992-1996). The sensitivity was at 52% with a reference value of 5 ng/ml and 68.7% for a reference value of 2.5 ng/ml. With a reference value of 5 ng/ml, the sensitivity of CEA was at 37% only for patients with colo-rectal carcinoma at Dukes B stage, 66.6% for patients at stage C and 75% for patients at stage D. The dosage of CEA was carried out with a sandwich immunoenzymatic technique in tube. There is no statistic significant correlation between the pre-operative rate of CEA and the localisation of the tumor and its histologic type; in contrast, it was significantly correlated with the ganglionnary metastasis. A significant relationship between the pre-operative rate of CEA and the Dukes stage was found for a reference value of 10 ng/ml but not for a reference value of 5 ng/ml. We calculated the specificity of the CEA for the cancers of colon and rectum which was at 76.98% with a reference value of 5 ng/ml and 86% with a reference value of 10 ng/ml.

Health-related quality of life and emotional wellbeing improve in parents after their children have undergone epilepsy surgery - A prospective population-based study.

PubMed

Reilly, Colin; Taft, Charles; Edelvik, Anna; Olsson, Ingrid; Malmgren, Kristina

2017-10-01

The objective was to compare parental health-related quality of life (HRQoL), anxiety, and depression at baseline and 2years after epilepsy surgery in a population-based series of children and young people who underwent surgery between 1995 and 1999 and to compare with population norms. Fifty mothers and 44 fathers of 50 children and young people (age: 1-20years) completed the Medical Outcome Study 36-item Short Form Health Survey (SF-36) and Hospital Anxiety and Depression (HAD) scale at baseline and at follow-up. Changes in SF-36 and HAD scores between baseline and follow-up were compared using Wilcoxon signed rank test. Scores on the SF-36 were compared with a reference sample from the Swedish population using the Mann Whitney U test. Factors associated with changes in SF-36 and HAD scores were analyzed using regression analysis. On the SF-36, the Physical Component Summary (PCS) scores were not significantly different between baseline and follow-up for mothers (p=0.177) or fathers (p=0.054). Mental Component Summary (MCS) scores improved significantly for mothers (p=0.008) and fathers (p<0.001). Mothers' baseline scores on seven of eight SF-36 domains were significantly lower than reference values. Scores at follow-up improved on these seven domains, but on three domains (primarily mental health domains), scores remained significantly lower than reference values. Fathers' baseline scores on four of eight SF-36 domains were significantly lower than reference values, and scores at follow-up remained significantly lower on the four primarily mental health domains. The proportions of mothers and fathers classified as HAD-A and HAD-D cases decreased at follow-up but did not reach statistical significance. Child epilepsy variables were in the main not associated with parental outcomes, but a greater reduction in AEDs was associated with a greater reduction in PCS scores. Parents of young people/children with seizure-free outcome were significantly more likely to have a reduction in depression scores than parents of young people/children with continued seizures. Many aspects of HRQoL and emotional wellbeing improved at 2-year follow-up for parents after epilepsy surgery on their children. There is a need to comprehensively identify factors associated with changes in parental HRQoL and emotional wellbeing to provide adequate support. Copyright © 2017 Elsevier Inc. All rights reserved.

Barriers to Implementing Treatment Integrity Procedures: Survey of Treatment Outcome Researchers

ERIC Educational Resources Information Center

Perepletchikova, Francheska; Hilt, Lori M.; Chereji, Elizabeth; Kazdin, Alan E.

2009-01-01

Treatment integrity refers to implementing interventions as intended. Treatment integrity is critically important for experimental validity and for drawing valid inferences regarding the relationship between treatment and outcome. Yet, it is rarely adequately addressed in psychotherapy research. The authors examined barriers to treatment integrity…

ANNOTATED BIBLIOGRAPHY OF HISTORICAL CONDITIONS IN STREAMS AND RIVERS OF THE WESTERN UNITED STATES

EPA Science Inventory

Resource managers are often challenged by the lack of adequate benchmarks, or reference conditions, for assessing the biological condition of streams. Increasing human alteration of landscapes reduces the availability of minimally-disturbed stream sites that can be used to repre...

34 CFR 361.37 - Information and referral programs.

Code of Federal Regulations, 2012 CFR

2012-07-01

... State agency will implement an information and referral system adequate to ensure that individuals with... statewide workforce investment system. (b) The State unit must refer to local extended employment providers....e., employment in an integrated setting); (2) Consistent with § 361.52 of this part, provide the...

34 CFR 361.37 - Information and referral programs.

Code of Federal Regulations, 2013 CFR

2013-07-01

... State agency will implement an information and referral system adequate to ensure that individuals with... statewide workforce investment system. (b) The State unit must refer to local extended employment providers....e., employment in an integrated setting); (2) Consistent with § 361.52 of this part, provide the...

34 CFR 361.37 - Information and referral programs.

Code of Federal Regulations, 2014 CFR

2014-07-01

... State agency will implement an information and referral system adequate to ensure that individuals with... statewide workforce investment system. (b) The State unit must refer to local extended employment providers....e., employment in an integrated setting); (2) Consistent with § 361.52 of this part, provide the...

34 CFR 361.37 - Information and referral programs.

Code of Federal Regulations, 2011 CFR

2011-07-01

... State agency will implement an information and referral system adequate to ensure that individuals with... statewide workforce investment system. (b) The State unit must refer to local extended employment providers....e., employment in an integrated setting); (2) Consistent with § 361.52 of this part, provide the...

75 FR 5351 - Proposed Revisions to Accounting Guide for LSC Recipients

Federal Register 2010, 2011, 2012, 2013, 2014

2010-02-02

... elements of an adequate accounting and financial reporting system, including the use of specific internal... checklist of accounting procedures and internal controls. The proposed revisions update the checklist to... accounting procedures and internal controls to reflect current best practices; (7) updated and new references...

78 FR 46274 - Pyroxasulfone; Pesticide Tolerances

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-31

... following a 4-week dermal exposure producing local inflammation and systemic effects of minimal to mild...- linear approach (i.e., Reference dose (RfD)) will adequately account for all chronic toxicity, including... and other relevant data. Cancer risk is quantified using a linear or nonlinear approach. If sufficient...

Sequencing and Validation of Reference Genes to Analyze Endogenous Gene Expression and Quantify Yellow Dwarf Viruses Using RT-qPCR in Viruliferous Rhopalosiphum padi

PubMed Central

Wu, Keke; Liu, Wenwen; Mar, Thithi; Liu, Yan; Wu, Yunfeng; Wang, Xifeng

2014-01-01

The bird cherry-oat aphid (Rhopalosiphum padi), an important pest of cereal crops, not only directly sucks sap from plants, but also transmits a number of plant viruses, collectively the yellow dwarf viruses (YDVs). For quantifying changes in gene expression in vector aphids, reverse transcription-quantitative polymerase chain reaction (RT-qPCR) is a touchstone method, but the selection and validation of housekeeping genes (HKGs) as reference genes to normalize the expression level of endogenous genes of the vector and for exogenous genes of the virus in the aphids is critical to obtaining valid results. Such an assessment has not been done, however, for R. padi and YDVs. Here, we tested three algorithms (GeNorm, NormFinder and BestKeeper) to assess the suitability of candidate reference genes (EF-1α, ACT1, GAPDH, 18S rRNA) in 6 combinations of YDV and vector aphid morph. EF-1α and ACT1 together or in combination with GAPDH or with GAPDH and 18S rRNA could confidently be used to normalize virus titre and expression levels of endogenous genes in winged or wingless R. padi infected with Barley yellow dwarf virus isolates (BYDV)-PAV and BYDV-GAV. The use of only one reference gene, whether the most stably expressed (EF-1α) or the least stably expressed (18S rRNA), was not adequate for obtaining valid relative expression data from the RT-qPCR. Because of discrepancies among values for changes in relative expression obtained using 3 regions of the same gene, different regions of an endogenous aphid gene, including each terminus and the middle, should be analyzed at the same time with RT-qPCR. Our results highlight the necessity of choosing the best reference genes to obtain valid experimental data and provide several HKGs for relative quantification of virus titre in YDV-viruliferous aphids. PMID:24810421

Reference Value Advisor: a new freeware set of macroinstructions to calculate reference intervals with Microsoft Excel.

PubMed

Geffré, Anne; Concordet, Didier; Braun, Jean-Pierre; Trumel, Catherine

2011-03-01

International recommendations for determination of reference intervals have been recently updated, especially for small reference sample groups, and use of the robust method and Box-Cox transformation is now recommended. Unfortunately, these methods are not included in most software programs used for data analysis by clinical laboratories. We have created a set of macroinstructions, named Reference Value Advisor, for use in Microsoft Excel to calculate reference limits applying different methods. For any series of data, Reference Value Advisor calculates reference limits (with 90% confidence intervals [CI]) using a nonparametric method when n≥40 and by parametric and robust methods from native and Box-Cox transformed values; tests normality of distributions using the Anderson-Darling test and outliers using Tukey and Dixon-Reed tests; displays the distribution of values in dot plots and histograms and constructs Q-Q plots for visual inspection of normality; and provides minimal guidelines in the form of comments based on international recommendations. The critical steps in determination of reference intervals are correct selection of as many reference individuals as possible and analysis of specimens in controlled preanalytical and analytical conditions. Computing tools cannot compensate for flaws in selection and size of the reference sample group and handling and analysis of samples. However, if those steps are performed properly, Reference Value Advisor, available as freeware at http://www.biostat.envt.fr/spip/spip.php?article63, permits rapid assessment and comparison of results calculated using different methods, including currently unavailable methods. This allows for selection of the most appropriate method, especially as the program provides the CI of limits. It should be useful in veterinary clinical pathology when only small reference sample groups are available. ©2011 American Society for Veterinary Clinical Pathology.

Selection and Validation of Reference Genes for Accurate RT-qPCR Data Normalization in Coffea spp. under a Climate Changes Context of Interacting Elevated [CO2] and Temperature

PubMed Central

Martins, Madlles Q.; Fortunato, Ana S.; Rodrigues, Weverton P.; Partelli, Fábio L.; Campostrini, Eliemar; Lidon, Fernando C.; DaMatta, Fábio M.; Ramalho, José C.; Ribeiro-Barros, Ana I.

2017-01-01

World coffee production has faced increasing challenges associated with ongoing climatic changes. Several studies, which have been almost exclusively based on temperature increase, have predicted extensive reductions (higher than half by 2,050) of actual coffee cropped areas. However, recent studies showed that elevated [CO2] can strongly mitigate the negative impacts of heat stress at the physiological and biochemical levels in coffee leaves. In addition, it has also been shown that coffee genotypes can successfully cope with temperatures above what has been traditionally accepted. Altogether, this information suggests that the real impact of climate changes on coffee growth and production could be significantly lower than previously estimated. Gene expression studies are an important tool to unravel crop acclimation ability, demanding the use of adequate reference genes. We have examined the transcript stability of 10 candidate reference genes to normalize RT-qPCR expression studies using a set of 24 cDNAs from leaves of three coffee genotypes (CL153, Icatu, and IPR108), grown under 380 or 700 μL CO2 L−1, and submitted to increasing temperatures from 25/20°C (day/night) to 42/34°C. Samples were analyzed according to genotype, [CO2], temperature, multiple stress interaction ([CO2], temperature) and total stress interaction (genotype, [CO2], and temperature). The transcript stability of each gene was assessed through a multiple analytical approach combining the Coeficient of Variation method and three algorithms (geNorm, BestKeeper, NormFinder). The transcript stability varied according to the type of stress for most genes, but the consensus ranking obtained with RefFinder, classified MDH as the gene with the highest mRNA stability to a global use, followed by ACT and S15, whereas α-TUB and CYCL showed the least stable mRNA contents. Using the coffee expression profiles of the gene encoding the large-subunit of ribulose-1,5-bisphosphate carboxylase/oxygenase (RLS), results from the in silico aggregation and experimental validation of the best number of reference genes showed that two reference genes are adequate to normalize RT-qPCR data. Altogether, this work highlights the importance of an adequate selection of reference genes for each single or combined experimental condition and constitutes the basis to accurately study molecular responses of Coffea spp. in a context of climate changes and global warming. PMID:28326094

Selection and Validation of Reference Genes for Accurate RT-qPCR Data Normalization in Coffea spp. under a Climate Changes Context of Interacting Elevated [CO2] and Temperature.

PubMed

Martins, Madlles Q; Fortunato, Ana S; Rodrigues, Weverton P; Partelli, Fábio L; Campostrini, Eliemar; Lidon, Fernando C; DaMatta, Fábio M; Ramalho, José C; Ribeiro-Barros, Ana I

2017-01-01

World coffee production has faced increasing challenges associated with ongoing climatic changes. Several studies, which have been almost exclusively based on temperature increase, have predicted extensive reductions (higher than half by 2,050) of actual coffee cropped areas. However, recent studies showed that elevated [CO 2 ] can strongly mitigate the negative impacts of heat stress at the physiological and biochemical levels in coffee leaves. In addition, it has also been shown that coffee genotypes can successfully cope with temperatures above what has been traditionally accepted. Altogether, this information suggests that the real impact of climate changes on coffee growth and production could be significantly lower than previously estimated. Gene expression studies are an important tool to unravel crop acclimation ability, demanding the use of adequate reference genes. We have examined the transcript stability of 10 candidate reference genes to normalize RT-qPCR expression studies using a set of 24 cDNAs from leaves of three coffee genotypes (CL153, Icatu, and IPR108), grown under 380 or 700 μL CO 2 L -1 , and submitted to increasing temperatures from 25/20°C (day/night) to 42/34°C. Samples were analyzed according to genotype, [CO 2 ], temperature, multiple stress interaction ([CO 2 ], temperature) and total stress interaction (genotype, [CO 2 ], and temperature). The transcript stability of each gene was assessed through a multiple analytical approach combining the Coeficient of Variation method and three algorithms (geNorm, BestKeeper, NormFinder). The transcript stability varied according to the type of stress for most genes, but the consensus ranking obtained with RefFinder, classified MDH as the gene with the highest mRNA stability to a global use, followed by ACT and S15 , whereas α -TUB and CYCL showed the least stable mRNA contents. Using the coffee expression profiles of the gene encoding the large-subunit of ribulose-1,5-bisphosphate carboxylase/oxygenase ( RLS ), results from the in silico aggregation and experimental validation of the best number of reference genes showed that two reference genes are adequate to normalize RT-qPCR data. Altogether, this work highlights the importance of an adequate selection of reference genes for each single or combined experimental condition and constitutes the basis to accurately study molecular responses of Coffea spp. in a context of climate changes and global warming.

Focus on prevention, diagnosis and treatment of hypertension in children and adolescents

PubMed Central

2013-01-01

The European Society of Hypertension has recently published its recommendations on prevention, diagnosis and treatment of high blood pressure in children and adolescents. Taking this contribution as a starting point the Study Group of Hypertension of the Italian Society of Pediatrics together with the Italian Society of Hypertension has conducted a reappraisal of the most recent literature on this subject. The present review does not claim to be an exhaustive description of hypertension in the pediatric population but intends to provide Pediatricians with practical and updated indications in order to guide them in this often unappreciated problem. This document pays particular attention to the primary hypertension which represents a growing problem in children and adolescents. Subjects at elevated risk of hypertension are those overweight, with low birth weight and presenting a family history of hypertension. However, also children who do not present these risk factors may have elevated blood pressure levels. In pediatric age diagnosis of hypertension or high normal blood pressure is made with repeated office blood pressure measurements that show values exceeding the reference values. Blood pressure should be monitored at least once a year with adequate methods and instrumentation and the observed values have to be interpreted according to the most updated nomograms that are adjusted for children’s gender, age and height. Currently other available methods such as ambulatory blood pressure monitoring and home blood pressure measurement are not yet adequately validated for use as diagnostic instruments. To diagnose primary hypertension it is necessary to exclude secondary forms. The probability of facing a secondary form of hypertension is inversely proportional to the child’s age and directly proportional to blood pressure levels. Medical history, clinical data and blood tests may guide the differential diagnosis of primary versus secondary forms. The prevention of high blood pressure is based on correct lifestyle and nutrition, starting from childhood age. The treatment of primary hypertension in children is almost exclusively dietary/behavioral and includes: a) reduction of overweight whenever present b) reduction of dietary sodium intake c) increase in physical activity. Pharmacological therapy will be needed rarely and only in specific cases. PMID:23510329

Measurement of susceptibility artifacts with histogram-based reference value on magnetic resonance images according to standard ASTM F2119.

PubMed

Heinrich, Andreas; Teichgräber, Ulf K; Güttler, Felix V

2015-12-01

The standard ASTM F2119 describes a test method for measuring the size of a susceptibility artifact based on the example of a passive implant. A pixel in an image is considered to be a part of an image artifact if the intensity is changed by at least 30% in the presence of a test object, compared to a reference image in which the test object is absent (reference value). The aim of this paper is to simplify and accelerate the test method using a histogram-based reference value. Four test objects were scanned parallel and perpendicular to the main magnetic field, and the largest susceptibility artifacts were measured using two methods of reference value determination (reference image-based and histogram-based reference value). The results between both methods were compared using the Mann-Whitney U-test. The difference between both reference values was 42.35 ± 23.66. The difference of artifact size was 0.64 ± 0.69 mm. The artifact sizes of both methods did not show significant differences; the p-value of the Mann-Whitney U-test was between 0.710 and 0.521. A standard-conform method for a rapid, objective, and reproducible evaluation of susceptibility artifacts could be implemented. The result of the histogram-based method does not significantly differ from the ASTM-conform method.

Tracer Kinetic Analysis of (S)-¹⁸F-THK5117 as a PET Tracer for Assessing Tau Pathology.

PubMed

Jonasson, My; Wall, Anders; Chiotis, Konstantinos; Saint-Aubert, Laure; Wilking, Helena; Sprycha, Margareta; Borg, Beatrice; Thibblin, Alf; Eriksson, Jonas; Sörensen, Jens; Antoni, Gunnar; Nordberg, Agneta; Lubberink, Mark

2016-04-01

Because a correlation between tau pathology and the clinical symptoms of Alzheimer disease (AD) has been hypothesized, there is increasing interest in developing PET tracers that bind specifically to tau protein. The aim of this study was to evaluate tracer kinetic models for quantitative analysis and generation of parametric images for the novel tau ligand (S)-(18)F-THK5117. Nine subjects (5 with AD, 4 with mild cognitive impairment) received a 90-min dynamic (S)-(18)F-THK5117 PET scan. Arterial blood was sampled for measurement of blood radioactivity and metabolite analysis. Volume-of-interest (VOI)-based analysis was performed using plasma-input models; single-tissue and 2-tissue (2TCM) compartment models and plasma-input Logan and reference tissue models; and simplified reference tissue model (SRTM), reference Logan, and SUV ratio (SUVr). Cerebellum gray matter was used as the reference region. Voxel-level analysis was performed using basis function implementations of SRTM, reference Logan, and SUVr. Regionally averaged voxel values were compared with VOI-based values from the optimal reference tissue model, and simulations were made to assess accuracy and precision. In addition to 90 min, initial 40- and 60-min data were analyzed. Plasma-input Logan distribution volume ratio (DVR)-1 values agreed well with 2TCM DVR-1 values (R(2)= 0.99, slope = 0.96). SRTM binding potential (BP(ND)) and reference Logan DVR-1 values were highly correlated with plasma-input Logan DVR-1 (R(2)= 1.00, slope ≈ 1.00) whereas SUVr(70-90)-1 values correlated less well and overestimated binding. Agreement between parametric methods and SRTM was best for reference Logan (R(2)= 0.99, slope = 1.03). SUVr(70-90)-1 values were almost 3 times higher than BP(ND) values in white matter and 1.5 times higher in gray matter. Simulations showed poorer accuracy and precision for SUVr(70-90)-1 values than for the other reference methods. SRTM BP(ND) and reference Logan DVR-1 values were not affected by a shorter scan duration of 60 min. SRTM BP(ND) and reference Logan DVR-1 values were highly correlated with plasma-input Logan DVR-1 values. VOI-based data analyses indicated robust results for scan durations of 60 min. Reference Logan generated quantitative (S)-(18)F-THK5117 DVR-1 parametric images with the greatest accuracy and precision and with a much lower white-matter signal than seen with SUVr(70-90)-1 images. © 2016 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

Reference Materials: Significance, General Requirements, and Demand.

PubMed

Kiełbasa, Anna; Gadzała-Kopciuch, Renata; Buszewski, Bogusław

2016-05-03

Reference materials play an important part in the quality control of measurements. Rapid development of such new scientific disciplines as proteomics, metabolomics, and genomics also necessitates development of new reference materials. This is a great challenge due to the complexity of the production of new reference materials and difficulties associated with achieving their homogeneity and stability. CRMs of tissue are of particular importance. They can be counted among the matrices that are most complex and time consuming in preparation. Tissue is the place of transformation and accumulation of many substances (e.g., metabolites, which are intermediate or end products resulting from metabolic processes). Trace amounts of many substances in tissues must be determined with adequate precision and accuracy. To meet the needs stemming from research and from problems and challenges faced by chemists, analysts, and toxicologists, the number of certified reference materials should be continuously increased.

Using the Gamma-Poisson Model to Predict Library Circulations.

ERIC Educational Resources Information Center

Burrell, Quentin L.

1990-01-01

Argues that the gamma mixture of Poisson processes, for all its perceived defects, can be used to make predictions regarding future library book circulations of a quality adequate for general management requirements. The use of the model is extensively illustrated with data from two academic libraries. (Nine references) (CLB)

Object Language and the Language Subject: On the Mediating Role of Applied Linguistics.

ERIC Educational Resources Information Center

Widdowson, Henry G.

2000-01-01

Examines the extent to which linguistic descriptions can adequately account for their reality for learners and provide a reference point for the design of language courses. Special concern is focused on second language learners as a particular kind of language user. (Author/VWL)

Regional Coordination: A Point of View.

ERIC Educational Resources Information Center

Faibisoff, Sylvia G.

To more adequately provide for newly perceived user needs, New York State libraries have adopted the philosophy of regionalism through which public, academic, and special libraries can cooperate and share resources. The state's 22 public library systems and 9 3R regions (Reference and Research Library Resources Councils) are organized…

School Finance Adequacy: What Is It and How Do We Measure It?

ERIC Educational Resources Information Center

Picus, Lawrence O.

2001-01-01

Discusses legal definition of school-finance "adequacy" and four methods for determining the cost of an adequate system: Cost function, observational methods, professional judgment, and costs of a comprehensive school design. Draws implications for school districts' resource-allocation decisions based on adequacy. (Contains 21 references.) (PKP)

Journals with Borders, Journals without Borders: Under-Representation of Asian Countries in Educational Research Journals

ERIC Educational Resources Information Center

Atkinson, Roger

2013-01-01

As "Australasian Journal of Educational Technology" (AJET) Production Editor, the author evaluates whether AJET is providing a fair and adequate representation for researchers in Asian countries, with particular reference to AJET's aspiration to be "a front ranked international journal with an Australasian character" (Atkinson…

7 CFR 1709.108 - Supporting data for determining community eligibility.

Code of Federal Regulations, 2013 CFR

2013-01-01

... UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE ASSISTANCE TO HIGH ENERGY COST COMMUNITIES RUS High Energy Cost... include the following: (a) Documentation of energy costs. Documents or references to published or other... eligibility, or where such information is unavailable or does not adequately reflect the actual cost of...

7 CFR 1709.108 - Supporting data for determining community eligibility.

Code of Federal Regulations, 2011 CFR

2011-01-01

... UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE ASSISTANCE TO HIGH ENERGY COST COMMUNITIES RUS High Energy Cost... include the following: (a) Documentation of energy costs. Documents or references to published or other... eligibility, or where such information is unavailable or does not adequately reflect the actual cost of...

7 CFR 1709.108 - Supporting data for determining community eligibility.

Code of Federal Regulations, 2012 CFR

2012-01-01

... UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE ASSISTANCE TO HIGH ENERGY COST COMMUNITIES RUS High Energy Cost... include the following: (a) Documentation of energy costs. Documents or references to published or other... eligibility, or where such information is unavailable or does not adequately reflect the actual cost of...

7 CFR 1709.108 - Supporting data for determining community eligibility.

Code of Federal Regulations, 2014 CFR

2014-01-01

... UTILITIES SERVICE, DEPARTMENT OF AGRICULTURE ASSISTANCE TO HIGH ENERGY COST COMMUNITIES RUS High Energy Cost... include the following: (a) Documentation of energy costs. Documents or references to published or other... eligibility, or where such information is unavailable or does not adequately reflect the actual cost of...

To amend the Federal Power Act to provide additional authorities to adequately protect the critical electric infrastructure against cyber attack, and for other purposes.

THOMAS, 111th Congress

Rep. Thompson, Bennie G. [D-MS-2

2009-04-30

House - 05/26/2009 Referred to the Subcommittee on Emerging Threats, Cybersecurity, and Science and Technology. (All Actions) Tracker: This bill has the status IntroducedHere are the steps for Status of Legislation:

Passive PE Sampling in Support of In Situ Remediation of Contaminated Sediments: Standard Operating Procedure for PED Deployment

DTIC Science & Technology

2012-12-01

mineral and organic materials situated beneath an aqueous layer. PEDs assembled, installed, and retrieved following these procedures will be suitable...at a minimum, wearing adequate protective equipment, flotation devices, and making use of lifelines. 8.0 References Massachusetts Institute of

Emotional and Behavioral Problems Reported in Child Welfare over 3 Years

ERIC Educational Resources Information Center

McCrae, Julie S.

2009-01-01

Child welfare agencies are required to provide services that ensure that children receive adequate mental health care. This study provides a comprehensive view of the emotional and behavioral problems of children who are referred to child welfare services, using nationally representative data. Bivariate analyses compare rates by child…

26 CFR 1.6662-4 - Substantial understatement of income tax.

Code of Federal Regulations, 2010 CFR

2010-04-01

...; General Explanations of tax legislation prepared by the Joint Committee on Taxation (the Blue Book... properly substantiated, or the taxpayer failed to keep adequate books and records with respect to the item... an understatement. (iv) Cross-reference. See § 1.6664-4(f) for certain rules regarding the...

A Brief Measure of Children's Behavior Problems: The Behavior Rating Index for Children.

ERIC Educational Resources Information Center

Stiffman, Arlene R.; And Others

1984-01-01

Describes the development of the Behavior Rating Index for Children (BRIC), a 13-item summated category partition scale that provides a prothetic measure of children's behavior problems. Evaluation of the BRIC with 600 referred and nonreferred children suggested adequate reliability and validity. (JAC)

Fostering Enterprise Architecture Education and Training with the Enterprise Architecture Competence Framework

ERIC Educational Resources Information Center

Tambouris, Efthimios; Zotou, Maria; Kalampokis, Evangelos; Tarabanis, Konstantinos

2012-01-01

Enterprise architecture (EA) implementation refers to a set of activities ultimately aiming to align business objectives with information technology infrastructure in an organization. EA implementation is a multidisciplinary, complicated and endless process, hence, calls for adequate education and training programs that will build highly skilled…

Quality Management and Calibration

NASA Astrophysics Data System (ADS)

Merkus, Henk G.

Good specification of a product’s performance requires adequate characterization of relevant properties. Particulate products are usually characterized by some PSD, shape or porosity parameter(s). For proper characterization, adequate sampling, dispersion, and measurement procedures should be available or developed and skilful personnel should use appropriate, well-calibrated/qualified equipment. The characterization should be executed, in agreement with customers, in a wellorganized laboratory. All related aspects should be laid down in a quality handbook. The laboratory should provide proof for its capability to perform the characterization of stated products and/or reference materials within stated confidence limits. This can be done either by internal validation and audits or by external GLP accreditation.

Systematic review to support the development of nutrient reference intake values: challenges and solutions

USDA-ARS?s Scientific Manuscript database

Workshops sponsored by the Institute of Medicine (IOM) and the World Health Organization (WHO) suggested that incorporating systematic reviews into the process of updating nutrient reference values would enhance the transparency of the process. The IOM issues the Dietary Reference Intake values (DR...

Iodine intake in human nutrition: a systematic literature review

PubMed Central

Gunnarsdottir, Ingibjörg; Dahl, Lisbeth

2012-01-01

The present literature review is a part of the NNR5 project with the aim of reviewing and updating the scientific basis of the 4th edition of the Nordic Nutrition Recommendations (NNR) issued in 2004. The main objective of the review is to assess the influence of different intakes of iodine at different life stages (infants, children, adolescents, adults, elderly, and during pregnancy and lactation) in order to estimate the requirement for adequate growth, development, and maintenance of health. The literature search resulted in 1,504 abstracts. Out of those, 168 papers were identified as potentially relevant. Full paper selection resulted in 40 papers that were quality assessed (A, B, or C). The grade of evidence was classified as convincing, probable, suggestive, and no conclusion. We found suggestive evidence for improved maternal iodine status and thyroid function by iodine supplementation during pregnancy. Suggestive evidence was found for the relationship between improved thyroid function (used as an indicator of iodine status) during pregnancy and cognitive function in the offspring up to 18 months of age. Moderately to severely iodine-deficient children will probably benefit from iodine supplementation or improved iodine status in order to improve their cognitive function, while only one study showed improved cognitive function following iodine supplementation in children from a mildly iodine-deficient area (no conclusion). No conclusions can be drawn related to other outcomes included in our review. There are no new data supporting changes in dietary reference values for children or adults. The rationale for increasing the dietary reference values for pregnant and lactating women in the NNR5 needs to be discussed in a broader perspective, taking iodine status of pregnant women in the Nordic countries into account. PMID:23060737

Factors associated with false positives in MDQ screening for bipolar disorder: Insight into the construct validity of the scale.

PubMed

Paterniti, Sabrina; Bisserbe, Jean-Claude

2018-05-29

Identifying bipolar patients in the first phases of the illness is essential to establish adequate treatment. The goal of this study was to examine the discriminant ability of the Mood Disorders Questionnaire (MDQ) in recognizing bipolar patients referred to a tertiary care structure. Between 2006 and 2012, we assessed 843 individuals referred to the Mood Disorders Program by family physicians in the community. The Structured Clinical Interview for DSM-IV-TR (SCID) was used to assess diagnoses. A nurse collected the information about lifetime symptoms of (hypo)mania in 759 individuals using the MDQ. Univariate chi-square test and logistic regression were used for the statistical analysis. Overall, 86% of the sample had a current anxiety or depressive disorder. When compared to the diagnoses formulated through the SCID, the sensitivity of the MDQ was 75.0%, the specificity was 74%, the positive predictive value was 55%, and the negative predictive value was 88%. Among non-bipolar patients, current post-traumatic stress disorder, borderline personality disorder, current or early remission substance use disorder, and the history of childhood abuse were independently associated with false positive screening using the MDQ. Individuals with current substance use disorders were under-represented, whether or not the patients were aware of their diagnosis of bipolar disorder was not recorded, and the history of childhood abuse was collected based on an open interview. The self-rated measure of the symptoms listed by the MDQ seems to measure a dimension shared by both bipolar disorder and other conditions characterized by affective instability and impulsivity. Copyright © 2018 Elsevier B.V. All rights reserved.

Acute contact toxicity test of insecticides (Cipermetrina 25, Lorsban 48E, Thionex 35) on honeybees in the southwestern zone of Uruguay.

PubMed

Carrasco-Letelier, Leonidas; Mendoza-Spina, Yamandú; Branchiccela, María Belén

2012-07-01

Glyphosate-resistant soybean cultivation is expanding rapidly in Uruguay, with its land area having increased by 95 times during the past 10 years. Because of the region's Neotropical conditions, insecticide use is required to ensure adequate soybean productivity. However, in areas shared by soybean crops and beekeepers - such as the southwestern zone of Uruguay (SWZU) - the use of insecticides can increase the risks of honeybee death and honey contamination. Uruguayan commercial and legal guidelines set out practices and field doses designed to prevent acute intoxication with insecticides. However, honeybees in the SWZU are predominantly a polyhybrid subspecies different from that used to set international reference values, and hence they may have a different acute toxicity response, thus rendering such precautions ineffective. The aim of this work was to assess the acute toxicity response of polyhybrid honeybees in the SWZU to cypermethrin (commercial formulation: Cipermetrina 25 Agrin®), chlorpyrifos (commercial formulation: Lorsban 48E®), and endosulfan (commercial formulation: Thionex 35®). Acute toxicity bioassays were conducted to determine the median lethal dose (LD(50)) of each insecticide for the honeybees. The results indicate that, compared with EU reference values, SWZU honeybees have a higher toxicological sensitivity to chlorpyrifos and endosulfan, and a lower toxicological sensitivity to cypermethrin, based on the commercial formulations tested. However, when these results were adjusted according to their field dose equivalents, only chlorpyrifos emerged as a potential problem for beekeeping, as the maximum recommended field dose of Lorsban 48E® for soybean crops in Uruguay is 23 times the corresponding LD(50) for honeybees in the SWZU. Copyright © 2012 Elsevier Ltd. All rights reserved.

Iodine status and thyroid function among Spanish schoolchildren aged 6-7 years: the Tirokid study.

PubMed

Vila, L; Donnay, S; Arena, J; Arrizabalaga, J J; Pineda, J; Garcia-Fuentes, E; García-Rey, C; Marín, J L; Serra-Prat, M; Velasco, I; López-Guzmán, A; Luengo, L M; Villar, A; Muñoz, Z; Bandrés, O; Guerrero, E; Muñoz, J A; Moll, G; Vich, F; Menéndez, E; Riestra, M; Torres, Y; Beato-Víbora, P; Aguirre, M; Santiago, P; Aranda, J; Gutiérrez-Repiso, C

2016-05-01

I deficiency is still a worldwide public health problem, with children being especially vulnerable. No nationwide study had been conducted to assess the I status of Spanish children, and thus an observational, multicentre and cross-sectional study was conducted in Spain to assess the I status and thyroid function in schoolchildren aged 6-7 years. The median urinary I (UI) and thyroid-stimulating hormone (TSH) levels in whole blood were used to assess the I status and thyroid function, respectively. A FFQ was used to determine the consumption of I-rich foods. A total of 1981 schoolchildren (52 % male) were included. The median UI was 173 μg/l, and 17·9 % of children showed UI<100 μg/l. The median UI was higher in males (180·8 v. 153·6 μg/l; P<0·001). Iodised salt (IS) intake at home was 69·8 %. IS consumption and intakes of ≥2 glasses of milk or 1 cup of yogurt/d were associated with significantly higher median UI. Median TSH was 0·90 mU/l and was higher in females (0·98 v. 0·83; P<0·001). In total, 0·5 % of children had known hypothyroidism (derived from the questionnaire) and 7·6 % had TSH levels above reference values. Median TSH was higher in schoolchildren with family history of hypothyroidism. I intake was adequate in Spanish schoolchildren. However, no correlation was found between TSH and median UI in any geographical area. The prevalence of TSH above reference values was high and its association with thyroid autoimmunity should be determined. Further assessment of thyroid autoimmunity in Spanish schoolchildren is desirable.

Estimation of the global burden of mesothelioma deaths from incomplete national mortality data.

PubMed

Odgerel, Chimed-Ochir; Takahashi, Ken; Sorahan, Tom; Driscoll, Tim; Fitzmaurice, Christina; Yoko-O, Makoto; Sawanyawisuth, Kittisak; Furuya, Sugio; Tanaka, Fumihiro; Horie, Seichi; Zandwijk, Nico van; Takala, Jukka

2017-12-01

Mesothelioma is increasingly recognised as a global health issue and the assessment of its global burden is warranted. To descriptively analyse national mortality data and to use reported and estimated data to calculate the global burden of mesothelioma deaths. For the study period of 1994 to 2014, we grouped 230 countries into 59 countries with quality mesothelioma mortality data suitable to be used for reference rates, 45 countries with poor quality data and 126 countries with no data, based on the availability of data in the WHO Mortality Database. To estimate global deaths, we extrapolated the gender-specific and age-specific mortality rates of the countries with quality data to all other countries. The global numbers and rates of mesothelioma deaths have increased over time. The 59 countries with quality data recorded 15 011 mesothelioma deaths per year over the 3 most recent years with available data (equivalent to 9.9 deaths per million per year). From these reference data, we extrapolated the global mesothelioma deaths to be 38 400 per year, based on extrapolations for asbestos use. Although the validity of our extrapolation method depends on the adequate identification of quality mesothelioma data and appropriate adjustment for other variables, our estimates can be updated, refined and verified because they are based on commonly accessible data and are derived using a straightforward algorithm. Our estimates are within the range of previously reported values but higher than the most recently reported values. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Diagnostic value of alarm symptoms for upper GI malignancy in patients referred to GI clinic: A 7 years cross sectional study.

PubMed

Emami, Mohammad Hasan; Ataie-Khorasgani, Masoud; Jafari-Pozve, Nasim

2017-01-01

Early upper gastrointestinal (UGI) cancer detection had led to organ-preserving endoscopic therapy. Endoscopy is a suitable method of early diagnosis of UGI malignancies. In Iran, exclusion of malignancy is the most important indication for endoscopy. This study is designed to see whether using alarm symptoms can predict the risk of cancer in patients. A total of 3414 patients referred to a tertiary gastrointestinal (GI) clinic in Isfahan, Iran, from 2009 to 2016 with dyspepsia, gastroesophageal reflux disease (GERD), and alarm symptoms, such as weight loss, dysphagia, GI bleeding, vomiting, positive familial history for cancer, and anorexia. Each patient had been underwent UGI endoscopy and patient data, including histology results, had been collected in the computer. We used logistic regression models to estimate the diagnostic accuracy of each alarm symptoms. A total of 3414 patients with alarm symptoms entered in this study, of whom 72 (2.1%) had an UGI malignancy. According to the logistic regression model, dysphagia ( P < 0.001) and weight loss ( P < 0.001) were found to be significant positive predictive factors for malignancy. Furthermore, males were in a significantly higher risk of developing UGI malignancy. Through receiver operating characteristic curve and the area under the curve (AUC) with adequate overall calibration and model fit measures, dysphagia and weight loss as a related cancer predictor had a high diagnostic accuracy (accuracy = 0. 72, AUC = 0. 881). Using a combination of age, alarm symptoms will lead to high positive predictive value for cancer. We recommend to do an early endoscopy for any patient with UGI symptoms and to take multiple biopsies from any rudeness or suspicious lesion, especially for male gender older than 50, dysphagia, or weight loss.

Beverage Consumption Habits among the European Population: Association with Total Water and Energy Intakes

PubMed Central

Nissensohn, Mariela; Sánchez-Villegas, Almudena; Galan, Pilar; Turrini, Aida; Arnault, Nathalie; Mistura, Lorenza; Ortiz-Andrellucchi, Adriana; Szabo de Edelenyi, Fabien; D’Addezio, Laura; Serra-Majem, Lluis

2017-01-01

Background: Fluid and water intake have received limited attention in epidemiological studies. The aim of this study was to compare the average daily consumption of foods and beverages in adults of selective samples of the European Union (EU) population in order to understand the contribution of these to the total water intake (TWI), evaluate if the EU adult population consumes adequate amounts of total water (TW) according to the current guidelines, and to illustrate the real water intake in Europe. Methods: Three national European dietary surveys have been selected: Spain used the Anthropometry, Intake, and Energy Balance Study (ANIBES) population database, Italy analyzed data from the Italian National Food Consumption Survey (INRAN-SCAI 2005-06), and French data came from the NutriNet-Santé database. Mean daily consumption was used to compare between individuals. TWI was compared with European Food Safety Authority (EFSA) reference values for adult men and women. Results: On average, in Spain, TWI was 1.7 L (SE 22.9) for men and 1.6 L (SE 19.4) for women; Italy recorded 1.7 L (SE 16.9) for men and 1.7 L (SE 14.1) for women; and France recorded 2.3 L (SE 4.7) for men and 2.1 L (SE 2.4) for women. With the exception of women in France, neither men nor women consumed sufficient amounts of water according to EFSA reference values. Conclusions: This study highlights the need to formulate appropriate health and nutrition policies to increase TWI in the EU population. The future of beverage intake assessment requires the use of new instruments, techniques, and the application of the new available technologies. PMID:28406441

Toxicity reference values for protecting aquatic birds in China from the effects of polychlorinated biphenyls.

PubMed

Su, Hailei; Wu, Fengchang; Zhang, Ruiqing; Zhao, Xiaoli; Mu, Yunsong; Feng, Chenglian; Giesy, John P

2014-01-01

PCBs are typical of persistent, bioaccumulative and toxic compounds (PBTs) that are widely distributed in the environment and can biomagnify through aquatic food webs, because of their stability and lipophilic properties. Fish-eating birds are top predators in the aquatic food chain and may suffer adverse effects from exposure to PCB concentrations. In this review, we address the toxicity of PCBs to birds and have derived tissue residue guidelines (TRGs) and toxic reference values (TRVs) for PCBs for protecting birds in China. In deriving these protective indices, we utilized available data and three approaches, to wit: species sensitivity distribution (SSD), critical study approach (CSA) and toxicity percentile rank method (TPRM). The TRGs and TRVs arrived at by using these methods were 42.3, I 0. 7, 4.3 pg TEQs/g diet wm and 16.7, 15.5, and 5.5 pg TEQs/g tissue wm for the CSA SSD and TPRM approaches, respectively. These criteria values were analyzed and compared with those derived by others. The following TRG and TRY, derived by SSD, were recommended as avian criteria for protecting avian species in China: 10.7 pg TEQs/g diet wm and 15.5 pg TEQs/g tissue wm, respectively. The hazard of PCBs to birds was assessed by comparing the TRVs and TRGs derived in this study with actual PCB concentrations detected in birds or fish. The criteria values derived in this study can be used to evaluate the risk of PCBs to birds in China, and to provide indices that are more reasonable for protecting Chinese avian species. However, several sources of uncertainty exists when deriving TRGs and TRVs for the PCBs in birds, such as lack of adequate toxicity data for birds and need to use uncertainty factors. Clearly, relevant work on PCBs and birds in China are needed in the future. For example, PCB toxicity data for resident avian species in China are needed. In addition, studies are needed on the actual PCB levels in birds and fish in China. Such information is needed to serve as a more firm foundation for future risk assessments.

Reference Values for Spirometry Derived Using Lambda, Mu, Sigma (LMS) Method in Korean Adults: in Comparison with Previous References.

PubMed

Jo, Bum Seak; Myong, Jun Pyo; Rhee, Chin Kook; Yoon, Hyoung Kyu; Koo, Jung Wan; Kim, Hyoung Ryoul

2018-01-15

The present study aimed to update the prediction equations for spirometry and their lower limits of normal (LLN) by using the lambda, mu, sigma (LMS) method and to compare the outcomes with the values of previous spirometric reference equations. Spirometric data of 10,249 healthy non-smokers (8,776 females) were extracted from the fourth and fifth versions of the Korea National Health and Nutrition Examination Survey (KNHANES IV, 2007-2009; V, 2010-2012). Reference equations were derived using the LMS method which allows modeling skewness (lambda [L]), mean (mu [M]), and coefficient of variation (sigma [S]). The outcome equations were compared with previous reference values. Prediction equations were presented in the following form: predicted value = e{a + b × ln(height) + c × ln(age) + M - spline}. The new predicted values for spirometry and their LLN derived using the LMS method were shown to more accurately reflect transitions in pulmonary function in young adults than previous prediction equations derived using conventional regression analysis in 2013. There were partial discrepancies between the new reference values and the reference values from the Global Lung Function Initiative in 2012. The results should be interpreted with caution for young adults and elderly males, particularly in terms of the LLN for forced expiratory volume in one second/forced vital capacity in elderly males. Serial spirometry follow-up, together with correlations with other clinical findings, should be emphasized in evaluating the pulmonary function of individuals. Future studies are needed to improve the accuracy of reference data and to develop continuous reference values for spirometry across all ages. © 2018 The Korean Academy of Medical Sciences.

Evaluating Daily Load Stimulus Formulas in Relating Bone Response to Exercise

NASA Technical Reports Server (NTRS)

Pennline, James A.; Mulugeta, Lealem

2014-01-01

Six formulas representing what is commonly referred to as "daily load stimulus" are identified, compared and tested in their ability to relate skeletal mechanical loading to bone maintenance and osteogenic response. Particular emphasis is placed on exercise- induced skeletal loading and whether or not the formulas can adequately capture the known experimental observations of saturation of continuous cyclic loading, rest insertion between repetitions (cycles), recovery of osteogenic potential following saturation, and multiple shorter bouts versus a single long bout of exercise. To evaluate the ability of the formulas to capture these characteristics, a set of exercise scenarios with type of exercise bout, specific duration, number of repetitions, and rest insertion between repetitions is defined. The daily load values obtained from the formulas for the loading conditions of the set of scenarios is illustrated. Not all of the formulas form estimates of daily load in units of stress or in terms of strain at a skeletal site due to the loading force from a specific exercise prescription. The comparative results show that none of the formulas are able to capture all of the experimentally observed characteristics of cyclic loading. However, the enhanced formula presented by Genc et al. does capture several characteristics of cyclic loading that the others do not, namely recovery of osteogenic potential and saturation. This could be a basis for further development of mathematical formulas that more adequately approximates the amount of daily stress at a skeletal site that contributes to bone adaptation.

Determinants of Hearing Aid Use Among Older Americans With Hearing Loss.

PubMed

McKee, Michael M; Choi, HwaJung; Wilson, Shelby; DeJonckheere, Melissa J; Zazove, Philip; Levy, Helen

2018-05-21

Hearing loss (HL) is common among older adults and is associated with significant psychosocial, cognitive, and physical sequelae. Hearing aids (HA) can help, but not all individuals with HL use them. This study examines how social determinants may impact HA use. We conducted an explanatory sequential mixed methods study involving a secondary analysis of a nationally representative data set, the Health and Retirement Study (HRS; n = 35,572). This was followed up with 1:1 qualitative interviews (n = 21) with community participants to clarify our findings. Both samples included individuals aged 55 and older with a self-reported HL, with or without HA. The main outcome measure was the proportion of participants with a self-reported HL who use HA. Analysis of HRS data indicated that younger, nonwhite, non-Hispanic, lower income, and less-educated individuals were significantly less likely to use HA than their referent groups (all p values < .001). Area of residence (e.g., urban) were not significantly associated with HA use. Qualitative findings revealed barriers to HA included cost, stigma, vanity, and a general low priority placed on addressing HL by health care providers. Facilitators to obtaining and using HA included family/friend support, knowledge, and adequate insurance coverage for HA. Many socioeconomic factors hinder individuals' ability to obtain and use HA, but these obstacles appeared to be mitigated in part when insurance plans provided adequate HA coverage, or when their family/friends provided encouragement to use HA.

Current Practices of Measuring and Reference Range Reporting of Free and Total Testosterone in the United States.

PubMed

Le, Margaret; Flores, David; May, Danica; Gourley, Eric; Nangia, Ajay K

2016-05-01

The evaluation and management of male hypogonadism should be based on symptoms and on serum testosterone levels. Diagnostically this relies on accurate testing and reference values. Our objective was to define the distribution of reference values and assays for free and total testosterone by clinical laboratories in the United States. Upper and lower reference values, assay methodology and source of published reference ranges were obtained from laboratories across the country. A standardized survey was reviewed with laboratory staff via telephone. Descriptive statistics were used to tabulate results. We surveyed a total of 120 laboratories in 47 states. Total testosterone was measured in house at 73% of laboratories. At the remaining laboratories studies were sent to larger centralized reference facilities. The mean ± SD lower reference value of total testosterone was 231 ± 46 ng/dl (range 160 to 300) and the mean upper limit was 850 ± 141 ng/dl (range 726 to 1,130). Only 9% of laboratories where in-house total testosterone testing was performed created a reference range unique to their region. Others validated the instrument recommended reference values in a small number of internal test samples. For free testosterone 82% of laboratories sent testing to larger centralized reference laboratories where equilibrium dialysis and/or liquid chromatography with mass spectrometry was done. The remaining laboratories used published algorithms to calculate serum free testosterone. Reference ranges for testosterone assays vary significantly among laboratories. The ranges are predominantly defined by limited population studies of men with unknown medical and reproductive histories. These poorly defined and variable reference values, especially the lower limit, affect how clinicians determine treatment. Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Matching the laser generated p bunch into a crossbar-H drift tube linac

NASA Astrophysics Data System (ADS)

Almomani, A.; Droba, M.; Ratzinger, U.; Hofmann, I.

