Biochemical methane potential (BMP) tests: Reducing test time by early parameter estimation.

PubMed

Da Silva, C; Astals, S; Peces, M; Campos, J L; Guerrero, L

2018-01-01

Biochemical methane potential (BMP) test is a key analytical technique to assess the implementation and optimisation of anaerobic biotechnologies. However, this technique is characterised by long testing times (from 20 to >100days), which is not suitable for waste utilities, consulting companies or plants operators whose decision-making processes cannot be held for such a long time. This study develops a statistically robust mathematical strategy using sensitivity functions for early prediction of BMP first-order model parameters, i.e. methane yield (B 0 ) and kinetic constant rate (k). The minimum testing time for early parameter estimation showed a potential correlation with the k value, where (i) slowly biodegradable substrates (k≤0.1d -1 ) have a minimum testing times of ≥15days, (ii) moderately biodegradable substrates (0.1testing times between 8 and 15 days, and (iii) rapidly biodegradable substrates (k≥0.2d -1 ) have testing times lower than 7days. Copyright © 2017 Elsevier Ltd. All rights reserved.

Using and Providing Services: Case Studies in Early Intervention.

ERIC Educational Resources Information Center

McWilliam, Robin; Tocci, Lynn; Sideris, John; Harbin, Gloria

A case study approach was used to examine the complexities of service utilization in early intervention with infants, toddlers, and young children with disabilities. Seventy-two families of children (ages birth to 4) participating in nine early intervention programs in three states (Colorado, North Carolina, and Pennsylvania) and their service…

Making the Case for Early Childhood Investments: Three Arguments

ERIC Educational Resources Information Center

Neugebauer, Roger

2011-01-01

Tamar Manuelyan Atinc, vice president of The World Bank, introduces a World Bank report, "Investing in Young Children: An Early Childhood Development Guide for Policy Dialogue and Project Preparation". This report, which is a must for inclusion in every advocate's make the case for investing in early childhood services. It defines three arguments…

Inversion Method for Early Detection of ARES-1 Case Breach Failure

NASA Technical Reports Server (NTRS)

Mackey, Ryan M.; Kulikov, Igor K.; Bajwa, Anupa; Berg, Peter; Smelyanskiy, Vadim

2010-01-01

A document describes research into the problem of detecting a case breach formation at an early stage of a rocket flight. An inversion algorithm for case breach allocation is proposed and analyzed. It is shown how the case breach can be allocated at an early stage of its development by using the rocket sensor data and the output data from the control block of the rocket navigation system. The results are simulated with MATLAB/Simulink software. The efficiency of an inversion algorithm for a case breach location is discussed. The research was devoted to the analysis of the ARES-l flight during the first 120 seconds after the launch and early prediction of case breach failure. During this time, the rocket is propelled by its first-stage Solid Rocket Booster (SRB). If a breach appears in SRB case, the gases escaping through it will produce the (side) thrust directed perpendicular to the rocket axis. The side thrust creates torque influencing the rocket attitude. The ARES-l control system will compensate for the side thrust until it reaches some critical value, after which the flight will be uncontrollable. The objective of this work was to obtain the start time of case breach development and its location using the rocket inertial navigation sensors and GNC data. The algorithm was effective for the detection and location of a breach in an SRB field joint at an early stage of its development.

Audit of the autoantibody test, EarlyCDT®-lung, in 1600 patients: an evaluation of its performance in routine clinical practice.

PubMed

Jett, James R; Peek, Laura J; Fredericks, Lynn; Jewell, William; Pingleton, William W; Robertson, John F R

2014-01-01

EarlyCDT(®)-Lung may enhance detection of early stage lung cancer by aiding physicians in assessing high-risk patients through measurement of biological markers (i.e., autoantibodies). The test's performance characteristics in routine clinical practice were evaluated by auditing clinical outcomes of 1613 US patients deemed at high risk for lung cancer by their physician, who ordered the EarlyCDT-Lung test for their patient. Clinical outcomes for all 1613 patients who provided HIPAA authorization are reported. Clinical data were collected from each patient's treating physician. Pathology reports when available were reviewed for diagnostic classification. Staging was assessed on histology, otherwise on imaging. Six month follow-up for the positives/negatives was 99%/93%. Sixty-one patients (4%) were identified with lung cancer, 25 of whom tested positive by EarlyCDT-Lung (sensitivity=41%). A positive EarlyCDT-Lung test on the current panel was associated with a 5.4-fold increase in lung cancer incidence versus a negative. Importantly, 57% (8/14) of non-small cell lung cancers detected as positive (where stage was known) were stage I or II. EarlyCDT-Lung has been extensively tested and validated in case-control settings and has now been shown in this audit to perform in routine clinical practice as predicted. EarlyCDT-Lung may be a complementary tool to CT for detection of early lung cancer. Copyright © 2013 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Comparison between DOT EIA IgM and Widal Test as early diagnosis of typhoid fever.

PubMed

Begum, Z; Hossain, M A; Musa, A K; Shamsuzzaman, A K; Mahmud, M C; Ahsan, M M; Sumona, A A; Ahmed, S; Jahan, N A; Alam, M; Begum, A

2009-01-01

A recently developed DOT enzyme immunoassay known as "Typhidot" for detecting IgM antibody against 50 KDa OMP antigen of Salmonella typhi, was evaluated on 100 clinically suspected typhoid fever cases and 40 age-sex matched controls, in the Department of Microbiology, Mymensingh Medical College during, the period from June 2006 to July 2007. Blood culture, Widal test, and DOT EIA for IgM test were performed in all patients. Among 100 clinically suspected typhoid fever cases, 35 were subsequently confirmed on the basis of positive blood culture for S. typhi and/or significant rising titre of Widal test. The DOT EIA IgM test could produce results within 1 hour. The result of the DOT EIA IgM test showed a good diagnostic value for typhoid fever. The sensitivity, specificity, positive and negative predictive value of the test was found as 91.42%, 90.00%, 88.88% and 92.30% respectively. On the other hand corresponding values for Widal test were of 42.85%, 85.00%, 71.42% and 62.96% respectively. Thus, The DOT EIA IgM seems to be a practical alternative to Widal test for early diagnosis of typhoid fever.

Probabilistic and Evolutionary Early Warning System: concepts, performances, and case-studies

NASA Astrophysics Data System (ADS)

Zollo, A.; Emolo, A.; Colombelli, S.; Elia, L.; Festa, G.; Martino, C.; Picozzi, M.

2013-12-01

PRESTo (PRobabilistic and Evolutionary early warning SysTem) is a software platform for Earthquake Early Warning that integrates algorithms for real-time earthquake location, magnitude estimation and damage assessment into a highly configurable and easily portable package. In its regional configuration, the software processes, in real-time, the 3-component acceleration data streams coming from seismic stations, for P-waves arrival detection and, in the case a quite large event is occurring, can promptly performs event detection and location, magnitude estimation and peak ground-motion prediction at target sites. The regional approach has been integrated with a threshold-based early warning method that allows, in the very first seconds after a moderate-to-large earthquake, to identify the most Probable Damaged Zone starting from the real-time measurement at near-source stations located at increasing distances from the earthquake epicenter, of the peak displacement (Pd) and predominant period of P-waves (τc), over a few-second long window after the P-wave arrival. Thus, each recording site independently provides an evolutionary alert level, according to the Pd and τc it measured, through a decisional table. Since 2009, PRESTo has been under continuous real-time testing using data streaming from the Iripinia Seismic Network (Southern Italy) and has produced a bulletin of some hundreds low magnitude events, including all the M≥2.5 earthquakes occurred in that period in Irpinia. Recently, PRESTo has been also implemented at the accelerometric network and broad-band networks in South Korea and in Romania, and off-line tested in Iberian Peninsula, in Turkey, in Israel, and in Japan. The feasibility of an Early Warning System at national scale, is currently under testing by studying the performances of the PRESTo platform for the Italian Accelerometric Network. Moreover, PRESTo is under experimentation in order to provide alert in a high-school located in the

Larval cases of caddisfly (Insecta: Trichoptera) affinity in Early Permian marine environments of Gondwana

NASA Astrophysics Data System (ADS)

Mouro, Lucas D.; Zatoń, Michał; Fernandes, Antonio C. S.; Waichel, Breno L.

2016-01-01

Caddisflies (Trichoptera) are small, cosmopolitan insects closely related to the Lepidoptera (moths and butterflies). Most caddisflies construct protective cases during their larval development. Although the earliest recognisable caddisflies date back to the early Mesozoic (Early and Middle Triassic), being particularly numerous and diverse during the Late Jurassic and Early Cretaceous, the first records of their larval case constructions are known exclusively from much younger, Early to Middle Jurassic non-marine deposits in the northern hemisphere. Here we present fossils from the Early Permian (Asselian-Sakmarian) marine deposits of Brazil which have strong morphological and compositional similarity to larval cases of caddisflies. If they are, which is very probable, these finds not only push back the fossil record of true caddisflies, but also indicate that their larvae constructed cases at the very beginning of their evolution in marine environments. Since modern caddisflies that construct larval cases in marine environments are only known from eastern Australia and New Zealand, we suggest that this marine ecology may have first evolved in western Gondwana during the Early Permian and later spread across southern Pangea.

Larval cases of caddisfly (Insecta: Trichoptera) affinity in Early Permian marine environments of Gondwana

PubMed Central

Mouro, Lucas D.; Zatoń, Michał; Fernandes, Antonio C.S.; Waichel, Breno L.

2016-01-01

Caddisflies (Trichoptera) are small, cosmopolitan insects closely related to the Lepidoptera (moths and butterflies). Most caddisflies construct protective cases during their larval development. Although the earliest recognisable caddisflies date back to the early Mesozoic (Early and Middle Triassic), being particularly numerous and diverse during the Late Jurassic and Early Cretaceous, the first records of their larval case constructions are known exclusively from much younger, Early to Middle Jurassic non-marine deposits in the northern hemisphere. Here we present fossils from the Early Permian (Asselian–Sakmarian) marine deposits of Brazil which have strong morphological and compositional similarity to larval cases of caddisflies. If they are, which is very probable, these finds not only push back the fossil record of true caddisflies, but also indicate that their larvae constructed cases at the very beginning of their evolution in marine environments. Since modern caddisflies that construct larval cases in marine environments are only known from eastern Australia and New Zealand, we suggest that this marine ecology may have first evolved in western Gondwana during the Early Permian and later spread across southern Pangea. PMID:26765261

Larval cases of caddisfly (Insecta: Trichoptera) affinity in Early Permian marine environments of Gondwana.

PubMed

Mouro, Lucas D; Zatoń, Michał; Fernandes, Antonio C S; Waichel, Breno L

2016-01-14

Caddisflies (Trichoptera) are small, cosmopolitan insects closely related to the Lepidoptera (moths and butterflies). Most caddisflies construct protective cases during their larval development. Although the earliest recognisable caddisflies date back to the early Mesozoic (Early and Middle Triassic), being particularly numerous and diverse during the Late Jurassic and Early Cretaceous, the first records of their larval case constructions are known exclusively from much younger, Early to Middle Jurassic non-marine deposits in the northern hemisphere. Here we present fossils from the Early Permian (Asselian-Sakmarian) marine deposits of Brazil which have strong morphological and compositional similarity to larval cases of caddisflies. If they are, which is very probable, these finds not only push back the fossil record of true caddisflies, but also indicate that their larvae constructed cases at the very beginning of their evolution in marine environments. Since modern caddisflies that construct larval cases in marine environments are only known from eastern Australia and New Zealand, we suggest that this marine ecology may have first evolved in western Gondwana during the Early Permian and later spread across southern Pangea.

Abnormal plasma DNA profiles in early ovarian cancer using a non-invasive prenatal testing platform: implications for cancer screening.

PubMed

Cohen, Paul A; Flowers, Nicola; Tong, Stephen; Hannan, Natalie; Pertile, Mark D; Hui, Lisa

2016-08-24

Non-invasive prenatal testing (NIPT) identifies fetal aneuploidy by sequencing cell-free DNA in the maternal plasma. Pre-symptomatic maternal malignancies have been incidentally detected during NIPT based on abnormal genomic profiles. This low coverage sequencing approach could have potential for ovarian cancer screening in the non-pregnant population. Our objective was to investigate whether plasma DNA sequencing with a clinical whole genome NIPT platform can detect early- and late-stage high-grade serous ovarian carcinomas (HGSOC). This is a case control study of prospectively-collected biobank samples comprising preoperative plasma from 32 women with HGSOC (16 'early cancer' (FIGO I-II) and 16 'advanced cancer' (FIGO III-IV)) and 32 benign controls. Plasma DNA from cases and controls were sequenced using a commercial NIPT platform and chromosome dosage measured. Sequencing data were blindly analyzed with two methods: (1) Subchromosomal changes were called using an open source algorithm WISECONDOR (WIthin-SamplE COpy Number aberration DetectOR). Genomic gains or losses ≥ 15 Mb were prespecified as "screen positive" calls, and mapped to recurrent copy number variations reported in an ovarian cancer genome atlas. (2) Selected whole chromosome gains or losses were reported using the routine NIPT pipeline for fetal aneuploidy. We detected 13/32 cancer cases using the subchromosomal analysis (sensitivity 40.6 %, 95 % CI, 23.7-59.4 %), including 6/16 early and 7/16 advanced HGSOC cases. Two of 32 benign controls had subchromosomal gains ≥ 15 Mb (specificity 93.8 %, 95 % CI, 79.2-99.2 %). Twelve of the 13 true positive cancer cases exhibited specific recurrent changes reported in HGSOC tumors. The NIPT pipeline resulted in one "monosomy 18" call from the cancer group, and two "monosomy X" calls in the controls. Low coverage plasma DNA sequencing used for prenatal testing detected 40.6 % of all HGSOC, including 38 % of early stage cases. Our

Choroidal metastasis from early rectal cancer: Case report and literature review

PubMed Central

Tei, Mitsuyoshi; Wakasugi, Masaki; Akamatsu, Hiroki

2014-01-01

INTRODUCTION Choroidal metastasis from colorectal cancer is rare, and there have been no reported cases of such metastasis from early colorectal cancer. We report a case of choroidal metastasis from early rectal cancer. PRESENTATION OF CASE A 61 year-old-man experienced myodesopsia in the left eye 2 years and 6 months after primary rectal surgery for early cancer, and was diagnosed with left choroidal metastasis and multiple lung metastases. Radiotherapy was initiated for the left eye and systemic chemotherapy is initiated for the multiple lung metastases. The patient is living 2 years and 3 months after the diagnosis of choroidal metastasis without signs of recurrence in the left eye, and continues to receive systemic chemotherapy for multiple lung metastases. DISCUSSION Current literatures have few recommendations regarding the appropriate treatment of choroidal metastasis from colorectal cancer, but an aggressive multi-disciplinary approach may be effective in local regression. CONCLUSION This is the first report of choroidal metastasis from early rectal cancer. We consider it important to enforce systemic chemotherapy in addition to radiotherapy for choroidal metastasis from colorectal cancer. PMID:25460493

[Validation of three screening tests used for early detection of cervical cancer].

PubMed

Rodriguez-Reyes, Esperanza Rosalba; Cerda-Flores, Ricardo M; Quiñones-Pérez, Juan M; Cortés-Gutiérrez, Elva I

2008-01-01

to evaluate the validity (sensitivity, specificity, and accuracy) of three screening methods used in the early detection of the cervical carcinoma versus the histopathology diagnosis. a selected sample of 107 women attended in the Opportune Detection of Cervicouterine Cancer Program in the Hospital de Zona 46, Instituto Mexicano del Seguro Social in Durango, during the 2003 was included. The application of Papa-nicolaou, acetic acid test, and molecular detection of human papillomavirus, and histopatholgy diagnosis were performed in all the patients at the time of the gynecological exam. The detection and tipification of the human papillomavirus was performed by polymerase chain reaction (PCR) and analysis of polymorphisms of length of restriction fragments (RFLP). Histopathology diagnosis was considered the gold standard. The evaluation of the validity was carried out by the Bayesian method for diagnosis test. the positive cases for acetic acid test, Papanicolaou, and PCR were 47, 22, and 19. The accuracy values were 0.70, 0.80 and 0.99, respectively. since the molecular method showed a greater validity in the early detection of the cervical carcinoma we considered of vital importance its implementation in suitable programs of Opportune Detection of Cervicouterino Cancer Program in Mexico. However, in order to validate this conclusion, cross-sectional studies in different region of country must be carried out.

A comparative study of the typhidot (Dot-EIA) and Widal tests in blood culture positive cases of typhoid fever.

PubMed

Khoharo, Haji Khan

2011-07-01

Seventy-six blood culture positive typhoid cases and forty-eight controls were studied. The typhidot test was positive in 74 (97.36%) cases, with a sensitivity, specificity and positive predictive value of 96%, 89.5%, and 95%, respectively, compared to the Widal test which was positive in 56 (73.68%) cases with a sensitivity, specificity, and positive predictive value of 72%, 87%, and 87%, respectively (P = 0.001). In the control group, seven (14.5%) cases tested positive for the Widal test and two (4.16%) for the typhidot (P = 0.001), yielding the sensitivity and specificity for the Widal test and the typhidot test of 63% and 83%, and 85% and 97%, respectively. We conclude that the Dot-EIA (enzyme immunoassay; typhidot) is a more sensitive and specific test which is easy to perform and more reliable compared to the Widal test and that it is useful in early therapy.

[Clinical study of induced abortion of early-early pregnancy: an analysis of 10, 404 cases].

PubMed

Kang, Jian; Wang, Xue-fen; Zhang, Li; Liu, Jian-hua

2012-01-03

To evaluate the advantages and disadvantages of early-early pregnancy induced abortion (EPIA). A total of 10 404 cases of EPIA performed at our hospital from January 1993 to December 2003 were retrospectively analyzed and compared with 9434 cases of common induced abortion (CIA). The amount of hemorrhage and operative duration, degree of pain, rate of induced-abortion syndrome, rate of incomplete abortion, menstrual changes and post-operative onset of Asherman's syndrome were observed and compared between 2 groups. The average age, ratio of parous cases, ratio of the cases of first-pregnancy induced abortion were not different between 2 groups (P > 0.05). The amount of hemorrhage bleeding ((4.9 ± 3.2) ml), operative duration ((90.3 ± 12.4) s), degree of pain, rate of induced-abortion syndrome, menstrual changes and the rate of Asherman's syndrome in the EPIA group were all significantly less than those in the CIA group (P < 0.05). However, the rate of incomplete abortion (0.44%) in the EPIA group was significantly higher than that (0.21%) in the CIA group (P < 0.05). EPIA has the advantages of lesser hemorrhage, less pain, shorter operative duration and fewer complications over CIA. Therefore the recovery of EPIA cases is earlier than that of CIA cases. While the risk of incomplete abortion stays high.

Early experience in microtia reconstruction: the first 100 cases.

PubMed

Sabbagh, Walid

2011-04-01

Auricular reconstruction in Microtia is a challenging operation with a steep learning curve. In view its rarity attaining a high standard for new surgeons is extremely difficult. This study analyses the first 100 microtia cases looking at complications, technique, pattern of progress and aesthetic outcome. The author performed 100 autologous ear reconstructions for microtia over a period of 4 years utilizing the two stage technique popularised by Nagata and Firmin. In 11 cases a temroparietal fascial flap was utilised because of either a low hairline or scarring. Follow up ranged from 3 to 36 months. Data was collected prospectively. There were 7 cases of partial skin necrosis, 3 of which healed with conservative management. In early cases deficiencies were seen in the proportions of the reconstructed ear and the quality of definition. Better shape and definition were evident as more surgical experience was gained. This occurred as a result of increased appreciation of the ear proportions and improved framework carving. Although two stages were planned 21 cases required further procedures. The series demonstrates the early learning curve in microtia reconstruction and underlines the importance of appropriate training and case availability in achieving high quality results in autologous ear reconstruction. Copyright © 2010 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Development and psychometric testing of the 'Motivation and Self-Efficacy in Early Detection of Skin Lesions' index.

PubMed

Dyson, Judith; Cowdell, Fiona

2014-12-01

To develop and psychometrically test the Motivation and Self-Efficacy in Early Detection of Skin Lesions Index. Skin cancer is the most frequently diagnosed cancer worldwide. The primary strategy used to prevent skin cancer is promotion of sun avoidance and the use of sun protection. However, despite costly and extensive campaigns, cases of skin cancer continue to increase. If found and treated early, skin cancer is curable. Early detection is, therefore, very important. The study was conducted in 2013. Instrument Development. A literature review and a survey identified barriers (factors that hinder) and levers (factors that help) to skin self-examination. These were categorized according to a the Theoretical Domains Framework and this formed the basis of an instrument, which was tested for validity and reliability using confirmatory factor analysis and Cronbach's alpha respectively. A five-factor 20-item instrument was used that tested well for reliability and construct validity. Test-retest reliability was good for all items and domains. The five factors were: (i) Outcome expectancies; (ii) Intention; (iii) Self-efficacy; (iv) Social influences; (v) Memory. The Motivation and Self-Efficacy in Early Detection of Skin Lesions Index provides a reliable and valid method of assessing barriers and levers to skin self-examination. The next step is to design a theory-based intervention that can be tailored according to individual determinants to behaviour change identified by this instrument. © 2014 John Wiley & Sons Ltd.

Fetal acoustic stimulation test for early intrapartum fetal monitoring.

PubMed

Goonewardene, M; Hanwellage, K

2011-03-01

The fetal acoustic stimulation test (FAST) is a simple cost effective screening test for antenatal fetal monitoring. The aim of the study was to evaluate the FAST as a screening test for early intrapartum fetal well being. An initial non stress test (NST) followed by a FAST using corometric model 146 was carried out in 486 participants in early labour with uncomplicated singleton pregnancies and > 32 weeks gestation. A repeat NST was recorded in the participants who had an initial non reactive NST. The results of the NST and FAST were compared with fetal outcome. Maternal perception of fetal movements after FAST, results of NST before and after FAST, and the babies' 5 minute APGAR scores were measured. Of the 486 participants 413 (85%) noticed fetal movements after FAST. Initial NST was non reactive in 203 (42%) but 149 (31%) became reactive after FAST. Compared to the NST, FAST had a better sensitivity (97% vs 62%, p < 0.001), specificity (100% vs 87%, p = 0.017), positive predictive value (100% vs 98%, p = 0.024), negative predictive value (79% vs 17%, p < 0.001) and accuracy (99%vs 64%, p < 0.001) in predicting 5 minute APGAR < 7 in the baby. FAST is a reliable screening test for assessing fetal well being in early labour. It complements the NST and is better than the NST alone.

First hundred cases of variant Creutzfeldt-Jakob disease: retrospective case note review of early psychiatric and neurological features

PubMed Central

Spencer, Michael D; Knight, Richard S G; Will, Robert G

2002-01-01

Objective To describe the early psychiatric and neurological features of variant Creutzfeldt-Jakob disease. Design Cohort study. Setting National surveillance system for Creutzfeldt-Jakob disease in the United Kingdom. Participants The first 100 cases of variant Creutzfeldt-Jakob disease identified in the United Kingdom. Main outcome measures The timing and nature of early psychiatric and neurological symptoms in variant Creutzfeldt-Jakob disease. Results The early stages of variant Creutzfeldt-Jakob disease are dominated by psychiatric symptoms, but neurological symptoms precede psychiatric symptoms in 15% of cases and are present in combination with psychiatric symptoms in 22% of cases from the onset of disease. Common early psychiatric features include dysphoria, withdrawal, anxiety, insomnia, and loss of interest. No common early neurological features exist, but a significant proportion of patients do exhibit neurological symptoms within 4 months of clinical onset, including poor memory, pain, sensory symptoms, unsteadiness of gait, and dysarthria. Conclusions Although the diagnosis of variant Creutzfeldt-Jakob disease may be impossible in the early stages of the illness, particular combinations of psychiatric and neurological features may allow early diagnosis in an appreciable proportion of patients. What is already known on this topicThe early stages of variant Creutzfeldt-Jakob disease are dominated by psychiatric symptomatologySome patients have early neurological features that might suggest the presence of an underlying neurological disorderWhat this study addsThis study provides a comprehensive description of the evolution of psychiatric and neurological features in variant Creutzfeldt-Jakob diseaseAn appreciable proportion of patients have early neurological symptomsA high proportion of patients have a combination of psychiatric and neurological features within four months of clinical onset that suggest the diagnosis of variant Creutzfeldt-Jakob disease

Video Head Impulse Test for Early Diagnosis of Vestibular Neuritis Among Acute Vertigo.

PubMed

Guan, Qiongfeng; Zhang, Lisan; Hong, Wenke; Yang, Yi; Chen, Zhaoying; Lu, Peilin; Zhang, Dan; Hu, Xingyue

2017-09-01

This study assesses the value of the video head impulse test (vHIT) for early diagnosis of vestibular neuritis (VN) among acute vertigo. Thirty-three cases of vestibular neuritis (VN), 96 patients with other acute vertigo (AV), and 50 cases of normal controls used vHIT to quantitatively test a pair of horizontal vestibulo-ocular reflection (VOR) gains, two pairs of vertical VOR gains, and the corresponding three pairs of VOR gain asymmetry. The peculiarity of VOR gains in VN and the differences between VN and other AV, normal controls by vHIT, were collected and analyzed. There were statistically significant differences in the three pairs of VOR gains asymmetry between VN and other AV, and normal controls (P<0.01). The sensitivity was 87.9% and specificity was 94.3% in differentiating VN from normal and other acute vertigo by vHIT. This study shows vHIT has advantages in the diagnosis of VN in acute vertigo with good sensitivity and specificity and indicates a widespread clinical application.

Early Phonological Development: Creating an Assessment Test

ERIC Educational Resources Information Center

Stoel-Gammon, Carol; Williams, A. Lynn

2013-01-01

This paper describes a new protocol for assessing the phonological systems of two-year-olds with typical development and older children with delays in vocabulary acquisition. The test (Profiles of Early Expressive Phonological Skills ("PEEPS"), Williams & Stoel-Gammon, in preparation) differs from currently available assessments in…

Some early cases of aphasia and the capacity to sing.

PubMed

Johnson, Julene K; Graziano, Amy B

2015-01-01

This chapter examines early cases of aphasia that include observations of the capacity to sing. Although the majority of these cases were published in the late nineteenth century, earlier reports exist and provide insights into the early thinking about the capacity to sing in aphasia, a topic that continues to the present day. The observation that some patients with aphasia and limited speech output were able to sing the texts of songs inspired scholars to examine the relationship between music and language. Early ideas about the capacity to sing were provided by well-known neurologists, such as John Hughlings Jackson and Adolf Kussmaul. The work of Herbert Spencer about the origins and function of music heavily influenced Jackson and others in their thinking about aphasia. This work also led to an increased interest in understanding music abilities in persons with aphasia and, later, in the brain mechanisms of music. The chapter provides a background as to why there was an interest in the capacity to sing in persons with aphasia and what influenced early thinking on this topic. © 2015 Elsevier B.V. All rights reserved.

Thyrotropin receptor autoantibodies and early miscarriages in patients with Hashimoto thyroiditis: a case-control study.

PubMed

Toulis, Konstantinos A; Goulis, Dimitrios G; Tsolakidou, Konstantina; Hilidis, Ilias; Fragkos, Marios; Polyzos, Stergios A; Gerofotis, Antonios; Kita, Marina; Bili, Helen; Vavilis, Dimitrios; Daniilidis, Michail; Tarlatzis, Basil C; Papadimas, Ioannis

2013-08-01

We have previously hypothesized that early miscarriage in women with Hashimoto thyroiditis might be the result of a cross-reactivity process, in which blocking autoantibodies against thyrotropin receptor (TSHr-Ab) antagonize hCG action on its receptor on the corpus luteum. To test this hypothesis from the clinical perspective, we investigated the presence of TSHr-Ab in Hashimoto thyroiditis patients with apparently unexplained, first-trimester recurrent miscarriages compared to that in Hashimoto thyroiditis patients with documented normal fertility. A total of 86 subjects (43 cases and 43 age-matched controls) were finally included in a case-control study. No difference in the prevalence of TSHr-Ab positivity was detected between cases and controls (Fisher's exact test, p value = 1.00). In patients with recurrent miscarriages, TSHr-Ab concentrations did not predict the number of miscarriages (univariate linear regression, p value = 0.08). These results were robust in sensitivity analyses, including only cases with full investigation or those with three or more miscarriages. We conclude that no role could be advocated for TSHr-Ab in the aetiology of recurrent miscarriages in women with Hashimoto thyroiditis.

Working Together with Children and Families: Case Studies in Early Intervention.

ERIC Educational Resources Information Center

McWilliam, P. J., Ed.; Bailey, Donald B., Jr., Ed.

This book presents 21 case studies of young children with disabilities in a variety of family situations and settings, for early interventionists to study in planning and applying recommended practices. Section I, "Defining and Delivering Quality Services in Early Intervention," provides two introductory chapters: "The Search for Quality…

Results from early programmatic implementation of Xpert MTB/RIF testing in nine countries

PubMed Central

2014-01-01

Background The Xpert MTB/RIF assay has garnered significant interest as a sensitive and rapid diagnostic tool to improve detection of sensitive and drug resistant tuberculosis. However, most existing literature has described the performance of MTB/RIF testing only in study conditions; little information is available on its use in routine case finding. TB REACH is a multi-country initiative focusing on innovative ways to improve case notification. Methods We selected a convenience sample of nine TB REACH projects for inclusion to cover a range of implementers, regions and approaches. Standard quarterly reports and machine data from the first 12 months of MTB/RIF implementation in each project were utilized to analyze patient yields, rifampicin resistance, and failed tests. Data was collected from September 2011 to March 2013. A questionnaire was implemented and semi-structured interviews with project staff were conducted to gather information on user experiences and challenges. Results All projects used MTB/RIF testing for people with suspected TB, as opposed to testing for drug resistance among already diagnosed patients. The projects placed 65 machines (196 modules) in a variety of facilities and employed numerous case-finding strategies and testing algorithms. The projects consumed 47,973 MTB/RIF tests. Of valid tests, 7,195 (16.8%) were positive for MTB. A total of 982 rifampicin resistant results were found (13.6% of positive tests). Of all tests conducted, 10.6% failed. The need for continuous power supply was noted by all projects and most used locally procured solutions. There was considerable heterogeneity in how results were reported and recorded, reflecting the lack of standardized guidance in some countries. Conclusions The findings of this study begin to fill the gaps among guidelines, research findings, and real-world implementation of MTB/RIF testing. Testing with Xpert MTB/RIF detected a large number of people with TB that routine services failed to

Results from early programmatic implementation of Xpert MTB/RIF testing in nine countries.

PubMed

Creswell, Jacob; Codlin, Andrew J; Andre, Emmanuel; Micek, Mark A; Bedru, Ahmed; Carter, E Jane; Yadav, Rajendra-Prasad; Mosneaga, Andrei; Rai, Bishwa; Banu, Sayera; Brouwer, Miranda; Blok, Lucie; Sahu, Suvanand; Ditiu, Lucica

2014-01-02

The Xpert MTB/RIF assay has garnered significant interest as a sensitive and rapid diagnostic tool to improve detection of sensitive and drug resistant tuberculosis. However, most existing literature has described the performance of MTB/RIF testing only in study conditions; little information is available on its use in routine case finding. TB REACH is a multi-country initiative focusing on innovative ways to improve case notification. We selected a convenience sample of nine TB REACH projects for inclusion to cover a range of implementers, regions and approaches. Standard quarterly reports and machine data from the first 12 months of MTB/RIF implementation in each project were utilized to analyze patient yields, rifampicin resistance, and failed tests. Data was collected from September 2011 to March 2013. A questionnaire was implemented and semi-structured interviews with project staff were conducted to gather information on user experiences and challenges. All projects used MTB/RIF testing for people with suspected TB, as opposed to testing for drug resistance among already diagnosed patients. The projects placed 65 machines (196 modules) in a variety of facilities and employed numerous case-finding strategies and testing algorithms. The projects consumed 47,973 MTB/RIF tests. Of valid tests, 7,195 (16.8%) were positive for MTB. A total of 982 rifampicin resistant results were found (13.6% of positive tests). Of all tests conducted, 10.6% failed. The need for continuous power supply was noted by all projects and most used locally procured solutions. There was considerable heterogeneity in how results were reported and recorded, reflecting the lack of standardized guidance in some countries. The findings of this study begin to fill the gaps among guidelines, research findings, and real-world implementation of MTB/RIF testing. Testing with Xpert MTB/RIF detected a large number of people with TB that routine services failed to detect. The study demonstrates the

Interpretation of Negative Molecular Test Results in Patients With Suspected or Confirmed Ebola Virus Disease: Report of Two Cases.

PubMed

Edwards, Jeffrey K; Kleine, Christian; Munster, Vincent; Giuliani, Ruggero; Massaquoi, Moses; Sprecher, Armand; Chertow, Daniel S

2015-12-01

Quantitative reverse-transcription polymerase chain reaction (qRT-PCR) is the most sensitive quantitative diagnostic assay for detection of Ebola virus in multiple body fluids. Despite the strengths of this assay, we present 2 cases of Ebola virus disease (EVD) and highlight the potential for false-negative results during the early and late stages of EVD. The first case emphasizes the low negative-predictive value of qRT-PCR during incubation and the early febrile stage of EVD, and the second case emphasizes the potential for false-negative results during recovery and late neurologic complications of EVD. Careful interpretation of test results are needed to guide difficult admission and discharge decisions in suspected or confirmed EVD.

40 CFR 797.1600 - Fish early life stage toxicity test.

Code of Federal Regulations, 2013 CFR

2013-07-01

... dilution water or the test solution. (4) “Control” an exposure of test organisms to dilution water only or... (treatment) concentrations of a test substance and one control are required to conduct an early life stage... trays or cups for each test concentration and control (i.e., 30 per embryo cup with 2 replicates); (C...

40 CFR 797.1600 - Fish early life stage toxicity test.

Code of Federal Regulations, 2010 CFR

2010-07-01

... dilution water or the test solution. (4) “Control” an exposure of test organisms to dilution water only or... (treatment) concentrations of a test substance and one control are required to conduct an early life stage... trays or cups for each test concentration and control (i.e., 30 per embryo cup with 2 replicates); (C...

40 CFR 797.1600 - Fish early life stage toxicity test.

Code of Federal Regulations, 2012 CFR

2012-07-01

... dilution water or the test solution. (4) “Control” an exposure of test organisms to dilution water only or... (treatment) concentrations of a test substance and one control are required to conduct an early life stage... trays or cups for each test concentration and control (i.e., 30 per embryo cup with 2 replicates); (C...

Patterns of Practice: Case Studies of Early Childhood Education & Family Engagement in Community Schools

ERIC Educational Resources Information Center

Jacobson, Linda; Rollins, S. Kwesi; Brown, Janet; Naviasky, Heather

2016-01-01

This "Patterns of Practice: Case Studies of Early Childhood Education & Family Engagement in Community Schools" report updates the community school case studies through a description of ongoing developments in Cincinnati, OH; Evansville, IN; Multnomah County, OR; and Tulsa, OK and adds to that knowledge base of early learning and…

Incompleteness of Bluetooth protocol conformance test cases

NASA Astrophysics Data System (ADS)

Wu, Peng; Gao, Qiang

2001-10-01

This paper describes a formal method to verify the completeness of conformance testing, in which not only Implementation Under Test (IUT) is formalized in SDL, but also conformance tester is described in SDL so that conformance testing can be performed in simulator provided with CASE tool. The protocol set considered is Bluetooth, an open wireless communication technology. Our research results show that Bluetooth conformance test specification is not complete in that it has only limited coverage and many important capabilities defined in Bluetooth core specification are not tested. We also give a detail report on the missing test cases against Bluetooth core specification, and provide a guide on further test case generation in the future.

The long-term consequences of early childhood trauma: a case study and discussion.

PubMed

Kaplow, Julie B; Saxe, Glenn N; Putnam, Frank W; Pynoos, Robert S; Lieberman, Alicia F

2006-01-01

There is a great need to better understand the impact of traumatic events very early in life on the course of children's future development. This report focuses on the intriguing case of a girl who witnessed the murder of her mother by her father at the age of 19 months and seemed to have no recollection of this incident until the age of 11, when she began to exhibit severe symptoms of posttraumatic stress disorder (PTSD) in response to a traumatic reminder. The case presentation serves as the basis for a discussion regarding pertinent issues involved in early childhood trauma. This case and accompanying discussion were originally presented at the 19th Annual Meeting of the International Society for Traumatic Stress Studies and were transcribed and revised for use in this article. Specific topics include early childhood memory and trauma, learning and the appraisal of danger, and PTSD and traumatic grief in early childhood. Clinical and public health implications are also discussed. This case illustrates the dramatic impact that "preverbal" traumatic memories can have on children's later functioning and speaks to the importance of assisting very young children in the immediate aftermath of traumatic events.

An Experimental Test of Parenting Practices as a Mediator of Early Childhood Physical Aggression

ERIC Educational Resources Information Center

Brotman, Laurie Miller; O'Neal, Colleen R.; Huang, Keng-Yen; Gouley, Kathleen Kiely; Rosenfelt, Amanda; Shrout, Patrick E.

2009-01-01

Background: Parenting practices predict early childhood physical aggression. Preventive interventions that alter parenting practices and aggression during early childhood provide the opportunity to test causal models of early childhood psychopathology. Although there have been several informative preventive intervention studies that test mediation…

IgG avidity test for the diagnosis of acute Toxoplasma gondii infection in early pregnancy.

PubMed

Pour Abolghasem, Shabnam; Bonyadi, Mohammad Reza; Babaloo, Zohre; Porhasan, Abolfazl; Nagili, Behroz; Gardashkhani, Omid Ali; Salehi, Parviz; Hashemi, Mohammad; Varshoghi, Mojtaba; Gaffari, Gafar Olade

2011-12-01

Toxoplasmosis is well known as an important infection in pregnant women. Although many serologic methods are available, diagnosis of early Toxoplasmosis may be extremely difficult. To detect the Toxoplasma IgG antibodies developed at the early stage of infection in pregnant women. 225 pregnant women, who were in the 2nd to 4th month of their pregnancy, enrolled in this study. Anti-toxoplasma IgG, IgM and IgG avidity were evaluated by ELISA method. The patients were categorized into three groups as follows: Group A, 124 cases; IgG+, IgM+, 55.1%; group B, 99 cases; IgG+, IgM-, 44%; and group C, 2 cases; IgG -, IgM +, 0.9%. Fifty five percent of the pregnant women had positive IgG and IgM among which 7.1% had low avidity which revealed an active infection in the pregnant women. In the current study, 44% of pregnant women had positive IgG and negative IgM, all of which had high avidity, which is an indication that in our population the level of toxoplasmosis infection is high and most women have had contacts with this parasite before pregnancy. In this study, the low avidity test was 7.1% showing that the occurrence of toxoplasmosis infection is still a serious issue. Observation of 45.8% high avidity among group A suggests that either IgM has a high half-life or there is a false positive IgM as a result of rheumatologic disorders. Therefore, avidity test is important in predicting maternal toxoplasmosis which is of value in disease treatment.

Alternatives to the fish early life-stage test: Developing a conceptual model for early fish development

EPA Science Inventory

Chronic fish toxicity is a key parameter for hazard classification and environmental risk assessment of chemicals, and the OECD 210 fish early life-stage (FELS) test is the primary guideline test used for various international regulatory programs. There exists a need to develop ...

Test Cases for a Rectangular Supercritical Wing Undergoing Pitching Oscillations

NASA Technical Reports Server (NTRS)

Bennett, Robert M.

2000-01-01

Steady and unsteady measured pressures for a Rectangular Supercritical Wing (RSW) undergoing pitching oscillations have been presented. From the several hundred compiled data points, 27 static and 36 pitching oscillation cases have been proposed for computational Test Cases to illustrate the trends with Mach number, reduced frequency, and angle of attack. The wing was designed to be a simple configuration for Computational Fluid Dynamics (CFD) comparisons. The wing had an unswept rectangular planform plus a tip of revolution, a panel aspect ratio of 2.0, a twelve per cent thick supercritical airfoil section, and no twist. The model was tested over a wide range of Mach numbers, from 0.27 to 0.90, corresponding to low subsonic flows up to strong transonic flows. The higher Mach numbers are well beyond the design Mach number such as might be required for flutter verification beyond cruise conditions. The pitching oscillations covered a broad range of reduced frequencies. Some early calculations for this wing are given for lifting pressure as calculated from a linear lifting surface program and from a transonic small perturbation program. The unsteady results were given primarily for a mild transonic condition at M = 0.70. For these cases the agreement with the data was only fair, possibly resulting from the omission of viscous effects. Supercritical airfoil sections are known to be sensitive to viscous effects (for example, one case cited). Calculations using a higher level code with the full potential equations have been presented for one of the same cases, and with the Euler equations. The agreement around the leading edge was improved, but overall the agreement was not completely satisfactory. Typically for low-aspect-ratio rectangular wings, transonic shock waves on the wing tend to sweep forward from root to tip such that there are strong three-dimensional effects. It might also be noted that for most of the test, the model was tested with free transition, but a

14 CFR 33.201 - Design and test requirements for Early ETOPS eligibility.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 14 Aeronautics and Space 1 2014-01-01 2014-01-01 false Design and test requirements for Early... Aircraft Engines § 33.201 Design and test requirements for Early ETOPS eligibility. An applicant seeking type design approval for an engine to be installed on a two-engine airplane approved for ETOPS without...

An Ice-and-Snow Hypothesis for Early Mars, and the Runoff-Production Test

NASA Astrophysics Data System (ADS)

Kite, E. S.

2017-10-01

Cold (snowmelt) models for Early Mars climate can be tested by measuring paleochannel widths and meander wavelengths for Early Mars watersheds with well-defined drainage area. I will review snowmelt models, and report results of these tests.

Early onset marfan syndrome: Atypical clinical presentation of two cases

PubMed Central

Ozyurt, A; Baykan, A; Argun, M; Pamukcu, O; Halis, H; Korkut, S; Yuksel, Z; Gunes, T; Narin, N

2015-01-01

Early onset Marfan Syndrome (eoMFS) is a rare, severe form of Marfan Syndrome (MFS). The disease has a poor prognosis and most patients present with resistance to heart failure treatment during the newborn period. This report presents two cases of eoMFS with similar clinical features diagnosed in the newborn period and who died at an early age due to the complications related to the involvement of the cardiovascular system. PMID:26929908

Earthquake Early Warning ShakeAlert System: Testing and certification platform

USGS Publications Warehouse

Cochran, Elizabeth S.; Kohler, Monica D.; Given, Douglas; Guiwits, Stephen; Andrews, Jennifer; Meier, Men-Andrin; Ahmad, Mohammad; Henson, Ivan; Hartog, Renate; Smith, Deborah

2017-01-01

Earthquake early warning systems provide warnings to end users of incoming moderate to strong ground shaking from earthquakes. An earthquake early warning system, ShakeAlert, is providing alerts to beta end users in the western United States, specifically California, Oregon, and Washington. An essential aspect of the earthquake early warning system is the development of a framework to test modifications to code to ensure functionality and assess performance. In 2016, a Testing and Certification Platform (TCP) was included in the development of the Production Prototype version of ShakeAlert. The purpose of the TCP is to evaluate the robustness of candidate code that is proposed for deployment on ShakeAlert Production Prototype servers. TCP consists of two main components: a real‐time in situ test that replicates the real‐time production system and an offline playback system to replay test suites. The real‐time tests of system performance assess code optimization and stability. The offline tests comprise a stress test of candidate code to assess if the code is production ready. The test suite includes over 120 events including local, regional, and teleseismic historic earthquakes, recentering and calibration events, and other anomalous and potentially problematic signals. Two assessments of alert performance are conducted. First, point‐source assessments are undertaken to compare magnitude, epicentral location, and origin time with the Advanced National Seismic System Comprehensive Catalog, as well as to evaluate alert latency. Second, we describe assessment of the quality of ground‐motion predictions at end‐user sites by comparing predicted shaking intensities to ShakeMaps for historic events and implement a threshold‐based approach that assesses how often end users initiate the appropriate action, based on their ground‐shaking threshold. TCP has been developed to be a convenient streamlined procedure for objectively testing algorithms, and it has

[Early detection of bowel cancer in occupational surveillance examinations: switching from a guaiak-based to an immunochemical fecal occult blood test].

PubMed

Webendörfer, S; Riemann, J F

2014-01-01

If the diagnosis is made early the cure rate of bowel cancer is more than 90 %. Occupational preventative medical care required by law and carried out by company physicians can be supplemented by a medical consultation and by simple screenings to interest employees in cancer prevention and refer them to registered general practitioners and specialist doctors for further diagnosis and treatment. Since 2001, BASF SE in Ludwigshafen, Germany offers its employees aged 45 and more a program to detect intestinal cancer early. The employees receive personal invitations for this program once a year. The participants answer a standard questionnaire about risk factors for bowel cancer and an endoscopic diagnosis, if this has already been carried out, and receive a FOBT. Since 2010 an immunological test system was used. We compare the results from two consecutive years with a Guajacum test system (g-FOBT) and an immunological test (i-FOBT). The German Association of Digestive and Metabolic Diseases, DGVS, recommends a colonoscopy if test results are positive or a family member has suffered from bowel cancer. Between 2008 and 2011, a total of 52,797 invitations were sent to employees aged 45 and over. Overall, 16,730 men (37.7 % of 46,245) and 1,585 women (24.4 % of 6,552) took part (in some cases more than once). The return rate of the FOBT increased from 66.7 % in 2008 to 79.5 % in 2011. Due to positive results and/or suspicious information in the questionnaire, 2,441 colonoscopies were recommended, 849 of them because of a positive FOBT. The medical department was informed of 224 endoscopy diagnoses. In 8 cases, manifested cancer (6 × colon, 2 × rectum) and in 57 cases adenomatous polyps were diagnosed as preliminary stages of cancer. Most of these diagnoses were made using the i-FOBT, the simultaneous increase in positive test results and therefore more frequent recommendations for a colonoscopy. The additional offer of a program for early detection of bowel

Focal cortical malformations in children with early infantile epilepsy and PCDH19 mutations: case report.

PubMed

Kurian, Mary; Korff, Christian M; Ranza, Emmanuelle; Bernasconi, Andrea; Lübbig, Anja; Nangia, Srishti; Ramelli, Gian Paolo; Wohlrab, Gabriele; Nordli, Douglas R; Bast, Thomas

2018-01-01

In this case report we assess the occurrence of cortical malformations in children with early infantile epilepsy associated with variants of the gene protocadherin 19 (PCDH19). We describe the clinical course, and electrographic, imaging, genetic, and neuropathological features in a cohort of female children with pharmacoresistant epilepsy. All five children (mean age 10y) had an early onset of epilepsy during infancy and a predominance of fever sensitive seizures occurring in clusters. Cognitive impairment was noted in four out of five patients. Radiological evidence of cortical malformations was present in all cases and, in two patients, validated by histology. Sanger sequencing and Multiplex Ligation-dependent Probe Amplification analysis of PCDH19 revealed pathogenic variants in four patients. In one patient, array comparative genomic hybridization showed a microdeletion encompassing PCDH19. We propose molecular testing and analysis of PCDH19 in patients with pharmacoresistant epilepsy, with onset in early infancy, seizures in clusters, and fever sensitivity. Structural lesions are to be searched in patients with PCDH19 pathogenic variants. Further, PCDH19 analysis should be considered in epilepsy surgery evaluation even in the presence of cerebral structural lesions. Focal cortical malformations and monogenic epilepsy syndromes may coexist. Structural lesions are to be searched for in patients with protocadherin 19 (PCDH19) pathogenic variants with refractory focal seizures. © 2017 Mac Keith Press.

TEST FUSION IN ADULT FORAMINIFERA: A REVIEW WITH NEW OBSERVATIONS OF AN EARLY EOCENE NUMMULITES SPECIMEN

PubMed Central

Ferràndez-Cañadell, Carles; Briguglio, Antonino; Hohenegger, Johann; Wöger, Julia

2015-01-01

In foraminifera, so-called “double tests” usually arise due to abnormal growth originating mainly from twinning, but may also be caused by irregularities in the early chambers and by regeneration after test injury that modifies the direction of growth. A fourth cause of double tests has only rarely been reported: the fusion of the tests of two adult individuals. We studied an early Eocene Nummulites double test consisting of two adult individuals that fused after an extended period of independent growth. The specimen was studied using computed tomography with micrometric resolution (micro-CT) that allowed bi- and three-dimensional visualization of the internal structure. Before fusion each individual test had 30–36 chambers, which, by comparison with growth rates in recent nummulitids, implies at least three months of independent growth. After fusion, the compound test grew in two spirals that fused after about one whorl and then continued in a single spiral. To fuse their tests, either adult individuals have to be forced to do so or the allorecognition (ability to distinguish between self and another individual) mechanisms must fail. A possible explanation for the merged Nummulites tests in this study is forced fusion in attached individuals after surviving ingestion and digestion by a metazoan. Alternatively, environmental stress could lead to a failure of allorecognition mechanisms and/or foraminiferal motility. Once fused, subsequent growth seems to be determined mainly by the relative orientation of individual tests. In any case, the frequency in which adult fusion occurs remains unknown. PMID:26166916

Early recognition of Cushing's disease: a case study.

PubMed

Iuliano, Sherry L; Laws, Edward R

2013-08-01

To present a case study of a 34-year-old woman with Cushing's disease and provide nurse practitioners (NPs) with the understanding of the clinical presentation needed for early recognition and treatment of the disease. A comprehensive review of published literature on Cushing's disease. Findings from history, physical examination, and diagnostic studies of a woman presenting to primary care NPs, physicians and other healthcare providers with multiple symptoms of Cushing's disease. Cushing's disease is the result of the pituitary gland producing excess amounts of adrenocorticotropic hormone (ACTH) causing the overproduction of cortisol. The disease is fairly rare and is seen mostly in women. Common chief complaints include increased facial hair, weight gain, amenorrhea, changes in the face, neck, and abdomen, with muscle wasting of the lower extremities. Untreated, diabetes mellitus and hypertension can occur and increase the patient's morbidity and mortality. Early recognition and appropriate referral can reverse the signs and symptoms over time and lead to a significantly improved quality of life. This case presented the challenges faced by NPs and physicians in diagnosing patients with Cushing's disease. ©2013 The Author(s) ©2013 American Association of Nurse Practitioners.

Stages of syphilis in South China - a multilevel analysis of early diagnosis.

PubMed

Wong, Ngai Sze; Huang, Shujie; Zheng, Heping; Chen, Lei; Zhao, Peizhen; Tucker, Joseph D; Yang, Li Gang; Goh, Beng Tin; Yang, Bin

2017-01-31

Early diagnosis of syphilis and timely treatment can effectively reduce ongoing syphilis transmission and morbidity. We examined the factors associated with the early diagnosis of syphilis to inform syphilis screening strategic planning. In an observational study, we analyzed reported syphilis cases in Guangdong Province, China (from 2014 to mid-2015) accessed from the national case-based surveillance system. We categorized primary and secondary syphilis cases as early diagnosis and categorized latent and tertiary syphilis as delayed diagnosis. Univariate analyses and multivariable logistic regressions were performed to identify the factors associated with early diagnosis. We also examined the factors associated with early diagnosis at the individual and city levels in multilevel logistic regression models with cases nested by city (n = 21), adjusted for age at diagnosis and gender. Among 83,944 diagnosed syphilis cases, 22% were early diagnoses. The city-level early diagnosis rate ranged from 7 to 46%, consistent with substantial geographic variation as shown in the multilevel model. Early diagnosis was associated with cases presenting to specialist clinics for screening, being male and attaining higher education level. Cases received syphilis testing in institutions and hospitals, and diagnosed in hospitals were less likely to be in early diagnosis. At the city-level, cases living in a city equipped with more hospitals per capita were less likely to be early diagnosis. To enhance early diagnosis of syphilis, city-specific syphilis screening strategies with a mix of passive and client/provider-initiated testing might be a useful approach.

[Case finding in early prevention networks - a heuristic for ambulatory care settings].

PubMed

Barth, Michael; Belzer, Florian

2016-06-01

One goal of early prevention is the support of families with small children up to three years who are exposed to psychosocial risks. The identification of these cases is often complex and not well-directed, especially in the ambulatory care setting. Development of a model of a feasible and empirical based strategy for case finding in ambulatory care. Based on the risk factors of postpartal depression, lack of maternal responsiveness, parental stress with regulation disorders and poverty a lexicographic and non-compensatory heuristic model with simple decision rules, will be constructed and empirically tested. Therefore the original data set from an evaluation of the pediatric documentary form on psychosocial issues of families with small children in well-child visits will be used and reanalyzed. The first diagnostic step in the non-compensatory and hierarchical classification process is the assessment of postpartal depression followed by maternal responsiveness, parental stress and poverty. The classification model identifies 89.0 % cases from the original study. Compared to the original study the decision process becomes clearer and more concise. The evidence-based and data-driven model exemplifies a strategy for the assessment of psychosocial risk factors in ambulatory care settings. It is based on four evidence-based risk factors and offers a quick and reliable classification. A further advantage of this model is that after a risk factor is identified the diagnostic procedure will be stopped and the counselling process can commence. For further validation of the model studies, in well suited early prevention networks are needed.

Choroidal metastasis from early rectal cancer: Case report and literature review.

PubMed

Tei, Mitsuyoshi; Wakasugi, Masaki; Akamatsu, Hiroki

2014-01-01

Choroidal metastasis from colorectal cancer is rare, and there have been no reported cases of such metastasis from early colorectal cancer. We report a case of choroidal metastasis from early rectal cancer. A 61 year-old-man experienced myodesopsia in the left eye 2 years and 6 months after primary rectal surgery for early cancer, and was diagnosed with left choroidal metastasis and multiple lung metastases. Radiotherapy was initiated for the left eye and systemic chemotherapy is initiated for the multiple lung metastases. The patient is living 2 years and 3 months after the diagnosis of choroidal metastasis without signs of recurrence in the left eye, and continues to receive systemic chemotherapy for multiple lung metastases. Current literatures have few recommendations regarding the appropriate treatment of choroidal metastasis from colorectal cancer, but an aggressive multi-disciplinary approach may be effective in local regression. This is the first report of choroidal metastasis from early rectal cancer. We consider it important to enforce systemic chemotherapy in addition to radiotherapy for choroidal metastasis from colorectal cancer. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

Impact of DNA testing for early-onset familial Alzheimer disease and frontotemporal dementia.

PubMed

Steinbart, E J; Smith, C O; Poorkaj, P; Bird, T D

2001-11-01

DNA testing of persons at risk for hereditary, degenerative neurologic diseases is relatively new. Only anecdotal reports of such testing in familial Alzheimer disease (FAD) exist, and little is know about the personal and social impact of such testing. In a descriptive, observational study, individuals at 50% risk for autosomal dominant, early-onset FAD or frontotemporal dementia with parkinsonism linked to chromosome 17 underwent DNA testing for the genetic mutations previously identified in affected family members. Individuals were followed up for (1/2) to 3 years and were interviewed regarding attitudes toward the testing process and the impact of the results. Twenty-one (8.4%) of 251 persons at risk for FAD or frontotemporal dementia requested genetic testing. The most common reasons for requesting testing were concern about early symptoms of dementia, financial or family planning, and relief from anxiety. Twelve individuals had positive DNA test results, and 6 of these had early symptoms of dementia; 8 had negative results; and 1 has not yet received results. Of 14 asymptomatic individuals completing testing, 13 believed the testing was beneficial. Two persons reported moderate anxiety and 1 reported moderate depression. As expected, persons with negative test results had happier experiences overall, but even they had to deal with ongoing anxiety and depression. Thus far, there have been no psychiatric hospitalizations, suicide attempts, or denials of insurance. Genetic testing in early-onset FAD and frontotemporal dementia can be completed successfully. Most individuals demonstrate effective coping skills and find the testing to be beneficial, but long-term effects remain unknown.

Formal methods for test case generation

NASA Technical Reports Server (NTRS)

Rushby, John (Inventor); De Moura, Leonardo Mendonga (Inventor); Hamon, Gregoire (Inventor)

2011-01-01

The invention relates to the use of model checkers to generate efficient test sets for hardware and software systems. The method provides for extending existing tests to reach new coverage targets; searching *to* some or all of the uncovered targets in parallel; searching in parallel *from* some or all of the states reached in previous tests; and slicing the model relative to the current set of coverage targets. The invention provides efficient test case generation and test set formation. Deep regions of the state space can be reached within allotted time and memory. The approach has been applied to use of the model checkers of SRI's SAL system and to model-based designs developed in Stateflow. Stateflow models achieving complete state and transition coverage in a single test case are reported.

Mother and child characteristics at birth and early age leukemia: a case-cohort population-based study.

