Science.gov

Sample records for geomagnetic cut-off rigidity

  1. Diurnal variations of cosmic ray geomagnetic cut-off threshold rigidities

    NASA Technical Reports Server (NTRS)

    Dvornikov, V. M.; Sdobnov, V. E.; Sergeev, A. V.; Danilova, O. A.; Tyasto, M. I.

    1985-01-01

    The spectrographic global survey method was used to investigate the rigidity variations Rc of geomagnetic cut-off as a function of local time and the level of geomagnetic disturbance for a number of stations of the world wide network. It is shown that geomagnetic cut-off threshold rigidities undergo diurnal variations. The diurnal wave amplitude decreases with increasing threshold rigidity Rc, and the wave maximum occurs at 2 to 4 hr LT. The amplitude of diurnal variations increases with increasing geomagnetic activity. The results agree with those from trajectory calculations made for an asymmetric model of the magnetosphere during different geomagnetic disturbance conditions.

  2. Atmospheric secondary charged cosmic radiation at a place of 11.5 GV geomagnetic cut-off

    NASA Astrophysics Data System (ADS)

    Azcarate, I. N.

    2002-04-01

    An experiment performed with a balloon-borne plastic scintillator is described. The detector system was transported by a stratospheric balloon, that was launched from Reconquista, province of Santa Fe, Argentina, on 24 February 1992. The geomagnetic cut-off of the site was 11.5 GV. The energy-loss spectra of both the atmospheric gamma radiation ( for E^γ>= 4.15 MeV) and the charged component of the secondary cosmic radiation were alternatively measured at different altitudes, during the ascent of the balloon, and at ceiling altitude. The author analyzed the atmospheric gamma-ray spectrum in a previous paper ( Azcárate, 2000). It was necessary to perform the computation of the response of the detector to the charged radiation in order to explain , at least qualitatively, the energy-loss spectrum in the detector produced by this type of radiation. It is argued that at ceiling altitude the observed feature in the spectrum is produced mainly by relativistic muons falling horizontally upon the detector. The growth curve for the counting rate below this feature and the intensity of relativistic μ-mesons were also obtained. References : Azcárate, I.N., Revista Mexicana de Astronomía y Astrofísica, 36, 81, 2000.

  3. Measurement of geomagnetic cutoff rigidities and particle fluxes below geomagnetic cutoff near Palestine, Texas.

    NASA Technical Reports Server (NTRS)

    Pennypacker, C. R.; Smoot, G. F.; Buffington, A.; Muller, R. A.; Smith, L. H.

    1973-01-01

    We report a high-statistics magnetic spectrometer measurement of the geomagnetic cutoff rigidity and related effects at Palestine, Texas. The effective cutoffs we observe are in agreement with computer-calculated cutoffs. We also report measured spectra of albedo and atmospheric secondary particles that come below geomagnetic cutoff.

  4. Fifty years of progress in geomagnetic cutoff rigidity determinations

    NASA Astrophysics Data System (ADS)

    Smart, D. F.; Shea, M. A.

    2009-11-01

    This paper is a review of the progress made in geomagnetic cutoff rigidity calculations over the past 50 years. Determinations of cosmic ray trajectories, and hence cutoff rigidities, using digital computers began in 1956 and progressed slowly until 1962 when McCracken developed an efficient computer program to determine cosmic ray trajectories in a high degree simulation of the geomagnetic field. The application of this cosmic ray trajectory technique was limited by the available computer power. As computers became faster it was possible to determine vertical cutoff rigidity values for cosmic ray stations and coarse world grids; however, the computational effort required was formidable for the computers of the 1960s. Since most cosmic ray experiments were conducted on the surface of the Earth, the vertical cutoff rigidity was adopted as a standard reference value. The effective cutoff value derived from trajectory calculations appeared to be adequate for ordering cosmic ray data from latitude surveys. As the geomagnetic field evolution became more apparent, it was found necessary to update the world grid of cutoff rigidity values using more accurate descriptions of the geomagnetic field. In the 1970s and 1980s it became possible to do experimental verification of the accuracy of these cosmic ray cutoff determinations and also to design experiments based on these cutoff rigidity calculations. The extensive trajectory calculations done in conjunction with the HEAO-3 satellite and a comparison between these experimental measurements and the trajectory calculations verified the Störmer theory prediction regarding angular cutoff variations and also confirmed that the structure of the first order penumbra is very stable and could be used for isotope separation. Contemporary work in improving cutoff rigidities seems to be concentrating on utilizing improved magnetospheric models in an effort to determine more accurate geomagnetic cutoff values. When using geomagnetic

  5. The geomagnetic cutoff rigidities at high latitudes for different solar wind and geomagnetic conditions

    NASA Astrophysics Data System (ADS)

    Chu, W.; Qin, G.

    2016-01-01

    Studying the access of the cosmic rays (CRs) into the magnetosphere is important to understand the coupling between the magnetosphere and the solar wind. In this paper we numerically studied CRs' magnetospheric access with vertical geomagnetic cutoff rigidities using the method proposed by Smart and Shea (1999). By the study of CRs' vertical geomagnetic cutoff rigidities at high latitudes we obtain the CRs' window (CRW) whose boundary is determined when the vertical geomagnetic cutoff rigidities drop to a value lower than a threshold value. Furthermore, we studied the area of CRWs and found out they are sensitive to different parameters, such as the z component of interplanetary magnetic field (IMF), the solar wind dynamic pressure, AE index, and Dst index. It was found that both the AE index and Dst index have a strong correlation with the area of CRWs during strong geomagnetic storms. However, during the medium storms, only AE index has a strong correlation with the area of CRWs, while Dst index has a much weaker correlation with the area of CRWs. This result on the CRW can be used for forecasting the variation of the cosmic rays during the geomagnetic storms.

  6. Geomagnetic Cutoff Rigidity Computer Program: Theory, Software Description and Example

    NASA Technical Reports Server (NTRS)

    Smart, D. F.; Shea, M. A.

    2001-01-01

    The access of charged particles to the earth from space through the geomagnetic field has been of interest since the discovery of the cosmic radiation. The early cosmic ray measurements found that cosmic ray intensity was ordered by the magnetic latitude and the concept of cutoff rigidity was developed. The pioneering work of Stoermer resulted in the theory of particle motion in the geomagnetic field, but the fundamental mathematical equations developed have 'no solution in closed form'. This difficulty has forced researchers to use the 'brute force' technique of numerical integration of individual trajectories to ascertain the behavior of trajectory families or groups. This requires that many of the trajectories must be traced in order to determine what energy (or rigidity) a charged particle must have to penetrate the magnetic field and arrive at a specified position. It turned out the cutoff rigidity was not a simple quantity but had many unanticipated complexities that required many hundreds if not thousands of individual trajectory calculations to solve. The accurate calculation of particle trajectories in the earth's magnetic field is a fundamental problem that limited the efficient utilization of cosmic ray measurements during the early years of cosmic ray research. As the power of computers has improved over the decades, the numerical integration procedure has grown more tractable, and magnetic field models of increasing accuracy and complexity have been utilized. This report is documentation of a general FORTRAN computer program to trace the trajectory of a charged particle of a specified rigidity from a specified position and direction through a model of the geomagnetic field.

  7. Supplemental Summary of Cutoff Rigidities Calculated Using the International Geomagnetic Reference Field for Various Epochs.

    DTIC Science & Technology

    1982-11-01

    Rigidities Calculated Using the International -Geomagnetic Reference Field for Various Epochs M.A. SHEA D.F. SMART 1 NOVEMBER 1982 Approved for publie...SUMMARY OF CUTOFF Scientific. Interim. RIGIDITIES CALCULATED USING THE INTER -_ _________ NATIONAL GEOMAGNETIC REFERENCE FIELD 6 PERFORMING 01G. REPORT...n-b.’I Cosmic rays Cutoff rigidities Geomagnetic field 20 ABSTRACT (ContinuC0 e o, sid. it ---. 0, -,d id- 5,.- 550,5- Tables of cosmic-ray cutoff

  8. The Development of a Dynamic Geomagnetic Cutoff Rigidity Model for the International Space Station

    NASA Technical Reports Server (NTRS)

    Smart, D. F.; Shea, M. A.

    1999-01-01

    We have developed a computer model of geomagnetic vertical cutoffs applicable to the orbit of the International Space Station. This model accounts for the change in geomagnetic cutoff rigidity as a function of geomagnetic activity level. This model was delivered to NASA Johnson Space Center in July 1999 and tested on the Space Radiation Analysis Group DEC-Alpha computer system to ensure that it will properly interface with other software currently used at NASA JSC. The software was designed for ease of being upgraded as other improved models of geomagnetic cutoff as a function of magnetic activity are developed.

  9. Local time and cutoff rigidity dependences of storm time increase associated with geomagnetic storms

    SciTech Connect

    Kudo, S.; Wada, M. ); Tanskanen, P. ); Kodama, M. )

    1987-05-01

    The cosmic ray increases due to considerable depressions of cosmic ray cutoff rigidity during large geomagnetic storms are investigated. Data from a worldwide network of cosmic ray neutron monitors are analyzed for 17 geomagnetic storms which occurred in the quiet phase of the solar activity cycle during 1966-1978. As expected from the longitudinal asymmetry of the low-altitude geomagnetic field during large geomagnetic storms, a significant local time dependence of the increment in the cosmic ray during large geomagnetic storms, a significant local time dependence of the increment in the cosmic ray intensity is obtained. It is shown that the maximum phases of the local time dependence occur at around 1800 LT and that the amplitudes of the local time dependence are consistent with presently available theoretical estimates. The dependence of the increment on the cutoff rigidity is obtained for both the local time dependent part and the local time independent part of the storm time increase. The local time independent part, excluding the randomizing local time dependent part, shows a clear-cut dependence on cutoff rigidity which is consistent with theoretical estimates.

  10. Millimeter-Wave Cut-Off Switch.

    DTIC Science & Technology

    A millimeter-wave cut -off switch in a dielectric waveguide having a semi-insulating core and a semi-conducting epitaxial layer. A controller affixed...When the waveguide is properly dimensioned such that the operating frequency lies in the high-loss section near the cut -off frequency on the loss vs

  11. The isotopic composition of helium at high rigidities

    NASA Technical Reports Server (NTRS)

    Jordan, S. P.; Meyer, P.

    1983-01-01

    The isotopic abundance distribution of the cosmic radiation at energies beyond 1 GeV/AMU can at the present time be determined only with the geomagnetic method. A balloon-borne instrument was flown for 12 hours near the geomagnetic equator to measure the relative abundance of the helium isotopes He-3 and He-4 around 12 GV rigidity. The sharp rigidity cut-off at equatorial latitudes permitted separation of the two isotopes using a high-resolution-gas Cerenkov counter. The experiment thus confirms the predicted sharp cut-off at those latitudes and demonstrates the potential for isotopic separation of other elements, once flights of longer duration can be made.

  12. Magnetospheric effects of cosmic rays. 1. Long-term changes in the geomagnetic cutoff rigidities for the stations of the global network of neutron monitors

    NASA Astrophysics Data System (ADS)

    Gvozdevskii, B. B.; Abunin, A. A.; Kobelev, P. G.; Gushchina, R. T.; Belov, A. V.; Eroshenko, E. A.; Yanke, V. G.

    2016-07-01

    Vertical geomagnetic cutoff rigidities are obtained for the stations of the global network of neutron monitors via trajectory calculations for each year of the period from 1950 to 2020. Geomagnetic cutoff rigidities are found from the model of the Earth's main field International Geomagnetic Reference Field (IGRF) for 1950-2015, and the forecast until 2020 is provided. In addition, the geomagnetic cutoff rigidities for the same period are obtained by Tsyganenko model T89 (Tsyganenko, 1989) with the average annual values of the Kp-index. In each case, the penumbra is taken into account in the approximation of the flat and power spectra of variations of cosmic rays. The calculation results show an overall decrease in geomagnetic cutoff rigidities, which is associated with the overall decrease and restructuring of the geomagnetic field during the reporting period, at almost all points.

  13. 49 CFR 229.93 - Safety cut-off device.

    Code of Federal Regulations, 2014 CFR

    2014-10-01

    ... 49 Transportation 4 2014-10-01 2014-10-01 false Safety cut-off device. 229.93 Section 229.93 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION... Equipment § 229.93 Safety cut-off device. The fuel line shall have a safety cut-off device that— (a) Is...

  14. 49 CFR 229.93 - Safety cut-off device.

    Code of Federal Regulations, 2010 CFR

    2010-10-01

    ... 49 Transportation 4 2010-10-01 2010-10-01 false Safety cut-off device. 229.93 Section 229.93 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION... Equipment § 229.93 Safety cut-off device. The fuel line shall have a safety cut-off device that— (a) Is...

  15. 49 CFR 229.93 - Safety cut-off device.

    Code of Federal Regulations, 2012 CFR

    2012-10-01

    ... 49 Transportation 4 2012-10-01 2012-10-01 false Safety cut-off device. 229.93 Section 229.93 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION... Equipment § 229.93 Safety cut-off device. The fuel line shall have a safety cut-off device that— (a) Is...

  16. 49 CFR 229.93 - Safety cut-off device.

    Code of Federal Regulations, 2011 CFR

    2011-10-01

    ... 49 Transportation 4 2011-10-01 2011-10-01 false Safety cut-off device. 229.93 Section 229.93 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION... Equipment § 229.93 Safety cut-off device. The fuel line shall have a safety cut-off device that— (a) Is...

  17. 49 CFR 229.93 - Safety cut-off device.

    Code of Federal Regulations, 2013 CFR

    2013-10-01

    ... 49 Transportation 4 2013-10-01 2013-10-01 false Safety cut-off device. 229.93 Section 229.93 Transportation Other Regulations Relating to Transportation (Continued) FEDERAL RAILROAD ADMINISTRATION... Equipment § 229.93 Safety cut-off device. The fuel line shall have a safety cut-off device that— (a) Is...

  18. Geomagnetic cutoff rigidities of cosmic rays in a model of the bounded magnetosphere with the ring current

    NASA Astrophysics Data System (ADS)

    Kichigin, G. N.; Sdobnov, V. E.

    2017-03-01

    The cosmic ray geomagnetic cutoff rigidities are obtained by analytical calculations within an axisymmetric model of bounded magnetosphere, the magnetic field of which is created by the dipole field of the Earth and by two spheres located beyond the Earth with the currents that flow along the parallels and have a value proportional to the cosine of latitude. The inner sphere models the ring current flowing in the westerly direction; the outer sphere simulates the currents over the magnetopause, which flow in the easterly direction. The analytical results of calculations of variations in the geomagnetic cutoff rigidity for different levels of geomagnetic disturbances are given. The results are compared with the results of analytical calculations within the model of unbounded magnetosphere (when the outer sphere is absent).

  19. The use of the McIlwain L-parameter to estimate cosmic ray vertical cutoff rigidities for different epochs of the geomagnetic field

    NASA Technical Reports Server (NTRS)

    Shea, M. A.; Smart, D. F.; Gentile, L. C.

    1985-01-01

    Secular changes in the geomagnetic field between 1955 and 1980 have been large enough to produce significant differences in both the verical cutoff rigidities and in the L-value for a specified position. A useful relationship employing the McIlwain L-parameter to estimate vertical cutoff rigidities has been derived for the twenty-five year period.

  20. High cut-off dialysis in chronic haemodialysis patients.

    PubMed

    Girndt, Matthias; Fiedler, Roman; Martus, Peter; Pawlak, Michael; Storr, Markus; Bohler, Torsten; Glomb, Marcus A; Liehr, Kristin; Henning, Christian; Templin, Markus; Trojanowicz, Bogusz; Ulrich, Christof; Werner, Kristin; Zickler, Daniel; Schindler, Ralf

    2015-12-01

    Haemodialysis patients suffer from chronic systemic inflammation and high incidence of cardiovascular disease. One cause for this may be the failure of diseased kidneys to eliminate immune mediators. Current haemodialysis treatment achieves insufficient elimination of proteins in the molecular weight range 15-45 kD. Thus, high cut-off dialysis might improve the inflammatory state. In this randomized crossover trial, 43 haemodialysis patients were treated for 3 weeks with high cut-off or high-flux dialysis. Inflammatory plasma mediators, monocyte subpopulation distribution and leucocyte gene expression were quantified. High cut-off dialysis supplemented by a low-flux filter did not influence the primary end-point, expression density of CD162 on monocytes. Nevertheless, treatment reduced multiple immune mediators in plasma. Such reduction proved - at least for some markers - to be a sustained effect over the interdialytic interval. Thus, for example, soluble TNF-receptor 1 concentration predialysis was reduced from median 13·3 (IQR 8·9-17·2) to 9·7 (IQR 7·5-13·2) ng/mL with high cut-off while remaining constant with high-flux treatment. The expression profile of multiple proinflammatory genes in leucocytes was significantly dampened. Treatment was well tolerated although albumin losses in high cut-off dialysis would be prohibitive against long-term use. The study shows for the first time that a dampening effect of high cut-off dialysis on systemic inflammation is achievable. Earlier studies had failed due to short study duration or insufficient dialysis efficacy. Removal of soluble mediators from the circulation influences cellular activation levels in leucocytes. Continued development of less albumin leaky membranes with similar cytokine elimination is justified. © 2015 Stichting European Society for Clinical Investigation Journal Foundation.

  1. TSH cut off point based on depression in hypothyroid patients.

    PubMed

    Talaei, A; Rafee, N; Rafei, F; Chehrei, A

    2017-09-07

    The prevalence of depressive symptoms in hypothyroidism is high. Considering that hypothyroidism and depression share some clinical features, some researchers use the "brain hypothyroidism" hypothesis to explain the pathogenesis of depression. We aimed to detect a new TSH cut-off value in hypothyroidism based on depression symptoms. A cross-sectional study was conducted on hypothyroid patients referred to endocrine clinics. Individuals who had developed euthyroid state under treatment with levothyroxine with TSH levels of 0.5-5 MIU/L with no need for dosage change were included in the study. After comprehensive history taking, laboratory tests including TSH, T4 and T3 were performed. Beck depression questionnaire was completed for all patients by trained interviewers. TSH cut-off values based on depression was determined by Roc Curve analysis. The participants were 174 hypothyroid patients (Female; 116: 66.7%, Male; 58: 33.3%) with mean age 45.5 ± 11.7 (19-68) years old. Based on Beck depression test, scores less than 10 was considered healthy and more than 10 were considered depressed. According to Roc curve analysis, the optimal cut- off value of TSH was 2.5 MIU/L with 89.66% sensitivity. The optimal TSH cut- off based on severe depression was 4 MIU/L. The present study suggests that a clinically helpful TSH cut-off value for hypothyroidism should be based on associated symptoms, not just in population studies. Based on the assessment of depression, our study concludes that a TSH cutofff value of 2.5 MIU/L is optimal.

  2. Cosmic rays cut-off in approach of dipole and homogeneous field for Jupiter system

    NASA Astrophysics Data System (ADS)

    Lavrukhin, A. S.; Tyutin, I. V.; Alexeev, I. I.; Parunakian, D. A.

    2012-09-01

    The strong Jovian magnetic field results in cosmic rays cut-off by the dipole magnetic field up to GV rigidity. The magnetospheric magnetic field in the inner magnetosphere inside of the Ganymed orbit strongly distorbed by the equatorial magnetodisk field. In the area close to the equatorial plane the magnetodisk field is directed opposite to the dipolemagnetic field, however in the outer magnetosphere the magnetodisk field reverses its direction. This results in enhancement of the effective dipole magnetic moment compared to planetary Jupiter dipole moment up to 3 times (see [1]). We studied the rigidity cut-off in Jupiter system at Io, Europe and Ganymede orbits. In our work we have used a generalization of the Stormer analysis for a dipole field by introducing additionally a homogenous magnetic field directed northward (opposite to planetary magnetic field). Such an analysis gives us the possibility to estimate the contribution of solar event particles to the total radiation dose a spacecraft in the Jovian system is exposed to. Also we can estimate the escape rate of energetic particles from trapped radiation zone to interplanetary space. In this process Jupiter serves as a source of energetic particles in Solar system.

  3. Rigidity Dependence of Cosmic Ray Modulation

    NASA Astrophysics Data System (ADS)

    Agarwal Mishra, Rekha; Mishra, Rajesh Kumar

    2012-07-01

    The various observed harmonics of the cosmic ray variation may be understood on a unified basis if the free space cosmic ray anisotropy is non-sinusoidal in form. The major objective of this paper is to study the first three harmonics of cosmic ray intensity on geo-magnetically quiet days over the period 1965-1990 for Deep River, Goose Bay and Tokyo neutron monitoring stations. The amplitude of first harmonic remains high for Deep River having low cutoff rigidity as compared to Tokyo neutron monitor having high cutoff rigidity on quiet days. The diurnal amplitude significantly decreases in 1987 at Deep River and in 1986 at Tokyo during solar activity minimum years. The diurnal time of maximum significantly shifts to an earlier time as compared to the corotational direction at both the stations having different cutoff rigidities. The time of maximum for first harmonic significantly shifts towards later hours and for second harmonic it shifts towards earlier hours at low cutoff rigidity station i.e. Deep River as compared to the high cut off rigidity station i.e. Tokyo on quiet days. The amplitude of second/third harmonics shows a good positive correlation with solar wind velocity, while the others (i.e. amplitude and phase) have no significant correlation on quiet days. The solar wind velocity significantly remains in the range 350 to 425 km/s i.e. being nearly average on quiet days. The amplitude and direction of the anisotropy on quiet days are weakly dependent on high-speed solar wind streams for these neutron monitoring stations of low and high cutoff rigidity threshold. Keywords: cosmic ray, cut off rigidity, quiet days, harmonics.

  4. Defining Obesity Cut-Off Points for Migrant South Asians

    PubMed Central

    Gray, Laura J.; Yates, Thomas; Davies, Melanie J.; Brady, Emer; Webb, David R.; Sattar, Naveed; Khunti, Kamlesh

    2011-01-01

    Background Body mass index (BMI) and waist circumference (WC) are used to define cardiovascular and type 2 diabetes risk. We aimed to derive appropriate BMI and WC obesity cut-off points in a migrant South Asian population. Methods 4688 White Europeans and 1333 South Asians resident in the UK aged 40–75 years inclusive were screened for type 2 diabetes. Principal components analysis was used to derive a glycaemia, lipid, and a blood pressure factor. Regression models for each factor, adjusted for age and stratified by sex, were used to identify BMI and WC cut-off points in South Asians that correspond to those defined for White Europeans. Findings For South Asian males, derived BMI obesity cut-off points equivalent to 30.0 kg/m2 in White Europeans were 22.6 kg/m2 (95% Confidence Interval (95% CI) 20.7 kg/m2 to 24.5 kg/m2) for the glycaemia factor, 26.0 kg/m2 (95% CI 24.7 kg/m2 to 27.3 kg/m2) for the lipid factor, and 28.4 kg/m2 (95% CI 26.5 kg/m2 to 30.4 kg/m2) for the blood pressure factor. For WC, derived cut-off points for South Asian males equivalent to 102 cm in White Europeans were 83.8 cm (95% CI 79.3 cm to 88.2 cm) for the glycaemia factor, 91.4 cm (95% CI 86.9 cm to 95.8 cm) for the lipid factor, and 99.3 cm (95% CI 93.3 cm to 105.2 cm) for the blood pressure factor. Lower ethnicity cut-off points were seen for females for both BMI and WC. Conclusions Substantially lower obesity cut-off points are needed in South Asians to detect an equivalent level of dysglycemia and dyslipidemia as observed in White Europeans. South Asian ethnicity could be considered as a similar level of risk as obesity (in White Europeans) for the development of type 2 diabetes. PMID:22039493

  5. Environmental sampling: Issues for the cut-off regime

    SciTech Connect

    Fearey, B.L.

    1995-09-01

    The fissile material cut-off treaty (FMCT) initiative under the Conference on Disarmament mandate is envisioned to include certain aspects of environmental sampling and monitoring. One of the intents of this treaty is to bring certain non-NPT signatories (e.g., threshold states) under this treaty agreement along with the nuclear weapon states (NWSs). This paper provides a brief overview of some of the relevant issues that may be involved in the implementation and use of environmental monitoring for (1) verification of the cut-off regime declarations, (2) the detection of undeclared activities, and, (3) application in non-routine inspections. The intent is to provide backstopping information important for treaty negotiators. Specific issues addressed within this paper include signature sampling, differences in the proposed detection regime, potential signature integrators, specific examples and spoofing concerns. Many of these issues must be carefully considered and weighed in order to create a credibly verifiable inspection regime. Importantly, the cut-off treaty must enable nondiscriminatory implementation, while carefully assuring that nonproliferation treaty requirements are maintained (i.e., preventing unintentional release of critical weapons design information--potentially through environmental sampling and analysis).

  6. 76 FR 33161 - Installation and Use of Engine Cut-off Switches on Recreational Vessels

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-08

    ... SECURITY Coast Guard 33 CFR Parts 175 and 183 RIN 1625-AB34 Installation and Use of Engine Cut-off Switches... on whether it should require engine cut-off switches as a standard safety feature on propulsion... whether it should require operators of these recreational vessels to use engine cut-off switches....

  7. Energetics of southeastern Pacific cut-off lows

    NASA Astrophysics Data System (ADS)

    Gan, Manoel Alonso; Piva, Everson Dal

    2016-06-01

    The existence of cut-off lows (COLs) over South Pacific and South America is often associated with adverse weather events such as intense precipitation over the central region of South America, frost episodes in southern Brazil and the development of Andes lee cyclones and intense cyclones over the southern coast of Brazil. Despite this importance, the formation and maintenance mechanisms of the COLs are not well understood. To detail the significant variability in terms of the eddy kinetic energy equation for fifty cases of COLs that formed over the southeastern Pacific Ocean is the aim of this study. Only the cases of COLs that formed over the ocean and remained there during most of their life were chosen. The main terms of the equation [ageostrophic flux convergence (AFC), baroclinic conversion (BRC) and barotropic conversion (BRT)] were calculated using the 6-hourly gridded data from the National Centers for Environmental Prediction/Department of Energy reanalysis. The formation mechanism of the COLs was associated with BRC and AFC. During the midlife period, the BRC term converted eddy kinetic energy to eddy potential energy and the AFC had a positive contribution until 6 h after the midlife point. In the dissipation phase, the BRC term remained positive and AFC became negative. The BRT extracted kinetic energy from the COL during the entire life cycle. The AFC term was the most important in all phases of the cut-off lifetime, and it was the responsible for extending the cut-off lifetime while the others terms were negatives.

  8. A parametric study of cut-off corrugated surface properties

    NASA Technical Reports Server (NTRS)

    Mentzer, C. A.; Peters, L., Jr.

    1973-01-01

    Corrugated horns involve a junction between the corrugated surface and a conducting groundplane. Proper horn design requires an understanding of the electromagnetic properties of the corrugated surface and this junction. Therefore, an integral equation solution has been used to study the influence of corrugation density and shape on the power loss. Surface current, and the scattering from a groundplane-corrugated surface junction. Both square and vee shape corrugations have been considered over the range of corrugation depths where the surface acts as a cut-off corrugated surface.

  9. Stimulated Calcitonin Cut-Offs by Different Tests

    PubMed Central

    Fugazzola, Laura

    2013-01-01

    Medullary thyroid cancer can be highly aggressive, especially if the diagnosis is done in advanced stages. Early diagnosis is based on RET genetic testing, for familial forms, and on the routine measurement of calcitonin (Ct). Nevertheless, since false-positive results can be obtained with the basal measurement of Ct, a provocative test to evaluate stimulated Ct is often needed. Pentagastrin which has been widely used to stimulate basal Ct, especially in European countries, is now hardly available. Thus, the stimulation with calcium (Ca), used in the 1970s-1980s and then abandoned for around 30 years, has recently elicited more interest. In the past 3 years, studies in patients and normal controls have demonstrated that the stimulation with Ca (2.3-2.5 mg/kg of elemental Ca, corresponding to 25 mg/kg of Ca gluconate) is highly potent and accurate. Novel gender-related cut-offs have been proposed for the Ca test, though the analysis of additional large series is predicted to modify these preliminary data. Finally, Ca seems to be the test of choice to stimulate Ct for the diagnosis and follow-up of medullary thyroid cancer, also because it is widely available, has a low cost and it is associated with a low number and intensity of side effects. In the present review the different methods to stimulate Ct and the cut-offs for the identification of the hyperplastic/neoplastic transformation of the C cells will be reported and discussed. PMID:24783038

  10. Permeability porosity relationships (K, Phi cut-off)

    SciTech Connect

    Djettou, F.; Reda, H.

    1995-08-01

    Several reservoirs of Lower Devonian in Ghadames basin present porosities greater than 10 Pu, but during the test they are rather impermeable. It seems that this phenomena extends to BERKINE and Rhourd Messaoud areas. This seriously affect the estimation of recovery reserves. The best we can do is to study and try to understand reservoir problems. The method we choose is based on statistical analysis of test results and their comparison with core and log measurements. It concerns mainly cummulative curves of productive and non-productive tests (dry test). This involves about 20 wells where are can define: Siegenian with: Fine grained in BBK and ROM Coarse grained toward BRN - Emsian is rather homogeneous in the region. The sand cut-off porosity is greater than 11 Pu. However the reservoir can`t produce itself then we can not take account in reserve estimation. In conclusion, a sandy reservoir of Lower Devonian in Ghadames basin may be very porous (11-12%) and impermeable while in the other cases reservoirs can produce with porosity of 7 or 8 Po. However a HC definition based on cut-off porosity in Ghadames basin should be done before net pay an recovery reserves estimation.

  11. Polypharmacy Cut-Off for Gait and Cognitive Impairments

    PubMed Central

    Pothier, Kristell; Morello, Remy; Lelong-Boulouard, Véronique; Lescure, Pascale; Bocca, Marie-Laure; Marcelli, Christian; Descatoire, Pablo; Chavoix, Chantal

    2016-01-01

    Background: Polypharmacy is a well-established risk factor for falls, and these are one of the major health problems that affect the quality of life as people age. However, the risk of mobility and cognitive impairments consecutive to polypharmacy has been little addressed, despite the association between these adverse outcomes and falls. Moreover, the rare polypharmacy cut-offs were all but one arbitrarily determined. Objective: Studying relationships between polypharmacy and both mobility and cognitive impairments, and statistically determining a cut-off point in the number of medicinal molecule beyond which polypharmacy has deleterious consequences with respect to mobility and cognitive impairment. Methods: We enrolled 113 community-dwelling adults aged 55 years and older with a fall history, with or without injury, in the previous year. We carefully collected information about daily medicinal molecules taken. We assessed basic mobility and global cognition with the Time-Up-and-Go and the Montreal Cognitive Assessment (MoCA) test, respectively (clinicaltrials.gov NCT02292316). Results: Timed-Up and Go test and MoCA scores were both significantly correlated with the number of molecule, used. Receiver Operating Characteristic curves indicate, with high prediction (p < 0.002), that daily consumption of five or more molecules is associated with risk for both impaired mobility and global cognition. These relationships were independent of the number of comorbidities and of the pharmacological class. Conclusion: Community-dwelling adults aged 55 years and older who take five or more daily medicinal molecules are at high risk for both mobility and cognitive impairments. Physicians and patients should be aware of these new findings, especially when there are multiple prescribers involved in the care of the patient. PMID:27630572

  12. A Proton Magnetometer Survey of Borrow Areas Along Cut-Off Lake: L-246,

    DTIC Science & Technology

    1980-05-01

    ABSTRACT A proton magnetometer survey of borrow areas along the north shore of Cut-Off Lake was performed using a GEOMETRICS proton precession ...AD-A127 252 A PROTON MAGNETOMETER SURVEY OF BORROW AREAS ALONG / CUT-OFF LAKE: L-246(U) NORTHEAST MISSOURI STATE UNIV KIRKSVILLE L GRANTHAM ET AL... PROTON MAGNETOMETER SURVEY OF BORROW AREAS ALONG CUT-OFF LAKE: L-246 Prepared by Larry Grantham Research Ins tructor Northeast Missouri State University

  13. Effect of cut-off points on performance of laser fluorescence for detecting occlusal caries.

    PubMed

    Braga, Mariana M; Mendes, Fausto M; Imparato, José Carlos P; Rodrigues, Célia R M D

    2007-01-01

    This in vitro study aimed to evaluate the influence of cut-off points on the performance of laser fluorescence (LF) in detecting occlusal caries in permanent and primary teeth. The use of different cut-off points influenced the performance of LF device in detection of occlusal caries in both kind of teeth, but the performance in permanent teeth suffered more influence from variation of cut-off points scales than in primary group.

  14. On Computations of Duct Acoustics with Near Cut-Off Frequency

    NASA Technical Reports Server (NTRS)

    Dong, Thomas Z.; Povinelli, Louis A.

    1997-01-01

    The cut-off is a unique feature associated with duct acoustics due to the presence of duct walls. A study of this cut-off effect on the computations of duct acoustics is performed in the present work. The results show that the computation of duct acoustic modes near cut-off requires higher numerical resolutions than others to avoid being numerically cut off. Duct acoustic problems in Category 2 are solved by the DRP finite difference scheme with the selective artificial damping method and results are presented and compared to reference solutions.

  15. Geomagnetic and atmospheric effects

    NASA Astrophysics Data System (ADS)

    Stoker, P. H.

    1983-08-01

    Geomagnetic and atmospheric processes affecting cosmic-ray earthbound spectrometry are analyzed. The topics discussed include: cutoff rigidities and asymptotic directions; cosmic ray secondaries in the atmosphere and magnetosphere; neutron counters without lead and neutron monitors; and coupling coefficients/yield functions and response functions of cosmic ray detectors. Theoretical simulations of the atmosphere and geomagnetism are presented, taking into account such factors as geomagnetic ring currents and meteorological effects. Diagrams and cutoff rigidity contours are included.

  16. A field test of cut-off importance sampling for bole volume

    Treesearch

    Jeffrey H. Gove; Harry T. Valentine; Michael J. Holmes

    2000-01-01

    Cut-off importance sampling has recently been introduced as a technique for estimating bole volume to some point below the tree tip, termed the cut-off point. A field test of this technique was conducted on a small population of eastern white pine trees using dendrometry as the standard for volume estimation. Results showed that the differences in volume estimates...

  17. Diagnostics principle of microwave cut-off probe for measuring absolute electron density

    SciTech Connect

    Jun, Hyun-Su

    2014-08-15

    A generalized diagnostics principle of microwave cut-off probe is presented with a full analytical solution. In previous studies on the microwave cut-off measurement of weakly ionized plasmas, the cut-off frequency ω{sub c} of a given electron density is assumed to be equal to the plasma frequency ω{sub p} and is predicted using electromagnetic simulation or electric circuit model analysis. However, for specific plasma conditions such as highly collisional plasma and a very narrow probe tip gap, it has been found that ω{sub c} and ω{sub p} are not equal. To resolve this problem, a generalized diagnostics principle is proposed by analytically solving the microwave cut-off condition Re[ε{sub r,eff}(ω = ω{sub c})] = 0. In addition, characteristics of the microwave cut-off condition are theoretically tested for correct measurement of the absolute electron density.

  18. Surface Tension of Methanol as a Function of cut-off Radius and Temperature Controllers

    NASA Astrophysics Data System (ADS)

    Obeidat, Abdalla; Jaradat, Adnan; Hamdan, Bushra

    Molecular dynamics is used to calculate the surface tension of van Leeuwen methanol. The van Leeuwen model of methanol is chosen over other models of methanol, since this model is widely used to study nucleation at low temperature. Usually, scientists use the cut-off radius to be three order of magnitude of segment diameter. In this study, we varied the cut-off radius to estimate the best cut-off at which the surface tension reaches its plateau. After deciding the best cut-off radius for van der Waals and Coulomb interactions (CUT-OFF and PME were used for Coulomb interaction), we varied the temperature controller (van-Housen, Berendsen, and v-rescale) to decide the best temperature controller to be used to study methanol. In all simulations, Gromacs is used at T =200-300K with periodic boundary conditions in all dimensions. JUST.

  19. Body mass index cut-offs for screening for childhood overweight and obesity in Indian children.

    PubMed

    Khadilkar, V V; Khadilkar, A V; Borade, A B; Chiplonkar, S A

    2012-01-01

    To develop age and sex specific cut offs for BMI to screen for overweight and obesity in Indian children linked to an adult BMI of 23 and 28 kg/m2 respectively, using contemporary Indian data. Cross-sectional. Multicentric, School based. 19834 children were measured from 11 affluent schools from five major geographical regions of India. Data were analyzed using the LMS method, which constructs growth reference percentiles adjusted for skewness. Compared to the cut-offs suggested for European populations and those by the Indian Academy of Pediatrics 2007 Guidelines, the age and sex specific cut off points for body mass index for overweight and obesity for Indian children suggested by this study are lower. Contemporary cross-sectional age and sex specific BMI cut-offs for Indian children linked to Asian cut-offs of 23 and 28 kg/m2 for the assessment of risk of overweight and obesity, respectively are presented.

  20. [ANTHROPOMETRIC PARAMETERS' CUT-OFF POINTS FOR DIAGNOSIS OF SARCOPENIA].

    PubMed

    Canda Moreno, Alicia S

    2015-08-01

    sarcopenia is a syndrome characterized by loss of muscle mass associated with reduced muscle strength and/or reduced functional capacity. The ageing of our population is producing an increase of the prevalence related with age in addition to other factors related to malnutrition and certain diseases. The aim of this study was to provide a tool for diagnosing sarcopenia while determining in an accessible way the loss of muscle mass. an anthropometric standardized protocol was completed on 883 men and 506 women, healthy and active, aged 20-39 years. The following muscular development indices were calculated: body circumferences (upper arm, forearm, thigh, and calf) corrected circumferences (upper arm, thigh and calf), cross-sectional area (CSA, upper arm, thigh, and calf) and whole- body muscle mass (kg), and as a percentage (%) and in relation to height (kg/m²) by Lee's equation. The cutoff point was established as the 2.5 percentile (lower endpoint of the 95% confidence interval) for the analyzed studied. significant differences by gender (p < 0.0001) were found in all the indicators analyzed. The cut-off points of the loss of skeletal muscle mass were 9,1 kg/m² in men; and 7.3 kg/m² in women. And in the CSA (cm²), men vs. women: upper arm, 37.7 vs. 24.2; , thigh, 154.3 vs. 115.8; and calf, 78.8 vs. 60.2. there is sexual dimorphism which requires considering differentiated diagnostic criteria. The anthropometric technique can serve as screening method for sarcopenia on the study of large populations. Copyright AULA MEDICA EDICIONES 2014. Published by AULA MEDICA. All rights reserved.

  1. Cut-off fuel exhaust mechanism in fuel injection pump

    SciTech Connect

    Ikeuchi, H.

    1988-08-23

    This patent describes a fuel injection pump having an exhaust means for exhausting fuel from the fuel pump at the time of cut-off of fuel flow through the pump, comprising: a pump body for positioning in a pump space for containing fuel to be pumped, the pump body having a fuel passage extending thereinto from the pump space and a valve means in the fuel passage; a plunger barrel mounted in the pump body and having a plunger bore therein and a fuel intake port extending through the plunger barrel from a position opposite the inner end of the fuel passage into the plunger bore; a plunger rotatably and slidably mounted in the plunger bore and defining a pressurizing chamber at the inner end of the plunger bore; the plunger barrel having an oil passage extending from the end within which the pressurizing chamber is defined to the periphery of the plunger barrel; the pump body having a lead hole therethrough from a position opposite the end of the oil passage at the periphery of the plunger barrel to the outside of the pump body, and further having an oil chamber extending thereinto from a position on the pump body near the end of the oil passage and an exhaust passage extending from the inner part of the oil chamber to the outside of the pump body and opening into the pump space; a valve housing mounted on the pump body over the end of the lead hole and the opening into the oil chamber and having a valve guide hole therein opening into the oil chamber and having a valve seat around the end thereof and having an oil induction hole therethrough from a position opposite the end of the lead hole and into the valve guide hole.

  2. Symptom-dependent cut-offs of urine metanephrines improve diagnostic accuracy for detecting pheochromocytomas in two separate cohorts, compared to symptom-independent cut-offs.

    PubMed

    Cho, Yoon Young; Song, Kee-Ho; Kim, Young Nam; Ahn, Seong Hee; Kim, Hyeonmok; Park, Sooyoun; Suh, Sunghwan; Kim, Beom-Jun; Lee, Soo-Youn; Chun, Sail; Koh, Jung-Min; Lee, Seung Hun; Kim, Jae Hyeon

    2016-10-01

    The development of advanced imaging techniques has increased the detection of subclinical pheochromocytomas. Because of the substantial proportions of subclinical pheochromocytomas, measurement of urine metanephrine concentrations is crucial due to detect or exclude pheochromocytoma. Although urine metanephrines are elevated in symptomatic subjects, diagnostic cut-offs according to the presence of adrenergic symptoms have not been studied. Pheochromocytomas patients who underwent adrenalectomy at Samsung Medical Center and a control group were compared to determine cut-off concentrations of urine metanephrines. An independent population was analyzed for urine metanephrines with different kits to validate the improvement in diagnostic accuracy using adjusted cut-offs. Symptom-dependent cut-offs of urine metanephrines were higher for symptomatic patients (307 μg/day in males, 235 μg/day in females for urine metanephrine, and 1,045 μg/day in males and 457 μg/day in females for urine normetanephrine) than for asymptomatic patients (206 μg/day in males, 199 μg/day in females for urine metanephrine, and 489 μg/day in males and 442 μg/day in females for urine normetanephrine). Symptom-dependent cut-offs of urine metanephrines improved a specificity from 92.7 % to 96.3 % and a high sensitivity of 97.8 % was maintained. Using the Symptom-dependent cut-offs raised diagnostic accuracy by 5.5 % (p <0.001). Similar trend was also observed in an independent population using different hormone kits. Using symptom-dependent cut-offs of urine metanephrines in symptomatic patients for pheochromocytomas resulted in a significant improvement in diagnostic accuracy in two separate cohorts.

  3. Validity of newly-developed BMI and waist cut-off values for Sri Lankan children.

    PubMed

    Wickramasinghe, V P; Arambepola, C; Bandara, D M P S; Abeysekera, M; Kuruppu, S; Dilshan, P; Dissanayake, B S

    2013-05-01

    Excess body fat leads to obesity-related morbidity and population/ethnicity-specific cut-off values of anthropometric measures are useful for better diagnosis. This study assesses the suitability of newly-developed Sri Lankan anthropometric cut-off values in the diagnosis of obesity in Sri Lankan children. A cross-sectional study was conducted at University of Colombo, Sri Lanka involving 5-15 year old children. Height, weight, waist (WC), and hip (HC) circumferences were measured. Total body fat (FM) was measured using whole body BIA. WHR and WHtR were calculated. Validity of anthropometric measures in detecting childhood obesity (Sri Lankan BMI/WC; IOTF, WHO, British and CDC BMI and British WC cut-off values) were evaluated. Nine hundred and twenty children were assessed. FM showed significant associations with BMI (r = 0.92, p < 0.001), WC (r = 0.90, p < 0.001) and HC (r = 0.85, p < 0.001), but poor association with WHR (r = 0.17, p < 0.001). However, WHtR had a high association with FM (r = 0.75, p < 0.001) and %FM (r = 0.78, p < 0.001). Based on %FM cut-offs, 85 (22.8%) girls and 101 (18.5%) boys were obese. All international anthropometric cut-off values under-estimated obesity. Sri Lankan WC and BMI cut-off values over-estimated obesity. International BMI based cut-off values had high specificity (>99%) but a low sensitivity (∼12-33%), while Sri Lankan BMI cut-off values had high sensitivity (>93.1) but low specificity (>79.7). Internationally available BMI cut-off values are poor in diagnosing obesity in Sri Lankan children. Newly developed Sri Lankan BMI cut-off values for children improved the diagnosis. WC can be used successfully as an alternative diagnostic tool of obesity.

  4. Tentative colistin epidemiological cut-off value for Salmonella spp.

    PubMed

    Agersø, Yvonne; Torpdahl, Mia; Zachariasen, Camilla; Seyfarth, Annemette; Hammerum, Anette M; Nielsen, Eva Møller

    2012-04-01

    The objective of this research was to determine minimal inhibitory concentration (MIC) population distributions for colistin for Salmonella on subtype level. Furthermore, we wanted to determine if differences in MIC for colistin could be explained by mutations in pmrA or pmrB encoding proteins involved in processes that influence the binding of colistin to the cell membrane. During 2008-2011, 6,583 Salmonella enterica subsp. enterica isolates of human origin and 1931 isolates of animal/meat origin were collected. The isolates were serotyped, and susceptibility was tested towards colistin (range 1-16 mg/L). Moreover, 37 isolates were tested for mutations in pmrA and pmrB by polymerase chain reaction (PCR) and DNA sequencing. MIC distribution for colistin at serotype level showed that Salmonella Dublin (n=198) followed by Salmonella Enteritidis (n=1247) were less susceptible than "other" Salmonella serotypes originating from humans (n=5,274) and Salmonella Typhimurium of animal/meat origin (n=1794). MIC was ≤1 mg/L for 98.9% of "other" Salmonella serotypes originating from humans, 99.4% of Salmonella Typhimurium, 61.3% of Salmonella Enteritidis, and 12.1% of Salmonella Dublin isolates. Interestingly, Salmonella Dublin and Salmonella Enteritidis belong to the same O-group (O:1, 9,12), suggesting that surface lipopolysaccharides (LPS) of the cell (O-antigen) play a role in colistin susceptibility. The epidemiological cut-off value of >2 mg/L for colistin suggested by European Committee on Antimicrobial Susceptibility Testing (EUCAST) is placed inside the distribution for both Salmonella Dublin and Salmonella Enteritidis. All tested Salmonella Dublin isolates, regardless of MIC colistin value, had identical pmrA and pmrB sequences. Missense mutations were found only in pmrA in one Salmonella Reading and in pmrB in one Salmonella Concord isolate, both with MIC of ≤1 for colistin. In conclusion, our study indicates that missense mutations are not necessarily

  5. Exploring cut-off values for large waist circumference in older adults: a new methodological approach.

    PubMed

    Heim, N; Snijder, M B; Heymans, M W; Deeg, D J H; Seidell, J C; Visser, M

    2010-04-01

    There is an ongoing debate about the applicability of current criteria for large waist circumference (WC) in older adults. Our aim was to explore cut-off values for large WC in adults aged 70 years and older, using previously used and new methods. Prospective cohort study. Data of 1049 participants of the Longitudinal Aging Study Amsterdam (LASA) (1995-1996), aged 70-88y, were used. Measured BMI and WC, and self-reported mobility limitations. Linear regression analyses showed that the values of WC corresponding to BMI of 25kg/m2 and 30kg/m2 were higher than the current cut-offs. Cut-offs found in men were 97 and 110cm, whereas 88 and 98cm represented the cut-offs in women. Areas under the Receiver Operating Characteristic (ROC) curves showed that the accuracy to predict mobility limitations improved when the higher cut-offs were applied. Spline regression curves showed that the relationship of WC with mobility limitations was U-shaped in men, while in women, the risk for mobility limitations increased gradually with increasing WC. However, at the level of current cut-off values for WC the odds for mobility limitations were not increased. Based on results of extensive analyses, this study suggests that the cut-offs for large WC should be higher when applied to older adults. The association of WC with other negative health outcomes needs to be investigated to establish the final cut-points.

  6. Optimal cut-off values and population means of waist circumference in different populations.

    PubMed

    Wang, Zhiqiang; Ma, Jun; Si, Damin

    2010-12-01

    Abdominal obesity is a risk factor for cardiometabolic disease, and has become a major public health problem in the world. Waist circumference is generally used as a simple surrogate marker to define abdominal obesity for population screening. An increasing number of publications solely rely on the method that maximises sensitivity and specificity to define 'optimal' cut-off values. It is well documented that the optimal cut-off values of waist circumference vary across different ethnicities. However, it is not clear if the variation in cut-off values is a true biological phenomenon or an artifact of the method for identifying optimal cut-off points. The objective of the present review was to assess the relationship between optimal cut-offs and population waist circumference levels. Among sixty-one research papers, optimal cut-off values ranged from 65·5 to 101·2 cm for women and 72·5 to 103·0 cm for men. Reported optimal cut-off values were highly correlated with population means (correlation coefficient: 0·91 for men and 0·93 for women). Such a strong association was independent of waist circumference measurement techniques or the health outcomes (dyslipidaemia, hypertension or hyperglycaemia), and existed in some homogeneous populations such as the Chinese and Japanese. Our findings raised some concerns about applying the sensitivity and specificity approach to determine cut-off values. Further research is needed to understand whether the differences among populations in waist circumference were genetically or environmentally determined, and to understand whether using region-specific cut-off points can identify individuals with the same absolute risk levels of metabolic and cardiovascular outcomes among different populations.

  7. Global changes of cosmic ray cutoff rigidities in the maximum of the geomagnetic storm of November 2003

    NASA Astrophysics Data System (ADS)

    Vernova, Elena; Tyasto, Marta; Danilova, Olga

    2017-04-01

    Vertical cosmic ray (CR) cutoff rigidities were calculated by the CR particle trajectory tracing method in the magnetic field of the Tsyganenko's disturbed magnetosphere model Ts01 for the minimum of the Dst-variation for world grid 5°x15°. The results were compared with cutoff rigidities of Shea & Smart for IGRF2000. The areas of the large differences between them are revealed.

  8. Upper and lower bounds for the speed of pulled fronts with a cut-off

    NASA Astrophysics Data System (ADS)

    Benguria, R. D.; Depassier, M. C.; Loss, M.

    2008-02-01

    We establish rigorous upper and lower bounds for the speed of pulled fronts with a cut-off. For all reaction terms of KPP type a simple analytic upper bound is given. The lower bounds however depend on details of the reaction term. For a small cut-off parameter the two leading order terms in the asymptotic expansion of the upper and lower bounds coincide and correspond to the Brunet-Derrida formula. For large cut-off parameters the bounds do not coincide and permit a simple estimation of the speed of the front.

  9. Integrated optical isolator based on nonreciprocal-mode cut-off.

    PubMed

    Hemme, H; Dötsch, H; Hertel, P

    1990-06-20

    A concept of an integrated optical isolator is presented which uses the TM(0) mode propagating perpendicular to the in-plane magnetization of a planar magnetooptical waveguide. The cut-off thickness of the waveguide depends on the propagation direction. If the magnetic film has a strong Faraday rotation and is weakly guiding, the cut-off thicknesses for forward and backward propagation differ markedly. Operating close to cut-off yields a large difference between coupling efficiencies to the waveguide for forward and backward propagation.

  10. Flow Characteristics with Variations of Cut-Off Angle of Multi-Blade Fan for Ventilation

    NASA Astrophysics Data System (ADS)

    Kang, Kyung Jun; Park, Jun Geon; Shin, You Hwan; Kim, Kwang Ho

    2010-06-01

    This study investigated on details of flow characteristics of a multi-blade fan for domestic ventilation. Experiments and analysis were carried out to describe on flow pattern with variations of cut-off angle near the scroll-housing throat, which were performed by PIV measurement for the flow field and by total pressure probes. The stagnation point at cut-off region of the fan moves to the exit of the scroll housing as cut-off angle increases. The movement of stagnation point and the variation of throat area of the scroll housing influence to the distribution of velocity magnitude at the exit of the fan. Furthermore, a large distortion of the velocity distribution at the scroll exit causes to increase mixing loss along the flow path. The improvement of the fan design on cut-off is expected through understanding the flow pattern.

  11. Resistive magneto-hydrodynamical cut-off of Alfvén wave in fully ionized plasmas

    SciTech Connect

    Vranjes, J.; Kono, M.

    2014-01-15

    The term cut-off in the theory of the Alfvén wave is used to describe several different phenomena. In this work, the cut-off due to magnetohydrodynamic resistive damping in fully ionized plasmas is revisited. This cut-off requires short enough wavelengths, it is routinely discussed in numerous works, and graphs depicting it are available even in textbooks. We show that this cut-off is hardly ever possible in real plasmas. This is due to the fact that some essential criteria and conditions become strongly violated in order to achieve the cut-off.

  12. Derivation of anthropometric cut-off levels to define CVD risk in Sri Lankan adults.

    PubMed

    Katulanda, P; Jayawardena, M A R; Sheriff, M H R; Matthews, D R

    2011-04-01

    Obesity is associated with increased cardiovascular risk. Anthropometric cut-off values derived for Caucasians may not be applicable to other populations. The main objective of the present study was to derive population-specific anthropometric cut-off values to define high CVD risk for Sri Lankan adults. A nationally representative sample of 4474 non-institutionalised adults aged ≥ 18 years was analysed. Cut-off values to provide optimum sensitivity and specificity were derived using receiver-operating characteristic curve analysis. BMI, waist circumference (WC), waist-to-hip ratio (WHR), blood pressure and overnight fasting venous blood samples were collected to measure glucose, HDL-cholesterol and TAG. An oral glucose tolerance test was also performed. The results suggested that the age-adjusted BMI, WC and WHR were significantly associated with all cardiovascular risk factors (P < 0·001). Cut-off values for BMI, WC and WHR for males were 20·7 kg/m2, 76·5 cm and 0·89, respectively. The respective values for females were 22·0 kg/m2, 76·3 cm and 0·85. The common cut-off value for BMI for males and females was 21·5 kg/m2. Similarly, WC and WHR cut-off values for both males and females were 76·3 cm and 0·87, respectively. The Asian and Caucasian anthropometric cut-off levels showed lower sensitivity and higher false negative percentage compared with newly derived cut-off levels. In conclusion, BMI, WC and WHR were all associated with increased CVD risk. We propose the following anthropometric cut-off points to determine high CVD risk level for Sri Lankan adults: BMI ≥ 21·5 kg/m2, WC ≥ 76 cm and WHR ≥ 0·85 (women) and 0·90 (men).

  13. The critical wave speed for the Fisher Kolmogorov Petrowskii Piscounov equation with cut-off

    NASA Astrophysics Data System (ADS)

    Dumortier, Freddy; Popovic, Nikola; Kaper, Tasso J.

    2007-04-01

    The Fisher-Kolmogorov-Petrowskii-Piscounov (FKPP) equation with cut-off was introduced in (Brunet and Derrida 1997 Shift in the velocity of a front due to a cut-off Phys. Rev. E 56 2597-604) to model N-particle systems in which concentrations less than ɛ = 1/N are not attainable. It was conjectured that the cut-off function, which sets the reaction terms to zero if the concentration is below the small threshold ɛ, introduces a substantial shift in the propagation speed of the corresponding travelling waves. In this paper, we prove the conjecture of Brunet and Derrida, showing that the speed of propagation is given by c_crit(\\varepsilon)=2-{\\pi^2}/{(\\ln\\varepsilon)^2}+\\cal{O}((\\ln\\varepsilon)^{-3}) , as ɛ → 0, for a large class of cut-off functions. Moreover, we extend this result to a more general family of scalar reaction-diffusion equations with cut-off. The main mathematical techniques used in our proof are the geometric singular perturbation theory and the blow-up method, which lead naturally to the identification of the reasons for the logarithmic dependence of ccrit on ɛ as well as for the universality of the corresponding leading-order coefficient (π2).

  14. Epidemiological cut-off values for Flavobacterium psychrophilum MIC data generated by a standard test protocol.

    PubMed

    Smith, P; Endris, R; Kronvall, G; Thomas, V; Verner-Jeffreys, D; Wilhelm, C; Dalsgaard, I

    2016-02-01

    Epidemiological cut-off values were developed for application to antibiotic susceptibility data for Flavobacterium psychrophilum generated by standard CLSI test protocols. The MIC values for ten antibiotic agents against Flavobacterium psychrophilum were determined in two laboratories. For five antibiotics, the data sets were of sufficient quality and quantity to allow the setting of valid epidemiological cut-off values. For these agents, the cut-off values, calculated by the application of the statistically based normalized resistance interpretation method, were ≤16 mg L(-1) for erythromycin, ≤2 mg L(-1) for florfenicol, ≤0.025 mg L(-1) for oxolinic acid (OXO), ≤0.125 mg L(-1) for oxytetracycline and ≤20 (1/19) mg L(-1) for trimethoprim/sulphamethoxazole. For ampicillin and amoxicillin, the majority of putative wild-type observations were 'off scale', and therefore, statistically valid cut-off values could not be calculated. For ormetoprim/sulphadimethoxine, the data were excessively diverse and a valid cut-off could not be determined. For flumequine, the putative wild-type data were extremely skewed, and for enrofloxacin, there was inadequate separation in the MIC values for putative wild-type and non-wild-type strains. It is argued that the adoption of OXO as a class representative for the quinolone group would be a valid method of determining susceptibilities to these agents.

  15. Calculating broad neutron resonances in a cut-off Woods-Saxon potential

    NASA Astrophysics Data System (ADS)

    Baran, Á.; Noszály, Cs.; Salamon, P.; Vertse, T.

    2015-07-01

    In a cut-off Woods-Saxon (CWS) potential with realistic depth S -matrix poles being far from the imaginary wave number axis form a sequence where the distances of the consecutive resonances are inversely proportional with the cut-off radius value, which is an unphysical parameter. Other poles lying closer to the imaginary wave number axis might have trajectories with irregular shapes as the depth of the potential increases. Poles being close repel each other, and their repulsion is responsible for the changes of the directions of the corresponding trajectories. The repulsion might cause that certain resonances become antibound and later resonances again when they collide on the imaginary axis. The interaction is extremely sensitive to the cut-off radius value, which is an apparent handicap of the CWS potential.

  16. Design of non-polarizing cut-off filters based on dielectric-metal-dielectric stacks.

    PubMed

    Cai, Qing-Yuan; Luo, Hai-Han; Zheng, Yu-Xiang; Liu, Ding-Quan

    2013-08-12

    Cut-off filters are usually operating at oblique incidence and exhibit polarization dependence properties. We propose a simple approach to design cut-off filters with low linear polarization sensitivity (LPS) based on dielectric-metal-dielectric (DMD) stacks. The designing method is derived from the theory of optical film characteristic matrix. The admittance loci of the film are adjusted to achieve similar spectral properties of s- and p-polarized light at oblique incidence. Different film structures are designed non-polarizing at different angles of incidence with the method. The results show that the designing method is efficient for designing non-polarizing cut-off filters, which are widely used in non-polarizing optical system.

  17. The optimum cut-off radius in Monte Carlo simulation of Yukawa potential point particles

    NASA Astrophysics Data System (ADS)

    Suwan, I.; Hussein, H.; Hussein, A.; Daragmeh, M.

    2017-06-01

    In this paper, infinite systems of point particles with Yukawa potential and periodic boundary conditions are simulated using Monte Carlo technique in three dimensions. Because of the short range nature of the Yukawa potential, cut-off radius rcut is considered in calculations (i.e, for each particle i, the effect of the other particles on it inside a sphere of radius rcut is taken into account). The cut-off radius used in Monte Carlo simulation affects the physical behavior of the system being simulated. A sequence of rcut values are used. When the change in the total potential energy becomes negligible, the optimum value of the cut-off radius is determined. This value is found to be independent of density and temperature in the NVT-ensemble case.

  18. Is the hymen a suitable cut-off point for clinically relevant pelvic organ prolapse?

    PubMed

    Wiegersma, Marian; Panman, Chantal M C R; Kollen, Boudewijn J; Berger, Marjolein Y; Lisman-van Leeuwen, Yvonne; Dekker, Janny H

    2017-05-01

    The primary objective was to evaluate the ability of different anatomic cut-off points, as established in specialist urogynecology populations, to identify clinically relevant prolapse in a population of postmenopausal women with pelvic floor symptoms recruited from primary care. Cross-sectional study among 890 women (≥55 years) screened for pelvic floor symptoms. The Pelvic Floor Distress Inventory 20 was used to measure symptoms, and the Pelvic Organ Prolapse Quantification (POP-Q) system was used to assess prolapse. Areas under the curves, sensitivity, and specificity were calculated for the hymen as a cut-off point for symptomatic prolapse of the anterior and posterior vaginal wall. For the apical compartment, a cut-off point of -5cm relative to the hymen was used. Vaginal bulging was the only symptom reported more often with increasing POP-Q stages. Areas under the curves (95% confidence intervals) to discriminate between women with and without vaginal bulging symptoms were 0.66 (0.61-0.72), 0.56 (0.50-0.63), and 0.61 (0.55-0.66) for the anterior (Ba), posterior (Bp) and apical (C) compartment, respectively. When the hymen was used as the cut-off point, Ba had a sensitivity of 38.1% and a specificity of 82.4%, and Bp had a sensitivity of 13.3% and a specificity of 96.5%. For C, the cut-off point of -5cm relative to the hymen had a sensitivity of 37.9% and a specificity of 73.1%. The anatomic cut-off points for clinically relevant prolapse established in the specialist urogynecology population cannot adequately identify symptomatic prolapse in a population of postmenopausal women with pelvic floor symptoms recruited from primary care. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. The acoustic cut-off frequency of roAp stars

    NASA Astrophysics Data System (ADS)

    Audard, N.; Kupka, F.; Morel, P.; Provost, J.; Weiss, W. W.

    1998-07-01

    Some of the rapidly oscillating (roAp) stars, have frequencies which are larger than the acoustic cut-off frequency determined from published stellar models which usually assume a grey atmosphere. As the cut-off frequency depends on the T(tau ) relation, we have computed models and adiabatic frequencies for pulsating Ap stars with more realistic atmospheres which include a frequency dependent treatment of radiative transfer, take blanketing effects into account, and which have a better treatment of the radiative pressure. In addition, we are using opacity distribution functions specific to the atmospheric composition. With these improvements over the classical stellar models the theoretical acoustic cut-off frequency for roAp stars are increased by about 200 mu Hz, which brings them close to the observations. We restrict the comparison of our computations with observations to those two `pathological' roAp stars for which more reliable astrophysical parameters are available, HD 24712 and alpha Cir, and comment briefly on a third one, HD 134214. For alpha Cir we find models which have indeed a cut-off frequency beyond the largest observed frequency and which are well within the Teff - L/L_⊙ error box. For HD 24712 only models which are hotter by about 100 K and less luminous by nearly 10% than what is actually the most probable value derived by spectroscopy would have an acoustic cut-off frequency large enough. HD 134214 fits our models best, however, the error box for Teff - L/L_⊙ is the largest of all three stars. One may thus speculate that the old controversy about a mismatch between observed largest frequencies and theoretical cut-off frequencies of roAp star models is resolved. Based on hipparcos data.

  20. 26 CFR 1.585-7 - Elective cut-off method of changing from the reserve method of section 585.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 26 Internal Revenue 7 2011-04-01 2009-04-01 true Elective cut-off method of changing from the... § 1.585-7 Elective cut-off method of changing from the reserve method of section 585. (a) General rule...)) may elect to use the cut-off method set forth in this section. Any such election must be made at the...

  1. 26 CFR 1.585-7 - Elective cut-off method of changing from the reserve method of section 585.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 26 Internal Revenue 7 2013-04-01 2013-04-01 false Elective cut-off method of changing from the... § 1.585-7 Elective cut-off method of changing from the reserve method of section 585. (a) General rule...)) may elect to use the cut-off method set forth in this section. Any such election must be made at the...

  2. 26 CFR 1.585-7 - Elective cut-off method of changing from the reserve method of section 585.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 26 Internal Revenue 7 2014-04-01 2013-04-01 true Elective cut-off method of changing from the... § 1.585-7 Elective cut-off method of changing from the reserve method of section 585. (a) General rule...)) may elect to use the cut-off method set forth in this section. Any such election must be made at the...

  3. 26 CFR 1.585-7 - Elective cut-off method of changing from the reserve method of section 585.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 26 Internal Revenue 7 2010-04-01 2010-04-01 true Elective cut-off method of changing from the... § 1.585-7 Elective cut-off method of changing from the reserve method of section 585. (a) General rule...)) may elect to use the cut-off method set forth in this section. Any such election must be made at the...

  4. 26 CFR 1.585-7 - Elective cut-off method of changing from the reserve method of section 585.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 26 Internal Revenue 7 2012-04-01 2012-04-01 false Elective cut-off method of changing from the... § 1.585-7 Elective cut-off method of changing from the reserve method of section 585. (a) General rule...)) may elect to use the cut-off method set forth in this section. Any such election must be made at the...

  5. The INTEGRAL high energy cut-off distribution of Seyfert galaxies

    NASA Astrophysics Data System (ADS)

    Malizia, Angela; Ubertini, Pietro; Bird, Antony; Bazzano, Angela; Stephen, John; Molina, Manuela; Bassani, Loredana

    We present the primary continuum parameters, the photon index and the high energy cut-off, of Seyfert galaxies extracted from the INTEGRAL complete sample of AGN. We performed a broad band (0.3-100 keV) spectral analysis by fitting simultaneously the soft and hard X-ray spectra obtained by XMM and INTEGRAL/IBIS-Swift/BAT respectively in order to investigate the general properties of these parameters in particular their distribution and mean values. We present the mean photon index for the t type 1 and type 2 objects of the whole sample as well as their mean high energy cut-off. This is the first time that the cut-off energy is constrained in a such large number of AGN. Using the main parameters of the primary continuum, we are able to obtain the actual physical parameters of the Comptonizing region i.e. the plasma temperature kTe the optical depth tau. Finally, with the high S/N spectra starting to come from NuSTAR it will soon be possible to better constrain the cut-off values in many AGN, allowing the determination of more physical models and so to better understand the continuum emission and geometry of the region surrounding black holes.

  6. 76 FR 35378 - Installation and Use of Engine Cut-Off Switches on Recreational Vehicles

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-06-17

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HOMELAND SECURITY Coast Guard 33 CFR Parts 175 and 183 RIN 1825-AB34 Installation and Use of Engine Cut-Off Switches on Recreational Vehicles Correction Proposed Rule document 2011-14140 was inadvertently published...

  7. A New Regularization Mechanism for the Boltzmann Equation Without Cut-Off

    NASA Astrophysics Data System (ADS)

    Silvestre, Luis

    2016-11-01

    We apply recent results on regularity for general integro-differential equations to derive a priori estimates in Hölder spaces for the space homogeneous Boltzmann equation in the non cut-off case. We also show an a priori estimate in {L^∞} which applies in the space inhomogeneous case as well, provided that the macroscopic quantities remain bounded.

  8. Ethnic-specific body mass index cut-off points for overweight and obesity in girls.

    PubMed

    Duncan, J Scott; Duncan, Elizabeth K; Schofield, Grant

    2010-03-19

    To develop ethnic-specific body mass index (BMI) cut-off points for overweight and obesity in girls from New Zealand's five major ethnic groups. A total of 1676 girls (41% European, 21% Pacific Island, 15% East Asian, 13% Māori, and 11% South Asian) aged 5-16 years participated in this study. BMI was determined from height and weight, and body fat percentage (%BF) was obtained from hand-to-foot bioelectrical impedance measurements. Using stepwise multiple regression, a series of ethnic-specific BMI cut-off points were developed that corresponded to the equivalent %BF of European girls at the BMI reference values provided by the International Obesity TaskForce (IOTF). The adjusted cut-off points for overweight and obesity ranged from an average of 3.3 and 3.8 kg.m(-2) (respectively) lower than the IOTF standards in South Asian girls to 1.5 and 1.9 kg.m(-2) higher in Pacific Island girls. We conclude that the ethnic-specific BMI cut-off points developed in this study are more appropriate than universal definitions of overweight and obesity for predicting excess adiposity in New Zealand girls.

  9. A Defensible Model for Determining a Minimal Cut-Off Score for Criterion Referenced Tests.

    ERIC Educational Resources Information Center

    Bernknopf, Stan; And Others

    The effectiveness of a model for determining a minimal cut-off score for criterion-referenced tests was examined. The model, based upon techniques presented originally by Nedelsky and by Angoff, was first used in conjunction with a multiple choice test developed for use in certifying school counselors in Georgia. A "knowledge estimation panel" was…

  10. The INTEGRAL High-energy Cut-off Distribution of Type 1 Active Galactic Nuclei

    NASA Astrophysics Data System (ADS)

    Malizia, A.; Molina, M.; Bassani, L.; Stephen, J. B.; Bazzano, A.; Ubertini, P.; Bird, A. J.

    2014-02-01

    In this Letter we present the primary continuum parameters, the photon index Γ, and the high-energy cut-off E c of 41 type-1 Seyfert galaxies extracted from the International Gamma-Ray Astrophysics Laboratory (INTEGRAL) complete sample of active galactic nuclei (AGNs). We performed broadband (0.3-100 keV) spectral analysis by simultaneously fitting the soft and hard X-ray spectra obtained by XMM and INTEGRAL/IBIS-Swift/BAT, respectively, in order to investigate the general properties of these parameters, in particular their distribution and mean values. We find a mean photon index of 1.73 with a standard deviation of 0.17 and a mean high-energy cut-off of 128 keV with a standard deviation of 46 keV for the whole sample. This is the first time that the cut-off energy is constrained in such a large number of AGNs. We have 26 measurements of the cut-off, which corresponds to 63% of the entire sample, distributed between 50 and 200 keV. There are a further 11 lower limits mostly below 300 keV. Using the main parameters of the primary continuum, we have been able to obtain the actual physical parameters of the Comptonizing region, i.e., the plasma temperature kT e from 20 to 100 keV and the optical depth τ < 4. Finally, with the high signal-to-noise ratio spectra starting to come from NuSTAR it will soon be possible to better constrain the cut-off values in many AGNs, allowing the determination of more physical models and thus better understand the continuum emission and geometry of the region surrounding black holes.

  11. Comparison of different DIAGNOdent cut-off limits for in vivo detection of occlusal caries.

    PubMed

    Heinrich-Weltzien, Roswitha; Kühnisch, J; Oehme, T; Ziehe, A; Stösser, L; García-Godoy, F

    2003-01-01

    This study tested recently recommended cut-off limits for the laser fluorescence based device DIAGNOdent (KaVo) for detection of occlusal caries. Two hundred and forty-eight permanent molars from 94 patients (mean age 19.2 years) of a general dental practice were included. After professional tooth cleaning, the teeth were examined visually and by the laser fluorescence method. The extent of occlusal lesions (gold standard) was determined after minimal operative intervention. Upon fissure opening, 24 teeth had enamel caries and 224 teeth revealed dentin caries, of which 58 and 166, respectively, were up to or beyond half the dentin. The optimal cut-off limits based on the highest kappa-values (0.51 and 0.54) were > 18 for superficial dentinal caries (D3) and > 37 for deep dentinal caries (D4). The comparison with DIAGNOdent cut-offs given by the manufacturer (n = 4) and those based on clinical trials with in vivo validation (n = 4) and in vitro studies with histological validation (n = 3) revealed a considerable variation in performance. Recommended cut-offs between 17 and 21 for superficial dentin lesions were in the same order of magnitude (0.48-0.51). On the D4 level, only the manufacturer's cut-off of > 34 achieved the best performance (0.51). According to the highest kappa-values and the area under the ROC curves (D3: A(z) = 0.903; D4: A(z) = 0.830), the agreement between the extent of validated caries and laser fluorescence value is still unsatisfactory.

  12. Multiple Sclerosis Questionnaire for Job Difficulties (MSQ-Job): definition of the cut-off score.

    PubMed

    Schiavolin, Silvia; Giovannetti, Ambra Mara; Leonardi, Matilde; Brenna, Greta; Brambilla, Laura; Confalonieri, Paolo; Frangiamore, Rita; Mantegazza, Renato; Moscatelli, Marco; Clerici, Valentina Torri; Cortese, Francesca; Covelli, Venusia; Ponzio, Michela; Zaratin, Paola; Raggi, Alberto

    2016-05-01

    Multiple Sclerosis (MS) mainly affects people of working age. The Multiple Sclerosis Questionnaire for Job Difficulties (MSQ-Job) was designed to measure difficulties in work-related tasks. Our aim is to define cut-off score of MSQ-Job to identify potential critical situations that might require specific attention. A sample of patients with MS completed the MSQ-Job, WHODAS 2.0 and MSQOL-54 respectively for work difficulties, disability and health-related quality of life (HRQoL) evaluation. K-means Cluster Analysis was used to divide the sample in three groups on the basis of HRQoL and disability. ANOVA test was performed to compare the response pattern between these groups. The cut-off score was defined using the receiver operating characteristic (ROC) curve analyses for MSQ-Job total and count of MSQ-Job items scores ≥3: a score value corresponding to the maximum of the sensitivity-to-specificity ratio was chosen as the cut-off. Out of 180 patients enrolled, twenty were clustered in the higher severity group. The area under the ROC curve was 0.845 for the MSQ-Job total and 0.859 for the count of MSQ-Job items scores ≥3 while the cut-off score was 15.8 for MSQ-Job total and 8 for count of items scored ≥3. We recommend the use of MSQ-Job with this calculation as cut-off for identifying critical situations, e.g. in vocational rehabilitation services, where work-related difficulties have a significant impact in terms of lower quality of life and higher disability.

  13. Clinically Relevant Cut-off Points for the Diagnosis of Sarcopenia in Older Korean People.

    PubMed

    Choe, Yu-Ri; Joh, Ju-Youn; Kim, Yeon-Pyo

    2017-04-21

    The optimal criteria applied to older Korean people have not been defined. We aimed to define clinically relevant cut-off points for older Korean people and to compare the predictive validity with other definitions of sarcopenia. Nine hundred and sixteen older Koreans (≥65 years) were included in this cross-sectional observational study. We used conditional inference tree analysis to determine cut-off points for height-adjusted grip strength (GS) and appendicular skeletal muscle mass (ASM), for use in the diagnosis of sarcopenia. We then compared the Korean sarcopenia criteria with the Foundation for the National Institutes of Health and Asian Working Group for Sarcopenia criteria, using frailty, assessed with the Korean Frailty Index, as an outcome variable. For men, a residual GS (GSre) of ≤ 0.25 was defined as weak, and a residual ASM (ASMre) of ≤ 1.29 was defined as low. Corresponding cut-off points for women were a GSre of ≤ 0.17 and an ASMre of ≤ 0.69. GSre and ASMre values were adjusted for height. In logistic regression analysis with new cut-off points, the adjusted odds ratios for pre-frail or frail status in the sarcopenia group were 3.23 (95% confidence interval [CI] 1.33-7.83) for the men and 1.74 (95% CI 0.91-3.35) for the women. In receiver operating characteristic curve analysis, the unadjusted area under the curve for Korean sarcopenia criteria in men and women were 0.653 and 0.608, respectively (p < .001). Our proposed cut-off points for low GS and low ASM should be useful in the diagnosis of sarcopenia in older Korean people.

  14. Starting the polypill: the use of a single age cut-off in males and females.

    PubMed

    Wald, Nicholas J; Luteijn, Johannes M; Morris, Joan K

    2017-03-01

    Objective Age screening and preventive medication for future myocardial infarction and stroke has been previously described. We aimed to ascertain whether different age cut-offs are needed for males and females. Methods We determined five parameters for each sex according to age cut-off: detection rate (sensitivity), false-positive rate, proportion of the population eligible for treatment with a polypill, proportion who benefit from taking a polypill (simvastatin 20 mg, losartan 25 mg, hydrochlorothiazide 12.5 mg, amlodipine 2.5 mg), and among these, years of life gained without a first myocardial infarction or stroke. Results Approximately one-third benefit, regardless of the age cut-off. For males and females combined, using ages 40 and 80, the detection rates are 98% and 52%, false-positive rates are 51% and 7%, population percentages eligible for treatment are 52% and 7%, and years of life gained without a first myocardial infarction or stroke are 8.4 and 3.6. Using age 50, detection rates are 93% (males) 98% (females), false-positive rates 37% (males) 40% (females), percentage of the population eligible for treatment 38% (males) 41% (females), percentage who benefit 35% (males) 33% (females), and years of life gained without an event 8.5 (males) 7.0 (females). At a given age cut-off, the sex differences are relatively small. Conclusion A single age cut-off can be used for both sexes.

  15. Starting the polypill: the use of a single age cut-off in males and females

    PubMed Central

    Luteijn, Johannes M; Morris, Joan K

    2016-01-01

    Objective Age screening and preventive medication for future myocardial infarction and stroke has been previously described. We aimed to ascertain whether different age cut-offs are needed for males and females. Methods We determined five parameters for each sex according to age cut-off: detection rate (sensitivity), false-positive rate, proportion of the population eligible for treatment with a polypill, proportion who benefit from taking a polypill (simvastatin 20 mg, losartan 25 mg, hydrochlorothiazide 12.5 mg, amlodipine 2.5 mg), and among these, years of life gained without a first myocardial infarction or stroke. Results Approximately one-third benefit, regardless of the age cut-off. For males and females combined, using ages 40 and 80, the detection rates are 98% and 52%, false-positive rates are 51% and 7%, population percentages eligible for treatment are 52% and 7%, and years of life gained without a first myocardial infarction or stroke are 8.4 and 3.6. Using age 50, detection rates are 93% (males) 98% (females), false-positive rates 37% (males) 40% (females), percentage of the population eligible for treatment 38% (males) 41% (females), percentage who benefit 35% (males) 33% (females), and years of life gained without an event 8.5 (males) 7.0 (females). At a given age cut-off, the sex differences are relatively small. Conclusion A single age cut-off can be used for both sexes. PMID:27072544

  16. Rationalizing thyroid function testing: which TSH cut-offs are optimal for testing free T4?

    PubMed

    Henze, Meg; Brown, Suzanne J; Hadlow, Narelle C; Walsh, John P

    2017-08-30

    Thyroid function testing often utilizes TSH measurement first, then reflex testing for free T4 if TSH is outside reference range limits. The utility of different TSH cut-offs for reflex testing is unknown. To examine different TSH cut-offs for reflex free T4 testing. We analyzed concurrent TSH and free T4 results from 120 403 individuals from a single laboratory in Western Australia (clinical cohort) and 4568 Busselton Health Study participants (community cohort). In the clinical cohort, restricting free T4 measurement to individuals with TSH below 0.3 or above 5.0 mU/L resulted in a 22% reduction in free T4 testing compared with TSH reference range limits of 0.4 and 4.0 mU/L; using TSH cut-offs of 0.2 and 6.0 mU/L resulted in a 34% reduction in free T4 testing. In the community cohort, the impact was less: 3.3% and 4.8% reductions in free T4 testing respectively. In the clinical cohort, using TSH cut-offs of 0.2 and 6.0 mU/L, elevated free T4 would go undetected in 4.2% of individuals with TSH 0.2-0.4 mU/L; in most, free T4 was marginally elevated, and unlikely to indicate clinically relevant hyperthyroidism. Low free T4 would go undetected in 2.5% of individuals with TSH 4-6 mU/L; in 94%, free T4 was marginally reduced and unlikely to indicate clinically relevant hypothyroidism. Setting TSH cut-offs 0.1-0.2 mU/L below and 1-2 mU/L above reference range limits for reflex testing of free T4 reduces the need for free T4 testing, with minimal impact on case-finding.

  17. Raised BMI cut-off for overweight in Greenland Inuit – a review

    PubMed Central

    Andersen, Stig; Fleischer Rex, Karsten; Noahsen, Paneeraq; Sørensen, Hans Christian Florian; Mulvad, Gert; Laurberg, Peter

    2013-01-01

    Background Obesity is associated with increased morbidity and premature death. Obesity rates have increased worldwide and the WHO recommends monitoring. A steep rise in body mass index (BMI), a measure of adiposity, was detected in Greenland from 1963 to 1998. Interestingly, the BMI starting point was in the overweight range. This is not conceivable in a disease-free, physically active, pre-western hunter population. Objective This led us to reconsider the cut-off point for overweight among Inuit in Greenland. Design and findings We found 3 different approaches to defining the cut-off point of high BMI in Inuit. First, the contribution to the height by the torso compared to the legs is relatively high. This causes relatively more kilograms per centimetre of height that increases the BMI by approximately 10% compared to Caucasian whites. Second, defining the cut-off by the upper 90-percentile of BMI from height and weight in healthy young Inuit surveyed in 1963 estimated the cut-off point to be around 10% higher compared to Caucasians. Third, if similar LDL-cholesterol and triglycerides are assumed for a certain BMI in Caucasians, the corresponding BMI in Inuit in both Greenland and Canada is around 10% higher. However, genetic admixture of Greenland Inuit and Caucasian Danes will influence this difference and hamper a clear distinction with time. Conclusion Defining overweight according to the WHO cut-off of a BMI above 25 kg/m2 in Greenland Inuit may overestimate the number of individuals with elevated BMI. PMID:23986904

  18. THE INTEGRAL HIGH-ENERGY CUT-OFF DISTRIBUTION OF TYPE 1 ACTIVE GALACTIC NUCLEI

    SciTech Connect

    Malizia, A.; Molina, M.; Bassani, L.; Stephen, J. B.; Bazzano, A.; Ubertini, P.; Bird, A. J.

    2014-02-20

    In this Letter we present the primary continuum parameters, the photon index Γ, and the high-energy cut-off E {sub c} of 41 type-1 Seyfert galaxies extracted from the International Gamma-Ray Astrophysics Laboratory (INTEGRAL) complete sample of active galactic nuclei (AGNs). We performed broadband (0.3-100 keV) spectral analysis by simultaneously fitting the soft and hard X-ray spectra obtained by XMM and INTEGRAL/IBIS-Swift/BAT, respectively, in order to investigate the general properties of these parameters, in particular their distribution and mean values. We find a mean photon index of 1.73 with a standard deviation of 0.17 and a mean high-energy cut-off of 128 keV with a standard deviation of 46 keV for the whole sample. This is the first time that the cut-off energy is constrained in such a large number of AGNs. We have 26 measurements of the cut-off, which corresponds to 63% of the entire sample, distributed between 50 and 200 keV. There are a further 11 lower limits mostly below 300 keV. Using the main parameters of the primary continuum, we have been able to obtain the actual physical parameters of the Comptonizing region, i.e., the plasma temperature kT {sub e} from 20 to 100 keV and the optical depth τ < 4. Finally, with the high signal-to-noise ratio spectra starting to come from NuSTAR it will soon be possible to better constrain the cut-off values in many AGNs, allowing the determination of more physical models and thus better understand the continuum emission and geometry of the region surrounding black holes.