2012-05-01

Proton bunches with energies up to 30 MeV have been measured at the PHELIX laser. Because of the laser-plasma interactions at a power density of about 4×1019W/cm2, a total yield of 1.5×1013protons was produced. For the reference energy of 10 MeV, the yield within ±0.5MeV was exceeding 1010protons. The important topic for a further acceleration of the laser generated bunch is the matching into the acceptance of an rf accelerator stage. With respect to the high space charge forces and the transit energy range, only drift tube linacs seem adequate for this purpose. A crossbar H-type (CH) cavity was chosen as the linac structure. Optimum emittance values for the linac injection are compared with the available laser generated beam parameters. Options for beam matching into a CH structure by a pulsed magnetic solenoid and by using the simulation codes LASIN and LORASR are presented.

Wind turbine power tracking using an improved multimodel quadratic approach.

PubMed

Khezami, Nadhira; Benhadj Braiek, Naceur; Guillaud, Xavier

2010-07-01

In this paper, an improved multimodel optimal quadratic control structure for variable speed, pitch regulated wind turbines (operating at high wind speeds) is proposed in order to integrate high levels of wind power to actively provide a primary reserve for frequency control. On the basis of the nonlinear model of the studied plant, and taking into account the wind speed fluctuations, and the electrical power variation, a multimodel linear description is derived for the wind turbine, and is used for the synthesis of an optimal control law involving a state feedback, an integral action and an output reference model. This new control structure allows a rapid transition of the wind turbine generated power between different desired set values. This electrical power tracking is ensured with a high-performance behavior for all other state variables: turbine and generator rotational speeds and mechanical shaft torque; and smooth and adequate evolution of the control variables. 2010 ISA. Published by Elsevier Ltd. All rights reserved.

Determination of mechanical properties of carbon/epoxy plates by tensile stress test

NASA Astrophysics Data System (ADS)

Bere, Paul; Krolczyk, Jolanta B.

2017-10-01

The polymeric composite materials used in aerospace, military, medical or racing cars manufacturing end up being used in our daily life Whether we refer to the performing vehicles, subassemblies or parts for aircrafts, wind, telegraph poles, or medical prostheses they all are present in our lives and they are made of composite materials (CM). This paper presents research regarding three different composite materials, plates by carbon fiber, in epoxy matrix. Starting with materials presentation, manufacturing methodology and determination of mechanical properties at carbon fiber/epoxy were done. Vacuum bag technology to obtain the composite structure offer opportunity to get a very compact and homogeny composite structure. For the moment this technology are adequate for high performances pieces. The mechanical characteristics of plates made of composite materials reinforced presented indicates closed value like metal materials. Based on the results, a comparative study between the reinforced materials typically used to manufacture the plates of CM is carried out.

[Research progress on breeding standard of medicinal animals and discussion on several key problems].

PubMed

Zhou, Yi-Quan; Qu, Xian-You; Yang, Guang; Li, Jun-de; Su, Yan; Li, Ying

2016-12-01

Medicinal animal breeding standards is regarded as the law to normalize relevant production that can guarantee the quality of traditional Chinese medicine of animal category. The article summarized the medicinal animal resources in our country and the present condition of medicinal animal breeding standards. It considered the current animal breeding standards system was in adequate, not only the quantity of breeding standards, the standard content and index were also uncomprehensive, which is not conducive to the scientific and orderly development and utilization of medicinal animal resources. The article pointed out that the development of the basic standards, environmental control, feed quality, raising management, inspection and quarantine should be included into the medicinal animal breeding standards, and the medicinal animal breeding standards content framework was introduced. Meanwhile, animal welfare, biological safety and file management should be concerned during the process of research. Hope the article has good reference value to medicinal animal breeding standards establishment and production management. Copyright© by the Chinese Pharmaceutical Association.

Utilisation of Chlorella vulgaris cell biomass for the production of enzymatic protein hydrolysates.

PubMed

Morris, Humberto J; Almarales, Angel; Carrillo, Olimpia; Bermúdez, Rosa C

2008-11-01

Studies on enzymatic hydrolysis of cell proteins in green microalgae Chlorella vulgaris 87/1 are described. Different proteases can be used for production of hydrolysates from ethanol extracted algae. The influence of reaction parameters on hydrolysis of extracted biomass with pancreatin was considered, and the composition of hydrolysates (Cv-PH) was investigated in relation to the starting materials. Significant changes in the degree of hydrolysis were observed only during the first 2h and it remained constant throughout the process. An enzyme-substrate ratio of 30-45 units/g algae, an algae concentration of 10-15% and pH values of 7.5-8.0 could be recommended. Differences in the chromatographic patterns of Cv-PH and a hot-extract from Chlorella biomass were observed. Adequate amounts of essential amino acids (44.7%) in relation to the reference pattern of FAO for human nutrition were found, except for sulfur amino acids. Cv-PH could be considered as a potential ingredient in the food industry.

Reference values for anxiety questionnaires: the Leiden Routine Outcome Monitoring Study.

PubMed

Schulte-van Maaren, Yvonne W M; Giltay, Erik J; van Hemert, Albert M; Zitman, Frans G; de Waal, Margot W M; Carlier, Ingrid V E

2013-09-25

The monitoring of patients with an anxiety disorder can benefit from Routine Outcome Monitoring (ROM). As anxiety disorders differ in phenomenology, several anxiety questionnaires are included in ROM: Brief Scale for Anxiety (BSA), PADUA Inventory Revised (PI-R), Panic Appraisal Inventory (PAI), Penn State Worry Questionnaire (PSWQ), Worry Domains Questionnaire (WDQ), Social Interaction, Anxiety Scale (SIAS), Social Phobia Scale (SPS), and the Impact of Event Scale-Revised (IES-R). We aimed to generate reference values for both 'healthy' and 'clinically anxious' populations for these anxiety questionnaires. We included 1295 subjects from the general population (ROM reference-group) and 5066 psychiatric outpatients diagnosed with a specific anxiety disorder (ROM patient-group). The MINI was used as diagnostic device in both the ROM reference group and the ROM patient group. To define limits for one-sided reference intervals (95th percentile; P95) the outermost 5% of observations were used. Receiver Operating Characteristics (ROC) analyses were used to yield alternative cut-off values for the anxiety questionnaires. For the ROM reference-group the mean age was 40.3 years (SD=12.6), and for the ROM patient-group it was 36.5 years (SD=11.9). Females constituted 62.8% of the reference-group and 64.4% of the patient-group. P95 ROM reference group cut-off values for reference versus clinically anxious populations were 11 for the BSA, 43 for the PI-R, 37 for the PAI Anticipated Panic, 47 for the PAI Perceived Consequences, 65 for the PAI Perceived Self-efficacy, 66 for the PSWQ, 74 for the WDQ, 32 for the SIAS, 19 for the SPS, and 36 for IES-R. ROC analyses yielded slightly lower reference values. The discriminative power of all eight anxiety questionnaires was very high. Substantial non-response and limited generalizability. For eight anxiety questionnaires a comprehensive set of reference values was provided. Reference values were generally higher in women than in men, implying the use of gender-specific cut-off values. Each instrument can be offered to every patient with MAS disorders to make responsible decisions about continuing, changing or terminating therapy. © 2013 Elsevier B.V. All rights reserved.

Reference values of inspiratory spirometry for Finnish adults.

PubMed

Kainu, Annette; Timonen, Kirsi L; Vanninen, Esko; Sovijärvi, Anssi R

2018-03-07

Inspiratory spirometry is used in evaluation of upper airway disorders e.g. fixed or variable obstruction. There are, however, very few published data on normal values for inspiratory spirometry. The main aim of this study was to produce reference values for inspiratory spirometry for healthy Finnish adults. Inspiratory spirometry was preplanned to a sample of the Finnish spirometry reference values sample. Data was successfully retrieved from 368 healthy nonsmoking adults (132 males) between 19 and 83 years of age. Reference equations were produced for forced inspiratory vital capacity (FIVC), forced inspiratory volume in one second (FIV1), FIV1/FIVC, peak inspiratory flow (PIF) and the ratios of FIV1/forced expiratory volume in one second and PIF/peak expiratory flow. The present values were compared to PIF values from previously used Finnish study of Viljanen et al. (1982) reference values and Norwegian values for FIV1, FIVC and FIV1/FIVC presented by Gulsvik et al. (2001). The predicted values from the Gulsvik et al. (2001), provided a good fit for FIVC, but smaller values for FIV1 with mean 108.3 and 109.1% of predicted values for males and females, respectively. PIF values were 87.4 and 91.2% of Viljanen et al. (1982) predicted values in males and females, respectively. Differences in measurement methods and selection of results may contribute to the observed differences. Inspiratory spirometry is technically more demanding and needs repeatability criteria to improve validity. New reference values are suggested to clinical use in Finland when assessing inspiratory spirometry. Utility of inspiratory to expiratory values indices in assessment of airway collapse need further study.

SUPPLEMENTARY COMPARISON: Final report on supplementary comparison APMP-T-S3-03 of industrial platinum resistance and liquid in glass thermometers from -40 °C to 250 °C

NASA Astrophysics Data System (ADS)

Norranim, Uthai; Nguyen, Mong Kim; Ballico, Mark J.

2007-01-01

Industrial thermometers such as industrial platinum resistance thermometers (iprts) and liquid-in-glass thermometers (LIGTs) are widely used in industry. Because Key Comparisons are limited to direct realizations of ITS-90, and not all APMP NMIs have participated in them, the national metrology institutes (NMIs) of Thailand and Australia (NIMT and NIMA) organized an APMP supplementary comparison to support the approval of CMCs (calibration and measurement capabilities) for these laboratories. The comparison, performed in 2003, covered the range from -40.0 °C to 250.0 °C, using IPRTs (Hart Scientific 5626-12-S), total immersion (ASTM 62C, 120C) and partial immersion (ASTM 40C) LIGTs. Ten NMIs from the APMP: KIM-LIPI (Indonesia), ITDI (Philippines), MSL (New Zealand), NBSM (Nepal), NMIA (Australia), NIMT (Thailand), SCL (Hong Kong), SIRIM (Malaysia), SPRING (Singapore) and VMI (Vietnam) were divided into two loops to shorten the circulation time, and these were linked by the two pilot laboratories. This report describes details of the artifacts, the circulation schedule, the measurement procedures, the results submitted by participants, uncertainties and the analysis of the results. Reference values calculated using simple mean, median and weighted mean were consistent with each other, but as the Birge criterion was satisfied, the weighted mean with its lower uncertainty was adopted. The artifacts were found to be stable over the comparison and the results of the loop linking labs consistent, allowing an uncertainty of 2 mK to 4 mK to be achieved for the IPRT reference value and 10 mK to 20 mK for the LIGT reference values. These uncertainties allowed the comparison data to be used to adequately test the uncertainties of all the participant laboratories, and hence to directly support their CMC claims. Main text. To reach the main text of this paper, click on Final Report. Note that this text is that which appears in Appendix B of the BIPM key comparison database kcdb.bipm.org/. The final report has been peer-reviewed and approved for publication by the APMP, according to the provisions of the CIPM Mutual Recognition Arrangement (MRA).

Extracellular micronutrient levels and pro-/antioxidant status in trauma patients with wound healing disorders: results of a cross-sectional study.

PubMed

Blass, Sandra C; Goost, Hans; Burger, Christof; Tolba, René H; Stoffel-Wagner, Birgit; Stehle, Peter; Ellinger, Sabine

2013-12-05

Disorders in wound healing (DWH) are common in trauma patients, the reasons being not completely understood. Inadequate nutritional status may favor DWH, partly by means of oxidative stress. Reliable data, however, are lacking. This study should investigate the status of extracellular micronutrients in patients with DWH within routine setting. Within a cross-sectional study, the plasma/serum status of several micronutrients (retinol, ascorbic acid, 25-hydroxycholecalciferol, α-tocopherol, β-carotene, selenium, and zinc) were determined in 44 trauma patients with DWH in addition to selected proteins (albumin, prealbumin, and C-reactive protein; CRP) and markers of pro-/antioxidant balance (antioxidant capacity, peroxides, and malondialdehyde). Values were compared to reference values to calculate the prevalence for biochemical deficiency. Correlations between CRP, albumin and prealbumin, and selected micronutrients were analyzed by Pearson's test. Statistical significance was set at P < 0.05. Mean concentrations of ascorbic acid (23.1 ± 15.9 μmol/L), 25-hydroxycholecalciferol (46.2±30.6 nmol/L), β-carotene (0.6 ± 0.4 μmol/L), selenium (0.79±0.19 μmol/L), and prealbumin (24.8 ± 8.2 mg/dL) were relatively low. Most patients showed levels of ascorbic acid (<28 μmol/L; 64%), 25-hydroxycholecalciferol (<50 μmol/L; 59%), selenium (≤ 94 μmol/L; 71%) and β-carotene (<0.9 μmol/L; 86%) below the reference range. Albumin and prealbumin were in the lower normal range and CRP was mostly above the reference range. Plasma antioxidant capacity was decreased, whereas peroxides and malondialdehyde were increased compared to normal values. Inverse correlations were found between CRP and albumin (P < 0.05) and between CRP and prealbumin (P < 0.01). Retinol (P < 0.001), ascorbic acid (P < 0.01), zinc (P < 0.001), and selenium (P < 0.001) were negatively correlated with CRP. Trauma patients with DWH frequently suffer from protein malnutrition and reduced plasma concentrations of several micronutrients probably due to inflammation, increased requirement, and oxidative burden. Thus, adequate nutritional measures are strongly recommended to trauma patients.

Prevalence of abnormal findings when adopting new national and international Global Lung Function Initiative reference values for spirometry in the Finnish general population

PubMed Central

Kainu, Annette; Lindqvist, Ari; Sovijärvi, Anssi R. A.

2016-01-01

Background New Finnish (Kainu2015) and international Global Lung Function Initiative (GLI2012) reference values for spirometry were recently published. The aim of this study is to compare the interpretative consequences of adopting these new reference values with older, currently used Finnish reference values (Viljanen1982) in the general population of native Finns. Methods Two Finnish general population samples including 1,328 adults (45% males) aged 21–74 years were evaluated. Airway obstruction was defined as a reduced ratio of forced expiratory volume in one second (FEV1)/forced vital capacity (FVC), possible restrictive pattern as reduced FVC, and decreased ventilatory capacity as reduced FEV1 below their respective 2.5th percentiles. The severity gradings of reduced lung function were also compared. Results Using the Kainu2015 reference values, the prevalence of airway obstruction in the population was 5.6%; using GLI2012 it was 4.0% and with Viljanen1982 it was 13.0%. Possible restrictive pattern was found in 4.2% using the Kainu2015 values, in 2.0% with GLI2012, and 7.9% with the Viljanen1982 values. The prevalence of decreased ventilatory capacity was 6.8, 4.0, and 13.3% with the Kainu2015, GLI2012 and Viljanen1982 values, respectively. Conclusions The application of the GLI2012 reference values underestimates the prevalence of abnormal spirometric findings in native Finns. The adoption of the Kainu2015 reference values reduces the prevalences of airways obstruction, decreased ventilatory capacity, and restrictive impairment by approximately 50%. Changing from the 2.5th percentile, the previously used lower limit of normal, to the 5th percentile recommended by the American Thoracic Society/European Respiratory Society will not increase the prevalence of abnormal findings in the implementation of spirometry reference values. PMID:27608270

Reference values of elements in human hair: a systematic review.

PubMed

Mikulewicz, Marcin; Chojnacka, Katarzyna; Gedrange, Thomas; Górecki, Henryk

2013-11-01

The lack of systematic review on reference values of elements in human hair with the consideration of methodological approach. The absence of worldwide accepted and implemented universal reference ranges causes that hair mineral analysis has not become yet a reliable and useful method of assessment of nutritional status and exposure of individuals. Systematic review of reference values of elements in human hair. PubMed, ISI Web of Knowledge, Scopus. Humans, hair mineral analysis, elements or minerals, reference values, original studies. The number of studies screened and assessed for eligibility was 52. Eventually, included in the review were 5 papers. The studies report reference ranges for the content of elements in hair: macroelements, microelements, toxic elements and other elements. Reference ranges were elaborated for different populations in the years 2000-2012. The analytical methodology differed, in particular sample preparation, digestion and analysis (ICP-AES, ICP-MS). Consequently, the levels of hair minerals reported as reference values varied. It is necessary to elaborate the standard procedures and furtherly validate hair mineral analysis and deliver detailed methodology. Only then it would be possible to provide meaningful reference ranges and take advantage of the potential that lies in Hair Mineral Analysis as a medical diagnostic technique. Copyright © 2013 Elsevier B.V. All rights reserved.

The theory of reference values: an unfinished symphony.

PubMed

Siest, Gerard; Henny, Joseph; Gräsbeck, Ralph; Wilding, Peter; Petitclerc, Claude; Queraltó, Josep M; Hyltoft Petersen, Peter

2013-01-01

The history of the theory of reference values can be written as an unfinished symphony. The first movement, allegro con fuoco, played from 1960 to 1980: a mix of themes devoted to the study of biological variability (intra-, inter-individual, short- and long-term), preanalytical conditions, standardization of analytical methods, quality control, statistical tools for deriving reference limits, all of them complex variations developed on a central melody: the new concept of reference values that would replace the notion of normality whose definition was unclear. Additional contributions (multivariate reference values, use of reference limits from broad sets of patient data, drug interferences) conclude the movement on the variability of laboratory tests. The second movement, adagio, from 1980 to 2000, slowly develops and implements initial works. International and national recommendations were published by the IFCC-LM (International Federation of Clinical Chemistry and Laboratory Medicine) and scientific societies [French (SFBC), Spanish (SEQC), Scandinavian societies…]. Reference values are now topics of many textbooks and of several congresses, workshops, and round tables that are organized all over the world. Nowadays, reference values are part of current practice in all clinical laboratories, but not without difficulties, particularly for some laboratories to produce their own reference values and the unsuitability of the concept with respect to new technologies such as HPLC, GCMS, and PCR assays. Clinicians through consensus groups and practice guidelines have introduced their own tools, the decision limits, likelihood ratios and Reference Change Value (RCV), creating confusion among laboratorians and clinicians in substituting reference values and decision limits in laboratory reports. The rapid development of personalized medicine will eventually call for the use of individual reference values. The beginning of the second millennium is played allegro ma non-troppo from 2000 to 2012: the theory of reference values is back into fashion. The need to revise the concept is emerging. The manufacturers make a friendly pressure to facilitate the integration of Reference Intervals (RIs) in their technical documentation. Laboratorians are anxiously awaiting the solutions for what to do. The IFCC-LM creates Reference Intervals and Decision Limits Committee (C-RIDL) in 2005. Simultaneously, a joint working group IFCC-CLSI is created on the same topic. In 2008 the initial recommendations of IFCC-LM are revised and new guidelines are published by the Clinical and Laboratory Standards Institute (CLSI C28-A3). Fundamentals of the theory of reference values are not changed, but new avenues are explored: RIs transference, multicenter reference intervals, and a robust method for deriving RIs from small number of subjects. Concomitantly, other statistical methods are published such as bootstraps calculation and partitioning procedures. An alternative to recruiting healthy subjects proposes the use of biobanks conditional to the availability of controlled preanalytical conditions and of bioclinical data. The scope is also widening to include veterinary biology! During the early 2000s, several groups proposed the concept of 'Universal RIs' or 'Global RIs'. Still controversial, their applications await further investigations. The fourth movement, finale: beyond the methodological issues (statistical and analytical essentially), important questions remain unanswered. Do RIs intervene appropriately in medical decision-making? Are RIs really useful to the clinicians? Are evidence-based decision limits more appropriate? It should be appreciated that many laboratory tests represent a continuum that weakens the relevance of RIs. In addition, the boundaries between healthy and pathological states are shady areas influenced by many biological factors. In such a case the use of a single threshold is questionable. Wherever it will apply, individual reference values and reference change values have their place. A variation on an old theme! It is strange that in the period of personalized medicine (that is more stratified medicine), the concept of reference values which is based on stratification of homogeneous subgroups of healthy people could not be discussed and developed in conjunction with the stratification of sick patients. That is our message for the celebration of the 50th anniversary of Clinical Chemistry and Laboratory Medicine. Prospects are broad, enthusiasm is not lacking: much remains to be done, good luck for the new generations!

Nonparametric spirometry reference values for Hispanic Americans.

PubMed

Glenn, Nancy L; Brown, Vanessa M

2011-02-01

Recent literature sites ethnic origin as a major factor in developing pulmonary function reference values. Extensive studies established reference values for European and African Americans, but not for Hispanic Americans. The Third National Health and Nutrition Examination Survey defines Hispanic as individuals of Spanish speaking cultures. While no group was excluded from the target population, sample size requirements only allowed inclusion of individuals who identified themselves as Mexican Americans. This research constructs nonparametric reference value confidence intervals for Hispanic American pulmonary function. The method is applicable to all ethnicities. We use empirical likelihood confidence intervals to establish normal ranges for reference values. Its major advantage: it is model free, but shares asymptotic properties of model based methods. Statistical comparisons indicate that empirical likelihood interval lengths are comparable to normal theory intervals. Power and efficiency studies agree with previously published theoretical results.

Nutrient intakes of US infants, toddlers, and preschoolers meet or exceed dietary reference intakes.

PubMed

Butte, Nancy F; Fox, Mary Kay; Briefel, Ronette R; Siega-Riz, Anna Maria; Dwyer, Johanna T; Deming, Denise M; Reidy, Kathleen C

2010-12-01

To assess the usual nutrient intakes of 3,273 US infants, toddlers, and preschoolers, aged 0 to 47 months, surveyed in the Feeding Infants and Toddlers Study (FITS) 2008; and to compare data on the usual nutrient intakes for the two waves of FITS conducted in 2002 and 2008. The FITS 2008 is a cross-sectional survey of a national random sample of US children from birth through age 47 months. Usual nutrient intakes derived from foods, beverages, and supplements were ascertained using a telephone-administered, multiple-pass 24-hour dietary recall. Infants aged birth to 5 months (n=382) and 6 to 11 months (n=505), toddlers aged 12 to 23 months (n=925), and preschoolers aged 24 to 47 months (n=1,461) were surveyed. All primary caregivers completed one 24-hour dietary recall and a random subsample (n=701) completed a second 24-hour dietary recall. The personal computer version of the Software for Intake Distribution Estimation was used to estimate the 10th, 25th, 50th, 75th, and 90th percentiles, as well as the proportions below and above cutoff values defined by the Dietary Reference Intakes or the 2005 Dietary Guidelines for Americans. Usual nutrient intakes met or exceeded energy and protein requirements with minimal risk of vitamin and mineral deficiencies. The usual intakes of antioxidants, B vitamins, bone-related nutrients, and other micronutrients were adequate relative to the Adequate Intakes or Estimated Average Requirements, except for iron and zinc in a small subset of older infants, and vitamin E and potassium in toddlers and preschoolers. Intakes of synthetic folate, preformed vitamin A, zinc, and sodium exceeded Tolerable Upper Intake Level in a significant proportion of toddlers and preschoolers. Macronutrient distributions were within acceptable macronutrient distribution ranges, except for dietary fat, in some toddlers and preschoolers. Dietary fiber was low in the vast majority of toddlers and preschoolers, and saturated fat intakes exceeded recommendations for the majority of preschoolers. The prevalence of inadequate intakes, excessive intake, and intakes outside the acceptable macronutrient distribution range was similar in FITS 2002 and FITS 2008. In FITS 2008, usual nutrient intakes were adequate for the majority of US infants, toddlers, and preschoolers, except for a small but important number of infants at risk for inadequate iron and zinc intakes. Diet quality should be improved in the transition from infancy to early childhood, particularly with respect to healthier fats and fiber in the diets of toddlers and preschoolers. Copyright © 2010 American Dietetic Association. Published by Elsevier Inc. All rights reserved.

Vertebral heights and ratios are not only race-specific, but also gender- and region-specific: establishment of reference values for mainland Chinese.

PubMed

Ning, Lei; Song, Li-Jiang; Fan, Shun-Wu; Zhao, Xing; Chen, Yi-Lei; Li, Zhao-Zhi; Hu, Zi-Ang

2017-10-11

This study established gender-specific reference values in mainland Chinese (MC) and is important for quantitative morphometry for diagnosis and epidemiological study of osteoporotic vertebral compressive fracture. Comparisons of reference values among different racial populations are then performed to demonstrate the MC-specific characteristic. Osteoporotic vertebral compressive fracture (OVCF) is a common complication of osteoporosis in the elder population. Clinical diagnosis and epidemiological study of OVCF often employ quantitative morphometry, which relies heavily on the comparison of patients' vertebral parameters to existing reference values derived from the normal population. Thus, reference values are crucial in clinical diagnosis. To our knowledge, this is the first study to establish reference values of the mainland Chinese (MC) for quantitative morphometry. Vertebral heights including anterior (Ha), middle (Hm), posterior (Hp) heights, and predicted posterior height (pp) from T4 to L5 were obtained; and ratios of Ha/Hp, Hm/Hp and Hp/pp. were calculated from 585 MC (both female and male) for establishing reference values and subsequent comparisons with other studies. Vertebral heights increased progressively from T4 to L3 but then decreased in L4 and L5. Both genders showed similar ratios of vertebral dimensions, but male vertebrae were statistically larger than those of female (P < 0.01). Vertebral size of MC population was smaller than that of US and UK population, but was surprisingly larger than that of Hong Kong Chinese, although these two are commonly considered as one race. Data from different racial populations showed similar dimensional ratios in all vertebrae. We established gender-specific reference values for MC. Our results also indicated the necessity of establishing reference values that are not only race- and gender-specific, but also population- or region-specific for accurate quantitative morphometric assessment of OVCF.

Coronary Flow Velocity Reserve during Dobutamine Stress Echocardiography

PubMed Central

de Abreu, José Sebastião; Lima, José Wellington Oliveira; Diógenes, Tereza Cristina Pinheiro; Siqueira, Jordana Magalhães; Pimentel, Nayara Lima; Gomes, Pedro Sabino; de Abreu, Marília Esther Benevides; Paes, José Nogueira

2014-01-01

Background A coronary flow velocity reserve (CFVR) ≥ 2 is adequate to infer a favorable prognosis or the absence of significant coronary artery disease. Objective To identify parameters which are relevant to obtain CFVR (adequate or inadequate) in the left anterior descending coronary artery (LAD) during dobutamine stress echocardiography (DSE). Methods 100 patients referred for detection of myocardial ischemia by DSE were evaluated; they were instructed to discontinue the use of β-blockers 72 hours prior to the test. CFVR was calculated as a ratio of the diastolic peak velocity (cm/s) (DPV) on DSE (DPV-DSE) to baseline DPV at rest (DPV-Rest). In group I, CFVR was < 2 and, in group II, CFVR was ≥ 2. The Fisher's exact test and Student's t test were used for the statistical analyses. P values < 0.05 were considered statistically significant. Results At rest, the time (in seconds) to obtain Doppler in LAD in groups I and II was not different (53±31 vs. 45±32; p=0.23). During DSE, LAD was recorded in 92 patients. Group I patients were older (65.9±9.3 vs. 61.2±10.8 years; p=0.04), had lower ejection fraction (61±10 vs. 66±6%; p=0.005), higher DPV-Rest (36.81±08 vs. 25.63 ± 06cm/s; p<0.0001) and lower CFVR (1.67 ± 0.24 vs. 2.53 ± 0.57; p<0.0001), but no difference was observed regarding DPVDSE (61.40±16 vs. 64.23±16cm/s; p=0.42). β-blocker discontinuation was associated with a 4-fold higher chance of a CFVR < 2 (OR= 4; 95% CI [1.171-13.63], p=0.027). Conclusion DPV-Rest was the main parameter to determine an adequate CFVR. β-blocker discontinuation was significantly associated with inadequate CFVR. The high feasibility and the time to record the LAD corroborate the use of this methodology. PMID:24676368

Guaiphenesin-ketamine-xylazine infusion to maintain anesthesia in mules undergoing field castration.

PubMed

Vullo, Cecilia; Carluccio, Augusto; Robbe, Domenico; Meligrana, Marina; Petrucci, Linda; Catone, Giuseppe

2017-10-11

In order to determine whether a combination of guaiphenesin, ketamine and xylazine can induce safe and satisfactory anaesthesia in mules undergoing field castration, eight healthy adult intact male mules were employed. They were premedicated with intravenous (IV) xylazine (1.3 mg/kg); an additional dose of xylazine (0.3 mg/kg IV) was administered in case of inadequate depth of sedation. Anaesthesia was induced with IV thiopental (6 mg/kg). The quality of sedation and induction was recorded. Anaesthesia was maintained with an infusion of guaiphenesin (50 mg/mL), ketamine (2 mg/mL) and xylazine (1 mg/mL) (GKX). The spermatic cord of each testis was infiltrated with 5 mL of 2% lidocaine. During anaesthesia heart rate (HR), respiratory rate (RR), rectal temperature (RT) and haemoglobin oxygen saturation (SpO 2 ) were measured every 5 min. The data were analysed with simple one-way analysis of variance (ANOVA). A P value < 0.05 was considered statistically significant. Time of anesthesia, time of surgery and time of recovery were recorded. Only one mule required an additional dose of xylazine to achieve a satisfactory depth of sedation. Thiopental at the dose of 6 mg/kg IV resulted in smooth induction and lateral recumbency in all animals. GKX provided adequate anaesthesia to perform castration in all mules. Muscle relaxation was deemed adequate and physiological variables remained stable and within references values during the anaesthesia and did not change in response to surgical stimulation. Time (mean ± standard deviation) from the end of the infusion to sternal recumbency and time from sternal recumbency to standing were 27.7 ± 4.6 and 30.1 ± 7.7 min, respectively. The combination of xylazine, thiopental and GKX provides satisfactory short-term anaesthesia in mules undergoing field castration.

Lake Louise Water (USGS47): A new isotopic reference water for stable hydrogen and oxygen isotope measurements

USGS Publications Warehouse

Qi, Haiping; Lorenz, Jennifer M.; Coplen, Tyler B.; Tarbox, Lauren V.; Mayer, Bernhard; Taylor, Steve

2014-01-01

RESULTS: The δ2H and δ18O values of this reference water are –150.2 ± 0.5 ‰ and –19.80 ± 0.02 ‰, respectively, relative to VSMOW on scales normalized such that the δ2H and δ18O values of SLAP reference water are, respectively, –428 and –55.5 ‰. Each uncertainty is an estimated expanded uncertainty (U = 2uc) about the reference value that provides an interval that has about a 95-percent probability of encompassing the true value. CONCLUSION: This isotopic reference material, designated as USGS47, is intended as one of two isotopic reference waters for daily normalization of stable hydrogen and stable oxygen isotopic analysis of water with a mass spectrometer or a laser absorption spectrometer. "

Quantifying Users' Interconnectedness in Online Social Networks - An Indispensible Step for Economic Valuation

NASA Astrophysics Data System (ADS)

Gneiser, Martin; Heidemann, Julia; Klier, Mathias; Landherr, Andrea; Probst, Florian

Online social networks have been gaining increasing economic importance in light of the rising number of their users. Numerous recent acquisitions priced at enormous amounts have illustrated this development and revealed the need for adequate business valuation models. The value of an online social network is largely determined by the value of its users, the relationships between these users, and the resulting network effects. Therefore, the interconnectedness of a user within the network has to be considered explicitly to get a reasonable estimate for the economic value. Established standard business valuation models, however, do not sufficiently take these aspects into account. Thus, we propose a measure based on the PageRank-algorithm to quantify users’ interconnectedness in an online social network. This is a first but indispensible step towards an adequate economic valuation of online social networks.

Reference values for heavy metals in soils of the Brazilian agricultural frontier in Southwestern Amazônia.

PubMed

dos Santos, Sabrina Novaes; Alleoni, Luís Reynaldo Ferracciú

2013-07-01

Guideline values are used to identify polluted or contaminated areas based on background values. Brazilian law establishes three guideline values for pollutants: a quality reference value (QRV), a prevention value, and an intervention value. Reference values refer to the natural concentration of an element or a substance in soils that have not been modified by anthropogenic impacts. These values inform assessments of soil quality and are used to establish maximum permissible limits. The objective of this study was to determine the natural levels and reference values for Cd, Co, Cr, Cu, Ni, Pb, and Zn in samples from the surface layer (0-20 cm) of 19 representative soils of the states of Mato Grosso and Rondônia, on Brazil's agricultural frontier. Pseudo-total metal concentrations were obtained following microwave-assisted digestion using the aqua regia and EPA3051 methods. QRVs were calculated for each element as the 75th and 90th percentiles of the frequency distribution of the data. Natural levels of heavy metals in the soil samples followed the order: Cr > Zn > Cu > Co > Pb > Ni > and Cd (aqua regia) and Cr > Co > Cu > Pb > Zn > Ni > Cd (EPA3051). These values are generally lower than those reported in the Brazilian and international literature, which highlights the importance of establishing reference values for each state or for each soil type, taking into account the geomorphological, pedological, and geological diversity of the region under study.

Early detection of lung function decrements in children and adolescents with cystic fibrosis using new reference values.

PubMed

Zacharasiewicz, Angela; Renner, Sabine; Haderer, Flora; Weber, Michael; Dehlink, Eleonore; Szepfalusi, Zsolt; Frischer, Thomas

2017-08-01

Interpretation of lung function values in children with cystic fibrosis (CF) depends on the applied reference values. We hypothesize that differences between the new global lung function initiative (GLI) values and the formerly used Zapletal et al. values produce significantly different clinical results. We analyzed 3719 lung function measurements of 108 children and adolescents (n = 54 male; aged 6-18 years) with CF treated between September 1991 and July 2009. Data were analyzed in milliliters (ml) and % predicted (pred.) and interpreted using Zapletal and GLI reference values. Applying GLI compared to Zapletal resulted in significantly lower mean forced expiratory volume in 1s (FEV1)% pred. Zapletal 86.6% (SD 20.6), GLI 79.9% (SD 20.3) and 32% (n = 497/1543) were misclassified as normal when using Zapletal. Despite showing no overall differences in FEV1 and forced vital capacity (FVC) between concomitant Pseudomonas detection (PA+) in n = 938 and Pseudomonas negative (PA-) (n = 2781) using either reference PA+ resulted in lower FEV1 and FVC values with increasing age; however, measurement of small airway obstruction with forced expiratory flow at 75% of FVC (FEF75) values - available for Zapletal -showed significant differences. Reassurance regarding lung function when using old reference values may occur with potential clinical significance. Discrepancies in lung function interpretation underline the importance of using uniform and best available reference values.

Abnormal carbohydrate metabolism in a canine model for muscular dystrophy.

PubMed

Amaral, Andressa R; Brunetto, Márcio A; Brólio, Marina P; Cima, Daniela S; Miglino, Maria A; Santos, João Paulo F; Ambrósio, Carlos E

2017-01-01

The canine golden retriever muscular dystrophy (GRMD) model is the best animal model for studying Duchenne muscular dystrophy in humans. Considering the importance of glucose metabolism in the muscles, the existence of metabolic and endocrine alterations in a wide range of muscular dystrophies, and the pre-existing relationship between blood insulin concentration and muscular atrophy, the present study aimed to evaluate the postprandial glucose and insulin response in GRMD dogs. A total of eighteen golden retriever dogs were randomly distributed into three experimental groups: healthy/control (G1), female GRMD carriers (G2), and male dogs affected by GRMD (G3). Higher plasma resting glucose levels ( P = 0·0047) were seen in G2 and G3 compared with G1, as was the case for minimum ( P = <0·0001), mean ( P = 0·0002) and maximum ( P = 0·0359) glucose values for G3 compared with G1. Fructosamine concentrations were in accordance with reference values found in the literature for dogs. Insulin levels were lower in G3 compared with G1 ( P = 0·0065); however, there was no evidence of insulin resistance according to the homeostasis model assessment index values obtained. As for the evaluation of postprandial responses, fluctuations of glucose ( P = 0·0007) and insulin ( P = 0·0149) were observed in G1 and G2, while in G3 the values remained constant. The results allowed us to identify metabolic changes related to carbohydrate metabolism in GRMD dogs, highlighting the importance of adequate food management for these animals.

Plant/life form considerations in the rangeland hydrology and erosion model (RHEM)

USDA-ARS?s Scientific Manuscript database

Resilience of rangeland to erosion has largely been attributed to adequate plant cover; however, plant life/growth form, and individual species presence can have a dramatic effect on hydrologic and erosion dynamics on rangelands. Plant life/growth form refers to genetic tendency of a plant to grow i...

Modeling Rare and Unique Documents: Using FRBR[subscript OO]/CIDOC CRM

ERIC Educational Resources Information Center

Le Boeuf, Patrick

2012-01-01

Both the library and the museum communities have developed conceptual models for the information they produce about the collections they hold: FRBR (Functional Requirements for Bibliographic Records) and CIDOC CRM (Conceptual Reference Model). But neither proves perfectly adequate when it comes to some specific types of rare and unique materials:…

Pluralism, the Right, and the Good in Choirs, Orchestras, and Bands

ERIC Educational Resources Information Center

Mantie, Roger; Tucker, Lynn

2012-01-01

Publicly funded schools are supposed to serve everyone equally in egalitarian, liberal democracies. In this paper we claim that school music ensembles fail, on the whole, to adequately reflect current socio-demographic patterns in both Canada and the United States. From a postcolonial perspective we attempt to problematize, with reference to…

36 CFR 1234.12 - What are the fire safety requirements that apply to records storage facilities?

Code of Federal Regulations, 2010 CFR

2010-07-01

... that have been incorporated to minimize loss. The report should make specific reference to appropriate.... Retrofitting may require modifications to the piping system to ensure that adequate water capacity and pressure... storage facilities, boiler rooms or rooms containing equipment operating with a fuel supply (such as...

We Are, Therefore I Am: A Multisystems Approach with Families in Poverty.

ERIC Educational Resources Information Center

Brown, Shunda L.

2002-01-01

Although many individuals living in poverty are referred for family counseling services via schools, court systems, and social service agencies, theories have failed to provide an adequate framework for treatment. This article addresses the common principles of the multisystems approach and feminist family therapies and how they can be applied in…

The Condition of the Infrastructure of New York Schools: Who Pays and Who Benefits?

ERIC Educational Resources Information Center

Crampton, Faith E.

1991-01-01

Insufficient resource allocation to facilities maintenance and decisions to defer maintenance are contributors to a backlog of deferred maintenance nationwide. Focuses on the infrastructure of New York schools and suggests incentives at the state level to ensure adequate attention is given to plant maintenance. (eight references) (MLF)

Prevalence and Nature of Late-Emerging Poor Readers

ERIC Educational Resources Information Center

Catts, Hugh W.; Compton, Donald; Tomblin, J. Bruce; Bridges, Mindy Sittner

2012-01-01

Some children demonstrate adequate or better reading achievement in early school grades but fall significantly behind their peers in later grades. These children are often referred to as late-emerging poor readers. In this study, we investigated the prevalence and heterogeneity of these poor readers. We also examined the early language and…

Police Use of Force: A Community Relations Concern.

ERIC Educational Resources Information Center

Pompa, Gilbert G.

Addressed in this speech are police/minority relations problems, particularly the issue of police use of excessive force. References are made to studies and reports on the subject and the difficulty in getting adequate and substantial information on the patterns of occurrence where community friction arising from the use of excessive force is…

The War for Boys: What Must We Do To Win?

ERIC Educational Resources Information Center

Feldman, Sandra

Children are entitled to grow up in secure and nurturing environments that include caring adults; safe streets; decent shelter; adequate nutrition; access to health care and education; and advocacy on their behalf against the toxic influences of society. Far too many children are being referred to special education and mislabeled and medicated.…

30 CFR 1227.200 - What are a State's general responsibilities if it accepts a delegation?

Code of Federal Regulations, 2011 CFR

2011-07-01

... controls and accountability; (4) Maintain a system of accounts that includes a comprehensive audit trail so... production information for royalty management purposes; (c) Assist ONRR in meeting the requirements of the... maintaining adequate reference, royalty, and production databases as provided in the Standards issued under...

40 CFR 123.63 - Criteria for withdrawal of State programs.

Code of Federal Regulations, 2010 CFR

2010-07-01

... withdrawal of State programs. (a) In the case of a sewage sludge management program, references in this... under this part, including failure to issue permits; (ii) Repeated issuance of permits which do not... sludge management program, § 501.14 of this chapter). (5) Where the State fails to develop an adequate...

The Importance of Social Context for an Australian Education Program.

ERIC Educational Resources Information Center

Dawkins, David

The study of education systems and educational programs cannot be adequate without reference to those systems' social context. This paper examines the Australian Transition Education program, enacted by the government in 1979, in light of its social context. The program's ostensible purpose was to prepare students for employment. The Liberal…

Reference Manual for Machine-Readable Bibliographic Descriptions.

ERIC Educational Resources Information Center

Martin, M. D., Comp.

UNESCO, in cooperation with several other organizations, has produced a manual, the scope and purpose of which has been to define, for most types of scientific and technical literature, a set of data elements which will constitute an adequate bibliographic citation, and to define the representation of these data elements as they should appear in a…

[Vitamin A deficiency and the anthropometric nutritional status of urban and rural marginalized children in the state of Zulia, Venezuela].

PubMed

Amaya-Castellanos, Daisy; Viloria-Castejón, Haydée; Ortega, Pablo; Gómez, Gisela; Urrieta, Jesús R; Lobo, Pablo; Estévez, Jesús

2002-06-01

The present transversal study was carried out to estimate the prevalence of both vitamin A deficiency (VAD) and protein-energy malnutrition among children (24 to 85 months) from three urban slums (n = 173) in Maracaibo city, Zulia State, Venezuela and a rural slum area (n = 34), vieinal to Maracaibo, by measuring serum retinol and z score of anthropometric indices Height//Age (H//AZ); Weight//Age (W//AZ) and Weight//Height (W//HZ), compared to NCHS-WHO reference values. The Graffar's methodology adapted to Venezuela by Méndez Castellano (1986) confirmed the underprivileged socio-economic condition of the children population. For serum retinol analysis, peripheral venous blood was drawn and serum was treated according to the Bieri et al. (1979) technique and HPLC procedure. Values were recorded in microgram/dL. Statistical analysis was done by using Epi Info 2000, release 1.0 and SAS release 6.0 (1996) computer programs. The prevalence of VAD (serum retinol < 20 micrograms/dL) in the total children population (n = 207) was 22.2%, being higher in urban children than in rural children (22.5% vs 20.5%). No clinical signs of VAD were detected in the children. The nutritional status analysed by Z score of anthropometric indices revealed that 27.4% of children suffered from undernutrition (Z score = -2 to > -3 SD), being 15.4% stunted, 9.6% wasted and 2.6% with acute protein-energy malnutrition. Neither severe malnutrition nor overweight were detected. According with the H//AZ index, 54.6% of children had adequate nutrition. However 23% of them suffered from VAD. In children at risk of developing undernutrition (Z score = -1 to > -2 SD), 20.9% had VAD and of the stunted children, 21.9% presented VAD. With W//AZ, 60.3%, 29.9% and 9.1% of children were with adequate nutrition, at risk, or wasted respectively; of each group, 25.6%, 17.7% and 15%, respectively had serum retinol values below 20 micrograms/dL. The Z score of W//HZ indicator revealed that 87.4%, 10.4% and 2.4% of children were in good nutrition, at risk, or with acute protein-energy malnutrition, respectively. In the three groups 22.1%, 23.8% and 20%, respectively were affected by VAD. These results indicate that VAD coexists indistinctly in healthy, adequately nourished children, as in those malnourished ones. Our VAD prevalence results and others from Venezuela, are higher than the criteria laid down by WHO and PAHO which warrant wide community intervention. This public health problem becomes more significant because children are apparently healthy and, if timely vitamin A supplementation is not given, any intercurrent infection is likely to worsen the vitamin A status, increasing the widely known consequences.

Psychophysics, reliability, and norm values for temporal contrast sensitivity implemented on the two alternative forced choice C-Quant device.

PubMed

van den Berg, Thomas J T P; Franssen, Luuk; Kruijt, Bastiaan; Coppens, Joris E

2011-08-01

The current paper describes the design and population testing of a flicker sensitivity assessment technique corresponding to the psychophysical approach for straylight measurement. The purpose is twofold: to check the subjects' capability to perform the straylight test and as a test for retinal integrity for other purposes. The test was implemented in the Oculus C-Quant straylight meter, using homemade software (MATLAB). The geometry of the visual field lay-out was identical, as was the subjects' 2AFC task. A comparable reliability criterion ("unc") was developed. Outcome measure was logTCS (temporal contrast sensitivity). The population test was performed in science fair settings on about 400 subjects. Moreover, 2 subjects underwent extensive tests to check whether optical defects, mimicked with trial lenses and scatter filters, affected the TCS outcome. Repeated measures standard deviation was 0.11 log units for the reference population. Normal values for logTCS were around 2 (threshold 1%) with some dependence on age (range 6 to 85 years). The test outcome did not change upon a tenfold (optical) deterioration in visual acuity or straylight. The test has adequate precision for checking a subject's capability to perform straylight assessment. The unc reliability criterion ensures sufficient precision, also for assessment of retinal sensitivity loss.

A Low-Noise, Modular, and Versatile Analog Front-End Intended for Processing In Vitro Neuronal Signals Detected by Microelectrode Arrays

PubMed Central

Regalia, Giulia; Biffi, Emilia; Ferrigno, Giancarlo; Pedrocchi, Alessandra

2015-01-01

The collection of good quality extracellular neuronal spikes from neuronal cultures coupled to Microelectrode Arrays (MEAs) is a binding requirement to gather reliable data. Due to physical constraints, low power requirement, or the need of customizability, commercial recording platforms are not fully adequate for the development of experimental setups integrating MEA technology with other equipment needed to perform experiments under climate controlled conditions, like environmental chambers or cell culture incubators. To address this issue, we developed a custom MEA interfacing system featuring low noise, low power, and the capability to be readily integrated inside an incubator-like environment. Two stages, a preamplifier and a filter amplifier, were designed, implemented on printed circuit boards, and tested. The system is characterized by a low input-referred noise (<1 μV RMS), a high channel separation (>70 dB), and signal-to-noise ratio values of neuronal recordings comparable to those obtained with the benchmark commercial MEA system. In addition, the system was successfully integrated with an environmental MEA chamber, without harming cell cultures during experiments and without being damaged by the high humidity level. The devised system is of practical value in the development of in vitro platforms to study temporally extended neuronal network dynamics by means of MEAs. PMID:25977683

Dynamic energy budget as a basis to model population-level effects of zinc-spiked sediments in the gastropod Valvata piscinalis.

PubMed

Ducrot, Virginie; Péry, Alexandre R R; Mons, Raphaël; Quéau, Hervé; Charles, Sandrine; Garric, Jeanne

2007-08-01

This paper presents original toxicity test designs and mathematical models that may be used to assess the deleterious effects of toxicants on Valvata piscinalis (Mollusca, Gastropoda). Results obtained for zinc, used as a reference toxicant, are presented. The feeding behavior, juvenile survival, growth, age at puberty, onset of reproduction, number of breedings during the life cycle, and fecundity were significantly altered when the snails were exposed to zinc-spiked sediments. Dynamic energy budget models (DEBtox) adequately predicted the effects of zinc on the V. piscinalis life cycle. They also provided estimates for lifecycle parameters that were used to parameterize a demographic model, based on a Z-transformed life-cycle graph. The effect threshold for the population growth rate (lambda) was estimated at 259 mg/kg dry sediment of zinc, showing that significant changes in abundance may occur at environmental concentrations. Significant effects occurring just above this threshold value were mainly caused by the severe impairment of reproductive endpoints. Sensitivity analysis showed that the value of lambda depended mainly on the juvenile survival rate. The impairment of this latter parameter may result in extinction of V. piscinalis. Finally, the present study highlights advantages of the proposed modeling approach in V. piscinalis and possible transfer to other test species and contaminants.

A low-noise, modular, and versatile analog front-end intended for processing in vitro neuronal signals detected by microelectrode arrays.