PubMed

Reis, Rejane de Souza; Silva, Neimar de Paula; Santos, Marceli de Oliveira; Oliveira, Julio Fernando Pinto; Thuler, Luiz Claudio Santos; de Camargo, Beatriz; Pombo-de-Oliveira, Maria S

The population-based cancer registries (PBCR) and the Information System on Live Births in Brazil (Sistema de Informações sobre Nascidos Vivos [SINASC]) have information that enables the test for risk factors associated with leukemia at an early age. The aim of this study was to identify maternal and birth characteristics associated with early-age acute leukemia (EAL) in Brazil. A case-cohort study was performed using secondary dataset information of PBCR and SINASC. The risk association variables were grouped into (i) characteristics of the child at birth and (ii) characteristics of maternal exposure during pregnancy. The case-control ratio was 1:4. Linkage was performed using R software; odds ratio (OR) and 95% confidence interval (CI) were calculated by logistic regression models. EAL was associated with maternal occupational exposure to chemicals (agricultural, chemical, and petrochemical industry; adjOR: 2.18, 95% CI: 1.16-4.10) and with birth defects (adjOR: 3.62, 95% CI: 1.19-11.00). The results of this study, with the identification of EAL risk factors in population-based case-cohort study, strengthen the knowledge and improve databases, contributing to investigations on risk factors associated with childhood leukemia worldwide. Copyright © 2017 Sociedade Brasileira de Pediatria. Published by Elsevier Editora Ltda. All rights reserved.

[Early diagnosis and treatment of compartment syndrome caused by landslides:a report of 20 cases].

PubMed

Xie, Hong-Bo; Peng, Zi-Lai; Liu, Xu-Bang; Chen, Lian

2012-01-01

To summarize early diagnosis and treatment methods of 20 patients with compartment syndrome caused by landslides during coal mine accidents in order to improve the level of diagnosis and treatment of compartment syndrome and reduce disability. From September 2006 to April 2010,20 patients with compartment syndrome were treated with the methods of early decompression, systemic support. All the patients were male with an average age of 42 years (ranged, 23 to 54). All the patients with high tension limb swelling, pain, referred pain passive positive; 5 extremities feeling diminish or disappear and the distal blood vessel beat were normal or weakened or disappeared; myoglobinuria, hyperkalemia, serum urea nitrogen and creatinine increased in 5 cases and oliguria in occurred 1 case. The function of affected limbs was observed according to disability ratings. Three cases complicated with infection of affected limb and 6 cases occurred with renal function insufficiency. Total recovery was in 16 cases, basically recovery in 3, amputation in 1 case. All patients were followed up for 6-15 months with an average of 12 months. The ability to work according to national standard identification--Employee work-related injuries and occupational disability rating classification (GB/T16180-2006) to assess, grade 5 was in 1 case, grade 8 in 2 cases, grade 10 in 1 case, no grade in 16 cases. Arteriopalmus of dorsalis pedis weaken and vanished can not be regard as an evidence in early diagnosis of compartment syndrome. Early diagnosis and decompression, systemic support and treatment is the key in reducing disability.

A case of functional growth hormone deficiency and early growth retardation in a child with IFT172 mutations.

PubMed

Lucas-Herald, Angela K; Kinning, Esther; Iida, Aritoshi; Wang, Zheng; Miyake, Noriko; Ikegawa, Shiro; McNeilly, Jane; Ahmed, S Faisal

2015-04-01

Ciliopathies are a group of rare conditions that present through a wide range of manifestations. Given the relative common occurrence of defects of the GH/IGF-I axis in children with short stature and growth retardation, the association between ciliopathies and these defects needs further attention. Our patient is a boy who was born at term and noted to have early growth retardation and weight gain within the first 18 months of life. Biochemical tests demonstrated low IGF-I but a normal peak GH on stimulation and an adequate increase in IGF-I on administration of recombinant human growth hormone (rhGH). A magnetic resonance imaging scan revealed pituitary hypoplasia and an ectopic posterior pituitary. His growth responded well to rhGH therapy. Subsequently he also developed a retinopathy of his rods and cones, metaphyseal dysplasia, and hypertension with renal failure requiring renal replacement therapy. Whole-exome sequencing demonstrated compound heterozygous mutations of IFT172, thus consistent with a ciliopathy. This is the first reported case of a child with a mutation in IFT172 who presented with growth retardation in early childhood and was initially managed as a case of functional GH deficiency that responded to rhGH therapy. This case highlights the importance of ciliary function in pituitary development and the link between early onset growth failure and ciliopathies.

Early diagnosis of Gorlin-Goltz syndrome: case report.

PubMed

Casaroto, Ana R; Loures, Daniela C N Rocha; Moreschi, Eduardo; Veltrini, Vanessa C; Trento, Cleverson L; Gottardo, Vilmar D; Lara, Vanessa S

2011-01-25

The Gorlin-Goltz syndrome, also known as nevoid basal cell carcinoma syndrome (NBCCS), is an infrequent multisystemic disease inherited in a dominant autosomal way, which shows a high level of penetrance and variable expressiveness. It is characterized by keratocystic odontogenic tumors (KCOT) in the jaw, multiple basal cell nevi carcinomas and skeletal abnormities. This syndrome may be diagnosed early by a dentist by routine radiographic exams in the first decade of life, since the KCOTs are usually one of the first manifestations of the syndrome. This article paper reports the case of a patient, a 10-year-old boy with NBCCS, emphasizing its clinical and radiographic manifestations. This study highlights the importance of health professionals in the early diagnosis of NBCCS and in a preventive multidisciplinary approach to provide a better prognosis for the patient.

[Dichotic digit test. Case].

PubMed

Zenker Castro, Franz; Fernández Belda, Rafael; Barajas de Prat, José Juan

2008-12-01

In this study we present a case of a 71-year-old female patient with sensorineural hearing loss and fitted with bilateral hearing aids. The patient complained of scant benefit from the hearing aid fitting with difficulties in understanding speech with background noise. The otolaryngology examination was normal. Audiological tests revealed bilateral sensorineural hearing loss with threshold values of 51 and 50 dB HL in the right and left ear. The Dichotic Digit Test was administered in a divided attention mode and focalizing the attention to each ear. Results in this test are consistent with a Central Auditory Processing Disorder.

Memory Alteration Test to Detect Amnestic Mild Cognitive Impairment and Early Alzheimer's Dementia in Population with Low Educational Level.

PubMed

Custodio, Nilton; Lira, David; Herrera-Perez, Eder; Montesinos, Rosa; Castro-Suarez, Sheila; Cuenca-Alfaro, José; Valeriano-Lorenzo, Lucía

2017-01-01

Background/Aims : Short tests to early detection of the cognitive impairment are necessary in primary care setting, particularly in populations with low educational level. The aim of this study was to assess the performance of Memory Alteration Test (M@T) to discriminate controls, patients with amnestic Mild Cognitive Impairment (aMCI) and patients with early Alzheimer's Dementia (AD) in a sample of individuals with low level of education. Methods : Cross-sectional study to assess the performance of the M@T (study test), compared to the neuropsychological evaluation (gold standard test) scores in 247 elderly subjects with low education level from Lima-Peru. The cognitive evaluation included three sequential stages: (1) screening (to detect cases with cognitive impairment); (2) nosological diagnosis (to determinate specific disease); and (3) classification (to differentiate disease subtypes). The subjects with negative results for all stages were considered as cognitively normal (controls). The test performance was assessed by means of area under the receiver operating characteristic (ROC) curve. We calculated validity measures (sensitivity, specificity and correctly classified percentage), the internal consistency (Cronbach's alpha coefficient), and concurrent validity (Pearson's ratio coefficient between the M@T and Clinical Dementia Rating (CDR) scores). Results : The Cronbach's alpha coefficient was 0.79 and Pearson's ratio coefficient was 0.79 ( p < 0.01). The AUC of M@T to discriminate between early AD and aMCI was 99.60% (sensitivity = 100.00%, specificity = 97.53% and correctly classified = 98.41%) and to discriminate between aMCI and controls was 99.56% (sensitivity = 99.17%, specificity = 91.11%, and correctly classified = 96.99%). Conclusions : The M@T is a short test with a good performance to discriminate controls, aMCI and early AD in individuals with low level of education from urban settings.

Early post-operative cerebrospinal fluid hypovolemia: Report of 7 cases.

PubMed

Hou, Kun; Zhu, Xiaobo; Zhang, Yang; Gao, Xianfeng; Suo, Shihuan; Zhao, Jinchuan; Li, Guichen

2018-06-01

Cerebrospinal fluid (CSF) hypovolemia is a common neurosurgical condition, which may be spontaneous or iatrogenic. At our institution, a substantial number of the reported cases of early post-operative CSF hypovolemia were identified to have unintentional or unrecognized post-operative continuous excessive CSF leakage. Cases who presented with post-operative CSF hypovolemia several days after uneventful intracranial surgeries without continuous CSF leakage were rarely reported. A retrospective review of the medical records of these patients was performed to identify those patients who developed early post-operative CSF hypovolemia without the presence of post-operative continuous CSF leakage. A total of 7 patients, 5 of which were males, were identified in this retrospective study. They experienced CSF hypovolemia between days 1 and 7 after emergency or scheduled intracranial surgeries. Ventricular collapse, cisternal effacement and midline shift are the most common radiological observations. With early diagnosis and management, 4 of the patients achieved a Glasgow Outcome Scale (GOS) score of 5, 1 achieved a GOS score of 4 and the remaining 2 had a GOS score of 3. No mortality was noted in this series. Although rare in incidence, early post-operative CSF hypovolemia may occur without the existence of post-operative continuous CSF leakage. When the diagnosis of CSF hypovolemia is reached, factors that may exacerbate CSF compensation should be promptly terminated. Trendelenburg position and sufficient intravenous hydration are practical and effective managements, and CSF hypovolemia may thereby be reversed in a substantial number of patients.

6. AN EARLY VIEW OF THE COMPLETE X15 VEHICLE TEST ...

Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

6. AN EARLY VIEW OF THE COMPLETE X-15 VEHICLE TEST STAND. Looking to the northeast. - Edwards Air Force Base, X-15 Engine Test Complex, Rocket Engine & Complete X-15 Vehicle Test Stands, Rogers Dry Lake, east of runway between North Base & South Base, Boron, Kern County, CA

Failures in Hybrid Microcircuits During Environmental Testing. History Cases

NASA Technical Reports Server (NTRS)

Teverovsky, Alexander

2008-01-01

This purpose of this viewgraph presentation is to discuss failures in hermetic hybrids observed at the GSFC PA Lab during environmental stress testing. The cases discussed are: Case I. Substrate metallization failures during Thermal cycling (TC). Case II. Flex lid-induced failure. Case Ill. Hermeticity failures during TC. Case IV. Die metallization cracking during TC. and how many test cycles and parts is necessary? Case V. Wire Bond failures after life test. Case VI. Failures caused by Au/In IMC growth.

[Heart failure as early manifestation of neonatal hyperthyroidism. Case report].

PubMed

Alvarado S, Jorge Luis; Fernández V, Zhirly Andrea

2014-04-01

Neonatal hyperthyroidism is usually a self-limited condition frequently associated with transplacental passage of thyroid stimulating antibodies secondary to maternal autoimmune disorders. To timely detect mothers with this medical antecedents decreases the risk for fetal adverse events. To report a case of neonatal hyperthyroidism associated with intrauterine growth restriction and heart failure. A 36 week-old newborn with birth weight of 1,240 g. Symptoms were tachycardia, distal coldness, exophthalmos, hepatomegaly and tremors. Echocardiogram ruled out structural heart disorders. Due to maternal symptoms suggestive of hyperthyroidism, TSH tests were performed showing 0.01 ulU/ml, free T4 7.7 ng/dl, so the diagnosis of neonatal hyperthyroidism was confirmed. It was treated with methimazole and propanol, alleviating the symptoms and decreasing the levels of free T4. To know the maternal history helps identify and manage neonatal complications of hyperthyroidism. Heart failure and other cardiopulmonary disorders are determinants of mortality during early neonatal period. High-risk newborns should receive follow up assessments.

Early Pregnancy Diabetes Screening and Diagnosis: Prevalence, Rates of Abnormal Test Results, and Associated Factors.

PubMed

Mission, John F; Catov, Janet; Deihl, Tiffany E; Feghali, Maisa; Scifres, Christina

2017-11-01

To evaluate the prevalence of early diabetes screening in pregnancy, rates of abnormal diabetes test results before 24 weeks of gestation, and factors associated with early diabetes screening. This was a retrospective cohort study of all singleton deliveries from 2012 to 2014 among diverse clinical practices at a large academic medical center. We assessed rates of early (less than 24 weeks of gestation) and routine (at or beyond 24 weeks of gestation) diabetes screening, with abnormal test results defined using the Carpenter-Coustan criteria, a 50-g glucose challenge test result greater than 200 mg/dL, or a hemoglobin A1C level greater than 6.5%. Univariate and multivariate analyses were used to evaluate clinical and demographic determinants of screening and diagnosis. Overall, 1,420 of 11,331 (12.5%) women underwent early screening. Increasing body mass index (BMI) category, race, public insurance, history of gestational diabetes mellitus, a family history of diabetes, and chronic hypertension were associated with early screening. Early screening rates rose with increasing BMI category, but only 268 of 551 (48.6%) of women with class III obesity underwent early screening. Among those screened early, 2.0% of normal-weight women, 4.0% of overweight women, 4.2% of class I obese women, 3.8% of class II obese women, and 9.0% of class III obese women had abnormal early test results (P<.001). Early diabetes screening is used inconsistently, and many women with risk factors do not undergo early screening. A significant proportion of women with class III obesity will test positive for gestational diabetes mellitus before 24 weeks of gestation, and studies are urgently needed to assess the effect of early diabetes screening and diagnosis on perinatal outcomes in high-risk women.

Endoscopic mucosal resection for early gastric cancer. A case report.

PubMed

Gheorghe, Cristian; Sporea, Ioan; Becheanu, Gabriel; Gheorghe, Liana

2002-03-01

European experience in endoscopic mucosal resection (EMR) for early gastric cancer is still relatively low, since early stomach cancer is diagnosed at a much lower rate in Europe than in Japan and generally operable patients are referred to surgery for radical resection. Endoscopic mucosal resection or mucosectomy was developed as a promising technology to diagnose and treat mucosal lesions in the esophagus, stomach and colon. In contrast to surgical resection, EMR allows "early cancers" to be removed with a minimal cost, morbidity and mortality. We present the case of a patient with hepatic cirrhosis incidentally diagnosed with an elevated-type IIa early gastric cancer. Echoendoscopy was performed in order to assess the depth of invasion into the gastric wall confirming the only mucosal involvement. We performed an EMR using "cup and suction" method. After the procedure, the patient experienced an acute upper gastrointestinal bleeding from the ulcer bed requiring argon plasma coagulation. The histopathological examination confirmed an early cancer, without involvement of muscularis mucosae. The patient has had an uneventful evolution being well at six months after the procedure

Science of Materials: A Case Study of Intentional Teaching in the Early Years

ERIC Educational Resources Information Center

Hackling, Mark; Barratt-Pugh, Caroline

2012-01-01

Australia's Early Years Learning Framework and leading international researchers argue for more intentional and purposeful teaching of science in the early years. This case study of exemplary practice illustrates intentional teaching of science materials which opened-up learning opportunities in literacy and number. Student-led hands-on…

Development of an alternative testing strategy for the fish early life-stage (FELS) test using the AOP framework

EPA Science Inventory

Currently, the fish early life-stage (FELS) test (OECD 210) is the primary guideline used to estimate chronic toxicity of regulated chemicals. Although already more cost-efficient than adult fish tests, the FELS test has some important drawbacks. Both industry and regulatory inst...

Early Adoption of a Multitarget Stool DNA Test for Colorectal Cancer Screening.

PubMed

Finney Rutten, Lila J; Jacobson, Robert M; Wilson, Patrick M; Jacobson, Debra J; Fan, Chun; Kisiel, John B; Sweetser, Seth; Tulledge-Scheitel, Sidna M; St Sauver, Jennifer L

2017-05-01

To characterize early adoption of a novel multitarget stool DNA (MT-sDNA) screening test for colorectal cancer (CRC) screening and to test the hypothesis that adoption differs by demographic characteristics and prior CRC screening behavior and proceeds predictably over time. We used the Rochester Epidemiology Project research infrastructure to assess the use of the MT-sDNA screening test in adults aged 50 to 75 years living in Olmsted County, Minnesota, in 2014 and identified 27,147 individuals eligible or due for screening colonoscopy from November 1, 2014, through November 30, 2015. We used electronic Current Procedure Terminology and Health Care Common Procedure codes to evaluate early adoption of the MT-sDNA screening test in this population and to test whether early adoption varies by age, sex, race, and prior CRC screening behavior. Overall, 2193 (8.1%) and 974 (3.6%) individuals were screened by colonoscopy and MT-sDNA, respectively. Age, sex, race, and prior CRC screening behavior were significantly and independently associated with MT-sDNA screening use compared with colonoscopy use after adjustment for all other variables (P<.05 for all). The rates of adoption of MT-sDNA screening increased over time and were highest in those aged 50 to 54 years, women, whites, and those who had a history of screening. The use of the MT-sDNA screening test varied predictably by insurance coverage. The rates of colonoscopy decreased over time, whereas overall CRC screening rates remained steady. The results of the present study are generally consistent with predictions derived from prior research and the diffusion of innovation framework, pointing to increasing use of the new screening test over time and early adoption by younger patients, women, whites, and those with prior CRC screening. Copyright © 2017 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

Building Physics Test Cases | Buildings | NREL

Science.gov Websites

building physics test cases in BESTEST-EX. In these cases, the model inputs that describe the house are programs. This diagram provides an overview of the BESTEST-EX physics case process. On the left side of the diagram is a box labeled "BESTEST-EX Document" with a list that contains two bulleted items. The

Understanding the High School Proficiency Test and the Early Warning Test in Relation to HCCC Enrollment Trends.

ERIC Educational Resources Information Center

Taffy, Fred

The Grade 11 High School Proficiency Test (HSPT) and the New Jersey Early Warning Test (EWT) are two key standardized tests that indicate academic ability of county high school graduates which colleges will need to address. While HSPT scores for county high school districts reflect a range of competency in reading, math, and writing, the majority…

Memory Alteration Test to Detect Amnestic Mild Cognitive Impairment and Early Alzheimer’s Dementia in Population with Low Educational Level

PubMed Central

Custodio, Nilton; Lira, David; Herrera-Perez, Eder; Montesinos, Rosa; Castro-Suarez, Sheila; Cuenca-Alfaro, José; Valeriano-Lorenzo, Lucía

2017-01-01

Background/Aims: Short tests to early detection of the cognitive impairment are necessary in primary care setting, particularly in populations with low educational level. The aim of this study was to assess the performance of Memory Alteration Test (M@T) to discriminate controls, patients with amnestic Mild Cognitive Impairment (aMCI) and patients with early Alzheimer’s Dementia (AD) in a sample of individuals with low level of education. Methods: Cross-sectional study to assess the performance of the M@T (study test), compared to the neuropsychological evaluation (gold standard test) scores in 247 elderly subjects with low education level from Lima-Peru. The cognitive evaluation included three sequential stages: (1) screening (to detect cases with cognitive impairment); (2) nosological diagnosis (to determinate specific disease); and (3) classification (to differentiate disease subtypes). The subjects with negative results for all stages were considered as cognitively normal (controls). The test performance was assessed by means of area under the receiver operating characteristic (ROC) curve. We calculated validity measures (sensitivity, specificity and correctly classified percentage), the internal consistency (Cronbach’s alpha coefficient), and concurrent validity (Pearson’s ratio coefficient between the M@T and Clinical Dementia Rating (CDR) scores). Results: The Cronbach’s alpha coefficient was 0.79 and Pearson’s ratio coefficient was 0.79 (p < 0.01). The AUC of M@T to discriminate between early AD and aMCI was 99.60% (sensitivity = 100.00%, specificity = 97.53% and correctly classified = 98.41%) and to discriminate between aMCI and controls was 99.56% (sensitivity = 99.17%, specificity = 91.11%, and correctly classified = 96.99%). Conclusions: The M@T is a short test with a good performance to discriminate controls, aMCI and early AD in individuals with low level of education from urban settings. PMID:28878665

Early extraction of the mandibular third molar in case of eruption disturbances of the second molar.

PubMed

Kavadia, S; Antoniades, K; Kaklamanos, E; Antoniades, V; Markovitsi, E; Zafiriadis, L

2003-01-01

General consensus has been reached on extracting mandibular third molars when they are involved in pathologic processes. However, early extraction is advisable in cases of eruption disturbances of the mandibular second molar, before or during orthodontic treatment. Thirty-two patients with early extraction of the mandibular third molar before or during orthodontic treatment were examined. In these cases either the presence of the third molar presented an obstacle in the eruption path of the second, or third molar germ removal was considered beneficial to the course of orthodontic treatment. Early extraction of the mandibular third molar facilitates the eruption of the second molar, especially in cases where evidence of crowding and lack of space in the posterior mandibular region exist. Orthodontic treatment may, in some cases, aggravate eruption disturbances of the second molar.

Arc Jet Testing of Thermal Protection Materials: 3 Case Studies

NASA Technical Reports Server (NTRS)

Johnson, Sylvia; Conley, Joe

2015-01-01

Arc jet testing is used to simulate entry to test thermal protection materials. This paper discusses the usefulness of arc jet testing for 3 cases. Case 1 is MSL and PICA, Case 2 is Advanced TUFROC, and Case 3 is conformable ablators.

Enhancing TB case detection: experience in offering upfront Xpert MTB/RIF testing to pediatric presumptive TB and DR TB cases for early rapid diagnosis of drug sensitive and drug resistant TB.

PubMed

Raizada, Neeraj; Sachdeva, Kuldeep Singh; Nair, Sreenivas Achuthan; Kulsange, Shubhangi; Gupta, Radhey Shayam; Thakur, Rahul; Parmar, Malik; Gray, Christen; Ramachandran, Ranjani; Vadera, Bhavin; Ekka, Shobha; Dhawan, Shikha; Babre, Ameet; Ghedia, Mayank; Alavadi, Umesh; Dewan, Puneet; Khetrapal, Mini; Khanna, Ashwini; Boehme, Catharina; Paramsivan, Chinnambedu Nainarappan

2014-01-01

Diagnosis of pulmonary tuberculosis (PTB) in children is challenging due to difficulties in obtaining good quality sputum specimens as well as the paucibacillary nature of disease. Globally a large proportion of pediatric tuberculosis (TB) cases are diagnosed based only on clinical findings. Xpert MTB/RIF, a highly sensitive and specific rapid tool, offers a promising solution in addressing these challenges. This study presents the results from pediatric groups taking part in a large demonstration study wherein Xpert MTB/RIF testing replaced smear microscopy for all presumptive PTB cases in public health facilities across India. The study covered a population of 8.8 million across 18 programmatic sub-district level tuberculosis units (TU), with one Xpert MTB/RIF platform established at each study TU. Pediatric presumptive PTB cases (both TB and Drug Resistant TB (DR-TB)) accessing any public health facilities in study area were prospectively enrolled and tested on Xpert MTB/RIF following a standardized diagnostic algorithm. 4,600 pediatric presumptive pulmonary TB cases were enrolled. 590 (12.8%, CI 11.8-13.8) pediatric PTB were diagnosed. Overall 10.4% (CI 9.5-11.2) of presumptive PTB cases had positive results by Xpert MTB/RIF, compared with 4.8% (CI 4.2-5.4) who had smear-positive results. Upfront Xpert MTB/RIF testing of presumptive PTB and presumptive DR-TB cases resulted in diagnosis of 79 and 12 rifampicin resistance cases, respectively. Positive predictive value (PPV) for rifampicin resistance detection was high (98%, CI 90.1-99.9), with no statistically significant variation with respect to past history of treatment. Upfront access to Xpert MTB/RIF testing in pediatric presumptive PTB cases was associated with a two-fold increase in bacteriologically-confirmed PTB, and increased detection of rifampicin-resistant TB cases under routine operational conditions across India. These results suggest that routine Xpert MTB/RIF testing is a promising solution to

Flow Test to Predict Early Hypotony and Hypertensive Phase After Ahmed Glaucoma Valve (AGV) Surgical Implantation.

PubMed

Cheng, Jason; Beltran-Agullo, Laura; Buys, Yvonne M; Moss, Edward B; Gonzalez, Johanna; Trope, Graham E

2016-06-01

To assess the validity of a preimplantation flow test to predict early hypotony [intraocular pressure (IOP)≤5 mm Hg on 2 consecutive visits and hypertensive phase (HP) (IOP>21 mm Hg) after Ahmed Glaucoma Valve (AGV) implantation. Prospective interventional study on patients receiving an AGV. A preimplantation flow test using a gravity-driven reservoir and an open manometer was performed on all AGVs. Opening pressure (OP) and closing pressure (CP) were defined as the pressure at which fluid was seen to flow or stop flowing through the AGV, respectively. OP and CP were measured twice per AGV. Patients were followed for 12 weeks. In total, 20 eyes from 19 patients were enrolled. At 12 weeks the mean IOP decreased from 29.2±9.1 to 16.8±5.2 mm Hg (P<0.01). The mean AGV OP was 17.5±5.4 mm Hg and the mean CP was 6.7±2.3 mm Hg. Early (within 2 wk postoperative) HP occurred in 37% and hypotony in 16% of cases. An 18 mm Hg cutoff for the OP gave a sensitivity of 0.71, specificity of 0.83, positive predictive value of 0.71, and negative predictive value of 0.83 for predicting an early HP. A 7 mm Hg cutoff for the CP yielded a sensitivity of 1.0, specificity of 0.38, positive predictive value of 0.23, and negative predictive value of 1.0 for predicting hypotony. Preoperative OP and CP may predict early hypotony or HP and may be used as a guide as to which AGV valves to discard before implantation surgery.

[Role of BoBs technology in early missed abortion chorionic villi].

PubMed

Li, Z Y; Liu, X Y; Peng, P; Chen, N; Ou, J; Hao, N; Zhou, J; Bian, X M

2018-05-25

Objective: To investigate the value of bacterial artificial chromosome-on-beads (BoBs) technology in the genetic analysis of early missed abortion chorionic villi. Methods: Early missed abortion chorionic villi were detected with both conventional karyotyping method and BoBs technology in Peking Union Medical Hospital from July 2014 to March 2015. Compared the results of BoBs with conventional karyotyping analysis to evaluate the sensitivity, specificity and accuracy of this new method. Results: (1) A total of 161 samples were tested successfully in the technology of BoBs, 131 samples were tested successfully in the method of conventional karyotyping. (2) All of the cases obtained from BoBs results in (2.7±0.6) days and obtained from conventional karyotyping results in (22.5±1.9) days. There was significant statistical difference between the two groups ( t= 123.315, P< 0.01) . (3) Out of 161 cases tested in BoBs, 85 (52.8%, 85/161) cases had the abnormal chromosomes, including 79 cases chromosome number abnormality, 4 cases were chromosome segment deletion, 2 cases mosaic. Out of 131 cases tested successfully in conventional karyotyping, 79 (60.3%, 79/131) cases had the abnormal chromosomes including 62 cases chromosome number abnormality, 17 cases other chromosome number abnormality, and the rate of chromosome abnormality between two methods was no significant differences ( P =0.198) . (4) Conventional karyotyping results were served as the gold standard, the accuracy of BoBs for abnormal chromosomes was 82.4% (108/131) , analysed the normal chromosomes (52 cases) and chromosome number abnormality (62 cases) tested in conventional karyotyping, the accuracy of BoBs for chromosome number abnormality was 94.7% (108/114) . Conclusion: BoBs is a rapid reliable and easily operated method to test early missed abortion chorionic villi chromosomal abnormalities.

A large Legionnaires' disease outbreak in Pamplona, Spain: early detection, rapid control and no case fatality

PubMed Central

CASTILLA, J.; BARRICARTE, A.; ALDAZ, J.; GARCÍA CENOZ, M.; FERRER, T.; PELAZ, C.; PINEDA, S.; BALADRÓN, B.; MARTÍN, I.; GOÑI, B.; ARATAJO, P.; CHAMORRO, J.; LAMEIRO, F.; TORROBA, L.; DORRONSORO, I.; MARTÍNEZ-ARTOLA, V.; ESPARZA, M. J.; GASTAMINZA, M. A.; FRAILE, P.; ALDAZ, P.

2008-01-01

SUMMARY An outbreak of Legionnaire's disease was detected in Pamplona, Spain, on 1 June 2006. Patients with pneumonia were tested to detect Legionella pneumophila antigen in urine (Binax Now; Binax Inc., Scarborough, ME, USA), and all 146 confirmed cases were interviewed. The outbreak was related to district 2 (22 012 inhabitants), where 45% of the cases lived and 50% had visited; 5% lived in neighbouring districts. The highest incidence was found in the resident population of district 2 (3/1000 inhabitants), section 2 (14/1000). All 31 cooling towers of district 2 were analysed. L. pneumophila antigen (Binax Now) was detected in four towers, which were closed on 2 June. Only the strain isolated in a tower situated in section 2 of district 2 matched all five clinical isolates, as assessed by mAb and two genotyping methods, AFLP and PFGE. Eight days after closing the towers, new cases ceased appearing. Early detection and rapid coordinated medical and environmental actions permitted immediate control of the outbreak and probably contributed to the null case fatality. PMID:17662166

A large Legionnaires' disease outbreak in Pamplona, Spain: early detection, rapid control and no case fatality.

PubMed

Castilla, J; Barricarte, A; Aldaz, J; García Cenoz, M; Ferrer, T; Pelaz, C; Pineda, S; Baladrón, B; Martín, I; Goñi, B; Aratajo, P; Chamorro, J; Lameiro, F; Torroba, L; Dorronsoro, I; Martínez-Artola, V; Esparza, M J; Gastaminza, M A; Fraile, P; Aldaz, P

2008-06-01

An outbreak of Legionnaire's disease was detected in Pamplona, Spain, on 1 June 2006. Patients with pneumonia were tested to detect Legionella pneumophila antigen in urine (Binax Now; Binax Inc., Scarborough, ME, USA), and all 146 confirmed cases were interviewed. The outbreak was related to district 2 (22 012 inhabitants), where 45% of the cases lived and 50% had visited; 5% lived in neighbouring districts. The highest incidence was found in the resident population of district 2 (3/1000 inhabitants), section 2 (14/1000). All 31 cooling towers of district 2 were analysed. L. pneumophila antigen (Binax Now) was detected in four towers, which were closed on 2 June. Only the strain isolated in a tower situated in section 2 of district 2 matched all five clinical isolates, as assessed by mAb and two genotyping methods, AFLP and PFGE. Eight days after closing the towers, new cases ceased appearing. Early detection and rapid coordinated medical and environmental actions permitted immediate control of the outbreak and probably contributed to the null case fatality.

Three cases of donor-derived pulmonary tuberculosis in lung transplant recipients and review of 12 previously reported cases: opportunities for early diagnosis and prevention.

PubMed

Mortensen, E; Hellinger, W; Keller, C; Cowan, L S; Shaw, T; Hwang, S; Pegues, D; Ahmedov, S; Salfinger, M; Bower, W A

2014-02-01

Solid organ transplant recipients have a higher frequency of tuberculosis (TB) than the general population, with mortality rates of approximately 30%. Although donor-derived TB is reported to account for <5% of TB in solid organ transplants, the source of Mycobacterium tuberculosis infection is infrequently determined. We report 3 new cases of pulmonary TB in lung transplant recipients attributed to donor infection, and review the 12 previously reported cases to assess whether cases could have been prevented and whether any cases that might occur in the future could be detected and investigated more quickly. Specifically, we evaluate whether opportunities existed to determine TB risk on the basis of routine donor history, to expedite diagnosis through routine mycobacterial smears and cultures of respiratory specimens early post transplant, and to utilize molecular tools to investigate infection sources epidemiologically. On review, donor TB risk was present among 7 cases. Routine smears and cultures diagnosed 4 asymptomatic cases. Genotyping was used to support epidemiologic findings in 6 cases. Validated screening protocols, including microbiological testing and newer technologies (e.g., interferon-gamma release assays) to identify unrecognized M. tuberculosis infection in deceased donors, are warranted. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Designing Studies to Test Causal Questions About Early Math: The Development of Making Pre-K Count.

PubMed

Mattera, Shira K; Morris, Pamela A; Jacob, Robin; Maier, Michelle; Rojas, Natalia

2017-01-01

A growing literature has demonstrated that early math skills are associated with later outcomes for children. This research has generated interest in improving children's early math competencies as a pathway to improved outcomes for children in elementary school. The Making Pre-K Count study was designed to test the effects of an early math intervention for preschoolers. Its design was unique in that, in addition to causally testing the effects of early math skills, it also allowed for the examination of a number of additional questions about scale-up, the influence of contextual factors and the counterfactual environment, the mechanism of long-term fade-out, and the role of measurement in early childhood intervention findings. This chapter outlines some of the design considerations and decisions put in place to create a rigorous test of the causal effects of early math skills that is also able to answer these questions in early childhood mathematics and intervention. The study serves as a potential model for how to advance science in the fields of preschool intervention and early mathematics. © 2017 Elsevier Inc. All rights reserved.

[Early macular edema after phacoemulsification and suspected overdose of cefuroxime: report of six cases].

PubMed

Le Dû, B; Pierre-Kahn, V

2014-03-01

Antibiotic prophylaxis by intracameral cefuroxime injection, 1mg/0.1 mL after cataract surgery is increasing in popularity. Several cases of early postoperative macular edema have recently been reported after cefuroxime injection, most of them due to accidental cefuroxime overdose. We report six additional cases of macular involvement after cataract surgery, with intracameral cefuroxime injection imputed to cause retinal toxicity. Formal proof of cefuroxime overdose has never been possible, due to rapid wash-out in a few hours and the diagnosis of the macular edema the day after surgery or within a few days. Thus, this strong suspicion is based on clinical, pharmacokinetic, tomographic and retinographic criteria. In our series of six cases, the first four patients involved the same surgeon in the same hospital, and two of them on the same day. For the sixth case, the diagnosis was made retrospectively and based on history and medium-term tomographic characteristics. All the patients underwent optical coherence tomography (OCT) relatively early. As early as day one after surgery, there is macular edema predominantly in the outer retinal layers associated with serous retinal detachment, similar to the cases described in the literature. In the late stage, three patients had functional impairment related to photoreceptor damage on OCT. Three cases are described with additional retinal imaging (angiography, autofluorescence) to better characterize this macular toxicity associated with cefuroxime. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

Early treatment of penile fractures: our experience.

PubMed

García Gómez, Borja; Romero, Javier; Villacampa, Felipe; Tejido, Angel; Díaz, Rafael

2012-09-01

To report our experience in early surgery of penile fractures. We review retrospectively all the cases that underwent surgery at our center from 1989 to 2009, with a total of 24. The cause of the fracture was sexual intercourse in most cases, and in all of them, surgical management was performed according to clinical presentation and physical exploration. In only 7 cases an ultrasound was performed as a complementary test. Early surgery allows prompt resolution of the problem with excellent functional outcomes and little side effects. The prognosis after emergency surgery was excellent in this review.

Geologic Tests for Snowmelt Runoff on Early Mars

NASA Astrophysics Data System (ADS)

Kite, E. S.; Sneed, J.; Mayer, D. P.

2017-12-01

Data from the Curiosity rover have sharpened the question: was Early Mars climate warm enough for rainfall, or was the climate cold? The hypothesis of a cold (snow-and-ice melt) climate on Early Mars can be tested using runoff production. Runoff production cannot exceed snowmelt rate in a cold climate. Therefore, high runoff production would rule out cold conditions, and would suggest rain (or catastrophic melting of snow). How can runoff production be reliably measured? To constrain runoff production, the lead author is measuring paleochannel widths and meander wavelengths for Early Mars watersheds with well-defined drainage area. The measurement method is the same as in Kite et al., EPSL, 2015. >250 channel-width measurements and 89 meander wavelength measurements are included, representing 158 drainage areas. The catalog emphasizes better-preserved (post-Noachian) paleochannels, but includes a re-survey of previously-reported paleochannel width and wavelength measurement sites. Channel widths and wavelengths are a proxy for paleodischarge. Discharge (m3/s) can be divided by drainage area (m2) to obtain a lower bound on runoff-production (mm/hr). If runoff production >(1-3) mm/hr, then a seasonal melting snow-and-ice climate is strongly disfavored. However, high runoff production would be consistent with rainfall. Initial results will be reported at the conference. The figure shows the locations of measurement sites for Early Mars channel width (black) and meander wavelength (red).

Impact of an Early Retirement Program: A Case Analysis of a Community College.

ERIC Educational Resources Information Center

Roman, Lawrence Allen

This case study examines the impact of Early Retirement Incentive Programs (ERIP) on Ohio's two-year public colleges through a single case study analysis at Monticello Community College. Data came from interviews and an examination of college documents. This study specifically sought to address: (1) the financial impact (savings versus costs) of…

Endogenous steroid hormone levels in early pregnancy and risk of testicular cancer in the offspring: a nested case-referent study.

PubMed

Holl, Katsiaryna; Lundin, Eva; Surcel, Heljä-Marja; Grankvist, Kjell; Koskela, Pentti; Dillner, Joakim; Hallmans, Göran; Wadell, Göran; Olafsdottir, Gudridur H; Ogmundsdottir, Helga M; Pukkala, Eero; Lehtinen, Matti; Stattin, Pär; Lukanova, Annekatrin

2009-06-15

According to the leading hypothesis on testicular cancer (TC) etiology exposure to a specific pattern of steroid hormones in utero, in particular, to high levels of estrogens and low levels of androgens is the major determinant of TC risk in the offspring. We performed a case-referent study nested within Finnish, Swedish and Icelandic maternity cohorts exploiting early pregnancy serum samples to evaluate the role of maternal endogenous steroid hormones with regard to the risk of TC. TC cases and referents were aged between 0 and 25 years. For each case-index mother pair, three or four matched referent-referent mother pairs were identified using national population registries. First trimester or early second trimester sera were retrieved from the index mothers of 73 TC cases and 286 matched referent mothers, and were tested for dehydroepiandrosterone sulfate (DHEAS), androstenedione, testosterone, estradiol, estrone, and sex hormone binding globulin (SHBG). Offspring of mothers with high DHEAS levels had a significantly decreased risk of TC (OR for highest vs. lowest DHEAS quartile, 0.18 (95% CI 0.06-0.58). In contrast, offspring of mothers with high androstenedione levels had an increased risk of TC (OR 4.1; 95% CI 1.2-12.0). High maternal total estradiol level also tended to be associated with an increased risk of TC in the offspring (OR 32; 95% CI 0.98-1,090). We report the first direct evidence that interplay of maternal steroid hormones in the early pregnancy is important in the etiology of TC in the offspring. Copyright 2008 UICC.

Early Adoption of a Multi-target Stool DNA Test for Colorectal Cancer Screening

PubMed Central

Finney Rutten, Lila J.; Jacobson, Robert M.; Wilson, Patrick M.; Jacobson, Debra J.; Fan, Chun; Kisiel, John B.; Sweetser, Seth R.; Tulledge-Scheitel, Sidna M.; St. Sauver, Jennifer L.

2017-01-01

Objective To characterize early adoption of a novelmulti-target stool deoxyribonucleic acid (MTsDNA) screening test for colorectal cancer (CRC) and test the hypothesis that adoption differs by demographic characteristics, prior CRC screening behavior, and proceeds predictably over time. Patients and Methods We used the Rochester Epidemiology Project infrastructure to assess MTsDNA screening test use among adults aged 50–75 years, and identified 27,147 individuals eligible/due for screening colonoscopy from November 1, 2014 through November 30, 2015, and living in Olmsted County, Minnesota in2014. We used electronic Current Procedure Terminology and Health Care Common Procedure codes to evaluate early adoption of MTsDNA screening test in this population and to test whether early adoption varies by age, sex, race, and prior screening behavior. Results Overall, 2,193 (8.1%) and 974 (3.6%) of individuals were screened by colonoscopy and MT-sDNA, respectively. Age, sex, race, and prior screening were significantly and independently associated with MT-sDNA screening use compared to colonoscopy use after adjustment for all other variables. Rates of adoption of MTsDNA screening increased over time and were highest among those aged 50–54 years, females, whites, and had a prior history of screening. MT-sDNA screening use varied predictably by insurance coverage. Rates of colonoscopy decreased over time, while overall CRC screening rates remained steady. Conclusion Our results are generally consistent with predictions derived from prior research and Diffusion of Innovation framework, pointing to increasing use of the new screening test over time, and early adoption by younger patients, females, whites and those with prior CRC screening. PMID:28473037

Comparison between the story recall test and the word-list learning test in Korean patients with mild cognitive impairment and early stage of Alzheimer's disease.

PubMed

Baek, Min Jae; Kim, Hyun Jung; Kim, Sangyun

2012-01-01

Among verbal memory tests, two that are commonly used to measure the ability of verbal memory function in cognitive impairment are story recall tests and word-list learning tests. However, research is limited regarding which test might be more sensitive in discriminating between normal cognitive aging and patients with Alzheimer's disease (AD) in the Korean population. The purpose of the current study was to compare the word-list learning test (Seoul Verbal Learning Test; SVLT) and the story recall test (Korean Story Recall Test; KSRT) to determine which test is more sensitive in discriminating between individuals with normal cognitive aging and patients with mild cognitive impairment (MCI) and early stage of AD in Korea. A total of 53 healthy adults, 127 patients with MCI, and 72 patients with early stage of AD participated in this study. The receiver-operating characteristic (ROC) curve and area under the curve (AUC) were evaluated to compare these two tests. The results showed that the AUC of the SVLT was significantly larger than the AUC of the KSRT in all three groups (healthy adults vs. MCI and early stage of AD; healthy adults vs. MCI; healthy adults vs. early stage of AD). However, in comparison of patients with MCI and early stage of AD, the AUC of SVLT and the AUC of KSRT were not significant. The word-list learning test is a more useful tool for examining verbal memory function for older adults in Korea than the story recall test.

Early sign of microangiopathy in systemic sclerosis: The significance of cold stress test in dynamic laser Doppler flowmetry.

PubMed

Yu, Sebastian; Hu, Stephen Chu-Sung; Yu, Hsin-Su; Chin, Yi-Ying; Cheng, Yang-Chun; Lee, Chih-Hung

2018-06-05

Skin physiology measurement is receiving more attention for detecting vasculopathy in systemic sclerosis (SSc). Laser Doppler flowmetry (LDF) is a widely used physiological measurement to assess cutaneous microcirculation. However, findings of LDF may be normal during early stage of microangiopathy in SSc. We hypothesized that cold stress test combined with LDF could detect early-stage microangiopathy in patients with SSc. A 67-year-old male came with multiple ulcerations on his fingers for one year. After excluding diseases such as diabetes mellitus-related peripheral arterial occlusive disease and smoking-related Buerger's disease, the diagnosis of SSc was made according to the 2013 ACR/EULAR criteria. We performed LDF and angiography for a patient with SSc and compared the results. Although occlusions of right ulnar and digital arteries were obvious in angiography, the baseline skin temperature and perfusion unit on right fingers remained within normal limits. While the microcirculatory abnormalities measured by LDF alone are subtle, LDF combined with cold stress test detected a significant slow recovery of skin blood flow 40 minutes after cold immersion. In conclusion, there may be discordance between macrovasculopathy and baseline microcirculatory blood flow in SSc. In such a case, cold immersion test is essential to measure the dynamic change and slow recovery of blood flow.

Early Education Screening Test Battery of Basic Skills Development: Criteria for Personalizing Programs.

ERIC Educational Resources Information Center

University City School District, MO.

The development and content of the Early Education Screening Test Battery are described elsewhere (TM 000 184). This report provides norms for the Gross Motor Test (GMO), Visual-Motor Integration (VMI), four scales of the Illinois Test of Psycholinguistic Abilities (ITPA), Peabody Picture Vocabulary Test (PPVT), and the Behavior Rating Scale…

Utility Bill Calibration Test Cases | Buildings | NREL

Science.gov Websites

illustrates the utility bill calibration test cases in BESTEST-EX. In these cases, participants are given software results have been generated. This diagram provides an overview of the BESTEST-EX utility bill calibration case process. On the left side of the diagram is a box labeled "BESTEST-EX Document"

A Phenomenological Case Study: Teacher Bias Effects on Early Education Assessments

ERIC Educational Resources Information Center

Reynolds, Rebecca Jeannine

2012-01-01

This qualitative phenomenological case study explored the lived experiences of a purposive sample of 20 current and past early education teachers who have experience in assessing children through observational assessment. The purpose of this study was to determine if bias affects the documentation of observational assessment and the implementation…

CoopEUS Case Study: Tsunami Modelling and Early Warning Systems for Near Source Areas (Mediterranean, Juan de Fuca).

NASA Astrophysics Data System (ADS)

Beranzoli, Laura; Best, Mairi; Chierici, Francesco; Embriaco, Davide; Galbraith, Nan; Heeseman, Martin; Kelley, Deborah; Pirenne, Benoit; Scofield, Oscar; Weller, Robert

2015-04-01

There is a need for tsunami modeling and early warning systems for near-source areas. For example this is a common public safety threat in the Mediterranean and Juan de Fuca/NE Pacific Coast of N.A.; Regions covered by the EMSO, OOI, and ONC ocean observatories. Through the CoopEUS international cooperation project, a number of environmental research infrastructures have come together to coordinate efforts on environmental challenges; this tsunami case study tackles one such challenge. There is a mutual need of tsunami event field data and modeling to deepen our experience in testing methodology and developing real-time data processing. Tsunami field data are already available for past events, part of this use case compares these for compatibility, gap analysis, and model groundtruthing. It also reviews sensors needed and harmonizes instrument settings. Sensor metadata and registries are compared, harmonized, and aligned. Data policies and access are also compared and assessed for gap analysis. Modelling algorithms are compared and tested against archived and real-time data. This case study will then be extended to other related tsunami data and model sources globally with similar geographic and seismic scenarios.

Test plan. Task 5, subtask 5.2: Early on-orbit TPSdebris impact tests

NASA Technical Reports Server (NTRS)

Greenberg, H. S.

1994-01-01

The limitation of damage to, and survival of, the cryogenic tankage during the on-orbit stay despite potential impact of orbital debris, may be a significant discriminator in the RHCTS trade studies described in the TA-1 trade study plan (ref. RHCTS-TSP-1) dated July 29, 1994. The objective of this early phase of an overall debris impact test program is to provide the data to support assessment of the relative suitability of integral and non integral tanks.

HLA-B*5701 clinical testing: early experience in the United States.

PubMed

Faruki, Hawazin; Heine, Uwe; Brown, Trisha; Koester, Ruth; Lai-Goldman, Myla

2007-10-01

HLA-B*5701 testing to provide risk stratification for abacavir hypersensitivity has the potential to reduce incidence of hypersensitivity reactions in susceptible individuals. Early experience with clinical HLA-B*5701 testing of the first 100 specimens, from a large clinical reference laboratory in the United States, is presented. Patient samples were tested using a two-step approach. The first step allowed rapid identification of most HLA-B*5701-negative samples in a high throughput mode. The second step involved resolution of putative positives by DNA sequencing to identify B*5701 specifically as well as other B57 subtypes. Test reporting included a phone call from a genetic counselor to obtain the ethnic background and indication for testing and to provide a patient-specific interpretation. The patients population was comprised of Caucasians, 84%; Hispanics, 13%; and African Americans, 3%. Among the 100 samples tested, 92% were HLA-B*5701-negative and 8% were positive for the HLA-B*5701 allele. All HLA-B*5701 allele positives were identified in Caucasian patients. Where the indication for testing was obtainable (57 patients), pre-abacavir therapy screening was the indication 67% of the time. Clarification of previous suspected history of hypersensitivity was the indication 33% of the time. Among samples tested to help clarify a previous history of hypersensitivity, 16/19 or 84% did not carry the HLA-B*5701 allele whereas 3/19 (16%) were carriers of the HLA-B*5701 allele. Early utilization of HLA-B*5701 testing in community practice was not always consistent with the clinical indications for testing. Post-test communication assisted in providing physician education and interpretation of patient-specific results.

A case of severe chlorite poisoning successfully treated with early administration of methylene blue, renal replacement therapy, and red blood cell transfusion: case report.

PubMed

Gebhardtova, Andrea; Vavrinec, Peter; Vavrincova-Yaghi, Diana; Seelen, Mark; Dobisova, Anna; Flassikova, Zora; Cikova, Andrea; Henning, Robert H; Yaghi, Aktham

2014-08-01

The case of a 55-year-old man who attempted suicide by ingesting <100 mL of 28% sodium chlorite solution is presented. On arrival in the intensive care unit, the patient appeared cyanotic with lowered consciousness and displayed anuria and chocolate brown serum.Initial laboratory tests revealed 40% of methemoglobin. The formation of methemoglobin was effectively treated with methylene blue (10% after 29 hours).To remove the toxin, and because of the anuric acute renal failure, the patient received renal replacement therapy. Despite these therapeutic measures, the patient developed hemolytic anemia and disseminated intravascular coagulation, which were treated with red blood cell transfusion and intermittent hemodialysis. These interventions led to the improvement of his condition and the patient eventually fully recovered. Patient gave written informed consent.This is the third known case of chlorite poisoning that has been reported. Based upon this case, we suggest the management of sodium chlorite poisoning to comprise the early administration of methylene blue, in addition to renal replacement therapy and transfusion of red blood cells.

Early Career Teachers' Emotional Experiences and Development--A Norwegian Case Study

ERIC Educational Resources Information Center

Jakhelln, Rachel

2011-01-01

Emotional experiences that are an integral part of the process of becoming teachers have been insufficiently explored in the research literature. The early experiences of three new teachers in a Norwegian upper secondary school are analysed using a collective case-study design and a socio-cultural theoretical framework. Emotions arising in the…

Obstacles in Using Randomization Tests in Single-Case Experimentation.

ERIC Educational Resources Information Center

Kazdin, Alan E.

1980-01-01

Problems associated with randomization tests in single- case experiments are discussed. This article follows a discussion of randomization tests in single case studies in the same issue of this journal. (See TM 505 799; 505 801).(Author/JKS)

"..., But I Cannot Do Research": Action-Research and Early Childhood Teachers. A Case Study from Greece

ERIC Educational Resources Information Center

Magos, Kostas

2012-01-01

Although action-research is a well-known research methodology in the field of education, in the case of Greece there are few actions-researches carried out by early childhood teachers. The absence of action-research in early childhood education settings is related to the way many early childhood teachers shape their professional role as well as…

Test Review: Huer, M. B., & Miller, L. Tecel (2011), "Test of Early Communication and Emerging Language." Austin, TX: Pro-Ed

ERIC Educational Resources Information Center

Hua, Yi

2018-01-01

This article describes and reviews the "Test of Early Communication and Emerging Language" (TECEL; Huer & Miller, 2011). The test was constructed to assess infants' and toddlers' earliest communication and language abilities. The TECEL is a revision of the Nonspeech Test for Receptive/ Expressive Language (NST; Huer, 1983, 1988). The…

Gut microbiota in early pediatric multiple sclerosis: a case-control study.

PubMed

Tremlett, Helen; Fadrosh, Douglas W; Faruqi, Ali A; Zhu, Feng; Hart, Janace; Roalstad, Shelly; Graves, Jennifer; Lynch, Susan; Waubant, Emmanuelle

2016-08-01

Alterations in the gut microbial community composition may be influential in neurological disease. Microbial community profiles were compared between early onset pediatric multiple sclerosis (MS) and control children similar for age and sex. Children ≤18 years old within 2 years of MS onset or controls without autoimmune disorders attending a University of California, San Francisco, USA, pediatric clinic were examined for fecal bacterial community composition and predicted function by 16S ribosomal RNA sequencing and phylogenetic reconstruction of unobserved states (PICRUSt) analysis. Associations between subject characteristics and the microbiota, including beta diversity and taxa abundance, were identified using non-parametric tests, permutational multivariate analysis of variance and negative binomial regression. Eighteen relapsing-remitting MS cases and 17 controls (mean age 13 years; range 4-18) were studied. Cases had a short disease duration (mean 11 months; range 2-24) and half were immunomodulatory drug (IMD) naïve. Whilst overall gut bacterial beta diversity was not significantly related to MS status, IMD exposure was (Canberra, P < 0.02). However, relative to controls, MS cases had a significant enrichment in relative abundance for members of the Desulfovibrionaceae (Bilophila, Desulfovibrio and Christensenellaceae) and depletion in Lachnospiraceae and Ruminococcaceae (all P and q < 0.000005). Microbial genes predicted as enriched in MS versus controls included those involved in glutathione metabolism (Mann-Whitney, P = 0.017), findings that were consistent regardless of IMD exposure. In recent onset pediatric MS, perturbations in the gut microbiome composition were observed, in parallel with predicted enrichment of metabolic pathways associated with neurodegeneration. Findings were suggestive of a pro-inflammatory milieu. © 2016 EAN.

Completed suicide in an autopsy-confirmed case of early onset Alzheimer's disease.

PubMed

Hartzell, Jennifer Wiener; Geary, Richard; Gyure, Kymberly; Chivukula, Venkata Ravi; Haut, Marc W

2018-04-01

We report a case of a 57-year-old male with clinically diagnosed and autopsy-confirmed early onset Alzheimer's disease who completed suicide by gunshot wound to the chest. This case has several unique aspects that have not been discussed in previous case reports of completed suicide in Alzheimer's disease. In particular, our patient's death was highly planned with successful compensation for his cognitive deficits. After all firearms had been removed from the home as a safety precaution, he obtained a new weapon, hid it and left himself cues to find and use it. The case is discussed in the context of literature differentiating the neural circuitry propagating impulsive versus planned suicidal acts.

Testing Drugs and Trying Cures: Experiment and Medicine in Medieval and Early Modern Europe.

PubMed

Leong, Elaine; Rankin, Alisha

2017-01-01

This article examines traditions of testing drugs (as substances) and trying cures (on patients) in medieval and early modern Europe. It argues that the history of drug testing needs to be a more central story to overall histories of scientific experiment. The practice of conducting thoughtful-and sometimes contrived-tests on drugs has a rich and varied tradition dating back to antiquity, which expanded in the Middle Ages and early modern period. Learned physicians paired text-based knowledge (reason) with hands-on testing (experience or experiment) in order to make claims about drugs' properties or effects on humans. Lay practitioners similarly used hands-on testing to gain knowledge of pharmaceutical effects. Although drug testing practices expanded in scale, actors, and sites, therpublished a work extolling the virtues of drugs froe was significant continuity from the Middle Ages to the eighteenth century.

Approach-Avoidance Motivational Profiles in Early Adolescents to the PACER Fitness Test

ERIC Educational Resources Information Center

Garn, Alex; Sun, Haichun

2009-01-01

The use of fitness testing is a practical means for measuring components of health-related fitness, but there is currently substantial debate over the motivating effects of these tests. Therefore, the purpose of this study was to examine the cross-fertilization of achievement and friendship goal profiles for early adolescents involved in the…

Automated Generation and Assessment of Autonomous Systems Test Cases

NASA Technical Reports Server (NTRS)

Barltrop, Kevin J.; Friberg, Kenneth H.; Horvath, Gregory A.

2008-01-01

This slide presentation reviews some of the issues concerning verification and validation testing of autonomous spacecraft routinely culminates in the exploration of anomalous or faulted mission-like scenarios using the work involved during the Dawn mission's tests as examples. Prioritizing which scenarios to develop usually comes down to focusing on the most vulnerable areas and ensuring the best return on investment of test time. Rules-of-thumb strategies often come into play, such as injecting applicable anomalies prior to, during, and after system state changes; or, creating cases that ensure good safety-net algorithm coverage. Although experience and judgment in test selection can lead to high levels of confidence about the majority of a system's autonomy, it's likely that important test cases are overlooked. One method to fill in potential test coverage gaps is to automatically generate and execute test cases using algorithms that ensure desirable properties about the coverage. For example, generate cases for all possible fault monitors, and across all state change boundaries. Of course, the scope of coverage is determined by the test environment capabilities, where a faster-than-real-time, high-fidelity, software-only simulation would allow the broadest coverage. Even real-time systems that can be replicated and run in parallel, and that have reliable set-up and operations features provide an excellent resource for automated testing. Making detailed predictions for the outcome of such tests can be difficult, and when algorithmic means are employed to produce hundreds or even thousands of cases, generating predicts individually is impractical, and generating predicts with tools requires executable models of the design and environment that themselves require a complete test program. Therefore, evaluating the results of large number of mission scenario tests poses special challenges. A good approach to address this problem is to automatically score the results

Investigating Alternatives to the Fish Early Life-Stage Test: A Strategy for Discovering and Annotating Adverse Outcome Pathways for Early Fish Development

EPA Science Inventory

The fish early life-stage (FELS) test (OECD Test Guideline 210) is the primary test used internationally to estimate chronic fish toxicity in support of ecological risk assessments and chemical management programs. As part of an on-going effort to develop efficient and cost-effec...

