Criteria for structural test

NASA Technical Reports Server (NTRS)

1973-01-01

The results of a study to define criteria and techniques of design, analysis and test which permit the use of a single major structural test article for performing dynamic, fatigue, and static testing are presented. The criteria developed is applicable to both space vehicles and aircraft structures operating in the subsonic or supersonic regime. The feasibility of such an approach was demonstrated by defining test interactions, compatibilities and incompatibilities between the three different types of tests. The results of the study indicate that the single test article concept is feasible with a testing sequence of dynamic test followed by a fatigue and static test.

Efficacy of single-agent bortezomib vs. single-agent thalidomide in patients with relapsed or refractory multiple myeloma: a systematic comparison

PubMed Central

Prince, H Miles; Adena, Michael; Smith, Dell Kingsford; Hertel, Judy

2007-01-01

Objective: To conduct a systematic review of the efficacy of single-agent bortezomib vs. single-agent thalidomide in patients with relapsed/refractory multiple. Methods: Publications in English from 1966 to June 2005 (MEDLINE, EMBASE, Cochrane library), publication reference lists, Janssen-Cilag data-on-file and abstracts from recent multiple myeloma conferences were reviewed. Prospective studies containing at least a single arm of either treatment group with n ≥ 30 were included. Studies adding dexamethasone for non-responders were excluded. Statistical pooling was performed for response rate and overall survival. Results: One bortezomib study (n = 333, NEJM 2005, 352; 2487–98) and 15 thalidomide (n = 1007) studies met these criteria and were included. Patient baseline characteristics including age, gender, IgG:IgA, disease duration and beta-2 microglobulin were well matched except that 48% of bortezomib patients had received prior thalidomide. Response rate, defined as serum M-protein reduction ≥ 50%, was 53% for patients receiving bortezomib vs. 32% for thalidomide (P < 0.001, n = 10 studies). Response rate determined by European Group for Blood and Marrow Transplantation (EBMT) criteria was 41% for patients receiving bortezomib vs. 22% for thalidomide (P < 0.001, n = 4 studies). Conclusion: Bortezomib was associated with a significantly higher response rate and complete remission rate using both M-protein and EBMT criteria. PMID:17608711

Diagnostic value of clinical tests for degenerative rotator cuff disease in medical practice.

PubMed

Lasbleiz, S; Quintero, N; Ea, K; Petrover, D; Aout, M; Laredo, J D; Vicaut, E; Bardin, T; Orcel, P; Beaudreuil, J

2014-06-01

To assess the diagnostic value of clinical tests for degenerative rotator cuff disease (DRCD) in medical practice. Patients with DRCD were prospectively included. Eleven clinical tests of the rotator cuff have been done. One radiologist performed ultrasonography (US) of the shoulder. Results of US were expressed as normal tendon, tendinopathy or full-thickness tear (the reference). For each clinical test and each US criteria, sensitivity, specificity, negative predictive value and positive predictive value, accuracy, negative likelihood ratio (NLR) and positive likelihood ratio (PLR) were calculated. Clinical relevance was defined as PLR ≥2 and NLR ≤0.5. For 35 patients (39 shoulders), Jobe (PLR: 2.08, NLR: 0.31) and full-can (2, 0.5) test results were relevant for diagnosis of supraspinatus tears and resisted lateral rotation (2.42, 0.5) for infraspinatus tears, with weakness as response criteria. The lift-off test (8.50, 0.27) was relevant for subscapularis tears with lag sign as response criteria. Yergason's test (3.7, 0.41) was relevant for tendinopathy of the long head of the biceps with pain as a response criterion. There was no relevant clinical test for diagnosis of tendinopathy of supraspinatus, infraspinatus or subscapularis. Five of 11 clinical tests were relevant for degenerative rotator cuff disease. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

The challenge of defining risk-based metrics to improve food safety: inputs from the BASELINE project.

PubMed

Manfreda, Gerardo; De Cesare, Alessandra

2014-08-01

In 2002, the Regulation (EC) 178 of the European Parliament and of the Council states that, in order to achieve the general objective of a high level of protection of human health and life, food law shall be based on risk analysis. However, the Commission Regulation No 2073/2005 on microbiological criteria for foodstuffs requires that food business operators ensure that foodstuffs comply with the relevant microbiological criteria. Such criteria define the acceptability of a product, a batch of foodstuffs or a process, based on the absence, presence or number of micro-organisms, and/or on the quantity of their toxins/metabolites, per unit(s) of mass, volume, area or batch. The same Regulation describes a food safety criterion as a mean to define the acceptability of a product or a batch of foodstuff applicable to products placed on the market; moreover, it states a process hygiene criterion as a mean indicating the acceptable functioning of the production process. Both food safety criteria and process hygiene criteria are not based on risk analysis. On the contrary, the metrics formulated by the Codex Alimentarius Commission in 2004, named Food Safety Objective (FSO) and Performance Objective (PO), are risk-based and fit the indications of Regulation 178/2002. The main aims of this review are to illustrate the key differences between microbiological criteria and the risk-based metrics defined by the Codex Alimentarius Commission and to explore the opportunity and also the possibility to implement future European Regulations including PO and FSO as supporting parameters to microbiological criteria. This review clarifies also the implications of defining an appropriate level of human protection, how to establish FSO and PO and how to implement them in practice linked to each other through quantitative risk assessment models. The contents of this review should clarify the context for application of the results collected during the EU funded project named BASELINE (www.baselineeurope.eu) as described in the papers of this special issue. Such results show how to derive POs for specific food/biological hazard combinations selected among fish, egg, dairy, meat and plant products. Copyright © 2014 Elsevier B.V. All rights reserved.

Air Quality Criteria for Particulate Matter (Final Report, 2004)

EPA Science Inventory

EPA has completed the process of updating and revising, where appropriate, its Air Quality Criteria for Particulate Matter (PM) as issued in 1996 (usually referred to as the Criteria Document). Sections 108 and 109 of the Clean Air Act require that EPA carry out a periodic revi...

Developing research criteria to define medical necessity in emergency medical services.

PubMed

Cone, David C; Schmidt, Terri A; Mann, N Clay; Brown, Lawrence

2004-01-01

"The Neely Conference: Developing Research Criteria to Define Medical Necessity in EMS" convened emergency medical services (EMS) physicians, researchers, administrators, providers, and federal agency representatives to begin the development of a set of uniform triage criteria and outcome measures that could be used to study and evaluate medical necessity among EMS patients. These standardized criteria might be used in research studies examining EMS dispatch and response (e.g., dispatch triage protocols, alternative response configurations), and EMS treatment and transport (e.g., field triage protocols, alternative care destinations). The conference process included review and analysis of the literature, expert judgment, and consensus building. There was general agreement on the following: 1. Any dispatch triage or field triage system that is developed must be designed to offer patients alternatives to EMS, not to refuse care to patients. 2. It is theoretically possible to develop a set of clinical criteria for need. Some groups of patients will clearly need a traditional EMS response and other groups will not, but this has yet to be defined. 3. In addition to clinical criteria, certain social and other nonclinical criteria such as pain or potential abuse may be used to justify a response. 4. Communication barriers, patient age, special needs, and other conditions complicate patient assessment but should not exclude patients from consideration for alternate triage or transport. 5. These research questions are important, and standard sets of outcome measures are needed so that different studies and innovative programs can be compared.

Aquatic Life Criteria - Lead

EPA Pesticide Factsheets

References and documents pertaining to Acute and Chronic Ambient Aquatic Life Water Quality Criteria for Lead. These documents include the safe levels of Lead in water that should protect the majority of species.

Points to consider for prioritizing clinical genetic testing services: a European consensus process oriented at accountability for reasonableness

PubMed Central

Severin, Franziska; Borry, Pascal; Cornel, Martina C; Daniels, Norman; Fellmann, Florence; Victoria Hodgson, Shirley; Howard, Heidi C; John, Jürgen; Kääriäinen, Helena; Kayserili, Hülya; Kent, Alastair; Koerber, Florian; Kristoffersson, Ulf; Kroese, Mark; Lewis, Celine; Marckmann, Georg; Meyer, Peter; Pfeufer, Arne; Schmidtke, Jörg; Skirton, Heather; Tranebjærg, Lisbeth; Rogowski, Wolf H

2015-01-01

Given the cost constraints of the European health-care systems, criteria are needed to decide which genetic services to fund from the public budgets, if not all can be covered. To ensure that high-priority services are available equitably within and across the European countries, a shared set of prioritization criteria would be desirable. A decision process following the accountability for reasonableness framework was undertaken, including a multidisciplinary EuroGentest/PPPC-ESHG workshop to develop shared prioritization criteria. Resources are currently too limited to fund all the beneficial genetic testing services available in the next decade. Ethically and economically reflected prioritization criteria are needed. Prioritization should be based on considerations of medical benefit, health need and costs. Medical benefit includes evidence of benefit in terms of clinical benefit, benefit of information for important life decisions, benefit for other people apart from the person tested and the patient-specific likelihood of being affected by the condition tested for. It may be subject to a finite time window. Health need includes the severity of the condition tested for and its progression at the time of testing. Further discussion and better evidence is needed before clearly defined recommendations can be made or a prioritization algorithm proposed. To our knowledge, this is the first time a clinical society has initiated a decision process about health-care prioritization on a European level, following the principles of accountability for reasonableness. We provide points to consider to stimulate this debate across the EU and to serve as a reference for improving patient management. PMID:25248395

Psychiatric comorbidity and the persistence of drug use disorders in the United States

PubMed Central

Fenton, Miriam C.; Keyes, Katherine; Geier, Timothy; Greenstein, Eliana; Skodol, Andrew; Krueger, Bob; Grant, Bridget F.; Hasin, Deborah S.

2011-01-01

Context DSM-IV drug use disorders, a major public health problem, are highly comorbid with other psychiatric disorders, but little is known about the role of this comorbidity when studied prospectively in the general population. Aims Determine the role of comorbid psychopathology in the three-year persistence of drug use disorders. Design Secondary data analysis using Waves 1 (2001-2) and 2 (2004-5) of the National Epidemiologic Survey on Alcohol and Related Conditions. Participants Respondents with current DSM-IV drug use disorder at Wave 1 who participated in Wave 2 (N=613). Measurements AUDADIS-IV obtained DSM-IV Axis I and II diagnoses. Persistent drug use disorder was defined as meeting full criteria for any drug use disorder between Waves 1 and 2. Findings Drug use disorders persisted in 30.9% of respondents. No Axis I disorders predicted persistence. Antisocial (OR=2.75; 95% CI=1.27–5.99), borderline (OR=1.91; 95% CI=1.06–3.45) and schizotypal (OR=2.77; 95% CI=1.42–5.39) personality disorders were significant predictors of persistent drug use disorders, controlling for demographics, psychiatric comorbidity, family history, treatment and number of drug use disorders. Deceitfulness and lack of remorse were the strongest antisocial criteria predictors of drug use disorder persistence, identity disturbance and self-damaging impulsivity were the strongest borderline criteria predictors, and ideas of reference and social anxiety were the strongest schizotypal criteria predictors. Conclusions Antisocial, borderline and schizotypal personality disorders are specific predictors of drug use disorder persistence over a three-year period. PMID:21883607

Points to consider for prioritizing clinical genetic testing services: a European consensus process oriented at accountability for reasonableness.

PubMed

Severin, Franziska; Borry, Pascal; Cornel, Martina C; Daniels, Norman; Fellmann, Florence; Victoria Hodgson, Shirley; Howard, Heidi C; John, Jürgen; Kääriäinen, Helena; Kayserili, Hülya; Kent, Alastair; Koerber, Florian; Kristoffersson, Ulf; Kroese, Mark; Lewis, Celine; Marckmann, Georg; Meyer, Peter; Pfeufer, Arne; Schmidtke, Jörg; Skirton, Heather; Tranebjærg, Lisbeth; Rogowski, Wolf H

2015-06-01

Given the cost constraints of the European health-care systems, criteria are needed to decide which genetic services to fund from the public budgets, if not all can be covered. To ensure that high-priority services are available equitably within and across the European countries, a shared set of prioritization criteria would be desirable. A decision process following the accountability for reasonableness framework was undertaken, including a multidisciplinary EuroGentest/PPPC-ESHG workshop to develop shared prioritization criteria. Resources are currently too limited to fund all the beneficial genetic testing services available in the next decade. Ethically and economically reflected prioritization criteria are needed. Prioritization should be based on considerations of medical benefit, health need and costs. Medical benefit includes evidence of benefit in terms of clinical benefit, benefit of information for important life decisions, benefit for other people apart from the person tested and the patient-specific likelihood of being affected by the condition tested for. It may be subject to a finite time window. Health need includes the severity of the condition tested for and its progression at the time of testing. Further discussion and better evidence is needed before clearly defined recommendations can be made or a prioritization algorithm proposed. To our knowledge, this is the first time a clinical society has initiated a decision process about health-care prioritization on a European level, following the principles of accountability for reasonableness. We provide points to consider to stimulate this debate across the EU and to serve as a reference for improving patient management.

Factors Influencing Progressive Failure Analysis Predictions for Laminated Composite Structure

NASA Technical Reports Server (NTRS)

Knight, Norman F., Jr.

2008-01-01

Progressive failure material modeling methods used for structural analysis including failure initiation and material degradation are presented. Different failure initiation criteria and material degradation models are described that define progressive failure formulations. These progressive failure formulations are implemented in a user-defined material model for use with a nonlinear finite element analysis tool. The failure initiation criteria include the maximum stress criteria, maximum strain criteria, the Tsai-Wu failure polynomial, and the Hashin criteria. The material degradation model is based on the ply-discounting approach where the local material constitutive coefficients are degraded. Applications and extensions of the progressive failure analysis material model address two-dimensional plate and shell finite elements and three-dimensional solid finite elements. Implementation details are described in the present paper. Parametric studies for laminated composite structures are discussed to illustrate the features of the progressive failure modeling methods that have been implemented and to demonstrate their influence on progressive failure analysis predictions.

A test of prospect theory.

PubMed

Feeny, David; Eng, Ken

2005-01-01

Prospect theory (PT) hypothesizes that people judge states relative to a reference point, usually assumed to be their current health. States better than the reference point are valued on a concave portion of the utility function; worse states are valued on a convex portion. Using prospectively collected utility scores, the objective is to test empirically implications of PT. Osteoarthritis (OA) patients undergoing total hip arthroplasty periodically provided standard gamble scores for three OA hypothetical states describing mild, moderate, and severe OA as well as their subjectively defined current state (SDCS). Our hypothesis was that most patients improved between the pre- and postsurgery assessments. According to PT, scores for hypothetical states previously > SDCS but now < SDCS should be lower at the postsurgery assessment. Fourteen patients met the criteria for testing the hypothesis. Predictions were confirmed for 0 patients; there was no change or mixed results for 6 patients (42.9 percent); and scores moved in the direction opposite to that predicted by PT for 8 patients (57.1 percent). In general, the direction and magnitude of the changes in hypothetical-state scores do not conform to the predictions of PT.

A judging principle of crucial vibrational transmission paths in plates

NASA Astrophysics Data System (ADS)

Wang, Bin; Li, Dong-Xu; Jiang, Jian-Ping; Liao, Yi-Huan

2016-10-01

This paper developed a judging principle of crucial vibrational transmission path (VTP) in plates. Novel generalized definitions of VTPs are given referred to the meaning of streamlines. And by comparing governing equations, the similarity between energy flow and fluid motion is firstly found so that an analytic method of VTPs in plates is proposed by analogy with fluid motion. Hereafter, the crucial VTP is defined for energy flows at objective points and relative judging criteria is given. Finally, based on two numerical experiments of passive control, the judging principle is indirectly verified by comparing the reduction effects of energy flows at focused points and relative judgment results of crucial VTPs. This paper is meaningful for analyzing and applying the VTPs in plates to guide the control design in future.

Overview and Status of the Bioastronautics Critical Path Roadmap (BCPR)

NASA Technical Reports Server (NTRS)

Charles, John

2004-01-01

Viewgraphs on the status and overview of the Bioastronautics Critical Path Roadmap (BCPR) are presented. The topics include: 1) BCPR Objectives; 2) BCPR and OBPR Program Management; 3) BCPR Disciplines & Cross-Cutting Areas; 4) Characteristics of BCPR Reference Missions; 5) Bioastronautics Timetable (notional); 6) BCPR Processes Risk Identification, Assessment, and Management; 7) Types of BCPR Risks; 8) Enabling Questions Categories; 9) Risk Mitigation Status; 10) Defining Levels of Accepted Risk; 11) BCPR Integration; 12) BCPR Implementation, Integration, and Validation; 13) BCPR Refinement Schedule; 14) Academy Review; 15) Rating Bioastronautics Risks; 16) Risk Rating Exercises; 17) Human Health Risk Assessment Criteria (examples); 18) A Recent Risk Rating Exercise; 19) Consensus Workshop Background; 20) Consensus Workshop Rating Analysis; 21) Consensus Workshop Selected Preliminary Recommendations; and 22) Access to BCPR Content.

Systemic Lupus Erythematosus: Definitions, Contexts, Conflicts, Enigmas

PubMed Central

Rekvig, Ole Petter

2018-01-01

Systemic lupus erythematosus (SLE) is an inadequately defined syndrome. Etiology and pathogenesis remain largely unknown. SLE is on the other hand a seminal syndrome that has challenged immunologists, biologists, genetics, and clinicians to solve its nature. The syndrome is characterized by multiple, etiologically unlinked manifestations. Unexpectedly, they seem to occur in different stochastically linked clusters, although single gene defects may promote a smaller spectrum of symptoms/criteria typical for SLE. There is no known inner coherence of parameters (criteria) making up the disease. These parameters are, nevertheless, implemented in The American College of Rheumatology (ACR) and The Systemic Lupus Collaborating Clinics (SLICC) criteria to classify SLE. Still, SLE is an abstraction since the ACR or SLICC criteria allow us to define hundreds of different clinical SLE phenotypes. This is a major point of the present discussion and uses “The anti-dsDNA antibody” as an example related to the problematic search for biomarkers for SLE. The following discussion will show how problematic this is: the disease is defined through non-coherent classification criteria, its complexity is recognized and accepted, its pathogenesis is plural and poorly understood. Therapy is focused on dominant symptoms or organ manifestations, and not on the syndrome itself. From basic scientific evidences, we can add substantial amount of data that are not sufficiently considered in clinical medicine, which may change the paradigms linked to what “The Anti-DNA antibody” is—and is not—in context of the imperfectly defined syndrome SLE. PMID:29545801

Diagnosing pediatric functional abdominal pain in children (4-15 years old) according to the Rome III Criteria: results from a Norwegian prospective study.

PubMed

Helgeland, Helene; Flagstad, Gro; Grøtta, Jon; Vandvik, Per Olav; Kristensen, Hanne; Markestad, Trond

2009-09-01

To determine the proportion of referred children with nonorganic abdominal pain who meet the criteria for 1 or more diagnoses of functional gastrointestinal disorders (FGID), explore the distribution of diagnoses according to the revised pediatric Rome III criteria (PRC-III), and to investigate reasons for failure to meet these criteria. We recruited children (4-15 years) consecutively referred by general practitioners to 4 general pediatric outpatient clinics for the evaluation of recurrent abdominal pain. FGID diagnoses were based on the Questionnaire on Pediatric Gastrointestinal Symptoms-Rome III version, completed by parents. To exclude organic disease, all patients underwent medical investigations and were reevaluated at follow-up after 6 to 9 months. Of the 152 patients included, 142 (93%) had functional abdominal pain. Of these, 124 (87%) met the criteria for 1 or more diagnoses according to the PRC-III: 66% met the criteria for 1, 29% for 2, and 5% for 3 diagnoses. Irritable bowel syndrome was the most common diagnosis (43%) and overlapped with aerophagia in 16 children (38% of the children with overlapping diagnoses) and with abdominal migraine in 14 (33%). In the 18 patients (13%) not fulfilling the PRC-III for any FGID diagnosis, the main reason was insufficient pain frequency (83%). Of the referred children with functional abdominal pain, 87% met the PRC-III for specific diagnoses. This supports the use of these criteria as a diagnostic tool. The significant overlap between different FGIDs, however, makes it unclear whether some of the diagnoses represent distinct disorders or artificial categories.

Sarcopenia Screened by the SARC-F Questionnaire and Physical Performances of Elderly Women: A Cross-Sectional Study.

PubMed

Rolland, Yves; Dupuy, Charlotte; Abellan Van Kan, Gabor; Cesari, Matteo; Vellas, Bruno; Faruch, Marie; Dray, Cedric; de Souto Barreto, Philipe

2017-10-01

Screening for sarcopenia in daily practice can be challenging. Our objective was to explore whether the SARC-F questionnaire is a valid screening tool for sarcopenia (defined by the Foundation for the National Institutes of Health [FNIH] criteria). Moreover, we evaluated the physical performance of older women according to the SARC-F questionnaire. Cross-sectional study. Data from the Toulouse and Lyon EPIDémiologie de l'OStéoporose study (EPIDOS) on 3025 women living in the community (mean age: 80.5 ± 3.9 years), without a previous history of hip fracture, were assessed. The SARC-F self-report questionnaire score ranges from 0 to 10: a score ≥4 defines sarcopenia. The FNIH criteria uses handgrip strength (GS) and appendicular lean mass (ALM; assessed by DXA) divided by body mass index (BMI) to define sarcopenia. Outcome measures were the following performance-based tests: knee-extension strength, 6-m gait speed, and a repeated chair-stand test. The associations of sarcopenia with performance-based tests was examined using bootstrap multiple linear-regression models; adjusted R 2 determined the percentage variation for each outcome explained by the model. Prevalence of sarcopenia was 16.7% (n = 504) according to the SARC-F questionnaire and 1.8% (n = 49) using the FNIH criteria. Sensibility and specificity of the SARC-F to diagnose sarcopenia (defined by FNIH criteria) were 34% and 85%, respectively. Sarcopenic women defined by SARC-F had significantly lower physical performance than nonsarcopenic women. The SARC-F improved the ability to predict poor physical performance. The validity of the SARC-F questionnaire to screen for sarcopenia, when compared with the FNIH criteria, was limited. However, sarcopenia defined by the SARC-F questionnaire substantially improved the predictive value of clinical characteristics of patients to predict poor physical performance. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Mapping the literature of case management nursing

PubMed Central

White, Pamela; Hall, Marilyn E.

2006-01-01

Objectives: Nursing case management provides a continuum of health care services for defined groups of patients. Its literature is multidisciplinary, emphasizing clinical specialties, case management methodology, and the health care system. This study is part of a project to map the literature of nursing, sponsored by the Nursing and Allied Health Resources Section of the Medical Library Association. The study identifies core journals cited in case management literature and indexing services that access those journals. Methods: Three source journals were identified based on established criteria, and cited references from each article published from 1997 to 1999 were analyzed. Results: Nearly two-thirds of the cited references were from journals; others were from books, monographs, reports, government documents, and the Internet. Cited journal references were ranked in descending order, and Bradford's Law of Scattering was applied. The many journals constituting the top two zones reflect the diversity of this field. Zone 1 included journals from nursing administration, case management, general medicine, medical specialties, and social work. Two databases, PubMed/MEDLINE and OCLC ArticleFirst, provided the best indexing coverage. Conclusion: Collections that support case management require a relatively small group of core journals. Students and health care professionals will need to search across disciplines to identify appropriate literature. PMID:16710470

Estimating the designated use attainment decision error rates of US Environmental Protection Agency's proposed numeric total phosphorus criteria for Florida, USA, colored lakes.

PubMed

McLaughlin, Douglas B

2012-01-01

The utility of numeric nutrient criteria established for certain surface waters is likely to be affected by the uncertainty that exists in the presence of a causal link between nutrient stressor variables and designated use-related biological responses in those waters. This uncertainty can be difficult to characterize, interpret, and communicate to a broad audience of environmental stakeholders. The US Environmental Protection Agency (USEPA) has developed a systematic planning process to support a variety of environmental decisions, but this process is not generally applied to the development of national or state-level numeric nutrient criteria. This article describes a method for implementing such an approach and uses it to evaluate the numeric total P criteria recently proposed by USEPA for colored lakes in Florida, USA. An empirical, log-linear relationship between geometric mean concentrations of total P (a potential stressor variable) and chlorophyll a (a nutrient-related response variable) in these lakes-that is assumed to be causal in nature-forms the basis for the analysis. The use of the geometric mean total P concentration of a lake to correctly indicate designated use status, defined in terms of a 20 µg/L geometric mean chlorophyll a threshold, is evaluated. Rates of decision errors analogous to the Type I and Type II error rates familiar in hypothesis testing, and a 3rd error rate, E(ni) , referred to as the nutrient criterion-based impairment error rate, are estimated. The results show that USEPA's proposed "baseline" and "modified" nutrient criteria approach, in which data on both total P and chlorophyll a may be considered in establishing numeric nutrient criteria for a given lake within a specified range, provides a means for balancing and minimizing designated use attainment decision errors. Copyright © 2011 SETAC.

Towards a new definition of return-to-work outcomes in common mental disorders from a multi-stakeholder perspective.

PubMed

Hees, Hiske L; Nieuwenhuijsen, Karen; Koeter, Maarten W J; Bültmann, Ute; Schene, Aart H

2012-01-01

To examine the perspectives of key stakeholders involved in the return-to-work (RTW) process regarding the definition of successful RTW outcome after sickness absence related to common mental disorders (CMD's). A mixed-method design was used: First, we used qualitative methods (focus groups, interviews) to identify a broad range of criteria important for the definition of successful RTW (N = 57). Criteria were grouped into content-related clusters. Second, we used a quantitative approach (online questionnaire) to identify, among a larger stakeholder sample (N = 178), the clusters and criteria most important for successful RTW. A total of 11 clusters, consisting of 52 unique criteria, were identified. In defining successful RTW, supervisors and occupational physicians regarded "Sustainability" and "At-work functioning" most important, while employees regarded "Sustainability," "Job satisfaction," "Work-home balance," and "Mental Functioning" most important. Despite agreement on the importance of certain criteria, considerable differences among stakeholders were observed. Key stakeholders vary in the aspects and criteria they regard as important when defining successful RTW after CMD-related sickness absence. Current definitions of RTW outcomes used in scientific research may not accurately reflect these key stakeholder perspectives. Future studies should be more aware of the perspective from which they aim to evaluate the effectiveness of a RTW intervention, and define their RTW outcomes accordingly.

SAGES's advanced GI/MIS fellowship curriculum pilot project.

PubMed

Weis, Joshua J; Goldblatt, Matthew; Pryor, Aurora; Dunkin, Brian J; Brunt, L Michael; Jones, Daniel B; Scott, Daniel J

2018-06-01

The American health care system faces deficits in quality and quantity of surgeons. SAGES is a major stakeholder in surgical fellowship training and is responsible for defining the curriculum for the Advanced GI/MIS fellowship. SAGES leadership is actively adapting this curriculum. The process of reform began in 2014 through a series of iterative meetings and discussions. A working group within the Resident and Fellow Training Committee reviewed case log data from 2012 to 2015. These data were used to propose new criteria designed to provide adequate exposure to core content. The working group also proposed using video assessment of an MIS case to provide objective assessment of competency. Case log data were available for 326 fellows with a total of 85,154 cases logged (median 227 per fellow). The working group proposed new criteria starting with minimum case volumes for five defined categories including foregut (20), bariatrics (25), inguinal hernia (10), ventral hernia (10), and solid organ/colon/thoracic (10). Fellows are expected to perform an additional 75 complex MIS cases of any category for a total of 150 required cases overall. The proposal also included a minimum volume of flexible endoscopy (50) and submission of an MIS foregut case for video assessment. The new criteria more clearly defined which surgeon roles count for major credit within individual categories. Fourteen fellowships volunteered to pilot these new criteria for the 2017-2018 academic year. The new SAGES Advanced GI/MIS fellowship has been crafted to better define the core content that should be contained in these fellowships, while still allowing sufficient heterogeneity so that individual learners can tailor their training to specific areas of interest. The criteria also introduce innovative, evidence-based methods for assessing competency. Pending the results of the pilot program, SAGES will consider broad implementation of the new fellowship criteria.

State-of-Science Approaches to Determine Sensitive Taxa for Water Quality Criteria Derivation

EPA Science Inventory

Current Ambient Water Quality Criteria (AWQC) guidelines specify pre-defined taxa diversity requirements, which has limited chemical-specific criteria development in the U.S. to less than 100 chemicals. A priori knowledge of sensitive taxa to toxicologically similar groups of che...

A systematic review of the evidence on home care reablement services.

PubMed

Legg, Lynn; Gladman, John; Drummond, Avril; Davidson, Alex

2016-08-01

To determine whether publically funded 'reablement services' have any effect on patient health or use of services. Systematic review of randomized controlled trials and non-randomized studies in which reablement interventions were compared with no care or usual care in people referred to public-funded personal care services. Data sources included: Cochrane Central Register of Controlled Trials, EPOC register of studies, trials registers, Medline, EMBASE, and CINHAL. Searches were from 2000 up to end February 2015. Not applicable. Investigators' definition of the target population for reablement interventions. Use of publically funded personal care services and dependence in personal activities of daily living. We found no studies fulfilling our inclusion criteria that assessed the effectiveness of reablement interventions. We did note the lack of an agreed understanding of the nature of reablement. Reablement is an ill-defined intervention targeted towards an ill-defined and potentially highly heterogeneous population/patient group. There is no evidence to suggest it is effective at either of its goals; increasing personal independence or reducing use of personal care services. © The Author(s) 2015.

Bullying in schools: the state of knowledge and effective interventions.

PubMed

Menesini, Ersilia; Salmivalli, Christina

2017-03-01

During the school years, bullying is one of the most common expressions of violence in the peer context. Research on bullying started more than forty years ago, when the phenomenon was defined as 'aggressive, intentional acts carried out by a group or an individual repeatedly and over time against a victim who cannot easily defend him- or herself'. Three criteria are relevant in order to define aggressive behaviour as bullying: (1) repetition, (2) intentionality and (3) an imbalance of power. Given these characteristics, bullying is often defined as systematic abuse of power by peers. It is recognised globally as a complex and serious problem. In the present paper, we discuss the prevalence, age and gender differences, and various types of bullying, as well as why it happens and how long it lasts, starting from the large surveys carried out in western countries and to a lower extent in low- and middle-income countries. The prevalence rates vary widely across studies; therefore, specific attention will be devoted to the definition, time reference period and frequency criterion. We will also focus on risk factors as well as short- and long-term outcomes of bullying and victimisation. Finally, a section will be dedicated to review what is known about effective prevention of bullying.

77 FR 26048 - Notice of Availability for the Final Certification Criteria for Non-Federal Regional Information...

Federal Register 2010, 2011, 2012, 2013, 2014

2012-05-02

...-Federal Regional Information Coordination Entities (RICE) as Approved by the Interagency Ocean Observing... final RICE certification criteria. These certification criteria establish eligibility for non-federal...) and are applicable to RICEs as defined in the Act, including Regional Associations. ADDRESSES: The...

Validating the WHO maternal near miss tool: comparing high- and low-resource settings.

PubMed

Witteveen, Tom; Bezstarosti, Hans; de Koning, Ilona; Nelissen, Ellen; Bloemenkamp, Kitty W; van Roosmalen, Jos; van den Akker, Thomas

2017-06-19

WHO proposed the WHO Maternal Near Miss (MNM) tool, classifying women according to several (potentially) life-threatening conditions, to monitor and improve quality of obstetric care. The objective of this study is to analyse merged data of one high- and two low-resource settings where this tool was applied and test whether the tool may be suitable for comparing severe maternal outcome (SMO) between these settings. Using three cohort studies that included SMO cases, during two-year time frames in the Netherlands, Tanzania and Malawi we reassessed all SMO cases (as defined by the original studies) with the WHO MNM tool (five disease-, four intervention- and seven organ dysfunction-based criteria). Main outcome measures were prevalence of MNM criteria and case fatality rates (CFR). A total of 3172 women were studied; 2538 (80.0%) from the Netherlands, 248 (7.8%) from Tanzania and 386 (12.2%) from Malawi. Total SMO detection was 2767 (87.2%) for disease-based criteria, 2504 (78.9%) for intervention-based criteria and 1211 (38.2%) for organ dysfunction-based criteria. Including every woman who received ≥1 unit of blood in low-resource settings as life-threatening, as defined by organ dysfunction criteria, led to more equally distributed populations. In one third of all Dutch and Malawian maternal death cases, organ dysfunction criteria could not be identified from medical records. Applying solely organ dysfunction-based criteria may lead to underreporting of SMO. Therefore, a tool based on defining MNM only upon establishing organ failure is of limited use for comparing settings with varying resources. In low-resource settings, lowering the threshold of transfused units of blood leads to a higher detection rate of MNM. We recommend refined disease-based criteria, accompanied by a limited set of intervention- and organ dysfunction-based criteria to set a measure of severity.

Automated identification of social interaction criteria in Drosophila melanogaster.

PubMed

Schneider, J; Levine, J D

2014-10-01

The study of social behaviour within groups has relied on fixed definitions of an 'interaction'. Criteria used in these definitions often involve a subjectively defined cut-off value for proximity, orientation and time (e.g. courtship, aggression and social interaction networks) and the same numerical values for these criteria are applied to all of the treatment groups within an experiment. One universal definition of an interaction could misidentify interactions within groups that differ in life histories, study treatments and/or genetic mutations. Here, we present an automated method for determining the values of interaction criteria using a pre-defined rule set rather than pre-defined values. We use this approach and show changing social behaviours in different manipulations of Drosophila melanogaster. We also show that chemosensory cues are an important modality of social spacing and interaction. This method will allow a more robust analysis of the properties of interacting groups, while helping us understand how specific groups regulate their social interaction space. © 2014 The Author(s) Published by the Royal Society. All rights reserved.

9th Annual CMMI Technology Conference and User Group-Tuesday

DTIC Science & Technology

2009-11-19

evaluating and quantifying risk likelihood and severity risks. Step 4 Project defines thresholds for each risk category. Step 5 Project defines bounds on the...defines consistent criteria for evaluating and quantifying risk likelihood and severity risks in the Risk Management Plan. Step 4 Project defines

Criteria-based audit to improve a district referral system in Malawi: a pilot study.

PubMed

Kongnyuy, Eugene J; Mlava, Grace; van den Broek, Nynke

2008-09-22

To study the feasibility of using criteria-based audit to improve a district referral system. A criteria-based audit was used to assess the Salima District referral system in Malawi. A retrospective review of 60 obstetric emergencies referred from 12 health centres was conducted and compared with prior established standards for optimal referral of emergencies. Recommendations were made and implemented. Three months later, a re-audit was conducted (62 cases). There were significant improvements in 4 out of 7 standards: adequate resuscitation before referral (33.3% vs 88.7%; p = 0.001); delay of less than 2 hours from the time the ambulance is called to when the ambulance brought the patient to the hospital (42.8% vs 88.3%; p = 0.014); clinician attends to patient within 30 minutes of arrival to hospital (30.8% vs 92.6%; p = 0.001) and feedback given to the referring health centres (1.7% vs 91.9%; p <0.001). The rest of the three standards showed a high level of attainment (>95%) in both the initial audit and the re-audit: referred patients accompanied by a referral form; ambulances are available at all times and the district hospital is informed through short-wave radio by the health centre when a patient is referred. Criteria-based audit can improve the ability of a district referral system to handle obstetric emergencies in countries with limited resources.

Defining recovery in adult bulimia nervosa.

PubMed

Yu, Jessica; Agras, W Stewart; Bryson, Susan

2013-01-01

To examine how different definitions of recovery lead to varying rates of recovery, maintenance of recovery, and relapse in bulimia nervosa (BN), end-of-treatment (EOT) and follow-up data were obtained from 96 adults with BN. Combining behavioral, physical, and psychological criteria led to recovery rates between 15.5% and 34.4% at EOT, though relapse was approximately 50%. Combining these criteria and requiring abstinence from binge eating and purging when defining recovery may lead to lower recovery rates than those found in previous studies; however, a strength of this definition is that individuals who meet this criteria have no remaining disordered behaviors or symptoms.

A review of competencies developed for disaster healthcare providers: limitations of current processes and applicability.

PubMed

Daily, Elaine; Padjen, Patricia; Birnbaum, Marvin

2010-01-01

In order to prepare the healthcare system and healthcare personnel to meet the health needs of populations affected by disasters, educational programs have been developed by numerous academic institutions, hospitals, professional organizations, governments, and non-government organizations. Lacking standards for best practices as a foundation, many organizations and institutions have developed "core competencies" that they consider essential knowledge and skills for disaster healthcare personnel. The Nursing Section of the World Association for Disaster and Emergency Medicine (WADEM) considered the possibility of endorsing an existing set of competencies that could be used to prepare nurses universally to participate in disaster health activities. This study was undertaken for the purpose of reviewing published disaster health competencies to determine commonalities and universal applicability for disaster preparedness. In 2007, a review of the electronic literature databases was conducted using the major keywords: disaster response competencies; disaster preparedness competencies; emergency response competencies; disaster planning competencies; emergency planning competencies; public health emergency preparedness competencies; disaster nursing competencies; and disaster nursing education competencies. A manual search of references and selected literature from public and private sources also was conducted. Inclusion criteria included: English language; competencies listed or specifically referred to; competencies relevant to disaster, mass-casualty incident (MCI), or public health emergency; and competencies relevant to healthcare. Eighty-six articles were identified; 20 articles failed to meet the initial inclusion criteria; 27 articles did not meet the additional criteria, leaving 39 articles for analysis. Twenty-eight articles described competencies targeted to a specific profession/discipline, while 10 articles described competencies targeted to a defined role or function during a disaster. Four of the articles described specific competencies according to skill level, rather than to a specific role or function. One article defined competencies according to specific roles as well as proficiency levels. Two articles categorized disaster nursing competencies according to the phases of the disaster management continuum. Fourteen articles described specified competencies as "core" competencies for various target groups, while one article described "cross-cutting" competencies applicable to all healthcare workers. Hundreds of competencies for disaster healthcare personnel have been developed and endorsed by governmental and professional organizations and societies. Imprecise and inconsistent terminology and structure are evident throughout the reviewed competency sets. Universal acceptance and application of these competencies are lacking and none have been validated. Further efforts must be directed to developing a framework and standardized terminology for the articulation of competency sets for disaster health professionals that can by accepted and adapted universally.

Integrating Green Building Criteria Into Housing Design Processes Case Study: Tropical Apartment At Kebon Melati, Jakarta

NASA Astrophysics Data System (ADS)

Farid, V. L.; Wonorahardjo, S.

2018-05-01

The implementation of Green Building criteria is relatively new in architectural practice, especially in Indonesia. Consequently, the integration of these criteria into design process has the potential to change the design process itself. The implementation of the green building criteria into the conventional design process will be discussed in this paper. The concept of this project is to design a residential unit with a natural air-conditioning system. To achieve this purpose, the Green Building criteria has been implemented since the beginning of the design process until the detailing process on the end of the project. Several studies was performed throughout the design process, such as: (1) Conceptual review, where several professionally proved theories related to Tropical Architecture and passive design are used for a reference, and (2) Computer simulations, such as Computational Fluid Dynamics (CFD) and wind tunnel simulation, used to represent the dynamic response of the surrounding environment towards the building. Hopefully this paper may become a reference for designing a green residential building.

IT-CARES: an interactive tool for case-crossover analyses of electronic medical records for patient safety.

PubMed

Caron, Alexandre; Chazard, Emmanuel; Muller, Joris; Perichon, Renaud; Ferret, Laurie; Koutkias, Vassilis; Beuscart, Régis; Beuscart, Jean-Baptiste; Ficheur, Grégoire

2017-03-01

The significant risk of adverse events following medical procedures supports a clinical epidemiological approach based on the analyses of collections of electronic medical records. Data analytical tools might help clinical epidemiologists develop more appropriate case-crossover designs for monitoring patient safety. To develop and assess the methodological quality of an interactive tool for use by clinical epidemiologists to systematically design case-crossover analyses of large electronic medical records databases. We developed IT-CARES, an analytical tool implementing case-crossover design, to explore the association between exposures and outcomes. The exposures and outcomes are defined by clinical epidemiologists via lists of codes entered via a user interface screen. We tested IT-CARES on data from the French national inpatient stay database, which documents diagnoses and medical procedures for 170 million inpatient stays between 2007 and 2013. We compared the results of our analysis with reference data from the literature on thromboembolic risk after delivery and bleeding risk after total hip replacement. IT-CARES provides a user interface with 3 columns: (i) the outcome criteria in the left-hand column, (ii) the exposure criteria in the right-hand column, and (iii) the estimated risk (odds ratios, presented in both graphical and tabular formats) in the middle column. The estimated odds ratios were consistent with the reference literature data. IT-CARES may enhance patient safety by facilitating clinical epidemiological studies of adverse events following medical procedures. The tool's usability must be evaluated and improved in further research. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association.

Functional gastroduodenal disorders

PubMed Central

Talley, N; Stanghellini, V; Heading, R; Koch, K; Malagelada, J; Tytgat, G

1999-01-01

While widely used in research, the 1991 Rome criteria for the gastroduodenal disorders, especially symptom subgroups in dyspepsia, remain contentious. After a comprehensive literature search, a consensus-based approach was applied, supplemented by input from international experts who reviewed the report. Three functional gastroduodenal disorders are defined. Functional dyspepsia is persistent or recurrent pain or discomfort centered in the upper abdomen; evidence of organic disease likely to explain the symptoms is absent, including at upper endoscopy. Discomfort refers to a subjective, negative feeling that may be characterized by or associated with a number of non-painful symptoms including upper abdominal fullness, early satiety, bloating, or nausea. A dyspepsia subgroup classification is proposed for research purposes, based on the predominant (most bothersome) symptom: (a) ulcer-like dyspepsia when pain (from mild to severe) is the predominant symptom, and (b) dysmotility-like dyspepsia when discomfort (not pain) is the predominant symptom. This classification is supported by recent evidence suggesting that predominant symptoms, but not symptom clusters, identify subgroups with distinct underlying pathophysiological disturbances and responses to treatment. Aerophagia is an unusual complaint characterized by air swallowing that is objectively observed and troublesome repetitive belching. Functional vomiting refers to frequent episodes of recurrent vomiting that is not self-induced nor medication induced, and occurs in the absence of eating disorders, major psychiatric diseases, abnormalities in the gut or central nervous system, or metabolic diseases that can explain the symptom. The current classification requires careful validation but the criteria should be of value in future research.