PubMed

Regalia, Giulia; Biffi, Emilia; Ferrigno, Giancarlo; Pedrocchi, Alessandra

2015-01-01

The collection of good quality extracellular neuronal spikes from neuronal cultures coupled to Microelectrode Arrays (MEAs) is a binding requirement to gather reliable data. Due to physical constraints, low power requirement, or the need of customizability, commercial recording platforms are not fully adequate for the development of experimental setups integrating MEA technology with other equipment needed to perform experiments under climate controlled conditions, like environmental chambers or cell culture incubators. To address this issue, we developed a custom MEA interfacing system featuring low noise, low power, and the capability to be readily integrated inside an incubator-like environment. Two stages, a preamplifier and a filter amplifier, were designed, implemented on printed circuit boards, and tested. The system is characterized by a low input-referred noise (<1 μV RMS), a high channel separation (>70 dB), and signal-to-noise ratio values of neuronal recordings comparable to those obtained with the benchmark commercial MEA system. In addition, the system was successfully integrated with an environmental MEA chamber, without harming cell cultures during experiments and without being damaged by the high humidity level. The devised system is of practical value in the development of in vitro platforms to study temporally extended neuronal network dynamics by means of MEAs.

Real-Time Three-Dimensional Echocardiography of the Left Ventricle-Pediatric Percentiles and Head-to-Head Comparison of Different Contour-Finding Algorithms: A Multicenter Study.

PubMed

Krell, Kristina; Laser, Kai Thorsten; Dalla-Pozza, Robert; Winkler, Christian; Hildebrandt, Ursula; Kececioglu, Deniz; Breuer, Johannes; Herberg, Ulrike

2018-03-28

Real-time three-dimensional echocardiography (RT3DE) is a promising method for accurate assessment of left ventricular (LV) volumes and function, however, pediatric reference values are scarce. The aim of the study was to establish pediatric percentiles in a large population and to compare the inherent influence of different evaluation software on the resulting measurements. In a multicenter prospective-design study, 497 healthy children (ages 1 day to 219 months) underwent RT3DE imaging of the LV (ie33, Philips, Andover, MA). Volume analysis was performed using QLab 9.0 (Philips) and TomTec 4DLV2.7 (vendor-independent; testing high (TomTec 75 ) and low (TomTec 30 ) contour-finding activity). Reference percentiles were computed using Cole's LMS method. In 22 subjects, cardiovascular magnetic resonance imaging (CMR) was used as the reference. A total of 370/497 (74.4%) of the subjects provided adequate data sets. LV volumes had a significant association with age, body size, and gender; therefore, sex-specific percentiles were indexed to body surface area. Intra- and interobserver variability for both workstations was good (relative bias ± SD for end-diastolic volume [EDV] in %: intraobserver: QLab = -0.8 ± 2.4; TomTec 30  = -0.7 ± 7.2; TomTec 75  = -1.9 ± 6.7; interobserver: QLab = 2.4 ± 7.5; TomTec 30  = 1.2 ± 5.1; TomTec 75  = 1.3 ± 4.5). Intervendor agreement between QLab and TomTec 30 showed larger bias and wider limits of agreement (bias: QLab vs TomTec 30 : end-systolic volume [ESV] = 0.8% ± 23.6%; EDV = -2.2% ± 17.0%) with notable individual differences in small children. QLab and TomTec underestimated CMR values, with the highest agreement between CMR and QLab. RT3DE allows reproducible noninvasive assessment of LV volumes and function. However, intertechnique variability is relevant. Therefore, our software-specific percentiles, based on a large pediatric population, serve as a reference for both commonly used quantification programs. Copyright © 2018 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

[Relationship between reference values of fibrinogen and geographical factors based on neural network analysis].

PubMed

Li, Meng-Jiao; Ge, Miao; Wang, Cong-Xia; Cen, Min-Yi; Jiang, Ji-Lin; He, Jin-Wei; Lin, Qian-Yi; Liu, Xin

2016-08-20

To analyze the relationship between the reference values of fibrinogen (FIB) in healthy Chinese adults and geographical factors to provide scientific evidences for establishing the uniform standard. The reference values of FIB of 10701 Chinese healthy adults from 103 cities were collected to investigate their relationship with 18 geographical factors including spatial index, terrain index, climate index, and soil index. Geographical factors that significantly correlated with the reference values were selected for constructing the BP neural network model. The spatial distribution map of the reference value of FIB of healthy Chinese adults was fitted by disjunctive kriging interpolation. We used the 5-layer neural network and selected 2000 times of training covering 11 hidden layers to build the simulation rule for simulating the relationship between FIB and geographical environmental factors using the MATLAB software. s The reference value of FIB in healthy Chinese adults was significantly correlated with the latitude, sunshine duration, annual average temperature, annual average relative humidity, annual precipitation, annual range of air temperature, average annual soil gravel content, and soil cation exchange capacity (silt). The artificial neural networks were created to analyze the simulation of the selected indicators of geographical factors. The spatial distribution map of the reference values of FIB in healthy Chinese adults showed a distribution pattern that FIB levels were higher in the South and lower in the North, and higher in the East and lower in the West. When the geographical factors of a certain area are known, the reference values of FIB in healthy Chinese adults can be obtained by establishing the neural network mode or plotting the spatial distribution map.

Hematologic and serum chemistry reference intervals for free-ranging lions (Panthera leo).

PubMed

Maas, Miriam; Keet, Dewald F; Nielen, Mirjam

2013-08-01

Hematologic and serum chemistry values are used by veterinarians and wildlife researchers to assess health status and to identify abnormally high or low levels of a particular blood parameter in a target species. For free-ranging lions (Panthera leo) information about these values is scarce. In this study 7 hematologic and 11 serum biochemistry values were evaluated from 485 lions from the Kruger National Park, South Africa. Significant differences between sexes and sub-adult (≤ 36 months) and adult (>36 months) lions were found for most of the blood parameters and separate reference intervals were made for those values. The obtained reference intervals include the means of the various blood parameter values measured in captive lions, except for alkaline phosphatase in the subadult group. These reference intervals can be utilized for free-ranging lions, and may likely also be used as reference intervals for captive lions. Copyright © 2013 Elsevier Ltd. All rights reserved.

Geographical distribution of reference value of aging people's left ventricular end systolic diameter based on the support vector regression.

PubMed

Han, Xiao; Ge, Miao; Dong, Jie; Xue, Ranying; Wang, Zixuan; He, Jinwei

2014-09-01

The aim of this paper is to analyze the geographical distribution of reference value of aging people's left ventricular end systolic diameter (LVDs), and to provide a scientific basis for clinical examination. The study is focus on the relationship between reference value of left ventricular end systolic diameter of aging people and 14 geographical factors, selecting 2495 samples of left ventricular end systolic diameter (LVDs) of aging people in 71 units of China, in which including 1620 men and 875 women. By using the Moran's I index to make sure the relationship between the reference values and spatial geographical factors, extracting 5 geographical factors which have significant correlation with left ventricular end systolic diameter for building the support vector regression, detecting by the method of paired sample t test to make sure the consistency between predicted and measured values, finally, makes the distribution map through the disjunctive kriging interpolation method and fits the three-dimensional trend of normal reference value. It is found that the correlation between the extracted geographical factors and the reference value of left ventricular end systolic diameter is quite significant, the 5 indexes respectively are latitude, annual mean air temperature, annual mean relative humidity, annual precipitation amount, annual range of air temperature, the predicted values and the observed ones are in good conformity, there is no significant difference at 95% degree of confidence. The overall trend of predicted values increases from west to east, increases first and then decreases from north to south. If geographical values are obtained in one region, the reference value of left ventricular end systolic diameter of aging people in this region can be obtained by using the support vector regression model. It could be more scientific to formulate the different distributions on the basis of synthesizing the physiological and the geographical factors. -Use Moran's index to analyze the spatial correlation. -Choose support vector machine to build model that overcome complexity of variables. -Test normal distribution of predicted data to guarantee the interpolation results. -Through trend analysis to explain the changes of reference value clearly. Copyright © 2014 Elsevier Inc. All rights reserved.

Reference-dependent risk sensitivity as rational inference.

PubMed

Denrell, Jerker C

2015-07-01

Existing explanations of reference-dependent risk sensitivity attribute it to cognitive imperfections and heuristic choice processes. This article shows that behavior consistent with an S-shaped value function could be an implication of rational inferences about the expected values of alternatives. Theoretically, I demonstrate that even a risk-neutral Bayesian decision maker, who is uncertain about the reliability of observations, should use variability in observed outcomes as a predictor of low expected value for outcomes above a reference level, and as a predictor of high expected value for outcomes below a reference level. Empirically, I show that combining past outcomes using an S-shaped value function leads to accurate predictions about future values. The theory also offers a rationale for why risk sensitivity consistent with an inverse S-shaped value function should occur in experiments on decisions from experience with binary payoff distributions. (c) 2015 APA, all rights reserved).

Bedside diagnosis of dysphagia: a systematic review.

PubMed

O'Horo, John C; Rogus-Pulia, Nicole; Garcia-Arguello, Lisbeth; Robbins, JoAnne; Safdar, Nasia

2015-04-01

Dysphagia is associated with aspiration, pneumonia, and malnutrition, but remains challenging to identify at the bedside. A variety of exam protocols and maneuvers are commonly used, but the efficacy of these maneuvers is highly variable. We conducted a comprehensive search of 7 databases, including MEDLINE, Embase, and Scopus, from each database's earliest inception through June 9, 2014. Studies reporting diagnostic performance of a bedside examination maneuver compared to a reference gold standard (videofluoroscopic swallow study or flexible endoscopic evaluation of swallowing with sensory testing) were included for analysis. From each study, data were abstracted based on the type of diagnostic method and reference standard study population and inclusion/exclusion characteristics, design, and prediction of aspiration. The search strategy identified 38 articles meeting inclusion criteria. Overall, most bedside examinations lacked sufficient sensitivity to be used for screening purposes across all patient populations examined. Individual studies found dysphonia assessments, abnormal pharyngeal sensation assessments, dual axis accelerometry, and 1 description of water swallow testing to be sensitive tools, but none were reported as consistently sensitive. A preponderance of identified studies was in poststroke adults, limiting the generalizability of results. No bedside screening protocol has been shown to provide adequate predictive value for presence of aspiration. Several individual exam maneuvers demonstrated reasonable sensitivity, but reproducibility and consistency of these protocols was not established. More research is needed to design an optimal protocol for dysphagia detection. © 2015 Society of Hospital Medicine.

[Detection of thyroid dysfunction in pregnant women: universal screening is justified].

PubMed

Vila, Lluís; Velasco, Inés; González, Stella; Morales, Francisco; Sánchez, Emilia; Lailla, José Maria; Martinez-Astorquiza, Txanton; Puig-Domingo, Manel

2012-11-03

There is a controversy among different scientific societies in relation to the recommendations on whether universal screening for the detection of thyroid dysfunction during gestation should be performed or not. Although various studies have shown an association between subclinical hypothyroidism or hypothyroxinemia with obstetric problems and/or neurocognitive impairment in the offspring, no evidence on the possible positive effects of treatment of such conditions with thyroxin has been demonstrated so far. However, there is a general agreement about the need for treatment of clinical hypothyroidism during pregnancy and the risks of not doing so. Because it is a common, easily diagnosed and effectively treated disorder without special risk, the working Group of Iodine Deficiency Disorders and Thyroid Dysfunction of the Spanish Society of Endocrinology and Nutrition and Spanish Society of Gynaecology and Obstetrics recommends an early evaluation (before week 10) of thyroid function in all pregnant women. Given the complex physiology of thyroid function during pregnancy, hormone assessment should be performed according to reference values for each gestational trimester and generated locally in each reference laboratory. Thyrotropin determination would be sufficient for screening purposes and only if it is altered, free thyroxin or total thyroxin would be required. Adequate iodine nutrition is also highly recommended before and during pregnancy to contribute to a normal thyroid function in the pregnant women and fetus.

Detection of thyroid dysfunction in pregnant women: universal screening is justified.

PubMed

Vila, Lluís; Velasco, Inés; González, Stella; Morales, Francisco; Sánchez, Emilia; Lailla, José Maria; Martinez-Astorquiza, Txanton; Puig-Domingo, Manel

2012-11-01

There is a controversy among different scientific societies in relation to the recommendations on whether universal screening for the detection of thyroid dysfunction during gestation should be performed or not. Although various studies have shown an association between subclinical hypothyroidism or hypothyroxinemia with obstetric problems and/or neurocognitive impairment in the offspring, no evidence on the possible positive effects of treatment of such conditions with thyroxin has been demonstrated so far. However, there is a general agreement about the need for treatment of clinical hypothyroidism during pregnancy and the risks of not doing so. Because it is a common, easily diagnosed and effectively treated disorder without special risk, the working Group of Iodine Deficiency Disorders and Thyroid Dysfunction of the Spanish Society of Endocrinology and Nutrition and Spanish Society of Gynaecology and Obstetrics recommends an early evaluation (before week 10) of thyroid function in all pregnant women. Given the complex physiology of thyroid function during pregnancy, hormone assessment should be performed according to reference values for each gestational trimester and generated locally in each reference laboratory. Thyrotropin determination would be sufficient for screening purposes and only if it is altered, free thyroxin or total thyroxin would be required. Adequate iodine nutrition is also highly recommended before and during pregnancy to contribute to a normal thyroid function in the pregnant women and fetus. Copyright © 2012 SEEN. Published by Elsevier Espana. All rights reserved.

Nutritional intake of various groups of Flemish vegetarians

PubMed Central

2011-01-01

Background The most recent national nutritional survey (2004) indicates that 1.2% of the Flemish population follows a vegetarian diet. Information on nutritional intake in vegetarians in this population is scarce. Objective The aim of the present study is to describe the nutritional intake and dietary adequacy of various groups of Flemish vegetarians. Materials and methods Nutritional intake was assessed in various vegetarian groups from different study designs: young children (aged 1 to 10 y; n = 27) (Group 1), adolescents and adults (aged 11 to 32 y; n = 50) (Group 2), college students (aged 18 to 24 y; n= 24) (Group 3), life-long vegetarians (aged 14 to 71 y; n = 36) (Group 4) and adults (aged 20 to 98; n= 106) (Group 5). Additionally, blood samples were collected and analysed in groups 3 and 4. Comparisons were made with standard references or with omnivores (Group 3). Results Nutritional intake was found to be close to the Belgian RDA. However, all groups showed a number of outliers with an intake of some nutrients above or below the RDAs. Blood biochemistry showed low cholesterol, iron and vitamin B12 levels in vegetarians when comparing respectively with omnivores pairs (Group 3) and with reference values (Group 4). Conclusions Data collected in Flemish vegetarians indicate that a vegetarian diet may be adequate. However, the outliers in all groups show that proper dietary planning is advisable.

High performance thin layer chromatography fingerprinting, phytochemical and physico-chemical studies of anti-diabetic herbal extracts

PubMed Central

Itankar, Prakash R.; Sawant, Dattatray B.; Tauqeer, Mohd.; Charde, Sonal S.

2015-01-01

Introduction: Herbal medicines have gained increasing popularity in the last few decades, and this global resurgence of herbal medicines increases their commercial value. However, this increasing demand has resulted in a decline in their quality, primarily due to a lack of adequate regulations pertaining to herbal medicines. Aim: To develop an optimized methodology for the standardization of herbal raw materials. Materials and Methods: The present study has been designed to examine each of the five herbal anti-diabetic drugs, Gymnema sylvester R. Br., Pterocarpus marsupium Roxburgh., Enicostema littorale Blume., Syzygium cumini (L.) Skeels. and Emblica officinalis Gaertn. The in-house extracts and marketed extracts were evaluated using physicochemical parameters, preliminary phytochemical screening, quantification of polyphenols (Folin–Ciocalteu colorimetric method) and high performance thin layer chromatography (HPTLC) fingerprint profiling with reference to marker compounds in plant extracts. Results: All the plants mainly contain polyphenolic compounds and are quantified in the range of 3.6–21.72% w/w. E. officinalis contain the highest and E. littorale contain the lowest content of polyphenol among plant extracts analyzed. HPTLC fingerprinting showed that the in-house extracts were of better quality than marketed extracts. Conclusion: The results obtained from the study could be utilized for setting limits for the reference phytoconstituents (biomarker) for the quality control and quality assurance of these anti-diabetic drugs. PMID:27011722

Better Red than Dead--Putting an End to the Social Irrelevance of Postwar Philosophy of Science

ERIC Educational Resources Information Center

Howard, Don

2009-01-01

This paper asks what is necessary in a theory of science adequate to the task of empowering philosophers of science to participate in public debate about science in a social context. It is argued that an adequate theory of science must be capable of theorizing the role of values and motives in science and that it must take seriously the…

Food Insecurity and Diabetes in Developed Societies.

PubMed

Essien, Utibe R; Shahid, Naysha N; Berkowitz, Seth A

2016-09-01

Food insecurity is an important issue in public health even in developed societies, particularly for vulnerable populations. Food insecurity refers to the uncertain or limited access to adequate and safe foods. Emerging evidence shows an association between food insecurity, type 2 diabetes risk factors, and management of type 1 and type 2 diabetes. A review of the current literature describing the association between food insecurity and diabetes reveals possible mechanisms and pathophysiologic pathways. There is less evidence for effective interventions, and much of the current literature is limited to cross-sectional studies. Future work should evaluate longitudinal associations and ways to help vulnerable patients with diabetes access adequate food for effective diabetes management.

Vitamin D and obesity.

PubMed

Vanlint, Simon

2013-03-20

Obesity is a significant health problem world-wide, particularly in developed nations. Vitamin D deficiency is pandemic, and has been implicated in a wide variety of disease states. This paper seeks to examine the consistently reported relationship between obesity and low vitamin D concentrations, with reference to the possible underlying mechanisms. The possibility that vitamin D may assist in preventing or treating obesity is also examined, and recommendations for future research are made. There is a clear need for adequately-powered, prospective interventions which include baseline measurement of 25D concentrations and involve adequate doses of supplemental vitamin D. Until such studies have been reported, the role of vitamin D supplementation in obesity prevention remains uncertain.

Understanding and Applying the Concept of Value Creation in Radiology.

PubMed

Larson, David B; Durand, Daniel J; Siegal, Daniel S

2017-04-01

The concept of value in radiology has been strongly advocated in recent years as a means of advancing patient care and decreasing waste. This article explores the concept of value creation in radiology and offers a framework for how radiology practices can create value according to the needs of their referring clinicians. Value only exists in the eyes of a customer. We propose that the primary purpose of diagnostic radiology is to answer clinical questions using medical imaging to help guide management of patient care. Because they are the direct recipient of this service, we propose that referring clinicians are the direct customers of a radiology practice and patients are indirect customers. Radiology practices create value as they understand and fulfill their referring clinicians' needs. To narrow those needs to actionable categories, we propose a framework consisting of four major dimensions: (1) how quickly the clinical question needs to be answered, (2) the degree of specialization required to answer the question, (3) how often the referring clinician uses imaging, and (4) the breadth of imaging that the referring clinician uses. We further identify three major settings in which referring clinicians utilize radiological services: (1) emergent or urgent care, (2) primary care, and (3) specialty care. Practices best meet these needs as they engage with their referring clinicians, create a shared vision, work together as a cohesive team, structure the organization to meet referring clinicians' needs, build the tools, and continually improve in ways that help referring clinicians care for patients. Copyright © 2016 American College of Radiology. Published by Elsevier Inc. All rights reserved.

Reference values for 34 frequently used laboratory tests in 80-year-old men and women.

PubMed

Helmersson-Karlqvist, Johanna; Ridefelt, Peter; Lind, Lars; Larsson, Anders

2016-10-01

Reference values are usually based on blood samples from healthy individuals in the age range 20-50 years. Most patients seeking health care are older than this reference population. Many reference intervals are age dependent and there is thus a need to have appropriate reference intervals also for elderly individuals. We analyzed a group of frequently used laboratory tests in an 80-year-old population (n=531, 266 females and 265 males). The 2.5th and 97.5th percentiles for these markers were calculated according to the International Federation of Clinical Chemistry guidelines on the statistical treatment of reference values. Reference values are reported for serum alanine transaminase (ALT), albumin, alkaline phosphatase, pancreatic amylase, apolipoprotein A1, apolipoprotein B, apolipoprotein B/apolipoprotein A1 ratio, aspartate aminotransferase (AST), AST/ALT ratio, bilirubin, calcium, calprotectin, cholesterol, HDL-cholesterol, creatinine kinase (CK), creatinine, creatinine estimated GFR, C-reactive protein, cystatin C, cystatin C estimated GFR, gamma-glutamyltransferase (GGT), iron, iron saturation, lactate dehydrogenase (LDH), magnesium, phosphate, transferrin, triglycerides, urate, urea, zinc, hemoglobin, platelet count and white blood cell count. The upper reference limit for creatinine and urea was significantly increased while the lower limit for iron and albumin was decreased in this elderly population in comparison with the population in the Nordic Reference Interval Project (NORIP). Reference values calculated from the whole population and a subpopulation without cardiovascular disease showed strong concordance. Several of the reference interval limits were outside the 90% confidence interval of NORIP. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Conversion of ICRP male reference phantom to polygon-surface phantom

NASA Astrophysics Data System (ADS)

Yeom, Yeon Soo; Han, Min Cheol; Kim, Chan Hyeong; Jeong, Jong Hwi

2013-10-01

The International Commission on Radiological Protection (ICRP) reference phantoms, developed based on computed tomography images of human bodies, provide much more realism of human anatomy than the previously used MIRD5 (Medical Internal Radiation Dose) mathematical phantoms. It has been, however, realized that the ICRP reference phantoms have some critical limitations showing a considerable amount of holes for the skin and wall organs mainly due to the nature of voxels of which the phantoms are made, especially due to their low voxel resolutions. To address this problem, we are planning to develop the polygon-surface version of ICRP reference phantoms by directly converting the ICRP reference phantoms (voxel phantoms) to polygon-surface phantoms. The objective of this preliminary study is to see if it is indeed possible to construct the high-quality polygon-surface phantoms based on the ICRP reference phantoms maintaining identical organ morphology and also to identify any potential issues, and technologies to address these issues, in advance. For this purpose, in the present study, the ICRP reference male phantom was roughly converted to a polygon-surface phantom. Then, the constructed phantom was implemented in Geant4, Monte Carlo particle transport code, for dose calculations, and the calculated dose values were compared with those of the original ICRP reference phantom to see how much the calculated dose values are sensitive to the accuracy of the conversion process. The results of the present study show that it is certainly possible to convert the ICRP reference phantoms to surface phantoms with enough accuracy. In spite of using relatively less resources (<2 man-months), we were able to construct the polygon-surface phantom with the organ masses perfectly matching the ICRP reference values. The analysis of the calculated dose values also implies that the dose values are indeed not very sensitive to the detailed morphology of the organ models in the phantom for highly penetrating radiations such as photons and neutrons. The results of the electron beams, on the other hand, show that the dose values of the polygon-surface phantom are higher by a factor of 2-5 times than those of the ICRP reference phantom for the skin and wall organs which have large holes due to low voxel resolution. The results demonstrate that the ICRP reference phantom could provide significantly unreasonable dose values to thin or wall organs especially for weakly penetrating radiations. Therefore, when compared to the original ICRP reference phantoms, it is believed that the polygon-surface version of ICRP reference phantoms properly developed will not only provide the same or similar dose values (say, difference <5 or 10%) for highly penetrating radiations, but also provide correct dose values for the weakly penetrating radiations such as electrons and other charged particles.

[ETAP: A smoking scale for Primary Health Care].

PubMed

González Romero, Pilar María; Cuevas Fernández, Francisco Javier; Marcelino Rodríguez, Itahisa; Rodríguez Pérez, María Del Cristo; Cabrera de León, Antonio; Aguirre-Jaime, Armando

2016-05-01

To obtain a scale of tobacco exposure to address smoking cessation. Follow-up of a cohort. Scale validation. Primary Care Research Unit. Tenerife. A total of 6729 participants from the "CDC de Canarias" cohort. A scale was constructed under the assumption that the time of exposure to tobacco is the key factor to express accumulated risk. Discriminant validity was tested on prevalent cases of acute myocardial infarction (AMI; n=171), and its best cut-off for preventive screening was obtained. Its predictive validity was tested with incident cases of AMI (n=46), comparing the predictive power with markers (age, sex) and classic risk factors of AMI (hypertension, diabetes, dyslipidaemia), including the pack-years index (PYI). The scale obtained was the sum of three times the years that they had smoked plus years exposed to smoking at home and at work. The frequency of AMI increased with the values of the scale, with the value 20 years of exposure being the most appropriate cut-off for preventive action, as it provided adequate predictive values for incident AMI. The scale surpassed PYI in predicting AMI, and competed with the known markers and risk factors. The proposed scale allows a valid measurement of exposure to smoking and provides a useful and simple approach that can help promote a willingness to change, as well as prevention. It still needs to demonstrate its validity, taking as reference other problems associated with smoking. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

Budgetary Impact of Telotristat Ethyl, a Novel Treatment for Patients with Carcinoid Syndrome Diarrhea: A US Health Plan Perspective.

PubMed

Joish, Vijay N; Frech, Feride; Lapuerta, Pablo

2017-12-01

Telotristat ethyl (TE) was recently approved for carcinoid syndrome diarrhea (CSD) in patients not adequately controlled with somatostatin analog long-acting release (SSA LAR) therapy alone. A budget impact model was developed to determine the short-term affordability of reimbursing TE in a US health plan. A budget impact model compared health care costs when CSD is managed per current treatment patterns (SSA LAR, reference drug scenario) versus when TE is incorporated in the treatment algorithm (SSA LAR + TE, new drug scenario). Prevalence of CSD, proportion of patients not adequately controlled on SSA LAR, monthly treatment costs (pharmacy and medical), and treatment efficacy were derived from the literature. In the reference drug scenario, an escalated monthly dose of SSA LAR therapy of 40 mg was assumed to treat patients with CSD not adequately controlled on the labeled dose of SSA LAR. In the new drug scenario, TE was added to the maximum labeled monthly dose of SSA LAR therapy of 30 mg. The incremental budget impact was calculated based on an assumed TE market uptake of 28%, 42%, and 55% during Years 1, 2, and 3, respectively. One-way sensitivity analyses were conducted to test model assumptions. A hypothetical health plan of 1 million members was estimated to have 42 prevalent CSD patients of whom 17 would be inadequately controlled on SSA LAR therapy. The monthly medical cost per patient not adequately controlled on SSA LAR in addition to pharmacotherapy was estimated to be $3946 based on the literature. Based on the observed treatment response in a clinical trial of 20% and 44% for the base case reference and new drug scenarios, total per patient per month costs were estimated to be $7563 and $11,205, respectively. Total annual costs in the new drug scenario were estimated to be $2.3 to $2.5 million during the first 3 years. The overall incremental annual costs were estimated to be $154,000 in Year 1, $231,000 in Year 2, and $302,000 in Year 3. This translated to an incremental per patient per month cost of $0.013, $0.019, and $0.025 for Years 1, 2, and 3. These results remained robust in 1-way sensitivity analyses. The availability of TE for patients not adequately controlled on SSA LAR therapy provides a novel treatment option for CSD. This model showed that providing access to this first-in-class oral agent would have a minimal budget impact to a US health plan. Copyright © 2017 Elsevier HS Journals, Inc. All rights reserved.

12 CFR 206.4 - Credit exposure.

Code of Federal Regulations, 2010 CFR

2010-01-01

... current market value of the collateral; (2) The proceeds of checks and other cash items deposited in an... that may be sold in ordinary circumstances with reasonable promptness at a fair market value determined... cannot obtain adequate information concerning the capital ratios of the correspondent, the bank shall...

Blood vitamins and trace elements in Northern-East African cheetahs (Acinonyx jubatus soemmeringii) in captivity in the Middle East.

PubMed

Beckmann, Katie M; O'Donovan, Declan; McKeown, Sean; Wernery, Ulli; Basu, Puja; Bailey, Tom A

2013-09-01

There are few published data regarding the endangered Northern-East African cheetah (Acinonyx jubatus soemmeringii), held in captivity in the Middle East and Europe. Studies have demonstrated a high incidence of disease in captive cheetahs, in which vitamin and trace element imbalances have often been implicated. Blood vitamin and trace element reference values in cheetahs merit further investigation. In this study, blood samples were opportunistically collected from apparently healthy A. j. soemmeringii from two collections (A and B) with successful breeding programs in the United Arab Emirates. The cheetahs were fed whole prey of mixed species (and, in Collection B, goat muscle and bone as well) dusted with vitamin and mineral supplements. Mean serum vitamin and trace element values (for cheetahs > 4 mo in age) were as follows: vitamin A (retinol), 2.20 microM/L (n = 27); vitamin B1, 0.0818 microM/L (n = 45); vitamin C, 28.6 microM/L (n=10); vitamin E (alpha-tocopherol), 35.6 microM/L (n = 27); copper (Cu), 12.53 microM/L (n = 27); selenium (Se), 3.10 microM/L (n = 27); and zinc (Zn), 10.87 microM/L (n = 27). Mean values of vitamin A, vitamin E, Cu, and Zn fell within ranges of published cheetah mean values, and mean Se was lower than range values for cheetahs presented in one previous study; blood vitamin B1 and vitamin C values of cheetahs have not previously been published. The values were taken to indicate that the cheetahs' nutritional status was adequate with regard to those nutrients analyzed. Serum vitamin E was particularly high in cheetahs fed fresh whole prey, and on this basis vitamin E supplementation of fresh whole prey appeared to have been unnecessary. There were differences (P < 0.05) between collections in serum vitamin B1, vitamin E, Cu, and 10 other hematologic and biochemical parameters. Nine hematologic and blood biochemical parameters differed among age categories.

A stellar tracking reference system

NASA Technical Reports Server (NTRS)

Klestadt, B.

1971-01-01

A stellar attitude reference system concept for satellites was studied which promises to permit continuous precision pointing of payloads with accuracies of 0.001 degree without the use of gyroscopes. It is accomplished with the use of a single, clustered star tracker assembly mounted on a non-orthogonal, two gimbal mechanism, driven so as to unwind satellite orbital and orbit precession rates. A set of eight stars was found which assures the presence of an adequate inertial reference on a continuous basis in an arbitrary orbit. Acquisition and operational considerations were investigated and inherent reference redundancy/reliability was established. Preliminary designs for the gimbal mechanism, its servo drive, and the star tracker cluster with its associated signal processing were developed for a baseline sun-synchronous, noon-midnight orbit. The functions required of the onboard computer were determined and the equations to be solved were found. In addition detailed error analyses were carried out, based on structural, thermal and other operational considerations.

Better Red than Dead—Putting an End to the Social Irrelevance of Postwar Philosophy of Science

NASA Astrophysics Data System (ADS)

Howard, Don

2009-02-01

This paper asks what is necessary in a theory of science adequate to the task of empowering philosophers of science to participate in public debate about science in a social context. It is argued that an adequate theory of science must be capable of theorizing the role of values and motives in science and that it must take seriously the irreducibly social nature of scientific knowledge.

Water Purification, Distribution and Sewage Disposal. Appropriate Technologies for Development. Reprint R-29.

ERIC Educational Resources Information Center

1979

This document, designed to serve as a training manual for technical instructors and as a field resource reference for Peace Corps volunteers, consists of nine units. Unit topics focus on: (1) water supply sources; (2) water treatment; (3) planning water distribution systems; (4) characteristics of an adequate system; (5) construction techniques;…

Occupational hazards to hospital personnel

DOE Office of Scientific and Technical Information (OSTI.GOV)

Patterson, W.B.; Craven, D.E.; Schwartz, D.A.

1985-05-01

Hospital personnel are subject to various occupational hazards. Awareness of these risks, compliance with basic preventive measures, and adequate resources for interventions are essential components of an occupational health program. Physical, chemical, and radiation hazards; important infectious risks; and psychosocial problems prevalent in hospital workers are reviewed. A rational approach to managing and preventing these problems is offered. 370 references.

31 CFR 306.11 - Forms of registration for transferable securities.

Code of Federal Regulations, 2011 CFR

2011-07-01

...) (123-45-6789). (d) Life tenant under will. A security may be registered in the name of a life tenant followed by an adequate identifying reference to the will. Example: Anne B. Smith, life tenant under the will of Adam A. Smith, deceased (12-3456789). The life tenant will be considered a fiduciary. (e...

La Capacitacion de Docentes en el Marco de la Regionalizacion Educativa (In-Service Teacher Training within Educational Regional Planning).

ERIC Educational Resources Information Center

Valle, Victor M.

A paper discusses inservice teacher training in the context of regionalized education, with reference to recent Latin American efforts to regionalize, decentralize, and de-concentrate educational systems in order to provide relavant and adequate regional educational systems and so make equal education possible. Basic concepts in regionalized…

76 FR 79211 - Notice of Application for Proposed Withdrawal Extension and Opportunity for Public Meeting; Oregon

Federal Register 2010, 2011, 2012, 2013, 2014

2011-12-21

... Information Relay Service (FIRS) at 1-(800) 877-8339 to reach either of the named contacts during normal... herein by reference. The purpose of the proposed withdrawal extension is to continue the protection of... cooperative agreement would not provide adequate protection. The USFS would not need to acquire water rights...

Clear, Complete, and Justified Problem Formulations for Aquatic Life Benchmark Values: Specifying the Dimensions

EPA Science Inventory

Nations that develop water quality benchmark values have relied primarily on standard data and methods. However, experience with chemicals such as Se, ammonia, and tributyltin has shown that standard methods do not adequately address some taxa, modes of exposure and effects. Deve...

CLEAR, COMPLETE, AND JUSTIFIED PROBLEM FORMULATIONS FOR AQUATIC LIFE BENCHMARK VALUES: SPECIFYING THE DIMENSIONS

EPA Science Inventory

Nations that develop water quality benchmark values have relied primarily on standard data and methods. However, experience with chemicals such as Se, ammonia, and tributyltin has shown that standard methods do not adequately address some taxa, modes of exposure and effects. Deve...

Reference values for serum ferritin and percentage of transferrin saturation in Korean children and adolescents.

PubMed

Oh, Hea Lin; Lee, Jun Ah; Kim, Dong Ho; Lim, Jung Sub

2018-03-01

Ferritin reference values vary by age, gender, and ethnicity. We aimed to determine reference values of serum ferritin (SF) and the percentage of transferrin saturation (TSAT) for Korean children and adolescents. We analyzed data from 2,487 participants (1,311 males and 1,176 females) aged 10-20 years from the Korea National Health and Nutrition Examination Survey (2010-2012). We calculated age- and gender-stratified means and percentile values for SF and TSAT. We first plotted mean SF and TSAT by gender and according to age. In males, mean SF tended to be relatively constant among participants aged 10 to 14 years, with an upward trend thereafter. Mean SF trended downward among female participants until the age of 15 years and remained constant thereafter. Thus, significant gender differences in ferritin exist from the age of 14 years. High levels of SF were associated with obesity, and lower SF levels were associated with anemia and menarche status. We established reference values of SF and TSAT according to age and gender. The reference values for SF calculated in this study can be used to test the association between SF values and other defined diseases in Korean children and adolescents.

Handwriting assessment of Franco-Quebec primary school-age students

PubMed

Couture, Mélanie; Morin, Marie-France; Coallier, Mélissa; Lavigne, Audrey; Archambault, Patricia; Bolduc, Émilie; Chartier, Émilie; Liard, Karolane; Jasmin, Emmanuelle

2016-12-01

Reasons for referring school-age children to occupational therapy mainly relate to handwriting problems. However, there are no validated tools or reference values for assessing handwriting in francophone children in Canada. This study aimed to adapt and validate the writing tasks described in an English Canadian handwriting assessment protocol and to develop reference values for handwriting speed for francophone children. Three writing tasks from the Handwriting Assessment Protocol-2nd Edition (near-point and far-point copying and dictation) were adapted for Québec French children and administered to 141 Grade 1 ( n = 73) and Grade 2 ( n = 68) students. Reference values for handwriting speed were obtained for near point and far point copying tasks. This adapted protocol and these reference values for speed will improve occupational therapy handwriting assessments for the target population.

A multi-source probabilistic hazard assessment of tephra dispersal in the Neapolitan area

NASA Astrophysics Data System (ADS)

Sandri, Laura; Costa, Antonio; Selva, Jacopo; Folch, Arnau; Macedonio, Giovanni; Tonini, Roberto

2015-04-01

In this study we present the results obtained from a long-term Probabilistic Hazard Assessment (PHA) of tephra dispersal in the Neapolitan area. Usual PHA for tephra dispersal needs the definition of eruptive scenarios (usually by grouping eruption sizes and possible vent positions in a limited number of classes) with associated probabilities, a meteorological dataset covering a representative time period, and a tephra dispersal model. PHA then results from combining simulations considering different volcanological and meteorological conditions through weights associated to their specific probability of occurrence. However, volcanological parameters (i.e., erupted mass, eruption column height, eruption duration, bulk granulometry, fraction of aggregates) typically encompass a wide range of values. Because of such a natural variability, single representative scenarios or size classes cannot be adequately defined using single values for the volcanological inputs. In the present study, we use a method that accounts for this within-size-class variability in the framework of Event Trees. The variability of each parameter is modeled with specific Probability Density Functions, and meteorological and volcanological input values are chosen by using a stratified sampling method. This procedure allows for quantifying hazard without relying on the definition of scenarios, thus avoiding potential biases introduced by selecting single representative scenarios. Embedding this procedure into the Bayesian Event Tree scheme enables the tephra fall PHA and its epistemic uncertainties. We have appied this scheme to analyze long-term tephra fall PHA from Vesuvius and Campi Flegrei, in a multi-source paradigm. We integrate two tephra dispersal models (the analytical HAZMAP and the numerical FALL3D) into BET_VH. The ECMWF reanalysis dataset are used for exploring different meteorological conditions. The results obtained show that PHA accounting for the whole natural variability are consistent with previous probabilities maps elaborated for Vesuvius and Campi Flegrei on the basis of single representative scenarios, but show significant differences. In particular, the area characterized by a 300 kg/m2-load exceedance probability larger than 5%, accounting for the whole range of variability (that is, from small violent strombolian to plinian eruptions), is similar to that displayed in the maps based on the medium magnitude reference eruption, but it is of a smaller extent. This is due to the relatively higher weight of the small magnitude eruptions considered in this study, but neglected in the reference scenario maps. On the other hand, in our new maps the area characterized by a 300 kg/m2-load exceedance probability larger than 1% is much larger than that of the medium magnitude reference eruption, due to the contribution of plinian eruptions at lower probabilities, again neglected in the reference scenario maps.

Habitat Restoration and Monitoring in Urban Streams: The Case of Tryon Creek in Portland, OR

NASA Astrophysics Data System (ADS)

Rios Touma, B. P.; Prescott, C.; Axtell, S.; Kondolf, G. M.

2013-12-01

Habitat enhancement in urban streams can be important for threatened species but challenging, because of altered catchment hydrology and urban encroachment on floodplains and channel banks. In Portland (OR) restoration actions have been undertaken at the watershed scale (e.g.: storm water management, protection of sites with high watershed value) to improve water quality, and at reach scale, when water quality and quantity are adequate, to increase habitat heterogeneity and stabilize banks. To evaluate reach-scale restoration projects in the Tryon Creek watershed, we sampled benthic macroinvertebrates and conducted habitat quality surveys pre-project and over 4 years post- project. Species sensitive to pollution and diversity of trophic groups increased after restoration. Although taxonomical diversity increased after restoration, but was still low compared to reference streams. We found no significant changes in trait proportions and functional diversity. Functional diversity, proportion of shredders and semivoltine invertebrates were significantly higher in reference streams than the restored stream reaches. We hypothesized that inputs of coarse particulate organic matter and land use at watershed scale may explain the differences in biodiversity between restored and reference stream reaches. Variables such as substrate composition, canopy cover or large wood pieces did not change from pre- to post-project, so could not explain the changes in the community. This may have been partly attributable to insensitivity of the visual estimate methods used, but likely also reflects an importance influence of watershed variables on aquatic biota - suggesting watershed actions may be more effective for the ecological recovery of streams. For future projects, we recommend multihabitat benthic sampling supported by studies of channel geomorphology to better understand stream response to restoration actions.

Implementation of Size-Dependent Local Diagnostic Reference Levels for CT Angiography.

PubMed

Boere, Hub; Eijsvoogel, Nienke G; Sailer, Anna M; Wildberger, Joachim E; de Haan, Michiel W; Das, Marco; Jeukens, Cecile R L P N

2018-05-01

Diagnostic reference levels (DRLs) are established for standard-sized patients; however, patient dose in CT depends on patient size. The purpose of this study was to introduce a method for setting size-dependent local diagnostic reference levels (LDRLs) and to evaluate these LDRLs in comparison with size-independent LDRLs and with respect to image quality. One hundred eighty-four aortic CT angiography (CTA) examinations performed on either a second-generation or third-generation dual-source CT scanner were included; we refer to the second-generation dual-source CT scanner as "CT1" and the third-generation dual-source CT scanner as "CT2." The volume CT dose index (CTDI vol ) and patient diameter (i.e., the water-equivalent diameter) were retrieved by dose-monitoring software. Size-dependent DRLs based on a linear regression of the CTDI vol versus patient size were set by scanner type. Size-independent DRLs were set by the 5th and 95th percentiles of the CTDI vol values. Objective image quality was assessed using the signal-to-noise ratio (SNR), and subjective image quality was assessed using a 4-point Likert scale. The CTDI vol depended on patient size and scanner type (R 2 = 0.72 and 0.78, respectively; slope = 0.05 and 0.02 mGy/mm; p < 0.001). Of the outliers identified by size-independent DRLs, 30% (CT1) and 67% (CT2) were adequately dosed when considering patient size. Alternatively, 30% (CT1) and 70% (CT2) of the outliers found with size-dependent DRLs were not identified using size-independent DRLs. A negative correlation was found between SNR and CTDI vol (R 2 = 0.36 for CT1 and 0.45 for CT2). However, all outliers had a subjective image quality score of sufficient or better. We introduce a method for setting size-dependent LDRLs in CTA. Size-dependent LDRLs are relevant for assessing the appropriateness of the radiation dose for an individual patient on a specific CT scanner.

Bioequivalence of two lansoprazole delayed release capsules 30 mg in healthy male volunteers under fasting, fed and fasting-applesauce conditions: a partial replicate crossover study design to estimate the pharmacokinetics of highly variable drugs.

PubMed

Thota, S; Khan, S M; Tippabhotla, S K; Battula, R; Gadiko, C; Vobalaboina, V

2013-11-01

An open-label, 2-treatment, 3-sequence, 3-period, single-dose, partial replicate crossover studies under fasting (n=48), fed (n=60) and fasting-applesauce (n=48) (sprinkled on one table spoonful of applesauce) modalities were conducted in healthy adult male volunteers to evaluate bioequivalence between 2 formulations of lansoprazole delayed release capsules 30 mg. In all the 3 studies, as per randomization, either test or reference formulations were administered in a crossover manner with a required washout period of at least 7 days. Blood samples were collected adequately (0-24 h) to determine lansoprazole plasma concentrations using a validated LC-MS/MS analytical method. To characterize the pharmacokinetic parameters (Cmax, AUC0-t, AUC0-∞, Tmax, Kel and T1/2) of lansoprazole, non-compartmental analysis and ANOVA was applied on ln-transformed values. The bioequivalence was tested based on within-subject variability of the reference formulation. In fasting and fed studies (within-subject variability>30%) bioequivalence was evaluated with scaled average bioequivalence, hence for the pharmacokinetic parameters Cmax, AUC0-t and AUC0-∞, the 95% upper confidence bound for (μT-μR)2-θσ2 WR was ≤0, and the point estimates (test-to-reference ratio) were within the regulatory acceptance limit 80.00-125.00%. In fasting-applesauce study (within-subject variability<30%) bioequivalence was evaluated with average bioequivalence, the 90% CI of ln-transformed data of Cmax, AUC0-t and AUC0-∞ were within the regulatory acceptance limit 80.00-125.00%. Based on these aforesaid statistical inferences, it was concluded that the test formulation is bioequivalent to reference formulation. © Georg Thieme Verlag KG Stuttgart · New York.

SU-E-J-194: Continuous Patient Surface Monitoring and Motion Analysis During Lung SBRT

DOE Office of Scientific and Technical Information (OSTI.GOV)

Chung, E; Rioux, A; Benedict, S

2015-06-15

Purpose: Continuous monitoring of the SBRT lung patient motion during delivery is critical for ensuring adequate target volume margins in stereotactic body radiotherapy (SBRT). This work assesses the deviation of the patient surface motion using a real-time surface tracking system throughout treatment delivery. Methods: Our SBRT protocol employs abdominal compression to reduce the diaphragm movement to within 1 cm, and this is confirmed daily with fluoroscopy. Most patients are prescribed 3–5 fractions, and on treatment day a repeat motion analysis with fluoroscopy is performed, followed by a kV CBCT is aligned with the original planning CT image for 3D setupmore » confirmation. During this entire process a patient surface data restricted to whole chest or the sternum at the middle of the breathing cycle was captured using AlignRT optical surface tracking system and defined as a reference surface. For 10 patients, the deviation of the patient position from the reference surface was recorded during the SBRT delivery in the anterior-posterior (AP) direction at 3–6 measurements per second. Results: On average, the patient position deviated from the reference surface more than 4 mm, 3 mm and 2 mm in the AP direction for 0.95%, 3.7% and 11.1% of the total treatment time, respectively. Only one of the 10 patients showed that the maximum deviation of the patient surface during the SBRT delivery was greater than 1 cm. The average deviation of the patient surface from the reference surface during the SBRT delivery was not greater than 1.6 mm for any patient. Conclusion: This investigation indicates that AP motion can be significant even though the frequency is low. Continuous monitoring during SBRT has demonstrated value in monitoring patient motion ensuring that margins selected for SBRT are appropriate, and the use of non-ionizing and high-frequency imaging can provide useful indicators of motion during treatment.« less

SU-G-TeP3-02: Determination of Geometry-Specific Backscatter Factors for Radiobiology Studies

DOE Office of Scientific and Technical Information (OSTI.GOV)

Viscariello, N; Culberson, W; Lawless, M

2016-06-15

Purpose: Radiation biology research relies on an accurate radiation dose delivered to the biological target. Large field irradiations in a cabinet irradiator may use the AAPM TG-61 protocol. This relies on an air-kerma measurement and conversion to absorbed dose to water (Dw) on the surface of a water phantom using provided backscatter factors. Cell or small animal studies differ significantly from this reference geometry. This study aims to determine the impact of the lack of full scatter conditions in four representative geometries that may be used in radiobiology studies. Methods: MCNP6 was used to model the Dw on the surfacemore » of a full scatter phantom in a validated orthovoltage x-ray reference beam. Dw in a cylindrical mouse, 100 mm Petri dish, 6-well and 96-well cell culture dishes was simulated and compared to this full scatter geometry. A reference dose rate was measured using the TG-61 protocol in a cabinet irradiator. This nominal dose rate was used to irradiate TLDs in each phantom to a given dose. Doses were obtained based on TLDs calibrated in a NIST-traceable beam. Results: Compared to the full scattering conditions, the simulated dose to water in the representative geometries were found to be underestimated by 12-26%. The discrepancy was smallest with the cylindrical mouse geometry, which most closely approximates adequate lateral- and backscatter. TLDs irradiated in the mouse and petri dish phantoms using the TG-61 determined dose rate showed similarly lower values of Dw. When corrected for this discrepancy, they agreed with the predicted Dw within 5%. Conclusion: Using the TG-61 in-air protocol and given backscatter factors to determine a reference dose rate in a biological irradiator may not be appropriate given the difference in scattering conditions between irradiation and calibration. Without accounting for this, the dose rate is overestimated and is dependent on irradiation geometry.« less

[Effect of emotional content and self reference of learning materials on recall performance].

PubMed

Spies, K

1994-01-01

It is assumed that high affective value and high self-reference of learning material help to improve memory performance as these factors allow better memory consolidation (activation hypothesis) or better integration of the new material into existing knowledge structures (extent-of-processing hypothesis). To test this assumption, 60 subjects were shown 16 short advertising films characterized by low vs. high affective value and low vs. high self-reference. Both factors were varied within subjects. After the films had each been presented twice, subjects had to recall the product names and answer two questions to each film. Results showed for both dependent variables that films with high affective values were better remembered than films with low affective values. The same held true--though to a lower extent--with respect to self-reference. According to the expected linear trend, performance was best for material scoring high on affective value as well as on self-reference, while it was worst for material scoring low on both factors.

[Reference values for lead in blood in urban population in southern Brazil].