Salivary fistula: Blue dye testing as part of an algorithm for early diagnosis

PubMed Central

Kiong, Kimberley L.; Tan, Ngian Chye; Skanthakumar, Thakshayeni; Teo, Constance E.H.; Soo, Khee Chee; Tan, Hiang Khoon; Roche, Elizabeth; Yee, Kaisin

2017-01-01

Objective Orocutaneous and pharyngocutaneous fistula (OPCF) is a debilitating complication of head and neck surgery for squamous cell carcinoma (SCC), resulting in delayed adjuvant treatment and prolonged hospitalization. As yet, there is no established test that can help in prompt and accurate diagnosis of OPCF. This study aims to determine the accuracy of bedside blue dye testing and its role as part of an algorithm for early diagnosis. We also analyze the risk factors predisposing to OPCF. Study Design Retrospective cohort study from 2012 to 2014. Methods Patients with head and neck SCC who underwent major resection and reconstruction, at risk of OPCF, were included. Results of blue‐dye and video‐fluoroscopic swallow‐studies (VFSS) testing for OPCF were recorded. For the patients that were noted to develop OPCF, the length of time to diagnosis of fistula and subsequent mode of management were examined. Results Of the 93 patients in this study, 25 (26.9%) developed OPCF. Advanced T‐classification (T3/T4) was the only significant predisposing risk factor (p = 0.013). The sensitivity and specificity of the bedside blue dye testing was found to be 36.4% and 100%, respectively. The test positive patients were diagnosed with OPCF at a median of postoperative day (POD) 9.5 as compared to POD 13 for the test negative patients (p = 0.001). Early diagnosis was associated with faster fistula resolution with treatment. Conclusion Blue dye testing is a simple bedside test that can assist in the early diagnosis of OPCF in patients, allowing treatment to be instituted earlier with improved outcomes. Level of Evidence 3 PMID:29299509

Case management in early psychosis intervention programme: Perspectives of clients and caregivers.

PubMed

Wong, Horng Hien; Yong, Yee Huei; Shahwan, Shazana; Cetty, Laxman; Vaingankar, Janhavi; Hon, Charlene; Lee, Helen; Loh, Christopher; Abdin, Edimansyah; Subramaniam, Mythily

2017-12-14

This qualitative study explored the perspectives of clients and caregivers on case management provided by the Singapore Early Psychosis Intervention Programme (EPIP), with the intent to understand the salient aspects of case management from their perspective. Clients and their caregivers were recruited from the EPIP outpatient clinics. Focus group discussions (FGDs) were conducted at a community centre outside the hospital with 47 clients and 19 caregivers. Facilitators were experienced researchers who were not involved in the care of the clients and trained in qualitative research methodologies. All FGDs were audio recorded and transcribed verbatim with all participants' identifiers omitted to protect confidentiality. Qualitative data analysis was conducted using thematic analysis. There were 11 themes that emerged from the FGDs: therapeutic alliance, holistic monitoring, collaborative role with other care providers, counselling and guidance, crisis management, bridging role, client-centred care, client empowerment and strength building, psychoeducation/education on illness, support and problem solving. "Problem solving" surfaced only from the client FGDs; the remaining themes were common to both groups. The voices of clients and caregivers are important to EPIP case management service. This study has provided insights into their perspectives, understandings and lived experiences of case management and its impact on clients and caregivers. © 2017 The Authors Early Intervention in Psychiatry Published by John Wiley & Sons Australia, Ltd.

Discovery Channel Telescope active optics system early integration and test

NASA Astrophysics Data System (ADS)

Venetiou, Alexander J.; Bida, Thomas A.

2012-09-01

The Discovery Channel Telescope (DCT) is a 4.3-meter telescope with a thin meniscus primary mirror (M1) and a honeycomb secondary mirror (M2). The optical design is an f/6.1 Ritchey-Chrétien (RC) with an unvignetted 0.5° Field of View (FoV) at the Cassegrain focus. We describe the design, implementation and performance of the DCT active optics system (AOS). The DCT AOS maintains collimation and controls the figure of the mirror to provide seeing-limited images across the focal plane. To minimize observing overhead, rapid settling times are achieved using a combination of feed-forward and low-bandwidth feedback control using a wavefront sensing system. In 2011, we mounted a Shack-Hartmann wavefront sensor at the prime focus of M1, the Prime Focus Test Assembly (PFTA), to test the AOS with the wavefront sensor, and the feedback loop. The incoming wavefront is decomposed using Zernike polynomials, and the mirror figure is corrected with a set of bending modes. Components of the system that we tested and tuned included the Zernike to Bending Mode transformations. We also started open-loop feed-forward coefficients determination. In early 2012, the PFTA was replaced by M2, and the wavefront sensor moved to its normal location on the Cassegrain instrument assembly. We present early open loop wavefront test results with the full optical system and instrument cube, along with refinements to the overall control loop operating at RC Cassegrain focus.

The universe of ANA testing: a case for point-of-care ANA testing.

PubMed

Konstantinov, Konstantin N; Rubin, Robert L

2017-12-01

Testing for total antinuclear antibodies (ANA) is a critical tool for diagnosis and management of autoimmune diseases at both the primary care and subspecialty settings. Repurposing of ANA from a test for lupus to a test for any autoimmune condition has driven the increase in ANA requests. Changes in ANA referral patterns include early or subclinical autoimmune disease detection in patients with low pre-test probability and use of negative ANA results to rule out underlying autoimmune disease. A positive result can lead to further diagnostic considerations. Currently, ANA tests are performed in centralized laboratories; an alternative would be ANA testing at the clinical point-of-care (POC). By virtue of its near real-time data collection capability, low cost, and ease of use, we believe the POC ANA has the potential to enable a new paradigm shift in autoimmune serology testing.

Herbalife hepatotoxicity: Evaluation of cases with positive reexposure tests.

PubMed

Teschke, Rolf; Frenzel, Christian; Schulze, Johannes; Schwarzenboeck, Alexander; Eickhoff, Axel

2013-07-27

To analyze the validity of applied test criteria and causality assessment methods in assumed Herbalife hepatotoxicity with positive reexposure tests. We searched the Medline database for suspected cases of Herbalife hepatotoxicity and retrieved 53 cases including eight cases with a positive unintentional reexposure and a high causality level for Herbalife. First, analysis of these eight cases focused on the data quality of the positive reexposure cases, requiring a baseline value of alanine aminotransferase (ALT) < 5 upper limit of normal (N) before reexposure, with N as the upper limit of normal, and a doubling of the ALT value at reexposure as compared to the ALT value at baseline prior to reexposure. Second, reported methods to assess causality in the eight cases were evaluated, and then the liver specific Council for International Organizations of Medical Sciences (CIOMS) scale validated for hepatotoxicity cases was used for quantitative causality reevaluation. This scale consists of various specific elements with scores provided through the respective case data, and the sum of the scores yields a causality grading for each individual case of initially suspected hepatotoxicity. Details of positive reexposure test conditions and their individual results were scattered in virtually all cases, since reexposures were unintentional and allowed only retrospective rather than prospective assessments. In 1/8 cases, criteria for a positive reexposure were fulfilled, whereas in the remaining cases the reexposure test was classified as negative (n = 1), or the data were considered as uninterpretable due to missing information to comply adequately with the criteria (n = 6). In virtually all assessed cases, liver unspecific causality assessment methods were applied rather than a liver specific method such as the CIOMS scale. Using this scale, causality gradings for Herbalife in these eight cases were probable (n = 1), unlikely (n = 4), and excluded (n = 3). Confounding

Herbalife hepatotoxicity: Evaluation of cases with positive reexposure tests

PubMed Central

Teschke, Rolf; Frenzel, Christian; Schulze, Johannes; Schwarzenboeck, Alexander; Eickhoff, Axel

2013-01-01

AIM: To analyze the validity of applied test criteria and causality assessment methods in assumed Herbalife hepatotoxicity with positive reexposure tests. METHODS: We searched the Medline database for suspected cases of Herbalife hepatotoxicity and retrieved 53 cases including eight cases with a positive unintentional reexposure and a high causality level for Herbalife. First, analysis of these eight cases focused on the data quality of the positive reexposure cases, requiring a baseline value of alanine aminotransferase (ALT) < 5 upper limit of normal (N) before reexposure, with N as the upper limit of normal, and a doubling of the ALT value at reexposure as compared to the ALT value at baseline prior to reexposure. Second, reported methods to assess causality in the eight cases were evaluated, and then the liver specific Council for International Organizations of Medical Sciences (CIOMS) scale validated for hepatotoxicity cases was used for quantitative causality reevaluation. This scale consists of various specific elements with scores provided through the respective case data, and the sum of the scores yields a causality grading for each individual case of initially suspected hepatotoxicity. RESULTS: Details of positive reexposure test conditions and their individual results were scattered in virtually all cases, since reexposures were unintentional and allowed only retrospective rather than prospective assessments. In 1/8 cases, criteria for a positive reexposure were fulfilled, whereas in the remaining cases the reexposure test was classified as negative (n = 1), or the data were considered as uninterpretable due to missing information to comply adequately with the criteria (n = 6). In virtually all assessed cases, liver unspecific causality assessment methods were applied rather than a liver specific method such as the CIOMS scale. Using this scale, causality gradings for Herbalife in these eight cases were probable (n = 1), unlikely (n = 4), and excluded (n

A random approach of test macro generation for early detection of hotspots

NASA Astrophysics Data System (ADS)

Lee, Jong-hyun; Kim, Chin; Kang, Minsoo; Hwang, Sungwook; Yang, Jae-seok; Harb, Mohammed; Al-Imam, Mohamed; Madkour, Kareem; ElManhawy, Wael; Kwan, Joe

2016-03-01

Multiple-Patterning Technology (MPT) is still the preferred choice over EUV for the advanced technology nodes, starting the 20nm node. Down the way to 7nm and 5nm nodes, Self-Aligned Multiple Patterning (SAMP) appears to be one of the effective multiple patterning techniques in terms of achieving small pitch of printed lines on wafer, yet its yield is in question. Predicting and enhancing the yield in the early stages of technology development are some of the main objectives for creating test macros on test masks. While conventional yield ramp techniques for a new technology node have relied on using designs from previous technology nodes as a starting point to identify patterns for Design of Experiment (DoE) creation, these techniques are challenging to apply in the case of introducing an MPT technique like SAMP that did not exist in previous nodes. This paper presents a new strategy for generating test structures based on random placement of unit patterns that can construct more meaningful bigger patterns. Specifications governing the relationships between those unit patterns can be adjusted to generate layout clips that look like realistic SAMP designs. A via chain can be constructed to connect the random DoE of SAMP structures through a routing layer to external pads for electrical measurement. These clips are decomposed according to the decomposition rules of the technology into the appropriate mandrel and cut masks. The decomposed clips can be tested through simulations, or electrically on silicon to discover hotspots. The hotspots can be used in optimizing the fabrication process and models to fix them. They can also be used as learning patterns for DFM deck development. By expanding the size of the randomly generated test structures, more hotspots can be detected. This should provide a faster way to enhance the yield of a new technology node.

Reflexivity, the role of history, and the case of mesmerism in early Victorian Britain.

PubMed

Lamont, Peter

2010-11-01

As part of a wider argument that history is essential to psychological understanding because of the reflexive nature of psychological knowledge, this article examines the case of mesmerism in early Victorian Britain as an example of how psychological knowledge is both constructive and constructed. It is argued that the shift from "mesmerism" to "hypnotism" was a change in understanding that created a new kind of psychological experience. It is also argued that demonstrations of mesmerism, far from being self-evident facts, could be framed as evidence either for or against the central claims of mesmerism. It is concluded that the case of mesmerism in early Victorian Britain provides a further example of the need for historical understanding within Psychology.

A Framework for Testing Scientific Software: A Case Study of Testing Amsterdam Discrete Dipole Approximation Software

NASA Astrophysics Data System (ADS)

Shao, Hongbing

Software testing with scientific software systems often suffers from test oracle problem, i.e., lack of test oracles. Amsterdam discrete dipole approximation code (ADDA) is a scientific software system that can be used to simulate light scattering of scatterers of various types. Testing of ADDA suffers from "test oracle problem". In this thesis work, I established a testing framework to test scientific software systems and evaluated this framework using ADDA as a case study. To test ADDA, I first used CMMIE code as the pseudo oracle to test ADDA in simulating light scattering of a homogeneous sphere scatterer. Comparable results were obtained between ADDA and CMMIE code. This validated ADDA for use with homogeneous sphere scatterers. Then I used experimental result obtained for light scattering of a homogeneous sphere to validate use of ADDA with sphere scatterers. ADDA produced light scattering simulation comparable to the experimentally measured result. This further validated the use of ADDA for simulating light scattering of sphere scatterers. Then I used metamorphic testing to generate test cases covering scatterers of various geometries, orientations, homogeneity or non-homogeneity. ADDA was tested under each of these test cases and all tests passed. The use of statistical analysis together with metamorphic testing is discussed as a future direction. In short, using ADDA as a case study, I established a testing framework, including use of pseudo oracles, experimental results and the metamorphic testing techniques to test scientific software systems that suffer from test oracle problems. Each of these techniques is necessary and contributes to the testing of the software under test.

Diagnostic challenges of early Lyme disease: Lessons from a community case series

PubMed Central

2009-01-01

Background Lyme disease, the most common vector-borne infection in North America, is increasingly reported. When the characteristic rash, erythema migrans, is not recognized and treated, delayed manifestations of disseminated infection may occur. The accuracy of diagnosis and treatment of early Lyme disease in the community is unknown. Methods A retrospective, consecutive case series of 165 patients presenting for possible early Lyme disease between August 1, 2002 and August 1, 2007 to a community-based Lyme referral practice in Maryland. All patients had acute symptoms of less than or equal to 12 weeks duration. Patients were categorized according to the Centers for Disease Control and Prevention criteria and data were collected on presenting history, physical findings, laboratory serology, prior diagnoses and prior treatments. Results The majority (61%) of patients in this case series were diagnosed with early Lyme disease. Of those diagnosed with early Lyme disease, 13% did not present with erythema migrans; of those not presenting with a rash, 54% had been previously misdiagnosed. Among those with a rash, the diagnosis of erythema migrans was initially missed in 23% of patients whose rash was subsequently confirmed. Of all patients previously misdiagnosed, 41% had received initial antibiotics likely to be ineffective against Lyme disease. Conclusion For community physicians practicing in high-risk geographic areas, the diagnosis of Lyme disease remains a challenge. Failure to recognize erythema migrans or alternatively, viral-like presentations without a rash, can lead to missed or delayed diagnosis of Lyme disease, ineffective antibiotic treatment, and the potential for late manifestations. PMID:19486523

Early detection of probable idiopathic Parkinson's disease: I. development of a diagnostic test battery.

PubMed

Montgomery, Erwin B; Koller, William C; LaMantia, Theodora J K; Newman, Mary C; Swanson-Hyland, Elizabeth; Kaszniak, Alfred W; Lyons, Kelly

2000-05-01

We developed a test battery as an inexpensive and objective aid for the early diagnosis of idiopathic Parkinson's disease (iPD) and its differential diagnoses. The test battery incorporates tests of motor function, olfaction, and mood. In the motor task, a wrist flexion-and-extension task to different targets, movement velocities were recorded. Olfaction was tested with the University of Pennsylvania Smell Identification Test. Mood was assessed with the Beck Depression Inventory. An initial regression model was developed from the results of 19 normal control subjects and 18 patients with early, mild, probable iPD. Prospective application to an independent validation set of 122 normal control subjects and 103 patients resulted in an 88% specificity rate and 69% sensitivity rate, with an area under the Receiver Operator Characteristic curve of 0.87. Copyright © 2000 Movement Disorder Society.

TIRS Cryocooler: Spacecraft Integration and Test and Early Flight Data

NASA Technical Reports Server (NTRS)

Boyle, R.; Marquardt, E.

2013-01-01

The Thermal Infrared Sensor (TIRS) is an instrument on Landsat 8, launched in February 2013. The focal plane is cooled by a two-stage Ball Aerospace Stirling cycle cryocooler, with a coldfinger operating at 40K. This paper describes events during the spacecraft integration and test program, and results from early orbit operation of the cryocooler.

Occult Blood Testing for Early Detection of Colorectal Cancer: Diagnostic Outcomes

PubMed Central

Hislop, T. Gregory; Morrison, Brenda J.; Hoogewerf, Peter E.; Burns, Sheilagh D.; Sizto, Ronald

1987-01-01

Three thousand five hundred and fifty-four asymptomatic persons from 32 family practices returned hemoccult II tests for colorectal cancer; 2.2% of these returned tests were positive. The diagnoses for the 47 persons with positive tests which were done while on meat restriction included six cancers (1.7/1000) and five polyps (1.4/1000); 18 were diagnosed with other known sources, and 18 were undiagnosed. All polyps and four of six cancers were diagnosed by combined barium enema with sigmoidoscopy or by colonoscopy. Five of six cancers were diagnosed at early stages. Meat restriction, the method of returning the test for analysis, the number of holes completed in the test, and the delay time from completing the test to analysis did not influence the likelihood of a positive test. PMID:20469468

Maternal hair testing for the assessment of fetal exposure to drug of abuse during early pregnancy: Comparison with testing in placental and fetal remains.

PubMed

Falcon, M; Pichini, S; Joya, J; Pujadas, M; Sanchez, A; Vall, O; García Algar, O; Luna, A; de la Torre, R; Rotolo, M C; Pellegrini, M

2012-05-10

Drug use by pregnant women in the first trimester of pregnancy and subsequent fetal exposure during early gestation can be assessed only by repetitive/systematic maternal blood/urine analysis or segmental hair analysis. No evidence of any relationship between maternal/fetal exposure during this specific period of gestation has been demonstrated to date in a human model. To clarify drugs toxicokinetics and transplacental passage during early pregnancy, the presence of the most widely used recreational drugs of abuse and metabolites was investigated in the proximal 4cm hair segments of women undergoing voluntary termination of pregnancy (n=280) during the 12th week of gestation and the results were compared to those from placenta and fetal tissue samples in order to verify whether maternal hair testing can reflect fetal exposure and, if so, to what extent. Hair, placenta and fetal remains were analyzed by validated gas chromatography mass spectrometry assays. Eighty one positive hair samples were identified: 60 were positive for cannabis (74.1%), 28 for cocaine (34.6%), 7 for opiates (8.6%), 3 for MDMA (3.7%) and 18.5% were positive for more than one drug. The positive hair test results were confirmed in placenta/fetal tissues in 10 cases out of 60 for cannabis (16. 7%); in 7 out of 28 for cocaine (25%); and none for the 6 opiates positive cases and 3 MDMA cases, respectively. Drugs/metabolites in hair of pregnant women can be used as biomarkers of past drug use (repetitive or sporadic), although the use is not always reflected in fetal/placental tissues. There are several possible hypotheses to explain the results: (1) the use occurred before the start of pregnancy, (2) past sporadic consumption which could be measured in hair but not in fetal and placental remains because of the narrow window of drug detection in placental/fetal tissues; (3) the sensitivity of the analytical methods was not high enough for the detection of the minute amount of drugs of abuse and

Distance to testing sites and its association with timing of HIV diagnosis.

PubMed

Cope, Anna B; Powers, Kimberly A; Serre, Marc L; Escamilla, Veronica; Emch, Michael E; Leone, Peter A; Mobley, Victoria L; Miller, William C

2016-11-01

Early HIV diagnosis enables prompt treatment initiation, thereby contributing to decreased morbidity, mortality, and transmission. We aimed to describe the association between distance from residence to testing sites and HIV disease stage at diagnosis. Using HIV surveillance data, we identified all new HIV diagnoses made at publicly funded testing sites in central North Carolina during 2005-2013. Early-stage HIV was defined as acute HIV (antibody-negative test with a positive HIV RNA) or recent HIV (normalized optical density <0.8 on the BED assay for non-AIDS cases); remaining diagnoses were considered post-early-stage HIV. Street distance between residence at diagnosis and (1) the closest testing site and (2) the diagnosis site was dichotomized at 5 miles. We fit log-binomial models using generalized estimating equations to estimate prevalence ratios (PR) and robust 95% confidence intervals (CI) for post-early-stage diagnoses by distance. Models were adjusted for race/ethnicity and testing period. Most of the 3028 new diagnoses were black (N = 2144; 70.8%), men who have sex with men (N = 1685; 55.7%), and post-early-stage HIV diagnoses (N = 2010; 66.4%). Overall, 1145 (37.8%) cases traveled <5 miles for a diagnosis. Among cases traveling ≥5 miles for a diagnosis, 1273 (67.6%) lived <5 miles from a different site. Residing ≥5 miles from a testing site was not associated with post-early-stage HIV (adjusted PR, 95% CI: 0.98, 0.92-1.04), but traveling ≥5 miles for a diagnosis was associated with higher post-early HIV prevalence (1.07, 1.02-1.13). Most of the elevated prevalence observed in cases traveling ≥5 miles for a diagnosis occurred among those living <5 miles from a different site (1.09, 1.03-1.16). Modest increases in post-early-stage HIV diagnosis were apparent among persons living near a site, but choosing to travel longer distances to test. Understanding reasons for increased travel distances could improve accessibility and

Implementing an Early Intervention Program for Residential Students Who Present with Suicide Risk: A Case Study

ERIC Educational Resources Information Center

Rivero, Estela M.; Cimini, M. Dolores; Bernier, Joseph E.; Stanley, Judith A.; Murray, Andrea D.; Anderson, Drew A.; Wright, Heidi R.

2014-01-01

Objective: This case study examined the effects of an early intervention program designed to respond to residential college students demonstrating risk for suicide. Participants: Participants were 108 undergraduates at a large northeastern public university referred to an early intervention program subsequent to presenting with risk factors for…

Establishing tools for early diagnosis of congenital toxoplasmosis: Flow cytometric IgG avidity assay as a confirmatory test for neonatal screening.

PubMed

de Castro Zacche-Tonini, Aline; Fonseca, Giuliana Schmidt França; de Jesus, Laura Néspoli Nassar Pansini; Barros, Geisa Baptista; Coelho-Dos-Reis, Jordana Grazziela Alves; Béla, Samantha Ribeiro; Machado, Anderson Silva; Carneiro, Ana Carolina Aguiar Vasconcelos; Andrade, Gláucia Manzan Queiroz; Vasconcelos-Santos, Daniel Vitor; Januário, José Nélio; Teixeira-Carvalho, Andréa; Vitor, Ricardo Wagner Almeida; Ferro, Eloísa Amália Vieira; Mineo, José Roberto; Martins-Filho, Olindo Assis; Lemos, Elenice Moreira

2017-12-01

The aim of this study was to evaluate the performance of conventional serology (Q-Preven™ and ELFAVIDAS™) and flow cytometry-based serologic tools for early serologic diagnosis of congenital toxoplasmosis. The study groups included prospectively confirmed cases of congenital toxoplasmosis (TOXO=88) and age-matching non-infected controls (NI=15).The results demonstrated that all samples tested positive/indeterminate for anti-T. gondii IgM screening at birth using air-dried whole blood samples. Serum samples collected at 30-45days after birth tested positive for ELFAVIDAS™ IgG in both groups. While all NI tested negative for ELFAVIDAS™ IgM and IgA, only 78% and 36% of TOXO tested positive for IgM and IgA, respectively. Flow cytometry-based anti-T. gondii IgM, IgA and IgG reactivity displayed moderate performance with low sensitivity (47.6%, 72.6% and 75.0%, respectively). Regardless the remarkable specificity of IgG1, IgG2 and IgG3 subclasses for early diagnosis, weak or moderate specificity was observed (Se=73.9%, 60.2% and 83.0%, respectively). The analysis of IgG avidity indices (AI) demonstrated the highest performance among the flow cytometry-based methods (Se=96.6%; Sp=93.3%), underscoring the low avidity index (AI<60%) within TOXO (97.0%) in contrast with the high avidity index (AI>60%) in NI (93%). Analysis of anti-T. gondii IgG and IgG3 reactivity for mother:infant paired samples may represent a relevant complementary tests for early diagnosis. In conclusion, a feasible high-standard algorithm (Accuracy=97.1%) was proposed consisting of Q-Preven™ IgM screening at birth, followed by ELFAVIDAS™ IgM and flow cytometric IgG avidity analysis at 30-45days after birth as a high performance tool for early serological diagnosis of congenital toxoplasmosis. Copyright © 2017. Published by Elsevier B.V.

Early Human Testing Initiative Phase 1 Regenerative Life Support Systems

NASA Image and Video Library

1995-08-08

Early Human Testing (EHT) Initiative Phase 1 Regenerative Life Support Systems Laboratory (RLSSL). Nigel Packham activities in the Variable Pressure Growth Chamber which he lived inside for 15 days. A crowd of well-wishers outside the test chamber, at the console are John Lewis, Ed Mohr and Marybeth Edeen (15577). Packham exiting the chamber (15578-81). Packham is the focus of television cameras and reporters (15582-3). Don Henninger interviewed by reporters (15584). Packham is presented with a jacket after his stay in the chamber (15585). Packham inside the wheat growth chamber checking the condition of the plants (15586-7, 15597). Packham exercising on a recumbant bicycle (15588, 15592). Packham, through the window into the growth chamber, displays a handful of wheat plants to console monitor Dan Barta (15589-90). Group portrait of the team conducting the Early Human Testing Initiative Phase 1 Regenerative Life Support Systems test and include, front row, from left: Jeff Dominick and Don Overton and back row, from left, unidentified member, Marybeth Edeen, Nigel Packham, John Lewis, Ed Mohr, Dan Barta and Tim Monk (15591). Harry Halford prepares to send a package through the airlock to Packham (15593). Packham displays a handful of wheat plants (15594). Packham fixes himself a bowl of cereal (15595) and retrieves a carton of milk from the refrigerator (15596). Packham retrieves a package from the airlock (15598). Packham packs up trash in plastic bag (15599-600) and sends it back through the airlock (15601). Packham gets a cup of water (15602) and heats it in the microwave (15603).

Artificial receptors in serologic tests for the early diagnosis of dengue virus infection.

PubMed

Tai, Dar-Fu; Lin, Chung-Yin; Wu, Tzong-Zeng; Huang, Jyh-Hsiung; Shu, Pei-Yun

2006-08-01

Because of the range and nonspecificity of clinical presentations of dengue virus infections, we felt there was a need to create diagnostic tests. We used artificial receptors for the virus to develop serologic assays to detect dengue virus infection. We coated a quartz crystal microbalance (QCM) with molecularly imprinted polymers specific for nonstructural protein 1 of flavivirus. These artificial receptors were specifically created on a QCM chip by polymerization of monomers and were cross-linked in the presence of the epitope site of nonstructural protein 1. We tested serum samples from patients with confirmed cases of dengue reported to the Center for Disease Control in Taipei. Samples were diluted 100-fold; no other sample pretreatment was used. The QCM response was compared with results of monoclonal ELISA. QCM signals were >15 Hz in 18 of 21 (86%) of dengue samples and in 0 of 16 control samples. The correlation (r2) of the QCM response and the ELISA result was 0.73. Within-run and run-to-run imprecisions (CV) were 4%-28% and 10%-32%, respectively. The described assay offers a serologic technique for diagnosis of early viremia. The results illustrate the potential of well-organized polymers on the highly sensitive sensor system for diagnostic and biotechnological applications.

The Development and Testing of a New Measure of Early Childhood Education Organizational Conditions

ERIC Educational Resources Information Center

Ehrlich, Stacy B.; Pacchiano, Debra M.; Luppescu, Stuart; Stein, Amanda

2016-01-01

The current study sought to scientifically adapt the existing five essentials teacher survey and develop a new parent survey, and pilot test them for use in early childhood education settings. The adaptation and development of these "Early Education Surveys" occurred in 2014-15, was based strongly on Bryk et al.'s (2010) existing…

The Early Start Denver Model: A Case Study of an Innovative Practice

ERIC Educational Resources Information Center

Vismara, Laurie A.; Rogers, Sally J.

2008-01-01

Intervention was implemented with an infant identified at 9 months of age with a behavioral profile consistent with autistic spectrum disorder. The intervention approach, the Early Start Denver model, consisted of a 12-week, 1.5-hr-per-week individualized parent-child education program. Results of this case study demonstrated that the parent…

Testing Verlinde's emergent gravity in early-type galaxies

NASA Astrophysics Data System (ADS)

Tortora, C.; Koopmans, L. V. E.; Napolitano, N. R.; Valentijn, E. A.

2018-01-01

Emergent Gravity (EG) has been proposed to resolve the missing mass problem in galaxies, replacing the potential of dark matter (DM) by the effect of the entropy displacement of dark energy by baryonic matter. This apparent DM depends only on the baryonic mass distribution and the present-day value of the Hubble parameter. In this paper we test the EG proposition, formalized by Verlinde for a spherical and isolated mass distribution using the central dynamics (Sloan Digital Sky Survey velocity dispersion, σ) and the K-band light distribution in a sample of 4032 massive (M_{\\star }≳ 10^{10} M_{⊙}) and local early-type galaxies (ETGs) from the SPIDER datasample. Our results remain unaltered if we consider the sample of 750 roundest field galaxies. Using these observations we derive the predictions by EG for the stellar mass-to-light ratio (M/L) and the initial mass function (IMF). We demonstrate that, consistently with a classical Newtonian framework with a DM halo component or alternative theories of gravity as MOdified Newtonian Dynamics (MOND), the central dynamics can be fitted if the IMF is assumed non-universal and systematically changing with σ. For the case of EG, we find lower, but still acceptable, stellar M/L if compared with the DM-based Navarro, Frenk & White (NFW) model and with MOND, but pretty similar to adiabatically contracted DM haloes and with expectations from spectral gravity-sensitive features. If the strain caused by the entropy displacement would be not maximal, as adopted in the current formulation, then the dynamics of ETGs could be reproduced with larger M/L.

Genetic characterization drives personalized therapy for early-stage non-small-cell lung cancer (NSCLC) patients and survivors with metachronous second primary tumor (MST): A case report.

PubMed

Ding, Xingchen; Wang, Linlin; Liu, Xijun; Sun, Xindong; Yu, Jinming; Meng, Xue

2017-03-01

The pathogenesis and progression of lung cancer is a complicated process in which many genes take part. But molecular gene testing is typically only performed in advanced-stage non-squamous non-small-cell lung cancer (NSCLC). The value of tyrosine kinase inhibitors (TKI) administration is not widely recognized with respect to early-stage NSCLC. Here, we present a case of a man, heavy smoker who initially presented with stage IA lung adenocarcinoma (LADC). Three years after a lung lobectomy, he was diagnosed with advanced lung squamous cell carcinoma (SCC), according to laboratory, imaging, and pathological examinations. The case initially had an early-stage LADC with an L858R epidermal growth factor receptor (EGFR) mutation. A subsequent advanced SCC bearing EGFR L858R/T790M mutations occurred 3 years after surgery. The comprehensive therapy we utilized, including surgical resection for the early-stage lesion and GP chemotherapy and local radiotherapy as the first line therapy along with gefitinib maintenance treatment for the advanced metachronous second primary tumors (MST). The synthetical therapy, have resulted in our patient with remaining alive and progression free for 4.5 years. This case suggests that changes in molecular pathology should be monitored closely throughout cancer progression to guide personalized therapy and improve prognosis. We further review administration of TKI to early-stage NSCLC and to the metachronous second primary tumors (MST) in survivors.

Early onset dementia in New Zealand Pacific boxers: a case series.

PubMed

Payman, Vahid; Yates, Susan; Cullum, Sarah

2018-05-04

To describe the biopsychosocial characteristics of a series of Pacific men living in South Auckland with a history of boxing presenting with early onset dementia. We discuss the history of boxing in Pacific people and the possibility of increased risk of early onset dementia in New Zealand Pacific men compared to their European counterparts. We reviewed the files of Pacific men with a history of amateur or professional boxing who presented to our memory and older adult mental health services with early onset dementia over a 45-month period. We gathered relevant information to construct a biopsychosocial paradigm as possible explanation of this phenomenon. We identified a series of eight New Zealand Pacific men with early onset dementia and with a history of boxing. Alcohol was a contributing factor in seven of the eight cases, and vascular risk factors in five. Historical, cultural and socio-economic factors underpin the attraction of some Pacific men to boxing as a sport. Given that New Zealand Pacific peoples may have an earlier onset of dementia than their European counterparts, further research is required to establish whether boxing is a contributory factor. Sports physicians should advise young New Zealand Pacific boxers about the long-term risks associated with their sport.

[The early pregnancy factor (EPF) as an early marker of disorders in pregnancy].

PubMed

Straube, W; Römer, T; Zeenni, L; Loh, M

1995-01-01

The early pregnancy factor (EPF) seems to be very helpful in clinical applications such as early detection of pregnancy, differential diagnosis of failure of fertilization or implementation and prognosis of a fertilized ovum. Our purpose was to investigate the diagnostic value of single and serial measurement of EPF, especially in the differential diagnosis of abortion and extrauterine pregnancy. Women with a history of 6-16 weeks amenorrhoea with/without vaginal bleeding were included in the prospective study. The EPF-test system was carried out by means of the rosette inhibition method. EPF proved to be always positive in normal pregnant women and always negative in nonpregnant controls. In case of threatened abortion the prognosis was good, when the EPF values were positive, and poor when they became negative. Patients suffering from spontaneous and missed abortion mostly showed negative EPF-values. This was also true in ectopic pregnancies. The sensitivity and specificity of EPF-test system were 83%. The positive predictive value was observed to be 54% and the negative predictive value 95%. The EPF as an early embryonic signal may be a suitable parameter for the clinical use detecting pregnancy disturbances very early.

Creation and pilot testing of cases for case-based learning: A pedagogical approach for pathology cancer diagnosis.

PubMed

Sayed, Shahin; Lester, Susan C; Wilson, Michael; Berney, Daniel; Masia, Ricard; Moloo, Zahir; Stall, Jennifer; Eslan, Alexia; Ayers, Stephanie; Mutuku, Angela; Guarner, Jeannette

2017-01-01

Case-based learning (CBL) is an established pedagogical active learning method used in various disciplines and defined based on the field of study and type of case. The utility of CBL for teaching specific aspects of cancer diagnosis to practising pathologists has not been previously studied in sub-Saharan Africa. We aimed to pilot test standardised cancer cases on a group of practising pathologists in sub-Saharan Africa to evaluate case content, clarity of questions and delivery of content. Expert faculty created cases for the four most commonly diagnosed cancers. The format included mini-cases and bullet cases which were all open-ended. The questions dealt with interpretation of clinical information, gross specimen examination, morphologic characteristics of tumours, ancillary testing, reporting and appropriate communication to clinicians. Cases on breast, cervical, prostate and colorectal cancers were tested on seven practising pathologists. Each case took an average of 45-90 min to complete.Questions that were particularly challenging to testers were on: Specimens they should have been but for some reason were not exposed to in routine practice.Ancillary testing and appropriate tumour staging.New knowledge gained included tumour grading and assessment of radial margins. Revisions to cases were made based on testers' feedback, which included rewording of questions to reduce ambiguity and adding of tables to clarify concepts. Cases were created for CBL in Kenya, but these are applicable elsewhere in Africa and beyond to teach cancer diagnosis. The pilot testing of cases prepared faculty for the actual CBL course and feedback provided by the testers assisted in improving the questions and impact on day-to-day practice.

Creation and pilot testing of cases for case-based learning: A pedagogical approach for pathology cancer diagnosis

PubMed Central

Wilson, Michael; Masia, Ricard; Moloo, Zahir; Stall, Jennifer; Eslan, Alexia; Ayers, Stephanie; Mutuku, Angela

2017-01-01

Background Case-based learning (CBL) is an established pedagogical active learning method used in various disciplines and defined based on the field of study and type of case. The utility of CBL for teaching specific aspects of cancer diagnosis to practising pathologists has not been previously studied in sub-Saharan Africa. Objectives We aimed to pilot test standardised cancer cases on a group of practising pathologists in sub-Saharan Africa to evaluate case content, clarity of questions and delivery of content. Methods Expert faculty created cases for the four most commonly diagnosed cancers. The format included mini-cases and bullet cases which were all open-ended. The questions dealt with interpretation of clinical information, gross specimen examination, morphologic characteristics of tumours, ancillary testing, reporting and appropriate communication to clinicians. Results Cases on breast, cervical, prostate and colorectal cancers were tested on seven practising pathologists. Each case took an average of 45–90 min to complete. Questions that were particularly challenging to testers were on: Specimens they should have been but for some reason were not exposed to in routine practice.Ancillary testing and appropriate tumour staging. New knowledge gained included tumour grading and assessment of radial margins. Revisions to cases were made based on testers’ feedback, which included rewording of questions to reduce ambiguity and adding of tables to clarify concepts. Conclusion Cases were created for CBL in Kenya, but these are applicable elsewhere in Africa and beyond to teach cancer diagnosis. The pilot testing of cases prepared faculty for the actual CBL course and feedback provided by the testers assisted in improving the questions and impact on day-to-day practice. PMID:29147646

Development and feasibility of smartphone application for cognitive-behavioural case management of individuals with early psychosis.

PubMed

Kim, Sung-Wan; Lee, Ga-Young; Yu, Hye-Young; Jung, Eun-I; Lee, Ju-Yeon; Kim, Seon-Young; Kim, Jae-Min; Shin, Il-Seon; Yoon, Jin-Sang

2017-05-18

This article describes the development of the smartphone application for cognitive-behavioural case management of young individuals with early psychosis and examines the acceptance and potential clinical benefits of this application through a pilot survey. Gwangju Bukgu-Community Mental Health Center developed and launched a smartphone application (Heal Your Mind [HYM]) for cognitive-behavioural case management and symptom monitoring. The HYM application for clients includes 6 main modules including thought record, symptom record, daily life record, official notices, communication and scales. The key module is the "thought record" for self-directed cognitive-behavioural treatment. When the client writes and sends the self-cognitive-behavioural therapy sheet to the case manager, the latter receives a notification and can provide feedback in real time. We conducted a survey to investigate the acceptance and feasibility of this approach among young clients with early psychosis. A total of 24 clients with early psychosis participated in this survey. More than 80% of participants reported that it was easy to learn to use this application, and no one described this application as very complicated or reported that they needed a long time to learn how to use it. About 80% of participants were satisfied with this application, and 70% reported that they received help as a result of using this application. This study suggests that this smartphone application is useful for young individuals with early psychosis and that it may contribute to the development of both young customer- and case manager-friendly systems for this clinical population. © 2017 John Wiley & Sons Australia, Ltd.

Increased Syphilis Testing of Men Who Have Sex With Men: Greater Detection of Asymptomatic Early Syphilis and Relative Reduction in Secondary Syphilis.

PubMed

Chow, Eric P F; Callander, Denton; Fairley, Christopher K; Zhang, Lei; Donovan, Basil; Guy, Rebecca; Lewis, David A; Hellard, Margaret; Read, Phillip; Ward, Alison; Chen, Marcus Y

2017-08-01

Syphilis rates have increased markedly among men who have sex with men (MSM) internationally. We examined trends in syphilis testing and detection of early syphilis among MSM in Australia. Serial cross-sectional analyses on syphilis testing and diagnoses among MSM attending a national sentinel network of 46 clinics in Australia between 2007 and 2014. 359313 clinic visits were included. The proportion of MSM serologically tested for syphilis annually increased in HIV-negative (48% to 91%; Ptrend < .0001) and HIV-positive MSM (42% to 77%; Ptrend < .0001). The mean number of tests per man per year increased from 1.3 to 1.6 in HIV-negative MSM (Ptrend < .0001) and from 1.6 to 2.3 in HIV-positive MSM (Ptrend < .0001). 2799 and 1032 syphilis cases were detected in HIV-negative and HIV-positive MSM, respectively. Among HIV-negative MSM, the proportion of infections that were early latent increased from 27% to 44% (Ptrend < .0001), while the proportion that were secondary decreased from 24% to 19% (Ptrend = .030). Among HIV-positive MSM, early latent infections increased from 23% to 45% (Ptrend < .0001), while secondary infections decreased from 45% to 26% (Ptrend = .0003). Among HIV-positive MSM, decreasing secondary syphilis correlated with increasing testing coverage (r = -0.87; P = .005) or frequency (r = -0.93; P = .001). Increases in syphilis screening were associated with increased detection of asymptomatic infectious syphilis and relative falls in secondary syphilis for both HIV-positive and HIV-negative MSM nationally, suggesting interruption of syphilis progression. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

Developing and testing an Early Warning System for Non Indigenous Species and Ballast Water Management

NASA Astrophysics Data System (ADS)

Magaletti, Erika; Garaventa, Francesca; David, Matej; Castriota, Luca; Kraus, Romina; Luna, Gian Marco; Silvestri, Cecilia; Forte, Cosmo; Bastianini, Mauro; Falautano, Manuela; Maggio, Teresa; Rak, Giulietta; Gollasch, Stephan

2018-03-01

This paper describes the methodological approach used for the development of an Early Warning System (EWS) for Non Indigenous Species (NIS) and ballast water management and summarizes the results obtained. The specific goals of the EWS are firstly to warn vessels to prevent loading of ballast water when critical biological conditions occur in ports and surrounding areas i.e. mass development or blooms of Harmful Aquatic Organisms and Pathogens (HAOP). Secondly, to warn environmental and health authorities when NIS or pathogens are present in ports or surrounding areas to enable an early response and an implementation of remediation measures. The EWS is designed to be used for implementing various parallel obligations, by taking into consideration different legal scopes, associated information and decision-making needs. The EWS was elaborated, tested in the Adriatic Sea and illustrated by two case studies. Although the EWS was developed with an Adriatic Sea focus, it is presented in a format so that it may be used as a model when establishing similar systems in other locations. The role of the various actors is discussed and recommendations on further developments of the EWS are presented. It was concluded that the EWS is a suitable tool to reduce the spread of potentially harmful and ballast water mediated species.

Dynamic test results for the CASES ground experiment

NASA Technical Reports Server (NTRS)

Bukley, Angelia P.; Patterson, Alan F.; Jones, Victoria L.

1993-01-01

The Controls, Astrophysics, and Structures Experiment in Space (CASES) Ground Test Facility (GTF) has been developed at Marshall Space Flight Center (MSFC) to provide a facility for the investigation of Controls/Structures Interaction (CSI) phenomena, to support ground testing of a potential shuttle-based CASES flight experiment, and to perform limited boom deployment and retraction dynamics studies. The primary objectives of the ground experiment are to investigate CSI on a test article representative of a Large Space Structure (LSS); provide a platform for Guest Investigators (GI's) to conduct CSI studies; to test and evaluate LSS control methodologies, system identification (ID) techniques, failure mode analysis; and to compare ground test predictions and flight results. The proposed CASES flight experiment consists of a 32 meter deployable/retractable boom at the end of which is an occulting plate. The control objective of the experiment is to maintain alignment of the tip plate (occulter) with a detector located at the base of the boom in the orbiter bay. The tip plate is pointed towards a star, the sun, or the galactic center to collect high-energy X-rays emitted by these sources. The tip plate, boom, and detector comprise a Fourier telescope. The occulting holes in the tip plate are approximately one millimeter in diameter making the alignment requirements quite stringent. Control authority is provided by bidirectional linear thrusters located at the boom tip and Angular Momentum Exchange Devices (AMED's) located at mid-boom and at the tip. The experiment embodies a number of CSI control problems including vibration suppression, pointing a long flexible structure, and disturbance rejection. The CASES GTF is representative of the proposed flight experiment with identical control objectives.

Cost-effectiveness of an autoantibody test (EarlyCDT-Lung) as an aid to early diagnosis of lung cancer in patients with incidentally detected pulmonary nodules.

PubMed

Edelsberg, John; Weycker, Derek; Atwood, Mark; Hamilton-Fairley, Geoffrey; Jett, James R

2018-01-01

Patients who have incidentally detected pulmonary nodules and an estimated intermediate risk (5-60%) of lung cancer frequently are followed via computed tomography (CT) surveillance to detect nodule growth, despite guidelines for a more aggressive diagnostic strategy. We examined the cost-effectiveness of an autoantibody test (AABT)-Early Cancer Detection Test-Lung (EarlyCDT-LungTM)-as an aid to early diagnosis of lung cancer among such patients. We developed a decision-analytic model to evaluate use of the AABT versus CT surveillance alone. In the model, patients with a positive AABT-because they are at substantially enhanced risk of lung cancer-are assumed to go directly to biopsy, resulting in diagnosis of lung cancer in earlier stages than under current guidelines (a beneficial stage shift). Patients with a negative AABT, and those scheduled for CT surveillance alone, are assumed to have periodic CT screenings to detect rapid growth and thus to have their lung cancers diagnosed-on average-at more advanced stages. Among 1,000 patients who have incidentally detected nodules 8-30 mm, have an intermediate-risk of lung cancer, and are evaluated by CT surveillance alone, 95 (9.5%) are assumed to have lung cancer (local, 73.6%; regional, 22.0%; distant, 4.4%). With use of the AABT set at a sensitivity/specificity of 41%/93% (stage shift = 10.8%), although expected costs would be higher by $949,442 ($949 per person), life years would be higher by 53 (0.05 per person), resulting in a cost per life-year gained of $18,029 and a cost per quality-adjusted life year (QALY) gained of $24,330. With use of the AABT set at a sensitivity/specificity of 28%/98% (stage shift = 7.4%), corresponding cost-effectiveness ratios would be $18,454 and $24,833. Under our base-case assumptions, and reasonable variations thereof, using AABT as an aid in the early diagnosis of lung cancer in patients with incidentally detected pulmonary nodules who are estimated to be at intermediate risk of

Early detection: the impact of genomics.

PubMed

van Lanschot, M C J; Bosch, L J W; de Wit, M; Carvalho, B; Meijer, G A

2017-08-01

The field of genomics has shifted our view on disease development by providing insights in the molecular and functional processes encoded in the genome. In the case of cancer, many alterations in the DNA accumulate that enable tumor growth or even metastatic dissemination. Identification of molecular signatures that define different stages of progression towards cancer can enable early tumor detection. In this review, the impact of genomics will be addressed using early detection of colorectal cancer (CRC) as an example. Increased understanding of the adenoma-to-carcinoma progression has led to the discovery of several diagnostic biomarkers. This combined with technical advancements, has facilitated the development of molecular tests for non-invasive early CRC detection in stool and blood samples. Even though several tests have already made it to clinical practice, sensitivity and specificity for the detection of precancerous lesions still need improvement. Besides the diagnostic qualities, also the accuracy of the intermediate endpoint is an important issue on how the effectiveness of a novel test is perceived. Here, progression biomarkers may provide a more precise measure than the currently used morphologically based features. Similar developments in biomarker use for early detection have taken place in other cancer types.

Early genetic testing of coastal Douglas-fir for Swiss needle cast tolerance.

Treesearch

Fatih Temel; G.R. Johnson; W.T. Adams

2005-01-01

The possibility of early testing coastal Douglas-fir (Pseudotsuga menziesii var. menziesii (Mirb.) Franco) for Swiss needle cast (SNC; caused by Phaeocryptopus gaeumannii (Rohde) Petrak) tolerance was investigated using 55 Douglas-fir families from western Oregon. Seedlings were inoculated with P...

Early Orthodontic Tooth Movement into Regenerative Bony Defects: A Case Report.

PubMed

Tsai, Hui-Chen; Yao, Chung-Chen Jane; Wong, Man-Ying

Early orthodontic tooth movement following regenerative surgery is controversial. In this case, during protraction of the maxillary right first premolar to substitute for the long-term missing maxillary right canine, Bio-Oss and Bio-Gide were used for lateral ridge augmentation at the area of the maxillary right lateral incisor and to cover the denuded surface at the buccal side of the first premolar. Orthodontic tooth movement (OTM) commenced 2 weeks after regenerative surgery. After 8 months, new bone formation was observed on the root surface of the first premolar during implant surgery. A cone beam computed tomography scan taken 1.5 years postsurgery revealed good maintenance of regenerative bone at the same site. This satisfactory outcome of early OTM following regenerative surgery suggests biomechanical stimulation may not jeopardize the regenerative effect.

[Risk factors for patent ductus arteriosus in early preterm infants: a case-control study].

PubMed

Du, Jin-Feng; Liu, Tian-Tian; Wu, Hui

2016-01-01

To investigate the risk factors for the occurrence of patent ductus arteriosus (PDA) and to provide a clinical basis for reducing the occurrence of PDA in early preterm infants. A total of 136 early preterm infants (gestational age≤32 weeks) who were hospitalized between January 2013 and December 2014 and diagnosed with hemodynamicalhy significant PDA (hs-PDA) were enrolled as the case group. Based on the matched case-control principle, 136 early preterm infants without hs-PDA were selected among those who were hospitalized within the same period at a ratio of 1:1 and enrolled as the control group. The two groups were matched for sex and gestational age. The basic information of neonates and maternal conditions during the pregnancy and perinatal periods were collected. Logistic regression analysis was performed to identify the risk factors for the development of PDA. Univariate analysis showed that neonatal infectious diseases, neonatal respiratory distress syndrome, decreased platelet count within 24 hours after birth, and low birth weight were associated with the development of hs-PDA (P<0.05). Multivariate conditional logistic regression analysis revealed that neonatal infectious diseases (OR=2.368) and decreased platelet count within 24 hours after birth (OR=0.996) were independent risk factors for hs-PDA. Neonatal infectious diseases and decreased platelet count within 24 hours after birth increase the risk of hs-PDA in early preterm infants.

Teaching and Testing Early Reading. Focus On

ERIC Educational Resources Information Center

Mraz, Maryann; Kissel, Brian

2007-01-01

This issue of "Focus On" provides an overview of several key early literacy components: phonemic awareness, alphabet knowledge, concepts of print, oral language development, writing, family literacy, and reading aloud. Suggestions for assessing early literacy development are provided, and examples of implementation of effective early literacy…

[Chickenpox case estimation in acyclovir pharmacy survey and early bioterrorism detection].

PubMed

Sugawara, Tamie; Ohkusa, Yasushi; Kawanohara, Hirokazu; Taniguchi, Kiyosu; Okabe, Nobuhiko

2011-11-01

Early potential health hazards and bioterrorism threats require early detection. Smallpox cases caused by terrorist could, for example, be treated by prescribing acyclovir to those having fever and vesicle exanthema diagnosed as chicken pox. We have constructed real-time pharmacy surveillance scenarios using information technology (IT) to monitor acyclovir prescription. We collected the number of acyclovir prescriptions from 5138 pharmacies using the Application Server Provider System (ASP) to estimate the number of cases. We then compared the number of those given acyclovir under 15 years old from pharmacy surveillance and sentinel surveillance for chickenpox under the Infection Disease Control Law. The estimated number of under 15 years old prescribed acyclovir in pharmacy surveillance resembled sentinel surveillance results and showed a similar seasonal chickenpox pattern. The correlation coefficient was 0.8575. The estimated numbers of adults, older than 15 but under 65 years old, and elderly, older than 65, prescribed acyclovir showed no clear seasonal pattern. Pharmacy surveillance for acyclovir identified the baseline and can be used to detect unusual chickenpox outbreak. Bioterrorism attack could potentially be detected using smallpox virus when acyclovir prescription for adults suddenly increases without outbreaks in children or the elderly. This acyclovir prescription monitoring such as an application is, to our knowledge, the first of its kind anywhre.

An optimal ultrasonographic diagnostic test for early gout: A prospective controlled study

PubMed Central

Petraitis, Mykolas; Apanaviciene, Indre; Virviciute, Dalia; Baranauskaite, Asta

2017-01-01

Objective To identify the optimal sites for classification of early gout by ultrasonography. Methods Sixty patients with monosodium urate crystal-proven gout (25 with early gout [≤2-year symptom duration], 35 with late gout [>2-year symptom duration], and 36 normouricemic healthy controls) from one centre were prospectively evaluated. Standardized blinded ultrasound examination of 36 joints and the triceps and patellar tendons was performed to identify tophi and the double contour (DC) sign. Results Ultrasonographic sensitivity was lower in early than late gout. Binary logistic regression analysis showed that two ultrasonographic signs (tophi in the first metatarsophalangeal joint [odds ratio, 16.46] and the DC sign in the ankle [odds ratio, 25.18]) significantly contributed to the final model for early gout diagnosis (sensitivity and specificity of 84% and 81%, respectively). The inter-reader reliability kappa value for the DC sign and tophi was 0.712. Conclusions Four-joint investigation (both first metatarsophalangeal joints for tophi and both ankles for the DC sign) is feasible and reliable and could be proposed as a screening test for early ultrasonographic gout classification in daily practice. PMID:28617199

An optimal ultrasonographic diagnostic test for early gout: A prospective controlled study.

PubMed

Norkuviene, Eleonora; Petraitis, Mykolas; Apanaviciene, Indre; Virviciute, Dalia; Baranauskaite, Asta

2017-08-01

Objective To identify the optimal sites for classification of early gout by ultrasonography. Methods Sixty patients with monosodium urate crystal-proven gout (25 with early gout [≤2-year symptom duration], 35 with late gout [>2-year symptom duration], and 36 normouricemic healthy controls) from one centre were prospectively evaluated. Standardized blinded ultrasound examination of 36 joints and the triceps and patellar tendons was performed to identify tophi and the double contour (DC) sign. Results Ultrasonographic sensitivity was lower in early than late gout. Binary logistic regression analysis showed that two ultrasonographic signs (tophi in the first metatarsophalangeal joint [odds ratio, 16.46] and the DC sign in the ankle [odds ratio, 25.18]) significantly contributed to the final model for early gout diagnosis (sensitivity and specificity of 84% and 81%, respectively). The inter-reader reliability kappa value for the DC sign and tophi was 0.712. Conclusions Four-joint investigation (both first metatarsophalangeal joints for tophi and both ankles for the DC sign) is feasible and reliable and could be proposed as a screening test for early ultrasonographic gout classification in daily practice.

[A Case of Early Gastric Cancer with Nodular Tumor-like Scalp Metastasis].

PubMed

Song, Young Wook; Kim, Woo Sub; Yun, Gee Young; Park, Sun Wook; Kang, Sun Hyung; Moon, Hee Seok; Sung, Jae Kyu; Jeong, Hyun Yong

2016-07-25

Many neoplasms, including lung cancer, breast cancer, melanoma, and gastrointestinal tract malignancy, possess potential for skin metastasis. Skin metastases can represent the first presentation of such malignancies and may be observed incidentally during routine exam. Skin metastases from gastric adenocarcinoma are uncommon, with a prevalence rate of 0.04-0.8%. Cutaneous metastases from gastric cancer are generally observed as the initial symptom of advanced gastric cancer. Early detection and treatment can increase patient survival. A 42-year-old woman visited our department with nodule about 1 cm in size on the right frontal scalp noticed incidentally after laparoscopy-assisted distal gastrectomy and adjuvant systemic chemo-therapy for early gastric cancer about 16 months prior. The patient was diagnosed with skin metastasis from gastric adenocarcinoma. Complete excision of the skin lesion and additional chemotherapy were performed. Herein, we report a case of nodular tumor-like scalp metastasis from early gastric cancer with a brief review of the literature.

Case Study of Tenure-Track Early Career Faculty in a College of Education

ERIC Educational Resources Information Center

Esping, Gretchen Revay

2010-01-01

This dissertation examines an understudied group according to the American Council on Education: the tenure-track early career faculty (ECF). The focus is on the culturalization, socialization, academic culture, and emergent themes discerned from ten semi-structured interviews with tenure-track ECF. This qualitative bounded system case study…

Early testing of new sanitation technology for urban slums: The case of the Blue Diversion Toilet.

PubMed

Tobias, Robert; O'Keefe, Mark; Künzle, Rahel; Gebauer, Heiko; Gründl, Harald; Morgenroth, Eberhard; Pronk, Wouter; Larsen, Tove A

2017-01-15

The toilets used most in informal urban settlements have detrimental consequences for the environment and human health due to the lack of proper collection and treatment of toilet waste. Concepts for safe, sustainable and affordable sanitation systems exist, but their feasibility and acceptance have to be investigated at an early stage of development, which is difficult due to the high costs of building working models. In this paper, we present an approach to estimate acceptance in a valid and representative form with only one working model, and apply it to test an innovative zero-emission toilet with recycling of wash water. Four basic principles were specified for investigation and nine hypotheses formulated to test the feasibility and acceptance of these principles: source separation of urine and feces with subsequent collection for resource recovery; provision of wash water in a separate cycle with on-site recovery through a membrane bioreactor; a convenient and attractive overall design; and a financially sustainable business plan. In Kampala (Uganda), in 2013, data was collected from 22 regular users, 308 one-time users and a representative sample of 1538 participants. Qualitative data was collected from the users, who evaluated their likes, perceived benefits, social norms and expected ease of use based on verbal and visual information. Most of the hypotheses were confirmed, indicating the feasibility and acceptance of the basic principles. Source separation and on-site water recovery were found to be feasible and accepted, provided users can be convinced that the emptying service and water recovery process work reliably. In the survey, the toilet was evaluated favorably and 51% of the participants agreed to be placed on a bogus waiting list. However, some design challenges were revealed, such as the size of the toilet, hiding feces from view and improving the separation of urine and water. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights

Undisplaced Intraoperative Fracture Presenting as Early Dislocation with Tapered Wedge Stems in Total Hip Arthroplasty - Case Series and Review of Literature

PubMed Central

Reddy, A V Gurava; Eachempati, Krishna Kiran; Mugalur, Aakash; Suchinder, A; Rao, V B N Prasad; Kamurukuru, Nalanda

2017-01-01

Introduction: Periprosthetic fractures and dislocation in the early post-operative period can be disastrous both for the surgeon and the patient. However, undisplaced periprosthetic fractures presenting with dislocation is uncommon. We describe successful management of two cases (one bilateral dislocation and one unilateral dislocation) of undisplaced iatrogenic fractures in total hip arthroplasty (THA) presenting as early dislocation. Case Report: Case 1 was a 45-year-old female with osteoarthritis of hip secondary to developmental dysplasia of the hip with bilateral early nontraumatic dislocation with bilateral identical periprosthetic fracture. It was managed by revision to long stem and encirclage wiring. Case 2 presented with early dislocation in the 2nd week post THA. We found an intertrochanteric fracture intra-operatively with unstable implant. Acetabular component and femoral component revision were done with reconstruction of the greater trochanter. Discussion: These fractures could be occult iatrogenic fractures characteristic of taper wedge stems which presented as early nontraumatic dislocation in the post-operative period. The prosthesis subsidence, loss of muscle tension and change of version might be the factors leading to dislocation. Conclusion: Unrecognized incomplete intraoperative fracture can occur with tapered wedge uncemented stems which can present as a dislocation in the immediate post-operative period. This will require early revision of the femoral component. PMID:29051875

Is MSAFP still a useful test for detecting open neural tube defects and ventral wall defects in the era of first-trimester and early second-trimester fetal anatomical ultrasounds?