Keywords: dyspepsia; functional dyspepsia; aerophagia; psychogenic vomiting; Rome II PMID:10457043

Somatic Cough Syndrome (Previously Referred to as Psychogenic Cough) and Tic Cough (Previously Referred to as Habit Cough) in Adults and Children

PubMed Central

Murad, Mohammad H.; Pringsheim, Tamara; Feinstein, Anthony; Chang, Anne B.; Newcombe, Peter A.; Rubin, Bruce K.; McGarvey, Lorcan P.; Weir, Kelly; Altman, Kenneth W.; Weinberger, Miles; Irwin, Richard S.; Adams, Todd M.; Altman, Kenneth W.; Barker, Alan F.; Birring, Surinder S.; Blackhall, Fiona; Bolser, Donald C.; Boulet, Louis-Philippe; Braman, Sidney S.; Brightling, Christopher; Callahan-Lyon, Priscilla; Canning, Brendan J.; Chang, Anne B.; Coeytaux, Remy; Cowley, Terrie; Davenport, Paul; Diekemper, Rebecca L.; Ebihara, Satoru; El Solh, Ali A.; Escalante, Patricio; Feinstein, Anthony; Field, Stephen K.; Fisher, Dina; French, Cynthia T.; Gibson, Peter; Gold, Philip; Gould, Michael K.; Grant, Cameron; Harding, Susan M.; Harnden, Anthony; Hill, Adam T.; Irwin, Richard S.; Kahrilas, Peter J.; Keogh, Karina A.; Lane, Andrew P.; Lim, Kaiser; Malesker, Mark A.; Mazzone, Peter; Mazzone, Stuart; McCrory, Douglas C.; McGarvey, Lorcan; Molasiotis, Alex; Murad, M. Hassan; Newcombe, Peter; Nguyen, Huong Q.; Oppenheimer, John; Prezant, David; Pringsheim, Tamara; Restrepo, Marcos I.; Rosen, Mark; Rubin, Bruce; Ryu, Jay H.; Smith, Jaclyn; Tarlo, Susan M.; Vertigan, Anne E.; Wang, Gang; Weinberger, Miles; Weir, Kelly; Wiener, Renda Soylemez

2015-01-01

BACKGROUND: We conducted a systematic review on the management of psychogenic cough, habit cough, and tic cough to update the recommendations and suggestions of the 2006 guideline on this topic. METHODS: We followed the American College of Chest Physicians (CHEST) methodologic guidelines and the Grading of Recommendations, Assessment, Development, and Evaluation framework. The Expert Cough Panel based their recommendations on data from the systematic review, patients’ values and preferences, and the clinical context. Final grading was reached by consensus according to Delphi methodology. RESULTS: The results of the systematic review revealed only low-quality evidence to support how to define or diagnose psychogenic or habit cough with no validated diagnostic criteria. With respect to treatment, low-quality evidence allowed the committee to only suggest therapy for children believed to have psychogenic cough. Such therapy might consist of nonpharmacologic trials of hypnosis or suggestion therapy, or combinations of reassurance, counseling, and referral to a psychologist, psychotherapy, and appropriate psychotropic medications. Based on multiple resources and contemporary psychologic, psychiatric, and neurologic criteria (Diagnostic and Statistical Manual of Mental Disorders, 5th edition and tic disorder guidelines), the committee suggests that the terms psychogenic and habit cough are out of date and inaccurate. CONCLUSIONS: Compared with the 2006 CHEST Cough Guidelines, the major change in suggestions is that the terms psychogenic and habit cough be abandoned in favor of somatic cough syndrome and tic cough, respectively, even though the evidence to do so at this time is of low quality. PMID:25856777

Validation of criteria for the definition of transient lower esophageal sphincter relaxations using high-resolution manometry.

PubMed

Roman, S; Holloway, R; Keller, J; Herbella, F; Zerbib, F; Xiao, Y; Bernard, L; Bredenoord, A J; Bruley des Varannes, S; Chen, M; Fox, M; Kahrilas, P J; Mittal, R K; Penagini, R; Savarino, E; Sifrim, D; Wu, J; Decullier, E; Pandolfino, J E; Mion, F

2017-02-01

Criteria for transient lower esophageal sphincter relaxations (TLESRs) are well-defined for Dentsleeve manometry. As high-resolution manometry (HRM) is now the gold standard to assess esophageal motility, our aim was to propose a consensus definition of TLESRs using HRM. Postprandial esophageal HRM combined with impedance was performed in 10 patients with gastroesophageal reflux disease. Transient lower esophageal sphincter relaxations identification was performed by 17 experts using a Delphi process. Four investigators then characterized TLESR candidates that achieved 100% agreement (TLESR events) and those that achieved less than 25% agreement (non-events) after the third round. Logistic regression and decision tree analysis were used to define optimal diagnostic criteria. All diagnostic criteria were more frequently encountered in the 57 TLESR events than in the 52 non-events. Crural diaphragm (CD) inhibition and LES relaxation duration >10 seconds had the highest predictive value to identify TLESR. Based on decision tree analysis, reflux on impedance, esophageal shortening, common cavity, upper esophageal sphincter relaxation without swallow and secondary peristalsis were alternate diagnostic criteria. Using HRM, TLESR might be defined as LES relaxation occurring in absence of swallowing, lasting more than 10 seconds and associated with CD inhibition. © 2016 John Wiley & Sons Ltd.

Patient access to reimbursed biological disease-modifying antirheumatic drugs in the European region.

PubMed

Kaló, Zoltán; Vokó, Zoltán; Östör, Andrew; Clifton-Brown, Emma; Vasilescu, Radu; Battersby, Alysia; Gibson, Edward

2017-01-01

Background & Objectives : Biological disease-modifying antirheumatic drugs (bDMARDs) for the treatment of rheumatoid arthritis (RA) are not always accessible to all patients in accordance with international guidelines, partly owing to their high direct costs against a background of restricted healthcare budgets. This study compares the size of RA patient populations with access to reimbursed bDMARDs across 37 European countries, Russia, and Turkey, according to their treatment eligibility defined by European League Against Rheumatism (EULAR) recommendations and national reimbursement criteria. Methods : The size of the RA patient population eligible for bDMARD treatment was estimated in a population model using published RA epidemiological data and clinical criteria defined by 2013 EULAR recommendations along with national reimbursement criteria defined in a survey of the 39 countries in November 2015. Results : According to EULAR recommendations, 32% of the total RA population in the European region is eligible for bDMARD treatment. However, only an average 59% of this EULAR-eligible population remains eligible after applying national reimbursement criteria (from 86% in 'high access' to 13% in 'low-access' countries). Conclusion : Access to reimbursed bDMARDs remains unequal in the European region. As biosimilars of bDMARDs are introduced, changes in reimbursement criteria may increase access to bDMARDs and reduce this inequality.

Examining the Clinical Correlates of Autism Spectrum Disorder in Youth by Ascertainment Source

PubMed Central

Joshi, Gagan; Faraone, Stephen V; Wozniak, Janet; Petty, Carter; Fried, Ronna; Galdo, Maribel; Furtak, Stephannie L.; McDermott, Katie; Epstien, Cecily; Walker, Rosemary; Caron, Ashley; Feinberg, Leah; Biederman, Joseph

2014-01-01

Objective To examine whether presentation of autism spectrum disorder (ASD) and associated patterns of psychiatric comorbidity and dysfunction vary by referral source. Methods ASD youth referred to a specialized ambulatory program for ASD (N=143) were compared to ASD youth referred to a general child psychiatry clinic (N=217). Results More ASD clinic youth met criteria for a more robust form of ASD (autistic disorder); more youth referred to the psychiatry clinic met criteria for broader spectrum ASD (PDD-NOS). General psychiatry clinic youth with ASD suffered from a greater burden of psychopathologies and higher levels of dysfunction. Conclusion The presentation of ASD in psychiatrically referred youth differs between general and ASD-specialized clinics, though both referral populations have high levels of comorbidity and dysfunction. PMID:24566937

Do state-and-transition models derived from vegetation succession also represent avian succession in restored mine pits?

PubMed

Craig, Michael D; Stokes, Vicki L; Fontaine, Joseph B; Hardy, Giles E StJ; Grigg, Andrew H; Hobbs, Richard J

2015-10-01

State-and-transition models are increasingly used as a tool to inform management of post-disturbance succession and effective conservation of biodiversity in production landscapes. However, if they are to do this effectively, they need to represent faunal, as well as vegetation, succession. We assessed the congruence between vegetation and avian succession by sampling avian communities in each state of a state-and-transition model used to inform management of post-mining restoration in a production landscape in southwestern Australia. While avian communities differed significantly among states classified as on a desirable successional pathway, they did not differ between desirable and deviated states of the same post-mining age. Overall, we concluded there was poor congruence between vegetation and avian succession in this state-and-transition model. We identified four factors that likely contributed to this lack of congruence, which were that long-term monitoring of succession in restored mine pits was not used to update and improve models, states were not defined based on ecological processes and thresholds, states were not defined by criteria that were important in structuring the avian community, and states were not based on criteria that related to values in the reference community. We believe that consideration of these four factors in the development of state-and-transition models should improve their ability to accurately represent faunal, as well as vegetation, succession. Developing state-and-transition models that better incorporate patterns of faunal succession should improve the ability to manage post-disturbance succession across a range of ecosystems for biodiversity conservation.

Proposal for new diagnostic criteria for low skeletal muscle mass based on computed tomography imaging in Asian adults.

PubMed

Hamaguchi, Yuhei; Kaido, Toshimi; Okumura, Shinya; Kobayashi, Atsushi; Hammad, Ahmed; Tamai, Yumiko; Inagaki, Nobuya; Uemoto, Shinji

2016-01-01

Low skeletal muscle, referred to as sarcopenia, has been shown to be an independent predictor of lower overall survival in various kinds of diseases. Several studies have evaluated the low skeletal muscle mass using computed tomography (CT) imaging. However, the cutoff values based on CT imaging remain undetermined in Asian populations. Preoperative plain CT imaging at the third lumbar vertebrae level was used to measure the psoas muscle mass index (PMI, cm(2)/m(2)) in 541 adult donors for living donor liver transplantation (LDLT). We analyzed PMI distribution according to sex or donor age, and determined the sex-specific cutoff values of PMI to define low skeletal muscle mass. PMI in men was significantly higher than observed in women (8.85 ± 1.61 cm(2)/m(2) versus 5.77 ± 1.21 cm(2)/m(2); P < 0.001). PMI was significantly lower in individuals ≥50 y than in younger donors in both men and women (P < 0.001 and P < 0.001, respectively). On the basis of the younger donor data, we determined the sex-specific cutoff values for the low skeletal muscle mass were 6.36 cm(2)/m(2) for men and 3.92 cm(2)/m(2) for women (mean - 2 SD). Data from healthy young Asian adults were used to establish new criteria for low skeletal muscle mass that would be applicable for defining sarcopenia in Asian populations. Copyright © 2016 Elsevier Inc. All rights reserved.

Clinical diagnostic model for sciatica developed in primary care patients with low back-related leg pain

PubMed Central

Konstantinou, Kika; Ogollah, Reuben; Hay, Elaine M.; Dunn, Kate M.

2018-01-01

Background Identification of sciatica may assist timely management but can be challenging in clinical practice. Diagnostic models to identify sciatica have mainly been developed in secondary care settings with conflicting reference standard selection. This study explores the challenges of reference standard selection and aims to ascertain which combination of clinical assessment items best identify sciatica in people seeking primary healthcare. Methods Data on 394 low back-related leg pain consulters were analysed. Potential sciatica indicators were seven clinical assessment items. Two reference standards were used: (i) high confidence sciatica clinical diagnosis; (ii) high confidence sciatica clinical diagnosis with confirmatory magnetic resonance imaging findings. Multivariable logistic regression models were produced for both reference standards. A tool predicting sciatica diagnosis in low back-related leg pain was derived. Latent class modelling explored the validity of the reference standard. Results Model (i) retained five items; model (ii) retained six items. Four items remained in both models: below knee pain, leg pain worse than back pain, positive neural tension tests and neurological deficit. Model (i) was well calibrated (p = 0.18), discrimination was area under the receiver operating characteristic curve (AUC) 0.95 (95% CI 0.93, 0.98). Model (ii) showed good discrimination (AUC 0.82; 0.78, 0.86) but poor calibration (p = 0.004). Bootstrapping revealed minimal overfitting in both models. Agreement between the two latent classes and clinical diagnosis groups defined by model (i) was substantial, and fair for model (ii). Conclusion Four clinical assessment items were common in both reference standard definitions of sciatica. A simple scoring tool for identifying sciatica was developed. These criteria could be used clinically and in research to improve accuracy of identification of this subgroup of back pain patients. PMID:29621243

Screening for phaeochromocytoma and paraganglioma: impact of using supine reference intervals for plasma metanephrines with samples collected from fasted/seated patients.

PubMed

Casey, R; Griffin, T P; Wall, D; Dennedy, M C; Bell, M; O'Shea, P M

2017-01-01

Background The Endocrine Society Clinical Practice Guideline on Phaeochomocytoma and Paraganglioma recommends phlebotomy for plasma-free metanephrines with patients fasted and supine using appropriately defined reference intervals. Studies have shown higher diagnostic sensitivities using these criteria. Further, with seated-sampling protocols, for result interpretation, reference intervals that do not compromise diagnostic sensitivity should be employed. Objective To determine the impact on diagnostic performance and financial cost of using supine reference intervals for result interpretation with our current plasma-free metanephrines fasted/seated-sampling protocol. Methods We conducted a retrospective cohort study of patients who underwent screening for PPGL using plasma-free metanephrines from 2009 to 2014 at Galway University Hospitals. Plasma-free metanephrines were measured using liquid chromatography-tandem mass spectrometry. Supine thresholds for plasma normetanephrine and metanephrine set at 610 pmol/L and 310 pmol/L, respectively, were used. Results A total of 183 patients were evaluated. Mean age of participants was 53.4 (±16.3) years. Five of 183 (2.7%) patients had histologically confirmed PPGL (males, n=4). Using seated reference intervals for plasma-free metanephrines, diagnostic sensitivity and specificity were 100% and 98.9%, respectively, with two false-positive cases. Application of reference intervals established in subjects supine and fasted to this cohort gave diagnostic sensitivity of 100% with specificity of 74.7%. Financial analysis of each pretesting strategy demonstrated cost-equivalence (€147.27/patient). Conclusion Our cost analysis, together with the evidence that fasted/supine-sampling for plasma-free metanephrines, offers more reliable exclusion of PPGL mandates changing our current practice. This study highlights the important advantages of standardized diagnostic protocols for plasma-free metanephrines to ensure the highest diagnostic accuracy for investigation of PPGL.

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.

Androgen profiling by liquid chromatography-tandem mass spectrometry (LC-MS/MS) in healthy normal-weight ovulatory and anovulatory late adolescent and young women.

PubMed

Fanelli, Flaminia; Gambineri, Alessandra; Belluomo, Ilaria; Repaci, Andrea; Di Lallo, Valentina Diana; Di Dalmazi, Guido; Mezzullo, Marco; Prontera, Olga; Cuomo, Gaia; Zanotti, Laura; Paccapelo, Alexandro; Morselli-Labate, Antonio Maria; Pagotto, Uberto; Pasquali, Renato

2013-07-01

Physiological transient imbalance typical of adolescence needs to be distinguished from hyperandrogenism-related dysfunction. The accurate determination of circulating androgens is the best indicator of hyperandrogenism. However, reliable reference intervals for adolescent and young women are not available. The aim of the study was to define androgen reference intervals in young women and to analyze the impact of the menstrual phase and ovulation efficiency over the androgen profile as assessed by reliable liquid chromatography-tandem mass spectrometry (LC-MS/MS) technique. Female high school students aged 16-19 years were included in the study. The study was performed on reference subjects properly selected among an unbiased population. Normal-weight, drug and disease free, eumenorrheic females with no signs of hyperandrogenism were included. The steroid hormone profile was determined by a validated in-house LC-MS/MS method. A statistical estimation of overall and menstrual phase-specific reference intervals was performed. A subgroup of anovulatory females was identified based on progesterone circulating levels. The impact of ovulation efficiency over hormonal profile was analyzed. A total of 159 females satisfied healthy criteria. Androgen levels did not vary according to menstrual phase, but a significantly higher upper reference limit was found for T in the luteal phase compared to the follicular phase. Higher T and androstenedione levels were observed in anovulatory compared to ovulatory females, paralleled by higher LH and FSH and lower 17-hydroxyprogesterone and 17β-estradiol levels. This is the first study providing LC-MS/MS-based, menstrual phase-specific reference intervals for the circulating androgen profile in young females. We identified a subgroup of anovulatory healthy females characterized by androgen imbalance.

Are CT scans obtained at referring institutions justified prior to transfer to a pediatric trauma center?

PubMed

Benedict, Leo Andrew; Paulus, Jessica K; Rideout, Leslie; Chwals, Walter J

2014-01-01

To assess whether pediatric trauma patients initially evaluated at referring institutions met Massachusetts statewide trauma field triage criteria for stabilization and immediate transfer to a Pediatric Trauma Center (PTC) without pre-transfer CT imaging. A 3-year retrospective cohort study was completed at our level 1 PTC. Patients with CT imaging at referring institutions were classified according to a triage scheme based on Massachusetts statewide trauma field triage criteria. Demographic data and injury profile characteristics were abstracted from patient medical records and our pediatric trauma registry. A total of 262 patients with 413 CT scans were reviewed from 2008 to 2011. 172 patients scanned (66%, 95% CI: 60%, 71%) met criteria for immediate transfer to a pediatric trauma center. Notably, 110 scans (27% of the total performed at referring institutions) were duplicated within four hours upon arrival to our PTC. GCS score <14 (45%) was the most common requirement for transfer, and CT scan of the head was the most frequent scan obtained (53%). The majority of pediatric trauma patients were subjected to CT scans at referring institutions despite meeting Massachusetts trauma triage guidelines that call for stabilization and immediate transfer to a pediatric trauma center without any CT imaging. © 2014.

Screening for basic drugs in equine urine using direct-injection differential-gradient LC-LC coupled to hybrid tandem MS/MS.

PubMed

Stanley, Shawn M R; Foo, Hsiao Ching

2006-05-19

A rapid, selective and robust direct-injection LC/hybrid tandem MS method has been developed for simultaneous screening of more than 250 basic drugs in the supernatant of enzyme hydrolysed equine urine. Analytes, trapped using a short HLB extraction column, are refocused and separated on a Sunfire C(18) analytical column using a controlled differential gradient generated by proportional dilution of the first column's eluent with water. Independent data acquisition (IDA) was configured to trigger a sensitive enhanced product ion (EPI) scan when a multiple reaction monitoring (MRM) survey scan signal exceeded the defined criteria. The decision on whether or not to report a sample as a positive result was based upon both the presence of a MRM response within the correct retention time range and a qualitative match between the EPI spectrum obtained and the corresponding reference standard. Ninety seven percent of the drugs targeted by this method met our detection criteria when spiked into urine at 100 ng/ml; 199 were found at 10 ng/ml, 83 at 1 ng/ml and 4 at 0.1 ng/ml.

Progestin treatment of atypical hyperplasia and well-differentiated adenocarcinoma of the endometrium to preserve fertility.

PubMed

Koskas, Martin; Azria, Elie; Walker, Francine; Luton, Dominique; Madelenat, Patrick; Yazbeck, Chadi

2012-03-01

To evaluate the outcome of a cohort of young women treated with progestin for fertility-sparing management of endometrial atypical hyperplasia (AH) and endometrial carcinoma (EC). This retrospective multicentre cohort study included women under the age of 40 years treated conservatively for AH and EC to preserve fertility using progestin for at least 3 months. Four inclusion criteria were defined: (i) the presence of AH or grade 1 EC confirmed by two pathologists (including a reference pathologist); (ii) the use of conservative management for fertility sparing; (iii) adequate radiological examination before conservative management; and (iv) a minimal follow-up time of one year. Twenty-two patients fulfilled the inclusion criteria (8 had EC, and 14 had AH). After progestin treatment, 17 patients responded. Among the 17 patients who experienced remission, three also experienced disease relapse. One patient initially diagnosed with AH experienced progression of her disease to stage IIIA EC. Ten pregnancies were achieved in eight patients. Fertility-sparing management using progestin offers the opportunity to fulfil maternal desires in young patients diagnosed with AH and EC. However, progression of the disease is possible and close follow-up is needed.

Pharmacotherapy of conduct disorder: Challenges, options and future directions.

PubMed

Hambly, Jessica L; Khan, Sohil; McDermott, Brett; Bor, William; Haywood, Alison

2016-10-01

There is a critical need for evaluation of the pharmacotherapies used in conduct disorder (CD), due to the high incidence of off-label prescribing. The aim of this review was to identify concerns associated with the safety, efficacy and impact on quality of life (QOL) that pharmacotherapy has in children and adolescents with CD. A systematic review was undertaken using pre-defined search criteria and four databases, including reference searches. We assessed these studies using the Strength of Recommendation Taxonomy, Grading of Recommendations Assessment, Development and Evaluation, and Review Manager Risk of Bias (RevMan®) tools. There were 12 randomised controlled trials that met our inclusion criteria. antipsychotics, atomoxetine, lithium, clonidine, divalproex sodium and psychostimulants. The antipsychotics demonstrated efficacy, but were associated with adverse effects. Other agents demonstrated mixed responses, highlighting the lack of clinical significance and increased incidence of adverse effects. The management of related adverse effects was addressed to assist with clinical gaps. Overall, there is limited evidence regarding the role of pharmacotherapy in CD. More research is needed that takes into account the heterogeneity of CD and analysis of pharmacotherapy in pure CD. © The Author(s) 2016.

Anaemia as a risk stratification tool for symptomatic patients referred via the two-week wait pathway for colorectal cancer.

PubMed

Mashlab, S; Large, P; Laing, W; Ng, O; D'Auria, M; Thurston, D; Thomson, S; Acheson, A G; Humes, D J; Banerjea, A

2018-05-01

Introduction Anaemia is associated with cancer. In 2014 a new form was introduced in our department requesting a haemoglobin (Hb) result on every two-week wait referral for suspected colorectal cancer (CRC). The aim of this study was to review the impact of this intervention. In particular, the significance of any evidence of anaemia (without additional indices) was investigated. Methods A review was conducted of 1,500 consecutive suspected CRC referrals recorded prospectively over a 10-month period. Data on demographics, referral Hb, referral criteria and outcomes were analysed. Anaemia was defined according to World Health Organization criteria (Hb <120g/l for women, Hb <130g/l for men). Results Overall, 1,015 patients were eligible for inclusion in the study. Over a third (38.2%) were documented as anaemic on referral. These patients were three times more likely to be diagnosed with CRC than non-anaemic patients (odds ratio [OR]: 3.22, 95% confidence interval [CI]: 1.87-5.57). Using a more stringent threshold (Hb <100g/l for women and <110g/l for men), they were four times more likely to have CRC (OR: 4.27, 95% CI: 2.35-7.75). Almost a quarter (23.7%) were actually anaemic at the time of referral but not referred with anaemia. In this subgroup, there was a 2.8-fold increase in risk of CRC diagnosis compared with non-anaemic patients (adjusted OR: 2.77, 95% CI: 1.55-4.95). Conclusions Nearly a quarter of patients not referred with iron deficiency anaemia had evidence of anaemia and this was still associated with a higher rate of CRC detection. A full blood count alone might help to risk stratify symptoms such as change in bowel habit in patients on urgent pathways and identify those cases most likely to benefit from invasive investigation.

JOURNAL CLUB: Plagiarism in Manuscripts Submitted to the AJR: Development of an Optimal Screening Algorithm and Management Pathways.

PubMed

Taylor, Donna B

2017-04-01

The objective of this study was to investigate the incidence of plagiarism in a sample of manuscripts submitted to the AJR using CrossCheck, develop an algorithm to identify significant plagiarism, and formulate management pathways. A sample of 110 of 1610 (6.8%) manuscripts submitted to AJR in 2014 in the categories of Original Research or Review were analyzed using CrossCheck and manual assessment. The overall similarity index (OSI), highest similarity score from a single source, whether duplication was from single or multiple origins, journal section, and presence or absence of referencing the source were recorded. The criteria outlined by the International Committee of Medical Journal Editors were the reference standard for identifying manuscripts containing plagiarism. Statistical analysis was used to develop a screening algorithm to maximize sensitivity and specificity for the detection of plagiarism. Criteria for defining the severity of plagiarism and management pathways based on the severity of the plagiarism were determined. Twelve manuscripts (10.9%) contained plagiarism. Nine had an OSI excluding quotations and references of less than 20%. In seven, the highest similarity score from a single source was less than 10%. The highest similarity score from a single source was the work of the same author or authors in nine. Common sections for duplication were the Materials and Methods, Discussion, and abstract. Referencing the original source was lacking in 11. Plagiarism was undetected at submission in five of these 12 articles; two had been accepted for publication. The most effective screening algorithm was to average the OSI including quotations and references and the highest similarity score from a single source and to submit manuscripts with an average value of more than 12% for further review. The current methods for detecting plagiarism are suboptimal. A new screening algorithm is proposed.

Anthropocene: Shifting Paradigms in Geoscience, Philosophy, History and Geopolitics

NASA Astrophysics Data System (ADS)

Maslin, M. A.; Lewis, S. L.

2015-12-01

The concept of the Anthropocene has created a profound paradigm shift within the scientific community that we argue will create equally important changes in philosophy, history and politics. There is general scientific agreement that human activity has been a geologically recent, yet profound, influence on the Earth System. The magnitude, variety and longevity of human-induced changes, to the lithosphere, hydrosphere, cryosphere, biosphere and atmosphere suggests that we should refer to the present, not as within the Holocene Epoch (as it is currently formally referred to), but instead as within the Anthropocene Epoch. Discussion is now centred on defining the start of the epoch using the fundamental principles of stratigraphy. These must include (i) a near permanent change to the Earth system that sets it on to a new trajectory and (ii) global changes to the Earth system recorded in a number of stratigraphic deposits worldwide to provide a correlative boundary event or marker called a Global Stratotype Section & Point (GSSP) or 'golden spike'. Using this framework we conclude that just two time-periods are likely adhere to the criteria. These are 1) the irreversible cross-ocean exchange of species alongside the globally synchronous coolest part of the Little Ice Age in the 17th century, marked by the 1610 minima of CO2 (Orbis Spike), and 2) the accelerating atmospheric, oceanic and terrestrial changes in the second half of the 20th century, referred to as the Great Acceleration and conveniently marked by the 1964 peak radionuclide fallout (Bomb Spike). We seek to clear up misconceptions and misunderstandings about geological criteria and relevant evidence that have crept into the literature. We also argue that there are multiple definitions of the Anthropocene and even if a formal definition of the Anthropocene Epoch is agreed by geoscientists, this would in no way invalidate other definitions or uses. It is the utility and wide appeal that makes the Anthropocene such an important concept.

Air Quality Criteria for Particulate Matter (Fourth External Review Draft) [revised Chapter 9, August 2004

EPA Science Inventory

EPA is in the process of updating and revising, where appropriate, its Air Quality Criteria for Particulate Matter (PM) as issued in 1996 (usually referred to as the Criteria Document). Sections 108 and 109 of the Clean Air Act require that EPA carry out a periodic review and re...

AIR QUALITY CRITERIA FOR PARTICULATE MATTER (FOURTH EXTERNAL REVIEW DRAFT) [REVISED CHAPTERS 7, 8, AND 9, JUNE 2004

EPA Science Inventory

EPA is in the process of updating and revising, where appropriate, its Air Quality Criteria for Particulate Matter as issued in 1996 (usually referred to as the Criteria Document). Sections 108 and 109 of the Clean Air Act require that EPA carry out a periodic review and revisio...

[Criteria for the classification as a "domestic-setting corpse"--a literature search and review to define the term].

PubMed

Merz, Marius; Birngruber, Christoph G; Heidorn, Frank; Ramsthaler, Frank; Risse, Manfred; Kreutz, Kerstin; Krähahn, Jonathan; Verhoff, Marcel A

2011-01-01

In German medical and media circles (daily routine, specialist literature, press, novels), the term "domestic-setting corpse" is frequently used, but the term is only vaguely defined. The authors thus decided to perform an in-depth study of the literature, including historic textbooks and all German- and English-language medicolegal journals, going as far back as their first issues, in an attempt to more clearly define the term. Inclusion criteria used in the search were a post-mortem interval of at least 24 hours prior to discovery and discovery of the corpse in a domestic setting. In the literature, 37 cases that complied with the above-mentioned inclusion criteria were found. These cases frequently described "advanced decomposition", often "unclear cause of death" and "problems in identification". These characteristics can thus be considered as being additional pointers in the definition. However, we suggest that the two general defining characteristics of a "domestic-setting corpse" are a post-mortem interval of more than 24 hours before discovery and the discovery of the corpse in a domestic setting.

Duplex evaluation following femoropopliteal angioplasty and stenting: criteria and utility of surveillance.

PubMed

Baril, Donald T; Marone, Luke K

2012-07-01

Surveillance following lower extremity bypass, carotid endarterectomy, and endovascular aortic aneurysm repair has become the standard of care at most institutions. Conversely, surveillance following lower extremity endovascular interventions is performed somewhat sporadically in part because the duplex criteria for recurrent stenoses have been ill defined. It appears that duplex surveillance after peripheral endovascular interventions, as with conventional bypass, is beneficial in identifying recurrent lesions which may preclude failure and occlusion. In-stent stenosis following superficial femoral artery angioplasty and stenting can be predicted by both peak systolic velocity and velocity ratio data as measured by duplex ultrasound. Duplex criteria have been defined to determine both ≥50% in-stent stenosis and ≥80% in-stent stenosis. Although not yet well studied, it appears that applying these criteria during routine surveillance may assist in preventing failure of endovascular interventions.

Towards a New Definition of Return-to-Work Outcomes in Common Mental Disorders from a Multi-Stakeholder Perspective

PubMed Central

Hees, Hiske L.; Nieuwenhuijsen, Karen; Koeter, Maarten W. J.; Bültmann, Ute; Schene, Aart H.

2012-01-01

Objectives To examine the perspectives of key stakeholders involved in the return-to-work (RTW) process regarding the definition of successful RTW outcome after sickness absence related to common mental disorders (CMD’s). Methods A mixed-method design was used: First, we used qualitative methods (focus groups, interviews) to identify a broad range of criteria important for the definition of successful RTW (N = 57). Criteria were grouped into content-related clusters. Second, we used a quantitative approach (online questionnaire) to identify, among a larger stakeholder sample (N = 178), the clusters and criteria most important for successful RTW. Results A total of 11 clusters, consisting of 52 unique criteria, were identified. In defining successful RTW, supervisors and occupational physicians regarded “Sustainability” and “At-work functioning” most important, while employees regarded “Sustainability,” “Job satisfaction,” “Work-home balance,” and “Mental Functioning” most important. Despite agreement on the importance of certain criteria, considerable differences among stakeholders were observed. Conclusions Key stakeholders vary in the aspects and criteria they regard as important when defining successful RTW after CMD-related sickness absence. Current definitions of RTW outcomes used in scientific research may not accurately reflect these key stakeholder perspectives. Future studies should be more aware of the perspective from which they aim to evaluate the effectiveness of a RTW intervention, and define their RTW outcomes accordingly. PMID:22768180

Simplified 4-item criteria for polycystic ovary syndrome: A bridge too far?

PubMed

Indran, Inthrani R; Huang, Zhongwei; Khin, Lay Wai; Chan, Jerry K Y; Viardot-Foucault, Veronique; Yong, Eu Leong

2018-05-30

Although the Rotterdam 2003 polycystic ovarian syndrome (PCOS) diagnostic criteria is widely used, the need to consider multiple variables makes it unwieldy in clinical practice. We propose a simplified PCOS criteria wherein diagnosis is made if two of the following three items were present: (i) oligomenorrhoea, (ii) anti-mullerian hormone (AMH) above threshold and/or (iii) hyperandrogenism defined as either testosterone above threshold and/or the presence of hirsutism. This prospective cross-sectional study consists of healthy women (n = 157) recruited at an annual hospital health screen for staff and volunteers from the university community, and a patient cohort (n = 174) comprising women referred for suspected PCOS. We used the healthy cohort to establish threshold values for serum testosterone, antral follicle counts (AFC), ovarian volume (OV) and AMH. Women from the patient cohort, classified as PCOS by simplified PCOS criteria, AMH alone and Rotterdam 2003, were compared with respect to prevalence of oligomenorrhoea, hyperandrogenism and metabolic indices. In healthy women, testosterone ≥1.89 nmol/L, AFC ≥22 follicles and OV ≥8.44 mL, best predicted oligomenorrhoea and were used as threshold values for PCOS criteria. An AMH level ≥37.0 pmol/L best predicted polycystic ovarian morphology. AMH alone as a single biomarker demonstrated poor specificity (58.9%) for PCOS compared to Rotterdam 2003. In contrast, there was a 94% overlap in women selected as PCOS by the simplified PCOS criteria and Rotterdam 2003. The population characteristics of these two groups of PCOS women showed no significant mean differences in androgenic, ovarian, AMH and metabolic (BMI, HOMA-IR) variables. Our data recommend the simplified PCOS criteria with population-specific thresholds for diagnosis of PCOS. Its ability to replace ovarian ultrasound biometry with the highly correlated variable AMH, and use of testosterone as a single marker for hyperandrogenaemia alongside the key symptoms of oligomenorrhoea and hirsutism confers significant clinical potential for the diagnosis of PCOS. © 2018 John Wiley & Sons Ltd.

Other- and Self-Directed Forms of Violence and Their Relationship With Number of Substance Use Disorder Criteria Among Youth Ages 12–17: Results From the National Survey on Drug Use and Health

PubMed Central

Harford, Thomas C.; Chen, Chiung M.; Grant, Bridget F.

2016-01-01

Objective: The purpose of this study was to examine the associations between the number of substance use disorder (SUD) criteria as listed in the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, and other- and self-directed forms of violence among youth ages 12–17 in the general population. Method: Data were obtained from the National Survey on Drug Use and Health pooled across survey years 2008–2013, with a combined sample of 108,560 respondents ages 12–17. Violence categories defined by suicide attempt (self-directed) and attacking someone with the intent for serious injury (other-directed) were categorized as follows: none, self-directed only, other-directed only, and combined self-/other-directed. Multinomial logistic regression estimated odds ratios of the increased number of criteria for alcohol, marijuana, and other illicit drug use, and nicotine dependence for each violence category, by controlling for sociodemographics and criminal justice involvement. Results: The multivariable model indicates that increased number of SUD criteria confers significantly higher odds for each violence category versus no violence. For combined violence versus self-directed violence, male gender, non-Hispanic Black and mixed race (with non-Hispanic White as referent), nicotine dependence, increased number of alcohol use disorder criteria, and other drug use disorder criteria have significantly higher odds, whereas Native Hawaiian/Pacific Islander and age have significantly lower odds. For combined violence versus other-directed violence, non-Hispanic mixed race and the increased number of other drug use disorder criteria have significantly higher odds, whereas male gender, non-Hispanic Black and Native Hawaiian/Pacific Islander, and Hispanic have significantly lower odds. Conclusions: The identification of the combined self-/other-directed violence in the general population provides additional support for clinical studies that established associations between self- and other-directed violent behaviors. Prevention and treatment programs need to address both instances of violence and suicidality. PMID:26997186

Valuing hydrological alteration in multi-objective water resources management

NASA Astrophysics Data System (ADS)

Bizzi, Simone; Pianosi, Francesca; Soncini-Sessa, Rodolfo

2012-11-01

SummaryThe management of water through the impoundment of rivers by dams and reservoirs is necessary to support key human activities such as hydropower production, agriculture and flood risk mitigation. Advances in multi-objective optimization techniques and ever growing computing power make it possible to design reservoir operating policies that represent Pareto-optimal tradeoffs between multiple interests. On the one hand, such optimization methods can enhance performances of commonly targeted objectives (such as hydropower production or water supply), on the other hand they risk strongly penalizing all the interests not directly (i.e. mathematically) included in the optimization algorithm. The alteration of the downstream hydrological regime is a well established cause of ecological degradation and its evaluation and rehabilitation is commonly required by recent legislation (as the Water Framework Directive in Europe). However, it is rarely embedded in reservoir optimization routines and, even when explicitly considered, the criteria adopted for its evaluation are doubted and not commonly trusted, undermining the possibility of real implementation of environmentally friendly policies. The main challenges in defining and assessing hydrological alterations are: how to define a reference state (referencing); how to define criteria upon which to build mathematical indicators of alteration (measuring); and finally how to aggregate the indicators in a single evaluation index (valuing) that can serve as objective function in the optimization problem. This paper aims to address these issues by: (i) discussing the benefits and constrains of different approaches to referencing, measuring and valuing hydrological alteration; (ii) testing two alternative indices of hydrological alteration, one based on the established framework of Indicators of Hydrological Alteration (Richter et al., 1996), and one satisfying the mathematical properties required by widely used optimization methods based on dynamic programming; (iii) demonstrating and discussing these indices by application River Ticino, in Italy; (iv) providing a framework to effectively include hydrological alteration within reservoir operation optimization.

The Health Care Financing Administration's new examination documentation criteria: minimum auditing standards for the neurologic examination to be used by Medicare and other payors. Report from the American Academy of Neurology Medical Economics and Management Subcommittee.

PubMed

Nuwer, M R; Sigsbee, B

1998-02-01

Medicare recently announced the adoption of minimum documentation criteria for the neurologic examination. These criteria are added to existing standards for the history and medical decision-making. These criteria will be used in compliance audits by Medicare and other payors. Given the current federal initiative to eliminate fraud in the Medicare program, all neurologists need to comply with these standards. These criteria are for documentation only. Neurologic standards of care require a more complex and diverse examination pertinent to the problem(s) under consideration. Further guidance as to the content of a neurologic evaluation is outlined in the article "Practice guidelines: Neurologic evaluation" (Neurology 1990; 40: 871). The level of history and examination required for specific services is defined in the American Medical Association current procedural terminology book. Documentation standards for examination of children are not yet defined.

Defining and understanding healthy lifestyles choices for adolescents.

PubMed

He, Ka; Kramer, Ellen; Houser, Robert F; Chomitz, Virginia R; Hacker, Karen A

2004-07-01

To: (a) establish criteria for defining positive health behaviors and lifestyle; and (b) identify characteristics of adolescents who practice a healthy lifestyle. Responses from a 1998 survey via questionnaire, of 1487 students, from a public high school, Cambridge, Massachusetts, were used to assess correlates of healthy lifestyle choices. Strict and broad assessments of healthy behaviors were defined for students: use of alcohol, tobacco, and illegal drugs; sexual behavior; attempted suicide. Whereas the "strict" criteria included only those adolescents who did not practice any of the behaviors in question, the broad criteria reflected experimentation and moderate risk-taking. The prevalence of positive behaviors was assessed by demographic and student characteristics. In addition, logistic regression models were created to predict determinants of teenagers' healthy lifestyles using both strict and broad definitions. Using strict criteria of healthy lifestyle, significant predictors were being female, born outside the United States, higher academic performance, and fewer stressful life events. Using a broad definition of a healthy lifestyle, significant predictors were being non-Caucasian, in the lower grade levels at the school, higher academic performance, and fewer stressful life events. In both models, peers' approval of risky behaviors negatively influenced teens' lifestyles, whereas parents' disapproval of risky behaviors was a positive influence. These results reinforce the importance of school, peer, and parent support of positive behaviors. It is important for public health workers and families to understand and define healthy lifestyles choices for adolescents.

Designing Excellence and Quality Model for Training Centers of Primary Health Care: A Delphi Method Study.

PubMed

Tabrizi, Jafar-Sadegh; Farahbakhsh, Mostafa; Shahgoli, Javad; Rahbar, Mohammad Reza; Naghavi-Behzad, Mohammad; Ahadi, Hamid-Reza; Azami-Aghdash, Saber

2015-10-01

Excellence and quality models are comprehensive methods for improving the quality of healthcare. The aim of this study was to design excellence and quality model for training centers of primary health care using Delphi method. In this study, Delphi method was used. First, comprehensive information were collected using literature review. In extracted references, 39 models were identified from 34 countries and related sub-criteria and standards were extracted from 34 models (from primary 39 models). Then primary pattern including 8 criteria, 55 sub-criteria, and 236 standards was developed as a Delphi questionnaire and evaluated in four stages by 9 specialists of health care system in Tabriz and 50 specialists from all around the country. Designed primary model (8 criteria, 55 sub-criteria, and 236 standards) were concluded with 8 criteria, 45 sub-criteria, and 192 standards after 4 stages of evaluations by specialists. Major criteria of the model are leadership, strategic and operational planning, resource management, information analysis, human resources management, process management, costumer results, and functional results, where the top score was assigned as 1000 by specialists. Functional results had the maximum score of 195 whereas planning had the minimum score of 60. Furthermore the most and the least sub-criteria was for leadership with 10 sub-criteria and strategic planning with 3 sub-criteria, respectively. The model that introduced in this research has been designed following 34 reference models of the world. This model could provide a proper frame for managers of health system in improving quality.

Defining the end-point of mastication: A conceptual model.

PubMed

Gray-Stuart, Eli M; Jones, Jim R; Bronlund, John E

2017-10-01

The great risks of swallowing are choking and aspiration of food into the lungs. Both are rare in normal functioning humans, which is remarkable given the diversity of foods and the estimated 10 million swallows performed in a lifetime. Nevertheless, it remains a major challenge to define the food properties that are necessary to ensure a safe swallow. Here, the mouth is viewed as a well-controlled processor where mechanical sensory assessment occurs throughout the occlusion-circulation cycle of mastication. Swallowing is a subsequent action. It is proposed here that, during mastication, temporal maps of interfacial property data are generated, which the central nervous system compares against a series of criteria in order to be sure that the bolus is safe to swallow. To determine these criteria, an engineering hazard analysis tool, alongside an understanding of fluid and particle mechanics, is used to deduce the mechanisms by which food may deposit or become stranded during swallowing. These mechanisms define the food properties that must be avoided. By inverting the thinking, from hazards to ensuring safety, six criteria arise which are necessary for a safe-to-swallow bolus. A new conceptual model is proposed to define when food is safe to swallow during mastication. This significantly advances earlier mouth models. The conceptual model proposed in this work provides a framework of decision-making to define when food is safe to swallow. This will be of interest to designers of dietary foods, foods for dysphagia sufferers and will aid the further development of mastication robots for preparation of artificial boluses for digestion research. It enables food designers to influence the swallow-point properties of their products. For example, a product may be designed to satisfy five of the criteria for a safe-to-swallow bolus, which means the sixth criterion and its attendant food properties define the swallow-point. Alongside other organoleptic factors, these properties define the end-point texture and enduring sensory perception of the food. © 2017 Wiley Periodicals, Inc.

78 FR 42140 - Self-Regulatory Organizations; National Securities Clearing Corporation; Notice of Filing...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-15

...\\ 17 CFR 240.19b-4. \\9\\ Defined terms that are not defined in this notice are defined in Amended... the Member, subject to satisfaction of reasonable lender criteria.\\12\\ NSCC states that this... Member's Special Activity Peak Liquidity Exposure (as defined) is less than or equal to NSCC's other...

Apnea in the term infant.

PubMed

Patrinos, Mary Elaine; Martin, Richard J

2017-08-01

Whereas apnea of prematurity has been well defined and its pathophysiology extensively studied, apnea in the term infant remains a greater challenge. Unfortunately, clear diagnostic criteria are lacking and pathogenesis and management vary widely. In this review we have arbitrarily organized the discussion chronologically into earlier and later postnatal periods. In the first days of life, presumed apnea may reflect physiologic events such as positional or feeding etiologies, or may be a manifestation of serious pathophysiology, such as a seizure disorder. Beyond the neonatal period, presumed apnea may be characterized as a BRUE event (brief resolved unexplained event; formerly referred to as ALTE: apparent life-threatening event) and most frequently a precipitating event cannot be identified. Medical providers are left with somewhat of a dilemma regarding the need to hospitalize and/or work up such patients. Copyright © 2017 Elsevier Ltd. All rights reserved.

GIS-Based Suitability Model for Assessment of Forest Biomass Energy Potential in a Region of Portugal

NASA Astrophysics Data System (ADS)

Quinta-Nova, Luis; Fernandez, Paulo; Pedro, Nuno

2017-12-01

This work focuses on developed a decision support system based on multicriteria spatial analysis to assess the potential for generation of biomass residues from forestry sources in a region of Portugal (Beira Baixa). A set of environmental, economic and social criteria was defined, evaluated and weighted in the context of Saaty’s analytic hierarchies. The best alternatives were obtained after applying Analytic Hierarchy Process (AHP). The model was applied to the central region of Portugal where forest and agriculture are the most representative land uses. Finally, sensitivity analysis of the set of factors and their associated weights was performed to test the robustness of the model. The proposed evaluation model provides a valuable reference for decision makers in establishing a standardized means of selecting the optimal location for new biomass plants.

Percentile curves for body fatness and cut-offs to define malnutrition in Russians

NASA Astrophysics Data System (ADS)

Nikolaev, D. V.; Rudnev, S. G.; Starunova, O. A.; Eryukova, T. A.; Kolesnikov, V. A.; Ponomareva, E. G.; Soboleva, N. P.; Sterlikov, S. A.