PubMed

Paoliello, M M; Gutierrez, P R; Turini, C A; Matsuo, T; Mezzaroba, L; Barbosa, D S; Carvalho, S R; Alvarenga, A L; Rezende, M I; Figueiroa, G A; Leite, V G; Gutierrez, A C; Lobo, B C; Cascales, R A

2001-05-01

To describe the reference values for lead in blood in an urban population in the city of Londrina, in the state of Paraná, Brazil. The reference population was composed of 520 adult volunteers who were assessed from November 1994 to December 1996. Exclusion criteria were: occupational exposure to lead, exposure through personal habits or practices, smoking more than 10 cigarettes per day, and living near industrial plants or other places that use lead in their production processes. Also excluded were individuals with abnormal clinical or laboratory results or with chronic diseases or cardiovascular disorders. Lead blood levels were determined using air-acetylene flame atomic absorption spectrophotometry. The detectable limit was 1.23 micrograms/dL. After the analyses of lead in blood, the following values were determined: minimum value, first quartile, median, third quartile, and maximum value; geometric mean; 95% confidence interval; experimental interval; and reference value. The reference values for lead in blood ranged from 1.20 micrograms/dL to 13.72 micrograms/dL. The geometric mean was 5.5 micrograms/dL. In general, the values found in this study are lower than those that have been reported for other countries. Additional data should be gathered from Brazilian populations living in more-industrialized areas.

Reference values of brachial-ankle pulse wave velocity according to age and blood pressure in a central Asia population.

PubMed

Yiming, Gulinuer; Zhou, Xianhui; Lv, Wenkui; Peng, Yi; Zhang, Wenhui; Cheng, Xinchun; Li, Yaodong; Xing, Qiang; Zhang, Jianghua; Zhou, Qina; Zhang, Ling; Lu, Yanmei; Wang, Hongli; Tang, Baopeng

2017-01-01

Brachial-ankle pulse wave velocity (baPWV), a direct measure of aortic stiffness, has increasingly become an important assessment for cardiovascular risk. The present study established the reference and normal values of baPWV in a Central Asia population in Xinjiang, China. We recruited participants from a central Asia population in Xinjiang, China. We performed multiple regression analysis to investigate the determinants of baPWV. The median and 10th-90th percentiles were calculated to establish the reference and normal values based on these categories. In total, 5,757 Han participants aged 15-88 years were included in the present study. Spearman correlation analysis showed that age (r = 0.587, p < 0.001) and mean blood pressure (MBP, r = 0.599, p <0.001) were the major factors influencing the values of baPWV in the reference population. Furthermore, in the multiple linear regression analysis, the standardized regression coefficients of age (0.445) and MBP (0.460) were much higher than those of body mass index, triglyceride, and glycemia (-0.054, 0.035, and 0.033, respectively). In the covariance analysis, after adjustment for age and MBP, only diabetes was the significant independent determinant of baPWV (p = 0.009). Thus, participants with diabetes were excluded from the reference value population. The reference values ranged from 14.3 to 25.2 m/s, and the normal values ranged from 13.9 to 21.2 m/s. This is the first study that has established the reference and normal values for baPWV according to age and blood pressure in a Central Asia population.

Reference values of fractional excretion of exhaled nitric oxide among non-smokers and current smokers.

PubMed

Torén, Kjell; Murgia, Nicola; Schiöler, Linus; Bake, Björn; Olin, Anna-Carin

2017-08-25

Fractional exhaled nitric oxide (FE NO ) is used to assess of airway inflammation; diagnose asthma and monitor adherence to advised therapy. Reliable and accurate reference values for FE NO are needed for both non-smoking and current smoking adults in the clinical setting. The present study was performed to establish reference adult FE NO values among never-smokers, former smokers and current smokers. FE NO was measured in 5265 subjects aged 25-75 years in a general-population study, using a chemiluminescence (Niox ™) analyser according to the guidelines of the American Thoracic Society and the European Respiratory Society. Atopy was based on the presence of immunoglobulin E (IgE) antibodies to common inhalant allergens (measured using Phadiatop® test). Spirometry without bronchodilation was performed and forced vital capacity (FVC), forced expired volume in 1 s (FEV 1 ) and the ratio of FEV 1 to FVC values were obtained. After excluding subjects with asthma, chronic bronchitis, spirometric airway obstruction and current cold, 3378 subjects remained. Equations for predictions of FE NO values were modelled using nonparametric regression models. FE NO levels were similar in never-smokers and former smokers, and these two groups were therefore merged into a group termed "non-smokers". Reference equations, including the 5th and 95th percentiles, were generated for female and male non-smokers, based on age, height and atopy. Regression models for current smokers were unstable. Hence, the proposed reference values for current smokers are based on the univariate distribution of FE NO and fixed cut-off limits. Reference values for FE NO among respiratory healthy non-smokers should be outlined stratified for gender using individual reference values. For current smokers separate cut-off limits are proposed.

Nationwide Multicenter Reference Interval Study for 28 Common Biochemical Analytes in China.

PubMed

Xia, Liangyu; Chen, Ming; Liu, Min; Tao, Zhihua; Li, Shijun; Wang, Liang; Cheng, Xinqi; Qin, Xuzhen; Han, Jianhua; Li, Pengchang; Hou, Li'an; Yu, Songlin; Ichihara, Kiyoshi; Qiu, Ling

2016-03-01

A nationwide multicenter study was conducted in the China to explore sources of variation of reference values and establish reference intervals for 28 common biochemical analytes, as a part of the International Federation of Clinical Chemistry and Laboratory Medicine, Committee on Reference Intervals and Decision Limits (IFCC/C-RIDL) global study on reference values. A total of 3148 apparently healthy volunteers were recruited in 6 cities covering a wide area in China. Blood samples were tested in 2 central laboratories using Beckman Coulter AU5800 chemistry analyzers. Certified reference materials and value-assigned serum panel were used for standardization of test results. Multiple regression analysis was performed to explore sources of variation. Need for partition of reference intervals was evaluated based on 3-level nested ANOVA. After secondary exclusion using the latent abnormal values exclusion method, reference intervals were derived by a parametric method using the modified Box-Cox formula. Test results of 20 analytes were made traceable to reference measurement procedures. By the ANOVA, significant sex-related and age-related differences were observed in 12 and 12 analytes, respectively. A small regional difference was observed in the results for albumin, glucose, and sodium. Multiple regression analysis revealed BMI-related changes in results of 9 analytes for man and 6 for woman. Reference intervals of 28 analytes were computed with 17 analytes partitioned by sex and/or age. In conclusion, reference intervals of 28 common chemistry analytes applicable to Chinese Han population were established by use of the latest methodology. Reference intervals of 20 analytes traceable to reference measurement procedures can be used as common reference intervals, whereas others can be used as the assay system-specific reference intervals in China.

Nationwide Multicenter Reference Interval Study for 28 Common Biochemical Analytes in China

PubMed Central

Xia, Liangyu; Chen, Ming; Liu, Min; Tao, Zhihua; Li, Shijun; Wang, Liang; Cheng, Xinqi; Qin, Xuzhen; Han, Jianhua; Li, Pengchang; Hou, Li’an; Yu, Songlin; Ichihara, Kiyoshi; Qiu, Ling

2016-01-01

Abstract A nationwide multicenter study was conducted in the China to explore sources of variation of reference values and establish reference intervals for 28 common biochemical analytes, as a part of the International Federation of Clinical Chemistry and Laboratory Medicine, Committee on Reference Intervals and Decision Limits (IFCC/C-RIDL) global study on reference values. A total of 3148 apparently healthy volunteers were recruited in 6 cities covering a wide area in China. Blood samples were tested in 2 central laboratories using Beckman Coulter AU5800 chemistry analyzers. Certified reference materials and value-assigned serum panel were used for standardization of test results. Multiple regression analysis was performed to explore sources of variation. Need for partition of reference intervals was evaluated based on 3-level nested ANOVA. After secondary exclusion using the latent abnormal values exclusion method, reference intervals were derived by a parametric method using the modified Box–Cox formula. Test results of 20 analytes were made traceable to reference measurement procedures. By the ANOVA, significant sex-related and age-related differences were observed in 12 and 12 analytes, respectively. A small regional difference was observed in the results for albumin, glucose, and sodium. Multiple regression analysis revealed BMI-related changes in results of 9 analytes for man and 6 for woman. Reference intervals of 28 analytes were computed with 17 analytes partitioned by sex and/or age. In conclusion, reference intervals of 28 common chemistry analytes applicable to Chinese Han population were established by use of the latest methodology. Reference intervals of 20 analytes traceable to reference measurement procedures can be used as common reference intervals, whereas others can be used as the assay system-specific reference intervals in China. PMID:26945390

26 CFR 1.467-2 - Rent accrual for section 467 rental agreements without adequate interest.

Code of Federal Regulations, 2010 CFR

2010-04-01

... but no prepaid rent, and the sum of the present values (within the meaning of paragraph (d) of this... greater than the sum of the present values of the fixed rent allocated to each rental period; or (iv) The rental agreement provides for prepaid rent but no deferred rent, and the sum of the present values of all...

Assessment of nutrient and water intake among adolescents from sports federations in the Federal District, Brazil.

PubMed

de Sousa, Eliene F; Da Costa, Teresa H M; Nogueira, Julia A D; Vivaldi, Lúcio J

2008-06-01

Adolescents aged 11-14 years (n 326), belonging to organized sports federations in the Federal District, Brazil were interviewed. Subjects (n 107) provided four non-consecutive days of food consumption and 219 subjects provided two non-consecutive days of intake. The objective was to assess their nutrient and water intake according to dietary reference intake values and their energy and macronutrient intake by sex and sports groups they were engaged in: endurance, strength-skill or mixed, according to the guidelines established by the American College of Sport Medicine (ACSM). Dietary data were corrected for intra-individual variation. Total energy expenditure was higher among endurance athletes (P < 0.001) following their higher training time (P < 0.001) when compared to adolescents engaged in strength-skill or mixed sports. Total energy intake was only significantly higher among endurance-engaged females (P = 0.05). Protein intake of males was above the guidelines established by the ACSM for all sports groups. All male sport groups fulfilled the intake levels of carbohydrate per kg body weight but only females engaged in endurance sports fulfilled carbohydrate guidelines. Intakes of micronutrients with low prevalence of adequate intake were: vitamins B1, E and folate, magnesium and phosphorus. Few adolescents ( < 5 %) presented adequate intake for calcium, fibre, drinking water and beverages. For micronutrients, prevalence of adequacies were lower for females than males, except for liquids and water. Nutrition guidance is needed to help adolescents fulfil specific guidelines of macronutrient intake for their sports and to improve their intake of micronutrients and water. Special attention should be given to female adolescent athletes.

Comparison of analytical and predictive methods for water, protein, fat, sugar, and gross energy in marine mammal milk.

PubMed

Oftedal, O T; Eisert, R; Barrell, G K

2014-01-01

Mammalian milks may differ greatly in composition from cow milk, and these differences may affect the performance of analytical methods. High-fat, high-protein milks with a preponderance of oligosaccharides, such as those produced by many marine mammals, present a particular challenge. We compared the performance of several methods against reference procedures using Weddell seal (Leptonychotes weddellii) milk of highly varied composition (by reference methods: 27-63% water, 24-62% fat, 8-12% crude protein, 0.5-1.8% sugar). A microdrying step preparatory to carbon-hydrogen-nitrogen (CHN) gas analysis slightly underestimated water content and had a higher repeatability relative standard deviation (RSDr) than did reference oven drying at 100°C. Compared with a reference macro-Kjeldahl protein procedure, the CHN (or Dumas) combustion method had a somewhat higher RSDr (1.56 vs. 0.60%) but correlation between methods was high (0.992), means were not different (CHN: 17.2±0.46% dry matter basis; Kjeldahl 17.3±0.49% dry matter basis), there were no significant proportional or constant errors, and predictive performance was high. A carbon stoichiometric procedure based on CHN analysis failed to adequately predict fat (reference: Röse-Gottlieb method) or total sugar (reference: phenol-sulfuric acid method). Gross energy content, calculated from energetic factors and results from reference methods for fat, protein, and total sugar, accurately predicted gross energy as measured by bomb calorimetry. We conclude that the CHN (Dumas) combustion method and calculation of gross energy are acceptable analytical approaches for marine mammal milk, but fat and sugar require separate analysis by appropriate analytic methods and cannot be adequately estimated by carbon stoichiometry. Some other alternative methods-low-temperature drying for water determination; Bradford, Lowry, and biuret methods for protein; the Folch and the Bligh and Dyer methods for fat; and enzymatic and reducing sugar methods for total sugar-appear likely to produce substantial error in marine mammal milks. It is important that alternative analytical methods be properly validated against a reference method before being used, especially for mammalian milks that differ greatly from cow milk in analyte characteristics and concentrations. Copyright © 2014 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Surgical treatment of secondary peritonitis : A continuing problem.

PubMed

van Ruler, O; Boermeester, M A

2017-01-01

Secondary peritonitis remains associated with high mortality and morbidity rates. Treatment of secondary peritonitis is challenging even in modern medicine. Surgical intervention for source control remains the cornerstone of treatment, beside adequate antimicrobial therapy and resuscitation. A randomized clinical trial showed that relaparotomy on demand (ROD) after initial emergency surgery is the preferred treatment strategy, irrespective of the severity and extent of peritonitis. The effective and safe use of ROD requires intensive monitoring of the patient in a setting where diagnostic tests and decision making about relaparotomy are guaranteed round the clock. The lack of knowledge on timely and adequate patient selection, together with the lack of use of easy but reliable monitoring tools, seems to hamper full implementation of ROD. The accuracy of the relap decision tool is reasonable for prediction of ongoing peritonitis and selection for computer tomography (CT). The value of CT in an early postoperative phase is unclear. Future research and innovative technologies should focus on the additive value of CT in cases of operated secondary peritonitis and on the further optimization of bedside prediction tools to enhance adequate patient selection for intervention in a multidisciplinary setting.

Reference centres for adults with rare and complex cancers - Policy recommendations to improve the organisation of care in Belgium.

PubMed

Stordeur, S; Vrijens, F; Leroy, R

2016-02-01

Rare and/or complex cancers call for a very specific expertise and adequate infrastructure. In Belgium, every hospital with a programme in oncology can deliver care for adults with rare and/or complex cancer types, without having demonstrated a specific know-how to adequately manage these patients. Therefore, the Minister of Health ordered a scenario for the organisation of care for adults with rare and/or complex cancers, taking into account the current Belgian situation and relevant foreign experience. Combined methods were used in this study: a literature review, the consultation of stakeholders, in depth discussions in 14 multidisciplinary groups leading to concrete proposals for several rare/complex cancers and the consultation of a panel of expert pathologists. The core recommendation is the set-up of shared care networks around reference centres, with multidisciplinary teams of recognised expertise in specific rare/complex cancers. The definition of minimum caseloads for hospitals and medical specialists, the evaluation of the quality of care, a model of diagnostic confirmation and the set-up of a national portal website which provides information on rare and/or complex cancers and reference centres are highly recommended. It is no longer practicable, efficient or ethical that every hospital or every practitioner continues to offer care for every rare/complex cancer. Improving the quality of rare/complex cancer care requires to concentrate expertise and sophisticated infrastructure in reference centres. Furthermore, the formation of networks between reference centres and peripheral centres will allow a delivery of care combining expertise and proximity. The next step is the translation of the recommendations into policy decisions. It is very well realised that this will take some courage and that a certain degree of resistance will have to be surmounted, but eventually, the best interest of the patient should prevail. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Uncovering Suitable Reference Proteins for Expression Studies in Human Adipose Tissue with Relevance to Obesity

PubMed Central

Pérez-Pérez, Rafael; López, Juan A.; García-Santos, Eva; Camafeita, Emilio; Gómez-Serrano, María; Ortega-Delgado, Francisco J.; Ricart, Wifredo; Fernández-Real, José M.; Peral, Belén

2012-01-01

Background Protein expression studies based on the two major intra-abdominal human fat depots, the subcutaneous and the omental fat, can shed light into the mechanisms involved in obesity and its co-morbidities. Here we address, for the first time, the identification and validation of reference proteins for data standardization, which are essential for accurate comparison of protein levels in expression studies based on fat from obese and non-obese individuals. Methodology and Findings To uncover adipose tissue proteins equally expressed either in omental and subcutaneous fat depots (study 1) or in omental fat from non-obese and obese individuals (study 2), we have reanalyzed our previously published data based on two-dimensional fluorescence difference gel electrophoresis. Twenty-four proteins (12 in study 1 and 12 in study 2) with similar expression levels in all conditions tested were selected and identified by mass spectrometry. Immunoblotting analysis was used to confirm in adipose tissue the expression pattern of the potential reference proteins and three proteins were validated: PARK7, ENOA and FAA. Western Blot analysis was also used to test customary loading control proteins. ENOA, PARK7 and the customary loading control protein Beta-actin showed steady expression profiles in fat from non-obese and obese individuals, whilst FAA maintained steady expression levels across paired omental and subcutaneous fat samples. Conclusions ENOA, PARK7 and Beta-actin are proper reference standards in obesity studies based on omental fat, whilst FAA is the best loading control for the comparative analysis of omental and subcutaneous adipose tissues either in obese and non-obese subjects. Neither customary loading control proteins GAPDH and TBB5 nor CALX are adequate standards in differential expression studies on adipose tissue. The use of the proposed reference proteins will facilitate the adequate analysis of proteins differentially expressed in the context of obesity, an aim difficult to achieve before this study. PMID:22272336

Controlling the potential hazards of government-sponsored technology. [such as weather modification and the supersonic transports

NASA Technical Reports Server (NTRS)

Wollan, M. J.

1975-01-01

The ability was examined of governmental agencies to adequately assess technological programs or projects to which they are committed. The hazards of government-sponsored activities are discussed; these include weather modification, supersonic transport noise, and the value conflicts involved in the fluoridation controversy. These three case studies indicate that the Federal vested interests in the continuation of its technological programs limit its ability to provide adequate technology assessment.

The impact of urban gardens on adequate and healthy food: a systematic review.

PubMed

Garcia, Mariana T; Ribeiro, Silvana M; Germani, Ana Claudia Camargo Gonçalves; Bógus, Cláudia M

2018-02-01

To examine the impacts on food and nutrition-related outcomes resulting from participation in urban gardens, especially on healthy food practices, healthy food access, and healthy food beliefs, knowledge and attitudes. The systematic review identified studies by searching the PubMed, ERIC, LILACS, Web of Science and Embase databases. An assessment of quality and bias risk of the studies was carried out and a narrative summary was produced. Studies published as original articles in peer-reviewed scientific journals in English, Spanish or Portuguese between 2005 and 2015 were included. The studies included were based on data from adult participants in urban gardens. Twenty-four studies were initially selected based on the eligibility criteria, twelve of which were included. There was important heterogeneity of settings, population and assessment methods. Assessment of quality and bias risk of the studies revealed the need for greater methodological rigour. Most studies investigated community gardens and employed a qualitative approach. The following were reported: greater fruit and vegetable consumption, better access to healthy foods, greater valuing of cooking, harvest sharing with family and friends, enhanced importance of organic production, and valuing of adequate and healthy food. Thematic patterns related to adequate and healthy food associated with participation in urban gardens were identified, revealing a positive impact on practices of adequate and healthy food and mainly on food perceptions.

Summary Diagrams for Coupled Hydrodynamic-Ecosystem Model Skill Assessment

DTIC Science & Technology

2009-01-01

reference point have the smallest unbiased RMSD value (Fig. 3). It would appear that the cluster of model points closest to the reference point may...total RMSD values. This is particularly the case for phyto- plankton absorption (Fig. 3B) where the cluster of points closest to the reference...pattern statistics and the bias (difference of mean values) each magnitude of the total Root-Mean-Square Difference ( RMSD ). An alternative skill score and

Reference value sensitivity of measures of unfair health inequality

PubMed Central

García-Gómez, Pilar; Schokkaert, Erik; Van Ourti, Tom

2014-01-01

Most politicians and ethical observers are not interested in pure health inequalities, as they want to distinguish between different causes of health differences. Measures of “unfair” inequality - direct unfairness and the fairness gap, but also the popular standardized concentration index - therefore neutralize the effects of what are considered to be “legitimate” causes of inequality. This neutralization is performed by putting a subset of the explanatory variables at reference values, e.g. their means. We analyze how the inequality ranking of different policies depends on the specific choice of reference values. We show with mortality data from the Netherlands that the problem is empirically relevant and we suggest a statistical method for fixing the reference values. PMID:24954998

Complex reference values for endocrine and special chemistry biomarkers across pediatric, adult, and geriatric ages: establishment of robust pediatric and adult reference intervals on the basis of the Canadian Health Measures Survey.

PubMed

Adeli, Khosrow; Higgins, Victoria; Nieuwesteeg, Michelle; Raizman, Joshua E; Chen, Yunqi; Wong, Suzy L; Blais, David

2015-08-01

Defining laboratory biomarker reference values in a healthy population and understanding the fluctuations in biomarker concentrations throughout life and between sexes are critical to clinical interpretation of laboratory test results in different disease states. The Canadian Health Measures Survey (CHMS) has collected blood samples and health information from the Canadian household population. In collaboration with the Canadian Laboratory Initiative on Pediatric Reference Intervals (CALIPER), the data have been analyzed to determine reference value distributions and reference intervals for several endocrine and special chemistry biomarkers in pediatric, adult, and geriatric age groups. CHMS collected data and blood samples from thousands of community participants aged 3 to 79 years. We used serum samples to measure 13 immunoassay-based special chemistry and endocrine markers. We assessed reference value distributions and, after excluding outliers, calculated age- and sex-specific reference intervals, along with corresponding 90% CIs, according to CLSI C28-A3 guidelines. We observed fluctuations in biomarker reference values across the pediatric, adult, and geriatric age range, with stratification required on the basis of age for all analytes. Additional sex partitions were required for apolipoprotein AI, homocysteine, ferritin, and high sensitivity C-reactive protein. The unique collaboration between CALIPER and CHMS has enabled, for the first time, a detailed examination of the changes in various immunochemical markers that occur in healthy individuals of different ages. The robust age- and sex-specific reference intervals established in this study provide insight into the complex biological changes that take place throughout development and aging and will contribute to improved clinical test interpretation. © 2015 American Association for Clinical Chemistry.

Trace element reference values in tissues from inhabitants of the EU. XII. Development of BioReVa program for statistical treatment.

PubMed

Iversen, B S; Sabbioni, E; Fortaner, S; Pietra, R; Nicolotti, A

2003-01-20

Statistical data treatment is a key point in the assessment of trace element reference values being the conclusive stage of a comprehensive and organized evaluation process of metal concentration in human body fluids. The EURO TERVIHT project (Trace Elements Reference Values in Human Tissues) was started for evaluating, checking and suggesting harmonized procedures for the establishment of trace element reference intervals in body fluids and tissues. Unfortunately, different statistical approaches are being used in this research field making data comparison difficult and in some cases impossible. Although international organizations such as International Federation of Clinical Chemistry (IFCC) or International Union of Pure and Applied Chemistry (IUPAC) have issued recommended guidelines for reference values assessment, including the statistical data treatment, a unique format and a standardized data layout is still missing. The aim of the present study is to present a software (BioReVa) running under Microsoft Windows platform suitable for calculating the reference intervals of trace elements in body matrices. The main scope for creating an ease-of-use application was to control the data distribution, to establish the reference intervals according to the accepted recommendation, on the base of the simple statistic, to get a standard presentation of experimental data and to have an application to which further need could be integrated in future. BioReVa calculates the IFCC reference intervals as well as the coverage intervals recommended by IUPAC as a supplement to the IFCC intervals. Examples of reference values and reference intervals calculated with BioReVa software concern Pb and Se in blood; Cd, In and Cr in urine, Hg and Mo in hair of different general European populations. University of Michigan

[Study on blood pressure standard in children using the automatic sphygmomanometer].

PubMed

Niida, Mami; Hataya, Hiroshi; Honda, Masataka

2015-01-01

In Japan, two treatment guidelines exist for pediatric patients with hypertension. The Guidelines for Drug Therapy in Pediatric Patients with Cardiovascular Diseases (JCS2012), by the Japanese Circulation Society, cite the stethoscopy-based American guidelines. The Guidelines for the Management of Hypertension (JSH2009), by the Japanese Society of Hypertension, focus on Japanese data obtained from automated sphygmomanometry. The frequent use of automated sphygmomanometers in clinical practice implies that the JSH2009 guidelines might be better; however with strict low reference values for the diastolic phase, overtreatment may result. Only the Japanese Circulation Society's guidelines include a therapeutic strategy, and the Chronic Kidney Disease (CKD) Guide, CKD Guidelines, and school urinary screening tests all cite these guidelines on stethoscopy-based blood pressure determination. Stethoscopy should be conducted during a medical examination; however, due to limited time in clinical practice, most physicians use automated sphygmomanometers while nevertheless relying on the Japanese Circulation Society reference values--which are stethoscopy-based. To find a compromise, we compared reference values in Japan with those from South Korea (automated sphygmomanometer-based) and those from the United States (stethoscopy-based). Moreover, we examined the results of recent accuracy tests for automated sphygmomanometers. Although the JSH2009 reference values for the systolic phase were consistent with those in the United States (stethoscopy-based), the reference values for the diastolic phase were lower. We observed the same tendency when comparing JSH2009 reference values with those in South Korea (automated sphygmomanometer-based). Conversely, there were only small differences between automated sphygmomanometry and mercury measurement, and we found it was possible to substitute the values from automated sphygmomanometry for stethoscopy. A large-scale study that takes into account patient height, measurement method, and treatment criteria is required to establish appropriate reference values. Even if automated sphygmomanometry is used until appropriate values are established, we consider the criteria provided in the American guidelines as appropriate.

Comparison of beverage consumption in adult populations from three different countries: do the international reference values allow establishing the adequacy of water and beverage intakes?

PubMed

Nissensohn, Mariela; Fuentes Lugo, Daniel; Serra-Majem, Lluis

2016-07-13

Recommendations of adequate total water intake (aTWI) have been proposed by the European Food Safety Agency (EFSA) and the Institute of Medicine (IOM)of the United States of America. However, there are differences in the approach used to support them: IOM recommendation is based on average intakes observed in NHANES III (Third National Health and Nutrition Examination Survey) and EFSA recommendation on a combination of observed intakes from 13 different European countries. Despite these recommendations of aTWI, the currently available scientifi c evidence is not sufficient to establish a cut-off value that would prevent disease, reduce the risk for chronic diseases or improve health status. To compare the average daily consumption of fluids (water and other beverages) in selective samples of population from Mexico, US and Spain, evaluating the quantity of fluid intake and understanding the contribution of each fluid type to the total fl uid intake. We also aim to determine if they reached adequate intake (AI) values, as defi ned by three different criteria: IOM, EFSA and water density. Three studies were compared: from Mexico, the National Health and Nutrition Survey conducted in 2012 (NHNS 2012); from US, the NHANES III 2005-2010 and from Spain the ANIBES study leaded in 2013. Different categories of beverages were used to establish the pattern of energy intake for each country. Only adult population was selected. TWI of each study was compared with EFSA and IOM AI recommendations, as well as applying the criterion of water density (mL/kcal). The American study obtained the higher value of total kcal/day from food and beverages (2,437 ± 13). Furthermore, the percentage of daily energy intake coming from beverages was, for American adults, 21%. Mexico was slightly behind with 19% and Spain ANIBES study registered only 12%. ANIBES showed signifi cantly low AI values for the overall population, but even more alarming in the case of males. Only 12% of men, in contrast with 21% of women, do satisfy the EFSA criterion. The IOM criterion reaches even less with higher recommended values for daily intake. In contrast, 60% of the American population reached the recommended intake of the IOM criterion. However, available data did not allow calculating the percentage reached by the EFSA criterion. Data from the Mexican study did not permit conducting comparisons with IOM or with EFSA. However, the water density criteria (mL/kcal) was higher than 1. There is a notable difference between all three populations in terms of TWI. Furthermore, within the same population, values of adequacy of TWI changed signifi cantly when they were assessed using different criteria. More scientifi c evidence is required for the production of better defined water intake recommendations in the future as well as more studies focusing on beverage consumption patterns in different settings.

The ``Leakage Current Sentinel'': A novel plug-in socket device for online biomedical equipment electrical safety surveillance

NASA Astrophysics Data System (ADS)

Cappa, Paolo; Marinozzi, Franco; Sciuto, Salvatore Andrea

2000-07-01

The Leakage Current Sentinel (LCS) has been designed and implemented for the detection of hazardous situations caused by dangerous earth leakage current values in intensive care units and operating theaters. The device, designed and manufactured with full compliance of the high risk environment requirements, is able to monitor online the earth leakage current and detect ground wire faults. Operation utilizes a microammeter with an overall sensitivity of 2.5×104 V/A. In order to assure the reliability of the device in providing alarm signals, the simultaneous presence of absorbed power current is monitored by means of another ammeter with decreased sensitivity (3.0 V/A). The measured root mean square current values are compared with reference values in order to send signals to NAND and OR complementary metal-oxide-semiconductor gates to enable audible and visible alarms according to the possible hazardous cases examined in the article. The final LCS packaging was shaped as a wall socket adapter for common electromedical device power cord plugs, with particular attention to minimizing its dimensions and to provide analog voltage outputs for both measured leakage and power currents, in order to allow automatic data acquisition and computerized hazardous situation management. Finally, a personal computer based automatic measuring system has been configured to simultaneously monitor several LCSs installed in the same intensive care unit room and, as a consequence, to distinguish different hazardous scenarios and provide an adequate alert to the clinical personnel whose final decision is still required. The test results confirm the effectiveness and reliability of the LCS in giving an alert in case of leakage current anomalous values, either in case of a ground fault or in case of a dangerous leakage current.

Communication of scientific uncertainty: international case studies on the development of folate and vitamin D Dietary Reference Values.

PubMed

Brown, Kerry A; de Wit, Liesbeth; Timotijevic, Lada; Sonne, Anne-Mette; Lähteenmäki, Liisa; Brito Garcia, Noé; Jeruszka-Bielak, Marta; Sicińska, Ewa; Moore, Alana N; Lawrence, Mark; Raats, Monique M

2015-06-01

Transparent evidence-based decision making has been promoted worldwide to engender trust in science and policy making. Yet, little attention has been given to transparency implementation. The degree of transparency (focused on how uncertain evidence was handled) during the development of folate and vitamin D Dietary Reference Values was explored in three a priori defined areas: (i) value request; (ii) evidence evaluation; and (iii) final values. Qualitative case studies (semi-structured interviews and desk research). A common protocol was used for data collection, interview thematic analysis and reporting. Results were coordinated via cross-case synthesis. Australia and New Zealand, Netherlands, Nordic countries, Poland, Spain and UK. Twenty-one interviews were conducted in six case studies. Transparency of process was not universally observed across countries or areas of the recommendation setting process. Transparency practices were most commonly seen surrounding the request to develop reference values (e.g. access to risk manager/assessor problem formulation discussions) and evidence evaluation (e.g. disclosure of risk assessor data sourcing/evaluation protocols). Fewer transparency practices were observed to assist with handling uncertainty in the evidence base during the development of quantitative reference values. Implementation of transparency policies may be limited by a lack of dedicated resources and best practice procedures, particularly to assist with the latter stages of reference value development. Challenges remain regarding the best practice for transparently communicating the influence of uncertain evidence on the final reference values. Resolving this issue may assist the evolution of nutrition risk assessment and better inform the recommendation setting process.

A Multilevel Latent Growth Curve Approach to Predicting Student Proficiency

ERIC Educational Resources Information Center

Choi, Kilchan; Goldschmidt, Pete

2012-01-01

Value-added models and growth-based accountability aim to evaluate school's performance based on student growth in learning. The current focus is on linking the results from value-added models to the ones from growth-based accountability systems including Adequate Yearly Progress decisions mandated by No Child Left Behind. We present a new…

26 CFR 25.2512-8 - Transfers for insufficient consideration.

Code of Federal Regulations, 2011 CFR

2011-04-01

... the value of the property transferred by the donor exceeds the value in money or money's worth of the... course of business (a transaction which is bona fide, at arm's length, and free from any donative intent), will be considered as made for an adequate and full consideration in money or money's worth. A...

26 CFR 25.2512-8 - Transfers for insufficient consideration.

Code of Federal Regulations, 2010 CFR

2010-04-01

... the value of the property transferred by the donor exceeds the value in money or money's worth of the... course of business (a transaction which is bona fide, at arm's length, and free from any donative intent), will be considered as made for an adequate and full consideration in money or money's worth. A...

26 CFR 25.2512-8 - Transfers for insufficient consideration.

Code of Federal Regulations, 2013 CFR

2013-04-01

... the value of the property transferred by the donor exceeds the value in money or money's worth of the... course of business (a transaction which is bona fide, at arm's length, and free from any donative intent), will be considered as made for an adequate and full consideration in money or money's worth. A...

26 CFR 25.2512-8 - Transfers for insufficient consideration.

Code of Federal Regulations, 2012 CFR

2012-04-01

... the value of the property transferred by the donor exceeds the value in money or money's worth of the... course of business (a transaction which is bona fide, at arm's length, and free from any donative intent), will be considered as made for an adequate and full consideration in money or money's worth. A...

26 CFR 25.2512-8 - Transfers for insufficient consideration.

Code of Federal Regulations, 2014 CFR

2014-04-01

... the value of the property transferred by the donor exceeds the value in money or money's worth of the... course of business (a transaction which is bona fide, at arm's length, and free from any donative intent), will be considered as made for an adequate and full consideration in money or money's worth. A...

Predicting Teacher Value-Added Results in Non-Tested Subjects Based on Confounding Variables: A Multinomial Logistic Regression

ERIC Educational Resources Information Center

Street, Nathan Lee

2017-01-01

Teacher value-added measures (VAM) are designed to provide information regarding teachers' causal impact on the academic growth of students while controlling for exogenous variables. While some researchers contend VAMs successfully and authentically measure teacher causality on learning, others suggest VAMs cannot adequately control for exogenous…

Abnormal glomerular filtration rate in children, adolescents and young adults starts below 75 mL/min/1.73 m(2).

PubMed

Pottel, Hans; Hoste, Liesbeth; Delanaye, Pierre

2015-05-01

The chronic kidney disease (CKD) classification system for children is similar to that for adults, with both mainly based on estimated glomerular filtration rate (eGFR) combined with fixed cut-off values. The main cut-off eGFR value used to define CKD is 60 mL/min/1.73 m(2), a value that is also applied for children older than 2 years of age, adolescents and young adults. Based on a literature search, we evaluated inclusion criteria for eGFR in clinical trials or research studies on CKD for children. We also collected information on direct measurements of GFR (mGFR) in children and adolescents, with the aim to estimate the normal reference range for GFR. Using serum creatinine (Scr) normal reference values and Scr-based eGFR-equations, we also evaluated the correspondence between Scr normal reference values and (e)GFR normal reference values. Based on our literature search, the inclusion of children in published CKD studies has been based on cut-off values for eGFR of >60 mL/min/1.73 m(2). The lower reference limits for mGFR far exceed this adult threshold. Using eGFR values calculated using Scr-based formulas, we found that abnormal Scr levels in children already correspond to eGFR values that are below a cut-off of 75 mL/min/1.73 m(2). Abnormal GFR in children, adolescents and young adults starts below 75 mL/min/1.73 m(2), and as abnormality is a sign of disease, we recommend referring children, adolescents and young adults with an (e)GFR of <75 mL/min/1.73 m(2) for further clinical assessment.

C-reactive protein reference percentiles among pre-adolescent children in Europe based on the IDEFICS study population.

PubMed

Schlenz, H; Intemann, T; Wolters, M; González-Gil, E M; Nappo, A; Fraterman, A; Veidebaum, T; Molnar, D; Tornaritis, M; Sioen, I; Mårild, S; Iacoviello, L; Ahrens, W

2014-09-01

C-reactive protein (CRP) is involved in a wide range of diseases. It is a powerful marker for inflammatory processes used for diagnostic and monitoring purposes. We aimed to establish reference values as data on the distribution of serum CRP levels in young European children are scarce. Reference values of high-sensitivity CRP concentrations were calculated for 9855 children aged 2.0-10.9 years, stratified by age and sex. The children were recruited during the population-based European IDEFICS study (Identification and prevention of Dietary- and lifestyle-induced health Effects in Children and infantS) with 18 745 participants recruited from 2007 to 2010. In 44.1% of the children, CRP values were below or equal the detection limit of 0.2 mg/l. Median CRP concentrations showed a slight negative age trend in boys and girls, whereas serum CRP values were slightly higher in girls than in boys across all age groups. Our population-based reference values of CRP may guide paediatric practice as elevated values may require further investigation or treatment. Therefore, the presented reference values represent a basis for clinical evaluation and for future research on risk assessment of diseases associated with increased CRP levels among children.

Learning as a Members' Phenomenon: Toward an Ethnographically Adequate Science of Learning

ERIC Educational Resources Information Center

Stevens, Reed

2010-01-01

This chapter argues that for the science of learning to become a fully "human" science, it needs to move from viewing learning from an exogenous perspective to an endogenous one. Taken from Latin, the term "endogenous" translates roughly to "from within," and in the meaning the author gives to it here, it refers to a perspective on learning from…

Detecting Intrajudge Inconsistency in Standard Setting Using Test Items with a Selected-Response Format. Research Report.

ERIC Educational Resources Information Center

van der Linden, Wim J.; Vos, Hans J.; Chang, Lei

In judgmental standard setting experiments, it may be difficult to specify subjective probabilities that adequately take the properties of the items into account. As a result, these probabilities are not consistent with each other in the sense that they do not refer to the same borderline level of performance. Methods to check standard setting…

The "Ad Circulorum" Fallacy and Comparative Advantage Debating or: Why Don't Debate Cases Make Sense to Outside Listeners?

ERIC Educational Resources Information Center

Richardson, Larry S.

Circular reasoning is often employed in comparative advantage debate cases when only a plan and advantages are articulated without adequate reference to the resolution which inspired the proposal. The advancing of such subtopical analyses as debate cases is deleterious to the long-range interests of educational debate because the practice…

[PSMA-PET/CT has to be performed in every patient with biochemical recurrence following radical prostatectomy for early tumor detection].

PubMed

Kotzerke, Jörg; Böhmer, Dirk; Schlomm, Thorsten; Maurer, Thomas; Beer, Ambros J; Schmidberger, Heinz

2018-06-01

The debate refers the known evidence for PSMA-PET/CT in biochemical recurrence of prostate cancer and consider carefully interdisciplinary in which situation which patient needs imaging to choose the adequate therapeutic option. General aspects for the care of cancer patients are taken into consideration. Schattauer GmbH.

The conventional tuning fork as a quantitative tool for vibration threshold.

PubMed

Alanazy, Mohammed H; Alfurayh, Nuha A; Almweisheer, Shaza N; Aljafen, Bandar N; Muayqil, Taim

2018-01-01

This study was undertaken to describe a method for quantifying vibration when using a conventional tuning fork (CTF) in comparison to a Rydel-Seiffer tuning fork (RSTF) and to provide reference values. Vibration thresholds at index finger and big toe were obtained in 281 participants. Spearman's correlations were performed. Age, weight, and height were analyzed for their covariate effects on vibration threshold. Reference values at the fifth percentile were obtained by quantile regression. The correlation coefficients between CTF and RSTF values at finger/toe were 0.59/0.64 (P = 0.001 for both). Among covariates, only age had a significant effect on vibration threshold. Reference values for CTF at finger/toe for the age groups 20-39 and 40-60 years were 7.4/4.9 and 5.8/4.6 s, respectively. Reference values for RSTF at finger/toe for the age groups 20-39 and 40-60 years were 6.9/5.5 and 6.2/4.7, respectively. CTF provides quantitative values that are as good as those provided by RSTF. Age-stratified reference data are provided. Muscle Nerve 57: 49-53, 2018. © 2017 Wiley Periodicals, Inc.

[Diagnostic reference levels in interventional radiology].

PubMed

Vañó Carruana, E; Fernández Soto, J M; Sánchez Casanueva, R M; Ten Morón, J I

2013-12-01

This article discusses the diagnostic reference levels for radiation exposure proposed by the International Commission on Radiological Protection (ICRP) to facilitate the application of the optimization criteria in diagnostic imaging and interventional procedures. These levels are normally established as the third quartile of the dose distributions to patients in an ample sample of centers and are supposed to be representative of good practice regarding patient exposure. In determining these levels, it is important to evaluate image quality as well to ensure that it is sufficient for diagnostic purposes. When the values for the dose received by patients are systematically higher or much lower than the reference levels, an investigation should determine whether corrective measures need to be applied. The European and Spanish regulations require the use of these reference values in quality assurance programs. For interventional procedures, the dose area product (or kerma area product) values are usually used as reference values together with the time under fluoroscopy and the total number of images acquired. The most modern imaging devices allow the value of the accumulated dose at the entrance to the patient to be calculated to optimize the distribution of the dose on the skin. The ICRP recommends that the complexity of interventional procedures be taken into account when establishing reference levels. In the future, diagnostic imaging departments will have automatic systems to manage patient dosimetric data; these systems will enable continuous dosage auditing and alerts about individual procedures that might involve doses several times above the reference values. This article also discusses aspects that need to be clarified to take better advantage of the reference levels in interventional procedures. Copyright © 2013 SERAM. Published by Elsevier Espana. All rights reserved.

Developing the role of patients as teachers: literature review

PubMed Central

Wykurz, Geoff; Kelly, Diana

2002-01-01

Objectives To identify the roles and settings in which patients participate as teachers in medical education and the benefits to learners, their educational institutions, and participating patients. Design Review of publications from 1970 to October 2001 providing descriptions, evaluations, or research of programmes involving patients as teachers in medical education. Data sources 1848 references were identified from various electronic databases. Applying inclusion criteria to abstracts generated 100 articles, from which 23 were selected after independent scrutiny. Results 13 articles discussed the role of patients in teaching physical examination skills, mostly musculoskeletal examination. Patients also taught pelvic and male genitorectal examination skills. Teaching roles varied, and 19 articles referred to patients' involvement as assessors. 18 articles described patients' training, with some patients being assessed. Reports of learners' experiences were all positive, many valuing the insights and confidence gained from practising skills on patients in a teaching role. Some learners preferred being taught by trained patients rather than doctors. Patients who were consulted enjoyed their teaching role. Several articles commented on the high quality of patients' teaching. Remuneration varied from payment of expenses to an hourly rate. Motivation for recruiting patients included the desire to reduce costs and the value attributed to the consumers' perspective. Conclusion Involving patients as teachers has important educational benefits for learners. Patients offer unique qualities that can enhance the acquisition of skills and change attitudes towards patients. What is already known on this topicPatients have a crucial role in medical education, but their involvement tends to be passiveSimulated and standardised patients are commonly used as alternatives to real patients in teaching communication skills and clinical examinationsWhat this study addsThe value of involving patients in an active teaching role, where learners can benefit from patients' experience and expertise, is being recognisedThe experience of being taught by a trained patient can increase confidence, reduce anxiety, and generate new insightsWhen patients are given adequate support, training, and remuneration, they can become colleagues in medical training, not just a teaching resource PMID:12376445

[The level of available methionine and the biological value of fish protein].

PubMed

Lipka, Z; Ganowiak, Z

1992-01-01

Food value of fish protein in fish canning was evaluated biologically and chemically (by available methionine). High-temperature sterilization (126 degrees) proved the least adequate for it causes the greatest loss in the protein food value. The chemical method by available methionine showing close correlation with biological techniques (NPU and PER rates) is thought demonstrative and convenient for technological control in fish processing industry.

USGS48 Puerto Rico precipitation - A new isotopic reference material for δ2H and δ18O measurements of water

USGS Publications Warehouse

Qi, Haiping; Coplen, Tyler B.; Tarbox, Lauren V.; Lorenz, Jennifer M.; Scholl, Martha A.

2014-01-01

A new secondary isotopic reference material has been prepared from Puerto Rico precipitation, which was filtered, homogenised, loaded into glass ampoules, sealed with a torch, autoclaved to eliminate biological activity, and calibrated by dual-inlet isotope-ratio mass spectrometry. This isotopic reference material, designated as USGS48, is intended to be one of two isotopic reference waters for daily normalisation of stable hydrogen (δ2H) and stable oxygen (δ18O) isotopic analysis of water with a mass spectrometer or a laser absorption spectrometer. The δ2H and δ18O values of this reference water are−2.0±0.4 and−2.224±0.012 ‰, respectively, relative to Vienna Standard Mean Ocean Water on scales normalised such that the δ2H and δ18O values of Standard Light Antarctic Precipitation reference water are−428 and−55.5 ‰, respectively. Each uncertainty is an estimated expanded uncertainty (U=2uc) about the reference value that provides an interval that has about a 95 % probability of encompassing the true value. This isotopic reference water is available by the case of 144 glass ampoules containing 5 mL of water in each ampoule.

Deriving the reference value from the circadian motor active patterns in the "non-dementia" population, compared to the "dementia" population: What is the amount of physical activity conducive to the good circadian rhythm.

PubMed

Kodama, Ayuto; Kume, Yu; Tsugaruya, Megumi; Ishikawa, Takashi

2016-01-01

The circadian rhythm in older adults is commonly known to change with a decrease in physical activity. However, the association between circadian rhythm metrics and physical activity remains unclear. The objective of this study was to examine circadian activity patterns in older people with and without dementia and to determine the amount of physical activity conducive to a good circadian measurement. Circadian parameters were collected from 117 older community-dwelling people (66 subjects without dementia and 52 subjects with dementia); the parameters were measured continuously using actigraphy for 7 days. A receiver operating characteristic (ROC) curve was applied to determine reference values for the circadian rhythm parameters, consisting of interdaily stability (IS), intradaily variability (IV), and relative amplitude (RA), in older subjects. The ROC curve revealed reference values of 0.55 for IS, 1.10 for IV, and 0.82 for RA. In addition, as a result of the ROC curve in the moderate-to-vigorous physical Activity (MVPA) conducive to the reference value of the Non-parametric Circadian Rhythm Analysis per day, the optimal reference values were 51 minutes for IV and 55 minutes for RA. However, the IS had no classification accuracy. Our results demonstrated the reference values derived from the circadian parameters of older Japanese population with or without dementia. Also, we determined the MVPA conducive to a good circadian rest-active pattern. This reference value for physical activity conducive to a good circadian rhythm might be useful for developing a new index for health promotion in the older community-dwelling population.

Effect of defuzzification method of fuzzy modeling

NASA Astrophysics Data System (ADS)

Lapohos, Tibor; Buchal, Ralph O.

1994-10-01

Imprecision can arise in fuzzy relational modeling as a result of fuzzification, inference and defuzzification. These three sources of imprecision are difficult to separate. We have determined through numerical studies that an important source of imprecision is the defuzzification stage. This imprecision adversely affects the quality of the model output. The most widely used defuzzification algorithm is known by the name of `center of area' (COA) or `center of gravity' (COG). In this paper, we show that this algorithm not only maps the near limit values of the variables improperly but also introduces errors for middle domain values of the same variables. Furthermore, the behavior of this algorithm is a function of the shape of the reference sets. We compare the COA method to the weighted average of cluster centers (WACC) procedure in which the transformation is carried out based on the values of the cluster centers belonging to each of the reference membership functions instead of using the functions themselves. We show that this procedure is more effective and computationally much faster than the COA. The method is tested for a family of reference sets satisfying certain constraints, that is, for any support value the sum of reference membership function values equals one and the peak values of the two marginal membership functions project to the boundaries of the universe of discourse. For all the member sets of this family of reference sets the defuzzification errors do not get bigger as the linguistic variables tend to their extreme values. In addition, the more reference sets that are defined for a certain linguistic variable, the less the average defuzzification error becomes. In case of triangle shaped reference sets there is no defuzzification error at all. Finally, an alternative solution is provided that improves the performance of the COA method.

[Reference values for lead levels in blood for the urban population].

PubMed

Paolielo, M M; Gutierrez, P R; Turini, C A; Matsuo, T; Mezzaroba, L; Barbosa, D S; Alvarenga, A L; Carvalho, S R; Figueiroa, G A; Leite, V G; Gutierrez, A C; Nogueira, K B; Inamine, W A; Zavatti, A M

1997-04-01

The lead reference values for blood used in Brazil come from studies conducted in other countries, where socioeconomic, clinical, nutritional and occupational conditions are significantly different. In order to guarantee an accurate biomonitoring of the population which is occupationally exposed to lead, a major health concern of the studied community, reference values for individuals who are not occupationally exposed and who live in the southern region of the city were established. The sample was composed of 206 subjects of at least 15 years of age. Various strategies were employed to assure good-quality sampling. Subjects who presented values outside clinical or laboratory norms were excluded, as well as those whose specific activities might interfere with the results. Lead reference values for blood were found to be from 2.40 to 16.6 micrograms.dL-1, obtained by the interval x +/- 2s (where x is the mean and s is the standard deviation form observed values) and the median was 7.9 micrograms.dL-1.