PubMed

Roman, Ashley S; Gupta, Simi; Fox, Nathan S; Saltzman, Daniel; Klauser, Chad K; Rebarber, Andrei

2015-01-01

To evaluate whether maternal serum α-fetoprotein (MSAFP) improves the detection rate for open neural tube defects (ONTDs) and ventral wall defects (VWD) in patients undergoing first-trimester and early second-trimester fetal anatomical survey. A cohort of women undergoing screening between 2005 and 2012 was identified. All patients were offered an ultrasound at between 11 weeks and 13 weeks and 6 days of gestational age for nuchal translucency/fetal anatomy followed by an early second-trimester ultrasound at between 15 weeks and 17 weeks and 6 days of gestational age for fetal anatomy and MSAFP screening. All cases of ONTD and VWD were identified via query of billing and reporting software. Sensitivity and specificity for detection of ONTD/VWD were calculated, and groups were compared using the Fisher exact test, with p < 0.05 as significance. A total of 23,790 women met the criteria for inclusion. Overall, 15 cases of ONTD and 17 cases of VWD were identified; 100% of cases were diagnosed by ultrasound prior to 18 weeks' gestation; none were diagnosed via MSAFP screening (p < 0.001). First-trimester and early second-trimester ultrasound had 100% sensitivity and 100% specificity for diagnosing ONTD/VWD. Ultrasound for fetal anatomy during the first and early second trimester detected 100% of ONTD/VWD in our population. MSAFP is not useful as a screening tool for ONTD and VWD in the setting of this ultrasound screening protocol. © 2014 S. Karger AG, Basel.

[High-risk HPV genotyping PCR testing as a means of cervical cancer and precancerous lesions early screening].

PubMed

Ma, Li; Cong, Xiao; Bian, Meilu; Shi, Mai; Wang, Xiuhong; Liu, Jun; Liu, Haiyan

2015-04-01

To explored high-risk HPV genotyping PCR testing whether as a feasible means for the early screening of cervical cancer and precancerous lesions. From January 2013 to June 2014, 15,192 outpatients in China-Japan Friendship Hospital voluntary were tested by high-risk type HPV genotyping PCR. The average age of them were (33±8) years old. High-risk HPV types genotyping PCR tested by fluorescence PCR technology, in which 13 kinds of high-risk HPV subtypes were detected, including HPV16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59 and 68. A total of 4,315 cases of them were tested by the liquid-based cytology (LCT), among them with positive of high-risk HPV genotyping tested by PCR (n=2,366) were biopsy under colposcope (648 cases) in those LCT results were positive or LCT negative but HPV16 positive or LCT negative but had the clear clinical symptoms or and non-HPV16 positive but with clear clinical symptoms. (1) Analysis high-risk HPV infection status of 15 192 women. (2) As the pathological diagnosis was the gold standard in the diagnosis of cervical lesions, analysis of the relationship among high-risk HPV infection, virus loads and cervical lesions. (3) To evaluated the value of high-risk HPV genotyping PCR tested method in screening of cervical cancer and precancerous lesions. ⑴ Of 15,192 cases tested by high-risk HPV genotyping PCR, 2,366 cases were HPV positive (HPV infection), the overall infection rate was 15.57% (2,366/15,192), in which a single subtype of HPV infection in 1,767 cases, infection rate was 11.63% (1,767/15,192), and multiple subtypes of HPV infection (two and more subtypes HPV infection) in 599 cases, infection rate was 3.94% (599/15,192). The HPV16, 52 and 58 infections were the most common HPV subtypes in 13 subtypes, the infection rate was 3.95% (600/15,192), 2.86% (435/15,192) and 2.67% (406/15,192), respectively. (2) The most relevant subtypes with cervical intraepithelial neoplasia (CIN) II and even higher lesion were HPV16, 52 and 58

Early Warning Signals of Social Transformation: A Case Study from the US Southwest

PubMed Central

2016-01-01

Recent research in ecology suggests that generic indicators, referred to as early warning signals (EWS), may occur before significant transformations, both critical and non-critical, in complex systems. Up to this point, research on EWS has largely focused on simple models and controlled experiments in ecology and climate science. When humans are considered in these arenas they are invariably seen as external sources of disturbance or management. In this article we explore ways to include societal components of socio-ecological systems directly in EWS analysis. Given the growing archaeological literature on ‘collapses,’ or transformations, in social systems, we investigate whether any early warning signals are apparent in the archaeological records of the build-up to two contemporaneous cases of social transformation in the prehistoric US Southwest, Mesa Verde and Zuni. The social transformations in these two cases differ in scope and severity, thus allowing us to explore the contexts under which warning signals may (or may not) emerge. In both cases our results show increasing variance in settlement size before the transformation, but increasing variance in social institutions only before the critical transformation in Mesa Verde. In the Zuni case, social institutions appear to have managed the process of significant social change. We conclude that variance is of broad relevance in anticipating social change, and the capacity of social institutions to mitigate transformation is critical to consider in EWS research on socio-ecological systems. PMID:27706200

Early Warning Signals of Social Transformation: A Case Study from the US Southwest.

PubMed

Spielmann, Katherine A; Peeples, Matthew A; Glowacki, Donna M; Dugmore, Andrew

2016-01-01

Recent research in ecology suggests that generic indicators, referred to as early warning signals (EWS), may occur before significant transformations, both critical and non-critical, in complex systems. Up to this point, research on EWS has largely focused on simple models and controlled experiments in ecology and climate science. When humans are considered in these arenas they are invariably seen as external sources of disturbance or management. In this article we explore ways to include societal components of socio-ecological systems directly in EWS analysis. Given the growing archaeological literature on 'collapses,' or transformations, in social systems, we investigate whether any early warning signals are apparent in the archaeological records of the build-up to two contemporaneous cases of social transformation in the prehistoric US Southwest, Mesa Verde and Zuni. The social transformations in these two cases differ in scope and severity, thus allowing us to explore the contexts under which warning signals may (or may not) emerge. In both cases our results show increasing variance in settlement size before the transformation, but increasing variance in social institutions only before the critical transformation in Mesa Verde. In the Zuni case, social institutions appear to have managed the process of significant social change. We conclude that variance is of broad relevance in anticipating social change, and the capacity of social institutions to mitigate transformation is critical to consider in EWS research on socio-ecological systems.

BRCA1 and BRCA2 mutation analysis of early-onset and familial breast cancer cases in Mexico.

PubMed

Ruiz-Flores, Pablo; Sinilnikova, Olga M; Badzioch, Michael; Calderon-Garcidueñas, A L; Chopin, Sandrine; Fabrice, Odefrey; González-Guerrero, J F; Szabo, Csilla; Lenoir, Gilbert; Goldgar, David E; Barrera-Saldaña, Hugo A

2002-12-01

The entire coding regions of BRCA1 and BRCA2 were screened for mutations by heteroduplex analysis in 51 Mexican breast cancer patients. One BRCA1 and one BRCA2 truncating mutation each was identified in the group of 32 (6%) early-onset breast cancer patients (< or =35 years). Besides these two likely deleterious mutations, eight rare variants of unknown significance, mostly in the BRCA2 gene, were detected in six of 32 (19%) early-onset breast cancer cases and in three of 17 (18%) site-specific breast cancer families, one containing a male breast cancer case. No mutations or rare sequence variants have been identified in two additional families including each an early-onset breast cancer case and an ovarian cancer patient. The two truncating mutations (BRCA1 3857delT; BRCA2 2663-2664insA) and six of the rare variants have never been reported before and may be of country-specific origin. The majority of the alterations appeared to be distinct, with only one of them being observed in more than one family. Copyright 2002 Wiley-Liss, Inc.

BEAT: A Web-Based Boolean Expression Fault-Based Test Case Generation Tool

ERIC Educational Resources Information Center

Chen, T. Y.; Grant, D. D.; Lau, M. F.; Ng, S. P.; Vasa, V. R.

2006-01-01

BEAT is a Web-based system that generates fault-based test cases from Boolean expressions. It is based on the integration of our several fault-based test case selection strategies. The generated test cases are considered to be fault-based, because they are aiming at the detection of particular faults. For example, when the Boolean expression is in…

A Case Study: Testing in the Albuquerque Public Schools.

ERIC Educational Resources Information Center

Robinson, Carol

1983-01-01

This case study of testing in the Albuquerque public schools highlights improvement of test results dissemination and use through cooperative planning, integrated database development, and a partnership with public media. (Author)

Risk factors for early miscarriage among Chinese: a hospital-based case-control study.

PubMed

Xu, Guangli; Wu, Yiming; Yang, Liming; Yuan, Lu; Guo, Huafeng; Zhang, Fuqing; Guan, Yichun; Yao, Wu

2014-06-01

To investigate the risk factors for early miscarriage among Chinese women. Hospital-based matched case-control study. Academic medical center and maternal health hospital. 620 women with early miscarriage (less than 13 weeks of gestation) and 1,240 normal pregnant women. Face-to-face questionnaire. Multivariable conditional odds ratio (OR) and 95% confidence interval (CI) to measure risk factors. After adjustment for confounding factors, the following were independently associated with increased risk: history of miscarriage, repeated induced abortion, working night shifts, and frequent staying up late. Vitamin supplementation and regular physical activity reduced the risk of miscarriage. We did not find paternal age, alcohol consumption, or smoking status to be linked with early miscarriage. Our findings suggest that a healthy diet, regular physical activity, and planned pregnancy may be advantageous for women in pre-pregnancy or early pregnancy. Induced abortion, working night shifts, and frequent staying up late were associated with an increased risk of miscarriage. Further work in larger populations is warranted. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Test Anxiety in Mathematics among Early Undergraduate Students in a British University in Malaysia

ERIC Educational Resources Information Center

Karjanto, Natanael; Yong, Su Ting

2013-01-01

The level of test anxiety in mathematics subjects among early undergraduate students at the University of Nottingham Malaysia Campus is studied in this article. The sample consists of 206 students taking several mathematics modules who completed the questionnaires on test anxiety just before they entered the venue for midterm examinations. The…

Organising, Providing and Evaluating Technical Training for Early Career Researchers: A Case Study

ERIC Educational Resources Information Center

van Besouw, Rachel M.; Rogers, Katrine S.; Powles, Christopher J.; Papadopoulos, Timos; Ku, Emery M.

2013-01-01

This paper considers the importance of providing technical training opportunities for Early Career Researchers (ECRs) worldwide through the case study of a MATLAB training programme, which was proposed, organised, managed and evaluated by a team of five ECRs at the University of Southampton. The effectiveness of the programme in terms of the…

Supernumerary Teeth in Primary Dentition and Early Intervention: A Series of Case Reports

PubMed Central

Bahadure, Rakesh N.; Thosar, Nilima; Jain, Eesha S.; Kharabe, Vidhi; Gaikwad, Rahul

2012-01-01

Supernumerary teeth are considered as one of the most significant dental anomalies during the primary and early mixed dentition stages. They are of great concern to the dentists and parents because of the eruption, occlusal, and esthetic problems they can cause. Supernumerary teeth occur more frequently in the permanent dentition but rarely in primary dentition. Mesiodens is the most common type of supernumerary teeth but rarely seen in lower arch. Early recognition and diagnosis of supernumerary teeth is important to prevent further complications in permanent dentition. Four cases of supernumerary teeth with mesiodens in upper and lower arch in primary dentition and their management have been discussed. PMID:22888456

[The importance of early diagnosis and intervention in children diagnosed with reading disorder. Case studies].

PubMed

Törö, Krisztina; Balázs, Judit

2015-06-01

Reading Disorder (RD) belongs to Specific Learning Disorders within the chapter of Neurodevelopmental Disorders in the Diagnostic and Statistic Manual of Mental Disorders 5th edition. Previous research shows that the time of the diagnosis of RD - early (before starting school) or late - has a great impact on the prognosis. In the current paper we present the cases of two children diagnosed with RD. Our cases demonstrate that if RD is diagnosed in early childhood, the child's and his/her family's quality of life can be influenced in a positive direction, while late recognition of RD might influence the child's and the family's quality of life negatively. For these reasons it is important that experts recognize RD in time, start appropriate treatment and give proper support to children diagnosed with RD and their families.

The early identification of psychosis: Can lessons be learnt from Cardiac Stress Testing?

PubMed Central

Gupta, Swapnil; Ranganathan, Mohini; D’Souza, Deepak Cyril

2015-01-01

Psychotic disorders including schizophrenia are amongst the most debilitating psychiatric disorders. There is an urgent need to develop methods to identify individuals at risk with greater precision and as early as possible. At present, a prerequisite for a diagnosis of schizophrenia is the occurrence of a psychotic episode. Therefore, attempting to detect schizophrenia on the basis of psychosis is analogous to diagnosing coronary artery disease (CAD) after the occurrence of a myocardial infarction (MI). The introduction of cardiac stress testing (CST) has revolutionized the detection of CAD and the prevention and management of angina and MI. In this paper we attempt to apply lessons learnt from cardiac stress testing to the early detection of psychosis by proposing the development of an analogous psychosis stress test. We discuss in detail the various parameters of a proposed psychosis stress test including the choice of a suitable psychological or psychopharmacological “stressor”, target population, outcome measures, safety of the approach and the necessary evolution of test to become clinically informative. The history of evolution of CST may guide the development of a similar approach for the detection and management of psychotic disorders. The initial development of a test to unmask latent risk for schizophrenia will require the selection of a suitable and safe stimulus and the development of outcome measures as a prelude to testing in populations with a range of risk to determine predictive value. The use of cardiac stress testing in coronary artery disease offers the intriguing possibility that a similar approach may be applied to the detection and management of schizophrenia. PMID:26566609

A five-year model to assess the early cost-effectiveness of new diagnostic tests in the early diagnosis of rheumatoid arthritis.

PubMed

Buisman, Leander R; Luime, Jolanda J; Oppe, Mark; Hazes, Johanna M W; Rutten-van Mölken, Maureen P M H

2016-06-10

There is a lack of information about the sensitivity, specificity and costs new diagnostic tests should have to improve early diagnosis of rheumatoid arthritis (RA). Our objective was to explore the early cost-effectiveness of various new diagnostic test strategies in the workup of patients with inflammatory arthritis (IA) at risk of having RA. A decision tree followed by a patient-level state transition model, using data from published literature, cohorts and trials, was used to evaluate diagnostic test strategies. Alternative tests were assessed as add-on to or replacement of the ACR/EULAR 2010 RA classification criteria for all patients and for intermediate-risk patients. Tests included B-cell gene expression (sensitivity 0.60, specificity 0.90, costs €150), MRI (sensitivity 0.90, specificity 0.60, costs €756), IL-6 serum level (sensitivity 0.70, specificity 0.53, costs €50) and genetic assay (sensitivity 0.40, specificity 0.85, costs €750). Patients with IA at risk of RA were followed for 5 years using a societal perspective. Guideline treatment was assumed using tight controlled treatment based on DAS28; if patients had a DAS28 >3.2 at 12 months or later patients could be eligible for starting biological drugs. The outcome was expressed in incremental cost-effectiveness ratios (€2014 per quality-adjusted life year (QALY) gained) and headroom. The B-cell test was the least expensive strategy when used as an add-on and as replacement in intermediate-risk patients, making it the dominant strategy, as it has better health outcomes and lower costs. As add-on for all patients, the B-cell test was also the most cost-effective test strategy. When using a willingness-to-pay threshold of €20,000 per QALY gained, the IL-6 and MRI strategies were not cost-effective, except as replacement. A genetic assay was not cost-effective in any strategy. Probabilistic sensitivity analysis revealed that the B-cell test was consistently superior in all strategies. When

Early diagnosis in glaucoma.

PubMed

Garway-Heath, David F

2008-01-01

This chapter reviews the evidence for the clinical application of vision function tests and imaging devices to identify early glaucoma, and sets out a scheme for the appropriate use and interpretation of test results in screening/case-finding and clinic settings. In early glaucoma, signs may be equivocal and the diagnosis is often uncertain. Either structural damage or vision function loss may be the first sign of glaucoma; neither one is consistently apparent before the other. Quantitative tests of visual function and measurements of optic-nerve head and retinal nerve fiber layer anatomy are useful to either raise or lower the probability that glaucoma is present. The posttest probability for glaucoma may be calculated from the pretest probability and the likelihood ratio of the diagnostic criterion, and the output of several diagnostic devices may be combined to achieve a final probability. However, clinicians need to understand how these diagnostic devices make their measurements, so that the validity of each test result can be adequately assessed. Only then should the result be used, together with the patient history and clinical examination, to derive a diagnosis.

Mobile phone base stations and early childhood cancers: case-control study.

PubMed

Elliott, Paul; Toledano, Mireille B; Bennett, J; Beale, L; de Hoogh, K; Best, N; Briggs, D J

2010-06-22

To investigate the risk of early childhood cancers associated with the mother's exposure to radiofrequency from and proximity to macrocell mobile phone base stations (masts) during pregnancy. Case-control study. Cancer registry and national birth register data in Great Britain. 1397 cases of cancer in children aged 0-4 from national cancer registry 1999-2001 and 5588 birth controls from national birth register, individually matched by sex and date of birth (four controls per case). Incidence of cancers of the brain and central nervous system, leukaemia, and non-Hodgkin's lymphomas, and all cancers combined, adjusted for small area measures of education level, socioeconomic deprivation, population density, and population mixing. Mean distance of registered address at birth from a macrocell base station, based on a national database of 76,890 base station antennas in 1996-2001, was similar for cases and controls (1107 (SD 1131) m v 1073 (SD 1130) m, P=0.31), as was total power output of base stations within 700 m of the address (2.89 (SD 5.9) kW v 3.00 (SD 6.0) kW, P=0.54) and modelled power density (-30.3 (SD 21.7) dBm v -29.7 (SD 21.5) dBm, P=0.41). For modelled power density at the address at birth, compared with the lowest exposure category the adjusted odds ratios were 1.01 (95% confidence interval 0.87 to 1.18) in the intermediate and 1.02 (0.88 to 1.20) in the highest exposure category for all cancers (P=0.79 for trend), 0.97 (0.69 to 1.37) and 0.76 (0.51 to 1.12), respectively, for brain and central nervous system cancers (P=0.33 for trend), and 1.16 (0.90 to 1.48) and 1.03 (0.79 to 1.34) for leukaemia and non-Hodgkin's lymphoma (P=0.51 for trend). There is no association between risk of early childhood cancers and estimates of the mother's exposure to mobile phone base stations during pregnancy.

Implementation of maternal blood cell-free DNA testing in early screening for aneuploidies.

PubMed

Gil, M M; Quezada, M S; Bregant, B; Ferraro, M; Nicolaides, K H

2013-07-01

To explore the feasibility of routine maternal blood cell-free (cf) DNA testing in screening for trisomies 21, 18 and 13 at 10 weeks' gestation. In this prospective study, women attending The Fetal Medicine Centre in London, UK, between October 2012 and April 2013, with singleton pregnancy and live fetus with CRL 32-45 mm, were screened for trisomies 21, 18 and 13 by cfDNA testing at 10 weeks and the combined test at 12 weeks. cfDNA testing was performed in 1005 singleton pregnancies with a median maternal age of 37 (range, 20-49) years. Risks for trisomies were provided for 957 (95.2%) cases and in 98.0% these were available within 14 days from sampling. In 48 (4.8%) cases no result was provided due to problems with delivery to the laboratory, low fetal fraction or assay failure. Repeat sampling was performed in 40 cases and a result obtained in 27 (67.5%) of these. In 11 cases the risk score for trisomy 21 and in five cases that for trisomy 18 was > 99%, in one the risk for trisomy 13 was 34% and in 968 the risk for each of the three trisomies was < 0.01%. The suspected trisomies were confirmed by karyotyping after chorionic villus sampling (CVS), except in one case of trisomy 18 in which the karyotype was normal. On the basis of the maternal age distribution of the study population, the expected and observed numbers for each of the three trisomies were similar. Both cfDNA and combined testing detected all trisomies, but the estimated false-positive rates (FPR) were 0.1% and 3.4%, respectively. Routine screening for trisomies 21, 18 and 13 by cfDNA testing at 10 weeks is feasible and has a lower FPR than does combined testing, but abnormal results require confirmation by CVS. Copyright © 2013 ISUOG. Published by John Wiley & Sons, Ltd.

A prevalence-based association test for case-control studies.

PubMed

Ryckman, Kelli K; Jiang, Lan; Li, Chun; Bartlett, Jacquelaine; Haines, Jonathan L; Williams, Scott M

2008-11-01

Genetic association is often determined in case-control studies by the differential distribution of alleles or genotypes. Recent work has demonstrated that association can also be assessed by deviations from the expected distributions of alleles or genotypes. Specifically, multiple methods motivated by the principles of Hardy-Weinberg equilibrium (HWE) have been developed. However, these methods do not take into account many of the assumptions of HWE. Therefore, we have developed a prevalence-based association test (PRAT) as an alternative method for detecting association in case-control studies. This method, also motivated by the principles of HWE, uses an estimated population allele frequency to generate expected genotype frequencies instead of using the case and control frequencies separately. Our method often has greater power, under a wide variety of genetic models, to detect association than genotypic, allelic or Cochran-Armitage trend association tests. Therefore, we propose PRAT as a powerful alternative method of testing for association.

Severe subarachnoid hemorrhage associated with cerebral venous thrombosis in early pregnancy: a case report.

PubMed

Yamamoto, Junkoh; Kakeda, Shingo; Takahashi, Mayu; Idei, Masaru; Nakano, Yoshiteru; Soejima, Yoshiteru; Saito, Takeshi; Akiba, Daisuke; Shibata, Eiji; Korogi, Yukunori; Nishizawa, Shigeru

2013-12-01

Cerebral venous thrombosis (CVT) rarely induces subarachnoid hemorrhage (SAH). During late pregnancy and puerperium, CVT is an uncommon but important cause of stroke. However, severe SAH resulting from CVT is extremely rare during early pregnancy. We report on a rare case of severe SAH due to CVT, and discuss the potential pitfalls of CVT diagnosis in early pregnancy. A 32-year-old pregnant woman (9th week of pregnancy) presented with slight head dullness. Initial magnetic resonance imaging (MRI) revealed focal, abnormal signal intensity in the left thalamus. Nine days later, the patient developed a generalized seizure and severe SAH was detected with computed tomography (CT) scan. MRI and cerebral angiography revealed a completely thrombosed superior sagittal sinus, vein of Galen, straight sinus, and right transverse sinus. Transvaginal sonography indicated a missed abortion. The day after admission, the patient presented again with a progressive loss of consciousness and signs of herniation. The patient underwent emergency decompressive craniotomy, followed by intrauterine curettage. Two months later, she made an excellent recovery except for a slight visual field defect. A rare case of severe SAH due to CVT is reported, with emphasis on the potential pitfalls of CVT diagnosis in early pregnancy. Copyright © 2013 Elsevier Inc. All rights reserved.

High-Definition transcranial direct current stimulation in early onset epileptic encephalopathy: a case study.

PubMed

Meiron, Oded; Gale, Rena; Namestnic, Julia; Bennet-Back, Odeya; David, Jonathan; Gebodh, Nigel; Adair, Devin; Esmaeilpour, Zeinab; Bikson, Marom

2018-01-01

Early onset epileptic encephalopathy is characterized by high daily seizure-frequency, multifocal epileptic discharges, severe psychomotor retardation, and death at infancy. Currently, there are no effective treatments to alleviate seizure frequency and high-voltage epileptic discharges in these catastrophic epilepsy cases. The current study examined the safety and feasibility of High-Definition transcranial direct current stimulation (HD-tDCS) in reducing epileptiform activity in a 30-month-old child suffering from early onset epileptic encephalopathy. HD-tDCS was administered over 10 intervention days spanning two weeks including pre- and post-intervention video-EEG monitoring. There were no serious adverse events or side effects related to the HD-tDCS intervention. Frequency of clinical seizures was not significantly reduced. However, interictal sharp wave amplitudes were significantly lower during the post-intervention period versus baseline. Vital signs and blood biochemistry remained stable throughout the entire study. These exploratory findings support the safety and feasibility of 4 × 1 HD-tDCS in early onset epileptic encephalopathy and provide the first evidence of HD-tDCS effects on paroxysmal EEG features in electroclinical cases under the age of 36 months. Extending HD-tDCS treatment may enhance electrographic findings and clinical effects.

Vertical parasagittal hemispherotomy for Sturge-Weber syndrome in early infancy: case report and literature review.

PubMed

Liu, Xiangyu; Otsuki, Taisuke; Takahashi, Akio; Kaido, Takanobu

2016-01-01

The authors here present a rare case of a 3-month-old infant with unilateral Sturge-Weber syndrome (SWS) who had excellent seizure control and no aggravation of previous existed neurological deficits after vertical parasagittal hemispherotomy (VPH). To our knowledge, this patient with SWS was the youngest one who received VPH. The use of VPH results in a successful treatment of intractable epilepsy in a patient with seizure onset in early infancy. At follow-up, the patient's neurodevelopmental status has been improved since the surgery. It is generally accepted that early-onset seizures in children with SWS are associated with worse neurological and developmental outcomes. However, when surgical treatment should be considered and how it should be performed remain a longstanding controversy. We promote early surgery in children with SWS and early-onset epilepsy. We suggest that VPH may be a useful adjuvant in the management of SWS with refractory epilepsy in early infancy and this procedure carries low neurological risk.

Lanthony 15-Hue Desaturated Test for screening of early color vision defects in uncomplicated juvenile diabetes.

PubMed

Giusti, C

2001-01-01

To identify the most appropriate test for screening of early color vision abnormalities in uncomplicated juvenile diabetes. Enrolled in this study were 39 diabetic adolescents, characterized by optimal Early Treatment Diabetic Retinopathy Study criteria for visual acuity, transparent dioptric means and angiographically normal retinas. Color vision was examined with Standard Pseudoisochromatic Plates (Part 2, SPP2), Roth 28-Hue Test (R28), Farnsworth-Munsell 100-Hue Tests (FM100), and Lanthony 15-Hue Desaturated Test (L15). Color confusion score (CCS) and desaturation angle (DSAT) were measured on L15 only. Thirty-nine normal subjects served as a control group. Poor metabolic control was an exclusion criteria. CCS was significantly higher in the patients than in the controls (37.8 +/- 11.1 vs 0 +/- P < .001) and normal scores were found in only 4 diabetic patients. DSAT values were spread, not showing a well-defined axis of the defect. The results of FM100 were clinically reliable but affected by a longer execution time. R28 and SPP2 demonstrated a low sensitivity, as all patients scored normally with both tests. Impaired color vision is a common observation even in patients with uncomplicated juvenile diabetes. Our results indicate that L15 is the most suitable test for screening of early color vision abnormalities in these subjects.

Early flowering and seed production in a yellow birch progeny test

Treesearch

Knud E. Clausen

1976-01-01

Trees in a yellow birch progeny test began to bear seed when 7 years old and the proportion of fruiting trees increased in the following 2 years. Male catkins were produced at age 8 and the number of trees with males increased greatly the following years. Although there is much variation between and within families in earliness of flowering and in number of flowers and...

GPs views and understanding of PSA testing, screening and early detection; survey.

PubMed

Sutton, J; Melia, J; Kirby, M; Graffy, J; Moss, S

2016-05-01

There is currently no national prostate cancer screening programme in the UK. However, patients 50 years and older are entitled to a prostate specific antigen (PSA) test, if informed on the advantages and disadvantages of testing and their risk of cancer. The Prostate Cancer Risk Management Programme (PCRMP) provides this guidance. The aim of this study was to access GPs' views and understanding of PSA testing, prostate cancer screening and early detection. A total of 708 questionnaires were returned by GPs across two English regions in 2013 and the GP questionnaire responses were quantitatively analysed. In the 699 completed questionnaires, the majority of GPs were well informed about PSA testing, screening and early detection. Only 32% used guidelines for referral, 14% knew all age-specific PSA referral levels, 71% that Black men have a higher prostate cancer risk than White men (22% correctly answered threefold increase) and 82% that family history is a risk factor. A further 78% thought electronic prompts during consultation would encourage PCRMP guideline usage and 75% had never been offered a PSA test and prostate cancer educational course, of which 73% would like to attend a course. Only 23% were aware of the latest PSA screening evidence and 94% would like an update. Participating GPs seem to be well informed but need more information and tools to help follow recommended guidance. In particular, increased awareness of PCRMP guidelines especially by automated methods, further educational courses and evidence updates would be beneficial. © 2016 John Wiley & Sons Ltd.

Hybridisation or Ousterisation? The Case of Local Accountability Policy in Finnish Early Childhood Education

ERIC Educational Resources Information Center

Paananen, Maiju; Lipponen, Lasse; Kumpulainen, Kristiina

2015-01-01

Drawing on the analytic concept of imaginary, this study investigates policy hybridisation in the Finnish early childhood education. Specifically, it illuminates how the interplay between different imaginaries enabled the neoliberal imaginary to oust the social-democratic imaginary through a tripartite process in a case of local productivity…

Revisiting the Rossby Haurwitz wave test case with contour advection

NASA Astrophysics Data System (ADS)

Smith, Robert K.; Dritschel, David G.

2006-09-01

This paper re-examines a basic test case used for spherical shallow-water numerical models, and underscores the need for accurate, high resolution models of atmospheric and ocean dynamics. The Rossby-Haurwitz test case, first proposed by Williamson et al. [D.L. Williamson, J.B. Drake, J.J. Hack, R. Jakob, P.N. Swarztrauber, A standard test set for numerical approximations to the shallow-water equations on the sphere, J. Comput. Phys. (1992) 221-224], has been examined using a wide variety of shallow-water models in previous papers. Here, two contour-advective semi-Lagrangian (CASL) models are considered, and results are compared with previous test results. We go further by modifying this test case in a simple way to initiate a rapid breakdown of the basic wave state. This breakdown is accompanied by the formation of sharp potential vorticity gradients (fronts), placing far greater demands on the numerics than the original test case does. We also go further by examining other dynamical fields besides the height and potential vorticity, to assess how well the models deal with gravity waves. Such waves are sensitive to the presence or not of sharp potential vorticity gradients, as well as to numerical parameter settings. In particular, large time steps (convenient for semi-Lagrangian schemes) can seriously affect gravity waves but can also have an adverse impact on the primary fields of height and velocity. These problems are exacerbated by a poor resolution of potential vorticity gradients.

Validating an artificial intelligence human proximity operations system with test cases

NASA Astrophysics Data System (ADS)

Huber, Justin; Straub, Jeremy

2013-05-01

An artificial intelligence-controlled robot (AICR) operating in close proximity to humans poses risk to these humans. Validating the performance of an AICR is an ill posed problem, due to the complexity introduced by the erratic (noncomputer) actors. In order to prove the AICR's usefulness, test cases must be generated to simulate the actions of these actors. This paper discusses AICR's performance validation in the context of a common human activity, moving through a crowded corridor, using test cases created by an AI use case producer. This test is a two-dimensional simplification relevant to autonomous UAV navigation in the national airspace.

Pseudohypoparathyroidism Type 1A-Subclinical Hypothyroidism and Rapid Weight Gain as Early Clinical Signs: A Clinical Review of 10 Cases

PubMed Central

Kayemba-Kay’s, Simon; Tripon, Cedric; Heron, Anne; Hindmarsh, Peter

2016-01-01

Objective: To evaluate the clinical signs and symptoms that would help clinicians to consider pseudohypoparathyroidism (PHP) type 1A as a diagnosis in a child. Methods: A retrospective review of the medical records of children diagnosed by erythrocyte Gsα activity and/or GNAS1 gene study and followed-up for PHP type 1A. Clinical and biochemical parameters along with epidemiological data were extracted and analyzed. Weight gain during infancy and early childhood was calculated as change in weight standard deviation score (SDS), using the French growth reference values. An upward gain in weight ≥0.67 SDS during these periods was considered indicative of overweight and/or obesity. Results: Ten cases of PHP type 1A were identified (mean age 41.1 months, range from 4 to 156 months). In children aged ≤2 years, the commonest clinical features were round lunar face, obesity (70%), and subcutaneous ossifications (60%). In older children, brachydactyly was present in 60% of cases. Seizures occurred in older children (3 cases). Short stature was common at all ages. Subclinical hypothyroidism was present in 70%, increased parathormone (PTH) in 83%, and hyperphosphatemia in 50%. Only one case presented with hypocalcemia. Erythrocyte Gsα activity tested in seven children was reduced; GNAS1 gene testing was performed in 9 children. Maternal transmission was the most common (six patients). In three other cases, the mutations were de novo, c.585delGACT in exon 8 (case 2) and c.344C>TP115L in exon 5 (cases 6&7). Conclusion: Based on our results, PHP type 1A should be considered in toddlers presenting with round face, rapid weight gain, subcutaneous ossifications, and subclinical hypothyroidism. In older children, moderate mental retardation, brachydactyly, afebrile seizures, short stature, and thyroid-stimulating hormone resistance are the most suggestive features. PMID:27467896

Modeling old-age wealth with endogenous early-life outcomes: The case of Mexico

PubMed Central

DeGraff, Deborah S.; Wong, Rebeca

2014-01-01

This paper contributes to the literature on the life course and aging by examining the association between early-life outcomes and late-life well being, using data from the Mexican Health and Aging Study. Empirical research in this area has been challenged by the potential endogeneity of the early-life outcomes of interest, an issue which most studies ignore or downplay. Our contribution takes two forms: (1) we examine in detail the potential importance of two key life-cycle outcomes, age at marriage (a measure of family formation) and years of educational attainment (a measure of human capital investment) for old-age wealth, and (2) we illustrate the empirical value of past context variables that could help model the association between early-life outcomes and late-life well being. Our illustrative approach, matching macro-level historical policy and census variables to individual records to use as instruments in modeling the endogeneity of early-life behaviors, yields a statistically identified two-stage model of old-age wealth with minimum bias. We use simulations to show that the results for the model of wealth in old age are meaningfully different when comparing the approach that accounts for endogeneity with an approach that assumes exogeneity of early-life outcomes. Furthermore, our results suggest that in the Mexican case, models which ignore the potential endogeneity of early-life outcomes are likely to under-estimate the effects of such variables on old-age wealth. PMID:25170434

Infant titi monkey behavior in the open field test and the effect of early adversity

PubMed Central

Larke, Rebecca H.; Toubiana, Alice; Lindsay, Katrina A.; Mendoza, Sally P.; Bales, Karen L.

2017-01-01

The open field test is commonly used to measure anxiety-related behavior and exploration in rodents. Here, we used it as a standardized novel environment in which to evaluate the behavioral response of infant titi monkeys (Callicebus cupreus), to determine the effect of presence of individual family members, and to assess how adverse early experience alters infant behavior. Infants were tested in the open field for 5 days at ages 4 and 6 months in four successive 5 min trials on each day. A transport cage, which was situated on one side of the open field, was either empty (non-social control) or contained the father, mother, or sibling. Infant locomotor, vocalization, and exploratory behavior were quantified. Results indicated that age, sex, social condition, and early experience all had significant effects on infant behavior. Specifically, infants were generally more exploratory at 6 months and male infants were more exploratory than females. Infants distinguished between social and non-social conditions but made few behavioral distinctions between the attachment figure and other individuals. Infants which had adverse early life experience demonstrated greater emotional and physical independence, suggesting that early adversity led to resiliency in the novel environment. PMID:28605039

Dental complications of rickets in early childhood: case report on 2 young girls.

PubMed

Davit-Béal, Tiphaine; Gabay, Julie; Antoniolli, Pauline; Masle-Farquhar, Jeanne; Wolikow, Maryse

2014-04-01

Vitamin D is an essential hormone for calcium gut absorption. It is also involved in child growth, cancer prevention, immune system responses, and tooth formation. Due to inadequate vitamin D intake and/or decreased sunlight exposure, vitamin D deficiency has resurfaced in developed countries despite known inexpensive and effective preventive methods. Vitamin D deficiency is a common cause of rickets, a condition that affects bone development in children and that can have serious dental complications. Deficiency during pregnancy can cause enamel hypoplasia of primary teeth. Enamel regeneration is currently impossible; hypoplasia is therefore irreversible, and once affected, teeth are prone to fast caries development. Deficiency during early childhood can affect permanent teeth and ensuing caries can sometimes lead to tooth loss at a young age. Oral manifestations of rickets should be diagnosed early by both physicians and dentists to prevent severe dental complications. This case study presents 2 young girls with rickets in early childhood who suffered from subsequent serious tooth decay.

Perinatal complications associated with autism--a case control study in a neurodevelopment and early intervention clinic.

PubMed

Nath, Saswati; Roy, Rita; Mukherjee, Suchandra

2012-08-01

Early and intensive intervention can have a profound impact on the quality of life for children at risk for autism. Hence a high degree of suspicion towards babies exposed to known risk factors is warranted. Previous studies have shown that different perinatal factors like antepartum bleeding, postmaturity, birth asphyxia, meconium aspiration syndrome, anaemia in early infancy and exposure to toxins of various origins makes an infant susceptible to development of autism; attention deficit hyperactivity disorder (ADHD) and other neurodevelopmental disorders in later life.This study aims to find out the association of perinatal risk factors in relation to development of autism spectrum disorders. All babies who are at least three years of age, attending the neurodevelopment and early intervention clinic at SSKM Hospital at Kolkata taken as cases. Age matched controls were taken from general paediatric OPD of the same hospital. After history taking, physical and neurological examination, developmental maturity was assessed by the Denver Developmental Screening Test (DDST) and Vineland Social Maturity Scale (VSMS). A semi-structured parent's questionnaire and the modified checklist for autism in toddlers (M-CHAT) was used to screen for autism. Diagnosis was confirmed by DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition, Text Revision) criteria. Significant correlation was found between presence of antepartum haemorrhage, pregnancy induced hypertension, preterm delivery and autism in the baby. Perinatal complications are important risk factor for autism. Knowing the risk factors will help clinicians to be aware of the avoidable complications, and to undertake either preventive steps or intense intervention to reduce the degree of disability.

Non-nuclear Testing of Reactor Systems in the Early Flight Fission Test Facilities (EFF-TF)

NASA Technical Reports Server (NTRS)

VanDyke, Melissa; Martin, James

2004-01-01

The Early Flight Fission-Test Facility (EFF-TF) can assist in the &sign and development of systems through highly effective non-nuclear testing of nuclear systems when technical issues associated with near-term space fission systems are "non-nuclear" in nature (e.g. system s nuclear operations are understood). For many systems. thermal simulators can he used to closely mimic fission heat deposition. Axial power profile, radial power profile. and fuel pin thermal conductivity can be matched. In addition to component and subsystem testing, operational and lifetime issues associated with the steady state and transient performance of the integrated reactor module can be investigated. Instrumentation at the EFF-TF allows accurate measurement of temperature, pressure, strain, and bulk core deformation (useful for accurately simulating nuclear behavior). Ongoing research at the EFF-TF is geared towards facilitating research, development, system integration, and system utilization via cooperative efforts with DOE laboratories, industry, universities, and other NASA centers. This paper describes the current efforts for the latter portion of 2003 and beginning of 2004.

Umbilical metastasis derived from early stage rectal cancer: a case report

PubMed Central

2014-01-01

Background Umbilical metastasis, also called Sister Mary Joseph’s nodule (SMJN), is defined as the umbilical nodule associated with advanced metastatic intra-abdominal and pelvic malignancies. A patient with umbilical metastasis has been deemed to have a poor prognosis. Rectal cancer presenting with a SMJN is a rare phenomenon, especially in the early stage and in middle-low rectal cancer. Case presentation We report a case of a 70-year-old male presenting with umbilical metastasis derived from rectal cancer (10 cm from the anal verge, T2N0). Discussion and conclusion For rectal cancer with umbilical metastasis, the exact metastatic routes as well as the criterion of diagnosis and treatments are not very clear. Here we review the literature on rectal cancer and SMJN to deepen the understanding of this disease. PMID:24708697

Early diagnosis of asthma in young children by using non-invasive biomarkers of airway inflammation and early lung function measurements: study protocol of a case-control study

PubMed Central

van de Kant, Kim DG; Klaassen, Ester MM; Jöbsis, Quirijn; Nijhuis, Annedien J; van Schayck, Onno CP; Dompeling, Edward

2009-01-01

Background Asthma is the most common chronic disease in childhood, characterized by chronic airway inflammation. There are problems with the diagnosis of asthma in young children since the majority of the children with recurrent asthma-like symptoms is symptom free at 6 years, and does not have asthma. With the conventional diagnostic tools it is not possible to differentiate between preschool children with transient symptoms and children with asthma. The analysis of biomarkers of airway inflammation in exhaled breath is a non-invasive and promising technique to diagnose asthma and monitor inflammation in young children. Moreover, relatively new lung function tests (airway resistance using the interrupter technique) have become available for young children. The primary objective of the ADEM study (Asthma DEtection and Monitoring study), is to develop a non-invasive instrument for an early asthma diagnosis in young children, using exhaled inflammatory markers and early lung function measurements. In addition, aetiological factors, including gene polymorphisms and gene expression profiles, in relation to the development of asthma are studied. Methods/design A prospective case-control study is started in 200 children with recurrent respiratory symptoms and 50 control subjects without respiratory symptoms. At 6 years, a definite diagnosis of asthma is made (primary outcome measure) on basis of lung function assessments and current respiratory symptoms ('golden standard'). From inclusion until the definite asthma diagnosis, repeated measurements of lung function tests and inflammatory markers in exhaled breath (condensate), blood and faeces are performed. The study is registered and ethically approved. Discussion This article describes the study protocol of the ADEM study. The new diagnostic techniques applied in this study could make an early diagnosis of asthma possible. An early and reliable asthma diagnosis at 2–3 years will have consequences for the management of

Early detection and response for measles and rubella cases through the (Nursery) School Absenteeism Surveillance System in Ibaraki Prefecture.

PubMed

Watanabe, Miki; Kurita, Junko; Takagi, Takeshi; Nagata, Noriko; Nagasu, Natsuki; Sugawara, Tamie; Ohkusa, Yasushi

2016-01-01

Objectives In Ibaraki Prefecture, all (nursery) schools have joined the (Nursery) School Absenteeism Surveillance System (hereafter denoted as (N)SASSy), which is operated by the Japan School Health Association to monitor the prevalence of infectious diseases, the early detection and response for outbreaks, and prevention of large outbreaks. Prefectural government officers also utilize it as a control measure for infectious diseases. In particular, when cases of measles or rubella are registered, (N)SASSy sends e-mails automatically to prefectural government officers to activate control measures. This paper summarizes administrative responses by prefectural government officers for measles or rubella cases using (N)SASSy and discusses the future challenges.Methods We summarized registration, detection, and first response data for measles or rubella cases in (N)SASSy and compared the number of detected and reported cases enforced by the Infectious Diseases Control Law from January 1, 2013 to December 31, 2014.Results The public health center questioned hospitals/clinics and (nursery) schools about all registered measles or rubella cases in (N)SASSy on the same day to check the entered information. In the past 2 years, there were 5 measles and 56 rubella cases in 2013 and 1 measles and 19 rubella cases in 2014 registered with (N)SASSy. All cases were checked and investigated by the public health center. Of all cases detected by (N)SASSy, 7 rubella cases in 2013 and 1 rubella case in 2014 were reported based on the law. No measles cases were reported in the 2 years. The results of investigations and laboratory tests were given as feedback to the (nursery) schools. If the case did not case definition determined by the law, we changed the status in (N)SASSy to suspected or discarded cases.Conclusion Since (N)SASSy assists prefectural government officers with earlier detection of and response for infectious diseases, it definitely contributes to infection control

Experimental impact testing and analysis of composite fan cases

NASA Astrophysics Data System (ADS)

Vander Klok, Andrew Joe

For aircraft engine certification, one of the requirements is to demonstrate the ability of the engine to withstand a fan blade-out (FBO) event. A FBO event may be caused by fatigue failure of the fan blade itself or by impact damage of foreign objects such as bird strike. An un-contained blade can damage flight critical engine components or even the fuselage. The design of a containment structure is related to numerous parameters such as the blade tip speed; blade material, size and shape; hub/tip diameter; fan case material, configuration, rigidity, etc. To investigate all parameters by spin experiments with a full size rotor assembly can be prohibitively expensive. Gas gun experiments can generate useful data for the design of engine containment cases at much lower costs. To replicate the damage modes similar to that on a fan case in FBO testing, the gas gun experiment has to be carefully designed. To investigate the experimental procedure and data acquisition techniques for FBO test, a low cost, small spin rig was first constructed. FBO tests were carried out with the small rig. The observed blade-to-fan case interactions were similar to those reported using larger spin rigs. The small rig has the potential in a variety of applications from investigating FBO events, verifying concept designs of rotors, to developing spin testing techniques. This rig was used in the developments of the notched blade releasing mechanism, a wire trigger method for synchronized data acquisition, high speed video imaging and etc. A relationship between the notch depth and the release speed was developed and verified. Next, an original custom designed spin testing facility was constructed. Driven by a 40HP, 40,000rpm air turbine, the spin rig is housed in a vacuum chamber of phi72inx40in (1829mmx1016mm). The heavily armored chamber is furnished with 9 viewports. This facility enables unprecedented investigations of FBO events. In parallel, a 15.4ft (4.7m) long phi4.1inch (105mm

Test Design Optimization in CAT Early Stage with the Nominal Response Model

ERIC Educational Resources Information Center

Passos, Valeria Lima; Berger, Martijn P. F.; Tan, Frans E.

2007-01-01

The early stage of computerized adaptive testing (CAT) refers to the phase of the trait estimation during the administration of only a few items. This phase can be characterized by bias and instability of estimation. In this study, an item selection criterion is introduced in an attempt to lessen this instability: the D-optimality criterion. A…

Evaluation of latex agglutination test (KAtex) for early diagnosis of kala-azar.

PubMed

Ahsan, M M; Islam, M N; Mollah, A H; Hoque, M A; Hossain, M A; Begum, Z; Islam, M T

2010-07-01

Kala-azar is one of the major public health problem in Bangladesh. But the diagnosis of the problem often is difficult, unusual and time consuming, a simple, noninvasive, easy to perform, reliable and rapid diagnostic test has been a long-felt need of the clinicians. Therefore, the present study was conducted to see the sensitivity and specificity of Latex Agglutination test (KAtex) to detect leishmanial antigen from urine of kala-azar cases. The study was carried out in the department of Paediatrics, Mymensingh Medical College and Hospital, Bangladesh during July to December, 2008. A total of 100 urine samples were collected of which 50 were confirmed kala-azar cases and 50 were age and sex matched controls. Out of 50 kala-azar cases 47 showed positive result of KAtex. The test was also positive in 01 out of 30 healthy controls. None of the febrile controls was positive by KAtex. The sensitivity, specificity, positive predictive value and negative predictive value of the test using presence of LD bodies in splenic and/or bone marrow aspirate as gold standard were 94%, 98%, 97.91% and 94.23% respectively. KAtex is simple, noninvasive, easy to perform, rapid and reliable test for diagnosing kala-azar in endemic area and useful for small, less equipped laboratories as well as for the laboratories with better facilities.

Climate Model Tests of the Early Anthropogenic Hypothesis

NASA Astrophysics Data System (ADS)

Vavrus, S.; Kutzbach, J.; Philippon, G.

2008-12-01

We test the hypothesis that greenhouse gas emissions produced by the combination of early and recent human activities, augmented by additional rises in greenhouse gases through ocean feedbacks, have kept the climate warmer than its natural level and offset an incipient glaciation. We use four different configurations of NCAR's Community Climate System Model to investigate the natural climate that should exist today if CO2 and CH4 concentrations had fallen to their average levels reached during previous interglaciations. The model simulations consist of three using a coupled atmosphere-slab ocean configuration---fixed land cover at moderate (T42) and high (T85) model resolution and interactive vegetation composition at T42 resolution--and one employing a coupled atmosphere-dynamical ocean configuration and fixed land cover at T42 resolution. With greenhouse gas concentrations lowered to their estimated natural levels, global mean temperature falls by 2.5-3.0 K in all four experiments. Of the total global cooling with fixed land cover and moderate model resolution, 38% (62%) is attributable to early agricultural activities (industrialization), while early agriculture accounts for approximately half of the expanded permanent snow cover area. The greenhouse cooling triggers widespread glacial inception in the Northern Hemisphere, where permanent snow cover expands by at least 80% and even more with the addition of enhanced model processes: 130% with the dynamical ocean, 150% with high (T85) model resolution, and 200% with vegetation feedbacks included. The regional pattern of incipient glaciation is strongly influenced by atmospheric and circulation changes, sea ice feedbacks, and model resolution. The simulation with a dynamical ocean produces a decrease in vertically integrated global ocean temperature of 1.25 K, a 20% weakening of the Atlantic meridional overturning cell, and an expansion of sea ice and reduced upwelling in the Southern Ocean. Viewed from the

Gold nanoparticle-enabled blood test for early stage cancer detection and risk assessment.

PubMed

Zheng, Tianyu; Pierre-Pierre, Nickisha; Yan, Xin; Huo, Qun; Almodovar, Alvin J O; Valerio, Felipe; Rivera-Ramirez, Inoel; Griffith, Elizabeth; Decker, David D; Chen, Sixue; Zhu, Ning

2015-04-01

When citrate ligands-capped gold nanoparticles are mixed with blood sera, a protein corona is formed on the nanoparticle surface due to the adsorption of various proteins in the blood to the nanoparticles. Using a two-step gold nanoparticle-enabled dynamic light scattering assay, we discovered that the amount of human immunoglobulin G (IgG) in the gold nanoparticle protein corona is increased in prostate cancer patients compared to noncancer controls. Two pilot studies conducted on blood serum samples collected at Florida Hospital and obtained from Prostate Cancer Biorespository Network (PCBN) revealed that the test has a 90-95% specificity and 50% sensitivity in detecting early stage prostate cancer, representing a significant improvement over the current PSA test. The increased amount of human IgG found in the protein corona is believed to be associated with the autoantibodies produced in cancer patients as part of the immunodefense against tumor. Proteomic analysis of the nanoparticle protein corona revealed molecular profile differences between cancer and noncancer serum samples. Autoantibodies and natural antibodies produced in cancer patients in response to tumorigenesis have been found and detected in the blood of many cancer types. The test may be applicable for early detection and risk assessment of a broad spectrum of cancer. This new blood test is simple, low cost, requires only a few drops of blood sample, and the results are obtained within minutes. The test is well suited for screening purpose. More extensive studies are being conducted to further evaluate and validate the clinical potential of the new test.

Clinical Impact and Cost-effectiveness of Diagnosing HIV Infection During Early Infancy in South Africa: Test Timing and Frequency.

PubMed

Francke, Jordan A; Penazzato, Martina; Hou, Taige; Abrams, Elaine J; MacLean, Rachel L; Myer, Landon; Walensky, Rochelle P; Leroy, Valériane; Weinstein, Milton C; Parker, Robert A; Freedberg, Kenneth A; Ciaranello, Andrea

2016-11-01

 Diagnosis of human immunodeficiency virus (HIV) infection during early infancy (commonly known as "early infant HIV diagnosis" [EID]) followed by prompt initiation of antiretroviral therapy dramatically reduces mortality. EID testing is recommended at 6 weeks of age, but many infant infections are missed.  We simulated 4 EID testing strategies for HIV-exposed infants in South Africa: no EID (diagnosis only after illness; hereafter, "no EID"), testing once (at birth alone or at 6 weeks of age alone; hereafter, "birth alone" and "6 weeks alone," respectively), and testing twice (at birth and 6 weeks of age; hereafter "birth and 6 weeks"). We calculated incremental cost-effectiveness ratios (ICERs), using discounted costs and life expectancies for all HIV-exposed (infected and uninfected) infants.  In the base case (guideline-concordant care), the no EID strategy produced a life expectancy of 21.1 years (in the HIV-infected group) and 61.1 years (in the HIV-exposed group); lifetime cost averaged $1430/HIV-exposed infant. The birth and 6 weeks strategy maximized life expectancy (26.5 years in the HIV-infected group and 61.4 years in the HIV-exposed group), costing $1840/infant tested. The ICER of the 6 weeks alone strategy versus the no EID strategy was $1250/year of life saved (19% of South Africa's per capita gross domestic product); the ICER for the birth and 6 weeks strategy versus the 6 weeks alone strategy was $2900/year of life saved (45% of South Africa's per capita gross domestic product). Increasing the proportion of caregivers who receive test results and the linkage of HIV-positive infants to antiretroviral therapy with the 6 weeks alone strategy improved survival more than adding a second test.  EID at birth and 6 weeks improves outcomes and is cost-effective, compared with EID at 6 weeks alone. If scale-up costs are comparable, programs should add birth testing after strengthening 6-week testing programs. © The Author 2016. Published by Oxford

The Case History Method of Testing Students in Gross Anatomy.

ERIC Educational Resources Information Center

Cruise, Leon J.

1980-01-01

The use of case histories to test a student's knowledge of the previous weeks' dissection in gross anatomy class is discussed. The test is seen as a way to integrate other basic sciences. An example of this type of test is provided. (MLW)

Impact Testing of Composites for Aircraft Engine Fan Cases

NASA Technical Reports Server (NTRS)

Roberts, Gary D.; Revilock, Duane M.; Binienda, Wieslaw K.; Nie, Walter Z.; Mackenzie, S. Ben; Todd, Kevin B.

2001-01-01

Before composite materials can be considered for use in the fan case of a commercial jet engine, the performance of a composite structure under blade-out loads needs to be demonstrated. The objective of this program is to develop an efficient test and analysis method for evaluating potential composite case concepts. Ballistic impact tests were performed on laminated glass/epoxy composites in order to identify potential failure modes and to provide data for analysis. Flat 7x7 in. panels were impacted with cylindrical titanium projectiles, and 15 in. diameter half-rings were impacted with wedge-shaped titanium projectiles. Composite failure involved local fiber fracture as well as tearing and delamination on a larger scale. A 36 in. diameter full-ring subcomponent was proposed for larger scale testing. Explicit, transient, finite element analyses were used to evaluate impact dynamics and subsequent global deformation for the proposed full-ring subcomponent test. Analyses on half-ring and quarter ring configurations indicated that less expensive smaller scale tests could be used to screen potential composite concepts when evaluation of local impact damage is the primary concern.

Internet-Delivered, Family-Based Treatment for Early-Onset OCD: A Preliminary Case Series

PubMed Central

Comer, Jonathan S.; Furr, Jami M.; Cooper-Vince, Christine E.; Kerns, Caroline E.; Chan, Priscilla T.; Edson, Aubrey L.; Khanna, Muniya; Franklin, Martin E.; Garcia, Abbe M.; Freeman, Jennifer B.

2014-01-01

Given the burdens of early-onset obsessive-compulsive disorder (OCD), limitations in the broad availability and accessibility of evidence-based care for affected youth present serious public health concerns. The growing potential for technological innovations to transform care for the most traditionally remote and underserved families holds enormous promise. This article presents the rationale, key considerations, and a preliminary case series for a promising behavioral telehealth innovation in the evidence-based treatment of early-onset OCD. We developed an Internet-based format for the delivery of family-based treatment for early-onset OCD directly to families in their homes, regardless of their geographic proximity to a mental health facility. Videoteleconferencing (VTC) methods were used to deliver real-time cognitive-behavioral therapy centering on exposure and response prevention to affected families. Participants in the preliminary case series included 5 children between the ages of 4 and 8 (MAge = 6.5) who received the Internet-delivered treatment format. All youth completed a full treatment course, all showed OCD symptom improvements and global severity improvements from pre- to posttreatment, all showed at least partial diagnostic response, and 60% no longer met diagnostic criteria for OCD at posttreatment. No participants got worse, and all mothers characterized the quality of services received as “excellent.” The present work adds to a growing literature supporting the potential of VTC and related computer technology for meaningfully expanding the reach of supported treatments for OCD and lays the foundation for subsequent controlled evaluations to evaluate matters of efficacy and engagement relative to standard in-office evidence-based care. PMID:24295036

Tea, coffee, and caffeine and early-onset basal cell carcinoma in a case-control study

PubMed Central

Ferrucci, Leah M.; Cartmel, Brenda; Molinaro, Annette M.; Leffell, David J.; Bale, Allen E.; Mayne, Susan T.