  19. 40 CFR 53.53 - Test for flow rate accuracy, regulation, measurement accuracy, and cut-off.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... measurement accuracy, coefficient of variability measurement accuracy, and the flow rate cut-off function. The... flow measurements are made at intervals not to exceed 5 minutes. The flow rate cut-off test, conducted... definitions. (1) Sample flow rate means the quantitative volumetric flow rate of the air stream caused by...

  20. 40 CFR 53.53 - Test for flow rate accuracy, regulation, measurement accuracy, and cut-off.

    Code of Federal Regulations, 2013 CFR

    2013-07-01

    ... measurement accuracy, coefficient of variability measurement accuracy, and the flow rate cut-off function. The... flow measurements are made at intervals not to exceed 5 minutes. The flow rate cut-off test, conducted... definitions. (1) Sample flow rate means the quantitative volumetric flow rate of the air stream caused by...

  1. 40 CFR 53.53 - Test for flow rate accuracy, regulation, measurement accuracy, and cut-off.

    Code of Federal Regulations, 2014 CFR

    2014-07-01

    ... measurement accuracy, coefficient of variability measurement accuracy, and the flow rate cut-off function. The... flow measurements are made at intervals not to exceed 5 minutes. The flow rate cut-off test, conducted... definitions. (1) Sample flow rate means the quantitative volumetric flow rate of the air stream caused by...

  2. 40 CFR 53.53 - Test for flow rate accuracy, regulation, measurement accuracy, and cut-off.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... measurement accuracy, coefficient of variability measurement accuracy, and the flow rate cut-off function. The... flow measurements are made at intervals not to exceed 5 minutes. The flow rate cut-off test, conducted... definitions. (1) Sample flow rate means the quantitative volumetric flow rate of the air stream caused by...

  3. 40 CFR 53.53 - Test for flow rate accuracy, regulation, measurement accuracy, and cut-off.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... measurement accuracy, coefficient of variability measurement accuracy, and the flow rate cut-off function. The... flow measurements are made at intervals not to exceed 5 minutes. The flow rate cut-off test, conducted... definitions. (1) Sample flow rate means the quantitative volumetric flow rate of the air stream caused by...

  4. Ethnic and sex-specific cut-off values for adult obesity in the Suriname Health Study.

    PubMed

    Krishnadath, Ingrid S K; Toelsie, Jerry R; Nahar-van Venrooij, Lenny; Hofman, Albert; Jaddoe, Vincent W V

    2016-10-06

    Sex-specific body mass index (BMI) and waist circumference (WC) cut-off values have been validated for a limited number of ethnic groups. We aimed to derive these cut-off values for Amerindians, Creoles, Hindustani, Javanese, Maroons and Mixed living in Suriname. Data from individuals aged 20-65, in the Suriname Health Study was used to derive optimal cut-off values for BMI and WC for the prediction of hypertension (n=4910) and cardio-metabolic risk (n=2924). Results from the analysis with Receiver Operating Curves were calculated and compared these with recommended values. The area under the ROC curve was consistently higher for WC compared to BMI among Creoles, Hindustani, Maroons and Mixed. The BMI cut-off values ranged from 24.8kg/m(2) for Creole men and 26.9kg/m(2) for Maroon women to 28.4kg/m(2) and 30.2kg/m(2) for Amerindian men and women, respectively. The WC cut-off values ranged from 80.7cm for Maroon men, 86.7cm for Javanese women to 90.8cm for Hindustani men and 95.7cm for Amerindian women. Optimal BMI cut-off values approximated Asian cut-off values from the World Health Organization whilst those of WC for men approximated and for women exceeded cut-off values from the International Diabetes Federation. In most ethnic groups, we found better discriminatory power for WC compared to BMI in the relation with cardiovascular risk factors. The estimated BMI and WC cut-off values differed between ethnic groups. Further studies are needed to identify cut-off values related to the future risk of cardiovascular disease and mortality. Copyright © 2016 Asia Oceania Association for the Study of Obesity. Published by Elsevier Ltd. All rights reserved.

  5. Well-posedness and Scattering for the Boltzmann Equations: Soft Potential with Cut-off

    NASA Astrophysics Data System (ADS)

    He, Lingbing; Jiang, Jin-Cheng

    2017-07-01

    We prove the global existence of the unique mild solution for the Cauchy problem of the cut-off Boltzmann equation for soft potential model γ =2-N with initial data small in L^N_{x,v} where N=2,3 is the dimension. The proof relies on the existing inhomogeneous Strichartz estimates for the kinetic equation by Ovcharov (SIAM J Math Anal 43(3):1282-1310, 2011) and convolution-like estimates for the gain term of the Boltzmann collision operator by Alonso et al. (Commun Math Phys 298:293-322, 2010). The global dynamics of the solution is also characterized by showing that the small global solution scatters with respect to the kinetic transport operator in L^N_{x,v}. Also the connection between function spaces and cut-off soft potential model -N<γ <2-N is characterized in the local well-posedness result for the Cauchy problem with large initial data.

  6. Edge plasmons and cut-off behavior of graphene nano-ribbon waveguides

    NASA Astrophysics Data System (ADS)

    Hou, Haowen; Teng, Jinghua; Palacios, Tomás; Chua, Soojin

    2016-07-01

    Graphene nano-ribbon waveguides with ultra-short plasmon wavelength are a promising candidate for nanoscale photonic applications. Graphene edge plasmons are the fundamental and lowest losses mode. Through finite element method, edge plasmons show large effective refractive index and strong field confinement on nanoscale ribbons. The edge plasmons follow a k1/2 dispersion relation. The wavelengths of the edge plasmons and center plasmons differ by a fixed factor. The width of edge plasmon is inversely proportional to wave vector of edge plasmon kedge. Edge defects associate with graphene nano-ribbon induce extra losses and reduce the propagation length. Cut-off width of edge plasmons reduces with increasing frequency. Cut-off width of center plasmon is enlarged by edge component but the enlargement effect diminishing with the increase of kedge. The results are important for the application of graphene plasmon towards ultra-compact photonic devices.

  7. Treatment of amitriptyline intoxications by extended high cut-off dialysis.

    PubMed

    Schmidt, Julius J; Bertram, Anna; Kühn-Velten, W Nikolaus; Suhling, Hendrik; Wiesner, Olaf; Schneider, Andrea; Kielstein, Jan T

    2015-12-01

    Antidepressants, especially amitriptyline, are among the most frequent drug classes involved in intoxications. Despite its small molecular weight, amitriptyline is not considered to be eliminated by extracorporeal treatment methods due to its high protein binding and large volume of distribution. New high cut-off dialysers have so far not been used for removal of amitriptyline. We report two cases of amitriptyline poisoning in which we measured the amitriptyline elimination using extended high cut-off (HCO) dialysis. Despite dialyser clearances of 33 and 58 mL/min, resulting in the reduction of initial serum concentrations by ∼30%, only 211 and 920 µg of amitryptilin, respectively, (<3% of the ingested amount) could be recovered in the total collected dialysate. Hence, due to the high volume of distribution of amitriptyline, even HCO dialysis does not contribute substantially to the extracorporeal removal of amitryptilin.

  8. Treatment of amitriptyline intoxications by extended high cut-off dialysis

    PubMed Central

    Schmidt, Julius J.; Bertram, Anna; Kühn-Velten, W. Nikolaus; Suhling, Hendrik; Wiesner, Olaf; Schneider, Andrea; Kielstein, Jan T.

    2015-01-01

    Antidepressants, especially amitriptyline, are among the most frequent drug classes involved in intoxications. Despite its small molecular weight, amitriptyline is not considered to be eliminated by extracorporeal treatment methods due to its high protein binding and large volume of distribution. New high cut-off dialysers have so far not been used for removal of amitriptyline. We report two cases of amitriptyline poisoning in which we measured the amitriptyline elimination using extended high cut-off (HCO) dialysis. Despite dialyser clearances of 33 and 58 mL/min, resulting in the reduction of initial serum concentrations by ∼30%, only 211 and 920 µg of amitryptilin, respectively, (<3% of the ingested amount) could be recovered in the total collected dialysate. Hence, due to the high volume of distribution of amitriptyline, even HCO dialysis does not contribute substantially to the extracorporeal removal of amitryptilin. PMID:26613042

  9. "Cut-off" effect of antioxidants and/or probes of variable lipophilicity in microheterogeneous media.

    PubMed

    Aliaga, Carolina; López de Arbina, Amaia; Rezende, Marcos Caroli

    2016-09-01

    The activities of two hydrophilic (ascorbic acid and Trolox) and two hydrophobic (α-tocopherol and BHT) antioxidants were measured by reaction with a series of 4-alkanoyloxyTEMPO radical probes 1 in buffered (pH 7), aqueous, micellar solutions of reduced Triton-X 100. In all cases, a cut-off effect was observed, in line with previous observations of the same effect for the partitioning of probe series 1 in this medium. These results support an interpretation of the cut-off effect in food emulsions, based on the "amphiphobic" nature of either the antioxidants or probes: competition between two molecular moieties, for the micellar hydrophobic core, tends to expose a reacting fragment differently to a more hydrophilic microenvironment, as the probe or antioxidant hydrophobicity increases.

  10. Validity of Alternative Cut-Off Scores for the Back-Saver Sit and Reach Test

    ERIC Educational Resources Information Center

    Looney, Marilyn A.; Gilbert, Jennie

    2012-01-01

    The purpose of the study was to determine if currently used FITNESSGRAM[R] cut-off scores for the Back Saver Sit and Reach Test had the best criterion-referenced validity evidence for 6-12 year old children. Secondary analyses of an existing data set focused on the passive straight leg raise and Back Saver Sit and Reach Test flexibility scores of…

  11. Resonances in Cut-Off Potentials Determined by the Exterior Complex-Scaling Method

    NASA Astrophysics Data System (ADS)

    Jaimes-Nájera, A.

    2017-05-01

    The resonances of one-dimensional short-range potentials defined by a cutoff are analyzed in terms of a modification of the well known complex-scaling method. Such a modification consists in transforming the eigenfunctions only in the zone where the potential is identically zero. As usual, the complex-scaled Hamiltonian is non-Hermitian and the functions that represent resonances become square-integrable. The method is illustrated by calculating the resonances of a concrete cut-off potential.

  12. Rise time of proton cut-off energy in 2D and 3D PIC simulations

    NASA Astrophysics Data System (ADS)

    Babaei, J.; Gizzi, L. A.; Londrillo, P.; Mirzanejad, S.; Rovelli, T.; Sinigardi, S.; Turchetti, G.

    2017-04-01

    The Target Normal Sheath Acceleration regime for proton acceleration by laser pulses is experimentally consolidated and fairly well understood. However, uncertainties remain in the analysis of particle-in-cell simulation results. The energy spectrum is exponential with a cut-off, but the maximum energy depends on the simulation time, following different laws in two and three dimensional (2D, 3D) PIC simulations so that the determination of an asymptotic value has some arbitrariness. We propose two empirical laws for the rise time of the cut-off energy in 2D and 3D PIC simulations, suggested by a model in which the proton acceleration is due to a surface charge distribution on the target rear side. The kinetic energy of the protons that we obtain follows two distinct laws, which appear to be nicely satisfied by PIC simulations, for a model target given by a uniform foil plus a contaminant layer that is hydrogen-rich. The laws depend on two parameters: the scaling time, at which the energy starts to rise, and the asymptotic cut-off energy. The values of the cut-off energy, obtained by fitting 2D and 3D simulations for the same target and laser pulse configuration, are comparable. This suggests that parametric scans can be performed with 2D simulations since 3D ones are computationally very expensive, delegating their role only to a correspondence check. In this paper, the simulations are carried out with the PIC code ALaDyn by changing the target thickness L and the incidence angle α, with a fixed a0 = 3. A monotonic dependence, on L for normal incidence and on α for fixed L, is found, as in the experimental results for high temporal contrast pulses.

  13. Establishment of triglyceride cut-off values to detect chylous ascites and pleural effusions.

    PubMed

    Thaler, Markus A; Bietenbeck, Andreas; Schulz, Christoph; Luppa, Peter B

    2017-02-01

    Lipoprotein electrophoresis is the gold standard for the detection of chylous ascites and pleural effusions. It is, however, not suitable as a front-line test and not widely available. Most clinicians must rely solely on the quantitative determination of lipids. The aim of this work was to establish lipid cut-off values for the presence of chylomicrons in pleural and peritoneal fluid. Triglyceride and cholesterol levels from 113 peritoneal and 154 pleural fluid samples investigated for chylomicrons via lipoprotein electrophoresis were considered. Receiver operating characteristic analyses were performed and cut-off levels determined. 54 peritoneal and 59 pleural fluid samples were positive for chylomicrons. In peritoneal fluid, triglycerides and triglycerides/cholesterol ratio exhibited areas under the curve (AUC) not significantly different from each other, but significantly larger than cholesterol alone. The AUC for triglycerides in pleural fluid was significantly larger than the AUCs for cholesterol and the triglycerides/cholesterol ratio. Triglyceride cut-offs with maximum Youden-Index, sensitivity >95%, and specificity >95% were calculated to be 187, 148, and 246mg/dl (2.13, 1.69, and 2.80mmol/l) for peritoneal fluid, and 240, 94, and 240mg/dl (2.74, 1.07, and 2.74mmol/l) for pleural fluid. Triglyceride levels are the best parameter to detect chylous body fluids when lipoprotein electrophoresis is not available. Single-point triglyceride cut-offs of 187 and 240mg/dl (2.13 and 2.74mmol/l) or alternatively equivocal ranges of 148-246 and 94-240mg/dl (1.69-2.80 and 1.07-2.74mmol/l) were established for peritoneal and pleural fluid, respectively. Copyright © 2016 The Canadian Society of Clinical Chemists. Published by Elsevier Inc. All rights reserved.

  14. Denseness of Ashtekar Lewandowski states and a generalized cut-off in loop quantum gravity

    NASA Astrophysics Data System (ADS)

    Velhinho, J. M.

    2005-07-01

    We show that the set of states of the Ashtekar Isham Lewandowski holonomy algebra defined by elements of the Ashtekar Lewandowski Hilbert space is dense in the space of all states. We consider weak convergence properties of a modified version of the cut-off procedure currently in use in loop quantum gravity. This version is adapted to vector states rather than to general distributions.

  15. Solutions to the 1d Klein Gordon equation with cut-off Coulomb potentials

    NASA Astrophysics Data System (ADS)

    Hall, Richard L.

    2007-12-01

    In a recent paper by Barton [G. Barton, J. Phys. A: Math. Gen. 40 (2007) 1011], the 1-dimensional Klein Gordon equation was solved analytically for the non-singular Coulomb-like potential V(|x|)=-α/(|x|+a). In the present Letter, these results are completely confirmed by a numerical formulation that also allows a solution for an alternative cut-off Coulomb potential V(|x|)=-α/|x|, |x|>a, and otherwise V(|x|)=-α/a.

  16. Determining cut-off points in functional assessment scales in stroke.

    PubMed

    Balasch i Bernat, Mercè; Balasch i Parisi, Sebastiá; Sebastián, Enrique Noé; Moscardó, Lirios Dueñas; Ferri Campos, Joan; López Bueno, Laura

    2015-01-01

    A wide variety of well-validated assessment scales of functioning and disability have been developed for stroke population. However, these instruments have limitations in their interpretation. Therefore, determining cut-off points for their categorization becomes necessary. To determine cut-off points for the BI, FIM and FAM scales to differentiate clinical disability categories and to establish the relationship between mRS and DOS scales. One hundred and six adults with ischemic or haemorrhagic stroke were mainly recruited from a rehabilitation facility (Hospitales Nisa, Valencia, Spain). A high correlation was observed between the DOS and mRS scales (Kendall's tau-b = 0.475; p = 0.000) although a certain amount of disagreement between the two scales was detected. The cut-off points were 62.90 (95% CI, 57.26-69.29) and 21.30 (95% CI, 16.34-26.03) for the BI; 70.62 (95% CI, 66.65-75.22) and 38.29 (95% CI, 34.07-42.25) for the FIM; and 116.07 (95% CI, 110.30-122.68) and 66.02 (95% CI, 59.20-72.35) for the FAM. DOS was observed to be more demanding than the mRS, in terms of patient independence. Additionally, the lower cut-off points separating the levels of severe and moderate disability in the BI, FIM and FAM were determined. These findings would facilitate practitioners clinical interpretation of disability levels in post-stroke patients.

  17. Evaluation of Serum Cotinine Cut-Off to Distinguish Smokers From Nonsmokers in the Korean Population

    PubMed Central

    Ko, Kiwoong; Yang, Song-Hyun; Moon, Chul-Jin; Lee, Eun Hee; Park, Hyosoon

    2016-01-01

    Background Cotinine has been widely used as an objective marker to identify current smokers. We conducted this study to address the absence of Korean studies investigating the efficacy of immunoassays and liquid chromatography–tandem mass spectrometry (LC-MS/MS) for the detection of serum cotinine and to determine the optimal serum cotinine cut-off level for differentiating current smokers from nonsmokers. Methods Serum specimens were obtained from 120 subjects. They were randomly chosen to represent a broad distribution of urine cotinine levels based on a retrospective review of questionnaires and results of urine cotinine levels. We determined serum cotinine levels using the IMMULITE 2000 XPi Immunoassay System (Siemens Healthcare Diagnostics Inc., USA) and LC-MS/MS (API-4000, Applied Biosystems, USA). Correlation was analyzed between IMMULITE serum cotinine, urine cotinine, and LC-MS/MS serum cotinine levels. ROC curve was analyzed to identify the optimal IMMULITE serum cotinine cut-off level for differentiating current smokers from nonsmokers. Results IMMULITE serum cotinine levels correlated with both urine cotinine and LC-MS/MS serum cotinine levels, with correlation coefficients of 0.958 and 0.986, respectively. The optimal serum cotinine cut-off level for distinguishing current smokers from nonsmokers was 13.2 ng/mL (95.7% sensitivity, 94.1% specificity) using IMMULITE. Conclusions This is the first study to investigate the use of LC-MS/MS for the measurement of serum cotinine and to determine the optimal serum cotinine cut-off level for the IMMULITE immunoassay. Our results could provide guidelines for differentiating current smokers from nonsmokers in the Korean population. PMID:27374707

  18. Equilibrium properties of blackbody radiation with an ultraviolet energy cut-off

    NASA Astrophysics Data System (ADS)

    Mishra, Dheeraj Kumar; Chandra, Nitin; Vaibhav, Vinay

    2017-10-01

    We study various equilibrium thermodynamic properties of blackbody radiation (i.e. a photon gas) with an ultraviolet energy cut-off. We find that the energy density, specific heat etc. follow usual acoustic phonon dynamics as have been well studied by Debye. Other thermodynamic quantities like pressure, entropy etc. have also been calculated. The usual Stefan-Boltzmann law gets modified. We observe that the values of the thermodynamic quantities with the energy cut-off is lower than the corresponding values in the theory without any such scale. The phase-space measure is also expected to get modified for an exotic spacetime appearing at Planck scale, which in turn leads to the modification of Planck energy density distribution and the Wien's displacement law. We found that the non-perturbative nature of the thermodynamic quantities in the SR limit (for both unmodified and modified cases), due to nonanalyticity of the leading term, is a general feature of the theory accompanied with an ultraviolet energy cut-off. We have also discussed the possible modification in the case of Big Bang and the Stellar objects and have suggested a table top experiment for verification in effective low energy case.

  19. ASEA 60/2 industrial robot project Bardons and Oliver cut-off lathe application

    SciTech Connect

    Sherman, S.J.

    1988-01-25

    The scope of this document is to define a test plan for the testing of the ASEA 60/2 industrial robot at the Bardons and Oliver (B and O) cut-off lathe in Plant 6. This test plan describes the administrative procedures to be used and the general responsibilities of the Westinghouse Materials Company of Ohio (WMCO) organizations which are most involved in the preparation, coordination, and conduct of the installation, startup, and testing. Any deviations to this procedure will be approved by the test coordinator, Manager, Development, and Plant 6 Supervisor. The purpose of this test is to evaluate the ASEA 60/2 industrial robot to determine the feasibility of implementing a robot at the Bardons and Oliver cut-off lathe in Plant 6 for material handling purposes. This robot will be used as a developmental robot in that it will be installed temporarily at the B and O and then be relocated to another application. The robot will be used for training purposes to familiarize personnel with programming, computer usage, maintenance, and operation of the robot. Radiation exposure reduction of the machine tool operators in Plant 6 will also be determined. Success of the testing will be measured by the amount of radiation exposure reduction and determining the complexity of incorporating automated machinery with the B and O cut-off lathe utilizing a robot.

  20. Clustered star formation as a natural explanation for the Halpha cut-off in disk galaxies.

    PubMed

    Pflamm-Altenburg, Jan; Kroupa, Pavel

    2008-10-02

    The rate of star formation in a galaxy is often determined by the observation of emission in the Halpha line, which is related to the presence of short-lived massive stars. Disk galaxies show a strong cut-off in Halpha radiation at a certain galactocentric distance, which has led to the conclusion that star formation is suppressed in the outer regions of disk galaxies. This is seemingly in contradiction to recent observations in the ultraviolet which imply that disk galaxies have star formation beyond the Halpha cut-off, and that the star-formation-rate surface density is linearly related to the underlying gas surface density, which is a shallower relationship than that derived from Halpha luminosities. In a galaxy-wide formulation, the clustered nature of star formation has recently led to the insight that the total galactic Halpha luminosity is nonlinearly related to the galaxy-wide star formation rate. Here we show that a local formulation of the concept of clustered star formation naturally leads to a steeper radial decrease in the Halpha surface luminosity than in the star-formation-rate surface density, in quantitative agreement with the observations, and that the observed Halpha cut-off arises naturally.

  1. Evaluation of Novel Large Cut-Off Ultrafiltration Membranes for Adenovirus Serotype 5 (Ad5) Concentration

    PubMed Central

    Peixoto, Cristina; Roederstein, Susanne; Schleuss, Tobias; Alves, Paula M.; Mota, José P. B.; Carrondo, Manuel J. T.

    2014-01-01

    The purification of virus particles and viral vectors for vaccine and gene therapy applications is gaining increasing importance in order to deliver a fast, efficient, and reliable production process. Ultrafiltration (UF) is a widely employed unit operation in bioprocessing and its use is present in several steps of the downstream purification train of biopharmaceuticals. However, to date few studies have thoroughly investigated the performance of several membrane materials and cut-offs for virus concentration/diafiltration. The present study aimed at developing a novel class of UF cassettes for virus concentration/diafiltration. A detailed study was conducted to evaluate the effects of (i) membrane materials, namely polyethersulfone (PES), regenerated cellulose (RC), and highly cross-linked RC (xRC), (ii) nominal cut-off, and (iii) UF device geometry at different production scales. The results indicate that the xRC cassettes with a cut-off of approximately 500 kDa are able to achieve a 10-fold concentration factor with 100% recovery of particles with a process time twice as fast as that of a commercially available hollow fiber. DNA and host cell protein clearances, as well as hydraulic permeability and fouling behavior, were also assessed. PMID:25546428

  2. Cut-off proposal for the detection of ketamine in hair.

    PubMed

    Salomone, A; Gerace, E; Diana, P; Romeo, M; Malvaso, V; Di Corcia, D; Vincenti, M

    2015-03-01

    Ketamine is a powerful anesthetic drug used in both human and veterinary surgery, but it is also commonly misused because of its psychotropic properties. Since the abuse of this drug has been reported in many countries worldwide, its determination in hair samples is offered as a specialist test by hundreds of laboratories. However, unlike other common drugs of abuse, a cut-off level for ketamine in hair has not been fixed yet. Therefore, aim of this study is to propose a concentration value for ketamine in hair analysis, in order to discriminate between chronic and occasional use, and between active use and external contamination. After considering the chemical properties of this molecule, and the experimental data collected in our laboratory or reported in several other published studies, we propose a cut-off level of 0.5ng/mg, as indicative of repeated exposure to ketamine. Additionally, we suggest that the detection of the metabolite norketamine should be mandatory to prove active intake and exclude false positive result from external contamination. Thus, a reasonable cut-off value for norketamine could be fixed at 0.1ng/mg, while the minimal concentration ratio norketamine/ketamine may be positively established at 0.05.

  3. Systematic review of the evidence for Trails B cut-off scores in assessing fitness-to-drive

    PubMed Central

    Roy, Mononita; Molnar, Frank

    2013-01-01

    Background Fitness-to-drive guidelines recommend employing the Trail Making B Test (a.k.a. Trails B), but do not provide guidance regarding cut-off scores. There is ongoing debate regarding the optimal cut-off score on the Trails B test. The objective of this study was to address this controversy by systematically reviewing the evidence for specific Trails B cut-off scores (e.g., cut-offs in both time to completion and number of errors) with respect to fitness-to-drive. Methods Systematic review of all prospective cohort, retrospective cohort, case-control, correlation, and cross-sectional studies reporting the ability of the Trails B to predict driving safety that were published in English-language, peer-reviewed journals. Results Forty-seven articles were reviewed. None of the articles justified sample sizes via formal calculations. Cut-off scores reported based on research include: 90 seconds, 133 seconds, 147 seconds, 180 seconds, and < 3 errors. Conclusions There is support for the previously published Trails B cut-offs of 3 minutes or 3 errors (the ‘3 or 3 rule’). Major methodological limitations of this body of research were uncovered including (1) lack of justification of sample size leaving studies open to Type II error (i.e., false negative findings), and (2) excessive focus on associations rather than clinically useful cut-off scores. PMID:23983828

  4. A review of the cut-off points for the diagnosis of vitamin B12 deficiency in the general population.

    PubMed

    Aparicio-Ugarriza, Raquel; Palacios, Gonzalo; Alder, Monika; González-Gross, Marcela

    2015-07-01

    Vitamin B12 deficit is one of the most common vitamin deficiencies. However, there is no consensus on the cut-off points for vitamin B12 and its co-markers, such as folate, holotranscobalamin, methylmalonic acid and homocysteine. In order to establish the state of the art about cut-off points used to determine vitamin B12 deficiency in the last decades, the database MEDLINE was used for searching studies published in adults between December 1992 and May 2014 (69 articles), using search terms like 'vitamin B12', 'cobalamin', 'cut-off', 'deficiency' alone or in combinations. Broad ranges of cut-off points for vitamin B12 and its biomarkers were identified: vitamin B12 ranged between 100 pmol/L and 350 pmol/L, holotranscobalamin 20-50 pmol/L, methylmalonic acid 0.210-0.470 μmol/L, homocysteine 10-21.6 μmol/L, serum folate 3.7-15.9 nmol/L and red blood cell 124-397 nmol/L. For the majority of studies, the potential influence of age, analytical methods, gender and fortified food consumption was not taken in account when choosing cut-off values. This could explain the discrepancies between studies on vitamin B12 and folate deficiency prevalences. We conclude that there is inconsistency in the literature regarding vitamin B12 cut-offs. It would be necessary to establish different reference cut-offs according to age, considering the analytical methods used.

  5. A cut-off value of basal serum calcitonin for detecting macroscopic medullary thyroid carcinoma.

    PubMed

    Kwon, Hyemi; Kim, Won Gu; Choi, Yun Mi; Jang, Eun Kyung; Jeon, Min Ji; Song, Dong Eun; Baek, Jung Hwan; Ryu, Jin-Sook; Hong, Suck Joon; Kim, Tae Yong; Kim, Won Bae; Shong, Young Kee

    2015-04-01

    Serum calcitonin (CT) level is used to detect medullary thyroid carcinoma (MTC), but the cut-off level is unclear. We aimed at identifying the optimal cut-off value of basal serum CT levels for detecting MTC. We retrospectively enrolled patients with hypercalcitoninemia (≥2·9 pmol/l) who had undergone thyroid ultrasonography (US) and subsequent work-up between 2001 and 2013 at Asan Medical Center. We divided patients into four groups: proven MTC (group 1, n = 93), pathologically proven non-MTC after surgery (group 2, n = 57), benign single nodule by cytology (group 3, n = 68) and patients without nodules on US (group 4, n = 24). Basal serum CT levels were evaluated. The median CT level of group 1 (119·5 pmol/l) was significantly higher than those of other groups (4·0, 3·8 and 3·8 pmol/l, P < 0·001). When we adopted 19·0 pmol/l of CT level as a cut-off value, the sensitivity, specificity, and positive and negative predictive values were 77·4%, 98·7%, 97·3% and 87·8%, respectively. When we compared 29·2 pmol/l (100 pg/ml) and 19·0 pmol/l (65 pg/ml) as cut-off values, 19·0 pmol/l was more sensitive and accurate than 29·2 pmol/l. Factors associated with hypercalcitoninemia in non-MTC groups were autoimmune thyroiditis, chronic kidney disease, proton pump inhibitors and other malignancies. Serum CT levels tended to decrease spontaneously in non-MTC groups. Basal serum CT levels higher than 19·0 pmol/l can be a useful cut-off value for detecting macroscopic MTC, even though values below 19·0 pmol/l cannot exclude the presence of MTC like small volume MTC or premalignant C-cell hyperplasia. © 2014 John Wiley & Sons Ltd.

  6. Defining a BMI Cut-Off Point for the Iranian Population: The Shiraz Heart Study

    PubMed Central

    Babai, Mohammad Ali; Arasteh, Peyman; Hadibarhaghtalab, Maryam; Naghizadeh, Mohammad Mehdi; Salehi, Alireza; Askari, Alireza; Homayounfar, Reza

    2016-01-01

    In this study we evaluated and redefined the optimum body mass index (BMI) cut-off point for the Iranian population based on metabolic syndrome (MeS) risk factors. We further evaluated BMI cut-off points with and without waist circumference (WC) as a cofactor of risk and compared the differences. This study is part of the largest surveillance programs conducted in Shiraz, Iran, termed the Shiraz Heart study. Our study sample included subjects between the ages of 20 to 65 years old. After excluding pregnant women, those with missing data and those with comorbid disease, a total of 12283 made up the study population. The participants underwent a series of tests and evaluations by trained professionals in accordance with WHO recommendations. Hypertension, abnormal fasting blood sugar (FBS), triglyceride (TG) and high density lipoprotein cholesterol (HDL) (in the context of the definition of metabolic syndrome) were prevalent among 32.4%, 27.6%, 42.1 and 44.2% of our participants, respectively. Women displayed higher rates of overall obesity compared to men (based on the definition by the WHO as higher than 30 kg/m2). Regarding MeS, 38.9% of our population had the all symptoms of MeS which was more prevalent among women (41.5% vs. 36%). When excluding WC in the definition of MeS, results showed that males tend to show a higher rate of metabolic risk factors (19.2% vs. 15.6%). Results of multivariate analysis showed that parallel to an increase in BMI, the odds ratio (OR) for acquiring each component of the metabolic syndrome increased (OR = 1.178; CI: 1.166–1.190). By excluding WC, the previous OR decreased (OR = 1.105; CI: 1.093–1.118). Receiver Operating Characteristic (ROC) curve analysis showed that the optimum BMI cut-off point for predicting metabolic syndrome was 26.1 kg/m2 and 26.2 kg/m2 [Accuracy (Acc) = 69% and 61%, respectively)] for males and females, respectively. The overall BMI cut-off for both sexes was 26.2 kg/m2 (Acc = 65%) with sensitivity and

  7. Comparing Approaches to Optimize Cut-off Scores for Short Cognitive Screening Instruments in Mild Cognitive Impairment and Dementia

    PubMed Central

    O’Caoimh, Rónán; Gao, Yang; Svendovski, Anton; Gallagher, Paul; Eustace, Joseph; Molloy, D. William

    2017-01-01

    Background: Although required to improve the usability of cognitive screening instruments (CSIs), the use of cut-off scores is controversial yet poorly researched. Objective: To explore cut-off scores for two short CSIs: the Standardized Mini-Mental State Examination (SMMSE) and Quick Mild Cognitive Impairment (Qmci) screen, describing adjustments in scores for diagnosis (MCI or dementia), age (≤, >75 years), and education (<, ≥12 years), comparing two methods: the maximal accuracy approach, derived from receiver operating characteristic curves, and Youden’s Index. Methods: Pooled analysis of assessments from patients attending memory clinics in Canada between 1999–2010 : 766 with mild cognitive impairment (MCI) and 1,746 with dementia, and 875 normal controls. Results: The Qmci was more accurate than the SMMSE in differentiating controls from MCI or cognitive impairment (MCI and dementia). Employing the maximal accuracy approach, the optimal SMMSE cut-off for cognitive impairment was <28/30 (AUC 0.86, sensitivity 74%, specificity 88%) versus <63/100 for the Qmci (AUC 0.93, sensitivity 85%, specificity 85%). Using Youden’s Index, the optimal SMMSE cut-off remained <28/30 but fell slightly to <62/100 for the Qmci (sensitivity 83%, specificity 87%). The optimal cut-off for MCI was <29/30 for the SMMSE and <67/100 for the Qmci, irrespective of technique. The maximal accuracy approach generally produced higher Qmci cut-offs than Youden’s Index, both requiring adjustment for age and education. There were no clinically meaningful differences in SMMSE cut-off scores by age and education or method employed. Conclusion: Caution should be exercised selecting cut-offs as these differ by age, education, and method of derivation, with the extent of adjustment varying between CSIs. PMID:28222528

  8. Cut-off wavenumber of Alfvén waves in partially ionized plasmas of the solar atmosphere

    NASA Astrophysics Data System (ADS)

    Zaqarashvili, T. V.; Carbonell, M.; Ballester, J. L.; Khodachenko, M. L.

    2012-08-01

    Context. Alfvén wave dynamics in partially ionized plasmas of the solar atmosphere shows that there is indeed a cut-off wavenumber, i.e. the Alfvén waves with wavenumbers higher than the cut-off value are evanescent. The cut-off wavenumber appears in single-fluid magnetohydrodynamic (MHD) approximation but it is absent in a multi-fluid approach. Up to now, an explanation for the existence of the cut-off wavenumber is still missing. Aims: The aim of this paper is to point out the reason for the appearance of a cut-off wavenumber in single-fluid MHD. Methods: Beginning with three-fluid equations (with electrons, protons and neutral hydrogen atoms), we performed consecutive approximations until we obtained the usual single-fluid description. We solved the dispersion relation of linear Alfvén waves at each step and sought the approximation responsible of the cut-off wavenumber appearance. Results: We have found that neglecting inertial terms significantly reduces the real part of the Alfvén frequency although it never becomes zero. Therefore, the cut-off wavenumber does not exist at this stage. However, when the inertial terms together with the Hall term in the induction equation are neglected, the real part of the Alfvén frequency becomes zero. Conclusions: The appearance of a cut-off wavenumber, when Alfvén waves in partially ionized regions of the solar atmosphere are studied, is the result of neglecting inertial and Hall terms, therefore it has no physical origin.

  9. Revisiting AdS/CFT at a finite radial cut-off

    NASA Astrophysics Data System (ADS)

    Mandal, Gautam; Nayak, Pranjal

    2016-12-01

    We revisit AdS/CFT at a finite radial cut-off, specifically in the context of double trace perturbations, O_n=O(x){({partial}^2)}^nO(x) , with arbitrary powers n. As well-known, the standard GKPW prescription, applied to a finite radial cut-off, leads to contact terms in correlators. de Haro et al. [1] introduced bulk counterterms to remove these. This prescription, however, yields additional terms in the correlator corresponding to spurious double trace deformations. Further, if we view the GKPW prescription coupled with the prescription in [1], in terms of a boundary wavefunction, we find that it is incompatible with radial Schrödinger evolution (in the spirit of holographic Wilsonian RG). We consider a more general wavefunction satisfying the Schrödinger equation, and find that generically such wavefunctions generate both (a) double trace deformations and (b) contact terms. However, we find that there exist special choices of these wavefunctions, amounting to a new AdS/CFT prescription at a finite cut-off, so that both (a) and (b) are removed and we obtain a pure power law behaviour for the correlator. We compare these special wavefunctions with a specific RG scheme in field theory. We give a geometric interpretation of these wavefunctions; these correspond to some specific smearing of boundary points in the Witten diagrams. We present a comprehensive calculation of exact double-trace beta-functions for all couplings O_n and match with a holographic computation using the method described above. The matching works with a mapping between the field theory and bulk couplings; such a map is highly constrained because the beta-functions are quadratic and exact on both sides. Our discussions include a generalization of the standard double-trace Wilson-Fisher flow to the space of the infinite number of couplings.

  10. Cut-off values of blessed dementia rating scale and its clinical application in elderly Taiwanese.

    PubMed

    Yang, Yuan-Han; Lai, Chiou-Lian; Lin, Ruey-Tay; Tai, Chih-Ta; Liu, Ching-Kuan

    2006-08-01

    Although the Blessed Dementia Rating Scale (BDRS), a clinical screening instrument, has been applied extensively, no suitable cut-off values and clinical application have been proposed, particularly in mild cognitive impairment (MCI), the precursor of dementia. The BDRS, Mini Mental State Examination (MMSE), and Clinical Dementia Rating Scale (CDR) were administrated in people aged 65 years and above, who were enrolled from southern Taiwan with multistep stratified random sampling and followed-up for 2 years. All subjects (total number = 3,027), with new onset of MCI (defined as CDR = 0.5) in the first year and dementia (defined as CDR > or = 1) in the second and third years were subjected to statistical analysis. In distinguishing normal from MCI, except in the literate group aged 65-74 years, MMSE was superior to BDRS, with cut-off values of 1 in both literate groups aged 65-74 years and > or = 75 years, and 1.5 and 2 in less educated groups aged 65-74 and > or = 75 years, respectively. In distinguishing MCI from dementia, BDRS had cut-off values of 2.5 in both literate groups aged 65-74 and > or = 75 years, and 2.5 and 3 in less educated groups aged 65-74 and > or = 75 years, respectively. These values were better than those for MMSE in all groups. BDRS might be considered as a better tool than MMSE to screen for MCI and dementia in the increasing proportion of literate elderly aged 65-74 years in the aging population.

  11. Child obesity cut-offs as derived from parental perceptions: cross-sectional questionnaire.

    PubMed

    Black, James A; Park, MinHae; Gregson, John; Falconer, Catherine L; White, Billy; Kessel, Anthony S; Saxena, Sonia; Viner, Russell M; Kinra, Sanjay

    2015-04-01

    Overweight children are at an increased risk of premature mortality and disease in adulthood. Parental perceptions and clinical definitions of child obesity differ, which may lessen the effectiveness of interventions to address obesity in the home setting. The extent to which parental and objective weight status cut-offs diverge has not been documented. To compare parental perceived and objectively derived assessment of underweight, healthy weight, and overweight in English children, and to identify sociodemographic characteristics that predict parental under- or overestimation of a child's weight status. Cross-sectional questionnaire completed by parents linked with objective measurement of height and weight by school nurses, in English children from five regions aged 4-5 and 10-11 years old. Parental derived cut-offs for under- and overweight were derived from a multinomial model of parental classification of their own child's weight status against school nurse measured body mass index (BMI) centile. Measured BMI centile was matched with parent classification of weight status in 2976 children. Parents become more likely to classify their children as underweight when they are at the 0.8th centile or below, and overweight at the 99.7th centile or above. Parents were more likely to underestimate a child's weight if the child was black or South Asian, male, more deprived, or the child was older. These values differ greatly from the BMI centile cut-offs for underweight (2nd centile) and overweight (85th). Clinical and parental classifications of obesity are divergent at extremes of the weight spectrum. © British Journal of General Practice 2015.

  12. Enhanced trans-Himalaya pollution transport to the Tibetan Plateau by cut-off low systems

    NASA Astrophysics Data System (ADS)

    Zhang, Ruixiong; Wang, Yuhang; He, Qiusheng; Chen, Laiguo; Zhang, Yuzhong; Qu, Hang; Smeltzer, Charles; Li, Jianfeng; Alvarado, Leonardo M. A.; Vrekoussis, Mihalis; Richter, Andreas; Wittrock, Folkard; Burrows, John P.

    2017-02-01

    Long-range transport followed by deposition of black carbon on glaciers of Tibet is one of the key issues of climate research as it induces changes on radiative forcing and subsequently impacting the melting of glaciers. The transport mechanism, however, is not well understood. In this study, we use short-lived reactive aromatics as proxies to diagnose transport of pollutants to Tibet. In situ observations of short-lived reactive aromatics across the Tibetan Plateau are analyzed using a regional chemistry and transport model. The model performance using the current emission inventories over the region is poor due to problems in the inventories and model transport. Top-down emissions constrained by satellite observations of glyoxal are a factor of 2-6 higher than the a priori emissions over the industrialized Indo-Gangetic Plain. Using the top-down emissions, agreement between model simulations and surface observations of aromatics improves. We find enhancements of reactive aromatics over Tibet by a factor of 6 on average due to rapid transport from India and nearby regions during the presence of a high-altitude cut-off low system. Our results suggest that the cut-off low system is a major pathway for long-range transport of pollutants such as black carbon. The modeling analysis reveals that even the state-of-the-science high-resolution reanalysis cannot simulate this cut-off low system accurately, which probably explains in part the underestimation of black carbon deposition over Tibet in previous modeling studies. Another model deficiency of underestimating pollution transport from the south is due to the complexity of terrain, leading to enhanced transport. It is therefore challenging for coarse-resolution global climate models to properly represent the effects of long-range transport of pollutants on the Tibetan environment and the subsequent consequence for regional climate forcing.

  13. Cut-off effect of radical TEMPO derivatives in olive oil-in-water emulsions.

    PubMed

    Lopez de Arbina, Amaia; Rezende, Marcos Caroli; Aliaga, Carolina

    2017-06-01

    Three oil-in-water emulsions were prepared from mixtures of olive oil and Tween 20 in water. The effectiveness of a series of radical 2,2,6,6-tetramethylpiperidinoxyl (TEMPO) derivatives of variable lipophilicity in reactions with antioxidant Trolox, and as pyrene-fluorescence quenchers, was compared in the three emulsions. A "cut-off" effect was observed for the pyrene quenching by the probes, but not for their reaction with Trolox. The results were rationalized in terms of the amphiphobic nature of the probes, and the different locations of probe, pyrene and Trolox in the three-phase microheterogeneous systems. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. Observation and calculation of trapped modes near cut-off in the ALS bellow-shield

    SciTech Connect

    Corlett, J.N.

    1996-06-01

    Observed heating of the RF shields in the bellows of the Advanced Light Source (ALS) storage ring has led to studies of possible causes. One such possibility is resonant impedances near the cut-off frequency of the beam-pipe that arise from small, localized, enlargements of the beampipe cross-section. Calculations of trapped modes in the elliptical-section vacuum chamber, approximated by a rectangular geometry, are described. Measurements of a bellows-shield in the test laboratory are also described, as are temperature measurements of a flexband in the storage ring.

  15. Interstellar Flow Longitude from Pickup Ion Cut-off Observations at 1 AU

    NASA Astrophysics Data System (ADS)

    Moebius, E.; Lee, M. A.; Gloeckler, G.; Drews, C.

    2015-12-01

    The precise determination of the interstellar neutral (ISN) flow direction is important in several different ways. As a cardinal axis of the heliosphere it has strong leverage on the plane subtended by the ISN velocity and interstellar magnetic field vector, which controls the shape of the heliosphere and its interaction with the interstellar medium. The observation of the ISN flow through the heliosphere for several decades has initiated a discussion about potential temporal variations in the ISN flow. To tackle these questions, a precision measurement of the ISN flow velocity vector is needed over a long time period. Recent efforts to obtain a consistent ISN vector and temperature with Ulysses and IBEX point to remaining uncertainties and potential systematic effects. In particular, IBEX measurements provide a very precise relation between ISN flow longitude and speed via the hyperbolic trajectory equation, but they contain larger uncertainties separately for longitude and speed. Pickup ion (PUI) observations of the ISN flow pattern at 1 AU can provide a complementary determination of the flow longitude with high precision. The interstellar PUI cut-off speed is a function of the ratio of the radial ISN flow component and the solar wind speed at the observer location [Möbius et al., 1999, GRL, 26, 3181]. We have compared STEREO A PLASTIC observations with a simple analytic model of the cut-off and performed a Pearson correlation analysis of the cut-off as a function of ecliptic longitude with its mirrored function. The two complementary approaches demonstrate that the ISN flow longitude can be obtained with a precision on the order of 0.1o. The cut-off speed is much less sensitive to systematic effects on PUIs, such as variations in the solar wind parameters, ionization, and transport. ACE SWICS, STEREO PLASTIC, and SOHO CTOF data are available that span almost two decades, which will allow long term studies with high precision. The availability of O and Ne PUI

  16. Detection of stratosphere troposphere exchange in cut-off low systems

    NASA Technical Reports Server (NTRS)

    Price, Jeremy D.; Vaughan, Geraint

    1994-01-01

    The Aberystwyth MST radar has been used as part of the TOASTE program to study the structure of the tropopause in cut-off-low system with an aim to identifying regions where stratosphere-troposphere exchange are taking place. Theory predicts that the vertical gradient in reflected power is proportional to the static stability of the reflecting region, and should therefore resolve tropopause structure. Comparisons of MST power profiles with radiosonde data are presented and show good agreement, revealing regions of indefinite tropopauses, where stratosphere-troposphere exchange is thought to take place. The continuous nature of MST data allows an estimation of the size of these regions.

  17. Color filters including infrared cut-off integrated on CMOS image sensor.

    PubMed

    Frey, Laurent; Parrein, Pascale; Raby, Jacques; Pellé, Catherine; Hérault, Didier; Marty, Michel; Michailos, Jean

    2011-07-04

    A color image was taken with a CMOS image sensor without any infrared cut-off filter, using red, green and blue metal/dielectric filters arranged in Bayer pattern with 1.75 µm pixel pitch. The three colors were obtained by a thickness variation of only two layers in the 7-layer stack, with a technological process including four photolithography levels. The thickness of the filter stack was only half of the traditional color resists, potentially enabling a reduction of optical crosstalk for smaller pixels. Both color errors and signal to noise ratio derived from optimized spectral responses are expected to be similar to color resists associated with infrared filter.

  18. Optimal BMI cut-off values for predicting diabetes, hypertension and hypercholesterolaemia in a multi-ethnic population.

    PubMed

    Cheong, Kee Chee; Yusoff, Ahmad F; Ghazali, Sumarni M; Lim, Kuang H; Selvarajah, Sharmini; Haniff, Jamaiyah; Khor, Geok L; Shahar, Suzana; Rahman, Jamalludin Abd; Zainuddin, Ahmad A; Mustafa, Amal N

    2013-03-01

    To determine the optimal cut-offs of BMI for Malaysian adults. Population-based, cross-sectional study. Receiver operating characteristic curves were used to determine the cut-off values of BMI with optimum sensitivity and specificity for the detection of three cardiovascular risk factors: diabetes mellitus, hypertension and hypercholesterolaemia. Gender-specific logistic regression analyses were used to examine the association between BMI and these cardiovascular risk factors. All fourteen states in Malaysia. Malaysian adults aged ≥18 years (n 32 703) who participated in the Third National Health and Morbidity Survey in 2006. The optimal BMI cut-off value for predicting the presence of diabetes mellitus, hypertension, hypercholesterolaemia or at least one of these cardiovascular risk factors varied from 23.3 to 24.1 kg/m2 for men and from 24.0 to 25.4 kg/m2 for women. In men and women, the odds ratio for having diabetes mellitus, hypertension, hypercholesterolaemia or at least one cardiovascular risk factor increased significantly as BMI cut-off point increased. Our findings indicate that BMI cut-offs of 23.0 kg/m2 in men and 24.0 kg/m2 in women are appropriate for classification of overweight. We suggest that these cut-offs can be used by health professionals to identify individuals for cardiovascular risk screening and weight management programmes.

  19. Optimised cut-off function for Tersoff-like potentials for a BN nanosheet: a molecular dynamics study

    NASA Astrophysics Data System (ADS)

    Kumar, Rajesh; Rajasekaran, G.; Parashar, Avinash

    2016-02-01

    In this article, molecular dynamics based simulations were carried out to study the tensile behaviour of boron nitride nanosheets (BNNSs). Four different sets of Tersoff potential parameters were used in the simulations for estimating the interatomic interactions between boron and nitrogen atoms. Modifications were incorporated in the Tersoff cut-off function to improve the accuracy of results with respect to fracture stress, fracture strain and Young’s modulus. In this study, the original cut-off function was optimised in such a way that small and large cut-off distances were made equal, and hence a single cut-off distance was used with all sets of Tersoff potential parameters. The single value of cut-off distance for the Tersoff potential was chosen after analysing the potential energy and bond forces experienced by boron and nitrogen atoms subjected to bond stretching. The simulations performed with the optimised cut-off function help in identifying the Tersoff potential parameters that reproduce the experimentally evaluated mechanical behaviour of BNNSs.

  20. Variability of cut-off values for the detection of lupus anticoagulants: results of an international multicenter multiplatform study.

    PubMed

    Tripodi, A; Chantarangkul, V; Cini, M; Devreese, K; Dlott, J S; Giacomello, R; Gray, E; Legnani, C; Martinuzzo, M E; Pradella, P; Siegemund, A; Subramanian, S; Suchon, P; Testa, S

    2017-06-01

    Essentials Between-lab variations of cut-off values in lupus anticoagulant detection are unknown. Cut-off values were calculated in 11 labs each testing plasma from 120 donors with 3 platforms. Major variation was observed even within the same platform. Cut-off values determined in different labs are not interchangeable. Background Cut-off values for interpretation of lupus anticoagulant (LA) detection are poorly investigated. Aims (i) To assess whether results from healthy donors were normally distributed and (ii) the between-laboratories differences in cut-off values for screening, mixing and LA confirmation when calculated as 99th or 95th centiles, and (iii) to assess their impact on the detection rate for LA. Methods Each of 11 laboratories using one of the three widely used commercial platforms for LA detection was asked to collect plasmas from 120 healthy donors and to perform screening, mixing and LA confirmation with two methods (activated partial thromboplastin time [APTT] and dilute Russell viper venom [dRVV]). A common set of LA-positive or LA-negative freeze-dried plasmas was used to assess the LA detection rate. Results were centralized (Milano) for statistical analysis. Results and conclusions (i) Clotting times or ratios for healthy subjects were not normally distributed in the majority of cases. The take-home message is that cut-off values should be determined preferably by the non-parametric method based on centiles. (ii) There were relatively large inter-laboratory cut-off variations even within the same platform and the variability was marginally attenuated when results were expressed as ratios (test-to-normal pooled plasma). The take-home message is that cut-off values should be determined locally. (iii) There were differences between cut-off values calculated as 99th or 95th centiles that translate into a different LA detection rate (the lower the centile the greater the detection rate). The take-home message is that cut-off values determined

  1. TDE fallback cut-off due to a pre-existing accretion disc

    NASA Astrophysics Data System (ADS)

    Kathirgamaraju, Adithan; Barniol Duran, Rodolfo; Giannios, Dimitrios

    2017-07-01

    Numerous tidal disruption event (TDE) candidates originating from galactic centres have been detected (e.g. by Swift and ASASSN). Some of their host galaxies show typical characteristics of a weak active galactic nucleus (AGN), indicative of a pre-existing accretion disc around the supermassive black hole (SMBH). In this work, we develop an analytic model to study how a pre-existing accretion disc affects a TDE. We assume the density of the disc ρ ∝ R-λ, R being the radial distance from the SMBH and λ varying between 0.5 and 1.5. Interactions between the pre-existing accretion disc and the stream of the tidally disrupted star can stall the stream far from the SMBH, causing a sudden drop in the rate of fallback of gas into the SMBH. These interactions could explain the steep cut-off observed in the light curve of some TDE candidates (e.g. Swift J1644 and Swift J2058). With our model, it is possible to use the time of this cut-off to constrain some properties pertaining to the pre-existing accretion disc, such as λ and the disc viscosity parameter α. We demonstrate this by applying our theory to the TDE candidates Swift J1644, Swift J2058 and ASASSN-14li. Our analysis favours a disc profile with λ ˜ 1 for viscosity parameters α ˜ 0.01-0.1.

  2. Characterization of thermal cut-off mechanisms in prismatic lithium-ion batteries

    NASA Astrophysics Data System (ADS)

    Venugopal, Ganesh

    Lithium-ion (Li-ion) cells that are subjected to electrical abuse, overcharge and external short-circuit in particular, exhibit a rapid increase in cell temperature that could potentially lead to catastrophic disassembly of the cell. For this reason these cells are integrated or combined with one or more safety components that are designed to restrict or even prevent current flow through the cell under abusive conditions. In this work, the characteristics of these components in several prismatic Li-ion cells are studied by monitoring the impedance ( Z) at 1 kHz and the open circuit voltage (OCV) of the discharged cells as a function of temperature. All the cells studied were found to use polyethylene-based shutdown (SD) separators that were irreversibly activated within a narrow temperature range between 130 and 135°C. In some cells irreversible cut-off was also provided by a current interrupt device (CID) or a thermal fuse. Both these devices had a circuit-breaker effect, causing the impedance of the cell to rise infinitely and the OCV to drop to zero. In addition to these irreversible cut-off mechanisms, some cells also contained internal or external positive-temperature-coefficient (PTC) devices that could provide current-limiting capability over a very wide temperature range. The interdependence of the thermal behavior of these components on each other and on other thermally dependant processes like cell venting, separator meltdown and weld joint failure are also discussed.

  3. Oscillation of solar radio emission at coronal acoustic cut-off frequency

    NASA Astrophysics Data System (ADS)

    Pylaev, O. S.; Zaqarashvili, T. V.; Brazhenko, A. I.; Melnik, V. N.; Hanslmeier, A.; Panchenko, M.

    2017-05-01

    Recent SECCHI COR2 observations on board STEREO-A spacecraft have detected density structures at a distance of 2.5-15 R0 propagating with periodicity of about 90 min. The observations show that the density structures probably formed in the lower corona. We used the large Ukrainian radio telescope URAN-2 to observe type IV radio bursts in the frequency range of 8-32 MHz during the time interval of 08:15-11:00 UT on August 1, 2011. Radio emission in this frequency range originated at the distance of 1.5-2.5 R0 according to the Baumbach-Allen density model of the solar corona. Morlet wavelet analysis showed the periodicity of 80 min in radio emission intensity at all frequencies, which demonstrates that there are quasi-periodic variations of coronal density at all heights. The observed periodicity corresponds to the acoustic cut-off frequency of stratified corona at a temperature of 1 MK. We suggest that continuous perturbations of the coronal base in the form of jets/explosive events generate acoustic pulses, which propagate upwards and leave the wake behind oscillating at the coronal cut-off frequency. This wake may transform into recurrent shocks due to the density decrease with height, which leads to the observed periodicity in the radio emission. The recurrent shocks may trigger quasi-periodic magnetic reconnection in helmet streamers, where the opposite field lines merge and consequently may generate periodic density structures observed in the solar wind.

  4. Comparison of helioseismic cut-off frequency formulations by the means of MHD simulation results

    NASA Astrophysics Data System (ADS)

    Bourdin, Philippe-A.; Thaler, Irina; Roth, Markus

    2017-04-01

    The discussion of helioseismic wave phenomena requires a self-consistent description of the plasma pressure. Magnetically active regions on the Sun are observed to have distinct wave phenomena as compared to quiet regions. With better helioseismologic diagnostics near active regions one may also better understand not only the chromospheric energy budget, but also halo formation and running penumbral waves. The line formation height (with respect to the beta=1 level) and the magnetic field inclination near the solar surface are in the same time difficult to measure and important to correctly interpret observations. With the help of a large-scale 3D magneto-hydrodynamic (MHD) model, that features an active region as bottom boundary and has shown good agreement to various observations, we may compute values for theoretically derived formulations of cut-off frequencies from the model plasma parameters. Our results show strongly varying vertical atmospheric profiles and we give estimates of their influence on the expected cut-off frequencies.

  5. Transaminase abnormalities and adaptations of the liver lobule manifest at specific cut-offs of steatosis

    PubMed Central

    Hall, Andrew; Covelli, Claudia; Manuguerra, Roberta; Luong, Tu Vinh; Buzzetti, Elena; Tsochatzis, Emmanuel; Pinzani, Massimo; Dhillon, Amar Paul

    2017-01-01

    There is little documented evidence suggesting that liver fat is responsible for liver injury in the absence of other disease processes. We investigated the relationships between liver fat, aminotransferases and hepatic architecture in liver biopsies with simple steatosis. We identified 136 biopsies with simple steatosis from the Royal Free Hospital Archives with both clinical data and sufficient material. Digital image analysis was employed to measure fat proportionate area (mFPA). Hepatocyte area (HA) and lobule radius (LR) were also measured. There were significant increases in ALT (p < 0.001) and AST (p = 0.013) with increased fat content and evidence to suggest both 5% and 20% mFPA as a cut-off for raised ALT. In liver with increased fat content there were significant increases in HA (p < 0.001). LR also increased as mFPA increased to 10% (p < 0.001), at which point the lobule ceased to expand further and was counterbalanced with a decrease in the number of hepatocytes per lobule (p = 0.029). Consequently there are mechanisms of adaption in the liver architecture to accommodate the accumulation of fat and these are accompanied by significant increases in transaminases. These results support the generally accepted cut-off of 5% fat for steatosis and indicate 20% as a threshold of more severe liver injury. PMID:28106158

  6. Open Skies and monitoring a fissile materials cut-off treaty

    SciTech Connect

    Allentuck, J.; Lemley, J.R.

    1995-09-01

    The Treaty on Open Skies (Open Skies) is intended among other things to provide, in the words of its preamble, means ``to facilitate the monitoring of compliance with existing or future arms control agreements.`` Open Skies permits overflights of the territory of member states by aircraft equipped with an array of sensors of various types. Their types and capabilities are treaty-limited. To find useful application in monitoring a cut-off treaty Open Skies would need to be amended. The number of signatories would need to be expanded so as to provide greater geographical coverage, and restrictions on sensor-array capabilities would need to be relaxed. To facilitate the detection of impending violations of a cut-off convention by Open Skies overflights, the data base provided by parties to the former should include among other things an enumeration of existing and former fuel cycle and research facilities including those converted to other uses, their precise geographic location, and a site plan.

  7. Memristor-capacitor passive filters to tune both cut-off frequency and bandwidth

    NASA Astrophysics Data System (ADS)

    Ali, Shawkat; Hassan, Arshad; Hassan, Gul; Bae, Jinho; Lee, Chong Hyun

    2017-04-01

    In various optical sensor applications, programmable analog filters are desirable to reduce the hardware requirement. Memristor is two state programmable nonvolatile resistor, which has a small size and low power consumption. Using these resistance switching characteristics of a memristor, we propose a novel memristor-capacitor (MC) based printed low pass and high pass filters for analog circuits to achieve tunable cut-off frequencies and bandwidth. The cut-off frequencies of filters are controlled through a memristor state switching (HRS/LRS), whereas the capacitor has a fixed value. The proposed MC filters utilize graphene/poly 4-vinlyphenol (G/PVP) for dielectric layer of capacitors and Graphene Quatum Dots (GQDs)/PVP for an active layer of memristor, and these layers are fabricated on ITO coated flexible PET substrate through electrohydrodynamic (EHD) technique. Both MC filters are designed as parameters of two state memristance and a capacitance. From comparison between designed and fabricated filters, we show that they are matched quite well.

  8. Cut-Off Values of Visceral Adiposity to Predict NAFLD in Brazilian Obese Adolescents

    PubMed Central

    Grotti Clemente, Ana Paula; Molin Netto, Bárbara Dal; Ganen, Aline di Piano; Tock, Lian; Arisa Caranti, Danielle; de Mello, Marco Túlio; Tufik, Sergio; Dâmaso, Ana R.

    2013-01-01

    Objectives. The present study aimed at determining cut-off points of visceral fat to predict NAFLD and analyzed metabolic disorders of obese adolescents. Methods. Cross-sectional study involved 165 obese adolescents ranged in age from 15 to 19 years. Glycemia, hepatic transaminases, lipid profile, and insulin resistance were analyzed. Visceral and subcutaneous fat were measured by ultrasound and body composition by plesthysmography. Results. The NAFLD adolescents had significantly higher values for body mass, BMI-for-age, BMI, total fat, waist circumference, and visceral fat when compared with non-NAFLD obese adolescents in both genders. Moreover, there were significant positive correlations between visceral fat with the variables BMI-for-age (r = 0.325,), TG (r = 0.277), AST (r = 0.509), ALT (r = 0.519), WC (r = 0.390), and visceral/subcutaneous ratio (r = 0.790) for NAFLD group. Total fat, triglycerides, and visceral fat were the independent predictors to NAFLD. Analysis of the ROC curves revealed cut-off points of visceral fat of 4.47 cm for girls and 4.21 cm for boys. Conclusions. The results may suggest that abdominal ultrasonography procedure may be a safe alternative method of assessing visceral adiposity aiming to be considered to the development of preventive and treatment strategies in obese individuals. This clinial trial is registered with ClinicalTrial.gov (NCT01358773). PMID:24381750

  9. Projection systems with a cut-off line for automotive applications

    NASA Astrophysics Data System (ADS)

    Kloos, G.; Eichhorn, K.

    2005-08-01

    The lighting systems of a car provide a variety of challenges from the point of view of illumination science and technology. Engineering work in this field has to deal both with reflector and lens design as well as with opto-mechanical design and sensor technology. It has direct implications on traffic safety and the efficiency in which energy is used. Therefore, these systems are continuously improved and optimized. In this context, adaptive systems that we investigate for automotive applications gain increasing importance. The properties of the light distribution in the vicinity of the cut-off line are of key importance for the safe and efficient operation of automotive headlamps. An alternative approach is proposed to refine the description of these properties in an attempt to make it more quantitative. This description is intended to facilitate intercomparison between different systems and/or to study environmental influences on the cut-off line of a system under investigation. Designing projection systems it is necessary to take a delicate trade-off between efficiency, light-distribution characteristics, mechanical boundary conditions, and legal requirements into account. Considerations and results on optical properties of three-axial reflectors in dependence of layout parameters will be given. They can serve as a guideline for the optical workshop and for free-form optimization.

  10. Hair ethyl glucuronide concentrations in teetotalers: Should we re-evaluate the lower cut-off?

    PubMed

    Crunelle, Cleo L; Yegles, Michel; De Doncker, Mireille; Cappelle, Delphine; Covaci, Adrian; van Nuijs, Alexander L N; Neels, Hugo

    2017-05-01

    Ethyl glucuronide in hair (hEtG) can be used to assess the retrospective consumption of alcohol. A lower cut-off of 7pg/mg hair in the 0-3cm proximal scalp hair segment has been used for repeated alcohol consumption in the previous three months. While a concentration below this cut-off is stated not to contradict self reported abstinence, it is often used to assess whether an individual has remained abstinent in the period prior to hair sampling. Here, we address hEtG concentrations in alcohol consuming individuals and critically evaluate this cut-off value. Ten individuals remained abstinent from alcohol for 12 weeks. A lock of hair was cut before the start of the study, and the regrown hairs were cut after twelve weeks of abstinence. Hair EtG concentrations were measured both at baseline and after 12 weeks of abstinence. Study compliance was assessed by urine analysis every 2-3 days by liquid chromatography-tandem mass spectrometry with a lower limit of quantification (LLOQ) of 0.1μg/mL. HEtG concentrations were assessed in the first 3cm hair using gas chromatography-tandem mass spectrometry with an LLOQ of 0.2pg/mg. At the beginning of the study, participants had hEtG concentrations ranging between

  11. DAS28-CRP and DAS28-ESR cut-offs for high disease activity in rheumatoid arthritis are not interchangeable

    PubMed Central

    Fleischmann, Roy M; van der Heijde, Désirée; Gardiner, Philip V; Szumski, Annette; Marshall, Lisa; Bananis, Eustratios

    2017-01-01

    Background In most patients with rheumatoid arthritis (RA), Disease Activity Score 28-joint count C reactive protein (DAS28-CRP) is lower than DAS28 erythrocyte sedimentation rate (DAS28-ESR), suggesting that use of the DAS28-ESR cut-off to assess high disease activity (HDA) with DAS28-CRP may underestimate the number of patients with HDA. We determined the DAS28-CRP value corresponding to the validated DAS28-ESR cut-off for HDA. Methods Baseline data were pooled from 2 clinical studies evaluating etanercept (ETN) plus methotrexate (MTX) or MTX in early RA; DAS28-CRP and DAS28-ESR were obtained, allowing the determination of the DAS28-CRP HDA value best corresponding to the DAS28-ESR cut-off of >5.1. Results At baseline, as expected, fewer patients had HDA by DAS28-CRP than DAS28-ESR; DAS28-CRP>5.1 and DAS28-ESR>5.1 had only modest agreement (κ coefficients 0.45–0.54). Mean DAS28-CRP and DAS28-ESR were 5.7 and 6.2, respectively, in the ETN+MTX group (n=571), and 6.0 and 6.5 in the MTX group (n=262). A DAS28-CRP cut-off of 4.6 corresponded to a DAS28-ESR cut-off of 5.1. Conclusions We have shown that a DAS28-CRP of 4.6 corresponds to 5.1 for DAS28-ESR. Since this is substantially lower than the DAS28-ESR cut-off of 5.1, using 5.1 as the cut-off for DAS28-CRP underestimates disease activity in RA. Trial registration number NCT00195494; NCT00913458. PMID:28255449

  12. Appropriate Body Mass Index Cut-Offs to Determine Thinness, Overweight and Obesity in South Asian Children in The Netherlands

    PubMed Central

    de Wilde, Jeroen A.; van Dommelen, Paula; Middelkoop, Barend J. C.

    2013-01-01

    Background Asian populations have an increased risk of developing cardiometabolic disorders at a lower body mass index (BMI) than other ethnic groups. Therefore, lower adult BMI cut-offs to determine overweight and obesity are recommended to assess the associated health risks for Asian (23 and 27.5 kg/m2 respectively) and Asian Indian (23, 25 kg/m2) populations. The objective of this study was to develop BMI cut-offs for thinness, overweight, and obesity for South Asian children in the Netherlands, and to compare the BMI cut-offs and distribution with an Asian Indian reference, the WHO Child Growth Reference, and universal BMI cut-offs. Methods A reference cohort of 546 Surinamese South Asian boys and 521 girls, born between 1974–1976 (during the pre-obesity era) with 3408 and 3267 BMI measurements respectively, was retrospectively analysed. BMI-for-age charts were created with the LMS method. BMI centile curves passing through the cut-off points of 15 (thinness), 23 (overweight), 25 and 27.5 kg/m2 (obesity) at 18y were drawn as cut-off levels. Results The BMI of Surinamese South Asian children had a similar distribution to the Asian Indian reference, apart from a lower mean and less variation. The BMI distribution differed considerably from the WHO reference and universal BMI criteria. The calculated BMI cut-offs corresponding to a BMI of 15, 23, 25, and 27.5 kg/m2 at 18y were at the 7.1, 81.1, 89.8, and 95.5 percentile respectively in boys, and at the 2.7, 79.5, 89.2, and 95.2 percentile in girls. Conclusions This is the first study proposing BMI cut-offs for South Asian children based on measurements from a prosperous population unaffected by the obesity epidemic. We recommend the use of these cut-offs in South Asian children in the Netherlands as these better reflect the health risks associated with thinness, overweight and obesity, and therefore may prevent the development of cardiometabolic disorders. PMID:24367559

  13. Cut-off characterisation of energy spectra of bright fermi sources: Current instrument limits and future possibilities

    NASA Astrophysics Data System (ADS)

    Romoli, C.; Taylor, A. M.; Aharonian, F.

    2017-02-01

    In this paper some of the brightest GeV sources observed by the Fermi-LAT were analysed, focusing on their spectral cut-off region. The sources chosen for this investigation were the brightest blazar flares of 3C 454.3 and 3C 279 and the Vela pulsar with a reanalysis with the latest Fermi-LAT software. For the study of the spectral cut-off we first explored the Vela pulsar spectrum, whose statistics in the time interval of the 3FGL catalog allowed strong constraints to be obtained on the parameters. We subsequently performed a new analysis of the flaring blazar SEDs. For these sources we obtained constraints on the cut-off parameters under the assumption that their underlying spectral distribution is described by a power-law with a stretched exponential cut-off. We then highlighted the significant potential improvements on such constraints by observations with next generation ground based Cherenkov telescopes, represented in our study by the Cherenkov Telescope Array (CTA). Adopting currently available simulations for this future observatory, we demonstrate the considerable improvement in cut-off constraints achievable by observations with this new instrument when compared with that achievable by satellite observations.

  14. oA novel nonparametric approach for estimating cut-offs in continuous risk indicators with application to diabetes epidemiology

    PubMed Central

    2009-01-01

    Background Epidemiological and clinical studies, often including anthropometric measures, have established obesity as a major risk factor for the development of type 2 diabetes. Appropriate cut-off values for anthropometric parameters are necessary for prediction or decision purposes. The cut-off corresponding to the Youden-Index is often applied in epidemiology and biomedical literature for dichotomizing a continuous risk indicator. Methods Using data from a representative large multistage longitudinal epidemiological study in a primary care setting in Germany, this paper explores a novel approach for estimating optimal cut-offs of anthropomorphic parameters for predicting type 2 diabetes based on a discontinuity of a regression function in a nonparametric regression framework. Results The resulting cut-off corresponded to values obtained by the Youden Index (maximum of the sum of sensitivity and specificity, minus one), often considered the optimal cut-off in epidemiological and biomedical research. The nonparametric regression based estimator was compared to results obtained by the established methods of the Receiver Operating Characteristic plot in various simulation scenarios and based on bias and root mean square error, yielded excellent finite sample properties. Conclusion It is thus recommended that this nonparametric regression approach be considered as valuable alternative when a continuous indicator has to be dichotomized at the Youden Index for prediction or decision purposes. PMID:19744332

  15. Determination of hair ketamine cut-off value from Hong Kong ketamine users by LC-MS/MS analysis.

    PubMed

    Leung, K Wing; Wong, Zack C F; Ho, Janet Y M; Yip, Ada W S; Ng, Jenny S C; Ip, Stanley P H; Ng, Winki Y Y; Ho, Karen K L; Duan, Ran; Zhu, Kevin Y; Tsim, Karl W K

    2016-02-01

    Ketamine is one of the most frequent abused drugs in Hong Kong and South-East Asia, and the cases of ketamine abused have been reported worldwide. Hair has been commonly used as a specimen for the proof of chronic drug abused because of its non-invasiveness and long detection windows. The determinations of ketamine in hair with varieties of state-of-the-art instruments and detection methods have been developed in the past decade; however, the cut-off value for ketamine abuser has not been developed according to the international guidelines. The aim of this study is to propose a cut-off value for ketamine in hair by analyzing ketamine and its metabolite norketamine by LC-MS/MS method in a population of ketamine users in Hong Kong. The limit of detection (LOD) and limit of quantification (LOQ) for ketamine and norketamine were 20pg/mg and 100pg/mg, respectively. From 977 ketamine abusers, the cut-off value for ketamine in hair was proposed to be 400pg/mg of hair. This proposed cut-off value is the concentration of hair ketamine when over 90% of samples are being detected with the presence of norketamine, which is a proof of ketamine abuse. This value could be applied as a screening or occupational cut-off for reference.

  16. Retardation of volatile organic compound movement by a bentonite slurry cut-off wall ameded with ground ties

    SciTech Connect

    Park, J.K.; Kim, J.Y.; Madsen, C.D.

    1996-12-31

    Bentonite slurry cut-off walls, have been used under site-specific conditions as an alternative to substantially reduce the spreading of groundwater contamination. Shredded tires were found to be used as a supplement to the engineered landfill clay liner system in order to retard VOC transport to a greater degree than that which occurs in the traditionally constructed engineered containment system. Laboratory-scale column permeameter tests were conducted to investigate the retardation of volatile organic compound (VOC) movement through a bentonite slurry cut-off wall amended with ground tires, which were found to sorb a significant amount of VOCs. The hydraulic conductivity was not affected by addition of ground tires but was affected by addition of VOCs at 10{approximately}15 mg/L. The hydraulic conductivity increased immediately after addition of VOCs but remained relatively constant throughout the test period. A typical slurry cut-off wall does not appear to be a good barrier for the containment of organic compounds. The organic compound breakthrough times were significantly prolonged by addition of ground tires. For example, m-xylene did not breakthrough in ground tire amended permeameters over 450 days but broke through in the silty-sand and bentonite mixed permeameter. Ground tires had a great deal of organic compound sorption capacity without deteriorating the performance of slurry cut-off walls. It appears that addition of ground tire to slurry cut-off walls significantly improve the efficiency of organic compound containment with minimal additional construction costs.

  17. The Cut-off Values of Triglycerides and Glucose Index for Metabolic Syndrome in American and Korean Adolescents

    PubMed Central

    2017-01-01

    The aim of this study was to establish ethnic- and gender-specific cut-off values of triglycerides and glucose index (TyG index) for clinical usefulness in a representative sample of Mexican American, Non-Hispanic White, Non-Hispanic Black, and Korean adolescents. The data were collected from datasets of the National Health and Nutrition Examination Survey between 1999 and 2012, and the Korean National Health and Nutrition Examination Survey between 2005 and 2013. Receiver operating characteristic curve analysis was used to find valid cut-off values of the TyG index for metabolic syndrome. The total number of eligible participants was 3,164 in the US and 4,873 in Korea. The optimal cut-off value with the Cook et al. definition revealed 8.55 in Mexican American, 8.55 in Non-Hispanic White, 8.35 in Non-Hispanic Black, and 8.45 in Korean, respectively. The cut-off value with the de Ferranti et al. definition was 8.45, 8.45, 8.15, and 8.35, and the cut-off value with the International Diabetes Federation definition was 8.65, 8.65, 8.15, and 8.55, respectively. These findings may be clinically useful for evaluating insulin resistance for determining metabolic abnormalities in adolescents. PMID:28145645

  18. The Cut-off Values of Triglycerides and Glucose Index for Metabolic Syndrome in American and Korean Adolescents.

    PubMed

    Moon, Shinje; Park, Joon Sung; Ahn, Youhern

    2017-03-01

    The aim of this study was to establish ethnic- and gender-specific cut-off values of triglycerides and glucose index (TyG index) for clinical usefulness in a representative sample of Mexican American, Non-Hispanic White, Non-Hispanic Black, and Korean adolescents. The data were collected from datasets of the National Health and Nutrition Examination Survey between 1999 and 2012, and the Korean National Health and Nutrition Examination Survey between 2005 and 2013. Receiver operating characteristic curve analysis was used to find valid cut-off values of the TyG index for metabolic syndrome. The total number of eligible participants was 3,164 in the US and 4,873 in Korea. The optimal cut-off value with the Cook et al. definition revealed 8.55 in Mexican American, 8.55 in Non-Hispanic White, 8.35 in Non-Hispanic Black, and 8.45 in Korean, respectively. The cut-off value with the de Ferranti et al. definition was 8.45, 8.45, 8.15, and 8.35, and the cut-off value with the International Diabetes Federation definition was 8.65, 8.65, 8.15, and 8.55, respectively. These findings may be clinically useful for evaluating insulin resistance for determining metabolic abnormalities in adolescents.

  19. Viscous holographic dark energy universe with Nojiri-Odintsov cut-off

    NASA Astrophysics Data System (ADS)

    Khurshudyan, Martiros

    2016-12-01

    In this paper we consider a toy model of large scale universe, when one of the dark components is a generalized holographic DE with a Nojiri-Odintsov cut-off. On the other hand, we made another assumption concerning to the companion of considered DE model due to impossibility of exact parameterization of dark side of the large scale universe. In particular, we assume an inhomogeneous viscous dark fluid discussed in literature very actively, to be possible candidate for the companion. In addition to cosmographic analysis we discuss the results from Om and two point Om analysis and estimated present day values of statefinder parameters (r,s) and (ω^' }_{de}, ω_{de}). Moreover, validity of generalized second law of thermodynamics is studied showing that theoretical results are well consistent with observational data. Constraints on cosmological parameters are due to Planck 2015 experiments.

  20. From Newton's Law to the Linear Boltzmann Equation Without Cut-Off

    NASA Astrophysics Data System (ADS)

    Ayi, Nathalie

    2017-03-01

    We provide a rigorous derivation of the linear Boltzmann equation without cut-off starting from a system of particles interacting via a potential with infinite range as the number of particles N goes to infinity under the Boltzmann-Grad scaling. More particularly, we will describe the motion of a tagged particle in a gas close to global equilibrium. The main difficulty in our context is that, due to the infinite range of the potential, a non-integrable singularity appears in the angular collision kernel, making no longer valid the single-use of Lanford's strategy. Our proof relies then on a combination of Lanford's strategy, of tools developed recently by Bodineau, Gallagher and Saint-Raymond to study the collision process, and of new duality arguments to study the additional terms associated with the long-range interaction, leading to some explicit weak estimates.

  1. The influence of cut off lows on sulfate burdens over the North Atlantic during April, 1987

    SciTech Connect

    Benkovitz, C.M.; Miller, M.A.; Schwartz, S.E.; Kwon, O.U.

    2001-01-14

    The authors have presented examples from a modeling study of the development of sulfur burdens over North America, the North Atlantic Ocean and Europe during April, 1987 using observation-derived meteorological data to represent the actual conditions for this period, focusing on the influence of cut-off lows on SO{sub 2} and sulfate column burdens over the North Atlantic Ocean. The analysis demonstrates that these systems can serve either as sources or sinks of sulfate, and that the major factor governing their resulting effect is the position during its formative stages relative to (a) sources of moisture, and (b) sulfur emissions, which regulates the availability of sulfur, cloud liquid water for sulfur oxidation, and the amount of precipitation for sulfate removal produced in the later stages of the life cycle.

  2. Extraordinary transmission beyond the cut-off through sub- λ annular aperture arrays

    NASA Astrophysics Data System (ADS)

    Baida, Fadi I.; Poujet, Yannick; Salvi, Jérôme; Labeke, Daniel Van; Guizal, Brahim

    2009-04-01

    It was recently established that coaxial nano-aperture arrays perforated in optically thick silver films exhibit an extraordinary transmission in the visible range thanks to a guided mode. However this mode has a cut-off wavelength beyond which the transmission dramatically decreases. We propose here a cascaded structure that is shown to act as a high quality spectral filter in the visible range (finesse up to 200). It is also found that the transmission is enhanced by a factor of 150 for specific wavelengths. This kind of cascaded nano-structured metallic layers offers many promising applications in nano-photonics such as the integration of functionalities for optical signal processing. It opens up the path for the conception of a new generation of integrated components based on metallo-dielectric structures that can be easily tailored as tunable devices.

  3. Estimation of cut-off wavelength of rare earth doped single-mode fibers

    NASA Astrophysics Data System (ADS)

    Kaur, Jagneet; Thyagarajan, K.; Pal, B. P.

    1999-11-01

    A new empirical relation is proposed describing spectral variation of mode-field radius (MFR) as inferred from measurements in the far-field of the fiber. It is shown that using this relation, it is possible to estimate the cut-off wavelength ( λc) of the fiber. The proposed technique is successfully tested through measurements made on two standard step index single-mode fibers, as well as on an erbium doped fiber (EDF) having λc falling within its strong absorption band around 980 nm. This empirical formula is more accurate than the widely used Marcuse's formula to describe spectral dependence of MFR determined through measurements made in the fiber's far-field. The proposed technique is especially suited for estimation of λc of doped fibers in which λc falls within an absorption band.

  4. From Newton's Law to the Linear Boltzmann Equation Without Cut-Off

    NASA Astrophysics Data System (ADS)

    Ayi, Nathalie

    2017-01-01

    We provide a rigorous derivation of the linear Boltzmann equation without cut-off starting from a system of particles interacting via a potential with infinite range as the number of particles N goes to infinity under the Boltzmann-Grad scaling. More particularly, we will describe the motion of a tagged particle in a gas close to global equilibrium. The main difficulty in our context is that, due to the infinite range of the potential, a non-integrable singularity appears in the angular collision kernel, making no longer valid the single-use of Lanford's strategy. Our proof relies then on a combination of Lanford's strategy, of tools developed recently by Bodineau, Gallagher and Saint-Raymond to study the collision process, and of new duality arguments to study the additional terms associated with the long-range interaction, leading to some explicit weak estimates.

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

    NASA Astrophysics Data System (ADS)

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

    2013-04-01

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

  6. Physical activity cut-offs and risk factors for preventing child obesity in Japan.

    PubMed

    Minematsu, Kazuo; Kawabuchi, Ryosuke; Okazaki, Hiromi; Tomita, Hiroyuki; Tobina, Takuro; Tanigawa, Takeshi; Tsunawake, Noriaki

    2015-01-01

    There is no official recommendations for physical activity level or steps for preventing and improving child obesity in Japan. Three hundred and two Japanese children aged 9-12 years were recruited wore 3-D speed sensors. Subjects were divided into two groups using the criteria for child obesity in Japan. Body composition was measured on bioelectrical impedance analysis. Physical fitness test was done to evaluate physical strength. Twenty-four hour total steps, energy expenditure, and metabolic equivalents (MET) from Monday to Sunday were consecutively measured. The cut-offs for steps and physical activity level for preventing child obesity were evaluated on receiver operating characteristic curves. Daily life-related risk factors for child obesity were assessed on logistic regression analysis. In both sexes, body volume; bodyweight, body mass index, fat mass, and percentage body fat in the obese group was significantly higher than in the normal group, but age and height were not different (P < 0.001). Aerobic power, running speed, and explosive strength in the obese group were inferior to those in the normal group (P < 0.001). More than 40 min of 4 MET exercise, defined as moderate-vigorous exercise, and 11,000 steps per day are essential to prevent child obesity. Additionally, >2 h TV viewing per day is a significant risk factor for child obesity (OR, 3.43; 95%CI: 1.27-9.31). Cut-offs for physical activity and potential risk factors for child obesity have been identified. Recommendations for changes to daily lifestyle for school-aged Japanese children are given. © 2014 Japan Pediatric Society.

