Risk-related 18F-FDG PET/CT and new diagnostic strategies in patients with solitary pulmonary nodule: the ITALIAN multicenter trial.

PubMed

Spadafora, Marco; Pace, Leonardo; Evangelista, Laura; Mansi, Luigi; Del Prete, Francesco; Saladini, Giorgio; Miletto, Paolo; Fanti, Stefano; Del Vecchio, Silvana; Guerra, Luca; Pepe, Giovanna; Peluso, Giuseppina; Nicolai, Emanuele; Storto, Giovanni; Ferdeghini, Marco; Giordano, Alessandro; Farsad, Mohsen; Schillaci, Orazio; Gridelli, Cesare; Cuocolo, Alberto

2018-05-05

Diagnosis of solitary pulmonary nodule (SPN) is an important public health issue and 18 F-FDG PET/CT has proven to be more effective than CT alone. Pre-test risk stratification and clinical presentation of SPN could affect the diagnostic strategy. A relevant issue is whether thoracic segmental (s)-PET/CT could be implemented in patients with SPN. This retrospective multicenter study compared the results of FDG whole-body (wb)-PET/CT to those of s-PET/CT. 18 F-FDG PET/CT of 502 patients, stratified for pre-test cancer risk, were retrospectively analyzed. The thoracic part of wb-PET/CT, considered s-PET/CT, was compared to wb-PET/CT. Clinical and PET/CT variables were investigated for SPN characterization as well as for identification of patients in whom s-PET/CT could be performed. Histopathology or follow-up data were used as a reference. In the study population, 36% had malignant, 35% benign, and 29% indeterminate SPN. 18 F-FDG uptake indicative of thoracic and extra-thoracic lesions was detectable in 13% and 3% of the patients. All patients with extra-thoracic metastases (n = 13) had thoracic lymph node involvement and highest 18 F-FDG uptake at level of SPN (negative predictive value 100%). Compared to wb-PET/CT, s-PET/CT could save about 2/3 of 18 F-FDG dose, radiation exposure or scan-time, without affecting the clinical impact of PET/CT. Pre-test probability of malignancy can guide the diagnostic strategy of 18 FDG-PET/CT in patients with SPN. In subjects with low-intermediate pretest probability s-PET/CT imaging might be planned in advance, while in those at high risk and with thoracic lymph node involvement a wb-PET/CT is necessary.

Clinical usefulness of the faecal calprotectin test in suspected paediatric inflammatory bowel disease.

PubMed

Akobeng, Anthony K

2018-04-29

The faecal calprotectin (FC) test is increasingly being used in clinical practice to help select children with gastrointestinal symptoms who might have inflammatory bowel disease (IBD) and benefit from endoscopies. We provide an overview of the advantages and limitations of the FC test. PubMed was searched for meta-analyses that had investigated the diagnostic accuracy of the FC test and the pooled sensitivity and specificity for distinguishing IBD from non-IBD patients were used to calculate likelihood ratios (LR). These were applied to practical examples to explain how easily clinicians can use the results to modify pre-test probabilities of IBD and generate post-test probabilities for IBD. The positive LR and negative LR of the FC test were 2.8 and 0.015, respectively. The usefulness of the FC test depended on the pre-test probability of IBD. When the pre-test probability of IBD was low, a positive FC test did not necessarily indicate IBD. However, because of the very small negative LR, a negative FC result virtually ruled out IBD in most cases. The FC test should not be used indiscriminately in children with gastrointestinal symptoms but should be targeted at those who are likely to have IBD. ©2018 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

A traditionally administered short course failed to improve medical students' diagnostic performance. A quantitative evaluation of diagnostic thinking.

PubMed

Noguchi, Yoshinori; Matsui, Kunihiko; Imura, Hiroshi; Kiyota, Masatomo; Fukui, Tsuguya

2004-05-01

Quite often medical students or novice residents have difficulty in ruling out diseases even though they are quite unlikely and, due to this difficulty, such students and novice residents unnecessarily repeat laboratory or imaging tests. To explore whether or not a carefully designed short training course teaching Bayesian probabilistic thinking improves the diagnostic ability of medical students. Ninety students at 2 medical schools were presented with clinical scenarios of coronary artery disease corresponding to high, low, and intermediate pretest probabilities. The students' estimates of test characteristics of exercise stress test, and pretest and posttest probability for each scenario were evaluated before and after the short course. The pretest probability estimates by the students, as well as their proficiency in applying Bayes's theorem, were improved in the high pretest probability scenario after the short course. However, estimates of pretest probability in the low pretest probability scenario, and their proficiency in applying Bayes's theorem in the intermediate and low pretest probability scenarios, showed essentially no improvement. A carefully designed, but traditionally administered, short course could not improve the students' abilities in estimating pretest probability in a low pretest probability setting, and subsequently students remained incompetent in ruling out disease. We need to develop educational methods that cultivate a well-balanced clinical sense to enable students to choose a suitable diagnostic strategy as needed in a clinical setting without being one-sided to the "rule-in conscious paradigm."

Enhancement of waste activated sludge (WAS) anaerobic digestion by means of pre- and intermediate treatments. Technical and economic analysis at a full-scale WWTP.

PubMed

Campo, Giuseppe; Cerutti, Alberto; Zanetti, Mariachiara; Scibilia, Gerardo; Lorenzi, Eugenio; Ruffino, Barbara

2018-06-15

Anaerobic digestion (AD) is the most commonly applied end-treatment for the excess of waste activated sludge (WAS) generated in biological wastewater treatment processes. The efficacy of different typologies of pre-treatments in liberating intra-cellular organic substances and make them more usable for AD was demonstrated in several studies. However, the production of new extracellular polymeric substances (EPSs) that occur during an AD process, due to microbial metabolism, self-protective reactions and cell lysis, partially neutralizes the benefit of pre-treatments. The efficacy of post- and inter-stage treatments is currently under consideration to overcome the problems due to this unavoidable byproduct. This work compares three scenarios in which low-temperature (<100 °C) thermal and hybrid (thermal+alkali) lysis treatments were applied to one sample of WAS and two samples of digestate with hydraulic retention times (HRTs) of 7 and 15 days. Batch mesophilic digestibility tests demonstrated that intermediate treatments were effective in making the residual organic substance of a 7-day digestate usable for a second-stage AD process. In fact, under this scenario, the methane generated in a two-stage AD process, with an in-between intermediate treatment, was 23% and 16% higher than that generated in the scenario that considers traditional pre-treatments carried out with 4% NaOH at 70 and 90 °C respectively. Conversely, in no cases (70 or 90 °C) the combination of a 15-day AD process, followed by an intermediate treatment and a second-stage AD process, made possible to obtain specific methane productions (SMPs) higher than those obtained with pre-treatments. The results of the digestibility tests were used for a tecno-economic assessment of pre- and intermediate lysis treatments in a full scale wastewater treatment plant (WWTP, 2,000,000 p.e.). It was demonstrated that the introduction of thermal or hybrid pre-treatments could increase the revenues from the electricity sale by between 13% and 25%, in comparison with the present scenario (no lysis treatments). Conversely, intermediate treatments on a 7-day digestate could provide a gain of 26% or 32%, depending on the process temperature (70 or 90 °C). Copyright © 2017 Elsevier Ltd. All rights reserved.

Rational use of Xpert testing in patients with presumptive TB: clinicians should be encouraged to use the test-treat threshold.

PubMed

Decroo, Tom; Henríquez-Trujillo, Aquiles R; De Weggheleire, Anja; Lynen, Lutgarde

2017-10-11

A recently published Ugandan study on tuberculosis (TB) diagnosis in HIV-positive patients with presumptive smear-negative TB, which showed that out of 90 patients who started TB treatment, 20% (18/90) had a positive Xpert MTB/RIF (Xpert) test, 24% (22/90) had a negative Xpert test, and 56% (50/90) were started without Xpert testing. Although Xpert testing was available, clinicians did not use it systematically. Here we aim to show more objectively the process of clinical decision-making. First, we estimated that pre-test probability of TB, or the prevalence of TB in smear-negative HIV infected patients with signs of presumptive TB in Uganda, was 17%. Second, we argue that the treatment threshold, the probability of disease at which the utility of treating and not treating is the same, and above which treatment should be started, should be determined. In Uganda, the treatment threshold was not yet formally established. In Rwanda, the calculated treatment threshold was 12%. Hence, one could argue that the threshold was reached without even considering additional tests. Still, Xpert testing can be useful when the probability of disease is above the treatment threshold, but only when a negative Xpert result can lower the probability of disease enough to cross the treatment threshold. This occurs when the pre-test probability is lower than the test-treat threshold, the probability of disease at which the utility of testing and the utility of treating without testing is the same. We estimated that the test-treatment threshold was 28%. Finally, to show the effect of the presence or absence of arguments on the probability of TB, we use confirming and excluding power, and a log10 odds scale to combine arguments. If the pre-test probability is above the test-treat threshold, empirical treatment is justified, because even a negative Xpert will not lower the post-test probability below the treatment threshold. However, Xpert testing for the diagnosis of TB should be performed in patients for whom the probability of TB was lower than the test-treat threshold. Especially in resource constrained settings clinicians should be encouraged to take clinical decisions and use scarce resources rationally.

The Influence of Optical Coherence Tomography Measurements of Retinal Nerve Fiber Layer on Decision-Making in Glaucoma Diagnosis.

PubMed

Fu, Lanxing; Aspinall, Peter; Bennett, Gary; Magidson, Jay; Tatham, Andrew J

2017-04-01

To quantify the influence of spectral domain optical coherence tomography (SDOCT) on decision-making in patients with suspected glaucoma. A prospective cross-sectional study involving 40 eyes of 20 patients referred by community optometrists due to suspected glaucoma. All patients had disc photographs and standard automated perimetry (SAP), and results were presented to 13 ophthalmologists who estimated pre-test probability of glaucoma (0-100%) for a total of 520 observations. Ophthalmologists were then permitted to modify probabilities of disease based on SDOCT retinal nerve fiber layer (RNFL) measurements (post-test probability). The effect of information from SDOCT on decision to treat, monitor, or discharge was assessed. Agreement among graders was assessed using intraclass correlation coefficients (ICC) and correlated component regression (CCR) was used to identify variables influencing management decisions. Patients had an average age of 69.0 ± 10.1 years, SAP mean deviation of 2.71 ± 3.13 dB, and RNFL thickness of 86.2 ± 16.7 μm. Average pre-test probability of glaucoma was 37.0 ± 33.6% with SDOCT resulting in a 13.3 ± 18.1% change in estimated probability. Incorporating information from SDOCT improved agreement regarding probability of glaucoma (ICC = 0.50 (95% CI 0.38 to 0.64) without SDOCT versus 0.64 (95% CI 0.52 to 0.76) with SDOCT). SDOCT led to a change from decision to "treat or monitor" to "discharge" in 22 of 520 cases and a change from "discharge" to "treat or monitor" in 11 of 520 cases. Pre-test probability and RNFL thickness were predictors of post-test probability of glaucoma, contributing 69 and 31% of the variance in post-test probability, respectively. Information from SDOCT altered estimated probability of glaucoma and improved agreement among clinicians in those suspected of having the disease.

Is D-dimer used according to clinical algorithms in the diagnostic work-up of patients with suspicion of venous thromboembolism? A study in six European countries.

PubMed

Kristoffersen, Ann Helen; Ajzner, Eva; Rogic, Dunja; Sozmen, Eser Y; Carraro, Paolo; Faria, Ana Paula; Watine, Joseph; Meijer, Piet; Sandberg, Sverre

2016-06-01

Clinical algorithms consisting of pre-test probability estimation and D-dimer testing are recommended in diagnostic work-up for suspected venous thromboembolism (VTE). The aim of this study was to explore how physicians working in emergency departments investigated patients suspected to have VTE. A questionnaire with two case histories related to the diagnosis of suspected pulmonary embolism (PE) (Case A) and deep venous thrombosis (DVT) (Case B) were sent to physicians in six European countries. The physicians were asked to estimate pre-test probability of VTE, and indicate their clinical actions. In total, 487 physicians were included. Sixty percent assessed pre-test probability of PE to be high in Case A, but 7% would still request only D-dimer and 11% would exclude PE if D-dimer was negative, which could be hazardous. Besides imaging, a D-dimer test was requested by 41%, which is a "waste of resources" (extra costs and efforts, no clinical benefit). For Case B, 92% assessed pre-test probability of DVT to be low. Correctly, only D-dimer was requested by 66% of the physicians, while 26% requested imaging, alone or in addition to D-dimer, which is a "waste of resources". These results should encourage scientific societies to improve the dissemination and knowledge of the current recommendations for the diagnosis of VTE. Copyright © 2016 Elsevier Ltd. All rights reserved.

Age-adjusted versus clinical probability-adjusted D-dimer to exclude pulmonary embolism.

PubMed

Takach Lapner, Sarah; Stevens, Scott M; Woller, Scott C; Snow, Gregory; Kearon, Clive

2018-05-05

A low D-dimer can exclude suspected pulmonary embolism (PE) in cases with low or intermediate clinical probability of disease. Yet D-dimer is nonspecific, so many cases without PE require imaging. D-dimer's specificity is improved by increasing the threshold for a positive test with age (age × 10 ng/mL; age-adjusted D-dimer; AADD) or clinical probability of PE (1000 ng/mL if low and 500 ng/mL if intermediate clinical probability; clinical probability-adjusted D-dimer; CPADD). It is unclear which approach is preferable. We report the sensitivity, specificity and negative predictive value (NPV) of AADD compared to CPADD in suspected PE. A retrospective cohort of 3500 consecutive cases imaged for suspected PE at two U.S. emergency departments was assembled. We analyzed cases with low or intermediate clinical probability of PE (Revised Geneva Score) who had a D-dimer. The outcome was acute PE on imaging at presentation. Of the 3500 cases, 1745 were eligible. 37% were low, and 63% were intermediate clinical probability of PE. PE was present in 145 (8.3%) cases. Sensitivity of CPADD was 87.5% vs. 96.6% for AADD (difference 9.1%; 95% CI 4.3% to 14.0%). NPV of CPADD was 97.1% vs. 99.0% for AADD (difference 1.9%; 95% CI, 0.7% to 3.1%). Specificity of CPADD was 37.5% vs. 30.2% for AADD (difference -7.3%; 95% CI -9.4% to -5.1%). D-dimer was negative in 35.4% of cases using CPADD vs. 28.0% using AADD. CPADD modestly improved the specificity of D-dimer, but had a lower NPV than AADD. AADD appears preferable in this analysis. Copyright © 2018 Elsevier Ltd. All rights reserved.

The Effects of Professional Development on the Knowledge, Attitudes, & Anxiety of Intermediate Teachers of Mathematics

ERIC Educational Resources Information Center

McCartney, Kathleen Perry

2013-01-01

This study examined the effects of a short-term professional development on the mathematical knowledge, anxiety, and attitudes of intermediate teachers. Participants in the control and experimental groups were pre-tested for knowledge using the eighth grade TCAP Item Sampler. Anxiety was measured through the use of Suinn and Winston's (2003)…

Probability of a false-negative HIV antibody test result during the window period: a tool for pre- and post-test counselling.

PubMed

Taylor, Darlene; Durigon, Monica; Davis, Heather; Archibald, Chris; Konrad, Bernhard; Coombs, Daniel; Gilbert, Mark; Cook, Darrel; Krajden, Mel; Wong, Tom; Ogilvie, Gina

2015-03-01

Failure to understand the risk of false-negative HIV test results during the window period results in anxiety. Patients typically want accurate test results as soon as possible while clinicians prefer to wait until the probability of a false-negative is virtually nil. This review summarizes the median window periods for third-generation antibody and fourth-generation HIV tests and provides the probability of a false-negative result for various days post-exposure. Data were extracted from published seroconversion panels. A 10-day eclipse period was used to estimate days from infection to first detection of HIV RNA. Median (interquartile range) days to seroconversion were calculated and probabilities of a false-negative result at various time periods post-exposure are reported. The median (interquartile range) window period for third-generation tests was 22 days (19-25) and 18 days (16-24) for fourth-generation tests. The probability of a false-negative result is 0.01 at 80 days' post-exposure for third-generation tests and at 42 days for fourth-generation tests. The table of probabilities of falsely-negative HIV test results may be useful during pre- and post-test HIV counselling to inform co-decision making regarding the ideal time to test for HIV. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Impact of Oral Health Education on Oral Health Knowledge of Private School Children in Riyadh City, Saudi Arabia

PubMed Central

Al Saffan, Abdulrahman Dahham; Baseer, Mohammad Abdul; Alshammary, Abdul Aziz; Assery, Mansour; Kamel, Ashraf; Rahman, Ghousia

2017-01-01

Aims and Objectives: To assess the early effect of oral health education on oral health knowledge of primary and intermediate school students of private schools by utilizing pre/post questionnaires data from oral health educational projects in Riyadh city, Saudi Arabia. Second, to examine topic-specific knowledge differences between genders, nationalities, and educational levels of the students. Materials and Methods: Cross-sectional oral health educational data of private school students (n = 1279) in primary and intermediate levels were extracted from the King Salman Centre for Children's Health (KSCCH) projects undertaken by Riyadh Colleges of Dentistry and Pharmacy. Student's pre- and post-test data were analyzed for changes in oral health knowledge. Overall knowledge score and topic-specific knowledge scores were calculated and the differences between gender, nationality, and educational level were examined using Mann–Whitney U-test. Pre/post change in the oral health knowledge was evaluated by Wilcoxon's sign rank test. Results: Immediately, after oral health educational session high knowledge score category showed an increase of 25.6%, medium and low knowledge score categories showed −3.2% and −22.3% decrease, and this change was statistically significant (P < 0.001). Comparison of correct responses between pre- and post-test showed statistically significant (P < 0.05) increase in all the questions except for the timing of tooth brushing. Females, non-Saudi nationals and students in primary level of education showed significantly high mean knowledge (P < 0.001) at posttest assessment. Conclusion: Primary and intermediate private school student's overall, and topic-specific oral health knowledge improved immediately after educational intervention provided by KSCCH. High knowledge gain was observed among female non-Saudi primary school students. PMID:29285475

PROJECT SUCCESS: Electricity. (Pre-post Tests, Vocabulary Lists, Beginning Circuitry, Intermediate Projects).

ERIC Educational Resources Information Center

James, Sally

Four packets comprise the electricity component of an enrichment program for gifted elementary students. Provided in the introductory packet are sample pre- and posttests for the unit. Remaining packets present vocabulary lists, student worksheets on beginning circuitry, and suggestions for student projects (such as making a battery, constructing…

An Improved WiFi Indoor Positioning Algorithm by Weighted Fusion

PubMed Central

Ma, Rui; Guo, Qiang; Hu, Changzhen; Xue, Jingfeng

2015-01-01

The rapid development of mobile Internet has offered the opportunity for WiFi indoor positioning to come under the spotlight due to its low cost. However, nowadays the accuracy of WiFi indoor positioning cannot meet the demands of practical applications. To solve this problem, this paper proposes an improved WiFi indoor positioning algorithm by weighted fusion. The proposed algorithm is based on traditional location fingerprinting algorithms and consists of two stages: the offline acquisition and the online positioning. The offline acquisition process selects optimal parameters to complete the signal acquisition, and it forms a database of fingerprints by error classification and handling. To further improve the accuracy of positioning, the online positioning process first uses a pre-match method to select the candidate fingerprints to shorten the positioning time. After that, it uses the improved Euclidean distance and the improved joint probability to calculate two intermediate results, and further calculates the final result from these two intermediate results by weighted fusion. The improved Euclidean distance introduces the standard deviation of WiFi signal strength to smooth the WiFi signal fluctuation and the improved joint probability introduces the logarithmic calculation to reduce the difference between probability values. Comparing the proposed algorithm, the Euclidean distance based WKNN algorithm and the joint probability algorithm, the experimental results indicate that the proposed algorithm has higher positioning accuracy. PMID:26334278

An Improved WiFi Indoor Positioning Algorithm by Weighted Fusion.

PubMed

Ma, Rui; Guo, Qiang; Hu, Changzhen; Xue, Jingfeng

2015-08-31

The rapid development of mobile Internet has offered the opportunity for WiFi indoor positioning to come under the spotlight due to its low cost. However, nowadays the accuracy of WiFi indoor positioning cannot meet the demands of practical applications. To solve this problem, this paper proposes an improved WiFi indoor positioning algorithm by weighted fusion. The proposed algorithm is based on traditional location fingerprinting algorithms and consists of two stages: the offline acquisition and the online positioning. The offline acquisition process selects optimal parameters to complete the signal acquisition, and it forms a database of fingerprints by error classification and handling. To further improve the accuracy of positioning, the online positioning process first uses a pre-match method to select the candidate fingerprints to shorten the positioning time. After that, it uses the improved Euclidean distance and the improved joint probability to calculate two intermediate results, and further calculates the final result from these two intermediate results by weighted fusion. The improved Euclidean distance introduces the standard deviation of WiFi signal strength to smooth the WiFi signal fluctuation and the improved joint probability introduces the logarithmic calculation to reduce the difference between probability values. Comparing the proposed algorithm, the Euclidean distance based WKNN algorithm and the joint probability algorithm, the experimental results indicate that the proposed algorithm has higher positioning accuracy.

White blood cell and platelet count as adjuncts to standard clinical evaluation for risk assessment in patients at low probability of acute aortic syndrome.

PubMed

Morello, Fulvio; Cavalot, Giulia; Giachino, Francesca; Tizzani, Maria; Nazerian, Peiman; Carbone, Federica; Pivetta, Emanuele; Mengozzi, Giulio; Moiraghi, Corrado; Lupia, Enrico

2017-08-01

Pre-test probability assessment is key in the approach to suspected acute aortic syndromes (AASs). However, most patients with AAS-compatible symptoms are classified at low probability, warranting further evaluation for decision on aortic imaging. White blood cell count, platelet count and fibrinogen explore pathophysiological pathways mobilized in AASs and are routinely assayed in the workup of AASs. However, the diagnostic performance of these variables for AASs, alone and as a bundle, is unknown. We tested the hypothesis that white blood cell count, platelet count and/or fibrinogen at presentation may be applied as additional tools to standard clinical evaluation for pre-test risk assessment in patients at low probability of AAS. This was a retrospective observational study conducted on consecutive patients managed in our Emergency Department from 2009 to 2014 for suspected AAS. White blood cell count, platelet count and fibrinogen were assayed during evaluation in the Emergency Department. The final diagnosis was obtained by computed tomography angiography. The pre-test probability of AAS was defined according to guidelines. Of 1210 patients with suspected AAS, 1006 (83.1%) were classified at low probability, and 271 (22.4%) were diagnosed with AAS. Within patients at low probability, presence of at least one alteration among white blood cell count >9*10 3 /µl, platelet count <200*10 3 /µl and fibrinogen <350 mg/dl was associated with a sensitivity of 95.5% (89.7-98.5%) and a specificity of 18.3% (15.6-21.2%). In patients at low probability, white blood cell count >9*10 3 /µl and platelet count <200*10 3 /µl were found as independent predictors of AAS beyond established clinical risk markers. Within patients at low probability, the estimated risk of AAS based on the number of alterations amongst white blood cell count >9*10 3 /µl and platelet count <200*10 3 /µl was 2.7% (1.2-5.7%) with zero alterations, 11.3% (8.8-14.3%) with one alteration and 31.9% (24.8-40%) with two alterations ( p<0.001). In addition to standard clinical evaluation, white blood cell count and platelet count may be used in patients at low pre-test probability to fine-tune risk assessment of AAS.

Preferential Hyperacuity Perimeter (PreView PHP) for detecting choroidal neovascularization study.

PubMed

Alster, Yair; Bressler, Neil M; Bressler, Susan B; Brimacombe, Judith A; Crompton, R Michael; Duh, Yi-Jing; Gabel, Veit-Peter; Heier, Jeffrey S; Ip, Michael S; Loewenstein, Anat; Packo, Kirk H; Stur, Michael; Toaff, Techiya

2005-10-01

To assess the ability of the Preferential Hyperacuity Perimeter (PreView PHP; Carl Zeiss Meditec, Dublin, CA) to detect recent-onset choroidal neovascularization (CNV) resulting from age-related macular degeneration (AMD) and to differentiate it from an intermediate stage of AMD. Prospective, comparative, concurrent, nonrandomized, multicenter study. Eligible participants' study eyes had a corrected visual acuity of 20/160 or better and either untreated CNV from AMD diagnosed within the last 60 days or an intermediate stage of AMD. After obtaining consent, visual acuity with habitual correction, masked PHP testing, stereoscopic color fundus photography, and fluorescein angiography were performed. Photographs and angiograms were evaluated by graders masked to diagnosis and PHP results. The reading center's diagnosis determined if the patient was categorized as having intermediate AMD or neovascular AMD. A successful study outcome was defined a priori as a sensitivity of at least 80% and a specificity of at least 80%. Of 185 patients who gave consent to be enrolled, 11 (6%) had PHP results judged to be unreliable. An additional 52 were not included because they did not meet all eligibility criteria. Of the remaining 122 patients, 57 had an intermediate stage of AMD and 65 had neovascular AMD. The sensitivity to detect newly diagnosed CNV using PHP testing was 82% (95% confidence interval [CI], 70%-90%). The specificity to differentiate newly diagnosed CNV from the intermediate stage of AMD using PHP testing was 88% (95% CI, 76%-95%). Preferential Hyperacuity Perimeter testing can detect recent-onset CNV resulting from AMD and can differentiate it from an intermediate stage of AMD with high sensitivity and specificity. These data suggest that monitoring with PHP should detect most cases of CNV of recent onset with few false-positive results at a stage when treatment usually would be beneficial. Thus, this monitoring should be considered in the management of the intermediate stage of AMD.

Evaluation of a pretest scoring system (4Ts) for the diagnosis of heparin-induced thrombocytopenia in a university hospital setting.

PubMed

Vatanparast, Rodina; Lantz, Sarah; Ward, Kristine; Crilley, Pamela Ann; Styler, Michael

2012-11-01

The initial diagnosis of heparin-induced thrombocytopenia (HIT) is made on clinical grounds because the assays with the highest sensitivity (eg, heparin-platelet factor 4 antibody enzyme-linked immunosorbent assay [ELISA]) and specificity (eg, serotonin release assay) may not be readily available. The clinical utility of the pretest scoring system, the 4Ts, was developed and validated by Lo et al in the Journal of Thrombosis and Haemostasis in 2006. The pretest scoring system looks at the degree and timing of thrombocytopenia, thrombosis, and the possibility of other etiologies. Based on the 4T score, patients can be categorized as having a high, intermediate, or low probability of having HIT. We conducted a retrospective study of 100 consecutive patients who were tested for HIT during their hospitalization at Hahnemann University Hospital (Philadelphia, PA) in 2009. Of the 100 patients analyzed, 72, 23, and 5 patients had 4T pretest probability scores of low, intermediate, and high, respectively. A positive HIT ELISA (optical density > 1.0 unit) was detected in 0 of 72 patients (0%) in the low probability group, in 5 of 23 patients (22%) in the intermediate probability group, and in 2 of 5 patients (40%) in the high probability group. The average turnaround time for the HIT ELISA was 4 to 5 days. Fourteen (19%) of the 72 patients with a low pretest probability of HIT were treated with a direct thrombin inhibitor. Ten (71%) of the 14 patients in the low probability group treated with a direct thrombin inhibitor had a major complication of bleeding requiring blood transfusion support. In this retrospective study, a low 4T score showed 100% correlation with a negative HIT antibody assay. We recommend incorporating the 4T scoring system into institutional core measures when assessing a patient with suspected HIT, selecting only patients with intermediate to high probability for therapeutic intervention, which may translate into reduced morbidity and lower health care costs.

Brook trout distributional response to unconventional oil and gas development: Landscape context matters

USGS Publications Warehouse

Merriam, Eric R.; Petty, J. Todd; Maloney, Kelly O.; Young, John A.; Faulkner, Stephen; Slonecker, Terry; Milheim, Lesley E.; Hailegiorgis, Atesmachew; Niles, Jonathan M.

2018-01-01

We conducted a large-scale assessment of unconventional oil and gas (UOG) development effects on brook trout (Salvelinus fontinalis) distribution. We compiled 2231 brook trout collection records from the Upper Susquehanna River Watershed, USA. We used boosted regression tree (BRT) analysis to predict occurrence probability at the 1:24,000 stream-segment scale as a function of natural and anthropogenic landscape and climatic attributes. We then evaluated the importance of landscape context (i.e., pre-existing natural habitat quality and anthropogenic degradation) in modulating the effects of UOG on brook trout distribution under UOG development scenarios. BRT made use of 5 anthropogenic (28% relative influence) and 7 natural (72% relative influence) variables to model occurrence with a high degree of accuracy [Area Under the Receiver Operating Curve (AUC) = 0.85 and cross-validated AUC = 0.81]. UOG development impacted 11% (n = 2784) of streams and resulted in a loss of predicted occurrence in 126 (4%). Most streams impacted by UOG had unsuitable underlying natural habitat quality (n = 1220; 44%). Brook trout were predicted to be absent from an additional 26% (n = 733) of streams due to pre-existing non-UOG land uses (i.e., agriculture, residential and commercial development, or historic mining). Streams with a predicted and observed (via existing pre- and post-disturbance fish sampling records) loss of occurrence due to UOG tended to have intermediate natural habitat quality and/or intermediate levels of non-UOG stress. Simulated development of permitted but undeveloped UOG wells (n = 943) resulted in a loss of predicted occurrence in 27 additional streams. Loss of occurrence was strongly dependent upon landscape context, suggesting effects of current and future UOG development are likely most relevant in streams near the probability threshold due to pre-existing habitat degradation.

The Effects of Conceptual Metaphors on the Acquisition of Phrasal Verbs by Turkish EFL Learners

ERIC Educational Resources Information Center

Kartal, Galip; Uner, Seda

2017-01-01

This study investigates the effects of conceptual metaphors on Turkish EFL learners' acquisition of phrasal verbs. The participants were 120 beginner, elementary, and pre-intermediate level students. The research follows a pre and post-test quasi-experimental research design. The students were assigned to proficiency levels according to their…

Patch-based frame interpolation for old films via the guidance of motion paths

NASA Astrophysics Data System (ADS)

Xia, Tianran; Ding, Youdong; Yu, Bing; Huang, Xi

2018-04-01

Due to improper preservation, traditional films will appear frame loss after digital. To deal with this problem, this paper presents a new adaptive patch-based method of frame interpolation via the guidance of motion paths. Our method is divided into three steps. Firstly, we compute motion paths between two reference frames using optical flow estimation. Then, the adaptive bidirectional interpolation with holes filled is applied to generate pre-intermediate frames. Finally, using patch match to interpolate intermediate frames with the most similar patches. Since the patch match is based on the pre-intermediate frames that contain the motion paths constraint, we show a natural and inartificial frame interpolation. We test different types of old film sequences and compare with other methods, the results prove that our method has a desired performance without hole or ghost effects.

Clinical utility of routine pre-operative axillary ultrasound and fine needle aspiration cytology in patient selection for sentinel lymph node biopsy.

PubMed

Rattay, T; Muttalib, M; Khalifa, E; Duncan, A; Parker, S J

2012-04-01

In patients with operable breast cancer, pre-operative evaluation of the axilla may be of use in the selection of appropriate axillary surgery. Pre-operative axillary ultrasound (US) and fine needle aspiration cytology (FNAC) assessments have become routine practice in many breast units, although the evidence base is still gathering. This study assessed the clinical utility of US+/-FNAC in patient selection for either axillary node clearance (ANC) or sentinel lymph node biopsy (SLNB) in patients undergoing surgery for operable breast cancer. Over a two-year period, 348 patients with a clinically negative axilla underwent axillary US. 67 patients with suspicious nodes on US also underwent FNAC. The sensitivity and specificity of axillary investigations to determine nodal involvement were 56% (confidence interval: 47-64%) and 90% (84-93%) for US alone, and 76% (61-87%) and 100% (65-100%) for FNAC combined with US, respectively. With a positive US, the post-test probability was 78%. A negative US carried a post-test probability of 25%. When FNAC was positive, the post-test probability was greater than unity. A negative FNAC yielded a post-test probability of 52%. All patients with positive FNAC and most patients with suspicious US were listed for axillary node clearance (ANC) after consideration at the multi-disciplinary team (MDT) meeting. With pre-operative axillary US+/-FNAC, 20% of patients were saved a potential second axillary procedure, facilitating a reduction in the overall re-operation rate to 12%. In this study, a positive pre-operative US+/-FNAC directs patients towards ANC. When the result is negative, other clinico-pathological factors need to be taken into account in the selection of the appropriate axillary procedure. Copyright © 2011 Elsevier Ltd. All rights reserved.

In routine UK hospital practice T-SPOT.TB™ is useful in some patients with a modest pre-test probability of active tuberculosis.

PubMed

Turtle, Lance; Kemp, Tim; Davies, Geraint R; Squire, S Bertie; Beeching, Nick J; Beadsworth, Michael B J

2012-06-01

to assess the usefulness of the T-SPOT.TB™ interferon-gamma release assay (IGRA), as used in a regional hospital infectious diseases unit in Northwest England, for the diagnosis of active tuberculosis. Retrospective case series. T-SPOT.TB™ test was applied to a group of 64 patients, 20 of whom had tuberculosis (mostly extra-pulmonary tuberculosis). The T-SPOT.TB™ test had a sensitivity of 83.3% and a specificity of 75% for the diagnosis of active tuberculosis, compared with culture. A positive IGRA approximately doubled the pre-test probability of disease from 0.23 to 0.5. This doubling of probability was true regardless of HIV status, though for HIV+ patients the sensitivity was lower (sensitivity 66.7%, post test probability 0.4 for a positive IGRA result). When extrapolated to the local population the test was most useful for exclusion of disease; post test probability 0.006 (or 1 in 167) for a negative IGRA result. Although it can add weight to a clinical diagnosis, T-SPOT.TB™ assay is not reliable for the diagnosis of active tuberculosis in a real world setting where the test is often used in patients with smear negative or extra-pulmonary disease. The test is useful for ruling out disease in HIV negative patients. Copyright © 2012. Published by Elsevier B.V.

Evaluation of a new nanoparticle-based lateral-flow immunoassay for the exclusion of heparin-induced thrombocytopenia (HIT).

PubMed

Sachs, Ulrich J; von Hesberg, Jakob; Santoso, Sentot; Bein, Gregor; Bakchoul, Tamam

2011-12-01

Heparin-induced thrombocytopenia (HIT) is an adverse complication of heparin caused by HIT antibodies (abs) that recognise platelet factor 4-heparin (PF4/hep) complexes. Several laboratory tests are available for the confirmation and/or refutation of HIT. A reliable and rapid single-sample test is still pending. It was the objective of this study to evaluate a new lateral-flow immunoassay based on nanoparticle technology. A cohort of 452 surgical and medical patients suspected of having HIT was evaluated. All samples were tested in two IgG-specific ELISAs, in a particle gel immunoassay (PaGIA) and in a newly developed lateral-flow immunoassay (LFI-HIT) as well as in a functional test (HIPA). Clinical pre-test probability was determined using 4T's score. Platelet-activating antibodies were present in 34/452 patients, all of whom had intermediate to high clinical probability. PF4/hep abs were detected in 79, 87, 86, and 63 sera using the four different immunoassays. The negative predictive values (NPV) were 100% for both ELISA tests and LFI-HIT but only 99.2% for PaGIA. There were less false positives (n=29) in the LFI-HIT compared to any other test. Additionally, significantly less time was required to perform LFI-HIT than to perform the other immunoassays. In conclusion, a newly developed lateral-flow assay, LFI-HIT, was capable of identifying all HIT patients in a cohort in a short period of time. Beside an NPV of 100%, the rate of false-positive signals is significantly lower with LFI-HIT than with other immunoassay(s). These performance characteristics suggest a high potency in reducing the risk and costs in patients suspected of having HIT.

How Experts Practice: A Novel Test of Deliberate Practice Theory

ERIC Educational Resources Information Center

Coughlan, Edward K.; Williams, A. Mark; McRobert, Allistair P.; Ford, Paul R.

2014-01-01

Performance improvement is thought to occur through engagement in deliberate practice. Deliberate practice is predicted to be challenging, effortful, and not inherently enjoyable. Expert and intermediate level Gaelic football players executed two types of kicks during an acquisition phase and pre-, post-, and retention tests. During acquisition,…

Predictive value of the complex magnetocardiographic index in patients with intermediate pretest probability of chronic coronary artery disease: results of a two-center study.

PubMed

Chaikovsky, Illya; Hailer, Birgit; Sosnytskyy, Volodymyr; Lutay, Mykhaylo; Mjasnikov, Georgiy; Kazmirchuk, Anatoly; Bydnyk, Mykola; Lomakovskyy, Alexander; Sosnytskaja, Taisia

2014-09-01

The aim of this paper is to investigate the predictive value of the new integrated magnetocardiographic (MCG) index (CI) in the diagnosis of coronary artery disease (CAD) in patients with suspected CAD with intermediate pretest probability of the disease and uninformative results of routine tests. The study was carried out in the Clinic of Cardiology of the Main Military Clinical Hospital of Ukraine, Kiev (clinic 1), and in the Second Medical Clinic of the 'Katholisches Klinikum Essen', Germany (clinic 2).The main group (group 1) included 89 patients without a history of myocardial infarction. Coronary angiography was performed because of chest pain. Depending on the results of coronary angiography, this group was divided into two subgroups: (i) those with at least 70% stenosis in at least one of the main coronary arteries (subgroup 1a) and (ii) those without hemodynamically significant stenosis (subgroup 1b). The control group included 43 healthy volunteers.In all participants, the MCG examination was performed using a seven-channel MCG system located in an unshielded room. An integrated MCG index (CI), consisting of six parameters, was calculated. It can be shown that CI was significantly higher in patients with stenosis 70% or more compared with the patients without stenosis and healthy volunteers. Sensitivity was 93%, specificity was 84%, positive predictive value was 85%, and negative predictive value was 93%. The MCG test at rest has the potential to be useful in the noninvasive diagnosis of CAD in patients with intermediate pretest probability of disease and uninformative results of routine tests.

Relationship between estimated pretest probability and accuracy of automated Mycobacterium tuberculosis assay in smear-negative pulmonary tuberculosis.

PubMed

Lim, T K; Gough, A; Chin, N K; Kumarasinghe, G

2000-09-01

The AMPLICOR assay (Roche; Branchburg, NJ), a rapid direct amplification test for Mycobacterium tuberculosis, has only been licensed for use in smear-positive respiratory specimens. However, many patients with pulmonary tuberculosis (PTB) have smear-negative disease. The clinical utility of this test in patients with smear-negative PTB is unknown. To evaluate the effect of pretest probability of PTB estimated by chest physicians on the accuracy of the AMPLICOR assay in patients with smear-negative PTB. A prospective study of consecutive patients suspected of having smear-negative PTB. Two chest physicians estimated the pretest probability of active disease (high, intermediate, and low categories). Respiratory specimens were examined with radiometric broth medium cultures and with the AMPLICOR assay for M tuberculosis. The decision on a final diagnosis of PTB was blinded to the AMPLICOR results. Active PTB was diagnosed in 25 of 441 patients (5.7%). The AMPLICOR assay had an overall sensitivity of 44% and a specificity of 99%. Results of the assay were negative in seven patients with culture-negative PTB. The proportions of patients in the high, intermediate, and low pretest groups were 4.5%, 19.7%, and 75.7%, respectively. The incidence of PTB for each group was 95%, 3.4%, and 0.9%, respectively. The sensitivities of the AMPLICOR assay in the three groups of patients were 47%, 33%, and 33%, respectively, while the specificities were 100%, 98%, and 99%, respectively. In patients suspected of having smear-negative PTB, the following conclusions were drawn: (1) the incidence of active PTB was low; (2) pretest estimates accurately discriminated between patients with high and low risk of PTB; (3) the risk of PTB was overestimated in the intermediate group; and (4) the utility of the AMPLICOR assay in the intermediate-risk group may be limited by the overestimation of disease prevalence and low test sensitivity. Further studies are needed on the role of the AMPLICOR assay in better selected patients with an intermediate risk of having smear-negative PTB.

The Long Exercise Test in Periodic Paralysis: A Bayesian Analysis.

PubMed

Simmons, Daniel B; Lanning, Julie; Cleland, James C; Puwanant, Araya; Twydell, Paul T; Griggs, Robert C; Tawil, Rabi; Logigian, Eric L

2018-05-12

The long exercise test (LET) is used to assess the diagnosis of periodic paralysis (PP), but LET methodology and normal "cut-off" values vary. To determine optimal LET methodology and cut-offs, we reviewed LET data (abductor digiti minimi (ADM) motor response amplitude, area) from 55 PP patients (32 genetically definite) and 125 controls. Receiver operating characteristic (ROC) curves were constructed and area-under-the-curve (AUC) calculated to compare 1) peak-to-nadir versus baseline-to-nadir methodologies, and 2) amplitude versus area decrements. Using Bayesian principles, optimal "cut-off" decrements that achieved 95% post-test probability of PP were calculated for various pre-test probabilities (PreTPs). AUC was highest for peak-to-nadir methodology and equal for amplitude and area decrements. For PreTP ≤50%, optimal decrement cut-offs (peak-to-nadir) were >40% (amplitude) or >50% (area). For confirmation of PP, our data endorse the diagnostic utility of peak-to-nadir LET methodology using 40% amplitude or 50% area decrement cut-offs for PreTPs ≤50%. This article is protected by copyright. All rights reserved. © 2018 Wiley Periodicals, Inc.

Degradation of alachlor and pyrimethanil by combined photo-Fenton and biological oxidation.

PubMed

Ballesteros Martín, M M; Sánchez Pérez, J A; García Sánchez, J L; Montes de Oca, L; Casas López, J L; Oller, I; Malato Rodríguez, S

2008-06-30

Biodegradability of aqueous solutions of the herbicide alachlor and the fungicide pyrimethanil, partly treated by photo-Fenton, and the effect of photoreaction intermediates on growth and DOC removal kinetics of the bacteria Pseudomonas putida CECT 324 are demonstrated. Toxicity of 30-120 mg L(-1) alachlor and pyrimethanil has been assayed in P. putida. The biodegradability of photocatalytic intermediates found at different photo-treatment times was evaluated for each pesticide. At a selected time during batch-mode phototreatment, larger-scale biodegradation kinetics were analysed in a 12 L bubble column bioreactor. Both alachlor and pyrimethanil are non-toxic for P. putida CECT 324 at the test concentrations, but they are not biodegradable. A approximately 100 min photo-Fenton pre-treatment was enough to enhance biodegradability, the biological oxidation response being dependent on the pesticide tested. The different alachlor and pyrimethanil respiration and carbon uptake rates in pre-treated solutions are related to change in the growth kinetics of P. putida. Reproducible results have shown that P. putida could be a suitable microorganism for determining photo-Fenton pre-treatment time.

The intron 1 of HPV 16 has a suboptimal branch point at a guanosine.

PubMed

De la Rosa-Rios, Marco Antonio; Martínez-Salazar, Martha; Martínez-Garcia, Martha; González-Bonilla, César; Villegas-Sepúlveda, Nicolás

2006-06-01

The branch point sequence (BPS) of intron 1 of the HPV-16 was determined via RT-PCR in a cell free system, using lariat intermediates obtained by in vitro splicing reactions. We used synthetic E6/E7 transcripts and HeLa nuclear protein extracts to obtain the splicing intermediates. Then, a divergent oligonucleotide primer set, pairing on the lariat RNA that encompassed the 2'-5' phosphodiester bond formed between the 5' end of the intron and the BPS, was used for cDNA synthesis and PCR amplification. Subsequent RT-PCR assays revealed four splicing intermediates, made up of a major intermediary corresponding to the BPS and four cryptic branched sequences. Only intermediates bound at the 5' end of the intron are probably the authentic branch point sequence, and all of them branch at guanosine 328 instead of the typical adenosine. Unusually, the BPS of intron 1 of HPV-16 is a suboptimal sequence (AGUGAGU) that differs from the eukaryotic consensus BPS, which correlates with the splicing profile observed for early transcripts of HPV-16 in tumors and tumor derived cell lines. The implications of this unusual branch point sequence for splicing of the HPV-16 pre-mRNA are discussed.

College Students' Achievement and Understanding of Experimental and Theoretical Probability: The Role of Tasks

ERIC Educational Resources Information Center

Papaieronymou, Irini

2012-01-01

This study examined the role of particular tasks implemented through two instructional methods on college students' "achievement" and understanding of probability. A mixed methods design that utilized a pre-test and post-test was used. This included treatment and control groups, each comprised of students in three sections of an…

Communication with patients during the prenatal testing procedure: an explorative qualitative study.

PubMed

van Zwieten, Myra; Willems, Dick; Knegt, Lia; Leschot, Nico

2006-10-01

While generally two phases of prenatal genetic counseling are distinguished, i.e. pre- and post-test counseling, we revealed a third form of communication during the testing procedure. The content of this intermediate communication was explored. A secondary analysis was performed on data obtained in another observational study, which was focussed on how indefinite testing results are clarified. Thirteen testing trajectories in which communication with parents took place during the testing procedure were further analysed. In the majority of cases the content of intermediate communication was similar to the content of pre-test counseling. In four cases the content was different, because the communication involved the parents in decision-making about a testing result, which was still being processed. Communication in (prenatal) genetic testing is not always restricted to separate phases, but can be an ongoing process occurring parallel to, and sometimes even intertwined with, the testing process. The advocated model of shared decision-making might work better once it is determined if the decision concerns the area wherein the provider is the expert, or the patient. Further research into the process of continuing decision-making could clarify how providers' and patients' responsibilities regarding the diagnostic process are distributed. Meanwhile, the possible occurrence of continuous decision-making should be mentioned in (prenatal) genetic counseling.

[Pre-test and post-test probabilities. Who cares?].

PubMed

Steurer, Johann

2009-01-01

The accuracy of a diagnostic test, i.e. abdomen ultrasound in patients with suspected acute appendicitis, is described in the terms of sensitivity and specificity. According to eminent textbooks physicians should use the values of the sensitivity and specificity of a test in their diagnostic reasoning. Physician's estimate, after taking the history, the pretest-probability of the suspected illness, order one or more tests and then calculate the respective posttest-probability. In practice physicians almost never follow this line of thinking. The main reasons are; to estimate concrete illness probabilities is difficult, the values for the sensitivity and specificity of a test are most often not known by physicians and calculations during daily practice are intricate. Helpful for busy physicians are trustworthy expert recommendations which test to apply in which clinical situation.

The Effect of Learner Constructed, Fill in the Map Concept Map Technique, and Summarizing Strategy on Iranian Pre-University Students' Reading Comprehension

ERIC Educational Resources Information Center

Soleimani, Hassan; Nabizadeh, Fatemeh

2012-01-01

Concept maps (CM) are powerful tools which have different uses in educational contexts; however, this study limited its extension and explored its impact on the reading comprehension skill of Iranian EFL students. To this purpose, a proficiency test was employed and 90 intermediate pre-university students were chosen and divided into three groups:…

Interactions of short-acting, intermediate-acting and pre-mixed human insulins with free radicals--Comparative EPR examination.

PubMed

Olczyk, Paweł; Komosinska-Vassev, Katarzyna; Ramos, Paweł; Mencner, Łukasz; Olczyk, Krystyna; Pilawa, Barbara

2015-07-25

Electron paramagnetic resonance (EPR) spectroscopy was used to examine insulins interactions with free radicals. Human recombinant DNA insulins of three groups were studied: short-acting insulin (Insuman Rapid); intermediate-acting insulins (Humulin N, Insuman Basal), and pre-mixed insulins (Humulin M3, Gensulin M50, Gensulin M40, Gensulin M30). The aim of an X-band (9.3GHz) study was comparative analysis of antioxidative properties of the three groups of human insulins. DPPH was used as a stable free radical model. Amplitudes of EPR lines of DPPH as the paramagnetic free radical reference, and DPPH interacting with the individual tested insulins were compared. For all the examined insulins kinetics of their interactions with free radicals up to 60 min were obtained. The strongest interactions with free radicals were observed for the short-acting insulin - Insuman Rapid. The lowest interactions with free radicals were characteristic for intermediate-acting insulin - Insuman Basal. The pre-mixed insulins i.e. Humulin M3 and Gensulin M50 revealed the fastest interactions with free radicals. The short acting, intermediate acting and premixed insulins have been found to be effective agents in reducing free radical formation in vitro and should be further considered as potential useful tools in attenuation of oxidative stress in diabetic patients. Copyright © 2015 Elsevier B.V. All rights reserved.

The association between pretest probability of coronary artery disease and stress test utilization and outcomes in a chest pain observation unit.

PubMed

Napoli, Anthony M

2014-04-01

Cardiology consensus guidelines recommend use of the Diamond and Forrester (D&F) score to augment the decision to pursue stress testing. However, recent work has reported no association between pretest probability of coronary artery disease (CAD) as measured by D&F and physician discretion in stress test utilization for inpatients. The author hypothesized that D&F pretest probability would predict the likelihood of acute coronary syndrome (ACS) and a positive stress test and that there would be limited yield to diagnostic testing of patients categorized as low pretest probability by D&F score who are admitted to a chest pain observation unit (CPU). This was a prospective observational cohort study of consecutively admitted CPU patients in a large-volume academic urban emergency department (ED). Cardiologists rounded on all patients and stress test utilization was driven by their recommendations. Inclusion criteria were as follows: age>18 years, American Heart Association (AHA) low/intermediate risk, nondynamic electrocardiograms (ECGs), and normal initial troponin I. Exclusion criteria were as follows: age older than 75 years with a history of CAD. A D&F score for likelihood of CAD was calculated on each patient independent of patient care. Based on the D&F score, patients were assigned a priori to low-, intermediate-, and high-risk groups (<10, 10 to 90, and >90%, respectively). ACS was defined by ischemia on stress test, coronary artery occlusion of ≥70% in at least one vessel, or elevations in troponin I consistent with consensus guidelines. A true-positive stress test was defined by evidence of reversible ischemia and subsequent angiographic evidence of critical stenosis or a discharge diagnosis of ACS. An estimated 3,500 patients would be necessary to have 1% precision around a potential 0.3% event rate in low-pretest-probability patients. Categorical comparisons were made using Pearson chi-square testing. A total of 3,552 patients with index visits were enrolled over a 29-month period. The mean (±standard deviation [SD]) age was 51.3 (±9.3) years. Forty-nine percent of patients received stress testing. Pretest probability based on D&F score was associated with stress test utilization (p<0.01), risk of ACS (p<0.01), and true-positive stress tests (p=0.03). No patients with low pretest probability were subsequently diagnosed with ACS (95% CI=0 to 0.66%) or had a true-positive stress test (95% CI=0 to 1.6%). Physician discretionary decision-making regarding stress test use is associated with pretest probability of CAD. However, based on the D&F score, low-pretest-probability patients who meet CPU admission criteria are very unlikely to have a true-positive stress test or eventually receive a diagnosis of ACS, such that observation and stress test utilization may be obviated. © 2014 by the Society for Academic Emergency Medicine.

"Combined Diagnostic Tool" APPlication to a Retrospective Series of Patients Undergoing Total Joint Revision Surgery.

PubMed

Gallazzi, Enrico; Drago, Lorenzo; Baldini, Andrea; Stockley, Ian; George, David A; Scarponi, Sara; Romanò, Carlo L

2017-01-01

Background : Differentiating between septic and aseptic joint prosthesis may be challenging, since no single test is able to confirm or rule out infection. The choice and interpretation of the panel of tests performed in any case often relies on empirical evaluation and poorly validated scores. The "Combined Diagnostic Tool (CDT)" App, a smartphone application for iOS, was developed to allow to automatically calculate the probability of having a of periprosthetic joint infection, on the basis of the relative sensitivity and specificity of the positive and negative diagnostic tests performed in any given patient. Objective : The aim of the present study was to apply the CDT software to investigate the ability of the tests routinely performed in three high-volume European centers to diagnose a periprosthetic infection. Methods : This three-center retrospective study included 120 consecutive patients undergoing total hip or knee revision, and included 65 infected patients (Group A) and 55 patients without infection (Group B). The following parameters were evaluated: number and type of positive and negative diagnostic tests performed pre-, intra- and post-operatively and resultant probability calculated by the CDT App of having a peri-prosthetic joint infection, based on pre-, intra- and post-operative combined tests. Results : Serological tests were the most common performed, with an average 2.7 tests per patient for Group A and 2.2 for Group B, followed by joint aspiration (0.9 and 0.8 tests per patient, respectively) and imaging techniques (0.5 and 0.2 test per patient). Mean CDT App calculated probability of having an infection based on pre-operative tests was 79.4% for patients in Group A and 35.7 in Group B. Twenty-nine patients in Group A had > 10% chance of not having an infection, and 29 of Group B had > 10% chance of having an infection. Conclusion : This is the first retrospective study focused on investigating the number and type of tests commonly performed prior to joint revision surgery and aimed at evaluating their combined ability to diagnose a peri-prosthetic infection. CDT App allowed us to demonstrate that, on average, the routine combination of commonly used tests is unable to diagnose pre-operatively a peri-prosthetic infection with a probability higher than 90%.

Spatial Skill Profile of Mathematics Pre-Service Teachers

NASA Astrophysics Data System (ADS)

Putri, R. O. E.

2018-01-01

This study is aimed to investigate the spatial intelligence of mathematics pre-service teachers and find the best instructional strategy that facilitates this aspect. Data were collected from 35 mathematics pre-service teachers. The Purdue Spatial Visualization Test (PSVT) was used to identify the spatial skill of mathematics pre-service teachers. Statistical analysis indicate that more than 50% of the participants possessed spatial skill in intermediate level, whereas the other were in high and low level of spatial skill. The result also shows that there is a positive correlation between spatial skill and mathematics ability, especially in geometrical problem solving. High spatial skill students tend to have better mathematical performance compare to those in two other levels. Furthermore, qualitative analysis reveals that most students have difficulty in manipulating geometrical objects mentally. This problem mostly appears in intermediate and low-level spatial skill students. The observation revealed that 3-D geometrical figures is the best method that can overcome the mentally manipulation problem and develop the spatial visualization. Computer application can also be used to improve students’ spatial skill.

Bayesian probability analysis: a prospective demonstration of its clinical utility in diagnosing coronary disease

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

Detrano, R.; Yiannikas, J.; Salcedo, E.E.

One hundred fifty-four patients referred for coronary arteriography were prospectively studied with stress electrocardiography, stress thallium scintigraphy, cine fluoroscopy (for coronary calcifications), and coronary angiography. Pretest probabilities of coronary disease were determined based on age, sex, and type of chest pain. These and pooled literature values for the conditional probabilities of test results based on disease state were used in Bayes theorem to calculate posttest probabilities of disease. The results of the three noninvasive tests were compared for statistical independence, a necessary condition for their simultaneous use in Bayes theorem. The test results were found to demonstrate pairwise independence inmore » patients with and those without disease. Some dependencies that were observed between the test results and the clinical variables of age and sex were not sufficient to invalidate application of the theorem. Sixty-eight of the study patients had at least one major coronary artery obstruction of greater than 50%. When these patients were divided into low-, intermediate-, and high-probability subgroups according to their pretest probabilities, noninvasive test results analyzed by Bayesian probability analysis appropriately advanced 17 of them by at least one probability subgroup while only seven were moved backward. Of the 76 patients without disease, 34 were appropriately moved into a lower probability subgroup while 10 were incorrectly moved up. We conclude that posttest probabilities calculated from Bayes theorem more accurately classified patients with and without disease than did pretest probabilities, thus demonstrating the utility of the theorem in this application.« less

Beyond English Proficiency: Rethinking Immigrant Integration

PubMed Central

Akresh, Ilana Redstone; Massey, Douglas S.; Frank, Reanne

2014-01-01

We develop and test a conceptual model of English language acquisition and the strength of the latter in predicting social and cultural assimilation. We present evidence that the path to English proficiency begins with exposure to English in the home country and on prior U.S. trips. English proficiency, then, has direct links to the intermediate migration outcomes of occupational status in the U.S., the amount of time in the U.S. since the most recent trip, and the co-ethnic residential context in the U.S. In turn, pre-migration characteristics and the intermediate characteristics work in tandem with English proficiency to determine social assimilation in the U.S., while cultural assimilation is primarily determined by pre-migration habits. A shift in focus to English use is desirable in studies of immigrant integration. PMID:24576636

Math Placement Validation Study: A Summary of the Criterion-Related Validity Evidence and Multiple Measures Data for the San Diego Community College District.

ERIC Educational Resources Information Center

Armstrong, William B.

In Fall 1994, the San Diego Community College District (SDCCD), in California, conducted a study to determine the validity of the Mathematics Diagnostic Testing Project (MDTP) placement test. The MDTP provides tests at four levels (i.e., algebra readiness, elementary algebra, intermediate algebra, and pre-calculus) and is used in the District for…

Barbados: Architecture and implications for accretion

NASA Astrophysics Data System (ADS)

Speed, R. C.; Larue, D. K.

1982-05-01

The island of Barbados exposes the crestal zone of the remarkably broad accretionary prism of the Lesser Antilles foreacrc. The architecture of Barbados is three-tiered: an upper arched cap of Pleistocene reefs that record rapid and differential uplift of the island, an intermediate zone of nappes of mainly abyssal or deep bathyal pelagic rocks, and a basal complex whose lithotypes extend to substantial depth and may be representative of the bulk of the western or inner accretionary prism. The exposed basal complex consists of generally steeply dipping ENE to NE-striking fault-bounded packets which contain rocks of one of three lithic suites: terrigenous (quartzose turbidite and mudstone), debris flow, and hemipelagic (chiefly radiolarite). Present but imcomplete rock dating indicates that the terrigenous and hemipelagic suites and the pelagic rocks of the intermediate zone are age overlapping in Early and Middle Eocene time. Deformation within packets of the basal complex is systematic, pre- or synfault, and indicative of shortening that is generally normal to packet boundaries. A unit of terrigenous materials that probably underwent local resedimentation in the Miocene is recognized in wells, but its relationship to exposed rocks is uncertain. The packet-bounding faults of the basal complex are interpreted to have been primary accretionary surfaces which may have been reactivated by later intraprism movements. Exposed sedimentary rocks of Barbados can be successfully assigned to contemporaneous depositional sites associated with an accretionary prism: terrigenous beds to a trench wedge that was connected to South American sediment sources, debris flow to trench floor or slope basin accumulations of material derived from the lower slope, hemipelagic to Atlantic plain strata, and pelagic rocks of the intermediate zone to deep outer forearc basin sites. The decollement at the base of the intermediate zone is probably due to uplift and arcward motion of the crestal zone of the accretionary prism with respect to the forearc basin during progressive prism growth. Principal uplift of the prism seems to have started, apparently abruptly, in the Miocene. Quaternary uplift of Barbados may be due partly to local diapirism. Paleogene subduction that created the arcward region of the prism probably occurred in a differently configured zone from the present one.

Prevalence of tuberculosis infection in healthcare workers of the public hospital network in Medellín, Colombia: a Bayesian approach.

PubMed

Ochoa, J; León, A L; Ramírez, I C; Lopera, C M; Bernal, E; Arbeláez, M P

2017-04-01

A latent tuberculosis infection (LTBI) prevalence survey was conducted using tuberculin skin test (TST) and Quantiferon test (QFT) in 1218 healthcare workers (HCWs) in Medellín, Colombia. In order to improve the prevalence estimates, a latent class model was built using a Bayesian approach with informative priors on the sensitivity and specificity of the TST. The proportion of concordant results (TST+,QFT+) was 41% and the discordant results contributed 27%. The marginal estimate of the prevalence P(LTBI+) was 62·1% [95% credible interval (CrI) 53·0-68·2]. The probability of LTBI+ given positive results for both tests was 99·6% (95% CrI 98·1-99·9). Sensitivity was 88·5 for TST and 74·3 for QFT, and specificity was 87·8 for TST and 97·6 for QFT. A high LTBI prevalence was found in HCWs with time-accumulated exposure in hospitals that lack control plans. In a context of intermediate tuberculosis (TB) incidence it is recommended to use only one test (either QFT or TST) in prevalence surveys or as pre-employment tests. Results will be useful to help implement TB infection control plans in hospitals where HCWs may be repeatedly exposed to unnoticed TB patients, and to inform the design of TB control policies.

Diagnostic accuracy of laparoscopy following computed tomography (CT) scanning for assessing the resectability with curative intent in pancreatic and periampullary cancer.

PubMed

Allen, Victoria B; Gurusamy, Kurinchi Selvan; Takwoingi, Yemisi; Kalia, Amun; Davidson, Brian R

2016-07-06

Surgical resection is the only potentially curative treatment for pancreatic and periampullary cancer. A considerable proportion of patients undergo unnecessary laparotomy because of underestimation of the extent of the cancer on computed tomography (CT) scanning. Laparoscopy can detect metastases not visualised on CT scanning, enabling better assessment of the spread of cancer (staging of cancer). This is an update to a previous Cochrane Review published in 2013 evaluating the role of diagnostic laparoscopy in assessing the resectability with curative intent in people with pancreatic and periampullary cancer. To determine the diagnostic accuracy of diagnostic laparoscopy performed as an add-on test to CT scanning in the assessment of curative resectability in pancreatic and periampullary cancer. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE via PubMed, EMBASE via OvidSP (from inception to 15 May 2016), and Science Citation Index Expanded (from 1980 to 15 May 2016). We included diagnostic accuracy studies of diagnostic laparoscopy in people with potentially resectable pancreatic and periampullary cancer on CT scan, where confirmation of liver or peritoneal involvement was by histopathological examination of suspicious (liver or peritoneal) lesions obtained at diagnostic laparoscopy or laparotomy. We accepted any criteria of resectability used in the studies. We included studies irrespective of language, publication status, or study design (prospective or retrospective). We excluded case-control studies. Two review authors independently performed data extraction and quality assessment using the QUADAS-2 tool. The specificity of diagnostic laparoscopy in all studies was 1 because there were no false positives since laparoscopy and the reference standard are one and the same if histological examination after diagnostic laparoscopy is positive. The sensitivities were therefore meta-analysed using a univariate random-effects logistic regression model. The probability of unresectability in people who had a negative laparoscopy (post-test probability for people with a negative test result) was calculated using the median probability of unresectability (pre-test probability) from the included studies, and the negative likelihood ratio derived from the model (specificity of 1 assumed). The difference between the pre-test and post-test probabilities gave the overall added value of diagnostic laparoscopy compared to the standard practice of CT scan staging alone. We included 16 studies with a total of 1146 participants in the meta-analysis. Only one study including 52 participants had a low risk of bias and low applicability concern in the patient selection domain. The median pre-test probability of unresectable disease after CT scanning across studies was 41.4% (that is 41 out of 100 participants who had resectable cancer after CT scan were found to have unresectable disease on laparotomy). The summary sensitivity of diagnostic laparoscopy was 64.4% (95% confidence interval (CI) 50.1% to 76.6%). Assuming a pre-test probability of 41.4%, the post-test probability of unresectable disease for participants with a negative test result was 0.20 (95% CI 0.15 to 0.27). This indicates that if a person is said to have resectable disease after diagnostic laparoscopy and CT scan, there is a 20% probability that their cancer will be unresectable compared to a 41% probability for those receiving CT alone.A subgroup analysis of people with pancreatic cancer gave a summary sensitivity of 67.9% (95% CI 41.1% to 86.5%). The post-test probability of unresectable disease after being considered resectable on both CT and diagnostic laparoscopy was 18% compared to 40.0% for those receiving CT alone. Diagnostic laparoscopy may decrease the rate of unnecessary laparotomy in people with pancreatic and periampullary cancer found to have resectable disease on CT scan. On average, using diagnostic laparoscopy with biopsy and histopathological confirmation of suspicious lesions prior to laparotomy would avoid 21 unnecessary laparotomies in 100 people in whom resection of cancer with curative intent is planned.

Application of the World Health Organization Fracture Risk Assessment Tool to predict need for dual-energy X-ray absorptiometry scanning in postmenopausal women.

PubMed

Chao, An-Shine; Chen, Fang-Ping; Lin, Yu-Ching; Huang, Ting-Shuo; Fan, Chih-Ming; Yu, Yu-Wei

2015-12-01

To evaluate the efficacy of the World Health Organization Fracture Risk Assessment Tool, excluding bone mineral density (pre-BMD FRAX), in identifying Taiwanese postmenopausal women needing dual-energy X-ray absorptiometry (DXA) examination for further treatment. The pre-BMD FRAX score was calculated for 231 postmenopausal women who participated in public health education workshops in the local Keelung community, Taiwan. DXA scanning and vertebral fracture assessment (VFA) were arranged for women classified as intermediate or high risk for fracture using the pre-BMD FRAX fracture probability. Pre-BMD FRAX classified 26 women as intermediate risk and 37 as having high risk for fracture. Subsequent DXA scans for these 63 women showed that 36 were osteoporotic, 19 were osteopenic, and eight had normal bone density. Concurrent VFA revealed 25 spine factures in which 14 were osteoporotic, seven were osteopenic, and four had normal bone density. The efficacy of the pre-BMD FRAX score to identify those patients with low bone mass by DXA was 87.3% (55/63). When VFA was combined with BMD to identify those patients with high risk (osteopenia, osteoporosis, or spinal fracture), the efficacy of the pre-BMD score increased to 93.7% (59/63). According to the National Osteoporosis Foundation, the overall concordance between pre-BMD FRAX and BMD, expressed through the kappa index, was 0.967. Compared with the evaluation when BMD was used alone, there was a significant increase in efficacy in identifying women who need treatment using BMD plus VFA or FRAX plus BMD. Furthermore, the highest efficacy was achieved when FRAX with BMD and VFA was used. The pre-BMD FRAX score not only efficiently predicts postmenopausal patients who are potentially at risk and might require treatment but also reduces unnecessary DXA use. Concurrent VFA during DXA use increases spine fracture detection. This improvement in diagnostic efficacy allows clinicians to provide the most appropriate therapeutic recommendation. Copyright © 2015. Published by Elsevier B.V.

Clinicians' perceptions of the value of ventilation-perfusion scans.

PubMed

Siegel, Alan; Holtzman, Stephen R; Bettmann, Michael A; Black, William C

2004-07-01

The goal of this investigation was to understand clinicians' perceptions of the probability of pulmonary embolism as a function of V/Q scan results of normal, low, intermediate, and high probability. A questionnaire was developed and distributed to 429 clinicians at a single academic medical center. The response rate was 44% (188 of 429). The questions included level of training, specialty, probability of PE given 1 of the 4 V/Q scan results, and estimations of the charges for V/Q scanning and pulmonary angiography, and estimations of the risks of pulmonary angiography. The medians and ranges for the probability of pulmonary embolism given a normal, low, intermediate, and high probability V/Q scan result were 2.5% (0-30), 12.5% (0.5-52.5), 41.25% (5-75), and 85% (5-100), respectively. Eleven percent (21 of 188) of the respondents listed the probability of PE in patients with a low probability V/Q scan as being 5% or less, and 33% (62 of 188) listed the probability of PE given an intermediate probability scan as 50% or greater. The majority correctly identified the rate of serious complications of pulmonary arteriography, but many respondents underestimated the charge for V/Q scans and pulmonary arteriography. A substantial minority of clinicians do not understand the probability of pulmonary embolism in patients with low and intermediate probability ventilation-perfusion scans. More quantitative reporting of results is recommended. This could be particularly important because VQ scans are used less frequently but are still needed in certain clinical situations.

Preemptive Anticoagulation in Patients With a High Pretest Probability of Pulmonary Embolism: Are Guidelines Followed?

PubMed

Willoughby, Laura; Adams, Daniel M; Evans, R Scott; Lloyd, James F; Stevens, Scott M; Woller, Scott C; Bledsoe, Joseph R; Aston, Valerie T; Wilson, Emily L; Elliott, C Gregory

2018-05-01

Guidelines suggest anticoagulation of patients with high pretest probability of pulmonary embolism (PE) while awaiting diagnostic test results (preemptive anticoagulation). Data relevant to the practice of preemptive anticoagulation are not available. We reviewed 3,500 consecutive patients who underwent CT pulmonary angiography (CTPA) at two EDs. We classified the pretest probability for PE using the revised Geneva Score (RGS) as low (RGS 0-3), intermediate (RGS 4-10), or high (RGS 11-18). We classified patients with a high pretest probability of PE as receiving preemptive anticoagulation if therapeutic anticoagulation was given before CTPA completion. Patients with a high bleeding risk and those receiving treatment for DVT before CTPA were excluded from the preemptive anticoagulation analysis. We compared the time elapsed between ED registration and CTPA completion for patients with a low, intermediate, and high pretest probability for PE. We excluded three of 3,500 patients because CTPA preceded ED registration. Of the remaining 3,497 patients, 167 (4.8%) had a high pretest probability for PE. After excluding 29 patients for high bleeding risk and 21 patients who were treated for DVT prior to CTPA, only two of 117 patients (1.7%) with a high pretest probability for PE received preemptive anticoagulation. Furthermore, 37 of the remaining 115 patients (32%) with a high pretest probability for PE had a preexisting indication for anticoagulation but did not receive preemptive anticoagulation. The time from ED registration to CTPA completion did not differ based on the pretest probability of PE. Physicians rarely use preemptive anticoagulation in patients with a high pretest probability for PE. Clinicians do not expedite CTPA examinations for patients with a high pretest probability for PE. Copyright © 2017 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

CT coronary angiography and exercise ECG in a population with chest pain and low-to-intermediate pre-test likelihood of coronary artery disease.

PubMed

Maffei, Erica; Seitun, Sara; Martini, Chiara; Palumbo, Alessandro; Tarantini, Giuseppe; Berti, Elena; Grilli, Roberto; Tedeschi, Carlo; Messalli, Giancarlo; Guaricci, Andrea; Weustink, Annick C; Mollet, Nico Ra; Cademartiri, Filippo

2010-12-01

To evaluate diagnostic accuracy of exercise ECG (ex-ECG) versus 64-slice CT coronary angiography (CT-CA) for the detection of significant coronary artery stenosis in a population with low-to-intermediate pre-test likelihood of coronary artery disease (CAD). Retrospective single centre. Tertiary academic hospital. 177 consecutive patients (88 men, 89 women, mean age 53.5±7.6 years) with chest pain and low-to-intermediate pre-test likelihood of CAD were retrospectively enrolled. All patients underwent ex-ECG, CT-CA and invasive coronary angiography (ICA). A lumen diameter reduction of ≥50% was considered as significant stenosis for CT-CA. Ex-ECG was classified as positive, negative or non-diagnostic. were compared with ICA. Diagnostic accuracy of CT-CA and ex-ECG was calculated using ICA as the reference standard. A parallel comparative analysis using a cut-off value of 70% for significant lumen reduction was also performed too. Results ICA disclosed an absence of significant stenosis (≥50% luminal narrowing) in 85.3% (151/177) patients, single-vessel disease in 9.0% (16/177) patients and multivessel disease in 5.6% (10/177) patients. Prevalence of obstructive disease at ICA was 14.7% (26/177). Sensitivity, specificity, positive and negative predictive values at the patient level were 100.0%, 98.7%, 92.9%, 100%, respectively, for CT-CA and 46.2%, 16.6%, 8.7%, 64.1%, respectively, for ex-ECG. Agreement between CT-CA and ex-ECG was 20.9%. CT-CA performed equally well in men and women, while ex-ECG had a better performance in men. After considering the cut-off value of 70% for significant stenosis, the difference between CT-CA and ex-ECG remained significant (p<0.01), with a low agreement (21.5%). CT-CA provides optimal diagnostic performance in patients with atypical chest pain and low-to-intermediate risk of CAD. Ex-ECG has poor diagnostic accuracy in this population. Concerns are related to risk of radiation dose versus the benefits of correct disease stratification.

Incremental diagnostic accuracy of hybrid SPECT/CT coronary angiography in a population with an intermediate to high pre-test likelihood of coronary artery disease.

PubMed

Schaap, Jeroen; Kauling, Robert M; Boekholdt, S Matthijs; Nieman, Koen; Meijboom, W Bob; Post, Martijn C; Van der Heyden, Jan A; de Kroon, Thom L; van Es, H Wouter; Rensing, Benno J; Verzijlbergen, J Fred

2013-07-01

Hybrid myocardial perfusion imaging with single photon emission computed tomography (SPECT) and CT coronary angiography (CCTA) has the potential to play a major role in patients with non-conclusive SPECT or CCTA results. We evaluated the performance of hybrid SPECT/CCTA vs. standalone SPECT and CCTA for the diagnosis of significant coronary artery disease (CAD) in patients with an intermediate to high pre-test likelihood of CAD. In total, 98 patients (mean age 62.5 ± 10.1 years, 68.4% male) with stable anginal complaints and a median pre-test likelihood of 87% (range 22-95%) were prospectively included in this study. Hybrid SPECT/CCTA was performed prior to conventional coronary angiography (CA) including fractional flow reserve (FFR) measurements. Hybrid analysis was performed by combined interpretation of SPECT and CCTA images. The sensitivity, specificity, positive (PPV), and negative (NPV) predictive values were calculated for standalone SPECT, CCTA, and hybrid SPECT/CCTA on per patient level, using an FFR <0.80 as a reference for significant CAD. Significant CAD was demonstrated in 56 patients (57.9%). Non-conclusive SPECT or CCTA results were found in 32 (32.7%) patients. SPECT had a sensitivity of 93%, specificity 79%, PPV 85%, and NPV 89%. CCTA had a sensitivity of 98%, specificity 62%, PPV 77%, and NPV 96%. Hybrid analysis of SPECT and CCTA improved the overall performance: sensitivity, specificity, PPV, and NPV for the presence of significant CAD to 96, 95, 96, and 95%, respectively. In > 40% of the patients with a high pre-test likelihood no significant CAD was demonstrated, emphasizing the value of accurate pre-treatment cardiovascular imaging. Hybrid SPECT/CCTA was able to accurately diagnose and exclude significant CAD surpassing standalone myocardial SPECT and CCTA, vs. a reference standard of FFR measurements.

Verbal versus Numerical Probabilities: Does Format Presentation of Probabilistic Information regarding Breast Cancer Screening Affect Women's Comprehension?

ERIC Educational Resources Information Center

Vahabi, Mandana

2010-01-01

Objective: To test whether the format in which women receive probabilistic information about breast cancer and mammography affects their comprehension. Methods: A convenience sample of 180 women received pre-assembled randomized packages containing a breast health information brochure, with probabilities presented in either verbal or numeric…

The role of the substrate in micro-scale scratching of epoxy-polyester films

NASA Astrophysics Data System (ADS)

Barletta, M.; Gisario, A.

2011-02-01

The present investigation analyzes the deformation response of electrostatically sprayed epoxy-polyester powder coatings by 'in situ' micro-mechanical tests. The characterization of the performance of the coatings was carried out by micro-scale scratching, by varying the indenter type, the applied load and the sliding speed. The tests were carried out on polymeric coatings deposited on as-received, micro and macro-corrugated AISI 304 stainless steel substrates and 'rigidly adhered' to them. Further tests were performed on 'free-standing' coatings, that is, on the as-received metal substrates pre-coated with an intermediate layer of silicon-based heat curable release coating. Experimental data allow us to evaluate the influence of the contact conditions between substrate and indenter and the role of the loading conditions on the scratch and penetration resistance of the epoxy-polyester coatings. The different responses of the polymeric coatings when deposited on untreated or pre-treated substrates as well as on an intermediate layer of release coating, contribute to a better understanding of the intrinsic roles of the polymeric material and substrate as well as the influence of the interfacial adhesion between coating and substrate.

The intermediate-age pre-cataclysmic variables SDSS J172406+562003 and RE J2013+4002

NASA Astrophysics Data System (ADS)

Shimansky, V. V.; Borisov, N. V.; Nurtdinova, D. N.; Mitrofanova, A. A.; Vlasyuk, V. V.; Spiridonova, O. I.

2012-06-01

We have analyzed the physical status of the pre-cataclysmic variables SDSSJ172406+562003 and RE J2013+4002, which have evolved after their common-envelope stage a time t = 106-107 years. Spectroscopy and photometry of these systems were performed with the 6-m and 1-m telescopes of the Special Astrophysical Observatory. We demonstrate that emission lines in the spectra were formed solely by the reflection of radiation emitted by the white dwarfs on the surfaces of their cool companions, under conditions close to local thermodynamic equilibrium. These effects are also responsible for most of the objects' photometric variability amplitude. However, comparing the light curves of SDSS 172406 from different epochs, we find aperiodic brightness variations, probably due to spottedness of the surface of the secondary. Jointly analyzing the spectra, radial-velocity curves, and light curves of the pre-cataclysmic variables and modeling the reflection effects, we have derived their fundamental parameters. We demonstrate that the secondaries in these systems are consistent with evolutionary models for main-sequence stars and do not have the luminosity excesses characteristic of cool stars in young pre-cataclysmic variables.

The Effect of Video-Based Tasks in Listening Comprehension of Iranian Pre-Intermediate EFL Learners

ERIC Educational Resources Information Center

Sarani, Abdullah; Behtash, Esmail Zare; Nezhad Arani, Saieed Moslemi

2014-01-01

This study aims at finding the effect of video-based tasks in improving the listening comprehension ability of Iranian pre-intermediate EFL (English Foreign Language) learners. After determining the level of learners, an experimental and control group, each of 20 participants, were nominated to contribute to the study. From the time the pre-test…

Kinetics and thermochemistry of 2,5-dimethyltetrahydrofuran and related oxolanes: next next-generation biofuels.

PubMed

Simmie, John M

2012-05-10

The enthalpies of formation, entropies, specific heats at constant pressure, enthalpy functions, and all carbon-hydrogen and carbon-methyl bond dissociation energies have been computed using high-level methods for the cyclic ethers (oxolanes) tetrahydrofuran, 2-methyltetrahydrofuran, and 2,5-dimethyltetrahydrofuran. Barrier heights for hydrogen-abstraction reactions by hydrogen atoms and the methyl radical are also computed and shown to correlate with reaction energy change. The results show a pleasing consistency and considerably expands the available data for these important compounds. Abstraction by ȮH is accompanied by formation of both pre- and postreaction weakly bound complexes. The resulting radicals formed after abstraction undergo ring-opening reactions leading to readily recognizable intermediates, while competitive H-elimination reactions result in formation of dihydrofurans. Formation enthalpies of all 2,3- and 2,5-dihydrofurans and associated radicals are also reported. It is probable that the compounds at the center of this study will be relatively clean-burning biofuels, although formation of intermediate aldehydes might be problematic.

BCRMD Program for Multiply Handicapped Pupils: Evaluation Report. School Year 1975-1976.

ERIC Educational Resources Information Center

Echternacht, Gary

Presented is an evaluation of a program which provided supplementary pre-reading and mathematics instruction to multiply handicapped children (physically and mentally handicapped) in six elementary and two intermediate schools. It is explained that students were individually instructed on objectives which they failed on the McGraw Hill Test of…

The Impact of Contemplative Practices on Foreign Language Anxiety and Learning

ERIC Educational Resources Information Center

Scida, Emily E.; Jones, Jill N.

2017-01-01

This study looked at the impact of the integration of contemplative practices on foreign language anxiety, positive and negative affect, self-efficacy, classroom climate, and language learning in students enrolled in an advanced intermediate Spanish language course in the USA. Data included pre- and post-test surveys, exam scores to measure…

Second Language Listening and Unfamiliar Proper Names: Comprehension Barrier?

ERIC Educational Resources Information Center

Kobeleva, Polina P.

2012-01-01

This study examines whether unfamiliar proper names affect English as a second language (ESL) learners' listening comprehension. A total of 110 intermediate to advanced ESL learners participated; comprehension of a short news text was tested under two conditions, Names Known (all proper names pre-taught in advance) and Names Unknown (all proper…

Pre-test probability of obstructive coronary stenosis in patients undergoing coronary CT angiography: Comparative performance of the modified diamond-Forrester algorithm versus methods incorporating cardiovascular risk factors.

PubMed

Ferreira, António Miguel; Marques, Hugo; Tralhão, António; Santos, Miguel Borges; Santos, Ana Rita; Cardoso, Gonçalo; Dores, Hélder; Carvalho, Maria Salomé; Madeira, Sérgio; Machado, Francisco Pereira; Cardim, Nuno; de Araújo Gonçalves, Pedro

2016-11-01

Current guidelines recommend the use of the Modified Diamond-Forrester (MDF) method to assess the pre-test likelihood of obstructive coronary artery disease (CAD). We aimed to compare the performance of the MDF method with two contemporary algorithms derived from multicenter trials that additionally incorporate cardiovascular risk factors: the calculator-based 'CAD Consortium 2' method, and the integer-based CONFIRM score. We assessed 1069 consecutive patients without known CAD undergoing coronary CT angiography (CCTA) for stable chest pain. Obstructive CAD was defined as the presence of coronary stenosis ≥50% on 64-slice dual-source CT. The three methods were assessed for calibration, discrimination, net reclassification, and changes in proposed downstream testing based upon calculated pre-test likelihoods. The observed prevalence of obstructive CAD was 13.8% (n=147). Overestimations of the likelihood of obstructive CAD were 140.1%, 9.8%, and 18.8%, respectively, for the MDF, CAD Consortium 2 and CONFIRM methods. The CAD Consortium 2 showed greater discriminative power than the MDF method, with a C-statistic of 0.73 vs. 0.70 (p<0.001), while the CONFIRM score did not (C-statistic 0.71, p=0.492). Reclassification of pre-test likelihood using the 'CAD Consortium 2' or CONFIRM scores resulted in a net reclassification improvement of 0.19 and 0.18, respectively, which would change the diagnostic strategy in approximately half of the patients. Newer risk factor-encompassing models allow for a more precise estimation of pre-test probabilities of obstructive CAD than the guideline-recommended MDF method. Adoption of these scores may improve disease prediction and change the diagnostic pathway in a significant proportion of patients. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Does self-efficacy mediate transfer effects in the learning of easy and difficult motor skills?

PubMed

Stevens, David; Anderson, David I; O'Dwyer, Nicholas J; Mark Williams, A

2012-09-01

The effect of task difficulty on inter-task transfer is a classic issue in motor learning. We examined the relation between self-efficacy and transfer of learning after practicing different versions of a stick balancing task. Practicing the same task or an easier version led to significant pre- to post-test transfer of learning, whereas practicing a more difficult version did not. Self-efficacy increased modestly from pre- to post-test with easy practice, but decreased significantly with difficult practice. In addition, self-efficacy immediately prior to the post-test was significantly lower after difficult practice than easy or intermediate practice. Self-efficacy immediately prior to the post-test, performance at the end of practice, and pre-test performance explained 75% of the variance in post-test performance. The mediating role of self-efficacy on transfer of learning offers an alternative explanation for recent findings on the superiority of easy-to-difficult transfer and may help clarify inconsistencies in earlier research. Copyright © 2012 Elsevier Inc. All rights reserved.

Improving rural and remote practitioners' knowledge of the diabetic foot: findings from an educational intervention.