2014-01-01

Objectives Tea and coffee are hypothesized to play a protective role in skin carcinogenesis via bioactive components, such as caffeine, yet the epidemiologic evidence is mixed. Existing data supports an inverse association with basal cell carcinoma (BCC) more so than for melanoma or squamous cell carcinoma. To understand if tea, coffee, and caffeine are related to early-onset BCC, we evaluated data from 767 non-Hispanic Whites under age 40 in a case-control study in Connecticut. Methods BCC cases (n=377) were identified through Yale's Dermatopathology database. Controls (n=390) were randomly sampled from individuals in the same database with benign skin diagnoses and frequency matched to cases on age, gender, and biopsy site. Subjects completed an in-person interview including assessment of caffeinated coffee and hot tea. We calculated multivariate odds ratios (OR) and 95% confidence intervals (CIs) with unconditional logistic regression for regular consumption and frequency and duration measures. Results Combined regular consumption of caffeinated coffee plus hot tea was inversely associated with early-onset BCC (OR=0.60, 95% CI=0.38–0.96). Those in the highest category of caffeine from these sources had a 43% reduced risk of BCC compared to non-consumers (OR=0.57, 95% CI=0.34–0.95, p-trend=0.037). Conclusions Our findings suggest a modest protective effect for caffeinated coffee plus tea in relation to early-onset BCC that may, in part, be due to caffeine. This study adds to the growing body of literature suggesting potential health benefits from these beverages. PMID:24841641

Tea, coffee, and caffeine and early-onset basal cell carcinoma in a case-control study.

PubMed

Ferrucci, Leah M; Cartmel, Brenda; Molinaro, Annette M; Leffell, David J; Bale, Allen E; Mayne, Susan T

2014-07-01

Tea and coffee are hypothesized to play a protective role in skin carcinogenesis through bioactive components, such as caffeine, yet the epidemiologic evidence is mixed. Existing data support an inverse association with basal cell carcinoma (BCC), more so than for melanoma or squamous cell carcinoma. To understand whether tea, coffee, and caffeine are related to early-onset BCC, we evaluated data from 767 non-Hispanic Whites under age 40 in a case-control study in Connecticut. BCC cases (n=377) were identified through Yale's Dermatopathology database. Controls (n=390) were randomly sampled from individuals in the same database with benign skin diagnoses and frequency matched to cases on age, sex, and biopsy site. Participants completed an in-person interview including assessment of caffeinated coffee and hot tea. We calculated multivariate odds ratios (ORs) and 95% confidence intervals (CIs) with unconditional logistic regression for regular consumption and frequency and duration measures. Combined regular consumption of caffeinated coffee plus hot tea was inversely associated with early-onset BCC (OR=0.60, 95% CI=0.38-0.96). Those in the highest category of caffeine from these sources had a 43% reduced risk of BCC compared with nonconsumers (OR=0.57, 95% CI=0.34-0.95, P-trend=0.037). Our findings suggest a modest protective effect for caffeinated coffee plus tea in relation to early-onset BCC that may, in part, be due to caffeine. This study adds to the growing body of literature suggesting potential health benefits from these beverages.

Coverage criteria for test case generation using UML state chart diagram

NASA Astrophysics Data System (ADS)

Salman, Yasir Dawood; Hashim, Nor Laily; Rejab, Mawarny Md; Romli, Rohaida; Mohd, Haslina

2017-10-01

To improve the effectiveness of test data generation during the software test, many studies have focused on the automation of test data generation from UML diagrams. One of these diagrams is the UML state chart diagram. Test cases are generally evaluated according to coverage criteria. However, combinations of multiple criteria are required to achieve better coverage. Different studies used various number and types of coverage criteria in their methods and approaches. The objective of this paper to propose suitable coverage criteria for test case generation using UML state chart diagram especially in handling loops. In order to achieve this objective, this work reviewed previous studies to present the most practical coverage criteria combinations, including all-states, all-transitions, all-transition-pairs, and all-loop-free-paths coverage. Calculation to determine the coverage percentage of the proposed coverage criteria were presented together with an example has they are applied on a UML state chart diagram. This finding would be beneficial in the area of test case generating especially in handling loops in UML state chart diagram.

Mobile phone base stations and early childhood cancers: case-control study

PubMed Central

Toledano, Mireille B; Bennett, J; Beale, L; de Hoogh, K; Best, N; Briggs, D J

2010-01-01

Objective To investigate the risk of early childhood cancers associated with the mother’s exposure to radiofrequency from and proximity to macrocell mobile phone base stations (masts) during pregnancy. Design Case-control study. Setting Cancer registry and national birth register data in Great Britain. Participants 1397 cases of cancer in children aged 0-4 from national cancer registry 1999-2001 and 5588 birth controls from national birth register, individually matched by sex and date of birth (four controls per case). Main outcome measures Incidence of cancers of the brain and central nervous system, leukaemia, and non-Hodgkin’s lymphomas, and all cancers combined, adjusted for small area measures of education level, socioeconomic deprivation, population density, and population mixing. Results Mean distance of registered address at birth from a macrocell base station, based on a national database of 76 890 base station antennas in 1996-2001, was similar for cases and controls (1107 (SD 1131) m v 1073 (SD 1130) m, P=0.31), as was total power output of base stations within 700 m of the address (2.89 (SD 5.9) kW v 3.00 (SD 6.0) kW, P=0.54) and modelled power density (−30.3 (SD 21.7) dBm v −29.7 (SD 21.5) dBm, P=0.41). For modelled power density at the address at birth, compared with the lowest exposure category the adjusted odds ratios were 1.01 (95% confidence interval 0.87 to 1.18) in the intermediate and 1.02 (0.88 to 1.20) in the highest exposure category for all cancers (P=0.79 for trend), 0.97 (0.69 to 1.37) and 0.76 (0.51 to 1.12), respectively, for brain and central nervous system cancers (P=0.33 for trend), and 1.16 (0.90 to 1.48) and 1.03 (0.79 to 1.34) for leukaemia and non-Hodgkin’s lymphoma (P=0.51 for trend). Conclusions There is no association between risk of early childhood cancers and estimates of the mother’s exposure to mobile phone base stations during pregnancy. PMID:20570865

Effect of Formative and Ability Test Results on Early Learning of Students

ERIC Educational Resources Information Center

Kadir, Abdul; Ardi, Muhammad; Nurhayati, B.; Dirawan, Gufran Darma

2016-01-01

The objective of this study was to examine the relationship of formative tests to early learning ability of students in the science learning style. This research used an experimental method with a 2 x 2 factorial design. The participants comprised all the students in class VII of the Islamic Junior High School State of Kolaka, a total of 343…

Early Pregnancy Loss

MedlinePlus

... known pregnancies. What causes early pregnancy loss? About one half of cases of early pregnancy loss are caused by a ... do not show any signs of an infection, one option is to wait and let the ... may take longer in some cases. Another option is to take medication that helps ...

Infant titi monkey behavior in the open field test and the effect of early adversity.

PubMed

Larke, Rebecca H; Toubiana, Alice; Lindsay, Katrina A; Mendoza, Sally P; Bales, Karen L

2017-09-01

The open field test is commonly used to measure anxiety-related behavior and exploration in rodents. Here, we used it as a standardized novel environment in which to evaluate the behavioral response of infant titi monkeys (Callicebus cupreus), to determine the effect of presence of individual family members, and to assess how adverse early experience alters infant behavior. Infants were tested in the open field for 5 days at ages 4 and 6 months in four successive 5 min trials on each day. A transport cage, which was situated on one side of the open field, was either empty (non-social control) or contained the father, mother, or sibling. Infant locomotor, vocalization, and exploratory behavior were quantified. Results indicated that age, sex, social condition, and early experience all had significant effects on infant behavior. Specifically, infants were generally more exploratory at 6 months and male infants were more exploratory than females. Infants distinguished between social and non-social conditions but made few behavioral distinctions between the attachment figure and other individuals. Infants which had adverse early life experience demonstrated greater emotional and physical independence, suggesting that early adversity led to resiliency in the novel environment. © 2017 Wiley Periodicals, Inc.

Safety Early Warning Research for Highway Construction Based on Case-Based Reasoning and Variable Fuzzy Sets

PubMed Central

Liu, Yan; Xu, Zhen-Jun

2013-01-01

As a high-risk subindustry involved in construction projects, highway construction safety has experienced major developments in the past 20 years, mainly due to the lack of safe early warnings in Chinese construction projects. By combining the current state of early warning technology with the requirements of the State Administration of Work Safety and using case-based reasoning (CBR), this paper expounds on the concept and flow of highway construction safety early warnings based on CBR. The present study provides solutions to three key issues, index selection, accident cause association analysis, and warning degree forecasting implementation, through the use of association rule mining, support vector machine classifiers, and variable fuzzy qualitative and quantitative change criterion modes, which fully cover the needs of safe early warning systems. Using a detailed description of the principles and advantages of each method and by proving the methods' effectiveness and ability to act together in safe early warning applications, effective means and intelligent technology for a safe highway construction early warning system are established. PMID:24191134

Safety early warning research for highway construction based on case-based reasoning and variable fuzzy sets.

PubMed

Liu, Yan; Yi, Ting-Hua; Xu, Zhen-Jun

2013-01-01

As a high-risk subindustry involved in construction projects, highway construction safety has experienced major developments in the past 20 years, mainly due to the lack of safe early warnings in Chinese construction projects. By combining the current state of early warning technology with the requirements of the State Administration of Work Safety and using case-based reasoning (CBR), this paper expounds on the concept and flow of highway construction safety early warnings based on CBR. The present study provides solutions to three key issues, index selection, accident cause association analysis, and warning degree forecasting implementation, through the use of association rule mining, support vector machine classifiers, and variable fuzzy qualitative and quantitative change criterion modes, which fully cover the needs of safe early warning systems. Using a detailed description of the principles and advantages of each method and by proving the methods' effectiveness and ability to act together in safe early warning applications, effective means and intelligent technology for a safe highway construction early warning system are established.

Using Augmented Reality in Early Art Education: A Case Study in Hong Kong Kindergarten

ERIC Educational Resources Information Center

Huang, Yujia; Li, Hui; Fong, Ricci

2016-01-01

Innovation in pedagogy by technology integration in kindergarten classroom has always been a challenge for most teachers. This design-based research aimed to explore the feasibility of using Augmented Reality (AR) technology in early art education with a focus on the gains and pains of this innovation. A case study was conducted in a typical…

Early Literacy and Early Numeracy: The Value of Including Early Literacy Skills in the Prediction of Numeracy Development

ERIC Educational Resources Information Center

Purpura, David J.; Hume, Laura E.; Sims, Darcey M.; Lonigan, Cristopher J.

2011-01-01

The purpose of this study was to examine whether early literacy skills uniquely predict early numeracy skills development. During the first year of the study, 69 3- to 5-year-old preschoolers were assessed on the Preschool Early Numeracy Skills (PENS) test and the Test of Preschool Early Literacy Skills (TOPEL). Participants were assessed again a…

Design and Testing of Braided Composite Fan Case Materials and Components

NASA Technical Reports Server (NTRS)

Roberts, Gary D.; Pereira, J. Michael; Braley, Michael S.; Arnold, William a.; Dorer, James D.; Watson, William R/.

2009-01-01

Triaxial braid composite materials are beginning to be used in fan cases for commercial gas turbine engines. The primary benefit for the use of composite materials is reduced weight and the associated reduction in fuel consumption. However, there are also cost benefits in some applications. This paper presents a description of the braided composite materials and discusses aspects of the braiding process that can be utilized for efficient fabrication of composite cases. The paper also presents an approach that was developed for evaluating the braided composite materials and composite fan cases in a ballistic impact laboratory. Impact of composite panels with a soft projectile is used for materials evaluation. Impact of composite fan cases with fan blades or blade-like projectiles is used to evaluate containment capability. A post-impact structural load test is used to evaluate the capability of the impacted fan case to survive dynamic loads during engine spool down. Validation of these new test methods is demonstrated by comparison with results of engine blade-out tests.

Alertness and cognitive control: Testing the early onset hypothesis.

PubMed

Schneider, Darryl W

2018-05-01

Previous research has revealed a peculiar interaction between alertness and cognitive control in selective-attention tasks: Congruency effects are larger on alert trials (on which an alerting cue is presented briefly in advance of the imperative stimulus) than on no-alert trials, despite shorter response times (RTs) on alert trials. One explanation for this finding is the early onset hypothesis, which is based on the assumptions that increased alertness shortens stimulus-encoding time and that cognitive control involves gradually focusing attention during a trial. The author tested the hypothesis in 3 experiments by manipulating alertness and stimulus quality (which were intended to shorten and lengthen stimulus-encoding time, respectively) in an arrow-based flanker task involving congruent and incongruent stimuli. Replicating past findings, the alerting manipulation led to shorter RTs but larger congruency effects on alert trials than on no-alert trials. The stimulus-quality manipulation led to longer RTs and larger congruency effects for degraded stimuli than for intact stimuli. These results provide mixed support for the early onset hypothesis, but the author discusses how data and theory might be reconciled if stimulus quality affects stimulus-encoding time and the rate of evidence accumulation in the decision process. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

A Human Proximity Operations System test case validation approach

NASA Astrophysics Data System (ADS)

Huber, Justin; Straub, Jeremy

A Human Proximity Operations System (HPOS) poses numerous risks in a real world environment. These risks range from mundane tasks such as avoiding walls and fixed obstacles to the critical need to keep people and processes safe in the context of the HPOS's situation-specific decision making. Validating the performance of an HPOS, which must operate in a real-world environment, is an ill posed problem due to the complexity that is introduced by erratic (non-computer) actors. In order to prove the HPOS's usefulness, test cases must be generated to simulate possible actions of these actors, so the HPOS can be shown to be able perform safely in environments where it will be operated. The HPOS must demonstrate its ability to be as safe as a human, across a wide range of foreseeable circumstances. This paper evaluates the use of test cases to validate HPOS performance and utility. It considers an HPOS's safe performance in the context of a common human activity, moving through a crowded corridor, and extrapolates (based on this) to the suitability of using test cases for AI validation in other areas of prospective application.

Assessing Very Early Infant Diagnosis Turnaround Times: Findings from a Birth Testing Pilot in Lesotho

PubMed Central

Hoffman, Heather J.; Mokone, Majoalane; Tukei, Vincent J.; Nchephe, Matsepeli; Phalatse, Mamakhetha; Tiam, Appolinaire; Guay, Laura; Mofenson, Lynne

2017-01-01

Very early infant diagnosis (VEID) (testing within two weeks of life), combined with rapid treatment initiation, could reduce early infant mortality. Our study evaluated turnaround time (TAT) to receipt of infants' HIV test results and ART initiation if HIV-infected, with and without birth testing availability. Data from facility records and national databases were collected for 12 facilities offering VEID, as part of an observational prospective cohort study, and 10 noncohort facilities. HIV-exposed infants born in January–June 2016 and any cohort infant diagnosed as HIV-infected at birth or six weeks were included. The median TAT from blood draw to caregiver result receipt was 76.5 days at birth and 63 and 70 days at six weeks at cohort and noncohort facilities, respectively. HIV-exposed infants tested at birth were approximately one month younger when their caregivers received results versus those tested at six weeks. Infants diagnosed at birth initiated ART about two months earlier (median 6.4 weeks old) than those identified at six weeks (median 14.8 weeks). However, the long TAT for testing at both birth and six weeks illustrates the prolonged process for specimen transport and result return that could compromise the effectiveness of adding VEID to existing overburdened EID systems. PMID:29410914

Understanding the link between early sexual initiation and later sexually transmitted infection: test and replication in two longitudinal studies.

PubMed

Epstein, Marina; Bailey, Jennifer A; Manhart, Lisa E; Hill, Karl G; Hawkins, J David; Haggerty, Kevin P; Catalano, Richard F

2014-04-01

Age at sexual initiation is strongly associated with sexually transmitted infections (STI); yet, prevention programs aiming to delay sexual initiation have shown mixed results in reducing STI. This study tested three explanatory mechanisms for the relationship between early sexual debut and STI: number of sexual partners, individual characteristics, and environmental antecedents. A test-and-replicate strategy was employed using two longitudinal studies: the Seattle Social Development Project (SSDP) and Raising Healthy Children (RHC). Childhood measures included pubertal age, behavioral disinhibition, and family, school, and peer influences. Alcohol use and age of sexual debut were measured during adolescence. Lifetime number of sexual partners and having sex under the influence were measured during young adulthood. Sexually transmitted infection diagnosis was self-reported at age 24. Early sex was defined as debut at <15 years. Path models were developed in SSDP evaluating relationships between measures, and were then tested in RHC. The relationship between early sex and STI was fully mediated by lifetime sex partners in SSDP, but only partially in RHC, after accounting for co-occurring factors. Behavioral disinhibition predicted early sex, early alcohol use, number of sexual partners, and sex under the influence, but had no direct effect on STI. Family management protected against early sex and early alcohol use, whereas antisocial peers exacerbated the risk. Early sexual initiation, a key mediator of STI, is driven by antecedents that influence multiple risk behaviors. Targeting co-occurring individual and environmental factors may be more effective than discouraging early sexual debut and may concomitantly improve other risk behaviors. Copyright © 2014 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Early literacy and early numeracy: the value of including early literacy skills in the prediction of numeracy development.

PubMed

Purpura, David J; Hume, Laura E; Sims, Darcey M; Lonigan, Christopher J

2011-12-01

The purpose of this study was to examine whether early literacy skills uniquely predict early numeracy skills development. During the first year of the study, 69 3- to 5-year-old preschoolers were assessed on the Preschool Early Numeracy Skills (PENS) test and the Test of Preschool Early Literacy Skills (TOPEL). Participants were assessed again a year later on the PENS test and on the Applied Problems and Calculation subtests of the Woodcock-Johnson III Tests of Achievement. Three mixed effect regressions were conducted using Time 2 PENS, Applied Problems, and Calculation as the dependent variables. Print Knowledge and Vocabulary accounted for unique variance in the prediction of Time 2 numeracy scores. Phonological Awareness did not uniquely predict any of the mathematics domains. The findings of this study identify an important link between early literacy and early numeracy development. Copyright © 2011 Elsevier Inc. All rights reserved.

A case of urinary retention in the early stages of herpes simplex virus type-1 encephalitis.

PubMed

Fukuoka, Takuya; Nakazato, Yoshihiko; Miyake, Akifumi; Tamura, Naotoshi; Araki, Nobuo; Yamamoto, Toshimasa

2017-06-01

A 70-year-old man developed urinary retention in the early stages of herpes simplex virus (HSV) type-1 encephalitis. A nerve conduction study suggested latent myeloradiculitis. This is the first report of human herpes simplex virus-1 encephalitis followed by urinary retention at early stage from the onset like the Elsberg syndrome. Although relatively few similar cases have been reported, we consider that urinary retention is common in HSV-1 encephalitis, in which disturbances of consciousness usually require bladder catheterization from the onset. We further emphasize that urinary retention may occasionally occur in early stages of HSV-1 encephalitis, with a significant possibility of recovery. Copyright © 2017. Published by Elsevier B.V.

Application of a High Throughput Method of Biomarker Discovery to Improvement of the EarlyCDT®-Lung Test

PubMed Central

Macdonald, Isabel K.; Murray, Andrea; Healey, Graham F.; Parsy-Kowalska, Celine B.; Allen, Jared; McElveen, Jane; Robertson, Chris; Sewell, Herbert F.; Chapman, Caroline J.; Robertson, John F. R.

2012-01-01

Background The National Lung Screening Trial showed that CT screening for lung cancer led to a 20% reduction in mortality. However, CT screening has a number of disadvantages including low specificity. A validated autoantibody assay is available commercially (EarlyCDT®-Lung) to aid in the early detection of lung cancer and risk stratification in patients with pulmonary nodules detected by CT. Recent advances in high throughput (HTP) cloning and expression methods have been developed into a discovery pipeline to identify biomarkers that detect autoantibodies. The aim of this study was to demonstrate the successful clinical application of this strategy to add to the EarlyCDT-Lung panel in order to improve its sensitivity and specificity (and hence positive predictive value, (PPV)). Methods and Findings Serum from two matched independent cohorts of lung cancer patients were used (n = 100 and n = 165). Sixty nine proteins were initially screened on an abridged HTP version of the autoantibody ELISA using protein prepared on small scale by a HTP expression and purification screen. Promising leads were produced in shake flask culture and tested on the full assay. These results were analyzed in combination with those from the EarlyCDT-Lung panel in order to provide a set of re-optimized cut-offs. Five proteins that still displayed cancer/normal differentiation were tested for reproducibility and validation on a second batch of protein and a separate patient cohort. Addition of these proteins resulted in an improvement in the sensitivity and specificity of the test from 38% and 86% to 49% and 93% respectively (PPV improvement from 1 in 16 to 1 in 7). Conclusion This is a practical example of the value of investing resources to develop a HTP technology. Such technology may lead to improvement in the clinical utility of the EarlyCDT­-Lung test, and so further aid the early detection of lung cancer. PMID:23272083

Rethinking Instructional Technology to Improve Pedagogy for Digital Literacy: A Design Case in a Graduate Early Childhood Education Course

ERIC Educational Resources Information Center

Langub, Lee Woodham; Lokey-Vega, Anissa

2017-01-01

Digital literacy is an important aspect to consider within teacher education as a way to address twenty-first century learner needs, particularly in early childhood contexts where developmental concerns should be paramount in making instructional design decisions. This article is a design case of a graduate level early childhood education…

ABCC6 mutations and early onset stroke: Two cases of a typical Pseudoxanthoma Elasticum.

PubMed

Bertamino, Marta; Severino, Mariasavina; Grossi, Alice; Rusmini, Marta; Tortora, Domenico; Gandolfo, Carlo; Pederzoli, Silvia; Malattia, Clara; Picco, Paolo; Striano, Pasquale; Ceccherini, Isabella; Di Rocco, Maja

2018-04-12

Pseudoxanthoma elasticum (PXE) is a rare genetic disorder characterized by fragmented and mineralized elastic fibers in the mid-dermis of the skin, eye, digestive tract and cardiovascular system. Clinical presentation includes typical skin lesions, ocular angioid streaks, and multisystem vasculopathy. The age of onset varies considerably from infancy to old age, but the diagnosis is usually made in young adults due to frequent absence of pathognomonic skin and ocular manifestations in early childhood. We report two children with PXE presenting with isolated multisystem vasculopathy and early-onset stroke. In the first patient, diagnosis was delayed until typical dermatologic alterations appeared; in the second patient, next-generation sequencing (NGS) study led to early diagnosis and specific follow-up, underlying the crucial role in idiopathic pediatric stroke of early genetic testing using NGS-based panels. Copyright © 2018 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

Early life predictors of preschool overweight and obesity: a case-control study in Sri Lanka.

PubMed

Rathnayake, Kumari M; Satchithananthan, Aberna; Mahamithawa, Senarath; Jayawardena, Ranil

2013-10-22

Childhood obesity increases the risk of obesity in adulthood and is associated with cardiovascular disease risk factors. Our aim was to assess the early life risk factors associated with overweight and obesity among preschool children. In this case-control study, from the 1087 preschool children measured, age, sex and ethnicity matched 71 cases and 71 controls were recruited. Cases and controls were defined according to the WHO 2006 growth standards. The birth and growth characteristics were extracted from the child health development records. Infant feeding practices and maternal factors were obtained from the mother. Rapid weight gain was defined as an increase in weight-for-age Z score (WHO standards) above 0.67 SD from birth to 2 years. The magnitude and significant difference in mean values of the variables associated with overweight and obesity were evaluated using logistic regressions and paired t-test, respectively. Cases had significantly shorter duration (months) of breastfeeding (19.4, 24.6, p = 0.003), and smaller duration (months) of exclusive breastfeeding (3.7, 5.1, p = 0.001) compared to controls. Rapid weight gain (OR = 6.3, 95% CI = 2.04-19.49), first born status (OR = 3.6, 95% CI = 1.17-10.91) and pre-pregnancy obesity (OR = 4.0, 95% CI = 1.46-10.76) were positively associated with overweight and obesity. Breastfeeding more than 2 years (OR = 0.2, 95% CI = 0.06-0.57) was negatively associated with overweight and obesity. Rapid weight gain within first two years, first-born status and pre-pregnancy obesity of the mother contributed for preschool obesity. Our results suggest that intervention may be indicated earlier in infancy and during the toddler and preschool years to tackle the increasing prevalence of obesity.

Risk factors for early death in transient myeloproliferative disorder without phenotypic features of Down syndrome: a case report and literature review.

PubMed

Kawase, Koya; Azuma, Eiichi; Ohshita, Hironori; Tanaka, Tatsushi; Hanada, Yu; Sasaki, Tomoaki; Sugimoto, Mari; Togawa, Takao; Kouwaki, Masanori; Ito, Tsuyoshi; Hirayama, Masahiro; Koyama, Norihisa

2012-08-01

Not only in newborns with Down syndrome, but newborns without phenotypic features of Down syndrome also develop transient myeloproliferative disorder (TMD). In these cases, trisomy 21 and related chromosomal abnormalities are either constitutionally mosaic or limited to blood cells. Risk factors for early death of these patients are unknown so far. We here report a fatal case of TMD without phenotypic features of Down syndrome and review literature to identify risk factors associated with early death. Not only are gestational age and white blood cell count risk factors for early death in TMD with Down syndrome, but they also appear to be risk factors in TMD without Down syndrome.

The business of genomic testing: a survey of early adopters.

PubMed

Crawford, James M; Bry, Lynn; Pfeifer, John; Caughron, Samuel K; Black-Schaffer, Stephen; Kant, Jeffrey A; Kaufman, Jill H

2014-12-01

The practice of "genomic" (or "personalized") medicine requires the availability of appropriate diagnostic testing. Our study objective was to identify the reasons for health systems to bring next-generation sequencing into their clinical laboratories and to understand the process by which such decisions were made. Such information may be of value to other health systems seeking to provide next-generation sequencing testing to their patient populations. A standardized open-ended interview was conducted with the laboratory medical directors and/or department of pathology chairs of 13 different academic institutions in 10 different states. Genomic testing for cancer dominated the institutional decision making, with three primary reasons: more effective delivery of cancer care, the perceived need for institutional leadership in the field of genomics, and the premise that genomics will eventually be cost-effective. Barriers to implementation included implementation cost; the time and effort needed to maintain this newer testing; challenges in interpreting genetic variants; establishing the bioinformatics infrastructure; and curating data from medical, ethical, and legal standpoints. Ultimate success depended on alignment with institutional strengths and priorities and working closely with institutional clinical programs. These early adopters uniformly viewed genomic analysis as an imperative for developing their expertise in the implementation and practice of genomic medicine.

Feasibility of nonselective testing for hemoglobinopathies in early pregnancy in The Netherlands.

PubMed

Kaufmann, Judith O; Demirel-Güngör, Gönül; Selles, Anke; Hudig, Cisca; Steen, Gerard; Ponjee, Gabrielle; Holleboom, Cas; Freeman, Liv M; Hendiks, Joris; Wijermans, Pierre; Giordano, Piero C; Kerkhoffs, Jean-Louis

2011-12-01

To examine the feasibility of standardized hemoglobinopathy (HBP) carrier testing for pregnant women in The Netherlands in addition to the standard anemia screening. We assessed the prevalence of HBP in women at the time of the first pregnancy visit using both a prospective cohort (N = 703) and a retrospective series of women selected at random (N = 588). For the purpose of analysis, the population was divided into a high risk and a low risk group for HBP based on maternal ethnicity. Screening for HBP utilized standard screening tests for anemia, with additional high performance liquid chromatography (Variant II); molecular analysis was performed by Gap-polymerase chain reaction (Gap-PCR) and if necessary, direct sequencing and multiplex ligation-dependent probe amplification (MLPA). Family history was reported or collected from the medical records. β-Globin defects were found in 3.9% of the total population (50/1291). The frequency in the high risk population was 5.6% (37/656), compared with 1.2% (6/501) in the low risk group. In the prospective study we found 30 HBP carriers, leading to testing of 16 partners and identification of two couples at risk. One affected child was born. Mean gestational age at the screening was 11.3 weeks with a standard deviation (SD) of 5.8. We found that the prevalence of HBP carriers is high enough in our population to warrant HBP testing for the entire multiethnic population in early pregnancy at the time of anemia screening. This is feasible as most women had their booking early in their first trimester. Copyright © 2011 John Wiley & Sons, Ltd.

Testing MODFLOW-LGR for simulating flow around buried Quaternary valleys - synthetic test cases

NASA Astrophysics Data System (ADS)

Vilhelmsen, T. N.; Christensen, S.

2009-12-01

In this study the Local Grid Refinement (LGR) method developed for MODFLOW-2005 (Mehl and Hill, 2005) is utilized to describe groundwater flow in areas containing buried Quaternary valley structures. The tests are conducted as comparative analysis between simulations run with a globally refined model, a locally refined model, and a globally coarse model, respectively. The models vary from simple one layer models to more complex ones with up to 25 model layers. The comparisons of accuracy are conducted within the locally refined area and focus on water budgets, simulated heads, and simulated particle traces. Simulations made with the globally refined model are used as reference (regarded as “true” values). As expected, for all test cases the application of local grid refinement resulted in more accurate results than when using the globally coarse model. A significant advantage of utilizing MODFLOW-LGR was that it allows increased numbers of model layers to better resolve complex geology within local areas. This resulted in more accurate simulations than when using either a globally coarse model grid or a locally refined model with lower geological resolution. Improved accuracy in the latter case could not be expected beforehand because difference in geological resolution between the coarse parent model and the refined child model contradicts the assumptions of the Darcy weighted interpolation used in MODFLOW-LGR. With respect to model runtimes, it was sometimes found that the runtime for the locally refined model is much longer than for the globally refined model. This was the case even when the closure criteria were relaxed compared to the globally refined model. These results are contradictory to those presented by Mehl and Hill (2005). Furthermore, in the complex cases it took some testing (model runs) to identify the closure criteria and the damping factor that secured convergence, accurate solutions, and reasonable runtimes. For our cases this is judged to

Rare missense coding variants in oxytocin receptor (OXTR) in schizophrenia cases are associated with early trauma exposure, cognition and emotional processing.

PubMed

Veras, Andre B; Getz, Mara; Froemke, Robert C; Nardi, Antonio Egidio; Alves, Gilberto Sousa; Walsh-Messinger, Julie; Chao, Moses V; Kranz, Thorsten M; Malaspina, Dolores

2018-02-01

Oxytocin is a peptide hormone that influences the integration of social cognition with behavior and affect regulation. Oxytocin also prominently directs the transition of neuronal GABA neurotransmission from excitatory to inhibitory after birth. The oxytocin receptor (OXTR) is linked to schizophrenia, a heterogeneous syndrome. Relationships of OXTR polymorphisms with specific clinical features could aid in evaluating any role of oxytocin in the pathogenesis of schizophrenia. Schizophrenia cases with rare missense coding OXTR single nucleotide variants (SNVs) were identified from a well-characterized sample of cases and controls who were assessed for symptoms, cognition and early life trauma. Five of 48 cases showed rare OXTR variants. Compared to the other cases they had less severe negative symptoms (deficits in emotional expression and motivation) and less severe general psychopathology scores (depression and anxiety). They demonstrated lower nonverbal (performance) than verbal intelligence due to deficient perceptual organization and slow processing speed. They also reported greater early trauma exposure (physical and sexual abuse and emotional trauma). Cases carrying rare OXTR SNVs had less negative and affective symptoms than other cases, but similar psychotic symptoms, along with specific cognitive deficits. The clinical characterization of these cases occurred in association with environmental exposure to early trauma, especially sexual abuse, which may have influenced the expression of schizophrenia in subjects harboring specific SNVs in the OXTR. Copyright © 2017 Elsevier Ltd. All rights reserved.

Paternity tests in Mexico: Results obtained in 3005 cases.

PubMed

García-Aceves, M E; Romero Rentería, O; Díaz-Navarro, X X; Rangel-Villalobos, H

2018-04-01

National and international reports regarding the paternity testing activity scarcely include information from Mexico and other Latin American countries. Therefore, we report different results from the analysis of 3005 paternity cases analyzed during a period of five years in a Mexican paternity testing laboratory. Motherless tests were the most frequent (77.27%), followed by trio cases (20.70%); the remaining 2.04% included different cases of kinship reconstruction. The paternity exclusion rate was 29.58%, higher but into the range reported by the American Association of Blood Banks (average 24.12%). We detected 65 mutations, most of them involving one-step (93.8% and the remaining were two-step mutations (6.2%) thus, we were able to estimate the paternal mutation rate for 17 different STR loci: 0.0018 (95% CI 0.0005-0.0047). Five triallelic patterns and 12 suspected null alleles were detected during this period; however, re-amplification of these samples with a different Human Identification (HID) kit confirmed the homozygous genotypes, which suggests that most of these exclusions actually are one-step mutations. HID kits with ≥20 STRs detected more exclusions, diminishing the rate of inconclusive results with isolated exclusions (<3 loci), and leading to higher paternity indexes (PI). However, the Powerplex 21 kit (20 STRs) and Powerplex Fusion kit (22 STRs) offered similar PI (p = 0.379) and average number of exclusions (PE) (p = 0.339) when a daughter was involved in motherless tests. In brief, besides to report forensic parameters from paternity tests in Mexico, results describe improvements to solve motherless paternity tests using HID kits with ≥20 STRs instead of one including 15 STRs. Copyright © 2018 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

A case of De Garengeot hernia requiring early surgery

PubMed Central

Pan, Chao-Wen; Tsao, Min-Jen; Su, Ming-Shan

2015-01-01

De Garengeot hernia is a rare clinical entity defined as the presence of a vermiform appendix within a femoral hernia sac. A 50-year-old woman presented to the emergency department with a painful lump over her right groin region. A bedside ultrasound was performed and soft tissue lesion was suspected. CT was performed and revealed a swollen tubular structure with fat stranding within the mass. De Garengeot hernia with acute appendicitis was diagnosed preoperatively, and an emergency appendectomy and hernioplasty were performed. Although it is usually an incidental finding during hernioplasty, De Garengeot hernia should be considered in the differential diagnosis of patients with an incarcerated femoral hernia. Mesh repair can be performed depending on the clinical situation. We report a rare case of incarcerated femoral hernia with acute appendicitis that required early surgical management to avoid associated complications. PMID:26199302

Donor Indocyanine Green Clearance Test Predicts Graft Quality and Early Graft Prognosis After Liver Transplantation.

PubMed

Tang, Yunhua; Han, Ming; Chen, Maogen; Wang, Xiaoping; Ji, Fei; Zhao, Qiang; Zhang, Zhiheng; Ju, Weiqiang; Wang, Dongping; Guo, Zhiyong; He, Xiaoshun

2017-11-01

Transplantation centers have given much attention to donor availability. However, no reliable quantitative methods have been employed to accurately assess graft quality before transplantation. Here, we report that the indocyanine green (ICG) clearance test is a valuable index for liver grafts. We performed the ICG clearance test on 90 brain-dead donors within 6 h before organ procurement between March 2015 and November 2016. We also analyzed the relationship between graft liver function and early graft survival after liver transplantation (LT). Our results suggest that the ICG retention rate at 15 min (ICGR15) of donors before procurement was independently associated with 3-month graft survival after LT. The best donor ICGR15 cutoff value was 11.0%/min, and we observed a significant increase in 3-month graft failure among patients with a donor ICGR15 above this value. On the other hand, a donor ICGR15 value of ≤ 11.0%/min could be used as an early assessment index of graft quality because it provides additional information to the transplant surgeon or organ procurement organization members who must maintain or improve organ function to adapt the LT. An ICG clearance test before liver procurement might be an effective quantitative method to predict graft availability and improve early graft prognosis after LT.

Test-Case Generation using an Explicit State Model Checker Final Report

NASA Technical Reports Server (NTRS)

Heimdahl, Mats P. E.; Gao, Jimin

2003-01-01

In the project 'Test-Case Generation using an Explicit State Model Checker' we have extended an existing tools infrastructure for formal modeling to export Java code so that we can use the NASA Ames tool Java Pathfinder (JPF) for test case generation. We have completed a translator from our source language RSML(exp -e) to Java and conducted initial studies of how JPF can be used as a testing tool. In this final report, we provide a detailed description of the translation approach as implemented in our tools.

Can overt diabetes mellitus be predicted by an early A1C value in gestational diabetics?

PubMed

Granada, Catalina; Forbes, Joanna; Sangi-Haghpeykar, Haleh; Davidson, Christina

2014-01-01

To test the hypothesis that a hemoglobin A1C value (A1C) in early pregnancy is predictive of overt diabetes mellitus (DM) postpartum in women with gestational diabetes (GDM). In this case-control analysis of women with an early pregnancy diagnosis of GDM, we estimated the association between an early pregnancy A1C and subsequent diagnosis of DM. Women with a normal postpartum diabetic screen (controls) were compared against those with confirmed postpartum DM (cases). Ability of A1C levels to predict DM was examined via logistic regression analysis and corresponding receiver operating characteristic values. During the 10-year study period 166 women met the inclusion criteria: 140 (84%) had normal postpartum testing (controls), and 26 (16%) were diagnosed with DM (cases). The mean A1C value was significantly higher among cases than controls (6.7 vs. 5.6, p < 0.0001, SD 1.3-5). Cases had A1Cs ranging from 5.5- 11.7%, while controls had A1Cs ranging from 4.3-7.8%. The best discriminatory cut point for postpartum DM was an A1C > 5.9% (sensitivity 81%, specificity 83%, positive predictive value 47%, negative predictive value Our findings suggest that an elevated early pregnancy A1C may be predictive of overt DM. Larger studies are needed to further validate this association.

Validation of early image acquisitions following Tc-99 m sestamibi injection using a semiconductors camera of cadmium-zinc-telluride.

PubMed

Meyer, Celine; Weinmann, Pierre

2017-08-01

Cadmium-zinc-telluride (CZT) cameras allow to decrease significantly the acquisition time of myocardial perfusion imaging (MPI), but the duration of the examination is still long. Therefore, this study was performed to test the feasibility of early imaging following injection of Tc-99 m sestamibi using a CZT camera. Seventy patients underwent both an early and a delayed image acquisition after exercise stress test (n = 30), dipyridamole stress test (n = 20), and at rest (n = 20). After injection of Tc-99 m sestamibi, the early image acquisition started on average within 5 minutes for the exercise and rest groups, and 3 minutes 30 seconds for the dipyridamole group. Two independent observers evaluated image quality and extracardiac uptake on four-point scales. The difference between early and later images for each patient was scored on a five-point scale. The image quality and extracardiac uptake of early and delayed image acquisitions were not different for the three groups (P > .05). There was no significant difference between early and delayed image acquisitions in the exercise, dipyridamole, and rest groups, respectively, in 63%, 40%, and 80% of cases. In the exercise group and rest group, a defect was only present in early MPI, respectively, in 13% and 20% of cases. A defect was only present in delayed images in 10% of cases in the exercise group and in 45% of cases in the dipyridamole group. There was no difference between early and later image acquisitions in terms of quality. This protocol reduces the length of the procedure for the patient. Beginning with early image acquisitions may help to overcome the artifacts that are observed at the delayed time.

30 CFR 250.525 - What do I submit if my casing diagnostic test requires action?

Code of Federal Regulations, 2011 CFR

2011-07-01

... 30 Mineral Resources 2 2011-07-01 2011-07-01 false What do I submit if my casing diagnostic test... if my casing diagnostic test requires action? Within 14 days after you perform a casing diagnostic... Corrective Action Plan within 30 days of the diagnostic test. (b) a casing pressure request, Regional...

[Early form of toxoplasmosis with accompanying enlargement of lymph nodes].

PubMed

Małafiej, Eugeniusz; Spiewak, Ewa; Frankowska, Joanna; Maciejewska, Ewa

2004-05-01

The paper describes a case of a 42-year-old female presented rapidly increasing enlargement of lymph nodes. Initially it was believed to be an effect of proliferous systemic changes. The diagnostic procedures did not confirm the initial diagnosis but they evoked a lot of stress of the patient as well as her psychic discomfort resulting from a number of biopsies. Serological tests carried out in the further course of the diagnostic procedure showed that the increased nodular reaction should be attributed to Toxoplasma gondii invasion, which was indicated by the presence of IgM and IgA antibodies and low avidity of IgG. The early administration of specific treatment with spiramycin led to the regression of the clinical symptoms and gradual normalization of the serological test. The case is worth attention for several reasons: 1. it indicates that it is necessary to consider T. gondii infection in basic clinical practice, which is frequently ignored, 2. it illustrates the effectiveness of early specific treatment, 3. it demonstrates the importance of well selected and properly interpreted microbiological tests.

Impact of a Routine, Opt-Out HIV Testing Program on HIV Testing and Case Detection in North Carolina Sexually-Transmitted Disease Clinics

PubMed Central

Klein, Pamela W.; Messer, Lynne C.; Myers, Evan R.; Weber, David J.; Leone, Peter A.; Miller, William C.

2016-01-01

The impact of routine, opt-out HIV testing programs in clinical settings is inconclusive. The objective of this study was to estimate the impact of an expanded, routine HIV testing program in North Carolina sexually transmitted disease (STD) clinics on HIV testing and case detection. Adults aged 18–64 who received an HIV test in a North Carolina STD clinic July 1, 2005 through June 30, 2011 were included in this analysis, dichotomized at the date of implementation on November 1, 2007. HIV testing and case detection counts and rates were analyzed using interrupted time series analysis, and Poisson and multilevel logistic regression. Pre-intervention, 426 new HIV-infected cases were identified from 128,029 tests (0.33%), whereas 816 new HIV-infected cases were found from 274,745 tests post-intervention (0.30%). Pre-intervention, HIV testing increased by 55 tests per month (95% confidence interval [CI]: 41, 72), but only 34 tests per month (95% CI: 26, 42) post-intervention. Increases in HIV testing rates were most pronounced in females and non-Hispanic whites. A slight pre-intervention decline in case detection was mitigated by the intervention (mean difference [MD]=0.01; 95% CI: −0.02, 0.05). Increases in case detection rates were observed among females and non-Hispanic blacks. The impact of a routine HIV screening in North Carolina STD clinics was marginal, with the greatest benefit among persons not traditionally targeted for HIV testing. The use of a pre-intervention comparison period identified important temporal trends that otherwise would have been ignored. PMID:24825338

Professional Identity of an Early Childhood Black Teacher in a Predominantly White School: A Case Study

ERIC Educational Resources Information Center

Al-Khatib, Amal J.; Lash, Martha J.

2017-01-01

This qualitative case study investigated the role of race, school context, and personal and professional experiences in the formation of an early childhood minority teacher's professional identity. Data sources included interviews, observations, conversations, field notes and school artefacts. Member checking, triangulation and extended…

[Clinical Advanced in Early-stage ALK-positive Non-small Cell Lung Cancer Patients].

PubMed

Gao, Qiongqiong; Jiang, Xiangli; Huang, Chun

2017-02-20

Lung cancer is the leading cause of cancer death in China. Non-small cell lung cancer (NSCLC) accounts for 85% of lung cancer cases, with the majority of the cases diagnosed at the advanced stage. Molecular targeted therapy is becoming the focus attention for advanced NSCLC. Echinoderm microtubule-associated protein-like 4 gene and the anaplastic lymphoma kinase gene (EML4-ALK) is among the most common molecular targets of NSCLC; its specific small-molecule tyrosine kinase inhibitors (TKIs) are approved for use in advanced NSCLC cases of ALK-positive. However, the influence of EML4-ALK fusion gene on the outcome of early-stage NSCLC cases and the necessity of application of TKIs for early-stage ALK-positive NSCLC patients are still uncertain. In this paper, we summarized the progression of testing methods for ALK-positive NSCLC patients as well as clinicopathological implication, outcome, and necessity of application of TKIs for early-stage ALK-positive NSCLC patients.

Cardiopulmonary exercise testing early after stroke using feedback-controlled robotics-assisted treadmill exercise: test-retest reliability and repeatability.

PubMed

Stoller, Oliver; de Bruin, Eling D; Schindelholz, Matthias; Schuster-Amft, Corina; de Bie, Rob A; Hunt, Kenneth J

2014-10-11

Exercise capacity is seriously reduced after stroke. While cardiopulmonary assessment and intervention strategies have been validated for the mildly and moderately impaired populations post-stroke, there is a lack of effective concepts for stroke survivors suffering from severe motor limitations. This study investigated the test-retest reliability and repeatability of cardiopulmonary exercise testing (CPET) using feedback-controlled robotics-assisted treadmill exercise (FC-RATE) in severely motor impaired individuals early after stroke. 20 subjects (age 44-84 years, <6 month post-stroke) with severe motor limitations (Functional Ambulatory Classification 0-2) were selected for consecutive constant load testing (CLT) and incremental exercise testing (IET) within a powered exoskeleton, synchronised with a treadmill and a body weight support system. A manual human-in-the-loop feedback system was used to guide individual work rate levels. Outcome variables focussed on standard cardiopulmonary performance parameters. Relative and absolute test-retest reliability were assessed by intraclass correlation coefficients (ICC), standard error of the measurement (SEM), and minimal detectable change (MDC). Mean difference, limits of agreement, and coefficient of variation (CoV) were estimated to assess repeatability. Peak performance parameters during IET yielded good to excellent relative reliability: absolute peak oxygen uptake (ICC =0.82), relative peak oxygen uptake (ICC =0.72), peak work rate (ICC =0.91), peak heart rate (ICC =0.80), absolute gas exchange threshold (ICC =0.91), relative gas exchange threshold (ICC =0.88), oxygen cost of work (ICC =0.87), oxygen pulse at peak oxygen uptake (ICC =0.92), ventilation rate versus carbon dioxide output slope (ICC =0.78). For these variables, SEM was 4-13%, MDC 12-36%, and CoV 0.10-0.36. CLT revealed high mean differences and insufficient test-retest reliability for all variables studied. This study presents

Specifications for a coupled neutronics thermal-hydraulics SFR test case

NASA Astrophysics Data System (ADS)

Tassone, A.; Smirnov, A. D.; Tikhomirov, G. V.

2017-01-01

Coupling neutronics/thermal-hydraulics calculations for the design of nuclear reactors are a growing trend in the scientific community. This approach allows to properly represent the mutual feedbacks between the neutronic distribution and the thermal-hydraulics properties of the materials composing the reactor, details which are often lost when separate analysis are performed. In this work, a test case for a generation IV sodium-cooled fast reactor (SFR), based on the ASTRID concept developed by CEA, is proposed. Two sub-assemblies (SA) characterized by different fuel enrichment and layout are considered. Specifications for the test case are provided including geometrical data, material compositions, thermo-physical properties and coupling scheme details. Serpent and ANSYS-CFX are used as reference in the description of suitable inputs for the performing of the benchmark, but the use of other code combinations for the purpose of validation of the results is encouraged. The expected outcome of the test case are the axial distribution of volumetric power generation term (q‴), density and temperature for the fuel, the cladding and the coolant.

Diagnostic yield of hair and urine toxicology testing in potential child abuse cases.

PubMed

Stauffer, Stephanie L; Wood, Stephanie M; Krasowski, Matthew D

2015-07-01

Detection of drugs in a child may be the first objective finding that can be reported in cases of suspected child abuse. Hair and urine toxicology testing, when performed as part of the initial clinical evaluation for suspected child abuse or maltreatment, may serve to facilitate the identification of at-risk children. Furthermore, significant environmental exposure to a drug (considered by law to constitute child abuse in some states) may be identified by toxicology testing of unwashed hair specimens. In order to determine the clinical utility of hair and urine toxicology testing in this population we performed a retrospective chart review on all children for whom hair toxicology testing was ordered at our academic medical center between January 2004 and April 2014. The medical records of 616 children aged 0-17.5 years were reviewed for injury history, previous medication and illicit drug use by caregiver(s), urine drug screen result (if performed), hair toxicology result, medication list, and outcome of any child abuse evaluation. Hair toxicology testing was positive for at least one compound in 106 cases (17.2%), with unexplained drugs in 82 cases (13.3%). Of these, there were 48 cases in which multiple compounds (including combination of parent drugs and/or metabolites within the same drug class) were identified in the sample of one patient. The compounds most frequently identified in the hair of our study population included cocaine, benzoylecgonine, native (unmetabolized) tetrahydrocannabinol, and methamphetamine. There were 68 instances in which a parent drug was identified in the hair without any of its potential metabolites, suggesting environmental exposure. Among the 82 cases in which hair toxicology testing was positive for unexplained drugs, a change in clinical outcome was noted in 71 cases (86.5%). Urine drug screens (UDS) were performed in 457 of the 616 reviewed cases. Of these, over 95% of positive UDS results could be explained by iatrogenic drug

Impact Testing and Analysis of Composites for Aircraft Engine Fan Cases

NASA Technical Reports Server (NTRS)

Roberts, Gary D.; Revilock, Duane M.; Binienda, Wieslaw K.; Nie, Walter Z.; Mackenzie, S. Ben; Todd, Kevin B.

2002-01-01

The fan case in a jet engine is a heavy structure because of its size and because of the requirement that it contain a blade released during engine operation. Composite materials offer the potential for reducing the weight of the case. Efficient design, test, and analysis methods are needed to efficiently evaluate the large number of potential composite materials and design concepts. The type of damage expected in a composite case under blade-out conditions was evaluated using a subscale test in which a glass/epoxy composite half-ring target was impacted with a wedge-shaped titanium projectile. Fiber shearing occurred near points of contact between the projectile and target. Delamination and tearing occurred on a larger scale. These damage modes were reproduced in a simpler test in which flat glass/epoxy composites were impacted with a blunt cylindrical projectile. A surface layer of ceramic eliminated fiber shear fracture but did not reduce delamination. Tests on 3D woven carbon/epoxy composites indicated that transverse reinforcement is effective in reducing delamination. A 91 cm (36 in.) diameter full-ring sub-component was proposed for larger scale testing of these and other composite concepts. Explicit, transient, finite element analyses indicated that a full-ring test is needed to simulate complete impact dynamics, but simpler tests using smaller ring sections are adequate when evaluation of initial impact damage is the primary concern.

Evaluation of continuing education of family health strategy teams for the early identification of suspected cases of cancer in children.

PubMed

Costa, Ana Maria Aranha Magalhaes; Magluta, Cynthia; Gomes Junior, Saint Clair

2017-09-07

This study evaluated the influence of continuing education of family health strategy teams by the Ronald McDonald Institute program on the early diagnosis of cancer in children and adolescents. The study applied Habicht's model to evaluate the adequacy and plausibility of continuing education by using as outcome the number of children with suspected cancer who were referred to the hospital of references in the 1 year before and 1 year after intervention and the number of patients referred by intervention group and control group family health strategy teams. Medical records from each hospital of reference were used to collect information of suspect cases of cancer. Descriptive analyses were performed using frequencies and mean values. Chi-square tests were used to assess statistically significant differences between the groups and periods by using p-values < 0.05. The results showed a 30.6% increase in the number of children referred to the hospital of reference for suspected cancer in the post-intervention period; in addition, the family health strategy teams that underwent the intervention referred 3.6 times more number of children to hospital of references than did the control group. Only the intervention group showed an increase in the number of confirmed cases. This evaluation of a continuing education program for early identification of pediatric cancer showed that the program was adequate in achieving the established goals and that the results could be attributed to the program.

[Seven cases of tuberculous otitis media].

PubMed

Nishiike, S; Irifune, M; Kubo, T

2000-12-01

Tuberculous otitis media (TOM) is a variable and puzzling infectious disease that is sometimes confused with other chronic middle ear diseases. A series of 7 cases (9 ears) of TOM recently treated at Osaka Prefectural Habikino Hospital is reviewed to assess the recent features of the disease. In most cases, the pathogenetic mechanism was probably aspiration of tubercle bacilli through the eustachian tube. In most cases, abundant granulations were observed in the middle and external ears, but multiple perforations of the tympanic membrane were not seen. The manifestations were variable, such as otorrhea from the perforation and otitis media with effusion. In their early stage, most cases of TOMs due to transmission via the eustachian tube are tend to resemble otitis media with effusion. Smear tests, culture, PCR, and histopathological examinations, each of which has advantages and disadvantages, must be repeated to achieve a definitive diagnosis. Tuberculin tests can be unreliable, but a chest x-ray is indispensable whenever TOM is suspected. Antitubercular chemotherapy and 2% kanamycin earwash yielded good results. Since the classical criteria for the diagnosis of TOM are no longer valid, we propose a new criterion for diagnosis in the early stage of the disease.

Palaeoclimate significance of speleothems in crystalline rocks: a test case from the Late Glacial and early Holocene (Vinschgau, northern Italy)

NASA Astrophysics Data System (ADS)

Koltai, Gabriella; Cheng, Hai; Spötl, Christoph

2018-03-01

Partly coeval flowstones formed in fractured gneiss and schist were studied to test the palaeoclimate significance of this new type of speleothem archive on a decadal-to-millennial timescale. The samples encompass a few hundred to a few thousand years of the Late Glacial and the early Holocene. The speleothem fabric is primarily comprised of columnar fascicular optic calcite and acicular aragonite, both indicative of elevated Mg / Ca ratios in the groundwater. Stable isotopes suggest that aragonite is more prone to disequilibrium isotope fractionation driven by evaporation and prior calcite/aragonite precipitation than calcite. Changes in mineralogy are therefore attributed to these two internal fracture processes rather than to palaeoclimate. Flowstones formed in the same fracture show similar δ18O changes on centennial scales, which broadly correspond to regional lacustrine δ18O records, suggesting that such speleothems may provide an opportunity to investigate past climate conditions in non-karstic areas. The shortness of overlapping periods in flowstone growth and the complexity of in-aquifer processes, however, render the establishment of a robust stacked δ18O record challenging.

Oral manifestations as an early clinical sign of acute myeloid leukaemia: a case report.

PubMed

Guan, G; Firth, N

2015-03-01

Leukaemia is the most common malignancy in children and one of the most common malignancies in young adults. Acute myeloid leukaemia is often associated with early oral manifestations. The purpose of this study is to report the case of a 49-year-old male with spontaneous gingival bleeding for over two years with undiagnosed leukaemia. Haematological investigation was instigated and on referral to the Haematology Department at Dunedin Public Hospital, the diagnosis of an acute myeloid leukaemia was confirmed. Since oral lesions can be one of the early events of acute myeloid leukaemia, they may be considered as an important diagnostic indicator for oral health practitioners, and their roles in diagnosing and treating such patients. © 2015 Australian Dental Association.

DYZ1 copy number variation, Y chromosome polymorphism and early recurrent spontaneous abortion/early embryo growth arrest.

PubMed

Yan, Junhao; Fan, Lingling; Zhao, Yueran; You, Li; Wang, Laicheng; Zhao, Han; Li, Yuan; Chen, Zi-Jiang

2011-12-01

To find the association between recurrent spontaneous abortion (RSA)/early embryo growth arrest and Y chromosome polymorphism. Peripheral blood samples of the male patients of big Y chromosome, small Y chromosome and other male patients whose partners suffered from unexplained RSA/early embryo growth arrest were collected. PCR and real-time fluorescent quantitative PCR were used to test the deletion and the copy number variation of DYZ1 region in Y chromosome of the patients. A total of 79 big Y chromosome patients (48 of whose partners suffered from RSA or early embryo growth arrest), 7 small Y chromosome patients, 106 other male patients whose partners had suffered from unexplained RSA or early embryo growth arrest, and 100 normal male controls were enrolled. There was no fraction deletion of DYZ1 detected both in big Y patients and in normal men. Of RSA patients, 1 case showed deletion of 266bp from the gene locus 25-290bp, and 2 cases showed deletion of 773bp from 1347 to 2119bp. Of only 7 small Y chromosome patients, 2 cases showed deletion of 266bp from 25 to 290bp, and 4 cases showed deletion of 773bp from 1347 to 2119bp and 275bp from 3128 to 3420bp. The mean of DYZ1 copies was 3900 in normal control men; the mean in big Y patients was 5571, in RSA patients was 2655, and in small Y patients was 1059. All of the others were significantly different (P<0.01) compared with normal control men, which meant that DYZ1 copy number in normal control men was less than that of big Y chromosome patients, and was more than that of unexplained early RSA patients and small Y patients. The integrity and copy number variation of DYZ1 are closely related to the Y chromosome length under microscope. The cause of RSA/early embryo growth arrest in some couples may be the increase (big Y patients) or decrease of DYZ1 copy number in the husbands' Y chromosome. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

Diagnosis of liver involvement in early syphilis. A critical review.

PubMed

Veeravahu, M

1985-01-01

The diagnosis of liver involvement in early syphilis has always posed problems because of its rarity and the difficulty of excluding coincidental liver disease caused by a multitude of pathogens. Case reports deal predominantly with jaundiced homosexual men in whom syphilis is discovered later, and the prospective studies of patients with early syphilis disclose only mild biochemical abnormalities in liver function test results. There is no single characteristic feature attributable to early syphilitic hepatitis. Even liver histologic findings are variable. At least in those patients who have jaundice, there is a likelihood of coincidental viral hepatitis. Therefore, the evidence to implicate Treponema pallidum as a liver pathogen in early syphilis is not convincing.

Early reading performance: a comparison of teacher-based and test-based assessments.