2013-04-01

Here, we report first results of the large-scale ongoing bioelectrical impedance body composition study in Russians. By the end of 2012, 216 out of 800 Russian Health Centres submitted raw bioimpedance data on 844,221 adults and children aged 5-80 years, representing nearly 0.6% of the Russian population, who were accessed cross-sectionally using the same type of bioimpedance meter, ABC-01 Medas. Estimates of overweight, obesity, and normal weight obesity prevalence in the general population, as well as characteristics of diagnostic sensitivity and specificity of the conventional WHO BMI-based criteria of obesity depending on age are obtained. The smoothed reference centile curves for percentage fat mass are constructed, and localized cut-offs for fatness and thinness are provided that can be used both at the individual and epidemiological levels.

Do the diagnostic criteria for subclinical hypercortisolism exist?

PubMed

Tabarin, Antoine

2018-06-01

"Subclinical hypercortisolism" (SH) refers to a condition associated with a mild chronic increase in cortisol secretion. By definition, patients with SH do not exhibit specific symptoms of overt Cushing's syndrome (such as purple striae, easy bruising, proximal muscle weakness), SH has been preferred to "subclinical Cushing's syndrome", a semantic ambiguity since Cushing's syndrome is, by definition, a set of symptoms; and to the term "preclinical Cushing syndrome" because the progression toward overt clinical hypercortisolism is very rare. However, SH still is misnomer as a number of studies suggest that this condition may induce long-term non-specific adverse conditions related to the mild cortisol excess (i.e. diabetes, hypertension, obesity, and osteoporosis). Various attempts have been made to define SH that remains a matter of controversies and uncertainties. Copyright © 2018. Published by Elsevier Masson SAS.

Development and evaluation of habitat suitability criteria for use in the instream flow incremental methodology

USGS Publications Warehouse

Bovee, Ken D.

1986-01-01

The Instream Flow Incremental Methodology (IFIM) is a habitat-based tool used to evaluate the environmental consequences of various water and land use practices. As such, knowledge about the conditions that provide favorable habitat for a species, and those that do not, is necessary for successful implementation of the methodology. In the context of IFIM, this knowledge is defined as habitat suitability criteria: characteristic behavioral traits of a species that are established as standards for comparison in the decision-making process. Habitat suitability criteria may be expressed in a variety of types and formats. The type, or category, refers to the procedure used to develop the criteria. Category I criteria are based on professional judgment, with little or no empirical data. Category II criteria have as their source, microhabitat data collected at locations where target organisms are observed or collected. These are called “utilization” functions because they are based on observed locations that were used by the target organism. These functions tend to be biased by the environmental conditions that were available to the fish or invertebrates at the time they were observed. Correction of the utilization function for environmental availability creates category III, or “preference” criteria, which tend to be much less site specific than category II criteria. There are also several ways to express habitat suitability in graphical form. The binary format establishes a suitable range for each variable as it pertains to a life stage of interest, and is presented graphically as a step function. The quality rating for a variable is 1.0 if it falls within the range of the criteria, and 0.0 if it falls outside the range. The univariate curve format established both the usable range and the optimum range for each variable, with conditions of intermediate usability expressed along the portion between the tails and the peak of the curve. Multivariate probability density functions, which can be used to compute suitability for several variables simultaneously, are conveyed as three dimensional figures with suitability on the z-axis, and two independent variables on the x-y plane. These functions are useful for incorporating interactive terms between two or more variable. Such interactions can also be demonstrated using conditional criteria, which are stratified by cover type or substrate size. Conditional criteria may be of any category or format, but are distinguishable by two or more sets of functional relationships for each life stage.

Incidence of rheumatoid arthritis, psoriatic arthritis and polymyalgia rheumatica in an inland area of central Italy: results of the CAMPO-RHE study.

PubMed

De Socio, Antonia; Perrotta, Fabio Massimo; Grasso, Guido Maria; Lubrano, Ennio

2018-01-01

The aim of the CAMPO-RHE study was to determine the incidence of rheumatoid arthritis (RA), psoriatic arthritis (PsA) and polymyalgia rheumatica (PMR) in patients attending a rheumatologic outpatient's clinic of a new institution in Campobasso, Italy. Campobasso is a small town of approximately 50,000 inhabitants located in the inland territory of central Italy (Molise), and Public Health is managed from a single health authority. In Italy, all citizens are registered with a National Health System of General Practitioner (GP) Physicians. Between the 1 st of June 2014 and the 31 st of May 2016, all consecutive adult patients, sent by a GP, of Campobasso with any diagnosis of musculoskeletal symptoms/signs/complaints were evaluated in a single rheumatology outpatient clinic of our Academic Unit. The clinic represents the first and unique reference for GPs about rheumatic diseases in the territory. Subjects were classified using the 2010 EULAR criteria for RA, the CASPAR criteria for PsA and the 2012 ACR classification criteria for PMR. 1003 adult patients, sent by GPs, with articular or musculoskeletal complaints visited our clinic. Of these, 409 inhabitants of the municipality of Campobasso were evaluated for the study. During the 2-year study period we diagnosed 18, 19 and 12 new cases of RA, PsA and PMR respectively, with a new incident cases rate of 21.4, 22.59 and 27.43/100,000/year on the population at risk. The results of our study could contribute to better define the incidence of these rheumatic diseases classified with the new classification criteria.

[Improvement in health care quality for patients from the thoracic/chest pain unit in a regional hospital].

PubMed

Castellano Ortega, M A; Romero de Castilla, R J; Rus Mansilla, C; Cortez Quiroga, G A; Bayona Gómez, A J; Duran Torralba, M C

2011-01-01

The evaluation of an improvement cycle in patients suffering thoracic/chest pain in hospital emergencies, especially in those who could benefit from the early Bruce Treadmill Test. A multidisciplinary group care protocol was designed, which identified improvement opportunities and gave priority to the fact that «an early Bruce Treadmill Test was carried out on fewer occasions than recommended». Causes were analysed (Ishikawa diagram) and six quality criteria were defined. These criteria were evaluated in a random sample of 30 patients out of the total of 180 who used the ergometer at the Hospital in the first six months of 2007, as well as questionnaire for the doctors. Corrective measures were introduced: circulation, accessibility through intranet and explicit information for new employees (doctors). The second evaluation was carried out during the first six-months of 2008 using another random sample of 30 patients from a total of 120. In the first evaluation, the classification of the risk according to the protocol was very low (100% non-compliance) and patients whose admission to the Chest Pain Unit was recommended and an early Bruce Treadmill Test (74% criteria failure) were referred to cardiology clinics. After implementation of the corrective measures, we obtain a general improvement in all the criteria, but very significant from the previous ones, with non-compliances being reduced to 17% in classification and to the 23% in referrals. The structured cycle has helped resolve the priority problem in the short-term. The adopted measures have mainly been organisational, dependent on the professionals involved, and at a very low cost. Simple but organised methodological approaches should be taken into account before the incorporation of higher cost technologies. Copyright © 2010 SECA. Published by Elsevier Espana. All rights reserved.

Air Quality Criteria for Particulate Matter (Fourth External Review Draft) [revised Drafts of Chapters 7 and 8, December 2003

EPA Science Inventory

EPA is in the process of updating and revising, where appropriate, its Air Quality Criteria for Particulate Matter as issued in 1996 (usually referred to as the Criteria Document). Sections 108 and 109 of the Clean Air Act require that EPA carry out a periodic review an...

An approach to developing numeric water quality criteria for coastal waters using the SeaWiFS Satellite Data Record.

PubMed

Schaeffer, Blake A; Hagy, James D; Conmy, Robyn N; Lehrter, John C; Stumpf, Richard P

2012-01-17

Human activities on land increase nutrient loads to coastal waters, which can increase phytoplankton production and biomass and associated ecological impacts. Numeric nutrient water quality standards are needed to protect coastal waters from eutrophication impacts. The Environmental Protection Agency determined that numeric nutrient criteria were necessary to protect designated uses of Florida's waters. The objective of this study was to evaluate a reference condition approach for developing numeric water quality criteria for coastal waters, using data from Florida. Florida's coastal waters have not been monitored comprehensively via field sampling to support numeric criteria development. However, satellite remote sensing had the potential to provide adequate data. Spatial and temporal measures of SeaWiFS OC4 chlorophyll-a (Chl(RS)-a, mg m(-3)) were resolved across Florida's coastal waters between 1997 and 2010 and compared with in situ measurements. Statistical distributions of Chl(RS)-a were evaluated to determine a quantitative reference baseline. A binomial approach was implemented to consider how new data could be assessed against the criteria. The proposed satellite remote sensing approach to derive numeric criteria may be generally applicable to other coastal waters.

An Approach to Developing Numeric Water Quality Criteria for Coastal Waters Using the SeaWiFS Satellite Data Record

PubMed Central

2011-01-01

Human activities on land increase nutrient loads to coastal waters, which can increase phytoplankton production and biomass and associated ecological impacts. Numeric nutrient water quality standards are needed to protect coastal waters from eutrophication impacts. The Environmental Protection Agency determined that numeric nutrient criteria were necessary to protect designated uses of Florida’s waters. The objective of this study was to evaluate a reference condition approach for developing numeric water quality criteria for coastal waters, using data from Florida. Florida’s coastal waters have not been monitored comprehensively via field sampling to support numeric criteria development. However, satellite remote sensing had the potential to provide adequate data. Spatial and temporal measures of SeaWiFS OC4 chlorophyll-a (ChlRS-a, mg m–3) were resolved across Florida’s coastal waters between 1997 and 2010 and compared with in situ measurements. Statistical distributions of ChlRS-a were evaluated to determine a quantitative reference baseline. A binomial approach was implemented to consider how new data could be assessed against the criteria. The proposed satellite remote sensing approach to derive numeric criteria may be generally applicable to other coastal waters. PMID:22192062

Definition of frailty in older men according to questionnaire data (RAND-36/SF-36): The Helsinki Businessmen Study.

PubMed

Sirola, J; Pitkala, K H; Tilvis, R S; Miettinen, T A; Strandberg, T E

2011-11-01

To explore the association of frailty according to questionnaire data (modified Fried criteria) with important endpoints in older men. Prospective cohort study (the Helsinki Businessmen Study) in Finland. In 1974, clinically healthy men (born 1919-1934, n=1815) of similar socioeconomic status were identified. After a 26-year follow-up in 2000 (mean age 73 years), disease prevalence, mobility-disability, and frailty status (80.9% of survivors, n=1125) were appraised using a postal questionnaire including RAND-36. Four criteria were used for definition: 1) >5% weight loss from midlife, or body mass index (BMI) <21 kg/m2; 2) reported physical inactivity; 3) low vitality (RAND-36); 4) physical weakness (RAND-36). Responders with 3-4, 1-2, and zero criteria were classified as frail (n=108), prefrail (n=567), and nonfrail (n=450), respectively. Eight-year mortality was assessed from registers, and in 2007, survivors were re-assessed with questionnaires. Nonfrail as referent and adjusted for age, BMI and smoking, both prefrail (HR 2.26; 95% CI, 1.57-3.26), and frail status (4.09; 95% CI, 2.60-6.44) were significant predictors of mortality. Nonfrailty predicted better survival independently of the frailty components, diseases, and disability, and also predicted faster walking speed and less disability 7 years later. Frailty, and also prefrailty, as defined using questionnaire data (RAND-36) independently predicted important endpoints in older men.

Serum biomarkers are similar in Churg-Strauss syndrome and hypereosinophilic syndrome

PubMed Central

Khoury, Paneez; Zagallo, Patricia; Talar-Williams, Cheryl; Santos, Carlo S.; Dinerman, Ellen; Holland, Nicole C.; Klion, Amy D.

2012-01-01

Rationale Churg-Strauss syndrome (CSS) and hypereosinophilic syndrome (HES) overlap considerably in clinical presentation. A reliable means of distinguishing between these groups of patients is needed, especially in the setting of glucocorticoid therapy. Methods A retrospective chart review of 276 adult subjects referred for evaluation of eosinophilia >1500/μl was performed, and subjects with a documented secondary cause of eosinophilia or a PDGFR-positive myeloproliferative neoplasm were excluded. The remaining subjects were assessed for the presence of American College of Rheumatology (ACR) criteria. Laboratory and clinical parameters were compared between subjects with biopsy-proven vasculitis (CSS; n=8), ≥4 ACR criteria (probable CSS; n=21), HES with asthma and/or sinusitis without other CSS-defining criteria (HESwAS; n=20), HES without asthma or sinusitis (HES; n=18), and normal controls (n=8). Serum biomarkers reported to be associated with CSS were measured using standard techniques. Results There were no differences between the subjects with definite or probable CSS or HES with respect to age, gender, or maintenance steroid dose. Serum CCL17, IL-8 and eotaxin levels were significantly increased in eosinophilic subjects as compared to normal controls, but were similar between the eosinophilic groups. Serum CCL17 correlated with eosinophil count (p<0.0001, r=0.73), but not with prednisone dose. Conclusions In patients with a history of asthma and sinusitis, distinguishing between ANCA-negative CSS and PDGFR-negative HES is difficult due to significant overlap in clinical presentation and biomarker profiles. PMID:22775568

Criteria for High Quality Biology Teaching: An Analysis

ERIC Educational Resources Information Center

Tasci, Guntay

2015-01-01

This study aims to analyze the process under which biology lessons are taught in terms of teaching quality criteria (TQC). Teaching quality is defined as the properties of efficient teaching and is considered to be the criteria used to measure teaching quality both in general and specific to a field. The data were collected through classroom…

2011 Information Systems Summit 2

DTIC Science & Technology

2011-04-06

to automate. Some criteria that should be considered: – Are the tests easy to automate? What makes a test easy to automate is the ability to script...ANSI-748-B defines 32 criteria needs for a FAR/DFAR compliant Earned Value Management System. These criteria address 5 areas of Earned Value...are the basis of Increasing the Probability of Success of any program. But there are 11 critical criteria that must be present not matter what

11 CFR 109.21 - What is a “coordinated communication”?

Code of Federal Regulations, 2012 CFR

2012-01-01

... 100.29. (2) A public communication, as defined in 11 CFR 100.26, that disseminates, distributes, or... public communication, as defined in 11 CFR 100.26, that expressly advocates, as defined in 11 CFR 100.22... section: (i) References to House and Senate candidates. The public communication refers to a clearly...

11 CFR 109.21 - What is a “coordinated communication”?

Code of Federal Regulations, 2014 CFR

2014-01-01

... 100.29. (2) A public communication, as defined in 11 CFR 100.26, that disseminates, distributes, or... public communication, as defined in 11 CFR 100.26, that expressly advocates, as defined in 11 CFR 100.22... section: (i) References to House and Senate candidates. The public communication refers to a clearly...

11 CFR 109.21 - What is a “coordinated communication”?

Code of Federal Regulations, 2011 CFR

2011-01-01

... 100.29. (2) A public communication, as defined in 11 CFR 100.26, that disseminates, distributes, or... public communication, as defined in 11 CFR 100.26, that expressly advocates, as defined in 11 CFR 100.22... section: (i) References to House and Senate candidates. The public communication refers to a clearly...

11 CFR 109.21 - What is a “coordinated communication”?

Code of Federal Regulations, 2013 CFR

2013-01-01

... 100.29. (2) A public communication, as defined in 11 CFR 100.26, that disseminates, distributes, or... public communication, as defined in 11 CFR 100.26, that expressly advocates, as defined in 11 CFR 100.22... section: (i) References to House and Senate candidates. The public communication refers to a clearly...

[Radicalism and feminism: The case of Poulain de la Barre].

PubMed

Pellegrin, Marie-Frédérique

2015-12-01

Early modern radicalism and its criteria are described and defined by Jonathan Israel in various works. Poulain de la Barre, one of the first modern feminist thinkers, first is used by Israel as an example of the so-called radical Enlightenment and finally is rejected as such. This case study exhibed the necessity of questionning the coherence of the required criteria for defining a « radical » thinker, especially when examinating carefully the last paragraph of Spinoza's Political Treatise.

Controversy in clinical endocrinology: diagnosis of polycystic ovarian syndrome: the Rotterdam criteria are premature.

PubMed

Azziz, Ricardo

2006-03-01

Polycystic ovary syndrome (PCOS) is defined most commonly according to the proceedings of an expert conference sponsored by the National Institutes of Health (NIH) in April 1990, which noted the disorder as having 1) hyperandrogenism and/or hyperandrogenemia, 2) oligoovulation, and 3) exclusion of known disorders. Alternatively, another expert conference held in Rotterdam in May 2003 defined PCOS, after the exclusion of related disorders, by two of the following three features: 1) oligo- or anovulation, 2) clinical and/or biochemical signs of hyperandrogenism, or 3) polycystic ovaries. In essence, the Rotterdam 2003 expanded the NIH 1990 definition creating two new phenotypes: 1) ovulatory women with polycystic ovaries and hyperandrogenism, and 2) oligoanovulatory women with polycystic ovaries, but without hyperandrogenism. The objective of this study was to ascertain the validity of using the Rotterdam 2003 criteria rather than the NIH 1991 criteria for the diagnosis of PCOS. Interventions included the use of the Rotterdam 2003 criteria for diagnosing PCOS and, in particular, the proposal to define two new phenotypes as PCOS. POSITIONS: Available data suggest that hyperandrogenic ovulatory women with polycystic ovaries tend to have mild insulin resistance and mild evidence of ovarian dysfunction, although significantly less than women with anovulatory PCOS. However, whether these women will have an increased risk of infertility or metabolic complications, such as type 2 diabetes, remains to be determined. Alternatively, the risk of insulin resistance and long-term metabolic risks of oligoovulatory women with polycystic ovaries is even less well characterized and may be nonexistent. Because of the paucity of data on the two new phenotypes and their long-term implications and the potential negative impact on research, clinical practice, and patient insurability, the adoption of the Rotterdam 2003 criteria for defining PCOS should be considered premature. However, because polycystic ovaries are a frequent feature of PCOS, a modification of the NIH 1990 criteria is proposed. Additional research characterizing the phenotypes and associated morbidities of PCOS is urgently required.

76 FR 16712 - Participation by Religious Organizations in USAID Programs

Federal Register 2010, 2011, 2012, 2013, 2014

2011-03-25

... are defined without reference to religion, (iii) has the effect of furthering a development objective... available to a wide range of organizations and beneficiaries which are defined without reference to religion...

Comparing extracorporeal cardiopulmonary resuscitation with conventional cardiopulmonary resuscitation: A meta-analysis.

PubMed

Kim, Su Jin; Kim, Hyun Jung; Lee, Hee Young; Ahn, Hyeong Sik; Lee, Sung Woo

2016-06-01

The objective was to determine whether extracorporeal cardiopulmonary resuscitation (ECPR), when compared with conventional cardiopulmonary resuscitation (CCPR), improves outcomes in adult patients, and to determine appropriate conditions that can predict good survival outcome in ECPR patients through a meta-analysis. We searched the relevant literature of comparative studies between ECPR and CCPR in adults, from the MEDLINE, EMBASE, and Cochrane databases. The baseline information and outcome data (survival, good neurologic outcome at discharge, at 3-6 months, and at 1 year after arrest) were extracted. Beneficial effect of ECPR on outcome was analyzed according to time interval, location of arrest (out-of-hospital cardiac arrest (OHCA) and in-hospital cardiac arrest (IHCA)), and pre-defined population inclusion criteria (witnessed arrest, initial shockable rhythm, cardiac etiology of arrest and CPR duration) by using Review Manager 5.3. Cochran's Q test and I(2) were calculated. 10 of 1583 publications were included. Although survival to discharge did not show clear superiority in OHCA, ECPR showed statistically improved survival and good neurologic outcome as compared to CCPR, especially at 3-6 months after arrest. In the subgroup of patients with pre-defined inclusion criteria, the pooled meta-analysis found similar results in studies with pre-defined criteria. Survival and good neurologic outcome tended to be superior in the ECPR group at 3-6 months after arrest. The effect of ECPR on survival to discharge in OHCA was not clearly shown. As ECPR showed better outcomes than CCPR in studies with pre-defined criteria, strict indications criteria should be considered when implementation of ECPR. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Behçet's disease departs the 'Silk Road': a case report and brief review of literature with geographical comparison.

PubMed

Ahmed, Zohair; Rossi, Maria L; Yong, Sherri; Martin, Daniel K; Walayat, Saqib; Cashman, Michael; Tsoraides, Steven; Dhillon, Sonu

2016-01-01

Behçet's disease (BD) is a chronic multisystem inflammatory disease most prevalent in Eastern Asia and along the Mediterranean basin, an area referred to as the 'Silk Road'. The diagnosis of BD is largely based on the International Study Group (ISG) criteria, which are more specific than sensitive. ISG criteria do not include intestinal manifestations, a feature more commonly seen in the West. Intestinal BD is one of several findings that are not typically seen along the 'Silk Road'. Herein we report a rare case of intestinal BD and compare Western versus traditional BD. A 25-year-old male with a history of painful oral aphthous ulcers, pericarditis, and diffuse papulopustular rash presented to the emergency department with two terminal ileal perforations. Pathology demonstrated mucosal necrosis with active inflammation and no chronic inflammatory changes. Post-surgical laboratory studies showed an elevated c-reactive protein of 35.57 mg/dL, erythrocyte sedimentation rate of 82 mm/h, and a positive anti-Saccharomyces cerevisiae antibody. Rheumatological workup including ANA, RF, PR3 antibody, MPO antibody, ANCA, SSA and SSB, Smith antibody, SCL-70, and anti-Jo-1 antibodies were all negative. His pericarditis symptoms improved with colchicine and prednisone prior to discharge. Our patient did not meet the current ISG criteria for traditional BD; however, he clearly showed findings typically seen in Western patients with BD, which include intestinal manifestations, cardiac involvement, and lack of pathergy reaction and ocular changes. Our investigation demonstrates that the clinical manifestations common to this disorder vary among geographic and ethnic populations. Commonly used criteria for the diagnosis of BD may not be sensitive for some populations, such as Western BD, potentially leading to underdiagnoses and mismanagement. Recognition and select inclusion of these differences may be one way to assist with diagnosing Western BD in the future. As our knowledge of BD continues to evolve, so must the population-specific criteria used to define BD.

78 FR 40000 - Method for the Determination of Lead in Total Suspended Particulate Matter

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-03

.... Purpose of the New Reference Method B. Rationale for Selection of the New Reference Method C. Comments on.../files/ambient/criteria/reference-equivalent-methods-list.pdf . C. Comments on the Proposed Rule On... information collection requirements beyond those imposed by the existing Pb monitoring requirements. C...

Comparison and validation of International Consensus Diagnostic Criteria for diagnosis of autoimmune pancreatitis from pancreatic cancer in a Taiwanese cohort.

PubMed

Chang, Ming-Chu; Liang, Po-Chin; Jan, I-Shiow; Yang, Ching-Yao; Tien, Yu-Wen; Wei, Shu-Chen; Wong, Jau-Min; Chang, Yu-Ting

2014-08-18

The International Consensus Diagnostic Criteria (ICDC) designed to diagnosis autoimmune pancreatitis (AIP) has been proposed recently. The diagnostic performance of ICDC has not been previously evaluated in diffuse-type and focal-type AIP, respectively, in comparison with the revised HISORt and Asian criteria in Taiwan. Prospective, consecutive patient cohort. Largest tertiary referred centre hospital managing pancreatic disease in Taiwan. 188 patients with AIP and 130 with tissue proofed pancreatic adenocarcinoma were consecutively recruited. The ICDC, as well as revised HISORt and Asian criteria, was applied for each participant. Each diagnostic criterion of ICDC was validated with special reference to levels 1 and 2 in diffuse-type and focal-type AIP. Sensitivity, specificity and accuracy. Each diagnostic criterion of ICDC was validated with special reference to levels 1 and 2 in AIP and focal-type AIP. The sensitivity, specificity and accuracy of ICDC for all AIP were the best: 89.4%, 100% and 93.7%, respectively, in these three criteria. The sensitivity, specificity and accuracy of ICDC for focal-type AIP (84.9%, 100% and 93.8%) were also the best among these three criteria. The area under the curve of receiver-operator characteristic of ICDC was 0.95 (95% CI 0.92 to 0.97) in all AIP and 0.93 (95% CI 0.88 to 0.97) in focal-type AIP. The sensitivity, specificity and accuracy of ICDC are higher than the revised HISORt and Asian criteria. The sensitivity, specificity and accuracy of each criterion are higher in diffuse-type AIP compared with focal-type AIP. Under the same specificity, the sensitivity and accuracy of ICDC are higher than other diagnostic criteria in focal-type AIP. ICDC has better diagnostic performance compared with previously proposed diagnostic criteria in diffuse-type and focal-type AIP. 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.

[Proposal for the classification of the periprosthetic membrane from loosened hip and knee endoprostheses].

PubMed

Morawietz, L; Gehrke, Th; Classen, R-A; Barden, B; Otto, M; Hansen, T; Aigner, Th; Stiehl, P; Neidel, J; Schröder, J H; Frommelt, L; Schubert, Th; Meyer-Scholten, C; König, A; Ströbel, Ph; Rader, Ch P; Kirschner, S; Lintner, F; Rüther, W; Skwara, A; Bos, I; Kriegsmann, J; Krenn, V

2004-09-01

After 10 years, loosening of total joint endoprostheses occurs in about 3 to 10 percent of all patients, requiring elaborate revision surgery. A periprosthetic membrane is routinely found between bone and loosened prosthesis. Further histomorphological examination allows determination of the etiology of the loosening process. Aim of this study is the introduction of clearly defined histopathological criteria for a standardized evaluation of the periprosthetic membrane. Based on histomorphological criteria and polarized light microscopy, four types of the periprosthetic membrane were defined: periprosthetic membrane of wear particle type (type I), periprosthetic membrane of infectious type (type II), periprosthetic membrane of combined type (type III), periprosthetic membrane of indifferent type (type IV). Periprosthetic membranes of 268 patients were analyzed according to the defined criteria. The correlation between histopathological and microbiological diagnosis was high (89%, p<0,001), the inter-observer reproducibility was sufficient (95%). This classification system enables a standardized diagnostic procedure and therefore is a basis for further studies concerning the etiology of and pathogenesis of prosthesis loosening.

Can we trust cancer information on the Internet?--A comparison of interactive cancer risk sites.

PubMed

Ekman, Alexandra; Hall, Per; Litton, Jan-Eric

2005-08-01

To investigate the prevalence and quality of interactive cancer risk sites on the Internet. A cancer risk site was defined as a website that gave an estimate of the individual risk of developing cancer. Six search engines and one Meta crawler were used to search the Internet for cancer risk sites (including breast, prostate, colon, and lung cancer). A set of defined quality criteria for health related websites was used to evaluate the websites during 2001 and 2002. The number of cancer risk sites, as defined above, increased by 50% between 2001 and 2002. Only two out of 22 cancer risk sites fulfilled the quality criteria adequately. No signs of a change in trend (with regard to the quality criteria met) were noted in January 2005. The overall quality of the documentation on the cancer risk sites was poor and no improvement was seen during the study period. The majority of the cancer risk sites do not give reliable risk estimates.

From the experience of development of composite materials with desired properties

NASA Astrophysics Data System (ADS)

Garkina, I. A.; Danilov, A. M.

2017-04-01

Using the experience in the development of composite materials with desired properties is given the algorithm of construction materials synthesis on the basis of their representation in the form of a complex system. The possibility of creation of a composite and implementation of the technical task originally are defined at a stage of cognitive modeling. On the basis of development of the cognitive map hierarchical structures of criteria of quality are defined; according to them for each allocated large-scale level the corresponding block diagrams of system are specified. On the basis of the solution of problems of one-criteria optimization with use of the found optimum values formalization of a multi-criteria task and its decision is carried out (the optimum organization and properties of system are defined). The emphasis is on methodological aspects of mathematical modeling (construction of a generalized and partial models to optimize the properties and structure of materials, including those based on the concept of systemic homeostasis).

Air Quality Criteria for Lead (First External Review Draft)

EPA Science Inventory

Background:

The Clean Air Act mandates periodic review of the National Ambient Air Quality Standards (NAAQS) for six common air pollutants, also referred to as criteria pollutants, including lead. Under the review process, EPA's Office of Research and Development d...

Language-Related Criteria as Determinants of Ethnicity. Goals and Results of a Feasibility Study in the Netherlands.

ERIC Educational Resources Information Center

Broeder, Peter; And Others

This paper addresses the potential value of language-related criteria for use in identifying ethnic minorities in the Netherlands. A description of the way the Dutch government defines ethnic minority groups is followed by a comparative outline of the use of language-related criteria in countries with a longer tradition of immigration (Australia,…

[Recognizing and defining dying. Analysis of end-of-life coverage in German nursing textbooks].

PubMed

Pleschberger, Sabine; Hornek, Alexandra

2011-08-01

Text books play an important role in basic education in nursing. This study aimed at capturing the extent and content of end-of-life issues in nursing text books in German language. For that reason, a quantitative and a qualitative analysis of relevant content in a comprehensive sample of nursing text books available (n = 65) were conducted. Whereas 29.2 % of the books do not cover the issue at all, 44.5 % dedicate a separate chapter to the issue of dying, which accounts for 1.34 % of all pages on average. Of all specialties, both surgery and internal medicine feature the lowest, and paediatrics and oncology the highest share of coverage. 41.53 % of all text books studied contain a definition of the term dying which is based on a great variety of approaches. 23 books list criteria that define the recognition of dying, 21 of which draw attention to symptoms of impending death. 84 % of the books refer to the work of Elisabeth Kübler-Ross. Overall, the amount of coverage of the issue of dying in nursing text books can be considered marginal by international comparison. What is problematic is the conceptual reduction to physiological signs of impending death and the lack of references to existing theoretical work. Integration of knowledge from the area of palliative care in all specialties is strongly needed. Additionally, there is a need for a stronger conceptual debate in order to avoid problems in communication about death and dying in nursing education and practice.

Revisiting the taxonomical classification of Porcine Circovirus type 2 (PCV2): still a real challenge.

PubMed

Franzo, Giovanni; Cortey, Martí; Olvera, Alex; Novosel, Dinko; Castro, Alessandra Marnie Martins Gomes De; Biagini, Philippe; Segalés, Joaquim; Drigo, Michele

2015-08-28

PCV2 has emerged as one of the most devastating viral infections of swine farming, causing a relevant economic impact due to direct losses and control strategies expenses. Epidemiological and experimental studies have evidenced that genetic diversity is potentially affecting the virulence of PVC2. The growing number of PCV2 complete genomes and partial sequences available at GenBank questioned the accepted PCV2 classification. Nine hundred seventy five PCV2 complete genomes and 1,270 ORF2 sequences available from GenBank were subjected to recombination, PASC and phylogenetic analyses and results were used for comparison with previous classification scheme. The outcome of these analyses favors the recognition of four genotypes on the basis of ORF2 sequences, namely PCV2a, PCV2b, PCV2c and PCV2d-mPCV2b. To deal with the difficulty of founding an unambiguous classification and accounting the impossibility to define a p-distance cut-off, a set of reference sequences that could be used in further phylogenetic studies for PCV2 genotyping was established. Being aware that extensive phylogenetic analyses are time-consuming and often impracticable during routine diagnostic activity, ORF2 nucleotide positions adequately conserved in the reference sequences were identified and reported to allow a quick genotype differentiation. Globally, the present work provides an updated scenario of PCV2 genotypes distribution and, based on the limits of the previous classification criteria, proposes new rapid and effective schemes for differentiating the four defined PCV2 genotypes.

Data Verification Tools for Minimizing Management Costs of Dense Air-Quality Monitoring Networks.

PubMed

Miskell, Georgia; Salmond, Jennifer; Alavi-Shoshtari, Maryam; Bart, Mark; Ainslie, Bruce; Grange, Stuart; McKendry, Ian G; Henshaw, Geoff S; Williams, David E

2016-01-19

Aiming at minimizing the costs, both of capital expenditure and maintenance, of an extensive air-quality measurement network, we present simple statistical methods that do not require extensive training data sets for automated real-time verification of the reliability of data delivered by a spatially dense hybrid network of both low-cost and reference ozone measurement instruments. Ozone is a pollutant that has a relatively smooth spatial spread over a large scale although there can be significant small-scale variations. We take advantage of these characteristics and demonstrate detection of instrument calibration drift within a few days using a rolling 72 h comparison of hourly averaged data from the test instrument with that from suitably defined proxies. We define the required characteristics of the proxy measurements by working from a definition of the network purpose and specification, in this case reliable determination of the proportion of hourly averaged ozone measurements that are above a threshold in any given day, and detection of calibration drift of greater than ±30% in slope or ±5 parts-per-billion in offset. By analyzing results of a study of an extensive deployment of low-cost instruments in the Lower Fraser Valley, we demonstrate that proxies can be established using land-use criteria and that simple statistical comparisons can identify low-cost instruments that are not stable and therefore need replacing. We propose that a minimal set of compliant reference instruments can be used to verify the reliability of data from a much more extensive network of low-cost devices.

Content validity of the DSM-IV borderline and narcissistic personality disorder criteria sets.

PubMed

Blais, M A; Hilsenroth, M J; Castlebury, F D

1997-01-01

This study sought to empirically evaluate the content validity of the newly revised DSM-IV narcissistic personality disorder (NPD) and borderline personality disorder (BPD) criteria sets. Using the essential features of each disorder as construct definitions, factor analysis was used to determine how adequately the criteria sets covered the constructs. In addition, this empirical investigation sought to: 1) help define the dimensions underlying these polythetic disorders; 2) identify core features of each diagnosis; and 3) highlight the characteristics that may be most useful in diagnosing these two disorders. Ninety-one outpatients meeting DSM-IV criteria for a personality disorder (PD) were identified through a retrospective analysis of chart information. Records of these 91 patients were independently rated on all of the BPD and NPD symptom criteria for the DSM-IV. Acceptable interrater reliability (kappa estimates) was obtained for both presence or absence of a PD and symptom criteria for BPD and NPD. The factor analysis, performed separately for each disorder, identified a three-factor solution for both the DSM-IV BPD and NPD criteria sets. The results of this study provide strong support for the content validity of the NPD criteria set and moderate support for the content validly of the BPD criteria set. Three domains were found to comprise the BPD criteria set, with the essential features of interpersonal and identity instability forming one domain, and impulsivity and affective instability each identified as separate domains. Factor analysis of the NPD criteria set found three factors basically corresponding to the essential features of grandiosity, lack of empathy, and need for admiration. Therefore, the NPD criteria set adequately covers the essential or defining features of the disorder.

Trace metal ions release from fixed orthodontic appliances and DNA damage in oral mucosa cells by in vivo studies: A literature review.

PubMed

Downarowicz, Patrycja; Mikulewicz, Marcin

2017-10-01

An overview of professional literature referring to the release of metal ions from fixed orthodontic appliances and their influence on oral mucosa in conditions of in vivo are presented, along with a detailed analysis of the exposure of the cells of cheek mucosa epithelium to metal ions. Electronic databases (PubMed, Elsevier, Ebsco) were searched with no language restrictions. The relevant orthodontic journals and reference lists were checked for all eligible studies. A total of 38 scientific articles were retrieved in the initial search. However, only 7 articles met the inclusion criteria. Statistically significant differences in the levels of the amount of nickel ions, cobalt ions and chromium ions were observed in cells of cheek mucosa. The most biocompatible material used in the production of fixed orthodontic appliances is titanium, and the least biocompatible material is steel, which releases the largest amount of nickel and chromium. Metal ions are released from fixed orthodontic appliances only in the first phase of treatment. It is recommended to conduct further, long-term research on a larger number of patients to define the influence of using fixed orthodontic appliances and biological effect they might have on tissues.

The use of immunohistochemistry for biomarker assessment--can it compete with other technologies?

PubMed

Dunstan, Robert W; Wharton, Keith A; Quigley, Catherine; Lowe, Amanda

2011-10-01

A morphology-based assay such as immunohistochemistry (IHC) should be a highly effective means to define the expression of a target molecule of interest, especially if the target is a protein. However, over the past decade, IHC as a platform for biomarkers has been challenged by more quantitative molecular assays with reference standards but that lack morphologic context. For IHC to be considered a "top-tier" biomarker assay, it must provide truly quantitative data on par with non-morphologic assays, which means it needs to be run with reference standards. However, creating such standards for IHC will require optimizing all aspects of tissue collection, fixation, section thickness, morphologic criteria for assessment, staining processes, digitization of images, and image analysis. This will also require anatomic pathology to evolve from a discipline that is descriptive to one that is quantitative. A major step in this transformation will be replacing traditional ocular microscopes with computer monitors and whole slide images, for without digitization, there can be no accurate quantitation; without quantitation, there can be no standardization; and without standardization, the value of morphology-based IHC assays will not be realized.

On the application of hybrid meshes in hydraulic machinery CFD simulations

NASA Astrophysics Data System (ADS)

Schlipf, M.; Tismer, A.; Riedelbauch, S.

2016-11-01

The application of two different hybrid mesh types for the simulation of a Francis runner for automated optimization processes without user input is investigated. Those mesh types are applied to simplified test cases such as flow around NACA airfoils to identify the special mesh resolution effects with reduced complexity, like rotating cascade flows, as they occur in a turbomachine runner channel. The analysis includes the application of those different meshes on the geometries by keeping defined quality criteria and exploring the influences on the simulation results. All results are compared with reference values gained by simulations with blockstructured hexahedron meshes and the same numerical scheme. This avoids additional inaccuracies caused by further numerical and experimental measurement methods. The results show that a simulation with hybrid meshes built up by a blockstructured domain with hexahedrons around the blade in combination with a tetrahedral far field in the channel is sufficient to get results which are almost as accurate as the results gained by the reference simulation. Furthermore this method is robust enough for automated processes without user input and enables comparable meshes in size, distribution and quality for different similar geometries as occurring in optimization processes.

Acute Sarcopenia Secondary to Hospitalisation - An Emerging Condition Affecting Older Adults

PubMed Central

Welch, Carly; K. Hassan-Smith, Zaki; A. Greig, Carolyn; M. Lord, Janet; A. Jackson, Thomas

2018-01-01

There has been increasing interest and research into sarcopenia in community-dwelling older adults since the European Working Group on Sarcopenia in Older People (EWGSOP) agreed a consensus definition in 2010. Sarcopenia has been defined as loss of muscle mass with loss of muscle function (strength or physical performance), with measurements two Standard Deviations (SDs) below the mean of a young reference population. This definition does not necessitate longitudinal measurements, or the absence of acute illness and diagnosis can be made from single measurements. We hypothesise that hospitalisation, due to a combination of acute inflammatory burden and muscle disuse, leads to an acute decline in muscle mass and function and may lead to some individuals meeting criteria for sarcopenia, acutely, based on the EWGSOP definition. This may be partially recoverable or may lead to increased risk of developing sarcopenia long-term. We have denoted the term “acute sarcopenia” to refer to acute loss of muscle mass and function associated with hospitalisation. This review discusses some of the current available research in this context and also identifies some of the knowledge gaps and potential areas for future research. PMID:29392090

Reference set for performance testing of pediatric vaccine safety signal detection methods and systems.

PubMed

Brauchli Pernus, Yolanda; Nan, Cassandra; Verstraeten, Thomas; Pedenko, Mariia; Osokogu, Osemeke U; Weibel, Daniel; Sturkenboom, Miriam; Bonhoeffer, Jan

2016-12-12

Safety signal detection in spontaneous reporting system databases and electronic healthcare records is key to detection of previously unknown adverse events following immunization. Various statistical methods for signal detection in these different datasources have been developed, however none are geared to the pediatric population and none specifically to vaccines. A reference set comprising pediatric vaccine-adverse event pairs is required for reliable performance testing of statistical methods within and across data sources. The study was conducted within the context of the Global Research in Paediatrics (GRiP) project, as part of the seventh framework programme (FP7) of the European Commission. Criteria for the selection of vaccines considered in the reference set were routine and global use in the pediatric population. Adverse events were primarily selected based on importance. Outcome based systematic literature searches were performed for all identified vaccine-adverse event pairs and complemented by expert committee reports, evidence based decision support systems (e.g. Micromedex), and summaries of product characteristics. Classification into positive (PC) and negative control (NC) pairs was performed by two independent reviewers according to a pre-defined algorithm and discussed for consensus in case of disagreement. We selected 13 vaccines and 14 adverse events to be included in the reference set. From a total of 182 vaccine-adverse event pairs, we classified 18 as PC, 113 as NC and 51 as unclassifiable. Most classifications (91) were based on literature review, 45 were based on expert committee reports, and for 46 vaccine-adverse event pairs, an underlying pathomechanism was not plausible classifying the association as NC. A reference set of vaccine-adverse event pairs was developed. We propose its use for comparing signal detection methods and systems in the pediatric population. Published by Elsevier Ltd.

A Systematic Literature Review of Studies Analyzing Inequalities in Health Expectancy among the Older Population

PubMed Central

Pongiglione, Benedetta; De Stavola, Bianca L.; Ploubidis, George B.

2015-01-01

Aim To collect, organize and appraise evidence of socioeconomic and demographic inequalities in health and mortality among the older population using a summary measure of population health: Health Expectancy. Methods A systematic literature review was conducted. Literature published in English before November 2014 was searched via two possible sources: three electronic databases (Web of Science, Medline and Embase), and references in selected articles. The search was developed combining terms referring to outcome, exposure and participants, consisting in health expectancy, socioeconomic and demographic groups, and older population, respectively. Results Of 256 references identified, 90 met the inclusion criteria. Six references were added after searching reference lists of included articles. Thirty-three studies were focused only on gender-based inequalities; the remaining sixty-three considered gender along with other exposures. Findings were organized according to two leading perspectives: the type of inequalities considered and the health indicators chosen to measure health expectancy. Evidence of gender-based differentials and a socioeconomic gradient were found in all studies. A remarkable heterogeneity in the choice of health indicators used to compute health expectancy emerged as well as a non-uniform way of defining same health conditions. Conclusions Health expectancy is a useful and convenient measure to monitor and assess the quality of ageing and compare different groups and populations. This review showed a general agreement of results obtained in different studies with regard to the existence of inequalities associated with several factors, such as gender, education, behaviors, and race. However, the lack of a standardized definition of health expectancy limits its comparability across studies. The need of conceiving health expectancy as a comparable and repeatable measure was highlighted as fundamental to make it an informative instrument for policy makers. PMID:26115099

1000 Norms Project: protocol of a cross-sectional study cataloging human variation.

PubMed

McKay, Marnee J; Baldwin, Jennifer N; Ferreira, Paulo; Simic, Milena; Vanicek, Natalie; Hiller, Claire E; Nightingale, Elizabeth J; Moloney, Niamh A; Quinlan, Kate G; Pourkazemi, Fereshteh; Sman, Amy D; Nicholson, Leslie L; Mousavi, Seyed J; Rose, Kristy; Raymond, Jacqueline; Mackey, Martin G; Chard, Angus; Hübscher, Markus; Wegener, Caleb; Fong Yan, Alycia; Refshauge, Kathryn M; Burns, Joshua

2016-03-01

Clinical decision-making regarding diagnosis and management largely depends on comparison with healthy or 'normal' values. Physiotherapists and researchers therefore need access to robust patient-centred outcome measures and appropriate reference values. However there is a lack of high-quality reference data for many clinical measures. The aim of the 1000 Norms Project is to generate a freely accessible database of musculoskeletal and neurological reference values representative of the healthy population across the lifespan. In 2012 the 1000 Norms Project Consortium defined the concept of 'normal', established a sampling strategy and selected measures based on clinical significance, psychometric properties and the need for reference data. Musculoskeletal and neurological items tapping the constructs of dexterity, balance, ambulation, joint range of motion, strength and power, endurance and motor planning will be collected in this cross-sectional study. Standardised questionnaires will evaluate quality of life, physical activity, and musculoskeletal health. Saliva DNA will be analysed for the ACTN3 genotype ('gene for speed'). A volunteer cohort of 1000 participants aged 3 to 100 years will be recruited according to a set of self-reported health criteria. Descriptive statistics will be generated, creating tables of mean values and standard deviations stratified for age and gender. Quantile regression equations will be used to generate age charts and age-specific centile values. This project will be a powerful resource to assist physiotherapists and clinicians across all areas of healthcare to diagnose pathology, track disease progression and evaluate treatment response. This reference dataset will also contribute to the development of robust patient-centred clinical trial outcome measures. Copyright © 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Core Competencies in Disaster Management and Humanitarian Assistance: A Systematic Review.