PubMed

Schoen, Deborah E; Gausia, Kaniz; Glance, David G; Thompson, Sandra C

2016-01-01

This study aimed to determine knowledge of national guidelines for diabetic foot assessment and risk stratification by rural and remote healthcare professionals in Western Australia and their implementation in practice. Assessment of diabetic foot knowledge, availability of equipment and delivery of foot care education in a primary healthcare setting at baseline enabled evaluation of the effectiveness of a diabetic foot education and training program for generalist healthcare professionals. This study employed a quasi-experimental pre-test/post-test study design. Healthcare practitioners' knowledge, attitudes and practice of diabetic foot assessment, diabetic foot risks, risk stratification, and use of the 2011 National Health and Medical Research Council Guidelines were investigated with an electronic pre-test survey(.) Healthcare professionals then undertook a 3-h education and training workshop before completing the electronic post-test knowledge, attitudes and practice survey. Comparison of pre-test/post-test survey findings was used to assess the change in knowledge, attitudes and intended practice due to the workshops. Two hundred and forty-six healthcare professionals from two rural and remote health regions of Western Australia participated in training workshops. Monofilaments and diabetes foot care education brochures, particularly brochures for Aboriginal people, were reported as not readily available in rural and remote health services. For most participants (58 %), their post-test knowledge score increased significantly from the pre-test score. Use of the Guidelines in clinical settings was low (19 %). The healthcare professionals' baseline diabetic foot knowledge was adequate to correctly identify the high risk category. However, stratification of the intermediate risk category was poor, even after training. This study reports the first assessment of Western Australia's rural and remote health professionals' knowledge, attitudes and practices regarding the diabetic foot. It shows that without training, generalists' levels of knowledge concerning the diabetic foot was low and they were unlikely to assess foot risk. The findings from this study in a rural and remote setting cast doubt on the ability of generalist healthcare professionals to stratify risk appropriately, especially for those at intermediate risk, without clinical decision support tools.

Trauma surgeon becomes consultant: evaluation of a protocol for management of intermediate-level trauma patients.

PubMed

Fallon, Sara C; Delemos, David; Christopher, Daniel; Frost, Mary; Wesson, David E; Naik-Mathuria, Bindi

2014-01-01

At our level 1 pediatric trauma center, 9-54 intermediate-level ("level 2") trauma activations are received per month. Previously, the surgery team was required to respond to and assume responsibility for all patients who had "level 2" trauma activations. In 8/2011, we implemented a protocol where the emergency room (ER) physician primarily manages these patients with trauma consultation for surgical evaluation or admission. The purpose of this study was to prospectively evaluate the effects of the new protocol to ensure that patient safety and quality of care were maintained. We compared outcomes of patients treated PRE-implementation (10/2010-7/2011) and POST-implementation (9/2011-5/2012), including surgeon consultation rate, utilization of imaging and laboratory testing, ER length of stay, admission rate, and missed injuries or readmissions. Statistical analysis included chi-square and Student's t-test. We identified 472 patients: 179 in the PRE and 293 in the POST period. The populations had similar baseline clinical characteristics. The surgical consultation rate in the POST period was only 42%, with no missed injuries or readmissions. The ER length of stay did not change. However, in the POST period there were significant decreases in the admission rate (73% to 44%) and the mean number of CT scans (1.4 to 1), radiographs (2.4 to 1.7), and laboratory tests (5.1 to 3.3) ordered in the emergency room (all p<0.001). Intermediate-level pediatric trauma patients can be efficiently and safely managed by pediatric emergency room physicians, with surgical consultation only as needed. The protocol change improved resource utilization by decreasing testing and admissions and streamlining resident utilization in an era of reduced duty hours. © 2014.

An efficient algorithm to compute marginal posterior genotype probabilities for every member of a pedigree with loops

PubMed Central

2009-01-01

Background Marginal posterior genotype probabilities need to be computed for genetic analyses such as geneticcounseling in humans and selective breeding in animal and plant species. Methods In this paper, we describe a peeling based, deterministic, exact algorithm to compute efficiently genotype probabilities for every member of a pedigree with loops without recourse to junction-tree methods from graph theory. The efficiency in computing the likelihood by peeling comes from storing intermediate results in multidimensional tables called cutsets. Computing marginal genotype probabilities for individual i requires recomputing the likelihood for each of the possible genotypes of individual i. This can be done efficiently by storing intermediate results in two types of cutsets called anterior and posterior cutsets and reusing these intermediate results to compute the likelihood. Examples A small example is used to illustrate the theoretical concepts discussed in this paper, and marginal genotype probabilities are computed at a monogenic disease locus for every member in a real cattle pedigree. PMID:19958551

A Study of Students' Attitude toward Teachers' Affective Factors in EFL Classrooms

ERIC Educational Resources Information Center

Ranjbar, Nahid Amini; Narafshan, Mehry Haddad

2016-01-01

In any teaching-learning situation, teacher plays a significant role in the classroom. This study aimed at investigating the students' attitude toward teachers' affective factors in EFL classrooms. In this study, the students' population was 300 pre-intermediate (based on the institutes' placement test) female EFL students (10 to 25 years old) in…

[Interpretation and use of routine pulmonary function tests: Spirometry, static lung volumes, lung diffusion, arterial blood gas, methacholine challenge test and 6-minute walk test].

PubMed

Bokov, P; Delclaux, C

2016-02-01

Resting pulmonary function tests (PFT) include the assessment of ventilatory capacity: spirometry (forced expiratory flows and mobilisable volumes) and static volume assessment, notably using body plethysmography. Spirometry allows the potential definition of obstructive defect, while static volume assessment allows the potential definition of restrictive defect (decrease in total lung capacity) and thoracic hyperinflation (increase in static volumes). It must be kept in mind that this evaluation is incomplete and that an assessment of ventilatory demand is often warranted, especially when facing dyspnoea: evaluation of arterial blood gas (searching for respiratory insufficiency) and measurement of the transfer coefficient of the lung, allowing with the measurement of alveolar volume to calculate the diffusing capacity of the lung for CO (DLCO: assessment of alveolar-capillary wall and capillary blood volume). All these pulmonary function tests have been the subject of an Americano-European Task force (standardisation of lung function testing) published in 2005, and translated in French in 2007. Interpretative strategies for lung function tests have been recommended, which define abnormal lung function tests using the 5th and 95th percentiles of predicted values (lower and upper limits of normal values). Thus, these recommendations need to be implemented in all pulmonary function test units. A methacholine challenge test will only be performed in the presence of an intermediate pre-test probability for asthma (diagnostic uncertainty), which is an infrequent setting. The most convenient exertional test is the 6-minute walk test that allows the assessment of walking performance, the search for arterial desaturation and the quantification of dyspnoea complaint. Copyright © 2015 Société nationale française de médecine interne (SNFMI). Published by Elsevier SAS. All rights reserved.

The utility of pre-test clinical scoring for clinical diagnosis of heparin-induced thrombocytopenia in cardiac surgery patients of a tertiary care centre in north India.

PubMed

Sachan, D; Gupta, N; Agarwal, P; Chaudhary, R

2011-08-01

Heparin-induced thrombocytopenia (HIT) should be diagnosed clinically as well as by laboratory assays for timely recognition, prevention and management of complications. To evaluate the clinical utility of pre-test clinical scoring system in combination with two immunoassays for the diagnosis of HIT in cardiac surgery patients. A total of 100 consecutive patients undergoing cardiac surgery were studied. Pre-test clinical scoring was carried out in patients with thrombocytopenia and further tested by two immunoassays, i.e., Heparin platelet factor 4 (H-PF4) enzyme-linked immunosorbent assay (ELISA) and particle gel immunoassay (PaGIA). Of the 100 patients studied, 42 patients developed thrombocytopenia post-operatively. On pre-test clinical scoring, low T-score was observed in 6 patients, intermediate in 28 and high score in 8 patients, whereas 19 patients (45.2%) were positive by H-PF4 ELISA and 10 (23.8%) by PaGIA for H-PF4 antibody. The difference in the incidence of clinically significant HIT antibodies in the three categories was statistically significant. A good correlation was also observed with ELISA optical density, T-scoring and PaGIA. Pre-test clinical scoring correlates well with the development of H-PF4 antibodies which are incriminated in the causation of thrombotic complications in patients with HIT. We also propose a protocol for diagnosing patients with clinical suspicion of HIT using pre-test clinical scoring and immunoassay. © 2011 The Authors. Transfusion Medicine © 2011 British Blood Transfusion Society.

ADAMTS13 test and/or PLASMIC clinical score in management of acquired thrombotic thrombocytopenic purpura: a cost-effective analysis.

PubMed

Kim, Chong H; Simmons, Sierra C; Williams, Lance A; Staley, Elizabeth M; Zheng, X Long; Pham, Huy P

2017-11-01

The ADAMTS13 test distinguishes thrombotic thrombocytopenic purpura (TTP) from other thrombotic microangiopathies (TMAs). The PLASMIC score helps determine the pretest probability of ADAMTS13 deficiency. Due to inherent limitations of both tests, and potential adverse effects and cost of unnecessary treatments, we performed a cost-effectiveness analysis (CEA) investigating the benefits of incorporating an in-hospital ADAMTS13 test and/or PLASMIC score into our clinical practice. A CEA model was created to compare four scenarios for patients with TMAs, utilizing either an in-house or a send-out ADAMTS13 assay with or without prior risk stratification using PLASMIC scoring. Model variables, including probabilities and costs, were gathered from the medical literature, except for the ADAMTS13 send-out and in-house tests, which were obtained from our institutional data. If only the cost is considered, in-house ADAMTS13 test for patients with intermediate- to high-risk PLASMIC score is the least expensive option ($4,732/patient). If effectiveness is assessed as measured by the number of averted deaths, send-out ADAMTS13 test is the most effective. Considering the cost/effectiveness ratio, the in-house ADAMTS13 test in patients with intermediate- to high-risk PLASMIC score is the best option, followed by the in-house ADAMTS13 test without the PLASMIC score. In patients with clinical presentations of TMAs, having an in-hospital ADAMTS13 test to promptly establish the diagnosis of TTP appears to be cost-effective. Utilizing the PLASMIC score further increases the cost-effectiveness of the in-house ADAMTS13 test. Our findings indicate the benefit of having a rapid and reliable in-house ADAMTS13 test, especially in the tertiary medical center. © 2017 AABB.

Usefulness of coronary calcium scoring to myocardial perfusion SPECT in the diagnosis of coronary artery disease in a predominantly high risk population.

PubMed

Schaap, Jeroen; Kauling, Robert M; Boekholdt, S Matthijs; Post, Martijn C; Van der Heyden, Jan A; de Kroon, Thom L; van Es, H Wouter; Rensing, Benno J W M; Verzijlbergen, J Fred

2013-03-01

Coronary calcium scoring (CCS) adds to the diagnostic performance of myocardial perfusion single-photon emission computed tomography (SPECT) to assess the presence of significant coronary artery disease (CAD). Patients with a high pre-test likelihood are expected to have a high CCS which potentially could enhance the diagnostic performance of myocardial perfusion SPECT in this specific patient group. We evaluated the added value of CCS to SPECT in the diagnosis of significant CAD in patients with an intermediate to high pre-test likelihood. In total, 129 patients (mean age 62.7 ± 9.7 years, 65 % male) with stable anginal complaints and intermediate to high pre-test likelihood of CAD (median 87 %, range 22-95) were prospectively included in this study. All patients received SPECT and CCS imaging preceding invasive coronary angiography (CA). Fractional flow reserve (FFR) measurements were acquired from patients with angiographically estimated 50-95 % obstructive CAD. For SPECT a SSS > 3 was defined significant CAD. For CCS the optimal cut-off value for significant CAD was determined by ROC curve analysis. The reference standard for significant CAD was a FFR of <0.80 acquired by CA. Significant CAD was demonstrated in 64 patients (49.6 %). Optimal CCS cut-off value for significant CAD was >182.5. ROC curve analysis for prediction of the presence of significant CAD for SPECT, CCS and the combination of CCS and SPECT resulted in an area under the curve (AUC) of 0.88 (95 % CI 81-94), 0.75 (95 % CI 66-83 %) and 0.92 (95 % CI 87-97 %) respectively. The difference of the AUC between SPECT and the combination of CCS and SPECT was 0.05 (P = 0.12). The addition of CCS did not significantly improve the diagnostic performance of SPECT in the evaluation of patients with a predominantly high pre-test likelihood of CAD.

Pre-Service Teachers' Conceptions of Probability

ERIC Educational Resources Information Center

Odafe, Victor U.

2011-01-01

Probability knowledge and skills are needed in science and in making daily decisions that are sometimes made under uncertain conditions. Hence, there is the need to ensure that the pre-service teachers of our children are well prepared to teach probability. Pre-service teachers' conceptions of probability are identified, and ways of helping them…

Food-based Science Curriculum Increases 4th Graders Multidisciplinary Science Knowledge

PubMed Central

Hovland, Jana A.; Carraway-Stage, Virginia G.; Cela, Artenida; Collins, Caitlin; Díaz, Sebastián R.; Collins, Angelo; Duffrin, Melani W.

2013-01-01

Health professionals and policymakers are asking educators to place more emphasis on food and nutrition education. Integrating these topics into science curricula using hand-on, food-based activities may strengthen students’ understanding of science concepts. The Food, Math, and Science Teaching Enhancement Resource (FoodMASTER) Initiative is a compilation of programs aimed at using food as a tool to teach mathematics and science. Previous studies have shown that students experiencing the FoodMASTER curriculum were very excited about the activities, became increasingly interested in the subject matter of food, and were able to conduct scientific observations. The purpose of this study was to: 1) assess 4th graders food-related multidisciplinary science knowledge, and 2) compare gains in food-related science knowledge after implementation of an integrated, food-based curriculum. During the 2009–2010 school year, FoodMASTER researchers implemented a hands-on, food-based intermediate curriculum in eighteen 4th grade classrooms in Ohio (n=9) and North Carolina (n=9). Sixteen classrooms in Ohio (n=8) and North Carolina (n=8), following their standard science curricula, served as comparison classrooms. Students completed a researcher-developed science knowledge exam, consisting of 13 multiple-choice questions administered pre- and post-test. Only subjects with pre- and post-test scores were entered into the sample (Intervention n=343; Control n=237). No significant differences were observed between groups at pre-test. At post-test, the intervention group scored (9.95±2.00) significantly higher (p=.000) than the control group (8.84±2.37) on a 13-point scale. These findings suggest the FoodMASTER intermediate curriculum is more effective than a standard science curriculum in increasing students’ multidisciplinary science knowledge related to food. PMID:25152539

Under the hood of statistical learning: A statistical MMN reflects the magnitude of transitional probabilities in auditory sequences.

PubMed

Koelsch, Stefan; Busch, Tobias; Jentschke, Sebastian; Rohrmeier, Martin

2016-02-02

Within the framework of statistical learning, many behavioural studies investigated the processing of unpredicted events. However, surprisingly few neurophysiological studies are available on this topic, and no statistical learning experiment has investigated electroencephalographic (EEG) correlates of processing events with different transition probabilities. We carried out an EEG study with a novel variant of the established statistical learning paradigm. Timbres were presented in isochronous sequences of triplets. The first two sounds of all triplets were equiprobable, while the third sound occurred with either low (10%), intermediate (30%), or high (60%) probability. Thus, the occurrence probability of the third item of each triplet (given the first two items) was varied. Compared to high-probability triplet endings, endings with low and intermediate probability elicited an early anterior negativity that had an onset around 100 ms and was maximal at around 180 ms. This effect was larger for events with low than for events with intermediate probability. Our results reveal that, when predictions are based on statistical learning, events that do not match a prediction evoke an early anterior negativity, with the amplitude of this mismatch response being inversely related to the probability of such events. Thus, we report a statistical mismatch negativity (sMMN) that reflects statistical learning of transitional probability distributions that go beyond auditory sensory memory capabilities.

64-Slice Computed Tomographic Angiography for the Diagnosis of Intermediate Risk Coronary Artery Disease

PubMed Central

2010-01-01

Executive Summary In July 2009, the Medical Advisory Secretariat (MAS) began work on Non-Invasive Cardiac Imaging Technologies for the Diagnosis of Coronary Artery Disease (CAD), an evidence-based review of the literature surrounding different cardiac imaging modalities to ensure that appropriate technologies are accessed by patients suspected of having CAD. This project came about when the Health Services Branch at the Ministry of Health and Long-Term Care asked MAS to provide an evidentiary platform on effectiveness and cost-effectiveness of non-invasive cardiac imaging modalities. After an initial review of the strategy and consultation with experts, MAS identified five key non-invasive cardiac imaging technologies for the diagnosis of CAD. Evidence-based analyses have been prepared for each of these five imaging modalities: cardiac magnetic resonance imaging, single photon emission computed tomography, 64-slice computed tomographic angiography, stress echocardiography, and stress echocardiography with contrast. For each technology, an economic analysis was also completed (where appropriate). A summary decision analytic model was then developed to encapsulate the data from each of these reports (available on the OHTAC and MAS website). The Non-Invasive Cardiac Imaging Technologies for the Diagnosis of Coronary Artery Disease series is made up of the following reports, which can be publicly accessed at the MAS website at: www.health.gov.on.ca/mas or at www.health.gov.on.ca/english/providers/program/mas/mas_about.html Single Photon Emission Computed Tomography for the Diagnosis of Coronary Artery Disease: An Evidence-Based Analysis Stress Echocardiography for the Diagnosis of Coronary Artery Disease: An Evidence-Based Analysis Stress Echocardiography with Contrast for the Diagnosis of Coronary Artery Disease: An Evidence-Based Analysis 64-Slice Computed Tomographic Angiography for the Diagnosis of Coronary Artery Disease: An Evidence-Based Analysis Cardiac Magnetic Resonance Imaging for the Diagnosis of Coronary Artery Disease: An Evidence-Based Analysis Pease note that two related evidence-based analyses of non-invasive cardiac imaging technologies for the assessment of myocardial viability are also available on the MAS website: Positron Emission Tomography for the Assessment of Myocardial Viability: An Evidence-Based Analysis Magnetic Resonance Imaging for the Assessment of Myocardial Viability: an Evidence-Based Analysis The Toronto Health Economics and Technology Assessment Collaborative has also produced an associated economic report entitled: The Relative Cost-effectiveness of Five Non-invasive Cardiac Imaging Technologies for Diagnosing Coronary Artery Disease in Ontario [Internet]. Available from: http://theta.utoronto.ca/reports/?id=7 Objective The objective of this report is to determine the accuracy of computed tomographic angiography (CTA) compared to the more invasive option of coronary angiography (CA) in the detection of coronary artery disease (CAD) in stable (non-emergent) symptomatic patients. CT Angiography CTA is a cardiac imaging test that assesses the presence or absence, as well as the extent, of coronary artery stenosis for the diagnosis of CAD. As such, it is a test of cardiac structure and anatomy, in contrast to the other cardiac imaging modalities that assess cardiac function. It is, however, unclear as to whether cardiac structural features alone, in the absence cardiac function information, are sufficient to determine the presence or absence of intermediate pretest risk of CAD. CTA technology is changing rapidly with increasing scan speeds and anticipated reductions in radiation exposure. Initial scanners based on 4, 8, 16, 32, and 64 slice machines have been available since the end of 2004. Although 320-slice machines are now available, these are not widely diffused and the existing published evidence is specific to 64-slice scanners. In general, CTA allows for 3-dimensional (3D) viewing of the coronary arteries derived from software algorithms of 2-dimensional (2D) images. The advantage of CTA over CA, the gold standard for the diagnosis of CAD, is that it is relatively less invasive and may serve as a test in determining which patients are best suited for a CA. CA requires insertion of a catheter through an artery in the arm or leg up to the area being studied, yet both tests involve contrast agents and radiation exposure. Therefore, the identification of patients for whom CTA or CA is more appropriate may help to avoid more invasive tests, treatment delays, and unnecessary radiation exposure. The main advantage of CA, however, is that treatment can be administered in the same session as the test procedure and as such, it’s recommended for patients with a pre-test probability of CAD of ≥80%. The progression to the more invasive CA allows for the diagnosis and treatment in one session without the added radiation exposure from a previous CTA. The visibility of arteries in CTA images is best in populations with a disease prevalence, or pre-test probabilities of CAD, of 40% to 80%, beyond which patients are considered at high pre-test probability. Visibility decreases with increasing prevalence as arteries become increasingly calcified (coronary artery calcification is based on the Agaston score). Such higher risk patients are not candidates for the less invasive diagnostic procedures and should proceed directly to CA, where treatment can be administered in conjunction with the test itself, while bypassing the radiation exposure from CTA. CTA requires the addition of an ionated contrast, which can be administered only in patients with sufficient renal function (creatinine levels >30 micromoles/litre) to allow for the clearing of the contrast from the body. In some cases, the contrast is administered in patients with creatinine levels less than 30 micromoles/litre. A second important criterion for the administration of the CTA is patient heart rate, which should be less than 65 beats/min for the single source CTA machines and less than 80 beats/min for the dual source machines. To decrease heart rates to these levels, beta-blockers are often required. Although the accuracy of these two machines does not differ, the dual source machines can be utilized in a higher proportion of patients than the single source machines for patients with heart beats of up to 80 beats/min. Approximately 10% of patients are considered ineligible for CTA because of this inability to decrease heart rates to the required levels. Additional contra-indications include renal insufficiency as described above and atrial fibrillation, with approximately 10% of intermediate risk patients ineligible for CTA due these contraindications. The duration of the procedure may be between 1 and 1.5 hours, with about 15 minutes for the CTA and the remaining time for the preparation of the patient. CTA is licensed by Health Canada as a Class III device. Currently, two companies have licenses for 64-slice CT scanners, Toshiba Medical Systems Corporation (License 67604) and Philips Medical Systems (License 67599 and 73260). Research Questions How does the accuracy of CTA compare to the more invasive CA in the diagnosis of CAD in symptomatic patients at intermediate risk of the disease? How does the accuracy for CTA compare to other modalities in the detection of CAD? Research Methods Literature Search A literature search was performed on July 20, 2009 using OVID MEDLINE, MEDLINE In-Process and Other Non-Indexed Citations, EMBASE, the Cumulative Index to Nursing & Allied Health Literature (CINAHL), the Cochrane Library, and the International Agency for Health Technology Assessment (INAHTA) for studies published from January 1, 2004 until July 20, 2009. Abstracts were reviewed by a single reviewer and, for those studies meeting the eligibility criteria, full-text articles were obtained. Reference lists were also examined for any relevant studies not identified through the search. The quality of evidence was assessed as high, moderate, low or very low according to GRADE methodology. Inclusion Criteria English language articles and English or French-language HTAs published from January 1, 2004 to July 20, 2009. Randomized controlled trials (RCTs), non-randomized clinical trials, systematic reviews and meta-analyses. Studies of symptomatic patients at intermediate pre-test probability of CAD. Studies of single source CTA compared to CA for the diagnosis of CAD. Studies in which sensitivity, specificity, negative predictive value (NPV) and positive predictive value (PPV) could be established. HTAs, SRs, clinical trials, observational studies. Exclusion Criteria Non-English studies. Pediatric populations. Studies of patients at low or high pre-test probability of CAD. Studies of unstable patients, e.g., emergency room visits, or a prior diagnosis of CAD. Studies in patients with non-ischemic heart disease. Studies in which outcomes were not specific to those of interest in this report. Studies in which CTA was not compared to CA in a stable population. Outcomes of Interest) CAD defined as ≥50% stenosis. Comparator Coronary angiography. Measures of Interest Sensitivity, specificity; Negative predictive value (NPV), positive predictive value (PPV); Area under the curve (AUC) and diagnostic odds ratios (DOR). Results of Literature Search and Evidence-Based Analysis The literature search yielded two HTAs, the first published by MAS in April 2005, the other from the Belgian Health Care Knowledge Centre published in 2008, as well as three recent non-randomized clinical studies. The three most significant studies concerning the accuracy of CTA versus CA are the CORE-64 study, the ACCURACY trial, and a prospective, multicenter, multivendor study conducted in the Netherlands. Five additional non-randomized studies were extracted from the Belgian Health Technology Assessment (2008). To provide summary estimates of sensitivity, specificity, area under the SROC curve (AUC) and diagnostic odds rations (DORs), a meta-analysis of the above-mentioned studies was conducted. Pooled estimates of sensitivity and specificity were 97.7% (95%CI: 95.5% - 99.9%) and 78.8% (95%CI: 70.8% - 86.8%), respectively. These results indicate that the sensitivity of CTA is almost as good as CA, while its specificity is poorer. The diagnostic odds ratio (DOR) was estimated at 157.0 (95%CI: 11.2 - 302.7) and the AUC was found to be 0.94; however, the inability to provide confidence estimates for this estimate decreased its utility as an adequate outcome measure in this review. This meta-analysis was limited by the significant heterogeneity between studies for both the pooled sensitivity and specificity (heterogeneity Chi-square p=0.000). To minimize these statistical concerns, the analysis was restricted to studies of intermediate risk patients with no previous history of cardiac events. Nevertheless, the underlying prevalence of CAD ranged from 24.8% to 78% between studies, indicating that there was still some variability in the pre-test probabilities of disease within this stable population. The variation in the prevalence of CAD, accompanied with differences in the proportion of calcification, likely affected the specificity directly and the sensitivity indirectly across studies. In February 2010, the results of the Ontario Multi-detector Computed Tomography Coronary Angiography Study (OMCAS) became available and were thus included in a second meta-analysis of the above studies. The OMCAS was a non-randomized double-blind study conducted in 3 centers in Ontario that was conducted as a result of a MAS review from 2005 requesting an evaluation of the accuracy of 64-slice CTA for CAD detection. Within 10 days of their scheduled CA, all patients received an additional evaluation with CTA. Included in the meta-analysis with the above-mentioned studies are 117 symptomatic patients with intermediate probability of CAD (10% - 90% probability), resulting in a pooled sensitivity of 96.1% (95%CI: 94.0%-98.3%) and pooled specificity of 81.5% (95%CI: 73.0% - 89.9%). Summary of Findings CTA is almost as good as CA in detecting true positives but poorer in the rate of false positives. The main value of CTA may be in ruling out significant CAD. Increased prevalence of CAD decreases study specificity, whereas specificity is increased in the presence of increased arterial calcification even in lower prevalence studies. Positive CT angiograms may require additional tests such as stress tests or the more invasive CA, partly to identify false positives. Radiation exposure is an important safety concern that needs to be considered, particularly the cumulative exposures from repeat CTAs. PMID:23074388

Retrospective Comparison of Cardiac Testing and Results on Inpatients with Low Pretest Probability Compared with Moderate/High Pretest Probability for Coronary Artery Disease.

PubMed

Lear, Aaron; Huber, Merritt; Canada, Amy; Robertson, Jessica; Bosman, Evan; Zyzanski, Stephen

2018-01-01

To determine whether admission, and provocative stress testing of patients who have ruled out for acute coronary syndrome put patients with low-risk category for coronary artery disease (CAD) at risk for false-positive provocative stress testing and unnecessary coronary angiogram/imaging. A retrospective chart review was performed on patients between 30 and 70 years old, with no pre-existing diagnosis of CAD, admitted to observation or inpatient status chest pain or related complaints. Included patients were categorized based on Duke Clinical Score for pretest probability for CAD into either low-risk group, or moderate/high-risk group. The inpatient course was compared including whether provocative stress testing was performed; results of stress testing; whether patients underwent further coronary imaging; and what the results of the further imaging showed. 543 patients were eligible: 305 low pretest probability, and 238 moderate/high pretest probability. No difference was found in rate of stress testing relative risk (RR) = 1.01 (95% CI, 0.852 to 1.192; P = 0); rate of positive or equivocal stress tests between the 2 groups: RR = 0.653 (95% CI, 0.415 to 1.028; P = .07,). Low-pretest-probability patients had a lower likelihood of positive coronary imaging after stress test, RR = 0.061 (95% CI, 0.004 to 0.957; P = .001). Follow-up provocative testing of all patients admitted/observed after emergency department presentation with chest pain is unlikely to find CAD in patients with low pretest probability. Testing all low-probability patients puts them at increased risk for unnecessary invasive confirmatory testing. Further prospective testing is needed to confirm these retrospective results. © Copyright 2018 by the American Board of Family Medicine.

Does prevalence matter to physicians in estimating post-test probability of disease? A randomized trial.

PubMed

Agoritsas, Thomas; Courvoisier, Delphine S; Combescure, Christophe; Deom, Marie; Perneger, Thomas V

2011-04-01

The probability of a disease following a diagnostic test depends on the sensitivity and specificity of the test, but also on the prevalence of the disease in the population of interest (or pre-test probability). How physicians use this information is not well known. To assess whether physicians correctly estimate post-test probability according to various levels of prevalence and explore this skill across respondent groups. Randomized trial. Population-based sample of 1,361 physicians of all clinical specialties. We described a scenario of a highly accurate screening test (sensitivity 99% and specificity 99%) in which we randomly manipulated the prevalence of the disease (1%, 2%, 10%, 25%, 95%, or no information). We asked physicians to estimate the probability of disease following a positive test (categorized as <60%, 60-79%, 80-94%, 95-99.9%, and >99.9%). Each answer was correct for a different version of the scenario, and no answer was possible in the "no information" scenario. We estimated the proportion of physicians proficient in assessing post-test probability as the proportion of correct answers beyond the distribution of answers attributable to guessing. Most respondents in each of the six groups (67%-82%) selected a post-test probability of 95-99.9%, regardless of the prevalence of disease and even when no information on prevalence was provided. This answer was correct only for a prevalence of 25%. We estimated that 9.1% (95% CI 6.0-14.0) of respondents knew how to assess correctly the post-test probability. This proportion did not vary with clinical experience or practice setting. Most physicians do not take into account the prevalence of disease when interpreting a positive test result. This may cause unnecessary testing and diagnostic errors.

Probability of reduced renal function after contrast-enhanced CT: a model based on serum creatinine level, patient age, and estimated glomerular filtration rate.

PubMed

Herts, Brian R; Schneider, Erika; Obuchowski, Nancy; Poggio, Emilio; Jain, Anil; Baker, Mark E

2009-08-01

The objectives of our study were to develop a model to predict the probability of reduced renal function after outpatient contrast-enhanced CT (CECT)--based on patient age, sex, and race and on serum creatinine level before CT or directly based on estimated glomerular filtration rate (GFR) before CT--and to determine the relationship between patients with changes in creatinine level that characterize contrast-induced nephropathy and patients with reduced GFR after CECT. Of 5,187 outpatients who underwent CECT, 963 (18.6%) had serum creatinine levels obtained within 6 months before and 4 days after CECT. The estimated GFR was calculated before and after CT using the four-variable Modification of Diet in Renal Disease (MDRD) Study equation. Pre-CT serum creatinine level, age, race, sex, and pre-CT estimated GFR were tested using multiple-variable logistic regression models to determine the probability of having an estimated GFR of < 60 and < 45 mL/min/1.73 m(2) after CECT. Two thirds of the patients were used to create and one third to test the models. We also determined discordance between patients who met standard definitions of contrast-induced nephropathy and those with a reduced estimated GFR after CECT. Significant (p < 0.002) predictors for a post-CT estimated GFR of < 60 mL/min/1.73 m(2) were age, race, sex, pre-CT serum creatinine level, and pre-CT estimated GFR. Sex, serum creatinine level, and pre-CT estimated GFR were significant factors (p < 0.001) for predicting a post-CT estimated GFR of < 45 mL/min/1.73 m(2). The probability is [exp(y) / (1 + exp(y))], where y = 6.21 - (0.10 x pre-CT estimated GFR) for an estimated GFR of < 60 mL/min/1.73 m(2), and y = 3.66 - (0.087 x pre-CT estimated GFR) for an estimated GFR of < 45 mL/min/1.73 m(2). A discrepancy between those who met contrast-induced nephropathy criteria by creatinine changes and those with a post-CT estimated GFR of < 60 mL/min/1.73 m(2) was detected in 208 of the 963 patients (21.6%). The probability of a reduced estimated GFR after CECT can be predicted by the pre-CT estimated GFR using the four-variable MDRD equation. Furthermore, standard criteria for contrast-induced nephropathy are poor predictors of poor renal function after CECT. Criteria need to be established for what is an acceptable risk to manage patients undergoing CECT.

Calculating the pre-consumer waste footprint: A screening study of 10 selected products.

PubMed

Laurenti, Rafael; Moberg, Åsa; Stenmarck, Åsa

2017-01-01

Knowledge about the total waste generated by the production of consumer goods can help raise awareness among policy-makers, producers and consumers of the benefits of closing loops in a future circular economy, avoiding unnecessary production and production steps and associated generation of large amounts of waste. In strict life cycle assessment practice, information on waste outputs from intermediate industrial processes of material and energy transformation is translated into and declared as potential environmental impacts, which are often not reported in the final results. In this study, a procedure to extract available intermediate data and perform a systematic pre-consumer waste footprint analysis was developed. The pre-consumer waste footprint concept was tested to analyse 10 generic products, which provided some novel and interesting results for the different product categories and identified a number of challenges that need to be resolved in development of the waste footprint concept. These challenges include standardised data declaration on waste in life cycle assessment, with a separation into waste categories illustrating the implicit environmental and scale of significance of waste types and quantities (e.g. hazardous waste, inert waste, waste for recycling/incineration) and establishment of a common definition of waste throughout sectors and nations.

Revisiting sweat chloride test results based on recent guidelines for diagnosis of cystic fibrosis.

PubMed

Pagaduan, Jayson V; Ali, Mahesheema; Dowlin, Michael; Suo, Liye; Ward, Tabitha; Ruiz, Fadel; Devaraj, Sridevi

2018-03-01

Recent sweat chloride guidelines published by the Cystic Fibrosis Foundation changed the intermediate sweat chloride concentration range from 40-59 mmol/L to 30-59 mmol/L for age > 6 months. We wanted to know how this new guideline would impact detection of cystic fibrosis among patients who previously had sweat tests done at Texas Children's Hospital. We revisited sweat chloride test results (n = 3012) in the last 5 years at Texas Children's Hospital based on the new guidelines on diagnosis of cystic fibrosis from the Cystic Fibrosis Foundation. We identified 125 patients that would be reclassified in the intermediate sweat chloride value with the new guidelines that were classified as "unlikely to have CF" in the previous guidelines. 8 (32%) patients with CFTR gene testing were positive for CFTR gene mutation(s). 4 (50%) of these patients were identified to have 2 CFTR mutations. One had variant combination that was reported to cause CF but all were diagnosed with CFTR-related metabolic syndrome. Our findings concur with the new CF diagnosis guidelines that changing the intermediate cut-off to 30-59 mmol/L sweat chloride concentration in combination with CFTR genetic analysis enhances the probability of identifying individuals that have risk of developing CF or have CF and enables for earlier therapeutic intervention.

Coronary computed tomography versus exercise testing in patients with stable chest pain: comparative effectiveness and costs.

PubMed

Genders, Tessa S S; Ferket, Bart S; Dedic, Admir; Galema, Tjebbe W; Mollet, Nico R A; de Feyter, Pim J; Fleischmann, Kirsten E; Nieman, Koen; Hunink, M G Myriam

2013-08-20

To determine the comparative effectiveness and costs of a CT-strategy and a stress-electrocardiography-based strategy (standard-of-care; SOC-strategy) for diagnosing coronary artery disease (CAD). A decision analysis was performed based on a well-documented prospective cohort of 471 outpatients with stable chest pain with follow-up combined with best-available evidence from the literature. Outcomes were correct classification of patients as CAD- (no obstructive CAD), CAD+ (obstructive CAD without revascularization) and indication for Revascularization (using a combination reference standard), diagnostic costs, lifetime health care costs, and quality-adjusted life years (QALY). Parameter uncertainty was analyzed using probabilistic sensitivity analysis. For men (and women), diagnostic cost savings were €245 (€252) for the CT-strategy as compared to the SOC-strategy. The CT-strategy classified 82% (88%) of simulated men (women) in the appropriate disease category, whereas 83% (85%) were correctly classified by the SOC-strategy. The long-term cost-effectiveness analysis showed that the SOC-strategy was dominated by the CT-strategy, which was less expensive (-€229 in men, -€444 in women) and more effective (+0.002 QALY in men, +0.005 in women). The CT-strategy was cost-saving (-€231) but also less effective compared to SOC (-0.003 QALY) in men with a pre-test probability of ≥ 70%. The CT-strategy was cost-effective in 100% of simulations, except for men with a pre-test probability ≥ 70% in which case it was 59%. The results suggest that a CT-based strategy is less expensive and equally effective compared to SOC in all women and in men with a pre-test probability <70%. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Implementing a probabilistic definition of freedom from infection to facilitate trade of livestock: putting theory into praxis for the example of bovine herpes virus-1.

PubMed

Schuppers, M E; Stegeman, J A; Kramps, J A; Stärk, K D C

2012-07-01

International trade of livestock and livestock products poses a significant potential threat for spread of diseases, and importing countries therefore often require that imported animals and products are free from certain pathogens. However, absolute freedom from infection cannot be documented, since all test protocols are imperfect and can lead to false-negative results. It is possible instead to estimate the "probability of freedom from infection" and its opposite, the probability of infection despite having a negative test result. These probabilities can be estimated based on a pre-defined target prevalence, known surveillance efforts in the target population and known test characteristics of any pre-export test. Here, calculations are demonstrated using the example of bovine herpes virus-1 (BoHV-1). In a population that recently became free of BoHV-1 without using vaccination, the probability of being infected of an animal randomly selected for trade is 800 per 1 million and this probability is reduced to 64 (95% probability interval PI 6-161) per 1 million when this animal is tested negatively prior to export with a gB-ELISA. In a population that recently became free of BoHV-1 using vaccination, the probability of being infected of an animal randomly selected for trade is 200 per 1 million, and this probability can be reduced to 63 (95% PI 42-87) when this animal is tested negatively prior to export with a gE-ELISA. Similar estimations can be made on a herd level when assumptions are made about the herd size and the intensity of the surveillance efforts. Subsequently, the overall probability for an importing country of importing at least 1 infected animal can be assessed by taking into account the trade volume. Definition of the acceptable level of risk, including the probability of false-negative results to occur, is part of risk management. Internationally harmonized target prevalence levels for the declaration of freedom from infection from selected pathogens provide a significant contribution to the facilitation of international trade of livestock and livestock products by allowing exporting countries to design tailor-made output-based surveillance programs, while providing equivalent guarantees regarding the probability of freedom from infection of the population. Combining this with an approach to assess the overall probability of introducing at least 1 infected animal into an importing country during a defined time interval will help importing countries to achieve their desired level of acceptable risk and will help to assess the equivalence of animal health and food safety standards between trading partners. Copyright © 2011 Elsevier B.V. All rights reserved.

Mathematics understanding and anxiety in collaborative teaching

NASA Astrophysics Data System (ADS)

Ansari, B. I.; Wahyu, N.

2017-12-01

This study aims to examine students’ mathematical understanding and anxiety using collaborative teaching. The sample consists of 51 students in the 7th-grade of MTs N Jeureula, one of the Islamic public junior high schools in Jeureula, Aceh, Indonesia. A test of mathematics understanding was administered to the students twice during the period of two months. The result suggests that there is a significant increase in mathematical understanding in the pre-test and post-test. We categorized the students into the high, intermediate, and low level of prior mathematics knowledge. In the high-level prior knowledge, there is no difference of mathematical understanding between the experiment and control group. Meanwhile, in the intermediate and low level of prior knowledge, there is a significant difference of mathematical understanding between the experiment and control group. The mathematics anxiety is at an intermediate level in the experiment class and at a high level in the control group. There is no interaction between the learning model and the students’ prior knowledge towards the mathematical understanding, but there are interactions towards the mathematics anxiety. It indicates that the collaborative teaching model and the students’ prior knowledge do not simultaneously impacts on the mathematics understanding but the mathematics anxiety.

The predictive value of chronic kidney disease for assessing cardiovascular events under consideration of pretest probability for coronary artery disease in patients who underwent stress myocardial perfusion imaging.

PubMed

Furuhashi, Tatsuhiko; Moroi, Masao; Joki, Nobuhiko; Hase, Hiroki; Masai, Hirofumi; Kunimasa, Taeko; Fukuda, Hiroshi; Sugi, Kaoru

2013-02-01

Pretest probability of coronary artery disease (CAD) facilitates diagnosis and risk stratification of CAD. Stress myocardial perfusion imaging (MPI) and chronic kidney disease (CKD) are established major predictors of cardiovascular events. However, the role of CKD to assess pretest probability of CAD has been unclear. This study evaluates the role of CKD to assess the predictive value of cardiovascular events under consideration of pretest probability in patients who underwent stress MPI. Patients with no history of CAD underwent stress MPI (n = 310; male = 166; age = 70; CKD = 111; low/intermediate/high pretest probability = 17/194/99) and were followed for 24 months. Cardiovascular events included cardiac death and nonfatal acute coronary syndrome. Cardiovascular events occurred in 15 of the 310 patients (4.8 %), but not in those with low pretest probability which included 2 CKD patients. In patients with intermediate to high pretest probability (n = 293), multivariate Cox regression analysis identified only CKD [hazard ratio (HR) = 4.88; P = 0.022) and summed stress score of stress MPI (HR = 1.50; P < 0.001) as independent and significant predictors of cardiovascular events. Cardiovascular events were not observed in patients with low pretest probability. In patients with intermediate to high pretest probability, CKD and stress MPI are independent predictors of cardiovascular events considering the pretest probability of CAD in patients with no history of CAD. In assessing pretest probability of CAD, CKD might be an important factor for assessing future cardiovascular prognosis.

The optimal imaging strategy for patients with stable chest pain: a cost-effectiveness analysis.

PubMed

Genders, Tessa S S; Petersen, Steffen E; Pugliese, Francesca; Dastidar, Amardeep G; Fleischmann, Kirsten E; Nieman, Koen; Hunink, M G Myriam

2015-04-07

The optimal imaging strategy for patients with stable chest pain is uncertain. To determine the cost-effectiveness of different imaging strategies for patients with stable chest pain. Microsimulation state-transition model. Published literature. 60-year-old patients with a low to intermediate probability of coronary artery disease (CAD). Lifetime. The United States, the United Kingdom, and the Netherlands. Coronary computed tomography (CT) angiography, cardiac stress magnetic resonance imaging, stress single-photon emission CT, and stress echocardiography. Lifetime costs, quality-adjusted life-years (QALYs), and incremental cost-effectiveness ratios. The strategy that maximized QALYs and was cost-effective in the United States and the Netherlands began with coronary CT angiography, continued with cardiac stress imaging if angiography found at least 50% stenosis in at least 1 coronary artery, and ended with catheter-based coronary angiography if stress imaging induced ischemia of any severity. For U.K. men, the preferred strategy was optimal medical therapy without catheter-based coronary angiography if coronary CT angiography found only moderate CAD or stress imaging induced only mild ischemia. In these strategies, stress echocardiography was consistently more effective and less expensive than other stress imaging tests. For U.K. women, the optimal strategy was stress echocardiography followed by catheter-based coronary angiography if echocardiography induced mild or moderate ischemia. Results were sensitive to changes in the probability of CAD and assumptions about false-positive results. All cardiac stress imaging tests were assumed to be available. Exercise electrocardiography was included only in a sensitivity analysis. Differences in QALYs among strategies were small. Coronary CT angiography is a cost-effective triage test for 60-year-old patients who have nonacute chest pain and a low to intermediate probability of CAD. Erasmus University Medical Center.

External validation of the HIT Expert Probability (HEP) score.

PubMed

Joseph, Lee; Gomes, Marcelo P V; Al Solaiman, Firas; St John, Julie; Ozaki, Asuka; Raju, Manjunath; Dhariwal, Manoj; Kim, Esther S H

2015-03-01

The diagnosis of heparin-induced thrombocytopenia (HIT) can be challenging. The HIT Expert Probability (HEP) Score has recently been proposed to aid in the diagnosis of HIT. We sought to externally and prospectively validate the HEP score. We prospectively assessed pre-test probability of HIT for 51 consecutive patients referred to our Consultative Service for evaluation of possible HIT between August 1, 2012 and February 1, 2013. Two Vascular Medicine fellows independently applied the 4T and HEP scores for each patient. Two independent HIT expert adjudicators rendered a diagnosis of HIT likely or unlikely. The median (interquartile range) of 4T and HEP scores were 4.5 (3.0, 6.0) and 5 (3.0, 8.5), respectively. There were no significant differences between area under receiver-operating characteristic curves of 4T and HEP scores against the gold standard, confirmed HIT [defined as positive serotonin release assay and positive anti-PF4/heparin ELISA] (0.74 vs 0.73, p = 0.97). HEP score ≥ 2 was 100 % sensitive and 16 % specific for determining the presence of confirmed HIT while a 4T score > 3 was 93 % sensitive and 35 % specific. In conclusion, the HEP and 4T scores are excellent screening pre-test probability models for HIT, however, in this prospective validation study, test characteristics for the diagnosis of HIT based on confirmatory laboratory testing and expert opinion are similar. Given the complexity of the HEP scoring model compared to that of the 4T score, further validation of the HEP score is warranted prior to widespread clinical acceptance.

The Effect of Error Correction vs. Error Detection on Iranian Pre-Intermediate EFL Learners' Writing Achievement

ERIC Educational Resources Information Center

Abedi, Razie; Latifi, Mehdi; Moinzadeh, Ahmad

2010-01-01

This study tries to answer some ever-existent questions in writing fields regarding approaching the most effective ways to give feedback to students' errors in writing by comparing the effect of error correction and error detection on the improvement of students' writing ability. In order to achieve this goal, 60 pre-intermediate English learners…

Indeterminate lung nodules in cancer patients: pretest probability of malignancy and the role of 18F-FDG PET/CT.

PubMed

Evangelista, Laura; Panunzio, Annalori; Polverosi, Roberta; Pomerri, Fabio; Rubello, Domenico

2014-03-01

The purpose of this study was to determine likelihood of malignancy for indeterminate lung nodules identified on CT comparing two standardized models with (18)F-FDG PET/CT. Fifty-nine cancer patients with indeterminate lung nodules (solid tumors; diameter, ≥5 mm) on CT had FDG PET/CT for lesion characterization. Mayo Clinic and Veterans Affairs Cooperative Study models of likelihood of malignancy were applied to solitary pulmonary nodules. High probability of malignancy was assigned a priori for multiple nodules. Low (<5%), intermediate (5-60%), and high (>60%) pretest malignancy probabilities were analyzed separately. Patients were reclassified with PET/CT. Histopathology or 2-year imaging follow-up established diagnosis. Outcome-based reclassification differences were defined as net reclassification improvement. A null hypothesis of asymptotic test was applied. Thirty-one patients had histology-proven malignancy. PET/CT was true-positive in 24 and true-negative in 25 cases. Negative predictive value was 78% and positive predictive value was 89%. On the basis of the Mayo Clinic model (n=31), 18 patients had low, 12 had intermediate, and one had high pretest likelihood; on the basis of the Veterans Affairs model (n=26), 5 patients had low, 20 had intermediate, and one had high pretest likelihood. Because of multiple lung nodules, 28 patients were classified as having high malignancy risk. PET/CT showed 32 negative and 27 positive scans. Net reclassification improvements respectively were 0.95 and 1.6 for Mayo Clinic and Veterans Affairs models (both p<0.0001). Fourteen of 31 (45.2%) and 12 of 26 (46.2%) patients with low and intermediate pretest likelihood, respectively, had positive findings on PET/CT for the Mayo Clinic and Veterans Affairs models, respectively. Of 15 patients with high pretest likelihood and negative findings on PET/CT, 13 (86.7%) did not have lung malignancy. PET/CT improves stratification of cancer patients with indeterminate pulmonary nodules. A substantial number of patients considered at low and intermediate pretest likelihood of malignancy with histology-proven lung malignancy showed abnormal PET/CT findings.

Minimal preparation computed tomography instead of barium enema/colonoscopy for suspected colon cancer in frail elderly patients: an outcome analysis study.

PubMed

Kealey, S M; Dodd, J D; MacEneaney, P M; Gibney, R G; Malone, D E

2004-01-01

To evaluate the efficacy of minimal preparation computed tomography (MPCT) in diagnosing clinically significant colonic tumours in frail, elderly patients. A prospective study was performed in a group of consecutively referred, frail, elderly patients with symptoms or signs of anaemia, pain, rectal bleeding or weight loss. The MPCT protocol consisted of 1.5 l Gastrografin 1% diluted with sterile water administered during the 48 h before the procedure with no bowel preparation or administration of intravenous contrast medium. Eight millimetre contiguous scans through the abdomen and pelvis were performed. The scans were double-reported by two gastrointestinal radiologists as showing definite (>90% certain), probable (50-90% certain), possible (<50% certain) neoplasm or normal. Where observers disagreed the more pessimistic of the two reports was accepted. The gold standard was clinical outcome at 1 year with positive end-points defined as (1) histological confirmation of CRC, (2) clinical presentation consistent with CRC without histological confirmation if the patient was too unwell for biopsy/surgery, and (3) death directly attributable to colorectal carcinoma (CRC) with/without post-mortem confirmation. Negative end-points were defined as patients with no clinical, radiological or post-mortem findings of CRC. Patients were followed for 1 year or until one of the above end-points were met. Seventy-two patients were included (mean age 81; range 62-93). One-year follow-up was completed in 94.4% (n=68). Mortality from all causes was 33% (n=24). Five histologically proven tumours were diagnosed with CT and there were two probable false-negatives. Results were analysed twice: assuming all CT lesions test positive and considering "possible" lesions test negative [brackets] (95% confidence intervals): sensitivity 0.88 (0.47-1.0) [0.75 (0.35-0.97)], specificity 0.47 (0.34-0.6) [0.87 (0.75-0.94)], positive predictive value 0.18 [0.43], negative predictive value 0.97 [0.96], positive likelihood ratio result 1.6 [5.63], negative likelihood ratio result 0.27 [0.29], kappa 0.31 [0.43]. Tumour prevalence was 12%. A graph of conditional probabilities was generated and analysed. A variety of unsuspected pathology was also found in this series of patients. MPCT should be double-reported, at least initially. "Possible" lesions should be ignored. Analysis of the graph of conditional probability applied to a group of frail, elderly patients with a high mortality from all causes (33% in our study) suggests: (1) if MPCT suggests definite or probable carcinoma, regardless of the pre-test probability, the post-test probability is high enough to warrant further action, (2) frail, elderly patients with a low pre-test probability for CRC and a negative MPCT should not have further investigation, (3) frail, elderly patients with a higher pre-test probability of CRC (such as those presenting with rectal bleeding) and a negative MPCT should have either double contrast barium enema (DCBE) or colonoscopy as further investigations or be followed clinically for 3-6 months. MPCT was acceptable to patients and clinicians and may reveal significant extra-colonic pathology.

The Effect of Explicit vs. Implicit Instruction on the Learnability of English Consonant Clusters by Iranian Learners of English

ERIC Educational Resources Information Center

Khanbeiki, Ruhollah; Abdolmanafi-Rokni, Seyed Jalal

2015-01-01

The present study was aimed at providing the English teachers across Iran with a good and fruitful method of teaching pronunciation. To this end, sixty female intermediate EFL learners were put in three different but equivalent groups of 20 based on the results of a pronunciation pre-test. One of the groups received explicit instruction including…

A novel approach to cardiac troponins to improve the diagnostic work-up in chest pain patients.

PubMed

Eggers, Kai M; Jaffe, Allan S; Svennblad, Bodil; Lindahl, Bertil

2012-12-01

In patients with acute chest pain, current guidelines recommend serial measurements of cardiac troponins at predefined and partly late time points. Consequently, diagnostic assessment in these patients tends to be lengthy and often results in unnecessary admissions. We, therefore, evaluated whether an approach integrating troponin results into the clinical context provided by the individual patient's presentation might facilitate the early diagnostic work-up. In 197 chest pain patients, cardiac troponin I (cTnI; Stratus CS) was measured serially within 12 hours after hospital admission. In patient cohorts with different chances of having myocardial infarction (MI) according to clinical data, electrocardiographic findings, and admission biomarker results, pretest probabilities for MI were calculated and compared with posttest probabilities derived from subsequent cTnI results after admission. Elevated cTnI levels at 1 to 2 hours after admission revealed ≥95.0% posttest probabilities for MI in cohorts with intermediate or high chances of having MI. The posttest probabilities for the absence of MI were 94.7% to 98.2% in cohorts with low or intermediate chances of having MI when cTnI was negative at 2 hours. Troponin testing considering the individual patient's pretest probability of MI seems, in conclusion, to provide clinically useful information already 1 to 2 hours after admission. Such an approach has the potential to identify both patient cohorts in whom early discharge or admittance for further evaluation would be appropriate. This could facilitate the early diagnostic work-up of chest pain patients, thereby improving patient flow and reducing overcrowding in healthcare facilities.

Emergency medical services and congestion : urban sprawl and pre-hospital emergency care time.

DOT National Transportation Integrated Search

2009-01-01

This research measured the association between urban sprawl and emergency medical service (EMS) response time. The purpose was to test the hypothesis that features of the built environment increase the probability of delayed ambulance arrival. Using ...

On-board processing for telecommunications satellites

NASA Technical Reports Server (NTRS)

Nuspl, P. P.; Dong, G.

1991-01-01

In this decade, communications satellite systems will probably face dramatic challenges from alternative transmission means. To balance and overcome such competition, and to prepare for new requirements, INTELSAT has developed several on-board processing techniques, including Satellite-Switched TDMA (SS-TDMA), Satellite-Switched FDMA (SS-FDMA), several Modulators/Demodulators (Modem), a Multicarrier Multiplexer and Demodulator MCDD), an International Business Service (IBS)/Intermediate Data Rate (IDR) BaseBand Processor (BBP), etc. Some proof-of-concept hardware and software were developed, and tested recently in the INTELSAT Technical Laboratories. These techniques and some test results are discussed.

ACCF/AHA/ASE/ASNC/HFSA/HRS/SCAI/SCCT/SCMR/STS 2013 multimodality appropriate use criteria for the detection and risk assessment of stable ischemic heart disease: a report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Thoracic Surgeons.

PubMed

Ronan, Grace; Wolk, Michael J; Bailey, Steven R; Doherty, John U; Douglas, Pamela S; Hendel, Robert C; Kramer, Christopher M; Min, James K; Patel, Manesh R; Rosenbaum, Lisa; Shaw, Leslee J; Stainback, Raymond F; Allen, Joseph M; Brindis, Ralph G; Kramer, Christopher M; Shaw, Leslee J; Cerqueira, Manuel D; Chen, Jersey; Dean, Larry S; Fazel, Reza; Hundley, W Gregory; Itchhaporia, Dipti; Kligfield, Paul; Lockwood, Richard; Marine, Joseph Edward; McCully, Robert Benjamin; Messer, Joseph V; O'Gara, Patrick T; Shemin, Richard J; Wann, L Samuel; Wong, John B; Patel, Manesh R; Kramer, Christopher M; Bailey, Steven R; Brown, Alan S; Doherty, John U; Douglas, Pamela S; Hendel, Robert C; Lindsay, Bruce D; Min, James K; Shaw, Leslee J; Stainback, Raymond F; Wann, L Samuel; Wolk, Michael J; Allen, Joseph M

2014-02-01

The American College of Cardiology Foundation along with key specialty and subspecialty societies, conducted an appropriate use review of common clinical presentations for stable ischemic heart disease (SIHD) to consider use of stress testing and anatomic diagnostic procedures. This document reflects an updating of the prior Appropriate Use Criteria (AUC) published for radionuclide imaging (RNI), stress echocardiography (Echo), calcium scoring, coronary computed tomography angiography (CCTA), stress cardiac magnetic resonance (CMR), and invasive coronary angiography for SIHD. This is in keeping with the commitment to revise and refine the AUC on a frequent basis. A major innovation in this document is the rating of tests side by side for the same indication. The side-by-side rating removes any concerns about differences in indication or interpretation stemming from prior use of separate documents for each test. However, the ratings were explicitly not competitive rankings due to the limited availability of comparative evidence, patient variability, and range of capabilities available in any given local setting. The indications for this review are limited to the detection and risk assessment of SIHD and were drawn from common applications or anticipated uses, as well as from current clinical practice guidelines. Eighty clinical scenarios were developed by a writing committee and scored by a separate rating panel on a scale of 1-9, to designate Appropriate, May Be Appropriate, or Rarely Appropriate use following a modified Delphi process following the recently updated AUC development methodology. The use of some modalities of testing in the initial evaluation of patients with symptoms representing ischemic equivalents, newly diagnosed heart failure, arrhythmias, and syncope was generally found to be Appropriate or May Be Appropriate, except in cases where low pre-test probability or low risk limited the benefit of most testing except exercise electrocardiogram (ECG). Testing for the evaluation of new or worsening symptoms following a prior test or procedure was found to be Appropriate. In addition, testing was found to be Appropriate or May Be Appropriate for patients within 90 days of an abnormal or uncertain prior result. Pre-operative testing was rated Appropriate or May Be Appropriate only for patients who had poor functional capacity and were undergoing vascular or intermediate risk surgery with 1 or more clinical risk factors or an organ transplant. The exercise ECG was suggested as an Appropriate test for cardiac rehabilitation clearance or for exercise prescription purposes. Testing in asymptomatic patients was generally found to be Rarely Appropriate, except for calcium scoring and exercise testing in intermediate and high-risk individuals and either stress or anatomic imaging in higher-risk individuals, which were all rated as May Be Appropriate. All modalities of follow-up testing after a prior test or percutaneous coronary intervention (PCI) within 2 years and within 5 years after coronary artery bypass graft (CABG) in the absence of new symptoms were rated Rarely Appropriate. Pre-operative testing for patients with good functional capacity, prior normal testing within 1 year, or prior to low-risk surgery also were found to be Rarely Appropriate. Imaging for an exercise prescription or prior to the initiation of cardiac rehabilitation was Rarely Appropriate except for cardiac rehabilitation clearance for heart failure patients.

ACCF/AHA/ASE/ASNC/HFSA/HRS/SCAI/SCCT/SCMR/STS 2013 multimodality appropriate use criteria for the detection and risk assessment of stable ischemic heart disease: a report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance, and Society of Thoracic Surgeons.

PubMed

Wolk, Michael J; Bailey, Steven R; Doherty, John U; Douglas, Pamela S; Hendel, Robert C; Kramer, Christopher M; Min, James K; Patel, Manesh R; Rosenbaum, Lisa; Shaw, Leslee J; Stainback, Raymond F; Allen, Joseph M

2014-02-04

The American College of Cardiology Foundation along with key specialty and subspecialty societies, conducted an appropriate use review of common clinical presentations for stable ischemic heart disease (SIHD) to consider use of stress testing and anatomic diagnostic procedures. This document reflects an updating of the prior Appropriate Use Criteria (AUC) published for radionuclide imaging (RNI), stress echocardiography (Echo), calcium scoring, coronary computed tomography angiography (CCTA), stress cardiac magnetic resonance (CMR), and invasive coronary angiography for SIHD. This is in keeping with the commitment to revise and refine the AUC on a frequent basis. A major innovation in this document is the rating of tests side by side for the same indication. The side-by-side rating removes any concerns about differences in indication or interpretation stemming from prior use of separate documents for each test. However, the ratings were explicitly not competitive rankings due to the limited availability of comparative evidence, patient variability, and range of capabilities available in any given local setting. The indications for this review are limited to the detection and risk assessment of SIHD and were drawn from common applications or anticipated uses, as well as from current clinical practice guidelines. Eighty clinical scenarios were developed by a writing committee and scored by a separate rating panel on a scale of 1 to 9, to designate Appropriate, May Be Appropriate, or Rarely Appropriate use following a modified Delphi process following the recently updated AUC development methodology. The use of some modalities of testing in the initial evaluation of patients with symptoms representing ischemic equivalents, newly diagnosed heart failure, arrhythmias, and syncope was generally found to be Appropriate or May Be Appropriate, except in cases where low pre-test probability or low risk limited the benefit of most testing except exercise electrocardiogram (ECG). Testing for the evaluation of new or worsening symptoms following a prior test or procedure was found to be Appropriate. In addition, testing was found to be Appropriate or May Be Appropriate for patients within 90 days of an abnormal or uncertain prior result. Pre-operative testing was rated Appropriate or May Be Appropriate only for patients who had poor functional capacity and were undergoing vascular or intermediate risk surgery with 1 or more clinical risk factors or an organ transplant. The exercise ECG was suggested as an Appropriate test for cardiac rehabilitation clearance or for exercise prescription purposes. Testing in asymptomatic patients was generally found to be Rarely Appropriate, except for calcium scoring and exercise testing in intermediate and high-risk individuals and either stress or anatomic imaging in higher-risk individuals, which were all rated as May Be Appropriate. All modalities of follow-up testing after a prior test or percutaneous coronary intervention (PCI) within 2 years and within 5 years after coronary artery bypass graft (CABG) in the absence of new symptoms were rated Rarely Appropriate. Pre-operative testing for patients with good functional capacity, prior normal testing within 1 year, or prior to low-risk surgery also were found to be Rarely Appropriate. Imaging for an exercise prescription or prior to the initiation of cardiac rehabilitation was Rarely Appropriate except for cardiac rehabilitation clearance for heart failure patients.

N-nitrosodimethylamine (NDMA) formation potential of amine-based water treatment polymers: Effects of in situ chloramination, breakpoint chlorination, and pre-oxidation.

PubMed

Park, Sang Hyuck; Padhye, Lokesh P; Wang, Pei; Cho, Min; Kim, Jae-Hong; Huang, Ching-Hua

2015-01-23

Recent studies show that cationic amine-based water treatment polymers may be important precursors that contribute to formation of the probable human carcinogen N-nitrosodimethylamine (NDMA) during water treatment and disinfection. To better understand how water treatment parameters affect NDMA formation from the polymers, the effects of in situ chloramination, breakpoint chlorination, and pre-oxidation on the NDMA formation from the polymers were investigated. NDMA formation potential (NDMA-FP) as well as dimethylamine (DMA) residual concentration were measured from poly(epichlorohydrin dimethylamine) (polyamine) and poly(diallyldimethylammonium chloride) (polyDADMAC) solutions upon reactions with oxidants including free chlorine, chlorine dioxide, ozone, and monochloramine under different treatment conditions. The results supported that dichloramine (NHCl2) formation was the critical factor affecting NDMA formation from the polymers during in situ chloramination. The highest NDMA formation from the polymers occurred near the breakpoint of chlorination. Polymer chain breakdown and transformation of the released DMA and other intermediates were important factors affecting NDMA formation from the polymers in pre-oxidation followed by post-chloramination. Pre-oxidation generally reduced NDMA-FP of the polymers; however, the treatments involving pre-ozonation increased polyDADMAC's NDMA-FP and DMA release. The strategies for reducing NDMA formation from the polymers may include the avoidance of the conditions favorable to NHCl2 formation and the avoidance of polymer exposure to strong oxidants such as ozone. Copyright © 2014 Elsevier B.V. All rights reserved.

Development and Validation of the Suprathreshold Stochastic Resonance-Based Image Processing Method for the Detection of Abdomino-pelvic Tumor on PET/CT Scans.

PubMed

Saroha, Kartik; Pandey, Anil Kumar; Sharma, Param Dev; Behera, Abhishek; Patel, Chetan; Bal, Chandrashekhar; Kumar, Rakesh

2017-01-01

The detection of abdomino-pelvic tumors embedded in or nearby radioactive urine containing 18F-FDG activity is a challenging task on PET/CT scan. In this study, we propose and validate the suprathreshold stochastic resonance-based image processing method for the detection of these tumors. The method consists of the addition of noise to the input image, and then thresholding it that creates one frame of intermediate image. One hundred such frames were generated and averaged to get the final image. The method was implemented using MATLAB R2013b on a personal computer. Noisy image was generated using random Poisson variates corresponding to each pixel of the input image. In order to verify the method, 30 sets of pre-diuretic and its corresponding post-diuretic PET/CT scan images (25 tumor images and 5 control images with no tumor) were included. For each sets of pre-diuretic image (input image), 26 images (at threshold values equal to mean counts multiplied by a constant factor ranging from 1.0 to 2.6 with increment step of 0.1) were created and visually inspected, and the image that most closely matched with the gold standard (corresponding post-diuretic image) was selected as the final output image. These images were further evaluated by two nuclear medicine physicians. In 22 out of 25 images, tumor was successfully detected. In five control images, no false positives were reported. Thus, the empirical probability of detection of abdomino-pelvic tumors evaluates to 0.88. The proposed method was able to detect abdomino-pelvic tumors on pre-diuretic PET/CT scan with a high probability of success and no false positives.

Intermediate-term forecasting of aftershocks from an early aftershock sequence: Bayesian and ensemble forecasting approaches

NASA Astrophysics Data System (ADS)

Omi, Takahiro; Ogata, Yosihiko; Hirata, Yoshito; Aihara, Kazuyuki

2015-04-01

Because aftershock occurrences can cause significant seismic risks for a considerable time after the main shock, prospective forecasting of the intermediate-term aftershock activity as soon as possible is important. The epidemic-type aftershock sequence (ETAS) model with the maximum likelihood estimate effectively reproduces general aftershock activity including secondary or higher-order aftershocks and can be employed for the forecasting. However, because we cannot always expect the accurate parameter estimation from incomplete early aftershock data where many events are missing, such forecasting using only a single estimated parameter set (plug-in forecasting) can frequently perform poorly. Therefore, we here propose Bayesian forecasting that combines the forecasts by the ETAS model with various probable parameter sets given the data. By conducting forecasting tests of 1 month period aftershocks based on the first 1 day data after the main shock as an example of the early intermediate-term forecasting, we show that the Bayesian forecasting performs better than the plug-in forecasting on average in terms of the log-likelihood score. Furthermore, to improve forecasting of large aftershocks, we apply a nonparametric (NP) model using magnitude data during the learning period and compare its forecasting performance with that of the Gutenberg-Richter (G-R) formula. We show that the NP forecast performs better than the G-R formula in some cases but worse in other cases. Therefore, robust forecasting can be obtained by employing an ensemble forecast that combines the two complementary forecasts. Our proposed method is useful for a stable unbiased intermediate-term assessment of aftershock probabilities.

Explosive to Effusive Transition in Intermediate Volcanism: An Analysis of Changing Magma System Conditions in Dominica

NASA Astrophysics Data System (ADS)

Bersson, J.; Waters, L. E.; Frey, H. M.; Nicolaysen, K. P.; Manon, M. R. F.

2017-12-01

The oscillation between explosive and effusive intermediate (59-62 wt% SiO2) volcanism in the Roseau Valley on Dominica, an island in the Lesser Antilles Arc, provides an opportunity to investigate temporal changes in the magmatic system. Here, we test the relationship between the Roseau ignimbrites (1-65 ka) and the Micotrin dome ( 1.1 ka) which are proposed to originate from the same magmatic system, with a detailed petrologic analysis of phenocrysts to determine commonalities or changes in pre-eruptive conditions (i.e., intensive variables). The ignimbrites are saturated in five phenocrysts (plagioclase + orthopyroxene + clinopyroxene + ilmenite + magnetite ± amphibole ± quartz), and the lava dome contains the same assemblage, but with notable differences: amphiboles are entirely reacted, and quartz occurs in greater abundance. Plagioclase in the ignimbrites ranges in composition from An46-93, and those in the dome range from An46-85. Two Fe-Ti oxide geo-thermometry reveal pre-eruptive temperatures from 730-820°C for three different ignimbrite units, whereas the pre-eruptive temperature for the dome is slightly hotter (850±23°C). Values of fO2 (relative to NNO) derived from Fe-Ti oxide oxygen-barometry range from +0.3 to +1.32 ΔNNO for the ignimbrites, which overlap with those from the dome (+0.5 to +0.9 ΔNNO). Pre-eruptive temperatures, plagioclase compositions, whole rock and glass compositions are incorporated into a plagioclase-liquid hygrometer to determine pre-eruptive melt H2O contents for each sample. H2O contents for ignimbrites range from 7.1-9.3 wt%, and those from the lava dome range from 6.7-7.1 wt%. Application of a H2O solubility model shows that water contents for the Roseau magmas correspond to pressures of 3-5 kbar. The most notable difference between the explosive and effusive magmas is that the lava dome has a higher pre-eruptive temperature than the ignimbrites. However, the results collectively suggest that more recent volcanism in the Roseau Valley (<5 ka) has hotter pre-eruptive temperatures, regardless of eruptive style, and that these intermediate magmas originate from sources in the deep crust (>5 kb). Understanding the magmatic system beneath Micotrin is important, as the capital of Roseau (pop. 15,000), is at the foot of the valley, built on old pyroclastic deposits.

Usefulness of DWI in preoperative assessment of deep myometrial invasion in patients with endometrial carcinoma: a systematic review and meta-analysis

PubMed Central

2014-01-01

Background The objective of this study was to perform a systematic review and a meta-analysis in order to estimate the diagnostic accuracy of diffusion weighted imaging (DWI) in the preoperative assessment of deep myometrial invasion in patients with endometrial carcinoma. Methods Studies evaluating DWI for the detection of deep myometrial invasion in patients with endometrial carcinoma were systematically searched for in the MEDLINE, EMBASE, and Cochrane Library from January 1995 to January 2014. Methodologic quality was assessed by using the Quality Assessment of Diagnostic Accuracy Studies tool. Bivariate random-effects meta-analytic methods were used to obtain pooled estimates of sensitivity, specificity, diagnostic odds ratio (DOR) and receiver operating characteristic (ROC) curves. The study also evaluated the clinical utility of DWI in preoperative assessment of deep myometrial invasion. Results Seven studies enrolling a total of 320 individuals met the study inclusion criteria. The summary area under the ROC curve was 0.91. There was no evidence of publication bias (P = 0.90, bias coefficient analysis). Sensitivity and specificity of DWI for detection of deep myometrial invasion across all studies were 0.90 and 0.89, respectively. Positive and negative likelihood ratios with DWI were 8 and 0.11 respectively. In patients with high pre-test probabilities, DWI enabled confirmation of deep myometrial invasion; in patients with low pre-test probabilities, DWI enabled exclusion of deep myometrial invasion. The worst case scenario (pre-test probability, 50%) post-test probabilities were 89% and 10% for positive and negative DWI results, respectively. Conclusion DWI has high sensitivity and specificity for detecting deep myometrial invasion and more importantly can reliably rule out deep myometrial invasion. Therefore, it would be worthwhile to add a DWI sequence to the standard MRI protocols in preoperative evaluation of endometrial cancer in order to detect deep myometrial invasion, which along with other poor prognostic factors like age, tumor grade, and LVSI would be useful in stratifying high risk groups thereby helping in the tailoring of surgical approach in patient with low risk of endometrial carcinoma. PMID:25608571

The meaning of diagnostic test results: a spreadsheet for swift data analysis.

PubMed

Maceneaney, P M; Malone, D E

2000-03-01

To design a spreadsheet program to: (a) analyse rapidly diagnostic test result data produced in local research or reported in the literature; (b) correct reported predictive values for disease prevalence in any population; (c) estimate the post-test probability of disease in individual patients. Microsoft Excel(TM)was used. Section A: a contingency (2 x 2) table was incorporated into the spreadsheet. Formulae for standard calculations [sample size, disease prevalence, sensitivity and specificity with 95% confidence intervals, predictive values and likelihood ratios (LRs)] were linked to this table. The results change automatically when the data in the true or false negative and positive cells are changed. Section B: this estimates predictive values in any population, compensating for altered disease prevalence. Sections C-F: Bayes' theorem was incorporated to generate individual post-test probabilities. The spreadsheet generates 95% confidence intervals, LRs and a table and graph of conditional probabilities once the sensitivity and specificity of the test are entered. The latter shows the expected post-test probability of disease for any pre-test probability when a test of known sensitivity and specificity is positive or negative. This spreadsheet can be used on desktop and palmtop computers. The MS Excel(TM)version can be downloaded via the Internet from the URL ftp://radiography.com/pub/Rad-data99.xls A spreadsheet is useful for contingency table data analysis and assessment of the clinical meaning of diagnostic test results. Copyright 2000 The Royal College of Radiologists.

Item Selection and Pre-equating with Empirical Item Characteristic Curves.

ERIC Educational Resources Information Center

Livingston, Samuel A.

An empirical item characteristic curve shows the probability of a correct response as a function of the student's total test score. These curves can be estimated from large-scale pretest data. They enable test developers to select items that discriminate well in the score region where decisions are made. A similar set of curves can be used to…

Identification and Targeting of Candidate Preexisting Lurker Cells That Give Rise to Castration-Resistant Prostate Cancer

DTIC Science & Technology

2016-10-01

cells as the pre-existing “lurker” cells in primary prostate tumors, to evaluate potential therapeutic targets in intermediate luminal progenitor cells...intermediate luminal progenitor cells as the pre-existing “lurker” cells in primary prostate tumors, to evaluate potential therapeutic targets in...candidate target expressed in CD38-lo cells and evaluated the role of CD38 in cell proliferation. No prior Hormonal *** No prior therapy

Cyclohexane isomerization. Unimolecular dynamics of the twist-boat intermediate.

PubMed

Kakhiani, Khatuna; Lourderaj, Upakarasamy; Hu, Wenfang; Birney, David; Hase, William L

2009-04-23

Direct dynamics simulations were performed at the HF/6-31G level of theory to investigate the intramolecular and unimolecuar dynamics of the twist-boat (TB) intermediate on the cyclohexane potential energy surface (PES). Additional calculations were performed at the MP2/aug-cc-pVDZ level of theory to further characterize the PES's stationary points. The trajectories were initiated at the C(1) and C(2) half-chair transition states (TSs) connecting a chair conformer with a TB intermediate, via an intrinsic reaction coordinate (IRC). Energy was added in accord with a microcanonical ensemble at the average energy for experiments at 263 K. Important nontransition state theory (TST), non-IRC, and non-RRKM dynamics were observed in the simulations. Trajectories initially directed toward the chair conformer had a high probability of recrossing the TS, with approximately 30% forming a TB intermediate instead of accessing the potential energy well for the conformer. The TB intermediate initially formed was not necessarily the one connected to the TS via the IRC. Of the trajectories initiated at the C(2) half-chair TS and initially directed toward the chair conformer, 35% formed a TB intermediate instead of the chair conformer. Also, of the trajectories forming a TB intermediate, only 16% formed the TB intermediate connected with the C(2) TS via the IRC. Up to eight consecutive TB --> TB isomerizations were followed, and non-RRKM behavior was observed in their dynamics. A TB can isomerize to two different TBs, one by a clockwise rotation of C-C-C-C dihedral angles and the other by a counterclockwise rotation. In contrast to RRKM theory, which predicts equivalent probabilities for these rotations, the trajectory dynamics show they are not equivalent and depend on whether the C(1) or C(2) half-chair TS is initially excited. Non-RRKM dynamics is also observed in the isomerization of the TB intermediates to the chair conformers. RRKM theory assumes equivalent probabilities for isomerizing to the two chair conformers. In contrast, for the first and following TB intermediate formed, there is a preference to isomerize to the chair conformer connected to the TS at which the trajectories were initiated. For the first TB intermediate formed, approximately 30% of the isomerization is to a chair conformer, but this fraction decreases for the later formed TB intermediates and becomes approximately 10% for the eighth consecutive TB intermediate formed.

Dynamics of a Landau-Zener non-dissipative system with fluctuating energy levels

NASA Astrophysics Data System (ADS)

Fai, L. C.; Diffo, J. T.; Ateuafack, M. E.; Tchoffo, M.; Fouokeng, G. C.

2014-12-01

This paper considers a Landau-Zener (two-level) system influenced by a three-dimensional Gaussian and non-Gaussian coloured noise and finds a general form of the time dependent diabatic quantum bit (qubit) flip transition probabilities in the fast, intermediate and slow noise limits. The qubit flip probability is observed to mimic (for low-frequencies noise) that of the standard LZ problem. The qubit flip probability is also observed to be the measure of quantum coherence of states. The transition probability is observed to be tailored by non-Gaussian low-frequency noise and otherwise by Gaussian low-frequency coloured noise. Intermediate and fast noise limits are observed to alter the memory of the system in time and found to improve and control quantum information processing.

Does clinical pretest probability influence image quality and diagnostic accuracy in dual-source coronary CT angiography?

PubMed

Thomas, Christoph; Brodoefel, Harald; Tsiflikas, Ilias; Bruckner, Friederike; Reimann, Anja; Ketelsen, Dominik; Drosch, Tanja; Claussen, Claus D; Kopp, Andreas; Heuschmid, Martin; Burgstahler, Christof

2010-02-01

To prospectively evaluate the influence of the clinical pretest probability assessed by the Morise score onto image quality and diagnostic accuracy in coronary dual-source computed tomography angiography (DSCTA). In 61 patients, DSCTA and invasive coronary angiography were performed. Subjective image quality and accuracy for stenosis detection (>50%) of DSCTA with invasive coronary angiography as gold standard were evaluated. The influence of pretest probability onto image quality and accuracy was assessed by logistic regression and chi-square testing. Correlations of image quality and accuracy with the Morise score were determined using linear regression. Thirty-eight patients were categorized into the high, 21 into the intermediate, and 2 into the low probability group. Accuracies for the detection of significant stenoses were 0.94, 0.97, and 1.00, respectively. Logistic regressions and chi-square tests showed statistically significant correlations between Morise score and image quality (P < .0001 and P < .001) and accuracy (P = .0049 and P = .027). Linear regression revealed a cutoff Morise score for a good image quality of 16 and a cutoff for a barely diagnostic image quality beyond the upper Morise scale. Pretest probability is a weak predictor of image quality and diagnostic accuracy in coronary DSCTA. A sufficient image quality for diagnostic images can be reached with all pretest probabilities. Therefore, coronary DSCTA might be suitable also for patients with a high pretest probability. Copyright 2010 AUR. Published by Elsevier Inc. All rights reserved.

Performance of FDG-PET/CT in solitary pulmonary nodule based on pre-test likelihood of malignancy: results from the ITALIAN retrospective multicenter trial.

PubMed

Evangelista, Laura; Cuocolo, Alberto; Pace, Leonardo; Mansi, Luigi; Del Vecchio, Silvana; Miletto, Paolo; Sanfilippo, Silvia; Pellegrino, Sara; Guerra, Luca; Pepe, Giovanna; Peluso, Giuseppina; Salvatore, Marco; Galicchio, Rosj; Zuffante, Michele; Annunziata, Salvatore; Farsad, Mohsen; Chiaravalloti, Agostino; Spadafora, Marco

2018-05-07

The aim of this study was to determine the performance of 18 F-FDG-PET/CT in patients with solitary pulmonary nodule (SPN), stratifying the risk according to the likelihood of pulmonary malignancy. FDG-PET/CT of 502 patients, stratified for pre-test cancer risk, were retrospectively analyzed. FDG uptake in SPN was assessed by a 4-point scoring system and semiquantitative analysis using the ratio between SUVmax in SPN and SUVmean in mediastinal blood pool (BP) and between SUVmax in SPN and SUVmean in liver (L). Histopathology and/or follow-up data were used as standard of reference. SPN was malignant in 180 (36%) patients, benign in 175 (35%), and indeterminate in 147 (29%). The 355 patients with a definitive SPN nature (malignant or benign) were considered for the analysis. Considering FDG uptake ≥ 2, sensitivity, specificity, positive (PPV) and negative (NPV) predictive values, and accuracy were 85.6%, 85.7%, 86%, 85.2%, and 85.6% respectively. Sensitivity and PPV were higher (P < 0.05) in intermediate and high-risk patients, while specificity and NPV were higher (P < 0.05) in low-risk patients. On receiver operating characteristic curve analysis, the cut-offs for better discrimination between benign and malignant SPN were 1.56 (sensitivity 81% and specificity 87%) and 1.12 (sensitivity 81% and specificity 86%) for SUVmax/SUVmeanBP and SUVmax/SUVmeanL respectively. In intermediate and high-risk patients, including the SUVmax/SUVmeanBP, the specificity shifted from 85% and 50% to 100%. Visual FDG-PET/CT has an acceptable performance in patients with SPN, but accuracy improves when SUVratios are considered, particularly in patients with intermediate and high risk of malignancy.

Should Malaria Treatment Be Guided by a Point of Care Rapid Test? A Threshold Approach to Malaria Management in Rural Burkina Faso

PubMed Central

Bisoffi, Zeno; Tinto, Halidou; Sirima, Bienvenu Sodiomon; Gobbi, Federico; Angheben, Andrea; Buonfrate, Dora; Van den Ende, Jef

2013-01-01

Background In Burkina Faso, rapid diagnostic tests for malaria have been made recently available. Previously, malaria was managed clinically. This study aims at assessing which is the best management option of a febrile patient in a hyperendemic setting. Three alternatives are: treating presumptively, testing, or refraining from both test and treatment. The test threshold is the tradeoff between refraining and testing, the test-treatment threshold is the tradeoff between testing and treating. Only if the disease probability lies between the two should the test be used. Methods and Findings Data for this analysis was obtained from previous studies on malaria rapid tests, involving 5220 patients. The thresholds were calculated, based on disease risk, treatment risk and cost, test accuracy and cost. The thresholds were then matched against the disease probability. For a febrile child under 5 in the dry season, the pre-test probability of clinical malaria (3.2%), was just above the test/treatment threshold. In the rainy season, that probability was 63%, largely above the test/treatment threshold. For febrile children >5 years and adults in the dry season, the probability was 1.7%, below the test threshold, while in the rainy season it was higher (25.1%), and situated between the two thresholds (3% and 60.9%), only if costs were not considered. If they were, neither testing nor treating with artemisinin combination treatments (ACT) would be recommended. Conclusions A febrile child under 5 should be treated presumptively. In the dry season, the probability of clinical malaria in adults is so low, that neither testing nor treating with any regimen should be recommended. In the rainy season, if costs are considered, a febrile adult should not be tested, nor treated with ACT, but a possible alternative would be a presumptive treatment with amodiaquine plus sulfadoxine-pyrimethamine. If costs were not considered, testing would be recommended. PMID:23472129

Estimation and prediction of maximum daily rainfall at Sagar Island using best fit probability models

NASA Astrophysics Data System (ADS)

Mandal, S.; Choudhury, B. U.

2015-07-01

Sagar Island, setting on the continental shelf of Bay of Bengal, is one of the most vulnerable deltas to the occurrence of extreme rainfall-driven climatic hazards. Information on probability of occurrence of maximum daily rainfall will be useful in devising risk management for sustaining rainfed agrarian economy vis-a-vis food and livelihood security. Using six probability distribution models and long-term (1982-2010) daily rainfall data, we studied the probability of occurrence of annual, seasonal and monthly maximum daily rainfall (MDR) in the island. To select the best fit distribution models for annual, seasonal and monthly time series based on maximum rank with minimum value of test statistics, three statistical goodness of fit tests, viz. Kolmogorove-Smirnov test (K-S), Anderson Darling test ( A 2 ) and Chi-Square test ( X 2) were employed. The fourth probability distribution was identified from the highest overall score obtained from the three goodness of fit tests. Results revealed that normal probability distribution was best fitted for annual, post-monsoon and summer seasons MDR, while Lognormal, Weibull and Pearson 5 were best fitted for pre-monsoon, monsoon and winter seasons, respectively. The estimated annual MDR were 50, 69, 86, 106 and 114 mm for return periods of 2, 5, 10, 20 and 25 years, respectively. The probability of getting an annual MDR of >50, >100, >150, >200 and >250 mm were estimated as 99, 85, 40, 12 and 03 % level of exceedance, respectively. The monsoon, summer and winter seasons exhibited comparatively higher probabilities (78 to 85 %) for MDR of >100 mm and moderate probabilities (37 to 46 %) for >150 mm. For different recurrence intervals, the percent probability of MDR varied widely across intra- and inter-annual periods. In the island, rainfall anomaly can pose a climatic threat to the sustainability of agricultural production and thus needs adequate adaptation and mitigation measures.