PubMed

Kenny, D T; Chekaluk, E

1993-04-01

An unresolved question in early screening is whether test-based or teacher-based assessments should form the basis of the classification of children at risk of educational failure. Available structured teacher rating scales are lacking in predictive validity, and teacher predictions of students likely to experience reading difficulties have yielded disappointing true positive rates, with teachers failing to identify the majority of severely disabled readers. For this study, three educational screening instruments were developed: (a) a single teacher rating, categorizing children into three levels of reading ability (advanced, average, poor); (b) a 15-item teacher questionnaire designed to measure students' cognitive and language ability, attentional and behavioral characteristics, and academic performance; and (c) a battery of language and reading tests that are predictive of, or correlate with, reading failure. The concurrent validity of each instrument was assessed in a sample of 312 Australian schoolchildren from kindergarten, Year 1, and Year 2. Students were assessed at the end of the 1989 school year after having completed 1, 2, or 3 years of schooling. The results suggest that the nature of the skills required for success in reading changes in the first 3 years of schooling. Both teachers and tests concur more closely as children progress through the elementary years and as the risk behavior (reading) becomes more accessible to direct measurement. Carefully focused teacher rating scales may be a cost-effective means of identifying children at risk of reading failure. Improved teacher rating scales should be developed and used to assist in the early screening process.

Comparison of nonstructural protein-1 antigen detection by rapid and enzyme-linked immunosorbent assay test and its correlation with polymerase chain reaction for early diagnosis of dengue

PubMed Central

Gaikwad, Seema; Sawant, Sandhya S.; Shastri, Jayanthi S.

2017-01-01

INTRODUCTION: Early diagnosis of dengue is important for appropriate clinical management and vector control. Different serological tests based on the principle of immunochromatography and enzyme-linked immunosorbent assay (ELISA) are commonly used for detection of antigen and antibodies of dengue virus. The performance of these tests depends on the sensitivity and specificity. Hence, the study was undertaken to compare nonstructural protein-1 (NS1) antigen detection by rapid and ELISA with real-time polymerase chain reaction (RT-PCR) for diagnosis of dengue. MATERIALS AND METHODS: Prospective laboratory study was carried out on sera samples (n = 200) from clinically suspected cases of dengue. The sera samples were subjected for NS1 antigen detection test by rapid test, NS1 ELISA, and RT-PCR. The results of rapid and ELISA tests were compared with real Time PCR. RESULTS: The sensitivity, specificity, positive, and negative predictive value of rapid dengue NS1 antigen test were 81.5%, 66.7%, 78.2%, and 71.1%, respectively whereas that of NS1 ELISA were 89.9%, 100%, 100%, and 94%, respectively. Concordance of Rapid NS1 and NS1 ELISA with PCR was 75.5% and 94%. DISCUSSION AND CONCLUSION: NS1 antigen ELISA can be implemented in diagnostic laboratories for diagnosis of dengue in the acute phase of illness. The test also has great potential value for use in epidemic situations, as it could facilitate the early screening of patients and limit disease expansion. PMID:28706387

Neonatal Early Warning Tools for recognising and responding to clinical deterioration in neonates cared for in the maternity setting: A retrospective case-control study.

PubMed

Paliwoda, Michelle; New, Karen; Bogossian, Fiona

2016-09-01

All newborns are at risk of deterioration as a result of failing to make the transition to extra uterine life. Signs of deterioration can be subtle and easily missed. It has been postulated that the use of an Early Warning Tool may assist clinicians in recognising and responding to signs of deterioration earlier in neonates, thereby preventing a serious adverse event. To examine whether observations from a Standard Observation Tool, applied to three neonatal Early Warning Tools, would hypothetically trigger an escalation of care more frequently than actual escalation of care using the Standard Observation Tool. A retrospective case-control study. A maternity unit in a tertiary public hospital in Australia. Neonates born in 2013 of greater than or equal to 34(+0) weeks gestation, admitted directly to the maternity ward from their birthing location and whose subsequent deterioration required admission to the neonatal unit, were identified as cases from databases of the study hospital. Each case was matched with three controls, inborn during the same period and who did not experience deterioration and neonatal unit admission. Clinical and physiological data recorded on a Standard Observation Tool, from time of admission to the maternity ward, for cases and controls were charted onto each of three Early Warning Tools. The primary outcome was whether the tool 'triggered an escalation of care'. Descriptive statistics (n, %, Mean and SD) were employed. Cases (n=26) comprised late preterm, early term and post-term neonates and matched by gestational age group with 3 controls (n=78). Overall, the Standard Observation Tool triggered an escalation of care for 92.3% of cases compared to the Early Warning Tools; New South Wales Health 80.8%, United Kingdom Newborn Early Warning Chart 57.7% and The Australian Capital Territory Neonatal Early Warning Score 11.5%. Subgroup analysis by gestational age found differences between the tools in hypothetically triggering an escalation of

A Case of Severe Chlorite Poisoning Successfully Treated With Early Administration of Methylene Blue, Renal Replacement Therapy, and Red Blood Cell Transfusion

PubMed Central

Gebhardtova, Andrea; Vavrinec, Peter; Vavrincova-Yaghi, Diana; Seelen, Mark; Dobisova, Anna; Flassikova, Zora; Cikova, Andrea; Henning, Robert H.; Yaghi, Aktham

2014-01-01

Abstract The case of a 55-year-old man who attempted suicide by ingesting <100 mL of 28% sodium chlorite solution is presented. On arrival in the intensive care unit, the patient appeared cyanotic with lowered consciousness and displayed anuria and chocolate brown serum. Initial laboratory tests revealed 40% of methemoglobin. The formation of methemoglobin was effectively treated with methylene blue (10% after 29 hours). To remove the toxin, and because of the anuric acute renal failure, the patient received renal replacement therapy. Despite these therapeutic measures, the patient developed hemolytic anemia and disseminated intravascular coagulation, which were treated with red blood cell transfusion and intermittent hemodialysis. These interventions led to the improvement of his condition and the patient eventually fully recovered. Patient gave written informed consent. This is the third known case of chlorite poisoning that has been reported. Based upon this case, we suggest the management of sodium chlorite poisoning to comprise the early administration of methylene blue, in addition to renal replacement therapy and transfusion of red blood cells. PMID:25144325

Community health workers provide integrated community case management using malaria rapid diagnostic test kits.

PubMed

Orji, Bright C; Rao, Namratha; Thompson, Elizabeth; Brieger, William R; 'Dipo Otolorin, Emmanuel

Throughout Nigeria malaria is an endemic disease. Efforts to treat malaria can also be combined with other illnesses including pneumonia and diarrhea, which are killing children under five years of age. The use of Rapid Diagnostic Test (RDT) aids early diagnosis of malaria and informs when other illnesses should be considered. Those with positive RDT results should be treated with Artemisinin-based Combination Therapy (ACTs), while those with negative RDTs results are further investigated for pneumonia and diarrhea. Critical health systems challenges such as human resource constraints mean that community case management (CCM) and community health workers such as volunteers called Community Directed Distributors (CDDs) can therefore play an important role in diagnosing and treating malaria. This repost described an effort to monitor and document the performance of trained CDDs in providing quality management of febrile illnesses including the use of RDTs. The program trained one hundred and fifty-two (152) CDDs on the use of RDTs to test for malaria and give ACTs for positive RDTs results, cotrimoxazole for the treatment of pneumonia and Oral rehydration solution and zinc for diarrhea They were also taught to counsel on compliance medicine, identify adverse reactions, and keep accurate records. The CDDs worked for 12 Calendar months. Their registers were retrieved and audited using a checklist to document client complaints, tests done, test results and treatment provided. No client identifying information was collected. There were 32 (21%) male CDDs and 120 (79%) females. The overall mean age of the CDDs was 36.8 (±8.7) years old. 89% of the male CDDs provided correct treatment based on RDT results compared to 97.6% of the female CDDs, a statistically significant difference. Likewise CDDs younger than 36 years of age provided 92.7% correct case management compared to those 36 years and older (98.4%). The difference between the age groups was also significant. There

Role of non-Invasive Tests for the Early Detection of Cancer | Division of Cancer Prevention

Cancer.gov

Speaker | Dr. Nickolas Papadopoulos will present "Role of non-Invasive Tests for the Early Detection of Cancers". Date: June 5, 2018; Time: 11:00am - 12:00pm; Location: NCI Shady Grove, Conference Room: Seminar 110 Terrace Level East

Test Cases for the Benchmark Active Controls: Spoiler and Control Surface Oscillations and Flutter

NASA Technical Reports Server (NTRS)

Bennett, Robert M.; Scott, Robert C.; Wieseman, Carol D.

2000-01-01

sets from the first two tests have been chosen for Test Cases for computational comparisons concentrating on static conditions and cases with harmonically oscillating control surfaces. Several flutter Test Cases from both tests have also been included. Some aerodynamic comparisons with the BACT data have been made using computational fluid dynamics codes at the Navier-Stokes level (and in the accompanying chapter SC). Some mechanical and active control studies have been presented. In this report several Test Cases are selected to illustrate trends for a variety of different conditions with emphasis on transonic flow effects. Cases for static angles of attack, static trailing-edge and upper-surface spoiler deflections are included for a range of conditions near those for the oscillation cases. Cases for trailing-edge control and upper-surface spoiler oscillations for a range of Mach numbers, angle of attack, and static control deflections are included. Cases for all three types of flutter instability are selected. In addition some cases are included for dynamic response measurements during forced oscillations of the controls on the flexible mount. An overview of the model and tests is given, and the standard formulary for these data is listed. Some sample data and sample results of calculations are presented. Only the static pressures and the first harmonic real and imaginary parts of the pressures are included in the data for the Test Cases, but digitized time histories have been archived. The data for the Test Cases are also available as separate electronic files.

Clinical trial: a randomized trial of early endoscopy, Helicobacter pylori testing and empirical therapy for the management of dyspepsia in primary care.

PubMed

Duggan, A E; Elliott, C A; Miller, P; Hawkey, C J; Logan, R F A

2009-01-01

Early endoscopy, Helicobacter pylori eradication and empirical acid suppression are commonly used dyspepsia management strategies in primary care but have not been directly compared in a single trial. To compare endoscopy, H. pylori test and refer, H. pylori test and treat and empirical acid suppression for dyspepsia in primary care. Patients presenting to their general practitioner with dyspepsia were randomized to endoscopy, H. pylori'test and treat', H. pylori test and endoscope positives, or empirical therapy with symptoms, patient satisfaction, healthcare costs and cost effectiveness at 12 months being the outcomes. At 2 months, the proportion of patients reporting no or minimal dyspeptic symptoms ranged from 74% for those having early endoscopy to 55% for those on empirical therapy (P = 0.009), but at 1 year, there was little difference among the four strategies. Early endoscopy was associated with fewer subsequent consultations for dyspepsia (P = 0.003). 'Test and treat' resulted in fewer endoscopies overall and was most cost-effective over a range of cost assumptions. Empirical therapy resulted in the lowest initial costs, but the highest rate of subsequent endoscopy. Gastro-oesophageal cancers were found in four patients randomized to the H. pylori testing strategies. While early endoscopy offered some advantages 'Test and treat' was the most cost-effective strategy. In older patients, early endoscopy may be an appropriate strategy in view of the greater risk of malignant disease. © 2008 The Authors. Journal compilation © 2008 Blackwell Publishing Ltd.

An Exploratory Case Study of One Early Career Teacher's Evolving Teaching Practice in Northern Canada

ERIC Educational Resources Information Center

Murray-Orr, Anne; Mitton-Kukner, Jennifer

2017-01-01

This paper focuses upon the case of one early career teacher, Don, a participant in a longitudinal study examining the transfer of learning about literacy practices from pre-service teacher education to the classrooms of secondary content area teachers. We followed Don from his B. Ed. program into his first two years of teaching in an Indigenous…

Pilot-Testing CATCH Early Childhood: A Preschool-Based Healthy Nutrition and Physical Activity Program

ERIC Educational Resources Information Center

Sharma, Shreela; Chuang, Ru-Jye; Hedberg, Ann Marie

2011-01-01

Background: The literature on theoretically-based programs targeting healthy nutrition and physical activity in preschools is scarce. Purpose: To pilot test CATCH Early Childhood (CEC), a preschool-based nutrition and physical activity program among children ages three to five in Head Start. Methods: The study was conducted in two Head Start…

Antigravity treadmill training during the early rehabilitation phase following unicompartmental knee arthroplasty: A case series.

PubMed

Huang, Chun-Hao; Schroeder, E Todd; Powers, Christopher

2018-02-26

Patients who have undergone unicompartmental knee arthroplasty (UKA) have been reported to exhibit altered gait 19-25 months post-surgery. The most common gait impairment in this population is inadequate knee flexion and a corresponding decrease in the knee extensor moment during loading response (i.e., quadriceps avoidance). The purpose of this case series was to determine whether incorporation of antigravity treadmill training into a standard physical therapy program can eliminate quadriceps avoidance gait during the early rehabilitation phase following UKA. Four females who underwent UKA were recruited for this study. Participants completed antigravity treadmill training three times per week for 12 weeks in addition to their standard physical therapy program. Instrumented gait analysis was performed at baseline (pre-intervention), week 6 (mid-intervention), and week 12 (post-intervention). We found that peak knee flexion and the peak knee extensor moment during the weight acceptance phase of gait increased to normal values following the 12-week intervention period (14.1 ± 6.5° to 20.6 ± 1.5° and 0.4 ± 0.3 to 0.7 ± 0.2 Nm/kg respectively). The findings of this case series suggest that a standard physical therapy program that incorporates early gait training using an antigravity treadmill may be beneficial in eliminating "quadriceps avoidance" during the early rehabilitation phase following UKA.

Rectus sheath haematoma following exercise testing: a case report

PubMed Central

2009-01-01

Introduction Exercise testing is a safe diagnostic procedure which is widely used in the evaluation of patients suspected of having coronary heart disease or for the assessment of the prognosis in patients with established disease. Its complications are mainly cardiac disorders. Here, we report a rectus sheath haematoma as a complication of this procedure in a patient with acute coronary syndrome. To our knowledge, this is the first case report of rectus sheath haematoma in association with exercise testing. Case presentation A 72-year-old Caucasian woman was admitted for acute coronary syndrome. She received conservative treatment including low molecular weight heparin and anti-platelet agents. On the fifth day of her hospital stay, she underwent an exercise test, where no ischaemic response occurred. Several hours later, she experienced pain in the left side of her abdomen. Subsequent investigations revealed a rectus sheath haematoma. The patient underwent surgical haematoma evacuation. A few days later, re-operation was performed for recurrent bleeding in the abdominal wall. The patient had several characteristics known to increase the risk of bleeding during treatment for acute coronary syndrome. Conclusion Awareness of this possible consequence of exercise testing is important for preventing and treating it correctly. For prevention, an assessment of the bleeding risk of the individual patient is necessary before the test, and excessive anticoagulation must be avoided. PMID:20338023

Test Review: C. K. Conners. Conners Early Childhood Manual

ERIC Educational Resources Information Center

Wiley, Colby P.; Wedeking, Travis; Galindo, Addy M.

2013-01-01

This article reviews the Conners Early Childhood (Conners EC; Conners, 2009), a behavior and development rating scale intended to assess children in early childhood, specifically defined as ages 2 to 6 years. Using multiple informants across multiple settings, the Conners EC is administered for the purpose of early identification of disorders or…

Validation of the Argentine version of the Memory Binding Test (MBT) for Early Detection of Mild Cognitive Impairment

PubMed Central

Roman, Fabian; Iturry, Mónica; Rojas, Galeno; Barceló, Ernesto; Buschke, Herman; Allegri, Ricardo F.

2016-01-01

ABSTRACT Background: "Forgetfulness" is frequent in normal aging and characteristic of the early stages of dementia syndromes. The episodic memory test is central for detecting amnestic mild cognitive impairment (MCI). The Memory Binding Test (MBT) is a simple, easy and brief memory test to detect the early stage of episodic memory impairment. Objective: To validate the Argentine version of the MBT in a Latin American population and to estimate the diagnostic accuracy as a tool for early detection of MCI. Methods: 88 subjects (46 healthy controls and 42 patients with amnestic MCI) matched for age and educational level were evaluated by an extensive neuropsychological battery and the memory binding test. Results: A significantly better performance was detected in the control group; all MBT scales were predictive of MCI diagnosis (p<.01). The MBT showed high sensitivity (69%) and high specificity (88%), with a PPV of 93% and a NPV of 55% for associative paired recall. A statistically significant difference (c2=14,164, p<.001) was obtained when comparing the area under the curve (AUC) of the MBT (0.88) and the MMSE (0.70). Conclusion: The Argentine version of the MBT correlated significantly with the MMSE and the memory battery and is a useful tool in the detection of MCI. The operating characteristics of the MBT are well suited, surpassing other tests commonly used for detecting MCI. PMID:29213458

Operational Cyber Testing Recommendations- Version 1

DTIC Science & Technology

2014-05-02

be used to verify 5 representative pieces of the environment via sample test runs. Also, ideally, an early version of each test case can also be stood...extraneous effort). Comparing the sample results collected from the scripts with expected results can reveal deficiencies in the data collection techniques...the reporting mechanisms, and the system components themselves. The sample results can also be used for confirming that data is collected with high

Experiments with Test Case Generation and Runtime Analysis

NASA Technical Reports Server (NTRS)

Artho, Cyrille; Drusinsky, Doron; Goldberg, Allen; Havelund, Klaus; Lowry, Mike; Pasareanu, Corina; Rosu, Grigore; Visser, Willem; Koga, Dennis (Technical Monitor)

2003-01-01

Software testing is typically an ad hoc process where human testers manually write many test inputs and expected test results, perhaps automating their execution in a regression suite. This process is cumbersome and costly. This paper reports preliminary results on an approach to further automate this process. The approach consists of combining automated test case generation based on systematically exploring the program's input domain, with runtime analysis, where execution traces are monitored and verified against temporal logic specifications, or analyzed using advanced algorithms for detecting concurrency errors such as data races and deadlocks. The approach suggests to generate specifications dynamically per input instance rather than statically once-and-for-all. The paper describes experiments with variants of this approach in the context of two examples, a planetary rover controller and a space craft fault protection system.

Post-conviction DNA testing: the UK's first ‘exoneration’ case?

PubMed Central

Johnson, Paul; Williams, Robin

2005-01-01

The routine incorporation of forensic DNA profiling into the criminal justice systems of the United Kingdom has been widely promoted as a device for improving the quality of investigative and prosecutorial processes. From its first uses in the 1980s, in cases of serious crime, to the now daily collection, analysis and comparison of genetic samples in the National DNA Database, DNA profiling has become a standard instrument of policing and a powerful evidential resource for prosecutors. However, the use of post-conviction DNA testing has, until recently, been uncommon in the United Kingdom. This paper explores the first case, in England, of the contribution of DNA profiling to a successful appeal against conviction by an imprisoned offender. Analysis of the details of this case is used to emphasise the ways in which novel forms of scientific evidence remain subject to traditional and heterogeneous tests of relevance and credibility. PMID:15112595

Hypochondriasis as an early manifestation of dementia with Lewy bodies: an autopsied case report.

PubMed

Fujishiro, Hiroshige; Iritani, Shuji; Sekiguchi, Hirotaka; Habuchi, Chikako; Torii, Youta; Matsunaga, Shinji; Ozaki, Norio; Yoshida, Mari; Fujita, Kiyoshi

2016-03-01

Discrepancies between clinical and pathological diagnoses of dementia with Lewy bodies (DLB) may occur because the full disease progression remains unclear, especially during the early stage. Herein, we report the case of a 78-year-old Japanese man with hypochondriasis who had autopsy-confirmed limbic-type DLB pathology. He exhibited no core clinical features of DLB. We attempted to identify the clinicopathological correlations in the early stages of DLB. At the age of 77, he became hypochondriacal and exhibited progressive cognitive decline after the death of his wife. He was concerned about his poor physical condition, but hospital examinations did not identify any overtly abnormal findings. At 78 years of age, he consulted a neurologist with complaints of facial numbness and irritability. Neurological examination revealed no overt abnormality, and he scored 21 points on the Mini-Mental State Examination. Magnetic resonance imaging of the brain showed mild bilateral ventricular enlargement. The patient was clinically diagnosed as having possible Alzheimer's disease. Approximately 1 month after his consult, he died of acute pneumonia in a psychiatric hospital to which he had been admitted for severe aggressive behaviour. He exhibited no core clinical features pointing towards a clinical diagnosis of DLB. Neuropathological investigation revealed limbic-type Lewy body disease with concurrent minimum Alzheimer-type pathology, which corresponds to high-likelihood DLB pathology based on the Third Consortium DLB pathological criteria. The patient had minimum nigral degeneration, which is consistent with the absence of parkinsonism. This autopsied case suggests that some DLB patients exhibit hypochondriasis in the early stage of the disease, even if they lack the core clinical features of DLB. © 2015 The Authors. Psychogeriatrics © 2015 Japanese Psychogeriatric Society.

30 CFR 250.1609 - Pressure testing of casing.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 2 2010-07-01 2010-07-01 false Pressure testing of casing. 250.1609 Section 250.1609 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT OF THE INTERIOR OFFSHORE OIL AND.... (When oil or gas is not present in the cap rock, the production liner need not be cemented in place...

A survey of physician receptivity to molecular diagnostic testing and readiness to act on results for early-stage colon cancer patients.

PubMed

Myers, Ronald E; Wolf, Thomas; Shwae, Phillip; Hegarty, Sarah; Peiper, Stephen C; Waldman, Scott A

2016-10-03

We sought to assess physician interest in molecular prognosic testing for patients with early stage colon cancer, and identify factors associated with the likelihood of test adoption. We identified physicians who care for patients with early-stage (pN0) colon cancer patients, mailed them a survey, and analyzed survey responses to assess clinician receptivity to the use of a new molecular test (GUCY2C) that identifies patients at risk for recurrence, and clinician readiness to act on abnormal test results. Of 104 eligible potential respondents, 41 completed and returned the survey. Among responding physicians, 56 % were receptive to using the new prognostic test. Multivariable analyses showed that physicians in academic medical centers were significantly more receptive to molecular test use than those in non-academic settings. Forty-one percent of respondents were ready to act on abnormal molecular test results. Physicians who viewed current staging methods as inaccurate and were confident in their capacity to incorporate molecular testing in practice were more likely to say they would act on abnormal test results. Physician receptivity to molecular diagnostic testing for early-stage colon cancer patients is likely to be influenced by practice setting and perceptions related to delivering quality care to patients. ClinicalTrials.gov Identifier: NCT01972737.

Use of cardiopulmonary exercise testing to assess early ventilatory changes related to occupational particulate matter

PubMed Central

Chao, T.P.; Sperandio, E.F.; Ostolin, T.L.V.P.; Almeida, V.R.; Romiti, M.; Gagliardi, A.R.T.; Arantes, R.L.; Dourado, V.Z.

2018-01-01

Spirometry has been used as the main strategy for assessing ventilatory changes related to occupational exposure to particulate matter (OEPM). However, in some cases, as one of its limitations, it may not be sensitive enough to show abnormalities before extensive damage, as seen in restrictive lung diseases. Therefore, we hypothesized that cardiopulmonary exercise testing (CPET) may be better than spirometry to detect early ventilatory impairment caused by OEPM. We selected 135 male workers with at least one year of exposure. After collection of self-reported socioeconomic status, educational level, and cardiovascular risk data, participants underwent spirometry, CPET, body composition assessment (bioelectrical impedance), and triaxial accelerometry (for level of physical activity in daily life). CPET was performed using a ramp protocol on a treadmill. Metabolic, cardiovascular, ventilatory, and submaximal relationships were measured. We compared 52 exposed to 83 non-exposed workers. Multiple linear regressions were developed using spirometry and CPET variables as outcomes and OEPM as the main predictor, and adjusted by the main covariates. Our results showed that OEPM was associated with significant reductions in peak minute ventilation, peak tidal volume, and breathing reserve index. Exposed participants presented shallower slope of ΔVT/ΔlnV̇E (breathing pattern), i.e., increased tachypneic breathing pattern. The OEPM explained 7.4% of the ΔVT/ΔlnV̇E variability. We found no significant influence of spirometric indices after multiple linear regressions. We conclude that CPET might be a more sensitive feature of assessing early pulmonary impairment related to OEPM. Our cross-sectional results suggested that CPET is a promising tool for the screening of asymptomatic male workers. PMID:29590255

30 CFR 250.524 - When am I required to take action from my casing diagnostic test?

Code of Federal Regulations, 2010 CFR

2010-07-01

... casing diagnostic test; (c) Any well that has demonstrated tubing/casing, tubing/riser, casing/casing... casing diagnostic test? 250.524 Section 250.524 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT... Gas Well-Completion Operations Casing Pressure Management § 250.524 When am I required to take action...

Predictors of early neurological deterioration after ischaemic stroke: a case-control study.

PubMed

Barber, Mark; Wright, Fiona; Stott, David J; Langhorne, Peter

2004-01-01

Early neurological deterioration after ischaemic stroke (stroke in progression) is reported to be common and associated with poor outcome or death. The causes of progressing stroke are, however, uncertain. To determine whether prior drug treatment (with anticoagulant or antiplatelet agents) or early adverse physiological features (pyrexia, hypoxia, dehydration or hyperglycaemia) are associated with progressing ischaemic stroke. The study used a case-control design. From a database of 873 consecutive acute stroke admissions, 196 cases of progressing ischaemic stroke (defined by point deterioration in components of the Scandinavian Stroke Scale or death over the first 72 h after hospital admission) were matched to 196 controls on the basis of age and stroke type. Univariate and conditional logistic regression techniques were used to explore predictors of progressing stroke. Cases and controls were well matched for baseline stroke severity. Warfarin use prior to admission was associated with a reduced risk of progressing stroke [odds ratio (OR) 0.10, p = 0.005]. Prior antiplatelet use was not related. A previous history of diabetes (OR 2.11, p = 0.039) and elevated systolic blood pressure on admission (OR 1.01 for each 1 mm Hg rise, p = 0.017) predicted progressing stroke. Although there were no differences in time to presentation or to brain imaging, a visible causative lesion on CT scanning was more common in the progressing stroke group (OR 2.30, p = 0.022). We found no evidence that adverse physiological features were associated with progressing stroke. Outcomes were worse in the progressing stroke group with 70% being dead or dependent by 30 days compared to 55% in the control group (p = 0.002). Prior warfarin use may be protective against progressing ischaemic stroke. A previous history of diabetes along with elevated admission systolic blood pressure predict deterioration. We found no evidence for an association between adverse physiological features and

Expression and copy number gains of the RET gene in 631 early and mid stage non‐small cell lung cancer cases

PubMed Central

Tan, Ling; Hu, Yerong; Tao, Yongguang; Wang, Bin; Xiao, Jun; Tang, Zhenjie; Lu, Ting

2018-01-01

Background To identify whether RET is a potential target for NSCLC treatment, we examined the status of the RET gene in 631 early and mid stage NSCLC cases from south central China. Methods RET expression was identified by Western blot. RET‐positive expression samples were verified by immunohistochemistry. RET gene mutation, copy number variation, and rearrangement were analyzed by DNA Sanger sequencing, TaqMan copy number assays, and reverse transcription‐PCR. ALK and ROS1 expression levels were tested by Western blot and EGFR mutation using Sanger sequencing. Results The RET‐positive rate was 2.5% (16/631). RET‐positive expression was related to poorer tumor differentiation (P < 0.05). In the 16 RET‐positive samples, only two samples of moderately and poorly differentiated lung adenocarcinomas displayed RET rearrangement, both in RET‐KIF5B fusion partners. Neither ALK nor ROS1 translocation was found. The EGFR mutation rate in RET‐positive samples was significantly lower than in RET‐negative samples (P < 0.05). Conclusion RET‐positive expression in early and mid stage NSCLC cases from south central China is relatively low and is related to poorer tumor differentiation. RET gene alterations (copy number gain and rearrangement) exist in all RET‐positive samples. RET‐positive expression is a relatively independent factor in NSCLC patients, which indicates that the RET gene may be a novel target site for personalized treatment of NSCLC. PMID:29473341

Early flight test experience with Cockpit Displayed Traffic Information (CDTI)

NASA Technical Reports Server (NTRS)

Abbott, T. S.; Moen, G. C.; Person, L. H., Jr.; Keyser, G. L., Jr.; Yenni, K. R.; Garren, J. F., Jr.

1980-01-01

Coded symbology, based on the results of early human factors studies, was displayed on the electronic horizontal situation indicator and flight tested on an advanced research aircraft in order to subject the coded traffic symbology to a realistic flight environment and to assess its value by means of a direct comparison with simple, uncoded traffic symbology. The tests consisted of 28 curved, decelerating approaches, flown by research-pilot flight crews. The traffic scenarios involved both conflict-free and blunder situations. Subjective pilot commentary was obtained through the use of a questionnaire and extensive pilot debriefing sessions. The results of these debriefing sessions group conveniently under either of two categories: display factors or task performance. A major item under the display factor category was the problem of display clutter. The primary contributors to clutter were the use of large map-scale factors, the use of traffic data blocks, and the presentation of more than a few aircraft. In terms of task performance, the cockpit displayed traffic information was found to provide excellent overall situation awareness.

Developing a dengue early warning system using time series model: Case study in Tainan, Taiwan

NASA Astrophysics Data System (ADS)

Chen, Xiao-Wei; Jan, Chyan-Deng; Wang, Ji-Shang

2017-04-01

Dengue fever (DF) is a climate-sensitive disease that has been emerging in southern regions of Taiwan over the past few decades, causing a significant health burden to affected areas. This study aims to propose a predictive model to implement an early warning system so as to enhance dengue surveillance and control in Tainan, Taiwan. The Seasonal Autoregressive Integrated Moving Average (SARIMA) model was used herein to forecast dengue cases. Temporal correlation between dengue incidences and climate variables were examined by Pearson correlation analysis and Cross-correlation tests in order to identify key determinants to be included as predictors. The dengue surveillance data between 2000 and 2009, as well as their respective climate variables were then used as inputs for the model. We validated the model by forecasting the number of dengue cases expected to occur each week between January 1, 2010 and December 31, 2015. In addition, we analyzed historical dengue trends and found that 25 cases occurring in one week was a trigger point that often led to a dengue outbreak. This threshold point was combined with the season-based framework put forth by the World Health Organization to create a more accurate epidemic threshold for a Tainan-specific warning system. A Seasonal ARIMA model with the general form: (1,0,5)(1,1,1)52 is identified as the most appropriate model based on lowest AIC, and was proven significant in the prediction of observed dengue cases. Based on the correlation coefficient, Lag-11 maximum 1-hr rainfall (r=0.319, P<0.05) and Lag-11 minimum temperature (r=0.416, P<0.05) are found to be the most positively correlated climate variables. Comparing the four multivariate models(i.e.1, 4, 9 and 13 weeks ahead), we found that including the climate variables improves the prediction RMSE as high as 3.24%, 10.39%, 17.96%, 21.81% respectively, in contrast to univariate models. Furthermore, the ability of the four multivariate models to determine whether the

Precursors of Adolescent Substance Use from Early Childhood and Early Adolescence: Testing a Developmental Cascade Model

PubMed Central

Sitnick, Stephanie; Shaw, Daniel S.; Hyde, Luke

2013-01-01

This study examined developmentally-salient risk and protective factors of adolescent substance use assessed during early childhood and early adolescence using a sample of 310 low-income boys. Child problem behavior and proximal family risk and protective factors (i.e., parenting, maternal depression) during early childhood, as well as child and family factors and peer deviant behavior during adolescence were explored as potential precursors to later substance use during adolescence using structural equation modeling. Results revealed that early childhood risk and protective factors (i.e., child externalizing problems, mothers’ depressive symptomatology, and nurturant parenting) were indirectly related to substance use at the age of 17 via risk and protective factors during early and middle adolescence (i.e., parental knowledge and externalizing problems). The implications of these findings for early prevention and intervention are discussed. PMID:24029248

Confidence intervals for single-case effect size measures based on randomization test inversion.

PubMed

Michiels, Bart; Heyvaert, Mieke; Meulders, Ann; Onghena, Patrick

2017-02-01

In the current paper, we present a method to construct nonparametric confidence intervals (CIs) for single-case effect size measures in the context of various single-case designs. We use the relationship between a two-sided statistical hypothesis test at significance level α and a 100 (1 - α) % two-sided CI to construct CIs for any effect size measure θ that contain all point null hypothesis θ values that cannot be rejected by the hypothesis test at significance level α. This method of hypothesis test inversion (HTI) can be employed using a randomization test as the statistical hypothesis test in order to construct a nonparametric CI for θ. We will refer to this procedure as randomization test inversion (RTI). We illustrate RTI in a situation in which θ is the unstandardized and the standardized difference in means between two treatments in a completely randomized single-case design. Additionally, we demonstrate how RTI can be extended to other types of single-case designs. Finally, we discuss a few challenges for RTI as well as possibilities when using the method with other effect size measures, such as rank-based nonoverlap indices. Supplementary to this paper, we provide easy-to-use R code, which allows the user to construct nonparametric CIs according to the proposed method.

Metachronous solitary splenic metastasis arising from early gastric cancer: a case report and literature review.

PubMed

Namikawa, Tsutomu; Kawanishi, Yasuhiro; Fujisawa, Kazune; Munekage, Eri; Munekage, Masaya; Sugase, Takahito; Maeda, Hiromichi; Kitagawa, Hiroyuki; Kumon, Tatsuya; Hiroi, Makoto; Kobayashi, Michiya; Hanazaki, Kazuhiro

2017-08-29

The metastasis of malignant tumors to the spleen is rare, and only a small percentage of cases can be treated surgically, as splenic metastases generally occur in the context of multivisceral metastatic cancer at a terminal stage. We report a rare case of metachronous solitary splenic metastasis arising from early gastric cancer. A 75-year-old man was initially referred to our hospital for examination of gastric cancer, diagnosed at a medical check-up. Esophagogastroduodenoscopy showed a slightly elevated lesion with a central irregular depression in the upper-third of the stomach. Biopsy specimens of the lesion showed a moderately-differentiated adenocarcinoma, and abdominal computed tomography showed no evidence of distant metastases. Endoscopic submucosal dissection was performed, with histological confirmation of a moderately-differentiated adenocarcinoma invading the submucosal layer. The patient subsequently underwent laparoscopic total gastrectomy with regional lymph node dissection, resulting in no residual carcinoma and no lymph node metastasis. Computed tomography, 28 months later, showed a well-defined mass measuring 4.2 cm in diameter in the spleen, and the patient underwent a splenectomy, since there was no evidence of further metastatic lesions in any other organs. Histological examination confirmed the diagnosis of a poorly-differentiated adenocarcinoma originating from the previous gastric cancer. The patient was alive 2 months after surgical resection of the splenic metastasis without any recurrence. To the best of our knowledge, this is only the second case of a solitary splenic metastasis from early gastric cancer to be reported in the English literature. The present case suggests surgical resection may be the preferred treatment of choice for patients with a solitary splenic metastasis from gastric cancer.

Cost-Utility of a Prognostic Test Guiding Adjuvant Chemotherapy Decisions in Early-Stage Non-Small Cell Lung Cancer.

PubMed

Stenehjem, David D; Bellows, Brandon K; Yager, Kraig M; Jones, Joshua; Kaldate, Rajesh; Siebert, Uwe; Brixner, Diana I

2016-02-01

A prognostic test was developed to guide adjuvant chemotherapy (ACT) decisions in early-stage non-small cell lung cancer (NSCLC) adenocarcinomas. The objective of this study was to compare the cost-utility of the prognostic test to the current standard of care (SoC) in patients with early-stage NSCLC. Lifetime costs (2014 U.S. dollars) and effectiveness (quality-adjusted life-years [QALYs]) of ACT treatment decisions were examined using a Markov microsimulation model from a U.S. third-party payer perspective. Cancer stage distribution and probability of receiving ACT with the SoC were based on data from an academic cancer center. The probability of receiving ACT with the prognostic test was estimated from a physician survey. Risk classification was based on the 5-year predicted NSCLC-related mortality. Treatment benefit with ACT was based on the prognostic score. Discounting at a 3% annual rate was applied to costs and QALYs. Deterministic one-way and probabilistic sensitivity analyses examined parameter uncertainty. Lifetime costs and effectiveness were $137,403 and 5.45 QALYs with the prognostic test and $127,359 and 5.17 QALYs with the SoC. The resulting incremental cost-effectiveness ratio for the prognostic test versus the SoC was $35,867/QALY gained. One-way sensitivity analyses indicated the model was most sensitive to the utility of patients without recurrence after ACT and the ACT treatment benefit. Probabilistic sensitivity analysis indicated the prognostic test was cost-effective in 65.5% of simulations at a willingness to pay of $50,000/QALY. The study suggests using a prognostic test to guide ACT decisions in early-stage NSCLC is potentially cost-effective compared with using the SoC based on globally accepted willingness-to-pay thresholds. Providing prognostic information to decision makers may help some patients with high-risk early stage non-small cell lung cancer receive appropriate adjuvant chemotherapy while avoiding the associated toxicities and

Music therapy for early cognitive rehabilitation post-childhood TBI: an intrinsic mixed methods case study.

PubMed

Bower, Janeen; Catroppa, Cathy; Grocke, Denise; Shoemark, Helen

2014-10-01

The primary aim of this case study was to explore the behavioural changes of a paediatric patient in post-traumatic amnesia (PTA) during a music therapy session. A secondary objective was to measure the effect of the music therapy intervention on agitation. Video data from pre, during and post-music therapy sessions were collected and analysed using video micro-analysis and the Agitated Behaviour Scale. The participant displayed four discrete categories of behaviours: Neutral, Acceptance, Recruitment and Rejection. Further analysis revealed brief but consistent and repeated periods of awareness and responsiveness to the live singing of familiar songs, which were classified as Islands of Awareness. Song offered an Environment of Potential to maximise these periods of emerging consciousness. The quantitative data analysis yielded inconclusive results in determining if music therapy was effective in reducing agitation during and immediately post the music therapy sessions. The process of micro-analysis illuminated four discrete participant behaviours not apparent in the immediate clinical setting. The results of this case suggest that the use of familiar song as a music therapy intervention may harness early patient responsiveness to foster cognitive rehabilitation in the early acute phase post-TBI.

Alcohol intake and early-onset basal cell carcinoma in a case-control study

PubMed Central

Zhang, Y; Ferrucci, L.M.; Cartmel, B.; Molinaro, A.M.; Leffell, D.J.; Bale, A.E.; Mayne, S.T.

2014-01-01

Background Previous epidemiologic studies of overall alcohol intake and basal cell carcinoma (BCC) are inconsistent, with some evidence for differences by type of alcoholic beverage. While alcohol may enhance the carcinogenicity of ultraviolet (UV) light, this has not been evaluated in existing epidemiologic studies. Objective To evaluate alcohol intake in relation to early-onset BCC, and explore potential interactions with UV exposure. Methods BCC cases (n=380) and controls with benign skin conditions (n=390) under age 40 were identified through Yale Dermatopathology. Participants provided information on lifetime alcohol intake, including type of beverage during an in-person interview. Self-report data on indoor tanning and outdoor sunbathing were used to categorize UV exposure. We calculated odds ratios (OR) and 95% confidence intervals (CI) using unconditional multivariate logistic regression in the full sample and in women only. Results There was no statistically significant association between lifetime alcohol intake and early-onset BCC overall (above median intake vs. no regular alcohol intake OR 1.10, 95% CI 0.69-1.73) or in women only (OR 1.21, 95% CI 0.73-2.01). Similarly, intake of red wine, white wine, beer or hard liquor and mixed drinks was not associated with early-onset BCC. In exploratory analyses, we saw limited evidence for an interaction (pinteraction=0.003), with highest risk for high alcohol and high UV exposures, especially in women, but subgroup risk estimates had wide and overlapping confidence intervals. Conclusions Overall, we did not observe any clear association between lifetime alcohol intake and early-onset BCC. PMID:25059635

The role of ability, motivation, and opportunity to work in the transition from work to early retirement--testing and optimizing the Early Retirement Model.

PubMed

de Wind, Astrid; Geuskens, Goedele A; Ybema, Jan Fekke; Bongers, Paulien M; van der Beek, Allard J

2015-01-01

Determinants in the domains health, job characteristics, skills, and social and financial factors may influence early retirement through three central explanatory variables, namely, the ability, motivation, and opportunity to work. Based on the literature, we created the Early Retirement Model. This study aims to investigate whether data support the model and how it could be improved. Employees aged 58-62 years (N=1862), who participated in the first three waves of the Dutch Study on Transitions in Employment, Ability and Motivation (STREAM) were included. Determinants were assessed at baseline, central explanatory variables after one year, and early retirement after two years. Structural equation modeling was applied. Testing the Early Retirement Model resulted in a model with good fit. Health, job characteristics, skills, and social and financial factors were related to the ability, motivation and/or opportunity to work (significant β range: 0.05-0.31). Lower work ability (β=-0.13) and less opportunity to work (attitude colleagues and supervisor about working until age 65: β=-0.24) predicted early retirement, whereas the motivation to work (work engagement) did not. The model could be improved by adding direct effects of three determinants on early retirement, ie, support of colleagues and supervisor (β=0.14), positive attitude of the partner with respect to early retirement (β=0.15), and not having a partner (β=-0.13). The Early Retirement Model was largely supported by the data but could be improved. The prolongation of working life might be promoted by work-related interventions focusing on health, work ability, the social work climate, social norms on prolonged careers, and the learning environment.

Videoteleconferencing Early Child Anxiety Treatment: A Case Study of the Internet-Delivered PCIT CALM (I-CALM) Program

PubMed Central

Cooper-Vince, Christine E.; Chou, Tommy; Furr, Jami M.; Puliafico, Anthony C.; Comer, Jonathan S.

2017-01-01

Anxiety disorders are one of the most prevalent and impairing classes of mental health difficulties affecting young children. Though the vast majority of supported programs for child anxiety focus on youth ages 7 years and up, preliminary support has emerged for exposure-based adaptations of parent-coaching interventions, i.e., the Parent Child Interaction Therapy (PCIT) CALM Program, to address anxiety disorders in early childhood. Despite these advances, low rates of community service use and accessibility persist. The increased ubiquity of Internet access has positioned videoteleconferencing (VTC) as a powerful tool to overcome traditional barriers to care. The present case study details the VTC delivery of the PCIT CALM Program in the treatment of a 6 year-old boy presenting with generalized anxiety disorder and separation anxiety disorder. This case provides qualitative support for the feasibility of delivering integrated real-time parent coaching and exposure therapy to address early childhood anxiety disorders via VTC. The remission of the patient’s anxiety across treatment sessions suggests that the telehealth format may be a useful modality for the delivery of early childhood anxiety treatment. The technical considerations for the delivery of VTC therapy as well as the implications for treatment are discussed. PMID:29104931

System Safety in Early Manned Space Program: A Case Study of NASA and Project Mercury

NASA Technical Reports Server (NTRS)

Hansen, Frederick D.; Pitts, Donald

2005-01-01

This case study provides a review of National Aeronautics and Space Administration s (NASA's) involvement in system safety during research and evolution from air breathing to exo-atmospheric capable flight systems culminating in the successful Project Mercury. Although NASA has been philosophically committed to the principals of system safety, this case study points out that budget and manpower constraints-as well as a variety of internal and external pressures can jeopardize even a well-designed system safety program. This study begins with a review of the evolution and early years of NASA's rise as a project lead agency and ends with the lessons learned from Project Mercury.

Early detection of Alzheimer disease: methods, markers, and misgivings.

PubMed

Green, R C; Clarke, V C; Thompson, N J; Woodard, J L; Letz, R

1997-01-01

There is at present no reliable predictive test for most forms of Alzheimer disease (AD). Although some information about future risk for disease is available in theory through ApoE genotyping, it is of limited accuracy and utility. Once neuroprotective treatments are available for AD, reliable early detection will become a key component of the treatment strategy. We recently conducted a pilot survey eliciting attitudes and beliefs toward an unspecified and hypothetical predictive test for AD. The survey was completed by a convenience sample of 176 individuals, aged 22-77, which was 75% female, 30% African-American, and of which 33% had a family member with AD. The survey revealed that 69% of this sample would elect to obtain predictive testing for AD if the test were 100% accurate. Individuals were more likely to desire predictive testing if they had an a priori belief that they would develop AD (p = 0.0001), had a lower educational level (p = 0.003), were worried that they would develop AD (p = 0.02), had a self-defined history of depression (p = 0.04), and had a family member with AD (p = 0.04). However, the desire for predictive testing was not significantly associated with age, gender, ethnicity, or income. The desire to obtain predictive testing for AD decreased as the assumed accuracy of the hypothetical test decreased. A better short-term strategy for early detection of AD may be computer-based neuropsychological screening of at-risk (older aged) individuals to identify very early cognitive impairment. Individuals identified in this manner could be referred for diagnostic evaluation and early cases of AD could be identified and treated. A new self-administered, touch-screen, computer-based, neuropsychological screening instrument called Neurobehavioral Evaluation System-3 is described, which may facilitate this type of screening.

Simple F Test Reveals Gene-Gene Interactions in Case-Control Studies

PubMed Central

Chen, Guanjie; Yuan, Ao; Zhou, Jie; Bentley, Amy R.; Adeyemo, Adebowale; Rotimi, Charles N.

2012-01-01

Missing heritability is still a challenge for Genome Wide Association Studies (GWAS). Gene-gene interactions may partially explain this residual genetic influence and contribute broadly to complex disease. To analyze the gene-gene interactions in case-control studies of complex disease, we propose a simple, non-parametric method that utilizes the F-statistic. This approach consists of three steps. First, we examine the joint distribution of a pair of SNPs in cases and controls separately. Second, an F-test is used to evaluate the ratio of dependence in cases to that of controls. Finally, results are adjusted for multiple tests. This method was used to evaluate gene-gene interactions that are associated with risk of Type 2 Diabetes among African Americans in the Howard University Family Study. We identified 18 gene-gene interactions (P < 0.0001). Compared with the commonly-used logistical regression method, we demonstrate that the F-ratio test is an efficient approach to measuring gene-gene interactions, especially for studies with limited sample size. PMID:22837643

Pre-lung transplant measures of reflux on impedance are superior to pH testing alone in predicting early allograft injury

PubMed Central

Lo, Wai-Kit; Burakoff, Robert; Goldberg, Hilary J; Feldman, Natan; Chan, Walter W

2015-01-01

AIM: To evaluate pre-lung transplant acid reflux on pH-testing vs corresponding bolus reflux on multichannel intraluminal impedance (MII) to predict early allograft injury. METHODS: This was a retrospective cohort study of lung transplant recipients who underwent pre-transplant combined MII-pH-testing at a tertiary care center from January 2007 to November 2012. Patients with pre-transplant fundoplication were excluded. Time-to-event analysis was performed using a Cox proportional hazards model to assess associations between measures of reflux on MII-pH testing and early allograft injury. Area under the receiver operating characteristic (ROC) curve (c-statistic) of the Cox model was calculated to assess the predictive value of each reflux parameter for early allograft injury. Six pH-testing parameters and their corresponding MII measures were specified a priori. The pH parameters were upright, recumbent, and overall acid reflux exposure; elevated acid reflux exposure; total acid reflux episodes; and acid clearance time. The corresponding MII measures were upright, recumbent, and overall bolus reflux exposure; elevated bolus reflux exposure; total bolus reflux episodes; and bolus clearance time. RESULTS: Thirty-two subjects (47% men, mean age: 55 years old) met the inclusion criteria of the study. Idiopathic pulmonary fibrosis (46.9%) represented the most common pulmonary diagnosis leading to transplantation. Baseline demographics, pre-transplant cardiopulmonary function, number of lungs transplanted (unilateral vs bilateral), and post-transplant proton pump inhibitor use were similar between reflux severity groups. The area under the ROC curve, or c-statistic, of each acid reflux parameter on pre-transplant pH-testing was lower than its bolus reflux counterpart on MII in the prediction of early allograft injury. In addition, the development of early allograft injury was significantly associated with three pre-transplant MII measures of bolus reflux: overall reflux

Early clinical observations on the use of imatinib mesylate in FOP: A report of seven cases.

PubMed

Kaplan, Frederick S; Andolina, Jeffrey R; Adamson, Peter C; Teachey, David T; Finklestein, Jerry Z; Ebb, David H; Whitehead, Benjamin; Jacobs, Benjamin; Siegel, David M; Keen, Richard; Hsiao, Edward; Pignolo, Robert J

2018-04-01

Fibrodysplasia ossificans progressiva (FOP) is an ultrarare genetic disorder of progressive, disabling heterotopic ossification (HO) for which there is presently no definitive treatment. Research studies have identified multiple potential targets for therapy in FOP, and novel drug candidates are being developed for testing in clinical trials. A complementary approach seeks to identify approved drugs that could be re-purposed for off-label use against defined targets in FOP. One such drug is imatinib mesylate, a tyrosine kinase inhibitor originally developed for use in patients with chronic myeloid leukemia (CML). Imatinib has the desirable effect of attacking multiple targets involved in the early hypoxic and inflammatory stages of FOP flare-ups, including HIF1-α, PDGFRα, c-KIT, and multiple MAP kinases. Based on compelling biologic rationale, strong preclinical data, and a favorable safety profile, imatinib has been prescribed on an off-label basis in a non-trial setting in seven children with continuous FOP flare-ups, predominantly in the axial regions, and which were not responsive to standard-of-care regimens. Anecdotal reports in these seven isolated cases document that the medication was well-tolerated with a ubiquitous reported decrease in the intensity of flare-ups in the six children who took the medication. These early clinical observations support the implementation of clinical trials in children with uncontrolled FOP flare-ups to determine if imatinib may ameliorate symptoms or alter the natural history of this debilitating and life-threatening disease. Copyright © 2017 Elsevier Inc. All rights reserved.

[Early diagnosis of ectopic pregnancy].

PubMed

Belics, Zoran; Gérecz, Balázs; Csákány, M György

2014-07-20

Ectopic pregnancy is a high-risk condition that occurs in 2% of reported pregnancies. This percentage is fivefold higher than that registered in the 1970s. Since 1970 there has been a two-fold increase in the ratio of ectopic pregnancies to all reported pregnancies in Hungary and in 2012 7.4 ectopic pregnancies per thousand registered pregnancies were reported. Recently, the majority (80%) of cases can be diagnosed in early stage, and the related mortality objectively decreased in the past few decades to 3.8/10,000 ectopic pregnancies. If a woman with positive pregnancy test has abdominal pain and/or vaginal bleeding the physician should perform a work-up to safely exclude the possibility of ectopic pregnancy. The basis of diagnosis is ultrasonography, especially vaginal ultrasound examination and measurement of the β-subunit of human chorionic gonadotropin. The ultrasound diagnosis is based on the visualization of an ectopic mass rather than the inability to visualize an intrauterine pregnancy. In some questionable cases the diagnostic uterine curettage or laparoscopy may be useful. The actuality of this topic is justified by practical difficulties in obtaining correct diagnosis, especially in the early gestational time.

Finasteride use during pregnancy and early neonatal outcome: a case report.

PubMed

AlSaad, Doua; Lee, Ben H; Al-Obaidly, Sawsan

2018-06-01

The use of antiandrogen drugs such as finasteride during pregnancy may carry the risk of birth defects, especially hypospadias. We report a 39-year-old woman, with 5 weeks unplanned pregnancy, the patient conceived while receiving daily dose of finasteride 2.5 mg for treatment of alopecia. The patient's partner was concurrently using finasteride for the same purpose. Ultrasound scans including detailed anatomy were normal throughout pregnancy and the fetal gender was detected to be male. The patient had her delivery at 38 +5 weeks' gestation, by elective cesarean section, a male infant with a weight of 3.58 kg and Apgar score of 9 and 10 at 1 and 5-min, respectively. The infant was healthy with no obvious dysmorphic features. In this case report, maternal use of finasteride in early pregnancy was not associated with external genitalia abnormalities of a male baby. Moreover, maternal exposure to the semen of partner who received finasteride did not adversely affect the short term neonatal outcomes. However, absence of apparent neonatal adverse effects in a single case report does not indicate safety of use. Population-based long term neonatal outcomes are yet to be established.

The Northern Ireland Early Onset Psychosis Study: Phenomenology and Co-Morbidity in the First 25 Cases

ERIC Educational Resources Information Center

Fulton, Karen; Short, Mary; Harvey-Smith, Diane; Rushe, Teresa M.; Mulholland, Ciaran

2008-01-01

Diagnosing psychotic disorders in young people is difficult. High rates of co-morbidity may be one reason for this difficulty, but it may also be the case that current diagnostic categories are not the most useful when approaching the care of young people with psychotic symptoms. The Northern Ireland Early Onset Psychosis Study is the first study…

[The Battelle developmental inventory screening test for early detection of developmental disorders in cerebral palsy].

PubMed

Moraleda-Barreno, E; Romero-López, M; Cayetano-Menéndez, M J

2011-12-01

Cerebral palsy is usually associated with motor, cognitive, and language deficits, and with other disorders that cause disability in daily living skills, personal independence, social interaction and academic activities. Early detection of these deficits in the clinical setting is essential to anticipate and provide the child with the necessary support for adapting to the environment in all possible areas. The main objective of this study is to demonstrate that these deficits can be detected at an early age and comprehensively through the use of a brief development scale. We studied 100 children between 4 and 70 months old, half of them with cerebral palsy and the other half without any disorder. All subjects were evaluated using the Battelle Developmental Inventory screening test. We compared the developmental quotients in both groups and between the subjects with different motor impairments, using a simple prospective ex post facto design. The test detected statistically significant differences between the clinical group and the control group at all age levels. Statistically significant differences were also found between tetraplegia and other motor disorders. There were no differences by gender. The deficit in development associated with cerebral palsy can be quantified at early ages through the use of a brief development scale, thus we propose that the systematic implementation of protocols with this screening tool would be helpful for treatment and early intervention. This would also help in anticipating and establishing the means for the multidisciplinary actions required, and could provide guidance to other health professionals, to provide adequate school, social, and family support,. Copyright © 2011 Asociación Española de Pediatría. Published by Elsevier Espana. All rights reserved.

Lost in Translation: the Case for Integrated Testing

NASA Technical Reports Server (NTRS)

Young, Aaron

2017-01-01

The building of a spacecraft is complex and often involves multiple suppliers and companies that have their own designs and processes. Standards have been developed across the industries to reduce the chances for critical flight errors at the system level, but the spacecraft is still vulnerable to the introduction of critical errors during integration of these systems. Critical errors can occur at any time during the process and in many cases, human reliability analysis (HRA) identifies human error as a risk driver. Most programs have a test plan in place that is intended to catch these errors, but it is not uncommon for schedule and cost stress to result in less testing than initially planned. Therefore, integrated testing, or "testing as you fly," is essential as a final check on the design and assembly to catch any errors prior to the mission. This presentation will outline the unique benefits of integrated testing by catching critical flight errors that can otherwise go undetected, discuss HRA methods that are used to identify opportunities for human error, lessons learned and challenges over ownership of testing will be discussed.

Estimates of 2012/13 influenza vaccine effectiveness using the case test-negative control design with different influenza negative control groups.

PubMed

Nunes, Baltazar; Machado, Ausenda; Guiomar, Raquel; Pechirra, Pedro; Conde, Patrícia; Cristovão, Paula; Falcão, Isabel

2014-07-31

In recent years several reports of influenza vaccine effectiveness (VE) have been made early for public health decision. The majority of these studies use the case test-negative control design (TND), which has been showed to provide, under certain conditions, unbiased estimates of influenza VE. Nevertheless, discussions have been taken on the best influenza negative control group to use. The present study aims to contribute to the knowledge on this field by comparing influenza VE estimates using three test-negative controls: all influenza negative, non-influenza respiratory virus and pan-negative. Incident ILI patients were prospectively selected and swabbed by a sample of general practitioners. Cases were ILI patients tested positive for influenza and controls ILI patients tested negative for influenza. The influenza negative control group was divided into non-influenza virus control group and pan-negative control group. Data were collected on vaccination status and confounding factors. Influenza VE was estimated as one minus the odds ratio of been vaccinated in cases versus controls adjusted for confounding effect by logistic regression. Confounder adjusted influenza VE against medically attended laboratory-confirmed influenza was 68.4% (95% CI: 20.7-87.4%) using all influenza negatives controls, 82.1% (95% CI: 47.6-93.9%) using non-influenza controls and 49.4% (95% CI: -44.7% to 82.3%) using pan-negative controls. Influenza VE estimates differed according to the influenza negative control group used. These results are in accordance with the expected under the hypothesis of differential viral interference between influenza vaccinated and unvaccinated individuals. Given the wide importance of TND study further studies should be conducted in order to clarify the observed differences. Copyright © 2014 Elsevier Ltd. All rights reserved.

Predictive value of vaginal IL-6 and TNFα bedside tests repeated until delivery for the prediction of maternal-fetal infection in cases of premature rupture of membranes.