PubMed

Ripoll Gallardo, Alba; Djalali, Ahmadreza; Foletti, Marco; Ragazzoni, Luca; Della Corte, Francesco; Lupescu, Olivera; Arculeo, Chris; von Arnim, Gotz; Friedl, Tom; Ashkenazi, Michael; Fisher, Philipp; Hreckovski, Boris; Khorram-Manesh, Amir; Komadina, Radko; Lechner, Konstanze; Stal, Marc; Patru, Cristina; Burkle, Frederick M; Ingrassia, Pier Luigi

2015-08-01

Disaster response demands a large workforce covering diverse professional sectors. Throughout this article, we illustrate the results of a systematic review of peer-reviewed studies to identify existing competency sets for disaster management and humanitarian assistance that would serve as guidance for the development of a common disaster curriculum. A systematic review of English-language articles was performed on PubMed, Google Scholar, Scopus, ERIC, and Cochrane Library. Studies were included if reporting competency domains, abilities, knowledge, skills, or attitudes for professionals involved disaster relief or humanitarian assistance. Exclusion criteria included abstracts, citations, case studies, and studies not dealing with disasters or humanitarian assistance. Thirty-eight papers were analyzed. Target audience was defined in all articles. Five references (13%) reported cross-sectorial competencies. Most of the articles (81.6%) were specific to health care. Eighteen (47%) papers included competencies for at least 2 different disciplines and 18 (47%) for different professional groups. Nursing was the most widely represented cadre. Eighteen papers (47%) defined competency domains and 36 (94%) reported list of competencies. Nineteen articles (50%) adopted consensus-building to define competencies, and 12 (31%) included competencies adapted to different professional responsibility levels. This systematic review revealed that the largest number of papers were mainly focused on the health care sector and presented a lack of agreement on the terminology used for competency-based definition.

Validation of predictive models for germline mutations in DNA mismatch repair genes in colorectal cancer.

PubMed

Monzon, Jose G; Cremin, Carol; Armstrong, Linlea; Nuk, Jennifer; Young, Sean; Horsman, Doug E; Garbutt, Kristy; Bajdik, Chris D; Gill, Sharlene

2010-02-15

Lynch syndrome is defined by the presence of germline mutations in mismatch repair (MMR) genes. Several models have been recently devised that predict mutation carrier status (Myriad Genetics, Wijnen, Barnetson, PREMM and MMRpro models). Families at moderate-high risk for harboring a Lynch-associated mutation, referred to the BC Cancer Agency (BCCA) Hereditary Cancer Program (HCP), underwent mutation analysis, immunohistochemistry and/or microsatellite testing. Seventy-two tested cases were included. Twenty-five patients were mutation positive (34.7%) and 47 were mutation negative (65.3%). Nineteen of 43 patients who were both microsatellite stable and normal on immunohistochemistry for MLH1 and MSH2 were also genotyped for mutations in these genes; all 19 were negative for MMR gene mutations. Model-derived probabilities of harboring a MMR gene mutation in the proband were calculated and compared to observed results. The area under the ROC curves were 0.75 (95%CI; 0.63-0.87), 0.86 (0.7-0.96), 0.89 (0.82-0.97), 0.89 (0.81-0.98) and 0.93 (0.86-0.99) for the Myriad, Barnetson, Wijnen, MMRpro and PREMM models, respectively. The Amsterdam II criteria had a sensitivity and specificity of 0.76 and 0.74, respectively, in this cohort. The PREMM model demonstrated the best performance for predicting carrier status based on the positive likelihood ratios at the >10%, >20% and >30% probability thresholds. In this referred cohort, the PREMM model had the most favorable concordance index and predictive performance for carrier status based on the positive LR. These prediction models (PREMM, MMRPro and Wijnen) may soon replace the Amsterdam II and revised Bethesda criteria as a prescreening tool for Lynch mutations.

VizieR Online Data Catalog: SDSS DR7 voids and superclusters (Nadathur+, 2014)

NASA Astrophysics Data System (ADS)

Nadathur, S.; Hotchkiss, S.

2016-02-01

This is a public catalogue of voids and superclusters identified in the SDSS DR7 main galaxy and luminous red galaxy samples. This version is dated 04.11.2013. We make the catalogues available for general use. If you use them for your own work, we ask that you cite the original paper, Nadathur & Hotchkiss (2014MNRAS.440.1248N). The top-level directory cat_v11.11.13 contains an example python script called postproc.py, and two folders called comovcoords and redshiftcoords containing two versions of the catalogue in different coordinate systems. The comoving coordinate system is pretty self-explanatory, for a description of the other one please refer to the paper. Each of these directories is further divided into six folders containing the Type1 and Type2 void catalogues and the supercluster catalogue for each of the galaxy samples analysed here, and a folder called tools, which contains data useful for users wishing to apply their own selection criteria. The basic information provided includes the location of the barycentre of each structure, its volume, effective radius, average density and minimum or maximum density, its core galaxy and seed zone, the total number of galaxies in the seed zone, the number of zones merged to form the structure, the total number of particles in the structure, and its density ratio. These are split between two files for each structure type and each sample, named xxxinfo.txt and xxxlist.txt, where xxx refers to the structure type. It is also possible to extract lists of member galaxies of each structure and their magnitudes. An example python script, postproc.py, demonstrates how to access this information and how to build alternative catalogues using user-defined selection criteria. (27 data files).

A prospective cohort study of light transmission platelet aggregometry for bleeding disorders: is testing native platelet-rich plasma non-inferior to testing platelet count adjusted samples?

PubMed

Castilloux, Jean Francois; Moffat, Karen A; Liu, Yang; Seecharan, Jodi; Pai, Menaka; Hayward, Catherine P M

2011-10-01

Light transmission platelet aggregometry (LTA) is important to diagnose bleeding disorders. Experts recommend testing LTA with native (N) rather than platelet count adjusted (A) platelet-rich plasma (PRP), although it is unclear if this provides non-inferior, or superior, detection of bleeding disorders. Our goal was to determine if LTA with NPRP is non-inferior to LTA with APRP for bleeding disorder assessments. A prospective cohort of patients, referred for bleeding disorder testing, and healthy controls, were evaluated by LTA using common agonists, NPRP and APRP (adjusted to 250 x 10⁹ platelets/l). Recruitment continued until 40 controls and 40 patients with definite bleeding disorders were tested. Maximal aggregation (MA) data were assessed for the detection of abnormalities from bleeding disorders (all causes combined to limit bias), using sample-type specific reference intervals. Areas under receiver-operator curves (AUROC) were evaluated using pre-defined criteria (area differences: < 0.15 for non-inferiority, > 0 for superiority). Forty-four controls and 209 patients were evaluated. Chart reviews for 169 patients indicated 67 had bleeding disorders, 28 from inherited platelet secretion defects. Mean MA differences between NPRP and APRP were small for most agonists (ranges, controls: -3.3 to 5.8; patients: -3.0 to 13.7). With both samples, reduced MA with two or more agonists was associated with a bleeding disorder. AUROC differences between NPRP and APRP were small and indicated that NPRP were non-inferior to APRP for detecting bleeding disorders by LTA, whereas APRP met superiority criteria. Our study validates using either NPRP or APRP for LTA assessments of bleeding disorders.

System and method for calibrating inter-star-tracker misalignments in a stellar inertial attitude determination system

NASA Technical Reports Server (NTRS)

Li, Rongsheng (Inventor); Wu, Yeong-Wei Andy (Inventor); Hein, Douglas H. (Inventor)

2004-01-01

A method and apparatus for determining star tracker misalignments is disclosed. The method comprises the steps of defining a defining a reference frame for the star tracker assembly according to a boresight of the primary star tracker and a boresight of a second star tracker wherein the boresight of the primary star tracker and a plane spanned by the boresight of the primary star tracker and the boresight of the second star tracker at least partially define a datum for the reference frame for the star tracker assembly; and determining the misalignment of the at least one star tracker as a rotation of the defined reference frame.

Reuse of bituminous pavements: A mini-review of research, regulations and modelling.

PubMed

Anthonissen, Joke; Van den Bergh, Wim; Braet, Johan

2017-04-01

Bituminous pavement can be recycled - even multiple times - by reusing it in new bituminous mixtures. If the mechanical properties of the binder get worse, this reclaimed asphalt is often used in the sub-structure of the road. Apparently, up till now, no end-of-life phase exists for the material. Actually, defining the end-of-life and the end-of-waste stage of a material is important for life cycle assessment modelling. Various standards and scientific studies on modelling life cycle assessment are known, but the crucial stages are not yet defined for reclaimed asphalt pavement. Unlike for iron, steel and aluminium scrap, at this moment, no legislative end-of-waste criteria for aggregates are formulated by the European Commission. More research is necessary in order to develop valuable end-of-life criteria for aggregates. This contribution is a mini-review article of the current regulations, standards and studies concerning end-of-life and end-of-waste of reclaimed asphalt pavement. The existing methodology in order to define end-of-waste criteria, a case study on aggregates and the argumentation used in finished legislative criteria are the basis to clarify some modelling issues for reclaimed asphalt material. Hence, this contribution elucidates the assignment of process environmental impacts to a life cycle stage as defined by EN15804, that is, end-of-life stage (C) and the supplementary information Module D with benefits and loads beyond the system boundary.

Application of 2011 American College of Cardiology Foundation/American Society of Echocardiography appropriateness use criteria in hospitalized patients referred for transthoracic echocardiography in a community setting.

PubMed

Ballo, Piercarlo; Bandini, Fabrizio; Capecchi, Irene; Chiodi, Leandro; Ferro, Giuseppe; Fortini, Alberto; Giuliani, Gabriele; Landini, Giancarlo; Laureano, Raffaele; Milli, Massimo; Nenci, Gabriele; Pizzarelli, Francesco; Santoro, Giovanni Maria; Vannelli, Pasquale; Cappelletti, Carlo; Zuppiroli, Alfredo

2012-06-01

A recent American College of Cardiology Foundation and American Society of Echocardiography document updated previous appropriate use criteria (AUC) for echocardiography. The aim of this study was to explore the application of the new AUC, and the resulting appropriateness rate, in hospitalized patients referred for transthoracic echocardiography (TTE) in a community setting. A total of 931 consecutive inpatients referred for TTE were prospectively recruited in five community hospitals. Patients were categorized as having appropriate, uncertain, or inappropriate indications for TTE according to the AUC. An additional group of 259 inpatients, discharged without having been referred for TTE, was also considered. In the group referred for TTE, the large majority of indications (98.8%) were classifiable according to the AUC with good interobserver reproducibility. Indications were appropriate in 739 patients (80.3%), of uncertain appropriateness in 46 (5.0%), and inappropriate in 135 (14.7%). Compared with patients with appropriate or uncertain indications, those with inappropriate indications were younger and more often referred by noncardiologists. Most common causes of inappropriate indications were related to the lack of changes in clinical status or to the absence of cardiovascular symptoms and signs. Examinations with appropriate or uncertain indications had an impact on clinical decision making more often than those with inappropriate indications (86.7% vs 14.1%, P < .0001). In the group discharged without having been referred for TTE, TTE might have been appropriate in 16.2% of cases. Clinical application of the new AUC was highly feasible in a community setting. Although inpatient referral for TTE was appropriate in most patients, strategies aimed at implementing these criteria in clinical practice are desirable. Copyright © 2012 American Society of Echocardiography. Published by Mosby, Inc. All rights reserved.

Methodology and preliminary results of a systematic literature review of ante-mortem and post-mortem diagnostic tests for bovine tuberculosis.

PubMed

Downs, Sara H; Parry, Jessica E; Upton, Paul A; Broughan, Jennifer M; Goodchild, Anthony V; Nuñez-Garcia, Javier; Greiner, Matthias; Abernethy, Darrell A; Cameron, Angus R; Cook, Alasdair J; de la Rua-Domenech, Ricardo; Gunn, Jane; Pritchard, Elizabeth; Rhodes, Shelley; Rolfe, Simon; Sharp, Michael; Vordermeier, H Martin; Watson, Eamon; Welsh, Michael; Whelan, Adam O; Woolliams, John A; More, Simon J; Clifton-Hadley, Richard S

2018-05-01

A systematic review was conducted to identify studies with data for statistical meta-analyses of sensitivity (Se) and specificity (Sp) of ante-mortem and post-mortem diagnostic tests for bovine tuberculosis (bTB) in cattle. Members of a working group (WG) developed and tested search criteria and developed a standardised two-stage review process, to identify primary studies with numerator and denominator data for test performance and an agreed range of covariate data. No limits were applied to year, language, region or type of test in initial searches of electronic databases. In stage 1, titles and available abstracts were reviewed. References that complied with stage 1 selection criteria were reviewed in entirety and agreed data were extracted from references that complied with stage 2 selection criteria. At stage 1, 9782 references were reviewed and 261 (2.6%) passed through to stage 2 where 215 English language references were each randomly allocated to two of 18 WG reviewers and 46 references in other languages were allocated to native speakers. Agreement regarding eligibility between reviewers of the same reference at stage 2 was moderate (Kappa statistic = 0.51) and a resolution procedure was conducted. Only 119 references (published 1934-2009) were identified with eligible performance estimates for one or more of 14 different diagnostic test types; despite a comprehensive search strategy and the global impact of bTB. Searches of electronic databases for diagnostic test performance data were found to be nonspecific with regard to identifying references with diagnostic test Se or Sp data. Guidelines for the content of abstracts to research papers reporting diagnostic test performance are presented. The results of meta-analyses of the sensitivity and specificity of the tests, and of an evaluation of the methodological quality of the source references, are presented in accompanying papers (Nuñez-Garcia et al., 2017; Downs et al., 2017). Copyright © 2017. Published by Elsevier B.V.

New reference values for thyroid volume by ultrasound in iodine-sufficient schoolchildren: a World Health Organization/Nutrition for Health and Development Iodine Deficiency Study Group Report.

PubMed

Zimmermann, Michael B; Hess, Sonja Y; Molinari, Luciano; De Benoist, Bruno; Delange, François; Braverman, Lewis E; Fujieda, Kenji; Ito, Yoshiya; Jooste, Pieter L; Moosa, Khairya; Pearce, Elizabeth N; Pretell, Eduardo A; Shishiba, Yoshimasa

2004-02-01

Goiter prevalence in school-age children is an indicator of the severity of iodine deficiency disorders (IDDs) in a population. In areas of mild-to-moderate IDDs, measurement of thyroid volume (Tvol) by ultrasound is preferable to palpation for grading goiter, but interpretation requires reference criteria from iodine-sufficient children. The study aim was to establish international reference values for Tvol by ultrasound in 6-12-y-old children that could be used to define goiter in the context of IDD monitoring. Tvol was measured by ultrasound in 6-12-y-old children living in areas of long-term iodine sufficiency in North and South America, central Europe, the eastern Mediterranean, Africa, and the western Pacific. Measurements were made by 2 experienced examiners using validated techniques. Data were log transformed, used to calculate percentiles on the basis of the Gaussian distribution, and then transformed back to the linear scale. Age- and body surface area (BSA)-specific 97th percentiles for Tvol were calculated for boys and girls. The sample included 3529 children evenly divided between boys and girls at each year ( +/- SD age: 9.3 +/- 1.9 y). The range of median urinary iodine concentrations for the 6 study sites was 118-288 micro g/L. There were significant differences in age- and BSA-adjusted mean Tvols between sites, which suggests that population-specific references in countries with long-standing iodine sufficiency may be more accurate than is a single international reference. However, overall differences in age- and BSA-adjusted Tvols between sites were modest relative to the population and measurement variability, which supports the use of a single, site-independent set of references. These new international reference values for Tvol by ultrasound can be used for goiter screening in the context of IDD monitoring.

Evaluation: The Process of Stimulating, Aiding, and Abetting Insightful Action.

ERIC Educational Resources Information Center

Guba, Egon G.; Stufflebeam, Daniel L.

Part 1 of this monograph discusses the status of educational evaluation and describes several problems in carrying out such evaluation: (1) defining the educational setting, (2) defining decision types, (3) designing educational evaluation, (4) designing evaluation systems, and (5) defining criteria for judging evaluation. Part 2 proposes an…

Fundamental Importance of Reference Glucose Analyzer Accuracy for Evaluating the Performance of Blood Glucose Monitoring Systems (BGMSs).

PubMed

Bailey, Timothy S; Klaff, Leslie J; Wallace, Jane F; Greene, Carmine; Pardo, Scott; Harrison, Bern; Simmons, David A

2016-07-01

As blood glucose monitoring system (BGMS) accuracy is based on comparison of BGMS and laboratory reference glucose analyzer results, reference instrument accuracy is important to discriminate small differences between BGMS and reference glucose analyzer results. Here, we demonstrate the important role of reference glucose analyzer accuracy in BGMS accuracy evaluations. Two clinical studies assessed the performance of a new BGMS, using different reference instrument procedures. BGMS and YSI analyzer results were compared for fingertip blood that was obtained by untrained subjects' self-testing and study staff testing, respectively. YSI analyzer accuracy was monitored using traceable serum controls. In study 1 (N = 136), 94.1% of BGMS results were within International Organization for Standardization (ISO) 15197:2013 accuracy criteria; YSI analyzer serum control results showed a negative bias (-0.64% to -2.48%) at the first site and a positive bias (3.36% to 6.91%) at the other site. In study 2 (N = 329), 97.8% of BGMS results were within accuracy criteria; serum controls showed minimal bias (<0.92%) at both sites. These findings suggest that the ability to demonstrate that a BGMS meets accuracy guidelines is influenced by reference instrument accuracy. © 2016 Diabetes Technology Society.

Definition of an Acceptable Glass composition Region (AGCR) via an Index System and a Partitioning Function

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

Peeler, D. K.; Taylor, A. S.; Edwards, T.B.

2005-06-26

The objective of this investigation was to appeal to the available ComPro{trademark} database of glass compositions and measured PCTs that have been generated in the study of High Level Waste (HLW)/Low Activity Waste (LAW) glasses to define an Acceptable Glass Composition Region (AGCR). The term AGCR refers to a glass composition region in which the durability response (as defined by the Product Consistency Test (PCT)) is less than some pre-defined, acceptable value that satisfies the Waste Acceptance Product Specifications (WAPS)--a value of 10 g/L was selected for this study. To assess the effectiveness of a specific classification or index systemmore » to differentiate between acceptable and unacceptable glasses, two types of errors (Type I and Type II errors) were monitored. A Type I error reflects that a glass with an acceptable durability response (i.e., a measured NL [B] < 10 g/L) is classified as unacceptable by the system of composition-based constraints. A Type II error occurs when a glass with an unacceptable durability response is classified as acceptable by the system of constraints. Over the course of the efforts to meet this objective, two approaches were assessed. The first (referred to as the ''Index System'') was based on the use of an evolving system of compositional constraints which were used to explore the possibility of defining an AGCR. This approach was primarily based on ''glass science'' insight to establish the compositional constraints. Assessments of the Brewer and Taylor Index Systems did not result in the definition of an AGCR. Although the Taylor Index System minimized Type I errors which allowed access to composition regions of interest to improve melt rate or increase waste loadings for DWPF as compared to the current durability model, Type II errors were also committed. In the context of the application of a particular classification system in the process control system, Type II errors are much more serious than Type I errors. A Type I error only reflects that the particular constraint system being used is overly conservative (i.e., its application restricts access to glasses that have an acceptable measured durability response). A Type II error results in a more serious misclassification that could result in allowing the transfer of a Slurry Mix Evaporator (SME) batch to the melter, which is predicted to produce a durable product based on the specific system applied but in reality does not meet the defined ''acceptability'' criteria. More specifically, a nondurable product could be produced in DWPF. Given the presence of Type II errors, the Index System approach was deemed inadequate for further implementation consideration at the DWPF. The second approach (the JMP partitioning process) was purely data driven and empirically derived--glass science was not a factor. In this approach, the collection of composition--durability data in ComPro was sequentially partitioned or split based on the best available specific criteria and variables. More specifically, the JMP software chose the oxide (Al{sub 2}O{sub 3} for this dataset) that most effectively partitions the PCT responses (NL [B]'s)--perhaps not 100% effective based on a single oxide. Based on this initial split, a second request was made to split a particular set of the ''Y'' values (good or bad PCTs based on the 10 g/L limit) based on the next most critical ''X'' variable. This ''splitting'' or ''partitioning'' process was repeated until an AGCR was defined based on the use of only 3 oxides (Al{sub 2}O{sub 3}, CaO, and MgO) and critical values of > 3.75 wt% Al{sub 2}O{sub 3}, {ge} 0.616 wt% CaO, and < 3.521 wt% MgO. Using this set of criteria, the ComPro database was partitioned in which no Type II errors were committed. The automated partitioning function screened or removed 978 of the 2406 ComPro glasses which did cause some initial concerns regarding excessive conservatism regardless of its ability to identify an AGCR. However, a preliminary review of glasses within the 1428 ''acceptable'' glasses defining the ACGR includes glass systems of interest to support the accelerated mission.« less

European consensus conference for external quality assessment in molecular pathology.

PubMed

van Krieken, J H; Siebers, A G; Normanno, N

2013-08-01

Molecular testing of tumor samples to guide treatment decisions is of increasing importance. Several drugs have been approved for treatment of molecularly defined subgroups of patients, and the number of agents requiring companion diagnostics for their prescription is expected to rapidly increase. The results of such testing directly influence the management of individual patients, with both false-negative and false-positive results being harmful for patients. In this respect, external quality assurance (EQA) programs are essential to guarantee optimal quality of testing. There are several EQA schemes available in Europe, but they vary in scope, size and execution. During a conference held in early 2012, medical oncologists, pathologists, geneticists, molecular biologists, EQA providers and representatives from pharmaceutical industries developed a guideline to harmonize the standards applied by EQA schemes in molecular pathology. The guideline comprises recommendations on the organization of an EQA scheme, defining the criteria for reference laboratories, requirements for EQA test samples and the number of samples that are needed for an EQA scheme. Furthermore, a scoring system is proposed and consequences of poor performance are formulated. Lastly, the contents of an EQA report, communication of the EQA results, EQA databases and participant manual are given.

[Goals in the discussion of old age insurance - a sketch].

PubMed

Schmähl, W

1980-01-01

In the Federal Republic of Germany often the discussion on social policy deals with instruments, yet seldom with goals to be realised. Scientific work on goals for old-age security policy is just starting. In this article the importance of distinctly defined goals is shown for rational economic and social policy, for an assessment of the existing situation, for a goal oriented selection and formation of measures and for success control. With reference to distributive goals in old-age security policy it is exemplified in which way scientific work can be helpful in defining goals in an operationalised form. For this it is important to deal with several distributive aspects, which are often mixed in discussions. As measures in one area of economic and social policy cannot be taken isolated, in order to avoid unwanted consequences, it is necessary for old-age security policies too, to take into consideration a general system of economic and social policy goals. As an example, it must be stated that e.g. aspects of business cycle and growth policy have to be considered while constructing a system of old-age security. Finally, some other criteria for old-age security policies, such as transparence, political feasibility and practicability are mentioned.

Scholarly Activities of Family Medicine Faculty: Results of a National Survey.

PubMed

Hinojosa, Jose; Benè, Kristen L; Hickey, Colleen; Marvel, Kim

2006-12-01

This survey examined how family medicine residency programs define scholarly activity, the productivity of programs, and perceived barriers to scholarly work. Five types of residency programs are compared: university-based, community-based (unaffiliated, university-affiliated, university-administered), and military. A 13 item web-based questionnaire was sent to all 455 U. S. family medicine residency programs. The survey solicited demographic information as well as program expectations of faculty, presence of a research coordinator/director, activities considered scholarly, productivity, and perceived barriers. A total of 177 surveys were completed for a response rate of 38%, similar to response rates of web-based surveys in the literature. 67.6% of programs encouraged, but did not require scholarly activity, and 44.5% indicated their program had no research coordinator/ director. University-based programs had the highest levels of productivity compared to other program types. Primary barriers to scholarly activity noted were lack of time (73/138, 53%) and lack of supportive infrastructure (37/138, 27%). While interpretations are limited by the response rate of the survey, results provide an increased understanding of how programs define scholarly activity as well as reference points for faculty productivity. This information can help program directors when setting criteria for scholarly work.

The prevalence of vegetative and minimally conscious states: a systematic review and methodological appraisal.

PubMed

Pisa, Federica Edith; Biasutti, Emanuele; Drigo, Daniela; Barbone, Fabio

2014-01-01

To systematically review prevalence studies of vegetative state (VS) and minimally conscious state (MCS) in geographically defined populations, to appraise study methods and assess sources of heterogeneity. MEDLINE, EBM Reviews, and EMBASE databases were searched using key terms. Two reviewers independently identified pertinent articles and screened the references for additional studies. Studies measuring the prevalence of VS and/or MCS in a defined population were included, and information on characteristics, methods, and results was extracted. Heterogeneity was quantified through the statistic I. We identified 5 cross-sectional prevalence surveys of VS and 1 of MCS. Prevalence ranged from 0.2 cases per 100,000 inhabitants to 3.4 for VS and was 1.5 per 100,000 for MCS. Relevant heterogeneity (I = 99.0%) prevented us from calculating a summary estimate. The prevalence of trauma cases varied from 21.9% to 53.8%. Variability pertaining to diagnostic criteria, definition of case, and methods of ascertainment was found. In the few prevalence studies of VS and MCS that were identified, the estimates showed high variability and could not be pooled. Future studies should consider using comparable methods for the definition, ascertainment, and confirmation of cases.

A new computational growth model for sea urchin skeletons.

PubMed

Zachos, Louis G

2009-08-07

A new computational model has been developed to simulate growth of regular sea urchin skeletons. The model incorporates the processes of plate addition and individual plate growth into a composite model of whole-body (somatic) growth. A simple developmental model based on hypothetical morphogens underlies the assumptions used to define the simulated growth processes. The data model is based on a Delaunay triangulation of plate growth center points, using the dual Voronoi polygons to define plate topologies. A spherical frame of reference is used for growth calculations, with affine deformation of the sphere (based on a Young-Laplace membrane model) to result in an urchin-like three-dimensional form. The model verifies that the patterns of coronal plates in general meet the criteria of Voronoi polygonalization, that a morphogen/threshold inhibition model for plate addition results in the alternating plate addition pattern characteristic of sea urchins, and that application of the Bertalanffy growth model to individual plates results in simulated somatic growth that approximates that seen in living urchins. The model suggests avenues of research that could explain some of the distinctions between modern sea urchins and the much more disparate groups of forms that characterized the Paleozoic Era.

Trends on epidemiological, virological, and clinical features among newly diagnosed HIV-1 persons in Northwest Spain over the last 10 years.

PubMed

Pernas, B; Mena, A; Cañizares, A; Grandal, M; Castro-Iglesias, A; Pértega, S; Pedreira, J D; Poveda, E

2015-08-01

To describe temporal trend and characteristics of newly HIV-diagnosed patients in a medical care area in Northwest Spain over the last 10 years. All newly diagnosed patients for HIV-infection from 2004 to 2013 at a reference medical care area in Northwest of Spain were identified. Epidemiological, virological, immunological, and clinical data, as well as HIV genotype and drug resistance information were recorded. A total of 565 newly HIV-diagnosed patients were identified. The number of new cases increased in the last 5 years (66 cases/year). Overall, 53.1% had a median CD4 counts < 350 cells/µl and 33.6% had an AIDS defining criteria. Non-B variants were found in 34.4% of patients being subtype F (25.8%) the most common non-B subtype. The rate of transmitted drug resistance (TDR) over the study period was 3.7%, but a decreased to 2.6% was observed in the last 5 years. The most prevalent TDR mutations were: T215 revertants (1.5%), K219QENR (1.2%), for NRTIs; K103N (1.9%), for NNRTIs; L90M (0.3%), for PIs. Overall, 73.2% of patients started antiretroviral treatment and 9.9% of patients died during follow-up. The number of newly HIV diagnosed patients increased since year 2009. There is a high prevalence of late diagnosis (53%) and 33% had an AIDS defining criteria. Interestingly, the most prevalent non-B subtype in our population was F (25.8%). These findings support the need to facilitate the access for HIV testing to reduce the rate of late HIV diagnosis, improve the clinical outcome and prevent HIV transmission. © 2015 Wiley Periodicals, Inc.

Courant number and unsteady flow computation

USGS Publications Warehouse

Lai, Chintu; ,

1993-01-01

The Courant number C, the key to unsteady flow computation, is a ratio of physical wave velocity, ??, to computational signal-transmission velocity, ??, i.e., C = ??/??. In this way, it uniquely relates a physical quantity to a mathematical quantity. Because most unsteady open-channel flows are describable by a set of n characteristic equations along n characteristic paths, each represented by velocity ??i, i = 1,2,....,n, there exist as many as n components for the numerator of C. To develop a numerical model, a numerical integration must be made on each characteristic curve from an earlier point to a later point on the curve. Different numerical methods are available in unsteady flow computation due to the different paths along which the numerical integration is actually performed. For the denominator of C, the ?? defined as ?? = ?? 0 = ??x/??t has been customarily used; thus, the Courant number has the familiar form of C?? = ??/??0. This form will be referred to as ???common Courant number??? in this paper. The commonly used numerical criteria C?? for stability, neutral stability and instability, are imprecise or not universal in the sense that r0 does not always reflect the true maximum computational data-transmission speed of the scheme at hand, i.e., Ctau is no indication for the Courant constraint. In view of this , a new Courant number, called the ???natural Courant number???, Cn, that truly reflects the Courant constraint, has been defined. However, considering the numerous advantages inherent in the traditional C??, a useful and meaningful composite Courant number, denoted by C??* has been formulated from C??. It is hoped that the new aspects of the Courant number discussed herein afford the hydraulician a broader perspective, consistent criteria, and unified guidelines, with which to model various unsteady flows.

Analysis and definition of potential new areas for viticulture in the Azores (Portugal)

NASA Astrophysics Data System (ADS)

Madruga, J.; Azevedo, E. B.; Sampaio, J. F.; Fernandes, F.; Reis, F.; Pinheiro, J.

2015-07-01

Vineyards in the Azores have been traditionally settled on lava field terroirs but the practical limitations of mechanization and high demand on man labor imposed by the typical micro parcel structure of these vineyards contradict the sustainability of these areas for wine production, except under government policies of heavy financial support. Besides the traditional vineyards there are significant areas in some of the islands whose soils, climate and physiographic characteristics suggest a potential for wine production that deserves to be the object of an assessment, with a view to the development of new vineyard areas offering conditions for better management and sustainability. The landscape zoning approach for the present study was based in a geographic information system (GIS) analysis incorporating factors related to climate, topography and soils. Three thermal intervals referred to climate maturity groups were defined and combined with a single slope interval of 0-15 % to exclude the landscape units above this limit. Over this resulting composite grid, the soils were then selectively cartographed through the exclusion of the soil units not fulfilling the suitability criteria. The results show that the thermal interval of warmer conditions, well represented in the traditional terroir of Pico island, has practically no expression in the other islands. However, for the intermediate and the cooler classes, we could map areas of 5611 and 18 115 ha respectively, fulfilling the defined soils and slope criteria, indicating thus the existence of some landscapes in the studied islands revealing adequate potential for future development of viticulture, although certainly demanding a good judgment on the better grape varieties to be adapted to those climatic conditions.

Analysis and definition of potential new areas for viticulture in the Azores (Portugal)

NASA Astrophysics Data System (ADS)

Madruga, J.; Azevedo, E. B.; Sampaio, J. F.; Reis, F.; Pinheiro, J.

2014-12-01

Vineyards in the Azores have been traditionally settled on lava field "terroirs" but the practical limitations of mechanization and high demand on man labor imposed by the typical micro parcel structure of these vineyards contradict the sustainability of these areas for wine production, except under government policies of heavy financial support. Besides the traditional vineyards there are significant areas in some of the islands whose soils, climate and physiographic characteristics suggest a potential for wine production that deserves to be object of an assessment, with a view to the development of new vineyard areas offering conditions for a better management and sustainability. The landscape zoning approach for the present study was based in a Geographic Information System (GIS) analysis incorporating factors related to climate, topography and soils. Three thermal intervals referred to climate maturity groups were defined and combined with a single slope interval of 0-15% to exclude the landscape units above this limit. Over this resulting composite grid, the soils were than selectively cartographed thru the exclusion of the soil units not fulfilling the suitability criteria. The results show that the thermal interval of warmer conditions, well represented in the traditional "terroir" of Pico island, has practically no expression in the other islands. However, for the intermediate and the cooler classes, we could map areas of 3739 and 19 395 ha respectively, fulfilling the defined soils and slope criteria, indicating thus the existence of some landscapes in the studied islands revealing adequate potential for future development of viticulture, although certainly demanding a good judgment on the better grape varieties to be adapted to those climatic conditions.

Is there an increased risk of metabolic syndrome among childhood acute lymphoblastic leukemia survivors? A developing country experience.

PubMed

Mohapatra, Sonali; Bansal, Deepak; Bhalla, A K; Verma Attri, Savita; Sachdeva, Naresh; Trehan, Amita; Marwaha, R K

2016-03-01

Data on metabolic syndrome (MS) in survivors of childhood acute lymphoblastic leukemia (ALL) from developing countries are lacking. The purpose of this single-center, uncontrolled, observational study was to assess the frequency of MS in our survivors. The survivors of ALL ≤15 years at diagnosis, who had completed therapy ≥2 years earlier, were enrolled. Anthropometric measurements (weight, height, waist circumference), biochemistry (glucose, insulin, triglycerides, high-density lipoprotein [HDL], thyroid function tests, C-reactive protein [CRP], magnesium), measurement of blood pressure, and Tanner staging were performed. MS was defined by International Diabetes Federation (IDF) and the National Cholesterol Education Program Third Adult Treatment Panel guidelines (NCEP ATP III) criteria, modified by Cook et al. (Arch Pediatr Adolesc Med. 2003;157:821-827) and Ford et al. (Diabetes Care. 2005;28:878-881). The median age of 76 survivors was 11.9 years (interquartile range [IQR]: 9.6-13.5). Twenty-four (32%) survivors were obese or overweight. The prevalence of insulin resistance (17%), hypertension (7%), hypertriglyceridemia (20%), and low HDL (37%) was comparable to the prevalence in children/adolescents in historical population-based studies from India. The prevalence of MS ranged from 1.3% to 5.2%, as per different defining criteria. Cranial radiotherapy, age at diagnosis, sex, or socioeconomic status were not risk factors for MS. The prevalence of MS in survivors of childhood ALL, at a median duration of 3 years from completion of chemotherapy, was comparable to the reference population. The prevalence of being obese or overweight was, however, greater than historical controls.

A guideline for the validation of likelihood ratio methods used for forensic evidence evaluation.

PubMed

Meuwly, Didier; Ramos, Daniel; Haraksim, Rudolf

2017-07-01

This Guideline proposes a protocol for the validation of forensic evaluation methods at the source level, using the Likelihood Ratio framework as defined within the Bayes' inference model. In the context of the inference of identity of source, the Likelihood Ratio is used to evaluate the strength of the evidence for a trace specimen, e.g. a fingermark, and a reference specimen, e.g. a fingerprint, to originate from common or different sources. Some theoretical aspects of probabilities necessary for this Guideline were discussed prior to its elaboration, which started after a workshop of forensic researchers and practitioners involved in this topic. In the workshop, the following questions were addressed: "which aspects of a forensic evaluation scenario need to be validated?", "what is the role of the LR as part of a decision process?" and "how to deal with uncertainty in the LR calculation?". The questions: "what to validate?" focuses on the validation methods and criteria and "how to validate?" deals with the implementation of the validation protocol. Answers to these questions were deemed necessary with several objectives. First, concepts typical for validation standards [1], such as performance characteristics, performance metrics and validation criteria, will be adapted or applied by analogy to the LR framework. Second, a validation strategy will be defined. Third, validation methods will be described. Finally, a validation protocol and an example of validation report will be proposed, which can be applied to the forensic fields developing and validating LR methods for the evaluation of the strength of evidence at source level under the following propositions. Copyright © 2016. Published by Elsevier B.V.

Guidelines for the acceptance of peroxide-containing oral hygiene products. American Dental Association Council on Dental Therapeutics.

PubMed

1994-08-01

Safety and efficacy criteria are defined for oral products containing various forms of peroxides. The guidelines ask for safety and efficacy studies plus observation criteria that include long-term follow-up.

Self Evaluation of Organizations.

ERIC Educational Resources Information Center

Pooley, Richard C.

Evaluation within human service organizations is defined in terms of accepted evaluation criteria, with reasonable expectations shown and structured into a model of systematic evaluation practice. The evaluation criteria of program effort, performance, adequacy, efficiency and process mechanisms are discussed, along with measurement information…

Revisiting Bioaccumulation Criteria

EPA Science Inventory

The objective of workgroup 5 was to revisit the B(ioaccumulation) criteria that are currently being used to identify POPs under the Stockholm Convention and PBTs under CEPA, TSCA, REACh and other programs. Despite the lack of a recognized definition for a B substance, we defined ...

AIR QUALITY CRITERIA FOR PARTICULATE MATTER, VOLUMES I-III

EPA Science Inventory

There is no abstract available for these documents. If further information is requested, please refer to the bibliographic citation and contact the Technical Information Staff at the number listed below.

• Air Quality Criteria for Particulate Matter, Volume I - EP...

• 38 CFR 17.804 - Loan approval criteria.

  Code of Federal Regulations, 2013 CFR

  2013-07-01

  ... of substance abuse, are financially able to pay their share of costs of maintaining the residence... Transitional Housing Loan Program § 17.804 Loan approval criteria. Upon consideration of the application... references, (b) Demonstrated ability to successfully address the needs of substance abusers as determined by...

• 38 CFR 17.804 - Loan approval criteria.

  Code of Federal Regulations, 2010 CFR

  2010-07-01

  ... of substance abuse, are financially able to pay their share of costs of maintaining the residence... Transitional Housing Loan Program § 17.804 Loan approval criteria. Upon consideration of the application... references, (b) Demonstrated ability to successfully address the needs of substance abusers as determined by...

• 38 CFR 17.804 - Loan approval criteria.

  Code of Federal Regulations, 2014 CFR

  2014-07-01

  ... of substance abuse, are financially able to pay their share of costs of maintaining the residence... Transitional Housing Loan Program § 17.804 Loan approval criteria. Upon consideration of the application... references, (b) Demonstrated ability to successfully address the needs of substance abusers as determined by...

• 38 CFR 17.804 - Loan approval criteria.

  Code of Federal Regulations, 2011 CFR

  2011-07-01

  ... of substance abuse, are financially able to pay their share of costs of maintaining the residence... Transitional Housing Loan Program § 17.804 Loan approval criteria. Upon consideration of the application... references, (b) Demonstrated ability to successfully address the needs of substance abusers as determined by...

• 38 CFR 17.804 - Loan approval criteria.

  Code of Federal Regulations, 2012 CFR

  2012-07-01

  ... of substance abuse, are financially able to pay their share of costs of maintaining the residence... Transitional Housing Loan Program § 17.804 Loan approval criteria. Upon consideration of the application... references, (b) Demonstrated ability to successfully address the needs of substance abusers as determined by...

• 40 CFR 46.160 - Evaluation of applications.

  Code of Federal Regulations, 2011 CFR

  2011-07-01

  ... application based on criteria identified in the request for applications or program announcement. Evaluation criteria may include: (a) The relevance of your proposed studies to EPA's mission. (b) Your potential for success, as reflected by your academic record, letters of reference, and any other available information...

• 40 CFR 46.160 - Evaluation of applications.

  Code of Federal Regulations, 2010 CFR

  2010-07-01

  ... application based on criteria identified in the request for applications or program announcement. Evaluation criteria may include: (a) The relevance of your proposed studies to EPA's mission. (b) Your potential for success, as reflected by your academic record, letters of reference, and any other available information...

• Reference Intervals of Common Clinical Chemistry Analytes for Adults in Hong Kong.

  PubMed

  Lo, Y C; Armbruster, David A

  2012-04-01

  Defining reference intervals is a major challenge because of the difficulty in recruiting volunteers to participate and testing samples from a significant number of healthy reference individuals. Historical literature citation intervals are often suboptimal because they're be based on obsolete methods and/or only a small number of poorly defined reference samples. Blood donors in Hong Kong gave permission for additional blood to be collected for reference interval testing. The samples were tested for twenty-five routine analytes on the Abbott ARCHITECT clinical chemistry system. Results were analyzed using the Rhoads EP evaluator software program, which is based on the CLSI/IFCC C28-A guideline, and defines the reference interval as the 95% central range. Method specific reference intervals were established for twenty-five common clinical chemistry analytes for a Chinese ethnic population. The intervals were defined for each gender separately and for genders combined. Gender specific or combined gender intervals were adapted as appropriate for each analyte. A large number of healthy, apparently normal blood donors from a local ethnic population were tested to provide current reference intervals for a new clinical chemistry system. Intervals were determined following an accepted international guideline. Laboratories using the same or similar methodologies may adapt these intervals if deemed validated and deemed suitable for their patient population. Laboratories using different methodologies may be able to successfully adapt the intervals for their facilities using the reference interval transference technique based on a method comparison study.

Definition and feasibility of isolation distances for transgenic maize cultivation.

PubMed

Sanvido, Olivier; Widmer, Franco; Winzeler, Michael; Streit, Bernhard; Szerencsits, Erich; Bigler, Franz

2008-06-01

A major concern related to the adoption of genetically modified (GM) crops in agricultural systems is the possibility of unwanted GM inputs into non-GM crop production systems. Given the increasing commercial cultivation of GM crops in the European Union (EU), there is an urgent need to define measures to prevent mixing of GM with non-GM products during crop production. Cross-fertilization is one of the various mechanisms that could lead to GM-inputs into non-GM crop systems. Isolation distances between GM and non-GM fields are widely accepted to be an effective measure to reduce these inputs. However, the question of adequate isolation distances between GM and non-GM maize is still subject of controversy both amongst scientists and regulators. As several European countries have proposed largely differing isolation distances for maize ranging from 25 to 800 m, there is a need for scientific criteria when using cross-fertilization data of maize to define isolation distances between GM and non-GM maize. We have reviewed existing cross-fertilization studies in maize, established relevant criteria for the evaluation of these studies and applied these criteria to define science-based isolation distances. To keep GM-inputs in the final product well below the 0.9% threshold defined by the EU, isolation distances of 20 m for silage and 50 m for grain maize, respectively, are proposed. An evaluation using statistical data on maize acreage and an aerial photographs assessment of a typical agricultural landscape by means of Geographic Information Systems (GIS) showed that spatial resources would allow applying the defined isolation distances for the cultivation of GM maize in the majority of the cases under actual Swiss agricultural conditions. The here developed approach, using defined criteria to consider the agricultural context of maize cultivation, may be of assistance for the analysis of cross-fertilization data in other countries.