  7. The cut-off value for normal nuchal translucency evaluated by chromosomal microarray analysis.

    PubMed

    Maya, Idit; Yacobson, Shiri; Kahana, Sarit; Yeshaya, Josepha; Tenne, Tamar; Agmon-Fishman, Ifaat; Cohen-Vig, Lital; Shohat, Mordechai; Basel-Vanagaite, Lina; Sharony, Reuven

    2017-01-30

    An association between isolated, increased nuchal translucency thickness and pathogenic chromosomal microarray analysis (CMA) has been reported. A recent meta-analysis reported that most studies used a 3.5 mm cut-off value. Considering nuchal translucency distribution and the commonly accepted 5% false positive rate in maternal serum screening, nuchal translucency cut-off levels should be reconsidered. This study evaluated the unique contribution of CMA to the investigation of foetuses with mildly increased nuchal translucency (NT) thickness of 3.0-3.4 mm. This was a retrospective, multicenter study. A single laboratory performed all genetic analyses. Comparative Genomic Hybridization Microarray analysis or Single Nucleotide Polymorphism Array technology was used for CMA. NT was divided into three groups (≤2.9; 3.0-3.4; ≥3.5 mm) and the results were compared, focusing on pregnancies with NT as the only medical indication for CMA at the time of the invasive procedure. If combined first trimester screening (NT and biochemistry) indicated increased risk for common aneuploidies, the case was excluded. CMA results were recorded in 1,588 pregnancies, of which 770 foetuses had NT as a normal or an isolated abnormal finding. Of these, 462 had NT ≤2.9 mm, 170 had NT 3.0-3.4 mm and 138 had NT ≥3.5 mm. Pathogenic copy number variations were found in 1.7%, 7.1%, and 13.0%, respectively. The results suggest that CMA should be part of the investigation in foetuses with isolated, mildly increased NT (3.0-3.4 mm). This article is protected by copyright. All rights reserved.

  8. Measurements and modeling of multipath interference at wavelengths below cable cut-off in a G.654 optical fiber span.

    PubMed

    Downie, John D; Hurley, Jason; DePedro, Hector; Garner, Steven; Blaker, Jeremy; Zakharian, Aramais; Ten, Sergey; Mills, Greg

    2017-04-17

    Transmission below the cable cut-off wavelength may be a concern in some systems, especially for an optical supervisory channel (OSC) operating below the signal transmission band in systems built with G.654 fiber. In this work, we constructed a cabled span of G.654-compliant fiber and measured the multipath interference (MPI) generated during propagation through the span at a range of wavelengths below the cable cut-offs of the constituent fibers. Measurements were made under a range of conditions including different splice losses and the presence or absence of higher order mode filters placed around the splices. MPI levels were found to be sufficiently low at wavelengths far below the average cable cut-off such that OSC transmission was penalty-free. We compare the experimental results to modeling predictions and find very good agreement.

  9. Fatigue life analysis of cracked gas receiver of emergency cut-off system in gas gathering station

    NASA Astrophysics Data System (ADS)

    Hu, Junzhi; Zhou, Jiyong; Li, Siyuan

    2017-06-01

    Small-scale air compressor and gas receiver are used as the driving gas of the emergency cut-off system in gas gathering station. Operation of block valve is ensured by starting and stopping compressor automatically. The frequent start-stop of compressor and the pressure fluctuation pose a threat to the service life of gas receiver, and then affect normal operation of the emergency cut-off system and security of gas gathering station. In this paper, the fatigue life of a pressure vessel with axial semi-elliptical surface crack in the inner wall is analyzed under the varying pressure by means of the theory of fracture mechanics. The influences of the amplitude of pressure fluctuation and the initial crack size on the residual life of gas receiver are discussed. It provides a basis for setting the working parameters of gas receiver of emergency cut-off system and determining the maintenance cycle.

  10. Cut-off point for WHOQOL-bref as a measure of quality of life of older adults.

    PubMed

    Silva, Patrícia Aparecida Barbosa; Soares, Sônia Maria; Santos, Joseph Fabiano Guimarães; Silva, Líliam Barbosa

    2014-06-01

    OBJECTIVE To propose a cut-off for the World Health Organization Quality of Life-Bref (WHOQOL-bref) as a predictor of quality of life in older adults.METHODS Cross-sectional study with 391 older adults registered in the Northwest Health District in Belo Horizonte, MG, Southeastern Brazil, between October 8, 2010 and May 23, 2011. The older adults' quality of life was measured using the WHOQOL-bref. The analysis was rationalized by outlining two extreme and simultaneous groups according to perceived quality of life and satisfaction with health (quality of life good/satisfactory - good or very good self-reported quality of life and being satisfied or very satisfied with health - G5; and poor/very poor quality of life - poor or very poor self-reported quality of life and feeling dissatisfied or very dissatisfied with health - G6). A Receiver-Operating Characteristic curve (ROC) was created to assess the diagnostic ability of different cut-off points of the WHOQOL-bref.RESULTS ROC curve analysis indicated a critical value 60 as the optimal cut-off point for assessing perceived quality of life and satisfaction with health. The area under the curve was 0.758, with a sensitivity of 76.8% and specificity of 63.8% for a cut-off of ≥ 60 for overall quality of life (G5) and sensitivity 95.0% and specificity of 54.4% for a cut-off of < 60 for overall quality of life (G6).CONCLUSIONS Diagnostic interpretation of the ROC curve revealed that cut-off < 60 for overall quality of life obtained excellent sensitivity and negative predictive value for tracking older adults with probable worse quality of life and dissatisfied with health.

  11. Cut-off point for WHOQOL-bref as a measure of quality of life of older adults

    PubMed Central

    Silva, Patrícia Aparecida Barbosa; Soares, Sônia Maria; Santos, Joseph Fabiano Guimarães; Silva, Líliam Barbosa

    2014-01-01

    OBJECTIVE To propose a cut-off for the World Health Organization Quality of Life-Bref (WHOQOL-bref) as a predictor of quality of life in older adults. METHODS Cross-sectional study with 391 older adults registered in the Northwest Health District in Belo Horizonte, MG, Southeastern Brazil, between October 8, 2010 and May 23, 2011. The older adults’ quality of life was measured using the WHOQOL-bref. The analysis was rationalized by outlining two extreme and simultaneous groups according to perceived quality of life and satisfaction with health (quality of life good/satisfactory – good or very good self-reported quality of life and being satisfied or very satisfied with health – G5; and poor/very poor quality of life – poor or very poor self-reported quality of life and feeling dissatisfied or very dissatisfied with health – G6). A Receiver-Operating Characteristic curve (ROC) was created to assess the diagnostic ability of different cut-off points of the WHOQOL-bref. RESULTS ROC curve analysis indicated a critical value 60 as the optimal cut-off point for assessing perceived quality of life and satisfaction with health. The area under the curve was 0.758, with a sensitivity of 76.8% and specificity of 63.8% for a cut-off of ≥ 60 for overall quality of life (G5) and sensitivity 95.0% and specificity of 54.4% for a cut-off of < 60 for overall quality of life (G6). CONCLUSIONS Diagnostic interpretation of the ROC curve revealed that cut-off < 60 for overall quality of life obtained excellent sensitivity and negative predictive value for tracking older adults with probable worse quality of life and dissatisfied with health. PMID:25119934

  12. Cut-off values for the applied version of the Beck Depression Inventory in a general working population.

    PubMed

    Rose, Uwe; March, Stefanie; Ebener, Melanie; du Prel, Jean-Baptist

    2015-01-01

    The Beck Depression Inventory (BDI) for the assessment of depressive symptoms is well established in clinical settings. An applied version (BDI-V) was previously developed in German for use within epidemiologic studies. The current study analyses the association between this applied version of the BDI and different measures of functioning. The aim is to determine BDI-V cut-off values when used in a population of employees. The study included 6339 employees of the first wave of a German cohort study on work, age, health and work participation. Depressive symptoms were assessed by an applied version of the BDI-V. Data on functioning were obtained from personal interviews. The determination of cut-off values is achieved with the min-max principle for classification applied to receiver operating characteristic (ROC) curves. The min-max principle points to a BDI-V cut-off between 20 and 24 for male and between 23 and 28 for female respondents. The corresponding sensitivities range between 0.64 and 0.75 for males and between 0.59 and 0.74 for females. Specificities range between 0.64 and 0.75 for males and between 0.60 and 0.74 for females. Female respondents have higher BDI-V cut-offs for all criteria. The range of values is lower than a recommendation in a former study. In addition to this, the values differ for gender. The current analyses focus on an easier-to-use version of the BDI formerly applied for epidemiologic studies. The determination of cut-off values is based on criteria which are indicators for impairment in (work) functioning in a population of employees. Therefore, grouping of individuals according to the reported cut-off values is guided by the relevance of these scores for occupational functioning.

  13. Shear avalanches in metallic glasses under nanoindentation: Deformation units and rate dependent strain burst cut-off

    SciTech Connect

    Bian, X. L.; Wang, G.; Gao, Y. L.; Zhai, Q. J.; Chan, K. C.; Ren, J. L.

    2013-09-02

    Indented metallic glasses at the nanoscale deform via strain bursts. Conventional continuum descriptions are not appropriate for such highly stochastic, intermittent deformations. In this study, after a statistical analysis of strain bursts in five metallic glasses, the dependence of the cut-off of the strain burst size on deformation units and loading rate is established. For soft metallic glasses with smaller deformation units, cut-off of the strain burst size truncates the scale-free behavior at larger strain burst sizes. For hard metallic glasses, scale-free behavior occurs in a wide range of strain burst sizes.

  14. Cut-off points to identify sarcopenia according to European Working Group on Sarcopenia in Older People (EWGSOP) definition.

    PubMed

    Bahat, Gulistan; Tufan, Asli; Tufan, Fatih; Kilic, Cihan; Akpinar, Timur Selçuk; Kose, Murat; Erten, Nilgun; Karan, Mehmet Akif; Cruz-Jentoft, Alfonso J

    2016-12-01

    The reported prevalence of sarcopenia ranges widely depending on its definition criterion. European Working Group on Sarcopenia in Older People (EWGSOP) developed a practical clinical definition and consensus diagnostic criteria. This definition recommends using normative data of the study population rather than other reference populations. We aimed to define the reference cut-off values for muscle mass, muscle strength and calf circumference in Turkey in order to improve general applicability of EWGSOP criteria. Healthy young adults between 18 and 39 years of age with no known chronic disease or chronic drug usage were included in our study to serve as reference population for assessing muscle mass. Community-dwelling older outpatients were prospectively recruited from the geriatrics outpatient clinics of a university hospital for assessing hand grip strength and calf circumference. Body composition was assessed by bioimpedance analysis. Muscle strength was assessed measuring hand grip strength with a Jamar hand dynamometer. The cut-off thresholds for muscle mass were defined as the mean-2SD of the values of the young reference study population; for grip strength were calculated from ROC analyses using cut-off values that predicted gait speed < 0.8 m/s; and for calf circumference were calculated from ROC analyses using cut-off values that predicted low muscle mass. The young reference group included a total of 301 participants (187 male, 114 female; mean age: 26.5 ± 4.6 years). The cut-off thresholds for skeletal muscle mass indexes were 9.2 kg/m(2) and 7.4 kg/m(2) in males and females, respectively. The older community dwelling group included 406 subjects (123 male, 283 female, mean age: 76.6 ± 6.7 years). The cut-off thresholds for hand grip strength were 32 kg and 22 kg for males and females. The cut-off threshold for calf circumference was 33 cm for both males and females. The cut-off thresholds for muscle mass, grip strength and calf

  15. High Discrepancy in Abdominal Obesity Prevalence According to Different Waist Circumference Cut-Offs and Measurement Methods in Children: Need for Age-Risk-Weighted Standardized Cut-Offs?

    PubMed

    Monzani, Alice; Rapa, Anna; Prodam, Flavia; Fuiano, Nicola; Diddi, Giuliana; Petri, Antonella; Bellone, Simonetta; Bona, Gianni

    2016-01-01

    Waist circumference (WC) is a good proxy measure of central adiposity. Due to the multiplicity of existing WC cut-offs and different measurement methods, the decision to use one rather than another WC chart may lead to different prevalence estimates of abdominal obesity in the same population. Aim of our study was to assess how much the prevalence of abdominal obesity varies in Italian schoolchildren using the different available WC cut-offs. We measured WC at just above the uppermost lateral border of the right ilium in 1062 Italian schoolchildren aged 7-14 years, 499 living in Northern Italy and 563 in Southern Italy. Abdominal obesity was defined as WC ≥90th percentile for gender and age according to nine WC charts. We found an extremely high variability in the prevalence of abdominal obesity detected in our study-populations according to the different WC charts, ranging in the overall group from 9.1% to 61.4%. In Northern Italy children it varied from 2.4% to 35.7%, and in Southern ones from 15.1% to 84.2%. On the basis of the chosen WC cut-offs the prevalence of abdominal obesity varies widely, because percentile-charts are strongly influenced by the population status in a particular moment. A further rate of variability may lay on the site of WC measurement and on the statistical method used to calculate WC cut-offs. Risk-weighted WC cut-offs measured in a standardized anatomic site and calculated by the appropriate method are needed to simply identify by WC measurement those children at high risk of cardio-metabolic complications to whom specific and prompt health interventions should be addressed.

  16. Definition of Advanced Age in HIV Infection: Looking for an Age Cut-Off

    PubMed Central

    Jarrín, Inmaculada; Vallejo, Manuel; Berenguer, Juan; Solera, Carmen; Rubio, Rafael; Pulido, Federico; Asensi, Victor; del Amo, Julia; Moreno, Santiago

    2012-01-01

    Abstract The age of 50 has been considered as a cut-off to discriminate older subjects within HIV-infected people according to the Centers for Disease Control and Prevention (CDC). However, the International AIDS Society (IAS) mentions 60 years of age and the Department of Health and Human Services (DHHS) makes no consideration. We aimed to establish an age cut-off that could differentiate response to highly active antiretroviral therapy (HAART) and, therefore, help to define advanced age in HIV-infected patients. CoRIS is an open, prospective, multicenter cohort of HIV adults naive to HAART at entry (January 2004 to October 2009). Survival, immunological response (IR) (CD4 increase of more than 100 cell/ml), and virological response (VR) (HIV RNA less than 50 copies/ml) were compared among 5-year age intervals at start of HAART using Cox proportional hazards models, stratified by hospital and adjusted for potential confounders. Among 5514 patients, 2726 began HAART. During follow-up, 2164 (79.4%) patients experienced an IR, 1686 (61.8%) a VR, and 54 (1.9%) died. Compared with patients aged <25 years at start of HAART, those aged 50–54, 55–59, 60–64, 65–59, and 70 or older were 32% (aHR: 0.68, 95% CI: 0.52–0.87), 29% (aHR: 0.71, 95% CI: 0.53–0.96), 34% (aHR: 0.66, 95% CI: 0.46–0.95), 39% (aHR: 0.61, 95% CI: 0.37–1.00), and 43% (aHR: 0.57, 95% CI: 0.31–1.04) less likely to experience an IR. The VR was similar across all age groups. Finally, patients aged 50–59 showed a 3-fold increase (aHR: 3.58; 95% CI: 1.07–11.99) in their risk of death compared to those aged <30 years. In HIV infection, patients aged ≥50 years have a poorer immunological response to HAART and a poorer survival. This age could be used to define medically advanced age in HIV-infected people. PMID:22607516

  17. Establishing pathological cut-offs of brain atrophy rates in multiple sclerosis

    PubMed Central

    De Stefano, Nicola; Stromillo, Maria Laura; Giorgio, Antonio; Bartolozzi, Maria Letizia; Battaglini, Marco; Baldini, Mariella; Amato, Maria Pia; Sormani, Maria Pia

    2016-01-01

    Objective To assess whether it is feasible to establish specific cut-off values able to discriminate ‘physiological’ or ‘pathological’ brain volume rates in patients with multiple sclerosis (MS). Methods The study was based on the analysis of longitudinal MRI data sets of patients with MS (n=206, 87% relapsing–remitting, 7% secondary progressive and 6% primary progressive) and healthy controls (HC; n=35). Brain atrophy rates were computed over a mean follow-up of 7.5 years (range 1–12) for patients with MS and 6.3 years (range 1–12.5) for HC with the SIENA software and expressed as annualised per cent brain volume change (PBVC/y). A weighted (on the follow-up length) receiver operating characteristic analysis and the area under the curve (AUC) were used for statistics. Results The weighted PBVC/y was −0.51±0.27% in patients with MS and −0.27±0.15% in HC (p<0.0001). There was a significant age-related difference in PBVC/y between HC older and younger than 35 years of age (p=0.02), but not in patients with MS (p=0.8). The cut-off of PBVC/y, as measured by SIENA that could maximise the accuracy in discriminating patients with MS from HC, was −0.37%, with 67% sensitivity and 80% specificity. According to the observed distribution, values of PBVC/y as measured by SIENA that could define a pathological range were above −0.52% with 95% specificity, above −0.46% with 90% specificity and above −0.40% with 80% specificity. Conclusions Our evidence-based criteria provide values able to discriminate the presence or absence of ‘pathological’ brain volume loss in MS with high specificity. Such results could be of great value in a clinical setting, particularly in assessing treatment efficacy in MS. PMID:25904813

  18. Definition of advanced age in HIV infection: looking for an age cut-off.

    PubMed

    Blanco, José R; Jarrín, Inmaculada; Vallejo, Manuel; Berenguer, Juan; Solera, Carmen; Rubio, Rafael; Pulido, Federico; Asensi, Victor; del Amo, Julia; Moreno, Santiago

    2012-09-01

    The age of 50 has been considered as a cut-off to discriminate older subjects within HIV-infected people according to the Centers for Disease Control and Prevention (CDC). However, the International AIDS Society (IAS) mentions 60 years of age and the Department of Health and Human Services (DHHS) makes no consideration. We aimed to establish an age cut-off that could differentiate response to highly active antiretroviral therapy (HAART) and, therefore, help to define advanced age in HIV-infected patients. CoRIS is an open, prospective, multicenter cohort of HIV adults naive to HAART at entry (January 2004 to October 2009). Survival, immunological response (IR) (CD4 increase of more than 100 cell/ml), and virological response (VR) (HIV RNA less than 50 copies/ml) were compared among 5-year age intervals at start of HAART using Cox proportional hazards models, stratified by hospital and adjusted for potential confounders. Among 5514 patients, 2726 began HAART. During follow-up, 2164 (79.4%) patients experienced an IR, 1686 (61.8%) a VR, and 54 (1.9%) died. Compared with patients aged <25 years at start of HAART, those aged 50-54, 55-59, 60-64, 65-59, and 70 or older were 32% (aHR: 0.68, 95% CI: 0.52-0.87), 29% (aHR: 0.71, 95% CI: 0.53-0.96), 34% (aHR: 0.66, 95% CI: 0.46-0.95), 39% (aHR: 0.61, 95% CI: 0.37-1.00), and 43% (aHR: 0.57, 95% CI: 0.31-1.04) less likely to experience an IR. The VR was similar across all age groups. Finally, patients aged 50-59 showed a 3-fold increase (aHR: 3.58; 95% CI: 1.07-11.99) in their risk of death compared to those aged <30 years. In HIV infection, patients aged ≥50 years have a poorer immunological response to HAART and a poorer survival. This age could be used to define medically advanced age in HIV-infected people.

  19. Cut-off in detection of eye irritation from vapors of homologous carboxylic acids and aliphatic aldehydes

    PubMed Central

    Cometto-Muñiz, J. Enrique; Cain, William S.; Abraham, Michael H.; Sánchez-Moreno, Ricardo

    2007-01-01

    Using neat vapors of selected homologous aldehydes (decanal, undecanal, dodecanal) and carboxylic acids (pentanoic, hexanoic, heptanoic, octanoic, nonanoic), we explored the point where a certain homolog (and all larger ones) becomes undetectable by eye irritation (i.e., by ocular chemesthesis). This phenomenon has been observed in other homologous series that also reach a break-point, or cut-off, in chemesthetic detection. Participants (11≤n≤32) were tested using a three-alternative, forced-choice procedure. Flowrate to the eye equaled 4 or 8 L/min and time of exposure was 6 sec. The outcome showed that dodecanal and heptanoic acid were the shortest undetectable homologs. When the vapor concentration of the stimuli was increased by heating the liquid source to 37°C, homologs located before the cut-off point (e.g., hexanoic acid) became readily detected by all subjects, whereas homologs located at the cut off remained largely undetected. In addition, a comparison of calculated values of eye irritation thresholds for aldehydes and acids (from a successful model of ocular chemesthetic potency) with values of saturated vapor concentration at 23 and 37 °C indicated that the vapor concentration of dodecanal and heptanoic acid should have been enough to produce detection. The outcome suggests that the cut-off observed does not result from a low vapor concentration but from limitations in the structure or dimension(s) of the molecules that render them unsuitable to interact effectively with chemesthetic receptors. PMID:17270354

  20. Flexible Lab-Tailored Cut-Offs for Suitability of Formalin-Fixed Tumor Samples for Diagnostic Mutational Analyses

    PubMed Central

    Mariani, Sara; Tondat, Fabrizio; Pacchioni, Donatella; Molinaro, Luca; Barreca, Antonella; Macrì, Luigia; Chiusa, Luigi; di Celle, Paola Francia; Cassoni, Paola; Sapino, Anna

    2015-01-01

    The selection of proper tissues from formalin-fixed and paraffin-embedded tumors before diagnostic molecular testing is responsibility of the pathologist and represents a crucial step to produce reliable test results. The international guidelines suggest two cut-offs, one for the percentage and one for the number of tumor cells, in order to enrich the tumor content before DNA extraction. The aim of the present work was two-fold: to evaluate to what extent a low percentage or absolute number of tumor cells can be qualified for somatic mutation testing; and to determine how assay sensitivities can guide pathologists towards a better definition of morphology-based adequacy cut-offs. We tested 1797 tumor specimens from melanomas, colorectal and lung adenocarcinomas. Respectively, their BRAF, K-RAS and EGFR genes were analyzed at specific exons by mutation-enriched PCR, pyrosequencing, direct sequencing and real-time PCR methods. We demonstrate that poorly cellular specimens do not modify the frequency distribution of either mutated or wild-type DNA samples nor that of specific mutations. This observation suggests that currently recommended cut-offs for adequacy of specimens to be processed for molecular assays seem to be too much stringent in a laboratory context that performs highly sensitive routine analytical methods. In conclusion, new cut-offs are needed based on test sensitivities and documented tumor heterogeneity. PMID:25844806

  1. On determining the most appropriate test cut-off value: the case of tests with continuous results

    PubMed Central

    Habibzadeh, Parham; Yadollahie, Mahboobeh

    2016-01-01

    There are several criteria for determination of the most appropriate cut-off value in a diagnostic test with continuous results. Mostly based on receiver operating characteristic (ROC) analysis, there are various methods to determine the test cut-off value. The most common criteria are the point on ROC curve where the sensitivity and specificity of the test are equal; the point on the curve with minimum distance from the left-upper corner of the unit square; and the point where the Youden’s index is maximum. There are also methods mainly based on Bayesian decision analysis. Herein, we show that a proposed method that maximizes the weighted number needed to misdiagnose, an index of diagnostic test effectiveness we previously proposed, is the most appropriate technique compared to the aforementioned ones. For determination of the cut-off value, we need to know the pretest probability of the disease of interest as well as the costs incurred by misdiagnosis. This means that even for a certain diagnostic test, the cut-off value is not universal and should be determined for each region and for each disease condition. PMID:27812299

  2. Intense, Narrow-band THz Emission from a Current Source Immersed in Cut-off of Plasma-like Media

    NASA Astrophysics Data System (ADS)

    Hur, Min Sup; Ersfeld, Bernhard; Noble, Adam; Suk, Hyyong; Jaroszynski, Dino

    2016-10-01

    Recently we found an interesting behavior of the electromagnetic radiation emerging from cut-off condition of a plasma-like medium, when it is driven by a current source. Differently from conventional total reflection of the incident wave at the cut-off, we found a spatially diffusing and temporally growing electromagnetic field from the current source. Direct result of such diffusion-growth is the selectively enhanced emission (SEE) at the cut-off frequency from a generally broadband current oscillation. We demonstrate examples demonstrating the SEE. One is the two-color-driven THz emission from field ionization of the gas slab located in a tapered waveguide. The emission propagating through the waveguide exhibits a significantly enhanced spectral density at the cut-off frequency. The other example is the THz emission from a magnetized plasma driven by two colliding ultra-short laser pulses. Since a very narrow-band emission can be selectively enhanced from a broadband radiation source, the SEE concept can be used for conversion of a general broadband THz source to a narrow-band one by locating it in a meta-structure such as the waveguide or a plasma-like medium. We discuss other possible systems to which SEE can be applied.

  3. Spectrally selective solar absorber with sharp and temperature dependent cut-off based on semiconductor nanowire arrays

    NASA Astrophysics Data System (ADS)

    Wang, Yang; Zhou, Lin; Zheng, Qinghui; Lu, Hong; Gan, Qiaoqiang; Yu, Zongfu; Zhu, Jia

    2017-05-01

    Spectrally selective absorbers (SSA) with high selectivity of absorption and sharp cut-off between high absorptivity and low emissivity are critical for efficient solar energy conversion. Here, we report the semiconductor nanowire enabled SSA with not only high absorption selectivity but also temperature dependent sharp absorption cut-off. By taking advantage of the temperature dependent bandgap of semiconductors, we systematically demonstrate that the absorption cut-off profile of the semiconductor-nanowire-based SSA can be flexibly tuned, which is quite different from most of the other SSA reported so far. As an example, silicon nanowire based selective absorbers are fabricated, with the measured absorption efficiency above (below) bandgap ˜97% (15%) combined with an extremely sharp absorption cut-off (transition region ˜200 nm), the sharpest SSA demonstrated so far. The demonstrated semiconductor-nanowire-based SSA can enable a high solar thermal efficiency of ≳86% under a wide range of operating conditions, which would be competitive candidates for the concentrated solar energy utilizations.

  4. Anthropometric parameters' cut-off points and predictive value for metabolic syndrome in women from Cartagena, Colombia.

    PubMed

    Mora-García, Gustavo José; Gómez-Camargo, Doris; Mazenett, Enrique; Alario, Ángelo; Fortich, Álvaro; Gómez-Alegría, Claudio

    2014-04-01

    Objective. To estimate anthropometric parameters' (APs) cut-off points and association for metabolic syndrome (MetS). Materials and methods. A cross-sectional study was carried out with a total of 434 adult women from Cartagena de Indias, Colombia, in 2012. APs measured were waist circumference (WC), body mass index (BMI), body adiposity index (BAI), waist-hip ratio (WHR) and waist-height ratio (WHtR). Cut-off points were estimated by a receiver operating characteristic curve (ROC). Logistic regression was applied to estimate possible associations. Results. Cut-off points for WC, BMI, BAI, WHR and WHtR were 85 cm, 28 kg/m(2), 39%, 0.80 and 56, respectively. Only WHtR was associated to MetS (OR=1.11, CI95% [1.07-1.15]). Conclusion. WC cut-off point was higher than those proposed for Latin-American women by the Joint Interim Statement (JIS). WHtR had a low predictive value for MetS.

  5. Dynamic monitoring of menopause hormone therapy and defining the cut-off value of endometrial thickness during uterine bleeding

    PubMed Central

    Sheng, Qiu; Yang, Jun; Zhao, Qiaoling; Li, Fen

    2016-01-01

    Abstract The aim of this study was to evaluate the effects of low-dose tibolone therapy on ovarian area, uterine volume and endometrial thickness, and define the cut-off value of endometrial thickness for curettage during uterine bleeding. We followed 619 postmenopausal women, aged 40-60 years, for two years. There were 301 subjects in the low-dose tibolone treatment group and 318 subjects in the control group. The ovarian area, uterine volume and endometrial thickness in all participants were measured by transvaginal ultrasound prior to, one and two years post enrollment, respectively. Endometrial specimens were collected from all subjects with abnormal uterine bleeding during the follow-up period. We found that the uterine volume in the treatment group was greater than that in the control group, and the difference was significant (P<0.05), but there were no significant differences in ovarian area and endometrial thickness between the two groups (P>0.05). When the cut-off value for endometrial thickness was 7.35 mm, the sensitivity and specificity were 100% and 79.07%, respectively, and 85.71% and 93.02% when 7.55 mm was set as the cut-off during tibolone therapy. The results indicate that low-dose tibolone therapy may postpone uterine atrophy and the cut-off value of endometrial thickness may be appropriately adjusted for curettage. PMID:27533929

  6. Screening for colorectal cancer: random comparison of guaiac and immunochemical faecal occult blood testing at different cut-off levels

    PubMed Central

    Hol, L; Wilschut, J A; van Ballegooijen, M; van Vuuren, A J; van der Valk, H; Reijerink, J C I Y; van der Togt, A C M; Kuipers, E J; Habbema, J D F; van Leerdam, M E

    2009-01-01

    Immunochemical faecal occult blood testing (FIT) provides quantitative test results, which allows optimisation of the cut-off value for follow-up colonoscopy. We conducted a randomised population-based trial to determine test characteristics of FIT (OC-Sensor micro, Eiken, Japan) screening at different cut-off levels and compare these with guaiac-based faecal occult blood test (gFOBT) screening in an average risk population. A representative sample of the Dutch population (n=10 011), aged 50–74 years, was 1 : 1 randomised before invitation to gFOBT and FIT screening. Colonoscopy was offered to screenees with a positive gFOBT or FIT (cut-off 50 ng haemoglobin/ml). When varying the cut-off level between 50 and 200 ng ml−1, the positivity rate of FIT ranged between 8.1% (95% CI: 7.2–9.1%) and 3.5% (95% CI: 2.9–4.2%), the detection rate of advanced neoplasia ranged between 3.2% (95% CI: 2.6–3.9%) and 2.1% (95% CI: 1.6–2.6%), and the specificity ranged between 95.5% (95% CI: 94.5–96.3%) and 98.8% (95% CI: 98.4–99.0%). At a cut-off value of 75 ng ml−1, the detection rate was two times higher than with gFOBT screening (gFOBT: 1.2%; FIT: 2.5%; P<0.001), whereas the number needed to scope (NNscope) to find one screenee with advanced neoplasia was similar (2.2 vs 1.9; P=0.69). Immunochemical faecal occult blood testing is considerably more effective than gFOBT screening within the range of tested cut-off values. From our experience, a cut-off value of 75 ng ml−1 provided an adequate positivity rate and an acceptable trade-off between detection rate and NNscope. PMID:19337257

  7. Relationship between glycated haemoglobin and microvascular complications: is there a natural cut-off point for the diagnosis of diabetes?

    PubMed

    Sabanayagam, C; Liew, G; Tai, E S; Shankar, A; Lim, S C; Subramaniam, T; Wong, T Y

    2009-07-01

    This study was designed to determine whether the relationship of glycated haemoglobin to diabetic microvascular complications shows any natural thresholds that could be useful in diagnosing diabetes. We examined a population-based sample of 3,190 Malay adults aged 40-80 years in Singapore. The microvascular outcomes of interest were: (1) any retinopathy, defined from fundus photographs; (2) mild retinopathy, defined as in (1); (3) moderate retinopathy, defined as in (1); (4) chronic kidney disease, defined from estimated glomerular filtration rate; (5) micro- or macroalbuminuria, defined from urinary albumin to creatinine ratio; and (6) peripheral neuropathy, defined from neurothesiometer or monofilament sensory testing. Increasing HbA(1c) was associated with all microvascular complications. The optimal cut-off points for detecting mild and moderate retinopathy were 6.6% (87.0% sensitivity, 77.1% specificity and area under the receiver operating characteristics [ROC] curve 0.899) and 7.0% (82.9% sensitivity, 82.3% specificity and area under ROC curve 0.904). The prevalences of mild and moderate retinopathy were <1% below the optimal cut-off points. For other complications, the association with HbA(1c) was linear without evidence of a distinct threshold. Although ROC analysis for these other complications also suggested optimal cut-off points between 6.6% and 7.0%, the sensitivity at these cut-off points was considerably lower than for mild and moderate retinopathy, ranging from 31.8% to 66.5%. Higher levels of HbA(1c) were associated with microvascular complications. Our data support use of an HbA(1c) cut-off point of between 6.6 and 7.0% in diagnosing diabetes. Cut-off points in this range were best for the identification of individuals with mild and moderate retinopathy. Any retinopathy, chronic kidney disease, albuminuria and peripheral neuropathy are less well detected at these cut-off points.

  8. Extended characterization of a new class of membranes for blood purification: the high cut-off membranes.

    PubMed

    Boschetti-de-Fierro, Adriana; Voigt, Manuel; Storr, Markus; Krause, Bernd

    2013-07-01

    High cut-off membranes are a new class of blood purification membranes whose particular characteristics present challenges for commonly-used characterization methods. Dextran sieving curves for representative blood purification membranes of the high-flux and high cut-off types were measured and compared to curves for the glomerular filtration barrier (GFB). The performance was also determined after blood exposure for the most permeable synthetic membranes. High cut-off membranes were observed to be more open than the GFB before blood exposure, but become tighter and more selective after the exposure, keeping the permeation for low and middle molecules while restraining the filtration of large species. Based on dextran sieving experiments for a variety of commercially available blood purification membranes, we present a novel method for classifying blood purification membranes. By using a well-established technique and introducing a new characteristic parameter for the sieving curve--the molecular weight retention onset (MWRO)--a graph of molecular weight cut-off versus molecular weight retention onset provides the landscape of dialysis membrane types. This meaningful representation is based on only one in vitro method, and allows the membrane classification by indirectly considering two structural parameters: pore size and pore size distribution. In this way, the families of low-flux, high-flux, protein leaking, and high cut-off membranes are clearly differentiated. The differentiation allows for the definition of MWCO/MWRO regions for the different types, so that further classification of newly developed membranes can be easily achieved.

  9. Estimate of a predictive cut-off value for serum 25-hydroxyvitamin D reflecting abdominal obesity in Korean adolescents.

    PubMed

    Nam, Ga Eun; Kim, Do Hoon; Cho, Kyung Hwan; Park, Yong Gyu; Han, Kyung Do; Choi, Youn Seon; Kim, Seon Mee; Ko, Byung Joon; Kim, Yang Hyun; Lee, Kyung Shik

    2012-06-01

    Vitamin D deficiency is a serious global issue. Although the serum 25-hydroxyvitamin D [25(OH)D] test is generally the most accurate way to assess vitamin D levels, the optimal range of 25(OH)D has yet to be established. Moreover, the optimal level may vary according to race, region, and age. Suboptimal vitamin D status is associated with obesity and metabolic syndrome, which are the major risk factors for cardiovascular disorders; however, these relationships in children and adolescents have yet to be clearly determined. Therefore, we identified the best predictive cut-off value for reflecting abdominal obesity and, based on this value, we investigated the relationship between suboptimal 25(OH)D status and the risk for having abdominal obesity, being overweight or obese, and having metabolic syndrome in Korean adolescents. We performed a cross-sectional analysis of 713 Korean adolescents, between 12-19 years of age, and used data collected from the 2008 Korea National Health and Nutrition Examination Survey (KNHANES). Receiver operation characteristic curve analysis was used to identify the cut-off value that reflected abdominal obesity. The cut-off value of serum 25(OH)D that reflected abdominal obesity in Korean adolescents was 17.6 ng/mL. After making adjustments for gender, age, and regular physical exercise, the group that had lower levels of serum 25(OH)D compared to the cut-off value had a significantly higher risk for abdominal obesity, obesity, and metabolic syndrome than the group with 25(OH)D levels higher than the cut-off value. Suboptimal vitamin D status based on this value is associated with increased risk for abdominal obesity, obesity, and metabolic syndrome among Korean adolescents.

  10. The Portuguese version of the Outcome Questionnaire (OQ-45): Normative data, reliability, and clinical significance cut-offs scores.

    PubMed

    Machado, Paulo P P; Fassnacht, Daniel B

    2015-12-01

    The Outcome Questionnaire (OQ-45) is one of the most extensively used standardized self-report instruments to monitor psychotherapy outcomes. The questionnaire is designed specifically for the assessment of change during psychotherapy treatments. Therefore, it is crucial to provide norms and clinical cut-off values for clinicians and researchers. The current study aims at providing study provides norms, reliability indices, and clinical cut-off values for the Portuguese version of the scale. Data from two large non-clinical samples (high school/university, N = 1,669; community, N = 879) and one clinical sample (n = 201) were used to investigate psychometric properties and derive normative data for all OQ-45 subscales and the total score. Significant and substantial differences were found for all subscales between the clinical and non-clinical sample. The Portuguese version also showed adequate reliabilities (internal consistency, test-retest), which were comparable to the original version. To assess individual clinical change, clinical cut-off values and reliable change indices were calculated allowing clinicians and researchers to monitor and evaluate clients' individual change. The Portuguese version of the OQ-45 is a reliable instrument with comparable Portuguese norms and cut-off scores to those from the original version. This allows clinicians and researchers to use this instrument for evaluating change and outcome in psychotherapy. This study provides norms for non-clinical and clinical Portuguese samples and investigates the reliability (internal consistency and test-retest) of the OQ-45. Cut-off values and reliable change index are provided allowing clinicians to evaluate clinical change and clients' response to treatment, monitoring the quality of mental health care services. These can be used, in routine clinical practice, as benchmarks for treatment progress and to empirically base clinical decisions such as continuation of treatment or considering

  11. Detection of the high-energy cut-off from the Seyfert 1.5 galaxy NGC 5273

    NASA Astrophysics Data System (ADS)

    Pahari, Mayukh; MᶜHardy, I. M.; Mallick, Labani; Dewangan, G. C.; Misra, R.

    2017-09-01

    We perform the NuSTAR and Swift/XRT joint energy spectral fitting of simultaneous observations from the broad-line Seyfert 1.5 galaxy NGC 5273. When fitted with the combination of an exponential cut-off power law and a reflection model, a high-energy cut-off is detected at 143^{+96}_{-40} keV with 2σ significance. Existence of such cut-off is also consistent with the observed Comptonizing electron temperature when fitted with a Comptonization model independently. We observe a moderate hard X-ray variability of the source over the time-scale of ∼12 yr using INTEGRAL/ISGRI observations in the energy range of 20-100 keV. When the hard-band count rate (6-20 keV) is plotted against the soft-band count rate (3-6 keV), a hard offset is observed. Our results indicate that the cut-off energy may not correlate with the coronal X-ray luminosity in a simple manner. Similarities in parameters that describe coronal properties indicate that the coronal structure of NGC 5273 may be similar to that of the broad-line radio galaxy 3C 390.3 and another galaxy MCG-5-23-16, where the coronal plasma is dominated by electrons, rather than electron-positron pairs. Therefore, the coronal cooling is equally efficient to the heating mechanism keeping the cut-off energy at low even at the low accretion rate.

  12. Holographic dark energy model with Hubble horizon as an IR cut-off

    SciTech Connect

    Xu, Lixin

    2009-09-01

    The main task of this paper is to realize a cosmic observational compatible universe in the framework of holographic dark energy model when the Hubble horizon H is taken as the role of an IR cut-off. When the model parameter c of a time variable cosmological constant (CC) Λ(t) = 3c{sup 2}H{sup 2}(t) becomes time or scale dependent, an extra term enters in the effective equation of sate (EoS) of the vacuum energy w{sup eff}{sub Λ} = −c{sup 2}−dln c{sup 2}/3dln a. This extra term can make the effective EoS of time variable CC cross the cosmological boundary and be phantom-like at present. For the lack of a first principle and fundamental physics theory to obtain the form c{sup 2}, we give a simple parameterized form of c{sup 2} as an example. Then the model is confronted by the cosmic observations including SN Ia, BAO and CMB shift parameter R. The result shows that the model is consistent with cosmic observations.

  13. Fluorescence imaging of macromolecule transport in high molecular weight cut-off microdialysis.

    PubMed

    Chu, Jiangtao; Koudriavtsev, Vitali; Hjort, Klas; Dahlin, Andreas P

    2014-11-01

    When microdialysis (MD) membrane exceeds molecular weight cut-off (MWCO) of 100 kDa, the fluid mechanics are in the ultrafiltration regime. Consequently, fluidic mass transport of macromolecules in the perfusate over the membrane may reduce the biological relevance of the sampling and cause an inflammatory response in the test subject. Therefore, a method to investigate the molecular transport of high MWCO MD is presented. An in vitro test chamber was fabricated to facilitate the fluorescent imaging of the MD sampling process, using fluoresceinylisothiocyanate (FITC) dextran and fluorescence microscopy. Qualitative studies on dextran behavior inside and outside the membrane were performed. Semiquantitative results showed clear dextran leakage from both 40 and 250 kDa dextran when 100 kDa MWCO membranes were used. Dextran 40 kDa leaked out with an order of magnitude higher concentration and the leakage pattern resembled more of a convective flow pattern compared with dextran 250 kDa, where the leakage pattern was more diffusion based. No leakage was observed when dextran 500 kDa was used as a colloid osmotic agent. The results in this study suggest that fluorescence imaging could be used as a method for qualitative and semiquantitative molecular transport and fluid dynamics studies of MD membranes and other hollow fiber catheter membranes.

  14. Sloshing in the Liquid Hydrogen and Liquid Oxygen Propellant Tanks After Main Engine Cut Off

    NASA Technical Reports Server (NTRS)

    Kim, Sura; West, Jeff

    2011-01-01

    NASA Marshall Space Flight Center is designing and developing the Main Propulsion System (MPS) for Ares launch vehicles. Propellant sloshing in the liquid hydrogen (LH2) and liquid oxygen (LO2) propellant tanks after Main Engine Cut Off (MECO) was modeled using the Volume of Fluid (VOF) module of the computational fluid dynamics code, CFD-ACE+. The present simulation shows that there is substantial sloshing side forces acting on the LH2 tank during the deceleration of the vehicle after MECO. The LH2 tank features a side wall drain pipe. The side loads result from the residual propellant mass motion in the LH2 tank which is initiated by the stop of flow into the drain pipe at MECO. The simulations show that radial force on the LH2 tank wall is less than 50 lbf and the radial moment calculated based up through the center of gravity of the vehicle is predicted to be as high as 300 lbf-ft. The LO2 tank features a bottom dome drain system and is equipped with sloshing baffles. The remaining LO2 in the tank slowly forms a liquid column along the centerline of tank under the zero gravity environments. The radial force on the LO2 tank wall is predicted to be less than 100 lbf. The radial moment calculated based on the center of gravity of the vehicle is predicted as high as 4500 lbf-ft just before MECO and dropped down to near zero after propellant draining stopped completely.

  15. Mechanically robust 39 GHz cut-off frequency graphene field effect transistors on flexible substrates.

    PubMed

    Wei, Wei; Pallecchi, Emiliano; Haque, Samiul; Borini, Stefano; Avramovic, Vanessa; Centeno, Alba; Amaia, Zurutuza; Happy, Henri

    2016-08-07

    Graphene has been regarded as a promising candidate channel material for flexible devices operating at radio-frequency (RF). In this work we fabricated and fully characterized double bottom-gate graphene field effect transistors on flexible polymer substrates for high frequency applications. We report a record high as-measured current gain cut-off frequency (ft) of 39 GHz. The corresponding maximum oscillation frequency (fmax) is 13.5 GHz. These state of the art high frequency performances are stable against bending, with a typical variation of around 10%, for a bending radius of up to 12 mm. To demonstrate the reliability of our devices, we performed a fatigue stress test for RF-GFETs which were dynamically bend tested 1000 times at 1 Hz. The devices are mechanically robust, and performances are stable with typical variations of 15%. Finally we investigate thermal dissipation, which is a critical parameter for flexible electronics. We show that at the optimum polarization the normalized power dissipated by the GFETs is about 0.35 mW μm(-2) and that the substrate temperature is around 200 degree centigrade. At a higher power, irreversible degradations of the performances are observed. Our study on state of the art flexible GFETs demonstrates mechanical robustness and stability upon heating, two important elements to assess the potential of GFETs for flexible electronics.

  16. Accuracy of Cameriere's cut-off value for third molar in assessing 18 years of age.

    PubMed

    De Luca, S; Biagi, R; Begnoni, G; Farronato, G; Cingolani, M; Merelli, V; Ferrante, L; Cameriere, R

    2014-02-01

    Due to increasingly numerous international migrations, estimating the age of unaccompanied minors is becoming of enormous significance for forensic professionals who are required to deliver expert opinions. The third molar tooth is one of the few anatomical sites available for estimating the age of individuals in late adolescence. This study verifies the accuracy of Cameriere's cut-off value of the third molar index (I3M) in assessing 18 years of age. For this purpose, a sample of orthopantomographs (OPTs) of 397 living subjects aged between 13 and 22 years (192 female and 205 male) was analyzed. Age distribution gradually decreases as I3M increases in both males and females. The results show that the sensitivity of the test was 86.6%, with a 95% confidence interval of (80.8%, 91.1%), and its specificity was 95.7%, with a 95% confidence interval of (92.1%, 98%). The proportion of correctly classified individuals was 91.4%. Estimated post-test probability, p was 95.6%, with a 95% confidence interval of (92%, 98%). Hence, the probability that a subject positive on the test (i.e., I3M<0.08) was 18 years of age or older was 95.6%. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  17. Susceptibility profile and epidemiological cut-off values of Cryptococcus neoformans species complex from Argentina.

    PubMed

    Córdoba, Susana; Isla, Maria G; Szusz, Wanda; Vivot, Walter; Altamirano, Rodrigo; Davel, Graciela

    2016-06-01

    Epidemiological cut-off values (ECVs) based on minimal inhibitory concentration (MIC) distribution have been recently proposed for some antifungal drug/Cryptococcus neoformans combinations. However, these ECVs vary according to the species studied, being serotypes and the geographical origin of strains, variables to be considered. The aims were to define the wild-type (WT) population of the C. neoformans species complex (C. neoformans) isolated from patients living in Argentina, and to propose ECVs for six antifungal drugs. A total of 707 unique C. neoformans isolates obtained from HIV patients suffering cryptococcal meningitis were studied. The MIC of amphotericin B, flucytosine, fluconazole, itraconazole, voriconazole and posaconazole was determined according to the EDef 7.2 (EUCAST) reference document. The MIC distribution, MIC50 , MIC90 and ECV for each of these drugs were calculated. The highest ECV, which included ≥95% of the WT population modelled, was observed for flucytosine and fluconazole (32 μg ml(-1) each). For amphotericin B, itraconazole, voriconazole and posaconazole, the ECVs were: 0.5, 0.5, 0.5 and 0.06 μg ml(-1) respectively. The ECVs determined in this study may aid in identifying the C. neoformans strains circulating in Argentina with decreased susceptibility to the antifungal drugs tested.

  18. Solute removal capacity of high cut-off membrane plasma separators.

    PubMed

    Ohkubo, Atsushi; Kurashima, Naoki; Nakamura, Ayako; Miyamoto, Satoko; Iimori, Soichiro; Rai, Tatemitsu

    2013-10-01

    In vitro blood filtration was performed by a closed circuit using high cut-off membrane plasma separators, EVACURE EC-2A10 (EC-2A) and EVACURE EC-4A10 (EC-4A). Samples were obtained from sampling sites before the plasma separator, after each plasma separator, and from the ultrafiltrate of each separator. The sieving coefficient (S.C.) of total protein (TP), albumin (Alb), IgG, interleukin-6 (IL-6), interleukin-8 (IL-8), tumor necrosis factor-α (TNF-α), fibrinogen (Fib), antithrombin III (AT-III), and coagulation factor XIII (FXIII) were calculated. The S.C. of each solute using EC-2A and EC-A4 were as follows; TP: 0.25 and 0.56, Alb: 0.32 and 0.73, IgG: 0.16 and 0.50, IL-6:0.73 and 0.95, IL-8:0.85 and 0.82, TNF-α: 1.07 and 0.99, Fib: 0 and 0, FXIII: 0.07 and 0.17, respectively. When compared with the conventional type of membrane plasma separators, EVACURE could efficiently remove cytokines while retaining coagulation factors such as fibrinogen. Moreover, EC-2A prevented protein loss, whereas EC-4A could remove approximately 50% of IgG. © 2013 The Authors. Therapeutic Apheresis and Dialysis © 2013 International Society for Apheresis.

  19. Azole susceptibility of Malassezia pachydermatis and Malassezia furfur and tentative epidemiological cut-off values.

    PubMed

    Cafarchia, Claudia; Iatta, Roberta; Immediato, Davide; Puttilli, Maria Rita; Otranto, Domenico

    2015-09-01

    This study aims to determine the minimal inhibitory concentration (MIC) distribution and the epidemiological cut-off values (ECVs) of Malassezia pachydermatis and Malassezia furfur isolates for fluconazole (FLZ), itraconazole (ITZ), posaconazole (POS), and voriconazole (VOR). A total of 62 M. pachydermatis strains from dogs with dermatitis and 78 M. furfur strains from humans with bloodstream infections (BSI) were tested by a modified broth microdilution Clinical and Laboratory Standards Institute (CLSI) method. ITZ and POS displayed lower MICs than VOR and FLZ, regardless of the Malassezia species. The MIC data for azoles of M. pachydermatis were four two-fold dilutions lower than those of M. furfur. Based on the ECVs, about 94% of Malassezia strains might be categorized within susceptible population for all azoles, except for FLZ, and azole cross-resistance was detected in association with FLZ in M. pachydermatis but not in M. furfur.The study proposes, for the first time, tentative azole ECVs for M. pachydermatis and M. furfur for monitoring the emergence of isolates with decreased susceptibilities and shows that the azole MIC distribution varied according to the Malassezia species tested, thus suggesting the usefulness of determining the susceptibility profile for effective treatment of each species.

  20. The Objective Borderline Method (OBM): A Probability-Based Model for Setting up an Objective Pass/Fail Cut-Off Score in Medical Programme Assessments

    ERIC Educational Resources Information Center

    Shulruf, Boaz; Turner, Rolf; Poole, Phillippa; Wilkinson, Tim

    2013-01-01

    The decision to pass or fail a medical student is a "high stakes" one. The aim of this study is to introduce and demonstrate the feasibility and practicality of a new objective standard-setting method for determining the pass/fail cut-off score from borderline grades. Three methods for setting up pass/fail cut-off scores were compared: the…

  1. Impact of age- and gender-specific cut-off values for the fecal immunochemical test for hemoglobin in colorectal cancer screening.

    PubMed

    Alvarez-Urturi, Cristina; Andreu, Montserrat; Hernandez, Cristina; Perez-Riquelme, Francisco; Carballo, Fernando; Ono, Akiko; Cruzado, Jose; Cubiella, Joaquín; Hernandez, Vicent; Mao, Carmen Gonzalez; Perez, Elena; Salas, Dolores; Andrés, Mercedes; Bujanda, Luis; Portillo, Isabel; Sarasqueta, Cristina; Quintero, Enrique; Morillas, Juan Diego; Lanas, Angel; Sostres, Carlos; Augé, Josep Maria; Castells, Antoni; Bessa, Xavier

    2016-05-01

    There is no information on the impact of age and gender on the diagnostic yield of different positivity thresholds for the fecal immunochemical test for hemoglobin (FIT). To evaluate the performance of this test at distinct positivity cut-offs in a population-based colorectal cancer (CRC) screening program. CRC detection rate (DR), and analysis of resources were evaluated retrospectively, at different cut-offs of FIT (20, 25, 30, 35 and 40μg Hb/g) respect to a reference value (15μg Hb/g), according to age and gender, in a screening population of 10,611 participants of the ColonPrev study (Quintero. NEJM 2013). At the reference cut-off value, 36 CRC and 252 advanced adenomas (AA) were diagnosed. Increasing the cut-off in women ≤60 years decreases colonoscopies performed by 44.5% without modifying the CRC (DR). Same CRC DR was observed in men ≤60 years and women >60 years increasing cut-off at 25-30μg Hb/g. In men >60 years, all increases in the cut-off affected the CRC DR, especially when the cut-off was increased from 35 to 40μg Hb/g (CRC miss rate 25%). To improve the performance of FIT in CRC screening programs, FIT cut-offs could be individualized by age and gender. Copyright © 2016 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  2. The Objective Borderline Method (OBM): A Probability-Based Model for Setting up an Objective Pass/Fail Cut-Off Score in Medical Programme Assessments

    ERIC Educational Resources Information Center

    Shulruf, Boaz; Turner, Rolf; Poole, Phillippa; Wilkinson, Tim

    2013-01-01

    The decision to pass or fail a medical student is a "high stakes" one. The aim of this study is to introduce and demonstrate the feasibility and practicality of a new objective standard-setting method for determining the pass/fail cut-off score from borderline grades. Three methods for setting up pass/fail cut-off scores were compared: the…

  3. Determination of most suitable cut off point of waist circumference for diagnosis of metabolic syndrome in Kerman.

    PubMed

    Gozashti, Mohammad Hossein; Najmeasadat, Fedaei; Mohadeseh, Shojaei; Najafipour, Hamid

    2014-01-01

    Metabolic syndrome is a determining indicator of cardiovascular diseases and diabetes. Abdominal obesity, determined by measuring waist circumference, is one of the most important criteria for diagnosing this syndrome. This criterion varies between men and women and among different races. The present study aims at the assessment of the sensitivity and specificity of the commonly used cut off point of waist circumference, and the estimation of the most suitable cut off point of waist circumference for the diagnosis of metabolic syndrome in the urban society of Kerman. 5332 subjects consisting of 2966 women and 2366 men, 20 years old and above were studied in a population based, cross sectional study. Waist circumference, blood pressure, blood sugar, and blood lipids were measured. People with at least two of the NCEP ATP III criteria - high blood pressure (BP>130/80), high triglycerides (TG>150), high glucose (FBG>100) and low HDL (HDL<40 in men and <50 in women) - were taken as population at risk. ROC analysis was used for determining the most suitable cut off point of waist circumference. The prevalence of metabolic syndrome was then assessed based on IDF, NCEP criteria and the proposed criterion, and agreement among the three methods in diagnosing people suffering from metabolic syndrome was examined. The average±standard deviation of waist circumference in women and in men was 83.90±12.55 and 87.99±11.94 cm respectively. The most suitable cut off point of waist circumference for metabolic syndrome diagnosis was 86 in women and 89 in men. These circumferences had the highest specificity and sensitivity. The prevalence of metabolic syndrome in IDF, NCPE, and the proposed criterion was 30.4%, 27.7%, and 35.2% respectively. The new criterion and the NCEP criterion achieved the highest agreement (kappa factor=83%). The cuts off point of waist circumference in men and women are close. It is possible, then, to determine a common cut off point of waist circumference

  4. Mechanically robust 39 GHz cut-off frequency graphene field effect transistors on flexible substrates

    NASA Astrophysics Data System (ADS)

    Wei, Wei; Pallecchi, Emiliano; Haque, Samiul; Borini, Stefano; Avramovic, Vanessa; Centeno, Alba; Amaia, Zurutuza; Happy, Henri

    2016-07-01

    Graphene has been regarded as a promising candidate channel material for flexible devices operating at radio-frequency (RF). In this work we fabricated and fully characterized double bottom-gate graphene field effect transistors on flexible polymer substrates for high frequency applications. We report a record high as-measured current gain cut-off frequency (ft) of 39 GHz. The corresponding maximum oscillation frequency (fmax) is 13.5 GHz. These state of the art high frequency performances are stable against bending, with a typical variation of around 10%, for a bending radius of up to 12 mm. To demonstrate the reliability of our devices, we performed a fatigue stress test for RF-GFETs which were dynamically bend tested 1000 times at 1 Hz. The devices are mechanically robust, and performances are stable with typical variations of 15%. Finally we investigate thermal dissipation, which is a critical parameter for flexible electronics. We show that at the optimum polarization the normalized power dissipated by the GFETs is about 0.35 mW μm-2 and that the substrate temperature is around 200 degree centigrade. At a higher power, irreversible degradations of the performances are observed. Our study on state of the art flexible GFETs demonstrates mechanical robustness and stability upon heating, two important elements to assess the potential of GFETs for flexible electronics.Graphene has been regarded as a promising candidate channel material for flexible devices operating at radio-frequency (RF). In this work we fabricated and fully characterized double bottom-gate graphene field effect transistors on flexible polymer substrates for high frequency applications. We report a record high as-measured current gain cut-off frequency (ft) of 39 GHz. The corresponding maximum oscillation frequency (fmax) is 13.5 GHz. These state of the art high frequency performances are stable against bending, with a typical variation of around 10%, for a bending radius of up to 12 mm. To

  5. Thirteen treated of acute renal failure secondary to multiple myeloma with high cut off filters.

    PubMed

    Berni Wennekers, Ana; Martín Azara, María Pilar; Dourdil Sahun, Victoria; Bergasa Liberal, Beatriz; Ruiz Laiglesia, José Esteban; Vernet Perna, Patricia; Alvarez Lipe, Rafael

    2016-01-01

    Multiple myeloma (MM) is a haematological tumour that is characterised by uncontrolled proliferation of plasma cells and a significant volume of serum free light chains (sFLCs), which can cause acute renal failure due to intratubular precipitation, resulting in cast nephropathy. Acute renal failure is a complication that can arise in more than 20% of patients with multiple myeloma, half of which will require dialysis. We report our experience with 13 patients who were treated with dialysis using high cut off filters (HCO) between July 2011 and February 2015. A total of 6 consecutive 6-hour sessions were performed using a 2.1 m(2) HCO filter (Theralite® by Gambro®). Afterwards, further 6-hour sessions were continued on alternate days. A total of 151 sessions were conducted, with an average of 11.6 sessions per patient (range 6-27). The treatment proved to be effective in removing both kappa and lambda sFLCs, resulting in a 93.7% fall in sFLCs by the end of treatment. The average reduction was 57.7% per dialysis session. 10 out of the 13 cases recovered sufficient renal function to become independent of dialysis. There were no major changes in albumin levels using an infusion protocol of 2 50-mL vials of 20% albumin at the end of the dialysis session. Combination treatment with chemotherapy and long dialysis with HCO filters was effective in reducing the sFLC levels and recovering sufficient renal function in 77% of cases. With HCO filters, significant cost savings are achieved, contrary to what was previously believed. Copyright © 2016 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

  6. An alternative method for Frailty Index cut-off points to define frailty categories.

    PubMed

    Romero-Ortuno, Roman

    2013-11-01

    the Frailty Index (FI) is a popular operationalization of frailty. FI cut-off points have been proposed to define, regardless of age, frailty categories with increasing risk. Here, an alternative method is described that takes age into account. 29,905 participants aged ≥ 50 from the first wave of the Survey of Health, Ageing and Retirement in Europe. The mean follow-up for mortality was 2.4 years. Curve estimation procedures were carried out between age and a FI, and 50% Confidence Intervals (CI) for the regression mean were derived. As opposed to the usual method (FI ≤ 0.08: non-frail; FI ≥ 0.25: frail; rest: pre-frail), the alternative method defines as 'fit for their age' those with a FI below the lower 50% CI; 'frail for their age' those with a FI above the upper 50% CI; the rest as 'average for their age'. Using both methods, the prevalence of the frailty categories and their associated mortality rates were compared for each age group. The best fit between age the FI was by cubic regression (R(2) = 0.174, P < 0.001). Among those in their 50s, 5% were frail by the usual method (mortality: 5%) and 14% by the alternative (mortality: 2%). Among those in their 90s, 64% were frail by the usual method (mortality: 43%) and 41% by the alternative (mortality: 48%). the alternative method may be more sensitive in younger ages and more specific in older ages. This may have implications for population screening.

  7. An alternative method for Frailty Index cut-off points to define frailty categories

    PubMed Central

    Romero-Ortuno, Roman

    2013-01-01

    Purpose the Frailty Index (FI) is a popular operationalization of frailty. FI cut-off points have been proposed to define, regardless of age, frailty categories with increasing risk. Here, an alternative method is described that takes age into account. Subjects and methods 29,905 participants aged ≥ 50 from the first wave of the Survey of Health, Ageing and Retirement in Europe. The mean follow-up for mortality was 2.4 years. Curve estimation procedures were carried out between age and a FI, and 50% Confidence Intervals (CI) for the regression mean were derived. As opposed to the usual method (FI ≤ 0.08: non-frail; FI ≥ 0.25: frail; rest: pre-frail), the alternative method defines as ‘fit for their age’ those with a FI below the lower 50% CI; ‘frail for their age’ those with a FI above the upper 50% CI; the rest as ‘average for their age’. Using both methods, the prevalence of the frailty categories and their associated mortality rates were compared for each age group. Results The best fit between age the FI was by cubic regression (R2 = 0.174, P < 0.001). Among those in their 50s, 5% were frail by the usual method (mortality: 5%) and 14% by the alternative (mortality: 2%). Among those in their 90s, 64% were frail by the usual method (mortality: 43%) and 41% by the alternative (mortality: 48%). Conclusion the alternative method may be more sensitive in younger ages and more specific in older ages. This may have implications for population screening. PMID:24379896

  8. Sloshing in Liquid Hydrogen and LOX Propellant Tanks After Main Engine Cut-off

    NASA Technical Reports Server (NTRS)

    Kim, Sura

    2011-01-01

    NASA Marshall Space Flight Center is designing and developing the Main Propulsion System (MPS) for Ares launch vehicles. The objective of this study is to calculate the sloshing forces and moments in the LH2 and LO2 propellant tanks using a CFD/VOF analysis under realistic flight conditions. Propellant sloshing in the liquid hydrogen (LH2) and the liquid oxygen (LO2) propellant tanks after Main Engine Cut Off (MECO) was modeled using the Volume of Fluid (VOF) module of the computational fluid dynamics code, CFD-ACE+. The present simulation shows that there are substantial sloshing side forces acting on the LH2 tank during the deceleration of the vehicle after MECO. The LH2 tank features a side wall drain pipe. The side loads result from the residual propellant mass motion in the LH2 tank which is initiated by the stop of flow into the drain pipe at MECO. The simulations show that radial force on the LH2 tank wall is less than 50 lbf and the radial moment calculated based up the center of gravity of the vehicle is predicted to be as high as 300 lbf-ft. The LO2 tank features a bottom dome drain system and is equipped with sloshing baffles. The remaining LO2 in the tank slowly forms a liquid column along the centerline of tank under the zero gravity environments. The radial force on the LO2 tank wall is predicted less than 100 lbf. The radial moment calculated based on the center of gravity of the vehicle is predicted as high as 4500 lbf-ft just before MECO and dropped down to near zero after propellant draining stopped completely.

  9. Metabolic syndrome in adolescents: definition based on regression of IDF adult cut-off points.

    PubMed

    Benmohammed, K; Valensi, P; Balkau, B; Lezzar, A

    2016-12-01

    The objective of this study was to derive a sex- and age-specific definition of the metabolic syndrome (MetS) and its abnormalities for adolescents. This is a cross-sectional study. A total of 1100 adolescent students, aged 12-18 y, were randomly selected from schools and classrooms in the city of Constantine, Algeria; all had anthropometric measurements taken, and 989 had blood tests. Gender-specific growth curves for components of the MetS were derived, using the LMS (lambda-mu-sigma) method, and the percentiles corresponding to the thresholds of the MetS components proposed for adults by the International Diabetes Federation (IDF) were identified. The prevalence of the MetS using this new definition was 4.3% for boys and 3.7% for girls (P = 0.64). Overall, a high waist circumference was the most frequent of the syndrome components, but the frequency was much higher in girls than that in boys, 33.6% and 6.9%, respectively. In contrast, a high systolic blood pressure was seen in 26.8% of the boys and only 11.4% of the girls. The prevalence of the MetS was higher among adolescents with a body mass index (BMI) ≥95th percentile of the study population, 28.8%, against 9.8% in adolescents with a BMI between the 95th and 85th percentile and 1.8% in those with a BMI <85th percentile (P < 0.0001). MetS during adolescence requires more studies to establish a consensus definition. For clinical practice, we propose a simplified definition for boys and girls based on regression of IDF adult cut-off points. This definition should be tested in further studies with other adolescent populations. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  10. [Cut-off point of epicardial adipose tissue thickness for predicting metabolic syndrome in Venezuelan population].

    PubMed

    Lima-Martínez, Marcos M; Paoli, Mariela; Donis, José H; Odreman, Rodolfo; Torres, Christopher; Iacobellis, Gianluca

    2013-12-01

    To define an echocardiographically-assessed cut-off point for epicardial adipose tissue (EAT) thickness associated to metabolic syndrome (MS) components in Venezuelan subjects. Fifty-two subjects aged 20-65 years diagnosed with MS according to International Diabetes Federation criteria and 45 sex- and age-matched controls were selected. Blood glucose and plasma lipids were tested; EAT thickness and left ventricular mass were measured by echocardiography. No significant age and sex differences were found between the two groups. Body weight, body mass index, waist circumference, and systolic and diastolic blood pressure were significantly higher (P=.0001) in the MS group. This group showed significantly higher levels of fasting blood glucose (P=.0001), total cholesterol (P=.002), LDL-C (P=.007), non-HDL-C (P=.0001), triglycerides (P=.0001), Tg-HDL-C ratio (P=.0001), and lower HDL-C levels (P=.0001) as compared to the control group. EAT thickness (P=.0001) and left ventricular mass (P=.017) were significantly higher in the MS group. The ROC curve showed an AUC of 0.852 (P=.0001) with a power of the test of 0.99. A 5-mm EAT thickness showed a sensitivity of 84.62% (95%CI: 71.9-93.1) and a specificity of 71.11% (95%CI: 55.7-83.6) for predicting MS. The odds ratio of this population for experiencing MS due to an EAT ≥ 5 mm was 8.25 (95%CI: 3.15-21.56; P=.0001). An EAT value ≥ 5 mm has good sensitivity and specificity for predicting MS in the Venezuelan population. Copyright © 2012 SEEN. Published by Elsevier Espana. All rights reserved.

  11. Metacognitive impairments in schizophrenia are arrested at extreme levels of psychopathy: The cut-off effect.

    PubMed

    Abu-Akel, Ahmad; Heinke, Dietmar; Gillespie, Steven M; Mitchell, Ian J; Bo, Sune

    2015-11-01

    Psychopathy and metacognitive difficulties have been associated with the occurrence of violence in schizophrenia. However, evidence suggests that nonschizophrenic psychopaths match or even outperform healthy controls on tests of metacognition. We hypothesize that the metacognitive difficulties associated with schizophrenia may be ameliorated by comorbid psychopathy. To this end, metacognition (using the Metacognition Assessment Scale-Abbreviated [MAS-A]) and psychopathy (using the Hare Psychopathy Checklist-Revised [PCL-R]) are assessed in 79 patients with schizophrenia with a history of criminal offending. Piecewise regression reveals that the association between metacognition and psychopathy changes from a negative to a positive association at a breakpoint corresponding to a score of 24 on the PCL-R. This score is within the range of the cut-off point used for the diagnosis of psychopathy in Europe, which corresponds to a score of 26 on the PCL-R. The patients scoring above 24 on the PCL-R demonstrated better overall metacognitive abilities, suggesting that these patients constitute a specific group in which schizophrenia has an attenuated impairing effect on metacognition. However, this effect was absent for the Mastery subscale of the MAS-A, which refers to the ability to use one's own mental states to solve social and psychological dilemmas. Our results suggest that the relative preservation of metacognitive abilities in schizophrenic patients with extreme levels of psychopathy may contribute to their offending behavior as it may enable them to understand how to manipulate and extort their victims. However, enhancing the Mastery domain of metacognition in these patients may attenuate this offending behavior.

  12. Galactomannan Assay and Invasive Pulmonary Aspergillosis - Comparison of the Test Performance at an in-house and the Kit Cut-off

    PubMed Central

    Menon, Nikhilesh Ravikumar; Sudharma, Arun Ramachandran; Jairaj, Vinutha; Mathew, Joshila

    2016-01-01

    Introduction Invasive Pulmonary Aspergillosis (IPA) is an important opportunistic infection with a high degree of mortality and morbidity. Galactomannan assay (GM assay) is found to be useful for diagnosis of IPA in patients with neutropenia. However the utility of this assay has not been evaluated in a mixed patient population with other co-morbid conditions. Though a kit cut-off of 0.5 has been recommended for the diagnosis of IPA, studies have reported a higher sensitivity with cut-offs more than 0.5. Aim To establish an in-house cut-off and compare its utility with the kit cut-off to diagnose and categorize IPA as proven, probable and possible in patients with varied underlying risk factors. Materials and Methods This observational study was done in St John’s Medical College, Bangalore, Karnataka, India from January 2013-December 2014. GM assay was performed on 25 each of healthy controls and clinically diagnosed cases of IPA. The in-house cut-off was calculated by plotting the Receiver Operating Characteristic Curve (ROC). Results The in-house cut-off was calculated to be 0.52. Using this and the kit cut-off (0.5), the Sensitivity, Specificity, Positive Predictive Value (PPV) and the Negative Predictive Value (NPV) were found to be 75%, 79%, 76%, 82% and 79%, 71%, 77%, 82% respectively. Diabetes mellitus was found to be associated with more than 50% of the patients. Conclusion The established in house cut-off using healthy controls and patients with clinical diagnosis of IPA was not significantly different from that of the kit cut-off. Using either of these cut-offs, we could re-categorize two of the possible IPA cases in the probable group. This study helped to understand the clinical utility of this assay even in a mixed patient population with multiple co-morbidities. PMID:27656435

  13. [Screening for Anxiety in Cardiovascular Rehabilitation Patients: Concurrent Validity and Cut-off Values of the ACAT-cardio].

    PubMed

    Müller, K; Baumeister, H; Abberger, B

    2016-08-01

    The computer adaptive test ACAT-cardio has been developed in order to screen cardiovascular rehabilitation patients for anxiety. This study aims at investigating the criterion validity, and identifying appropriate cut-off values for its use in cardiac rehabilitation. 106 cardiovascular rehabilitation patients were tested for anxiety disorders using the instruments ACAT-cardio and SKID-I. Receiver operating characteristics were employed to analyse the results of 3 stopping rules of the ACAT-cardio. ROC analyses for the stopping rules yielded areas under the curve (AUC) between 0.80 and 0.84. The ideal cut-off values of the ACAT-cardio (theta scores) were - 0.20 (sensitivity: 86%),-0.23 (sensitivity: 71%) and - 0.35 (sensitivity: 86%). The ACAT-cardio has proven to be a valid instrument that can be used for screening anxiety disorders in cardiac rehabilitation. © Georg Thieme Verlag KG Stuttgart · New York.

  14. Cut-off analysis of 19-cell Yb-doped double-cladding rod-type photonic crystal fibers.

    PubMed

    Poli, F; Coscelli, E; Alkeskjold, T T; Passaro, D; Cucinotta, A; Leick, L; Broeng, J; Selleri, S

    2011-05-09

    Yb-doped double-cladding large mode area rod-type photonic crystal fibers are a key component for power scaling in fiber laser systems. Recently, designs with 19-cell core defect, that is with 19 missing air-holes in the center of the photonic crystal cladding, have been proposed, with reported core diameter up to 100 μm. In this paper an analysis of the cut-off wavelength of the first high-order mode in such low-NA fibers is reported, accounting for different approaches for the definition of the cladding effective index. Results have shown that taking into account the finite fiber cross-section and considering the first cladding mode of the actual fiber is mandatory to obtain a correct estimate of the cut-off wavelength.

  15. The use of questionnaires in child psychiatry research: measuring their performance and choosing an optimal cut-off.

    PubMed

    Fombonne, E

    1991-05-01

    This paper introduces the basic principles of Receiver Operating Characteristics (ROC) analysis, a technique to evaluate and compare the discriminant power of questionnaires employed in psychiatric research. ROC curves may assist in the selection of an optimal cut-off point, which has been shown to depend upon the prevalence rate, the consequences of correct and incorrect classifications, and the distributions of scale scores among normal individuals and cases. Then, ROC analysis is applied to the Child Behavior Checklist on a sample of 564 6-11-year old French children. The performances of the social competence scales of this instrument are poorer than those of the behavior problem scales. The findings suggest also that the cut-offs should be varied within this same age group and be higher for screening in community surveys. Further applications of ROC analysis are discussed.

  16. [Receiver operating characteristic analysis and the cost--benefit analysis in determination of the optimal cut-off point].

    PubMed

    Vránová, J; Horák, J; Krátká, K; Hendrichová, M; Kovaírková, K

    2009-01-01

    An overview of the use of Receiver Operating Characteristic (ROC) analysis within medicine is provided. A survey of the theory behind the analysis is offered together with a presentation on how to create a ROC curve and how to use Cost--Benefit analysis to determine the optimal cut-off point or threshold. The use of ROC analysis is exemplified in the "Cost--Benefit analysis" section of the paper. In these examples, it can be seen that the determination of the optimal cut-off point is mainly influenced by the prevalence and the severity of the disease, by the risks and adverse events of treatment or the diagnostic testing, by the overall costs of treating true and false positives (TP and FP), and by the risk of deficient or non-treatment of false negative (FN) cases.

  17. Relevance of an inverse problem approach to overcome cut-off wavenumbers disparities in infrared stationary Fourier transform spectrometers.

    PubMed

    Benoît-Pasanau, Céline; Gillard, Frédéric; Ferrec, Yann; Lefebvre, Sidonie; Rommeluère, Sylvain; Guérineau, Nicolas; Primot, Jérôme

    2012-04-10

    One of the major limitations to the use of infrared focal plane arrays (IRFPAs) in stationary Fourier transform spectrometers (FTSs) comes from the spatial inhomogeneities of the pixel responses, where the inhomogeneities of the cut-off wavenumbers of the pixels can prevail. The hypothesis commonly assumed for FTSs that all the pixels are equivalent is thus inaccurate and results in a degradation of the estimated spectrum, even far from the cut-off wavenumbers. However, if the individual spectral responses of the pixels are measured beforehand, this a priori information can be used in the inversion process to produce reliable spectra. Thus, spatial inhomogeneities are not an obstacle for the use of infrared stationary FTS. This result is illustrated in this paper by numerical simulations, based on a realistic description of an IRFPA.

  18. Current MUAC Cut-Offs to Screen for Acute Malnutrition Need to Be Adapted to Gender and Age: The Example of Cambodia

    PubMed Central

    Fiorentino, Marion; Sophonneary, Prak; Laillou, Arnaud; Whitney, Sophie; de Groot, Richard; Perignon, Marlène; Kuong, Khov; Berger, Jacques; Wieringa, Frank T.

    2016-01-01

    Background Early identification of children <5 yrs with acute malnutrition is a priority. Acute malnutrition is defined by the World Health Organization as a mid-upper-arm circumference (MUAC) <12.5 cm or a weight-for-height Z-score (WHZ) <-2. MUAC is a simple and low-cost indicator to screen for acute malnutrition in communities, but MUAC cut-offs currently recommended by WHO do not identify the majority of children with weight-for-height Z-score (<-2 (moderate malnourished) or r<-3 (severe malnourished). Also, no cut-offs for MUAC are established for children >5 yrs. Therefore, this study aimed at defining gender and age-specific cut-offs to improve sensitivity of MUAC as an indicator of acute malnutrition. Methods To establish new age and gender-specific MUAC cut-offs, pooled data was obtained for 14,173 children from 5 surveys in Cambodia (2011–2013). Sensitivity, false positive rates, and areas under receiver-operator characteristic curves (AUC) were calculated using wasting for children <5yrs and thinness for children ≥5yrs as gold standards. Among the highest values of AUC, the cut-off with the highest sensitivity and a false positive rate ≤33% was selected as the optimal cut-off. Results Optimal cut-off values increased with age. Boys had higher cut-offs than girls, except in the 8–10.9 yrs age range. In children <2yrs, the cut-off was lower for stunted children compared to non stunted children. Sensitivity of MUAC to identify WHZ<-2 and <-3 z-scores increased from 24.3% and 8.1% to >80% with the new cut-offs in comparison with the current WHO cut-offs. Conclusion Gender and age specific MUAC cut-offs drastically increased sensitivity to identify children with WHZ-score <-2 z-scores. International reference of MUAC cut-offs by age group and gender should be established to screen for acute malnutrition at the community level. PMID:26840899

  19. Norms and Cut off Scores for the Autism Spectrum Disorders Diagnosis for Adults (ASD-DA)with Intellectual Disability

    ERIC Educational Resources Information Center

    Matson, Johnny L.; Boisjoli, Jessica A.; Gonzalez, Melissa L.; Smith, Kimberly R.; Wilkins, Jonathan

    2007-01-01

    Establishing the cut-off scores for Autism Spectrum Disorder-Diagnostic (ASD-DA) scale for adults with intellectual disability (ID) and autism or PDD-NOS was the primary goal of this investigation. The aim of Study 1 was to determine if the ASD-DA was able to differentiate between adults with ID with and without an autism spectrum disorder, and to…

  20. Cut-Off Value for Pain Sensitivity Questionnaire in Predicting Surgical Success in Patients with Lumbar Disc Herniation

    PubMed Central

    Azimi, Parisa; Benzel, Edward C.

    2016-01-01

    Various factors related to predict surgical success were studied; however, a standard cut-off point for the Pain Sensitivity Questionnaire (PSQ) measure has not yet been established for a favorable surgical outcome for lumbar disc herniation (LDH). This study was to find the optimal cut-off point on the PSQ to distinguish surgical success in patients with LDH. A total of 154 patients with LDH consecutively referred to our clinic were enrolled into this prospective study between February 2011 and January 2014. All participants completed the PSQ. Patients completed the Oswestry Disability Index (ODI) score before surgery, and at 2 years after surgery. Surgical success was defined as a 13-point improvement from the baseline ODI scores. The cut-off value for PSQ was determined by the receiver-operating characteristic curve (ROC). The mean age of patients was 49.3±9.6 years, and there were 80 women. The mean time for follow-up assessment was 31±5 months (range 24–35). Post-surgical success was 79.9% (n = 123) at 2 years follow up. The mean score for the total PSQ, PSQ-minor, and PSQ-moderate were 6.0 (SD = 1.6), 5.4 (SD = 1.9) and 6.5 (SD = 1.7), respectively. Total PSQ score was also significantly correlated with the total scores of the ODI. The optimal total PSQ cut-off point was determined as > 5.2 to predict surgical success in LDH patients, with 80.0% sensitivity and 75.6% specificity (AUC-0.814, 95% CI 0.703–0.926). This study showed that the PSQ could be considered a parameter for predicting surgical success in patients with LDH, and can be useful in clinical practice. PMID:27494617

  1. Gestational Age-specific Cut-off Values Are Needed for Diagnosis of Subclinical Hypothyroidism in Early Pregnancy

    PubMed Central

    Kim, Hye Sung; Kim, Byoung Jae; Oh, Sohee; Lee, Da Young; Hwang, Kyu Ri; Jeon, Hye Won

    2015-01-01

    During the first trimester of pregnancy, thyroid-stimulating hormone (TSH) >2.5 mIU/L has been suggested as the universal criterion for subclinical hypothyroidism. However, TSH levels change continuously during pregnancy, even in the first trimester. Therefore the use of a fixed cut-off value for TSH may result in a different diagnosis rate of subclinical hypothyroidism according to gestational age. The objective of this study was to obtain the normal reference range of TSH during the first trimester in Korean gravida and to determine the diagnosis rate of subclinical hypothyroidism using the fixed cut-off value (TSH >2.5 mIU/L). The study population consisted of pregnant women who were measured for TSH during the first trimester of pregnancy (n=492) and nonpregnant women (n=984). Median concentration of TSH in pregnant women was lower than in non-pregnant women. There was a continuous decrease of median TSH concentration during the first trimester of pregnancy (median TSH concentration: 1.82 mIU/L for 3+0 to 6+6 weeks; 1.53 mIU/L for 7+0 to 7+6 weeks; and 1.05 mIU/L for 8+0 to 13+6 weeks). Using the fixed cut-off value of TSH >2.5 mIU/L, the diagnosis rate of subclinical hypothyroidism decreased significantly according to the gestational age (GA) at TSH (25% in 3+0 to 6+6 weeks, 13% in 7+0 to 7+6 weeks, and 9% for 8+0 to 13+6 weeks, P<0.001), whereas the diagnosis rate was 5% in all GA with the use of a GA-specific cut-off value (P=0.995). Therefore, GA-specific criteria might be more appropriate for the diagnosis of subclinical hypothyroidism. PMID:26339172

  2. Preoperative haemoglobin cut-off values for the prediction of post-operative transfusion in total knee arthroplasty.

    PubMed

    Yeh, Jared Ze Yang; Chen, Jerry Yongqiang; Bin Abd Razak, Hamid Rahmatullah; Loh, Bryan Huai Gu; Hao, Ying; Yew, Andy Khye Soon; Chia, Shi-Lu; Lo, Ngai Nung; Yeo, Seng Jin

    2016-10-01

    The purpose of this study is to determine preoperative haemoglobin cut-off values that could accurately predict post-operative transfusion outcome in patients undergoing primary unilateral total knee arthroplasty (TKA). This will allow surgeons to provide selective preoperative type and screen to only patients at high risk of transfusion. A total of 1457 patients diagnosed with osteoarthritis and underwent primary unilateral TKA between January 2012 and December 2014 were retrospectively reviewed. Logistic regression analyses were applied to identify factors that could predict transfusion outcome. A total of 37 patients (2.5 %) were transfused postoperatively. Univariate analysis revealed preoperative haemoglobin (p < 0.001), age (p < 0.001), preoperative haematocrit (p < 0.001), and preoperative creatinine (p < 0.001) to be significant predictors. In the multivariate analysis with patients dichotomised at 70 years of age, preoperative haemoglobin remained significant with adjusted odds ratio of 0.33. Receiver operating characteristic curve identified the preoperative haemoglobin cut-off values to be 12.4 g/dL (AUC = 0.86, sensitivity = 87.5 %, specificity = 77.2 %) and 12.1 g/dL (AUC = 0.85, sensitivity = 69.2 %, specificity = 87.1 %) for age above and below 70, respectively. The authors recommend preoperative haemoglobin cut-off values of 12.4 g/dL for age above 70 and 12.1 g/dL for age below 70 to be used to predict post-operative transfusion requirements in TKA. To maximise the utilisation of blood resources, the authors recommend that only patients with haemoglobin level below the cut-off should receive routine preoperative type and screen before TKA. IV.