"I Don't Really Understand Probability at All": Final Year Pre-Service Teachers' Understanding of Probability

ERIC Educational Resources Information Center

Maher, Nicole; Muir, Tracey

2014-01-01

This paper reports on one aspect of a wider study that investigated a selection of final year pre-service primary teachers' responses to four probability tasks. The tasks focused on foundational ideas of probability including sample space, independence, variation and expectation. Responses suggested that strongly held intuitions appeared to…

A global logrank test for adaptive treatment strategies based on observational studies.

PubMed

Li, Zhiguo; Valenstein, Marcia; Pfeiffer, Paul; Ganoczy, Dara

2014-02-28

In studying adaptive treatment strategies, a natural question that is of paramount interest is whether there is any significant difference among all possible treatment strategies. When the outcome variable of interest is time-to-event, we propose an inverse probability weighted logrank test for testing the equivalence of a fixed set of pre-specified adaptive treatment strategies based on data from an observational study. The weights take into account both the possible selection bias in an observational study and the fact that the same subject may be consistent with more than one treatment strategy. The asymptotic distribution of the weighted logrank statistic under the null hypothesis is obtained. We show that, in an observational study where the treatment selection probabilities need to be estimated, the estimation of these probabilities does not have an effect on the asymptotic distribution of the weighted logrank statistic, as long as the estimation of the parameters in the models for these probabilities is n-consistent. Finite sample performance of the test is assessed via a simulation study. We also show in the simulation that the test can be pretty robust to misspecification of the models for the probabilities of treatment selection. The method is applied to analyze data on antidepressant adherence time from an observational database maintained at the Department of Veterans Affairs' Serious Mental Illness Treatment Research and Evaluation Center. Copyright © 2013 John Wiley & Sons, Ltd.

Intermediate Pond Sizes Contain the Highest Density, Richness, and Diversity of Pond-Breeding Amphibians

PubMed Central

Semlitsch, Raymond D.; Peterman, William E.; Anderson, Thomas L.; Drake, Dana L.; Ousterhout, Brittany H.

2015-01-01

We present data on amphibian density, species richness, and diversity from a 7140-ha area consisting of 200 ponds in the Midwestern U.S. that represents most of the possible lentic aquatic breeding habitats common in this region. Our study includes all possible breeding sites with natural and anthropogenic disturbance processes that can be missing from studies where sampling intensity is low, sample area is small, or partial disturbance gradients are sampled. We tested whether pond area was a significant predictor of density, species richness, and diversity of amphibians and if values peaked at intermediate pond areas. We found that in all cases a quadratic model fit our data significantly better than a linear model. Because small ponds have a high probability of pond drying and large ponds have a high probability of fish colonization and accumulation of invertebrate predators, drying and predation may be two mechanisms driving the peak of density and diversity towards intermediate values of pond size. We also found that not all intermediate sized ponds produced many larvae; in fact, some had low amphibian density, richness, and diversity. Further analyses of the subset of ponds represented in the peak of the area distribution showed that fish, hydroperiod, invertebrate density, and canopy are additional factors that drive density, richness and diversity of ponds up or down, when extremely small or large ponds are eliminated. Our results indicate that fishless ponds at intermediate sizes are more diverse, produce more larvae, and have greater potential to recruit juveniles into adult populations of most species sampled. Further, hylid and chorus frogs are found predictably more often in ephemeral ponds whereas bullfrogs, green frogs, and cricket frogs are found most often in permanent ponds with fish. Our data increase understanding of what factors structure and maintain amphibian diversity across large landscapes. PMID:25906355

Management of Pulmonary Nodules by Community Pulmonologists: A Multicenter Observational Study.

PubMed

Tanner, Nichole T; Aggarwal, Jyoti; Gould, Michael K; Kearney, Paul; Diette, Gregory; Vachani, Anil; Fang, Kenneth C; Silvestri, Gerard A

2015-12-01

Pulmonary nodules (PNs) are a common reason for referral to pulmonologists. The majority of data for the evaluation and management of PNs is derived from studies performed in academic medical centers. Little is known about the prevalence and diagnosis of PNs, the use of diagnostic testing, or the management of PNs by community pulmonologists. This multicenter observational record review evaluated 377 patients aged 40 to 89 years referred to 18 geographically diverse community pulmonary practices for intermediate PNs (8-20 mm). Study measures included the prevalence of malignancy, procedure/test use, and nodule pretest probability of malignancy as calculated by two previously validated models. The relationship between calculated pretest probability and management decisions was evaluated. The prevalence of malignancy was 25% (n = 94). Nearly one-half of the patients (46%, n = 175) had surveillance alone. Biopsy was performed on 125 patients (33.2%). A total of 77 patients (20.4%) underwent surgery, of whom 35% (n = 27) had benign disease. PET scan was used in 141 patients (37%). The false-positive rate for PET scan was 39% (95% CI, 27.1%-52.1%). Pretest probability of malignancy calculations showed that 9.5% (n = 36) were at a low risk, 79.6% (n = 300) were at a moderate risk, and 10.8% (n = 41) were at a high risk of malignancy. The rate of surgical resection was similar among the three groups (17%, 21%, 17%, respectively; P = .69). A substantial fraction of intermediate-sized nodules referred to pulmonologists ultimately prove to be lung cancer. Despite advances in imaging and nonsurgical biopsy techniques, invasive sampling of low-risk nodules and surgical resection of benign nodules remain common, suggesting a lack of adherence to guidelines for the management of PNs.

Attitudes of the Preparatory Class Students towards the Writing Course and Their Attitude-Success Relationship in Writing

ERIC Educational Resources Information Center

Paker, Turan; Erarslan, Ali

2015-01-01

This study aims to explore the attitudes of Turkish EFL students towards the writing course at university and to investigate the relationship between students' attitudes and their overall proficiency in writing. The participants were 782 students from various departments in the pre-intermediate, intermediate and upper-intermediate levels in a…

Bayes’ theorem, the ROC diagram and reference values: Definition and use in clinical diagnosis

PubMed Central

Kallner, Anders

2017-01-01

Medicine is diagnosis, treatment and care. To diagnose is to consider the probability of the cause of discomfort experienced by the patient. The physician may face many options and all decisions are liable to uncertainty to some extent. The rational action is to perform selected tests and thereby increase the pre-test probability to reach a superior post-test probability of a particular option. To draw the right conclusions from a test, certain background information about the performance of the test is necessary. We set up a partially artificial dataset with measured results obtained from the laboratory information system and simulated diagnosis attached. The dataset is used to explore the use of contingency tables with a unique graphic design and software to establish and compare ROC graphs. The loss of information in the ROC curve is compensated by a cumulative data analysis (CDA) plot linked to a display of the efficiency and predictive values. A standard for the contingency table is suggested and the use of dynamic reference intervals discussed. PMID:29209139

Use of ozone in a pilot-scale plant for textile wastewater pre-treatment: physico-chemical efficiency, degradation by-products identification and environmental toxicity of treated wastewater.

PubMed

Somensi, Cleder A; Simionatto, Edésio L; Bertoli, Sávio L; Wisniewski, Alberto; Radetski, Claudemir M

2010-03-15

In this study, ozonation of raw textile wastewater was conducted in a pilot-scale plant and the efficiency of this treatment was evaluated based on the parameters color removal and soluble organic matter measured as chemical oxygen demand (COD), at two pH values (9.1 and 3.0). Identification of intermediate and final degradation products of ozone pre-treatment, as well as the evaluation of the final ecotoxicity (Lumistox test) of pre-treated wastewater, was also carried out. After 4h of ozone treatment with wastewater recirculation (flow rate of 0.45 m(3)h(-1)) the average efficiencies for color removal were 67.5% (pH 9.1) and 40.6% (pH 3.0), while COD reduction was 25.5% (pH 9.1) and 18.7% (pH 3.0) for an ozone production capacity of 20 g h(-1). Furthermore, ozonation enhances the biodegradability of textile wastewater (BOD(5)/COD ratios) by a factor of up to 6.8-fold. A GC-MS analysis of pre-treated textile wastewater showed that some products were present at the end of the pre-treatment time. In spite of this fact, the bacterial luminescence inhibition test (Lumistox test) showed a significant toxicity reduction on comparing the raw and treated textile wastewater. In conclusion, pre-ozonation of textile wastewater is an important step in terms of improving wastewater biodegradability, as well as reducing acute ecotoxicity, which should be removed completely through sequential biological treatment. (c) 2009. Published by Elsevier B.V.

A Formative Evaluation of Me Now, Unit I, Digestion and Circulation, Life Sciences for the Educable Mentally Handicapped Intermediate Grades (11-13 years).

ERIC Educational Resources Information Center

Robinson, James T.; Tolman, Richard R.

In order to evaluate Unit I (Digestion and Circulation) of the Me Now series of Life Sciences for the Educable Mentally Handicapped, 139 students in an experimental group (mean IQ 72.04; mean CA 144.9 months) and 154 control subjects (mean IQ 70.2; mean CA 148.3 months) were pre- and post-tested following instruction in the Me Now series…

Structure of a Venezuelan equine encephalitis virus assembly intermediate isolated from infected cells

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

Lamb, Kristen; Lokesh, G.L.; Sherman, Michael

2010-10-25

Venezuelan equine encephalitis virus (VEEV) is a prototypical enveloped ssRNA virus of the family Togaviridae. To better understand alphavirus assembly, we analyzed newly formed nucleocapsid particles (termed pre-viral nucleocapsids) isolated from infected cells. These particles were intermediates along the virus assembly pathway, and ultimately bind membrane-associated viral glycoproteins to bud as mature infectious virus. Purified pre-viral nucleocapsids were spherical with a unimodal diameter distribution. The structure of one class of pre-viral nucleocapsids was determined with single particle reconstruction of cryo-electron microscopy images. These studies showed that pre-viral nucleocapsids assembled into an icosahedral structure with a capsid stoichiometry similar to themore » mature nucleocapsid. However, the individual capsomers were organized significantly differently within the pre-viral and mature nucleocapsids. The pre-viral nucleocapsid structure implies that nucleocapsids are highly plastic and undergo glycoprotein and/or lipid-driven rearrangements during virus self-assembly. This mechanism of self-assembly may be general for other enveloped viruses.« less

Quantum interference of position and momentum: A particle propagation paradox

NASA Astrophysics Data System (ADS)

Hofmann, Holger F.

2017-08-01

Optimal simultaneous control of position and momentum can be achieved by maximizing the probabilities of finding their experimentally observed values within two well-defined intervals. The assumption that particles move along straight lines in free space can then be tested by deriving a lower limit for the probability of finding the particle in a corresponding spatial interval at any intermediate time t . Here, it is shown that this lower limit can be violated by quantum superpositions of states confined within the respective position and momentum intervals. These violations of the particle propagation inequality show that quantum mechanics changes the laws of motion at a fundamental level, providing a different perspective on causality relations and time evolution in quantum mechanics.

Cardiac examination and the effect of dual-processing instruction in a cardiopulmonary simulator.

PubMed

Sibbald, Matt; McKinney, James; Cavalcanti, Rodrigo B; Yu, Eric; Wood, David A; Nair, Parvathy; Eva, Kevin W; Hatala, Rose

2013-08-01

Use of dual-processing has been widely touted as a strategy to reduce diagnostic error in clinical medicine. However, this strategy has not been tested among medical trainees with complex diagnostic problems. We sought to determine whether dual-processing instruction could reduce diagnostic error across a spectrum of experience with trainees undertaking cardiac physical exam. Three experiments were conducted using a similar design to teach cardiac physical exam using a cardiopulmonary simulator. One experiment was conducted in each of three groups: experienced, intermediate and novice trainees. In all three experiments, participants were randomized to receive undirected or dual-processing verbal instruction during teaching, practice and testing phases. When tested, dual-processing instruction did not change the probability assigned to the correct diagnosis in any of the three experiments. Among intermediates, there was an apparent interaction between the diagnosis tested and the effect of dual-processing instruction. Among relative novices, dual processing instruction may have dampened the harmful effect of a bias away from the correct diagnosis. Further work is needed to define the role of dual-processing instruction to reduce cognitive error. This study suggests that it cannot be blindly applied to complex diagnostic problems such as cardiac physical exam.

Interactive visualisation for interpreting diagnostic test accuracy study results.

PubMed

Fanshawe, Thomas R; Power, Michael; Graziadio, Sara; Ordóñez-Mena, José M; Simpson, John; Allen, Joy

2018-02-01

Information about the performance of diagnostic tests is typically presented in the form of measures of test accuracy such as sensitivity and specificity. These measures may be difficult to translate directly into decisions about patient treatment, for which information presented in the form of probabilities of disease after a positive or a negative test result may be more useful. These probabilities depend on the prevalence of the disease, which is likely to vary between populations. This article aims to clarify the relationship between pre-test (prevalence) and post-test probabilities of disease, and presents two free, online interactive tools to illustrate this relationship. These tools allow probabilities of disease to be compared with decision thresholds above and below which different treatment decisions may be indicated. They are intended to help those involved in communicating information about diagnostic test performance and are likely to be of benefit when teaching these concepts. A substantive example is presented using C reactive protein as a diagnostic marker for bacterial infection in the older adult population. The tools may also be useful for manufacturers of clinical tests in planning product development, for authors of test evaluation studies to improve reporting and for users of test evaluations to facilitate interpretation and application of the results. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

PCR colorimetric dot-blot assay and clinical pretest probability for diagnosis of Pulmonary Tuberculosis in Smear-Negative patients

PubMed Central

Scherer, Luciene Cardoso; Sperhacke, Rosa Dea; Jarczewski, Carla; Cafrune, Patrícia I; Minghelli, Simone; Ribeiro, Marta Osório; Mello, Fernanda CQ; Ruffino-Netto, Antonio; Rossetti, Maria LR; Kritski, Afrânio L

2007-01-01

Background Smear-negative pulmonary tuberculosis (SNPTB) accounts for 30% of Pulmonary Tuberculosis (PTB) cases reported annually in developing nations. Polymerase chain reaction (PCR) may provide an alternative for the rapid detection of Mycobacterium tuberculosis (MTB); however little data are available regarding the clinical utility of PCR in SNPTB, in a setting with a high burden of TB/HIV co-infection. Methods To evaluate the performance of the PCR dot-blot in parallel with pretest probability (Clinical Suspicion) in patients suspected of having SNPTB, a prospective study of 213 individuals with clinical and radiological suspicion of SNPTB was carried out from May 2003 to May 2004, in a TB/HIV reference hospital. Respiratory specialists estimated the pretest probability of active disease into high, intermediate, low categories. Expectorated sputum was examined by direct microscopy (Ziehl-Neelsen staining), culture (Lowenstein Jensen) and PCR dot-blot. Gold standard was based on culture positivity combined with the clinical definition of PTB. Results In smear-negative and HIV subjects, active PTB was diagnosed in 28.4% (43/151) and 42.2% (19/45), respectively. In the high, intermediate and low pretest probability categories active PTB was diagnosed in 67.4% (31/46), 24% (6/25), 7.5% (6/80), respectively. PCR had sensitivity of 65% (CI 95%: 50%–78%) and specificity of 83% (CI 95%: 75%–89%). There was no difference in the sensitivity of PCR in relation to HIV status. PCR sensitivity and specificity among non-previously TB treated and those treated in the past were, respectively: 69%, 43%, 85% and 80%. The high pretest probability, when used as a diagnostic test, had sensitivity of 72% (CI 95%:57%–84%) and specificity of 86% (CI 95%:78%–92%). Using the PCR dot-blot in parallel with high pretest probability as a diagnostic test, sensitivity, specificity, positive and negative predictive values were: 90%, 71%, 75%, and 88%, respectively. Among non-previously TB treated and HIV subjects, this approach had sensitivity, specificity, positive and negative predictive values of 91%, 79%, 81%, 90%, and 90%, 65%, 72%, 88%, respectively. Conclusion PCR dot-blot associated with a high clinical suspicion may provide an important contribution to the diagnosis of SNPTB mainly in patients that have not been previously treated attended at a TB/HIV reference hospital. PMID:18096069

Cost-Effectiveness of Screening for Intermediate Age-Related Macular Degeneration during Diabetic Retinopathy Screening.

PubMed

Chan, Christina K W; Gangwani, Rita A; McGhee, Sarah M; Lian, JinXiao; Wong, David S H

2015-11-01

To determine whether screening for age-related macular degeneration (AMD) during a diabetic retinopathy (DR) screening program would be cost effective in Hong Kong. We compared and evaluated the impacts of screening, grading, and vitamin treatment for intermediate AMD compared with no screening using a Markov model. It was based on the natural history of AMD in a cohort with a mean age of 62 years, followed up until 100 years of age or death. Subjects attending a DR screening program were recruited. A cost-effectiveness analysis was undertaken from a public provider perspective. It included grading for AMD using the photographs obtained for DR screening and treatment with vitamin therapy for those with intermediate AMD. The measures of effectiveness were obtained largely from a local study, but the transition probabilities and utility values were from overseas data. Costs were all from local sources. The main assumptions and estimates were tested in sensitivity analyses. The outcome was cost per quality-adjusted life year (QALY) gained. Both costs and benefits were discounted at 3%. All costs are reported in United States dollars ($). The cost per QALY gained through screening for AMD and vitamin treatment for appropriate cases was $12,712 after discounting. This would be considered highly cost effective based on the World Health Organization's threshold of willingness to pay (WTP) for a QALY, that is, less than the annual per capita gross domestic product of $29,889. Because of uncertainty regarding the utility value for those with advanced AMD, we also tested an extreme, conservative value for utility under which screening remained cost effective. One-way sensitivity analyses revealed that, besides utility values, the cost per QALY was most sensitive to the progression rate from intermediate to advanced AMD. The cost-effectiveness acceptability curve showed a WTP for a QALY of $29,000 or more has a more than 86% probability of being cost effective compared with no screening. Our analysis demonstrated that AMD screening carried out simultaneously with DR screening for patients with diabetes would be cost effective in a Hong Kong public healthcare setting. Copyright © 2015 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Fluorescence intensity positivity classification of Hep-2 cells images using fuzzy logic

NASA Astrophysics Data System (ADS)

Sazali, Dayang Farzana Abang; Janier, Josefina Barnachea; May, Zazilah Bt.

2014-10-01

Indirect Immunofluorescence (IIF) is a good standard used for antinuclear autoantibody (ANA) test using Hep-2 cells to determine specific diseases. Different classifier algorithm methods have been proposed in previous works however, there still no valid set as a standard to classify the fluorescence intensity. This paper presents the use of fuzzy logic to classify the fluorescence intensity and to determine the positivity of the Hep-2 cell serum samples. The fuzzy algorithm involves the image pre-processing by filtering the noises and smoothen the image, converting the red, green and blue (RGB) color space of images to luminosity layer, chromaticity layer "a" and "b" (LAB) color space where the mean value of the lightness and chromaticity layer "a" was extracted and classified by using fuzzy logic algorithm based on the standard score ranges of antinuclear autoantibody (ANA) fluorescence intensity. Using 100 data sets of positive and intermediate fluorescence intensity for testing the performance measurements, the fuzzy logic obtained an accuracy of intermediate and positive class as 85% and 87% respectively.

Quantitative Risk Assessment for African Horse Sickness in Live Horses Exported from South Africa

PubMed Central

Sergeant, Evan S.

2016-01-01

African horse sickness (AHS) is a severe, often fatal, arbovirus infection of horses, transmitted by Culicoides spp. midges. AHS occurs in most of sub-Saharan Africa and is a significant impediment to export of live horses from infected countries, such as South Africa. A stochastic risk model was developed to estimate the probability of exporting an undetected AHS-infected horse through a vector protected pre-export quarantine facility, in accordance with OIE recommendations for trade from an infected country. The model also allows for additional risk management measures, including multiple PCR tests prior to and during pre-export quarantine and optionally during post-arrival quarantine, as well as for comparison of risk associated with exports from a demonstrated low-risk area for AHS and an area where AHS is endemic. If 1 million horses were exported from the low-risk area with no post-arrival quarantine we estimate the median number of infected horses to be 5.4 (95% prediction interval 0.5 to 41). This equates to an annual probability of 0.0016 (95% PI: 0.00015 to 0.012) assuming 300 horses exported per year. An additional PCR test while in vector-protected post-arrival quarantine reduced these probabilities by approximately 12-fold. Probabilities for horses exported from an area where AHS is endemic were approximately 15 to 17 times higher than for horses exported from the low-risk area under comparable scenarios. The probability of undetected AHS infection in horses exported from an infected country can be minimised by appropriate risk management measures. The final choice of risk management measures depends on the level of risk acceptable to the importing country. PMID:26986002

Quantitative Risk Assessment for African Horse Sickness in Live Horses Exported from South Africa.

PubMed

Sergeant, Evan S; Grewar, John D; Weyer, Camilla T; Guthrie, Alan J

2016-01-01

African horse sickness (AHS) is a severe, often fatal, arbovirus infection of horses, transmitted by Culicoides spp. midges. AHS occurs in most of sub-Saharan Africa and is a significant impediment to export of live horses from infected countries, such as South Africa. A stochastic risk model was developed to estimate the probability of exporting an undetected AHS-infected horse through a vector protected pre-export quarantine facility, in accordance with OIE recommendations for trade from an infected country. The model also allows for additional risk management measures, including multiple PCR tests prior to and during pre-export quarantine and optionally during post-arrival quarantine, as well as for comparison of risk associated with exports from a demonstrated low-risk area for AHS and an area where AHS is endemic. If 1 million horses were exported from the low-risk area with no post-arrival quarantine we estimate the median number of infected horses to be 5.4 (95% prediction interval 0.5 to 41). This equates to an annual probability of 0.0016 (95% PI: 0.00015 to 0.012) assuming 300 horses exported per year. An additional PCR test while in vector-protected post-arrival quarantine reduced these probabilities by approximately 12-fold. Probabilities for horses exported from an area where AHS is endemic were approximately 15 to 17 times higher than for horses exported from the low-risk area under comparable scenarios. The probability of undetected AHS infection in horses exported from an infected country can be minimised by appropriate risk management measures. The final choice of risk management measures depends on the level of risk acceptable to the importing country.

Pre-processing of data coming from a laser-EMAT system for non-destructive testing of steel slabs.

PubMed

Sgarbi, Mirko; Colla, Valentina; Cateni, Sivia; Higson, Stuart

2012-01-01

Non destructive test systems are increasingly applied in the industrial context for their strong potentialities in improving and standardizing quality control. Especially in the intermediate manufacturing stages, early detection of defects on semi-finished products allow their direction towards later production processes according to their quality, with consequent considerable savings in time, energy, materials and work. However, the raw data coming from non destructive test systems are not always immediately suitable for sophisticated defect detection algorithms, due to noise and disturbances which are unavoidable, especially in harsh operating conditions, such as the ones which are typical of the steelmaking cycle. The paper describes some pre-processing operations which are required in order to exploit the data coming from a non destructive test system. Such a system is based on the joint exploitation of Laser and Electro-Magnetic Acoustic Transducer technologies and is applied to the detection of surface and sub-surface cracks in cold and hot steel slabs. Copyright © 2011 ISA. Published by Elsevier Ltd. All rights reserved.

United States Middle School Students' Perspectives on Learning Statistics

ERIC Educational Resources Information Center

Dwyer, Jerry; Moorhouse, Kim; Colwell, Malinda J.

2009-01-01

This paper describes an intervention at the 8th grade level where university mathematics researchers presented a series of lessons on introductory concepts in probability and statistics. Pre- and post-tests, and interviews were conducted to examine whether or not students at this grade level can understand these concepts. Students showed a…

Influence of an Intermediate Option on the Description-Experience Gap and Information Search

PubMed Central

Sharma, Neha; Debnath, Shoubhik; Dutt, Varun

2018-01-01

Research shows that people tend to overweight small probabilities in description and underweight them in experience, thereby leading to a different pattern of choices between description and experience; a phenomenon known as the Description-Experience (DE) gap. However, little is known on how the addition of an intermediate option and contextual framing influences the DE gap and people’s search strategies. This paper tests the effects of an intermediate option and contextual framing on the DE gap and people’s search strategies, where problems require search for information before a consequential choice. In the first experiment, 120 participants made choice decisions across investment problems that differed in the absence or presence of an intermediate option. Results showed that adding an intermediate option did not reduce the DE gap on the maximizing option across a majority of problems. There were a large majority of choices for the intermediate option. Furthermore, there was an increase in switching between options due to the presence of the intermediate option. In the second experiment, 160 participants made choice decisions in problems like those presented in experiment 1; however, problems lacked the investment framing. Results replicated findings from the first experiment and showed a similar DE gap on the maximizing option in a majority of problems in both the absence and presence of the intermediate option. Again, there were a large majority of choices for the intermediate option. Also, there was an increase in switching between options due to the presence of the intermediate option. Meta-analyses revealed that the absence or presence of the intermediate option created certain differences in the strength of frequency and recency processes. Also, a single natural-mean heuristic model was able to account for the experimental results across both experiments. We discuss implications of our findings to consequential decisions made after information search. PMID:29643821

Influence of an Intermediate Option on the Description-Experience Gap and Information Search.

PubMed

Sharma, Neha; Debnath, Shoubhik; Dutt, Varun

2018-01-01

Research shows that people tend to overweight small probabilities in description and underweight them in experience, thereby leading to a different pattern of choices between description and experience; a phenomenon known as the Description-Experience (DE) gap. However, little is known on how the addition of an intermediate option and contextual framing influences the DE gap and people's search strategies. This paper tests the effects of an intermediate option and contextual framing on the DE gap and people's search strategies, where problems require search for information before a consequential choice. In the first experiment, 120 participants made choice decisions across investment problems that differed in the absence or presence of an intermediate option. Results showed that adding an intermediate option did not reduce the DE gap on the maximizing option across a majority of problems. There were a large majority of choices for the intermediate option. Furthermore, there was an increase in switching between options due to the presence of the intermediate option. In the second experiment, 160 participants made choice decisions in problems like those presented in experiment 1; however, problems lacked the investment framing. Results replicated findings from the first experiment and showed a similar DE gap on the maximizing option in a majority of problems in both the absence and presence of the intermediate option. Again, there were a large majority of choices for the intermediate option. Also, there was an increase in switching between options due to the presence of the intermediate option. Meta-analyses revealed that the absence or presence of the intermediate option created certain differences in the strength of frequency and recency processes. Also, a single natural-mean heuristic model was able to account for the experimental results across both experiments. We discuss implications of our findings to consequential decisions made after information search.

Pre-operative endoscopic ultrasonography can optimise the management of patients undergoing laparoscopic cholecystectomy with abnormal liver function tests as the sole risk factor for choledocholithiasis: a prospective study.

PubMed

Meroni, E; Bisagni, P; Bona, S; Fumagalli, U; Zago, M; Rosati, R; Malesci, A

2004-01-01

Pre-operative endosonography has been proposed as a cost-effective procedure in the management of patients who undergo laparoscopic cholecystectomy having an intermediate risk of common bile duct stones. We prospectively evaluated the impact of pre-operative endosonography on the management of patients facing laparoscopic cholecystectomy with abnormal liver function tests as the sole risk factor for choledocolithiasis. Among 587 consecutive patients scheduled for laparoscopic cholecystectomy, 47 (8%) patients having one or more abnormal liver function tests but a normal appearance of common bile duct at abdominal ultrasound, underwent pre-operative endosonography. In patients with endosonography-detected common bile duct stones, a pre-operative endoscopic retrograde cholangiography was performed, or an intra-operative endoscopic retrograde cholangiography was scheduled. In all endosonography-negative patients, an intra-operative trans-cystic cholangiography was performed. Endosonography detected common bile duct stones in nine patients (19%) but only in five of them stones were radiologically confirmed (PPV 0.55). Endosonography-detected stones were confirmed in four of four (100%) patients in whom cholangiography was performed within 1 week, but only in one of five (20%) patients in whom radiology was further delayed (P < 0.05). In three of four cases (75%), stones detected at endosonography but not confirmed at X-rays, were smaller than 2.0 mm. Among 38 patients with negative endosonography, common bile duct stones were found in two patients (NPV 0.95), whereas unplanned endoscopic stone extraction was needed only in one patient (NPV 0.97). Pre-operative endosonography can spare unnecessary pre-operative endoscopic retrograde cholangiography as well as inappropriate scheduling of intra-operative endoscopic retrograde cholangiography in patients undergoing laparoscopic cholecystectomy with abnormal liver function tests. To maximise the impact of endosonography on the management of these patients, the procedure should be performed immediately before laparoscopic cholecystectomy.

Why We Should Not Be Indifferent to Specification Choices for Difference-in-Differences.

PubMed

Ryan, Andrew M; Burgess, James F; Dimick, Justin B

2015-08-01

To evaluate the effects of specification choices on the accuracy of estimates in difference-in-differences (DID) models. Process-of-care quality data from Hospital Compare between 2003 and 2009. We performed a Monte Carlo simulation experiment to estimate the effect of an imaginary policy on quality. The experiment was performed for three different scenarios in which the probability of treatment was (1) unrelated to pre-intervention performance; (2) positively correlated with pre-intervention levels of performance; and (3) positively correlated with pre-intervention trends in performance. We estimated alternative DID models that varied with respect to the choice of data intervals, the comparison group, and the method of obtaining inference. We assessed estimator bias as the mean absolute deviation between estimated program effects and their true value. We evaluated the accuracy of inferences through statistical power and rates of false rejection of the null hypothesis. Performance of alternative specifications varied dramatically when the probability of treatment was correlated with pre-intervention levels or trends. In these cases, propensity score matching resulted in much more accurate point estimates. The use of permutation tests resulted in lower false rejection rates for the highly biased estimators, but the use of clustered standard errors resulted in slightly lower false rejection rates for the matching estimators. When treatment and comparison groups differed on pre-intervention levels or trends, our results supported specifications for DID models that include matching for more accurate point estimates and models using clustered standard errors or permutation tests for better inference. Based on our findings, we propose a checklist for DID analysis. © Health Research and Educational Trust.

Effect of Seed Position on Parental Plant on Proportion of Seeds Produced with Nondeep and Intermediate Physiological Dormancy

PubMed Central

Lu, Juan J.; Tan, Dun Y.; Baskin, Carol C.; Baskin, Jerry M.

2017-01-01

The position in which seeds develop on the parental plant can have an effect on dormancy-break and germination. We tested the hypothesis that the proportion of seeds with intermediate physiological dormancy (PD) produced in the proximal position on a raceme of Isatis violascens plants is higher than that produced in the distal position, and further that this difference is related to temperature during seed development. Plants were watered at 3-day intervals, and silicles and seeds from the proximal (early) and distal (late) positions of racemes on the same plants were collected separately and tested for germination. After 0 and 6 months dry storage at room temperature (afterripening), silicles and seeds were cold stratified for 0–16 weeks and tested for germination. Mean daily maximum and minimum temperatures during development/maturation of the two groups of seeds did not differ. A higher proportion of seeds with the intermediate level than with the nondeep level of PD was produced by silicles in the proximal position than by those in the distal position, while the proportion of seeds with nondeep PD was higher in the distal than in the proximal position of the raceme. The differences were not due only to seed mass. Since temperature and soil moisture conditions were the same during development of the seeds in the raceme, differences in proportion of seeds with intermediate and nondeep PD are attributed to position on parental plant. The ecological consequence of this phenomenon is that it ensures diversity in dormancy-breaking and germination characteristics within a seed cohort, a probable bet-hedging strategy. This is the first demonstration of position effects on level of PD in the offspring. PMID:28232842

Analysis of membrane fusion as a two-state sequential process: evaluation of the stalk model.

PubMed

Weinreb, Gabriel; Lentz, Barry R

2007-06-01

We propose a model that accounts for the time courses of PEG-induced fusion of membrane vesicles of varying lipid compositions and sizes. The model assumes that fusion proceeds from an initial, aggregated vesicle state ((A) membrane contact) through two sequential intermediate states (I(1) and I(2)) and then on to a fusion pore state (FP). Using this model, we interpreted data on the fusion of seven different vesicle systems. We found that the initial aggregated state involved no lipid or content mixing but did produce leakage. The final state (FP) was not leaky. Lipid mixing normally dominated the first intermediate state (I(1)), but content mixing signal was also observed in this state for most systems. The second intermediate state (I(2)) exhibited both lipid and content mixing signals and leakage, and was sometimes the only leaky state. In some systems, the first and second intermediates were indistinguishable and converted directly to the FP state. Having also tested a parallel, two-intermediate model subject to different assumptions about the nature of the intermediates, we conclude that a sequential, two-intermediate model is the simplest model sufficient to describe PEG-mediated fusion in all vesicle systems studied. We conclude as well that a fusion intermediate "state" should not be thought of as a fixed structure (e.g., "stalk" or "transmembrane contact") of uniform properties. Rather, a fusion "state" describes an ensemble of similar structures that can have different mechanical properties. Thus, a "state" can have varying probabilities of having a given functional property such as content mixing, lipid mixing, or leakage. Our data show that the content mixing signal may occur through two processes, one correlated and one not correlated with leakage. Finally, we consider the implications of our results in terms of the "modified stalk" hypothesis for the mechanism of lipid pore formation. We conclude that our results not only support this hypothesis but also provide a means of analyzing fusion time courses so as to test it and gauge the mechanism of action of fusion proteins in the context of the lipidic hypothesis of fusion.

Influence on anaerobic digestion by intermediate thermal hydrolysis of waste activated sludge and co-digested wheat straw.

PubMed

Bjerg-Nielsen, Michael; Ward, Alastair James; Møller, Henrik Bjarne; Ottosen, Lars Ditlev Mørck

2018-02-01

This paper analyses time (30 and 60 min) and temperature (120-190 °C) effects of intermediate thermal hydrolysis (ITHP) in a two-step anaerobic digestion of waste activated sludge (WAS) with and without wheat straw as a co-substrate. Effects were analyzed by measuring biochemical methane potential for 60 days and assessing associated kinetic and chemical data. Compared to non-treatment, ITHP increased the secondary step methane yield from 52 to 222 L CH 4  kg VS -1 and from 147 to 224 L CH 4  kg VS -1 for pre-digested WAS and pre-co-digested WAS respectively at an optimum of 170 °C and 30 min. The hydrolysis coefficients (k hyd ) increased by up to 127% following treatment. Increasing ITHP time from 30 to 60 min showed ambiguous results regarding methane yields, whilst temperature had a clear and proportional effect on the concentrations of acetic acid. The energy balances were found to be poor and dewatering to increase total solids above the values tested here is necessary for this process to be energetically feasible. Copyright © 2017 Elsevier Ltd. All rights reserved.

A pilot plant study using conventional and advanced water treatment processes: Evaluating removal efficiency of indicator compounds representative of pharmaceuticals and personal care products.

PubMed

Zhang, Shuangyi; Gitungo, Stephen; Axe, Lisa; Dyksen, John E; Raczko, Robert F

2016-11-15

With widespread occurrence of pharmaceuticals and personal care products (PPCPs) in the water cycle, their presence in source water has led to the need to better understand their treatability and removal efficiency in treatment processes. Fifteen indicator compounds were identified to represent the large number of PPCPs reported worldwide. Criteria applied to determine the indicator compounds included PPCPs widely used, observed at great frequency in aqueous systems, resistant to treatment, persistent in the environment, and representative of classes of organics. Through a pilot plant investigation to understand the optimal combination of unit process for treating PPCPs, 12 treatment trains with their additive and synergistic contributions were investigated; processes included dissolved air flotation (DAF), pre- and intermediate-ozonation with and without H 2 O 2 , intermediate chlorination, dual media filtration, granular activated carbon (GAC), and UV/H 2 O 2 . Treatment trains that achieved the greatest removals involved 1. DAF followed by intermediate ozonation, dual media filtration, and virgin GAC; 2. pre-ozonation followed by DAF, dual media filtration, and virgin GAC; and, 3. DAF (with either pre- or intermediate oxidation) followed by dual media filtration and UV/H 2 O 2 . Results revealed significant removal efficiencies for virgin GAC (preceded by DAF and intermediate ozonation) and UV/H 2 O 2 with an intensity of 700 mJ/cm 2 , where more than 12 of the compounds were removed by greater than 90%. Reduced PPCP removals were observed with virgin GAC preceded by pre-ozonation and DAF. Intermediate ozonation was more effective than using pre-ozonation, demonstrating the importance of this process targeting PPCPs after treatment of natural organic matter. Removal efficiencies of indicator compounds through ozonation were found to be a function of the O 3 rate constants (k O3 ). For compounds with low O 3 rate constants (k O3  < 10 M -1 s -1 ), H 2 O 2 addition in the O 3 reactor was required. Of the 15 indicator compounds, tri(2-chloroethyl) phosphate (TCEP) and cotinine were observed to be the most recalcitrant. Although UV/H 2 O 2 with elevated intensity (700 mJ/cm 2 ) was effective for PPCP removals, energy requirements far exceed intensities applied for disinfection. Copyright © 2016 Elsevier Ltd. All rights reserved.

Investigation of negative moment reinforcing in bridge decks.

DOT National Transportation Integrated Search

2015-09-01

Multi-span pre-tensioned pre-stressed concrete beam (PPCB) bridges made continuous usually experience a negative live load : moment region over the intermediate supports. Conventional thinking dictates that sufficient reinforcement must be provided i...

Evaluation of an Educational Program to Improve School Nursing Staff Perceptions of Bullying In Pinellas County, Florida.

PubMed

Salmeron, Patricia A; Christian, Becky J

2016-01-01

The purpose of this project was to determine if a bullying educational program for school nurses and certified nursing assistants/health technicians (CNAs/HTs) would increase knowledge of bullying, probability of reporting a bully, and probability of assisting a bullied victim. This educational program and evaluation employed a retrospective, post-then-pre-test design. Instruments used included a 17-item demographic questionnaire and the 12-item Reduced Aggression/ Victimization Scale Bullying Assessment Tool (BAT), a 5-point Likert Scale de - signed to assess school nurses’ and CNAs’/HTs’ understanding of bullying, the probability of reporting bullies, and the probability of assisting bullied victims before and after the educational presentation. Findings of this educational evaluation program indicated that the majority of school nurses and CNAs/HTs had an increased understanding of bullying, higher probability of reporting a bully, and assisting a bullied victim after the presentation.

CPAS Preflight Drop Test Analysis Process

NASA Technical Reports Server (NTRS)

Englert, Megan E.; Bledsoe, Kristin J.; Romero, Leah M.

2015-01-01

Throughout the Capsule Parachute Assembly System (CPAS) drop test program, the CPAS Analysis Team has developed a simulation and analysis process to support drop test planning and execution. This process includes multiple phases focused on developing test simulations and communicating results to all groups involved in the drop test. CPAS Engineering Development Unit (EDU) series drop test planning begins with the development of a basic operational concept for each test. Trajectory simulation tools include the Flight Analysis and Simulation Tool (FAST) for single bodies, and the Automatic Dynamic Analysis of Mechanical Systems (ADAMS) simulation for the mated vehicle. Results are communicated to the team at the Test Configuration Review (TCR) and Test Readiness Review (TRR), as well as at Analysis Integrated Product Team (IPT) meetings in earlier and intermediate phases of the pre-test planning. The ability to plan and communicate efficiently with rapidly changing objectives and tight schedule constraints is a necessity for safe and successful drop tests.

Consolidating Pre-Service Physics Teachers' Subject Matter Knowledge Using Didactical Reconstructions

ERIC Educational Resources Information Center

Mäntylä, T.; Nousiainen, M.

2014-01-01

In the Department of Physics, University of Helsinki, there are advanced physics courses designed for the needs of pre-service physics teachers. The starting point is that after introductory and intermediate physics courses, pre-service physics teachers know laws and definitions but the knowledge is quite fragmented and does not form coherent…

Bottom-Water Conditions in a Marine Basin after the Cretaceous–Paleogene Impact Event: Timing the Recovery of Oxygen Levels and Productivity

PubMed Central

Sosa-Montes De Oca, Claudia; Martínez-Ruiz, Francisca; Rodríguez-Tovar, Francisco Javier

2013-01-01

An ultra-high-resolution analysis of major and trace element contents from the Cretaceous–Paleogene boundary interval in the Caravaca section, southeast Spain, reveals a quick recovery of depositional conditions after the impact event. Enrichment/depletion profiles of redox sensitive elements indicate significant geochemical anomalies just within the boundary ejecta layer, supporting an instantaneous recovery –some 102 years– of pre-impact conditions in terms of oxygenation. Geochemical redox proxies point to oxygen levels comparable to those at the end of the Cretaceous shortly after impact, which is further evidenced by the contemporary macrobenthic colonization of opportunistic tracemakers. Recovery of the oxygen conditions was therefore several orders shorter than traditional proposals (104–105 years), suggesting a probable rapid recovery of deep-sea ecosystems at bottom and in intermediate waters. PMID:24349232

The Clinical Practice of Assessing Cognitive Function in Adults Receiving Electroconvulsive Therapy: Whom Are We Missing?

PubMed

Obbels, Jasmien; Vanbrabant, Koen; Bouckaert, Filip; Verwijk, Esmée; Sienaert, Pascal

2016-06-01

Cognition can be affected by electroconvulsive therapy (ECT). Good clinical practice includes neuropsychological assessment, although this is seldom a part of routine clinical practice. It looks like a substantial part of patients fail to complete cognitive assessments. This constitutes a problem in the generalizability of published clinical research on cognitive side effects. Most studies of ECT-related cognitive adverse effects do not discuss this important issue of so-called cognitive test nonparticipants. Recent findings suggest that cognitive test nonparticipants are more severely ill, and probably more vulnerable to cognitive side effects. To examine the feasibility of a neuropsychological test battery in daily clinical practice, in an adult population referred for ECT. We reviewed the clinical records of 84 patients referred for ECT. Demographic and clinical characteristics of those patients who were able to complete our routine cognitive testing at baseline are compared with those who could not complete the assessment. From 84 ECT patients, 60 (71%) completed a pre-ECT cognitive assessment, whereas 24 (29%) did not. Patients with a unipolar depression, with psychotic symptoms, who started their treatment with a bitemporal electrode placement were more likely to be test noncompleters than test completers. Patients with a unipolar depression, with psychotic features, who are treated with a bitemporal electrode placement, have a higher likelihood of not completing a pre-ECT cognitive assessment. These patients probably represent a subgroup more vulnerable to cognitive side effects.

Pre-Service Mathematics Teachers' Use of Probability Models in Making Informal Inferences about a Chance Game

ERIC Educational Resources Information Center

Kazak, Sibel; Pratt, Dave

2017-01-01

This study considers probability models as tools for both making informal statistical inferences and building stronger conceptual connections between data and chance topics in teaching statistics. In this paper, we aim to explore pre-service mathematics teachers' use of probability models for a chance game, where the sum of two dice matters in…

A scoring algorithm for predicting the presence of adult asthma: a prospective derivation study.

PubMed

Tomita, Katsuyuki; Sano, Hiroyuki; Chiba, Yasutaka; Sato, Ryuji; Sano, Akiko; Nishiyama, Osamu; Iwanaga, Takashi; Higashimoto, Yuji; Haraguchi, Ryuta; Tohda, Yuji

2013-03-01

To predict the presence of asthma in adult patients with respiratory symptoms, we developed a scoring algorithm using clinical parameters. We prospectively analysed 566 adult outpatients who visited Kinki University Hospital for the first time with complaints of nonspecific respiratory symptoms. Asthma was comprehensively diagnosed by specialists using symptoms, signs, and objective tools including bronchodilator reversibility and/or the assessment of bronchial hyperresponsiveness (BHR). Multiple logistic regression analysis was performed to categorise patients and determine the accuracy of diagnosing asthma. A scoring algorithm using the symptom-sign score was developed, based on diurnal variation of symptoms (1 point), recurrent episodes (2 points), medical history of allergic diseases (1 point), and wheeze sound (2 points). A score of >3 had 35% sensitivity and 97% specificity for discriminating between patients with and without asthma and assigned a high probability of having asthma (accuracy 90%). A score of 1 or 2 points assigned intermediate probability (accuracy 68%). After providing additional data of forced expiratory volume in 1 second/forced vital capacity (FEV(1)/FVC) ratio <0.7, the post-test probability of having asthma was increased to 93%. A score of 0 points assigned low probability (accuracy 31%). After providing additional data of positive reversibility, the post-test probability of having asthma was increased to 88%. This pragmatic diagnostic algorithm is useful for predicting the presence of adult asthma and for determining the appropriate time for consultation with a pulmonologist.

Improving stress testing compliance following chest pain presentations to the emergency department.

PubMed

Chung, Kevin; Playford, David; Macdonald, Stephen P J

2012-10-01

To determine whether a booked appointment time improves early outpatient exercise stress testing (EST) guideline adherence in patients discharged from the ED following assessment for possible acute coronary syndrome (ACS). In this pre and post study with a historical control group, patients classified as intermediate risk after negative ECG and serial troponin work-up for possible ACS were referred for EST. The intervention group were given an appointment time for EST at discharge, and the control group were given a referral but asked to book their own appointment. The primary outcome measure was the proportion in each group who attended for EST. Secondary outcomes were time to EST and rates of death, myocardial infarction and coronary revascularisation within 30 days in both groups. In addition, we explored reasons for non-attendance for EST for the intervention group. There were 96 participants in the intervention group (mean age 55 ± 3 years) and 121 controls (mean age 62 ± 3 years). Seventy-two (75%) of the intervention group attended for EST compared with 38 (31%) of the control group, P < 0.001 after adjustment for differences in baseline variables. A poor understanding of the rationale for EST was a significant factor in patient non-attendance. Pre-booked appointment times for EST improve timely attendance among patients discharged from the ED with intermediate-risk ACS. Compliance might improve further with patient education. © 2012 The Authors. EMA © 2012 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Learning to Listen: Does Intervention Make a Difference?

ERIC Educational Resources Information Center

Lotfi, Ghazal; Maftoon, Parviz; Birjandi, Parviz

2016-01-01

This study explored the impact of listening strategy training conducted within two strategy interventions on pre-intermediate and intermediate EFL learners' comprehension of unidirectional listening. Participants were divided into two experimental groups (n = 156) and a comparison group (n = 50). Each experimental group was trained in eight…

Investigation of negative moment reinforcing in bridge decks : [tech transfer summary].

DOT National Transportation Integrated Search

2015-09-01

Multi-span pre-tensioned pre-stressed concrete beam (PPCB) bridges made : continuous, for live loads, usually may experience a negative total moment : over the intermediate supports, which this research investigated as part of an : investigation into...

An exact computational method for performance analysis of sequential test algorithms for detecting network intrusions

NASA Astrophysics Data System (ADS)

Chen, Xinjia; Lacy, Fred; Carriere, Patrick

2015-05-01

Sequential test algorithms are playing increasingly important roles for quick detecting network intrusions such as portscanners. In view of the fact that such algorithms are usually analyzed based on intuitive approximation or asymptotic analysis, we develop an exact computational method for the performance analysis of such algorithms. Our method can be used to calculate the probability of false alarm and average detection time up to arbitrarily pre-specified accuracy.

Phaeochromocytoma: diagnostic challenges for biochemical screening and diagnosis.

PubMed

Barron, Jeffrey

2010-08-01

The aim of this article is to provide knowledge of the origin of catecholamines and metabolites so that there can be an informed approach to the methods for biochemical screening for a possible phaeochromocytoma; The article includes a review of catecholamine and metadrenaline metabolism, with methods used in biochemical screening. In the adrenal medulla and a phaeochromocytoma, catecholamines continuously leak from chromaffin granules into the cytoplasm and are converted to metadrenalines. For a phaeochromocytoma to become biochemically detectable, metnoradrenaline secretion needs to rise fourfold, whereas noradrenaline secretion needs to rise 15-fold. The prevalence of a sporadic phaeochromocytoma is low; therefore false-positive results exceed true-positive results. Assay sensitivity is high because it is important not to miss a possible phaeochromocytoma. The use of urine or plasma fractionated metadrenalines as the first-line test has been recommended due to improved sensitivity. A negative result excludes a phaeochromocytoma. Only after a sporadic phaeochromocytoma has been diagnosed biochemically is it cost effective to request imaging. Sensitivities and specificities of the assays differ according to pre-test probabilities of the presence of a phaeochromocytoma, with hereditary and incidentalomas having a higher pre-test probability than sporadic phaeochromocytoma. In conclusion, in screening for a possible phaeochromocytoma, biochemical investigations should be completed first to exclude or establish the diagnosis. The preferred biochemical screening test is fractionated metadrenalines, including methoxytyramine so as not to miss dopamine-secreting tumours.

Consistency of extreme flood estimation approaches

NASA Astrophysics Data System (ADS)

Felder, Guido; Paquet, Emmanuel; Penot, David; Zischg, Andreas; Weingartner, Rolf

2017-04-01

Estimations of low-probability flood events are frequently used for the planning of infrastructure as well as for determining the dimensions of flood protection measures. There are several well-established methodical procedures to estimate low-probability floods. However, a global assessment of the consistency of these methods is difficult to achieve, the "true value" of an extreme flood being not observable. Anyway, a detailed comparison performed on a given case study brings useful information about the statistical and hydrological processes involved in different methods. In this study, the following three different approaches for estimating low-probability floods are compared: a purely statistical approach (ordinary extreme value statistics), a statistical approach based on stochastic rainfall-runoff simulation (SCHADEX method), and a deterministic approach (physically based PMF estimation). These methods are tested for two different Swiss catchments. The results and some intermediate variables are used for assessing potential strengths and weaknesses of each method, as well as for evaluating the consistency of these methods.

The effect of pre-straining and pre-ageing on a novel thermomechanical treatment for improving the mechanical properties of AA2139 aerospace aluminium alloys

NASA Astrophysics Data System (ADS)

Bakare, F.; Alsubhi, Y.; Ragkousis, A.; Ebomwonyi, O.; Damisa, J.; Okunzuwa, S.

2017-07-01

The novel thermomechanical treatment employed by Wang Z et al (2014 Mater. Sci. Eng. A 607 313-7) in enhancing the mechanical and microstructure properties of 6000 series aluminium alloys has been replicated for AA2139 aerospace aluminium alloys. The novel route which involves under-ageing, cold-rolling reductions and re-ageing at a fixed temperature has been carried out focusing on the effect of pre-straining and pre-ageing on the alloy properties. The influence of varying cold-rolling reductions and pre-ageing has been examined by tensile testing, hardness testing, differential scanning calorimetry, thermoelectric power measurements and scanning electron microscope (SEM). Further analyses were conducted with DSC and TEP measurements to check for precipitation sequence and solute retention respectively. On comparing the hardness and strength of the non pre-aged to the pre-aged samples, there is a remarkable increase in the hardness and strength of the aerospace alloy showing the huge influence of both pre-ageing and pre-straining stage of the novel thermomechanical treatment as observed in the 6000 series alloy, albeit at a higher rate. The treatments that exhibited the most promising mechanical properties (hardness, yield and ultimate tensile strength, elongation to failure) were found to be at a pre-ageing temperature of 175 °C for 1.5 h, 40% cold-rolling and re-ageing at 150 °C. The material was found to have yield strength of 590 MPa and 8.1% uniform elongation, which is well above the 5% acceptable value for structural applications and with strength levels adaptable for aerospace industries. The presence of higher volume fraction of well dispersed precipitates observed in the SEM further shows that intermediate cold-rolling reductions combines well with pre-ageing to give the best mechanical properties in this alloy.

Simultaneous determination of diastereoisomeric and enantiomeric impurities in SSS-octahydroindole-2-carboxylic acid by chiral high-performance liquid chromatography with pre-column derivatization.

PubMed

Wang, Jin Zhao; Zeng, Su; Hu, Gong Yun; Wang, Dan Hua

2009-04-10

SSS-Octahydroindole-2-carboxylic acid (SSS-Oic) is a key intermediate used in the synthesis of some angiotensin-converting enzyme (ACE) inhibitors. The separation of diastereoisomers and enantiomers of Oic was performed using a pre-column derivatization chiral HPLC method. Phenyl isothiocyanate (PITC) was used as the derivatization reagent. Three PITC derivatives of Oic stereoisomers were separated on an Ultron ES-OVM chiral column (150 mm x 4.6 mm, 5 microm). Derivatization conditions such as reaction temperature, reaction time and derivatization reagent concentration were investigated. The chromatographic conditions for separation of the three PITC-Oic derivatives were optimized. The method was successfully applied in the diastereoisomeric and enantiomeric purity test of SSS-Oic.

The cytoplasmic mRNA degradation factor Pat1 is required for rRNA processing

PubMed Central

Muppavarapu, Mridula; Huch, Susanne; Nissan, Tracy

2016-01-01

ABSTRACT Pat1 is a key cytoplasmic mRNA degradation factor, the loss of which severely increases mRNA half-lives. Several recent studies have shown that Pat1 can enter the nucleus and can shuttle between the nucleus and the cytoplasm. As a result, many nuclear roles have been proposed for Pat1. In this study, we analyzed four previously suggested nuclear roles of Pat1 and show that Pat1 is not required for efficient pre-mRNA splicing or pre-mRNA decay in yeast. However, lack of Pat1 results in accumulation of pre-rRNA processing intermediates. Intriguingly, we identified a novel genetic relationship between Pat1 and the rRNA decay machinery, specifically the exosome and the TRAMP complex. While the pre-rRNA processing intermediates that accumulate in the pat1 deletion mutant are, at least to some extent, recognized as aberrant by the rRNA degradation machinery, it is unlikely that these accumulations are the cause of their synthetic sick relationship. Here, we show that the dysregulation of the levels of mRNAs related to ribosome biogenesis could be the cause of the accumulation of the pre-rRNA processing intermediates. Although our results support a role for Pat1 in transcription, they nevertheless suggest that the primary cause of the dysregulated mRNA levels is most likely due to Pat1's role in mRNA decapping and mRNA degradation. PMID:26918764

The cytoplasmic mRNA degradation factor Pat1 is required for rRNA processing.

PubMed

Muppavarapu, Mridula; Huch, Susanne; Nissan, Tracy

2016-01-01

Pat1 is a key cytoplasmic mRNA degradation factor, the loss of which severely increases mRNA half-lives. Several recent studies have shown that Pat1 can enter the nucleus and can shuttle between the nucleus and the cytoplasm. As a result, many nuclear roles have been proposed for Pat1. In this study, we analyzed four previously suggested nuclear roles of Pat1 and show that Pat1 is not required for efficient pre-mRNA splicing or pre-mRNA decay in yeast. However, lack of Pat1 results in accumulation of pre-rRNA processing intermediates. Intriguingly, we identified a novel genetic relationship between Pat1 and the rRNA decay machinery, specifically the exosome and the TRAMP complex. While the pre-rRNA processing intermediates that accumulate in the pat1 deletion mutant are, at least to some extent, recognized as aberrant by the rRNA degradation machinery, it is unlikely that these accumulations are the cause of their synthetic sick relationship. Here, we show that the dysregulation of the levels of mRNAs related to ribosome biogenesis could be the cause of the accumulation of the pre-rRNA processing intermediates. Although our results support a role for Pat1 in transcription, they nevertheless suggest that the primary cause of the dysregulated mRNA levels is most likely due to Pat1's role in mRNA decapping and mRNA degradation.

Foot-ankle complex injury risk curves using calcaneus bone mineral density data.

PubMed

Yoganandan, Narayan; Chirvi, Sajal; Voo, Liming; DeVogel, Nicholas; Pintar, Frank A; Banerjee, Anjishnu

2017-08-01

Biomechanical data from post mortem human subject (PMHS) experiments are used to derive human injury probability curves and develop injury criteria. This process has been used in previous and current automotive crashworthiness studies, Federal safety standards, and dummy design and development. Human bone strength decreases as the individuals reach their elderly age. Injury risk curves using the primary predictor variable (e.g., force) should therefore account for such strength reduction when the test data are collected from PMHS specimens of different ages (age at the time of death). This demographic variable is meant to be a surrogate for fracture, often representing bone strength as other parameters have not been routinely gathered in previous experiments. However, bone mineral densities (BMD) can be gathered from tested specimens (presented in this manuscript). The objective of this study is to investigate different approaches of accounting for BMD in the development of human injury risk curves. Using simulated underbody blast (UBB) loading experiments conducted with the PMHS lower leg-foot-ankle complexes, a comparison is made between the two methods: treating BMD as a covariate and pre-scaling test data based on BMD. Twelve PMHS lower leg-foot-ankle specimens were subjected to UBB loads. Calcaneus BMD was obtained from quantitative computed tomography (QCT) images. Fracture forces were recorded using a load cell. They were treated as uncensored data in the survival analysis model which used the Weibull distribution in both methods. The width of the normalized confidence interval (NCIS) was obtained using the mean and ± 95% confidence limit curves. The mean peak forces of 3.9kN and 8.6kN were associated with the 5% and 50% probability of injury for the covariate method of deriving the risk curve for the reference age of 45 years. The mean forces of 5.4 kN and 9.2kN were associated with the 5% and 50% probability of injury for the pre-scaled method. The NCIS magnitudes were greater in the covariate-based risk curves (0.52-1.00) than in the risk curves based on the pre-scaled method (0.24-0.66). The pre-scaling method resulted in a generally greater injury force and a tighter injury risk curve confidence interval. Although not directly applicable to the foot-ankle fractures, when compared with the use of spine BMD from QCT scans to pre-scale the force, the calcaneus BMD scaled data produced greater force at the same risk level in general. Pre-scaling the force data using BMD is an alternate, and likely a more accurate, method instead of using covariate to account for the age-related bone strength change in deriving risk curves from biomechanical experiments using PMHS. Because of the proximity of the calcaneus bone to the impacting load, it is suggested to use and determine the BMD of the foot-ankle bone in future UBB and other loading conditions to derive human injury probability curves for the foot-ankle complex. Copyright © 2017. Published by Elsevier Ltd.

Coronary artery calcium score and CT angiography in asymptomatic elderly patients with high pretest probability for coronary artery disease.

PubMed

Imanzadeh, Amir; George, Elizabeth; Kondo, Takeshi; Takase, Shinichi; Amanuma, Makoto; Rybicki, Frank J; Kumamaru, Kanako K

2016-02-01

To evaluate the role of coronary artery calcium scoring (CACS) and/or coronary CT angiography (CCTA) in asymptomatic elderly patients with high pretest probability for coronary artery disease (CAD). Forty-eight consecutive asymptomatic elderly (>65 years) subjects who had a high pretest probability and underwent CACS/CCTA were included. Each CCTA was evaluated for adequacy for assessment of coronary stenosis. Significant stenosis (>50% diameter narrowing) was assessed on evaluable CT images and by invasive catheter angiography (ICA). All subjects were men with mean CACS of 880 ± 1779. Among those with low (0-99), intermediate (100-399), and high (400-999) CACS, ICA-verified significant stenosis was present in 8% (1/13), 23% (2/13), and 67% (8/12), respectively. Among those with very high CACS (≥ 1000) (n = 10), 90% of CCTAs were not evaluable for stenosis. In asymptomatic elderly subjects with high pretest probability, CACS followed by CCTA may be considered for those with intermediate to high CACS.

Wavelength assignment algorithm considering the state of neighborhood links for OBS networks

NASA Astrophysics Data System (ADS)

Tanaka, Yu; Hirota, Yusuke; Tode, Hideki; Murakami, Koso

2005-10-01

Recently, Optical WDM technology is introduced into backbone networks. On the other hand, as the future optical switching scheme, Optical Burst Switching (OBS) systems become a realistic solution. OBS systems do not consider buffering in intermediate nodes. Thus, it is an important issue to avoid overlapping wavelength reservation between partially interfered paths. To solve this problem, so far, the wavelength assignment scheme which has priority management tables has been proposed. This method achieves the reduction of burst blocking probability. However, this priority management table requires huge memory space. In this paper, we propose a wavelength assignment algorithm that reduces both the number of priority management tables and burst blocking probability. To reduce priority management tables, we allocate and manage them for each link. To reduce burst blocking probability, our method announces information about the change of their priorities to intermediate nodes. We evaluate its performance in terms of the burst blocking probability and the reduction rate of priority management tables.

Influence of pre-storage incubation on hatchability traits, thyroid hormones, antioxidative status and immunity of newly hatched chicks at two chicken breeder flock ages.

PubMed

Ebeid, T A; Twfeek, F A; Assar, M H; Bealish, A M; Abd El-Karim, R E; Ragab, M

2017-11-01

Egg storage longer than 7 days is associated with negative effects on hatchability traits. Pre-storage incubation has been a suggested method to reduce the negative effects of long-term storage times by enhancing the developmental stage of the embryo and probably reducing the embryonic stress. The objective of the present study was to investigate the effects of pre-storage incubation and storage time on hatchability characteristics, chick quality and serum thyroid hormones, antioxidative properties and immunoglobulin Y (IgY) concentrations of newly hatched chicks at two breeder flock ages. A total of 8000 fertile eggs were obtained from two different ages of chicken breeder hens (Egyptian local cross, Inshas). Half of the eggs were collected from young breeder hens (28 weeks old) and the other half from old breeder hens (50 weeks old). In each breeder flock age, eggs were distributed in a completely randomized experimental design in a 2×4 factorial arrangement, with two storage periods (4 or 14 days) and four pre-storage incubation durations (0, 4, 6 or 8 h at 37.5°C). At 28 and 50 weeks of age, pre-storage incubation and its interaction with storage period influenced significantly the apparent fertility, hatchability of set eggs and hatchability of fertile eggs and this improvement in hatchability is attributed to the reduction in embryonic mortality (early, intermediate and late). Pre-storage incubation for 6 or 8 h elevated significantly the grade A chicks and reduced the grade B chicks in comparison with non-heated controls. Interestingly, for eggs stored for 14 days, pre-storage incubation for 6 or 8 h enhanced serum triiodothyronine, thyroxine, glutathione peroxidase activity, total antioxidant capacity and IgY concentrations significantly and decreased serum malondialdehyde concentration significantly in the newly hatched chicks. It could be concluded that pre-storage incubation enhanced the hatching results, improved the antioxidative properties, reduced lipid peroxidation and elevated the humoral immunity in the newly hatched chicks. Hence, several benefits might be gained by pre-storage incubation when fertilized eggs will be stored for long periods.

Radiation-Hardened Circuitry Using Mask-Programmable Analog Arrays. Report 3

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

Britton, Jr, Charles L.; Shelton, Jacob H.; Ericson, Milton Nance

As the recent accident at Fukushima Daiichi so vividly demonstrated, telerobotic technologies capable of withstanding high radiation environments need to be readily available to enable operations, repair, and recovery under severe accident scenarios when human entry is extremely dangerous or not possible. Telerobotic technologies that enable remote operation in high dose rate environments have undergone revolutionary improvement over the past few decades. However, much of this technology cannot be employed in nuclear power environments because of the radiation sensitivity of the electronics and the organic insulator materials currently in use. This is a report of the activities involving Task 3more » of the Nuclear Energy Enabling Technologies (NEET) 2 project Radiation Hardened Circuitry Using Mask-Programmable Analog Arrays [1]. Evaluation of the performance of the system for both pre- and post-irradiation as well as operation at elevated temperature will be performed. Detailed performance of the system will be documented to ensure the design meets requirements prior to any extended evaluation. A suite of tests will be developed which will allow evaluation before and after irradiation and during temperature. Selection of the radiation exposure facilities will be determined in the early phase of the project. Radiation exposure will consist of total integrated dose (TID) up to 200 kRad or above with several intermediate doses during test. Dose rates will be in various ranges determined by the facility that will be used with a target of 30 kRad/hr. Many samples of the pre-commercial devices to be used will have been tested in previous projects to doses of at least 300 kRad and temperatures up to 125C. The complete systems will therefore be tested for performance at intermediate doses. Extended temperature testing will be performed up to the limit of the commercial sensors. The test suite performed at each test point will consist of operational testing of the three basic measurement functions plus electronic functional testing (power dissipation, voltage offset changes, noise variations, etc.). This suite will be developed as part of this task.« less

Patient-Centered Research

PubMed Central

Wicki, J; Perneger, TV; Junod, AF; Bounameaux, H; Perrier, A

2000-01-01

PURPOSE We aimed to develop a simple standardized clinical score to stratify emergency ward patients with clinically suspected PE into groups with a high, intermediate, or low probability of PE, in order to improve and simplify the diagnostic approach. METHODS Analysis of a database of 1090 consecutive patients admitted to the emergency ward for suspected PE, in whom diagnosis of PE was ruled in or out by a standard diagnostic algorithm. Logistic regression was used to predict clinical parameters associated with PE. RESULTS 296 out of 1090 patients (27%) were found to have PE. The optimal estimate of clinical probability was based on eight variables: recent surgery, previous thromboembolic event, older age, hypocapnia, hypoxemia, tachycardia, band atelectasis or elevation of a hemidiaphragm on chest X-ray. A probability score was calculated by adding points assigned to these variables. A cut-off score of 4 best identified patients with low probability of PE. 486 patients (49%) had a low clinical probability of PE (score < 4), of which 50 (10.3%) had a proven PE. The prevalence of PE was 38% in the 437 patients with an intermediate probability (score 5–8, n = 437) and 81% in the 63 patients with a high probability (score>9). CONCLUSION This clinical score, based on easily available and objective variables, provides a standardized assessment of the clinical probability of PE. Applying this score to emergency ward patients suspected of PE could allow a more efficient diagnostic process.

The predictive validity of the BioMedical Admissions Test for pre-clinical examination performance.

PubMed

Emery, Joanne L; Bell, John F

2009-06-01

Some medical courses in the UK have many more applicants than places and almost all applicants have the highest possible previous and predicted examination grades. The BioMedical Admissions Test (BMAT) was designed to assist in the student selection process specifically for a number of 'traditional' medical courses with clear pre-clinical and clinical phases and a strong focus on science teaching in the early years. It is intended to supplement the information provided by examination results, interviews and personal statements. This paper reports on the predictive validity of the BMAT and its predecessor, the Medical and Veterinary Admissions Test. Results from the earliest 4 years of the test (2000-2003) were matched to the pre-clinical examination results of those accepted onto the medical course at the University of Cambridge. Correlation and logistic regression analyses were performed for each cohort. Section 2 of the test ('Scientific Knowledge') correlated more strongly with examination marks than did Section 1 ('Aptitude and Skills'). It also had a stronger relationship with the probability of achieving the highest examination class. The BMAT and its predecessor demonstrate predictive validity for the pre-clinical years of the medical course at the University of Cambridge. The test identifies important differences in skills and knowledge between candidates, not shown by their previous attainment, which predict their examination performance. It is thus a valid source of additional admissions information for medical courses with a strong scientific emphasis when previous attainment is very high.

Math Ties: Problem Solving, Logic Teasers, and Math Puzzles All "Tied" To the Math Curriculum. Book B1.

ERIC Educational Resources Information Center

Santi, Terri

This book contains a classroom-tested approach to the teaching of problem solving to all students in Grades 6-8, regardless of ability. Information on problem solving in general is provided, then mathematical problems on logic, exponents, fractions, pre-algebra, algebra, geometry, number theory, set theory, ratio, proportion, percent, probability,…

3D Mapping of Language Networks in Clinical and Pre-Clinical Alzheimer's Disease

ERIC Educational Resources Information Center

Apostolova, Liana G.; Lu, Po; Rogers, Steve; Dutton, Rebecca A.; Hayashi, Kiralee M.; Toga, Arthur W.; Cummings, Jeffrey L.; Thompson, Paul M.

2008-01-01

We investigated the associations between Boston naming and the animal fluency tests and cortical atrophy in 19 probable AD and 5 multiple domain amnestic mild cognitive impairment patients who later converted to AD. We applied a surface-based computational anatomy technique to MRI scans of the brain and then used linear regression models to detect…

Teaching Probability in Intermediate Grades

ERIC Educational Resources Information Center

Engel, Arthur

1971-01-01

A discussion of the importance and procedures for including probability in the elementary through secondary mathematics curriculum is presented. Many examples and problems are presented which the author feels students can understand and will be motivated to do. Random digits, Monte Carlo methods, combinatorial theory, and Markov chains are…

Surface friction alters the agility of a small Australian marsupial.

PubMed

Wheatley, Rebecca; Clemente, Christofer J; Niehaus, Amanda C; Fisher, Diana O; Wilson, Robbie S

2018-04-23

Movement speed can underpin an animal's probability of success in ecological tasks. Prey often use agility to outmanoeuvre predators; however, faster speeds increase inertia and reduce agility. Agility is also constrained by grip, as the foot must have sufficient friction with the ground to apply the forces required for turning. Consequently, ground surface should affect optimum turning speed. We tested the speed-agility trade-off in buff-footed antechinus ( Antechinus mysticus ) on two different surfaces. Antechinus used slower turning speeds over smaller turning radii on both surfaces, as predicted by the speed-agility trade-off. Slipping was 64% more likely on the low-friction surface, and had a higher probability of occurring the faster the antechinus were running before the turn. However, antechinus compensated for differences in surface friction by using slower pre-turn speeds as their amount of experience on the low-friction surface increased, which consequently reduced their probability of slipping. Conversely, on the high-friction surface, antechinus used faster pre-turn speeds in later trials, which had no effect on their probability of slipping. Overall, antechinus used larger turning radii (0.733±0.062 versus 0.576±0.051 m) and slower pre-turn (1.595±0.058 versus 2.174±0.050 m s -1 ) and turning speeds (1.649±0.061 versus 2.01±0.054 m s -1 ) on the low-friction surface. Our results demonstrate the interactive effect of surface friction and the speed-agility trade-off on speed choice. To predict wild animals' movement speeds, future studies should examine the interactions between biomechanical trade-offs and terrain, and quantify the costs of motor mistakes in different ecological activities. © 2018. Published by The Company of Biologists Ltd.

Automatic detection of anomalies in screening mammograms

PubMed Central

2013-01-01

Background Diagnostic performance in breast screening programs may be influenced by the prior probability of disease. Since breast cancer incidence is roughly half a percent in the general population there is a large probability that the screening exam will be normal. That factor may contribute to false negatives. Screening programs typically exhibit about 83% sensitivity and 91% specificity. This investigation was undertaken to determine if a system could be developed to pre-sort screening-images into normal and suspicious bins based on their likelihood to contain disease. Wavelets were investigated as a method to parse the image data, potentially removing confounding information. The development of a classification system based on features extracted from wavelet transformed mammograms is reported. Methods In the multi-step procedure images were processed using 2D discrete wavelet transforms to create a set of maps at different size scales. Next, statistical features were computed from each map, and a subset of these features was the input for a concerted-effort set of naïve Bayesian classifiers. The classifier network was constructed to calculate the probability that the parent mammography image contained an abnormality. The abnormalities were not identified, nor were they regionalized. The algorithm was tested on two publicly available databases: the Digital Database for Screening Mammography (DDSM) and the Mammographic Images Analysis Society’s database (MIAS). These databases contain radiologist-verified images and feature common abnormalities including: spiculations, masses, geometric deformations and fibroid tissues. Results The classifier-network designs tested achieved sensitivities and specificities sufficient to be potentially useful in a clinical setting. This first series of tests identified networks with 100% sensitivity and up to 79% specificity for abnormalities. This performance significantly exceeds the mean sensitivity reported in literature for the unaided human expert. Conclusions Classifiers based on wavelet-derived features proved to be highly sensitive to a range of pathologies, as a result Type II errors were nearly eliminated. Pre-sorting the images changed the prior probability in the sorted database from 37% to 74%. PMID:24330643

Risk stratification using stress echocardiography: incremental prognostic value over historic, clinical, and stress electrocardiographic variables across a wide spectrum of bayesian pretest probabilities for coronary artery disease.

PubMed

Bangalore, Sripal; Gopinath, Devi; Yao, Siu-Sun; Chaudhry, Farooq A

2007-03-01

We sought to evaluate the risk stratification ability and incremental prognostic value of stress echocardiography over historic, clinical, and stress electrocardiographic (ECG) variables, over a wide spectrum of bayesian pretest probabilities of coronary artery disease (CAD). Stress echocardiography is an established technique for the diagnosis of CAD. However, data on incremental prognostic value of stress echocardiography over historic, clinical, and stress ECG variables in patients with known or suggested CAD is limited. We evaluated 3259 patients (60 +/- 13 years, 48% men) undergoing stress echocardiography. Patients were grouped into low (<15%), intermediate (15-85%), and high (>85%) pretest CAD likelihood subgroups using standard software. The historical, clinical, stress ECG, and stress echocardiographic variables were recorded for the entire cohort. Follow-up (2.7 +/- 1.1 years) for confirmed myocardial infarction (n = 66) and cardiac death (n = 105) was obtained. For the entire cohort, an ischemic stress echocardiography study confers a 5.0 times higher cardiac event rate than the normal stress echocardiography group (4.0% vs 0.8%/y, P < .0001). Furthermore, Cox proportional hazard regression model showed incremental prognostic value of stress echocardiography variables over historic, clinical, and stress ECG variables across all pretest probability subgroups (global chi2 increased from 5.1 to 8.5 to 20.1 in the low pretest group, P = .44 and P = .01; from 20.9 to 28.2 to 116 in the intermediate pretest group, P = .47 and P < .0001; and from 17.5 to 36.6 to 61.4 in the high pretest group, P < .0001 for both groups). A normal stress echocardiography portends a benign prognosis (<1% event rate/y) in all pretest probability subgroups and even in patients with high pretest probability and yields incremental prognostic value over historic, clinical, and stress ECG variables across all pretest probability subgroups. The best incremental value is, however, in the intermediate pretest probability subgroup.

Triage of ASC-H: a meta-analysis of the accuracy of hrHPV testing and other markers to detect cervical precancer

PubMed Central

Xu, Lan; Verdoodt, Freija; Wentzensen, Nicolas; Bergeron, Christine; Arbyn, Marc

2015-01-01

Background Women with a cytological diagnosis of atypical squamous cells, cannot exclude high-grade squamous intraepithelial lesion (ASC-H) are usually immediately referred to colposcopy. However, triage may reduce the burden of diagnostic work-up and avoid over-treatment. Methods A meta-analysis was conducted to assess the accuracy of hrHPV testing, and testing for other molecular markers to detect CIN of grade II or III or worse (CIN2+ or CIN3+) in women with ASC-H. An additional question assessed was whether triage is useful given the relatively high pre-triage probability of underlying precancer. Results The pooled absolute sensitivity and specificity for CIN2+ of HC2 (derived from 19 studies) was 93% (95% CI: 89–95%) and 45% (95% CI: 41–50%), respectively. The p16INK4a staining (only 3 studies) has similar sensitivity (93%, 95% CI:75–100%) but superior specificity (specificity ratio: 1.69) to HC2 for CIN2+. Testing for PAX1 gene methylation (only 1 study) showed a superior specificity of 95% (specificity ratio: 2.08). The average pre-test risk was 34% for CIN2+ and 20% for CIN3+. A negative HC2 result decreased this to 8% and 5%, whereas a positive result upgraded the risk to 47% and 28%. Conclusions Due to the high probability of precancer in ASC-H, the utility of triage is limited. The usual recommendation to refer women with ASC-H to colposcopy is not altered by a positive triage test, whatever the test used. A negative hrHPV DNA or p16INK4a test may allow for repeat testing but this recommendation will depend on local decision thresholds for referral. PMID:26618614

Continuing dental education in radiation protection: knowledge retention following a postgraduate course.

PubMed

Absi, E G; Drage, N A; Thomas, H S; Newcombe, R G; Cowpe, J

2011-08-01

To evaluate medium-term knowledge retention of dental personnel following attendance at a postgraduate course in radiation protection. Knowledge was measured using identical pre- and post-course validated single best-answer multiple-choice instruments, administered immediately before and after training and at follow-up at 6 or 12 months. These comprise 16 questions each with 5 choices. The range of possible scores was from 0 to 16, and scores were scaled to percentages. Participants were predominantly dental practitioners, but a minority consisted of dental care professionals (dental nurses, hygienists and therapists). Of 285 participants, 272 (95.4%) completed both pre- and post-course questionnaires. One hundred and seventeen (43%) of these also completed the follow-up test, but only 109 (40%) individuals could be linked to the original course. Mean (standard deviation) pre-, post-course and follow-up-corrected percentage scores were 39.1 (16.1), 74.6 (16.9) and 58.9 (22.7), respectively. There was attrition in knowledge at follow-up: the average increase in adjusted score after training was 35.5 points, but only 56% of this was retained at follow-up. Paired t-tests confirmed that the mean score at follow-up was firmly intermediate between the pre- and post-course scores. Of the 109 participants, 7 (6%) achieved a satisfactory score pre-training, 82 (75%) immediately post-training and 41 (38%) at follow-up. There were gross differences between the levels of performance achieved for the eight subject areas tested. Immediate post-course assessments have indicated that current postgraduate courses in radiation protection are effective. However, a substantial amount of knowledge is lost by 6-12 months following course attendance. To achieve long-term knowledge retention, early or repeated reinforcement may be necessary. © 2011 John Wiley & Sons A/S.

Time-Dependent Stress Rupture Strength Degradation of Hi-Nicalon Fiber-Reinforced Silicon Carbide Composites at Intermediate Temperatures

NASA Technical Reports Server (NTRS)

Sullivan, Roy M.

2016-01-01

The stress rupture strength of silicon carbide fiber-reinforced silicon carbide composites with a boron nitride fiber coating decreases with time within the intermediate temperature range of 700 to 950 degree Celsius. Various theories have been proposed to explain the cause of the time-dependent stress rupture strength. The objective of this paper is to investigate the relative significance of the various theories for the time-dependent strength of silicon carbide fiber-reinforced silicon carbide composites. This is achieved through the development of a numerically based progressive failure analysis routine and through the application of the routine to simulate the composite stress rupture tests. The progressive failure routine is a time-marching routine with an iterative loop between a probability of fiber survival equation and a force equilibrium equation within each time step. Failure of the composite is assumed to initiate near a matrix crack and the progression of fiber failures occurs by global load sharing. The probability of survival equation is derived from consideration of the strength of ceramic fibers with randomly occurring and slow growing flaws as well as the mechanical interaction between the fibers and matrix near a matrix crack. The force equilibrium equation follows from the global load sharing presumption. The results of progressive failure analyses of the composite tests suggest that the relationship between time and stress-rupture strength is attributed almost entirely to the slow flaw growth within the fibers. Although other mechanisms may be present, they appear to have only a minor influence on the observed time-dependent behavior.

Cost-effectiveness of anatomical and functional test strategies for stable chest pain: public health perspective from a middle-income country.

PubMed

Bertoldi, Eduardo G; Stella, Steffen F; Rohde, Luis Eduardo P; Polanczyk, Carisi A

2017-05-04

The aim of this research is to evaluate the relative cost-effectiveness of functional and anatomical strategies for diagnosing stable coronary artery disease (CAD), using exercise (Ex)-ECG, stress echocardiogram (ECHO), single-photon emission CT (SPECT), coronary CT angiography (CTA) or stress cardiacmagnetic resonance (C-MRI). Decision-analytical model, comparing strategies of sequential tests for evaluating patients with possible stable angina in low, intermediate and high pretest probability of CAD, from the perspective of a developing nation's public healthcare system. Hypothetical cohort of patients with pretest probability of CAD between 20% and 70%. The primary outcome is cost per correct diagnosis of CAD. Proportion of false-positive or false-negative tests and number of unnecessary tests performed were also evaluated. Strategies using Ex-ECG as initial test were the least costly alternatives but generated more frequent false-positive initial tests and false-negative final diagnosis. Strategies based on CTA or ECHO as initial test were the most attractive and resulted in similar cost-effectiveness ratios (I$ 286 and I$ 305 per correct diagnosis, respectively). A strategy based on C-MRI was highly effective for diagnosing stable CAD, but its high cost resulted in unfavourable incremental cost-effectiveness (ICER) in moderate-risk and high-risk scenarios. Non-invasive strategies based on SPECT have been dominated. An anatomical diagnostic strategy based on CTA is a cost-effective option for CAD diagnosis. Functional strategies performed equally well when based on ECHO. C-MRI yielded acceptable ICER only at low pretest probability, and SPECT was not cost-effective in our analysis. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

Course and Curriculum Improvement Materials: Mathematics, Science, Social Sciences - Elementary, Intermediate, Secondary.

ERIC Educational Resources Information Center

National Science Foundation, Washington, DC.

This is a list of curriculum improvement materials produced by major course and curriculum projects supported by the National Science Foundation's Division of Pre-College Education in Science. The materials are grouped by educational level (elementary, intermediate, and secondary) and within each level by broad discipline groupings (mathematics,…

Relationship between EFL Learners' Autonomy and Speaking Strategies They Use in Conversation Classes

ERIC Educational Resources Information Center

Salehi, Hadi; Ebrahimi, Marziyeh; Sattar, Susan; Shojaee, Mohammad

2015-01-01

The present study was conducted at Parsayan Language Institute in Isfahan, Iran. The students in pre-intermediate and intermediate classes were examined to investigate the relationship between degrees of learner autonomy, use of strategies for coping with speaking problems and the learners' success in their speaking classes. To determine the…

Capturing a flavivirus pre-fusion intermediate.

PubMed

Kaufmann, Bärbel; Chipman, Paul R; Holdaway, Heather A; Johnson, Syd; Fremont, Daved H; Kuhn, Richard J; Diamond, Michael S; Rossmann, Michael G

2009-11-01

During cell entry of flaviviruses, low endosomal pH triggers the rearrangement of the viral surface glycoproteins to a fusion-active state that allows the release of the infectious RNA into the cytoplasm. In this work, West Nile virus was complexed with Fab fragments of the neutralizing mAb E16 and was subsequently exposed to low pH, trapping the virions in a pre-fusion intermediate state. The structure of the complex was studied by cryo-electron microscopy and provides the first structural glimpse of a flavivirus fusion intermediate near physiological conditions. A radial expansion of the outer protein layer of the virion was observed compared to the structure at pH 8. The resulting approximately 60 A-wide shell of low density between lipid bilayer and outer protein layer is likely traversed by the stem region of the E glycoprotein. By using antibody fragments, we have captured a structural intermediate of a virus that likely occurs during cell entry. The trapping of structural transition states by antibody fragments will be applicable for other processes in the flavivirus life cycle and delineating other cellular events that involve conformational rearrangements.