The use of digital PCR to improve the application of quantitative molecular diagnostic methods for tuberculosis.

PubMed

Devonshire, Alison S; O'Sullivan, Denise M; Honeyborne, Isobella; Jones, Gerwyn; Karczmarczyk, Maria; Pavšič, Jernej; Gutteridge, Alice; Milavec, Mojca; Mendoza, Pablo; Schimmel, Heinz; Van Heuverswyn, Fran; Gorton, Rebecca; Cirillo, Daniela Maria; Borroni, Emanuele; Harris, Kathryn; Barnard, Marinus; Heydenrych, Anthenette; Ndusilo, Norah; Wallis, Carole L; Pillay, Keshree; Barry, Thomas; Reddington, Kate; Richter, Elvira; Mozioğlu, Erkan; Akyürek, Sema; Yalçınkaya, Burhanettin; Akgoz, Muslum; Žel, Jana; Foy, Carole A; McHugh, Timothy D; Huggett, Jim F

2016-08-03

Real-time PCR (qPCR) based methods, such as the Xpert MTB/RIF, are increasingly being used to diagnose tuberculosis (TB). While qualitative methods are adequate for diagnosis, the therapeutic monitoring of TB patients requires quantitative methods currently performed using smear microscopy. The potential use of quantitative molecular measurements for therapeutic monitoring has been investigated but findings have been variable and inconclusive. The lack of an adequate reference method and reference materials is a barrier to understanding the source of such disagreement. Digital PCR (dPCR) offers the potential for an accurate method for quantification of specific DNA sequences in reference materials which can be used to evaluate quantitative molecular methods for TB treatment monitoring. To assess a novel approach for the development of quality assurance materials we used dPCR to quantify specific DNA sequences in a range of prototype reference materials and evaluated accuracy between different laboratories and instruments. The materials were then also used to evaluate the quantitative performance of qPCR and Xpert MTB/RIF in eight clinical testing laboratories. dPCR was found to provide results in good agreement with the other methods tested and to be highly reproducible between laboratories without calibration even when using different instruments. When the reference materials were analysed with qPCR and Xpert MTB/RIF by clinical laboratories, all laboratories were able to correctly rank the reference materials according to concentration, however there was a marked difference in the measured magnitude. TB is a disease where the quantification of the pathogen could lead to better patient management and qPCR methods offer the potential to rapidly perform such analysis. However, our findings suggest that when precisely characterised materials are used to evaluate qPCR methods, the measurement result variation is too high to determine whether molecular quantification of Mycobacterium tuberculosis would provide a clinically useful readout. The methods described in this study provide a means by which the technical performance of quantitative molecular methods can be evaluated independently of clinical variability to improve accuracy of measurement results. These will assist in ultimately increasing the likelihood that such approaches could be used to improve patient management of TB.

Reliability, reference values and predictor variables of the ulnar sensory nerve in disease free adults.

PubMed

Ruediger, T M; Allison, S C; Moore, J M; Wainner, R S

2014-09-01

The purposes of this descriptive and exploratory study were to examine electrophysiological measures of ulnar sensory nerve function in disease free adults to determine reliability, determine reference values computed with appropriate statistical methods, and examine predictive ability of anthropometric variables. Antidromic sensory nerve conduction studies of the ulnar nerve using surface electrodes were performed on 100 volunteers. Reference values were computed from optimally transformed data. Reliability was computed from 30 subjects. Multiple linear regression models were constructed from four predictor variables. Reliability was greater than 0.85 for all paired measures. Responses were elicited in all subjects; reference values for sensory nerve action potential (SNAP) amplitude from above elbow stimulation are 3.3 μV and decrement across-elbow less than 46%. No single predictor variable accounted for more than 15% of the variance in the response. Electrophysiologic measures of the ulnar sensory nerve are reliable. Absent SNAP responses are inconsistent with disease free individuals. Reference values recommended in this report are based on appropriate transformations of non-normally distributed data. No strong statistical model of prediction could be derived from the limited set of predictor variables. Reliability analyses combined with relatively low level of measurement error suggest that ulnar sensory reference values may be used with confidence. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Using cytology to increase small animal practice revenue.

PubMed

Hodges, Joanne

2013-11-01

Diagnostic cytology is a useful, noninvasive test with practical foundations in high-quality medicine and applications to practice building. Cytology will generate practice revenue whether assessed in-house or sent to a clinical pathologist. Thorough in-house evaluation is adequate in some cases, but expert opinion is important in many cases. Specimen slides should at least be reviewed in-house for assessment of cellularity and potential artifacts before submission to a reference laboratory. Reference laboratories also provide special stains and advanced molecular diagnostics to help further characterize many neoplastic processes, search for organisms, identify pigments, and address other important aspects of the lesion. Copyright © 2013 Elsevier Inc. All rights reserved.

Recommended energy and nutrients intakes in the European Union: 2008-2016

PubMed

García Gabarra, Antoni; Castellà Soley, Marta; Calleja Fernández, Alicia

2017-03-30

The aim of this document is to refl ect the changes happened in the European Union legislation and the opinions of the European Food Safety Authority in relation to the nutritional labeling on food, the reference values for energy, macronutrients and micronutrients, and the tolerable upper safe levels. The European legislation in force uses the labeling reference values established by the Scientific Committee on Food in 2003. There would be advisable an update of them from the reference values for vitamins and minerals established by the European Food Safety Authority. Equally, there would be good to include reference labeling values for polyunsaturated fatty acids, dietary fiber and choline, and specific reference labeling values for children from 6 to 36 months. For vitamins and minerals there would be desirable the revision of tolerable upper safe levels and the establishment of maximum amounts allowed in fortified food and food supplements in the European Union; its absence might represent a risk in some population groups for an excessive and unsafe intake of certain minerals and vitamins.

Biscayne aquifer drinking water (USGS45): a new isotopic reference material for δ2H and δ18O measurements of water

USGS Publications Warehouse

Lorenz, Jennifer M.; Tarbox, Lauren V.; Buck, Bryan; Qi, Haiping; Coplen, Tyler B.

2014-01-01

RATIONALE As a result of the scarcity of isotopic reference waters for daily use, a new secondary isotopic reference material for international distribution has been prepared from drinking water collected from the Biscayne aquifer in Ft. Lauderdale, Florida. METHODS This isotopic reference water was filtered, homogenized, loaded into glass ampoules, sealed with a torch, autoclaved to eliminate biological activity, and measured by dual-inlet isotope-ratio mass spectrometry. This reference material is available by the case of 144 glass ampoules containing either 4 mL or 5 mL of water in each ampoule. RESULTS The δ2H and δ18O values of this reference material are –10.3 ± 0.4 ‰ and –2.238 ± 0.011 ‰, respectively, relative to VSMOW, on scales normalized such that the δ2H and δ18O values of SLAP reference water are, respectively, –428 and –55.5 ‰. Each uncertainty is an estimated expanded uncertainty (U = 2uc) about the reference value that provides an interval that has about a 95 % probability of encompassing the true value. CONCLUSIONS This isotopic reference material, designated as USGS45, is intended as one of two isotopic reference waters for daily normalization of stable hydrogen and oxygen isotopic analysis of water with an isotope-ratio mass spectrometer or a laser absorption spectrometer. 

EFFECT ON PERFUSION VALUES OF SAMPLING INTERVAL OF CT PERFUSION ACQUISITIONS IN NEUROENDOCRINE LIVER METASTASES AND NORMAL LIVER

PubMed Central

Ng, Chaan S.; Hobbs, Brian P.; Wei, Wei; Anderson, Ella F.; Herron, Delise H.; Yao, James C.; Chandler, Adam G.

2014-01-01

Objective To assess the effects of sampling interval (SI) of CT perfusion acquisitions on CT perfusion values in normal liver and liver metastases from neuroendocrine tumors. Methods CT perfusion in 16 patients with neuroendocrine liver metastases were analyzed by distributed parameter modeling to yield tissue blood flow, blood volume, mean transit time, permeability, and hepatic arterial fraction, for tumor and normal liver. CT perfusion values for the reference sampling interval of 0.5s (SI0.5) were compared with those of SI datasets of 1s, 2s, 3s and 4s, using mixed-effects model analyses. Results Increases in SI beyond 1s were associated with significant and increasing departures of CT perfusion parameters from reference values at SI0.5 (p≤0.0009). CT perfusion values deviated from reference with increasing uncertainty with increasing SIs. Findings for normal liver were concordant. Conclusion Increasing SIs beyond 1s yield significantly different CT perfusion parameter values compared to reference values at SI0.5. PMID:25626401

[Reference values of energy for the Venezuelan population].

PubMed

Landaeta-Jiménez, Maritza; Aliaga, Carla; Sifontes, Yaritza; Vásquez, Maura; Ramírez, Guillermo; Falque Madrid, Luís; Herrera, Marianella; María Reyes, Ana; Emilia, Elzakem; Herrera, Ctor; Bernal, Jennifer

2013-12-01

The project of updating the Venezuelan energy reference values respond to the recommendations made by an FAO experts committee, several decades ago for the countries assuming this work. Because of the dramatic changes experienced globally regarding energy intake/expenditure and particularly variations on the Venezuelan nutritional scenario with the presence of "the double burden of malnutrition" it a review of Energy Reference Values (VRE) from a more integral approach is pertinent. This report follows the methodology proposed by FAO/WHO/UNU 2004 experts committee and energy reference values were established by group of age and gender, also average energy values for Venezuelan population were obtained. For calculation of these requirements, the energy expenditure was included by taking into account Basal Metabolic Rate and physical activity level for some specific groups. The score average values updated in 2012 of 2.200 kcal/dia reported to be lower than those of 2000 at all ages for masculine gender except for the 16-17 age group and for feminine gender just until ages 10-12 years and from there are slightly above the values obtained in 2000.

76 FR 71797 - Federal Agricultural Mortgage Corporation Funding and Fiscal Affairs; Farmer Mac Investments and...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-18

...The Farm Credit Administration (FCA, Agency, us, or we) proposes to amend our regulations governing the Federal Agricultural Mortgage Corporation (Farmer Mac or the Corporation) in the areas of non-program investments and liquidity. We are proposing to modify the specific requirements supporting our objective to ensure that Farmer Mac maintains adequate liquidity to withstand stressful conditions in accordance with board-established risk tolerance and holds only high- quality, liquid investments in its liquidity reserve. We also propose to expand the allowable purposes of Farmer Mac's non-program investments to include investments that would add value to Farmer Mac's operations by complementing its program activities. Further, we request comments on the best approach for compliance with section 939A of the Dodd-Frank Wall Street Reform and Consumer Protection Act (Dodd-Frank Act or DFA), which requires us to remove all references to and requirements relating to credit ratings and to substitute other appropriate standards of creditworthiness. Finally, we propose significant reorganizing of sections to make the flow of the issues covered more logical.

Faith-Based Institutions as Venues for Obesity Prevention.

PubMed

Maynard, Maria J

2017-06-01

The aim of this current narrative review is to critique the scope and value of recent studies with a focus on obesity-related health promotion in faith organizations. Electronic database searches, scanning of the reference lists of identified articles, and hand searching of journals for articles written in English and published in 2013-2016 revealed 16 studies. Half of the studies involved African-Americans, in churches and with predominantly female participants. Research among other ethnic groups was more likely to be exploratory. All of the 11 studies reporting the impact of programmes on weight-related measures showed favourable outcomes. However, due to study limitations (small sample size, short duration, attrition), significant unbiased effects cannot yet be concluded for most of the interventions reviewed. Study strengths included application of theory in community engagement and detailed description of cultural tailoring. Faith organizations show promise as settings for obesity prevention among high-risk groups, particularly African-Americans. Support for progressing formative work to adequately powered, randomized controlled trials is vital. Wider involvement of diverse faith settings and targeting obesity in men and childhood would be valuable developments.

Optimal Parameter Design of Coarse Alignment for Fiber Optic Gyro Inertial Navigation System.

PubMed

Lu, Baofeng; Wang, Qiuying; Yu, Chunmei; Gao, Wei

2015-06-25

Two different coarse alignment algorithms for Fiber Optic Gyro (FOG) Inertial Navigation System (INS) based on inertial reference frame are discussed in this paper. Both of them are based on gravity vector integration, therefore, the performance of these algorithms is determined by integration time. In previous works, integration time is selected by experience. In order to give a criterion for the selection process, and make the selection of the integration time more accurate, optimal parameter design of these algorithms for FOG INS is performed in this paper. The design process is accomplished based on the analysis of the error characteristics of these two coarse alignment algorithms. Moreover, this analysis and optimal parameter design allow us to make an adequate selection of the most accurate algorithm for FOG INS according to the actual operational conditions. The analysis and simulation results show that the parameter provided by this work is the optimal value, and indicate that in different operational conditions, the coarse alignment algorithms adopted for FOG INS are different in order to achieve better performance. Lastly, the experiment results validate the effectiveness of the proposed algorithm.

Volunteer melanoma screenings. Follow-up, compliance, and outcome.

PubMed

de Rooij, M J; Rampen, F H; Schouten, L J; Neumann, H A

1997-03-01

Follow-up information on free melanoma screening clinics is not readily available. We studied the follow-up, compliance, and outcome of positive screenees after a screening campaign for melanoma in the Netherlands. Of the 4146 participants, 486 (11.7%) had a suspicious premalignant or malignant lesion warranting referral to his or her general physician indicating the proposed line of management. Participants with borderline lesions were not referred. Referral of borderline cases should have resulted in a considerable increase of the number of positive screenees (18.1%). All positive screenees but two gave permission for follow-up. Only 18 screenees (3.7%) were lost during follow-up. Moreover, one screenee with a presumed basal cell carcinoma and six screenees suspicious of having a premalignant lesion decided not to seek medical attention despite several reminders. The positive predictive value for melanoma was 17.2%, and for nonmelanoma skin cancers was 42.9%. A selective referral policy may reduce the generated costs of melanoma screenings substantially. Adequate follow-up of positive screenees is mandatory in order to determine the ultimate yield and usefulness of such campaigns.

Internal consistency of the self-reporting questionnaire-20 in occupational groups

PubMed Central

Santos, Kionna Oliveira Bernardes; Carvalho, Fernando Martins; de Araújo, Tânia Maria

2016-01-01

ABSTRACT OBJECTIVE To assess the internal consistency of the measurements of the Self-Reporting Questionnaire (SRQ-20) in different occupational groups. METHODS A validation study was conducted with data from four surveys with groups of workers, using similar methods. A total of 9,959 workers were studied. In all surveys, the common mental disorders were assessed via SRQ-20. The internal consistency considered the items belonging to dimensions extracted by tetrachoric factor analysis for each study. Item homogeneity assessment compared estimates of Cronbach’s alpha (KD-20), the alpha applied to a tetrachoric correlation matrix and stratified Cronbach’s alpha. RESULTS The SRQ-20 dimensions showed adequate values, considering the reference parameters. The internal consistency of the instrument items, assessed by stratified Cronbach’s alpha, was high (> 0.80) in the four studies. CONCLUSIONS The SRQ-20 showed good internal consistency in the professional categories evaluated. However, there is still a need for studies using alternative methods and additional information able to refine the accuracy of latent variable measurement instruments, as in the case of common mental disorders. PMID:27007682

Aerodynamics of the advanced launch system (ALS) propulsion and avionics (P/A) module

NASA Technical Reports Server (NTRS)

Ferguson, Stan; Savage, Dick

1992-01-01

This paper discusses the design and testing of candidate Advanced Launch System (ALS) Propulsion and Avionics (P/A) Module configurations. The P/A Module is a key element of future launch systems because it is essential to the recovery and reuse of high-value propulsion and avionics hardware. The ALS approach involves landing of first stage (booster) and/or second stage (core) P/A modules near the launch site to minimize logistics and refurbishment cost. The key issue addressed herein is the aerodynamic design of the P/A module, including the stability characteristics and the lift-to-drag (L/D) performance required to achieve the necessary landing guidance accuracy. The reference P/A module configuration was found to be statically stable for the desired flight regime, to provide adequate L/D for targeting, and to have effective modulation of the L/D performance using a body flap. The hypersonic aerodynamic trends for nose corner radius, boattail angle and body flap deflections were consistent with pretest predictions. However, the levels for the L/D and axial force for hypersonic Mach numbers were overpredicted by impact theories.

Nine time steps: ultra-fast statistical consistency testing of the Community Earth System Model (pyCECT v3.0)

NASA Astrophysics Data System (ADS)

Milroy, Daniel J.; Baker, Allison H.; Hammerling, Dorit M.; Jessup, Elizabeth R.

2018-02-01

The Community Earth System Model Ensemble Consistency Test (CESM-ECT) suite was developed as an alternative to requiring bitwise identical output for quality assurance. This objective test provides a statistical measurement of consistency between an accepted ensemble created by small initial temperature perturbations and a test set of CESM simulations. In this work, we extend the CESM-ECT suite with an inexpensive and robust test for ensemble consistency that is applied to Community Atmospheric Model (CAM) output after only nine model time steps. We demonstrate that adequate ensemble variability is achieved with instantaneous variable values at the ninth step, despite rapid perturbation growth and heterogeneous variable spread. We refer to this new test as the Ultra-Fast CAM Ensemble Consistency Test (UF-CAM-ECT) and demonstrate its effectiveness in practice, including its ability to detect small-scale events and its applicability to the Community Land Model (CLM). The new ultra-fast test facilitates CESM development, porting, and optimization efforts, particularly when used to complement information from the original CESM-ECT suite of tools.

Liquid chromatography with isotope-dilution mass spectrometry for determination of water-soluble vitamins in foods.

PubMed

Phillips, Melissa M

2015-04-01

Vitamins are essential for improving and maintaining human health, and the main source of vitamins is the diet. Measurement of the quantities of water-soluble vitamins in common food materials is important to understand the impact of vitamin intake on human health, and also to provide necessary information for regulators to determine adequate intakes. Liquid chromatography (LC) and mass spectrometry (MS) based methods for water-soluble vitamin analysis are abundant in the literature, but most focus on only fortified foods or dietary supplements or allow determination of only a single vitamin. In this work, a method based on LC/MS and LC/MS/MS has been developed to allow simultaneous quantitation of eight water-soluble vitamins, including multiple forms of vitamins B3 and B6, in a variety of fortified and unfortified food-matrix Standard Reference Materials (SRMs). Optimization of extraction of unbound vitamin forms and confirmation using data from external laboratories ensured accuracy in the assigned values, and addition of stable isotope labeled internal standards for each of the vitamins allowed for increased precision.

The nutritional requirements of infants. Towards EU alignment of reference values: the EURRECA network.

PubMed

Hermoso, Maria; Tabacchi, Garden; Iglesia-Altaba, Iris; Bel-Serrat, Silvia; Moreno-Aznar, Luis A; García-Santos, Yurena; García-Luzardo, Ma del Rosario; Santana-Salguero, Beatriz; Peña-Quintana, Luis; Serra-Majem, Lluis; Moran, Victoria Hall; Dykes, Fiona; Decsi, Tamás; Benetou, Vassiliki; Plada, Maria; Trichopoulou, Antonia; Raats, Monique M; Doets, Esmée L; Berti, Cristiana; Cetin, Irene; Koletzko, Berthold

2010-10-01

This paper presents a review of the current knowledge regarding the macro- and micronutrient requirements of infants and discusses issues related to these requirements during the first year of life. The paper also reviews the current reference values used in European countries and the methodological approaches used to derive them by a sample of seven European and international authoritative committees from which background scientific reports are available. Throughout the paper, the main issues contributing to disparities in micronutrient reference values for infants are highlighted. The identification of these issues in relation to the specific physiological aspects of infants is important for informing future initiatives aimed at providing standardized approaches to overcome variability of micronutrient reference values across Europe for this age group. © 2010 Blackwell Publishing Ltd.

Detection of infragenual arterial disease using noncontrast-enhanced MR angiography in patients with diabetes

PubMed Central

Liu, Xin; Zhang, Na; Fan, Zhaoyang; Feng, Fei; Yang, Qi; Zheng, Hairong; Liu, Pengcheng; Li, Debiao

2013-01-01

Purpose To evaluate the diagnostic performance of a newly developed noncontrast-enhanced MR angiography (NCE-MRA) technique using flow-sensitive dephasing (FSD) prepared steady-state free precession (SSFP) for detecting calf arterial disease in patients with diabetes. Materials and Methods Forty-five patients with diabetes who underwent routine CE-MRA of lower extremities were recruited for NCE-MRA at the calf on a 1.5T MR system. Image quality evaluated on a four-point scale and diagnostic performance for detecting more than 50% arterial stenosis were statistically analyzed, using CE-MRA as the standard of reference. Results A total of 264 calf arterial segments were obtained in the 45 patients with 88 legs. The percentage of diagnostic arterial segments was all 98% for NCE- and CE-MRA. The image quality, SNR, CNR was 3.3, 177, 138 and 3.5, 103, 99 for NCE-MRA and CE-MRA respectively. The average sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of NCE-MRA were 97%, 96%, 90%, 99%, and 96%, respectively on a per-segment basis and 90%, 84%, 82%, 91%, and 87%, respectively on a per-patients basis. Conclusion The NCE-MRA technique demonstrates adequate image quality in the delineation of calf arteries and consistent diagnostic performance for detecting significant stenosis with CE-MRA in patients with diabetes. PMID:24925770

Beyond BMI: Conceptual Issues Related to Overweight and Obese Patients

PubMed Central

Müller, Manfred James; Braun, Wiebke; Enderle, Janna; Bosy-Westphal, Anja

2016-01-01

BMI is widely used as a measure of weight status and disease risks; it defines overweight and obesity based on statistical criteria. BMI is a score; neither is it biologically sound nor does it reflect a suitable phenotype worthwhile to study. Because of its limited value, BMI cannot provide profound insight into obesity biology and its co-morbidity. Alternative assessments of weight status include detailed phenotyping by body composition analysis (BCA). However, predicting disease risks, fat mass, and fat-free mass as assessed by validated techniques (i.e., densitometry, dual energy X ray absorptiometry, and bioelectrical impedance analysis) does not exceed the value of BMI. Going beyond BMI and descriptive BCA, the concept of functional body composition (FBC) integrates body components into regulatory systems. FBC refers to the masses of body components, organs, and tissues as well as to their inter-relationships within the context of endocrine, metabolic and immune functions. FBC can be used to define specific phenotypes of obesity, e.g. the sarcopenic-obese patient. Well-characterized obesity phenotypes are a precondition for targeted research (e.g., on the genomics of obesity) and patient-centered care (e.g., adequate treatment of individual obese phenotypes such as the sarcopenic-obese patient). FBC contributes to a future definition of overweight and obesity based on physiological criteria rather than on body weight alone. PMID:27286962

Identification of different nutritional status groups in institutionalized elderly people by cluster analysis.

PubMed

López-Contreras, María José; López, Maria Ángeles; Canteras, Manuel; Candela, María Emilia; Zamora, Salvador; Pérez-Llamas, Francisca

2014-03-01

To apply a cluster analysis to groups of individuals of similar characteristics in an attempt to identify undernutrition or the risk of undernutrition in this population. A cross-sectional study. Seven public nursing homes in the province of Murcia, on the Mediterranean coast of Spain. 205 subjects aged 65 and older (131 women and 74 men). Dietary intake (energy and nutrients), anthropometric (body mass index, skinfold thickness, mid-arm muscle circumference, mid-arm muscle area, corrected arm muscle area, waist to hip ratio) and biochemical and haematological (serum albumin, transferrin, total cholesterol, total lymphocyte count). Variables were analyzed by cluster analysis. The results of the cluster analysis, including intake, anthropometric and analytical data showed that, of the 205 elderly subjects, 66 (32.2%) were over - weight/obese, 72 (35.1%) had an adequate nutritional status and 67 (32.7%) were undernourished or at risk of undernutrition. The undernourished or at risk of undernutrition group showed the lowest values for dietary intake and the anthropometric and analytical parameters measured. Our study shows that cluster analysis is a useful statistical method for assessing the nutritional status of institutionalized elderly populations. In contrast, use of the specific reference values frequently described in the literature might fail to detect real cases of undernourishment or those at risk of undernutrition. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

Realization of daily evapotranspiration in arid ecosystems based on remote sensing techniques

NASA Astrophysics Data System (ADS)

Elhag, Mohamed; Bahrawi, Jarbou A.

2017-03-01

Daily evapotranspiration is a major component of water resources management plans. In arid ecosystems, the quest for an efficient water budget is always hard to achieve due to insufficient irrigational water and high evapotranspiration rates. Therefore, monitoring of daily evapotranspiration is a key practice for sustainable water resources management, especially in arid environments. Remote sensing techniques offered a great help to estimate the daily evapotranspiration on a regional scale. Existing open-source algorithms proved to estimate daily evapotranspiration comprehensively in arid environments. The only deficiency of these algorithms is the course scale of the used remote sensing data. Consequently, the adequate downscaling algorithm is a compulsory step to rationalize an effective water resources management plan. Daily evapotranspiration was estimated fairly well using an Advance Along-Track Scanner Radiometer (AATSR) in conjunction with (MEdium Resolution Imaging Spectrometer) MERIS data acquired in July 2013 with 1 km spatial resolution and 3 days of temporal resolution under a surface energy balance system (SEBS) model. Results were validated against reference evapotranspiration ground truth values using standardized Penman-Monteith method with R2 of 0.879. The findings of the current research successfully monitor turbulent heat fluxes values estimated from AATSR and MERIS data with a temporal resolution of 3 days only in conjunction with reliable meteorological data. Research verdicts are necessary inputs for a well-informed decision-making processes regarding sustainable water resource management.

World Health Organization discontinues its drinking-water guideline for manganese.

PubMed

Frisbie, Seth H; Mitchell, Erika J; Dustin, Hannah; Maynard, Donald M; Sarkar, Bibudhendra

2012-06-01

The World Health Organization (WHO) released the fourth edition of Guidelines for Drinking-Water Quality in July 2011. In this edition, the 400-µg/L drinking-water guideline for manganese (Mn) was discontinued with the assertion that because "this health-based value is well above concentrations of manganese normally found in drinking water, it is not considered necessary to derive a formal guideline value." In this commentary, we review the WHO guideline for Mn in drinking water--from its introduction in 1958 through its discontinuation in 2011. For the primary references, we used the WHO publications that documented the Mn guidelines. We used peer-reviewed journal articles, government reports, published conference proceedings, and theses to identify countries with drinking water or potential drinking-water supplies exceeding 400 µg/L Mn and peer-reviewed journal articles to summarize the health effects of Mn. Drinking water or potential drinking-water supplies with Mn concentrations > 400 µg/L are found in a substantial number of countries worldwide. The drinking water of many tens of millions of people has Mn concentrations > 400 µg/L. Recent research on the health effects of Mn suggests that the earlier WHO guideline of 400 µg/L may have been too high to adequately protect public health. The toxic effects and geographic distribution of Mn in drinking-water supplies justify a reevaluation by the WHO of its decision to discontinue its drinking-water guideline for Mn.

Bioelectrical impedance analysis for diagnosing sarcopenia and cachexia: what are we really estimating?

PubMed

Gonzalez, Maria Cristina; Heymsfield, Steven B

2017-04-01

As reference methods are not available for identifying low skeletal muscle mass in clinical practice, the European Group on Sarcopenia in Older People the Asian Working Group for Sarcopenia and the International Consensus for Cancer Cachexia guidelines accept bioelectrical impedance analysis (BIA) as an option for sarcopenia and cachexia assessment. Using different BIA equations, several components that represent 'muscularity' can be assessed. Total skeletal muscle mass or appendicular skeletal muscle mass normalized in relation to height (skeletal muscle mass index or appendicular skeletal muscle index, respectively) is the most common term used in the consensus. These terms are similar, but they should not be used as synonymous. Both terms can be used to define sarcopenia, but adequate equations and cut-off values should be used according to the studied population. However, there is a disagreement between the sarcopenia definition assessed by using BIA from the European Group on Sarcopenia in Older People and Cachexia Consensus, and this can lead to an overestimation of sarcopenia and, consequently, cachexia. An effort should be made to standardize the terminology employed by the Societies to define low muscularity and sarcopenia by using BIA. Future validation studies may show the need for specific cut-off values for each population using this method. © 2017 The Authors. Journal of Cachexia, Sarcopenia and Muscle published by John Wiley & Sons Ltd on behalf of the Society on Sarcopenia, Cachexia and Wasting Disorders.

[Reference values of calcium, vitamin D, phosphorus, magnesium and fluoride for the Venezuelan population].

PubMed

Macías-Tomei, Coromoto; Palacios, Cristina; Mariño Elizondo, Mariana; Carías, Diamela; Noguera, Dalmacia; Chávez Pérez, José Félix

2013-12-01

The following micronutrients were considered together for their role in bone health: calcium, vitamin D, phosphorus, magnesium and fluoride. Calcium: not enough is known to change current recommendations. In adolescents and adults, limited data suggest that consuming the recommended level is associated with normal bone mass. In older adults, the limited data reported low consumption and a high rate of fractures but there is no information on whether the current values are adequate. Vitamin D: the limited data reported high deficiency in older adults, which was related to osteoporosis. Given the recent increase in North American recommendation for their contribution to bone health, we proposed to increase the recommendation to 400-600 IU/d for Venezuela. Phosphorus, magnesium and fluoride: the lack of local data does not support changing the latest recommendations. Therefore, it highlights the lack of local studies to assess current recommendations. Studies are needed to estimate the intake of these micronutrients in the population and evaluate their interaction and their relation to bone and overall health. Information of the adequacy of these nutrients in human milk for infants is needed. Alto, it is necessary to implement an effective nutrition surveillance system and implement interventions that maximize bone health from an early stage, including the design and implementation of a dairy policy that leads to an increase in production and consumption by the population.

Clinical chemistry reference intervals of healthy adult populations in Gojjam Zones of Amhara National Regional State, Northwest Ethiopia.

PubMed

Mekonnen, Zewdie; Amuamuta, Asmare; Mulu, Wondemagegn; Yimer, Mulat; Zenebe, Yohannes; Adem, Yesuf; Abera, Bayeh; Gebeyehu, Wondemu; Gebregziabher, Yakob

2017-01-01

Reference interval is crucial for disease screening, diagnosis, monitoring, progression and treatment efficacy. Due to lack of locally derived reference values for the parameters, clinicians use reference intervals derived from western population. But, studies conducted in different African countries have indicated differences between locally and western derived reference values. Different studies also indicated considerable variation in clinical chemistry reference intervals by several variables such as age, sex, geographical location, environment, lifestyle and genetic variation. This study aimed to determine the reference intervals of common clinical chemistry parameters of the community of Gojjam Zones, Northwest Ethiopia. Population based cross-sectional study was conducted from November 2015 to December 2016 in healthy adult populations of Gojjam zone. Data such as, medical history, physical examination and socio-demographic data were collected. In addition, laboratory investigations were undertaken to screen the population. Clinical chemistry parameters were measured using Mindray BS 200 clinical chemistry autoanalyzer as per the manufacturer's instructions. Descriptive statistics was used to calculate mean, median and 95th percentiles. Independent sample T-test and one way ANOVA were used to see association between variables. After careful screening of a total of 799 apparently healthy adults who were consented for this study, complete data from 446 (224 females and 222 males) were included for the analysis. The mean age of both the study participants was 28.8 years. Males had high (P<0.05) mean and 2.5th-97.5th percentile ranges of ALT, AST, ALP, creatinine and direct bilirubin. The reference intervals of amylase, LDH, total protein and total bilirubin were not significantly different between the two sex groups (P>0.05). Mean, median, 95% percentile values of AST, ALP, amylase, LDH, creatinine, total protein, total bilirubin, and direct bilirubin across all age groups of participants were similar (P>0.05). But, there was a significant difference in the value of ALT (P<0.05). The reference intervals of ALT, total protein and creatinine were significantly (P<0.05) high in people having monthly income >1500 ETB compared to those with low monthly income. Significant (P<0.05) higher values of the ALT, ALP and total protein were observed in people living in high land compared to low land residences. The study showed that some of the common clinical chemistry parameters reference intervals of healthy adults in Gojjam zones were higher than the reference intervals generated from developed countries. Therefore, strict adherence to the reference values generated in developed countries could lead to inappropriate diagnosis and treatment of patients. There was also variation of reference interval values based on climate, gender, age, monthly income and geographical locations. Therefore, further study is required to establish reference intervals for Ethiopian population.

Molprobity's ultimate rotamer-library distributions for model validation.

PubMed

Hintze, Bradley J; Lewis, Steven M; Richardson, Jane S; Richardson, David C

2016-09-01

Here we describe the updated MolProbity rotamer-library distributions derived from an order-of-magnitude larger and more stringently quality-filtered dataset of about 8000 (vs. 500) protein chains, and we explain the resulting changes and improvements to model validation as seen by users. To include only side-chains with satisfactory justification for their given conformation, we added residue-specific filters for electron-density value and model-to-density fit. The combined new protocol retains a million residues of data, while cleaning up false-positive noise in the multi- χ datapoint distributions. It enables unambiguous characterization of conformational clusters nearly 1000-fold less frequent than the most common ones. We describe examples of local interactions that favor these rare conformations, including the role of authentic covalent bond-angle deviations in enabling presumably strained side-chain conformations. Further, along with favored and outlier, an allowed category (0.3-2.0% occurrence in reference data) has been added, analogous to Ramachandran validation categories. The new rotamer distributions are used for current rotamer validation in MolProbity and PHENIX, and for rotamer choice in PHENIX model-building and refinement. The multi-dimensional χ distributions and Top8000 reference dataset are freely available on GitHub. These rotamers are termed "ultimate" because data sampling and quality are now fully adequate for this task, and also because we believe the future of conformational validation should integrate side-chain with backbone criteria. Proteins 2016; 84:1177-1189. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Service delivery under translation: multi-stakeholder accountability in the non-profit community sector in New Zealand.

PubMed

Boon, Bronwyn; Greatbanks, Richard; Munro, Jenny; Gaffney, Michael

2017-03-01

This paper addresses the challenge reported in the research literature of providing adequate accounts of service quality and value to multiple stakeholders. Rather than starting with a particular accountability practice, we examine the accounts of complex service delivery and results from the perspective of five key stakeholder groups. The case study at the empirical centre of this research is a small New Zealand non-profit organisation that provides community-based wraparound casework to young people, and their families, with multiple and complex needs. This paper reports on data collected during 2009-2012 through interviews with five key stakeholders of this service: the young people, the caseworkers, the co-providers, the managers and the funders. Drawing on translation theory, the different points of reference and the consequential shifts in focus, content and meaning within the multiple stakeholder accounts are traced. The findings show that while each stakeholder group brings a unique point of reference to the service delivery, there are degrees of overlap in the focus and content of the accounts. This is particularly evident in the 'relationship' dimension. While overlaps may exist, points of invisibility are also revealed. Accountability tensions can be traced directly to these points of invisibility. As a result of this analysis, it is argued that more explicit attention to the impact of multiple stakeholders at the level of epistemology provides a mechanism for addressing some of the tensions routinely raised. © 2015 John Wiley & Sons Ltd.

Bedside Diagnosis of Dysphagia: A Systematic Review

PubMed Central

O’Horo, John C.; Rogus-Pulia, Nicole; Garcia-Arguello, Lisbeth; Robbins, JoAnne; Safdar, Nasia

2015-01-01

Background Dysphagia is associated with aspiration, pneumonia and malnutrition, but remains challenging to identify at the bedside. A variety of exam protocols and maneuvers are commonly used, but the efficacy of these maneuvers is highly variable. Methods We conducted a comprehensive search of seven databases, including MEDLINE, EMBASE and Scopus, from each database’s earliest inception through June 5th, 2013. Studies reporting diagnostic performance of a bedside examination maneuver compared to a reference gold standard (videofluoroscopic swallow study [VFSS] or flexible endoscopic evaluation of swallowing with sensory testing [FEEST]) were included for analysis. From each study, data were abstracted based on the type of diagnostic method and reference standard study population and inclusion/exclusion characteristics, design and prediction of aspiration. Results The search strategy identified 38 articles meeting inclusion criteria. Overall, most bedside examinations lacked sufficient sensitivity to be used for screening purposes across all patient populations examined. Individual studies found dysphonia assessments, abnormal pharyngeal sensation assessments, dual axis accelerometry, and one description of water swallow testing to be sensitive tools, but none were reported as consistently sensitive. A preponderance of identified studies was in post-stroke adults, limiting the generalizability of results. Conclusions No bedside screening protocol has been shown to provide adequate predictive value for presence of aspiration. Several individual exam maneuvers demonstrated reasonable sensitivity, but reproducibility and consistency of these protocols was not established. More research is needed to design an optimal protocol for dysphagia detection. PMID:25581840

MolProbity’s Ultimate Rotamer-Library Distributions for Model Validation

PubMed Central

Hintze, Bradley J.; Lewis, Steven M.; Richardson, Jane S.; Richardson, David C.

2016-01-01

Here we describe the updated MolProbity rotamer-library distributions derived from an order-of-magnitude larger and more stringently quality-filtered dataset of about 8000 (vs. 500) protein chains, and we explain the resulting changes and improvements to model validation as seen by users. To include only sidechains with satisfactory justification for their given conformation, we added residue-specific filters for electron-density value and model-to-density fit. The combined new protocol retains a million residues of data, while cleaning up false-positive noise in the multi-χ datapoint distributions. It enables unambiguous characterization of conformational clusters nearly 1000-fold less frequent than the most common ones. We describe examples of local interactions that favor these rare conformations, including the role of authentic covalent bond-angle deviations in enabling presumably strained sidechain conformations. Further, along with favored and outlier, an allowed category (0.3% to 2.0% occurrence in reference data) has been added, analogous to Ramachandran validation categories. The new rotamer distributions are used for current rotamer validation in Mol-Probity and PHENIX, and for rotamer choice in PHENIX model-building and refinement. The multi-dimensional χ distributions and Top8000 reference dataset are freely available on GitHub. These rotamers are termed “ultimate” because data sampling and quality are now fully adequate for this task, and also because we believe the future of conformational validation should integrate sidechain with backbone criteria. PMID:27018641

Estimation of reference intervals from small samples: an example using canine plasma creatinine.

PubMed

Geffré, A; Braun, J P; Trumel, C; Concordet, D

2009-12-01

According to international recommendations, reference intervals should be determined from at least 120 reference individuals, which often are impossible to achieve in veterinary clinical pathology, especially for wild animals. When only a small number of reference subjects is available, the possible bias cannot be known and the normality of the distribution cannot be evaluated. A comparison of reference intervals estimated by different methods could be helpful. The purpose of this study was to compare reference limits determined from a large set of canine plasma creatinine reference values, and large subsets of this data, with estimates obtained from small samples selected randomly. Twenty sets each of 120 and 27 samples were randomly selected from a set of 1439 plasma creatinine results obtained from healthy dogs in another study. Reference intervals for the whole sample and for the large samples were determined by a nonparametric method. The estimated reference limits for the small samples were minimum and maximum, mean +/- 2 SD of native and Box-Cox-transformed values, 2.5th and 97.5th percentiles by a robust method on native and Box-Cox-transformed values, and estimates from diagrams of cumulative distribution functions. The whole sample had a heavily skewed distribution, which approached Gaussian after Box-Cox transformation. The reference limits estimated from small samples were highly variable. The closest estimates to the 1439-result reference interval for 27-result subsamples were obtained by both parametric and robust methods after Box-Cox transformation but were grossly erroneous in some cases. For small samples, it is recommended that all values be reported graphically in a dot plot or histogram and that estimates of the reference limits be compared using different methods.

Experimental validation of beam quality correction factors for proton beams

NASA Astrophysics Data System (ADS)

Gomà, Carles; Hofstetter-Boillat, Bénédicte; Safai, Sairos; Vörös, Sándor

2015-04-01

This paper presents a method to experimentally validate the beam quality correction factors (kQ) tabulated in IAEA TRS-398 for proton beams and to determine the kQ of non-tabulated ionization chambers (based on the already tabulated values). The method is based exclusively on ionometry and it consists in comparing the reading of two ionization chambers under the same reference conditions in a proton beam quality Q and a reference beam quality 60Co. This allows one to experimentally determine the ratio between the kQ of the two ionization chambers. In this work, 7 different ionization chamber models were irradiated under the IAEA TRS-398 reference conditions for 60Co beams and proton beams. For the latter, the reference conditions for both modulated beams (spread-out Bragg peak field) and monoenergetic beams (pseudo-monoenergetic field) were studied. For monoenergetic beams, it was found that the experimental kQ values obtained for plane-parallel chambers are consistent with the values tabulated in IAEA TRS-398; whereas the kQ values obtained for cylindrical chambers are not consistent—being higher than the tabulated values. These results support the suggestion (of previous publications) that the IAEA TRS-398 reference conditions for monoenergetic proton beams should be revised so that the effective point of measurement of cylindrical ionization chambers is taken into account when positioning the reference point of the chamber at the reference depth. For modulated proton beams, the tabulated kQ values of all the ionization chambers studied in this work were found to be consistent with each other—except for the IBA FC65-G, whose experimental kQ value was found to be 0.6% lower than the tabulated one. The kQ of the PTW Advanced Markus chamber, which is not tabulated in IAEA TRS-398, was found to be 0.997 ± 0.042 (k = 2), based on the tabulated value of the PTW Markus chamber.

Values for Human-to-Human Reference.

ERIC Educational Resources Information Center

Gorman, Michael

2001-01-01

Defines "values" and lists the eight values (stewardship, service, intellectual freedom, rationalism, literacy and learning, equity of access, privacy, democracy) derived by the author in an earlier work. Gives a brief history of the evolution of human-to-human reference service and discusses its future. Relates each of the author's eight values…

Performance comparison of the medtronic sof-sensor and enlite glucose sensors in inpatient studies of individuals with type 1 diabetes.

PubMed

Calhoun, Peter; Lum, John; Beck, Roy W; Kollman, Craig

2013-09-01

Knowledge of the accuracy of continuous glucose monitoring (CGM) devices is important for its use as a management tool for individuals with diabetes and for its use to assess outcomes in clinical studies. Using data from several inpatient studies, we compared the accuracy of two sensors, the Medtronic Enlite™ using MiniMed Paradigm(®) Veo™ calibration and the Sof-Sensor(®) glucose sensor using Guardian(®) REAL-Time CGM calibration (all from Medtronic Diabetes, Northridge, CA). Nocturnal data were analyzed from eight inpatient studies in which both CGM and reference glucose measurements were available. The analyses included 1,666 CGM-reference paired glucose values for the Enlite in 54 participants over 69 nights and 3,627 paired values for the Sof-Sensor in 66 participants over 91 nights. The Enlite sensor tended to report glucose levels lower than the reference over the entire range of glucose values, whereas the Sof-Sensor values tended to be higher than reference values in the hypoglycemic range and lower than reference values in the hyperglycemic range. The overall median sensor-reference difference was -15 mg/dL for the Enlite and -1 mg/dL for the Sof-Sensor (P<0.001). The median relative absolute difference was 15% for the Enlite versus 12% for the Sof-Sensor (P=0.06); 66% of Enlite values and 73% of Sof-Sensor values met International Organization for Standardization criteria. We found that the Enlite tended to be biased low over the entire glucose range, whereas the Sof-Sensor showed the more typical sensor pattern of being biased high in the hypoglycemic range and biased low in the hyperglycemic range.

Estimation of the behavior factor of existing RC-MRF buildings

NASA Astrophysics Data System (ADS)

Vona, Marco; Mastroberti, Monica

2018-01-01

In recent years, several research groups have studied a new generation of analysis methods for seismic response assessment of existing buildings. Nevertheless, many important developments are still needed in order to define more reliable and effective assessment procedures. Moreover, regarding existing buildings, it should be highlighted that due to the low knowledge level, the linear elastic analysis is the only analysis method allowed. The same codes (such as NTC2008, EC8) consider the linear dynamic analysis with behavior factor as the reference method for the evaluation of seismic demand. This type of analysis is based on a linear-elastic structural model subject to a design spectrum, obtained by reducing the elastic spectrum through a behavior factor. The behavior factor (reduction factor or q factor in some codes) is used to reduce the elastic spectrum ordinate or the forces obtained from a linear analysis in order to take into account the non-linear structural capacities. The behavior factors should be defined based on several parameters that influence the seismic nonlinear capacity, such as mechanical materials characteristics, structural system, irregularity and design procedures. In practical applications, there is still an evident lack of detailed rules and accurate behavior factor values adequate for existing buildings. In this work, some investigations of the seismic capacity of the main existing RC-MRF building types have been carried out. In order to make a correct evaluation of the seismic force demand, actual behavior factor values coherent with force based seismic safety assessment procedure have been proposed and compared with the values reported in the Italian seismic code, NTC08.

Cerebrospinal Fluid Glucose and Lactate: Age-Specific Reference Values and Implications for Clinical Practice

PubMed Central

Leen, Wilhelmina G.; Willemsen, Michèl A.; Wevers, Ron A.; Verbeek, Marcel M.

2012-01-01

Cerebrospinal fluid (CSF) analysis is an important tool in the diagnostic work-up of many neurological disorders, but reference ranges for CSF glucose, CSF/plasma glucose ratio and CSF lactate based on studies with large numbers of CSF samples are not available. Our aim was to define age-specific reference values. In 1993 The Nijmegen Observational CSF Study was started. Results of all CSF samples that were analyzed between 1993 and 2008 at our laboratory were systematically collected and stored in our computerized database. After exclusion of CSF samples with an unknown or elevated erythrocyte count, an elevated leucocyte count, elevated concentrations of bilirubin, free hemoglobin, or total protein 9,036 CSF samples were further studied for CSF glucose (n = 8,871), CSF/plasma glucose ratio (n = 4,516) and CSF lactate values (n = 7,614). CSF glucose, CSF/plasma glucose ratio and CSF lactate were age-, but not sex dependent. Age-specific reference ranges were defined as 5–95th percentile ranges. CSF glucose 5th percentile values ranged from 1.8 to 2.9 mmol/L and 95th percentile values from 3.8 to 5.6 mmol/L. CSF/plasma glucose ratio 5th percentile values ranged from 0.41 to 0.53 and 95th percentile values from 0.82 to 1.19. CSF lactate 5th percentile values ranged from 0.88 to 1.41 mmol/L and 95th percentile values from 2.00 to 2.71 mmol/L. Reference ranges for all three parameters were widest in neonates and narrowest in toddlers, with lower and upper limits increasing with age. These reference values allow a reliable interpretation of CSF results in everyday clinical practice. Furthermore, hypoglycemia was associated with an increased CSF/plasma glucose ratio, whereas hyperglycemia did not affect the CSF/plasma glucose ratio. PMID:22880096

Educators' Perceptions and Value of Career and Technical Education Programs

ERIC Educational Resources Information Center

Shanklin, Stacey L.

2014-01-01

It is not known the extent to which CTE teachers compared to core teachers, student advisors, and administrators perceive the value of CTE programs in relationship to the 21st century skills needed for success in employment and postsecondary endeavors and the professional relationships needed to adequately support and grow CTE programs. The sample…

26 CFR 20.2043-1 - Transfers for insufficient consideration.

Code of Federal Regulations, 2010 CFR

2010-04-01

..., rights or powers enumerated and described in sections 2035 through 2038 and section 2041 are not subject... been made in good faith, and the price must have been an adequate and full equivalent reducible to a money value. If the price was less than such a consideration, only the excess of the fair market value...

Sensitivity of Value Added School Effect Estimates to Different Model Specifications and Outcome Measures

ERIC Educational Resources Information Center

Pride, Bryce L.

2012-01-01

The Adequate Yearly Progress (AYP) Model has been used to make many high-stakes decisions concerning schools, though it does not provide a complete assessment of student academic achievement and school effectiveness. To provide a clearer perspective, many states have implemented various Growth and Value Added Models, in addition to AYP. The…

A Developmental Study Examining the Value, Effectiveness, and Quality of a Data Literacy Intervention

ERIC Educational Resources Information Center

Rogers, Michelle Antionette

2015-01-01

Previous research indicates that pre- and in-service teachers are not receiving adequate training to implement data-informed instructional decision making. This is problematic given the promise this decision making process holds for improving instruction and student learning. At the same time, many educators do not see the value of different types…

Social Equity and the Assemblage of Values in Australian Higher Education

ERIC Educational Resources Information Center

Rizvi, Fazal; Lingard, Bob

2011-01-01

The paper argues that the policy concept of social equity cannot be adequately understood in a generalised abstract manner, but is better viewed as an assemblage that brings together a number of contrasting, and sometimes competing, values. Our use of assemblage is somewhat eclectic and is designed to underscore the performative character of…

Acceptable Tolerances for Matching Icing Similarity Parameters in Scaling Applications

NASA Technical Reports Server (NTRS)

Anderson, David N.