  3. Gestational Age-specific Cut-off Values Are Needed for Diagnosis of Subclinical Hypothyroidism in Early Pregnancy.

    PubMed

    Kim, Hye Sung; Kim, Byoung Jae; Oh, Sohee; Lee, Da Young; Hwang, Kyu Ri; Jeon, Hye Won; Lee, Seung Mi

    2015-09-01

    During the first trimester of pregnancy, thyroid-stimulating hormone (TSH) >2.5 mIU/L has been suggested as the universal criterion for subclinical hypothyroidism. However, TSH levels change continuously during pregnancy, even in the first trimester. Therefore the use of a fixed cut-off value for TSH may result in a different diagnosis rate of subclinical hypothyroidism according to gestational age. The objective of this study was to obtain the normal reference range of TSH during the first trimester in Korean gravida and to determine the diagnosis rate of subclinical hypothyroidism using the fixed cut-off value (TSH >2.5 mIU/L). The study population consisted of pregnant women who were measured for TSH during the first trimester of pregnancy (n=492) and nonpregnant women (n=984). Median concentration of TSH in pregnant women was lower than in non-pregnant women. There was a continuous decrease of median TSH concentration during the first trimester of pregnancy (median TSH concentration: 1.82 mIU/L for 3+0 to 6+6 weeks; 1.53 mIU/L for 7+0 to 7+6 weeks; and 1.05 mIU/L for 8+0 to 13+6 weeks). Using the fixed cut-off value of TSH >2.5 mIU/L, the diagnosis rate of subclinical hypothyroidism decreased significantly according to the gestational age (GA) at TSH (25% in 3+0 to 6+6 weeks, 13% in 7+0 to 7+6 weeks, and 9% for 8+0 to 13+6 weeks, P<0.001), whereas the diagnosis rate was 5% in all GA with the use of a GA-specific cut-off value (P=0.995). Therefore, GA-specific criteria might be more appropriate for the diagnosis of subclinical hypothyroidism.

  4. Appraisal and standardization of curvilinear velocity (VCL) cut-off values for CASA analysis of Japanese quail (Coturnix japonica) sperm.

    PubMed

    Farooq, U; Malecki, I A; Mahmood, M; Martin, G B

    2017-06-01

    One of the basic steps in objective analysis of sperm motility is the subdivision of a motile sperm population into slow, medium and rapid categories based on their velocity. However, for CASA analysis of quail sperm, the velocity values for categorization of slow, medium and rapid sperm have not yet been standardized. To identify the cut-off values of "velocity curvilinear" (VCL) for quail sperm categorization, we captured and analysed 22,300 tracks of quail sperm using SCA(®) -CASA. The median and mean VCL values were 85 and 97 μm/s. To define the VCL cut-off values, we used two methods. In the first, we identified the upper (rapid sperm) and lower (slow sperm) cut-off values using: (i) median VCL ± 25% or ± 50% or ± 75% of median VCL value; (ii) first and third quartile values of VCL data (i.e. 25% cut-off setting); and (iii) 33% and 66% of VCL data. Among these settings, sperm categories and their corresponding motility characteristics recorded using the "25%" setting (i.e. slow ≤36 ≤ medium ≤154 ≤ rapid) were found the most realistic and coherent with male ranking by fertility. In the second method, we calculated heteroscedasticity in the total VCL data using PCA and the two-step clustering method. With this approach, the mean of the high and low clusters was 165 and 51 μm/s, respectively. Together, the mean from two methods suggested that, for SCA(®) -CASA categorization of quail sperm, sperm should be classed as "rapid" at VCL ≥160 μm/s and "slow" at VCL ≤45 μm/s. © 2017 Blackwell Verlag GmbH.

  5. Improved nonparametric estimation of the optimal diagnostic cut-off point associated with the Youden index under different sampling schemes.

    PubMed

    Yin, Jingjing; Samawi, Hani; Linder, Daniel

    2016-07-01

    A diagnostic cut-off point of a biomarker measurement is needed for classifying a random subject to be either diseased or healthy. However, the cut-off point is usually unknown and needs to be estimated by some optimization criteria. One important criterion is the Youden index, which has been widely adopted in practice. The Youden index, which is defined as the maximum of (sensitivity + specificity -1), directly measures the largest total diagnostic accuracy a biomarker can achieve. Therefore, it is desirable to estimate the optimal cut-off point associated with the Youden index. Sometimes, taking the actual measurements of a biomarker is very difficult and expensive, while ranking them without the actual measurement can be relatively easy. In such cases, ranked set sampling can give more precise estimation than simple random sampling, as ranked set samples are more likely to span the full range of the population. In this study, kernel density estimation is utilized to numerically solve for an estimate of the optimal cut-off point. The asymptotic distributions of the kernel estimators based on two sampling schemes are derived analytically and we prove that the estimators based on ranked set sampling are relatively more efficient than that of simple random sampling and both estimators are asymptotically unbiased. Furthermore, the asymptotic confidence intervals are derived. Intensive simulations are carried out to compare the proposed method using ranked set sampling with simple random sampling, with the proposed method outperforming simple random sampling in all cases. A real data set is analyzed for illustrating the proposed method. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  6. Pharmacokinetics of lenalidomide during high cut-off dialysis in a patient with multiple myeloma and renal failure.

    PubMed

    Dao, Kim; Lu, Yimin; Peer, Cody J; Figg, William D; Stadelmann, Raphael; Burnier, Michel; Buclin, Thierry; Kissling, Sebastien

    2017-01-01

    High cut-off dialysis, increasingly used in multiple myeloma patients, is susceptible to influence anticancer drug elimination. We report about lenalidomide disposition in a patient on high cut-off dialysis for renal failure secondary to myeloma cast nephropathy. The patient received a higher dosage of lenalidomide (5 mg b.i.d.), owing to concerns about a potential decrease in lenalidomide exposure during dialysis sessions. A set of blood samples was taken in order to develop a pharmacokinetic model accounting for lenalidomide concentrations in this setting. According to our model, the area under the curve was 3273 µg h/L, i.e., 60% higher than expected under usual dosage (25 mg q.d.) with normal renal function. Despite this, the patient did not develop major hematological toxicity. Lenalidomide doses of 5 mg b.i.d. led to high exposure in a patient with renal failure undergoing high cut-off dialysis. Yet, the dosage of 5 mg q.d. recommended in conventional dialysis would probably be adequate in such patients.

  7. Does the 65 cm height cut-off as age proxy exclude children eligible for nutritional assessment in Bangladesh?

    PubMed

    Ali, E; Zachariah, R; Hinderaker, S G; Satyanarayana, S; Kizito, W; Alders, P; Shams, Z; Allaouna, M; Draguez, B; Delchevalerie, P; Enarson, D A

    2012-12-21

    Kamrangirchar slum, Dhaka, Bangladesh. During nutritional surveys and in circumstances when it is difficult to ascertain children's age, length/height cut-offs are used as proxy for age to sample children aged 6-59 months. In a context of prevalent stunting, using data from primary health care centres where age and height parameters were well-recorded, we assessed the proportion of children aged between 6 and 59 months who would be excluded from nutritional assessment using a height cut-off of 65 cm as a proxy for age ≥6 months. This was a secondary data analysis of primary health centre data. A total of 2060 children were included in the analysis, with a median age of 24 months and a median height of 78 cm (SD 12.1, range 50-109 cm). There were 240 (12%, 95%CI 10-13) children aged between 6 and 29 months, with a height <65 cm. The majority (59%) of these children were females; 97.5% were aged 6-17 months. In an urban slum setting in Bangladesh, the use of the current height cut-off as a proxy for age excludes vulnerable children from nutritional assessment and could also lead to underestimation of the prevalence of malnutrition in nutritional surveys.

  8. The Potential of Established Fitness Cut-off Points for Monitoring Women with Fibromyalgia: The al-Ándalus Project.

    PubMed

    Castro-Piñero, José; Aparicio, Virginia A; Estévez-López, Fernando; Álvarez-Gallardo, Inmaculada C; Borges-Cosic, Milkana; Soriano-Maldonado, Alberto; Delgado-Fernández, Manuel; Segura-Jiménez, Víctor

    2017-05-01

    The aim of the present study was to determinate whether fitness cut-off points discriminate the severity of major fibromyalgia symptoms and health-related quality of life. Additionally, we investigated which American Colleague of Rheumatology (ACR) fibromyalgia criteria (1990 vs. modified 2010) better discriminate fibromyalgia symptomatology. A total of 488 women with fibromyalgia and 200 non-fibromyalgia (control) women participated. All participants underwent both the 1990 and the modified 2010 ACR preliminary criteria (hereinafter 1990c and m-2010c, respectively). We used fitness cut-off points (Senior Fitness Tests Battery plus handgrip strength test) to discriminate between presence and absence of fibromyalgia. Additionally, we employed several instruments to assess fibromyalgia symptoms. Fitness cut-off points discriminated between high and low levels of the main symptoms the disease in all age groups (P from <0.001 to 0.01). Overall, the arm-curl and the 30-s chair stand tests presented the highest effect sizes in all symptoms, reinforcing the inclusion of fitness testing as a complementary tool for fibromyalgia diagnosis and monitoring. Moreover, the effect size of the differences in symptoms between women with fibromyalgia and controls were overall larger using the m-2010c compared with the 1990c, except for the tender points count, reflecting better the polysymptomatic distress condition of fibromyalgia. © Georg Thieme Verlag KG Stuttgart · New York.

  9. Cut-off values of blood mercury concentration in relation to increased body mass index and waist circumference in Koreans.

    PubMed

    Bae, Suhyun; Park, Soo-Jung; Yeum, Kyung-Jin; Choi, Beomhee; Kim, Young-Sang; Joo, Nam-Seok

    2016-04-01

    Blood mercury (methyl-mercury) from environmental exposure may be related to inflammation in our body. We investigated the cut-off values of blood mercury concentration in relation to increased body mass index (BMI) and waist circumference. On the basis of data obtained from the Korea National Health and Nutrition Examination Survey (KNHANES, 2008-2012), 11,159 subjects (5543 males and 5616 females) were analyzed cross-sectionally. Partial correlation, linear regression, and analysis of covariance (according to the mercury quartile) tests were performed to evaluate the relationship between blood mercury and BMI or waist circumference. In addition, we determined the cut-off values of blood mercury concentration in relation to increased BMI and waist circumference in both genders. Mean values of blood mercury concentration were 5.07 ± 0.07 μg/L in males and 3.59 ± 0.04 μg/L in females. After log transformation of blood mercury, significant (p < 0.001) correlation was found between blood mercury concentration and BMI or waist circumference. BMI and waist circumference showed a significant and gradual increase as mercury quartile increased in both genders. Blood mercury concentration was weakly but significantly (p < 0.001) associated with BMI and waist circumference. Cut-off values of blood mercury concentration correlated with increased BMI and waist circumference were around 3.95 μg/L in males and 3.40 μg/L in females.

  10. Cut-off values for step count and TV viewing time as discriminators of hyperglycaemia in Brazilian children and adolescents.

    PubMed

    Gordia, Alex Pinheiro; Quadros, Teresa Maria Bianchini de; Silva, Luciana Rodrigues; Mota, Jorge

    2016-09-01

    The use of step count and TV viewing time to discriminate youngsters with hyperglycaemia is still a matter of debate. To establish cut-off values for step count and TV viewing time in children and adolescents using glycaemia as the reference criterion. A cross-sectional study was conducted on 1044 schoolchildren aged 6-18 years from Northeastern Brazil. Daily step counts were assessed with a pedometer over 1 week and TV viewing time by self-report. The area under the curve (AUC) ranged from 0.52-0.61 for step count and from 0.49-0.65 for TV viewing time. The daily step count with the highest discriminatory power for hyperglycaemia was 13 884 (sensitivity = 77.8; specificity = 51.8) for male children and 12 371 (sensitivity = 55.6; specificity = 55.5) and 11 292 (sensitivity = 57.7; specificity = 48.6) for female children and adolescents respectively. The cut-off for TV viewing time with the highest discriminatory capacity for hyperglycaemia was 3 hours/day (sensitivity = 57.7-77.8; specificity = 48.6-53.2). This study represents the first step for the development of criteria based on cardiometabolic risk factors for step count and TV viewing time in youngsters. However, the present cut-off values have limited practical application because of their poor accuracy and low sensitivity and specificity.

  11. Interstellar flow longitude from pickup ion cut-off observations at 1 AU with STEREO and ACE

    NASA Astrophysics Data System (ADS)

    Möbius, E.; Lee, M. A.; Gloeckler, G.; Drews, C.; Keilbach, D.

    2016-11-01

    A precision determination of the interstellar neutral (ISN) flow direction is important in several ways. As a cardinal axis of the heliosphere it has strong leverage on the plane subtended by the ISN velocity and interstellar magnetic field vector, which controls the shape of the heliosphere and its interaction with the interstellar medium. Continuing observations of the ISN flow through the heliosphere for several decades allow the search for potential temporal variations of the ISN flow and comparison with astronomical observations. Recent efforts to obtain a consistent ISN vector and temperature with Ulysses and IBEX neutral gas observations point to remaining uncertainties and potential systematic effects. In particular, IBEX measurements provide a very precise relation between ISN flow longitude and speed via the hyperbolic trajectory equation, but they contain larger uncertainties along the parameter tube defined by this relation. The pickup ion (PUI) cut-off variation with ecliptic longitude at 1 AU can provide a complementary determination of the ISN flow longitude with high precision. We compare STEREO PLASTIC and ACE SWICS observations with a simple analytical model of the cut-off. We perform a Pearson correlation analysis of the cut-off as a function of ecliptic longitude with its mirrored function and obtain the symmetry axis with a statistical uncertainty <0.1°. Here we test variations of this value due to Poisson fluctuations in the original data with simulations and due to systematic effects with multi year and location ACE SWICS and STEREO PLASTIC samples.

  12. Ozone transport during a cut-off low event studied in the frame of the TOASTE program

    NASA Technical Reports Server (NTRS)

    Ancellet, G.; Beekmann, M.; Papayannis, A.; Megie, G.

    1994-01-01

    A study of ozone transfer to the troposphere has been performed during two phases of the evolution of a cut-off low using both ozone vertical profiles and objective analysis of the ECMWF to compute potential vorticity distributions and air mass trajectories. Ozone profiles were measured by a ground based lidar system at the Observatoire de Haute Provence (OHP, 43 deg 55 N, 5 deg 42 E). A stratospheric ozone transport into the troposphere has been observed during a tropopause fold which occurred at the beginning of the cut-off low formation and during the erosion phase of the cut-off low. From the estimate of the maximum ozone content transferred to the troposphere, both mechanisms have the same order of magnitude of influence on the ozone flux to the troposphere. On a time scale of a few days, the correlation is very good between the potential vorticity and the ozone time evolution in the vicinity of the upper level frontal system.

  13. Some Factors Affecting the Reproducibility of Penetration and the Cut-Off of Oil Sprays for Fuel-injection Engines

    NASA Technical Reports Server (NTRS)

    Beardsley, E G

    1928-01-01

    This investigation was undertaken at the Langley Memorial Aeronautical Laboratory in connection with a general research on fuel-injection for aircraft. The purpose of the investigation was to determine the factors controlling the reproducibility of spray penetration and secondary discharges after cut-off. The development of single sprays from automatic injection valves was recorded by means of special high-speed photographic apparatus capable of taking 25 consecutive pictures of the moving spray at a rate of 4,000 per second. The effect of two types of injection valves, injection-valve tube length, initial pressure in the injection-valve tube, speed of the injection control mechanism, and time of spray cut-off, on the reproducibility of spray penetration, and on secondary discharges were investigated. It was found that neither type of injection valve materially affected spray reproducibility. The initial pressure in the injection-valve tube controlled the reproducibility of spray penetrations. An increase in the initial pressure or in the length of the injection-valve tube slightly increased the spray penetration within the limits of this investigation. The speed of the injection-control mechanism did not affect the penetration. Analysis of the results indicates that secondary discharges were caused in this apparatus by pressure waves initiated by the rapid opening of the cut-off valve. The secondary discharges were eliminated in this investigation by increasing the length of the injection-valve tube. (author)

  14. Insulin sensitivity indices: a proposal of cut-off points for simple identification of insulin-resistant subjects.

    PubMed

    Radikova, Z; Koska, J; Huckova, M; Ksinantova, L; Imrich, R; Vigas, M; Trnovec, T; Langer, P; Sebokova, E; Klimes, I

    2006-05-01

    Demanding measurement of insulin sensitivity using clamp methods does not simplify the identification of insulin resistant subjects in the general population. Other approaches such as fasting- or oral glucose tolerance test-derived insulin sensitivity indices were proposed and validated with the euglycemic clamp. Nevertheless, a lack of reference values for these indices prevents their wider use in epidemiological studies and clinical practice. The aim of our study was therefore to define the cut-off points of insulin resistance indices as well as the ranges of the most frequently obtained values for selected indices. A standard 75 g oral glucose tolerance test was carried out in 1156 subjects from a Caucasian rural population with no previous evidence of diabetes or other dysglycemias. Insulin resistance/sensitivity indices (HOMA-IR, HOMA-IR2, ISI Cederholm, and ISI Matsuda) were calculated. The 75th percentile value as the cut-off point to define IR corresponded with a HOMA-IR of 2.29, a HOMA-IR2 of 1.21, a 25th percentile for ISI Cederholm, and ISI Matsuda of 57 and 5.0, respectively. For the first time, the cut-off points for selected indices and their most frequently obtained values were established for groups of subjects as defined by glucose homeostasis and BMI. Thus, insulin-resistant subjects can be identified using this simple approach.

  15. High cut-off dialysis in chronic haemodialysis patients reduces serum procalcific activity.

    PubMed

    Zickler, Daniel; Willy, Kevin; Girndt, Matthias; Fiedler, Roman; Martus, Peter; Storr, Markus; Schindler, Ralf

    2016-10-01

    Vascular calcification is enhanced in chronic dialysis patients, possibly due to the insufficient removal of various intermediate molecular weight uraemic toxins such as interleukins with conventional membranes. In this study, we assessed the modulation of in vitro vascular calcification with the use of high cut-off (HCO) membranes in chronic dialysis patients. In a PERCI trial, 43 chronic dialysis patients were treated with conventional high-flux and HCO filters for 3 weeks in a randomized order following a 2-period crossover design. After each phase, serum predialysis samples were drawn. Calcifying human coronary vascular smooth muscle cells (VSMCs) were incubated with the patient's serum samples. Calcification was assessed with alkaline phosphatase (ALP) and alizarin red staining. In the clinical trial, HCO dialysis reduced the serum levels of the soluble tumour necrosis factor receptor (sTNFR) 1 and 2, vascular cell adhesion molecule 1 (VCAM-1) and soluble interleukin-2 receptor (sIL2R). We therefore investigated the in vitro effects of these mediators on vascular calcification. VSMCs incubated with HCO dialysis serum showed a 26% reduction of ALP with HCO serum compared with high-flux serum. Alizarin was 43% lower after incubation with the HCO serum compared with the high-flux serum. While sIL2R and sTNFR 1 and 2 showed no effects on VSMC calcification, VCAM-1 caused a dose-dependent enhancement of calcification. The use of HCO dialysis membranes in chronic dialysis patients reduces the procalcific effects of serum on VSMC in vitro. The mechanisms of the strong effect of HCO on in vitro calcification are not completely understood. One factor may be lower levels of VCAM-1 in HCO serum samples, since VCAM-1 was able to induce vascular calcification in our experiments. Neither sTNFR 1, sTNFR 2 nor sIL2R enhance vascular calcification in vitro. Regardless of the mechanisms, our results encourage further studies of highly permeable filters in chronic dialysis

  16. A rare East Indian Ocean autumn season tropical cut-off low: impacts and a high-resolution modelling study

    NASA Astrophysics Data System (ADS)

    Buckley, B. W.; Leslie, L. M.; Sullivan, W.; Leplastrier, M.; Qi, L.

    2007-04-01

    There are two aims of this study. The first is to provide a synoptic description of the lifecycle and impacts of a seasonally rare but intense cut-off low of tropical origin that developed off the northwest coast of Australia, during the Southern Hemisphere autumn months of late April/early May, 2005. The second, and more important, part of this study is an assessment of the capacity of a state-of-the-science numerical model, assimilating all available satellite-derived observational data, to predict the track, intensity, duration, and severe weather that occurred during the life cycle of the cut-off low. The system was unusual in that its initial development occurred over tropical waters and was associated with a strong and highly involuted subtropical jetstream, generating a cloud band that produced record 24 h rainfall totals in northwest Western Australia for this time of the year. The cut-off low then underwent further deepening which produced more unseasonable heavy rainfall. Confirmed tornado reports occurred over the populous southwest corner of Western Australia. The synoptic discussion focuses initially on the intensification phase of the system, next on the period of heavy rainfall and gale to storm force winds that were generated by the cut-off during its most intense phase, and finally on the severe thunderstorm outbreak over southwest Western Australia. The study reveals a possible additional reason for the intensification of the tropical low, namely, the presence of positive SST anomalies of up to 3 °C over which the storm track passed early in its life. The modelling study used a high-resolution version (10 km horizontal grid spacing) of a coupled atmosphere-ocean model developed at the University of Oklahoma. The 96 hour forecast covered the period 00 UTC April 28 to 00 UTC May 2, 2005. The initial and boundary conditions were obtained from the archived analyses and forecasts from the Australian Bureau of Meteorology. The numerical forecasts

  17. Amphetamines and 3,4-methylendioxymetamphetamine (MDMA): evaluation of KIMS (kinetic interaction of microparticles in solution) assay at two cut-off levels.

    PubMed

    Marchioro, Lucio; Bassetto, Flavia; Dall'Olio, Giuliano; Tedeschi, Luciano; Castagna, Franca; Plebani, Mario

    2004-05-01

    Two screening methods for the assay of amphetamines and their derivatives have been applied to the same analytical instrument for their evaluation. In addition to an assay at a cut-off of 1000 microg/l, a new specific reagent was evaluated for an ultra-sensitive assay of amphetamines and 3,4-methylendioxymetamphetamine with a cut-off of 300 microg/l. The assay confirmation was performed using high-performance liquid chromatography and gas chromatography/ mass spectrometry techniques. The results were positive for both screening methods, confirming the efficacy of two simultaneous methods with different cut-off levels.

  18. Geomagnetism applications

    USGS Publications Warehouse

    Campbell, Wallace H.

    1995-01-01

    The social uses of geomagnetism include the physics of the space environment, satellite damage, pipeline corrosion, electric power-grid failure, communication interference, global positioning disruption, mineral-resource detection, interpretation of the Earth's formation and structure, navigation, weather, and magnetoreception in organisms. The need for continuing observations of the geomagnetic field, together with careful archiving of these records and mechanisms for dissemination of these data, is emphasized.

  19. High frequency cut-off in 1/f conductivity noise of hole-doped La1-x Ca x MnO3 manganite single crystals

    NASA Astrophysics Data System (ADS)

    Przybytek, Jacek; Fink-Finowicki, Jan; Puźniak, Roman; Jung, Grzegorz

    2016-05-01

    High frequency bias and temperature-dependent Lorentzian cut-off has been observed in the 1/f spectra of the conductivity fluctuations in low hole-doped ferromagnetic insulating La1-x Ca x MnO3 manganite at low temperatures. The cut-off frequency depends on dc current bias and temperature. The high frequency cut-off has been tentatively associated with intrinsic limits of the appearance of 1/f noise in the hopping regime of the Coulomb glass state. The assumption is validated by the fact that the Efros-Shklovskii temperature {{T}\\text{ES}} , estimated from the fit of the model to the experimentally measured temperature dependence of the cut-off frequency, has the same value as the temperature {{T}\\text{ES}} evaluated independently from the temperature dependence of the resistivity in the corresponding temperature range.

  20. Geomagnetic anomaly maps of Central Victoria Land (East Antarctica) from ground measurements

    NASA Astrophysics Data System (ADS)

    Bozzo, E.; Meloni, A.

    1992-10-01

    The results of an extensive ground geomagnetic survey over the Central Victoria Land (East Antarctica) between the Transantarctic Mountains and the Ross Sea are used to plot the residual field map of the area under consideration. The data indicate that intense positive anomalies occur along two corridors, one near Mt. Nansen and the other near Mt. Melbourne. Further elaboration of our measurements has produced three other geomagnetic maps: (1) a high-pass filter (cut-off wavelength of 20 km) map; (2) a low-pass filter (cut-off wavelength of 80 km) map; and (3) an upward continuation of the geomagnetic field up to 12000 ft (3660 m) map. The residual field map and the high-pass filter geomagnetic map indicate that all the intense anomalies (both positive and negative) are of shallow origin. The low pass filter map and the upward continuation map show that the land mass of the Central Victoria Land is characterized-by a weak, negative geomagnetic anomaly whereas the near-shore area, close to Terra Nova Bay, displays a weak positive anomaly. Our measurements indicate that all rock types characterized by high susceptibility produce geomagnetic anomalies, even if their outcrop is not extensive. These rocks belong to the Mt. Melbourne volcanics, Jurassic dolerites and Granite Harbour plutons. None of the formations of the metamorphic complex are responsible for intense magnetic signals.

  1. Elevated d-dimer cut-off values for computed tomography pulmonary angiography—d-dimer correlates with location of embolism

    PubMed Central

    Kubak, Mateuzs Piotr; Borthne, Arne; Ruud, Espen Asak; Ashraf, Haseem

    2016-01-01

    Background Acute pulmonary embolism (APE) is a potentially fatal condition, and making a timely diagnosis can be challenging. Computed tomography pulmonary angiography (CTPA) has become the modality of choice, and this contributes to the increasing load on emergency room CT scanners. Our purpose was to investigate whether an elevated d-dimer cut-off could reduce the demand for CTPA while maintaining a high sensitivity and negative predictive value (NPV). Methods We retrospectively reviewed all patients referred for CTPA with suspicion of APE in 2012, and collected d-dimer values and CTPA results. We investigated the diagnostic performance of d-dimer using a 0.5 mg/L cut-off and an age adjusted cut-off. We also evaluated a new and elevated cut-off. Cases were categorized according to their CTPA result into: no embolism, peripheral embolism, lobar embolism and central embolism. Finally we investigated a possible correlation between d-dimer values and location of embolism. Results We included 1,051 CTPAs, from which 216 (21%) showed pulmonary embolism. There were concomitant d-dimer analyses in 822 CTPA examinations. The current 0.5 mg/L cut-off achieved a sensitivity and NPV of 99%. The age-adjusted cut-off achieved a sensitivity and NPV of 98%, and our suggested cut-off of 0.9 mg/L achieved a sensitivity and NPV of 97%. Conclusions We conclude that the elevated d-dimer cut-off of 0.9 mg/L achieved a high sensitivity and NPV, while reducing the number of CTPA by 27%. The correlation between d-dimer values and location of embolisms supports the suggestion of an elevated d-dimer value. PMID:27386486

  2. Screening for Congenital Hypothyroidism: Comparison of Borderline Screening Cut-Off Points and the Effect on the Number of Children Treated with Levothyroxine

    PubMed Central

    Langham, Shirley; Hindmarsh, Peter; Krywawych, Steven; Peters, Catherine

    2013-01-01

    Background The newborn screening programme for congenital hypothyroidism (CH) has led to the prevention of severe developmental delay associated with this condition. In the UK, thyroid-stimulating hormone (TSH) screening cut-off points have changed over time, in some instances prompted by changing methodological platforms. The use of borderline cut-off points varies throughout the country. Objective To use discordance in cut-off points to assess the performance of the UK Newborn Screening Programme Centre (UKNSPC) definitions. Methods Between January 2006 and December 2007, 223,658 newborn infants were screened by the Great Ormond Street Hospital (GOSH) for CH. All children with positive results and those with blood-spot TSH concentrations >6 mU/l on repeat screening were referred to GOSH. We compared the numbers of children detected and treated for CH using the GOSH cut-off points (>6 mU/l) and those of the national screening programme (>10 mU/l). Children were defined as transient CH if levothyroxine treatment had been discontinued by 3 years. Results Of the children screened between January 2006 and December 2007, 167 out of 223,658 fulfilled the GOSH screening criteria; 136 of these required levothyroxine treatment, but 29 (21%) of the children treated would not have been detected by the current UKNSPC guidelines. Transient CH was found in 17/47 (36%) of the treated children detected with a cut-off point >6 mU/l. Raising the cut-off point to >10 mU/l reduced the number of children treated for transient CH to 4/18 (22%). Conclusion A significant number of children with true and transient CH are missed with a screening cut-off point of >10 mU/l. Our data suggests that a cut-off point of 6 mU/l is appropriate. PMID:24847451

  3. Different diagnostic cut-off values of urinary fractionated metanephrines according to sex for the diagnosis of pheochromocytoma in Korean subjects.

    PubMed

    Sohn, Seo Young; Park, Hyung Doo; Lee, Soo Youn; Kim, Jung Han; Jung, Byong Chang; Kim, Hye Jeong; Jang, Hye Won; Kim, Kwang Won; Lee, Moon Kyu; Min, Yong Ki; Kim, Jae Hyeon

    2012-01-01

    The diagnosis of pheochromocytoma depends on the documentation of catecholamine overproduction. The use of urinary fractionated metanephrines has recently become common for the diagnosis of pheochromocytoma. In order to avoid false positive and false negative results, optimal cut-off levels are necessary; however, there have been few published reports on whether different cut-off levels are needed to diagnose pheochromocytoma according to sex. We reviewed the medical records of 815 subjects (including 103 pheochromocytoma patients) whose of 24-h urinary fractionated metanephrine was measured using high-performance liquid chromatography methods and adrenal imaging at Samsung Medical Center. Receiver operating characteristic (ROC) curves were used to determine cut-off values according to sex. The upper limit values of fractionated metanephrine in healthy volunteers and the control group were significantly higher in male subjects compared with females. When we applied cut-off values according to sex, the diagnostic efficacies (defining a positive test as either metanephrine or normetanephrine levels above the cut-off value) were a sensitivity of 96% in male subjects and 98.1% in female subjects and a specificity of 88.6% in male subjects and 94.1% in female subjects. However, when we applied cut-off values without considering sex, the specificity decreased from 88.6% to 77.8% in male subjects. In this study, urinary fractionated metanephrines had a high level of sensitivity and specificity for the diagnosis of pheochromocytoma. However, diagnostic cut-off values were higher in male subjects than in female subjects. Therefore, different cut-off values may be needed according to sex to diagnose pheochromocytoma in Koreans.

  4. Diagnostic yield of a one sample immunochemical test at different cut-off values in an organised screening programme for colorectal cancer.

    PubMed

    Hamza, S; Dancourt, V; Lejeune, C; Bidan, J M; Lepage, C; Faivre, J

    2013-08-01

    Quantitative immunochemical faecal occult blood tests have become the recommended tests for colorectal cancer screening. The aim of this study was to complete our knowledge on the performance of one of the quantitative immunochemical tests available, FOB-Gold, and to propose a possible strategy for an organised screening programme. Within the French organised screening programme, 23,231 average-risk individuals, aged 50-74 performed both a 3-day Hemoccult test and a 1-day FOB-Gold test. Performances of the immunochemical test were evaluated at different cut-off levels. The positivity rate for the Hemoccult was 2.1% and for the FOB-Gold varied between 4.6% (cut-off value of 100 ng/mL, the lowest studied cut-off) and 2.1% (cut-off value of 352 ng/mL). The number of colonoscopies decreased with increasing cut-off values by 21.5% (150 ng/mL), 35.4% (200 ng/mL) and 53.3% (352 ng/mL). The corresponding miss rate for CRC was respectively 6.4%, 11.1% and 22.2%, and for advanced adenoma respectively 16.3%, 29.2% and 43.6%. Compared with the reference cut-off for the FOB-Gold (100 ng/mL) the miss rate for Hemoccult was 53% for CRC and 77% for advanced adenoma. The study suggests that in countries with colonoscopy facilities compatible with a screening test positivity rate of up to 5%, use of a 1-day test with a cut-off value between 100 and 150 ng/mL could be the recommended strategy. Further increasing the cut-off value up to the same positivity rate as Hemoccult could be used in areas with limited access to colonoscopy. Copyright © 2013 Elsevier Ltd. All rights reserved.

  5. Bronchodilator response cut-off points and FEV 0.75 reference values for spirometry in preschoolers

    PubMed Central

    Burity, Edjane Figueiredo; Pereira, Carlos Alberto de Castro; Jones, Marcus Herbert; Sayão, Larissa Bouwman; de Andrade, Armèle Dornelas; de Britto, Murilo Carlos Amorim

    2016-01-01

    ABSTRACT Objective: To determine the cut-off points for FEV1, FEV0.75, FEV0.5, and FEF25-75% bronchodilator responses in healthy preschool children and to generate reference values for FEV0.75. Methods: This was a cross-sectional community-based study involving children 3-5 years of age. Healthy preschool children were selected by a standardized questionnaire. Spirometry was performed before and after bronchodilator use. The cut-off point of the response was defined as the 95th percentile of the change in each parameter. Results: We recruited 266 children, 160 (60%) of whom were able to perform acceptable, reproducible expiratory maneuvers before and after bronchodilator use. The mean age and height were 57.78 ± 7.86 months and 106.56 ± 6.43 cm, respectively. The success rate for FEV0.5 was 35%, 68%, and 70% in the 3-, 4-, and 5-year-olds, respectively. The 95th percentile of the change in the percentage of the predicted value in response to bronchodilator use was 11.6%, 16.0%, 8.5%, and 35.5% for FEV1, FEV0.75, FEV0.5, and FEF25-75%, respectively. Conclusions: Our results provide cut-off points for bronchodilator responsiveness for FEV1, FEV0.75, FEV0.5, and FEF25-75% in healthy preschool children. In addition, we proposed gender-specific reference equations for FEV0.75. Our findings could improve the physiological assessment of respiratory function in preschool children. PMID:27812631

  6. Aeromonas Diversity and Antimicrobial Susceptibility in Freshwater—An Attempt to Set Generic Epidemiological Cut-Off Values

    PubMed Central

    Baron, Sandrine; Granier, Sophie A.; Larvor, Emeline; Jouy, Eric; Cineux, Maelan; Wilhelm, Amandine; Gassilloud, Benoit; Le Bouquin, Sophie; Kempf, Isabelle; Chauvin, Claire

    2017-01-01

    The importance of the role of environment in the dissemination of antimicrobial resistant bacteria is now well recognized. Thus, bacterial indicators to monitor the phenomena are required. The Aeromonas genus is autochthonous in the aquatic environment and easy to detect in any water type, such as freshwater, or wastewater. These microorganisms are also causing infections in humans and animals (including fish). Furthermore, as Aeromonas spp. is able to acquire antimicrobial resistance mechanisms, it is candidate for indicator bacteria to follow antimicrobial resistance dissemination in aquatic environments. Unfortunately, to date, interpretation criteria for Aeromonas spp. for antimicrobial susceptibility tests are scarce in the literature. No epidemiological cut-off values for Aeromonas are currently available at EUCAST to interpret Minimum Inhibitory Concentrations (MIC). The only interpretation criteria available are clinical breakpoints from CLSI that are adapted from Enterobacteriaceae. Based on the results of MIC distributions obtained for a collection of environmental isolates of Aeromonas, this study aimed at proposing tentative epidemiological cut-off values (COWT) for Aeromonas spp. assessing whether the genus is an acceptable level of definition. Thus, 233 isolates collected from 16 rivers were identified at species level using Maldi-Tof (Bruker). Eleven different species were identified, the most abundant were A. bestiarum (n = 54), A. salmonicida (n = 45), A. sobria (n = 41), and A. eucrenophila (n = 37). 96-well micro-plates containing different concentrations of 15 antimicrobials, namely cefotaxime, ceftazidime, chloramphenicol, colistin, enrofloxacin, erythromycin, florfenicol, flumequine, gentamicin, nalidixic acid, oxolinic acid, streptomycin, temocillin, tetracycline, and trimethoprim-sulfamethoxazole, were prepared. The broth micro-dilution method was used to determine the antimicrobial susceptibility of each isolate. The estimation of COWT

  7. Relationship between childhood obesity cut-offs and metabolic and vascular comorbidities: comparative analysis of three growth standards.

    PubMed

    Martínez-Costa, C; Núñez, F; Montal, A; Brines, J

    2014-04-01

    To compare the association between metabolic and vascular comorbidities and the body mass (BMI)-for-age cut-off criteria from three growth standards [Centers for Disease Control and Prevention (CDC), 2000; World Health Organization (WHO), 2007; Spanish Reference Criteria (Carrascosa Lezcano et al., 2008)] that are used to define being overweight and obese in childhood. A prospective study was conducted in 137 children (aged 8-16 years). Based on BMI-for-age Z-scores according to WHO cut-offs, 59 participants were obese, 35 were overweight and 43 were normal-weight. All participating children were subsequently reclassified applying the CDC and Spanish Reference Criteria. Blood pressure (BP), biochemical variables and vascular parameters (stiffness and intima-media thickness) were analysed. According to WHO and CDC references, 48% and 43% of the children, respectively, were categorised as obese, whereas 16% were considered as obese using the Spanish Reference Criteria. Applying WHO criteria, obese children showed significantly higher levels of insulin, homeostasis model assessment index and most vascular parameters, as well as lower high-density lipoprotein (HDL)-cholesterol than overweight children. Moreover, overweight children showed higher BP, insulin and uric acid, and lower HDL-cholesterol than normal weight children. The CDC criteria yielded similar results, although with fewer differences between obese and overweight children. Applying Spanish criteria, the differences between obese and overweight children disappeared. WHO and CDC BMI-for-age references and cut-offs are useful for defining obesity and being overweight in children because they clearly identify metabolic and vascular comorbidities. The Spanish Reference Criteria underdiagnose obesity because overweight children show comorbidities typical of the obese. © 2013 The British Dietetic Association Ltd.

  8. Enhanced Trans-Himalaya Pollution Transport to the Tibetan Plateau by the Cut-off Low System

    NASA Astrophysics Data System (ADS)

    Zhang, R.; Wang, Y.; He, Q.; Chen, L.; Zhang, Y.; Li, J.; Smeltzer, C. D.; Qu, H.; Alvarado, L.; Vrekoussis, M.; Richter, A.; Wittrock, F.; Burrows, J. P.

    2016-12-01

    Deposition of long-range transported black carbon on glaciers of Tibet is one of the key issues of climate research. The transport mechanism, however, is not well understood. We analyze in situ observations of aromatics across Tibetan Plateau using a regional chemistry and transport model. The model performance using the current emission inventories over the region is poor due to problems in the inventories and model transport. Top-down emissions constrained by satellite observations of glyoxal (CHOCHO) are a factor of 2-6 higher than the a priori emissions over the industrialized Indo-Gangetic Plain. We find enhancements of reactive aromatics over Tibet by a factor of 6 in average due to rapid transport from India and nearby regions during the presence of a high-altitude cut-off low system. Our results suggest that the cut-off low system is a major pathway for long-transport of pollutants such as black carbon, the deposition rate of which can greatly increase the melting of remaining glaciers over Tibet. The modeling analysis reveal that even the state-of-the-science high-resolution reanalysis cannot simulate the cut-off low system accurately, which probably explains in part the underestimation of black carbon deposition over Tibet in previous modeling studies. Furthermore, another model deficiency of underestimating pollution transport from the south is due to the complexity of terrain, leading to enhanced transport. It is therefore challenging for coarse-resolution global climate models to properly represent the effects of long-range transport of pollutants on the Tibetan environment and the subsequent consequence for regional climate forcing.

  9. Normal Limits of Electrocardiogram and Cut-Off Values for Left Ventricular Hypertrophy in Young Adult Nigerians.

    PubMed

    Ayoka, A O; Ogunlade, O; Akintomide, A O; Akomolafe, R O; Ajayi, O E

    2014-06-19

    This study assessed healthy young adults to determine the normal limits for electrocardiographic variables and cut-off values for left ventricular hypertrophy. It was a cross sectional descriptive study in which the participants were evaluated clinically by standard 12-lead resting electrocardiogram (ECG) at 25 mm/s during quiet respiration. The heart rate, P wave duration, axis and amplitude, PR and QT intervals, QRS duration, axis and amplitude and T wave axis were assessed. Three hundred and twenty four (324) volunteers comprising of 175 males and 149 females aged 20 to 30 years (mean, 23.01 ± 2.88 years) participated in the study. The normal limits for heart rate, P wave duration, amplitude and axis in lead II, QRS duration and axis, T wave axis, PR interval, QT interval and QTc respectively were; 61-93 beats per minute,0.08-0.12s,1.00-2.00 mm,22.00-79.000,78.00-106.00 ms,15.50-81.000, 24.25-69.000,0.12-0.19s, 0.32-0.40s and 0.36-0.44s. The cut-off values for Sokolow-Lyon, Cornell and Araoye criteria for assessment of left ventricular hypertrophy (LVH) were higher than those previously in use in medical practice. Gender difference exists in some cut-off values for LVH. This study defined the normal limits for electrocardiographic variables for young adult Nigerians. Racial factor should be taken into consideration in interpretation of ECG.

  10. The Adjustment Disorder--New Module 20 as a Screening Instrument: Cluster Analysis and Cut-off Values.

    PubMed

    Lorenz, L; Bachem, R C; Maercker, A

    2016-10-01

    Adjustment disorder (AjD) is a transient mental health condition emerging after stressful life events. Its diagnostic criteria have recently been under revision which led to the development of the Adjustment Disorder--New Module 20 (ADNM-20) as a self-report assessment. To identify a threshold value for people at high risk for AjD. As part of a randomized controlled trial evaluating a self-help manual for burglary victims, the baseline data of all participants (n=80) were analyzed. Besides the ADNM-20, participants answered self-report questionnaires regarding the external variables post-traumatic stress disorder symptomatology, depression, anxiety, and stress levels. We used cluster analysis and ROC analysis to identify the most appropriate cut-off value. The cluster analysis identified three different subgroups. They differed in their level of AjD symptomatology from low to high symptom severity. The same pattern of impairment was found for the external variables. The ROC analysis testing the ADNM-20 sum scoreagainst the theory-based diagnostic algorithm, revealed an optimal cut-off score at 47.5 to distinguish between people at high risk for AjD and people at low risk. The ADNM-20 distinguishes between people with low, moderate, and high symptomatology. The recommendation for a cut-off score at 47.5 facilitates the use of the ADNM-20 in research and practice.

  11. GABAA Receptor Modulation by Phenyl Ring Compounds Is Associated with a Water Solubility Cut-Off Value.

    PubMed

    Brosnan, Robert J; Pham, Trung L

    2016-01-01

    The modulation of N-methyl-D-aspartate receptors is associated with a molar water solubility cut-off effect of approximately 1.1 mmol/l and hence are unaffected by significantly less soluble compounds. However, compounds with this molar water solubility are still able to modulate x03B3;-aminobutyric acid type A (GABAA) receptors. We hypothesized that GABAA receptor modulation by phenolic compounds would exhibit cut-off at a molar water solubility value less than 1.1 mmol/l. GABAA receptors consisting of human α1 and rat β2 and x03B3;2s subunits were expressed in Xenopus laevis oocytes, and drug responses were measured using standard 2-electrode voltage clamp techniques. Twenty substituted phenols and benzenes of similar size and molecular volume were studied at saturated aqueous concentrations. Reversible and statistically significant change in GABAA receptor current that was 10% or greater in magnitude from the baseline response defined a positive drug effect. All phenyl ring compounds with a molar water solubility value equal to or greater than 0.46 mmol/l positively modulated GABAA receptor currents. No compounds with a molar water solubility value equal to or less than 0.10 mmol/l had any effect on GABAA receptor currents. Saturated solutions of phenols with 2,6-dimethyl and 2,6-diisopropyl substituents also caused channel opening in the absence of GABA. The molar water solubility cut-off for GABAA receptor modulation by phenyl ring compounds lies between 0.10 and 0.46 mmol/l. Data suggest that hydrocarbons, perhaps including inhaled anesthetics, might modulate GABAA receptors by displacing water from one or more low-affinity amphipathic binding sites to induce conformational changes that increase ion conductance. © 2016 S. Karger AG, Basel.

  12. Clinically relevant cut-off values for the Parkinson's Disease Sleep Scale-2 (PDSS-2): a validation study.

    PubMed

    Muntean, Maria-Lucia; Benes, Heike; Sixel-Döring, Friederike; Chaudhuri, Kallol Ray; Suzuki, Keisuke; Hirata, Koichi; Zimmermann, Johannes; Trenkwalder, Claudia

    2016-08-01

    Sleep disturbances are a major problem encountered by neurologists attending Parkinson's disease (PD) patients. The Parkinson's Disease Sleep Scale-2 (PDSS-2) assesses a wide spectrum of disease-specific sleep problems and is easy to administer as a patient self-rating scale. The validation study showed that the scale is reliable, valid, and precise. Until now, however, only one Japanese study has assessed cut-off scores to define poor sleepers. In this context we aimed to determine the PDSS-2 cut-off values that define a sleep disturbance severe enough to require referral of the patient to a sleep center or the need for specific treatment. Inpatients with idiopathic PD consecutively admitted to our hospital were enrolled. Patients completed the PDSS-2. The attending physician, who was blinded to the PDSS-2 results, but familiar with the patients' history and current disease status, completed a questionnaire consisting of two general questions on the presence of PD-specific and non-PD related sleep problems. Statistical analysis was performed to determine cut-off values for the PDSS-2 and correlation with the physician's evaluation of sleep disturbance severity. A natural cohort of non-PD patients with sleep disorders represented the control group. The sample consisted of 52 (56%) men and 41 (44%) women with an average age of 69.22 ± 8.74 years. PDSS-2 showed a sensitivity of 77.6% and a specificity of 74.3% in relation to physician's evaluation of PD-specific sleep problems. According to the physician's evaluation, PD-specific sleep disturbances occurred in 62% of the patients. 83% of patients with PDSS-2 scores ≥18 had clinically relevant sleep disturbances compared to only 33% of PD patients with scores <18. The severity of PD-specific sleep problems was well correlated with the PDSS-2 total score (r = 0.49). To our knowledge, this is the first study to define PDSS-2 cut-off values for the severity of sleep disturbances in a European PD sample. Our

  13. Cut-Off Value of Total Adiponectin for Managing Risk of Developing Metabolic Syndrome in Male Japanese Workers

    PubMed Central

    Hata, Akiko; Yonemoto, Koji; Shikama, Yosuke; Aki, Nanako; Kosugi, Chisato; Tamura, Ayako; Ichihara, Takako; Minagawa, Takako; Kuwamura, Yumi; Miyoshi, Masashi; Nakao, Takayuki; Funaki, Makoto

    2015-01-01

    Aim To determine the optimal cut-off value of serum total adiponectin for managing the risk of developing metabolic syndrome (MetS) in male Japanese workers. Methods A total of 365 subjects without MetS aged 20–60 years were followed up prospectively for a mean of 3.1 years. The accelerated failure-time model was used to estimate time ratio (TR) and cut-off value for developing MetS. Results During follow-up, 45 subjects developed MetS. Age-adjusted TR significantly declined with decreasing total adiponectin level (≤ 4.9, 5.0–6.6, 6.7–8.8 and ≥ 8.9 μg/ml, P for trend = 0.003). In multivariate analyses, TR of MetS was 0.12 (95% CI 0.02–0.78; P = 0.03) in subjects with total adiponectin level of 5.0–6.6 μg/ml, and 0.15 (95% CI 0.02–0.97; P = 0.047) in subjects with total adiponectin level ≤ 4.9 μg/ml compared with those with total adiponectin level ≥ 8.9 μg/ml. The accelerated failure-time model showed that the optimal cut-off value of total adiponectin for managing the risk of developing MetS was 6.2 μg/ml. In the multivariate-adjusted model, the mean time to the development of MetS was 78% shorter for total adiponectin level ≤ 6.2 μg/ml compared with > 6.2 μg/ml (TR 0.22, 95% CI: 0.08–0.64, P = 0.005). Conclusion Our findings suggest that the cut-off value for managing the risk of developing MetS is 6.2 μg/ml in male Japanese workers. Subjects with total adiponectin level ≤ 6.2 μg/ml developed MetS more rapidly than did those with total adiponectin level > 6.2 μg/ml. PMID:25705909

  14. Improving the intrinsic cut-off frequency of gate-all-around quantum-wire transistors without channel length scaling

    NASA Astrophysics Data System (ADS)

    Benali, A.; Traversa, F. L.; Albareda, G.; Aghoutane, M.; Oriols, X.

    2013-04-01

    Progress in high-frequency transistors is based on reducing electron transit time, either by scaling their lengths or by introducing materials with higher electron mobility. For gate-all-around quantum-wire transistors with lateral dimensions similar or smaller than their length, a careful analysis of the displacement current reveals that a time shorter than the transit time controls their high-frequency performance. Monte Carlo simulations of such transistors with a self-consistent solution of the 3D Poisson equation clearly show an improvement of the intrinsic cut-off frequency when their lateral areas are reduced, without length scaling.

  15. The usefulness of plasma histamine and different tryptase cut-off points in the diagnosis of peranaesthetic hypersensitivity reactions.

    PubMed

    Berroa, F; Lafuente, A; Javaloyes, G; Ferrer, M; Moncada, R; Goikoetxea, M J; Urbain, C M; Sanz, M L; Gastaminza, G

    2014-02-01

    Anaesthetic hypersensitivity reactions can be IgE- or not IgE-mediated and are a challenge to find the causal agent. Histamine and tryptase determination are classically considered useful in the diagnosis of these reactions. The aim of our study was to assess the diagnostic usefulness of plasma histamine and different cut-off points of serum tryptase. Patients suffering a reaction suggestive of hypersensitivity during general anaesthesia in Clínica Universidad de Navarra (2008-2012) were included. Serum tryptase and plasma histamine were measured at the time of the reaction and 2 h later. Baseline tryptase was also determined. Four to eight weeks after the reaction an allergological study was performed to all the drugs or products involved in the reaction. Sixty-five patients suffered an immediate hypersensitivity reaction during the period of the study. Thirty-seven patients (20 male) with median age 48 years (12-79) were included because they completed allergological study, and histamine and tryptase were correctly obtained. Elevated plasma histamine was observed in 34 cases (92%). Tryptase exceeded twice the basal values in 10 patients (31%). Using different cut-off points of tryptase, the number of patients with elevated tryptase would be 15 patients (41%) for a cut-off point of 5 μg/L; 12 patients (32%) for a cut-off point of 8.23 μg/L; nine patients (24%) for 10.5 μg/L; and eight patients (22%) for 11.4 μg/L. The median tryptase level for the IgE-mediated reactions was 9.0 μg/L (2-70 μg/L) and 4.0 μg/L (3-13 μg/L) in non-IgE-mediated reactions (P < 0.01). Median tryptase levels were higher in more severe reactions (grade 2 or 3) in comparison with grade 1. The best ratio for serum-tryptase-during-reaction/basal-serum-tryptase to discriminate between IgE and non-IgE reactions was 2.0. The best criterion for discriminating IgE- and non IgE-mediated hypersensitivity reactions in anaesthesia was a tryptase value exceeding twice the basal one

  16. Acoustic characterization and prediction of the cut-off dimensionless frequency of an elastic tube by neural networks.

    PubMed

    Dariouchy, Abdelilah; Aassif, El Houcein; Décultot, Dominique; Maze, Gérard

    2007-05-01

    A neural network is developed to predict cut-off dimensionless frequencies of the antisymmetric circumferential waves (Ai) propagating around an elastic circular cylindrical shell of different radius ratio b/a (a, outer radius; b, inner radius). The useful data to train and test the performances of the model are determinated from calculated trajectories of natural modes of resonances or extracted from time-frequency representations of Wigner-Ville of the acoustic backscattered time signal obtained from a computation. In this work, the studied tubes are made of aluminum or stainless steel. The material density, the radius ratio b/a, the index i of the antisymmetric waves, and the propagation velocities in the tube, are selected like relevant entries of the model of neural network. During the development of the network, several configurations are evaluated. The optimal model selected is a network with two hidden layers. This model is able to predict the cut-off dimensionless frequencies with a mean relative error (MRE) of about 1%, a mean absolute error (MAE) of 3.10(-3) k1a, and a standard error (SE) of 10(-3) k1a (k1a is the dimensionless frequency, k is the wave number in water).

  17. Taming cut-off induced artifacts in molecular dynamics studies of solvated polypeptides. The reaction field method.

    PubMed

    Schreiber, H; Steinhauser, O

    1992-12-05

    In this paper we present a model system of a solvated polypeptide, which is a suitable reference platform for the systematic exploration of methods for taming artifacts introduced by an incorrect treatment of long-range Coulomb forces. The essential feature of the system composed of an alpha-helical peptide and 1021 water molecules is the strict neutrality of all charge groups. The dynamical properties of the peptide, i.e. unfolding or maintenance of the helix, already give first hints on the influence of boundary effects. A rigorous and deeper insight is gained, however, if analyzing the system by means of the generalized Kirkwood g-factor, which projects the net dipole moment of concentric spheres onto the respective dipole moment of the reference charge group. The g-factor is a global measure for, and a sensitive probe of, the orientational structure, which in its turn reflects even the smallest inconsistencies in the treatment of long-range forces. While the cut-off scheme failed the g-factor test, the "reaction field" method, the simplest cut-off correction scheme, enables a consistent description. In other words, with the aid of the reaction field, the correct orientational structure is restored. As a consequence, the helix stability is regained and we were able to calculate the dielectric constant epsilon approximately 55 to 60 for our system, which is slightly below the corresponding value epsilon SPC = 66 of the pure solvent.

  18. Interstellar flow direction from pickup ion cut-off dependence on longitude, flow and solar wind speed

    NASA Astrophysics Data System (ADS)

    Möbius, Eberhard; Lee, Martin A.; Drews, Christian; Gloeckler, George

    2016-03-01

    The precise interstellar neutral (ISN) flow direction is important because of its strong leverage on the plane subtended by the ISN and magnetic field vectors, which controls the heliospheric shape and interaction with the interstellar medium. IBEX measurements provide a very precise relation between ISN flow longitude and speed via the hyperbolic trajectory equation, forming a 4-dimensional tube in the ISN parameter space, with substantially larger uncertainty along this tube and thus for the longitude alone. As demonstrated before, the interstellar pickup ion (PUI) cut-off speed is a function of the ratio of the radial ISN flow component and the solar wind speed at the observer location. The former is largest precisely upwind and decreases symmetrically with the angle from the upwind direction. Using this functional dependence and the observed solar wind speed, the PUI cut-off can be constructed solely as a function of the ISN flow longitude. From ACE SWICS and STEREO PLASTIC, data sets that span 18+ years are available. We will show, in particular, that by selecting observations for local interplanetary magnetic fields perpendicular to the solar wind and transforming the observed distributions into the solar wind frame, a comparison with data can be devised that is much less sensitive to PUI production and transport effects than methods that rely on pickup ion fluxes.

  19. Cut-off scaling of high-harmonic generation driven by a femtosecond visible optical parametric amplifier

    NASA Astrophysics Data System (ADS)

    Cirmi, Giovanni; Lai, Chien-Jen; Granados, Eduardo; Huang, Shu-Wei; Sell, Alexander; Hong, Kyung-Han; Moses, Jeffrey; Keathley, Phillip; Kärtner, Franz X.

    2012-10-01

    We studied high-harmonic generation (HHG) in Ar, Ne and He gas jets using a broadly tunable, high-energy optical parametric amplifier (OPA) in the visible wavelength range. We optimized the noncollinear OPA to deliver tunable, femtosecond pulses with 200-500 µJ energy at the 1 kHz repetition rate with excellent spatiotemporal properties, suitable for HHG experiments. By tuning the central wavelength of the OPA while keeping other parameters (energy, duration and beam size) constant, we experimentally studied the scaling law of cut-off energy with the driver wavelength in helium. Our measurements show a λ1.7 + 0.2 dependence of the HHG cut-off photon energy over the full visible range in agreement with previous experiments of near- and mid-IR wavelengths. By tuning the central wavelength of the driver source, the high-order harmonic spectra in the extreme ultraviolet cover the full range of photon energy between ˜25 and ˜100 eV. Due to the high coherence intrinsic in HHG, as well as the broad and continuous tunability in the extreme UV range, a high energy, high repetition rate version of this source might be an ideal seed for free electron lasers.

  20. STS-114: Engine Cut-Off Sensors Are a No-Go: Teaching Notes for NASA Case Study

    NASA Technical Reports Server (NTRS)

    Ransom, Khadijah S.; Johnson, Grace K.

    2013-01-01

    This case study format is intended to simulate the experience of facing the same difficult challenges and making the same critical decisions as managers, engineers, and scientists in the Space Shuttle Program. It has been designed for use in the classroom setting to help students develop skills related to decision-making. Students will read about the engine cut-off sensor anomaly which created challenges during the STS-114 mission and have the opportunity to make decisions as lead NASA engineers and Mission Management Team members. Included within this document are three case study presentation options - class discussion, group activity, and open-ended research. Please read the full case prior to in-class presentation to allow ample time for students' analysis and reflection, as well as to prepare additional questions. activities or exercises, material selection, etc. Depending upon the setting of your presentation and the number of participants, please choose at least one presentation format beforehand and plan accordingly. You may expect the following learning objectives by using the proposed formats. Learning Objectives: To enable students to experience the responsibilities of NASA management, engineers, and analysis; to discover possible procedures for investigating system anomalies; to become familiar with the liquid hydrogen low level engine cut-off sensor, including its function, connecting components, and location within the Space Shuttle; and to encourage critical analysis and stimulating discussion of Space Shuttle mission challenges.

  1. Identifying Atlantic tropical cyclones influenced by subtropical Cut-off low systems in their genesis and maintenance

    NASA Astrophysics Data System (ADS)

    Nieto, R.; Gimeno, L.; de La Torre, L.; Tesouro, M.; Añel, J. A.; García, R.

    2003-04-01

    Cut-off low-pressure systems-COLS- are usually closed circulations at middle and upper troposphere developed from a deep trough in the westerlies. There is a significant percentage of COLs that occur in the Subtropics. These subtropical Cut-off low systems are important for tropical cyclone forecasting as they can force large amounts of harmful vertical wind shear over tropical disturbances and tropical cyclones. There are also suggestions that subtropical COLs can assist tropical cyclone genesis and intensification by providing additional forced ascent near the storm center and/or by allowing for an efficient outflow channel in the upper troposphere. In this study we identify COLs systems in Subtropical for a 41-year period (1958 to 1998) using an approach based in imposing the three main physical characteristics of the conceptual model of COL (a. closed circulation and minimum of geopotential, minimum of equivalent thickness, and two two baroclinic zones, one in front of the low and the other behind the low). Data from NCAR-NCEP reanalysis were used. The objective was to identify those tropical cyclones in the Atlantic basis that were related to COLs in their genesis, intensification or maintenance as well as to characterize contour conditions that permit a COL to assist tropical cyclone genesis what will be useful for its predictive potential.

  2. Determination of the accuracy and optimal cut-off point for ELISA test in diagnosis of human brucellosis in Iran.

    PubMed

    Hasibi, Mehrdad; Jafari, Sirus; Mortazavi, Habibollah; Asadollahi, Marjan; Esmaeeli Djavid, Gholamreza

    2013-01-01

    In endemic area the most challenging problem for brucellosis is to find a reliable diagnostic method. In this case-control study, we investigated the accuracy of ELISA test for diagnosis of human brucellosis and determined the optimal cut-off value for ELISA results in Iran. The laboratory diagnosis of brucellosis was performed by blood isolation of Brucella organism with a BACTEC 9240 system and/or detection of Brucella antibodies by standard agglutination test (titer ≥ 1:160). Serum level of ELISA IgG and ELISA IgM from 56 confirmed cases of brucellosis and 126 controls were compared with each other by Box plot graph and Receiver Operating Characteristic (ROC) curve. Box plot graphs showed the high degree of dispersion for IgG and IgM data in patients compared with all controls. We observed partially overlapping for IgM data (not for IgG) between cases and controls in graphs. The area under ROC curve for distinguishing between cases and controls was larger for IgG compared to IgM. Based on results of this study, ELISA IgG test was more reliable than ELISA IgM test in diagnosis of human brucellosis in Iran. Using a cut-off of 10 IU/ml and 50 IU/ml had most sensitivity (92.9%) and most specificity (100%) for ELISA IgG test, respectively.

  3. In Vitro Dialysis of Cytokine-Rich Plasma With High and Medium Cut-Off Membranes Reduces Its Procalcific Activity.

    PubMed

    Willy, Kevin; Hulko, Michael; Storr, Markus; Speidel, Rose; Gauss, Julia; Schindler, Ralf; Zickler, Daniel

    2017-09-01

    Recently developed high-flux (HF) dialysis membranes with extended permeability provide better clearance of middle-sized molecules such as interleukins (ILs). Whether this modulation of inflammation influences the procalcific effects of septic plasma on vascular smooth muscle cells (VSMCs) is not known. To assess the effects of high cut-off (HCO) and medium cut-off (MCO) membranes on microinflammation and in vitro vascular calcification we developed a miniature dialysis model. Plasma samples from lipopolysaccharide-spiked blood were dialyzed with HF, HCO, and MCO membranes in an in vitro miniature dialysis model. Afterwards, IL-6 concentrations were determined in dialysate and plasma. Calcifying VSMCs were incubated with dialyzed plasma samples and vascular calcification was assessed. Osteopontin (OPN) and matrix Gla protein (MGP) were measured in VSMC supernatants. IL-6 plasma concentrations were markedly lower with HCO and MCO dialysis. VSMC calcification was significantly lower after incubation with MCO- and HCO-serum compared to HF plasma. MGP and OPN levels in supernatants were significantly lower in the MCO but not in the HCO group compared to HF. In vitro dialysis of cytokine-enriched plasma samples with MCO and HCO membranes reduces IL-6 levels. The induction of vascular calcification by cytokine-enriched plasma is reduced after HCO and MCO dialysis. © 2017 International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

  4. Accuracy of cut-off value by measurement of third molar index: Study of a Colombian sample.

    PubMed

    De Luca, Stefano; Aguilar, Lina; Rivera, Marcela; Palacio, Luz Andrea Velandia; Riccomi, Giulia; Bestetti, Fiorella; Cameriere, Roberto

    2016-04-01

    The aim of this cross-sectional study was to test the accuracy of cut-off value of 0.08 by measurement of third molar index (I3M) in assessing legal adult age of 18 years in a sample of Colombian children and young adults. Digital orthopantomographs of 288 Colombian children and young adults (163 girls and 125 boys), aged between 13 and 22 years, were analysed. Concordance correlation coefficient (ρc) and κ statistics (Cohen's Kappa coefficient) showed that repeatability and reproducibility are high for both intra- and inter-observer error. κ statistics for intra- and inter-observer agreement in decision on adult or minor was 0.913 and 0.877, respectively. Age distribution gradually decreases as I3M increases in both girls and boys. For girls, the sensitivity test was 95.1% (95% CI 87.1%-95%) and specificity was 93.8% (95% CI 87.1%-98.8%). The proportion of correctly classified individuals was 95.1%. For boys, the sensitivity test was 91.7% (95% CI 85.1%-96.8%) and specificity was 90.6% (95% CI 82.1%-97.8%). The proportion of correctly classified individuals was 89.7%. The cut-off value of 0.08 is highly useful to determine if a subject is 18 years of age or older or not. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  5. Defining morbid obesity in children based on BMI 40 at age 18 using the extended international (IOTF) cut-offs.

    PubMed

    Bervoets, L; Massa, G

    2014-10-01

    Studies have reported that children who are obese are becoming more severely obese. We aimed to classify obese children based on age- and gender-specific centile curves passing through body mass index (BMI) 30, 35 and 40 at age 18 as 'class I', 'class II' or severe, and 'class III' or morbid obesity. In addition to the International Obesity Task Force BMI cut-offs corresponding to BMI 30 and 35, we calculated the BMI cut-offs corresponding to BMI 40 using the LMS method proposed by Cole and Lobstein. We classified 217 obese children according to these criteria. Fifty-six (25.8%) children had class III obesity, 73 (33.6%) class II obesity and 88 (40.6%) class I obesity. Class III obese children had a higher waist circumference, systolic blood pressure and fasting insulinaemia compared with less obese children. It is clinically important to classify obese children in different classes of obesity severity. © 2014 The Authors. Pediatric Obesity © 2014 International Association for the Study of Obesity.

  6. Cut-off of anthropometry measurement and nutritional status among elderly outpatient in Indonesia: multi-centre study.

    PubMed

    Setiati, Siti; Istanti, Rahmi; Andayani, Rejeki; Kuswardhani, R A Tuty; Aryana, I G P Suka; Putu, I Dewa; Apandi, M; Ichwani, Jusri; Soewoto, Sumarmi; Dinda, Rose; Mustika, Syifa

    2010-10-01

    To obtain the cut-off value of anthropometric measurements and nutritional status of elderly in Indonesia. A multicentre-cross sectional study was performed at 9 hospitals in Indonesia. The data collected comprises of samples characteristics, anthropometric measurements (weight, height, trisep, bisep, subscapular, suprailiac, and circumference of the hip, waist, arm, calf, and thigh), albumin value, MNA score and ADL Index of Barthel. A total of 702 subjects were collected. The average value of serum albumin is 4.28 g/dl, with 98% subjects had normal serum albumin (> 3.5 g/dl). The mean MNA score and BMI was 23.07 and 22.54 respectively. Most of subjects (56.70%) had risk of malnutrition based on MNA score, and 45.01% had normal nutritional status based on body mass index. Average value of several anthropometric measures (weight, stature, and body mass index; sub-scapular and supra-iliac skinfolds; thigh, calf, mid-arm, and waist circumferences) in various age groups in both groups of women and men were obtained. Cut-off values of various anthropometric indicators were also analyzed in this study with MNA as a gold standard. This study showed age related anthropometric measurement differences in both men and women aged 60 years and older.

  7. Geomagnetic Disturbances.

    DTIC Science & Technology

    1986-01-01

    Sheeley, Jr., and J.T. Hoeksema. Lund University, Lund , Sweden, August 1983 (Invited Talks): "The Structure of the Heliospheric Current Sheet: 1976...Society, San Franciso, California, January 13-16, 1980: "Geomagnetic Activity and Hale Sector Boundaries," Henrik Lundstedt. "Solar Oscillations with

  8. A sensitive assay for urinary cocaine metabolite benzoylecgonine shows more positive results and longer half-lives than those using traditional cut-offs.

    PubMed

    Nickley, Joyce; Pesce, Amadeo J; Krock, Kevin

    2017-08-01

    Cocaine is a common drug of abuse. To detect its use, a screening detection concentration for the cocaine metabolite benzoylecgonine is commonly set at 150 ng/mL and its confirmatory cut-off is set at 100 ng/mL. Studies have suggested that these cut-offs may be set too high, allowing some patients with this substance abuse problem to be missed or improperly monitored. With the advent of liquid chromatography-tandem mass spectrometry (LC-MS/MS) technology it is possible to reliably detect and quantify lower concentrations of its metabolite benzoylecgonine as part of a larger drug panel. One purpose of the study was to establish if there was a significant increase in detection of cocaine use with a ten-fold more sensitive cut-off. A very sensitive dilute and shoot assay for benzoylecgonine was developed with a lower limit of quantitation of 5 ng/mL. Validation of the 5 ng/mL cut-off was achieved by plotting all the positive cocaine observations as a frequency distribution on a logarithmic scale. The number of positive results with measurable concentrations below the typical industry 100 ng/mL cut-off level but above the high sensitivity 5 ng/mL cut-off level was observed to be 51.9% of the observed positives. The lower cut-off also allowed a re-evaluation of the window of detection after cessation of use. It was observed to be between 17 and 22 days. © 2016 Precision Diagnostics, LLC. Drug Testing and Analysis published by John Wiley & Sons, Ltd. © 2016 Precision Diagnostics, LLC. Drug Testing and Analysis published by John Wiley & Sons, Ltd.

  9. Maturity negates the gender-related difference in physical activity among youth. Is this equally justified whatever the accelerometer cut-off point used?

    PubMed

    Zitouni, Djamel; Guinhouya, Benjamin C

    2012-07-01

    To examine the consistency in findings about the influence of maturity on the gender-difference in moderate-to-vigorous physical activity (MVPA) of children using different cut-off points for MVPA. Cross-sectional observation study. The sample involved 253 children (139 boys) of 9.9±0.9 years. Their physical activity was evaluated using an Actigraph accelerometer. The biological age of children was determined with their estimated age at the peak height velocity, and maturity categories were gender-specific defined. Boys spent more time in MVPA than girls (P<0.0001), and no maturity-related differences were obtained on the whole sample. It was only among boys that differences were found between maturity groups with cut-off points of 3000 cpm (P=0.034), 3200 cpm (P=0.024), and 3600 cpm (P=0.011). At a given maturity level, boys spent significantly more time in MVPA than girls, except with the cut-off point of 1000 cpm (P=0.07). There were higher proportions of sufficiently active boys, but significances were reached only with cut-off points above 3000 cpm. There were no maturity-related differences in the proportion of sufficiently active children as MVPA was computed using cut-off points of 1000 cpm, 2000 cpm or 3000 cpm. The role of maturity in the gender-difference in MVPA seems unclear as one another cut-off point is used among children. Even if a relatively greater consistency was found with the three cut-off points above 3000 cpm, data comparison may require a conversion system until a consensus is reached about the exact value to be used among children. Copyright © 2011 Sports Medicine Australia. Published by Elsevier Ltd. All rights reserved.

  10. The cut-off values of anthropometric variables for predicting mild cognitive impairment in Malaysian older adults: a large population based cross-sectional study

    PubMed Central

    Won, Huiloo; Abdul, Manaf Zahara; Mat Ludin, Arimi Fitri; Omar, Mohd Azahadi; Razali, Rosdinom; Shahar, Suzana

    2017-01-01

    Purpose Older adults are at risk of mild cognitive impairment (MCI), and simple anthropometric measurements can be used to screen for this condition. Thus, the aim of this study was to explore the cut-off values of body mass index (BMI) and waist circumference (WC) for predicting the risk of MCI in older Malaysian adults. Methods A total of 2,240 Malaysian older adults aged ≥60 years were recruited using multistage random sampling in a population based cross-sectional study. Receiver operating characteristic (ROC) curve was used to determine the cut-off values of BMI and WC with optimum sensitivity and specificity for the detection of MCI. Age, gender, years of education, smoking habit, alcohol consumption, depression, and medical conditions were used as confounding factors in this analysis. Results A BMI cut-off value of 26 kg/m2 (area under the receiver operating characteristic curve [AUC] 0.725; sensitivity 90.5%; specificity 38.8%) was appropriate in identifying the risk of getting MCI in both men and women. The optimum WC cut-offs for likelihood of MCI were 90 cm (AUC 0.745; sensitivity 78.0%; specificity 59.8%) for men and 82 cm (AUC 0.714; sensitivity 84.3%; specificity 49.7%) for women. The optimum calf circumference (CC) cut-off values for identifying MCI were 29 cm (AUC 0.731; sensitivity 72.6%; specificity 61.1%) for men and 26 cm (AUC 0.598; sensitivity 79.1%; specificity 45.3%) for women. Conclusion The cut-off values could be advocated and used as part of the screening of MCI among older Malaysian adults. There is a need to further determine the predictive values of these cut-off points on outcomes through longitudinal study design. PMID:28223785

  11. Body mass index, waist circumference and waist-to-hip ratio cut-off points for categorisation of obesity among Omani Arabs.

    PubMed

    Al-Lawati, Jawad A; Jousilahti, Pekka

    2008-01-01

    There are no data on optimal cut-off points to classify obesity among Omani Arabs. The existing cut-off points were obtained from studies of European populations. To determine gender-specific optimal cut-off points for body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) associated with elevated prevalent cardiovascular disease (CVD) risk among Omani Arabs. A community-based cross-sectional study. The survey was conducted in the city of Nizwa in Oman in 2001. The study contained a probabilistic random sample of 1421 adults aged > or =20 years. Prevalent CVD risk was defined as the presence of at least two of the following three risk factors: hyperglycaemia, hypertension and dyslipidaemia. Logistic regression and receiver-operating characteristic (ROC) curve analyses were used to determine optimal cut-off points for BMI, WC and WHR in relation to the area under the curve (AUC), sensitivity and specificity. Over 87% of Omanis had at least one CVD risk factor (38% had hyperglycaemia, 19% hypertension and 34.5% had high total cholesterol). All three indices including BMI (AUC = 0.766), WC (AUC = 0.772) and WHR (AUC = 0.767) predicted prevalent CVD risk factors equally well. The optimal cut-off points for men and women respectively were 23.2 and 26.8 kg m-2 for BMI, 80.0 and 84.5 cm for WC, and 0.91 and 0.91 for WHR. To identify Omani subjects of Arab ethnicity at high risk of CVD, cut-off points lower than currently recommended for BMI, WC and WHR are needed for men while higher cut-off points are suggested for women.

  12. The theoretical and practical determination of clinical cut-offs for the British Sign Language versions of PHQ-9 and GAD-7.

    PubMed

    Belk, Rachel A; Pilling, Mark; Rogers, Katherine D; Lovell, Karina; Young, Alys

    2016-11-03

    The PHQ-9 and the GAD-7 assess depression and anxiety respectively. There are standardised, reliability-tested versions in BSL (British Sign Language) that are used with Deaf users of the IAPT service. The aim of this study is to determine their appropriate clinical cut-offs when used with Deaf people who sign and to examine the operating characteristics for PHQ-9 BSL and GAD-7 BSL with a clinical Deaf population. Two datasets were compared: (i) dataset (n = 502) from a specialist IAPT service for Deaf people; and (ii) dataset (n = 85) from our existing study of Deaf people who self-reported having no mental health difficulties. Parameter estimates, with the precision of AUC value, sensitivity, specificity, positive predicted value (ppv) and negative predicted value (npv), were carried out to provide the details of the clinical cut-offs. Three statistical choices were included: Maximising (Youden: maximising sensitivity + specificity), Equalising (Sensitivity = Specificity) and Prioritising treatment (False Negative twice as bad as False Positive). Standard measures (as defined by IAPT) were applied to examine caseness, recovery, reliable change and reliable recovery for the first dataset. The clinical cut-offs for PHQ-9 BSL and GAD-7 BSL are 8 and 6 respectively. This compares with the original English version cut-offs in the hearing population of 10 and 8 respectively. The three different statistical choices for calculating clinical cut-offs all showed a lower clinical cut-off for the Deaf population with respect to the PHQ-9 BSL and GAD-7 BSL with the exception of the Maximising criteria when used with the PHQ-9 BSL. Applying the new clinical cut-offs, the percentage of Deaf BSL IAPT service users showing reliable recovery is 54.0 % compared to 63.7 % using the cut-off scores used for English speaking hearing people. These compare favourably with national IAPT data for the general population. The correct clinical cut-offs for the PHQ-9 BSL and

  13. Ultrasound cut-off values for intima-media thickness of temporal, facial and axillary arteries in giant cell arteritis.

    PubMed

    Schäfer, Valentin S; Juche, Aaron; Ramiro, Sofia; Krause, Andreas; Schmidt, Wolfgang A

    2017-09-01

    To evaluate the intima-media thickness (IMT) of arteries involved in GCA for determining cut-off values. Forty newly diagnosed GCA patients in a fast-track GCA clinic and 40 age- and sex-matched controls were included. IMT measurement was performed at or within 24 h after diagnosis. The common superficial temporal arteries with their frontal and parietal branches and the facial arteries were bilaterally examined with a 10-22 MHz probe and the axillary artery with a 6-18 MHz probe. Receiver operating characteristics analysis was performed for estimating cut-off values. The mean age was 72 years (s.d. 9) and 68% were females. In the control group, IMT was 0.23 mm (s.d. 0.04), 0.19 mm (s.d. 0.03), 0.20 mm (s.d. 0.03), 0.24 mm (s.d. 0.05) and 0.59 mm (s.d. 0.10) for the common superficial temporal arteries, the frontal and parietal branches, the facial arteries and the axillary arteries, respectively. In vasculitic segments of GCA patients, IMT was 0.65 mm (s.d. 0.18), 0.54 mm (s.d. 0.18), 0.50 mm (s.d. 0.17), 0.53 mm (s.d. 0.16) and 1.7 mm (s.d. 0.41), respectively. Cut-off values are 0.42, 0.34, 0.29, 0.37 and 1.0 mm, respectively, with 100% sensitivities and specificities for common superficial temporal arteries, for frontal branches and for axillary arteries and sensitivities of 97.2 and 87.5% and specificities of 98.7 and 98.8% for parietal branches and facial arteries, respectively. The intraclass correlation coefficient was between 0.87 and 0.98. IMT measurement can correctly distinguish vasculitic from normal arteries in suspected GCA.

  14. Trend, projection, and appropriate body mass index cut-off point for diabetes and hypertension in Bangladesh.

    PubMed

    Rahman, Md Mizanur; Akter, Shamima; Jung, Jenny; Rahman, Md Shafiur; Sultana, Papia

    2017-04-01

    Rapid increasing of high body mass index (BMI) is a global health concern. Population with high BMI predicts an increased risk of diabetes and hypertension. The objective of the present study is to estimate the trend and prediction of diabetes and hypertension in Bangladesh, to examine the association of BMI with risk of diabetes and hypertension, and to ascertain an appropriate BMI cut-off point for screening diabetes. We searched PubMed from inception to August 2016 and identified studies reporting diabetes and hypertension prevalence in Bangladesh. Bangladesh Demographic and Health Survey 2011 data was also included in this study. Bayesian model was used to estimate trend and projection in diabetes and hypertension prevalence by sex and residence. Receiver operating characteristic curves was used to determine the optimal BMI cut-off point for screening diabetes. Of 535 articles reviewed, 35 studies reported prevalence of diabetes and hypertension. Prevalence of diabetes (95% credible interval) increased between 1992 and 2015 from 3.2% (2.2-4.3) to 12.1% (9.1-15.4) in men, and from 2.5% (1.8-3.5) to 13.4% (9.7-17.6) in women. Diabetes prevalence in 2030 is expected to reach 23.6% (13.6-36.3) for men and 33.5% (19.9-50.9) for women. Hypertension prevalence increased between 1992 and 2015 from 11.0% (8.6-13.7) to 20.4% (18.4-22.4%) in 2015 in men, and from 14.0% (10.3-19.0) to 21.3% (19.0-23.6) in women. Annual average rate of change for diabetes prevalence was higher among women and in rural areas, while for hypertension prevalence it was higher in men and urban areas. Adults with BMI of 22.5kg/m(2) or above had a higher risk of diabetes and hypertension in this study. The optimal BMI cut-off point for screening diabetes was 23kg/m(2) for overall population, 22kg/m(2) for men, and 23kg/m(2) for women. Diabetes is more prevalent among women and rural population groups, while hypertension is more prevalent among men and urban population groups in Bangladesh. A BMI

  15. One millimetre is the safe cut-off for magnetic resonance imaging prediction of surgical margin status in rectal cancer.

    PubMed

    Taylor, F G M; Quirke, P; Heald, R J; Moran, B; Blomqvist, L; Swift, I; St Rose, S; Sebag-Montefiore, D J; Tekkis, P; Brown, G

    2011-06-01

    A pathologically involved margin in rectal cancer is defined as tumour within 1 mm of the surgical resection margin. There is no standard definition of a predicted safe margin on magnetic resonance imaging (MRI). The aim of this study was to assess which cut-off (1, 2 or 5 mm) was the best predictor of local recurrence based on preoperative MRI assessment of the circumferential resection margin (CRM). Data were collected prospectively on the distance between the tumour and mesorectal fascia for patients with documented radiological margin status in the MERCURY study. Positive margin and local recurrence rates were compared for MRI distances from the tumour to the mesorectal fascia of 1 mm or less, more than 1 mm up to 2 mm, more than 2 mm up to 5 mm, and more than 5 mm. The Cox proportional hazard regression method was used to determine the effect of level of margin involvement on time to local recurrence. Univariable analysis showed that, relative to a distance measured by MRI of more than 5 mm, the hazard ratio (HR) for local recurrence was 3·90 (95 per cent confidence interval 1·99 to 7·63; P < 0·001) for a margin of 1 mm or less, 0·81 (0·36 to 1·85; P = 0·620) for a margin of more than 1 mm up to 2 mm, and 0·33 (0·10 to 1·08; P = 0·067) for a margin greater than 2 mm up to 5 mm. Multivariable analysis of the effect of MRI distance to the mesorectal fascia and preoperative treatment on local recurrence showed that a margin of 1 mm or less remained significant regardless of preoperative treatment (HR 3·72, 1·43 to 9·71; P = 0·007). For preoperative staging of rectal cancer, the best cut-off distance for predicting CRM involvement using MRI is 1 mm. Using a cut-off greater than this does not appear to identify patients at higher risk of local recurrence. Copyright © 2011 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

  16. The impact of an underground cut-off wall on nutrient dynamics in groundwater in the lower Wang River watershed, China.

    PubMed

    Kang, Pingping; Xu, Shiguo

    2017-03-01

    Underground cut-off walls in coastal regions are mainly used to prevent saltwater intrusion, but their impact on nutrient dynamics in groundwater is not clear. In this study, a combined analysis of multiple isotopes ([Formula: see text]) and nitrogen and phosphorus concentrations is used in order to assess the impact of the underground cut-off walls on the nutrient dynamics in groundwater in the lower Wang River watershed, China. Compared with the nitrogen and phosphorus concentrations in groundwater downstream of the underground cut-off walls, high [Formula: see text] and total dissolved nitrogen concentrations and similar concentration levels of [Formula: see text] and total dissolved phosphorus are found in groundwater upstream of the underground cut-off walls. The isotopic data indicated the probable occurrence of denitrification and nitrification processes in groundwater upstream, whereas the fingerprint of these processes was not shown in groundwater downstream. The management of fertilizer application is critical to control nitrogen concentrations in groundwater restricted by the underground cut-off walls.