I Plan Therefore I Choose: Free-Choice Bias Due to Prior Action-Probability but Not Action-Value

PubMed Central

Suriya-Arunroj, Lalitta; Gail, Alexander

2015-01-01

According to an emerging view, decision-making, and motor planning are tightly entangled at the level of neural processing. Choice is influenced not only by the values associated with different options, but also biased by other factors. Here we test the hypothesis that preliminary action planning can induce choice biases gradually and independently of objective value when planning overlaps with one of the potential action alternatives. Subjects performed center-out reaches obeying either a clockwise or counterclockwise cue-response rule in two tasks. In the probabilistic task, a pre-cue indicated the probability of each of the two potential rules to become valid. When the subsequent rule-cue unambiguously indicated which of the pre-cued rules was actually valid (instructed trials), subjects responded faster to rules pre-cued with higher probability. When subjects were allowed to choose freely between two equally rewarded rules (choice trials) they chose the originally more likely rule more often and faster, despite the lack of an objective advantage in selecting this target. In the amount task, the pre-cue indicated the amount of potential reward associated with each rule. Subjects responded faster to rules pre-cued with higher reward amount in instructed trials of the amount task, equivalent to the more likely rule in the probabilistic task. Yet, in contrast, subjects showed hardly any choice bias and no increase in response speed in favor of the original high-reward target in the choice trials of the amount task. We conclude that free-choice behavior is robustly biased when predictability encourages the planning of one of the potential responses, while prior reward expectations without action planning do not induce such strong bias. Our results provide behavioral evidence for distinct contributions of expected value and action planning in decision-making and a tight interdependence of motor planning and action selection, supporting the idea that the underlying neural mechanisms overlap. PMID:26635565

miRNA Profiles as a Predictor of Chemoresponsiveness in Wilms’ Tumor Blastema

PubMed Central

Watson, Jenny A.; Bryan, Kenneth; Williams, Richard; Popov, Sergey; Vujanic, Gordan; Coulomb, Aurore; Boccon-Gibod, Liliane; Graf, Norbert; Pritchard-Jones, Kathy; O’Sullivan, Maureen

2013-01-01

The current SIOP treatment protocol for Wilms’ tumor involves pre-operative chemotherapy followed by nephrectomy. Not all patients benefit equally from such chemotherapy. The aim of this study was to generate a miRNA profile of chemo resistant blastemal cells in high risk Wilms’ tumors which might serve as predictive markers of therapeutic response at the pre-treatment biopsy stage. We have shown here that unsupervised hierarchical clustering of genome-wide miRNA expression profiles can clearly separate intermediate risk tumors from high risk tumors. A total of 29 miRNAs were significantly differentially expressed between post-treatment intermediate risk and high risk groups, including miRNAs that have been previously linked to chemo resistance in other cancer types. Furthermore, 7 of these 29 miRNAs were already at the pre-treatment biopsy stage differentially expressed between cases ultimately deemed intermediate risk compared to high risk. These miRNA alterations include down-regulation in high risk cases of miR-193a.5p, miR-27a and the up-regulation of miR-483.5p, miR-628.5p, miR-590.5p, miR-302a and miR-367. The demonstration of such miRNA markers at the pre-treatment biopsy stage could permit stratification of patients to more tailored treatment regimens. PMID:23308219

40 CFR 86.246-94 - Intermediate temperature testing.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 19 2013-07-01 2013-07-01 false Intermediate temperature testing. 86... New Medium-Duty Passenger Vehicles; Cold Temperature Test Procedures § 86.246-94 Intermediate temperature testing. (a) This section is applicable to tests which are conducted at an intermediate...

40 CFR 86.246-94 - Intermediate temperature testing.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 19 2012-07-01 2012-07-01 false Intermediate temperature testing. 86... New Medium-Duty Passenger Vehicles; Cold Temperature Test Procedures § 86.246-94 Intermediate temperature testing. (a) This section is applicable to tests which are conducted at an intermediate...

40 CFR 86.246-94 - Intermediate temperature testing.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 18 2011-07-01 2011-07-01 false Intermediate temperature testing. 86... New Medium-Duty Passenger Vehicles; Cold Temperature Test Procedures § 86.246-94 Intermediate temperature testing. (a) This section is applicable to tests which are conducted at an intermediate...

Supernova SN 2011fe from an exploding carbon-oxygen white dwarf star.

PubMed

Nugent, Peter E; Sullivan, Mark; Cenko, S Bradley; Thomas, Rollin C; Kasen, Daniel; Howell, D Andrew; Bersier, David; Bloom, Joshua S; Kulkarni, S R; Kandrashoff, Michael T; Filippenko, Alexei V; Silverman, Jeffrey M; Marcy, Geoffrey W; Howard, Andrew W; Isaacson, Howard T; Maguire, Kate; Suzuki, Nao; Tarlton, James E; Pan, Yen-Chen; Bildsten, Lars; Fulton, Benjamin J; Parrent, Jerod T; Sand, David; Podsiadlowski, Philipp; Bianco, Federica B; Dilday, Benjamin; Graham, Melissa L; Lyman, Joe; James, Phil; Kasliwal, Mansi M; Law, Nicholas M; Quimby, Robert M; Hook, Isobel M; Walker, Emma S; Mazzali, Paolo; Pian, Elena; Ofek, Eran O; Gal-Yam, Avishay; Poznanski, Dovi

2011-12-14

Type Ia supernovae have been used empirically as 'standard candles' to demonstrate the acceleration of the expansion of the Universe even though fundamental details, such as the nature of their progenitor systems and how the stars explode, remain a mystery. There is consensus that a white dwarf star explodes after accreting matter in a binary system, but the secondary body could be anything from a main-sequence star to a red giant, or even another white dwarf. This uncertainty stems from the fact that no recent type Ia supernova has been discovered close enough to Earth to detect the stars before explosion. Here we report early observations of supernova SN 2011fe in the galaxy M101 at a distance from Earth of 6.4 megaparsecs. We find that the exploding star was probably a carbon-oxygen white dwarf, and from the lack of an early shock we conclude that the companion was probably a main-sequence star. Early spectroscopy shows high-velocity oxygen that slows rapidly, on a timescale of hours, and extensive mixing of newly synthesized intermediate-mass elements in the outermost layers of the supernova. A companion paper uses pre-explosion images to rule out luminous red giants and most helium stars as companions to the progenitor.

Clock face drawing test performance in children with ADHD.

PubMed

Ghanizadeh, Ahmad; Safavi, Salar; Berk, Michael

2013-01-01

The utility and discriminatory pattern of the clock face drawing test in ADHD is unclear. This study therefore compared Clock Face Drawing test performance in children with ADHD and controls. 95 school children with ADHD and 191 other children were matched for gender ratio and age. ADHD symptoms severities were assessed using DSM-IV ADHD checklist and their intellectual functioning was assessed. The participants completed three clock-drawing tasks, and the following four functions were assessed: Contour score, Numbers score, Hands setting score, and Center score. All the subscales scores of the three clock drawing tests of the ADHD group were lower than that of the control group. In ADHD children, inattention and hyperactivity/ impulsivity scores were not related to free drawn clock test scores. When pre-drawn contour test was performed, inattentiveness score was statistically associated with Number score while none of the other variables of age, gender, intellectual functioning, and hand use preference were associated with that kind of score. In pre-drawn clock, no association of ADHD symptoms with any CDT subscales found significant. In addition, more errors are observed with free drawn clock and Pre-drawn contour than pre-drawn clock. Putting Numbers and Hands setting are more sensitive measures to screen ADHD than Contour and Center drawing. Test performance, except Hands setting, may have already reached a developmental plateau. It is probable that Hand setting deficit in children with ADHD may not decrease from age 8 to 14 years. Performance of children with ADHD is associated with complexity of CDT.

A TCP model for external beam treatment of intermediate-risk prostate cancer

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

Walsh, Sean; Putten, Wil van der

2013-03-15

Purpose: Biological models offer the ability to predict clinical outcomes. The authors describe a model to predict the clinical response of intermediate-risk prostate cancer to external beam radiotherapy for a variety of fractionation regimes. Methods: A fully heterogeneous population averaged tumor control probability model was fit to clinical outcome data for hyper, standard, and hypofractionated treatments. The tumor control probability model was then employed to predict the clinical outcome of extreme hypofractionation regimes, as utilized in stereotactic body radiotherapy. Results: The tumor control probability model achieves an excellent level of fit, R{sup 2} value of 0.93 and a root meanmore » squared error of 1.31%, to the clinical outcome data for hyper, standard, and hypofractionated treatments using realistic values for biological input parameters. Residuals Less-Than-Or-Slanted-Equal-To 1.0% are produced by the tumor control probability model when compared to clinical outcome data for stereotactic body radiotherapy. Conclusions: The authors conclude that this tumor control probability model, used with the optimized radiosensitivity values obtained from the fit, is an appropriate mechanistic model for the analysis and evaluation of external beam RT plans with regard to tumor control for these clinical conditions.« less

The reaction probability of N2O5 with sulfuric acid aerosols at stratospheric temperatures and compositions

NASA Technical Reports Server (NTRS)

Fried, Alan; Henry, Bruce E.; Calvert, Jack G.; Mozurkewich, Michael

1994-01-01

We have measured the rate of reaction of N2O5 with H2O on monodisperse, submicrometer H2SO4 particles in a low-temperature flow reactor. Measurements were carried out at temperatures between 225 K and 293 K on aerosol particles with sizes and compositions comparable to those found in the stratosphere. At 273 K, the reaction probability was found to be 0.103 +/- 0.0006, independent of H2SO4 composition from 64 to 81 wt%. At 230 K, the reaction probability increased from 0.077 for compositions near 60% H2SO4 to 0.146 for compositions near 70% H2SO4. Intermediate conditions gave intermediate results except for low reaction probabilities of about 0.045 at 260 K on aerosols with about 78% H2SO4. The reaction probability did not depend on particle size. These results imply that the reaction occurs essentially at the surface of the particle. A simple model for this type of reaction that reproduces the general trends observed is presented. the presence of formaldehyde did not affect the reaction rate.

Exome sequencing identifies CTSK mutations in patients originally diagnosed as intermediate osteopetrosis☆

PubMed Central

Pangrazio, Alessandra; Puddu, Alessandro; Oppo, Manuela; Valentini, Maria; Zammataro, Luca; Vellodi, Ashok; Gener, Blanca; Llano-Rivas, Isabel; Raza, Jamal; Atta, Irum; Vezzoni, Paolo; Superti-Furga, Andrea; Villa, Anna; Sobacchi, Cristina

2014-01-01

Autosomal Recessive Osteopetrosis is a genetic disorder characterized by increased bone density due to lack of resorption by the osteoclasts. Genetic studies have widely unraveled the molecular basis of the most severe forms, while cases of intermediate severity are more difficult to characterize, probably because of a large heterogeneity. Here, we describe the use of exome sequencing in the molecular diagnosis of 2 siblings initially thought to be affected by “intermediate osteopetrosis”, which identified a homozygous mutation in the CTSK gene. Prompted by this finding, we tested by Sanger sequencing 25 additional patients addressed to us for recessive osteopetrosis and found CTSK mutations in 4 of them. In retrospect, their clinical and radiographic features were found to be compatible with, but not typical for, Pycnodysostosis. We sought to identify modifier genes that might have played a role in the clinical manifestation of the disease in these patients, but our results were not informative. In conclusion, we underline the difficulties of differential diagnosis in some patients whose clinical appearance does not fit the classical malignant or benign picture and recommend that CTSK gene be included in the molecular diagnosis of high bone density conditions. PMID:24269275

Measurement of urinary metanephrines to screen for pheochromocytoma in an unselected hospital referral population

PubMed Central

Brain, Keith L.; Kay, Jonathan; Shine, Brian

2009-01-01

Background Despite the rarity of pheochromocytoma, the dangers of uncontrolled severe hypertension and the very effective surgical treatment of this condition mean that diagnosis is important. Urinary or plasma catecholamines or catecholamine-derivatives are commonly used to screen for pheochromocytomas prior to imaging. This study investigates whether derived measures obtained from 24-hour urinary metanephrine results, patient age and sex can better predict tumors in populations with a low pre-test probability. Methods This study takes a pragmatic approach by retrospectively studying the outcomes of an unselected population referred for urinary metanephrine testing (1819 patients) to a tertiary hospital laboratory, and investigates the usefulness of some simple derivative measures for detecting pheochromocytoma. Urinary 24-hour excretion of metanephrine, normetanephrine and 3-methoxytyramine were normalized by dividing by an age- and sex- specific reference range. The ability of products of these normalized measures to predict pheochromocytomas was assessed, compared to a gold standard of biopsy-confirmed tumor. Results The normalized product of urinary metanephrine and normetanephrine excretion (nMAD.nNMT) proved to be a highly sensitive (100%) and specific (99.1%) measure yielding a positive predictive value 82%. Receiver-operator characteristic curves were not improved by including the normalized 3-methoxytyramine concentrations in the product. nMAD.nNMT gave higher sensitivity and specificity than either test alone. Conclusion We suggest that nMAD.nNMT is a useful measure for identifying pheochromocytoma in a population with a low pre-test probability. PMID:16990424

Characterization of 16S rRNA Processing with Pre-30S Subunit Assembly Intermediates from E. coli.

PubMed

Smith, Brian A; Gupta, Neha; Denny, Kevin; Culver, Gloria M

2018-06-08

Ribosomal RNA (rRNA) is a major component of ribosomes and is fundamental to the process of translation. In bacteria, 16S rRNA is a component of the small ribosomal subunit and plays a critical role in mRNA decoding. rRNA maturation entails the removal of intervening spacer sequences contained within the pre-rRNA transcript by nucleolytic enzymes. Enzymatic activities involved in maturation of the 5'-end of 16S rRNA have been identified, but those involved in 3'-end maturation of 16S rRNA are more enigmatic. Here, we investigate molecular details of 16S rRNA maturation using purified in vivo-formed small subunit (SSU) assembly intermediates (pre-SSUs) from wild-type Escherichia coli that contain precursor 16S rRNA (17S rRNA). Upon incubation of pre-SSUs with E. coli S100 cell extracts or purified enzymes implicated in 16S rRNA processing, the 17S rRNA is processed into additional intermediates and mature 16S rRNA. These results illustrate that exonucleases RNase R, RNase II, PNPase, and RNase PH can process the 3'-end of pre-SSUs in vitro. However, the endonuclease YbeY did not exhibit nucleolytic activity with pre-SSUs under these conditions. Furthermore, these data demonstrate that multiple pathways facilitate 16S rRNA maturation with pre-SSUs in vitro, with the dominant pathways entailing complete processing of the 5'-end of 17S rRNA prior to 3'-end maturation or partial processing of the 5'-end with concomitant processing of the 3'-end. These results reveal the multifaceted nature of SSU biogenesis and suggest that E. coli may be able to escape inactivation of any one enzyme by using an existing complementary pathway. Copyright © 2018 Elsevier Ltd. All rights reserved.

Globalization and the price decline of illicit drugs.

PubMed

Costa Storti, Cláudia; De Grauwe, Paul

2009-01-01

This study aims at understanding the mechanisms underlying the dramatic decline of the retail prices of major drugs like cocaine and heroin during the past two decades. It also aims at analysing the implications of this decline for drug policies. We use a theoretical model to identify the possible causes of this price decline. This allows us to formulate the hypothesis that the major driving force behind the price decline is a reduction of the intermediation margin (the difference between the retail and producer prices). We also develop the hypothesis that globalization has been an important factor behind the decline of the intermediation margin. We then analyse the statistical information to test these hypotheses. We find that the decline in the retail prices of drugs is related to the strong decline in the intermediation margin in the drug business, and that globalization is the main driving force behind this phenomenon. Globalization has done so by increasing the efficiency of the distribution of drugs, by reducing the risk premium involved in dealing with drugs, and by increasing the degree of competition in the drug markets. We conclude that the cocaine and heroin price declines were due to a sharp fall in the intermediation margin, which was probably influenced by globalization. This phenomenon might have a strong impact on the effectiveness of drug policies, increasing the relative effectiveness of policies aiming at reducing the demand of drugs.

Hydrogeology and potential effects of changes in water use, Carson Desert agricultural area, Churchill County, Nevada

USGS Publications Warehouse

Maurer, Douglas K.; Johnson, Ann K.; Welch, Alan H.

1996-01-01

Operating Criteria and Procedures for Newlands Project irrigation and Public Law 101-618 could result in reductions in surface water used for agriculture in the Carson Desert, potentially affecting ground-water supplies from shallow, intermediate, and basalt aquifers. A near-surface zone could exist at the top of the shallow aquifer near the center and eastern parts of the basin where underlying clay beds inhibit vertical flow and could limit the effects of changes in water use. In the basalt aquifer, water levels have declined about 10 feet from pre-pumping levels, and chloride and arsenic concentrations have increased. Conceptual models of the basin suggest that changes in water use in the western part of the basin would probably affect recharge to the shallow, intermediate, and basalt aquifers. Lining canals and removing land from production could cause water-level declines greater than 10 feet in the shallow aquifer up to 2 miles from lined canals. Removing land from production could cause water levels to decline from 4 to 17 feet, depending on the distribution of specific yield in the basin and the amount of water presently applied to irrigated fields. Where wells pump from a near-surface zone of the shallow aquifer, water level declines might not greatly affect pumping wells where the thickness of the zone is greatest, but could cause wells to go dry where the zone is thin.

A Preliminary Report on a New Grammar Checker to Help Students of English as a Foreign Language

ERIC Educational Resources Information Center

Lawley, Jim

2004-01-01

Whereas many pre-intermediate and intermediate level students of English as a Foreign Language (EFL) might benefit from receiving detailed feedback on mistakes in their written compositions, there are obvious practical limits to the amount of corrective feedback that teachers in schools and universities can provide. This article briefly describes…

Whereas Short-Term Facilitation Is Presynaptic, Intermediate-Term Facilitation Involves Both Presynaptic and Postsynaptic Protein Kinases and Protein Synthesis

ERIC Educational Resources Information Center

Jin, Iksung; Kandel, Eric R.; Hawkins, Robert D.

2011-01-01

Whereas short-term plasticity involves covalent modifications that are generally restricted to either presynaptic or postsynaptic structures, long-term plasticity involves the growth of new synapses, which by its nature involves both pre- and postsynaptic alterations. In addition, an intermediate-term stage of plasticity has been identified that…

A concise evidence-based physical examination for diagnosis of acromioclavicular joint pathology: a systematic review.

PubMed

Krill, Michael K; Rosas, Samuel; Kwon, KiHyun; Dakkak, Andrew; Nwachukwu, Benedict U; McCormick, Frank

2018-02-01

The clinical examination of the shoulder joint is an undervalued diagnostic tool for evaluating acromioclavicular (AC) joint pathology. Applying evidence-based clinical tests enables providers to make an accurate diagnosis and minimize costly imaging procedures and potential delays in care. The purpose of this study was to create a decision tree analysis enabling simple and accurate diagnosis of AC joint pathology. A systematic review of the Medline, Ovid and Cochrane Review databases was performed to identify level one and two diagnostic studies evaluating clinical tests for AC joint pathology. Individual test characteristics were combined in series and in parallel to improve sensitivities and specificities. A secondary analysis utilized subjective pre-test probabilities to create a clinical decision tree algorithm with post-test probabilities. The optimal special test combination to screen and confirm AC joint pathology combined Paxinos sign and O'Brien's Test, with a specificity of 95.8% when performed in series; whereas, Paxinos sign and Hawkins-Kennedy Test demonstrated a sensitivity of 93.7% when performed in parallel. Paxinos sign and O'Brien's Test demonstrated the greatest positive likelihood ratio (2.71); whereas, Paxinos sign and Hawkins-Kennedy Test reported the lowest negative likelihood ratio (0.35). No combination of special tests performed in series or in parallel creates more than a small impact on post-test probabilities to screen or confirm AC joint pathology. Paxinos sign and O'Brien's Test is the only special test combination that has a small and sometimes important impact when used both in series and in parallel. Physical examination testing is not beneficial for diagnosis of AC joint pathology when pretest probability is unequivocal. In these instances, it is of benefit to proceed with procedural tests to evaluate AC joint pathology. Ultrasound-guided corticosteroid injections are diagnostic and therapeutic. An ultrasound-guided AC joint corticosteroid injection may be an appropriate new standard for treatment and surgical decision-making. II - Systematic Review.

A nonparametric test for Markovianity in the illness-death model.

PubMed

Rodríguez-Girondo, Mar; de Uña-Álvarez, Jacobo

2012-12-30

Multistate models are useful tools for modeling disease progression when survival is the main outcome, but several intermediate events of interest are observed during the follow-up time. The illness-death model is a special multistate model with important applications in the biomedical literature. It provides a suitable representation of the individual's history when a unique intermediate event can be experienced before the main event of interest. Nonparametric estimation of transition probabilities in this and other multistate models is usually performed through the Aalen-Johansen estimator under a Markov assumption. The Markov assumption claims that given the present state, the future evolution of the illness is independent of the states previously visited and the transition times among them. However, this assumption fails in some applications, leading to inconsistent estimates. In this paper, we provide a new approach for testing Markovianity in the illness-death model. The new method is based on measuring the future-past association along time. This results in a detailed inspection of the process, which often reveals a non-Markovian behavior with different trends in the association measure. A test of significance for zero future-past association at each time point is introduced, and a significance trace is proposed accordingly. Besides, we propose a global test for Markovianity based on a supremum-type test statistic. The finite sample performance of the test is investigated through simulations. We illustrate the new method through the analysis of two biomedical data analysis. Copyright © 2012 John Wiley & Sons, Ltd.

A Comparison of the Updated Diamond-Forrester, CAD Consortium, and CONFIRM History-Based Risk Scores for Predicting Obstructive Coronary Artery Disease in Patients With Stable Chest Pain: The SCOT-HEART Coronary CTA Cohort.

PubMed

Baskaran, Lohendran; Danad, Ibrahim; Gransar, Heidi; Ó Hartaigh, Bríain; Schulman-Marcus, Joshua; Lin, Fay Y; Peña, Jessica M; Hunter, Amanda; Newby, David E; Adamson, Philip D; Min, James K

2018-04-13

This study sought to compare the performance of history-based risk scores in predicting obstructive coronary artery disease (CAD) among patients with stable chest pain from the SCOT-HEART study. Risk scores for estimating pre-test probability of CAD are derived from referral-based populations with a high prevalence of disease. The generalizability of these scores to lower prevalence populations in the initial patient encounter for chest pain is uncertain. We compared 3 scores among patients with suspected CAD in the coronary computed tomographic angiography (CTA) randomized arm of the SCOT-HEART study for the outcome of obstructive CAD by coronary CTA: the updated Diamond-Forrester score (UDF), CAD Consortium clinical score (CAD2), and CONFIRM risk score (CRS). We tested calibration with goodness-of-fit, discrimination with area under the receiver-operating curve (AUC), and reclassification with net reclassification improvement (NRI) to identify low-risk patients. In 1,738 patients (58 ± 10 years and 44.0% women), overall calibration was best for UDF, with underestimation by CRS and CAD2. Discrimination by AUC was highest for CAD2 at 0.79 (95% confidence interval [CI]: 0.77 to 0.81) than for UDF (0.77 [95% CI: 0.74 to 0.79]) or CRS (0.75 [95% CI: 0.73 to 0.77]) (p < 0.001 for both comparisons). Reclassification of low-risk patients at the 10% probability threshold was best for CAD2 (NRI 0.31, 95% CI: 0.27 to 0.35) followed by CRS (NRI 0.21, 95% CI: 0.17 to 0.25) compared with UDF (p < 0.001 for all comparisons), with a consistent trend at the 15% threshold. In this multicenter clinic-based cohort of patients with suspected CAD and uniform CAD evaluation by coronary CTA, CAD2 provided the best discrimination and classification, despite overestimation of obstructive CAD as evaluated by coronary CTA. CRS exhibited intermediate performance followed by UDF for discrimination and reclassification. Copyright © 2018. Published by Elsevier Inc.

Personalized treatment of women with early breast cancer: a risk-group specific cost-effectiveness analysis of adjuvant chemotherapy accounting for companion prognostic tests OncotypeDX and Adjuvant!Online.

PubMed

Jahn, Beate; Rochau, Ursula; Kurzthaler, Christina; Hubalek, Michael; Miksad, Rebecca; Sroczynski, Gaby; Paulden, Mike; Bundo, Marvin; Stenehjem, David; Brixner, Diana; Krahn, Murray; Siebert, Uwe

2017-10-16

Due to high survival rates and the relatively small benefit of adjuvant therapy, the application of personalized medicine (PM) through risk stratification is particularly beneficial in early breast cancer (BC) to avoid unnecessary harms from treatment. The new 21-gene assay (OncotypeDX, ODX) is a promising prognostic score for risk stratification that can be applied in conjunction with Adjuvant!Online (AO) to guide personalized chemotherapy decisions for early BC patients. Our goal was to evaluate risk-group specific cost effectiveness of adjuvant chemotherapy for women with early stage BC in Austria based on AO and ODX risk stratification. A previously validated discrete event simulation model was applied to a hypothetical cohort of 50-year-old women over a lifetime horizon. We simulated twelve risk groups derived from the joint application of ODX and AO and included respective additional costs. The primary outcomes of interest were life-years gained, quality-adjusted life-years (QALYs), costs and incremental cost-effectiveness (ICER). The robustness of results and decisions derived were tested in sensitivity analyses. A cross-country comparison of results was performed. Chemotherapy is dominated (i.e., less effective and more costly) for patients with 1) low ODX risk independent of AO classification; and 2) low AO risk and intermediate ODX risk. For patients with an intermediate or high AO risk and an intermediate or high ODX risk, the ICER is below 15,000 EUR/QALY (potentially cost effective depending on the willingness-to-pay). Applying the AO risk classification alone would miss risk groups where chemotherapy is dominated and thus should not be considered. These results are sensitive to changes in the probabilities of distant recurrence but not to changes in the costs of chemotherapy or the ODX test. Based on our modeling study, chemotherapy is effective and cost effective for Austrian patients with an intermediate or high AO risk and an intermediate or high ODX risk. In other words, low ODX risk suggests chemotherapy should not be considered but low AO risk may benefit from chemotherapy if ODX risk is high. Our analysis suggests that risk-group specific cost-effectiveness analysis, which includes companion prognostic tests are essential in PM.

[How to screen for pheochromocytoma, primary aldosteronism and Cushing's syndrome].

PubMed

Meyer, Patrick

2009-01-07

Pheochromocytoma, primary aldosteronism and Cushing's syndrome are uncommon disorders and are difficult to diagnose because laboratory tests lack validation and specificity. Despite these limitations, practice guidelines are proposed to standardize the screening procedure. The most reliable method to diagnose pheochromocytoma is the measurement of plasmatic and/or urinary metanephrines and normetanephrines depending on the pre-test probability of the disease. The approach for detection of primary aldosteronism is based on the aldosterone-renin ratio under standard conditions. Finally, three tests are available to establish the diagnosis of Cushing's syndrome: 24-h urinary free cortisol excretion, low-dose dexamethasone suppression test and the recent and promising late evening salivary cortisol.

Carbonate-coordinated metal complexes precede the formation of liquid amorphous mineral emulsions of divalent metal carbonates†

PubMed Central

Wolf, Stephan E.; Müller, Lars; Barrea, Raul; Kampf, Christopher J.; Leiterer, Jork; Panne, Ulrich; Hoffmann, Thorsten

2011-01-01

During the mineralisation of metal carbonates MCO3 (M = Ca, Sr, Ba, Mn, Cd, Pb) liquid-like amorphous intermediates emerge. These intermediates that form via a liquid/liquid phase separation behave like a classical emulsion and are stabilized electrostatically. The occurrence of these intermediates is attributed to the formation of highly hydrated networks whose stability is mainly based on weak interactions and the variability of the metal-containing pre-critical clusters. Their existence and compositional freedom are evidenced by electrospray ionization mass spectrometry (ESI-MS). Liquid intermediates in non-classical crystallisation pathways seem to be more common than assumed. PMID:21218241

The Path of Carbon in Photosynthesis VIII. The Role of Malic Acid

DOE R&D Accomplishments Database

Bassham, James A.; Benson, Andrew A.; Calvin, Melvin

1950-01-25

Malonate has been found to inhibit the formation of malic acid during short periods of photosynthesis with radioactive carbon dioxide. This result, together with studies which show the photosynthetic cycle to be operating normally at the same time, indicates that malic acid is not an intermediate in photosynthesis but is probably closely related to some intermediate of the cycle. Absence of labeled succinic and fumaric acids in these experiments, in addition to the failure of malonate to inhibit photosynthesis, precludes the participation of these acids as intermediates in photosynthesis.

Forming an age hardenable aluminum alloy with intermediate annealing

NASA Astrophysics Data System (ADS)

Wang, Kaifeng; Carsley, John E.; Stoughton, Thomas B.; Li, Jingjing; Zhang, Lianhong; He, Baiyan

2013-12-01

A method to improve formability of aluminum sheet alloys by a two-stage stamping process with intermediate annealing was developed for a non-age hardenable Al-Mg alloy where the annealing heat treatment provided recovery of cold work from the initial stamping and recrystallization of the microstructure to enhance the forming limits of the material. This method was extended to an age hardenable, Al-Mg-Si alloy, which is complicated by the competing metallurgical effects during heat treatment including recovery (softening effect) vs. precipitation (hardening effect). An annealing heat treatment process condition was discovered wherein the stored strain energy from an initial plastic deformation can be sufficiently recovered to enhance formability in a second deformation; however, there is a deleterious effect on subsequent precipitation hardening. The improvement in formability was quantified with uniaxial tensile tests as well as with the forming limit diagram. Since strain-based forming limit curves (FLC) are sensitive to pre-strain history, both stress-based FLCs and polar-effective-plastic-strain (PEPS) FLCs, which are path-independent, were used to evaluate the forming limits after preform annealing. A technique was developed to calculate the stress-based FLC in which a residual-effective-plastic-strain (REPS) was determined by overlapping the hardening curve of the pre-strained and annealed material with that of the simply-annealed- material. After converting the strain-based FLCs using the constant REPS method, it was found that the stress-based FLCs and the PEPS FLCs of the post-annealed materials were quite similar and both tools are applicable for evaluating the forming limits of Al-Mg-Si alloys for a two-step stamping process with intermediate annealing.

Compensatory Evolution of Intrinsic Transcription Terminators in Bacillus Cereus

PubMed Central

Safina, Ksenia R.; Mironov, Andrey A.

2017-01-01

Many RNA molecules possess complicated secondary structure critical to their function. Mutations in double-helical regions of RNA may disrupt Watson–Crick (WC) interactions causing structure destabilization or even complete loss of function. Such disruption can be compensated by another mutation restoring base pairing, as has been shown for mRNA, rRNA and tRNA. Here, we investigate the evolution of intrinsic transcription terminators between closely related strains of Bacillus cereus. While the terminator structure is maintained by strong natural selection, as evidenced by the low frequency of disrupting mutations, we observe multiple instances of pairs of disrupting-compensating mutations in RNA structure stems. Such two-step switches between different WC pairs occur very fast, consistent with the low fitness conferred by the intermediate non-WC variant. Still, they are not instantaneous, and probably involve transient fixation of the intermediate variant. The GU wobble pair is the most frequent intermediate, and remains fixed longer than other intermediates, consistent with its less disruptive effect on the RNA structure. Double switches involving non-GU intermediates are more frequent at the ends of RNA stems, probably because they are associated with smaller fitness loss. Together, these results show that the fitness landscape of bacterial transcription terminators is rather rugged, but that the fitness valleys associated with unpaired stem nucleotides are rather shallow, facilitating evolution. PMID:28201729

Cellular and humoral immunity after vaccination or natural mumps infection.

PubMed

Terada, Kihei; Hagihara, Kimiko; Oishi, Tomohiro; Miyata, Ippei; Akaike, Hiroto; Ogita, Satoko; Ohno, Naoki; Ouchi, Kazunobu

2017-08-01

This study measured cell-mediated immunity (CMI) and serum antibody to clarify the basis of breakthrough after vaccination and reinfection after mumps. From a pool of 54 college students, 17 seronegative subjects and 14 subjects with intermediate level of antibodies against mumps were vaccinated with a monovalent mumps vaccine, and CMI was assessed using interferon-γ release assay. CMI positivity according to pre-existing antibody level, defined as titer <2.0 index units, negative; 2.0-3.9 index units, intermediate; and ≥4.0 index units, positive, was 8/17 (47.1%), 9/14 (64.3%) and 19/23 (82.6%) before vaccination, respectively. Of the 17 seronegative subjects, seven (41.2%) had a history of vaccination and/or natural infection, four (57.1%) of whom were CMI positive or intermediate. Ten (71%) of 14 subjects with intermediate antibody level had a history of vaccination or natural infection, eight (80%) of whom were CMI positive or intermediate. After vaccination the interferon (IFN)-γ and antibody titers increased significantly, but seven (41.2%) of the 17 seronegative subjects and 13 (92.9%) of the 14 intermediate-level subjects tested positive for both antibody and CMI. In a comparison of the natural infection group (confirmed as IgG seropositive and/or CMI positive without vaccination) versus the vaccination group, IgG antibody titer (mean ± SD) was 14.4 ± 8.0 versus 3.6 ± 2.4 index units (P < 0.01) and IFN-γ was 122.7 ± 90.0 pg/mL versus 59.5 ± 37.8 pg/mL (P > 0.05), respectively. Vaccination or even natural mumps infection did not always induce both cellular and humoral immunity. © 2017 Japan Pediatric Society.

Prey resources before spawning influence gonadal investment of female, but not male, white crappie

USGS Publications Warehouse

Bunnell, D.B.; Thomas, S.E.; Stein, R.A.

2007-01-01

In this study, an outdoor pool experiment was used to evaluate the effect of prey resources during 4 months before spawning on the gonadal investments of male and female white crappie Pomoxis annularis, a popular freshwater sportfish that exhibits erratic recruitment. Fish were assigned one of three feeding treatments: starved, fed once every 5 days (intermediate) or fed daily (high). All measurements of male testes (i.e. wet mass, energy density and spermatocrit) were similar across treatments. Conversely, high-fed females produced larger ovaries than those of intermediate-fed and starved fish, and invested more energy in their ovaries than starved fish. Compared to pre-experiment fish, starved and intermediate-fed females appeared to increase their ovary size by relying on liver energy stores (‘capital’ spawning). Conversely, high-fed females increased liver and gonad mass, implying an ‘income’-spawning strategy (where gonads are built from recently acquired energy). Fecundity did not differ among treatments, but high-fed fish built larger eggs than those starved. Females rarely ‘skipped’ spawning opportunities when prey resources were low, as only 8% of starved females and 8% of intermediate-fed females lacked vitellogenic eggs. These results suggest that limited prey resources during the months before spawning can limit ovary production, which, in turn, can limit reproductive success of white crappies.

Coyote removal, understory cover, and survival of white-tailed deer neonates: Coyote Control and Fawn Survival

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

Kilgo, John C.; Vukovich, Mark; Ray, H. Scott

Predation by coyotes (Canis latrans) on white-tailed deer (Odocoileus virginianus) neonates has led to reduced recruitment in many deer populations in southeastern North America. This low recruitment combined with liberal antlerless deer harvest has resulted in declines in some deer populations, and consequently, increased interest in coyote population control. We investigated whether neonate survival increased after coyote removal, whether coyote predation on neonates was additive to other mortality sources, and whether understory vegetation density affected neonate survival. We monitored neonate survival for 4 years prior to (2006–2009) and 3 years during (2010–2012) intensive coyote removal on 3 32-km 2 unitsmore » on the United States Department of Energy’s Savannah River Site, South Carolina. We removed 474 coyotes (1.63 coyotes/km 2 per unit per year), reducing coyote abundance by 78% from pre-removal levels. The best model (w i = 0.927) describing survival probability among 216 radio-collared neonates included a within-year quadratic time trend variable, date of birth, removal treatment, and a varying removal year effect. Under this model, survival differed between pre-treatment and removal periods and it differed among years during the removal period, being >100% greater than pre-treatment survival (0.228) during the first removal year (0.513), similar to pre-treatment survival during the second removal year (0.202), and intermediate during the third removal year (0.431). Despite an initial increase, the overall effect of coyote removal on neonate survival was modest. Mortality rate attributable to coyote predation was lowest during the first removal year (0.357) when survival was greatest, but the mortality rate from all other causes did not differ between the pretreatment period and any year during removals, indicating that coyote predation acted as an additive source of mortality. Survival probability was not related to vegetation cover, either directly or in interaction with coyote abundance. When the objective is to increase the recruitment of white-tailed deer, we conclude that neither coyote control nor vegetation management appear effective. Reduction of the antlerless harvest may be necessary to meet this objective, but this harvest strategy warrants additional research in Southeastern deer populations.« less

Mechanisms for the inversion of chirality: global reaction route mapping of stereochemical pathways in a probable chiral extraterrestrial molecule, 2-aminopropionitrile.

PubMed

Kaur, Ramanpreet; Vikas

2015-02-21

2-Aminopropionitrile (APN), a probable candidate as a chiral astrophysical molecule, is a precursor to amino-acid alanine. Stereochemical pathways in 2-APN are explored using Global Reaction Route Mapping (GRRM) method employing high-level quantum-mechanical computations. Besides predicting the conventional mechanism for chiral inversion that proceeds through an achiral intermediate, a counterintuitive flipping mechanism is revealed for 2-APN through chiral intermediates explored using the GRRM. The feasibility of the proposed stereochemical pathways, in terms of the Gibbs free-energy change, is analyzed at the temperature conditions akin to the interstellar medium. Notably, the stereoinversion in 2-APN is observed to be more feasible than the dissociation of 2-APN and intermediates involved along the stereochemical pathways, and the flipping barrier is observed to be as low as 3.68 kJ/mol along one of the pathways. The pathways proposed for the inversion of chirality in 2-APN may provide significant insight into the extraterrestrial origin of life.

Sequential protein association with nascent 60S ribosomal particles.

PubMed

Saveanu, Cosmin; Namane, Abdelkader; Gleizes, Pierre-Emmanuel; Lebreton, Alice; Rousselle, Jean-Claude; Noaillac-Depeyre, Jacqueline; Gas, Nicole; Jacquier, Alain; Fromont-Racine, Micheline

2003-07-01

Ribosome biogenesis in eukaryotes depends on the coordinated action of ribosomal and nonribosomal proteins that guide the assembly of preribosomal particles. These intermediate particles follow a maturation pathway in which important changes in their protein composition occur. The mechanisms involved in the coordinated assembly of the ribosomal particles are poorly understood. We show here that the association of preribosomal factors with pre-60S complexes depends on the presence of earlier factors, a phenomenon essential for ribosome biogenesis. The analysis of the composition of purified preribosomal complexes blocked in maturation at specific steps allowed us to propose a model of sequential protein association with, and dissociation from, early pre-60S complexes for several preribosomal factors such as Mak11, Ssf1, Rlp24, Nog1, and Nog2. The presence of either Ssf1 or Nog2 in complexes that contain the 27SB pre-rRNA defines novel, distinct pre-60S particles that contain the same pre-rRNA intermediates and that differ only by the presence or absence of specific proteins. Physical and functional interactions between Rlp24 and Nog1 revealed that the assembly steps are, at least in part, mediated by direct protein-protein interactions.

Shockley-Read-Hall recombination in pre-filled and photo-filled intermediate band solar cells

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

Mayani, Maryam Gholami; Reenaas, Turid Worren, E-mail: turid.reenaas@ntnu.no

2014-08-18

In this work, we study how Shockley-Read-Hall (SRH) recombination via energy levels in the bandgap, caused by defects or impurities, affects the performance of both photo-filled and pre-filled intermediate band solar cells (IBSCs). For a pre-filled cell, the IB is half-filled in equilibrium, while it is empty for the photo-filled cell in equilibrium. The energy level, density, and capture cross-sections of the defects/impurities are varied systematically. We find that the photo-filled cells are, in general, less efficient than pre-filled cells, except when the defect level is between the conduction band and the IB. In that case, for a range ofmore » light intensities, the photo-filled cell performs better than the pre-filled. When the defect level is at the same energy as the IB, the efficiency is above 82% of the defect-free case, when less than 50% of the states at the IB lead to SRH recombination. This shows that even if SRH recombination via the IB takes place, high efficiencies can be achieved. We also show that band gap optimization can be used to reduce the SRH recombination.« less

Morphology of Dbx1 respiratory neurons in the preBötzinger complex and reticular formation of neonatal mice.

PubMed

Akins, Victoria T; Weragalaarachchi, Krishanthi; Picardo, Maria Cristina D; Revill, Ann L; Del Negro, Christopher A

2017-08-01

The relationship between neuron morphology and function is a perennial issue in neuroscience. Information about synaptic integration, network connectivity, and the specific roles of neuronal subpopulations can be obtained through morphological analysis of key neurons within a microcircuit. Here we present morphologies of two classes of brainstem respiratory neurons. First, interneurons derived from Dbx1-expressing precursors (Dbx1 neurons) in the preBötzinger complex (preBötC) of the ventral medulla that generate the rhythm for inspiratory breathing movements. Second, Dbx1 neurons of the intermediate reticular formation that influence the motor pattern of pharyngeal and lingual movements during the inspiratory phase of the breathing cycle. We describe the image acquisition and subsequent digitization of morphologies of respiratory Dbx1 neurons from the preBötC and the intermediate reticular formation that were first recorded in vitro. These data can be analyzed comparatively to examine how morphology influences the roles of Dbx1 preBötC and Dbx1 reticular interneurons in respiration and can also be utilized to create morphologically accurate compartmental models for simulation and modeling of respiratory circuits.

Which visual functions depend on intermediate visual regions? Insights from a case of developmental visual form agnosia.

PubMed

Gilaie-Dotan, Sharon

2016-03-01

A key question in visual neuroscience is the causal link between specific brain areas and perceptual functions; which regions are necessary for which visual functions? While the contribution of primary visual cortex and high-level visual regions to visual perception has been extensively investigated, the contribution of intermediate visual areas (e.g. V2/V3) to visual processes remains unclear. Here I review more than 20 visual functions (early, mid, and high-level) of LG, a developmental visual agnosic and prosopagnosic young adult, whose intermediate visual regions function in a significantly abnormal fashion as revealed through extensive fMRI and ERP investigations. While expectedly, some of LG's visual functions are significantly impaired, some of his visual functions are surprisingly normal (e.g. stereopsis, color, reading, biological motion). During the period of eight-year testing described here, LG trained on a perceptual learning paradigm that was successful in improving some but not all of his visual functions. Following LG's visual performance and taking into account additional findings in the field, I propose a framework for how different visual areas contribute to different visual functions, with an emphasis on intermediate visual regions. Thus, although rewiring and plasticity in the brain can occur during development to overcome and compensate for hindering developmental factors, LG's case seems to indicate that some visual functions are much less dependent on strict hierarchical flow than others, and can develop normally in spite of abnormal mid-level visual areas, thereby probably less dependent on intermediate visual regions. Copyright © 2015 Elsevier Ltd. All rights reserved.

Partial entrainment of gravel bars during floods

USGS Publications Warehouse

Konrad, Christopher P.; Booth, Derek B.; Burges, Stephen J.; Montgomery, David R.

2002-01-01

Spatial patterns of bed material entrainment by floods were documented at seven gravel bars using arrays of metal washers (bed tags) placed in the streambed. The observed patterns were used to test a general stochastic model that bed material entrainment is a spatially independent, random process where the probability of entrainment is uniform over a gravel bar and a function of the peak dimensionless shear stress τ0* of the flood. The fraction of tags missing from a gravel bar during a flood, or partial entrainment, had an approximately normal distribution with respect to τ0* with a mean value (50% of the tags entrained) of 0.085 and standard deviation of 0.022 (root‐mean‐square error of 0.09). Variation in partial entrainment for a given τ0* demonstrated the effects of flow conditioning on bed strength, with lower values of partial entrainment after intermediate magnitude floods (0.065 < τ0*< 0.08) than after higher magnitude floods. Although the probability of bed material entrainment was approximately uniform over a gravel bar during individual floods and independent from flood to flood, regions of preferential stability and instability emerged at some bars over the course of a wet season. Deviations from spatially uniform and independent bed material entrainment were most pronounced for reaches with varied flow and in consecutive floods with small to intermediate magnitudes.

Suspected pulmonary embolism and lung scan interpretation: Trial of a Bayesian reporting method

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

Becker, D.M.; Philbrick, J.T.; Schoonover, F.W.

The objective of this research is to determine whether a Bayesian method of lung scan (LS) reporting could influence the management of patients with suspected pulmonary embolism (PE). The study is performed by the following: (1) A descriptive study of the diagnostic process for suspected PE using the new reporting method; (2) a non-experimental evaluation of the reporting method comparing prospective patients and historical controls; and (3) a survey of physicians' reactions to the reporting innovation. Of 148 consecutive patients enrolled at the time of LS, 129 were completely evaluated; 75 patients scanned the previous year served as controls. Themore » LS results of patients with suspected PE were reported as posttest probabilities of PE calculated from physician-provided pretest probabilities and the likelihood ratios for PE of LS interpretations. Despite the Bayesian intervention, the confirmation or exclusion of PE was often based on inconclusive evidence. PE was considered by the clinician to be ruled out in 98% of patients with posttest probabilities less than 25% and ruled in for 95% of patients with posttest probabilities greater than 75%. Prospective patients and historical controls were similar in terms of tests ordered after the LS (e.g., pulmonary angiography). Patients with intermediate or indeterminate lung scan results had the highest proportion of subsequent testing. Most physicians (80%) found the reporting innovation to be helpful, either because it confirmed clinical judgement (94 cases) or because it led to additional testing (7 cases). Despite the probabilistic guidance provided by the study, the diagnosis of PE was often neither clearly established nor excluded. While physicians appreciated the innovation and were not confused by the terminology, their clinical decision making was not clearly enhanced.« less

Pulmonary hypertension in interstitial lung disease: Limitations of echocardiography compared to cardiac catheterization.

PubMed

Keir, Gregory J; Wort, S John; Kokosi, Maria; George, Peter M; Walsh, Simon L F; Jacob, Joseph; Price, Laura; Bax, Simon; Renzoni, Elisabetta A; Maher, Toby M; MacDonald, Peter; Hansell, David M; Wells, Athol U

2018-01-12

In interstitial lung disease (ILD), pulmonary hypertension (PH) is a major adverse prognostic determinant. Transthoracic echocardiography (TTE) is the most widely used tool when screening for PH, although discordance between TTE and right heart catheter (RHC) measured pulmonary haemodynamics is increasingly recognized. We evaluated the predictive utility of the updated European Society of Cardiology/European Respiratory Society (ESC/ERS) TTE screening recommendations against RHC testing in a large, well-characterized ILD cohort. Two hundred and sixty-five consecutive patients with ILD and suspected PH underwent comprehensive assessment, including RHC, between 2006 and 2012. ESC/ERS recommended tricuspid regurgitation (TR) velocity thresholds for assigning high (>3.4 m/s), intermediate (2.9-3.4 m/s) and low (<2.8 m/s) probabilities of PH were evaluated against RHC testing. RHC testing confirmed PH in 86% of subjects with a peak TR velocity >3.4 m/s, and excluded PH in 60% of ILD subjects with a TR velocity <2.8 m/s. Thus, the ESC/ERS guidelines misclassified 40% of subjects as 'low probability' of PH, when PH was confirmed on subsequent RHC. Evaluating alternative TR velocity thresholds for assigning a low probability of PH did not significantly improve the ability of TR velocity to exclude a diagnosis of PH. In patients with ILD and suspected PH, currently recommended ESC/ERS TR velocity screening thresholds were associated with a high positive predictive value (86%) for confirming PH, but were of limited value in excluding PH, with 40% of patients misclassified as low probability when PH was confirmed at subsequent RHC. © 2018 Asian Pacific Society of Respirology.

The Differential Effects of an Opt-Out HIV Testing Policy for Pregnant Women in Ethiopia When Accounting for Stigma: Secondary Analysis of DHS Data.

PubMed

Kaufman, Michelle R; Mooney, Alyssa; Gebretsadik, Lakew Abebe; Sudhakar, Morankar N; Rieder, Rachel; Limaye, Rupali J; Girma, Eshetu; Rimal, Rajiv N

2017-02-01

Individual factors associated with HIV testing have been studied across multiple populations; however, testing is not just an individual-level phenomenon. This secondary analysis of 2005 and 2011 Ethiopia Demographic and Health Survey data was conducted to determine the extent to which the 2007 institution of an opt-out policy of HIV testing during antenatal care increased testing among women, and whether effects differed by women's stigmatizing beliefs about HIV. A logit model with interaction between pre-/post-policy year and policy exposure (birth in the past year) was used to estimate the increased probability of past-year testing, which may be attributable to the policy. Results suggested the policy contributed to a nine-point increase in the probability of testing (95% CI 0.06-0.13, p < 0.0001). A three-way interaction was used to compare the effects of exposure to the policy among women holding higher and lower HIV stigmatizing beliefs. The increase in the probability of past-year testing was 16 percentage points greater among women with lower stigmatizing beliefs (95% CI 0.06-0.27, p = 0.002). Women with higher stigmatizing beliefs were less likely to report attending antenatal care (ANC), testing at their last ANC visit, or being offered a test at their last ANC visit. We encourage researchers and practitioners to explore interventions that operate at multiple levels of socio-ecological spheres of influence, addressing both stigma and structural barriers to testing, in order to achieve the greatest results in preventing HIV.

Yuji Tonomura: a pioneer in the field of energy transduction in muscle contraction.

PubMed

Onishi, Hirofumi

2009-07-01

Late Professor Yuji Tonomura has made a great contribution in the study of energy transduction in muscle contraction. He was the investigator who first proposed that a myosin-phosphate intermediate is produced subsequently to the Michaelis-Menten complex in the pre-steady state of the myosin ATPase reaction and that it is a key intermediate for muscle contraction. Here, his proposed intermediate will be viewed from the prospective of today's understanding of actomyosin ATPase kinetics and in the context of myosin motor domain crystal structures.

The use of complete sets of orthogonal operators in spectroscopic studies

NASA Astrophysics Data System (ADS)

Raassen, A. J. J.; Uylings, P. H. M.

1996-01-01

Complete sets of orthogonal operators are used to calculate eigenvalues and eigenvector compositions in complex spectra. The latter are used to transform the LS-transition matrix into realistic intermediate coupling transition probabilities. Calculated transition probabilities for some close lying levels in Ni V and Fe III illustrate the power of the complete orthogonal operator approach.

A probable case of congenital syphilis from pre-Columbian Austria.

PubMed

Gaul, Johanna Sophia; Grossschmidt, Karl; Gusenbauer, Christian; Kanz, Fabian

2015-01-01

This study examines the skeletal remains of a subadult from an archeological site in Austria. Radiocarbon dating and archeological attribution indicate that this individual is of pre-Columbian origin. Most of the skeleton was recovered, and only the teeth and the orbital roofs show changes. Dental defects such as the mulberry molar and a tapered, fang-like canine suggest a diagnosis of congenital syphilis. This is the first probable case of congenital syphilis from pre-Columbian Central Europe. Our findings contribute to the pre-Columbian theory, offering counter evidence to the assumption that syphilis was carried from Columbus' crew from the New to the Old World.

Computed tomography versus invasive coronary angiography: design and methods of the pragmatic randomised multicentre DISCHARGE trial.

PubMed

Napp, Adriane E; Haase, Robert; Laule, Michael; Schuetz, Georg M; Rief, Matthias; Dreger, Henryk; Feuchtner, Gudrun; Friedrich, Guy; Špaček, Miloslav; Suchánek, Vojtěch; Fuglsang Kofoed, Klaus; Engstroem, Thomas; Schroeder, Stephen; Drosch, Tanja; Gutberlet, Matthias; Woinke, Michael; Maurovich-Horvat, Pál; Merkely, Béla; Donnelly, Patrick; Ball, Peter; Dodd, Jonathan D; Quinn, Martin; Saba, Luca; Porcu, Maurizio; Francone, Marco; Mancone, Massimo; Erglis, Andrejs; Zvaigzne, Ligita; Jankauskas, Antanas; Sakalyte, Gintare; Harań, Tomasz; Ilnicka-Suckiel, Malgorzata; Bettencourt, Nuno; Gama-Ribeiro, Vasco; Condrea, Sebastian; Benedek, Imre; Čemerlić Adjić, Nada; Adjić, Oto; Rodriguez-Palomares, José; Garcia Del Blanco, Bruno; Roditi, Giles; Berry, Colin; Davis, Gershan; Thwaite, Erica; Knuuti, Juhani; Pietilä, Mikko; Kępka, Cezary; Kruk, Mariusz; Vidakovic, Radosav; Neskovic, Aleksandar N; Díez, Ignacio; Lecumberri, Iñigo; Geleijns, Jacob; Kubiak, Christine; Strenge-Hesse, Anke; Do, The-Hoang; Frömel, Felix; Gutiérrez-Ibarluzea, Iñaki; Benguria-Arrate, Gaizka; Keiding, Hans; Katzer, Christoph; Müller-Nordhorn, Jacqueline; Rieckmann, Nina; Walther, Mario; Schlattmann, Peter; Dewey, Marc

2017-07-01

More than 3.5 million invasive coronary angiographies (ICA) are performed in Europe annually. Approximately 2 million of these invasive procedures might be reduced by noninvasive tests because no coronary intervention is performed. Computed tomography (CT) is the most accurate noninvasive test for detection and exclusion of coronary artery disease (CAD). To investigate the comparative effectiveness of CT and ICA, we designed the European pragmatic multicentre DISCHARGE trial funded by the 7th Framework Programme of the European Union (EC-GA 603266). In this trial, patients with a low-to-intermediate pretest probability (10-60 %) of suspected CAD and a clinical indication for ICA because of stable chest pain will be randomised in a 1-to-1 ratio to CT or ICA. CT and ICA findings guide subsequent management decisions by the local heart teams according to current evidence and European guidelines. Major adverse cardiovascular events (MACE) defined as cardiovascular death, myocardial infarction and stroke as a composite endpoint will be the primary outcome measure. Secondary and other outcomes include cost-effectiveness, radiation exposure, health-related quality of life (HRQoL), socioeconomic status, lifestyle, adverse events related to CT/ICA, and gender differences. The DISCHARGE trial will assess the comparative effectiveness of CT and ICA. • Coronary artery disease (CAD) is a major cause of morbidity and mortality. • Invasive coronary angiography (ICA) is the reference standard for detection of CAD. • Noninvasive computed tomography angiography excludes CAD with high sensitivity. • CT may effectively reduce the approximately 2 million negative ICAs in Europe. • DISCHARGE addresses this hypothesis in patients with low-to-intermediate pretest probability for CAD.

Dual role for argonautes in microRNA processing and posttranscriptional regulation of microRNA expression.

PubMed

Diederichs, Sven; Haber, Daniel A

2007-12-14

MicroRNAs are small endogenous noncoding RNAs involved in posttranscriptional gene regulation. During microRNA biogenesis, Drosha and Dicer process the primary transcript (pri-miRNA) through a precursor hairpin (pre-miRNA) to the mature miRNA. The miRNA is incorporated into the RNA-Induced Silencing Complex (RISC) with Argonaute proteins, the effector molecules in RNA interference (RNAi). Here, we show that all Argonautes elevate mature miRNA expression posttranscriptionally, independent of RNase activity. Also, we identify a role for the RISC slicer Argonaute2 (Ago2) in cleaving the pre-miRNA to an additional processing intermediate, termed Ago2-cleaved precursor miRNA or ac-pre-miRNA. This endogenous, on-pathway intermediate results from cleavage of the pre-miRNA hairpin 12 nucleotides from its 3'-end. By analogy to siRNA processing, Ago2 cleavage may facilitate removal of the nicked passenger strand from RISC after maturation. The multiple roles of Argonautes in the RNAi effector phase and miRNA biogenesis and maturation suggest coordinate regulation of microRNA expression and function.

Home is Hard to Find: Neighborhoods, Institutions, and the Residential Trajectories of Returning Prisoners

PubMed Central

Harding, David J.; Morenoff, Jeffrey D.; Herbert, Claire W.

2012-01-01

Poor urban communities experience high rates of incarceration and prisoner reentry. This paper examines the residences where former prisoners live after prison, focusing on returns to pre-prison social environments, residential mobility, and the role of intermediate sanctions. Drawing on a unique dataset that follows a cohort of Michigan parolees released in 2003 over time using administrative records, we examine returns to pre-prison environments, both immediately after prison and in the months and years after release. We then investigate the role of intermediate sanctions – punishments for parole violations that are less severe than returning to prison – in residential mobility among parolees. Our results show low rates of return to former neighborhoods and high rates of residential mobility after prison, a significant portion of which is driven by intermediate sanctions resulting from criminal justice system supervision. These results suggest that, through parole supervision, the criminal justice system generates significant residential mobility. PMID:23645931

When Do We Really Need Coronary Calcium Scoring Prior to Contrast-Enhanced Coronary Computed Tomography Angiography? Analysis by Age, Gender and Coronary Risk Factors

PubMed Central

Iwan, Johannes; Voss, Andreas; Atsiatorme, Edem; Hofmann, Nina P.; Buss, Sebastian J.; Siebert, Stefan; Kauczor, Hans-Ulrich; Giannitsis, Evangelos; Katus, Hugo A.; Korosoglou, Grigorios

2014-01-01

Aims To investigate the value of coronary calcium scoring (CCS) as a filter scan prior to coronary computed tomography angiography (CCTA). Methods and Results Between February 2008 and April 2011, 732 consecutive patients underwent clinically indicated CCTA. During this ‘control phase’, CCS was performed in all patients. In patients with CCS≥800, CCTA was not performed. During a subsequent ‘CCTA phase’ (May 2011–May 2012) another 200 consecutive patients underwent CCTA, and CCS was performed only in patients with increased probability for severe calcification according to age, gender and atherogenic risk factors. In patients where CCS was not performed, calcium scoring was performed in contrast-enhanced CCTA images. Significant associations were noted between CCS and age (r = 0.30, p<0.001) and coronary risk factors (χ2 = 37.9; HR = 2.2; 95%CI = 1.7–2.9, p<0.001). Based on these associations, a ≤3% pre-test probability for CCS≥800 was observed for males <61 yrs. and females <79 yrs. According to these criteria, CCS was not performed in 106 of 200 (53%) patients during the ‘CCTA phase’, including 47 (42%) males and 59 (67%) females. This resulted in absolute radiation saving of ∼1 mSv in 75% of patients younger than 60 yrs. Of 106 patients where CCS was not performed, estimated calcium scoring was indeed <800 in 101 (95%) cases. Non-diagnostic image quality due to calcification was similar between the ‘control phase’ and the ‘CCTA’ group (0.25% versus 0.40%, p = NS). Conclusion The value of CCS as a filter for identification of a high calcium score is limited in younger patients with intermediate risk profile. Omitting CCS in such patients can contribute to further dose reduction with cardiac CT studies. PMID:24714677

Assessing agreement with relative area under the coverage probability curve.

PubMed

Barnhart, Huiman X

2016-08-15

There has been substantial statistical literature in the last several decades on assessing agreement, and coverage probability approach was selected as a preferred index for assessing and improving measurement agreement in a core laboratory setting. With this approach, a satisfactory agreement is based on pre-specified high satisfactory coverage probability (e.g., 95%), given one pre-specified acceptable difference. In practice, we may want to have quality control on more than one pre-specified differences, or we may simply want to summarize the agreement based on differences up to a maximum acceptable difference. We propose to assess agreement via the coverage probability curve that provides a full spectrum of measurement error at various differences/disagreement. Relative area under the coverage probability curve is proposed for the summary of overall agreement, and this new summary index can be used for comparison of different intra-methods or inter-methods/labs/observers' agreement. Simulation studies and a blood pressure example are used for illustration of the methodology. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Ancient DNA Analysis Suggests Negligible Impact of the Wari Empire Expansion in Peru’s Central Coast during the Middle Horizon

PubMed Central

Barreto Romero, María Inés; Flores Espinoza, Isabel; Cooper, Alan; Fehren-Schmitz, Lars

2016-01-01

The analysis of ancient human DNA from South America allows the exploration of pre-Columbian population history through time and to directly test hypotheses about cultural and demographic evolution. The Middle Horizon (650–1100 AD) represents a major transitional period in the Central Andes, which is associated with the development and expansion of ancient Andean empires such as Wari and Tiwanaku. These empires facilitated a series of interregional interactions and socio-political changes, which likely played an important role in shaping the region’s demographic and cultural profiles. We analyzed individuals from three successive pre-Columbian cultures present at the Huaca Pucllana archaeological site in Lima, Peru: Lima (Early Intermediate Period, 500–700 AD), Wari (Middle Horizon, 800–1000 AD) and Ychsma (Late Intermediate Period, 1000–1450 AD). We sequenced 34 complete mitochondrial genomes to investigate the potential genetic impact of the Wari Empire in the Central Coast of Peru. The results indicate that genetic diversity shifted only slightly through time, ruling out a complete population discontinuity or replacement driven by the Wari imperialist hegemony, at least in the region around present-day Lima. However, we caution that the very subtle genetic contribution of Wari imperialism at the particular Huaca Pucllana archaeological site might not be representative for the entire Wari territory in the Peruvian Central Coast. PMID:27248693

Ancient DNA Analysis Suggests Negligible Impact of the Wari Empire Expansion in Peru's Central Coast during the Middle Horizon.

PubMed

Valverde, Guido; Barreto Romero, María Inés; Flores Espinoza, Isabel; Cooper, Alan; Fehren-Schmitz, Lars; Llamas, Bastien; Haak, Wolfgang

2016-01-01

The analysis of ancient human DNA from South America allows the exploration of pre-Columbian population history through time and to directly test hypotheses about cultural and demographic evolution. The Middle Horizon (650-1100 AD) represents a major transitional period in the Central Andes, which is associated with the development and expansion of ancient Andean empires such as Wari and Tiwanaku. These empires facilitated a series of interregional interactions and socio-political changes, which likely played an important role in shaping the region's demographic and cultural profiles. We analyzed individuals from three successive pre-Columbian cultures present at the Huaca Pucllana archaeological site in Lima, Peru: Lima (Early Intermediate Period, 500-700 AD), Wari (Middle Horizon, 800-1000 AD) and Ychsma (Late Intermediate Period, 1000-1450 AD). We sequenced 34 complete mitochondrial genomes to investigate the potential genetic impact of the Wari Empire in the Central Coast of Peru. The results indicate that genetic diversity shifted only slightly through time, ruling out a complete population discontinuity or replacement driven by the Wari imperialist hegemony, at least in the region around present-day Lima. However, we caution that the very subtle genetic contribution of Wari imperialism at the particular Huaca Pucllana archaeological site might not be representative for the entire Wari territory in the Peruvian Central Coast.

Altered nuclear tRNA metabolism in La-deleted Schizosaccharomyces pombe is accompanied by a nutritional stress response involving Atf1p and Pcr1p that is suppressible by Xpo-t/Los1p.

PubMed

Cherkasova, Vera; Maury, Luis Lopez; Bacikova, Dagmar; Pridham, Kevin; Bähler, Jürg; Maraia, Richard J

2012-02-01

Deletion of the sla1(+) gene, which encodes a homologue of the human RNA-binding protein La in Schizosaccharomyces pombe, causes irregularities in tRNA processing, with altered distribution of pre-tRNA intermediates. We show, using mRNA profiling, that cells lacking sla1(+) have increased mRNAs from amino acid metabolism (AAM) genes and, furthermore, exhibit slow growth in Edinburgh minimal medium. A subset of these AAM genes is under control of the AP-1-like, stress-responsive transcription factors Atf1p and Pcr1p. Although S. pombe growth is resistant to rapamycin, sla1-Δ cells are sensitive, consistent with deficiency of leucine uptake, hypersensitivity to NH4, and genetic links to the target of rapamycin (TOR) pathway. Considering that perturbed intranuclear pre-tRNA metabolism and apparent deficiency in tRNA nuclear export in sla1-Δ cells may trigger the AAM response, we show that modest overexpression of S. pombe los1(+) (also known as Xpo-t), encoding the nuclear exportin for tRNA, suppresses the reduction in pre-tRNA levels, AAM gene up-regulation, and slow growth of sla1-Δ cells. The conclusion that emerges is that sla1(+) regulates AAM mRNA production in S. pombe through its effects on nuclear tRNA processing and probably nuclear export. Finally, the results are discussed in the context of stress response programs in Saccharomyces cerevisiae.

Altered nuclear tRNA metabolism in La-deleted Schizosaccharomyces pombe is accompanied by a nutritional stress response involving Atf1p and Pcr1p that is suppressible by Xpo-t/Los1p

PubMed Central

Cherkasova, Vera; Lopez Maury, Luis; Bacikova, Dagmar; Pridham, Kevin; Bähler, Jürg; Maraia, Richard J.

2012-01-01

Deletion of the sla1+ gene, which encodes a homologue of the human RNA-binding protein La in Schizosaccharomyces pombe, causes irregularities in tRNA processing, with altered distribution of pre-tRNA intermediates. We show, using mRNA profiling, that cells lacking sla1+ have increased mRNAs from amino acid metabolism (AAM) genes and, furthermore, exhibit slow growth in Edinburgh minimal medium. A subset of these AAM genes is under control of the AP-1–like, stress-responsive transcription factors Atf1p and Pcr1p. Although S. pombe growth is resistant to rapamycin, sla1-Δ cells are sensitive, consistent with deficiency of leucine uptake, hypersensitivity to NH4, and genetic links to the target of rapamycin (TOR) pathway. Considering that perturbed intranuclear pre-tRNA metabolism and apparent deficiency in tRNA nuclear export in sla1-Δ cells may trigger the AAM response, we show that modest overexpression of S. pombe los1+ (also known as Xpo-t), encoding the nuclear exportin for tRNA, suppresses the reduction in pre-tRNA levels, AAM gene up-regulation, and slow growth of sla1-Δ cells. The conclusion that emerges is that sla1+ regulates AAM mRNA production in S. pombe through its effects on nuclear tRNA processing and probably nuclear export. Finally, the results are discussed in the context of stress response programs in Saccharomyces cerevisiae. PMID:22160596

Software for Training in Pre-College Mathematics

NASA Technical Reports Server (NTRS)

Shelton, Robert O.; Moebes, Travis A.; VanAlstine, Scot

2003-01-01

The Intelligent Math Tutor (IMT) is a computer program for training students in pre-college and college-level mathematics courses, including fundamentals, intermediate algebra, college algebra, and trigonometry. The IMT can be executed on a server computer for access by students via the Internet; alternatively, it can be executed on students computers equipped with compact- disk/read-only-memory (CD-ROM) drives. The IMT provides interactive exercises, assessment, tracking, and an on-line graphing calculator with algebraic-manipulation capabilities. The IMT provides an innovative combination of content, delivery mechanism, and artificial intelligence. Careful organization and presentation of the content make it possible to provide intelligent feedback to the student based on performance on exercises and tests. The tracking and feedback mechanisms are implemented within the capabilities of a commercial off-the-shelf development software tool and are written in the Unified Modeling Language to maximize reuse and minimize development cost. The graphical calculator is a standard feature of most college and pre-college algebra and trigonometry courses. Placing this functionality in a Java applet decreases the cost, provides greater capabilities, and provides an opportunity to integrate the calculator with the lessons.

Inconclusive quantum measurements and decisions under uncertainty

NASA Astrophysics Data System (ADS)

Yukalov, Vyacheslav; Sornette, Didier

2016-04-01

We give a mathematical definition for the notion of inconclusive quantum measurements. In physics, such measurements occur at intermediate stages of a complex measurement procedure, with the final measurement result being operationally testable. Since the mathematical structure of Quantum Decision Theory has been developed in analogy with the theory of quantum measurements, the inconclusive quantum measurements correspond, in Quantum Decision Theory, to intermediate stages of decision making in the process of taking decisions under uncertainty. The general form of the quantum probability for a composite event is the sum of a utility factor, describing a rational evaluation of the considered prospect, and of an attraction factor, characterizing irrational, subconscious attitudes of the decision maker. Despite the involved irrationality, the probability of prospects can be evaluated. This is equivalent to the possibility of calculating quantum probabilities without specifying hidden variables. We formulate a general way of evaluation, based on the use of non-informative priors. As an example, we suggest the explanation of the decoy effect. Our quantitative predictions are in very good agreement with experimental data.

Assessment of nurses' cardiopulmonary resuscitation knowledge and skills within three district hospitals in Botswana.

PubMed

Rajeswaran, Lakshmi; Cox, Megan; Moeng, Stoffel; Tsima, Billy M

2018-04-12

 Nurses are usually the first to identify the need for and initiate cardiopulmonary resuscitation (CPR) on patients with cardiopulmonary arrest in the hospital setting. Cardiopulmonary resuscitation has been shown to reduce in-hospital deaths when received from adequately trained health care professionals.  We aimed to investigate nurses' retention of CPR knowledge and skills at district hospitals in Botswana.  A quantitative, quasi-experimental study was conducted at three hospitals in Botswana. A pre-test, intervention, post-test, and a re-test after 6 months were utilised to determine the retention of CPR knowledge and skills. Non-probability, convenience sampling technique was used to select 154 nurses.The sequences of the test were consistent with the American Heart Association's 2010 basic life support (BLS) guidelines for health care providers. Data were analysed to compare performance over time.  This study showed markedly deficient CPR knowledge and skills among registered nurses in the three district hospitals. The pre-test knowledge average score (48%) indicated that the nurses did not know the majority of the BLS steps. Only 85 nurses participated in the re-evaluation test at 6 months. While a 26.4% increase was observed in the immediate post-test score compared with the pre-test, the performance of the available participants dropped by 14.5% in the re-test 6 months after the post-test.  Poor CPR knowledge and skills among registered nurses may impede the survival and management of cardiac arrest victims. Employers and nursing professional bodies in Botswana should encourage and monitor regular CPR refresher courses.

Assessment of nurses’ cardiopulmonary resuscitation knowledge and skills within three district hospitals in Botswana

PubMed Central

2018-01-01

Background Nurses are usually the first to identify the need for and initiate cardiopulmonary resuscitation (CPR) on patients with cardiopulmonary arrest in the hospital setting. Cardiopulmonary resuscitation has been shown to reduce in-hospital deaths when received from adequately trained health care professionals. Aim We aimed to investigate nurses’ retention of CPR knowledge and skills at district hospitals in Botswana. Methods A quantitative, quasi-experimental study was conducted at three hospitals in Botswana. A pre-test, intervention, post-test, and a re-test after 6 months were utilised to determine the retention of CPR knowledge and skills. Non-probability, convenience sampling technique was used to select 154 nurses. The sequences of the test were consistent with the American Heart Association’s 2010 basic life support (BLS) guidelines for health care providers. Data were analysed to compare performance over time. Results This study showed markedly deficient CPR knowledge and skills among registered nurses in the three district hospitals. The pre-test knowledge average score (48%) indicated that the nurses did not know the majority of the BLS steps. Only 85 nurses participated in the re-evaluation test at 6 months. While a 26.4% increase was observed in the immediate post-test score compared with the pre-test, the performance of the available participants dropped by 14.5% in the re-test 6 months after the post-test. Conclusion Poor CPR knowledge and skills among registered nurses may impede the survival and management of cardiac arrest victims. Employers and nursing professional bodies in Botswana should encourage and monitor regular CPR refresher courses. PMID:29781687

Teaching Probability to Pre-Service Teachers with Argumentation Based Science Learning Approach

ERIC Educational Resources Information Center

Can, Ömer Sinan; Isleyen, Tevfik

2016-01-01

The aim of this study is to explore the effects of the argumentation based science learning (ABSL) approach on the teaching probability to pre-service teachers. The sample of the study included 41 students studying at the Department of Elementary School Mathematics Education in a public university during the 2014-2015 academic years. The study is…

Hidden Markov analysis of mechanosensitive ion channel gating.

PubMed

Khan, R Nazim; Martinac, Boris; Madsen, Barry W; Milne, Robin K; Yeo, Geoffrey F; Edeson, Robert O

2005-02-01

Patch clamp data from the large conductance mechanosensitive channel (MscL) in E. coli was studied with the aim of developing a strategy for statistical analysis based on hidden Markov models (HMMs) and determining the number of conductance levels of the channel, together with mean current, mean dwell time and equilibrium probability of occupancy for each level. The models incorporated state-dependent white noise and moving average adjustment for filtering, with maximum likelihood parameter estimates obtained using an EM (expectation-maximisation) based iteration. Adjustment for filtering was included as it could be expected that the electronic filter used in recording would have a major effect on obviously brief intermediate conductance level sojourns. Preliminary data analysis revealed that the brevity of intermediate level sojourns caused difficulties in assignment of data points to levels as a result of over-estimation of noise variances. When reasonable constraints were placed on these variances using the better determined noise variances for the closed and fully open levels, idealisation anomalies were eliminated. Nevertheless, simulations suggested that mean sojourn times for the intermediate levels were still considerably over-estimated, and that recording bandwidth was a major limitation; improved results were obtained with higher bandwidth data (10 kHz sampled at 25 kHz). The simplest model consistent with these data had four open conductance levels, intermediate levels being approximately 20%, 51% and 74% of fully open. The mean lifetime at the fully open level was about 1 ms; estimates for the three intermediate levels were 54-92 micros, probably still over-estimates.

Degradation of triclosan and its main intermediates during the combined irradiation and biological treatment.

PubMed

Wang, Shizong; Wang, Jianlong

2018-05-01

Triclosan is an extensively applied antimicrobial agent which has been frequently detected in the environment. In this paper, the degradation of triclosan and its main intermediates was investigated during the combined irradiation and biological treatment. The results showed that triclosan degradation increased with increase of absorbed dose, the removal efficiency of triclosan was 62%, 77%, 87%, 91% and 94%, respectively at 1, 2, 3, 4 and 5 kGy. The final removal efficiency of triclosan after the combined irradiation and biological process was 81%, 86%, 90%, 92% and 95%, respectively. During the irradiation process, two main intermediates, that is, 4,4'-2'-phenoxyphenol (Intermediate 1) and 4-chloro-2'-phenoxyphenol (Intermediate 2) were detected, in which Intermediate 1 dominated during the irradiation process. In the following biological treatment process, Intermediates 1 and 2 could be further degraded. In single biological treatment process, the final removal efficiency of triclosan was 54%, and Intermediates 1 and 2 were detected. Intermediate 1 could be biodegraded while Intermediate 2 could not. The concentration of Intermediate 2 increased during biological treatment process. In conclusion, irradiation as pre-treatment process can enhance the degradation of triclosan and improve the biodegradability of Intermediate 2. Combined irradiation and biological process can be promising for treating antibiotic-containing wastewater.

Electrodiagnosis of ulnar neuropathy at the elbow (Une): a Bayesian approach.

PubMed

Logigian, Eric L; Villanueva, Raissa; Twydell, Paul T; Myers, Bennett; Downs, Marlene; Preston, David C; Kothari, Milind J; Herrmann, David N

2014-03-01

In ulnar neuropathy at the elbow (UNE), we determined how electrodiagnostic cutoffs [across-elbow ulnar motor conduction velocity slowing (AECV-slowing), drop in across-elbow vs. forearm CV (AECV-drop)] depend on pretest probability (PreTP). Fifty clinically defined UNE patients and 50 controls underwent ulnar conduction testing recording abductor digiti minimi (ADM) and first dorsal interosseous (FDI), stimulating wrist, below-elbow, and 6-, 8-, and 10-cm more proximally. For various PreTPs of UNE, the cutoffs required to confirm UNE (defined as posttest probability = 95%) were determined with receiver operator characteristic (ROC) curves and Bayes Theorem. On ROC and Bayesian analyses, the ADM 10-cm montage was optimal. For PreTP = 0.25, the confirmatory cutoffs were >23 m/s (AECV-drop), and <38 m/s (AECV-slowing); for PreTP = 0.75, they were much less conservative: >14 m/s, and <47 m/s, respectively. (1) In UNE, electrodiagnostic cutoffs are critically dependent on PreTP; rigid cutoffs are problematic. (2) AE distances should be standardized and at least 10 cm. Copyright © 2013 Wiley Periodicals, Inc.

Genomic Evidence that Methanotrophic Endosymbionts Likely Provide Deep-Sea Bathymodiolus Mussels with a Sterol Intermediate in Cholesterol Biosynthesis

PubMed Central

Takaki, Yoshihiro; Chikaraishi, Yoshito; Ikuta, Tetsuro; Ozawa, Genki; Yoshida, Takao; Ohkouchi, Naohiko; Fujikura, Katsunori

2017-01-01

Sterols are key cyclic triterpenoid lipid components of eukaryotic cellular membranes, which are synthesized through complex multi-enzyme pathways. Similar to most animals, Bathymodiolus mussels, which inhabit deep-sea chemosynthetic ecosystems and harbor methanotrophic and/or thiotrophic bacterial endosymbionts, possess cholesterol as their main sterol. Based on the stable carbon isotope analyses, it has been suggested that host Bathymodiolus mussels synthesize cholesterol using a sterol intermediate derived from the methanotrophic endosymbionts. To test this hypothesis, we sequenced the genome of the methanotrophic endosymbiont in Bathymodiolus platifrons. The genome sequence data demonstrated that the endosymbiont potentially generates up to 4,4-dimethyl-cholesta-8,14,24-trienol, a sterol intermediate in cholesterol biosynthesis, from methane. In addition, transcripts for a subset of the enzymes of the biosynthetic pathway to cholesterol downstream from a sterol intermediate derived from methanotroph endosymbionts were detected in our transcriptome data for B. platifrons. These findings suggest that this mussel can de novo synthesize cholesterol from methane in cooperation with the symbionts. By in situ hybridization analyses, we showed that genes associated with cholesterol biosynthesis from both host and endosymbionts were expressed exclusively in the gill epithelial bacteriocytes containing endosymbionts. Thus, cholesterol production is probably localized within these specialized cells of the gill. Considering that the host mussel cannot de novo synthesize cholesterol and depends largely on endosymbionts for nutrition, the capacity of endosymbionts to synthesize sterols may be important in establishing symbiont–host relationships in these chemosynthetic mussels. PMID:28453654

Image processing and machine learning for fully automated probabilistic evaluation of medical images.

PubMed

Sajn, Luka; Kukar, Matjaž

2011-12-01

The paper presents results of our long-term study on using image processing and data mining methods in a medical imaging. Since evaluation of modern medical images is becoming increasingly complex, advanced analytical and decision support tools are involved in integration of partial diagnostic results. Such partial results, frequently obtained from tests with substantial imperfections, are integrated into ultimate diagnostic conclusion about the probability of disease for a given patient. We study various topics such as improving the predictive power of clinical tests by utilizing pre-test and post-test probabilities, texture representation, multi-resolution feature extraction, feature construction and data mining algorithms that significantly outperform medical practice. Our long-term study reveals three significant milestones. The first improvement was achieved by significantly increasing post-test diagnostic probabilities with respect to expert physicians. The second, even more significant improvement utilizes multi-resolution image parametrization. Machine learning methods in conjunction with the feature subset selection on these parameters significantly improve diagnostic performance. However, further feature construction with the principle component analysis on these features elevates results to an even higher accuracy level that represents the third milestone. With the proposed approach clinical results are significantly improved throughout the study. The most significant result of our study is improvement in the diagnostic power of the whole diagnostic process. Our compound approach aids, but does not replace, the physician's judgment and may assist in decisions on cost effectiveness of tests. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

Interpreting results of cluster surveys in emergency settings: is the LQAS test the best option?

PubMed

Bilukha, Oleg O; Blanton, Curtis

2008-12-09

Cluster surveys are commonly used in humanitarian emergencies to measure health and nutrition indicators. Deitchler et al. have proposed to use Lot Quality Assurance Sampling (LQAS) hypothesis testing in cluster surveys to classify the prevalence of global acute malnutrition as exceeding or not exceeding the pre-established thresholds. Field practitioners and decision-makers must clearly understand the meaning and implications of using this test in interpreting survey results to make programmatic decisions. We demonstrate that the LQAS test--as proposed by Deitchler et al.--is prone to producing false-positive results and thus is likely to suggest interventions in situations where interventions may not be needed. As an alternative, to provide more useful information for decision-making, we suggest reporting the probability of an indicator's exceeding the threshold as a direct measure of "risk". Such probability can be easily determined in field settings by using a simple spreadsheet calculator. The "risk" of exceeding the threshold can then be considered in the context of other aggravating and protective factors to make informed programmatic decisions.

Exome sequencing identifies CTSK mutations in patients originally diagnosed as intermediate osteopetrosis.

PubMed

Pangrazio, Alessandra; Puddu, Alessandro; Oppo, Manuela; Valentini, Maria; Zammataro, Luca; Vellodi, Ashok; Gener, Blanca; Llano-Rivas, Isabel; Raza, Jamal; Atta, Irum; Vezzoni, Paolo; Superti-Furga, Andrea; Villa, Anna; Sobacchi, Cristina

2014-02-01

Autosomal Recessive Osteopetrosis is a genetic disorder characterized by increased bone density due to lack of resorption by the osteoclasts. Genetic studies have widely unraveled the molecular basis of the most severe forms, while cases of intermediate severity are more difficult to characterize, probably because of a large heterogeneity. Here, we describe the use of exome sequencing in the molecular diagnosis of 2 siblings initially thought to be affected by "intermediate osteopetrosis", which identified a homozygous mutation in the CTSK gene. Prompted by this finding, we tested by Sanger sequencing 25 additional patients addressed to us for recessive osteopetrosis and found CTSK mutations in 4 of them. In retrospect, their clinical and radiographic features were found to be compatible with, but not typical for, Pycnodysostosis. We sought to identify modifier genes that might have played a role in the clinical manifestation of the disease in these patients, but our results were not informative. In conclusion, we underline the difficulties of differential diagnosis in some patients whose clinical appearance does not fit the classical malignant or benign picture and recommend that CTSK gene be included in the molecular diagnosis of high bone density conditions. Copyright © 2013 The Authors. Published by Elsevier Inc. All rights reserved.

Study on Effects of the Stochastic Delay Probability for 1d CA Model of Traffic Flow

NASA Astrophysics Data System (ADS)

Xue, Yu; Chen, Yan-Hong; Kong, Ling-Jiang

Considering the effects of different factors on the stochastic delay probability, the delay probability has been classified into three cases. The first case corresponding to the brake state has a large delay probability if the anticipant velocity is larger than the gap between the successive cars. The second one corresponding to the following-the-leader rule has intermediate delay probability if the anticipant velocity is equal to the gap. Finally, the third case is the acceleration, which has minimum delay probability. The fundamental diagram obtained by numerical simulation shows the different properties compared to that by the NaSch model, in which there exist two different regions, corresponding to the coexistence state, and jamming state respectively.

HIV Prevention among Mexican Migrants at Different Migration Phases: Exposure to Prevention Messages and Association With Testing Behaviors

PubMed Central

Martinez-Donate, Ana P.; Rangel, M. Gudelia; Zhang, Xiao; Simon, Norma-Jean; Rhoads, Natalie; Gonzalez-Fagoaga, J. Eduardo; Gonzalez, Ahmed Asadi

2016-01-01

Mobile populations are at increased risk for HIV infection. Exposure to HIV prevention messages at all phases of the migration process may help decrease im/migrants’ HIV risk. We investigated levels of exposure to HIV prevention messages, factors associated with message exposure, and the association between exposure to prevention messages and HIV testing behavior among Mexican im/migrants at different phases of the migration process. We conducted a cross-sectional, probability survey of Mexican im/migrants (N=3,149) traveling through the border city of Tijuana, Mexico. The results indicate limited exposure to prevention messages (57%–75%) and suboptimal last 12-month HIV testing rates (14%–25%) across five migration phases. Compared to pre-departure levels (75%), exposure to messages decreases at all post-departure migration phases (57%–63%, p<.001). In general, exposure to prevention messages is positively associated with greater odds of HIV testing at the pre-departure, destination, and interception phases. Binational efforts need to be intensified to reach and deliver HIV prevention to Mexican im/migrants across the migration continuum. PMID:26595267

The contribution of threat probability estimates to reexperiencing symptoms: a prospective analog study.

PubMed

Regambal, Marci J; Alden, Lynn E

2012-09-01

Individuals with posttraumatic stress disorder (PTSD) are hypothesized to have a "sense of current threat." Perceived threat from the environment (i.e., external threat), can lead to overestimating the probability of the traumatic event reoccurring (Ehlers & Clark, 2000). However, it is unclear if external threat judgments are a pre-existing vulnerability for PTSD or a consequence of trauma exposure. We used trauma analog methodology to prospectively measure probability estimates of a traumatic event, and investigate how these estimates were related to cognitive processes implicated in PTSD development. 151 participants estimated the probability of being in car-accident related situations, watched a movie of a car accident victim, and then completed a measure of data-driven processing during the movie. One week later, participants re-estimated the probabilities, and completed measures of reexperiencing symptoms and symptom appraisals/reactions. Path analysis revealed that higher pre-existing probability estimates predicted greater data-driven processing which was associated with negative appraisals and responses to intrusions. Furthermore, lower pre-existing probability estimates and negative responses to intrusions were both associated with a greater change in probability estimates. Reexperiencing symptoms were predicted by negative responses to intrusions and, to a lesser degree, by greater changes in probability estimates. The undergraduate student sample may not be representative of the general public. The reexperiencing symptoms are less severe than what would be found in a trauma sample. Threat estimates present both a vulnerability and a consequence of exposure to a distressing event. Furthermore, changes in these estimates are associated with cognitive processes implicated in PTSD. Copyright © 2012 Elsevier Ltd. All rights reserved.