2003-01-01

This paper reviews past work and presents new data to evaluate how changes in similarity parameters affect ice shapes and how closely scale values of the parameters should match reference values. Experimental ice shapes presented are from tests by various researchers in the NASA Glenn Icing Research Tunnel. The parameters reviewed are the modified inertia parameter (which determines the stagnation collection efficiency), accumulation parameter, freezing fraction, Reynolds number, and Weber number. It was demonstrated that a good match of scale and reference ice shapes could sometimes be achieved even when values of the modified inertia parameter did not match precisely. Consequently, there can be some flexibility in setting scale droplet size, which is the test condition determined from the modified inertia parameter. A recommended guideline is that the modified inertia parameter be chosen so that the scale stagnation collection efficiency is within 10 percent of the reference value. The scale accumulation parameter and freezing fraction should also be within 10 percent of their reference values. The Weber number based on droplet size and water properties appears to be a more important scaling parameter than one based on model size and air properties. Scale values of both the Reynolds and Weber numbers need to be in the range of 60 to 160 percent of the corresponding reference values. The effects of variations in other similarity parameters have yet to be established.

Reference values for blood pressure response to cycle ergometry in the first two decades of life: comparison with patients with a repaired coarctation of the aorta.

PubMed

Kaafarani, Mirna; Schroer, Christian; Takken, Tim

2017-12-01

Hemodynamic responses to exercise are used as markers of diagnosis for cardiac diseases, systolic blood pressure (SBP) especially. However, the reference values for SBP in children at peak exertion level are outdated. This study aimed to establish current reference values for SBP, rate pressure product (RPP), and circulatory power (CircP). Data from children who previously underwent cardiopulmonary exercise testing were categorized as healthy (N = 184; age 12.6 ± 2.9 years), and CoA patients (N = 25; age 13.0 ± 3.2 years). With the Lambda-Mu-Sigma (LMS) method, percentile curves were made for SBP, CircP, and RPP in function of peak work rate (Wpeak). Data of CoA patients were used to validate the reference values. Wpeak was the best predictor of peak SBP during exercise. The prediction equations for SBP, CircP and RPP were: (0.2853 x Wpeak) + 111.46; (10.56 x Wpeak) + 2550.2 and (61.879 x Wpeak) + 19.887, respectively. CoA patients showed significantly increased values for peak SBP (Z-score 1.063 ± 1.347). This study provides reference values for SBP, RPP, and CircP at peak exercise. These values can be used for objective evaluation of participants 6-18 years of age in a Dutch population.

Study of extremely low frequency electromagnetic fields in infant incubators.

PubMed

Cermáková, Eleonora

2003-01-01

The aim of the work was to present the results of measurements of extremely low frequency electromagnetic fields (ELF EMF), namely the magnetic flux density, inside infant incubators, and to compare these results with the data published by other authors who point out to a possible association between leukemia or other diseases observed in newborns kept in incubators after the birth and the ELF EMF exposure in the incubator. The measured magnetic flux densities were compared with the reference values for this frequency range indicated in the European Union (EU) recommendations. The repeated measurements in incubators were made with a calibrated magnetometer EFA 300 in the frequency range of 5-30 kHz. Effective values of magnetic flux densities of ELF EMF were determined taking account of the reference values. The results of many repeated measurements showing the values of magnetic flux density in modern incubators with plastic supporting frame, were compared with those obtained in old type incubators with iron skeleton. A power frequency of 50 Hz was detected in the incubator and the ELF EMF values were by over two orders lower than the EU reference values. The paper emphasizes the need to take a special care of newborns kept in incubators even if only the sub-reference values are detected. The EU reference values are intended for the adult human population. A baby in an incubator has much smaller dimensions, higher electric conductivity and maybe trigger another mechanism of response to ELF EMF than that indicated in this paper.

Crazing in Polymeric and Composite Systems

DTIC Science & Technology

1990-04-23

these physical variations into consideration in any mathematical modeling and formulation in analyzing the stresses from the time when crazes incept to...as boundary tractions with great strength; any governing mathematical formulation must include this feature for any adequate analysis. Crazes of...constants the mathematical model describing the crazing mechanism have been successful [25-29]. References 1 J. A. Sauer, J. Marin and C. C. Hsiao, J. App

WILDLIFE TOXICITY REFERENCE VALUES FOR POLYNUCLEAR AROMATIC HYDROCARBONS AND DDT

EPA Science Inventory

The presentation will provide an overview of the procedures used in deriving mammalian and avian wildlife toxicity reference values to be used in development of ecological soil screening levels (Eco-SSLs).

DOE Office of Scientific and Technical Information (OSTI.GOV)

Williams, L.R.

Much research has been devoted to measurement of total blood volume (TBV) and cardiac output (CO) in humans but not enough effort has been devoted to collection and reduction of results for the purpose of deriving typical or {open_quotes}reference{close_quotes} values. Identification of normal values for TBV and CO is needed not only for clinical evaluations but also for the development of biokinetic models for ultra-short-lived radionuclides used in nuclear medicine (Leggett and Williams 1989). The purpose of this report is to offer reference values for TBV and CO, along with estimates of the associated uncertainties that arise from intra- andmore » inter-subject variation, errors in measurement techniques, and other sources. Reference values are derived for basal supine CO and TBV in reference adult humans, and differences associated with age, sex, body size, body position, exercise, and other circumstances are discussed.« less

[Reference values for the blood coagulation tests in Mexico: usefulness of the pooled plasma from blood donors].

PubMed

Calzada-Contreras, Adriana; Moreno-Hernández, Manuel; Castillo-Torres, Noemi Patricia; Souto-Rosillo, Guadalupe; Hernández-Juárez, Jesús; Ricardo-Moreno, María Tania; Sánchez-Fernández, Maria Guadalupe de Jesús; García-González, América; Majluf-Cruz, Abraham

2012-01-01

The blood coagulation system maintains the blood in a liquid state and bleeding and thrombosis are the manifestations of its malfunction. Blood coagulation laboratory evaluates the physiology of this system. To establish both, the reference values for several tests performed at the blood coagulation laboratory as well as the utility of the pooled plasma to perform these assays. MATERIAL AND: In this descriptive, cross-sectional, randomized study, we collected plasma from Mexican Mestizos. Each pooled plasma was prepared with the plasma from at least 20 blood donors. We performed screening and special tests and the Levey-Jennings graphs were built and interpreted after each pass. Results of the tests were analyzed and their distribution was established using the Kolmogorov-Smirnov test. To establish the reference values we used 95% confidence intervals. We collected 72 pooled plasmas. The distribution for PT, APTT, and TT tests was abnormal. Although the PT test showed a bimodal distribution it was normal for factor VII. The reference values for the hemostatic, anticoagulant, and fibrinolytic factors were different from those suggested by the manufacturers. We established the reference values for the blood coagulation tests in the adult Mexican population. We have shown that the pooled plasma must be used for the screening tests. We suggest that each clinical laboratory should establish its own reference values (at least for the screening tests). To reach this objective, we encourage the use of the pooled plasma.

Repeatability, variability and reference values of pulsed wave Doppler echocardiographic measurements in healthy Saanen goats

PubMed Central

2012-01-01

Background Pulsed wave (PW) Doppler echocardiography has become a routine non invasive cardiac diagnostic tool in most species. However, evaluation of intracardiac blood flow requires reference values, which are poorly documented in goats. The aim of this study was to test the repeatability, the variability, and to establish the reference values of PW measurements in healthy adult Saanen goats. Using a standardised PW Doppler echocardiographic protocol, 10 healthy adult unsedated female Saanen goats were investigated three times at one day intervals by the same observer. Mitral, tricuspid, aortic and pulmonary flows were measured from a right parasternal view, and mitral and aortic flows were also measured from a left parasternal view. The difference between left and right side measurements and the intra-observer inter-day repeatability were tested and then the reference values of PW Doppler echocardiographic parameters in healthy adult female Saanen goats were established. Results As documented in other species, all caprine PW Doppler parameters demonstrated a poor inter-day repeatability and a moderate variability. Tricuspid and pulmonary flows were best evaluated on the right side whereas mitral and aortic flows were best obtained on the left side, and reference values are reported for healthy adult Saanen goats. Conclusions PW Doppler echocardiography allows the measurement of intracardiac blood flow indices in goats. The reference values establishment will help interpreting these indices of cardiac function in clinical cardiac cases and developing animal models for human cardiology research. PMID:23067875

Age-related differences in limb fat-free mass and fat mass in healthy Chinese Adults.

PubMed

Bai, Mei; Wang, Rui; Zhu, Linhao; Li, Guixin; Yuan, Dongya; Wang, Li; Jin, Tianbo

2018-05-22

Fat mass (FM) and fat-free mass (FFM) are important elements to evaluate nutritional status. The aims of this study were to establish reference values for FM and FFM of limbs, develop percentile distributions and assess age-related regional differences in body composition by multifrequency bioelectrical impedance analyzer (BIA) in healthy adults. A cross-sectional study was conducted on 3419 healthy subjects, 1595 men and 1824 women. Regional FM and FFM were measured by BIA. FM in men remained stable in both upper and lower limbs, with reference values (25-75th percentile) of 1-1.5 kg and 4.9-7.2 kg, respectively. Women's leg FM remained stable with aging (reference values 6.2-7.9 kg), increasing in their arms (0.9-1.5 kg for youngest, 1.3-2.3 kg oldest). The reference values of upper limbs FFM were 5.3-6.2 kg in men and 3.3-3.9 kg in women. Lower limbs FFM decreased with age in both gender: the reference values were 19.5-23.3 kg (men) and 13.8-15.4 kg (women) for 18-30 age group, and 17.3-20 kg and 11.2-13.1 kg, respectively, for 60+ age group. These data provided reference values of FM and FFM in both limbs, enabling the identification of age and gender-related changes in limb composition in healthy Chinese subjects.

Serum biomarkers for the early diagnosis of TIA: The MIND-TIA study protocol.

PubMed

Dolmans, L Servaas; Rutten, Frans H; El Bartelink, Marie-Louise; Seppenwoolde, Gerdien; van Delft, Sanne; Kappelle, L Jaap; Hoes, Arno W

2015-07-28

A Transient Ischaemic Attack (TIA) bears a high risk of a subsequent ischaemic stroke. Adequate diagnosis of a TIA should be followed immediately by the start of appropriate preventive therapy, including antiplatelets. The diagnosis of a TIA based on symptoms and signs only is notoriously difficult and biomarkers of brain ischaemia might improve the recognition, and target management and prognosis of TIA patients. Our aim is to quantify the added diagnostic value of serum biomarkers of brain ischaemia in patients suspected of TIA. a cross-sectional diagnostic accuracy study with an additional six month follow-up period. 350 patients suspected of TIA in the primary care setting. Patients suspected of a TIA will be recruited by at least 200 general practitioners (GPs) in the catchment area of seven TIA outpatient clinics willing to participate in the study. In all patients a blood sample will be drawn as soon as possible after the patient has contacted the GP, but at least within 72 h after onset of symptoms. Participants will be referred by the GP to the regional TIA outpatient clinic for additional investigations, including brain imaging. The 'definite' diagnosis (reference standard) will be made by a panel consisting of three experienced neurologists who will use all available diagnostic information and the clinical information obtained during the outpatient clinic assessment, and a six month follow-up period. The diagnostic accuracy, and value in addition to signs and symptoms of candidate serum biomarkers will be assessed in terms of discrimination with C statistics, and calibration with plots. We aim to include 350 suspected cases, with 250 patients with indeed definite TIA (or minor stroke) according to the panel. We hope to find novel biomarkers that will enable a rapid and accurate diagnosis of TIA. This would largely improve the management and prognosis of such patients. ClinicalTrials.gov Identifier NCT01954329.

Quantitative imaging biomarkers: Effect of sample size and bias on confidence interval coverage.

PubMed

Obuchowski, Nancy A; Bullen, Jennifer

2017-01-01

Introduction Quantitative imaging biomarkers (QIBs) are being increasingly used in medical practice and clinical trials. An essential first step in the adoption of a quantitative imaging biomarker is the characterization of its technical performance, i.e. precision and bias, through one or more performance studies. Then, given the technical performance, a confidence interval for a new patient's true biomarker value can be constructed. Estimating bias and precision can be problematic because rarely are both estimated in the same study, precision studies are usually quite small, and bias cannot be measured when there is no reference standard. Methods A Monte Carlo simulation study was conducted to assess factors affecting nominal coverage of confidence intervals for a new patient's quantitative imaging biomarker measurement and for change in the quantitative imaging biomarker over time. Factors considered include sample size for estimating bias and precision, effect of fixed and non-proportional bias, clustered data, and absence of a reference standard. Results Technical performance studies of a quantitative imaging biomarker should include at least 35 test-retest subjects to estimate precision and 65 cases to estimate bias. Confidence intervals for a new patient's quantitative imaging biomarker measurement constructed under the no-bias assumption provide nominal coverage as long as the fixed bias is <12%. For confidence intervals of the true change over time, linearity must hold and the slope of the regression of the measurements vs. true values should be between 0.95 and 1.05. The regression slope can be assessed adequately as long as fixed multiples of the measurand can be generated. Even small non-proportional bias greatly reduces confidence interval coverage. Multiple lesions in the same subject can be treated as independent when estimating precision. Conclusion Technical performance studies of quantitative imaging biomarkers require moderate sample sizes in order to provide robust estimates of bias and precision for constructing confidence intervals for new patients. Assumptions of linearity and non-proportional bias should be assessed thoroughly.

Bone and Gallium Single-Photon Emission Computed Tomography-Computed Tomography is Equivalent to Magnetic Resonance Imaging in the Diagnosis of Infectious Spondylodiscitis: A Retrospective Study.

PubMed

Tamm, Alexander S; Abele, Jonathan T

2017-02-01

Spondylodiscitis has historically been a difficult clinical diagnosis. Two imaging techniques that address this problem are magnetic resonance imaging (MRI) and combined bone ( 99m Tc-methylene diphosphonate) and gallium-67 single-photon emission computed tomography-computed tomography (SPECT-CT). Their accuracies have not been adequately compared. The purpose of this study is to compare the sensitivities and specificities of bone and gallium SPECT-CT and MRI in infectious spondylodiscitis. This retrospective study assessed all patients who underwent a bone or gallium SPECT-CT of the spine to assess for infectious spondylodiscitis from January 1, 2010, to May 2, 2012, at a single tertiary care centre. Thirty-four patients (23 men; average 62 ± 14 years of age) were included. The results of the bone or gallium SPECT-CT were compared against MRI for all patients in the cohort who underwent an MRI within 12 weeks of the SPECT-CT. A diagnosis of spondylodiscitis in the discharge summary was considered the reference standard, and was based on a combination of clinical scenario, response to therapy, imaging, or microbiology. Spondylodiscitis was diagnosed in 18 patients and excluded in 16. Bone or gallium SPECT-CT and MRI had similar (P > .05; κ = 0.74) sensitivities (0.94 vs 0.94), specificities (1.00 vs 1.00), positive predictive values (1.00 vs 1.00), negative predictive values (0.94 vs 0.80), and accuracies (0.97 vs 0.95) when compared to the reference standard. Although MRI remains the initial modality of choice in diagnosing spondylodiscitis, bone and gallium SPECT-CT appears diagnostically equivalent and should be considered a viable supplementary or alternative imaging modality particularly if there is contraindication or inaccessibility to MRI. Copyright © 2016 Canadian Association of Radiologists. Published by Elsevier Inc. All rights reserved.

Differences in case-mix can influence the comparison of standardised mortality ratios even with optimal risk adjustment: an analysis of data from paediatric intensive care.

PubMed

Manktelow, Bradley N; Evans, T Alun; Draper, Elizabeth S

2014-09-01

The publication of clinical outcomes for consultant surgeons in 10 specialties within the NHS has, along with national clinical audits, highlighted the importance of measuring and reporting outcomes with the aim of monitoring quality of care. Such information is vital to be able to identify good and poor practice and to inform patient choice. The need to adequately adjust outcomes for differences in case-mix has long been recognised as being necessary to provide 'like-for-like' comparisons between providers. However, directly comparing values of the standardised mortality ratio (SMR) between different healthcare providers can be misleading even when the risk-adjustment perfectly quantifies the risk of a poor outcome in the reference population. An example is shown from paediatric intensive care. Using observed case-mix differences for 33 paediatric intensive care units (PICUs) in the UK and Ireland for 2009-2011, SMRs were calculated under four different scenarios where, in each scenario, all of the PICUs were performing identically for each patient type. Each scenario represented a clinically plausible difference in outcome from the reference population. Despite the fact that the outcome for any patient was the same no matter which PICU they were to be admitted to, differences between the units were seen when compared using the SMR: scenario 1, 1.07-1.21; scenario 2, 1.00-1.14; scenario 3, 1.04-1.13; scenario 4, 1.00-1.09. Even if two healthcare providers are performing equally for each type of patient, if their patient populations differ in case-mix their SMRs will not necessarily take the same value. Clinical teams and commissioners must always keep in mind this weakness of the SMR when making decisions. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Technologic advances for evaluation of cervical cytology: is newer better?

PubMed

Hartmann, K E; Nanda, K; Hall, S; Myers, E

2001-12-01

Among those women who have cervical cancer and have been screened, 14% to 33% of the cases represent failure to detect abnormalities that existed at the time of screening. New technologies intended to improve detection of cytologic abnormalities include liquid-based, thin-layer cytology (ThinPrep, AutoCyte), computerized rescreening (PAPNET), and algorithm-based computer rescreening (AutoPap). This report combines evidence reviews conducted for the U.S. Preventive Services Task Force and the Agency for Healthcare Research and Quality, in which we systematically identified articles on cervical neoplasia, cervical dysplasia, and screening published between January 1966 and March 2001. We note the challenges for improving screening methods, providing an overview of methods for collecting and evaluating cytologic samples, and examining the evidence about the diagnostic performance of new technologies for detecting cervical lesions. Using standard criteria for evaluation of the diagnostic tests, we determined that knowledge about the sensitivity, specificity, and predictive values of new technologies is meager. Only one study of liquid-based cytology used a reference standard of colposcopy, with histology as indicated, to assess participants with normal screening results. Lack of an adequate reference standard is the overwhelming reason that test characteristics cannot be properly assessed or compared. Most publications compare results of screening using the new technology with expert panel review of the cytologic specimen. In that case, the tests are not independent measures and do nothing to relate the screening test findings to the true status of the cervix, making determination of false-negatives, and thus sensitivity, specificity, and negative predictive value, impossible. We did not identify any literature about health outcomes or cost effectiveness of using these tools in a system of screening. For the purposes of guiding decision making about choice of screening tools, the current evidence is inadequate to gauge whether new technologies are "better" than conventional cytology..

[Establishment of Reference Value of Hs-cTnT in Sichuan Region and Its Diagnostic Value in Patients with Chest Pain].

PubMed

Guo, Ying; Du, Xiang-Yang; Huang, Hua-Lan; Wang, Wei-Qing; Nie, Xin; Li, Gui-Xing

2017-11-01

To establish the reference value of high sensitive cardiac troponin T (hs-cTnT) and the efficiency of reference value in the diagnosis of chest pain. Volunteers from eight independent communities in Chengdu,Sichuan were selected with detailed records of physical examination,electrocardiogram,ultrasound examination. The level of hs-cTnT for healthy volunteers was tested to determine ninety-ninth percentile references according to sex and ages. 2 249 patients with chest pain in the emergency department of Western China Hospital from July 2009 to July 2014 were enrolled to measure the efficiency of reference value for diagnosing acute myocardial infarction (AMI). There were 1 305 volunteers included finally. Among them,the mean hs-cTnT level of male was 4.3 (3.2-5.9) ng/L,which was significantly higher than that of female 3.0 (3.0-3.1) ng/L ( P <0.01) . The correlation coefficient between age and hs-cTnT level was 0.43 (male) and 0.29 (female),and the P -value was less than 0.01. The 99th percentile values of male were 10.8 ng/L,15.4 ng/L and 19.7 ng/L for <45 yr.,45-<60 yr. and ≥60 yr.,respectively. Those values of female were 4.6 ng/L,8.9 ng/L,18.8 ng/L,respectively. There was no difference in sensitivity and specificity between the value we figured out and manufactures provided (14.0 ng/L) for those<60 yr.. For the patients ≥60 yr.,the sensitivity and negative predictive value did not show diversity ( P >0.05) but the specificity and positive predictive value showed significant difference (male: 0.67 vs. 0.56 and 0.83 vs. 0.79, P <0.05;female:0.75 vs. 0.68 and 0.74 vs. 0.69, P <0.05). We recommends that the ninety-ninth percentile reference value of patients<60 yr. should be 14.0 ng/L,while 20.0 ng/L for those patients≥60 yr.

USGS46 Greenland ice core water – A new isotopic reference material for δ2H and δ18O measurements of water

USGS Publications Warehouse

Coplen, Tyler B.; Qi, Haiping; Tarbox, Lauren V.; Lorenz, Jennifer M.; Buck, Bryan

2015-01-01

Ice core from Greenland was melted, filtered, homogenised, loaded into glass ampoules, sealed, autoclaved to eliminate biological activity, and calibrated by dual-inlet isotope-ratio mass spectrometry. This isotopic reference material (RM), USGS46, is intended as one of two secondary isotopic reference waters for daily normalisation of stable hydrogen (δ2H) and stable oxygen (δ18O) isotopic analysis of water with a mass spectrometer or a laser absorption spectrometer. The measured δ2H and δ18O values of this reference water were −235.8 ± 0.7‰ and −29.80 ± 0.03‰, respectively, relative to VSMOW on scales normalised such that the δ2H and δ18O values of SLAP reference water are, respectively, −428 and −55.5‰. Each uncertainty is an estimated expanded uncertainty (U = 2uc) about the reference value that provides an interval that has about a 95-percent probability of encompassing the true value. This reference water is available in cases containing 144 glass ampoules that are filled with either 4 ml or 5 ml of water per ampoule.

[Validation of the Schizophrenia Quality Of Life Scale (SQLS) to Measure Quality of Life in Patients Diagnosed With Schizophrenia in Colombia].

PubMed

Suárez, María Fernanda; Sánchez, Ricardo; Calvo, José Manuel

2013-09-01

To validate the SQLS scale in Colombian patients diagnosed with schizophrenia. The self-report scale was applied to 251 patients. Measures of test-retest reliability, internal consistency and correlation inter-scales with the SF-12 were made by applying the scale 2 days later in 28 patients, and 30 days later in 38; 50 patients filled-out the SF-12 scale to determine the concurrent validity. Three domains were found with all of them having Cronbach's alphas >0.7. The three factors model did not show adequate fit indexes. Test-retest evaluation showed satisfactory correlation values (>0.86). Sensitivity to change did not shown significant differences between the repeated measures. As regards concurrent validity, acceptable correlation values were found only in SF-12 domains related to mental health and functioning. The SQLS has a factorial structure consistent with previous reports, adequate internal consistency and temporal stability. However, a more detailed examination of some of these items is required, considering that the measurement of the construct does not appear to be adequate. Copyright © 2013 Asociación Colombiana de Psiquiatría. Publicado por Elsevier España. All rights reserved.

Properties of colour reference solutions of the European Pharmacopoea in CIE L*a*b* colour space.

PubMed

Subert, J; Farsa, O; Gajdosová, Z

2006-12-01

The coordinates of CIE L*a*b* uniform colour space have been acquired from the transmitance spectra of colour reference solutions of European Pharmacopoeia (Ph.Eur.). Calculation of colour differences of these solutions from purified water deltaE* gave their values in the range between 0.7 (B9 solution) to 36 (Y1 solution) CIE units. Excluding red colour reference soulutions, deltaE* values did not depend on concentrations of colour compounds linearly. Small deltaE* values founded by the brown and brownish-yellow colour reference solutions of the lowest concentrations can possibly cause some problems of visual examination of the degree of coloration of liquids according to Ph.Eur.

42 CFR 411.354 - Financial relationship, compensation, and ownership or investment interest.

Code of Federal Regulations, 2010 CFR

2010-10-01

... into account, the volume or value of referrals or other business generated by the referring physician... volume or value of referrals or other business generated by the referring physician for the entity... aggregate compensation that varies with, or takes into account, the volume or value of referrals or other...

VASCOMP II. The V/STOL Aircraft Sizing and Performance Computer Program. Volume VI. User’s Manual. Revision 3

DTIC Science & Technology

1980-05-01

idlers, etc. Main hydraulic systems including pumps, reservoirs, accumulators, filters, valves , lines, fluid, and supports (Figure 4-40). 4-159 -4...SPEED CORRECTION Ny DN-(VALUES OF N. v VALUES OF KPR VALUES OF *111OPT VALUES OF KPN 4.OC VAL.UE LOC VALVE LOC VALU~E LOC VALUE 1207 _______ 1225...TCVT (t/c)qT 0131 TENN NUMBER OF M 0309 TF REFERRED THRUST AS A 1609 - 1616 FUNCTION OF (T/0) TF1 REFERRED N1 AS A FUNCTION 16k1 - 1648 OF (T/e) TF2

Doppler-broadened NICE-OHMS beyond the cavity-limited weak absorption condition - II: Experimental verification

NASA Astrophysics Data System (ADS)

Hausmaninger, Thomas; Silander, Isak; Ma, Weiguang; Axner, Ove

2016-01-01

Doppler-broadened (Db) noise-immune cavity-enhanced optical heterodyne molecular spectrometry (NICE-OHMS) is normally described by an expression, here termed the conventional (CONV) description, that is restricted to the conventional cavity-limited weak absorption condition (CCLWA), i.e. when the single pass absorbance is significantly smaller than the empty cavity losses, i.e. when α0 L < < π / F. To describe NICE-OHMS signals beyond this limit two simplified extended descriptions (termed the extended locking and extended transmission description, ELET, and the extended locking and full transmission description, ELFT), which are assumed to be valid under the relaxed cavity-limited weak absorption condition (RCLWA), i.e. when α0 L < π / F, and a full description (denoted FULL), presumed to be valid also when the α0 L < π / F condition does not hold, have recently been derived in an accompanying work (Ma W, et al. Doppler-broadened NICE-OHMS beyond the cavity-limited weak absorption condition - I. Theoretical Description. J Quant Spectrosc Radiat Transfer, 2015, http://dx.doi.org/10.1016/j.jqsrt.2015.09.007). The present work constitutes an experimental verification and assessment of the validity of these, performed in the Doppler limit for a set of Fα0 L / π values (up to 3.5); it is shown under which conditions the various descriptions are valid. It is concluded that for samples with Fα0 L / π up to 0.01, all descriptions replicate the data well. It is shown that the CONV description is adequate and provides accurate assessments of the signal strength (and thereby the analyte concentration) up to Fα0 L / π of around 0.1, while the ELET is accurate for Fα0 L / π up to around 0.3. The ELFT description mimics the Db NICE-OHMS signal well for Fα0 L / π up to around unity, while the FULL description is adequate for all Fα0 L / π values investigated. Access to these descriptions both increases considerably the dynamic range of the technique and facilitates calibration using certified reference gases, which thereby significantly broadens the applicability of the Db NICE-OHMS technique.

Value of Information References

DOE Data Explorer

Morency, Christina

2014-12-12

This file contains a list of relevant references on value of information (VOI) in RIS format. VOI provides a quantitative analysis to evaluate the outcome of the combined technologies (seismology, hydrology, geodesy) used to monitor Brady's Geothermal Field.

Reference values of aortic pulse wave velocity in the elderly.

PubMed

Alecu, Cosmin; Labat, Carlos; Kearney-Schwartz, Anna; Fay, Renaud; Salvi, Paolo; Joly, Laure; Lacolley, Patrick; Vespignani, Hervé; Benetos, Athanase

2008-11-01

Increased aortic pulse wave velocity (AoPWV) is an independent predictor of cardiovascular morbidity and mortality. There are, however, no generally accepted limits for defining the normal or reference values. The aim of the present study was to define reference values for AoPWV. AoPWV was assessed using applanation tonometry (PulsePen device) in a community living ambulatory population of 455 individuals aged 60-75 years. AoPWV was studied in a group of 206 individuals without hypertension or diabetes, called the 'reference-values group' (RVG), and in a group of 249 individuals with hypertension or diabetes, called the hypertension-diabetes group (HDG). The 95th percentile of the samples was used to determine the upper limit of AoPWV reference values. Mean AoPWV was 8.7+/-2.3 m/s in the RVG and 10.2+/-2.5 m/s in the hypertension-diabetes group (P<0.0001). In the RVG, median AoPWV in the three age subgroups was 8.0 m/s (7.6-8.5) in the 60-64-, 8.0 m/s (7.5-9.0) in the 65-69- and 9.0 m/s (7.9-9.5) in the 70-75-year-old group (NS among groups). In the entire RVG, the upper bounds of the 75th and the 95th percentile of the sample's AoPWV were 10 and 13 m/s, respectively, with no difference between sexes. In elderly individuals of 60-75 years, an AoPWV value below 10 m/s, measured with the PulsePen device, can be considered as a normal value. Values of 10-13 m/s can be considered as 'high normal' or 'borderline', whereas an AoPWV above 13 m/s is frankly elevated. This study provides, for the first time in the elderly, reference values of AoPWV.

The accuracy of references in PhD theses: a case study.

PubMed

Azadeh, Fereydoon; Vaez, Reyhaneh

2013-09-01

Inaccurate references and citations cause confusion, distrust in the accuracy of a report, waste of time and unnecessary financial charges for libraries, information centres and researchers. The aim of the study was to establish the accuracy of article references in PhD theses from the Tehran and Tabriz Universities of Medical Sciences and their compliance with the Vancouver style. We analysed 357 article references in the Tehran and 347 in the Tabriz. Six bibliographic elements were assessed: authors' names, article title, journal title, publication year, volume and page range. Referencing errors were divided into major and minor. Sixty two percent of references in the Tehran and 53% of those in the Tabriz were erroneous. In total, 164 references in the Tehran and 136 in the Tabriz were complete without error. Of 357 reference articles in the Tehran, 34 (9.8%) were in complete accordance with the Vancouver style, compared with none in the Tabriz. Accuracy of referencing did not differ significantly between the two groups, but compliance with the Vancouver style was significantly better in the Tehran. The accuracy of referencing was not satisfactory in both groups, and students need to gain adequate instruction in appropriate referencing methods. © 2013 The authors. Health Information and Libraries Journal © 2013 Health Libraries Group.

Determination of reference ranges for elements in human scalp hair.

PubMed

Druyan, M E; Bass, D; Puchyr, R; Urek, K; Quig, D; Harmon, E; Marquardt, W

1998-06-01

Expected values, reference ranges, or reference limits are necessary to enable clinicians to apply analytical chemical data in the delivery of health care. Determination of references ranges is not straightforward in terms of either selecting a reference population or performing statistical analysis. In light of logistical, scientific, and economic obstacles, it is understandable that clinical laboratories often combine approaches in developing health associated reference values. A laboratory may choose to: 1. Validate either reference ranges of other laboratories or published data from clinical research or both, through comparison of patients test data. 2. Base the laboratory's reference values on statistical analysis of results from specimens assayed by the clinical reference laboratory itself. 3. Adopt standards or recommendations of regulatory agencies and governmental bodies. 4. Initiate population studies to validate transferred reference ranges or to determine them anew. Effects of external contamination and anecdotal information from clinicians may be considered. The clinical utility of hair analysis is well accepted for some elements. For others, it remains in the realm of clinical investigation. This article elucidates an approach for establishment of reference ranges for elements in human scalp hair. Observed levels of analytes from hair specimens from both our laboratory's total patient population and from a physician-defined healthy American population have been evaluated. Examination of levels of elements often associated with toxicity serves to exemplify the process of determining reference ranges in hair. In addition the approach serves as a model for setting reference ranges for analytes in a variety of matrices.

32 CFR 644.44 - Fee appraisals.

Code of Federal Regulations, 2010 CFR

2010-07-01

... basic knowledge of the principle and techniques involved and must be certain that he has adequate data.... Many times the remainder is of less value after the taking, indicating a “severance damage.” The...

Spectral performance of Square Kilometre Array Antennas - II. Calibration performance

NASA Astrophysics Data System (ADS)

Trott, Cathryn M.; de Lera Acedo, Eloy; Wayth, Randall B.; Fagnoni, Nicolas; Sutinjo, Adrian T.; Wakley, Brett; Punzalan, Chris Ivan B.

2017-09-01

We test the bandpass smoothness performance of two prototype Square Kilometre Array (SKA) SKA1-Low log-periodic dipole antennas, SKALA2 and SKALA3 ('SKA Log-periodic Antenna'), and the current dipole from the Murchison Widefield Array (MWA) precursor telescope. Throughout this paper, we refer to the output complex-valued voltage response of an antenna when connected to a low-noise amplifier, as the dipole bandpass. In Paper I, the bandpass spectral response of the log-periodic antenna being developed for the SKA1-Low was estimated using numerical electromagnetic simulations and analysed using low-order polynomial fittings, and it was compared with the HERA antenna against the delay spectrum metric. In this work, realistic simulations of the SKA1-Low instrument, including frequency-dependent primary beam shapes and array configuration, are used with a weighted least-squares polynomial estimator to assess the ability of a given prototype antenna to perform the SKA Epoch of Reionisation (EoR) statistical experiments. This work complements the ideal estimator tolerances computed for the proposed EoR science experiments in Trott & Wayth, with the realized performance of an optimal and standard estimation (calibration) procedure. With a sufficient sky calibration model at higher frequencies, all antennas have bandpasses that are sufficiently smooth to meet the tolerances described in Trott & Wayth to perform the EoR statistical experiments, and these are primarily limited by an adequate sky calibration model and the thermal noise level in the calibration data. At frequencies of the Cosmic Dawn, which is of principal interest to SKA as one of the first next-generation telescopes capable of accessing higher redshifts, the MWA dipole and SKALA3 antenna have adequate performance, while the SKALA2 design will impede the ability to explore this era.

Adequacy of nutritional intake among older men living in Sydney, Australia: findings from the Concord Health and Ageing in Men Project (CHAMP).

PubMed

Waern, Rosilene V R; Cumming, Robert G; Blyth, Fiona; Naganathan, Vasi; Allman-Farinelli, Margaret; Le Couteur, David; Simpson, Stephen J; Kendig, Hal; Hirani, Vasant

2015-09-14

Previous research shows that older men tend to have lower nutritional intakes and higher risk of under-nutrition compared with younger men. The objectives of this study were to describe energy and nutrient intakes, assess nutritional risk and investigate factors associated with poor intake of energy and key nutrients in community-dwelling men aged ≥75 years participating in the Concord Health and Ageing in Men Project - a longitudinal cohort study on older men in Sydney, Australia. A total of 794 men (mean age 81·4 years) had a detailed diet history interview, which was carried out by a dietitian. Dietary adequacy was assessed by comparing median intakes with nutrient reference values (NRV): estimated average requirement, adequate intake or upper level of intake. Attainment of NRV of total energy and key nutrients in older age (protein, Fe, Zn, riboflavin, Ca and vitamin D) was incorporated into a 'key nutrients' variable dichotomised as 'good' (≥5) or 'poor' (≤4). Using logistic regression modelling, we examined associations between key nutrients with factors known to affect food intake. Median energy intake was 8728 kJ (P5=5762 kJ, P95=12 303 kJ), and mean BMI was 27·7 (sd 4·0) kg/m2. Men met their NRV for most nutrients. However, only 1 % of men met their NRV for vitamin D, only 19 % for Ca, only 30 % for K and only 33 % for dietary fibre. Multivariate logistic regression analysis showed that only country of birth was significantly associated with poor nutritional intake. Dietary intakes were adequate for most nutrients; however, only half of the participants met the NRV of ≥5 key nutrients.

The role of observational reference data for climate downscaling: Insights from the VALUE COST Action

NASA Astrophysics Data System (ADS)

Kotlarski, Sven; Gutiérrez, José M.; Boberg, Fredrik; Bosshard, Thomas; Cardoso, Rita M.; Herrera, Sixto; Maraun, Douglas; Mezghani, Abdelkader; Pagé, Christian; Räty, Olle; Stepanek, Petr; Soares, Pedro M. M.; Szabo, Peter

2016-04-01

VALUE is an open European network to validate and compare downscaling methods for climate change research (http://www.value-cost.eu). A key deliverable of VALUE is the development of a systematic validation framework to enable the assessment and comparison of downscaling methods. Such assessments can be expected to crucially depend on the existence of accurate and reliable observational reference data. In dynamical downscaling, observational data can influence model development itself and, later on, model evaluation, parameter calibration and added value assessment. In empirical-statistical downscaling, observations serve as predictand data and directly influence model calibration with corresponding effects on downscaled climate change projections. We here present a comprehensive assessment of the influence of uncertainties in observational reference data and of scale-related issues on several of the above-mentioned aspects. First, temperature and precipitation characteristics as simulated by a set of reanalysis-driven EURO-CORDEX RCM experiments are validated against three different gridded reference data products, namely (1) the EOBS dataset (2) the recently developed EURO4M-MESAN regional re-analysis, and (3) several national high-resolution and quality-controlled gridded datasets that recently became available. The analysis reveals a considerable influence of the choice of the reference data on the evaluation results, especially for precipitation. It is also illustrated how differences between the reference data sets influence the ranking of RCMs according to a comprehensive set of performance measures.

Public health and human values

PubMed Central

Häyry, M

2006-01-01

The ends and means of public health activities are suggested to be at odds with the values held by human individuals and communities. Although promoting longer lives in better health for all seems like an endeavour that is obviously acceptable, it can be challenged by equally self‐evident appeals to autonomy, happiness, integrity and liberty, among other values. The result is that people's actual concerns are not always adequately dealt with by public health measures and assurances. PMID:16943332

Clinical chemistry reference intervals of healthy adult populations in Gojjam Zones of Amhara National Regional State, Northwest Ethiopia

PubMed Central

Amuamuta, Asmare; Mulu, Wondemagegn; Yimer, Mulat; Zenebe, Yohannes; Adem, Yesuf; Abera, Bayeh; Gebeyehu, Wondemu; Gebregziabher, Yakob

2017-01-01

Background Reference interval is crucial for disease screening, diagnosis, monitoring, progression and treatment efficacy. Due to lack of locally derived reference values for the parameters, clinicians use reference intervals derived from western population. But, studies conducted in different African countries have indicated differences between locally and western derived reference values. Different studies also indicated considerable variation in clinical chemistry reference intervals by several variables such as age, sex, geographical location, environment, lifestyle and genetic variation. Objective This study aimed to determine the reference intervals of common clinical chemistry parameters of the community of Gojjam Zones, Northwest Ethiopia. Method Population based cross-sectional study was conducted from November 2015 to December 2016 in healthy adult populations of Gojjam zone. Data such as, medical history, physical examination and socio-demographic data were collected. In addition, laboratory investigations were undertaken to screen the population. Clinical chemistry parameters were measured using Mindray BS 200 clinical chemistry autoanalyzer as per the manufacturer’s instructions. Descriptive statistics was used to calculate mean, median and 95th percentiles. Independent sample T-test and one way ANOVA were used to see association between variables. Results After careful screening of a total of 799 apparently healthy adults who were consented for this study, complete data from 446 (224 females and 222 males) were included for the analysis. The mean age of both the study participants was 28.8 years. Males had high (P<0.05) mean and 2.5th-97.5th percentile ranges of ALT, AST, ALP, creatinine and direct bilirubin. The reference intervals of amylase, LDH, total protein and total bilirubin were not significantly different between the two sex groups (P>0.05). Mean, median, 95% percentile values of AST, ALP, amylase, LDH, creatinine, total protein, total bilirubin, and direct bilirubin across all age groups of participants were similar (P>0.05). But, there was a significant difference in the value of ALT (P<0.05). The reference intervals of ALT, total protein and creatinine were significantly (P<0.05) high in people having monthly income >1500 ETB compared to those with low monthly income. Significant (P<0.05) higher values of the ALT, ALP and total protein were observed in people living in high land compared to low land residences. Conclusion The study showed that some of the common clinical chemistry parameters reference intervals of healthy adults in Gojjam zones were higher than the reference intervals generated from developed countries. Therefore, strict adherence to the reference values generated in developed countries could lead to inappropriate diagnosis and treatment of patients. There was also variation of reference interval values based on climate, gender, age, monthly income and geographical locations. Therefore, further study is required to establish reference intervals for Ethiopian population. PMID:28886191

Effectiveness of touch and feel (TAF) technique on first aid measures for visually challenged.

PubMed

Mary, Helen; Sasikalaz, D; Venkatesan, Latha

2013-01-01

There is a common perception that a blind person cannot even help his own self. In order to challenge that view, a workshop for visually-impaired people to develop the skills to be independent and productive members of society was conceived. An experimental study was conducted at National Institute of Visually Handicapped, Chennai with the objective to assess the effectiveness of Touch and Feel (TAF) technique on first aid measures for the visually challenged. Total 25 visually challenged people were selected by non-probability purposive sampling technique and data was collected using demographic variable and structured knowledge questionnaire. The score obtained was categorised into three levels: inadequate (0-8), moderately adequate (8 - 17), adequate (17 -25). The study revealed that most of the visually challenged (40%) had inadequate knowledge, and 56 percent had moderately adequate and only few (4%) had adequate knowledge in the pre-test, whereas most (68%) of them had adequate knowledge in the post-test which is statistically significant at p < 0.000 with t-value 6.779. This proves that TAF technique was effective for the visually challenged. There was no association between the demographic variables and their level of knowledge regarding first aid.

Age- and sex-specific reference values for fasting serum insulin levels and insulin resistance/sensitivity indices in healthy Iranian adults: Tehran Lipid and Glucose Study.

PubMed

Tohidi, Maryam; Ghasemi, Asghar; Hadaegh, Farzad; Derakhshan, Arash; Chary, Abdolreza; Azizi, Fereidoun

2014-04-01

Increased insulin concentration is a surrogate for insulin resistance and early assessment of fasting insulin may help in identifying those who are potentially at high risk of type 2 diabetes, hypertension, and cardiovascular disease. The aim of this study was to determine age- and sex-related reference values for serum insulin and insulin resistance/sensitivity indices in Iranian subjects. Serum insulin levels were measured by electrochemiluminescence immunoassay in 5786 participants of the Tehran Lipid and Glucose Study. After application of exclusion criteria, 309 non-obese healthy subjects (124 men and 185 women), aged 24-83 y, were included. The International Federation of Clinical Chemistry guidelines (non-parametric method) and the robust method were used for determining reference values. Overall 95% reference values for fasting insulin were 1.61-11.37, 2.34-11.98, and 2.11-12.49 μU/mL in men, women, and total population respectively. Mean fasting insulin concentration showed a decreasing trend with age in both genders (p for trend ≤0.001). Age, waist circumference, and systolic blood pressures were biological determinants of fasting insulin in both genders; in addition, insulin was modulated by triglycerides in men and fasting glucose in women. Reference intervals for HOMA1-IR, HOMA2-IR, and QUICKI were 0.63-2.68, 0.40-1.80, and 0.33-0.42, respectively. This study presents the first set of reference values for fasting serum insulin to be 2-12 μU/mL for both genders in a healthy sample of Iranian adults along with the reference values for insulin resistance/sensitivity indices. These values could be used for identifying subjects with insulin resistance in epidemiological and clinical research. Copyright © 2014 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

Commonly used reference values underestimate oxygen uptake in healthy, 50-year-old Swedish women.

PubMed

Genberg, M; Andrén, B; Lind, L; Hedenström, H; Malinovschi, A

2018-01-01

Cardiopulmonary exercise testing (CPET) is the gold standard among clinical exercise tests. It combines a conventional stress test with measurement of oxygen uptake (V O 2 ) and CO 2 production. No validated Swedish reference values exist, and reference values in women are generally understudied. Moreover, the importance of achieved respiratory exchange ratio (RER) and the significance of breathing reserve (BR) at peak exercise in healthy individuals are poorly understood. We compared V O 2 at maximal load (peakV O 2 ) and anaerobic threshold (V O 2@ AT ) in healthy Swedish individuals with commonly used reference values, taking gender into account. Further, we analysed maximal workload and peakV O 2 with regard to peak RER and BR. In all, 181 healthy, 50-year-old individuals (91 women) performed CPET. PeakV O 2 was best predicted using Jones et al. (100·5%), while SHIP reference values underestimated peakV O 2 most: 112·5%. Furthermore, underestimation of peakV O 2 in women was found for all studied reference values (P<0·001) and was largest for SHIP: women had 128% of predicted peakV O 2 , while men had 104%. PeakV O 2 was similar in subjects with peak RER of 1-1·1 and RER > 1·1 (2 328·7 versus 2 176·7 ml min -1 , P = 0·11). Lower BR (≤30%) related to significantly higher peakV O 2 (P<0·001). In conclusion, peakV O 2 was best predicted by Jones. All studied reference values underestimated oxygen uptake in women. No evidence for demanding RER > 1·1 in healthy individuals was found. A lowered BR is probably a normal response to higher workloads in healthy individuals. © 2016 Scandinavian Society of Clinical Physiology and Nuclear Medicine. Published by John Wiley & Sons Ltd.

Matrix-assisted laser desorption ionization time-of-flight mass spectrometry for fast and accurate identification of clinically relevant Aspergillus species.

PubMed

Alanio, A; Beretti, J-L; Dauphin, B; Mellado, E; Quesne, G; Lacroix, C; Amara, A; Berche, P; Nassif, X; Bougnoux, M-E

2011-05-01

New Aspergillus species have recently been described with the use of multilocus sequencing in refractory cases of invasive aspergillosis. The classical phenotypic identification methods routinely used in clinical laboratories failed to identify them adequately. Some of these Aspergillus species have specific patterns of susceptibility to antifungal agents, and misidentification may lead to inappropriate therapy. We developed a matrix-assisted laser desorption ionization time-of-flight (MALDI-TOF) mass spectrometry (MS)-based strategy to adequately identify Aspergillus species to the species level. A database including the reference spectra of 28 clinically relevant species from seven Aspergillus sections (five common and 23 unusual species) was engineered. The profiles of young and mature colonies were analysed for each reference strain, and species-specific spectral fingerprints were identified. The performance of the database was then tested on 124 clinical and 16 environmental isolates previously characterized by partial sequencing of the β-tubulin and calmodulin genes. One hundred and thirty-eight isolates of 140 (98.6%) were correctly identified. Two atypical isolates could not be identified, but no isolate was misidentified (specificity: 100%). The database, including species-specific spectral fingerprints of young and mature colonies of the reference strains, allowed identification regardless of the maturity of the clinical isolate. These results indicate that MALDI-TOF MS is a powerful tool for rapid and accurate identification of both common and unusual species of Aspergillus. It can give better results than morphological identification in clinical laboratories. © 2010 The Authors. Clinical Microbiology and Infection © 2010 European Society of Clinical Microbiology and Infectious Diseases.

A Comparison between Value-Added School Estimates and Currently Used Metrics of School Accountability in California

ERIC Educational Resources Information Center

Fagioli, Loris P.

2014-01-01

This study compared a value-added approach to school accountability to the currently used metrics of accountability in California of Adequate Yearly Progress (AYP) and Academic Performance Index (API). Five-year student panel data (N?=?53,733) from 29 elementary schools in a large California school district were used to address the research…

Intermittent child employment and its implications for estimates of child labour

PubMed Central

LEVISON, Deborah; HOEK, Jasper; LAM, David; DURYEA, Suzanne

2008-01-01

Using longitudinal data from urban Brazil, the authors track the employment patterns of thousands of children aged 10-16 during four months of their lives in the 1980s and 1990s. The proportion of children who work at some point during a four-month period is substantially higher than the fraction observed working in any single month. The authors calculate an intermittency multiplier to summarize the difference between employment rates in one reference week vs. four reference weeks over a four-month period. They conclude that intermittent employment is a crucial characteristic of child labour which must be recognized to capture levels of child employment adequately and identify child workers. PMID:18815624

Streamflow data

USGS Publications Warehouse

Holmes, Robert R.; Singh, Vijay P.