  17. Near-infrared cut-off filters based on CMOS nanostructures for ambient light sensors and image sensors

    NASA Astrophysics Data System (ADS)

    Junger, Stephan; Verwaal, Nanko; Tschekalinskij, Wladimir; Weber, Norbert

    2014-02-01

    Silicon based photodiodes provide spectral response in the visible wavelength range (VIS) but also in the near-infrared (NIR). For ambient light sensors (ALS) and image sensors with high color reproducibility the sensitivity in the NIR is unwanted as it impairs the sensing performance. Typically, external thin film filters are applied as near-infrared cut-off filters added to the photodiode or image sensor. We demonstrate plasmonic nanostructures fabricated directly within an extended CMOS (complementary metal-oxide-semiconductor) process. Designs in one and two metal layers are used and enable ambient light sensors as well as image sensors with pixel level NIR-blocking filters for color vision and additional NIR-sensitive pixels for simultaneous acquisition of VIS and NIR images.

  18. Mid-wavelength infrared InAsSb/InSb nBn detector with extended cut-off wavelength

    NASA Astrophysics Data System (ADS)

    Soibel, Alexander; Ting, David Z.; Hill, Cory J.; Fisher, Anita M.; Hoglund, Linda; Keo, Sam. A.; Gunapala, Sarath D.

    2016-09-01

    We extended the cut-off wavelength λc of bulk InAsSb nBn detectors to λc = 4.6 μm at T = 200 K by incorporating series of single InSb monolayer into InAsSb absorber. Detectors with 2 μm thick absorber showed a temperature independent quantum efficiency QEm≈ 0.45 for back-side illumination without antireflection coating. The dark current density was jd = 5 × 10-6 A/cm2 at T = 150 K, and increased to jd = 2 × 10-3 A/cm2 at T = 200 K. At temperatures of T = 150 K and below, the demonstrated photodetectors operate in the background limited performance mode, with detectivity D*(λ) = 3-6 × 1011 cm Hz0.5/W for the background temperature of 300 K, and f/2 field of view.

  19. Psychometric properties and clinical cut-off scores of the Spanish version of the Social Anxiety Scale for Adolescents.

    PubMed

    Garcia-Lopez, Luis J; Inglés, Cándido J; García-Fernández, José M; Hidalgo, María D; Bermejo, Rosa; Puklek Levpušček, Melita

    2011-01-01

    This study examined the reliability and validity evidence drawn from the scores of the Spanish version of the Slovenian-developed Social Anxiety Scale for Adolescents (SASA; Puklek, 1997; Puklek & Vidmar, 2000) using a community sample (Study 1) and a clinical sample (Study 2). Confirmatory factor analysis in Study 1 replicated the 2-factor structure found by the original authors in a sample of Slovenian adolescents. Test-retest reliability was adequate. Furthermore, the SASA correlated significantly with other social anxiety scales, supporting concurrent validity evidence in Spanish adolescents. The results of Study 2 confirmed the correlations between the SASA and other social anxiety measures in a clinical sample. In addition, findings revealed that the SASA can effectively discriminate between adolescents with a clinical diagnosis of social anxiety disorder (SAD) and those without this disorder. Finally, cut-off scores for the SASA are provided for Spanish adolescents.

  20. A new perspective of the climatological features of upper-level cut-off lows in the Southern Hemisphere

    NASA Astrophysics Data System (ADS)

    Pinheiro, Henri Rossi; Hodges, Kevin Ivan; Gan, Manoel Alonso; Ferreira, Nelson Jesuz

    2017-01-01

    This study presents a detailed view of the seasonal variability of upper-level cut-off lows (COLs) in the Southern Hemisphere. The COLs are identified and tracked using data from a 36-year period of the European Centre for Medium Range Weather Forecast reanalysis (ERA-Interim). The objective identification of the COLs uses a new approach, which is based on 300 hPa relative vorticity minima, and three restrictive criteria of the presence of a cold-core, stratospheric potential vorticity intrusion, and cut-off cyclonic circulation. The highest COL activity is in agreement with previous studies, located near three main continental areas (Australia, South America, and Africa), with maximum frequencies usually observed in the austral autumn. The COL mean intensity values show a marked seasonal and spatial variation, with maximum (minimum) values during the austral winter (summer), a unique feature that has not been observed previously in studies based on the geopotential. The link between intensity and lysis is examined, and finds that weaker systems are more susceptible to lysis in the vicinity of the Andes Cordillera, associated with the topographic Rossby wave. Lysis and genesis regions are close to each other, confirming that COLs are quasi-stationary systems. Also, COLs tend to move eastward and are faster over the higher latitudes. The mean growth/decay rates coincide with the major genesis and lysis density regions, such as the significant decay values across the Andes all year. As a consequence of using vorticity for the tracking method a longer lifetime of COLs is detected than in other studies, but this does not affect the total frequency of occurrence. Comparisons with other studies suggest that the differences in seasonality are due to uncertainties in the reanalyses and the methods used to identify COLs.

  1. Therapeutic Efficacy and Cost Effectiveness of High Cut-Off Dialyzers Compared to Conventional Dialysis in Patients with Cast Nephropathy

    PubMed Central

    Curti, Adriano; Schwarz, Albin; Trachsler, Johannes; Tomonaga, Yuki

    2016-01-01

    Background High Cut-Off (HCO) dialysis membranes efficiently reduce serum free light chain (FLC) concentrations and may improve renal recovery and survival from multiple myeloma (MM) associated renal failure with cast nephropathy. However, clinical trials comparing dialysis with HCO versus conventional filters are lacking. The aim of this study was to assess clinical outcomes and economic impact of HCO dialyzers compared to conventional hemodialysis membranes in cast nephropathy. Methods Multicenter retrospective analysis of 19 patients treated for renal failure from FLC associated cast nephropathy with standard induction chemotherapy (bortezomib/dexamethasone). We compared hemodialysis treatment with High Cut-Off (n = 12) versus conventional dialyzers (n = 7). Primary endpoint was survival; secondary endpoints were renal recovery, renal function and treatment costs. Results At 12 months, patient survival was 25% in the HCO group versus 0% in controls (p = NS). A tendency towards faster renal recovery (p = 0.066) and better renal function at 3, 6 and 12 months (p = 0.109) after diagnosis of MM was noted in the HCO group. Complete renal response rate was achieved in 10.5 and 0% of HCO and control patients, respectively, partial renal response in 15.8 and 5.3%, and minor renal response in 26.3 and 15.8%, respectively. Both patient survival and renal recovery were significantly correlated with the extent of free light chain (FLC) reduction in serum. Median treatment costs were CHF 230’000 and 223’000 (p = NS) in the HCO and control group, respectively. Conclusions Hemodialysis treatment with HCO membranes for cast nephropathy tended towards better survival as well as faster and better recovery of renal function versus conventional dialyzers. Moreover, total medical costs were comparable between groups. In the absence of results from randomized prospective trials on this topic, the use of HCO dialyzers in patients with renal failure from cast nephropathy may be

  2. Molecular Weight Cut-Off and Structural Analysis of Vacuum-Assisted Titania Membranes for Water Processing

    PubMed Central

    Abd Jalil, Siti Nurehan; Wang, David K.; Yacou, Christelle; Motuzas, Julius; Smart, Simon; Diniz da Costa, João C.

    2016-01-01

    This work investigates the structural formation and analyses of titania membranes (TM) prepared using different vacuum exposure times for molecular weight (MW) cut-off performance and oil/water separation. Titania membranes were synthesized via a sol-gel method and coated on macroporous alumina tubes followed by exposure to a vacuum between 30 and 1200 s and then calcined at 400 °C. X-ray diffraction and nitrogen adsorption analyses showed that the crystallite size and particle size of titania increased as a function of vacuum time. All the TM membranes were mesoporous with an average pore diameter of ~3.6 nm with an anatase crystal morphology. Water, glucose, sucrose, and polyvinylpyrrolidone with 40 and 360 kDa (PVP-40 kDa and PVP-360 kDa) were used as feed solutions for MW cut-off and hexadecane solution for oil filtration investigation. The TM membranes were not able to separate glucose and sucrose, thus indicating the membrane pore sizes are larger than the kinetic diameter of sucrose of 0.9 nm, irrespective of vacuum exposure time. They also showed only moderate rejection (20%) of the smaller PVP-40 kDa, however, all the membranes were able to obtain an excellent rejection of near 100% for the larger PVP-360 kDa molecule. Furthermore, the TM membranes were tested for the separation of oil emulsions with a high concentration of oil (3000 ppm), reaching high oil rejections of more than 90% of oil. In general, the water fluxes increased with the vacuum exposure time indicating a pore structural tailoring effect. It is therefore proposed that a mechanism of pore size tailoring was formed by an interconnected network of Ti–O–Ti nanoparticles with inter-particle voids, which increased as TiO2 nanoparticle size increased as a function of vacuum exposure time, and thus reduced the water transport resistance through the TM membranes. PMID:28774057

  3. Molecular Weight Cut-Off and Structural Analysis of Vacuum-Assisted Titania Membranes for Water Processing.

    PubMed

    Abd Jalil, Siti Nurehan; Wang, David K; Yacou, Christelle; Motuzas, Julius; Smart, Simon; Diniz da Costa, João C

    2016-11-18

    This work investigates the structural formation and analyses of titania membranes (TM) prepared using different vacuum exposure times for molecular weight (MW) cut-off performance and oil/water separation. Titania membranes were synthesized via a sol-gel method and coated on macroporous alumina tubes followed by exposure to a vacuum between 30 and 1200 s and then calcined at 400 °C. X-ray diffraction and nitrogen adsorption analyses showed that the crystallite size and particle size of titania increased as a function of vacuum time. All the TM membranes were mesoporous with an average pore diameter of ~3.6 nm with an anatase crystal morphology. Water, glucose, sucrose, and polyvinylpyrrolidone with 40 and 360 kDa (PVP-40 kDa and PVP-360 kDa) were used as feed solutions for MW cut-off and hexadecane solution for oil filtration investigation. The TM membranes were not able to separate glucose and sucrose, thus indicating the membrane pore sizes are larger than the kinetic diameter of sucrose of 0.9 nm, irrespective of vacuum exposure time. They also showed only moderate rejection (20%) of the smaller PVP-40 kDa, however, all the membranes were able to obtain an excellent rejection of near 100% for the larger PVP-360 kDa molecule. Furthermore, the TM membranes were tested for the separation of oil emulsions with a high concentration of oil (3000 ppm), reaching high oil rejections of more than 90% of oil. In general, the water fluxes increased with the vacuum exposure time indicating a pore structural tailoring effect. It is therefore proposed that a mechanism of pore size tailoring was formed by an interconnected network of Ti-O-Ti nanoparticles with inter-particle voids, which increased as TiO₂ nanoparticle size increased as a function of vacuum exposure time, and thus reduced the water transport resistance through the TM membranes.

  4. Absolute depth of myometrial invasion in endometrial cancer is superior to the currently used cut-off value of 50%.

    PubMed

    Geels, Y P; Pijnenborg, J M A; van den Berg-van Erp, S H M; Snijders, M P M L; Bulten, J; Massuger, L F A G

    2013-05-01

    In endometrial carcinoma, myometrial invasion is a well known predictor of recurrence, and important in the decision making for adjuvant treatment. According to the FIGO staging system, myometrial invasion is expressed as invasion of <50%> of the myometrium (50%MI). It has been suggested to use the absolute depth of invasion (DOI), or the tumor free distance to the serosa (TFD). The aim of this study was to compare DOI, 50%MI, and TFD. All patients diagnosed with endometrioid endometrial carcinoma at the RUNMC, and the CWH from 1999 to 2009 were included. Histologic slides were reviewed for histologic type and grade, DOI, 50%MI, and TFD. After review, 335 patients were identified. DOI, 50%MI, and TFD were evaluated for their prediction of clinicopathologic characteristics. The prediction of recurrence was best performed by DOI when compared to TFD, with an area under the ROC curve of 0.726, and 0.638 respectively. The optimal cut-off value for DOI was 4mm. DOI independently correlated with recurrence of disease, and death of disease. TFD was associated with advanced age and large tumor diameter. DOI was the best predictor of progression-free and disease-specific survival next to 50%MI and TFD (HR 3.15, 95%CI 1.16-8.56) and (HR 10.35, 95%CI 1.23-86.93). DOI showed better predictive performance than TFD, and was more strongly correlated with clinicopathologic parameters than TFD and 50%MI. Possibly, DOI should substitute 50%MI as measure to express myometrial invasion in daily clinical practice. External validation is mandatory to confirm the proposed cut-off value of 4mm. Copyright © 2013 Elsevier Inc. All rights reserved.

  5. Use of the Azimuth Wavelength Cut-Off to Retrieve the Sea Surface Wind Speed from Sentinel 1 and COSMO-SkyMed SAR Data

    NASA Astrophysics Data System (ADS)

    Grieco, G.; Nirchio, F.; Montuori, A.; Migliaccio, M.; Lin, W.; Portabella, M.

    2016-08-01

    The dependency of the azimuth wavelength cut-off on the wind speed has been studied through a dataset of Sentinel-1 multi look SAR images co-located with wind speed measurements, significant wave height and mean wave direction from ECMWF operational output.A Geophysical Model Function (GMF) has been fitted and a retrieval exercise has been done comparing the results to a set of independent wind speed scatterometer measurements of the Chinese mission HY-2A. The preliminary results show that the dependency of the azimuth cut-off on the wind speed is linear only for fully developed sea states and that the agreement between the retrieved values and the measurements is good especially for high wind speed.A similar approach has been used to assess the dependency of the azimuth cut-off also for X-band COSMO-SkyMed data. The dataset is still incomplete but the preliminary results show a similar trend.

  6. HPV self-sampling in CIN2+ detection: sensitivity and specificity of different RLU cut-off of HC2 in specimens from 786 women.

    PubMed

    Bottari, F; Igidbashian, S; Boveri, S; Tricca, A; Gulmini, C; Sesia, M; Spolti, N; Sideri, M; Landoni, F; Sandri, M T

    2017-04-01

    Mortality for cervical cancer varies between the different regions of the world, with high rates in low-income countries where screening programmes are not present and organised. However, increasing screening coverage is still a priority in all countries: one way to do that is to base screening on self-sampled screening. The success of a self-sampling screening strategy depends on capacity to recruit unscreened women, on the performance and acceptability of the device and on the clinical performance of the high-risk human papillomavirus (HPV) test. This study based on 786 enrolled women investigates the best cut-off value of Hybrid Capture 2 HPV test (HC2) for self-sampled specimens in terms of sensitivity and specificity. In this population, we found that the sensitivity and the specificity for cervical intraepithelial neoplasia grade 2 or more detection of HC2 performed on self-sampled specimens were 82.5% and 82.8%, respectively considering the relative light units (RLU) cut-off value of 1. Increasing the cut-off value the sensitivity decreases and the specificity raises and the best area under the curve for the RLU cut-off value is 1. Our results confirm that the cut-off value of 1 suggested by Qiagen for PreservCyt specimen is the best cut-off value also for self-sampled specimens. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  7. Amputee locomotion: Frequency content of prosthetic vs. intact limb vertical ground reaction forces during running and the effects of filter cut-off frequency.

    PubMed

    Kiernan, Dovin; Miller, Ross H; Baum, Brian S; Kwon, Hyun Joon; Shim, Jae Kun

    2017-07-26

    Compared to intact limbs, running-specific prostheses have high resonance non-biologic materials and lack active tissues to damp high frequencies. These differences may lead to ground reaction forces (GRFs) with high frequency content. If so, ubiquitously applying low-pass filters to prosthetic and intact limb GRFs may attenuate veridical high frequency content and mask important and ecologically valid data from prostheses. To explore differences in frequency content between prosthetic and intact limbs we divided signal power from transtibial unilateral amputees and controls running at 2.5, 3.0, and 3.5m/s into Low (<10Hz), High (10-25Hz), and Non-biologic (>25Hz) frequency bandwidths. Faster speeds tended to reduce the proportion of signal power in the Low bandwidth while increasing it in the High and Non-biologic bandwidths. Further, prostheses had lower proportions of signal power at the High frequency bandwidth but greater proportions at the Non-biologic bandwidth. To evaluate whether these differences in frequency content interact with filter cut-offs and alter results, we filtered GRFs with cut-offs from 1 to 100Hz and calculated vertical impact peak (VIP). Changing cut-off had inconsistent effects on VIP across speeds and limbs: Faster speeds had significantly larger changes in VIP per change in cut-off while, compared to controls, prosthetic limbs had significantly smaller changes in VIP per change in cut-off. These findings reveal differences in GRF frequency content between prosthetic and intact limbs and suggest that a cut-off frequency that is appropriate for one limb or speed may be inappropriate for another. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Evaluation of the diagnostic and predictive power of PCA3 in the prostate cancer. A different best cut-off in each different scenario. Preliminary results.

    PubMed

    Albino, Giuseppe; Capoluongo, Ettore; Rocchetti, Sandro; Palumbo, Sara; Zuppi, Cecilia; Cirillo-Marucco, Ettore

    2014-12-30

    Aim of this study is to evaluate the diagnostic performance of PCA3 in patients with indication to perform a new biopsy, according to the histological doubt such as High Grade Prostatic Intraepithelial Neoplasia (HGPIN) or Atypical Small Gland Proliferation (ASAP) or the clinical suspicion. One hundred men were enrolled. We used the PCA3 - PROGENSA™ procedure. After the PCA3 test a repeated prostate biopsy was proposed. The histological findings were correlated to the PCA3 scores. We calculated the positive predictive value (PPV), the sensibility, the specificity, the Youden's index, the ROC curves, the area under the curve (AUC) for each cut-off value of PCA3 score. These results are preliminary, because at present only 50 of the 100 enlisted men were subjected to rebiopsy. We calculated the best cut-off PCA3 score 20 at the first diagnosis; for patients with HGPIN or ASAP at first biopsy the best sensitivity cut-off is 45; the best cutoff is 45 when you already have a diagnosis of HGPIN, and 35 for ASAP. If we normalize the PCA3 score to the prostate volume, the best cut-off would be 20, with 100% sensitivity with a prostate volume of 65 ml. All results are statistically significant. The real problem, also present in literature, is the constant presence of not diagnosed prostate cancers, for any cut-off value. Our preliminary results suggest that, to get the best diagnostic performance, it would be wrong to maintain a single cut-off, but it should be chosen according to the scenario of the patients subgroup. It is to explore the possibility to search for the PCA3 in the serum to bridge the gap of the aggressive PCa missed by the urinary test.

  9. Cut-Offs and Response Criteria for the Hospital Universitario La Princesa Index (HUPI) and Their Comparison to Widely-Used Indices of Disease Activity in Rheumatoid Arthritis

    PubMed Central

    Castrejón, Isabel; Ortiz, Ana M.; Toledano, Esther; Castañeda, Santos; García-Vadillo, Alberto; Carmona, Loreto

    2016-01-01

    Objective To estimate cut-off points and to establish response criteria for the Hospital Universitario La Princesa Index (HUPI) in patients with chronic polyarthritis. Methods Two cohorts, one of early arthritis (Princesa Early Arthritis Register Longitudinal [PEARL] study) and other of long-term rheumatoid arthritis (Estudio de la Morbilidad y Expresión Clínica de la Artritis Reumatoide [EMECAR]) including altogether 1200 patients were used to determine cut-off values for remission, and for low, moderate and high activity through receiver operating curve (ROC) analysis. The areas under ROC (AUC) were compared to those of validated indexes (SDAI, CDAI, DAS28). ROC analysis was also applied to establish minimal and relevant clinical improvement for HUPI. Results The best cut-off points for HUPI are 2, 5 and 9, classifying RA activity as remission if ≤2, low disease activity if >2 and ≤5), moderate if >5 and <9 and high if ≥9. HUPI’s AUC to discriminate between low-moderate activity was 0.909 and between moderate-high activity 0.887. DAS28’s AUCs were 0.887 and 0.846, respectively; both indices had higher accuracy than SDAI (AUCs: 0.832 and 0.756) and CDAI (AUCs: 0.789 and 0.728). HUPI discriminates remission better than DAS28-ESR in early arthritis, but similarly to SDAI. The HUPI cut-off for minimal clinical improvement was established at 2 and for relevant clinical improvement at 4. Response criteria were established based on these cut-off values. Conclusions The cut-offs proposed for HUPI perform adequately in patients with either early or long term arthritis. PMID:27603313

  10. Cut-Offs and Response Criteria for the Hospital Universitario La Princesa Index (HUPI) and Their Comparison to Widely-Used Indices of Disease Activity in Rheumatoid Arthritis.

    PubMed

    González-Álvaro, Isidoro; Castrejón, Isabel; Ortiz, Ana M; Toledano, Esther; Castañeda, Santos; García-Vadillo, Alberto; Carmona, Loreto

    2016-01-01

    To estimate cut-off points and to establish response criteria for the Hospital Universitario La Princesa Index (HUPI) in patients with chronic polyarthritis. Two cohorts, one of early arthritis (Princesa Early Arthritis Register Longitudinal [PEARL] study) and other of long-term rheumatoid arthritis (Estudio de la Morbilidad y Expresión Clínica de la Artritis Reumatoide [EMECAR]) including altogether 1200 patients were used to determine cut-off values for remission, and for low, moderate and high activity through receiver operating curve (ROC) analysis. The areas under ROC (AUC) were compared to those of validated indexes (SDAI, CDAI, DAS28). ROC analysis was also applied to establish minimal and relevant clinical improvement for HUPI. The best cut-off points for HUPI are 2, 5 and 9, classifying RA activity as remission if ≤2, low disease activity if >2 and ≤5), moderate if >5 and <9 and high if ≥9. HUPI's AUC to discriminate between low-moderate activity was 0.909 and between moderate-high activity 0.887. DAS28's AUCs were 0.887 and 0.846, respectively; both indices had higher accuracy than SDAI (AUCs: 0.832 and 0.756) and CDAI (AUCs: 0.789 and 0.728). HUPI discriminates remission better than DAS28-ESR in early arthritis, but similarly to SDAI. The HUPI cut-off for minimal clinical improvement was established at 2 and for relevant clinical improvement at 4. Response criteria were established based on these cut-off values. The cut-offs proposed for HUPI perform adequately in patients with either early or long term arthritis.

  11. Age-related differences in recommended anthropometric cut-off point validity to identify cardiovascular risk factors in ostensibly healthy women

    PubMed Central

    Björkelund, Cecilia; Guo, Xinxin; Skoog, Ingmar; Bosaeus, Ingvar; Lissner, Lauren

    2014-01-01

    Aim: To investigate validity of widely recommended anthropometric and total fat percentage cut-off points in screening for cardiovascular risk factors in women of different ages. Methods: A population-based sample of 1002 Swedish women aged 38, 50, 75 (younger, middle-aged and elderly, respectively) underwent anthropometry, health examinations and blood tests. Total fat was estimated (bioimpedance) in 670 women. Sensitivity, specificity of body mass index (BMI; ≥25 and ≥30), waist circumference (WC; ≥80 cm and ≥88 cm) and total fat percentage (TF; ≥35%) cut-off points for cardiovascular risk factors (dyslipidaemias, hypertension and hyperglycaemia) were calculated for each age. Cut-off points yielding high sensitivity together with modest specificity were considered valid. Women reporting hospital admission for cardiovascular disease were excluded. Results: The sensitivity of WC ≥80 cm for one or more risk factors was ~60% in younger and middle-aged women, and 80% in elderly women. The specificity of WC ≥80 cm for one or more risk factors was 69%, 57% and 40% at the three ages (p < .05 for age trends). WC ≥80 cm yielded ~80% sensitivity for two or more risk factors across all ages. However, specificity decreased with increasing age (p < .0001), being 33% in elderly. WC ≥88 cm provided better specificity in elderly women. BMI and TF % cut-off points were not better than WC. Conclusions: Validity of recommended anthropometric cut-off points in screening asymptomatic women varies with age. In younger and middle-age, WC ≥80 cm yielded high sensitivity and modest specificity for two or more risk factors, however, sensitivity for one or more risk factor was less than optimal. WC ≥88 cm showed better validity than WC ≥80 cm in elderly. Our results support age-specific screening cut-off points for women. PMID:25294689

  12. The assessment of anorexia in patients with cancer: cut-off values for the FAACT-A/CS and the VAS for appetite.

    PubMed

    Blauwhoff-Buskermolen, S; Ruijgrok, C; Ostelo, R W; de Vet, H C W; Verheul, H M W; de van der Schueren, M A E; Langius, J A E

    2016-02-01

    Anorexia is a frequently observed symptom in patients with cancer and is associated with limited food intake and decreased quality of life. Diagnostic instruments such as the Anorexia/Cachexia Subscale (A/CS) of the Functional Assessment of Anorexia/Cachexia Therapy (FAACT) questionnaire and the visual analog scale (VAS) for appetite have been recommended in the assessment of anorexia, but validated cut-off values are lacking. This study aimed to obtain cut-off values of these instruments for the assessment of anorexia in patients with cancer. The FAACT-A/CS and the VAS for appetite were administered to patients with cancer before start of chemotherapy. As reference standard for anorexia, two external criteria were used: (1) a cut-off value of ≥2 on the anorexia symptom scale of the EORTC QLQ C-30 and (2) the question "Do you experience a decreased appetite?" (yes/no). ROC curves were used to examine the optimal cut-off values for the FAACT-A/CS and VAS. A total of 273 patients (58 % male; 64.0 ± 10.6 years) were included. The median score on the FAACT-A/CS was 38 (IQR 32-42) points and 77 (IQR 47-93) points on the VAS. Considering both external criteria, the optimal cut-off value for the FAACT-A/CS was ≤37 (sensitivity (se) 80 %, specificity (sp) 81 %, positive predictive value (PV(+)) 79 %, negative predictive value (PV(-)) 82 %) and for the VAS was ≤70 (se 76 %, sp 83 %, PV(+) 80 %, PV(-) 79 %). For the assessment of anorexia in patients with cancer, our study suggests cut-off values of ≤37 for the FAACT-A/CS and ≤70 for the VAS. Future studies should confirm our findings in other patient samples.

  13. Comparison of Interferon-γ Release Assay to Two Cut-Off Points of Tuberculin Skin Test to Detect Latent Mycobacterium tuberculosis Infection in Primary Health Care Workers

    PubMed Central

    de Souza, Fernanda Mattos; do Prado, Thiago Nascimento; Pinheiro, Jair dos Santos; Peres, Renata Lyrio; Lacerda, Thamy Carvalho; Loureiro, Rafaela Borge; Carvalho, Jose Américo; Fregona, Geisa; Dias, Elias Santos; Cosme, Lorrayne Beliqui; Rodrigues, Rodrigo Ribeiro; Riley, Lee Wood; Maciel, Ethel Leonor Noia

    2014-01-01

    Background An interferon-γ release assay, QuantiFERON-TB (QFT) test, has been introduced an alternative test for the diagnosis of latent Mycobacterium tuberculosis infection (LTBI). Here, we compared the performance of QFT with tuberculin skin test (TST) measured at two different cut-off points among primary health care work (HCW) in Brazil. Methods A cross-sectional study was carried out among HCWs in four Brazilian cities with a known history of high incidence of TB. Results of the QFT were compared to TST results based on both ≥5 mm and ≥10 mm as cut-off points. Results We enrolled 632 HCWs. When the cut-off value of ≥10 mm was used, agreement between QFT and TST was 69% (k = 0.31), and when the cut-off of ≥5 mm was chosen, the agreement was 57% (k = 0.22). We investigated possible factors of discordance of TST vs QFT. Compared to the TST−/QFT− group, risk factors for discordance in the TST+/QFT− group with TST cut-off of ≥5 mm included age between 41–45 years [OR = 2.70; CI 95%: 1.32–5.51] and 46–64 years [OR = 2.04; CI 95%: 1.05–3.93], BCG scar [OR = 2.72; CI 95%: 1.40–5.25], and having worked only in primary health care [OR = 2.30; CI 95%: 1.09–4.86]. On the other hand, for the cut-off of ≥10 mm, BCG scar [OR = 2.26; CI 95%: 1.03–4.91], being a household contact of a TB patient [OR = 1.72; CI 95%: 1.01–2.92] and having had a previous TST [OR = 1.66; CI 95%: 1.05–2.62], were significantly associated with the TST+/QFT− group. No statistically significant associations were found among the TST−/QFT+ discordant group with either TST cut-off value. Conclusions Although we identified BCG vaccination to contribute to the discordance at both TST cut-off measures, the current Brazilian recommendation for the initiation of LTBI treatment, based on information gathered from medical history, TST, chest radiograph and physical examination, should not be changed. PMID:25137040

  14. Can a glucagon stimulation test characterized by lower GH cut-off value be used for the diagnosis of growth hormone deficiency in adults?

    PubMed

    Diri, Halit; Karaca, Zuleyha; Simsek, Yasin; Tanriverdi, Fatih; Unluhizarci, Kursad; Selcuklu, Ahmet; Kelestimur, Fahrettin

    2015-12-01

    The aim of this study was to assess diagnostic values of insulin tolerance test (ITT), glucagon stimulation test (GST), and insulin like growth factor-I (IGF-I) level, to find optimal GH cut-off values for GST, and to evaluate efficiencies of patient age, gender, body-mass index (BMI), and additional pituitary hormone deficiencies (PHDs) in the diagnosis of growth hormone deficiency (GHD). This retrospective study involved 216 patients with a pituitary disease and 26 healthy controls. Age, gender, BMI, medical histories, and hormonal data including baseline and stimulated hormone values were evaluated. Three cut-off values for peak GH responses to stimulation tests were evaluated: (a) 3.00 µg/L on ITT, (b) 3.00 µg/L on GST, and (c) 1.07 µg/L on GST. According to the ITT, GST with 3.00 µg/L cut-off, and GST with 1.07 µg/L cut-off, GHD was present in 86.1, 74.5, and 54.2 % patients, respectively. Patient age, BMI, and number of PHDs, but not gender, were found to be correlated with IGF-I and peak GH concentrations. All patients with an IGF-I concentration ≤95 ng/ml or ≥3 PHD had GHD. None of the patients with adequate GH response to the GST with 1.07 µg/L cut-off, but blunted responses to ITT and GST with 3.00 µg/L cut-off, had ≥3 PHDs. 12 out of 26 (46.2 %) healthy subjects failed the GST with 3.00 µg/L cut-off, but not with 1.07 µg/L cut-off. Patient age, IGF-I, BMI, and number of PHDs are efficient factors associated with the diagnosis of GHD. A 4 h GST with a diagnostic GH threshold of 1.07 µg/L seems to be a good diagnostic method for GHD.

  15. Comparison of interferon-γ release assay to two cut-off points of tuberculin skin test to detect latent Mycobacterium tuberculosis infection in primary health care workers.

    PubMed

    de Souza, Fernanda Mattos; do Prado, Thiago Nascimento; Pinheiro, Jair dos Santos; Peres, Renata Lyrio; Lacerda, Thamy Carvalho; Loureiro, Rafaela Borge; Carvalho, Jose Américo; Fregona, Geisa; Dias, Elias Santos; Cosme, Lorrayne Beliqui; Rodrigues, Rodrigo Ribeiro; Riley, Lee Wood; Maciel, Ethel Leonor Noia

    2014-01-01

    An interferon-γ release assay, QuantiFERON-TB (QFT) test, has been introduced an alternative test for the diagnosis of latent Mycobacterium tuberculosis infection (LTBI). Here, we compared the performance of QFT with tuberculin skin test (TST) measured at two different cut-off points among primary health care work (HCW) in Brazil. A cross-sectional study was carried out among HCWs in four Brazilian cities with a known history of high incidence of TB. Results of the QFT were compared to TST results based on both ≥5 mm and ≥10 mm as cut-off points. We enrolled 632 HCWs. When the cut-off value of ≥10 mm was used, agreement between QFT and TST was 69% (k = 0.31), and when the cut-off of ≥5 mm was chosen, the agreement was 57% (k = 0.22). We investigated possible factors of discordance of TST vs QFT. Compared to the TST-/QFT- group, risk factors for discordance in the TST+/QFT- group with TST cut-off of ≥5 mm included age between 41-45 years [OR = 2.70; CI 95%: 1.32-5.51] and 46-64 years [OR = 2.04; CI 95%: 1.05-3.93], BCG scar [OR = 2.72; CI 95%: 1.40-5.25], and having worked only in primary health care [OR = 2.30; CI 95%: 1.09-4.86]. On the other hand, for the cut-off of ≥10 mm, BCG scar [OR = 2.26; CI 95%: 1.03-4.91], being a household contact of a TB patient [OR = 1.72; CI 95%: 1.01-2.92] and having had a previous TST [OR = 1.66; CI 95%: 1.05-2.62], were significantly associated with the TST+/QFT- group. No statistically significant associations were found among the TST-/QFT+ discordant group with either TST cut-off value. Although we identified BCG vaccination to contribute to the discordance at both TST cut-off measures, the current Brazilian recommendation for the initiation of LTBI treatment, based on information gathered from medical history, TST, chest radiograph and physical examination, should not be changed.

  16. Determinants of self-reported smoking and misclassification during pregnancy, and analysis of optimal cut-off points for urinary cotinine: a cross-sectional study.

    PubMed

    Aurrekoetxea, Juan J; Murcia, Mario; Rebagliato, Marisa; López, María José; Castilla, Ane Miren; Santa-Marina, Loreto; Guxens, Mónica; Fernández-Somoano, Ana; Espada, Mercedes; Lertxundi, Aitana; Tardón, Adonina; Ballester, Ferran

    2013-01-24

    To estimate the prevalence and factors associated with smoking and misclassification in pregnant women from INMA (INfancia y Medio Ambiente, Environment and Childhood) project, Spain, and to assess the optimal cut-offs for urinary cotinine (UC) that best distinguish daily and occasional smokers with varying levels of second-hand smoke (SHS) exposure. We used logistic regression models to study the relationship between sociodemographic variables and self-reported smoking and misclassification (self-reported non-smokers with UC >50 ng/ml). Receiver operating characteristic (ROC) curves were used to calculate the optimal cut-off point for discriminating smokers. The cut-offs were also calculated after stratification among non-smokers by the number of sources of SHS exposure. The cut-off points used to discriminate smoking status were the level of UC given by Youden's index and for 50 and 100 ng/ml for daily smokers, or 25 and 50 ng/ml for occasional smokers. At the third trimester of pregnancy, 2263 pregnant women of the INMA Project were interviewed between 2004 and 2008 and a urine sample was collected. Prevalence of self-reported smokers at the third trimester of pregnancy was 18.5%, and another 3.9% misreported their smoking status. Variables associated with self-reported smoking and misreporting were similar, including born in Europe, educational level and exposure to SHS. The optimal cut-off was 82 ng/ml (95% CI 42 to 133), sensitivity 95.2% and specificity 96.6%. The area under the ROC curve was 0.986 (95% CI 0.982 to 0.990). The cut-offs varied according to the SHS exposure level being 42 (95% CI 27 to 57), 82 (95% CI 46 to 136) and 106 ng/ml (95% CI 58 to 227) for not being SHS exposed, exposed to one, and to two or more sources of SHS, respectively. The optimal cut-off for discriminating occasional smokers from non-smokers was 27 ng/ml (95% CI 11 to 43). Prevalence of smoking during pregnancy in Spain remains high. UC is a reliable biomarker for classifying

  17. [Potential utility of a renal function adjusted D-dimer cut-off value for improving the exclusion of pulmonary embolism].

    PubMed

    Xi, Xin; Yang, Jinghua; Wang, Zengzhi; Zhu, Chenxi; Li, Jie; Liu, Shuang

    2015-08-11

    To evaluate the potential utility of a renal function adjusted D-dimer cut-off value for improving the exclusion of pulmonary embolism. Retrospective analyses were performed for 1 784 inpatients and outpatients with low and moderate probability of pulmonary embolism at Anzhen Hospital from January 2011 to June 2013. The Well's score was used. The diagnoses of pulmonary embolism were confirmed by computed tomography pulmonary angiogram and ventilation-perfusion scan. Based upon estimated glomerular filtration rate (GFR), they were divided into three subgroups of normal renal function, mild renal impairment and moderate renal impairment. Negative D-dimer was defined as a level of age-standardized D-dimer value<500 µg/L. The proportions of patients with negative D-dimer and the utility of D-dimer for ruling out pulmonary embolism were compared between three subgroups. A new D-dimer cut-off point in patients with renal impairment was developed by receiver operating characteristics (ROC) curves and the effect of diagnostic efficiency of ruling out pulmonary embolism with renal function adjusted D-dimer cut-off was assessed. The medians of D-dimer of three subgroups with normal renal function, mild renal impairment and moderate renal impairment were 291.5, 995.5 and 1 901.5 µg/L (P<0.001) respectively. The sensitivity of negative D-dimer for ruling out pulmonary embolism was 99%-100% and the specificity 70%, 42% and 23% in three subgroups. The number of patients needed to test (NNT) for one negative test of D-dimer in three subgroups of different renal function was 3.32, 3.58 and 3.95 respectively. The new D-dimer cut-off value increased to 1.2 and 1.75 times of old one in patients with mild and moderate renal impairments and the proportion of patients with a negative D-dimer level rose from 48.7% to 53.0% as compared with old D-dimer cut-off value. The sensitivity and specificity of negative D-dimer for ruling out pulmonary embolism was 98% and 62% with the new cut-off

  18. Determinants of self-reported smoking and misclassification during pregnancy, and analysis of optimal cut-off points for urinary cotinine: a cross-sectional study

    PubMed Central

    Aurrekoetxea, Juan J; Murcia, Mario; Rebagliato, Marisa; López, María José; Castilla, Ane Miren; Santa-Marina, Loreto; Guxens, Mónica; Fernández-Somoano, Ana; Espada, Mercedes; Lertxundi, Aitana; Tardón, Adonina; Ballester, Ferran

    2013-01-01

    Objectives To estimate the prevalence and factors associated with smoking and misclassification in pregnant women from INMA (INfancia y Medio Ambiente, Environment and Childhood) project, Spain, and to assess the optimal cut-offs for urinary cotinine (UC) that best distinguish daily and occasional smokers with varying levels of second-hand smoke (SHS) exposure. Design We used logistic regression models to study the relationship between sociodemographic variables and self-reported smoking and misclassification (self-reported non-smokers with UC >50 ng/ml). Receiver operating characteristic (ROC) curves were used to calculate the optimal cut-off point for discriminating smokers. The cut-offs were also calculated after stratification among non-smokers by the number of sources of SHS exposure. The cut-off points used to discriminate smoking status were the level of UC given by Youden's index and for 50 and 100 ng/ml for daily smokers, or 25 and 50 ng/ml for occasional smokers. Participants At the third trimester of pregnancy, 2263 pregnant women of the INMA Project were interviewed between 2004 and 2008 and a urine sample was collected. Results Prevalence of self-reported smokers at the third trimester of pregnancy was 18.5%, and another 3.9% misreported their smoking status. Variables associated with self-reported smoking and misreporting were similar, including born in Europe, educational level and exposure to SHS. The optimal cut-off was 82 ng/ml (95% CI 42 to 133), sensitivity 95.2% and specificity 96.6%. The area under the ROC curve was 0.986 (95% CI 0.982 to 0.990). The cut-offs varied according to the SHS exposure level being 42 (95% CI 27 to 57), 82 (95% CI 46 to 136) and 106 ng/ml (95% CI 58 to 227) for not being SHS exposed, exposed to one, and to two or more sources of SHS, respectively. The optimal cut-off for discriminating occasional smokers from non-smokers was 27 ng/ml (95% CI 11 to 43). Conclusions Prevalence of smoking during pregnancy in

  19. Bronchodilator response cut-off points and FEV 0.75 reference values for spirometry in preschoolers.

    PubMed

    Burity, Edjane Figueiredo; Pereira, Carlos Alberto de Castro; Jones, Marcus Herbert; Sayão, Larissa Bouwman; Andrade, Armèle Dornelas de; Britto, Murilo Carlos Amorim de

    2016-01-01

    To determine the cut-off points for FEV1, FEV0.75, FEV0.5, and FEF25-75% bronchodilator responses in healthy preschool children and to generate reference values for FEV0.75. This was a cross-sectional community-based study involving children 3-5 years of age. Healthy preschool children were selected by a standardized questionnaire. Spirometry was performed before and after bronchodilator use. The cut-off point of the response was defined as the 95th percentile of the change in each parameter. We recruited 266 children, 160 (60%) of whom were able to perform acceptable, reproducible expiratory maneuvers before and after bronchodilator use. The mean age and height were 57.78 ± 7.86 months and 106.56 ± 6.43 cm, respectively. The success rate for FEV0.5 was 35%, 68%, and 70% in the 3-, 4-, and 5-year-olds, respectively. The 95th percentile of the change in the percentage of the predicted value in response to bronchodilator use was 11.6%, 16.0%, 8.5%, and 35.5% for FEV1, FEV0.75, FEV0.5, and FEF25-75%, respectively. Our results provide cut-off points for bronchodilator responsiveness for FEV1, FEV0.75, FEV0.5, and FEF25-75% in healthy preschool children. In addition, we proposed gender-specific reference equations for FEV0.75. Our findings could improve the physiological assessment of respiratory function in preschool children. Determinar os pontos de corte de resposta ao broncodilatador do VEF1, VEF0,75, VEF0,5 e FEF25-75% em crianças pré-escolares saudáveis e gerar valores de referência para o VEF0,75. Foi realizado um estudo transversal de base comunitária em crianças de 3-5 anos de idade. Pré-escolares saudáveis foram selecionados por um questionário padronizado. Foi realizada espirometria antes e depois do uso de broncodilatador. Foram definidos os pontos de corte dessa resposta como o percentil 95 de variação em cada parâmetro. Foram recrutadas 266 crianças, e 160 (60,0%) foram capazes de gerar manobras expiratórias aceitáveis e reprodut

  20. Evaluation of total body weight and body mass index cut-offs for increased cefazolin dose for surgical prophylaxis.

    PubMed

    Hites, Maya; Deprez, Guillaume; Wolff, Fleur; Ickx, Brigitte; Verleije, Anita; Closset, Jean; Loi, Patrizia; Prévost, Jessica; Taccone, Fabio S; Racapé, Judith; Cotton, Frédéric; Jacobs, Frédérique

    2016-12-01

    French and American guidelines recommend increased dosage regimens of cefazolin (CFZ) for surgical prophylaxis in patients with a body mass index (BMI) ≥ 35 kg/m(2) or with a total body weight (TBW) ≥ 120 kg. The objective of this study was to evaluate the accuracy of these cut-offs in identifying patients who require CFZ dose adjustment. A pharmacokinetic study was conducted in patients of varying TBW and BMI who received 2 g of CFZ intravenously for prophylaxis prior to digestive surgery. Adequacy of therapy, defined as a serum concentration of unbound CFZ (fCFZ) ≥ 4 mg/L, was evaluated 180 min (T180) and 240 min (T240) after the start of CFZ infusion. Possible factors associated with insufficient fCFZ levels were also assessed. A P-value of <0.05 was considered statistically significant. A total of 63 patients were included in the study, categorised according to BMI (<35 kg/m(2), 20 patients; and ≥35 kg/m(2), 43 patients) and TBW (<120 kg, 41 patients; and ≥120 kg, 22 patients). All patients had adequate drug levels at T180 but only 40/63 patients (63%) had adequate levels at T240. At T240, therapy was adequate in 15/20 patients (75%) and 25/43 patients (58%) with BMI <35 kg/m(2) and ≥35 kg/m(2), respectively (P = 0.20), and in 28/41 patients (68%) and 12/22 patients (55%) with TBW <120 kg and ≥120 kg, respectively (P = 0.28). No factor associated with insufficient fCFZ was identified. In conclusion, current BMI and TBW cut-offs are poor indicators of which patients could benefit from increased CFZ dosage regimens. Copyright © 2016 The Authors. Published by Elsevier B.V. All rights reserved.

  1. Cosmological properties and reconstruction of scalar field models of the Holographic Dark Energy model with Granda-Oliveros cut-off in Kaluza-Klein cosmology

    NASA Astrophysics Data System (ADS)

    Pasqua, Antonio; Chattopadhyay, Surajit; Assaf, Khudhair A.; Salako, Ines G.

    2016-06-01

    In this paper, we study the properties of the Holographic Dark Energy (HDE) model in the context of Kaluza-Klein (KK) cosmology with infrared cut-off given by the recently proposed by Granda-Oliveros cut-off, which contains a term proportional to the time derivative of the Hubble parameter and one proportional to the Hubble parameter squared. Moreover, this cut-off is characterized by two free parameters which are the proportional constants of the two terms of the cut-off. We derive the expression of the Equation of State (EoS) parameter ωD and of the deceleration parameter q for both non-interacting and interacting Dark Sectors and in the limiting case of a flat Dark Dominated Universe. Moreover, we study the squared speed of the sound vs2 and the statefinder diagnostic \\{r,s\\} in order to understand the cosmological properties of the model considered. We also develop a correspondence between the model considered and three scalar field models: the tachyon, the k-essence and the quintessence ones.

  2. Analysis of 2014 Post UTME Score of Candidates in the University of Ibadan with Two Methods of Standard Setting to Set Cut Off Points

    ERIC Educational Resources Information Center

    Oladele, Babatunde

    2017-01-01

    The aim of the current study is to analyse the 2014 Post UTME scores of candidates in the university of Ibadan towards the establishment of cut off using two methods of standard settings. Prospective candidates who seek admission to higher institution are often denied admission through the Post UTME exercise. There is no single recommended…

  3. Estimation of Saliva Cotinine Cut-Off Points for Active and Passive Smoking during Pregnancy-Polish Mother and Child Cohort (REPRO_PL).

    PubMed

    Polanska, Kinga; Krol, Anna; Kaluzny, Pawel; Ligocka, Danuta; Mikolajewska, Karolina; Shaheen, Seif; Walton, Robert; Hanke, Wojciech

    2016-12-08

    A reliable assessment of smoking status has significant public health implications and is essential for research purposes. The aim of this study was to determine optimal saliva cotinine cut-off values for smoking during pregnancy. The analyses were based on data from 1771 women from the Polish Mother and Child Cohort. Saliva cotinine concentrations were assessed by high performance liquid chromatography coupled with tandem mass spectrometry (HPLC-ESI + MS/MS). The saliva cotinine cut-off value for active smoking was established at 10 ng/mL (sensitivity 96%, specificity 95%) and for passive smoking at 1.5 ng/mL (sensitivity 63%, specificity 71%). About 5% of the self-reported non-smoking women were classified as smokers based on the cotinine cut-off value. Significantly more younger, single, and less educated self-reported non-smokers had a cotinine concentration higher than 10 ng/mL compared to those who were older, married, and who had a university degree. Close to 30% of the non-smokers who indicated that smoking was not allowed in their home could be classified as exposed to passive smoking based on the cut-off value. The study suggests that self-reported smoking status is a valid measure of active smoking, whereas in the case of passive smoking, a combination of questionnaire data and biomarker verification may be required.

  4. Enhanced Narrow-band, Coherent Emission from a Current Source Immersed in Cut-off of a Plasma-like Medium

    NASA Astrophysics Data System (ADS)

    Hur, Min Sup; Ersfeld, Bernhard; Noble, Adam; Suk, Hyyong; Jaroszynski, Dino

    2016-10-01

    In plasma-like media sharing a similar dispersion relation, there exists a cut-off frequency to make the wave number zero. This particular situation has been understood classically in a way that the radiation impedance becomes infinite, resulting in a total reflection of an incident wave. However, in this framework of understanding the cut-off, a pure current source immersed in the cut-off region leads to infinite radiation power from Ohm's law. This is obviously unphysical and requires a different approach to address the problem. In this presentation, we show that by solving the driven time-dependent Schrödinger equation, the radiation at the cut-off frequency can be selectively enhanced by several times the pure vacuum-emission. Important question here is whether such current sources are available in practical systems. We find that quasi-current sources are actually ubiquitous as long as the conversion efficiency from the current driver to the radiation emission is low. We demonstrate two such cases by PIC simulations; THz radiation from a plasma driven by colliding laser pulses, and THz from two-color lasers enclosed by a tapered waveguide. We also discuss the previous experimental results in terms of this enhanced emission concept.

  5. Prevalence of the metabolic syndrome and determination of optimal cut-off values of waist circumference in university employees from Angola

    PubMed Central

    Magalhães, Pedro; Capingana, Daniel P; Mill, José G

    2014-01-01

    Summary Background Estimates of the prevalence of the metabolic syndrome in Africans may be inconsistent due to lack of African-specific cut-off values of waist circumference (WC). This study determined the prevalence of the metabolic syndrome and defined optimal values of WC in Africans. Methods This cross-sectional study collected demographic, anthropometric and clinical data of 615 Universitary employees, in Luanda, Angola. The metabolic syndrome was defined using the third report of the National Cholesterol Education Program Adult Treatment Panel (ATPIII) and the Joint Interim Statement (JIS) criteria. Receiver operating characteristics curves were constructed to assess cut-off values of WC. Results The crude prevalence of the metabolic syndrome was higher with the JIS definition (27.8%, age-standardised 14.1%) than with the ATP III definition (17.6%, age-standardised 8.7%). Optimal cut-off values of WC were 87.5 and 80.5 cm in men and women, respectively. Conclusions There was a high prevalence of the metabolic syndrome among our African subjects. Our data suggest different WC cut-off values for Africans in relation to other populations. PMID:24626517

  6. Estimation of Saliva Cotinine Cut-Off Points for Active and Passive Smoking during Pregnancy—Polish Mother and Child Cohort (REPRO_PL)

    PubMed Central

    Polanska, Kinga; Krol, Anna; Kaluzny, Pawel; Ligocka, Danuta; Mikolajewska, Karolina; Shaheen, Seif; Walton, Robert; Hanke, Wojciech

    2016-01-01

    A reliable assessment of smoking status has significant public health implications and is essential for research purposes. The aim of this study was to determine optimal saliva cotinine cut-off values for smoking during pregnancy. The analyses were based on data from 1771 women from the Polish Mother and Child Cohort. Saliva cotinine concentrations were assessed by high performance liquid chromatography coupled with tandem mass spectrometry (HPLC-ESI + MS/MS). The saliva cotinine cut-off value for active smoking was established at 10 ng/mL (sensitivity 96%, specificity 95%) and for passive smoking at 1.5 ng/mL (sensitivity 63%, specificity 71%). About 5% of the self-reported non-smoking women were classified as smokers based on the cotinine cut-off value. Significantly more younger, single, and less educated self-reported non-smokers had a cotinine concentration higher than 10 ng/mL compared to those who were older, married, and who had a university degree. Close to 30% of the non-smokers who indicated that smoking was not allowed in their home could be classified as exposed to passive smoking based on the cut-off value. The study suggests that self-reported smoking status is a valid measure of active smoking, whereas in the case of passive smoking, a combination of questionnaire data and biomarker verification may be required. PMID:27941658

  7. The optimal cut-off value of the preoperative prognostic nutritional index for the survival differs according to the TNM stage in hepatocellular carcinoma.

    PubMed

    Okamura, Yukiyasu; Sugiura, Teiichi; Ito, Takaaki; Yamamoto, Yusuke; Ashida, Ryo; Uesaka, Katsuhiko

    2017-08-01

    To establish the optimal cut-off value of the preoperative prognostic nutritional index (PNI) for prognosis according to the Tumor Node Metastasis (TNM) stage of hepatocellular carcinoma (HCC) after curative resection. This retrospective study reviewed the records of 375 patients. The optimal cut-off value of the PNI was established according to the TNM stage, and overall survival was compared between the low and high PNI groups. The optimal cut-off value of the PNI decreased with increasing TNM stage, with 52, 47, and 43 patients having stage I, II, and III HCC, respectively. A low preoperative PNI predicted a poorer overall survival than did a high PNI for stage I (P < 0.001) and II (P = 0.002), but not stage III disease (P = 0.052). Multivariate analysis revealed that the preoperative PNI was an independent predictor of overall survival for stage I and II HCC (hazard ratios: 6.96 and 3.57, P = 0.001 and P = 0.001, respectively). The findings of this study show that the optimal cut-off value for the PNI for prognosis differs among the TNM stages and that the preoperative PNI is a favorable prognostic factor for stage I HCC.

  8. Using Logistic Regression for Validating or Invalidating Initial Statewide Cut-Off Scores on Basic Skills Placement Tests at the Community College Level

    ERIC Educational Resources Information Center

    Secolsky, Charles; Krishnan, Sathasivam; Judd, Thomas P.

    2013-01-01

    The community colleges in the state of New Jersey went through a process of establishing statewide cut-off scores for English and mathematics placement tests. The colleges wanted to communicate to secondary schools a consistent preparation that would be necessary for enrolling in Freshman Composition and College Algebra at the community college…

  9. Forecasts of solar and geomagnetic activity

    NASA Technical Reports Server (NTRS)

    Joselyn, Joann

    1987-01-01

    Forecasts of solar and geomagnetic activity are critical since these quantities are such important inputs to the thermospheric density models. At this time in the history of solar science there is no way to make such a forecast from first principles. Physical theory applied to the Sun is developing rapidly, but is still primitive. Techniques used for forecasting depend upon the observations over about 130 years, which is only twelve solar cycles. It has been noted that even-numbered cycles systematically tend to be smaller than the odd-numbered ones by about 20 percent. Another observation is that for the last 12 cycle pairs, an even-numbered sunspot cycle looks rather like the next odd-numbered cycle, but with the top cut off. These observations are examples of approximate periodicities that forecasters try to use to achieve some insight into the nature of an upcoming cycle. Another new and useful forecasting aid is a correlation that has been noted between geomagnetic indices and the size of the next solar cycle. Some best estimates are given concerning both activities.

  10. Epidemiologic Behavior and Estimation of an Optimal Cut-Off Point for Homeostasis Model Assessment-2 Insulin Resistance: A Report from a Venezuelan Population

    PubMed Central

    Bermúdez, Valmore; Martínez, María Sofía; Apruzzese, Vanessa; Chávez-Castillo, Mervin; Gonzalez, Robys; Torres, Yaquelín; Bello, Luis; Añez, Roberto; Chacín, Maricarmen; Toledo, Alexandra; Cabrera, Mayela; Mengual, Edgardo; Ávila, Raquel; López-Miranda, José

    2014-01-01

    Background. Mathematical models such as Homeostasis Model Assessment have gained popularity in the evaluation of insulin resistance (IR). The purpose of this study was to estimate the optimal cut-off point for Homeostasis Model Assessment-2 Insulin Resistance (HOMA2-IR) in an adult population of Maracaibo, Venezuela. Methods. Descriptive, cross-sectional study with randomized, multistaged sampling included 2,026 adult individuals. IR was evaluated through HOMA2-IR calculation in 602 metabolically healthy individuals. For cut-off point estimation, two approaches were applied: HOMA2-IR percentile distribution and construction of ROC curves using sensitivity and specificity for selection. Results. HOMA2-IR arithmetic mean for the general population was 2.21 ± 1.42, with 2.18 ± 1.37 for women and 2.23 ± 1.47 for men (P = 0.466). When calculating HOMA2-IR for the healthy reference population, the resulting p75 was 2.00. Using ROC curves, the selected cut-off point was 1.95, with an area under the curve of 0.801, sensibility of 75.3%, and specificity of 72.8%. Conclusions. We propose an optimal cut-off point of 2.00 for HOMA2-IR, offering high sensitivity and specificity, sufficient for proper assessment of IR in the adult population of our city, Maracaibo. The determination of population-specific cut-off points is needed to evaluate risk for public health problems, such as obesity and metabolic syndrome. PMID:27379332

  11. Proposed cut-off values of the waist circumference for metabolic syndrome based on visceral fat volume in a Japanese population.

    PubMed

    Tsukiyama, Hidekazu; Nagai, Yoshio; Matsubara, Fumiaki; Shimizu, Hiroyuki; Iwamoto, Teruaki; Yamanouchi, Eigoro; Sada, Yukiyoshi; Kato, Hiroyuki; Ohta, Akio; Tanaka, Yasushi

    2016-07-01

    Waist circumference (WC) is the most important parameter for diagnosis of metabolic syndrome. The present study was carried out to obtain optimal WC cut-off values for diagnosis of metabolic syndrome in a Japanese population based on the measurement of total intra-abdominal visceral fat volume (VFV), which could be expected to reflect visceral obesity more precisely than visceral fat area. A total of 405 Japanese persons undergoing health screening were investigated. visceral fat volume was calculated from the data in 700-800 computed tomography slices from the top of the liver to the floor of the pelvic cavity. Then, receiver operating characteristic analysis was used to determine the cut-off value of the VFV/height ratio. Subsequently, the corresponding WC value was obtained by linear regression analysis. The cut-off value of the VFV/height ratio was 2,317 cm(3) /m in men and 1,425 cm(3) /m in women. The sensitivity and specificity of the ratio were 52.9 and 86.4% in men vs 63.4 and 82.2% in women, respectively. The corresponding cut-off value of WC was 86.0 cm in men and 80.9 cm in women. The proposed cut-off values of WC for metabolic syndrome are 85 cm in Japanese men and 80 cm in Japanese women. © 2015 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.

  12. Critical evaluation of energy intake using the Goldberg cut-off for energy intake:basal metabolic rate. A practical guide to its calculation, use and limitations.

    PubMed

    Black, A E

    2000-09-01

    To re-state the principles underlying the Goldberg cut-off for identifying under-reporters of energy intake, re-examine the physiological principles and update the values to be substituted into the equation for calculating the cut-off, and to examine its use and limitations. New values are suggested for each element of the Goldberg equation. The physical activity level (PAL) for comparison with energy intake:basal metabolic rate (EI:BMR) should be selected to reflect the population under study; the PAL value of 1.55 x BMR is not necessarily the value of choice. The suggested value for average within-subject variation in energy intake is 23% (unchanged), but other sources of variation are increased in the light of new data. For within-subject variation in measured and estimated BMR, 4% and 8.5% respectively are suggested (previously 2.5% and 8%), and for total between-subject variation in PAL, the suggested value is 15% (previously 12.5%). The effect of these changes is to widen the confidence limits and reduce the sensitivity of the cut-off. The Goldberg cut-off can be used to evaluate the mean population bias in reported energy intake, but information on the activity or lifestyle of the population is needed to choose a suitable PAL energy requirement for comparison. Sensitivity for identifying under-reporters at the individual level is limited. In epidemiological studies information on home, leisure and occupational activity is essential in order to assign subjects to low, medium or high PAL levels before calculating the cut-offs. In small studies, it is desirable to measure energy expenditure, or to calculate individual energy requirements, and to compare energy intake directly with energy expenditure.

  13. Measuring Global Brain Atrophy with the Brain Volume/Cerebrospinal Fluid Index: Normative Values, Cut-Offs and Clinical Associations.

    PubMed

    Orellana, Camila; Ferreira, Daniel; Muehlboeck, J-Sebastian; Mecocci, Patrizia; Vellas, Bruno; Tsolaki, Magda; Kłoszewska, Iwona; Soininen, Hilkka; Lovestone, Simon; Simmons, Andrew; Wahlund, Lars-Olof; Westman, Eric

    2016-01-01

    Global brain atrophy is present in normal aging and different neurodegenerative disorders such as Alzheimer's disease (AD) and is becoming widely used to monitor disease progression. The brain volume/cerebrospinal fluid index (BV/CSF index) is validated in this study as a measurement of global brain atrophy. We tested the ability of the BV/CSF index to detect global brain atrophy, investigated the influence of confounders, provided normative values and cut-offs for mild, moderate and severe brain atrophy, and studied associations with different outcome variables. A total of 1,009 individuals were included [324 healthy controls, 408 patients with mild cognitive impairment (MCI) and 277 patients with AD]. Magnetic resonance images were segmented using FreeSurfer, and the BV/CSF index was calculated and studied both cross-sectionally and longitudinally (1-year follow-up). Both AD patients and MCI patients who progressed to AD showed greater global brain atrophy compared to stable MCI patients and controls. Atrophy was associated with older age, larger intracranial volume, less education and presence of the ApoE ε4 allele. Significant correlations were found with clinical variables, CSF biomarkers and several cognitive tests. The BV/CSF index may be useful for staging individuals according to the degree of global brain atrophy, and for monitoring disease progression. It also shows potential for predicting clinical changes and for being used in the clinical routine. © 2015 S. Karger AG, Basel.

  14. Kinetic Isotope Effects from QM/MM Subset Hessians: "Cut-Off" Analysis for SN2 Methyl Transfer in Solution.

    PubMed

    Williams, Ian H

    2012-02-14

    Isotopic partition-function ratios and kinetic isotope effects for reaction of S-adenosylmethionine with catecholate in water are evaluated using a subset of 324 atoms within its surrounding aqueous environment at the AM1/TIP3P level. Two alternative methods for treating motion in the six librational degrees of freedom of the subset atoms relative to their environment are compared. A series of successively smaller subset Hessians are generated by cumulative deletion of rows and columns from the initial 972 × 972 Hessian. We find that it is better to treat these librations as vibrations than as translations and rotations and that there is no need to invoke the Teller-Redlich product rule. The validity of "cut-off" procedures for computation of isotope effects with truncated atomic subsets is assessed: to ensure errors in ln(KIE) < 1% (or 2% for the quantum-corrected KIE) for all isotopic substitutions considered, it is necessary to use a less-restrictive procedure than is suggested by the familiar two-bond cutoff rule.

  15. Optimal Cut-Off Value of the Superior Articular Process Area as a Morphological Parameter to Predict Lumbar Foraminal Stenosis

    PubMed Central

    Lim, Tae-Ha; Choi, Soo Il; Cho, Hyung Rae; Kang, Keum Nae; Rhyu, Chang Joon; Chae, Eun Young; Lim, Young Su; Lee, Yongsoo

    2017-01-01

    Background. We devised a new morphological parameter called the superior articular process area (SAPA) to evaluate the connection between lumbar foraminal stenosis (LFS) and the superior articular process. Objective. We hypothesized that the SAPA is an important morphologic parameter in the diagnosis of LFS. Methods. All patients over 60 years of age were included. Data regarding the SAPA were collected from 137 patients with LFS. A total of 167 control subjects underwent lumbar magnetic resonance imaging (MRI) as part of a routine medical examination. We analyzed the cross-sectional area of the bone margin of the superior articular process at the level of L4-L5 facet joint in the axial plane. Results. The average SAPA was 96.3 ± 13.6 mm2 in the control group and 128.1 ± 17.2 mm2 in the LFS group. The LFS group was found to have significantly higher levels of SAPA (p < 0.001) in comparison to the control group. In the LFS group, the optimal cut-off value was 112.1 mm2, with 84.4% sensitivity, 83.9% specificity, and AUC of 0.94 (95% CI: 0.91–0.96). Conclusions. Higher SAPA values were associated with a higher possibility of LFS. These results are important in the evaluation of patients with LFS. PMID:28163566

  16. What constitutes a positive result in hair analysis: proposal for the establishment of cut-off values.

    PubMed

    Kintz, P; Mangin, P

    1995-01-05

    Hair is still a seldom used specimen in most laboratories but its analysis has the potential of making a valuable contribution. Despite the many worthwhile reports, the scientific community at large still has reservations about the validity of hair analysis. Some of this is due to a lack of consensus among the active investigators on how to interpret the results from an analysis of hair. In USA, passive exposure seems to be a major problem, which can only be eliminated with difficulty. On the other hand, in Europe, scientists are performing standard decontamination procedures. It would be very helpful if a group of active researchers on hair analysis, representative of academic, government and private laboratories could define what are the areas of agreement and what are the issues that require further efforts to get a consensus. We propose the following guidelines: (1) a complete decontamination procedure, including the analysis of the wash solution; (2) two distinct analytical methods (immunoassay and GC/MS, or two different GC/MS methods); (3) the establishment of cut-off values (using 30-mg hair samples), 0.5 ng/mg of 6-MAM in the case of heroin abuse, and 1 ng/mg of cocaine in the case of cocaine abuse, which can be decreased to 0.5 ng/mg when use is supported by other evidence of drug intake.

  17. The acid phosphatase test two minute cut-off: an insufficient time to detect some semen stains.

    PubMed

    Redhead, Paul; Brown, Melanie K

    2013-06-01

    The ability to detect semen in sexual offence cases is a crucial first step to locating stains which may be suitable for DNA profiling. Since the development of the acid phosphatase test in the late 1950s by Stuart S. Kind, the process undertaken to perform the test has gone largely unchanged. The method currently accepted by operational forensic science laboratories allows 2 min for a reaction to be obtained, and until relatively recently, this has not been challenged. In this research, samples of semen were obtained from three donors and a range of dilutions for each sample were prepared. Each dilution was subjected to acid phosphatase testing using both direct testing and the 'press test' method. The results showed that semen could be detected in excess of 15 min in dilutions up to 1 in 400 using the press test method and in dilutions up to 1 in 1000 using the direct method. Of further significance was the observation that using the press test method, the two minute cut-off was insufficient to detect the majority of stains and in some cases, semen stains as strong as 1 in 20 dilutions. This research provides compelling evidence for protocols currently utilised in forensic practice to be reviewed in order that forensic scientists do not overlook potential evidential material that may prove suitable for body fluid identification such as DNA STR profiling.

  18. Urinary hepcidin identifies a serum ferritin cut-off for iron supplementation in young athletes: a pilot study.

    PubMed

    Borrione, P; Spaccamiglio, A; Rizzo, M; Termine, A; Chierto, E; Campostrini, N; Quaranta, F; Di Gianfrancesco, A; Pigozzi, F

    2011-01-01

    The use of iron supplements should be a judicious choice, primarily when considering the possible risks deriving from an unjustified treatment. In trained athletes, levels of ferritin between 15 and 30 microg/L are frequently observed. Within this ferritin range, the usefulness of iron supplementation is still controversial. The aim of the present study is to evaluate the clinical usefulness of hepcidin assessment in the analysis of the iron status of young non-anemic athletes. Fifty young athletes were enrolled. The subjects were divided into 4 groups according to their ferritin levels. No statistically significant difference was found regarding hepcidin levels between athletes with ferritin lower than 15 microg/L and those in the 15-30 microg/L range. Similarly, no difference was found between athletes with ferritin higher than 50 microg/L and those in the 30-50 microg/L range. On the contrary, statistically significant differences were found between athletes with ferritin levels ranging from 15 to 30 microg/L and those in the 30-50 microg/L range. The present study suggests that serum ferritin levels below 30 microg/L indicate an asymptomatic iron deficiency status inhibiting hepcidin expression and that 30 microg/L should be considered the ferritin cut-off when considering an iron supplementation in young athletes.

  19. On a holographic dark energy model with a Nojiri-Odintsov cut-off in general relativity

    NASA Astrophysics Data System (ADS)

    Khurshudyan, Martiros

    2016-07-01

    In this paper we consider the models of the accelerated expanding large scale universe (according to general relativity) containing a generalized holographic dark energy with a Nojiri-Odintsov cut-off. The second component of the darkness is assumed to be the pressureless cold dark matter according to observed symmetries of the large scale universe. Moreover, we assume specific forms of the interaction between these two components and besides the cosmographic analysis, we discuss appropriate results from Om and Om3 analysis and organize a closer look to the models via the statefinder hierarchy analysis, too. In this way we study mainly impact of the interaction on the dynamics of the background of our universe (within specific forms of interaction). To complete the cosmographic analysis, the present day values of the statefinder parameters (r,s) and (ω^'_{de}, ω_{de}) has been estimated for all cases and the validity of the generalized second law of thermodynamics is demonstrated. Our study showed that theoretical results from considered phenomenological models are consistent with the available observational data and symmetries.

  20. Accuracy of a cut-off value based on the third molar index: Validation in an Australian population.

    PubMed

    Franklin, Daniel; Karkhanis, Shalmira; Flavel, Ambika; Collini, Federica; DeLuca, Stefano; Cameriere, Roberto

    2016-09-01

    According to Recommendation N°196 of the Australian Law Reform Commission (ALRC), the age at which a child reaches adulthood for the purposes of criminal law should be 18 years in all Australian jurisdictions. With specific reference to age at majority, the only tooth with development spanning adolescence (and thus the legally relevant 18 years of age) is the third molar, which limits the number of methods that can be applied from those available in the published literature. The aim of the present study is to test the accuracy of the third molar index (I3M=0.08), based on the correlation between chronological age and normalized measures of the open apices and height of the third mandibular molar, in order to assess the legal adult age of 18 years. Digital orthopantomographs of 143 living Australian subjects (72 boys and 71 girls) are analyzed. The results demonstrate that the sensitivity is 0.90 in boys and 0.90 in girls; associated specificity values are 0.85 and 0.87 respectively. We conclude that the cut-off value of I3M=0.08 is statistically robust and thus valid for forensic application in an Australian population. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  1. Influence of temperature and upper cut-off voltage on the formation of lithium-ion cells

    NASA Astrophysics Data System (ADS)

    German, Florian; Hintennach, Andreas; LaCroix, Annette; Thiemig, Denny; Oswald, Steffen; Scheiba, Frieder; Hoffmann, Michael J.; Ehrenberg, Helmut

    2014-10-01

    The influences of temperature on the formation losses and subsequent electrical performance of Lix(Ni1/3Co1/3Mn1/3)yO2 (NCM)/graphite lithium-ion cells were investigated. It was shown that the total capacity loss during formation of a full cell at 25 °C consists of losses on the positive and negative electrode to about one half each. The losses of the negative electrode (ca. 10%) are due to solid electrolyte interphase (SEI) formation on graphite but are masked by the losses of the positive side (ca. 20%) which are mainly caused by a kinetic inhibition of NCM and are theoretically reversible when the cell is discharged to very low potentials. The total loss of a full cell fits with the loss of the positive electrode. With increased temperature the ratio of losses on positive and negative electrode decreases as the diffusion coefficient of lithium in NCM increases. In total, an elevated formation temperature leads to increased irreversible losses on both electrodes and significantly lower cell performance of graphite. The upper cut-off voltage has an influence on the positive electrode formation losses in a reversible manner. The constituents of the SEI identified via the combination of XPS and FTIR are mainly RCH2OCO2Li, RCOOLi and LiF for the outer SEI and mainly Li2CO3, Li2O and LiF for the inner SEI.

  2. Adherence to a standardized protocol for measuring grip strength and appropriate cut-off values in adults over 65 years with sarcopenia: a systematic review protocol.

    PubMed

    Fox, Benjamin; Henwood, Tim; Schaap, Laura; Bruyère, Olivier; Reginster, Jean-Yves; Beaudart, Charlotte; Buckinx, Fanny; Roberts, Helen; Cooper, Cyrus; Cherubini, Antonio; dellʼAquilla, Giuseppina; Maggio, Marcello; Volpato, Stefano

    2015-10-01

    The objective of this review is to examine the use of grip strength analysis in well and unwell populations in adults 65 years and over as a tool to establish muscle strength in sarcopenia.More specifically, the main review question is:1. What protocol, if any, is most commonly used among older adults with sarcopenia and does this match the standardized protocol suggested in 2011 by Roberts et al.1?Secondary review questions are:2. What are the reported cut-off values being used to determine sarcopenia in older adults, with consideration for ethnic and gender variability?3. Is grip strength, as a tool to measure muscle strength, suitable for people with common comorbidities and geriatric syndromes, such as osteoarthritis, often associated with sarcopenia? Sarcopenia, a commonly used concept in geriatrics and gerontology, is characterized by a loss of muscle mass, muscle strength and/or physical functioning. Prevalence rates vary between 1-39% in community dwelling older populations and 14-33% in long-term care populations. Several epidemiological studies have shown the association of sarcopenia with adverse health outcomes such as falls, disability, hospitalization and mortality. Originally, sarcopenia refers to the loss of muscle mass with aging, which was later complemented with loss of muscle strength and physical functioning.In 2010, the European Working Group on Sarcopenia in Older People (EWGSOP) reported a consensus definition of sarcopenia, which included measurement of low muscle mass and low muscle function (strength or physical performance). This consensus definition can be used to identify sarcopenia patients in clinical practice and to select individuals for clinical trials. Well-designed clinical trials could ultimately lead to effective treatment and prevention strategies for sarcopenia. Since the publication of the consensus report, many studies have adopted this definition, which could potentially lead to better comparison of results between

  3. The Vector Matching Method in Geomagnetic Aiding Navigation.

    PubMed

    Song, Zhongguo; Zhang, Jinsheng; Zhu, Wenqi; Xi, Xiaoli

    2016-07-20

    In this paper, a geomagnetic matching navigation method that utilizes the geomagnetic vector is developed, which can greatly improve the matching probability and positioning precision, even when the geomagnetic entropy information in the matching region is small or the geomagnetic contour line's variety is obscure. The vector iterative closest contour point (VICCP) algorithm that is proposed here has better adaptability with the positioning error characteristics of the inertial navigation system (INS), where the rigid transformation in ordinary ICCP is replaced with affine transformation. In a subsequent step, a geomagnetic vector information fusion algorithm based on Bayesian statistical analysis is introduced into VICCP to improve matching performance further. Simulations based on the actual geomagnetic reference map have been performed for the validation of the proposed algorithm.

  4. The Vector Matching Method in Geomagnetic Aiding Navigation

    PubMed Central

    Song, Zhongguo; Zhang, Jinsheng; Zhu, Wenqi; Xi, Xiaoli

    2016-01-01

    In this paper, a geomagnetic matching navigation method that utilizes the geomagnetic vector is developed, which can greatly improve the matching probability and positioning precision, even when the geomagnetic entropy information in the matching region is small or the geomagnetic contour line’s variety is obscure. The vector iterative closest contour point (VICCP) algorithm that is proposed here has better adaptability with the positioning error characteristics of the inertial navigation system (INS), where the rigid transformation in ordinary ICCP is replaced with affine transformation. In a subsequent step, a geomagnetic vector information fusion algorithm based on Bayesian statistical analysis is introduced into VICCP to improve matching performance further. Simulations based on the actual geomagnetic reference map have been performed for the validation of the proposed algorithm. PMID:27447645

  5. Practical cut-offs for visual rating scales of medial temporal, frontal and posterior atrophy in Alzheimer's disease and mild cognitive impairment.

    PubMed

    Ferreira, D; Cavallin, L; Larsson, E-M; Muehlboeck, J-S; Mecocci, P; Vellas, B; Tsolaki, M; Kłoszewska, I; Soininen, H; Lovestone, S; Simmons, A; Wahlund, L-O; Westman, E

    2015-09-01

    Atrophy in the medial temporal lobe, frontal lobe and posterior cortex can be measured with visual rating scales such as the medial temporal atrophy (MTA), global cortical atrophy - frontal subscale (GCA-F) and posterior atrophy (PA) scales, respectively. However, practical cut-offs are urgently needed, especially now that different presentations of Alzheimer's disease (AD) are included in the revised diagnostic criteria. The aim of this study was to generate a list of practical cut-offs for the MTA, GCA-F and PA scales, for both diagnosis of AD and determining prognosis in mild cognitive impairment (MCI), and to evaluate the influence of key demographic and clinical factors on these cut-offs. AddNeuroMed and ADNI cohorts were combined giving a total of 1147 participants (322 patients with AD, 480 patients with MCI and 345 control subjects). The MTA, GCA-F and PA scales were applied and a broad range of cut-offs was evaluated. The MTA scale showed better diagnostic and predictive performances than the GCA-F and PA scales. Age, apolipoprotein E (ApoE) ε4 status and age at disease onset influenced all three scales. For the age ranges 45-64, 65-74, 75-84 and 85-94 years, the following cut-offs should be used. MTA: ≥1.5, ≥1.5, ≥2 and ≥2.5; GCA-F, ≥1, ≥1, ≥1 and ≥1; and PA, ≥1, ≥1, ≥1 and ≥1, respectively, with an adjustment for early-onset ApoE ε4 noncarrier AD patients (MTA: ≥2, ≥2, ≥3 and ≥3; and GCA-F: ≥1, ≥1, ≥2 and ≥2, respectively). If successfully validated in clinical settings, the list of practical cut-offs proposed here might be useful in clinical practice. Their use might also (i) promote research on atrophy subtypes, (ii) increase the understanding of different presentations of AD, (iii) improve diagnosis and prognosis and (iv) aid population selection and enrichment for clinical trials. © 2015 The Association for the Publication of the Journal of Internal Medicine.

  6. Detectability of small blood vessels with high-frequency power Doppler and selection of wall filter cut-off velocity for microvascular imaging.

    PubMed

    Pinter, Stephen Z; Lacefield, James C

    2009-07-01

    Power Doppler imaging of physiologic and pathologic angiogenesis is widely used in preclinical studies to track normal development, disease progression and treatment efficacy but can be challenging given the presence of small blood vessels and slow flow velocities. Power Doppler images can be plagued with false-positive color pixels or undetected vessels, thereby complicating the interpretation of vascularity metrics such as color pixel density (CPD). As an initial step toward improved microvascular quantification, flow-phantom experiments were performed to establish relationships between vessel detection and various combinations of vessel size (160, 200, 250, 300 and 360 microm), flow velocity (4, 3, 2, 1 and 0.5 mm/s) and transducer frequency (30 and 40 MHz) while varying the wall filter cut-off velocity. Receiver operating characteristic (ROC) curves and areas under ROC curves indicate that good vessel detection performance can be achieved with a 40-MHz transducer for flow velocities > or =2 mm/s and with a 30-MHz transducer for flow velocities > or =1 mm/s. In the second part of the analysis, CPD was plotted as a function of wall filter cut-off velocity for each flow-phantom data set. Three distinct regions were observed: overestimation of CPD at low cut-offs, underestimation of CPD at high cut-offs and a plateau at intermediate cut-offs. The CPD at the plateau closely matched the phantom's vascular volume fraction and the length of the plateau corresponded with the flow-detection performance of the Doppler system assessed using ROC analysis. Color pixel density vs. wall filter cut-off curves from analogous in vivo experiments exhibited the same shape, including a distinct CPD plateau. The similar shape of the flow-phantom and in vivo curves suggests that the presence of a plateau in vivo can be used to identify the best-estimate CPD value that can be treated as a quantitative vascularity metric. The ability to identify the best CPD estimate is expected to

  7. Population-based colorectal cancer screening programmes using a faecal immunochemical test: should faecal haemoglobin cut-offs differ by age and sex?

    PubMed

    Arana-Arri, Eunate; Idigoras, Isabel; Uranga, Begoña; Pérez, Raquel; Irurzun, Ana; Gutiérrez-Ibarluzea, Iñaki; Fraser, Callum G; Portillo, Isabel

    2017-08-29

    The Basque Colorectal Cancer Screening Programme has both high participation rate and high compliance rate of colonoscopy after a positive faecal occult blood test (FIT). Although, colorectal cancer (CRC) screening with biannual (FIT) has shown to reduce CRC mortality, the ultimate effectiveness of the screening programmes depends on the accuracy of FIT and post-FIT colonoscopy, and thus, harms related to false results might not be underestimated. Current CRC screening programmes use a single faecal haemoglobin concentration (f-Hb) cut-off for colonoscopy referral for both sexes and all ages. We aimed to determine optimum f-Hb cut-offs by sex and age without compromising neoplasia detection and interval cancer proportion. Prospective cohort study using a single-sample faecal immunochemical test (FIT) on 444,582 invited average-risk subjects aged 50-69 years. A result was considered positive at ≥20 μg Hb/g faeces. Outcome measures were analysed by sex and age for a wide range of f-Hb cut-offs. We analysed 17,387 positive participants in the programme who underwent colonoscopy. Participation rate was 66.5%. Men had a positivity rate for f-Hb of 8.3% and women 4.8% (p < 0.0001). The detection rate for advanced neoplasia (cancer plus advanced adenoma) was 44.0‰ for men and 15.9‰ for women (p < 0.0001). The number of colonoscopies required decreased in both sexes and all age groups through increasing the f-Hb cut-off. However, the loss in CRC detection increased by up to 28.1% in men and 22.9% in women. CRC missed were generally at early stages (Stage I-II: from 70.2% in men to 66.3% in women). This study provides detailed outcomes in men and women of different ages at a range of f-Hb cut-offs. We found differences in positivity rates, neoplasia detection rate, number needed to screen, and interval cancers in men and women and in younger and older groups. However, there are factors other than sex and age to consider when consideration is given to setting

  8. Examination of the cut-off scores determined by the Ages and Stages Questionnaire in a population-based sample of 6 month-old Norwegian infants

    PubMed Central

    2011-01-01

    Background Few population-based samples have previously published performance on the Ages and Stages Questionnaire (ASQ), a recommended screening tool to detect infant developmental delay. The aim of the study was to investigate performance on the ASQ in a population-based sample of 6-month-old infants. Methods In this population-based questionnaire study from Oslo, Norway, the 30 item ASQ 6 month Questionnaire (N = 1053) were included, however without the pictograms, and compared to the Norwegian reference sample (N.ref) (N = 169) and to US cut-off values. Exclusion criteria were maternal non-Scandinavian ethnicity, infant age < 5.0 or > 7.0 months (corrected age), twins, and birth weight < 2.5 kg. Cut-off = 2.5 percentile (equivalent to mean minus 2 standard deviations). Pearson's Chi square and Mann-Whitney U were used to compare items and areas, respectively, with N.ref. Results The reported ASQ scores were lower on all but one of the 10 significantly different items, and in all areas except Personal social, compared to the N.ref sample. The estimated cut-off values for suspected developmental delay (Communication 25, Gross motor 15, Fine motor 18, Problem solving 25 and Personal social 20) were lower than the recommended American (US) values in all areas, and lower than the Norwegian values in two areas. Scores indicating need for further assessment were reached by 13.8% or 20.5% of the infants (missing items scored according to the US or the Norwegian manual), and by 33.8% or 30.3% of the infants using the recommended US or the Norwegian cut-off values, in this population-based sample. The Fine motor area demonstrated a large variability depending on the different cut-off and scoring possibilities. Both among the items excluding pictograms and the items that do not have pictograms, approximately every third item differed significantly compared to the N.ref sample. Conclusion The psychomotor developmental scores were lower than in the reference samples in this

  9. Examination of the cut-off scores determined by the Ages and Stages Questionnaire in a population-based sample of 6 month-old Norwegian infants.