Mathematical Methods of System Analysis in Construction Materials

NASA Astrophysics Data System (ADS)

Garkina, Irina; Danilov, Alexander

2017-10-01

System attributes of construction materials are defined: complexity of an object, integrity of set of elements, existence of essential, stable relations between elements defining integrative properties of system, existence of structure, etc. On the basis of cognitive modelling (intensive and extensive properties; the operating parameters) materials (as difficult systems) and creation of the cognitive map the hierarchical modular structure of criteria of quality is under construction. It actually is a basis for preparation of the specification on development of material (the required organization and properties). Proceeding from a modern paradigm (model of statement of problems and their decisions) of development of materials, levels and modules are specified in structure of material. It when using the principles of the system analysis allows to considered technological process as the difficult system consisting of elements of the distinguished specification level: from atomic before separate process. Each element of system depending on an effective objective is considered as separate system with more detailed levels of decomposition. Among them, semantic and qualitative analyses of an object (are considered a research objective, decomposition levels, separate elements and communications between them come to light). Further formalization of the available knowledge in the form of mathematical models (structural identification) is carried out; communications between input and output parameters (parametrical identification) are defined. Hierarchical structures of criteria of quality are under construction for each allocated level. On her the relevant hierarchical structures of system (material) are under construction. Regularities of structurization and formation of properties, generally are considered at the levels from micro to a macrostructure. The mathematical model of material is represented as set of the models corresponding to private criteria by which separate modules and their levels (the mathematical description, a decision algorithm) are defined. Adequacy is established (compliance of results of modelling to experimental data; is defined by the level of knowledge of process and validity of the accepted assumptions). The global criterion of quality of material is considered as a set of private criteria (properties). Synthesis of material is carried out on the basis of one-criteria optimization on each of the chosen private criteria. Results of one-criteria optimization are used at multicriteria optimization. The methods of developing materials as single-purpose, multi-purpose, including contradictory, systems are indicated. The scheme of synthesis of composite materials as difficult systems is developed. The specified system approach effectively was used in case of synthesis of composite materials with special properties.

Planning for CD-ROM in the Reference Department.

ERIC Educational Resources Information Center

Graves, Gail T.; And Others

1987-01-01

Outlines the evaluation criteria used by the reference department at the Williams Library at the University of Mississippi in selecting databases and hardware used in CD-ROM workstations. The factors discussed include database coverage, costs, and security. (CLB)

Low agreement between the fitnessgram criterion references for adolescents

PubMed Central

Coledam, Diogo Henrique Constantino; Batista, João Pedro; Glaner, Maria Fátima

2015-01-01

OBJECTIVE: To analyze the association and agreement of fitnessgram reference criteria (RC) for cardiorespiratory fitness, body mass index (BMI) and strength in youth. METHODS: The study included 781 youth, 386 females, aged 10 to 18 years of Londrina-PR. It were performed cardiorespiratory fitness and muscular strength tests and was calculated body mass index. The association between the tests was analyzed using Poisson regression to obtain prevalence ratio (PR) and confidence intervals of 95%, while agreement of the reference criteria was tested by Kappa index. RESULTS: Significant associations were found between cardiorespiratory fitness and BMI (PR=1,49, 1,27-1,75), muscle strength and BMI (PR=1,55, 1,17-2,08), cardiorespiratory fitness and muscle strength (PR=1,81, 1,47-2,24). The agreement between reference criteria ranged from weak to fair, 48.8% (k=0.05, p=0.10) for cardiorespiratory fitness and BMI, 52.9% (k=0.09, p=0.001) for muscle strength and BMI and 38.4% (k=0.22, p<0.001) for cardiorespiratory fitness and muscle strength. CONCLUSIONS: Although RC for cardiorespiratory fitness, muscle strength and BMI are associated, the agreement between them ranged from weak to fair. To evaluate health related physical fitness it is suggest the execution of all tests, since each test has specific characteristics. PMID:25649383

2011 Information Systems Summit 2 Held in Baltimore, Maryland on April 4-6, 2011

DTIC Science & Technology

2011-04-04

to automate. Some criteria that should be considered: – Are the tests easy to automate? What makes a test easy to automate is the ability to script...ANSI-748-B defines 32 criteria needs for a FAR/DFAR compliant Earned Value Management System. These criteria address 5 areas of Earned Value...are the basis of Increasing the Probability of Success of any program. But there are 11 critical criteria that must be present not matter what

Selection of reference standard during method development using the analytical hierarchy process.

PubMed

Sun, Wan-yang; Tong, Ling; Li, Dong-xiang; Huang, Jing-yi; Zhou, Shui-ping; Sun, Henry; Bi, Kai-shun

2015-03-25

Reference standard is critical for ensuring reliable and accurate method performance. One important issue is how to select the ideal one from the alternatives. Unlike the optimization of parameters, the criteria of the reference standard are always immeasurable. The aim of this paper is to recommend a quantitative approach for the selection of reference standard during method development based on the analytical hierarchy process (AHP) as a decision-making tool. Six alternative single reference standards were assessed in quantitative analysis of six phenolic acids from Salvia Miltiorrhiza and its preparations by using ultra-performance liquid chromatography. The AHP model simultaneously considered six criteria related to reference standard characteristics and method performance, containing feasibility to obtain, abundance in samples, chemical stability, accuracy, precision and robustness. The priority of each alternative was calculated using standard AHP analysis method. The results showed that protocatechuic aldehyde is the ideal reference standard, and rosmarinic acid is about 79.8% ability as the second choice. The determination results successfully verified the evaluation ability of this model. The AHP allowed us comprehensive considering the benefits and risks of the alternatives. It was an effective and practical tool for optimization of reference standards during method development. Copyright © 2015 Elsevier B.V. All rights reserved.

FRAMEWORK FOR DEVELOPING SUSPENDED AND BEDDED SEDIMENT (SABS) WATER QUALITY CRITERIA: STEP 4 - DEFINE POTENTIAL RANGES IN VALUE OF THE SABS AND RESPONSE INDICATORS, AND CLASSIFICATION OF WATERBODIES USING AN EMPIRICAL APPROACH

EPA Science Inventory

After reviewing existing water quality criteria and consulting stakeholders, EPA developed a process that states, tribes, and regions can use to develop scientifically defensible SABS criteria. The process is flexible, can be adapted to utilize existing data sets, and can be gea...

Web Site Design Benchmarking within Industry Groups.

ERIC Educational Resources Information Center

Kim, Sung-Eon; Shaw, Thomas; Schneider, Helmut

2003-01-01

Discussion of electronic commerce focuses on Web site evaluation criteria and applies them to different industry groups in Korea. Defines six categories of Web site evaluation criteria: business function, corporate credibility, contents reliability, Web site attractiveness, systematic structure, and navigation; and discusses differences between…

SENSITIVITY ANALYSIS OF THE APPLICATION OF CHEMICAL EXPOSURE CRITERIA FOR COMPARING SITES AND WATERSHEDS

EPA Science Inventory

A methodology was developed for deriving quantitative exposure criteria useful for comparing a site or watershed to a reference condition. The prototype method used indicators of exposures to oil contamination and combustion by-products, naphthalene and benzo(a)pyrene metabolites...

Model documentation Natural Gas Transmission and Distribution Model of the National Energy Modeling System. Volume 1

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

NONE

1996-02-26

The Natural Gas Transmission and Distribution Model (NGTDM) of the National Energy Modeling System is developed and maintained by the Energy Information Administration (EIA), Office of Integrated Analysis and Forecasting. This report documents the archived version of the NGTDM that was used to produce the natural gas forecasts presented in the Annual Energy Outlook 1996, (DOE/EIA-0383(96)). The purpose of this report is to provide a reference document for model analysts, users, and the public that defines the objectives of the model, describes its basic approach, and provides detail on the methodology employed. Previously this report represented Volume I of amore » two-volume set. Volume II reported on model performance, detailing convergence criteria and properties, results of sensitivity testing, comparison of model outputs with the literature and/or other model results, and major unresolved issues.« less

Preliminary report on aerotoxic syndrome (AS) and the need for diagnostic neurophysiological tests.

PubMed

Hale, Margaret A; Al-Seffar, Judith A

2009-09-01

Researchers have found, in studies carried out over several years, that many passengers and crew, following their recent flights in commercial jet aeroplanes, have become unwell, with a range of symptoms in common. This condition, which has not yet been officially recognised, is called Aerotoxic Syndrome (AS). It seems to be caused, primarily, by neurotoxic organophosphates contaminating the air circulating in jet cabins. Patients with such symptoms may visit their GPs, who then arrange diagnostic tests. Some of their symptoms fall within the jurisdiction of diagnostic neurophysiological investigations, but neurophysiology practitioners may be unaware of this syndrome. Until AS is officially recognised as an illness, and guidelines for diagnostic procedures established, patients requiring specific investigations may not be appropriately referred, or tests may be performed unnecessarily. This report seeks to stimulate debate within the field, and facilitate studies, if needed, to help define the diagnostic criteria.

Quality standards of the European Pharmacopoeia.

PubMed

Bouin, Anne-Sophie; Wierer, Michael

2014-12-02

The European Pharmacopoeia (Ph. Eur.) provides a legal and scientific reference for the quality control of medicines. It is legally binding in the 38 signatory parties of the Convention on the elaboration of a European Pharmacopoeia (37 member states and the European Union). The requirements for a specific herbal drug are prescribed in the corresponding individual monograph and the relevant general monographs. Criteria for pesticides and heavy metals for example are defined in the general monograph on Herbal drugs. The Ph. Eur. also provides general methods including methods for determination of aflatoxins B1 and ochratoxin A. Screening methods for aristolochic acids are applied for herbal drugs that may be subject to adulteration or substitution with plant material containing aristolochic acids. The Ph. Eur. collaborate in many areas with the European Medicines Agency (EMA) to ensure close collaboration as regards the respective work programmes and approach. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

STEPS: a grid search methodology for optimized peptide identification filtering of MS/MS database search results.

PubMed

Piehowski, Paul D; Petyuk, Vladislav A; Sandoval, John D; Burnum, Kristin E; Kiebel, Gary R; Monroe, Matthew E; Anderson, Gordon A; Camp, David G; Smith, Richard D

2013-03-01

For bottom-up proteomics, there are wide variety of database-searching algorithms in use for matching peptide sequences to tandem MS spectra. Likewise, there are numerous strategies being employed to produce a confident list of peptide identifications from the different search algorithm outputs. Here we introduce a grid-search approach for determining optimal database filtering criteria in shotgun proteomics data analyses that is easily adaptable to any search. Systematic Trial and Error Parameter Selection--referred to as STEPS--utilizes user-defined parameter ranges to test a wide array of parameter combinations to arrive at an optimal "parameter set" for data filtering, thus maximizing confident identifications. The benefits of this approach in terms of numbers of true-positive identifications are demonstrated using datasets derived from immunoaffinity-depleted blood serum and a bacterial cell lysate, two common proteomics sample types. © 2013 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Using baldrige performance excellence program approaches in the pursuit of radiation oncology quality care, patient satisfaction, and workforce commitment.

PubMed

Sternick, Edward S

2011-01-01

The Malcolm Baldrige National Quality Improvement Act was signed into law in 1987 to advance US business competitiveness and economic growth. Administered by the National Institute of Standards and Technology, the Act created the Baldrige National Quality Program, recently renamed the Baldrige Performance Excellence Program. The comprehensive analytical approaches referred to as the Baldrige Healthcare Criteria, are very well-suited for the evaluation and sustainable improvement of radiation oncology management and operations. A multidisciplinary self-assessment approach is used for radiotherapy program evaluation and development in order to generate a fact-based, knowledge-driven system for improving quality of care, increasing patient satisfaction, enhancing leadership effectiveness, building employee engagement, and boosting organizational innovation. This methodology also provides a valuable framework for benchmarking an individual radiation oncology practice's operations and results against guidelines defined by accreditation and professional organizations and regulatory agencies.

Cumulative incidence and prevalence of childhood autism in children in Japan.

PubMed

Honda, H; Shimizu, Y; Misumi, K; Niimi, M; Ohashi, Y

1996-08-01

An epidemiological survey of childhood autism as defined in ICD-10 Research Criteria was conducted in the northern part of Yokohama, Japan. The routine health checkup for 18-month-old children served as the initial mass-screening, and all facilities which provide child care services function to detect all cases with childhood autism and refer them to the Yokohama Rehabilitation Centre. Cumulative incidence of childhood autism up to 5 years of age among the birth cohort of 1988, and prevalence on 1 January 1994, among residents born in 1988 were estimated Cumulative incidence and prevalence were 16.2 per 10,000 and 21.1 per 10,000, respectively. Children with high-functioning autism who had IQs of 70 and over constituted approximately half of all the children with childhood autism. CONCLUSION. It was confirmed through better detection of high-functioning cases that childhood autism in Japan is more common than formerly estimated.

Exercise guidelines for inpatients following ventricular assist device placement: a systematic review of the literature.

PubMed

Scheiderer, Rachel; Belden, Courtney; Schwab, Darla; Haney, Casey; Paz, Jaime

2013-06-01

For patients with end-stage heart failure awaiting transplantation, lack of donor organs has created an increased need for alternatives such as left ventricular assist device (LVAD) implantation. The purpose of this study is to determine safe and effective exercise parameters for physical therapy in the acute care setting. A systematic literature review was conducted according to PRISMA guidelines using Sackett's Levels of Evidence to rate the evidence. Multiple databases were searched with inclusion criteria of: available in English, inpatient care up to 6 months postoperatively, description of intervention type and exercise parameters. no defined exercise parameters, outpatient treatment, infection post VAD, or palliative or hospice care post VAD. Six studies out of 1,291 articles met inclusion criteria. Common exercise parameters used were the Borg Rating of Perceived Exertion scale 11-13 (6-20 scale) or > 4 (0-10 scale), Dyspnea scale > 2 (0-4 scale) and > 5 (0-10 scale), mean arterial pressure (MAP) 70-95 mmHg, and LVAD flow > 3L/min. Levels of evidence ranged from case controlled to expert opinion. Current evidence on inpatient exercise parameters for patient's status post LVAD implantation is not sufficient to suggest definitive guidelines; however, these exercise parameters provide a reference for patient care.

Snake venoms: A brief treatise on etymology, origins of terminology, and definitions.

PubMed

Weinstein, Scott A

2015-09-01

The ancient perceptions of "venomous" and "poisonous snakes", as well as the Indo-European (IE) etymological origins of the term "venom" specifically associated with snakes are considered. Although several ancient cultures perceived snakes as symbols of fecundity and renewal, concurrent beliefs also associated venomous snakes with undesirable human characteristics or as portending non-propitious events. The respective IE roots of the terms "venom" and "poison", "wen" and "poi" refer to desire or the act of ingesting liquids. The origin of the term, "venom", is associated with polytheistic cults that emphasized attainment of desires sometimes assisted by "love potions", a term later interpolated with the word, "poison". Specific interpretation of the term, venom, has varied since its first probable use in the mid-Thirteenth Century. The definition of snake venom has long been contended, and interpretations have often reflected emphasis on the pharmacological or experimental toxicity of medically relevant snake venoms with less regard for the basic biological bases of these venoms, as well as those from snakes with no known medical significance. Several definitions of "snake venom" and their defining criteria are reviewed, and critical consideration is given to traditional criteria that might facilitate the future establishment of a biologically accurate definition. Crown Copyright © 2015. Published by Elsevier Ltd. All rights reserved.

Diagnostic Performance of Breast Magnetic Resonance Imaging in Non-Calcified Equivocal Breast Findings: Results from a Systematic Review and Meta-Analysis.

PubMed

Bennani-Baiti, Barbara; Bennani-Baiti, Nabila; Baltzer, Pascal A

2016-01-01

To evaluate the performance of MRI for diagnosis of breast cancer in non-calcified equivocal breast findings. We performed a systematic review and meta-analysis of peer-reviewed studies in PubMed from 01/01/1986 until 06/15/2015. Eligible were studies applying dynamic contrast-enhanced breast MRI as an adjunct to conventional imaging (mammography, ultrasound) to clarify equivocal findings without microcalcifications. Reference standard for MRI findings had to be established by histopathological sampling or imaging follow-up of at least 12 months. Number of true or false positives and negatives and other characteristics were extracted, and possible bias was determined using the QUADAS-2 applet. Statistical analyses included data pooling and heterogeneity testing. Fourteen out of 514 studies comprising 2,316 lesions met our inclusion criteria. Pooled diagnostic parameters were: sensitivity (99%, 95%-CI: 93-100%), specificity (89%, 95%-CI: 85-92%), PPV (56%, 95%-CI: 42-70%) and NPV (100%, 95%-CI: 99-100%). These estimates displayed significant heterogeneity (P<0.001). Breast MRI demonstrates an excellent diagnostic performance in case of non-calcified equivocal breast findings detected in conventional imaging. However, considering the substantial heterogeneity with regard to prevalence of malignancy, problem solving criteria need to be better defined.

Clinical criteria for psychiatric diagnosis and DSM-III.

PubMed

Spitzer, R L; Endicott, J; Robins, E

1975-11-01

The authors identify the differences in formal inclusion and exclusion criteria used to classify patient data into diagnoses as the largest source of diagnostic unreliability in psychiatry. They describe the efforts that have been made to reduce these differences, particularly the specified criteria approach to defining diagnostic categories, which was developed for research purposes. On the basis of studies showing that the use of specified criteria increases the reliability of diagnostic judgments, they suggest that including such criteria in the next edition of APA's Diagnostic and Statistical Manual of Mental Disorders (DSM-III) would improve the reliability and validity of routine psychiatric diagnosis.

[Unnecessary routine laboratory tests in patients referred for surgical services].

PubMed

Mata-Miranda, María del Pilar; Cano-Matus, Norberto; Rodriguez-Murrieta, Margarita; Guarneros-Zapata, Idalia; Ortiz, Mario

2016-01-01

To question the usefulness of the lab analysis considered routine testing for the identification of abnormalities in the surgical care. To determine the percentage of unnecessary laboratory tests in the preoperative assessment as well as to estimate the unnecessary expenses. A descriptive, cross-sectional study of patients referred for surgical evaluation between January 1st and March 31st 2013. The database of laboratory testing and electronic files were reviewed. Reference criteria from surgical services were compared with the tests requested by the family doctor. In 65% of the patients (n=175) unnecessary examinations were requested, 25% (n=68) were not requested the tests that they required, and only 10% of the patients were requested laboratory tests in accordance with the reference criteria (n=27). The estimated cost in unnecessary examinations was $1,129,552 in a year. The results were similar to others related to this theme, however, they had not been revised from the perspective of the first level of attention regarding the importance of adherence to the reference criteria which could prevent major expenditures. It is a priority for leaders and operational consultants in medical units to establish strategies and lines of action that ensure compliance with institutional policies so as to contain spending on comprehensive services, and which in turn can improve the medical care. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

Long chain omega-3 dietary supplements: a review of the National Library of Medicine Herbal Supplement Database.

PubMed

Zargar, Atanaz; Ito, Matthew K

2011-08-01

Dietary fish oil supplements are increasingly used as an alternative to prescription-grade omega-3 fatty acids (P-OM3) for the treatment of hypertriglyceridemia. The content of eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) in these supplement products varies widely and may result in a suboptimal response. The aim of this study was to review marketed fish oil supplements and to develop a reference for clinicians to compare products. The National Library of Medicine Herbal Supplement Database was systematically searched using fish oil, EPA, DHA, and omega-3 fatty acid as search terms. Daily doses needed to achieve the Food and Drug Administration (FDA)-approved dose (RxDose) (3,360 mg of combined EPA and DHA) were calculated from the milligrams of EPA and DHA per serving, and suggested retail prices were used to calculate monthly cost of each product. A "usage criteria" was set to highlight products at the RxDose with a monthly cost of <$50, daily servings <8, daily amount of vitamins A and D less than or equal to the U.S. Dietary Reference Intake upper limit defined as 10,000 and 4,000 IU, respectively, and if the product was U.S. Pharmacopeia verified. A total of 163 products were identified, and 102 nonliquid and liquid products met our entry criteria. The median amount of EPA and DHA per serving in the nonliquid products was 216 mg and 200 mg, respectively, and the median number of servings at the RxDose was 11.2 at a median monthly cost of $63.49. The median amount of EPA (460 mg) and DHA (400 mg) per serving in the liquid products was higher than the nonliquid products. Thus, the median number of servings at the RxDose was only 3.6 teaspoons and the median monthly cost of $13.60. Only 22% of products met our "usage criteria." The amount of EPA and DHA per recommended serving in these products was highly variable. Clinicians should heighten their scrutiny in terms of selection of the appropriate product.

Association of prediabetes, defined by fasting glucose, HbA1c only, or combined criteria, with the risk of cardiovascular disease in Koreans.

PubMed

Kim, Hong-Kyu; Lee, Jung Bok; Kim, Seon Ha; Jo, Min-Woo; Kim, Eun Hee; Hwang, Jenie Yoonoo; Bae, Sung Jin; Jung, Chang Hee; Lee, Woo Je; Park, Joong-Yeol; Park, Gyung-Min; Kim, Young-Hak; Choe, Jaewon

2016-09-01

The aim of the present study was to compare the association between cardiovascular diseases (CVD) and prediabetes defined by either fasting plasma glucose (FPG), HbA1c, or their combination in a Korean population. In all, 76 434 South Koreans who voluntarily underwent a general health examination in the Health Screening & Promotion Center (Asan Medical Center) were analyzed after excluding patients with a previous history of CVD. Cardiovascular events and death due to CVD during a median follow-up period of 3.1 years (interquartile range 1.9-4.3 years) were identified from the Nationwide Health Insurance Claims Database and death certificates using ICD-10 codes. Age- and sex-adjusted hazard ratios (HRs) for overall CVD events were significantly greater for subjects with prediabetes defined by FPG only (HR 1.19; 95% confidence interval [CI] 1.08-1.31), HbA1c only (HR 1.28; 95% CI 1.16-1.42), and combined criteria (HR 1.20; 95% CI 1.09-1.32) compared with the normoglycemic group. After adjusting for multiple conventional risk factors (e.g. hypertension, low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, smoking status, family history of CVD, and BMI), the HRs for overall CVD were significantly increased only for participants with prediabetes defined by HbA1c. Age- and sex-adjusted HRs for major ischemic heart disease events were significantly increased for subjects with prediabetes defined either by HbA1c or combined criteria. Similarly, age- and sex-adjusted HRs for percutaneous coronary intervention were significantly higher for subjects with prediabetes defined by HbA1c only. For diabetes, the multivariate-adjusted HRs for all outcomes were significantly increased by all three criteria. Adding an HbA1c criterion when defining prediabetes in Koreans can help identify individuals with an increased risk of CVD. © 2016 Ruijin Hospital, Shanghai Jiaotong University School of Medicine and John Wiley & Sons Australia, Ltd.

A Quick Reference on Magnesium.

PubMed

Bateman, Shane W

2017-03-01

This article serves as a quick reference on the distribution, handling, and supplementation of magnesium. It also lists the manifestations and causes of magnesium deficit and provides criteria for the diagnosis of a magnesium deficit. Copyright © 2016 Elsevier Inc. All rights reserved.

Concepts, Structures, and Goals: Redefining Ill-Definedness

ERIC Educational Resources Information Center

Lynch, Collin; Ashley, Kevin D.; Pinkwart, Niels; Aleven, Vincent

2009-01-01

In this paper we consider prior definitions of the terms "ill-defined domain" and "ill-defined problem". We then present alternate definitions that better support research at the intersection of Artificial Intelligence and Education. In our view both problems and domains are ill-defined when essential concepts, relations, or criteria are un- or…

Additional nuclear criticality safety calculations for small-diameter containers

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

Hone, M.J.

This report documents additional criticality safety analysis calculations for small diameter containers, which were originally documented in Reference 1. The results in Reference 1 indicated that some of the small diameter containers did not meet the criteria established for criticality safety at the Portsmouth facility (K{sub eff} +2{sigma}<.95) when modeled under various contingency assumptions of reflection and moderation. The calculations performed in this report reexamine those cases which did not meet the criticality safety criteria. In some cases, unnecessary conservatism is removed, and in other cases mass or assay limits are established for use with the respective containers.

7 CFR 3401.17 - Review criteria.

Code of Federal Regulations, 2011 CFR

2011-01-01

... RESEARCH GRANTS PROGRAM Scientific Peer Review of Research Applications for Funding § 3401.17 Review criteria. (a) Federally funded research supported under these provisions shall be designed to, among other... revegetation and/or rehabilitation of rangelands; (4) Examine the health of rangelands; and (5) Define economic...

45 CFR 1308.17 - Eligibility criteria: Other impairments.

Code of Federal Regulations, 2010 CFR

2010-10-01

... State Education Agency eligibility criteria for preschool children include an additional category which... of special education,” “educationally handicapped,” and “non-categorically handicapped.” (c) Children ages three to five, inclusive, who are experiencing developmental delays, as defined by their State and...

45 CFR 1308.17 - Eligibility criteria: Other impairments.

Code of Federal Regulations, 2011 CFR

2011-10-01

... State Education Agency eligibility criteria for preschool children include an additional category which... of special education,” “educationally handicapped,” and “non-categorically handicapped.” (c) Children ages three to five, inclusive, who are experiencing developmental delays, as defined by their State and...

Space shuttle program: Lightning protection criteria document

NASA Technical Reports Server (NTRS)

1975-01-01

The lightning environment for space shuttle design is defined and requirements that the design must satisfy to insure protection of the vehicle system from direct and indirect effects of lightning are imposed. Specifications, criteria, and guidelines included provide a practical and logical approach to protection problems.

Predicting School Performance with the Early Screening Inventory.

ERIC Educational Resources Information Center

Meisels, Samuel J.; And Others

1984-01-01

Proposes criteria for defining and selecting preschool developmental screening instruments and describes the Early Screening Inventory (ESI), a developmental screening instrument designed to satisfy these criteria. Presents results of several studies demonstrating that the ESI predicts school performance with moderate to excellent accuracy through…

7 CFR 170.12 - What are the selection criteria for participation in the USDA Farmers Market?

Code of Federal Regulations, 2010 CFR

2010-01-01

... referred to the Internal Revenue Service or a tax advisor. Receipts for donated foods may be obtained from... Agriculture (Continued) AGRICULTURAL MARKETING SERVICE (Standards, Inspections, Marketing Practices... Farmers Market? The selection criteria are designed to ensure a consistently high level of quality and...

AIR QUALITY CRITERIA FOR PARTICULATE MATTER, VOLUMES I-III, (EXTERNAL REVIEW DRAFT, 1995)

EPA Science Inventory

There is no abstract available for these documents.

If further information is requested, please refer to the bibliographic citation and contact the Technical Information Staff at the number listed above.

• Air Quality Criteria for Particulate Matter, Volume I, Extern...

• 40 CFR 152.50 - Contents of application.

  Code of Federal Regulations, 2010 CFR

  2010-07-01

  ... applicant must submit materials to demonstrate that he has complied with the FIFRA sec. 3(c)(1)(F) and... child-resistant packaging. If the product meets the criteria for child-resistant packaging, the... packaging. Refer to part 157 of this chapter for the criteria and certification requirements. (h) Request...

• 40 CFR 152.50 - Contents of application.

  Code of Federal Regulations, 2011 CFR

  2011-07-01

  ... applicant must submit materials to demonstrate that he has complied with the FIFRA sec. 3(c)(1)(F) and... child-resistant packaging. If the product meets the criteria for child-resistant packaging, the... packaging. Refer to part 157 of this chapter for the criteria and certification requirements. (h) Request...

• Reference Condition Approach for Numeric Nutrient Criteria for Oregon Estuaries

  EPA Science Inventory

  Development of nutrient criteria for all water body types of the US remains a top priority for EPA. Estuaries in the Pacific Northwest receive nutrients from both the watershed and the coastal ocean, and thus are particularly complex systems in which to establish water quality c...

• Sensitivity and Specificity of Polysomnographic Criteria for Defining Insomnia

  PubMed Central

  Edinger, Jack D.; Ulmer, Christi S.; Means, Melanie K.

  2013-01-01

  Study Objectives: In recent years, polysomnography-based eligibility criteria have been increasingly used to identify candidates for insomnia research, and this has been particularly true of studies evaluating pharmacologic therapy for primary insomnia. However, the sensitivity and specificity of PSG for identifying individuals with insomnia is unknown, and there is no consensus on the criteria sets which should be used for participant selection. In the current study, an archival data set was used to test the sensitivity and specificity of PSG measures for identifying individuals with primary insomnia in both home and lab settings. We then evaluated the sensitivity and specificity of the eligibility criteria employed in a number of recent insomnia trials for identifying primary insomnia sufferers in our sample. Design: Archival data analysis. Settings: Study participants' homes and a clinical sleep laboratory. Participants: Adults: 76 with primary insomnia and 78 non-complaining normal sleepers. Measurements and Results: ROC and cross-tabs analyses were used to evaluate the sensitivity and specificity of PSG-derived total sleep time, latency to persistent sleep, wake after sleep onset, and sleep efficiency for discriminating adults with primary insomnia from normal sleepers. None of the individual criteria accurately discriminated PI from normal sleepers, and none of the criteria sets used in recent trials demonstrated acceptable sensitivity and specificity for identifying primary insomnia. Conclusions: The use of quantitative PSG-based selection criteria in insomnia research may exclude many who meet current diagnostic criteria for an insomnia disorder. Citation: Edinger JD; Ulmer CS; Means MK. Sensitivity and specificity of polysomnographic criteria for defining insomnia. J Clin Sleep Med 2013;9(5):481-491. PMID:23674940

• Serum biomarkers are similar in Churg-Strauss syndrome and hypereosinophilic syndrome.

  PubMed

  Khoury, P; Zagallo, P; Talar-Williams, C; Santos, C S; Dinerman, E; Holland, N C; Klion, A D

  2012-09-01

  Churg-Strauss syndrome (CSS) and hypereosinophilic syndrome (HES) overlap considerably in clinical presentation. A reliable means of distinguishing between these groups of patients is needed, especially in the setting of glucocorticoid therapy. A retrospective chart review of 276 adult subjects referred for evaluation of eosinophilia > 1500/μl was performed, and subjects with a documented secondary cause of eosinophilia or a PDGFR -positive myeloproliferative neoplasm were excluded. The remaining subjects were assessed for the presence of American College of Rheumatology (ACR) criteria. Laboratory and clinical parameters were compared between subjects with biopsy-proven vasculitis (CSS; n = 8), ≥4 ACR criteria (probable CSS; n = 21), HES with asthma and/or sinusitis without other CSS-defining criteria (HESwAS; n = 20), HES without asthma or sinusitis (HES; n = 18), and normal controls (n = 8). Serum biomarkers reported to be associated with CSS were measured using standard techniques. There were no differences between the subjects with definite or probable CSS or HES with respect to age, gender, or maintenance steroid dose. Serum CCL17, IL-8, and eotaxin levels were significantly increased in eosinophilic subjects as compared to normal controls, but were similar between the eosinophilic groups. Serum CCL17 correlated with eosinophil count (P < 0.0001, r = 0.73), but not with prednisone dose. In patients with a history of asthma and sinusitis, distinguishing between ANCA-negative CSS and PDGFR-negative HES is difficult because of significant overlap in clinical presentation and biomarker profiles. Published 2012. This article is a U.S. Government work and is in the public domain in the USA.

• Patient issues in health research and quality of care: an inventory and data synthesis.

  PubMed

  Teunissen, Truus; Visse, Merel; de Boer, Pim; Abma, Tineke A

  2013-12-01

  The purpose of this review is to generate an inventory of issues that matter from a patient perspective in health research and quality of care. From these issues, criteria will be elicited to support patient(s) (groups) in their role as advisor or advocate when appraising health research, health policy and quality of health care. Literature shows that patients are beginning to develop their own voice and agenda's with issues in order to be prepared for the collaboration with professionals. Yet, patient issues have not been investigated systematically. This review addresses what patients find important and help to derive patient criteria for appraising research and quality of care. METHODS/SEARCH STRATEGY: Information was gathered from Western countries with similar economic, societal and health-care situations. We searched (from January 2000 to March 2010) for primary sources, secondary sources and tertiary sources; non-scientific publications were also included. The international inventory of issues that were defined by patients is covering a large array of domains. In total, 35 issue clusters further referred to as criteria were found ranging from dignity to cost effectiveness and family involvement. Issues from a patient perspective reveal patient values and appear to be adding to professional issues. Patient issues cover a broad domain, including fundamental values, quality of life, quality of care and personal development. Quite a few issues do not find its reflection in the scientific literature in spite of their clear and obvious appearance from tertiary sources. This may indicate a gap between the scientific research community and patient networks. © 2011 John Wiley & Sons Ltd.

• Patient issues in health research and quality of care: an inventory and data synthesis

  PubMed Central

  Teunissen, Truus; Visse, Merel; de Boer, Pim; Abma, Tineke A.

  2011-01-01

  Abstract Aim  The purpose of this review is to generate an inventory of issues that matter from a patient perspective in health research and quality of care. From these issues, criteria will be elicited to support patient(s) (groups) in their role as advisor or advocate when appraising health research, health policy and quality of health care. Background  Literature shows that patients are beginning to develop their own voice and agenda’s with issues in order to be prepared for the collaboration with professionals. Yet, patient issues have not been investigated systematically. This review addresses what patients find important and help to derive patient criteria for appraising research and quality of care. Methods/search strategy  Information was gathered from Western countries with similar economic, societal and health‐care situations. We searched (from January 2000 to March 2010) for primary sources, secondary sources and tertiary sources; non‐scientific publications were also included. Results  The international inventory of issues that were defined by patients is covering a large array of domains. In total, 35 issue clusters further referred to as criteria were found ranging from dignity to cost effectiveness and family involvement. Issues from a patient perspective reveal patient values and appear to be adding to professional issues. Conclusions  Patient issues cover a broad domain, including fundamental values, quality of life, quality of care and personal development. Quite a few issues do not find its reflection in the scientific literature in spite of their clear and obvious appearance from tertiary sources. This may indicate a gap between the scientific research community and patient networks. PMID:21771226

• Iron Intake and Dietary Sources in the Spanish Population: Findings from the ANIBES Study

  PubMed Central

  Samaniego-Vaesken, Mᵃ de Lourdes; Partearroyo, Teresa; Olza, Josune; Aranceta-Bartrina, Javier; Gil, Ángel; González-Gross, Marcela; Ortega, Rosa M.; Serra-Majem, Lluis; Varela-Moreiras, Gregorio

  2017-01-01

  Background: Iron deficiency is one of the most common nutritional problems in the world. It is frequent in both developed and developing countries and mainly affects women of childbearing age and children. Methods: Results were derived from the ANIBES cross-sectional study using a nationally-representative sample of the Spanish population (9–75 years, n = 2009). A three-day dietary record, collected by means of a tablet device, was used to obtain information about food and beverage consumption and leftovers. Results: Total median dietary iron intake was 9.8 mg/day for women and 11.3 mg/day for men. Highest intakes were observed among plausible adolescent reporters (13.3 mg/day), followed by adults (13.0 mg/day), elderly (12.7 mg/day), and children (12.2 mg/day). Prevalence of adequacy for iron intakes as assessed by EFSA criteria was higher than for the Spanish Recommended Iron Intake values in all age groups. Females had lower adequacy than males for both criteria, 27.3% and 17.0% vs. 77.2% and 57.0% respectively. Cereals or grains (26.7%–27.4%), meats and derivatives (19.8%–22.7%), and vegetables (10.3%–12.4%) were the major iron contributors. Conclusion: Higher iron intakes were observed in adolescents and were highest for non-heme iron. The prevalence of adequate iron intake according to EFSA criteria was higher than compared to national recommendations, and women had the lowest intakes. Therefore, there is a need to define standard dietary reference intake to determine inadequate iron intakes in the Spanish population. PMID:28264431

Iron Intake and Dietary Sources in the Spanish Population: Findings from the ANIBES Study.

PubMed

Samaniego-Vaesken, Mᵃ de Lourdes; Partearroyo, Teresa; Olza, Josune; Aranceta-Bartrina, Javier; Gil, Ángel; González-Gross, Marcela; Ortega, Rosa M; Serra-Majem, Lluis; Varela-Moreiras, Gregorio

2017-02-27

Iron deficiency is one of the most common nutritional problems in the world. It is frequent in both developed and developing countries and mainly affects women of childbearing age and children. Results were derived from the ANIBES cross-sectional study using a nationally-representative sample of the Spanish population (9-75 years, n = 2009). A three-day dietary record, collected by means of a tablet device, was used to obtain information about food and beverage consumption and leftovers. Total median dietary iron intake was 9.8 mg/day for women and 11.3 mg/day for men. Highest intakes were observed among plausible adolescent reporters (13.3 mg/day), followed by adults (13.0 mg/day), elderly (12.7 mg/day), and children (12.2 mg/day). Prevalence of adequacy for iron intakes as assessed by EFSA criteria was higher than for the Spanish Recommended Iron Intake values in all age groups. Females had lower adequacy than males for both criteria, 27.3% and 17.0% vs. 77.2% and 57.0% respectively. Cereals or grains (26.7%-27.4%), meats and derivatives (19.8%-22.7%), and vegetables (10.3%-12.4%) were the major iron contributors. Higher iron intakes were observed in adolescents and were highest for non-heme iron. The prevalence of adequate iron intake according to EFSA criteria was higher than compared to national recommendations, and women had the lowest intakes. Therefore, there is a need to define standard dietary reference intake to determine inadequate iron intakes in the Spanish population.

MANCaLog: A Logic for Multi-Attribute Network Cascades

DTIC Science & Technology

2013-01-01

influence function , whose precise effects will be described later on when we discuss the semantics. As a result, a rule consists of four major parts...i) an influence function , (ii) neighbor criteria, (iii) target criteria, and (iv) a target. Intuitively, (i) specifies how the neighbors influence the...in terms of these elements. First, we define influence functions and neighbor criteria. Definition 2.6 ( Influence Function ). An influence function is a

Coexisting cerebral infarction in Alzheimer's disease is associated with fast dementia progression: applying the National Institute for Neurological Disorders and Stroke/Association Internationale pour la Recherche et l'Enseignement en Neurosciences Neuroimaging Criteria in Alzheimer's Disease with Concomitant Cerebral Infarction.

PubMed

Sheng, Bun; Cheng, Lik Fai; Law, Chun Bon; Li, Ho Lun; Yeung, Kwan Mo; Lau, Kwok Kwong

2007-06-01

To determine whether patients with Alzheimer's disease (AD) and coexisting cerebral infarction (CI) that satisfy the National Institute for Neurological Disorders and Stroke/Association Internationale pour la Recherche et l'Enseignement en Neurosciences (NINDS-AIREN) neuroimaging criteria for vascular dementia (VaD) progress faster than those who do not satisfy the neuroimaging criteria. Retrospective cohort study. Multidisciplinary memory clinic in a tertiary hospital. One hundred thirty consecutive patients with AD, with or without CI, followed up regularly for more than 1 year. The patients were classified according to the distribution and severity of CI as defined according to the NINDS-AIREN neuroimaging criteria into those with AD and no CI (AD-N), those with AD and CI not fulfilling neuroimaging criteria (AD-I), and those with AD and CI fulfilling neuroimaging criteria (AD-V), and their differences in dementia progression were tested. The loss of independence, indicated by institution admission or a clinical dementia rating (CDR) score of 3, was defined as the endpoint for a poor outcome. The mean age was 75.8, and 68.5% were women. The initial Mini-Mental State Examination (MMSE) score was 15.3+/-0.4, and the average duration of follow up was 30.4 months. Fifty-four patients had reached study endpoint at the time of analysis. AD-V (hazard ratio (HR)=3.1, 95% confidence interval (CI)=1.2-8.2), use of psychotropic drugs (HR=2.7, 95% CI=1.1-6.4), and initial MMSE score (HR=0.9, 95% CI=0.8-1.0) were independent predictors of poor outcome in the Cox regression model. In AD, co-occurrence of CI with distribution and severity as defined in the NINDS-AIREN neuroimaging criteria for VaD is associated with faster dementia progression.

Evaluating Electronic Reference Services: Issues, Approaches and Criteria.

ERIC Educational Resources Information Center

Novotny, Eric

2001-01-01

Discussion of electronic library reference services focuses on an overview of the chief methodologies available for conducting assessments of electronic services. Highlights include quantitative measures and benchmarks, including equity and access; quality measures; behavioral aspects of quality, including librarian-patron interaction; and future…

Rapid assessment of urban wetlands: Do hydrogeomorpic classification and reference criteria work?

EPA Science Inventory

The Hydrogeomorphic (HGM) functional assessment method is predicated on the ability of a wetland classification method based on hydrology (HGM classification) and a visual assessment of disturbance and alteration to provide reference standards against which functions in individua...

A Practical Clinical Approach to Diagnosis of Fetal Alcohol Spectrum Disorders: Clarification of the 1996 Institute of Medicine Criteria

PubMed Central

Eugene Hoyme, H.; May, Philip A.; Kalberg, Wendy O.; Kodituwakku, Piyadasa; Phillip Gossage, J.; Trujillo, Phyllis M.; Buckley, David G.; Miller, Joseph H.; Aragon, Alfredo S.; Khaole, Nathaniel; Viljoen, Denis L.; Jones, Kenneth Lyons; Robinson, Luther K.

2006-01-01

Background. The adverse effects of alcohol on the developing human represent a spectrum of structural anomalies and behavioral and neurocognitive disabilities, most accurately termed fetal alcohol spectrum disorders (FASD). The first descriptions in the modern medical literature of a distinctly recognizable pattern of malformations associated with maternal alcohol abuse were reported in 1968 and 1973. Since that time, substantial progress has been made in developing specific criteria for defining and diagnosing this condition. Two sets of diagnostic criteria are now used most widely for evaluation of children with potential diagnoses in the FASD continuum, ie, the 1996 Institute of Medicine (IOM) criteria and the Washington criteria. Although both approaches have improved the clinical delineation of FASD, both suffer from significant drawbacks in their practical application in pediatric practice. Objective. The purpose of this report is to present specific clarifications of the 1996 IOM criteria for the diagnosis of FASD, to facilitate their practical application in clinical pediatric practice. Methods. A large cohort of children who were prenatally exposed to alcohol were identified, through active case-ascertainment methods, in 6 Native American communities in the United States and 1 community in the Western Cape Province of South Africa. The children and their families underwent standardized multidisciplinary evaluations, including a dysmorphology examination, developmental and neuropsychologic testing, and a structured maternal interview, which gathered data about prenatal drinking practices and other demographic and family information. Data for these subjects were analyzed, and revisions and clarifications of the existing IOM FASD diagnostic categories were formulated on the basis of the results. Results. The revised IOM method defined accurately and completely the spectrum of disabilities among the children in our study. On the basis of this experience, we propose specific diagnostic criteria for fetal alcohol syndrome and partial fetal alcohol syndrome. We also define alcohol-related birth defects and alcohol-related neurodevelopmental disorder from a practical standpoint. Conclusions. The 1996 IOM criteria remain the most appropriate diagnostic approach for children prenatally exposed to alcohol. The proposed revisions presented here make these criteria applicable in clinical pediatric practice. Pediatrics 2005;115:39–47; fetal alcohol syndrome, fetal alcohol spectrum disorders, diagnostic criteria, mental retardation, developmental disabilities. PMID:15629980

Approaches to defining reference regimes for river restoration planning

NASA Astrophysics Data System (ADS)

Beechie, T. J.

2014-12-01

Reference conditions or reference regimes can be defined using three general approaches, historical analysis, contemporary reference sites, and theoretical or empirical models. For large features (e.g., floodplain channels and ponds) historical data and maps are generally reliable. For smaller features (e.g., pools and riffles in small tributaries), field data from contemporary reference sites are a reasonable surrogate for historical data. Models are generally used for features that have no historical information or present day reference sites (e.g., beaver pond habitat). Each of these approaches contributes to a watershed-wide understanding of current biophysical conditions relative to potential conditions, which helps create not only a guiding vision for restoration, but also helps quantify and locate the largest or most important restoration opportunities. Common uses of geomorphic and biological reference conditions include identifying key areas for habitat protection or restoration, and informing the choice of restoration targets. Examples of use of each of these three approaches to define reference regimes in western USA illustrate how historical information and current research highlight key restoration opportunities, focus restoration effort in areas that can produce the largest ecological benefit, and contribute to estimating restoration potential and assessing likelihood of achieving restoration goals.

WAIS Performance in Unincarcerated Groups of MMPI-Defined Sociopaths and Normal Controls

ERIC Educational Resources Information Center

Allain, Albert N.