2016-01-01

The importance of streamflow data to the world’s economy, environmental health, and public safety continues to grow as the population increases. The collection of streamflow data is often an involved and complicated process. The quality of streamflow data hinges on such things as site selection, instrumentation selection, streamgage maintenance and quality assurance, proper discharge measurement techniques, and the development and continued verification of the streamflow rating. This chapter serves only as an overview of the streamflow data collection process as proper treatment of considerations, techniques, and quality assurance cannot be addressed adequately in the space limitations of this chapter. Readers with the need for the detailed information on the streamflow data collection process are referred to the many references noted in this chapter. 

The yield of adequate and conclusive fine-needle aspiration results in thyroid nodules is uniform across functional and goiter types.

PubMed

Liel, Y

1999-01-01

Relatively little is known about the cytological characteristics of hyperfunctioning (hot) thyroid nodules. Concern has been expressed that fine-needle aspiration (FNA) identifies hot nodules as follicular tumors or indeterminate, and as a consequence patients could be unnecessarily referred for surgery. Between 1979 and 1996, thyroid FNA was performed on 829 patients. Result of thyroid scan was available in 326; 69 (21%) patients had hot, and 257 (79%) had warm or cold thyroid nodules. Nodules in each of these major groups were divided into 2 subgroups: clinically solitary nodules and dominant nodules in multinodular goiters (MNG). The frequencies of adequate versus inadequate FNA samples, and of conclusive versus indeterminate FNA results were determined separately for each of the groups and subgroups. In addition, patients with hot nodules and overt hyperthyroidism were identified and evaluated separately. Bivariate analyses were performed for the frequency of adequate versus inadequate smears and conclusive versus indeterminate results between hot, toxic, and cold-warm nodules, and between solitary nodules and MNG. The frequency of adequate aspirations and conclusive results in the various groups and subgroups was found to be statistically indistinguishable. In conclusion, the yield of adequate samples and the rate of conclusive results of FNA in thyroid nodules is similar, irrespective of the functional state or of goiter presentation. Hot thyroid nodules do not seem to produce an increase in the rate of inadequate or indeterminate FNA results, and therefore, do not affect the overall performance of thyroid FNA.

Pool power control in remelting systems

DOEpatents

Williamson, Rodney L [Albuquerque, NM; Melgaard, David K [Albuquerque, NM; Beaman, Joseph J [Austin, TX

2011-12-13

An apparatus for and method of controlling a remelting furnace comprising adjusting current supplied to an electrode based upon a predetermined pool power reference value and adjusting the electrode drive speed based upon the predetermined pool power reference value.

Optimal weighted combinatorial forecasting model of QT dispersion of ECGs in Chinese adults.

PubMed

Wen, Zhang; Miao, Ge; Xinlei, Liu; Minyi, Cen

2016-07-01

This study aims to provide a scientific basis for unifying the reference value standard of QT dispersion of ECGs in Chinese adults. Three predictive models including regression model, principal component model, and artificial neural network model are combined to establish the optimal weighted combination model. The optimal weighted combination model and single model are verified and compared. Optimal weighted combinatorial model can reduce predicting risk of single model and improve the predicting precision. The reference value of geographical distribution of Chinese adults' QT dispersion was precisely made by using kriging methods. When geographical factors of a particular area are obtained, the reference value of QT dispersion of Chinese adults in this area can be estimated by using optimal weighted combinatorial model and reference value of the QT dispersion of Chinese adults anywhere in China can be obtained by using geographical distribution figure as well.

Marginal Micronutrient Intake in High-Performance Male Wheelchair Basketball Players: A Dietary Evaluation and the Effects of Nutritional Advice.

PubMed

Grams, Lena; Garrido, Guadalupe; Villacieros, Jorge; Ferro, Amelia

2016-01-01

Wheelchair basketball has evolved into a high-performance sport over several years, and small variations in player performance can determine the difference between winning and losing. Therefore, adequate micronutrient intake may influence this difference if performance-promoting macronutrient intake and physical fitness are equal between teams. Seventeen elite male wheelchair basketball players belonging to the Spanish National Team participated in this study. Macro- and micronutrient intake were determined using a food-weighing diary over three consecutive days during three training camps in two consecutive years. Current Dietary Reference Intake levels were used to determine the adequacy of intake of seventeen micronutrients of particular interest for athletes. After categorizing the consumed foods into fourteen food groups according to the National Nutrient Database for Standard References (USDA) these groups were used to identify the best predictors of the adequacy of intake for each micronutrient. Total energy intake correlated positively with the adequacy of all micronutrient intake levels, except for vitamins A and E. Five B vitamins and phosphorus, selenium, and iron showed 100% adequacy. All other micronutrient intake levels were found to be inadequate, e.g., vitamin E (51% adequacy) and calcium (73%). The fruit, fish and cereal food groups were found to be predictors of adequate intake of most micronutrients. Together with energy intake (p = .009, η2 = 0.49), the intake of the fruit (p = .032, η2 = 0.39) and egg (p = .036, Kendall's W = 0.42) food groups increased significantly over time, along with improved iodine (p = .008, W = 0.61) and magnesium (p = .030, W = 0.44) adequacy levels. Because the adequacy of micronutrient intake correlates positively with energy intake (R = 0.64, p < .001), a varied diet that includes cereals, fish and fruits is especially important for players with low levels of energy intake. Supplements may be a possible solution if adequate micronutrient intake cannot be achieved through regular dietary intake alone. However, dietary analyses should be conducted on a regular basis throughout the year to improve the nutritional knowledge of the athletes and assure adequate micronutrient intake.

Marginal Micronutrient Intake in High-Performance Male Wheelchair Basketball Players: A Dietary Evaluation and the Effects of Nutritional Advice

PubMed Central

Grams, Lena; Garrido, Guadalupe; Villacieros, Jorge; Ferro, Amelia

2016-01-01

Wheelchair basketball has evolved into a high-performance sport over several years, and small variations in player performance can determine the difference between winning and losing. Therefore, adequate micronutrient intake may influence this difference if performance-promoting macronutrient intake and physical fitness are equal between teams. Seventeen elite male wheelchair basketball players belonging to the Spanish National Team participated in this study. Macro- and micronutrient intake were determined using a food-weighing diary over three consecutive days during three training camps in two consecutive years. Current Dietary Reference Intake levels were used to determine the adequacy of intake of seventeen micronutrients of particular interest for athletes. After categorizing the consumed foods into fourteen food groups according to the National Nutrient Database for Standard References (USDA) these groups were used to identify the best predictors of the adequacy of intake for each micronutrient. Total energy intake correlated positively with the adequacy of all micronutrient intake levels, except for vitamins A and E. Five B vitamins and phosphorus, selenium, and iron showed 100% adequacy. All other micronutrient intake levels were found to be inadequate, e.g., vitamin E (51% adequacy) and calcium (73%). The fruit, fish and cereal food groups were found to be predictors of adequate intake of most micronutrients. Together with energy intake (p = .009, η2 = 0.49), the intake of the fruit (p = .032, η2 = 0.39) and egg (p = .036, Kendall’s W = 0.42) food groups increased significantly over time, along with improved iodine (p = .008, W = 0.61) and magnesium (p = .030, W = 0.44) adequacy levels. Because the adequacy of micronutrient intake correlates positively with energy intake (R = 0.64, p < .001), a varied diet that includes cereals, fish and fruits is especially important for players with low levels of energy intake. Supplements may be a possible solution if adequate micronutrient intake cannot be achieved through regular dietary intake alone. However, dietary analyses should be conducted on a regular basis throughout the year to improve the nutritional knowledge of the athletes and assure adequate micronutrient intake. PMID:27383836

Reference Values of 14 Serum Trace Elements for Pregnant Chinese Women: A Cross-Sectional Study in the China Nutrition and Health Survey 2010-2012.

PubMed

Liu, Xiaobing; Zhang, Yu; Piao, Jianhua; Mao, Deqian; Li, Yajie; Li, Weidong; Yang, Lichen; Yang, Xiaoguang

2017-03-21

The development of reference values of trace elements is recognized as a fundamental prerequisite for the assessment of trace element nutritional status and health risks. In this study, a total of 1400 pregnant women aged 27.0 ± 4.5 years were randomly selected from the China Nutrition and Health Survey 2010-2012 (CNHS 2010-2012). The concentrations of 14 serum trace elements were determined by high-resolution inductively coupled plasma mass spectrometry. Reference values were calculated covering the central 95% reference intervals (P2.5-P97.5) after excluding outliers by Dixon's test. The overall reference values of serum trace elements were 131.5 (55.8-265.0 μg/dL for iron (Fe), 195.5 (107.0-362.4) μg/dL for copper (Cu), 74.0 (51.8-111.3) μg/dL for zinc (Zn), 22.3 (14.0-62.0) μg/dL for rubidium (Rb), 72.2 (39.9-111.6) μg/L for selenium (Se), 45.9 (23.8-104.3) μg/L for strontium (Sr), 1.8 (1.2-3.6) μg/L for molybdenum (Mo), 2.4 (1.2-8.4) μg/L for manganese (Mn), 1.9 (0.6-9.0) ng/L for lead (Pb), 1.1 (0.3-5.6) ng/L for arsenic (As), 835.6 (219.8-4287.7) ng/L for chromium (Cr), 337.9 (57.0-1130.0) ng/L for cobalt (Co), 193.2 (23.6-2323.1) ng/L for vanadium (V), and 133.7 (72.1-595.1) ng/L for cadmium (Cd). Furthermore, some significant differences in serum trace element reference values were observed between different groupings of age intervals, residences, anthropometric status, and duration of pregnancy. We found that serum Fe, Zn, and Se concentrations significantly decreased, whereas serum Cu, Sr, and Co concentrations elevated progressively compared with reference values of 14 serum trace elements in pregnant Chinese women. The reference values of serum trace elements established could play a key role in the following nutritional status and health risk assessment.

Choice by Value Encoding and Value Construction: Processes of Loss Aversion

ERIC Educational Resources Information Center

Willemsen, Martijn C.; Bockenholt, Ulf; Johnson, Eric J.

2011-01-01

Loss aversion and reference dependence are 2 keystones of behavioral theories of choice, but little is known about their underlying cognitive processes. We suggest an additional account for loss aversion that supplements the current account of the value encoding of attributes as gains or losses relative to a reference point, introducing a value…

BiliChek transcutaneous bilirubin meter overestimates serum bilirubin as measured by the Doumas reference method.

PubMed

Karon, Brad S; Wickremasinghe, Andrea C; Lo, Stanley F; Saenger, Amy K; Cook, Walter J

2010-08-01

To determine the relationship between BiliChek TcB (Respironics, Marietta GA) and Doumas reference serum or plasma total bilirubin (TSB). Pooled samples with values assigned by the Doumas reference method were used to establish the relationship between a local laboratory and reference Doumas TSB. We then established the relationship between TcB and TSB in the 3 months before and after reassignment of calibrator setpoints undertaken to match the local laboratory to Doumas reference bilirubin values. Before calibrator setpoint reassignment TSB as measured in our laboratory overestimated Doumas reference bilirubin. After calibrator adjustment laboratory TSB was within 1.7-6.8 micromol/L (0.1-0.4 mg/dL) of Doumas reference values. Mean bias between BiliChek TcB and TSB was 42.8+/-22.2 micromol/L (2.5+/-1.3mg/dL) (n=94) before and 49.6+/-22.2 micromol/L (2.9+/-1.3mg/dL) (n=115) after calibration adjustment. BiliChek TcB significantly overestimates TSB as measured by the Doumas reference method. 2010 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

Preparation and value assignment of standard reference material 968e fat-soluble vitamins, carotenoids, and cholesterol in human serum.

PubMed

Thomas, Jeanice B; Duewer, David L; Mugenya, Isaac O; Phinney, Karen W; Sander, Lane C; Sharpless, Katherine E; Sniegoski, Lorna T; Tai, Susan S; Welch, Michael J; Yen, James H

2012-01-01

Standard Reference Material 968e Fat-Soluble Vitamins, Carotenoids, and Cholesterol in Human Serum provides certified values for total retinol, γ- and α-tocopherol, total lutein, total zeaxanthin, total β-cryptoxanthin, total β-carotene, 25-hydroxyvitamin D(3), and cholesterol. Reference and information values are also reported for nine additional compounds including total α-cryptoxanthin, trans- and total lycopene, total α-carotene, trans-β-carotene, and coenzyme Q(10). The certified values for the fat-soluble vitamins and carotenoids in SRM 968e were based on the agreement of results from the means of two liquid chromatographic methods used at the National Institute of Standards and Technology (NIST) and from the median of results of an interlaboratory comparison exercise among institutions that participate in the NIST Micronutrients Measurement Quality Assurance Program. The assigned values for cholesterol and 25-hydroxyvitamin D(3) in the SRM are the means of results obtained using the NIST reference method based upon gas chromatography-isotope dilution mass spectrometry and liquid chromatography-isotope dilution tandem mass spectrometry, respectively. SRM 968e is currently one of two available health-related NIST reference materials with concentration values assigned for selected fat-soluble vitamins, carotenoids, and cholesterol in human serum matrix. This SRM is used extensively by laboratories worldwide primarily to validate methods for determining these analytes in human serum and plasma and for assigning values to in-house control materials. The value assignment of the analytes in this SRM will help support measurement accuracy and traceability for laboratories performing health-related measurements in the clinical and nutritional communities.

Junction Potentials Bias Measurements of Ion Exchange Membrane Permselectivity.

PubMed

Kingsbury, Ryan S; Flotron, Sophie; Zhu, Shan; Call, Douglas F; Coronell, Orlando

2018-04-17

Ion exchange membranes (IEMs) are versatile materials relevant to a variety of water and waste treatment, energy production, and industrial separation processes. The defining characteristic of IEMs is their ability to selectively allow positive or negative ions to permeate, which is referred to as permselectivity. Measured values of permselectivity that equal unity (corresponding to a perfectly selective membrane) or exceed unity (theoretically impossible) have been reported for cation exchange membranes (CEMs). Such nonphysical results call into question our ability to correctly measure this crucial membrane property. Because weighing errors, temperature, and measurement uncertainty have been shown to not explain these anomalous permselectivity results, we hypothesized that a possible explanation are junction potentials that occur at the tips of reference electrodes. In this work, we tested this hypothesis by comparing permselectivity values obtained from bare Ag/AgCl wire electrodes (which have no junction) to values obtained from single-junction reference electrodes containing two different electrolytes. We show that permselectivity values obtained using reference electrodes with junctions were greater than unity for CEMs. In contrast, electrodes without junctions always produced permselectivities lower than unity. Electrodes with junctions also resulted in artificially low permselectivity values for AEMs compared to electrodes without junctions. Thus, we conclude that junctions in reference electrodes introduce two biases into results in the IEM literature: (i) permselectivity values larger than unity for CEMs and (ii) lower permselectivity values for AEMs compared to those for CEMs. These biases can be avoided by using electrodes without a junction.

Development of saw palmetto (Serenoa repens) fruit and extract standard reference materials.

PubMed

Schantz, Michele M; Bedner, Mary; Long, Stephen E; Molloy, John L; Murphy, Karen E; Porter, Barbara J; Putzbach, Karsten; Rimmer, Catherine A; Sander, Lane C; Sharpless, Katherine E; Thomas, Jeanice B; Wise, Stephen A; Wood, Laura J; Yen, James H; Yarita, Takashi; NguyenPho, Agnes; Sorenson, Wendy R; Betz, Joseph M

2008-10-01

As part of a collaboration with the National Institutes of Health's Office of Dietary Supplements and the Food and Drug Administration's Center for Drug Evaluation and Research, the National Institute of Standards and Technology has developed two standard reference materials (SRMs) representing different forms of saw palmetto (Serenoa repens), SRM 3250 Serenoa repens fruit and SRM 3251 Serenoa repens extract. Both of these SRMs have been characterized for their fatty acid and phytosterol content. The fatty acid concentration values are based on results from gas chromatography with flame ionization detection (GC-FID) and mass spectrometry (GC/MS) analysis while the sterol concentration values are based on results from GC-FID and liquid chromatography with mass spectrometry analysis. In addition, SRM 3250 has been characterized for lead content, and SRM 3251 has been characterized for the content of beta-carotene and tocopherols. SRM 3250 (fruit) has certified concentration values for three phytosterols, 14 fatty acids as triglycerides, and lead along with reference concentration values for four fatty acids as triglycerides and 16 free fatty acids. SRM 3251 (extract) has certified concentration values for three phytosterols, 17 fatty acids as triglycerides, beta-carotene, and gamma-tocopherol along with reference concentration values for three fatty acids as triglycerides, 17 fatty acids as free fatty acids, beta-carotene isomers, and delta-tocopherol and information values for two phytosterols. These SRMs will complement other reference materials currently available with concentrations for similar analytes and are part of a series of SRMs being developed for dietary supplements.

[Reference values of proteins for the Venezuelan population].

PubMed

Guerra, Marisa; Hernández, María N; López, Michelle; Alfaro, María J

2013-12-01

This study presents the reference values for protein requirements. The consumption of the Venezuelan population was obtained according to the Food Consumption Monitoring Survey (ESCA) 2010-2012. The diet provided good quality proteins, combining animal and vegetable foods in an approximate ratio of 1:1. The reference values were calculated based on the safe levels of protein intake recommended by WHO/FAO/UN 2007, with an adjustment for protein supply depending on age, weight, and contribution to the caloric formula of proteins for light physical activity. The reference values for protein requirements recommended as safe levels of intake in g/kg/day are 1.14 to 1.80 for males and females less than one-year-old, from 1 to 3 years, 0.90 to 1.14; from 4 to 6 years old, 0.86 to 0.89; and from 7 to 10 years old, 0.91 to 0.92. For adolescents, the average is 0.88 and 1.07 for males and females, respectively. In adults from 20 to 59 years old, 0.83 for men and women is recommended, and for older adults, 1.00 for men and women. In pregnant women, additional consumptions are recommended according to gestation time. Adolescent pregnant women must consume additional 1.2 to 1.7 g/kg/day to normal requirement. In breastfeeding women, the values differ between the first six months postnatal period and after six months of breastfeeding. The reference values for protein in this update were lower than the values of the 2000 version.

Washing the patient: dignity and aesthetic values in nursing care.

PubMed

Pols, Jeannette

2013-07-01

Dignity is a fundamental concept, but its meaning is not clear. This paper attempts to clarify the term by analysing and reconnecting two meanings of dignity: humanitas and dignitas. Humanitas refers to citizen values that protect individuals as equal to one another. Dignitas refers to aesthetic values embedded in genres of sociality that relate to differences between people. The paper explores these values by way of an empirical ethical analysis of practices of washing psychiatric patients in nursing care. Nurses legitimate the washing of reluctant patients with reference to dignity. The analysis shows the intertwinement of humanitas and dignitas that gives dignity its fundamental meaning. © 2013 John Wiley & Sons Ltd.

The Value Estimation of an HFGW Frequency Time Standard for Telecommunications Network Optimization

NASA Astrophysics Data System (ADS)

Harper, Colby; Stephenson, Gary

2007-01-01

The emerging technology of gravitational wave control is used to augment a communication system using a development roadmap suggested in Stephenson (2003) for applications emphasized in Baker (2005). In the present paper consideration is given to the value of a High Frequency Gravitational Wave (HFGW) channel purely as providing a method of frequency and time reference distribution for use within conventional Radio Frequency (RF) telecommunications networks. Specifically, the native value of conventional telecommunications networks may be optimized by using an unperturbed frequency time standard (FTS) to (1) improve terminal navigation and Doppler estimation performance via improved time difference of arrival (TDOA) from a universal time reference, and (2) improve acquisition speed, coding efficiency, and dynamic bandwidth efficiency through the use of a universal frequency reference. A model utilizing a discounted cash flow technique provides an estimation of the additional value using HFGW FTS technology could bring to a mixed technology HFGW/RF network. By applying a simple net present value analysis with supporting reference valuations to such a network, it is demonstrated that an HFGW FTS could create a sizable improvement within an otherwise conventional RF telecommunications network. Our conservative model establishes a low-side value estimate of approximately 50B USD Net Present Value for an HFGW FTS service, with reasonable potential high-side values to significant multiples of this low-side value floor.

Biscayne aquifer drinking water (USGS45): a new isotopic reference material for δ2H and δ18O measurements of water.

PubMed

Lorenz, Jennifer M; Tarbox, Lauren; Buck, Bryan; Qi, Haiping; Coplen, Tyler B

2014-10-15

As a result of the scarcity of isotopic reference waters for daily use, a new secondary isotopic reference material for international distribution has been prepared from drinking water collected from the Biscayne aquifer in Ft. Lauderdale, Florida. This isotopic reference water was filtered, homogenized, loaded into glass ampoules, sealed with a torch, autoclaved to eliminate biological activity, and measured by dual-inlet isotope-ratio mass spectrometry. This reference material is available by the case of 144 glass ampoules containing either 4 mL or 5 mL of water in each ampoule. The δ(2)H and δ(18)O values of this reference material are -10.3 ± 0.4‰ and -2.238 ± 0.011‰, respectively, relative to VSMOW, on scales normalized such that the δ(2)H and δ(18)O values of SLAP reference water are, respectively, -428 and -55.5‰. Each uncertainty is an estimated expanded uncertainty (U = 2uc ) about the reference value that provides an interval that has about a 95% probability of encompassing the true value. This isotopic reference material, designated as USGS45, is intended as one of two isotopic reference waters for daily normalization of stable hydrogen and oxygen isotopic analysis of water with an isotope-ratio mass spectrometer or a laser absorption spectrometer. Published in 2014. This article is a U.S. Government work and is in the public domain in the USA. Published in 2014. This article is a U.S. Government work and is in the public domain in the USA.

Creatine and guanidinoacetate reference values in a French population.

PubMed

Joncquel-Chevalier Curt, Marie; Cheillan, David; Briand, Gilbert; Salomons, Gajja S; Mention-Mulliez, Karine; Dobbelaere, Dries; Cuisset, Jean-Marie; Lion-François, Laurence; Des Portes, Vincent; Chabli, Allel; Valayannopoulos, Vassili; Benoist, Jean-François; Pinard, Jean-Marc; Simard, Gilles; Douay, Olivier; Deiva, Kumaran; Tardieu, Marc; Afenjar, Alexandra; Héron, Delphine; Rivier, François; Chabrol, Brigitte; Prieur, Fabienne; Cartault, François; Pitelet, Gaëlle; Goldenberg, Alice; Bekri, Soumeya; Gerard, Marion; Delorme, Richard; Porchet, Nicole; Vianey-Saban, Christine; Vamecq, Joseph

2013-11-01

Creatine and guanidinoacetate are biomarkers of creatine metabolism. Their assays in body fluids may be used for detecting patients with primary creatine deficiency disorders (PCDD), a class of inherited diseases. Their laboratory values in blood and urine may vary with age, requiring that reference normal values are given within the age range. Despite the long known role of creatine for muscle physiology, muscle signs are not necessarily the major complaint expressed by PCDD patients. These disorders drastically affect brain function inducing, in patients, intellectual disability, autistic behavior and other neurological signs (delays in speech and language, epilepsy, ataxia, dystonia and choreoathetosis), being a common feature the drop in brain creatine content. For this reason, screening of PCDD patients has been repeatedly carried out in populations with neurological signs. This report is aimed at providing reference laboratory values and related age ranges found for a large scale population of patients with neurological signs (more than 6 thousand patients) previously serving as a background population for screening French patients with PCDD. These reference laboratory values and age ranges compare rather favorably with literature values for healthy populations. Some differences are also observed, and female participants are discriminated from male participants as regards to urine but not blood values including creatine on creatinine ratio and guanidinoacetate on creatinine ratio values. Such gender differences were previously observed in healthy populations; they might be explained by literature differential effects of testosterone and estrogen in adolescents and adults, and by estrogen effects in prepubertal age on SLC6A8 function. Finally, though they were acquired on a population with neurological signs, the present data might reasonably serve as reference laboratory values in any future medical study exploring abnormalities of creatine metabolism and transport. © 2013 Elsevier Inc. All rights reserved.

Antarctic ice-core water (USGS49) – A new isotopic reference material for δ2H and δ18O measurements of water

USGS Publications Warehouse

Lorenz, Jennifer M.; Qi, Haiping; Coplen, Tyler B.

2017-01-01

As a result of the scarcity of isotopic reference waters for daily use, a new secondary isotopic reference material for international distribution has been prepared from ice-core water from the Amundsen–Scott South Pole Station. This isotopic reference material, designated as USGS49, was filtered, homogenised, loaded into glass ampoules, sealed with a torch, autoclaved to eliminate biological activity and measured by dual-inlet isotope-ratio mass spectrometry. The δ2H and δ18O values of USGS49 are −394.7 ± 0.4 and −50.55 ± 0.04 mUr (where mUr = 0.001 = ‰), respectively, relative to VSMOW, on scales normalised such that the δ2H and δ18O values of SLAP reference water are, respectively, −428 and −55.5 mUr. Each uncertainty is an estimated expanded uncertainty (U = 2uc) about the reference value that provides an interval that has about a 95% probability of encompassing the true value. This isotopic reference material is intended as one of two isotopic reference waters for daily normalisation of stable hydrogen and oxygen isotopic analysis of water with an isotope-ratio mass spectrometer or a laser absorption spectrometer. It is available by the case of 144 glass ampoules or as a set of sixteen glass ampoules containing 5 ml of water in each ampoule.

On the value of the phenotypes in the genomic era.

PubMed

Gonzalez-Recio, O; Coffey, M P; Pryce, J E

2014-12-01

Genetic improvement programs around the world rely on the collection of accurate phenotypic data. These phenotypes have an inherent value that can be estimated as the contribution of an additional record to genetic gain. Here, the contribution of phenotypes to genetic gain was calculated using traditional progeny testing (PT) and 2 genomic selection (GS) strategies that, for simplicity, included either males or females in the reference population. A procedure to estimate the theoretical economic contribution of a phenotype to a breeding program is described for both GS and PT breeding programs through the increment in genetic gain per unit of increase in estimated breeding value reliability obtained when an additional phenotypic record is added. The main factors affecting the value of a phenotype were the economic value of the trait, the number of phenotypic records already available for the trait, and its heritability. Furthermore, the value of a phenotype was affected by several other factors, including the cost of establishing the breeding program and the cost of phenotyping and genotyping. The cost of achieving a reliability of 0.60 was assessed for different reference populations for GS. Genomic reference populations of more sires with small progeny group sizes (e.g., 20 equivalent daughters) had a lower cost than those reference populations with either large progeny group sizes for fewer genotyped sires, or female reference populations, unless the heritability was large and the cost of phenotyping exceeded a few hundred dollars; then, female reference populations were preferable from an economic perspective. Copyright © 2014 American Dairy Science Association. Published by Elsevier Inc. All rights reserved.

Health Related Quality of Life in a Dutch Rehabilitation Population: Reference Values and the Effect of Physical Activity.

PubMed

Krops, Leonie A; Jaarsma, Eva A; Dijkstra, Pieter U; Geertzen, Jan H B; Dekker, Rienk

2017-01-01

To establish reference values for Health Related Quality of Life (HRQoL) in a Dutch rehabilitation population, and to study effects of patient characteristics, diagnosis and physical activity on HRQoL in this population. Former rehabilitation patients (3169) were asked to fill in a questionnaire including the Dutch version of the RAND-36. Differences between our rehabilitation patients and Dutch reference values were analyzed (t-tests). Effects of patient characteristics, diagnosis and movement intensity on scores on the subscales of the RAND-36 were analyzed using block wise multiple regression analyses. In total 1223 patients (39%) returned the questionnaire. HRQoL was significantly poorer in the rehabilitation patients compared to Dutch reference values on all subscales (p<0.001) except for health change (p = 0.197). Longer time between questionnaire and last treatment was associated with a smaller health change (p = 0.035). Higher age negatively affected physical functioning (p<0.001), social functioning (p = 0.004) and health change (p = 0.001). Diagnosis affected outcomes on all subscales except role limitations physical, and mental health (p ranged <0.001 to 0.643). Higher movement intensity was associated with better outcomes on all subscales except for mental health (p ranged <0.001 to 0.190). HRQoL is poorer in rehabilitation patients compared to Dutch reference values. Physical components of HRQoL are affected by diagnosis. In rehabilitation patients an association between movement intensity and HRQoL was found. For clinical purposes, results of this study can be used as reference values for HRQoL in a rehabilitation setting.

[Dietary reference intakes of trace elements for Japanese and problems in clinical fields].

PubMed

Inoue, Yoshifumi

2016-07-01

In the dietary reference intakes, EAR(estimated average requirement), RDA(recommended dietary allowance), AL(adequate intake), DG(tentative dietary goal for preventing life style related diseases) and UL(tolerable upper intake level) of eight types of trace elements (iron: Fe, zinc: Zn, copper: Cu, manganese: Mn, iodine: I, selenium: Se, chromium: Cr, molybdenum: Mo) have been set. However, in the meals of hospitals, only iron of which has been taken into account. The content of these trace elements in the enteral nutrient released after 2000 was determined by considering the content of dietary reference intakes of trace elements for Japanese and considered so not fall into deficiency. However, enteral nutrient must be used considering the content of Zn, Cu and the Zn/Cu ratio, the selenium content, and the route of administration, in order to avoid falling into deficiency.

OTTER: An Optimized Transit Tool And Easy Reference

DTIC Science & Technology

2016-03-01

as stated in the CNO’s Position Report: 2014. While a number of fuel -saving measures have been implemented in recent years, the effects of...saving measures have been implemented in recent years, the effects of operational transit speed on fuel consumption have not been adequately...their estimated savings As clearly seen, operating configuration has the most effect by far on fuel savings. Source: Fonte S (2009). In 2015

Development of High-Speed IV-VI Photodiodes

DTIC Science & Technology

1976-06-01

is not yet an adequate theoretical analysis. However, early experimental results indicated that collection efficienclea near unitv are attainable...82171~$* te g w w ( I .f 1 INTRODUCTION 2 EXPERIMENTAL 3 JUNCTION CAPACITANCE 4 THE PINCHED-OFF PHOTODIODE 4.1 Genaral Considerations 4.2...developed by Ford Research Staff. The essential references to this previous work and to new experimental detVKji are given In Section 2 of the

Special Observance Planning Guide

DTIC Science & Technology

2015-11-01

Finding the right speaker for an event can be a challenge. Many speakers are recommended based on word-of-mouth or through a group connected to...An unprepared, rambling speaker or one who intentionally or unintentionally attacks a group or its members can be extremely damaging to a program...Don’t assume that an organizational senior leader is an adequate speaker based on position, rank, and/or affiliation with a reference group

Guidelines for Calibration and Application of Storm.

DTIC Science & Technology

1977-12-01

combination method uses the SCS method on pervious areas and the coefficient method on impervious areas of the watershed. Storm water quality is computed...stations, it should be accomplished according to procedures outlined In Reference 7. Adequate storm water quality data are the most difficult and costly...mass discharge of pollutants is negligible. The state-of-the-art in urban storm water quality modeling precludes highly accurate simulation of

Choline: Clinical Nutrigenetic/Nutrigenomic Approaches for Identification of Functions and Dietary Requirements

PubMed Central

Zeisel, Steven H.

2013-01-01

Nutrigenetics/nutrigenomics (the study of the bidirectional interactions between genes and diet) is a rapidly developing field that is changing research and practice in human nutrition. Though eventually nutrition clinicians may be able to provide personalized nutrition recommendations, in the immediate future they are most likely to use this knowledge to improve dietary recommendations for populations. Currently, estimated average requirements are used to set dietary reference intakes because scientists cannot adequately identify subsets of the population that differ in requirement for a nutrient. Recommended intake levels must exceed the actual required intake for most of the population in order to assure that individuals with the highest requirement ingest adequate amounts of the nutrient. As a result, dietary reference intake levels often are set so high that diet guidelines suggest almost unattainable intakes of some foods. Once it is possible to identify common subgroups that differ in nutrient requirements using nutrigenetic/nutrigenomic profiling, targeted interventions and recommendations can be refined. In addition, when a large variance exists in response to a nutrient, statistical analyses often argue for a null effect. If responders could be differentiated from nonre-sponders based on nutrigenetic/nutrigenomic profiling, this statistical noise could be eliminated and the sensitivity of nutrition research greatly increased. PMID:20436254

Nutrient intake of children with intractable epilepsy compared with healthy children.

PubMed

Volpe, Stella L; Schall, Joan I; Gallagher, Paul R; Stallings, Virginia A; Bergqvist, A G Christina

2007-06-01

Growth retardation is common among children with epilepsy, and poor dietary intake may be one of the causes. The goal of this cross-sectional study was to compare the nutrient intake of children 1 to 8 years of age with intractable epilepsy to healthy children of the same age from the National Health and Nutrition Examination Survey 2001 to 2002 (N=1,718) and with the Dietary Reference Intakes. Children with intractable epilepsy were divided into two age groups: 1.0 to 3.9 and 4.0 to 8.9 years, to correspond with the Dietary Reference Intakes. Forty-three children with intractable epilepsy, mean age=4.7+/-2.2 years, had significantly lower intakes (P<0.05) of total energy; protein; carbohydrate; fat; dietary fiber; vitamins A, E, B-6, and B-12; riboflavin; niacin; folate; calcium; phosphorus; magnesium; zinc; copper; and selenium compared with healthy children. Thirty percent or more of the children with intractable epilepsy in both age groups had intakes below the Recommended Dietary Allowance or Adequate Intake for vitamins D, E, and K; folate; calcium; linoleic acid; and alpha-linolenic acid. Health care professionals caring for children with intractable epilepsy should be aware of this pattern of decreased nutrient intake and educate families to provide an adequate diet and/or consider vitamin/mineral supplementation.

Techniques for Developing Child Dummy Protection Reference Values. Event Report

DOT National Transportation Integrated Search

1996-10-01

The purpose of this report is to present background information and techniques : for developing protection reference values (PRV) to use with child dummies in : out-of-position (OOP) child/air bag interaction testing. Biomechanics experts : agree tha...

[The Study of Health in Pomerania (SHIP) reference values for cardiopulmonary exercise testing].

PubMed

Gläser, S; Ittermann, T; Schäper, C; Obst, A; Dörr, M; Spielhagen, T; Felix, S B; Völzke, H; Bollmann, T; Opitz, C F; Warnke, C; Koch, B; Ewert, R

2013-01-01

The interpretation of gas exchange measured by cardiopulmonary exercise testing (CPET) depends on reliable reference values. Within the population based Study of Health in Pomerania (SHIP) CPET was assessed in 1706 volunteers. The assessment based on symptom limited exercise tests on a bicycle in a sitting position according to a modified Jones protocol. CPET was embedded in an extensive examination program. After the exclusion of active smokers and volunteers with evidence of cardiopulmonary and musculoskeletal disorders the reference population comprised 616 healthy subjects (333 women) aged 25 to 85 years. Reference equations including upper and/or lower limits based on quantile regression were assessed. All values were corrected for the most important influencing factors.This study provides reference equations for gas exchange and exercise capacity assessed within a population in Germany. © Georg Thieme Verlag KG Stuttgart · New York.

Determination of polychlorinated dibenzo-p-dioxin and dibenzofuran congeners in air particulate and marine sediment standard reference materials (SRMs).

PubMed

Chiu, C H; Turle, R; Poole, G; Thibert, B; Brubaker, W W; Schantz, M M; Wise, S A

2001-02-01

Due to the limited number of environmental matrix certified reference materials (CRMs) with assigned values for natural levels of polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs), an interlaboratory study was undertaken by the National Institute of Standards and Technology (NIST) and Environment Canada to establish reference concentration values for selected PCDD/Fs in two well-characterized NIST Standard Reference Materials (SRMs): SRM 1649a (Urban Dust) and SRM 1944 (New York/New Jersey Waterway Sediment). Results from 14 laboratories were used to provide reference values for the seventeen 2, 3, 7, 8-substituted PCDD/F congeners, the totals for individual tetra- through hepta-substituted PCDD/F homologues, and the total amount of tetra- through hepta-substituted PCDD/Fs. The mass fractions for the individual 2, 3, 7, 8-substituted congeners range from approximately 0.01 microg/kg to 7 microg/kg dry mass.

26 CFR 25.2512-3 - Valuation of interest in businesses.

Code of Federal Regulations, 2011 CFR

2011-04-01

... net amount which a willing purchaser, whether an individual or a corporation, would pay for the... extent applicable. Special attention should be given to determining an adequate value of the good will of...

26 CFR 25.2512-3 - Valuation of interest in businesses.

Code of Federal Regulations, 2013 CFR

2013-04-01

... net amount which a willing purchaser, whether an individual or a corporation, would pay for the... extent applicable. Special attention should be given to determining an adequate value of the good will of...

26 CFR 25.2512-3 - Valuation of interest in businesses.

Code of Federal Regulations, 2014 CFR

2014-04-01

... net amount which a willing purchaser, whether an individual or a corporation, would pay for the... extent applicable. Special attention should be given to determining an adequate value of the good will of...

26 CFR 25.2512-3 - Valuation of interest in businesses.

Code of Federal Regulations, 2012 CFR

2012-04-01

... net amount which a willing purchaser, whether an individual or a corporation, would pay for the... extent applicable. Special attention should be given to determining an adequate value of the good will of...

Determination of the air w-value in proton beams using ionization chambers with gas flow capability.

PubMed

Moyers, M F; Vatnitsky, S M; Miller, D W; Slater, J M

2000-10-01

The purpose of this work was to determine the w-value of air for protons using the paired gas method. Several plastic- and magnesium-walled chambers were used with air, synthetic air, nitrogen, and argon flowing gases. Using argon as a reference gas, the w-value of air was measured and ranged from 32.7 to 34.5 J/C for protons with energies encountered in radiotherapy. Using nitrogen as a reference gas, the w-value of air ranged from 35.2 to 35.4 J/C over the same range of proton energies. The w-value was found, at a given energy, to be independent of the ion chamber used. The uncertainty in these measurements was estimated at 5.2% at the 2sigma level. This uncertainty was dominated by the 4.4% uncertainty in the w-value of the reference gas.

HSQC-1,n-ADEQUATE: a new approach to long-range 13C-13C correlation by covariance processing.

PubMed

Martin, Gary E; Hilton, Bruce D; Willcott, M Robert; Blinov, Kirill A

2011-10-01

Long-range, two-dimensional heteronuclear shift correlation NMR methods play a pivotal role in the assembly of novel molecular structures. The well-established GHMBC method is a high-sensitivity mainstay technique, affording connectivity information via (n)J(CH) coupling pathways. Unfortunately, there is no simple way of determining the value of n and hence no way of differentiating two-bond from three- and occasionally four-bond correlations. Three-bond correlations, however, generally predominate. Recent work has shown that the unsymmetrical indirect covariance or generalized indirect covariance processing of multiplicity edited GHSQC and 1,1-ADEQUATE spectra provides high-sensitivity access to a (13)C-(13) C connectivity map in the form of an HSQC-1,1-ADEQUATE spectrum. Covariance processing of these data allows the 1,1-ADEQUATE connectivity information to be exploited with the inherent sensitivity of the GHSQC spectrum rather than the intrinsically lower sensitivity of the 1,1-ADEQUATE spectrum itself. Data acquisition times and/or sample size can be substantially reduced when covariance processing is to be employed. In an extension of that work, 1,n-ADEQUATE spectra can likewise be subjected to covariance processing to afford high-sensitivity access to the equivalent of (4)J(CH) GHMBC connectivity information. The method is illustrated using strychnine as a model compound. Copyright © 2011 John Wiley & Sons, Ltd.

Oral administration of forskolin and rutin contributes to intraocular pressure control in primary open angle glaucoma patients under maximum tolerated medical therapy.

PubMed

Vetrugno, Michele; Uva, Maurizio G; Russo, Vincenzo; Iester, Michele; Ciancaglini, Marco; Brusini, Paolo; Centofanti, Marco; Rossetti, Luca M

2012-10-01

Tight control of intraocular pressure (IOP) is still the only therapeutic approach available for the treatment of primary open angle glaucoma (POAG). However, some patients do not respond adequately to hypotonising drugs, and despite multiple drug combinations they cannot reach their target IOP. Forskolin is a natural compound that has already shown efficacy in IOP reduction following topical application. The aim of this study was to evaluate the effects on the IOP of a food supplement containing forskolin and rutin when administered to POAG patients under maximum tolerated medical therapy (MTMT) and on a waiting list for filtrating surgery to further decrease their IOP. The design of the study was open and case-controlled. Ninety-seven (52 in the treatment group, and 45 in the reference group) patients were enrolled in 8 different glaucoma centers in Italy, all under MTMT and with IOP enrollment values above their target pressure. During the 30 days before surgery, patients in the treatment group were prescribed 2 tablets per day of a food supplement containing rutin and forskolin in addition to their usual topical drug treatment. Their IOP values were measured at 3 time points during the day, at enrollment and once a week until surgery. Control patients continued only with their normal topical therapy. All patients in the treatment group, independently of the combination drug therapy that they were taking, showed a further 10% decrease (P<0.01) of their IOP, starting from 1 week after introduction of the oral supplement and lasting until the last evaluation before surgery. This decrease was more evident (15% of the enrollment value; P<0.01) in those subjects with high (IOP≥21 mmHg) enrollment values rather than in those with low (IOP<21) enrollment values (9%; P<0.01). On the contrary, IOP values in the control group remained stable from the beginning to the end of the observation period, independently of their enrollment values. Forskolin and rutin given as oral treatment appear to contribute to a better control and a further small reduction of IOP in patients who were poorly responsive to multitherapy treatment.

Individual selection of X-ray tube settings in computed tomography coronary angiography: Reliability of an automated software algorithm to maintain constant image quality.

PubMed

Durmus, Tahir; Luhur, Reny; Daqqaq, Tareef; Schwenke, Carsten; Knobloch, Gesine; Huppertz, Alexander; Hamm, Bernd; Lembcke, Alexander

2016-05-01

To evaluate a software tool that claims to maintain a constant contrast-to-noise ratio (CNR) in high-pitch dual-source computed tomography coronary angiography (CTCA) by automatically selecting both X-ray tube voltage and current. A total of 302 patients (171 males; age 61±12years; body weight 82±17kg, body mass index 27.3±4.6kg/cm(2)) underwent CTCA with a topogram-based, automatic selection of both tube voltage and current using dedicated software with quality reference values of 100kV and 250mAs/rotation (i.e., standard values for an average adult weighing 75kg) and an injected iodine load of 222mg/kg. The average radiation dose was estimated to be 1.02±0.64mSv. All data sets had adequate contrast enhancement. Average CNR in the aortic root, left ventricle, and left and right coronary artery was 15.7±4.5, 8.3±2.9, 16.1±4.3 and 15.3±3.9 respectively. Individual CNR values were independent of patients' body size and radiation dose. However, individual CNR values may vary considerably between subjects as reflected by interquartile ranges of 12.6-18.6, 6.2-9.9, 12.8-18.9 and 12.5-17.9 respectively. Moreover, average CNR values were significantly lower in males than females (15.1±4.1 vs. 16.6±11.7 and 7.9±2.7 vs. 8.9±3.0, 15.5±3.9 vs. 16.9±4.6 and 14.7±3.6 vs. 16.0±4.1 respectively). A topogram-based automatic selection of X-ray tube settings in CTCA provides diagnostic image quality independent of patients' body size. Nevertheless, considerable variation of individual CNR values between patients and significant differences of CNR values between males and females occur which questions the reliability of this approach. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Establishment of new complete blood count reference values for healthy Thai adults.

PubMed

Wongkrajang, P; Chinswangwatanakul, W; Mokkhamakkun, C; Chuangsuwanich, N; Wesarachkitti, B; Thaowto, B; Laiwejpithaya, S; Komkhum, O

2018-04-28

Laboratory reference ranges are essential for diagnostic orientation and treatment decision. As complete blood count parameters are influenced by various factors, including gender, geographic origin, and ethnic origin, it is important to establish specific hematologic reference values for specific populations. This study was conducted at the Department of Clinical Pathology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand. Blood samples were taken from healthy adults aged 18-60 years that attended a health check-up program at our hospital during February 2015 to July 2015. Hematologic and routine chemistry analysis were performed. Participants were determined to be healthy based on medical history and routine medical examinations. Serum vitamin B12, folate, ferritin, and hemoglobin typing were also analyzed to exclude the possible presence of anemia. A statistically significant difference was observed between males and females for Hb level, hematocrit level, red blood cell count, mean corpuscular hemoglobin concentration, percentage neutrophils, monocytes and eosinophils, and absolute neutrophil, lymphocyte, basophil, and platelet counts. Accordingly, gender-specific reference intervals were established for all complete blood count parameters in healthy Thai adult population. The reference value ranges established in this study reflect significant differences between genders. It is possible that these reference ranges may be generalizable to adults living in Thailand. The findings of this study emphasize the importance of establishing specific hematologic reference values for specific populations. © 2018 John Wiley & Sons Ltd.

Child malnutrition and mortality among families not utilizing adequately iodized salt in Indonesia.

PubMed

Semba, Richard D; de Pee, Saskia; Hess, Sonja Y; Sun, Kai; Sari, Mayang; Bloem, Martin W

2008-02-01

Salt iodization is the main strategy for reducing iodine deficiency disorders worldwide. Characteristics of families not using iodized salt need to be known to expand coverage. The objective was to determine whether families who do not use iodized salt have a higher prevalence of child malnutrition and mortality and to identify factors associated with not using iodized salt. Use of adequately iodized salt (>or =30 ppm), measured by rapid test kits, was assessed between January 1999 and September 2003 in 145 522 and 445 546 families in urban slums and rural areas, respectively, in Indonesia. Adequately iodized salt was used by 66.6% and 67.2% of families from urban slums and rural areas, respectively. Among families who used adequately iodized salt, mortality in neonates, infants, and children aged <5 y was 3.3% compared with 4.2%, 5.5% compared with 7.1%, and 6.9% compared with 9.1%, respectively (P < 0.0001 for all), in urban slums; among families who did not use adequately iodized salt, the respective values were 4.2% compared with 6.3%, 7.1% compared with 11.2%, and 8.5% compared with 13.3% (P < 0.0001 for all) in rural areas. Families not using adequately iodized salt were more likely to have children who were stunted, underweight, and wasted. In multivariate analyses that controlled for potential confounders, low maternal education was the strongest factor associated with not using adequately iodized salt. In Indonesia, nonuse of adequately iodized salt is associated with a higher prevalence of child malnutrition and mortality in neonates, infants, and children aged <5 y. Stronger efforts are needed to expand salt iodization in Indonesia.

The importance of information on relatives for the prediction of genomic breeding values and the implications for the makeup of reference data sets in livestock breeding schemes.

PubMed

Clark, Samuel A; Hickey, John M; Daetwyler, Hans D; van der Werf, Julius H J

2012-02-09

The theory of genomic selection is based on the prediction of the effects of genetic markers in linkage disequilibrium with quantitative trait loci. However, genomic selection also relies on relationships between individuals to accurately predict genetic value. This study aimed to examine the importance of information on relatives versus that of unrelated or more distantly related individuals on the estimation of genomic breeding values. Simulated and real data were used to examine the effects of various degrees of relationship on the accuracy of genomic selection. Genomic Best Linear Unbiased Prediction (gBLUP) was compared to two pedigree based BLUP methods, one with a shallow one generation pedigree and the other with a deep ten generation pedigree. The accuracy of estimated breeding values for different groups of selection candidates that had varying degrees of relationships to a reference data set of 1750 animals was investigated. The gBLUP method predicted breeding values more accurately than BLUP. The most accurate breeding values were estimated using gBLUP for closely related animals. Similarly, the pedigree based BLUP methods were also accurate for closely related animals, however when the pedigree based BLUP methods were used to predict unrelated animals, the accuracy was close to zero. In contrast, gBLUP breeding values, for animals that had no pedigree relationship with animals in the reference data set, allowed substantial accuracy. An animal's relationship to the reference data set is an important factor for the accuracy of genomic predictions. Animals that share a close relationship to the reference data set had the highest accuracy from genomic predictions. However a baseline accuracy that is driven by the reference data set size and the overall population effective population size enables gBLUP to estimate a breeding value for unrelated animals within a population (breed), using information previously ignored by pedigree based BLUP methods.

Techniques for developing child dummy protection reference values : event report

DOT National Transportation Integrated Search

1996-10-01

The purpose of this report is to present background information and techniques for developing protection reference values (PRV) to use with child dummies in out-of-position (OOP) child/air bag interaction testing. This report summarizes the literatur...