    PubMed

    Alvik, Astrid; Grøholt, Berit

    2011-12-19

    Few population-based samples have previously published performance on the Ages and Stages Questionnaire (ASQ), a recommended screening tool to detect infant developmental delay. The aim of the study was to investigate performance on the ASQ in a population-based sample of 6-month-old infants. In this population-based questionnaire study from Oslo, Norway, the 30 item ASQ 6 month Questionnaire (N = 1053) were included, however without the pictograms, and compared to the Norwegian reference sample (N.ref) (N = 169) and to US cut-off values. Exclusion criteria were maternal non-Scandinavian ethnicity, infant age < 5.0 or > 7.0 months (corrected age), twins, and birth weight < 2.5 kg. Cut-off = 2.5 percentile (equivalent to mean minus 2 standard deviations). Pearson's Chi square and Mann-Whitney U were used to compare items and areas, respectively, with N.ref. The reported ASQ scores were lower on all but one of the 10 significantly different items, and in all areas except Personal social, compared to the N.ref sample. The estimated cut-off values for suspected developmental delay (Communication 25, Gross motor 15, Fine motor 18, Problem solving 25 and Personal social 20) were lower than the recommended American (US) values in all areas, and lower than the Norwegian values in two areas. Scores indicating need for further assessment were reached by 13.8% or 20.5% of the infants (missing items scored according to the US or the Norwegian manual), and by 33.8% or 30.3% of the infants using the recommended US or the Norwegian cut-off values, in this population-based sample. The Fine motor area demonstrated a large variability depending on the different cut-off and scoring possibilities. Both among the items excluding pictograms and the items that do not have pictograms, approximately every third item differed significantly compared to the N.ref sample. The psychomotor developmental scores were lower than in the reference samples in this study of ASQ 6 month Questionnaire

  10. Body composition-derived BMI cut-offs for overweight and obesity in Indians and Creoles of Mauritius: comparison with Caucasians

    PubMed Central

    Hunma, S; Ramuth, H; Miles-Chan, J L; Schutz, Y; Montani, J-P; Joonas, N; Dulloo, A G

    2016-01-01

    Background and Aims: Global estimates of overweight and obesity prevalence are based on the World Health Organisation (WHO) body mass index (BMI) cut-off values of 25 and 30 kg m−2, respectively. To validate these BMI cut-offs for adiposity in the island population of Mauritius, we assessed the relationship between BMI and measured body fat mass in this population according to gender and ethnicity. Methods: In 175 young adult Mauritians (age 20-42 years) belonging to the two main ethnic groups—Indians (South Asian descent) and Creoles (African/Malagasy descent), body weight, height and waist circumference (WC) were measured, total body fat assessed by deuterium oxide (D2O) dilution and trunk (abdominal) fat by segmental bioimpedance analysis. Results: Compared to body fat% predicted from BMI using Caucasian-based equations, body fat% assessed by D2O dilution in Mauritians was higher by 3–5 units in Indian men and women as well as in Creole women, but not in Creole men. This gender-specific ethnic difference in body composition between Indians and Creoles is reflected in their BMI–Fat% relationships, as well as in their WC–Trunk Fat% relationships. Overall, WHO BMI cut-offs of 25 and 30 kg m−2 for overweight and obesity, respectively, seem valid only for Creole men (~24 and 29.5, respectively), but not for Creole women whose BMI cut-offs are 2–4 units lower (21–22 for overweight; 27–28 for obese) nor for Indian men and women whose BMI cut-offs are 3–4 units lower (21–22 for overweight; 26–27 for obese). Conclusions: The use of BMI cut-off points for classifying overweight and obesity need to take into account both ethnicity and gender to avoid gross adiposity status misclassification in this population known to be at high risk for type-2 diabetes and cardiovascular diseases. This is particularly of importance in obesity prevention strategies both in clinical medicine and public health. PMID:27698347

  11. Spectral properties and the effect on redshift cut-off of compact active galactic nuclei from the AT20G survey

    NASA Astrophysics Data System (ADS)

    Chhetri, R.; Ekers, R. D.; Mahony, E. K.; Jones, P. A.; Massardi, M.; Ricci, R.; Sadler, E. M.

    2012-05-01

    Spectral index has been traditionally used to separate extragalactic radio sources into compact and extended populations, with the spectral transition placed variably between -0.4 and -0.6. We use high angular resolution data, measured from visibility of sources at the longest baseline of 4500 m of the Australia Telescope Compact Array (ATCA), for the Australia Telescope 20 GHz (AT20G) survey to obtain angular size information for over 94 per cent of AT20G sources. We confirm the previous AT20G result that due to the high survey frequency of 20 GHz, the source population is strongly dominated by compact sources (79 per cent). At 0.15-arcsec angular resolution limit, we show a very strong correlation between the compact and extended sources with flat and steep-spectrum sources respectively for spectral indices obtained between 1 and 5 GHz. Thus, we provide a firm physical basis for the traditional spectral classification into flat and steep-spectrum sources to select compact and extended sources. We find that for spectral indices between 1 and 5 GHz, the cut-offs at -0.4 and -0.5 are quite similar to the optimum cut-off of -0.46 and, hence, recommend the continued use of -0.5 for future studies. We use the recently published redshift data to study the effect of spectral curvature on the redshift cut-off of compact active galactic nuclei (AGNs). Using spectral indices at different frequencies, we correct for the redshift effect and also produce rest-frame frequency spectra for compact sources for redshifts up to z˜ 5. We show that the spectra of most compact sources are flat to ˜30 GHz and then start to steepen. At higher frequencies, the spectra of both compact and extended sources are steep, so the use of spectral index does not separate the compact and extended source populations as well as in lower frequencies. We also find that due to spectral steepening at high frequencies, surveys of compact sources at higher frequencies (ν > 5 GHz) will have redshift cut-off

  12. Combined Effect of an Atmospheric River and a Cut-off Low in Hiroshima Flooding Event on August 19, 2014

    NASA Astrophysics Data System (ADS)

    Takayabu, Y. N.; Hirota, N.; Kato, M.; Arakane, S.

    2015-12-01

    An extraordinary precipitation over 100 mmhr-1in Hiroshima on August 19, 2014, caused a flash flood which resulted in 74 fatalities and collapse of 330 houses. In order to examine the meteorological background of this flooding event, we carried out a detailed analysis utilizing rain gauge data, satellite precipitation dataset, and a meso scale and a global scale objective analyses provided from the Japan Meteorological Agency. Then, we performed numerical experiments using a nonhydrostatic compressible equation model called the Cloud-Resolving Storm Simulator (CReSS). As a result, a combined effect of an atmospheric river (AR) and a cut-off low (COL) in this flooding event was elucidated. During the event, a filamentary transport of moisture extending from the Indochina Peninsula to the Japanese Islands was observed along the southern side of the subtropical jet, forming an AR. This AR had a deep structure with an amount of free tropospheric moisture comparable to that of the boundary layer. Concurrently, there was a COL, detached from the Mid-Pacific Trough, moving northwestward toward the Japanese Archipelago. With various sensitivity experiments, we concluded that a mid-tropospheric instability associated with the cold core of the COL and a dynamical ascent induced in its foreside, collaboratively worked with the anomalous moisture in the free troposphere associated with the AR, to extraordinarily enhance the precipitation over Hiroshima region. An orographic effect to concentrate the precipitation in this region was also confirmed. An implication on a difference in effects of AR in this event with a climatologically moist boundary layer, from those in the US west coast with a very dry environment, was also obtained. Acknowledgment: This study is supported by the Environment Research and Technology Development Fund (2-1503) of the Ministry of the Environment, Japan, and by the Ministry of Education, Culture, Sports, Science and Technology, Japan.

  13. Impact of donor age in donation after cardiac death liver transplantation: Is the cut-off "60" still of relevance?

    PubMed

    Schlegel, Andrea; Scalera, Irene; Thamara, M; Perera, P R; Kalisvaart, Marit; Mergental, Hynek; Mirza, Darius F; Isaac, John; Muiesan, Paolo

    2017-09-08

    Background Advanced donor age has been identified as risk factor, when combined with donor warm ischemia, e.g. in donation after circulatory death (DCD). In several countries DCD livers, older than 60 years are not considered suitable due to concerns related to poor graft function and development of ischaemic cholangiopathy. We evaluate in this study outcome after DCD liver transplantation using grafts from donors older than 60 years. Methodology We analysed outcome after DCD liver transplantation (n=315), comparing donors >60 years (n=93) and donors ≤60 years (n=222) from our centre between 2005 and 2015. Endpoints included graft function and complications, patient and graft survival. Multivariate risk analysis was performed to define further key factors that predicted inferior outcome. Results Donor age at the cut-off 60 years failed to stratify patient and graft survival. The rate of vascular, biliary and overall complications was comparably low in both cohorts and the median CCI was 42,7 points, independent from the donor age. Secondly, donor BMI above a threshold of 25 kg/m(2) significantly impacted on graft and patient survival, at any donor age, while donor warm and cold ischemia times were not predictive for graft loss. Conclusion Older DCD donors can be successfully used for liver transplantation with good long-term outcomes, when further risk factors are limited. Additional risk is transmitted by an increased donor BMI, regardless of donor age. This article is protected by copyright. All rights reserved. © 2017 by the American Association for the Study of Liver Diseases.

  14. Impact of pore space topology on permeability, cut-off frequencies and validity of wave propagation theories

    NASA Astrophysics Data System (ADS)

    Sarout, Joël.

    2012-04-01

    For the first time, a comprehensive and quantitative analysis of the domains of validity of popular wave propagation theories for porous/cracked media is provided. The case of a simple, yet versatile rock microstructure is detailed. The microstructural parameters controlling the applicability of the scattering theories, the effective medium theories, the quasi-static (Gassmann limit) and dynamic (inertial) poroelasticity are analysed in terms of pores/cracks characteristic size, geometry and connectivity. To this end, a new permeability model is devised combining the hydraulic radius and percolation concepts. The predictions of this model are compared to published micromechanical models of permeability for the limiting cases of capillary tubes and penny-shaped cracks. It is also compared to published experimental data on natural rocks in these limiting cases. It explicitly accounts for pore space topology around the percolation threshold and far above it. Thanks to this permeability model, the scattering, squirt-flow and Biot cut-off frequencies are quantitatively compared. This comparison leads to an explicit mapping of the domains of validity of these wave propagation theories as a function of the rock's actual microstructure. How this mapping impacts seismic, geophysical and ultrasonic wave velocity data interpretation is discussed. The methodology demonstrated here and the outcomes of this analysis are meant to constitute a quantitative guide for the selection of the most suitable modelling strategy to be employed for prediction and/or interpretation of rocks elastic properties in laboratory-or field-scale applications when information regarding the rock's microstructure is available.

  15. Impact of oxygen cut off and starvation conditions on biological activity and physico-chemical properties of activated sludge.

    PubMed

    Villain, Maud; Clouzot, Ludiwine; Guibaud, Gilles; Marrot, Benoit

    2013-01-01

    Physico-chemical and biological parameters were monitored both throughout different oxygen cut off and starvation (OCS) times (6 h-72 h) and after the restoration of normal operational conditions. Sludge apparent viscosity and soluble extracellular polymeric substances (EPS) characteristics were measured to determine the activated sludge (AS) properties. Oxygen transfer, biological activity with specific oxygen uptake rate (SOUR) measurements during endogenous/exogenous conditions (without any external substrate/with external substrate consumption) and chemical oxygen demand (COD) removal were measured to assess the AS performances. During the different stress times, AS deflocculated as a decrease of apparent viscosity was observed and microorganisms biodegraded the released EPS to survive. After aeration return, and under endogenous conditions, size exclusion chromatographic fingerprints of soluble EPS were modified and macromolecules probably of type humic-like substances appeared in significant quantities. These new macromolecules presumably acted as biosurfactants. Consequently, the liquid surface tension, as well as the oxygen transfer rate (OTR), decreased. Under exogenous conditions, high biological activity (SOUR = 11.8 +/- 2.1 mg(O2 x g(MLVSS)(-1) x h(-1)) compensated the decrease of oxygen transfer. Finally, AS biomass maintained a constant COD degradation rate (15.7 +/- 1.9 mg(O2) x g(MLVSS)(-1) x h(-1)) before and after the disturbances for all times tested. This work demonstrates that AS microorganisms can counteract concomitant oxygen and nutrients shortage when the duration of such a condition does not exceed 72 h. Dissociation of endogenous/exogenous conditions appears to offer an ideal laboratory model to study EPS and biomass activity effects on oxygen transfer.

  16. Establishing New Cut-Off Limits for Galactose 1-Phosphate-Uridyltransferase Deficiency for the Dutch Newborn Screening Programme.

    PubMed

    Kemper, E A; Boelen, A; Bosch, A M; van Veen-Sijne, M; van Rijswijk, C N; Bouva, M J; Fingerhut, R; Schielen, P C J I

    2017-01-01

    Newborn screening for classical galactosemia in the Netherlands is performed by five laboratories and is based on the measurement of galactose 1-phosphate-uridyltransferase (GALT) activity and total galactose (TGAL) in heel prick blood spots. Unexpected problems with the GALT assay posed a challenge to switch to a new assay. The aim of this study was to make an analytical and clinical evaluation of GALT assays to replace the current assay and to establish new cut-off values (COVs).First, the manual assay from PerkinElmer (NG-1100) and the GSP assay were compared by analyzing 626 anonymous heel prick samples in parallel. Secondly, a manual GSP method was evaluated and 2,052 samples were compared with the automated GSP assay. Finally, a clinical evaluation was performed by collecting data from 93 referred newborns.No satisfactory correlation was observed between GALT activity measured with the manual NG-1100 assay and the automated GSP assay. An acceptable correlation was found between the manual and automated GSP assay. Intra- and inter-assay variation of the automated GSP were 1.8-10.0% and 3.1-13.9%, respectively. Evaluation of clinical data demonstrated that adjusting the COVs for GALT to 2.0 U/dl and TGAL to 1,100 μmol/l improved specificity of screening for classical galactosemia.An assay designed for automated processing to measure GALT activity in heel prick samples works equally well when processed manually. We therefore adopted both methods in the Dutch screening laboratories. As a result of this evaluation new COVs for GALT and TGAL have been introduced and are valid from July 2015.

  17. Cut-off net acid generation pH in predicting acid-forming potential in mine spoils.

    PubMed

    Liao, B; Huang, L N; Ye, Z H; Lan, C Y; Shu, W S

    2007-01-01

    Acidification of mine wastes can lead to a series of environmental problems, such as acid drainage, heavy metal mobilization, and ecosystem degradation. Prediction of acid-forming potential is one of the key steps in management of sulfide-bearing mine wastes. In this paper, the acid-forming potential of 180 mine waste samples collected from 17 mine sites in China were studied using a net acid generation (NAG) method. The samples contained different contents of total sulfur (ranging from 0.6 to 200 g kg(-1)), pyritic sulfur (ranging from 0 to 100 g kg(-1)), and acid neutralization capacity (ANC, ranging from -41 to 274 kg H2SO4 t(-1)). Samples with high acid-forming potential are generally due to their high sulfur content or low acid neutralization capacity. After the samples were oxidized by H2O2, the amounts of acid generation and the final NAG pH were measured. Results indicated that the final NAG pH gave a well-defined demarcation between acid-forming and non-acid-forming materials. Samples with final NAG pH >or= 5 could be classified as non-acid-forming materials, while those with NAG pH 2.5, but < 5, had low risk of being acid-forming. The confirmation of cut-off NAG pH will be used as a rapid and cost-effective operational monitoring tool for the in-pit prediction of acid-forming potential of mine wastes and classification of waste types.

  18. Evaluation of cut-off saw exposure control methods for respirable dust and crystalline silica in roadway construction.

    PubMed

    Middaugh, Beauregard; Hubbard, Bryan; Zimmerman, Neil; McGlothlin, James

    2012-01-01

    Dust reduction equipment adapted for single-person operation was evaluated for gas-powered, commercially available cut-off saws during concrete curb cutting. Cutting was performed without dust control and with two individual exposure control methods: wet suppression and local exhaust ventilation (LEV). The wet suppression system comprised a two-nozzle spray system and a 13.3-L hand-pressurized water supply system with an optimum mean flow rate of 0.83 L/min for 16 min of cutting. The LEV system consisted of a spring-loaded guard, an 18.9-L collection bag, and a centrifugal fan with an estimated exhaust rate of 91 ft(3)/min. Task-based, personal filter samples were obtained for four saw operators during cutting durations of 4 to 16 min on five job sites. Seventeen filter samples were collected without dust control, 14 with wet suppression, and 12 with LEV, yielding a geometric mean respirable dust concentration of 16.4 mg/m(3), 3.60 mg/m(3), and 4.40 mg/m(3), respectively. A dust reduction of 78.0% for wet suppression and 73.2% for LEV was observed vs. no dust control. A statistically significant difference (p < 0.001) was also revealed for wet suppression and LEV when compared with no dust control; however, a significant difference (p = 0.09) was not observed between wet suppression and LEV. Despite these significant dust reductions, workers are still projected to exceed the ACGIH 8-hr time-weighted average threshold limit value for quartz (0.025 mg/m(3)) in less than 1 hr of cutting for both dust control methods. Further research is still needed to improve dust reduction and portability of both control methods, but the current LEV system offers important advantages, including a drier, less slippery work area and year-round functionality in cold weather.

  19. Geomagnetic transmission of solar energetic protons during the geomagnetic disturbances of October 1989

    NASA Technical Reports Server (NTRS)

    Boberg, P. R.; Tylka, A. J.; Adams J. H., JR.; Flueckiger, E. O.; Kobel, E.

    1995-01-01

    Orbit-averaged geomagnetic transmission measurements during the large solar energetic particle events of October 1989 are presented using proton data from the NOAA-10 and GOES-7 satellies. The measurements are compared to geomagnetic transmission calculations determined by tracing particle trajectories through the combination of the International Geomagnetic Reference Field (IGRF) model and the 1989 Tsyganenko magnetospheric magnetic field model. The effective 'ring current' parameter in the 1989 Tsyganenko model based on the Dst data. Results are compared to calculations employing only the IGRF and to a parameterization of geomagnetically quiet-time cutoff rigidities derived from Cosmos/intercosmos observations. The 3-hour orbit-averaged results have approximately 15% accuracy during the October 1989 events.

  20. Development and validation of optimal cut-off value in inter-arm systolic blood pressure difference for prediction of cardiovascular events.

    PubMed

    Hirono, Akira; Kusunose, Kenya; Kageyama, Norihito; Sumitomo, Masayuki; Abe, Masahiro; Fujinaga, Hiroyuki; Sata, Masataka

    2017-08-19

    An inter-arm systolic blood pressure difference (IAD) is associated with cardiovascular disease. The aim of this study was to develop and validate the optimal cut-off value of IAD as a predictor of major adverse cardiac events in patients with arteriosclerosis risk factors. From 2009 to 2014, 1076 patients who had at least one cardiovascular risk factor were included in the analysis. We defined 700 randomly selected patients as a development cohort to confirm that IAD was the predictor of cardiovascular events and to determine optimal cut-off value of IAD. Next, we validated outcomes in the remaining 376 patients as a validation cohort. The blood pressure (BP) of both arms measurements were done simultaneously using the ankle-brachial blood pressure index (ABI) form of automatic device. The primary endpoint was the cardiovascular event and secondary endpoint was the all-cause mortality. During a median period of 2.8 years, 143 patients reached the primary endpoint in the development cohort. In the multivariate Cox proportional hazards analysis, IAD was the strong predictor of cardiovascular events (hazard ratio: 1.03, 95% confidence interval: 1.01-1.05, p=0.005). The receiver operating characteristic curve revealed that 5mmHg was the optimal cut-off point of IAD to predict cardiovascular events (p<0.001). In the validation cohort, the presence of a large IAD (IAD ≥5mmHg) was significantly associated with the primary endpoint (p=0.021). IAD is significantly associated with future cardiovascular events in patients with arteriosclerosis risk factors. The optimal cut-off value of IAD is 5mmHg. Copyright © 2017 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

  1. Determining the cut-off point of osteoporosis based on the osteoporosis self-assessment tool, body mass index and weight in Taiwanese young adult women.

    PubMed

    Chang, Shu Fang; Yang, Rong Sen

    2014-09-01

    To examine the cut-off point of the osteoporosis self-assessment tool, age, weight and body mass index for osteoporosis among young adult Taiwanese women, using a large-scale health examination database containing bone mineral density tests. The cut-off points of osteoporosis risk factors identified earlier focus on menopausal or senior Caucasian and Asian women. However, young adult Asian women have seldom been identified. A retrospective historical cohort study. Using the 2009-2011 health examination database of a large-scale medical centre in northern Taiwan, this study investigated young adult Asian women (i.e. range in age from 30-49 years) in Taiwan who had received dual-energy X-ray absorptiometry test. This study also explored the cut-off point, sensitivity, specificity and diagnostic accuracy of receiver operating characteristics of osteoporosis among young adult females in Taiwan. This study collected 2454 young adult Asian women in Taiwan. Cochran-Armitage analysis results indicated that the prevalence of osteoporosis increased with decreasing weight, body mass index and osteoporosis self-assessment method quartiles. According to the results of receiver operating characteristics, weight, body mass index and osteoporosis self-assessment tool approaches can generally be used as indicators to predict osteoporosis among young adult Asian women. Results of this study demonstrate that Taiwanese women contracting osteoporosis tend to be young and underweight, as well as having a low body mass index and osteoporosis self-assessment scores. Those results further suggest that the assessment indicators for cut-off points are appropriately suitable for young adult women in Taiwan. Early detection is the only available means of preventing osteoporosis. Professional nurses should apply convenient and accurate assessment procedures to help young adult women to adopt preventive strategies against osteoporosis early, thus eliminating the probability of osteoporotic

  2. Cerebrospinal Fluid Neopterin Analysis in Neuropediatric Patients: Establishment of a New Cut Off-Value for the Identification of Inflammatory-Immune Mediated Processes

    PubMed Central

    Molero-Luis, Marta; Fernández-Ureña, Sergio; Jordán, Iolanda; Serrano, Mercedes; Ormazábal, Aida; Garcia-Cazorla, Àngels; Artuch, Rafael

    2013-01-01

    Objective A high level of cerebrospinal fluid (CSF) neopterin is a marker of central nervous system inflammatory-immune mediated processes. We aimed to assess data from 606 neuropediatric patients, describing the clinical and biochemical features of those neurological disorders presenting CSF neopterin values above a new cut-off value that was defined in our laboratory. Methods To establish the new CSF neopterin cut-off value, we studied two groups of patients: Group 1 comprised 68 patients with meningoencephalitis, and Group 2 comprised 52 children with a confirmed peripheral infection and no central nervous system involvement. We studied 606 CSF samples from neuropediatric patients who were classified into 3 groups: genetic diagnosis (A), acquired/unknown etiologic neurologic diseases (B) and inflammatory-immune mediated processes (C). Results The CSF neopterin cut-off value was 61 nmol/L. Out of 606 cases, 56 presented a CSF neopterin level above this value. Group C had significantly higher CSF neopterin, protein and leukocyte values than the other groups. Sixteen of twenty-three patients in this group had a CSF neopterin level above the cut-off, whereas three and seven patients presented increased leukocyte and protein values, respectively. A significant association was found among CSF neopterin, proteins and leukocytes in the 606 patients. White matter disturbances were associated with high CSF neopterin concentrations. Conclusions Although children with inflammatory-immune mediated processes presented higher CSF neopterin values, patients with other neurological disorders also showed increased CSF neopterin concentrations. These results stress the importance of CSF neopterin analysis for the identification of inflammatory-immune mediated processes. PMID:24367586

  3. Power-law entropy-corrected holographic dark energy in Hořava-Lifshitz cosmology with Granda-Oliveros cut-off

    NASA Astrophysics Data System (ADS)

    Pasqua, Antonio; Chattopadhyay, Surajit; Myrzakulov, Ratbay

    2016-11-01

    In this paper, we study the Power-Law Entropy-Corrected Holographic Dark Energy (PLECHDE) model in the framework of Hořava-Lifshitz cosmology considering a non-flat Universe. As infrared cut-off of the system, we choose the recently proposed Granda-Oliveros (GO) cut-off, which is a function of the Hubble parameter squared H2 and of the first time derivative of the Hubble parameter dot{H}. Moreover, the GO cut-off is characterized by two constant parameters, α and β, representing the multiplying factors of the two terms forming the cut-off itself. We derive the evolutionary form of the fractional energy densities of DE, DM and curvature ΩD', Ωm' and Ωk', the pressure of DE pD, the Equation-of-State (EoS) parameter of DE ωD and the deceleration parameter q . Using the parametrization of the EoS parameter ωD(z) = ω0+ω1 z, we obtain the expressions of ω0 and ω1. We also study the behavior of the statefinder parameters { r, s}, the snap and lerk cosmographic parameters s_{cosmo} and l and the squared speed of the sound v s 2 in order to have a better comprehension of the properties of the model considered. We also calculate the present day values of the quantities we study for different values of the running parameter λ (which is a characteristic parameter of Hořava-Lifshitz cosmology) and for different sets of values of α and β. All the quantities are derived for both non-interacting and interacting DE and Dark Matter (DM).

  4. The impact of lowering the cut-off value on the sensitivity of the Platelia Elisa IgG (Bio-Rad) test for toxoplasmosis diagnosis

    PubMed Central

    Mouri, Oussama; Kendjo, Eric; Touafek, Feriel; Fekkar, Arnaud; Konte, Ousmane; Imbert, Sebastien; Courtin, Régis; Mazier, Dominique; Paris, Luc

    2015-01-01

    Determining specific immune status against Toxoplasma gondii is essential for assessing the risk of reactivation in immunocompromised patients or defining serological monitoring and appropriate prophylactic measures during pregnancy. In France, toxoplasmosis serological screening requires systematic testing for IgM and IgG antibodies. The Platelia Toxo IgG and IgM test (Bio-Rad) is one of the most widely used tests for anti-toxoplasmic antibody detection. We performed a study on 384 sera, including 123 IgG negative (<6 IU/mL) and 261 IgG equivocal (6–9 IU/mL) sera tested with Platelia Toxo IgG and collected during routine screening at Pitié-Salpêtrière Hospital, Paris, France to determine the best-performing IgG titer cut-off value. Out of these 383 sera, 298 were IgM negative by Platelia Toxo IgM and 86 were IgM positive. All sera were also tested against Toxo IgG II LD BIO western blot test as confirmation. Our results indicated that an IgG titer cut-off value of ≥4.4 IU/mL for the Platelia Toxo IgG met the definition of positivity, a value significantly lower than that indicated by the manufacturers. In the presence of IgM antibodies, the IgG titer cut-off decreased significantly to a value ≥0.2 IU/mL. This latter cut-off also allowed adequate diagnosis of proven toxoplasmosis seroconversion in 76.7% of cases (33/43). Our findings may improve toxoplasmosis care by reducing therapeutic intervention time and eliminating the need for further serological monitoring. PMID:26187780

  5. Diagnostic performance of two mental status tests in the older chinese: influence of education and age on cut-off values.

    PubMed

    Sahadevan, S; Lim, P P; Tan, N J; Chan, S P

    2000-03-01

    To (1) establish the clinical usefulness of the 10-item Abbreviated Mental Test (AMT) and the 18-item Chinese Mini-Mental Status Examination (CMMSE) for detecting cognitive impairment associated with dementia in the elderly Chinese; (2) determine how the tests' optimal cut-off scores varied with the patients' educational level and age; and (3) evaluate which was the more accurate test. 151 cognitively-healthy, community dwelling elderly Chinese subjects and 95 elderly Chinese outpatients with dementia were administered the AMT and CMMSE. Receiver-Operating Characteristic (ROC) analysis was used to determine the tests' optimal cut-off scores for each of the education-by-age subgroups and their areas-under-the-curve were compared non-parametrically to evaluate which test was more accurate. Both the AMT and CMMSE could identify cognitive impairment accurately, but higher cut-off values were necessary for the younger and more educated cohort, while lower values were adequate for the older and less educated subgroup. The AMT appeared to reach a ceiling effect in the more educated categories. The diagnostic accuracies of the two instruments were statistically equivalent; there was a trend, however, for the CMMSE to be performing better in the more educated subgroups. To maximise the diagnostic efficiency of these two clinically useful mental status tests, it is important to adjust their cut-off scores for the patients' education and age. Though no clear superiority of either instrument was established in this study, we recommend the AMT for patients with 0-6 years of education, whereas for those with greater levels of literacy, we think it better to administer the CMMSE.

  6. Establishing a cut-off for the serum levels of specific IgE to milk and its components for cow's milk allergy: results from a specific population.

    PubMed

    Castro, A P; Pastorino, A C; Gushken, A K F; Kokron, C M; Filho, U D; Jacob, C M A

    2015-01-01

    Cow's milk allergy diagnosis many times requires double-blind placebo-controlled food challenge (DBPCFC), which presents high accuracy but involves risks, specifically in infants and anaphylactic patients. The identification of the cut-off values for specific IgE to milk or its components would contribute to cow's milk allergy (CMA) diagnosis. The aim of this study was to compare discriminating concentration of a cow's milk specific IgE and its fractions (α-lactoalbumin, β-lactoglobulin, casein) in children for the CMA diagnosis. this study included 123 patients (M:F=1.3:1) median age at diagnosis=1.91 years, (3.5m to 13.21y) with CMA diagnosis via DBPCFC (n=26), proven anaphylaxis due to cow's milk (n=46) or a suggestive clinical history associated with a positive skin prick test (n=51) and open oral food challenge. The control group included 61 patients (1 male:1.1 female) ages ranging from 0.66 to 16.7 years (median=6.83 years). Receiver operator characteristics (ROC) curves were constructed to determine the best cut-offs that guarantees high specificity (>95%) for cow's milk and its components. considering 98% specificity, cut-off points were: 3.06 kU/L for cow's milk, 2.06 kU/L for α-lactalbumin, 1.85 kU/L for β-lactoglobulin and 1.47kU/L for casein. The best ROC curve (area under the curve=0.929) was obtained evaluating cow's milk. this study showed that the cut-off point detected for whole cow's milk revealed a better discriminatory capacity for CMA diagnosis without the necessity of the milk components testing. Copyright © 2013 SEICAP. Published by Elsevier Espana. All rights reserved.

  7. Cut-off points for mild, moderate, and severe pain on the visual analogue scale for pain in patients with chronic musculoskeletal pain.

    PubMed

    Boonstra, Anne M; Schiphorst Preuper, Henrica R; Balk, Gerlof A; Stewart, Roy E

    2014-12-01

    The aim of this study was to find the cut-off points on the visual analogue scale (VAS) to distinguish among mild, moderate, and severe pain, in relation to the following: pain-related interference with functioning; verbal description of the VAS scores; and latent class analysis for patients with chronic musculoskeletal pain. A total of 456 patients were included. Pain was assessed using the VAS and verbal rating scale; functioning was assessed using the domains of the Short Form (36) Health Survey (SF-36). Eight cut-off point schemes were tested using multivariate analysis of variance (MANOVA), ordinal logistic regression, and latent class analysis. The study results showed that VAS scores ⩽ 3.4 corresponded to mild interference with functioning, whereas 3.5 to 6.4 implied moderate interference, and ⩾ 6.5 implied severe interference. VAS scores ⩽ 3.4 were best described for patients with chronic musculoskeletal pain as mild pain, 3.5 to 7.4 as moderate pain, and ⩾ 7.5 as severe pain. Latent class analysis found that a 3-class solution fitted best, resulting in the classes 0.1 to 3.8, 3.9 to 5.7, and 5.8 to 10 cm. Findings from our study agree with those of some other studies, although many other studies found different optimal cut-off point schemes. As there appear to be no universally accepted cut-off points, and in view of the low-to-moderate associations between VAS scores and functioning and between VAS and verbal rating scale scores, the correct classification of VAS scores as mild, moderate. or severe in clinical practice seems doubtful.

  8. Should the cut-off value of D-dimer be elevated to exclude pulmonary embolism in acute exacerbation of COPD?

    PubMed Central

    Akpinar, Evrim Eylem; Hoşgün, Derya; Doğanay, Beyza; Ataç, Gökçe Kaan; Gülhan, Meral

    2013-01-01

    Objective The aim of this study was to evaluate the D-dimer levels in patients with chronic obstructive pulmonary disease (COPD) exacerbation with and without pulmonary embolism (PE) and to attempt to define a new cut-off value for D-dimer to exclude the diagnosis of PE in patients with COPD exacerbation. Methods This cross-sectional study was performed between the June 2012 and January 2013. The COPD patients who were admitted to the emergency department with acute exacerbation were consecutively included. D-dimer levels were measured upon admission. All patients underwent computed tomography angiography (CTA) and Doppler ultrasonography (US) of the lower extremities. Results A total of 148 patients were enrolled. Fifty-three patients (36%) who did not have PE had higher than normal (>0.5 pg/mL) D-dimer levels. The D-dimer levels of the COPD patients with PE were significantly higher than those of the patients without PE (2.38±2.80 vs. 1.06±1.51 pg/mL) (P<0.001). The cut-off value for D-dimer in diagnosing PE in the COPD patients was 0.95 pg/mL. The area under the receiver operating characteristic (ROC) curve was 0.752±0.040 (95% CI: 0.672-0.831) (P<0.001). Conclusions This study showed that the D-dimer concentrations of COPD patients who are in the exacerbation period may be higher than normal, even without PE. The cut-off level for D-dimer was 0.95 pg/mL (sensitivity 70%, spesificity 71%) for the exclusion of PE in the patients with COPD exacerbation. The D-dimer cut-off value that is used to exclude PE in patients with acute exacerbation of COPD should be reevaluated to prevent the excessive use of further diagnostic procedures. PMID:23991298

  9. Cerebrospinal fluid neopterin analysis in neuropediatric patients: establishment of a new cut off-value for the identification of inflammatory-immune mediated processes.

    PubMed

    Molero-Luis, Marta; Fernández-Ureña, Sergio; Jordán, Iolanda; Serrano, Mercedes; Ormazábal, Aida; Garcia-Cazorla, Àngels; Artuch, Rafael

    2013-01-01

    A high level of cerebrospinal fluid (CSF) neopterin is a marker of central nervous system inflammatory-immune mediated processes. We aimed to assess data from 606 neuropediatric patients, describing the clinical and biochemical features of those neurological disorders presenting CSF neopterin values above a new cut-off value that was defined in our laboratory. To establish the new CSF neopterin cut-off value, we studied two groups of patients: Group 1 comprised 68 patients with meningoencephalitis, and Group 2 comprised 52 children with a confirmed peripheral infection and no central nervous system involvement. We studied 606 CSF samples from neuropediatric patients who were classified into 3 groups: genetic diagnosis (A), acquired/unknown etiologic neurologic diseases (B) and inflammatory-immune mediated processes (C). The CSF neopterin cut-off value was 61 nmol/L. Out of 606 cases, 56 presented a CSF neopterin level above this value. Group C had significantly higher CSF neopterin, protein and leukocyte values than the other groups. Sixteen of twenty-three patients in this group had a CSF neopterin level above the cut-off, whereas three and seven patients presented increased leukocyte and protein values, respectively. A significant association was found among CSF neopterin, proteins and leukocytes in the 606 patients. White matter disturbances were associated with high CSF neopterin concentrations. Although children with inflammatory-immune mediated processes presented higher CSF neopterin values, patients with other neurological disorders also showed increased CSF neopterin concentrations. These results stress the importance of CSF neopterin analysis for the identification of inflammatory-immune mediated processes.

  10. Cut-off values of serum IgE (total and A. fumigatus -specific) and eosinophil count in differentiating allergic bronchopulmonary aspergillosis from asthma.

    PubMed

    Agarwal, Ritesh; Aggarwal, Ashutosh N; Garg, Mandeep; Saikia, Biman; Chakrabarti, Arunaloke

    2014-11-01

    The cut-off values of immunological tests employed in diagnosis of allergic bronchopulmonary aspergillosis (ABPA) have never been validated. Herein, we compare the immunological findings in patients with ABPA and asthma using receiver operating characteristic analysis. Consecutive asthmatic subjects underwent all the following investigations: Aspergillus skin test, IgE levels (total and A. fumigatus-specific), Aspergillus precipitins, eosinophil count, chest radiograph and CT chest. There were 372 subjects (179 men, mean age 35.9 years) with a mean asthma duration of 8 years. ABPA was diagnosed in 76 patients (64 bronchiectasis, 12 without bronchiectasis). ABPA was separated from asthma using the best cut-off values of total IgE, A. fumigatus IgE and total eosinophil count of 2347 IU ml(-1) , 1.91 kUA l(-1) and 507 cells per μl respectively. The sensitivity/specificity of these parameters were 87/81%; 99/87%; and, 79/76% respectively. The corresponding AUC values were 0.95, 0.90 and 0.82 respectively. The combination of these three tests at the aforementioned cut-offs provided 100% specificity. Our study provides evidence-based cut-off values of IgE (total and A. fumigatus-specific) and eosinophil counts in differentiating ABPA from asthma. As this is a single centre retrospective study, further studies from different centres are required, as these values could vary by ethnicity and environmental exposure. © 2014 Blackwell Verlag GmbH.

  11. Positivity rates and performances of immunochemical faecal occult blood tests at different cut-off levels within a colorectal cancer screening programme.

    PubMed

    Faivre, Jean; Dancourt, Vincent; Manfredi, Sylvain; Denis, Bernard; Durand, Gérard; Gendre, Isabelle; Bidan, Jeanne Marie; Jard, Christine; Levillain, Romuald; Jung, Sylvie; Viguier, Jérôme; Dorval, Etienne

    2012-08-01

    Immunochemical faecal occult blood tests have greater sensitivity for colorectal cancer screening than guaiac-based tests; however the number of positive tests required is still under discussion. A direct comparison of Hemoccult II with two immunochemical quantitative tests (OC-Sensor and FOB-Gold) using a 2-sample strategy was performed in over 30,000 patients undergoing colorectal cancer screening in France. Positivity ratio between immunochemical tests and Hemoccult II varied between 2.2 (OC-Sensor) and 2.4 (FOB-Gold) for the lowest cut-off value and 1.5-1.4 for the highest cut-off value. The positive predictive value for colorectal cancer was similar for immunochemical tests and Hemoccult II, and significantly higher for immunochemical tests for advanced adenomas. The detection rate of both colorectal cancer and advanced adenomas was higher with immunochemical tests than with Hemoccult II. With the 2-sample strategy and the lowest cut-off value the detection rate of colorectal cancer almost doubled and for advanced adenomas quadrupled. For colorectal cancer screening with immunochemical faecal occult blood tests, an acceptable strategy would be 2-day sampling with at least one positive test at a cut-off between 150 and 200 ng/mL (OC-Sensor) and 176 and 234 ng/mL (FOB-Gold). Data on the ease of test interpretation and cost-effectiveness now necessary to make definitive choices. Copyright © 2012 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  12. High-titre circulating tissue transglutaminase-2 antibodies predict small bowel villous atrophy, but decision cut-off limits must be locally validated.

    PubMed

    Beltran, L; Koenig, M; Egner, W; Howard, M; Butt, A; Austin, M R; Patel, D; Sanderson, R R; Goubet, S; Saleh, F; Lavender, J; Stainer, E; Tarzi, M D

    2014-05-01

    Numerous studies suggest that high levels of circulating immunoglobulin (Ig)A tissue transglutaminase (TTG2) antibodies predict coeliac disease with high specificity. Accordingly, it has been suggested that duodenal biopsy may not be required routinely for diagnostic confirmation where quantitative serology identifies the presence of high antibody titres. However, defining a cut-off TTG2 threshold is problematic, as the multiple available assay methods are not harmonized and most studies have been focused on the paediatric population. Recent paediatric guidelines proposed a TTG2 antibody diagnostic cut-off at 10 × the upper limit of normal (ULN) for the method; however, concerns remain about errors of generalization, between both methods and laboratories. In this study, we used retrospective laboratory data to investigate the relationship between TTG2 antibody levels and Marsh 3 histology in the seropositive population of adults and children at a single centre. Among 202 seropositive patients with corresponding biopsies, it was possible to define a TTG2 antibody cut-off with 100% specificity for Marsh 3 histology, at just over 10 × ULN for the method. However, UK National External Quality Assurance Scheme returns during the study period showed a wide dispersion of results and poor consensus, both between methods and between laboratories using the same method. Our results support the view that high-titre TTG2 antibody levels have strong predictive value for villous atrophy in adults and children, but suggest that decision cut-offs to guide biopsy requirement will require local validation. TTG2 antibody assay harmonization is a priority, in order to meet the evolving requirements of laboratory users in this field. © 2013 British Society for Immunology.

  13. High-titre circulating tissue transglutaminase-2 antibodies predict small bowel villous atrophy, but decision cut-off limits must be locally validated

    PubMed Central

    Beltran, L; Koenig, M; Egner, W; Howard, M; Butt, A; Austin, M R; Patel, D; Sanderson, R R; Goubet, S; Saleh, F; Lavender, J; Stainer, E; Tarzi, M D

    2014-01-01

    Numerous studies suggest that high levels of circulating immunoglobulin (Ig)A tissue transglutaminase (TTG2) antibodies predict coeliac disease with high specificity. Accordingly, it has been suggested that duodenal biopsy may not be required routinely for diagnostic confirmation where quantitative serology identifies the presence of high antibody titres. However, defining a cut-off TTG2 threshold is problematic, as the multiple available assay methods are not harmonized and most studies have been focused on the paediatric population. Recent paediatric guidelines proposed a TTG2 antibody diagnostic cut-off at 10 × the upper limit of normal (ULN) for the method; however, concerns remain about errors of generalization, between both methods and laboratories. In this study, we used retrospective laboratory data to investigate the relationship between TTG2 antibody levels and Marsh 3 histology in the seropositive population of adults and children at a single centre. Among 202 seropositive patients with corresponding biopsies, it was possible to define a TTG2 antibody cut-off with 100% specificity for Marsh 3 histology, at just over 10 × ULN for the method. However, UK National External Quality Assurance Scheme returns during the study period showed a wide dispersion of results and poor consensus, both between methods and between laboratories using the same method. Our results support the view that high-titre TTG2 antibody levels have strong predictive value for villous atrophy in adults and children, but suggest that decision cut-offs to guide biopsy requirement will require local validation. TTG2 antibody assay harmonization is a priority, in order to meet the evolving requirements of laboratory users in this field. PMID:24325651

  14. Is the BMI cut-off level for Japanese females for obesity set too high? A consideration from a body composition perspective.

    PubMed

    Kagawa, Masaharu; Uenishi, Kazuhiro; Kuroiwa, Chiharu; Mori, Miki; Binns, Colin W

    2006-01-01

    The aim of the study was to determine the sensitivity and specificity of the BMI cut-off points that have been applied in the National Nutritional Survey in Japan (NNS-J) for young Japanese females. The relationship between the body mass index (BMI) and percentage body fat (%BF) of 139 young Japanese females (aged 18-27 years old) was examined using dual energy x-ray absorptiometry (DXA) and anthropometry. The sensitivity and specificity of the BMI cut-off point that has been in use in Japan was compared with the cut-off point proposed for Asia-Pacific population (the WPRO classification). The regression equation calculated for the relationship between the BMI and %BF using the DXA scan data was %BF = -15.152+2.058*BMI; R2 = 0.612, SEE = 3.66. From this equation the BMI value that corresponded with %BF of 30% was calculated to be 21.9kg/m2 (95%CI: 16.9-28.6). From the sensitivity and specificity analysis, it was found that more than 90% of Japanese females with %BF >30% were misclassified as "not obese" when the BMI value of 25kg/m2 was used to identify obese individuals. The misclassification reduced to 60% when the BMI value of 23kg/m2 was used as a cut-off point. The results indicate that the current classification used in the NNS-J may not precisely reflect the obesity status of young Japanese females and a considerable proportion of females with a large fat deposition would be misclassified as not obese. The current study shows the importance of including detailed body composition assessments to determine obesity level of individuals.

  15. Survival functions for defining a clinical management Lost To Follow-Up (LTFU) cut-off in Antiretroviral Therapy (ART) program in Zomba, Malawi.

    PubMed

    Rachlis, Beth; Cole, Donald C; van Lettow, Monique; Escobar, Michael

    2016-05-05

    While, lost to follow-up (LTFU) from antiretroviral therapy (ART) can be considered a catch-all category for patients who miss scheduled visits or medication pick-ups, operational definitions and methods for defining LTFU vary making comparisons across programs challenging. Using weekly cut-offs, we sought to determine the probability that an individual would return to clinic given that they had not yet returned in order to identify the LTFU cut-off that could be used to inform clinical management and tracing procedures. Individuals who initiated ART with Dignitas International supported sites (n = 22) in Zomba, Malawi between January 1 2007-June 30 2010 and were ≥ 1 week late for a follow-up visit were included. Lateness was categorized using weekly cut-offs from ≥1 to ≥26 weeks late. At each weekly cut-off, the proportion of patients who returned for a subsequent follow-up visit were identified. Cumulative Distribution Functions (CDFs) were plotted to determine the probability of returning as a function of lateness. Hazard functions were plotted to demonstrate the proportion of patients who returned each weekly interval relative to those who had yet to return. In total, n = 4484 patients with n = 7316 follow-up visits were included. The number of included follow-up visits per patient ranged from 1-10 (median: 1). Both the CDF and hazard function demonstrated that after being ≥9 weeks late, the proportion of new patients who returned relative to those who had yet to return decreased substantially. We identified a LTFU definition useful for clinical management. The simple functions plotted here did not require advanced statistical expertise and were created using Microsoft Excel, making it a particularly practical method for HIV programs in resource-constrained settings.

  16. Optimal Elasticity cut-off value for discriminating Healthy to Pathological Fibrotic patients employing Fuzzy C-Means automatic segmentation in Liver Shear Wave Elastography images

    NASA Astrophysics Data System (ADS)

    Gatos, Ilias; Tsantis, Stavros; Skouroliakou, Aikaterini; Theotokas, Ioannis; Zoumpoulis, Pavlos S.; Kagadis, George C.

    2015-09-01

    The aim of the present study is to determine an optimal elasticity cut-off value for discriminating Healthy from Pathological fibrotic patients by means of Fuzzy C-Means automatic segmentation and maximum participation cluster mean value employment in Shear Wave Elastography (SWE) images. The clinical dataset comprised 32 subjects (16 Healthy and 16 histological or Fibroscan verified Chronic Liver Disease). An experienced Radiologist performed SWE measurement placing a region of interest (ROI) on each subject's right liver lobe providing a SWE image for each patient. Subsequently Fuzzy C-Means clustering was performed on every SWE image utilizing 5 clusters. Mean Stiffness value and pixels number of each cluster were calculated. The mean stiffness value feature of the cluster with maximum pixels number was then fed as input for ROC analysis. The selected Mean Stiffness value feature an Area Under the Curve (AUC) of 0.8633 with Optimum Cut-off value of 7.5 kPa with sensitivity and specificity values of 0.8438 and 0.875 and balanced accuracy of 0.8594. Examiner's classification measurements exhibited sensitivity, specificity and balanced accuracy value of 0.8125 with 7.1 kPa cutoff value. A new promising automatic algorithm was implemented with more objective criteria of defining optimum elasticity cut-off values for discriminating fibrosis stages for SWE. More subjects are needed in order to define if this algorithm is an objective tool to outperform manual ROI selection.

  17. Optimal cut-off value for the number of colorectal liver metastases: a project study for hepatic surgery of the Japanese Society of Hepato-Biliary-Pancreatic Surgery.

    PubMed

    Beppu, Toru; Sakamoto, Yoshihiro; Hasegawa, Kiyoshi; Honda, Goro; Tanaka, Kuniya; Kotera, Yoshihito; Nitta, Hiroyuki; Yoshidome, Hiroyuki; Hatano, Etsuro; Ueno, Masaki; Takamura, Hiroyuki; Baba, Hideo; Kosuge, Tomoo; Kokudo, Norihiro; Takahashi, Keiichi; Endo, Itaru; Wakabayashi, Go; Miyazaki, Masaru; Uemoto, Shinji; Ohta, Tetsuo; Kikuchi, Ken; Takayama, Tadatoshi; Yamaue, Hiroki; Yamamoto, Masakazu; Takada, Tadahiro

    2014-03-01

    The optimal cut-off value of the number of colorectal liver metastases (CRLM) to predict prognosis after hepatic resection remains unclear. This study was conducted to determine a suitable cut-off value. A total of 727 hepatectomized patients with CRLM were evaluated. We proposed the following optimal cut-off values: first, a small P-value for the log-rank test with no overlapping of the 95% confidence interval (CI) for median survival time using the Kaplan-Meier method and the hazard ratio (HR) using the Cox proportional hazards model and, second, the maximum HR value for accurate separation. For disease-free survival analysis, of the three group separations, A2 (1, 2-4, and ≥5) showed a small P-value and the largest HR, whereas two group separations, B2, B3 and B4 showed similarly small P-values, but B4 (1-4, ≥5) indicated the largest HR. Regarding the overall survival analysis, of the three group separations, A2 showed the smallest P-value, whereas the two group separations, B4 showed similarly small P-values, with the largest HR. Tumor number separation in patients with CRLM after hepatic resection should be performed using the A2 (1, 2-4, and ≥5) or B4 (1-4 and ≥5) classifications. © 2013 Japanese Society of Hepato-Biliary-Pancreatic Surgery.

  18. Return to Work: A Cut-Off of FIM Gain with Montebello Rehabilitation Factor Score in Order to Identify Predictive Factors in Subjects with Acquired Brain Injury.

    PubMed

    Franceschini, Marco; Massimiani, Maria Pia; Paravati, Stefano; Agosti, Maurizio

    2016-01-01

    Return to work (RTW) for people with acquired brain injury (ABI) represents a main objective of rehabilitation: this work presents a strong correlation between personal well-being and quality of life. The aim of this study is to investigate the prognostic factors that can predict RTW after ABI (traumatic or non- traumatic aetiology) in patients without disorders of consciousness (e.g. coma, vegetative or minimally conscious state) at the beginning of their admission to rehabilitation. At the end of a 6-month follow-up after discharge, data were successfully collected in 69 patients. The rehabilitation effectiveness (functional Recovery) between admission and discharge was assessed by Functional Independent Measure (FIM) gain, through the Montebello Rehabilitation Factor Score (MRFS), which was obtained as follows: (discharge FIM-admission FIM)/(Maximum possible FIM-Admission FIM) x 100. The cut-off value (criterion) deriving from MRFS, which helped identify RTW patients, resulted in .659 (sn 88.9%; sp 52.4%). Considering the Mini Mental State Examination (MMSE) and the MRFS data, the multivariable binary logistic regression analysis presented 62.96% of correct RTW classification cases, 80.95% of non-RTW leading to an overall satisfactory predictability of 73.91%. The results of the present study suggest that occupational therapy intervention could modify cut-off in patients with an MFRS close to target at the end of an in-hospital rehabilitative program thus developing their capabilities and consequently surpassing cut-off itself.

  19. Methods for identifying the cost-effective case definition cut-off for sequential monitoring tests: an extension of Phelps and Mushlin.

    PubMed

    Longo, Roberta; Baxter, Paul; Hall, Peter; Hewison, Jenny; Afshar, Mehran; Hall, Geoff; McCabe, Christopher

    2014-04-01

    The arrival of personalized medicine in the clinic means that treatment decisions will increasingly rely on test results. The challenge of limited healthcare resources means that the dissemination of these technologies will be dependent on their value in relation to their cost, i.e., their cost effectiveness. Phelps and Mushlin have described how to optimize tests to meet a cost-effectiveness target. However, when tests are applied repeatedly the case mix of the patients tested changes with each administration, and this impacts upon the value of each subsequent test administration. In this article, we present a modification of Phelps and Mushlin's framework for diagnostic tests; to identify the cost-effective cut-off for monitoring tests. Using the Ca125 test monitoring for relapse in ovarian cancer, we show how the repeated use of the initial cut-off can lead to a substantially increased false-negative rate compared with the monitoring cut-off-over 4% higher than in this example-with the associated harms for individual and population health.

  20. Return to Work: A Cut-Off of FIM Gain with Montebello Rehabilitation Factor Score in Order to Identify Predictive Factors in Subjects with Acquired Brain Injury

    PubMed Central

    2016-01-01

    Return to work (RTW) for people with acquired brain injury (ABI) represents a main objective of rehabilitation: this work presents a strong correlation between personal well-being and quality of life. The aim of this study is to investigate the prognostic factors that can predict RTW after ABI (traumatic or non- traumatic aetiology) in patients without disorders of consciousness (e.g. coma, vegetative or minimally conscious state) at the beginning of their admission to rehabilitation. At the end of a 6-month follow-up after discharge, data were successfully collected in 69 patients. The rehabilitation effectiveness (functional Recovery) between admission and discharge was assessed by Functional Independent Measure (FIM) gain, through the Montebello Rehabilitation Factor Score (MRFS), which was obtained as follows: (discharge FIM—admission FIM)/(Maximum possible FIM—Admission FIM) x 100. The cut-off value (criterion) deriving from MRFS, which helped identify RTW patients, resulted in .659 (sn 88.9%; sp 52.4%). Considering the Mini Mental State Examination (MMSE) and the MRFS data, the multivariable binary logistic regression analysis presented 62.96% of correct RTW classification cases, 80.95% of non-RTW leading to an overall satisfactory predictability of 73.91%. The results of the present study suggest that occupational therapy intervention could modify cut-off in patients with an MFRS close to target at the end of an in-hospital rehabilitative program thus developing their capabilities and consequently surpassing cut-off itself. PMID:27780215

  1. Effect of Accelerometer Cut-Off Points on the Recommended Level of Physical Activity for Obesity Prevention in Children

    PubMed Central

    Dygrýn, Jan; Mitáš, Josef; Jakubec, Lukáš; Frömel, Karel

    2016-01-01

    There is no general consensus regarding which accelerometer cut-off point (CoP) is most acceptable to estimate the time spent in moderate-to-vigorous physical activity (MVPA) in children and choice of an appropriate CoP primarily remains a subjective decision. Therefore, this study aimed to analyze the influence of CoP selection on the mean MVPA and to define the optimal thresholds of MVPA derived from different accelerometer CoPs to avoid overweight/obesity and adiposity in children aged 7 to 12 years. Three hundred six children participated. Physical activity (PA) was monitored for seven consecutive days using an ActiGraph accelerometer (model GT3X) and the intensity of PA was estimated using the five most frequently published CoPs. Body adiposity was assessed using a multi-frequency bioelectrical impedance analysis. There was found a wide range of mean levels of MVPA that ranged from 27 (Puyau CoP) to 231 min∙d–1 (Freedson 2005 CoP). A receiver operating characteristic curve analysis indicated that the optimal thresholds for counts per minute (cpm) and MVPA derived from the Puyau CoP was the most useful in classifying children according to their body mass index (BMI) and fat mass percentage (FM%). In the total sample, the optimal thresholds of the MVPA derived from the Puyau CoP were 22 and 23 min∙d–1 when the categories based on BMI and FM%, respectively, were used. The children who did not meet these optimal thresholds had a significantly increased risk of being overweight/obese (OR = 2.88, P < 0.01) and risk of having excess fat mass (OR = 2.41, P < 0.01). In conclusion, the decision of selecting among various CoPs significantly influences the optimal levels of MVPA. The Puyau CoP of 3 200 cmp seems to be the most useful for defining the optimal level of PA for pediatric obesity prevention. PMID:27723835

  2. Medium Cut-Off (MCO) Membranes Reduce Inflammation in Chronic Dialysis Patients—A Randomized Controlled Clinical Trial

    PubMed Central

    Zickler, Daniel; Schindler, Ralf; Willy, Kevin; Martus, Peter; Pawlak, Michael; Storr, Markus; Hulko, Michael; Boehler, Torsten; Glomb, Marcus A.; Liehr, Kristin; Henning, Christian; Templin, Markus; Trojanowicz, Bogusz; Ulrich, Christof; Werner, Kristin; Fiedler, Roman; Girndt, Matthias

    2017-01-01

    Background To increase the removal of middle-sized uremic toxins a new membrane with enhanced permeability and selectivity, called Medium Cut-Off membrane (MCO-Ci) has been developed that at the same time ensures the retention of albumin. Because many middle-sized substances may contribute to micro-inflammation we hypothesized that the use of MCO-Ci influences the inflammatory state in hemodialysis patients. Methods The randomized crossover trial in 48 patients compared MCO-Ci dialysis to High-flux dialysis of 4 weeks duration each plus 8 weeks extension phase. Primary endpoint was the gene expression of TNF-α and IL-6 in peripheral blood mononuclear cells (PBMCs), secondary endpoints were plasma levels of specified inflammatory mediators and cytokines. Results After four weeks of MCO-Ci the expression of TNF-α mRNA (Relative quantification (RQ) from 0.92 ± 0.34 to 0.75 ± 0.31, -18.5%, p<0.001)-α and IL-6 mRNA (RQ from 0.78 ± 0.80 to 0.60 ± 0.43, -23.1%, p<0.01) was reduced to a significantly greater extent than with High-flux dialyzers (TNF mRNA-RQ: -14.3%; IL-6 mRNA-RQ: -3.5%). After retransformation of logarithmically transformed data, measurements after MCO were reduced to 82% of those after HF (95% CI 74%–91%). 4 weeks use of MCO-Ci resulted in long-lasting change in plasma levels of several cytokines and other substances with a significant decrease for sTNFR1, kappa and lambda free light chains, urea and an increase for Lp-PLA2 (PLA2G7) compared to High-flux. Albumin levels dropped significantly after 4 weeks of MCO dialysis but increased after additional 8 weeks of MCO dialysis. Twelve weeks treatment with MCO-Ci was well tolerated regarding the number of (S)AEs. In the extension period levels of CRP, TNF-α-mRNA and IL-6 mRNA remained stable in High-flux as well as in MCO-Ci. Conclusions MCO-Ci dialyzers modulate inflammation in chronic HD patients to a greater extent compared to High-flux dialyzers. Transcription of pro-inflammatory cytokines in

  3. Endogenous gamma-hydroxybutyric acid (GHB) concentrations in post-mortem specimens and further recommendation for interpretative cut-offs.

    PubMed

    Andresen-Streichert, Hilke; Jensen, P; Kietzerow, J; Schrot, M; Wilke, N; Vettorazzi, E; Mueller, A; Iwersen-Bergmann, S

    2015-01-01

    When interpreting gamma-hydroxybutyric acid (GHB) concentrations in post-mortem specimens, a possible increase in GHB concentrations because of post-mortem generation must be considered. In this study, endogenous GHB concentrations in post-mortem biological fluids were investigated. Additionally, we review post-mortem GHB concentrations already published in the literature. Heart and peripheral blood samples, cerebrospinal fluid, urine, and vitreous humor were collected from 64 autopsies in subjects where the cause of death excluded GHB exposure. Sample analysis was carried out either on the day of autopsy or later after immediate freezing and storage at -20 °C. GHB concentrations in venous blood samples (n = 61) were <0.6-28.7 mg/L (mean 11.9 mg/L; median 10.6 mg/L), <0.6-65.3 mg/L (mean 15.2 mg/L; median 12.8 mg/L) in heart blood (n = 56), <0.6-25.1 mg/L (mean 6.0 mg/L; median 3.8 mg/L) in urine (n = 50), <0.6-39.0 mg/L (mean 9.6 mg/L; median 7.5 mg/L), in vitreous humor (n = 54), and <0.6-24.0 mg/L (mean 4.2 mg/L; median 3.2 mg/L) in cerebrospinal fluid (n = 52). There was no significant difference between GHB concentrations in cases where there were signs of beginning putrefaction at the time of autopsy (n = 9) and cases without obvious signs of putrefaction. In one case with advanced putrefaction, the GHB concentration in venous blood was 32.7 mg/L. In conclusion, for post-mortem venous blood, urine, and cerebrospinal fluid, an interpretative cut-off of 30 mg/L for GHB concentrations is suggested in cases where GHB analysis is conducted on the day of sample collection at autopsy or if samples have been stored at -20 °C immediately after collection.

  4. Further performance evaluation of 5.3 μm cut-off Hawaii-2RG detectors

    NASA Astrophysics Data System (ADS)

    Ives, Derek; Beckmann, Udo; Alvarez, Domingo; Finger, Gert; Geimer, Christoph; Heininger, Matthias; Mehrgan, Leander; Tulloch, Simon

    2016-07-01

    ESO has now delivered or tested in-house, four new 5.3 μm cut-off H2RG detectors, for various projects, such as MATISSE for the VLTI and the upgrade project for CRIRES, the cryogenic high-resolution infrared echelle spectrograph for the VLT. The specified instruments have required the implementation of some of the more unusual read out options for these detectors, which may have already been used by other groups, for example, the line-reset-read and line-read-reset modes rather than the standard global reset mode. The detectors are also offered with both output speed options, that is, the standard slow, low noise readout and the faster, higher noise readout, where > 10 frames/s are possible. In the process of building these detector systems and implementing these new options we have delved deeper into some of the lesser known features of these detectors and tried to characterize them more fully. It is important that these characteristics are well understood before delivery of the next generation of detectors for the ELTs where high speed and windowing options are required. We obtain very good performance at 2 Mpixel/s pixel speeds with less than 40 e- rms read noise, in all other aspects such as linearity, noise versus number of non-destructive reads and cross talk then the performance of the outputs is the same as slow speed operation. However, the high speed output stages are quite complex to operate, they need to be very well tuned and are prone to oscillation, if not set correctly. We will report on the best bias options to optimize their performance. Some stability issues are also seen with the slow outputs and this is also reported. Likewise we have observed differences between global reset and line reset for the detectors, manifested in a significant increase in detector full well for the line reset option, this also will be reported on. We have also determined that there may be signal induced by the detector readout clocking process for certain detector

  5. Prevalence of body mass index and body weight cut-off points for in vitro fertilization treatment at U.S. clinics and current clinic weight loss strategy recommendations.

    PubMed

    Turner-McGrievy, Gabrielle M; Grant, Breănna L

    2015-09-01

    The goal of this study was to determine how many clinics providing in vitro fertilization (IVF) in the United States require a body mass index (BMI) or body weight cut-off point to determine treatment eligibility. US clinics listed as members on the Society of Assisted Reproduction website in late 2013 were contacted by phone between January and March 2014. Clinic personnel were asked if a BMI or body weight cut-off points was used to determine IVF treatment eligibility and what strategies they recommended for their patients to achieve a healthy body weight. Of the 379 clinics contacted, 347 responded (92% response rate) and 35% (n = 120) reported using a BMI or body weight cut-off points to determine eligibility for IVF treatment. Mean BMI (± SD) cut-off points was 38.4 ± 5.2 kg/m(2) and mean body weight (± SD) cut-off points was 130.2 ± 14.8 kg. Of the clinics using a set cut-off points, half (46%) provided no weight loss recommendations for patients. A sizable portion of US IVF clinics report a required or preferred BMI or body weight cut-off points for treatment. Despite this, most clinics did not provide a recommended program or approach for weight loss with very few clinics reporting an in-house program.

  6. Effects of various sample pretreatment procedures on ethyl glucuronide quantification in hair samples: Comparison of positivity rates and appraisal of cut-off values.

    PubMed

    Salomone, A; Baumgartner, M R; Lombardo, T; Alladio, E; Di Corcia, D; Vincenti, M

    2016-10-01

    The quantification of ethylglucuronide (EtG) in hair is nowadays recognized as the approach with the highest diagnostic performance to evaluate harmful drinking. A widely accepted cut-off of 30pg/mg has been selected after several accurate compared studies. While most of the studies that were used to establish the appropriate cut-off value prescribed to cut hair into small segments before their extraction, hair milling has subsequently been identified as the most efficient pretreatment procedure and was therefore recommended in the last Consensus document issued by the Society of Hair Testing. In this study, we initially compared the results obtained with the two sample preparations, namely cutting and milling, both being applied to the same specimens (n=781). Among these, 205 samples produced measurable EtG values with both methods, with differences ranging from -41.7% up to +415% (the mean increase in EtG concentration, switching from cutting to milling, was +62.1% and the median was +42.3%). Among the aforementioned 205 samples, 29 specimens (3.7% of the total 781 samples) produced significantly different outcome, being classified as negative (i.e., below 30pg/mg) if the cutting procedure is used, but largely positive (above 40pg/mg) when milling is used. Subsequently, the positivity rates obtained on a large population dataset (>27,000 samples) with the two procedures, were retrospectively compared using variable cut-offs values. The percentage of head hair samples with EtG concentration exceeding 30pg/mg upon application of the milling procedure shows a 45% increase (from 10.9% to 15.8%) with respect to cutting procedure, whereas the fraction of hair samples with EtG exceeding 40pg/mg (10.5%) overlaps the percentage of positive samples obtained after cutting pretreatment and applying a cut-off of 30pg/mg. On the basis of these results, it would be worth considering the application of cut-off values linked with the pretreatment procedure, taking into account

  7. Prognostic impact of proliferation for resected early stage 'pure' invasive lobular breast cancer: Cut-off analysis of Ki67 according to histology and clinical validation.

    PubMed

    Carbognin, Luisa; Sperduti, Isabella; Fabi, Alessandra; Dieci, Maria Vittoria; Kadrija, Dzenete; Griguolo, Gaia; Pilotto, Sara; Guarneri, Valentina; Zampiva, Ilaria; Brunelli, Matteo; Orvieto, Enrico; Nortilli, Rolando; Fiorio, Elena; Parolin, Veronica; Manfrin, Erminia; Caliò, Anna; Nisticò, Cecilia; Pellini, Francesca; Scarpa, Aldo; Pollini, Giovanni Paolo; Conte, Pierfranco; Tortora, Giampaolo; Bria, Emilio

    2017-10-01

    The intent of this analysis was to investigate and validate the prognostic potential of Ki67 in a multi-center series of patients affected by early stage 'pure' invasive lobular carcinoma (ILC). Clinical-pathological data of patients affected by ILC were correlated with overall survival and disease-free survival (OS/DFS); data from a parallel invasive ductal carcinoma (IDC) patients' cohort were gathered as well. The maximally selected Log-Rank statistics analysis was applied to Ki67 continuous variable to estimate the appropriate cut-off. The Subpopulation Treatment Effect Pattern Plot (STEPP) analysis was performed as well. Data from overall 1097 (457/222 ILC: training/validation set; 418 IDC) patients were gathered. The identified optimal Ki67 cut-offs were 4% and 14% for DFS in ILC and IDC cohort, respectively. In ILC patients, the Ki67 cut-off was an independent OS predictor. Ten-years OS and DFS were 89.9% and 77.2% (p = 0.007) and 79.4% and 69.2% (p = 0.03) for patients with Ki67 ≤ 4% and >4%, respectively. In IDC patients, 10-years OS was 93.8% and 71.7%, p = 0.02, DFS was 84.0% and 52.6%, p = 0.0003, for patients with Ki67 ≤ 14% and >14%, respectively. In the validation set, the optimal Ki67 OS cut-off was 5%. The STEPP analysis showed that in the presence of low Ki67 values, IDC patients have a better DFS than ILC patients, while with the increase of values the prognosis tends to overlap. Despite the retrospective design of the study, the prognostic relevance of Ki67 (as well as its optimal cut-off) seems to significantly differ according to breast cancer histology. Copyright © 2017 Elsevier Ltd. All rights reserved.

  8. Optimal cut-off of obesity indices to predict cardiovascular disease risk factors and metabolic syndrome among adults in Northeast China.

    PubMed

    Yu, Jianxing; Tao, Yuchun; Tao, Yuhui; Yang, Sen; Yu, Yaqin; Li, Bo; Jin, Lina

    2016-10-13

    CVD risk factors (hypertension, dyslipidemia and diabetes) and MetS are closely related to obesity. The selection of an optimal cut-off for various obesity indices is particularly important to predict CVD risk factors and MetS. Sixteen thousand seven hundred sixty-six participants aged 18-79 were recruited in Jilin Province in 2012. Five obesity indices, including BMI, WC, WHR, WHtR and BAI were investigated. ROC analyses were used to evaluate the predictive ability and determine the optimal cut-off values of the obesity indices for CVD risk factors and MetS. BMI had the highest adjusted ORs, and the adjusted ORs for hypertension, dyslipidemia, diabetes and MetS were 1.19 (95 % CI, 1.17 to 1.20), 1.20 (95 % CI, 1.19 to 1.22), 1.12 (95 % CI, 1.10 to 1.13), and 1.40 (95 % CI, 1.38 to 1.41), respectively. However, BMI did not always have the largest adjusted AUROC. In general, the young age group (18 ~ 44) had higher ORs and AUROCs for CVD risk factors and MetS than those of the other age groups. In addition, the optimal cut-off values for WC and WHR in males were relatively higher than those in females, whereas the BAI in males was comparatively lower than that in females. The appropriate obesity index, with the corresponding optimal cut-off values, should be selected in different research studies and populations. Generally, the obesity indices and their optimal cut-off values are: BMI (24 kg/m(2)), WC (male: 85 cm; female: 80 cm), WHR (male: 0.88; female: 0.85), WHtR (0.50), and BAI (male: 25 cm; female: 30 cm). Moreover, WC is superior to other obesity indices in predicting CVD risk factors and MetS in males, whereas, WHtR is superior to other obesity indices in predicting CVD risk factors and MetS in females.

  9. Fatty acid ethyl esters in hair as alcohol markers: estimating a reliable cut-off point by evaluation of 1,057 autopsy cases.

    PubMed

    Hastedt, Martin; Bossers, Lydia; Krumbiegel, Franziska; Herre, Sieglinde; Hartwig, Sven

    2013-06-01

    Alcohol abuse is a widespread problem, especially in Western countries. Therefore, it is important to have markers of alcohol consumption with validated cut-off points. For many years research has focused on analysis of hair for alcohol markers, but data on the performance and reliability of cut-off values are still lacking. Evaluating 1,057 cases from 2005 to 2011, included a large sample group for the estimation of an applicable cut-off value when compared to earlier studies on fatty acid ethyl esters (FAEEs) in hair. The FAEEs concentrations in hair, police investigation reports, medical history, and the macroscopic and microscopic alcohol-typical results from autopsy, such as liver, pancreas, and cardiac findings, were taken into account in this study. In 80.2 % of all 1,057 cases pathologic findings that may be related to alcohol abuse were reported. The cases were divided into social drinkers (n = 168), alcohol abusers (n = 502), and cases without information on alcohol use. The median FAEEs concentration in the group of social drinkers was 0.302 ng/mg (range 0.008-14.3 ng/mg). In the group of alcohol abusers a median of 1.346 ng/mg (range 0.010-83.7 ng/mg) was found. Before June 2009 the hair FAEEs test was routinely applied to a proximal hair segment of 0-6 cm, changing to a routinely investigated hair length of 3 cm after 2009, as proposed by the Society of Hair Testing (SoHT). The method showed significant differences between the groups of social drinkers and alcoholics, leading to an improvement in the postmortem detection of alcohol abuse. Nevertheless, the performance of the method was rather poor, with an area under the curve calculated from receiver operating characteristic (ROC curve AUC) of 0.745. The optimum cut-off value for differentiation between social and chronic excessive drinking calculated for hair FAEEs was 1.08 ng/mg, with a sensitivity of 56 % and a specificity of 80 %. In relation to the "Consensus on Alcohol Markers 2012

  10. Validation of two age dependent D-dimer cut-off values for exclusion of deep vein thrombosis in suspected elderly patients in primary care: retrospective, cross sectional, diagnostic analysis

    PubMed Central

    Koek, H L (Dineke); Oudega, Ruud; Geersing, Geert-Jan; Janssen, Kristel J M; van Delden, Johannes J M; Moons, Karel G M

    2012-01-01

    Objective To determine whether the use of age adapted D-dimer cut-off values can be translated to primary care patients who are suspected of deep vein thrombosis. Design Retrospective, cross sectional diagnostic study. Setting 110 primary care doctors affiliated with three hospitals in the Netherlands. Participants 1374 consecutive patients (936 (68.1%) aged >50 years) with clinically suspected deep vein thrombosis. Main outcome measures Proportion of patients with D-dimer values below two proposed age adapted cut-off levels (age in years×10 μg/L in patients aged >50 years, or 750 μg/L in patients aged ≥60 years), in whom deep vein thrombosis could be excluded; and the number of false negative results. Results Using the Wells score, 647 patients had an unlikely clinical probability of deep vein thrombosis. In these patients (at all ages), deep vein thrombosis could be excluded in 309 (47.8%) using the age dependent cut-off value compared with 272 (42.0%) using the conventional cut-off value of 500 μg/L (increase 5.7%, 95% confidence interval 4.1% to 7.8%). This exclusion rate resulted in 0.5% and 0.3% false negative cases, respectively (increase 0.2%, 0.004% to 8.6%).The increase in exclusion rate by using the age dependent cut-off value was highest in the oldest patients. In patients older than 80 years, deep vein thrombosis could be safely excluded in 22 (35.5%) patients using the age dependent cut-off value compared with 13 (21.0%) using the conventional cut-off value (increase 14.5%, 6.8% to 25.8%). Compared with the age dependent cut-off value, the cut-off value of 750 μg/L had a similar exclusion rate (307 (47.4%) patients) and false negative rate (0.3%). Conclusions Combined with a low clinical probability of deep vein thrombosis, use of the age dependent D-dimer cut-off value for patients older than 50 years or the cut-off value of 750 μg/L for patients aged 60 years and older resulted in a considerable increase in the proportion of patients in

  11. Abdominal rigidity

    MedlinePlus

    Rigidity of the abdomen ... is a sore area inside the belly or abdomen, the pain will get worse when a hand ... Causes can include: Abscess inside the abdomen Appendicitis ... small intestine, large bowel, or gallbladder ( gastrointestinal ...

  12. Usefulness of the CAPE-P15 for detecting people at ultra-high risk for psychosis: Psychometric properties and cut-off values.

    PubMed

    Bukenaite, Akvile; Stochl, Jan; Mossaheb, Nilufar; Schäfer, Miriam R; Klier, Claudia M; Becker, Jana; Schloegelhofer, Monika; Papageorgiou, Konstantinos; Montejo, Angel L; Russo, Debra A; Jones, Peter B; Perez, Jesus; Amminger, G Paul

    2017-02-26

    A need for a brief, easy to complete self-report questionnaire to detect people at ultra-high risk for psychosis (UHR) in busy clinical settings has been recognised. Our aim was to explore whether the Community Assessment of Psychic Experiences - Positive 15-items Scale (CAPE-P15) could be used as a screening tool to identify people at UHR in a clinical setting. Our objectives were to confirm the CAPE-P15 factorial structure as well as its reliability and determine cut-off values for the detection of such individuals using the Comprehensive Assessment of At-Risk Mental States (CAARMS), a commonly used clinical interview for the detection of UHR. 165 participants aged between 13 and 18 referred to the General Hospital of Vienna were included in the analysis. 50.9% of the sample were "CAARMS-positive" and 49.1% "CAARMS-negative". The Youden method determined CAPE-P15 cut-off values for UHR detection of 1.47 for both frequency of and distress associated with psychotic experiences. The cut-off value of 1.47 for frequency showed sensitivity of 77%, specificity of 58%, a positive predictive value of 66% and a negative predictive value of 71%; whilst for distress it showed sensitivity of 73%, specificity of 63%, a positive predictive value of 69% and a negative predictive value of 66%. Good reliability and the previously suggested three-correlated factor model as well as an alternative bi-factor model of the CAPE-P15 were confirmed. The CAPE-P15 seems to be a promising screening tool for identifying people who might be at UHR in busy clinical settings.

  13. Insulin resistance (HOMA-IR) cut-off values and the metabolic syndrome in a general adult population: effect of gender and age: EPIRCE cross-sectional study

    PubMed Central

    2013-01-01

    Background Insulin resistance has been associated with metabolic and hemodynamic alterations and higher cardio metabolic risk. There is great variability in the threshold homeostasis model assessment of insulin resistance (HOMA-IR) levels to define insulin resistance. The purpose of this study was to describe the influence of age and gender in the estimation of HOMA-IR optimal cut-off values to identify subjects with higher cardio metabolic risk in a general adult population. Methods It included 2459 adults (range 20–92 years, 58.4% women) in a random Spanish population sample. As an accurate indicator of cardio metabolic risk, Metabolic Syndrome (MetS), both by International Diabetes Federation criteria and by Adult Treatment Panel III criteria, were used. The effect of age was analyzed in individuals with and without diabetes mellitus separately. ROC regression methodology was used to evaluate the effect of age on HOMA-IR performance in classifying cardio metabolic risk. Results In Spanish population the threshold value of HOMA-IR drops from 3.46 using 90th percentile criteria to 2.05 taking into account of MetS components. In non-diabetic women, but no in men, we found a significant non-linear effect of age on the accuracy of HOMA-IR. In non-diabetic men, the cut-off values were 1.85. All values are between 70th-75th percentiles of HOMA-IR levels in adult Spanish population. Conclusions The consideration of the cardio metabolic risk to establish the cut-off points of HOMA-IR, to define insulin resistance instead of using a percentile of the population distribution, would increase its clinical utility in identifying those patients in whom the presence of multiple metabolic risk factors imparts an increased metabolic and cardiovascular risk. The threshold levels must be modified by age in non-diabetic women. PMID:24131857

  14. Using a 3% Proton Density Fat Fraction as a Cut-Off Value Increases Sensitivity of Detection of Hepatic Steatosis, Based on Results From Histopathology Analysis.

    PubMed

    Nasr, Patrik; Forsgren, Mikael F; Ignatova, Simone; Dahlström, Nils; Cedersund, Gunnar; Leinhard, Olof Dahlqvist; Norén, Bengt; Ekstedt, Mattias; Lundberg, Peter; Kechagias, Stergios

    2017-07-01

    It is possible to estimate hepatic triglyceride content by calculating the proton density fat fraction (PDFF), using proton magnetic resonance spectroscopy ((1)H-MRS), instead of collecting and analyzing liver biopsy specimens to detect steatosis. However, the current PDFF cut-off value (5%) used to define steatosis by magnetic resonance was derived from studies that did not use histopathology as the reference standard. We performed a prospective study to determine the accuracy of (1)H-MRS PDFF in the measurement of steatosis using histopathology analysis as the standard. We collected clinical, serologic, (1)H-MRS PDFF, and liver biopsy data from 94 adult patients with increased levels of liver enzymes (≥6 mo) referred to the Department of Gastroenterology and Hepatology at Linköping University Hospital in Sweden from 2007 through 2014. Steatosis was graded using the conventional histopathology method and fat content was quantified in biopsy samples using stereologic point counts (SPCs). We correlated the (1)H-MRS PDFF findings with SPCs (r = 0.92; P < .001). (1)H-MRS PDFF results correlated with histopathology results (ρ = 0.87; P < .001), and SPCs correlated with histopathology results (ρ = 0.88; P < .001). All 25 subjects with PDFF values of 5.0% or more had steatosis based on histopathology findings (100% specificity for PDFF). However, of 69 subjects with PDFF values less than 5.0% (negative result), 22 were determined to have steatosis based on histopathology findings (53% sensitivity for PDFF). Reducing the PDFF cut-off value to 3.0% identified patients with steatosis with 100% specificity and 79% sensitivity; a PDFF cut-off value of 2.0% identified patients with steatosis with 94% specificity and 87% sensitivity. These findings might be used to improve noninvasive detection of steatosis. Copyright © 2017 AGA Institute. Published by Elsevier Inc. All rights reserved.

  15. Diagnostic Accuracy of Transient Elastography for Detecting Liver Fibrosis After Liver Trannsplantation: A Specific Cut-Off Value Is Really Needed?

    PubMed

    Della-Guardia, B; Evangelista, A S; Felga, G E; Marins, L V; Salvalaggio, P R; Almeida, M D

    2017-01-01

    Liver transplant recipients often perform liver biopsy (LB), specially in the context of potentially recurring diseases, such as hepatitis C infection. However, the LB has risks of complications, despite being the gold standard. Transient elastography (TE) is a noninvasive method comparable to the LB to evaluate liver fibrosis in various settings, but its accuracy among transplant recipients is not fully understood. To determine the accuracy of TE in liver transplant recipients compared with LB to successfully predict liver fibrosis. Patients who underwent liver transplantation at Hospital Israelita Albert Einstein from 2010 to 2012 and presented with LB indication were also subjected to TE at the time of LB. The medium value of ten successful measurements was kept as a representative of the liver stiffness. The definition of cut-off points was made to ensure specificity of ≥90 % for all fibrosis stages (F0-F4). LB was performed in 267 patients. TE was not analyzed in only 8 (3 %) due to an elevated body mass index. The optimal liver stiffness cut-off value and diagnostic performance were 8.1 kPa for F ≥ 1, 12.3 kPa for F ≥ 2, 15.1 for F ≥ 3, and 16.7 for F = 4 for all patients and were 8.1 kPa for F ≥ 1, 12.3 kPa for F ≥ 2, 16.5 for F ≥ 3, and 17.6 for F = 4 for patients with hepatitis C. TE demonstrated good performance in defining cut-off points for fibrosis on liver histology observed in transplant recipients. The TE can be considered an alternative to LB in post-liver transplantation.

  16. The Use of Innovative Two-Component Cluster Analysis and Serodiagnostic Cut-Off Methods to Estimate Prevalence of Pertussis Reinfections

    PubMed Central

    van Twillert, Inonge; Bonačić Marinović, Axel A.; van Gaans-van den Brink, Jacqueline A. M.; Kuipers, Betsy; Berbers, Guy A. M.; van der Maas, Nicoline A. T.; Verheij, Theo J. M.; Versteegh, Florens G. A.; Teunis, Peter F. M.; van Els, Cécile A. C. M.