1974-01-01

This investigation examines WAIS performance in groups of 32 sociopaths and 33 normal controls defined by Minnesota Multiphasic Personality Inventory criteria. Sociopaths and normal controls show no differences in overall level of intellectual functioning. (Author)

Fundamental Importance of Reference Glucose Analyzer Accuracy for Evaluating the Performance of Blood Glucose Monitoring Systems (BGMSs)

PubMed Central

Bailey, Timothy S.; Klaff, Leslie J.; Wallace, Jane F.; Greene, Carmine; Pardo, Scott; Harrison, Bern; Simmons, David A.

2016-01-01

Background: As blood glucose monitoring system (BGMS) accuracy is based on comparison of BGMS and laboratory reference glucose analyzer results, reference instrument accuracy is important to discriminate small differences between BGMS and reference glucose analyzer results. Here, we demonstrate the important role of reference glucose analyzer accuracy in BGMS accuracy evaluations. Methods: Two clinical studies assessed the performance of a new BGMS, using different reference instrument procedures. BGMS and YSI analyzer results were compared for fingertip blood that was obtained by untrained subjects’ self-testing and study staff testing, respectively. YSI analyzer accuracy was monitored using traceable serum controls. Results: In study 1 (N = 136), 94.1% of BGMS results were within International Organization for Standardization (ISO) 15197:2013 accuracy criteria; YSI analyzer serum control results showed a negative bias (−0.64% to −2.48%) at the first site and a positive bias (3.36% to 6.91%) at the other site. In study 2 (N = 329), 97.8% of BGMS results were within accuracy criteria; serum controls showed minimal bias (<0.92%) at both sites. Conclusions: These findings suggest that the ability to demonstrate that a BGMS meets accuracy guidelines is influenced by reference instrument accuracy. PMID:26902794

5 CFR 551.205 - Executive exemption criteria.

Code of Federal Regulations, 2010 CFR

2010-01-01

... Section 551.205 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE REGULATIONS PAY... criteria. (a) An executive employee is an employee whose primary duty is management (as defined in § 551... takes into consideration those organizations that use matrix management, i.e., a system of “shared...

Ventilator-Associated Pneumonia in Trauma Patients: Different Criteria, Different Rates.

PubMed

Leonard, Kenji L; Borst, Gregory M; Davies, Stephen W; Coogan, Michael; Waibel, Brett H; Poulin, Nathaniel R; Bard, Michael R; Goettler, Claudia E; Rinehart, Shane M; Toschlog, Eric A

2016-06-01

No consensus exists regarding the definition of ventilator-associated pneumonia (VAP). Even within a single institution, inconsistent diagnostic criteria result in conflicting rates of VAP. As a Level 1 trauma center participating in the Trauma Quality Improvement Project (TQIP) and the National Healthcare Safety Network (NHSN), our institution showed inconsistencies in VAP rates depending on which criteria was applied. The purpose of this study was to compare VAP definitions, defined by culture-based criteria, National Trauma Data Bank (NTDB) and NHSN, using incidence in trauma patients. A retrospective chart review of consecutive trauma patients who were diagnosed with VAP and met pre-determined inclusion and exclusion criteria admitted to our rural, 861-bed, Level 1 trauma and tertiary care center between January 2008 and December 2011 was performed. These patients were identified from the National Trauma Registry of the American College of Surgeons (NTRACS) database and an in-house infection control database. Ventilator-associated pneumonia diagnosis criteria defined by the U.S. Center for Disease Control and Prevention (used by the NHSN), the NTDB, and our institutional, culture-based criteria gold standard were compared among patients. Two hundred seventy-nine patients were diagnosed with VAP (25.4% met NHSN criteria, 88.2% met NTDB, and 76.3% met culture-based criteria). Only 58 (20.1%) patients met all three criteria. When NHSN criteria were compared with culture-based criteria, NHSN showed a high specificity (92.5%) and low sensitivity (28.2%). The positive predictive value (PPV) was 84.5%, but the negative predictive value (NPV) was 47.1%. The agreement between the NHSN and the culture-based criteria was poor (κ = 0.18). Conversely, the NTDB showed a lower specificity (57.8%), but greater sensitivity (86.4%) compared with culture-based criteria. The PPV and NPV were both 74% and the two criteria showed fair agreement (κ = 0.41). The lack of standard diagnostic criteria for VAP resulted in variable reporting to different agencies. Emphasis on establishing a consensus VAP definition should be undertaken.

The Geochemical Databases GEOROC and GeoReM - What's New?

NASA Astrophysics Data System (ADS)

Sarbas, B.; Jochum, K. P.; Nohl, U.; Weis, U.

2017-12-01

The geochemical databases GEOROC (http: georoc.mpch-mainz.gwdg.de) and GeoReM (http: georem.mpch-mainz.gwdg.de) are maintained by the Max Planck Institute for Chemistry in Mainz, Germany. Both online databases became crucial tools for geoscientists from different research areas. They are regularly upgraded by new tools and new data from recent publications obtained from a wide range of international journals. GEOROC is a collection of published analyses of volcanic rocks and mantle xenoliths. Since recently, data for plutonic rocks are added. The analyses include major and trace element concentrations, radiogenic and non-radiogenic isotope ratios as well as analytical ages for whole rocks, glasses, minerals and inclusions. Samples come from eleven geological settings and span the whole geological age scale from Archean to Recent. Metadata include, among others, geographic location, rock class and rock type, geological age, degree of alteration, analytical method, laboratory, and reference. The GEOROC web page allows selection of samples by geological setting, geography, chemical criteria, rock or sample name, and bibliographic criteria. In addition, it provides a large number of precompiled files for individual locations, minerals and rock classes. GeoReM is a database collecting information about reference materials of geological and environmental interest, such as rock powders, synthetic and natural glasses as well as mineral, isotopic, biological, river water and seawater reference materials. It contains published data and compilation values (major and trace element concentrations and mass fractions, radiogenic and stable isotope ratios). Metadata comprise, among others, uncertainty, analytical method and laboratory. Reference materials are important for calibration, method validation, quality control and to establish metrological traceability. GeoReM offers six different search strategies: samples or materials (published values), samples (GeoReM preferred values), chemical criteria, chemical criteria based on bibliography, bibliography, as well as methods and institutions.

An alternative regionalization scheme for defining nutrient criteria for rivers and streams

USGS Publications Warehouse

Robertson, Dale M.; Saad, David A.; Wieben, Ann M.

2001-01-01

The environmental nutrient zone approach can be applied to specific states or nutrient ecoregions and used to develop criteria as a function of stream type. This approach can also be applied on the basis of environmental characteristics of the watershed alone rather than the general environmental characteristics from the region in which the site is located. The environmental nutrient zone approach will enable states to refine the basic nutrient criteria established by the USEPA by developing attainable criteria given the environmental characteristics where the streams are located.

[Definition and biomarkers of acute renal damage: new perspectives].

PubMed

Seijas, M; Baccino, C; Nin, N; Lorente, J A

2014-01-01

The RIFLE and AKIN criteria have definitely help out to draw attention to the relationship between a deterioration of renal function that produces a small increase in serum creatinine and a worse outcome. However, the specific clinical utility of using these criteria remains to be well-defined. It is believed that the main use of these criteria is for the design of epidemiological studies and clinical trials to define inclusion criteria and objectives of an intervention. AKI adopting term, re-summoning former ARF terminology, it is appropriate to describe the clinical condition characterized by damage to kidney, in the same way as the term is used to describe acute lung damage where the lung injury situation still has not increased to a situation of organ failure (dysfunction). The serum and urine biomarkers (creatinine, urea, and diuresis) currently in use are not sensitive or specific for detecting kidney damage, limiting treatment options and potentially compromising the outcome. New biomarkers are being studied in order to diagnose an earlier and more specific AKI, with the potential to change the definition criteria of AKI with different stages, currently based in diuresis and serum creatinine. Copyright © 2013 Elsevier España, S.L. and SEMICYUC. All rights reserved.

Characterizing discrete subsets of polycystic ovary syndrome as defined by the Rotterdam criteria: the impact of weight on phenotype and metabolic features.

PubMed

Welt, C K; Gudmundsson, J A; Arason, G; Adams, J; Palsdottir, H; Gudlaugsdottir, G; Ingadottir, G; Crowley, W F

2006-12-01

The Rotterdam criteria for polycystic ovary syndrome (PCOS) defines discrete subgroups whose phenotypes are not yet clear. The phenotypic characteristics of women in the PCOS subgroups defined by the Rotterdam criteria were compared. The study was observational. Subjects were studied in an outpatient setting in Boston and Reykjavik. Four subgroups of subjects with PCOS defined by 1) irregular menses (IM), hyperandrogenism (HA), and polycystic ovary morphology (PCOM, n = 298); 2) IM/HA (n = 7); 3) HA/PCOM (n = 77); and 4) IM/PCOM (n = 36) and a group of controls (n = 64), aged 18-45 yr, were examined. Subjects underwent a physical exam; fasting blood samples for androgens, gonadotropins, and metabolic parameters; and a transvaginal ultrasound. The phenotype was compared between groups. Ninety-seven percent of women with IM/HA had PCOM. Therefore, the groups with and without PCOM were combined. The Ferriman-Gallwey score and androgen levels were highest in the hyperandrogenic groups (IM/HA and HA/PCOM), whereas ovarian volume was higher in all PCOS subgroups compared with controls, as expected based on the definitions of the PCOS subgroups. Body mass index and insulin levels were highest in the IM/HA subgroup. Subjects with PCOS defined by IM/HA are the most severely affected women on the basis of androgen levels, ovarian volumes, and insulin levels. Their higher body mass index partially accounts for the increased insulin levels, suggesting that weight gain exacerbates the symptoms of PCOS.

Assessing Professionalism: A Theoretical Framework for Defining Clinical Rotation Assessment Criteria.

PubMed

Armitage-Chan, Elizabeth

Although widely accepted as an important graduate competence, professionalism is a challenging outcome to define and assess. Clinical rotations provide an excellent opportunity to develop student professionalism through the use of experiential learning and effective feedback, but without appropriate theoretical frameworks, clinical teachers may find it difficult to identify appropriate learning outcomes. The adage "I know it when I see it" is unhelpful in providing feedback and guidance for student improvement, and criteria that are more specifically defined would help students direct their own development. This study sought first to identify how clinical faculty in one institution currently assess professionalism, using retrospective analysis of material obtained in undergraduate teaching and faculty development sessions. Subsequently, a faculty workshop was held in which a round-table type discussion sought to develop these ideas and identify how professionalism assessment could be improved. The output of this session was a theoretical framework for teaching and assessing professionalism, providing example assessment criteria and ideas for clinical teaching. This includes categories such as client and colleague interaction, respect and trust, recognition of limitations, and understanding of different professional identities. Each category includes detailed descriptions of the knowledge, skills, and behaviors expected of students in these areas. The criteria were determined by engaging faculty in the development of the framework, and therefore they should represent a focused development of criteria already used to assess professionalism, and not a novel and unfamiliar set of assessment guidelines. The faculty-led nature of this framework is expected to facilitate implementation in clinical teaching.

Recommended Water Quality Criteria for Octahydro-1,3,5,7-Tentranitro-1, 3,5,7-Tetrazocin (HMX).

DTIC Science & Technology

1989-03-27

possible to derive water quality criteria for protection of aquatic life following USEPA guidelines. Based on the NOAEL of 50 mg/kg/day from the 13-week...special reference to those on human, mammalian, and aquatic health effects, and to generate water quality criteria for drinking water and for the...and discussed below. Aquatic Invertebrates Bentley et al. (1977) performed static acute toxicity tests on four species of freshwater invertebrates

North American Multicenter Volumetric CT Study for Clinical Staging of Malignant Pleural Mesothelioma: Feasibility and Logistics of Setting Up a Quantitative Imaging Study.

PubMed

Gill, Ritu R; Naidich, David P; Mitchell, Alan; Ginsberg, Michelle; Erasmus, Jeremy; Armato, Samuel G; Straus, Christopher; Katz, Sharyn; Patios, Demetrois; Richards, William G; Rusch, Valerie W

2016-08-01

Clinical tumor (T), node, and metastasis staging is based on a qualitative assessment of features defining T descriptors and has been found to be suboptimal for predicting the prognosis of patients with malignant pleural mesothelioma (MPM). Previous work suggests that volumetric computed tomography (VolCT) is prognostic and, if found practical and reproducible, could improve clinical MPM classification. Six North American institutions electronically submitted clinical, pathologic, and imaging data on patients with stages I to IV MPM to an established multicenter database and biostatistical center. Two reference radiologists blinded to clinical data independently reviewed the scans; calculated clinical T, node, and metastasis stage by standard criteria; performed semiautomated tumor volume calculations using commercially available software; and submitted the findings to the biostatistical center. Study end points included the feasibility of a multi-institutional VolCT network, concordance of independent VolCT assessments, and association of VolCT with pathological T classification. Of 164 submitted cases, 129 were evaluated by both reference radiologists. Discordant clinical staging of most cases confirmed the inadequacy of current criteria. The overall correlation between VolCT estimates was good (Spearman correlation 0.822), but some were significantly discordant. Root cause analysis of the most discordant estimates identified four common sources of variability. Despite these limitations, median tumor volume estimates were similar within subgroups of cases representing each pathological T descriptor and increased monotonically for each reference radiologist with increasing pathological T status. The good correlation between VolCT estimates obtained for most cases reviewed by two independent radiologists and qualitative association of VolCT with pathological T status combine to encourage further study. The identified sources of user error will inform design of a follow-up prospective trial to more formally assess interobserver variability of VolCT and its potential contribution to clinical MPM staging. Copyright © 2016 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.

Symptoms and Character Traits in Patients Selected for Long-term Psychodynamic Psychotherapy

PubMed Central

Wilczek, Alexander; Weinryb, Robert M.; Gustavsson, Petter J.; Barber, Jacques P.; Schubert, Johan; ÅSBERG, Marie

1998-01-01

In this naturalistic study of 55 outpatients selected for long-term psychodynamic psychotherapy, two Swedish assessment instruments are presented (the Karolinska Psychodynamic Profile and the Karolinska Scales of Personality), and the significance of psychodynamic criteria for the selection of patients is discussed. Thirty patients (55%) fulfilled criteria for a DSM-III-R diagnosis. The most prominent psychodynamically defined character pathology was found in the areas of coping with aggressive affects; dependency and separation; frustration tolerance; and impulse control. Some psychodynamically defined character traits, particularly poor frustration tolerance, were related to symptomatic suffering. PMID:9407473

Astrophysics of Reference Frame Tie Objects

NASA Technical Reports Server (NTRS)

Johnston, Kenneth J.; Boboltz, David; Fey, Alan Lee; Gaume, Ralph A.; Zacharias, Norbert

2004-01-01

The Astrophysics of Reference Frame Tie Objects Key Science program will investigate the underlying physics of SIM grid objects. Extragalactic objects in the SIM grid will be used to tie the SIM reference frame to the quasi-inertial reference frame defined by extragalactic objects and to remove any residual frame rotation with respect to the extragalactic frame. The current realization of the extragalactic frame is the International Celestial Reference Frame (ICRF). The ICRF is defined by the radio positions of 212 extragalactic objects and is the IAU sanctioned fundamental astronomical reference frame. This key project will advance our knowledge of the physics of the objects which will make up the SIM grid, such as quasars and chromospherically active stars, and relates directly to the stability of the SIM reference frame. The following questions concerning the physics of reference frame tie objects will be investigated.

EMQN best practice guidelines for the molecular genetic diagnosis of hereditary hemochromatosis (HH).

PubMed

Porto, Graça; Brissot, Pierre; Swinkels, Dorine W; Zoller, Heinz; Kamarainen, Outi; Patton, Simon; Alonso, Isabel; Morris, Michael; Keeney, Steve

2016-04-01

Molecular genetic testing for hereditary hemochromatosis (HH) is recognized as a reference test to confirm the diagnosis of suspected HH or to predict its risk. The vast majority (typically >90%) of patients with clinically characterized HH are homozygous for the p.C282Y variant in the HFE gene, referred to as HFE-related HH. Since 1996, HFE genotyping was implemented in diagnostic algorithms for suspected HH, allowing its early diagnosis and prevention. However, the penetrance of disease in p.C282Y homozygotes is incomplete. Hence, homozygosity for p.C282Y is not sufficient to diagnose HH. Neither is p.C282Y homozygosity required for diagnosis as other rare forms of HH exist, generally referred to as non-HFE-related HH. These pose significant challenges when defining criteria for referral, testing protocols, interpretation of test results and reporting practices. We present best practice guidelines for the molecular genetic diagnosis of HH where recommendations are classified, as far as possible, according to the level and strength of evidence. For clarification, the guidelines' recommendations are preceded by a detailed description of the methodology and results obtained with a series of actions taken in order to achieve a wide expert consensus, namely: (i) a survey on the current practices followed by laboratories offering molecular diagnosis of HH; (ii) a systematic literature search focused on some identified controversial topics; (iii) an expert Best Practice Workshop convened to achieve consensus on the practical recommendations included in the guidelines.

Diagnostic performance of EUS in predicting advanced cancer among patients with Barrett's esophagus and high-grade dysplasia/early adenocarcinoma: systematic review and meta-analysis.

PubMed

Qumseya, Bashar J; Brown, Jessica; Abraham, Merna; White, Donna; Wolfsen, Herbert; Gupta, Neil; Vennalaganti, Prashanth; Sharma, Prateek; Wallace, Michael B

2015-04-01

The role of EUS among patients with Barrett's esophagus (BE) with high-grade dysplasia (HGD) or suspected mucosal carcinoma is controversial. To define the role of EUS in detecting advanced disease among patients with BE. Systematic review and meta-analysis. MEDLINE, Embase, Web of Science, and Cochrane Central databases. Patients with BE and HGD or esophageal adenocarcinoma (EAC) who were referred for endoscopic evaluation and underwent EUS. EUS. Pooled proportion of patients with advanced EAC identified by EUS among patients with BE who are referred for HGD or EAC (with or without visible lesions). Forest plots were used to contrast effect sizes in each of the studies and random effect models when tests of heterogeneity were significant (I(2) > 50% or P < .1 for the Q statistic). Of 1278 articles, 47 were reviewed in full text, and 11 articles met the inclusion criteria, including a total of 656 patients. Based on a random-effects model, the proportion of patients with advanced disease detected on EUS was 14% (95% confidence interval, 8%-22%; P < .0001). In a subanalysis, the pooled proportion of patients with advanced disease on EUS in the absence of nodules was 4% (95% confidence interval, 2%-6%, P < .0001). Significant heterogeneity among studies. EUS will result in a change in the therapeutic approach among in a significant minority of patients with BE who are referred for HGD or EAC. Copyright © 2015. Published by Elsevier Inc.

[Transplant coordination and logistics of intra and extra-hospital cadaver donor tissue. "The Pamplona Model". Sequence of tasks performed from 1992-2006].

PubMed

Maraví-Poma, E; Martín, A; Maraví-Aznar, A; Iturralde, O; Compains, E; Álvarez, J; Cabal, S; Maraví-Aznar, E; Teijeira, R; Unzué, J J; González, R

2006-01-01

Tissue and organ donations are the only option for many patients. Cerebral death (CD) facilitates this approach. However, hospitals that do not provide CD donors have to adapt in order to obtain donors, referred to as tissue donors (TD), who have died from cardiac arrest. Is this paper it descripte the model for coordination and donation of intra and extra-hospital TD in the Autonomous Community of Navarra. It creats a program for detection, donation and extractions called the Pamplona Model, from 1992-2006. In 1990, a transplant team was created by an Intensive Medicine Physician of HVC, INML and SOS-Navarra. In 1996, VCH Transplant Coordination is defined as a reference centre for the Tissue Transplant Programme in the Autonomous Community of Navarra. Consensus protocols for "intra and extra-hospital detection" of persons having died from cardiac arrest are developed: - Alerts from NHS-O hospitals, SOS-Navarra; judges and INML forensic pathologists. - Criteria for selection, search and contacts with relatives. - Alert serology, extraction and transport teams. - Logistics and distribution of tissue. - Agreed incentives: Economic, administrative and relevant regulations. The Pamplona Model, with the Virgen Del Camino hospital has made important contributions and is unique in the world. Intra and extra-hospital coordination of cadaver donor from a referred hospital, it is a scientific and organizational advance to have in it counts for the creation of extraction and transplant tissues teams.

EMQN best practice guidelines for the molecular genetic diagnosis of hereditary hemochromatosis (HH)

PubMed Central

Porto, Graça; Brissot, Pierre; Swinkels, Dorine W; Zoller, Heinz; Kamarainen, Outi; Patton, Simon; Alonso, Isabel; Morris, Michael; Keeney, Steve

2016-01-01

Molecular genetic testing for hereditary hemochromatosis (HH) is recognized as a reference test to confirm the diagnosis of suspected HH or to predict its risk. The vast majority (typically >90%) of patients with clinically characterized HH are homozygous for the p.C282Y variant in the HFE gene, referred to as HFE-related HH. Since 1996, HFE genotyping was implemented in diagnostic algorithms for suspected HH, allowing its early diagnosis and prevention. However, the penetrance of disease in p.C282Y homozygotes is incomplete. Hence, homozygosity for p.C282Y is not sufficient to diagnose HH. Neither is p.C282Y homozygosity required for diagnosis as other rare forms of HH exist, generally referred to as non-HFE-related HH. These pose significant challenges when defining criteria for referral, testing protocols, interpretation of test results and reporting practices. We present best practice guidelines for the molecular genetic diagnosis of HH where recommendations are classified, as far as possible, according to the level and strength of evidence. For clarification, the guidelines' recommendations are preceded by a detailed description of the methodology and results obtained with a series of actions taken in order to achieve a wide expert consensus, namely: (i) a survey on the current practices followed by laboratories offering molecular diagnosis of HH; (ii) a systematic literature search focused on some identified controversial topics; (iii) an expert Best Practice Workshop convened to achieve consensus on the practical recommendations included in the guidelines. PMID:26153218

Criteria for Evaluating the Performance of Compilers

DTIC Science & Technology

1974-10-01

cannot be made to fit, then an auxiliary mechanism outside the parser might be used . Finally, changing the choice of parsing tech - nique to a...was not useful in providing a basic for compiler evaluation. The study of the first question eztablished criteria and methodb for assigning four...program. The study of the second question estab- lished criteria for defining a "compiler Gibson mix", and established methods for using this "mix" to

"Ex Corde Universitatis": From the Heart of the University

ERIC Educational Resources Information Center

O'Brien, George Dennis

2004-01-01

This paper explores the place of religion within the assumptions of the modern research university. The issue for Christianity is essentially epistemic: Given the criteria for truth or plausibility that prevail in advanced academic communities, what are the warrants for Christian belief? Are the prevailing criteria defined such that Christian…

42 CFR 413.89 - Bad debts, charity, and courtesy allowances.

Code of Federal Regulations, 2013 CFR

2013-10-01

... SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES Specific... allowable costs. (e) Criteria for allowable bad debt. A bad debt must meet the following criteria to be... amount of allowable bad debt (as defined in paragraph (e) of this section) is reduced: (i) For cost...

42 CFR 413.89 - Bad debts, charity, and courtesy allowances.

Code of Federal Regulations, 2014 CFR

2014-10-01

... SERVICES; OPTIONAL PROSPECTIVELY DETERMINED PAYMENT RATES FOR SKILLED NURSING FACILITIES Specific... allowable costs. (e) Criteria for allowable bad debt. A bad debt must meet the following criteria to be... amount of allowable bad debt (as defined in paragraph (e) of this section) is reduced: (i) For cost...

42 CFR 505.5 - Loan criteria.

Code of Federal Regulations, 2011 CFR

2011-10-01

... meet the following criteria: (1) The hospital is located in a State that, based on population density, is defined as a rural State. A rural State is one of ten States with the lowest population density... prioritized beginning with the State with the lowest population density. Population density is determined...

42 CFR 505.5 - Loan criteria.

Code of Federal Regulations, 2012 CFR

2012-10-01

... that meet the following criteria: (1) The hospital is located in a State that, based on population density, is defined as a rural State. A rural State is one of ten States with the lowest population... prioritized beginning with the State with the lowest population density. Population density is determined...

42 CFR 505.5 - Loan criteria.

Code of Federal Regulations, 2013 CFR

2013-10-01

... that meet the following criteria: (1) The hospital is located in a State that, based on population density, is defined as a rural State. A rural State is one of ten States with the lowest population... prioritized beginning with the State with the lowest population density. Population density is determined...

42 CFR 505.5 - Loan criteria.

Code of Federal Regulations, 2014 CFR

2014-10-01

... that meet the following criteria: (1) The hospital is located in a State that, based on population density, is defined as a rural State. A rural State is one of ten States with the lowest population... prioritized beginning with the State with the lowest population density. Population density is determined...

34 CFR 647.21 - What selection criteria does the Secretary use?

Code of Federal Regulations, 2012 CFR

2012-07-01

... uses the following criteria to evaluate an application for a new grant: (a) Need (16 Points). The... definitively demonstrate the need for a McNair project to serve the target population. In particular, the Secretary looks for information that clearly defines the target population; describes the academic...

42 CFR 505.5 - Loan criteria.

Code of Federal Regulations, 2010 CFR

2010-10-01

... meet the following criteria: (1) The hospital is located in a State that, based on population density, is defined as a rural State. A rural State is one of ten States with the lowest population density... prioritized beginning with the State with the lowest population density. Population density is determined...

Presentation of Atomic Structure in Turkish General Chemistry Textbooks

ERIC Educational Resources Information Center

Niaz, Mansoor; Costu, Bayram

2009-01-01

Research in science education has recognized the importance of teaching atomic structure within a history and philosophy of science perspective. The objective of this study is to evaluate general chemistry textbooks published in Turkey based on the eight criteria developed in previous research. Criteria used referred to the atomic models of…

Assessing Graduate Attributes: Building a Criteria-Based Competency Model

ERIC Educational Resources Information Center

Ipperciel, Donald; ElAtia, Samira

2014-01-01

Graduate attributes (GAs) have become a necessary framework of reference for the 21st century competency-based model of higher education. However, the issue of evaluating and assessing GAs still remains unchartered territory. In this article, we present a criteria-based method of assessment that allows for an institution-wide comparison of the…

Occupational health standards. An international comparison.

PubMed

Holmberg, B; Winell, M

1977-03-01

The background for establishing standards for toxic agents is reviewed, and the standards of 14 different countries, including Sweden, are compared with special reference to criteria and organizational aspects. The differences among countries in the numerical limit values for toxic substances are largely due to differences in definitions, biomedical criteria, technical feasibility and sociopolitical judgements.

Apoptosis and the FLIP and NF-kappa B proteins as pharmacodynamic criteria for biosimilar TNF-alpha antagonists

PubMed Central

Urbano, Paulo César Martins; Soccol, Vanete Thomaz; Azevedo, Valderilio Feijó

2014-01-01

Various criteria are necessary to assess the efficacy and safety of biological medications in order to grant companies the right to register these medications with the appropriate bodies that regulate their sale. The imminent expiration of the patents on reference biological products which block the cytokine TNF-α (tumor necrosis factor-α) raises the possibility of bringing so-called biosimilars to the market (similar to the biologicals of reference products). This occurrence is inevitable, but criteria to adequately evaluate these medications are now needed. Even among controversy, there is a demand from publications correlating the pro-apoptotic mechanism of the original TNF-α antagonists (etanercept, infliximab, adalimumab, golimumab, and certolizumab pegol) in the treatment of rheumatoid arthritis and other diseases. In this article, the authors discuss the possibility of utilizing the pro-apoptotic effect correlated with the regulation of the anti-apoptotic proteins FLIP and NF-κB as new criteria for analyzing the pharmacodynamics of possible biosimilar TNF-α antagonists which should be submitted to regulatory agencies for evaluation. PMID:25114503

The relationship between extreme precipitation events and landslides distributions in 2009 in Lower Austria

NASA Astrophysics Data System (ADS)

Katzensteiner, H.; Bell, R.; Petschko, H.; Glade, T.

2012-04-01

The prediction and forecast of widespread landsliding for a given triggering event is an open research question. Numerous studies tried to link spatial rainfall and landslide distributions. This study focuses on analysing the relationship between intensive precipitation and rainfall-triggered shallow landslides in the year 2009 in Lower Austria. Landslide distributions were gained from the building ground register, which is maintained by the Geological Survey of Lower Austria. It contains detailed information of landslides, which were registered due to damage reports. Spatially distributed rainfall estimates were extracted from INCA (Integrated Nowcasting through Comprehensive Analysis) precipitation analysis, which is a combination of station data interpolation and radar data in a spatial resolution of 1km developed by the Central Institute for Meteorology and Geodynamics (ZAMG), Vienna, Austria. The importance of the data source is shown by comparing rainfall data based on reference gauges, spatial interpolation and INCA-analysis for a certain storm period. INCA precipitation data can detect precipitating cells that do not hit a station but might trigger a landslide, which is an advantage over the application of reference stations for the definition of rainfall thresholds. Empirical thresholds at regional scale were determined based on rainfall-intensity and duration in the year 2009 and landslide information. These thresholds are dependent on the criteria which separate the landslide triggering and non-triggering precipitation events from each other. Different approaches for defining thresholds alter the shape of the threshold as well. A temporarily threshold I=8,8263*D^(-0.672) for extreme rainfall events in summer in Lower Austria was defined. A verification of the threshold with similar events of other years as well as following analyses based on a larger landslide database are in progress.

Solution of the determinantal assignment problem using the Grassmann matrices

NASA Astrophysics Data System (ADS)

Karcanias, Nicos; Leventides, John

2016-02-01

The paper provides a direct solution to the determinantal assignment problem (DAP) which unifies all frequency assignment problems of the linear control theory. The current approach is based on the solvability of the exterior equation ? where ? is an n -dimensional vector space over ? which is an integral part of the solution of DAP. New criteria for existence of solution and their computation based on the properties of structured matrices are referred to as Grassmann matrices. The solvability of this exterior equation is referred to as decomposability of ?, and it is in turn characterised by the set of quadratic Plücker relations (QPRs) describing the Grassmann variety of the corresponding projective space. Alternative new tests for decomposability of the multi-vector ? are given in terms of the rank properties of the Grassmann matrix, ? of the vector ?, which is constructed by the coordinates of ?. It is shown that the exterior equation is solvable (? is decomposable), if and only if ? where ?; the solution space for a decomposable ?, is the space ?. This provides an alternative linear algebra characterisation of the decomposability problem and of the Grassmann variety to that defined by the QPRs. Further properties of the Grassmann matrices are explored by defining the Hodge-Grassmann matrix as the dual of the Grassmann matrix. The connections of the Hodge-Grassmann matrix to the solution of exterior equations are examined, and an alternative new characterisation of decomposability is given in terms of the dimension of its image space. The framework based on the Grassmann matrices provides the means for the development of a new computational method for the solutions of the exact DAP (when such solutions exist), as well as computing approximate solutions, when exact solutions do not exist.

Interpreting Mobile and Handheld Air Sensor Readings in Relation to Air Quality Standards and Health Effect Reference Values: Tackling the Challenges.

PubMed

Woodall, George M; Hoover, Mark D; Williams, Ronald; Benedict, Kristen; Harper, Martin; Soo, Jhy-Charm; Jarabek, Annie M; Stewart, Michael J; Brown, James S; Hulla, Janis E; Caudill, Motria; Clements, Andrea L; Kaufman, Amanda; Parker, Alison J; Keating, Martha; Balshaw, David; Garrahan, Kevin; Burton, Laureen; Batka, Sheila; Limaye, Vijay S; Hakkinen, Pertti J; Thompson, Bob

2017-01-01

The US Environmental Protection Agency (EPA) and other federal agencies face a number of challenges in interpreting and reconciling short-duration (seconds to minutes) readings from mobile and handheld air sensors with the longer duration averages (hours to days) associated with the National Ambient Air Quality Standards (NAAQS) for the criteria pollutants-particulate matter (PM), ozone, carbon monoxide, lead, nitrogen oxides, and sulfur oxides. Similar issues are equally relevant to the hazardous air pollutants (HAPs) where chemical-specific health effect reference values are the best indicators of exposure limits; values which are often based on a lifetime of continuous exposure. A multi-agency, staff-level Air Sensors Health Group (ASHG) was convened in 2013. ASHG represents a multi-institutional collaboration of Federal agencies devoted to discovery and discussion of sensor technologies, interpretation of sensor data, defining the state of sensor-related science across each institution, and provides consultation on how sensors might effectively be used to meet a wide range of research and decision support needs. ASHG focuses on several fronts: improving the understanding of what hand-held sensor technologies may be able to deliver; communicating what hand-held sensor readings can provide to a number of audiences; the challenges of how to integrate data generated by multiple entities using new and unproven technologies; and defining best practices in communicating health-related messages to various audiences. This review summarizes the challenges, successes, and promising tools of those initial ASHG efforts and Federal agency progress on crafting similar products for use with other NAAQS pollutants and the HAPs. NOTE: The opinions expressed are those of the authors and do not necessary represent the opinions of their Federal Agencies or the US Government. Mention of product names does not constitute endorsement.

The Short Cosyntropin Test Revisited: New Normal Reference Range Using LC-MS/MS.

PubMed

Ueland, Grethe Å; Methlie, Paal; Øksnes, Marianne; Thordarson, Hrafnkell B; Sagen, Jørn; Kellmann, Ralf; Mellgren, Gunnar; Ræder, Maria; Dahlqvist, Per; Dahl, Sandra R; Thorsby, Per M; Løvås, Kristian; Husebye, Eystein S

2018-04-01

The cosyntropin test is used to diagnose adrenal insufficiency (AI) and nonclassical congenital adrenal hyperplasia (NCCAH). Current cutoffs for cortisol and 17-hydroxyprogesterone (17-OHP) are derived from nonstandardized immunoassays. Liquid chromatography tandem mass spectrometry (LC-MS/MS) offers direct measurement of steroids, prompting the need to re-establish normal ranges. The goal of this study was to define cutoff values for cortisol and 17-OHP in serum by LC-MS/MS 30 and 60 minutes after intravenous administration of 250 µg tetracosactide acetate to healthy volunteers and to compare the results with LC-MS/MS with routine immunoassays. Cosyntropin testing was performed in healthy subjects (n = 138) and in patients referred for evaluation of adrenocortical function (n = 94). Steroids were assayed by LC-MS/MS and compared with two immunoassays used in routine diagnostics (Immulite and Roche platforms). The cutoff level for cortisol was defined as the 2.5% percentile in healthy subjects not using oral estrogens (n = 121) and for 17-OHP as the 97.5% percentile. Cortisol cutoff levels for LC-MS/MS were 412 and 485 nmol/L at 30 and 60 minutes, respectively. Applying the new cutoffs, 13 of 60 (22%) subjects who had AI according to conventional criteria now had a normal test result. For 17-OHP, the cutoff levels were 8.9 and 9.0 nmol/L at 30 and 60 minutes, respectively. LC-MS/MS provides cutoff levels for cortisol and 17-OHP after cosyntropin stimulation that are lower than those based on immunoassays, possibly because cross-reactivity between steroid intermediates and cortisol is eliminated. This reduces the number of false-positive tests for AI and false-negative tests for NCCAH.

DCD lung donation: donor criteria, procedural criteria, pulmonary graft function validation, and preservation.

PubMed

Erasmus, Michiel E; van Raemdonck, Dirk; Akhtar, Mohammed Zeeshan; Neyrinck, Arne; de Antonio, David Gomez; Varela, Andreas; Dark, John

2016-07-01

In an era where there is a shortage of lungs for transplantation is increased utilization of lungs from donation after circulatory death (DCD) donors. We review the reports of 11 controlled and 1 uncontrolled DCD programs focusing on donor criteria, procedural criteria, graft assessment, and preservation techniques including the use of ex vivo lung perfusion. We have formulated conclusions and recommendations for each of these areas, which were presented at the 6th International Conference on Organ Donation. A table of recommendations, the grade of recommendations, and references are provided. © 2015 Steunstichting ESOT.

The Portable Pediatrician.

ERIC Educational Resources Information Center

Markel, Howard; And Others

This ready reference health guide features 240 major topics that occur regularly in clinical work with children and adolescents. It sorts out the information vital to successful management of common health problems and concerns by presentation of tables, charts, lists, criteria for diagnosis, and other useful tips. References on which the entries…

49 CFR 385.321 - What failures of safety management practices disclosed by the safety audit will result in a...

Code of Federal Regulations, 2011 CFR

2011-10-01

... occurrence. This violation refers to a driver operating a CMV as defined under § 383.5. 9. § 387.7(a... unqualified driver Single occurrence. This violation refers to a driver operating a CMV as defined under § 390...

Novel effects of sarcopenic osteoarthritis on metabolic syndrome, insulin resistance, osteoporosis, and bone fracture: the national survey.

PubMed

Chung, S M; Hyun, M H; Lee, E; Seo, H S

2016-08-01

This study compared the effects sarcopenic osteoarthritis on metabolic syndrome, insulin resistance, osteoporosis, and bone fracture. By using national survey data, we suggest that the relationship between sarcopenia and metabolic syndrome or insulin resistance is potentiated by the severity of osteoarthritis and is independent of body weight. Sarcopenia and osteoarthritis are known risk factors for metabolic syndrome. However, their combined effects on metabolic syndrome, insulin resistance and osteoporosis remain uncertain. We used data from the fifth Korean National Health and Nutrition Examination Survey using a total of 3158 adults (age >50 years). Sarcopenia was defined as a skeletal muscle index score (appendicular skeletal muscle mass/body weight) within the fifth percentile of sex-matched younger reference participants. Radiographic knee osteoarthritis was defined as a Kellgren-Lawrence (K-L) grade of 2 or greater. Metabolic syndrome was diagnosed using the National Cholesterol Education Program criteria. Insulin resistance was evaluated using the homeostasis model assessment-estimated insulin resistance index (HOMA-IR). Osteoporosis was defined using the World Health Organization T-score criteria. In multivariable logistic regression analysis, the sarcopenic osteoarthritis group had a higher odds ratio (OR) for metabolic syndrome (OR = 11.00, 95 % confidential interval (CI) = 2.12-56.99, p = 0.013) than the non-sarcopenic osteoarthritis (OR = 1.02, 95 % CI = 0.65-1.62, p = 0.972) and sarcopenic non-osteoarthritis groups (OR = 7.15, 95 % CI = 1.57-32.53, p = 0.027). Similarly, sarcopenic osteoarthritis had a greater OR of highest HOMA-IR quartiles (OR = 8.19, 95 % CI = 2.03-33.05, p = 0.003) than the other groups. Overall, the association between the K-L grade and body mass index was significant; however, this significance was lower in individuals with sarcopenia and was lost in those with sarcopenic osteoarthritis. Additionally, osteoporosis and bone fracture were not associated to sarcopenic osteoarthritis (p > 0.05). These results suggest that the relationship between sarcopenia and metabolic syndrome or insulin resistance is potentiated by the severity of osteoarthritis and is independent of body weight.

National Cholesterol Educational Program and International Diabetes Federation diagnostic criteria for metabolic syndrome in an Italian cohort: results from the FIBAR Study.

PubMed

Mannucci, E; Monami, M; Bardini, G; Ognibene, A; Rotella, C M

2007-12-01

The adoption of the International Diabetes Federation (IDF) criteria for metabolic syndrome (MS), in comparison with the National Cholesterol Educational Program (NCEP) criteria, produces different changes in estimates of prevalence in diverse populations. Few data are available in Caucasian non-diabetic subjects. The prevalence of NCEP- and IDF-defined MS was assessed in a sample of 2,945 individuals, aged 55.2+/-11.5 yr, enrolled in a screening program for diabetes. Association of different definitions of MS with glucose intolerance (120-min glucose 7.8 mmol/l after a 75 g-oral glucose load) and hyperuricemia (>0.38 mmol/l) was also assessed. The prevalence of MS was 16.6% and 29.7% with NCEP and IDF definitions, respectively. The prevalence of NCEP-defined MS was higher than IDF-MS through all age ranges; among those aged >60 yr, the prevalence of IDF-MS reached 52.8% (vs 33.1% for NCEP-MS). Both NCEP- and IDF-MS were associated with glucose intolerance and hyperuricemia. Individuals fulfilling IDF, but not NCEP criteria for MS, showed a prevalence of glucose intolerance (22.7%) significantly (p<0.05) lower than those fulfilling NCEP criteria only (31.6%) or both sets of criteria (31.8%). In Caucasian subjects without known diabetes, IDF criteria produce a relevant increase in estimates of prevalence of MS, particularly in older subjects, when compared with NCEP criteria. NCEP-MS seems to be more effective than IDF-MS in the identification of glucose intolerant subjects.

Characteristics of binge eating disorder in relation to diagnostic criteria

PubMed Central

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

2016-01-01

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

Chest-lead ST-J amplitudes using arm electrodes as reference instead of the Wilson central terminal in smartphone ECG applications: Influence on ST-elevation myocardial infarction criteria fulfillment.

PubMed

Lindow, Thomas; Engblom, Henrik; Khoshnood, Ardavan; Ekelund, Ulf; Carlsson, Marcus; Pahlm, Olle

2018-05-07

"Smartphone 12-lead ECG" for the assessment of acute myocardial ischemia has recently been introduced. In the smartphone 12-lead ECG either the right or the left arm can be used as reference for the chest electrodes instead of the Wilson central terminal. These leads are labeled "CR leads" or "CL leads." We aimed to compare chest-lead ST-J amplitudes, using either CR or CL leads, to those present in the conventional 12-lead ECG, and to determine sensitivity and specificity for the diagnosis of STEMI for CR and CL leads. Five hundred patients (74 patients with ST elevation myocardial infarction (STEMI), 66 patients with nonischemic ST deviation and 360 controls) were included. Smartphone 12-lead ECG chest-lead ST-J amplitudes were calculated for both CR and CL leads. ST-J amplitudes were 9.1 ± 29 μV larger for CR leads and 7.7 ± 42 μV larger for CL leads than for conventional chest leads (V leads). Sensitivity and specificity were 94% and 95% for CR leads and 81% and 97% for CL leads when fulfillment of STEMI criteria in V leads was used as reference. In ischemic patients who met STEMI criteria in V leads, but not in limb leads, STEMI criteria were met with CR or CL leads in 91%. By the use of CR or CL leads, smartphone 12-lead ECG results in slightly lower sensitivity in STEMI detection. Therefore, the adjustment of STEMI criteria may be needed before application in clinical practice. © 2018 The Authors. Annals of Noninvasive Electrocardiology Published by Wiley Periodicals, Inc.

Validation of a case definition for leptospirosis diagnosis in patients with acute severe febrile disease admitted in reference hospitals at the State of Pernambuco, Brazil.

PubMed

Albuquerque Filho, Alfredo Pereira Leite de; Araújo, Jéssica Guido de; Souza, Inacelli Queiroz de; Martins, Luciana Cardoso; Oliveira, Marta Iglis de; Silva, Maria Jesuíta Bezerra da; Montarroyos, Ulisses Ramos; Miranda Filho, Demócrito de Barros

2011-01-01

Leptospirosis is often mistaken for other acute febrile illnesses because of its nonspecific presentation. Bacteriologic, serologic, and molecular methods have several limitations for early diagnosis: technical complexity, low availability, low sensitivity in early disease, or high cost. This study aimed to validate a case definition, based on simple clinical and laboratory tests, that is intended for bedside diagnosis of leptospirosis among hospitalized patients. Adult patients, admitted to two reference hospitals in Recife, Brazil, with a febrile illness of less than 21 days and with a clinical suspicion of leptospirosis, were included to test a case definition comprising ten clinical and laboratory criteria. Leptospirosis was confirmed or excluded by a composite reference standard (microscopic agglutination test, ELISA, and blood culture). Test properties were determined for each cutoff number of the criteria from the case definition. Ninety seven patients were included; 75 had confirmed leptospirosis and 22 did not. Mean number of criteria from the case definition that were fulfilled was 7.8±1.2 for confirmed leptospirosis and 5.9±1.5 for non-leptospirosis patients (p<0.0001). Best sensitivity (85.3%) and specificity (68.2%) combination was found with a cutoff of 7 or more criteria, reaching positive and negative predictive values of 90.1% and 57.7%, respectively; accuracy was 81.4%. The case definition, for a cutoff of at least 7 criteria, reached average sensitivity and specificity, but with a high positive predictive value. Its simplicity and low cost make it useful for rapid bedside leptospirosis diagnosis in Brazilian hospitalized patients with acute severe febrile disease.