Interlaboratory comparison of reference materials for nitrogen-isotope-ratio measurements

USGS Publications Warehouse

Böhlke, John Karl; Coplen, Tyler B.

1995-01-01

Aliquots of seven different reference materials were distributed for an interlaboratory comparison of stable nitrogen-isotope-ratio measurements. Results from 15 laboratories were compiled and evaluated selectively to yield provisional values of 515N for each material, i, with respect to atmospheric N2 (o1SN,7air). The 515N values reported by the different laboratories are correlated in such a way that some of the major discrepancies may be removed by normalization (/. e., by altering the length of the ô N scale for each laboratory by an amount defined by local measurements of reference materials with extreme values).

[Determination of normal reference value of pyrrole adducts in urine in young people in a university in Shandong, China].

PubMed

Wang, Hui; Wang, Yiping; Zhou, Zhenwei; Wang, Shuo; Yin, Hongyin; Xie, Keqin

2015-06-01

To determine the normal reference value of pyrrole adducts in urine in young people in a university in Shandong, China, and to provide a reliable basis for the clinical diagnosis of n-hexane poisoning. A total of 240 college students were randomly selected. After excluding 32 ineligible students, 208 subjects were included in this study, consisting of 104 males and 104 females, with a mean age of 21?3 years (range: 18 to 24 years). Morning urine was collected from each subject. The content of pyrrole adducts was determined by chromatometry. The content of pyrrole adducts in both male and female obeyed a positively skewed distribution. The median level of pyrrole adducts in male subjects was 0.88 nmol/ml, and the reference value was 0.14-3.92 nmol/ml. The median level of pyrrole adducts in female subjects was 0.93 nmol/ ml, and the reference value was 0.09-3.27 nmol/ml. Student's t test identified no statistical difference in pyrrole adduct level between male and female subjects (t=0.15, P>0.05). The median level of pyrrole adducts in normal young people is 0.91 nmol/ml, and the reference value is 0.11-3.95 nmol/ml.

Children's Perceived Competence Scale: Reference values in Japan.

PubMed

Nagai, Yukiyo; Nomura, Kayo; Nagata, Masako; Ohgi, Shohei; Iwasa, Mitsuji

2015-12-01

To support children with chronic diseases, reference values to measure developmental changes in self-perception and self-esteem are considered a useful yardstick. To develop reference values to measure self-perceived competence and self-esteem in Japanese children, the Children's Perceived Competence Scale (CPCS) was administered to 768 children of elementary school grade 1 (6 years) to grade 6 (11 years) at four public schools in Japan, from November to December 2012. After excluding 74 with chronic diseases and/or incomplete responses, 694 children were included. CPCS measures children's self-perceived competence in cognitive, social, physical domains, and general self-worth, namely self-esteem. There was a tendency for scores of cognitive and general self-worth to decrease with increasing grade. Scores among grade 5 respondents were significantly lower than those among grade 4 respondents for both social and physical domains. Scores among boys and girls differed significantly, with boys scoring higher for physical domain in grades 3 and 6 and for general self-worth domain in grade 6. The CPCS reference values to measure self-perceived competence and self-esteem in Japanese children were developed in this study. These reference values are useful to inform practitioners supporting children with psychological or psychiatric problems or those with chronic diseases. © The Author(s) 2014.

Polyurethane Foam Wound Dressing Technique for Areola Skin Graft Stabilization and Nipple Protection After Nipple-Areola Reconstruction.

PubMed

Satake, Toshihiko; Muto, Mayu; Nagashima, Yu; Haga, Shoko; Homma, Yuki; Nakasone, Reiko; Kadokura, Marina; Kou, Seiko; Fujimoto, Hiroshi; Maegawa, Jiro

2018-04-01

We describe a new wound management technique using a soft dressing material to stabilize the areola skin graft and protect the nipple after nipple-areola reconstruction at the final stage of breast reconstruction. We introduced a center-fenestrated multilayered hydrocellular polyurethane foam dressing material that provides adequate pressure and retains a moist environment for a smooth skin graft "take." Moreover, the reconstructed nipple can be monitored at any time through the fenestrated window for adequate blood circulation. Altogether, this simple and inexpensive wound dressing technique improves the clinical outcome. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Quantum Mechanical Modeling: A Tool for the Understanding of Enzyme Reactions

PubMed Central

Náray-Szabó, Gábor; Oláh, Julianna; Krámos, Balázs

2013-01-01

Most enzyme reactions involve formation and cleavage of covalent bonds, while electrostatic effects, as well as dynamics of the active site and surrounding protein regions, may also be crucial. Accordingly, special computational methods are needed to provide an adequate description, which combine quantum mechanics for the reactive region with molecular mechanics and molecular dynamics describing the environment and dynamic effects, respectively. In this review we intend to give an overview to non-specialists on various enzyme models as well as established computational methods and describe applications to some specific cases. For the treatment of various enzyme mechanisms, special approaches are often needed to obtain results, which adequately refer to experimental data. As a result of the spectacular progress in the last two decades, most enzyme reactions can be quite precisely treated by various computational methods. PMID:24970187

Normal Values for Heart Electrophysiology Parameters of Healthy Swine Determined on Electrophysiology Study.

PubMed

Noszczyk-Nowak, Agnieszka; Cepiel, Alicja; Janiszewski, Adrian; Pasławski, Robert; Gajek, Jacek; Pasławska, Urszula; Nicpoń, Józef

2016-01-01

Swine are a well-recognized animal model for human cardiovascular diseases. Despite the widespread use of porcine model in experimental electrophysiology, still no reference values for intracardiac electrical activity and conduction parameters determined during an invasive electrophysiology study (EPS) have been developed in this species thus far. The aim of the study was to develop a set of normal values for intracardiac electrical activity and conduction parameters determined during an invasive EPS of swine. The study included 36 healthy domestic swine (24-40 kg body weight). EPS was performed under a general anesthesia with midazolam, propofol and isoflurane. The reference values for intracardiac electrical activity and conduction parameters were calculated as arithmetic means ± 2 standard deviations. The reference values were determined for AH, HV and PA intervals, interatrial conduction time at its own and imposed rhythm, sinus node recovery time (SNRT), corrected sinus node recovery time (CSNRT), anterograde and retrograde Wenckebach points, atrial, atrioventricular node and ventricular refractory periods. No significant correlations were found between body weight and heart rate of the examined pigs and their electrophysiological parameters. The hereby presented reference values can be helpful in comparing the results of various studies, as well as in more accurately estimating the values of electrophysiological parameters that can be expected in a given experiment.

Reference value of impulse oscillometry in taiwanese preschool children.

PubMed

Lai, Shen-Hao; Yao, Tsung-Chieh; Liao, Sui-Ling; Tsai, Ming-Han; Hua, Men-Chin; Yeh, Kuo-Wei; Huang, Jing-Long

2015-06-01

Impulse oscillometry is a potential technique for assessing the respiratory mechanism-which includes airway resistance and reactance during tidal breathing-in minimally cooperative young children. The reference values available in Asian preschool children are limited, especially in children of Chinese ethnicity. This study aimed to develop reference equations for lung function measurements using impulse oscillometry in Taiwanese children for future clinical application and research exploitation. Impulse oscillometry was performed in 150 healthy Taiwanese children (aged 2-6 years) to measure airway resistance and reactance at various frequencies. We used regression analysis to generate predictive equations separately by age, body height, body weight, and gender. The stepwise regression model revealed that body height was the most significant determinant of airway resistance and reactance in preschool young children. With the growth in height, a decrease in airway resistance and a paradoxical increase in reactance occurred at different frequencies. The regression curve of resistance at 5 Hz was comparable to previous reference values. This study provided reference values for several variables of the impulse oscillometry measurements in healthy Taiwanese children aged 2-6 years. With these reference data, clinical application of impulse oscillometry would be expedient in diagnosing respiratory diseases in preschool children. Copyright © 2014. Published by Elsevier B.V.

Histological Value of Duodenal Biopsies

PubMed Central

Gupta, Limci; B., Hamid

2005-01-01

This study was performed to see the value of histopathological diagnosis in management of patients with duodenal biopsies; to look for correlation of histology and serology in suspected cases of coeliac disease; the reasons for taking duodenal biopsies and whether proper adequate histories are provided on the forms sent with request for histopathological view on duodenal biopsies. Here are the observations of the study followed by the discussion. PMID:15915293

[How can the impact of Health Technology Assessment (HTA) in the Austrian healthcare system be assessed? Design of a conceptual framework].

PubMed

Schumacher, I; Zechmeister, I

2012-04-01

In Austria research in Health Technology Assessment (HTA) has been conducted since the 1990s. Research in HTA aims at supporting an adequate and efficient use of health care resources in order to sustain a publicly financed and solidary health care system. Ultimately, HTA research should result in better health of the population. Research results should provide independent information for decision makers. For legitimizing further research resources and for prioritizing future HTA research and guaranteeing the value of future research, HTA research needs itself to undergo evaluation. Aim of the study is to design a conceptual framework for evaluating the impact of HTA research in Austria on the basis of the existing literature. An already existing review which presents methods and concepts how to evaluate HTA-impact was updated by a systematic research including literature of the years 2004-January 2010. Results were analysed in regard to 4 categories: definition of the term impact, target groups and system levels, operationalisation of indicators and evaluation methods. Overall, 19 publications were included. Referring to the 4 categories, an explanation of impact has to take into account HTAs multidisciplinary setting and needs a context related definition. Target groups, system levels, indicators and methods depend on the impact defined. Studies investigated direct and indirect impact and were focused on different target groups like physicians, nurses and decision makers on the micro-, and meso level, as well as politicians and reimbursement institutions on the macro level. Except for one reference all studies applied already known and mostly qualitative methods for measuring the impact of HTA research. Thus, an appropriate pool of instruments seems to be available. There is a lack of information about validity of applied methods and indicators. By adapting adequate methods and concepts a conceptual framework for the Austrian HTA-Impact evaluation has been designed. The paper presents an overview of existing methods for the evaluation of the HTA research. This has been used to identify useful approaches for measuring the HTA-impact in Austria. By providing a context sensitive framework for impact evaluation in Austria the Austrian HTA-research contributes to the international trend of impact-evaluation. © Georg Thieme Verlag KG Stuttgart · New York.

Selection of metrics based on the seagrass Cymodocea nodosa and development of a biotic index (CYMOX) for assessing ecological status of coastal and transitional waters

NASA Astrophysics Data System (ADS)

Oliva, Silvia; Mascaró, Oriol; Llagostera, Izaskun; Pérez, Marta; Romero, Javier

2012-12-01

Bioindicators, based on a large variety of organisms, have been increasingly used in the assessment of the status of aquatic systems. In marine coastal waters, seagrasses have shown a great potential as bioindicator organisms, probably due to both their environmental sensitivity and the large amount of knowledge available. However, and as far as we are aware, only little attention has been paid to euryhaline species suitable for biomonitoring both transitional and marine waters. With the aim to contribute to this expanding field, and provide new and useful tools for managers, we develop here a multi-bioindicator index based on the seagrass Cymodocea nodosa. We first compiled from the literature a suite of 54 candidate metrics, i. e. measurable attribute of the concerned organism or community that adequately reflects properties of the environment, obtained from C. nodosa and its associated ecosystem, putatively responding to environmental deterioration. We then evaluated them empirically, obtaining a complete dataset on these metrics along a gradient of anthropogenic disturbance. Using this dataset, we selected the metrics to construct the index, using, successively: (i) ANOVA, to assess their capacity to discriminate among sites of different environmental conditions; (ii) PCA, to check the existence of a common pattern among the metrics reflecting the environmental gradient; and (iii) feasibility and cost-effectiveness criteria. Finally, 10 metrics (out of the 54 tested) encompassing from the physiological (δ15N, δ34S, % N, % P content of rhizomes), through the individual (shoot size) and the population (root weight ratio), to the community (epiphytes load) organisation levels, and some metallic pollution descriptors (Cd, Cu and Zn content of rhizomes) were retained and integrated into a single index (CYMOX) using the scores of the sites on the first axis of a PCA. These scores were reduced to a 0-1 (Ecological Quality Ratio) scale by referring the values to the optimal (reference) and worst (most degraded) conditions. The ecological status of sites obtained applying CYMOX correlated significantly with the environmental gradient, validating its adequacy to reflect ecosystem health. In conclusion, the results presented here suggest that this index can be an adequate alternative for ecological status assessment in water bodies where other species are absent and, specifically, in transitional waters.

Reference values for voluntary and stimulated single-fibre EMG using concentric needle electrodes: a multicentre prospective study.

PubMed

Kokubun, Norito; Sonoo, Masahiro; Imai, Tomihiro; Arimura, Yumiko; Kuwabara, Satoshi; Komori, Tetsuo; Kobayashi, Masahito; Nagashima, Takahide; Hatanaka, Yuki; Tsuda, Emiko; Misawa, Sonoko; Abe, Tatsuya; Arimura, Kimiyoshi

2012-03-01

The aim of this study is to establish reference values for single-fibre electromyography (SFEMG) using concentric needles in a prospective, multicentre study. Voluntary or stimulated SFEMG at the extensor digitorum communis (EDC) or frontalis (FRO) muscles was conducted in 56-63 of a total of 69 normal subjects below the age of 60years at six Japanese institutes. The cut-off values for mean consecutive difference (MCD) of individual potentials were calculated using +2.5 SD or 95% prediction limit (one-tail) of the upper 10th percentile MCD value for individual subjects. The cut-off values for individual MCD (+2.5 SD) were 56.8μs for EDC-V (voluntary SFEMG for EDC), 58.8μs for EDC-S (stimulated SFEMG for EDC), 56.8μs for FRO-V (voluntary SFEMG for FRO) and 51.0μs for FRO-S (stimulated SFEMG for FRO). The false positive rates using these cut-off values were around 2%. The +2.5 SD and 95% prediction limit might be two optimal cut-off values, depending on the clinical question. The obtained reference values were larger than those reported previously using concentric needles, but might better coincide with conventional values. This is the first multicentre study reporting reference values for SFEMG using concentric needles. The way to determine cut-off values and the statistically correct definition of the percentile were discussed. Copyright © 2011 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

Stability of BUN and creatinine determinations on the Siemens Advia 1800 analyzer.

PubMed

Qin, Jia; Wang, Huiying; Rets, Anton; Harari, Saul; Alexis, Herol; Eid, Ikram; Pincus, Matthew R

2013-11-01

Serum creatinine values of patients tend to change as a result of the use of different blanks used for creatinine determinations on the Advia 1650. After upgrading the analyzer to the Advia 1800, creatinine values tended to be more reproducible. As part of a quality assurance investigation to test the reproducibilities of creatinine values, we determined serial creatinine values in the sera of 13 patients whose initial values were either in the reference range or elevated (range 0.58-7.8 mg/dl). These values were determined concurrently with serum blood urea nitrogen (BUN) determinations (range 6.0-84.4 mg/dl) as these two analytes are used together in evaluation of renal function. We determined BUN and creatinine values, using the glutamate dehydrogenase lined enzyme assay system and the Jaffe method, respectively. We find that all values for creatinine on samples stored at 4 °C were reproducible as were the corresponding BUN values, which is revealed by low values for the coefficients of variation (CVs), that is, mean CV of 4.55% for creatinine and 2.52% for BUN. One sample with relatively high CV (10.6%) for creatinine was found to have an initial value of 1.1 mg/dl, in the reference range; but, on repeat determinations, the obtained levels were as high as 1.5 mg/dl, above the reference range. BUN values for this sample remained in the reference range, suggesting that no renal disease was present. We conclude that creatinine and BUN determinations are stable, but occasional spurious creatinine values can occur on the Advia 1800 analyzer. © 2013 Wiley Periodicals, Inc.

41 CFR 102-79.10 - What basic assignment and utilization of space policy governs an Executive agency?

Code of Federal Regulations, 2010 CFR

2010-07-01

... must provide a quality workplace environment that supports program operations, preserves the value of... fitness facilities in the workplace when adequately justified. An Executive agency must promote maximum...

Blood plasma chemistries from wild mourning doves held in captivity.

PubMed

Schulz, J H; Bermudez, A J; Tomlinson, J L; Firman, J D; He, Z

2000-07-01

Despite the extensive amount of research conducted on mourning doves (Zenaida macroura), no biochemical reference values exist for this species. Our objective, therefore, was to establish base line clinical chemistry reference values for mourning doves to assist with establishing clinical diagnoses. Wild mourning doves were captured 19 March 1996 to 8 August 1996, and 6 February 1998 to 12 May 1998; blood samples were collected from 382 mourning doves. Plasma biochemical values were established for glucose, sodium, potassium, chloride, enzymatic CO2, albumin, total protein, globulin, calcium, phosphorus, cholesterol, magnesium, aspartate aminotransferase (AST), gamma glutamyl transferase (GGT), lactate dehydrogenase (LDH), and uric acid. These reference values are invaluable for determining diagnosis of diseases of the gastrointestinal, hepatic, renal, cardiovascular, musculoskeletal, and endocrine systems.

Using Tradtional Ecological Knowledge to Protect Wetlands: the Swinomish Tribe's Wetland Cultural Assessment Project

NASA Astrophysics Data System (ADS)

Mitchell, T.

2017-12-01

"Traditional" wetland physical assessment modules do not adequately identify Tribal cultural values of wetlands and thus wetlands may not be adequately protected for cultural uses. This Swinomish Wetlands Cultural Assessment Project has developed a cultural resource scoring module that can be incorporated into wetland assessments to better inform wetland protections. Local native knowledge was gathered about the traditional uses of 99 native wetland plant species. A cultural scoring matrix was developed based on the presence of traditionally used plants in several use categories including: construction, ceremonial, subsistence, medicinal, common use, plant rarity, and place of value for each wetland. The combined score of the cultural and physcial modules provides an overall wetland score that relates to proscribed buffer protection widths. With this local native knowledge incorporated into wetland assessments, we are protecting and preserving Swinomish Reservation wetlands for both cultural uses and ecological functionality through the Tribe's wetland protection law.

Promotional Perspectives of Reference Group Influence: Advertising Implications

ERIC Educational Resources Information Center

Lessig, V. Parker; Park, C. Whan

1978-01-01

Examines the role of reference groups and promotional appeals in satisfying consumer motivations. Emphasizes three motivational reference group functions: informational, utilitarian, and value-expressive. (RL)

Reference Values for Weight, Height, Head Circumference, and Body Mass Index in Turkish Children.

PubMed

Neyzi, Olcay; Bundak, Rüveyde; Gökçay, Gülbin; Günöz, Hülya; Furman, Andrzej; Darendeliler, Feyza; Baş, Firdevs

2015-12-01

This study aimed to integrate the existing updated reference standards for the growth of Turkish infants and children and to compare these values with World Health Organization (WHO) reference data, data from some European countries, and also with previous local data. Weight, height, and head circumference measurements were obtained on 2,391 boys and 2,102 girls who were regular attenders of a well child clinic and on 1,100 boys and 1,020 girls attending schools in relatively well-off districts in İstanbul. Mean number of measurements per child was 8.2±3.6 in the age group 0-5 years and 5.5±3.3 in the age group 6-18 years. All children were from well-to-do families and all were healthy. All measurements with the exception of measurements at birth, which were based on reported values, were done by trained personnel. The LMS method was used in the analyses and in the construction of the percentile charts. There is an increase in weight for age and body mass index values for age starting in prepubertal ages, indicating an increasing trend for obesity. Compared to WHO reference data, weight and height values in Turkish children were slightly higher in infants and in children younger than 5 years, while they showed similarity to those reported for children from Norway and Belgium. Head circumference values, which were slightly higher than the WHO references in the first 5 years, were comparable to the data on Belgian and Norwegian children in the first 9 years of life. At older ages, Turkish children showed higher values for head circumference. The relatively larger head circumference values were interpreted to reflect a genetic characteristic.

Appendicular Skeletal Muscle Mass Reference Values and the Peak Muscle Mass to Identify Sarcopenia among Iranian Healthy Population.

PubMed

Shafiee, Gita; Ostovar, Afshin; Heshmat, Ramin; Keshtkar, Abbas Ali; Sharifi, Farshad; Shadman, Zhaleh; Nabipour, Iraj; Soltani, Akbar; Larijani, Bagher

2018-01-01

Sacopenia is a common problem in elderly with the adverse outcomes. The objective of this study was to estimate the peak appendicular skeletal muscle mass (ASM) and age of its attainment by sex among the Iranian population. A total of 691 men and women aged 18-94 years participated in this cross-sectional, population-based study in Bushehr, Iran. ASM was measured by dual X-ray absorptiometry. Cutoff points for men and women were established considering two standard deviations (SDs) below the mean values of the skeletal muscle index (SMI) for young reference groups. The relationship between ASM and age was described by the second-degree regression models. Two SDs below the mean SMIs of reference groups were as cutoff values of low muscle mass in Iranian population. The peak ASM values were 21.35 ± 0.12 Kg and 13.68 ± 0.10 Kg, and the age at peak ASM were 26 (24-28) years and 34 (33-35) years for men and women, respectively. Mean and SD of SMI in those ages were 7.01 ± 0.02 Kg/m 2 and 5.44 ± 0.02 Kg/m 2 among men and women, respectively. Calculated cutoff values of low muscle mass among the Iranian population were 7.0 Kg/m 2 and 5.4 Kg/m 2 among men and women, respectively. Iranian reference values of SMI for both genders were similar to Asia Working Group for Sarcopenia recommendation and lower than the United States and European values. Further studies from different nations and the Middle East countries are needed to obtain reference values for populations, enabling the researchers for comparison and also more valid reports on sarcopenia prevalence.

Mn and Btex Reference Value Arrays (Final Reports)

EPA Science Inventory

These final reports are a summary of reference value arrays with critical supporting documentation for the chemicals manganese, benzene, toluene, ethylbenzene, and xylene. Each chemical is covered in a separate document, and each is a statement of the status of the available inha...

On the effectiveness of vocal imitations and verbal descriptions of sounds.

PubMed

Lemaitre, Guillaume; Rocchesso, Davide

2014-02-01

Describing unidentified sounds with words is a frustrating task and vocally imitating them is often a convenient way to address the issue. This article reports on a study that compared the effectiveness of vocal imitations and verbalizations to communicate different referent sounds. The stimuli included mechanical and synthesized sounds and were selected on the basis of participants' confidence in identifying the cause of the sounds, ranging from easy-to-identify to unidentifiable sounds. The study used a selection of vocal imitations and verbalizations deemed adequate descriptions of the referent sounds. These descriptions were used in a nine-alternative forced-choice experiment: Participants listened to a description and picked one sound from a list of nine possible referent sounds. Results showed that recognition based on verbalizations was maximally effective when the referent sounds were identifiable. Recognition accuracy with verbalizations dropped when identifiability of the sounds decreased. Conversely, recognition accuracy with vocal imitations did not depend on the identifiability of the referent sounds and was as high as with the best verbalizations. This shows that vocal imitations are an effective means of representing and communicating sounds and suggests that they could be used in a number of applications.

Prenatal Brain MR Imaging: Reference Linear Biometric Centiles between 20 and 24 Gestational Weeks.

PubMed

Conte, G; Milani, S; Palumbo, G; Talenti, G; Boito, S; Rustico, M; Triulzi, F; Righini, A; Izzo, G; Doneda, C; Zolin, A; Parazzini, C

2018-05-01

Evaluation of biometry is a fundamental step in prenatal brain MR imaging. While different studies have reported reference centiles for MR imaging biometric data of fetuses in the late second and third trimesters of gestation, no one has reported them in fetuses in the early second trimester. We report centiles of normal MR imaging linear biometric data of a large cohort of fetal brains within 24 weeks of gestation. From the data bases of 2 referral centers of fetal medicine, accounting for 3850 examinations, we retrospectively collected 169 prenatal brain MR imaging examinations of singleton pregnancies, between 20 and 24 weeks of gestational age, with normal brain anatomy at MR imaging and normal postnatal neurologic development. To trace the reference centiles, we used the CG-LMS method. Reference biometric centiles for the developing structures of the cerebrum, cerebellum, brain stem, and theca were obtained. The overall interassessor agreement was adequate for all measurements. Reference biometric centiles of the brain structures in fetuses between 20 and 24 weeks of gestational age may be a reliable tool in assessing fetal brain development. © 2018 by American Journal of Neuroradiology.

Reference genes for normalization of gene expression studies in human osteoarthritic articular cartilage.

PubMed

Pombo-Suarez, Manuel; Calaza, Manuel; Gomez-Reino, Juan J; Gonzalez, Antonio

2008-01-29

Assessment of gene expression is an important component of osteoarthritis (OA) research, greatly improved by the development of quantitative real-time PCR (qPCR). This technique requires normalization for precise results, yet no suitable reference genes have been identified in human articular cartilage. We have examined ten well-known reference genes to determine the most adequate for this application. Analyses of expression stability in cartilage from 10 patients with hip OA, 8 patients with knee OA and 10 controls without OA were done with classical statistical tests and the software programs geNorm and NormFinder. Results from the three methods of analysis were broadly concordant. Some of the commonly used reference genes, GAPDH, ACTB and 18S RNA, performed poorly in our analysis. In contrast, the rarely used TBP, RPL13A and B2M genes were the best. It was necessary to use together several of these three genes to obtain the best results. The specific combination depended, to some extent, on the type of samples being compared. Our results provide a satisfactory set of previously unused reference genes for qPCR in hip and knee OA This confirms the need to evaluate the suitability of reference genes in every tissue and experimental situation before starting the quantitative assessment of gene expression by qPCR.

'Sportmotorische Bestandesaufnahme': criterion- vs. norm-based reference values of fitness tests for Swiss first grade children.

PubMed

Tomatis, Laura; Krebs, Andreas; Siegenthaler, Jessica; Murer, Kurt; de Bruin, Eling D

2015-01-01

Health is closely linked to physical activity and fitness. It is therefore important to monitor fitness in children. Although many reports on physical tests have been published, data comparison between studies is an issue. This study reports Swiss first grade norm values of fitness tests and compares these with criterion reference data. A total of 10,565 boys (7.18 ± 0.42 years) and 10,204 girls (7.14 ± 0.41 years) were tested for standing long jump, plate tapping, 20-m shuttle run, lateral jump and 20-m sprint. Average values for six-, seven- and eight-year-olds were analysed and reference curves for age were constructed. Z-values were generated for comparisons with criterion references reported in the literature. Results were better for all disciplines in seven-year-old first grade children compared to six-year-old children (p < 0.01). Eight-year-old children did not perform better compared to seven-year-old children in the sprint run (p = 0.11), standing long jump (p > 0.99) and shuttle run (p = 0.43), whereas they were better in all other disciplines compared to their younger peers. The average performance of boys was better than girls except for tapping at the age of 8 (p = 0.06). Differences in performance due to testing protocol and setting must be considered when test values from a first grade setting are compared to criterion-based benchmarks. In a classroom setting, younger children tended to have better results and older children tended to have worse outcomes when compared to their age group criterion reference values. Norm reference data are valid allowing comparison with other data generated by similar test protocols applied in a classroom setting.

Analyses of laboratory data and establishment of reference values and intervals for healthy elderly people.

PubMed

Kubota, K; Kadomura, T; Ohta, K; Koyama, K; Okuda, H; Kobayashi, M; Ishii, C; Fujiwara, Y; Nishiora, T; Ohmae, Y; Ohmae, T; Kitajima, M

2012-04-01

Protein-energy malnutrition is a common disorder in the elderly. Although serum albumin is commonly used as a nutritional marker, data is lacking on serum albumin levels in the elderly. The purpose of this study was to determine whether serum albumin levels decrease with advancing age and to establish reference value and interval of laboratory data for elderly people (75 years and over). Blood samples from 13821 healthy people, 42064 outpatients, and 15959 inpatients were collected during 2008. Blood from 127 of our nutrition support team (NST) patients was also collected during August 2006 and May 2009, and analyzed. Serum albumin, hemoglobin, total cholesterol levels and lymphocyte count were determined. We analyzed the change in each parameter in accordance with age, compared the data for elderly people with younger people, and established new reference values. Clinical outcomes were examined depending on the improved reference values. Albumin was lower in older persons than in younger persons. The estimated reference value and interval were 42 (48-36) g/l in older persons and was much lower in NST patients. Hemoglobin was decreased while cholesterol and lymphocyte count were not changed in older persons: all were markedly decreased in NST patients. Terms of hospital stay were significantly longer and mortality rates were significantly higher in older persons, comparing from above to below using a new reference value of albumin (36 g/l). The serum albumin level decreases with advancing age, but it was maintained to some extent in healthy older people. Serum albumin levels related to the clinical outcome. Hemoglobin and cholesterol levels and lymphocyte count were all lower in NST patients. These measurements may be valuable markers of nutritional status and can help in guiding the need for nutritional support.

Reference Values for Cardiac and Aortic Magnetic Resonance Imaging in Healthy, Young Caucasian Adults.

PubMed

Eikendal, Anouk L M; Bots, Michiel L; Haaring, Cees; Saam, Tobias; van der Geest, Rob J; Westenberg, Jos J M; den Ruijter, Hester M; Hoefer, Imo E; Leiner, Tim

2016-01-01

Reference values for morphological and functional parameters of the cardiovascular system in early life are relevant since they may help to identify young adults who fall outside the physiological range of arterial and cardiac ageing. This study provides age and sex specific reference values for aortic wall characteristics, cardiac function parameters and aortic pulse wave velocity (PWV) in a population-based sample of healthy, young adults using magnetic resonance (MR) imaging. In 131 randomly selected healthy, young adults aged between 25 and 35 years (mean age 31.8 years, 63 men) of the general-population based Atherosclerosis-Monitoring-and-Biomarker-measurements-In-The-YOuNg (AMBITYON) study, descending thoracic aortic dimensions and wall thickness, thoracic aortic PWV and cardiac function parameters were measured using a 3.0T MR-system. Age and sex specific reference values were generated using dedicated software. Differences in reference values between two age groups (25-30 and 30-35 years) and both sexes were tested. Aortic diameters and areas were higher in the older age group (all p<0.007). Moreover, aortic dimensions, left ventricular mass, left and right ventricular volumes and cardiac output were lower in women than in men (all p<0.001). For mean and maximum aortic wall thickness, left and right ejection fraction and aortic PWV we did not observe a significant age or sex effect. This study provides age and sex specific reference values for cardiovascular MR parameters in healthy, young Caucasian adults. These may aid in MR guided pre-clinical identification of young adults who fall outside the physiological range of arterial and cardiac ageing.

Reference standards for body fat measures using GE dual energy x-ray absorptiometry in Caucasian adults.

PubMed

Imboden, Mary T; Welch, Whitney A; Swartz, Ann M; Montoye, Alexander H K; Finch, Holmes W; Harber, Matthew P; Kaminsky, Leonard A

2017-01-01

Dual energy x-ray absorptiometry (DXA) is an established technique for the measurement of body composition. Reference values for these variables, particularly those related to fat mass, are necessary for interpretation and accurate classification of those at risk for obesity-related health complications and in need of lifestyle modifications (diet, physical activity, etc.). Currently, there are no reference values available for GE-Healthcare DXA systems and it is known that whole-body and regional fat mass measures differ by DXA manufacturer. To develop reference values by age and sex for DXA-derived fat mass measurements with GE-Healthcare systems. A de-identified sample of 3,327 participants (2,076 women, 1,251 men) was obtained from Ball State University's Clinical Exercise Physiology Laboratory and University of Wisconsin-Milwaukee's Physical Activity & Health Research Laboratory. All scans were completed using a GE Lunar Prodigy or iDXA and data reported included percent body fat (%BF), fat mass index (FMI), and ratios of android-to-gynoid (A/G), trunk/limb, and trunk/leg fat measurements. Percentiles were calculated and a factorial ANOVA was used to determine differences in the mean values for each variable between age and sex. Normative reference values for fat mass variables from DXA measurements obtained from GE-Healthcare DXA systems are presented as percentiles for both women and men in 10-year age groups. Women had higher (p<0.01) mean %BF and FMI than men, whereas men had higher (p<0.01) mean ratios of A/G, trunk/limb, and trunk/leg fat measurements than women. These reference values provide clinicians and researchers with a resource for interpretation of DXA-derived fat mass measurements specific to use with GE-Healthcare DXA systems.

Using physiologically based pharmacokinetic modeling to address nonlinear kinetics and changes in rodent physiology and metabolism due to aging and adaptation in deriving reference values for propylene glycol methyl ether and propylene glycol methyl ether acetate.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Kirman, C R.; Sweeney, Lisa M.; Corley, Rick A.

2005-04-01

Reference values, including an oral reference dose (RfD) and an inhalation reference concentration (RfC), were derived for propylene glycol methyl ether (PGME), and an oral RfD was derived for its acetate (PGMEA). These values were based upon transient sedation observed in F344 rats and B6C3F1 mice during a two-year inhalation study. The dose-response relationship for sedation was characterized using internal dose measures as predicted by a physiologically based pharmacokinetic (PBPK) model for PGME and its acetate. PBPK modeling was used to account for changes in rodent physiology and metabolism due to aging and adaptation, based on data collected during weeksmore » 1, 2, 26, 52, and 78 of a chronic inhalation study. The peak concentration of PGME in richly perfused tissues was selected as the most appropriate internal dose measure based upon a consideration of the mode of action for sedation and similarities in tissue partitioning between brain and other richly perfused tissues. Internal doses (peak tissue concentrations of PGME) were designated as either no-observed-adverse-effect levels (NOAELs) or lowest-observed-adverse-effect levels (LOAELs) based upon the presence or absence of sedation at each time-point, species, and sex in the two year study. Distributions of the NOAEL and LOAEL values expressed in terms of internal dose were characterized using an arithmetic mean and standard deviation, with the mean internal NOAEL serving as the basis for the reference values, which was then divided by appropriate uncertainty factors. Where data were permitting, chemical-specific adjustment factors were derived to replace default uncertainty factor values of ten. Nonlinear kinetics are were predicted by the model in all species at PGME concentrations exceeding 100 ppm, which complicates interspecies and low-dose extrapolations. To address this complication, reference values were derived using two approaches which differ with respect to the order in which these extrapolations were performed: (1) uncertainty factor application followed by interspecies extrapolation (PBPK modeling); and (2) interspecies extrapolation followed by uncertainty factor application. The resulting reference values for these two approaches are substantially different, with values from the former approach being 7-fold higher than those from the latter approach. Such a striking difference between the two approaches reveals an underlying issue that has received little attention in the literature regarding the application of uncertainty factors and interspecies extrapolations to compounds where saturable kinetics occur in the range of the NOAEL. Until such discussions have taken place, reference values based on the latter approach are recommended for risk assessments involving human exposures to PGME and PGMEA.« less

BMI percentile curves for Chinese children aged 7-18 years, in comparison with the WHO and the US Centers for Disease Control and Prevention references.

PubMed

Ma, Jun; Wang, Zhiqiang; Song, Yi; Hu, Peijin; Zhang, Bing

2010-12-01

To establish BMI percentile curves that describe the contemporary BMI distribution among Chinese children, and to compare their BMI percentile curves with those in two recently developed international references: the WHO and the US Centers for Disease Control and Prevention (US CDC) growth references. A cross-sectional national survey. Thirty provinces, municipalities and autonomous regions in China. Nationally representative sample of 232 140 school students aged 7-18 years. BMI percentile curves were established using the LMS method, and were compared with the percentiles of the WHO and the US CDC references. BMI distributions and growth patterns in Chinese children were dramatically different from those in the two international reference populations. Compared with the international reference populations, younger Chinese boys (7-12 years of age) had higher values of the percentiles above the median and lower values of the percentiles below the median, suggesting that they had larger proportions of extreme BMI values in both directions. Chinese girls and older Chinese boys (15-18 years of age) had substantially lower BMI percentiles than their counterparts in the reference populations, particularly those high percentiles among older age groups. The present study described the unique patterns of BMI curves at the national level, and these curves are useful as a reference for comparing different regions and for monitoring changes over time in Chinese children. Higher proportions of children with extreme values in both directions indicate that China is currently facing both an increasing level of obesity and a high level of undernutrition, simultaneously.

Corn-Soy-Blend Fortified with Phosphorus to Prevent Refeeding Hypophosphatemia in Undernourished Piglets

PubMed Central

Hother, Anne-Louise; Lykke, Mikkel; Martinussen, Torben; Poulsen, Hanne Damgaard; Mølgaard, Christian; Sangild, Per Torp; Briend, André; Hansen, Christian Fink; Friis, Henrik; Michaelsen, Kim F.; Thymann, Thomas

2017-01-01

Background Phosphorus (P) levels in refeeding diets are very important as undernourished children are at risk of hypophosphatemia during refeeding. For this reason, conventional corn-soy-blends (CSB) have been reformulated by the World Food Programme to obtain a mono-calcium-phosphate fortified product (CSB+) and a product further fortified with skim milk powder (CBS++). Methods Using a piglet model of undernourished children, we hypothesized that feeding of CSB+, CSB++ or CSB+ with added whey permeate (CSB+/wp) would help to prevent refeeding hypophosphatemia. Pigs were weaned at 4 weeks of age and undernutrition was induced with a nutritionally inadequate pure maize diet for 7 weeks, after which they were refed for 3 weeks with either CSB+ (n = 10), CSB++ (n = 10) or CSB+/wp (n = 10). For reference, a fourth group continued on the maize diet (REF, n = 10). Results Following induction of undernutrition, body weight and length were 29±5% and 67±4% (means±SD) of values in age-matched pigs fed a nutritionally adequate diet, and the mean serum P level was 1.77±0.34 mmol/l. During the first week of refeeding, P levels in the CSB+ pigs decreased to 55% of values before refeeding (P < 0.05) while values in the CSB++ and CSB+/wp pigs were able to maintain their plasma phosphate at a similar level as before refeeding. Conclusion We conclude that fortification of CSB with only monocalcium-phosphate does not prevent hypophosphatemia. Dairy products like skim milk powder or whey permeate may represent relevant sources of phosphorus during refeeding. The content and form of phosphorus in such diets need to be carefully evaluated, and the undernourished piglet may be used to test the efficacy of such diets. PMID:28081252

Corn-Soy-Blend Fortified with Phosphorus to Prevent Refeeding Hypophosphatemia in Undernourished Piglets.

PubMed

Hother, Anne-Louise; Lykke, Mikkel; Martinussen, Torben; Poulsen, Hanne Damgaard; Mølgaard, Christian; Sangild, Per Torp; Briend, André; Hansen, Christian Fink; Friis, Henrik; Michaelsen, Kim F; Thymann, Thomas

2017-01-01

Phosphorus (P) levels in refeeding diets are very important as undernourished children are at risk of hypophosphatemia during refeeding. For this reason, conventional corn-soy-blends (CSB) have been reformulated by the World Food Programme to obtain a mono-calcium-phosphate fortified product (CSB+) and a product further fortified with skim milk powder (CBS++). Using a piglet model of undernourished children, we hypothesized that feeding of CSB+, CSB++ or CSB+ with added whey permeate (CSB+/wp) would help to prevent refeeding hypophosphatemia. Pigs were weaned at 4 weeks of age and undernutrition was induced with a nutritionally inadequate pure maize diet for 7 weeks, after which they were refed for 3 weeks with either CSB+ (n = 10), CSB++ (n = 10) or CSB+/wp (n = 10). For reference, a fourth group continued on the maize diet (REF, n = 10). Following induction of undernutrition, body weight and length were 29±5% and 67±4% (means±SD) of values in age-matched pigs fed a nutritionally adequate diet, and the mean serum P level was 1.77±0.34 mmol/l. During the first week of refeeding, P levels in the CSB+ pigs decreased to 55% of values before refeeding (P < 0.05) while values in the CSB++ and CSB+/wp pigs were able to maintain their plasma phosphate at a similar level as before refeeding. We conclude that fortification of CSB with only monocalcium-phosphate does not prevent hypophosphatemia. Dairy products like skim milk powder or whey permeate may represent relevant sources of phosphorus during refeeding. The content and form of phosphorus in such diets need to be carefully evaluated, and the undernourished piglet may be used to test the efficacy of such diets.

Numerical and clinical precision of continuous glucose monitoring in Colombian patients treated with insulin infusion pump with automated suspension in hypoglycemia.

PubMed

Gómez, Ana M; Marín Sánchez, Alejandro; Muñoz, Oscar M; Colón Peña, Christian Alejandro

2015-12-01

Insulin pump therapy associated with continuous glucose monitoring has shown a positive clinical impact on diabetes control and reduction of hypoglycemia episodes. There are descriptions of the performance of this device in other populations, but its precision and accuracy in Colombia and Latin America are unknown, especially in the routine outpatient setting. Data from 33 type 1 and type 2 diabetes patients with sensor-augmented pump therapy with threshold suspend automation, MiniMed Paradigm® Veo™ (Medtronic, Northridge, California), managed at Hospital Universitario San Ignacio (Bogotá, Colombia) and receiving outpatient treatment, were analyzed. Simultaneous data from continuous glucose monitoring and capillary blood glucose were compared, and their precision and accuracy were calculating with different methods, including Clarke error grid. Analyses included 2,262 continuous glucose monitoring -reference paired glucose values. A mean absolute relative difference of 20.1% was found for all measurements, with a value higher than 23% for glucose levels ≤75mg/dL. Global compliance with the ISO criteria was 64.9%. It was higher for values >75mg/dl (68.3%, 1,308 of 1,916 readings), than for those ≤ 75mg/dl (49.4%, 171 of 346 readings). Clinical accuracy, as assessed by the Clarke error grid, showed that 91.77% of data were within the A and B zones (75.6% in hypoglycemia). A good numerical accuracy was found for continuous glucose monitoring in normo and hyperglycemia situations, with low precision in hypoglycemia. The clinical accuracy of the device was adequate, with no significant safety concerns for patients. Copyright © 2015 SEEN. Published by Elsevier España, S.L.U. All rights reserved.

Development and validation of a GC-C-IRMS method for the confirmation analysis of pseudo-endogenous glucocorticoids in doping control.

PubMed

de la Torre, Xavier; Curcio, Davide; Colamonici, Cristiana; Molaioni, Francesco; Cilia, Marta; Botrè, Francesco

2015-01-01

Glucocorticoids are included in the S9 section of the World Anti-doping Agency (WADA) prohibited list international standard. Some among them are pseudo-endogenous steroids, like cortisol and cortisone, which present the same chemical structure as endogenously produced steroids. We are proposing an analytical method based on gas chromatography coupled to isotope ratio mass spectrometry (GC-C-IRMS) which allows discrimination between endogenous and synthetic origin of the urinary metabolites of the pseudo-endogenous glucocorticoids. A preliminary purification treatment by high-performance liquid chromatography (HPLC) of the target compounds (TC) (i.e., cortisol, tetrahydrocortisone (THE) 5α-tetrahydrocortisone (aTHE), tetrahydrocortisol (THF), and 5α-tetrahydrocortisol (aTHF)) allows collection of extracts with adequate purity for the subsequent analysis by IRMS. A population of 40 urine samples was analyzed for the TC and for the endogenous reference compounds (ERC: i.e., 11-desoxy-tetrahydrocortisol (THS) or pregnanediol). For each sample, the difference between the delta values of the ERCs and TCs (Δδ values) were calculated and based on that, some decision limits for atypical findings are proposed. The limits are below 3% units except for cortisol. The fit to purpose of the method has been confirmed by the analysis of urine samples collected in two patients under treatment with 25 mg of cortisone acetate (p.o). The samples showed Δδ values higher than 3 for at least 24 h following administration depending on the TC considered. The method can easily be integrated into existing procedures already used for the HPLC purification and IRMS analysis of pseudo-endogenous steroids with androgenic/anabolic activity. Copyright © 2015 John Wiley & Sons, Ltd.

In vivo continuous glucose monitoring using a chip based near infrared sensor

NASA Astrophysics Data System (ADS)

Ben Mohammadi, L.; Sigloch, S.; Frese, I.; Welzel, K.; Göddel, M.; Klotzbücher, T.

2014-05-01

Diabetes is a serious health condition considered to be one of the major healthcare epidemics of modern era. An effective treatment of this disease can be only achieved by reliable continuous information on blood glucose levels. In this work we present a minimally invasive, chip-based near infrared (NIR) sensor, combined with microdialysis, for continuous glucose monitoring (CGM). The sensor principle is based on difference absorption spectroscopy in the 1st overtone band of the near infrared spectrum. The device features a multi-emitter LED and InGaAs-Photodiodes, which are located on a single electronic board (non-disposable part), connected to a personal computer via Bluetooth. The disposable part consists of a chip containing the fluidic connections for microdialysis, two fluidic channels acting as optical transmission cells and total internally reflecting mirrors for in- and out-coupling of the LED light to the chip and to the detectors. The sensor is combined with an intraveneous microdialysis to separate the glucose from the cells and proteins in the blood and operates without any chemical consumption. In vitro measurements showed a linear relationship between glucose concentration and the integrated difference signal with a coefficient of determination of 99 % in the relevant physiological concentration range from 0 to 400 mg/dl. In vivo measurements on 10 patients showed that the NIR-CGM sensor data reflects the blood reference values adequately, if a proper calibration and signal drift compensation is applied. The MARE (mean absolute relative error) value taken over all patient data is 13.8 %. The best achieved MARE value is at 4.8 %, whereas the worst is 25.8 %, with a standard deviation of 5.5 %.

Gestational exposure to high perchlorate concentrations in drinking water and neonatal thyroxine levels.

PubMed

Amitai, Yona; Winston, Gary; Sack, Joseph; Wasser, Janice; Lewis, Matthew; Blount, Benjamin C; Valentin-Blasini, Liza; Fisher, Nirah; Israeli, Avi; Leventhal, Alex

2007-09-01

To assess the effect of gestational perchlorate exposure through drinking water on neonatal thyroxine (T(4)). T(4) values were compared among newborns in Ramat Hasharon, Israel, whose mothers resided in suburbs where drinking water contained perchlorate < or = 340 microg/L (very high exposure, n = 97), 42-94 microg/L (high exposure, n = 216), and < 3 microg/L (low exposure, n = 843). In the very high and high exposure areas, T(4) values in newborns whose mothers drank tap water exclusively (as determined by a telephone interview) were analyzed as a subset. Serum perchlorate levels in blood from donors residing in the area were used as proxy indicators of exposure. Neonatal T(4) values (mean +/- SD) in the very high, high, and low exposure groups were 13.9 +/- 3.8, 13.9 +/- 3.4, and 14.0 +/- 3.5 microg/dL, respectively (p = NS). Serum perchlorate concentrations in blood from donors residing in areas corresponding to these groups were 5.99 +/- 3.89, 1.19 +/- 1.37, and 0.44 +/- 0.55 microg/L, respectively. T(4) levels of neonates with putative gestational exposure to perchlorate in drinking water were not statistically different from controls. This study finds no change in neonatal T(4) levels despite maternal consumption of drinking water that contains perchlorate at levels in excess of the Environmental Protection Agency (EPA) drinking water equivalent level (24.5 microg/L) based on the National Research Council reference dose (RfD) [0.7 microg/(kg.day)]. Therefore the perchlorate RfD is likely to be protective of thyroid function in neonates of mothers with adequate iodide intake.

[Surgical treatment of secondary peritonitis: A continuing problem. German version].

PubMed

van Ruler, O; Boermeester, M A

2016-01-01

Secondary peritonitis remains associated with high mortality and morbidity rates. Treatment of secondary peritonitis is still challenging even in the era of modern medicine. Surgical intervention for source control remains the cornerstone of treatment besides adequate antimicrobial therapy and when necessary intensive medical care measures and resuscitation. A randomized clinical trial showed that relaparotomy on demand (ROD) after initial emergency surgery was the preferred treatment strategy, irrespective of the severity and extent of peritonitis. The effective and safe use of ROD requires intensive monitoring of the patient in a setting where diagnostic tests and decision making about relaparotomy are guaranteed round the clock. The lack of knowledge on timely and adequate patient selection, together with the lack of use of easy but reliable monitoring tools seem to hamper full implementation of ROD. The accuracy of the relaparotomy decision tool is reasonable for prediction of the formation of peritonitis and necessary selection of patients for computed tomography (CT). The value of CT in the early postoperative phase is unclear. Future research and innovative technologies should focus on the additive value of CT after surgical treatment for secondary peritonitis and on the further optimization of bedside prediction tools to enhance adequate patient selection for interventions in a multidisciplinary setting.