    2016-01-01

    Bordetella pertussis circulates even in highly vaccinated countries affecting all age groups. Insight into the scale of concealed reinfections is important as they may contribute to transmission. We therefore investigated whether current single-point serodiagnostic methods are suitable to estimate the prevalence of pertussis reinfection. Two methods based on IgG-Ptx plasma levels alone were used to evaluate the proportion of renewed seroconversions in the past year in a cohort of retrospective pertussis cases ≥ 24 months after a proven earlier symptomatic infection. A Dutch population database was used as a baseline. Applying a classical 62.5 IU/ml IgG-Ptx cut-off, we calculated a seroprevalence of 15% in retrospective cases, higher than the 10% observed in the population baseline. However, this method could not discriminate between renewed seroconversion and waning of previously infection-enhanced IgG-Ptx levels. Two-component cluster analysis of the IgG-Ptx datasets of both pertussis cases and the general population revealed a continuum of intermediate IgG-Ptx levels, preventing the establishment of a positive population and the comparison of prevalence by this alternative method. Next, we investigated the complementary serodiagnostic value of IgA-Ptx levels. When modelling datasets including both convalescent and retrospective cases we obtained new cut-offs for both IgG-Ptx and IgA-Ptx that were optimized to evaluate renewed seroconversions in the ex-cases target population. Combining these cut-offs two-dimensionally, we calculated 8.0% reinfections in retrospective cases, being below the baseline seroprevalence. Our study for the first time revealed the shortcomings of using only IgG-Ptx data in conventional serodiagnostic methods to determine pertussis reinfections. Improved results can be obtained with two-dimensional serodiagnostic profiling. The proportion of reinfections thus established suggests a relatively increased period of protection to renewed

  17. The Use of Innovative Two-Component Cluster Analysis and Serodiagnostic Cut-Off Methods to Estimate Prevalence of Pertussis Reinfections.

    PubMed

    van Twillert, Inonge; Bonačić Marinović, Axel A; van Gaans-van den Brink, Jacqueline A M; Kuipers, Betsy; Berbers, Guy A M; van der Maas, Nicoline A T; Verheij, Theo J M; Versteegh, Florens G A; Teunis, Peter F M; van Els, Cécile A C M

    2016-01-01

    Bordetella pertussis circulates even in highly vaccinated countries affecting all age groups. Insight into the scale of concealed reinfections is important as they may contribute to transmission. We therefore investigated whether current single-point serodiagnostic methods are suitable to estimate the prevalence of pertussis reinfection. Two methods based on IgG-Ptx plasma levels alone were used to evaluate the proportion of renewed seroconversions in the past year in a cohort of retrospective pertussis cases ≥ 24 months after a proven earlier symptomatic infection. A Dutch population database was used as a baseline. Applying a classical 62.5 IU/ml IgG-Ptx cut-off, we calculated a seroprevalence of 15% in retrospective cases, higher than the 10% observed in the population baseline. However, this method could not discriminate between renewed seroconversion and waning of previously infection-enhanced IgG-Ptx levels. Two-component cluster analysis of the IgG-Ptx datasets of both pertussis cases and the general population revealed a continuum of intermediate IgG-Ptx levels, preventing the establishment of a positive population and the comparison of prevalence by this alternative method. Next, we investigated the complementary serodiagnostic value of IgA-Ptx levels. When modelling datasets including both convalescent and retrospective cases we obtained new cut-offs for both IgG-Ptx and IgA-Ptx that were optimized to evaluate renewed seroconversions in the ex-cases target population. Combining these cut-offs two-dimensionally, we calculated 8.0% reinfections in retrospective cases, being below the baseline seroprevalence. Our study for the first time revealed the shortcomings of using only IgG-Ptx data in conventional serodiagnostic methods to determine pertussis reinfections. Improved results can be obtained with two-dimensional serodiagnostic profiling. The proportion of reinfections thus established suggests a relatively increased period of protection to renewed

  18. Cut-off points of the visceral adiposity index (VAI) identifying a visceral adipose dysfunction associated with cardiometabolic risk in a Caucasian Sicilian population.

    PubMed

    Amato, Marco C; Giordano, Carla; Pitrone, Maria; Galluzzo, Aldo

    2011-10-19

    The Visceral Adiposity Index (VAI) is a sex-specific mathematical index, based on Waist Circumference (WC), Body Mass Index (BMI), triglycerides (TG) and HDL cholesterol (HDL) levels, indirectly expressing visceral adipose function and insulin sensitivity. Our aim was to find the optimal cut-off points of VAI identifying a visceral adipose dysfunction (VAD) associated with cardiometabolic risk in a Caucasian Sicilian population. Medical check-up data of 1,764 Primary Care patients (PC patients) were retrospectively and cross-sectionally examined using a receiver-operating characteristic (ROC) curve to determine appropriate stratified-for-age cut-off of VAI, for the identification of PC patients with Metabolic Syndrome (MetS) according to the NCEP-ATP III criteria. The PC patients with higher VAI scores were subdivided into three groups according to VAI tertiles (i.e. PC patients with mild VAD, moderate VAD or severe VAD). Finally, VAD classes were compared to classical cardio- and cerebrovascular risk factors as independent predictors of coronary heart disease and/or myocardial infarction, transient ischemic attack and/or ischemic stroke. Moderate and severe VADs proved to be independently associated with cardiovascular events [(OR: 5.35; 95% CI: 1.92-14.87; p = 0.001) and (OR: 7.46; 95% CI: 2.64-21.05; p < 0.001) respectively]. Mild, moderate and severe VADs were found to be independently associated with cerebrovascular events [(OR: 2.73; 95% CI: 1.12-6.65; p = 0.027), (OR: 4.20; 95% CI: 1.86-9.45; p = 0.001) and (OR: 5.10; 95% CI: 2.14-12.17; p < 0.001) respectively]. Our study suggests that among Caucasian Sicilian subjects there are clear cut-off points of VAI able to identify a VAD strongly associated with cardiometabolic risk.

  19. Optimal Cut-Off Points on the Health Anxiety Inventory, Illness Attitude Scales and Whiteley Index to Identify Severe Health Anxiety

    PubMed Central

    Hedman, Erik; Lekander, Mats; Ljótsson, Brjánn; Lindefors, Nils; Rück, Christian; Andersson, Gerhard; Andersson, Erik

    2015-01-01

    Background Health anxiety can be viewed as a dimensional phenomenon where severe health anxiety in form of DSM-IV hypochondriasis represents a cut-off where the health anxiety becomes clinically significant. Three of the most reliable and used self-report measures of health anxiety are the Health Anxiety Inventory (HAI), the Illness Attitude Scales (IAS) and the Whiteley Index (WI). Identifying the optimal cut-offs for classification of presence of a diagnosis of severe health anxiety on these measures has several advantages in clinical and research settings. The aim of this study was therefore to investigate the HAI, IAS and WI as proximal diagnostic instruments for severe health anxiety defined as DSM-IV hypochondriasis. Methods We investigated sensitivity, specificity and predictive value on the HAI, IAS and WI using a total of 347 adult participants of whom 158 had a diagnosis of severe health anxiety, 97 had obsessive-compulsive disorder and 92 were healthy non-clinical controls. Diagnostic assessments were conducted using the Anxiety Disorder Interview Schedule. Results Optimal cut-offs for identifying a diagnosis of severe health anxiety was 67 on the HAI, 47 on the IAS, and 5 on the WI. Sensitivity and specificity were high, ranging from 92.6 to 99.4%. Positive and negative predictive values ranged from 91.6 to 99.4% using unadjusted prevalence rates. Conclusions The HAI, IAS and WI have very good properties as diagnostic indicators of severe health anxiety and can be used as cost-efficient proximal estimates of the diagnosis. PMID:25849477

  20. Energy-averaged electron-ion momentum transport cross section in the Born approximation and Debye-Hückel potential: Comparison with the cut-off theory

    NASA Astrophysics Data System (ADS)

    Zaghloul, Mofreh R.; Bourham, Mohamed A.; Doster, J. Michael

    2000-04-01

    An exact analytical expression for the energy-averaged electron-ion momentum transport cross section in the Born approximation and Debye-Hückel exponentially screened potential has been derived and compared with the formulae given by other authors. A quantitative comparison between cut-off theory and quantum mechanical perturbation theory has been presented. Based on results from the Born approximation and Spitzer's formula, a new approximate formula for the quantum Coulomb logarithm has been derived and shown to be more accurate than previous expressions.

  1. Energy-averaged electron-ion momentum transport cross section in the Born Approximation and Debye-Hückel potential: Comparison with the cut-off theory

    NASA Astrophysics Data System (ADS)

    Zaghloul, Mofreh R.; Bourham, Mohamed A.; Doster, J. Michael

    2000-02-01

    An exact analytical expression for the energy-averaged electron-ion momentum transport cross section in the Born approximation and Debye-Hückel exponentially screened potential has been derived and compared with the formulae given by other authors. A quantitative comparison between cut-off theory and quantum mechanical perturbation theory has been presented. Based on results from the Born approximation and Spitzer's formula, a new approximate formula for the quantum Coulomb logarithm has been derived and shown to be more accurate than previous expressions.

  2. Investigation and reduction of sub-microgram peptide loss using molecular weight cut-off fractionation prior to mass spectrometric analysis

    PubMed Central

    Cunningham, Robert; Wang, Jingxin; Wellner, Daniel; Li, Lingjun

    2013-01-01

    This work investigates the suitability of molecular weight cut-off membrane-based centrifugal filter devices (MWCO) for sub-microgram peptide enrichment passing through the membrane by introduction of methanol and a salt modifier. Using a neuropeptide standard, bradykinin, a reduction in sample loss of over two orders of magnitude is demonstrated with and without undigested protein present. Additionally, a bovine serum albumin (BSA) tryptic digestion was investigated and 27 tryptic peptides were identified using MALDI mass spectrometry whereas only two BSA tryptic peptides were identified after MWCO separation using H2O. The protocol presented here enhances recovery from MWCO separation for sub-μg peptide samples. PMID:23019164

  3. A preliminary evaluation of the occurrence and characteristics of cut-off ponds of the Maryland shores of the Chesapeake Bay

    SciTech Connect

    Not Available

    1980-10-01

    Under the auspices of the Maryland Power Plant Siting Program, a preliminary investigation of occurrence and characteristics of cut-off ponds in the Maryland portion of the Chesapeake Bay was conducted. These small ponds occur commonly along the Bay shore. A sand berm separates the freshwaters of the ponds from the saline waters of the Bay; this berm is occasionally breached permitting interchange between ponds and Bay. A survey of aerial maps and photographs has revealed approximately 1800 ponds bordering the mid and upper Bay.

  4. Optimal Body Mass Index Cut-offs for Identification of Patients with Coronary Artery Disease at High Risk of Obstructive Sleep Apnoea.

    PubMed

    Chan, Po-Fun; Tai, Bee-Choo; Loo, Germaine; Koo, Chieh-Yang; Ong, Thun-How; Yeo, Tiong-Cheng; Lee, Chi-Hang

    2016-08-01

    We sought to evaluate the relationship between Body Mass Index (BMI) and obstructive sleep apnoea (OSA) in Chinese patients hospitalised with coronary artery disease, and to determine the optimal BMI cut-off for prediction of OSA. Consecutive Chinese patients who were hospitalised with symptomatic coronary artery disease were recruited to undergo an in-hospital sleep study. A total of 587 patients were recruited. Using cut-off for Asians, 81.2% of the cohort was overweight (BMI ≥23kg/m(2)) and 31.6% was obese (≥27kg/m(2)). A total of 59.5% was diagnosed with OSA, defined as apnoea-hypopnoea index ≥15. Body mass index, hypertension and smoking were predictors of OSA. Multiple logistic regression analysis showed that BMI remains an independent predictor of OSA (odds ratio: 1.11 [95% confidence interval: 1.06 to 1.17], p<0.001) after adjusting for smoking and hypertension. Further analysis using BMI and Apnoea-Hypopnoea Index (AHI) as continuous variables showed significant correlation between BMI and AHI (Pearson's r =0.25, P<0.001). In adjusted models, optimal BMI cut-offs to screen for OSA were 27.3kg/m(2), 23.0-23.9kg/m(2), and 20kg/m(2) for patients with neither, either, or both predictors (smoking and hypertension) respectively. The area under the curve for the adjusted and unadjusted models were similar (0.6013 vs 0.6262, p=0.118). Body mass index represents a convenient and readily available tool for bedside identification of patients at high risk of OSA. Body mass index cut-offs to predict risks of OSA in Chinese patients with symptomatic coronary artery disease are defined in this study. Copyright © 2016 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier B.V. All rights reserved.

  5. Optimal cut-off points of fasting plasma glucose for two-step strategy in estimating prevalence and screening undiagnosed diabetes and pre-diabetes in Harbin, China.

    PubMed

    Bao, Chundan; Zhang, Dianfeng; Sun, Bo; Lan, Li; Cui, Wenxiu; Xu, Guohua; Sui, Conglan; Wang, Yibaina; Zhao, Yashuang; Wang, Jian; Li, Hongyuan

    2015-01-01

    To identify optimal cut-off points of fasting plasma glucose (FPG) for two-step strategy in screening abnormal glucose metabolism and estimating prevalence in general Chinese population. A population-based cross-sectional study was conducted on 7913 people aged 20 to 74 years in Harbin. Diabetes and pre-diabetes were determined by fasting and 2 hour post-load glucose from the oral glucose tolerance test in all participants. Screening potential of FPG, cost per case identified by two-step strategy, and optimal FPG cut-off points were described. The prevalence of diabetes was 12.7%, of which 65.2% was undiagnosed. Twelve percent or 9.0% of participants were diagnosed with pre-diabetes using 2003 ADA criteria or 1999 WHO criteria, respectively. The optimal FPG cut-off points for two-step strategy were 5.6 mmol/l for previously undiagnosed diabetes (area under the receiver-operating characteristic curve of FPG 0.93; sensitivity 82.0%; cost per case identified by two-step strategy ¥261), 5.3 mmol/l for both diabetes and pre-diabetes or pre-diabetes alone using 2003 ADA criteria (0.89 or 0.85; 72.4% or 62.9%; ¥110 or ¥258), 5.0 mmol/l for pre-diabetes using 1999 WHO criteria (0.78; 66.8%; ¥399), and 4.9 mmol/l for IGT alone (0.74; 62.2%; ¥502). Using the two-step strategy, the underestimates of prevalence reduced to nearly 38% for pre-diabetes or 18.7% for undiagnosed diabetes, respectively. Approximately a quarter of the general population in Harbin was in hyperglycemic condition. Using optimal FPG cut-off points for two-step strategy in Chinese population may be more effective and less costly for reducing the missed diagnosis of hyperglycemic condition.

  6. Geomagnetic cutoffs: a review for space dosimetry applications.

    PubMed

    Smart, D F; Shea, M A

    1994-10-01

    The earth's magnetic field acts as a shield against charged particle radiation from interplanetary space, technically described as the geomagnetic cutoff. The cutoff rigidity problem (except for the dipole special case) has "no solution in closed form". The dipole case yields the Stormer equation which has been repeatedly applied to the earth in hopes of providing useful approximations of cutoff rigidities. Unfortunately the earth's magnetic field has significant deviations from dipole geometry, and the Stormer cutoffs are not adequate for most applications. By application of massive digital computer power it is possible to determine realistic geomagnetic cutoffs derived from high order simulation of the geomagnetic field. Using this technique, "world-grids" of directional cutoffs for the earth's surface and for a limited number of satellite altitudes have been derived. However, this approach is so expensive and time consuming it is impractical for most spacecraft orbits, and approximations must be used. The world grids of cutoff rigidities are extensively used as lookup tables, normalization points and interpolation aids to estimate the effective geomagnetic cutoff rigidity of a specific location in space. We review the various options for estimating the cutoff rigidity for earth-orbiting satellites.

  7. Italians do it worse. Montreal Cognitive Assessment (MoCA) optimal cut-off scores for people with probable Alzheimer's disease and with probable cognitive impairment.

    PubMed

    Bosco, Andrea; Spano, Giuseppina; Caffò, Alessandro O; Lopez, Antonella; Grattagliano, Ignazio; Saracino, Giuseppe; Pinto, Katia; Hoogeveen, Frans; Lancioni, Giulio E

    2017-02-02

    Montreal cognitive assessment (MoCA) is a test providing a brief screening for people with cognitive impairment due to aging or neurodegenerative syndromes. In Italy, as in the rest of the world, several validation studies of MoCA have been carried out. This study compared, for the first time in Italy, a sample of people with probable Alzheimer's Disease (AD) with healthy counterparts. The study also compared two community-dwelling groups of aged participants with and without probable cognitive impairment, as discriminated by two cut-off points of adjusted MMSE score. All the comparisons were carried out according to ROC statistics. Optimal cutoff for a diagnosis of probable AD was a MoCA score ≤14. Optimal cutoff for the discrimination of probable cognitive impairment was a MoCA score ≤17 (associated to MMSE cutoff of 23.8). Results confirm the substantial discrepancy in cut-off points existing between Italian and other international validation studies, showing that Italian performance on MoCA seems to be globally lower than that in other Countries. Characteristics of population might explain these results.

  8. Age-stratified cut-off points for the nocturnal penile tumescence measurement using Nocturnal Electrobioimpedance Volumetric Assessment (NEVA(®) ) in sexually active healthy men.

    PubMed

    Tok, A; Eminaga, O; Burghaus, L; Herden, J; Akbarov, I; Engelmann, U; Wille, S

    2016-08-01

    The current nocturnal penile tumescence (NPT) measurement is based on standard cut-off levels defined regardless of age. This study was conducted to provide age-stratified cut-off points for NPT measurement. Forty sexually active healthy men between 20 and 60 years old were enrolled and divided equally into four groups defined by age (20-29, 30-39, 40-49 and 50-60 years.). None of the candidates had sexual dysfunction or sleep disturbance or used supportive medication to enhance sexual function. Erectile function was evaluated by using the 5-item version of the international index of erectile function (IIEF-5). NPT was observed using the nocturnal electrobioimpedance volumetric assessment (NEVA(®) ). The NPT values of healthy men aged 20-60 years varied from 268.7% to 202.3%. The NPT differed significantly between age groups (P < 0.0009); however, no significant differences between men aged 30-39 and 40-49 (P = 0.593) were observed. Age was weakly associated with IIEF-5 scores (P = 0.004), whereas a strong and negative correlation between age and NPT (P < 0.0001) was found. IEF-5 scores were not significantly associated with NPT (P = 0.95). Therefore, the standard values for NPT testing should be considered in the evaluation of the nocturnal penile activity of men of all ages. © 2015 Blackwell Verlag GmbH.

  9. Triceps and Subscapular Skinfold Thickness Percentiles and Cut-Offs for Overweight and Obesity in a Population-Based Sample of Schoolchildren and Adolescents in Bogota, Colombia.

    PubMed

    Ramírez-Vélez, Robinson; López-Cifuentes, Mario Ferney; Correa-Bautista, Jorge Enrique; González-Ruíz, Katherine; González-Jiménez, Emilio; Córdoba-Rodríguez, Diana Paola; Vivas, Andrés; Triana-Reina, Hector Reynaldo; Schmidt-RioValle, Jacqueline

    2016-09-24

    The assessment of skinfold thickness is an objective measure of adiposity. The aims of this study were to establish Colombian smoothed centile charts and LMS L (Box-Cox transformation), M (median), and S (coefficient of variation) tables for triceps, subscapular, and triceps + subscapular skinfolds; appropriate cut-offs were selected using receiver operating characteristic (ROC) analysis based on a population-based sample of children and adolescents in Bogotá, Colombia. A cross-sectional study was conducted in 9618 children and adolescents (55.7% girls; age range of 9-17.9 years). Triceps and subscapular skinfold measurements were obtained using standardized methods. We calculated the triceps + subscapular skinfold (T + SS) sum. Smoothed percentile curves for triceps and subscapular skinfold thickness were derived using the LMS method. ROC curve analyses were used to evaluate the optimal cut-off point of skinfold thickness for overweight and obesity, based on the International Obesity Task Force definitions. Subscapular and triceps skinfolds and T + SS were significantly higher in girls than in boys (p < 0.001). The ROC analysis showed that subscapular and triceps skinfolds and T + SS have a high discriminatory power in the identification of overweight and obesity in the sample population in this study. Our results provide sex- and age-specific normative reference standards for skinfold thickness values from a population from Bogotá, Colombia.

  10. Soro West: A non-seismically defined, fault cut-off prospect in the Papuan Fold and Thrust Belt, Papua New Guinea

    SciTech Connect

    Robinson, W.F.; Swift, C.M. Jr.

    1996-12-31

    Soro West is a fault cut-off prospect located in the frontal portion of the Papuan Fold and Thrust Belt. Prospective Toro and Imburu sandstones are interpreted to be in the hanging wall of the Soro Thrust. Truncation against the thrust, both updip and through lateral ramps, provides the trapping mechanism. The Soro West Prospect was defined using geological, geochemical, remote sensing, and geophysical data. The definition and location of the trap is a primary risk and work was focused on this aspect. Surface geological data (lithology, strikes, and dips) topography and synthetic aperture radar imagery were incorporated into the evaluation. Statistical curvature analysis techniques helped define the shape of the structure and the locations of the lateral ramps. Strontium isotope analyses of Darai Limestone surface samples refined erosional levels using a locally-derived reference curve. Severe karst precludes the acquisition of coherent surface seismic data, so the primary geophysical tool used was magnetotellurics (MT). A detailed, pre-survey feasibility study defined expected responses from alternative structural models. The MT data demonstrated that the limestone at surface is underlain by thick conductive clastics and not another Darai Limestone sheet. The data also constrained the range of fault cut-off positions significantly. Multiple, three-dimensionally consistent, restorable alternative structural models were created using results from all analyses. These led to a positive assessment of the prospect and an exploratory test is to be drilled in 1996.

  11. Increased impedance near cut-off in plasma-like media leading to emission of high-power, narrow-bandwidth radiation

    PubMed Central

    Hur, M. S.; Ersfeld, B.; Noble, A.; Suk, H.; Jaroszynski, D. A.

    2017-01-01

    Ultra-intense, narrow-bandwidth, electromagnetic pulses have become important tools for exploring the characteristics of matter. Modern tuneable high-power light sources, such as free-electron lasers and vacuum tubes, rely on bunching of relativistic or near-relativistic electrons in vacuum. Here we present a fundamentally different method for producing narrow-bandwidth radiation from a broad spectral bandwidth current source, which takes advantage of the inflated radiation impedance close to cut-off in a medium with a plasma-like permittivity. We find that by embedding a current source in this cut-off region, more than an order of magnitude enhancement of the radiation intensity is obtained compared with emission directly into free space. The method suggests a simple and general way to flexibly use broadband current sources to produce broad or narrow bandwidth pulses. As an example, we demonstrate, using particle-in-cell simulations, enhanced monochromatic emission of terahertz radiation using a two-colour pumped current source enclosed by a tapered waveguide. PMID:28071681

  12. Understanding capacity fade in silicon based electrodes for lithium-ion batteries using three electrode cells and upper cut-off voltage studies

    NASA Astrophysics Data System (ADS)

    Beattie, Shane D.; Loveridge, M. J.; Lain, Michael J.; Ferrari, Stefania; Polzin, Bryant J.; Bhagat, Rohit; Dashwood, Richard

    2016-01-01

    Commercial Li-ion batteries are typically cycled between 3.0 and 4.2 V. These voltages limits are chosen based on the characteristics of the cathode (e.g. lithium cobalt oxide) and anode (e.g. graphite). When alternative anode/cathode chemistries are studied the same cut-off voltages are often, mistakenly, used. Silicon (Si) based anodes are widely studied as a high capacity alternative to graphite for Lithium-ion batteries. When silicon-based anodes are paired with high capacity cathodes (e.g. Lithium Nickel Cobalt Aluminium Oxide; NCA) the cell typically suffers from rapid capacity fade. The purpose of this communication is to understand how the choice of upper cut-off voltage affects cell performance in Si/NCA cells. A careful study of three-electrode cell data will show that capacity fade in Si/NCA cells is due to an ever-evolving silicon voltage profile that pushes the upper voltage at the cathode to >4.4 V (vs. Li/Li+). This behaviour initially improves cycle efficiency, due to liberation of new lithium, but ultimately reduces cycling efficiency, resulting in rapid capacity fade.

  13. Triceps and Subscapular Skinfold Thickness Percentiles and Cut-Offs for Overweight and Obesity in a Population-Based Sample of Schoolchildren and Adolescents in Bogota, Colombia

    PubMed Central

    Ramírez-Vélez, Robinson; López-Cifuentes, Mario Ferney; Correa-Bautista, Jorge Enrique; González-Ruíz, Katherine; González-Jiménez, Emilio; Córdoba-Rodríguez, Diana Paola; Vivas, Andrés; Triana-Reina, Hector Reynaldo; Schmidt-RioValle, Jacqueline

    2016-01-01

    The assessment of skinfold thickness is an objective measure of adiposity. The aims of this study were to establish Colombian smoothed centile charts and LMS L (Box–Cox transformation), M (median), and S (coefficient of variation) tables for triceps, subscapular, and triceps + subscapular skinfolds; appropriate cut-offs were selected using receiver operating characteristic (ROC) analysis based on a population-based sample of children and adolescents in Bogotá, Colombia. A cross-sectional study was conducted in 9618 children and adolescents (55.7% girls; age range of 9–17.9 years). Triceps and subscapular skinfold measurements were obtained using standardized methods. We calculated the triceps + subscapular skinfold (T + SS) sum. Smoothed percentile curves for triceps and subscapular skinfold thickness were derived using the LMS method. ROC curve analyses were used to evaluate the optimal cut-off point of skinfold thickness for overweight and obesity, based on the International Obesity Task Force definitions. Subscapular and triceps skinfolds and T + SS were significantly higher in girls than in boys (p < 0.001). The ROC analysis showed that subscapular and triceps skinfolds and T + SS have a high discriminatory power in the identification of overweight and obesity in the sample population in this study. Our results provide sex- and age-specific normative reference standards for skinfold thickness values from a population from Bogotá, Colombia. PMID:27669294

  14. One strategy to enhance electrochemical properties of Ni-based cathode materials under high cut-off voltage for Li-ion batteries

    NASA Astrophysics Data System (ADS)

    Liang, Longwei; Jiang, Feng; Cao, Yanbing; Hu, Guorong; Du, Ke; Peng, Zhongdong

    2016-10-01

    Well-distributed, nano-sized and amorphous or crystalized NaTi2(PO4)3 (NTP) coating layer with high ionic conductivity is successfully introduced onto the surface of LiNi0.6Co0.2Mn0.2O2 (LNCM) particles by a simple and effective mechanical activation method followed by adjusting the reheating temperature appropriately. The promoting influence of NTP coating on the structure stability, cycle life and high rate capability under elevated cut-off voltage has been investigated in-depth. Particularly for the crystalized NTP-coated LNCM, the main reason for the enhanced electrochemical performance can be attributed to the NTP layer with rhombohedral structure providing convenient and low activation barrier diffusion pathways for Li+ ions to insert/extract the interface of electrode/electrolyte. Besides, the NTP-coated layer with stable structure can effectively inhibit the surface side reaction during the long charge/discharge process under high cut-off voltage, which will reduce the harmful insulative by-products. It's worth mentioning that the cyclic stability of crystalized NTP-coated LNCM between 3.0 and 4.6 V is also improved significantly even under the rigorous test environment.

  15. [Logistic regression analysis of the risk factors for difficult airway and the cut-off value of height-to-thyromental distance ratio].

    PubMed

    Jin, Hao; Chen, Ping

    2015-08-01

    To analyze the risk factors for difficult airway in laryngoscopy and mask ventilation. A total of 300 patients receiving general anesthesia with tracheal intubation were examined preoperatively for height, thyromental and sternomental distance (TMD), range of neck movement, inter-incisor distance, and modified Mallampati class. Intubation Difficult Score was used to identify a difficult laryngoscopy. Difficult airway was defined as either difficult laryngoscopy or difficult mask ventilation. The association between the airway characteristics and difficult airway was analyzed by logistic regression analysis, and the cut-off values for the height-to-TMD ratio was determined by the ROC curve. Eight airway characteristics were identified to contribute to a difficult airway, including (OR [95%CI]) the height-to-TMD ratio (3.58[1.95-8.46]), modified Mallampati class (3.34 [1.82-7.14]), BMI (3.07 [1.64-6.69]), history of a previous difficult airway (2.79 [1.28-5.25]), a thick neck (2.15 [1.04-4.37]), range of neck movement (1.98 [0.96-3.89]), sternomental and angulus mandibulae distance (1.46 [0.67-3.04]), and inter-incisor distance (1.01 [0.49-2.54]). The optimal cut-off value for the height-to-TMD ratio was 22.8 for predicting a difficult airway.

  16. Influence of the Lift-Off Effect on the Cut-Off Frequency of the EMAT-Generated Rayleigh Wave Signal

    PubMed Central

    Yi, Pengxing; Zhang, Kang; Li, Yahui; Zhang, Xuming

    2014-01-01

    The electromagnetic acoustic transducer (EMAT), a non-contact NDT tool with large lift-off, is becoming an attractive method for detecting the cracks in the metal parts. However, the lift-off of the transducer has a direct effect on the feature that is used to characterize the defects. A detailed investigation on the relationship between the feature and the lift-off of the EMAT is crucial in the detection process. This paper investigates the lift-off effect on the feature, cut-off frequency of EMAT in the Rayleigh wave. The study can be divided into two parts. Firstly, with a multi-field coupling environment, 2-D electromagnetic and wave generation EMAT models are built to simulate the interaction of the Rayleigh wave with the surface crack. Then, the lift-off effect on the cut-off frequency is investigated through simulation and experiment. Compared to the previous studies, it is found that lift-off would cause a negative result when the lift-off varies in the testing process. Besides, the calibration obtained from the tests at a random lift-off value can be used in other tests with any different lift off value provided that the lift-off is kept as a constant during the detection process. PMID:25340446

  17. Gamma-hydroxybutyric acid endogenous production and post-mortem behaviour - the importance of different biological matrices, cut-off reference values, sample collection and storage conditions.

    PubMed

    Castro, André L; Dias, Mário; Reis, Flávio; Teixeira, Helena M

    2014-10-01

    Gamma-Hydroxybutyric Acid (GHB) is an endogenous compound with a story of clinical use, since the 1960's. However, due to its secondary effects, it has become a controlled substance, entering the illicit market for recreational and "dance club scene" use, muscle enhancement purposes and drug-facilitated sexual assaults. Its endogenous context can bring some difficulties when interpreting, in a forensic context, the analytical values achieved in biological samples. This manuscript reviewed several crucial aspects related to GHB forensic toxicology evaluation, such as its post-mortem behaviour in biological samples; endogenous production values, whether in in vivo and in post-mortem samples; sampling and storage conditions (including stability tests); and cut-off reference values evaluation for different biological samples, such as whole blood, plasma, serum, urine, saliva, bile, vitreous humour and hair. This revision highlights the need of specific sampling care, storage conditions, and cut-off reference values interpretation in different biological samples, essential for proper practical application in forensic toxicology. Copyright © 2014 Elsevier Ltd and Faculty of Forensic and Legal Medicine. All rights reserved.

  18. Increased impedance near cut-off in plasma-like media leading to emission of high-power, narrow-bandwidth radiation

    NASA Astrophysics Data System (ADS)

    Hur, M. S.; Ersfeld, B.; Noble, A.; Suk, H.; Jaroszynski, D. A.

    2017-01-01

    Ultra-intense, narrow-bandwidth, electromagnetic pulses have become important tools for exploring the characteristics of matter. Modern tuneable high-power light sources, such as free-electron lasers and vacuum tubes, rely on bunching of relativistic or near-relativistic electrons in vacuum. Here we present a fundamentally different method for producing narrow-bandwidth radiation from a broad spectral bandwidth current source, which takes advantage of the inflated radiation impedance close to cut-off in a medium with a plasma-like permittivity. We find that by embedding a current source in this cut-off region, more than an order of magnitude enhancement of the radiation intensity is obtained compared with emission directly into free space. The method suggests a simple and general way to flexibly use broadband current sources to produce broad or narrow bandwidth pulses. As an example, we demonstrate, using particle-in-cell simulations, enhanced monochromatic emission of terahertz radiation using a two-colour pumped current source enclosed by a tapered waveguide.

  19. Increased impedance near cut-off in plasma-like media leading to emission of high-power, narrow-bandwidth radiation.

    PubMed

    Hur, M S; Ersfeld, B; Noble, A; Suk, H; Jaroszynski, D A

    2017-01-10

    Ultra-intense, narrow-bandwidth, electromagnetic pulses have become important tools for exploring the characteristics of matter. Modern tuneable high-power light sources, such as free-electron lasers and vacuum tubes, rely on bunching of relativistic or near-relativistic electrons in vacuum. Here we present a fundamentally different method for producing narrow-bandwidth radiation from a broad spectral bandwidth current source, which takes advantage of the inflated radiation impedance close to cut-off in a medium with a plasma-like permittivity. We find that by embedding a current source in this cut-off region, more than an order of magnitude enhancement of the radiation intensity is obtained compared with emission directly into free space. The method suggests a simple and general way to flexibly use broadband current sources to produce broad or narrow bandwidth pulses. As an example, we demonstrate, using particle-in-cell simulations, enhanced monochromatic emission of terahertz radiation using a two-colour pumped current source enclosed by a tapered waveguide.

  20. The Eating Disorder Diagnostic Scale: psychometric features within a clinical population and a cut-off point to differentiate clinical patients from healthy controls.

    PubMed

    Krabbenborg, Manon A M; Danner, Unna N; Larsen, Junilla K; van der Veer, Nienke; van Elburg, Annemarie A; de Ridder, Denise T D; Evers, Catharine; Stice, Eric; Engels, Rutger C M E

    2012-07-01

    The Eating Disorder Diagnostic Scale (EDDS) is a brief self-report measure for diagnosing anorexia nervosa, bulimia nervosa and binge eating disorder. Research has provided evidence of the reliability and validity of this scale in non-clinical populations. Our study is the first to examine the psychometric features of the EDDS in a clinical population of eating disordered patients. We identified a cut-off point that differentiates clinical patients from healthy controls. A clinical group of 59 Dutch female eating disordered patients and a control group of 45 Dutch students completed the EDDS, the Eating Disorder Examination Interview, the Body Attitude Test and the Beck Depression Inventory--II. The EDDS showed good test-retest reliability, internal consistency, criterion validity and convergent validity with other scales assessing eating and general pathology. An overall symptom composite cut-off score of 16.5 accurately distinguished clinical patients from healthy controls. The EDDS may be a useful instrument in clinical settings and in aetiologic, prevention and treatment research.

  1. Examination of a cut-off score to express the meaningful activity of people with dementia using iPad application (ADOC).

    PubMed

    Tomori, Kounosuke; Nagayama, Hirofumi; Saito, Yuki; Ohno, Kanta; Nagatani, Ryutaro; Higashi, Toshio

    2015-03-01

    To determine a quantifiable measure to identify patients with dementia who can choose an illustration of meaningful activity using an iPad application, Aid for Decision-making in Occupation Choice (ADOC). We recruited 116 patients from 5 institutions in Japan. Occupational therapists interviewed patients with dementia to determine meaningful activities using ADOC. The most meaningful activity was confirmed by their primary caregivers. The cut-off was estimated from Mini-Mental State Examination (MMSE). Receiver operating characteristic analysis indicated that an MMSE score of 8 was the cut-off for choosing meaningful activities using ADOC. Sensitivity and specificity was 91.0% and 74.1%, respectively, and the area under the curve value was 0.89. ADOC can provide individualized information regarding meaningful activities for patients with moderate dementia. Implications for Rehabilitation As dementia progresses, difficulty in expressing needs or desires regarding meaningful activity may increase. The iPad application (Aid for Decision-making in Occupation Choice; ADOC) can be useful to promote shared decision-making through a systematic goal-setting process involving a choice of 95 illustrations describing daily activities. Mini-Mental State Examination (MMSE) score greater than 8 points is required to use the ADOC to choose most meaningful activities. ADOC provides individual information regarding meaningful activities for patients with moderate dementia.

  2. Rocking at 81 and Rolling at 34: ROC Cut-Off Scores for the Negative Acts Questionnaire–Revised in Serbia

    PubMed Central

    Petrović, Ivana B.; Vukelić, Milica; Čizmić, Svetlana

    2017-01-01

    Researchers are still searching for the ways to identify different categories of employees according to their exposure to negative acts and psychological experience of workplace bullying. We followed Notelaers and Einarsen’s application of the ROC analysis to determine the NAQ-R cut-off scores applying a “lower” and “higher” threshold. The main goal of this research was to develop and test different gold standards of personal and organizational relevance in determining the NAQ-R cut-off scores in a specific cultural and economic context of Serbia. Apart from combining self-labeling as a victim with self-perceived health, the objectives were to test the gold standards developed as a combination of self-labeling with life satisfaction, self-labeling with intention to leave and a complex gold standard based on self-labeling, self-perceived health, life satisfaction and intention to leave taken together. The ROC analysis on Serbian workforce data supports applying of different gold standards. For identifying employees in a preliminary stage of bullying, the most applicable was the gold standard based on self-labeling and intention to leave (score 34 and higher). The most accurate identification of victims could be based on the most complex gold standard (score 81 and higher). This research encourages further investigation of gold standards in different cultures. PMID:28119652

  3. The Optimal Cut-Off Level of The Fecal Immunochemical Test For Colorectal Cancer Screening in a Country with Limited Colonoscopy Resources: A Multi-Center Study from Thailand

    PubMed Central

    Aniwan, Satimai; Ek, Thawee Ratanachu; Pongprasobchai, Supot; Limsrivilai, Julajak; Praisontarangkul, Ong Ard; Pisespongsa, Pises; Mairiang, Pisaln; Sangchan, Apichat; Sottisuporn, Jaksin; Wisedopas, Naruemon; Kullavanijaya, Pinit; Rerknimitr, Rungsun

    2017-01-01

    Background: Selecting the cut-off point for the fecal immunochemical test (FIT) for colorectal cancer (CRC) screening programs is of prime importance. The balance between the test performance for detecting advanced neoplasia and the available colonoscopy resources should be considered. We aimed to identify the optimal cut-off of FIT for advanced neoplasia in order to minimize colonoscopy burden. Methods: We conducted a multi-center study in 6 hospitals from diverse regions of Thailand. Asymptomatic participants, aged 50-75 years, were tested with one-time quantitative FIT (OC-SENSOR, Eiken Chemical Co.,Ltd., Tokyo, Japan) and all participants underwent colonoscopy. We assessed test performance in detecting advanced neoplasia (advanced adenoma and CRC) and measured the burden of colonoscopy with different cut-offs [25 (FIT25), 50 (FIT50), 100 (FIT100), 150 (FIT150), and 200 (FIT200)ng/ml]. Results: Among 1,479 participants, advanced neoplasia and CRC were found in 137 (9.3%) and 14 (0.9%), respectively. From FIT25 to FIT200, the positivity rate decreased from 18% to 4.9%. For advanced neoplasia, an increased cut-off decreased sensitivity from 42.3% to 16.8% but increased specificity from 84.2% to 96.3%. The increased cut-off increased the positive predictive value (PPV) from 21.5% to 31.5%. However, all cut-off points provided a high negative predictive value (NPV) (>90%). For CRC, the miss rate for FIT25 to FIT 150 was the same (n=3, 21%), whereas that with FIT200 increased to 35% (n=5). Conclusions: In a country with limited-colonoscopy resources, using FIT150 may be preferred because it offers both high PPV and NPV for advanced neoplasia detection. It could also decrease colonoscopy workload, while maintaining a CRC miss rate similar to those with lower cut-offs. PMID:28345822

  4. A cut-off of 2150 cytokeratin 19 mRNA copy number in sentinel lymph node may be a powerful predictor of non-sentinel lymph node status in breast cancer patients

    PubMed Central

    Terrenato, Irene; D’Alicandro, Valerio; Casini, Beatrice; Perracchio, Letizia; Rollo, Francesca; De Salvo, Laura; Di Filippo, Simona; Di Filippo, Franco; Pescarmona, Edoardo; Maugeri-Saccà, Marcello; Mottolese, Marcella

    2017-01-01

    Since 2007, one-step nucleic acid amplification (OSNA) has been used as a diagnostic system for sentinel lymph node (SLN) examination in patients with breast cancer. This study aimed to define a new clinical cut-off of CK19 mRNA copy number based on the calculation of the risk that an axillary lymph node dissection (ALND) will be positive. We analyzed 1529 SLNs from 1140 patients with the OSNA assay and 318 patients with positive SLNs for micrometastasis (250 copies) and macrometastasis (5000 copies) underwent ALND. Axillary non–SLNs were routinely examined. ROC curves and Youden’s index were performed in order to identify a new cut-off value. Logistic regression models were performed in order to compare OSNA categorical variables created on the basis of our and traditional cut-off to better identify patients who really need an axillary dissection. 69% and 31% of OSNA positive patients had a negative and positive ALND, respectively. ROC analysis identified a cut-off of 2150 CK19 mRNA copies with 95% sensitivity and 51% specificity. Positive and negative predictive values of this new cut-off were 47% and 96%, respectively. Logistic regression models indicated that the cut-off of 2150 copies better discriminates patients with node negative or positive in comparison with the conventional OSNA cut-off (p<0.0001). This cut-off identifies false positive and false negative cases and true-positive and true negative cases very efficiently, and therefore better identifies which patients really need an ALND and which patients can avoid one. This is why we suggest that the negative cut-off should be raised from 250 to 2150. Furthermore, we propose that for patients with a copy number that ranges between 2150 and 5000, there should be a multidisciplinary discussion concerning the clinical and bio-morphological features of primary breast cancer before any decision is taken on whether to perform an ALND or not. PMID:28187209

  5. Cut-off value of initial serum β-hCG level predicting a successful MTX therapy in tubal ectopic pregnancy: a retrospective cohort study.

    PubMed

    Helmy, S; Bader, Y; Pablik, E; Tiringer, D; Pils, S; Laml, T; Kölbl, H; Koch, M

    2014-08-01

    To determine the optimal serum β-hCG cut-off level to predict MTX treatment success in tubal ectopic pregnancy (EP). Data of 240 women, who presented between 2003 and 2011 at the Department of Gynecology and Obstetrics, Medical University of Vienna, with tubal EP and who received MTX as primary treatment, were retrieved from the hospital information system (KIS). 198 patients could be included for final evaluation. Statistical analysis included area under the ROC curve, maximal Euclidean and Youden index, chi-squared and a five-fold cross validation. The serum β-hCG level cut-off value was calculated at 2121mlU/ml with a specificity of 76.54% and sensitivity of 80.56% (AUC 0.789; p<0.001). Patients with an initial serum β-hCG level below 2121mlU/ml (n=131) experienced MTX treatment failure in 5.3% (n=7), compared to 43.3% (n=29) of patients with an initial serum β-hCG level equal to or above 2121mlU/ml (n=67). There was no statistically significant correlation between clinical symptoms and the MTX therapy outcome (p=0.580; likelihood quotient p=0.716). The correct decision of therapy in patients with tubal ectopic pregnancy still represents a challenge. In this study we can conclude that, according to our results there is no endpoint of initial serum β-hCG levels, which can be clearly used as cut-off value for the optimal management of tubal EP. However, an initial serum β-hCG level of less than 2121mlU/ml seems to be a good value to expect a successful MTX treatment. Limitations are the retrospective study design and the inability of classifying clinical symptoms like pain as an objective parameter. Wider implications of the findings may include more detailed patient information and more accurate selection of suitable patients for MTX therapy. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  6. Yield and Water Productivity Responses to Irrigation Cut-off Strategies after Fruit Set Using Stem Water Potential Thresholds in a Super-High Density Olive Orchard.

    PubMed

    Ahumada-Orellana, Luis E; Ortega-Farías, Samuel; Searles, Peter S; Retamales, Jorge B

    2017-01-01

    An increase in the land area dedicated to super-high density olive orchards has occurred in Chile in recent years. Such modern orchards have high irrigation requirements, and optimizing water use is a priority. Moreover, this region presents low water availability, which makes necessary to establish irrigation strategies to improve water productivity. An experiment was conducted during four consecutive growing seasons (2010-2011 to 2013-2014) to evaluate the responses of yield and water productivity to irrigation cut-off strategies. These strategies were applied after fruit set using midday stem water potential (Ψstem) thresholds in a super-high density olive orchard (cv. Arbequina), located in the Pencahue Valley, Maule Region, Chile. The experimental design was completely randomized with four irrigation cut-off treatments based on the Ψstem thresholds and four replicate plots per treatment (five trees per plot). Similar to commercial growing conditions in our region, the Ψstem in the T1 treatment was maintained between -1.4 and -2.2 MPa (100% of actual evapotranspiration), while T2, T3 and T4 treatments did not receive irrigation from fruit set until they reached a Ψstem threshold of approximately -3.5, -5.0, and -6.0 MPa, respectively. Once the specific thresholds were reached, irrigation was restored and maintained as T1 in all treatments until fruits were harvested. Yield and its components were not significantly different between T1 and T2, but fruit yield and total oil yield, fruit weight, and fruit diameter were decreased by the T3 and T4 treatments. Moreover, yield showed a linear response with water stress integral (SΨ), which was strongly influenced by fruit load. Total oil content (%) and pulp/stone ratio were not affected by the different irrigation strategies. Also, fruit and oil water productivities were significantly greater in T1 and T2 than in the T3 and T4. Moreover, the T2, T3, and T4 treatments averaged 37, 51, and 72 days without

  7. Breslow thickness and (18)F-FDG PET-CT result in initial staging of cutaneous melanoma: Can a cut-off point be established?

    PubMed

    Ortega-Candil, A; Rodríguez-Rey, C; Cano-Carrizal, R; Cala-Zuluaga, E; González Larriba, J L; Jiménez-Ballvé, A; Fuentes-Ferrer, M E; Cabrera-Martín, M N; Pérez-Castejón, M J; García García-Esquinas, M; Lapeña-Gutierrez, L; Carreras-Delgado, J L

    2016-01-01

    To establish a Breslow Thickness (BT) cut-off point for indication of PET-CT of cutaneous melanoma in early stages and evaluate its prognostic value. Retrospective analysis of 347 PET-CT studies with diagnosis of melanoma, of which 108 were performed for initial staging. Thirty-one patients were excluded, and a final sample of 77 patients remained. A ROC curve analysis was performed to establish an optimal cut-off point. A survival analysis was performed, considering death assignable to melanoma as the main event, for the evaluation of its prognostic value. Forty-seven (61.04%) of all 77 patients selected were men, and 11 (14.29%) had a positive PET-CT result. Mean age was 65.17±15.00 years. The median BT in patients with a negative PET-CT result was 2.75 mm (IQR 1.83-4.50) and in the positive group 6.25 mm (IQR 5.40-7.50) (P=.0013). In the ROC curve analysis (AUC 0.804, SE 0.054), an optimal value of 5 mm BT with the following values was obtained: sensitivity 90.91%, specificity 78.79%, negative predictive value (NPV) 98.1%, positive predictive value (PPV) 41.7%, diagnostic OR 37.1, and accuracy 80.52%. Mean follow-up was 18.66±14,35 months, detecting 2/53 (3.77%) deaths in the BT<5 mm group, and 7/24 (29.17%) in the BT≥5 mm group. Survival curves between both groups were significantly different (P=.0013). A 5 mm cut-off point correctly distinguishes those patients with positive PET-CT from those with negative results in the early stages of cutaneous melanoma; therefore it could be included in initial staging of this subgroup of patients. Copyright © 2015 Elsevier España, S.L.U. and SEMNIM. All rights reserved.

  8. Yield and Water Productivity Responses to Irrigation Cut-off Strategies after Fruit Set Using Stem Water Potential Thresholds in a Super-High Density Olive Orchard

    PubMed Central

    Ahumada-Orellana, Luis E.; Ortega-Farías, Samuel; Searles, Peter S.; Retamales, Jorge B.

    2017-01-01

    An increase in the land area dedicated to super-high density olive orchards has occurred in Chile in recent years. Such modern orchards have high irrigation requirements, and optimizing water use is a priority. Moreover, this region presents low water availability, which makes necessary to establish irrigation strategies to improve water productivity. An experiment was conducted during four consecutive growing seasons (2010–2011 to 2013–2014) to evaluate the responses of yield and water productivity to irrigation cut-off strategies. These strategies were applied after fruit set using midday stem water potential (Ψstem) thresholds in a super-high density olive orchard (cv. Arbequina), located in the Pencahue Valley, Maule Region, Chile. The experimental design was completely randomized with four irrigation cut-off treatments based on the Ψstem thresholds and four replicate plots per treatment (five trees per plot). Similar to commercial growing conditions in our region, the Ψstem in the T1 treatment was maintained between -1.4 and -2.2 MPa (100% of actual evapotranspiration), while T2, T3 and T4 treatments did not receive irrigation from fruit set until they reached a Ψstem threshold of approximately -3.5, -5.0, and -6.0 MPa, respectively. Once the specific thresholds were reached, irrigation was restored and maintained as T1 in all treatments until fruits were harvested. Yield and its components were not significantly different between T1 and T2, but fruit yield and total oil yield, fruit weight, and fruit diameter were decreased by the T3 and T4 treatments. Moreover, yield showed a linear response with water stress integral (SΨ), which was strongly influenced by fruit load. Total oil content (%) and pulp/stone ratio were not affected by the different irrigation strategies. Also, fruit and oil water productivities were significantly greater in T1 and T2 than in the T3 and T4. Moreover, the T2, T3, and T4 treatments averaged 37, 51, and 72 days without

  9. Geomagnetically Induced Currents: Principles

    NASA Astrophysics Data System (ADS)

    Oliveira, Denny M.; Ngwira, Chigomezyo M.

    2017-10-01

    The geospace, or the space environment near Earth, is constantly subjected to changes in the solar wind flow generated at the Sun. The study of this environment variability is called Space Weather. Examples of effects resulting from this variability are the occurrence of powerful solar disturbances, such as coronal mass ejections (CMEs). The impact of CMEs on the Earth's magnetosphere very often greatly perturbs the geomagnetic field causing the occurrence of geomagnetic storms. Such extremely variable geomagnetic fields trigger geomagnetic effects measurable not only in the geospace but also in the ionosphere, upper atmosphere, and on and in the ground. For example, during extreme cases, rapidly changing geomagnetic fields generate intense geomagnetically induced currents (GICs). Intense GICs can cause dramatic effects on man-made technological systems, such as damage to high-voltage power transmission transformers leading to interruption of power supply, and/or corrosion of oil and gas pipelines. These space weather effects can in turn lead to severe economic losses. In this paper, we supply the reader with theoretical concepts related to GICs as well as their general consequences. As an example, we discuss the GIC effects on a North American power grid located in mid-latitude regions during the 13-14 March 1989 extreme geomagnetic storm. That was the most extreme storm that occurred in the space era age.

  10. The cut-off value for interleukin 34 as an additional potential inflammatory biomarker for the prediction of the risk of diabetic complications.

    PubMed

    Zorena, Katarzyna; Jachimowicz-Duda, Olga; Wąż, Piotr

    2016-01-01

    In the present study, we have decided to evaluate whether serum interleukin 34 (IL-34) levels may have diagnostic value in predicting the risk of vascular diabetic complications. The study included 49 patients with type 2 diabetes mellitus (T2DM) and 23 high-risk group. The receiver operating characteristic (ROC) curve analysis has shown that IL-34 has more discriminatory power than C-reactive protein (CRP) for the risk of diabetic complications. The cut-off value for IL-34 was established as 91.2 pg/mL. The gist of our research was identification of IL-34 as an additional potential inflammatory biomarker for the prediction of the risk of vascular diabetic complications.

  11. Geomagnetism-Paleomagnetism Committee

    NASA Astrophysics Data System (ADS)

    Banerjee, Subir K.

    I n response to strong member concerns about the future of geomagnetism, Neil D. Opdyke, President of the Geomagnetism and Paleomagnetism Section, has appointed an ad hoc Committee for the Future of Geomagnetism and Paleomagnetism consisting of Subir K. Banerjee (chair; University of Minnesota, Minneapolis), Joseph Cain (U.S. Geological Survey, Denver, Colo.) and Rob Van der Voo (University of Michigan, Ann Arbor). The committee seeks, from the membership at large, perceptions of future directions of research, help in identifying a few expanding research areas that show a promise of delivering significant results in the next 5 to 10 years, and guidance in generating a strategy to bring these about.

  12. The optimum cut-off value to differentiate Echinococcus granulosus sensu stricto from other species of E. granulosus sensu lato using larval rostellar hook morphometry.

    PubMed

    Soriano, S V; Pierangeli, N B; Pianciola, L A; Mazzeo, M; Lazzarini, L E; Debiaggi, M F; Bergagna, H F J; Basualdo, J A

    2015-01-01

    Cystic echinococcosis caused by Echinococcus granulosus sensu lato is one of the most important helminth zoonoses in the world; it affects both humans and livestock. The disease is endemic in Argentina and highly endemic in the province of Neuquén. Considerable genetic and phenotypic variation has been demonstrated in E. granulosus, and ten different genotypes (G1-G10) have been identified using molecular tools. Echinococcus granulosus sensu lato may be considered a species complex, comprised of E. granulosus sensu stricto (G1-G3), E. equinus (G4), E. ortleppi (G5) and E. canadensis (G6-G10). In endemic areas, the characterization of cystic echinococcosis molecular epidemiology is important in order to apply adequate control strategies. A cut-off value for larval large hook total length to distinguish E. granulosus sensu stricto isolates from those produced by other species of the complex was defined for the first time. Overall, 1780 larval hooks of 36 isolates obtained from sheep (n= 11, G1), goats (n= 10, G6), cattle (n= 5, G6) and pigs (n= 10, G7) were analysed. Validation against molecular genotyping as gold standard was carried out using the receiver operating characteristic (ROC) curve analysis. The optimum cut-off value was defined as 26.5 μm. The proposed method showed high sensitivity (97.8%) and specificity (91.1%). Since in most endemic regions the molecular epidemiology of echinococcosis includes the coexistence of the widely distributed E. granulosus sensu stricto G1 strain and other species of the complex, this technique could be useful as a quick and economical tool for epidemiological and surveillance field studies, when fertile cysts are present.

  13. Serum cortisol concentration with exploratory cut-off values do not predict the effects of hydrocortisone administration in children with low cardiac output after cardiac surgery.

    PubMed

    Verweij, E J; Hogenbirk, Karin; Roest, Arno A W; van Brempt, Ronald; Hazekamp, Mark G; de Jonge, Evert

    2012-10-01

    Low cardiac output syndrome is common after paediatric cardiac surgery. Previous studies suggested that hydrocortisone administration may improve haemodynamic stability in case of resistant low cardiac output syndrome in critically ill children. This study was set up to test the hypothesis that the effects of hydrocortisone on haemodynamics in children with low cardiac output syndrome depend on the presence of (relative) adrenal insufficiency. A retrospective study was done on paediatric patients who received hydrocortisone when diagnosed with resistant low cardiac output syndrome after paediatric cardiac surgery in the period from 1 November 2005 to 31 December 2008. We studied the difference in effects of treatment with hydrocortisone administration between patients with adrenal insufficiency defined as an exploratory cut-off value of total cortisol of <100 nmol/l and patients with a serum total cortisol of ≥ 100 nmol/l. A total of 62 of patients were enrolled, meeting the inclusion criteria for low cardiac output syndrome. Thirty-two patients were assigned to Group 1 (<100 nmol/l) and 30 were assigned to Group 2 (≥ 100 nmol/l). Haemodynamics improved after hydrocortisone administration, with an increase in blood pressure, a decrease in administered vasopressors and inotropic drugs, an increase in urine production and a decrease in plasma lactate concentrations. The effects of treatment with hydrocortisone in children with low cardiac output after cardiac surgery was similar in patients with a low baseline serum cortisol concentration and those with normal baseline cortisol levels. A cortisol value using an exploratory cut-off value of 100 nmol/l for adrenal insufficiency should not be used as a criterion to treat these patients with hydrocortisone.

  14. Muscle function-dependent sarcopenia and cut-off values of possible predictors in community-dwelling Turkish elderly: calf circumference, midarm muscle circumference and walking speed.

    PubMed

    Akın, S; Mucuk, S; Öztürk, A; Mazıcıoğlu, M; Göçer, Ş; Arguvanlı, S; Şafak, E D

    2015-10-01

    The aim of this study was to determine the prevalence of muscle strength-based sarcopenia and to determine possible predictors. This is a cross-sectional population-based study in the community-dwelling Turkish elderly. Anthropometric measurements, namely body height, weight, triceps skin fold (TSF), mid upper arm circumference (MUAC), waist circumference (WC) and calf circumference (CC), were noted. The midarm muscle circumference (MAMC) was calculated by using MUAC and TSF measurement. Sarcopenia was assessed, adjusted for body mass index (BMI) and gender, according to muscle strength. Physical performance was determined by 4 m walking speed (WS; m/s). The receiver operating curve analysis was performed to determine cut-offs of CC, MAMC and 4 m WS. A total of 879 elderly subjects, 50.1% of whom were female, were recruited. The mean handgrip strength (HGS) and s.d. was 24.2 (8.8) kg [17.9 (4.8) female, 30.6 (7.1) male]. The muscle function-dependent sarcopenia was 63.4% (female 73.5%, male 53.2%). The muscle mass-dependent sarcopenia for CC (<31 cm) and MAMC(<21.1 cm in males, <19.9 cm in females) was 6.7% and 7.3%, respectively. The prevalence of low 4 m WS (≤ 0.8 m/s) was 81.8% (91.3% in females and 72.3% in males, respectively). We compared MAMC, CC and 4 m WS and found that AUC for 4 m WS was the best predictor of sarcopenia. An adequate muscle mass may not mean a reliable muscle function. Muscle function may describe sarcopenia better compared with muscle mass. The CC, MAMC and 4 m WS cut-offs may be used to assess sarcopenia in certain age groups.

  15. Profiles of body mass index and the nutritional status among children and adolescents categorized by waist-to-height ratio cut-offs.

    PubMed

    Zhang, Ying-Xiu; Wang, Zhao-Xia; Chu, Zun-Hua; Zhao, Jin-Shan

    2016-11-15

    Waist-to-height ratio (WHtR) is proposed as a simple, valid and convenient measure of abdominal obesity and health risks in practice. The present study examined the distribution of nutritional status among children and adolescents categorized by WHtR cut-offs. A total of 30,459 students (15,249 boys and 15,210 girls) aged 7-18years participated in the study. Height, weight and waist circumference (WC) of all subjects were measured, body mass index (BMI) and WHtR were calculated. The grades of nutritional status (thinness, normal weight, overweight and obesity) was defined by the international BMI cut-offs. All subjects were divided into three groups (low, moderate and high) according to their WHtR, BMI level and the distribution of nutritional status among the three groups were compared. In both boys and girls, significant differences in BMI level and the nutritional status were observed among the three groups. Children and adolescents aged 7-18years in the 'high WHtR group' (≥0.5) had higher BMI than those in the 'low WHtR group' (<0.4) by 6.00-10.15kg/m(2) for boys and 5.24-9.51kg/m(2) for girls. 'low WHtR group' had higher prevalence of thinness, and 'high WHtR group' had higher prevalence of overweight and obesity. The optimal distribution of nutritional status is found in the 'moderate WHtR group' (between 0.4 and 0.5) with the highest proportion of normal weight and low prevalence of thinness and obesity. WHtR is associated with nutritional status, which could be an indicator of nutritional status and early health risk. It is necessary to develop optimal boundary values in the future. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  16. Clonidine-stimulated growth hormone concentrations (cut-off values) measured by immunochemiluminescent assay (ICMA) in children and adolescents with short stature

    PubMed Central

    de Fátima Borges, Maria; Teixeira, Flávia Carolina Cândida; Feltrin, Aline Karin; Ribeiro, Karina Alvarenga; Nascentes, Gabriel Antonio Nogueira; Resende, Elisabete Aparecida Mantovani Rodrigues; Ferreira, Beatriz Pires; Silva, Adriana Paula; Palhares, Heloísa Marcelina Cunha

    2016-01-01

    OBJECTIVES: To establish cut-off values for growth hormone concentrations using clonidine as a secretagogue and an immunochemiluminescent assay as the method of measurement and to analyze the response time as well as the influence of gender, nutritional status and pubertal stage. METHODS: A total of 225 tests were performed in 3 patient groups, categorized as group 1 (normal), group 2 (idiopathic short stature) and group 3 (growth hormone deficiency). Among the 199 disease-free individuals, 138 were prepubertal, and 61 were pubertal. Clonidine (0.1 mg/m2) was orally administered, and the growth hormone level was measured by immunochemiluminescent assay. The growth hormone peak and the difference between the growth hormone peak and the baseline level were then analyzed. Statistical analyses were performed using Student's t-test or the Mann-Whitney test and Kruskal-Wallis test followed by Dunn's post hoc test. Cut-off values were determined using a receiver operating characteristic curve. RESULTS: Group 1 and group 2 had no difference in growth hormone peak, gender, body mass index standard deviation score, or pubertal stage. Group 3 exhibited a significantly lower growth hormone peak than the other groups did. The receiver operating characteristic curve demonstrated that growth hormone concentrations ≥ 3.0 ng/mL defined responsiveness to clonidine. In total, 3.02% of individuals in group 1 and group 2 were considered false positive, i.e., these children lacked growth hormone deficiency and had a peak below 3.0 ng/mL. CONCLUSION: Clonidine-stimulated growth hormone concentrations ≥3 ng/mL, as measured by immunochemiluminescent assay, suggest responsiveness to the stimulus regardless of gender, body mass index standard deviation score or pubertal stage. PMID:27166774

  17. Cosmic ray proton spectra at low rigidities

    NASA Technical Reports Server (NTRS)

    Seo, E. S.; Ormes, J. F.; Streitmatter, R. E.; Lloyd-Evans, J.; Jones, W. V.

    1990-01-01

    The cosmic ray proton rigidity spectra have been investigated with data collected in the Low Energy Antiproton (LEAP) balloon flight experiment flown from Prince Albert, Canada in 1987. The LEAP apparatus was designed to measure antiprotons using a superconducting magnet spectrometer with ancillary scintillator, time-of-flight, and liquid Cherenkov detectors. After reaching float altitude the balloon drifted south and west to higher geomagnetic cutoffs. The effect of the changing geomagnetic cutoff on the observed spectra was observed during analysis of the proton data along the balloon trajectory. This is the first measurement of the primary and splash albedo spectra over a wide rigidity range (few hundred MV to about 100 GV) with a single instrument.

  18. On Saturnian cosmic ray cutoff rigidities

    NASA Astrophysics Data System (ADS)

    Sauer, H. H.

    1980-03-01

    It has been determined that Saturn possesses a relatively pure dipolar magnetic field through magnetometer measurements made by Ness et al. (1979, private comm.) and Smith et al. (1979). The paper briefly outlines the dipole geomagnetic cutoff theory and demonstrates the scaling required for its applicability to energetic particle measurements in the vicinity of Saturn. Since the cutoff rigidity is a function of viewing direction, the effective cutoff rigidity must be determined as an integration over the finite viewing angle of a physical detector.

  19. Utilization of a detection level of 25ng/mL for cannabinoids in urine using a CEDIA THCPLUS immunoassay: application of this cut-off to urines of school children.

    PubMed

    Madhavaram, Hima; Couch, Ronald A F

    2010-05-20

    Cannabis is the most widely used illicit drug in New Zealand. About 4 years ago schools in New Zealand began introducing drug programmes in order ascertain a pupil's likely cannabinoid use. Our toxicology laboratory screened such specimens for the presence of cannabinoids, using CEDIA immunoassay, at a cut-off of 50ng/mL as directed by the AS/NZS 4308:2001 standard. However, the consequent result that we reported, as not detected (<50ng/mL), in many cases did not parallel the pupil's confessed cannabis use. Our laboratory has therefore used a lower cut-off of 25ng/mL, by this immunoassay. We use this cut-off only for non-evidential analyses. Stored specimens were analysed over two time periods. Initially 2359 urine samples were screened for cannabinoids. 130 of these specimens had a value between 25 and 49ng/mL and 60 of this group were randomly selected for confirmation by GC-MS. In all the 60 specimens, the presence of THCCOOH was confirmed. A further 760 specimens were collected over a later time period. Of these, 48 specimens had an immunoassay value of 25-49ng/mL and all 48 specimens were confirmed positive for THCCOOH by GC-MS. This study indicates that the CEDIA THCPLUS immunoassay can be used to screen for the presence of urinary cannabinoids using a 25ng/mL cut-off. Use of such a cut-off will limit the occurrence of false negative cannabinoid screening results. For school children a lower cut-off may be important, as consequent remedial action, following a positive immunoassay result, may limit the adverse outcomes such as dependence and impairment of achievements as suggested in a New Zealand study by Fergusson and Joseph.

  20. Geomagnetic excitation of nutation

    NASA Astrophysics Data System (ADS)

    Ron, C.; Vondrák, J.

    2015-08-01

    We tested the hypothesis of Malkin (2013), who demonstrated that the observed changes of Free Core Nutation parameters (phase, amplitude) occur near the epochs of geomagnetic jerks. We found that if the numerical integration of Brzeziński broad-band Liouville equations of atmospheric/oceanic excitations is re-initialized at the epochs of geomagnetic jerks, the agreement between the integrated and observed celestial pole offsets is improved (Vondrák & Ron, 2014). Nevertheless, this approach assumes that the influence of geomagnetic jerks leads to a stepwise change in the position of celestial pole, which is physically not acceptable. Therefore we introduce a simple continuous excitation function that hypothetically describes the influence of geomagnetic jerks, and leads to rapid but continuous changes of pole position. The results of numerical integration of atmospheric/oceanic excitations and this newly introduced excitation are then compared with the observed celestial pole offsets, and prove that the agreement is improved significantly.

  1. The Optimal Ethnic-Specific Waist-Circumference Cut-Off Points of Metabolic Syndrome among Low-Income Rural Uyghur Adults in Far Western China and Implications in Preventive Public Health.

    PubMed

    He, Jia; Ma, Rulin; Liu, Jiaming; Zhang, Mei; Ding, Yusong; Guo, Heng; Mu, Lati; Zhang, Jingyu; Wei, Bin; Yan, Yizhong; Ma, Jiaolong; Pang, Hongrui; Li, Shugang; Guo, Shuxia

    2017-02-08

    Background: Metabolic syndrome is pandemic; however, the cut-off values for waist circumference (WC) vary widely depending on the ethnic groups studied and the criteria applied for WC measurement. Previous studies for defining optimal WC cut-off points included high-income and urban settings, and did not cover low-income, rural settings, especially for ethnic minorities. This study aimed at defining optimal ethnic-specific WC cut-off points in a low-income, rural population comprising the largest inhabitant minority group residing in far Western China. Methods: Questionnaire-based surveys, physical examinations, and blood testing of 3542 individuals were conducted in 2010, using a stratified cluster random sampling method in rural Uyghur residents (≥18 years old) from 12 villages in Xinjiang, China, approximately 4407 km away from the capital city, Beijing. Metabolic syndrome was defined according to the International Diabetes Federation (IDF) criteria. Optimal, ethnic-specific WC cut-off values for diagnosing metabolic syndrome were determined using receiver operator characteristic (ROC) curve analysis. Results: As WC increased, there was a significant, increasing trend of detection and risk in rural Uyghur adults, regardless of the presence of ≥1 or ≥2 components of metabolic syndrome by IDF criteria. The optimal ethnic-specific WC cut-off point to predict the presence of metabolic syndrome was 85 cm for men and 82 cm for women. With these cut-off points, the prevalence rates of metabolic syndrome among men, women, and overall population in Uyghur adults were 19.5%, 23.0%, and 21.3%, respectively. Conclusions: We report a high prevalence of metabolic syndrome, especially in women, among rural Uyghurs in Western China. A WC cut-off of 85 cm in men and 82 cm in women was the best predictor of metabolic syndrome in this population. Because of the cost-effectiveness in measuring WC, we recommend that these WC cut-off points be integrated into local preventive

  2. The Optimal Ethnic-Specific Waist-Circumference Cut-Off Points of Metabolic Syndrome among Low-Income Rural Uyghur Adults in Far Western China and Implications in Preventive Public Health

    PubMed Central

    He, Jia; Ma, Rulin; Liu, Jiaming; Zhang, Mei; Ding, Yusong; Guo, Heng; Mu, Lati; Zhang, Jingyu; Wei, Bin; Yan, Yizhong; Ma, Jiaolong; Pang, Hongrui; Li, Shugang; Guo, Shuxia

    2017-01-01

    Background: Metabolic syndrome is pandemic; however, the cut-off values for waist circumference (WC) vary widely depending on the ethnic groups studied and the criteria applied for WC measurement. Previous studies for defining optimal WC cut-off points included high-income and urban settings, and did not cover low-income, rural settings, especially for ethnic minorities. This study aimed at defining optimal ethnic-specific WC cut-off points in a low-income, rural population comprising the largest inhabitant minority group residing in far Western China. Methods: Questionnaire-based surveys, physical examinations, and blood testing of 3542 individuals were conducted in 2010, using a stratified cluster random sampling method in rural Uyghur residents (≥18 years old) from 12 villages in Xinjiang, China, approximately 4407 km away from the capital city, Beijing. Metabolic syndrome was defined according to the International Diabetes Federation (IDF) criteria. Optimal, ethnic-specific WC cut-off values for diagnosing metabolic syndrome were determined using receiver operator characteristic (ROC) curve analysis. Results: As WC increased, there was a significant, increasing trend of detection and risk in rural Uyghur adults, regardless of the presence of ≥1 or ≥2 components of metabolic syndrome by IDF criteria. The optimal ethnic-specific WC cut-off point to predict the presence of metabolic syndrome was 85 cm for men and 82 cm for women. With these cut-off points, the prevalence rates of metabolic syndrome among men, women, and overall population in Uyghur adults were 19.5%, 23.0%, and 21.3%, respectively. Conclusions: We report a high prevalence of metabolic syndrome, especially in women, among rural Uyghurs in Western China. A WC cut-off of 85 cm in men and 82 cm in women was the best predictor of metabolic syndrome in this population. Because of the cost-effectiveness in measuring WC, we recommend that these WC cut-off points be integrated into local preventive

  3. Cut-Off Points for Mild, Moderate, and Severe Pain on the Numeric Rating Scale for Pain in Patients with Chronic Musculoskeletal Pain: Variability and Influence of Sex and Catastrophizing

    PubMed Central

    Boonstra, Anne M.; Stewart, Roy E.; Köke, Albère J. A.; Oosterwijk, René F. A.; Swaan, Jeannette L.; Schreurs, Karlein M. G.; Schiphorst Preuper, Henrica R.

    2016-01-01

    Objectives: The 0–10 Numeric Rating Scale (NRS) is often used in pain management. The aims of our study were to determine the cut-off points for mild, moderate, and severe pain in terms of pain-related interference with functioning in patients with chronic musculoskeletal pain, to measure the variability of the optimal cut-off points, and to determine the influence of patients’ catastrophizing and their sex on these cut-off points. Methods: 2854 patients were included. Pain was assessed by the NRS, functioning by the Pain Disability Index (PDI) and catastrophizing by the Pain Catastrophizing Scale (PCS). Cut-off point schemes were tested using ANOVAs with and without using the PSC scores or sex as co-variates and with the interaction between CP scheme and PCS score and sex, respectively. The variability of the optimal cut-off point schemes was quantified using bootstrapping procedure. Results and conclusion: The study showed that NRS scores ≤ 5 correspond to mild, scores of 6–7 to moderate and scores ≥8 to severe pain in terms of pain-related interference with functioning. Bootstrapping analysis identified this optimal NRS cut-off point scheme in 90% of the bootstrapping samples. The interpretation of the NRS is independent of sex, but seems to depend on catastrophizing. In patients with high catastrophizing tendency, the optimal cut-off point scheme equals that for the total study sample, but in patients with a low catastrophizing tendency, NRS scores ≤ 3 correspond to mild, scores of 4–6 to moderate and scores ≥7 to severe pain in terms of interference with functioning. In these optimal cut-off schemes, NRS scores of 4 and 5 correspond to moderate interference with functioning for patients with low catastrophizing tendency and to mild interference for patients with high catastrophizing tendency. Theoretically one would therefore expect that among the patients with NRS scores 4 and 5 there would be a higher average PDI score for those with low

  4. Cut-Off Points for Mild, Moderate, and Severe Pain on the Numeric Rating Scale for Pain in Patients with Chronic Musculoskeletal Pain: Variability and Influence of Sex and Catastrophizing.

    PubMed

    Boonstra, Anne M; Stewart, Roy E; Köke, Albère J A; Oosterwijk, René F A; Swaan, Jeannette L; Schreurs, Karlein M G; Schiphorst Preuper, Henrica R

    2016-01-01

    Objectives: The 0-10 Numeric Rating Scale (NRS) is often used in pain management. The aims of our study were to determine the cut-off points for mild, moderate, and severe pain in terms of pain-related interference with functioning in patients with chronic musculoskeletal pain, to measure the variability of the optimal cut-off points, and to determine the influence of patients' catastrophizing and their sex on these cut-off points. Methods: 2854 patients were included. Pain was assessed by the NRS, functioning by the Pain Disability Index (PDI) and catastrophizing by the Pain Catastrophizing Scale (PCS). Cut-off point schemes were tested using ANOVAs with and without using the PSC scores or sex as co-variates and with the interaction between CP scheme and PCS score and sex, respectively. The variability of the optimal cut-off point schemes was quantified using bootstrapping procedure. Results and conclusion: The study showed that NRS scores ≤ 5 correspond to mild, scores of 6-7 to moderate and scores ≥8 to severe pain in terms of pain-related interference with functioning. Bootstrapping analysis identified this optimal NRS cut-off point scheme in 90% of the bootstrapping samples. The interpretation of the NRS is independent of sex, but seems to depend on catastrophizing. In patients with high catastrophizing tendency, the optimal cut-off point scheme equals that for the total study sample, but in patients with a low catastrophizing tendency, NRS scores ≤ 3 correspond to mild, scores of 4-6 to moderate and scores ≥7 to severe pain in terms of interference with functioning. In these optimal cut-off schemes, NRS scores of 4 and 5 correspond to moderate interference with functioning for patients with low catastrophizing tendency and to mild interference for patients with high catastrophizing tendency. Theoretically one would therefore expect that among the patients with NRS scores 4 and 5 there would be a higher average PDI score for those with low

  5. Modeling solar proton access to geostationary spacecraft with geomagnetic cutoffs

    NASA Astrophysics Data System (ADS)

    Kress, B. T.; Rodriguez, J. V.; Mazur, J. E.; Engel, M.

    2013-12-01

    Solar energetic particle (SEP) cutoffs at geosynchronous orbit are sensitive to moderate geomagnetic activity and undergo daily variations due to the day-night asymmetry of the magnetosphere. At geosynchronous orbit, cutoff rigidity also has a large directional dependence, with the highest cutoff rigidity corresponding to ions arriving from magnetic east and lowest cutoff rigidity corresponding to ions incident from the west. Consequently, during geomagnetically quiet periods, the SEP flux observed by an eastward facing particle detector is significantly lower than observed by a westward facing particle detector. During geomagnetically disturbed periods the cutoff is suppressed allowing SEPs access well inside of geosynchronous, so that the east-west SEP flux ratio approaches unity. Variations in the east-west SEP flux ratio observed by GOES Energetic Particle Sensors (EPS) have recently been reported by Rodriguez et al. (2010). In NOAA's operational processing of EPS count rates into differential fluxes, the differential flux is treated as isotropic and flat over the energy width of the channel. To compare modeled SEP flux with GOES EPS observations, the anisotropy of the flux over the EPS energy range and field of view must be taken into account. A technique for making direct comparisons between GOES EPS observations and SEP flux modeled using numerically computed geomagnetic cutoffs is presented. Initial results from a comparison between modeled and observed flux during the 6-11 December 2006 SEP event are also presented. The modeled cutoffs reproduce the observed flux variations well but are in general too high.

  6. Alzheimer's disease dementia as the diagnosis best supported by the cerebrospinal fluid biomarkers: difference in cut-off levels from thai experience.

    PubMed

    Senanarong, V; Siwasariyanon, N; Washirutmangkur, L; Poungvarin, N; Ratanabunakit, C; Aoonkaew, N; Udomphanthurak, S

    2012-01-01

    Objectives. To determine how beta-amyloid 1-42 (Aβ 1-42), total tau (tTau), and phosphorylated tau (pTau) levels in CSF behave in a cohort of Thai patients from the Memory Clinic in Bangkok, Thailand. Methods. During 2009-2011, twenty eight subjects from the memory clinic at Siriraj Hospital had CSF analysis for AD biomarkers. Aβ 1-42, tTau, and pTau (at amino acid 181) were measured in CSF by ELISA technique. Results. Mean of Thai mental state examination (TMSE) of 28 Thai cohort was 16.48 (6.63). Fourteen had AD, ten had non-AD dementia, and four non-cases were those with subjective memory complaint (SMC) without dementia. Mean CSF Aβ 1-42, tTau, ptau (181), and pTau/Aβ 1-42 in the AD group were 241.36 (60.14) pg/mL, 222.79 (212.24) pg/mL, 40.79 (27.84) pg/mL, and 0.18 (0.12) accordingly. Mean CSF Aβ 1-42, tTau, pTau (181), and pTau/Aβ 1-42 in the non-AD dementia group were 430.40 (125.18) pg/mL, 349.30 (692.16) pg/mL, 36.80 (14.90) pg/mL, and 0.09 (0.04) accordingly. Mean CSF Aβ 1-42, tTau, pTau (181), and pTau/Aβ 1-42 in the non-cases with SMC without dementia were 499.75 (93.44) pg/mL, 137.25 (62.74) pg/mL, 31.75 (17.48) pg/mL, and 0.06 (0.02). There is significant difference (P < 0.05) among the 3 groups in CSF Aβ 1-42 and pTau/Aβ 1-42. We propose mean + 1.5 SD of CSF Aβ 1-42 in AD group (331.57 pg/mL) to be the cut-off point in Thai subjects. Conclusion. There are significant different in CSF Aβ 1-42 and CSF p-tau/Aβ 1-42 among those with AD, non-AD dementia and non cases with SMC without dementia in Thai cohort. Cut-off point of CSF Aβ 1-42 of 331.57 pg/mL is suggested in Thai study.

  7. Removal of methadone by extended dialysis using a high cut-off dialyzer: implications for the treatment of overdose and for pain management in patients undergoing light chain removal.

    PubMed

    Arelin, Viktor; Schmidt, Julius J; Kayser, Nathalie; Kühn-Velten, W Nikolaus; Suhling, Hendrik; Eden, Gabriele; Kielstein, Jan T

    2016-06-01

    The synthetic opioid methadone hydrochloride has a low molecular weight of 346 D, a high volume of distribution (4 - 7 L/kg), and is lipophilic. It is used as an analgesic and for the maintenance treatment of opiate dependence. In drug addicts, methadone is frequently involved in mixed intoxications that can lead to death. Here we present the case of a drug addict in whom a high cut-off dialysis membrane together with extended dialysis was used in the setting of suspected overdose and acute kidney injury. Although the observed dialyzer plasma clearance (31.5 mL/min) and reduction ratio (38%) were higher than previously reported for standard hemodialysis, the total amount of methadone in the spent dialysate after 1 extended dialysis session was quite low. Hence, even extended dialysis with a high cut-off membrane does not seem to offer a clinically relevant benefit in the setting of overdose for enhanced methadone removal. On the other hand, in patients undergoing high cut-off dialysis for the removal of light chains, methadone could still be used as an analgesic without an additional dose after high cut-off hemodialysis.

  8. Calculation of the ELISA’s cut-off based on the change-point analysis method for detection of Trypanosoma cruzi infection in Bolivian dogs in the absence of controls

    PubMed Central

    Lardeux, Frédéric; Torrico, Gino; Aliaga, Claudia

    2016-01-01

    In ELISAs, sera of individuals infected by Trypanosoma cruzi show absorbance values above a cut-off value. The cut-off is generally computed by means of formulas that need absorbance readings of negative (and sometimes positive) controls, which are included in the titer plates amongst the unknown samples. When no controls are available, other techniques should be employed such as change-point analysis. The method was applied to Bolivian dog sera processed by ELISA to diagnose T. cruzi infection. In each titer plate, the change-point analysis estimated a step point which correctly discriminated among known positive and known negative sera, unlike some of the six usual cut-off formulas tested. To analyse the ELISAs results, the change-point method was as good as the usual cut-off formula of the form “mean + 3 standard deviation of negative controls”. Change-point analysis is therefore an efficient alternative method to analyse ELISA absorbance values when no controls are available. PMID:27384081

  9. Optimal cut-off of homeostasis model assessment of insulin resistance (HOMA-IR) for the diagnosis of metabolic syndrome: third national surveillance of risk factors of non-communicable diseases in Iran (SuRFNCD-2007)

    PubMed Central

    2010-01-01

    Aim We have recently determined the optimal cut-off of the homeostatic model assessment of insulin resistance for the diagnosis of insulin resistance (IR) and metabolic syndrome (MetS) in non-diabetic residents of Tehran, the capital of Iran. The aim of the present study is to establish the optimal cut-off at the national level in the Iranian population with and without diabetes. Methods Data of the third National Surveillance of Risk Factors of Non-Communicable Diseases, available for 3,071 adult Iranian individuals aging 25-64 years were analyzed. MetS was defined according to the Adult Treatment Panel III (ATPIII) and International Diabetes Federation (IDF) criteria. HOMA-IR cut-offs from the 50th to the 95th percentile were calculated and sensitivity, specificity, and positive likelihood ratio for MetS diagnosis were determined. The receiver operating characteristic (ROC) curves of HOMA-IR for MetS diagnosis were depicted, and the optimal cut-offs were determined by two different methods: Youden index, and the shortest distance from the top left corner of the curve. Results The area under the curve (AUC) (95%CI) was 0.650 (0.631-0.670) for IDF-defined MetS and 0.683 (0.664-0.703) with the ATPIII definition. The optimal HOMA-IR cut-off for the diagnosis of IDF- and ATPIII-defined MetS in non-diabetic individuals was 1.775 (sensitivity: 57.3%, specificity: 65.3%, with ATPIII; sensitivity: 55.9%, specificity: 64.7%, with IDF). The optimal cut-offs in diabetic individuals were 3.875 (sensitivity: 49.7%, specificity: 69.6%) and 4.325 (sensitivity: 45.4%, specificity: 69.0%) for ATPIII- and IDF-defined MetS, respectively. Conclusion We determined the optimal HOMA-IR cut-off points for the diagnosis of MetS in the Iranian population with and without diabetes. PMID:20374655

  10. Validity of the rheumatoid arthritis impact of disease (RAID) score and definition of cut-off points for disease activity states in a population-based European cohort of patients with rheumatoid arthritis.