Context-dependent female mate choice maintains variation in male sexual activity

PubMed Central

Plath, Martin; Gismann, Jakob; Helfrich, Claudia; Bierbach, David

2017-01-01

The existence of individual variation in males' motivation to mate remains a conundrum as directional selection should favour high mating frequencies. Balancing selection resulting from (context-dependent) female mate choice could contribute to the maintenance of this behavioural polymorphism. In dichotomous choice tests, mosquitofish (Gambusia holbrooki) females preferred virtual males showing intermediate mating frequencies, reflecting females' tendencies to avoid harassment by highly sexually active males. When tested in the presence of a female shoal—which protects females from male harassment—focal females showed significantly stronger preferences for high sexual activity. A trade-off between (indirect) benefits and (direct) costs of mating with sexually active males probably explains context-dependent female mate choice, as costs depend on the social environment in which females choose their mates. No preference was observed when we tested virgin females, suggesting that the behavioural pattern described here is part of the learned behavioural repertoire of G. holbrooki females. PMID:28791157

Using the Geoscience Concept Inventory to Understand how Students Learn about Geologic Time

NASA Astrophysics Data System (ADS)

Teed, R. E.

2009-12-01

108 pre-service teachers completed a standardized multiple-choice test at the beginning and at the end of a ten-week introductory survey course on geology. Four of the fifteen questions dealt explicitly with geologic time. Correct student answers that the age of the Earth is known from uranium-series dating increased significantly, but only from ~0% to about 20%. However, answers that included U-series dating with other (irrelevant) sources of evidence increased from ~10% to ~70%. On the pre-test, students avoided the U-series dating in favor of incorrect, but probably more familiar, dating techniques or combinations of dating techniques. They seem to have gained familiarity with, if not an understanding of U-series dating in the class. There was no real change in students’ conceptions of what the newly-formed Earth would have looked like. Most (70% on pre-test, 65% on post-test) chose an image that looked like the modern Earth with a single continent (which they may have believed to be Pangea). Interestingly, 78% of those who chose that image on the pre-test chose it on the post-test, so they were not guessing. This is a powerful misconception and remained intact in most cases despite the work the students did in the geology class. On the other hand, most students appeared to be guessing when they answered how long Pangea took to break up. There were no significant changes in the totals for any response, but about half students changed their answers between the pre- and post-test with no significant pattern in the changes. Responses to a choice of timelines which all included the formation of the Earth, the appearances of life, dinosaurs, and humans, and the disappearance of dinosaurs, were more complex. There was an increase in the number of students who chose the correct timeline (from 20% to 42%), and a decrease in the number who chose a timeline in which all life appears at once (from 14% to 10%). In this case some misconceptions (based on incorrect answers on the pre-test) were more likely than others to grow into a correct understanding. For example, students who chose “C”, an incorrect timeline with events in the correct order but incorrectly scaled, on the pretest, were more likely to choose correctly on the post-test than students who gave other incorrect answers on the pre-test.

Mechanisms for the inversion of chirality: Global reaction route mapping of stereochemical pathways in a probable chiral extraterrestrial molecule, 2-aminopropionitrile

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

Kaur, Ramanpreet; Vikas, E-mail: qlabspu@pu.ac.in, E-mail: qlabspu@yahoo.com

2015-02-21

2-Aminopropionitrile (APN), a probable candidate as a chiral astrophysical molecule, is a precursor to amino-acid alanine. Stereochemical pathways in 2-APN are explored using Global Reaction Route Mapping (GRRM) method employing high-level quantum-mechanical computations. Besides predicting the conventional mechanism for chiral inversion that proceeds through an achiral intermediate, a counterintuitive flipping mechanism is revealed for 2-APN through chiral intermediates explored using the GRRM. The feasibility of the proposed stereochemical pathways, in terms of the Gibbs free-energy change, is analyzed at the temperature conditions akin to the interstellar medium. Notably, the stereoinversion in 2-APN is observed to be more feasible than themore » dissociation of 2-APN and intermediates involved along the stereochemical pathways, and the flipping barrier is observed to be as low as 3.68 kJ/mol along one of the pathways. The pathways proposed for the inversion of chirality in 2-APN may provide significant insight into the extraterrestrial origin of life.« less

[Possible health effects associated with Pre-Columbian metallurgy].

PubMed

Idrovo, Alvaro Javier

2005-09-01

In the Old World, several researchers have indicated that adverse health effects were associated with exposure to arsenic, and that this influenced a change in the use of copper-arsenic alloys to others less toxic. This hypothesis was evaluated for three Pre-Columbian metallurgy traditions: Central Andes, Intermediate Area, and West Mexico. The metal artifacts from the Central Andes showed arsenic concentrations similar to those in the Old World (0.5%-1.0%). In the Intermediate Area the values were smallest; however, in West Mexico the arsenic content was very high (7%-25%). In Central Andes arsenical bronze was used initially, but copper-tin alloys when introduced were preferred and distributed throughout the Inca Empire. Osteological and artistic evidences of foot amputations among Moche individuals from Central Andes support the presence of "black foot disease" (a condition associated with arsenic poisoning) among Pre-Columbian populations. In conclusion, the adverse effects of arsenic have been observed in the New World, and that these effects promoted a change toward the use of less toxic alloys.

SA45. Amotivation in Schizophrenia, Bipolar Disorder, and Major Depressive Disorder: A Preliminary Comparison Study

PubMed Central

Zou, Ying-min; Ni, Ke; Wang, Yang-yu; Yu, En-qing; Lui, Simon S. Y.; Cheung, Eric F. C.; Chan, Raymond C. K.

2017-01-01

Abstract Background: Deficits in reward processing, such as approaching motivation, reward learning and effort-based decision-making, have been observed in patients with schizophrenia (SCZ), bipolar disorder (BD), and major depressive disorder (MDD). However, little is known about the nature of reward-processing deficits in these 3 diagnostic groups. The present study aimed to compare and contrast amotivation in these 3 diagnostic groups using an effort-based decision-making task. Methods: Sixty patients (19 SCZ patients, 18 BD patients and 23 MDD patients) and 27 healthy controls (HC) were recruited for the present study. The Effort Expenditure for Reward Task (EEfRT) was administered to evaluate their effort allocation pattern. This task required participants to choose easy or hard tasks in response to different levels of reward magnitude and reward probability. Results: Results showed that SCZ, BD, and MDD patients chose fewer hard tasks compared to HC. As reward magnitude increased, MDD patients made the least effort to gain reward compared to the other groups. When reward probability was intermediate, MDD patients chose fewer hard tasks than SCZ patients, whereas BD patients and HC chose more hard tasks than MDD and SCZ patients. When the reward probability was high, all 3 groups of patients tried fewer hard tasks than HC. Moreover, SCZ and MDD patients were less likely to choose hard tasks than BD patients and HC in the intermediate estimated value conditions. However, in the highest estimated value condition, there was no group difference in hard task choices between these 3 clinical groups, and they were all less motivated than HC. Conclusion: SCZ, BD, and MDD patients shared common deficits in gaining reward if the reward probability and estimated value were high. SCZ and MDD patients showed less motivation than BD patients in gaining reward when the reward probability and estimated value was intermediate.

Shunting normal pressure hydrocephalus: the predictive value of combined clinical and CT data.

PubMed

Vanneste, J; Augustijn, P; Tan, W F; Dirven, C

1993-03-01

The value of an ordinal global scale derived from combined clinical and CT data (clin/CT scale) to predict the clinical outcome in 112 patients shunted for presumed normal pressure hydrocephalus (NPH) was analysed. The clinical data were retrospectively collected, all CT scans were re-evaluated, and the clin/CT scale was determined blind to the results of further ancillary tests and to the post-surgical outcome. The scale ranked three classes of prediction: on the basis of clinical and CT characteristics, improvement after shunting was probable, possible, or improbable. The predictive value of the clin/CT scale for the subgroup of communicating NPH was established for two different strategies, depending on the strictness of selection criteria for shunting. In the subgroup of patients with presumed communicating NPH, the prevalence of shunt responsiveness was 29%; the best strategy was to shunt only patients with probable shunt-responsive NPH: the sensitivity was 0.54, the specificity 0.84, and the predictive accuracy 0.75, with a limited number of ineffective shunts (11%) and missed improvements (13%). The study illustrates its need to assess the pre-test probability of NPH based on combined clinical and CT data, before establishing the clinical usefulness of an ancillary test.

Shunting normal pressure hydrocephalus: the predictive value of combined clinical and CT data.

PubMed Central

Vanneste, J; Augustijn, P; Tan, W F; Dirven, C

1993-01-01

The value of an ordinal global scale derived from combined clinical and CT data (clin/CT scale) to predict the clinical outcome in 112 patients shunted for presumed normal pressure hydrocephalus (NPH) was analysed. The clinical data were retrospectively collected, all CT scans were re-evaluated, and the clin/CT scale was determined blind to the results of further ancillary tests and to the post-surgical outcome. The scale ranked three classes of prediction: on the basis of clinical and CT characteristics, improvement after shunting was probable, possible, or improbable. The predictive value of the clin/CT scale for the subgroup of communicating NPH was established for two different strategies, depending on the strictness of selection criteria for shunting. In the subgroup of patients with presumed communicating NPH, the prevalence of shunt responsiveness was 29%; the best strategy was to shunt only patients with probable shunt-responsive NPH: the sensitivity was 0.54, the specificity 0.84, and the predictive accuracy 0.75, with a limited number of ineffective shunts (11%) and missed improvements (13%). The study illustrates its need to assess the pre-test probability of NPH based on combined clinical and CT data, before establishing the clinical usefulness of an ancillary test. PMID:8459240

Angiogenic factors combined with clinical risk factors to predict preterm pre-eclampsia in nulliparous women: a predictive test accuracy study.

PubMed

Myers, J E; Kenny, L C; McCowan, L M E; Chan, E H Y; Dekker, G A; Poston, L; Simpson, N A B; North, R A

2013-09-01

To assess the performance of clinical risk factors, uterine artery Doppler and angiogenic markers to predict preterm pre-eclampsia in nulliparous women. Predictive test accuracy study. Prospective multicentre cohort study Screening for Pregnancy Endpoints (SCOPE). Low-risk nulliparous women with a singleton pregnancy were recruited. Clinical risk factor data were obtained and plasma placental growth factor (PlGF), soluble endoglin and soluble fms-like tyrosine kinase-1 (sFlt-1) were measured at 14-16 weeks of gestation. Prediction models were developed using multivariable stepwise logistic regression. Preterm pre-eclampsia (delivered before 37(+0)  weeks of gestation). Of the 3529 women recruited, 187 (5.3%) developed pre-eclampsia of whom 47 (1.3%) delivered preterm. Controls (n = 188) were randomly selected from women without preterm pre-eclampsia and included women who developed other pregnancy complications. An area under a receiver operating characteristic curve (AUC) of 0.76 (95% CI 0.67-0.84) was observed using previously reported clinical risk variables. The AUC improved following the addition of PlGF measured at 14-16 weeks (0.84; 95% CI 0.77-0.91), but no further improvement was observed with the addition of uterine artery Doppler or the other angiogenic markers. A sensitivity of 45% (95% CI 0.31-0.59) (5% false-positive rate) and post-test probability of 11% (95% CI 9-13) were observed using clinical risk variables and PlGF measurement. Addition of plasma PlGF at 14-16 weeks of gestation to clinical risk assessment improved the identification of nulliparous women at increased risk of developing preterm pre-eclampsia, but the performance is not sufficient to warrant introduction as a clinical screening test. These findings are marker dependent, not assay dependent; additional markers are needed to achieve clinical utility. © 2013 The Authors BJOG An International Journal of Obstetrics and Gynaecology © 2013 RCOG.

Online quench-flow electrospray ionization Fourier transform ion cyclotron resonance mass spectrometry for elucidating kinetic and chemical enzymatic reaction mechanisms.

PubMed

Clarke, David J; Stokes, Adam A; Langridge-Smith, Pat; Mackay, C Logan

2010-03-01

We have developed an automated quench-flow microreactor which interfaces directly to an electrospray ionization (ESI) mass spectrometer. We have used this device in conjunction with ESI Fourier transform ion cyclotron resonance mass spectrometry (FTICR MS) to demonstrate the potential of this approach for studying the mechanistic details of enzyme reactions. For the model system chosen to test this device, namely, the pre-steady-state hydrolysis of p-nitrophenyl acetate by the enzyme chymotrypsin, the kinetic parameters obtained are in good agreement with those in the literature. To our knowledge, this is the first reported use of online quench-flow coupled with FTICR MS. Furthermore, we have exploited the power of FTICR MS to interrogate the quenched covalently bound enzyme intermediate using top-down fragmentation. The accurate mass capabilities of FTICR MS permitted the nature of the intermediate to be assigned with high confidence. Electron capture dissociation (ECD) fragmentation allowed us to locate the intermediate to a five amino acid section of the protein--which includes the known catalytic residue, Ser(195). This experimental approach, which uniquely can provide both kinetic and chemical details of enzyme mechanisms, is a potentially powerful tool for studies of enzyme catalysis.

Probabilistic analysis on the failure of reactivity control for the PWR

NASA Astrophysics Data System (ADS)

Sony Tjahyani, D. T.; Deswandri; Sunaryo, G. R.

2018-02-01

The fundamental safety function of the power reactor is to control reactivity, to remove heat from the reactor, and to confine radioactive material. The safety analysis is used to ensure that each parameter is fulfilled during the design and is done by deterministic and probabilistic method. The analysis of reactivity control is important to be done because it will affect the other of fundamental safety functions. The purpose of this research is to determine the failure probability of the reactivity control and its failure contribution on a PWR design. The analysis is carried out by determining intermediate events, which cause the failure of reactivity control. Furthermore, the basic event is determined by deductive method using the fault tree analysis. The AP1000 is used as the object of research. The probability data of component failure or human error, which is used in the analysis, is collected from IAEA, Westinghouse, NRC and other published documents. The results show that there are six intermediate events, which can cause the failure of the reactivity control. These intermediate events are uncontrolled rod bank withdrawal at low power or full power, malfunction of boron dilution, misalignment of control rod withdrawal, malfunction of improper position of fuel assembly and ejection of control rod. The failure probability of reactivity control is 1.49E-03 per year. The causes of failures which are affected by human factor are boron dilution, misalignment of control rod withdrawal and malfunction of improper position for fuel assembly. Based on the assessment, it is concluded that the failure probability of reactivity control on the PWR is still within the IAEA criteria.

Aquarius Salinity Retrieval Algorithm: Final Pre-Launch Version

NASA Technical Reports Server (NTRS)

Wentz, Frank J.; Le Vine, David M.

2011-01-01

This document provides the theoretical basis for the Aquarius salinity retrieval algorithm. The inputs to the algorithm are the Aquarius antenna temperature (T(sub A)) measurements along with a number of NCEP operational products and pre-computed tables of space radiation coming from the galaxy and sun. The output is sea-surface salinity and many intermediate variables required for the salinity calculation. This revision of the Algorithm Theoretical Basis Document (ATBD) is intended to be the final pre-launch version.

Spontaneous Subarachnoid Hemorrhage: A Systematic Review and Meta-Analysis Describing the Diagnostic Accuracy of History, Physical Exam, Imaging, and Lumbar Puncture with an Exploration of Test Thresholds

PubMed Central

Carpenter, Christopher R.; Hussain, Adnan M.; Ward, Michael J.; Zipfel, Gregory J.; Fowler, Susan; Pines, Jesse M.; Sivilotti, Marco L.A.

2016-01-01

Background Spontaneous subarachnoid hemorrhage (SAH) is a rare, but serious etiology of headache. The diagnosis of SAH is especially challenging in alert, neurologically intact patients, as missed or delayed diagnosis can be catastrophic. Objectives To perform a diagnostic accuracy systematic review and meta-analysis of history, physical examination, cerebrospinal fluid (CSF) tests, computed tomography (CT), and clinical decision rules for spontaneous SAH. A secondary objective was to delineate probability of disease thresholds for imaging and lumbar puncture (LP). Methods PUBMED, EMBASE, SCOPUS, and research meeting abstracts were searched up to June 2015 for studies of emergency department (ED) patients with acute headache clinically concerning for spontaneous SAH. QUADAS-2 was used to assess study quality and, when appropriate, meta-analysis was conducted using random effects models. Outcomes were sensitivity, specificity, positive (LR+) and negative (LR−) likelihood ratios. To identify test- and treatment-thresholds, we employed the Pauker-Kassirer method with Bernstein test-indication curves using the summary estimates of diagnostic accuracy. Results A total of 5,022 publications were identified, of which 122 underwent full text-review; 22 studies were included (average SAH prevalence 7.5%). Diagnostic studies differed in assessment of history and physical exam findings, CT technology, analytical techniques used to identify xanthochromia, and criterion standards for SAH. Study quality by QUADAS-2 was variable; however, most had a relatively low-risk of biases. A history of neck pain (LR+ 4.1 [95% CI 2.2-7.6]) and neck stiffness on physical exam (LR+ 6.6 [4.0-11.0]) were the individual findings most strongly associated with SAH. Combinations of findings may rule out SAH, yet promising clinical decision rules await external validation. Non-contrast cranial CT within 6 hours of headache onset accurately ruled-in (LR+ 230 [6-8700]) and ruled-out SAH (LR− 0.01 [0-0.04]); CT beyond 6 hours had a LR− of 0.07 [0.01-0.61]. CSF analyses had lower diagnostic accuracy, whether using red blood cell (RBC) count or xanthochromia. At a threshold RBC count of 1,000 × 106/L, the LR+ was 5.7 [1.4-23] and LR− 0.21 [0.03-1.7]. Using the pooled estimates of diagnostic accuracy and testing risks and benefits, we estimate LP only benefits CT negative patients when the pre-LP probability of SAH is on the order of 5%, which corresponds to a pre-CT probability greater than 20%. Conclusions Less than one in ten headache patients concerning for SAH are ultimately diagnosed with SAH in recent studies. While certain symptoms and signs increase or decrease the likelihood of SAH, no single characteristic is sufficient to rule-in or rule-out SAH. Within 6 hours of symptom onset, non-contrast cranial CT is highly accurate, while a negative CT beyond 6 hours substantially reduces the likelihood of SAH. LP appears to benefit relatively few patients within a narrow pre-test probability range. With improvements in CT technology and an expanding body of evidence, test-thresholds for LP may become more precise, obviating the need for a post-CT LP in more acute headache patients. Existing SAH clinical decision rules await external validation, but offer the potential to identify subsets most likely to benefit from post-CT LP, angiography, or no further testing. PMID:27306497

The effect of herbivore faeces on the edaphic mite community: implications for tapeworm transmission.

PubMed

Václav, Radovan; Kalúz, Stanislav

2014-03-01

Oribatid mites may be of epidemiological and medical importance because several species have been shown to serve as intermediate hosts for anoplocephalid tapeworms of wild and domestic animals. Despite their economic and conservation significance, relatively few studies examined factors influencing the effective number of oribatid mites that can serve as intermediate hosts. We examined variation in the structure of the edaphic arthropod community in functionally different territory parts of the Alpine marmot (Marmota marmota latirostris), a known definitive host of a prevalent anoplocephalid tapeworm, Ctenotaenia marmotae. We used a field experiment to test whether the abundance of oribatid mites in marmot pastures is affected by the presence of fresh herbivore faeces. We found that the abundance of soil and litter dwelling oribatid mites in marmot pastures did not change shortly after faeces addition. In contrast, numbers of other predominant soil-litter and phoretic microarthropods increased after faeces addition. The abundance of the two predominant phoretic mites colonizing the faeces was inversely related to the abundance of oribatid mites. In contrast, the abundance of a ubiquitous soil-litter mesostigmatid mite was a positive function of oribatid numbers. Although absolute numbers of oribatid mites did not change after faeces addition, our study suggests that, depending on soil quality or type, the probability of tapeworm egg ingestion by oribatid mites can be reduced due to increased interspecific prey-predatory and trophic interactions. Latrine site selection in Alpine marmots is consistent with a reduced probability of tapeworm transmission by oribatids.

[Influence of pre-transplant serum level of soluble CD30 on the long-term survival rates of kidney transplant recipients and grafts].

PubMed

Chen, Jiang-hua; Lü, Rong; Chen, Ying; Wu, Jian-yong; He, Qiang; Huang, Hong-feng; Qu, Li-hui

2005-06-15

To investigate the influence of pre-transplant sCD30 level on the long-term survival rates of kidney transplant recipients and grafts among Chinese. A retrospective cohort of 707 patients undergoing cadaver renal transplants between Dec.1998 and Aug 2003, 467 males and 240 females, aged 40 +/- 11, with their blood samples preserved was studied. The plasma levels of sCD30 were determined by ELISA. The 5-year graft survival/functional rates of the high sCD30 group were 77.7% +/- 3.5%/85.0% +/- 3.2%, significantly lower than those of the low and intermediate groups, 84.7% +/- 2.1%/98.9% +/- 1.1% and 88.1% +/- 2.9%/95.1% +/- 1.6% respectively (all P < 0.05). The 5-year recipient survival rate of the intermediate sCD30 group was 92.4% +/- 1.6%, higher than those of the low and high sCD30 groups, 84.7% +/- 3.9% and 87.1% +/- 2.7% respectively with a significant difference between the intermediate and high sCD30 groups (P = 0.032). Pre-transplant serum level of sCD30 reflects the immune status. Recipients with high sCD30 are prone to rejection while those with low sCD30 are prone to infections.

Monte Carlo Perturbation Theory Estimates of Sensitivities to System Dimensions

DOE PAGES

Burke, Timothy P.; Kiedrowski, Brian C.

2017-12-11

Here, Monte Carlo methods are developed using adjoint-based perturbation theory and the differential operator method to compute the sensitivities of the k-eigenvalue, linear functions of the flux (reaction rates), and bilinear functions of the forward and adjoint flux (kinetics parameters) to system dimensions for uniform expansions or contractions. The calculation of sensitivities to system dimensions requires computing scattering and fission sources at material interfaces using collisions occurring at the interface—which is a set of events with infinitesimal probability. Kernel density estimators are used to estimate the source at interfaces using collisions occurring near the interface. The methods for computing sensitivitiesmore » of linear and bilinear ratios are derived using the differential operator method and adjoint-based perturbation theory and are shown to be equivalent to methods previously developed using a collision history–based approach. The methods for determining sensitivities to system dimensions are tested on a series of fast, intermediate, and thermal critical benchmarks as well as a pressurized water reactor benchmark problem with iterated fission probability used for adjoint-weighting. The estimators are shown to agree within 5% and 3σ of reference solutions obtained using direct perturbations with central differences for the majority of test problems.« less

The Space Shuttle Program Pre-Flight Meteoroid and Orbital Debris Risk/Damage Predictions and Post-Flight Damage Assessments

NASA Technical Reports Server (NTRS)

Levin, George M.; Christiansen, Eric L.

1997-01-01

The pre-flight predictions and postflight assessments carried out in relation to a series of Space Shuttle missions are reviewed, and data are presented for the meteoroid and orbital debris damage observed on the Hubble Space Telescope during the 1994 Hubble repair mission. Pre-flight collision risk analyses are carried out prior to each mission, and in the case of an unacceptable risk, the mission profile is altered until the risk is considered to be acceptable. The NASA's BUMPER code is used to compute the probability of damage from debris and meteoroid particle impacts based on the Poisson statistical model for random events. The penetration probability calculation requires information concerning the geometry of the critical systems, the penetration resistance and mission profile parameters. Following each flight, the orbiter is inspected for meteoroid and space debris damage. The emphasis is on areas such as the radiator panels, the windows and the reinforced carbon-carbon structures on the leading wing edges and on the nose cap. The contents of damage craters are analyzed using a scanning electron microscope to determine the nature and origin of the impactor. Hypervelocity impact tests are often performed to simulate the observed damage and to estimate the nature of the damaging particles. The number and type of damage observed provides information concerning the orbital debris environment.

Improved orthodontic bonding to silver amalgam. Part 2. Lathe-cut, admixed, and spherical amalgams with different intermediate resins.

PubMed

Büyükyilmaz, T; Zachrisson, B U

1998-08-01

Flat rectangular tabs (n = 270) prepared from spherical (Tytin), admixed (Dispersalloy) or lathe-cut amalgam (ANA 2000) were subjected to aluminum oxide sandblasting with either 50-mu or 90-mu abrasive powder. Mandibular incisor edgewise brackets were bonded to these tabs. An intermediate resin was used, either All-Bond 2 Primers A + B or a 4-META product--Amalgambond Plus (AP) or Reliance Metal Primer (RMP)--followed by Concise. All specimens were stored in water at 37 degrees C for 24 hours and thermocycled 1000 times from 5 degrees C to 55 degrees C and back before tensile bond strength testing. The bond strength of Concise to etched enamel of extracted, caries-free premolars was used as a control. Bond failure sites were classified using a modified adhesive remnant index (ARI) system. Results were expressed as mean bond strength with SD, and as a function relating the probability of bond failure to stress by means of Weibull analysis. Mean tensile bond strength in the experimental groups ranged from 2.9 to 11.0 MPa--significantly weaker than the control sample (16.0 MPa). Bond failure invariably occurred at the amalgam/adhesive interface. The strongest bonds were created to the spherical and lathe-cut amalgams (range 6.8 to 11.0 MPa). Bonds to the spherical amalgam were probably more reliable. The intermediate application of the 4-META resins AP and RMP generally created significantly stronger bonds to all three basic types of amalgam products than the bonds obtained with the All-Bond 2 primers. The effect of abrasive-particle size on bond strength to different amalgam surfaces was not usually significant (p > 0.05). The implications of these findings are discussed in relationship to clinical experience bonding orthodontic attachments to large amalgam restorations in posterior teeth.

Probabilistic Estimates of Climate Impacts of the Paris Agreement and Contributions from Different Countries.

NASA Astrophysics Data System (ADS)

Sokolov, A. P.; Paltsev, S.; Chen, Y. H. H.; Monier, E.; Libardoni, A. G.; Forest, C. E.

2017-12-01

In December of 2015 during COP21 meeting in Paris almost 200 countries signed an agreement pledging to reduce their anthropogenic greenhouse gas (GHG) emissions. Recently USA announced plans to withdraw from the agreement. In this study, we estimate an impact of this decision on future climate using the MIT Integrated Global System Model, which consists of the human activity model, Economic Projection and Policy Analysis (EPPA) model, and a climate model of intermediate complexity, the MIT Earth System Model (MESM). For comparison, we also estimated impacts of possible withdrawals of China, Europe or India. In addition to the "no climate policy" scenario, we consider five emissions scenarios: Paris, Paris_no_USA, Paris_no_EUR and so on. Climate simulations were carried out from 1861 to 2005 driven by prescribed changes in GHGs and natural forcings and them continued to 2100 driven by GHG emissions produced by EPPA model. Because Paris agreement only cover the period up to 2030, last five scenarios were created assuming that emissions or carbon intensity will continue to decrease after 2030 at the same rate as in the 2020-2030 period. To account for uncertainty in climate system response to external forcing, we carry out 400 member ensembles on climate simulations for each scenario. Probability distributions for climate parameters are obtained by comparing simulated climate for 1861 to 2010 with observations. Our analysis shows that, full implementation of Paris agreement (under above-descried assumptions) will increase probability of surface air temperature in the last decade of this century increasing by less than 3oC relative to pre-industrial form about 20% for "no climate policy" to about 86%. Withdrawal of USA, China, Europe or India will decrease this probability to about 63, 67, 75 and 82%, respectively.

Welfare and Taxes: Extending Benefits and Taxes to Puerto Rico, Virgin Islands, Guam, and American Samoa.

DTIC Science & Technology

1987-09-01

including pre- scribed drugs, intermediate care facility services, eyeglasses, dental ser- vi-s, and inpatient psychiatric care for individuals under...does not seek federal Medicaid reim- bursement for required skilled nursing or optional intermediate care facility services. Also, we do not know... care facility services-high-cost Medicaid benefits. 5’. We do not believe assuming such persons would be in institutions in the area is reasonable

Dementia and art: neuronal intermediate filament inclusion disease and dissolution of artistic creativity.

PubMed

Budrys, Valmantas; Skullerud, Kari; Petroska, Donatas; Lengveniene, Jurate; Kaubrys, Gintaras

2007-01-01

The paper presents a new case of neuronal intermediate filament inclusion disease (NIFID), a recently described new variant of early-onset frontotemporal dementia. Documented with repetitive brain images, morphologically proven cases additionally endorse evolving the clinical and pathological phenotype of NIFID. For the first time the paper describes the probable influence of NIFID on the artistic creativity of an accomplished artist showing rapid dissolution of artistic talent. Copyright (c) 2007 S. Karger AG, Basel.

Long term variability of Cygnus X-1. V. State definitions with all sky monitors

NASA Astrophysics Data System (ADS)

Grinberg, V.; Hell, N.; Pottschmidt, K.; Böck, M.; Nowak, M. A.; Rodriguez, J.; Bodaghee, A.; Cadolle Bel, M.; Case, G. L.; Hanke, M.; Kühnel, M.; Markoff, S. B.; Pooley, G. G.; Rothschild, R. E.; Tomsick, J. A.; Wilson-Hodge, C. A.; Wilms, J.

2013-06-01

We present a scheme for determining the spectral state of the canonical black hole Cyg X-1 using data from previous and current X-ray all sky monitors (RXTE-ASM, Swift-BAT, MAXI, and Fermi-GBM). Determinations of the hard/intermediate and soft state agree to better than 10% between different monitors, facilitating the determination of the state and its context for any observation of the source, potentially over the lifetimes of different individual monitors. A separation of the hard and the intermediate states, which strongly differ in their spectral shape and short-term timing behavior, is only possible when data in the soft X-rays (<5 keV) are available. A statistical analysis of the states confirms the different activity patterns of the source (e.g., month- to year-long hard-state periods or phases during which numerous transitions occur). It also shows that the hard and soft states are stable, with the probability of Cyg X-1 remaining in a given state for at least one week to be larger than 85% in the hard state and larger than 75% in the soft state. Intermediate states are short lived, with a 50% probability that the source leaves the intermediate state within three days. Reliable detection of these potentially short-lived events is only possible with monitor data that have a time resolution better than 1 d.

La Deletion from Mouse Brain Alters Pre-tRNA Metabolism and Accumulation of Pre-5.8S rRNA, with Neuron Death and Reactive Astrocytosis

PubMed Central

Blewett, Nathan H.; Iben, James R.; Gaidamakov, Sergei

2017-01-01

ABSTRACT Human La antigen (Sjögren's syndrome antigen B [SSB]) is an abundant multifunctional RNA-binding protein. In the nucleoplasm, La binds to and protects from 3′ exonucleases, the ends of precursor tRNAs, and other transcripts synthesized by RNA polymerase III and facilitates their maturation, while a nucleolar isoform has been implicated in rRNA biogenesis by multiple independent lines of evidence. We showed previously that conditional La knockout (La cKO) from mouse cortex neurons results in defective tRNA processing, although the pathway(s) involved in neuronal loss thereafter was unknown. Here, we demonstrate that La is stably associated with a spliced pre-tRNA intermediate. Microscopic evidence of aberrant nuclear accumulation of 5.8S rRNA in La cKO is supported by a 10-fold increase in a pre-5.8S rRNA intermediate. To identify pathways involved in subsequent neurodegeneration and loss of brain mass in the cKO cortex, we employed mRNA sequencing (mRNA-Seq), immunohistochemistry, and other approaches. This revealed robust enrichment of immune and astrocyte reactivity in La cKO cortex. Immunohistochemistry, including temporal analyses, demonstrated neurodegeneration, followed by astrocyte invasion associated with immune response and decreasing cKO cortex size over time. Thus, deletion of La from postmitotic neurons results in defective pre-tRNA and pre-rRNA processing and progressive neurodegeneration with loss of cortical brain mass. PMID:28223366

Anti-hypertensive treatment prolongs tPA door-to-treatment time: Secondary analysis of the INSTINCT trial.

PubMed Central

Skolarus, Lesli E.; Scott, Phillip A.; Burke, James F.; Adelman, Eric E.; Frederiksen, Shirley M.; Kade, Allison M.; Kalbfleisch, Jack D.; Ford, Andria L.; Meurer, William J.

2012-01-01

Background/Purpose Identifying modifiable tPA treatment delays may improve stroke outcomes. We hypothesized that pre-thrombolytic anti-hypertensive treatment (AHT) may prolong door-to-treatment time (DTT). Methods Analysis of consecutive tPA-treated patients at 24 randomly selected community hospitals in the INSTINCT trial between 2007-2010. DTTs among stroke patients who received pre-thrombolytic AHT were compared to those that did not receive pre-thrombolytic AHT. We then calculated a propensity score for the probability of receiving pre-thrombolytic AHT using logistic regression with demographics, stroke risk factors, home medications, stroke severity (NIHSS), onset-to-door time, admission glucose, pretreatment blood pressure, EMS transport and location at time of stroke as independent variables. A paired t-test was performed to compare the DTTs between the propensity matched groups. Results Of 534 tPA treated stroke patients analyzed, 95 received pre-thrombolytic AHT. In the unmatched cohort, patients who received pre-thrombolytic AHT had a longer DTT (mean increase 9 minutes; 95% confidence interval (CI) 2-16 minutes) than patients who did not. After propensity matching, patients who received pre-thrombolytic AHT had a longer DTT (mean increase 10.4 minutes, 95% CI 1.9 - 18.8) than patients who did not receive pre-thrombolytic AHT. Conclusion Pre-thrombolytic AHT is associated with modest delays in DTT. This represents a potential target for quality improvement initiatives. Further research evaluating optimum pre-thrombolytic hypertension management is warranted. PMID:23033348

A new account of the effect of probability on task switching: ERP evidence following the manipulation of switch probability, cue informativeness and predictability

PubMed Central

Nessler, Doreen; Friedman, David; Johnson, Ray

2012-01-01

This task-switching ERP study of 16 young participants investigated whether increased RT slowing on stay trials and faster RTs on switch trials for frequent than infrequent switching are explained by an activation or preparation account. The activation account proposes that task sets are maintained at a higher baseline activation level for frequent switching, necessitating increased task-set updating, as reflected by a larger and/or longer lasting early parietal positivity. The preparation account assumes advance (pre-cue) switch preparation (i.e., task-set reconfiguration), preceding stay and switch trials for frequent switching, as reflected by pre-cue and post-cue late parietal positivities. By and large, the data support the activation account. However, we also found increased, pre-cue task-set updating on frequent stay trials and pre-cue, task-set reconfiguration prior to predictable, frequent switches. These results lead us to propose an extended activation account to explain the effects of switch probability on the executive processes underlying task-switching behavior. PMID:22820040

Pre-attentive auditory discrimination skill in Indian classical vocal musicians and non-musicians.

PubMed

Sanju, Himanshu Kumar; Kumar, Prawin

2016-09-01

To test for pre-attentive auditory discrimination skills in Indian classical vocal musicians and non-musicians. Mismatch negativity (MMN) was recorded to test for pre-attentive auditory discrimination skills with a pair of stimuli of /1000 Hz/ and /1100 Hz/, with /1000 Hz/ as the frequent stimulus and /1100 Hz/ as the infrequent stimulus. Onset, offset and peak latencies were the considered latency parameters, whereas peak amplitude and area under the curve were considered for amplitude analysis. Exactly 50 participants, out of which the experimental group had 25 adult Indian classical vocal musicians and 25 age-matched non-musicians served as the control group, were included in the study. Experimental group participants had a minimum professional music experience in Indian classic vocal music of 10 years. However, control group participants did not have any formal training in music. Descriptive statistics showed better waveform morphology in the experimental group as compared to the control. MANOVA showed significantly better onset latency, peak amplitude and area under the curve in the experimental group but no significant difference in the offset and peak latencies between the two groups. The present study probably points towards the enhancement of pre-attentive auditory discrimination skills in Indian classical vocal musicians compared to non-musicians. It indicates that Indian classical musical training enhances pre-attentive auditory discrimination skills in musicians, leading to higher peak amplitude and a greater area under the curve compared to non-musicians.

Interpreting results of cluster surveys in emergency settings: is the LQAS test the best option?

PubMed Central

Bilukha, Oleg O; Blanton, Curtis

2008-01-01

Cluster surveys are commonly used in humanitarian emergencies to measure health and nutrition indicators. Deitchler et al. have proposed to use Lot Quality Assurance Sampling (LQAS) hypothesis testing in cluster surveys to classify the prevalence of global acute malnutrition as exceeding or not exceeding the pre-established thresholds. Field practitioners and decision-makers must clearly understand the meaning and implications of using this test in interpreting survey results to make programmatic decisions. We demonstrate that the LQAS test–as proposed by Deitchler et al. – is prone to producing false-positive results and thus is likely to suggest interventions in situations where interventions may not be needed. As an alternative, to provide more useful information for decision-making, we suggest reporting the probability of an indicator's exceeding the threshold as a direct measure of "risk". Such probability can be easily determined in field settings by using a simple spreadsheet calculator. The "risk" of exceeding the threshold can then be considered in the context of other aggravating and protective factors to make informed programmatic decisions. PMID:19068120

Genomic and experimental evidence for multiple metabolic functions in the RidA/YjgF/YER057c/UK114 (Rid) protein family

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

Niehaus, Thomas D.; Gerdes, Svetlana; Hodge-Hanson, Kelsey

It is now recognized that enzymatic or chemical side-reactions can convert normal metabolites to useless or toxic ones and that a suite of enzymes exists to mitigate such metabolite damage. Examples are the reactive imine/enamine intermediates produced by threonine dehydratase, which damage the pyridoxal 5'-phosphate cofactor of various enzymes causing inactivation. This damage is pre-empted by RidA proteins, which hydrolyze the imines before they do harm. RidA proteins belong to the YjgF/YER057c/UK114 family (here renamed the Rid family). Most other members of this diverse and ubiquitous family lack defined functions. Phylogenetic analysis divided the Rid family into a widely distributed,more » apparently archetypal RidA subfamily and seven other subfamilies (Rid1 to Rid7) that are largely confined to bacteria and often co-occur in the same organism with RidA and each other. The Rid1 to Rid3 subfamilies, but not the Rid4 to Rid7 subfamilies, have a conserved arginine residue that, in RidA proteins, is essential for imine-hydrolyzing activity. Analysis of the chromosomal context of bacterial RidA genes revealed clustering with genes for threonine dehydratase and other pyridoxal 5'-phosphate-dependent enzymes, which fits with the known RidA imine hydrolase activity. Clustering was also evident between Rid family genes and genes specifying FAD-dependent amine oxidases or enzymes of carbamoyl phosphate metabolism. Biochemical assays showed that Salmonella enterica RidA and Rid2, but not Rid7, can hydrolyze imines generated by amino acid oxidase. Genetic tests indicated that carbamoyl phosphate overproduction is toxic to S. enterica cells lacking RidA, and metabolomic profiling of Rid knockout strains showed ten-fold accumulation of the carbamoyl phosphate-related metabolite dihydroorotate. Like the archetypal RidA subfamily, the Rid2, and probably the Rid1 and Rid3 subfamilies, have imine-hydrolyzing activity and can pre-empt damage from imines formed by amine oxidases as well as by pyridoxal 5'-phosphate enzymes. The RidA subfamily has an additional damage pre-emption role in carbamoyl phosphate metabolism that has yet to be biochemically defined. As a result, the Rid4 to Rid7 subfamilies appear not to hydrolyze imines and thus remain mysterious.« less

Genomic and experimental evidence for multiple metabolic functions in the RidA/YjgF/YER057c/UK114 (Rid) protein family

DOE PAGES

Niehaus, Thomas D.; Gerdes, Svetlana; Hodge-Hanson, Kelsey; ...

2015-05-15

It is now recognized that enzymatic or chemical side-reactions can convert normal metabolites to useless or toxic ones and that a suite of enzymes exists to mitigate such metabolite damage. Examples are the reactive imine/enamine intermediates produced by threonine dehydratase, which damage the pyridoxal 5'-phosphate cofactor of various enzymes causing inactivation. This damage is pre-empted by RidA proteins, which hydrolyze the imines before they do harm. RidA proteins belong to the YjgF/YER057c/UK114 family (here renamed the Rid family). Most other members of this diverse and ubiquitous family lack defined functions. Phylogenetic analysis divided the Rid family into a widely distributed,more » apparently archetypal RidA subfamily and seven other subfamilies (Rid1 to Rid7) that are largely confined to bacteria and often co-occur in the same organism with RidA and each other. The Rid1 to Rid3 subfamilies, but not the Rid4 to Rid7 subfamilies, have a conserved arginine residue that, in RidA proteins, is essential for imine-hydrolyzing activity. Analysis of the chromosomal context of bacterial RidA genes revealed clustering with genes for threonine dehydratase and other pyridoxal 5'-phosphate-dependent enzymes, which fits with the known RidA imine hydrolase activity. Clustering was also evident between Rid family genes and genes specifying FAD-dependent amine oxidases or enzymes of carbamoyl phosphate metabolism. Biochemical assays showed that Salmonella enterica RidA and Rid2, but not Rid7, can hydrolyze imines generated by amino acid oxidase. Genetic tests indicated that carbamoyl phosphate overproduction is toxic to S. enterica cells lacking RidA, and metabolomic profiling of Rid knockout strains showed ten-fold accumulation of the carbamoyl phosphate-related metabolite dihydroorotate. Like the archetypal RidA subfamily, the Rid2, and probably the Rid1 and Rid3 subfamilies, have imine-hydrolyzing activity and can pre-empt damage from imines formed by amine oxidases as well as by pyridoxal 5'-phosphate enzymes. The RidA subfamily has an additional damage pre-emption role in carbamoyl phosphate metabolism that has yet to be biochemically defined. As a result, the Rid4 to Rid7 subfamilies appear not to hydrolyze imines and thus remain mysterious.« less

Rational clinical evaluation of suspected acute coronary syndromes: The value of more information.

PubMed

Hancock, David G; Chuang, Ming-Yu Anthony; Bystrom, Rebecca; Halabi, Amera; Jones, Rachel; Horsfall, Matthew; Cullen, Louise; Parsonage, William A; Chew, Derek P

2017-12-01

Many meta-analyses have provided synthesised likelihood ratio data to aid clinical decision-making. However, much less has been published on how to safely combine clinical information in practice. We aimed to explore the benefits and risks of pooling clinical information during the ED assessment of suspected acute coronary syndrome. Clinical information on 1776 patients was collected within a randomised trial conducted across five South Australian EDs between July 2011 and March 2013. Bayes theorem was used to calculate patient-specific post-test probabilities using age- and gender-specific pre-test probabilities and likelihood ratios corresponding to the presence or absence of 18 clinical factors. Model performance was assessed as the presence of adverse cardiac outcomes among patients theoretically discharged at a post-test probability less than 1%. Bayes theorem-based models containing high-sensitivity troponin T (hs-troponin) outperformed models excluding hs-troponin, as well as models utilising TIMI and GRACE scores. In models containing hs-troponin, a plateau in improving discharge safety was observed after the inclusion of four clinical factors. Models with fewer clinical factors better approximated the true event rate, tended to be safer and resulted in a smaller standard deviation in post-test probability estimates. We showed that there is a definable point where additional information becomes uninformative and may actually lead to less certainty. This evidence supports the concept that clinical decision-making in the assessment of suspected acute coronary syndrome should be focused on obtaining the least amount of information that provides the highest benefit for informing the decisions of admission or discharge. © 2017 Australasian College for Emergency Medicine and Australasian Society for Emergency Medicine.

Photometric investigation of the totally eclipsing contact binary V12 in the intermediate-age open cluster NGC 7789

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

Qian, S.-B.; Wang, J.-J.; Liu, L.

2015-02-01

NGC 7789 is an intermediate-age open cluster with an age similar to the mean age of contact binary stars. V12 is a bright W UMa-type binary star with an orbital period of 0.3917 days. The first complete light curves of V12 in the V, R, and I bands are presented and analyzed with the Wilson–Devinney (W-D) method. The results show that V12 is an intermediate-contact binary (f=43.0(±2.2)%) with a mass ratio of 3.848, and it is a W-type contact binary where the less massive component is slightly hotter than the more massive one. The asymmetry of the light curves ismore » explained by the presence of a dark spot on the more massive component. The derived orbital inclination (i=83{sub .}{sup ∘}6) indicates that it is a totally eclipsing binary, which suggests that the determined parameters are reliable. The orbital period may show a long-term increase at a rate of P-dot =+2.48(±0.17)×10{sup −6} days yr{sup −1} that reveals a rapid mass transfer from the less massive component to the more massive one. However, more observations are needed to confirm this conclusion. The presence of an intermediate-contact binary in an intermediate-age open cluster may suggest that some contact binaries have a very short pre-contact timescale. The presence of a third body and/or stellar collision may help to shorten the pre-contact evolution.« less

Time-varying SMART design and data analysis methods for evaluating adaptive intervention effects.

PubMed

Dai, Tianjiao; Shete, Sanjay

2016-08-30

In a standard two-stage SMART design, the intermediate response to the first-stage intervention is measured at a fixed time point for all participants. Subsequently, responders and non-responders are re-randomized and the final outcome of interest is measured at the end of the study. To reduce the side effects and costs associated with first-stage interventions in a SMART design, we proposed a novel time-varying SMART design in which individuals are re-randomized to the second-stage interventions as soon as a pre-fixed intermediate response is observed. With this strategy, the duration of the first-stage intervention will vary. We developed a time-varying mixed effects model and a joint model that allows for modeling the outcomes of interest (intermediate and final) and the random durations of the first-stage interventions simultaneously. The joint model borrows strength from the survival sub-model in which the duration of the first-stage intervention (i.e., time to response to the first-stage intervention) is modeled. We performed a simulation study to evaluate the statistical properties of these models. Our simulation results showed that the two modeling approaches were both able to provide good estimations of the means of the final outcomes of all the embedded interventions in a SMART. However, the joint modeling approach was more accurate for estimating the coefficients of first-stage interventions and time of the intervention. We conclude that the joint modeling approach provides more accurate parameter estimates and a higher estimated coverage probability than the single time-varying mixed effects model, and we recommend the joint model for analyzing data generated from time-varying SMART designs. In addition, we showed that the proposed time-varying SMART design is cost-efficient and equally effective in selecting the optimal embedded adaptive intervention as the standard SMART design.

MASTER: a model to improve and standardize clinical breakpoints for antimicrobial susceptibility testing using forecast probabilities.

PubMed

Blöchliger, Nicolas; Keller, Peter M; Böttger, Erik C; Hombach, Michael

2017-09-01

The procedure for setting clinical breakpoints (CBPs) for antimicrobial susceptibility has been poorly standardized with respect to population data, pharmacokinetic parameters and clinical outcome. Tools to standardize CBP setting could result in improved antibiogram forecast probabilities. We propose a model to estimate probabilities for methodological categorization errors and defined zones of methodological uncertainty (ZMUs), i.e. ranges of zone diameters that cannot reliably be classified. The impact of ZMUs on methodological error rates was used for CBP optimization. The model distinguishes theoretical true inhibition zone diameters from observed diameters, which suffer from methodological variation. True diameter distributions are described with a normal mixture model. The model was fitted to observed inhibition zone diameters of clinical Escherichia coli strains. Repeated measurements for a quality control strain were used to quantify methodological variation. For 9 of 13 antibiotics analysed, our model predicted error rates of < 0.1% applying current EUCAST CBPs. Error rates were > 0.1% for ampicillin, cefoxitin, cefuroxime and amoxicillin/clavulanic acid. Increasing the susceptible CBP (cefoxitin) and introducing ZMUs (ampicillin, cefuroxime, amoxicillin/clavulanic acid) decreased error rates to < 0.1%. ZMUs contained low numbers of isolates for ampicillin and cefuroxime (3% and 6%), whereas the ZMU for amoxicillin/clavulanic acid contained 41% of all isolates and was considered not practical. We demonstrate that CBPs can be improved and standardized by minimizing methodological categorization error rates. ZMUs may be introduced if an intermediate zone is not appropriate for pharmacokinetic/pharmacodynamic or drug dosing reasons. Optimized CBPs will provide a standardized antibiotic susceptibility testing interpretation at a defined level of probability. © The Author 2017. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Temporal dynamics of choice behavior in rats and humans: an examination of pre- and post-choice latencies

PubMed Central

Fam, Justine; Westbrook, Fred; Arabzadeh, Ehsan

2016-01-01

Identifying similarities and differences in choice behavior across species is informative about how basic mechanisms give rise to more complex processes. In the present study, we compared pre- and post-choice latencies between rats and humans under two paradigms. In Experiment 1, we used a cued choice paradigm where subjects were presented with a cue that directed them as to which of two options to respond for rewards. In Experiment 2, subjects were free to choose between two options in order to procure rewards. In both Experiments rewards were delivered with distinct probabilities. The trial structure used in these experiments allowed the choice process to be decomposed into pre- and post-choice processes. Overall, post-choice latencies reflected the difference in reward probability between the two options, where latencies for the option with higher probability of reward were longer than those for the option with lower probability of reward. An interesting difference between rats and humans was observed: the choice behavior for humans, but not rats, was sensitive to the free-choice aspect of the tasks, such that in free-choice trials post-choice latencies no longer reflected the difference in reward probabilities between the two options. PMID:26862000

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

PubMed

Konstantinov, Konstantin N; Rubin, Robert L

2017-12-01

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

Medical physics: the perfect intermediate level physics class

NASA Astrophysics Data System (ADS)

Christensen, Nelson

2001-07-01

Medical physics is currently a rapidly growing field of physics. Numerous academic, clinical and industrial opportunities are open to physicists in the medical world. I report on an intermediate level physics course on medical physics taught at Carleton College. The topics covered in this course cover all areas of physics, but with examples drawn from medical applications. In addition to physics majors, this course appeals to biology, chemistry and pre-medical students who have a keen interest in physics.

A probabilistic method for determining the volume fraction of pre-embedded capsules in self-healing materials

NASA Astrophysics Data System (ADS)

Lv, Zhong; Chen, Huisu

2014-10-01

Autonomous healing of cracks using pre-embedded capsules containing healing agent is becoming a promising approach to restore the strength of damaged structures. In addition to the material properties, the size and volume fraction of capsules influence crack healing in the matrix. Understanding the crack and capsule interaction is critical in the development and design of structures made of self-healing materials. Assuming that the pre-embedded capsules are randomly dispersed we theoretically model flat ellipsoidal crack interaction with capsules and determine the probability of a crack intersecting the pre-embedded capsules i.e. the self-healing probability. We also develop a probabilistic model of a crack simultaneously meeting with capsules and catalyst carriers in two-component self-healing system matrix. Using a risk-based healing approach, we determine the volume fraction and size of the pre-embedded capsules that are required to achieve a certain self-healing probability. To understand the effect of the shape of the capsules on self-healing we theoretically modeled crack interaction with spherical and cylindrical capsules. We compared the results of our theoretical model with Monte-Carlo simulations of crack interaction with capsules. The formulae presented in this paper will provide guidelines for engineers working with self-healing structures in material selection and sustenance.

An XMM-Newton Study of 9SGR and the Lagoon Nebula

NASA Technical Reports Server (NTRS)

Rauw, G.; Blomme, R.; Waldron, W. L.; Naze, Y.; Harries, T. J.; Chapman, J. M.; Corcoran, M. F.; Detal, A.; Gosset, E.

2001-01-01

We report preliminary results of an XMM-Newton observation of the 04 V star 9 Sgr (= HD 164794). 9 Sgr is one of a few single OB stars that display a non-thermal radio emission attributed to synchrotron emission by relativistic electrons. Inverse Compton scattering of photospheric UV photons by these relativistic electrons is a priori expected to generate a non-thermal power-law tail in the X-ray spectrum. Our EPIC and RGS spectra of 9 Sgr suggest a more complex situation than expected from this 'simple' theoretical picture. Furthermore, soft-band EPIC images of the region around 9 Sgr reveal a number of point sources inside the Lagoon Nebula (M8). Most of these sources have optical counterparts inside the very young open cluster NGC 6530 and several X-ray sources are associated with low and intermediate mass pre-main sequence stars. Finally, we also detect (probably) diffuse X-ray emission from the Hourglass Region that might reveal a hot bubble blown by the stellar wind of Herschel 36, the ionizing star of the HG region.

A disease management programme for patients with diabetes mellitus is associated with improved quality of care within existing budgets.

PubMed

Steuten, L M G; Vrijhoef, H J M; Landewé-Cleuren, S; Schaper, N; Van Merode, G G; Spreeuwenberg, C

2007-10-01

To assess the impact of a disease management programme for patients with diabetes mellitus (Type 1 and Type 2) on cost-effectiveness, quality of life and patient self-management. By organizing care in accordance with the principles of disease management, it is aimed to increase quality of care within existing budgets. Single-group, pre-post design with 2-year follow-up in 473 patients. Substantial significant improvements in glycaemic control, health-related quality of life (HRQL) and patient self-management were found. No significant changes were detected in total costs of care. The probability that the disease management programme is cost-effective compared with usual care amounts to 74%, expressed in an average saving of 117 per additional life year at 5% improved HRQL. Introduction of a disease management programme for patients with diabetes is associated with improved intermediate outcomes within existing budgets. Further research should focus on long-term cost-effectiveness, including diabetic complications and mortality, in a controlled setting or by using decision-analytic modelling techniques.

A cortical-spinal prosthesis for targeted limb movement in paralyzed primate avatars

PubMed Central

Shanechi, Maryam M.; Hu, Rollin C.; Williams, Ziv M.

2014-01-01

Motor paralysis is among the most disabling aspects of injury to the central nervous system. Here we develop and test a target-based cortical-spinal neural prosthesis that employs neural activity recorded from pre-motor neurons to control limb movements in functionally paralyzed primate avatars. Given the complexity by which muscle contractions are naturally controlled, we approach the problem of eliciting goal-directed limb movement in paralyzed animals by focusing on the intended targets of movement rather than their intermediate trajectories. We then match this information in real-time with spinal cord and muscle stimulation parameters that produce free planar limb movements to those intended target locations. We demonstrate that both the decoded activities of pre-motor populations and their adaptive responses can be used, after brief training, to effectively direct an avatar’s limb to distinct targets variably displayed on a screen. These findings advance the future possibility of reconstituting targeted limb movement in paralyzed subjects. PMID:24549394

Network analysis of the hominin origin of Herpes Simplex virus 2 from fossil data

PubMed Central

Underdown, Simon J.; Kumar, Krishna

2017-01-01

Abstract Herpes simplex virus 2 (HSV2) is a human herpesvirus found worldwide that causes genital lesions and more rarely causes encephalitis. This pathogen is most common in Africa, and particularly in central and east Africa, an area of particular significance for the evolution of modern humans. Unlike HSV1, HSV2 has not simply co-speciated with humans from their last common ancestor with primates. HSV2 jumped the species barrier between 1.4 and 3 MYA, most likely through intermediate but unknown hominin species. In this article, we use probability-based network analysis to determine the most probable transmission path between intermediate hosts of HSV2, from the ancestors of chimpanzees to the ancestors of modern humans, using paleo-environmental data on the distribution of African tropical rainforest over the last 3 million years and data on the age and distribution of fossil species of hominin present in Africa between 1.4 and 3 MYA. Our model identifies Paranthropus boisei as the most likely intermediate host of HSV2, while Homo habilis may also have played a role in the initial transmission of HSV2 from the ancestors of chimpanzees to P.boisei. PMID:28979799

Network analysis of the hominin origin of Herpes Simplex virus 2 from fossil data.

PubMed

Underdown, Simon J; Kumar, Krishna; Houldcroft, Charlotte

2017-07-01

Herpes simplex virus 2 (HSV2) is a human herpesvirus found worldwide that causes genital lesions and more rarely causes encephalitis. This pathogen is most common in Africa, and particularly in central and east Africa, an area of particular significance for the evolution of modern humans. Unlike HSV1, HSV2 has not simply co-speciated with humans from their last common ancestor with primates. HSV2 jumped the species barrier between 1.4 and 3 MYA, most likely through intermediate but unknown hominin species. In this article, we use probability-based network analysis to determine the most probable transmission path between intermediate hosts of HSV2, from the ancestors of chimpanzees to the ancestors of modern humans, using paleo-environmental data on the distribution of African tropical rainforest over the last 3 million years and data on the age and distribution of fossil species of hominin present in Africa between 1.4 and 3 MYA. Our model identifies Paranthropus boisei as the most likely intermediate host of HSV2, while Homo habilis may also have played a role in the initial transmission of HSV2 from the ancestors of chimpanzees to P.boisei .

How to conduct External Quality Assessment Schemes for the pre-analytical phase?

PubMed

Kristensen, Gunn B B; Aakre, Kristin Moberg; Kristoffersen, Ann Helen; Sandberg, Sverre

2014-01-01

In laboratory medicine, several studies have described the most frequent errors in the different phases of the total testing process, and a large proportion of these errors occur in the pre-analytical phase. Schemes for registration of errors and subsequent feedback to the participants have been conducted for decades concerning the analytical phase by External Quality Assessment (EQA) organizations operating in most countries. The aim of the paper is to present an overview of different types of EQA schemes for the pre-analytical phase, and give examples of some existing schemes. So far, very few EQA organizations have focused on the pre-analytical phase, and most EQA organizations do not offer pre-analytical EQA schemes (EQAS). It is more difficult to perform and standardize pre-analytical EQAS and also, accreditation bodies do not ask the laboratories for results from such schemes. However, some ongoing EQA programs for the pre-analytical phase do exist, and some examples are given in this paper. The methods used can be divided into three different types; collecting information about pre-analytical laboratory procedures, circulating real samples to collect information about interferences that might affect the measurement procedure, or register actual laboratory errors and relate these to quality indicators. These three types have different focus and different challenges regarding implementation, and a combination of the three is probably necessary to be able to detect and monitor the wide range of errors occurring in the pre-analytical phase.

Cost-effectiveness of 64-slice CT angiography compared to conventional coronary angiography based on a coverage with evidence development study in Ontario.

PubMed

Goeree, Ron; Blackhouse, Gord; Bowen, James M; O'Reilly, Daria; Sutherland, Simone; Hopkins, Robert; Chow, Benjamin; Freeman, Michael; Provost, Yves; Dennie, Carole; Cohen, Eric; Marcuzzi, Dan; Iwanochko, Robert; Moody, Alan; Paul, Narinder; Parker, John D

2013-10-01

Conventional coronary angiography (CCA) is the standard diagnostic for coronary artery disease (CAD), but multi-detector computed tomography coronary angiography (CTCA) is a non-invasive alternative. A multi-center coverage with evidence development study was undertaken and combined with an economic model to estimate the cost-effectiveness of CTCA followed by CCA vs CCA alone. Alternative assumptions were tested in patient scenario and sensitivity analyses. CCA was found to dominate CTCA, however, CTCA was relatively more cost-effective in females, in advancing age, in patients with lower pre-test probabilities of CAD, the higher the sensitivity of CTCA and the lower the probability of undergoing a confirmatory CCA following a positive CTCA. RESULTS were very sensitive to alternative patient populations and modeling assumptions. Careful consideration of patient characteristics, procedures to improve the diagnostic yield of CTCA and selective use of CCA following CTCA will impact whether CTCA is cost-effective or dominates CCA.

NAFLD fibrosis score: a prognostic predictor for mortality and liver complications among NAFLD patients.

PubMed

Treeprasertsuk, Sombat; Björnsson, Einar; Enders, Felicity; Suwanwalaikorn, Sompongse; Lindor, Keith D

2013-02-28

To study whether the severity of liver fibrosis estimated by the nonalcoholic fatty liver disease (NAFLD) fibrosis score can predict all-cause mortality, cardiac complications, and/or liver complications of patients with NAFLD over long-term follow-up. A cohort of well-characterized patients with NAFLD diagnosed during the period of 1980-2000 was identified through the Rochester Epidemiology Project. The NAFLD fibrosis score (NFS) was used to separate NAFLD patients with and without advanced liver fibrosis. We used the NFS score to classify the probability of fibrosis as < -1.5 for low probability, > -1.5 to < 0.67 for intermediate probability, and > 0.67 for high probability. Primary endpoints included all-cause death and cardiovascular- and/or liver-related mortality. From the 479 patients with NAFLD assessed, 302 patients (63%) greater than 18 years old were included. All patients were followed, and medical charts were reviewed until August 31, 2009 or the date when the first primary endpoint occurred. By using a standardized case record form, we recorded a detailed history and physical examination and the use of statins and metformin during the follow-up period. A total of 302/479 (63%) NAFLD patients (mean age: 47 ± 13 year) were included with a follow-up period of 12.0 ± 3.9 year. A low probability of advanced fibrosis (NFS < -1.5 at baseline) was found in 181 patients (60%), while an intermediate or high probability of advanced fibrosis (NSF > -1.5) was found in 121 patients (40%). At the end of the follow-up period, 55 patients (18%) developed primary endpoints. A total of 39 patients (13%) died during the follow-up. The leading causes of death were non-hepatic malignancy (n = 13/39; 33.3%), coronary heart disease (CHD) (n = 8/39; 20.5%), and liver-related mortality (n = 5/39; 12.8%). Thirty patients had new-onset CHD, whereas 8 of 30 patients (27%) died from CHD-related causes during the follow-up. In a multivariate analysis, a higher NFS at baseline and the presence of new-onset CHD were significantly predictive of death (OR = 2.6 and 9.2, respectively; P < 0.0001). Our study showed a significant, graded relationship between the NFS, as classified into 3 subgroups (low, intermediate and high probability of liver fibrosis), and the occurrence of primary endpoints. The use of metformin or simvastatin for at least 3 mo during the follow-up was associated with fewer deaths in patients with NAFLD (OR = 0.2 and 0.03, respectively; P < 0.05). Additionally, the rate of annual NFS change in patients with an intermediate or high probability of advanced liver fibrosis was significantly lower than those patients with a low probability of advanced liver fibrosis (0.06 vs 0.09, P = 0.004). The annual NFS change in patients who died was significantly higher than those in patients who survived (0.14 vs 0.07, P = 0.03). At the end of the follow-up, we classified the patients into 3 subgroups according to the progression pattern of liver fibrosis by comparing the NFS at baseline to the NFS at the end of the follow-up period. Most patients were in the stable-fibrosis (60%) and progressive-fibrosis (37%) groups, whereas only 3% were in the regressive fibrosis. A higher NAFLD fibrosis score at baseline and a new onset of CHD were significantly predictive of death in patients with NAFLD.

Altered visual sensory fusion in children with reading difficulties.

PubMed

González-Castro, P; Rodríguez, C; Núñez, J C; Vallejo, G; González-Pienda, J A

2014-12-01

Reading is a multi-sensory and multi-cognitive task, and its difficulties (e.g., dyslexia) are not a unitary disorder. There are probably a variety of manifestations that relate to the actual site of impairment. A randomized, pre-test/post-test nonequivalent-groups design was conducted over 4 months with three groups aged between 6 and 8 years. One group comprised 76 participants (34 boys, 42 girls) with reading difficulties and altered sensory fusion (RD+ASF), a second group was made up of 123 students (59 boys, 64 girls) with reading difficulties but without altered sensory fusion (RD), and a third group comprised 81 participants (39 boys, 42 girls) who were young readers (RL) without reading delay, paired with the RD group on reading level. The experimental groups received intervention in the skills of control, stimulus recognition, and phonological awareness during a 4-month period. Both pre-test and post-test measures of errors in reading mechanics and reading routes (word and pseudo-word) were obtained. Poorer results in mechanics and reading routes of the RD+ASF group suggest that the effectiveness of the intervention depended on the characteristics of the groups and on the presence of sensory fusion deficits in the RD students.

Performance evaluation of intermediate cover soil barrier for removal of heavy metals in landfill leachate.

PubMed

Suzuki, Kazuyuki; Anegawa, Aya; Endo, Kazuto; Yamada, Masato; Ono, Yusaku; Ono, Yoshiro

2008-11-01

This pilot-scale study evaluated the use of intermediate cover soil barriers for removing heavy metals in leachate generated from test cells for co-disposed fly ash from municipal solid waste incinerators, ash melting plants, and shredder residue. Cover soil barriers were mixtures of Andisol (volcanic ash soil), waste iron powder, (grinder dust waste from iron foundries), and slag fragments. The cover soil barriers were installed in the test cells' bottom layer. Sorption/desorption is an important process in cover soil bottom barrier for removal of heavy metals in landfill leachate. Salt concentrations such as those of Na, K, and Ca in leachate were extremely high (often greater than 30 gL(-1)) because of high salt content in fly ash from ash melting plants. Concentrations of all heavy metals (nickel, manganese, copper, zinc, lead, and cadmium) in test cell leachates with a cover soil barrier were lower than those of the test cell without a cover soil barrier and were mostly below the discharge limit, probably because of dilution caused by the amount of leachate and heavy metal removal by the cover soil barrier. The cover soil barriers' heavy metal removal efficiency was calculated. About 50% of copper, nickel, and manganese were removed. About 20% of the zinc and boron were removed, but lead and cadmium were removed only slightly. Based on results of calculation of the Langelier saturation index and analyses of core samples, the reactivity of the cover soil barrier apparently decreases because of calcium carbonate precipitation on the cover soil barriers' surfaces.

Phenotypes and genes of resistance of pneumococci to penicillin isolated from children.

PubMed

Kotevska, V; Trajkovska-Dokic, E; Jankoska, G; Kaftandzieva, A; Panovski, N; Petrovska, M

2009-07-01

(Full text is available at http://www.manu.edu.mk/prilozi). In recent decades, the increase of Streptococcus pneumoniae strains resistant to beta-lactams, to other classes of antimicrobial drugs and especially to penicillin (penicillin-resistant pneumococcus - PRP) has further complicated the treatment of pneumococcal infection. Penicillin resistance in pneumococci is due to the development of altered penicillin-binding proteins (PBPs) in the bacterial cell wall. PBPs are known as six different variants (PBP1a, 1b, 2x, 2a, 2b and 3). to compare the presence and types of genes responsible for penicillin resistance in Streptococcus pneumoniae isolates with the minimal inhibitory concentrations (MIC) of penicillin as well as their correlation within the period of childhood. A total of 45 pneumococci obtained from nasal swabs and tracheal aspirates of children treated at the University Paediatric Clinic in Skopje were examined. According to age, the children were grouped as 1-3, 4-6 and 7-10 years. the oxacillin test (1microg) was used as a rapid screening test for the detection of PRP. MIC of penicillin were determined using the agar dilution method and interpreted according to NCCLS as resistant (if MIC are > 2 microg/ml), intermediate resistant (between 0,12-1.0 microg/ml) and susceptible (< 0,06 microg/ml). The genes pbp2b and pbp 2x, which are the genes mainly responsible for the onset of PRP, were detected using polymerase chain reaction (PCR). the oxacillin test showed that 38 pneumococci were resistant and 7 susceptible to penicillin. MIC of penicillin showed that 7 strains were resistant, 33 strains were intermediate resistant (12, 18, and 3 with MIC of 0.5 microg/ml, 0.25 microg/ml and 0.12 microg/ml, respectively) and 5 susceptible. According to MIC, of the total 40 resistant/intermediate resistant pneumococci, in 22 genes pbp2b and/or pbp2x, were confirmed (3 resistant strains with both genes; 7 intermediate resistant and 3 resistant strains with pbp2x genes; whereas 8 intermediate resistance and 1 susceptible strain with pbp2b). In a total of 11 strains (10 intermediate resistant and one resistant according to MIC), pbp2b and/or pbp2x genes were not detected, and their resistance is probably due to some other mechanisms or other genes that code PBP. The largest number of the examined pneumococci (32) were isolated from children aged 1-3 years and in 18 of them either pbp2b or pbp2x genes were detected. the oxacillin test is not suitable for discriminating the intermediate resistant and resistant pneumococci, while it is relevant for the detection of susceptible strains. Penicillin resistance of pneumococci that were causes of infection in children was on a lower level (15.5% resistant strains with MIC 1double dagger2 mg/ml and 73.3% intermediate resistant strains with MIC 0.12double dagger1 microg/ml). Pbp2b and/or pbp2x genes were detected in 22 of the examined strains and all of them except one were intermediate resistant or resistant. The Pbp2b gene is mostly present in the intermediate resistant strains and because it was detected in one susceptible strain, this gene is responsible for a low level of resistance. The pbp2x gene was detected in all the resistant strains and that is why we could conclude that it was coding the high level of resistance. Streptococcus pneumoniae was predominantly isolated from the age group 1-3 years where the PRP were not significant (Chi square; p > 0.05). Key words: Streptococcus pneumoniae, Penicillin resistance, Minimal Inhibitory Concentration (MIC), Genes of Resistance.

The Quantitative Science of Evaluating Imaging Evidence.

PubMed

Genders, Tessa S S; Ferket, Bart S; Hunink, M G Myriam

2017-03-01

Cardiovascular diagnostic imaging tests are increasingly used in everyday clinical practice, but are often imperfect, just like any other diagnostic test. The performance of a cardiovascular diagnostic imaging test is usually expressed in terms of sensitivity and specificity compared with the reference standard (gold standard) for diagnosing the disease. However, evidence-based application of a diagnostic test also requires knowledge about the pre-test probability of disease, the benefit of making a correct diagnosis, the harm caused by false-positive imaging test results, and potential adverse effects of performing the test itself. To assist in clinical decision making regarding appropriate use of cardiovascular diagnostic imaging tests, we reviewed quantitative concepts related to diagnostic performance (e.g., sensitivity, specificity, predictive values, likelihood ratios), as well as possible biases and solutions in diagnostic performance studies, Bayesian principles, and the threshold approach to decision making. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Stereoselectivity in catalytic reactions: CO oxidation on Pd(100) by rotationally aligned O2 molecules

NASA Astrophysics Data System (ADS)

Vattuone, L.; Gerbi, A.; Savio, L.; Cappelletti, D.; Pirani, F.; Rocca, M.

2010-05-01

We report on stereodynamical effects in heterogeneous catalytic reactions as measured by molecular beam-surface experiments. Specifically for CO oxidation on Pd(100) we find that the rotational alignment of the incoming O2 at low (Θ = 0.04 ML) and at intermediate (ΘCO = 0.17 ML) CO pre-coverage, causes a higher reactivity of molecules in high and in low helicity states, respectively (corresponding to helicoptering and cartwheeling motion of O2). In first approximation, at low CO pre-coverage the difference in reactivity is determined by the different location of the O atoms generated in the dissociation process by the different parent molecules, while at intermediate CO pre-coverage the reactivity is influenced also by the different ability of cartwheeling and helicoptering O2 to penetrate through the CO adlayer. In accord with this the total amount of CO2 produced is always largest for helicopters which generate supersurface O atoms at least in the low CO pre-coverage limit. A deeper inspection of the data indicates, however, that the dynamics is more complex, two different pathways being present for the reaction with O generated by helicopters and one for O generated by cartwheels. Moreover, cartwheels generated oxygen influences the reactivity of subsequently arriving helicopters.

Physician Assessment of Pretest Probability of Malignancy and Adherence With Guidelines for Pulmonary Nodule Evaluation.

PubMed

Tanner, Nichole T; Porter, Alexander; Gould, Michael K; Li, Xiao-Jun; Vachani, Anil; Silvestri, Gerard A

2017-08-01

The annual incidence of pulmonary nodules is estimated at 1.57 million. Guidelines recommend using an initial assessment of nodule probability of malignancy (pCA). A previous study found that despite this recommendation, physicians did not follow guidelines. Physician assessments (N = 337) and two previously validated risk model assessments of pretest probability of cancer were evaluated for performance in 337 patients with pulmonary nodules based on final diagnosis and compared. Physician-assessed pCA was categorized into low, intermediate, and high risk, and the next test ordered was evaluated. The prevalence of malignancy was 47% (n = 158) at 1 year. Physician-assessed pCA performed better than nodule prediction calculators (area under the curve, 0.85 vs 0.75; P < .001 and .78; P = .0001). Physicians did not follow indicated guidelines when selecting the next test in 61% of cases (n = 205). Despite recommendations for serial CT imaging in those with low pCA, 52% (n = 13) were managed more aggressively with PET imaging or biopsy; 12% (n = 3) underwent biopsy procedures for benign disease. Alternatively, in the high-risk category, the majority (n = 103 [75%]) were managed more conservatively. Stratified by diagnosis, 92% (n = 22) with benign disease underwent more conservative management with CT imaging (20%), PET scanning (15%), or biopsy (8%), although three had surgery (8%). Physician assessment as a means for predicting malignancy in pulmonary nodules is more accurate than previously validated nodule prediction calculators. Despite the accuracy of clinical intuition, physicians did not follow guideline-based recommendations when selecting the next diagnostic test. To provide optimal patient care, focus in the areas of guideline refinement, implementation, and dissemination is needed. Published by Elsevier Inc.

HIV-1 Env trimer opens through an asymmetric intermediate in which individual protomers adopt distinct conformations.

PubMed

Ma, Xiaochu; Lu, Maolin; Gorman, Jason; Terry, Daniel S; Hong, Xinyu; Zhou, Zhou; Zhao, Hong; Altman, Roger B; Arthos, James; Blanchard, Scott C; Kwong, Peter D; Munro, James B; Mothes, Walther

2018-03-21

HIV-1 entry into cells requires binding of the viral envelope glycoprotein (Env) to receptor CD4 and coreceptor. Imaging of individual Env molecules on native virions shows Env trimers to be dynamic, spontaneously transitioning between three distinct well-populated conformational states: a pre-triggered Env (State 1), a default intermediate (State 2) and a three-CD4-bound conformation (State 3), which can be stabilized by binding of CD4 and coreceptor-surrogate antibody 17b. Here, using single-molecule Fluorescence Resonance Energy Transfer (smFRET), we show the default intermediate configuration to be asymmetric, with individual protomers adopting distinct conformations. During entry, this asymmetric intermediate forms when a single CD4 molecule engages the trimer. The trimer can then transition to State 3 by binding additional CD4 molecules and coreceptor.

Improving the reliability of automated non-destructive inspection

NASA Astrophysics Data System (ADS)

Brierley, N.; Tippetts, T.; Cawley, P.

2014-02-01

In automated NDE a region of an inspected component is often interrogated several times, be it within a single data channel, across multiple channels or over the course of repeated inspections. The systematic combination of these diverse readings is recognized to provide a means to improve the reliability of the inspection, for example by enabling noise suppression. Specifically, such data fusion makes it possible to declare regions of the component defect-free to a very high probability whilst readily identifying indications. Registration, aligning input datasets to a common coordinate system, is a critical pre-computation before meaningful data fusion takes place. A novel scheme based on a multiobjective optimization is described. The developed data fusion framework, that is able to identify and rate possible indications in the dataset probabilistically, based on local data statistics, is outlined. The process is demonstrated on large data sets from the industrial ultrasonic testing of aerospace turbine disks, with major improvements in the probability of detection and probability of false call being obtained.

What is the value of routinely testing full blood count, electrolytes and urea, and pulmonary function tests before elective surgery in patients with no apparent clinical indication and in subgroups of patients with common comorbidities: a systematic review of the clinical and cost-effective literature.

PubMed

Czoski-Murray, C; Lloyd Jones, M; McCabe, C; Claxton, K; Oluboyede, Y; Roberts, J; Nicholl, J P; Rees, A; Reilly, C S; Young, D; Fleming, T

2012-12-01

The evidence base which supported the National Institute for Health and Clinical Excellence (NICE) published Clinical Guideline 3 was limited and 50% was graded as amber. However, the use of tests as part of pre-operative work-up remains a low-cost but high-volume activity within the NHS, with substantial resource implications. The objective of this study was to identify, evaluate and synthesise the published evidence on the clinical effectiveness and cost-effectiveness of the routine use of three tests, full blood counts (FBCs), urea and electrolytes tests (U&Es) and pulmonary function tests, in the pre-operative work-up of otherwise healthy patients undergoing minor or intermediate surgery in the NHS. The aims of this study were to estimate the clinical effectiveness and cost-effectiveness of routine pre-operative testing of FBC, electrolytes and renal function and pulmonary function in adult patients classified as American Society of Anaesthesiologists (ASA) grades 1 and 2 undergoing elective minor (grade 1) or intermediate (grade 2) surgical procedures; to compare NICE recommendations with current practice; to evaluate the cost-effectiveness of mandating or withdrawing each of these tests in this patient group; and to identify the expected value of information and whether or not it has value to the NHS in commissioning further primary research into the use of these tests in this group of patients. The following electronic bibliographic databases were searched: (1) BIOSIS; (2) Cumulative Index to Nursing and Allied Health Literature; (3) Cochrane Database of Systematic Reviews; (4) Cochrane Central Register of Controlled Trials; (5) EMBASE; (6) MEDLINE; (7) MEDLINE In-Process & Other Non-Indexed Citations; (8) NHS Database of Abstracts of Reviews of Effects; (9) NBS Health Technology Assessment Database; and (10) Science Citation Index. To identify grey and unpublished literature, the Cochrane Register of Controlled Trials, National Research Register Archive, National Institute for Health Research Clinical Research Network Portfolio database and the Copernic Meta-search Engine were searched. A large routine data set which recorded the results of tests was obtained from Leeds Teaching Hospitals Trust. A systematic review of the literature was carried out. The searches were undertaken in March to April 2008 and June 2009. Searches were designed to retrieve studies that evaluated the clinical effectiveness and cost-effectiveness of routine pre-operative testing of FBC, electrolytes and renal function and pulmonary function in the above group of patients. A postal survey of current practice in testing patients in this group pre-operatively was undertaken in 2008. An exemplar cost-effectiveness model was constructed to demonstrate what form this would have taken had there been sufficient data. A large routine data set that recorded the results of tests was obtained from Leeds Teaching Hospitals Trust. This was linked to individual patient data with surgical outcomes, and regression models were estimated. A comprehensive and systematic search of both the clinical effectiveness and cost-effectiveness literature identified a large number of potentially relevant studies. However, when these studies were subjected to detailed review and quality assessment, it became clear that the literature provides no evidence on the clinical effectiveness and cost-effectiveness of these specific tests in the specific patient groups. The postal survey had a 17% response rate. Results reported that in ASA grade 1, patients aged < 40 years with no comorbidities undergoing minor surgery did not have routine tests for FBC, electrolytes and renal function and pulmonary function. The results from the regression model showed that the frequency of test use was not consistent with the hypothesis of their routine use. FBC tests were performed in only 58% of patients in the data set and U&E testing was carried out in only 57%. Systematic searches of the clinical effectiveness and cost-effectiveness literature found that there is no evidence on the clinical effectiveness or cost-effectiveness of these tests in this specific clinical context for the NHS. A survey of NHS hospitals found that respondent trusts were implementing current NICE guidance in relation to pre-operative testing generally, and a de novo analysis of routine data on test utilisation and post-operative outcome found that the tests were not be used in routine practice; rather, use was related to an expectation of a more complex clinical case. The paucity of published evidence is a limitation of this study. The studies included relied on non-UK health-care systems data, which may not be transferable. The inclusion of non-randomised studies is associated with an increased risk of bias and confounding. Scoping work to establish the likely mechanism of action by which tests would impact upon outcomes and resource utilisation established that the cause of an abnormal test result is likely to be a pivotal determinant of the cost-effectiveness of a pre-operative test and therefore evaluations would need to consider tests in the context of the underlying risk of specific clinical problems (i.e. risk guided rather than routine use). The time of universal utilisation of pre-operative tests for all surgical patients is likely to have passed. The evidence we have identified, though weak, indicates that tests are increasingly utilised in patients in whom there is a reason to consider an underlying raised risk of a clinical abnormality that should be taken into account in their clinical management. It is likely that this strategy has led to substantial resource savings for the NHS, although there is not a published evidence base to establish that this is the case. The total expenditure on pre-operative tests across the NHS remains significant. Evidence on current practice indicates that clinical practice has changed to such a degree that the original research question is no longer relevant to UK practice. Future research on the value of these tests in pre-operative work-up should be couched in terms of the clinical effectiveness and cost-effectiveness in the identification of specific clinical abnormalities in patients with a known underlying risk. We suggest that undertaking a multicentre study making use of linked, routinely collected data sets would identify the extent and nature of pre-operative testing in this group of patients. The National Institute for Health Research Health Technology Assessment programme.

How does audit and feedback influence intentions of health professionals to improve practice? A laboratory experiment and field study in cardiac rehabilitation.

PubMed

Gude, Wouter T; van Engen-Verheul, Mariëtte M; van der Veer, Sabine N; de Keizer, Nicolette F; Peek, Niels

2017-04-01

To identify factors that influence the intentions of health professionals to improve their practice when confronted with clinical performance feedback, which is an essential first step in the audit and feedback mechanism. We conducted a theory-driven laboratory experiment with 41 individual professionals, and a field study in 18 centres in the context of a cluster-randomised trial of electronic audit and feedback in cardiac rehabilitation. Feedback reports were provided through a web-based application, and included performance scores and benchmark comparisons (high, intermediate or low performance) for a set of process and outcome indicators. From each report participants selected indicators for improvement into their action plan. Our unit of observation was an indicator presented in a feedback report (selected yes/no); we considered selecting an indicator to reflect an intention to improve. We analysed 767 observations in the laboratory experiment and 614 in the field study, respectively. Each 10% decrease in performance score increased the probability of an indicator being selected by 54% (OR, 1.54; 95% CI 1.29% to 1.83%) in the laboratory experiment, and 25% (OR, 1.25; 95% CI 1.13% to 1.39%) in the field study. Also, performance being benchmarked as low and intermediate increased this probability in laboratory settings. Still, participants ignored the benchmarks in 34% (laboratory experiment) and 48% (field study) of their selections. When confronted with clinical performance feedback, performance scores and benchmark comparisons influenced health professionals' intentions to improve practice. However, there was substantial variation in these intentions, because professionals disagreed with benchmarks, deemed improvement unfeasible or did not consider the indicator an essential aspect of care quality. These phenomena impede intentions to improve practice, and are thus likely to dilute the effects of audit and feedback interventions. NTR3251, pre-results. 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/.

Plasma protein biomarkers enhance the clinical prediction of kidney injury recovery in patients undergoing liver transplantation.