PubMed

Kayem, Gilles; Batteux, Frederic; Girard, Noémie; Schmitz, Thomas; Willaime, Marion; Maillard, Francoise; Jarreau, Pierre Henri; Goffinet, Francois

2017-04-01

Examine the predictive value for maternal-fetal infection of routine bedside tests detecting the proinflammatory cytokines, TNFα and IL-6, in the vaginal secretions of women with premature rupture of the membranes (PROM). This prospective two-center cohort study included all women hospitalized for PROM over a 2-year period. A bedside test assessed IL-6 and TNFα in vaginal secretions. Both centers routinely tested CRP and leukocytes, assaying both in maternal serum, and analyzed vaginal bacterial flora; all samples were repeated twice weekly until delivery. The study included 689 women. In cases of preterm PROM (PPROM) before 37 weeks (n=184), a vaginal sample positive for one or more bacteria was the only marker associated with early neonatal infection (OR 5.6, 95%CI; 2.0-15.7). Its sensitivity was 82% (95%CI; 62-94) and its specificity 56% (95%CI; 47-65). All positive markers of infection were associated with the occurrence of chorioamnionitis. In cases of PROM from 37 weeks onward (n=505), only CRP >5mg/dL was associated with early neonatal infection (OR=8.3, 95%CI; 1.1-65.4) or clinical chorioamnionitis (OR=6.8, 95%CI; 1.5-30.0). The sensitivity of CRP >5mg/dL was 91% (95%CI; 59-100) and its specificity 45% (95%CI; 40-51) for predicting early neonatal infection, and 89% (95%CI; 65-99) and 46% (95%CI; 41-51), respectively, for predicting clinical chorioamnionitis. The association of vaginal cytokines with maternal-fetal infection is weak and thus prevents their use as a good predictor of maternal-fetal infection. CRP and vaginal samples may be useful for identifying a group of women at low risk of infection. Copyright © 2017 Elsevier B.V. All rights reserved.

Concept Test of a Smoking Cessation Smart Case.

PubMed

Comello, Maria Leonora G; Porter, Jeannette H

2018-04-05

Wearable/portable devices that unobtrusively detect smoking and contextual data offer the potential to provide Just-In-Time Adaptive Intervention (JITAI) support for mobile cessation programs. Little has been reported on the development of these technologies. To address this gap, we offer a case report of users' experiences with a prototype "smart" cigarette case that automatically tracks time and location of smoking. Small-scale user-experience studies are typical of iterative product design and are especially helpful when proposing novel ideas. The purpose of the study was to assess concept acceptability and potential for further development. We tested the prototype case with a small sample of potential users (n = 7). Participants used the hardware/software for 2 weeks and reconvened for a 90-min focus group to discuss experiences and provide feedback. Participants liked the smart case in principle but found the prototype too bulky for easy portability. The potential for the case to convey positive messages about self also emerged as a finding. Participants indicated willingness to pay for improved technology (USD $15-$60 on a one-time basis). The smart case is a viable concept, but design detail is critical to user acceptance. Future research should examine designs that maximize convenience and that explore the device's ability to cue intentions and other cognitions that would support cessation. This study is the first to our knowledge to report formative research on the smart case concept. This initial exploration provides insights that may be helpful to other developers of JITAI-support technology.

30 CFR 250.523 - How long do I keep records of casing pressure and diagnostic tests?

Code of Federal Regulations, 2011 CFR

2011-07-01

... and diagnostic tests? 250.523 Section 250.523 Mineral Resources BUREAU OF OCEAN ENERGY MANAGEMENT... long do I keep records of casing pressure and diagnostic tests? Records of casing pressure and diagnostic tests must be kept at the field office nearest the well for a minimum of 2 years. The last casing...

The Influence of Test-Based Accountability Policies on Early Elementary Teachers: School Climate, Environmental Stress, and Teacher Stress

ERIC Educational Resources Information Center

Saeki, Elina; Segool, Natasha; Pendergast, Laura; von der Embse, Nathaniel

2018-01-01

This study examined the potential influence of test-based accountability policies on school environment and teacher stress among early elementary teachers. Structural equation modeling of data from 541 kindergarten through second grade teachers across three states found that use of student performance on high-stakes tests to evaluate teachers…

Brief Report: Impact of Early Antiretroviral Therapy on the Performance of HIV Rapid Tests and HIV Incidence Assays.

PubMed

Fogel, Jessica M; Piwowar-Manning, Estelle; Debevec, Barbara; Walsky, Tamara; Schlusser, Katherine; Laeyendecker, Oliver; Wilson, Ethan A; McCauley, Marybeth; Gamble, Theresa; Tegha, Gerald; Soko, Dean; Kumwenda, Johnstone; Hosseinipour, Mina C; Chen, Ying Q; Cohen, Myron S; Eshleman, Susan H

2017-08-01

Antiretroviral therapy (ART) can downregulate antibody responses to HIV infection. We evaluated the impact of early vs. delayed ART on the performance of HIV diagnostic and incidence assays. Samples were obtained from 207 participants in the HPTN 052 trial, who were stably suppressed on ART for ≥4 years [Malawi sites; pre-ART CD4 cell count 350-550 cells/mm (early ART arm, N = 180) or <250 cells/mm or an AIDS-defining illness (delayed ART arm, N = 27)]. Samples were tested with 2 HIV rapid tests and 2 HIV incidence assays; selected samples were also tested with two fourth-generation immunoassays and a Western blot (WB) assay. A pre-ART sample was analyzed if the follow-up sample had a false-negative or weakly-reactive rapid test result, or had an incidence assay result indicative of recent infection (false-recent result). Ten (4.8%) samples had a nonreactive or weakly-reactive rapid test result (7/180 early ART arm, 3/27 delayed ART arm, P = 0.13); one sample had nonreactive fourth-generation assay results and 3 had indeterminate WBs. Forty (18.9%) samples had a false-recent incidence assay result; 16 (7.8%) had false-recent results with both incidence assays. Baseline samples had stronger rapid test and WB bands, higher fourth-generation assay signal-to-cutoff values, and fewer HIV incidence assay results indicative of recent infection. False-negative/weakly-reactive HIV rapid tests and false-recent HIV incidence assay results were observed in virally-suppressed individuals, regardless of pre-ART CD4 cell count. Downregulation of the antibody response to HIV infection in the setting of ART may impact population-level surveys of HIV prevalence and incidence.

Alcohol intake and early-onset basal cell carcinoma in a case-control study.

PubMed

Zhang, Y; Ferrucci, L M; Cartmel, B; Molinaro, A M; Leffell, D J; Bale, A E; Mayne, S T

2014-12-01

Previous epidemiological studies of overall alcohol intake and basal cell carcinoma (BCC) are inconsistent, with some evidence for differences by type of alcoholic beverage. While alcohol may enhance the carcinogenicity of ultraviolet (UV) radiation, this has not been evaluated in existing epidemiological studies. To evaluate alcohol intake in relation to early-onset BCC, and explore potential interactions with UV exposure. Basal cell carcinoma cases (n = 380) and controls with benign skin conditions (n = 390) under 40 years of age were identified through Yale Dermatopathology. Participants provided information on lifetime alcohol intake, including type of beverage, during an in-person interview. Self-reported data on indoor tanning and outdoor sunbathing were used to categorize UV exposure. We calculated odds ratios (OR) and 95% confidence intervals (CIs) using unconditional multivariate logistic regression in the full sample and in women only. There was no statistically significant association between lifetime alcohol intake and early-onset BCC overall [above median intake vs. no regular alcohol intake (OR 1·10, 95% CI 0·69-1·73)] or in women only (OR 1·21, 95% CI 0·73-2·01). Similarly, intake of red wine, white wine, beer or spirits and mixed drinks was not associated with early-onset BCC. In exploratory analyses, we saw limited evidence for an interaction (P(interaction) = 0·003), with highest risk for high alcohol and high UV exposures, especially in women, but subgroup risk estimates had wide and overlapping CIs. Overall, we did not observe any clear association between lifetime alcohol intake and early-onset BCC. © 2014 British Association of Dermatologists.

2-tiered antibody testing for early and late Lyme disease using only an immunoglobulin G blot with the addition of a VlsE band as the second-tier test.

PubMed

Branda, John A; Aguero-Rosenfeld, Maria E; Ferraro, Mary Jane; Johnson, Barbara J B; Wormser, Gary P; Steere, Allen C

2010-01-01

Standard 2-tiered immunoglobulin G (IgG) testing has performed well in late Lyme disease (LD), but IgM testing early in the illness has been problematic. IgG VlsE antibody testing, by itself, improves early sensitivity, but may lower specificity. We studied whether elements of the 2 approaches could be combined to produce a second-tier IgG blot that performs well throughout the infection. Separate serum sets from LD patients and control subjects were tested independently at 2 medical centers using whole-cell enzyme immunoassays and IgM and IgG immunoblots, with recombinant VlsE added to the IgG blots. The results from both centers were combined, and a new second-tier IgG algorithm was developed. With standard 2-tiered IgM and IgG testing, 31% of patients with active erythema migrans (stage 1), 63% of those with acute neuroborreliosis or carditis (stage 2), and 100% of those with arthritis or late neurologic involvement (stage 3) had positive results. Using new IgG criteria, in which only the VlsE band was scored as a second-tier test among patients with early LD (stage 1 or 2) and 5 of 11 IgG bands were required in those with stage 3 LD, 34% of patients with stage 1, 96% of those with stage 2, and 100% of those with stage 3 infection had positive responses. Both new and standard testing achieved 100% specificity. Compared with standard IgM and IgG testing, the new IgG algorithm (with VlsE band) eliminates the need for IgM testing; it provides comparable or better sensitivity, and it maintains high specificity.

Toxicology Testing in Fatally Injured Workers: A Review of Five Years of Iowa FACE Cases

PubMed Central

Ramirez, Marizen; Bedford, Ronald; Sullivan, Ryan; Anthony, T. Renee; Kraemer, John; Faine, Brett; Peek-Asa, Corinne

2013-01-01

Toxicology testing of fatally injured workers is not routinely conducted. We completed a case-series study of 2005–2009 occupational fatalities captured by Iowa’s Fatality Assessment and Control Evaluation (FACE) Program. The goals of our research were to: (1) measure the proportion of FACE cases that undergo toxicology testing, and describe the factors associated with being tested, and (2) measure the rate of positive toxicology tests, the substances identified and the demographics and occupations of victims who tested positive. Case documents and toxicology laboratory reports were reviewed. There were 427 occupational deaths from 2005 to 2009. Only 69% underwent toxicology testing. Younger workers had greater odds of being tested. Among occupational groups, workers in farming, fishing and forestry had half the odds of being tested compared to other occupational groups. Of the 280 cases with toxicology tests completed, 22% (n = 61) were found to have positive toxicology testing. Commonly identified drug classes included cannabinoids and alcohols. Based on the small number of positive tests, older victims (65+ years) tested positive more frequently than younger workers. Management, business, science, arts, service and sales/office workers had proportionately more positive toxicology tests (almost 30%) compared with other workers (18–22%). These results identify an area in need of further research efforts and a potential target for injury prevention strategies. PMID:24240727

Early Clinical Features of Dengue Virus Infection in Nicaraguan Children: A Longitudinal Analysis

PubMed Central

Biswas, Hope H.; Ortega, Oscar; Gordon, Aubree; Standish, Katherine; Balmaseda, Angel; Kuan, Guillermina; Harris, Eva

2012-01-01

Background Tens of millions of dengue cases and approximately 500,000 life-threatening complications occur annually. New tools are needed to distinguish dengue from other febrile illnesses. In addition, the natural history of pediatric dengue early in illness in a community-based setting has not been well-defined. Methods Data from the multi-year, ongoing Pediatric Dengue Cohort Study of approximately 3,800 children aged 2–14 years in Managua, Nicaragua, were used to examine the frequency of clinical signs and symptoms by day of illness and to generate models for the association of signs and symptoms during the early phase of illness and over the entire course of illness with testing dengue-positive. Odds ratios (ORs) and 95% confidence intervals were calculated using generalized estimating equations (GEE) for repeated measures, adjusting for age and gender. Results One-fourth of children who tested dengue-positive did not meet the WHO case definition for suspected dengue. The frequency of signs and symptoms varied by day of illness, dengue status, and disease severity. Multivariable GEE models showed increased odds of testing dengue-positive associated with fever, headache, retro-orbital pain, myalgia, arthralgia, rash, petechiae, positive tourniquet test, vomiting, leukopenia, platelets ≤150,000 cells/mL, poor capillary refill, cold extremities and hypotension. Estimated ORs tended to be higher for signs and symptoms over the course of illness compared to the early phase of illness. Conclusions Day-by-day analysis of clinical signs and symptoms together with longitudinal statistical analysis showed significant associations with testing dengue-positive and important differences during the early phase of illness compared to the entire course of illness. These findings stress the importance of considering day of illness when developing prediction algorithms for real-time clinical management. PMID:22413033

To what extent does climate explain variations in reported malaria cases in early 20th century Uganda?

PubMed

Tompkins, Adrian M; Larsen, Laragh; McCreesh, Nicky; Taylor, David

2016-03-31

Malaria case statistics were analysed for the period 1926 to 1960 to identify inter-annual variations in malaria cases for the Uganda Protectorate. The analysis shows the mid-to-late 1930s to be a period of increased reported cases. After World War II, malaria cases trend down to a relative minimum in the early 1950s, before increasing rapidly after 1953 to the end of the decade. Data for the Western Province confirm these national trends, which at the time were attributed to a wide range of causes, including land development and management schemes, population mobility, interventions and misdiagnosis. Climate was occasionally proposed as a contributor to enhanced case numbers, and unusual precipitation patterns were held responsible; temperature was rarely, if ever, considered. In this study, a dynamical malaria model was driven with available precipitation and temperature data from the period for five stations located across a range of environments in Uganda. In line with the historical data, the simulations produced relatively enhanced transmission in the 1930s, although there is considerable variability between locations. In all locations, malaria transmission was low in the late 1940s and early 1950s, steeply increasing after 1954. Results indicate that past climate variability explains some of the variations in numbers of reported malaria cases. The impact of multiannual variability in temperature, while only on the order of 0.5°C, was sufficient to drive some of the trends observed in the statistics and thus the role of climate was likely underestimated in the contemporary reports. As the elimination campaigns of the 1960s followed this partly climate-driven increase in malaria, this emphasises the need to account for climate when planning and evaluating intervention strategies.

Draft Test Guideline: Fish Early-Life Stage Toxicity Test

EPA Pesticide Factsheets

The following draft test guideline is part of a series of test guidelines that have been developed by EPA for use in the testing of pesticides and toxic substances, and the development of test data for submission to the Agency for review.

Integrating non-animal test information into an adaptive testing strategy - skin sensitization proof of concept case.

PubMed

Jaworska, Joanna; Harol, Artsiom; Kern, Petra S; Gerberick, G Frank

2011-01-01

There is an urgent need to develop data integration and testing strategy frameworks allowing interpretation of results from animal alternative test batteries. To this end, we developed a Bayesian Network Integrated Testing Strategy (BN ITS) with the goal to estimate skin sensitization hazard as a test case of previously developed concepts (Jaworska et al., 2010). The BN ITS combines in silico, in chemico, and in vitro data related to skin penetration, peptide reactivity, and dendritic cell activation, and guides testing strategy by Value of Information (VoI). The approach offers novel insights into testing strategies: there is no one best testing strategy, but the optimal sequence of tests depends on information at hand, and is chemical-specific. Thus, a single generic set of tests as a replacement strategy is unlikely to be most effective. BN ITS offers the possibility of evaluating the impact of generating additional data on the target information uncertainty reduction before testing is commenced.

30 CFR 250.525 - What do I submit if my casing diagnostic test requires action?

Code of Federal Regulations, 2010 CFR

2010-07-01

... 30 Mineral Resources 2 2010-07-01 2010-07-01 false What do I submit if my casing diagnostic test... INTERIOR OFFSHORE OIL AND GAS AND SULPHUR OPERATIONS IN THE OUTER CONTINENTAL SHELF Oil and Gas Well-Completion Operations Casing Pressure Management § 250.525 What do I submit if my casing diagnostic test...

Case report of an atypical early onset X-linked retinoschisis in monozygotic twins.

PubMed

Murro, Vittoria; Caputo, Roberto; Bacci, Giacomo Maria; Sodi, Andrea; Mucciolo, Dario Pasquale; Bargiacchi, Sara; Giglio, Sabrina Rita; Virgili, Gianni; Rizzo, Stanislao

2017-02-24

X-linked Retinoschisis (XLRS) is one of the most common macular degenerations in young males, with a worldwide prevalence ranging from 1:5000 to 1:20000. Clinical diagnosis of XLRS can be challenging due to the highly variable phenotypic presentation and limited correlation has been identified between mutation type and disease severity or progression. We report the atypical early onset of XLRS in 3-month-old monozygotic twins. Fundus examination was characterized by severe bullous retinal schisis with pre-retinal and intraretinal haemorrhages. Molecular genetic analysis of the RS1 was performed and the c.288G > A (p. Trp96Ter) mutation was detected in both patients. Early onset XLRS is associated with a more progressive form of the disease, characterized by large bullous peripheral schisis involving the posterior pole, vascular abnormalities and haemorrhages. The availability of specific technology permitted detailed imaging of the clinical picture of unusual cases of XLRS. The possible relevance of modifying genes should be taken into consideration for the future development of XLRS gene therapy.

Factors influencing behavioral intention to undergo Papanicolaou testing in early adulthood: Comparison of Japanese and Korean women.

PubMed

Kang, Kyung-Ah; Kim, Shin-Jeong; Kaneko, Noriyo

2017-12-01

In this study, we identified the factors influencing behavioral intention to undergo Papanicolaou testing among Japanese and Korean women in early adulthood. Their behavioral intentions were compared in this cross-sectional descriptive study. In total, 887 women (Japanese = 498, Korean = 389) aged 20-39 years participated in this study. Using a self-report questionnaire, knowledge, attitudes, subjective norm, perceived behavioral control, and behavioral intention were surveyed. There were significant differences between Japanese and Korean women's scores on all main variables. For Japanese women, all the variables moderately correlated with behavioral intention. In comparison, for Korean women, all independent variables, except for knowledge, moderately correlated with behavioral intention. Through a multiple regression analysis, age, undergoing Papanicolaou testing, attitudes, subjective norm, and perceived behavioral control were identified as significant predictors of behavioral intention among Japanese women. Among Korean women, job status, undergoing a Papanicolaou test, attitudes, subjective norm, and perceived behavioral control were demonstrated as significant predictors of behavioral intention. Health professionals should consider these factors to encourage Papanicolaou testing in women in early adulthood. © 2017 John Wiley & Sons Australia, Ltd.

Testing Gene-Gene Interactions in the Case-Parents Design

PubMed Central

Yu, Zhaoxia

2011-01-01

The case-parents design has been widely used to detect genetic associations as it can prevent spurious association that could occur in population-based designs. When examining the effect of an individual genetic locus on a disease, logistic regressions developed by conditioning on parental genotypes provide complete protection from spurious association caused by population stratification. However, when testing gene-gene interactions, it is unknown whether conditional logistic regressions are still robust. Here we evaluate the robustness and efficiency of several gene-gene interaction tests that are derived from conditional logistic regressions. We found that in the presence of SNP genotype correlation due to population stratification or linkage disequilibrium, tests with incorrectly specified main-genetic-effect models can lead to inflated type I error rates. We also found that a test with fully flexible main genetic effects always maintains correct test size and its robustness can be achieved with negligible sacrifice of its power. When testing gene-gene interactions is the focus, the test allowing fully flexible main effects is recommended to be used. PMID:21778736

Extending the Research on the Tests of Early Numeracy: Longitudinal Analyses over Two School Years

ERIC Educational Resources Information Center

Baglici, Stephanie Petreshock; Codding, Robin; Tryon, Georgiana

2010-01-01

The purpose of this study was to extend the research on the "Tests of Early Numeracy" (TEN) by following a cohort of 61 students from kindergarten through first grade. Specifically, this study examined the relationship between kindergarten and first-grade TEN measures built within and across school years and their predictive validity of a math…

Clinical value of the Treponema pallidum haemagglutination test.

PubMed

Robertson, D H; McMillan, A

1975-04-01

In 1,129 patients attending the Department for Sexually Transmitted Diseases, the serum was examined by three screening tests (VDRL slide, RPCF, and TPHA) and twelve cases of syphilis (1 per cent. of patients attenting the clinic) were discovered. Six of these patients were considered to have latent syphilis (5 acquired, 1 congenital) and were detected only by the TPHA; all six cases were confirmed by the FTA-ABS, The TPHA failed to detect three of the remaining six cases (2 primary and 1 very early, the latter in a contact of a patient with primary syphilis). All six cases were, however, detected by the VDRL. In seven cases, the TPHA was positive in the absence of other evidence of present or previous syphilis. In these cases the FTA-ABS was also negative. The clinical application of the TPHA test in the detection of syphilis is discussed.

Bedside ultrasound of the soft tissue of the face: a case of early Ludwig's angina.

PubMed

Gaspari, Romolo J

2006-10-01

A case is reported of a 38-year-old man presenting with early Ludwig's angina. It is difficult to differentiate superficial from deep infections of the face and neck by physical examination alone. The diagnosis of this condition with bedside soft tissue ultrasound of the face is described. Ludwig's angina is an uncommon infection of the deep tissues of the face and neck that usually evolves from more superficial infections such as dental abscesses.

The roles of birth inputs and outputs in predicting health, behaviour and test scores in early childhood.

PubMed

Li, Kai; Poirier, Dale J

2003-11-30

The goal of this study is to address directly the predictive value of birth inputs and outputs, particularly birth weight, for measures of early childhood development in a simultaneous equations modelling framework. Strikingly, birth outputs have virtually no structural/causal effects on early childhood developmental outcomes, and only maternal smoking and drinking during pregnancy have some effects on child height. Not surprisingly, family child-rearing environment has sizeable negative and positive effects on a behavioural problems index and a mathematics/reading test score, respectively, and a mildly surprising negative effect on child height. Despite little evidence of a structural/causal effect of birth weight on early childhood developmental outcomes, our results demonstrate that birth weight nonetheless has strong predictive effects on early childhood outcomes. Furthermore, these effects are largely invariant to whether family child-rearing environment is taken into account. Family child-rearing environment has both structural and predictive effects on early childhood outcomes, but they are largely orthogonal and in addition to the effects of birth weight. Copyright 2003 John Wiley & Sons, Ltd.

A case with atrophic autoimmune thyroiditis-related hypothyroidism causing multisystem involvement in early childhood.

PubMed

Kurnaz, Erdal; Savaş-Erdeve, Şenay; Keskin, Melikşah; Doğan, Vehbi; Çetinkaya, Semra; Aycan, Zehra

2016-01-01

The most common reason of acquired hypothyroidism is autoimmune (Hashimoto) thyroiditis. Autoimmune thyroiditis can be atrophic or goitrogenic. Atrophic autoimmune thyroiditis (ATT) related acquired hypothyroidism causes interruption of growth, obesity, and bone age retardation in early ages while goitrogenic thyroiditis has a higher incidence rate and mostly presents with diffuse goiter. We discuss the effects of hypothyroidism on various systems through a case found to have pericardial effusion during the echocardiography performed after cardiac murmur was detected and later diagnosed with ATT related hypothyroidism.

30 CFR 250.520 - When do I have to perform a casing diagnostic test?

Code of Federal Regulations, 2010 CFR

2010-07-01

... test? 250.520 Section 250.520 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT OF THE INTERIOR OFFSHORE OIL AND GAS AND SULPHUR OPERATIONS IN THE OUTER CONTINENTAL SHELF Oil and Gas Well-Completion Operations Casing Pressure Management § 250.520 When do I have to perform a casing diagnostic test? (a) You...

Enhancing HIV Testing and Treatment among Men Who Have Sex with Men in China: A Pilot Model with Two-Rapid Tests, Single Blood Draw Session, and Intensified Case Management in Six Cities in 2013.

PubMed

Zhang, Dapeng; Lu, Hongyan; Zhuang, Minghua; Wu, Guohui; Yan, Hongjing; Xu, Jun; Wei, Xiaoli; Li, Chengmei; Meng, Sining; Fu, Xiaojing; Qi, Jinlei; Wang, Peng; Luo, Mei; Dai, Min; Yip, Ray; Sun, Jiangping; Wu, Zunyou

2016-01-01

positives referred to designated ART hospitals (88.0% and 93.3%) than the Model A and Model D (4.6% and 5.7% for CD4 cell count test, and 68.9% and 64.4% for referring to designated ART hospitals). The proportion of cases where the screening test was reactive that were commenced on ART was highest in Model C; 52.8% of cases commenced on ART compared to 38.9%, 34.2% and 21.1% in Models A, B and D respectively. Using Model A as a reference group, the multivariate logistic regression results also showed the advantages of Models B, C and D, which increased CD4 cell count test, referral to designated ART hospitals and initiation of ART, when controlling for program city and other factors. This study has demonstrated that involvement of CBOs in HIV rapid testing provision, streamlining testing and care procedures and early hospital case management can improve testing, linkage to, and retention in care and treatment among MSM in China.

Twenty Years On!: Updating the IEA BESTEST Building Thermal Fabric Test Cases for ASHRAE Standard 140

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

Judkoff, R.; Neymark, J.

2013-07-01

ANSI/ASHRAE Standard 140, Standard Method of Test for the Evaluation of Building Energy Analysis Computer Programs applies the IEA BESTEST building thermal fabric test cases and example simulation results originally published in 1995. These software accuracy test cases and their example simulation results, which comprise the first test suite adapted for the initial 2001 version of Standard 140, are approaching their 20th anniversary. In response to the evolution of the state of the art in building thermal fabric modeling since the test cases and example simulation results were developed, work is commencing to update the normative test specification and themore » informative example results.« less

Fission Surface Power Technology Development Testing at NASA's Early Flight Fission Test Facility

NASA Technical Reports Server (NTRS)

Houts. Michael G.

2009-01-01

while still providing excellent performance on the surface of the moon or Mars. Recent testing at NASA s Early Flight Fission Test Facility (EFF-TF) has helped assess the viability of the reference FSP system, and has helped evaluate methods for system integration. In June, 2009, a representative pumped NaK loop (provided by Marshall Space Flight Center) was coupled to a Stirling power converter (provided by Glenn Research Center) and tested at various conditions representative of those that would be seen during actual FSP system operation. In all areas, performance of the integrated system exceeded project goals. High-temperature NaK pump testing has also been performed at the EFF-TF, as has testing of methods for providing long-duration NaK purity.

Early prognostic markers for fatal fulminant hepatic failure cases with viral hepatitis: proton nuclear magnetic resonance spectroscopic studies of serum.

PubMed

Bala, Lakshmi; Mehrotra, Mayank; Mohindra, Samir; Saxena, Rajan; Khetrapal, Chunni Lal

2013-02-01

Fulminant hepatic failure is associated with liver metabolic derangements which could have fatal consequences. The aim of the present study is to identify serum markers for early prediction of the outcome. Proton nuclear magnetic resonance spectroscopic studies of serum of fulminant hepatic failure patients due to viral hepatitis with grade II/III of encephalopathy (twenty-four: ten prospective and fourteen retrospective) and twenty-five controls were undertaken. Of the twenty-four patients, fifteen survived with medical management alone while nine had fatal outcome. The results demonstrated significantly elevated indices of amino acids (alanine, lysine, glutamine, histidine, tyrosine, phenylalanine and 1,2-propanediol) in fatal cases compared to survivors and controls. Principal component analysis showed clear separation of fatal and surviving cases. Liver function parameters were significantly deranged in patients but they failed to provide early significant differences between surviving and fatal cases. Compared to model for end-stage liver disease scores, principal component analysis appear to be better as an early prognostic indicator. Biochemical mapping of pathways suggested interruptions in amino acid metabolism and urea cycle. Proton nuclear magnetic resonance studies of serum have the potential of rapidly identifying patients with irreversible fulminant hepatic failure requiring liver transplantation as life saving option. Copyright © 2012 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

Huntington's disease predictive testing: the case for an assessment approach to requests from adolescents.

PubMed Central

Binedell, J; Soldan, J R; Scourfield, J; Harper, P S

1996-01-01

Adolescents who are actively requesting Huntington's predictive testing of their own accord pose a dilemma to those providing testing. In the absence of empirical evidence as regards the impact of genetic testing on minors, current policy and guidelines, based on the ethical principles of non-maleficence and respect for individual autonomy and confidentiality, generally exclude the testing of minors. It is argued that adherence to an age based exclusion criterion in Huntington's disease predictive testing protocols is out of step with trends in UK case law concerning minors' consent to medical treatment. Furthermore, contributions from developmental psychology and research into adolescents' decision making competence suggest that adolescents can make informed choices about their health and personal lives. Criteria for developing an assessment approach to such requests are put forward and the implications of a case by case evaluation of competence to consent in terms of clinicians' tolerance for uncertainty are discussed. PMID:8950670

Five common tumor biomarkers and CEA for diagnosing early gastric cancer: A protocol for a network meta-analysis of diagnostic test accuracy.

PubMed

Shen, Minghui; Wang, Hui; Wei, Kongyuan; Zhang, Jianling; You, Chongge

2018-05-01

Although surgical resection is the recommended treatment for the patients with gastric cancer, lots of patients show advanced or metastatic gastric cancer at the time of diagnosis. Detection of gastric cancer at early stages is a huge challenge because of lack of appropriate detection tests. Unfortunately, existing clinical guidelines focusing on early diagnosis of gastric cancer do not provide consistent and prudent evidence. Serum carcinoembryonic antigen was considered as a complementary test, although it is not good enough to diagnose early gastric cancer. There are no other tumor markers recommended for diagnosing early gastric cancer. This study aims to evaluate and compare the diagnostic accuracy of 5 common tumor biomarkers (CA19-9, CA125, PG, IncRNA, and DNA methylation) and CEA and their combinations for diagnosing gastric cancer through network meta-analysis method, and to rank these tests using a superiority index. PubMed, EMBASE.com, and the Cochrane Central Register of Controlled Trials (CENTRAL) will be searched from their inception to March 2018. We will include diagnostic tests which assessed the accuracy of the above-mentioned tumor biomarkers and CEA for diagnosing gastric cancer. The risk of bias for each study will be independently assessed as low, moderate, or high using criteria adapted from Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2). Network meta-analysis will be performed using STATA 12.0 and R 3.4.1 software. The competing diagnostic tests will be ranked by a superiority index. This study is ongoing and will be submitted to a peer-reviewed journal for publication. This study will provide systematically suggestions to select different tumor biomarkers for detecting the early gastric cancer.

Testing objective measures of motor impairment in early Parkinson's disease: Feasibility study of an at-home testing device.

PubMed

Goetz, Christopher G; Stebbins, Glenn T; Wolff, David; DeLeeuw, William; Bronte-Stewart, Helen; Elble, Rodger; Hallett, Mark; Nutt, John; Ramig, Lorraine; Sanger, Terence; Wu, Allan D; Kraus, Peter H; Blasucci, Lucia M; Shamim, Ejaz A; Sethi, Kapil D; Spielman, Jennifer; Kubota, Ken; Grove, Andrew S; Dishman, Eric; Taylor, C Barr

2009-03-15

We tested the feasibility of a computer based at-home testing device (AHTD) in early-stage, unmedicated Parkinson's disease (PD) patients over 6 months. We measured compliance, technical reliability, and patient satisfaction to weekly assessments of tremor, small and large muscle bradykinesia, speech, reaction/movement times, and complex motor control. relative to the UPDRS motor score. The AHTD is a 6.5'' x 10'' computerized assessment battery. Data are stored on a USB memory stick and sent by internet to a central data repository as encrypted data packets. Although not designed or powered to measure change, the study collected data to observe patterns relative to UPDRS motor scores. Fifty-two PD patients enrolled, and 50 completed the 6 month trial, 48 remaining without medication. Patients complied with 90.6% of weekly 30-minute assessments, and 98.5% of data packets were successfully transmitted and decrypted. On a 100-point scale, patient satisfaction with the program at study end was 87.2 (range: 80-100). UPDRS motor scores significantly worsened over 6 months, and trends for worsening over time occurred for alternating finger taps (P = 0.08), tremor (P = 0.06) and speech (P = 0.11). Change in tremor was a significant predictor of change in UPDRS (P = 0.047) and was detected in the first month of the study. This new computer-based technology offers a feasible format for assessing PD-related impairment from home. The high patient compliance and satisfaction suggest the feasibility of its incorporation into larger clinical trials, especially when travel is difficult and early changes or frequent data collection are considered important to document.

Use of a Case-Based Hypermedia Resource in an Early Literacy Coaching Intervention with Pre-Kindergarten Teachers

ERIC Educational Resources Information Center

Powell, Douglas R.; Diamond, Karen E.; Koehler, Matthew J.

2010-01-01

Use of a case-based hypermedia resource (HR) was examined in a Web-based early literacy coaching intervention with pre-kindergarten teachers of at-risk children. Web usage logs, written records of coach feedback to teachers on their instruction, and a teacher questionnaire were the primary data sources. Visits to the HR content pages were unevenly…

Discussions On Worst-Case Test Condition For Single Event Burnout

NASA Astrophysics Data System (ADS)

Liu, Sandra; Zafrani, Max; Sherman, Phillip

2011-10-01

This paper discusses the failure characteristics of single- event burnout (SEB) on power MOSFETs based on analyzing the quasi-stationary avalanche simulation curves. The analyses show the worst-case test condition for SEB would be using the ion that has the highest mass that would result in the highest transient current due to charge deposition and displacement damage. The analyses also show it is possible to build power MOSFETs that will not exhibit SEB even when tested with the heaviest ion, which have been verified by heavy ion test data on SEB sensitive and SEB immune devices.

Parenting style and oral health practices in early childhood caries: a case-control study.

PubMed

Dabawala, Suhel; Suprabha, Baranya S; Shenoy, Ramya; Rao, Arathi; Shah, Nachiket

2017-03-01

There is a need to carry out controlled investigations regarding risk factors for early childhood caries (ECC). To study the type of parenting style and oral health practices as risk factors among children with ECC in an Indian preschool population. Two hundred and eleven children with ECC and equal number of controls participated in this case-control study. A questionnaire was answered by parents regarding oral health practices such as oral hygiene methods, feeding habits, daily sugar intake, and dental attendance pattern along with socioeconomic and demographic status. The parenting style was determined using Parenting Styles Dimension Questionnaire (PSDQ) index. Data were statistically analyzed using chi-square test and multiple logistic regression analysis. Risk factors associated with ECC were higher birth order, lower socioeconomic status, non-use of fluoridated toothpaste, breast/bottle feeding for more than one year, presence of formula milk or milk with sugar in the feeding bottle while falling asleep, higher sweet scores in the diet chart, and visiting dentist only when a problem was perceived. Majority of parents of children with and without ECC had authoritative parenting style. Improper oral health practices are the risk factors for ECC. The association of parenting style with ECC could not be confirmed. © 2016 BSPD, IAPD and John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Test case for VVER-1000 complex modeling using MCU and ATHLET

NASA Astrophysics Data System (ADS)

Bahdanovich, R. B.; Bogdanova, E. V.; Gamtsemlidze, I. D.; Nikonov, S. P.; Tikhomirov, G. V.

2017-01-01

The correct modeling of processes occurring in the fuel core of the reactor is very important. In the design and operation of nuclear reactors it is necessary to cover the entire range of reactor physics. Very often the calculations are carried out within the framework of only one domain, for example, in the framework of structural analysis, neutronics (NT) or thermal hydraulics (TH). However, this is not always correct, as the impact of related physical processes occurring simultaneously, could be significant. Therefore it is recommended to spend the coupled calculations. The paper provides test case for the coupled neutronics-thermal hydraulics calculation of VVER-1000 using the precise neutron code MCU and system engineering code ATHLET. The model is based on the fuel assembly (type 2M). Test case for calculation of power distribution, fuel and coolant temperature, coolant density, etc. has been developed. It is assumed that the test case will be used for simulation of VVER-1000 reactor and in the calculation using other programs, for example, for codes cross-verification. The detailed description of the codes (MCU, ATHLET), geometry and material composition of the model and an iterative calculation scheme is given in the paper. Script in PERL language was written to couple the codes.

Test anxiety in mathematics among early undergraduate students in a British university in Malaysia

NASA Astrophysics Data System (ADS)

Karjanto, Natanael; Yong, Su Ting

2013-03-01

The level of test anxiety in mathematics subjects among early undergraduate students at the University of Nottingham Malaysia Campus is studied in this article. The sample consists of 206 students taking several mathematics modules who completed the questionnaires on test anxiety just before they entered the venue for midterm examinations. The sample data include the differences in the context of academic levels, gender groups and nationality backgrounds. The level of test anxiety in mathematics is measured using seven Likert questionnaire statements adapted from the Test Anxiety Inventory describing one's emotional feeling before the start of an examination. In general, the result shows that the students who had a lower score expectation were more anxious than those who had a higher score expectation, but that they obtained a better score than the expected score. In the context of academic levels, gender groups and nationality backgrounds, there were no significant correlations between the level of test anxiety and the students' academic performance. The effect size of the correlation values ranged from extremely small to moderate.

30 CFR 250.523 - How long do I keep records of casing pressure and diagnostic tests?

Code of Federal Regulations, 2010 CFR

2010-07-01

... field office nearest the well for a minimum of 2 years. The last casing diagnostic test for each casing... and diagnostic tests? 250.523 Section 250.523 Mineral Resources MINERALS MANAGEMENT SERVICE... Gas Well-Completion Operations Casing Pressure Management § 250.523 How long do I keep records of...

Early Statin Use and the Progression of Alzheimer Disease: A Total Population-Based Case-Control Study.

PubMed

Lin, Feng-Cheng; Chuang, Yun-Shiuan; Hsieh, Hui-Min; Lee, Tzu-Chi; Chiu, Kuei-Fen; Liu, Ching-Kuan; Wu, Ming-Tsang

2015-11-01

The protective effect of statin on Alzheimer disease (AD) is still controversial, probably due to the debate about when to start the use of statin and the lack of any large-scale randomized evidence that actually supports the hypothesis. The purpose of this study was to examine the protective effect of early statin use on mild-to-moderate AD in the total Taiwanese population.This was a total population-based case-control study, using the total population of Taiwanese citizens seen in general medical practice; therefore, the findings can be applied to the general population. The study patients were those with newly diagnosed dementia (ICD-9 290.x) and prescribed any acetylcholinesterase inhibitors (AChEI) from the Taiwan National Health Insurance dataset in 1997 to 2008. The newly diagnosed eligible mild-to-moderate AD patients were traced from the dates of their index dates, which was defined as the first day to receive any AChEI treatment, back to 1 year (exposure period) to categorize them into AD with early statin use and without early statin use. Early statin use was defined as patients using statin before AChEI treatment. Alzheimer disease patients with early statin use were those receiving any statin treatment during the exposure period. Then, we used propensity-score-matched strategy to match these 2 groups as 1:1. The matched study patients were followed-up from their index dates. The primary outcome was the discontinuation of AChEI treatment, indicating AD progression.There were 719 mild-to-moderate AD-paired patients with early statin use and without early statin use for analyses. Alzheimer disease progression was statistically lower in AD patients with early statin use than those without (P = 0.00054). After adjusting for other covariates, mild-to-moderate AD patients with early stain use exhibited a 0.85-risk (95% CI = 0.76-0.95, P = 0.0066) to have AD progression than those without.Early statin use was significantly associated with a reduction in AD

[A Case of Severe Legionella longbeachae Pneumonia and Usefulness of LAMP Assay].

PubMed

Matsushita, Kumiko; Hijikuro, Kohei; Arita, Shohei; Kaneko, Yu; Isozaki, Masahiro

2017-08-15

Urinary antigen test is frequently used as a routine laboratory test for early diagnosis of Legionella infection , which is especially suitable for ordinary Legionella pneumophila serogroup 1, but not for other types of Legionella . We report a case of severe pneumonia caused by Legionella longbeachae , where a method of loop-mediated isothermal amplification (LAMP) assay contributed an important role for the early detection. This case involved an 83-year-old man who developed fever, dyspnea, and productive cough. Since the medication of prescribed ceftriaxone had not been effective, he visited the emergency room of our hospital, where an X-ray revealed a severe pneumonia harboring a consolidation with air bronchogram in his right lower lung. His sputum and urine were subjected to the routine bacterial culture or the urinary antigen test for Legionella , which initially brought negative results. However, a positive result of LAMP assay enabled early diagnosis of Legionella pneumonia . Later, the bacterial cultures of sputum made some progress and 16S rRNA sequencing provided a proof of L. longbeachae . This LAMP assay may bring a benefit for the patients with Legionella pneumonia by enabling early detection of not only specific L. pneumophila serogroup 1, but also of the other Legionella species.

Improving knowledge and behaviours related to the cause, transmission and prevention of Tuberculosis and early case detection: a descriptive study of community led Tuberculosis program in Flores, Indonesia.

PubMed

Dewi, Christa; Barclay, Lesley; Passey, Megan; Wilson, Shawn

2016-08-08

The community's awareness of Tuberculosis (TB) and delays in health care seeking remain important issues in Indonesia despite the extensive efforts of community-based TB programs delivered by a non-government organisation (NGO). This study explored the knowledge and behaviours in relation to TB and early diagnosis before and after an asset-based intervention designed to improve these issues. Six villages in Flores, Indonesia were purposively selected to participate in this study. Three villages served as intervention villages and the other three villages provided a comparison group. Data collection included interviews, group discussions, observations, field notes and audit of records. In total, 50 participants across six villages were interviewed and three group discussions were conducted in the intervention villages supplemented by 1 - 5 h of observation during monthly visits. Overall, participants in all villages had limited knowledge regarding the cause and transmission of TB before the intervention. The delay in health seeking behaviour was mainly influenced by ignorance of TB symptoms. Health care providers also contributed to delayed diagnosis by ignoring the symptoms of TB suspects at the first visit and failing to examine TB suspects with sputum tests. Stigmatisation of TB patients by the community was reported, although this did not seem to be common. Early case detection was less than 50 % in four of the six villages before the asset-based intervention. Knowledge of TB improved after the intervention in the intervention villages alongside improved education activities. Early case detection also increased in the intervention villages following this intervention. The behaviour changes related to prevention of TB were also obvious in the intervention villages but not the comparison group. This small project demonstrated that an asset-based intervention can result in positive changes in community's knowledge and behaviour in relation to TB and early case

Economic evaluation of genomic test-directed chemotherapy for early-stage lymph node-positive breast cancer.

PubMed

Hall, Peter S; McCabe, Christopher; Stein, Robert C; Cameron, David

2012-01-04

Multi-parameter genomic tests identify patients with early-stage breast cancer who are likely to derive little benefit from adjuvant chemotherapy. These tests can potentially spare patients the morbidity from unnecessary chemotherapy and reduce costs. However, the costs of the test must be balanced against the health benefits and cost savings produced. This economic evaluation compared genomic test-directed chemotherapy using the Oncotype DX 21-gene assay with chemotherapy for all eligible patients with lymph node-positive, estrogen receptor-positive early-stage breast cancer. We performed a cost-utility analysis using a state transition model to calculate expected costs and benefits over the lifetime of a cohort of women with estrogen receptor-positive lymph node-positive breast cancer from a UK perspective. Recurrence rates for Oncotype DX-selected risk groups were derived from parametric survival models fitted to data from the Southwest Oncology Group 8814 trial. The primary outcome was the incremental cost-effectiveness ratio, expressed as the cost (in 2011 GBP) per quality-adjusted life-year (QALY). Confidence in the incremental cost-effectiveness ratio was expressed as a probability of cost-effectiveness and was calculated using Monte Carlo simulation. Model parameters were varied deterministically and probabilistically in sensitivity analysis. Value of information analysis was used to rank priorities for further research. The incremental cost-effectiveness ratio for Oncotype DX-directed chemotherapy using a recurrence score cutoff of 18 was £5529 (US $8852) per QALY. The probability that test-directed chemotherapy is cost-effective was 0.61 at a willingness-to-pay threshold of £30 000 per QALY. Results were sensitive to the recurrence rate, long-term anthracycline-related cardiac toxicity, quality of life, test cost, and the time horizon. The highest priority for further research identified by value of information analysis is the recurrence rate in test

Real-Time Extended Interface Automata for Software Testing Cases Generation

PubMed Central

Yang, Shunkun; Xu, Jiaqi; Man, Tianlong; Liu, Bin

2014-01-01

Testing and verification of the interface between software components are particularly important due to the large number of complex interactions, which requires the traditional modeling languages to overcome the existing shortcomings in the aspects of temporal information description and software testing input controlling. This paper presents the real-time extended interface automata (RTEIA) which adds clearer and more detailed temporal information description by the application of time words. We also establish the input interface automaton for every input in order to solve the problems of input controlling and interface covering nimbly when applied in the software testing field. Detailed definitions of the RTEIA and the testing cases generation algorithm are provided in this paper. The feasibility and efficiency of this method have been verified in the testing of one real aircraft braking system. PMID:24892080

Use of the Randomization Test in Single-Case Research

ERIC Educational Resources Information Center

Grünke, Matthias; Boon, Richard T.; Burke, Mack D.

2015-01-01

The purpose of this study was to illustrate the use of the randomization test for single-case research designs (SCR; Kratochwill & Levin, 2010). To demonstrate the application of this approach, a systematic replication of Grünke, Wilbert, and Calder Stegemann (2013) was conducted to evaluate the effects of a story map to improve the reading…

Test Cases for Flutter of the Benchmark Models Rectangular Wings on the Pitch and Plunge Apparatus

NASA Technical Reports Server (NTRS)

Bennett, Robert M.

2000-01-01

The supercritical airfoil was chosen as a relatively modem airfoil for comparison. The BOO12 model was tested first. Three different types of flutter instability boundaries were encountered, a classical flutter boundary, a transonic stall flutter boundary at angle of attack, and a plunge instability near M = 0.9 and for zero angle of attack. This test was made in air and was Transonic Dynamics Tunnel (TDT) Test 468. The BSCW model (for Benchmark SuperCritical Wing) was tested next as TDT Test 470. It was tested using both with air and a heavy gas, R-12, as a test medium. The effect of a transition strip on flutter was evaluated in air. The B64AOlO model was subsequently tested as TDT Test 493. Some further analysis of the experimental data for the BOO12 wing is presented. Transonic calculations using the parameters for the BOO12 wing in a two-dimensional typical section flutter analysis are given. These data are supplemented with data from the Benchmark Active Controls Technology model (BACT) given and in the next chapter of this document. The BACT model was of the same planform and airfoil as the BOO12 model, but with spoilers and a trailing edge control. It was tested in the heavy gas R-12, and was instrumented mostly at the 60 per cent span. The flutter data obtained on PAPA and the static aerodynamic test cases from BACT serve as additional data for the BOO12 model. All three types of flutter are included in the BACT Test Cases. In this report several test cases are selected to illustrate trends for a variety of different conditions with emphasis on transonic flutter. Cases are selected for classical and stall flutter for the BSCW model, for classical and plunge for the B64AOlO model, and for classical flutter for the BOO12 model. Test Cases are also presented for BSCW for static angles of attack. Only the mean pressures and the real and imaginary parts of the first harmonic of the pressures are included in the data for the test cases, but digitized time

Telomere length and early trauma in schizophrenia.

PubMed

Riley, Gabriella; Perrin, Mary; Vaez-Azizi, Leila M; Ruby, Eugene; Goetz, Raymond R; Dracxler, Roberta; Walsh-Messinger, Julie; Keefe, David L; Buckley, Peter F; Szeszko, Philip R; Malaspina, Dolores

2018-04-02

Childhood trauma is emerging as a risk factor for schizophrenia, but its mechanism with respect to etiology is unknown. One possible pathway is through leucocyte telomere length (LTL) shortening, a measure of cellular aging associated with trauma. This study examined early trauma and LTL shortening in schizophrenia and considered sex effects. The early trauma inventory (ETI) was administered to 48 adults with DSM-5 schizophrenia and 18 comparison participants. LTL was measured using qPCR. Cases had significantly more global trauma (F=4.10, p<0.01) and traumatic events (F=11.23, p<0.001), but case and control groups had similar LTL (1.91±0.74 and 1.83±0.62: p=0.68). The association of early trauma and LTL differed by sex in cases and controls (Fisher's R: Z<0.05). Significant negative associations were shown in male cases and, conversely, in female controls. For example, physical punishment was associated LTL shortening in males' cases (r=-0.429, p<01). Only female controls showed significant telomere shortening in association with early trauma. This data confirms the substantial excess of early trauma among schizophrenia cases. There were significant sex-differences in the relationship of the trauma to LTL, with only male cases showing the expected shortening. There were converse sex effects in the control group. Mean LTL was notably similar in cases and controls, despite the trauma-related shortening in male cases, cigarette smoking, older age and chronic illness of the cases. Factors may lengthen LTL in some schizophrenia cases. The converse sex differences in the cases are consistent with findings defective sexual differentiation in schizophrenia, consistent with other findings in the field. Copyright © 2018 Elsevier B.V. All rights reserved.

Psychometric Evaluation of the Ford Insomnia Response to Stress Test (FIRST) in Early Pregnancy.

PubMed

Gelaye, Bizu; Zhong, Qiu-Yue; Barrios, Yasmin V; Redline, Susan; Drake, Christopher L; Williams, Michelle A

2016-04-15

To evaluate the construct validity and factor structure of the Spanish-language version of the Ford Insomnia Response to Stress Test questionnaire (FIRST-S) when used in early pregnancy. A cohort of 647 women were interviewed at ≤ 16 weeks of gestation to collect information regarding lifestyle, demographic, and sleep characteristics. The factorial structure of the FIRST-S was tested through exploratory and confirmatory factor analyses (EFA and CFA). Internal consistency and construct validity were also assessed by evaluating the association between the FIRST-S with symptoms of depression, anxiety, and sleep quality. Item response theory (IRT) analyses were conducted to complement classical test theory (CTT) analytic approaches. The mean score of the FIRST-S was 13.8 (range: 9-33). The results of the EFA showed that the FIRST-S contained a one-factor solution that accounted for 69.8% of the variance. The FIRST-S items showed good internal consistency (Cronbach α = 0.81). CFA results corroborated the one-factor structure finding from the EFA; and yielded measures indicating goodness of fit (comparative fit index of 0.902) and accuracy (root mean square error of approximation of 0.057). The FIRST-S had good construct validity as demonstrated by statistically significant associations of FIRST-S scores with sleep quality, antepartum depression and anxiety symptoms. Finally, results from IRT analyses suggested excellent item infit and outfit measures. The FIRST-S was found to have good construct validity and internal consistency for assessing vulnerability to insomnia during early pregnancy. © 2016 American Academy of Sleep Medicine.

A history of the early days of personality testing in American industry: an obsession with adjustment.

PubMed

Gibby, Robert E; Zickar, Michael J

2008-08-01

Objective personality testing began with Woodworth's Personal Data Sheet in 1917. That test was developed to identify soldiers prone to nervous breakdowns during enemy bombardment in World War I (WWI). Soon after, many competing personality tests were developed for use in industry. Many of these tests, like Woodworth's, focused on the construct of employee maladjustment and were deemed important in screening out applicants who would create workplace disturbances. In this article, the authors review the history of these early personality tests, especially the Bernreuter Personality Inventory and the Humm-Wadsworth Temperament Scale, and discuss the implications of personality testers' obsession with the construct of employee maladjustment. In addition, the authors discuss the industry's obsession with emotional maladjustment and how this obsession coincided with a cultural shift in norms relating to cultural expression.

A case management tool for occupational health nurses: development, testing, and application.

PubMed

Mannon, J A; Conrad, K M; Blue, C L; Muran, S

1994-08-01

1. Case management is a process of coordinating an individual client's health care services to achieve optimal, quality care delivered in a cost effective manner. The case manager establishes a provider network, recommends treatment plans that assure quality and efficacy while controlling costs, monitors outcomes, and maintains a strong communication link among all the parties. 2. Through development of audit tools such as the one presented in this article, occupational health nurses can document case management activities and provide employers with measurable outcomes. 3. The Case Management Activity Checklist was tested using data from 61 firefighters' musculoskeletal injury cases. 4. The activities on the checklist are a step by step process: case identification/case disposition; assessment; return to work plan; resource identification; collaborative communication; and evaluation.

The Subtlety of Age, Gender, and Race Barriers: A Case Study of Early Career African American Female Principals

ERIC Educational Resources Information Center

Jean-Marie, Gaetane

2013-01-01

While all educational leaders face challenges in achieving success, African American female principals often face a unique set of challenges associated with the complexity of their gender, race, and, as examined in this study, age. This case study investigates the experiences of two highly visible, early career African American female principals…

System development and early biological tests in NASA's biomass production chamber

NASA Technical Reports Server (NTRS)

Wheeler, R. M.; Mackowiak, C. L.; Dreschel, T. W.; Sager, J. C.; Prince, R. P.; Knott, W. M.; Hinkle, C. R.; Strayer, R. F.

1990-01-01

The Biomass Production Chamber at Kennedy Space Center was constructed to conduct large scale plant growth studies for NASA's CELSS program. Over the past four years, physical systems and computer control software have been continually upgraded and the degree of atmospheric leakage from the chamber has decreased from about 40 to 5 percent of the total volume per day. Early tests conducted with a limited degree of closure showed that total crop (wheat) growth from the best trays was within 80 percent of reported optimal yields for similar light levels. Yields from subsequent tests under more tightly closed conditions have not been as good--up to only 65 percent of optimal yields. Yields appear to have decreased with increasing closure, yet potential problems exist in cultural techniques and further studies are warranted. With the ability to tightly seal the chamber, quantitative data were gathered on CO2 and water exchange rates. Results showed that stand photosynthesis and transpiration reached a peak near 25 days after planting, soon after full vegetative ground cover was established. In the final phase of testing when atmospheric closure was the highest, ethylene gas levels in the chamber rose from about 10 to nearly 120 ppb. Evidence suggests that the ethylene originated from the wheat plants themselves and may have caused an epinastic rolling of the leaves, but no apparent detrimental effects on whole plant function.

[Management and Nursing care for a patient with Lynch syndrome: A case report].

PubMed

Pacheco-Pérez, Luis Arturo; Guevara Valtier, Milton Carlos

2016-01-01

Colorectal cancer is one of the leading causes of death from cancer worldwide. Main interventions to reduce the impact are aimed to enhance prevention and early detection. Results of several studies show that tests such as the fecal occult blood test and colonoscopy are effective for early diagnosis. There are hereditary syndromes such as Lynch Syndrome that can lead to certain types of cancers, including bowel neoplasms, therefore early detection needs to be included as part of the treatment. In these cases, family genetic testing is recommended if the bowel cancer is diagnosed before 50 years old. A care plan including the NANDA (North American Nursing Diagnosis Association), NOC (Nursing Outcomes Classification) and NIC (Nursing Interventions Classification) was developed for a patient with suspected Lynch Syndrome. Nurses should be qualified to identify potential cases of cancer associated with this syndrome, and thus, reduce the likelihood that family members develop the disease, through genetic counseling and education of environmental risk factors. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

Targeting the initial investigation and management in cases of acute pulmonary embolism.

PubMed

Moore, Nicholas; Hawkins, Peter

2013-01-01

It was noted by consultants in our hospital that the early investigation of suspected pulmonary embolism (PE) lacked structure. This was causing delays in definitive diagnosis and early management. The resulting unnecessary use of investigation was also wasting resources. In particular, the inappropriate use of serum d-dimer tests was causing concern. The National Institute of Clinical Excellence (NICE) guidelines recommend use of the 2-level Well's score to target investigation in suspected PE. A baseline audit against the NICE guideline revealed that Well's scores were rarely used (only calculated in 12% of cases) and confirmed the suspicion that early investigation was poorly targeted. This project intervened using educational talks promoting the use of Well's scores in cases of suspected PE. Well's score proformas were placed in the emergency department and emergency assessment unit for reference. Their availability was advertised. This significantly increased the use of Well's scores (46% vs 11%, p<0.001). Fewer patients underwent unnecessary d-dimer measurements in cases of likely PE (65% vs 86%). Initial investigation was more targeted in cases where a Well's score had been calculated than in cases without a Well's score. For example, significantly fewer unnecessary d-dimer tests were performed in these cases (45% vs 100%, p<0.05). The cost of unnecessary investigation in suspected PE is not only significant financially but also in the resulting delay in definitive diagnosis and management for the patient. The simple intervention used here was effective in addressing this problem.

Alternatives to the Fish Early Life-Stage Test: A Research Strategy for Discovering and Annotating Adverse Outcome Pathways During Fish Development

EPA Science Inventory

The OECD 210 fish early life]stage (FELS) test is the primary guideline test used to estimate chronic fish toxicity, as well as support ecological risk assessments and chemical management programs around the world. As a step toward developing alternatives to the FELS test, a HES...

Changes in pathology test ordering by early career general practitioners: a longitudinal study.

PubMed

Magin, Parker J; Tapley, Amanda; Morgan, Simon; Henderson, Kim; Holliday, Elizabeth G; Davey, Andrew R; Ball, Jean; Catzikiris, Nigel F; Mulquiney, Katie J; van Driel, Mieke L

2017-07-17

To assess the number of pathology tests ordered by general practice registrars during their first 18-24 months of clinical general practice. Longitudinal analysis of ten rounds of data collection (2010-2014) for the Registrar Clinical Encounters in Training (ReCEnT) study, an ongoing, multicentre, cohort study of general practice registrars in Australia. The principal analysis employed negative binomial regression in a generalised estimating equations framework (to account for repeated measures on registrars).Setting, participants: General practice registrars in training posts with five of 17 general practice regional training providers in five Australian states. The registrar participation rate was 96.4%. Number of pathology tests requested per consultation. The time unit for analysis was the registrar training term (the 6-month full-time equivalent component of clinical training); registrars contributed data for up to four training terms. 876 registrars contributed data for 114 584 consultations. The number of pathology tests requested increased by 11% (95% CI, 8-15%; P < 0.001) per training term. Contrary to expectations, pathology test ordering by general practice registrars increased significantly during their first 2 years of clinical practice. This causes concerns about overtesting. As established general practitioners order fewer tests than registrars, test ordering may peak during late vocational training and early career practice. Registrars need support during this difficult period in the development of their clinical practice patterns.