    PubMed

    Salaffi, Fausto; Di Carlo, Marco; Vojinovic, Jelena; Tincani, Angela; Sulli, Alberto; Soldano, Stefano; Andreoli, Laura; Dall'Ara, Francesca; Ionescu, Ruxandra; Simić Pašalić, Katarina; Balčune, Ineta; Ferraz-Amaro, Iván; Tlustochowicz, Malgorzata; Butrimienė, Irena; Punceviciene, Egle; Toroptsova, Natalia; Grazio, Simeon; Morović-Vergles, Jadranka; Masaryk, Pavol; Otsa, Kati; Bernardes, Miguel; Boyadzhieva, Vladimira; Cutolo, Maurizio

    2017-05-24

    To assess the validity of the rheumatoid arthritis impact of disease (RAID) for measuring disease activity of rheumatoid arthritis (RA) and to determine cut-off values for defining the disease activity states. A total of 622 RA patients from an European database have been included. Cross-validation was based on assessment of convergent and discriminant validity. Optimal cut-offs were determined against external criteria by calculating the respective 25th and 75th percentiles mean values of RAID. External criteria included definitions for remission (REM), low disease activity (LDA), moderate disease activity (MDA) and high disease activity (HDA), cut-offs of the 28-joint disease activity score-C-reactive protein (DAS28-CRP) score. The RAID showed a moderate degree of correlation with respect to DAS28-CRP (rho=0.417; P<0.0001). The receiver operating characteristic (ROC) curves to discriminate the ability of RAID to distinguish patients with active and non-active disease was very good with an area under the curve (AUC) of 0.847 (95% confidence interval [CI]: 0.816 to 0.878; P<0.0001). Based on the distributions of RAID in the different disease activity groups, we propose the following cut-off values for REM: RAID ≤3; for LDA: RAID >3 and ≤4; for MDA: RAID >4 and ≤6; for HDA: RAID >6. Mean RAID differed significantly between patients classified as REM, LDA, MDA or HDA (P=0.001). The cut-offs revealed good measurement characteristics in cross-validation analysis, had great discriminatory performance in distinguishing patients with different levels of disease activity and are suited for widespread use in everyday practice application and research. Copyright © 2017 Société française de rhumatologie. Published by Elsevier SAS. All rights reserved.

  11. Calculation of cut-off values based on the Autoimmune Bullous Skin Disorder Intensity Score (ABSIS) and Pemphigus Disease Area Index (PDAI) pemphigus scoring systems for defining moderate, significant and extensive types of pemphigus.

    PubMed

    Boulard, C; Duvert Lehembre, S; Picard-Dahan, C; Kern, J S; Zambruno, G; Feliciani, C; Marinovic, B; Vabres, P; Borradori, L; Prost-Squarcioni, C; Labeille, B; Richard, M A; Ingen-Housz-Oro, S; Houivet, E; Werth, V P; Murrell, D F; Hertl, M; Benichou, J; Joly, P

    2016-07-01

    Two pemphigus severity scores, Autoimmune Bullous Skin Disorder Intensity Score (ABSIS) and Pemphigus Disease Area Index (PDAI), have been proposed to provide an objective measure of disease activity. However, the use of these scores in clinical practice is limited by the absence of cut-off values that allow differentiation between moderate, significant and extensive types of pemphigus. To calculate cut-off values defining moderate, significant and extensive pemphigus based on the ABSIS and PDAI scores. In 31 dermatology departments in six countries, consecutive patients with newly diagnosed pemphigus were assessed for pemphigus severity, using ABSIS, PDAI, Physician's Global Assessment (PGA) and Dermatology Life Quality Index (DLQI) scores. Cut-off values defining moderate, significant and extensive subgroups were calculated based on the 25th and 75th percentiles of the ABSIS and PDAI scores. The median ABSIS, PDAI, PGA and DLQI scores of the three severity subgroups were compared in order to validate these subgroups. Ninety-six patients with pemphigus vulgaris (n = 77) or pemphigus foliaceus (n = 19) were included. The median PDAI activity and ABSIS total scores were 27·5 (range 3-84) and 34·8 points (range 0·5-90·5), respectively. The respective cut-off values corresponding to the first and third quartiles of the scores were 15 and 45 for the PDAI, and 17 and 53 for ABSIS. The moderate, significant and extensive subgroups were thus defined, and had distinguishing median ABSIS (P < 0·001), PDAI (P < 0·001), PGA (P < 0·001) and DLQI (P = 0·03) scores. This study suggests cut-off values of 15 and 45 for PDAI and 17 and 53 for ABSIS, to distinguish moderate, significant and extensive pemphigus forms. Identifying these pemphigus activity subgroups should help physicians to classify and manage patients with pemphigus. © 2016 British Association of Dermatologists.

  12. D-dimer use for deep venous thrombosis exclusion in elderly patients: a comparative analysis of three different approaches to establish cut-off values for an assay with results expressed in D-dimer units.

    PubMed

    Cini, M; Legnani, C; Frascaro, M; Sartori, M; Cosmi, B; Palareti, G

    2014-10-01

    The use of adapted cut-off values in the elderly, combined with clinical probability (PTP), increases the proportion of patients in whom venous thromboembolism (VTE) can be safely excluded, compared with the conventional cut-off value of 500 μg/L fibrinogen equivalent units (FEU). We evaluated the clinical performance of three different approaches to establish cut-off values for a D-dimer assay whose results are expressed in D-dimer units (D-DU). HemosIL D-dimer HS assay (Instrumentation Laboratory) was performed in 279 consecutive outpatients with suspected deep venous thrombosis (DVT) and nonhigh PTP. Considering patients >60 years, the number of negative D-dimer results increased using the modified (376 ng/mL if ≥60 years) and the age-adjusted cut-off (age years × 5 ng/mL if >50 years) compared to the conventional one (230 ng/mL for all patients; 54.6%, 58.2%, and 25.0%, respectively), with no false-negative results. The higher increase was observed in patients >80 years (43.9%, 56.1%, and 8.8%, respectively). For the HemosIL D-dimer HS, the use of specific cut-off values in older subjects with suspected DVT and nonhigh PTP increases the number of patients in whom DVT can be safely excluded. © 2014 John Wiley & Sons Ltd.

  13. Determining cut-off values for neck circumference as a measure of the metabolic syndrome amongst a South African cohort: the SABPA study.

    PubMed

    Hoebel, S; Malan, L; de Ridder, J H

    2012-10-01

    The aim was to determine receiver operating characteristic (ROC) neck circumference (NC) cut offs best associated with the metabolic syndrome (MetS) in a South African cohort. We included 409 urban Africans and Caucasians and stratified them into gender and age groups (25-45 years; 45-65 years). Measurements included anthropometric, fasting overnight urine and biological markers for the MetS (systolic and diastolic blood pressure, glucose, triglycerides, and high density lipoprotein). ROC analysis determined pathological (NC) cut-points of 39 and 35 cm for young and older African men; 32 and 35 cm for young and old African women; 40 and 41 cm for Caucasian men; 34 and 33 cm for Caucasian women. Pathological NC cut-points significantly predicted MetS in all ethnic-gender-age groups except in African women (ORs 2.3-5.4; 95% CI 1.36-16.5). Multiple regression analyses revealed that MetS prevalence and ROC cut-points were not associated with renal impairment in any groups. ROC NC cut-points demonstrated that NC may be used as an additional anthropometric marker to predict the MetS in a South African cohort but not in African women.

  14. Epidemiological cut-off value of clinical isolates of Burkholderia pseudomallei from Northern Queensland to meropenem, ceftazidime, trimethoprim/sulfamethoxazole and doxycycline by the microbroth dilution method.

    PubMed

    Maloney, Samuel; Engler, Cathy; Norton, Robert

    2017-09-01

    Melioidosis is caused by the bacterium Burkholderia pseudomallei. The most common antibiotics used to treat melioidosis in Australia are meropenem, ceftazidime, trimethoprim/sulfamethoxazole (SXT) and doxycycline. The European Committee on Antimicrobial Susceptibility Testing (EUCAST) and Clinical and Laboratory Standards Institute (CLSI) do not provide standards for assessing the susceptibility of B. pseudomallei for these agents. The International Standards Organisation (ISO) microbroth dilution method is accepted both by the CLSI and EUCAST as the gold standard of antimicrobial susceptibility testing. Many previous studies of the susceptibility of B. pseudomallei used Etest or disk diffusion and presented the results as aggregate data. Etest and disk diffusion methods have not been standardised for B. pseudomallei and aggregate data cannot be used to determine an epidemiological cut-off value (ECOFF). An ECOFF is vital for the setting of clinical breakpoints. In this study, minimum inhibitory concentrations (MICs) of meropenem, ceftazidime, SXT and doxycycline were assessed by microbroth dilution for a library of 234 well characterised clinical isolates of B. pseudomallei from Northern Queensland, Australia. The resultant histograms and aggregate data represent the first MIC profile of a large library of B. pseudomallei that has been successfully produced using microbroth dilution. The MIC profiles can be used to contribute towards a determination of an ECOFF for this species for these agents, which will aid in the setting and refining of clinical breakpoints for the most important antimicrobials used to treat melioidosis. Copyright © 2017. Published by Elsevier Ltd.

  15. Evaluation of epidemiological cut-off values indicates that biocide resistant subpopulations are uncommon in natural isolates of clinically-relevant microorganisms.

    PubMed

    Morrissey, Ian; Oggioni, Marco Rinaldo; Knight, Daniel; Curiao, Tania; Coque, Teresa; Kalkanci, Ayse; Martinez, Jose Luis

    2014-01-01

    To date there are no clear criteria to determine whether a microbe is susceptible to biocides or not. As a starting point for distinguishing between wild-type and resistant organisms, we set out to determine the minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) distributions for four common biocides; triclosan, benzalkonium chloride, chlorhexidine and sodium hypochlorite for 3319 clinical isolates, with a particular focus on Staphylococcus aureus (N = 1635) and Salmonella spp. (N = 901) but also including Escherichia coli (N = 368), Candida albicans (N = 200), Klebsiella pneumoniae (N = 60), Enterobacter spp. (N = 54), Enterococcus faecium (N = 53), and Enterococcus faecalis (N = 56). From these data epidemiological cut-off values (ECOFFs) are proposed. As would be expected, MBCs were higher than MICs for all biocides. In most cases both values followed a normal distribution. Bimodal distributions, indicating the existence of biocide resistant subpopulations were observed for Enterobacter chlorhexidine susceptibility (both MICs and MBCs) and the susceptibility to triclosan of Enterobacter (MBC), E. coli (MBC and MIC) and S. aureus (MBC and MIC). There is a concern on the potential selection of antibiotic resistance by biocides. Our results indicate however that resistance to biocides and, hence any potential association with antibiotic resistance, is uncommon in natural populations of clinically relevant microorganisms.

  16. Determination of cut-off cycle threshold values in routine RT-PCR assays to assist differential diagnosis of norovirus in children hospitalized for acute gastroenteritis.

    PubMed

    Trang, N V; Choisy, M; Nakagomi, T; Chinh, N T M; Doan, Y H; Yamashiro, T; Bryant, J E; Nakagomi, O; Anh, D D

    2015-11-01

    Norovirus (NV) is an important cause of acute gastroenteritis in children, but is also frequently detected in asymptomatic children, which complicates the interpretation of NV detection results in both the clinical setting and population prevalence studies. A total of 807 faecal samples from children aged <5 years hospitalized for acute gastroenteritis were collected in Thai Binh, Vietnam, from January 2011 to September 2012. Real-time RT-PCR was used to detect and quantify NV-RNA in clinical samples. A bimodal distribution of cycle threshold (Ct) values was observed in which the lower peak was assumed to represent cases for which NV was the causal agent of diarrhoea, whereas the higher peak was assumed to represent cases involving an alternative pathogen other than NV. Under these assumptions, we applied finite-mixture modelling to estimate a threshold of Ct <21·36 (95% confidence interval 20·29-22·46) to distinguish NV-positive patients for which NV was the likely cause of diarrhoea. We evaluated the validity of the threshold through comparisons with NV antigen ELISA results, and comparisons of Ct values in patients co-infected with rotavirus. We conclude that the use of an appropriate cut-off value in the interpretation of NV real-time RT-PCR results may improve differential diagnosis of enteric infections, and could contribute to improved estimates of the burden of NV disease.

  17. A cut-off in ocular chemesthesis from vapors of homologous alkylbenzenes and 2-ketones as revealed by concentration-detection functions

    SciTech Connect

    Cometto-Muniz, J. Enrique Abraham, Michael H.

    2008-08-01

    Studies of homologous series of environmental vapors have shown that their chemesthetic (i.e., sensory irritation) potency increases with carbon chain length (that is, their detection thresholds decrease) until they reach a homolog that fails to be detected, even at vapor saturation. All ensuing homologs cannot be detected either. In this investigation, we measured concentration-detection (i.e., psychometric) functions for ocular chemesthesis from homologous alkylbenzenes (pentyl, hexyl, and heptyl benzene) and 2-ketones (undecanone, dodecanone, and tridecanone). Using a three-alternative forced-choice procedure against air blanks, we tested a total of 18 to 24 subjects, about half of them females, average age 31 years, ranging from 18 to 56 years. Stimuli were generated and presented by a computer-controlled, vapor delivery device whose output was quantified by gas chromatography. Exposure time was 6 s and delivery flow 2.5 L/min. Within the context of present and previous findings, the outcome indicated that the functions for heptylbenzene and 2-tridecanone reached a plateau where further increases in concentration did not enhance detection. We conclude that: a) a cut-off point in ocular chemesthetic detection is reached along homologous alkylbenzenes and 2-ketones at the level of heptylbenzene and 2-tridecanone, respectively, and b) the observed effect rests on the homologs exceeding a critical molecular size (or dimension) rather than on them failing to achieve a high enough vapor concentration.

  18. The Influence of the Changing Geomagnetic Field on Cosmic Ray Measurements

    DTIC Science & Technology

    1990-01-01

    spectrum a station in the equatorial regions is required. Unfortunately the station with the longest history of operation is located in Huancayo , Peru...the Huancayo neutron monitor prior to any correction for the decrease in the geomagnetic field over the 35-year period. A decreasing cutoff rigidity...at Huancayo (COOPIER and SIMPSON, 1979). Efforts are now underway to correct these cosmic ray intensity values for the changes in the geomagnetic

  19. Introduction to Geomagnetic Fields

    NASA Astrophysics Data System (ADS)

    Hinze, William J.

    Coincidentally, as I sat down in late October 2003 to read and review the second edition of Wallace H. Campbell's text, Introduction to Geomagnetic Fields, we received warnings from the news media of a massive solar flare and its possible effect on power supply systems and satellite communications. News programs briefly explained the source of Sun-Earth interactions. If you are interested in learning more about the physics of the connection between sun spots and power supply systems and their impact on orbiting satellites, I urge you to become acquainted with Campbell's book. It presents an interesting and informative explanation of the geomagnetic field and its applications to a wide variety of topics, including oil exploration, climate change, and fraudulent claims of the utility of magnetic fields for alleviating human pain. Geomagnetism, the study of the nature and processes of the Earth's magnetic fields and its application to the investigation of the Earth, its processes, and history, is a mature science with a well-developed theoretical foundation and a vast array of observations. It is discussed in varied detail in Earth physics books and most entry-level geoscience texts. The latter treatments largely are driven by the need to discuss paleomagnetism as an essential tool in studying plate tectonics. A more thorough explanation of geomagnetism is needed by many interested scientists in related fields and by laypersons. This is the objective of Campbell's book. It is particularly germane in view of a broad range of geomagnetic topics that are at the forefront of today's science, including environmental magnetism, so-called ``jerks'' observed in the Earth's magnetic field, the perplexing magnetic field of Mars, improved satellite magnetic field observations, and the increasing availability of high-quality continental magnetic anomaly maps, to name only a few.

  20. Specific cut-off points for waist circumference and waist-to-height ratio as predictors of cardiometabolic risk in Black subjects: a cross-sectional study in Benin and Haiti.

    PubMed

    El Mabchour, Asma; Delisle, Hélène; Vilgrain, Colette; Larco, Philippe; Sodjinou, Roger; Batal, Malek

    2015-01-01

    Waist circumference (WC) and waist-to-height ratio (WHtR) are widely used as indicators of abdominal adiposity and the cut-off values have been validated primarily in Caucasians. In this study we identified the WC and WHtR cut-off points that best predicted cardiometabolic risk (CMR) in groups of African (Benin) and African ancestry (Haiti) Black subjects. This cross-sectional study included 452 apparently healthy subjects from Cotonou (Benin) and Port-au-Prince (Haiti), 217 women and 235 men from 25 to 60 years. CMR biomarkers were the metabolic syndrome components. Additional CMR biomarkers were a high atherogenicity index (total serum cholesterol/high density lipoprotein cholesterol ≥4 in women and ≥5 in men); insulin resistance set at the 75th percentile of the calculated Homeostasis Model Assessment index (HOMA-IR); and inflammation defined as high-sensitivity C-reactive protein (hsCRP) concentrations between 3 and 10 mg/L. WC and WHtR were tested as predictors of two out of the three most prevalent CMR biomarkers. Receiver operating characteristic (ROC) curves, Youden's index, and likelihood ratios were used to assess the performance of specific WC and WHtR cut-offs. High atherogenicity index (59.5%), high blood pressure (23.2%), and insulin resistance (25% by definition) were the most prevalent CMR biomarkers in the study groups. WC and WHtR were equally valid as predictors of CMR. Optimal WC cut-offs were 80 cm and 94 cm in men and women, respectively, which is exactly the reverse of the generic cut-offs. The standard 0.50 cut-off of WHtR appeared valid for men, but it had to be increased to 0.59 in women. CMR was widespread in these population groups. The present study suggests that in order to identify Africans with high CMR, WC thresholds will have to be increased in women and lowered in men. Data on larger samples are needed.

  1. Comparing the Cervista HPV HR Test and Hybrid Capture 2 Assay in a Dutch Screening Population: Improved Specificity of the Cervista HPV HR Test by Changing the Cut-Off

    PubMed Central

    Boers, Aniek; Slagter-Menkema, Lorian; van Hemel, Bettien M.; Belinson, Jerome L.; Ruitenbeek, Teus; Buikema, Henk J.; Klip, Harry; Ghyssaert, Hilde; van der Zee, Ate G. J.; de Bock, Geertruida H.; Wisman, G. Bea A.; Schuuring, Ed

    2014-01-01

    The diagnostic performance of the widely-used Cervista HPV HR test was compared to the Hybrid Capture 2 (HC2) test in a Dutch population-based cervical cancer screening program. In 900 scrapings of women with normal cytomorphology, specificity was 90% (95%CI: 87.84–91.87) for the Cervista HPV HR test and 96% (95%CI: 94.76–97.37) for the HC2 test with 93% agreement between both tests (κ = 0.5, p<0.001). The sensitivity for CIN2+ using 65 scrapings of women with histological-confirmed CIN2+ was 91% (95%CI: 80.97–96.51) for the Cervista HPV HR test and 92% (95%CI: 82.94–97.43) for the HC2 test with 95% agreement between both tests (κ = 0.7, p<0.001). Fifty-seven of 60 HC2 negative/Cervista positive cases tested HPV-negative with PCR-based HPV assays; of these cases 56% were defined as Cervista triple-positive with FOZ values in all 3 mixes higher than the second cut-off of 1.93 (as set by manufacturer). By setting this cut-off at 5.0, specificity improved significantly without affecting sensitivity. External validation of this new cut-off at 5.0 in triple-positive scrapings of women selected from the SHENCCASTII database revealed that 22/24 histological normal cases now tested HPV-negative in the Cervista HPV HR test, while CIN2+ lesions remained HPV-positive. The intra-laboratory reproducibility of the Cervista HPV HR test (n = 510) showed a concordance of 92% and 93% for cut-off 1.93 and 5.0 (κ = 0.83 and κ = 0.84, p<0.001) and inter-laboratory agreement of the Cervista HPV HR test was 90% and 93% for cut-off 1.93 and 5.0 (κ = 0.80 and κ = 0.85, p<0.001). In conclusion, the specificity of the Cervista HPV HR test could be improved significantly by increasing the second cut-off from 1.93 to 5.0, without affecting the sensitivity of the test in a population-based screening setting. PMID:25051098

  2. Specific cut-off points for waist circumference and waist-to-height ratio as predictors of cardiometabolic risk in Black subjects: a cross-sectional study in Benin and Haiti

    PubMed Central

    EL Mabchour, Asma; Delisle, Hélène; Vilgrain, Colette; Larco, Philippe; Sodjinou, Roger; Batal, Malek

    2015-01-01

    Purpose Waist circumference (WC) and waist-to-height ratio (WHtR) are widely used as indicators of abdominal adiposity and the cut-off values have been validated primarily in Caucasians. In this study we identified the WC and WHtR cut-off points that best predicted cardiometabolic risk (CMR) in groups of African (Benin) and African ancestry (Haiti) Black subjects. Methods This cross-sectional study included 452 apparently healthy subjects from Cotonou (Benin) and Port-au-Prince (Haiti), 217 women and 235 men from 25 to 60 years. CMR biomarkers were the metabolic syndrome components. Additional CMR biomarkers were a high atherogenicity index (total serum cholesterol/high density lipoprotein cholesterol ≥4 in women and ≥5 in men); insulin resistance set at the 75th percentile of the calculated Homeostasis Model Assessment index (HOMA-IR); and inflammation defined as high-sensitivity C-reactive protein (hsCRP) concentrations between 3 and 10 mg/L. WC and WHtR were tested as predictors of two out of the three most prevalent CMR biomarkers. Receiver operating characteristic (ROC) curves, Youden’s index, and likelihood ratios were used to assess the performance of specific WC and WHtR cut-offs. Results High atherogenicity index (59.5%), high blood pressure (23.2%), and insulin resistance (25% by definition) were the most prevalent CMR biomarkers in the study groups. WC and WHtR were equally valid as predictors of CMR. Optimal WC cut-offs were 80 cm and 94 cm in men and women, respectively, which is exactly the reverse of the generic cut-offs. The standard 0.50 cut-off of WHtR appeared valid for men, but it had to be increased to 0.59 in women. Conclusion CMR was widespread in these population groups. The present study suggests that in order to identify Africans with high CMR, WC thresholds will have to be increased in women and lowered in men. Data on larger samples are needed. PMID:26604808

  3. [Establishment of a cut-off value for the diagnosis of acute myocardial infarction using a new CK-MB activity measurement reagent containing anti-MtCK antibody].

    PubMed

    Murakami, Mariko; Kodama, Mayumi; Yoshida, Risa; Asada, Takashi; Sano, Takahiro; Sano, Michitaka; Kamakura, Shiro; Nonogi, Hiroshi

    2011-07-01

    CK-MB is an important marker for the diagnosis of acute myocardial infarction (AMI). Since mitochondrial CK (MtCK) is universally present in the blood of healthy individuals, it is known to positively affect the measurement of CK-MB using the immunoinhibition method, causing false-positive results. We performed basic evaluation of ACCURAS AUTO CK-MB MtO, a new reagent containing anti-MtCK antibody that inhibits MtCK activity, and attempted to calculate a cut-off CK-MB level to diagnose AMI. The measurement was performed in samples submitted to the Clinical Laboratory of our center for the measurement of CK-MB. This method was confirmed to have satisfactory basic attributes concerning the reproducibility, linearity, lower detection limit, and effects of interfering substances. When 2886 samples were examined using this and conventional methods, the results of the two methods were correlated in some but not in others. In the samples that showed no correlation, MtCK was demonstrated by isozyme analysis using electrophoresis. The AUC calculated from the ROC curve in AMI patients was 0.912 with this method and 0.861 with the conventional method. The sensitivity and specificity of the new method were higher than those of the conventional method. The cut-off value determined by ROC analysis was 7.7 U/l using the new method and 13.6 U/l using the conventional method, causing an increase in false-positive results compared with the cut off value of 25 U/l widely used for the conventional method to date. However, the cut-off value for the new method that yielded a specificity comparable to 99.1%, which is the specificity of the conventional method using a cut-off value of 25 U/l, was 12 U/l. With a cut-off value of 12 U/l, the sensitivity was improved compared with that employing the conventional method, and both the sensitivity and specificity became comparable to those of the CK-MB mass method. This method is very useful for the accurate measurement of CK-MB activity.

  4. Cut off from supplies - sulfate exhaustion and implications for methane emissions in a brackish rewetted peatland after separation from the coast

    NASA Astrophysics Data System (ADS)

    Koebsch, Franziska; Liu, Bo; Schmiedinger, Iris; Spitzy, Alejandro; Köhler, Stefan; Koch, Marian; Jurasinski, Gerald; Gehre, Matthias; Sachs, Torsten; Böttcher, Michael

    2016-04-01

    Coastal ecosystems are at the interface between marine and freshwater and exhibit a special geochemistry. We investigate the S and C geochemistry of a coastal, degraded fen peatland. The site has been cut off from the Baltic Sea since 1995 and was rewetted with freshwater from the surrounding catchment in 2010. Despite of locally high pore water sulfate (SO42-) concentrations, the fen turned into a strong source for methane (CH4) with annual budgets up to 0.26±0.06 kg m-2 (Hahn et al. 2015). To reconcile this apparent contradiction we use concentration patterns and stable isotope signatures of water, SO42-, pyrite, dissolved carbon, and CH4 (δ2H, δ13C, δ18O, δ34S) along a transect with increasing distance to the Baltic coastline (300-1500 m). The current peatland geochemistry is characterized by a combination of relict signals reflecting former brackish water intrusion events and indicators of recent human activities such as internal eutrophication and increasing freshwater contribution. The shallow peat layer (depth mostly ≤ 55 cm) exhibited a pronounced vertical gradient with a freshwater-front lying on top of the brackish water layer. S geochemistry was decoupled from present brackish water distribution as marine SO42- was almost completely biotically reduced and converted to pyrite. The remaining pore water SO42- pool was remarkably 34S-enriched in relation to Baltic Sea SO42- (up to +86.4 and +21‰, respectively) and also δ34S-values of pyrite were comparatively high (+4.8‰), thereby demonstrating a distinct reservoir effect under closed-system conditions. However, one of the profiles situated 1150 m from the Baltic Sea coast line exhibited a contrasting S pattern with pronounced excess of isotopically lighter SO42- at depth (up to 32.8 mM and +22.7‰). We hypothesize, that local groundwater seeps might provide electron acceptors such as NO3- for the contemporary oxidation of pyrite. δ13C in DIC exhibited a pronounced vertical shift from -23.9

  5. A climatological study of the associated weather events to Cut-off low systems in the Southwestern Europe and Northern Africa

    NASA Astrophysics Data System (ADS)

    Nieto, R.; Gimeno, L.; de La Torre, L.; Tesouro, M.; Añel, J.; Ribera, P.

    2003-04-01

    Cut-off low-pressure systems-COLS- are usually closed circulations at middle and upper troposphere developed from a deep trough in the westerlies. As general rule troposphere below COLs is unstable and convective severe events can occur as a function of the surface conditions. COLs can bring moderate to heavy rainfall over large areas. In particular they are among the most important weather systems that affect Southern Europe and Northern Africa and responsible for some of the most catastrophic weather events in terms of precipitation rate. In this study we identify COLs systems in Southwestern Europe and Northern Africa for a 41-year period (1958 to 1998) using an approach based in imposing the three main physical characteristics of the conceptual model of COL (a. closed circulation and minimum of geopotential, minimum of equivalent thickness, and two two baroclinic zones, one in front of the low and the other behind the low). Data from NCAR-NCEP reanalysis were used. The objective was to check the expected weather events according to the conceptual model of COL in an area where precipitation due to COL is relevant. In general terms results confirm expected weather events: a frontal cloud band on the leading edge of an upper level low that is usually thick enough to produce precipitation. Over cold surface there is no convection, and therefore no showers occur. Over Sea, moderate to heavy showery precipitation is frequent. The heaviest precipitation occur when convective cells are observed in the centre and over warm ocean, fall flash flood is frequent.

  6. Cognitive impairment in hemodialysis patients: Implementation of cut-off values for the Montreal Cognitive Assessment (MoCA)-test for feasible screening.

    PubMed

    Angermann, Susanne; Baumann, Marcus; Steubl, Dominik; Lorenz, Georg; Hauser, Christine; Suttmann, Yana; Reichelt, Anna-Lena; Satanovskij, Robin; Sonntag, Franziska; Heemann, Uwe; Grimmer, Timo; Schmaderer, Christoph

    2017-01-01

    Reliable identification of cognitive impairment in hemodialysis patients is of utmost importance, as it is associated with poor outcomes including dialysis withdrawal and death. High prevalence of cognitive impairment has been demonstrated in several studies using brief screening instruments or neuropsychological test batteries. However, the relevance of cognitive impairment as well as the accuracy of screening procedures have never been studied in this patient population. 151 chronic hemodialysis patients (mean age 65.78 ± 14.88 years, 73,5% male) underwent cognitive testing under standardized conditions by the Montreal Cognitive Assessment (MoCA) and, in a second step, the Clinical Dementia Rating scale (CDR), an international standard to measure the severity of dementia. For calculating MoCA cut-off values on the basis of the CDR global score, receiver operator characteristics (ROC) analysis and c-statistic were applied. 49.0% of patients were categorized as 0.5 in the CDR global with memory being the predominantly affected domain (47.7% of patients scored ≥ 0.5). Youden's Index led to a threshold of 23.5 points for the MoCA test for optimal differentiation between cognitively normal (CDR global < 0.5) and impaired patients (CDR global ≥ 0.5) based on a sensitivity of approximately 99% and a specificity of approximately 74%. Interference of cognitive impairment with patients' independence and daily life was shown using the CDR for the first time in hemodialysis patients. A MoCA score of 23.5 points turned out as optimal threshold to differentiate between patients with and without functional impairment in the CDR, thereby paving the way for implementation of the MoCA test as a quick and thus highly feasible screening instrument for periodic testing in clinical routine.

  7. The Significance of Body Mass Index in Calculating the Cut-Off Points for Low Muscle Mass in the Elderly: Methodological Issues

    PubMed Central

    Dworak, Lechoslaw B.

    2014-01-01

    Objectives. Cut-off points (COPs) for appendicular lean mass (ALM) index, essential to define low muscle mass (LMM) in the elderly, have never been officially defined for Poland. The aim of the study was to establish them. Additionally, the significance of body mass index (BMI) for correctly defining the COPs in a young, healthy reference group was assessed. Methods. The study was composed of reference group (n = 1113) and the elderly group (n = 200). In all subjects, body composition was assessed by bioimpedance analysis, and ALM index was calculated. Next, COPs (kg/m2) were set up for the whole reference group and for particular subgroups with different BMIs separately. They were used to diagnose sarcopenia in the elderly. Results. COP for all young females was 5.37 (COP-F), while it was equal to 5.52 (COP-F2) when only those with a recommended BMI (18.50–24.99 kg/m2) were taken into consideration. For males, it was 7.32 and 7.29, respectively. Only 7% of elderly females had LMM based on COP-F and 15% had LMM based on COP-F2 (P < 0.05); for males, the percentages were 18% and 16%, respectively. Conclusions. COPs for LMM for Poland are 5.52 kg/m2 (females) and 7.29 kg/m2 (males). The reference group BMI is an important factor in establishing COPs for low muscle mass. PMID:25506592

  8. Burst of reactive oxygen species in pedicel-mediated fruit abscission after carbohydrate supply was cut off in longan (Dimocarpus longan)

    PubMed Central

    Yang, Ziqin; Zhong, Xiumei; Fan, Yan; Wang, Huicong; Li, Jianguo; Huang, Xuming

    2015-01-01

    Cutting off carbohydrate supply to longan (Dimocarpus longan Lour.) fruit by girdling and defoliation or by detachment induced 100% abscission within a few days. We used these treatments to study the involvement of reactive oxygen species (ROS) in fruit abscission. Girdling plus defoliation decreased sugar concentrations in the fruit and pedicel and depleted starch grains in the chloroplasts in the cells of abscission zone. Prior to the occurrence of intensive fruit abscission, there was a burst in ROS in the pedicel, which peaked at 1 day after treatment (DAT), when H2O2 in the abscission zone was found to be chiefly located along the plasma membrane (PM). H2O2 was found exclusively in the cell walls 2 DAT, almost disappeared 3 DAT, and reappeared in the mitochondria and cell walls 4 DAT. Signs of cell death such as cytoplasm breakdown were apparent from 3 DAT. The burst of ROS coincided with a sharp increase in the activity of PM-bound NADPH oxidase in the pedicel. At the same time, activities of antioxidant enzymes including superoxide dismutase (SOD), catalase, and peroxidase (POD) were all increased by the treatment and maintained higher than those in the control. Accompanying the reduction in H2O2 abundance, there was a sharp decrease in PM-bound NADPH oxidase activity after 1 DAT in the treated fruit. H2O2 scavenger dimethylthiourea (DMTU, 1 g L–1) significantly inhibited fruit abscission in detached fruit clusters and suppressed the increase in cellulase activity in the abscission zone. These results suggest that fruit abscission induced by carbohydrate stress is mediated by ROS. Roles of ROS in regulating fruit abscission were discussed in relation to its subcellular distribution. PMID:26074931

  9. The impact of cut-off lows on ozone in the upper troposphere and lower stratosphere over Changchun from ozonesonde observations

    NASA Astrophysics Data System (ADS)

    Song, Yushan; Lü, Daren; Li, Qian; Bian, Jianchun; Wu, Xue; Li, Dan

    2016-02-01

    In situ measurements of the vertical structure of ozone were made in Changchun (43.53°N, 125.13°E), China, by the Institute of Atmosphere Physics, in the summers of 2010-13. Analysis of the 89 validated ozone profiles shows the variation of ozone concentration in the upper troposphere and lower stratosphere (UTLS) caused by cut-off lows (COLs) over Changchun. During the COL events, an increase of the ozone concentration and a lower height of the tropopause are observed. Backward simulations with a trajectory model show that the ozone-rich airmass brought by the COL is from Siberia. A case study proves that stratosphere-troposphere exchange (STE) occurs in the COL. The ozone-rich air mass transported from the stratosphere to the troposphere first becomes unstable, then loses its high ozone concentration. This process usually happens during the decay stage of COLs. In order to understand the influence of COLs on the ozone in the UTLS, statistical analysis of the ozone profiles within COLs, and other profiles, are employed. The results indicate that the ozone concentrations of the in-COL profiles are significantly higher than those of the other profiles between ±4 km around the tropopause. The COLs induce an increase in UTLS column ozone by 32% on average. Meanwhile, the COLs depress the lapse-rate tropopause (LRT)/dynamical tropopause height by 1.4/1.7 km and cause the atmosphere above the tropopause to be less stable. The influence of COLs is durable because the increased ozone concentration lasts at least one day after the COL has passed over Changchun. Furthermore, the relative coefficient between LRT height and lower stratosphere (LS) column ozone is -0.62, which implies a positive correlation between COL strength and LS ozone concentration.

  10. Foundations of Geomagnetism

    NASA Astrophysics Data System (ADS)

    Jackson, Andy

    The study of the magnetic field of the Earth, or geomagnetism, is one of the oldest lines of scientific enquiry. Indeed, it has often been said that William Gilbert's De Magnete, published in 1600 and predating Isaac Newton's Principia by 87 years, can claim to be the first true scientific textbook; his study was essentially the first of academic rather than practical interest.What then, we may ask, has been accomplished in the nearly 400 intervening years up to the publication of Foundations of Geomagnetism? In short, a wealth of observational evidence, considerable physical understanding, and a great deal of mathematical apparatus have accrued, placing the subject on a much surer footing.The latter two categories are described in considerable detail, and with attendant rigor, in this book. The sphericity of the Earth means that a frequent theme in the book is the solution of the partial differential equations of electrodynamics in a spherical geometry.

  11. On regional geomagnetic charts

    USGS Publications Warehouse

    Alldredge, L.R.

    1987-01-01

    When regional geomagnetic charts for areas roughly the size of the US were compiled by hand, some large local anomalies were displayed in the isomagnetic lines. Since the late 1960s, when the compilation of charts using computers and mathematical models was started, most of the details available in the hand drawn regional charts have been lost. One exception to this is the Canadian magnetic declination chart for 1980. This chart was constructed using a 180 degrees spherical harmonic model. -from Author

  12. Application of the fracture risk assessment tool (FRAX(®)) and determination of suitable cut-off values during primary screening in specific health check-ups in Japan.

    PubMed

    Nakatoh, Shinichi; Takemaru, Yuki

    2013-11-01

    Specific health check-ups, which do not include osteoporosis screening, are conducted more frequently than periodic osteoporosis screening in Japan. In this study, we investigated the usefulness of the fracture risk assessment tool (FRAX(®)) during specific health check-ups, evaluated the variations in its usefulness for 2 consecutive years, and determined FRAX(®) cut-off values for osteoporosis screening. FRAX(®) questionnaires were distributed to subjects who underwent specific health check-ups in 2009 and 2010 at Asahi-machi. Subjects who exhibited FRAX(®) cut-off values of ≥10 % were advised to be screened at a medical institution. Bone mineral densities (BMDs) were measured in 201 subjects in 2009 and 105 subjects in 2010 after specific health check-ups, and treatment was initiated for 79 subjects in 2009 and 24 subjects in 2010. The number of subjects examined and the rate of treatment initiation following specific health check-ups were higher than those in subjects following periodic osteoporosis screening in 2009. However, the number and the rate following specific health check-ups dropped in 2010. According to receiver operating characteristic curves analyses, the sensitivity and specificity of FRAX(®) to determine osteoporosis treatment were highest when the cut-off values were 8 % for men and 10.5 % for women. In conclusion, the combination of FRAX(®) and specific health check-ups was more useful than periodic osteoporosis screening to narrow down the subjects and to motivate them to seek follow-up. Cut-off values for specific health check-up using FRAX(®) should be approximately 8 % for men and 10.5 % for women.

  13. Heart-type fatty acid binding protein (H-FABP) in patients in an emergency department setting, suspected of acute coronary syndrome: optimal cut-off point, diagnostic value and future opportunities in primary care.

    PubMed

    Willemsen, Robert T A; van Severen, Evie; Vandervoort, Pieter M; Grieten, Lars; Buntinx, Frank; Glatz, Jan F C; Dinant, Geert Jan

    2015-01-01

    Most patients presenting chest complaints in primary care are referred to secondary care facilities, whereas only a few are diagnosed with acute coronary syndrome (ACS). The aim is to determine the optimal cut-off value for a point-of-care heart-type fatty acid binding protein (H-FABP) test in patients presenting to the emergency department and to evaluate a possible future role of H-FABP in safely ruling out ACS in primary care. Serial plasma H-FABP (index test) and high sensitivity troponin T (hs-cTnT) (reference test) were determined in patients with any new-onset chest complaint. In a receiver operating characteristic (ROC) curve, the optimal cut-off value of H-FABP for ACS was determined. Predictive values of H-FABP for ACS were calculated. For 202 consecutive patients (prevalence ACS 59%), the ROC curve based on the results of the first H-FABP was equal to the ROC curve of hs-cTnT (AUC 0.79 versus 0.80). Using a cut-off value of 4.0 ng/ml for H-FABP, sensitivity for ACS of the H-FABP (hs-cTnT) tests was 73.9% (70.6%). Negative predictive value (NPV) of H-FABP for ACS in a population representative for primary care (incidence of ACS 22%) thus could reach 90.8%. In patients presenting chest pain, plasma H-FABP reaches the highest diagnostic value when a cut-off value of 4 ng/ml is used. Diagnostic values of an algorithm combining point-of-care H-FABP measurement and a score of signs and symptoms should be studied in primary care, to learn if such an algorithm could safely reduce referral rate by GPs.

  14. [Selective cervical dorsal root cutting off part of the vertebral lateral mass fixation combined with exercise therapy for treating spastic cerebral paralysis of the upper limbs caused by cerebral palsy].

    PubMed

    Zhang, Peng; Hu, Wei; Cao, Xu; Xu, Shi-gang; Li, De-kui; Xu, Lin

    2009-10-01

    To explore the feasibility and the result for the surgical treatment of spastic cerebral paralysis of the upper limbs in patients who underwent the selective cervical dorsal root cutting off part of the vertebral lateral mass fixation combined with exercise therapy. From March 2004 to April 2008, 27 patients included 19 boys and 8 girls, aging 13-21 years with an average of 15 years underwent selective cervical dorsal root cutting off part of the vertebral lateral mass fixation with exercise therapy. The AXIS 8 holes titanium plate was inserted into the lateral mass of spinous process through guidance of the nerve stimulator, choosed fasciculus of low-threshold nerve dorsal root and cut off its 1.5 cm. After two weeks, training exercise therapy was done in patients. Training will include lying position, turning body, sitting position, crawling, kneeling and standing position, walking and so on. Spastic Bobath inhibiting abnormal pattern was done in the whole process of training. The muscular tension, motor function (GMFM), functional independence (WeeFIM) were observed after treatment. All patients were followed up from 4 to 16 months with an average of 6 months. Muscular tension score were respectively 3.30 +/- 0.47 and 1.25 +/- 0.44 before and after treatment;GMFM score were respectively 107.82 +/- 55.17 and 131.28 +/- 46.45; WeeFIM score were respectively 57.61 +/- 25.51 and 87.91 +/- 22.39. There was significant improvement before and after treatment (P < 0.01). Selective cervical dorsal root cutting off part of the vertebral lateral mass fixation combined with exercise therapy was used to treat spastic cerebral paralysis of the upper limbs is safe and effective method, which can decrease muscular tension and improve motor function, which deserves more wide use.

  15. On extreme geomagnetic storms

    NASA Astrophysics Data System (ADS)

    Cid, Consuelo; Palacios, Judith; Saiz, Elena; Guerrero, Antonio; Cerrato, Yolanda

    2014-10-01

    Extreme geomagnetic storms are considered as one of the major natural hazards for technology-dependent society. Geomagnetic field disturbances can disrupt the operation of critical infrastructures relying on space-based assets, and can also result in terrestrial effects, such as the Quebec electrical disruption in 1989. Forecasting potential hazards is a matter of high priority, but considering large flares as the only criterion for early-warning systems has demonstrated to release a large amount of false alarms and misses. Moreover, the quantification of the severity of the geomagnetic disturbance at the terrestrial surface using indices as Dst cannot be considered as the best approach to give account of the damage in utilities. High temporal resolution local indices come out as a possible solution to this issue, as disturbances recorded at the terrestrial surface differ largely both in latitude and longitude. The recovery phase of extreme storms presents also some peculiar features which make it different from other less intense storms. This paper goes through all these issues related to extreme storms by analysing a few events, highlighting the March 1989 storm, related to the Quebec blackout, and the October 2003 event, when several transformers burnt out in South Africa.

  16. Improved cycle stability of high-capacity Ni-rich LiNi0.8Mn0.1Co0.1O2 at high cut-off voltage by Li2SiO3 coating

    NASA Astrophysics Data System (ADS)

    Zhao, Enyue; Chen, Minmin; Hu, Zhongbo; Chen, Dongfeng; Yang, Limei; Xiao, Xiaoling

    2017-03-01

    A high cut-off voltage is pretty pivotal for the improvement of the energy density of cathode materials. Unfortunately, high-capacity Ni-rich cathode materials usually show serious capacity attenuation at high cut-off voltage. Herein, we propose a Li2SiO3-surface modification strategy to highly improve the cycle performance of the Ni-rich LiNi0.8Mn0.1Co0.1O2 material at high voltage. The capacity retention of the pristine and Li2SiO3-coated electrodes is 57.6 and 77.7%, respectively, at the cut-off voltage of 4.6 V after 50 cycles. Meanwhile, the problems of polarization and voltage reduction of LiNi0.8Mn0.1Co0.1O2 are also alleviated. Our results show that Li2SiO3-surface modification is a very effective strategy for improving the cycle stability of Ni-rich cathode materials and can be used for other high capacity electrode materials.

  17. Reference centile curves for triceps skinfold thickness for Indian children aged 5 to 17 years and cut offs for predicting risk of childhood hypertension: a multi-centric study.

    PubMed

    Khadilkar, Anuradha; Mandlik, Rubina; Chiplonkar, Shashi; Khadilkar, Vaman; Ekbote, Veena; Patwardhan, Vivek

    2015-08-01

    To create age and gender specific Triceps Skinfold Thickness percentile curves for Indian children; and to determine cut-offs for predicting the risk of childhood hypertension. Cross-sectional. Multicentric, school-based, 5 major Indian cities. 13375 children (7590 boys) aged 5-17 years. Data on height, weight, blood pressure, triceps skinfold thickness (using Harpenden Skinfold caliper) were collected. Reference triceps skinfold thickness percentile curves were derived for boys and girls by LMS (lambda-mu-sigma) method. Receiver operating curve analyses were performed to determine the optimal cut-off of triceps skinfold thickness centile for predicting the risk of hypertension. Percentile curves for boys plateau around 13 years whereas for girls the curves increase steadily till the age of 17 years. Median triceps skinfold thickness increased by 7% to 9% till the age of 9 years in boys and girls. After 12 years, median triceps skinfold thickness decreased by 1% to 2% in boys but increased by 3% to 4% in girls. The optimal cut-off percentile yielding maximal sensitivity (68%) and specificity (74-78%) for predicting high blood pressure was the 70th triceps skinfold thickness percentile in both genders. Percentile curves for triceps skinfold thickness developed in the present study would be useful in the assessment of adiposity and the risk of hypertension in Indian children.

  18. The national geomagnetic initiative

    NASA Astrophysics Data System (ADS)

    The Earth's magnetic field, through its variability over a spectrum of spatial and temporal scales, contains fundamental information on the solid Earth and geospace environment (the latter comprising the atmosphere, ionosphere, and magnetosphere). Integrated studies of the geomagnetic field have the potential to address a wide range of important processes in the deep mantle and core, asthenosphere, lithosphere, oceans, and the solar-terrestrial environment. These studies have direct applications to important societal problems, including resource assessment and exploration, natural hazard mitigation, safe navigation, and the maintenance and survivability of communications and power systems on the ground and in space. Studies of the Earth's magnetic field are supported by a variety of federal and state agencies as well as by private industry. Both basic and applied research is presently supported by several federal agencies, including the National Science Foundation (NSF), U.S. Geological Survey (USGS), U.S. Department of Energy (DOE), National Oceanic and Atmospheric Administration (NOAA), National Aeronautics and Space Administration (NASA), and U.S. Department of Defense (DOD) (through the Navy, Air Force, and Defense Mapping Agency). Although each agency has a unique, well-defined mission in geomagnetic studies, many areas of interest overlap. For example, NASA, the Navy, and USGS collaborate closely in the development of main field reference models. NASA, NSF, and the Air Force collaborate in space physics. These interagency linkages need to be strengthened. Over the past decade, new opportunities for fundamental advances in geomagnetic research have emerged as a result of three factors: well-posed, first-order scientific questions; increased interrelation of research activities dealing with geomagnetic phenomena; and recent developments in technology. These new opportunities can be exploited through a national geomagnetic initiative to define objectives and

  19. The national geomagnetic initiative

    NASA Technical Reports Server (NTRS)

    1993-01-01

    The Earth's magnetic field, through its variability over a spectrum of spatial and temporal scales, contains fundamental information on the solid Earth and geospace environment (the latter comprising the atmosphere, ionosphere, and magnetosphere). Integrated studies of the geomagnetic field have the potential to address a wide range of important processes in the deep mantle and core, asthenosphere, lithosphere, oceans, and the solar-terrestrial environment. These studies have direct applications to important societal problems, including resource assessment and exploration, natural hazard mitigation, safe navigation, and the maintenance and survivability of communications and power systems on the ground and in space. Studies of the Earth's magnetic field are supported by a variety of federal and state agencies as well as by private industry. Both basic and applied research is presently supported by several federal agencies, including the National Science Foundation (NSF), U.S. Geological Survey (USGS), U.S. Department of Energy (DOE), National Oceanic and Atmospheric Administration (NOAA), National Aeronautics and Space Administration (NASA), and U.S. Department of Defense (DOD) (through the Navy, Air Force, and Defense Mapping Agency). Although each agency has a unique, well-defined mission in geomagnetic studies, many areas of interest overlap. For example, NASA, the Navy, and USGS collaborate closely in the development of main field reference models. NASA, NSF, and the Air Force collaborate in space physics. These interagency linkages need to be strengthened. Over the past decade, new opportunities for fundamental advances in geomagnetic research have emerged as a result of three factors: well-posed, first-order scientific questions; increased interrelation of research activities dealing with geomagnetic phenomena; and recent developments in technology. These new opportunities can be exploited through a national geomagnetic initiative to define objectives and

  20. Antimicrobial Susceptibility of Flavobacterium psychrophilum from Chilean Salmon Farms and Their Epidemiological Cut-Off Values Using Agar Dilution and Disk Diffusion Methods

    PubMed Central

    Miranda, Claudio D.; Smith, Peter; Rojas, Rodrigo; Contreras-Lynch, Sergio; Vega, J. M. Alonso

    2016-01-01

    Flavobacterium psychrophilum is the most important bacterial pathogen for freshwater farmed salmonids in Chile. The aims of this study were to determine the susceptibility to antimicrobials used in fish farming of Chilean isolates and to calculate their epidemiological cut-off (COWT) values. A number of 125 Chilean isolates of F. psychrophilum were isolated from reared salmonids presenting clinical symptoms indicative of flavobacteriosis and their identities were confirmed by 16S rRNA polymerase chain reaction. Susceptibility to antibacterials was tested on diluted Mueller-Hinton by using an agar dilution MIC method and a disk diffusion method. The COWT values calculated by Normalized Resistance Interpretation (NRI) analysis allow isolates to be categorized either as wild-type fully susceptible (WT) or as manifesting reduced susceptibility (NWT). When MIC data was used, NRI analysis calculated a COWT of ≤0.125, ≤2, and ≤0.5 μg mL-1 for amoxicillin, florfenicol, and oxytetracycline, respectively. For the quinolones, the COWT were ≤1, ≤0.5, and ≤0.125 μg mL-1 for oxolinic acid, flumequine, and enrofloxacin, respectively. The disk diffusion data sets obtained in this work were extremely diverse and were spread over a wide range. For the quinolones there was a close agreement between the frequencies of NWT isolates calculated using MIC and disk data. For oxolinic acid, flumequine, and enrofloxacin the frequencies were 45, 39, and 38% using MIC data, and 42, 41, and 44%, when disk data were used. There was less agreement with the other antimicrobials, because NWT frequencies obtained using MIC and disk data, respectively, were 24 and 10% for amoxicillin, 8 and 2% for florfenicol, and 70 and 64% for oxytetracycline. Considering that the MIC data was more precise than the disk diffusion data, MIC determination would be the preferred method for susceptibility testing for this species and the NWT frequencies derived from the MIC data sets should be considered

  1. The use of PROMIS CAT Physical Function Pre-surgical Scores to Predict Recovery and Establish Pre-surgical Cut-off Values

    PubMed Central

    Papuga, Owen; Voloshin, Ilya; Nicandri, Gregg; Goldblatt, John P.; Bronstein, Robert D.; Rouse, Lucien M.; Maloney, Michael D.

    2017-01-01

    Objectives: There is a lack of standardized outcome measures or methods to study the effects of treatment and to effectively monitor and document patient outcomes. We have used Patient Reported Outcome Measurement Information System (PROMIS) computed adaptive testing questionnaires collected during routine office visits to describe the pre-surgical and postsurgical physical function scores and to assess the ability of pre-surgical scores to predict scores at 6 month after surgery. Methods: A retrospective analysis of 619 patients undergoing ACL reconstructive surgery at a large academic medical system was conducted to compare the predictive value of baseline PROMIS physical function scores to predict those scores after surgery. Patients with PROMIS physical Function scores within 1 standard deviation of the normal population at baseline were compare to those who fell below that score. Longitudinal comparisons of PROMIS scores between subsets was then made to identify any significant differences. PROMIS scores were assessed for discriminatory ability using receiver operating characteristic (ROC) curve analyses, with overall accuracy summarized using the area under the ROC curve (AUC). Nonparametric estimates and 95% confidence intervals for the AUC were used for each measurement at similar time points. Results: As shown in figure 1 average PROMIS physical function scores at later timepoints were comparable to those who had higher baseline scores. An ANOVA general linear (GROUP x TIME) model found statically significant (p<. 001) differences between the two groups at earlier time points. Further, ROC curve analysis demonstrated that PROMIS physical function scores have moderate to strong predictive ability (AUC>0.826). Using the ROC analysis an “optimal” cut-off pre-surgical score was determined to be a T-Score of 42.6. Conclusion: If fully utilized, these outcome measures can help inform physicians in individual surgical cases, as well as be used to show overall

  2. Antimicrobial Susceptibility of Flavobacterium psychrophilum from Chilean Salmon Farms and Their Epidemiological Cut-Off Values Using Agar Dilution and Disk Diffusion Methods.

    PubMed

    Miranda, Claudio D; Smith, Peter; Rojas, Rodrigo; Contreras-Lynch, Sergio; Vega, J M Alonso

    2016-01-01

    Flavobacterium psychrophilum is the most important bacterial pathogen for freshwater farmed salmonids in Chile. The aims of this study were to determine the susceptibility to antimicrobials used in fish farming of Chilean isolates and to calculate their epidemiological cut-off (COWT) values. A number of 125 Chilean isolates of F. psychrophilum were isolated from reared salmonids presenting clinical symptoms indicative of flavobacteriosis and their identities were confirmed by 16S rRNA polymerase chain reaction. Susceptibility to antibacterials was tested on diluted Mueller-Hinton by using an agar dilution MIC method and a disk diffusion method. The COWT values calculated by Normalized Resistance Interpretation (NRI) analysis allow isolates to be categorized either as wild-type fully susceptible (WT) or as manifesting reduced susceptibility (NWT). When MIC data was used, NRI analysis calculated a COWT of ≤0.125, ≤2, and ≤0.5 μg mL(-1) for amoxicillin, florfenicol, and oxytetracycline, respectively. For the quinolones, the COWT were ≤1, ≤0.5, and ≤0.125 μg mL(-1) for oxolinic acid, flumequine, and enrofloxacin, respectively. The disk diffusion data sets obtained in this work were extremely diverse and were spread over a wide range. For the quinolones there was a close agreement between the frequencies of NWT isolates calculated using MIC and disk data. For oxolinic acid, flumequine, and enrofloxacin the frequencies were 45, 39, and 38% using MIC data, and 42, 41, and 44%, when disk data were used. There was less agreement with the other antimicrobials, because NWT frequencies obtained using MIC and disk data, respectively, were 24 and 10% for amoxicillin, 8 and 2% for florfenicol, and 70 and 64% for oxytetracycline. Considering that the MIC data was more precise than the disk diffusion data, MIC determination would be the preferred method for susceptibility testing for this species and the NWT frequencies derived from the MIC data sets should be

  3. Organ dysfunction during continuous veno-venous high cut-off hemodialysis in patients with septic acute kidney injury: A prospective observational study

    PubMed Central

    Chelazzi, Cosimo; Morettini, Elena; Zamidei, Lucia; Valente, Serafina; Caldini, A. Lucia; Zagli, Giovanni; De Gaudio, A. Raffaele; Romagnoli, Stefano

    2017-01-01

    Background Continuous veno-venous hemodialysis with high cut-off membranes (HCO-CVVHD) removes inflammatory mediators involved in organ dysfunction during sepsis. The aim of the present study was to assess the variations in SOFA score and identify early predictors of short-term mortality in a cohort of patients with septic shock, treated with HCO-CVVHD for acute kidney injury (AKI). Methods An observational prospective multicenter cohort study was conducted in four mixed medical-surgical ICUs. Thirty-eight patients with septic shock and AKI (KDIGO stage≥1) treated with HCO-CVVHD have been included in this study. Patients were divided into Survivors and non-Survivors according to mortality observed at 72nd hr of treatment. The variation of SOFA scores and clinical/biochemical parameters were described over time for the entire population and specifically for Survivors and non-Survivors. Similarly, circulating inflammatory mediators (as IL-6, TNF-a and IL-10) were described over time. A logistic regression analysis was used to identify the baseline clinical and biochemical parameters associated with 72 hrs-ICU mortality. Results Overall, the mean SOFA score was 12±3 at baseline, 10.9±3 at 6hrs, 9.8±3 at 12hrs, 8.9±3.3 at 24 hrs, and 8±3.5 at 48 hrs after HCO-CVVHD initiation; and 6.5±2.7 at 24 hrs and 6.6±3 at 48 hrs after HCO-CVVHD discontinuation. In the multivariate regression analysis, baseline serum lactate levels and AKI stage independently correlated with short-term mortality during HCO-CVVHD. A significant reduction was observed in circulating levels of TNFα and IL-6 among Survivors. Conclusions SOFA score significantly decreased early after initiation of HCO-CVVHD in patients with septic AKI. Baseline lactate levels and the AKI stage resulted to be associated to 72 hrs-ICU-mortality. PMID:28207795

  4. Consistency and inconsistency in testing biomarkers in breast cancer. A GRELL study in cut-off variability in the Romance language countries.

    PubMed

    Crocetti, Emanuele; Caldarella, Adele; Ferretti, Stefano; Ardanaz, Eva; Arveux, Patrick; Bara, Simona; Barrios, Enrique; Bento, Maria J; Bordoni, Andrea; Buzzoni, Carlotta; Candela, Giuseppina; Colombani, Françoise; Delafosse, Patricia; Federico, Massimo; Francart, Julie; Giacomin, Adriano; Grosclaude, Pascale; Guizard, Anne V; Izarzugaza, Isabel; Konzelmann, Isabelle; La Rosa, Francesco; Lapotre, Benedicte; Leone, Nathalie; Ligier, Karine; Mangone, Lucia; Marcos-Gragera, R; Martinez, Ruth; Michelena, Maria J; Michiara, Maria; Miranda, Ana; Molinié, Florence; Mugarza-Gomez, Conception; Paci, Eugenio; Piffer, Silvano; Puig-Vives, Montserrat; Sacchettini, Claudio; Sánchez, Maria J; Traina, Adele; Tretarre, Brigitte; Tumino, Rosario; Van Vaerenbergh, Elke; Velten, Michel; Woronoff, Anne S

    2013-08-01

    Biological markers are crucial factors in order to differentiate female breast cancers and to determine the right therapy. This study aims at evaluating whether testing for biomarkers for female breast cancer has similar frequency and characteristics across and within countries. Population-based cancer registries of the Association for cancer registration and epidemiology in Romance language countries (GRELL) were asked to complete a questionnaire on biomarkers testing. The data collected referred to invasive female breast cancer cases diagnosed between 2004 and 2009. The investigation focused on 1) the overexpression and amplification of the human epidermal growth factor receptor 2 oncogene (HER2); 2) the expression of oestrogen (ER) and progesterone (PgR) receptors; and 3) the proliferation index (PI). Weighted percentages, the heterogeneity among and within countries, and the correlation between responses and calendar years were evaluated. The study was based on 19,644 breast cancers. Overall, 85.9% of the cases were tested for HER2, 91.8% for both ER and PgR, and 74.1% for proliferative markers. For HER2 and ER-PgR, the frequency of testing increased from 2004 to 2009. Testing varied among countries (HER2 from 82.0% to 95.9%, ER-PgR from 89.3% to 98.9%, PI from 10% to 92%) and also within the same country (e.g. HER2 in Italy from 51% to 99%) as well as within single cancer registries. The most relevant differences were in the scores for positive/negative/not clearly defined HER2 (e.g. HER2 was defined positive if IHC 3+ in 21/33 registries), and in the cut-off of positive cells for ER/PgR (from >0% to >30%) and PI positivity (from >0% to >20%). Biological markers are widely tested in the Romance language countries; however, the parameters defining their positivity may vary, raising concerns about homogeneity in breast cancer classification and treatment. Copyright © 2013 Elsevier Ltd. All rights reserved.

  5. Optimal waist circumference cut-off points and ability of different metabolic syndrome criteria for predicting diabetes in Japanese men and women: Japan Epidemiology Collaboration on Occupational Health Study.

    PubMed

    Hu, Huanhuan; Kurotani, Kayo; Sasaki, Naoko; Murakami, Taizo; Shimizu, Chii; Shimizu, Makiko; Nakagawa, Tohru; Honda, Toru; Yamamoto, Shuichiro; Okazaki, Hiroko; Nagahama, Satsue; Uehara, Akihiko; Yamamoto, Makoto; Tomita, Kentaro; Imai, Teppei; Nishihara, Akiko; Kochi, Takeshi; Eguchi, Masafumi; Miyamoto, Toshiaki; Hori, Ai; Kuwahara, Keisuke; Akter, Shamima; Kashino, Ikuko; Kabe, Isamu; Liu, Weiping; Mizoue, Tetsuya; Kunugita, Naoki; Dohi, Seitaro

    2016-03-03

    We sought to establish the optimal waist circumference (WC) cut-off point for predicting diabetes mellitus (DM) and to compare the predictive ability of the metabolic syndrome (MetS) criteria of the Joint Interim Statement (JIS) and the Japanese Committee of the Criteria for MetS (JCCMS) for DM in Japanese. Participants of the Japan Epidemiology Collaboration on Occupational Health Study, who were aged 20-69 years and free of DM at baseline (n = 54,980), were followed-up for a maximum of 6 years. Time-dependent receiver operating characteristic analysis was used to determine the optimal cut-off points of WC for predicting DM. Time-dependent sensitivity, specificity, and positive and negative predictive values for the prediction of DM were compared between the JIS and JCCMS MetS criteria. During 234,926 person-years of follow-up, 3180 individuals developed DM. Receiver operating characteristic analysis suggested that the most suitable cut-off point of WC for predicting incident DM was 85 cm for men and 80 cm for women. MetS was associated with 3-4 times increased hazard for developing DM in men and 7-9 times in women. Of the MetS criteria tested, the JIS criteria using our proposed WC cut-off points (85 cm for men and 80 cm for women) had the highest sensitivity (54.5 % for men and 43.5 % for women) for predicting DM. The sensitivity and specificity of the JCCMS MetS criteria were ~37.7 and 98.9 %, respectively. Data from the present large cohort of workers suggest that WC cut-offs of 85 cm for men and 80 cm for women may be appropriate for predicting DM for Japanese. The JIS criteria can detect more people who later develop DM than does the JCCMS criteria.

  6. Glycolipid metabolic status of overweight/obese adolescents aged 9- to 15-year-old and the BMI-SDS/BMI cut-off value of predicting dyslipidemiain boys, Shanghai, China: a cross-sectional study

    PubMed Central

    2013-01-01

    Background The prevalence of adolescents’ obesity and overweight has dramatically elevated in China. Obese children were likely to insulin resistance and dyslipidemia, which are risk factors of cardiovascular diseases. However there was no cut-off point of anthropometric values to predict the risk factors in Chinese adolescents. The present study was to investigate glycolipid metabolism status of adolescents in Shanghai and to explore the correlations between body mass index standard deviation score (BMI-SDS) and metabolic indices, determine the best cut-off value of BMI-SDS to predict dyslipidemia. Methods Fifteen schools in Shanghai’s two districts were chosen by cluster sampling and primary screening was done in children aged 9-15 years old. After screening of bodyweight and height, overweight and obese adolescents and age-matched children with normal body weight were randomly recruited in the study. Anthropometric measurements, biochemical measurements of glycolipid profiles were done. SPSS19.0 was used to analyze the data. Receiver operating characteristic (ROC) curves were made and the best cut-off values of BMI-SDS to predict dyslipidemia were determined while the Youden indices were maximum. Results Five hundred and thirty-eight adolescents were enrolled in this research, among which 283 have normal bodyweight, 115 were overweight and 140 were obese. No significant differences of the ages among 3 groups were found. There were significant differences of WC-SDS (p<0.001), triacylglycerol (p<0.05), high and low density lipoprotein cholesterol (p<0.01), fasting insulin (p<0.01) and C-peptide (p<0.001) among 3 groups. Significant difference of fasting glucose was only found between normal weight and overweight group. Significant difference of total cholesterol was found between obese and normal weight group. There was no significant difference of glycated hemoglobin among 3 groups. The same tendency was found in boys but not in girls. Only HDL-C reduced and

  7. Glycolipid metabolic status of overweight/obese adolescents aged 9- to 15-year-old and the BMI-SDS/BMI cut-off value of predicting dyslipidemiain boys, Shanghai, China: a cross-sectional study.

    PubMed

    Gong, Chun-dan; Wu, Qiao-ling; Chen, Zheng; Zhang, Dan; Zhao, Zheng-yan; Peng, Yong-mei

    2013-08-28

    The prevalence of adolescents' obesity and overweight has dramatically elevated in China. Obese children were likely to insulin resistance and dyslipidemia, which are risk factors of cardiovascular diseases. However there was no cut-off point of anthropometric values to predict the risk factors in Chinese adolescents. The present study was to investigate glycolipid metabolism status of adolescents in Shanghai and to explore the correlations between body mass index standard deviation score (BMI-SDS) and metabolic indices, determine the best cut-off value of BMI-SDS to predict dyslipidemia. Fifteen schools in Shanghai's two districts were chosen by cluster sampling and primary screening was done in children aged 9-15 years old. After screening of bodyweight and height, overweight and obese adolescents and age-matched children with normal body weight were randomly recruited in the study. Anthropometric measurements, biochemical measurements of glycolipid profiles were done. SPSS19.0 was used to analyze the data. Receiver operating characteristic (ROC) curves were made and the best cut-off values of BMI-SDS to predict dyslipidemia were determined while the Youden indices were maximum. Five hundred and thirty-eight adolescents were enrolled in this research, among which 283 have normal bodyweight, 115 were overweight and 140 were obese. No significant differences of the ages among 3 groups were found. There were significant differences of WC-SDS (p<0.001), triacylglycerol (p<0.05), high and low density lipoprotein cholesterol (p<0.01), fasting insulin (p<0.01) and C-peptide (p<0.001) among 3 groups. Significant difference of fasting glucose was only found between normal weight and overweight group. Significant difference of total cholesterol was found between obese and normal weight group. There was no significant difference of glycated hemoglobin among 3 groups. The same tendency was found in boys but not in girls. Only HDL-C reduced and TG increased while BMI elevated

  8. Torque Balances on the Taylor Cylinders in the Geomagnetic Data Assimilation

    NASA Technical Reports Server (NTRS)

    Kuang, Weijia; Tangborn, Andrew

    2004-01-01

    In this presentation we report on our continuing effort in geomagnetic data assimilation, aiming at understanding and predicting geomagnetic secular variation on decadal time scales. In particular, we focus on the effect of the torque balances on the cylindrical surfaces in the core co-axial with the Earth's rotation axis (the Taylor cylinders) on the time evolution of assimilated solutions. We use our MoSST core dynamics,model and observed geomagnetic field at the Earth's surface derived via Comprehensive Field Model (CFM) for the geomagnetic data assimilation. In our earlier studies, a model solution is selected randomly from our numerical database. It is then assimilated with the observations such that the poloidal field possesses the same field tomography on the core-mantel boundary (CMB) continued downward from surface observations. This tomography change is assumed to be effective through out the outer core. While this approach allows rapid convergence between model solutions and the observations, it also generates sevee numerical instabilities: the delicate balance between weak fluid inertia and the magnetic torques on the Taylor cylinders are completely altered. Consequently, the assimilated solution diverges quickly (in approximately 10% of the magnetic free-decay time in the core). To improve the assimilation, we propose a partial penetration of the assimilation from the CMB: The full-scale modification at the CMB decreases linearly and vanish at an interior radius r(sub a). We shall examine from our assimilation tests possible relationships between the convergence rate of the model solutions to observations and the cut-off radius r(sub a). A better assimilation shall serve our nudging tests in near future.

  9. Torque Balances on the Taylor Cylinders in the Geomagnetic Data Assimilation

    NASA Technical Reports Server (NTRS)

    Kuang, Weijia; Tangborn, Andrew

    2004-01-01

    In this presentation we report on our continuing effort in geomagnetic data assimilation, aiming at understanding and predicting geomagnetic secular variation on decadal time scales. In particular, we focus on the effect of the torque balances on the cylindrical surfaces in the core co-axial with the Earth's rotation axis (the Taylor cylinders) on the time evolution of assimilated solutions. We use our MoSST core dynamics,model and observed geomagnetic field at the Earth's surface derived via Comprehensive Field Model (CFM) for the geomagnetic data assimilation. In our earlier studies, a model solution is selected randomly from our numerical database. It is then assimilated with the observations such that the poloidal field possesses the same field tomography on the core-mantel boundary (CMB) continued downward from surface observations. This tomography change is assumed to be effective through out the outer core. While this approach allows rapid convergence between model solutions and the observations, it also generates sevee numerical instabilities: the delicate balance between weak fluid inertia and the magnetic torques on the Taylor cylinders are completely altered. Consequently, the assimilated solution diverges quickly (in approximately 10% of the magnetic free-decay time in the core). To improve the assimilation, we propose a partial penetration of the assimilation from the CMB: The full-scale modification at the CMB decreases linearly and vanish at an interior radius r(sub a). We shall examine from our assimilation tests possible relationships between the convergence rate of the model solutions to observations and the cut-off radius r(sub a). A better assimilation shall serve our nudging tests in near future.

  10. Hazards of geomagnetic storms

    USGS Publications Warehouse

    Herzog, D.C.

    1992-01-01

    Geomagnetic storms are large and sometimes rapid fluctuations in the Earth's magnetic field that are related to disturbances on the Sun's surface. Although it is not widely recognized, these transient magnetic disturbances can be a significant hazard to people and property. Many of us know that the intensity of the auroral lights increases during magnetic storms, but few people realize that these storms can also cause massive power outages, interrupt radio communications and satellite operations, increase corrosion in oil and gas pipelines, and lead to spuriously high rejection rates in the manufacture of sensitive electronic equipment. 

  11. Operational Geomagnetic Forecast Service

    NASA Astrophysics Data System (ADS)

    Semeniv, O.; Polonska, A.; Parnowski, A.

    2014-12-01

    The operational forecasting service for real-time geomagnetic indices Dst and Kp was described. The warning time for the Earth to the intersection of the Dst index is 1-4 hours, for the Kp index - 3 hours. The skillscore parameter, which is defined as a decrease of the relative mean square error with respect to the trivial model, was approximately 40% for Dst and 15% for Kp. The service works on-line freely available through STAFF http://www.staff.oma.be/ browser.

  12. Magnetosphere of Earth: Geomagnetic Tail

    NASA Astrophysics Data System (ADS)

    Pulkkinen, T.; Murdin, P.

    2000-11-01

    The geomagnetic tail is an elongated region of the MAGNETOSPHERE OF EARTH extending from the near-Earth space in the antisunward direction. It acts as a giant energy reservoir for the magnetosphere and is therefore an important participant in dynamic processes such as GEOMAGNETIC STORMS and substorms (see MAGNETOSPHERE OF EARTH: SUBSTORMS)....

  13. Rigid particulate matter sensor

    SciTech Connect

    Hall, Matthew

    2011-02-22

    A sensor to detect particulate matter. The sensor includes a first rigid tube, a second rigid tube, a detection surface electrode, and a bias surface electrode. The second rigid tube is mounted substantially parallel to the first rigid tube. The detection surface electrode is disposed on an outer surface of the first rigid tube. The detection surface electrode is disposed to face the second rigid tube. The bias surface electrode is disposed on an outer surface of the second rigid tube. The bias surface electrode is disposed to face the detection surface electrode on the first rigid tube. An air gap exists between the detection surface electrode and the bias surface electrode to allow particulate matter within an exhaust stream to flow between the detection and bias surface electrodes.

  14. Proterozoic Geomagnetic Field Geometry

    NASA Astrophysics Data System (ADS)

    Panzik, J. E.; Evans, D. A.

    2011-12-01

    Pre-Mesozoic continental reconstructions and paleoclimatic inferences from paleomagnetism rely critically upon the assumption of a time-averaged geocentric axial dipole (GAD) magnetic field. We have been testing the GAD assumption and localized non-dipole components in a different manner, by observing directional variations within the Matachewan, Mackenzie and Franklin dyke swarms. Large dyke swarms, commonly emplaced within a few million years, provide the necessary broad areal coverage to perform a test of global geomagnetic field geometry. Our analysis varies the quadrupole and octupole values of the generalized paleolatitude equation to determine a minimal angular dispersion and maximum precision of paleopoles from each dyke swarm. As a control, paleomagnetic data from the central Atlantic magmatic province (CAMP) show the sensitivities of our method to non-GAD contributions to the ancient geomagnetic field. Within the uncertainties, CAMP data are consistent with independent estimates of non-GAD contributions derived from global tectonic reconstructions (Torsvik & Van der Voo, 2002). Current results from the three Proterozoic dyke swarms all have best fits that are non-dipolar, but they differ in their optimal quadrupole/ octupole components. Treated together under the hypothesis of a static Proterozoic field geometry, the data allow a pure GAD geodynamo within the uncertainty of the method. Current results were performed using Fisherian statistics, but Bingham statistics will be included to account for the ellipticity of data.

  15. False-positive results in neonatal screening for cystic fibrosis based on a three-stage protocol (IRT/DNA/IRT): Should we adjust IRT cut-off to ethnic origin?

    PubMed

    Cheillan, D; Vercherat, M; Chevalier-Porst, F; Charcosset, M; Rolland, M O; Dorche, C

    2005-01-01

    Since 1979, newborn screening for cystic fibrosis (CF) has been possible by measuring immunoreactive tryspinogen (IRT) in blood spots. In France, a programme based on a three-stage strategy (IRT/DNA/IRT) started in 2002. In the Rhône-Alpes area, the positive screening rate (i.e. the proportion of samples sent for genotyping) observed after the first IRT measurement was higher than the expected rate (0.65% versus 0.50%), without a greater CF incidence. We hypothesized that the IRT reference range could differ according to the ethnic origin of the newborns. 35 141 newborns were studied and divided into two groups: European ethnic group 26 324 (75%) and North African ethnic group 8817 (25%). 243 positive newborns were identified: 146 (60%) in the European ethnic group and 97 (40%) in the North African ethnic group. Three CF patients and 11 unaffected heterozygotes were found in the European group, but no mutations were found in the North African group. Mean IRT values and the percentage of IRT values over the cut-off were significantly higher in the North African group than in the European group (mean IRT = 21.17 microg/L and 19.74 microg/L, p < 0.0001; %IRT > cut-off = 1.1% and 0.5%, respectively). For the positive screened newborns, term and IRT mean were comparable, whereas birth weight was higher in the North African ethnic group. These results lead us to conclude that (i) newborns from families of North African origin have higher IRT values and (ii) most of the positive screened newborns in this population could be considered as 'false positives'. These conclusions could explain, in part, the large variations seen in the positive screening rate in the French CF neonatal screening and raise the question whether it is relevant to adapt cut-off to ethnic origin of the newborns.

  16. Comparison of image quality and radiation dose between prospectively ECG-triggered and retrospectively ECG-gated CT angiography: Establishing heart rate cut-off values in first-generation dual-source CT.

    PubMed

    Ünal, Emre; Yıldız, A Elçin; Güler, Ezgi; Karcaaltıncaba, Muşturay; Akata, Deniz; Kılınçer, Abidin; Atlı, Eray; Topçuoğlu, Melih; Hazırolan, Tuncay

    2015-09-01

    To evaluate radiation dose and image quality of prospectively electrocardiography (ECG)-triggered and retrospectively ECG-gated coronary computed tomography (CT) angiography and to establish cut-off values of heart rates (HRs) for each technique in first-generation dual-source CT. A total of 200 consecutive patients with suspected coronary artery disease were accepted into the study. Patients were selected randomly for each technique (prospective triggering group n=99, mean age 55.85±10.74 and retrospective gating group n=101, mean age 53.38±11.58). Two independent radiologists scored coronary artery segments for image quality using a 5-point scale. Also, attenuation values of each coronary artery segment and dose-length product values were measured. For each technique, cut-off HR values were determined for the best image quality. Mean image quality scores and attenuation values were found to be higher in the prospective triggering group (p<0.05). Mean radiation dose was 73% lower for the prospective triggering group (p<0.01). The cut-off HR values for good image quality scores were ≤67 beats per minute (bpm) and ≤80 bpm for the prospective triggering and retrospective gating groups, respectively (p<0.05). Increased HR (≥68 and ≥81 bpm, respectively) had negative effects on image quality (p<0.05). The prospective ECG triggering technique has better image quality scores than retrospective ECG gating, particularly in patients who have an HR of less than 68 bpm. Also, a 73% radiation dose reduction can be achieved with prospective ECG triggering. In patients with higher heart rates, retrospective ECG gating is recommended.

  17. Optimal cut-off values for the homeostasis model assessment of insulin resistance (HOMA-IR) and pre-diabetes screening: Developments in research and prospects for the future.

    PubMed

    Tang, Qi; Li, Xueqin; Song, Peipei; Xu, Lingzhong

    2015-12-01

    Diabetes mellitus (DM) appears to be increasing rapidly, threatening to reduce life expectancy for humans around the globe. The International Diabetes Federation (IDF) has estimated that there will be 642 million people living with the disease by 2040 and half as many again who will be not diagnosed. This means that pre-DM screening is a critical issue. Insulin resistance (IR) has emerged as a major pathophysiological factor in the development and progression of DM since it is evident in susceptible individuals at the early stages of DM, and particularly type 2 DM (T2DM). Therefore, assessment of IR via the homeostasis model assessment of IR (HOMA-IR) is a key index for the primary prevention of DM and is thus found in guidelines for screening of high-risk groups. However, the cut-off values of HOMA-IR differ for different races, ages, genders, diseases, complications, etc. due to the complexity of IR. This hampers the determination of specific cut-off values of HOMA-IR in different places and in different situations. China has not published an official index to gauge IR for primary prevention of T2DM in the diabetic and non-diabetic population except for children and adolescents ages 6-12 years. Hence, this article summarizes developments in research on IR, HOMA-IR, and pre-DM screening in order to provide a reference for optimal cut-off values of HOMA-IR for the diagnosis of DM in the Chinese population.

  18. Optimal Cut-Offs of Homeostasis Model Assessment of Insulin Resistance (HOMA-IR) to Identify Dysglycemia and Type 2 Diabetes Mellitus: A 15-Year Prospective Study in Chinese

    PubMed Central

    Lee, C. H.; Shih, A. Z. L.; Woo, Y. C.; Fong, C. H. Y.; Leung, O. Y.; Janus, E.; Cheung, B. M. Y.; Lam, K. S. L.

    2016-01-01

    Background The optimal reference range of homeostasis model assessment of insulin resistance (HOMA-IR) in normal Chinese population has not been clearly defined. Here we address this issue using the Hong Kong Cardiovascular Risk Factor Prevalence Study (CRISPS), a prospective population-based cohort study with long-term follow-up. Material & Methods In this study, normal glucose tolerance (NGT), impaired fasting glucose (IFG), impaired glucose tolerance (IGT) and type 2 diabetes mellitus (T2DM) were defined according to the 1998 World Health Organization criteria. Dysglycemia referred to IFG, IGT or T2DM. This study comprised two parts. Part one was a cross-sectional study involving 2,649 Hong Kong Chinese subjects, aged 25–74 years, at baseline CRISPS-1 (1995–1996). The optimal HOMA-IR cut-offs for dysglycemia and T2DM were determined by the receiver-operating characteristic (ROC) curve. Part two was a prospective study involving 872 subjects who had persistent NGT at CRISPS-4 (2010–2012) after 15 years of follow-up. Results At baseline, the optimal HOMA-IR cut-offs to identify dysglyceia and T2DM were 1.37 (AUC = 0.735; 95% confidence interval [CI] = 0.713–0.758; Sensitivity [Se] = 65.6%, Specificity [Sp] = 71.3%] and 1.97 (AUC = 0.807; 95% CI = 0.777–0.886; Se = 65.5%, Sp = 82.9%) respectively. These cut-offs, derived from the cross-sectional study at baseline, corresponded closely to the 75th (1.44) and 90th (2.03) percentiles, respectively, of the HOMA-IR reference range derived from the prospective study of subjects with persistent NGT. Conclusions HOMA-IR cut-offs, of 1.4 and 2.0, which discriminated dysglycemia and T2DM respectively from NGT in Southern Chinese, can be usefully employed as references in clinical research involving the assessment of insulin resistance. PMID:27658115

  19. Bayesian inference in geomagnetism

    NASA Technical Reports Server (NTRS)

    Backus, George E.

    1988-01-01

    The inverse problem in empirical geomagnetic modeling is investigated, with critical examination of recently published studies. Particular attention is given to the use of Bayesian inference (BI) to select the damping parameter lambda in the uniqueness portion of the inverse problem. The mathematical bases of BI and stochastic inversion are explored, with consideration of bound-softening problems and resolution in linear Gaussian BI. The problem of estimating the radial magnetic field B(r) at the earth core-mantle boundary from surface and satellite measurements is then analyzed in detail, with specific attention to the selection of lambda in the studies of Gubbins (1983) and Gubbins and Bloxham (1985). It is argued that the selection method is inappropriate and leads to lambda values much larger than those that would result if a reasonable bound on the heat flow at the CMB were assumed.

  20. Transient cosmic ray increase associated with a geomagnetic storm

    NASA Technical Reports Server (NTRS)

    Kudo, S.; Wada, M.; Tanskanen, P.; Kodama, M.

    1985-01-01

    On the basis of worldwide network data of cosmic ray nucleonic components, the transient cosmic ray increase due to the depression of cosmic ray cutoff rigidity during a severe geomagnetic storm was investigated in terms of the longitudinal dependence. Multiple correlation analysis among isotropic and diurnal terms of cosmic ray intensity variations and Dst term of the geomagnetic field is applied to each of various station's data. It is shown that the amplitude of the transient cosmic ray increase associated with Dst depends on the local time of the station, and that its maximum phase is found in the evening sector. This fact is consistent with the theoretical estimation based on the azimuthally asymmetric ring current model for the magnetic DS field.