PubMed

Levitsky, Josh; Baker, Talia B; Jie, Chunfa; Ahya, Shubhada; Levin, Murray; Friedewald, John; Al-Saden, Patrice; Salomon, Daniel R; Abecassis, Michael M

2014-12-01

Biomarkers predictive of recovery from acute kidney injury (AKI) after liver transplantation (LT) could enhance decision algorithms regarding the need for liver-kidney transplantation or renal sparing regimens. Multianalyte plasma/urine kidney injury protein panels were performed immediately before and 1 month post-LT in an initial test group divided by reversible pre-LT AKI (rAKI = post-LT renal recovery) versus no AKI (nAKI). This was followed by a larger validation set that included an additional group: irreversible pre-LT AKI (iAKI = no post-LT renal recovery). In the test group (n = 16), six pre-LT plasma (not urine) kidney injury proteins (osteopontin [OPN], neutrophil gelatinase-associated lipocalin, cystatin C, trefoil factor 3, tissue inhibitor of metalloproteinase [TIMP]-1, and β-2-microglobulin) were higher in rAKI versus nAKI (P < 0.05) and returned to normal values with renal recovery post-LT. In the validation set (n = 46), a number of proteins were significantly higher in both rAKI and iAKI versus nAKI. However, only pre-LT plasma OPN (P = 0.009) and TIMP-1 (P = 0.019) levels were significantly higher in rAKI versus iAKI. Logistic regression modeling was used to correlate the probability of post-LT rAKI, factoring in both pre-LT protein markers and clinical variables. A combined model including elevated OPN and TIMP-1 levels, age <57, and absence of diabetes had the highest area under the curve of 0.82, compared to protein-only and clinical variable-only models. These data suggest that plasma protein profiles might improve the prediction of pre-LT kidney injury recovery after LT. However, multicenter, prospective studies are needed to validate these findings and ultimately test the value of such protein panels in perioperative management and decision making. © 2014 by the American Association for the Study of Liver Diseases.

[Scores and stages in pneumology].

PubMed

Kuhn, Max

2013-10-01

Useful scales and classifications for patients with pulmonary diseases are discussed. The modified Medical Research Council breathlessness scale (mMRC) is a measure of disability in lung patients. The GOLD classifications, the COPD-Assessment Test (CAT) and the BODE Index are important to classify the severity of COPD and to measure the disability of these patients. The Geneva score is a clinical prediction rule used in determining the pre-test probability of pulmonary embolism. The Pulmonary Embolism Severity Index (PESI) is a scoring system used to predict 30 day mortality in patients with pulmonary embolism. The Epworth Sleepiness Scale is intended to measure daytime sleepiness in patients with sleep apnea syndrome. The Asthma Controll Test (ACT) determines if asthma symptoms are well controlled.

The prevalence of positive serological tests for syphilis among elderly hospital patients.

PubMed

Corrado, O J; Bowie, P C; Bagnall, W E; Waugh, M A

1989-11-01

Serological tests for syphilis were performed on 659 elderly patients admitted to hospital medical and psychiatric departments. Positive tests were found in 23 patients (3.5% of the sample), 17 women and 6 men. Six were subsequently discovered to have been treated previously for syphilis, and one other had radiological evidence to suggest that she had been treated with bismuth in the pre-penicillin era. Difficulties were encountered in classifying the stage of infection in some patients, particularly those with significant intellectual impairment. Eleven were diagnosed as late latent syphilis, seven as probable late latent syphilis, one as tabes dorsalis, one as possible cardiovascular syphilis, one as possible meningovascular syphilis, and one as late congenital syphilis.

Chlorofluorocarbon and tritium age determination of ground-water recharge in the Ryan Flat subbasin, Trans-Pecos Texas

USGS Publications Warehouse

Bartolino, J.R.

1997-01-01

A study was conducted to determine the relative influence of mountain-front infiltration in the Ryan Flat subbasin and to determine whether recent recharge (post-1940), which is of importance to water-use planning, has reached the Salt Basin aquifer, Trans-Pecos Texas. The alluvial and volcanic Salt Basin aquifer lies within a bolson, and the average depth to water in most of the subbasin is approximately 250 feet. Concentrations of the chlorofluorocarbons CFC-11, CFC-12, and CFC-113, as well as tritium, were measured in water from 10 wells in the study area. CFC-model recharge dates ranged from pre-1940 to the early 1970's. Ground water in five wells had CFC-model dates of pre-1940 or pre-1945. Ground water in two wells had dates of the mid- to late 1940's. Ground water from one well had a CFC-model recharge age of the early 1950's. Samples from the remaining two wells were most probably contaminated in some manner and are probably unreliable. CFC-model ages were calculated independently for the three chlorofluorocarbons, though the presence of volatile organic compounds affected agreement among them. Tritium activities in the nine wells for which tritium was analyzed indicated pre-1953 recharge and thus agreed approximately with the CFC-model dates. Ground water was analyzed for selected water-quality constituents. Water from all wells met U.S. Environmental Protection Agency national primary and secondary drinking water standards for all tested constituents except fluoride in samples from three wells. Silica concentrations in water from six wells exceeded a range considered typical in natural waters.

Digital intermediate frequency QAM modulator using parallel processing

DOEpatents

Pao, Hsueh-Yuan [Livermore, CA; Tran, Binh-Nien [San Ramon, CA

2008-05-27

The digital Intermediate Frequency (IF) modulator applies to various modulation types and offers a simple and low cost method to implement a high-speed digital IF modulator using field programmable gate arrays (FPGAs). The architecture eliminates multipliers and sequential processing by storing the pre-computed modulated cosine and sine carriers in ROM look-up-tables (LUTs). The high-speed input data stream is parallel processed using the corresponding LUTs, which reduces the main processing speed, allowing the use of low cost FPGAs.

FATTY MUSCLE INFILTRATION IN CUFF TEAR: PRE AND POST OPERATIVE EVALUATION BY MRI.

PubMed

Miyazaki, Alberto Naoki; Santos, Pedro Doneux; da Silva, Luciana Andrade; Sella, Guilherme do Val; Miranda, Eduardo Régis de Alencar Bona; Zampieri, Rodrigo

2015-01-01

To evaluate the fatty infiltration and atrophy of the supraespinatus in the pre- and postoperative of a rotator cuff lesion (RCL), by MRI. Ten patients with full-thickness rotator cuff tears who had undergone surgical arthroscopic rotator cuff repair between September and December 2011 were included. This is a prospective study, with analysis and comparison of fatty infiltration and atrophy of the supraespinatus. The occupation ratio was measured using the magic selection tool in Adobe Photoshop CS3((r)) on T1 oblique sagittal Y-view MRI. Through Photoshop, the proportion occupied by the muscle belly regarding its fossae was calculated. There was a statistically significant increase in the muscle ratio (p=0.013) comparing images pre and postoperative, analyzed by the Wilcoxon T test. The proportion of the supraspinal muscle above the pit increases in the immediate postoperative period, probably due to the traction exerted on the tendon at the time of repair. Level of Evidence II, Cohort Study.

Importance of acetylacetone and 2,2'-bipyridyl ligands in radiation-chemical processes of complex compounds

NASA Astrophysics Data System (ADS)

Kalecińska, E.; Kaleciński, J.

The study of radiation response of free ligands: acetylacetone and 2,2'-bipyridyl in frozen chloride-alcohol-water glasses allows us to identify the intermediates playing the significant role in radiation decomposition of the complexes. On the basis of absorption spectra of the intermediates it has been shown that both examined ligands are effective scavengers of electrons. In the case of acetylacetone the intermediate most probably acacOH (exhibiting absorption band with λ max at ca. 580 nm) is not sensitive for bleaching light and its concentration increases during the warming up (from 77 to 160 K) of the sample. In the case of 2,2'-bipyridyl two intermediates (high intensity narrow bands with λ max at ca. 385 and 370 nm) are formed depending on pH of the system. Their formation and interconversion have also been studied.

Effect of special diabetes program for Indians funding on system changes in diabetes care and outcomes among American Indian/Alaska Native people 1994-2004.

PubMed

Ramesh, Meera; Schraer, Cynthia; Mayer, Ann Marie; Asay, Elvin; Koller, Kathryn

2008-06-01

The Alaska Native Medical Center diabetes program analysed Diabetes Care and Outcomes Audit data from 1994-2004 to evaluate the impact of the Special Diabetes Program for Indians (SDPI) funding on process and intermediate outcomes. We conducted a retrospective analysis of data from standardized medical records reviews conducted between 1994 and 2004 from regional sites in Alaska. We analysed 7,735 randomly selected records for trends over three time periods (pre-SDPI, transition and SDPI). Hemoglobin A1c, total and LDL cholesterol, triglycerides and blood pressure significantly improved from the pre-SDPI to the SDPI period. However, as the number of people with diabetes increased, the percentage of patients receiving foot, eye and dental exams decreased, as did the percentage receiving nutrition, exercise and diabetes education. SDPI funding provided resources for interventions necessary to improve the effectiveness of diabetes care. This was associated with improved intermediate outcomes in American Indian/Alaska Native patients with diabetes. Further observations are needed to evaluate whether or not intermediate outcomes result in decreased cardiovascular disease, amputations, dialysis and retinopathy.

Effect of Baseline Anxiety and Depression Symptoms on Selected Outcomes Following Pulmonary Rehabilitation.

PubMed

Cullen, Kate; Talbot, Daniel; Gillmor, Julie; McGrath, Colin; OʼDonnell, Rory; Baily-Scanlan, Maria; Broderick, Julie

2017-07-01

Anxiety and depression are prevalent comorbidities in people with chronic respiratory diseases (CRDs). This study sought to quantify the influence of varying degrees of anxiety and depression on functional performance and disease impact in a population with CRDs following pulmonary rehabilitation (PR) intervention. The Hospital Anxiety and Depression Scale (HADS), the 6-Minute Walk Test (6MWT), and the Chronic Obstructive Pulmonary Disease Assessment Test (CAT) were assessed pre- and post-PR. Participants were categorized into 3 groups (None, Probable, and Present) based on their level of anxiety and depression. Functional performance and disease impact outcomes were compared pre- and post-PR. Patients consisted of a total of 134 program completers (72 males, 62 females; mean age = 67.8 years). Significant improvements in functional performance with regard to 6MWT scores were observed across all groups postintervention (P < .05). The Present group, in both the anxiety and depression domains, failed to reach a minimally clinically important difference postintervention. The Probable and Present groups achieved a significant improvement in CAT scores postintervention (P < .05). This study showed that symptoms of anxiety and depression in people with CRDs were significantly related to lower exercise tolerance levels and higher levels of disease impact. People with increased levels of anxiety and depression have the potential to significantly improve disease impact outcomes post-PR. The results demonstrated that the detection and treatment of anxiety and depression symptoms in people with CRDs are likely to be clinically important.

Kid-Short Marfan Score (Kid-SMS) Is a Useful Diagnostic Tool for Stratifying the Pre-Test Probability of Marfan Syndrome in Childhood

PubMed Central

Stark, Veronika C.; Arndt, Florian; Harring, Gesa; von Kodolitsch, Yskert; Kozlik-Feldmann, Rainer; Mueller, Goetz C.; Steiner, Kristoffer J.; Mir, Thomas S.

2015-01-01

Due to age dependent organ manifestation, diagnosis of Marfan syndrome (MFS) is a challenge, especially in childhood. It is important to identify children at risk of MFS as soon as possible to direct those to appropriate treatment but also to avoid stigmatization due to false diagnosis. We published the Kid-Short Marfan Score (Kid-SMS) in 2012 to stratify the pre-test probability of MFS in childhood. Hence we now evaluate the predictive performance of Kid-SMS in a new cohort of children. We prospectively investigated 106 patients who were suspected of having MFS. At baseline, children were examined according to Kid-SMS. At baseline and follow-up visit, diagnosis of MFS was established or rejected using standard current diagnostic criteria according to the revised Ghent Criteria (Ghent-2). At baseline 43 patients were identified with a risk of MFS according to Kid-SMS whereas 21 patients had Ghent-2 diagnosis of MFS. Sensitivity was 100%, specificity 77%, negative predictive value 100% and Likelihood ratio of Kid-SMS 4.3. During follow-up period, three other patients with a stratified risk for MFS were diagnosed according to Ghent-2. We confirm very good predictive performance of Kid-SMS with excellent sensitivity and negative predictive value but restricted specificity. Kid-SMS avoids stigmatization due to diagnosis of MFS and thus restriction to quality of life. Especially outpatient pediatricians and pediatric cardiologists can use it for primary assessment. PMID:28943606

Kid-Short Marfan Score (Kid-SMS) Is a Useful Diagnostic Tool for Stratifying the Pre-Test Probability of Marfan Syndrome in Childhood.

PubMed

Stark, Veronika C; Arndt, Florian; Harring, Gesa; von Kodolitsch, Yskert; Kozlik-Feldmann, Rainer; Mueller, Goetz C; Steiner, Kristoffer J; Mir, Thomas S

2015-03-12

Due to age dependent organ manifestation, diagnosis of Marfan syndrome (MFS) is a challenge, especially in childhood. It is important to identify children at risk of MFS as soon as possible to direct those to appropriate treatment but also to avoid stigmatization due to false diagnosis. We published the Kid-Short Marfan Score (Kid-SMS) in 2012 to stratify the pre-test probability of MFS in childhood. Hence we now evaluate the predictive performance of Kid-SMS in a new cohort of children. We prospectively investigated 106 patients who were suspected of having MFS. At baseline, children were examined according to Kid-SMS. At baseline and follow-up visit, diagnosis of MFS was established or rejected using standard current diagnostic criteria according to the revised Ghent Criteria (Ghent-2). At baseline 43 patients were identified with a risk of MFS according to Kid-SMS whereas 21 patients had Ghent-2 diagnosis of MFS. Sensitivity was 100%, specificity 77%, negative predictive value 100% and Likelihood ratio of Kid-SMS 4.3. During follow-up period, three other patients with a stratified risk for MFS were diagnosed according to Ghent-2. We confirm very good predictive performance of Kid-SMS with excellent sensitivity and negative predictive value but restricted specificity. Kid-SMS avoids stigmatization due to diagnosis of MFS and thus restriction to quality of life. Especially outpatient pediatricians and pediatric cardiologists can use it for primary assessment.

Target intersection probabilities for parallel-line and continuous-grid types of search

USGS Publications Warehouse

McCammon, R.B.

1977-01-01

The expressions for calculating the probability of intersection of hidden targets of different sizes and shapes for parallel-line and continuous-grid types of search can be formulated by vsing the concept of conditional probability. When the prior probability of the orientation of a widden target is represented by a uniform distribution, the calculated posterior probabilities are identical with the results obtained by the classic methods of probability. For hidden targets of different sizes and shapes, the following generalizations about the probability of intersection can be made: (1) to a first approximation, the probability of intersection of a hidden target is proportional to the ratio of the greatest dimension of the target (viewed in plane projection) to the minimum line spacing of the search pattern; (2) the shape of the hidden target does not greatly affect the probability of the intersection when the largest dimension of the target is small relative to the minimum spacing of the search pattern, (3) the probability of intersecting a target twice for a particular type of search can be used as a lower bound if there is an element of uncertainty of detection for a particular type of tool; (4) the geometry of the search pattern becomes more critical when the largest dimension of the target equals or exceeds the minimum spacing of the search pattern; (5) for elongate targets, the probability of intersection is greater for parallel-line search than for an equivalent continuous square-grid search when the largest dimension of the target is less than the minimum spacing of the search pattern, whereas the opposite is true when the largest dimension exceeds the minimum spacing; (6) the probability of intersection for nonorthogonal continuous-grid search patterns is not greatly different from the probability of intersection for the equivalent orthogonal continuous-grid pattern when the orientation of the target is unknown. The probability of intersection for an elliptically shaped target can be approximated by treating the ellipse as intermediate between a circle and a line. A search conducted along a continuous rectangular grid can be represented as intermediate between a search along parallel lines and along a continuous square grid. On this basis, an upper and lower bound for the probability of intersection of an elliptically shaped target for a continuous rectangular grid can be calculated. Charts have been constructed that permit the values for these probabilities to be obtained graphically. The use of conditional probability allows the explorationist greater flexibility in considering alternate search strategies for locating hidden targets. ?? 1977 Plenum Publishing Corp.

New Concepts in the Evaluation of Biodegradation/Persistence of Chemical Substances Using a Microbial Inoculum

PubMed Central

Thouand, Gérald; Durand, Marie-José; Maul, Armand; Gancet, Christian; Blok, Han

2011-01-01

The European REACH Regulation (Registration, Evaluation, Authorization of CHemical substances) implies, among other things, the evaluation of the biodegradability of chemical substances produced by industry. A large set of test methods is available including detailed information on the appropriate conditions for testing. However, the inoculum used for these tests constitutes a “black box.” If biodegradation is achievable from the growth of a small group of specific microbial species with the substance as the only carbon source, the result of the test depends largely on the cell density of this group at “time zero.” If these species are relatively rare in an inoculum that is normally used, the likelihood of inoculating a test with sufficient specific cells becomes a matter of probability. Normally this probability increases with total cell density and with the diversity of species in the inoculum. Furthermore the history of the inoculum, e.g., a possible pre-exposure to the test substance or similar substances will have a significant influence on the probability. A high probability can be expected for substances that are widely used and regularly released into the environment, whereas a low probability can be expected for new xenobiotic substances that have not yet been released into the environment. Be that as it may, once the inoculum sample contains sufficient specific degraders, the performance of the biodegradation will follow a typical S shaped growth curve which depends on the specific growth rate under laboratory conditions, the so called F/M ratio (ratio between food and biomass) and the more or less toxic recalcitrant, but possible, metabolites. Normally regulators require the evaluation of the growth curve using a simple approach such as half-time. Unfortunately probability and biodegradation half-time are very often confused. As the half-time values reflect laboratory conditions which are quite different from environmental conditions (after a substance is released), these values should not be used to quantify and predict environmental behavior. The probability value could be of much greater benefit for predictions under realistic conditions. The main issue in the evaluation of probability is that the result is not based on a single inoculum from an environmental sample, but on a variety of samples. These samples can be representative of regional or local areas, climate regions, water types, and history, e.g., pristine or polluted. The above concept has provided us with a new approach, namely “Probabio.” With this approach, persistence is not only regarded as a simple intrinsic property of a substance, but also as the capability of various environmental samples to degrade a substance under realistic exposure conditions and F/M ratio. PMID:21863143

A thiamin-bound, pre-decarboxylation reaction intermediate analogue in the pyruvate dehydrogenase E1 subunit induces large scale disorder-to-order transformations in the enzyme and reveals novel structural features in the covalently bound adduct.

PubMed

Arjunan, Palaniappa; Sax, Martin; Brunskill, Andrew; Chandrasekhar, Krishnamoorthy; Nemeria, Natalia; Zhang, Sheng; Jordan, Frank; Furey, William

2006-06-02

The crystal structure of the E1 component from the Escherichia coli pyruvate dehydrogenase multienzyme complex (PDHc) has been determined with phosphonolactylthiamin diphosphate (PLThDP) in its active site. PLThDP serves as a structural and electrostatic analogue of the natural intermediate alpha-lactylthiamin diphosphate (LThDP), in which the carboxylate from the natural substrate pyruvate is replaced by a phosphonate group. This represents the first example of an experimentally determined, three-dimensional structure of a thiamin diphosphate (ThDP)-dependent enzyme containing a covalently bound, pre-decarboxylation reaction intermediate analogue and should serve as a model for the corresponding intermediates in other ThDP-dependent decarboxylases. Regarding the PDHc-specific reaction, the presence of PLThDP induces large scale conformational changes in the enzyme. In conjunction with the E1-PLThDP and E1-ThDP structures, analysis of a H407A E1-PLThDP variant structure shows that an interaction between His-407 and PLThDP is essential for stabilization of two loop regions in the active site that are otherwise disordered in the absence of intermediate analogue. This ordering completes formation of the active site and creates a new ordered surface likely involved in interactions with the lipoyl domains of E2s within the PDHc complex. The tetrahedral intermediate analogue is tightly held in the active site through direct hydrogen bonds to residues His-407, Tyr-599, and His-640 and reveals a new, enzyme-induced, strain-related feature that appears to aid in the decarboxylation process. This feature is almost certainly present in all ThDP-dependent decarboxylases; thus its inclusion in our understanding of general thiamin catalysis is important.

Unemployment in Iraqi Refugees: The Interaction of Pre and Post-Displacement Trauma

PubMed Central

Wright, A. Michelle; Dhalimi, Abir; Lumley, Mark A.; Jamil, Hikmet; Pole, Nnamdi; Arnetz, Judith E.; Arnetz, Bengt B.

2016-01-01

Previous refugee research has been unable to link pre-displacement trauma with unemployment in the host country. The current study assessed the role of pre-displacement trauma, post-displacement trauma, and the interaction of both trauma types to prospectively examine unemployment in a random sample of newly-arrived Iraqi refugees. Participants (N=286) were interviewed three times over the first two years post-arrival. Refugees were assessed for pre-displacement trauma exposure, post-displacement trauma exposure, a history of unemployment in the country of origin and host country, and symptoms of posttraumatic stress disorder (PTSD) and depression. Analyses found that neither pre-displacement nor post-displacement trauma independently predicted unemployment 2 years post-arrival; however, the interaction of pre and post-displacement trauma predicted 2-year unemployment. Refugees with high levels of both pre and post-displacement trauma had a 91% predicted probability of unemployment, whereas those with low levels of both traumas had a 20% predicted probability. This interaction remained significant after controlling for sociodemographic variables and mental health upon arrival to the U.S. Resettlement agencies and community organizations should consider the interactive effect of encountering additional trauma after escaping the hardships of the refugee's country of origin. PMID:27535348

Development and validation of climate change system thinking instrument (CCSTI) for measuring system thinking on climate change content

NASA Astrophysics Data System (ADS)

Meilinda; Rustaman, N. Y.; Firman, H.; Tjasyono, B.

2018-05-01

The Climate Change System Thinking Instrument (CCSTI) is developed to measure a system thinking ability in the concept of climate change. CCSTI is developed in four phase’s development including instrument draft development, validation and evaluation including readable material test, expert validation, and field test. The result of field test is analyzed by looking at the readability score in Cronbach’s alpha test. Draft instrument is tested on college students majoring in Biology Education, Physics Education, and Chemistry Education randomly with a total number of 80 college students. Score of Content Validation Index at 0.86, which means that the CCSTI developed are categorized as very appropriate with question indicators and Cronbach’s alpha about 0.605 which mean categorized undesirable to minimal acceptable. From 45 questions of system thinking, there are 37 valid questions spread in four indicators of system thinking, which are system thinking phase I (pre-requirement), system thinking phase II (basic), system thinking phase III (intermediate), and system thinking phase IV (coherent expert).

Identification of oxidative coupling products of xylenols arising from laboratory-scale phytoremediation.

PubMed

Poerschmann, J; Schultze-Nobre, L; Ebert, R U; Górecki, T

2015-01-01

Oxidative coupling reactions take place during the passage of xylenols through a laboratory-scale helophyte-based constructed wetland system. Typical coupling product groups including tetramethyl-[1,1'-biphenyl] diols and tetramethyl diphenylether monools as stable organic intermediates could be identified by a combination of pre-chromatographic derivatization and GC/MS analysis. Structural assignment of individual analytes was performed by an increment system developed by Zenkevich to pre-calculate retention sequences. The most abundant analyte turned out to be 3,3',5,5'-tetramethyl-[1,1'-biphenyl]-4,4'-diol, which can be formed by a combination of radicals based on 2,6-xylenol or by an attack of a 2,6-xylenol-based radical on 2,6-xylenol. Organic intermediates originating from oxidative coupling could also be identified in anaerobic constructed wetland systems. This finding suggested the presence of (at least partly) oxic conditions in the rhizosphere. Copyright © 2014 Elsevier Ltd. All rights reserved.

Mandibular position and movements: Suitability for diagnosis of sleep apnoea.

PubMed

Martinot, Jean-Benoit; Borel, Jean-Christian; Cuthbert, Valérie; Guénard, Hervé Jean-Pierre; Denison, Stéphane; Silkoff, Philip E; Gozal, David; Pepin, Jean-Louis

2017-04-01

Mandibular movements (MMs) and position during sleep reflect respiratory efforts related to increases in upper airway resistance and micro-arousals. The study objective was to assess whether MM identifies sleep-disordered breathing (SDB) in patients with moderate to high pre-test probability. This was a prospective study of 87 consecutive patients referred for an in-laboratory sleep test. Magnetometer-derived MM signals were incorporated into standard polysomnography (PSG). Respiratory events detected with MM analysis were compared with PSG for respiratory disturbance index (RDI) with a blinded scoring. All records were scored manually according to American Academy of Sleep Medicine rules. Primary outcome was to rule-in obstructive sleep apnoea syndrome (OSAS) defined as RDI cut-off value ≥5 or 15/h total sleep time (TST). High concordance emerged between MM and PSG-derived RDI with high temporal coincidence between events (R 2  = 0.906; P < 0.001). The mean diagnostic accuracy of MM for OSAS using RDI MM cut-off values of 5.9 and 13.5 was 0.935 (0.86-0.97) and 0.913 (0.84-0.95), with a mean positive likelihood ratio (LLR+) of 3.73 (2.7-20.4) and 8.46 (2.3-31.5), respectively. Receiver operating characteristic (ROC) curves at PSG cut-off values of 5 and 15/h TST had areas under the curve (AUC) of 0.96 (95% CI: 0.89-0.99) and 0.97 (95% CI: 0.91-0.99) (P < 0.001), respectively. MM analysis accurately identified SDB at different levels of severity. RDI assessed by MM is highly concordant with PSG, suggesting a role of ambulatory MM recordings to screen for SDB in patients with moderate to high pre-test probability. © 2016 Asian Pacific Society of Respirology.

The identification of selected vegetation types in Arizona through the photointerpretation of intermediate scale aerial photography. M.S. Thesis

NASA Technical Reports Server (NTRS)

Ross, G. F. (Principal Investigator)

1973-01-01

The author has identified the following significant results. Nine photography interpretation tests were performed with a total of 19 different interpreters. Three tests were conducted with black and white intermediate scale photography and six tests with color infrared intermediate scale photography. The black and white test results show that the interpretation of vegetation mapped at the association level of classification is reliable for all the classes used at 61%. The color infrared tests indicate that the association level of mapping is unsatisfactory for vegetation interpretation of classes 1 and 6. Students' t-test indicated that intermediate scale black and white photography is significantly better than this particular color infrared photography for the interpretation of southeastern Arizona vegetation mapped at the association level.

Reviews

NASA Astrophysics Data System (ADS)

2002-09-01

CD-ROM REVIEWS (449) It's Physics Furry Elephant: Electricity Explained BOOK REVIEWS (450) What Are the Chances? Voodoo Deaths, Office Gossip and Other Adventures in Probability Dictionary of Mechanics: A handbook for teachers and students Intermediate 2 Physics PLACES TO VISIT (452) Spaceguard Centre WEB WATCH (455) Risk

Feasibility of streamlining an interactive Bayesian-based diagnostic support tool designed for clinical practice

NASA Astrophysics Data System (ADS)

Chen, Po-Hao; Botzolakis, Emmanuel; Mohan, Suyash; Bryan, R. N.; Cook, Tessa

2016-03-01

In radiology, diagnostic errors occur either through the failure of detection or incorrect interpretation. Errors are estimated to occur in 30-35% of all exams and contribute to 40-54% of medical malpractice litigations. In this work, we focus on reducing incorrect interpretation of known imaging features. Existing literature categorizes cognitive bias leading a radiologist to an incorrect diagnosis despite having correctly recognized the abnormal imaging features: anchoring bias, framing effect, availability bias, and premature closure. Computational methods make a unique contribution, as they do not exhibit the same cognitive biases as a human. Bayesian networks formalize the diagnostic process. They modify pre-test diagnostic probabilities using clinical and imaging features, arriving at a post-test probability for each possible diagnosis. To translate Bayesian networks to clinical practice, we implemented an entirely web-based open-source software tool. In this tool, the radiologist first selects a network of choice (e.g. basal ganglia). Then, large, clearly labeled buttons displaying salient imaging features are displayed on the screen serving both as a checklist and for input. As the radiologist inputs the value of an extracted imaging feature, the conditional probabilities of each possible diagnosis are updated. The software presents its level of diagnostic discrimination using a Pareto distribution chart, updated with each additional imaging feature. Active collaboration with the clinical radiologist is a feasible approach to software design and leads to design decisions closely coupling the complex mathematics of conditional probability in Bayesian networks with practice.

Age Spreads and the Temperature Dependence of Age Estimates in Upper Sco

NASA Astrophysics Data System (ADS)

Fang, Qiliang; Herczeg, Gregory J.; Rizzuto, Aaron

2017-06-01

Past estimates for the age of the Upper Sco Association are typically 11–13 Myr for intermediate-mass stars and 4–5 Myr for low-mass stars. In this study, we simulate populations of young stars to investigate whether this apparent dependence of estimated age on spectral type may be explained by the star formation history of the association. Solar and intermediate mass stars begin their pre-main sequence evolution on the Hayashi track, with fully convective interiors and cool photospheres. Intermediate-mass stars quickly heat up and transition onto the radiative Henyey track. As a consequence, for clusters in which star formation occurs on a timescale similar to that of the transition from a convective to a radiative interior, discrepancies in ages will arise when ages are calculated as a function of temperature instead of mass. Simple simulations of a cluster with constant star formation over several Myr may explain about half of the difference in inferred ages versus photospheric temperature; speculative constructions that consist of a constant star formation followed by a large supernova-driven burst could fully explain the differences, including those between F and G stars where evolutionary tracks may be more accurate. The age spreads of low-mass stars predicted from these prescriptions for star formation are consistent with the observed luminosity spread of Upper Sco. The conclusion that a lengthy star formation history will yield a temperature dependence in ages is expected from the basic physics of pre-main sequence evolution, and is qualitatively robust to the large uncertainties in pre-main sequence evolutionary models.

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

Fang Qiliang; Herczeg, Gregory J.; Rizzuto, Aaron

Past estimates for the age of the Upper Sco Association are typically 11–13 Myr for intermediate-mass stars and 4–5 Myr for low-mass stars. In this study, we simulate populations of young stars to investigate whether this apparent dependence of estimated age on spectral type may be explained by the star formation history of the association. Solar and intermediate mass stars begin their pre-main sequence evolution on the Hayashi track, with fully convective interiors and cool photospheres. Intermediate-mass stars quickly heat up and transition onto the radiative Henyey track. As a consequence, for clusters in which star formation occurs on amore » timescale similar to that of the transition from a convective to a radiative interior, discrepancies in ages will arise when ages are calculated as a function of temperature instead of mass. Simple simulations of a cluster with constant star formation over several Myr may explain about half of the difference in inferred ages versus photospheric temperature; speculative constructions that consist of a constant star formation followed by a large supernova-driven burst could fully explain the differences, including those between F and G stars where evolutionary tracks may be more accurate. The age spreads of low-mass stars predicted from these prescriptions for star formation are consistent with the observed luminosity spread of Upper Sco. The conclusion that a lengthy star formation history will yield a temperature dependence in ages is expected from the basic physics of pre-main sequence evolution, and is qualitatively robust to the large uncertainties in pre-main sequence evolutionary models.« less

AFM stiffness nanotomography of normal, metaplastic and dysplastic human esophageal cells

NASA Astrophysics Data System (ADS)

Fuhrmann, A.; Staunton, J. R.; Nandakumar, V.; Banyai, N.; Davies, P. C. W.; Ros, R.

2011-02-01

The mechanical stiffness of individual cells is important in tissue homeostasis, cell growth, division and motility, and the epithelial-mesenchymal transition in the initiation of cancer. In this work, a normal squamous cell line (EPC2) and metaplastic (CP-A) as well as dysplastic (CP-D) Barrett's Esophagus columnar cell lines are studied as a model of pre-neoplastic progression in the human esophagus. We used the combination of an atomic force microscope (AFM) with a scanning confocal fluorescence lifetime imaging microscope to study the mechanical properties of single adherent cells. Sixty four force indentation curves were taken over the nucleus of each cell in an 8 × 8 grid pattern. Analyzing the force indentation curves, indentation depth-dependent Young's moduli were found for all cell lines. Stiffness tomograms demonstrate distinct differences between the mechanical properties of the studied cell lines. Comparing the stiffness for indentation forces of 1 nN, most probable Young's moduli were calculated to 4.7 kPa for EPC2 (n = 18 cells), 3.1 kPa for CP-A (n = 10) and 2.6 kPa for CP-D (n = 19). We also tested the influence of nuclei and nucleoli staining organic dyes on the mechanical properties of the cells. For stained EPC2 cells (n = 5), significant stiffening was found (9.9 kPa), while CP-A cells (n = 5) showed no clear trend (2.9 kPa) and a slight softening was observed (2.1 kPa) in the case of CP-D cells (n = 16). Some force-indentation curves show non-monotonic discontinuities with segments of negative slope, resembling a sawtooth pattern. We found the incidence of these 'breakthrough events' to be highest in the dysplastic CP-D cells, intermediate in the metaplastic CP-A cells and lowest in the normal EPC2 cells. This observation suggests that the microscopic explanation for the increased compliance of cancerous and pre-cancerous cells may lie in their susceptibility to 'crumble and yield' rather than their ability to 'bend and flex'.

Relationship of academic success of medical students with motivation and pre-admission grades.

PubMed

Luqman, Muhammad

2013-01-01

To determine predictive validity of pre-admission scores of medical students, evaluate correlation between level of motivation and later on academic success in a medical college. Analytical study. Foundation University Medical College, Islamabad, from June to August 2011. A non-probability convenience sampling of students of 1st to final year MBBS classes was done after obtaining informed consent. These students filled out 'Strength of Motivation for Medical School' (SMMS) questionnaire. The data of pre-admission grades of these students along with academic success in college according to examination results in different years were collected. The correlation between the pre-admission grades and score of SMMS questionnaire with their academic success in medical college was found by applying Pearson co-efficient of correlation in order to determine the predictive validity. Only 46% students revealed strong motivation. A significant, moderate correlation was found between preadmission scores and academic success in 1st year modular examination (0.52) which became weaker in various professional examinations in higher classes. However, no significant correlation was observed between motivation and academic success of medical students in college. Selecting medical students by pre-admission scores or motivation level alone may not be desirable. A combination of measures of cognitive ability criteria (FSc/pre-admission test scores) and non-cognitive skills (personality traits) is recommended to be employed with the use of right tools for selection of students in medical schools.

Complex Faulting Across the Los Angeles Portion of the Pacific-North American Plate Boundary

NASA Technical Reports Server (NTRS)

Donnellan, Andrea; Parker, Jay; Granat, Robert; Glasscae, Maggi; Lyzenga, Greg; Grant Ludwig, Lisa; Rundle, John

2011-01-01

We propose to observe seismically and tectonically active regions in northern and southern California using UAVSAR to support EarthScope activities. We will test the earthquake forecasting methodology developed by Rundle through NASA's QuakeSim project by observing regions indicated as having high probability for earthquakes in the near future (5-10 years). The UAVSAR flights will serve as a baseline for pre-earthquake activity. Should an earthquake occur during the course of this project, we will also be able to observe postseismic motions associated with the earthquakes.

Pharmacodynamic analysis of ceftriaxone, gatifloxacin,and levofloxacin against Streptococcus pneumoniae with the use of Monte Carlo simulation.

PubMed

Frei, Christopher R; Burgess, David S

2005-09-01

To evaluate the pharmacodynamics of four intravenous antimicrobial regimens-ceftriaxone 1 g, gatifloxacin 400 mg, levofloxacin 500 mg, and levofloxacin 750 mg, each every 24 hours-against recent Streptococcus pneumoniae isolates. Pharmacodynamic analysis using Monte Carlo simulation. The Surveillance Network (TSN) 2002 database. Streptococcus pneumoniae isolates (7866 isolates) were stratified according to penicillin susceptibilities as follows: susceptible (4593), intermediate (1986), and resistant (1287). Risk analysis software was used to simulate 10,000 patients by integrating published pharmacokinetic parameters, their variability, and minimum inhibitory concentration (MIC) distributions from the TSN database. Probability of target attainment was determined for percentage of time above the MIC (%T > MIC) from 0-100% for ceftriaxone and area under the concentration-time curve (AUC):MIC ratio from 0-150 for the fluoroquinolones. For ceftriaxone, probability of target attainment remained 90% or greater against the three isolate groups until a %T > MIC of 70% or greater, and it remained 90% or greater against susceptible and intermediate isolates over the entire interval (%T > MIC 0-100%). For levofloxacin 500 mg, probability of target attainment was 90% at an AUC:MIC < or = 30, but the curve declined sharply with further increases in pharmacodynamic target. Levofloxacin 750 mg achieved a probability of target attainment of 99% at an AUC:MIC ratio < or = 30; the probability remained approximately 90% until a target of 70 or greater, when it declined steeply. Gatifloxacin demonstrated a high probability (99%) of target attainment at an AUC:MIC ratio < or = 30, and it remained above 90% until a target of 70. Ceftriaxone maintained high probability of target attainment over a broad range of pharmacodynamic targets regardless of penicillin susceptibility (%T > MIC 0-60%). Levofloxacin 500 mg maintained high probability of target attainment for AUC:MIC ratios 0-30; whereas, levofloxacin 750 mg and gatifloxacin maintained high probability of target attainment for AUC:MIC ratios 0-60. Rate of decline in the pharmacodynamic curve was most pronounced for the two levofloxacin regimens and more gradual for gatifloxacin and ceftriaxone.

Normal myocardial perfusion scan portends a benign prognosis independent from the pretest probability of coronary artery disease. Sub-analysis of the J-ACCESS study.

PubMed

Imamura, Yosihiro; Fukuyama, Takaya; Nishimura, Sigeyuki; Nishimura, Tsunehiko

2009-08-01

We assessed the usefulness of gated stress/rest 99mTc-tetrofosmin myocardial perfusion single photon emission computed tomography (SPECT) to predict ischemic cardiac events in Japanese patients with various estimated pretest probabilities of coronary artery disease (CAD). Of the 4031 consecutively registered patients for a J-ACCESS (Japanese Assessment of Cardiac Events and Survival Study by Quantitative Gated SPECT) study, 1904 patients without prior cardiac events were selected. Gated stress/rest myocardial perfusion SPECT was performed and segmental perfusion scores and quantitative gated SPECT results were derived. The pretest probability for having CAD was estimated using the American College of Cardiology/American Heart Association/American College of Physicians-American Society of Internal Medicine guideline data for the management of patients with chronic stable angina, which includes age, gender, and type of chest discomfort. The patients were followed up for three years. During the three-year follow-up period, 96 developed ischemic cardiac events: 17 cardiac deaths, 8 nonfatal myocardial infarction, and 71 clinically driven revascularization. The summed stress score (SSS) was the most powerful independent predictor of all ischemic cardiac events (hazard ratio 1.077, CI 1.045-1.110). Abnormal SSS (> 3) was associated with a significantly higher cardiac event rate in patients with an intermediate to high pretest probability of CAD. Normal SSS (< or = 3) was associated with a low event rate in patients with any pretest probability of CAD. Myocardial perfusion SPECT is useful for further risk-stratification of patients with suspected CAD. The abnormal scan result (SSS > 3) is discriminative for subsequent cardiac events only in the groups with an intermediate to high pretest probability of CAD. The salient result is that normal scan results portend a benign prognosis independent from the pretest probability of CAD.

An actuarial approach to retrofit savings in buildings

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

Subbarao, Krishnappa; Etingov, Pavel V.; Reddy, T. A.

An actuarial method has been developed for determining energy savings from retrofits from energy use data for a number of buildings. This method should be contrasted with the traditional method of using pre- and post-retrofit data on the same building. This method supports the U.S. Department of Energy Building Performance Database of real building performance data and related tools that enable engineering and financial practitioners to evaluate retrofits. The actuarial approach derives, from the database, probability density functions (PDFs) for energy savings from retrofits by creating peer groups for the user’s pre post buildings. From the energy use distribution ofmore » the two groups, the savings PDF is derived. This provides the basis for engineering analysis as well as financial risk analysis leading to investment decisions. Several technical issues are addressed: The savings PDF is obtained from the pre- and post-PDF through a convolution. Smoothing using kernel density estimation is applied to make the PDF more realistic. The low data density problem can be mitigated through a neighborhood methodology. Correlations between pre and post buildings are addressed to improve the savings PDF. Sample size effects are addressed through the Kolmogorov--Smirnov tests and quantile-quantile plots.« less

Elevated expression of LSD1 (Lysine-specific demethylase 1) during tumour progression from pre-invasive to invasive ductal carcinoma of the breast

PubMed Central

2012-01-01

Background Lysine-specific demethylase1 (LSD1) is a nuclear protein which belongs to the aminooxidase-enzymes playing an important role in controlling gene expression. It has also been found highly expressed in several human malignancies including breast carcinoma. Our aim was to detect LSD1 expression also in pre-invasive neoplasias of the breast. In the current study we therefore analysed LSD1 protein expression in ductal carcinoma in situ (DCIS) in comparison to invasive ductal breast cancer (IDC). Methods Using immunohistochemistry we systematically analysed LSD1 expression in low grade DCIS (n = 27), intermediate grade DCIS (n = 30), high grade DCIS (n = 31) and in invasive ductal breast cancer (n = 32). SPSS version 18.0 was used for statistical analysis. Results LSD1 was differentially expressed in DCIS and invasive ductal breast cancer. Interestingly, LSD1 was significantly overexpressed in high grade DCIS versus low grade DCIS. Differences in LSD1 expression levels were also statistically significant between low/intermediate DCIS and invasive ductal breast carcinoma. Conclusions LSD1 is also expressed in pre-invasive neoplasias of the breast. Additionally, there is a gradual increase of LSD1 expression within tumour progression from pre-invasive DCIS to invasive ductal breast carcinoma. Therefore upregulation of LSD1 may be an early tumour promoting event. PMID:22920283

Elevated expression of LSD1 (Lysine-specific demethylase 1) during tumour progression from pre-invasive to invasive ductal carcinoma of the breast.

PubMed

Serce, Nuran; Gnatzy, Annette; Steiner, Susanne; Lorenzen, Henning; Kirfel, Jutta; Buettner, Reinhard

2012-08-24

Lysine-specific demethylase1 (LSD1) is a nuclear protein which belongs to the aminooxidase-enzymes playing an important role in controlling gene expression. It has also been found highly expressed in several human malignancies including breast carcinoma. Our aim was to detect LSD1 expression also in pre-invasive neoplasias of the breast. In the current study we therefore analysed LSD1 protein expression in ductal carcinoma in situ (DCIS) in comparison to invasive ductal breast cancer (IDC). Using immunohistochemistry we systematically analysed LSD1 expression in low grade DCIS (n = 27), intermediate grade DCIS (n = 30), high grade DCIS (n = 31) and in invasive ductal breast cancer (n = 32). SPSS version 18.0 was used for statistical analysis. LSD1 was differentially expressed in DCIS and invasive ductal breast cancer. Interestingly, LSD1 was significantly overexpressed in high grade DCIS versus low grade DCIS. Differences in LSD1 expression levels were also statistically significant between low/intermediate DCIS and invasive ductal breast carcinoma. LSD1 is also expressed in pre-invasive neoplasias of the breast. Additionally, there is a gradual increase of LSD1 expression within tumour progression from pre-invasive DCIS to invasive ductal breast carcinoma. Therefore upregulation of LSD1 may be an early tumour promoting event.

Choosing Fighting Competitors Among Men: Testosterone, Personality, and Motivations.

PubMed

Borráz-León, Javier I; Cerda-Molina, Ana Lilia; Rantala, Markus J; Mayagoitia-Novales, Lilian

2018-01-01

Higher testosterone levels have been positively related to a variety of social behaviors and personality traits associated with intrasexual competition. The aim of this study was to evaluate the role of testosterone levels and personality traits such as aggressiveness, competitiveness, and self-esteem on the task of choosing a fighting competitor (a rival) with or without a motivation to fight. In Study 1, a group of 119 men participated in a task for choosing a rival through pictures of men with high-dominant masculinity versus low-dominant masculinity. Participants completed three personality questionnaires and donated two saliva samples (pre-test and post-test sample) to quantify their testosterone levels. We found that the probability of choosing high-dominant masculine men as rivals increased with higher aggressiveness scores. In Study 2, the task of choosing rivals was accompanied by motivations to fight (pictures of women with high or low waist-to-hip ratio [WHR]). In this context, we observed that the probability of choosing dominant masculine men as rivals depended on the WHR of the women. Overall, average levels of post-test testosterone, aggressiveness, and high self-esteem increased the probability to fight for women with low WHR independently of the dominance masculinity of the rivals. Our results indicate that human decisions, in the context of intrasexual competition and mate choice, are regulated by physiological and psychological mechanisms allowing men to increase their biological fitness. We discuss our results in the light of the plasticity of human behavior according to biological and environmental forces.

Septic arthritis of the hip in a Cambodian child caused by multidrug-resistant Salmonella enterica serovar Typhi with intermediate susceptibility to ciprofloxacin treated with ceftriaxone and azithromycin.

PubMed

Pocock, J M; Khun, P A; Moore, C E; Vuthy, S; Stoesser, N; Parry, C M

2014-08-01

Septic arthritis is a rare complication of typhoid fever. A 12-year-old boy without pre-existing disease attended a paediatric hospital in Cambodia with fever and left hip pain. A hip synovial fluid aspirate grew multidrug-resistant Salmonella enterica ser. Typhi with intermediate susceptibility to ciprofloxacin. Arthrotomy, 2 weeks of intravenous ceftriaxone and 4 weeks of oral azithromycin led to resolution of symptoms. The optimum management of septic arthritis in drug-resistant typhoid is undefined.

Reappraisal of Hydatigera taeniaeformis (Batsch, 1786) (Cestoda: Taeniidae) sensu lato with description of Hydatigera kamiyai n. sp.

PubMed

Lavikainen, Antti; Iwaki, Takashi; Haukisalmi, Voitto; Konyaev, Sergey V; Casiraghi, Maurizio; Dokuchaev, Nikolai E; Galimberti, Andrea; Halajian, Ali; Henttonen, Heikki; Ichikawa-Seki, Madoka; Itagaki, Tadashi; Krivopalov, Anton V; Meri, Seppo; Morand, Serge; Näreaho, Anu; Olsson, Gert E; Ribas, Alexis; Terefe, Yitagele; Nakao, Minoru

2016-05-01

The common cat tapeworm Hydatigera taeniaeformis is a complex of three morphologically cryptic entities, which can be differentiated genetically. To clarify the biogeography and the host spectrum of the cryptic lineages, 150 specimens of H. taeniaeformis in various definitive and intermediate hosts from Eurasia, Africa and Australia were identified with DNA barcoding using partial mitochondrial cytochrome c oxidase subunit 1 gene sequences and compared with previously published data. Additional phylogenetic analyses of selected isolates were performed using nuclear DNA and mitochondrial genome sequences. Based on molecular data and morphological analysis, Hydatigera kamiyai n. sp. Iwaki is proposed for a cryptic lineage, which is predominantly northern Eurasian and uses mainly arvicoline rodents (voles) and mice of the genus Apodemus as intermediate hosts. Hydatigera taeniaeformis sensu stricto (s.s.) is restricted to murine rodents (rats and mice) as intermediate hosts. It probably originates from Asia but has spread worldwide. Despite remarkable genetic divergence between H. taeniaeformis s.s. and H. kamiyai, interspecific morphological differences are evident only in dimensions of rostellar hooks. The third cryptic lineage is closely related to H. kamiyai, but its taxonomic status remains unresolved due to limited morphological, molecular, biogeographical and ecological data. This Hydatigera sp. is confined to the Mediterranean and its intermediate hosts are unknown. Further studies are needed to classify Hydatigera sp. either as a distinct species or a variant of H. kamiyai. According to previously published limited data, all three entities occur in the Americas, probably due to human-mediated introductions. Copyright © 2016 Australian Society for Parasitology Inc. Published by Elsevier Ltd. All rights reserved.

Fortune Favors the Brave. Tactical Behaviors in the Middle Distance Running Events at the 2017 IAAF World Championships.

PubMed

Casado, Arturo; Renfree, Andrew

2018-05-29

To assess tactical and performance factors associated with progression from qualification rounds in the 800 m and 1500 m running events at the 2017 IAAF World Championships. Official results were used to access final and intermediate positions and times, as well as performance characteristics of competitors. Shared variance between intermediate positions and rank order lap times (ROSPT) with finishing positions were calculated, along with probability of automatic qualification, for athletes in each available race position at the end of every 400 m lap. Differences in race positions and lap times relative to season´s best (SB) performances were assessed between automatic qualifiers (AQ), fastest losers (FL), and non-qualifiers (NQ). Race positions at the end of each 400 m lap remained more stable through 800 m races than 1500 m races. Probability of automatic qualification decreased with both race position and ROSPT on each lap, although ROSPT accounted for a higher degree of shared variance than did intermediate position. In the 1500 m event FL ran at a higher percentage of SB speed, and adopted positions closer to the race lead in the early stages. This was not the case in the 800 m. Intermediate positioning and the ability to produce a fast final race segment are strongly related to advancement from qualification rounds in middle distance running events. The adoption of a more 'risky' strategy characterized by higher speeds relative to SB may be associated with increased likelihood of qualification as FL in the 1500 m event.

Characterization of H 1743-322 during its 2003 outburst with TCAF Solution.

NASA Astrophysics Data System (ADS)

Nagarkoti, Shreeram; Debnath, Dipak; Chakrabarti, Sandip Kumar; Mondal, Santanu; Chatterjee, Arka

2016-07-01

Transiant black hole candidate (BHC) H 1743-322 became active in X-rays on 2003 March 21 after remaining dormant for around two decades. We study both the spectral and temporal properties of the source during its 2003 outburst under TCAF paradigm. The classification of different spectral states (hard, hard-intermediate, soft-intermediate, soft) and their intermediate transitions are more clear from the variation of TCAF model fitted/derived physical flow parameters and nature of quasi-periodic oscillations (if present). We also studied evolutions of low frequency QPOs during rising and declining phases of the outburst with propagating oscillatory shock (POS) model. We get a good estimation of the probable mass range of the objects from prediction methods using TCAF and POS model, as discussed in Molla et al. (2016).

Impact of Mindfulness-based Stress Reduction (MBSR) on Depression among Elderly Residing in Residential Homes.

PubMed

Kumar, Sasi; Adiga, Kasturi Ramesh; George, Anice

2014-01-01

Old age is a period when people need physical, emotional, and psychological support. Depression is the most prevalent mental health problem among older adults and it contributes to increase in medical morbidity and mortality, reduces quality of life and elevates health care costs. Therefore early diagnosis and effective management are required to improve the quality of life of older adults suffering from depression. Intervention like Mindfulness based Stress Reduction is a powerful relaxation technique to provide quick way to get rid of depression and negative emotions by increasing mindfulness. The study was undertaken to assess the effectiveness of MBSR on depression among elderly residing in residential homes, Bangalore. In this study, quasi experimental pre-test post-test control group research design was used. There were two groups: experimental and control, each group had 30 samples selected from different residential homes by non-probability convenience sampling technique. Pre-test depression and mindfulness was assessed before the first day of intervention. Experimental group participants were provided intervention on MBSR. Assessment of post-test depression and mindfulness was done at the end of the intervention programme for both group participants. The study revealed significant reduction in depression (p < 0.001) and increase in mindfulness (p < 0.001) among elderly in the experimental group who were subjected to MBSR technique.

Heparin-induced thrombocytopenia: reducing misdiagnosis via collaboration between an inpatient anticoagulation pharmacy service and hospital reference laboratory.

PubMed

Burnett, Allison E; Bowles, Harmony; Borrego, Matthew E; Montoya, Tiffany N; Garcia, David A; Mahan, Charles

2016-11-01

Misdiagnosis of heparin-induced thrombocytopenia (HIT) is common and exposes patients to high-risk therapies and potentially serious adverse events. The primary objective of this study was to evaluate the impact of collaboration between an inpatient pharmacy-driven anticoagulation management service (AMS) and hospital reference laboratory to reduce inappropriate HIT antibody testing via pharmacist intervention and use of the 4T pre-test probability score. Secondary objectives included clinical outcomes and cost-savings realized through reduced laboratory testing and decreased unnecessary treatment of HIT. This was a single center, pre-post, observational study. The hospital reference laboratory contacted the AMS when they received a blood sample for an enzyme-linked immunosorbent HIT antibody (HIT Ab). Trained pharmacists prospectively scored each HIT Ab ordered by using the 4T score with subsequent communication to physicians recommending for or against processing and reporting of lab results. Utilizing retrospective chart review and a database for all patients with a HIT Ab ordered during the study period, we compared the incidence of HIT Ab testing before and after implementation of the pharmacy-driven 4T score intervention. Our intervention significantly reduced the number of inappropriate HIT Ab tests processed (176 vs. 63, p < 0.0001), with no increase in thrombotic or hemorrhagic events. Overall incidence of suspected and confirmed HIT was <3 and <0.005 %, respectively. Overall cost savings were $75,754 (US) or 62 % per patient exposed to heparin between the pre and post intervention groups. Collaboration between inpatient pharmacy AMS and hospital reference laboratories can result in reduction of misdiagnosis of HIT and significant cost savings with similar safety.

Predicting the onset of smoking in boys and girls.

PubMed

Charlton, A; Blair, V

1989-01-01

The problem of the high prevalence of smoking among girls and young women is of great concern. In an attempt to identify the factors which influence girls and boys respectively to attempt smoking, the study examines social background, advertising and brand awareness, knowledge, teaching and personal beliefs in conjunction as predictors of smoking. In this study which involved the administration of identical pre- and post-test questionnaires to a sample of boys and girls aged 12 and 13 years, nine variables expressed by never-smokers at pre-test stage were assessed as predictors of immediate future smoking. The two tests were administered 4 months apart to 1125 boys and 1213 girls in northern England. The nine variables included were parental smoking, best friends' smoking, perceived positive values of smoking, perceived negative values of smoking, correct health knowledge, cigarette-brand awareness, having a favourite cigarette advertisement, having a cigarette-brand sponsored sport in four top favourites on television. One group received teaching about smoking between the pre- and post-tests and this was also included as a variable. For boys, no variable investigated had any consistently statistically significant correlation with the uptake of smoking. The most important predictor of smoking for boys, having a best friend who smoked, was significant on application of the chi 2 test (P 0.037), although it was non-significant when included singly in a logistic regression model (0.094); the discrepancy was probably due to the small number of best friends known to smoke. For girls, four variables were found to be significant predictors of smoking when included singly in a logistic regression.(ABSTRACT TRUNCATED AT 250 WORDS)

A comparison of hands-on inquiry instruction to lectureinstruction with special needs high school biology students

NASA Astrophysics Data System (ADS)

Jensen-Ruopp, Helga Spitko

A comparison of hands-on inquiry instruction with lecture instruction was presented to 134 Patterns and Process Biology students. Students participated in seven biology lessons that were selected from Biology Survey of Living Things (1992). A pre and post paper and pencil assessment was used as the data collecting instrument. The treatment group was taught using hands-on inquiry strategies while the non-treatment group was taught in the lecture method of instruction. The team teaching model was used as the mode of presentation to the treatment group and the non-treatment group. Achievement levels using specific criterion; novice (0% to 50%), developing proficiency (51% to 69%), accomplished (70% to 84) and exceptional or mastery level (85% to 100%) were used as a guideline to tabulate the results of the pre and post assessment. Rubric tabulation was done to interpret the testing results. The raw data was plotted using percentage change in test score totals versus reading level score by gender as well as percentage change in test score totals versus auditory vocabulary score by gender. Box Whisker plot comparative descriptive of individual pre and post test scores for the treatment and non-treatment group was performed. Analysis of covariance (ANCOVA) using MINITAB Statistical Software version 14.11 was run on data of the seven lessons, as well as on gender (male results individual and combined, and female results individual and combined) results. Normal Probability Plots for total scores as well as individual test scores were performed. The results suggest that hands-on inquiry based instruction when presented to special needs students including; at-risk; English as a second language limited, English proficiency and special education inclusive students' learning may enhance individual student achievement.

Age-related changes in pre- and post-conization HPV genotype distribution among women with high-grade cervical intraepithelial neoplasia.

PubMed

Giannella, Luca; Fodero, Cristina; Boselli, Fausto; Rubino, Teresa; Mfuta, Kabala; Prandi, Sonia

2017-04-01

To assess the effect of age on pre- and post-conization HPV genotype distribution. The present retrospective observational study included consecutive women with high-grade cervical intraepithelial neoplasia who underwent conization at the Cervical Cancer Screening Centre of Reggio Emilia, Italy, and University Hospital of Modena, Italy, between February 1, 2012, and October 31, 2014. Pre-conization and 6-month post-conization HPV genotyping results were compared between four age groups (<30, 30-39, 40-49, and ≥50 years) and age-related changes in the HPV genotypes present were evaluated. There were 162 patients included. The lowest occurrence of pre-conization high-risk and probable high-risk HPV genotypes was observed among patients aged at least 50 years when compared with younger patients (P=0.017). Conversely, women aged at least 50 years exhibited the highest level of post-conization high-risk and probable high-risk HPV genotypes (P=0.043). Additionally, an increasing incidence of recording identical pre- and post-conization HPV genotypes was associated with increasing age (P=0.024), as was increasing post-treatment recurrence of cervical intraepithelial neoplasia grade 2+ (P=0.030). The presence of high-risk and probable high-risk HPV genotypes was lowest among older patients before conization and was highest among these patients post-conization; post-treatment HPV clearance decreased with age and increasing age could be a risk factor for post-conization recurrence. © 2017 International Federation of Gynecology and Obstetrics.

Sibship effects on dispersal behaviour in a pre-industrial human population.

PubMed

Nitsch, A; Lummaa, V; Faurie, C

2016-10-01

Understanding dispersal behaviour and its determinants is critical for studies on life-history maximizing strategies. Although many studies have investigated the causes of dispersal, few have focused on the importance of sibship, despite that sibling interactions are predicted to lead to intrafamilial differences in dispersal patterns. Using a large demographic data set from pre-industrial Finland (n = 9000), we tested whether the sex-specific probability of dispersal depended on the presence of same-sex or opposite-sex elder siblings who can both compete and cooperate in the family. Overall, following our predictions, the presence of same-sex elder siblings increased the probability of dispersal from natal population for both sexes, whereas the number of opposite-sex siblings had less influence. Among males, dispersal was strongly linked to access to land resources. Female dispersal was mainly associated with competition over availability of mates but likely mediated by competition over access to wealthy mates rather mate availability per se. Besides ecological constraints, sibling interactions are strongly linked with dispersal decisions and need to be better considered in the studies on the evolution of family dynamics and fitness maximizing strategies in humans and other species. © 2016 European Society For Evolutionary Biology. Journal of Evolutionary Biology © 2016 European Society For Evolutionary Biology.

Research methodology workshops evaluation using the Kirkpatrick's model: translating theory into practice.

PubMed

Abdulghani, Hamza Mohammad; Shaik, Shaffi Ahamed; Khamis, Nehal; Al-Drees, Abdulmajeed Abdulrahman; Irshad, Mohammad; Khalil, Mahmoud Salah; Alhaqwi, Ali Ibrahim; Isnani, Arthur

2014-04-01

Qualitative and quantitative evaluation of academic programs can enhance the development, effectiveness, and dissemination of comparative quality reports as well as quality improvement efforts. To evaluate the five research methodology workshops through assessing participants' satisfaction, knowledge and skills gain and impact on practices by the Kirkpatrick's evaluation model. The four level Kirkpatrick's model was applied for the evaluation. Training feedback questionnaires, pre and post tests, learner development plan reports and behavioral surveys were used to evaluate the effectiveness of the workshop programs. Of the 116 participants, 28 (24.1%) liked with appreciation, 62 (53.4%) liked with suggestions and 26 (22.4%) disliked the programs. Pre and post MCQs tests mean scores showed significant improvement of relevant basic knowledge and cognitive skills by 17.67% (p ≤ 0.005). Pre-and-post tests scores on workshops sub-topics also significantly improved for the manuscripts (p ≤ 0.031) and proposal writing (p ≤ 0.834). As for the impact, 56.9% of participants started research, and 6.9% published their studies. The results from participants' performance revealed an overall positive feedback and 79% of participant reported transfer of training skills at their workplace. The course outcomes achievement and suggestions given for improvements offer insight into the program which were encouraging and very useful. Encouraging "research culture" and work-based learning are probably the most powerful determinants for research promotion. These findings therefore encourage faculty development unit to continue its training and development in the research methodology aspects.

Steady state, relaxation and first-passage properties of a run-and-tumble particle in one-dimension

NASA Astrophysics Data System (ADS)

Malakar, Kanaya; Jemseena, V.; Kundu, Anupam; Vijay Kumar, K.; Sabhapandit, Sanjib; Majumdar, Satya N.; Redner, S.; Dhar, Abhishek

2018-04-01

We investigate the motion of a run-and-tumble particle (RTP) in one dimension. We find the exact probability distribution of the particle with and without diffusion on the infinite line, as well as in a finite interval. In the infinite domain, this probability distribution approaches a Gaussian form in the long-time limit, as in the case of a regular Brownian particle. At intermediate times, this distribution exhibits unexpected multi-modal forms. In a finite domain, the probability distribution reaches a steady-state form with peaks at the boundaries, in contrast to a Brownian particle. We also study the relaxation to the steady-state analytically. Finally we compute the survival probability of the RTP in a semi-infinite domain with an absorbing boundary condition at the origin. In the finite interval, we compute the exit probability and the associated exit times. We provide numerical verification of our analytical results.

Tracking Co(I) Intermediate in operando in Photocatalytic Hydrogen Evolution by X-ray transient Absorption Spectroscopy and DFT Calculation

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

Li, Zhi-Jun; Zhan, Fei; Xiao, Hongyan

X-ray transient absorption spectroscopy (XTA) and optical transient spectroscopy (OTA) were used to probe the Co(I) intermediate generated in situ from an aqueous photocatalytic hydrogen evolution system, with [RuII(bpy)3]Cl2·6H2O as the photosensitizer, ascorbic acid/ascorbate as the electron donor, and the Co-polypyridyl complex ([CoII(DPABpy) Cl]Cl) as the pre-catalyst. Upon exposure to light, the XTA measured at Co K-edge visualizes the grow and decay of the Co(I) intermediate, and reveals its Co-N bond contraction of 0.09 ± 0.03 Å. Density functional theory (DFT) calculations support the bond contraction and illustrate that the metal-to-ligand π back-bonding greatly stabilizes the penta-coordinated Co(I) intermediate, whichmore » provides easy photon access. To the best of our knowledge, this is the first example of capturing the penta-coordinated Co(I) intermediate in operando with bond contraction by XTA, thereby providing new insights for fundamental understanding of structure– function relationship of cobalt-based molecular catalysts.« less

Importance of the Pre-Industrial Baseline in Determining the Likelihood of Exceeding the Paris Limits

NASA Astrophysics Data System (ADS)

Mann, M. E.; Schurer, A. P.; Hawkins, E.; Tett, S. F.; Hegerl, G. C.

2017-12-01

During the Paris Conference in 2015, nations of the world strengthened the United NationsFramework Convention on Climate Change by agreeing to holding "the increase in the globalaverage temperature to well below 2°C above pre-industrial levels and pursuing efforts to limitthe temperature increase to 1.5°C. However, "pre-industrial" was not defined. Here weinvestigate the implications of different choices of the pre-industrial baseline on the likelihood ofexceeding these two temperature thresholds. We find that for the strongest mitigation scenarioRCP2.6 and a medium scenario RCP4.5 the probability of exceeding the thresholds and timingof exceedance is highly dependent on the pre-industrial baseline, for example the probability ofcrossing 1.5°C by the end of the century under RCP2.6, varies from 61% to 88% depending onhow the baseline is defined. In contrast, in the scenario with no mitigation, RCP8.5, boththresholds will almost certainly be exceeded by the middle of the century with the definition ofthe pre-industrial baseline of less importance. Allowable carbon emissions for thresholdstabilisation are similarly highly dependent on the pre-industrial baseline. For stabilisation at2°C, allowable emissions decrease by as much as 40% when earlier than 19th century climatesare considered as a baseline.

Unemployment in Iraqi refugees: The interaction of pre and post-displacement trauma.

PubMed

Wright, A Michelle; Dhalimi, Abir; Lumley, Mark A; Jamil, Hikmet; Pole, Nnamdi; Arnetz, Judith E; Arnetz, Bengt B

2016-12-01

Previous refugee research has been unable to link pre-displacement trauma with unemployment in the host country. The current study assessed the role of pre-displacement trauma, post-displacement trauma, and the interaction of both trauma types to prospectively examine unemployment in a random sample of newly-arrived Iraqi refugees. Participants (N = 286) were interviewed three times over the first two years post-arrival. Refugees were assessed for pre-displacement trauma exposure, post-displacement trauma exposure, a history of unemployment in the country of origin and host country, and symptoms of posttraumatic stress disorder (PTSD) and depression. Analyses found that neither pre-displacement nor post-displacement trauma independently predicted unemployment 2 years post-arrival; however, the interaction of pre and post-displacement trauma predicted 2-year unemployment. Refugees with high levels of both pre and post-displacement trauma had a 91% predicted probability of unemployment, whereas those with low levels of both traumas had a 20% predicted probability. This interaction remained significant after controlling for sociodemographic variables and mental health upon arrival to the US. Resettlement agencies and community organizations should consider the interactive effect of encountering additional trauma after escaping the hardships of the refugee's country of origin. © 2016 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

Semiclassical S-matrix for black holes

DOE PAGES

Bezrukov, Fedor; Levkov, Dmitry; Sibiryakov, Sergey

2015-12-01

In this study, we propose a semiclassical method to calculate S-matrix elements for two-stage gravitational transitions involving matter collapse into a black hole and evaporation of the latter. The method consistently incorporates back-reaction of the collapsing and emitted quanta on the metric. We illustrate the method in several toy models describing spherical self-gravitating shells in asymptotically flat and AdS space-times. We find that electrically neutral shells reflect via the above collapse-evaporation process with probability exp(–B), where B is the Bekenstein-Hawking entropy of the intermediate black hole. This is consistent with interpretation of exp(B) as the number of black hole states.more » The same expression for the probability is obtained in the case of charged shells if one takes into account instability of the Cauchy horizon of the intermediate Reissner-Nordström black hole. As a result, our semiclassical method opens a new systematic approach to the gravitational S-matrix in the non-perturbative regime.« less

Enzymes catalyzing pre-hydrolysis facilitated the anaerobic fermentation of waste activated sludge with acidogenic and microbiological perspectives.

PubMed

Xin, Xiaodong; He, Junguo; Li, Lin; Qiu, Wei

2018-02-01

This study investigated acidogenic and microbiological perspectives in the anaerobic fermentation (AF) of waste activated sludge (WAS) pre-hydrolyzed by enzymes catalysis. The enzymes catalysis boosted WAS biodegradability dramatically with nearly 8500 mg/L soluble chemical oxygen demand (SCOD) increase just within 4 h. The volatile fatty acids (VFAs) in the acidogenesis were accumulated effectively with over 3200 mg COD/L in 12 d, which reached 0.687 kWh/kg VSS electricity conversion efficiency (2.5 times higher than the control test). The fermentation process favored the compression of fermentative sludge with the distribution spread index (DSI) rising. The core populations of bacteria and archaea shifting enlarged the dissimilarity of communities at different fermentation stages. Increase of community diversity contributed to VFAs accumulation stability. Moreover, the intermediate bacterial community evenness favored VFAs accumulation potentially. The enzymes catalysis might be a promising solution for strengthening VFAs accumulation in the WAS fermentation with boosting the electricity conversion potential. Copyright © 2017 Elsevier Ltd. All rights reserved.

Point-of-care D-dimer testing in emergency departments.

PubMed

Marquardt, Udo; Apau, Daniel

2015-09-01

Overcrowding and prolonged patient stays in emergency departments (EDs) affect patients' experiences and outcomes, and increase healthcare costs. One way of addressing these problems is through using point-of-care blood tests, laboratory testing undertaken near patient locations with rapidly available results. D-dimer tests are used to exclude venous thromboembolism (VTE), a common presentation in EDs, in low-risk patients. However, data on the effects of point-of-care D-dimer testing in EDs and other urgent care settings are scarce. This article reports the results of a literature review that examined the benefits to patients of point-of-care D-dimer testing in terms of reduced turnaround times (time to results), and time to diagnosis, discharge or referral. It also considers the benefits to organisations in relation to reduced ED crowding and increased cost effectiveness. The review concludes that undertaking point-of-care D-dimer tests, combined with pre-test probability scores, can be a quick and safe way of ruling out VTE and improving patients' experience.

A meta-analysis reveals a positive correlation between genetic diversity metrics and environmental status in the long-lived seagrass Posidonia oceanica.

PubMed

Jahnke, Marlene; Olsen, Jeanine L; Procaccini, Gabriele

2015-05-01

The seagrass Posidonia oceanica is a key engineering species structuring coastal marine systems throughout much of the Mediterranean basin. Its decline is of concern, leading to the search for short- and long-term indicators of seagrass health. Using ArcGIS maps from a recent, high-resolution (1-4 km) modelling study of 18 disturbance factors affecting coastal marine systems across the Mediterranean (Micheli et al. 2013, http://globalmarine.nceas.ucsb.edu/mediterranean/), we tested for correlations with genetic diversity metrics (allelic diversity, genotypic/clonal diversity and heterozygosity) in a meta-analysis of 56 meadows. Contrary to initial predictions, weak but significantly positive correlations were found for commercial shipping, organic pollution (pesticides) and cumulative impact. This counterintuitive finding suggests greater resistance and resilience of individuals with higher genetic and genotypic diversity under disturbance (at least for a time) and/or increased sexual reproduction under an intermediate disturbance model. We interpret the absence of low and medium levels of genetic variation at impacted locations as probable local extinctions of individuals that already exceeded their resistance capacity. Alternatively, high diversity at high-impact sites is likely a temporal artefact, reflecting the mismatch with pre-environmental impact conditions, especially because flowering and sexual recruitment are seldom observed. While genetic diversity metrics are a valuable tool for restoration and mitigation, caution must be exercised in the interpretation of correlative patterns as found in this study, because the exceptional longevity of individuals creates a temporal mismatch that may falsely suggest good meadow health status, while gradual deterioration of allelic diversity might go unnoticed. © 2015 John Wiley & Sons Ltd.

Research project shows importance of pre-employment hearing testing.

PubMed

Karlovich, R S

1992-02-01

Forty employees received pure-tone baseline hearing tests at the time they began employment as LSM operators for the U.S. Postal Services; the workplace eight-hour average sound level (TWA) was 85 dBA. Nineteen operators from the original group had their hearing retested three years later. None of the retested subjects showed large or systematic changes in hearing sensitivity over the three-year period. For the audiometric frequencies most susceptible to noise exposure (3000, 4000, 6000 Hz), only 5 percent of the operators showed a bilateral change in threshold greater than 5 dB at any frequency, and none of them showed more than a 10 dB threshold change in both ears. None of the operators displayed a Standard Threshold Shift as described by OSHA. The data further suggested that many workers began their LSM work assignment with a pre-existing hearing loss and, based upon audiometric and history information, the impairment probably resulted from prior occupational and/or nonoccupational noise exposure. The importance of hearing-conservation programs for employees is emphasized.

Pre-Discovery Detection of ASASSN-18fv by Evryscope

NASA Astrophysics Data System (ADS)

Corbett, H.; Law, N.; Goeke, E.; Ratzloff, J.; Howard, W.; Fors, O.; del Ser, D.; Quimby, R. M.

2018-03-01

We have identified pre-discovery imaging of the probable classical nova ASASSN-18fv by Evryscope-South (http://evryscope.astro.unc.edu/), an array of 6-cm telescopes continuously monitoring 8000 square degrees of sky at 2-minute cadence from CTIO, Chile.

Nomogram predicting response after chemoradiotherapy in rectal cancer using sequential PETCT imaging: a multicentric prospective study with external validation.

PubMed

van Stiphout, Ruud G P M; Valentini, Vincenzo; Buijsen, Jeroen; Lammering, Guido; Meldolesi, Elisa; van Soest, Johan; Leccisotti, Lucia; Giordano, Alessandro; Gambacorta, Maria A; Dekker, Andre; Lambin, Philippe

2014-11-01

To develop and externally validate a predictive model for pathologic complete response (pCR) for locally advanced rectal cancer (LARC) based on clinical features and early sequential (18)F-FDG PETCT imaging. Prospective data (i.a. THUNDER trial) were used to train (N=112, MAASTRO Clinic) and validate (N=78, Università Cattolica del S. Cuore) the model for pCR (ypT0N0). All patients received long-course chemoradiotherapy (CRT) and surgery. Clinical parameters were age, gender, clinical tumour (cT) stage and clinical nodal (cN) stage. PET parameters were SUVmax, SUVmean, metabolic tumour volume (MTV) and maximal tumour diameter, for which response indices between pre-treatment and intermediate scan were calculated. Using multivariate logistic regression, three probability groups for pCR were defined. The pCR rates were 21.4% (training) and 23.1% (validation). The selected predictive features for pCR were cT-stage, cN-stage, response index of SUVmean and maximal tumour diameter during treatment. The models' performances (AUC) were 0.78 (training) and 0.70 (validation). The high probability group for pCR resulted in 100% correct predictions for training and 67% for validation. The model is available on the website www.predictcancer.org. The developed predictive model for pCR is accurate and externally validated. This model may assist in treatment decisions during CRT to select complete responders for a wait-and-see policy, good responders for extra RT boost and bad responders for additional chemotherapy. Copyright © 2014 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

Analysis of the heat transfer in double and triple concentric tube heat exchangers

NASA Astrophysics Data System (ADS)

Rădulescu, S.; Negoiţă, L. I.; Onuţu, I.

2016-08-01

The tubular heat exchangers (shell and tube heat exchangers and concentric tube heat exchangers) represent an important category of equipment in the petroleum refineries and are used for heating, pre-heating, cooling, condensation and evaporation purposes. The paper presents results of analysis of the heat transfer to cool a petroleum product in two types of concentric tube heat exchangers: double and triple concentric tube heat exchangers. The cooling agent is water. The triple concentric tube heat exchanger is a modified constructive version of double concentric tube heat exchanger by adding an intermediate tube. This intermediate tube improves the heat transfer by increasing the heat area per unit length. The analysis of the heat transfer is made using experimental data obtained during the tests in a double and triple concentric tube heat exchanger. The flow rates of fluids, inlet and outlet temperatures of water and petroleum product are used in determining the performance of both heat exchangers. Principally, for both apparatus are calculated the overall heat transfer coefficients and the heat exchange surfaces. The presented results shows that triple concentric tube heat exchangers provide better heat transfer efficiencies compared to the double concentric tube heat exchangers.

Copepod (Crustacea) emergence from soils from everglades marshes with different hydroperiods

USGS Publications Warehouse

Loftus, W.F.; Reid, J.W.

2000-01-01

During a severe drought period in the winter and spring of 1989, we made three collections of dried marsh soils from freshwater sloughs in Everglades National Park, Florida, at sites characterized by either long or intermediate annual periods of flooding (hydroperiod). After rehydrating the soils in aquaria, we documented the temporal patterns of copepod emergence over two-week periods. The species richness of copepods in the rehydrated soils was lower than in pre-drought samples from the same slough sites. Only six of the 16 species recorded from the Everglades emerged in the aquarium tests. The long hydroperiod site had a slightly different assemblage and higher numbers of most species than the intermediate-hydroperiod sites. More individuals and species emerged from the early dry-season samples compared with samples taken later in the dry season. The harpacticoid, Cletocamptus deitersi, and the cyclopoid, Microcyclops rubellus, were abundant at most sites. The cyclopoids - Ectocyclops phaleratus, Homocyclops ater, and Paracyclops chiltoni - are new records for the Everglades. We infer that 1) only a subset of Everglades copepod species can survive drought by resting in soils; and that 2) survival ability over time differs by species.

Cytogenetics-based risk prediction of blastic transformation of chronic myeloid leukemia in the era of TKI therapy

PubMed Central

Gong, Zimu; Medeiros, L. Jeffrey; Cortes, Jorge E.; Chen, Zi; Zheng, Lan; Li, Yan; Bai, Shi; Lin, Pei; Miranda, Roberto N.; Jorgensen, Jeffrey L.; McDonnell, Timothy J.; Wang, Wei; Kantarjian, Hagop M.

2017-01-01

The high fatality of patients with blast phase (BP) chronic myeloid leukemia (CML) necessitates identification of high-risk (HR) patients to prevent onset of BP. Here, we investigated the risk of BP based on additional chromosomal abnormality (ACA) profiles in a cohort of 2326 CML patients treated with tyrosine kinase inhibitors (TKIs). We examined the time intervals from initial diagnosis to ACA emergence (interval 1), from ACA emergence to onset of BP (interval 2), and survival after onset of BP (interval 3). Based on BP risk associated with each ACA, patients were stratified into intermediate-1, intermediate-2, and HR groups, with a median duration of interval 2 of unreached, 19.2 months, and 1.9 months, respectively. There was no difference in durations of intervals 1 or 3 among 3 groups. Including patients without ACAs who formed the standard-risk group, the overall 5-year cumulative probability of BP was 9.8%, 28.0%, 41.7%, and 67.4% for these 4 groups, respectively. The pre-BP disease course in those who developed BP was similar regardless of cytogenetic alterations, and 84.4% of BP patients developed BP within the first 5 years of diagnosis. In summary, interval 2 is the predominant determinant of BP risk and patient outcome. By prolonging the duration of interval 2, TKI therapy mitigates BP risk associated with low-risk ACAs or no ACAs but does not alter the natural course of CML with HR ACAs. Thus, we have identified a group of patients who have HR of BP and may benefit from timely alternative treatment to prevent onset of BP. PMID:29296906

Absolute Transition Probabilities of Lines in the Spectra of Astrophysical Atoms, Molecules, and Ions

NASA Technical Reports Server (NTRS)

Parkinson, W. H.; Smith, P. L.; Yoshino, K.

1984-01-01

Progress in the investigation of absolute transition probabilities (A-values or F values) for ultraviolet lines is reported. A radio frequency ion trap was used for measurement of transition probabilities for intersystem lines seen in astronomical spectra. The intersystem line at 2670 A in Al II, which is seen in pre-main sequence stars and symbiotic stars, was studied.

Chemistry For Kids: Pre-Chemistry Acid Rain Activities for Kids.

ERIC Educational Resources Information Center

Barrow, Lloyd H.

1985-01-01

Presents two activities on acid rain for students in intermediate grades. Materials needed and procedures used are included. Also describes "chemical magic" shows performed by high school students for sixth-grade students in seven elementary schools in Altus, Oklahoma. (JN)

Cost-effectiveness of the 21-gene assay for guiding adjuvant chemotherapy decisions in early breast cancer.

PubMed

Paulden, Mike; Franek, Jacob; Pham, Ba'; Bedard, Philippe L; Trudeau, Maureen; Krahn, Murray

2013-01-01

Adjuvant chemotherapy decisions in early breast cancer are complex. The 21-gene assay can potentially aid such decisions, but costs US $4175 per patient. Adjuvant! Online is a freely available decision aid. We evaluate the cost-effectiveness of using the 21-gene assay in conjunction with Adjuvant! Online, and of providing adjuvant chemotherapy conditional upon risk classification. A probabilistic Markov decision model simulated risk classification, treatment, and the natural history of breast cancer in a hypothetical cohort of 50-year-old women with lymph node-negative, estrogen receptor- and/or progesterone receptor-positive, human epidermal growth factor receptor 2/neu-negative early breast cancer. Cost-effectiveness was considered from an Ontario public-payer perspective by deriving the lifetime incremental cost (2012 Canadian dollars) per quality-adjusted life-year (QALY) for each strategy, and the probability each strategy is cost-effective, assuming a willingness-to-pay of $50,000 per QALY. The 21-gene assay has an incremental cost per QALY in patients at low, intermediate, or high Adjuvant Online! risk of $22,440 (probability cost-effective 78.46%), $2,526 (99.40%), or $1,111 (99.82%), respectively. In patients at low (high) 21-gene assay risk, adjuvant chemotherapy increases (reduces) costs and worsens (improves) health outcomes. For patients at intermediate 21-gene assay risk and low, intermediate, or high Adjuvant! Online risk, chemotherapy has an incremental cost per QALY of $44,088 (50.59%), $1,776 (77.65%), or $1,778 (82.31%), respectively. The 21-gene assay appears cost-effective, regardless of Adjuvant! Online risk. Adjuvant chemotherapy appears cost-effective for patients at intermediate or high 21-gene assay risk, although this finding is uncertain in patients at intermediate 21-gene assay and low Adjuvant! Online risk. Copyright © 2013 International Society for Pharmacoeconomics and Outcomes Research (ISPOR). Published by Elsevier Inc. All rights reserved.

Most probable number enumeration of H2-utilizing acetogenic bacteria from the digestive tract of animals and man.

PubMed

Doré, J; Morvan, B; Rieu-Lesme, F; Goderel, I; Gouet, P; Pochart, P

1995-07-15

A method is proposed that allows the enrichment and most probable number estimation of H2/CO2(-)utilizing acetogenic bacteria. It is based on the difference in acetate production for serial dilutions incubated under either a test H2/CO2 (4:1), or a control N2/CO2 (4:1) headspace atmosphere. A nutritionally non-selective medium was used, containing bromoethane-sulfonic acid as inhibitor of methanogenic archaea and 10% pre-incubated clarified rumen fluid. Acetogenic bacteria were enumerated in rumen and hindgut contents of animals and in human feces. They ranged from below 10(2) to above 10(8) per gram wet weight gut content and their population levels were the highest in the absence of methanogenesis. The method described therein should prove useful to better understand the diversity and ecological importance of dominant gut acetogens.

Enhanced picture of protein-folding intermediates using organic solvents in H/D exchange and quench-flow experiments

PubMed Central

Nishimura, Chiaki; Dyson, H. Jane; Wright, Peter E.

2005-01-01

Hydrogen/deuterium exchange followed by trapping of the labeled species in the aprotic solvent DMSO has been used to elucidate structure in both the burst-phase molten globule-folding intermediate of apomyoglobin and in an equilibrium intermediate that models the kinetic intermediate. Precise estimates can be made of exchange times in an interrupted exchange-out experiment at pH 4 followed by analysis in DMSO solution, giving extensive sequence-specific information about the structure of the equilibrium intermediate. In addition, the use of DMSO as a solvent for NMR measurements after quench-flow pH-pulse labeling experiments gives a greatly increased data set for the elucidation of the kinetic folding pathway. Interestingly, differences are observed in some regions of apomyoglobin between the equilibrium and kinetic intermediates. These differences are quantitative rather than qualitative; that is, the overall patterns of labeling and secondary structure formation remain similar between the two species. However, local differences are observed, which probably reflect the difference in the solution conditions for the equilibrium experiment (pH 4) vs. the kinetic experiment (pH 6) and the change in the status of the stabilizing hydrogen bond between the side chains of His-24 and His-119. PMID:15769860

An immunologic model for rapid vaccine assessment -- a clinical trial in a test tube.

PubMed

Higbee, Russell G; Byers, Anthony M; Dhir, Vipra; Drake, Donald; Fahlenkamp, Heather G; Gangur, Jyoti; Kachurin, Anatoly; Kachurina, Olga; Leistritz, Del; Ma, Yifan; Mehta, Riyaz; Mishkin, Eric; Moser, Janice; Mosquera, Luis; Nguyen, Mike; Parkhill, Robert; Pawar, Santosh; Poisson, Louis; Sanchez-Schmitz, Guzman; Schanen, Brian; Singh, Inderpal; Song, Haifeng; Tapia, Tenekua; Warren, William; Wittman, Vaughan

2009-09-01

While the duration and size of human clinical trials may be difficult to reduce, there are several parameters in pre-clinical vaccine development that may be possible to further optimise. By increasing the accuracy of the models used for pre-clinical vaccine testing, it should be possible to increase the probability that any particular vaccine candidate will be successful in human trials. In addition, an improved model will allow the collection of increasingly more-informative data in pre-clinical tests, thus aiding the rational design and formulation of candidates entered into clinical evaluation. An acceleration and increase in sophistication of pre-clinical vaccine development will thus require the advent of more physiologically-accurate models of the human immune system, coupled with substantial advances in the mechanistic understanding of vaccine efficacy, achieved by using this model. We believe the best viable option available is to use human cells and/or tissues in a functional in vitro model of human physiology. Not only will this more accurately model human diseases, it will also eliminate any ethical, moral and scientific issues involved with use of live humans and animals. An in vitro model, termed "MIMIC" (Modular IMmune In vitro Construct), was designed and developed to reflect the human immune system in a well-based format. The MIMIC System is a laboratory-based methodology that replicates the human immune system response. It is highly automated, and can be used to simulate a clinical trial for a diverse population, without putting human subjects at risk. The MIMIC System uses the circulating immune cells of individual donors to recapitulate each individual human immune response by maintaining the autonomy of the donor. Thus, an in vitro test system has been created that is functionally equivalent to the donor's own immune system and is designed to respond in a similar manner to the in vivo response. 2009 FRAME.