Streptococcus pneumoniae-associated pneumonia complicated by purulent pericarditis: case series *

PubMed Central

Cillóniz, Catia; Rangel, Ernesto; Barlascini, Cornelius; Piroddi, Ines Maria Grazia; Torres, Antoni; Nicolini, Antonello

2015-01-01

Abstract Objective: In the antibiotic era, purulent pericarditis is a rare entity. However, there are still reports of cases of the disease, which is associated with high mortality, and most such cases are attributed to delayed diagnosis. Approximately 40-50% of all cases of purulent pericarditis are caused by Gram-positive bacteria, Streptococcus pneumoniae in particular. Methods: We report four cases of pneumococcal pneumonia complicated by pericarditis, with different clinical features and levels of severity. Results: In three of the four cases, the main complication was cardiac tamponade. Microbiological screening (urinary antigen testing and pleural fluid culture) confirmed the diagnosis of severe pneumococcal pneumonia complicated by purulent pericarditis. Conclusions: In cases of pneumococcal pneumonia complicated by pericarditis, early diagnosis is of paramount importance to avoid severe hemodynamic compromise. The complications of acute pericarditis appear early in the clinical course of the infection. The most serious complications are cardiac tamponade and its consequences. Antibiotic therapy combined with pericardiocentesis drastically reduces the mortality associated with purulent pericarditis. PMID:26398760

Early Complications and Outcomes in Combat Injury Related Invasive Fungal Wound Infections: A Case-Control Analysis

PubMed Central

Lewandowski, Louis R.; Weintrob, Amy C.; Tribble, David R.; Rodriguez, Carlos J.; Petfield, Joseph; Lloyd, Bradley A.; Murray, Clinton K.; Stinner, Daniel; Aggarwal, Deepak; Shaikh, Faraz; Potter, Benjamin K.

2015-01-01

Objective Clinicians have anecdotally noted that combat-related invasive fungal wound infections (IFIs) lead to residual limb shortening, additional days and operative procedures prior to initial wound closure, and high early complication rates. We evaluated the validity of these observations and identified risk factors that may impact time to initial wound closure. Design Retrospective review and case-control analysis. Setting Military hospitals. Patients/Participants United States military personnel injured during combat operations (2009–2011). The IFI cases were identified based upon the presence of recurrent, necrotic extremity wounds with mold growth in culture and/or histopathologic fungal evidence. Non-IFI controls were matched on injury pattern and severity. In a supplemental matching analysis, non-IFI controls were also matched by blood volume transfused within 24 hours of injury. Intervention None. Main Outcome Measurements Amputation revision rate and loss of functional levels. Results Seventy-one IFI cases (112 fungal-infected extremity wounds) were identified and matched to 160 control patients (315 non-IFI extremity wounds). The IFI wounds resulted in significantly more changes in amputation level (p<0.001). Additionally, significantly (p<0.001) higher number of operative procedures and longer duration to initial wound closure was associated with IFI. A shorter duration to initial wound closure was significantly associated with wounds lacking IFIs (Hazard ratio: 1.53; 95% CI: 1.17, 2.01). The supplemental matching analysis found similar results. Conclusions Our analysis indicates that IFIs adversely impact wound healing and patient recovery, requiring more frequent proximal amputation revisions and leading to higher early complication rates. PMID:26360542

Rasch Modeling of the Test of Early Mathematics Ability-Third Edition with a Sample of K1 Children in Singapore

ERIC Educational Resources Information Center

Yao, Shih-Ying; Muñez, David; Bull, Rebecca; Lee, Kerry; Khng, Kiat Hui; Poon, Kenneth

2017-01-01

The Test of Early Mathematics Ability-Third Edition (TEMA-3) is a commonly used measure of early mathematics knowledge for children aged 3 years to 8 years 11 months. In spite of its wide use, research on the psychometric properties of TEMA-3 remains limited. This study applied the Rasch model to investigate the psychometric properties of TEMA-3…

High-dose calcium stimulation test in a case of insulinoma masquerading as hysteria.

PubMed

Nakamura, Yoshio; Doi, Ryuichiro; Kohno, Yasuhiro; Shimono, Dai; Kuwamura, Naomitsu; Inoue, Koichi; Koshiyama, Hiroyuki; Imamura, Masayuki

2002-11-01

It is reported that some cases with insulinoma present with neuropsychiatric symptoms and are often misdiagnosed as psychosis. Here we report a case of insulinoma masquerading as hysteria, whose final diagnosis could be made using high-dose calcium stimulation test. A 28-yr-old woman was referred presenting with substupor, mutism, mannerism, restlessness, and incoherence. Laboratory examinations revealed hypoglycemia (33 mg/dL) and detectable insulin levels (9.7 microU/mL), suggesting the diagnosis of insulinoma. However, neither imaging studies nor selective arterial calcium injection (SACI) test with a conventional dose of calcium (0.025 mEq/kg) indicated the tumor. High-dose calcium injection (0.05 mEq/kg) evoked insulin secretion when injected into superior mesenteric artery. A solitary tumor in the head of the pancreas was resected, and her plasma glucose returned to normal. Postoperatively, iv injection of secretin resulted in a normal response of insulin, which was not found preoperatively. This case suggests the usefulness of the SACI test with high-dose of calcium in the case of insulinoma when the standard dose fails to detect such a tumor.

Verbal and visual memory in patients with early Parkinson's disease: effect of levodopa.

PubMed

Singh, Sumit; Behari, Madhuri

2006-03-01

The effect of initiation of levodopa therapy on the memory functions in patients with Parkinson's disease remains poorly understood. To evaluate the effect of initiation of levodopa therapy on memory, in patients with early Parkinson's disease. Prospective case control study. Seventeen patients with early Parkinson's disease were evaluated for verbal memory using Rey's auditory verbal learning test, and visual memory using the Benton's visual retention test and Form sequence learning test. UPDRS scores, Hoehn and Yahr's Staging and Schwab and England scores of Activities of daily living. Hamilton's depression rating scale and MMSE were also evaluated. Six controls were also evaluated according to similar study protocol. Levodopa was then prescribed to the cases. Same tests were repeated on all the subjects after 12 weeks. The mean age of the patients was 59.8 (+ 12.9 yrs); mean disease duration of 3.26 (+ 2.06 yrs). The mean UPDRS scores of patients were 36.52 (+ 15.84). Controls were of a similar age and sex distribution. A statistically significant improvement in the scores on the UPDRS, Hamilton's depression scale, Schwab and England scale, and a statistically significant deterioration in the scores of visual memory was observed in patients with PD after starting levodopa, as compared to their baseline scores. There was no correlation between degree of deterioration and the dose of levodopa. Initiation of levodopa therapy in patients with early and stable Parkinson's disease is associated with deterioration in visual memory functions, with relative preservation of the verbal memory.

An improved interim therapeutic restoration technique for management of anterior early childhood caries: report of two cases.

PubMed

Nelson, Travis

2013-01-01

Early childhood caries presents unique treatment challenges that often require advanced behavior management techniques, such as general anesthesia or procedural sedation. In some cases, use of these pharmacologic adjuncts is undesirable or not possible. The interim therapeutic restoration is a treatment method that, while sometimes employed in such cases, can often produce unsatisfactory results in primary anterior teeth. This is often due to insufficient bulk of material and lack of retention. The purpose of this report was to describe a simple alternative technique (resin modified glass ionomer strip crowns) that may be employed to deliver esthetic anterior restorations to marginally cooperative children in the dental clinic setting and to report on two cases in which it was successfully used. \\\\\\Department of Pediatric Dentistry, University of Washington, Seattle, Wash., USA. tmnelson@uw.edu

Mathematical Basis and Test Cases for Colloid-Facilitated Radionuclide Transport Modeling in GDSA-PFLOTRAN

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

Reimus, Paul William

This report provides documentation of the mathematical basis for a colloid-facilitated radionuclide transport modeling capability that can be incorporated into GDSA-PFLOTRAN. It also provides numerous test cases against which the modeling capability can be benchmarked once the model is implemented numerically in GDSA-PFLOTRAN. The test cases were run using a 1-D numerical model developed by the author, and the inputs and outputs from the 1-D model are provided in an electronic spreadsheet supplement to this report so that all cases can be reproduced in GDSA-PFLOTRAN, and the outputs can be directly compared with the 1-D model. The cases include examplesmore » of all potential scenarios in which colloid-facilitated transport could result in the accelerated transport of a radionuclide relative to its transport in the absence of colloids. Although it cannot be claimed that all the model features that are described in the mathematical basis were rigorously exercised in the test cases, the goal was to test the features that matter the most for colloid-facilitated transport; i.e., slow desorption of radionuclides from colloids, slow filtration of colloids, and equilibrium radionuclide partitioning to colloids that is strongly favored over partitioning to immobile surfaces, resulting in a substantial fraction of radionuclide mass being associated with mobile colloids.« less

Genetic Risk Score Analysis in Early-Onset Bipolar Disorder

PubMed Central

Croarkin, Paul E.; Luby, Joan L.; Cercy, Kelly; Geske, Jennifer R.; Veldic, Marin; Simonson, Matthew; Joshi, Paramjit T.; Wagner, Karen Dineen; Walkup, John T.; Nassan, Malik M.; Cuellar-Barboza, Alfredo B.; Casuto, Leah; McElroy, Susan L.; Jensen, Peter S.; Frye, Mark A.; Biernacka, Joanna M.

2018-01-01

Objective In this study, we performed a candidate genetic risk score (GRS) analysis of early-onset bipolar disorder. Method Treatment of Early Age Mania (TEAM) study enrollment and sample collection took place from 2003–2008. Mayo Clinic Bipolar Biobank samples were collected from 2009–2013. Genotyping and analyses for the present study took place from 2013–2014. The diagnosis of bipolar disorder was based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision criteria. Eight single-nucleotide polymorphisms (SNPs), previously reported in genome-wide association studies to be associated with bipolar disorder, were chosen for GRS analysis in early-onset bipolar disease. These SNPs map to 3 genes: CACNA1C (calcium channel, voltage-dependent, L type, alpha 1C subunit), ANK3 (ankyrin-3, node of Ranvier [ankyrin G]), and ODZ4 (teneurin transmembrane protein 4 [formerly “odz, odd Oz/ten-m homolog 4 {Drosophila}, ODZ4”]). The 8 candidate SNPs were genotyped in patients from the TEAM study (n=69), adult patients with bipolar disorder (n=732) including a subset with early-onset illness [n=192]), and healthy controls (n=776). GRS analyses were performed comparing early-onset cases with controls. In addition, associations of early-onset BD with individual SNPs and haplotypes were explored. Results GRS analysis revealed associations of the risk score with early-onset bipolar disorder (P=.01). Gene-level haplotype analysis comparing TEAM patients with controls suggested association of early-onset bipolar disorder with a CACNA1C haplotype (global test, P=.01). At the level of individual SNPs, comparison of TEAM cases with healthy controls provided nominally significant evidence for association of SNP rs10848632 in CACNA1C with early-onset bipolar disorder (P=.017), which did not remain significant after correction for multiple comparisons. Conclusion These preliminary analyses suggest that previously identified bipolar disorder risk loci

Genetic Risk Score Analysis in Early-Onset Bipolar Disorder.

PubMed

Croarkin, Paul E; Luby, Joan L; Cercy, Kelly; Geske, Jennifer R; Veldic, Marin; Simonson, Matthew; Joshi, Paramjit T; Wagner, Karen Dineen; Walkup, John T; Nassan, Malik M; Cuellar-Barboza, Alfredo B; Casuto, Leah; McElroy, Susan L; Jensen, Peter S; Frye, Mark A; Biernacka, Joanna M

In this study, we performed a candidate genetic risk score (GRS) analysis of early-onset bipolar disorder (BD). Treatment of Early Age Mania (TEAM) study enrollment and sample collection took place from 2003 to 2008. Mayo Clinic Bipolar Biobank samples were collected from 2009 to 2013. Genotyping and analyses for the present study took place from 2013 to 2014. The diagnosis of BD was based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision criteria. Eight single-nucleotide polymorphisms (SNPs), previously reported in genome-wide association studies to be associated with BD, were chosen for GRS analysis in early-onset bipolar disease. These SNPs map to 3 genes: CACNA1C (calcium channel, voltage-dependent, L type, alpha 1C subunit), ANK3 (ankyrin-3, node of Ranvier [ankyrin G]), and ODZ4 (teneurin transmembrane protein 4 [formerly "odz, odd Oz/10-m homolog 4 {Drosophila}, ODZ4"]). The 8 candidate SNPs were genotyped in patients from the TEAM study (n = 69); adult patients with BD (n = 732), including a subset with early-onset illness (n = 192); and healthy controls (n = 776). GRS analyses were performed to compare early-onset cases with controls. In addition, associations of early-onset BD with individual SNPs and haplotypes were explored. GRS analysis revealed associations of the risk score with early-onset BD (P = .01). Gene-level haplotype analysis comparing TEAM patients with controls suggested association of early-onset BD with a CACNA1C haplotype (global test, P = .01). At the level of individual SNPs, comparison of TEAM cases with healthy controls provided nominally significant evidence for association of SNP rs10848632 in CACNA1C with early-onset BD (P = .017), which did not remain significant after correction for multiple comparisons. These preliminary analyses suggest that previously identified BD risk loci, especially CACNA1C, have a role in early-onset BD, possibly with stronger effects than for late-onset BD. �

Sex-Specific Pathways to Early Puberty, Sexual Debut, and Sexual Risk Taking: Tests of an Integrated Evolutionary-Developmental Model

ERIC Educational Resources Information Center

James, Jenee; Ellis, Bruce J.; Schlomer, Gabriel L.; Garber, Judy

2012-01-01

The current study tested sex-specific pathways to early puberty, sexual debut, and sexual risk taking, as specified by an integrated evolutionary-developmental model of adolescent sexual development and behavior. In a prospective study of 238 adolescents (n = 129 girls and n = 109 boys) followed from approximately 12-18 years of age, we tested for…

The Case For A Warm Wet Early Mars

NASA Astrophysics Data System (ADS)

Craddock, R. A.; Howard, A. D.; Irwin, R. P., III

2016-12-01

Many current climate models fail to explain how early Mars could have experienced surface water under faint young Sun conditions, so the debate regarding the nature of the early martian climate continues. However, the geologic evidence is quite clear: early Mars was warm and wet. Older impact craters in the highlands are preserved at different sizes and in various states of degradation. These craters indicate that an early climate supported rainfall and surface runoff, and this climate persisted through the Noachian. When compared to terrestrial streams martian valley networks typically have shorter lengths, constant widths, and lower sinuosity. Divides between tributaries are rare, and the measured drainage densities are low. These observations indicate that valley networks represent immature drainage systems that did not fully integrate with the cratered landscape. The development of large alluvial fans, the limited amount of breaching of formerly enclosed drainage basins, and the style of entrenchment of rivers suggest that the more humid environmental conditions that supported valley network formation were maintained for only a geologically brief period of time (potentially as short as 104-106 years) at the end of the Noachian/beginning of the Hesperian. Other fluvial features include the large catastrophic outflow channels, which also suggest that climatic conditions reached an optimum during the Hesperian. Outflow channels may also indicated that there were sizeable lakes and seas at this time. Although multispectral observations of phyllosilicates and sulfates been interpreted differently, recent geochemical modeling indicates that the commonly observed stratigraphic relationship where sulfates overlie phyllosilicates can be explained simply if acid rain had leached through a deposit of basaltic rock. There is also multispectral evidence for chloride-bearing deposits that are best explained by evaporation of small standing bodies of water. Perhaps the most

Twenty Years On!: Updating the IEA BESTEST Building Thermal Fabric Test Cases for ASHRAE Standard 140: Preprint

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

Judkoff, R.; Neymark, J.

2013-07-01

ANSI/ASHRAE Standard 140, Standard Method of Test for the Evaluation of Building Energy Analysis Computer Programs applies the IEA BESTEST building thermal fabric test cases and example simulation results originally published in 1995. These software accuracy test cases and their example simulation results, which comprise the first test suite adapted for the initial 2001 version of Standard 140, are approaching their 20th anniversary. In response to the evolution of the state of the art in building thermal fabric modeling since the test cases and example simulation results were developed, work is commencing to update the normative test specification and themore » informative example results.« less

Early neonatal Glutaric aciduria type I hidden by perinatal asphyxia: a case report.

PubMed

Biasucci, Giacomo; Morelli, Nicola; Natacci, Federica; Mastrangelo, Massimo

2018-01-15

Perinatal asphyxia (PA) occurs in about 2 to 10 per 1000 live full-term births. Although neonatal epileptic seizures are observed in up to 60% of cases, PA may mimic or subtend other conditions. Hypoxia related brain injury is particularly relevant, as it may have permanent effects on neuropsychomotor development. Antepartum obstetric conditions, may, in turn, lead to hypoxic-ischemic damage to the fetus and the newborn, often underlying PA. Herein, a case of PA that hid and triggered signs and symptoms of Glutaric Aciduria type I (GA-I), is reported. R.F. was born at term after prolonged labour, by induced vaginal delivery with the Kristeller manoeuvre. He presented with severe asphyxia and asystoly. Immediate cardiopulmonary resuscitation promptly restored cardiorespiratory parameters, allowing for early extubation 30 min after. During the following hours, severe axial muscle hypotonia with an increased tone of the limb extensor muscles became evident. The absence of crying and archaic reflexes persisted and there was an onset of generalized tonic or clonic seizure. First level metabolic and inflammatory markers were within the normal range. An inherited metabolic disease was then suspected, due to the persistent clinical signs of severe neurological damage without any detectable septic parameter. GA-I was assessed and specific treatment started without any clinical improvement, although ensuring adequate growth and metabolic control. Thereafter, the baby developed a severe encephalopathy with drug resistant epileptic seizures. The progression of the neurological damage and a CVC-related sepsis led him to exitus at 2 years. To the best of our knowledge, this is the first case of early post-natal onset of GA-I reported in literature to date, in the absence of expanded newborn screening (NBS) programme. As expanded NBS programmes for inborn errors of metabolism have not yet been internationally adopted, we are of the opinion that such diseases may well be hidden

An Early Reader Two Decades Later: A Follow-Up Case Study on the Metacognitive Reading Strategies of "Jan"

ERIC Educational Resources Information Center

Brenna, Beverley A.

2011-01-01

This is a follow-up study regarding one of the early readers whose metacognitive reading strategies were explored in my 1991 qualitative case study research, published in "Reading", 29 (2), 30-33. Unique factors in the original study involve the inclusion of young children as informants related to self, task and text. Six-year-old…

Relationship between histopathological changes in post partum renal biopsies and renal function tests of African women with early onset pre-eclampsia.

PubMed

Khedun, S M; Naicker, T; Moodley, J

2000-05-01

To improve the diagnostic accuracy of concurrent renal disease in hypertension of pregnancy, biopsy evaluation is essential. In addition, establishing underlying renal disease is important for prognosis on future pregnancies. We therefore designed a study to determine the diagnostic yield of postpartum renal biopsy and the nature and frequency of complications associated with this procedure. Also, to determine relationships, if any, between renal function tests and ultrastructural and histopathological findings. Fifty renal biopsies were performed in the immediate postpartum period in black African women with early onset pre-eclampsia. Each biopsy specimen was placed in a separate container and coded so that sampling was unknown to the electron microscopist. Each biopsy specimen was divided into three parts, and processed and stained for light, fluorescent and transmission electron microscopy using conventional techniques. Renal tissue biopsies were adequate for diagnostic purposes in all cases. There were no complications in any of the 50 patients studied. Ultrastructural examination confirmed the light microscopy findings. In addition the ultrastructural findings showed intramembranous deposits, foot process fusion and mesangial deposits. In 16 patients with normal renal function tests; the biopsies evaluation from these patients showed ultrastructural changes. In the remaining 34 patients with abnormal renal function tests of varying severity; biopsy evaluation from these patients showed both ultrastructural and histopathological changes. Renal biopsy procedure is safe, and ultrastructural and histological findings obtained from postpartum renal biopsies are more informative than the routine renal function tests.

Promoter methylation of MCAM, ERα and ERβ in serum of early stage prostate cancer patients.

PubMed

Brait, Mariana; Banerjee, Mithu; Maldonado, Leonel; Ooki, Akira; Loyo, Myriam; Guida, Elisa; Izumchenko, Evgeny; Mangold, Leslie; Humphreys, Elizabeth; Rosenbaum, Eli; Partin, Alan; Sidransky, David; Hoque, Mohammad Obaidul

2017-02-28

Prostate cancer (PC) is the second most common cancer among men worldwide. Currently, the most common non-invasive approach for screening and risk assessment of PC is measuring the level of serum prostate-specific antigen (PSA). However, the sensitivity of PSA is 42.8 % and specificity is 41.1%. As a result, the serum PSA test leads to numerous unneeded biopsies. Therefore, a rigorous search for biomarkers for early detection of PC is ongoing. In this study, we aim to assess a panel of epigenetic markers in an intend to develop an early detection test for PC. The sensitivity and specificity of hypermethylation of MCAM was 66% and 73% respectively which is an improvement from the sensitivity and specificity of PSA. Considering a combination marker panel of MCAM, ERα and ERβ increased the sensitivity to 75% and the specificity became 70% for the minimally invasive early detection test of PC. Sixteen primary matched tumor and serum were analyzed by quantitative methylation specific PCR (QMSP) to determine analytical and clinical sensitivity of the genes tested (SSBP2, MCAM, ERα, ERβ, APC, CCND2, MGMT, GSTP1, p16 and RARβ2). Additionally, serum samples from eighty four cases of PC, thirty controls and seven cases diagnosed as high grade Prostatic Intraepithelial Neoplasia (HGPIN) were analyzed. Promoter methylation of MCAM, ERα and ERβ have a potential to be utilized as biomarker for the early detection of prostate PC as their sensitivity and specificity seem to be better than serum PSA in our cohort of samples. After robust validation in a larger prospective cohort, our findings may reduce the numbers of unwarranted prostate biopsies.

Early life course risk factors for childhood obesity: the IDEFICS case-control study.

PubMed

Bammann, Karin; Peplies, Jenny; De Henauw, Stefaan; Hunsberger, Monica; Molnar, Denes; Moreno, Luis A; Tornaritis, Michael; Veidebaum, Toomas; Ahrens, Wolfgang; Siani, Alfonso

2014-01-01

The early life course is assumed to be a critical phase for childhood obesity; however the significance of single factors and their interplay is not well studied in childhood populations. The investigation of pre-, peri- and postpartum risk factors on the risk of obesity at age 2 to 9. A case-control study with 1,024 1:1-matched case-control pairs was nested in the baseline survey (09/2007-05/2008) of the IDEFICS study, a population-based intervention study on childhood obesity carried out in 8 European countries in pre- and primary school settings. Conditional logistic regression was used for identification of risk factors. For many of the investigated risk factors, we found a raw effect in our study. In multivariate models, we could establish an effect for gestational weight gain (adjusted OR = 1.02; 95%CI 1.00-1.04), smoking during pregnancy (adjusted OR = 1.48; 95%CI 1.08-2.01), Caesarian section (adjusted OR = 1.38; 95%CI 1.10-1.74), and breastfeeding 4 to 11 months (adjusted OR = 0.77; 95%CI 0.62-0.96). Birth weight was related to lean mass rather than to fat mass, the effect of smoking was found only in boys, but not in girls. After additional adjustment for parental BMI and parental educational status, only gestational weight gain remained statistically significant. Both, maternal as well as paternal BMI were the strongest risk factors in our study, and they confounded several of the investigated associations. Key risk factors of childhood obesity in our study are parental BMI and gestational weight gain; consequently prevention approaches should target not only children but also adults. The monitoring of gestational weight seems to be of particular importance for early prevention of childhood obesity.

Early diagnosis of Budd-Chiari syndrome by computed tomography and ultrasonography: report of five cases

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

Baert, A.L.; Fevery, J.; Marchal, G.

1983-03-01

In 5 patients with Budd-Chiari syndrome, computed tomography after intravenous bolus injection of iodinated contrast agents demonstrated images not previously seen in other diseases. The images are compatible with stagnation of contrast material at the periphery of the liver. In 3 of the 5 cases, grey-scale ultrasonography failed to document the normal hepatic veins draining into the inferior caval vein, but showed an intrahepatic network of comma-shaped venous structures. It is proposed that these two noninvasive approaches can help in establishing an early diagnosis.

Heterozygous truncation mutations of the SMC1A gene cause a severe early onset epilepsy with cluster seizures in females: Detailed phenotyping of 10 new cases.

PubMed

Symonds, Joseph D; Joss, Shelagh; Metcalfe, Kay A; Somarathi, Suresh; Cruden, Jamie; Devlin, Anita M; Donaldson, Alan; DiDonato, Nataliya; Fitzpatrick, David; Kaiser, Frank J; Lampe, Anne K; Lees, Melissa M; McLellan, Ailsa; Montgomery, Tara; Mundada, Vivek; Nairn, Lesley; Sarkar, Ajoy; Schallner, Jens; Pozojevic, Jelena; Parenti, Ilaria; Tan, Jeen; Turnpenny, Peter; Whitehouse, William P; Zuberi, Sameer M

2017-04-01

The phenotype of seizure clustering with febrile illnesses in infancy/early childhood is well recognized. To date the only genetic epilepsy consistently associated with this phenotype is PCDH19, an X-linked disorder restricted to females, and males with mosaicism. The SMC1A gene, which encodes a structural component of the cohesin complex is also located on the X chromosome. Missense variants and small in-frame deletions of SMC1A cause approximately 5% of Cornelia de Lange Syndrome (CdLS). Recently, protein truncating mutations in SMC1A have been reported in five females, all of whom have been affected by a drug-resistant epilepsy, and severe developmental impairment. Our objective was to further delineate the phenotype of SMC1A truncation. Female cases with de novo truncation mutations in SMC1A were identified from the Deciphering Developmental Disorders (DDD) study (n = 8), from postmortem testing of an affected twin (n = 1), and from clinical testing with an epilepsy gene panel (n = 1). Detailed information on the phenotype in each case was obtained. Ten cases with heterozygous de novo mutations in the SMC1A gene are presented. All 10 mutations identified are predicted to result in premature truncation of the SMC1A protein. All cases are female, and none had a clinical diagnosis of CdLS. They presented with onset of epileptic seizures between <4 weeks and 28 months of age. In the majority of cases, a marked preponderance for seizures to occur in clusters was noted. Seizure clusters were associated with developmental regression. Moderate or severe developmental impairment was apparent in all cases. Truncation mutations in SMC1A cause a severe epilepsy phenotype with cluster seizures in females. These mutations are likely to be nonviable in males. Wiley Periodicals, Inc. © 2017 International League Against Epilepsy.

Evaluation of Modified 2-Tiered Serodiagnostic Testing Algorithms for Early Lyme Disease

PubMed Central

Strle, Klemen; Nigrovic, Lise E.; Lantos, Paul M.; Lepore, Timothy J.; Damle, Nitin S.; Ferraro, Mary Jane; Steere, Allen C.

2017-01-01

Abstract Background. The conventional 2-tiered serologic testing protocol for Lyme disease (LD), an enzyme immunoassay (EIA) followed by immunoglobulin M and immunoglobulin G Western blots, performs well in late-stage LD but is insensitive in patients with erythema migrans (EM), the most common manifestation of the illness. Western blots are also complex, difficult to interpret, and relatively expensive. In an effort to improve test performance and simplify testing in early LD, we evaluated several modified 2-tiered testing (MTTT) protocols, which use 2 assays designed as first-tier tests sequentially, without the need of Western blots. Methods. The MTTT protocols included (1) a whole-cell sonicate (WCS) EIA followed by a C6 EIA; (2) a WCS EIA followed by a VlsE chemiluminescence immunoassay (CLIA); and (3) a variable major protein-like sequence, expressed (VlsE) CLIA followed by a C6 EIA. Sensitivity was determined using serum from 55 patients with erythema migrans; specificity was determined using serum from 50 patients with other illnesses and 1227 healthy subjects. Results. Sensitivity of the various MTTT protocols in patients with acute erythema migrans ranged from 36% (95% confidence interval [CI], 25%–50%) to 54% (95% CI, 42%–67%), compared with 25% (95% CI, 16%–38%) using the conventional protocol (P = .003–0.3). Among control subjects, the 3 MTTT protocols were similarly specific (99.3%–99.5%) compared with conventional 2-tiered testing (99.5% specificity; P = .6–1.0). Conclusions. Although there were minor differences in sensitivity and specificity among MTTT protocols, each provides comparable or greater sensitivity in acute EM, and similar specificity compared with conventional 2-tiered testing, obviating the need for Western blots. PMID:28329259

The case-only test for gene-environment interaction is not uniformly powerful: an empirical example

PubMed Central

Wu, Chen; Chang, Jiang; Ma, Baoshan; Miao, Xiaoping; Zhou, Yifeng; Liu, Yu; Li, Yun; Wu, Tangchun; Hu, Zhibin; Shen, Hongbing; Jia, Weihua; Zeng, Yixin; Lin, Dongxin; Kraft, Peter

2016-01-01

The case-only test has been proposed as a more powerful approach to detect gene-environment (G×E) interactions. This approach assumes that the genetic and environmental factors are independent. While it is well known that Type I error rate will increase if this assumption is violated, it is less widely appreciated that gene-environment correlation can also lead to power loss. We illustrate this phenomenon by comparing the performance of the case-only test to other approaches to detect G×E interactions in a genome-wide association study of esophageal squamous carcinoma (ESCC) in Chinese populations. Some of these approaches do not use information on the correlation between exposure and genotype (standard logistic regression), while others seek to use this information in a robust fashion to boost power without increasing Type I error (two-step, empirical Bayes and cocktail methods). G×E interactions were identified involving drinking status and two regions containing genes in the alcohol metabolism pathway, 4q23 and 12q24. Although the case-only test yielded the most significant tests of G×E interaction in the 4q23 region, the case-only test failed to identify significant interactions in the 12q24 region which were readily identified using other approaches. The low power of the case-only test in the 12q24 region is likely due to the strong inverse association between the SNPs in this region and drinking status. This example underscores the need to consider multiple approaches to detect gene-environment interactions, as different tests are more or less sensitive to different alternative hypotheses and violations of the gene-environment independence assumption. PMID:23595356

TESTING OBJECTIVE MEASURES OF MOTOR IMPAIRMENT IN EARLY PARKINSON’S DISEASE: FEASIBILITY STUDY OF AN AT-HOME TESTING DEVICE

PubMed Central

Goetz, Christopher G.; Stebbins, Glenn T.; Wolff, David; DeLeeuw, William; Bronte-Stewart, Helen; Elble, Rodger; Hallett, Mark; Nutt, John; Ramig, Lorraine; Sanger, Terence; Wu, Allan D.; Kraus, Peter H.; Blasucci, Lucia M.; Shamim, Ejaz A.; Sethi, Kapil D.; Spielman, Jennifer; Kubota, Ken; Grove, Andrew S.; Dishman, Eric; Taylor, C Barr

2014-01-01

We tested the feasibility of a computer based at-home testing device (AHTD) in early-stage, unmedicated Parkinson’s disease (PD) patients over 6 months. We measured compliance, technical reliability, and patient satisfaction to weekly assessments of tremor, small and large muscle bradykinesia, speech, reaction/movement times, and complex motor control. relative to the UPDRS motor score. The AHTD is a 6.5 x 10 computerized assessment battery. Data are stored on a USB memory stick and sent by internet to a central data repository as encrypted data packets. Although not designed or powered to measure change, the study collected data to observe patterns relative to UPDRS motor scores. Fifty-two PD patients enrolled, and 50 completed the six month trial, 48 remaining without medication. Patients complied with 90.6% of weekly 30-minute assessments, and 98.5% of data packets were successfully transmitted and decrypted. On a 100-point scale, patient satisfaction with the program at study end was 87.2 (range 80–100). UPDRS motor scores significantly worsened over 6 months, and trends for worsening over time occurred for alternating finger taps (p=.08), tremor (p=.06) and speech (p=.11). Change in tremor was a significant predictor of change in UPDRS (p=0.047) and was detected in the first month of the study. This new computer-based technology offers a feasible format for assessing PD-related impairment from home. The high patient compliance and satisfaction suggest the feasibility of its incorporation into larger clinical trials, especially when travel is difficult and early changes or frequent data collection are considered important to document. PMID:19086085

Retaining early career registered nurses: a case study.

PubMed

Mills, Jane; Chamberlain-Salaun, Jennifer; Harrison, Helena; Yates, Karen; O'Shea, Andrea

2016-01-01

A core objective of the Australian health system is to provide high quality, safe health care that meets the needs of all Australians. To achieve this, an adequate and effective workforce must support the delivery of care. With rapidly changing health care systems and consumer demographics, demand for care is increasing and retention of sufficient numbers of skilled staff is now a critical priority to meet current and future health care demands. Nurses are the largest cohort of professionals within the health workforce. Reducing the rates at which nurses leave the profession and supporting nurses to practice in their profession longer will have beneficial implications for the sustainability of a nursing workforce and, ultimately, to patient outcomes. The aim of the study was to describe and explain early career registered nurses' (ECRNs) experiences and support requirements during the first five years of practice for the purposes of identifying strategies that would support greater retention of ECRNs. A single case study design focused on early career registered nurses (ECRNs) working in a hospital and health service in northern Australia. The research team adopted Djukic et al's definition of ECRNs as "RNs who have practiced for less than 5 years". Data was collected via three individual interviews and two focus groups. Thirty-five ECRNs participated in the study. Qualitative analysis of data generated during interviews and focus groups, identified the key themes of receiving career advice and choice or no choice . Analysis of study data in the context of the broader literature resulted in the researchers identifying six areas of focus for ECRN retention: 1) well-planned, supported and structured transition periods; 2) consideration of rotation through different areas with a six month minimum for skills development; 3) empowering decision making; 4) placement opportunities and choice in decisions of where to work; 5) career advice and support that considers ECRNs

Airside HVAC BESTEST. Adaptation of ASHRAE RP 865 Airside HVAC Equipment Modeling Test Cases for ASHRAE Standard 140. Volume 1, Cases AE101-AE445

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

Neymark, J.; Kennedy, M.; Judkoff, R.

This report documents a set of diagnostic analytical verification cases for testing the ability of whole building simulation software to model the air distribution side of typical heating, ventilating and air conditioning (HVAC) equipment. These cases complement the unitary equipment cases included in American National Standards Institute (ANSI)/American Society of Heating, Refrigerating, and Air-Conditioning Engineers (ASHRAE) Standard 140, Standard Method of Test for the Evaluation of Building Energy Analysis Computer Programs, which test the ability to model the heat-transfer fluid side of HVAC equipment.

Prolepsis, Syncretism, and Synergy in Early Language and Literacy Practices: A Case Study of Family Language Policy in Singapore

ERIC Educational Resources Information Center

Ren, Li; Hu, Guangwei

2013-01-01

This article reports a case study of two Chinese-English bilingual families in Singapore and illustrates the importance of incorporating two hitherto disconnected fields of research--family language policy and family literacy practices--to an understanding of early language and literacy acquisition in the familial milieu. Specifically, this work…

Graphs as a Managerial Tool: A Case Study of Du Pont's Use of Graphs in the Early Twentieth Century.

ERIC Educational Resources Information Center

Yates, JoAnne

1985-01-01

Sketches the development of business graphs in America. Examines their early use at Du Pont and the origin of the chart room around 1920, an important factor in the executive control systems at Du Pont. Draws lessons from this case study for managers and teachers of business communication. (PD)

Early detection of glaucoma by means of a novel 3D computer‐automated visual field test

PubMed Central

Nazemi, Paul P; Fink, Wolfgang; Sadun, Alfredo A; Francis, Brian; Minckler, Donald

2007-01-01

Purpose A recently devised 3D computer‐automated threshold Amsler grid test was used to identify early and distinctive defects in people with suspected glaucoma. Further, the location, shape and depth of these field defects were characterised. Finally, the visual fields were compared with those obtained by standard automated perimetry. Patients and methods Glaucoma suspects were defined as those having elevated intraocular pressure (>21 mm Hg) or cup‐to‐disc ratio of >0.5. 33 patients and 66 eyes with risk factors for glaucoma were examined. 15 patients and 23 eyes with no risk factors were tested as controls. The recently developed 3D computer‐automated threshold Amsler grid test was used. The test exhibits a grid on a computer screen at a preselected greyscale and angular resolution, and allows patients to trace those areas on the grid that are missing in their visual field using a touch screen. The 5‐minute test required that the patients repeatedly outline scotomas on a touch screen with varied displays of contrast while maintaining their gaze on a central fixation marker. A 3D depiction of the visual field defects was then obtained that was further characterised by the location, shape and depth of the scotomas. The exam was repeated three times per eye. The results were compared to Humphrey visual field tests (ie, achromatic standard or SITA standard 30‐2 or 24‐2). Results In this pilot study 79% of the eyes tested in the glaucoma‐suspect group repeatedly demonstrated visual field loss with the 3D perimetry. The 3D depictions of visual field loss associated with these risk factors were all characteristic of or compatible with glaucoma. 71% of the eyes demonstrated arcuate defects or a nasal step. Constricted visual fields were shown in 29% of the eyes. No visual field changes were detected in the control group. Conclusions The 3D computer‐automated threshold Amsler grid test may demonstrate visual field abnormalities characteristic of

A Report On Eight Early-Stage State And Regional Projects Testing Value-Based Payment

PubMed Central

Conrad, Douglas; Grembowski, David; Gibbons, Claire; Marcus-Smith, Miriam; Hernandez, Susan E.; Chang, Judy; Renz, Anne; Lau, Bernard; Cruz, Erin dela

2014-01-01

To help contain health care spending and improve the quality of care, practitioners and policy makers are trying to move away from fee-for-service toward value-based payment, which links providers’ reimbursement to the value, rather than the volume, of services delivered. With funding from the Robert Wood Johnson Foundation, eight grantees across the country are designing and implementing value-based payment reform projects. For example, in Salem, Oregon, the Physicians Choice Foundation is testing “Program Oriented Payments,” which include incentives for providers who follow a condition-specific program of care designed to meet goals set jointly by patient and provider. In this article we describe the funding rationale and the specific objectives, strategies, progress, and early stages of implementation of the eight projects. We also share some early lessons and identify prerequisites for success, such as ensuring that providers have broad and timely access to data so they can meet patients’ needs in cost-effective ways. PMID:23650332

Vignettes of scholars: A case study of black male students at a STEM early college high school

NASA Astrophysics Data System (ADS)

Adams, Tempestt Richardson

Ensuring students graduate high school ready to enter college or the workforce has become a prime focus within secondary education. High school graduates are often ill-prepared for college-level work and often have to register for remedial courses before they can take standard college level courses (Southern Regional Education Board, 2010). Serving as both a solution to this concern and an alternative to traditional high schools, early college high schools were created to focus on increasing the number of students graduating from high school and enrolling in college. Early college high schools seek to serve students who have traditionally underperformed in school and those who are underrepresented in higher education including students of color, first-generation college students, students from low socioeconomic backgrounds, and English language learners (Barnett, Bucceri, Hindo, Kim, 2013; "Overview & FAQS," 2013). In efforts to learn more about how early colleges are meeting the needs of students, this dissertation examines the experiences, identity construction, and perceptions of Black male students at a science, technology, engineering, and mathematics (STEM) based early college high school. Using a qualitative case study design, participants were eight Black male upperclassmen enrolled in a STEM early college high school, located on the campus of a four-year university. Data was collected through focus groups and individual interviews and data was analyzed thematically. Findings suggest students in this study have largely positive experiences at their early college high school. Despite some challenges, the early college high school environment helps facilitate scholar identities, and the STEM focus of the school helps students learn more about their strengths and weaknesses. The implications of the research, recommendations for educational stakeholders, and recommendations for future research are discussed.

30 CFR 250.524 - When am I required to take action from my casing diagnostic test?

Code of Federal Regulations, 2012 CFR

2012-07-01

... psig during a casing diagnostic test; (c) Any well that has demonstrated tubing/casing, tubing/riser, casing/casing, riser/casing, or riser/riser communication; (d) Any well that has sustained casing... operations described in § 250.521; (e) Any hybrid well with casing or riser pressure exceeding 100 psig; or...

30 CFR 250.525 - When am I required to take action from my casing diagnostic test?

Code of Federal Regulations, 2013 CFR

2013-07-01

... psig during a casing diagnostic test; (c) Any well that has demonstrated tubing/casing, tubing/riser, casing/casing, riser/casing, or riser/riser communication; (d) Any well that has sustained casing... operations described in § 250.521; (e) Any hybrid well with casing or riser pressure exceeding 100 psig; or...

30 CFR 250.525 - When am I required to take action from my casing diagnostic test?

Code of Federal Regulations, 2014 CFR

2014-07-01

... psig during a casing diagnostic test; (c) Any well that has demonstrated tubing/casing, tubing/riser, casing/casing, riser/casing, or riser/riser communication; (d) Any well that has sustained casing... operations described in § 250.521; (e) Any hybrid well with casing or riser pressure exceeding 100 psig; or...

Developing Molecular Methods to Identify and Quantify Ballast Water Organisms: A Test Case with Cnidarians

DTIC Science & Technology

2004-04-15

Developing Molecular Methods to Identify and Quantify Ballast Water Organisms: A Test Case with Cnidarians SERDP Project # CP-1251...2004 4. TITLE AND SUBTITLE Developing Molecular Methods to Identify and Quantify Ballast Water Organisms: A Test Case with Cnidarians 5a. CONTRACT... cnidarians ? 9 Indicators of ballast water exchange 9 Materials and Methods 11 Phase I. Specimens 11 DNA

Early Detection of Alzheimer's Disease Based on the Patient's Creative Drawing Process: First Results with a Novel Neuropsychological Testing Method.

PubMed

Heymann, Petra; Gienger, Regine; Hett, Andreas; Müller, Stephan; Laske, Christoph; Robens, Sibylle; Ostermann, Thomas; Elbing, Ulrich

2018-01-01

Based on the knowledge of art therapy, we developed a new neuropsychological drawing test in order to identify individuals with mild cognitive impairment (MCI) as well as dementia patients and healthy controls (HC). By observing a variety of drawing characteristics of 92 participants with a mean age of 67.7, art therapy and dementia experts discriminate HC from MCI, early dementia of the Alzheimer-type (eDAT), and moderate dementia of the Alzheimer-type (mDAT) by the process analysis of tree drawings on a digitizing tablet. The art therapist's average categorical rating of healthy and MCI or demented individuals matched the clinical diagnosis by 88%. In a first small study, we analyzed interrater reliability, sensitivity, specificity, negative and positive predicted values of our tree drawing test (TDT) in comparison with the clock drawing test (CDT). Similar values of moderate interrater reliability were found for the TDT (0.56) as well as for the CDT (0.54). A significant high sensitivity of 0.9 within this binary impairment scale (HC versus impaired or demented) can be demonstrated. Substantial values for the specificity (0.67) could be obtained that however remain under a perfect value of the CDT (1.0). Considering 31 individuals that received the clinical diagnosis "impaired or demented" the TDT shows a higher recognition rate for the MCI group than the CDT. Furthermore in 8 of 12 borderline cases of clinical diagnosis, the outcome of the TDT diagnosis was consistent with the final clinical result.

Skin testing for immediate hypersensitivity to corticosteroids: a case series and literature review.

PubMed

Baker, A; Empson, M; The, R; Fitzharris, P

2015-03-01

Immediate hypersensitivity to corticosteroids is reported to occur with an incidence of 0.1%. The largest previous case series reporting corticosteroid skin testing has seven patients. We identified 23 patients (mean age 50 years, 65% female) from Auckland City Hospital who underwent skin testing (ST) for suspected corticosteroid hypersensitivity between July 2005 and April 2012. We performed a retrospective clinical case note review detailing clinical history of reaction, skin test results and subsequent management. Most patients (21/23) had a standard panel of testing with prednisolone, triamcinolone, methylprednisolone, hydrocortisone and dexamethasone. Skin tests used a 10% steroid stock concentration for skin prick tests (SPT) and dilutions of 1 : 1000, 1 : 100 and 1 : 10 for subsequent intradermal testing. A weal 3 mm greater than the negative control was considered positive. A total of 23 patients were identified who had skin testing for suspected acute hypersensitivity to corticosteroids, eight of which had a history of anaphylaxis. From 28 reactions (in 23 patients), the most common route of administration was intra-articular (13), followed by oral (7), intravenous (3) and other (5). Skin tests were positive in 8/23 patients, and 7/8 of these patients had a history of corticosteroid-associated anaphylaxis. Skin tests were positive at either the skin prick test or intradermal stages. There was evidence suggesting clinical and skin test cross-reactivity between corticosteroids in one patient. One patient had a positive skin test, but negative oral challenge suggesting the skin test was false positive. Skin tests were negative in 15/23 patients. One patient had a negative prednisolone skin test and positive unblinded oral challenge, suggesting a false-negative skin test. Skin testing can provide sufficient evidence to diagnose allergy in patients with a clear history of immediate hypersensitivity to corticosteroids such as anaphylaxis. Both skin prick

Demographic profile of families and children in the Study to Explore Early Development (SEED): Case-control study of autism spectrum disorder

PubMed Central

DiGuiseppi, Carolyn G.; Daniels, Julie L.; Fallin, Daniele M.; Rosenberg, Steven A.; Schieve, Laura A.; Thomas, Kathleen C.; Windham, Gayle C.; Goss, Cynthia W.; Soke, Gnakub N.; Currie, Dustin W.; Singer, Alison B.; Lee, Li-Ching; Bernal, Pilar; Croen, Lisa A.; Miller, Lisa A.; Pinto-Martin, Jennifer A.; Young, Lisa M.; Schendel, Diana E.

2016-01-01

Background The Study to Explore Early Development (SEED) is designed to enhance knowledge of autism spectrum disorder characteristics and etiologies. Objective This paper describes the demographic profile of enrolled families and examines sociodemographic differences between children with autism spectrum disorder and children with other developmental problems or who are typically developing. Methods This multi-site case-control study used health, education, and birth certificate records to identify and enroll children aged 2–5 years into one of three groups: 1) cases (children with autism spectrum disorder), 2) developmental delay or disorder controls, or 3) general population controls. Study group classification was based on sampling source, prior diagnoses, and study screening tests and developmental evaluations. The child's primary caregiver provided demographic characteristics through a telephone (or occasionally face-to-face) interview. Groups were compared using ANOVA, chi-squared test, or multinomial logistic regression as appropriate. Results Of 2768 study children, sizeable proportions were born to mothers of non-White race (31.7%), Hispanic ethnicity (11.4%), and foreign birth (17.6%); 33.0% of households had incomes below the US median. The autism spectrum disorder and population control groups differed significantly on nearly all sociodemographic parameters. In contrast, the autism spectrum disorder and developmental delay or disorder groups had generally similar sociodemographic characteristics. Conclusions SEED enrolled a sociodemographically diverse sample, which will allow further, in-depth exploration of sociodemographic differences between study groups and provide novel opportunities to explore sociodemographic influences on etiologic risk factor associations with autism spectrum disorder and phenotypic subtypes. PMID:26917104

Demographic profile of families and children in the Study to Explore Early Development (SEED): Case-control study of autism spectrum disorder.

PubMed

DiGuiseppi, Carolyn G; Daniels, Julie L; Fallin, Daniele M; Rosenberg, Steven A; Schieve, Laura A; Thomas, Kathleen C; Windham, Gayle C; Goss, Cynthia W; Soke, Gnakub N; Currie, Dustin W; Singer, Alison B; Lee, Li-Ching; Bernal, Pilar; Croen, Lisa A; Miller, Lisa A; Pinto-Martin, Jennifer A; Young, Lisa M; Schendel, Diana E

2016-07-01

The Study to Explore Early Development (SEED) is designed to enhance knowledge of autism spectrum disorder characteristics and etiologies. This paper describes the demographic profile of enrolled families and examines sociodemographic differences between children with autism spectrum disorder and children with other developmental problems or who are typically developing. This multi-site case-control study used health, education, and birth certificate records to identify and enroll children aged 2-5 years into one of three groups: 1) cases (children with autism spectrum disorder), 2) developmental delay or disorder controls, or 3) general population controls. Study group classification was based on sampling source, prior diagnoses, and study screening tests and developmental evaluations. The child's primary caregiver provided demographic characteristics through a telephone (or occasionally face-to-face) interview. Groups were compared using ANOVA, chi-squared test, or multinomial logistic regression as appropriate. Of 2768 study children, sizeable proportions were born to mothers of non-White race (31.7%), Hispanic ethnicity (11.4%), and foreign birth (17.6%); 33.0% of households had incomes below the US median. The autism spectrum disorder and population control groups differed significantly on nearly all sociodemographic parameters. In contrast, the autism spectrum disorder and developmental delay or disorder groups had generally similar sociodemographic characteristics. SEED enrolled a sociodemographically diverse sample, which will allow further, in-depth exploration of sociodemographic differences between study groups and provide novel opportunities to explore sociodemographic influences on etiologic risk factor associations with autism spectrum disorder and phenotypic subtypes. Copyright © 2016 Elsevier Inc. All rights reserved.

Drug skin tests in cutaneous adverse drug reactions to pristinamycin: 29 cases with a study of cross-reactions between synergistins.

PubMed

Barbaud, A; Trechot, P; Weber-Muller, F; Ulrich, G; Commun, N; Schmutz, J L

2004-01-01

The present study was made to determine the value of drug skin tests in patients with cutaneous adverse drug reactions (CADRs) due to a synergistin (pristinamycin) and to determine the frequency of cross-reactions between synergistins. 29 patients were referred during the onset of the CADR due to pristinamycin: 18 with maculopapular rash, 9 erythrodermas, 1 angioedema and 1 Stevens-Johnson syndrome. They all had patch tests with pristinamycin and, in most cases, with other synergistins [virginiamycin and dalfopristin-quinupristin (DQ)], prick tests (10 cases) and intradermal tests (IDT) (5 cases). Skin tests with synergistins were positive in 27 cases, patch tests with pristinamycin in 20/29 cases (69%), prick tests with pristinamycin in 3/9 cases on immediate (1 case) or on delayed (2 cases) readings, and IDT with DQ in 4/5 cases. Cross-reactions between synergistins occurred in 9/22 with virginiamycin and in 7/8 cases with DQ. Skin tests with synergistins are useful in investigating CADR due to pristinamycin. Synergistins are composed of 2 chains (1 depsipeptide and 1 macrocyclic lactone) with many structural analogies between all synergistins. According to the chemical structures and our results, it seems advisable to avoid all synergistins in patients with CADR due to pristinamycin.

Paternity testing in case of brother-sister incest.

PubMed

Macan, Marijana; Uvodić, Petra; Botica, Vladimir

2003-06-01

We performed a paternity test in a case of incest between brother and sister. DNA from blood samples of the alleged parents and their two children was obtained with Chelex DNA extraction method and quantified with Applied Biosystems QuantiBlot quantitation kit. Polymerase chain reaction (PCR) amplification of DNA samples was performed with AmpFlSTR SGM Plus PCR amplification kit and GenePrint PowerPlex PCR amplification kit. The amplified products were separated and detected by using the Perkin Elmer's ABI PRISM trade mark 310 Genetic Analyser. DNA and data analysis of 17 loci and Amelogenin confirmed the suspicion of brother-sister incest. Since both children had inherited all of the obligate alleles from the alleged father, we could confirm with certainty of 99.999999% that the oldest brother in the family was the biological father of both children. Calculated data showed that even in a case of brother-sister incest, paternity could be proved by the analysis of Amelogenin and 17 DNA loci.

Gifted and Talented Education: A National Test Case in Peoria.

ERIC Educational Resources Information Center

Fetterman, David M.

1986-01-01

This article presents a study of a program in Peoria, Illinois, for the gifted and talented that serves as a national test case for gifted education and minority enrollment. It was concluded that referral, identification, and selection were appropriate for the program model but that inequalities resulted from socioeconomic variables. (Author/LMO)

Testing, Requirements, and Metrics

NASA Technical Reports Server (NTRS)

Rosenberg, Linda; Hyatt, Larry; Hammer, Theodore F.; Huffman, Lenore; Wilson, William

1998-01-01

The criticality of correct, complete, testable requirements is a fundamental tenet of software engineering. Also critical is complete requirements based testing of the final product. Modern tools for managing requirements allow new metrics to be used in support of both of these critical processes. Using these tools, potential problems with the quality of the requirements and the test plan can be identified early in the life cycle. Some of these quality factors include: ambiguous or incomplete requirements, poorly designed requirements databases, excessive or insufficient test cases, and incomplete linkage of tests to requirements. This paper discusses how metrics can be used to evaluate the quality of the requirements and test to avoid problems later. Requirements management and requirements based testing have always been critical in the implementation of high quality software systems. Recently, automated tools have become available to support requirements management. At NASA's Goddard Space Flight Center (GSFC), automated requirements management tools are being used on several large projects. The use of these tools opens the door to innovative uses of metrics in characterizing test plan quality and assessing overall testing risks. In support of these projects, the Software Assurance Technology Center (SATC) is working to develop and apply a metrics program that utilizes the information now available through the application of requirements management tools. Metrics based on this information provides real-time insight into the testing of requirements and these metrics assist the Project Quality Office in its testing oversight role. This paper discusses three facets of the SATC's efforts to evaluate the quality of the requirements and test plan early in the life cycle, thus preventing costly errors and time delays later.

Case management after long-term absence from work in China: a case report.

PubMed

Tang, Dan; Yu, Ignatius Tak Sun; Luo, Xiaoyuan; Liang, Youxin; He, Yonghua

2011-03-01

Return-to-work (RTW) after occupational injuries is an important and challenging issue. Case managers are expected to play a vital role in successful RTW. In China, RTW intervention is in its early phase and requires further research and practice. This case report describes Mr. H's RTW process for illustrating the work of a case management team in China. Suggestions on developing and optimizing the process in China are given. After 9 years of absence from work due to severe burn injuries at work, Mr. H was referred for RTW interventions. Mr. H received social and occupational rehabilitation services of 3 months, and the following workplace visits and work trials. After the job placement, the case manager continued the liaison with the worker and employer. Mr. H showed positive changes in occupational and social adjustment after the case management interventions. This was reflected from the shift from the contemplation to action stage on the Lam Assessment of Stages of Employment Readiness. Despite he did not show significant changes on functional capacity and fear avoidance beliefs, Mr. H passed the job credential test and was offered a maintenance technician position at a new company. Both the worker and the employer were satisfied with the outcome of the case management. The RTW interventions carried out by the case managers appeared to be effective within the Chinese system. The results suggested that professional training of case managers, RTW-related policies and technological standards, early integrated interventions should be further developed in China. Disability Adjustment Group Therapy and RTW Support Groups perhaps are useful approaches in workers' returning to work.

The early and long-term outcomes of completion pneumonectomy: report of 56 cases.

PubMed

Pan, Xufeng; Fu, Shijie; Shi, Jianxin; Yang, Jun; Zhao, Heng

2014-09-01

The aim of this study was to analyse the early and long-term results of completion pneumonectomy (CP). A retrospective review of consecutive patients who underwent CP in the Shanghai Chest Hospital. Fifty-six CP were performed between January 2003 and July 2013. There were 45 conventional CP (CCP) and 11 rescue CP (RCP) cases. CCP was defined as resection of the remaining lung because of the occurrence of new lesions in patients with previous lung resection. RCP was defined as resection of the remaining lung because of severe complication after primary lung surgery. The mortality and morbidity rates of CCP were 4.4 and 33.3%, respectively. For CCP, the morbidity was significantly higher in benign cases than in malignant cases (80.0 vs 27.5%, P = 0.04). The mortality and morbidity rates of RCP were 27.3 and 90.9%, respectively. For RCP, advanced age (P = 0.046) and preoperative mechanical ventilation (P = 0.03) were related to higher postoperative mortality. The overall 5-year survival rate was 80% for benign cases, whereas for lung malignancy cases, it was 30%. Survival varied (median 60.0 vs 35.0 vs 10.0 months, I vs II vs III, P < 0.01) for different TNM stages and was better for a time interval (between primary surgery and occurrence of lesion) of >2 years (median 60.0 vs 18.0 months, P < 0.01). CP was an operation with high risk, especially for RCP. Advanced age and mechanical ventilation before the operation were related to higher mortality in RCP. CCP of benign cases was related to higher postoperative risk, but with good survival. For lung malignancy, survival was better for a time interval (between primary surgery and occurrence of lesion) of >2 years. © The Author 2014. Published by Oxford University Press on behalf of the European Association for Cardio-Thoracic Surgery. All rights reserved.

Economic evaluation of medical tests at the early phases of development: a systematic review of empirical studies.

PubMed

Frempong, Samuel N; Sutton, Andrew J; Davenport, Clare; Barton, Pelham