A Prospective Study of the Concordance of DSM-IV and DSM-5 Diagnostic Criteria for Autism Spectrum Disorder.

PubMed

Mazurek, Micah O; Lu, Frances; Symecko, Heather; Butter, Eric; Bing, Nicole M; Hundley, Rachel J; Poulsen, Marie; Kanne, Stephen M; Macklin, Eric A; Handen, Benjamin L

2017-09-01

The transition from DSM-IV to DSM-5 criteria for autism spectrum disorder (ASD) sparked considerable concern about the potential implications of these changes. This study was designed to address limitations of prior studies by prospectively examining the concordance of DSM-IV and final DSM-5 criteria on a consecutive sample of 439 children referred for autism diagnostic evaluations. Concordance and discordance were assessed using a consistent diagnostic battery. DSM-5 criteria demonstrated excellent overall specificity and good sensitivity relative to DSM-IV criteria. Sensitivity and specificity were strongest for children meeting DSM-IV criteria for autistic disorder, but poor for those meeting criteria for Asperger's disorder and pervasive developmental disorder. Higher IQ, older age, female sex, and less pronounced ASD symptoms were associated with greater discordance.

A Framework for the Development and Interpretation of Different Sepsis Definitions and Clinical Criteria

PubMed Central

Angus, Derek C.; Seymour, Christopher W.; Coopersmith, Craig M.; Deutschman, Clifford; Klompas, Michael; Levy, Mitchell M.; Martin, Greg S.; Osborn, Tiffany M.; Rhee, Chanu; Watson, R. Scott

2016-01-01

Although sepsis was described more than 2,000 years ago, and clinicians still struggle to define it, there is no “gold standard,” and multiple competing approaches and terms exist. Challenges include the ever-changing knowledge base that informs our understanding of sepsis, competing views on which aspects of any potential definition are most important, and the tendency of most potential criteria to be distributed in at-risk populations in such a way as to hinder separation into discrete sets of patients. We propose that the development and evaluation of any definition or diagnostic criteria should follow four steps: 1) define the epistemologic underpinning, 2) agree on all relevant terms used to frame the exercise, 3) state the intended purpose for any proposed set of criteria, and 4) adopt a scientific approach to inform on their usefulness with regard to the intended purpose. Usefulness can be measured across six domains: 1) reliability (stability of criteria during retesting, between raters, over time, and across settings), 2) content validity (similar to face validity), 3) construct validity (whether criteria measure what they purport to measure), 4) criterion validity (how new criteria fare compared to standards), 5) measurement burden (cost, safety, and complexity), and 6) timeliness (whether criteria are available concurrent with care decisions). The relative importance of these domains of usefulness depends on the intended purpose, of which there are four broad categories: 1) clinical care, 2) research, 3) surveillance, and 4) quality improvement and audit. This proposed methodologic framework is intended to aid understanding of the strengths and weaknesses of different approaches, provide a mechanism for explaining differences in epidemiologic estimates generated by different approaches, and guide the development of future definitions and diagnostic criteria. PMID:26901559

Aging, female sex, migration, elevated HDL-C, and inflammation are associated with prevalence of metabolic syndrome among African bank employees.

PubMed

Gombet, Thierry; Longo-Mbenza, Benjamin; Ellenga-Mbolla, Bertrand; Ikama, Meo Stephane; Mokondjimobe, Etienne; Kimbally-Kaky, Gisele; Nkoua, Jean-Louis

2012-01-01

The objective of this study was to compare four different criteria for diagnosing metabolic syndrome (MS) and to correlate sociodemographic data, liver enzymes, lipids, inflammation, and insulin resistance with MS definitions. This cross-sectional study included a random number of 126 African bank employees from Brazzaville, Congo. THE PREVALENCE OF MS VARIED ACCORDING TO THE DIFFERENT DEFINITIONS USED: 4.8% under World Health Organization (WHO) criteria, 8.7% under the National Cholesterol Education Program Adult Treatment Panel III (NECP-ATPIII) criteria, 14.3% under the International Diabetes Federation (IDF) for Europe, and 15.9% by the IDF for Central Africa. According to the IDF, specific cutoff points for the erythrocyte sedimentation rate, ≥13 mm at first hour and ≥30 mm at second hour, defined MS for Central Africa. The best agreement was observed between the IDF for Europe and the IDF for Central Africa (Kappa = 0.938; P < 0.0001) criteria. The worst agreements were between the WHO and IDF for Central Africa (Kappa = 0.419; P < 0.0001) criteria and between the WHO and IDF for Europe (Kappa = 0.462; P < 0.0001) criteria. The NECP-ATPIII criteria did not agree with either the IDF for Europe or the IDF for Central Africa criteria. There was a significant relationship between female sex, aging, elevated liver enzymes, elevated phospholipids, high homeostasis model assessment of insulin resistance, and MS defined by the IDF for Central Africa. The IDF definition of the MS modified for Central Africa provides higher prevalence estimates of MS than the estimates based on the NECP-ATPIII and IDF for Europe criteria. Liver enzymes, phospholipids, and homeostasis model assessment of insulin resistance should be included in clinical practice to stratify cardiovascular disease risk among Africans.

A Framework for the Development and Interpretation of Different Sepsis Definitions and Clinical Criteria.

PubMed

Angus, Derek C; Seymour, Christopher W; Coopersmith, Craig M; Deutschman, Clifford S; Klompas, Michael; Levy, Mitchell M; Martin, Gregory S; Osborn, Tiffany M; Rhee, Chanu; Watson, R Scott

2016-03-01

Although sepsis was described more than 2,000 years ago, and clinicians still struggle to define it, there is no "gold standard," and multiple competing approaches and terms exist. Challenges include the ever-changing knowledge base that informs our understanding of sepsis, competing views on which aspects of any potential definition are most important, and the tendency of most potential criteria to be distributed in at-risk populations in such a way as to hinder separation into discrete sets of patients. We propose that the development and evaluation of any definition or diagnostic criteria should follow four steps: 1) define the epistemologic underpinning, 2) agree on all relevant terms used to frame the exercise, 3) state the intended purpose for any proposed set of criteria, and 4) adopt a scientific approach to inform on their usefulness with regard to the intended purpose. Usefulness can be measured across six domains: 1) reliability (stability of criteria during retesting, between raters, over time, and across settings), 2) content validity (similar to face validity), 3) construct validity (whether criteria measure what they purport to measure), 4) criterion validity (how new criteria fare compared to standards), 5) measurement burden (cost, safety, and complexity), and 6) timeliness (whether criteria are available concurrent with care decisions). The relative importance of these domains of usefulness depends on the intended purpose, of which there are four broad categories: 1) clinical care, 2) research, 3) surveillance, and 4) quality improvement and audit. This proposed methodologic framework is intended to aid understanding of the strengths and weaknesses of different approaches, provide a mechanism for explaining differences in epidemiologic estimates generated by different approaches, and guide the development of future definitions and diagnostic criteria.

Severe community-acquired pneumonia. Assessment of severity criteria.

PubMed

Ewig, S; Ruiz, M; Mensa, J; Marcos, M A; Martinez, J A; Arancibia, F; Niederman, M S; Torres, A

1998-10-01

The purpose of the study was to validate the criteria used in the guidelines of the American Thoracic Society (ATS) for severe community-acquired pneumonia (CAP). Severe pneumonia was defined as admission to the intensive care unit (ICU). Overall 331 nonsevere (84%) and 64 severe cases (16%) of CAP were prospectively studied. Mortality was 19 of 395 (5%) and 19 of 64 (30%), respectively. Single severity criteria as well as the ATS definition of severe pneumonia were assessed calculating the operative indices. A modified prediction rule including minor (baseline) and major (baseline or evolutionary) criteria was derived. Single minor criteria at admission had a low sensitivity and positive predictive value. Defining severe pneumonia according to the ATS guidelines had a high sensitivity (98%). However, specificity and positive predictive value were low (32% and 24%, respectively). A modified prediction rule (presence of two or three minor criteria [systolic blood pressure < 90 mm Hg, multilobar involvement, PaO2/FIO2 < 250] or one of two major criteria [requirement of mechanical ventilation, presence of septic shock]) had a sensitivity of 78%, a specificity of 94%, a positive predictive value of 75%, and a negative predictive value of 95%. The ATS definition of severe pneumonia was highly sensitive but insufficiently specific and had a low positive predictive value. Our suggested modified rule had a more balanced performance and, if validated in an independent population, may represent a more accurate definition of severe CAP.

78 FR 42127 - Self-Regulatory Organizations; National Securities Clearing Corporation; Notice of Filing...

Federal Register 2010, 2011, 2012, 2013, 2014

2013-07-15

....S.C. 5465(e)(1). \\10\\ 17 CFR 240.19b-4(n)(1)(i). \\11\\ Defined terms that are not defined in this notice are defined in Amended Exhibit 5 to the Advance Notice, available at http://sec.gov/rules/sro/nscc... Member, subject to satisfaction of reasonable lender criteria.\\13\\ NSCC states that this commitment would...

Budget impact of applying appropriateness criteria for myocardial perfusion scintigraphy: The perspective of a developing country.

PubMed

Dos Santos, Mauro Augusto; Santos, Marisa Silva; Tura, Bernardo Rangel; Félix, Renata; Brito, Adriana Soares X; De Lorenzo, Andrea

2016-10-01

Myocardial perfusion imaging is widely used for the risk stratification of coronary artery disease. In view of its cost, besides radiation issues, judicious evaluation of the appropriateness of its indications is essential to prevent an unnecessary economic burden on the health system. We evaluated, at a tertiary-care, public Brazilian hospital, the appropriateness of myocardial perfusion scintigraphy indications, and estimated the budget impact of applying appropriateness criteria. An observational, cross-sectional study of 190 patients with suspected or known coronary artery disease referred for myocardial perfusion imaging was conducted. The appropriateness of myocardial perfusion imaging indications was evaluated with the Appropriate Use Criteria for Cardiac Radionuclide Imaging published in 2009. Budget impact analysis was performed with a deterministic model. The prevalence of appropriate requests was 78%; of inappropriate indications, 12%; and of uncertain indications, 10%. Budget impact analysis showed that the use of appropriateness criteria, applied to the population referred to myocardial perfusion scintigraphy within 1 year, could generate savings of $ 64,252.04 dollars. The 12% inappropriate requests for myocardial perfusion scintigraphy at a tertiary-care hospital suggest that a reappraisal of MPI indications is needed. Budget impact analysis estimated resource savings of 18.6% with the establishment of appropriateness criteria for MPI.

How should an incident case of atopic dermatitis be defined? A systematic review of primary prevention studies

PubMed Central

Simpson, Eric L.; Keck, Laura E.; Chalmers, Joanne R.; Williams, Hywel C.

2012-01-01

Background Eczema prevention is now an active area of dermatologic and allergic research. Defining an incident case is therefore a prerequisite for such as study. Objective We sought to examine how an incident case of atopic dermatitis was defined in previous atopic dermatitis prevention studies in order to make recommendations on a standard definition of new atopic dermatitis cases for use in future prevention trials. Methods We conducted a systematic review of controlled interventional atopic dermatitis prevention studies using searches of Medline and Cochrane databases from 1980 to the end of January 2011. Studies that included atopic dermatitis as a secondary outcome, such as asthma prevention trials, were included. Results One hundred and two (102) studies were included in the final analysis, of which 27 (26.5%) did not describe any criteria for defining an incident case of atopic dermatitis. Of the remaining 75 studies with reported disease criteria, the Hanifin-Rajka criteria were the most commonly used (28 studies). A disease definition unique to that particular study (21 studies) was the second most commonly used disease definition, although the sources for such novel definitions were not cited. Conclusions The results from this systematic review highlight the need for improved reporting and standardization of the definition used for an incident case in atopic dermatitis prevention studies. Most prevention studies have used disease definitions such as the Hanifin-Rajka criteria that include disease chronicity. While acceptable for cumulative incidence outcomes, inclusion of disease chronicity precludes the precise measurement of disease onset. We propose a definition based on existing scientific studies that could be used in future prospective studies. PMID:22424882

Reference values for TSH may be inadequate to define hypothyroidism in persons with morbid obesity: Di@bet.es study.

PubMed

Valdés, Sergio; Maldonado-Araque, Cristina; Lago-Sampedro, Ana; Lillo-Muñoz, Juan Antonio; Garcia-Fuentes, Eduardo; Perez-Valero, Vidal; Gutiérrez-Repiso, Carolina; Garcia-Escobar, Eva; Goday, Albert; Urrutia, Inés; Peláez, Laura; Calle-Pascual, Alfonso; Bordiú, Elena; Castaño, Luis; Castell, Conxa; Delgado, Elias; Menéndez, Edelmiro; Franch-Nadal, Josep; Gaztambide, Sonia; Girbés, Joan; Ortega, Emilio; Vendrell, Joan; Chacón, Matilde R; Javier Chaves, F; Soriguer, Federico; Rojo-Martínez, Gemma

2017-04-01

To analyze the reference range of thyroid-stimulating hormone (TSH) in different BMI categories and its impact on the classification of hypothyroidism. The study included 3,928 individuals free of thyroid disease (without previous thyroid disease, no interfering medications, TSH <10 µUI/mL and thyroid peroxidase antibodies [TPO Abs] <50 IU/mL) who participated in a national, cross-sectional, population-based study and were representative of the adult population of Spain. Data gathered included clinical and demographic characteristics, physical examination, and blood and urine sampling. TSH, free thyroxine, free triiodothyronine, and TPO Ab were analyzed by electrochemiluminescence (E170, Roche Diagnostics, Basel, Switzerland). The reference range (p2.5-97.5) for TSH was estimated as 0.6 to 4.8 µUI/mL in the underweight category (BMI<20 kg/m 2 ), 0.6 to 5.5 µUI/mL in the normal-weight category (BMI 20-24.9 kg/m 2 ), 0.6 to 5.5 µUI/mL in the overweight category (BMI 25-29.9 kg/m 2 ), 0.5 to 5.9 µUI/mL in the obesity category (BMI 30-39.9 kg/m 2 ), and 0.7 to 7.5 µUI/mL in the morbid obesity category (BMI ≥40). By using the reference criteria for the normal-weight population, the prevalence of high TSH levels increased threefold in the morbid obesity category (P < 0.01). Persons with morbid obesity might be inappropriately classified if the standard ranges of normality of TSH for the normal-weight population are applied to them. © 2017 The Obesity Society.

Nonimaging optical illumination system

DOEpatents

Winston, R.; Ries, H.

1996-12-17

A nonimaging illumination optical device for producing a selected far field illuminance over an angular range. The optical device includes a light source, a light reflecting surface, and a family of light edge rays defined along a reference line with the reflecting surface defined in terms of the reference line as a parametric function R(t) where t is a scalar parameter position and R(t)=k(t)+Du(t) where k(t) is a parameterization of the reference line, and D is a distance from a point on the reference line to the reflection surface along the desired edge ray through the point. 35 figs.

Nonimaging optical illumination system

DOEpatents

Winston, R.; Ries, H.

1998-10-06

A nonimaging illumination optical device for producing a selected far field illuminance over an angular range. The optical device includes a light source a light reflecting surface, and a family of light edge rays defined along a reference line with the reflecting surface defined in terms of the reference lines a parametric function R(t) where t is a scalar parameter position and R(t)=k(t)+Du(t) where k(t) is a parameterization of the reference line, and D is a distance from a point on the reference line to the reflection surface along the desired edge ray through the point. 35 figs.

Defining Top-of-Atmosphere Flux Reference Level for Earth Radiation Budget Studies

NASA Technical Reports Server (NTRS)

Loeb, N. G.; Kato, S.; Wielicki, B. A.

2002-01-01

To estimate the earth's radiation budget at the top of the atmosphere (TOA) from satellite-measured radiances, it is necessary to account for the finite geometry of the earth and recognize that the earth is a solid body surrounded by a translucent atmosphere of finite thickness that attenuates solar radiation differently at different heights. As a result, in order to account for all of the reflected solar and emitted thermal radiation from the planet by direct integration of satellite-measured radiances, the measurement viewing geometry must be defined at a reference level well above the earth s surface (e.g., 100 km). This ensures that all radiation contributions, including radiation escaping the planet along slant paths above the earth s tangent point, are accounted for. By using a field-of- view (FOV) reference level that is too low (such as the surface reference level), TOA fluxes for most scene types are systematically underestimated by 1-2 W/sq m. In addition, since TOA flux represents a flow of radiant energy per unit area, and varies with distance from the earth according to the inverse-square law, a reference level is also needed to define satellite-based TOA fluxes. From theoretical radiative transfer calculations using a model that accounts for spherical geometry, the optimal reference level for defining TOA fluxes in radiation budget studies for the earth is estimated to be approximately 20 km. At this reference level, there is no need to explicitly account for horizontal transmission of solar radiation through the atmosphere in the earth radiation budget calculation. In this context, therefore, the 20-km reference level corresponds to the effective radiative top of atmosphere for the planet. Although the optimal flux reference level depends slightly on scene type due to differences in effective transmission of solar radiation with cloud height, the difference in flux caused by neglecting the scene-type dependence is less than 0.1%. If an inappropriate TOA flux reference level is used to define satellite TOA fluxes, and horizontal transmission of solar radiation through the planet is not accounted for in the radiation budget equation, systematic errors in net flux of up to 8 W/sq m can result. Since climate models generally use a plane-parallel model approximation to estimate TOA fluxes and the earth radiation budget, they implicitly assume zero horizontal transmission of solar radiation in the radiation budget equation, and do not need to specify a flux reference level. By defining satellite-based TOA flux estimates at a 20-km flux reference level, comparisons with plane-parallel climate model calculations are simplified since there is no need to explicitly correct plane-parallel climate model fluxes for horizontal transmission of solar radiation through a finite earth.

Methodology Series Module 2: Case-control Studies.

PubMed

Setia, Maninder Singh

2016-01-01

Case-Control study design is a type of observational study. In this design, participants are selected for the study based on their outcome status. Thus, some participants have the outcome of interest (referred to as cases), whereas others do not have the outcome of interest (referred to as controls). The investigator then assesses the exposure in both these groups. The investigator should define the cases as specifically as possible. Sometimes, definition of a disease may be based on multiple criteria; thus, all these points should be explicitly stated in case definition. An important aspect of selecting a control is that they should be from the same 'study base' as that of the cases. We can select controls from a variety of groups. Some of them are: General population; relatives or friends; and hospital patients. Matching is often used in case-control control studies to ensure that the cases and controls are similar in certain characteristics, and it is a useful technique to increase the efficiency of the study. Case-Control studies can usually be conducted relatively faster and are inexpensive - particularly when compared with cohort studies (prospective). It is useful to study rare outcomes and outcomes with long latent periods. This design is not very useful to study rare exposures. Furthermore, they may also be prone to certain biases - selection bias and recall bias.

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

Dinh, Nam; Athe, Paridhi; Jones, Christopher

The Virtual Environment for Reactor Applications (VERA) code suite is assessed in terms of capability and credibility against the Consortium for Advanced Simulation of Light Water Reactors (CASL) Verification and Validation Plan (presented herein) in the context of three selected challenge problems: CRUD-Induced Power Shift (CIPS), Departure from Nucleate Boiling (DNB), and Pellet-Clad Interaction (PCI). Capability refers to evidence of required functionality for capturing phenomena of interest while capability refers to the evidence that provides confidence in the calculated results. For this assessment, each challenge problem defines a set of phenomenological requirements against which the VERA software is assessed. Thismore » approach, in turn, enables the focused assessment of only those capabilities relevant to the challenge problem. The evaluation of VERA against the challenge problem requirements represents a capability assessment. The mechanism for assessment is the Sandia-developed Predictive Capability Maturity Model (PCMM) that, for this assessment, evaluates VERA on 8 major criteria: (1) Representation and Geometric Fidelity, (2) Physics and Material Model Fidelity, (3) Software Quality Assurance and Engineering, (4) Code Verification, (5) Solution Verification, (6) Separate Effects Model Validation, (7) Integral Effects Model Validation, and (8) Uncertainty Quantification. For each attribute, a maturity score from zero to three is assigned in the context of each challenge problem. The evaluation of these eight elements constitutes the credibility assessment for VERA.« less

Preliminary bioelectrical impedance analysis (BIA) equation for body composition assessment in young females from Colombia

NASA Astrophysics Data System (ADS)

Caicedo-Eraso, J. C.; González-Correa, C. H.; González-Correa, C. A.

2013-04-01

A previous study showed that reported BIA equations for body composition are not suitable for Colombian population. The purpose of this study was to develop and validate a preliminary BIA equation for body composition assessment in young females from Colombia, using hydrodensitometry as reference method. A sample of 30 young females was evaluated. Inclusion and exclusion criteria were defined to minimize the variability of BIA. Height, weight, BIA, residual lung volume (RV) and underwater weight (UWW) were measured. A preliminary BIA equation was developed (r2 = 0.72, SEE = 2.48 kg) by stepwise multiple regression with fat-free mass (FFM) as dependent variable and weight, height and impedance measurements as independent variables. The quality of regression was evaluated and a cross-validation against 50% of sample confirmed that results obtained with the preliminary BIA equation is interchangeable with results obtained with hydrodensitometry (r2 = 0.84, SEE = 2.62 kg). The preliminary BIA equation can be used for body composition assessment in young females from Colombia until a definitive equation is developed. The next step will be increasing the sample, including a second reference method, as deuterium oxide dilution (D2O), and using multi-frequency BIA (MF-BIA). It would also be desirable to develop equations for males and other ethnic groups in Colombia.

Identifying atypical femoral fractures--a retrospective review.

PubMed

Juby, Angela G; Crowther, Sean; Cree, Marilyn

2014-11-01

Subtrochanteric atypical femoral fractures (AFFs) have been reported in patients on osteoporosis therapy (bisphosphonates and denosumab). In 2010, and again in 2013, the ASBMR AFF Task Force developed strict diagnostic criteria for AFFs. This is the first study using these criteria to define the prevalence of AFFs in Canada. This study is a retrospective review of all adult patients (April 2002-March 2013) with an ICD 10 code for hip, femoral or subtrochanteric fracture, from two referral hospitals in Alberta, Canada. All identified as isolated subtrochanteric fractures were further evaluated by chart review, prescription review and examination of radiographs. Of 349 subjects, 79 had isolated subtrochanteric fractures. Of the 70 cases of subtrochanteric fractures that were radiographically assessed (9 films unavailable), 41 fulfilled ASBMR 2013 AFF criteria. The remaining subjects had subtrochanteric fractures but did not meet the ASBMR criteria to qualify as AFFs. There were 11 AFFs in 2012/2013, giving a rate of AFFs of 1.42 per 100,000 50 + year adults, compared to a rate of 103.47 per 100,000 50+ year adults for typical hip fractures. Isolated subtrochanteric fractures are rare. They cannot reliably be identified by ICD coding alone. In this study, only 59 % of all isolated subtrochanteric/femoral shaft fractures fulfilled the ASBMR task force criteria for true AFFs. The rate of typical hip fractures was substantially higher than the rate of AFFs, defined by ASBMR diagnostic criteria.

Meeting Reference Responsibilities through Library Web Sites.

ERIC Educational Resources Information Center

Adams, Michael

2001-01-01

Discusses library Web sites and explains some of the benefits when libraries make their sites into reference portals, linking them to other useful Web sites. Topics include print versus Web information sources; limitations of search engines; what Web sites to include, including criteria for inclusions; and organizing the sites. (LRW)

An Evaluation Instrument for Internet Web Sites.

ERIC Educational Resources Information Center

Livengood, Stephanie Plank

This paper describes the creation of a comprehensive evaluation tool for reference librarians in adult service divisions to use in selecting World Wide Web sites as reference sources. Traditional evaluation criteria, endorsed and applied by librarians over the years, are not sufficient for the evaluation of today's hypermedia web site environment.…

ARBA Guide to Biographical Resources 1986-1997.

ERIC Educational Resources Information Center

Wick, Robert L., Ed.; Mood, Terry Ann, Ed.

This guide provides a representative selection of biographical dictionaries and related works useful to the reference and collection development processes in all types of libraries. Three criteria were used in selection: (1) each item included was published within the past 12 years; (2) each item has been included in American Reference Books…

Guide to Reference Materials for School Library Media Centers. Fifth Edition.

ERIC Educational Resources Information Center

Safford, Barbara Ripp

This publication lists current reference sources that serve the information needs of school library users, including books, CD-ROMs, and World Wide Web sources in all curricular and some extracurricular areas. Criteria for selection include usefulness for curricular applications by elementary and secondary students and teachers, interest for…

Understanding Frame-of-Reference Training Success: A Social Learning Theory Perspective

ERIC Educational Resources Information Center

Sulsky, Lorne M.; Kline, Theresa J. B.

2007-01-01

Employing the social learning theory (SLT) perspective on training, we analysed the effects of alternative frame-of-reference (FOR) training protocols on various criteria of training effectiveness. Undergraduate participants (N = 65) were randomly assigned to one of four FOR training conditions and a control condition. Training effectiveness was…

Thoracic and respirable particle definitions for human health risk assessment.

PubMed

Brown, James S; Gordon, Terry; Price, Owen; Asgharian, Bahman

2013-04-10

Particle size-selective sampling refers to the collection of particles of varying sizes that potentially reach and adversely affect specific regions of the respiratory tract. Thoracic and respirable fractions are defined as the fraction of inhaled particles capable of passing beyond the larynx and ciliated airways, respectively, during inhalation. In an attempt to afford greater protection to exposed individuals, current size-selective sampling criteria overestimate the population means of particle penetration into regions of the lower respiratory tract. The purpose of our analyses was to provide estimates of the thoracic and respirable fractions for adults and children during typical activities with both nasal and oral inhalation, that may be used in the design of experimental studies and interpretation of health effects evidence. We estimated the fraction of inhaled particles (0.5-20 μm aerodynamic diameter) penetrating beyond the larynx (based on experimental data) and ciliated airways (based on a mathematical model) for an adult male, adult female, and a 10 yr old child during typical daily activities and breathing patterns. Our estimates show less penetration of coarse particulate matter into the thoracic and gas exchange regions of the respiratory tract than current size-selective criteria. Of the parameters we evaluated, particle penetration into the lower respiratory tract was most dependent on route of breathing. For typical activity levels and breathing habits, we estimated a 50% cut-size for the thoracic fraction at an aerodynamic diameter of around 3 μm in adults and 5 μm in children, whereas current ambient and occupational criteria suggest a 50% cut-size of 10 μm. By design, current size-selective sample criteria overestimate the mass of particles generally expected to penetrate into the lower respiratory tract to provide protection for individuals who may breathe orally. We provide estimates of thoracic and respirable fractions for a variety of breathing habits and activities that may benefit the design of experimental studies and interpretation of particle size-specific health effects.

Thoracic and respirable particle definitions for human health risk assessment

PubMed Central

2013-01-01

Background Particle size-selective sampling refers to the collection of particles of varying sizes that potentially reach and adversely affect specific regions of the respiratory tract. Thoracic and respirable fractions are defined as the fraction of inhaled particles capable of passing beyond the larynx and ciliated airways, respectively, during inhalation. In an attempt to afford greater protection to exposed individuals, current size-selective sampling criteria overestimate the population means of particle penetration into regions of the lower respiratory tract. The purpose of our analyses was to provide estimates of the thoracic and respirable fractions for adults and children during typical activities with both nasal and oral inhalation, that may be used in the design of experimental studies and interpretation of health effects evidence. Methods We estimated the fraction of inhaled particles (0.5-20 μm aerodynamic diameter) penetrating beyond the larynx (based on experimental data) and ciliated airways (based on a mathematical model) for an adult male, adult female, and a 10 yr old child during typical daily activities and breathing patterns. Results Our estimates show less penetration of coarse particulate matter into the thoracic and gas exchange regions of the respiratory tract than current size-selective criteria. Of the parameters we evaluated, particle penetration into the lower respiratory tract was most dependent on route of breathing. For typical activity levels and breathing habits, we estimated a 50% cut-size for the thoracic fraction at an aerodynamic diameter of around 3 μm in adults and 5 μm in children, whereas current ambient and occupational criteria suggest a 50% cut-size of 10 μm. Conclusions By design, current size-selective sample criteria overestimate the mass of particles generally expected to penetrate into the lower respiratory tract to provide protection for individuals who may breathe orally. We provide estimates of thoracic and respirable fractions for a variety of breathing habits and activities that may benefit the design of experimental studies and interpretation of particle size-specific health effects. PMID:23575443

Methodological factors in determining rates of dementia in transient ischemic attack and stroke: (I) impact of baseline selection bias.

PubMed

Pendlebury, Sarah T; Chen, Ping-Jen; Bull, Linda; Silver, Louise; Mehta, Ziyah; Rothwell, Peter M

2015-03-01

Many previous studies on dementia in stroke have restrictive inclusion criteria, which may result in underestimation of dementia rates. We undertook a large prospective population-based study of all transient ischemic attack and stroke to determine the impact of study entry criteria on measured rates of pre- and postevent dementia. All patients with acute transient ischemic attack or stroke from a defined population of 92 728 are referred from primary care or at hospital admission to the Oxford Vascular Study (2002-2007) and have baseline clinical and cognitive assessment and follow-up. We examined the impact of early death, other nonavailability, and commonly used selection criteria, on measured rates of dementia. Among 1236 patients (mean age/SD 75.2/12.1 years, 582 men, 403 transient ischemic attack), 139 died or were otherwise unavailable for baseline assessment, 319 had prior dependency, 425 had comorbidity, 512 were aged ≥80 years, 85 were dysphasic, and 502 were hospitalized. Pre-event dementia was 3-fold higher in patients dying preascertainment (10/47, 21%) and twice as high in other nonassessed (14/92, 15%) versus assessed patients (69/1097, 6%; P=0.0006 and P=0.002) and was several-fold higher in those with prior functional impairment (24% versus 3%; P<0.0001), age >80 years (13% versus 3%; P<0.0001), dysphasia (11% versus 7%; P<0.0001), and comorbidity (10% versus 6%; P=0.04). Findings for postevent dementia were similar: prior functional impairment (40% versus 13%; P<0.0001), age >80 years (28% versus 10%; P<0.0001), dysphasia (39% versus 15%; P<0.0001), and comorbidity (20% versus 15%; P=0.04). Exclusion of patients unavailable for assessment, and other widely used selection criteria, results in underestimation of the measured rate of dementia associated with transient ischemic attack and stroke. © 2015 American Heart Association, Inc.

Using Algal Metrics and Biomass to Evaluate Multiple Ways of Defining Concentration-Based Nutrient Criteria in Streams and their Ecological Relevance

EPA Science Inventory

We examined the utility of nutrient criteria derived solely from total phosphorus (TP) concentrations in streams (regression models and percentile distributions) and evaluated their ecological relevance to diatom and algal biomass responses. We used a variety of statistics to cha...

Retrospective Cognition by Food-Caching Western Scrub-Jays

ERIC Educational Resources Information Center

de Kort, S.R.; Dickinson, A.; Clayton, N.S.

2005-01-01

Episodic-like memory, the retrospective component of cognitive time travel in animals, needs to fulfil three criteria to meet the behavioral properties of episodic memory as defined for humans. Here, we review results obtained with the cache-recovery paradigm with western scrub-jays and conclude that they fulfil these three criteria. The jays…

A Critique of Radical Innovation as a Solution to Contemporary Problems of Education.

ERIC Educational Resources Information Center

Baumrind, Diana

Without well-defined criteria for success, all radical innovations are doomed to failure. To facilitate successful experimentation the following are necessary: an outside agency to conduct evaluation; criteria of success acceptable to innovators and critics; and, in control and comparison groups, assessment and accounting of the initial versus…

Sensitivity and Specificity of Proposed DSM-5 Criteria for Autism Spectrum Disorder in Toddlers

ERIC Educational Resources Information Center

Barton, Marianne L.; Robins, Diana L.; Jashar, Dasal; Brennan, Laura; Fein, Deborah

2013-01-01

Autism spectrum disorder (ASD) diagnosis is based on behavioral presentation; changes in conceptual models or defining behaviors may significantly impact diagnosis and uptake of ASD-specific interventions. The literature examining impact of DSM-5 criteria is equivocal. Toddlers may be especially vulnerable to the stringent requirements of…

Wittgenstein's Contextualist Approach to Judging "Sound" Teaching: Escaping Enthrallment in Criteria-Based Assessments

ERIC Educational Resources Information Center

Stickney, Jeff Alan

2009-01-01

Comparing the early, analytic attempt to define "sound" teaching with the current use of criteria-based rating schemes, Jeff Stickney turns to Wittgenstein's holistic, contextualist approach to judging teaching against its complex "background" within our "form of life." To exemplify this approach, Stickney presents cases of classroom practice…

25 CFR 13.12 - Criteria for approval of reassumption petitions.

Code of Federal Regulations, 2010 CFR

2010-04-01

... Section 13.12 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE INTERIOR LAW AND ORDER TRIBAL REASSUMPTION OF JURISDICTION OVER CHILD CUSTODY PROCEEDINGS Reassumption § 13.12 Criteria for approval of... jurisdiction over Indian child custody matters if: (1) Any reservation, as defined in 25 U.S.C. 1903(10...

Gestalt Effect of Self Assessment

ERIC Educational Resources Information Center

McDonald, Betty

2012-01-01

Defining self assessment as the involvement of students in identifying standards and/or criteria to apply to their work and making judgements about the extent to which they have met these criteria and standards, this paper seeks to highlight the gestalt effect of self assessment. The total effect of self assessment on the learner is greater than…

14 CFR 170.23 - LORAN-C establishment criteria.

Code of Federal Regulations, 2010 CFR

2010-01-01

... (CONTINUED) NAVIGATIONAL FACILITIES ESTABLISHMENT AND DISCONTINUANCE CRITERIA FOR AIR TRAFFIC CONTROL...-cost ratio equals or exceeds one). As defined in § 170.3 of this part, the benefit-cost ratio is the ratio of the present value of the LORAN-C life-cycle benefits (PVB) to the present value of LORAN-C life...

Self Assessment for Socializing

ERIC Educational Resources Information Center

McDonald, Betty

2011-01-01

Socializing is an integral part of human relations and auger well for the human development. Defined as "the involvement of students in identifying standards and/or criteria to apply to their work and making judgments about the extent to which they have met these criteria and standards", self assessment by its nature teaches students how to…

40 CFR 258.20 - Procedures for excluding the receipt of hazardous waste.

Code of Federal Regulations, 2011 CFR

2011-07-01

... of hazardous waste. 258.20 Section 258.20 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES CRITERIA FOR MUNICIPAL SOLID WASTE LANDFILLS Operating Criteria § 258.20 Procedures..., regulated hazardous waste means a solid waste that is a hazardous waste, as defined in 40 CFR 261.3, that is...

40 CFR 258.20 - Procedures for excluding the receipt of hazardous waste.

Code of Federal Regulations, 2010 CFR

2010-07-01

... of hazardous waste. 258.20 Section 258.20 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES CRITERIA FOR MUNICIPAL SOLID WASTE LANDFILLS Operating Criteria § 258.20 Procedures..., regulated hazardous waste means a solid waste that is a hazardous waste, as defined in 40 CFR 261.3, that is...

Geostatistics as a tool to define various categories of resources

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

Sabourin, R.

1983-02-01

Definition of 'measured' and 'indicated' resources tend to be vague. Yet, the calculation of such categories of resources in a mineral deposit calls for specific technical criteria. The author discusses how a geostatistical methodology provides the technical criteria required to classify reasonably assured resources by levels of assurance of their existence.

High incidence of secondary hypertension in patients referred for renal denervation--the Copenhagen experience.

PubMed

Olsen, Lene Kjær; Kamper, Anne-Lise; Svendsen, Jesper Hastrup; Bang, Lia Evi; Frimodt-Møller, Marie; Kelbæk, Henning; Sander, Mikael; Feldt-Rasmussen, Bo

2014-08-01

Percutaneous renal denervation is a new treatment option for patients with resistant hypertension and little is known about the eligibility of patients referred. 100 consecutive patients were referred for renal denervation from March 2011 through September 2012. Clinical data were prospectively extracted from letters and documents from referring clinics and from our physical examination. Of the 100 patients included, 68 were men and the mean age was 60 (± 12) years. Office blood pressure was 176 (± 28)/99 (± 19) mmHg and 24-h ambulatory blood pressure 156 (± 20)/88 (± 13) mmHg. The mean number of antihypertensive agents was 4.0 (± 1.6). Nearly four-fifths (82%) of the patients were categorized as having resistant hypertension based on the criteria stated by The American Heart Association's stated criteria. Nine patients declined interest in renal denervation before completing the clinical workup program. Thus, 91 patients were screened, and of those 51 were found to be candidates for renal denervation. Forty patients were not candidates, of which secondary hypertension was the most common cause (n = 10). Only 51% of patients referred for renal denervation were eligible for treatment. The prevalence of secondary hypertension was 10% of the referred population. Secondary hypertension should therefore be considered in the evaluation of candidates for renal denervation.

Genotyping in 46 patients with tentative diagnosis of Treacher Collins syndrome revealed unexpected phenotypic variation.

PubMed

Teber, Ozge Altug; Gillessen-Kaesbach, Gabriele; Fischer, Sven; Böhringer, Stefan; Albrecht, Beate; Albert, Angelika; Arslan-Kirchner, Mine; Haan, Eric; Hagedorn-Greiwe, Monika; Hammans, Christof; Henn, Wolfram; Hinkel, Georg Klaus; König, Rainer; Kunstmann, Erdmute; Kunze, Jürgen; Neumann, Luitgard M; Prott, Eva-Christina; Rauch, Anita; Rott, Hans-Dieter; Seidel, Heide; Spranger, Stephanie; Sprengel, Martin; Zoll, Barbara; Lohmann, Dietmar R; Wieczorek, Dagmar

2004-11-01

To define the range of phenotypic expression in Treacher Collins syndrome (TCS; Franceschetti-Klein syndrome), we performed mutation analysis in the TCOF1 gene in 46 patients with tentative diagnosis of TCS and evaluated the clinical data, including a scoring system. A total of 27 coding exons of TCOF1 and adjacent splice junctions were analysed by direct sequencing. In 36 patients with a clinically unequivocal diagnosis of TCS, we detected 28 pathogenic mutations, including 25 novel alterations. No mutation was identified in the remaining eight patients with unequivocal diagnosis of TCS and 10 further patients, in whom the referring diagnosis of TCS was clinically doubtful. There is no overt genotype-phenotype correlation except that conductive deafness is significantly less frequent in patients with mutations in the 3' part of the open reading frame. Inter- and intrafamilial variation is wide. Some mutation carriers, parents of typically affected patients, are so mildly affected that the diagnosis might be overlooked clinically. This suggests that modifying factors are important for phenotypic expression. Based on these findings, minimal diagnostic criteria were defined: downward slanting palpebral fissures and hypoplasia of the zygomatic arch. The difficulties in genetic counselling, especially diagnosis of family members with a mild phenotype, are described.

TH-D-204-00: The Pursuit of Radiation Oncology Performance Excellence

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

NONE

The Malcolm Baldrige National Quality Improvement Act was signed into law in 1987 to advance U.S. business competitiveness and economic growth. Administered by the National Institute of Standards and Technology NIST, the Act created the Baldrige National Quality Program, now renamed the Baldrige Performance Excellence Program. The comprehensive analytical approaches referred to as the Baldrige Healthcare Criteria, are very well suited for the evaluation and sustainable improvement of radiation oncology management and operations. A multidisciplinary self-assessment approach is used for radiotherapy program evaluation and development in order to generate a fact based knowledge driven system for improving quality of care,more » increasing patient satisfaction, building employee engagement, and boosting organizational innovation. The methodology also provides a valuable framework for benchmarking an individual radiation oncology practice against guidelines defined by accreditation and professional organizations and regulatory agencies. Learning Objectives: To gain knowledge of the Baldrige Performance Excellence Program as it relates to Radiation Oncology. To appreciate the value of a multidisciplinary self-assessment approach in the pursuit of Radiation Oncology quality care, patient satisfaction, and workforce commitment. To acquire a set of useful measurement tools with which an individual Radiation Oncology practice can benchmark its performance against guidelines defined by accreditation and professional organizations and regulatory agencies.« less

TH-D-204-01: The Pursuit of Radiation Oncology Performance Excellence

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

Sternick, E.

The Malcolm Baldrige National Quality Improvement Act was signed into law in 1987 to advance U.S. business competitiveness and economic growth. Administered by the National Institute of Standards and Technology NIST, the Act created the Baldrige National Quality Program, now renamed the Baldrige Performance Excellence Program. The comprehensive analytical approaches referred to as the Baldrige Healthcare Criteria, are very well suited for the evaluation and sustainable improvement of radiation oncology management and operations. A multidisciplinary self-assessment approach is used for radiotherapy program evaluation and development in order to generate a fact based knowledge driven system for improving quality of care,more » increasing patient satisfaction, building employee engagement, and boosting organizational innovation. The methodology also provides a valuable framework for benchmarking an individual radiation oncology practice against guidelines defined by accreditation and professional organizations and regulatory agencies. Learning Objectives: To gain knowledge of the Baldrige Performance Excellence Program as it relates to Radiation Oncology. To appreciate the value of a multidisciplinary self-assessment approach in the pursuit of Radiation Oncology quality care, patient satisfaction, and workforce commitment. To acquire a set of useful measurement tools with which an individual Radiation Oncology practice can benchmark its performance against guidelines defined by accreditation and professional organizations and regulatory agencies.« less

Energy-efficiency based classification of the manufacturing workstation

NASA Astrophysics Data System (ADS)

Frumuşanu, G.; Afteni, C.; Badea, N.; Epureanu, A.

2017-08-01

EU Directive 92/75/EC established for the first time an energy consumption labelling scheme, further implemented by several other directives. As consequence, nowadays many products (e.g. home appliances, tyres, light bulbs, houses) have an EU Energy Label when offered for sale or rent. Several energy consumption models of manufacturing equipments have been also developed. This paper proposes an energy efficiency - based classification of the manufacturing workstation, aiming to characterize its energetic behaviour. The concept of energy efficiency of the manufacturing workstation is defined. On this base, a classification methodology has been developed. It refers to specific criteria and their evaluation modalities, together to the definition & delimitation of energy efficiency classes. The energy class position is defined after the amount of energy needed by the workstation in the middle point of its operating domain, while its extension is determined by the value of the first coefficient from the Taylor series that approximates the dependence between the energy consume and the chosen parameter of the working regime. The main domain of interest for this classification looks to be the optimization of the manufacturing activities planning and programming. A case-study regarding an actual lathe classification from energy efficiency point of view, based on two different approaches (analytical and numerical) is also included.

Metabolic syndrome and its components among university students in Kenya.

PubMed

Mbugua, Samuel Mungai; Kimani, Samuel Thuo; Munyoki, Gilbert

2017-11-28

Metabolic syndrome refers to a cluster of interrelated disorders which occur together causing an increase in the risk of developing cardiovascular disease and diabetes. The university population is an understudied group despite the increase in the frequency of related disorders and metabolic risk factors e.g. obesity and diabetes, majorly due to the assumption that they are in their most active phase of life therefore healthy. This study looked at metabolic syndrome, the sedentary lifestyles and dietary habits present among university students attending Mount Kenya University, main campus. Stratified sampling was used to select participants. Self-administered questionnaires were issued to participants after a signed consent had been obtained following which clinical assessments and biochemical measures were performed. They included blood pressure, fasting blood glucose, triglycerides, high density lipoprotein-cholesterol, anthropometric measurements; height, weight, BMI and waist circumference. Pearson's chi-square tests and non-parametric independent t-test were used to analyze the prevalence of metabolic syndrome criteria per gender, the number of metabolic syndrome criteria per BMI and prevalence of metabolic syndrome criteria per BMI category. The study established that 1.9% of the participants met the criteria for diagnosis of metabolic syndrome according to HJSS criteria. Among the elements, there was statistical difference in gender BMI and waist circumference. 11.8% of subjects had two metabolic syndrome components while 3.1% had three components while none of the subjects had all six components. Elevated triglycerides was the most prevalent defining component for metabolic syndrome. There is a statistically significant relationship between sedentary lifestyle and dietary habits as risk factors to metabolic syndrome. Young adults in university have begun developing metabolic syndrome and the risk of developing the syndrome continues to increase with the components being reported in early age. Educational initiatives to encourage healthy eating should be conducted within school premises in order to reinforce the message on healthy diets and physical exercise. Pre-admission screening to identify at risk students should be conducted. Targeted interventions development through a mandatory extra co-curricular program should be enforced to positively engage those at risk.