Three stages in the Late Paleozoic to Triassic magmatism of southwestern Gondwana, and the relationships with the volcanogenic events in coeval basins

NASA Astrophysics Data System (ADS)

Sato, Ana María; Llambías, Eduardo J.; Basei, Miguel A. S.; Castro, Carlos E.

2015-11-01

The intermediate to acid Choiyoi Magmatic Province is the most conspicuous feature along the Late Paleozic continental margin of southwestern Gondwana, and is generally regarded as the possible source for the widespread ash fall deposits interlayered with sedimentary sequences in the adjacent Gondwana basins. The Choiyoi magmatism is geologically constrained between the early Permian San Rafael orogenic phase and the Triassic extensional Huarpica phase in the region of Argentine Frontal Cordillera, Precordillera and San Rafael Block. In order to better assess the Choiyoi magmatism in Argentine Frontal Cordillera, we obtained 6 new LA-ICPMS U-Pb ages between 278.8 ± 3.4 Ma and 252.5 ± 1.9 Ma from plutonic rocks of the Colangüil Batholith and an associated volcanic rock. The global analysis of age data compiled from Chilean and Argentine Late Paleozoic to Triassic outcrops allows us to identify three stages of magmatism: (1) pre-Choiyoi orogenic magmatism, (2) Choiyoi magmatism (286-247 Ma), and (3) post-Choiyoi magmatism related to extensional tectonics. In the Choiyoi stage is there an eastward shift and expansion of the magmatism to the southeast, covering an extensive region that defines the Choiyoi magmatic province. On the basis of comparison with the ages from volcanogenic levels identified in the coeval Gondwana basins, we propose: (a) The pre-Choiyoi volcanism from the Paganzo basin (320-296 Ma) probably has a local source in addition to the Frontal Cordillera region. (b) The pre-Choiyoi and Choiyoi events identified in the Paraná basin (304-275 Ma) are likely to have their source in the Chilean Precordillera. (c) The early stage of the Choiyoi magmatism found in the Sauce Grande basin (284-281 Ma) may have come from the adjacent Las Matras to Chadileuvú blocks. (d) The pre-Choiyoi and Choiyoi events in the Karoo basins (302-253 Ma) include the longest Choiyoi interval, and as a whole bear the best resemblance to the age records along the Chilean and Argentine Frontal Cordillera.

Insulin resistance, obesity, hypofibrinolysis, hyperandrogenism, and coronary heart disease risk factors in 25 pre-perimenarchal girls age < or =14 years, 13 with precocious puberty, 23 with a first-degree relative with polycystic ovary syndrome.

PubMed

Glueck, Charles J; Morrison, John A; Wang, Ping

2008-10-01

Pre-peri-menarchal diagnosis of polycystic ovary syndrome (PCOS) is important, because intervention with metformin-diet may prevent progression to full blown PCOS. In 25 girls age < or =14 years with probable familial PCOS, 10 pre-, 15 post-menarchal, 13 with precocious puberty, 23 with a first-degree relative with PCOS, we hypothesized that reversible coronary heart disease (CHD) risk factors, insulin resistance, clinical and biochemical hyperandrogenism, and hypofibrinolysis were already established. Fasting measures: insulin, glucose, total, LDL- (LDL-C), and HDL-cholesterol (HDL-C), triglycerides (TG), systolic and diastolic blood pressure (SBP, DBP), plasminogen activator inhibitor activity (PAI-Fx), total (T) and free testosterone (FT), androstenedione, and DHEAS. Clinical and/or biochemical hyperandrogenism was present in all 25 girls, with elevations of T or FT, or androstenedione in seven of ten pre-menarchal girls and in all 15 post-menarche. PAI-Fx was high in 28% of the 25 girls vs 6.5% in age-gender-race matched controls (p = 0.013). Categorized by race-age-specific distributions in 870 schoolgirls, the 25 girls with probable familial PCOS were more likely to have top decile body mass index (BMI), insulin, HOMA-insulin resistance (HOMA-IR), SBP, DBP, and TG, and bottom decile HDL-C. By analysis of variance, adjusting for race, age and BMI, PCOS girls had higher FT and waist circumference than controls, but did not differ for SBP, DBP, HDL-C, or TG (p>0.05). Pre-peri-menarchal acquisition of centripetal obesity amplifies CHD risk factors and hypofibrinolysis in hyperandrogenemic girls with probable familial PCOS and precocious puberty. When schoolgirls become as obese as girls with probable familial PCOS, they acquire the same CHD risk factors, and differ only by lower free T and less centripetal obesity.

Effect of intermediate layers on atomic layer deposition-aluminum oxide protected silver mirrors

NASA Astrophysics Data System (ADS)

Fryauf, David M.; Diaz Leon, Juan J.; Phillips, Andrew C.; Kobayashi, Nobuhiko P.

2017-07-01

This work investigates intermediate materials deposited between silver (Ag) thin-film mirrors and an aluminum oxide (AlOx) barrier overlayer and compares the effects on mirror durability to environmental stresses. Physical vapor deposition of various fluorides, oxides, and nitrides in combination with AlOx by atomic layer deposition (ALD) is used to develop several coating recipes. Ag-AlOx samples with different intermediate materials undergo aggressive high-temperature (80°C), high-humidity (80%) (HTHH) testing for 10 days. Reflectivity of mirror samples is measured before and after HTHH testing, and image processing techniques are used to analyze the specular surface of the samples after HTHH testing. Among the seven intermediate materials used in this work, TiN, MgAl2O4, NiO, and Al2O3 intermediate layers offer more robust protection against chemical corrosion and moisture when compared with samples with no intermediate layer. In addition, results show that the performance of the ALD-AlOx barrier overlayer depends significantly on the ALD-growth process temperature. Because higher durability is observed in samples with less transparent TiN and NiO layers, we propose a figure of merit based on post-HTHH testing reflectivity change and specular reflective mirror surface area remaining after HTHH testing to judge overall barrier performance.

A proposed physical model for the impregnated tungsten cathode based on Auger surface studies of the Ba-O-W system

NASA Technical Reports Server (NTRS)

Forman, R.

1979-01-01

Auger spectra and work function measurements are used to study the surface reactions between tungsten surface and adsorbed layers of barium, and barium and oxygen. The barium on an impregnated tungsten cathod seems to be an intermediate state, probably a coadsorbed barium-oxygen layer on tungsten. A slightly revised version of the previously suggested (1976) impregnated tungsten cathode model is proposed. This revised model assumes that the cathode surface during life has an adsorbed surface layer of a monolayer or less of both barium and oxygen on the surface. At end of life, steep drop in electron emission and resultant cathode failure occur. Recent NASA life test results on TWT type tubes are reported and explained by the proposed model.

Extensive testing or focused testing of patients with elevated liver enzymes.

PubMed

Tapper, Elliot B; Saini, Sameer D; Sengupta, Neil

2017-02-01

Many patients have elevated serum aminotransferases reflecting many underlying conditions, both common and rare. Clinicians generally apply one of two evaluative strategies: testing for all diseases at once (extensive) or just common diseases first (focused). We simulated the evaluation of 10,000 adult outpatients with elevated with alanine aminotransferase to compare both testing strategies. Model inputs employed population-based data from the US (National Health and Nutrition Examination Survey) and Britain (Birmingham and Lambeth Liver Evaluation Testing Strategies). Patients were followed until a diagnosis was provided or a diagnostic liver biopsy was considered. The primary outcome was US dollars per diagnosis. Secondary outcomes included doctor visits per diagnosis, false-positives per diagnosis and confirmatory liver biopsies ordered. The extensive testing strategy required the lowest monetary cost, yielding diagnoses for 54% of patients at $448/patient compared to 53% for $502 under the focused strategy. The extensive strategy also required fewer doctor visits (1.35 vs. 1.61 visits/patient). However, the focused strategy generated fewer false-positives (0.1 vs. 0.19/patient) and more biopsies (0.04 vs. 0.08/patient). Focused testing becomes the most cost-effective strategy when accounting for pre-test probabilities and prior evaluations performed. This includes when the respective prevalence of alcoholic, non-alcoholic and drug-induced liver disease exceeds 51.1%, 53.0% and 13.0%. Focused testing is also the most cost-effective strategy in the referral setting where assessments for viral hepatitis, alcoholic and non-alcoholic fatty liver disease have already been performed. Testing for elevated liver enzymes should be deliberate and focused to account for pre-test probabilities if possible. Many patients have elevated liver enzymes reflecting one of many possible liver diseases, some of which are very common and some of which are rare. Tests are widely available for most causes but it is unclear whether clinicians should order them all at once or direct testing based on how likely a given disease may be given the patient's history and physical exam. The tradeoffs of both approaches involve the money spent on testing, number of office visits needed, and false positive results generated. This study shows that if there are no clues available at the time of evaluation, testing all at once saves time and money while causing more false positives. However, if there are strong clues regarding the likelihood of a particular disease, limited testing saves time, money and prevents false positives. Copyright © 2016 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.

Impact of High-Flow Nasal Cannula Use on Neonatal Respiratory Support Patterns and Length of Stay.

PubMed

Hoffman, Suma B; Terrell, Natalie; Driscoll, Colleen Hughes; Davis, Natalie L

2016-10-01

Heated humidified high-flow nasal cannula (HFNC) is thought to be comparable with nasal CPAP. The effect of multimodality mid-level respiratory support use in the neonatal ICU is unknown. The objective of this work was to evaluate the effect of introducing HFNC on length of respiratory support and stay. A chart review was conducted on subjects at 24-32 weeks gestation requiring mid-level support (HFNC/nasal CPAP) 1 y before and after HFNC implementation. The 2 groups were compared for clinical and demographic data using t test or chi-square analysis. Further, multivariate linear and logistic regression was done to determine significant risk factors for outcomes controlling for covariates. Eighty subjects were eligible in the pre-HFNC group, and 83 were eligible in the post-HFNC group. Subjects were similar in their baseline characteristics. In clinical outcomes, the post-HFNC group had higher rates of retinopathy of prematurity (P = .02) and a trend toward higher bronchopulmonary dysplasia rates (P = .063). The post-HFNC subjects had longer duration of mid-level support and were older at the time they were weaned to stable low-flow nasal cannula (P < .05). Although the length of respiratory support and stay and corrected gestational age at discharge were similar, those in the pre-HFNC period were more likely to be receiving full oral feeds and be discharged home versus being transferred to an intermediate care facility (P < .05). HFNC introduction was significantly associated with a longer duration of mid-level respiratory support, decrease in oral feeding at discharge, increased retinopathy of prematurity rates, and higher use of intermediate care facilities, leading us to examine our noninvasive ventilation and weaning strategies. Copyright © 2016 by Daedalus Enterprises.

Effect of feedback mode and task difficulty on quality of timing decisions in a zero-sum game.

PubMed

Tikuisis, Peter; Vartanian, Oshin; Mandel, David R

2014-09-01

The objective was to investigate the interaction between the mode of performance outcome feedback and task difficulty on timing decisions (i.e., when to act). Feedback is widely acknowledged to affect task performance. However, the extent to which feedback display mode and its impact on timing decisions is moderated by task difficulty remains largely unknown. Participants repeatedly engaged a zero-sum game involving silent duels with a computerized opponent and were given visual performance feedback after each engagement. They were sequentially tested on three different levels of task difficulty (low, intermediate, and high) in counterbalanced order. Half received relatively simple "inside view" binary outcome feedback, and the other half received complex "outside view" hit rate probability feedback. The key dependent variables were response time (i.e., time taken to make a decision) and survival outcome. When task difficulty was low to moderate, participants were more likely to learn and perform better from hit rate probability feedback than binary outcome feedback. However, better performance with hit rate feedback exacted a higher cognitive cost manifested by higher decision response time. The beneficial effect of hit rate probability feedback on timing decisions is partially moderated by task difficulty. Performance feedback mode should be judiciously chosen in relation to task difficulty for optimal performance in tasks involving timing decisions.

Nuclear Ensemble Approach with Importance Sampling.

PubMed

Kossoski, Fábris; Barbatti, Mario

2018-06-12

We show that the importance sampling technique can effectively augment the range of problems where the nuclear ensemble approach can be applied. A sampling probability distribution function initially determines the collection of initial conditions for which calculations are performed, as usual. Then, results for a distinct target distribution are computed by introducing compensating importance sampling weights for each sampled point. This mapping between the two probability distributions can be performed whenever they are both explicitly constructed. Perhaps most notably, this procedure allows for the computation of temperature dependent observables. As a test case, we investigated the UV absorption spectra of phenol, which has been shown to have a marked temperature dependence. Application of the proposed technique to a range that covers 500 K provides results that converge to those obtained with conventional sampling. We further show that an overall improved rate of convergence is obtained when sampling is performed at intermediate temperatures. The comparison between calculated and the available measured cross sections is very satisfactory, as the main features of the spectra are correctly reproduced. As a second test case, one of Tully's classical models was revisited, and we show that the computation of dynamical observables also profits from the importance sampling technique. In summary, the strategy developed here can be employed to assess the role of temperature for any property calculated within the nuclear ensemble method, with the same computational cost as doing so for a single temperature.

Cost-effectiveness analysis of the Xpert MTB/RIF assay for rapid diagnosis of suspected tuberculosis in an intermediate burden area.

PubMed

You, Joyce H S; Lui, Grace; Kam, Kai Man; Lee, Nelson L S

2015-04-01

We examined, from a Hong Kong healthcare providers' perspective, the cost-effectiveness of rapid diagnosis with Xpert in patients hospitalized for suspected active pulmonary tuberculosis (PTB). A decision tree was designed to simulate outcomes of three diagnostic assessment strategies in adult patients hospitalized for suspected active PTB: conventional approach, sputum smear plus Xpert for acid-fast bacilli (AFB) smear-negative, and a single sputum Xpert test. Model inputs were derived from the literature. Outcome measures were direct medical cost, one-year mortality rate, quality-adjusted life-years (QALYs) and incremental cost per QALY (ICER). In the base-case analysis, Xpert was more effective with higher QALYs gained and a lower mortality rate when compared with smear plus Xpert by an ICER of USD99. A conventional diagnostic approach was the least preferred option with the highest cost, lowest QALYs gained and highest mortality rate. Sensitivity analysis showed that Xpert would be the most cost-effective option if the sensitivity of sputum AFB smear microscopy was ≤74%. The probabilities of Xpert, smear plus Xpert and a conventional approach to be cost-effective were 94.5%, 5.5% and 0%, respectively, in 10,000 Monte Carlo simulations. The Xpert sputum test appears to be a highly cost-effective diagnostic strategy for patients with suspected active PTB in an intermediate burden area like Hong Kong. Copyright © 2015 The British Infection Association. Published by Elsevier Ltd. All rights reserved.

Understanding Intermediate-Level Speakers' Strengths and Weaknesses: An Examination of OPIc Tests from Korean Learners of English

ERIC Educational Resources Information Center

Cox, Troy L.

2017-01-01

This study profiled Intermediate-level learners in terms of their linguistic characteristics and performance on different proficiency tasks. A stratified random sample of 300 Korean learners of English with holistic ratings of Intermediate Low (IL), Intermediate Mid (IM), and Intermediate High (IH) on Oral Proficiency Interviews-computerized…

Morphology of Lonar Crater, India: Comparisons and implications

USGS Publications Warehouse

Fudali, R.F.; Milton, D.J.; Fredriksson, K.; Dube, A.

1980-01-01

Lonar Crater is a young meteorite impact crater emplaced in Deccan basalt. Data from 5 drillholes, a gravity network, and field mapping are used to reconstruct its original dimensions, delineate the nature of the pre-impact target rocks, and interpret the emplacement mode of the ejecta. Our estimates of the pre-erosion dimensions are: average diameter of 1710 m; average rim height of 40 m (30-35 m of rim rock uplift, 5-10 m of ejected debris); depth of 230-245 m (from rim crest to crater floor). The crater's circularity index is 0.9 and is unlikely to have been lower in the past. There are minor irregularities in the original crater floor (present sediment-breccia boundary) possibly due to incipient rebound effects. A continuous ejecta blanket extends an average of 1410 m beyond the pre-erosion rim crest. In general, 'fresh' terrestrial craters, less than 10 km in diameter, have smaller depth/diameter and larger rim height/diameter ratios than their lunar counterparts. Both ratios are intermediate for Mercurian craters, suggesting that crater shape is gravity dependent, all else being equal. Lonar demonstrates that all else is not always equal. Its depth/diameter ratio is normal but, because of less rim rock uplift, its rim height/diameter ratio is much smaller than both 'fresh' terrestrial and lunar impact craters. The target rock column at Lonar consists of one or more layers of weathered, soft basalt capped by fresh, dense flows. Plastic deformation and/or compaction of this lower, incompetent material probably absorbed much of the energy normally available in the cratering process for rim rock uplift. A variety of features within the ejecta blanket and the immediately underlying substrate, plus the broad extent of the blanket boundaries, suggest that a fluidized debris surge was the dominant mechanism of ejecta transportation and deposition at Lonar. In these aspects, Lonar should be a good analog for the 'fluidized craters' of Mars. ?? 1980 D. Reidel Publishing Co.

Identification of a pre-active conformation of a pentameric channel receptor

PubMed Central

Menny, Anaïs; Lefebvre, Solène N; Schmidpeter, Philipp AM; Drège, Emmanuelle; Fourati, Zaineb; Delarue, Marc; Edelstein, Stuart J; Nimigean, Crina M; Joseph, Delphine; Corringer, Pierre-Jean

2017-01-01

Pentameric ligand-gated ion channels (pLGICs) mediate fast chemical signaling through global allosteric transitions. Despite the existence of several high-resolution structures of pLGICs, their dynamical properties remain elusive. Using the proton-gated channel GLIC, we engineered multiple fluorescent reporters, each incorporating a bimane and a tryptophan/tyrosine, whose close distance causes fluorescence quenching. We show that proton application causes a global compaction of the extracellular subunit interface, coupled to an outward motion of the M2-M3 loop near the channel gate. These movements are highly similar in lipid vesicles and detergent micelles. These reorganizations are essentially completed within 2 ms and occur without channel opening at low proton concentration, indicating that they report a pre-active intermediate state in the transition pathway toward activation. This provides a template to investigate the gating of eukaryotic neurotransmitter receptors, for which intermediate states also participate in activation. DOI: http://dx.doi.org/10.7554/eLife.23955.001 PMID:28294942

When More Transmission Equals Less Disease: Reconciling the Disconnect between Disease Hotspots and Parasite Transmission

PubMed Central

Park, Andrew W.; Magori, Krisztian; White, Brad A.; Stallknecht, David E.

2013-01-01

The assumed straightforward connection between transmission intensity and disease occurrence impacts surveillance and control efforts along with statistical methodology, including parameter inference and niche modeling. Many infectious disease systems have the potential for this connection to be more complicated–although demonstrating this in any given disease system has remained elusive. Hemorrhagic disease (HD) is one of the most important diseases of white-tailed deer and is caused by viruses in the Orbivirus genus. Like many infectious diseases, the probability or severity of disease increases with age (after loss of maternal antibodies) and the probability of disease is lower upon re-infection compared to first infection (based on cross-immunity between virus strains). These broad criteria generate a prediction that disease occurrence is maximized at intermediate levels of transmission intensity. Using published US field data, we first fit a statistical model to predict disease occurrence as a function of seroprevalence (a proxy for transmission intensity), demonstrating that states with intermediate seroprevalence have the highest level of case reporting. We subsequently introduce an independently parameterized mechanistic model supporting the theory that high case reporting should come from areas with intermediate levels of transmission. This is the first rigorous demonstration of this phenomenon and illustrates that variation in transmission rate (e.g. along an ecologically-controlled transmission gradient) can create cryptic refuges for infectious diseases. PMID:23579922

The weaker effects of First-order mean motion resonances in intermediate inclinations

NASA Astrophysics Data System (ADS)

Chen, YuanYuan; Quillen, Alice C.; Ma, Yuehua; Chinese Scholar Council, the National Natural Science Foundation of China, the Natural Science Foundation of Jiangsu Province, the Minor Planet Foundation of the Purple Mountain Observatory

2017-10-01

During planetary migration, a planet or planetesimal can be captured into a low-order mean motion resonance with another planet. Using a second-order expansion of the disturbing function in eccentricity and inclination, we explore the sensitivity of the capture probability of first-order mean motion resonances to orbital inclination. We find that second-order inclination contributions affect the resonance strengths, reducing them at intermediate inclinations of around 10-40° for major first-order resonances. We also integrated the Hamilton's equations with arbitrary initial arguments, and provided the varying tendencies of resonance capture probabilities versus orbital inclinations for different resonances and different particle or planetary eccentricities. Resonance-weaker ranges in inclinations generally appear at the places where resonance strengths are low, around 10-40° in general. The weaker ranges disappear with a higher particle eccentricity (≳0.05) or planetary eccentricity (≳0.05). These resonance-weaker ranges in inclinations implies that intermediate-inclination objects are less likely to be disturbed or captured into the first-order resonances, which would make them entering into the chaotic area around Neptune with a larger fraction than those with low inclinations, during the epoch of Neptune's outward migration. The privilege of high-inclination particles leave them to be more likely captured into Neptune Trojans, which might be responsible for the unexpected high fraction of high-inclination Neptune Trojans.

Sport Education as a Curriculum Approach to Student Learning of Invasion Games: Effects on Game Performance and Game Involvement.

PubMed

Farias, Cláudio; Valério, Carla; Mesquita, Isabel

2018-03-01

The teaching and learning of games and sport-based activities has historically been the dominant form of the physical education curricula. With an interest in providing to students meaningful and culturally situated sporting experiences, Sport Education is probably the most implemented and researched pedagogical model worldwide. However, although there is considerable evidence that the model as a curriculum approach can benefit the development of social goals and healthy sport behaviors, not a single study as to date examined students' game-play development beyond participation in single and isolated teaching units. Therefore, the purpose of this study was to examine students' development of Game Performance and Game Involvement during participation in three consecutive Sport Education seasons of invasion games. The participants were an experienced physical education teacher and one seventh-grade class totaling 26 students (10 girls and 16 boys). Using the Game Performance Assessment Instrument (Oslin et al., 1998), pre-test to post-tests measures of students' Game Performance and Game Involvement were collected during their participation in basketball (20 lessons), handball (16 lessons), and football (18 lessons) units. Inter-group differences and pre-test to post-test improvements within each season were analyzed through 2 (time) x group (sport) repeated measures ANOVA tests. There were found significant pre-test to post-test improvements in Game Performance and Game Involvement in the second (handball) and third (football) seasons, but not in the first season (basketball). Students' Game Performance and Involvement scores of handball and football were significantly higher than their scores while playing basketball. The opportunity for an extended engagement in game-play activities and prolonged membership of students in the same teams throughout three consecutive seasons of Sport Education were key to the outcomes found. The specific configurations of the game forms played by students either inhibited or enabled their game-play development.

Effects of breastfeeding on postpartum weight loss among U.S. women

PubMed Central

Jarlenski, Marian P.; Bennett, Wendy L.; Bleich, Sara N.; Barry, Colleen L.; Stuart, Elizabeth A.

2014-01-01

Objective To evaluate the effects of breastfeeding on maternal weight loss in the 12 months postpartum among U.S. women. Methods Using data from a national cohort of U.S. women conducted in 2005-2007 (N=2,102), we employed propensity scores to match women who breastfed exclusively and non-exclusive for at least three months to comparison women who had not breastfed or breastfed for less than three months. Outcomes included postpartum weight loss at 3, 6, 9, and 12 months postpartum; and the probability of returning to pre-pregnancy body mass index (BMI) category and the probability of returning to pre-pregnancy weight. Results Compared to women who did not breastfeed or breastfed non-exclusively, exclusive breastfeeding for at least 3 months resulted in 3.2 pounds (95% CI: 1.4,4.7) greater weight loss at 12 months postpartum, a 6.0-percentage-point increase (95% CI: 2.3,9.7) in the probability of returning to the same or lower BMI category postpartum; and a 6.1-percentage-point increase (95% CI: 1.0,11.3) in the probability of returning to pre-pregnancy weight or lower postpartum. Non-exclusive breastfeeding did not significantly affect any outcomes. Conclusion Our study provides evidence that exclusive breastfeeding for at least three months has a small effect on postpartum weight loss among U.S. women. PMID:25284261

Effects of breastfeeding on postpartum weight loss among U.S. women.

PubMed

Jarlenski, Marian P; Bennett, Wendy L; Bleich, Sara N; Barry, Colleen L; Stuart, Elizabeth A

2014-12-01

The aim of this study is to evaluate the effects of breastfeeding on maternal weight loss in the 12months postpartum among U.S. women. Using data from a national cohort of U.S. women conducted in 2005-2007 (N=2102), we employed propensity scores to match women who breastfed exclusively and non-exclusive for at least three months to comparison women who had not breastfed or breastfed for less than three months. Outcomes included postpartum weight loss at 3, 6, 9, and 12months postpartum; and the probability of returning to pre-pregnancy body mass index (BMI) category and the probability of returning to pre-pregnancy weight. Compared to women who did not breastfeed or breastfed non-exclusively, exclusive breastfeeding for at least 3months resulted in 3.2 pound (95% CI: 1.4,4.7) greater weight loss at 12months postpartum, a 6.0-percentage-point increase (95% CI: 2.3,9.7) in the probability of returning to the same or lower BMI category postpartum; and a 6.1-percentage-point increase (95% CI: 1.0,11.3) in the probability of returning to pre-pregnancy weight or lower postpartum. Non-exclusive breastfeeding did not significantly affect any outcomes. Our study provides evidence that exclusive breastfeeding for at least three months has a small effect on postpartum weight loss among U.S. women. Copyright © 2014 Elsevier Inc. All rights reserved.

Optimized lower leg injury probability curves from postmortem human subject tests under axial impacts.

PubMed

Yoganandan, Narayan; Arun, Mike W J; Pintar, Frank A; Szabo, Aniko

2014-01-01

Derive optimum injury probability curves to describe human tolerance of the lower leg using parametric survival analysis. The study reexamined lower leg postmortem human subjects (PMHS) data from a large group of specimens. Briefly, axial loading experiments were conducted by impacting the plantar surface of the foot. Both injury and noninjury tests were included in the testing process. They were identified by pre- and posttest radiographic images and detailed dissection following the impact test. Fractures included injuries to the calcaneus and distal tibia-fibula complex (including pylon), representing severities at the Abbreviated Injury Score (AIS) level 2+. For the statistical analysis, peak force was chosen as the main explanatory variable and the age was chosen as the covariable. Censoring statuses depended on experimental outcomes. Parameters from the parametric survival analysis were estimated using the maximum likelihood approach and the dfbetas statistic was used to identify overly influential samples. The best fit from the Weibull, log-normal, and log-logistic distributions was based on the Akaike information criterion. Plus and minus 95% confidence intervals were obtained for the optimum injury probability distribution. The relative sizes of the interval were determined at predetermined risk levels. Quality indices were described at each of the selected probability levels. The mean age, stature, and weight were 58.2±15.1 years, 1.74±0.08 m, and 74.9±13.8 kg, respectively. Excluding all overly influential tests resulted in the tightest confidence intervals. The Weibull distribution was the most optimum function compared to the other 2 distributions. A majority of quality indices were in the good category for this optimum distribution when results were extracted for 25-, 45- and 65-year-olds at 5, 25, and 50% risk levels age groups for lower leg fracture. For 25, 45, and 65 years, peak forces were 8.1, 6.5, and 5.1 kN at 5% risk; 9.6, 7.7, and 6.1 kN at 25% risk; and 10.4, 8.3, and 6.6 kN at 50% risk, respectively. This study derived axial loading-induced injury risk curves based on survival analysis using peak force and specimen age; adopting different censoring schemes; considering overly influential samples in the analysis; and assessing the quality of the distribution at discrete probability levels. Because procedures used in the present survival analysis are accepted by international automotive communities, current optimum human injury probability distributions can be used at all risk levels with more confidence in future crashworthiness applications for automotive and other disciplines.

Adhesion of resin materials to S2-glass unidirectional and E-glass multidirectional fiber reinforced composites: effect of polymerization sequence protocols.

PubMed

Polacek, Petr; Pavelka, Vladimir; Ozcan, Mutlu

2013-12-01

To evaluate the effect of different polymerization sequences employed during application of bis-GMAbased particulate filler composites (PFC) or a flowable resin (FR) on fiber-reinforced composite (FRC). Unidirectional, pre-impregnated S2-glass fibers (Dentapreg) and multidirectional preimpregnated E-glass fibers (Dentapreg) (length: 40 mm; thickness: 0.5 mm) were obtained (N = 144, n = 12 per group) and embedded in translucent silicone material with the adhesion surface exposed. The resulting specimens were randomly divided into 12 groups for the following application sequences: a) FRC+PFC (photopolymerized in one step), b) FRC+FR (photopolymerized in one step), c) FRC+PFC (photopolymerized individually), d) FRC+FR (photopolymerized individually), e) FRC (photopolymerized)+intermediate adhesive resin and PFC (photopolymerized in one step), f) FRC (photopolymerized)+intermediate adhesive resin and FR (photopolymerized in one step). The sequences of unidirectional (groups a to f) were repeated for multidirectional (groups g to l) FRCs. PFCs were debonded from the FRC surfaces using the shear bond test in a universal testing machine (1 mm/min). On additional specimens from each FRC type, thermogravimetric analysis (TGA) was performed to characterize the fiber weight content (Wf) (N = 6, n = 3 per group). After debonding, all specimens were analyzed using SEM to categorize the failure modes. The data were statistically analyzed using 3-way ANOVA and Tukey's tests (α = 0.05). Significant effects of the FRC type (S2 or E-glass) (p < 0.01), resin type (PFC or FR) (p < 0.01) and polymerization protocol (p < 0.05) were observed on the bond strength (MPa). Interaction terms were also significant (p < 0.05). The multidirectional FRC groups (g to l) showed significantly lower bond strengths (2.3 ± 0.2 to 7.3 ± 0.3 MPa) than did the unidirectional FRC groups (a to f) (10.7 ± 0.6 to 24.4 ± 0.8 MPa). Among the unidirectional FRC groups, the highest values were obtained with protocol f (24.4 ± 0.8), followed by protocol e (18.6 ± 0.4). PFC adhesion to unidirectional FRC was lower when FRC and PFC were polymerized in one step (protocol a: 11.3 ± 0.5) than individual polymerization (protocol c: 14.1 ± 0.5). The opposite situation was true for FR (protocol b: 17.5 ± 0.4; protocol d: 10.7 ± 0.6). Groups a to f presented exclusively mixed failures (a combination of partial cohesive failure in the PFC and adhesive failure between the FRC and PFC) and groups g to l demonstrated only adhesive failure (intact FRC no cohesive failure of PFC). TGA revealed 55 ± 3 wt% fiber content for multidirectional and 60 ± 3 wt% for unidirectional FRCs tested. Multidirectional pre-impregnated E-glass fibers cannot be recommended in combination with the PFC and FR materials tested in this study. Application of an intermediate adhesive resin layer increases the adhesion of both PFC and FR to unidirectional FRC. FRC and FR can be polymerized in one step, but FRC and PFC combinations should be polymerized individually.

Testing BR photocycle kinetics.

PubMed Central

Nagle, J F; Zimanyi, L; Lanyi, J K

1995-01-01

An improved K absorption spectrum in the visible is obtained from previous photocycle data for the D96N mutant of bacteriorhodopsin, and the previously obtained M absorption spectrum in the visible and the fraction cycling are confirmed at 25 degrees C. Data at lower temperatures are consistent with negligible temperature dependence in the spectra from 5 degrees C to 25 degrees C. Detailed analysis strongly indicates that there are two intermediates in addition to the first intermediate K and the last intermediate M. Assuming two of the intermediates have the same spectrum and using the L spectrum obtained previously, the best kinetic model with four intermediates that fits the time course of the intermediates is rather unusual, with two L's on a cul-de-sac. However, a previously proposed, more conventional model with five intermediates, including two L's with the same spectra and two M's with the same spectra, also fits the time course of the intermediates nearly as well. A new criterion that tests an individual proposed spectrum against data is also proposed. PMID:7787034

Test Bias in the Intermediate Mental Alertness, Mechanical Comprehension, Blox and High Level Figure Classification Tests. An NTB/HSRC Report.

ERIC Educational Resources Information Center

Holburn, P. T.

Research is reported on four tests commonly used in South Africa to select apprentices, the Intermediate Mental Alertness Test, the High Level Figure Classification Test, the Blox Test, and the Mechanical Comprehension Test. Samples were as follows: (1) 206 Asian, 208 Black, 102 Coloured, and 99 White mostly male applicants for sugar industry…

Cenozoic volcanic geology and probable age of inception of basin-range faulting in the southeasternmost Chocolate Mountains, California

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

Crowe, B.M.

1978-02-01

A complex sequence of Oligocene-age volcanic and volcaniclastic rocks form a major volcanic center in the Picacho area of the southeasternmost Chocolate Mountains, Imperial County, California. Basal-volcanic rocks consist of lava flows and flow breccia of trachybasalt, pyroxene rhyodacite, and pyroxene dacite (32 My old). These volcanic rocks locally overlie fanglomerate and rest unconformably on pre-Cenozoic basement rocks. South and southeast of a prominent arcuate fault zone in the central part of the area, the rhyolite ignimbrite (26 My old) forms a major ash-flow sheet. In the southwestern part of the Picacho area the rhyolite ignimbrite interfingers with and ismore » overlain by dacite flows and laharic breccia. The rhyolite ignimbrite and the dacite of Picacho Peak are overlapped by lava flows and breccia of pyroxene andesite (25 My old) that locally rest on pre-Cenozoic basement rocks. The volcanic rocks of the Picacho area form a slightly bimodal volcanic suite consisting chiefly of silicic volcanic rocks with subordinate andesite. Late Miocene augite-olivine basalt is most similar in major-element abundances to transitional alkali-olivine basalt of the Basin and Range province. Normal separation faults in the Picacho area trend northwest and north parallel to major linear mountain ranges in the region. The areal distribution of the 26-My-old rhyolite ignimbrite and the local presence of megabreccia and fanglomerate flanking probable paleohighs suggest that the ignimbrite was erupted over irregular topography controlled by northwest- and north-trending probable basin-range faults. These relations date the inception of faulting in southeasternmost California at pre-26 and probably pre-32 My ago. A transition of basaltic volcanism in the area is dated at 13 My ago. 9 figures, 2 tables.« less

Component Test Facility (Comtest) Phase 1 Engineering For 760°C (1400°F) Advanced Ultrasupercritical (A-USC) Steam Generator Development

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

Weitzel, Paul

2016-05-13

The Babcock & Wilcox Company (B&W) performed a Pre-Front End Engineering Design (Pre-FEED) of an A-USC steam superheater for a proposed component test program achieving 760°C (1400°F) steam temperature. This would lead to follow-on work in a Phase 2 and Phase 3 that would involve detail design, manufacturing, construction and operation of the ComTest. Phase 1 results have provided the engineering data necessary for proceeding to the next phase of ComTest. The steam generator superheater would subsequently supply the steam to an A-USC prototype intermediate pressure steam turbine. The ComTest program is important in that it will place functioning A-USCmore » components in operation and in coordinated boiler and turbine service. It is also important to introduce the power plant operation and maintenance personnel to the level of skills required and provide the first background experience with hands-on training. The project will provide a means to exercise the complete supply chain events required in order to practice and perfect the process for A-USC power plant design, supply, manufacture, construction, commissioning, operation and maintenance. Representative participants will then be able to transfer knowledge and recommendations to the industry. ComTest is conceived in the manner of using a separate standalone plant facility that will not jeopardize the host facility or suffer from conflicting requirements in the host plant’s mission that could sacrifice the nickel alloy components and not achieve the testing goals. ComTest will utilize smaller quantities of the expensive materials and reduce the risk in the first operational practice for A-USC technology in the United States. Components at suitable scale in ComTest provide more assurance before putting them into practice in the full size A-USC demonstration plant.« less

Magnetic fields of intermediate mass T Tauri stars

NASA Astrophysics Data System (ADS)

Lavail, A.; Kochukhov, O.; Hussain, G. A. J.; Alecian, E.; Herczeg, G. J.; Johns-Krull, C.

2017-12-01

Aims: In this paper, we aim to measure the strength of the surface magnetic fields for a sample of five intermediate mass T Tauri stars and one low mass T Tauri star from late-F to mid-K spectral types. While magnetic fields of T Tauri stars at the low mass range have been extensively characterized, our work complements previous studies towards the intermediate mass range; this complementary study is key to evaluate how magnetic fields evolve during the transition from a convective to a radiative core. Methods: We studied the Zeeman broadening of magnetically sensitive spectral lines in the H-band spectra obtained with the CRIRES high-resolution near-infrared spectrometer. These data are modelled using magnetic spectral synthesis and model atmospheres. Additional constraints on non-magnetic line broadening mechanisms are obtained from modelling molecular lines in the K band or atomic lines in the optical wavelength region. Results: We detect and measure mean surface magnetic fields for five of the six stars in our sample: CHXR 28, COUP 107, V2062 Oph, V1149 Sco, and Par 2441. Magnetic field strengths inferred from the most magnetically sensitive diagnostic line range from 0.8 to 1.8 kG. We also estimate a magnetic field strength of 1.9 kG for COUP 107 from an alternative diagnostic. The magnetic field on YLW 19 is the weakest in our sample and is marginally detected, with a strength of 0.8 kG. Conclusions: We populate an uncharted area of the pre-main-sequence HR diagram with mean magnetic field measurements from high-resolution near-infrared spectra. Our sample of intermediate mass T Tauri stars in general exhibits weaker magnetic fields than their lower mass counterparts. Our measurements will be used in combination with other spectropolarimetric studies of intermediate mass and lower mass T Tauri stars to provide input into pre-main-sequence stellar evolutionary models.

The role of pre-morbid intelligence and cognitive reserve in predicting cognitive efficiency in a sample of Italian elderly.

PubMed

Caffò, Alessandro O; Lopez, Antonella; Spano, Giuseppina; Saracino, Giuseppe; Stasolla, Fabrizio; Ciriello, Giuseppe; Grattagliano, Ignazio; Lancioni, Giulio E; Bosco, Andrea

2016-12-01

Models of cognitive reserve in aging suggest that individual's life experience (education, working activity, and leisure) can exert a neuroprotective effect against cognitive decline and may represent an important contribution to successful aging. The objective of the present study is to investigate the role of cognitive reserve, pre-morbid intelligence, age, and education level, in predicting cognitive efficiency in a sample of healthy aged individuals and with probable mild cognitive impairment. Two hundred and eight aging participants recruited from the provincial region of Bari (Apulia, Italy) took part in the study. A battery of standardized tests was administered to them to measure cognitive reserve, pre-morbid intelligence, and cognitive efficiency. Protocols for 10 participants were excluded since they did not meet inclusion criteria, and statistical analyses were conducted on data from the remaining 198 participants. A path analysis was used to test the following model: age, education level, and intelligence directly influence cognitive reserve and cognitive efficiency; cognitive reserve mediates the influence of age, education level, and intelligence on cognitive efficiency. Cognitive reserve fully mediates the relationship between pre-morbid intelligence and education level and cognitive efficiency, while age maintains a direct effect on cognitive efficiency. Cognitive reserve appears to exert a protective effect regarding cognitive decline in normal and pathological populations, thus masking, at least in the early phases of neurodegeneration, the decline of memory, orientation, attention, language, and reasoning skills. The assessment of cognitive reserve may represent a useful evaluation supplement in neuropsychological screening protocols of cognitive decline.

Importance of the pre-industrial baseline for likelihood of exceeding Paris goals

NASA Astrophysics Data System (ADS)

Schurer, Andrew P.; Mann, Michael E.; Hawkins, Ed; Tett, Simon F. B.; Hegerl, Gabriele C.

2017-08-01

During the Paris conference in 2015, nations of the world strengthened the United Nations Framework Convention on Climate Change by agreeing to holding `the increase in the global average temperature to well below 2 °C above pre-industrial levels and pursuing efforts to limit the temperature increase to 1.5 °C' (ref. ). However, `pre-industrial' was not defined. Here we investigate the implications of different choices of the pre-industrial baseline on the likelihood of exceeding these two temperature thresholds. We find that for the strongest mitigation scenario RCP2.6 and a medium scenario RCP4.5, the probability of exceeding the thresholds and timing of exceedance is highly dependent on the pre-industrial baseline; for example, the probability of crossing 1.5 °C by the end of the century under RCP2.6 varies from 61% to 88% depending on how the baseline is defined. In contrast, in the scenario with no mitigation, RCP8.5, both thresholds will almost certainly be exceeded by the middle of the century with the definition of the pre-industrial baseline of less importance. Allowable carbon emissions for threshold stabilization are similarly highly dependent on the pre-industrial baseline. For stabilization at 2 °C, allowable emissions decrease by as much as 40% when earlier than nineteenth-century climates are considered as a baseline.

Cost-Effectiveness of Opt-Out Chlamydia Testing for High-Risk Young Women in the U.S.

PubMed

Owusu-Edusei, Kwame; Hoover, Karen W; Gift, Thomas L

2016-08-01

In spite of chlamydia screening recommendations, U.S. testing coverage continues to be low. This study explored the cost-effectiveness of a patient-directed, universal, opportunistic Opt-Out Testing strategy (based on insurance coverage, healthcare utilization, and test acceptance probabilities) for all women aged 15-24 years compared with current Risk-Based Screening (30% coverage) from a societal perspective. Based on insurance coverage (80%); healthcare utilization (83%); and test acceptance (75%), the proposed Opt-Out Testing strategy would have an expected annual testing coverage of approximately 50% for sexually active women aged 15-24 years. A basic compartmental heterosexual transmission model was developed to account for population-level transmission dynamics. Two groups were assumed based on self-reported sexual activity. All model parameters were obtained from the literature. Costs and benefits were tracked over a 50-year period. The relative sensitivity of the estimated incremental cost-effectiveness ratios to the variables/parameters was determined. This study was conducted in 2014-2015. Based on the model, the Opt-Out Testing strategy decreased the overall chlamydia prevalence by >55% (2.7% to 1.2%). The Opt-Out Testing strategy was cost saving compared with the current Risk-Based Screening strategy. The estimated incremental cost-effectiveness ratio was most sensitive to the female pre-opt out prevalence, followed by the probability of female sequelae and discount rate. The proposed Opt-Out Testing strategy was cost saving, improving health outcomes at a lower net cost than current testing. However, testing gaps would remain because many women might not have health insurance coverage, or not utilize health care. Published by Elsevier Inc.

Response of the carbon cycle in an intermediate complexity model to the different climate configurations of the last nine interglacials

NASA Astrophysics Data System (ADS)

Bouttes, Nathaelle; Swingedouw, Didier; Roche, Didier M.; Sanchez-Goni, Maria F.; Crosta, Xavier

2018-03-01

Atmospheric CO2 levels during interglacials prior to the Mid-Brunhes Event (MBE, ˜ 430 ka BP) were around 40 ppm lower than after the MBE. The reasons for this difference remain unclear. A recent hypothesis proposed that changes in oceanic circulation, in response to different external forcings before and after the MBE, might have increased the ocean carbon storage in pre-MBE interglacials, thus lowering atmospheric CO2. Nevertheless, no quantitative estimate of this hypothesis has been produced up to now. Here we use an intermediate complexity model including the carbon cycle to evaluate the response of the carbon reservoirs in the atmosphere, ocean and land in response to the changes of orbital forcings, ice sheet configurations and atmospheric CO2 concentrations over the last nine interglacials. We show that the ocean takes up more carbon during pre-MBE interglacials in agreement with data, but the impact on atmospheric CO2 is limited to a few parts per million. Terrestrial biosphere is simulated to be less developed in pre-MBE interglacials, which reduces the storage of carbon on land and increases atmospheric CO2. Accounting for different simulated ice sheet extents modifies the vegetation cover and temperature, and thus the carbon reservoir distribution. Overall, atmospheric CO2 levels are lower during these pre-MBE simulated interglacials including all these effects, but the magnitude is still far too small. These results suggest a possible misrepresentation of some key processes in the model, such as the magnitude of ocean circulation changes, or the lack of crucial mechanisms or internal feedbacks, such as those related to permafrost, to fully account for the lower atmospheric CO2 concentrations during pre-MBE interglacials.

Modelling detectability of kiore (Rattus exulans) on Aguiguan, Mariana Islands, to inform possible eradication and monitoring efforts

USGS Publications Warehouse

Adams, A.A.Y.; Stanford, J.W.; Wiewel, A.S.; Rodda, G.H.

2011-01-01

Estimating the detection probability of introduced organisms during the pre-monitoring phase of an eradication effort can be extremely helpful in informing eradication and post-eradication monitoring efforts, but this step is rarely taken. We used data collected during 11 nights of mark-recapture sampling on Aguiguan, Mariana Islands, to estimate introduced kiore (Rattus exulans Peale) density and detection probability, and evaluated factors affecting detectability to help inform possible eradication efforts. Modelling of 62 captures of 48 individuals resulted in a model-averaged density estimate of 55 kiore/ha. Kiore detection probability was best explained by a model allowing neophobia to diminish linearly (i.e. capture probability increased linearly) until occasion 7, with additive effects of sex and cumulative rainfall over the prior 48 hours. Detection probability increased with increasing rainfall and females were up to three times more likely than males to be trapped. In this paper, we illustrate the type of information that can be obtained by modelling mark-recapture data collected during pre-eradication monitoring and discuss the potential of using these data to inform eradication and posteradication monitoring efforts. ?? New Zealand Ecological Society.

Intercultural Qualitative Research and Ph.D. Students

ERIC Educational Resources Information Center

Ditton, Mary

2007-01-01

The educational environment for postgraduate health professionals from developing countries in contemporary western universities is an intermediate zone between home and host culture. In this zone, knowledge is shaped through the development of concepts within the limitations of (often) pre-fluent language capacity. It is characterized by the…

Low incidence of new biochemical and clinical hypogonadism following hypofractionated stereotactic body radiation therapy (SBRT) monotherapy for low- to intermediate-risk prostate cancer

PubMed Central

2011-01-01

Background The CyberKnife is an appealing delivery system for hypofractionated stereotactic body radiation therapy (SBRT) because of its ability to deliver highly conformal radiation therapy to moving targets. This conformity is achieved via 100s of non-coplanar radiation beams, which could potentially increase transitory testicular irradiation and result in post-therapy hypogonadism. We report on our early experience with CyberKnife SBRT for low- to intermediate-risk prostate cancer patients and assess the rate of inducing biochemical and clinical hypogonadism. Methods Twenty-six patients were treated with hypofractionated SBRT to a dose of 36.25 Gy in 5 fractions. All patients had histologically confirmed low- to intermediate-risk prostate adenocarcinoma (clinical stage ≤ T2b, Gleason score ≤ 7, PSA ≤ 20 ng/ml). PSA and total testosterone levels were obtained pre-treatment, 1 month post-treatment and every 3 months thereafter, for 1 year. Biochemical hypogonadism was defined as a total serum testosterone level below 8 nmol/L. Urinary and gastrointestinal toxicity was assessed using Common Toxicity Criteria v3; quality of life was assessed using the American Urological Association Symptom Score, Sexual Health Inventory for Men and Expanded Prostate Cancer Index Composite questionnaires. Results All 26 patients completed the treatment with a median 15 months (range, 13-19 months) follow-up. Median pre-treatment PSA was 5.75 ng/ml (range, 2.3-10.3 ng/ml), and a decrease to a median of 0.7 ng/ml (range, 0.2-1.8 ng/ml) was observed by one year post-treatment. The median pre-treatment total serum testosterone level was 13.81 nmol/L (range, 5.55 - 39.87 nmol/L). Post-treatment testosterone levels slowly decreased with the median value at one year follow-up of 10.53 nmol/L, significantly lower than the pre-treatment value (p < 0.013). The median absolute fall was 3.28 nmol/L and the median percent fall was 23.75%. There was no increase in biochemical hypogonadism at one year post-treatment. Average EPIC sexual and hormonal scores were not significantly changed by one year post-treatment. Conclusions Hypofractionated SBRT offers the radiobiological benefit of a large fraction size and is well-tolerated by men with low- to intermediate-risk prostate cancer. Early results are encouraging with an excellent biochemical response. The rate of new biochemical and clinical hypogonadism was low one year after treatment. PMID:21439088

Remission of Intermediate Uveitis: Incidence and Predictive Factors.

PubMed

Kempen, John H; Gewaily, Dina Y; Newcomb, Craig W; Liesegang, Teresa L; Kaçmaz, R Oktay; Levy-Clarke, Grace A; Nussenblatt, Robert B; Rosenbaum, James T; Sen, H Nida; Suhler, Eric B; Thorne, Jennifer E; Foster, C Stephen; Jabs, Douglas A; Payal, Abhishek; Fitzgerald, Tonetta D

2016-04-01

To evaluate the incidence of remission among patients with intermediate uveitis; to identify factors potentially predictive of remission. Retrospective cohort study. Involved eyes of patients with primary noninfectious intermediate uveitis at 4 academic ocular inflammation subspecialty practices, followed sufficiently long to meet the remission outcome definition, were studied retrospectively by standardized chart review data. Remission of intermediate uveitis was defined as a lack of inflammatory activity at ≥2 visits spanning ≥90 days in the absence of any corticosteroid or immunosuppressant medications. Factors potentially predictive of intermediate uveitis remission were evaluated using survival analysis. Among 849 eyes (of 510 patients) with intermediate uveitis followed over 1934 eye-years, the incidence of intermediate uveitis remission was 8.6/100 eye-years (95% confidence interval [CI], 7.4-10.1). Factors predictive of disease remission included prior pars plana vitrectomy (PPV) (hazard ratio [HR] [vs no PPV] = 2.39; 95% CI, 1.42-4.00), diagnosis of intermediate uveitis within the last year (HR [vs diagnosis >5 years ago] =3.82; 95% CI, 1.91-7.63), age ≥45 years (HR [vs age <45 years] = 1.79; 95% CI, 1.03-3.11), female sex (HR = 1.61; 95% CI, 1.04-2.49), and Hispanic race/ethnicity (HR [vs white race] = 2.81; 95% CI, 1.23-6.41). Presence/absence of a systemic inflammatory disease, laterality of uveitis, and smoking status were not associated with differential incidence. Our results suggest that intermediate uveitis is a chronic disease with an overall low rate of remission. Recently diagnosed patients and older, female, and Hispanic patients were more likely to remit. With regard to management, pars plana vitrectomy was associated with increased probability of remission. Copyright © 2016 Elsevier Inc. All rights reserved.

Remission of Intermediate Uveitis: Incidence and Predictive Factors

PubMed Central

Kempen, John H.; Gewaily, Dina Y.; Newcomb, Craig W.; Liesegang, Teresa L.; Kaçmaz, R. Oktay; Levy-Clarke, Grace A.; Nussenblatt, Robert B.; Rosenbaum, James T.; Sen, H. Nida; Suhler, Eric B.; Thorne, Jennifer E.; Foster, C. Stephen; Jabs, Douglas A.; Payal, Abhishek; Fitzgerald, Tonetta D.

2016-01-01

Purpose To evaluate the incidence of remission among patients with intermediate uveitis; to identify factors potentially predictive of remission. Design Retrospective cohort study. Methods Involved eyes of patients with primary non-infectious intermediate uveitis at 4 academic ocular inflammation subspecialty practices, followed sufficiently long to meet the remission outcome definition, were studied retrospectively by standardized chart review data. Remission of intermediate uveitis was defined as a lack of inflammatory activity at ≥2 visits spanning ≥90 days in the absence of any corticosteroid or immunosuppressant medications. Factors potentially predictive of intermediate uveitis remission were evaluated using survival analysis. Results Among 849 eyes (of 510 patients) with intermediate uveitis followed over 1,934 eye-years, the incidence of intermediate uveitis remission was 8.6/100 eye-years (95% confidence interval (CI), 7.4–10.1). Factors predictive of disease remission included prior pars plana vitrectomy (PPV) (HR (vs. no PPV)=2.39; 95% CI, 1.42–4.00), diagnosis of intermediate uveitis within the last year (vs. diagnosis >5 years ago)=3.82; 95% CI, 1.91–7.63), age ≥45 years (HR (vs. age <45 years)=1.79; 95% CI, 1.03–3.11), female sex (HR=1.61; 95% CI, 1.04–2.49), and Hispanic race/ethnicity (HR (vs. white race)=2.81; 95% CI, 1.23–6.41). Presence/absence of a systemic inflammatory disease, laterality of uveitis, and smoking status were not associated with differential incidence. Conclusions Our results suggest that intermediate uveitis is a chronic disease with an overall low rate of remission. Recently diagnosed cases, and older, female and Hispanic cases were more likely to remit. With regards to management, pars plana vitrectomy was associated with increased probability of remission. PMID:26772874

Multiple electron processes of He and Ne by proton impact

NASA Astrophysics Data System (ADS)

Terekhin, Pavel Nikolaevich; Montenegro, Pablo; Quinto, Michele; Monti, Juan; Fojon, Omar; Rivarola, Roberto

2016-05-01

A detailed investigation of multiple electron processes (single and multiple ionization, single capture, transfer-ionization) of He and Ne is presented for proton impact at intermediate and high collision energies. Exclusive absolute cross sections for these processes have been obtained by calculation of transition probabilities in the independent electron and independent event models as a function of impact parameter in the framework of the continuum distorted wave-eikonal initial state theory. A binomial analysis is employed to calculate exclusive probabilities. The comparison with available theoretical and experimental results shows that exclusive probabilities are needed for a reliable description of the experimental data. The developed approach can be used for obtaining the input database for modeling multiple electron processes of charged particles passing through the matter.

Mosses in Ohio wetlands respond to indices of disturbance and vascular plant integrity

USGS Publications Warehouse

Stapanian, Martin A.; Schumacher, William; Gara, Brian; Viau, Nick

2016-01-01

We examined the relationships between an index of wetland habitat quality and disturbance (ORAM score) and an index of vascular plant integrity (VIBI-FQ score) with moss species richness and a moss quality assessment index (MQAI) in 45 wetlands in three vegetation types in Ohio, USA. Species richness of mosses and MQAI were positively associated with ORAM and VIBI-FQ scores. VIBI-FQ score was a better predictor of both moss species richness and MQAI than was either ORAM score or vegetation type. This result was consistent with the strict microhabitat requirements for many moss species, which may be better assessed by VIBI-FQ than ORAM. Probability curves as a function of VIBI-FQ score were then generated for presence of groups of moss species having the same degree of fidelity to substrate and plant communities relative to other species in the moss flora (coefficients of conservatism, CCs). Species having an intermediate- or high degree of fidelity to substrate and plant communities (i.e., species with CC ≥ 5) had a 50% probability of presence (P50) and 90% probability of presence (P90) in wetlands with intermediate- and high VIBI-FQ scores, respectively. Although moss species richness, probability of presence of species based on CC, and MQAI may reflect wetland habitat quality, the 95% confidence intervals around P50 and P90 values may be too wide for regulatory use. Moss species richness, MQAI, and presence of groups of mosses may be more useful for evaluating moss habitat quality in wetlands than a set of “indicator species.”

Maternal whole grain intake and outcomes of in vitro fertilization.

PubMed

Gaskins, Audrey J; Chiu, Yu-Han; Williams, Paige L; Keller, Myra G; Toth, Thomas L; Hauser, Russ; Chavarro, Jorge E

2016-06-01

To evaluate the relationship between pretreatment intake of whole grains and outcomes of IVF. Prospective cohort study. Academic medical center. A total of 273 women who collectively underwent 438 IVF cycles. Whole grain intake was assessed with a validated food frequency questionnaire at enrollment. Intermediate and clinical end points of IVF were abstracted from medical records. Women had a median whole grain intake of 34.2 g per day (∼1.2 servings/day). Higher pretreatment whole grain intake was associated with higher probability of implantation and live birth. The adjusted percentage of cycles resulting in live birth for women in the highest quartile of whole grain intake (>52.4 g/day) was 53% (95% confidence interval [CI] 41%, 65%) compared with 35% (95% CI 25%, 46%) for women in the lowest quartile (<21.4 g/day). This association was largely driven by intake of bran as opposed to germ. When intermediate end points of IVF were examined, only endometrial thickness on the day of ET was associated with whole grain intake. A 28-g per day (∼1 serving/day) increase in whole grain intake was associated with a 0.4-mm (95% CI 0.1, 0.7 mm) increase in endometrial thickness. Higher pretreatment whole grain intake was related to higher probability of live birth among women undergoing IVF. The higher probability of live birth may result from increased endometrial thickness on the day of ET and improved embryo receptivity manifested in a higher probability of implantation. Copyright © 2016 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

Combining information from surveys of several species to estimate the probability of freedom from Echinococcus multilocularis in Sweden, Finland and mainland Norway

PubMed Central

2011-01-01

Background The fox tapeworm Echinococcus multilocularis has foxes and other canids as definitive host and rodents as intermediate hosts. However, most mammals can be accidental intermediate hosts and the larval stage may cause serious disease in humans. The parasite has never been detected in Sweden, Finland and mainland Norway. All three countries require currently an anthelminthic treatment for dogs and cats prior to entry in order to prevent introduction of the parasite. Documentation of freedom from E. multilocularis is necessary for justification of the present import requirements. Methods The probability that Sweden, Finland and mainland Norway were free from E. multilocularis and the sensitivity of the surveillance systems were estimated using scenario trees. Surveillance data from five animal species were included in the study: red fox (Vulpes vulpes), raccoon dog (Nyctereutes procyonoides), domestic pig, wild boar (Sus scrofa) and voles and lemmings (Arvicolinae). Results The cumulative probability of freedom from EM in December 2009 was high in all three countries, 0.98 (95% CI 0.96-0.99) in Finland and 0.99 (0.97-0.995) in Sweden and 0.98 (0.95-0.99) in Norway. Conclusions Results from the model confirm that there is a high probability that in 2009 the countries were free from E. multilocularis. The sensitivity analyses showed that the choice of the design prevalences in different infected populations was influential. Therefore more knowledge on expected prevalences for E. multilocularis in infected populations of different species is desirable to reduce residual uncertainty of the results. PMID:21314948

Flow variation and substrate type affect dislodgement of the freshwater polychaete, Manayunkia speciosa

USGS Publications Warehouse

Malakauskas, David M.; Wilson, Sarah J.; Wilzbach, Margaret A.; Som, Nicholas A.

2013-01-01

We quantified microscale flow forces and their ability to entrain the freshwater polychaete, Manayunkia speciosa, the intermediate host for 2 myxozoan parasites (Ceratomyxa shasta and Parvicapsula minibicornis) that cause substantial mortalities in salmonid fishes in the Pacific Northwest. In a laboratory flume, we measured the shear stress associated with 2 mean flow velocities and 3 substrates and quantified associated dislodgement of polychaetes, evaluated survivorship of dislodged polychaetes, and observed behavioral responses of the polychaetes in response to increased flow. We used a generalized linear mixed model to estimate the probability of polychaete dislodgement for treatment combinations of velocity (mean flow velocity  =  55 cm/s with a shear velocity  =  3 cm/s, mean flow velocity  =  140 cm/s with a shear velocity  =  5 cm/s) and substrate type (depositional sediments and analogs of rock faces and the filamentous alga, Cladophora). Few polychaetes were dislodged at shear velocities <3 cm/s on any substrate. Above this level of shear, probability of dislodgement was strongly affected by both substrate type and velocity. After accounting for substrate, odds of dislodgement were 8× greater at the higher flow. After accounting for velocity, probability of dislodgement was greatest from fine sediments, intermediate from rock faces, and negligible from Cladophora. Survivorship of dislodged polychaetes was high. Polychaetes exhibited a variety of behaviors for avoiding increases in flow, including extrusion of mucus, burrowing into sediments, and movement to lower-flow microhabitats. Our findings suggest that polychaete populations probably exhibit high resilience to flow-mediated disturbances.

Late Glacial-Holocene record of benthic foraminiferal morphogroups from the eastern Arabian Sea OMZ: Paleoenvironmental implications

NASA Astrophysics Data System (ADS)

Verma, K.; Bharti, S. K.; Singh, A. D.

2018-03-01

The Arabian Sea is characterized today by a well-developed and perennial oxygen minimum zone (OMZ) at mid-water depths. The Indian margin where the OMZ impinges provides sediment records ideal to study past changes in the OMZ intensity and its vertical extent in response to the changes of monsoon-driven primary productivity and intermediate water ventilation. Benthic foraminifera, depending upon their adaptation capabilities to variation in sea floor environment and microhabitat preferences, develop various functional morphologies that can be potentially used in paleoenvironmental reconstruction. In this study, we analysed benthic foraminiferal morphogroups in assemblage records of the last 30 ka in a sediment core collected from the lower OMZ of the Indian margin (off Goa). In total, nine morphogroups within two broadly classified epifaunal and infaunal microhabitat categories are identified. The abundance of morphogroups varies significantly during the late Glacial, Deglacial and Holocene. It appears that monsoon wind driven organic matter flux, and water column ventilation governing the OMZ intensity and sea-bottom oxygen condition, have profound influence on structuring the benthic foraminiferal morphogroups. We found a few morphogroups showing major changes in their abundances during the periods corresponding to the northern hemisphere climatic events. Benthic foraminifera with planoconvex tests are abundant during the cold Heinrich events, when the sea bottom was oxygenated due to a better ventilated, weak OMZ; whereas, those having tapered/cylindrical tests dominate during the last glacial maximum and the Holocene between 5 and 8 ka BP, when the OMZ was intensified and poorly ventilated, leading to oxygen-depleted benthic environment. Characteristically, increased abundance of taxa with milioline tests during the Heinrich 1 further suggests enhanced ventilation attributed probably to the influence of oxygen-rich Antarctic Intermediate Water (AAIW).

Embedding resilience in the design of the electricity supply for industrial clients

PubMed Central

Moura, Márcio das Chagas; Diniz, Helder Henrique Lima; da Cunha, Beatriz Sales; Lins, Isis Didier; Simoni, Vicente Ribeiro

2017-01-01

This paper proposes an optimization model, using Mixed-Integer Linear Programming (MILP), to support decisions related to making investments in the design of power grids serving industrial clients that experience interruptions to their energy supply due to disruptive events. In this approach, by considering the probabilities of the occurrence of a set of such disruptive events, the model is used to minimize the overall expected cost by determining an optimal strategy involving pre- and post-event actions. The pre-event actions, which are considered during the design phase, evaluate the resilience capacity (absorption, adaptation and restoration) and are tailored to the context of industrial clients dependent on a power grid. Four cases are analysed to explore the results of different probabilities of the occurrence of disruptions. Moreover, two scenarios, in which the probability of occurrence is lowest but the consequences are most serious, are selected to illustrate the model’s applicability. The results indicate that investments in pre-event actions, if implemented, can enhance the resilience of power grids serving industrial clients because the impacts of disruptions either are experienced only for a short time period or are completely avoided. PMID:29190777

Embedding resilience in the design of the electricity supply for industrial clients.

PubMed

Moura, Márcio das Chagas; Diniz, Helder Henrique Lima; Droguett, Enrique López; da Cunha, Beatriz Sales; Lins, Isis Didier; Simoni, Vicente Ribeiro

2017-01-01

This paper proposes an optimization model, using Mixed-Integer Linear Programming (MILP), to support decisions related to making investments in the design of power grids serving industrial clients that experience interruptions to their energy supply due to disruptive events. In this approach, by considering the probabilities of the occurrence of a set of such disruptive events, the model is used to minimize the overall expected cost by determining an optimal strategy involving pre- and post-event actions. The pre-event actions, which are considered during the design phase, evaluate the resilience capacity (absorption, adaptation and restoration) and are tailored to the context of industrial clients dependent on a power grid. Four cases are analysed to explore the results of different probabilities of the occurrence of disruptions. Moreover, two scenarios, in which the probability of occurrence is lowest but the consequences are most serious, are selected to illustrate the model's applicability. The results indicate that investments in pre-event actions, if implemented, can enhance the resilience of power grids serving industrial clients because the impacts of disruptions either are experienced only for a short time period or are completely avoided.

Deep and intermediate mediterranean water in the western Alboran Sea

NASA Astrophysics Data System (ADS)

Parrilla, Gregorio; Kinder, Thomas H.; Preller, Ruth H.

1986-01-01

Hydrographic and current meter data, obtained during June to October 1982, and numerical model experiments are used to study the distribution and flow of Mediterranean waters in the western Alboran Sea. The Intermediate Water is more pronounced in the northern three-fourths of the sea, but its distribution is patchy as manifested by variability of the temperature and salinity maxima at scales ≤10 km. Current meters in the lower Intermediate Water showed mean flow toward the Strait at 2 cm s -1. A reversal of this flow lasted about 2 weeks. A rough estimate of the mean westward Intermediate Water transport was 0.4 × 10 6 m 3 s -1, about one-third of the total outflow, so that the best estimates of the contributions of traditionally defined Intermediate Water and Deep Water account for only about one-half of the total outflow. The Deep Water was uplifted against the southern continental slope from Alboran Island (3°W) to the Strait. There was also a similar but much weaker banking against the Spanish slope, but a deep current record showed that the eastward recirculation implied by this banking is probably intermittent. Two-layer numerical model experiments simulated the Intermediate Water flow with a flat bottom and the Deep Water with realistic bottom topography. Both experiments replicated the major circulation features, and the Intermediate Water flow was concentrated in the north because of rotation and the Deep Water flow in the south because of topographic control.

Evaluation of LABType® SSO HLA Typing using the Luminex Platform: Cord Blood Registry Typing for the Korean Population.

PubMed

Roh, Eun-Youn; Song, Eun-Young; Chang, Jee-Young; Yoon, Jong-Hyun; Shin, Sue

2016-08-01

The performance of a new intermediate-resolution method using a PCR-Luminex platform and LABType® SSO A, B DRB1 kits as an HLA typing method for the cord blood (CB) registry of the Korean population was investigated. A total of 1,413 cord blood units (CBUs) were enrolled - 1,382 from Koreans and 31 from non-Koreans or mixed-ancestry individuals. HLA-A, -B, and -DRB1 typing was performed using the LABType® SSO typing kits. HLA typing with the DNA method and 2-digit results are mandatory for the public CB bank in Korea according to the "CB Act." The proportions of ambiguous results in the 2-digit assignment were 14.6% (206/1,413) and 14.8% (205/ 1,382) among the total subjects and the Korean donors, respectively. In the 2-digit resolution, 3 different HLA-A types (69 CBUs), 31 HLA-B types (124 CBUs), and 3 HLA-DRB1 types (13 CBUs) showed ambiguous results. The 'most probable type' to the ambiguous results based on the reported Korean HLA allele frequencies were able to be assigned. The most probable results were 100% consistent with the confirmed types as determined by the HD kits (DRB1) and additional PCR-SBT or PCR-SSP tests (A and B). Luminex technology is more automated and less labor intensive than the conventional SSO typing method, and the results are less affected by differences between inspectors. Although it is not satisfactory as a sole confirmation test and cannot be used as a replacement for the PCR-SBT test, the combination of Luminex technology with LABType® SSO kits and population frequency data provides a proper typing platform that can be used as a qualifying test for CB registries.

12-year Temporal Trend in Referral Pattern and Test Results of Stress Echocardiography in a Tertiary Care Referral Center with Moderate Volume Activities and Cath-lab Facility.

PubMed

Barbieri, Andrea; Mantovani, Francesca; Bursi, Francesca; Bartolacelli, Ylenia; Manicardi, Marcella; Lauria, Maria Giulia; Boriani, Giuseppe

2018-01-01

Data on stress echocardiography (SE) time-related changes in referral patterns and diagnostic yield for detection of inducible ischemia could enhance Echo Lab quality benchmarks and performance measures. This study aims to evaluate temporal trends in SE test results among ambulatory patients with suspected or known coronary artery disease (CAD) in a tertiary care referral center with moderate (>100/year) volume SE activities and Cath-Lab facility. From January 2004 to December 2015, 1954 patients (mean age 62 ± 12 years, 42% women, 27% with known CAD) underwent SE (1673 exercise SE, 86%, 246 pharmacological SE, 12%, 35 pacing SE, 2%). Time was grouped into three 4 year periods, where clinical data and test results were evaluated. Our series comprised low-to-intermediate pretest probability of CAD throughout the observation period (overall pretest probability of CAD 19% ± 15%). A progressive decline over time in the rate of pharmacological SE instead of a dramatic increment of exercise SE (79%-96%, P < 0.0001) was noted. The use of beta-blockers increased (from 43% to 66%, P < 0.0001), while the use of nitrates decreased (from 11% to 4%, P < 0.0001) over time. We noted a very uncommon occurrence of abnormal test results with a further decrease in the last period (from 11% to 3%, P < 0.0001). We observed, over a 12-year period, a progressive decrease in the frequency of inducible myocardial ischemia among patients with known or suspected CADe referred to our Echo Lab for SE with Cath-Lab facility, and this trend was parallel to changes in SE referral practice. These findings are particularly relevant if we consider the practical implications on diagnostic SE accuracy and risk assessment.

Deciphering the X-ray Emission of the Nearest Herbig Ae Star

NASA Technical Reports Server (NTRS)

Skinner, Stephen L.

2004-01-01

In this research program, we obtained and analyzed an X-ray observation of the young nearby intermediate mass pre-main sequence star HD 104237 using the XMM-Newton space-based observatory. The observation was obtained on 17 Feb. 2002. This observation yielded high-quality X-ray images, spectra, and timing data which provided valuable information on the physical processes responsible for the X-ray emission. This star is a member of the group of so-called Herbig Ae/Be stars, which are young intermediate mass (approx. 2 - 4 solar masses) pre-main sequence (PMS) stars a few million years old that have not yet begun core hydrogen burning. The objective of the XMM-Newton observation was to obtain higher quality data than previously available in order to constrain possible X-ray emission mechanisms. The origin of the X-ray emission from Herbig Ae/Be stars is not yet known. These intermediate mass PMS stars lie on radiative tracks and are not expected to emit X-rays via solar-like magnetic processes, nor are their winds powerful enough to produce X-rays by radiative wind shocks as in more massive O-type stars. The emission could originate in unseen low-mass companions, or it may be intrinsic to the Herbig stars themselves if they still have primordial magnetic fields or can sustain magnetic activity via a nonsolar dynamo.

Particulate representation of a chemical reaction mechanism

NASA Astrophysics Data System (ADS)

Lee, Kam-Wah Lucille

1999-09-01

A growing area of interest in chemical education has been the research associated with conceptual understanding at the particulate level. This study investigated the views of 10 university chemistry lecturers, 85 pre-service chemistry teachers and 23 Secondary 3 (equivalent to Year 9) chemistry students about the particulate level of a chemical reaction, namely the heating of copper (II) carbonate. Four characteristic views were identified on the basis of their diagrammatic representations of particles. These were: (a) formation of intermediates; (b) formation of free particles (e. g., atoms or ions); (c) combination of a and b: formation of free particles (e. g., atoms or ions) first, and then intermediates; (d) no mechanism. Both the majority of the lecturers and the pre-service teachers held an identical view about the reaction mechanism, namely that the decomposition of copper (II) carbonate goes through a transition stage by forming intermediates. In contrast, even though the students were familiar with this reaction, about half of them naïvely believed that copper (II) carbonate broke up on heating and the particles recombined directly to form copper (II) oxide and carbon dioxide, the two observed products. About one-third of the students had neither any notion of how the atoms in the copper (II) carbonate lattice interacted and were rearranged in the reaction nor any concept of bond-breaking and reformation in a chemical reaction.

Progress in the Long $${\\rm Nb}_{3}{\\rm Sn}$$ Quadrupole R&D by LARP

DOE PAGES

Ambrosio, G.; Andreev, N.; Anerella, M.; ...

2011-11-14

After the successful test of the first long Nb 3Sn quadrupole (LQS01) the US LHC Accelerator Research Program (LARP, a collaboration of BNL, FNAL, LBNL and SLAC) is assessing training memory, reproducibility, and other accelerator quality features of long Nb 3Sn quadrupole magnets. LQS01b (a reassembly of LQS01 with more uniform and higher pre-stress) was subjected to a full thermal cycle and reached the previous plateau of 222 T/m at 4.5 K in two quenches. A new set of four coils, made of the same type of conductor used in LQS01 (RRP 54/61 by Oxford Superconducting Technology), was assembled inmore » the LQS01 structure and tested at 4.5 K and lower temperatures. The new magnet (LQS02) reached the target gradient (200 T/m) only at 2.6 K and lower temperatures, at intermediate ramp rates. The preliminary test analysis, here reported, showed a higher instability in the limiting coil than in the other coils of LQS01 and LQS02.« less

A scenario tree model for the Canadian Notifiable Avian Influenza Surveillance System and its application to estimation of probability of freedom and sample size determination.

PubMed

Christensen, Jette; Stryhn, Henrik; Vallières, André; El Allaki, Farouk

2011-05-01

In 2008, Canada designed and implemented the Canadian Notifiable Avian Influenza Surveillance System (CanNAISS) with six surveillance activities in a phased-in approach. CanNAISS was a surveillance system because it had more than one surveillance activity or component in 2008: passive surveillance; pre-slaughter surveillance; and voluntary enhanced notifiable avian influenza surveillance. Our objectives were to give a short overview of two active surveillance components in CanNAISS; describe the CanNAISS scenario tree model and its application to estimation of probability of populations being free of NAI virus infection and sample size determination. Our data from the pre-slaughter surveillance component included diagnostic test results from 6296 serum samples representing 601 commercial chicken and turkey farms collected from 25 August 2008 to 29 January 2009. In addition, we included data from a sub-population of farms with high biosecurity standards: 36,164 samples from 55 farms sampled repeatedly over the 24 months study period from January 2007 to December 2008. All submissions were negative for Notifiable Avian Influenza (NAI) virus infection. We developed the CanNAISS scenario tree model, so that it will estimate the surveillance component sensitivity and the probability of a population being free of NAI at the 0.01 farm-level and 0.3 within-farm-level prevalences. We propose that a general model, such as the CanNAISS scenario tree model, may have a broader application than more detailed models that require disease specific input parameters, such as relative risk estimates. Crown Copyright © 2011. Published by Elsevier B.V. All rights reserved.

Path integrals, the ABL rule and the three-box paradox

NASA Astrophysics Data System (ADS)

Sokolovski, D.; Puerto Giménez, I.; Sala Mayato, R.

2008-10-01

The three-box problem is analysed in terms of virtual pathways, interference between which is destroyed by a number of intermediate measurements. The Aharonov-Bergmann-Lebowitz (ABL) rule is shown to be a particular case of Feynman's recipe for assigning probabilities to exclusive alternatives. The ‘paradoxical’ features of the three box case arise in an attempt to attribute, in contradiction to the uncertainty principle, properties pertaining to different ensembles produced by different intermediate measurements to the same particle. The effect can be mimicked by a classical system, provided an observation is made to perturb the system in a non-local manner.

Interactive E-learning module in pharmacology: a pilot project at a rural medical college in India.

PubMed

Gaikwad, Nitin; Tankhiwale, Suresh

2014-01-01

Many medical educators are experimenting with innovative ways of E-learning. E-learning provides opportunities to students for self-directed learning in addition to other advantages. In this study, we designed and evaluated an interactive E-learning module in pharmacology for effectiveness, acceptability and feasibility, with the aim of promoting active learning in this fact-filled subject. A quasi-experimental single-group pre-test/post-test study was conducted with fourth-semester students of the second professionals course (II MBBS), selected using non-probability convenience sampling method. An E-learning module in endocrine pharmacology was designed to comprise three units of interactive PowerPoint presentations. The pre-validated presentations were uploaded on the website according to a predefined schedule and the 42 registered students were encouraged to self-learning using these interactive presentations. Cognitive gain was assessed using an online pre- and post-test for each unit. Students' perceptions were recorded using an online feedback questionnaire on a 5-point Likert scale. Finally, focused group discussion was conducted to further explore students' views on E-learning activity. Significant attrition was observed during the E-learning activity. Of the 42 registered students, only 16 students completed the entire E-learning module. The summed average score of all three units (entire module) was increased significantly from 38.42 % (summed average pre-test score: 11.56/30 ± 2.90) to 66.46 % (summed average post-test score: 19.94/30 ± 6.13). The class-average normalized gain for the entire module was 0.4542 (45.42). The students accepted this E-learning activity well as they perceived it to be innovative, convenient, flexible and useful. The average rating was between 4 (agree) and 5 (strongly agree). The interactive E-learning module in pharmacology was moderately effective and well perceived by the students. The simple, cost-effective and readily available Microsoft PowerPoint tool appealed to medical educators to use this kind of simple E-learning technology blended with traditional teaching to encourage active learning among students especially in a rural setup is attractive.

Applying Adverse Outcome Pathways (AOPs) to support Integrated Approaches to Testing and Assessment (IATA).

PubMed

Tollefsen, Knut Erik; Scholz, Stefan; Cronin, Mark T; Edwards, Stephen W; de Knecht, Joop; Crofton, Kevin; Garcia-Reyero, Natalia; Hartung, Thomas; Worth, Andrew; Patlewicz, Grace

2014-12-01

Chemical regulation is challenged by the large number of chemicals requiring assessment for potential human health and environmental impacts. Current approaches are too resource intensive in terms of time, money and animal use to evaluate all chemicals under development or already on the market. The need for timely and robust decision making demands that regulatory toxicity testing becomes more cost-effective and efficient. One way to realize this goal is by being more strategic in directing testing resources; focusing on chemicals of highest concern, limiting testing to the most probable hazards, or targeting the most vulnerable species. Hypothesis driven Integrated Approaches to Testing and Assessment (IATA) have been proposed as practical solutions to such strategic testing. In parallel, the development of the Adverse Outcome Pathway (AOP) framework, which provides information on the causal links between a molecular initiating event (MIE), intermediate key events (KEs) and an adverse outcome (AO) of regulatory concern, offers the biological context to facilitate development of IATA for regulatory decision making. This manuscript summarizes discussions at the Workshop entitled "Advancing AOPs for Integrated Toxicology and Regulatory Applications" with particular focus on the role AOPs play in informing the development of IATA for different regulatory purposes. Copyright © 2014 Elsevier Inc. All rights reserved.

Random-Forest Classification of High-Resolution Remote Sensing Images and Ndsm Over Urban Areas

NASA Astrophysics Data System (ADS)

Sun, X. F.; Lin, X. G.

2017-09-01

As an intermediate step between raw remote sensing data and digital urban maps, remote sensing data classification has been a challenging and long-standing research problem in the community of remote sensing. In this work, an effective classification method is proposed for classifying high-resolution remote sensing data over urban areas. Starting from high resolution multi-spectral images and 3D geometry data, our method proceeds in three main stages: feature extraction, classification, and classified result refinement. First, we extract color, vegetation index and texture features from the multi-spectral image and compute the height, elevation texture and differential morphological profile (DMP) features from the 3D geometry data. Then in the classification stage, multiple random forest (RF) classifiers are trained separately, then combined to form a RF ensemble to estimate each sample's category probabilities. Finally the probabilities along with the feature importance indicator outputted by RF ensemble are used to construct a fully connected conditional random field (FCCRF) graph model, by which the classification results are refined through mean-field based statistical inference. Experiments on the ISPRS Semantic Labeling Contest dataset show that our proposed 3-stage method achieves 86.9% overall accuracy on the test data.

Hsp47 and cyclophilin B traverse the endoplasmic reticulum with procollagen into pre-Golgi intermediate vesicles. A role for Hsp47 and cyclophilin B in the export of procollagen from the endoplasmic reticulum.

PubMed

Smith, T; Ferreira, L R; Hebert, C; Norris, K; Sauk, J J

1995-08-04

Hsp47 and cyclophilin B (CyPB) are residents of the endoplasmic reticulum (ER). Both of these proteins are closely associated with polysome-associated alpha 1(I) procollagen chains. Hsp47 possesses chaperone properties early during the translation of procollagen while the cis/trans-isomerase properties of CyPB facilitate procollagen folding. In this report, we further investigate the interaction of these proteins with procollagen I during export from the ER. To inhibit vesicular budding and retain procollagen within the ER, cells were treated with the heterotrimeric G protein inhibitor mastoparan or calphostin C, a specific inhibitor of diacylglycerol/phorbol ester binding proteins. To arrest procollagen in pre-Golgi intermediate vesicles, cells were treated with guanosine 5'-3-O-(thio)triphosphate. Pulse-chase experiments of cells labeled with [35S]methionine followed by immunoprecipitation during the chase period with anti-procollagen, anti-Hsp47, and anti-CyPB antibodies were performed to reveal the relationship between Hsp47/CyPB/procollagen I. The distribution of procollagen, Hsp47, and CyPB to the ER and/or pre-Golgi vesicles was verified by immunofluorescence. Hsp47 and CyPB remained associated with procollagen retained within the ER. Hsp47 and CyPB were also associated with procollagen exported from the ER into pre-Golgi intermediate vesicles. Treatment of cells with cyclosporin A diminished the levels of CyPB bound to procollagen and diminished the rate of Hsp47 released from procollagen and the rate of procollagen secretion, suggesting that Hsp47 release from procollagen may be driven by helix formation. Also, these studies suggest that Hsp47 may resemble protein disulfide isomerase and possess both chaperone and anti-chaperone properties. During translation, high levels of Hsp47 are seen to limit protein aggregation and facilitate chain registration. Later, Hsp47 and/or CyPB and protein disulfide isomerase act as anti-chaperones and provide the basis for concentration of procollagen for ER export.

Teaching English Stress: A Case Study

ERIC Educational Resources Information Center

Sadat-Tehrani, Nima

2017-01-01

This article addresses the issue of teaching pronunciation in English as a second language (ESL) classes by specifically looking at the impact of teaching lexical stress rules and tendencies on learners' stress placement performance. Sixteen rules in the form of interactive worksheets were taught in three ESL classes at pre-intermediate,…

Operationally Defining Work, Individualized Teacher Preparation.

ERIC Educational Resources Information Center

Florida State Univ., Tallahassee. Dept. of Science Education.

This publication is one of 14 modules prepared for training pre- and in-service teachers to teach Intermediate Science Curriculum Study (ISCS) materials. The organization of this publication is centered around the first unit at level I discussing the broad physics concept of "work." Various activities are suggested for teachers. This…

Seals. Grades 3-6.

ERIC Educational Resources Information Center

New England Aquarium, Boston, MA.

Explanations of a marine mammal rescue program and information on seals and sea lions are presented in this curriculum package for intermediate grade teachers. Activities are highlighted which focus on the natural history of harbor seals. This unit contains: (1) pre-trip activities (including fact sheets and worksheets on the different types of…

Teaching Foreign Cultural Literacy with Margarethe von Trotta's "Das Versprechen"

ERIC Educational Resources Information Center

Kuttenberg, Eva

2003-01-01

This article describes model units for an in-depth cultural analysis of "Das Versprechen" in undergraduate college courses including intermediate German, German culture and civilization, advanced conversation and composition, and film. Practical suggestions for pre-viewing, viewing, and post-viewing activities as well as assessment in…

American Industries. Junior Hi. Pre-Vocational. Power and Transportation.

ERIC Educational Resources Information Center

Goldsbury, Paul; And Others

Several intermediate performance objectives and corresponding criterion measures are listed for each of 10 terminal objectives in this junior high school power and transportation course guide. Each objective also includes learning steps and suggestions for supplementary instructional aids. The overall focus is on the concepts of industrial…

How Life History Can Sway the Fixation Probability of Mutants

PubMed Central

Li, Xiang-Yi; Kurokawa, Shun; Giaimo, Stefano; Traulsen, Arne

2016-01-01

In this work, we study the effects of demographic structure on evolutionary dynamics when selection acts on reproduction, survival, or both. In contrast to the previously discovered pattern that the fixation probability of a neutral mutant decreases while the population becomes younger, we show that a mutant with a constant selective advantage may have a maximum or a minimum of the fixation probability in populations with an intermediate fraction of young individuals. This highlights the importance of life history and demographic structure in studying evolutionary dynamics. We also illustrate the fundamental differences between selection on reproduction and selection on survival when age structure is present. In addition, we evaluate the relative importance of size and structure of the population in determining the fixation probability of the mutant. Our work lays the foundation for also studying density- and frequency-dependent effects in populations when demographic structures cannot be neglected. PMID:27129737

Spatial organization of foreshocks as a tool to forecast large earthquakes.

PubMed

Lippiello, E; Marzocchi, W; de Arcangelis, L; Godano, C

2012-01-01

An increase in the number of smaller magnitude events, retrospectively named foreshocks, is often observed before large earthquakes. We show that the linear density probability of earthquakes occurring before and after small or intermediate mainshocks displays a symmetrical behavior, indicating that the size of the area fractured during the mainshock is encoded in the foreshock spatial organization. This observation can be used to discriminate spatial clustering due to foreshocks from the one induced by aftershocks and is implemented in an alarm-based model to forecast m > 6 earthquakes. A retrospective study of the last 19 years Southern California catalog shows that the daily occurrence probability presents isolated peaks closely located in time and space to the epicenters of five of the six m > 6 earthquakes. We find daily probabilities as high as 25% (in cells of size 0.04 × 0.04deg(2)), with significant probability gains with respect to standard models.

Spatial organization of foreshocks as a tool to forecast large earthquakes

PubMed Central

Lippiello, E.; Marzocchi, W.; de Arcangelis, L.; Godano, C.

2012-01-01

An increase in the number of smaller magnitude events, retrospectively named foreshocks, is often observed before large earthquakes. We show that the linear density probability of earthquakes occurring before and after small or intermediate mainshocks displays a symmetrical behavior, indicating that the size of the area fractured during the mainshock is encoded in the foreshock spatial organization. This observation can be used to discriminate spatial clustering due to foreshocks from the one induced by aftershocks and is implemented in an alarm-based model to forecast m > 6 earthquakes. A retrospective study of the last 19 years Southern California catalog shows that the daily occurrence probability presents isolated peaks closely located in time and space to the epicenters of five of the six m > 6 earthquakes. We find daily probabilities as high as 25% (in cells of size 0.04 × 0.04deg2), with significant probability gains with respect to standard models. PMID:23152938

A manifesto for cardiovascular imaging: addressing the human factor†

PubMed Central

Fraser, Alan G

2017-01-01

Abstract Our use of modern cardiovascular imaging tools has not kept pace with their technological development. Diagnostic errors are common but seldom investigated systematically. Rather than more impressive pictures, our main goal should be more precise tests of function which we select because their appropriate use has therapeutic implications which in turn have a beneficial impact on morbidity or mortality. We should practise analytical thinking, use checklists to avoid diagnostic pitfalls, and apply strategies that will reduce biases and avoid overdiagnosis. We should develop normative databases, so that we can apply diagnostic algorithms that take account of variations with age and risk factors and that allow us to calculate pre-test probability and report the post-test probability of disease. We should report the imprecision of a test, or its confidence limits, so that reference change values can be considered in daily clinical practice. We should develop decision support tools to improve the quality and interpretation of diagnostic imaging, so that we choose the single best test irrespective of modality. New imaging tools should be evaluated rigorously, so that their diagnostic performance is established before they are widely disseminated; this should be a shared responsibility of manufacturers with clinicians, leading to cost-effective implementation. Trials should evaluate diagnostic strategies against independent reference criteria. We should exploit advances in machine learning to analyse digital data sets and identify those features that best predict prognosis or responses to treatment. Addressing these human factors will reap benefit for patients, while technological advances continue unpredictably. PMID:29029029

The Independent Specialty Medical Advocate Model of Patient Navigation and Intermediate Health Outcomes in Newly Diagnosed Cancer Patients.

PubMed

Cobran, Ewan K; Merino, Yesenia; Roach, Beth; Bigelow, Sharon M; Godley, Paul A

2017-10-01

Navigation programs are generally characterized as providing patient-centered support and guidance intended to help patients and family members overcome barriers such as timely diagnosis resolution, patient satisfaction, coping with primary and adjuvant treatment, management of side effects, and patient engagement in the healthcare process. The aim of this study was to examine the associations between the Independent Specialty Medical Advocate (ISMA) model of patient navigation and intermediate patient health outcomes for newly diagnosed cancer patients. A pre-post intervention study was conducted in 26 newly diagnosed cancer patients recruited from a national partnership between the LIVE STRONG Cancer Navigation Service Program and the NavigateCancer Foundation between April 2013 and December 2015. Participants received a 1-hour initial telephone consultation, and then a navigation care plan was developed for the 6-week study period. A paired t test was conducted to assess changes in intermediate health outcomes at baseline and 6 weeks after study intervention. The majority of study participants were males (62%), married (50%), and Caucasian (69%). Overall, there was a statistically significant reduction in anxiety at 6 weeks postintervention (mean, 2.48; SD, 0.62; P <.05) compared with baseline (mean, 2.92; SD, 0.82) and in depression at 6 weeks postintervention (mean, 2.00; SD, 0.81; P <.05) compared with baseline (mean, 2.45; SD, 0.19). The ISMA model of patient navigation appears to be associated with significant reduction in anxiety and depression. Further studies are needed to evaluate the ISMA model of patient navigation on long-term patient outcomes.

40 CFR 1066.420 - Pre-test verification procedures and pre-test data collection.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 34 2013-07-01 2013-07-01 false Pre-test verification procedures and pre-test data collection. 1066.420 Section 1066.420 Protection of Environment ENVIRONMENTAL PROTECTION... Test § 1066.420 Pre-test verification procedures and pre-test data collection. (a) Follow the...

40 CFR 1066.420 - Pre-test verification procedures and pre-test data collection.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 34 2012-07-01 2012-07-01 false Pre-test verification procedures and pre-test data collection. 1066.420 Section 1066.420 Protection of Environment ENVIRONMENTAL PROTECTION... Test § 1066.420 Pre-test verification procedures and pre-test data collection. (a) Follow the...

Hospital incident command system (HICS) performance in Iran; decision making during disasters

PubMed Central

2012-01-01

Background Hospitals are cornerstones for health care in a community and must continue to function in the face of a disaster. The Hospital Incident Command System (HICS) is a method by which the hospital operates when an emergency is declared. Hospitals are often ill equipped to evaluate the strengths and vulnerabilities of their own management systems before the occurrence of an actual disaster. The main objective of this study was to measure the decision making performance according to HICS job actions sheets using tabletop exercises. Methods This observational study was conducted between May 1st 2008 and August 31st 2009. Twenty three Iranian hospitals were included. A tabletop exercise was developed for each hospital which in turn was based on the highest probable risk. The job action sheets of the HICS were used as measurements of performance. Each indicator was considered as 1, 2 or 3 in accordance with the HICS. Fair performance was determined as < 40%; intermediate as 41-70%; high as 71-100% of the maximum score of 192. Descriptive statistics, T-test, and Univariate Analysis of Variance were used. Results None of the participating hospitals had a hospital disaster management plan. The performance according to HICS was intermediate for 83% (n = 19) of the participating hospitals. No hospital had a high level of performance. The performance level for the individual sections was intermediate or fair, except for the logistic and finance sections which demonstrated a higher level of performance. The public hospitals had overall higher performances than university hospitals (P = 0.04). Conclusions The decision making performance in the Iranian hospitals, as measured during table top exercises and using the indicators proposed by HICS was intermediate to poor. In addition, this study demonstrates that the HICS job action sheets can be used as a template for measuring the hospital response. Simulations can be used to assess preparedness, but the correlation with outcome remains to be studied. PMID:22309772

Intermediate-Mass Black Holes in Globular Cluster Systems

NASA Astrophysics Data System (ADS)

Wrobel, J. M.; Miller-Jones, J. C. A.; Nyland, K. E.; Maccarone, T. J.

2018-01-01

Theory suggests that globular clusters (GCs) of stars can host intermediate-mass black holes (IMBHs) with masses of about 100 to 100,000 solar masses. We invoke a semi-empirical model to predict the mass of an IMBH that, if undergoing accretion in the long-lived hard X-ray state, is consistent with the synchrotron radio luminosity of a GC. We apply this model to extant images from the Karl G. Jansky Very Large Array (VLA) and to simulated images from the Next Generation Very Large Array (ngVLA). Guided by our VLA results for M81's system of 206 probable GCs at a distance of 3.6 Mpc, we consider using the ngVLA to study the hundreds of globular cluster systems out to a distance of 25 Mpc. With its sensitivity, spatial resolution, and field of view, we conclude that the ngVLA at 2cm will efficiently probe IMBH masses for tens of thousands of GCs. Finding IMBHs in GCs could validate a formation channel for seed BHs in the early universe, underpin gravitational wave predictions for space missions, and test scaling relations between stellar systems and the central BHs they host. The NRAO is a facility of the NSF, operated under cooperative agreement by AUI, Inc.

Random Breakage of a Rod into Unit Lengths

ERIC Educational Resources Information Center

Gani, Joe; Swift, Randall

2011-01-01

In this article we consider the random breakage of a rod into "L" unit elements and present a Markov chain based method that tracks intermediate breakage configurations. The probability of the time to final breakage for L = 3, 4, 5 is obtained and the method is shown to extend in principle, beyond L = 5.

REMEDIATION OF MTBE - CONTAMINATED WATER: STUDIES ON THE DEGRADATION OF MTBE INTERMEDIATES USING THE FENTON'S REAGENT

EPA Science Inventory

The recent findings of unusual oncentrations of MTBE in groundwater aquifers and surface waters [1] originated most probably from the leaking of underground storage gasoline tanks [2[ has led to a series of judicial and legislative actions, especially in the state of California w...

First-principles study of intermediate-spin ferrous iron in the Earth's lower mantle

NASA Astrophysics Data System (ADS)

Hsu, Han; Wentzcovitch, Renata M.

2014-11-01

Spin crossover of iron is of central importance in solid Earth geophysics. It impacts all physical properties of minerals that altogether constitute ˜95 vol% of the Earth's lower mantle: ferropericlase [(Mg,Fe)O] and Fe-bearing magnesium silicate (MgSiO3) perovskite. Despite great strides made in the past decade, the existence of an intermediate-spin (IS) state in ferrous iron (Fe2 +) (with total electron spin S =1 ) and its possible role in the pressure-induced spin crossover in these lower-mantle minerals still remain controversial. Using density functional theory + self-consistent Hubbard U (DFT+Usc ) calculations, we investigate all possible types of IS states of Fe2 + in (Mg,Fe)O and (Mg,Fe)SiO3 perovskite. Among the possible IS states in these minerals, the most probable IS state has an electronic configuration that significantly reduces the electron overlap and the iron nuclear quadrupole splitting (QS). These most probable IS states, however, are still energetically disfavored, and their QSs are inconsistent with Mössbauer spectra. We therefore conclude that IS Fe2 + is highly unlikely in the Earth's lower mantle.

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

Dumbser, Michael, E-mail: michael.dumbser@unitn.it; Balsara, Dinshaw S., E-mail: dbalsara@nd.edu

In this paper a new, simple and universal formulation of the HLLEM Riemann solver (RS) is proposed that works for general conservative and non-conservative systems of hyperbolic equations. For non-conservative PDE, a path-conservative formulation of the HLLEM RS is presented for the first time in this paper. The HLLEM Riemann solver is built on top of a novel and very robust path-conservative HLL method. It thus naturally inherits the positivity properties and the entropy enforcement of the underlying HLL scheme. However, with just the slight additional cost of evaluating eigenvectors and eigenvalues of intermediate characteristic fields, we can represent linearlymore » degenerate intermediate waves with a minimum of smearing. For conservative systems, our paper provides the easiest and most seamless path for taking a pre-existing HLL RS and quickly and effortlessly converting it to a RS that provides improved results, comparable with those of an HLLC, HLLD, Osher or Roe-type RS. This is done with minimal additional computational complexity, making our variant of the HLLEM RS also a very fast RS that can accurately represent linearly degenerate discontinuities. Our present HLLEM RS also transparently extends these advantages to non-conservative systems. For shallow water-type systems, the resulting method is proven to be well-balanced. Several test problems are presented for shallow water-type equations and two-phase flow models, as well as for gas dynamics with real equation of state, magnetohydrodynamics (MHD & RMHD), and nonlinear elasticity. Since our new formulation accommodates multiple intermediate waves and has a broader applicability than the original HLLEM method, it could alternatively be called the HLLI Riemann solver, where the “I” stands for the intermediate characteristic fields that can be accounted for. -- Highlights: •New simple and general path-conservative formulation of the HLLEM Riemann solver. •Application to general conservative and non-conservative hyperbolic systems. •Inclusion of sub-structure and resolution of intermediate characteristic fields. •Well-balanced for single- and two-layer shallow water equations and multi-phase flows. •Euler equations with real equation of state, MHD equations, nonlinear elasticity.« less

Ancient representation of Meige's syndrome in the Moche culture in the pre-Columbian Peru.

PubMed

Martinez-Castrillo, Juan Carlos; Mariscal, Ana; Garcia-Ruiz, Pedro

2010-03-15

The Moches were a pre-Columbian culture from Peru, who had a fine ceramic technique and used to represent diseases. One example is the potter presented here which represents a man with a probable Meige's syndrome and may be the first artistic representation of this disease.

Exemplary Science PreK-4: Standards-Based Success Stories

ERIC Educational Resources Information Center

Yager, Robert E., Ed.; Enger, Sandra

2006-01-01

Since their release in 1996, the National Science Education Standards have provided the vision for science education reform. But has that reform actually taken hold in elementary school? "Yes!," reports Robert Yager, editor of Exemplary Science in Grades PreK-4: Standards-Based Success Stories. "Probably the Standards have done more to change…

The Australian electricity market's pre-dispatch process: Some observations on its efficiency using ordered probit model

NASA Astrophysics Data System (ADS)

Zainudin, Wan Nur Rahini Aznie; Becker, Ralf; Clements, Adam

2015-12-01

Many market participants in Australia Electricity Market had cast doubts on whether the pre-dispatch process in the electricity market is able to give them good and timely quantity and price information. In a study by [11], they observed a significant bias (mainly indicating that the pre-dispatch process tends to underestimate spot price outcomes), a seasonality features of the bias across seasons and/or trading periods and changes in bias across the years in our sample period (1999 to 2007). In a formal setting of an ordered probit model we establish that there are some exogenous variables that are able to explain increased probabilities of over- or under-predictions of the spot price. It transpires that meteorological data, expected pre-dispatch prices and information on past over- and under-predictions contribute significantly to explaining variation in the probabilities for over- and under-predictions. The results allow us to conjecture that some of the bids and re-bids provided by electricity generators are not made in good faith.

Geophysical interpretations west of and within the northwestern part of the Nevada Test Site

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

Grauch, V.J.; Sawyer, D.A.; Fridrich, C.J.

1997-12-31

This report focuses on interpretation of gravity and new magnetic data west of the Nevada Test Site (NTS) and within the northwestern part of NTS. The interpretations integrate the gravity and magnetic data with other geophysical, geological, and rock property data to put constraints on tectonic and magmatic features not exposed at the surface. West of NTS, where drill hole information is absent, these geophysical data provide the best available information on the subsurface. Interpreted subsurface features include calderas, intrusions, basalt flows and volcanoes, Tertiary basins, structurally high pre-Tertiary rocks, and fault zones. New features revealed by this study includemore » (1) a north-south buried tectonic fault east of Oasis Mountain, which the authors call the Hogback fault; (2) an east striking fault or accommodation zone along the south side of Oasis Valley basin, which they call the Hot Springs fault; (3) a NNE striking structural zone coinciding with the western margins of the caldera complexes; (4) regional magnetic highs that probably represent a thick sequence of Tertiary volcanic rocks; and (5) two probable buried calderas that may be related to the tuffs of Tolicha Peak and of Sleeping Butte, respectively.« less

Weak measurements measure probability amplitudes (and very little else)

NASA Astrophysics Data System (ADS)

Sokolovski, D.

2016-04-01

Conventional quantum mechanics describes a pre- and post-selected system in terms of virtual (Feynman) paths via which the final state can be reached. In the absence of probabilities, a weak measurement (WM) determines the probability amplitudes for the paths involved. The weak values (WV) can be identified with these amplitudes, or their linear combinations. This allows us to explain the ;unusual; properties of the WV, and avoid the ;paradoxes; often associated with the WM.

Pre-transplant soluble CD30 level as a predictor of not only acute rejection and graft loss but pneumonia in renal transplant recipients.

PubMed

Wang, Dong; Wu, Wei-Zhen; Chen, Jin-Hua; Yang, Shun-Liang; Wang, Qing-Hua; Zeng, Zhang-Xin; Tan, Jian-Ming

2010-02-01

Pre-transplant sera of 586 renal graft recipients were tested to investigate whether soluble CD30 (sCD30) is a useful predictor of some severe clinical episodes post-transplant. Correlation analysis showed sCD30 level was significantly correlated with acute rejection (AR) (r=0.242, P<0.001), graft loss (r=0.162, P<0.001), and pneumonia (r=-0.147, P<0.001). Higher sCD30 levels were observed in patients with AR than the others (180.0+/-89.1 vs. 135.3+/-72.7U/ml, P<0.001). And patients with pneumonia had significantly lower pre-transplant sCD30 level than the others (123.2+/-75.5 vs. 150.7+/-79.6U/ml, P=0.003). Based on statistical results, 120 and 240U/ml were selected as the optimal couple of cut-off value to divide patients into three groups: Group High (H), Group Intermedial (I) and Group Low (L). The lowest AR rate of 17.4% was observed in Group L (P<0.001). Significant difference of AR rate was also observed between Group I (29.2%) and H (42.9%) (P<0.001). There were much more patients suffering pneumonia in Group L (P=0.001). Significantly lower 5-year patient survival rate (79.4%) was observed in Group H (P=0.016). These data showed that elevated pre-transplant sCD30 level of renal allograft recipients may reflect an immune state detrimental for renal allograft survival. But sCD30 level lower than <120U/ml may be associated with a high risk of pneumonia. Pre-transplant sCD30 level is an independent predictor of acute rejection, lung infection, even graft survival. Suitable immunosuppression protocol should be selected according to pre-transplant sCD30 level in an attempt to promote patient and graft survival. Copyright 2010 Elsevier B.V. All rights reserved.

40 CFR 1065.520 - Pre-test verification procedures and pre-test data collection.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 40 Protection of Environment 34 2013-07-01 2013-07-01 false Pre-test verification procedures and pre-test data collection. 1065.520 Section 1065.520 Protection of Environment ENVIRONMENTAL PROTECTION... Specified Duty Cycles § 1065.520 Pre-test verification procedures and pre-test data collection. (a) If your...

40 CFR 1065.520 - Pre-test verification procedures and pre-test data collection.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 40 Protection of Environment 34 2012-07-01 2012-07-01 false Pre-test verification procedures and pre-test data collection. 1065.520 Section 1065.520 Protection of Environment ENVIRONMENTAL PROTECTION... Specified Duty Cycles § 1065.520 Pre-test verification procedures and pre-test data collection. (a) If your...

40 CFR 1065.520 - Pre-test verification procedures and pre-test data collection.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 40 Protection of Environment 33 2014-07-01 2014-07-01 false Pre-test verification procedures and pre-test data collection. 1065.520 Section 1065.520 Protection of Environment ENVIRONMENTAL PROTECTION... Specified Duty Cycles § 1065.520 Pre-test verification procedures and pre-test data collection. (a) For...

40 CFR 1065.520 - Pre-test verification procedures and pre-test data collection.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 40 Protection of Environment 32 2010-07-01 2010-07-01 false Pre-test verification procedures and pre-test data collection. 1065.520 Section 1065.520 Protection of Environment ENVIRONMENTAL PROTECTION... Specified Duty Cycles § 1065.520 Pre-test verification procedures and pre-test data collection. (a) If your...

40 CFR 1065.520 - Pre-test verification procedures and pre-test data collection.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 40 Protection of Environment 33 2011-07-01 2011-07-01 false Pre-test verification procedures and pre-test data collection. 1065.520 Section 1065.520 Protection of Environment ENVIRONMENTAL PROTECTION... Specified Duty Cycles § 1065.520 Pre-test verification procedures and pre-test data collection. (a) If your...

Understanding Pre-Quantitative Risk in Projects

NASA Technical Reports Server (NTRS)

Cooper, Lynne P.

2011-01-01

Standard approaches to risk management in projects depend on the ability of teams to identify risks and quantify the probabilities and consequences of these risks (e.g., the 5 x 5 risk matrix). However, long before quantification does - or even can - occur, and long after, teams make decisions based on their pre-quantitative understanding of risk. These decisions can have long-lasting impacts on the project. While significant research has looked at the process of how to quantify risk, our understanding of how teams conceive of and manage pre-quantitative risk is lacking. This paper introduces the concept of pre-quantitative risk and discusses the implications of addressing pre-quantitative risk in projects.

Effects of food availability on yolk androgen deposition in the black-legged kittiwake (Rissa tridactyla), a seabird with facultative brood reduction

USGS Publications Warehouse

Benowitz-Fredericks, Z.M.; Kitaysky, Alexander S.; Welcker, Jorg; Hatch, Scott A.

2013-01-01

In birds with facultative brood reduction, survival of the junior chick is thought to be regulated primarily by food availability. In black-legged kittiwakes (Rissa tridactyla) where parents and chicks are provided with unlimited access to supplemental food during the breeding season, brood reduction still occurs and varies interannually. Survival of the junior chick is therefore affected by factors in addition to the amount of food directly available to them. Maternally deposited yolk androgens affect competitive dynamics within a brood, and may be one of the mechanisms by which mothers mediate brood reduction in response to a suite of environmental and physiological cues. The goal of this study was to determine whether food supplementation during the pre-lay period affected patterns of yolk androgen deposition in free-living kittiwakes in two years (2003 and 2004) that varied in natural food availability. Chick survival was measured concurrently in other nests where eggs were not collected. In both years, supplemental feeding increased female investment in eggs by increasing egg mass. First-laid (“A”) eggs were heavier but contained less testosterone and androstenedione than second-laid (“B”) eggs across years and treatments. Yolk testosterone was higher in 2003 (the year with higher B chick survival) across treatments. The difference in yolk testosterone levels between eggs within a clutch varied among years and treatments such that it was relatively small when B chick experienced the lowest and the highest survival probabilities, and increased with intermediate B chick survival probabilities. The magnitude of testosterone asymmetry in a clutch may allow females to optimize fitness by either predisposing a brood for reduction or facilitating survival of younger chicks.

Variability over time in the sources of South Portuguese Zone turbidites: evidence of denudation of different crustal blocks during the assembly of Pangaea

NASA Astrophysics Data System (ADS)

Pereira, M. F.; Ribeiro, C.; Vilallonga, F.; Chichorro, M.; Drost, K.; Silva, J. B.; Albardeiro, L.; Hofmann, M.; Linnemann, U.

2014-07-01

This study combines geochemical and geochronological data in order to decipher the provenance of Carboniferous turbidites from the South Portuguese Zone (SW Iberia). Major and trace elements of 25 samples of graywackes and mudstones from the Mértola (Visean), Mira (Serpukhovian), and Brejeira (Moscovian) Formations were analyzed, and 363 U-Pb ages were obtained on detrital zircons from five samples of graywackes from the Mira and Brejeira Formations using LA-ICPMS. The results indicate that turbiditic sedimentation during the Carboniferous was marked by variability in the sources, involving the denudation of different crustal blocks and a break in synorogenic volcanism. The Visean is characterized by the accumulation of immature turbidites (Mértola Formation and the base of the Mira Formation) inherited from a terrane with intermediate to mafic source rocks. These source rocks were probably formed in relation to Devonian magmatic arcs poorly influenced by sedimentary recycling, as indicated by the almost total absence of pre-Devonian zircons typical of the Gondwana and/or Laurussia basements. The presence of Carboniferous grains in Visean turbidites indicates that volcanism was active at this time. Later, Serpukhovian to Moscovian turbiditic sedimentation (Mira and Brejeira Formations) included sedimentary detritus derived from felsic mature source rocks situated far from active magmatism. The abundance of Precambrian and Paleozoic zircons reveals strong recycling of the Gondwana and/or Laurussia basements. A peri-Gondwanan provenance is indicated by zircon populations with Neoproterozoic (Cadomian-Avalonian and Pan-African zircon-forming events), Paleoproterozoic, and Archean ages. The presence of late Ordovician and Silurian detrital zircons in Brejeira turbidites, which have no correspondence in the Gondwana basement of SW Iberia, indicates Laurussia as their most probable source.

Genetic ancestry of families of putative Inka descent.

PubMed

Sandoval, José R; Lacerda, Daniela R; Jota, Marilza S; Elward, Ronald; Acosta, Oscar; Pinedo, Donaldo; Danos, Pierina; Cuellar, Cinthia; Revollo, Susana; Santos, Fabricio R; Fujita, Ricardo

2018-03-03

This study focuses on the descendants of the royal Inka family. The Inkas ruled Tawantinsuyu, the largest pre-Columbian empire in South America, which extended from southern Colombia to central Chile. The origin of the royal Inkas is currently unknown. While the mummies of the Inka rulers could have been informative, most were destroyed by Spaniards and the few remaining disappeared without a trace. Moreover, no genetic studies have been conducted on present-day descendants of the Inka rulers. In the present study, we analysed uniparental DNA markers in 18 individuals predominantly from the districts of San Sebastian and San Jerónimo in Cusco (Peru), who belong to 12 families of putative patrilineal descent of Inka rulers, according to documented registries. We used single-nucleotide polymorphisms and short tandem repeat (STR) markers of the Y chromosome (Y-STRs), as well as mitochondrial DNA D-loop sequences, to investigate the paternal and maternal descent of the 18 alleged Inka descendants. Two Q-M3* Y-STR clusters descending from different male founders were identified. The first cluster, named AWKI-1, was associated with five families (eight individuals). By contrast, the second cluster, named AWKI-2, was represented by a single individual; AWKI-2 was part of the Q-Z19483 sub-lineage that was likely associated with a recent male expansion in the Andes, which probably occurred during the Late Intermediate Period (1000-1450 AD), overlapping the Inka period. Concerning the maternal descent, different mtDNA lineages associated with each family were identified, suggesting a high maternal gene flow among Andean populations, probably due to changes in the last 1000 years.

An XMM-Newton Observation of the Lagoon Nebula and the Very Young Open Cluster NGC 6530

NASA Technical Reports Server (NTRS)

Rauw, G.; Naze, Y.; Gosset, E.; Stevens, I. R.; Blomme, R.; Corcoran, M. F.; Pittard, J. M.; Runacres, M. C.

2002-01-01

We report the results of an XMM-Newton observation of the Lagoon Nebula (M 8). Our EPIC images of this region reveal a cluster of point sources, most of which have optical counterparts inside the very young open cluster NGC 6530. The bulk of these X-ray sources are probably associated with low and intermediate mass pre-main sequence stars. One of the sources experiences a flare-like increase of its X-ray flux making it the second brightest source in M 8 after the O4 star 9 Sgr. The X-ray spectra of most of the brightest sources can be fitted with thermal plasma models with temperatures of kT approximately a few keV. Only a few of the X-ray selected PMS candidates are known to display H(alpha) emission and were previously classified as classical T Tauri stars. This suggests that most of the X-ray emitting PMS stars in NGC 6530 are weak line T Tauri stars. In addition to 9 Sgr, our EPIC field of view contains also a few early-type stars. The X-ray emission from HD 164816 is found to be typical for an O9.5III-IV star. At least one of the known Herbig Be stars in NGC 6530 (LkH(alpha) 115) exhibits a relatively strong X-ray emission, while most of the main sequence stars of spectral type B1 and later are not detected. We also detect (probably) diffuse X-ray emission from the Hourglass Region that might reveal a hot bubble blown by the stellar wind of Herschel 36, the ionizing star of the Hourglass Region.

Causality in time-neutral cosmologies

NASA Astrophysics Data System (ADS)

Kent, Adrian

1999-02-01

Gell-Mann and Hartle (GMH) have recently considered time-neutral cosmological models in which the initial and final conditions are independently specified, and several authors have investigated experimental tests of such models. We point out here that GMH time-neutral models can allow superluminal signaling, in the sense that it can be possible for observers in those cosmologies, by detecting and exploiting regularities in the final state, to construct devices which send and receive signals between space-like separated points. In suitable cosmologies, any single superluminal message can be transmitted with probability arbitrarily close to one by the use of redundant signals. However, the outcome probabilities of quantum measurements generally depend on precisely which past and future measurements take place. As the transmission of any signal relies on quantum measurements, its transmission probability is similarly context dependent. As a result, the standard superluminal signaling paradoxes do not apply. Despite their unusual features, the models are internally consistent. These results illustrate an interesting conceptual point. The standard view of Minkowski causality is not an absolutely indispensable part of the mathematical formalism of relativistic quantum theory. It is contingent on the empirical observation that naturally occurring ensembles can be naturally pre-selected but not post-selected.

Seed removal in a tropical North American desert: an evaluation of pre- and post-dispersal seed removal in Stenocereus stellatus.

PubMed

Álvarez-Espino, R; Ríos-Casanova, L; Godínez-Álvarez, H

2017-05-01

To determine seed removal influence on seed populations, we need to quantify pre- and post-dispersal seed removal. Several studies have quantified seed removal in temperate American deserts, but few studies have been performed in tropical deserts. These studies have only quantified pre- or post-dispersal seed removal, thus underestimating the influence of seed removal. We evaluated pre- and post-dispersal seed removal in the columnar cactus Stenocereus stellatus in a Mexican tropical desert. We performed selective exclosure experiments to estimate percentage of seeds removed by ants, birds and rodents during the pre- and post-dispersal phases. We also conducted field samplings to estimate abundance of the most common seed removers. Birds (10-28%) removed a higher percentage of seeds than ants (2%) and rodents (1-4%) during pre-dispersal seed removal. Melanerpes hypopolius was probably the main bird removing seeds from fruits. Ants (62-64%) removed a higher percentage of seeds than birds (34-38%) and rodents (16-30%) during post-dispersal seed removal. Pogonomyrmex barbatus was probably the main ant removing seeds from soil. Birds and ants are the main pre- and post-dispersal seed removers in S. stellatus, respectively. Further studies in other S. stellatus populations and plants with different life forms and fruit types will contribute to evaluate seed removal in tropical American deserts. © 2016 German Botanical Society and The Royal Botanical Society of the Netherlands.

The postsunset vertical plasma drift during geomagnetic storms and its effects on the generation of equatorial spread F

NASA Astrophysics Data System (ADS)

Huang, C.

2017-12-01

We will present two distinct phenomena related to the postsunset vertical plasma drift and equatorial spread F (ESF) observed by the Communication/Navigation Outage Forecasting System satellite over six years. The first phenomenon is the behavior of the prereversal enhancement (PRE) of the vertical plasma drift during geomagnetic storms. Statistically, storm-time disturbance dynamo electric fields cause the PRE to decrease from 30 to 0 m/s when Dst changes from -60 to -100 nT, but the PRE does not show obvious variations when Dst varies from 0 to -60 nT. The observations show that the storm activities affect the evening equatorial ionosphere only for Dst < -60 nT and that the dynamo electric field becomes dominant during the storm recovery phase. The second phenomenon is the relationship between the PRE and the generation of ESF. It is found that the occurrence of large-amplitude ESF irregularities is well correlated with the PRE and that the occurrence of small-amplitude ESF irregularities does not show a clear pattern at low solar activity but is anti-correlated with large-amplitude irregularities and the PRE at moderate solar activity. That is, the months and longitudes with high occurrence probability of large-amplitude irregularities are exactly those with low occurrence probability of small-amplitude irregularities, and vice versa. The generation of large-amplitude ESF irregularities is controlled by the PRE, and the generation of small-amplitude ESF irregularities may be caused by gravity waves and other disturbances, rather than by the PRE.

Maternal obesity in the rat programs male offspring exploratory, learning and motivation behavior: prevention by dietary intervention pre-gestation or in gestation.

PubMed

Rodriguez, J S; Rodríguez-González, G L; Reyes-Castro, L A; Ibáñez, C; Ramírez, A; Chavira, R; Larrea, F; Nathanielsz, P W; Zambrano, E

2012-04-01

We studied the effects of maternal high fat diet (HFD, 25% calories from fat administered before and during pregnancy and lactation) and dietary intervention (switching dams from HFD to control diet) at different periconceptional periods on male offspring anxiety related behavior, exploration, learning, and motivation. From weaning at postnatal day (PND) 21, female subjects produced to be the mothers in the study received either control diet (CTR - 5% calories from fat), HFD through pregnancy and lactation (MO), HFD during PNDs 21-90 followed by CTR diet (pre-gestation (PG) intervention) or HFD from PND 21 to 120 followed by CTR diet (gestation and lactation (G) intervention) and bred at PND 120. At 19 days of gestation maternal serum corticosterone was increased in MO and the PG and G dams showed partial recovery with intermediate levels. In offspring, no effects were found in the elevated plus maze test. In the open field test, MO and G offspring showed increase zone entries, displaying less thigmotaxis; PG offspring showed partial recuperation of this behavior. During initial operant conditioning MO, PG and G offspring displayed decreased approach behavior with subsequent learning impairment during the acquisition of FR-1 and FR-5 operant conditioning for sucrose reinforcement. Motivation during the progressive ratio test increased in MO offspring; PG and G intervention recuperated this behavior. We conclude that dietary intervention can reverse negative effects of maternal HFD and offspring outcomes are potentially due to elevated maternal corticosterone. Copyright © 2012 ISDN. Published by Elsevier Ltd. All rights reserved.

Evaluation of selected properties of a new root repair cement containing surface pre-reacted glass ionomer fillers.

PubMed

Yassen, Ghaeth H; Huang, Ruijie; Al-Zain, Afnan; Yoshida, Takamitsu; Gregory, Richard L; Platt, Jeffrey A

2016-11-01

This study evaluated selected properties of a prototype root repair cement containing surface pre-reacted glass ionomer fillers (S-PRG) in comparison to mineral trioxide aggregate (MTA) and intermediate restorative material (IRM). The antibacterial effect of S-PRG, MTA, and IRM cements was tested against Porphyromonas gingivalis and Enterococcus faecalis after 1 and 3 days of aging of the cements. The set cements were immersed in distilled water for 4 h to 28 days, and ion-releasing ability was evaluated. Initial and final setting times of all cements were evaluated using Gilmore needles. The push-out bond strength between radicular dentin and all cements was tested at different levels of the roots. S-PRG and IRM cements, but not MTA cement, demonstrated significant antibacterial effect against P. gingivalis. All types of cements exhibited significant antibacterial effect against E. faecalis without being able to eliminate the bacterium. S-PRG cement provided continuous release of fluoride, strontium, boron, sodium, aluminum, and zinc throughout all tested time points. Both initial and final setting times were significantly shorter for S-PRG and IRM cements in comparison to MTA. The push-out bond strength was significantly lower for S-PRG cement in comparison to MTA and IRM at coronal and middle levels of the roots. S-PRG cement demonstrated significant antibacterial effects against endodontic pathogens, multiple ion-releasing ability, relatively short setting time, and low bonding strength. S-PRG cement can be used as a one-visit root repair material with promising antibacterial properties and ion-releasing capacity.

Study on pre-irradiation grafting of BSA⧸NASI conjugates on agarose and its application

NASA Astrophysics Data System (ADS)

Min, Yi; Baolin, Zhang; Hongfei, Ha

1993-10-01

In this work we used N-acryloxysuccinimide (NASI) with a function group as the intermediate to graft the Bovine Serum Albumin (BSA), passthrough BSA / NASI conjugates, onto agarose which has been pre-irradiated in Co-60 γ-source. Preparation of BSA / NASI conjugates was carried out at 37°C for 2h, the molar ratio of BSA and NASI in reaction is 1:6. Pre-irradiation of agarose sample was carried out at room temperature in air and grafting was performed below 37°C for 5h under bubbling nitrogen. The total dose used was lower than 7 kGy. This technique is applicable to immobilize BSA and other proteins or separate the tryptophans enantiomer as well.

Improved Simulation of the Pre-equilibrium Triton Emission in Nuclear Reactions Induced by Nucleons

NASA Astrophysics Data System (ADS)

Konobeyev, A. Yu.; Fischer, U.; Pereslavtsev, P. E.; Blann, M.

2014-04-01

A new approach is proposed for the calculation of non-equilibrium triton energy distributions in nuclear reactions induced by nucleons of intermediate energies. It combines models describing the nucleon pick-up, the coalescence and the triton knock-out processes. Emission and absorption rates for excited particles are represented by the pre-equilibrium hybrid model. The model of Sato, Iwamoto, Harada is used to describe the nucleon pick-up and the coalescence of nucleons from exciton configurations starting from (2p,1h) states. The contribution of the direct nucleon pick-up is described phenomenologically. Multiple pre-equilibrium emission of tritons is accounted for. The calculated triton energy distributions are compared with available experimental data.

Large eddy simulation of turbulent premixed combustion using tabulated detailed chemistry and presumed probability density function

NASA Astrophysics Data System (ADS)

Zhang, Hongda; Han, Chao; Ye, Taohong; Ren, Zhuyin

2016-03-01

A method of chemistry tabulation combined with presumed probability density function (PDF) is applied to simulate piloted premixed jet burner flames with high Karlovitz number using large eddy simulation. Thermo-chemistry states are tabulated by the combination of auto-ignition and extended auto-ignition model. To evaluate the predictive capability of the proposed tabulation method to represent the thermo-chemistry states under the condition of different fresh gases temperature, a-priori study is conducted by performing idealised transient one-dimensional premixed flame simulations. Presumed PDF is used to involve the interaction of turbulence and flame with beta PDF to model the reaction progress variable distribution. Two presumed PDF models, Dirichlet distribution and independent beta distribution, respectively, are applied for representing the interaction between two mixture fractions that are associated with three inlet streams. Comparisons of statistical results show that two presumed PDF models for the two mixture fractions are both capable of predicting temperature and major species profiles, however, they are shown to have a significant effect on the predictions for intermediate species. An analysis of the thermo-chemical state-space representation of the sub-grid scale (SGS) combustion model is performed by comparing correlations between the carbon monoxide mass fraction and temperature. The SGS combustion model based on the proposed chemistry tabulation can reasonably capture the peak value and change trend of intermediate species. Aspects regarding model extensions to adequately predict the peak location of intermediate species are discussed.

The path from nucleolar 90S to cytoplasmic 40S pre-ribosomes.

PubMed

Schäfer, Thorsten; Strauss, Daniela; Petfalski, Elisabeth; Tollervey, David; Hurt, Ed

2003-03-17

Recent reports have increased our knowledge of the consecutive steps during 60S ribosome biogenesis substantially, but 40S subunit formation is less well understood. Here, we investigate the maturation of nucleolar 90S pre-ribosomes into cytoplasmic 40S pre-ribosomes. During the transition from 90S to 40S particles, the majority of non-ribosomal proteins (approximately 30 species) dissociate, and significantly fewer factors associate with 40S pre-ribosomes. Notably, some of these components are part of both early 90S and intermediate 40S pre-particles in the nucleolus (e.g. Enp1p, Dim1p and Rrp12p), whereas others (e.g. Rio2p and Nob1p) are found mainly on late cytoplasmic pre-40S subunits. Finally, temperature-sensitive mutants mapping either in earlier (enp1-1) or later (rio2-1) components exhibit defects in the formation and nuclear export of pre-40S subunits. Our data provide an initial biochemical map of the pre-40S ribosomal subunit on its path from the nucleolus to the cytoplasm. This pathway involves fewer changes in composition than seen during 60S biogenesis.

Performance characteristics of an automated latex immunoturbidimetric assay [HemosIL® HIT-Ab(PF4-H)] for the diagnosis of immune heparin-induced thrombocytopenia.

PubMed

Warkentin, Theodore E; Sheppard, Jo-Ann I; Linkins, Lori-Ann; Arnold, Donald M; Nazy, Ishac

2017-05-01

Heparin-induced thrombocytopenia (HIT) is a prothrombotic drug reaction caused by platelet-activating anti-PF4/heparin antibodies. Given time-sensitive treatment considerations, a rapid and accurate laboratory test for HIT antibodies is needed. To determine operating characteristics for the HemosIL ® HIT-Ab (PF4/H) , a rapid, on-demand, fully-automated, latex immunoturbidimetric assay (LIA), for diagnosis of HIT. We evaluated LIA sensitivity, specificity, negative (NPV) and positive predictive value (PPV), negative (LR-) and positive likelihood ratio (LR+), using citrated-plasma from 429 patients (prospective cohort study of 4Ts scoring; HIT, n=31), and from consecutive HIT patients (n=125), using reference standard serotonin-release assay (SRA). Comparators included two PF4-dependent enzyme-immunoassays (EIAs). We used stratum-specific likelihood ratios (SSLRs) to determine how differing magnitudes of LIA-positivity influenced post-test probability of HIT. LIA operating characteristics were: sensitivity=97.4% (152/156); specificity=94.0% (374/398); PPV=55.6% (30/54); and NPV=99.7% (374/375). At manufacturers' cutoffs, LIA specificity and PPV were superior to the EIAs. Although a negative LIA pointed strongly against HIT (LR-, 0.034), the post-test probability was ~2% with high 4Ts score. The LIA's LR+ was high (16.0), with SSLRs rising substantially with greater LIA-positivity: 5.7 (1.0-4.9U/mL), 31 (5.0-15.9U/mL), and 128 (≥16U/mL). A LIA-positive result (at 1.0 cutoff) indicated at least 24% HIT probability (low 4Ts score), rising to 90% with high 4Ts score. Although approximately 1 in 40 SRA-positive patients tested LIA-negative, the LIA's high NPV and PPV indicate that this rapid assay is useful for the diagnostic evaluation of HIT, including in low pre-test situations. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Using optical tweezers to relate the chemical and mechanical cross-bridge cycles.

PubMed

Steffen, Walter; Sleep, John

2004-12-29

In most current models of muscle contraction there are two translational steps, the working stroke, whereby an attached myosin cross-bridge moves relative to the actin filament, and the repriming step, in which the cross-bridge returns to its original orientation. The development of single molecule methods has allowed a more detailed investigation of the relationship of these mechanical steps to the underlying biochemistry. In the normal adenosine triphosphate cycle, myosin.adenosine diphosphate.phosphate (M.ADP.Pi) binds to actin and moves it by ca. 5 nm on average before the formation of the end product, the rigor actomyosin state. All the other product-like intermediate states tested were found to give no net movement indicating that M.ADP.Pi alone binds in a pre-force state. Myosin states with bound, unhydrolysed nucleoside triphosphates also give no net movement, indicating that these must also bind in a post-force conformation and that the repriming, post- to pre-transition during the forward cycle must take place while the myosin is dissociated from actin. These observations fit in well with the structural model in which the working stroke is aligned to the opening of the switch 2 element of the ATPase site.

Energy-positive sewage sludge pre-treatment with a novel ultrasonic flatbed reactor at low energy input.

PubMed

Lippert, Thomas; Bandelin, Jochen; Musch, Alexandra; Drewes, Jörg E; Koch, Konrad

2018-05-20

The performance of a novel ultrasonic flatbed reactor for sewage sludge pre-treatment was assessed for three different waste activated sludges. The study systematically investigated the impact of specific energy input (200 - 3,000 kJ/kg TS ) on the degree of disintegration (DD COD , i.e. ratio between ultrasonically and maximum chemically solubilized COD) and methane production enhancement. Relationship between DD COD and energy input was linear, for all sludges tested. Methane yields were significantly increased for both low (200 kJ/kg TS ) and high (2,000 - 3,000 kJ/kg TS ) energy inputs, while intermediate inputs (400 - 1,000 kJ/kg TS ) showed no significant improvement. High inputs additionally accelerated reaction kinetics, but were limited to similar gains as low inputs (max. 12%), despite the considerably higher DD COD values. Energy balance was only positive for 200 kJ/kg TS -treatments, with a maximum energy recovery of 122%. Results suggest that floc deagglomeration rather than cell lysis (DD COD =1% - 5% at 200 kJ/kg TS ) is the key principle of energy-positive sludge sonication. Copyright © 2018 Elsevier Ltd. All rights reserved.

Improvement of Landfill Leachate Biodegradability with Ultrasonic Process

PubMed Central

Mahvi, Amir Hossein; Roodbari, Ali Akbar; Nabizadeh Nodehi, Ramin; Nasseri, Simin; Dehghani, Mohammad Hadil; Alimohammadi, Mahmood

2012-01-01

Landfills leachates are known to contain recalcitrant and/or non-biodegradable organic substances and biological processes are not efficient in these cases. A promising alternative to complete oxidation of biorecalcitrant leachate is the use of ultrasonic process as pre-treatment to convert initially biorecalcitrant compounds to more readily biodegradable intermediates. The objectives of this study are to investigate the effect of ultrasonic process on biodegradability improvement. After the optimization by factorial design, the ultrasonic were applied in the treatment of raw leachates using a batch wise mode. For this, different scenarios were tested with regard to power intensities of 70 and 110 W, frequencies of 30, 45 and 60 KHz, reaction times of 30, 60, 90 and 120 minutes and pH of 3, 7 and 10. For determining the effects of catalysts on sonication efficiencies, 5 mg/l of TiO2 and ZnO have been also used. Results showed that when applied as relatively brief pre-treatment systems, the sonocatalysis processes induce several modifications of the matrix, which results in significant enhancement of its biodegradability. For this reason, the integrated chemical–biological systems proposed here represent a suitable solution for the treatment of landfill leachate samples. PMID:22829863

A directed-overflow and damage-control N -glycosidase in riboflavin biosynthesis

DOE PAGES

Frelin, Océane; Huang, Lili; Hasnain, Ghulam; ...

2015-02-15

Plants and bacteria synthesize the essential human micronutrient riboflavin (vitamin B2) via the same multistep pathway. The early intermediates of this pathway are notoriously reactive, and may be overproduced in vivo because riboflavin biosynthesis enzymes lack feedback controls. Here we demonstrate disposal of riboflavin intermediates by COG3236 (DUF1768), a protein of previously unknown function that is fused to two different riboflavin pathway enzymes in plants and bacteria (RIBR and RibA, respectively). We present cheminformatic, biochemical, genetic, and genomic evidence to show that: (i) plant and bacterial COG3236 proteins cleave the N-glycosidic bond of the first two intermediates of riboflavin biosynthesis,more » yielding relatively innocuous products; (ii) certain COG3236 proteins are in a multienzyme riboflavin biosynthesis complex that gives them privileged access to riboflavin intermediates; and (iii) COG3236 action in Arabidopsis thaliana and Escherichia coli helps maintain flavin levels. We find COG3236 proteins thus illustrate two emerging principles in chemical biology: directed overflow metabolism, in which excess flux is diverted out of a pathway, and the pre-emption of damage from reactive metabolites.« less

Conditioning geostatistical simulations of a heterogeneous paleo-fluvial bedrock aquifer using lithologs and pumping tests

NASA Astrophysics Data System (ADS)

Niazi, A.; Bentley, L. R.; Hayashi, M.

2016-12-01

Geostatistical simulations are used to construct heterogeneous aquifer models. Optimally, such simulations should be conditioned with both lithologic and hydraulic data. We introduce an approach to condition lithologic geostatistical simulations of a paleo-fluvial bedrock aquifer consisting of relatively high permeable sandstone channels embedded in relatively low permeable mudstone using hydraulic data. The hydraulic data consist of two-hour single well pumping tests extracted from the public water well database for a 250-km2 watershed in Alberta, Canada. First, lithologic models of the entire watershed are simulated and conditioned with hard lithological data using transition probability - Markov chain geostatistics (TPROGS). Then, a segment of the simulation around a pumping well is used to populate a flow model (FEFLOW) with either sand or mudstone. The values of the hydraulic conductivity and specific storage of sand and mudstone are then adjusted to minimize the difference between simulated and actual pumping test data using the parameter estimation program PEST. If the simulated pumping test data do not adequately match the measured data, the lithologic model is updated by locally deforming the lithology distribution using the probability perturbation method and the model parameters are again updated with PEST. This procedure is repeated until the simulated and measured data agree within a pre-determined tolerance. The procedure is repeated for each well that has pumping test data. The method creates a local groundwater model that honors both the lithologic model and pumping test data and provides estimates of hydraulic conductivity and specific storage. Eventually, the simulations will be integrated into a watershed-scale groundwater model.

A minimal standardization setting for language mapping tests: an Italian example.

PubMed

Rofes, Adrià; de Aguiar, Vânia; Miceli, Gabriele

2015-07-01

During awake surgery, picture-naming tests are administered to identify brain structures related to language function (language mapping), and to avoid iatrogenic damage. Before and after surgery, naming tests and other neuropsychological procedures aim at charting naming abilities, and at detecting which items the subject can respond to correctly. To achieve this goal, sufficiently large samples of normed and standardized stimuli must be available for preoperative and postoperative testing, and to prepare intraoperative tasks, the latter only including items named flawlessly preoperatively. To discuss design, norming and presentation of stimuli, and to describe the minimal standardization setting used to develop two sets of Italian stimuli, one for object naming and one for verb naming, respectively. The setting includes a naming study (to obtain picture-name agreement ratings), two on-line questionnaires (to acquire age-of-acquisition and imageability ratings for all test items), and the norming of other relevant language variables. The two sets of stimuli have >80 % picture-name agreement, high levels of internal consistency and reliability for imageability and age of acquisition ratings. They are normed for psycholinguistic variables known to affect lexical access and retrieval, and are validated in a clinical population. This framework can be used to increase the probability of reliably detecting language impairments before and after surgery, to prepare intraoperative tests based on sufficient knowledge of pre-surgical language abilities in each patient, and to decrease the probability of false positives during surgery. Examples of data usage are provided. Normative data can be found in the supplementary materials.

Probing Pre- and In-service Physics Teachers' Knowledge Using the Double-Slit Thought Experiment

NASA Astrophysics Data System (ADS)

Asikainen, Mervi A.; Hirvonen, Pekka E.

2014-09-01

This study describes the use of the double-slit thought experiment as a diagnostic tool for probing physics teachers' understanding. A total of 9 pre-service teachers and 18 in-service teachers with a variety of different experience in modern physics teaching at the upper secondary level responded in a paper-and-pencil test and three of these teachers were interviewed. The results showed that the physics teachers' thought experiments with classical particles, light, and electrons were often partial. Many teachers also suffered a lack of the basic ideas and principles of physics, which probably hindered thought experimenting. In particular, understanding the ontological nature of classical particles, light and electrons seemed to be essential in performing the double-slit experiment in an appropriate way. However, the in-service physics teachers who had teaching experience in modern physics were more prepared for the double-slit thought experiment than the pre-service teachers. The results suggest that both thought experiments and the double-slit experiment should be given more weight in physics teacher education, even if experience in modern physics teaching at upper secondary school seems to some extent to develop teachers' abilities.

The Effect of Computer-Assisted Teaching on Remedying Misconceptions: The Case of the Subject "Probability"

ERIC Educational Resources Information Center

Gurbuz, Ramazan; Birgin, Osman

2012-01-01

The aim of this study is to determine the effects of computer-assisted teaching (CAT) on remedying misconceptions students often have regarding some probability concepts in mathematics. Toward this aim, computer-assisted teaching materials were developed and used in the process of teaching. Within the true-experimental research method, a pre- and…

Evaluation of carotid plaque echogenicity based on the integral of the cumulative probability distribution using gray-scale ultrasound images.

PubMed

Huang, Xiaowei; Zhang, Yanling; Meng, Long; Abbott, Derek; Qian, Ming; Wong, Kelvin K L; Zheng, Rongqing; Zheng, Hairong; Niu, Lili

2017-01-01

Carotid plaque echogenicity is associated with the risk of cardiovascular events. Gray-scale median (GSM) of the ultrasound image of carotid plaques has been widely used as an objective method for evaluation of plaque echogenicity in patients with atherosclerosis. We proposed a computer-aided method to evaluate plaque echogenicity and compared its efficiency with GSM. One hundred and twenty-five carotid plaques (43 echo-rich, 35 intermediate, 47 echolucent) were collected from 72 patients in this study. The cumulative probability distribution curves were obtained based on statistics of the pixels in the gray-level images of plaques. The area under the cumulative probability distribution curve (AUCPDC) was calculated as its integral value to evaluate plaque echogenicity. The classification accuracy for three types of plaques is 78.4% (kappa value, κ = 0.673), when the AUCPDC is used for classifier training, whereas GSM is 64.8% (κ = 0.460). The receiver operating characteristic curves were produced to test the effectiveness of AUCPDC and GSM for the identification of echolucent plaques. The area under the curve (AUC) was 0.817 when AUCPDC was used for training the classifier, which is higher than that achieved using GSM (AUC = 0.746). Compared with GSM, the AUCPDC showed a borderline association with coronary heart disease (Spearman r = 0.234, p = 0.050). Our experimental results suggest that AUCPDC analysis is a promising method for evaluation of plaque echogenicity and predicting cardiovascular events in patients with plaques.

Fostering EFL Learners' Reading Comprehension: Animation Film Technique

ERIC Educational Resources Information Center

Torabian, Asefeh; Tajadini, Massoud

2017-01-01

The current study investigated the effect of implementing animation films on developing reading comprehension texts among EFL learners of a language institute in Kerman. For this purpose, two groups of pre-intermediate EFL learners were chosen (30 participants in each group). After three months of instruction, twice a week, 2story books named the…

Pre-Service Mathematics Teacher Efficacy: Its Nature and Relationship to Teacher Concerns and Orientation

ERIC Educational Resources Information Center

Pyper, Jamie Scott

2014-01-01

In a mixed method study, teacher efficacy and contributing theoretical constructs of teacher concerns and teacher orientation with Intermediate/Senior mathematics preservice teachers from two Ontario Faculties of Education are examined. Data sources include a web-based questionnaire containing two teacher efficacy scales and short answer…

CLONING AND CHARACTERIZATION OF THE PHTHALATE CATABOLISM REGION OF PRE1 OF ARTHROBACTER KEYSERI 12B

EPA Science Inventory

o-Phthalate (benzene-1,2-dicarboxylate) is a central intermediate in the bacterial degradation of phthalate ester plasticizers as well as of a number of fused-ring polycyclic aromatic hydrocarbons found in fossil fuels. In Arthrobacter keyseri 12B, the genes encoding catabolism o...

Corrective Feedback, Spoken Accuracy and Fluency, and the Trade-Off Hypothesis

ERIC Educational Resources Information Center

Chehr Azad, Mohammad Hassan; Farrokhi, Farahman; Zohrabi, Mohammad

2018-01-01

The current study was an attempt to investigate the effects of different corrective feedback (CF) conditions on Iranian EFL learners' spoken accuracy and fluency (AF) and the trade-off between them. Consequently, four pre-intermediate intact classes were randomly selected as the control, delayed explicit metalinguistic CF, extensive recast, and…

Intermediate cultural practices

Treesearch

W. Robert Dinneen

1977-01-01

What are these interesting sounding things? Are they theory, are they pie in the sky, fantasies of desk foresters - or are they the real McCoy - something the landowner needs if he is going to make his woodlands pay a return on his investment. To list briefly, shall we say they are pre-commercial treatments, marginal commercial treatments, commercial thinnings,...

FUV Spectroscopy Of Outflows And Disks Around The Intermediate Mass Pre-main-sequence Stars HD135344B And HD104237

NASA Astrophysics Data System (ADS)

Brown, Alexander; Herczeg, G.; Brown, J. M.; Walter, F. M.; Ayres, T. R.; DAOof TAU Team

2011-01-01

The intermediate-mass, pre-main-sequence (Herbig Ae/Fe) stars HD135344B (F4) and HD104237 (A8 IV-V) are both still surrounded by almost face-on circumstellar disks. The disk around HD135344B is a ``transitional'' disk with a 25 AU radius cleared inner hole but still with some gas and dust very close to the star. We have obtained FUV spectra of these stars using the HST COS and STIS spectrographs that show that both stars have dramatic high-velocity (terminal velocity = 300-400 km/s) outflows and rich fluorescently-excited molecular hydrogen emission, originating primarily from warm gas in their disks. We present these FUV spectra and outline the outflow and disk properties implied by the observed emission and absorption line profiles. The profiles and widths of the molecular hydrogen lines provide strong constraints on the location of the emitting regions. This work is supported by HST grants for GO projects 11828 and 11616, and Chandra grant GO9-0015X to the University of Colorado.

An allosteric Sec61 inhibitor traps nascent transmembrane helices at the lateral gate

PubMed Central

MacKinnon, Andrew L; Paavilainen, Ville O; Sharma, Ajay; Hegde, Ramanujan S; Taunton, Jack

2014-01-01

Membrane protein biogenesis requires the coordinated movement of hydrophobic transmembrane domains (TMD) from the cytosolic vestibule of the Sec61 channel into the lipid bilayer. Molecular insight into TMD integration has been hampered by the difficulty of characterizing intermediates during this intrinsically dynamic process. In this study, we show that cotransin, a substrate-selective Sec61 inhibitor, traps nascent TMDs in the cytosolic vestibule, permitting detailed interrogation of an early pre-integration intermediate. Site-specific crosslinking revealed the pre-integrated TMD docked to Sec61 near the cytosolic tip of the lateral gate. Escape from cotransin-arrest depends not only on cotransin concentration, but also on the biophysical properties of the TMD. Genetic selection of cotransin-resistant cancer cells uncovered multiple mutations clustered near the lumenal plug of Sec61α, thus revealing cotransin’s likely site of action. Our results suggest that TMD/lateral gate interactions facilitate TMD transfer into the membrane, a process that is allosterically modulated by cotransin binding to the plug. DOI: http://dx.doi.org/10.7554/eLife.01483.001 PMID:24497544

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

Warpinski, N.R.; Branagan, P.; Sattler, A.R.

This paper is a case study of the stimulation and testing of tight lenticular sands in the paludal interval of the Mesaverde Group in the Piceance basin as DOE's Multiwell Experiment site in Colorado. Prestimulation data acquired include (1) geologic studies which delineate the size and shape of the lenses, (2) detailed core reservoir/rock property data, (3) stress test data showing the vertical distribution of stress throgh the interval, (4) drawdown, buildup, and interference tests which provide in situ reservoir properties, and (5) laboratory data on frac fluid invasion and damage. Stimulation of the zone was conducted in two phases.more » The first phase consisted of steprate/flowback tests and two minifracs in which pre-frac design information was obtained. The main stimulation was the second phase and it consisted of 75,000 gal (284 m/sup 3/) of cross-linked HPG and 193,000 lbs. (87,545 kg) of sand. Bottomhole pressure and temperature, as well as all surface data, were obtained and borehole geophones were used for fracture diagnostics. Detailed pre-frac, between-frac, and post-frac well test programs were conducted in conjunction with the stimulation. Severe cleanup problems and remedial actions are documented. The analyses and diagnostics give some indication of fracture geometry in this lenticular environment. Complications such as high treatment pressures and frac-fluid damage are detailed. Gas production was decreased (at least over short test periods) by both phases of the treatment; this was probably due to damage to the natural fractures which did not have sufficient time to clean up. 14 references, 10 figures, 1 table.« less

Metabolomic analysis reveals altered skeletal muscle amino acid and fatty acid handling in obese humans.

PubMed

Baker, Peter R; Boyle, Kristen E; Koves, Timothy R; Ilkayeva, Olga R; Muoio, Deborah M; Houmard, Joseph A; Friedman, Jacob E

2015-05-01

Investigate the effects of obesity and high-fat diet (HFD) exposure on fatty acid oxidation and TCA cycle intermediates and amino acids in skeletal muscle to better characterize energy metabolism. Plasma and skeletal muscle metabolomic profiles were measured from lean and obese males before and after a 5-day HFD in the 4 h postprandial condition. At both time points, plasma short-chain acylcarnitine species (SCAC) were higher in the obese subjects, while the amino acids glycine, histidine, methionine, and citrulline were lower in skeletal muscle of obese subjects. Skeletal muscle medium-chain acylcarnitines (MCAC) C6, C8, C10:2, C10:1, C10, and C12:1 increased in obese subjects, but decreased in lean subjects, from pre- to post-HFD. Plasma content of C10:1 was also decreased in the lean but increased in the obese subjects from pre- to post-HFD. CD36 increased from pre- to post-HFD in obese but not lean subjects. Lower skeletal muscle amino acid content and accumulation of plasma SCAC in obese subjects could reflect increased anaplerosis for TCA cycle intermediates, while accumulation of MCAC suggests limitations in β-oxidation. These measures may be important markers of or contributors to dysregulated metabolism observed in skeletal muscle of obese humans. © 2015 The Obesity Society.

The prognostic value of serum C-reactive protein, ferritin, and albumin prior to allogeneic transplantation for acute myeloid leukemia and myelodysplastic syndromes

PubMed Central

Artz, Andrew S.; Logan, Brent; Zhu, Xiaochun; Akpek, Gorgun; Bufarull, Rodrigo Martino; Gupta, Vikas; Lazarus, Hillard M.; Litzow, Mark; Loren, Alison; Majhail, Navneet S.; Maziarz, Richard T.; McCarthy, Philip; Popat, Uday; Saber, Wael; Spellman, Stephen; Ringden, Olle; Wickrema, Amittha; Pasquini, Marcelo C.; Cooke, Kenneth R.

2016-01-01

We sought to confirm the prognostic importance of simple clinically available biomarkers of C-reactive protein, serum albumin, and ferritin prior to allogeneic hematopoietic cell transplantation. The study population consisted of 784 adults with acute myeloid leukemia in remission or myelodysplastic syndromes undergoing unrelated donor transplant reported to the Center for International Blood and Marrow Transplant Research. C-reactive protein and ferritin were centrally quantified by ELISA from cryopreserved plasma whereas each center provided pre-transplant albumin. In multivariate analysis, transplant-related mortality was associated with the pre-specified thresholds of C-reactive protein more than 10 mg/L (P=0.008) and albumin less than 3.5 g/dL (P=0.01) but not ferritin more than 2500 ng/mL. Only low albumin independently influenced overall mortality. Optimal thresholds affecting transplant-related mortality were defined as: C-reactive protein more than 3.67 mg/L, log(ferritin), and albumin less than 3.4 g/dL. A 3-level biomarker risk group based on these values separated risks of transplant-related mortality: low risk (reference), intermediate (HR=1.66, P=0.015), and high risk (HR=2.7, P<0.001). One-year survival was 74%, 67% and 56% for low-, intermediate- and high-risk groups. Routinely available pre-transplant biomarkers independently risk-stratify for transplant-related mortality and survival. PMID:27662010

Late Holocene Radiocarbon Variability in Northwest Atlantic Slope Waters

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

Sherwood, O; Edinger, E; Guilderson, T P

2008-08-15

Deep-sea gorgonian corals secrete a 2-part skeleton of calcite, derived from dissolved inorganic carbon at depth, and gorgonin, derived from recently fixed and exported particulate organic matter. Radiocarbon contents of the calcite and gorgonin provide direct measures of seawater radiocarbon at depth and in the overlying surface waters, respectively. Using specimens collected from Northwest Atlantic slope waters, we generated radiocarbon records for surface and upper intermediate water layers spanning the pre- and post bomb-{sup 14}C eras. In Labrador Slope Water (LSW), convective mixing homogenizes the pre-bomb {Delta}{sup 14}C signature (-67 {+-} 4{per_thousand}) to at least 1000 m depth. Surface watermore » bomb-{sup 14}C signals were lagged and damped (peaking at {approx} +45{per_thousand} in the early 1980s) relative to other regions of the northwest Atlantic, and intermediate water signals were damped further. Off southwest Nova Scotia, the vertical gradient in {Delta}{sup 14}C is much stronger. In surface water, pre-bomb {Delta}{sup 14}C averaged -75 {+-} 5{per_thousand}. At 250-475 m depth, prebomb {Delta}{sup 14}C oscillated quasi-decadally between -80 and -100{per_thousand}, likely reflecting interannual variability in the presence of Labrador Slope Water vs. Warm Slope Water (WSW). Finally, subfossil corals reveal no systematic changes in vertical {Delta}{sup 14}C gradients over the last 1200 years.« less

Tumor genome analysis includes germline genome: Are we ready for surprises?

PubMed Central

Catenacci, Daniel VT; Amico, Andrea L; Nielsen, Sarah M; Geynisman, Daniel M; Rambo, Brittany; Carey, George B; Gulden, Cassandra; Fackenthal, Jim; Marsh, Robert D; Kindler, Hedy L; Olopade, Olufunmilayo I

2015-01-01

We sought to describe the spectrum of potential and confirmed germline genomic events incidentally identified during routine medium-throughput somatic tumor DNA sequencing, and to provide a framework for pre- and post-test consent and counseling for patients and families. Targeted tumor-only next-generation sequencing (NGS) had been used to evaluate for possible druggable genomic events obtained from consecutive new patients with metastatic gastroesophageal, hepatobiliary or colorectal cancer seen at the University of Chicago. A panel of medical oncologists, cancer geneticists and genetic counselors retrospectively grouped these patients (N = 111) based on probability of possessing a potentially inherited mutation in a cancer susceptibility gene, both prior to and after incorporating tumor-only NGS results. High-risk patients (determined from NGS results) were contacted and counseled in person by a genetic counselor (N = 21). When possible and indicated, germline genetic testing was offered. Of 8 evaluable high-risk patients, 7 underwent germline testing. Three (37.5%) had confirmed actionable germline mutations (all in the BRCA2 gene). NGS offers promise, but poses significant challenges for oncologists who are ill prepared to handle incidental findings that have clinical implications for at risk family members. In this relatively small cohort of patients undergoing tumor genomic testing for gastrointestinal malignancies, we incidentally identified 3 BRCA2 mutations carriers. This report underscores the need for oncologists to develop a framework for pre- and post-test communication of risks to patients undergoing routine tumor-only sequencing. What's new? High-throughput, ‘next-generation sequencing’ (NGS) allows millions of DNA strands to be sequenced in parallel. NGS is increasingly used to test tumors for mutations that may guide therapy. Sometimes, however, this testing can reveal mutations that are known to be inherited, which means that family members are also at increased risk for cancer. How should this information be presented? This article underscores the need for oncologists to develop a framework for pre- and post-test communication and counseling regarding risk for patients undergoing tumor-only sequencing. PMID:25123297

Assignment of Pre-edge Features in the Ru K-edge X-ray Absorption Spectra of Organometallic Ruthenium Complexes

PubMed Central

Getty, Kendra; Delgado-Jaime, Mario Ulises

2010-01-01

The nature of the lowest energy bound-state transition in the Ru K-edge X-ray Absorption Spectra for a series of Grubbs-type ruthenium complexes was investigated. The pre-edge feature was unambiguously assigned as resulting from formally electric dipole forbidden Ru 4d←1s transitions. The intensities of these transitions are extremely sensitive to the ligand environment and the symmetry of the metal centre. In centrosymmetric complexes the pre-edge is very weak since it is limited by the weak electric quadrupole intensity mechanism. By contrast, upon breaking centrosymmetry, Ru 5p-4d mixing allows for introduction of electric dipole allowed character resulting in a dramatic increase in the pre-edge intensity. The information content of this approach is explored as it relates to complexes of importance in olefin metathesis and its relevance as a tool for the study of reactive intermediates. PMID:20151030

Chunk Limits and Length Limits in Immediate Recall: A Reconciliation

PubMed Central

Chen, Zhijian; Cowan, Nelson

2008-01-01

Whereas some research on immediate recall of verbal lists has suggested that it is limited by the number of chunks that can be recalled (e.g., Tulving & Patkau, 1962; Cowan, Chen, & Rouder, 2004), other research has suggested that it is limited by the length of the material to be recalled (e.g., Baddeley, Thomson, & Buchanan, 1975). We investigated this question by teaching new paired associations between words to create two-word chunks. The results suggest that both chunk capacity limits and length limits come into play. For the free recall of 12-word lists, 6 pre-learned pairs could be recalled about as well as 6 pre-exposed singletons, suggesting a chunk limit. However, for the serially-ordered recall of 8-word lists, 4 pre-learned pairs could be recalled about as well as 8 pre-exposed singletons, suggesting a length limit. Other conditions yielded intermediate results suggesting that sometimes both limits may operate together. PMID:16393043

Toward earlier detection of choroidal neovascularization secondary to age-related macular degeneration: multicenter evaluation of a preferential hyperacuity perimeter designed as a home device.

PubMed

Loewenstein, Anat; Ferencz, Joseph R; Lang, Yaron; Yeshurun, Itamar; Pollack, Ayala; Siegal, Ruth; Lifshitz, Tova; Karp, Joseph; Roth, Daniel; Bronner, Guri; Brown, Justin; Mansour, Sam; Friedman, Scott; Michels, Mark; Johnston, Richards; Rapp, Moshe; Havilio, Moshe; Rafaeli, Omer; Manor, Yair

2010-01-01

The primary purpose of this study was to evaluate the ability of a home device preferential hyperacuity perimeter to discriminate between patients with choroidal neovascularization (CNV) and intermediate age-related macular degeneration (AMD), and the secondary purpose was to investigate the dependence of sensitivity on lesion characteristics. All participants were tested with the home device in an unsupervised mode. The first part of this work was retrospective using tests performed by patients with intermediate AMD and newly diagnosed CNV. In the second part, the classifier was prospectively challenged with tests performed by patients with intermediate AMD and newly diagnosed CNV. The dependence of sensitivity on lesion characteristics was estimated with tests performed by patients with CNV of both parts. In 66 eyes with CNV and 65 eyes with intermediate AMD, both sensitivity and specificity were 0.85. In the retrospective part (34 CNV and 43 intermediate AMD), sensitivity and specificity were 0.85 +/- 0.12 (95% confidence interval) and 0.84 +/- 0.11 (95% confidence interval), respectively. In the prospective part (32 CNV and 22 intermediate AMD), sensitivity and specificity were 0.84 +/- 0.13 (95% confidence interval) and 0.86 +/- 0.14 (95% confidence interval), respectively. Chi-square analysis showed no dependence of sensitivity on type (P = 0.44), location (P = 0.243), or size (P = 0.73) of the CNV lesions. A home device preferential hyperacuity perimeter has good sensitivity and specificity in discriminating between patients with newly diagnosed CNV and intermediate AMD. Sensitivity is not dependent on lesion characteristics.

Application of a Novel Diagnostic Rule in the Differential Diagnosis between Acute Gouty Arthritis and Septic Arthritis.

PubMed

Lee, Kwang-Hoon; Choi, Sang-Tae; Lee, Soo-Kyung; Lee, Joo-Hyun; Yoon, Bo-Young

2015-06-01

Septic arthritis and gout are major diseases that should be suspected in patients with acute monoarthritis. These two diseases are clinically similar and often indistinguishable without the help of synovial fluid analysis. Recently, a novel diagnostic rule for gout without synovial fluid analysis was developed and showed relevant performances. This study aimed to determine whether this diagnostic rule could perform well in distinguishing gout from septic arthritis. The diagnostic rule comprises 7 clinical and laboratory variables, each of which is given a specified score. The probability of gout is classified into 3 groups according to the sum of the scores: high (≥ 8), intermediate (> 4 to < 8) and low probability (≤ 4). In this retrospective study, we applied this diagnostic rule to 136 patients who presented as acute monoarthritis and were subsequently diagnosed as acute gout (n = 82) and septic arthritis (n = 54) based on synovial fluid analysis. The mean sum of scores of acute gout patients was significantly higher than that of those with septic arthritis (8.6 ± 0.2 vs. 3.6 ± 0.32, P < 0.001). Patients with acute gout had significantly more 'high', and less 'low' probabilities compared to those with septic arthritis (Eta[η]: 0.776). The prevalence of acute gouty arthritis, as confirmed by the presence of monosodium crystal, was 95.5% (61/64), 57.5% (19/33), and 5.1% (2/39) in high, intermediate and low probability group, respectively. The recently introduced diagnostic rule properly discriminates acute gout from septic arthritis. It may help physicians diagnose gout in cases difficult to be differentiated from septic arthritis.

Changes in peak systolic velocity induced by chronic therapy with phosphodiesterase type-5 inhibitor.

PubMed

Sighinolfi, M C; Mofferdin, A; De Stefani, S; Celia, A; Micali, S; Cicero, A F G; Bianchi, G

2006-06-01

The aim of this study was to assess the influence of chronic therapy with phosphodiesterase type-5 inhibitor on penile haemodynamics at colour Doppler ultrasound. Thirty patients affected by erectile dysfunction (ED) of different aetiology tested with the International Index of Erectile Function (IIEF-5) were evaluated with penile colour Doppler ultrasound during basic and dynamic phases (10 microg PGE1) before and after chronic self-administration of sildenafil citrate (dosage: 100 mg as required, two to three times a week) for a period of 5-20 months (mean: 12.3). Treatment was interrupted 14-21 days before the second ultrasound evaluation. Peak systolic velocity (PSV) and end-diastolic velocity (EDV) were recorded by means of colour Doppler; cut off values were 25 and 5 cm s(-1) respectively. Data were compared by nonparametric tests. Twenty-two of the 30 patients showed normal pre-treatment PSV, while eight of 30 had an insufficient arterial flow. Mean pre-treatment EDV was 4.7 +/- 0.5. After chronic therapy with sildenafil, a global improvement of 10.5% on PSV was seen (P < 0.001), without any statistical difference between patients with normal pre-treatment peak and those with a borderline one. No statistically significant changes were found for EDV (P = 0.98). It is concluded that chronic therapy with phosphodiesterase-5 inhibitor results in a significant improvement in PSV values, probably due to a penile chronic vasoactive enhancement.

Hot Evolved Companions to Intermediate-Mass Main-Sequence Stars: Solving the Mystery of KOI-81

NASA Astrophysics Data System (ADS)

Gies, Douglas

2010-09-01

The NASA Kepler Science Team recently announced the discovery of twotransiting binaries that have "planets" hotter than their host stars.These systems probably represent the first known examples of white dwarfsformed through mass loss and transfer among intermediate mass, closebinary stars. Here we propose to obtain COS FUV spectroscopy of one ofthese systems, KOI-81, in order to detect the hot companion in a part of the spectrum where it is relatively bright. The spectral flux and Doppler shift measurements will yield the temperatures, masses, radii, and compositions of both components. These observations will provide our first opportunity to explore this previously hidden stage of close binary evolution.

Optimized lower leg injury probability curves from post-mortem human subject tests under axial impacts

PubMed Central

Yoganandan, Narayan; Arun, Mike W.J.; Pintar, Frank A.; Szabo, Aniko

2015-01-01

Objective Derive optimum injury probability curves to describe human tolerance of the lower leg using parametric survival analysis. Methods The study re-examined lower leg PMHS data from a large group of specimens. Briefly, axial loading experiments were conducted by impacting the plantar surface of the foot. Both injury and non-injury tests were included in the testing process. They were identified by pre- and posttest radiographic images and detailed dissection following the impact test. Fractures included injuries to the calcaneus and distal tibia-fibula complex (including pylon), representing severities at the Abbreviated Injury Score (AIS) level 2+. For the statistical analysis, peak force was chosen as the main explanatory variable and the age was chosen as the co-variable. Censoring statuses depended on experimental outcomes. Parameters from the parametric survival analysis were estimated using the maximum likelihood approach and the dfbetas statistic was used to identify overly influential samples. The best fit from the Weibull, log-normal and log-logistic distributions was based on the Akaike Information Criterion. Plus and minus 95% confidence intervals were obtained for the optimum injury probability distribution. The relative sizes of the interval were determined at predetermined risk levels. Quality indices were described at each of the selected probability levels. Results The mean age, stature and weight: 58.2 ± 15.1 years, 1.74 ± 0.08 m and 74.9 ± 13.8 kg. Excluding all overly influential tests resulted in the tightest confidence intervals. The Weibull distribution was the most optimum function compared to the other two distributions. A majority of quality indices were in the good category for this optimum distribution when results were extracted for 25-, 45- and 65-year-old at five, 25 and 50% risk levels age groups for lower leg fracture. For 25, 45 and 65 years, peak forces were 8.1, 6.5, and 5.1 kN at 5% risk; 9.6, 7.7, and 6.1 kN at 25% risk; and 10.4, 8.3, and 6.6 kN at 50% risk, respectively. Conclusions This study derived axial loading-induced injury risk curves based on survival analysis using peak force and specimen age; adopting different censoring schemes; considering overly influential samples in the analysis; and assessing the quality of the distribution at discrete probability levels. Because procedures used in the present survival analysis are accepted by international automotive communities, current optimum human injury probability distributions can be used at all risk levels with more confidence in future crashworthiness applications for automotive and other disciplines. PMID:25307381

The pre-rRNA processing factor DEF is rate limiting for the pathogenesis of MYCN-driven neuroblastoma.

PubMed

Tao, T; Sondalle, S B; Shi, H; Zhu, S; Perez-Atayde, A R; Peng, J; Baserga, S J; Look, A T

2017-07-06

The nucleolar factor, digestive organ expansion factor (DEF), has a key role in ribosome biogenesis, functioning in pre-ribosomal RNA (pre-rRNA) processing as a component of the small ribosomal subunit (SSU) processome. Here we show that the peripheral sympathetic nervous system (PSNS) is very underdeveloped in def-deficient zebrafish, and that def haploinsufficiency significantly decreases disease penetrance and tumor growth rate in a MYCN-driven transgenic zebrafish model of neuroblastoma that arises in the PSNS. Consistent with these findings, DEF is highly expressed in human neuroblastoma, and its depletion in human neuroblastoma cell lines induces apoptosis. Interestingly, overexpression of MYCN in zebrafish and in human neuroblastoma cells results in the appearance of intermediate pre-rRNAs species that reflect the processing of pre-rRNAs through Pathway 2, a pathway that processes pre-rRNAs in a different temporal order than the more often used Pathway 1. Our results indicate that DEF and possibly other components of the SSU processome provide a novel site of vulnerability in neuroblastoma cells that could be exploited for targeted therapy.

Process performance assessment of advanced anaerobic digestion of sewage sludge including sequential ultrasound-thermal (55 °C) pre-treatment.

PubMed

Neumann, Patricio; Barriga, Felipe; Álvarez, Claudia; González, Zenón; Vidal, Gladys

2018-03-15

The aim of this study was to evaluate the performance and digestate quality of advanced anaerobic digestion of sewage sludge including sequential ultrasound-thermal (55 °C) pre-treatment. Both stages of pre-treatment contributed to chemical oxygen demand (COD) solubilization, with an overall factor of 11.4 ± 2.2%. Pre-treatment led to 19.1, 24.0 and 29.9% increased methane yields at 30, 15 and 7.5 days solid retention times (SRT), respectively, without affecting process stability or accumulation of intermediates. Pre-treatment decreased up to 4.2% water recovery from the digestate, but SRT was a more relevant factor controlling dewatering. Advanced digestion showed 2.4-3.1 and 1.5 logarithmic removals of coliforms and coliphages, respectively, and up to a 58% increase in the concentration of inorganics in the digestate solids compared to conventional digestion. The COD balance of the process showed that the observed increase in methane production was proportional to the pre-treatment solubilization efficiency. Copyright © 2018 Elsevier Ltd. All rights reserved.

Investigation of the Factors Affecting the Pre-Test Effect in National Curriculum Science Assessment Development in England

ERIC Educational Resources Information Center

Pyle, Katie; Jones, Emily; Williams, Chris; Morrison, Jo

2009-01-01

Background: All national curriculum tests in England are pre-tested as part of the development process. Differences in pupil performance between pre-test and live test are consistently found. This difference has been termed the pre-test effect. Understanding the pre-test effect is essential in the test development and selection processes and in…

Stromal characterization and comparison of odontogenic cysts and odontogenic tumors using picrosirius red stain and polarizing microscopy: A retrospective and histochemical study.

PubMed

Jahagirdar, P B; Kale, A D; Hallikerimath, S

2015-01-01

Odontogenic lesions represent a range of conditions, the features of which probably depend on the stage of induction towards tooth formation reached prior to neoplastic or hamartomatous proliferation. It has been also suggested that inductive changes may allow progression from one type of odontogenic tumor to another. The epithelium also plays an important role in the pathogenesis of these lesions; even stroma is likely to play an equally important role in the pathogenesis and biological behavior. So, this study was performed to investigate, compare, and correlate different types of collagen fibers in odontogenic cysts and odontogenic tumors. Thirty each pre-diagnosed odontogenic cysts and tumors were histochemically analyzed using a special stain (Picrosirius red stain) and polarizing microscopy. Seven cases (99%) of inflammatory cysts exhibited predominantly greenish-yellow birefringence indicating procollagen, intermediate, or pathologic collagen fibers suggestive of loosely packed collagen fibers. Predominant yellowish-orange birefringence exhibited by 21 cases (99%) of developmental cysts was comparable to the yellowish-orange and orangish-red to red birefringence exhibited by odontogenic tumors suggesting tightly packed fibers. The Picrosirius red stain in conjunction with polarizing microscopy serves as a specific and sensitive tool in characterizing collagen fibers in odontogenic cysts and odontogenic tumor.

Rrp12 and the Exportin Crm1 participate in late assembly events in the nucleolus during 40S ribosomal subunit biogenesis.

PubMed

Moriggi, Giulia; Nieto, Blanca; Dosil, Mercedes

2014-12-01

During the biogenesis of small ribosomal subunits in eukaryotes, the pre-40S particles formed in the nucleolus are rapidly transported to the cytoplasm. The mechanisms underlying the nuclear export of these particles and its coordination with other biogenesis steps are mostly unknown. Here we show that yeast Rrp12 is required for the exit of pre-40S particles to the cytoplasm and for proper maturation dynamics of upstream 90S pre-ribosomes. Due to this, in vivo elimination of Rrp12 leads to an accumulation of nucleoplasmic 90S to pre-40S transitional particles, abnormal 35S pre-rRNA processing, delayed elimination of processing byproducts, and no export of intermediate pre-40S complexes. The exportin Crm1 is also required for the same pre-ribosome maturation events that involve Rrp12. Thus, in addition to their implication in nuclear export, Rrp12 and Crm1 participate in earlier biosynthetic steps that take place in the nucleolus. Our results indicate that, in the 40S subunit synthesis pathway, the completion of early pre-40S particle assembly, the initiation of byproduct degradation and the priming for nuclear export occur in an integrated manner in late 90S pre-ribosomes.