Pressure Sores and Systemic Inflammatory Response Syndrome: UC Davis Quality Improvement Initiative.

PubMed

Jairam, Abhishek; Song, Ping; Patel, Nirav B; Wong, Michael S

2018-05-01

The National Pressure Ulcer Advisory Panel estimates pressure sore care to approach $11 billion annually. It is not uncommon for these patients to present to the emergency department (ED) with a chief concern of a pressure sore, while concurrently carrying an undiagnosed infectious process that is the culprit for the acute presentation, rather than the chronic pressure injury. We aim to identify patients who met systemic inflammatory response syndrome (SIRS) criteria at ED presentation who were referred to plastic and reconstructive surgery for pressure sore debridement prior to a complete medical workup. We hypothesize that a restructuring of the ED triaging system would help conserve hospital resources, reduce costs of pressure sore management, and improve patient care and outcomes by first treating primary, underlying pathologies. This is a retrospective chart review of 36 patients who presented to the University of California, Davis Medical Center Emergency Department with a pressure sore and met SIRS criteria, but obtained a plastic surgery consult prior to a full medical workup. We defined SIRS based on standardized criteria: temperature greater than 100.4°F or less than 96.8°F, pulse rate greater than 90 beats/min, respiratory rate greater than 20 breaths/min or PaCO2 less than 32 mm Hg, white blood cell count greater than 12,000, less than 4000, or greater than 10% bands. Fifty percent of patients (18/36) met SIRS criteria at ED presentation for their pressure sores. Of these SIRS patients, 9 (50%) had a diagnosis of urinary tract infection or urosepsis, 6 (33.3%) had sepsis of undefined origin, and 3 (16.7%) had other diagnoses such as osteomyelitis or acute respiratory distress syndrome. Half of patients consulted while in the University of California, Davis Medical Center Emergency Department with pressure sores met SIRS criteria and received a plastic and reconstructive surgery consult prior to a full medical workup. We propose a new algorithm for triaging pressure sore patients be established in our institution that emphasizes a medical and surgical collaborative approach in order to reduce cost, conserve resources, and improve patient care.

Criteria for designation of clinical substage in canine lymphoma: a survey of veterinary oncologists.

PubMed

Barber, L G; Weishaar, K M

2016-08-01

Clinical substage is frequently reported to be prognostic in dogs with lymphoma, yet formal criteria for defining this parameter are lacking. The World Health Organization TNM Classification of Tumors of Domestic Animals simply defines substage as the absence or presence of systemic signs (substages a and b, respectively). We designed a survey to query veterinary oncologists on the criteria they use to determine clinical substage in practice. Gastrointestinal, constitutional and respiratory signs were the most commonly identified clinical factors, with greater than 90% respondents indicating that inappetence, vomiting, diarrhoea, changes in attitude, weakness and dyspnea were integral in assigning clinical substage. Nevertheless, more than three-quarters of respondents also considered metabolic, neurologic and nutritional parameters when making this determination. For most factors, respondents reported mild-to-moderate severity of clinical signs was sufficient for substage b designation. © 2014 John Wiley & Sons Ltd.

[Medical indications for acupuncture: Systematic review].

PubMed

Muñoz-Ortego, Juan; Solans-Domènech, Maite; Carrion, Carme

2016-09-16

Acupuncture is a medical procedure with a very wide range of indications according to the WHO. However the indications require robust scientific evidence to support them. We have conducted a systematic review (2010-2015) in order to define in which pathologies acupuncture can be an effective strategy, STRICTA criteria that aim to set up acupuncture clinical trials standard criteria were defined in 2010. Only systematic reviews and meta-analyses of good or very good methodological quality according to SIGN criteria were selected. Its main objective was to evaluate the effectiveness of acupuncture in the management of any disease. Most of the final 31 selected reviews focus on chronic pain-related diseases, mainly in the disciplines of Neurology, Orthopaedics and Rheumatology. Current evidence supports the use of acupuncture in the treatment of headaches, migraines, back pain, cervical pain and osteoarthritis. The remaining pathologies still require further good quality studies. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

Identification of candidate reference chemicals for in vitro steroidogenesis assays.

PubMed

Pinto, Caroline Lucia; Markey, Kristan; Dix, David; Browne, Patience

2018-03-01

The Endocrine Disruptor Screening Program (EDSP) is transitioning from traditional testing methods to integrating ToxCast/Tox21 in vitro high-throughput screening assays for identifying chemicals with endocrine bioactivity. The ToxCast high-throughput H295R steroidogenesis assay may potentially replace the low-throughput assays currently used in the EDSP Tier 1 battery to detect chemicals that alter the synthesis of androgens and estrogens. Herein, we describe an approach for identifying in vitro candidate reference chemicals that affect the production of androgens and estrogens in models of steroidogenesis. Candidate reference chemicals were identified from a review of H295R and gonad-derived in vitro assays used in methods validation and published in the scientific literature. A total of 29 chemicals affecting androgen and estrogen levels satisfied all criteria for positive reference chemicals, while an additional set of 21 and 15 chemicals partially fulfilled criteria for positive reference chemicals for androgens and estrogens, respectively. The identified chemicals included pesticides, pharmaceuticals, industrial and naturally-occurring chemicals with the capability to increase or decrease the levels of the sex hormones in vitro. Additionally, 14 and 15 compounds were identified as potential negative reference chemicals for effects on androgens and estrogens, respectively. These candidate reference chemicals will be informative for performance-based validation of in vitro steroidogenesis models. Copyright © 2017. Published by Elsevier Ltd.

PCOGR: phylogenetic COG ranking as an online tool to judge the specificity of COGs with respect to freely definable groups of organisms.

PubMed

Meereis, Florian; Kaufmann, Michael

2004-10-15

The rapidly increasing number of completely sequenced genomes led to the establishment of the COG-database which, based on sequence homologies, assigns similar proteins from different organisms to clusters of orthologous groups (COGs). There are several bioinformatic studies that made use of this database to determine (hyper)thermophile-specific proteins by searching for COGs containing (almost) exclusively proteins from (hyper)thermophilic genomes. However, public software to perform individually definable group-specific searches is not available. The tool described here exactly fills this gap. The software is accessible at http://www.uni-wh.de/pcogr and is linked to the COG-database. The user can freely define two groups of organisms by selecting for each of the (current) 66 organisms to belong either to groupA, to the reference groupB or to be ignored by the algorithm. Then, for all COGs a specificity index is calculated with respect to the specificity to groupA, i. e. high scoring COGs contain proteins from the most of groupA organisms while proteins from the most organisms assigned to groupB are absent. In addition to ranking all COGs according to the user defined specificity criteria, a graphical visualization shows the distribution of all COGs by displaying their abundance as a function of their specificity indexes. This software allows detecting COGs specific to a predefined group of organisms. All COGs are ranked in the order of their specificity and a graphical visualization allows recognizing (i) the presence and abundance of such COGs and (ii) the phylogenetic relationship between groupA- and groupB-organisms. The software also allows detecting putative protein-protein interactions, novel enzymes involved in only partially known biochemical pathways, and alternate enzymes originated by convergent evolution.

A comparison of human metapneumovirus and respiratory syncytial virus WHO-defined severe pneumonia in Moroccan children.

PubMed

Jroundi, I; Mahraoui, C; Benmessaoud, R; Moraleda, C; Tligui, H; Seffar, M; El Kettani, S E C; Benjelloun, B S; Chaacho, S; Muñoz-Almagro, C; Ruiz, J; Alonso, P L; Bassat, Q

2016-02-01

Acute respiratory infections remain the principal cause of morbidity and mortality in Moroccan children. Besides bacterial infections, respiratory syncytial virus (RSV) and human metapneumovirus (hMPV) are prominent among other viruses due to their high prevalence and association with severe clinical episodes. We aimed to describe and compare RSV- and hMPV-associated cases of WHO-defined severe pneumonia in a paediatric population admitted to Morocco's reference hospital. Children aged 2-59 months admitted to the Hôpital d'Enfants de Rabat, Morocco meeting WHO-defined severe pneumonia criteria were recruited during 14 months and thoroughly investigated to ascertain a definitive diagnosis. Viral prevalence of RSV, hMPV and other viruses causing respiratory symptoms was investigated in nasopharyngeal aspirate samples through the use of molecular methods. Of the 683 children recruited and included in the final analysis, 61/683 (8·9%) and 124/683 (18·2%) were infected with hMPV and RSV, respectively. Besides a borderline significant tendency for higher age in hMPV cases, patients infected with either of the viruses behaved similarly in terms of demographics, patient history, past morbidity and comorbidity, vaccination history, socioeconomic background and family environment. Clinical presentation on arrival was also similar for both viruses, but hMPV cases were associated with more severity than RSV cases, had a higher risk of intensive care need, and received antibiotic treatment more frequently. RSV and hMPV are common and potentially life-threatening causes of WHO-defined pneumonia in Moroccan children. Both viruses show indistinctive clinical symptomatology, but in Moroccan children, hMPV was associated with a more severe evolution.

Using a new incentive mechanism to improve wastewater sector performance: the case study of Italy.

PubMed

De Gisi, Sabino; Petta, Luigi; Farina, Roberto; De Feo, Giovanni

2014-01-01

The system of "Service Objectives", introduced by the Italian National Strategic Framework 2007-2013, is an innovative results-oriented programme concerning 4 thematic areas (education, care for the elderly and children, management of municipal solid wastes and integrated water service) in which the Ministry of Economic Development and eight Southern Italy districts are involved. The system was initially associated to an incentive mechanism which provided subsidies for a total amount of EUR 3 billion from the national Underdeveloped Areas Fund, according to the achievement of specific targets set for 11 service indicators in 2013. The indicators used for the integrated water service refer to the efficiency in water supply service as well as the coverage of wastewater treatment service. The aim of the study is to describe the activities carried out in Italy by the ENEA Agency in order to define a new performance indicator for wastewater treatment service taking into account the appropriateness and efficiency of existing plants equipment and, consequently, evaluating economic incentives. The proposed procedure takes into account both wastewater treatment demand and quality of wastewater treatment service offered to citizens. Input data, provided by the National Institute of Statistics (ISTAT), were elaborated in order to define appropriate parameters, with a multi-criteria analysis being used to define the new performance indicator. The applicability of the proposed procedure was verified considering all the 8 Southern Italy and Island districts (Abruzzo, Molise, Campania, Apulia, Basilicata, Calabria, Sicily and Sardinia) involved in the programme. The obtained results show that the quality of municipal wastewater may influence the calculation of the incentive amount. The performance indicators defined in this work might be conveniently extended to other contexts similar to the assessed geographical area (Southern Italy and Islands). Copyright © 2013 Elsevier Ltd. All rights reserved.

Development and Reliability Testing of the FEDS System for Classifying Glenohumeral Instability

PubMed Central

Kuhn, John E.; Helmer, Tara T.; Dunn, Warren R.; Throckmorton V, Thomas W.

2010-01-01

Background Classification systems for glenohumeral instability (GHI) are opinion based, not validated, and poorly defined. This study is designed to methodologically develop and test a GHI classification system. Methods: Classification System Development A systematic literature review identified 18 systems for classifying GHI. The frequency characteristics used was recorded. Additionally 31 members of the American Shoulder and Elbow Surgeons responded to a survey to identify features important to characterize GHI. Frequency, Etiology, Direction, and Severity (FEDS), were found to be most important. Frequency was defined as solitary (one episode), occasional (2–5x/year), or frequent (>5x/year). Etiology was defined as traumatic or atraumatic. Direction referred to the primary direction of instability (anterior, posterior, or inferior). Severity was defined as either subluxation or dislocation. Methods: Reliability Testing Fifty GHI patients completed a questionnaire at their initial visit. One of six sports medicine fellowship trained physicians completed a similar questionnaire after examining the patient. Patients returned after two weeks and were examined by the original physician and two other physicians. Inter- and intra-rater agreement for the FEDS classification system was calculated. Results Agreement between patients and physicians was lowest for frequency (39%; k=0.130) and highest for direction (82%; k=0.636). Physician intra-rater agreement was 84– 97% for the individual FEDS characteristics (k=0.69 to 0.87)). Physician inter-rater agreement ranged from 82–90% (k=0.44 to 0.76). Conclusions The FEDS system has content validity and is highly reliable for classifying GHI. Physical examination using provocative testing to determine the primary direction of instability produces very high levels of inter- and intra-rater agreement. Level of evidence Level II, Development of Diagnostic Criteria with Consecutive Series of Patients, Diagnosis Study. PMID:21277809

Criteria-based audit to improve quality of care of foetal distress: standardising obstetric care at a national referral hospital in a low resource setting, Tanzania.

PubMed

Mgaya, Andrew H; Litorp, Helena; Kidanto, Hussein L; Nyström, Lennarth; Essén, Birgitta

2016-11-08

In Tanzania, substandard intrapartum management of foetal distress contributes to a third of perinatal deaths, and the majority are term deliveries. We conducted a criteria-based audit with feedback to determine whether standards of diagnosis and management of foetal distress would be improved in a low-resource setting. During 2013-2015, a criteria-based audit was performed at the national referral hospital in Dar es Salaam. Case files of deliveries with a diagnosis of foetal distress were identified and audited. Two registered nurses under supervision of a nurse midwife, a specialist obstetrician and a consultant obstetrician, reviewed the case files. Criteria for standard diagnosis and management of foetal distress were developed based on international and national guidelines, and literature reviews, and then, stepwise applied, in an audit cycle. During the baseline audit, substandard care was identified, and recommendations for improvement of care were proposed and implemented. The effect of the implementations was assessed by the differences in percentage of standard diagnosis and management between the baseline and re-audit, using Chi-square test or Fisher's exact test, when appropriate. In the baseline audit and re-audit, 248 and 251 deliveries with a diagnosis of foetal distress were identified and audited, respectively. The standard of diagnosis increased significantly from 52 to 68 % (p < 0.001). Standards of management improved tenfold from 0.8 to 8.8 % (p < 0.001). Improved foetal heartbeat monitoring using a Fetal Doppler was the major improvement in diagnoses, while change of position of the mother and reduced time interval from decision to perform caesarean section to delivery were the major improvements in management (all p < 0.001). Percentage of cases with substandard diagnosis and management was significantly reduced in both referred public and non-referred private patients (all p ≤ 0.01) but not in non-referred public and referred private patients. The criteria-based audit was able to detect substandard diagnosis and management of foetal distress and improved care using feedback and available resources.

Department of Defense Strategy to Support Multi-Agency Bat Conservation Initiative within the State of Utah

DTIC Science & Technology

2008-02-28

Range, and Section are entered. Datum: Geometric reference surface. Original Site Location datum is defined by user’s map datum; e.g. NAD27...Section are entered. Datum: Geometric reference surface. Original Site Location datum is defined by user’s map datum; e.g. NAD27 Conus or NAD83...Calculated and recorded automatically if the fields UTM_N and UTM_E or Township, Range, and Section are entered. 41 Datum: Geometric reference surface

Sustainability assessment of alternative end-uses for disused areas based on multi-criteria decision-making method.

PubMed

De Feo, Giovanni; De Gisi, Sabino; De Vita, Sabato; Notarnicola, Michele

2018-08-01

The main aim of this study was to define and apply a multidisciplinary and multi-criteria approach to sustainability in evaluating alternative end-uses for disused areas. Taking into account the three pillars of sustainability (social, economic and environmental dimension) as well as the need for stakeholders to have new practical instruments, the innovative approach consists of four modules stated (i) sociological, (ii) economic, (iii) environmental and (iv) multi-criteria assessment. By means of a case study on a small Municipality in Southern Italy, three end-uses alternatives, representing three essential services for citizens, were selected: Municipal gym; Market area; Municipal Solid Waste (MSW) separate collection centre. The sociological module was useful to select the most socially sound alternative by means of a consultative referendum, simulated with the use of a structured questionnaire administered to a sample of the population. The economic evaluation was conducted defining the bill of quantities with regarding to six main items (soil handling, landfill disposal tax, public services, structure and services, completion work, equipment and furnishings). The environmental evaluation was performed applying the Delphi method with local technicians who were involved in a qualitative-quantitative evaluation of the three alternatives with regarding to eight possible environmental impacts (landscape impact, soil handling, odour, traffic, noise, atmospheric pollution, wastewater, waste). Finally, the Simple Additive Weighting was used as multi-criteria technique to define alternatives priorities. The obtained results showed how the multi-criteria analysis is a useful decision support tool able to identify transparently and efficiently the most sustainable solutions to a complex social problem. Copyright © 2018 Elsevier B.V. All rights reserved.

Speaking the same language: underestimating financial impact when using diagnosis-related group versus ICD-9-based definitions for trauma inclusion criteria.

PubMed

Deppe, Sharon; Truax, Christopher B; Opalek, Judy M; Santanello, Steven A

2009-04-01

Hospital accounting methods use diagnosis-related group (DRG) data to identify patients and derive financial analyses and reports. The National Trauma Data Bank and trauma programs identify patients with trauma by International Classification of Diseases, Ninth Edition (ICD-9)-based definitions for inclusion criteria. These differing methods of identifying patients result in economic reports that vary significantly and fail to accurately identify the financial impact of trauma services. Routine financial data were collected for patients admitted to our Trauma Service from July 1, 2005 to June 30, 2006 using two methods of identifying the cases; by trauma DRGs and by trauma registry database inclusion criteria. The resulting data were compared and stratified to define the financial impact on hospital charges, reimbursement, costs, contribution to margin, downstream revenue, and estimated profit or loss. The results also defined the impact on supporting services, market share and total revenue from trauma admissions, return visits, discharged trauma alerts, and consultations. A total of 3,070 patients were identified by the trauma registry as meeting ICD-9 inclusion criteria. Trauma-associated DRGs accounted for 871 of the 3,070 admissions. The DRG-driven data set demonstrated an estimated profit of $800,000 dollars; the ICD-9 data set revealed an estimated 4.8 million dollar profit, increased our market share, and showed substantial revenue generated for other hospital service lines. Trauma DRGs fail to account for most trauma admissions. Financial data derived from DRG definitions significantly underestimate the trauma service line's financial contribution to hospital economics. Accurately identifying patients with trauma based on trauma database inclusion criteria better defines the business of trauma.

Abnormal glucose tolerance post-gestational diabetes mellitus as defined by the International Association of Diabetes and Pregnancy Study Groups criteria.

PubMed

Noctor, Eoin; Crowe, Catherine; Carmody, Louise A; Saunders, Jean A; Kirwan, Breda; O'Dea, Angela; Gillespie, Paddy; Glynn, Liam G; McGuire, Brian E; O'Neill, Ciarán; O'Shea, P M; Dunne, F P

2016-10-01

An increase in gestational diabetes mellitus (GDM) prevalence has been demonstrated across many countries with adoption of the International Association of the Diabetes and Pregnancy Study Groups (IADPSG) diagnostic criteria. Here, we determine the cumulative incidence of abnormal glucose tolerance among women with previous GDM, and identify clinical risk factors predicting this. Two hundred and seventy women with previous IADPSG-defined GDM were prospectively followed up for 5years (mean 2.6) post-index pregnancy, and compared with 388 women with normal glucose tolerance (NGT) in pregnancy. Cumulative incidence of abnormal glucose tolerance (using American Diabetes Association criteria for impaired fasting glucose, impaired glucose tolerance and diabetes) was determined using the Kaplan-Meier method of survival analysis. Cox regression models were constructed to test for factors predicting abnormal glucose tolerance. Twenty-six percent of women with previous GDM had abnormal glucose tolerance vs 4% with NGT, with the log-rank test demonstrating significantly different survival curves (P<0.001). Women meeting IADPSG, but not the World Health Organization (WHO) 1999 criteria, had a lower cumulative incidence than women meeting both sets of criteria, both in the early post-partum period (4.2% vs 21.7%, P<0.001) and at longer-term follow-up (13.7% vs 32.6%, P<0.001). Predictive factors were glucose levels on the pregnancy oral glucose tolerance test, family history of diabetes, gestational week at testing, and BMI at follow-up. The proportion of women developing abnormal glucose tolerance remains high among those with IADPSG-defined GDM. This demonstrates the need for continued close follow-up, although the optimal frequency and method needs further study. © 2016 European Society of Endocrinology.

Differences in Prevalence of Muscle Wasting in Patients Receiving Peritoneal Dialysis per Dual-Energy X-Ray Absorptiometry Due to Variation in Guideline Definitions of Sarcopenia.

PubMed

Hung, Rachel; Wong, Bethany; Goldet, Gabrielle; Davenport, Andrew

2017-08-01

Muscle wasting is associated with increased risk for mortality. There is no agreed universal definition for muscle wasting (sarcopenia), and we wished to determine whether using different criteria altered the prevalence in patients treated by peritoneal dialysis. We measured lean body and appendicular lean mass indices in 325 outpatients by dual-energy x-ray absorptiometry, comparing muscle mass with that used to define muscle wasting (sarcopenia) by various clinical guideline publications. Lean body and appendicular lean mass indices did not differ by sex: female, 17.7 ± 4.6 kg/m 2 ; male, 17.4 ± 4.3; female, 6.9 (5.6-8.5) kg/m 2 ; male, 6.7 (5.3-8.3), respectively. Depending on the criteria, the prevalence of muscle wasting varied from 2.2%-31.3% for women and 25.1%-75.6% for men. Male patients were older (58.3 ± 16 vs 53.4 ± 15.7 years). Criteria based on cutoffs derived from young healthy patients gave the higher prevalence rates. The prevalence of muscle wasting was not associated with dialysis adequacy, estimated protein intake, duration of dialysis treatment, comorbidity, diabetes, or ethnicity. The prevalence of sarcopenic obesity was low (<5% females, 7% males). We found that the prevalence varied markedly depending on the cutoff criteria used to define muscle wasting. Very few patients had sarcopenic obesity. The higher prevalence for males requires further study but was not associated with dialysis treatment. Our study highlights the need for agreed criteria to define pathologic muscle wasting from that which is age associated to allow for interventional screening programs.

Air Quality Criteria for Ozone and Related Photochemical ...

EPA Pesticide Factsheets

In February 2006, EPA released the final document, Air Quality Criteria for Ozone and Other Photochemical Oxidants. Tropospheric or surface-level ozone (O3) is one of six major air pollutants regulated by National Ambient Air Quality Standards (NAAQS) under the U.S. Clean Air Act. As mandated by the Clean Air Act, the U.S. Environmental Protection Agency (EPA) must periodically review the scientific bases (or criteria) for the various NAAQS by assessing newly available scientific information on a given criteria air pollutant. This document, Air Quality Criteria for Ozone and Other Photochemical Oxidants, is an updated revision of the 1996 Ozone Air Quality Criteria Document (O3 AQCD) that provided scientific bases for the current O3 NAAQS set in 1997. The Clean Air Act mandates periodic review of the National Ambient Air Quality Standards (NAAQS) for six common air pollutants, also referred to as criteria pollutants, including ozone.

Nutrient and chlorophyll relations in selected streams of the New England Coastal Basins in Massachusetts and New Hampshire, June-September 2001

USGS Publications Warehouse

Riskin, Melissa L.; Deacon, J.R.; Liebman, M.L.; Robinson, K.W.

2003-01-01

The U.S. Environmental Protection Agency is developing guidance to assist states with defining nutrient criteria for rivers and streams and to better describe nutrient-algal relations. As part of this effort, 13 wadeable stream sites were selected, primarily in eastern Massachusetts, for a nutrient-assessment study during the summer of 2001. The sites represent a range of water-quality impairment conditions (reference, moderately impaired, impaired) based on state regulatory agency assessments and previously assessed nitrogen, phosphorus, and dissolved-oxygen data. In addition, a combination of open- and closed-canopy locations were sampled at six of the sites to investigate the effect of sunlight on algal growth. Samples for nutrients and for chlorophyll I from phytoplankton and periphyton were collected at all stream sites. Total nitrogen (dissolved nitrite + nitrate + total ammonia + organic nitrogen) and total phosphorus (phosphorus in an unfiltered water sample) concentrations were lowest at reference sites and highest at impaired sites. There were statistically significant differences (p < 0.05) among reference, moderately impaired, and impaired sites for total nitrogen and total phosphorus. Chlorophyll a concentrations from phytoplankton were not significantly different among site impairment designations. Concentrations of chlorophyll a from periphyton were highest at nutrient-impaired open-canopy sites. Chlorophyll a concentrations from periphyton samples were positively correlated with total nitrogen and total phosphorus at the open- and closed-canopy sites. Correlations were higher at open-canopy sites (p < 0.05, rho = 0.64 to 0.71) than at closed-canopy sites (p < 0.05, rho = 0.36 to 0.40). Statistically significant differences in the median concentrations of chlorophyll a from periphyton samples were observed between the open- and closed-canopy sites (p < 0.05). Total nitrogen and total phosphorus data from moderately impaired and impaired sites in this study exceeded the preliminary U.S. Environmental Protection Agency nutrient criteria values for the coastal region of New England. In an effort to establish more appropriate nutrient and chlorophyll criteria for streams in the New England coastal region, relations between total nitrogen and total phosphorus to periphyton chlorophyll a in wadeable streams from this study were quantified to present potential techniques for determining nutrient concentrations. Linear regression was used to estimate the total nitrogen and total phosphorus concentrations that corresponded to various chlorophyll a concentrations. On the basis of this relation, a median concentration for moderately enriched streams of 21 milligrams per square meter (mg/m2) of periphyton chlorophyll a from the literature corresponded to estimated concentrations of 1.3 milligrams per liter (mg/L) for total nitrogen and 0.12 mg/L for total phosphorus. The median concentration for periphyton chlorophyll a from the literature is similar to the 50th-percentile concentration of periphyton chlorophyll a (17 mg/m2) calculated with the data from open-canopy sites in this study. The 25th-percentile concentration for periphyton chlorophyll a of all open-canopy sites (5.2 mg/m2) and the 75th-percentile concentration for periphyton chlorophyll a of open-canopy reference sites (16 mg/m2) also were plotted to provide additional estimates and methods for developing total nitrogen and total phosphorus criteria. The 25th-percentile concentrations of total nitrogen and total phosphorus were calculated based on all sites in this study and were used as another potential criteria estimation. A concentration of 0.64 mg/L for total nitrogen and 0.030 mg/L for total phosphorus were calculated. As another possible method to develop threshold concentrations, the 10th-percentile concentrations of total nitrogen and total phosphorus were calculated based on all the impaired sites in this study. A concentration threshold of 0

An evaluation of the significance of transfers of debris: criteria for association and exclusion.

PubMed

Cwiklik, C

1999-11-01

Several criteria are proposed for making decisions about comparing sets of debris involving the transfer of non-component particles and fibers--those produced from something other than the item itself--using a model based upon rudimentary set theory. Decisions about the significance of an association or an exclusion based upon trace evidence require an evaluation of debris in its context; reference points for such evaluation are presented. Samples of debris from the sites relevant to the event under investigation must be available, as well as debris standards from the usual environments of the people involved, and must be adequate to permit a determination of normal versus foreign debris. Criteria are proposed for establishing contact based upon corresponding sets of particles and fibers, for excluding contact in the absence of corresponding particles or fibers, and for refraining from making either an association or an exclusion. Conditions for reaching qualified conclusions or other types of associations when these criteria are only partially met are also discussed; conclusions may sometimes be reached if potential sources for debris particles and fibers can be found. Decisions about the strength of an association or an exclusion based upon comparisons of non-component debris particles and fibers can be made by reference to the criteria for reaching a conclusion. The criteria can be tested via Bayes' Theorem. The analysis itself is based primarily upon light microscopy, although other methods may be used as well. Case examples are presented.

Fixing a Reference Frame to a Moving and Deforming Continent

NASA Astrophysics Data System (ADS)

Blewitt, G.; Kreemer, C.; Hammond, W. C.

2016-12-01

The U.S. National Spatial Reference System will be modernized in 2022. A foundational component will be a geocentric reference frame fixed to the North America tectonic plate. Here we address challenges of fixing a reference frame to a moving and deforming continent. Scientific applications motivate that we fix the frame with a scale consistent with the SI system, an origin that coincides with the Earth system's center of mass, and with axes attached to the rigidly rotating interior of the North America plate. Realizing the scale and origin is now achieved to < 0.5 mm/yr by combining space-geodetic techniques (SLR, VLBI, GPS, and DORIS) in the global system, ITRS. To realize the no-net rotation condition, the complexity of plate boundary deformation demands that we only select GPS stations far from plate boundaries. Another problem is that velocity uncertainties in models of glacial isostatic adjustment (GIA) are significant compared to uncertainties in observed velocities. GIA models generally agree that far-field horizontal velocities tend to be directed toward/away from Hudson Bay, depending on mantle viscosity, with uncertain sign and magnitude of velocity. Also in the far field, strain rates tend to be small beyond the peripheral bulge ( US-Canada border). Thus the Earth's crust in the US east of the Rockies may appear to be rigid, even if this region moves relative to plate motion. This can affect Euler vector estimation, with implications (pros and cons) on scientific interpretation. Our previous approach [ref. 1] in defining the NA12 frame was to select a core set of 30 stations east of the Rockies and south of the U.S.-Canada border that satisfy strict criteria on position time series quality. The resulting horizontal velocities have an RMS of 0.3 mm/yr, quantifying a combination of plate rigidity and accuracy. However, this does not rule out possible common-mode motion arising from GIA. For the development of new frame NA16, we consider approaches to this problem. We also apply new techniques including the MIDAS robust velocity estimator [ref. 2] and "GPS Imaging" of vertical motions and strain rates (Fig. 1), which together could assist in better defining "stable North America".[1] Blewitt et al. (2013). J. Geodyn. 72, 11-24, doi:10.1016/j.jog.2013.08.004[2] Blewitt et al. (2016). JGR 121, doi:10.1002/2015JB012552

Theoretical foundation, methods, and criteria for calibrating human vibration models using frequency response functions

PubMed Central

Dong, Ren G.; Welcome, Daniel E.; McDowell, Thomas W.; Wu, John Z.

2015-01-01

While simulations of the measured biodynamic responses of the whole human body or body segments to vibration are conventionally interpreted as summaries of biodynamic measurements, and the resulting models are considered quantitative, this study looked at these simulations from a different angle: model calibration. The specific aims of this study are to review and clarify the theoretical basis for model calibration, to help formulate the criteria for calibration validation, and to help appropriately select and apply calibration methods. In addition to established vibration theory, a novel theorem of mechanical vibration is also used to enhance the understanding of the mathematical and physical principles of the calibration. Based on this enhanced understanding, a set of criteria was proposed and used to systematically examine the calibration methods. Besides theoretical analyses, a numerical testing method is also used in the examination. This study identified the basic requirements for each calibration method to obtain a unique calibration solution. This study also confirmed that the solution becomes more robust if more than sufficient calibration references are provided. Practically, however, as more references are used, more inconsistencies can arise among the measured data for representing the biodynamic properties. To help account for the relative reliabilities of the references, a baseline weighting scheme is proposed. The analyses suggest that the best choice of calibration method depends on the modeling purpose, the model structure, and the availability and reliability of representative reference data. PMID:26740726

The challenges of simulating wake vortex encounters and assessing separation criteria

NASA Technical Reports Server (NTRS)

Dunham, R. E.; Stuever, Robert A.; Vicroy, Dan D.

1993-01-01

During landings and take-offs, the longitudinal spacing between airplanes is in part determined by the safe separation required to avoid the trailing vortex wake of the preceding aircraft. Safe exploration of the feasibility of reducing longitudinal separation standards will require use of aircraft simulators. This paper discusses the approaches to vortex modeling, methods for modeling the aircraft/vortex interaction, some of the previous attempts of defining vortex hazard criteria, and current understanding of the development of vortex hazard criteria.

Design criteria for a self-actuated shutdown system to ensure limitation of core damage. [LMFBR

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

Deane, N.A.; Atcheson, D.B.

1981-09-01

Safety-based functional requirements and design criteria for a self-actuated shutdown system (SASS) are derived in accordance with LOA-2 success criteria and reliability goals. The design basis transients have been defined and evaluated for the CDS Phase II design, which is a 2550 MWt mixed oxide heterogeneous core reactor. A partial set of reactor responses for selected transients is provided as a function of SASS characteristics such as reactivity worth, trip points, and insertion times.

Nutritional evaluation of patients receiving dialysis for the management of protein-energy wasting: what is old and what is new?

PubMed

Riella, Miguel C

2013-05-01

Advances in the nutritional support of hospitalized patients in the early 1970s led to the recognition that tools were needed to evaluate the nutritional status of patients. The observation that malnutrition in patients receiving dialysis was associated with increased morbidity and mortality prompted many expert groups to develop nutritional scoring systems to be applied in these patients. Given the diverse and confusing terminologies that emerged from these publications, the International Society of Renal Nutritional and Metabolism convened an expert panel to recommend a new nomenclature and preferred methods to evaluate the nutritional status of patients with chronic kidney disease (CKD). The new and inclusive term protein-energy wasting (PEW) refers to a systematically defined condition based on certain criteria and reflects malnutrition and wasting caused not only by inadequate nutrient intake but also by depletion resulting from the inflammatory and noninflammatory conditions that prevail in this population. Serial assessment of nutritional status for detection and management of PEW is recommended using old and new scoring tools, including the Subjective Global Assessment (SGA), malnutrition inflammation score (MIS), Geriatric Nutritional Risk Index (GNRI), and PEW definition criteria. These tools, which are reliable methods and predictors of outcomes, are reviewed in this article. Copyright © 2013 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.

The diagnostic value of history and physical examination for COPD in suspected or known cases: a systematic review.

PubMed

Broekhuizen, Berna D L; Sachs, Alfred P E; Oostvogels, Rimke; Hoes, Arno W; Verheij, Theo J M; Moons, Karel G M

2009-08-01

According to current guidelines, spirometry should be performed in patients suspected of chronic obstructive pulmonary disease (COPD) by the results of history taking and physical examination. However, little is known about the diagnostic value of patient history and physical examination for COPD. To review the existing evidence on the diagnostic value of history taking and physical examination in recognizing COPD in patients suspected of COPD. A systematic literature search was performed in electronic medical databases. Studies were included after using defined inclusion and exclusion criteria and judged on their methodological quality by using the Quality Assessment of Diagnostic Accuracy Studies criteria. A formal meta-analysis was not performed because all studied items of history and physical examination were investigated in only in a maximum of three studies. Six studies were included. The history items dyspnoea, wheezing, previous consultation for wheezing or cough, self-reported COPD, age and smoking and the physical examination items wheezing, forced expiratory time, laryngeal height and prolonged expiration were found to have diagnostic value for COPD. These items were studied in maximally three studies and study population studies were heterogenic. The reference test for COPD in five of the six studies concerned obstructive lung disease in general and not COPD. There is insufficient evidence to assess the value of history taking and physical examination for diagnosing COPD.

Panic disorder with agoraphobia from a behavioral neuroscience perspective: Applying the research principles formulated by the Research Domain Criteria (RDoC) initiative.

PubMed

Hamm, Alfons O; Richter, Jan; Pané-Farré, Christiane; Westphal, Dorte; Wittchen, Hans-Ulrich; Vossbeck-Elsebusch, Anna N; Gerlach, Alexander L; Gloster, Andrew T; Ströhle, Andreas; Lang, Thomas; Kircher, Tilo; Gerdes, Antje B M; Alpers, Georg W; Reif, Andreas; Deckert, Jürgen

2016-03-01

In the current review, we reconceptualize a categorical diagnosis-panic disorder and agoraphobia-in terms of two constructs within the domain "negative valence systems" suggested by the Research Domain Criteria initiative. Panic attacks are considered as abrupt and intense fear responses to acute threat arising from inside the body, while anxious apprehension refers to anxiety responses to potential harm and more distant or uncertain threat. Taking a dimensional view, panic disorder with agoraphobia is defined with the threat-imminence model stating that defensive responses are dynamically organized along the dimension of the proximity of the threat. We tested this model within a large group of patients with panic disorder and agoraphobia (N = 369 and N = 124 in a replication sample) and found evidence that panic attacks are indeed instances of circa strike defense. This component of the defensive reactivity was related to genetic modulators within the serotonergic system. In contrast, anxious apprehension-characterized by attentive freezing during postencounter defense-was related to general distress and depressive mood, as well as to genetic modulations within the hypothalamic-pituitary-adrenal (HPA) axis. Patients with a strong behavioral tendency for active and passive avoidance responded better to exposure treatment if the therapist guides the patient through the exposure exercises. © 2016 Society for Psychophysiological Research.

Linkage of the National Health Interview Survey to air quality data.

PubMed

Parker, Jennifer D; Kravets, Nataliya; Woodruff, Tracey J

2008-02-01

This report describes the linkage between the National Health Interview Survey (NHIS) and air monitoring data from the U.S. Environmental Protection Agency (EPA). There have been few linkages of these data sources, partly because of restrictions on releasing geographic detail from NHIS on public-use files in order to protect participant confidentiality. Pollution exposures for NHIS respondents were calculated by averaging the annual average exposure estimates from EPA air monitors both within 5, 10, 15, and 20 miles of the respondent's block-group location (which is available on restricted NHIS data files) and by county of residence. The 1987-2005 linked data files--referred to as NHIS-EPAAnnualAir--were used to describe the percentage of NHIS respondents linked and the median exposures by linkage method, survey year, and pollutant. Using the 2005 NHIS-EPAAnnualAir data file, the percentage linked and median exposure were described by respondent characteristics, linkage method, and pollutant. Many decisions were made to define pollution exposures for NHIS respondents, including monitor selection, location assignment for NHIS respondents, and geographic linkage criteria. Geographic linkage criteria for assigning area-level exposure estimates affected the percentage and composition of respondents included in the resulting linked sample. Median exposure estimates, however, were similar among geographic linkage methods. NHIS-EPAAnnualAir data files for 1985 through 2005 are currently available to users in the NCHS Research Data Center.

Systemic inflammatory response syndrome criteria in defining severe sepsis.

PubMed

Kaukonen, Kirsi-Maija; Bailey, Michael; Pilcher, David; Cooper, D Jamie; Bellomo, Rinaldo

2015-04-23

The consensus definition of severe sepsis requires suspected or proven infection, organ failure, and signs that meet two or more criteria for the systemic inflammatory response syndrome (SIRS). We aimed to test the sensitivity, face validity, and construct validity of this approach. We studied data from patients from 172 intensive care units in Australia and New Zealand from 2000 through 2013. We identified patients with infection and organ failure and categorized them according to whether they had signs meeting two or more SIRS criteria (SIRS-positive severe sepsis) or less than two SIRS criteria (SIRS-negative severe sepsis). We compared their characteristics and outcomes and assessed them for the presence of a step increase in the risk of death at a threshold of two SIRS criteria. Of 1,171,797 patients, a total of 109,663 had infection and organ failure. Among these, 96,385 patients (87.9%) had SIRS-positive severe sepsis and 13,278 (12.1%) had SIRS-negative severe sepsis. Over a period of 14 years, these groups had similar characteristics and changes in mortality (SIRS-positive group: from 36.1% [829 of 2296 patients] to 18.3% [2037 of 11,119], P<0.001; SIRS-negative group: from 27.7% [100 of 361] to 9.3% [122 of 1315], P<0.001). Moreover, this pattern remained similar after adjustment for baseline characteristics (odds ratio in the SIRS-positive group, 0.96; 95% confidence interval [CI], 0.96 to 0.97; odds ratio in the SIRS-negative group, 0.96; 95% CI, 0.94 to 0.98; P=0.12 for between-group difference). In the adjusted analysis, mortality increased linearly with each additional SIRS criterion (odds ratio for each additional criterion, 1.13; 95% CI, 1.11 to 1.15; P<0.001) without any transitional increase in risk at a threshold of two SIRS criteria. The need for two or more SIRS criteria to define severe sepsis excluded one in eight otherwise similar patients with infection, organ failure, and substantial mortality and failed to define a transition point in the risk of death. (Funded by the Australian and New Zealand Intensive Care Research Centre.).

Incidence of neonatal necrotising enterocolitis in high-income countries: a systematic review.

PubMed

Battersby, Cheryl; Santhalingam, Tharsika; Costeloe, Kate; Modi, Neena

2018-03-01

To conduct a systematic review of neonatal necrotising enterocolitis (NEC) rates in high-income countries published in peer-reviewed journals. We searched MEDLINE, Embase and PubMed databases for observational studies published in peer-reviewed journals. We selected studies reporting national, regional or multicentre rates of NEC in 34 Organisation for Economic Co-operation and Development countries. Two investigators independently screened studies against predetermined criteria. For included studies, we extracted country, year of publication in peer-reviewed journal, study time period, study population inclusion and exclusion criteria, case definition, gestation or birth weight-specific NEC and mortality rates. Of the 1888 references identified, 120 full manuscripts were reviewed, 33 studies met inclusion criteria, 14 studies with the most recent data from 12 countries were included in the final analysis. We identified an almost fourfold difference, from 2% to 7%, in the rate of NEC among babies born <32 weeks' gestation and an almost fivefold difference, from 5% to 22%, among those with a birth weight <1000 g but few studies covered the entire at-risk population. The most commonly applied definition was Bell's stage ≥2, which was used in seven studies. Other definitions included Bell's stage 1-3, definitions from the Centers for Disease Control and Prevention, International Classification for Diseases and combinations of clinical and radiological signs as specified by study authors. The reasons for international variation in NEC incidence are an important area for future research. Reliable inferences require clarity in defining population coverage and consistency in the case definition applied. PROSPERO INTERNATIONAL PROSPECTIVE REGISTER OF SYSTEMATIC REVIEWS REGISTRATION NUMBER: CRD42015030046. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

A systematic review of randomised controlled trials evaluating the effect of mother/baby skin-to-skin care on successful breast feeding.

PubMed

Carfoot, Sue; Williamson, Paula R; Dickson, Rumona

2003-06-01

to examine the effects of early skin-to-skin contact between mother and baby on the initiation and duration of breast feeding. electronic databases--the Cochrane Library, MEDLINE,CINAHL and EMBASE. References of studies were examined to identify additional trials and contact was made with researchers in the field. Study selection criteria: randomised or quasi-randomised controlled trials in any language in which skin-to-skin contact between mothers and their healthy full-term newborn babies was compared to routine contact. Primary outcomes were success of first breast feed and duration of breast feeding. Secondary outcomes included, baby temperature and behaviour. STUDY-QUALITY ASSESSMENT: validity of included studies was assessed using criteria defined by the Cochrane Collaboration. Application of inclusion criteria, validity assessment and data extraction were carried out independently by two reviewers with a third reviewer to resolve differences. seven randomised controlled trials were identified. Five studies assessed duration of breast feeding with mixed results. None of the studies assessed the success of the first breast-feeding experience. Study quality was variable with methods of randomisation and blinding of assessment unclear in four of the five studies providing relevant results. the findings of this systematic review fail to support the current initiatives to implement changes in clinical practice to include skin-to-skin contact. Methodological flaws within the included studies prohibit firm conclusions being reached with regard to the effect of skin-to-skin contact on the duration of breast feeding, timing of first breast feed or baby physiological factors. The review highlights the need for further primary research to assess the effect of skin-to-skin contact on the breast-feeding experience.